Newswise, November 16, 2015 — Women with apple-shaped bodies –
those who store more of their fat in their trunk and abdominal regions – may be
at particular risk for the development of eating episodes during which they
experience a sense of “loss of control,” according to a new study from Drexel
University.
The study also found that women with greater fat stores in
their midsections reported being less satisfied with their bodies, which may
contribute to loss-of-control eating.
This study marks the first investigation of the connections
between fat distribution, body image disturbance and the development of
disordered eating.
“Eating disorders that are detected early are much more likely
to be successfully treated. Although existing eating disorder risk models
comprehensively address psychological factors, we know of very few
biologically-based factors that help us predict who may be more likely to
develop eating disorder behaviors,” said lead author Laura Berner, PhD, who
completed the research while pursuing a doctoral degree at Drexel.
“Our preliminary findings reveal that centralized fat
distribution may be an important risk factor for the development of eating
disturbance, specifically for loss-of-control eating,” said Berner.
“This suggests that targeting individuals who store more of
their fat in the midsection and adapting psychological interventions to focus
specifically on body fat distribution could be beneficial for preventing eating
disorders.
The study, titled “Examination of Central Body Fat Deposition
as a Risk Factor for Loss-of-Control Eating,” was published in the American
Journal of Clinical Nutrition.
Berner is now a postdoctoral research fellow at the Eating
Disorders Center for Treatment and Research at UC San Diego Health. Michael R.
Lowe, PhD, a professor in Drexel’s College of Arts and Sciences, was a
co-author, along with Danielle Arigo, PhD, who was a postdoctoral research
fellow at Drexel and is now an assistant professor of psychology at the
University of Scranton; Laurel Mayer, MD, associate professor of clinical
psychiatry at the Columbia University College of Physicians and Surgeons and
the New York State Psychiatric Institute,; and David B. Sarwer, PhD, professor
of psychology in Psychiatry and Surgery at the Perelman School of Medicine at
the University of Pennsylvania as well as director of clinical services at the
Center for Weight and Eating Disorders.
Mounting evidence suggests that experiencing a sense of
loss-of-control during eating – feeling driven or compelled to keep eating or
that stopping once one has started is difficult – is the most significant
element of binge-eating episodes regardless of how much food is consumed,
according to the researchers.
“This sense of loss of control is experienced across a range
of eating disorder diagnoses: bulimia nervosa, binge eating disorder and the
binge-eating/purging subtype of anorexia nervosa,” said Berner. “We wanted to
see if a measurable biological characteristic could help predict who goes on to
develop this feeling, as research shows that individuals who feel this sense of
loss of control over eating but don’t yet have an eating disorder are more likely
to develop one.”
“This sense of loss of control is experienced across a range
of eating disorder diagnoses: bulimia nervosa, binge eating disorder and the
binge-eating/purging subtype of anorexia nervosa,” said Berner.
“We wanted to see if a measurable biological characteristic
could help predict who goes on to develop this feeling, as research shows that
individuals who feel this sense of loss of control over eating but don’t yet
have an eating disorder are more likely to develop one."
Using a large dataset that followed female college freshman
for two years, the researchers preliminarily investigated whether body fat
distribution is linked to body dissatisfaction over time and increases risk for
the development or worsening of loss-of-control eating.
The nearly 300 young adult women completed assessments at
baseline, six months and 24 months, that looked at height, weight and total
body fat percentage and where it’s distributed. Participants, none of whom met
the diagnostic criteria for eating disorders at the start of the study, were
assessed for disordered eating behaviors through standardized clinical
interviews in which experiences of sense of loss of control were self-reported.
In this sample, the researchers found that women with greater
central fat stores, independent of total body mass and depression levels, were
more likely to develop loss-of-control eating and demonstrated steadier
increases in loss-of-control eating episode frequency over time.
Women with a larger percentage of their body fat stored in the
trunk region were also less satisfied with their bodies, regardless of their
total weight or depression level.
The findings indicate that storage of body fat in trunk and
abdominal regions, rather than elsewhere in the body, is more strongly predictive
of loss-of-control eating development and worsening over time, and that larger
percentages of fat stored in these central regions and body dissatisfaction may
serve as maintenance or exacerbation for loss-of-control eating.
“Our results suggest that centralized fat deposition increased
disordered eating risk above and beyond other known risk factors,” said Berner.
“The specificity of our
findings to centralized fat deposition was also surprising.
“For example, a one-unit increase in the percentage of body
fat stored in the abdominal region was associated with a 53 percent increase in
the risk of developing loss-of-control eating over the next two years, whereas
total percentage body fat did not predict loss-of-control eating development.”
According to Berner, more research is needed to explain the
mechanism behind these findings, though she speculates that there are a number
of reasons why this might happen.
“It’s possible that this kind of fat distribution is not only
psychologically distressing, but biologically influential through, for example,
alterations in hunger and satiety signaling,” she said.
“Fat cells release signals to the brain that influence how
hungry or satiated we feel. Our study didn’t include hormone assays, so we
can’t know for sure, but in theory it’s possible that if a centralized
distribution of fat alters the hunger and satiety messages it sends, it could
make a person feel out of control while eating.”
The findings may apply to other disordered eating behaviors
beyond loss-of-control eating, but more research is needed.
“Body fat distribution hasn’t been studied in disorders
characterized by binge-eating behaviors as much as it has in anorexia nervosa,”
said Berner.
“The participants in our sample didn’t develop eating disorder
diagnoses within the two year period that we studied them, but this study
suggests that future research should investigate whether individuals with
greater central fat stores are more likely to develop bulimia nervosa and binge
eating disorder."
