UNC Charlotte Department of Psychology, 9201 University City Blvd., Charlotte, NC 28223, USA.
Eat Behav. 2011 Aug;12(3):175-81. doi: 10.1016/j.eatbeh.2011.04.007. Epub 2011 Apr 21.
An emerging literature has illuminated an important link between Type 2 diabetes mellitus (DM) and binge eating disorder (BED) within obese cohorts. However, prior work has not examined this relationship specifically in a weight loss surgery (WLS) sample or fully explored potential psychosocial factors associated with this co-occurrence. Therefore, the present investigation sought to identify socio-demographic (i.e. age, education, BMI, ethnicity, gender, age of obesity onset) and psychological (i.e. depressive symptoms, hedonic hunger/food locus of control beliefs, severity of binge eating-related cognitions) correlates of the co-occurrence of Type 2 DM and BED among bariatric surgery candidates. An archival sample of 488 patients seeking surgical treatment for clinical obesity completed a standard battery of pre-operative psychosocial measures. The presence of BED was evaluated using a semi-structured clinical interview based on the DSM-IV TR (APA, 2000) and was further corroborated by responses on the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R; Spitzer, Yanovski, & Marcus, 1993). Results indicated that 8.2% of the sample was classified as having both Type 2 DM and BED concurrently. A multivariate logistic regression model revealed that in addition to other psychological (e.g., binge eating-related cognitions, hedonic hunger) and demographic variables (i.e. male gender), African American ethnicity (OR=3.3: 1.41-7.73) was a particularly robust indicator of comorbid status. Findings support and extend previous health disparity research urging greater attention to the needs of traditionally underserved, at-risk populations seeking treatment for obesity complicated by dysregulated eating and metabolism. Additionally, these preliminary results underscore the relevance of considering the potential benefits of providing quality comprehensive pre- and post-operative psychological care among bariatric patients towards optimizing both short- and long-term health and well-being.
一段新兴的文献阐明了肥胖人群中 2 型糖尿病(DM)和暴食障碍(BED)之间的重要联系。然而,先前的工作并未专门在减肥手术(WLS)样本中检查这种关系,也未充分探讨与这种共病相关的潜在心理社会因素。因此,本研究旨在确定肥胖症手术候选者中 2 型糖尿病和 BED 共病的社会人口统计学(即年龄、教育程度、BMI、种族、性别、肥胖发病年龄)和心理因素(即抑郁症状、享乐性饥饿/食物控制信念、暴食相关认知的严重程度)的相关性。对 488 名寻求手术治疗临床肥胖的患者进行了档案样本的分析,他们完成了一套标准的术前心理社会测量工具。使用基于 DSM-IV TR(APA,2000)的半结构化临床访谈评估 BED 的存在,并通过对修订后的饮食和体重模式问卷(QEWP-R;Spitzer、Yanovski 和 Marcus,1993)的回答进一步证实。结果表明,该样本中有 8.2%同时患有 2 型糖尿病和 BED。多变量逻辑回归模型显示,除了其他心理(例如,与暴食相关的认知、享乐性饥饿)和人口统计学变量(即男性性别)外,非裔美国人种族(OR=3.3:1.41-7.73)是共病状态的一个特别有力的指标。这些发现支持并扩展了以前的健康差异研究,敦促更多地关注传统服务不足、面临风险的人群的需求,这些人群因饮食和代谢失调而寻求肥胖治疗。此外,这些初步结果强调了在肥胖症患者中提供优质全面的术前和术后心理护理的潜在益处,以优化短期和长期的健康和幸福感。