Binge Eating More Likely to Lead to Metabolic Syndrome in Men

Deborah Brauser

September 26, 2013

Obese men with binge eating disorder (BED) are much more likely than their female counterparts to develop metabolic syndrome, new research suggests.

A study of nearly 200 obese adults with BED showed that the men were almost 3 times more likely than their female counterparts to meet criteria for metabolic syndrome. In addition, they had significantly higher blood pressure, triglyceride levels, and fasting glucose levels than women with BED.

The investigators note that these findings underline the importance of primary care screening for BED and for metabolic syndrome in men who are obese ― as well as including more of these men in clinical studies, where traditionally they have been underrepresented.

"A lot of primary care physicians are still not aware of [BED], particularly in men. Common thinking is still that eating disorders are women's problems," lead author Tomoko Udo, PhD, associate research scientist in the Department of Psychiatry at Yale University School of Medicine in New Haven, Connecticut, told Medscape Medical News.

"But, as we've shown in this study, this type of disorder can have significant impact on men's health," said Dr. Udo, adding that this is something that psychiatrists also need to be aware of.

The study was published online August 19 in General Hospital Psychiatry.

Metabolic Risk

The study included 190 treatment-seeking obese adults (74% women; mean age, 45.5 years). All participants had a body mass index (BMI) of 30 kg/m2 or higher and met or exceeded criteria for BED.

Ages at first onset of becoming overweight, dieting, and binge eating were determined with the Questionnaire for Eating and Weight Patterns–Revised. The Eating Disorder Examination and the Emotional Overeating Questionnaire were also administered.

Psychosocial characteristics were assessed using the Perceived Stress Scale, the Beck Depression Inventory, the Brief Self-Control Scale, and the Godin Leisure-Time Exercise Questionnaire.

In addition, height, weight, waist circumference, heart rate, blood pressure, fasting lipid profile, glucose levels, and glycated hemoglobin 1Ac (HbA1c) were measured for all participants.

Results showed "few significant differences" between the 2 sexes in current levels and history of eating disorder features or in psychosocial factors, the researchers report.

However, even after adjusting for race and BMI, the men with BED were significantly more likely than the women to meet the criteria for metabolic syndrome (odds ratio [OR], 2.98; 95% confidence interval [CI], 1.45 - 6.10; P < .01).

They also had significantly higher levels of fasting glucose, HbA1c, and triglycerides (all, P < .01); higher systolic blood pressure (P = .02); and a greater waist circumference than the women (P < .01).

The men also had significantly reduced high-density lipoprotein (HDL) levels (P < .01) and reported participating more frequently in strenuous exercise (P < .01).

Consistent Findings

Women reported dieting at a significantly younger age than the men (22 vs 30.5 years of age, P < .01). They also reported a younger age at first being overweight (P = .04) and a greater number of times dieting overall (P = .03) and dieting while supervised (P < .01).

There were no significant between-group differences in age of binge eating onset, emotional eating scores, depressive symptoms, or self-control.

Dr. Tomoko Udo

The investigators note that the overall findings show the importance of screening for and treating obesity and BED, especially in men, because of the strong association between metabolic syndrome and conditions such as cardiovascular diseases and type 2 diabetes.

"Primary care settings provide a potential valuable opportunity to implement interventions or to provide appropriate specialist referrals for obese patients with BED," they write.

Dr. Udo reported that in a recently completed study, she and her colleagues found that obese men with BED were at higher risk for metabolic problems compared with women even after controlling for menopause status in the women.

"So it seems to me that these findings are consistent," she said.

The study was funded by grants from the National Institutes of Health. Five of the 6 study authors, including Dr. Udo, have disclosed no relevant financial relationships. The sixth author reports receiving royalties from Guilford Press and Taylor and Francis Books for academic books.

Gen Hosp Psychiatry. Published online August 19, 2013. Abstract

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