(PS8-A11) The Psychological Phenotype of Older Women with Binge Eating

Background:  Eating disorders (ED) are serious psychiatric illnesses that often present with comorbid mental and physical health problems. ED research historically focused on female adolescents, yet recent evidence suggests that EDs are also prevalent in older women. Among this population, binge eating (BE) is the most common form of disordered eating (e.g.,12-26%). Little is known, however, about the psychological characteristics of older adult women with BE. Thus, the objective of this study was to describe the psychological phenotype, including health behaviors and psychiatric comorbidities, of older women with BE.

Method: We enrolled 21 older women (60+ years; M age = 66.0±4.59) with active BE at the clinical frequency of ³weekly episodes. Participants completed measures of BE severity, depression, anxiety, sleep/insomnia, body appreciation, social isolation, positive affect, and nutrition. BMI was measured objectively in the lab (M = 35.08±8.64 kg/m²); current BE frequency and BE age of onset were identified through clinical interview. For measures with clinical cutoffs, frequencies of psychiatric comorbidities are presented. For measures without clinical cutoffs, we conducted partial correlations controlling for BMI to determine the relations between BE severity and other psychological constructs.

Results: The majority of participants reported BE age of onset in midlife (age 42-55; 28.6%) or later (age 56+; 42.9%), while only 28.6% (n=6) reported youth onset with either chronic course (n=4) or a remit/relapse pattern (n=2). Regarding BE severity, 19/21 participants reported moderate (38.1%) or severe (52.38%) symptoms, indicating there was significant distress and feeling out of control of eating behaviors. The majority (61.9%) met the clinical cutoff for depression; 57.1% met the clinical cutoff for anxiety. Regarding current sleep quality, 81.0% reported severe sleep problems; 42.9% had subthreshold insomnia and 23.8% met criteria for clinical-level insomnia. Controlling for BMI, BE severity was significantly correlated with body appreciation (r = -.478, p = .015), social isolation (r = .456, p = .022), positive affect (r = -.463, p = .02), and nutritional intake (r = .557, p = .005). All models had moderate to large effect sizes.

Conclusions: Though data are cross-sectional, findings suggest BE in later life is accompanied by psychiatric comorbidities and poorer health behaviors, comprising a psychological phenotype that likely impacts wellbeing and quality of life for older women. Future research is needed to disentangle temporal relations of psychiatric comorbidities with BE, and to develop BE interventions tailored to meet the unique needs of the older adult population.