Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic

Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.

Optical neuroimaging of executive function impairments in food addiction

This study investigated the neural mechanisms located in the prefrontal cortex(PFC)involved in maintaining addictive-like eating behavior.Therefore,we aimed toll a gap in the existing literature and help clarify the food addiction(FA)cycle by inspecting the relationship between the executive control and psychopathology involved in the FA cycle.Twenty-three students recruited from the University of Macao participated in this study.We investigated a hemodynamic response captured by NIRS recordings,activated during n-back,set-shifting,and go/nogo paradigms.Moreover,we investigated the FA symptoms through the YFAS clinical inventory to better understand the relationship between hemodynamic response and clinical symptomatology in college students.First,the hemodynamicndings conrm that altered cognitive control in executive function performance appears to be linked to addictive-like eating behaviors,which in turn conrms a circuit similarity between FA and the substance abuse population(SUD)as reported in previous fMRI studies.Secondly,the psychologicalndings conrm the signicant association between the working memory decits and symptoms severity which suggest the role of self-control and regulation in limiting the storage resources as a potential trigger to develop overconsumption episodes in the FA cycle.Ourndings highlight how disrupted self-control and regulation of craving and negative a®ect induced by mental imagery might shape and overload the working memory storage as a potential trigger to develop binge eating episodes to maintain the FA cycle.In conclusion,the use of fNIRS in the context of eating disorders studies represents a valuable application,noninvasive,and patientfriendly tool,providing new insights into understanding the addiction cycle and treatment guidelines.

Indoor tanning bed use and risk of food addiction based on the modified Yale Food Addiction Scale

The popularity of indoor tanning may be partly attributed to the addictive characteristics of tanning for some individuals.We aimed to determine the association between frequent indoor tanning,which we view as a sunogate for tanning addiction,and food addiction.A total of 67,910 women were included from the Nurses＇ Health Study II.In2005,we collected information on indoor tanning during high school/college and age 25-35 years,and calculated the average use of indoor tanning during these periods.Food addiction was defined as ≥3 clinically significant symptoms plus clinically significant impairment or distress,assessed in 2009 using a modified version of the Yale Food Addiction Scale.Totally 23.3%（15,822） of the participants reported indoor tanning at high school/college or age 25-35 years.A total of 5,557（8.2%） women met the criteria for food addiction.We observed a dose-response relationship between frequency of indoor tanning and the likelihood of food addiction（P_（trend）〈 0.0001）,independent of depression,BMI,and other confounders.Compared with never indoor tanners,the odds ratio（95%confidence interval） of food addiction was 1.07（0.99-1.17） for average indoor tanning 1-2 times/year,1.25（1.09-1.43） for 3-5times/year,1.34（1.14-1.56） for 6-11 times/year,1.61（1.35-1.91） for 12-23 times/year,and 2.98（1.95-4.57） for 24 or more times/year.Frequent indoor tanning before or at early adulthood is associated with prevalence of food addiction at middle age.Our data support the addictive property of frequent indoor tanning,which may guide intervention strategies to curb indoor tanning and prevent skin cancer.

Clinical efficacy observation of acupoint thread-embedding in treating obese patients with food addiction

Objective To observe the effects of acupoint thread-embedding therapy and low-carbohydrate diet therapy on obese patients with food addiction.Methods Sixty-five eligible patients were randomized into a thread-embedding group of 33 cases and a diet group of 32 cases to respectively receive 12-week treatment.Before treatment,after treatment and at 6-month follow-up,the two groups were observed and compared in terms of body mass(BM),waist circumference(WC),hip circumference(HC),waist-to-hip ratio(WHR),body mass index(BMI),body fat rate(BFR),basal metabolic rate(BMR)and Yale food addiction scale version 2.0(YFAS 2.0).Results At the end of treatment,there were no significant differences in the general efficacy,and the improvements in BM,BMI,WC,HC,WHR and BFR between the thread-embedding group and diet group(all P>0.05).At follow-up,the thread-embedding group showed more significant improvements in all the aforementioned indicators compared with the diet group except HC(all P<0.05).At the end of treatment and follow-up,BMR and YFSA 2.0 had more significant improvements in the thread-embedding group than in the diet group(all P<0.05).Conclusion Acupoint thread-embedding therapy can produce significant efficacy in treating obese patients with food addiction;it can improve the food addiction state and work better in maintaining the efficacy compared with low-carbohydrate diet therapy.

Clinical Food Addiction Is Not Associated with Development of Metabolic Complications in Liver Transplant Recipients

Background and Aims:Given the increased risk of posttransplant metabolic syndrome(PTMS;defined by hypertension,diabetes mellitus and hyperlipidemia),we aimed to identify the potential role of food addiction in the development of metabolic complications in the post-liver transplant population.Methods:Inclusion criteria included adult liver transplant recipients followed at our institution between June 2016 and November 2016.Participants were administered a demographic survey as well as the Yale Food Assessment Scale 2.0,a 35-item questionnaire used to assess frequency of food addiction in accordance with the DSM-V guidelines of substance use disorders.Demographic and clinical data were collected.Results:Our study included 236 liver transplant recipients(139 males,97 females).The median(interquartile range[IQR])BMI of participants was 26.8 kg/m2(24.2,30.4),and median(IQR)time since transplantation was 50.9 months(19.6,119.8).The prevalence rates of hypertension,hypercholesterolemia and diabetes mellitus were 54.7%,25.0%and 27.1%,respectively.Twelve participants(5.1%)were found to have a diagnosis of food addiction.A diagnosis of food misuse was made in 94(39.8%)of the transplant recipients.Conclusions:Our findings are consistent with prior data that indicate high prevalence of metabolic complications among liver transplant recipients.Food addiction was not predictive of metabolic complications within this population.Nevertheless,we found that this population was at high risk of demonstrating symptoms of food misuse,and they were not likely to appreciate the risks of pathologic patterns of eating.Given the increasing risk of cardiovascular morbidity and mortality in this population,efforts should be made to identify risk factors for the development of PTMS.