Impulsivity and test meal intake in obese binge eating women Jennifer A. Nasser a, * , Marci E. Gluck a , Allan Geliebter a,b a Department of Medicine, NY Obesity Research Center, St Luke’s/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, WH-1020, 1111 Amsterdam Ave, New York, NY 10025, USA b Department of Psychiatry, NY Obesity Research Center, St. Luke’s/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA Received 5 March 2004; revised 13 April 2004; accepted 15 April 2004 Abstract Greater impulsivity has been observed in those with chemical (cocaine, marijuana, alcohol) and behavioral addictions (gambling, sex, shopping), as well as in individuals with personality and conduct disorders. Greater impulsivity has also been described in those with Bulimia Nervosa and attributed to aberrations in serotonin, as has eating in response to negative affect.However, less is known about the impact of impulsivity on eating behavior in obese humans in general, and in those who meet sub-clinical and full clinical criteria for Binge Eating Disorder (BED) in particular. Using a laboratory test meal paradigm, we demonstrated: (1) greater Motor Impulsivity (Barratt Impulsivity Scale (BIS) ðp ¼ 0:05Þ in those with BED ðn ¼ 11Þ as compared to those without BED ðn ¼ 11Þ; (2) a positive correlation between BED criteria and BIS scores ðp , 0:01Þ; (3) a positive correlation between test meal duration and Zung Depression Score, and (4) a positive correlation between Motor Impulsivity and mood rated before consuming the test meal. These associations suggest potential aberrations in serotonin transmission in BED, and a possible target for pharmacotherapy of BED especially in those who are resistant to Cognitive Behavioral Therapy. q 2004 Elsevier Ltd. All rights reserved. Keywords: Impulsivity; Binge eating; Obesity; Test meal intake Introduction Current literature define impulsivity as (1) the inclination to choose small, immediately available rewards over larger, delayed rewards, and/or (2) the inclination to respond rapidly without forethought and/or attention to consequences (Evenden, 1999; Swann, Bjork, Moeller, & Dougherty, 2002). Greater impulsivity has been reported in those with chemical (cocaine, alcohol, nicotine) (Allen, Moeller, Rhoades, & Cherek, 1998; Mitchell, 1999; Richards, Zhang, Mitchell, & de Wit, 1999) and behavioral addictions (gambling, sex, shopping) as well as in those with personality and conduct disorders (Hollander & Evers, 2002), where it correlates with severity of dependence or disordered state. Some investigators, using treatment program patients, report greater impulsivity in individuals with eating disorders compared to normal controls (Fahy & Eisler, 1993; Keel & Mitchell, 1997; Newton, Freeman, & Munro, 1993; Wolfe, Jimerson, & Levine, 1994). Bushnell et al. (1996) reports that rates of impulsivity in those with substance use disorder or Bulimia Nervosa (BN), who are not in treatment programs, are no greater than in the general population. Furthermore, he cautions that eating disorder patients in treatment programs, who often have multiple co-morbid conditions, may show greater impulsiv- ity and therefore not be representative of individuals with eating disorders in general. The lack of consistent association of impulsivity with treatment response lends support to Bushnell’s suggestion for caution. Wolfe et al. (1994) report that in BN patients, impulsivity did not correlate with frequency of binge eating episodes, while Fahy and Eisler (1993) and Keel and Mitchell (1997) found association between poor treatment response and high impulsivity in patients with BN. Steiger et al. (2001) demonstrated that impulsivity in women with BN is related to decreased serotonin functioning, and Fischer, Smith, and Anderson (2003) suggest that impulsivity in those with BN, correlates with eating in response to negative affect, which is also related to aberrant 0195-6663/$ - see front matter q 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.appet.2004.04.006 Appetite 43 (2004) 303–307 www.elsevier.com/locate/appet * Corresponding author. E-mail address: jnasser@att.net (J.A. Nasser).