Hsu L K G, Mulliken B, McDonagh B, Krupa Das S, Rand W, Fairburn C G, Rolls B, McCrory M A, Saltzman E, Shikora S, Dwyer J, Roberts S
Department of Psychiatry, New England Medical Center, Boston, Massachusetts 02111, USA.
Int J Obes Relat Metab Disord. 2002 Oct;26(10):1398-403. doi: 10.1038/sj.ijo.0802081.
To determine whether extremely obese binge eating disorder (BED) subjects (BED defined by the Eating Disorder Examination) differ from their extremely obese non-BED counterparts in terms of their eating disturbances, psychiatric morbidity and health status.
Prospective clinical comparison of BED and non-BED subjects undergoing gastric bypass surgery (GBP).
Thirty seven extremely obese (defined as BMI > or = 40 kg/m(2)) subjects (31 women, six men), aged 22-58 y.
Eating Disorder Examination 12th Edition (EDE), Three Factor Eating Questionnaire (TFEQ), Structured Clinical Interview for the Diagnostic and Statistical Manual-IV (SCID-IV), Short-Form Health Status Survey (SF-36), and 24 h Feeding Paradigm.
Twenty-five percent of subjects were classified as BED (11% met full and 14% partial BED criteria) and 75% of subjects were classified as non-BED. BED (full and partial) subjects had higher eating disturbance in terms of eating concern and shape concern (as found by the EDE), higher disinhibition (as found by the TFEQ), and they consumed more liquid meal during the 24 h feeding paradigm. No difference was found in psychiatric morbidity between BED and non-BED in terms of DSM-IV Axis I diagnosis. The health status scores of both BED and non-BED subjects were significantly lower than US norms on all subscales of the SF-36, particularly the BED group.
Our findings support the validity of the category of BED within a population of extremely obese individuals before undergoing GBP. BED subjects differed from their non-BED counterparts in that they had a greater disturbance in eating attitudes and behavior, a poorer physical and mental health status, and a suggestion of impaired hunger/satiety control. However, in this population of extremely obese subjects, the stability of BED warrants further study.
确定极度肥胖的暴饮暴食症（BED）患者（根据饮食失调检查定义的BED）在饮食紊乱、精神疾病发病率和健康状况方面是否与其极度肥胖的非BED患者存在差异。
对接受胃旁路手术（GBP）的BED和非BED患者进行前瞻性临床比较。
37名极度肥胖（定义为体重指数≥40kg/m²）患者（31名女性，6名男性），年龄在22 - 58岁之间。
《饮食失调检查第12版》（EDE）、三因素饮食问卷（TFEQ）、《精神疾病诊断与统计手册第四版》结构化临床访谈（SCID-IV）、简短健康状况调查问卷（SF-36）以及24小时进食模式。
25%的患者被归类为BED（11%符合完全BED标准，14%符合部分BED标准），75%的患者被归类为非BED。BED（完全和部分）患者在饮食关注和体型关注方面（如EDE所发现）有更高的饮食紊乱，更高程度的去抑制（如TFEQ所发现），并且在24小时进食模式中摄入更多流食。在DSM-IV轴I诊断方面，BED和非BED患者的精神疾病发病率没有差异。BED和非BED患者的健康状况评分在SF-36的所有子量表上均显著低于美国标准，尤其是BED组。
我们的研究结果支持在接受GBP之前的极度肥胖个体群体中BED这一分类的有效性。BED患者与其非BED患者的不同之处在于，他们在饮食态度和行为方面有更大的紊乱，身心健康状况更差，并且有饥饿/饱腹感控制受损的迹象。然而，在这一极度肥胖患者群体中，BED的稳定性值得进一步研究。
