Saskia Mels

Loss of control over eating in overweight youngsters: the role of anxiety, depression and emotional eating.

The current study investigated loss of control (LC) over eating and the role of anxiety, depression and emotional eating in a sample of both treatment seeking (N = 115) and non-treatment seeking (N = 73) overweight youngsters (aged 8-18) using a semi-structured clinical interview and self-report questionnaires. It was found that treatment seekers reported twice as much LC (40%) compared to non-treatment seekers (21%). Cross-sectional prediction models indicated that increased anxiety was associated with emotional eating and LC. Emotional eating tended to mediate the relationship between anxiety and LC. Increased depression was associated with emotional eating but not with LC. Especially overweight treatment seekers turn out to be at risk for LC. Because LC may develop as a result of inadequate coping with negative emotions like anxiety, obesity treatment should focus on teaching more effective coping strategies. Longitudinal research is recommended to further elaborate affect regulation and LC.

Weight parameters and pathological eating as predictors of obesity treatment outcome in children and adolescents.

OBJECTIVE The current study investigated weight parameters and pathological eating as predictors of treatment outcome in obese youngsters. METHOD Obese youngsters (N=132) were examined before participating in an obesity treatment program. Weight loss was measured during and at the end of treatment. RESULTS Baseline adjusted BMI, restrained eating style and weight loss after 4 months of treatment positively predicted weight loss at the end, whereas larger weight loss after 1 month of treatment predicted less total weight loss. Lower baseline adjusted BMI was associated with more drop-out whereas subjective binge eating was positively related to program completion. CONCLUSION Specific weight and eating pathology parameters affected positive as well as negative obesity treatment outcome. Identifying more pre-treatment predictors for drop-out can ameliorate our treatment approach.

Psychological disorder, symptom severity and weight loss in inpatient adolescent obesity treatment

OBJECTIVE This study aimed to investigate whether psychological disorders and symptom severity hamper weight loss in obese adolescents and explored the effect of evidence-based adolescent obesity treatment on psychological disorders and symptom severity. METHOD Participants were 66 adolescents admitted for a 10-month obesity treatment programme. At the start of treatment both clinical interviews and self-report questionnaires were administered. Weight loss was registered at several time points. Half of the sample was invited to complete questionnaires and be interviewed once again at the end of the programme. RESULTS Baseline degree of overweight was the strongest predictor of weight loss. The presence of at least one psychological disorder appeared a negative predictor of weight loss after four months. At post-test, a decrease in eating, shape and weight concern and binge eating episodes was demonstrated. A similar trend was found for internalizing symptoms. All eating disorders resolved, but a substantial number of adolescents still suffered from psychological disorders at the end of treatment. CONCLUSION During inpatient obesity treatment, youngsters who are more severely obese lose most weight. In girls and in adolescents suffering from psychological disorders, long-term care should be the aim to prevent an experience of failure. From a psychological health perspective, the inclusion of psychotherapy during inpatient obesity treatment for adolescents suffering from psychiatric disorders is worth considering. All together, the findings of this study demonstrate the importance of adopting both a medical and a psychological perspective on obesity (treatment) in youth.

Personality Pathology Comorbidity in Adult Females with Eating Disorders

Personality pathology is examined in 100 female in-patients diagnosed with eating disorders. The Eating Disorder Inventory-II and the NEO-PI-R were self-administered and personality pathology was assessed using a structured interview. Clinicians additionally evaluated patients’ global functioning. The results indicated sizeable personality disorder comorbidity, and two dimensions of personality pathology, for example, an internalizing and an externalizing factor, could be identified. Patients’ global functioning was primarily associated with dimensions of personality pathology, but not with eating disorder symptoms. Assessment and therapeutic interventions should focus on this co-occurring pathology in order to improve patients’ functioning.