Cognitive function in morbidly obese individuals with and without binge eating disorder

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Abstract

Objective

Obesity is associated with poorer cognitive function and impulsivity, which may contribute to binge eating disorder (BED). The objective of this study was to compare cognitive function in morbidly obese individuals with and without BED.

Method

A total of 131 morbidly obese individuals (41 with past or present BED, 90 with no BED history) completed a computerized battery of cognitive tests including executive, memory, language, and attention.

Results

Both groups of participants evidenced high rates of cognitive impairment; however, no significant differences emerged between persons with and without BED on cognitive testing. Comparison of persons without BED, current BED, and past BED also yielded no differences.

Discussion

In the present sample, morbidly obese individuals with and without BED were clinically indistinguishable on tests of cognitive function. Our findings suggest that obesity, rather than binge eating, may be more directly related to cognition. Future studies should further examine this relationship because it might provide greater insight into the neural mechanisms for this BED.

Section snippets

Cognitive function in individuals with and without binge eating disorder

Binge eating disorder (BED) involves the consumption of an objectively large amount of food with an associated loss of control over eating, in the absence of extreme compensatory weight control behaviors [1]. Binge eating disorder occurs in approximately 2% of the general population and up to 30% of those in weight loss treatment programs [2]. Persons with BED are more likely to be obese and have elevated rates of mental health comorbidities, including suicide attempts [3], [4], [5].

Loss of

Methods

All procedures were approved by the appropriate institutional review boards, and all participants provided written informed consent before study involvement.

Demographic and medical characteristics

Of the 131 participants in our sample, 41 met criteria for a lifetime history of either subthreshold BED or full BED. The average age of the sample was 42 years (SD, 10.8 years) and average BMI was 45.0 kg/m2 (SD, 6.42 kg/m2). Independent-samples t tests and χ2 found no differences in age, BMI, sex, sleep apnea, diabetes, hypertension, current major depressive disorder, current generalized anxiety disorder, or current bulimia nervosa (see Table 1).

No differences in prevalence of clinical impairment

Clinically meaningful levels of cognitive

Discussion

The goal of the current study was to examine possible cognitive test differences in a sample of morbidly obese persons with and without BED. Eating disorders such as anorexia nervosa and bulimia nervosa have long been associated with neurocognitive deficits [21], [22], [23], and 2 recent studies found that persons with BED demonstrate reduced performance on tests of executive function [9], [10]. Although both groups evidenced high rates of cognitive impairment, no differences in executive

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      However, differences between obese individuals with and without BED are less clear. While some literature suggests that obesity and its heterogeneous manifestations are generally associated with cognitive deficits (Galioto et al., 2012), others suggest a separate “obese + BED” phenotype, linked to deficits in inhibitory control and decision-making (Danner et al., 2012; Kittel et al., 2017). A commonly used measure of decision-making in eating disorder studies is the Iowa Gambling Task (IGT).

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    Data collection supported by DK075119. Manuscript supported in part by HL089311.

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