Objective: Binge eating and associated eating disorders are characterized by abnormalities in reward processing. One component of reward is willingness to expend effort to obtain a reinforcer. The Effort Expenditure for Rewards Task (EEfRT) is a widely used behavioral measure of willingness to work for money. We sought to modify the EEfRT to examine willingness to work for food reward and to preliminarily examine the association between binge eating and effort expenditure for food.
Method: Participants were 63 females recruited to span the spectrum of binge-eating severity. The modified EEfRT required participants to make a series of choices between an easier, low-reward option (one portion of food) and a harder, high-reward option (between two to five portions of food). Each trial also varied on probability of winning.
Results: Participants self-reported engagement in the task, working hard at easy and hard tasks, and making choices based on reward probability and magnitude. As with the original EEfRT, probability, reward magnitude, and their interaction predicted the likelihood of choosing the hard task. Across two different measures, binge-eating symptoms interacted with reward magnitude, such that those with high binge eating used reward magnitude more to make trial choices than those with low binge eating.
Discussion: These data provide initial support for the validity of the EEfRT modified for food as a behavioral measure of willingness to work for food reward. The impact of binge eating on effort expenditure must be replicated in samples of patients with eating disorders.
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http://dx.doi.org/10.1002/eat.22999 | DOI Listing |
Health Aff Sch
January 2025
Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90024, United States.
Prior research demonstrates that local government spending on social policies, excluding health care, is linked to improved population health. Whether such spending is associated with better access to primary care and reduced acute care utilization remains unclear. In this cross-sectional study, we evaluated the associations between county-level social spending and individual-level health care utilization among low-income Medicare beneficiaries, aged ≥65 years, from 2016 to 2018.
View Article and Find Full Text PDFMedicina (Kaunas)
January 2025
School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland.
Adherence to therapy, defined as the extent to which a patient follows prescribed therapeutic recommendations, is a pivotal factor in the effective management of chronic diseases such as diabetes, hypertension, and cardiovascular conditions. This review highlights the profound influence of adherence on clinical outcomes, healthcare costs, and patient quality of life. Despite its critical importance, non-adherence remains a pervasive challenge globally, contributing to suboptimal treatment results, higher rates of complications, increased hospitalizations, and substantial healthcare expenditures.
View Article and Find Full Text PDFAm J Manag Care
January 2025
Schaeffer Center for Health Policy & Economics, University of Southern California, 635 Downey Way, Verna & Peter Dauterive Hall, Los Angeles, CA 90089. Email:
Objectives: To assess trends in the medical loss ratio (MLR) and understand how health insurance premiums in the large group market are driven by medical claims spending and insurer margins.
Study Design: Study of approximately 500 insurers covering more than 40 million lives annually in the large group market that submitted an MLR submission form (2014-2022).
Methods: We assessed trends in the MLR, premiums, medical claims spending, administrative costs, quality improvement spending, and margins among all insurers in the large group market.
Front Med (Lausanne)
January 2025
Ethiopian Statistical Services, Bahirdar, Ethiopia.
Background: Irrational use of medicines is a problem globally that soon needs to be addressed. According to estimates from the World Health Organization, almost half of all medications were improperly prescribed. This study aimed to assess the drug prescribing patterns based on World Health Organization drug use indicators in the dermatology outpatient department of Injibara General Hospital.
View Article and Find Full Text PDFChin Med J (Engl)
January 2025
Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application (Beijing Hospital), Beijing 100730, China.
Background: The use of potentially inappropriate medications (PIMs) is a major concern for medication safety as it may entail more harm than potential benefits for older adults. This study aimed to explore the prescribing rate, healthcare utilization, and expenditure of older adults using PIMs in China.
Methods: A cross-sectional analysis was conducted using a national representative database of all medical insurance beneficiaries across China, extracting ambulatory visit records of adults aged 65 years and above between 2015 and 2017.
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