Department of Psychology, University of Wyoming, Laramie, Wyoming, USA.
Int J Eat Disord. 2022 Oct;55(10):1291-1295. doi: 10.1002/eat.23758. Epub 2022 Jun 15.
Caloric consumption occurs in rhythms, typically during daytime, waking hours, marked by peaks at mealtimes. These rhythms are disrupted in individuals with eating disorders; mealtime peaks are blunted and delayed relative to sleep/waketimes. Individuals with eating disorders also tend to experience an overall phase delay in appetite; they lack hunger earlier in the day and experience atypically high hunger later in the day, the latter of which may culminate in binge-eating episodes. This disruptive appetitive behavior-early in the day restrictive eating and later in the day binge eating-may be partially accounted for by circadian disruptions, which play a role in coordinating appetitive rhythms. Moreover, restrictive eating and binge eating themselves may further disrupt circadian synchronization, as meal timing serves as one of many external signals to the central circadian pacemaker. Here, we introduce the biobehavioral circadian model of restrictive eating and binge eating, which posits a central role for circadian disruption in the development and maintenance of restrictive eating and binge eating, highlighting modifiable pathways unacknowledged in existing explanatory models. Evidence supporting this model would implicate the need for biobehavioral circadian regulation interventions to augment existing eating disorder treatments for individuals experiencing circadian rhythm disruption. PUBLIC SIGNIFICANCE: Existing treatments for eating disorders that involve binge eating and restrictive eating mandate a regular pattern of eating; this is largely responsible for early behavioral change. This intervention may work partly by regulating circadian rhythm and diurnal appetitive disruptions. Supplementing existing treatments with additional elements specifically designed to regulate circadian rhythm and diurnal appetitive rhythms may increase the effectiveness of treatments, which presently do not benefit all who receive them.
热量消耗存在节律，通常在白天、清醒时间发生，以进餐时的峰值为特征。这些节律在饮食失调患者中被打乱；与睡眠/清醒时间相比，进餐高峰变平且延迟。饮食失调患者也往往会经历整体的食欲相位延迟；他们在白天早期缺乏饥饿感，在白天后期经历异常高的饥饿感，后者可能导致暴食发作。这种扰乱的食欲行为——白天早期限制进食，晚上暴食——可能部分归因于昼夜节律紊乱，它在协调食欲节律中起着作用。此外，限制进食和暴食本身也可能进一步破坏昼夜节律同步，因为用餐时间是中枢昼夜节律起搏器的众多外部信号之一。在这里，我们介绍了限制进食和暴食的生物行为昼夜节律模型，该模型认为昼夜节律紊乱在限制进食和暴食的发展和维持中起着核心作用，突出了现有解释模型中未被认识到的可修改途径。支持这一模型的证据表明，需要进行生物行为昼夜节律调节干预，以增强目前针对昼夜节律紊乱个体的饮食障碍治疗。公共意义：涉及暴食和限制进食的现有饮食失调治疗方法需要有规律的进食模式；这在很大程度上导致了早期的行为改变。这种干预可能部分通过调节昼夜节律和昼夜食欲紊乱起作用。在现有的治疗方法中加入专门设计用于调节昼夜节律和昼夜食欲节律的额外元素，可能会提高治疗效果，因为目前并非所有接受治疗的人都能从中受益。
