Author Interviews, Infections, JAMA, Mental Health Research, Pediatrics / 25.04.2019 Interview with: Lauren Breithaupt, PhD Department of Psychology George Mason University Fairfax, Virginia What is the background for this study? What are the main findings?  Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders. We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    (more…)
Author Interviews, Eating Disorders, Weight Research / 04.06.2018 Interview with: Tomoko Udo, PhD Assistant Professor Department of Health Policy, Management, and Behavior School of Public Health University at Albany, State University of New York What is the background for this study?   Response: The National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC III) was the largest epidemiological study on psychiatric disorders in US non-institutionalized adults that was conducted by the National Institution on Alcohol Abuse and Alcoholism, and the first one sinceDSM-5 came out. The last population-based study with US adults that examined eating disorders was the National Comorbidity Survey-Replication Study conducted by Hudson and his colleagues and published in 2007. We felt that it was important to obtain new prevalence estimates in a larger and representative sample especially because the DSM-5 included several changes to the criteria for eating disorders from the earlier DSM-IV. Thus, we thought it was important to provide updated and new prevalence estimates for eating disorders as well as how they are distributed across sex, ethnicity/race, and age.  Many  researchers and clinicians expected higher estimates than earlier studies as a result of “loosening” of diagnostic criteria for eating disorders. (more…)
Author Interviews, Depression, Eating Disorders, JAMA, Mental Health Research, Pediatrics / 13.04.2018 Interview with: Tracy Vaillancourt, Ph.D. Full Professor and Canada Research Chair Children’s Mental Health and Violence Prevention Counselling Psychology, Faculty of Education School of Psychology, Faculty of Social Sciences University of Ottawa What is the background for this study? Response: Although there have been a few studies that have looked at the relation between being bullied and disordered eating, most studies have looked at it from the perspective of does being bullied lead to disordered eating and does depressive symptoms mediate (i.e., explain) the link. We wanted to look more closely at how bullying, disordered eating, and depression were related over time among teenagers by examining all possible pathways. Another novel aspect of our study was the focus on disordered eating behaviour only (e.g., vomiting, using diet pills, binge eating). Most previous work has examined behaviour and thoughts together, but because disordered eating thoughts are so common (termed normative discontent; e.g., fear of fat, dissatisfaction with body shape or size), particularly among girls and women, we wanted to focus on behaviour, which is more problematic in terms of physical and psychiatric health. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, OBGYNE, Weight Research / 20.03.2018 Interview with: Madhusmita Misra, MD, MPH Division Chief, Pediatric Endocrinology Fritz Bradley Talbot and Nathan Bill Talbot Professor of Pediatrics, Harvard Medical School What is the background for this study? What are the main findings? Response: Disordered eating behavior is common in conditions of functional hypothalamic amenorrhea, such as anorexia nervosa and exercise-induced amenorrhea, which are also associated with anxiety and depression. In hypoestrogenic rodents, estrogen replacement reduces anxiety-related behavior. Similarly, physiologic estrogen replacement in adolescents with anorexia nervosa reduces anxiety and prevents the increased body dissatisfaction observed with increasing weightHowever, the impact of estrogen administration on disordered eating behavior and psychopathology in normal-weight young women with exercise-induced amenorrhea is unknown. Adolescent and young adult normal-weight athletes 14-25 years old with irregular periods were randomized to receive (i) physiologic estrogen replacement using a transdermal patch with cyclic progesterone, or (ii) an oral estrogen-progesterone containing pill (an oral contraceptive pill), or (iii) no estrogen for 12-months. The Eating Disorder Inventory-2 (EDI-2) and Three-Factor Eating Questionnaire (TFEQ) were administered ag the beginning and the end of the study to assess disordered eating behavior and psychopathology. We found that the group that did not receive estrogen had a worsening of disordered eating behavior and psychopathology over the 12-months duration of the study, but this was not observed in the group that received estrogen replacement. Further, body dissatisfaction scores improved over 12-months in the groups receiving estrogen replacement, with the transdermal estrogen group showing the strongest effect. (more…)
Author Interviews, Eating Disorders, Genetic Research / 24.06.2017 Interview with: Camron D. Bryant Ph.D Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Department of Psychiatry Boston University, Boston, MA What is the background for this study? What are the main findings? Response: We previously used genome-wide linkage analysis, fine mapping, gene validation, and pharmacological targeting to identify a negative regulatory role for the gene casein kinase 1-epsilon (Csnk1e) in behavioral sensitivity to drugs of abuse, including psychostimulants and opioids. Parallel human candidate genetic association studies identified an association between multiple genetic variants in CSNK1E with heroin addiction in multiple populations. Drug addiction is a multi-stage process that begins with the initial acute subjective and physiological responses that can progress to chronic administration, tolerance, and withdrawal. The recovery process begins with abstinence from drug taking but can quickly be derailed by relapse to drug taking behavior. Preclinical pharmacological studies also support a role for CSNK1E in reinstatement of opioid self-administration and relapse to alcohol drinking. Despite the evidence that disruption of Csnk1e gene and protein function can affect various behaviors associated with drug and alcohol addiction, it is unclear what stage of the addiction process these genetic and pharmacological manipulations modulate. In this study, we show that disruption of the Csnk1e gene resulted in an enhancement of the rewarding properties of the highly potent and addictive opioid, fentanyl.  Unexpectedly, we also discovered that disruption of Csnk1e also enhanced binge eating – but only in female mice. (more…)
Author Interviews, Eating Disorders / 13.05.2017 Interview with: Cynthia Bulik, PhD, FAED Founding director of the UNC Center of Excellence for Eating Disorders and Professor at Karolinska Institutet in Stockholm, Sweden. What is the background for this study? Response: Researchers and clinicians from around the world came together to create the most powerful genome-wide association study of anorexia nervosa to date. Via this global collaboration, we were able to identify the first significant locus that influences risk for anorexia nervosa. We have known that anorexia is heritable for over a decade, but now we are actually identifying which genes are implicated. This is the first one identified! (more…)
Author Interviews, Eating Disorders, PLoS, Weight Research / 26.01.2017 Interview with: Dr Maria Kekic PhD Research Worker | The TIARA study: Transcranial magnetic stimulation and imaging in anorexia nervosa Section of Eating Disorders | Department of Psychological Medicine Institute of Psychiatry, Psychology & Neuroscience | King’s College London What is the background for this study?  What are the main findings? Response: Bulimia nervosa is an eating disorder characterised by repeated episodes of binge-eating and inappropriate compensatory behaviours. It is associated with multiple medical complications and with an increased risk of mortality. Although existing treatments for bulimia are effective for many patients, a sizeable proportion remain symptomatic following therapy and some do not respond at all. Evidence shows that bulimia is underpinned by functional alterations in certain brain pathways, including those that underlie self-control processes. Neuroscience-based techniques with the ability to normalise these pathways may therefore hold promise as treatments for the disorder. One such technique is called transcranial direct current stimulation (tDCS) – a form of non-invasive brain stimulation that delivers weak electrical currents to the brain through two electrodes placed on the head. It is safe and painless, and the most common side effect is a slight itching or tingling on the scalp. (more…)
Author Interviews, Weight Research / 26.10.2016 Interview with: Dr. Susan L. McElroy, M.D. Professor of Psychiatry and Behavioral Neuroscience Chief Research Officer Lindner Center of HOPE University of Cincinnati College of Medicine. What is the background for this study? What are the main findings? Response: SPD489-346, designed as a multi-center, double-blind, placebo-controlled, dose-optimized, randomized-withdrawal study, is the first-ever longer-term pharmacologic study (38 weeks) to evaluate the maintenance of efficacy between Vyvanse and placebo in adults with moderate to severe binge eating disorder (B.E.D.). Study SPD489-346 evaluated the longer-term maintenance of efficacy (38 weeks) between Vyvanse and placebo based on the primary endpoint of time to relapse during the randomized-withdrawal phase in adults aged 18 to 55 (N=267) with moderate to severe B.E.D. based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition – Text Revision (DSM-IV-TR®) criteria. In the study, relapse was defined as having two or more binge days per week for two consecutive weeks prior to any visit and an increase in Clinical Global Impressions-Severity (CGI-S) score of two or more points relative to the randomized-withdrawal baseline visit Results from SPD489-346 indicated that Vyvanse (n=136) demonstrated significant maintenance of efficacy compared to placebo (n=131) based upon the primary endpoint of time to relapse. At the conclusion of the study, maintenance of efficacy for patients who had an initial response during the open-label phase, and then continued on Vyvanse during the randomized-withdrawal phase, was demonstrated with Vyvanse being superior over placebo as measured by time to relapse. Safety and tolerability evaluations of Vyvanse included treatment-emergent adverse events (TEAEs) and vital signs. The safety profile for Vyvanse in this study was generally consistent with the known profile reported in previous studies in adult patients with moderate to severe B.E.D. Vyvanse is indicated for the treatment of moderate to severe B.E.D. in adults. Vyvanse is not for weight loss. It is not known if Vyvanse is safe and effective for the treatment of obesity. Vyvanse is a federally controlled substance (CII) because it can be abused or lead to dependence. Keep in a safe place to prevent misuse and abuse. Selling or sharing Vyvanse may harm others and is illegal. (more…)
Addiction, ADHD, Author Interviews, Eating Disorders / 29.01.2016 Interview with: Dr. Kenneth Koblan PhD Sunovion Pharmaceuticals Inc. Fort Lee, NJ and Marlborough, MA Medical Research: What is the background for this study? Dr. Koblan: Assessing abuse potential is important in the clinical development process for any therapy affecting the central nervous system, especially those that may act on dopamine and norepinephrine neurotransmitter systems. Human abuse liability studies are conducted to evaluate the abuse potential associated with drugs that affect the central nervous system. Drugs that increase dopamine levels may be associated with stimulant effects and abuse (e.g., cocaine and amphetamine), whereas drugs that increase serotonin and/or norepinephrine levels are not generally associated with recreational abuse (e.g., selective serotonin reuptake inhibitors). Among drugs with effects on dopamine neurotransmission, slowing the rate of absorption is thought to reduce abuse potential, and increasing the rate of elimination is thought to reduce rewarding effects and abuse liability due to sustained elevations in drug concentrations resulting in sustained inhibition of dopamine transporters (DAT). Dasotraline is an investigational dopamine and norepinephrine reuptake inhibitor from Sunovion in late-stage development to evaluate its use in treating the symptoms of attention deficit hyperactivity disorder (ADHD) and binge-eating disorder (BED). Dasotraline has slow absorption and elimination that supports the potential for plasma concentrations yielding a continuous therapeutic effect over the 24-hour dosing interval at steady state. (more…)
Author Interviews, Eating Disorders, Psychological Science, Weight Research / 18.01.2016 Interview with: Samuel Chng PhD Researcher in Psychology Applied to Health University of Exeter Medical School St Luke’s campus Exeter, EX1 2LU, United Kingdom Medical Research: What is the background for this study? What are the main findings? Response: The study was conceptualised from the curious question from my childhood, “How did my parents influence my behaviours?” Together with my co-author, Dr. Daniel Fassnacht, we decided to explore how a specific form of parental influence, their comments, would influence the development of disordered eating symptoms. From studies conducted with Western samples that parental comments play a role in the development of eating disorder symptoms, and body dissatisfaction is one of the more studied mediator of this relationship. However, we could not find any study that investigated the influential nature of parent comments in Asia. So, we decided to focus our study on Asian parents and their children. Singapore, a developed Asian country that continues to have strong familial roots, provided an ideal population for our study, and we would expect, the relationships we found indicated some potential differences in amongst Asian families. We found that young women, compared to young men, in Singapore generally reported higher levels of parental comments (about their weight, body shape and eating habit), body dissatisfaction and disordered eating symptoms. However what we found for both young women and men was that negative comments from mothers (for example, ‘You need to lose weight’) was the only category of comments that predicted disordered eating and this was mediated by the presence of body dissatisfaction. Positive comments from parents, though suggested from past studies to be a protective factor, did not influence body dissatisfaction and disordered eating. (more…)
Author Interviews, Eating Disorders, Nature / 17.11.2014

Pietro Cottone, Ph.D. Associate Professor Departments of Pharmacology and Psychiatry Laboratory of Addictive Disorders Boston University School of Medicine Boston, MA Interview with: Pietro Cottone, Ph.D. Associate Professor Departments of Pharmacology and Psychiatry Laboratory of Addictive Disorders Boston University School of Medicine Boston, MA 02118 Medical Research: What is the background for this study? What are the main findings? Dr. Cottone: Binge-eating disorder affects over ten million people in the USA and it is characterized by excessive consumption of junk food within brief periods of time, accompanied by loss of control, uncomfortable fullness and intense feelings of disgust and embarrassment. Increasing evidence suggests that binge-eating disorder can be regarded as an addiction behavior. Memantine, a neuroprotective drug which blocks the glutamatergic system in the brain, is an Alzheimer's disease medication, and it has been shown potential to treat a variety of addictive disorders. We first developed a rodent model of binge eating by providing a sugary, chocolate diet only for one hour a day, while the control group was given the standard laboratory diet. Rats exposed to the sugary diet rapidly develop binge eating behavior, observed as a 4 fold increase in food intake compared to controls. Furthermore, binge eating rats are willing to work to a much greater extent to obtain just the cue associated with the sugary food (not the actual food), as compared to controls. In addition, binge eating subjects exhibit compulsive behavior by putting themselves in a potentially risky situation in order to get to the sugary food, while the control group obviously avoids that risk. We then tested whether administering memantine could reduce binge eating of the sugary diet, the strength of cues associated with junk food as well as the compulsiveness associated with binge eating. In addition, we studied which area of the brain was mediating the effects of memantine, by injecting the drug directly into the brain of binge eating rats. Our data show that memantine was able to block binge eating of the sugary diet, the willingness to work to obtain a cue associated with junk food, as well as the risky behavior of rats when the sugary diet was provided in a potentially unsafe environment. When we injected the drug directly into the nucleus accumbens of rats, they stopped binge eating. Importantly, the drug had no effects in control rats eating a standard laboratory diet. (more…)
Author Interviews, BMJ, Eating Disorders, Weight Research / 09.04.2014

Ulla Räisänen Senior Researcher HERG Health Experiences Research Group Department of Primary Care Health Sciences University of Oxford Oxford OX1  Interview with Ulla Räisänen Senior Researcher HERG Health Experiences Research Group Department of Primary Care Health Sciences University of Oxford Oxford OX1 2ET : What are the main findings of the study? Answer: We conducted a qualitative interview study exploring how young men (aged 16-25) recognise eating disorder symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care in the UK. Our data suggest that the widespread perception of eating disorders as uniquely or predominantly a female problem led to an initial failure by young men to recognise their behaviours as symptoms of an eating disorder. Many presented late in their illness trajectory when eating disorder behaviours and symptoms were entrenched, and some felt that opportunities to recognise their illness had been missed because of others’ lack of awareness of eating disorders in men. In addition, the men discussed the lack of gender-appropriate information and resources for men with eating disorders as an additional impediment to making sense of their experiences, and some felt that health and other professionals had been slow to recognise their symptoms because they were men. (more…)
Author Interviews, Eating Disorders, General Medicine, Social Issues / 09.04.2014 Interview with Stephen M. Amrock, SM Department of Pediatrics New York University School of Medicine New York, NY 10016 What are the main findings of the study? Answer: We analyzed data from a nationally representative survey on youth risk behaviors. After adjusting for other risk taking behaviors, we found that high school adolescents who indoor tan were much more likely to also engage in behaviors typically associated with eating disorders. We also noted that the link between indoor tanning and such harmful weight control behaviors was even stronger among males than females. (more…)
Author Interviews, Depression, Diabetes, Diabetologia, Weight Research / 07.02.2014

Dr Peter de Jonge Interdisciplinary Center for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Interview with: Dr Peter de Jonge Interdisciplinary Center for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Netherlands What are the main findings of the study? Dr. de Jonge: The main findings were that depression and impulse control disorders, in particular binge eating and bulimia were associated with diabetes. (more…)