Projects
Researchers: Ricarda Schmidt (PI), PhD, Anja Hilbert (PI), PhD
Doctoral students: Lorenz Hack, Josefa Ilg, Lena Kramer, Anne-Kathrin Merz, Alexander Nettlau, Moritz Schumacher
Summary:
Avoidant/restrictive food intake disorder (ARFID) is a relatively new diagnosis, introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013) and the International Classification of Diseases (ICD-11; WHO, 2022) as an expansion of earlier feeding disorder classifications. ARFID is characterized by highly restrictive eating behaviors that lead to significant health or psychosocial impairment, such as weight loss, nutritional deficiencies, dependence on tube feeding, or severe functional impairment, without concerns about body weight or shape. Instead, ARFID often arises from sensory sensitivities, food-related fears, or emotional difficulties. Although ARFID is frequently observed in clinical settings, systematic research is still limited. Existing studies suggest similarities to anorexia nervosa (e.g., low body weight, anxiety, medical comorbidities) but also important differences, including fewer concerns about body image. Risk factors remain poorly understood but may include altered appetite regulation, heightened sensitivity to taste, anxiety traits, or early traumatic oral experiences. For diagnosis, structured interviews and a few screening questionnaires exist, but no validated tool reliably distinguishes ARFID with high sensitivity and specificity. Such an instrument would be critical for clinical practice, research, and estimating prevalence in the general population. The present study thus focuses on two aims: First, to provide a detailed clinical characterization of ARFID and explore potential risk and maintaining factors. Second, to develop and validate a questionnaire for both diagnostic and dimensional assessment of ARFID, following international standards of measure development.
Funding: Internal funds of the Behavioral Medicine research unit
Project number: 233/23-ek
Duration: 11/2023 – 03/2026
Noradrenergic control of neurobehavior in human binge-eating disorder and obesity (NOBEAD)
Researchers: Swen Hesse (PI), MD, Anja Hilbert (PI), PhD, Franziska Zientek, PhD, Michael Rullmann, PhD, Kerstin Mayer-Carius, PhD
Cooperation partner: Adrienne S. Juarascio, PhD, Guido K. W. Frank, MD
Summary:
The neurobehavioral underpinnings of binge-eating disorder (BED), which co-occurs with obesity (OB), are largely unknown. This research project conceptualizes BED as a disorder with dysfunctional emotion regulation (ER) linked with changes in central noradrenaline (NA) transmission and NA-modulated neuronal networks. To assess the role of NA transmission in BED, we aim to quantify changes of NA transporter (NAT) availability using the highly NAT-specific [11C]methylreboxetin (MRB) and positron emission tomography-magnetic resonance imaging (PET-MRI) technology that allows to measure molecular and functional (neuronal) changes simultaneously before and after an ER intervention. Acceptance-based behavioral therapy augmented by ecological momentary intervention via smartphone application will be applied for the improvement of ER. By obtaining biological and behavioral markers, the proposed study will further disentangle the involvement of NAT and central NA system in the modulation of neuronal networks that influence eating behavior. We expect abnormalities in NA activity in both BED and OB as a key molecular target of pathological overeating, which is likely to be most pronounced in BED. We further expect that these abnormalities are modifiable through state-of-the-art ER intervention, specifically in individuals with BED. Individuals with OB and BED (OB+BED), individuals OB without BED (OB-BED), and individuals with normal weight (NW) will undergo assessments of NAT availability and of neuronal network activity under rest and stimulated conditions as well as behavioral assessments including clinical interviews and self-report questionnaires on eating behavior, ER, mental and physical health, and quality of life, and neuropsychological tests on executive function. Thereafter, in an experimental randomized-controlled trial, individuals with OB+BED and OB-BED will be randomized to smartphone-supported ER intervention versus waitlist and will be re-assessed after 10 weeks. These data will provide a molecular signature beyond functional imaging biomarkers as a marker towards precision medicine tailoring treatments for individuals with BED and OB. Neurobehavioral mechanisms of change in ER intervention will be determined.
Funding: German Research Foundation
Project number: 933100-042
Duration: 04/2022 – 12/2026
Smartphone-supported behavioral weight loss treatment in adults with severe obesity: An exploratory randomized-controlled study (SmartBWL)
Researchers: Anja Hilbert (PI), PhD, Claudia Hübner, PhD, Rebekka Ried, MSc
Cooperation partner: Adrienne S. Juarascio, PhD
Summary:
Behavioral weight loss (BWL) treatment is the standard treatment for severe obesity (SO; body mass index ≥ 35 kg/m²), a common chronic health condition. BWL leads to moderate weight loss, which often, however, cannot be maintained in the long term. How successfully a patient loses weight depends on the extent to which therapeutic weight loss skills are used in daily life. For optimal weight loss, it is therefore central to support skills use in everyday life, for example, regarding lifestyle and emotion regulation. The exploratory clinical trial SmartBWL aims to apply a cognitive-behavioral smartphone application (app) to BWL treatment that supports a patient individually when he/she needs it most. Following a patient-oriented approach, the app, originally developed for cognitive-behavioral therapy of eating disorders (bulimia nervosa, binge-eating disorder), will be adapted, piloted, and optimized for BWL treatment in patients with SO. In a randomized-controlled exploratory trial with adults with SO, it will be examined if the use of the app adjunctive to BWL treatment improves weight loss, skills use, and well-being compared to BWL treatment alone and if it is feasible and acceptable for patients. Positive results of this study will form the basis for a large-scale clinical trial investigating the app's long-term efficacy, which is a prerequisite for making it widely available to people with SO in BWL treatment.
Funding: German Federal Ministry of Education and Research
Project number: 933100-038
Duration: 04/2021 – 08/2025
SMARTPHONE-SUPPORTED COGNITIVE-BEHAVIORAL THERAPY FOR BINGE-EATING DISORDER (SmartCBT)
Researchers: Anja Hilbert (PI), PhD, Carl Bartl, MSc
Cooperation partner: Adrienne S. Juarascio, PhD
Summary:
Binge-eating disorder (BED) is the most common clinical eating disorder characterized by recurrent binge-eating episodes in the absence of extreme compensatory behaviors to prevent weight gain. It is associated with severe eating disorder and general psychopathology, mental comorbidity, obesity and related medical conditions as well as significant impairment of quality of life and psychosocial functioning, resulting in increased health care costs. Cognitive-Behavioral Therapy (CBT) is the most well established treatment for BED and leads to sustained remission of eating disorders in 50% of patients. A further increase in the efficacy of CBT for BED is therefore urgently needed. To ensure that patients benefit optimally from CBT, it is essential to support them in using the skills they have learned during CBT in everyday life. New mobile health (mHealth) technologies, such as smartphone applications (apps), make it possible to offer personalized support in everyday life when the patient needs it most (e.g., in a very negative mood, which often leads to binge eating). A prerequisite for such an app support is the recording and timely evaluation of psychological symptoms and skills use in everyday life in order to offer personalized assistance via smartphone in critical situations (e.g., guidance on the use of therapeutic skills for emotion regulation). The aim of this research project is to specify and expand a smartphone app developed and tested for bulimia nervosa for patients with BED and to evaluate feasibility, acceptance, and skills use in an exploratory randomized-controlled treatment study, as well as to assess the additional efficacy compared to CBT alone. This research is essential for optimizing the efficacy of psychotherapy for BED and improving the outpatient care of these patients cost-effectively. In addition, it has the potential to significantly advance medical technology progress in the development of personalized health-related smartphone apps using artificial intelligence.
Funding: Roland Ernst Foundation for Health Care
Project number: 933100-032
Duration: 04/2020 – 09/2022
CARE-FAM-NET: CHILDREN AFFECTED BY RARE DISEASE AND THEIR FAMILIES – NETWORK
Study center Leipzig: Anja Hilbert, PhD, Wieland Kiess, MD, Lisa Koziel, MSc, Dagny Kühner, MSc, Skadi Beblo, MD, Alena Thiele, PhD
Consortium management at University Medical Center Hamburg-Eppendorf: Silke Wiegand-Grefe (PI), PhD, Jonas Denecke, MD
Summary:
About two million children and adolescents in Germany live with a rare chronic disease. Their families are often affected by fears, insecurities, and worries. CARE-FAM-NET is a multicenter study aimed at improving the psychosocial care of these children and their families. Within this study, families receive comprehensive psychological diagnostics, early detection, and treatment of mental illness. Two new interventions are being evaluated for this purpose. CARE-FAM is a family-oriented intervention with 6-8 sessions per family over a period of six months, including consultations with the parents, with the affected child and its siblings, and the whole family. The structure of the sessions and the general procedure follow a treatment manual. WEP-CARE is based on the principles of cognitive-behavioral writing therapy and is directed to the parents of affected children. Parents complete ten standardized writing tasks within ten weeks and receive regular feedback from trained specialists. We expect that the interventions will lead to a sustainable improvement in mental health and health-related quality of life of the families.
Funding: Innovation Fund
Project number: IFBADI-034
Duration: 10/2018 – 09/2022
NEAR INFRARED SPECTROSCOPY – NEUROFEEDBACK FOR PATIENTS WITH BINGE-EATING DISORDER (NIRSBED)
Researchers: Anja Hilbert (PI), PhD, Ricarda Schmidt, PhD, Birgit Fuchs, MSc, Rika Otsubo, MSc, Pia Schermaul, MSc, Marius Huber, MSc
Cooperation partner: Ann-Christine Ehlis, PhD
Summary:
Binge-eating disorder (BED) is the most prevalent eating disorder in the adult population. Patients with BED suffer from recurrent binge-eating episodes, defined as eating large amounts of food accompanied by a sense of loss of control over eating, which occurs in the absence of regular inappropriate compensatory behaviors to prevent weight gain. Research indicated that patients with BED show impairment in dealing with food, for instance, an increased food-related impulsivity. These deficits are mirrored neurologically in a differential activation of particular brain areas related to reward sensitivity and self-control in response to disorder-relevant cues, such as food stimuli. Until recently, there has been no specific brain-directed treatment targeting food-related impulse control so far in patients with BED, which could improve impulsive symptoms and weight management. Neurofeedback is a computer-based training method, which allows participants to perceive and to regulate their own brain activity. Electroencephalography (EEG) is a frequently used non-invasive imaging method, which visualizes electrical activity of the brain. Initial evidence exists on the efficacy of EEG neurofeedback using food stimuli to improve binge eating in patients with BED. A novel approach of neurofeedback uses functional near-infrared spectroscopy (fNIRS), an optical imaging method, which allows for non-invasive in vivo measurement of changes in the concentration of oxygenated and deoxygenated hemoglobin in brain tissue. Studies using fNIRS neurofeedback in the treatment of BED are lacking so far. Hence, the goal of this randomized-controlled trial is to evaluate the feasibility and efficacy of fNIRS neurofeedback compared to EEG neurofeedback in patients with BED and overweight or obesity.
Funding: Federal Ministry of Education and Research
Project number: AD2-7110
Duration: 11/2017 – 12/2020
LONGITUDINAL ASSESSMENT OF BARIATRIC SURGERY: PSYCHOSOCIAL ASPECTS (PRAC)
Researchers: Anja Hilbert (PI), Arne Dietrich, MD, Ricarda Schmidt, PhD, Tina Schwalbe, BSc, Claudia Hübner, PhD, Lisa Schäfer, MSc
Summary:
Bariatric surgery maximizes long-term weight loss and psychosocial functioning. However, a significant proportion of patients experience poor weight-loss outcome and weight regain over time. Although there is first evidence that maladaptive eating and lifestyle behaviors (e.g., loss of control eating) or general psychopathology are associated with bariatric surgery outcome, longitudinal bariatric surgery cohorts with a long-term follow-up of a comprehensive assessment of psychosocial aspects are widely lacking. Based on the multicenter longitudinal Psychosocial Registry for Bariatric Surgery (PRAC) established in 2012, the present research project aims at extending the data record and the long-term assessments for up to 8 years following surgery. All bariatric surgery candidates at the Integrated Research and Treatment Center AdiposityDiseases will be approached for first inclusion in PRAC prior to surgery and repeated bi-annual or annual follow-up assessments. For the in-depth examination of diverse psychosocial aspects, state-of-the-art interviews and self-report questionnaires are used, for example, on forms of non-normative eating behaviors, psychopathology, personality characteristics, such as impulsivity, self-esteem, and experiences of weight stigma. In order to minimize attrition, extensive effort is placed on retention strategies. The overarching goal of PRAC is to elucidate the association between psychosocial factors and bariatric surgery outcome in the long term and to allow for identification of patients at increased need for post-bariatric behavioral treatment.
Funding: Federal Ministry of Education and Research
Project number: AD2-6C90
Duration: 5/2015 – ongoing
GENERAL AND FOOD-SPECIFIC IMPULSIVITY BEFORE AND AFTER BARIATRIC SURGERY: AN EYE-TRACKING STUDY
Researchers: Lisa Schäfer (PI), MSc, Anja Hilbert, PhD
Summary:
Bariatric surgery (BS) is the most effective treatment for severe obesity, usually leading to significant weight loss and improvements in patients' medical, psychosocial, and cognitive functioning. However, little is known about the effects of BS on impulsivity. Impulsivity, particularly towards food, is a potential risk factor for increased energy intake and weight regain after behavioral and surgical weight-loss treatment. To date, only two studies have longitudinally investigated impulsivity after BS so far, indicating that general impulsivity did not change after BS, whereas food-specific impulsivity significantly decreased. The interpretation of these studies is especially limited by small sample sizes, a missing control group, or lacking prospective design. For the first time, this prospective, longitudinal study aims to assess general and food-specific impulsivity in bariatric patients from pre- to one year postsurgery in comparison to a body mass index-, sex-, and age-matched control group without BS. Different aspects of impulsivity (e.g., attention bias for visual food cues, reward sensitivity, inhibition) were assessed using a variety of methods (e.g., eye-tracking, neuropsychological tasks, self-report questionnaires) and both food and non-food stimuli-related assessments. Additionally, associations between attentional processing, impulsivity, postbariatric weight loss, and general and eating disorder psychopathology were analyzed.
Funding: MD Pro 2 Program by of the IFB AdiposityDiseases, University of Leipzig
Project number: AD2-0304
Duration: 7/2018 - 6/2019
CLINICAL DESCRIPTION AND ASSESSMENT OF AVOIDANT/ RESTRICTIVE FOOD INTAKE DISORDER IN CHILDREN WITH OBESITY
Researchers: Ricarda Schmidt (PI), PhD, Anja Hilbert, PhD
Summary:
While about half of the children with an eating disorder in middle childhood met the diagnostic criteria of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) for anorexia nervosa or bulimia nervosa, approximately half were diagnosed with an unspecified eating disorder. With the aim of specifying and reducing this residual category of eating disorders, "avoidant/restrictive food intake disorder" (ARFID) was included in the most recent version of the DSM (DSM-5). ARFID is characterized by the persistent and clinically significant failure to meet nutritional and/or energy needs, which is not due to body image problems. The motivation for food avoidance or restriction is only partially explored so far; in particular, a lack of interest in food and eating, sensory sensitivities, food-related anxieties, or emotional problems are assumed. To date, there has been little research into diagnostic methods and prevalence rates of ARFID as well as its clinical features and presentations, especially in the context of childhood obesity. However, there is evidence that children with obesity show specific nutritional deficiencies and selective eating behaviors. The first aim of this study was therefore to comprehensively evaluate the symptomatology of restrictive eating behaviors in children with obesity. To this end, children with obesity aged between 8 and 13 years were assessed using a newly developed interview to make a diagnosis of ARFID via self-report and parental report, questionnaires on eating disorder psychopathology, and a food diary to record the actual food intake. For weight-specific analyses, ARFID was also studied in children with underweight and normal weight. The second objective was to validate the newly developed ARFID interview module, which will allow for a standardized assessment of ARFID for the first time.
Funding: PostDoc Program of the IFB AdiposityDiseases, University of Leipzig
Project number: AD2-7106
Duration: 6/2017 - 4/2020
COGNITIVE REMEDIATION THERAPY FOR ADULTS WITH OBESITY – A RANDOMIZED-CONTROLLED EFFICACY STUDY (CRT)
Researchers: Anja Hilbert (PI), PhD, Claudia Hübner, PhD, Marie Blume, MSc
Cooperation partner: Phillipa Hay, MD
Summary:
Individuals with obesity (i.e., an excess of body fat) show deficits in executive functioning, for example, difficulties in decision-making, planning, problem-solving, inhibition, and flexibility. Recently, these difficulties have been assumed to play an important role in weight-loss outcome in conservative and surgical obesity treatment. Despite the relevance of executive functioning in obesity, research has only begun to develop interventions to specifically improve these functions in this condition. Cognitive remediation therapy (CRT), a well-established treatment approach with a focus on neurocognitive functioning in a range of mental and physical disorders, has preliminary evidence in improving executive functions and weight loss in obesity, however, confirmatory support, especially for preparatory pre-weight loss use, is outstanding. This randomized-controlled trial aimed at determining the efficacy of CRT versus no treatment control condition in patients with obesity enrolled at the IFB Outpatient Unit before entering behavioral weight-loss treatment. It was hypothesized that individuals who received brief group-based CRT will show greater weight-loss outcome in subsequent behavioral weight-loss treatment, beyond improved executive functioning.
Funding: Federal Ministry of Education and Research
Project number: AD2-6C89
Duration: 5/2015 – 1/2019
EEG NEUROFEEDBACK FOR ADULTS WITH BINGE-EATING DISORDER
Researchers: Anja Hilbert (PI), PhD, Marie Blume, MSc
Summary:
Individuals with binge-eating disorder (BED) exhibit strong food cravings and have difficulties controlling their eating behavior, for example, cannot stop eating or prevent overeating. This behavior is similar to the craving and addictive behaviors that individuals with substance use disorder display. BED is characterized by recurrent binge eating defined as eating a large amount of food accompanied by a sense of loss of control over eating that occurs in the absence of regular inappropriate compensatory behaviors to prevent weight gain. Individuals with BED were found to show an increased impulsivity and impaired executive functioning including a diminished ability to suppress spontaneous action impulses, an increased reward sensitivity (e.g., for food), and reduced planning and problem-solving ability. Such deficits in executive functioning may impair healthy control of eating behavior and weight management. While psychological approaches have proven efficacious in the treatment of binge eating, interventions focusing on improving impulsivity and executive control are lacking. Electroencephalographic (EEG) neurofeedback is a form of biofeedback, which helps individuals learning to control their brain activity. Numerous studies on attention-deficit/hyperactivity disorder (ADHD) showed that EEG neurofeedback can significantly improve impulsivity, attention, and hyperactivity. Due to the high prevalence of BED and its psychological and physical sequelae, it is relevant to investigate new interventions, such as EEG neurofeedback as a treatment option. If EEG neurofeedback proves to be efficacious, it could be used as adjunct intervention in the treatment of BED. The research-guiding question for this study was whether EEG neurofeedback is suitable to reduce addictive-like eating behavior within a randomized-controlled trial on the feasibility, acceptance, and efficacy of EEG neurofeedback in individuals with obesity and BED.
Funding: Institute Danone Nutrition for Health e.V.
Project number: ADI-018
Duration: 3/2015 – 9/2018
EXAMINATION OF ELECTRO-PHYSIOLOGICAL BRAIN ACTIVITY AND PILOT RUN OF A NEWLY DEVELOPED EEG-NEUROFEEDBACK PARADIGM FOR IMPROVING SELF-REGULATION IN CHILDREN WITH OVERWEIGHT
Researchers: Ricarda Schmidt (PI), PhD, Claudia Hübner, PhD, Lisa Schäfer, MSc
Summary:
First part of the study (EEG): Functional magnetic resonance imaging studies indicated neuronal abnormalities in children with overweight. However, it remained unclear if these abnormalities can be found in electroencephalography (EEG) as well. Therefore, this research project aimed to examine differences in resting state and food-specific brain activity measured via EEG between children with overweight and normal-weight controls. EEG frequency band analyses were conducted in order to provide information on potentially abnormal brain activity (i.e., over- and under-activation) in children with overweight. Second part of the study (EEG neurofeedback training): Second goal was the development and evaluation of EEG neurofeedback training in children with obesity or food-specific impulsivity to increase general and food-specific self-regulation. The feasibility and efficacy of a high-beta neurofeedback paradigm was tested in a pilot study. During the EEG neurofeedback training, children received a visual feedback of their brain activity while processing food stimuli. They were instructed to regulate their EEG frequency band activity into a pre-defined range. It was hypothesized that the EEG neurofeedback training will enhance children's general as well as food-specific self-regulation.
Funding: Junior Research Program of the Medical Faculty of the University of Leipzig
Project number: IFBADI-024
Duration: 1/2017 – 6/2018
SOCIAL FACILITATION MAINTENANCE TREATMENT FOR ADULTS – A RANDOMIZED-CONTROLLED FEASIBILITY STUDY (SFM)
Researchers: Anja Hilbert (PI), PhD, Swen Hesse (Co-PI), MD, Claudia Hübner, PhD
Cooperation partner: Denise E. Wilfley, PhD
Summary:
The long-term success of behavioral weight loss (WL) treatment in adults is limited by substantial relapse. Until now, only a few weight loss maintenance (WLM) treatments for adults have been evaluated. This clinical trial investigated the feasibility of a Social Facilitation Maintenance (SFM) program for WLM that was specifically tailored to adults with obesity, who had undergone behavioral WL treatment at the Outpatient Unit of the Integrated Research and Treatment Center AdiposityDiseases. Based on the social-ecological model, the program had established cognitive-behavioral interventions on promoting a social support network to maximize long-term behavioral change on eating behavior and physical activity. In the trial, the 16-month SFM program was compared to a treatment as usual (TAU) control condition in N = 69 adults. It was hypothesized that patients receiving SFM treatment will sustain larger amounts of weight loss compared to the control group, with at least medium effect size. Feasibility was examined with a focus on recruitment process, attrition, assessment non-completion, and patients' program evaluation.
Funding: Federal Ministry of Education and Research
Project number: ADI-K7-62
Duration: 11/2013 – 4/2015
TREATMENT OF BINGE-EATING DISORDER IN ADOLESCENTS (BEDA)
Researchers: Anja Hilbert (PI), PhD, Rebekka Kittel, PhD, Ricarda Schmidt, PhD, Anne Tetzlaff, PhD, Anne Brauhardt, PhD
Summary:
Binge-eating disorder (BED) is characterized by repeated episodes of binge eating. This disorder is the most common eating disorder, occurs in both sexes, and is frequently associated with overweight and obesity. While studies have shown that BED in adults can be effectively treated by psychotherapy, evidence for adolescents is largely lacking. For adults with BED, cognitive-behavioral therapy is the standard psychological treatment. In this single-center randomized-controlled trial, the efficacy of a cognitive-behavioral treatment program tailored to adolescents with BED was evaluated. Building on evidence-based cognitive-behavioral therapy for adults with BED, the program adapted to adolescents aimed at establishing healthy eating behaviors that prevent binge-eating episodes from occurring and contribute to a stabilization of body weight. Further goals were the development of a positive body image and self-acceptance. Strategies for coping with negative emotions and problem solving in everyday life were acquired. After baseline diagnostics, 73 participants were randomized to one of two treatment conditions. Half of the participants immediately started with cognitive-behavioral therapy, the other half started therapy after a four-month waiting period. The treatment program included 20 individual sessions with the adolescent over four months. Additionally, parents were involved in the treatment via coaching. For participants of both treatment conditions, assessments were conducted at baseline (and for the delayed treatment control condition additionally two months prior to treatment and at the beginning of treatment), midtreatment, posttreatment, six-month follow-up, and 12-month follow-up. It was expected that cognitive-behavioral therapy will significantly reduce episodes of binge eating when compared to the delayed treatment control condition. It was further expected that the specific eating disorder psychopathology, general psychopathology, body weight, quality of life, and self-esteem will be significantly improved.
Funding: Federal Ministry of Education and Research
Project number: ADI-K7-16
Duration: 9/2011 – 4/2015
PSYCHOSOCIAL REGISTRY FOR BARIATRIC SURGERY (PRAC)
Cooperating Centers: Anja Hilbert (PI), PhD, Holger Till (Leipzig, Co-PI), MD, Christian Jurowich (Würzburg), MD, Beate Herbig (Hamburg), MD, Wolfgang Tigges (Hamburg), MD, Stefan Kaiser (Konstanz), MD
Summary:
Bariatric surgery is the treatment of choice for morbid obesity, resulting in a long-term weight loss and an improvement of medical comorbidity after bariatric surgery. Yet, a substantial number of patients show either no or only insufficient weight loss and weight regain over time. Although no robust predictors for treatment success were identified, there is evidence that bariatric surgery influences eating behavior and psychosocial adjustment and that these factors are relevant for postoperative weight control. The present registry on the longitudinal assessment of psychosocial parameters in bariatric surgery (PRAC) included a comprehensive assessment of the psychosocial aspects of bariatric surgery in a consecutive sample of adolescent and adult patients. Eating behavior, psychopathology, quality of life, and other psychosocial variables were prospectively documented, using state-of-the-art psychometric instruments.
Funding: Federal Ministry of Education and Research
Project number: ADI-K7-25
Duration: 9/2011 – 4/2015
CHILDHOOD EATING AND FOOD INTAKE DISORDERS
Researchers: Anja Hilbert (PI), PhD, Wieland Kiess (Co-PI), MD
Summary:
Eating disturbances in childhood are common, but the nosology remains largely unclear. Only about half of the children from middle childhood diagnosed with an eating disorder fulfill the diagnostic criteria of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR) for anorexia nervosa (AN) or bulimia nervosa (BN), whereas the remainder is diagnosed as an eating disorder not otherwise specified. There is increasing evidence that binge-eating disorder (BED), characterized by recurrent episodes of binge eating in the absence of regular compensatory behaviors, presents in a child-specific way, which was, however, not specified in the DSM. The DSM-5 has recently included Avoidant/Restrictive Food Intake Disorder (ARFID) as a new diagnostic category to capture food restrictions resulting in a persistent failure to meet appropriate nutritional and/or energy needs. All these eating or food intake disorders have significant impact on body weight (obesity or underweight) and impairments in physical or mental health. However, the epidemiology of these childhood eating or food intake disorders, their nosology, etiology, and course need further research. This project aimed at determining the prevalence and course of childhood eating and food intake disturbances, correlates and predictors, and implications for health and well-being based on the Leipzig Center of Civilization Diseases LIFE CHILD Health and LIFE CHILD Obesity studies. This research aimed at identifying targets of early intervention or prevention, in order to reduce chronicity and psychological, social, and medical sequelae, as well as associated societal and health care costs.
Project number: LIFE-206-Function 6 EU
Duration: 1/2014 – 12/2014
BINGE-EATING DISORDER IN CHILDHOOD
Researchers: Anja Hilbert (PI), PhD, Simone Munsch (Co-PI), PhD
Summary:
Recent research indicates that binge eating, referred to as loss of control (LOC) eating, is a common and psychopathologically relevant experience in childhood. LOC eating and the clinically significant binge-eating disorder (BED) are associated with increased eating disorder and general psychopathology and risk for overweight and obesity. However, it remains unclear which psychological and social factors contribute to the maintenance of LOC eating and how LOC eating relates to comorbid conditions such as attention-deficit/hyperactivity disorder (ADHD). The goal of this research project was to examine the eating behavior of children with BED in the context of psychological and familial maintaining factors, with special consideration of impulsivity, using experimental and naturalistic designs. 102 children ages 8-12 with and without BED and with ADHD were recruited from the community. A laboratory test meal study was conducted to examine psychological determinants of satiety, the reactivity and habituation to food cues, and hedonics in an eating in the absence of hunger design. The role of general compared to food-specific reward sensitivity in LOC eating was assessed in a computer task and a behavioral observation paradigm, and general and food-specific expressed emotions were examined by interview and behavioral observation. In a dyadic ecological momentary assessment study, child and parent perceptions of negative mood, events and interactions were explored as antecedents of LOC episodes in the naturalistic environment. The research project was expected to clarify the association between BED, obesity, and ADHD and to identify targets of early intervention or prevention of childhood BED that will help stabilize body weight or prevent excessive weight gain.
Funding: Swiss National Science Foundation
Project number: 100014_132045/1
Duration: 1/2011 – 12/2014
INTERNET-BASED GUIDED SELF-HELP FOR OVERWEIGHT AND OBESE PATIENTS WITH BINGE EATING DISORDER: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL
Researchers: Martina de Zwaan (PI), MD, Anja Hilbert (Co-PI), PhD
Cooperation partners: Hans-Christoph Friederich, MD, Stephan Herpertz, MD, Brunna Tuschen-Caffier, PhD, Stefan Zipfel, MD
Summary:
Cognitive-behavioral therapy (CBT) represents the most well-established treatment for binge-eating disorder (BED); however, most individuals with BED do not have access to this specialist treatment. Therefore, the aim of this multicenter, randomized-controlled trial was to evaluate the efficacy of internet-based guided self-help (GSH-I) compared with traditional face-to-face CBT. A total of 178 adult outpatients with full or subsyndromal BED was included and received either 20 individual, face-to-face CBT sessions or completed 11 internet modules with weekly email contact to a study coach. It was evaluated whether GSH-I would be noninferior compard to CBT in reducing the number of days with objective binge-eating episodes after the end of treatment (after 4 months) and up to 18 months post-treatment. This trial aimed at clarifying the role of eHealth technologies with low barriers of access for delivering psychotherapy.
Funding: Federal Ministry of Education and Research
Project number: 01GV0601
Duration: 1/2010 – 12/2013