Exploring personalized diagnosis and intervention in binge eating disorder: Five case reports
Abstract
Background: Binge Eating Disorder (BED) has gained attention in recent years due to its complexity and the challenges it poses in diagnosis and treatment. Unlike other eating disorders such as anorexia nervosa and bulimia, BED has been less researched, particularly regarding the influence of genetic factors and biomechanical on eating behaviors. This study introduces a novel approach by individually analyzing how genetic predisposition and biomechanical factors impacts the diagnosis of BED. The primary objective of this research was to demonstrate the diagnostic variability and intervention possibilities in patients with BED, highlighting the importance of an interdisciplinary approach that integrates biomechanical principles. Additionally, it aimed to identify individual factors—clinical, psychosocial, biomechanical and genetic—that influence the presence of the disorder, and to evaluate the efficacy of personalized treatments that include psychological, psychiatric, and nutritional interventions tailored to each patient’s unique needs. Case presentation: The main concerns of the patients were how to manage their food-related anxiety, which was often exacerbated by biomechanical stressors. Many felt stigmatized by their weight and guilty for being unable to control their binge eating, which they initially attributed to a lack of self-control. However, upon learning about their genetic profile and the biomechanical underpinnings of their condition, patients began to better understand their eating behaviors, allowing them to reduce the associated guilt. Clinically, it was observed that after receiving interdisciplinary treatment, which included both psychological interventions and precision nutritional management, and biomechanical modulation, binge eating episodes significantly decreased. In four out of five cases, episodes disappeared. Conclusions: This reinforces the importance of tailoring treatments to the genetic and psychosocial, and biomechanical specifics of each patient. By incorporating biomechanical insights into therapeutic strategies, new research opportunities are opened, and the therapeutic approach for BED is significantly improved. This interdisciplinary framework not only addresses the psychological and nutritional aspects of BED but also leverages biomechanical principles to optimize treatment outcomes, offering a more holistic and effective approach to managing this complex disorder.
References
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Publishing; 2013.
2. Hudson JI, Hiripi E, Pope HG, et al. The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biological Psychiatry. 2007; 61(3): 348-358. doi: 10.1016/j.biopsych.2006.03.040
3. Duncan AE, Ziobrowski HN, & Nicol G. Binge eating disorder: Prevalence, associated morbidity, and treatment options. Psychology Research and Behavior Management. 2020; 13: 331–341.
4. Grilo CM, White MA, & Masheb RM. Diagnostic efficiency of DSM‐5 criteria for binge eating disorder in patients with obesity. Obesity. 2015; 23(11): 2380–2384. doi: 10.1002/oby.21283
5. Gormally J, Black S, Daston S, & Rardin D. The assessment of binge eating severity among obese persons. Addictive Behaviors. 1982; 7(1): 47-55. doi: 10.1016/0306-4603(82)90024-7
6. Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009; 52(2): 430-436. doi: 10.1016/j.appet.2008.12.003
7. Gearhardt AN, Corbin WR, Brownell KD. Development of the Yale Food Addiction Scale Version 2.0. Psychology of Addictive Behaviors. 2016; 30(1): 113-121. doi: 10.1037/adb0000136
8. Duarte ACS, da Silva NR, Santos Gonçalves VS, et al. The Influence of Single Nucleotide Polymorphisms On Body Weight Trajectory After Bariatric Surgery: A Systematic Review. Current Obesity Reports. 2023; 12(3): 280-307. doi: 10.1007/s13679-023-00514-3
9. Finlayson G. Food addiction and obesity: Unnecessary medicalization of hedonic overeating. Nature Reviews Endocrinology. 2017; 13(8): 493-498. doi: 10.1038/nrendo.2017.61
10. Fletcher PC, & Kenny PJ. Food addiction: A valid concept? Neuropsychopharmacology. 2018; 43(13): 2506–2513. doi: 10.1038/s41386-018-0137-4
11. Trace SE, Baker JH, Peñas-Lledó E, et al. The Genetics of Eating Disorders. Annual Review of Clinical Psychology. 2013; 9(1): 589-620. doi: 10.1146/annurev-clinpsy-050212-185546
12. Gluck ME. Stress response and binge eating disorder. Appetite. 2006; 46(1): 26-30. doi: 10.1016/j.appet.2005.05.004
13. Munn-Chernoff MA, Baker JH, & Smoller JW. Genetic studies of eating disorders: Past, present, and future. Journal of Eating Disorders. 2020; 8(1): 5. doi: 10.1186/s40337-020-0276-9
14. Monserrat Hernández M, Jiménez-Rodríguez D. Relationship of Genetic Polymorphisms and Microbial Composition with Binge Eating Disorder: A Systematic Review. Healthcare. 2024; 12(14): 1441. doi: 10.3390/healthcare12141441
15. Wilson GT, Grilo CM, Vitousek KM. Psychological treatment of eating disorders. American Psychologist. 2007; 62(3): 199-216. doi: 10.1037/0003-066x.62.3.199
16. Safer DL, Telch CF, & Chen EY. Dialectical behavior therapy for binge eating and bulimia. The Guilford Press; 2009.
17. Vocks S, Tuschen‐Caffier B, Pietrowsky R, et al. Meta‐analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder. International Journal of Eating Disorders. 2009; 43(3): 205-217. doi: 10.1002/eat.20696
18. Hudson JI, McElroy SL, Ferreira-Cornwell MC, et al. Efficacy of Lisdexamfetamine in Adults With Moderate to Severe Binge-Eating Disorder. JAMA Psychiatry. 2017; 74(9): 903. doi: 10.1001/jamapsychiatry.2017.1889
19. U.S. Food and Drug Administration. FDA expands uses of Vyvanse to treat binge-eating disorder. Available online: https://www.fda.gov/ (accessed on 13 October 2024).
20. Schulte EM, & Gearhardt AN. Development of the modified Yale food addiction scale version 2.0. European Eating Disorders Review. 2017; 25(4): 302-308. doi: 10.1002/erv.2515
21. European Food Safety Authority (EFSA). Dietary reference values for nutrients. Available online: https://multimedia.efsa.europa.eu/drvs/index.htm (accessed on 13 October 2024).
22. Gagnier JJ, Kienle G, Altman DG, et al. The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development. Global advances in health and medicine. 2013; 2(5): 38-43. doi: 10.7453/gahmj.2013.008
23. World Medical Association. WMA Declaration of Helsinki: Ethical principles for medical research involving human subjects. Available online: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ (accessed on 13 October 2024).
24. Granero R, Jiménez-Murcia S, Gearhardt AN, et al. Validation of the Spanish Version of the Yale Food Addiction Scale 2.0 (YFAS 2.0) and Clinical Correlates in a Sample of Eating Disorder, Gambling Disorder, and Healthy Control Participants. Frontiers in Psychiatry. 2018; 9. doi: 10.3389/fpsyt.2018.00208
25. Ceccarini MR, Fittipaldi S, Ciccacci C, et al. Association Between DRD2 and DRD4 Polymorphisms and Eating Disorders in an Italian Population. Frontiers in Nutrition. 2022; 9. doi: 10.3389/fnut.2022.838177
26. González LM, Mota-Zamorano S, García-Herráiz A, et al. Genetic variants in dopamine pathways affect personality dimensions displayed by patients with eating disorders. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. 2019; 26(1): 93-101. doi: 10.1007/s40519-019-00820-7
27. Magno FCCM, Guaraná HC, da Fonseca ACP, et al. Association of the MC4R rs17782313 polymorphism with plasma ghrelin, leptin, IL6 and TNFα concentrations, food intake and eating behaviors in morbidly obese women. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity. 2020; 26(4): 1079-1087. doi: 10.1007/s40519-020-01003-5
28. Cameron JD, Tasca GA, Little J, et al. Effects of fat mass and obesity-associated (FTO) gene polymorphisms on binge eating in women with binge-eating disorder: The moderating influence of attachment style. Nutrition. 2019; 61: 208-212. doi: 10.1016/j.nut.2018.11.006
29. Manfredi L, Accoto A, Couyoumdjian A, et al. A Systematic Review of Genetic Polymorphisms Associated with Binge Eating Disorder. Nutrients. 2021; 13(3): 848. doi: 10.3390/nu13030848
30. Palmeira L, Cunha M, Padez C, et al. Association study of variants in genes FTO, SLC6A4, DRD2, BDNF and GHRL with binge eating disorder (BED) in Portuguese women. Psychiatry Research. 2019; 273: 309-311. doi: 10.1016/j.psychres.2019.01.047
31. Choi JH. TAS1R2 sweet taste receptor genetic variation and dietary intake in Korean females. Appetite. 2021; 164: 105281. doi: 10.1016/j.appet.2021.105281
32. Mera-Charria A, Nieto-Lopez F, Francès MP, et al. Genetic variant panel allows predicting both obesity risk, and efficacy of procedures and diet in weight loss. Frontiers in Nutrition. 2023; 10. doi: 10.3389/fnut.2023.1274662
33. Barahona MJ, Langlet F, Labouèbe G, et al. GLUT2 expression by glial fibrillary acidic protein-positive tanycytes is required for promoting feeding-response to fasting. Scientific Reports. 2022; 12(1). doi: 10.1038/s41598-022-22489-2
34. Zhou K, et al. Variation in the glucose transporter gene SLC2A2 is associated with glycemic response to metformin. Nature Genetics. 2016; 48(9): 1055-1059. doi: 10.1038/ng.3632
35. Drucker DJ. The role of GLP-1 in metabolic regulation: Therapeutic implications in obesity and diabetes. Science. 2023; 380(6638): 456–459.
36. Najd-Hassan-Bonab L, Givi NJ, Moazzam-Jazi M, et al. Sex-specific association of FABP2 polymorphisms with the risk of obesity in the Tehran Cardio-Metabolic Genetic Study (TCGS). Gene. 2023; 876: 147519. doi: 10.1016/j.gene.2023.147519
37. Monteleone P, Tortorella A, Docimo L, et al. Investigation of 3111T/C polymorphism of the CLOCK gene in obese individuals with or without binge eating disorder: Association with higher body mass index. Neuroscience Letters. 2008; 435(1): 30-33. doi: 10.1016/j.neulet.2008.02.003
38. Culbert KM, Racine SE, & Barlow DH. Genetic and environmental contributions to the etiology of eating disorders. Clinical Psychology Review. 2015; 35: 108–118. doi: 10.1016/j.cpr.2015.10.006
39. Basiri R, Seidu B, Cheskin LJ. Key Nutrients for Optimal Blood Glucose Control and Mental Health in Individuals with Diabetes: A Review of the Evidence. Nutrients. 2023; 15(18): 3929. doi: 10.3390/nu15183929
40. Calderón‐Ospina CA, Nava‐Mesa MO. B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. CNS Neuroscience & Therapeutics. 2019; 26(1): 5-13. doi: 10.1111/cns.13207
41. Rico-de la Rosa L, Cervantes-Pérez E, Robledo-Valdez M, et al. The role of nutrition in mental health and psychiatric disorders: a translational perspective (Spanish). Journal of Clinical Nutrition and Metabolism. 2022; 5(1): 51-60. doi: 10.35454/rncm.v5n1.358
42. Quimis NCB, Díaz IA, Campus JGA, et al. Development of healthy habits using technologies. An experience from praxis. In: Educational research in the Ecuadorian context: Challenges and prospective. Dykinson; 2023. pp. 11–16.
43. Yilmaz Z, Hardaway JA, & Bulik CM. Genetics and epigenetics of eating disorders. Advances in Genomics and Genetics. 2015; 5: 131-150. doi: 10.2147/AGG.S55776
44. Schulte EM, Avena NM, & Gold MS. A commentary on the relationship between food addiction and obesity. The American Journal of Clinical Nutrition. 2016; 104(3): 547–551.
45. Puhl RM, & Latner JD. Stigma, obesity, and the health of the nation’s children. Psychological bulletin. 2007; 133(4): 557-580. doi: 10.1037/0033-2909.133.4.557
46. Micali N, Field AE, Treasure JL, et al. Are obesity risk genes associated with binge eating in adolescence? Obesity. 2015; 23(8): 1729-1736. doi: 10.1002/oby.21147
47. Stice E, & Shaw HE. Role of body dissatisfaction in the onset of eating disorders: A longitudinal study. Journal of Abnormal Psychology. 2022; 111(1): 1–10.
48. Wade TD, Byrne S, & Bryant-Waugh R. The Eating Disorder Examination: A review of the past 25 years.European Eating Disorders Review. 2018; 26(4): 273-274. doi: 10.1002/erv.2550
49. Hartmann A, Zoller P, & von Rüden U. Effects of an interdisciplinary treatment program for eating disorders: A longitudinal study. Eating and Weight Disorders. 2018; 23(4): 579–587. doi: 10.1007/s40519-017-0438-0
50. Dalle Grave R, Calugi S, Sartirana M, et al. Transdiagnostic cognitive behaviour therapy for adolescents with an eating disorder who are not underweight. Behaviour Research and Therapy. 2015; 73: 79-82. doi: 10.1016/j.brat.2015.07.014
51. Saukko PM, Reed M, Britten N, Hogarth S. Negotiating the boundary between medicine and consumer culture: Online marketing of nutrigenetic tests. Social Science & Medicine. 2010; 70(5): 744-753. doi: 10.1016/j.socscimed.2009.10.066
52. Kessler RC, Berglund P, Demler O, et al. Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005; 62(6): 593. doi: 10.1001/archpsyc.62.6.593
53. Trepanowski JF, Bloomer RJ. The impact of religious fasting on human health. Nutrition Journal. 2010; 9(1). doi: 10.1186/1475-2891-9-57
54. Levine MP, Murnen SK. “Everybody Knows That Mass Media are/are not [pick one] a Cause of Eating Disorders”: A Critical Review of Evidence for a Causal Link Between Media, Negative Body Image, and Disordered Eating in Females. Journal of Social and Clinical Psychology. 2009; 28(1): 9-42. doi: 10.1521/jscp.2009.28.1.9
55. Dunn EC, Brown RC, Dai Y, et al. Genetic determinants of depression: recent findings and future directions. Harvard Review of Psychiatry. 2015; 23(1): 1-18. doi: 10.1097/HRP.0000000000000054
56. Varela C, Hoyo Á, Tapia-Sanz ME, et al. An update on the underlying risk factors of eating disorders onset during adolescence: a systematic review. Frontiers in Psychology. 2023; 14. doi: 10.3389/fpsyg.2023.1221679
57. Rocha A dos S, Teixeira CSS, Coelho CG, et al. The relationship between nutritional deficiencies and mental health. Revista chilena de nutrición. 2021; 48(1): 103-108. doi: 10.4067/s0717-75182021000100103
58. Forand NR, Gunthert KC, German RE, et al. Appearance Investment and Everyday Interpersonal Functioning: An Experience Sampling Study. Psychology of Women Quarterly. 2010; 34(3): 380-393. doi: 10.1111/j.1471-6402.2010.01583.x
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