A report published in Psychotherapy and Psychosomatics analyzes the link between impulsivity and binge eating in obese subjects. Most of the eating disorder (ED) features and behaviors such as dieting and binge eating should be considered secondary epiphenomena of a profound psychopathological core. In the ED population, impulsivity has been associated with binge eating and purging. Taking into account a dimensional approach which considers that ED psychopathology is distributed along with a continuum of severity (from a high-risk population to full-blown ED patients), in the present study the authors administered the Identity and Eating Disorders questionnaire (IDEA) to a sample of morbidly obese patients seeking bariatric surgery.
The sample consisted of 204 obese patients (158 women; 77.5%; mean age: 43.4 ± 12.3 years; mean BMI: 44.37 ± 9.69) attending the Obesity Surgery Clinic of the Florence University School of Medicine (Italy). The bariatric surgery group was compared to a sample of 140 ED patients enrolled at the Outpatient Clinic for Eating Disorders of the University of Florence. The sample included 50 anorexia nervosa patients (45 women; 95.7%; mean age: 24.3 ± 7.7 years; mean BMI: 16.12 ± 1.39), 47 bulimia nervosa patients (45 women; 95.7%; mean age: 27.8 ± 9.05 years; BMI: 23.42 ± 6.05) and 46 binge ED patients (42 women; 91.3%; mean age: 34.9 ± 12.6 years; BMI: 38.07 ± 8.45) as well as a group of 145 healthy, normal-weight control subjects (113 women; 77.9%; mean age: 28.5 ± 5.6 years; BMI: 22.07 ± 3.01) recruited among students and residents by means of advertising at the university.
Healthy controls, bariatric surgery and ED patients showed significant differences in terms of IDEA total scores (F = 32.55; p < 0.001). In particular, IDEA scores were found to vary along a continuum of severity from healthy control subjects (reporting the lowest IDEA total score: 0.49 ± 0.54) up to ED patients [reporting the highest IDEA scores, without significant differences between anorexia nervosa (1.56 ± 0.88), bulimia nervosa (1.67 ± 1.06) and binge ED (1.56 ± 0.94)]; bariatric surgery patients reported intermediate IDEA scores (total score: 1.11 ± 0.71).
Results confirmed the hypothesis that abnormal bodily experiences are a core feature not just for 'over-threshold' ED patients but also for a high-risk population such as morbidly obese patients. IDEA scores express a gradient of vulnerability to ED psychopathology and behaviors from high-risk subjects (bariatric surgery subjects) up to the clinical groups. The authors concluded that vulnerability to ED behaviors such as binge eating appeared to be associated with abnormal bodily experiences in a dimensional pattern.