Eliot, Alexandra O.; Baker, Christina Wood
Described a sample of eating disordered adolescent males who were seen for treatment at Boston Children's Hospital Outpatient Eating Disorders Clinic. Findings suggest the idea that clinicians, coaches, peers, and family should encourage young men to share concerns about body image and weight at an earlier, less severe juncture, with the assurance…
Ray, Shannon L.
Research indicates that the primary onset of eating disorders occurs in adolescence and that there is a growing prevalence of adolescent males with eating disorders. This article describes the eating disorders of anorexia nervosa and bulimia nervosa as they relate to adolescent males. Diagnostic criteria, at-risk groups, and implications for…
Eddy, Kamryn T.; Doyle, Angela Celio; Hoste, Renee Rienecke; Herzog, David B.; Le Grange, Daniel
A study to examine the kind of eating disorders not otherwise specified (EDNOS) among adolescents encountered during treatment at an outpatient eating disorder clinic is conducted. Results indicate that EDNOS is more predominant among adolescents seeking treatment for eating disorders.
Patel, Dilip R.; Greydanus, Donald E.; Pratt, Helen D.; Phillips, Elaine L.
Reviews research on eating disorders in adolescent athletes, including prevalence, its uncommonness among male athletes, risk factors, medical complications, prevention strategies, and implications for sport and exercise participation, management, and prognosis. (EV)
Muuss, Rolf E.
Examines anorexia nervosa, an eating disorder seen with increasing frequency, especially among adolescent girls. Presents five theories about causation, discusses early characteristics, typical family patterns, physical and medical characteristics, social adjustment problems, and society's contribution to anorexia. Describes course of the…
Massey-Stokes, Marilyn S.
Discusses unhealthy dieting behaviors that can lead to eating disorders during adolescence. Outlines ways middle school and high school teachers and administrators can aid in the prevention of disordered eating among adolescents. Lists resources for eating disorders awareness and prevention. (SR)
Ramirez, Maria E.; McIntosh, David E.; Kruczek, Theresa
Eating disorders, once thought to be exclusively a disorder of the more affluent Western countries, are now spreading around the world. Despite the wealth of information on the prevalence of eating disorders in developed countries, epidemiological data for South America is scarce. The 26-item Eating Attitude Test (EAT-26) was used to explore the…
Buser, Juleen K.
School counselors play an important role in identifying and intervening with students struggling with disordered eating (e.g., Bardick et al., 2004). Research has shown that American Indian adolescents report higher rates of certain disordered eating behaviors than other racial groups. The literature on the prevalence and etiology of disordered…
Shomaker, Lauren B; Furman, Wyndol
Perceived socio-cultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Most prospective studies included only girls, and less is known about the influence on boys. This study investigated interpersonal influences on changes in late adolescent boys' and girls' symptoms of disordered eating over one year. Participants were a community sample of late adolescents 16-19 years of age (N=199; 49.75% girls), their mothers, and friends. Structural equation modeling revealed that interpersonal pressure to be thin and criticism about appearance predicted increases in disordered eating over time. Late adolescents', mothers' and friends' reports of pressure were associated with disordered eating at Time 1 and Time 2. Further, adolescents' perceptions and friends' reports of pressure to be thin predicted changes in disordered eating over time. Findings underscore the significance of interpersonal relationships for disordered eating during late adolescence in both girls and boys.
Ponton, L E
Many review articles address the diverse and rapidly developing field of eating disorders, but there are far fewer articles addressing the specific population of adolescents. The social contributors (desire for thinness amplified by the media) to these illnesses are considerable and affect all adolescent and latency-age girls to some degree. Understanding the full range of behavior and those at high risk to develop pathology is important. Developing prevention programs that target adolescent girls and their families, schools, and the relevant media is also important. Prevention has been a much-neglected area within the field of eating disorders. The chronic nature of eating disorders characterized by remission and relapse bears further study. Attention to the factors that provoke a symptomatic period is crucial. Along with relapse and remission are shifts between diagnostic categories within the field of eating disorders and comorbid illnesses. A better understanding of the factors that cause these shifts to occur would be quite valuable. Outcome and prospective studies would provide valuable information about the course of the illnesses and further identify the individuals at high risk. Certain groups are known to be at high risk, such as girls involved in specific athletics (e.g., gymnastics) or career activities, but recent investigations have indicated that girls involved in what was previously believed to be a low risk activity, such as swimming, may also be at risk (Benson et al., 1990). Further investigation of these factors is crucial. Cultural factors play a role in these illnesses, and cross-cultural studies provide crucial information. We must also continue to explore the biological and psychological correlates of these illnesses and further define the complex and heterogeneous etiology of these illnesses. Their study still promises to yield exciting challenges. Increased public awareness regarding the need for treatment of these illnesses is a high
Golden, Neville H
Eating disorders are prevalent in adolescents and are associated with significant medical and psychiatric morbidity. Amenorrhoea, one of the cardinal features of anorexia nervosa, is the most likely reason for consulting the gynaecologist. Amenorrhoea in a young woman should alert the gynaecologist to the possibility of an underlying eating disorder. Osteopenia is a potentially irreversible complication of prolonged amenorrhoea and a low oestrogen state. Eating disorders are best managed by a team approach, with the team comprising a physician, nutritionist and therapist. Oestrogen replacement therapy has not been shown to be an effective treatment for osteopenia in anorexia nervosa and the gynaecologist should avoid simply prescribing oestrogen replacement therapy without referring the patient for comprehensive treatment of the eating disorder. Nutritional rehabilitation, weight restoration and resumption of spontaneous menses are the mainstay of medical management. Calcium and vitamin D supplementation and moderate weight-bearing exercise should be prescribed where indicated. Newer therapeutic options for the treatment of osteopenia include DHEA, IGF-1 and alendronate.
Bryla, Karen Y.
Disordered eating among American adolescent females represents a significant health issue in our current cultural climate. Disordered eating receives insufficient attention, however, due to the public's unfamiliarity with symptoms and consequences, absence of treatment options, and unreliable instrumentation to detect disordered eating. Disordered…
Gerbasi, Margaret E.; Richards, Lauren K.; Thomas, Jennifer J.; Agnew-Blais, Jessica C.; Thompson-Brenner, Heather; Gilman, Stephen E.; Becker, Anne E.
Objective The increasing global health burden imposed by eating disorders warrants close examination of social exposures associated with globalization that potentially elevate risk during the critical developmental period of adolescence in low- and middle-income countries (LMICs). The study aim was to investigate the association of peer influence and perceived social norms with adolescent eating pathology in Fiji, a LMIC undergoing rapid social change. Method We measured peer influence on eating concerns (with the Inventory of Peer Influence on Eating Concerns; IPIEC), perceived peer norms associated with disordered eating and body concerns, perceived community cultural norms, and individual cultural orientations in a representative sample of school-going ethnic Fijian adolescent girls (n=523). We then developed a multivariable linear regression model to examine their relation to eating pathology (measured by the Eating Disorder Examination-Questionnaire; EDE-Q). Results We found independent and statistically significant associations between both IPIEC scores and our proxy for perceived social norms specific to disordered eating (both p <.001) and EDE-Q global scores in a fully adjusted linear regression model. Discussion Study findings support the possibility that peer influence as well as perceived social norms relevant to disordered eating may elevate risk for disordered eating in Fiji, during the critical developmental period of adolescence. Replication and extension of these research findings in other populations undergoing rapid social transition—and where globalization is also influencing local social norms—may enrich etiologic models and inform strategies to mitigate risk. PMID:25139374
Golden, Neville H; Schneider, Marcie; Wood, Christine
Obesity and eating disorders (EDs) are both prevalent in adolescents. There are concerns that obesity prevention efforts may lead to the development of an ED. Most adolescents who develop an ED did not have obesity previously, but some teenagers, in an attempt to lose weight, may develop an ED. This clinical report addresses the interaction between obesity prevention and EDs in teenagers, provides the pediatrician with evidence-informed tools to identify behaviors that predispose to both obesity and EDs, and provides guidance about obesity and ED prevention messages. The focus should be on a healthy lifestyle rather than on weight. Evidence suggests that obesity prevention and treatment, if conducted correctly, do not predispose to EDs.
Gowen, L. Kris; Hayward, Chris; Killen, Joel D.; Robinson, Thomas N.; Taylor, C. Barr
Examined relationship between acculturation and eating-disorder symptoms in normative samples of 920 adolescents girls of high school age. Found that acculturation was positively associated with structured-interview defined partial syndrome eating disorders in Hispanic girls, but not in Asian or European-American girls. There was no relation…
Bisetto Pons, David; Botella Guijarro, Álvaro; Sancho Muñoz, Alberto
The aim of the study was to show whether there was a connection between drug use and Eating Disorders, as well as to identify the type of drugs most widely used and to ascertain whether they are used to suppress appetite. An "ad hoc" scale was developed using the items of the Eating Disorder Diagnostic Scale, whose aim is to detect cases at risk of certain types of eating disorder, and items for assessing drug use. This scale was applied to samples of teenagers (n=446) aged 13-18 from various secondary schools in the Valencia Region (Comunidad Valenciana) in Spain. An association was found between teenagers that use drugs, and particularly between the variable "use of some kind of drug as an appetite suppressant", and being at risk of having an eating disorder. Tobacco was the drug most commonly used (accounting for 66% of those within the risk threshold of the Eating Disorder Diagnostic Scale). We conclude that those teenagers from the sample who fall within any of the risk thresholds consume more drugs than those who do not fall within the risk threshold of the Eating Disorder Diagnostic Scale. Stimulant-type drugs are those most widely used by these teenagers with the aim of suppressing appetite.
Rosen, David S
The incidence and prevalence of eating disorders in children and adolescents has increased significantly in recent decades, making it essential for pediatricians to consider these disorders in appropriate clinical settings, to evaluate patients suspected of having these disorders, and to manage (or refer) patients in whom eating disorders are diagnosed. This clinical report includes a discussion of diagnostic criteria and outlines the initial evaluation of the patient with disordered eating. Medical complications of eating disorders may affect any organ system, and careful monitoring for these complications is required. The range of treatment options, including pharmacotherapy, is described in this report. Pediatricians are encouraged to advocate for legislation and policies that ensure appropriate services for patients with eating disorders, including medical care, nutritional intervention, mental health treatment, and care coordination.
Shomaker, Lauren B.; Furman, Wyndol
Perceived socio-cultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Most prospective studies included only girls, and less is known about the influence on boys. This study investigated interpersonal influences on changes in late adolescent boys’ and girls’ symptoms of disordered eating over one year. Participants were a community sample of late adolescents 16–19 years of age (N = 199; 49.75% girls), their mothers, and friends. Structural equation modeling revealed that interpersonal pressure to be thin and criticism about appearance predicted increases in disordered eating over time. Late adolescents’, mothers’ and friends’ reports of pressure were associated with disordered eating at Time 1 and Time 2. Further, adolescents’ perceptions and friends’ reports of pressure to be thin predicted changes in disordered eating over time. Findings underscore the significance of interpersonal relationships for disordered eating during late adolescence in both girls and boys. PMID:19447351
Schmidt, Ricarda; Tetzlaff, Anne; Hilbert, Anja
A sizeable body of research has documented Expressed Emotion (EE) to predict clinical outcomes in various psychiatric disorders, including eating disorders. Patients' perceptions of relative's EE, however, were found to play an important role in the processing of EE. This study aimed to examine the level of perceived EE in adolescent binge-eating disorder (BED) and its impact on eating disorder psychopathology. Adolescents (12-20 years) seeking treatment for BED (n = 40) were compared to adolescents without current or lifetime eating disorder (CG; n = 40). Both groups were stratified according to age, sex, body mass index (BMI, kg/m(2)), and socio-economic status. The Five Minute Speech Sample (FMSS) and the Brief Dyadic Scale of EE were administered to assess patients' perceived maternal EE. Additionally, adolescents and mothers completed questionnaires on eating disorder and general psychopathology. On the FMSS, 37.5 % of patients with BED perceived their mothers as high EE (vs. 12.5 % in the CG). On the Brief Dyadic Scale of EE, patients with BED reported significantly higher levels of perceived maternal criticism, emotional overinvolvement, and lower levels of perceived warmth than controls. After controlling for the diagnosis of BED, perceived criticism and warmth, as assessed by questionnaire, significantly explained adolescents' global eating disorder psychopathology. Negative perceptions of maternal behavior and emotional atmosphere towards the child are characteristic of adolescent BED. As documented for other eating disorders, family factors are likely to have substantial implications for the maintenance and treatment of adolescent BED.
Jordan, Amy B; Kramer-Golinkoff, Emily K; Strasburger, Victor C
In this article we examine media use and its relationship to adolescent overweight/obesity and adolescent eating disorders. We consider the potential mechanisms through which exposure to media during adolescence (both amount of time and choice of content) might exacerbate unhealthy eating and physical activity patterns. We consider strategies that health care providers can use to identify problematic media use and suggestions they might offer to adolescents and their parents for ways to make media a more positive agent in young people's healthy development.
Forsberg, Sarah; Lock, James
Best-practice guidelines for the treatment of child and adolescent eating disorders recommend the inclusion of parents. Family-based treatment (FBT) posits that families are not only important in supporting their children but are critical change agents in the recovery process. As originally developed for anorexia nervosa, parents take a central role in managing and disrupting eating disorder symptoms. The most evidence-based treatment model for adolescent anorexia nervosa, FBT has also recently been found to be useful in the treatment of adolescent bulimia nervosa. This article provides a summary of the theoretic model, evidence base, and application of FBT.
Adherence to self-management and medication regimens is required to achieve optimal blood glucose control in adolescents with type 1 diabetes mellitus. Non-adherence places adolescents at serious risk of short and long-term health complications. Adherence difficulties may be exacerbated by concurrent eating disorders. Diabulimia is a term used to describe the deliberate administration of insufficient insulin to maintain glycaemic control for the purpose of causing weight loss. This article explores the concept of diabulimia and the compounding complications of an eating disorder on maintaining self-management regimens in adolescents with diabetes.
Erzegovesi, Stefano; Bellodi, Laura
Twenty years have passed from the International Classification of Diseases, Tenth Revision (ICD-10) to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and, in the meanwhile, a lot of research data about eating disorders has been published. This article reviews the main modifications to the classification of eating disorders reported in the "Feeding and Eating Disorders" chapter of the DSM-5, and compares them with the ICD-10 diagnostic guidelines. Particularly, we will show that DSM-5 criteria widened the diagnoses of anorexia and bulimia nervosa to less severe forms (so decreasing the frequency of Eating Disorders, Not Otherwise Specified (EDNOS) diagnoses), introduced the new category of Binge Eating Disorder, and incorporated several feeding disorders that were first diagnosed in infancy, childhood, or adolescence. On the whole, the DSM-5 revision should allow the clinician to make more reliable and timely diagnoses for eating disorders.
Bayer, Alan E.; Baker, Daniel H.
This document presents an overview of anorexia nervosa and bulimia in adolescents. A brief review of the historical background of these eating disorders is included. Causes of anorexia and bulimia are discussed and physical, behavioral, emotional, and perceptual characteristics of the disorders are listed in a section on symptoms. The need for a…
Glovinsky, Diane M.
In a culture glorifying thinness and beauty, most females (especially adolescents) carry some risk of developing eating disorders. A recent survey of 280 South Carolina middle school students disclosed significant female/male differences. About 70% of the girls felt fat; many used various weight-loss techniques, including dieting, fasting,…
Loth, Katie A.; MacLehose, Richard F.; Fulkerson, Jayne A.; Crow, Scott; Neumark-Sztainer, Dianne
Objective To examine associations between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors, within a sample of parent-adolescent pairs. Method Adolescents (N=2231) and their parents (N=3431) participated in two, coordinated, population-based studies designed to examine factors associated with weight and weight-related behaviors in adolescents. Results Overall, higher levels of pressure-to-eat or food restriction was significantly and positively associated with use of disordered eating behaviors among boys. For every one unit increase [Scale Range: 1-(low control) to 4 – (high control)] in mothers’ food restriction, boys were twice as likely to engage in extreme weight control behaviors (p≤0.01). Examination of the association between food-related parenting practices and disordered eating behaviors among girls revealed fewer significant associations. However, analyses did reveal that for every one unit increase in mothers’ food restriction, girls were 1.33 times more likely to engage in extreme weight control behaviors (p=0.04). Discussion Study findings provide evidence of an association between controlling food-related parenting practices and adolescent disordered eating behaviors, particularly in boys. Future longitudinal research is needed to establish directionality of observed associations. PMID:24105668
Objective Although eating disorders are common psychiatric disorders that usually onset during adolescence, few evidence-based treatments for this age group have been identified. A critical review of treatments used for Anorexia Nervosa (AN) and Bulimia Nervosa (BN) and related conditions (EDNOS) is provided that summarizes the rationale for the treatments, evidence of effectiveness available, and outcomes. Method Critical review of published randomized clinical trials (RCTs). Results There are only seven published RCTs of psychotherapy for AN in adolescents with a total of 480 subjects. There are only two published RCTs for outpatient psychotherapy for adolescent BN with a total of 165 subjects. There are no published RCTs examining medications for adolescent AN or BN. For adolescent AN, Family-Based Treatment (FBT) is the treatment with the most evidence supporting its use. Three RCTs suggest that FBT is superior to individual therapy at the end of treatment; however, at follow-up differences between individual and family approaches are generally reduced. For adolescent BN, one study found no differences between Cognitive Behavioral Therapy and FBT at the end of treatment or follow-up, while the other found FBT superior to individual therapy. Conclusions Although the evidence remains limited, FBT appears to be the first line treatment for adolescent AN. There is little evidence to support a specific treatment for adolescent BN. There is a need for additional studies of treatment of child and adolescent eating disorders. New treatments studies may build on current evidence as well as examine new approaches based on novel findings in the neurosciences about cognitive and emotional processes in eating disorders. PMID:21532979
Lock, James; La Via, Maria C
This Practice Parameter reviews evidence-based practices for the evaluation and treatment of eating disorders in children and adolescents. Where empirical support is limited, clinical consensus opinion is used to supplement systematic data review. The Parameter focuses on the phenomenology of eating disorders, comorbidity of eating disorders with other psychiatric and medical disorders, and treatment in children and adolescents. Because the database related to eating disorders in younger patients is limited, relevant literature drawn from adult studies is included in the discussion.
... Loss Surgery? A Week of Healthy Breakfasts Shyness Eating Disorders KidsHealth > For Teens > Eating Disorders A A A ... average weight or can be overweight. continue Binge Eating Disorder This eating disorder is similar to anorexia and ...
Petersen, Jennifer L; Hyde, Janet S
Peer sexual harassment is a pervasive problem in schools and is associated with a variety of negative mental health outcomes. Objectification theory suggests that sexual attention in the form of peer harassment directs unwanted attention to the victim's body and may lead to a desire to alter the body via disordered eating. In the current study, we used latent growth modeling with a sample of 406 U.S. adolescents to examine the relationship between longitudinal trends in peer sexual harassment from 5th to 9th grade and disordered eating in 9th grade. Longitudinal trends in self-surveillance were proposed as a mediator of the relationships. Results indicated that the relationship between upsetting sexual harassment at 5th grade and disordered eating symptoms at 9th grade was mediated by self-surveillance at 5th grade. Girls reported more upsetting sexual harassment, more self-surveillance, and thus more disordered eating than boys did. These results are in accord with objectification theory, which proposes that sexual harassment is a form of sexual objectification and may lead to self-surveillance and disordered eating.
Nakai, Yoshikatsu; Noma, Shun'ichi; Nin, Kazuko; Teramukai, Satoshi; Wonderlich, Stephen A
To investigate eating disorder behaviors and attitudes in adolescents, we administered the eating disorder examination questionnaire (EDE-Q) to Japanese adolescent girls and boys. The EDE-Q global scores in Japanese girls and boys, respectively, were significantly lower than those in girls and boys in previous studies. Objective binge eating episodes and extreme dietary restriction were the common behaviors, whereas self-induced vomiting and the misuse of laxatives were uncommon. Differences in the EDE-Q data between Japanese adolescents and adolescents in previous studies from Western countries suggest that there may be certain cultural differences in eating disorder psychopathology in adolescents.
Boisseau, Christina L; Thompson-Brenner, Heather; Eddy, Kamryn T; Satir, Dana A
Impulsivity among individuals with eating disorders (EDs) is associated with severe comorbidities and poor treatment outcome. However, research investigating the construct of impulsivity in EDs is limited. The objectives of the present study were to characterize multiple dimensions of impulsivity in adolescents with EDs; determine if differences in impulsivity were associated with ED diagnosis and/or broader personality traits; and explore the relationship between impulsivity and etiologically significant variables. Experienced clinicians from a practice-research network provided data on ED symptoms, impulsive characteristics, personality pathology, The Diagnostic and Statistical Manual of Mental Disorders comorbidity, and family and developmental history for 120 adolescent patients with EDs. Three distinct types of impulsivity were identified: general, acting out, and aggressive/destructive. The impulsivity types showed specific relationships to ED diagnosis, broader personality factors, individual histories of adverse (traumatic) events, and family histories of externalizing disorders, supporting the importance of taking, assessing, and addressing impulsivity in ED research and treatment.
Safer, Debra L.; Couturier, Jennifer L.; Lock, James
Given the lack of empirically supported treatments available for adolescents with eating disorders, it is important to investigate the clinical utility of extending treatments for adults with eating disorders to younger populations. Dialectical behavior therapy for binge eating disorder, based on the affect-regulation model, conceptualizes binge…
Shaw, Heather; Ng, Janet; Stice, Eric
Increasingly, researchers in the areas of eating disorders and obesity prevention are recognizing the benefits of collaborative efforts aimed at curbing the spectrum of eating-related disturbances. Research suggests that eating disorders and overweight tend to co-occur, and that individuals cross over from one eating-related disturbance to…
This study was conducted to examine the list of identifying factors and predictors of childhood physical abuse, extrafamilial sexual abuse, and incest among male and female adolescents in the general population. In 1989, a survey was administered to 6,224 9th and 12th grade students in public schools in Minnesota. The findings revealed that more…
Hamel, Andrea E; Zaitsoff, Shannon L; Taylor, Andrew; Menna, Rosanne; Le Grange, Daniel
The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12-18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others'. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.
Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela
The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder.…
Thompson-Brenner, Heather; Boisseau, Christina L; Satir, Dana A
This naturalistic study investigated the treatment and outcome of adolescents with eating disorders (EDs) in the community. Clinicians from a practice-research network provided data on ED symptoms, global functioning, comorbidity, treatment, and outcome for 120 adolescents with EDs. ED "not otherwise specified" was the most common ED diagnosed. After an average of 8 months of treatment, about one third of patients had recovered, with patients with anorexia nervosa showing the most improvement. Clinicians utilized a range of psychotherapy interventions and two thirds of the patients had received adjunct psychoactive medication. Although CBT showed the strongest association with outcome in a subsample characterized by poor relational/personality functioning, dynamic therapy was associated with better global outcome in the overall sample.
Thompson-Brenner, Heather; Boisseau, Christina L.; Satir, Dana A.
This naturalistic study investigated the treatment and outcome of adolescents with eating disorders (EDs) in the community. Clinicians from a practice-research network provided data on ED symptoms, global functioning, comorbidity, treatment, and outcome for 120 adolescents with EDs. ED “not otherwise specified” was the most common ED diagnosed. After an average of 8 months of treatment, about one third of patients had recovered, with patients with anorexia nervosa showing the most improvement. Clinicians utilized a range of psychotherapy interventions and two thirds of the patients had received adjunct psychoactive medication. Although CBT showed the strongest association with outcome in a subsample characterized by poor relational/personality functioning, dynamic therapy was associated with better global outcome in the overall sample. PMID:19938166
Swanson, SA; Aloisio, KM; Horton, NJ; Sonneville, KR; Crosby, RD; Eddy, KT; Field, AE; Micali, N
Objectives Epidemiologic studies of adolescent psychiatric disorders often collect information from adolescents and parents, yet most eating disorder epidemiologic studies rely only on adolescent report. Methods We studied the eating disorder symptom reports provided by 7,968 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC), and their parents, who were sent questionnaires at participants’ ages 14 and 16 years. Both adolescents and parents were asked questions about the adolescent's eating disorder symptoms, including binge eating, vomiting, laxative use, fasting, and thinness. We assessed the concordance of parent and adolescent report cross-sectionally using kappa coefficients, and further looked at how the symptom reports were predictive of adolescent body mass and composition measured at a clinical assessment at 17.5 years. Generalized estimating equations were used to model the symptom reports’ associations with risk factors and clinical outcomes. Results Parents and adolescents were largely discordant on symptom reports cross-sectionally (kappas<0.3), with the parent generally less likely to report bulimic symptoms than the adolescent but more likely to report thinness. Female adolescents were more likely to report bulimic symptoms than males (e.g., 2-4 times more likely to report binge eating), while prevalence estimates according to parent reports of female vs. male adolescents were similar. Both parent and adolescent symptom reports at ages 14 and 16 years were predictive of age-17.5 body mass and composition measures; parentally-reported binge eating was more strongly predictive of higher body mass and composition. Discussion Parent report of eating disorder symptoms seemed to measure different, but potentially important, aspects of these symptoms during adolescence. Epidemiologic eating disorder studies should consider the potential value added from incorporating parental reports. In particular, studies of male eating
Gander, Manuela; Sevecke, Kathrin; Buchheim, Anna
In the present article we review findings from an emerging body of research on attachment issues in adolescents with eating disorders from a developmental perspective. Articles for inclusion in this review were identified from PsychINFO (1966–2013), Sciencedirect (1970–2013), Psychindex (1980–2013), and Pubmed (1980–2013). First, we will outline the crucial developmental changes in the attachment system and discuss how they might be related to the early onset of the disease. Then we will report on the major results from attachment studies using self-report and narrative instruments in that age group. Studies with a developmental approach on attachment will be analyzed in more detail. The high incidence of the unresolved attachment pattern in eating disorder samples is striking, especially for patients with anorexia nervosa. Interestingly, this predominance of the unresolved category was also found in their mothers. To date, these transgenerational aspects are still poorly understood and therefore represent an exciting research frontier. Future studies that include larger adolescent samples and provide a more detailed description including symptom severity and comorbidity would contribute to a better understanding of this complex and painful condition. PMID:26321974
Andrist, Linda C
This article examines the literature related to the media, body image, and diet/weight issues in children and young women. The media holds an awesome power to influence young women, bombarding them with images of abnormally thin models who seem to represent the ideal. When the majority of adolescents inevitably fail to achieve the extremely thin image they crave, body dissatisfaction results, and disordered eating can begin. Emerging research in the pediatric and adolescent literature demonstrates that children as young as 5 are already anxious about their bodies, and want to be thinner. This obsessive interest in body weight is only fueled by a dramatic increase in the number of Internet Web sites devoted to disordered eating. Unfortunately many of the Web sites are "pro-ana" (pro anorexia) and "pro-mia" (pro bulimia); these Web sites encourage young people at risk to begin starving themselves, or to begin binge-purging. As nurses know, each of these scenarios can lead to serious illness, and sometimes to death.
Gander, Manuela; Sevecke, Kathrin; Buchheim, Anna
In the present article we review findings from an emerging body of research on attachment issues in adolescents with eating disorders from a developmental perspective. Articles for inclusion in this review were identified from PsychINFO (1966-2013), Sciencedirect (1970-2013), Psychindex (1980-2013), and Pubmed (1980-2013). First, we will outline the crucial developmental changes in the attachment system and discuss how they might be related to the early onset of the disease. Then we will report on the major results from attachment studies using self-report and narrative instruments in that age group. Studies with a developmental approach on attachment will be analyzed in more detail. The high incidence of the unresolved attachment pattern in eating disorder samples is striking, especially for patients with anorexia nervosa. Interestingly, this predominance of the unresolved category was also found in their mothers. To date, these transgenerational aspects are still poorly understood and therefore represent an exciting research frontier. Future studies that include larger adolescent samples and provide a more detailed description including symptom severity and comorbidity would contribute to a better understanding of this complex and painful condition.
Eating disorders are relatively common and serious disorders in adolescents. However, there are few controlled psychosocial intervention studies with this younger population. This review updates a previous Journal of Clinical Child and Adolescent Psychology review published in 2008. The recommendations in this review were developed after searching the literature including PubMed/Medline and employing the relevant medical subject headings. In addition, the bibliographies of book chapters and treatment guideline articles were reviewed; last, colleagues were asked for suggested additional source materials. Psychosocial treatments examined include family therapy, individual therapy, cognitive behavioral therapy, interpersonal psychotherapy, cognitive training, and dialectical behavior therapy. Using the most recent Journal of Clinical Child and Adolescent Psychology methodological review criteria, family treatment-behavior (FT-B) is the only well-established treatment for adolescents with anorexia nervosa. Family treatment-systemic and insight oriented individual psychotherapy are probably efficacious treatments for adolescents with anorexia nervosa. There are no well-established treatments for adolescents with bulimia nervosa, binge eating disorder, or avoidant restrictive food intake disorder. Possibly efficacious psychosocial treatments for adolescent bulimia nervosa include FT-B and supportive individual therapy. Internet-delivered cognitive behavioral therapy is a possibly efficacious treatment for binge eating disorder. Experimental treatments for adolescent eating disorders include enhanced cognitive behavioral therapy, dialectical behavioral therapy, cognitive training, and interpersonal psychotherapy. FT-B is the only well-established treatment for adolescent eating disorders. Additional research examining treatment for eating disorders in youth is warranted.
... Binge-eating, which is out-of-control eating Women are more likely than men to have eating disorders. They usually start in the teenage years and often occur along with depression, anxiety disorders, and substance abuse. Eating disorders can lead ...
Reijonen, Jori H.; Pratt, Helen D.; Patel, Dilip R.; Greydanus, Donald E.
Selectively reviews the literature on the diagnostic criteria for eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorder) as described in "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) and "International Classification of Diseases" (10th ed.). Discusses the prevalence and course of…
Adamo, Kristi B.; Wilson, Shanna L.; Ferraro, Zachary M.; Hadjiyannakis, Stasia; Doucet, Éric; Goldfield, Gary S.
Objective. This study aimed to investigate potential differences in appetite sensations, ghrelin, peptide YY, and glucose and their relationship with energy and macronutrient intake in obese adolescents with subclinical binge eating disorder. Methods. Fifteen obese adolescents (six and nine individuals with and without subclinical binge eating disorder, resp.) qualified for this study. Visual analog scales and Three-Factor Eating Questionnaires were used to assess eating behaviours. Circulating ghrelin, peptide YY, and glucose were measured after fasting and at multiple time points postprandially following a standardized breakfast meal. Energy and macronutrient intake were measured with an ad libitum lunch buffet. Results. Emotional eating scores were significantly higher in obese adolescents with subclinical binge eating disorder. Hunger levels rose and satiety levels fell significantly over the course of the monitoring period but there was no difference between the two groups. Obese adolescents with subclinical binge eating disorder did not have significantly different levels of appetite signaling proteins or glucose. Obese adolescents with subclinical binge eating disorder had a nonsignificantly higher energy and macronutrient intake. Conclusions. A significant difference between the two groups in terms of their emotional eating scores highlights the important role that psychological factors play in relation to eating behaviours. PMID:25006530
Zullig, Keith J; Matthews-Ewald, Molly R; Valois, Robert F
Although emotional disorders and disordered eating behaviors are known to be related, the relationship between emotional self-efficacy (ESE) and disordered eating is unknown. This study examined the relationship between ESE and disordered eating in a statewide sample of public high school adolescents (n=2566). The Centers for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression adjusted for key covariates explored the relationship between low ESE and disordered eating among selected race and gender groups. Self-perceived weight as underweight or overweight; and dieting, vomiting or taking laxatives, taking diet pills, and fasting to lose weight were each associated (p<.05) with lower levels of ESE for certain race/gender groups. Findings provide increased justification for tailoring disordered eating interventions and treatments to accommodate the highest risk groups. Measures of ESE should be considered for adolescent mental health assessments in fieldwork, research, and evaluation efforts.
Rohde, Paul; Stice, Eric; Marti, C. Nathan
Objective Although several prospective studies have identified factors that increase risk for eating disorders, little is known about when these risk factors emerge and escalate, or when they begin to predict future eating disorder onset. The objective of this report was to address these key research gaps. Method Data were examined from a prospective study of 496 community female adolescents (M = 13.5, SD = 0.7 at baseline) who completed eight annual assessments of potential risk factors and eating disorders from preadolescence to young adulthood. Results Three variables exhibited positive linear increases: Perceived pressure to be thin, thin-ideal internalization and body dissatisfaction; three were best characterized as quadratic effects: dieting (essentially little change); negative affectivity (overall decrease), and BMI (overall increase). Elevated body dissatisfaction at ages 13, 14, 15, and 16 predicted DSM-5 eating disorders onset in the 4 year period after each assessment, but the predictive effects of other risk factors were largely confined to age 14; BMI did not predict eating disorders at any age. Discussion The results imply that these risk factors are present by early adolescence, though eating disorders tend to emerge in late adolescence and early adulthood. These findings emphasize the need for efficacious eating disorder prevention programs for early adolescent girls, perhaps targeting 14 year olds, when risk factors appear to be most predictive. In early adolescence, it might be fruitful to target girls with body dissatisfaction, as this was the most consistent predictor of early eating disorder onset in this study. PMID:24599841
Slane, Jennifer D.; Klump, Kelly L.; McGue, Matthew; Iacono, William G.
Objective Research examining changes in eating disorder symptoms across adolescence suggests an increase in disordered eating from early to late adolescence. However, relevant studies have largely been cross-sectional in nature and most have not examined the changes in the attitudinal symptoms of eating disorders (e.g., weight concerns). This longitudinal study aimed to address gaps in the available data by examining the developmental trajectories of disordered eating in females from preadolescence into young adulthood. Method Participants were 745 same-sex female twins from the Minnesota Twin Family Study. Disordered eating was assessed using the Total Score, Body Dissatisfaction subscale, Weight Preoccupation subscale, and a combined Binge Eating and Compensatory Behavior subscale from the Minnesota Eating Behavior Survey assessed at the ages of 11, 14, 18, 21, and 25. Several latent growth models were fit to the data to identify the trajectory that most accurately captures the changes in disordered eating symptoms from 11 to 25 years. Results The best-fitting models for overall levels of disordered eating, body dissatisfaction, and weight preoccupation showed an increase in from 11 through 25 years. In contrast, bulimic behaviors increased to age of 18 and then stabilized to age of 25. Discussion The findings expanded upon extant research by investigating longitudinal, symptom specific, within-person changes and showing an increase in cognitive symptoms into young adulthood and the stability of disordered eating behaviors past late adolescence. PMID:24995824
PUSTIVŠEK, Suzana; HADŽIĆ, Vedran; DERVIŠEVIĆ, Edvin
Objective Eating disorders (ED) are an important and increasing problem in adolescents. The objective of this study was to examine the risk factors and the prevalence of risk for ED among male adolescent elite athletes and nonathletic controls. Differences between male athletes competing in aerobic, anaerobic and aerobic-anaerobic sports were examined as well. Methods This was a cross-sectional epidemiological study. A cross-sectional questionnaire survey and anthropometric measurements were conducted on 351 adolescents (athletes n = 228; controls n = 123). All participants were aged 15–17 at the time of measuring. Risk for ED was determined using a SCOFF questionnaire. Results The overall prevalence of the risk for ED in male adolescents was 24.8%, with no significant differences among athletes and controls or different subgroups of athletes (p>0.05), although the highest prevalence (37.2%) was registered in aerobic subgroup of athletes. Higher number of attempts to lose weight was associated with increased risk of ED in each group (athletes and controls). Other predictors referred to lack of breakfast and body composition in aerobic subgroup of athletes and number of meals and training frequency in anaerobic subgroup. The most common reasons for dieting were improvement of sport results (19.6–44.2%) and better self-esteem (41.5%) in athletes and controls respectively. Conclusions Participation in the competitive sport itself is not associated with the increased risk for ED. It seems that risk factors for ED for adolescent athletes competing in aerobic and anaerobic sports represent a subject that deserves consideration and further investigation in the future. PMID:27646623
Baş, Murat; Karabudak, Efsun; Kiziltan, Gül
The purpose of this study was to determine whether differences exist in eating attitudes, self-esteem, social trait anxiety and social physique anxiety of self-reported vegetarian and nonvegetarian Turkish adolescents. The sample for the Turkish University' students is designed to provide the estimates of vegetarian indicators and prevalence. The participants were 608 females and 597 males, in total 1205 adolescents aged between 17 and 21 years. Disturbed eating behaviors (EAT-26> or =20) was found in 45.2% (14 of vegetarian) of the total vegetarian sample; which included two of the male vegetarians and 12 of the female vegetarians. The mean BMI was 19.78+/-1.49 kg/m(2) for female vegetarians and 20.78+/-2.46 kg/m(2) for female nonvegetarians (p<0.05). Male vegetarians had significantly higher score than male nonvegetarians on EAT-26 (17.25+/-11.18 for male vegetarians and 9.38+/-6.60 for male nonvegetarians), dieting (6.50+/-7.65 for male vegetarians and 2.55+/-3.87 for male nonvegetarians) and oral control (6.13+/-4.67 for male vegetarians and 3.20+/-3.19 for male nonvegetarians) scores (p<0.05). Besides, female vegetarians had significantly higher score than female nonvegetarians on EAT-26 (22.04+/-13.62 for female vegetarians and 11.38+/-8.28 for female nonvegetarians), dieting (10.35+/-9.58 for female vegetarians and 4.41+/-5.30 for female nonvegetarians), oral control (7.78+/-5.13 for female vegetarians and 3.33+/-3.51 for female nonvegetarians) and STAI (51.39+/-7.28 for female vegetarians and 47.29+/-5.13 for female nonvegetarians) scores (p<0.05). As a conclusion, the present study indicated abnormal eating attitudes, low self-esteem, high social physique anxiety, and high trait anxiety in Turkish vegetarian adolescents. The vegetarian adolescents may be more likely to display disordered eating attitudes and behaviors than nonvegetarians.
Horndasch, Stefanie; Kratz, Oliver; Holczinger, Anna; Heinrich, Hartmut; Hönig, Florian; Nöth, Elmar; Moll, Gunther H
Visual attention allocation of adolescent girls with and without an eating disorder while viewing body images of underweight, normal-weight and overweight women was studied using eye tracking. While all girls attended more to specific body parts (e.g. hips, upper legs), eating-disordered girls showed an attentional bias towards unclothed body parts.
Jackson, Todd; Chen, Hong
This 18-month prospective study investigated factors that contributed to changes in eating disorder symptoms among adolescents living in the People's Republic of China. Five hundred forty-one Chinese middle school and high school students (182 boys, 359 girls) completed measures of eating disorder symptoms; body dissatisfaction; appearance ideal…
Kerwin, MaryLouise E.; Berkowitz, Robert I.
The fourth edition of the "Diagnostic Statistical Manual of Mental Disorders" (DSM) recognizes that feeding problems of infants and children are not typically the same as eating problems of adolescents, thus the addition of a broad diagnostic category, "Feeding and Eating Disorders of Infancy or Early Childhood." Subtypes are…
Stachowitz, Annie L.
Eating disorders, disordered eating, and body dissatisfaction prevalence rates are on the rise among adolescent females. The present study sought to examine a commonly used social-emotional instrument, the Behavior Assessment System for Children-Second Edition, Self-Report of Personality (BASC-2, SRP), for the emergence of a common profile of…
Giles, Michelle; Hass, Michael
Eating disorders are among the most frequently seen chronic illnesses found in adolescent females. In this paper, we discuss school-based prevention and intervention efforts that seek to reduce the impact of this serious illness. School counselors play a key role in the prevention of eating disorders and can provide support even when not directly…
Dalle Grave, Riccardo; Calugi, Simona; Sartirana, Massimiliano; Fairburn, Christopher G
Little is known about the treatment of adolescents with an eating disorder who are not underweight. Enhanced cognitive behaviour therapy (CBT-E) is a potential option as it is a treatment for adult patients with eating disorders of this type and it has been shown to be effective with adolescent patients who are underweight. The aim of the present cohort study was to evaluate the effects of CBT-E on non-underweight adolescents with an eating disorder. Sixty-eight adolescent patients with an eating disorder and a body mass index (BMI) centile corresponding to an adult BMI ≥ 18.5 were recruited from consecutive referrals to a community-based eating disorder clinic. Each was offered 20 sessions of CBT-E over 20 weeks. Three-quarters completed the full 20 sessions. There was a marked treatment response with two-thirds (67.6%, intent-to-treat) having minimal residual eating disorder psychopathology by the end of treatment. CBT-E therefore appears to be a promising treatment for those adolescents with an eating disorder who are not underweight.
Zaider, Talia I.; Johnson, Jeffrey G.; Cockell, Sarah J.
Conducted a prospective longitudinal study to investigate whether anxiety, depressive, personality, or substance abuse disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Findings for 201 adolescents suggest that adolescents with chronic depressive symptoms may be at elevated risk for the…
Pamies Aubalat, Lidia; Quiles Marcos, Yolanda
The first aim of this study was to analyse the relationship between coping styles and strategies in Spanish adolescents of both genders, with high and low eating disorder risk. Secondly, this study aims to examine the relation of coping styles and coping strategies with eating disorder risk. The sample comprised 2142 adolescents (1.130 girls and 1.012 boys), mean age 13,96 years (SD= 1.34). They completed the Adolescent Coping Scale (ACS) and the Eating Attitude Test (EAT-40). The results showed high use of intropunitive avoidance coping in both female and male adolescents with high EAT-40 scores. The regression analysis indicated that, in both girls and boys, the intropunitive avoidance and the tension reduction coping strategy explained a high percentage of variance of eating disorder risk. The results of this study have implications for the prevention of these behaviours in adolescents, because people with a high risk of developing an eating disorder present a maladaptive coping style before the onset of the eating disorder.
Mairs, Rebecca; Nicholls, Dasha
Feeding and eating disorders (FEDs) are serious mental health disorders that cause impairments in physical health, development, cognition and psychosocial function and can go undetected for months or years. They are characterised by disturbed eating behaviour associated with concerns about weight and shape or by disinterest in food, phobic avoidance or avoidance due to sensory aspects of food. Restrictive forms of FEDs lead to significant weight loss requiring intervention. Without specific knowledge of these conditions, they can evade detection, delaying time to diagnosis and treatment and potentially influencing outcome. This review article focuses on the key factors involved in the psychiatric assessment and treatment of four feeding or eating disorders (EDs): anorexia nervosa, avoidant-restrictive food intake disorder, bulimia nervosa and binge eating disorder. They have been chosen for discussion as they are most likely to be encountered in both a psychiatric and paediatric setting. It emphasises the importance of a family-focused, developmentally appropriate and multidisciplinary approach to care. It does not address aspects of medical assessment and treatment. Other feeding or EDs not included in this article are pica, rumination disorder, other specified feeding and eating disorder and unspecified feeding and eating disorder.
Legenbauer, Tanja; Thiemann, Pia; Vocks, Silja
Body image is multifaceted and incorporates perceptual, affective, and cognitive components as well as behavioral features. Only few studies have examined the character of body-image disturbance in children/adolescents with eating disorders. It is unknown whether body-image disturbances in children/adolescent with eating disturbances are comparable to those of adult patients with eating disorders. Body-image disturbance might differ quantitatively and qualitatively according to the cognitive developmental status and the age of the individual. This paper provides an overview of the current evidence for body-image disturbance in children/adolescents with eating disorders, and how they compare with those adults with eating disorders. Current evidence indicates that older adolescent patients show similar deficits as adult patients with eating disorders, in particular for the attitudinal body-image component. However, evidence for a perceptual body-image disturbance in adolescent patients, in particular anorexia nervosa, is not conclusive. Reliable statements for childhood can hardly be made because clinical studies are not available. Investigations of body-image disturbance in children have focused on the predictive value for eating disorders. Limitations of the current evidence are discussed, and future directions for research and therapy are indicated.
Rodgers, Rachel F; Ganchou, Camille; Franko, Debra L; Chabrol, Henri
The pursuit of muscularity is an important body image concern among boys which has been described within sociocultural models of risk for eating disorders. This study explored a sociocultural model of disordered eating in which drive for thinness and pursuit of muscularity were both pathways to disordered eating among French adolescent boys. A sample of 146 adolescents completed a questionnaire assessing drive for thinness, drive for muscularity, media-ideal internalization, appearance comparison, and sociocultural pressure. The model was a good fit to the data and both drive for thinness and the pursuit of muscularity were related to disordered eating. Furthermore, internalization and appearance comparison mediated the relationships between pressure to increase muscle and both drive for muscularity and drive for thinness. Longitudinal research could help clarify the role of the pursuit of muscularity in the development of disordered eating and extreme body shape changing behaviors.
Rodgers, Rachel F; Paxton, Susan J; McLean, Siân A
Body image and eating concerns are prevalent among early adolescent girls, and associated with biological, psychological and sociocultural risk factors. To date, explorations of biopsychosocial models of body image concerns and disordered eating in early adolescent girls are lacking. A sample of 488 early adolescent girls, mean age = 12.35 years (SD = 0.53), completed a questionnaire assessing depressive symptoms, self-esteem, body mass index (BMI), sociocultural appearance pressures, thin-ideal internalization, appearance comparison, body image concerns and disordered eating. Structural equation modelling was conducted to test a hypothetical model in which internalization and comparison were mediators of the effect of both negative affect and sociocultural influences on body image concerns and disordered eating. In addition, the model proposed that BMI would impact body image concerns. Although the initial model was a poor fit to the data, the fit was improved after the addition of a direct pathway between negative affect and bulimic symptoms. The final model explained a large to moderate proportion of the variance in body image and eating concerns. This study supports the role of negative affect in biopsychosocial models of the development of body image concerns and disordered eating in early adolescent girls. Interventions including strategies to address negative affect as well as sociocultural appearance pressures may help decrease the risk for body image concerns and disordered eating among this age group.
Chisuwa, Naomi; O'Dea, Jennifer A
This review describes the prevalence of eating disorders and disordered eating behaviors as well as factors influencing body image disturbance amongst Japanese adolescents and compares the prevalence and trends with those of Westernized countries. Although eating disorders have been previously regarded as peculiar to Western society, they are now a more global issue with reports of non-Western countries including Japan having increasing rates of eating disorders. As the aetiology of eating disorders is related to societal norms, culture and ethnicity, their study requires an understanding of body image disturbance within different cultural contexts. Although considered less prevalent than in the West, Japan has an early history of eating disorder research and trends outlined in this review suggest that, as in Western countries the interest in, and study of eating disorders in Japan has increased during the 1980s. The prevalence of eating disorders in Japan based on available reviews, epidemiological studies and clinical reports ranges from 0.025% to 0.2% for AN and from 1.9% to 2.9% for BN. Studies suggest that the prevalence of eating disorders has increased significantly during the past two decades but the prevalence is still quite low compared to those in Western countries. Strategies for culturally appropriate prevention are discussed.
Stachowitz, Annie L.; Choi, Hee-Sook; Schweinle, Amy
Eating disorders, disordered eating, and body dissatisfaction prevalence rates are on the rise among adolescent females. The present study examined the potential use of a commonly used social--emotional instrument, the Behavior Assessment System for Children-Second Edition (BASC-2), for detecting the presence of possible eating disorders in…
Austin, S. Bryn; Ziyadeh, Najat; Kahn, Jessica A.; Camargo, Carlos A.; Colditz, Graham A.; Field, Alison E.
Objective: To examine sexual orientation group differences in eating disorder symptoms in adolescent girls and boys. Method: Cross-sectional associations were examined using multivariate regression techniques using data gathered in 1999 from 10,583 adolescents in the Growing Up Today Study, a cohort of children of women participating in the…
Smolak, Linda; Levine, Michael P.
It is important for adults who work with youth to know how to address the issues of eating disorders and steroid use. This article provides signs and symptoms for both, and then gives practical suggestions for talking with youth about a potential problem. It ends with prevention strategies for adults who work with youth. (Contains 3 tables.)
Geller, Josie; Brown, Krista E.; Zaitsoff, Shannon L.; Menna, Rosanne; Bates, Mollie E.; Dunn, Erin C.
The Readiness and Motivation Interview (RMI) is a semistructured interview measure of readiness and motivation to change that can be used for all eating disorder diagnoses. The RMI has demonstrated excellent psychometric properties and has both clinical and predictive utility in adult samples. This study examined the psychometric properties of the…
Petersen, Jennifer L.; Hyde, Janet S.
Peer sexual harassment is a pervasive problem in schools and is associated with a variety of negative mental health outcomes. Objectification theory suggests that sexual attention in the form of peer harassment directs unwanted attention to the victim's body and may lead to a desire to alter the body via disordered eating. In the current study, we…
Hopwood, Christopher J.; Ansell, Emily B.; Fehon, Dwain C.; Grilo, Carlos M.
Objective This study examined evidence for personality variability in adolescents with eating disorder features based in light of previous evidence that personality variability in adult women with eating pathology carries important clinical implications. Method Millon Adolescent Clinical Inventory personality data from adolescent girls with disturbed eating who were psychiatrically hospitalized were cluster analyzed and resulting groups were compared in terms of eating and comorbid pathology. Results Three sub-groups were identified among the 153 patients with eating disorder features: high-functioning, internalizing, and externalizing. The internalizing group was marked by eating-related and mood dysfunction, the externalizing group by elevated eating and mood pathology as well as impulsivity, aggression, and substance use, and the high-functioning group by lower levels of psychopathology and relatively high self-esteem. Conclusions These findings converge with previous research using different personality models in adult samples and highlight the clinical utility of considering personality heterogeneity among adolescent and adult women with disturbed eating. PMID:20965304
Gelin, Zoé; Fuso, Silvana; Hendrick, Stephan; Cook-Darzens, Solange; Simon, Yves
Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty-two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI-2), the Outcome Questionnaire 45 (OQ-45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ-45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions.
Kass, Andrea E.; Accurso, Erin C.; Goldschmidt, Andrea B.; Anam, Seeba; Byrne, Catherine E.; Kinasz, Kate; Goodyear, Alexandria; O'Brien, Setareh; Le Grange, Daniel
Objective Picking and nibbling (P&N), defined as eating in an unplanned and repetitious way between meals and snacks, is prevalent among adults with eating disorders (EDs), but unexamined among youth with EDs. This study sought to assess the prevalence of P&N in youth with EDs and its association with ED and comorbid pathology. Method Youth (N = 515; ages 7–18) who presented to one outpatient ED research-clinical program were assessed for ED and comorbid pathology. Results Two-fifths (n = 214, 41.6%) of youth endorsed P&N. These individuals were older (p < .001) and had a higher percent expected body weight (p = .006) than those who denied P&N. Controlling for age and percent expected body weight, P&N was only associated with global ED pathology in youth with anorexia nervosa (AN) or atypical AN (p = .007). P&N was not associated with ED diagnosis, ED pathology in youth with bulimia nervosa or subclinical bulimia nervosa, binge eating, compensatory behaviors, secret eating, or the presence of a mood or anxiety disorder (p's > .05). Discussion Consistent with research in adults, P&N is prevalent but not significantly associated with ED pathology, except for global ED pathology in youth with AN/atypical AN, or comorbid disorders. PMID:26282064
Ricciardelli, Lina A.; McCabe, Marita P.
This review provides an evaluation of the correlates and/or risk factors associated with disordered eating and the pursuit of muscularity among adolescent boys. One of the main conclusions is that similar factors and processes are associated with both behavioral problems. Several factors found to be consistently associated with disordered eating…
Weinstein, Erica S.
This paper presents a review of 25 sources on school-based eating disorder prevention programs for pre-adolescents and adolescents. The sources used to collect the information include Search ERIC database, PsycINFO, InterScience, and Expanded Academic. A review of the literature concluded that the most effective method of implementing a…
Brausch, Amy M.; Gutierrez, Peter M.
There is much empirical literature on factors for adolescent suicide risk, but body image and disordered eating are rarely included in these models. In the current study, disordered eating and body image were examined as risk factors for suicide ideation since these factors are prevalent in adolescence, particularly for females. It was…
Zaina, Fabio; Donzelli, Sabrina; Lusini, Monia; Vismara, Luca; Capodaglio, Paolo; Neri, Laura; Negrini, Stefano
A recent study suggests a correlation between idiopathic scoliosis in adolescence and eating disorders. However, this does not correspond with our clinical experience in the same population. The aim of this study was to verify the correlation between scoliosis and eating disorders in adolescence. A cross-sectional study was designed including 187…
... for Parents for Kids for Teens Teens Home Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Q& ... and friends again. Eating disorders involve both the mind and body. So medical doctors, mental health professionals, and dietitians ...
Eating disorder - binge eating; Eating - binge; Overeating - compulsive; Compulsive overeating ... as having close relatives who also have an eating disorder Changes in brain chemicals Depression or other emotions, ...
Bartholdy, Savani; Allen, Karina; Hodsoll, John; O'Daly, Owen G; Campbell, Iain C; Banaschewski, Tobias; Bokde, Arun L W; Bromberg, Uli; Büchel, Christian; Quinlan, Erin Burke; Conrod, Patricia J; Desrivières, Sylvane; Flor, Herta; Frouin, Vincent; Gallinat, Jürgen; Garavan, Hugh; Heinz, Andreas; Ittermann, Bernd; Martinot, Jean-Luc; Artiges, Eric; Nees, Frauke; Orfanos, Dimitri Papadopoulos; Paus, Tomáš; Poustka, Luise; Smolka, Michael N; Mennigen, Eva; Walter, Henrik; Whelan, Robert; Schumann, Gunter; Schmidt, Ulrike
This study investigated the prevalence of disordered eating cognitions and behaviours across mid-adolescence in a large European sample, and explored the extent to which prevalence ratings were affected by informant (parent/adolescent), or the sex or age of the adolescent. The Development and Well-Being Assessment was completed by parent-adolescent dyads at age 14 (n = 2225) and again at age 16 (n = 1607) to explore the prevalence of 7 eating disorder symptoms (binge eating, purging, fear of weight gain, distress over shape/weight, avoidance of fattening foods, food restriction, and exercise for weight loss). Informant agreement was assessed using kappa coefficients. Generalised estimating equations were performed to explore the impact of age, sex and informant on symptom prevalence. Slight to fair agreement was observed between parent and adolescent reports (kappa estimates between 0.045 and 0.318); however, this was largely driven by agreement on the absence of behaviours. Disordered eating behaviours were more consistently endorsed amongst girls compared to boys (odds ratios: 2.96-5.90) and by adolescents compared to their parents (odds ratios: 2.71-9.05). Our data are consistent with previous findings in epidemiological studies. The findings suggest that sex-related differences in the prevalence of disordered eating behaviour are established by mid-adolescence. The greater prevalence rates obtained from adolescent compared to parent reports may be due to the secretive nature of the behaviours and/or lack of awareness by parents. If adolescent reports are overlooked, the disordered behaviour may have a greater opportunity to become more entrenched.
Jewell, Tom; Blessitt, Esther; Stewart, Catherine; Simic, Mima; Eisler, Ivan
Eating disorder-focused family therapy has emerged as the strongest evidence-based treatment for adolescent anorexia nervosa, supported by evidence from nine RCTs, and there is increasing evidence of its efficacy in treating adolescent bulimia nervosa (three RCTs). There is also emerging evidence for the efficacy of multifamily therapy formats of this treatment, with a recent RCT demonstrating the benefits of this approach in the treatment of adolescent anorexia nervosa. In this article, we critically review the evidence for eating disorder-focused family therapy through the lens of a moderate common factors paradigm. From this perspective, this treatment is likely to be effective as it provides a supportive and nonblaming context that: one, creates a safe, predictable environment that helps to contain anxiety generated by the eating disorder; two, promotes specific change early on in treatment in eating disorder-related behaviors; and three, provides a vehicle for the mobilization of common factors such as hope and expectancy reinforced by the eating disorder expertise of the multidisciplinary team. In order to improve outcomes for young people, there is a need to develop an improved understanding of the moderators and mediators involved in this treatment approach. Such an understanding could lead to the refining of the therapy, and inform adaptations for those families who do not currently benefit from treatment.
Lee, Ju-Yeon; Kim, Sung-Wan; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang
Orthodontic treatment typically occurs during early childhood and adolescence but the wearing of dental braces is often associated with sudden changes in eating patterns that prolong treatment into the teenage years. Despite these changes, psychological assessments related to eating disorders during the course of orthodontic treatment are often ignored. Based on the findings of the present case report, it is suggested that adolescent patients who wear braces and exhibit severe weight loss should be carefully monitored for psychiatric problems, including eating disorders.
Thompson-Brenner, Heather; Eddy, Kamryn T.; Satir, Dana A.; Boisseau, Christina L.; Westen, Drew
Background: Research has identified three personality subtypes in adults with eating disorders (EDs): a high-functioning, an undercontrolled, and an overcontrolled group. The current study investigated whether similar personality prototypes exist in adolescents with EDs, and whether these personality prototypes show relationships to external…
Gowers, Simon; Bryant-Waugh, Rachel
Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…
Finds that exposure to fat-character television, thin-ideal magazines, and sports magazines predicted eating-disorder symptomatology for adolescent females, especially older ones; exposure to fat-character television also predicted body dissatisfaction for younger males; and that relationships remain significant when selective exposure based on…
Rodgers, Rachel F.; Paxton, Susan J.; Chabrol, Henri
This study aimed to explore the role of depression as a moderator of sociocultural influences on eating disorder symptoms. A sample of 509 adolescents (56% female) completed self-report questionnaires assessing depression, body dissatisfaction, drive for thinness, bulimic symptoms and sociocultural influences on appearance from family, peers and…
Magtoto, Joanne; Cox, David; Saewyc, Elizabeth
Using a province-wide school-based health survey, this article investigated body satisfaction as a mediator of the association between eating disorder behaviors and immigrant status. Participants were a sample of adolescent girls (n = 15,066) and boys (n = 14,200) who completed the 2008 McCreary Centre Society Adolescent Health Survey IV.…
virtue of their parent (s)’ weight. Goodman and Whitaker were able to notice an increase in BMI after one year of adolescence , and Pine and colleagues...qualities than did their parents . Compared to families where eating disorders are not present, families of adolescent and young adult women with...daughters, inadequate parental supervision predicted unhealthy weight loss behaviors, and low paternal assistance to the mother also predicted
Thamotharan, Sneha; Hubbard, Meagan; Fields, Sherecce
Adolescence represents an integral developmental period for the prevention and intervention of disordered eating. Individuals with high levels of neuroticism have been shown to respond with greater impulsivity and use of disordered eating as a coping mechanism. However, the exact mechanism through which neuroticism and impulsivity affect disordered eating remains unknown. To understand the effects of personality and impulsivity on disordered eating in adolescence, the present study aimed to investigate whether impulsivity mediated the relationship between neuroticism and disordered eating. Adolescents (N=40) between the ages of 13 and 19 (Mage=18.25years; S.D.=1.30) were queried on eating attitudes and personality, as well as completed behavioral tasks assessing impulsivity (delay discounting, disinhibition and inattention). Mediation analyses revealed that neuroticism was significantly associated with patterns of disordered eating, but delay discounting, and not disinhibition and inattention, appeared to mediate the relationship between neuroticism and disordered eating. These results should guide prospective research exploring the relations between neurotic and impulsive behavior, particularly delay discounting on disordered eating, which will assist in future treatment efforts targeting the development of maladaptive eating behaviors.
Holtkamp, Kristian; Herpertz-Dahlmann, Beate; Vloet, Timo; Hagenah, Ulrich
Family-based treatment in adolescents and individual psychoeducation in adults are accepted components in a multimodal treatment of eating disorders. However, only few studies have been conducted on the use of parent-based psychoeducation. This paper presents the structure and content, as well as a preliminary evaluation, of a group psychoeducation program for parents of adolescent patients with eating disorders. The program is limited to five 90-minute sessions and aimed at increasing the parents' understanding of the disorder and promoting high transparency with regard to our treatment principles. The vast majority of parents rated the group psychoeducation as helpful in coping with their child's disorder and would recommend others to take part in the program.
Rocco, Pier Luigi; Ciano, Rossana P.; Balestrieri, Matteo
The aim of this report is to analyse the impact of a psychoeducational preventive programme on the eating habits of a sample of adolescent schoolgirls. Of the 112 schoolgirls attending five classes, about 86% agreed to participate in the program. Of these, 63 participants belonged to the experimental group and 33 agreed to the control group. The psychoeducational sessions were performed once a month for each of three experimental classes. The programme involved discussions on the nature of eating disorders, on epidemiological aspects and on the importance of early detection of risk factors. The tests used to evaluate the sample were the EDI-2 and the PF-16. The results showed a significant improvement in bulimic attitudes, asceticism, feelings of ineffectiveness, and maturity fears. Anxiety traits were also better managed in the experimental group. Our conclusions suggest that correct information about eating disorders can ameliorate unhealthy attitudes towards eating behaviour.
Rocco, P L; Ciano, R P; Balestrieri, M
The aim of this report is to analyse the impact of a psychoeducational preventive programme on the eating habits of a sample of adolescent schoolgirls. Of the 112 schoolgirls attending five classes, about 86% agreed to participate in the program. Of these, 63 participants belonged to the experimental group and 33 agreed to the control group. The psychoeducational sessions were performed once a month for each of three experimental classes. The programme involved discussions on the nature of eating disorders, on epidemiological aspects and on the importance of early detection of risk factors. The tests used to evaluate the sample were the EDI-2 and the PF-16. The results showed a significant improvement in bulimic attitudes, asceticism, feelings of ineffectiveness, and maturity fears. Anxiety traits were also better managed in the experimental group. Our conclusions suggest that correct information about eating disorders can ameliorate unhealthy attitudes towards eating behaviour.
The incidence of eating disorders is increasing, and health care professionals are faced with the difficult task of treating these refractory conditions. The first clinical description of anorexia nervosa (AN) was reported in 1694 and included symptoms such as decreased appetite, amenorrhea, food av...
Loeb, Katharine L; le Grange, Daniel
Family-based treatment (FBT) is emerging as a treatment of choice for adolescent anorexia nervosa (AN) and bulimia nervosa (BN). This paper reviews the history of FBT, core clinical and theoretical elements, and key findings from the FBT for AN and BN treatment outcome literature. In addition, we address clinical questions and controversies regarding FBT for eating disorders, including whether FBT is clinically appropriate for all adolescents (e.g., older adolescents, patients with comorbid conditions), and whether it indicated for all types of families (e.g., critical, enmeshed, and non-intact families). Finally, we outline recently manualized, innovative applications of FBT for new populations currently under early investigation, such as FBT as a preventive/early intervention for AN, FBT for young adults with eating disorders, and FBT for pediatric overweight. PMID:20191109
Loth, Katie; Wall, Melanie; Choi, Chien-Wen; Bucchianeri, Michaela; Quick, Virginia; Larson, Nicole; Neumark-Sztainer, Dianne
Objective To examine the association between family meals and disordered eating behaviors within a diverse sample of adolescents and further investigate whether family-level variables moderate this association. Method Data from adolescents (EAT 2010: Eating and Activity in Teens) and their parents (Project F-EAT: Families and Eating and Activity among Teens) were collected in 2009–2010. Surveys were completed by 2,382 middle and high school students (53.2% girls, mean age = 14.4 years) from Minneapolis/St. Paul, MN, public schools. Parents/guardians (n = 2,792) completed surveys by mail or phone. Results Greater frequency of family meals was associated with decreased odds of engaging in unhealthy weight control behaviors in boys, and dieting, unhealthy and extreme weight control behaviors in girls. Results indicate that the protective effects of family meals are, in general, robust to family-level variables; 64 interactions were examined and only seven were statistically significant. For example, among girls, the protective nature of family meals against dieting and unhealthy weight control behaviors was diminished if they also reported family weight-related teasing (both p < .01). Discussion The results confirmed previous research indicating that participation in family meals is protective against disordered eating for youth, particularly girls. However, results suggest that in some cases, the protection offered by family meals may be modified by family-level variables. PMID:25130186
King, Stephanie L.
Adolescents entering college are often affected by eating disorders and during this transition to emerging adulthood, individuals begin to establish personal values and beliefs, which makes this population interesting when studying Eating Disorders, values, and faith. This research project seeks to examine the association among strength of…
Rodgers, Rachel F; Paxton, Susan J; Chabrol, Henri
This study aimed to explore the role of depression as a moderator of sociocultural influences on eating disorder symptoms. A sample of 509 adolescents (56% female) completed self-report questionnaires assessing depression, body dissatisfaction, drive for thinness, bulimic symptoms and sociocultural influences on appearance from family, peers and the media. Both girls and boys displaying high levels of depressive symptoms perceived stronger media and peer influences on appearance. Among girls, eating disorder symptoms were directly affected by sociocultural influences, in particular media influences, as well as by depression. However, depression played only a limited role as a moderator of these relationships. Among boys, sociocultural influences and depression revealed fewer direct effects on eating disorder symptoms. However, depression had a greater moderating effect on these relationships. Future research into the role of depression may increase the understanding of gender differences in body dissatisfaction, drive for thinness and bulimic symptoms.
Wade, Tracey D; Wilksch, Simon M; Paxton, Susan J; Byrne, Susan M; Austin, S Bryn
While perfectionism is widely considered to influence risk for eating disorders, results of longitudinal studies are mixed. The goal of the current study was to investigate a more complex model of how baseline perfectionism (both high personal standards and self-critical evaluative concerns) might influence change in risk status for eating disorders in young adolescent girls, through its influence on ineffectiveness. The study was conducted with 926 girls (mean age of 13 years), and involved three waves of data (baseline, 6- and 12-month follow-up). Latent growth curve modelling, incorporating the average rate at which risk changed over time, the intercept (initial status) of ineffectiveness, and baseline perfectionism, was used to explore longitudinal mediation. Personal standards was not supported as contributing to risk but results indicated that the higher mean scores on ineffectiveness over the three waves mediated the relationship between higher baseline self-critical evaluative concerns and both measures of eating disorder risk. The relationship between concern over mistakes and change in risk was small and negative. These results suggest the usefulness of interventions related to self-criticism and ineffectiveness for decreasing risk for developing an eating disorder in young adolescent girls.
Boachie, Ahmed; Kusi Appiah, Edigna; Jubin, Michelle; Jasper, Karin
This case report describes five independent cases of children and adolescents assessed for eating disorders who disclosed using the Heimlich maneuver as a purging technique. The maneuver is meant to be used only in life or death situations, likely once or less in any person's lifetime. A child or adolescent with an eating disorder may be using it to self-induce vomiting on a daily basis, increasing the risk of complications, including potential damage to major organs of the body. Asking patients who purge to elaborate on the methods with which they purge can provide clinicians with fuller information, improving their ability to select appropriate medical tests and interventions. Thorough investigations of physical complaints during the patient assessment may be warranted, including examining patients for possible rib fractures, hemorrhages, perforations of the hollow viscous, and other forms of blunt abdominal traumas.
Schmidt, Ricarda; Lüthold, Patrick; Kittel, Rebekka; Tetzlaff, Anne; Hilbert, Anja
Evidence suggests that adults with binge-eating disorder (BED) are prone of having their attention interfered by food cues, and that food-related attentional biases are associated with calorie intake and eating disorder psychopathology. For adolescents with BED experimental evidence on attentional processing of food cues is lacking. Using eye-tracking and a visual search task, the present study examined visual orienting and disengagement processes of food in youth with BED. Eye-movement data and reaction times were recorded in 25 adolescents (12-20 years) with BED and 25 controls (CG) individually matched for sex, age, body mass index, and socio-economic status. During a free exploration paradigm, the BED group showed a greater gaze duration bias for food images than the CG. Groups did not differ in gaze direction biases. In a visual search task, the BED group showed a greater detection bias for food targets than the CG. Group differences were more pronounced for personally attractive than unattractive food images. Regarding clinical associations, only in the BED group the gaze duration bias for food was associated with increased hunger and lower body mass index, and the detection bias for food targets was associated with greater reward sensitivity. The study provided first evidence of an attentional bias to food in adolescents with BED. However, more research is needed for further specifying disengagement and orienting processes in adolescent BED, including overt and covert attention, and their prospective associations with binge-eating behaviors and associated psychopathology.
Rukavina, T; Pokrajac-Bulian, A
The aim of this investigation was to study the relationship between unhealthy eating habits and behaviors, perception and acceptance of societal standards regarding thinness, body dissatisfaction, and family and peer pressure to be thin. One hundred and twentythree high school girls from Rijeka (Croatia) were surveyed using Eating Attitudes Test (EAT- 26), Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ), Body Esteem Questionnaire for Adolescents and Adults (BES), and Scale of perceived pressure to be thin from family and peers. The results of path analyses showed that social pressure from family and peers, experience of weight-related teasing and criticism by family members, contributed to development of eating disturbance. The acceptance of social standards related to appearance, contributed to onset of disturbed eating habits. Weight satisfaction alone influences the development of some eating disorder symptoms, but it is also a mediator of higher body mass index (BMI) and internalization of societal appearance standards. Girls with higher BMI, who accepted societal standards of thin-ideal, perceived major social pressure to be thin through direct and persuasive comments designed to establish the importance of dieting, and probably develop eating disturbed habits, or some symptoms of anorexia (AN) or bulimia nervosa (BN).
Lee, Ju-Yeon; Kim, Sung-Wan; Shin, Il-Seon; Yoon, Jin-Sang
Orthodontic treatment typically occurs during early childhood and adolescence but the wearing of dental braces is often associated with sudden changes in eating patterns that prolong treatment into the teenage years. Despite these changes, psychological assessments related to eating disorders during the course of orthodontic treatment are often ignored. Based on the findings of the present case report, it is suggested that adolescent patients who wear braces and exhibit severe weight loss should be carefully monitored for psychiatric problems, including eating disorders. PMID:26207138
George, Melissa W; Fairchild, Amanda J; Mark Cummings, E; Davies, Patrick T
Disordered eating behaviors, including frequent dieting, unhealthy weight control behaviors (e.g., vomiting and skipping meals for weight loss) and binge eating are prevalent among adolescents. While negative, conflict-ridden family environments have long been implicated as problematic and a contributing factor to the development of disordered eating, few studies have examined the influence of marital conflict exposure in childhood to understand the development of these behaviors in adolescence. The current study investigates the impact of marital conflict, children's emotional insecurity about the marital relationship, and disordered eating behaviors in early adolescence in a prospective, longitudinal study of a community sample of 236 families in Midwest and Northeast regions of the U.S. Full structural mediation analyses utilizing robust latent constructs of marital conflict and emotional insecurity about the marital relationship, support children's emotional insecurity as an explanatory mechanism for the influence of marital conflict on adolescent disordered eating behaviors. Findings are discussed with important implications for the long-term impact of marital conflict and the development of disordered eating in adolescence.
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Background Binge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder – the gold standard treatment for adults with binge eating disorder. Methods/design In a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight. Discussion This trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results
Marzola, Enrica; Knatz, Stephanie; Murray, Stuart B; Rockwell, Roxanne; Boutelle, Kerri; Eisler, Ivan; Kaye, Walter H
Family therapy approaches have generated impressive empirical evidence in the treatment of adolescent eating disorders (EDs). However, the paucity of specialist treatment providers limits treatment uptake; therefore, our group developed the intensive family therapy (IFT)-a 5-day treatment based on the principles of family-based therapy for EDs. We retrospectively examined the long-term efficacy of IFT in both single-family (S-IFT) and multi-family (M-IFT) settings evaluating 74 eating disordered adolescents who underwent IFT at the University of California, San Diego, between 2006 and 2013. Full remission was defined as normal weight (≥ 95% of expected for sex, age, and height), Eating Disorder Examination Questionnaire (EDE-Q) global score within 1 SD of norms, and absence of binge-purging behaviours. Partial remission was defined as weight ≥ 85% of expected or ≥ 95% but with elevated EDE-Q global score and presence of binge-purging symptoms (<1/week). Over a mean follow-up period of 30 months, 87.8% of participants achieved either full (60.8%) or partial remission (27%), while 12.2% reported a poor outcome, with both S-IFT and M-IFT showing comparable outcomes. Short-term, intensive treatments may be cost-effective and clinically useful where access to regular specialist treatment is limited.
Eddy, Kamryn T.; Le Grange, Daniel; Crosby, Ross D.; Hoste, Renee Rienecke; Doyle, Angela Celio; Smyth, Angela; Herzog, David B.
Objective: The purpose of this study was to empirically derive eating disorder phenotypes in a clinical sample of children and adolescents using latent profile analysis (LPA), and to compare these latent profile (LP) groups to the DSM-IV-TR eating disorder categories. Method: Eating disorder symptom data collected from 401 youth (aged 7 through 19…
Obeid, Nicole; Buchholz, Annick; Boerner, Katelynn E; Henderson, Katherine A; Norris, Mark
This study explored symptoms of social anxiety and multidimensional self-esteem in a clinical, adolescent female eating disorder population. Using self-report measures, data from 344 females revealed significant negative relationships between dimensions of self-esteem and social anxiety. A diagnostic difference emerged, with the restricting subgroup reporting significantly higher perceived physical appearance and global self-worth than those with binge/purge symptoms or bulimia nervosa. No significant age differences or age by diagnosis interaction effects emerged. These findings suggest that in clinical samples of adolescent eating disorders, self-esteem and social anxiety share a significant inverse relationship and seem to remain fairly constant across adolescence.
Herpertz-Dahlmann, Beate; Dempfle, Astrid; Konrad, Kerstin; Klasen, Fionna; Ravens-Sieberer, Ulrike
This study reports the outcomes of childhood and adolescent eating-disordered behaviour on the development of body mass index (BMI) and psychological functioning in young adulthood in a population-based sample in Germany (the BELLA study). Information at baseline and follow-up was obtained through a telephone interview and mailed self-report questionnaires. At both measurement points, BMI, eating disorder symptoms (SCOFF questionnaire), and symptoms of depression and anxiety were assessed in the same cohort of 771 participants (n = 420 females, n = 351 males). The age range at baseline was 11-17 years, and the age range at follow-up was 17-23 years. High scores for eating-disordered behaviour in childhood or adolescence significantly predicted eating-disordered behaviour in young adulthood (multiplicative effect estimate: 1.31; 95 % CI: 1.2-1.42, p < 0.0001), although there was a decline in prevalence (from 19.3 to 13.8 %, p = 0.002) and severity (mean decrease in SCOFF 0.07, 95 % CI: -0.01-0.14, p = 0.06). After accounting for potentially confounding variables at baseline (SES, probands' BMI, parental BMI, depressive symptoms), participants with more eating disorder symptoms at baseline had a higher risk of developing overweight (odds ratio (OR): 1.58; 95 % CI: 1.19-2.09, p = 0.001), obesity (OR = 1.67; 95 % CI: 1.03-2.66, p = 0.03), and depressive symptoms at follow-up (additive effect estimate: 0.45; 95 %CI: 0.19-0.7, p = 0.0006). Early symptoms of depression showed a significant relationship with extreme underweight in young adulthood (OR = 1.13; 95 %CI: 1.01-1.25, p = 0.02). The high stability of eating disorder symptoms and the significant association with overweight and worse mental health in adulthood underscore the need for early detection and intervention during childhood and adolescence. Youth with depression should be monitored for the development of restrictive eating disorders.
Salbach-Andrae, Harriet; Schneider, Nora; Bürger, Arne; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Holzhausen, Martin
The present study examines the psychometric properties of the German version of the Eating Disorder Inventory EDI-2 (1997) in 371 adolescents aged 13 to 18 years. Internal consistency, convergent and divergent validity were examined and a confirmatory factor analysis was conducted. Internal consistency was high for the group of patients and satisfactory for both control groups. Associations with other clinical instruments point in the expected direction and support the external validity of the EDI-2. The EDI-2 differentiated very well between the group of eating disorder patients (n=71) and the female (n=150) and male control groups (n=150). A discriminant analysis demonstrated that 86.0% of the cases were correctly classified, and a confirmatory factor analysis largely supported the six-factor structure generated by the German version of the EDI-2 (Thiel et al., 1997).
Tsitsika, Artemis K; Tzavela, Eleni C; Apostolidou, Eftychia; Antonogeorgos, George; Sakou, Irine-Ikbale; Bakoula, Chryssa
The health effects of eating disorders (EDs) in adolescence have been widely studied, but their impact on present adolescent psychosocial adjustment and development have been overseen. This study aimed to investigate the association between EDs and career aspirations in middle adolescence. The participants were 147 adolescents diagnosed with EDs. Participants reported on their future career aspirations, and these were coded according to the International Standard Classification of Education of 1997. Of the participants, 83 adolescents were followed up longitudinally, and their aspirations were reassessed and compared for stability across the two assessments. Moreover, participants' career aspirations were compared to those of healthy (non-ED) best-friend controls. Health-related and social-behavioral science careers were chosen significantly more by adolescents with an ED as compared to their non-ED counterparts. For adolescents with an ED, career choices were consistent across reassessments. These findings suggest that adolescents with an ED gravitate toward careers associated with their pathology, namely, both facets of their mind-body pathology. This finding may indicate restricted identity development for adolescents with an ED. Suggestions for treatments protocols to include identity exploration are discussed.
Akgül, Sinem; Derman, Orhan; Kanbur, Nuray Ö
Culture-based contributors play a role in eating disorders (EDs). Here, we present one such factor that may play a role in triggering ED's in adolescents: Fasting during the holy period of Ramadan. Ramadan is the Islamic month of fasting, in which participating Muslims refrain from eating, drinking, and smoking, which starts from dawn lasting until sunset. For the past 2 years, we have noticed an increase in patients with disordered eating patterns that have applied to Hacettepe University, Division of Adolescent Medicine during or shortly after Ramadan. We document six of these patients, three of which were diagnosed with an ED and three that did not meet full criteria. We argue that the possible effects of a drastic change in ones diet such as that which occurs during Ramadan, play an important role in triggering ED's in adolescents with a predisposition or may exacerbate an eating pathology.
Álvarez-Malé, María Luisa; Bautista Castaño, Inmaculada; Serra Majem, Lluis
Objetivos: evaluar la prevalencia de trastornos de la conducta alimentaria en estudiantes con edades comprendidas entre los 12 a 20 años mediante medidas estandarizadas. Material y métodos: se seleccionaron al azar un total de 1342 participantes de centros educativos de la isla de Gran Canaria, España. Se empleó un diseño transversal de dos fases que incluía un primer cuestionario de cribado (EAT-40 con el punto de corte establecido en 20) y una entrevista clínica semi-estructurada (EDE). También se evaluaron variables sociodemográficas y el estado ponderal de los alumnos. Resultados: en el año 2013 estudiamos a participantes de 15 centros educativos de Gran Canaria. En la primera fase se halló una prevalencia de riesgo de 27,42% (33% de mujeres, 20,6% de hombres). En la segunda fase, 538 participantes accedieron a ser evaluados mediante entrevista clínica (285 en riesgo, con altas puntuaciones en el EAT; 253 seleccionados del grupo sin riesgo). La prevalencia global de trastorno de la conducta alimentaria fue de 4,11% (5,46% de mujeres, 2,55% de hombres). Empleando los criterios diagnósticos del DSM-IV-TR, la prevalencia para la anorexia nerviosa fue de 0,19%, para la bulimia nerviosa de 0,57% y para el trastorno de la conducta alimentaria no especificado de 3,34%. Conclusiones: la prevalencia diagnóstica de trastornos de la conducta alimentaria en Gran Canaria es similar a la del resto de España. Sin embargo, la prevalencia de riesgo de desarrollar dichos trastornos es especialmente elevada en Gran Canaria, teniendo en cuenta los datos de estudios tanto nacionales como internacionales.
Toro, J; Gila, A; Castro, J; Pombo, C; Guete, O
The aim was to study differences between male and female adolescents as regards body dissatisfaction, some risk factors for eating disorders, and exposure to social influences that create ideal body figures among these populations. A questionnaire comprising 40 items was administered to 240 male adolescents at 12 public and private schools in Barcelona. Twenty-nine of the questions were the same as those in another study administered to a sample of 675 female adolescents attending similar schools in the same geographical area. The other 11 questions were specifically for males. The differences between boys and girls were highly significant on almost all the items. Girls' scores were significantly higher (p = 0.000) in the following areas: dieting and exercising in order to be thin; feelings of anxiety on seeing or showing the body in public; tendency to focus on the bodies of others and on the amount of food they eat; the belief that thin people are more popular. In addition, the girls were significantly more vulnerable to potentially dangerous social influences. For the most part, males sought a heavier, more muscular body. Though a minority of males also feared being overweight, one out of four ate more than normal to gain weight and two out of three exercised to develop their muscles. The same proportion reported envying the build of certain actors. In adolescence, the ideal body figures of the sexes vary widely. This divergence reflects a greater risk of eating disorders in girls, who are also far more exposed to social situations that cause body dissatisfaction and shape risk attitudes and behaviors.
Lipsky, Rachele K; McGuinness, Teena M
Children and adolescents who eat unusually large amounts of food, feel guilty about it, and try to hide their overeating may be struggling with binge eating disorder (BED), a condition associated with suicidal ideation and other eating disorders. Although BED is new to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the syndrome is becoming increasingly recognized. The study of BED in children and adolescents is in its natal phase, but the importance of recognition and possible treatment strategies are discussed in the current article along with psychiatric nursing implications.
Zerwas, Stephanie; Von Holle, Ann; Watson, Hunna; Gottfredson, Nisha; Bulik, Cynthia M.
Objective The goal of the present paper was to examine whether childhood anxiety trajectories predict eating psychopathology. We predicted that girls with trajectories of increasing anxiety across childhood would have significantly greater risk of disordered eating in adolescence in comparison to girls with stable or decreasing trajectories of anxiety over childhood. Method Data were collected as part of the prospective longitudinal NICHD Study of Early Child Care and Youth Development (N=450 girls). Childhood anxiety was assessed yearly (54 months through 6th grade) via maternal report on the Child Behavior Checklist. Disordered eating behaviors were assessed at age 15 via adolescent self-report on the Eating Attitudes Test (EAT-26). We conducted latent growth mixture modeling to define girls’ childhood anxiety trajectories. Maternal sensitivity, maternal postpartum depression, maternal anxiety, and child temperament were included as predictors of trajectory membership. Results The best fitting model included three trajectories of childhood anxiety, the low-decreasing class (22.9% of girls), the high-increasing class (35.4%), and the high-decreasing class (41.6%). Mothers with more symptoms of depression and separation anxiety had girls who were significantly more likely to belong to the high-increasing anxiety trajectory. There were no significant differences in adolescent disordered eating for girls across the three childhood anxiety trajectories. Conclusions Childhood anxiety, as captured by maternal report, may not be the most robust predictor of adolescent disordered eating and may be of limited utility for prevention programs that aim to identify children in the community at greatest risk for disordered eating. PMID:24938214
Espinoza, Paola; Penelo, Eva; Raich, Rosa M
We assessed the prospective association of risk factors for eating and body image disturbances after a 2-year follow-up in a community sample of Spanish adolescent girls. The participants included 128 Spanish girls aged 12-14, who took part in a 28-month prospective study. Aspects assessed were eating attitudes (Eating Attitudes Test), influence of the body shape model (questionnaire on influences of the aesthetic body shape model), extreme weight-control behaviors (Eating Disorder Examination-Questionnaire), body image (Body Image Questionnaire) and Body Mass Index (BMI). BMI, extreme weight-control behaviors and body image problems emerged as potential predictors of an increase in eating disturbances. An increased influence of the thinness model was significantly associated with reduced body satisfaction and body image problems. Preventive programs are needed to contribute reducing the impact of sociocultural influences with regard to thinness, the use of extreme weight-control behaviors and overweight in adolescents.
Patrick, Julie Hicks; Stahl, Sarah T.; Sundaram, Murali
The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress.…
Lopez, Vera; Corona, Rosalie; Halfond, Raquel
This study examined the main and interaction effects of gender, traditional gender role orientation, and media-influenced sociocultural values and ideals about appearance in a sample of 96 Latino adolescents controlling for age, country of origin, and BMI. Girls and less traditionally oriented youth reported significantly more disordered eating and appearance concerns than did boys and more traditionally oriented youth. Gender moderated the relationship between traditional gender role orientation and disordered eating and appearance concerns. Contrary to our hypothesis, media-influenced sociocultural values and ideals about appearance did not significantly predict disordered eating and appearance concerns. However, the interaction between gender and sociocultural values and ideals about appearance was significant. Our findings highlight the importance of continued research on gender, media, and cultural influences as they relate to disordered eating and appearance concerns among Latino youth.
Baker, Jessica H; Runfola, Cristin D
Eating disorders afflict women across the lifespan with peak onset during critical or sensitive developmental periods of reproductive hormone change, such as puberty. A growing body of research supports the role of reproductive hormones, specifically estrogen, in the risk for eating disorders and related symptomatology in adolescence and young adulthood. Like puberty, perimenopause is characterized by estrogen change and may also present a window of vulnerability to eating disorder development. Here, we discuss the evidence that suggests perimenopause indeed may be a vulnerable period for the development or redevelopment of an eating disorder for midlife women. Drawing from what is known about the influence of estrogen on eating disorders at younger ages and from other psychiatric disorders with similar risk trajectories (i.e., perimenopausal depression), we describe a potential mechanism of risk for a perimenopausal eating disorder and how this can be explored in future research. Investigating vulnerability to perimenopausal eating disorders will clarify eating disorder etiology, identify reproductive stage-specific risk profiles, and guide future treatment directions.
Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M
Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.
Balentine, Margaret; And Others
Study identified African-American low-income adolescents who thought they had bulimia or anorexia nervosa, identified common behaviors, and compared actual and perceived body weight and dieting methods. About 12 percent suspected an eating disorder and perceived themselves as heavier more often than their peers. Fasting was the most common dieting…
Wade, Tracey D.; Davidson, Susan; O'Dea, Jennifer A.
Investigates the enjoyment and perceived value associated with two interventions designed to reduce risk factors for eating disorders in young adolescents, a media literacy program or a self-esteem program. Overall, the media literacy program was the intervention preferred by students. Students in both interventions said that they had learnt to…
... Eating disorders primarily affect girls and women, but boys and men also are vulnerable. Boys with eating disorders show the same types of ... as girls, but for a variety of reasons, boys are less likely to be diagnosed with what ...
Alexander, Kristina; Pohren, Philip
Eating disorders are a problem that receives too little attention. These disorders have a great impact on student relationships, self-esteem, health, and achievement. Administrators and teacher leaders must take the initiative to think proactively and intervene.
McVey, Gail L.; Pepler, Debra; Davis, Ron; Flett, Gordon L.; Abdolell, Mohamed
Risk and protective factors associated with disordered eating were examined in girls in middle-level school. Analysis showed that low competence in physical appearance, high importance of social acceptance, high self-oriented perfectionism, and low parental support were correlated significantly with reports of high levels of disordered eating.…
Walcott, Delores D.; Pratt, Helen D.; Patel, Dilip R.
Briefly reviews the common assumptions and knowledge about eating disorders, then reviews and compares recent research that is beginning to address underrepresented groups of color. Concludes with a brief statement of findings, the implications of eating disorders on a national level, and the rising risk to teenagers. (EV)
Caqueo-Urízar, Alejandra; Ferrer-García, Marta; Toro, José; Gutiérrez-Maldonado, José; Peñaloza, Claudia; Cuadros-Sosa, Yasna; Gálvez-Madrid, Ma José
This study explored the relationships between perceived sociocultural pressure to fulfill the thin beauty ideal, body distress, and the presence of eating disorder symptoms. Participants were 437 Chilean adolescent girls from Arica, northern Chile, aged 13-18. Results showed significant associations between perceived pressure from social agents to be thin and the presence of disrupted eating attitudes and behavior. The perceived influence of advertising, verbal messages and social situations related to eating and dieting emerged as the strongest predictors of eating disorders symptoms. Influence of advertising was also the strongest predictor of body image distress. Age differences emerged in perceived sociocultural pressure to be thin, with older participants reporting higher sociocultural pressure to fulfill the slender beauty ideal. This paper provides information about body distress and associated disturbances, a phenomenon which has seldom been studied in non-Western countries, but which has important health implications.
Bas, Murat; Bozan, Nuray; Cigerim, Nevin
The purpose of this study was to determine the relationship among dieting, dietary restraint, disinhibition, hunger, and binge eating among overweight adolescent girls. Participants were 743 overweight adolescent girls between 16 and 19 years of age. The mean BMI was 24.9 [+ or -] 0.8 kg/[m[superscript 2] in the low-restraint group and 25.1 [+ or…
Girz, Laura; Robinson, Adele Lafrance; Tessier, Carole
This study examined medical residents' comfort with and knowledge of eating disorder assessment and treatment practices for children and adolescents. Since entering medical school, the majority of respondents reported receiving fewer than 5 hours of training in this area. Participants reported feeling more comfortable with the assessment of eating disorders than with their medical management and treatment. Questions testing participants' knowledge in these domains reflected this finding; participants did well on the assessment questions, but quite poorly on the treatment questions. Intensity of training and self-reported comfort with these skills predicted residents' knowledge, suggesting that additional training opportunities are warranted.
Su, Xiujuan; Liang, Hong; Yuan, Wei; Olsen, Jørn; Cnattingius, Sven; Li, Jiong
Females are more likely than males to develop eating disorders (EDs) in the adolescence and youth, and the etiology remains unclear. We aimed to estimate the effect of severe early life stress following bereavement, the death of a close relative, on the risk of EDs among females aged 10-26 years. This population-based cohort study included girls born in Denmark (from 1973 to 2000) or Sweden (from 1970 to 1997). Girls were categorized as exposed if they were born to mothers who lost a close relative 1 year prior to or during pregnancy or if the girl herself lost a parent or a sibling within the first 10 years of life. All other girls were included in unexposed group. An ED case was defined by a diagnosis of EDs at ages of 10-26 years, including broadly defined bulimia nervosa, broadly defined anorexia nervosa and mixed EDs. Poisson regression models were used to estimate the incidence rate ratio (IRR) between exposed group and unexposed group.A total of 64453 (3.05 %) girls were included in the exposed group. We identified 9477 girls with a diagnosis of EDs, of whom 307 (3.24 %) were from the exposed group. Both prenatal and postnatal exposure following bereavement by unexpected death was associated with an increased overall risk of EDs (IRRprenatal: 1.49, 95 % CI: 1.01-2.19 and IRRpostnatal: 1.34, 95 % CI: 1.05-1.71). We observed similar results for subtypes of broadly defined bulimia nervosa (IRR: 2.47, 95 % CI: 1.67-3.65) and mixed EDs (IRR: 1.45, 95 % CI: 1.02-2.07).Our findings suggest that prenatal and early postnatal life stress due to unexpected death of a close relative is associated with an increased overall risk of eating disorders in adolescent girls and young women. The increased risk might be driven mainly by differences in broadly defined bulimia nervosa and mixed eating disorders, but not broadly defined anorexia nervosa.
Fitzsimmons-Craft, Ellen E; Ciao, Anna C; Accurso, Erin C; Pisetsky, Emily M; Peterson, Carol B; Byrne, Catherine E; Le Grange, Daniel
This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology.
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Baker, Jessica H.; Thornton, Laura M.; Lichtenstein, Paul; Bulik, Cynthia M.
Objective Early maturing girls are at increased risk for disordered eating. However, it is unclear if the association between puberty and disordered eating continues throughout pubertal development and if a similar association is exhibited in boys. Method Participants included 1340 same- and 624 opposite-sex twins from the Swedish Twin Study of Child and Adolescent Development. Pubertal development was assessed at age 13–14 with the Pubertal Development Scale. General disordered eating, measured with the Eating Disorder Inventory-2 (EDI) was assessed at age 16–17, and dieting and purging behaviors were assessed at both ages 16–17 and 19–20. We applied analysis of variance and logistic regression analyses to determine whether pubertal development in early-to-mid adolescence predicted eating disorder-related behaviors in late adolescence and young adulthood Results Pubertal development in early-to-mid adolescence was significantly associated with EDI scores and dieting in late adolescence. No significant association was observed between pubertal development and dieting and purging in young adulthood. Discussion Complex combinations of cultural and biological influences likely converge during pubertal development increasing vulnerability to disordered eating. The impact of pubertal development on disordered eating appears to be limited to the adolescent period. PMID:22522282
Juli, Maria Rosaria
The origin and course of eating disorders and nutrition have a multifactorial etiology and should therefore take into consideration: psychological factors, evolutionary, biological and socio-cultural (Juli 2012). Among the psychological factors we will focus on violence (in any form) and in particular on the consequences that they have on women, which vary in severity. Recent studies show that women get sick more than men, both from depression and eating disorders, with a ratio of 2:1; this difference begins in adolescence and continues throughout the course of life (Niolu 2010). The cause of this difference remains unclear. Many studies agree that during adolescence girls have negative feelings more frequently and for a longer duration caused by stressful life events and difficult circumstances, such as abuse or violence. This results in an increased likelihood of developing a symptom that will be connected to eating disorders and/or depression. As far as the role of food is concerned in eating disorders, it has a symbolic significance and offers emotional comfort. Eating means to incorporate and assimilate, and even in an ideal sense, the characteristics of the foods become part of the individual. Feelings that lead to binges with food are normally a result of feelings related to abuse or violence and lead to abnormal behavior which leads to binging and the final result being that the person is left feeling guilty and ashamed. Research confirms that 30% of patients who have been diagnosed with eating disorders, especially bulimia, have a history of sexual abuse during childhood. Ignoring the significance of this factor can result in the unleashing of this disease as the patient uses the disorder as his expressive theater (Mencarelli 2008). Factors that contribute to the possibility of developing an eating disorder are both the age of the patient at the time of the abuse and the duration of the abuse. The psychological effects that follow may include dissociative
Rhea, Deborah J; Thatcher, W Gregory
The purpose of this study was two-fold: to determine the relationship between ethnic identity and self-esteem as dimensions of one's self-concept; and to determine if differences exist among one's ethnicity, ethnic identity, and/or self-esteem when examining at-risk eating disordered behaviors. A total of 893 urban adolescent females completed three behavioral subscales: the Eating Disorder Inventory, Rosenberg's Self-Esteem Scale, and Phinney's Multigroup Ethnic Identity Measure. As hypothesized, ethnic identity was significantly associated with self-esteem to form one's self-concept. When compared to Mexican American and White females, only Black females who were in the higher ethnic identity and self-esteem categories had significantly lower at-risk eating disordered scores. Our findings suggest eating disorder status in Mexican American and White females may not be associated as much with ethnic identity as with other acculturation and self-concept factors. Further, this study demonstrated ethnicity, self-esteem, and ethnic identity play significant roles in eating disorder risks.
Jalali-Farahani, Sara; Chin, Yit Siew; Mohd Nasir, Mohd Taib; Amiri, Parisa
This study aimed to determine the association between disordered eating and overweight and also health-related quality of life (HRQOL) among adolescents in high schools of Tehran. The participants were 465 adolescents, aged 14-17 years. After anthropometric measurements, body mass index-for-age and body weight status were determined using World Health Organization cut offs. The Eating Attitudes Test-26 (EAT-26) and Pediatric Quality of Life Inventory (PedsQL™4.0) were used to assess disordered eating and HRQOL, respectively. Disordered eating was prevalent in 18.9% of adolescents, with higher prevalence in girls (26.4%) compared to boys (11.8%; χ(2):16.29, p < 0.05). Disordered eating was associated with overweight in girls (χ(2) = 11.07, p < 0.05), but not in boys (χ(2) = 2.01, p = 0.16). Disordered eating was associated with poor HRQOL especially in psychosocial domains of HRQOL. Considering the high prevalence of disordered eating and its association with overweight and poor HRQOL, preventive interventions targeting adolescents are recommended.
The comorbidity of schizophrenia and eating disorders is understudied. In the early nineteenth century, Eugen Bleuler has reported cases of schizophrenia with eating disorders that were related to delusional ideas. Potomania, merycism and pica have often been described in schizophrenic patients. Schizophrenic patients with eating disorders usually do not meet all criteria for typical eating disorders and are therefore classified as "eating disorders not otherwise specified" (EDNOS). It may even be difficult to recognize schizophrenia in patients with eating disorders associated to delusional ideas and distorted cognitions related to food or body perception. In any case, the diagnosis of schizophrenia should preferably be made and is only valid after renutrition is achieved. The prevalence of schizophrenia in samples of patients with eating disorders is generally below 10% but reaches 35% in males, the most frequent form being hebephrenia. Cognitive behavioural therapies for eating disorders need to be adapted in cases of comorbid schizophrenia. The new antipsychotic medications seem helpful in patients with eating disorders with or without schizophrenia. They reduce anxiety towards eating and bring in better adherence to treatments.
Parker, Elizabeth K.; Faruquie, Sahrish S.; Anderson, Gail; Gomes, Linette; Kennedy, Andrew; Wearne, Christine M.; Kohn, Michael R.; Clarke, Simon D.
Introduction. This study examines weight gain and assesses complications associated with refeeding hospitalised adolescents with restrictive eating disorders (EDs) prescribed initial calories above current recommendations. Methods. Patients admitted to an adolescent ED structured “rapid refeeding” program for >48 hours and receiving ≥2400 kcal/day were included in a 3-year retrospective chart review. Results. The mean (SD) age of the 162 adolescents was 16.7 years (0.9), admission % median BMI was 80.1% (10.2), and discharge % median BMI was 93.1% (7.0). The mean (SD) starting caloric intake was 2611.7 kcal/day (261.5) equating to 58.4 kcal/kg (10.2). Most patients (92.6%) were treated with nasogastric tube feeding. The mean (SD) length of stay was 3.6 weeks (1.9), and average weekly weight gain was 2.1 kg (0.8). No patients developed cardiac signs of RFS or delirium; complications included 4% peripheral oedema, 1% hypophosphatemia (<0.75 mmol/L), 7% hypomagnesaemia (<0.70 mmol/L), and 2% hypokalaemia (<3.2 mmol/L). Caloric prescription on admission was associated with developing oedema (95% CI 1.001 to 1.047; p = 0.039). No statistical significance was found between electrolytes and calories provided during refeeding. Conclusion. A rapid refeeding protocol with the inclusion of phosphate supplementation can safely achieve rapid weight restoration without increased complications associated with refeeding syndrome. PMID:27293884
Warschburger, P; Krentz, E M; Helfert, S
Eating disorders are serious, hard to treat and widely spread. Hence it was the goal of the present project to develop and evaluate a universal preventive concept (Potsdam Prevention at Schools). The POPS programme focuses in an interactive manner on topics such as coping with social pressure, strengthening the media and problem-solving competence and healthy eating. Results from the ITT analysis support its efficacy, even over the course of one year in terms of reduction of body dissatisfaction, perceived media pressure, internalising of the media beauty ideal and disordered eating.
Campbell, Kenisha; Peebles, Rebecka
Despite their high prevalence, associated morbidity and mortality, and available treatment options, eating disorders (EDs) continue to be underdiagnosed by pediatric professionals. Many adolescents go untreated, do not recover, or reach only partial recovery. Higher rates of EDs are seen now in younger children, boys, and minority groups; EDs are increasingly recognized in patients with previous histories of obesity. Medical complications are common in both full and subthreshold EDs and affect every organ system. No single cause of EDs has emerged, although neurobiological and genetic predispositions are emerging as important. Recent treatment paradigms acknowledge that they are not caused by families or chosen by patients. EDs present differently in pediatric populations, and providers should have a high index of suspicion using new Diagnostic and Statistical Manual, 5th edition diagnostic criteria because early intervention can affect prognosis. Outpatient family-based treatment focused on weight restoration, reducing blame, and empowering caregivers has emerged as particularly effective; cognitive behavioral therapy, individual therapy, and higher levels of care may also be appropriate. Pharmacotherapy is useful in specific contexts. Full weight restoration is critical, often involves high-calorie diets, and must allow for continued growth and development; weight maintenance is typically inappropriate in pediatric populations. Physical, nutritional, behavioral, and psychological health are all metrics of a full recovery, and pediatric EDs have a good prognosis with appropriate care. ED prevention efforts should work toward aligning with families and understanding the impact of antiobesity efforts. Primary care providers can be key players in treatment success.
Loth, Katie; Wall, Melanie; Larson, Nicole; Neumark-Sztainer, Dianne
Objective In this research study, we examine how both overweight and nonoverweight adolescent girls and boys fared from 1999 to 2010 in terms of disordered eating behaviors and psychosocial well-being. Method A repeated cross-sectional design was used. Participants were recruited from public schools in 1999 (n = 3072, mean age = 14.6 ± 1.8) and 2010 (n = 2793, mean age = 14.4 ± 2.0). Secular trends were examined by weight status and gender using inverse probability weighting to control for changes in socio-demographics. Results In general, the prevalence of disordered eating behaviors and markers of psychosocial well-being among overweight girls and boys remained the same from 1999 to 2010. In contrast, among nonoverweight girls, chronic dieting, unhealthy weight control behaviors, and extreme weight control behaviors decreased, and body satisfaction improved during this time period. Further, among non-overweight boys, the prevalence of unhealthy and extreme weight control behaviors decreased, as did mean depression scores. Discussion Overall, findings indicate a strong need to ensure that messages about the dangers of disordered eating behaviors are reaching overweight youth. Obesity prevention interventions should not overlook the comorbid nature of obesity, disordered eating and poor psychosocial health; prevention programming should address shared risk factors, including dieting, media use, body dissatisfaction, and weight-related teasing. PMID:25641764
Although commonly associated with girls and women, eating disorders do not discriminate. School nurses need to be aware that male students also can suffer from the serious health effects of anorexia nervosa, bulimia, anorexia athletica, and eating disorders not otherwise specified. Sports that focus on leanness and weight limits can add to a…
Rojo-Moreno, Luis; Arribas, Pilar; Plumed, Javier; Gimeno, Natalia; García-Blanco, Ana; Vaz-Leal, Francisco; Luisa Vila, María; Livianos, Lorenzo
The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis.
Jung, Jaehee; Forbes, Gordon B.
Multiple measures of body dissatisfaction and behaviors associated with disordered eating were studied in 258 White girls, 223 White boys, 106 Black girls, and 82 Black boys. All participants were unpaid volunteers between the ages of 12 and 15 attending six middle schools in Delaware and Maryland. On two self-ideal figure drawing discrepancy…
Donaldson, Abigail A.; Gordon, Catherine M.
Anorexia Nervosa (AN) is a psychiatric illness with profound medical consequences. Among the many adverse physical sequelae of AN, bone health is impacted by starvation and can be permanently impaired over the course of the illness. In this review of skeletal complications associated with eating disorders, we discuss the epidemiology, neuroendocrine changes, adolescent vs. adult skeletal considerations, orthopedic concerns, assessment of bone health, and treatment options for individuals with AN. The focus of the review is the skeletal sequelae associated with anorexia nervosa, but we also briefly consider other eating disorders that may afflict adolescents and young adults. The review presents updates to the field of bone health in AN, and also suggests knowledge gaps and areas for future investigation. PMID:26166318
Fakra, Eric; Belzeaux, R; Azorin, J M; Adida, M
Epidemiologic studies show a frequent co-occurence of affective and eating disorders. The incidence of one disorder in patients suffering from the other disorder is well over the incidence in the general population. Several causes could explain this increased comorbidity. First, the iatrogenic origin is detailed. Indeed, psychotropic drugs, and particularly mood stabilizers, often lead to modification in eating behaviors, generally inducing weight gain. These drugs can increase desire for food, reduce baseline metabolism or decrease motor activity. Also, affective and eating disorders share several characteristics in semiology. These similarities can not only obscure the differential diagnosis but may also attest of conjoint pathophysiological bases in the two conditions. However, genetic and biological findings so far are too sparse to corroborate this last hypothesis. Nonetheless, it is noteworthy that comorbidity of affective and eating disorders worsens patients'prognosis and is associated with more severe forms of affective disorders characterized by an earlier age of onset in the disease, higher number of mood episodes and a higher suicidality. Lastly, psychotropic drugs used in affective disorders (lithium, antiepileptic mood stabilizers, atypical antipsychotics, antidepressants) are reviewed in order to weigh their efficacy in eating disorders. This could help establish the best therapeutic option when confronted to comorbidity.
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Pinhas-Hamiel, Orit; Hamiel, Uri; Levy-Shraga, Yael
Eating disorders (ED) are characterized by a persistent disturbance of eating that impairs health or psychosocial functioning. They are associated with increased rates of medical complications and mortality. Insulin omission is a unique purging behavior available to individuals with type 1 diabetes mellitus (T1DM). The standard treatment regimen for T1DM requires a major focus on food and eating patterns. Moreover, intensive insulin therapy is associated with increasing body weight. These factors, combined with the psychological burden of chronic disease management and depression, may contribute to ED. The comorbidity of ED in T1DM patients is associated with poorer glycemic control and consequently higher rates of diabetes complications. Early recognition and adequate treatment of ED in T1DM is essential. PMID:25897361
White, J H
The eating disorders of anorexia nervosa and bulimia nervosa are important health problems for women today. Nurses at different practice sites are in a position to assess, treat, and refer these women, depending on educational and clinical preparation. This article presents information to facilitate the role of the nurse in working with women with eating disorders. Clinical features, risk factors, and treatment options are discussed.
Kravvariti, V; Gonidakis, Fr
Women suffering from eating disorders, present considerable retardation and difficulties in their psychosexual development during adolescence. This leads to primary or secondary insufficiencies in their adult sexual life. The cause of these difficulties seems to be a series of biological, family and psychosocial factors. The majority of the research findings indicate that eating disorders have a negative impact on the patient's sexual function. The factors related to eating disorders symptomatology that influence sexuality are various and differ among each eating disorder diagnostic categories. Considering anorexia nervosa, it has been reported that women have negative attitudes to sexual issues and their body. Their sexual motivation increases when they engage in psychotherapy and their body weight is gradually restored. Starvation and its consequences on the human physiology and especially on the brain function seem to be the main factor that leads to reduced sexual desire and scarce sexual activity. Moreover, personality traits that are common in patients suffering from anorexia nervosa such as compulsivity and rigidity are also related with difficulties initiating and retaining romantic and sexual relationships. Usually patients suffering from anorexia nervosa report impaired sexual behavior and lack of interest to engage in a sexual relationship. Considering Bulimia Nervosa, impulsivity and difficulties in emotion regulation that are common features of the individuals that suffer from bulimia nervosa are also related to impulsive and sometimes self-harming sexual behaviors. Moreover women sufferers often report repulsion, anger and shame towards their body and weight, mainly due to the distorted perception that they are fat and ugly. It is interesting that a number of research findings indicate that although patients suffering from bulimia nervosa are more sexually active and have more sexual experiences than patients suffering from anorexia nervosa, both
Richards, Kaye; Allin, Linda
The history and etiology of eating disorders are briefly outlined, with attention to their prevalence in adolescent girls. A critical examination of the links among outdoor adventure, eating disorders, and physicality shows how adventure programs can reinforce eating disorders. Strategies are presented that illustrate the potential of outdoor…
Sharan, Pratap; Sundar, A. Shyam
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations. PMID:26330646
Moriarty, Dick; Moriarty, Mary
Since sports can sometimes lend themselves to eating disorders, coaches and sports administrators must get involved in the detection and treatment of this problem. While no reliable studies or statistics exist on the incidence of anorexia nervosa and/or bulimia among athletes, some research suggests that such disorders occur frequently among…
Jasik, Carolyn Bradner
Eating behavior in adolescents can be as high risk as other behaviors that arise during this period and can have serious health consequences. This article presents a framework for screening and treatment of abnormal adolescent eating behavior by the primary care provider. A review of the types of disordered eating is presented along with suggested ways to screen. Indications for subspecialty eating disorder referrals and key aspects of screening and intervention in adolescent obesity and eating disorders are also reviewed. Specific attention is paid to the aspects of care that can be provided in primary care and multidisciplinary care.
Cartwright, Martina M
Eating disorders are maladaptive eating behaviors that typically develop in adolescence and early adulthood. Psychiatric maladies and comorbid conditions, especially insulin-dependent diabetes mellitus, frequently co-exist with eating disorders. Serious medical complications affecting all organs and tissues can develop and result in numerous emergent hospitalizations. This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.
Coelho, Gabriela Morgado de Oliveira; Gomes, Ainá Innocencio da Silva; Ribeiro, Beatriz Gonçalves; Soares, Eliane de Abreu
Eating disorders are serious mental diseases that frequently appear in female athletes. They are abnormal eating behaviors that can be diagnosed only by strict criteria. Disordered eating, although also characterized as abnormal eating behavior, does not include all the criteria for diagnosing eating disorders and is therefore a way to recognize the problem in its early stages. It is important to identify factors to avoid clinical progression in this high-risk population. Therefore, the purpose of this review is to discuss critical information for the prevention of eating disorders in female athletes. This review discusses the major correlates for the development of an eating disorder. We also discuss which athletes are possibly at highest risk for eating disorders, including those from lean sports and female adolescent athletes. There is an urgent need for the demystification of myths surrounding body weight and performance in sports. This review includes studies that tested different prevention programs’ effectiveness, and the majority showed positive results. Educational programs are the best method for primary prevention of eating disorders. For secondary prevention, early identification is essential and should be performed by preparticipation exams, the recognition of dietary markers, and the use of validated self-report questionnaires or clinical interviews. In addition, more randomized clinical trials are needed with athletes from multiple sports in order for the most reliable recommendations to be made and for some sporting regulations to be changed. PMID:24891817
Juarascio, Adrienne S; Felton, Julia W; Borges, Allison M; Manasse, Stephanie M; Murray, Helen B; Lejuez, Carl W
The current study examined internalizing symptoms, affect reactivity, and distress intolerance as prospective predictors of increases in eating disorder (ED)-attitudes during adolescence. Adolescents (n = 206) took part in a six-year longitudinal study examining the development of psychopathology. Latent growth curve analysis was used to examine associations between predictors and later ED-attitudes. Distress intolerance and internalizing symptoms were associated with ED-attitudes at baseline, but did not predict increases over time. Affect reactivity, however, was significantly associated with increases in ED-attitudes over time. Baseline affect reactivity did not interact with baseline distress intolerance to predict increases in ED-attitudes; however higher baseline internalizing symptoms interacted with distress intolerance to predict increases in ED-attitudes across adolescence. These results are among the first to document that affect reactivity alone and the combined effect of high internalizing symptoms and high distress intolerance early in adolescence are risk factors for the later development of ED-attitudes.
Keel, Pamela K.; Haedt, Alissa
Eating disorders represent a significant source of psychological impairment among adolescents. However, most controlled treatment studies have focused on adult populations. This review provides a synthesis of existing data concerning the efficacy of various psychosocial interventions for eating disorders in adolescent samples. Modes of therapy…
Góngora, Vanesa C
This study aimed to investigate the relationship among three potential protective factors: satisfaction with life, three routes to well-being and meaning in life, and eating disorder symptoms and body dissatisfaction in male and female adolescents. The sample was composed of 247 adolescent students aged 13 to 18 years. The findings of this study support the protective roles of satisfaction with life and engagement as routes to well-being in male adolescents and particularly in female adolescents. Positive interventions to promote satisfaction with life and engagement in activities in school are highly recommended.
Abebe, Dawit Shawel; Torgersen, Leila; Lien, Lars; Hafstad, Gertrud S.; von Soest, Tilmann
We investigated longitudinal predictors for disordered eating from early adolescence to young adulthood (12-34 years) across gender and different developmental phases among Norwegian young people. Survey data from a population-based sample were collected at four time points (T) over a 13-year time span. A population-based sample of 5,679 females…
Mond, J. M.; Marks, P.; Hay, P. J.; Rodgers, B.; Kelly, C.; Owen, C.; Paxton, S. J.
This research examined the "mental health literacy" of adolescents concerning eating-disordered behavior. A vignette describing a fictional 16-year old female meeting diagnostic criteria for bulimia nervosa was presented to 522 female high school students, followed by a series of questions concerning treatment of and treatment-seeking…
Depestele, Lies; Lemmens, Gilbert M D; Dierckx, Eva; Baetens, Imke; Schoevaerts, Katrien; Claes, Laurence
This study investigated the caregiving experiences of mothers and fathers of restrictive and binge-eating/purging eating disordered (ED) inpatients with and without non-suicidal self-injury (NSSI). Sixty-five mothers and 65 fathers completed the Experience of Caregiving Inventory. All inpatients completed the Self-Injury Questionnaire-Treatment Related to assess NSSI and the Eating Disorder Evaluation Scale to assess eating disorder symptoms. Mothers reported significant more negative and more positive caregiving experiences compared with fathers. Mothers (but not fathers) of restrictive ED patients reported more positive caregiving experiences compared with mothers of binge-eating/purging patients. The presence of NSSI in ED patients was associated with more negative caregiving experiences of both parents. Mothers and fathers of ED inpatients differ in caregiving experiences, and both binge-eating behaviours and NSSI negatively affect their caregiving experience. Therefore, supportive interventions for parents of ED patients are necessary, especially of those patients who engage in NSSI.
Pearson, Carolyn M.; Zapolski, Tamika C. B.; Smith, Gregory T.
Objective This article tested whether disordered eating in the spring of sixth grade can be predicted by the behaviors of fifth grade elementary school children. Method Measurements of disordered eating were collected from 1906 children (mean age = 10.86 years) at Time 1 (spring of fifth grade), Time 2 (fall of sixth grade), and Time 3 (spring of sixth grade). Results A number of fifth grade children reported disordered eating during the previous 2 weeks: 12.1% reported objective binge episodes, 4.8% reported purging food, and 9.8% reported restricting food intake. These behaviors predicted disordered eating during the spring of sixth grade. In addition, fifth grade pubertal onset predicted higher levels of restricting for girls. Conclusion A substantial number of fifth grade children reported disordered eating behaviors, and these behaviors predicted disordered eating behaviors in the spring of sixth grade. Disordered eating can be studied at least as early as fifth grade. PMID:22961314
Ruiz-Lazaro, P M
Considerable advances have been made in research of epidemiology of eating behavior disorders in Spain. This report summarizes recent studies. This review suggests that the prevalence of abnormal eating attitudes and behaviors in Spanish clinical and non-clinical populations is not markedly different from that already reported for other developed countries. The wide range of variation in published prevalence rates for eating disorders in adults and adolescents can be understood in the face of the many methodological problems inherent to this type of research. Anorexia nervosa and related eating disorders are most commonly investigated in adolescent girls and young women and a number of researchers have investigated prevalence rates in this
Pliatskidou, S; Samakouri, M; Kalamara, E; Papageorgiou, E; Koutrouvi, K; Goulemtzakis, C; Nikolaou, E; Livaditis, M
The aim of this study is to examine the validity of the Greek version of the Eating Disorder Examination Questionnaire 6.0 (EDE-Q-6.0) in a sample of adolescent pupils. EDE-Q is a self- report instrument that assesses attitudes and behaviors related to Eating Disorders (EDs). A two-stage identification protocol has been applied to the 16 schools that agreed to participate in the present study. Initially, 2058 adolescents, in class under the supervision of one research assistant and one teacher, completed a Questionnaire on socio-demographic data, the Greek EDE-Q-6.0 and the Greek Eating Attitudes Test (EAT-26) while their weight and height were measured. Six-hundred and twenty six participants, who had scores on EAT-26≥20 and/or were underweight or overweight, were considered as "possible-cases" while the remaining 1432 pupils of the sample were thought as "non-possible cases". At the second stage, parents of 66 of the participants identified as possible-cases as well as parents of 72 participants from 358 controls randomly selected from the sample of "non-possible cases" agreed that their children would be examined by means of Best Estimate Diagnostic Procedure. Participants meeting DSM-IV-TR Eating Disorders criteria were identified. Receiver Operating Characteristics (ROC) analysis was applied to reveal EDE-Q's criterion validity. The kappa statistic test was used as measure of agreement between categorical variables at EDE-Q and at interview (the presence of objective binge eating episode, of self-induced vomiting, the use of laxatives and of excessive exercise). The Discriminant and Convergent validity were assessed using the non-parametric Mann-Whitney U test and by means of the Spearman's correlation coefficient, respectively. Nineteen cases of EDs were identified [one case of Anorexia Nervosa (AN), 13 cases of Eating Disorder Not Otherwise Specified (EDNOS), 5 cases of Binge Eating Disorder (BED)]. At the cut off point of 2.6125 on the EDE-Q's global
Jackson, Todd; Chen, Hong
Even though reliable eating disorder risk factors have been identified among adolescent girls, little is known about predictors of increased vulnerability within specific phases of adolescence or among adolescent boys, particularly in highly populated non-Western contexts. In this study, early and middle adolescent boys (n = 1,271) and girls (n = 1,415) from Chongqing, China completed validated measures of eating disorder pathology and putative risk factors at baseline and 2 years follow-up. Multivariate models for boys of each age group indicated increases in disordered eating at follow-up were predicted by higher initial body mass index, negative affect and body dissatisfaction levels as well as attendant increases in perceived appearance pressure from mass media, body dissatisfaction, negative affect between assessments. High baseline levels of reported appearance pressure from parents and dating partners contributed, respectively, to prediction models of younger and older boys. More distinct constellations of significant predictors emerged in multivariate models of early versus middle adolescent girls. Together, findings indicated body dissatisfaction and negative affect were fairly robust risk factors for exacerbations in disturbances across samples while risk factors such as perceived pressure from desired/prospective dating partners were salient only during particular phases of adolescence.
Rosling, Agneta; Salonen Ros, Helena; Swenne, Ingemar
Aims To study the 1-year outcome and to analyse predictors of outcome of a cohort of adolescent girls with anorexia nervosa (AN) or restrictive eating disorders not otherwise specified (EDNOSr) treated as out-patients in a family-based programme at a specialized eating disorder service. To calculate the incidence of anorexia nervosa among treatment-seeking girls younger than 18 in Uppsala County from 2004 to 2006. Methods A total of 168 female patients were offered treatment, and 141 were followed-up 1 year after starting treatment, 29 with AN and 112 with EDNOSr. Results Of the 29 girls who initially had AN, 6 (20%) had a good outcome and were free of any form of eating disorder at follow-up; only 1 (3%) had AN. Of the patients with EDNOSr, 54 (48%) had a good outcome and were free of eating disorders. Three (3%) had a poor outcome and had developed AN. The incidence of AN was 18/100,000 person-years in girls younger than 12 and 63/100,000 in girls younger than 18. Conclusion Restrictive eating disorders, including AN, in children and adolescents can be successfully treated in a family-based specialized out-patient service without in-patient care. PMID:26915921
Rosling, Agneta; Salonen Ros, Helena; Swenne, Ingemar
Aims To study the 1-year outcome and to analyse predictors of outcome of a cohort of adolescent girls with anorexia nervosa (AN) or restrictive eating disorders not otherwise specified (EDNOSr) treated as out-patients in a family-based programme at a specialized eating disorder service. To calculate the incidence of anorexia nervosa among treatment-seeking girls younger than 18 in Uppsala County from 2004 to 2006. Methods A total of 168 female patients were offered treatment, and 141 were followed-up 1 year after starting treatment, 29 with AN and 112 with EDNOSr. Results Of the 29 girls who initially had AN, 6 (20%) had a good outcome and were free of any form of eating disorder at follow-up; only 1 (3%) had AN. Of the patients with EDNOSr, 54 (48%) had a good outcome and were free of eating disorders. Three (3%) had a poor outcome and had developed AN. The incidence of AN was 18/100,000 person-years in girls younger than 12 and 63/100,000 in girls younger than 18. Conclusion Restrictive eating disorders, including AN, in children and adolescents can be successfully treated in a family-based specialized out-patient service without in-patient care.
Brooks, Samantha J; Solstrand Dahlberg, Linda; Swenne, Ingemar; Aronsson, Marianne; Zarei, Sanaz; Lundberg, Lina; Jacobsson, Josefin A; Rask-Andersen, Mathias; Salonen-Ros, Helena; Rosling, Agneta; Larsson, Elna-Marie; Schiöth, Helgi B
The role of rumination at the beginning of eating disorder (ED) is not well understood. We hypothesised that impulsivity, rumination and restriction could be associated with neural activity in response to food stimuli in young individuals with eating disorders (ED). We measured neural responses with functional magnetic resonance imaging (fMRI), tested working memory (WM) and administered the eating disorders examination questionnaire (EDE-Q), Barratt impulsivity scale (BIS-11) and obsessive-compulsive inventory (OCI-R) in 15 adolescent females with eating disorder not otherwise specified (EDNOS) (mean age 15 years) and 20 age-matched healthy control females. We found that EDNOS subjects had significantly higher scores on the BIS 11, EDE-Q and OCI-R scales. Significantly increased neural responses to food images in the EDNOS group were observed in the prefrontal circuitry. OCI-R scores in the EDNOS group also significantly correlated with activity in the prefrontal circuitry and the cerebellum. Significantly slower WM responses negatively correlated with bilateral superior frontal gyrus activity in the EDNOS group. We conclude that ruminations, linked to WM, are present in adolescent females newly diagnosed with EDNOS. These may be risk factors for the development of an eating disorder and may be detectable before disease onset.
Lauer, Christoph J; Krieg, Jürgen-Christian
Sleep research on eating disorders has addressed two major questions: (1) the effects of chronic starvation in anorexia nervosa and of rapidly fluctuating eating patterns in bulimia nervosa on the sleep regulating processes and (2) the search for a significant neurobiological relationship between eating disorders and major depression. At present, the latter question appears to be resolved, since most of the available evidences clearly underline the notion that eating disorders (such as anorexia and bulimia nervosa) and affective disorders are two distinct entities. Regarding the effects of starvation on sleep regulation, recent research in healthy humans and in animals demonstrates that such a condition results in a fragmentation of sleep and a reduction of slow wave sleep. Although several peptides are supposed to be involved in these regulatory processes (i.e. CCK, orexin, leptin), their mode of action is still poorly understood. In opposite to these experimentally induced sleep disturbances are the findings that the sleep patterns in eating disorder patients per se do not markedly differ from those in healthy subjects. However, when focusing on the so-called restricting anorexics, who maintain their chronic underweight by strictly dieting, the expected effects of malnutrition on sleep can be ascertained. Furthermore, at least partial weight restoration results in a 'deepening' of nocturnal sleep in the anorexic patients. However, our knowledge about the neurobiological systems (as well as their circadian pattern of activity) that transmit the effects of starvation and of weight restoration on sleep is still limited and should be extended to metabolic signals mediating sleep.
Boone, Liesbet; Soenens, Bart; Braet, Caroline; Goossens, Lien
Although the association between perfectionism and eating disorder (ED) symptoms is well-established, debate remains about the relative contribution of two central dimensions of perfectionism, that is, Personal Standards (PS) perfectionism and Evaluative Concerns (EC) perfectionism, in the prediction of ED symptoms. This study used cluster analysis to establish naturally occurring combinations of PS and EC perfectionism in early-to-mid adolescents (N = 656; M age = 13.9 years). Evidence was obtained for four perfectionism profiles: (1) maladaptive perfectionism (high PS and high EC), (2) pure evaluative concerns perfectionism (high EC only), (3) adaptive perfectionism (high PS, low EC), and (4) non-perfectionism (low on both PS and EC). A comparison of participants in these four clusters in terms of ED symptoms suggests that a combination of high personal standards and evaluative concerns (rather than the presence of one of these two dimensions alone) is most strongly related to ED symptoms.
Allison, Kelly C.; Grilo, Carlos M.; Masheb, Robin M.; Stunkard, Albert J.
The authors compared eating patterns, disordered eating, features of eating disorders, and depressive symptoms in persons with binge eating disorder (BED; n = 177), with night eating syndrome (NES; n = 68), and in an overweight comparison group without BED or NES (comparison; n = 45). Participants completed semistructured interviews and several…
Cotrufo, Paolo; Gnisci, Augusto; Caputo, Immacolata
We screened a sample of 259 female students, aged 17-20 years old, by means of the Eating Disorder Inventory 2 (EDI 2) and the General Health Questionnaire (GHQ-28). Those students identified to be at risk for an eating disorder underwent a semi-structured interview to provide a diagnosis according to DSM-IV criteria. We also considered the…
Allen, Karina L.; Byrne, Susan M.; Forbes, David; Oddy, Wendy H.
A sample of 14-year-old boys and girls were studied using previously collected biomedical, familial, antenatal, demographic, and social data to identify prospective predictors of eating disorders. Findings suggest that parents' perceptions on their child's weight were more powerful predictors of the development of eating disorders compared to…
Micali, Nadia; Horton, N J; Crosby, R D; Swanson, S A; Sonneville, K R; Solmi, F; Calzo, J P; Eddy, K T; Field, A E
Diagnostic criteria for eating disorders (ED) remain largely based on clinical presentations, but do not capture the full range of behaviours in the population. We aimed to derive an empirically based ED behaviour classification using behavioural and body mass index (BMI) indicators at three time-points in adolescence, and to validate classes investigating prospective associations with adverse outcomes. Adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC) provided data on ED at age 14 (n = 6615), 16 (n = 5888), and 18 years (n = 5100), and had weight and height measured. Psychological and behavioural outcomes were assessed at 15.5/16 and 17.5/18 years. We fit gender- and age-stratified latent class models, and employed logistic regression to investigate associations between classes and later outcomes. One asymptomatic and two symptomatic (largely representing higher and lower frequency ED behaviours) classes were observed at each time-point, although their relative prevalence varied by age and gender. The majority of girls in symptomatic classes remained symptomatic at subsequent assessments. Girls in symptomatic classes had higher odds of subsequent anxiety and depressive disorders, binge drinking, drug use, and deliberate self-harm. Data analyses were underpowered amongst boys. The presence of two symptomatic classes (characterised by different ED behaviour frequency) and their prospective association with adverse outcomes suggest a need to refine diagnostic thresholds based on empirical data. Despite some instability of classes, particularly in mid-adolescence, evidence that half of girls in symptomatic classes remained symptomatic suggests persistence of ED behaviours in adolescence, and highlights a need for early identification to reduce chronicity.
Racicka, Ewa; Bryńska, Anita
Diabetes is associated with increased risk for eating disorders, various dependent on type of diabetes. Binge eating disorder is more common in patient with type 2 diabetes (T2DM). Whereas, intentional omission of insulin doses for the purpose of weight loss occurs mainly in patient with type 1 diabetes (T1DM), however, in some patients with type 2 diabetes omission of oral hypoglycemic drugs can be present. Risk factors for the development of eating disorders in patients with diabetes include: age, female gender, greater body weight, body image dissatisfaction, history of dieting and history of depression. Poor glycemic control, recurrent episodes of ketoacidosis or recurrent episodes of hypoglycemia, secondary to intentional insulin overdose, missed clinical appointments, dietary manipulation and low self-esteem should raise concern. The consequence of eating disorders or disordered eating patterns in patients with diabetes is poor glycemic control and hence higher possibility of complications such as nephropathy, retinopathy and premature death.
Mayes, Susan Dickerson; Fernandez-Mendoza, Julio; Baweja, Raman; Calhoun, Susan; Mahr, Fauzia; Aggarwal, Richa; Arnold, Mariah
This is the first study determining correlates of suicide behavior in children with eating disorders using multiple sleep, psychological, and demographic variables. Mothers rated suicide ideation and attempts in 90 children ages 7-18 with bulimia nervosa or anorexia nervosa. Suicide ideation was more prevalent in children with bulimia nervosa (43%) than children with anorexia nervosa (20%). All children with bulimia nervosa who experienced ideation attempted suicide, whereas only 3% of children with anorexia nervosa attempted suicide. Correlates of ideation were externalizing behavior problems and sleep disturbances. Correlates of attempts were bulimia nervosa, self-induced vomiting, nightmares, and physical or sexual abuse. These problems should be assessed and targeted for intervention because of their association with suicide behavior.
Pliatskidou, S; Samakouri, M; Kalamara, E; Goulemtzakis, C; Koutrouvi, K; Papageorgiou, E; Livadites, M
The increasing prevalence of Eating Disorders over the last decades generates a growing interest of researchers and health care providers for their early detection through suitable questionnaires. The aim of the present study is to examine the reliability of the Greek version of EDE-Q 6.0 among secondary school adolescents. EDE-Q is a widely used self-report questionnaire that assesses the specific psychopathology of eating disorders. Its 6.0th version consists of 28 items. It yields two types of data: (a) four subscale scores (Restraint, Eating Concern, Shape Concern and Weight Concern) as well as a global score which is the average of the four subscale scores and (b) frequency data on key eating and compensatory behaviors (e.g. binge eating episodes, self-induced vomiting, excessive exercise). The sample comprises 257 secondary school students (133 girls and 124 boys) residents of north Evros-Greece, aged 16.1±1.4 years. The students completed the EDE-Q twice within a median interval of 34 days. In addition, their demographic data were collected and their weight and height were measured. The reliability of the EDE-Q was assessed by means of: (a) its internal consistency which was tested by Cronbach's alpha coefficient for each of the EDE-Q subscales as well as for the global score at both data collection times and (b) its test-retest reliability which was estimated by calculating: (1) intraclass correlation coefficients (ICCs) and Pearson's correlation coefficients (PCCs) for continuous variables (subscales and global score) and (2) Kendal's tau b coefficients for categorical variables (frequency of behavioral features). Cronbach's alphas indicating internal consistency of EDE-Q ranged from 0.71 to 0.91. ICCs and PCCs indicating the test-retest reliability of each subscale and the global score of the questionnaire ranged from 0.55 to 0.70 and from 0.58 to 0.73 respectively. Kendal tau b coefficients indicating the test-retest reliability of items assessing
Goebel-Fabbri, Ann E.
The problem of insulin restriction is an important women's health issue in type 1 diabetes. This behavior is associated with increased rates of diabetes complications and decreased quality of life. Clinical and technological research is greatly needed to improve treatment tools and strategies for this problem. In this commentary, the author describes the scope of the problem of eating disorders and diabetes, as well as offers ideas about ways technology may be applied to help solve this complex problem. PMID:19885221
Stice, Eric; Rohde, Paul; Gau, Jeff; Shaw, Heather
Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program…
Hogan, Marjorie J; Strasburger, Victor C
Adolescence is a time of tremendous change in physical appearance. Many adolescents report dissatisfaction with their body shape and size. Forming one's body image is a complex process, influenced by family, peers, and media messages. Increasing evidence shows that the combination of ubiquitous ads for foods and emphasis on female beauty and thinness in both advertising and programming leads to confusion and dissatisfaction for many young people. Sociocultural factors, specifically media exposure, play an important role in the development of disordered body image. Of significant concern, studies have revealed a link between media exposure and the likelihood of having symptoms of disordered eating or a frank eating disorder. Pediatricians and other adults must work to promote media education and make media healthier for young people. More research is needed to identify the most vulnerable children and adolescents.
Penelo, Eva; Raich, Rosa M.
Aims To contribute new evidence to the controversy about the factor structure of the Eating Disorder Examination Questionnaire (EDE-Q) and to provide, for the first time, norms based on a large adolescent Mexican community sample, regarding sex and area of residence (urban/rural). Methods A total of 2928 schoolchildren (1544 females and 1384 males) aged 11-18 were assessed with the EDE-Q and other disordered eating questionnaire measures. Results Confirmatory factor analysis of the attitudinal items of the EDE-Q did not support the four theorized subscales, and a two-factor solution, Restraint and Eating-Shape-Weight concern, showed better fit than the other models examined (RMSEA = .054); measurement invariance for this two-factor model across sex and area of residence was found. Satisfactory internal consistency (ω ≥ .80) and two-week test-retest reliability (ICCa ≥ .84; κ ≥ .56), and evidence for convergent validity with external measures was obtained. The highest attitudinal EDE-Q scores were found for urban females and the lowest scores were found for rural males, whereas the occurrence of key eating disorder behavioural features and compensatory behaviours was similar in both areas of residence. Conclusions This study reveals satisfactory psychometric properties and provides population norms of the EDE-Q, which may help clinicians and researchers to interpret the EDE-Q scores of adolescents from urban and rural areas in Mexico. PMID:24367587
Jáuregui Lobera, Ignacio; Lozano, Pilar León; Ríos, Patricia Bolaños; Candau, Juan Romero; del Villar y Lebreros, Gregorio Sánchez; Millán, M Teresa Morales; González, M Teresa Montaña; Martín, Lourdes Andrés; Villalobos, Isabela Justo; Sánchez, Nuria Vargas
eating disorders, better outcomes are achieved by new models which target the attitudes and behavior of adolescents rather than focusing solely on the provision of risk information to raise awareness. PMID:21042426
Levin, Rivka L; Rawana, Jennine S
Attention-deficit/hyperactivity disorder (ADHD) and eating disorders are common and concerning mental health disorders. There is both empirical and theoretical support for an association between ADHD and eating disorders or disordered eating. This systematic review aims to summarize the extant literature on the comorbidity of ADHD and eating disorders across the lifespan, including the influences of sex, age, eating disorder diagnosis, and potential mediators. A total of 37 peer-reviewed studies on diagnosed ADHD and eating disturbances were identified through key research databases. Twenty-six studies supported a strong empirical association between ADHD and eating disorders or disordered eating. The systematic review findings suggest that children with ADHD are at risk for disordered eating, while adolescents, emerging adults, and adults are at risk for both eating disorders and disordered eating. Methodological considerations, future research, and clinical implications are discussed.
Heinicke, Brooke E.; Paxton, Susan J.; McLean, Sian A.; Wertheim, Eleanor H.
This study evaluated a targeted intervention designed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program. The program consisted of six, 90-minute weekly small group, synchronous on-line sessions and was facilitated by a therapist and manual. Participants were…
Hammerle, Florian; Huss, Michael; Ernst, Verena; Bürger, Arne
Objectives Investigating for the first time in Germany Diagnostic and Statistical Manual Fifth Edition (DSM-5) prevalences of adolescent full syndrome, Other Specified Feeding or Eating Disorder (OSFED), partial and subthreshold anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). Method A national school-based cross-sectional survey with nine schools in Germany was undertaken that was aimed at students from grades 7 and 8. Of the 1775 students who were contacted to participate in the study, 1654 participated (participation rate: 93.2%). The sample consisted of 873 female and 781 male adolescents (mean age=13.4 years). Prevalence rates were established using direct symptom criteria with a structured inventory (SIAB-S) and an additional self-report questionnaire (Eating Disorder Inventory 2 (EDI-2)). Results Prevalences for full syndrome were 0.3% for AN, 0.4% for BN, 0.5% for BED and 3.6% for OSFED-atypical AN, 0% for BN (low frequency/limited duration), 0% for BED (low frequency/limited duration) and 1.9% for purging disorder (PD). Prevalences of partial syndrome were 10.9% for AN (7.1% established with cognitive symptoms only, excluding weight criteria), 0.2% for BN and 2.1% for BED, and of subthreshold syndrome were 0.8% for AN, 0.3% for BN and 0.2% for BED. Cases on EDI-2 scales were much more pronounced with 12.6–21.1% of the participants with significant sex differences. Conclusions The findings were in accordance with corresponding international studies but were in contrast to other German studies showing much higher prevalence rates. The study provides, for the first time, estimates for DSM-5 prevalences of eating disorders in adolescents for Germany, and evidence in favour of using valid measures for improving prevalence estimates. Trial registration number DRKS00005050; Results. PMID:27150185
Wilson, G. Terence; Grilo, Carlos M.; Vitousek, Kelly M.
Significant progress has been achieved in the development and evaluation of evidence-based psychological treatments for eating disorders over the past 25 years. Cognitive behavioral therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder, and existing evidence supports the use of a specific form of family therapy…
Ashby, Jeffrey S.; Kottman, Terry; Schoen, Eva
Examines differences between college women being treated for eating disorders and a comparison group on measures of adaptive and maladaptive perfectionism. Results show that individuals with eating disorders had significantly higher scores on a factor representing perfectionism; however, there were no significant differences between the two groups…
Wagener, Amy M.; Much, Kari
This article focuses on the complex nature of eating disorders, specifically highlighting their use as coping mechanisms for underlying emotional and psychological concerns. Case examples of college counseling center clients are discussed in order to illustrate common ways in which eating disorders are utilized by clients with varying…
Zuckerman-Levin, N; Hochberg, Z; Latzer, Y
Eating disorders (EDs) put adolescents and young adults at risk for impaired bone health. Low bone mineral density (BMD) with ED is caused by failure to accrue peak bone mass in adolescence and bone loss in young adulthood. Although ED patients diagnosed with bone loss may be asymptomatic, some suffer bone pains and have increased incidence of fractures. Adolescents with ED are prone to increased prevalence of stress fractures, kyphoscoliosis and height loss. The clinical picture of the various EDs involves endocrinopathies that contribute to impaired bone health. Anorexia nervosa (AN) is characterized by low bone turnover, with relatively higher osteoclastic (bone resorptive) than osteoblastic (bone formation) activity. Bone loss in AN occurs in both the trabecular and cortical bones, although the former is more vulnerable. Bone loss in AN has been shown to be influenced by malnutrition and low weight, reduced fat mass, oestrogen and androgen deficiency, glucocorticoid excess, impaired growth hormone-insulin-like growth factor 1 axis, and more. Bone loss in AN may not be completely reversible despite recovery from the illness. Treatment modalities involving hormonal therapies have limited effectiveness, whereas increased caloric intake, weight gain and resumption of menses are essential to improved BMD.
Mitchell, James E.; Roerig, James; Steffen, Kristine
Objective To provide a comprehensive review of pharmacotherapy and other biological treatments for eating disorders. Method Literature on this topic was systematically reviewed. Results The bulimia nervosa literature underscores the utility of antidepressants, particularly SSRIs, in improving the symptoms of the disorder. The literature on binge eating disorder supports efficacy on reduction in binge eating frequency for a variety of compounds. However, such compounds have only modest effects on weight. Certain antiepileptic agents such as topiramate, if tolerated, are probably more useful in terms of weight loss. The number of controlled trials in patients with anorexia nervosa in particular has been quite small, and recent meta-analyses show disappointing results using atypical antipsychotics in anorexia nervosa. Discussion The pharmacological treatment of eating disorders remains an underdeveloped field although drug therapy clearly plays a role in the treatment of those with bulimia nervosa and binge eating disorder. Other biological therapies have not been adequately studied. PMID:23658094
Peroutsi, A; Gonidakis, F
During the last 50 years, eating disorders have developed to a complicated and widespread medical and social issue. The latest research results indicate that eating disorders have a quite complicated and multifactorial etiology. According to the multifactorial etiological model, the impact of mass media can be regarded mainly as a precipitating factor. The literature review showed that mass media have a considerable impact on the development and perpetuation of eating disorders. Mass media contribute to the promotion of the thinness ideal as a way to achieve social approval, recognition and success. Mass media also promote dieting and food deprivation, as a successful way of life or as a socially agreeable practice. Furthermore, the literature review showed that mass media remain the main source of information about eating disorders. Considering the above result, mass media could play a major role in the promotion of prevention practices and early diagnosis and treatment of eating disorders.
Mora, Marisol; Penelo, Eva; Gutiérrez, Teresa; Espinoza, Paola; González, Marcela L.; Raich, Rosa M.
Aims. To evaluate the long-term effects of two school-based prevention programs administered to a universal mixed-sex sample of school-going adolescents on disturbed eating attitudes, aesthetic ideal internalization, and other eating disorder risk factors, when compared to a control group. Methods. Participants were 200 adolescents aged 12–15 selected by means of incidental sampling from second-year compulsory secondary education at schools. An interactive multimedia media literacy program (ML + NUT, Media Literacy and Nutrition) and a program focused on the same topics using dramatic arts (Theatre Alive) were applied and compared with a control group. Pretest, posttest (1 month later), and 5- and 13-month follow-up measurements were taken. Analyses were conducted with two-way mixed 3 × 3 ANCOVA (group × phase) adjusted by baseline levels, body mass index, and sex. Results. Participants in both experimental groups showed significantly higher self-esteem scores than the control group over time. The ML + NUT group also presented lower aesthetic ideal internalization scores than the control group. Discussion. Both programs can benefit students' self-esteem. Moreover, ML + NUT program was useful in reducing thin-ideal internalization. However, differences in body dissatisfaction and disordered eating attitudes were not found. The programs may be protective on the core psychological variables, which are essential to adaptive adolescent development. PMID:25802888
Yarborough, Bobbi Jo; DeBar, Lynn L.; Firemark, Alison; Leung, Sue; Clarke, Gregory N.; Wilson, G. Terence
Whereas effective treatments exist for adults with recurrent binge eating, developmental factors specific to adolescents point to the need for a modified treatment approach for youth. We adapted an existing cognitive behavioral therapy treatment manual for adults with bulimia nervosa and binge eating disorder (Fairburn, 2008) for use with…
... a doctor warns. For example, many people with anorexia are skillful at hiding their weight loss by ... of eating disorders and adolescent medicine. People with anorexia are often cold and may develop a fine ...
Jenkins, Sandra; Horner, Sharon D
Adolescence is a time of rapid growth and development with biologic, psychological, and emotional changes occurring simultaneously. We conducted a critical review of the literature to analyze key topics in the study of adolescents' eating behaviors and to identify barriers to healthy eating experienced by adolescents. The literature documents that nutritional deficits and poor eating established during adolescence have long-term health, growth, and developmental consequences. Gaps in the literature are identified and recommendations for future studies are proposed.
Benowitz-Fredericks, Carson A; Garcia, Kaylor; Massey, Meredith; Vasagar, Brintha; Borzekowski, Dina L G
Historically and currently, media messages around body shape and size emphasize the importance of being below-average weight for women and hypermuscular for men. The media messages around physical appearance are not realistic for most and lead to body dissatisfaction for most adolescents. Interventions designed to mitigate the influence of negative media messages on adolescents' body image are presented; however, most have shown limited success.
McNamara, Caroline; Hay, Phillipa; Katsikitis, Mary; Chur-Hansen, Anna
We aimed to assess and compare emotional responses to different foods in relationship to eating disorder and associated features, across gender and age groups. We hypothesized that negative emotional responses to images of foods would be higher in (i) those with higher body dissatisfaction and (ii) older females. Five hundred and thirty-six (18% Grade 5, 39% Grade 8 or 9, and 43% Grade 11 or 12) school, and 93 university students participated. Emotive responses to images of foods were assessed with a PowerPoint presentation of 16 differing food and four 'neutral' images shown over 30s intervals. Responses were rated on three 10-cm visual analog scales measuring levels of happiness, fear and disgust. Body image concern was assessed with the nine-item body dissatisfaction subscale of the EDI and eating disorder symptoms with the Eating Disorder Examination Questionnaire. With increasing age all three emotional responses towards food fell and body dissatisfaction increased. Compared to females, males showed significantly higher levels of a 'happy' response to food, and in adult females a fear emotive response correlated positively with eating concern and body dissatisfaction. In men, positive emotive responses to food may be indicative of broader factors that reduce their vulnerability to eating disorders.
Stice, Eric; Gau, Jeff M; Rohde, Paul; Shaw, Heather
Because no single report has examined risk factors that predict future onset each type of eating disorder and core symptom dimensions that crosscut disorders, we addressed these aims to advance knowledge regarding risk factor specificity. Data from 3 prevention trials that targeted young women with body dissatisfaction (N = 1,272; Mage = 18.5, SD = 4.2) and collected annual diagnostic interview data over 3-year follow-up were combined to identify predictors of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Negative affect and functional impairment predicted onset of all eating disorders. Thin-ideal internalization, body dissatisfaction, dieting, overeating, and mental health care predicted onset of subthreshold/threshold BN, BED, and PD; positive thinness expectations, denial of cost of pursuing the thin ideal, and fasting predicted onset of 2 of these 3 disorders. Similar risk factors predicted core eating disorder symptom onset. Low BMI and dieting specifically predicted onset of subthreshold/threshold AN or low BMI. Only a subset of factors showed unique predictive effects in multivariate models, likely due to moderate correlations between the risk factors (M r = .14). Results provide support for the theory that pursuit of the thin ideal and the resulting body dissatisfaction, dieting, and unhealthy weight control behaviors increase risk for binge/purge spectrum eating disorders, but suggest that youth who are inherently lean, rather than purposely pursuing the thin ideal, are at risk for AN. Impaired interpersonal functioning and negative affect are transdiagnostic risk factors, suggesting these factors should be targeted in prevention programs. (PsycINFO Database Record
Chan, Kara; Prendergast, Gerard; Gronhoj, Alice; Bech-Larsen, Tino
Purpose: The purpose of this paper is to explore Chinese adolescents' perceptions of healthy eating, their perceptions of various socializing agents shaping their eating habits, and their opinions about various regulatory measures which might be imposed to encourage healthy eating. Design/methodology/approach: Four focus group interview sessions…
Allen, Karina L; Byrne, Susan M; Crosby, Ross D
Binge eating disorder and purging disorder have gained recognition as distinct eating disorder diagnoses, but risk factors for these conditions have not yet been established. This study aimed to evaluate a prospective, mediational model of risk for the full range of binge eating and purging eating disorders, with attention to possible diagnostic differences. Specific aims were to determine, first, whether eating, weight and shape concerns at age 14 would mediate the relationship between parent-perceived childhood overweight at age 10 and a binge eating or purging eating disorder between age 15 and 20, and, second, whether this mediational model would differ across bulimia nervosa, binge eating disorder, and purging disorder. Participants (N = 1,160; 51 % female) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, which has followed children from pre-birth to age 20. Eating disorders were assessed via self-report questionnaires when participants were aged 14, 17 and 20. There were 146 participants (82 % female) with a binge eating or purging eating disorder with onset between age 15 and 20 [bulimia nervosa = 81 (86 % female), binge eating disorder = 43 (74 % female), purging disorder = 22 (77 % female)]. Simple mediation analysis with bootstrapping was used to test the hypothesized model of risk, with early adolescent eating, weight and shape concerns positioned as a mediator between parent-perceived childhood overweight and later onset of a binge eating or purging eating disorder. Subsequently, a conditional process model (a moderated mediation model) was specified to determine if model pathways differed significantly by eating disorder diagnosis. In the simple mediation model, there was a significant indirect effect of parent-perceived childhood overweight on risk for a binge eating or purging eating disorder in late adolescence, mediated by eating, weight and shape concerns in early adolescence. In the conditional process model
McCabe, Marita P; Ricciardelli, Lina; Mellor, David; Ball, Kylie
There has been no previous investigation of body image concerns and body change strategies among indigenous Australians. This study was designed to investigate the level of body satisfaction, body change strategies, and perceived media messages about body change strategies among 50 indigenous (25 males, 25 females) and 50 non-indigenous (25 males, 25 females) Australian adolescents (mean age 14.05, SD = 1.05). Consistent with past studies, girls were more likely to be dissatisfied with their weight and engage in strategies to lose weight. However, contrary to expectations, indigenous adolescents engaged in more strategies to lose weight, increase weight, and increase muscles than did non-indigenous adolescents, despite perceiving fewer media messages about losing weight. Additional factors that may explain the findings and the need for further research with different cultural groups are highlighted.
Baker, Jessica H.; Thornton, Laura M.; Bulik, Cynthia M.; Kendler, Kenneth S.; Lichtenstein, Paul
Purpose An early age at menarche is associated with disordered eating in women. However, it is unclear whether they share genetic factors. The goal of the current study is to delineate the genetic correlation between age at menarche and disordered eating. Methods Participants included 427 monozygotic and 329 dizygotic 16-17 year-old female twins from the Swedish Twin Study of Child and Adolescent Development. Disordered eating was assessed with the Eating Disorder Inventory-2. Age at menarche was assessed via self-report. A bivariate correlated factors model was used to delineate the genetic correlation between age at menarche and disordered eating. Results The analysis revealed a negative genetic correlation of −.18 in the best-fit model indicating that the genetic factors that influence younger age at menarche are associated with increased liability for disordered eating. Conclusion Future research should examine possible causes for this correlation such as the estrogen system and gene-environment interactions. PMID:23084171
This review examines the current debate on the role that sexual and physical abuse may play in predisposing to eating disorders in women. Despite some discordant opinions, clinicians agree that the experience of abuse in early childhood may be important for understanding the complex genesis of the eating disorders of some women. Three groups of studies are presented: those in which no connections emerge between sexual abuse and eating disorders, those in which a strong link is present and those in which the results refer to a multifactorial interpretative model. Some of the main symptoms, such as reactualization of the trauma, dissociation, personality disorders, pathological relationship with food, distortion of body image, suicide attempts and self-inflicted punishment that victims of abuse and eating disordered subjects share are examined.
Manley, Ronald S.; Rickson, Heidi; Standeven, Bill
this article provides an overview of anorexia nervosa and bulimia in children and adolescents, including ages of onset, prevalence, and clinical characteristics. Behavior, cognitive, and affective characteristics are outlined. Strategies are provided for teachers and counselors who are concerned about students who have or may have eating…
Opinion statement Binge eating disorder is a common eating disorder that recently has received increasing attention. Goals in treating binge eating disorder typically include controlling binge eating and diminishing excess body weight. A variety of treatment approaches have been used, including diet/lifestyle modification, psychotherapy, and pharmacologic treatment. Diet and lifestyle interventions are somewhat effective in diminishing the binge eating behavior and lead to modest weight loss, but the weight effects are limited and not typically lasting. A number of psychotherapies have been shown to be beneficial, mostly for stopping binge eating, and tend to show little impact on weight loss. Numerous pharmacologic interventions have been developed, with the focus on antidepressants (used for their anti-binge eating effects) and weight loss drugs. Both have been shown to be helpful but again, for antidepressants, bringing about lasting weight loss appears to be difficult. The most effective approach to treating binge eating disorder (if available) is likely psychotherapy combined with medication management as indicated. PMID:26251823
Hodson, Christopher; Newcomb, Michael D.; Locke, Thomas F.; Goodyear, Rodney K.
Objective: Although many studies have identified associations between childhood maltreatment and later substance use and disordered eating, few have examined causal or explanatory pathways, and whether victim characteristics predict the development of one versus the other of these outcomes remains uninvestigated. Furthermore, relatively little…
Wichmann, Susan; Martin, D. R.
Defines different eating disorders, discusses athlete eating problems, and presents the signs physicians should look for that signal the presence of an eating disorder. The article also discusses the tailoring of treatment programs, questions to ask athletes about eating habits, and society's influence on an athlete's eating behavior. (GLR)
Darcy, Alison M; Lock, James
Dissemination and implementation of evidence-based treatments are among the biggest challenges facing clinical psychiatry. Developing scalable evidence-based treatments is a major priority and fraught with challenges. This article describes the development of 3 technology-based innovations. It discusses the use of massive open online courses (MOOCs) and mobile applications. Three projects are presented: (1) the modification of a MOOC methodology for psychotherapy training clinicians in manualized family-based therapy (FBT) for adolescents with anorexia nervosa; (2) a modified MOOC platform for the delivery of FBT; and (3) the development of mobile applications for treatment augmentation and delivery.
Ledoux, Sylvie; And Others
Adolescents (n=3,287) completed questionnaire concerning eating behaviors. Found that binge eaters had disorderly eating habits (skipping meals, snacking, eating sweets, unbalanced diets), concern with body shape (feeling too fat), and depressive symptoms more often than nonbinge eaters did. Relationship between binging episodes and eating habits,…
Olivo, Gaia; Wiemerslage, Lyle; Swenne, Ingemar; Zhukowsky, Christina; Salonen-Ros, Helena; Larsson, Elna-Marie; Gaudio, Santino; Brooks, Samantha J.; Schiöth, Helgi B.
Few studies have used diffusion tensor imaging (DTI) to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED), and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs) through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA) and mean, radial and axial diffusivities (MD, RD and AD, respectively). Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic–thalamo–cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior. PMID:28248991
Sherwood, Nancy E.; Neumark-Sztainer, Dianne; Story, Mary; Beuhring, Trish; Resnick, Michael D.
Examined the relationship between weight-related sport involvement, disordered eating, health behavior, and psycho-social factors in female adolescents. Survey data indicated that girls in weight-related sports were at increased risk for disordered eating, though the majority did not report disordered eating. This group was also at decreased risk…
DeBar, Lynn L.; Wilson, G. Terence; Yarborough, Bobbi Jo; Burns, Beryl; Oyler, Barbara; Hildebrandt, Tom; Clarke, Gregory N.; Dickerson, John; Striegel, Ruth H.
There is a need for treatment interventions to address the high prevalence of disordered eating throughout adolescence and early adulthood. We developed an adolescent-specific manualized CBT protocol to treat female adolescents with recurrent binge eating and tested its efficacy in a small, pilot randomized controlled trial. We present lessons…
Eating disorders (EDs) are chronic clinical mental disorders that are disruptive to the psychological and social development of children and adolescents. They can be difficult to prevent and treat and are considered among the most chronic and medically lethal of mental disorders. Research suggests that the incidence and prevalence of eating…
... himself. Understanding Binge Eating If you gorged on chocolate during Halloween or ate so much pumpkin pie ... For example, the hypothalamus (the part of the brain that controls appetite) may fail to send proper ...
... more chips to eat while he does his math. He hates that he's overweight, but he can' ... The Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart. ...
Luca, Antonina; Luca, Maria; Calandra2, Carmela
Eating disorders are a heterogeneous group of complex psychiatric disorders characterized by abnormal eating behaviours that lead to a high rate of morbidity, or even death, if underestimated and untreated. The main disorders enlisted in the chapter of the Diagnostic and Statistic Manual of Mental Disorders-5 dedicated to “Feeding and Eating Disorders” are: anorexia nervosa, bulimia nervosa and binge eating disorder. Even though these abnormal behaviours are mostly diagnosed during childhood, interesting cases of late-life eating disorders have been reported in literature. In this review, these eating disorders are discussed, with particular attention to the diagnosis and management of those cases occurring in late-life. PMID:25657852
Striegel-Moore, Ruth H.; Bulik, Cynthia M.
The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances…
Tzischinski, O; Lazer, Y
Nocturnal eating disorder (NED) is a rare syndrome that includes disorders of both eating and sleeping. It is characterized by awakening in the middle of the night, getting out of bed, and consuming large quantities of food quickly and uncontrollably, then returning to sleep. This may occur several times during the night. Some patients are fully conscious during their nocturnal eating, while some indicate total amnesia. The etiology of NED is still unclear, as research findings are contradictory. Those suffering from NED exhibit various levels of anxiety and depression, and many lead stressful life-styles. Familial conflict, loneliness and personal crises are commonly found. Recently, a connection has been discovered between NED and unclear self-definition, faulty interpersonal communication, and low frustration threshold. Several authors link it to sleepwalking, leg movements during sleep, and sleep apnea. Treatment is still unclear and there have been trials of pharmacotherapy, psychotherapy, or a combination of both. However, pharmacological treatment has generally been found to be the most effective, although each case must be considered individually. In 1998, 7 women referred to our Eating Disorders Clinic, 5% of all referrals, were subsequently diagnosed as suffering from NED. Of these, 3 suffered from concurrent binge-eating disorder and 4 also from bulimia nervosa. 2 case studies representative of NED are presented.
Beaver, Kevin M.; Flores, Tori; Boutwell, Brian B.; Gibson, Chris L.
Behavioral genetic research shows that variation in eating habits and food consumption is due to genetic and environmental factors. The current study extends this line of research by examining the genetic contribution to adolescent eating habits. Analysis of sibling pairs drawn from the National Longitudinal Study of Adolescent Health (Add Health)…
Haycraft, Emma; Blissett, Jackie
This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders.
Podfigurna-Stopa, Agnieszka; Czyzyk, Adam; Katulski, Krzysztof; Smolarczyk, Roman; Grymowicz, Monika; Maciejewska-Jeske, Marzena; Meczekalski, Blazej
Eating disorders (EDs) are disturbances that seriously endanger the physical health and often the lives of sufferers and affect their psychosocial functioning. EDs are usually thought of as problems afflicting teenagers. However, the incidence in older women has increased in recent decades. These cases may represent either late-onset disease or, more likely, a continuation of a lifelong disorder. The DSM-5 classification differentiates 4 categories of eating disorder: anorexia nervosa, bulimia nervosa, binge-eating disorders and other specified feeding and eating disorders. The weight loss and malnutrition resulting from EDs have widespread negative consequences for physical, mental and social health. The main risk factors for developing long-term consequences are the degree of weight loss and the chronicity of the illness. Most of the cardiac, neurological, pulmonary, gastric, haematological and dermatological complications of EDs are reversible with weight restoration. EDs are serious illnesses and they should never be neglected or treated only as a manifestation of the fashion for dieting or a woman's wish to achieve an imposed standard feminine figure. Additionally, EDs are associated with high risk of morbidity and mortality. The literature concerning EDs in older, postmenopausal women is very limited. The main aim of this paper is to ascertain the epidemiology and prognosis of EDs in older women, and to review their diagnosis and management.
Dakanalis, Antonios; Carrà, Giuseppe; Calogero, Rachel; Zanetti, M Assunta; Volpato, Chiara; Riva, Giuseppe; Clerici, Massimo; Cipresso, Pietro
Anxiety in situations where one's overall appearance (including body shape) may be negatively evaluated is hypothesized to play a central role in Eating Disorders (EDs) and in their co-occurrence with Social Anxiety Disorder (SAD). Three studies were conducted among community (N = 1995) and clinical (N = 703) ED samples of 11- to 18-year-old Italian girls and boys to (a) evaluate the psychometric qualities and measurement equivalence/invariance (ME/I) of the Social Appearance Anxiety (SAA) Scale (SAAS) and (b) determine to what extent SAA or other situational domains of social anxiety related to EDs distinguish adolescents with an ED only from those with SAD. Results upheld the one-factor structure and ME/I of the SAAS across samples, gender, age categories, and diagnostic status (i.e., ED participants with and without comorbid SAD). The SAAS demonstrated high internal consistency and 3-week test-retest reliability. The strength of the inter-relationships between SAAS and measures of body image, teasing about appearance, ED symptoms, depression, social anxiety, avoidance, and distress, as well as the ability of SAAS to discriminate community adolescents with high and low levels of ED symptoms and community participants from ED participants provided construct validity evidence. Only SAA strongly differentiated adolescents with any ED from those with comorbid SAD (23.2 %). Latent mean comparisons across all study groups were performed and discussed.
Hellings, Bridie; Bowles, Terry
Children and adolescents suffering from an eating disorder will typically experience the adverse impact of such a disorder upon their education. These sufferers are often forced to defer their education whilst seeking treatment. However, there are a number of signs educators and school psychologists can look for to identify a student who may be…
Krentz, Adrienne; Chew, Judy; Arthur, Nancy
The purpose of this study was to characterize the psychological processes of recovery from binge eating disorder (BED). A model was developed by asking the research question, "What is the experience of recovery for women with BED?" Unstructured interviews were conducted with six women who met the DSM-IV criteria for BED, and who were recovered…
Martín Murcia, Francisco M; Cangas, Adolfo J; Pozo, Eugenia M; Martínez Sánchez, Margarita; López Pérez, Manuel
Personality disorders in eating disorder patients. A follow-up study was designed to analyze the relation between personality disorders (PD) and the course of eating disorders (ED) in 34 patients who required treatment over 4 years and half. 91% of the clinical sample met the criteria for PD at the initial assessment and 36% at the end of treatment, with a significant reduction in MCMI-II scores at follow-up. The outcome of the ED was significantly related to the PD outcome. There was a higher rate of improvement of PD in the bulimic group (61%) than in anorexic group (34%). The patients who presented schizoid and avoidant personality disorders were the most resistant and they adhered less to treatment. The prevalence of PD in the clinical sample and its relation to the course of ED from a person-centered model is discussed.
Webb, C M; Thuras, P; Peterson, C B; Lampert, J; Miller, D; Crow, S J
Although previous research has supported the importance of anxiety as an etiological and maintenance factor for eating disorders, the specific mechanisms are not well understood. The role of anxiety in the context of eating behavior is especially unclear. The purpose of this study was to identify anxiety-eliciting eating situations and anxiety management strategies patients use to mitigate anxiety experienced in the context of eating as determined by diagnostic groups and symptom patterns. Fifty-three eating disorder outpatients were administered the Eating and Anxiety Questionnaire (EAQ) and the Eating Disorder Diagnostic Scale. Ratings indicated significant anxiety in most eating situations, whereas management strategies were more limited yet regularly employed. Factor analysis of the EAQ revealed a 6-factor solution for anxiety management strategies and a 4-factor solution for anxiety-eliciting situations. These results indicate patients with eating disorders report high levels of anxiety associated with eating behaviors but utilize limited yet consistent anxiety management strategies. Effective intervention strategies for managing eating-related anxiety should be incorporated into treatment and may need to be specified for different diagnostic subgroups.
Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Anorexia nervosa and bulimia nervosa are the two main types of eating disorders. Eating disorders frequently co-occur with…
Hughes-Scalise, Abby; Connell, Arin
Biopsychosocial conceptualizations of eating disorders (EDs) suggest the combination of an individual's emotional vulnerability and invalidating environment increases the likelihood of developing pervasive emotion dysregulation, and subsequent use of ED behaviors to regulate emotion (Haynos & Fruzetti, 2011; Safer, Telch, & Chen, 2009). The current study aimed to provide initial support for this model in adolescent EDs, through examining the interaction between an adolescent's emotional vulnerability, indexed by attentional biases for emotions, and an invalidating family environment. Specifically, we examined the ability of this interaction to discriminate youth with EDs from a comparison group of youth with chronic pain diagnoses, who were used to control for the presence of non-specific effects of having any illness. Fifty adolescent girls (25 with EDs and 25 with chronic pain) completed an emotional dot-probe task assessing attentional biases for emotional faces, and parents completed the Emotions as a Child Scale (Magai, 1996; Klimes-Dougan et al., 2007) to assess response to teen emotion. Results showed that teen angry attentional bias moderated the relationship between parental response to sadness and teen ED status: for teens with high attention bias towards angry faces, maladaptive parental response to sadness predicted increased odds of ED status versus chronic pain status.
Williamson, Donald A.; White, Marney A.; York-Crowe, Emily; Stewart, Tiffany M.
This article presents an integrated cognitive-behavioral theory of eating disorders that is based on hypotheses developed over the past 30 years. The theory is evaluated using a selected review of the eating disorder literature pertaining to cognitive biases, negative emotional reactions, binge eating, compensatory behaviors, and risk factors for…
Stoutjesdyk, Dexa; Jevne, Ronna
Whether athletes in sports that emphasize leanness differ from athletes in other sports with regard to eating attitudes and disposition toward eating disorders was studied for 104 female and 87 male postsecondary level athletes. Results indicate that different groups of athletes may be at different risks of eating disorders. (SLD)
Jones, Lakaii A; Cook-Cottone, Catherine
Objective. To investigate media and cultural influences in eating disorder development in African-American adolescent females. Method. Fifty-seven participants were recruited through churches and community organizations to complete a questionnaire. Results. Mainstream sociocultural identification was associated with more eating disorder behavior in African-American females; cultural ethnic identification was not significantly associated with eating disorder behavior in African-American females, mainstream sociocultural identification, cultural ethnic identification, and body dissatisfaction significantly predicted eating disorder behavior; and cultural ethnic identification was positively correlated with mainstream sociocultural identification. This study provides support for the importance of eating disorder prevention interventions that focus specifically on African-American girls.
Jones, Lakaii A.; Cook-Cottone, Catherine
Objective. To investigate media and cultural influences in eating disorder development in African-American adolescent females. Method. Fifty-seven participants were recruited through churches and community organizations to complete a questionnaire. Results. Mainstream sociocultural identification was associated with more eating disorder behavior in African-American females; cultural ethnic identification was not significantly associated with eating disorder behavior in African-American females, mainstream sociocultural identification, cultural ethnic identification, and body dissatisfaction significantly predicted eating disorder behavior; and cultural ethnic identification was positively correlated with mainstream sociocultural identification. This study provides support for the importance of eating disorder prevention interventions that focus specifically on African-American girls. PMID:24967141
Eiber, R; Friedman, S
Anorectics and bulimics often complain sleep onset insomnia and disrupted sleep. During awakenings bulimics can have binges. Conversely, eating disorders can be a clinical expression of a concomitantly occurring sleep disorder. Two clinical entities have been recently described: the Night Eating Syndrome (NES) and the Sleep Related Eating Disorders. The main goal of this literature review was to better characterize the relationships between eating disorders and sleep disturbances. No specific EEG sleep pattern emerges in anorectic and bulimic patients. However, all studies include several methodological limitations: a few number of patients, heterogeneous patient groups, various diagnostic criteria. The results of studies evaluating the impact of depression on sleep EEG in eating disorder patients are also subject to controversy. The only study examining the relationship between sleep EEG and morphological alterations in anorectics and normal weight bulimics shows that patients with enlarged cerebrospinal fluid spaces spent more time in slow wave sleep and that the duration of rapid eye movement (REM) sleep was reduced. The ventricular brain ratio was negatively correlated with REM sleep. The Night Eating Syndrome consists in insomnia, binge eating and morning anorexia. Other criteria are proposed to characterize the NES: more than 50% of the daily energy intake is consumed after the last evening meal, awakenings at least once a night, repetition of the provisional criteria for more than 3 months, subjects do not meet criteria for bulimia nervosa or binge eating disorder. Patients have no amnesia nor alteration of alertness, and no other sleep disorder. There is no modification of sleep EEG except sleep maintenance. The prevalence of the NES is 1.5% in the general population. Some neuroendocrine disturbances have been found in the NES. The delimitation with eating disorders is not yet clearly established. If it shares the compulsive features with eating disorders
Pettersen, Ingvild; Hernæs, Erik; Skårderud, Finn
Aim To examine the prevalence of disordered eating (DE) among the total population of Norwegian female cross-country skiers and biathletes at the junior level, and to determine whether sociodemographic characteristics predict DE among athletes. Methods A cross-sectional population study of Norwegian female junior cross-country skiers and biathletes (n=262), with a response rate of 86%. Descriptive statistics and logistic regression analyses explored the prevalence of DE and its relation to sports, competitive age groups, competitive status and education. DE was defined as meeting at least 1 of the following criteria from 2 subscales of the Eating Disorder Inventory-2: the Drive for Thinness score ≥15 and/or the Body Dissatisfaction score ≥14. Results 18.7% of the athletes had DE. There was no significant difference in the occurrence of DE between the sports or the competitive age groups. Athletes who had dropped out of sports had a significantly higher occurrence of DE, while athletes who attended upper secondary schools of elite sports or general studies had a significantly higher occurrence of DE based on Drive for Thinness. Conclusions The number of female cross-country skiers and biathletes with DE is higher than that found in previous similar studies using the same screening instruments. Type of education and competitive status are significant predictors of DE, indicating that DE in addition to having adverse effects on an athlete's health, may also lead to early dropout of sport. This indicates that health and achievement are not always compatible within sports. PMID:27900180
Sun, Bomin; Liu, Wei
Eating disorders (EDs) are a group of severely impaired eating behaviors, which include three subgroups: anorexia nervosa (AN), bulimia nervosa (BN), and ED not otherwise specified (EDNOS). The precise mechanism of EDs is still unclear and the disorders cause remarkable agony for the patients and their families. Although there are many available treatment methods for EDs today, such as family therapy, cognitive behavioral therapy, medication, psychotherapy, and so on, almost half of the patients are refractory to all current medical treatment and never fully recover. For treatment-refractory EDs, stereotactic surgery may be an alternative therapy. This review discusses the history of stereotactic surgery, the modern procedures, and the mostly used targets of stereotactic surgery in EDs. In spite of the limited application of stereotactic surgery in ED nowadays, stereotactic lesion and deep brain stimulation (DBS) are promising treatments with the development of modern functional imaging techniques and the increasing understanding of its mechanism in the future. PMID:23682343
Sun, Bomin; Liu, Wei
EATING DISORDERS (EDS) ARE A GROUP OF SEVERELY IMPAIRED EATING BEHAVIORS, WHICH INCLUDE THREE SUBGROUPS: anorexia nervosa (AN), bulimia nervosa (BN), and ED not otherwise specified (EDNOS). The precise mechanism of EDs is still unclear and the disorders cause remarkable agony for the patients and their families. Although there are many available treatment methods for EDs today, such as family therapy, cognitive behavioral therapy, medication, psychotherapy, and so on, almost half of the patients are refractory to all current medical treatment and never fully recover. For treatment-refractory EDs, stereotactic surgery may be an alternative therapy. This review discusses the history of stereotactic surgery, the modern procedures, and the mostly used targets of stereotactic surgery in EDs. In spite of the limited application of stereotactic surgery in ED nowadays, stereotactic lesion and deep brain stimulation (DBS) are promising treatments with the development of modern functional imaging techniques and the increasing understanding of its mechanism in the future.
Melin, Anna; Torstveit, Monica Klungland; Burke, Louise; Marks, Saul; Sundgot-Borgen, Jorunn
Disordered eating behavior (DE) and eating disorders (EDs) are of great concern because of their associations with physical and mental health risks and, in the case of athletes, impaired performance. The syndrome originally known as the Female Athlete Triad, which focused on the interaction of energy availability, reproductive function, and bone health in female athletes, has recently been expanded to recognize that Relative Energy Deficiency in Sport (RED-S) has a broader range of negative effects on body systems with functional impairments in both male and female athletes. Athletes in leanness-demanding sports have an increased risk for RED-S and for developing EDs/DE. Special risk factors in aquatic sports related to weight and body composition management include the wearing of skimpy and tight-fitting bathing suits, and in the case of diving and synchronized swimming, the involvement of subjective judgments of performance. The reported prevalence of DE and EDs in athletic populations, including athletes from aquatic sports, ranges from 18 to 45% in female athletes and from 0 to 28% in male athletes. To prevent EDs, aquatic athletes should practice healthy eating behavior at all periods of development pathway, and coaches and members of the athletes' health care team should be able to recognize early symptoms indicating risk for energy deficiency, DE, and EDs. Coaches and leaders must accept that DE/EDs can be a problem in aquatic disciplines and that openness regarding this challenge is important.
Tanofsky-Kraff, Marian; Marcus, Marsha D; Yanovski, Susan Z; Yanovski, Jack A
Binge eating is common in middle childhood (6-12 years) and often presents in concert with disordered eating attitudes, emotional distress, overweight and adiposity. Binge eating is also predictive of excessive weight gain and is associated with energy intake. However, few children meet DSM-IV-TR criteria for binge eating disorder, thereby making treatment recommendations a challenge. We propose criteria for a new diagnosis, Loss of Control Eating Disorder in Children age 12 years and younger, for further study. The criteria put forward are a revision of Marcus and Kalarchian's [Marcus, M.D., & Kalarchian, M.A. (2003). Binge eating in children and adolescents. International Journal of Eating Disorders, 34 Suppl, S47-S57.] provisional binge eating disorder research criteria for children 14 years and younger, and are based upon the evolving literature in children with binge and loss of control eating episodes. A rationale for the new criteria set is provided, and future research directions are proposed.
Eating disorders are severe and disabling mental disorders. The scientific study of eating disorders has expanded dramatically over the past few decades, and provided significant understanding of eating disorders and their treatments. Those significant advances notwithstanding, there is scant knowledge about key processes that are crucial to clinical improvement. The lack of understanding mechanisms that cause, maintain and change eating disorders, currently is the biggest problem facing the science of eating disorders. It hampers the development of really effective interventions that could be fine-tuned to target the mechanisms of change and, therefore, the development of more effective treatments. It is argued here that the science of eating disorders and eating disorder treatment could benefit tremendously from pure experimental studies into its mechanisms of change, that is, experimental psychopathology (EPP). To illustrate why eating disorders need more EPP research, some key symptoms - restriction of intake, binge eating and body overvaluation - will be discussed. EPP studies challenge some generally accepted views and offer a fresh new look at key symptoms. This will, consequently, better inform eating disorder treatments.
Cinosi, E; Di Iorio, G; Acciavatti, T; Cornelio, M; Vellante, F; De Risio, L; Martinotti, G
Psychiatric disorders are frequently associated with disturbances of sleep and circadian rhythms. This review focus on the relationship between sleep disturbances and eating disorders. In the first part are discussed the presence of sleep disorders among patients suffering from anorexia nervosa and bulimia nervosa, the macrostructure and microstructure of theirs sleep, the differences between the various subtypes in ED patients, the dreams of eating disordered patients and their recurrent contents. In the second part, there are treated sleep disturbances in binge eating disorder and other eating disorders not otherwise specified, such as nocturnal (night) eating syndrome and sleep-related eating disorder. In the third part, there are presented data concerning the neurobiological and neuroendocrinological correlates between feeding, metabolism, weight restoration and the processes regulating sleep. In conclusion, possible future investigations are proposed.
Norris, Mark; Strike, Melanie; Pinhas, Leora; Gomez, Rebecca; Elliott, April; Ferguson, Patricia; Gusella, Joanne
Objective To explore and describe philosophies and characteristics of intensive eating disorder (ED) treatment programs based in tertiary care institutions across Canada. Method: A ninety-item survey examining ED services for adolescents was developed, piloted, and completed by 11 programs across Canada. Information pertaining to program characteristics and components, governance, staffing, referrals, assessments, therapeutic modalities in place, nutritional practices, and treatment protocols were collected. Results: The results highlight the diversity of programming available but also the lack of a unified approach to intensive eating disorder treatment in youth. Conclusions: This report provides important baseline data that offers a framework that programs can use to come together to establish assessment and treatment protocols as well as a process for outcome evaluation. Continued collaboration will be essential moving forward to ensure Canadian youth, regardless of geographic location, receive the necessary treatment required to attain and sustain recovery. PMID:24223051
... also help reduce symptoms of depression, anxiety or obsessive-compulsive disorder, which frequently occur along with eating disorders. You ... Mental health conditions such as depression, anxiety and obsessive-compulsive disorder Lack of menstruation and problems with infertility and ...
Watanabe, Kumi; Okada, Ayumi; Okabe, Nobuyuki; Onishi, Masaru; Morishima, Tsuneo
The purpose of this study was to investigate the psychological needs of children and adolescents with eating disorders (ED) directed toward their mothers. Patients with ED have low self-assertion and various abnormal eating behaviors. Therefore, mothers face difficulty in understanding their children's psychological needs, and the mother-child relationship is sometimes strained. We developed a One-Message Question (OMQ)-structured interview. The OMQ was easy to answer, and it helped the patients with ED. We examined the relationship between psychological needs and illness phase of the children and adolescents, and we discuss the viability of implementing the OMQ in clinical settings. The subjects were 23 patients and their parents. Their parents were just asked about the patients' background. The mean age of the patients was 15.8 years, and the average age of ED onset was 13.5 years. The EDs were anorexia nervosa (n＝20) and bulimia nervosa (n＝3). The phases of patients' illness were identified as anorexic (n＝5), bulimic (n＝7), chronic (n＝3), and stable (n＝8). All subjects provided specific responses to the OMQ-structured interview. Data analyses revealed the following seven categories of patients' psychological needs directed toward their mothers:attachment, cooperation in meeting their goals, longing for love, changing attitude toward family members, respect for self-reliance, expression of apology, and expression of appreciation. These findings suggested that the OMQ-structured interview may prove useful for mothers to understand their children's psychological needs and may encourage positive interactions as a foundation for future recovery.
Frank, Guido K W
Over the past decade, brain imaging has helped to better define eating disorder-related brain circuitry. Brain research on gray matter (GM) and white matter (WM) volumes had been inconsistent, possibly due to the effects of acute starvation, exercise, medication, and comorbidity, but newer studies have controlled for such effects. Those studies suggest larger left medial orbitofrontal gyrus rectus volume in ill adult and adolescent anorexia nervosa after recovery from anorexia nervosa, and in adult bulimia nervosa. The orbitofrontal cortex is important in terminating food intake, and altered function could contribute to self-starvation. The right insula, which processes taste but also interoception, was enlarged in ill adult and adolescent anorexia nervosa, as well as adults recovered from the illness. The fixed perception of being fat in anorexia nervosa could be related to altered insula function. A few studies investigated WM integrity, with the most consistent finding of reduced fornix integrity in anorexia and bulimia nervosa-a limbic pathway that is important in emotion but also food intake regulation. Functional brain imaging using basic sweet taste stimuli in eating disorders during the ill state or after recovery implicated repeatedly reward pathways, including insula and striatum. Brain imaging that targeted dopamine-related brain activity using taste-reward conditioning tasks suggested that this circuitry is hypersensitive in anorexia nervosa, but hyporesponsive in bulimia nervosa and obesity. Those results are in line with basic research and suggest adaptive reward system changes in the human brain in response to extremes of food intake-changes that could interfere with normalization of eating behavior.
Bardick, Angela D.; Bernes, Kerry B.; McCulloch, Ariana R. M.; Witko, Kim D.; Spriddle, Jennifer W.; Roest, Allison R.
School counselors are in daily contact with the highest risk group for developing eating disorders--children and adolescents. School counselors are in a position to identify at-risk individuals, implement effective school-based prevention programs, make appropriate referrals, and provide support for recovering individuals. An overview of a theory…
Sansone, R A; Chu, J W; Wiederman, M W; Lam, C
According to the empirical literature, there are high rates of borderline personality disorder (BPD) among individuals with formal diagnoses of eating disorders, and high rates of eating disorders among individuals with BPD. In this study, we examined relationships between three eating disorder symptoms (i.e., binge eating, starving oneself, abusing laxatives) and borderline personality symptomatology according to two self-report measures (the borderline personality scale of the Personality Diagnostic Questionnaire-4 and the Self- Harm Inventory) in a sample of psychiatric inpatients (N=126) and in a sample of internal medicine outpatients (N=419). Each individual eating disorder item, as well as a composite score of all three items, demonstrated statistically significant correlations with both measures of borderline personality symptomatology in both samples. In addition, endorsement of all three symptoms was invariably associated with borderline personality symptomatology on both measures. Specific eating disorder symptoms, alone, may predict for borderline personality symptomatology.
McAdams, Carrie J; Smith, Whitney
Eating disorders are complex and serious psychiatric illnesses whose etiology includes psychological, biological, and social factors. Treatment of eating disorders is challenging as there are few evidence-based treatments and limited understanding of the mechanisms that result in sustained recovery. In the last 20 years, we have begun to identify neural pathways that are altered in eating disorders. Consideration of how these pathways may contribute to an eating disorder can provide an understanding of expected responses to treatments. Eating disorder behaviors include restrictive eating, compulsive overeating, and purging behaviors after eating. Eating disorders are associated with changes in many neural systems. In this targeted review, we focus on three cognitive processes associated with neurocircuitry differences in subjects with eating disorders such as reward, decision-making, and social behavior. We briefly examine how each of these systems function in healthy people, using Neurosynth meta-analysis to identify key regions commonly implicated in these circuits. We review the evidence for disruptions of these regions and systems in eating disorders. Finally, we describe psychiatric and psychological treatments that are likely to function by impacting these regions. PMID:26767185
Wonderlich, Stephen A.; Joiner, Thomas E., Jr.; Keel, Pamela K.; Williamson, Donald A.; Crosby, Ross D.
Decisions about the classification of eating disorders have significant scientific and clinical implications. The eating disorder diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) reflect the collective wisdom of experts in the field but are frequently not supported in…
Sassaroli, Sandra; Lauro, Leonor J Romero; Ruggiero, Giovanni Maria; Mauri, Massimo C; Vinai, Piergiuseppe; Frost, Randy
High levels of perfectionism have been observed in major depression, anxiety disorders and eating disorders. Though few studies have compared levels of perfectionism across these disorders, there is reason to believe that different dimensions of perfectionism may be involved in eating disorders than in depression or anxiety [Bardone-Cone, A. M. et al. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 84-405]. The present study compared patients with major depression, obsessive-compulsive disorder, and eating disorders on dimensions of perfectionism. Concern over Mistakes was elevated in each of the patient groups while Pure Personal Standards was only elevated in the eating disorder sample. Doubts about Actions was elevated in both patients with obsessive-compulsive disorder and eating disorders, but not in depressed patients. Analyses of covariance indicated that Concern over Mistakes accounted for most of the variance in the relationship of perfectionism to these forms of psychopathology.
Kinzl, J F; Traweger, C; Trefalt, E; Mangweth, B; Biebl, W
The present study examined the prevalence of eating disorders in a male representative random sample in Tyrol. The data were collected by telephone. Of the 1000 men, 8 (0.8%) met the DSM-IV diagnostic criteria for binge eating disorder. An additional 42 subjects (4.2%) exhibited a partial binge eating syndrome. These two otherwise widely identical groups of binge eaters were separated only by the DSM-IV frequency criterion. Five subjects (0.5%) met the DSM-IV criteria for the diagnosis of bulimia nervosa, and 94 men (9.4%) reported recurrent overeating. Men with any eating disorder were mostly overweight or obese. The findings show that there is a significant difference in eating disorders between men and women, but certain eating disorders are frequent not only in women but also in men.
Beaver, Kevin M; Flores, Tori; Boutwell, Brian B; Gibson, Chris L
Behavioral genetic research shows that variation in eating habits and food consumption is due to genetic and environmental factors. The current study extends this line of research by examining the genetic contribution to adolescent eating habits. Analysis of sibling pairs drawn from the National Longitudinal Study of Adolescent Health (Add Health) revealed significant genetic influences on variance in an unhealthy eating habits scale (h(2) = .42), a healthy eating habits scale (h(2) = .51), the number of meals eaten at a fast-food restaurant (h(2) = .33), and the total number of meals eaten per week (h(2) = .26). Most of the remaining variance was due to nonshared environmental factors. Additional analyses conducted separately for males and females revealed a similar pattern of findings. The authors note the limitations of the study and offer suggestions for future research.
Preti, Antonio; Usai, Ambra; Miotto, Paola; Petretto, Donatella Rita; Masala, Carmelo
Fashion models are thought to be at an elevated risk for eating disorders, but few methodologically rigorous studies have explored this assumption. We have investigated the prevalence of eating disorders in a group of 55 fashion models born in Sardinia, Italy, comparing them with a group of 110 girls of the same age and of comparable social and cultural backgrounds. The study was based on questionnaires and face-to-face interviews, to reduce the bias due to symptom under-reporting and to social desirability responding. When compared on three well-validated self-report questionnaires (the EAT, BITE, BAT), the models and controls did not differ significantly. However, in a detailed interview (the Eating Disorder Examination), models reported significantly more symptoms of eating disorders than controls, and a higher prevalence of partial syndromes of eating disorders was found in models than in controls. A body mass index below 18 was found for 34 models (54.5%) as compared with 14 controls (12.7%). Three models (5%) and no controls reported an earlier clinical diagnosis of anorexia nervosa. Further studies will be necessary to establish whether the slight excess of partial syndromes of eating disorders among fashion models was a consequence of the requirement in the profession to maintain a slim figure or if the fashion modeling profession is preferably chosen by girls already oriented towards symptoms of eating disorders, since the pressure to be thin imposed by this profession can be more easily accepted by people predisposed to eating disorders.
Jackson, Todd; Chen, Hong
Body surveillance and body shame are features of objectified body consciousness (OBC) that have been linked to disordered eating, yet the evidence base is largely cross-sectional and limited to samples in certain Western countries. Furthermore, it is not clear whether these factors contribute to the prediction of eating disturbances independent of conceptually related risk factors emphasized within other sociocultural accounts. In this prospective study, body surveillance, body shame, and features of complementary sociocultural models (i.e., perceived appearance pressure from mass media and close interpersonal networks, appearance social comparisons, negative affect, body dissatisfaction) were assessed as risk factors for and concomitants of eating disturbances over time. University-age, mainland Chinese women (n = 2144) and men (n = 1017) completed validated measures of eating-disorder pathology and hypothesized risk factors at baseline (T1) and 1-year follow-up (T2). Among women, elevations on T1 measures of sociocultural-model features predicted more T2 eating disturbances, independent of T1 disturbances. After controlling for other T1 predictors, body surveillance and shame made modest unique contributions to the model. Finally, heightened T2 body dissatisfaction, media, and interpersonal appearance pressure, negative affect, and body shame predicted concomitant increases in T2 eating concerns. For men, T1 features of sociocultural accounts (negative affect, body dissatisfaction) but not OBC predicted T2 eating disturbances, along with attendant elevations in T2 negative affect, interpersonal appearance pressure, and body shame. Implications are discussed for theory and intervention that target disordered eating.
Barzin, M., Hosseinpanah, F., Fekri, S., & Azizi, F. (2011). Predictive value ofbody mass index and waist circumference for metabolic syndrome in 6-12...significant public health threat among children and adolescents. The identification of common risk factors promoting obesity and eating disorders in youth...and loss of control eating-appear to elevate risk for eating disorder psychopathology, general psychopathology, and weight problems among children
Chiba, Hiromi; Nagamitsu, Shinichiro; Sakurai, Rieko; Mukai, Takayo; Shintou, Hiroko; Koyanagi, Kenshi; Yamashita, Yushiro; Kakuma, Tatsuyuki; Uchimura, Naohisa; Matsuishi, Toyojiro
Eating disorders (ED) are serious psychosomatic disorders that commonly occur in girls during adolescence. An increase in earlier onset ED has recently been suggested. Therefore, accurate assessment of eating attitudes in children is a necessary part of school mental health. The 26-item Children's Eating Attitudes Test (ChEAT-26) is widely used internationally to assess abnormal eating attitudes. The present study aimed to validate the Japanese version of the ChEAT-26. Participants were 7076 school children (aged 10-15years) from large, medium-sized, and small cities, and 44 children with anorexia nervosa. We examined the average ChEAT-26 score by participant attributes, including sex, age, geographical region, and school style. Factor analysis of the ChEAT-26 content was performed with varimax rotation. The optimal cut-off point was evaluated using receiver operating characteristic (ROC) analysis. The mean ChEAT-26 score was 7.94 for girls and 5.86 for boys. The mean score was significantly higher in children from larger cities than small cities, and was higher with increasing age, and private schools. Five factors explained 31.4% of the variance. The Cronbach's alpha was 0.81 for the scale. The area under the ROC curve was 0.83; sensitivity was 0.69 and specificity was 0.93 for a cut-off score of 18. The Japanese version of the ChEAT-26 is a reliable and valid psychometric tool that may be useful in the triage and assessment of children with anorexia nervosa.
Brown, Tiffany A.; Keel, Pamela K.
Eating disorders are a significant source of psychiatric morbidity in young women and demonstrate high comorbidity with mood, anxiety, and substance use disorders. Thus, clinicians may encounter eating disorders in the context of treating other conditions. This review summarizes the efficacy of current and emerging treatments for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Treatment trials were identified using electronic and manual searches and by reviewing abstracts from conference proceedings. Family based therapy has demonstrated superiority for adolescents with AN but no treatment has established superiority for adults. For BN, both 60 mg fluoxetine and cognitive behavioral therapy (CBT) have well-established efficacy. For BED, selective serotonin reuptake inhibitors, CBT, and interpersonal psychotherapy have demonstrated efficacy. Emerging directions for AN include investigation of the antipsychotic olanzapine and several novel psychosocial treatments. Future directions for BN and BED include increasing CBT disseminability, targeting affect regulation, and individualized stepped-care approaches. PMID:22879753
Bryan, Christopher J.; Yeager, David S.; Hinojosa, Cintia P.; Chabot, Aimee; Bergen, Holly; Kawamura, Mari; Steubing, Fred
What can be done to reduce unhealthy eating among adolescents? It was hypothesized that aligning healthy eating with important and widely shared adolescent values would produce the needed motivation. A double-blind, randomized, placebo-controlled experiment with eighth graders (total n = 536) evaluated the impact of a treatment that framed healthy eating as consistent with the adolescent values of autonomy from adult control and the pursuit of social justice. Healthy eating was suggested as a way to take a stand against manipulative and unfair practices of the food industry, such as engineering junk food to make it addictive and marketing it to young children. Compared with traditional health education materials or to a non–food-related control, this treatment led eighth graders to see healthy eating as more autonomy-assertive and social justice-oriented behavior and to forgo sugary snacks and drinks in favor of healthier options a day later in an unrelated context. Public health interventions for adolescents may be more effective when they harness the motivational power of that group’s existing strongly held values. PMID:27621440
Nishizono-Maher, A; Ikuta, N; Ogiso, Y; Moriya, N; Miyake, Y; Minakawa, K
The authors investigated images held by eating disorder patients toward selected stimulus words using the semantic differential method. The concept "object image" was introduced here to designate the images which any person has about the mother, the father, etc. A comparison was made between 22 eating disorder patients with concurrent borderline personality disorder, 20 patients without borderline pathology, and 48 controls. The eating disorder patients were found to have a "weaker" image of "motherliness" and "womanliness" compared to the control group. Another characteristic of eating disorder patients was their unfavorable image of children. The authors also studied the images held by fathers and mothers. In the families with borderline patients, the discrepancies between what we term "object images" held by fathers, mothers, and daughters were conspicuous. The importance of a tripartite (daughter-mother-father) relationship in the psychopathology of eating disorder is discussed.
Jáuregui Lobera, I; Bolaños Ríos, P; Garrido Casals, O
The aim of the study was to analyse the parental bonding profiles in patients with eating disorders (ED), as well as the relationship among the different styles of parenting and some psychological and psychopathological variables. In addition, the association between the perceived parental bonding and different coping strategies was analysed. Perception of parenting styles was analysed in a sample of 70 ED patients. The Parental Bonding Instrument, Self-Esteem Scale of Rosenberg, Coping Strategies Inventory, State-Trait Anxiety Inventory, Beck Depression Inventory and Eating Disorders Inventory-2 were used. Kruskal-Wallis test (comparisons), Spearman correlation coefficients (association among different variables) and χ(2)-test (parental bonding profiles differences) were applied. The stereotyped style among ED patients is low care-high control during the first 16 years, and the same can be said about current styles of the mothers. Between 8.6% and 12.9% of the patients perceive their parents' styles as neglectful. The neglectful parenting is the style mainly involved in the specific ED symptoms as drive for thinness, body dissatisfaction and bulimia. In order to achieve a better balanced parents' role during the treatment, it would be necessary to improve the role of the mothers as caregivers, decreasing their role mainly based on the overprotection.
Tanofsky-Kraff, Marian; Goossens, Lien; Eddy, Kamryn T.; Ringham, Rebecca; Goldschmidt, Andrea; Yanovski, Susan Z.; Braet, Caroline; Marcus, Marsha D.; Wilfley, Denise E.; Olsen, Cara; Yanovski, Jack A.
The phenomenology of childhood and adolescent loss of control (LOC) eating is unknown. The authors interviewed 445 youths to assess aspects of aberrant eating. LOC was associated with eating forbidden food before the episode; eating when not hungry; eating alone; and experiencing secrecy, negative emotions, and a sense of “numbing” while eating (ps < .01). Hierarchical cluster analysis revealed a subgroup, most of whom reported LOC eating. Cluster members reported having a trigger initiate episodes, eating while watching television, and having decreased awareness regarding the amount consumed. The authors conclude that aspects of LOC eating during youth are similar to aspects of adult episodes, but a youth-specific presentation may exist. Findings may provide an intervening point to prevent excessive weight gain and eating disorders. PMID:18085907
Tanofsky-Kraff, Marian; Goossens, Lien; Eddy, Kamryn T; Ringham, Rebecca; Goldschmidt, Andrea; Yanovski, Susan Z; Braet, Caroline; Marcus, Marsha D; Wilfley, Denise E; Olsen, Cara; Yanovski, Jack A
The phenomenology of childhood and adolescent loss of control (LOC) eating is unknown. The authors interviewed 445 youths to assess aspects of aberrant eating. LOC was associated with eating forbidden food before the episode; eating when not hungry; eating alone; and experiencing secrecy, negative emotions, and a sense of "numbing" while eating (ps<.01). Hierarchical cluster analysis revealed a subgroup, most of whom reported LOC eating. Cluster members reported having a trigger initiate episodes, eating while watching television, and having decreased awareness regarding the amount consumed. The authors conclude that aspects of LOC eating during youth are similar to aspects of adult episodes, but a youth-specific presentation may exist. Findings may provide an intervening point to prevent excessive weight gain and eating disorders.
Courbasson, Christine Marie; Rizea, Christian; Weiskopf, Nicole
Emotional eating occurs frequently in individuals with eating disorders and is an overlooked factor within addictions research. The present study identified the relationship between emotional eating, substance use, and eating disorders, and assessed the usefulness of the Emotional Eating Scale (EES) for individuals with concurrent eating disorders…
Raymond, N C; Chang, P N; Crow, S J; Mitchell, J E; Dieperink, B S; Beck, M M; Crosby, R D; Clawson, C C; Warwick, W J
This study was designed to examine rates of eating disorders and psychopathology in patients with cystic fibrosis (CF). Fifty-eight CF patients and 43 healthy control participants were evaluated using structured psychiatric interviews and rating scales. Two control participants and no CF patients were diagnosed with an eating disorder. Additionally, 11 CF patients were diagnosed with one or more psychiatric disorders. Group means on the rating scales did not show clinically meaningful elevations in either group. These data indicate no evidence for elevated rates of eating disorders in CF patients. Similarly, rates of other psychiatric disorders in the CF group were not greater than the prevalence reported in the general population.
Background The HOPE (Helping to Outline Paediatric Eating Disorders) Project is an ongoing registry study made up of a sequential cross-sectional sample prospectively recruited over 17 years, and is designed to answer empirical questions about paediatric eating disorders. This paper introduces the HOPE Project, describes the registry sample to-date, and discusses future directions and challenges and accomplishments. The project and clinical service were established in a tertiary academic hospital in Western Australia in 1996 with a service development grant. Research processes were inbuilt into the initial protocols and data collection was maintained in the following years. Recognisable progress with the research agenda accelerated only when dedicated research resources were obtained. The registry sample consists of consecutive children and adolescents assessed at the eating disorder program from 1996 onward. Standardised multidisciplinary data collected from family intake interview, parent and child clinical interviews, medical review, parent, child and teacher psychometric assessments, and inpatient admission records populate the HOPE Project database. Results The registry database to-date contains 941 assessments, of whom 685 met DSM-IV diagnostic criteria for an eating disorder at admission. The majority of the sample were females (91%) from metropolitan Perth (83%). The cases with eating disorders consist of eating disorders not otherwise specified (68%), anorexia nervosa (25%) and bulimia nervosa (7%). Among those with eating disorders, a history of weight loss since illness onset was almost universal (96%) with fear of weight gain (71%) common, and the median duration of illness was 8 months. Conclusions Over the next five years and more, we expect that the HOPE Project will make a strong scientific contribution to paediatric eating disorders research and will have important real-world applications to clinical practice and policy as the research unfolds
Keca, Janine; Cook-Cottone, Catherine
Children and adolescents live in a world where thin is "in" and the pressure to conform to society's view of the ideal body, when combined with other life factors, can set the stage for an eating disorder, a psychiatric illness characterized by an extreme desire to be thin and an intense fear of weight gain. Clinical eating disorders and…
Natenshon, Abigail H.
Discusses the role of families and schools in preventing eating disorders in children and adolescents, explaining that eating disorders are not just about food, but rather a misuse of food to resolve emotional problems; describing various primary, secondary, and tertiary prevention methods; and offering strategies for educators (activism and…
Examined the hypothesis that adolescent girls attending single-sex schools would exhibit greater body dissatisfaction and disordered eating than their coeducational counterparts, reanalyzing data from relevant subscales of an eating disorder inventory (drive for thinness, bulimia, and body dissatisfaction) and a figure rating scale from an earlier…
Describes bulimia, a disorder involving binge eating and purging increasingly prevalent in young women. Reviews the literature and describes symptoms, etiological factors, and treatment considerations and approaches for the disorder. (Author)
Derenne, Jennifer L.; Beresin, Eugene V.
Objective: Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The…
Binge eating disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided self-help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and…
Rance, Nicola M; Moller, Naomi P; Douglas, Barbara A
Debate exists in the eating disorders field about the fitness to practise of counsellors with eating disorder histories (Johnston, Smethurst & Gowers, 2005). Yet despite widespread acknowledgement of the demanding nature of eating disorder counselling in general (Zerbe, 2008), almost no research exists about the actual experiences of recovered eating disorder counsellors in particular. Using semi-structured interviews this study aimed to address the research gap by investigating the experiences of 7 counsellors with eating disorder histories. Particular emphasis was given to their beliefs about the impact of their work on their own body image, weight and relationship with food. Results derived from an Interpretative Phenomenological Analysis suggested that the counsellors' experienced their eating disorder history as a double-edged sword that led them to engage in a number of self-presentational activities. Implications of these findings for the eating disorders field are discussed.
Brown, Amanda Joelle; Parman, Kortney M; Rudat, Deirdre A; Craighead, Linda W
Clinically significant trait perfectionism is often characteristic of individuals exhibiting symptoms of eating disorders. The present study reports on a measure developed to assess the use of food rules and evaluates the hypothesis that adherence to food rules may be one mechanism through which trait perfectionism exacerbates risk for developing eating disorder symptoms. Forty-eight female college students completed a battery of questionnaires, and multiple regression analyses were used to test a mediational model. Results indicated that adherence to food rules mediated the relationship between self-oriented perfectionism and three indices of disordered eating in this sample. This relationship was specific to self-oriented perfectionism and did not hold for other-oriented or socially prescribed perfectionism. These findings may have implications for designing early interventions for disordered eating and may be useful in tailoring treatment for individuals with disordered eating who also report high levels of perfectionism.
Nguyen-Michel, Selena T; Unger, Jennifer B; Spruijt-Metz, Donna
To better understand the relation between emotional eating and dietary choices, dietary correlates of emotional eating were investigated in an adolescent sample. Participants were 617 predominantly Latino middle school students from seven schools in Los Angeles County. Analyses of cross-sectional data revealed that emotional eating was associated with increased frequency of intake of sweet high energy-dense foods, such as cake and ice cream, salty high energy-dense foods like chips, and soda. Gender stratified analyses revealed an association between emotional eating and more frequent fruit and vegetable intake in boys only, and a positive association between emotional eating and salty high energy-dense intake in both boys and girls. These data support previous literature that reports a preference for high energy-dense food in emotional eating, and shows that this association may be generalizable to Latino youth. Considering that emotional eating may lead to overeating because it often takes place in the absence of hunger, it may be appropriate to develop interventions to teach youth healthier substitutions and regulate mood by means other than eating in order to reduce risk for obesity, especially in high risk populations, such as Latinos.
O'Dea, Jennifer A.; Abraham, Suzanne
Used the Eating and Exercise Examination to investigate the eating, weight, shape, and exercise behaviors of 93 male college students. About 20 percent of respondents displayed eating attitudes and behaviors characteristic of eating disorders and disordered eating. They were similar to female students in eating attitudes, undereating, overeating,…
McClain, Zachary; Peebles, Rebecka
Adolescence is a crucial period for emerging sexual orientation and gender identity and also body image disturbance and disordered eating. Body image distortion and disordered eating are important pediatric problems affecting individuals along the sexual orientation and gender identity spectrum. Lesbian, gay, bisexual, transgender (LGBT) youth are at risk for eating disorders and body dissatisfaction. Disordered eating in LGBT and gender variant youth may be associated with poorer quality of life and mental health outcomes. Pediatricians should know that these problems occur more frequently in LGBT youth. There is evidence that newer treatment paradigms involving family support are more effective than individual models of care.
Ferreiro, Fatima; Seoane, Gloria; Senra, Carmen
The interplay between intrapersonal risk (low self-esteem, perfectionism and body dissatisfaction) and interpersonal protection (social support) appears relevant for delineating gender-specific pathways that lead to both depressive and eating psychopathology. The aims of this longitudinal study were to examine gender differences in the levels of…
Tasca, Giorgio A
This is a commentary on 3 case studies of relationship-focused therapies for eating disorders. The 3 approaches vary along a number of dimensions, but nevertheless share important similarities especially related to the role played by variables such as interpersonal problems and affect dysregulation. I briefly review research on interpersonal- and attachment-based models of eating disorders that provide the evidence-base for theories of therapy that are relationship-focused. The Interpersonal Psychotherapy case presented by Tanofsky-Kraff, Shomaker, Young, and Wilfley (2016) illustrates how a group context can facilitate change in key role disputes and role transitions in an adolescent at risk of developing an eating disorder later in her life. The Integrative-Dynamic Therapy case presented by Richards, Shingleton, Goldman, Siegel, and Thompson-Brenner (2016) is a novel sequential combination of cognitive-behavioral therapy followed by dynamic psychotherapy for a young adult with bulimia nervosa that likely reflects what most clinicians do in everyday practice. The Psychoanalytic Psychotherapy case presented by Lunn, Poulsen, and Daniel (2016) of a patient with severe personality pathology demonstrates how treatments for eating disorders sometimes must address complex attachment dysfunction, self-organization, and therapist countertransference in order to provide a useful therapeutic experience. Relationship-focused theories and therapies for eating disorders have come a long way over the past decades, thus providing therapists with a wider range of approaches that can be truly personalized to their clients. (PsycINFO Database Record
Culbert, Kristen M.; Breedlove, S. Marc; Sisk, Cheryl L.; Keel, Pamela K.; Neale, Michael C.; Boker, Steven M.; Burt, S. Alexandra; Klump, Kelly L.
Prenatal testosterone exposure may be protective against disordered eating. However, prior studies have produced mixed results. Developmental differences in prenatal testosterone's protective effects on disordered eating may explain these discrepancies. Indeed, studies have differed in the age of participants assessed, with data supporting prenatal testosterone effects on disordered eating in early adolescent and young adult samples but not in late adolescence. The present series of studies are the first to investigate age differences in prenatal testosterone's protective effects on disordered eating. Two indirect markers of higher prenatal testosterone were examined: 1) lower finger-length ratios [index (2D)/ring (4D) finger] (Study 1), and 2) lower disordered eating in females from opposite-sex twin pairs (who are thought to be exposed to higher prenatal testosterone from their male co-twin) relative to female controls (Study 2). Participants were twins from the Michigan State University Twin Registry (Study 1: n = 409; Study 2: n = 1,538) in early adolescence, late adolescence, or young adulthood. Disordered eating was assessed with well-validated questionnaires. Finger-length ratios were measured from hand scans, using electronic computer calipers. Findings were consistent across both studies. Higher prenatal testosterone (lower 2D:4D; females from opposite-sex twin pairs vs. controls) predicted lower disordered eating in early adolescence and young adulthood only. Prenatal testosterone-disordered eating associations were not observed during late adolescence. Results point to the possibility of developmental windows of expression for prenatal testosterone's protective effects on disordered eating and suggest that prior discrepant results may reflect age differences across samples. PMID:25621790
Shuman, Nicole K.; Krug, Isabel; Maxwell, Millie; Pinheiro, Andrea Poyastro; Brewerton, Timothy; Thornton, Laura M.; Berrettini, Wade H.; Brandt, Harry; Crawford, Steven; Crow, Scott; Fichter, Manfred M.; Halmi, Katherine A.; Johnson, Craig; Kaplan, Allan S.; Keel, Pamela; LaVia, Maria; Mitchell, James; Rotondo, Alessandro; Strober, Michael; Woodside, D. Blake; Kaye, Walter H.; Bulik, Cynthia M.
We assessed the relation between season of birth and eating disorder symptoms and personality characteristics in a sample of 880 women with eating disorders and 580 controls from two Price Foundation Studies. Eating disorder symptoms were assessed using Structured Interview of Anorexic and Bulimic Disorders and the Structured Clinical Interview for DSM-IV. Personality traits were assessed using the Temperament and Character Inventory and the Frost Multidimensional Perfectionism Scale. Date of birth was obtained from a sociodemographic questionnaire. No significant differences were observed 1) in season of birth across eating disorder subtypes and controls; nor 2) for any clinical or personality variables and season of birth. We found no evidence of season of birth variation in eating disorders symptoms or personality traits. Contributing to previous conflicting findings, the present results do not support a season of birth hypothesis for eating disorders. PMID:21150253
Shuman, N K; Krug, I; Maxwell, M; Pinheiro, A Poyastro; Brewerton, T; Thornton, L M; Berrettini, W H; Brandt, H; Crawford, S; Crow, S; Fichter, M M; Halmi, K A; Johnson, C; Kaplan, A S; Keel, P; Lavia, M; Mitchell, J; Rotondo, A; Strober, M; Woodside, D Blake; Kaye, W H; Bulik, C M
We assessed the relation between season of birth and eating disorder symptoms and personality characteristics in a sample of 880 women with eating disorders and 580 controls from two Price Foundation Studies. Eating disorder symptoms were assessed using the Structured Interview of Anorexic and Bulimic Disorders and the Structured Clinical Interview for DSM-IV. Personality traits were assessed using the Temperament and Character Inventory and the Frost Multidimensional Perfectionism Scale. Date of birth was obtained from a sociodemographic questionnaire. No significant differences were observed 1) in season of birth across eating disorder subtypes and controls; nor 2) for any clinical or personality variables and season of birth. We found no evidence of season of birth variation in eating disorders symptoms or personality traits. Contributing to previous conflicting findings, the present results do not support a season of birth hypothesis for eating disorders.
Phillips, Lauren; Kemppainen, Jeanne K; Mechling, Brandy M; MacKain, Sally; Kim-Godwin, Yeounsoo; Leopard, Louisa
Associations were examined between eating disorder symptoms and spiritual well-being in a convenience sample of college students. Undergraduate nursing students at a university in a Mid-Atlantic coastal beach community were recruited for the study. A total of 115 students completed the Spiritual Well-Being Scale (SWBS); the Sick, Control, One Stone, Fat, Food (SCOFF) screening questionnaire; and the Eating Attitudes Test (EAT-26). Approximately one quarter of students had positive screens for an eating disorder, and 40% admitted to binging/purging. SWBS scores reflected low life satisfaction and a lack of clarity and purpose among students. A significant association was found between EAT-26 scores and SWBS Existential Well-Being (EWB) sub-scale scores (p = 0.014). SCOFF scores were significantly associated with SWBS EWB scores (p = 0.001). Symptoms of eating disorders were pervasive. Future research that assesses the impact of spiritual factors on eating disorders may help health care providers better understand the unique contributions to the development of eating disorders. [Journal of Psychosocial Nursing and Mental Health Services, 53(1), 30-37.].
Stevenson, Clifford; Doherty, Glenda; Barnett, Julie; Muldoon, Orla T.; Trew, Karen
Contemporary Western society has encouraged an obesogenic culture of eating amongst youth. Multiple factors may influence an adolescent's susceptibility to this eating culture, and thus act as a barrier to healthy eating. Given the increasing prevalence of obesity amongst adolescents, the need to reduce these barriers has become a necessity.…
Reinblatt, Shauna P
Attention deficit/hyperactivity disorder (ADHD) is a disorder characterized by impulsivity, hyperactivity, and inattention. Binge-eating behavior is often impulsive and is the hallmark of the two eating disorders, binge-eating disorder (BED) and bulimia nervosa (BN), both of which are associated with significant health impairment. Bingeing behavior is also seen in the binge purge subtype of anorexia nervosa. Individuals with AN of the binge purge subtypes, BN and BED, have been found to exhibit impulsive behaviors that are often not limited to binge eating alone. There is preliminary evidence linking ADHD to BN and to BED in both adults and children. The neurobiological mechanisms behind these associations are only beginning to emerge; however, they suggest that impulse control deficits may play a role in these eating disorders. Additionally, although they may not meet full criteria for one of these eating disorders, some adults and children with ADHD present with dysregulated, impulsive eating disorder behaviors and there is a growing association between ADHD, obesity, and binge-eating behavior in both children and adults. The relationship between ADHD and binge eating is novel, supported by growing evidence and worthy of further research. We will review the underlying neurobiological underpinnings, neuroimaging data, and possible psychopharmacological treatment options, which target both ADHD and binge-eating behaviors as well as future research and treatment directions.
Reinblatt, Shauna P.
Opinion statement Attention deficit/hyperactivity disorder (ADHD) is a disorder characterized by impulsivity, hyperactivity, and inattention. Binge-eating behavior is often impulsive and is the hallmark of the two eating disorders, binge-eating disorder (BED) and bulimia nervosa (BN), both of which are associated with significant health impairment. Bingeing behavior is also seen in the binge purge subtype of anorexia nervosa. Individuals with AN of the binge purge subtypes, BN and BED, have been found to exhibit impulsive behaviors that are often not limited to binge eating alone. There is preliminary evidence linking ADHD to BN and to BED in both adults and children. The neurobiological mechanisms behind these associations are only beginning to emerge; however, they suggest that impulse control deficits may play a role in these eating disorders. Additionally, although they may not meet full criteria for one of these eating disorders, some adults and children with ADHD present with dysregulated, impulsive eating disorder behaviors and there is a growing association between ADHD, obesity, and binge-eating behavior in both children and adults. The relationship between ADHD and binge eating is novel, supported by growing evidence and worthy of further research. We will review the underlying neurobiological underpinnings, neuroimaging data, and possible psychopharmacological treatment options, which target both ADHD and binge-eating behaviors as well as future research and treatment directions. PMID:26949595
Tanofsky-Kraff, Marian; Haynos, Ann F.; Kotler, Lisa A.; Yanovski, Susan Z.; Yanovski, Jack A.
The prevalence of pediatric overweight has increased dramatically over the past three decades, likely due to changes in food intake as well as physical activity. Therefore, information examining eating patterns among children and adolescents is needed to illuminate which aspects of eating behavior require modification to prevent and treat pediatric overweight. Because child self-report and parent-report of children's eating habits are often inconsistent and limited by recall and other biases, laboratory-based studies in which food intake is observed and monitored have increased in number. Such studies offer objective and controlled methods of measuring and describing eating behaviors. However, to our knowledge, no publication exists that consolidates, reviews, and provides critical commentary on the literature to date in pediatric samples. In this paper, we review the literature of studies utilizing laboratory methods to examine eating behavior in samples ranging from birth through adolescence. Our review includes all relevant articles retrieved from the PubMed, Medline and PsychInfo search engines. Specifically, we examine meal-feeding studies conducted during the various developmental stages (infancy, preschool, middle childhood, and adolescence), with a focus on methodology. Included in our review are feeding studies related to dietary regulation, exposure and preference, as well as paradigms examining disordered eating patterns and their relationship to body composition. We have structured this review so that both consistent and inconsistent findings are presented by age group, and innovative methods of assessment are discussed in more detail. Following each section, we summarize findings and draw potential conclusions from the available data. We then discuss clinical implications of the research data and suggest directions for the next generation of studies of feeding behavior in children. PMID:19030122
Calado, María; Lameiras, María; Sepulveda, Ana R; Rodríguez, Yolanda; Carrera, María V
The aim of this study was to investigate the association between disordered eating behaviours/attitudes and mass media exposure in a cross-sectional national survey of 1165 Spanish secondary students (age between 14 and 16 years). A battery of questionnaires were used to investigate mass media influence, body dissatisfaction, physical appearance, sociocultural attitudes and self-esteem. Likewise, the EAT-26 questionnaire was used to assess disordered eating behaviours/attitudes, identifying that 6.6% (n = 32) of the male and 13.6% (n = 68) of the female students reached a cut-off point of 20 or above. The main finding was that female and male adolescents with disordered eating showed an increased exposure to TV and magazine sections related to body image, specifically regarding music video channels, in comparison with those without eating disordered, gender-matched counterparts. However, findings indicate that media exposure was different to some degree between males and females with disordered eating behaviour. Males with disordered eating behaviours and attitudes were associated with higher TV and magazine exposure to health sections and also greater body dissatisfaction, internalisation of the thin-ideal and social and appearance comparison. In females, disordered eating was associated with higher TV and magazine exposure to dieting, fashion and sport sections, greater body dissatisfaction, internalisation and awareness of the thin-ideal and lower self-esteem. Understanding the mechanism involved in the media exposure's influence on adolescents is critical in preventing disordered eating.
McElroy, Susan L; Guerdjikova, Anna I; Mori, Nicole; Keck, Paul E
Psychopharmacologic treatment is playing a greater role in the management of patients with eating disorders. In this paper, we review randomized, placebo-controlled trials (RCTs) conducted in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other eating disorders over the past 3 years. Fluoxetine remains the only medication approved for an eating disorder, that being BN. RCTs of antipsychotics in AN have had mixed results; the only agent with some evidence of efficacy is olanzapine. One study suggests dronabinol may induce weight gain in AN. Preliminary studies suggest lack of efficacy of alprazolam, dehydroepiandrosterone, or physiologic estrogen replacement in AN; erythromycin in BN; and the opioid antagonist ALKS-33 in BED. In BED with obesity or overweight, bupropion may cause mild weight loss without seizures, and chromium may improve glucose regulation. Also in BED, three RCTs suggest the stimulant prodrug lisdexamfetamine may reduce binge eating episodes, and another RCT suggests intranasal naloxone may decrease time spent binge eating. There remains a disconnection between the size of eating disorders as a public health problem and the lack of pharmacotherapy research of these conditions.
Refer patients with eating disorder not otherwise specified (NOS) for cognitive behavioral therapy. CBT, which has proven to be the most useful behavioral treatment for bulimia, has now been shown to be effective for patients in the NOS category.
Parkinson, Kathryn N; Drewett, Robert F; Le Couteur, Ann S; Adamson, Ashley J
The aim of the study was to examine predictors of eating disorder symptoms in a population based sample at the earliest age at which they can be measured using the Children's Eating Attitudes Test. Data were collected from the longitudinal Gateshead Millennium Study cohort; 609 children participated in the 7 year data sweep (and their mothers and teachers), and 589 children participated in the 9 year data sweep. Eating disorder symptoms at 9 years were higher in boys, and in children from more deprived families. Higher eating disorder symptoms were associated with more body dissatisfaction at 9 years. Higher symptoms were predicted by higher levels of dietary restraint and of emotional symptoms, but not greater body dissatisfaction, 2 years earlier. The study showed that some correlates of high eating disorder symptoms found in adolescents and adults are also found in children, before the rise in diagnosable eating disorders over the pubertal period.
Cachelin, Fary M.; Gil-Rivas, Virginia; Vela, Alyssa
This paper provides a brief summary of the literature on eating disorders (EDs) among Latinas in the U.S and presents data that illustrate symptomatology and associated psychopathology in this group. The current empirical evidence suggests similarities between Latinas and white European-American women in regards to risk factors, symptomatology, psychopathology, and prevalence of EDs. Despite these similarities, Latinas are less likely to report dieting, dietary restriction, and are more likely to be obese compared to white women. Although Latinas report distress associated with EDs, only a small proportion ever seek treatment. Several factors appear to contribute to their under-utilization of services including lack of knowledge, stigma, beliefs about seeking treatment, lack of health insurance, and lack of affordable and accessible treatment services. It is unclear whether the identified differences between white and Latina women are the result of cultural factors or are better explained by disparities in SES. Efforts to meet the treatment needs of Latinas in the U.S. should aim to increase awareness and education about EDs in this population and to address cultural beliefs and norms that may act as barriers to treatment utilization. Further, it is important to educate and train healthcare professionals to be aware that EDs may develop in or affect Latina patients, and to develop accessible, culturally-appropriate and cost-effective evidence-based treatments that can be disseminated through partnerships with primary care providers and community organizations. PMID:24999448
Walsh, Judith M E; Wheat, Mary E; Freund, Karen
OBJECTIVE To describe how primary care clinicians can detect an eating disorder and identify and manage the associated medical complications. DESIGN A review of literature from 1994 to 1999 identified by a medlinesearch on epidemiology, diagnosis, and therapy of eating disorders, including anorexia nervosa and bulimia nervosa. MEASUREMENTS AND MAIN RESULTS Detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (e.g., participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair) and bulimia nervosa (e.g., unsuccessful attempts at weight loss, history of childhood sexual abuse, family history of depression, erosion of tooth enamel from vomiting, partoid gland swelling, and gastroesophageal reflux). Providers must also remain alert for disordered eating in female athletes (the female athlete triad) and disordered eating in diabetics. Treatment requires a multidisciplinary team including a primary care practitioner, nutritionist, and mental health professional. The role of the primary care practitioner is to help determine the need for hospitalization and to manage medical complications (e.g., arrhythmias, refeeding syndrome, osteoporosis, and electrolyte abnormalities such as hypokalemia). CONCLUSION Primary care providers have an important role in detecting and managing eating disorders. PMID:10940151
Argente, J; Caballo, N; Barrios, V; Muñoz, M T; Pozo, J; Chowen, J A; Hernández, M
Numerous endocrine abnormalities of the growth hormone (GH)-insulin-like growth factor axis have been described in patients with both anorexia nervosa and obesity during childhood and adolescence. These alterations include changes in the levels of 24-hour spontaneous GH secretion, high-affinity, low-capacity GH binding protein (GHBP), IGF-I, IGF-II and the IGF binding proteins (IGFBPs). However, the existing information is sometimes confusing and contradictory. Furthermore, little or no data in these pathologies are available concerning IGFBP-2 or free IGF-I. We have analysed the GH-IGF axis in large populations of adolescents with anorexia nervosa and prepubertal children with exogenous obesity. These patients were studied at the time of diagnosis and at two timepoints during nutritional therapy and normal weight recovery. The results of these studies using age- and sex-matched controls are described here.
Perpiñá, Conxa; Cebolla, Ausiàs; Botella, Cristina; Lurbe, Empar; Torró, Maria-Isabel
The aims of this study were to validate the Emotional Eating Scale version for children (EES-C) in a Spanish population and study the differences in emotional eating among children with binge eating (BE), overeating (OE), and no episodes of disordered eating (NED). The questionnaire was completed by 199 children aged 9 to 16 years. Confirmatory factor analysis revealed five scales: eating in response to anger, anxiety, restlessness, helplessness, and depression. The EES-C showed good internal consistency and test-retest reliability, and it showed moderate relationships with measures of disordered-eating [Children's Eating Attitudes Test-26 (ChEAT-26), Questionnaire of Eating and Weight Patterns-Adolescent Version (QEWP-A)] and psychopathology (State-Trait Anxiety Inventory for Children, Children's Depression Inventory, Child Behavior Checklist). There were significant differences between the BE/NED groups (with the OE group in the middle position) in desire to eat when Anger (the girls in BE group, and the oldest children in OE group obtaining higher scores) or Helplessness were present. Eating due to Depression was higher in the older groups. Multiple regression analysis conducted showed that anxiety-trait was the best predictor of emotional eating. Results support the potential utility of the EES-C in the study of emotional eating in children and its validity in the Spanish population.
Evans, Elizabeth H; Adamson, Ashley J; Basterfield, Laura; Le Couteur, Ann; Reilly, Jessica K; Reilly, John J; Parkinson, Kathryn N
Eating disorders pose risks to health and wellbeing in young adolescents, but prospective studies of risk factors are scarce and this has impeded prevention efforts. This longitudinal study aimed to examine risk factors for eating disorder symptoms in a population-based birth cohort of young adolescents at 12 years. Participants from the Gateshead Millennium Study birth cohort (n = 516; 262 girls and 254 boys) completed self-report questionnaire measures of eating disorder symptoms and putative risk factors at age 7 years, 9 years and 12 years, including dietary restraint, depressive symptoms and body dissatisfaction. Body mass index (BMI) was also measured at each age. Within-time correlates of eating disorder symptoms at 12 years of age were greater body dissatisfaction for both sexes and, for girls only, higher depressive symptoms. For both sexes, higher eating disorder symptoms at 9 years old significantly predicted higher eating disorder symptoms at 12 years old. Dietary restraint at 7 years old predicted boys' eating disorder symptoms at age 12, but not girls'. Factors that did not predict eating disorder symptoms at 12 years of age were BMI (any age), girls' dietary restraint at 7 years and body dissatisfaction at 7 and 9 years of age for both sexes. In this population-based study, different patterns of predictors and correlates of eating disorder symptoms were found for girls and boys. Body dissatisfaction, a purported risk factor for eating disorder symptoms in young adolescents, developed concurrently with eating disorder symptoms rather than preceding them. However, restraint at age 7 and eating disorder symptoms at age 9 years did predict 12-year eating disorder symptoms. Overall, our findings suggest that efforts to prevent disordered eating might beneficially focus on preadolescent populations.
Chabas, Dorothée; Foulon, Christine; Gonzalez, Jesus; Nasr, Mireille; Lyon-Caen, Olivier; Willer, Jean-Claude; Derenne, Jean-Philippe; Arnulf, Isabelle
Study Objective: To evaluate eating behavior and energy balance as a cause of increased body mass index (BMI) in narcolepsy. Design: Case controlled pilot study. Settings: University hospital Participants: 13 patients with narcolepsy (7 “typical” patients, with HLA DQB1*0602 and clear cut cataplexy, with suspected hypocretin deficiency; and 6 “atypical” narcoleptics, i.e., HLA negative or without cataplexy), and 9 healthy controls matched for age, gender, and ethnicity. Intervention: Energy balance was evaluated by measuring BMI, rest energy expenditure with calorimetry, daily food and water intake, and plasma hormone levels. Eating behavior was evaluated using psychometric tests (EAT-40, EDI2, CIDI-2, MADRS). Results: Patients with narcolepsy (whether typical or not) tended to be overweight and to have a lower basal metabolism than controls. Only patients with typical narcolepsy tended to eat less than controls. Narcoleptic patients who were overweight ate half as much as others, indicating caloric restriction. Plasma glucose, cortisol, thyroid, and sex hormones levels did not differ between groups, while prolactin levels were twice as high in patients with narcolepsy as in controls. Narcoleptic patients had higher EAT-40 scores and more frequent features of bulimia nervosa (independent of depressive mood) than controls, suggesting a mild eating disorder, classified as “Eating Disorder Not Other Specified.” Discussion: Both lower basal metabolism and subtle changes in eating behavior (rather than in calorie intake) could explain the positive energy balance leading to overweight in narcolepsy. Eating behavior changes may be a strategy to control weight or to avoid daytime sleepiness. Citation: Chabas D; Foulon C; Gonzalez J; Nasr M; Lyon-Caen O; Willer JC; Derenne JP; Amulf I. Eating disorder and metabolism in narcoleptic patients. SLEEP 2007;30(10):1267-1273. PMID:17969460
Culbert, Kristen M; Racine, Sarah E; Klump, Kelly L
This review summarizes the current state of the literature regarding hormonal correlates of, and etiologic influences on, eating pathology. Several hormones (e.g., ghrelin, CCK, GLP-1, PYY, leptin, oxytocin, cortisol) are disrupted during the ill state of eating disorders and likely contribute to the maintenance of core symptoms (e.g., dietary restriction, binge eating) and/or co-occurring features (e.g., mood symptoms, attentional biases). Some of these hormones (e.g., ghrelin, cortisol) may also be related to eating pathology via links with psychological stress. Despite these effects, the role of hormonal factors in the etiology of eating disorders remains unknown. The strongest evidence for etiologic effects has emerged for ovarian hormones, as changes in ovarian hormones predict changes in phenotypic and genetic influences on disordered eating. Future studies would benefit from utilizing etiologically informative designs (e.g., high risk, behavioral genetic) and continuing to explore factors (e.g., psychological, neural responsivity) that may impact hormonal influences on eating pathology.
Túry, Ferenc; Güleç, Hayriye; Kohls, Elisabeth
The growing interest in the treatment and research of eating disorders has stimulated the development of assessment methods, and there are now many questionnaires for evaluating behavioral and attitudinal characteristics of eating pathology. The present article sets out to review the assessment tools that are widely used in clinical practice and research. In particular, it covers self-report measures with summaries of their psychometric properties. It also presents diagnostic questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria. The instruments described include screening questionnaires, measurement tools for specific eating disorder symptoms, measurement of quality of life in eating disorders, and some tools for the measurement of body image disorder, a common feature of eating disorders. There is also a discussion of distorting factors that decrease the authenticity of assessment tools. These problems arise from the definition of some constructs and from the phenomena of denial and concealment, which are frequent among eating-disordered individuals. The frequent co-occurrence of other psychopathological features (e.g., multiimpulsive symptoms) shows that other psychological phenomena should also be evaluated in line with the assessment of eating disorders.
Gillett, Kyle S.; Harper, James M.; Larson, Jeffry H.; Berrett, Michael E.; Hardman, Randy K.
Family environment has been shown to be one of the factors related to the presence of eating disorders among young-adult females. Clinical experience and theories about eating disorders postulate that implicit family rules are an intricate part of family process that may have a great effect on the creation and maintenance of such problems. This…
The primary objective of this review of literature was to examine the relationship of eating disorders and disordered eating among female collegiate athletes. Since the institution of Title IX in 1972, the Educational Amendment to the Civil Rights Act of 1964, female participation in sports has been consistently rising at all levels of…
HALMI, KATHERINE A.
The treatment of eating disorders is based on a multimodal model, recognizing that these disorders do not have a single cause or a predictable course. The treatment strategy is determined by the severity of illness and the specific eating disorder diagnosis. For the treatment of anorexia nervosa, the key elements are medical management, behavioral therapy, cognitive therapy and family therapy, while pharmacotherapy is at best an adjunct to other therapies. In bulimia nervosa, the treatment of choice is cognitive-behavioral therapy, but a greater improvement in mood and anxiety occurs when antidepressant therapy is added. In binge eating disorder, cognitive-behavioral therapy and interpersonal therapy produce substantial and long-lasting changes and pharmacological treatment has often a useful role. PMID:16633511
Viesselman, J O; Roig, M
The first 95 patients admitted to an inpatient Eating Disorders Program and diagnosed as having bulimia (binge eating only), bulimarexia (binging and purging), and anorexia nervosa (food restriction only) were evaluated for depression, suicidality, and family history. Major depression was found in 80% of patients; 20% had made suicide attempts in their life; and 40% of those attempting suicide made potentially lethal attempts. Patients with anorexia and bulimarexia tended to be younger, single, and Protestant. Patients with bulimarexia had overeating, oversleeping, more preoccupation with suicide, and more depression in their mothers. Patients with anorexia had more relatives with anorexia and bulimarexia, and patients with bulimia had more relatives with obesity. These findings suggest that eating disorders are unique disorders and not variants of affective disorder or alcoholism.
To determine the prevalence of binge eating disorder (BED) and night eating syndrome (NES) among applicants to the Look AHEAD (Action for Health in Diabetes) study. The Eating Disorders Examination-Questionnaire (EDE-Q) and the Night Eating Questionnaire (NEQ) were used to screen patients. Phone int...
Salwen, Jessica K; Hymowitz, Genna F; Bannon, Sarah M; O'Leary, K Daniel
The purpose of this article was to evaluate theories that (1) weight-related abuse (WRA) plays a unique role in the development of disordered eating, above and beyond general childhood verbal abuse and weight-related teasing, and (2) the perceived emotional impact of WRA mediates the relationship between WRA and current disordered eating. Self-report questionnaires on childhood trauma, weight-related teasing, WRA, and current eating behaviors were administered to a total of 383 undergraduate students. In initial regressions, WRA significantly predicted binge eating, emotional eating, night eating, and unhealthy weight control. WRA continued to significantly predict all 4 forms of disordered eating following the introduction of measures of weight-related teasing and childhood verbal abuse into the regression. Latent variable analysis confirmed that perceived emotional impact of WRA mediated the relationship between WRA and disordered eating, and tests for indirect effects yielded a significant indirect effect of WRA on disordered eating through perceived emotional impact. In sum, WRA is a unique construct and the content of childhood or adolescent maltreatment is important in determining eventual psychopathology outcomes. These findings support the necessity of incorporating information on developmental history and cognitive factors into assessment and treatment of individuals with disordered eating.
Ferguson, Christopher J; Muñoz, Mónica E; Garza, Adolfo; Galindo, Mariza
The degree to which media contributes to body dissatisfaction, life satisfaction and eating disorder symptoms in teenage girls continues to be debated. The current study examines television, social media and peer competition influences on body dissatisfaction, eating disorder symptoms and life satisfaction in a sample of 237 mostly Hispanic girls. 101 of these girls were reassessed in a later 6-month follow-up. Neither television exposure to thin ideal media nor social media predicted negative outcomes either concurrently nor prospectively with the exception of a small concurrent correlation between social media use and life satisfaction. Social media use was found to contribute to later peer competition in prospective analysis, however, suggesting potential indirect but not direct effects on body related outcomes. Peer competition proved to be a moderate strong predictor of negative outcomes both concurrently and prospectively. It is concluded that the negative influences of social comparison are focused on peers rather than television or social media exposure.
Collins, Brittany; Fischer, Sarah; Stojek, Monika; Becker, Kendra
This study utilizes a prospective design to examine the interaction of recent rape/attempted rape with individual differences in thought suppression on increases in disordered eating symptoms during late adolescence/emerging adulthood. Thought suppression is the attempt to suppress unwanted thoughts. We propose that emerging adult women who have experienced recent rape/attempted rape and tend to use thought suppression as a coping mechanism are at risk for increases in disordered eating. 319 women completed the Eating Disorder Examination Questionnaire, the Sexual Experiences Survey, the Childhood Trauma Questionnaire, and the White Bear Thought Suppression Inventory in their first month of college and three months later. The experience of recent rape/attempted rape in the three months prior to the assessment accounted for unique variance in disordered eating at Time 2. Levels of thought suppression assessed at Time 1 significantly moderated the influence of recent rape/attempted rape on disordered eating at Time 2.
Howell, Michael J; Schenck, Carlos H; Crow, Scott J
Nighttime eating is categorized as either night eating syndrome (NES) or sleep-related eating disorder (SRED). These conditions represent an interruption in the overnight fast that characterizes human sleep. A critical review of the literature on NES and SRED will suggest that they are situated at opposite poles of a disordered eating spectrum. NES could be considered an abnormality in the circadian rhythm of meal timing with a normal circadian timing of sleep onset. Conversely, the feeding behavior in SRED is characterized by recurrent episodes of eating after an arousal from nighttime sleep with or without amnesia. Both conditions are often relentless and chronic. Multiple definitions of night eating have limited our ability to determine the exact prevalence of NES. Studies have suggested that central nervous system (CNS) serotonin modulation may lead to an effective treatment of NES. SRED is frequently associated with other sleep disorders, in particular parasomnias. Early studies have shown that the anti-seizure medication topiramate may be an effective treatment for SRED.
Alvarenga, M S; Koritar, P; Pisciolaro, F; Mancini, M; Cordás, T A; Scagliusi, F B
The objective was to compare eating attitudes, conceptualized as beliefs, thoughts, feelings, behaviors and relationship with food, of anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) patients and a group of obese (OBS) without eating disorders (ED). Female patients from an Eating Disorder (ED) Unit with AN (n=42), BN (n=52) and BED (n=53) and from an obesity service (n=37) in Brazil answered the Disordered Eating Attitude Scale (DEAS) which evaluate eating attitudes with 5 subscales: relationship with food, concerns about food and weight gain, restrictive and compensatory practices, feelings toward eating, and idea of normal eating. OBS patients were recruited among those without ED symptoms according to the Binge Eating Scale and the Questionnaire on Eating and Weight Patterns. ANOVA was used to compare body mass index and age between groups. Bonferroni test was used to analyze multiple comparisons among groups. AN and BN patients presented more dysfunctional eating attitudes and OBS patients less dysfunctional (p<0.001). For DEAS total score, AN and BN patients were similar and all other were different (p<0.001). Similarities suggested between BN and BED were true just for the "Relationship with food" and "Idea of normal eating." BED patients were worst than OBS for "Relationship with food" and as dysfunctional as AN patients - besides their behavior could be considered the opposite. Differences and similarities support a therapeutic individualized approach for ED and obese patients, call attention for the theoretical differences between obesity and ED, and suggest more research focused on eating attitudes.
This article provides an overview of key research on significant comorbidities that occur among adolescents with attention-deficit/hyperactivity disorder, including disruptive behaviors. Such comorbidities include oppositional defiant disorder and conduct disorder, as well as depressive disorders, anxiety disorders, personality disorders, suicidality, eating disorders, sleep disorders, learning disabilities, Internet "addiction," tic disorders, new-onset pediatric epilepsy, and celiac disease.
Berner, Laura A; Allison, Kelly C
Night eating syndrome (NES) is a form of disordered eating associated with evening hyperphagia (overeating at night) and nocturnal ingestions (waking at night to eat). As with other forms of disordered eating, cognitive and behavioral treatment modalities may be effective in reducing NES symptoms. This review presents evidence for a variety of behavioral treatment approaches, including behavioral therapy, phototherapy, behavioral weight loss treatment, and cognitive-behavioral therapy. A more detailed overview of cognitive-behavioral therapy for NES is provided. All of these studies have been case studies or included small samples, and all but one have been uncontrolled, but the outcomes of many of these approaches are promising. Larger randomized controlled trials are warranted to advance NES treatment literature. With the inclusion of NES in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a “Feeding or Eating Disorder Not Elsewhere Classified,” more sophisticated, empirically-supported, behaviorally-based treatment approaches are much needed. PMID:23569400
Background Although score reliability is a sample-dependent characteristic, researchers often only report reliability estimates from previous studies as justification for employing particular questionnaires in their research. The present study followed reliability generalization procedures to determine the mean score reliability of the Eating Disorder Inventory and its most commonly employed subscales (Drive for Thinness, Bulimia, and Body Dissatisfaction) and the Eating Attitudes Test as a way to better identify those characteristics that might impact score reliability. Methods Published studies that used these measures were coded based on their reporting of reliability information and additional study characteristics that might influence score reliability. Results Score reliability estimates were included in 26.15% of studies using the EDI and 36.28% of studies using the EAT. Mean Cronbach’s alphas for the EDI (total score = .91; subscales = .75 to .89), EAT-40 (total score = .81) and EAT-26 (total score = .86; subscales = .56 to .80) suggested variability in estimated internal consistency. Whereas some EDI subscales exhibited higher score reliability in clinical eating disorder samples than in nonclinical samples, other subscales did not exhibit these differences. Score reliability information for the EAT was primarily reported for nonclinical samples, making it difficult to characterize the effect of type of sample on these measures. However, there was a tendency for mean score reliability to be higher in the adult (vs. adolescent) samples and in female (vs. male) samples. Conclusions Overall, this study highlights the importance of assessing and reporting internal consistency during every test administration because reliability is affected by characteristics of the participants being examined. PMID:24764530
Sato, Yasuhiro; Fukudo, Shin
The two most clinically serious eating disorders are anorexia nervosa and bulimia nervosa. A drive for thinness and fear of fatness lead patients with anorexia nervosa either to restrict their food intake or binge-eat then purge (through self-induced vomiting and/or laxative abuse) to reduce their body weight to much less than the normal range. A drive for thinness leads patients with bulimia nervosa to binge-eat then purge but fail to reduce their body weight. Patients with eating disorders present with various gastrointestinal disturbances such as postprandial fullness, abdominal distention, abdominal pain, gastric distension, and early satiety, with altered esophageal motility sometimes seen in patients with anorexia nervosa. Other common conditions noted in patients with eating disorders are postprandial distress syndrome, superior mesenteric artery syndrome, irritable bowel syndrome, and functional constipation. Binge eating may cause acute gastric dilatation and gastric perforation, while self-induced vomiting can lead to dental caries, salivary gland enlargement, gastroesophageal reflux disease, and electrolyte imbalance. Laxative abuse can cause dehydration and electrolyte imbalance. Vomiting and/or laxative abuse can cause hypokalemia, which carries a risk of fatal arrhythmia. Careful assessment and intensive treatment of patients with eating disorders is needed because gastrointestinal symptoms/disorders can progress to a critical condition.
Seeman, Mary V
Psychotic disorders and eating disorders sometimes occur in the same person, and sometimes, but not always, at the same time. This can cause diagnostic confusion and uncertainty about treatment. This paper examines seven ways in which symptoms of both conditions can co-exist. The literature on this topic consists to a large extent of case reports, so that firm conclusions cannot be drawn from their examination. There is no consistent sequence in the co-occurrence of the two conditions-eating disorders sometimes precede, and sometimes follow the onset of psychosis. The advent of the psychosis, and sometimes the treatment of the psychosis can cure the eating disorder, but it can sometimes aggravate it. Psychosis is not necessarily a mark of severity in the course of an eating disorder, and food refusal can occur independent of severity in psychotic illness, but it can be a cause of death. There is some genetic association and some overlap of physiologic, cognitive and brain structure deficits in the two types of disorder. The connection between the two, however, remains speculative. The area of comorbidity and overlapping symptoms in psychiatry requires more research. Clinical recommendations include attention to the different individual ways in which these two disparate conditions often overlap.
The importance of the family in eating disorders has been the subject of a great deal of speculation ever since anorexia nervosa was first described some 130 years ago. Given the importance of the family in child and adolescent development, it also has great bearing on how young people learn to deal with food. But the research is inconclusive as to the family's precise role in the development of an eating disorder. There is no support in the literature on which to base a comprehensive understanding of the family setting in which a member develops an eating disorder; this also applies to anorexia nervosa cases. When groups of families afflicted with different psychiatric disorders are compared, it seems that families in which bulimia nervosa occurs tend to be more dysfunctional than families afflicted with anorexia nervosa. It also seems that families afflicted with anorexia nervosa function better than families afflicted by other psychiatric disorders. In this article the research on family functioning in relation to anorexia nervosa and bulimia nervosa is reviewed and its relevance discussed.
Knoll, Susanne; Föcker, Manuel; Hebebrand, Johannes
The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) resulted in substantial changes with regard to the classification of Eating Disorders. In DSM-5, Feeding and Eating Disorders are for the first time subsumed in a single category. The Binge Eating Disorder (BED) was established as the third classical eating disorder in addition to Anorexia Nervosa (AN) and Bulimia Nervosa (BN). The criteria for AN changed remarkably, whereas there were only minor changes to the BN criteria. The criteria for BED differ only marginally from the DSM-IV research criteria. There are now subtypes of AN, BN, and BED in the new category "Other Specific Feeding and Eating Disorders." The rest category "Eating Disorders Not Otherwise Specified" has been renamed to "Unspecified Feeding or Eating Disorders." The practicability of the DSM-5 criteria for Eating Disorders, and for AN in particular, for both clinical practice and research remains to be seen.
Lewis, Stephen P; Klauninger, Laura; Marcincinova, Ivana
Pro eating disorder websites often contain celebrity-focused content (e.g., images) used as thinspiration to engage in unhealthy eating disorder behaviours. The current study was conducted to examine whether news media stories covering eating disorder disclosures of celebrities corresponded with increases in Internet searches for pro eating disorder material. Results indicated that search volumes for pro eating disorder terms spiked in the month immediately following such news coverage but only for particularly high-profile celebrities. Hence, there may be utility in providing recovery-oriented resources within the search results for pro-eating disorder Internet searches and within news stories of this nature.
Cole-Detke, H; Kobak, R
This study examines the relationship between attachment strategies and symptom reporting among college women. Sixty-one college women were selected who reported high or low levels of depressive and eating disorder symptoms. The Adult Attachment Interview (AAI) was administered, and interview transcripts were rated with the Attachment Interview Q-Sort. The results indicated that women with hyperactivating AAI strategies were prone to reporting elevated levels of depressive symptoms, whereas women with deactivating strategies were prone to reporting elevated levels of eating-disorder symptoms, when depression was statistically controlled. These findings support the hypothesis that secondary or defensive attachment strategies predispose individuals toward different forms of symptom expression.
... media often portrays women with the eating disorders anorexia and bulimia as untreatable, and sadly, in about ... will have an eating disorder. Death rates from anorexia nervosa and bulimia nervosa are estimated to be ...
Tromp, Marilou DP; Donners, Anouk AMT; Garssen, Johan; Verster, Joris C
Objective To investigate the relationship between eating disorders, body mass index (BMI), sleep disorders, and daytime functioning. Design Survey. Setting The Netherlands. Participants N=574 Dutch young adults (18–35 years old). Measurements Participants completed a survey on eating and sleep habits including the Eating Disorder Screen for Primary care (ESP) and SLEEP-50 questionnaire subscales for sleep apnea, insomnia, circadian rhythm disorder (CRD), and daytime functioning. SLEEP-50 outcomes of participants who screened negative (≤2) and positive (>2) on the ESP were compared. In addition, SLEEP-50 scores of groups of participants with different ESP scores (0–4) and different BMI groups (ie, underweight, healthy weight, overweight, and obese) were compared using nonparametric statistics. Results Almost 12% (n=67) of participants screened positive for having an eating disorder. Relative to participants without eating disorders, participants who screened positive for eating disorders reported significantly higher scores on sleep apnea (3.7 versus 2.9, P=0.012), insomnia (7.7 versus 5.5, P<0.0001), CRD (2.9 versus 2.3, P=0.011), and impairment of daytime functioning (8.8 versus 5.8, P=0.0001). ESP scores were associated with insomnia (r=0.117, P=0.005), sleep apnea (r=0.118, P=0.004), sleep quality (r=−0.104, P=0.012), and daytime functioning (r=0.225, P<0.0001), but not with CRD (r=0.066, P=0.112). BMI correlated significantly with ESP scores (r=0.172, P<0.0001) and scores on sleep apnea (r=0.171, P<0.0001). When controlling for BMI, the partial correlation between ESP and sleep apnea remained significant (r=0.10, P=0.015). Conclusion Participants who score positive for eating disorders scored significantly higher on sleep disorder scales, and reported significantly more impairment of daytime functioning. PMID:26848280
Smith, Gregory T; Simmons, Jean R; Flory, Kate; Annus, Agnes M; Hill, Kelly K
One's expectancies for reinforcement from eating or from thinness are thought to represent summaries of one's eating-related learning history and to thus influence the development of binge-eating and purging behavior. In a 3-year longitudinal study, the authors tested this hypothesis and the hypothesis that binge eating also influences subsequent expectancy development. The authors used trajectory analysis to identify groups of middle school girls who followed different trajectories of binge eating, purging, eating expectancies, and thinness expectancies. Initial eating and thinness reinforcement expectancies identified girls whose binge eating and purging increased during middle school, and expectancies differentiated girls who began these problem behaviors from girls who did not. Initial binge-eating scores differentiated among eating expectancy developmental trajectories. The onset of most behaviors can be understood in terms of learned expectancies for reinforcement from these behaviors. The same model can be applied to the risk for eating disorders.
Larrañaga, Alejandra; Docet, María F; García-Mayor, Ricardo V
Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population. PMID:22087355
Larrañaga, Alejandra; Docet, María F; García-Mayor, Ricardo V
Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.
Binge Eating Disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided Self Help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and cost-effective than existing, efficacious BED specialty treatments which are limited in public health utility and impact given their time and expense demands. No existing BED GSH treatment has incorporated affect regulation models of binge eating, which appears warranted given research linking negative affect and binge eating. Integrative Response Therapy (IRT), a new group-based guided self-help treatment, based on the affect regulation model of binge eating, that has shown initial promise in a pilot sample of adults meeting DSM IV criteria for BED, is described. Fifty-four% and 67% of participants were abstinent at post-treatment and three month follow-up respectively. There was a significant reduction in the number of binge days over the previous 28 days from baseline to post-treatment [14.44 (±7.16) to 3.15 (±5.70); t=7.71, p<.001; d=2.2] and from baseline to follow-up [14.44 (±7.16) to 1.50 (±2.88); t=5.64, p<.001; d=1.7]. All subscales from both the Eating Disorder Examination – Questionnaire and Emotional Eating Scale were significantly lower at post-treatment compared to baseline. 100% of IRT participants would recommend the program to a friend or family member in need. IRT’s longer-term efficacy and acceptability are presently being tested in a National Institute of Mental Health funded randomized controlled trial. PMID:24605043
Hilbert, Anja; Pike, Kathleen; Goldschmidt, Andrea; Wilfley, Denise; Fairburn, Christopher; Dohm, Faith-Anne; Walsh, Timothy; Weissman, Ruth Striegel
This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs. PMID:25103674
Strother, Eric; Lemberg, Raymond; Stanford, Stevie Chariese; Turberville, Dayton
This article provides a survey of eating disorders in men, highlights the dramatic rise in eating disorders, identifies issues specific to males, and suggests areas for research and intervention. This survey concludes that men with eating disorders are currently under-diagnosed, undertreated, and misunderstood by many clinicians who encounter them. Ongoing research addressing these issues is expected to result in assessment tools and treatment interventions that will advance positive outcomes for men with eating disorders. PMID:22985232
Tremblay, Line; Lariviere, Michel
The main objective of this study is to verify the hypothesis that pubertal development, obesity, body satisfaction, as well as family and peer influences predict unhealthy eating habits in children and adolescents. A randomized stratified sample of young Quebecers aged 9, 13, and 16 years on March 31, 1999 [608 children aged of 9 years (325 girls and 283 boys) and 662 adolescents aged of 13 and 16 years (349 girls and 313 boys)] were used. Children's weight, height, and Body Mass Index (BMI) were recorded. Questionnaires were administered to children and a parent (usually the mother). Among 9-year-old children, this study found that weight loss or weight control behaviors were predicted mainly by the onset of puberty, lower maternal abusive control, and the level of peer pressure. Among adolescents, mother's BMI, income, peer pressure, and negative comments about the child's weight most strongly predicted behaviors to control weight, strategies to lose weight and the frequency of such behaviors. The findings suggest that both parents and children need to understand the impact of comments on a child's behavior.
Stevenson, Clifford; Doherty, Glenda; Barnett, Julie; Muldoon, Orla T; Trew, Karen
Contemporary Western society has encouraged an obesogenic culture of eating amongst youth. Multiple factors may influence an adolescent's susceptibility to this eating culture, and thus act as a barrier to healthy eating. Given the increasing prevalence of obesity amongst adolescents, the need to reduce these barriers has become a necessity. Twelve focus group discussions of single-sex groups of boys or girls ranging from early to-mid adolescence (N=73) were employed to identify key perceptions of, and influences upon, healthy eating behaviour. Thematic analysis identified four key factors as barriers to healthy eating. These factors were: physical and psychological reinforcement of eating behaviour; perceptions of food and eating behaviour; perceptions of contradictory food-related social pressures; and perceptions of the concept of healthy eating itself. Overall, healthy eating as a goal in its own right is notably absent from the data and would appear to be elided by competing pressures to eat unhealthily and to lose weight. This insight should inform the development of future food-related communications to adolescents.
Riva, G; Bacchetta, M; Baruffi, M; Defrance, C; Gatti, F; Galimberti, C; Nugues, P; Ferretti, G S; Tonci, A
Virtual Reality Environments for Psychoneurophysiological Assessment and Rehabilitation (VREPAR) are two European Community funded projects (Telematics for health-HC 1053/HC 1055-http://www.psicologia.net) whose aim is (a) to develop a PC based virtual reality system (PC-VRS) for the medical market that can be marketed at a price that is accessible to its possible endusers (hospitals, universities, and research centres) and that would have the modular, connectability and interoperability characteristics that the existing systems lack; and (b) to develop three hardware/software modules for the application of the PC-VRS in psychoneurophysiological assessment and rehabilitation. The chosen development areas are eating disorders (bulimia, anorexia, and obesity), movement disorders (Parkinson's disease and torsion dystonia), and stroke disorders (unilateral neglect and hemiparesis). In particular, the VREPAR 2 project is now testing the eating disorders module on a clinical sample.
Price, Joy A.; And Others
Findings from 337 school counselors revealed 11 percent rated themselves as very competent in helping students with eating disorders (anorexia and bulimia nervosa), 49 percent considered themselves moderately competent, 40 percent believed they were not very competent; 75 percent did not believe it was their role to treat students with eating…
Halmi, Katherine A.
Background: Etiological hypotheses of eating disorders, anorexia nervosa and bulimia nervosa have not produced informative research for predictably effective treatment. Methods: The rationale for applying a model of allostasis, a dysregulation of reward circuits with activation of brain and hormonal stress responses to maintain apparent stability,…
Hamilton, Kristin L.
Maladaptive eating behaviors are a growing phenomenon which has captured the interest of not only health and psychology professionals, but also the general public. This paper examines the various types of treatment and counseling approaches for treating anorexia nervosa and bulimia nervosa. Definitions for both disorders are provided, followed by…
Abbate-Daga, Giovanni; Quaranta, Michela; Marzola, Enrica; Cazzaniga, Giovanna; Amianto, Federico; Fassino, Secondo
Eating Disorders (ED) are often severe illnesses entailing a heavy burden for families. Family therapy is recommended for young patients, but only a few studies have investigated therapeutic interventions with families tailored also to adult and longstanding patients. We recruited 87 families with daughters affected by an ED, aiming to assess the…
McCanne, Lynn P. Fisher
Recent research indicates that a significant number of college-age women suffer from bulimarexia (also called the gorging-purging syndrome, the binge-purge cycle, bulimia or bulimia nervosa). To examine the relationship of three personality variables (anxiety, assertiveness, and locus of control) to eating disorders, 46 college students…
Phelps, LeAdelle; Sapia, Jennifer; Nathanson, David; Nelson, Linda
An eating disorder prevention program was completed with middle school, high school, and college females. Some successful outcomes included: (1) facilitating an acknowledgement of pressures to attain a model skeletal look; (2) changing attitudes about standards of beauty; and (3) altering the participants' current and future intentional use of…
Talleyrand, Regine M.
There is little attention devoted to studying eating disorder symptoms in racially and ethnically diverse groups despite the fact that the prevalence rates among women of color for eating disorder symptoms are similar to those of European American women. This article reviews research related to eating disorders in women of color, including a…
Peck, Lisa D.; Lightsey, Owen Richard
Among 261 undergraduate women, increased severity of eating disorders along a continuum was associated with decreased self-esteem, increased perfectionism, and increased scores on 7 subscales of the Eating Disorders Inventory-2. Women with eating disorders differed from both symptomatic women and asymptomatic women on all variables, whereas…
Elgin, Jenna; Pritchard, Mary
Previous research on gender differences between males and females on the risk factors leading to disordered eating is sparse, especially on males and eating disorders using attachment theory. This study examined the relationship between adult attachment style and disordered eating in men and women. Secure attachment scores were significantly…
Shelton, Virginia L.; Valkyrie, Karena T.
Eating disorders are compulsive behaviors that can consume a person's life to the point of becoming life threatening. Previous research found stress associated with eating disorders. College can be a stressful time. If stress predicted precursor behaviors to eating disorders, then counselors would have a better chance to help students sooner. This…
Efforts aimed at the prevention of eating disorders need to consider the context within which these disorders develop and aim to promote not only healthy eating and physical activity but also address mental health factors, such as body image. Exploring the relationship between body image and eating disorders will provide a foundation and further…
This retrospective study explored the experience of recovery from anorexia nervosa and bulimia nervosa without professional treatment. A nine-question open-ended electronic survey was posted for a period of four months at a mid-western university. Sixteen female and two male respondents reported recovery from adolescent-onset full syndrome…
Westerberg, J; Edlund, B; Ghaderi, A
The aim of this longitudinal study of 383 Swedish adolescent girls (11 and 13 years old at year 1) and their parents was to examine changes in eating attitudes over a two-year period, and to investigate the predictive value of eating attitudes, perfectionism, asceticism, family climate and body mass index (BMI) for the development of disturbed eating attitudes. The following self-report questionnaires were used: Children's Eating Attitudes test, Eating Attitudes Test, Eating Disorder Inventory for Children, Eating Disorder Inventory 2, I Think I Am and The Family Climate. The frequency of disturbed eating attitudes increased with increased age in the girls. Children's eating attitudes, higher BMI than peers, the girls rating of a less healthy relation to family and their fathers' eating attitudes at year 1 contributed most to the prediction of disturbed eating attitudes for the girls 2 years later. The results suggest that early signs of disturbed eating attitudes and higher BMI than peers may be important predictors for the development of more serious eating disturbances among adolescent girls.
Story, Mary; Neumark-Sztainer, Dianne; French, Simone
Food choices of adolescents are not consistent with the Dietary Guidelines for Americans. Food intakes tend to be low in fruits, vegetables, and calcium-rich foods and high in fat. Skipping meals is also a concern among adolescents, especially girls. Factors influencing eating behaviors of adolescents need to be better understood to develop effective nutrition interventions to change eating behaviors. This article presents a conceptual model based on social cognitive theory and an ecological perspective for understanding factors that influence adolescent eating behaviors and food choices. In this model, adolescent eating behavior is conceptualized as a function of individual and environmental influences. Four levels of influence are described: individual or intrapersonal influences (eg, psychosocial, biological); social environmental or interpersonal (eg, family and peers); physical environmental or community settings (eg, schools, fast food outlets, convenience stores); and macrosystem or societal (eg, mass media, marketing and advertising, social and cultural norms).
Kelly, Nichole R.; Shomaker, Lauren B.; Pickworth, Courtney K.; Grygorenko, Mariya V.; Radin, Rachel M.; Vannucci, Anna; Shank, Lisa M.; Brady, Sheila M.; Courville, Amber B.; Tanofsky-Kraff, Marian; Yanovski, Jack A.
Data suggest that depressed affect and dietary restraint are related to disinhibited eating patterns in children and adults. Yet, experimental research has not determined to what extent depressed affect acutely affects eating in the absence of physiological hunger (EAH) in adolescents. In the current between-subjects experimental study, we measured EAH in 182 adolescent (13-17y) girls (65%) and boys as ad libitum palatable snack food intake after youth ate to satiety from a buffet meal. Just prior to EAH, participants were randomly assigned to view either a sad or neutral film clip. Dietary restraint was measured with the Eating Disorder Examination. Adolescents who viewed the sad film clip reported small but significant increases in state depressed affect relative to adolescents who viewed the neutral film clip (p < .001). Yet, there was no main effect of film condition on EAH (p = .26). Instead, dietary restraint predicted greater EAH among girls, but not boys (p < .001). These findings provide evidence that adolescent girls’ propensity to report restrained eating is associated with their greater disinhibited eating in the laboratory. Additional experimental research, perhaps utilizing a more potent laboratory stressor and manipulating both affective state and dietary restraint, is required to elucidate how state affect may interact with dietary restraint to influence EAH during adolescence. PMID:25936291
Kelly, Nichole R; Shomaker, Lauren B; Pickworth, Courtney K; Grygorenko, Mariya V; Radin, Rachel M; Vannucci, Anna; Shank, Lisa M; Brady, Sheila M; Courville, Amber B; Tanofsky-Kraff, Marian; Yanovski, Jack A
Data suggest that depressed affect and dietary restraint are related to disinhibited eating patterns in children and adults. Yet, experimental research has not determined to what extent depressed affect acutely affects eating in the absence of physiological hunger (EAH) in adolescents. In the current between-subjects experimental study, we measured EAH in 182 adolescent (13-17 y) girls (65%) and boys as ad libitum palatable snack food intake after youth ate to satiety from a buffet meal. Just prior to EAH, participants were randomly assigned to view either a sad or neutral film clip. Dietary restraint was measured with the Eating Disorder Examination. Adolescents who viewed the sad film clip reported small but significant increases in state depressed affect relative to adolescents who viewed the neutral film clip (p < .001). Yet, there was no main effect of film condition on EAH (p = .26). Instead, dietary restraint predicted greater EAH among girls, but not boys (p < .001). These findings provide evidence that adolescent girls' propensity to report restrained eating is associated with their greater disinhibited eating in the laboratory. Additional experimental research, perhaps utilizing a more potent laboratory stressor and manipulating both affective state and dietary restraint, is required to elucidate how state affect may interact with dietary restraint to influence EAH during adolescence.
Ahonen, Pirkko S.
The purpose of this study was to examine, describe, and explain experiences of men with eating disorders and to gain understanding of the relevant life issues, perceptions, and attitudes. What are some of the contributing factors and experiences of men who suffer from eating disorders despite the widely held assumption that eating disorders are…
Goldschmidt, Andrea B.; Wall, Melanie M.; Choo, Tse-Hwei J.; Bruening, Meg; Eisenberg, Marla E.; Neumark-Sztainer, Dianne
Objective Binge eating is prevalent among adolescents, but little is known about how parents and friends may influence such behaviors. This study examined associations between adolescent binge eating behaviors, and similar behaviors in their parents and friends. Method Participants were 2,770 target adolescent boys and girls who had at least one friend and/or parent who also participated. Logistic regression, stratified by gender, examined associations between parents’ and friends’ self-reported binge eating, and similar behaviors in target adolescents. Results Girls’ binge eating was associated with their male friends’ (odds ratio=2.33; p=.03) and fathers’ binge eating (odds ratio=3.38; p=.02), but not with their female friends’ or mothers’ binge eating (p>.05). For boys, binge eating was not associated with parents’ or friends’ behavior. Discussion Adolescent girls’ binge eating is associated with similar behaviors in their other-sex parents and friends. Results should be replicated, and mechanisms explaining this relation should be further explored. PMID:24105696
Imaz, C; Ballesteros, Mc; Higuera, Mbn; Conde, Vjm
One of the aims of epidemiological research is to provide some information that makes it possible to adapt and structure health care services. There is an open debate on the need and/or adequacy of the specific units for care given to eating behavior disorders (EBD) and a proper health care model. One way to contribute some ideas in this debate is to make a critical analysis of the reality of the care given for eating behavior disorders, observing the activity of the different health care levels, in our case in the province of Valladolid. The existence of several epidemiological studies, coinciding in space and time, makes it possible to conclude that 23% of new cases treated in the Community are detected in primary health care, while the percentage of those seen by the child-adolescent psychiatry departments is reduced to 2.56%, 16% of which are referred from hospital admission. The regional proposal of promoting a reference hospital admission unit for eating behavior disorders for all of the region of Castilla y Leon is considered ineffective according to this reality, the creation of specific functional units being proposed.
Andersen, A E; Holman, J E
Males represent only 10 percent of eating disorder cases. This gender discrepancy is among the most extreme in psychiatry and medicine. Determining what differences in etiology and mechanism best explain the discrepancy presents an intellectual challenge. Beginning at about the third grade, boys and girls diverge in social development. Boys show significantly less desire to lose weight, express dissatisfaction with the upper rather than the lower body, and use dieting to achieve specific external goals rather than as a cultural norm. Males reach a significantly higher body mass index (BMI) than females do before they beginning dieting. (27.2 versus 24.3, p < .01). While overall treatment principles are similar, males in treatment require attainment of a different hormonal milieu (testosterone), attention to past and future sexual role, amelioration of perception of stigma, and preparation for return to male social roles. Males and females suffer comparable degrees of osteopenia and brain shrinkage during anorexia nervosa. The effectiveness of antidepressants in males with eating disorders (compared with that in females) has not been well studied. Male gender is not an adverse factor in short-term or long-term treatment outcome. Understanding the lower frequency of these illnesses in males may lead to more effective means of protecting girls from eating disorders and from the culturally induced distress about normal body size and shape that burdens adolescent development and adult life.
Poor social support is a risk factor for the development of eating disorders (Ghaderi, 2003). We designed this study to investigate the relationship between social support and eating disorder symptomatology among a female, nonclinical population. The work is of international interest because disordered eating behavior is common across many nations. The results of this research should help build a better understanding of the links between social support and participants at risk of developing an eating disorder. In this study, family support was not correlated with disordered eating, but satisfaction with social support was.
Sala, Margarita; Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M.; Bardone-Cone, Anna
We investigated racial/ethnic stereotyping in the recognition and referral of eating disorders with 663 university students. We explored responses to problem and eating disorder recognition, and health care referral after reading a vignette concerning a patient of different race/ethnic background presenting with eating disorders. A series of three 4 × 3 ANOVAs revealed significant main effects for eating disorder across all three outcome variables. There were no significant main effects across the four different race/ethnicity conditions and no significant race by condition interactions. Lack of general eating disorder recognition and health care referral by student participants were found. PMID:24044598
Most people envision eating disorders occurring in young women with anorexia or bulimia. Today, disordered eating is increasingly prevalent in males and in every age group, along with new terms: binge eating, bigorexia, orthorexia, and diabulimia. Healthcare providers aware of and knowledgeable about eating disorders, signs and symptoms, risk factors, and treatment are better able to screen patients, assist them in receiving help earlier, and increase the likelihood of successful outcomes.
Ciao, Anna C.; Loth, Katie; Neumark-Sztainer, Dianne
Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors’ descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research. PMID:24821099
Ciao, Anna C; Loth, Katie; Neumark-Sztainer, Dianne
Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors' descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research.
Lachat, Carl; Khanh, Le Nguyen Bao; Huynh, Thi Thanh Tuyen; Verstraeten, Roosmarijn; Nago, Eunice; Roberfroid, Dominique; Kolsteren, Patrick
Eating out of home (OH) is nutritionally important in some developing countries. This study identifies the factors associated with eating OH in Vietnamese adolescents. Data were obtained from a cross-sectional cluster survey of 502 adolescents in rural and urban areas in Vietnam. Factors associated with eating OH were recorded with a Likert scale and analysed using factor analysis. Data on eating OH was collected using a frequency questionnaire and a 1-day 24h recall. A first pattern "Convenience" incorporated preparation time, price, variety, taste, proximity and social aspects as items associated with eating OH. A second pattern "Nutritional and food safety concerned" reflected concerns with regard to hygiene, fat and salt content of the food prepared OH. Adolescents characterised by the convenience pattern were more likely (OR=1.51, P<0.001) to eat OH more frequently. The highest tertile of the Nutritional and food safety concerned pattern was less likely (OR=0.61, P=0.03) to eat OH compared to lower tertiles. Both patterns were not associated with the % energy from eating OH per day. Convenience and to a lesser extent Nutritional and food safety concerns are significant factors associated with the frequency of eating OH in Vietnamese adolescents.
Richards, P Scott; Crowton, Sabree; Berrett, Michael E; Smith, Melissa H; Passmore, Kimberly
The present article reports on a 2-year pilot study that evaluated the effectiveness of an intuitive eating program for patients in an eating disorder treatment center. Standardized measures of intuitive eating and eating disorder and psychological symptoms were administered. Psychotherapists and dietitians rated patients on the healthiness of their eating attitudes and behaviors. Preliminary findings indicated that patients can develop the skills of intuitive eating, and that the ability to eat intuitively is associated with positive treatment outcomes for each diagnostic category (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). We conclude by offering recommendations about how to implement intuitive eating training safely and effectively in inpatient and residential treatment programs.
Torstveit, Monica Klungland; Aagedal-Mortensen, Kjersti; Stea, Tonje Holte
Disordered eating and eating disorders are of great concern due to their associations with physical and mental health risks. Even if adolescence has been identified as the most vulnerable time for developing disordered eating, few studies have used a broad spectrum of criteria to investigate the prevalence of disordered eating among high school students of both genders, in different programs of study, nor assessed correlates of disordered eating among this important target group. The purposes of this study were therefore to investigate the prevalence and correlates of disordered eating among both male and female high school students in sport-, general and vocational programs. A comprehensive questionnaire was completed by 2,451 students (98.7%), aged 15–17 years. The total prevalence of disordered eating was 54.9%, with 64.3% among girls and 45.0% among boys (p<0.001). The highest prevalence of disordered eating was found among vocational students (60.7%), followed by students in general programs (49.8%) and sport students (38.3%) (p<0.001). Female gender, school program (vocational and general), overweight/obesity and weight regulation were positively associated with disordered eating. The high prevalence indicates the importance of tailored prevention efforts directed at high school students, particularly in vocational programs. Furthermore, a smaller girls–boys ratio than expected indicates that the efforts to identify and manage disordered eating among high school students should include both genders. PMID:25825877
Dalky, Heyam F; Al Momani, Maysa H; Al-Drabaah, Taghreed Kh; Jarrah, Samiha
The study aimed to assess adolescent patterns of eating habits, determine factors influencing these patterns, and identify male and female differences related to eating habits. Using a cross-sectional study approach, a sample of adolescents (N = 423) in randomly selected clusters chosen from government and private schools in the south of Jordan completed self-administered questionnaires relating to socio-demographic data and personal eating habits. Results showed that parents, peers, and mass media are contributing factors, with peer pressure likely outweighing parental guidance. Males were more likely to be influenced by peers than females, whereas females were more likely to be influenced by media-based advertising. Lower body mass indices correlate with eating breakfast, which a majority of adolescents reported they do not do. Interventions targeted toward improving eating and active behaviors should involve peers as well as parents.
Snoek, Harriëtte M; van Strien, Tatjana; Janssens, Jan M A M; Engels, Rutger C M E
The purpose of this study was to determine how emotional, external and restrained eating behavior and other health-related lifestyle factors were associated with being overweight in adolescents. Moreover, demographic and ethnic differences in eating behavior have been examined. The respondents were 10,087 Dutch adolescents aged 11-16 years (M= 13.0, SD= 0.8). Self-reported eating behavior was measured with the DEBQ. Health-related lifestyle was determined by physical activity, breakfasting, fruit consumption and snacking. High restrained, and low external eating were positively associated with being overweight, whereas no significant association between emotional eating and being overweight was found for girls, and a negative association for boys. Adolescents who ate breakfast on a daily basis were less likely to be overweight than those who ate breakfast irregularly or never. Being overweight was positively associated with fruit consumption for girls and negatively with physical activity for boys.
Walther, Mireille; Hilbert, Anja
Overweight, a common health condition in adolescence, has been linked with difficulties in emotional processing. This study investigates associations between emotional processing, conceptualised through the model of Emotional Openness (EO), problematic eating behaviours, including Eating in the Absence of Hunger and disinhibited eating, and overweight in adolescents. Several self-report instruments were completed by 160 youngsters (mean age: 14.36±0.61years) from the community, including 39 overweight and obese adolescents (24.5%). In girls, bootstrap analyses supported a mediating effect of restrained eating on the relation between three EO dimensions and body mass index percentile, in particular the communication of emotions, the cognitive-conceptual representation of emotions, and the perception of bodily indicator of emotions. No mediating effect was found in boys. These results have important implications for psychological weight management interventions, as they underline the relevance of work on emotional processing in order to reduce problematic eating behaviours.
Krentz, E M; Warschburger, P
Previous studies have indicated a higher risk of disordered eating in certain types of elite sports such as aesthetic sports (e.g., rhythmical gymnastics, figure skating). But even though some studies on risk factors for disordered eating in sports exist, most research on this topic is based on cross-sectional data with limitations on causal inferences. We examined sports-related risk factors for disordered eating in a 1-year longitudinal study with two assessment points. The participants were 65 adolescent athletes from aesthetic sports (mean age 14.0 ±.2.2 years) who completed measures of disordered eating, social pressure from the sports environment, sports-related body dissatisfaction, desire to be leaner to improve sports performance, and emotional distress resulting from missed exercise sessions. All variables were relatively stable in the mean. Individual changes in the desire to be leaner to improve sports performance were associated with individual changes in disordered eating. Furthermore, a cross-lagged partial correlation analysis showed that the desire to be leaner to improve sports performance was predictive of disordered eating and not vice versa. The results of our study indicate that athletes are more at risk for disordered eating if they believe it is possible to enhance their sports performance through weight regulation.
Schaffner, Angela D.; Buchanan, Linda Paulk
This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…
Kirk, Ginger; Singh, Kusum; Getz, Hildy
Compares the prevalence of eating disorder behaviors between female collegiate athletes and female college nonathletes. Although female nonathletes had somewhat higher average scores on the Eating Attitudes Test 26, the proportion at risk for disordered eating was not different in the two groups. There was no significant difference among female…
Talleyrand, Regine M.
Given the recent focus on eating disorders in children, it is imperative that counselors consider eating concerns that affect children of all racial and ethnic groups and hence are effective in working with this population. The author discusses risk factors that potentially contribute to eating disorders in African American girls given their…
Copeland, William E.; Bulik, Cynthia M.; Zucker, Nancy; Wolke, Dieter; Lereya, Suzet Tanya; Costello, E. Jane
Objective Bullying is a common childhood experience with enduring psychosocial consequences. The aim of this study was to test whether bullying increases risk for eating disorder symptoms. Method Ten waves of data on 1420 participants between ages 9 and 25 were used from the prospective population-based Great Smoky Mountains Study. Structured interviews were used to assess bullying involvement and symptoms of anorexia nervosa and bulimia nervosa as well as associated features. Bullying involvement was categorized as not involved, bully only, victim only, or both bully and victim (bully-victims). Results Within childhood/adolescence, victims of bullying were at increased risk for symptoms of anorexia nervosa and bulimia nervosa as well as associated features. These associations persisted after accounting for prior eating disorder symptom status as well as preexisting psychiatric status and family adversities. Bullies were at increased risk of symptoms of bulimia and associated features of eating disorders, and bully-victims had higher levels of anorexia symptoms. In terms of individual items, victims were at risk for binge eating and bully-victims had more binge eating and use of vomiting as a compensatory behavior. There was little evidence in this sample that these effects differed by sex. Childhood bullying status was not associated with increased risk for persistent eating disorder symptoms into adulthood (ages 19, 21, and 25). Discussion Bullying predicts eating disorder symptoms for both bullies and victims. Bullying involvement should be a part of risk assessment and treatment planning for children with eating problems. PMID:26337405
de Barse, Lisanne M; Tharner, Anne; Micali, Nadia; Jaddoe, Vincent V W; Hofman, Albert; Verhulst, Frank C; Franco, Oscar H; Tiemeier, Henning; Jansen, Pauline W
We aimed to examine whether a maternal history of eating disorders predicted mothers' feeding practices and preschoolers' emotional eating patterns. Data were available from 4851 mothers and their children, who participated in a Dutch population-based cohort study (the Generation R Study). Maternal history of lifetime eating disorders was assessed during pregnancy using a self-report questionnaire. Mothers filled out the Child Feeding Questionnaire and the Child Eating Behaviour Questionnaire when children were four years old. Linear regression analyses were performed, adjusting for potential confounders. Of all mothers, 8.6% had a history of an eating disorder (2.5% anorexia nervosa (AN); 3.9% bulimia nervosa (BN); 2.2% both AN and BN). Compared to mothers without a history of eating disorders, mothers with a history of eating disorders, in particular AN, used less pressuring feeding strategies (standardized B = -0.30; 95% CI: -0.49, -0.11). Children of mothers with a history of AN had relatively high levels of emotional overeating (standardized B = 0.19; 95% CI: 0.00, 0.39). Maternal history of BN was not related to mothers' feeding practices or children's emotional eating. Overall, the levels of emotional overeating among children of mothers with a history of eating disorders are noteworthy, particularly considering the young age (4 years) of participating children. This finding may reflect an effect of maternal eating disorders on the development of disordered eating patterns, but could also be subject to mothers' perception.
El-Radhi, A Sahib
Eating disorders are essentially psychological diseases that are characterised by abnormal eating habits. Anorexia nervosa and bulimia are the most common forms of eating disorders. There is an increased recognition of eating disorders among both men and women, and growing numbers of children and teenagers seeking help for eating disorders. Fear of body-weight gain is central to both anorexia nervosa and bulimia. Before the diagnosis of an eating disorder is made, it is essential to exclude organic diseases that may present with similar symptoms to eating disorders. Management initially should focus on correcting the nutritional deficiencies and dehydration at a paediatric or paediatric gastroenterology department, followed by a multidisciplinary approach. At the other extreme, the prevalence of obesity in children is increasing at an alarming rate, and presents a serious public health challenge.
Bruening, Meg; Larson, Nicole; Story, Mary; Neumark-Sztainer, Dianne; Hannan, Peter
Objective: To identify predictors of breakfast consumption among adolescents. Methods: Five-year longitudinal study Project EAT (Eating Among Teens). Baseline surveys were completed in Minneapolis-St. Paul schools and by mail at follow-up by youth (n = 800) transitioning from middle to high school. Linear regression models examined associations…
Bas, Murat; Asci, F. Hulya; Karabudak, Efsun; Kiziltan, Gul
This study examined the eating attitudes and psychological characteristics of Turkish late adolescents. Seven hundred eighty-three university students were administered the Eating Attitudes Test, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Social Physique Anxiety Scale. More than one in ten (9.2% of the males and 13.1% of the…
Myers, Laura L.; Wiman, Allison M.
In 1994, binge eating disorder (BED) was introduced as a disorder requiring further study in the "American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders", fourth edition ("DSM-IV"). It is now listed as a distinct eating disorder in the "DSM-5", along with bulimia nervosa and anorexia…
Eisenberg, Marla E.; Wall, Melanie; Shim, Jin Joo; Bruening, Meg; Loth, Katie; Neumark-Sztainer, Dianne
Dieting, unhealthy weight control and muscle-enhancing behaviors are common among adolescents: friends are a probable source of influence on these behaviors. The present study uses data provided by nominated friends to examine associations between friends' disordered eating and muscle-enhancing behaviors and participants' own behaviors in a diverse sample of American youth. Male and female adolescents (mean age = 14.4) completed surveys and identified their friends from a class roster; friends' survey data were then linked to each participant. Participants (N = 2126) who had at least one nominated friend were included in the analytic sample. Independent variables were created using the same weight control and muscle-enhancing behaviors reported by nominated friends, and were used in logistic regression models to test associations between participants' and their friends' behaviors, stratified by gender. Results indicated that dieting, disordered eating and muscle-enhancing behaviors were common in this sample, and selected friends' behaviors were associated with the same behaviors in participants. For example, girls whose friends reported extreme weight control behaviors had significantly greater odds of using these behaviors than girls whose friends did not report these same behaviors (OR = 2.39). This research suggests that friends' weight- and shape-related behaviors are a feature of social relationships, and is the first report demonstrating these associations for muscle-enhancing behaviors. Capitalizing on the social element may be important to the development of increasingly effective intervention and prevention programs. PMID:23010337
Cuzzocrea, F; Larcan, R; Lanzarone, C
Few studies have focused on the relationship between personality trait and eating behaviors in a normal sample of adolescents. The purpose of this research was to examine differences between male and female non-clinical adolescents in eating behaviors, personality traits and state and trait anxiety and to verify the relationship between personality traits, anxiety and eating behaviors in males and females. 592 individuals (324 male and 267 females) were selected. Participants were asked to fill: Eating Disorder Inventory-2 (EDI-2), State-Training Anxiety Inventory (STAI - Forma Y) and Eysenck Personality Questionnaire - Revised (EPQ-R). The results highlighted specific differences in eating behaviors and in personality traits between genders. No statistical differences in anxiety were found. Our results underline the importance of focussing on anxiety levels for girls, while, for boys, on personality traits such as neuroticism and psychoticism. It was confirmed the opinion that, to prevent eating disorders, not only is it necessary to carry out a campaign based on proper nutrition, but also to investigate thoroughly aspects of personality that may be predictive of these disorders.
Crow, Scott; Eisenberg, Marla E.; Story, Mary; Neumark-Sztainer, Dianne
Disordered eating, body dissatisfaction, and obesity have been associated cross sectionally with suicidal behavior in adolescents. To determine the extent to which these variables predicted suicidal ideation and attempts, the authors examined these relationships in a longitudinal design. The study population included 2,516 older adolescents and…
Casswall, T; Bäckström, B; Drapinski, M; Henström, L; Bolander, P; Ejderhamn, J; Roth, A J; Thörne, A; Dahlström, K A
Percutaneous endoscopic gastrostomy (PEG) has gained great popularity for children with malnutrition and eating disorders secondary to chronic illness. However, the procedure is not without risks. We report on 62 infants and children, median age 4 years (1 month-20 years), who underwent PEG placement. Cerebral palsy with or without mental retardation was the most common diagnosis (50%). No complications related to the PEG procedure itself occurred, but postoperative pneumonia was seen in 10%. Late complications were few: intraperitoneal migration of the button in one child and prolapse of the stoma in another. At the time of button placement, after median 14 weeks, mean weight had increased from a standard deviation score of -2.7 to -2.2 (P < 0.001). We consider PEG to be a safe procedure for children with malnutrition requiring enteral feeding. Due to potential risks and complications related to this method, a multidisciplinary approach, as found in a "nutritional support team", is recommended.
Bardone-Cone, Anna M; Wonderlich, Stephen A; Frost, Randy O; Bulik, Cynthia M; Mitchell, James E; Uppala, Saritha; Simonich, Heather
The literature examining the relation between perfectionism and eating disorders was reviewed and content and methodological comparisons were made with the perfectionism literature in anxiety disorders and depressive disorders. A PsychInfo search using the key words "perfectionism/perfect/perfectionistic," "anorexia," "bulimia," and "eating disorders" was performed and the generated list of papers was supplemented based on a review of reference lists in the papers. A total of 55 papers published between 1990 and 2005 were identified that assessed perfectionism among individuals with diagnosed eating disorders. The key research questions were distilled from these publications and empirical findings were summarized for each question, followed by a comparison with perfectionism papers in the anxiety and depressive disorder literatures. Also, key research design methodological parameters were identified and comparisons made across the three literatures: eating disorders, anxiety disorders, depressive disorders. The current review concludes with conceptual and methodological recommendations for researchers interested in perfectionism and eating disorders.
This module includes six lessons which focus on issues related to body image and self-esteem, eating disorders, and sensible eating habits for adolescents in grades 9-12. In lesson 1, students examine influences on body image, assess their personal traits, and trade assessments with their peers. In lesson 2, students look at pressure and…
Alvarenga, Marle dos Santos; Scagliusi, Fernanda Baeza; Philippi, Sonia Tucunduva
The aim of this study was to develop and validate the Disordered Eating Attitude Scale to measure disordered eating attitudes, defined as abnormal beliefs, thoughts, feelings, behaviors, and relationship regarding food. Exploratory factor analysis was performed and internal consistency assessed in a sample of female university students (N=196). Convergent validity was acceptable based on statistically significant correlations with the Eating Attitude Test-26 and Restraint Scale. Known-groups validity was determined by comparing the student sample's mean scores against scores of an eating disorder group (N=51). The Disordered Eating Attitude Scale comprises 25 questions and five subscales explaining 54.3% of total variance. The total scores differentiated student, bulimia, and anorexia groups. The scale should prove useful for evaluating eating attitudes in various population groups and eating disordered patients.
Talbot, Lisa S; Maguen, Shira; Epel, Elissa S; Metzler, Thomas J; Neylan, Thomas C
The present study investigated the relationship between posttraumatic stress disorder (PTSD) and emotional eating in a sample of medically healthy and medication-free adults. Participants with PTSD (n = 44) and control participants free of lifetime psychiatric history (n = 49) completed a measure of emotional eating. Emotional eating is the tendency to eat or overeat in response to negative emotions. PTSD participants exhibited greater emotional eating than control participants (η(2) = .20) and emotional eating increased with higher PTSD symptom severity (R(2) = .11). Results supported the stress-eating-obesity model whereby emotional eating is a maladaptive response to stressors. Over time, this could lead to weight gain, particularly abdominal stores, and contribute to higher risk for comorbid medical disorders. Findings suggest the importance of future longitudinal research to understand whether emotional eating contributes to the high rates of obesity, diabetes, and heart disease in PTSD.
Flanagan, Theresa B; Sutton, Jill A; Brown, Laurie M; Weinstein, David A; Merlo, Lisa J
Glycogen storage disease (GSD) is an inherited disorder that requires a complex medical regimen to maintain appropriate metabolic control. Previous research has suggested the disease is associated with decreased quality of life, and clinical experience suggests that patients are at risk for disordered eating behaviors that may significantly compromise their health. The current study assessed eating attitudes, eating disorder symptoms, and body image among 64 patients with GSD ranging from 7-52 years old (M = 18.5 years old). About half the participants were male (n = 33, 51.6%). Most participants were diagnosed with GSD Type I (n = 52, 81.3%). Quantitative and qualitative analyses were utilized. Results indicated that 14.8% of children and 11.1% of adolescents/adults with GSD met the clinical cutoff for dysfunctional attitudes toward eating, suggesting high likelihood for presence of an eating disorder. However, traditional eating disorder symptoms (e.g., binging, purging, fasting, etc.) were less prevalent in the GSD sample compared to population norms (t = -6.45, p < 0.001). Body esteem was generally lower for both children and adolescents/adults with GSD compared to population norms. These results were consistent with interview responses indicating that GSD patients experience negative feedback from peers regarding their bodies, especially during childhood and adolescence. However, they reported growing acceptance of their bodies with age and reported less negative attitudes and behaviors. Assessing mental health, including symptoms of disordered eating and low body esteem, among individuals with GSD should be an important component of clinical care.
Peat, Christine M.; Von Holle, Ann; Watson, Hunna; Huang, Lu; Thornton, Laura M.; Zhang, Bing; Du, Shufa; Kleiman, Susan C.; Bulik, Cynthia M.
Objective China has historically reported a low prevalence of eating disorders. However, the rapid social and economic development of this country as well as Western ideals widely disseminated by television and the Internet have led to distinct patterns of behavioral choices that could affect eating disorder risk. Thus, the current study explored the relation between disordered eating and media use. Method Participants were females from the 2009 wave of the China Health and Nutrition Survey (N = 1,053). Descriptive statistics were obtained and logistic regression models, stratified by age (adolescents ages 12-17 and adults ages 18-35), were used to evaluate the association of media use with disordered eating. Results In adolescents, 46.8% had access to the Internet and those with access averaged one hour per day each of Internet and television use. In adults, 41.4% had access to the Internet, and those with access averaged one hour per day of Internet use and two hours per day of television use. Internet access was significantly associated with a subjective belief of fatness (OR = 2.8, 95% CI: 1.6, 4.9) and worry over losing control over eating (OR = 4.8, 95% CI: 2.3, 9.8) only in adults. Discussion These findings help characterize the overall pattern of media use and report of eating disorder symptoms in a large sample of female Chinese adolescents and adults. That Internet access in adults was significantly associated with disordered eating cognitions might suggest that media access negatively influences these domains;however,more granular investigations are warranted. PMID:25346164
Mond, J. M.; Hay, P. J.; Darby, A.; Paxton, S. J.; Quirk, F.; Buttner, P.; Owen, C.; Rodgers, B.
Variables associated with the use of health services were examined in a prospective, community-based study of women with bulimic-type eating disorders who did (n = 33) or did not (n = 58) receive treatment for an eating problem during a 12-month follow-up period. Participants who received treatment for an eating problem differed from those who did…
Tylka, Tracy L.; Wilcox, Jennifer A.
Two studies explored whether intuitive eating (i.e., eating based on physiological hunger and satiety cues rather than situational and emotional cues) is a distinct construct from low levels of eating disorder (ED) symptomatology among college women. Previous research has demonstrated that high levels of ED symptomatology are related to lower…
Loeb, Katharine L.; Lock, James; Greif, Rebecca; le Grange, Daniel
This paper describes the transdiagnostic theory and application of family-based treatment (FBT) for children and adolescents with eating disorders. We review the fundamentals of FBT, a transdiagnostic theoretical model of FBT and the literature supporting its clinical application, adaptations across developmental stages and the diagnostic spectrum…
Stice, Eric; Shaw, Heather; Burton, Emily; Wade, Emily
In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only…
Sala, Margarita; Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M; Bardone-Cone, Anna
We investigated racial/ethnic stereotyping in the recognition and referral of eating disorders with 663 university students. We explored responses to problem and eating disorder recognition and health care referrals after subjects read a vignette concerning a patient of a different race/ethnic background presenting with eating disorders. A series of three 4 × 3 ANOVAs revealed significant main effects for eating disorders across all three outcome variables. There were no significant main effects across the four different race/ethnicity conditions and no significant race by condition interactions. Lack of general eating disorder recognition and health care referrals by student participants were found. [Supplemental files are available for this article. Go to the publishers's online edition of Eating Disorders for the following free supplemental resource: online appendix containing vignettes 1-3, as described in the "Methods" section].
Meyer, D F
This study examined the role of codependency in the relationship between stressful events and the development of eating disorders. Ninety-five undergraduate women completed the Codependency Assessment, the Eating Disorder Inventory-2, the Differentiation of Self Scale, and an open-ended questionnaire asking about stressful experiences, including relationships with alcoholic family members. Results supported the hypothesis that women who reported experience with an alcoholic significant other or a chronic stressful situation exhibited higher levels of eating disordered behavior. However, a family history of parental alcohol abuse alone did not result in differences in eating disorder symptoms. Further, women who exhibited more characteristics of codependency (e.g., caretaking, needs for control) also evidenced more eating disorder symptoms. The findings suggest a developmental sequence, whereby codependency mediates the relationship between excessive stress and the development of an eating disorder.
Frisch, Maria J; Franko, Debra L; Herzog, David B
Arts-based therapies are increasingly being employed, in conjunction with empirically valid traditional therapies, in the residential treatment of eating disorders. A systematic database search of arts-based therapies in the treatment of eating disorders was conducted. In addition, program staff at 22 residential eating disorder treatment programs were contacted to provide information regarding arts-based therapy utilization rates. Of the 19 programs that participated in this study, all incorporate arts-based therapies on at least a weekly basis in the treatment of eating disorders. However, while published narrative reflections on arts-based therapies and eating disorders imply a generally positive outcome, no known, empirically valid studies exist on this experiential form of therapy within the area of eating disorders.
Zehr, Julia L.; Culbert, Kristen M.; Sisk, Cheryl L.; Klump, Kelly L.
Eating and anxiety disorders are more prevalent in females, increase during adolescence, and are associated with early pubertal development. This study examined whether timing of puberty onset is associated with disordered eating and anxiety in a large sample of post-pubertal male and female undergraduate students. Self-report questionnaires assessed timing of puberty, disordered eating, anxiety, alcohol use, personality, and sensation seeking. Females scored significantly higher on measures of disordered eating (binge eating, dietary restraint, eating concerns, and weight and shape concerns) and anxiety (state and trait anxiety) than did males. In addition, early maturing women and men scored significantly higher on measures of disordered eating and anxiety than on-time or late maturing women and men. Measures of alcohol use, sensation seeking, and personality characteristics differed in males and females but did not vary with pubertal timing. Findings suggest that early puberty is associated with disordered eating and anxiety, and this association may be due to an organizational effect of pubertal hormones. Despite important differences in body fat composition, both males and females experiencing early puberty had an increased incidence of disordered eating. The fact that early puberty was associated with increased eating and anxiety symptoms in both sexes suggests that puberty may influence these symptoms through both biological and psychosocial mechanisms. PMID:17707381
Zehr, Julia L; Culbert, Kristen M; Sisk, Cheryl L; Klump, Kelly L
Eating and anxiety disorders are more prevalent in females, increase during adolescence, and are associated with early pubertal development. This study examined whether timing of puberty onset is associated with disordered eating and anxiety in a large sample of postpubertal male and female undergraduate students. Self-report questionnaires assessed timing of puberty, disordered eating, anxiety, alcohol use, personality, and sensation seeking. Females scored significantly higher on measures of disordered eating (binge eating, dietary restraint, eating concerns, and weight and shape concerns) and anxiety (state and trait anxiety) than did males. In addition, early maturing women and men scored significantly higher on measures of disordered eating and anxiety than on time or late maturing women and men. Measures of alcohol use, sensation seeking, and personality characteristics differed in males and females but did not vary with pubertal timing. Findings suggest that early puberty is associated with disordered eating and anxiety, and this association may be due to an organizational effect of pubertal hormones. Despite important differences in body fat composition, both males and females experiencing early puberty had an increased incidence of disordered eating. The fact that early puberty was associated with increased eating and anxiety symptoms in both sexes suggests that puberty may influence these symptoms through both biological and psychosocial mechanisms.
Hermont, Ana Paula; Oliveira, Patrícia A. D.; Martins, Carolina C.; Paiva, Saul M.; Pordeus, Isabela A.; Auad, Sheyla M.
Background Eating disorders are associated with the highest rates of morbidity and mortality of any mental disorders among adolescents. The failure to recognize their early signs can compromise a patient's recovery and long-term prognosis. Tooth erosion has been reported as an oral manifestation that might help in the early detection of eating disorders. Objectives The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the following clinical question: Do eating disorders increase the risk of tooth erosion? Methods An electronic search addressing eating disorders and tooth erosion was conducted in eight databases. Two independent reviewers selected studies, abstracted information and assessed its quality. Data were abstracted for meta-analysis comparing tooth erosion in control patients (without eating disorders) vs. patients with eating disorders; and patients with eating disorder risk behavior vs. patients without such risk behavior. Combined odds ratios (ORs) and a 95% confidence interval (CI) were obtained. Results Twenty-three papers were included in the qualitative synthesis and assessed by a modified version of the Newcastle-Ottawa Scale. Fourteen papers were included in the meta-analysis. Patients with eating disorders had more risk of tooth erosion (OR = 12.4, 95%CI = 4.1–37.5). Patients with eating disorders who self-induced vomiting had more risk of tooth erosion than those patients who did not self-induce vomiting (OR = 19.6, 95%CI = 5.6–68.8). Patients with risk behavior of eating disorder had more risk of tooth erosion than patients without such risk behavior (Summary OR = 11.6, 95%CI = 3.2–41.7). Conclusion The scientific evidence suggests a causal relationship between tooth erosion and eating disorders and purging practices. Nevertheless, there is a lack of scientific evidence to fulfill the basic criteria of causation between the risk behavior for eating disorders and tooth
Pedersen, Susanne; Grønhøj, Alice; Thøgersen, John
It is commonly believed that during adolescence children become increasingly influenced by peers at the expense of parents. To test the strength of this tendency with regards to healthy eating (fruit and vegetable intake), a survey was completed by 757 adolescent-parent dyads. Our theoretical framework builds on social cognitive theory and the focus theory of normative conduct, and data are analysed by means of confirmatory factor analysis and structural equation modelling. The study reveals that when it comes to adolescents' fruit and vegetable intake, parents remain the main influencer, with what they do (descriptive norms) being more important than what they say (injunctive norms). The study contributes to a more comprehensive understanding of what influences adolescent healthy eating, including the social influence of parents and friends, while also taking adolescent self-efficacy and outcome expectations into account. No previous studies have included all these factors in the same analysis. The study has a number of important implications: (1) healthy eating interventions should aim at strengthening self-efficacy and positive outcome expectations among adolescents, (2) the family context should be included when implementing healthy eating interventions and (3) parents' awareness of their influence on their children's healthy eating should be reinforced.
Kelly, Nichole R.; Pickworth, Courtney K.; Thompson, Katherine A.; Brady, Sheila M.; Demidowich, Andrew; Galescu, Ovidiu; Altschul, Anne M.; Shank, Lisa M.; Yanovski, Susan Z.; Tanofsky-Kraff, Marian; Yanovski, Jack A.
Background Adults with binge-eating disorder may have an exaggerated or blunted cortisol response to stress. Yet, limited data exist among youth who report loss of control (LOC) eating, a developmental precursor to binge-eating disorder. Methods We studied cortisol reactivity among 178 healthy adolescents with and without LOC eating. Following a buffet lunch meal adolescents were randomly assigned to watch a neutral or sad film clip. After, they were offered snacks from a multi-item array to assess eating in the absence of hunger. Salivary cortisol was collected at −80, 0, 30, and 50 minutes relative to film administration, and state mood ratings were reported before and after the film. Results Adolescents with LOC had greater increases in negative affect during the experimental paradigm in both conditions (ps>.05). Depressive symptoms, but not LOC, related to a greater cortisol response in the sad film condition (ps>.05). Depressive symptoms and state LOC were related to different aspects of eating behavior, independent of film condition or cortisol response (ps>.05). Conclusions A film clip that induced depressed state affect increased salivary cortisol only in adolescents with more elevated depressive symptoms. Adolescents with and without LOC were differentiated by greater increases in state depressed affect during laboratory test meals, but had no difference in cortisol reactivity. Future studies are required to determine if adolescents with LOC manifest alterations in stress reactivity to alternative stress-inducing situations. PMID:26667312
Weiselberg, E C; Gonzalez, M; Fisher, M
The first description of anorexia nervosa appeared in the literature over three hundred years ago. Since then, much has been learned about eating disorders, including the different presentations, medical complications, prognosis, and treatment strategies. In spite of this knowledge, the prevalence of eating disorders continues to grow. As well, eating disorders are seen in increasing frequency among males, children, and adults, and from all cultures and ethnicities. Of particular concern, is that patients with eating disorders often first present because of a complication such as amenorrhea, syncope, or abdominal pain, without disclosing the eating disorder. Therefore, all physicians should be aware of the various presentations of eating disorders, including the medical complications and risks, and be able to screen for a possible eating disorder. The major medical complications are due to the decreased caloric intake which leads to a hypometabolic state. While most complications are reversible with recovery, some, such as bone loss, may not be. Of particular concern during recovery is the possible development of a refeeding syndrome which occurs as the body goes from a catabolic to an anabolic state, causing hypophosphatemia, hypocalcemia and hypomagnesemia, which can lead to delirium, coma and death. Of further concern is that eating disorders have the highest mortality rate of all psychiatric disorders at 5.6% per decade. This article will review the changing demographics, medical complications, treatment options, and prognosis of eating disorders.
Averett, Susan; Terrizzi, Sabrina; Wang, Yang
Eating disorders are currently the deadliest mental disorder in the United States, affecting an estimated 12%-25% of all college women. Previous research has found a positive correlation between sorority membership and eating disorders, but the causal link has not been firmly established. We contribute to the literature by investigating a possible causal link among sororities and diagnosed eating disorders, measurable weight outcomes, and disordered-eating behaviors using data from the American College Health Association Survey. We handle the potential endogeneity of sorority membership using propensity score matching and instrumental variable methods to determine whether joining a sorority is a cause of the weight-related outcomes we study. We find that sorority members exhibit worse weight-related outcomes than those not in a sorority. However, our propensity score matching and instrumental variable results suggest that, other than BMI, this is merely a correlation, and there is little evidence that sorority membership is a cause of the outcomes we study. Copyright © 2016 John Wiley & Sons, Ltd.
Iles, Irina A; Atwell Seate, Anita; Waks, Leah
This research explores the intended and unintended consequences of eating disorder public service announcements. We assessed participants' attitudes toward eating disorders and people with eating disorders, willingness to interact with people with eating disorders, and experience with eating disorders (covariate) at Time 1. At Time 2, participants were randomly assigned to watch a stigmatizing or a non-stigmatizing eating disorder public service announcement. Exposure to the stigmatizing public service announcement resulted in more negative attitudes toward eating disorders and in less willingness to interact with people with eating disorders, but not in significantly more negative attitudes toward people with eating disorders. The discussion highlights the practical implications for health communication campaigns.
Dunker, K L L; Philippi, S T; Ikeda, J P
During a four month scholarly leave in United States of America, researchers designed a culturally appropriate prevention program for eating disorders (ED) for Brazilian adolescent girls. The program "Se Liga na Nutrição" was modeled on other effective programs identified in a research literature review and was carried out over eleven interactive sessions. It was positively received by the adolescents who suggested that it be part of school curricula. The girls reported that it helped them to develop critical thinking skills with regards to sociocultural norms about body image, food and eating practices.
Because such eating disorders as anorexia and bulimia have been found to be more common in women than in men, much recent research on these disorders has examined their relationship to gender roles. Some evidence exists supporting the existence of two types of eating disorders; one associated with stereotypically feminine concerns, the other…
Beals, Katherine A.; Brey, Rebecca A.; Gonyou, Julianna B.
Examines three disorders that can affect female athletes who focus on succeeding athletically and achieving a prescribed body weight: disordered eating, amenorrhea, and osteoporosis. The paper presents prevention and treatment suggestions for athletes with eating disorders, focusing on primary, secondary, and tertiary prevention. Recommends that…
Reina, Samantha A; Shomaker, Lauren B; Mooreville, Mira; Courville, Amber B; Brady, Sheila M; Olsen, Cara; Yanovski, Susan Z; Tanofsky-Kraff, Marian; Yanovski, Jack A
Parental feeding practices and sociocultural pressures theoretically influence eating behavior. Yet, whether these factors relate to eating in the absence of hunger (EAH) is unknown. We assessed if sociocultural pressures were associated with EAH among 90 adolescents (Mage=15.27, SD=1.39; 48% female). Parents completed the Child Feeding Questionnaire. Adolescents completed the Perceived Sociocultural Pressures Scale, Sociocultural Attitudes Towards Appearance Questionnaire-3, and Multidimensional Body Self-Relations Questionnaire-Appearance Scales. On two occasions, EAH was assessed as snack food intake after adolescents ate to satiety. Controlling for body composition and demographics, parental restriction and family pressure to be thin were associated with greater EAH. Media pressure was related to more EAH in girls. Appearance orientation and preoccupation with becoming overweight mediated links between sociocultural pressures and EAH. Findings support the notion that sociocultural pressures and their links to body image may contribute to the course of disinhibited eating behaviors during adolescence.
Reina, Samantha A.; Shomaker, Lauren B.; Mooreville, Mira; Courville, Amber B.; Brady, Sheila M.; Olsen, Cara; Yanovski, Susan Z.; Tanofsky-Kraff, Marian; Yanovski, Jack A.
Parental feeding practices and sociocultural pressures theoretically influence eating behavior. Yet, whether these factors relate to eating in the absence of hunger (EAH) is unknown. We assessed if sociocultural pressures were associated with EAH among 90 adolescents (Mage = 15.27, SD = 1.39; 48% female). Parents completed the Child Feeding Questionnaire. Adolescents completed the Perceived Sociocultural Pressures Scale, Sociocultural Attitudes Towards Appearance Questionnaire-3, and Multidimensional Body Self-Relations Questionnaire-Appearance Scales. On two occasions, EAH was assessed as snack food intake after adolescents ate to satiety. Controlling for body composition and demographics, parental restriction and family pressure to be thin were associated with greater EAH. Media pressure was related to more EAH in girls. Appearance orientation and preoccupation with becoming overweight mediated links between sociocultural pressures and EAH. Findings support the notion that sociocultural pressures and their links to body image may contribute to the course of disinhibited eating behaviors during adolescence. PMID:23394966
The paper presents the attachment theory in relation to eating disorders. In the first part, the classic concepts of anorexia and bulimia nervosa are discussed taking into account assumptions of Bowlby's and his followers' model. In the second part, empirical data on anorexia and bulimia nervosa and attachment patterns are presented. The importance of methodological issues is stressed regarding the attachment model particularly in eating disorders. In the conclusion significant findings correlation of attachment patterns and eating disorders are indicated.
Individuals with type 1diabetes are at increased risk of developing an eating disorder, the effects of which can be physically and psychologically damaging. Early detection of an eating disorder and appropriate treatment is therefore essential. This article explores the possible factors that may increase the risk of people with type 1 diabetes developing an eating disorder, and highlights the signs and symptoms to help healthcare professionals detect people at risk so they can encourage them to accept appropriate help.
Gratwick-Sarll, Kassandra; Mond, Jonathan; Hay, Phillipa
Self-recognition of eating-disordered behavior was examined among female college students (n = 94) with a high level of bulimic-type eating disorder symptoms. A vignette was presented describing a fictional young woman with bulimia nervosa. Participants were asked whether they might currently have a problem such as the one described, while also completing self-report measures of eating disorder symptoms, general psychological distress, and functional impairment. Less than half (47.9%) of participants believed that they currently had a problem with their eating. In both bivariate and multivariable analysis, the variables most strongly associated with self-recognition were overall levels of eating disorder psychopathology, prior treatment for an eating problem, and the use of self-induced vomiting as a means of controlling weight or shape. No other eating disorder behaviors were independently associated with self-recognition. The findings support the hypothesis that young women with eating disorder symptoms may be unlikely, or at least less likely, to recognize a problem with their eating behavior when that behavior does not entail self-induced vomiting. Health promotion and early intervention programs for eating disorders may need to address the perception that, among young women of normal or above-average body weight, only problems with eating that involve self-induced vomiting are pathological.
Speranza, Mario; Revah-Levy, Anne; Giquel, Ludovic; Loas, Gwenolé; Venisse, Jean-Luc; Jeammet, Philippe; Corcos, Maurice
The aim of this study was to examine how far Goodman's addictive disorder criteria were met by individuals with eating disorders according to subtypes. The study provided a cross-sectional comparison among three samples of eating disorders [restricting anorexia nervosa (R-AN), N = 68; purging anorexia nervosa (P-AN), N = 42; and bulimia nervosa (BN), N = 66], a sample of substance-related disorders (SRDs, N = 48) and a sample of matched controls (N = 201). Diagnosis of addictive disorder was made following Goodman's criteria. Addictive personality traits were assessed with the Addiction Potential Scale of the Minnesota Multiphasic Personality Inventory--2 and with the Zuckerman's Sensation Seeking Scale. Results showed that individuals with BN met Goodman's addictive disorder criteria in the same proportion as drug-addicted individuals (65% vs 60%, p = NS). They both showed higher rates than R-AN individuals (35%; R-AN versus BN: F = 11.9, p < 0.001 and R-AN versus SRD: F = 7.16, p < 0.01). Although BN and SRD showed higher rates of addictive disorders compared with P-AN, differences were not significant. Scores on the Sensation Seeking and on the Addictive Potential scales paralleled the distribution of addictive disorders, with individuals with BN and with P-AN showing higher levels than individuals with R-AN. Results showed that a subgroup of individuals with an eating disorder experiences their disorder as an addiction and may deserve specific therapeutic attention.
Munkholm, Anja; Olsen, Else Marie; Rask, Charlotte Ulrikka; Clemmensen, Lars; Rimvall, Martin K; Jeppesen, Pia; Micali, Nadia; Skovgaard, Anne Mette
Preadolescence is a key period in the early stages of eating disorder development. The aim of the present study was, firstly, to investigate restrained, emotional and external eating in a general population-based sample of 11-12 year olds. Secondly, we sought to explore how these eating behaviours are associated with possible predictors of eating disorders, such as body dissatisfaction, weight status and mental disorders. A subsample of 1567 children (47.7% boys; 52.3% girls) from the Copenhagen Child Cohort (CCC2000) completed web-based questionnaires on eating behaviours and body dissatisfaction using The Eating Pattern Inventory for Children (EPI-C) and The Children's Figure Rating Scale. Mental disorders were assessed using the online version of the Development and Well-Being Assessment (DAWBA) based on parental replies with final DSM-IV diagnoses determined by experienced child- and adolescent psychiatrists. Height and weight were measured at a face-to-face assessment. The results showed that restrained eating was significantly associated with overweight, body dissatisfaction and emotional disorders in both genders. Emotional eating showed similar associations with overweight and body dissatisfaction in both genders, but was only associated with mental disorders in girls. External eating was significantly associated with body dissatisfaction and neurodevelopmental disorders in both genders, but was only associated with overweight in girls. Our findings show that problematic eating behaviours can be identified in preadolescence, and co-exist with weight problems and mental disorders. Thus restrained, emotional and external eating was, in different ways, associated with overweight, body dissatisfaction and mental disorders. Our findings point to significant eating behaviours in preadolescence, which could constitute potential predictors of later eating disorder risk.
Gates, K; Pritchard, M
Although religion is thought to be a positive aspect of life, sometimes that is not always the case. One potentially negative effect of religion is the way people learn to perceive their bodies. Although many studies have examined factors that influence disordered eating (e.g., gender, self-esteem), few studies have examined the relationships among disordered eating and religious affiliation and religious angst. In the present study of 330 undergraduates, we found that Catholics and Christians displayed significantly more disordered eating than did other students. In addition, individuals scoring high on religious angst also reported more disordered eating behaviors than did other students. Implications for counseling will be discussed.
Tan, Jacinta Oon Ai; Calitri, Raff; Bloodworth, Andrew; McNamee, Michael J
Eating disorders and disordered eating are more common in high performance sports than the general population, and particularly so in high performance aesthetic sports. This paper presents some of the conceptual difficulties in understanding and diagnosing eating disorders in high performance gymnasts. It presents qualitative and quantitative data from a study designed to ascertain the pattern of eating disorder symptoms, depressive symptoms and levels of self-esteem among national and international level gymnasts from the UK in the gymnastic disciplines of sport acrobatics, tumbling, and rhythmic gymnastics.
Unoka, Zsolt; Tölgyes, Tamás; Czobor, Pál; Simon, Lajos
To examine relationship between Eating Disorder Behaviors (EDB) and Early Maladaptive Schemas (EMS) across eating disorder (ED) subgroups. EMS and ED behaviors were measured by Young Schema Questionnaire and Eating Behavior Severity Scale, respectively, among patients diagnosed with Restrictive or Binge/purging Anorexia, or bulimia nervosa. Canonical component analysis showed significant association between ED behaviors and EMSs. Canonical factor-pairs (EDB and EMS) revealed specific associations between certain patterns of EDBs, including binge-purging and physical exercise, and certain patterns of maladaptive cognitive schema, including Emotional deprivation, Abandonment, Enmeshments, Subjugation, and Emotional inhibition. ED subgroups significantly differred between the EMS and EDB canonical factors, respectively. Our findings indicate that EMS and EDB are associated, and that the factors that potentially mediate the association differ significantly among ED subgroups. These results are consistent with the notion that EMSs play a specific role in the development and maintenance of ED behaviors.
Tyagi, Himanshu; Patel, Rupal; Rughooputh, Fabienne; Abrahams, Hannah; Watson, Andrew J.; Drummond, Lynne
Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD) and other common anxiety disorders. Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups. Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group. Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population. PMID:26366407
Rodgers, Cheryl; Young, Anne; Hockenberry, Marilyn; Binder, Brenda; Symes, Lene
Bone marrow transplant (BMT) is a common treatment option for adolescents with various diseases; however, the aggressive therapy often causes significant side effects that can lead to poor eating. There is little documentation of eating experiences and necessary support needed after the initial BMT hospitalization. This phenomenological study, guided by Martin Heidegger's philosophical influences, revealed the meaning of adolescents' eating experiences, eating strategies, and the impact of eating on the adolescents' quality of life during the first 100 days post-BMT. Individual interviews were conducted at 50 and 100 days post-BMT. Data analysis used the hermeneutic circle and revealed 5 themes. Adolescents discussed the slow return of eating, barriers that affected their eating, personal eating strategies, significance of eating, and feelings regarding eating. Eating issues do not end when a BMT patient is discharged from the hospital, and caregivers need to have a better understanding of the ongoing issues affecting adolescents throughout the BMT recovery phase.
Dupont, Marie-Estelle; Corcos, Maurice
Self-starvation as well as binge eating appears to be far more complex than the uniformity of eating disorders clinical features let us predict. One reason is that these "body-centred" behaviours generate severe biological effects, the complications playing a great part in the recovery process. Furthermore, these disorders which origins are likely to be multi-factorial seem to arise from physiological (ephebic modifications, gene pool...), family and sociocultural factors, psychological features predominating in a synergy always leading to a specificity that cannot be ignored. The progression towards mixed forms made the distinction between anorexia and bulimia nervosa, insufficiently accurate, leading to examine the addictive dimension these troubles have in common. Despite different theoretical surroundings, it has been suggested that an insecure style of attachment may be highly implicated in the disorders occurring. Moreover, a great number of surveys insisted on identity disturbance, and predisposition to intemperate dependency, resulting from the poor quality of internalized relationships. From that viewpoint, both fasting and binge eating appear as a form of addiction meant to mitigate the defense mechanisms failure and the flaws of the psychological organization. Impulsivity appears as a way to avoid processing affects, acting-out being here to balance the ego weakness deriving from the lack of inner security. The fluctuations in the sense of self lead them to self-damaging behaviours meant to vent their pervasive, chronic feeling of emptiness. Occurring whereas the subject still depends on his parents, puberty reactivates a vivid anguish of passivity, and generates attempts to take the control back. Therefore, these patients re-enact in their dealings with food and their body dissatisfaction the pattern of unstable relationships established with their kin, characterized by alternating between merging and rejection, engulfment and remoteness.
Tice, L; Hall, R C; Beresford, T P; Quinones, J; Hall, A K
The incidence of sexual abuse in eating disorder patients appears significant. Fifty percent of both our anorectic and bulimic patients reported a history of sexual abuse while only 28% of a non-anorexic, non-bulimic control population reported similar problems (p less than 0.01). Several patterns of behavior seemed related to previous sexual assault. In one, the eating disorder was used to change the body image of the patient and therefore to provide a defense to future abuse. Other behaviors which occurred more specifically in bulimic women dealt with a projection of repressed anger toward male authority figures. Forty six percent of the bulimic women seen in our study exhibited some promiscuous behavior, using sex either as a gauge of their own self worth or as a means of punishing men. It is essential that sexual issues be addressed early in the treatment of patients with eating disorders. Disclosure is often difficult particularly in outpatient situations where the patient lives at home with her family. It usually does not occur in such cases until the later stages of therapy, or until the patient is hospitalized. Rape is the exception since our data suggests that it is usually revealed early in the course of treatment (p less than 0.001). Once disclosure occurs, a dramatic change is usually seen in the patient and treatment becomes more effective. As the patient deals with the issues of sexual abuse, they no longer need to deny their sexuality or punish themselves or others. Issues of guilt, depression, repressed anger, low self-esteem, social isolation and inadequacy are important and need to be addressed during the course of therapy with sexually abused patients.
Loeb, Katharine L; Lock, James; Grange, Daniel le; Greif, Rebecca
This paper describes the transdiagnostic theory and application of family-based treatment (FBT) for children and adolescents with eating disorders. We review the fundamentals of FBT, a transdiagnostic theoretical model of FBT and the literature supporting its clinical application, adaptations across developmental stages and the diagnostic spectrum of eating disorders, and the strengths and challenges of this approach, including its suitability for youth. Finally, we report a case study of an adolescent female with eating disorder not otherwise specified (EDNOS) for whom FBT was effective. We conclude that FBT is a promising outpatient treatment for anorexia nervosa, bulimia nervosa, and their EDNOS variants. The transdiagnostic model of FBT posits that while the etiology of an eating disorder is unknown, the pathology affects the family and home environment in ways that inadvertently allow for symptom maintenance and progression. FBT directly targets and resolves family level variables, including secrecy, blame, internalization of illness, and extreme active or passive parental responses to the eating disorder. Future research will test these mechanisms, which are currently theoretical.
Gorgulho, Alessandra A; Pereira, Julio L B; Krahl, Scott; Lemaire, Jean-Jacques; De Salles, Antonio
Extremes of eating disorders (ED) have become prevalent in both developed and developing countries. Available therapies, though largely effective, fail in a substantial number of patients and carry considerable side effects. Morbid obesity and anorexia nervosa (AN) represent important causes of morbidity and mortality among young adults. Morbid obesity affects disproportionate numbers of children. AN is also important for its high mortality in young adults. The challenges of effectively treating AN are well recognized. In this article, important aspects of ED are reviewed in detail and novel approaches to the treatment of ED are proposed.
This article explores the possible relationship between professional writing on eating disorders and the occurrence of symptoms. The clinical situation is seen as one in which negotiation about symptoms affects and is affected by both professional and popular explanatory models. Professional understanding is not necessarily categorically distinct from popular conceptions. Furthermore, it may be that different academic models hold different assumptions about normality and may expect different types of 'normal' behaviour from patients. Professional writing and educative material may be playing a function not dissimilar from material generally seen as exploitative in educating women into development of symptoms. This possibility has implications for the way that professional understanding is viewed and contextualized.
Mahn, Heather Mciver; Lordly, Daphne
The diet industry and media have a powerful influence over women, leading many to believe that they must modify their appearance for societal acceptance. Dietetics, as one of many predominantly female professions, may be particularly vulnerable to these pressures. An integrative review process was used to examine eating disorders and disordered eating within the dietetics profession with the aim to both synthesize existing data and develop questions for future research. Seventeen articles were reviewed using broad search terms and dates because of the dearth of available literature. Given nutrition programs and dietetic practice often involve significant exposure to food, ideas and opinions about food, weight, and its place in health and dietetic practice researchers were compelled to ask "why". Findings were organized under 3 categories including thinness ideology, implications of food and body associated with nutrition or dietetic education, and establishment of a continuum. This review serves as a platform to inspire future research in an understudied but important topic related to dietetic education and practice. Minimally as a profession, baseline data need to be collected to understand the prevalence of disordered eating and eating disorders along the continuum of practice in Canada.
Barufaldi, Laura Augusta; Abreu, Gabriela de Azevedo; Oliveira, Juliana Souza; dos Santos, Debora França; Fujimori, Elizabeth; Vasconcelos, Sandra Mary Lima; de Vasconcelos, Francisco de Assis Guedes; Tavares, Bruno Mendes
ABSTRACT OBJECTIVE To describe the prevalence of eating habits considered healthy in adolescents according to sex, age, education level of the mother, school type, session of study, and geographic region. METHODS The assessed data come from the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, national and school-based study. Adolescents of 1,247 schools of 124 Brazilian municipalities were evaluated using a self-administered questionnaire with a section on aspects related to eating behaviors. The following eating behaviors were considered healthy: consuming breakfast, drinking water, and having meals accompanied by parents or legal guardians. All prevalence estimates were presented proportionally, with their respective 95% confidence intervals. The Chi-square test was used to evaluate the differences in healthy eating habits prevalences according to other variables. The module survey of the Stata program version 13.0 was used to analyze complex data. RESULTS We evaluated 74,589 adolescents (72.9% of the eligible students). Of these, 55.2% were female, average age being 14.6 years (SD = 1.6). Among Brazilian adolescents, approximately half of them showed healthy eating habits when consuming breakfast, drinking five or more glasses of water a day, and having meals with parents or legal guardians. All analyzed healthy eating habits showed statistically significant differences by sex, age, type of school, session of study, or geographic region . CONCLUSIONS We suggest that specific actions of intersectoral approach are implemented for the dissemination of the benefits of healthy eating habits. Older female adolescents (15 to 17 years old) who studied in public schools, resided in the Southeast region, and whose mothers had lower education levels, should be the focus of these actions since they present lower frequencies concerning the evaluated healthy habits. PMID:26910548
Rieger, Elizabeth; Van Buren, Dorothy J; Bishop, Monica; Tanofsky-Kraff, Marian; Welch, Robinson; Wilfley, Denise E
Several studies support the efficacy of interpersonal psychotherapy (IPT) in the treatment of eating disorders. Treatment outcomes are likely to be augmented through a greater understanding, and hence treatment targeting, of the mechanisms whereby IPT induces therapeutic gains. To this end, the present paper seeks to develop a theoretical model of IPT in the context of eating disorders (IPT-ED). After providing a brief description of IPT, the IPT-ED model is presented and research supporting its theorized mechanisms is summarized. This model proposes that negative social evaluation plays a pivotal role as both a cause (via its detrimental impact on self evaluation and associated affect) and consequence of eating disorder symptoms. In the final section, key eating disorder constructs (namely, the developmental period of adolescence, clinical perfectionism, cognitive dysfunction, and affect regulation) are re-interpreted from the standpoint of negative social evaluation thereby further explicating IPT's efficacy as an intervention for individuals with an eating disorder.
Fogarty, Sarah; Ramjan, Lucie; Hay, Phillipa
In this review, we aimed to explore the benefits, effects and experiences of mentoring on those with an eating disorder or disordered eating. After a systematic search of the literature, four papers were included in the review. A qualitative analysis of the papers identified three key themes. The themes were (1) diverse benefits (mentees), (2) finding comfort in belonging (mentees), and (3) affirmation of the transformation they have made (mentors). The experience of mentoring was shown to have value for both mentors and mentees. Mentorship should be further utilized in the areas of eating disorders and disordered eating, as it shows promising reciprocal benefits for both mentor and mentee.
Berge, Jerica M.; Loth, Katie; Hanson, Carrie; Croll, Jillian; Neumark-Sztainer, Dianne
Aims and Objective The aim of this retrospective qualitative study is to understand how transitions in the family life cycle and responses to these events may relate to the onset of eating disorders in an attempt to generate new theoretical insights and inform future research in the area of eating disorder prevention. Background Little is known about the contextual factors that occur throughout the family life cycle that may be risk factors for the development of eating disorders. Design and Methods Semi-structured interviews were conducted with 27 individuals of varied ages (age range =17–64; Median = 27; SD 13.7) currently receiving treatment for eating disorders in an outpatient clinic specialising in eating disorder treatment. Data were analysed using grounded theory methods. Results Six themes were identified as family life cycle transitional events that preceded the onset of participants’ eating disorders: (a) School Transitions, (b) Death of a Family Member, (c) Relationship Changes, (d) Home and Job Transitions (e) Illness/Hospitalisation and (f) Abuse, Sexual Assault, or Incest. Conclusions Results indicated that transitional events in the family life cycle followed by a lack of needed support during these transitions may precipitate the onset of eating disorders. Thus, future research should use these findings to inform the creation of interventions that reduce the intensity of the stress brought about by these transitional periods and increase the adaptability and coping skills of individuals and family members to prevent eating disorders. Relevance to Clinical Practice Nurses and other healthcare professionals should be aware of the importance of transitional events occurring in the family life cycle of adolescents and young adults. Helping parents to be aware and supportive of difficult transitional events may be more important than trying to solve or fix the problem. PMID:21749510
UHER, RUDOLF; RUTTER, MICHAEL
Current classification of eating disorders is failing to classify most clinical presentations; ignores continuities between child, adolescent and adult manifestations; and requires frequent changes of diagnosis to accommodate the natural course of these disorders. The classification is divorced from clinical practice, and investigators of clinical trials have felt compelled to introduce unsystematic modifications. Classification of feeding and eating disorders in ICD-11 requires substantial changes to remediate the shortcomings. We review evidence on the developmental and cross-cultural differences and continuities, course and distinctive features of feeding and eating disorders. We make the following recommendations: a) feeding and eating disorders should be merged into a single grouping with categories applicable across age groups; b) the category of anorexia nervosa should be broadened through dropping the requirement for amenorrhoea, extending the weight criterion to any significant underweight, and extending the cognitive criterion to include developmentally and culturally relevant presentations; c) a severity qualifier “with dangerously low body weight” should distinguish the severe cases of anorexia nervosa that carry the riskiest prognosis; d) bulimia nervosa should be extended to include subjective binge eating; e) binge eating disorder should be included as a specific category defined by subjective or objective binge eating in the absence of regular compensatory behaviour; f) combined eating disorder should classify subjects who sequentially or concurrently fulfil criteria for both anorexia and bulimia nervosa; g) avoidant/restrictive food intake disorder should classify restricted food intake in children or adults that is not accompanied by body weight and shape related psychopathology; h) a uniform minimum duration criterion of four weeks should apply. PMID:22654933
Schvey, Natasha A.; Sbrocco, Tracy; Stephens, Mark; Bryant, Edny J.; Ress, Rachel; Spieker, Elena A.; Conforte, Allison; Bakalar, Jennifer L.; Pickworth, Courtney K.; Barmine, Marissa; Klein, David; Brady, Sheila M.; Yanovski, Jack A.; Tanofsky-Kraff, Marian
Objective Limited data suggest that the children of U.S. service members may be at increased risk for disordered-eating. To date, no study has directly compared adolescent military-dependents to their civilian peers along measures of eating pathology and associated correlates. We, therefore, compared overweight and obese adolescent female military-dependents to their civilian counterparts along measures of eating-related pathology and psychosocial functioning. Method Adolescent females with a BMI between the 85th and 97th percentiles and who reported loss-of-control eating completed interview and questionnaire assessments of eating-related and general psychopathology. Results 23 military-dependents and 105 civilians participated. Controlling for age, race, and BMI-z, military-dependents reported significantly more binge episodes per month (p<.01), as well as greater eating-concern, shape-concern, and weight-concern (p’s<.01) than civilians. Military-dependents also reported more severe depression (p<.05). Discussion Adolescent female military-dependents may be particularly vulnerable to disordered-eating compared to civilian peers. This potential vulnerability should be considered when assessing military-dependents. PMID:25955761
Forrester-Knauss, Christine; Perren, Sonja; Alsaker, Françoise D
The aim of this study was (1) to examine whether childhood BMI is a significant predictor of restrained eating in preadolescents, (2) to investigate gender differences in restrained and emotional eating, and (3) to determine whether emotional problems, and body esteem were related to eating problems of preadolescents. In this longitudinal study with two measurement points, data from 428 children (50% female) were used. At time 1 (t1) children were on average 5.9years old. BMI was assessed using objective measures. At time 2 (t2) participants were 12years old. The adolescents and their parents completed questionnaires assessing restrained and emotional eating, body esteem, emotional problems, and BMI. Multiple regression analysis showed that restrained eating was significantly predicted by t1 BMI, by change in BMI between t1 and t2, and t2 body esteem. Emotional eating was, as expected, not predicted by t1 BMI, but associated with t2 body esteem and t2 emotional problems. Gender was not a significant predictor. The stability of BMI between childhood and preadolescence and its ability to predict restrained eating suggests that it is important to start prevention of overweight, body dissatisfaction and disordered eating at an early age.
Walther, Mireille; Hilbert, Anja
Obesity, a common health condition in adolescence leading to severe medical complications, is assumed to be influenced by temperament factors. This paper investigates associations between reactive and regulative temperament, problematic eating behaviours and excess weight. Several self-report instruments were completed by 130 adolescents (mean age 14.13 ± 0.61 years), including 27 overweight and obese individuals (20.8%). Bootstrap analysis revealed a mediating effect of restrained eating on the relation between reactive temperament and body mass index percentile, which differed according to gender: Restrained eating, which predicted weight gain, was more present in girls having a higher sensitivity to reward and in boys showing a higher sensitivity to punishment. No effect of regulative temperament was found. These results have important implications for weight management programmes, as they suggest that reducing restrained eating by working on temperament may help to control weight.
Balodis, Iris M; Grilo, Carlos M; Potenza, Marc N
Biobehavioral features associated with binge-eating disorder (BED) have been investigated; however, few systematic reviews to date have described neuroimaging findings from studies of BED. Emerging functional and structural studies support BED as having unique and overlapping neural features as compared with other disorders. Neuroimaging studies provide evidence linking heightened responses to palatable food cues with prefrontal areas, particularly the orbitofrontal cortex (OFC), with specific relationships to hunger and reward-sensitivity measures. While few studies to date have investigated non-food-cue responses; these suggest a generalized hypofunctioning in frontostriatal areas during reward and inhibitory control processes. Early studies applying neuroimaging to treatment efforts suggest that targeting neural function underlying motivational processes may prove important in the treatment of BED.
Yilmaz, Zeynep; Hardaway, J Andrew; Bulik, Cynthia M
Eating disorders (EDs) are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of AN, BN, and BED, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research.
Yilmaz, Zeynep; Hardaway, J. Andrew; Bulik, Cynthia M.
Eating disorders (EDs) are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of AN, BN, and BED, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research. PMID:27013903
Goossens, Lien; Soenens, Bart; Braet, Caroline
The objective of this article was to investigate the prevalence and psychological correlates of binge eating among adolescents. Self-report questionnaires were administered to a community sample of 708 adolescents (M[subscript age] = 14 years). Adolescents reporting loss of control over eating (17% of the sample) reported more eating pathology and…
Simpson, Annabelle K; Magid, Viktoriya
Cannabis use in the adolescent population poses a significant threat of addiction potential resulting in altered neurodevelopment. There are multiple mechanisms of treatment of cannabis use disorder including behavioral therapy management and emerging data on treatment via pharmacotherapy. Recognizing the diagnostic criteria for cannabis use disorder, cannabis withdrawal syndrome, and mitigating factors that influence adolescent engagement in cannabis use allows for comprehensive assessment and management in the adolescent population.
... Shyness I Think My Friend May Have an Eating Disorder. What Should I Do? KidsHealth > For Teens > I ... Signs of Eating Disorders How to Help About Eating Disorders Every year, thousands of teens (and adults, too) ...
Gitau, Tabither M; Micklesfield, Lisa K; Pettifor, John M; Norris, Shane A
Failure to consume an adequate diet or over consumption during adolescence can disrupt normal growth and development, resulting in undesirable weight change. This leads to an increase in unhealthy weight control practices related to eating and exercise among both adolescent girls and boys to meet the societal 'ideal' body shape. This study therefore aims to examine the longitudinal changes in eating attitudes, body-esteem and weight control behaviours among adolescents between 13 and 17 years; and, to describe perceptions around body shape at age 17 years. A total of 1435 urban South African black and mixed ancestry boys and girls, who had data at both age 13 and 17 years from the Birth to Twenty cohort were included. Data were collected through self-administered questionnaires on eating attitudes (EAT-26), body esteem and weight control behaviours for either weight loss or muscle gain attempts. Height and weight were measured at both time points and BMI was calculated. Black females had a higher BMI (p<0.001) and an increased risk of developing eating disorders as well as significant increase in the prevalence of weight loss practices between the ages 13 and 17 years. At age 17 years both Mixed ancestry adolescents had lower body-esteem compared to black adolescents. The prevalence of possible eating disorders was 11% and 13.1% in early and late adolescents respectively. Males and females shared similar opinions on normal silhouettes being the 'best', 'getting respect' and being the 'happiest', while the obese silhouette was associated with the 'worst' and the 'unhappiest', and the underweight silhouette with the "weakest". Black females had a higher BMI and an increased risk of developing eating disorders. Adolescent females engaged more in weight loss practices whereas, males in muscle gain practices indicating that Western norms of thinness as the ideal are becoming more common in South Africa.
Uzunian, Laura Giron; Vitalle, Maria Sylvia de Souza
The purpose of this study is to provide a review of the literature on the relationship between eating disorders and social skills in adolescents. A search was made on the Medline, SciELO and Lilacs databases, for items combining the terms 'eating disorders', 'anorexia nervosa', 'bulimia nervosa' and 'food behavior', with the terms 'social psychology' and 'social isolation', and with the keywords 'social competence', 'social skill' and 'interpersonal relations'. The following were included: studies on adolescents; in Portuguese, English and Spanish; published in the years 2007 through 2012. The search resulted in 63 articles, and 50 were included in this review. The majority of the studies were made in Brazil and the United States. Of the total, 43 were original articles. The studies aimed to understand how emotional state could influence the establishment of eating disorders, interpersonal relationships and peer relationship. The articles also discussed the influence of the media and of society in this process. Based on the analysis of the studies, it was observed that the greater an adolescent's repertory of social skills, the greater his or her factor of protection against the development of eating disorders.
Mallick, M. Joan; And Others
Studied adolescent girls who were eating-disordered (N=41), athletes (N=87), or students (N=120) to determine their menstrual, dieting, and exercise patterns and their self-images. Found that eating-disordered subjects had extremely low scores on emotional tone and social relationships, suggesting that these dimensions may distinguish the…
Cheney, Ann M
This study is one of the first to examine the narrative links connecting social change, contested gender norms, body image, and eating disordered practices among southern Italian women. The research is based on 16 months of fieldwork, and I compare and contrast the stories of 23 educated women in southern Italy to highlight the contentious realities of entering adolescence in conservative social contexts where gender relations and value systems are undergoing rapid transformations. I examine how these young women dealt with conflicting cultural expectations of womanhood and whether it affected their emotional, psychological, and physical well-being. Their stories shed light on how parental control, community surveillance, and conflicts in developing gender identities and maturing womanly bodies contributed to their emotional distress. Distressed young women used rebellion and manipulation and control of food and the body to negotiate unjust social relations, specifically gender relations, that delegitimized their selves and, in some cases, their bodies.
Goodale, Kimberly R.; Watkins, Patti Lou; Cardinal, Bradley J.
Examined symptoms of muscle dysmorphia (MD), a variation of the eating disorders anorexia nervosa and bulimia, among college students. Surveys indicated that MD symptomatology appears in the general population and among both sexes. MD significantly related to eating disorder pathology and depression, and to some degree to impaired social support.…
Hrabosky, Joshua I.; Masheb, Robin M.; White, Marney A.; Grilo, Carlos M.
The excessive influence of shape or weight on self-evaluation--referred to as overvaluation--is considered by some a central feature across eating disorders but is not a diagnostic requirement for binge eating disorder (BED). This study examined shape/weight overvaluation in 399 consecutive patients with BED. Participants completed semistructured…
Stice, Eric; Fisher, Melissa; Martinez, Erin
The authors conducted 4 studies investigating the reliability and validity of the Eating Disorder Diagnostic Scale (HDDS; E. Stice, C. F. Telch, & S. L. Rizvi, 2000), a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa, and binge eating disorder. Study 1 found that the HDDS showed criterion validity with interview-based…
Juli, Giada; Juli, Luigi
Eating disorders are perplexing diseases of which the etiology is still unknown. Recent research has focused on the possibility that genetics plays a role in vulnerability to these pathologies. This study gives an overview of the available literature focusing on family, twin and molecular genetic studies of eating disorders.
Steck, Erin L.; Abrams, Laura M.; Phelps, LeAdelle
Traditionally the identification of, and treatment for, eating disorders has been based on developmental psychopathology theory and research, thereby emphasizing risk factors and the elimination of maladaptive behaviors. This article seeks to reconceptualize the prevention of, and protective factors for, eating disordered behavior from the…
The factor structure of the Beck Depression Inventory (BDI) was studied with a subsample of 93 bulimic women from a total sample of 110 women with eating disorders. Results suggested that the BDI appears to assess a unidimensional construct in patients with eating disorders. (SLD)
Reyes-Rodriguez, Mae Lynn; Sala, Margarita; Von Holle, Ann; Unikel, Claudia; Bulik, Cynthia M.; Camara-Fuentes, Luis; Suarez-Torres, Alba
Objective: To explore disordered eating and eating disorders (EDs) in Latino males. Participants: Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Methods: Participants were selected from a list of sections of required courses for first-year students on each campus.…
Wechsler, Lisa S.; Riggs, Shelley A.; Stabb, Sally D.; Marshall, David M.
The current study examined patterns of association among mutuality, self-silencing, and disordered eating in an ethnically diverse sample of college women (N = 149). Partner mutuality and overall self-silencing were negatively correlated and together were associated with six disordered eating indices. All four self-silencing subscales were…
Black, David R., Ed.
Eating disorders among athletes has become an important topic both nationally and internationally. This volume of empirically focused articles presents theory, issues, and the latest research in a concise form for a variety of audiences. The 11 chapters are: (1) "Eating Disorders among Athletes: Current Perspective" (D. R. Black); (2)…
Cachelin, Fary M.; Phinney, Jean S.; Schug, Robert A.; Striegel-Moore, Ruth H.
Our purpose was to investigate acculturation and eating disorders by examining the role of ethnic identity and by utilizing a bidimensional perspective toward two cultures. We predicted that orientation toward European American culture and lower ethnic identity would be positively associated with eating disorders. Participants were 188 Mexican…
Ousley, Louise; Cordero, Elizabeth Diane; White, Sabina
Eating disorders and body dissatisfaction among undergraduate men are less documented and researched than are eating disorders and body dissatisfaction among undergraduate women. Objective and Participants: In this study, the authors examined these issues in undergraduate men to identify similarities and differences between this population and…
... for Families Guide Panic Disorder In Children And Adolescents No. 50; Updated July 2013 Panic disorder is a common and treatable disorder. Children and adolescents with panic disorder have unexpected and repeated periods ...
Beukers, Laura; Berends, Tamara; de Man-van Ginkel, Janneke M; van Elburg, Annemarie A; van Meijel, Berno
An important part of inpatient treatment for adolescents with anorexia nervosa is to restore normal eating behaviour. Health-care professionals play a significant role in this process, but little is known about their interventions during patients' meals. The purpose of the present study was to describe nursing interventions aimed at restoring normal eating behaviour in patients with anorexia nervosa. The main research question was: 'Which interventions aimed at restoring normal eating behaviour do health-care professionals in a specialist eating disorder centre use during meal times for adolescents diagnosed with anorexia nervosa? The present study was a qualitative, descriptive study that used video recordings made during mealtimes. Thematic data analysis was applied. Four categories of interventions emerged from the data: (i) monitoring and instructing; (ii) encouraging and motivating; (iii) supporting and understanding; and (iv) educating. The data revealed a directive attitude aimed at promoting behavioural change, but always in combination with empathy and understanding. In the first stage of clinical treatment, health-care professionals focus primarily on changing patients' eating behaviour. However, they also address the psychosocial needs that become visible in patients as they struggle to restore normal eating behaviour. The findings of the present study can be used to assist health-care professionals, and improve multidisciplinary guidelines and health-care professionals' training programmes.
Sadeh-Sharvit, Shiri; Levy-Shiff, Rachel; Feldman, Talya; Ram, Anca; Gur, Eitan; Zubery, Eynat; Steiner, Evelyne; Latzer, Yael; Lock, James D
Feeding and eating difficulties are documented among the offspring of mothers with eating disorders. Understanding the perspective of mothers with eating disorders is likely essential to develop parent-based early prevention programs for children of these mothers. In the present study, twenty-nine mothers who were diagnosed with an eating disorder prior to becoming mothers and who currently had toddler age children participated in a semi-structured interview examining maternal functioning and child feeding. The maternal perceptions that emerged from the interviews were sorted into central themes and subcategories using interpretive phenomenological analysis. Data indicate that mothers with eating disorders express preoccupation with their child's eating, shape and weight, and many dilemmas about child feeding. They also reported rarity of family meals and their toddlers' preliminary awareness of maternal symptoms. Maternal concerns regarding child nutrition, feeding and weight were reported as more intense in regards to daughters. These maternal perceptions illuminate the maternal psychological processes that underlie the feeding and eating problems of the children of mothers with lifetime eating disorders. Findings should be addressed in the evaluation, treatment, and research of adult and childhood eating disorders.
Tanofsky-Kraff, Marian; Goossens, Lien; Eddy, Kamryn T.; Ringham, Rebecca; Goldschmidt, Andrea; Yanovski, Susan Z.; Braet, Caroline; Marcus, Marsha D.; Wilfley, Denise E.; Olsen, Cara; Yanovski, Jack A.
The phenomenology of childhood and adolescent loss of control (LOC) eating is unknown. The authors interviewed 445 youths to assess aspects of aberrant eating. LOC was associated with eating forbidden food before the episode; eating when not hungry; eating alone; and experiencing secrecy, negative emotions, and a sense of "numbing" while eating…
Moy, Jordan; Petrie, Trent A; Dockendorff, Sally; Greenleaf, Christy; Martin, Scott
Dieting to lose weight, with its focus on restriction of caloric intake, may disrupt intuitive eating processes, though other forms of weight loss, such as exercising, which do not emphasize food may not. In a sample of 669 middle school boys and 708 girls, regardless of sex or exercising, dieting was related to feeling less free to eat what was wanted and to eating more to soothe emotions than to satisfy actual physical hunger. Exercising, independent of dieting, was associated with feeling less permission to eat what was wanted, but also eating to satisfy physical hunger as opposed to coping with emotional distress. Overall, girls were more aware and trusting of their bodily hunger and satiety cues than boys, but when boys were exercising, they scored similarly to girls on this dimension. These findings suggest that different weight loss approaches - dieting vs. exercising - have unique relationships to young adolescents' intuitive eating and these associations tend to be stable across sex. Longitudinal studies now are needed to examine how dieting that begins in childhood or early adolescence might have long-term effects on the progression of intuitive eating.
Donofry, Shannon D; Roecklein, Kathryn A; Rohan, Kelly J; Wildes, Jennifer E; Kamarck, Marissa L
Eating pathology in Seasonal Affective Disorder (SAD) may be more severe than hyperphagia during winter. Although research has documented elevated rates of subclinical binge eating in women with SAD, the prevalence and correlates of binge eating disorder (BED) in SAD remain largely uncharacterized. We examined the prevalence and correlates of binge eating, weekly binge eating with distress, and BED as defined by the DSM-IV-TR in SAD. We also tested whether binge eating exhibits a seasonal pattern among individuals with BED. Two samples were combined to form a sample of individuals with SAD (N=112). A third sample included non-depressed adults with clinical (n=12) and subclinical (n=11) BED. All participants completed the Questionnaire of Eating and Weight Patterns-Revised (QEWP-R) and modified Seasonal Pattern Assessment Questionnaire (M-SPAQ). In the SAD sample, 26.5% reported binge eating, 11.6% met criteria for weekly binge eating with distress, and 8.9% met criteria for BED. Atypical symptom severity predicted binge eating and BED. In the BED sample, 30% endorsed seasonal worsening of mood, and 26% reported a winter pattern of binge eating. The spectrum of eating pathology in SAD includes symptoms of BED, which are associated with atypical depression symptoms, but typical depression symptoms.
Eating disorders have traditionally been described as a typically 'Western' illness. Cases that occur outside Western countries are often regarded as atypical. Peculiarities are thus emphasized. However, eating disorders are now prevalent in Japan, among non-Western immigrants in Europe, and in other societies. The author focuses on the universality of the background of eating disorders and looks at them as 'culture change syndromes'. Change in the family and in women's roles are the central themes. The majority of the subjects experienced very little emotional relationship with their parents when they were children. It is misleading to say that eating disorder patients lack femininity and that they should be encouraged to be more feminine, more passive. Gender issues concerning treatment settings such as the doctor-patient relationship, the doctor-nurse relationship influence the treatment process. Typical anorexics described in a 1788 Japanese document are briefly presented in order to challenge further the idea of eating disorders as a Western illness.
Davis, Heather A.; Holland, Lauren A.; Keel, Pamela K.
Objective To evaluate correlates of a compensatory eating disorder (CED) characterized by recurrent nonpurging compensatory behaviors in the absence of objectively large binge episodes among normal weight individuals who endorse undue influence of weight/shape on self-evaluation as possible indicators of clinical significance and distinctiveness. Method Women with CED (n=20), women with bulimia nervosa (BN) (n=20), and controls (n=20) completed an interview and questionnaires assessing eating disorder and general psychopathology and weight history. Results Compared to controls, women with CED reported significantly greater body image disturbance and disordered eating, higher anxiety proneness, increased perfectionism, and greater weight suppression. Compared to BN, CED was associated with significantly less body image disturbance, disordered eating, weight suppression, and lower likelihood of being overweight in childhood. However, CED and BN did not differ on anxiety proneness or perfectionism. Discussion CED merits further examination to determine whether it is a clinically significant and distinct eating disorder. PMID:24105678
Catalina Zamora, M L; Bote Bonaechea, B; García Sánchez, F; Ríos Rial, B
New eating behavior disorders such as bigorexia (muscle dysmorphia) and orthorexia are appearing in developed countries. These disorders have not been officially recognized so that they are not classified as independent entities. The term orthorexia comes from the Greek word orthos (straight, proper) and orexia (appetite). It is characterized by the pathological obsession for biologically pure food, which leads to important dietary restrictions. Orthorexic patients exclude foods from their diets that they consider to be impure because they have herbicides, pesticides or artificial substances and they worry in excess about the techniques and materials used in the food elaboration. This obsession leads to loss of social relationships and affective dissatisfactions which, in turn, favors obsessive concern about food. In orthorexia, that patient initially wants to improve his/her health, treat a disease or lose weight. Finally, the diet becomes the most important part of their lives. We present a clinical case that responds to the characteristics of orthorexia. The differential diagnosis with chronic delusional disorder, anorexia nervosa and obsessive-compulsive disorder is carried out.
Brownley, Kimberly A; Peat, Christine M; La Via, Maria; Bulik, Cynthia M
In the USA, binge eating disorder (BED) is the most common eating disorder, with a lifetime prevalence of ~3.5 % in adult women, 2.0 % in adult men, and 1.6 % in adolescents. BED is characterized by frequent episodes of binge eating that are accompanied by a sense of loss of control over eating and result in marked psychological distress. BED is highly co-morbid with obesity and with depression and other psychiatric conditions, and it is associated with substantial role impairment. Currently, there are no US FDA-approved pharmacological treatments for BED. Animal and human studies implicate underlying dysregulation in dopamine, opioid, acetylcholine, and serotonin neurocircuitry within brain reward regions in the pathogenesis and maintenance of BED. To date, the efficacy of various agents that target these and other neurotransmitter systems involved in motivated feeding behavior, mood regulation, and impulse control have been investigated in the treatment of BED. Several antidepressant and anticonvulsant agents have demonstrated efficacy in reducing binge eating frequency, but only in limited cases have these effects resulted in patients achieving abstinence, which is the primary goal of treatment; they also range from less (fluvoxamine) to more (topiramate) effective in achieving weight loss that is both clinically meaningful and significantly greater than placebo. Collectively, the literature on pharmacological treatment approaches to BED is limited in that very few agents have been studied in multiple, confirmatory trials with adequate follow up, and almost none have been evaluated in large patient samples that are diverse with respect to age, sex, and ethnicity. In addition, prior trials have not adequately addressed, through study design, the high placebo response commonly observed in this patient population. Several novel agents are in various phases of testing, and recent animal studies focusing on glutamate-signaling circuits linking the amygdala to the
Reyes-Rodríguez, Mae Lynn; Franko, Debra L.; Matos-Lamourt, Anguelique; Bulik, Cynthia M.; Von Holle, Ann; Cámara-Fuentes, Luis R.; Rodríguez-Angleró, Dianisa; Cervantes-López, Sarah; Suárez-Torres, Alba
Objective This study investigated the prevalence of eating disorder symptoms in first-year students at the University of Puerto Rico. Method Responses to the Bulimia Test Revised (BULIT-R), the Eating Attitudes Test (EAT-26), and the Beck Depression Inventory (BDI) were analyzed in a sample of 2,163 freshman students. Results The percentage of students at or above the clinical cut-off points was 3.24% for the BULIT-R, 9.59% for the EAT-26 and 1.88% met the cut-off point for both instruments. The 36.44% of the students who screen positive on eating disorders measures scored 18 or more on the BDI and 5.93% on this group presented high suicidal risk based on their responses to BDI items assessing suicidal thoughts. Discussion Eating disorder symptoms occur frequently in Puerto Rican college students, and prevention, detection, and treatment efforts are needed. PMID:20455253
Conason, A H; Brunstein Klomek, A; Sher, L
Eating disorders and alcohol/drug abuse are frequently comorbid. Eating-disordered patients are already at an increased risk for morbidity and mortality, so alcohol and drug use pose additional dangers for these patients. Restricting anorexics, binge eaters, and bulimics appear to be distinct subgroups within the eating-disordered population, with binge eaters and bulimics more prone to alcohol and drug use. Personality traits such as impulsivity have been linked to both bulimia nervosa and substance abuse. Many researchers have proposed that an addictive personality is an underlying trait that predisposes individuals to both eating disorders and alcohol abuse. Interviewing is generally the most useful tool in diagnosing alcohol and substance abuse disorders in individuals with eating disorders. It is essential for the physician to be non-judgmental when assessing for substance abuse disorders in this population. We discuss interviewing techniques, screening instruments, physical examination, and biological tests that can be used in evaluating patients with comorbid eating disorders and substance abuse. More studies are needed to understand psychobiological mechanisms of this comorbidity, and to develop treatments for individuals with comorbid eating disorders and substance misuse.
De Bolle, Marleen; De Clercq, Barbara; Pham-Scottez, Alexandra; Mels, Saskia; Rolland, Jean-Pierre; Guelfi, Julien Daniel; Braet, Caroline; De Fruyt, Filip
Personality pathology is examined in 100 female in-patients diagnosed with eating disorders. The Eating Disorder Inventory-II and the NEO-PI-R were self-administered and personality pathology was assessed using a structured interview. Clinicians additionally evaluated patients' global functioning. The results indicated sizeable personality disorder comorbidity, and two dimensions of personality pathology, for example, an internalizing and an externalizing factor, could be identified. Patients' global functioning was primarily associated with dimensions of personality pathology, but not with eating disorder symptoms. Assessment and therapeutic interventions should focus on this co-occurring pathology in order to improve patients' functioning.
Cummins, Lillian Huang; Simmons, Angela M; Zane, Nolan W S
There is increasing evidence that eating disorders are present among ethnically diverse populations, and researchers have suggested that investigations in this area may inform the field's understanding of how sociocultural factors are related to the development of eating disorders. Although it is generally accepted that sociocultural factors are key in eating disorder etiology, knowledge on how best to study these influences in diverse groups is still limited. In this article, the authors review how the research literature has explored relationships among culture, ethnicity, and eating disorders in Asian populations and critically examine strategies that have been used to investigate these issues across 1 ethnic/racial group. The methodological challenges encountered in these approaches are identified and considered in the provision of recommendations for future endeavors to improve the field's understanding of how culture is related to eating disorders.
Arias Horcajadas, Francisco
Cannabinoid system is a crucial mechanism in regulating food intake and energy metabolism. It is involved in central and peripheral mechanisms regulating such behavior, interacting with many other signaling systems with a role in metabolic regulation. Cannabinoid agonists promote food intake, and soon a cannabinoid antagonist, rimonabant, will be marketed for the treatment of obesity. It not only causes weight loss, but also alleviates metabolic syndrome. We present a review of current knowledge on this subject, along with data from our own research: genetic studies on this system in eating disorders and obesity and studies locating cannabinoid receptors in areas related to food intake. Such studies suggest cannabinoid hyperactivity in obesity, and this excessive activity may have prognostic implications.
A multitude of empirical studies clearly demonstrates that the origin and course of eating disorders is closely linked to family factors. The influence is exerted in a direct way by conveying attitudes towards food, eating, weight, shape and appearance within the family and in a more indirect way by the family relationships. Families of bulimics differ from those of anorexics by a higher degree of conflict, impulsivity, expressiveness and by lower affective resonance and cohesion. Family therapy has proven to be effective in the treatment of eating disorders. A sketch of a family therapy describes the conflict oriented approach which includes behavioral elements in oder to stabilize the eating behavior and the weight.
Micali, Nadia; Field, Alison E; Treasure, Janet L; Evans, David M
Objective Cognitions and behaviors characteristic of binge eating are associated with a polymorphism in the FTO gene, robustly related to body mass index (BMI) and obesity risk. We investigated the association between binge eating and the individual and combined effect of 32 SNPs robustly associated with BMI in a population-based sample. We hypothesized that higher BMI and binge eating might share a common genetic etiology. Methods Binge eating was assessed in adolescents from the Avon Longitudinal Study of Parents and Children at age 14 (n = 5,958) and 16 years (n = 4,948). We tested associations between 32 BMI-related SNPs and binge eating in crude and BMI-, age-, and gender-adjusted regression models. Results Crude analyses showed an association between binge eating and rs1558902 (FTO) that persisted after adjustment for BMI (OR = 1.20, P = 8 × 10−3). A weighted allelic score consisting of all 32 BMI-related SNPs was associated with binge eating (P = 8 × 10−4); this association attenuated (P = 0.08) when rs1558902 was removed from the weighted allelic score. Conclusions BMI-related genes are associated with adolescent binge eating, in particular an FTO polymorphism. Although replication is needed, our findings have biological plausibility and are consistent with a postulated effect of FTO on appetite and food intake. Future studies should aim to understand the mechanisms underlying the relationship between FTO, binge eating, and obesity. PMID:26193063
Mitchell, James E.; King, Wendy C.; Courcoulas, Anita; Dakin, George; Elder, Katherine; Engel, Scott; Flum, David; Kalarchian, Melissa; Khandelwal, Saurabh; Pender, John; Pories, Walter; Wolfe, Bruce
Objective To describe eating patterns, prevalence of problematic eating behaviors, and determine factors associated with binge eating disorder (BED), prior to bariatric surgery. Method Prior to surgery, 2,266 participants (median age 46 years; 78.6% female; 86.9% white; median body mass index 45.9 kg/m2) of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study completed eating behavior survey items in the self-administered LABS-2 Behavior form. Other measures included the Alcohol Use Disorder Identification Test, the LABS-2 Psychiatric and Emotional Test Survey, the Beck Depression Inventory, the Interpersonal Support Evaluation List-12, the Short Form-36 Health Survey and Impact of Weight Quality of Life-Lite Survey. Results The vast majority (92.1%) of participants reported eating dinner regularly, while just over half (54.0%) reported eating breakfast regularly. Half of the participants reported eating at least 4 meals/week at restaurants; two meals/week were fast food. Loss of control eating was reported by 43.4%, night eating syndrome by 17.7%; 15.7% satisfied criteria for binge eating disorder (BED), 2% for bulimia nervosa. Factors that independently increased the odds of BED were being a college graduate, eating more times per day, taking medication for psychiatric or emotional problems, and having symptoms of alcohol use disorder, lower self-esteem and greater depressive symptoms. Discussion Prior to undergoing bariatric surgery a substantial proportion of patients report problematic eating behaviors. Several factors associated with BED were identified, most suggesting other mental health problems, including higher levels of depressive symptomotology. The strengths of this study include the large sample size, the multi-center design and use of standardized assessment practices. PMID:24719222
Reas, Deborah L.; Grilo, Carlos M.
Introduction This study evaluated controlled treatment studies of pharmacotherapy for binge eating disorder (BED). Areas Covered The primary focus of the review was on phase II and III controlled trials testing medications for BED. A total of 46 studies were considered and 26 were reviewed in detail. BED outcomes included binge-eating remission, binge-eating frequency, associated eating-disorder psychopathology, associated depression, and weight loss. Expert Opinion Data from controlled trials suggests that certain medications are superior to placebo for stopping binge-eating and for producing faster reductions in binge eating, and - to varying degrees - for reducing associated eating-disorder psychopathology, depression, and weight loss over the short-term. Almost no data exist regarding longer-term effects of medication for BED. Except for topiramate, which reduces both binge eating and weight, weight loss is minimal with medications tested for BED. Psychological interventions and the combination of medication with psychological interventions produce binge-eating outcomes that are superior to medication-only approaches. Combining medications with psychological interventions does not significantly enhance binge-eating outcomes, although the addition of certain medications enhances weight losses achieved with cognitive-behavioral therapy and behavioral weight loss, albeit modestly. PMID:24460483
Bilali, Aggeliki; Galanis, Petros; Velonakis, Emmanuel; Katostaras, Theofanis
Objective: To estimate the prevalence of abnormal eating attitudes among Greek adolescents and identify possible risk factors associated with these attitudes. Design: Cross-sectional, school-based study. Setting: Six randomly selected schools in Patras, southern Greece. Participants: The study population consisted of 540 Greek students aged 13-18…
Fahlman, Mariane; McCaughtry, Nate; Martin, Jeffrey; Garn, Alex C.; Shen, Bo
Background: There is a need for instruments that can accurately determine the effectiveness of nutrition interventions targeting low-income, inner-city adolescents. Purpose: To examine the development of a valid and reliable eating behavior scale (EBS) for use in school-based nutrition interventions in urban, inner-city communities dominated by…
Conley, Amanda; Boardman, Jason D.
Objective This paper examines the association between weight overestimation and symptoms of disordered eating behaviors using a nationally representative sample of young women. Method We use data from Wave III of the National Longitudinal Study of Adolescent Health to compare self-reported weight (in pounds) to measure weight obtained by interviewers using a scale. Focusing on normal weight women between the ages of 18 and 24 (n = 2,805) we compare the discrepancy in self-reported and measured weight among women with and without any disordered eating behaviors. Results Women who over report their weight by at least five percent are significantly more likely than those who either under report or accurately report their weights to exhibit disordered eating behaviors. These results persist despite controlling for distorted body image. Conclusion Our findings support both motivational and perceptual bias explanations for overestimating weight among those who exhibit disordered eating behaviors. We argue that weight over-estimation, together with other important information regarding women’s nutrition, exercise, mental health, and health-related behaviors, should be treated as a potential indicator for the diagnosis of an eating disorder among young normal weight women. PMID:17497706
Krug, Isabel; Bulik, Cynthia M; Vall-Llovera, Olga Nebot; Granero, Roser; Agüera, Zaida; Villarejo, Cynthia; Jiménez-Murcia, Susana; Fernández-Aranda, Fernando
The goals of the study were to compare anger expressions in individuals with eating disorders and healthy controls, and to explore the relation among eating disorder symptoms, comorbid psychopathology, personality traits, and impulsive behaviours. Participants comprised 135 eating disorder patients consecutively admitted to our unit and 103 healthy controls. Assessment measures included the Eating Disorders Inventory 2 (EDI-2), Bulimic Investigatory Test Edinburgh (BITE), Symptom Checklist-Revised (SCL-90-R), Social Avoidance Distress Scale (SAD), Temperament and Character Inventory-Revised (TCI-R), State-Trait Anger Expression Inventory 2 (STAXI-2), and other clinical and psychopathological indices. In the control group also the General Health Questionnaire-28 (GHQ-28) was also used. Women with eating disorders obtained significantly higher mean scores than controls on all STAXI-2 scales except for Anger Control. When various purging methods were assessed independently, the frequency of laxative use was associated with anger suppression. Eating disorder symptoms and specific personality traits were positively associated with different forms of anger expression. Finally, patients with higher scores on anger suppression were more likely to report self-harming behaviors. Eating disorder patients may have inadequate anger expression and deficits in coping with anger and frustration. Furthermore, different purging methods may be related to different facets of anger.
Redenbach, Joanna; Lawler, Jocalyn
There are few studies seeking to understand the illness from the experiential perspective of a person who has recovered from an eating disorder. The clinical and research literature shows inconsistencies and varying degrees of support for the risk factors associated with eating disordered behaviour. It is important to note, however, that most contemporary research relies upon brief self-report questionnaires, which may be providing a fragmented picture of the behaviour. The focus of the current study is to gain a greater understanding of women's perceptions of developing, living with and recovering from an eating disorder. This study reports interviews with five former eating disorder sufferers who were recruited via an advertisement placed in an Eating Disorders Support Network newsletter. Life histories were gathered from each woman and the paper reports how these women perceive the origins of their illness and what event(s) lead to their recovery. Participants' narratives were analysed to elucidate themes pertaining to the lived experience of illness and recovery. The women talk about a lack of control of their lives and unrealistic family expectations as reasons for the development of their eating disordered behaviour. Recovery was very strongly related to self-determination and self-acceptance. Suggestions concerning new ways of conceptualising recovery from eating disordered behaviour are posited.
Gross, Janet; And Others
Assessed criterion and concurrent validity of the Eating Attitudes Test and the Eating Disorder Inventory in 82 women with bulimia nervosa. Both tests demonstrated criterion validity by discriminating bulimia nervosa subjects from normals. Only weak support was found for concurrent validity within bulimia subjects. Recommends combination of…
Vannucci, Anna; Nelson, Eric E.; Bongiorno, Diana M.; Pine, Daniel S.; Yanovski, Jack A.; Tanofsky-Kraff, Marian
Background Pediatric loss-of-control eating is a robust behavioral precursor to binge-type eating disorders. Elucidating precursors to loss-of-control eating and binge-type eating disorders may refine developmental risk models of eating disorders and inform interventions. Method We review evidence within constructs of the Negative Valence Systems (NVS)-domain, as specified by the Research Domain Criteria framework. Based on published studies, we propose an integrated NVS model of binge-type eating disorder risk. Results Data implicate altered corticolimbic functioning, neuroendocrine dysregulation, and self-reported negative affect as possible risk-factors. However, neuroimaging and physiological data in children and adolescents are sparse, and most prospective studies are limited to self-report measures. Conclusions We discuss a broad NVS framework for conceptualizing early risk for binge-type eating disorders. Future neural and behavioral research on the developmental trajectory of loss-of-control and binge-type eating disorders is required. PMID:26040923
Walker, Morgan; Thornton, Laura; De Choudhury, Munmun; Teevan, Jaime; Bulik, Cynthia M.; Levinson, Cheri A.; Zerwas, Stephanie
Purpose Disordered eating behavior—dieting, laxative use, fasting, binge eating—is common in college-aged women (11–20%). A documented increase in the number of young women experiencing psychopathology has been blamed on the rise of engagement with social media sites such as Facebook. We predicted that college-aged women’s Facebook intensity (e.g., the amount of time spent on Facebook, number of Facebook friends, and integration of Facebook into daily life), online physical appearance comparison (i.e., comparing one’s appearance to others’ on social media) and online “fat talk” (i.e., talking negatively about one’s body) would be positively associated with their disordered eating behavior. Methods In an online survey, 128 college-aged women (81.3% Caucasian, 6.7% Asian, 9.0% African-American, and 3.0% Other) completed items, which measured their disordered eating, Facebook intensity, online physical appearance comparison, online fat talk, body mass index, depression, anxiety, perfectionism, impulsivity, and self-efficacy. Results In regression analyses, Facebook intensity, online physical appearance comparison, and online fat talk were significantly and uniquely associated with disordered eating and explained a large percentage of the variance in disordered eating (60%) in conjunction with covariates. However, greater Facebook intensity was associated with decreased disordered eating behavior whereas both online physical appearance comparison and online fat talk were associated with greater disordered eating. Conclusions College-aged women who endorsed greater Facebook intensity were less likely to struggle with disordered eating when online physical appearance comparison was accounted for statistically. Facebook intensity may carry both risks and benefits for disordered eating. PMID:26206436
Hormes, Julia M; Orloff, Natalia C; Timko, C Alix
Chocolate craving in women has previously been linked to disordered eating behaviors. A relatively higher prevalence of eating disorder pathology may account for the fact that chocolate craving is significantly more common in women in North America, compared to many other countries. While support for a causal role of disordered eating in the etiology of craving in women is growing, little is known about the extent to which food cravings are associated with disordered eating behaviors in men. This study was designed to systematically assess the impact of gender and chocolate craving on measures of attitudes to chocolate, responsiveness to food cues in the environment, body shape dissatisfaction, dietary restraint, and eating disorder and general pathology. Undergraduate men and women (n = 645, 37.2% male) were invited to complete self-report questionnaires assessing demographics, height and weight, food cravings, dietary attitudes and behaviors, along with eating disorder and general pathology. Data suggest that the relationship between chocolate craving and disordered eating behaviors in men is the opposite of what has previously been observed in women: compared to non-cravers, male chocolate cravers reported significantly more guilt related to craving, but were significantly less likely to diet and reported lower levels of dietary restraint, less frequent weight fluctuations, and fewer symptoms of eating disorders. Findings indicate that a positive relationship between disordered eating behaviors and chocolate craving may be unique to women (and potentially women in North America). Findings have important implications for our understanding of cultural and psychosocial factors involved in the etiology of food cravings.
Reas, Deborah L; Stedal, Kristin
Eating disorders are serious psychiatric illnesses which can occur across the lifespan. Men aged midlife and beyond are vulnerable to stigma, shame, and stereotypes portraying eating disorders as afflictions of youth and female gender. Historically, men have been neglected in the field of eating disorders owing to traditional and female-centric approaches to conceptualization and classification. In this literature review, we identified 16 case reports of eating disorders in males ranging from the age of 40 to 81 years. The majority of cases reported an earlier onset in life, followed by a variable course of illness with periods of relapse interspersed with remission. Diagnostic crossover or symptom fluctuation was common. High rates of comorbid depression were found, and several cases described a history of weight cycling and premorbid obesity. Precipitating factors included stressors which disproportionately occur in later life, including loss due to death or divorce, changes in financial or housing situation, and medical issues. Very little is known regarding the prevalence of eating disorders in older men, with initial population estimates ranging from 0.02% to 1.6%. Rates of subthreshold eating disordered behavior are higher and appear to be increasing among older individuals and males in the community. Recent revisions in the DSM-5 will likely increase the broader applicability of diagnostic criteria for eating disorders, stimulating improved recognition of diverse presentations occurring across the lifespan for both genders. Eating disorders should be included in the differential diagnosis of unexplained weight gain or weight loss irrespective of age or gender. Multi-site studies are needed for adequate sampling and to allow larger empirical investigations regarding how to improve clinical practices in screening and assessment, as well the provision of differential care for older men suffering from an eating disorder.
Eisenberg, Marla E; Berge, Jerica M; Fulkerson, Jayne A; Neumark-Sztainer, Dianne
Research has found that weight-teasing is associated with disordered eating in adolescents. This study expands on the existing research by examining associations between hurtful weight comments by family and a significant other and disordered eating in young adults. Data come from 1,902 young adults (mean age 25) who completed surveys in 1998, 2003 and 2009. Correlations were examined between receiving hurtful comments from family and significant others, and four disordered eating behaviors in young adulthood, adjusting for prior disordered eating and prior teasing. Disordered eating behaviors were common in young adulthood, and were associated with hearing hurtful weight-related comments from family members and a significant other, for both females and males. Disordered eating prevention activities, which include messages about the potential harm associated with hurtful weight-related comments, should be expanded to address young adults, and programs may want to target relationship partners.
Chacko, Sara A.; Chiodi, Sarah N.; Wee, Christina C.
Objective In clinical practice, behavioral approaches to obesity treatment focus heavily on diet and exercise recommendations. However, these approaches may not be effective for patients with disordered eating behaviors. Little is known about the prevalence of disordered eating behaviors in primary care patients with obesity or whether they affect difficulty making dietary changes. Methods We conducted a telephone interview of 337 primary care patients aged 18–65 years with BMI≥35kg/m2 in Greater-Boston, 2009–2011 (58% response rate, 69% women). We administered the Three-Factor Eating Questionnaire R-18 (Scores 0–100) and the Impact of Weight on Quality of Life-Lite (IWQOL-lite) (Scores 0–100). We measured difficulty making dietary changes using four questions regarding perceived difficulty changing diet (Scores 0–10). Results 50% of patients reported high emotional eating (score>50) and 28% reported high uncontrolled eating (score>50). Women were more likely to report emotional [OR=4.14 (2.90, 5.92)] and uncontrolled eating [OR=2.11 (1.44, 3.08)] than men. African Americans were less likely than Caucasians to report emotional [OR=0.29 (95% CI: 0.19, 0.44)] and uncontrolled eating [OR=0.11 (0.07, 0.19)]. For every 10-point reduction in QOL score (IWQOL-lite), emotional and uncontrolled eating scores rose significantly by 7.82 and 5.48, respectively. Furthermore, participants who reported emotional and uncontrolled eating reported greater difficulty making dietary changes. Conclusions Disordered eating behaviors are prevalent among obese primary care patients and disproportionately affect women, Caucasians, and patients with poor QOL. These eating behaviors may impair patients' ability to make clinically recommended dietary changes. Clinicians should consider screening for disordered eating behaviors and tailoring obesity treatment accordingly. PMID:25572624
Henderson, Katherine A; Buchholz, Annick; Perkins, Julie; Norwood, Sarah; Obeid, Nicole; Spettigue, Wendy; Feder, Stephen
This study describes the development and validation of the clinician-rated Eating Disorder Symptom Severity Scale (EDS(3)), created to address a gap in measurement options for youth with eating disorders. The EDS(3) is modeled on the Childhood Severity and Acuity of Psychiatric Illness Scales (Lyons, J. S, 1998). Factor analysis revealed a 5-factor solution and accounted for 78% of the variance, and internal consistency within the subscales was good (Cronbach alphas: 0.69 to 0.93). The EDS(3) is a valid and reliable measure designed for clinicians to help assess the severity of a youth's eating disorder and to facilitate outcomes research.
de Gracia, Manuel; Marcó, María; Trujano, Patricia
The goals of this study are the preliminary Spanish adaptation and validation of the following questionnaires: the Children's Eating Attitudes Test (ChEAT), the Lawrence Self-Esteem Questionnaire (LAWSEQ) and the Body Esteem Scale (BES). In addition, we studied bodily self-esteem in pre-adolescent children, and their possible relation to certain eating attitudes and general self-esteem. This study is cross-sectional, analytical and observational. The sample was made up of 457 participants, 55.14% boys and 44.86% girls aged between 8 and 12 (M = 10.14, SD = 1.30). A multivariate analysis of variance (Age x Sex) was carried out with the total scores of LAWSEQ, ChEAT, BES, BIA and BMI. Cronbach's alpha reliability coefficient was .76, .80, and .67 for ChEAT, BES, and LAWSEQ, respectively. The boys presented significantly higher total scores in the ChEAT than the girls. Of the sample, 10.4% (n = 45) scored over the cut-off point of the ChEAT: These subjects presented lower general and bodily self-esteem, a slimmer ideal image and a greater discrepancy between their real self and their social self.
Forney, K. Jean; Haedt-Matt, Alissa A.; Keel, Pamela K.
Objective Purging Disorder (PD), an Other Specified Feeding or Eating Disorder,1 is characterized by recurrent purging in the absence of binge eating. Though objectively large binge episodes are not present, individuals with PD may experience a loss of control (LOC) while eating a normal or small amounts of food. The present study sought to examine the role of LOC eating in PD using archival data from 101 women with PD. Method Participants completed diagnostic interviews and self-report questionnaires. Analyses examined the relationship between LOC eating and eating disorder features, psychopathology, personality traits, and impairment, in bivariate models and then in multivariate models controlling for purging frequency, age, and body mass index. Results Across bivariate and multivariate models, LOC eating frequency was associated with greater disinhibition around food, hunger, depressive symptoms, negative urgency, and distress and impairment. Discussion LOC eating is a clinically significant feature of PD and should be considered in future definitions of PD. Future research should examine whether LOC eating better represents a dimension of severity in PD or a specifier that may impact treatment response or course. PMID:24185981
Bisaga, Katarzyna; Whitaker, Agnes; Davies, Mark; Chuang, Shirley; Feldman, Judith; Walsh, B Timothy
This study examined ethnic group differences in the rates of eating disorder symptoms (EDS) and depressive disorder symptoms (DDS) with respect to ethnic identity, relative body weight, and abnormal eating behaviors among adolescent girls. A district-wide sample of high school girls (N = 1445) from different ethnic backgrounds was surveyed. EDS were assessed with the Eating Attitudes Test-26, abnormal eating behaviors with the Eating Behaviors Survey, and DDS with the Short Mood and Feelings Questionnaire. Two dimensions of ethnic identity, ethnic identity achievement and other group orientation, were assessed with Multi-Group Ethnic Identity Measure. Hispanic and non-Hispanic white girls had the highest and African-American (AA) and Caribbean girls the lowest rates of EDS. Asian girls reported the highest and AA girls the lowest rates of DDS. Early dieting was associated with EDS and DDS in Caribbean, non-Hispanic white, and mixed background girls. Relative body weight was related to EDS in all ethnic groups except in non-Hispanic white and mixed background girls. The authors did not find an effect of ethnic identity achievement on psychopathology, but there was an effect of other group orientation on both EDS and DDS. Clinicians should inquire about EDS and DDS in girls of all ethnic groups. Prevention efforts to delay unsupervised dieting may protect adolescent girls from the development of EDS and DDS.
Sonneville, Kendrin R.; Calzo, Jerel P.; Horton, Nicholas J.; Haines, Jess; Austin, S. Bryn; Field, Alison E.
Objective To examine if body satisfaction is associated with body mass index (BMI) change and whether it protects against the development of frequent binge eating among overweight and obese adolescent girls. Methods We used prospective data from 9 waves of an ongoing cohort study of adolescents, the Growing Up Today Study. At enrollment in 1996, participants were 9 to 14 years old. Questionnaires were mailed to participants annually until 2001, then biennially through 2007. Girls who were overweight or obese in 1996 were included in the analysis (n=1 559). Our outcomes were annual change in BMI and incident frequent binge eating, defined as binge eating at least weekly and no use of compensatory behaviors. Results At baseline, 57.2% of the overweight and obese girls were at least somewhat satisfied with their bodies. During 11 years of follow-up, 9.5% (95% confidence interval (CI) [7.8, 10.8]) of the girls started to binge eat frequently. Controlling for BMI and other confounders, overweight and obese girls who reported being at least somewhat satisfied with their bodies made smaller BMI gains (β=−0.10 kg/m2, 95% CI [−0.19, −0.02]) and had 61% lower odds of starting to binge eat frequently (odds ratio (OR)=0.39, 95% CI [0.24, 0.64]) than their less satisfied peers. Compared to girls who were the least satisfied with their bodies, girls who were the most satisfied had 85% lower odds of starting to binge eat frequently (OR=0.15, 95% CI [0.06, 0.37]). The association between body satisfaction and starting to binge eat frequently was stronger for younger adolescents than older adolescents. Conclusions While body dissatisfaction is common among overweight and obese girls, body satisfaction may protect against excessive weight gain and binge eating. Prevention of body dissatisfaction must begin early and should be considered as a component of both obesity and eating disorder prevention programs. PMID:22565419
Grilo, Carlos M.; Masheb, Robin M.; Wilson, Terence G.
The authors examined rapid response among 108 patients with binge eating disorder (BED) who were randomly assigned to 1 of 4 16-week treatments: fluoxetine, placebo, cognitive-behavioral therapy (CBT) plus fluoxetine, or CBT plus placebo. Rapid response, defined as 65% or greater reduction in binge eating by the 4th treatment week, was determined…
Schaumberg, Katherine; Anderson, Lisa M.; Reilly, Erin; Anderson, Drew A.
Objective: The current study investigated rates of endorsement of eating-related compensatory behaviors within a college sample. Participants: This sample included male and female students (N = 1,158). Methods: Participants completed the Eating Disorder Examination Questionnaire (EDE-Q). The study defined 3 groups of students: those who did not…
Berger, Sarah Shafer; Elliott, Camden; Ranzenhofer, Lisa M; Shomaker, Lauren B; Hannallah, Louise; Field, Sara E; Young, Jami F; Sbrocco, Tracy; Wilfley, Denise E; Yanovski, Jack A; Tanofsky-Kraff, Marian
This study investigated the links among interpersonal problem areas, depression, and alexithymia in adolescent girls at high risk for excessive weight gain and binge eating disorder. Participants were 56 girls (Mage = 14.30, SD = 1.56; 53% non-Hispanic White) with a body mass index (BMI, kg/m(2)) between the 75th and 97th percentiles (MBMI z = 1.57, SD = 0.32). By design, all participants reported loss of control eating patterns in the past month. Adolescents were individually interviewed prior to participating in a group interpersonal psychotherapy obesity and eating disorder prevention program, termed IPT for the prevention of excessive weight gain (IPT-WG). Participants' interpersonal problem areas were coded by trained raters. Participants also completed questionnaires assessing depression and alexithymia. Primary interpersonal problem areas were categorized as interpersonal deficits [as defined in the eating disorders (ED) literature] (n = 29), role disputes (n = 22), or role transitions (n = 5). Girls with interpersonal deficits-ED had greater depressive symptoms and alexithymia than girls with role disputes (p's ≤ 0.01). However, girls with role transitions did not differ from girls with interpersonal deficits-ED or role disputes. Interpersonal problem area had an indirect association with depression via alexithymia; interpersonal deficits-ED were related to greater alexithymia, which in turn, was related to greater depressive symptoms (p = 0.01). Among girls at risk for excess weight gain and eating disorders, those with interpersonal deficits-ED appear to have greater distress as compared to girls with role disputes or role transitions. Future research is required to elucidate the impact of interpersonal problem areas on psychotherapy outcomes.
Ackard, Diann M.; Neumark-Sztainer, Dianne
The purpose of this study was to assess the prevalence of sexual abuse, including multiple victimizations, among adolescents and to examine associations among history of sexual abuse, disordered eating behaviors and psychological health. The sample included 81,247 students (40,946 girls and 40,301 boys) in 9th and 12th grades in Minnesota public…
Knatz, Stephanie; Braden, Abby; Boutelle, Kerri N
A significant proportion of both healthy and treatment-seeking youth report eating for emotional reasons. Emotional eating (EE) is associated with medical and psychological sequelae including overeating and eating disorder symptoms. Youth with EE are thought to have a predisposition toward a high level of emotional sensitivity, with a tendency to experience emotions intensely, and for a long duration. Interventions are needed to address emotion dysregulation associated with EE. Parent-focused interventions that emphasize training parents to respond to emotion dysregulation in their children have the potential to reduce the incidence of EE. This article describes an emotion-focused parent training intervention for youth who engage in EE.
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Pinna, Federica; Sanna, Lucia; Carpiniello, Bernardo
A high percentage of individuals affected by eating disorders (ED) achieve incomplete recovery following treatment. In an attempt to improve treatment outcome, it is crucial that predictors of outcome are identified, and personalized care approaches established in line with new treatment targets, thus facilitating patient access to evidence-based treatments. Among the psychological factors proposed as predictors of outcome in ED, alexithymia is of outstanding interest. The objective of this paper is to undertake a systematic review of the literature relating to alexithymia, specifically in terms of the implications for treatment of ED. In particular, issues concerning the role of alexithymia as a predictor of outcome and as a factor to be taken into account in the choice of treatment will be addressed. The effect of treatments on alexithymia will also be considered. A search of all relevant literature published in English using PubMed, PsycINFO, and Scopus databases was carried out on the basis of the following keywords: alexithymia, anorexia nervosa, bulimia nervosa, eating disorders, and treatment; no time limits were imposed. Despite the clinical relevance of alexithymia, the number of studies published on the above cited aspects is somewhat limited, and these studies are largely heterogeneous and feature significant methodological weaknesses. Overall, data currently available mostly correlate higher levels of alexithymia with a less favorable outcome in ED. Accordingly, alexithymia is seen as a relevant treatment target with the aim of achieving recovery of these patients. Treatments focusing on improving alexithymic traits, and specifically those targeting emotions, seem to show greater efficacy, although alexithymia levels often remain high even after specific treatment. Further investigations are needed to overcome the methodological limitations of previous studies, to understand the actual impact of alexithymia on ED outcome, and to allow more precise
Townsend, Lisa; Reinblatt, Shauna P.; Mendelson, Tamar
Binge eating behavior is a public health concern with serious physical and mental health consequences. Certain personality traits have been found to contribute to the development of eating disorders in clinical samples of youth, but little is known about associations between personality traits and binge eating in the general adolescent population. We examined the associations of neuroticism and impulsivity–both independently and in combination–with lifetime prevalence of binge eating, using nationally representative, cross-sectional data from the National Comorbidity Survey: Adolescent Supplement (n=437). Neuroticism and impulsivity were each significantly associated with lifetime prevalence of binge eating (adjusted prevalence ratio [aPR]=1.11, confidence interval [CI]=1.07, 1.15, p<0.001; aPR=1.06, CI=1.04, 1.09, p<0.001, respectively). The combination of high neuroticism and high impulsivity was associated with higher lifetime binge eating than the combination of low neuroticism and low impulsivity (aPR=3.72, CI=2.45, 5.65, p<0.001), and this association was stronger for female than male adolescents (females: aPR=5.37, CI=3.24, 8.91, p<0.001 vs. males: aPR=2.45, CI=1.43, 4.22, p=0.002). Our findings have implications for informing theories of etiology and interventions to target binge eating behaviors. PMID:26705374
Lee-Winn, Angela E; Townsend, Lisa; Reinblatt, Shauna P; Mendelson, Tamar
Binge eating behavior is a public health concern with serious physical and mental health consequences. Certain personality traits have been found to contribute to the development of eating disorders in clinical samples of youth, but little is known about associations between personality traits and binge eating in the general adolescent population. We examined the associations of neuroticism and impulsivity-both independently and in combination-with lifetime prevalence of binge eating, using nationally representative, cross-sectional data from the National Comorbidity Survey: Adolescent Supplement (n=437). Neuroticism and impulsivity were each significantly associated with lifetime prevalence of binge eating (adjusted prevalence ratio [aPR]=1.11, confidence interval [CI]=1.07, 1.15, p<0.001; aPR=1.06, CI=1.04, 1.09, p<0.001, respectively). The combination of high neuroticism and high impulsivity was associated with higher lifetime binge eating than the combination of low neuroticism and low impulsivity (aPR=3.72, CI=2.45, 5.65, p<0.001), and this association was stronger for female than male adolescents (females: aPR=5.37, CI=3.24, 8.91, p<0.001 vs. males: aPR=2.45, CI=1.43, 4.22, p=0.002). Our findings have implications for informing theories of etiology and interventions to target binge eating behaviors.
Ranzenhofer, Lisa M.; Engel, Scott G.; Crosby, Ross D.; Anderson, Micheline; Vannucci, Anna; Cohen, L. Adelyn; Cassidy, Omni; Tanofsky-Kraff, Marian
Objective Pediatric loss of control (LOC) eating is predictive of partial- and full-syndrome binge eating disorder. The interpersonal model proposes that LOC eating is used to cope with negative mood states resulting from interpersonal distress, possibly on a momentary level. We therefore examined temporal associations between interpersonal problems, negative affect, and LOC eating among overweight adolescent girls using ecological momentary assessment (EMA). Method Thirty overweight and obese (≥85th body mass index (BMI) percentile; BMI: M = 36.13, SD = 7.49 kg/m2) adolescent females (Age: M = 14.92, SD = 1.54 y; 60.0% African American) who reported at least two LOC episodes in the past month completed self-report momentary ratings of interpersonal problems, state affect, and LOC eating for 2 weeks. A series of 2-level multilevel models with centering within subjects was conducted. Results Between- and within-subjects interpersonal problems (p’s < .05), but not between- (p = .12) or within- (p = .32) subjects negative affect predicted momentary LOC eating. At the between-subjects level, interpersonal problems significantly predicted increases in negative affect (p < 001). Discussion Naturalistic data lend support to the predictive value of interpersonal problems for LOC eating among adolescents. Interventions targeting interpersonal factors on a momentary basis may be useful during this developmental stage. PMID:25046850
Matton, Annelies; Goossens, Lien; Braet, Caroline; Vervaet, Myriam
Little is known about the role of sensitivity to punishment (SP) and reward (SR) in eating problems during adolescence. Therefore, the aim of the present study was to examine the naturally occurring clusters of high and low SP and SR among nonclinical adolescents and the between-cluster differences in various eating problems and weight. A total of 579 adolescents (14-19 years, 39.8% boys) completed the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), the Behavioural Inhibition System and Behavioural Activation System scales (BIS/BAS scales), the Dutch Eating Behaviour Questionnaire and the Child Eating Disorder Examination Questionnaire and were weighed and measured. On the basis of the SPSRQ, four clusters were established, interpreted as lowSP × lowSR, lowSP × highSR, highSP × highSR and highSP × lowSR. These were associated with eating problems but not with adjusted body mass index. It seemed that specifically the highSP × highSR cluster outscored the other clusters on eating problems. These results were partly replicated with the BIS/BAS scales, although less significant relations between the clusters and eating problems were found. The implications of the findings in terms of possible risk and protective clusters are discussed.
Knapp, Jessica; Aerni, Giselle; Anderson, Jeffrey
Screening female athletes for eating disorders is not performed commonly even though the American College of Sports Medicine, National Athletic Trainer Association, and International Olympic Committee have guidelines recommending screening. Eating disorders are more prevalent in the female athlete population than in the general population and carry short-term and long-term consequences that can affect sport performance. There are several screening tools available that have been studied in the general population and fewer tools that were validated specifically in female athletes. Female athletes with eating disorder pathology often have different factors and environmental pressures contributing to their pathology that can be identified best with an athlete-specific screening tool. We will discuss various screening tools available and the evidence for each one. Screening for eating disorders in all female athletes is an important part of the preparticipation examination and should be done using a tool specifically validated for the female athlete.
... normal body weight, teens can easily develop the perception that they're fat. This can trigger an ... org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-eating-disorders/art-20044635 . Mayo Clinic Footer ...
Vannucci, Anna; Tanofsky-Kraff, Marian; Crosby, Ross D.; Ranzenhofer, Lisa M.; Shomaker, Lauren B.; Field, Sara E.; Mooreville, Mira; Reina, Samantha A.; Kozlosky, Merel; Yanovski, Susan Z.; Yanovski, Jack A.
Objective: We used latent profile analysis (LPA) to classify children and adolescents into subtypes based on the overlap of disinhibited eating behaviors--eating in the absence of hunger, emotional eating, and subjective and objective binge eating. Method: Participants were 411 youths (8-18 years) from the community who reported on their…
HALMI, KATHERINE A.
Eating disorders are challenging and difficult to treat, because of the necessity of a multidisciplinary treatment team for effective outcomes and the high mortality rate of anorexia nervosa. An adequate initial assessment and evaluation requires a psychiatric assessment, a medical history and medical examination, a social history and an interview of family members or collateral informants. A comprehensive eating disorder treatment team includes a psychiatrist coordinating the treatment and appropriate medical physician specialists, nutritionists, and psychotherapists. An adequate outpatient eating disorder clinic needs to provide individual psychotherapy with cognitive behavioral techniques specific for anorexia nervosa and bulimia nervosa, family therapy, pharmacological treatment and the resources to obtain appropriate laboratory tests. Eating disorder patients requiring inpatient care are best treated in a specialized eating disorder inpatient unit. A cognitive behavioral framework is most useful for the overall unit milieu. Medical management and nutritional rehabilitation are the primary goals for inpatient treatment. Various group therapies can cover common core eating disorder psychopathology problems and dialectical behavior therapy groups can be useful for managing emotional dysregulation. Residential, partial hospitalization and day treatment programs are useful for transitioning patients from an inpatient program or for patients needing some monitoring. In these programs, at least one structured meal is advisable as well as nutritional counseling, group therapy or individual counseling sessions. Group therapies usually address issues such as social skills training, social anxiety, body image distortion or maturity fears. Unfortunately there is s paucity of evidence based randomized control trials to recommend the salient components for a comprehensive service for eating disorders. Experienced eating disorder clinicians have come to the conclusion that a
MacLaren, Vance V; Best, Lisa A
Female undergraduate students at two Canadian universities (N = 378) completed the NEO PI-R (Costa, P.T. & McCrae, R.R. (1992). NEO PI-R Professional Manual. Lutz, FL: Psychological Assessment Resources) and the Eating Attitudes Test (EAT-26; Garner, D. M., Olmstead, M. P., Bohr, Y. & Garfinkel, P. E. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871-878.). Eating disorder symptomatic (N = 43) and nonsymptomatic (N = 335) women differed on facets of Neuroticism, Extraversion, and Agreeableness. Among symptomatic women, the Oral Control subscale of the EAT-26 was correlated significantly with facets of Neuroticism, Agreeableness and Conscientiousness. Specifically, the Impulsivity facet of Neuroticism was positively correlated with the Bulimia and Food Preoccupation subscale of EAT-26, but negatively correlated with the Oral Control and Dieting subscales. Overall, results suggest that high scores on Neuroticism may be a risk factor for development of disordered eating behavior and that the degree of Impulsiveness may predict the eating disorder subtype to which one is most susceptible.