Goldschmidt Andrea B, Crosby Ross D, Cao Li, Wonderlich Stephen A, Mitchell James E, Engel Scott G, Peterson Carol B
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island.
Department of Biostatistics, Neuropsychiatric Research Institute, Fargo, North Dakota.
Int J Eat Disord. 2018 Jan;51(1):87-91. doi: 10.1002/eat.22795. Epub 2017 Nov 7.
Binge eating is common in adults with obesity. The Diagnostic and Statistical Manual for Psychiatric Disorders describes five indicators of binge eating (eating more rapidly than usual; eating until uncomfortably full; eating large amounts of food when not physically hungry; eating alone because of embarrassment over how much one is eating; and feeling disgusted with oneself, depressed, or very guilty after overeating), but their validity is unclear.
We examined preliminary associations between the five indicators and binge versus nonbinge episodes among 50 adults with obesity via ecological momentary assessment.
Generalized linear models revealed that, relative to nonbinge episodes, self-reported binge episodes were associated with lower pre-episode hunger (p = .004), higher postepisode fullness (p < .001), a greater likelihood of reporting moderate to extreme shame prior to eating in conjunction with eating alone (p < .001), and a greater likelihood of reporting moderate to extreme disgust, depression, and/or guilt after eating (p < .001), but not with eating more rapidly than usual (p = .85).
Results support the validity of most binge-eating indicators, although the utility of the rapid eating criterion is questionable. Future research should examine whether modifying these indicators in binge-eating interventions would reduce the occurrence of loss of control and/or overeating.
暴饮暴食在肥胖成年人中很常见。《精神疾病诊断与统计手册》描述了暴饮暴食的五个指标（进食速度比平时快；吃到感觉不舒服的饱腹感；在身体不饿时吃大量食物；因对自己进食量感到尴尬而独自进食；以及在暴饮暴食后对自己感到厌恶、沮丧或非常内疚），但其有效性尚不清楚。
我们通过生态瞬时评估研究了50名肥胖成年人中这五个指标与暴饮暴食发作和非暴饮暴食发作之间的初步关联。
广义线性模型显示，与非暴饮暴食发作相比，自我报告的暴饮暴食发作与发作前较低的饥饿感相关（p = 0.004），发作后较高的饱腹感相关（p < 0.001），在进食前伴有独自进食时报告中度至极度羞耻感的可能性更大（p < 0.001），以及在进食后报告中度至极度厌恶、沮丧和/或内疚感的可能性更大（p < 0.001），但与进食速度比平时快无关（p = 0.85）。
结果支持了大多数暴饮暴食指标的有效性，尽管快速进食标准的效用值得怀疑。未来的研究应该探讨在暴饮暴食干预中修改这些指标是否会减少失控和/或暴饮暴食的发生。
