Remission of loss of control eating and changes in components of the metabolic syndrome

Abstract

Objective: Pediatric loss of control (LOC) eating prospectively predicts the worsening of metabolic syndrome components. However, it is unknown if remission of LOC eating is associated with improvements in metabolic health. Therefore, we conducted a secondary analysis of a trial that enrolled adolescent girls with LOC eating, examining whether LOC remission (vs. persistence) at end-of-treatment was associated with changes in metabolic syndrome components at 6-month follow-up.

Method: One hundred three adolescent girls (age 14.5 ± 1.7 years; BMI-z 1.5 ± 0.3; 56.3% non-Hispanic White, 24.3% non-Hispanic Black) with elevated weight (75th-97th BMI %ile) and reported LOC eating were assessed for metabolic syndrome components at baseline and again six months following the interventions. The main effects of LOC status at end-of-treatment (persistence vs. remission) on metabolic syndrome components (waist circumference, lipids, glucose, and blood pressure) at 6-month follow-up were examined, adjusting for baseline age, depressive symptoms, LOC frequency, fat mass, and height, as well as race, change in height, change in fat mass, and the baseline value of each respective component.

Results: Youth with LOC remission at end-of-treatment had lower glucose (83.9 ± 6.4 vs. 86.5 ± 5.8 mg/dL; p = .02), higher high-density lipoprotein cholesterol (50.3 ± 11.8 vs. 44.8 ± 11.9 mg/dL; p = .01), and lower triglycerides (84.4 ± 46.2 vs. 96.9 ± 53.7 mg/dL; p = .02) at 6-month follow-up when compared with youth with persistent LOC, despite no baseline differences in these components. No other component significantly differed by LOC eating status (ps > .05).

Discussion: Reducing LOC eating in adolescent girls may have a beneficial impact on some components of the metabolic syndrome.

Trial registration: ClinicalTrials.gov NCT00680979.

Keywords: adolescents; loss of control eating; metabolic syndrome; obesity; overweight.

Figure 1

Unadjusted means and standard errors for metabolic components at baseline and 6-month follow-up are shown by loss of control (LOC) eating status at end-of-treatment. A. Unadjusted means and standard errors for plasma glucose at baseline and 6-month follow-up are shown by LOC eating remission versus persistence at end-of-treatment for participants with data at both time points. After adjusting for covariates including baseline plasma glucose, youth with persistent LOC eating had significantly higher fasting plasma glucose than girls whose LOC eating whose LOC eating had remitted at 6-month follow-up (p = .02). B. Unadjusted means and standard errors for high-density lipoprotein cholesterol (HDL-C) at baseline and 6-month follow-up are shown by LOC eating remission versus persistence at end-of-treatment for participants with data at both time points. After adjusting for covariates including baseline HDL-C, youth with persistent LOC eating had significantly lower HDL-C than girls whose LOC eating whose LOC eating had remitted at 6-month follow-up (p = .01). C. Unadjusted means and standard errors for triglycerides at baseline and 6-month follow-up are shown by LOC eating remission versus persistence at end-of-treatment for participants with data at both time points. After adjusting for covariates including baseline triglycerides, youth with persistent LOC eating had significantly lower triglycerides than girls whose LOC eating had remitted at 6-month follow-up (p = .02).