The potential of technology-based psychological interventions for anorexia and bulimia nervosa: a systematic review and recommendations for future research.

PubMed

Schlegl, Sandra; Bürger, Carolina; Schmidt, Luise; Herbst, Nirmal; Voderholzer, Ulrich

2015-03-31

Previous studies have shown an unmet need in the treatment of eating disorders. In the last decade, interest in technology-based interventions (TBIs) (including computer- and Internet-based interventions [CBIs] or mobile interventions) for providing evidence-based therapies to individuals with different mental disorders has increased. The aim of this review was to systematically evaluate the potential of TBIs in the field of eating disorders, namely for anorexia nervosa (AN) and bulimia nervosa (BN), for both prevention and treatment, and also for carers of eating disorder patients. A systematic literature search was conducted using Medline and PsycINFO. Bibliographies of retrieved articles were also reviewed without date or study type restrictions. Forty studies resulting in 45 publications reporting outcomes fulfilled the inclusion criteria: 22 randomized controlled trials, 2 controlled studies, and 16 uncontrolled studies. In total, 3646 patients were included. Overall, the studies provided evidence for the efficacy of guided CBIs, especially for BN patients and for compliant patients. Furthermore, videoconferencing also appeared to be a promising approach. Evaluation results of Internet-based prevention of eating disorders and Internet-based programs for carers of eating disorder patients were also encouraging. Finally, there was preliminary evidence for the efficacy of mobile interventions. TBIs may be an additional way of delivering evidence-based treatments to eating disorder patients and their use is likely to increase in the near future. TBIs may also be considered for the prevention of eating disorders and to support carers of eating disorder patients. Areas of future research and important issues such as guidance, therapeutic alliance, and dissemination are discussed.

Eating disorder symptoms among undergraduate and graduate students at 12 U.S. colleges and universities.

PubMed

Lipson, S K; Sonneville, K R

2017-01-01

We sought to estimate the prevalence of eating disorder symptoms in a large sample of U.S. college students and variations therein across student characteristics. Participants were 9713 students from 12 colleges and universities participating in the Healthy Bodies Study. We used gender-stratified logistic regression to estimate bivariate correlates of elevated eating disorder symptoms, past-month objective binge eating, and past-month compensatory behaviors across student characteristics including age, degree-level, sexual orientation, race/ethnicity, first-generation status, citizenship, academic and extracurricular characteristics, and weight status. Eating disorder outcomes were based on the Eating Disorder Examination Questionnaire. We observed higher prevalence of objective binge eating among females relative to males (49% versus 30%, p<0.001), but similar prevalence of compensatory behaviors (31% versus 29%). Weight status was the most consistent predictor of eating disorder risk with significantly more symptoms seen among individuals with overweight and obesity. When compared to individuals with a healthy weight, those with overweight had greater eating disorder risk (males OR=3.5; females OR=2.0), binge eating (males OR=2.1; females OR=1.9), and use of compensatory behaviors (males OR=1.5; females OR=1.3). This study suggests smaller gender difference in prevalence of eating disorder symptoms than previously reported and identifies students with overweight/obesity as salient targets for campus-based eating disorder screening and early intervention efforts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Eating Disorder Risk and Body Dissatisfaction Based on Muscularity and Body Fat in Male University Students

ERIC Educational Resources Information Center

Mayo, Carrie; George, Valerie

2014-01-01

Objective: To investigate the relationship between risk of eating disorders, body dissatisfaction, and perceptual attractiveness in male university students. Participants: Research was conducted January-April 2012 and involved 339 male and 441 female students. Methods: Eating disorder risk was assessed with the Eating Attitudes Test (EAT) and body…

Evidence-Based Psychosocial Treatments for Eating Problems and Eating Disorders

ERIC Educational Resources Information Center

Keel, Pamela K.; Haedt, Alissa

2008-01-01

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…

Neural correlates of eating disorders: translational potential

PubMed Central

McAdams, Carrie J; Smith, Whitney

2015-01-01

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

Dimensions of impulsivity in relation to eating disorder recovery.

PubMed

Bardone-Cone, Anna M; Butler, Rachel M; Balk, Margaret R; Koller, Katherine A

2016-11-01

Impulsivity is associated with eating pathology, but different dimensions of impulsivity have not been extensively studied in the eating disorders. The current study examined the relationship between four facets of impulsivity and eating disorder recovery status. Females formerly seen for an eating disorder were categorized as having an eating disorder (n = 53), partially recovered (n = 15), or fully recovered (n = 20) based on a diagnostic interview and physical, behavioral, and psychological indices. These groups and non-eating disorder controls were compared on impulsivity facets from the UPPS Impulsive Behavior Scale (UPPS): Urgency (negative urgency), Premeditation (lack of), Perseverance (lack of), and Sensation Seeking. Negative urgency (the tendency to engage in impulsive behavior to alleviate negative affect) was related to recovery. The fully recovered group and controls experienced significantly less negative urgency than those with a current eating disorder; the partially recovered group did not differ from the eating disorder group. Findings suggest that negative urgency may be a particularly important facet of impulsivity to target in therapeutic intervention for eating disorders, especially among those with a history of binge eating and/or purging. Future longitudinal work is needed to test a potential causal relationship between negative urgency and eating disorder recovery. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1027-1031). © 2016 Wiley Periodicals, Inc.

Appearance-based rejection sensitivity as a mediator of the relationship between symptoms of social anxiety and disordered eating cognitions and behaviors.

PubMed

Linardon, Jake; Braithwaite, Rachel; Cousins, Rachel; Brennan, Leah

2017-12-01

Previous research has established a robust relationship between symptoms of social anxiety and disordered eating. However, the mechanisms that may underpin this relationship are unclear. Appearance-based rejection sensitivity (ABRS)-the tendency to anxiously expect and overreact to signs of appearance-based rejection-may be a crucial explanatory mechanism, as ABRS has been shown to maintain social anxiety symptoms and predict disordered eating. We therefore tested whether ABRS mediated the relationship between social anxiety symptoms and various indices of disordered eating (over-evaluation of weight/shape, restraint, binge eating, compulsive exercise, and vomiting). Data from community-based females (n=299) and males (n=87) were analyzed. ABRS was shown to mediate the relationship between social anxiety and the over-evaluation, restraint, binge eating, and compulsive exercise frequency, but not vomiting. These effects also occurred for both females and males separately. Findings demonstrated that ABRS may be an important mechanism explaining why socially anxious individuals report elevated symptoms of disordered eating. Future research testing all proposed mediating variables of the social anxiety-disordered eating link in a single, integrative model is required to identify the most influential mechanisms driving this relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interpersonal problems across restrictive and binge-purge samples: data from a community-based eating disorders clinic.

PubMed

Raykos, Bronwyn C; McEvoy, Peter M; Carter, Olivia; Fursland, Anthea; Nathan, Paula

2014-08-01

Contemporary models of eating disorders suggest that interpersonal problems contribute to the maintenance of eating disorders. This study examined whether baseline interpersonal problems differed across eating disorder diagnoses and across eating disorder subtypes ("restrictors" vs. "binge-purge" patients) in a large clinical sample. Patients with a primary eating disorder diagnosis (N=406) completed measures of interpersonal problems, eating disorder symptoms, and mood prior to treatment at a specialist eating disorder clinic. Across the sample, more severe eating disorder psychopathology was associated with significantly greater difficulty socializing. Anorexia Nervosa (AN)/restrictor patients reported significantly greater difficulty socializing than Bulimia Nervosa (BN)/binge-purge patients. AN patients reported significantly greater difficulty on a measure of competitiveness/assertiveness compared to BN and Eating Disorder Not Otherwise Specified patients. All findings were significant after controlling for comorbid depression and anxiety symptoms. Interpersonal problems appear to be unique risk factors for eating disorders. Specific interpersonal mechanisms include difficulties socializing and being assertive, which were most pronounced in AN patients. These findings provide potential avenues for enhancing interventions, such as adjunctive assertiveness training for AN. Copyright © 2014 Elsevier Ltd. All rights reserved.

The measurement of "eating-disorder-thoughts" and "eating-disorder-behaviors": Implications for assessment and detection of eating disorders in epidemiological studies.

PubMed

Miller, Jessie L; Vaillancourt, Tracy; Hanna, Steven E

2009-04-01

To test a theoretically driven second-order factor model of eating disorders, with eating-disordered thoughts and eating-disordered behaviors representing the higher order factors, we conducted a confirmatory factor analysis using a female university student sample (N=1816). The 'Thought' latent construct was comprised of indicators representing fear of fat and dissatisfaction with body shape/weight and the latent construct 'Behavior' was comprised of indicators representing binging, purging and restricting. From the thought and behavior latent factors, composite groups were created by varying the level of thoughts and behaviors (high, moderate, and few/or none). We examined the independent contributions of thoughts and behaviors on a measure of psychopathology (depression). A second-order model of "eating disorder thoughts" and "eating disorder behaviors" was supported by the data, based on model fit, factor loadings, and model parsimony. Mean scores on depression were clinically significant for groups engaged in any level of eating disorder behavior whereas thoughts contributed to risk for depression only at the extreme end. Because of the disproportionate representation of eating disorder thoughts (high) and eating disorder behaviors (low) in non-clinical populations, the measurement and detection of eating disorders may be enhanced by measuring thoughts separate from behaviors.

Chronic Illness and Disordered Eating: A Discussion of the Literature12

PubMed Central

Quick, Virginia M.; Byrd-Bredbenner, Carol; Neumark-Sztainer, Dianne

2013-01-01

This paper describes the prevalence of eating disorders and disordered eating behaviors, the reasons why these practices are endorsed, and the potential consequences in youths and young adults with selected diet-related chronic health conditions (DRCHCs) and provides recommendations for eating disorder prevention interventions and research efforts. Although it remains unclear whether the prevalence of eating disorders is higher in those with DRCHCs compared with the general population, overall findings suggest that young people with DRCHCs may be at risk of endorsing disordered eating behaviors that may lead to diagnosis of an eating disorder and other health problems over the course of their treatment. Thus, health care providers should be aware that young people with DRCHCs may be at risk of eating disorders and carefully monitor psychological changes and the use of unhealthy weight control methods. It is also important to develop and evaluate theory-based interventions and disease-specific eating disorder risk screening tools that are effective in halting the progression of eating disorders and negative health outcomes in young people with chronic health conditions. PMID:23674793

Cognitive-Behavioral Theories of Eating Disorders

ERIC Educational Resources Information Center

Williamson, Donald A.; White, Marney A.; York-Crowe, Emily; Stewart, Tiffany M.

2004-01-01

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…

Assessment of the menstrual cycle, eating disorders and self-esteem of Polish adolescents.

PubMed

Drosdzol-Cop, Agnieszka; Bąk-Sosnowska, Monika; Sajdak, Dominika; Białka, Agnieszka; Kobiołka, Agnieszka; Franik, Grzegorz; Skrzypulec-Plinta, Violetta

2017-03-01

Eating disorders are an important factor in menstrual cycle disorders in girls. Moreover, low self-esteem among adolescent girls may be a risk factor for eating disorders. The aim of the study was to assess the menstrual cycle, eating habits and self-esteem of Polish adolescents. The study was conducted from January 2014 to March 2015 and included 623 girls, aged 15-19, from randomly selected junior high schools in Silesia, Poland, in which their menstrual cycle, risk of eating disorders and self-esteem were evaluated. A five-part questionnaire was used to assess basic demographic data, lifestyle and physical activity, gynecological history, as well as Rosenberg Self-Esteem Scale (SES) and Eating Attitude Test (EAT-26). Irregular menstrual cycles were observed in 236 (37.88%) girls; 5.20% presented secondary amenorrhea. Based on the EAT-26 test, 101 (16.21%) girls were indicated being at risk for an eating disorder. Low self-esteem was observed in 340 (54.57%) study girls on the base of SES. Girls with irregular menses had higher scores on the EAT-26 test in subscales: EAT-overall score, EAT-diet and EAT-bulimia, while lower scores on the SES. In our study, we did not observe a significant relationship between exercise intensity, body mass, BMI and menstrual cycle regularity. Low self-esteem among adolescent girls may be a risk factor for eating disorders which could interrupt the menstrual cycle.

Parental and Child Characteristics Related to Early-Onset Disordered Eating: A Systematic Review.

PubMed

Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Micali, Nadia; Andersen, Anne-Marie Nybo

2015-01-01

After participating in this activity, learners should be better able to: Evaluate the evidence regarding parental and child characteristics related to early-onset disordered eating. Eating disorders are rare in children, but disordered eating is common. Understanding the phenomenology of disordered eating in childhood can aid prevention of full-blown eating disorders. The purpose of this review is to systematically extract and synthesize the evidence on parental and child characteristics related to early-onset disordered eating. Systematic searches were conducted in PubMED/MEDLINE, EMBASE, and PsycInfo using the following search terms: eating disorder, disordered eating, problem eating, anorexia nervosa, bulimia nervosa, binge eating, child, preadolescent, and early onset. Studies published from 1990 to 2013 addressing parental and child characteristics of disordered eating in children aged 6 to 12 years were eligible for inclusion. The search was restricted to studies with cross-sectional, case-control, or longitudinal designs, studies in English, and with abstracts available. Forty-four studies fit these criteria. Most studies were based on community samples with a cross-sectional design. The included studies varied considerably in size, instruments used to assess early-onset disordered eating, and parental and child characteristics investigated. Important determinants included the following: higher body weight, previously reported disordered eating, body dissatisfaction, depression, parental disordered eating, and parental comments/concerns about child's weight and eating. The findings were inconsistent for sex, age, socioeconomic status, ethnicity, self-esteem/worth, and parental body weight. In conclusion, characteristics related to early-onset disordered eating have mainly been explored with a cross-sectional design. Full understanding of causal pathways will require good-quality longitudinal studies designed to address the influence of parental eating behaviors, mental and physical health, family interactions, and child growth patterns.

Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States.

PubMed

Perez, Marisol; Ohrt, Tara K; Hoek, Hans W

2016-11-01

We reviewed the recent literature on prevalence rates, and application of evidence-based treatments for eating disorders among Hispanics/Latinos residing in the United States. Lifetime prevalence rates of anorexia nervosa are lower among Hispanic/Latinos than non-Hispanic Whites. There are comparable rates of bulimia nervosa and binge eating disorder (BED) among Hispanic/Latinos and non-Hispanic Whites. BED is the most common eating disorder among Hispanic/Latinos. Evidence-based treatments have begun to be implemented with Hispanics/Latinos. The core concepts of cognitive behavioral therapy for bulimia nervosa and BED apply to this population. Culture-specific adaptations include strengthening the collectivistic framework within an individualistic treatment, psychoeducation of immediate and extended family, and adjustment of meal plans that incorporated cultural foods. There are more similarities than differences in the prevalence of eating disorders across Hispanics/Latinos and non-Hispanic Whites. However, the social context such as immigration status and acculturation is important to consider in the development of eating disorders. In addition, the Westernization of Latin America may change the future relationship of immigration status and development of eating disorder within the United States. Overall, cultural adaptations of evidence-based treatments involved the inclusion of family within treatment, acculturation-related issues, and managing family conflicts that arise because of the changes in eating patterns.

Eating Disorders among a Community-Based Sample of Chilean Female Adolescents

ERIC Educational Resources Information Center

Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela

2011-01-01

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.…

[Clinical characteristics and gender identity among eating disordered patients subtypes].

PubMed

Behar, Rosa; de la Barrera, Mónica; Michelotti, Julio

2003-07-01

Gender identity is a relevant issue in the approach to eating disorders. To compare psychological and behavioural characteristics and traits of gender identity among women with eating disorders and its subtypes and non eating disordered female subjects. An structured clinical interview based on the DSM-IV diagnostic criteria for eating disorders, the EAT-40 (Eating Attitudes Test), the Eating Disorders Inventory (EDI) and the Bem Sex Role Inventory (IBRS) were administered to 58 compulsive-purgative anorectics (AN/BN group), 15 restrictive anorectics (AN group), 33 patients suffering from eating disorder not otherwise identified, 33 purgative bulimics and to 82 female students without eating disorders. Patients with eating disorders ranked significantly higher on the EAT-40 and EDI and all its items (p < 0.001). The AN/BN group ranked significantly higher on the EDI (p < 0.001) and on Drive for thinness, Perfectionism and interpersonal distrust (p < 0.001). The AN group ranked higher on Maturity fears (p < 0.001). The BN group ranged higher on Body dissatisfaction, Ineffectiveness and Interoceptive awareness (p < 0.001). Patients with eating disorders were significantly identified with Feminine category and subjects without eating disorders with Androgynous and Undifferentiated categories on the IBRS (p = 0.002). The AN group showed the highest percentage on Feminine category and the lowest on Androgynous and Undifferentiated categories. All the groups rejected and approved feminine, masculine and neutral qualities. Femininity emerged as the main trait of gender identity in patients suffering from eating disorders, in contrast to androgyny, showed by healthy women.

Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders.

PubMed

2006-12-01

It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling, by a registered dietitian (RD) is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care. Diagnostic criteria for eating disorders provide important guidelines for identification and treatment. However, it is thought that a continuum of disordered eating may exist that ranges from persistent dieting to subthreshold conditions and then to defined eating disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder. Understanding the complexities of eating disorders, such as influencing factors, comorbid illness, medical and psychological complications, and boundary issues, is critical in the effective treatment of eating disorders. The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists. The RD is an integral member of the treatment team and is uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. RDs provide nutritional counseling, recognize clinical signs related to eating disorders, and assist with medical monitoring while cognizant of psychotherapy and pharmacotherapy that are cornerstones of eating disorder treatment. Specialized resources are available for RDs to advance their level of expertise in the field of eating disorders. Further efforts with evidenced-based research must continue for improved treatment outcomes related to eating disorders along with identification of effective primary and secondary interventions.

The diagnosis and treatment of eating disorders.

PubMed

Herpertz, Stephan; Hagenah, Ulrich; Vocks, Silja; von Wietersheim, Jörn; Cuntz, Ulrich; Zeeck, Almut

2011-10-01

Eating disorders are of major significance both in clinical medicine and in society at large. Anorexia and bulimia nervosa almost exclusively afflict young persons, severely impairing their physical and mental health. The peak ages for these diseases are in late adolescence and young adulthood; patients therefore suffer setbacks both in school and/or in their occupational careers. This scientifically based S3 guideline was developed with the intention of improving the treatment of eating disorders and motivating future research in this area. The existing national and international guidelines on the three types of eating disorders were synoptically compared, the literature on the subject was systematically searched, and meta-analyses on bulimia nervosa and binge-eating disorder were carried out. 15 consensus conferences were held, as a result of which 44 evidence-based recommendations were issued. Anorexia and bulimia nervosa are diagnosed according to the ICD-10 criteria (International Classification of Diseases), binge-eating disorder according to those of the DSM (Diagnostic and Statistical Manual of Mental Disorders). Psychotherapy is the mainstay of treatment for all three disorders, and cognitive behavioral therapy is the form of psychotherapy best supported by the available evidence. The administration of selective serotonin reuptake inhibitors (SSRI) can be recommended as a flanking measure in the treatment of bulimia nervosa only. The evidence does not support any type of pharmacotherapy for anorexia nervosa or binge-eating disorder. Bulimia nervosa and binge-eating disorder can usually be treated on an outpatient basis, as long as they are no more than moderately severe; full-fledged anorexia nervosa is generally an indication for in-hospital treatment. This guideline contains evidence- and consensus-based recommendations for the diagnosis and treatment of eating disorders. If strictly implemented, it should result in improved care for the affected patients.

Eating disorders in adolescents: how does the DSM-5 change the diagnosis?

PubMed

Fisher, Martin; Gonzalez, Marisol; Malizio, Joan

2015-11-01

This study aimed to determine the changes in diagnosis that occur in making the transition from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in an adolescent medicine eating disorder program. During the months of September 2011 through December 2012, a data sheet was completed at the end of each new outpatient eating disorder evaluation listing the patient's gender, age, ethnicity, weight, height, DSM-IV diagnosis, and proposed DSM-5 diagnosis. Distributions were calculated using the Mann-Whitney and Wilcoxon rank sum analyses to determine differences between diagnostic groups. There were 309 patients evaluated during the 16-month period. DSM-IV diagnoses were as follows: anorexia nervosa, 81 patients (26.2%); bulimia nervosa, 29 patients (9.4%); binge eating disorder, 1 patient (0.3%); and eating disorder not otherwise specified (EDNOS), 198 patients (64.6%). By contrast, DSM-5 diagnoses were as follows: anorexia nervosa, 100 patients; atypical anorexia nervosa, 93 patients; avoidant/restrictive food intake disorder, 60 patients; bulimia nervosa, 29 patients; purging disorder, 18 patients; unspecified feeding or eating disorder, 4 patients; subthreshold bulimia nervosa, 2 patients; subthreshold binge eating disorder, 2 patients; and binge eating disorder, 1 patient. Almost two thirds (64.6%) of the 309 patients had a diagnosis of EDNOS based on the DSM-IV criteria. By contrast, only four patients had a diagnosis of unspecified feeding or eating disorder based on the DSM-5 criteria. These data demonstrate that the goal of providing more specific diagnoses for patients with eating disorders has been accomplished very successfully by the new DSM-5 criteria.

What Contributes to Excessive Diet Soda Intake in Eating Disorders: Appetitive Drive, Weight Concerns, or Both?

PubMed Central

Brown, Tiffany A.; Keel, Pamela K.

2013-01-01

Excessive diet soda intake is common in eating disorders. The present study examined factors contributing to excessive intake in a sample of individuals with lifetime eating disorders based on proposed DSM-5 criteria (n=240) and non-eating disorder controls (n=157). Individuals with eating disorders, particularly bulimia nervosa, consumed more diet soda than controls. Eating disorder symptoms that reflect increased appetitive drive or increased weight concerns were associated with increased diet soda intake. Increased weight concerns were associated with increased diet soda intake when levels of appetitive drive were high, but not when they were low. Results highlight the importance of monitoring diet soda intake in individuals with eating disorders and may have implications for the maintenance of dysregulated taste reward processing in BN. PMID:23600556

Setting policy priorities to address eating disorders and weight stigma: views from the field of eating disorders and the US general public

PubMed Central

2014-01-01

Background The prevalence and health consequences of eating disorders and weight stigmatization have prompted increasing discussion of potential policy actions to address these public health issues. The present study aimed to assess support for policy strategies to address eating disorders and weight stigmatization among the general public and relevant health professionals. Methods An Internet survey was fielded to a national sample of 944 US adults and 1,420 members of professional organizations specializing in eating disorders to examine their support for 23 potential policy strategies to address eating disorders and weight stigma. Participants also rated policy actions according to their potential for positive impact and feasible implementation. Results Support for the majority of health and social policies was high in both samples. For example, strategies to 1) improve school-based health curriculum to include content aimed at preventing eating disorders, 2) require training for educators and health providers on the prevention and early identification of eating disorders, and 3) implement school-based anti-bullying policies that that protect students from being bullied about their weight, were supported by over two-thirds of participants. Conclusions Our findings suggest that both health and social policy actions will be important in broader policy initiatives to address eating disorders and weight stigma. PMID:24884645

Eating Disorders and Their Associated Risk Factors among Iranian Population – A Community Based Study

PubMed Central

Garrusi, Behshid; Baneshi, Mohammad Reza

2013-01-01

Backgrounds: Many socio cultural variables could be affect eating disorders in Asian countries. In Iran, there are few researches regarding eating disorders and their contributing factors. The aim of this study is to explore frequency of eating disorders and their risk factors in an Iranian population. Materials and Methods: About 1204 participants were selected aged between fourteen to 55 years. Frequency of eating disorders and effects of variables such as demographic characteristics, Body Mass Index (BMI), use of media, body dissatisfaction, self-esteem, social comparison and social pressure for thinness in individuals with and without eating disorders, were assessed. Findings: The prevalence of eating disorders was 11.5% that included 0.8% anorexia nervosa, 6.2% full threshold bulimia nervosa, 1.4% sub threshold anorexia nervosa and 30% sub threshold binge eating disorder. Symptoms of bulimic syndrome were greater in males. Conclusion: In Iran, eating disorders and related problems are new issue that could be mentioned seriously The identification of these disorders and their related contributing factors are necessity of management and preventive programs planning. PMID:23283053

Are eating disorders and their symptoms increasing in prevalence among adolescent population?

PubMed

Litmanen, Jessi; Fröjd, Sari; Marttunen, Mauri; Isomaa, Rasmus; Kaltiala-Heino, Riittakerttu

2017-01-01

A debate concerns whether eating disorders are increasing in prevalence. The role of socio-economic status (SES) for adolescent eating disorders (ED) is another matter of debate. To ascertain whether self-reported eating disorders or their symptoms have increased in prevalence in adolescent population from the early 2000s to early 2010s. A person-identifiable classroom survey, Adolescent Mental Health Cohort study, was carried out among the 9th graders in comprehensive schools in Tampere, Finland, during academic year 2002-2003, and replicated among then 9th graders during academic years 2012-2013. Eating disorders were elicited with questionnaires tailored according to DSM-IV criteria for anorexia nervosa and bulimia nervosa. No changes were observed between 2002-2003 and 2012-2013 in the prevalence of anorexia and bulimia, most of the symptoms of anorexia and bulimia, or the proportion of adolescents having received treatment due to eating disorders among the girls or the boys. Eating disorders, treatment contacts due to eating disorders, and eating disorder symptoms were not systematically associated with either low or high parental socio-economic status. Based on this dataset, eating disorders are not increasing in the adolescent population. Adolescent eating disorders are not associated with socio-economic status of their family.

Calorie estimation accuracy and menu labeling perceptions among individuals with and without binge eating and/or purging disorders.

PubMed

Roberto, Christina A; Haynos, Ann F; Schwartz, Marlene B; Brownell, Kelly D; White, Marney A

2013-09-01

Menu labeling is a public health policy that requires chain restaurants in the USA to post kilocalorie information on their menus to help consumers make informed choices. However, there is concern that such a policy might promote disordered eating. This web-based study compared individuals with self-reported binge eating disorder (N = 52), bulimia nervosa (N = 25), and purging disorder (N = 17) and those without eating disorders (No ED) (N = 277) on restaurant calorie information knowledge and perceptions of menu labeling legislation. On average, people answered 1.46 ± 1.08 questions correctly (out of 6) (25%) on a calorie information quiz and 92% of the sample was in favor of menu labeling. The findings did not differ based on eating disorder, dieting, or weight status, or race/ethnicity. The results indicated that people have difficulty estimating the calories in restaurant meals and individuals with and without eating disorders are largely in favor of menu labeling laws.

Prevalence and correlates of eating disorders among young adults in Finland.

PubMed

Lähteenmäki, Sini; Saarni, Suoma; Suokas, Jaana; Saarni, Samuli; Perälä, Jonna; Lönnqvist, Jouko; Suvisaari, Jaana

2014-04-01

This study investigated the epidemiology of eating disorders in a population-based sample of young adults. A mental health questionnaire was sent to a nationally representative two-stage cluster sample of 1863 Finns aged 20-35 years. All screen-positives and a random sample of screen-negatives were invited to participate in a Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. Case records from all lifetime mental health treatments were also obtained and were used to complement the diagnostic assessment. The lifetime prevalence of anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified and any eating disorder among women were 2.1%, 2.3%, 2.0% and 6.0%, respectively, while there was only one man with an eating disorder. Unlike other mental disorders, they are associated with high education. Of women diagnosed with lifetime eating disorder, 67.9% had at least one comorbid Axis I psychiatric disorder, most commonly depressive disorder. While 79.3% of women with lifetime eating disorder had had a treatment contact, only one third of persons with current eating disorder had a current treatment contact. Women whose eating disorder had remitted still experienced more psychological distress and had lower psychosocial functioning that women without lifetime Axis I disorders. Eating disorders are the fourth largest group of mental disorders among young women. They tend to be comorbid, often remain untreated and are associated with residual symptoms after the remission of eating disorder symptoms.

Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients.

PubMed

Kuipers, Greet S; van Loenhout, Zara; van der Ark, L Andries; Bekker, Marrie H J

2016-01-01

To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Eating disorder patients' low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.

Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms.

PubMed

Zickgraf, Hana F; Franklin, Martin E; Rozin, Paul

2016-01-01

One presentation of Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by picky eating, i.e., selective eating based on the sensory properties of food. The present study has two aims. The first is to describe distress and impairment in individuals with ARFID secondary to picky eating. The second is to determine whether eating behaviors hypothesized to be specific to picky eating can differentiate picky eaters with and without ARFID from typical eaters (e.g., individuals not reporting picky or disordered eating) and individuals who strongly endorse attitudes associated with anorexia and bulimia (eating disordered attitudes). Participants were recruited from Amazon's Mechanical Turk ( N =  325) and an online support group for adult picky eaters ( N =  81). Participants were grouped based on endorsement of picky eating, ARFID symptoms, and elevated eating disordered attitudes on the Eating Attitudes Test (EAT-26). The resulting four eating behavior groups were compared on measures of distress and impairment (e.g., anxiety/depression and, obsessive compulsive disorder symptoms, eating-related quality of life) and on measures of eating behaviors associated with picky eating (e.g., food neophobia, inflexibility about preparation and presentation of preferred foods, sensitivity to sensory stimuli, and eating from a very narrow range of foods). The groups were compared using one way ANOVA with post-hoc Tamhane's T2 tests. On measures of distress and impairment, participants with ARFID reported higher scores than both typical eaters and picky eaters without ARFID, and comparable scores to those with disordered eating attitudes. Three of four measures of picky eating behavior, eating inflexibility, food neophobia, and eating from a range of 20 or fewer foods, distinguished picky eaters with and without ARFID form typical eaters and those with disordered eating attitudes. Picky eaters with ARFID reported greater food neophobia and eating inflexibility, and were more likely to eat from a narrow range of foods, compared to picky eaters without ARFID. Adult picky eaters can be differentiated from those with symptoms of anorexia and bulimia by their stronger endorsement of food neophobia and inflexible eating behaviors, and by eating from a very narrow range of foods. Picky eaters with ARFID symptoms can be differentiated from picky eaters without these symptoms on the basis of these three eating behaviors, and by their higher endorsement of internalizing distress, OCD symptoms, and eating-related quality of life impairment. This study provides evidence that ARFID symptoms exist independently of symptoms of other eating disorders and are characterized by several distinct eating behaviors. In a clinical analogue sample of disordered eaters, ARFID symptoms were associated with distress and impairment at levels comparable to symptoms of anorexia and bulimia.

Defining Recovery from an Eating Disorder: Conceptualization, Validation, and Examination of Psychosocial Functioning and Psychiatric Comorbidity

PubMed Central

Bardone-Cone, Anna M.; Harney, Megan B.; Maldonado, Christine R.; Lawson, Melissa A.; Robinson, D. Paul; Smith, Roma; Tosh, Aneesh

2009-01-01

Conceptually, eating disorder recovery should include physical, behavioral, and psychological components, but such a comprehensive approach has not been consistently employed. Guided by theory and recent recovery research, we identified a “fully recovered” group (n=20) based on physical (body mass index), behavioral (absence of eating disorder behaviors), and psychological (Eating Disorder Examination-Questionnaire) indices, and compared them with groups of partially recovered (n=15), active eating disorder (n=53), and healthy controls (n=67). The fully recovered group was indistinguishable from controls on all eating disorder-related measures used, while the partially recovered group was less disordered than the active eating disorder group on some measures, but not on body image. Regarding psychosocial functioning, both the fully and partially recovered groups had psychosocial functioning similar to the controls, but there was a pattern of more of the partially recovered group reporting eating disorder aspects interfering with functioning. Regarding other psychopathology, the fully recovered group was no more likely than the controls to experience current Axis I pathology, but they did have elevated rates of current anxiety disorder. Results suggest that a stringent definition of recovery from an eating disorder is meaningful. Clinical implications and future directions regarding defining eating disorder recovery are discussed. PMID:19945094

Comparing cognitive behavioural therapy for eating disorders integrated with behavioural weight loss therapy to cognitive behavioural therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: study protocol for a randomised controlled trial.

PubMed

Palavras, Marly Amorim; Hay, Phillipa; Touyz, Stephen; Sainsbury, Amanda; da Luz, Felipe; Swinbourne, Jessica; Estella, Nara Mendes; Claudino, Angélica

2015-12-18

Around 40 % of individuals with eating disorders of recurrent binge eating, namely bulimia nervosa and binge eating disorder, are obese. In contrast to binge eating disorder, currently there is no evidence base for weight management or weight loss psychological therapies in the treatment of bulimia nervosa despite their efficacy in binge eating disorder. Thus, a manualised therapy called HAPIFED (Healthy APproach to weIght management and Food in Eating Disorders) has been developed. HAPIFED integrates the leading evidence-based psychological therapies, cognitive behavioural therapy-enhanced (CBT-E) and behavioural weight loss treatment (BWLT) for binge eating disorder and obesity respectively. The aim of the present study is to detail the protocol for a randomised controlled trial (RCT) of HAPIFED versus CBT-E for people with bulimia nervosa and binge eating disorder who are overweight/obese. A single-blind superiority RCT is proposed. One hundred Brazilian participants aged ≥ 18 years, with a diagnosis of bulimia nervosa or binge eating disorder, BMI > 27 to < 40 kg/m(2), will be recruited from both community and clinics and individually randomised to a therapy arm. Five groups of ten participants will receive the experimental intervention (HAPIFED) and the other five groups of ten the control intervention (CBT-E). Both therapies are manualised, and in this RCT will comprise 1 individual session and 29 office-based group sessions over 6 months. Assessment points will be at baseline, end of therapy, and 6 and 12 months after end of therapy. The primary outcome of this intervention will be reduced weight. Secondary outcomes will be improved metabolic indicators of weight management, reduction in eating disorder symptoms including improved control over eating, improved adaptive function, physical and mental health-related quality of life, and reduced levels of depression and anxiety. This study will be the first to investigate a psychological therapy that aims to assist weight management in people with co-morbid overweight or obesity bulimia nervosa as well as with binge eating disorder. It will have the potential to improve health outcomes for the rapidly increasing number of adults with co-morbid obesity and binge eating disorder or bulimia nervosa. US National Institutes of Health clinical trial registration number NCT02464345 , date of registration 1 June 2015.

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial.

PubMed

ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; DeJong, Cor A J

2013-11-16

Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants' motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. The protocol for this study is registered with the Netherlands Trial Registry NTR2415.

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial

PubMed Central

2013-01-01

Background Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Methods/design This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants’ motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. Discussion This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Trial registration The protocol for this study is registered with the Netherlands Trial Registry NTR2415. PMID:24238630

Behavioral and Neurodevelopmental Precursors to Binge-Type Eating Disorders: Support for the Role of Negative Valence Systems

PubMed Central

Vannucci, Anna; Nelson, Eric E.; Bongiorno, Diana M.; Pine, Daniel S.; Yanovski, Jack A.; Tanofsky-Kraff, Marian

2015-01-01

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

Moderators of the Intervention Effects for a Dissonance-Based Eating Disorder Prevention Program; Results from an Amalgam of Three Randomized Trials

PubMed Central

Müller, Sina; Stice, Eric

2013-01-01

Objective To investigate factors hypothesized to moderate the effects of a dissonance-based eating disorder prevention program, including initial elevations in thin-ideal internalization, body dissatisfaction, eating disorder symptoms, and older participant age. Method Adolescent female high school and college students with body image concerns (N = 977; M age = 18.6) were randomized to a dissonance-based thin-ideal internalization reduction program or an assessment-only control condition in three prevention trials. Results The intervention produced (a) significantly stronger reductions in thin-ideal internalization for participants with initial elevations in thin-ideal internalization and a threshold/subthreshold DSM-5 eating disorder at baseline, (b) significantly greater reductions in eating disorder symptoms for participants with versus without a DSM-5 eating disorder at baseline, and (c) significantly stronger reductions in body dissatisfaction for late adolescence/young adulthood versus mid-adolescent participants. Baseline body dissatisfaction did not moderate the intervention effects. Conclusion Overall, intervention effects tended to be amplified for individuals with initial elevations in risk factors and a DSM-5 eating disorder at baseline. Results suggest that this prevention program is effective for a broad range of individuals, but is somewhat more beneficial for the subgroups identified in the moderation analyses. PMID:23337181

Antecedents and consequences of binge eating episodes in women with an eating disorder.

PubMed

Kjelsås, E; Børsting, I; Gudde, C Buch

2004-03-01

The aim of this study was to explore antecedents and sequelae of binge eating episodes. A sample of eating disorders (n = 154 women) was selected from a total of 1849 female respondents (out of 2500) recruited as part of a general population-based survey. Included participants met DSM-III-R criteria for anorexia nervosa (AN), bulimia nervosa (BN) or eating disorder not otherwise specified (EDNOS) based on the Survey for Eating Disorders (SEDs). Preliminary criteria for binge eating disorder (BED) were added. Results indicated that the most frequently reported antecedents and consequences of binge eating were emotional and physiological factors. There were significant differences between the different ED subgroups in their frequency of binge eating episodes. Regarding antecedents of a binge eating episode, the SEDs-defined ED subgroups had overall differences in frequency on "stomach feeling". In particular, the BN-group reported "euphoria" more frequently than the BED and EDNOS-groups. Concerning consequences of a binge eating episode, there were overall differences between the ED subgroups on "fall asleep", and in addition a borderline significance was found for "disturbed by others" (p = 0.059). None of the eight women in the AN group reported "euphoria" as a factor that terminated a binge eating episode. The findings may have important implications with regard to prevention and treatment of ED.

Mapping the evidence for the prevention and treatment of eating disorders in young people

PubMed Central

2014-01-01

Abstract Eating disorders often develop during adolescence and young adulthood, and are associated with significant psychological and physical burden. Identifying evidence-based interventions is critical and there is need to take stock of the extant literature, to inform clinical practice regarding well-researched interventions and to direct future research agendas by identifying gaps in the evidence base. Aim To investigate and quantify the nature and distribution of existing high-quality research on the prevention and treatment of eating disorders in young people using evidence mapping methodology. Method A systematic search for prevention and treatment intervention studies in adolescents and young adults (12–25 years) was conducted using EMBASE, PSYCINFO and MEDLINE. Studies were screened and mapped according to disorder, intervention modality, stage of eating disorder and study design. Included studies were restricted to controlled trials and systematic reviews published since 1980. Results The eating disorders evidence map included 197 trials and 22 systematic reviews. Prevention research was dominated by trials of psychoeducation (PE). Bulimia nervosa (BN) received the most attention in the treatment literature, with cognitive behavioural therapy (CBT) and antidepressants the most common interventions. For anorexia nervosa (AN), family based therapy (FBT) was the most studied. Lacking were trials exploring treatments for binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS). Relapse prevention strategies were notably absent across the eating disorders. Conclusions Despite substantial literature devoted to the prevention and treatment of eating disorders in young people, the evidence base is not well established and significant gaps remain. For those identified as being at-risk, there is need for prevention research exploring strategies other than passive PE. Treatment interventions targeting BED and EDNOS are required, as are systematic reviews synthesising BN treatment trials (e.g., CBT, antidepressants). FBTs for AN require investigation against other validated psychological interventions, and the development of relapse prevention strategies is urgently required. By systematically identifying existing interventions for young people with eating disorders and exposing gaps in the current literature, the evidence map can inform researchers, funding bodies and policy makers as to the opportunities for future research. PMID:24999427

Mapping the evidence for the prevention and treatment of eating disorders in young people.

PubMed

Bailey, Alan P; Parker, Alexandra G; Colautti, Lauren A; Hart, Laura M; Liu, Ping; Hetrick, Sarah E

2014-01-01

Eating disorders often develop during adolescence and young adulthood, and are associated with significant psychological and physical burden. Identifying evidence-based interventions is critical and there is need to take stock of the extant literature, to inform clinical practice regarding well-researched interventions and to direct future research agendas by identifying gaps in the evidence base. To investigate and quantify the nature and distribution of existing high-quality research on the prevention and treatment of eating disorders in young people using evidence mapping methodology. A systematic search for prevention and treatment intervention studies in adolescents and young adults (12-25 years) was conducted using EMBASE, PSYCINFO and MEDLINE. Studies were screened and mapped according to disorder, intervention modality, stage of eating disorder and study design. Included studies were restricted to controlled trials and systematic reviews published since 1980. The eating disorders evidence map included 197 trials and 22 systematic reviews. Prevention research was dominated by trials of psychoeducation (PE). Bulimia nervosa (BN) received the most attention in the treatment literature, with cognitive behavioural therapy (CBT) and antidepressants the most common interventions. For anorexia nervosa (AN), family based therapy (FBT) was the most studied. Lacking were trials exploring treatments for binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS). Relapse prevention strategies were notably absent across the eating disorders. Despite substantial literature devoted to the prevention and treatment of eating disorders in young people, the evidence base is not well established and significant gaps remain. For those identified as being at-risk, there is need for prevention research exploring strategies other than passive PE. Treatment interventions targeting BED and EDNOS are required, as are systematic reviews synthesising BN treatment trials (e.g., CBT, antidepressants). FBTs for AN require investigation against other validated psychological interventions, and the development of relapse prevention strategies is urgently required. By systematically identifying existing interventions for young people with eating disorders and exposing gaps in the current literature, the evidence map can inform researchers, funding bodies and policy makers as to the opportunities for future research.

Motor-based bodily self is selectively impaired in eating disorders.

PubMed

Campione, Giovanna Cristina; Mansi, Gianluigi; Fumagalli, Alessandra; Fumagalli, Beatrice; Sottocornola, Simona; Molteni, Massimo; Micali, Nadia

2017-01-01

Body representation disturbances in body schema (i.e. unconscious sensorimotor body representations for action) have been frequently reported in eating disorders. Recently, it has been proposed that body schema relies on adequate functioning of the motor system, which is strongly implicated in discriminating between one's own and someone else's body. The present study aimed to investigate the motor-based bodily self in eating disorders and controls, in order to examine the role of the motor system in body representation disturbances at the body schema level. Female outpatients diagnosed with eating disorders (N = 15), and healthy controls (N = 18) underwent a hand laterality task, in which their own (self-stimuli) and someone else's hands (other-stimuli) were displayed at different orientations. Participants had to mentally rotate their own hand in order to provide a laterality judgement. Group differences in motor-based bodily self-recognition-i.e. whether a general advantage occurred when implicitly processing self- vs. other-stimuli - were evaluated, by analyzing response times and accuracy by means of mixed ANOVAs. Patients with eating disorders did not show a temporal advantage when mentally rotating self-stimuli compared to other-stimuli, as opposed to controls (F(1, 31) = 5.6, p = 0.02; eating disorders-other = 1092 ±256 msec, eating disorders-self = 1097±254 msec; healthy controls-other = 1239±233 msec, healthy controls -self = 1192±232 msec). This study provides initial indication that high-level motor functions might be compromised as part of body schema disturbances in eating disorders. Further larger investigations are required to test motor system abnormalities in the context of body schema disturbance in eating disorders.

Hacia una adaptación cultural para el tratamiento de trastornos alimentarios en latinos en Estados Unidos.

PubMed

Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M

2010-01-01

Eating disorders affect all ethnic and socioeconomic groups. However, evidence based treatments for eating disorders have been developed and tested exclusively on Caucasian populations. With the purpose to develop a culturally sensitive framework for the eating disorders treatment in Latinos/as, the objectives of this work were: 1) identify and describe some of the relevant cultural elements for eating disorders in the Latino population and, 2) to draft a culturally sensitive intervention model for eating disorders in Latino population in the United States. Providing culturally sensitive treatments for Latinos with psychiatric disorders is essential to reverse public health disparities.

Hacia una adaptación cultural para el tratamiento de trastornos alimentarios en latinos en Estados Unidos

PubMed Central

Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M.

2011-01-01

Eating disorders affect all ethnic and socioeconomic groups. However, evidence based treatments for eating disorders have been developed and tested exclusively on Caucasian populations. With the purpose to develop a culturally sensitive framework for the eating disorders treatment in Latinos/as, the objectives of this work were: 1) identify and describe some of the relevant cultural elements for eating disorders in the Latino population and, 2) to draft a culturally sensitive intervention model for eating disorders in Latino population in the United States. Providing culturally sensitive treatments for Latinos with psychiatric disorders is essential to reverse public health disparities. PMID:22003472

Practice parameter for the assessment and treatment of children and adolescents with eating disorders.

PubMed

Lock, James; La Via, Maria C

2015-05-01

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. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

'I can't accept that feeling': Relationships between interoceptive awareness, mindfulness and eating disorder symptoms in females with, and at-risk of an eating disorder.

PubMed

Lattimore, Paul; Mead, Bethan R; Irwin, Leanne; Grice, Lorna; Carson, Ruth; Malinowski, Peter

2017-01-01

Mindfulness based therapies (MBTs) for eating disorders show potential benefit for outcomes yet evidence is scarce regarding the mechanisms by which they influence remission from symptoms. One way that mindfulness approaches create positive outcomes is through enhancement of emotion regulation skills. Maladaptive emotion regulation is a key psychological feature of all eating disorders. The aim of the current study was to identify facets of emotion regulation involved in the relationship between mindfulness and maladaptive eating behaviours. In three cross-sectional studies, clinical (n=39) and non-clinical (n=137 and 119) female participants completed: 1) the Eating Disorder Inventory (EDI) eating specific scales (drive-for-thinness and bulimia) and the EDI psychological symptom scales (emotion dysregulation and interoceptive deficits); and 2) mindfulness, impulsivity, and emotion regulation questionnaires. In all samples mindfulness was significantly and inversely associated with EDI eating and psychological symptom scales, and impulsivity. In non-clinical samples interoceptive deficits mediated the relationship between mindfulness and EDI eating specific scales. Non-acceptance of emotional experience, a facet of interoceptive awareness, mediated the relationship between mindfulness and eating specific EDI scores. Further investigations could verify relationships identified so that mindfulness based approaches can be optimised to enhance emotion regulation skills in sufferers, and those at-risk, of eating disorders. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Parenting styles and eating disorder pathology.

PubMed

Enten, Roni S; Golan, Moria

2009-06-01

Our objective was to investigate the association between parenting style and eating disorder symptoms in patients treated in an intensive outpatient center for eating disorders. The study design is a cross-sectional survey set in a community-based facility for eating disorders. Participants included 53 families, including 32 with a child meeting the DSM-IV criteria for anorexia nervosa, 18 for bulimia nervosa, and 3 diagnosed ED-NOS. Data was collected using the Parental Authority Questionnaire (PAQ), the Eating Disorders Inventory-2 (EDI-2) and the Eating Attitudes Test (EAT-26). Significant, negative correlations were found between drive for thinness scores and body dissatisfaction scores and the patient's perception of the father as authoritative. Total patient EDI score was significantly and positively correlated with patient's perception of the father as authoritarian and inversely correlated with her perception of him as authoritative. These results emphasize the importance of fathers' role in the eating disorder pathology, a relatively untapped area of research.

A history of the identification of the characteristic eating disturbances of Bulimia Nervosa, Binge Eating Disorder and Anorexia Nervosa.

PubMed

Heaner, Martica K; Walsh, B Timothy

2013-06-01

During the last 25 years, the careful examination of the eating behavior of individuals with eating disorders has provided critical insights into the nature of these disorders. Crucially, studies investigating components of different eating behaviors have documented that Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED) are characterized by objective disturbances in eating patterns that are significantly different than behaviors exhibited by individuals who do not have these eating disorders. The detailed description of the disturbances in eating behavior has helped to identify diagnostic criteria associated with each disorder, and has led to important hypotheses about the underlying pathophysiology. These advances in understanding have provided, and continue to provide, a foundation for translational research and for the development of novel treatment interventions. This review is based on a presentation given by B. Timothy Walsh, M.D. at the 40th anniversary symposium of the Columbia University Appetite talks outlining the evolution of the discovery of the characteristic eating disturbances seen with each disorder. Copyright © 2013 Elsevier Ltd. All rights reserved.

Positive Psychology in the Prevention of Eating Disorders

ERIC Educational Resources Information Center

Steck, Erin L.; Abrams, Laura M.; Phelps, LeAdelle

2004-01-01

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…

Exploring the mind's eye: Contents and characteristics of mental images in overweight individuals with binge eating behaviour.

PubMed

Dugué, Rebecca; Keller, Silke; Tuschen-Caffier, Brunna; Jacob, Gitta A

2016-12-30

Mental images play a role in various mental disorders and are strongly associated with emotions. Negative emotions and their regulation are important in eating disorders. However, research on mental imagery in eating disorders is still scarce. We investigated mental images and their relation to distress and eating disorder psychopathology in individuals with binge eating behaviour. Content and characteristics of mental images and their relation to psychopathology of 21 individuals with binge eating behaviour, 19 mixed patient controls and 21 healthy controls have been assessed with a semi-structured interview. Occurrence and vividness of food-related images did not differ between groups. However they were experienced as more distressing and distracting and more difficult to control by eating disordered patients. Body-related mental images were less associated with desire to eat than expected. Mental images of social rejection were experienced as more vivid by both clinical groups and caused desire to eat in individuals with binge eating behaviour. Mental images are relevant in binge eating behaviour, but with different patterns regarding concomitant distress and eating disorder psychopathology. As transdiagnostic mental images of social rejection are relevant for individuals with binge eating behaviour, research on imagery based techniques in eating disorders seems promising. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Safety of pharmacotherapy options for bulimia nervosa and binge eating disorder.

PubMed

Bello, Nicholas T; Yeomans, Bryn L

2018-01-01

Eating disorders represent a set of psychiatric illnesses with lifelong complications and high relapse rates. Individuals with eating disorders are often stigmatized and clinicians have a limited set of treatments options. Pharmacotherapy has the potential to improve long term compliance and patient commitment to treatment for eating disorders. Areas covered: This review will examine the efficacy and safety profile of the FDA-approved medications for the treatment of bulimia nervosa (BN) and binge eating disorder (BED). This will include the evaluation of fluoxetine for BN, and lisdexamfetamine for BED. Safety information will be review from randomized control trials (RCT), open label trials, and case reports. Expert opinion: Fluoxetine for BN and lisdexamfetamine for BED are relatively safe and well-tolerated. Despite these properties, these two medications represent a limited arsenal for the pharmacological treatment of eating disorders. Thus, more research-based strategies are needed to develop safe, effective, and more targeted therapies for eating disorders.

Eating disorders and disordered weight and shape control behaviors in sexual minority populations

PubMed Central

Calzo, Jerel P.; Blashill, Aaron J.; Brown, Tiffany A.; Argenal, Russell L.

2017-01-01

Purpose of review This review summarized trends and key findings from empirical studies conducted between 2011–2017 regarding eating disorders and disordered weight and shape control behaviors among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations. Recent findings Recent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are transgender or ethnic minorities. Dissonance-based eating disorder prevention programs may hold promise for sexual minority males. Summary Continued research must examine the intersections of sexual orientation, gender, and ethnic identities, given emergent data that eating disorder risk may be most prominent among specific subgroups. More research is needed within sexual minorities across the lifespan. There are still a lack of eating disorder treatment and prevention studies for sexual minorities. PMID:28660475

Recognition and management of eating disorders in children and young people.

PubMed

Oakley, Thomas James; Dey, Indranil; Discombe, Sandra; Fitzpatrick, Lynn; Paul, Siba Prosad

2017-10-25

Eating disorders form a group of mental health conditions characterised by abnormal eating habits and are associated with high mortality rates. This article provides nurses working in various settings with evidence-based strategies to identify, manage and refer children and young people with eating disorders. It explores what eating disorders are, and their association with physical and psychiatric co-morbidities. Eating disorders have a significant effect on children and young people's health and development, and nurses have a vital role in managing them. This article presents a case study that illustrates some of the challenges nurses may experience when managing children and young people with eating disorders. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

A Preliminary Trial of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program for Young Women with Body Image Concerns

ERIC Educational Resources Information Center

Stice, Eric; Rohde, Paul; Durant, Shelley; Shaw, Heather

2012-01-01

Objective: A group dissonance-based eating disorder prevention program, in which young women critique the thin ideal, reduces eating disorder risk factors and symptoms, but it can be difficult to identify school clinicians with the time and expertise to deliver the intervention. Thus, we developed a prototype Internet version of this program and…

Testing Mediators Hypothesized to Account for the Effects of a Dissonance-Based Eating Disorder Prevention Program over Longer Term Follow-Up

ERIC Educational Resources Information Center

Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

2011-01-01

Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students…

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses.

PubMed

Kass, Andrea E; Jones, Megan; Kolko, Rachel P; Altman, Myra; Fitzsimmons-Craft, Ellen E; Eichen, Dawn M; Balantekin, Katherine N; Trockel, Mickey; Taylor, C Barr; Wilfley, Denise E

2017-04-01

Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight. 1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses. Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns. Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students. Copyright © 2016 Elsevier Ltd. All rights reserved.

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

PubMed Central

Kass, Andrea E.; Jones, Megan; Kolko, Rachel P.; Altman, Myra; Fitzsimmons-Craft, Ellen E.; Eichen, Dawn M.; Balantekin, Katherine N.; Trockel, Mickey; Taylor, C. Barr; Wilfley, Denise E.

2016-01-01

Purpose Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight. Methods 1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses. Results Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns. Conclusions Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students. PMID:27090854

Course and predictors of maternal eating disorders in the postpartum period

PubMed Central

Knoph, Cecilie; Holle, Ann Von; Zerwas, Stephanie; Torgersen, Leila; Tambs, Kristian; Stoltenberg, Camilla; Bulik, Cynthia M; Reichborn-Kjennerud, Ted

2012-01-01

Objective To investigate course and predictors of eating disorders in the postpartum period. Method A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM-IV criteria for pre-pregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS-P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum. Results Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS-P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED. Discussion This is the first large-scale population-based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with pre-pregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors. PMID:23307499

Evaluation of the DSM-5 severity indicator for binge eating disorder in a clinical sample

PubMed Central

Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

2015-01-01

Objective This study tested the new DSM-5 severity criterion for binge eating disorder (BED) based on frequency of binge-eating in a clinical sample. This study also tested overvaluation of shape/weight as an alternative severity specifier. Method Participants were 834 treatment-seeking adults diagnosed with DSM-5 BED using semistructured diagnostic and eating-disorder interviews. Participants sub-grouped based on DSM-5 severity levels and on overvaluation of shape/weight were compared on demographic and clinical variables. Results Based on DSM-5 severity definitions, 331 (39.7%) participants were categorized as mild, 395 (47.5%) as moderate, 83 (10.0%) as severe, and 25 (3.0%) as extreme. Analyses comparing three (mild, moderate, and severe/extreme) severity groups revealed no significant differences in demographic variables or body mass index (BMI). Analyses revealed significantly higher eating-disorder psychopathology in the severe/extreme than moderate and mild groups and higher depression in moderate and severe/extreme groups than the mild group; effect sizes were small. Participants characterized with overvaluation (N = 449; 54%) versus without overvaluation (N = 384; 46%) did not differ significantly in age, sex, BMI, or binge-eating frequency, but had significantly greater eating-disorder psychopathology and depression. The robustly greater eating-disorder psychopathology and depression levels (medium-to-large effect sizes) in the overvaluation group was observed without attenuation of effect sizes after adjusting for ethnicity/race and binge-eating severity/frequency. Conclusions Our findings provide support for overvaluation of shape/weight as a severity specifier for BED as it provides stronger information about the severity of homogeneous groupings of patients than the DSM-5 rating based on binge-eating. PMID:26114779

Randomized Controlled Trial of an Internet-Based Cognitive-Behavioral Treatment Program for Binge-Eating Disorder.

PubMed

Wagner, Birgit; Nagl, Michaela; Dölemeyer, Ruth; Klinitzke, Grit; Steinig, Jana; Hilbert, Anja; Kersting, Anette

2016-07-01

Binge-eating disorder (BED) is a prevalent health condition associated with obesity. Few people with BED receive appropriate treatment. Personal barriers include shame, fear of stigma, geographic distance to mental health services, and long wait-lists. The aims of this study were to examine the efficacy of an Internet-based cognitive-behavioral intervention for adults with threshold BED (DSM-IV) and to examine the stability of treatment effects over 12months. Participants were randomly assigned to a 16-week Internet-based cognitive-behavioral intervention (n=69) or a wait-list condition (n=70). Binge-eating frequency and eating disorder psychopathology were measured with the Eating Disorder Examination-Questionnaire and the Eating Disorder Examination administered over the telephone. Additionally, body weight and body mass index, depression, and anxiety were assessed before and immediately after treatment. Three-, 6-, and 12-month follow-up data were recorded in the treatment group. Immediately after the treatment the number of binge-eating episodes showed significant improvement (d=1.02, between group) in the treatment group relative to the wait-list condition. The treatment group had also significantly reduced symptoms of all eating psychopathology outcomes relative to the wait-list condition (0.82≤d≤1.11). In the treatment group significant improvement was still observed for all measures 1year after the intervention relative to pretreatment levels. The Internet-based intervention proved to be efficacious, significantly reducing the number of binge-eating episodes and eating disorder pathology long term. Low-threshold e-health interventions should be further evaluated to improve treatment access for patients suffering from BED. Copyright © 2016. Published by Elsevier Ltd.

Group-Based Compassion-Focused Therapy as an Adjunct to Outpatient Treatment for Eating Disorders: A Pilot Randomized Controlled Trial.

PubMed

Kelly, Allison Catherine; Wisniewski, Lucene; Martin-Wagar, Caitlin; Hoffman, Ellen

2017-03-01

The current study sought to assess the acceptability and feasibility of a compassion-focused therapy (CFT) group as an adjunct to evidence-based outpatient treatment for eating disorders, and to examine its preliminary efficacy relative to treatment as usual (TAU). Twenty-two outpatients with various types of eating disorders were randomly assigned to 12 weeks of TAU (n = 11) or TAU plus weekly CFT groups adapted for an eating disorder population (CFT + TAU; n = 11). Participants in both conditions completed measures of self-compassion, fears of compassion, shame and eating disorder pathology at baseline, week 4, week 8 and week 12. Additionally, participants receiving the CFT group completed measures assessing acceptability and feasibility of the group. Results indicated that the CFT group demonstrated strong acceptability; attendance was high and the group retained over 80% of participants. Participants rated the group positively and indicated they would be very likely to recommend it to peers with similar symptoms. Intention-to-treat analyses revealed that compared to the TAU condition, the CFT + TAU condition yielded greater improvements in self-compassion, fears of self-compassion, fears of receiving compassion, shame and eating disorder pathology over the 12 weeks. Results suggest that group-based CFT, offered in conjunction with evidence-based outpatient TAU for eating disorders, may be an acceptable, feasible and efficacious intervention. Furthermore, eating disorder patients appear to see benefit in, and observe gains from, working on the CFT goals of overcoming fears of compassion, developing more self-compassion and accessing more compassion from others. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Improving Inhibitory Control Abilities (ImpulsE)-A Promising Approach to Treat Impulsive Eating?

PubMed

Preuss, Hanna; Pinnow, Marlies; Schnicker, Katja; Legenbauer, Tanja

2017-11-01

Although there is preliminary evidence that inhibitory control training improves impulsive eating, less is known about the effects on eating behaviour and weight loss in clinical samples. Sixty-nine treatment-seeking adults with obesity (binge-eating disorder 33.3%; other specific feeding and eating disorders 40.6%) were randomly blockwise allocated to ImpulsE, an intervention to improve inhibitory control and emotion regulation abilities or a guideline-appropriate cognitive behavioural therapy (CBT)-based treatment as usual. Self-reported and performance-based impulsivity, eating disorder pathology and BMI were compared at baseline (T1), post-treatment (T2) and 1- or 3-month follow-up. ImpulsE led to better food-specific inhibition performance (p = .004), but groups did not differ regarding improvements in global Eating Disorder Examination Questionnaire (EDE-Q) score at T2. At 3-month follow-up, binge eaters benefited most from ImpulsE (p = .028) and completers of ImpulsE demonstrated a significantly greater weight reduction (p = .030). The current findings propose ImpulsE as a promising approach to treat obesity, illustrating acceptability and additional benefits for course of weight. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Eating disorders: progress and challenges.

PubMed

Dalle Grave, Riccardo

2011-04-01

Eating disorders are common health problems afflicting mainly female adolescents and young women. They are associated with important physical health and psychosocial morbidity, and carry increased risk of death. Their cause is not yet completely understood and their management is complex, with some patients resisting all available treatments. AIMS OF THIS REVIEW: To provide the readers with an update regarding our knowledge and understanding of eating disorders. Medline database has been used for searching articles on eating disorders published since 1980. The key words used were eating disorders, anorexia nervosa, bulimia nervosa, bulimia, and binge eating. Professional books published during this period has been also reviewed. In the last 30 years a substantial improvement has been achieved both in the understanding and management of eating disorders, but many problems still need to be resolved. Three principal priorities should be addressed. First, the actual classification of eating disorders should be revised, since about half the cases seen in clinical practice receive a diagnosis of eating disorder not otherwise specified, and it is common to observe a migration between eating disorder diagnoses. Second, the research on pathogenesis should better clarify the exact role of genetic and environmental risk factors, and how they interact and vary across the development and maintenance of eating disorders. Third, there is an urgent need both to disseminate the few evidence-based treatments available, and to develop more potent treatments for all the eating disorder diagnostic categories. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Emotional Reactivity and Appraisal of Food in Relation to Eating Disorder Cognitions and Behaviours: Evidence to Support the Motivational Conflict Hypothesis.

PubMed

Racine, Sarah E; Hebert, Karen R; Benning, Stephen D

2018-01-01

Eating disorders are associated with both negative and positive emotional reactions towards food. Individual eating disorder symptoms may relate to distinct emotional responses to food, which could necessitate tailored treatments based on symptom presentation. We examined associations between eating disorder symptoms and psychophysiological responses to food versus neutral images in 87 college students [mean (SD) age = 19.70 (2.09); mean (SD) body mass index = 23.25(2.77)]. Reflexive and facial electromyography measures tapping negative emotional reactivity (startle blink reflex) and appraisal (corrugator muscle response) as well as positive emotional reactivity (postauricular reflex) and appraisal (zygomaticus muscle response) were collected. Eating disorder cognitions correlated with more corrugator activity to food versus neutral images, indicating negative appraisals of food. Binge eating was associated with increased postauricular reflex reactivity to food versus neutral images, suggesting enhanced appetitive motivation to food. The combination of cognitive eating disorder symptoms and binge eating may result in motivational conflict towards food. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Eating disorders: Insights from imaging and behavioral approaches to treatment.

PubMed

Stice, Eric; Shaw, Heather

2017-11-01

Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.

Neurocognitive Treatments for Eating Disorders and Obesity.

PubMed

Eichen, Dawn M; Matheson, Brittany E; Appleton-Knapp, Sara L; Boutelle, Kerri N

2017-09-01

Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.

Dissonance-based eating disorder program reduces cardiac risk: A preliminary trial.

PubMed

Green, Melinda A; Willis, Mary; Fernandez-Kong, Kristen; Reyes, Shuhan; Linkhart, Ruby; Johnson, Molly; Thorne, Tyler; Kroska, Emily; Woodward, Halley; Lindberg, Jessica

2017-04-01

We conducted a randomized, controlled preliminary trial to examine the effect of a dissonance-based eating disorder program on eating disorder symptoms and cardiac risk indices in a community sample of women with subclinical and clinical symptoms (N = 47), examining the efficacy of the program in both the indicated prevention and treatment realms. Eating disorder symptoms, body mass index, and biomarkers of cardiac risk were examined in dissonance and assessment-only control conditions at baseline, postintervention, and 2-month follow-up. Specifically, we assessed mean R wave amplitude, QT interval length, vagal tone (high frequency spectral power of heart rate variability), and sympathetic tone (low/high frequency spectral power ratio) via electocardiography (ECG) at each assessment period. We predicted a statistically significant 2 (condition: control, dissonance) × 3 (time: baseline, postintervention, 2-month follow-up) interaction in the mixed factorial MANOVA results. Results confirmed this hypothesis. Eating disorder symptoms and cardiac risk indices decreased significantly among participants in the dissonance condition at postintervention and 2-month follow-up compared with baseline. Results provide support for the efficacy of a dissonance-based program in the reduction of eating disorder symptoms and cardiac risk indices among women with subclinical and clinical eating disorder symptoms. Findings establish the efficaciousness of this dissonance-based approach in the indicated prevention and treatment realms and establish its efficacy in reducing cardiac risk indicators. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Rumination in Patients with Binge-Eating Disorder and Obesity: Associations with Eating-Disorder Psychopathology and Weight-bias Internalization.

PubMed

Wang, Shirley B; Lydecker, Janet A; Grilo, Carlos M

2017-03-01

Overvaluation of shape and weight in binge-eating disorder (BED) is associated with greater eating-disorder psychopathology and greater weight-bias internalization, which are-in turn-associated with poorer mental and physical health. Little is known, however, about the significance of other cognitive processes, such as rumination, in BED. This study examined rumination and overvaluation of shape/weight with eating-disorder psychopathology and weight-bias internalization among 237 treatment-seeking patients with BED and comorbid obesity. Hierarchical multiple regressions indicated that rumination was associated with eating-disorder psychopathology and weight-bias internalization above and beyond the influence of overvaluation of shape/weight. Findings suggest that, among patients with BED/obesity, rumination is an important cognitive process associated with severity of eating-disorder psychopathology even after accounting for overvaluation of shape/weight. Patients with greater rumination might be more likely to dwell on weight-based discrimination experiences and internalize these negative attitudes. Additional controlled examination could determine whether rumination represents another potential target for BED/obesity treatment. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Maternal eating disorder and infant diet. A latent class analysis based on the Norwegian Mother and Child Cohort Study (MoBa).

PubMed

Torgersen, Leila; Ystrom, Eivind; Siega-Riz, Anna Maria; Berg, Cecilie Knoph; Zerwas, Stephanie C; Reichborn-Kjennerud, Ted; Bulik, Cynthia M

2015-01-01

Knowledge of infant diet and feeding practices among children of mothers with eating disorders is essential to promote healthy eating in these children. This study compared the dietary patterns of 6-month-old children of mothers with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified-purging subtype, to the diet of children of mothers with no eating disorders (reference group). The study was based on 53,879 mothers in the Norwegian Mother and Child Cohort Study (MoBa). Latent class analysis (LCA) was used to identify discrete latent classes of infant diet based on the mothers' responses to questions about 16 food items. LCA identified five classes, characterized by primarily homemade vegetarian food (4% of infants), homemade traditional food (8%), commercial cereals (35%), commercial jarred baby food (39%), and a mix of all food groups (11%). The association between latent dietary classes and maternal eating disorders were estimated by multinomial logistic regression. Infants of mothers with bulimia nervosa had a lower probability of being in the homemade traditional food class compared to the commercial jarred baby food class, than the referent (O.R. 0.59; 95% CI 0.36-0.99). Infants of mothers with binge eating disorder had a lower probability of being in the homemade vegetarian class compared to the commercial jarred baby food class (O.R. 0.77; 95% CI 0.60-0.99), but only before adjusting for relevant confounders. Anorexia nervosa and eating disorder not otherwise specified-purging subtype were not statistically significantly associated with any of the dietary classes. These results suggest that maternal eating disorders may to some extent influence the child's diet at 6 months; however, the extent to which these differences influence child health and development remains an area for further inquiry. Copyright © 2014 Elsevier Ltd. All rights reserved.

Psychological Treatment of Eating Disorders

ERIC Educational Resources Information Center

Wilson, G. Terence; Grilo, Carlos M.; Vitousek, Kelly M.

2007-01-01

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…

Maternal eating disorder and infant diet. A latent class analysis based on the Norwegian Mother and Child Cohort Study (MoBa)

PubMed Central

Torgersen, Leila; Ystrom, Eivind; Siega-Riz, Anna Maria; Berg, Cecilie Knoph; Zerwas, Stephanie; Reichborn-Kjennerud, Ted; Bulik, Cynthia M.

2015-01-01

Knowledge of infant diet and feeding practices among children of mothers with eating disorders is essential to promote healthy eating in these children. This study compared the dietary patterns of 6-month-old children of mothers with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified - purging subtype, to the diet of children of mothers with no eating disorders. The study was based on 53,879 mothers in the Norwegian Mother and Child Cohort Study (MoBa). Latent class analysis (LCA) was used to identify discrete latent classes of infant diet based on the mothers’ responses to questions about 16 food items. LCA identified five classes, characterized by primarily homemade vegetarian food (4% of the infants in the sample), homemade traditional food (8%), commercial infant cereals (35%), commercial jarred baby food (39%), and a mix of all food groups (11%). We then estimated the association between the different latent dietary classes and maternal eating disorders using a multinomial logistic regression model. Infants of mothers with bulimia nervosa had a lower probability of being in the homemade traditional food class compared to the commercial jarred baby food class, than the referent without an eating disorder (O.R. 0.59; 95% CI 0.36–0.99). Infants of mothers with binge eating disorder had a lower probability of being in the homemade vegetarian class compared to the commercial jarred baby food class, than the referent (O.R. 0.77; 95% CI 0.60–0.99), but only before controlling for relevant confounders. Anorexia nervosa and eating disorder not otherwise specified-purging subtype were not statistically significant associated with any of the dietary classes. These results suggest that in the general population, maternal eating disorders may to some extent influence the child’s diet as early as 6 months after birth; however, the extent to which these differences influence child health and development remain an area for further inquiry. PMID:25453594

Food cravings, binge eating, and eating disorder psychopathology: Exploring the moderating roles of gender and race

PubMed Central

Chao, Ariana M.; Grilo, Carlos M.; Sinha, Rajita

2016-01-01

Objective To examine the moderating effects of gender and race on the relationships among food cravings, binge eating, and eating disorder psychopathology in a community sample. Methods Data were collected from a convenience sample of 320 adults (53% male; mean age 28.5±8.2 years; mean BMI 27.1±5.2 kg/m2; mean education 15.1±2.2 years; 64% white, 24% black, and 13% other race) participating in a cross-sectional study examining the interactions between stress, self-control and addiction. Participants completed a comprehensive assessment panel including a demographic questionnaire, the Food Craving Inventory, and Eating Disorder Examination Questionnaire. Data were analyzed using multiple logistic regression for binge eating behavior and multiple linear regression for eating disorder psychopathology. Results Overall, food cravings demonstrated significant main effects for binge eating behavior (adjusted OR=2.65, p<.001) and global eating disorder psychopathology (B=.47±.09, p<.001). Females had a stronger relationship between food cravings and eating disorder psychopathology than males; there were no statistically significant differences by race. Conclusion These findings, based on a diverse sample recruited from the community, suggest that food cravings are associated with binge eating and eating disorder psychopathology and may represent an important target for interventions. PMID:26741258

Food cravings, binge eating, and eating disorder psychopathology: Exploring the moderating roles of gender and race.

PubMed

Chao, Ariana M; Grilo, Carlos M; Sinha, Rajita

2016-04-01

To examine the moderating effects of gender and race on the relationships among food cravings, binge eating, and eating disorder psychopathology in a community sample. Data were collected from a convenience sample of 320 adults (53% male; mean age 28.5±8.2years; mean BMI 27.1±5.2kg/m(2); mean education 15.1±2.2years; 64% white, 24% black, and 13% other race) participating in a cross-sectional study examining the interactions between stress, self-control and addiction. Participants completed a comprehensive assessment panel including a demographic questionnaire, the Food Craving Inventory, and Eating Disorder Examination Questionnaire. Data were analyzed using multiple logistic regression for binge eating behavior and multiple linear regression for eating disorder psychopathology. Overall, food cravings demonstrated significant main effects for binge eating behavior (adjusted OR=2.65, p<.001) and global eating disorder psychopathology (B=.47±.09, p<.001). Females had a stronger relationship between food cravings and eating disorder psychopathology than males; there were no statistically significant differences by race. These findings, based on a diverse sample recruited from the community, suggest that food cravings are associated with binge eating and eating disorder psychopathology and may represent an important target for interventions. Copyright © 2015. Published by Elsevier Ltd.

Physiologic Screening Test for Eating Disorders/Disordered Eating Among Female Collegiate Athletes.

PubMed

Black, David R.; Larkin, Laurie J.S.; Coster, Daniel C.; Leverenz, Larry J.; Abood, Doris A.

2003-12-01

OBJECTIVE: To develop and evaluate a physiologic screening test specifically designed for collegiate female athletes engaged in athletic competition or highly athletic performances in order to detect eating disorders/disordered eating. No such physiologically based test currently exists. METHODS: Subjects included 148 (84.5%) of 175 volunteer, National Collegiate Athletic Association Division I (n = 92), club (n = 15), and dance team (n = 41) athletes 18 to 25 years old who attended a large, Midwestern university. Participants completed 4 tests: 2 normed for the general population (Eating Disorders Inventory-2 and Bulimia Test-Revised); a new physiologic test, developed and pilot tested by the investigators, called the Physiologic Screening Test; and the Eating Disorder Exam 12.0D, a structured, validated, diagnostic interview used for criterion validity. RESULTS: The 18-item Physiologic Screening Test produced the highest sensitivity (87%) and specificity (78%) and was superior to the Eating Disorders Inventory-2 (sensitivity = 62%, specificity = 74%) and Bulimia Test-Revised (sensitivity = 27%, specificity = 99%). A substantial number (n = 51, 35%) of athletes were classified as eating disordered/disordered eating. CONCLUSIONS: The Physiologic Screening Test should be considered for screening athletes for eating disorders/disordered eating. The Physiologic Screening Test seems to be a viable alternative to existing tests because it is specifically designed for female athletes, it is brief (4 measurements and 14 items), and validity is enhanced and response bias is lessened because the purpose is less obvious, especially when included as part of a mandatory preparticipation examination.

A systematic review of cost-effectiveness studies of prevention and treatment for eating disorders.

PubMed

Le, Long Khanh-Dao; Hay, Phillipa; Mihalopoulos, Cathrine

2018-04-01

Eating disorders are serious mental disorders and are associated with substantial economic and social burden. The aim of this study is to undertake a systematic review of the cost-effectiveness studies of both preventive and treatment interventions for eating disorder. Electronic databases (including the Cochrane Controlled Trial Register, MEDLINE, PsycINFO, Academic Search Complete, Global Health, CINAHL complete, Health Business Elite, Econlit, Health Policy Reference Center and ERIC) were searched for published cost-effectiveness studies of eating disorder prevention and treatment including papers published up to January 2017. The quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. In all, 13 studies met the review inclusion criteria as full cost-effectiveness studies and 8 were published since 2011. The studies included three modelled and one trial-based study focused on prevention, two trial-based and one modelled study for anorexia nervosa treatment and three trial-based studies for bulimia nervosa treatment. The remaining studies targeted binge-eating disorder or non-specific eating disorder treatment. The average percent of CHEERS checklist items reported was 71% (standard deviation 21%). Eating disorder interventions were mainly cost-saving or more effective and more costly compared to comparators; however, some results did not reach statistical significance. In the two studies that achieved 100% CHEERS checklist, one study reported that a cognitive dissonance intervention might be cost-effective for prevention of anorexia nervosa and bulimia nervosa with a 90% participation rate and the second study supported lisdexamfetamine to be cost-effective in the treatment of binge-eating disorder. Insufficient evidence for long-term cost-effectiveness (e.g. over 2 years) was found. Cost-effectiveness studies in eating disorder appear to be increasing in number over the last 6 years. Findings were inconsistent and no firm conclusion can be drawn with regard to comparative value-for-money conclusions. However, some promising interventions were identified. Further research with improved methodology is required.

The role of media literacy in body dissatisfaction and disordered eating: A systematic review.

PubMed

McLean, Siân A; Paxton, Susan J; Wertheim, Eleanor H

2016-12-01

This study comprised a systematic review of literature examining empirical relationships between levels of media literacy and body dissatisfaction and disordered eating. The review aimed to integrate research on this topic. Electronic databases were searched for key concepts: media literacy, body dissatisfaction, and disordered eating. Media literacy measures were coded for consistency with media literacy constructs. Sixteen eligible studies were identified. Cross-sectional outcomes depended upon the media literacy construct assessed. Some relationships between high scores on measures consistent with media literacy constructs and low scores on body dissatisfaction and related attitudes were found. Media literacy-based interventions revealed improvements in media literacy constructs realism scepticism, influence of media, and awareness of media motives for profit, and improvements in body-related variables, but not disordered eating. Further research examining relationships between theoretically driven media literacy constructs and body and eating concerns is needed. Recommendations are made for evaluating media literacy-based eating disorder prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls.

PubMed

Bodell, Lindsay P; Wildes, Jennifer E; Cheng, Yu; Goldschmidt, Andrea B; Keenan, Kate; Hipwell, Alison E; Stepp, Stephanie D

2018-04-01

Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.

Population-based prevention of eating disorders: an application of the Rose prevention model.

PubMed

Austin, S B

2001-03-01

Several decades of concerted research on eating disorders have generated a broad range of proposed causal influences, but much of this etiologic research does not elucidate practical avenues for preventive interventions. Translating etiologic theory into community health interventions depends on the identification of key leverage points, factors that are amenable to public health intervention and provide an opportunity to maximize impact on the outcome of interest. Population-based preventive strategies, elaborated by epidemiologist Geoffrey Rose, can maximize the impact of public health interventions. In the case of eating disorders, Rose's model is instructive: Dieting stands out as risk behavior that may both fit Rose's model well and be a key leverage point for preventive intervention. Grounded in Rose's work, this article lodges a theoretical argument for the population-based prevention of eating disorders. In the introductory section, existing research on the epidemiology of dieting is reviewed, showing that it is extremely common among adolescent girls and women and that the behavior has been implicated as a causal factor for disordered eating. Next, new evidence is offered to build a case for how a population-wide reduction in dieting may be an effective strategy for prevention of eating pathology. Finally Rose's prevention framework is used to introduce a unique and provocative perspective on the prevention of eating disorders. Dieting is a normative behavior in our culture with psychological and physiological effects in the causal chain leading to eating pathology. This behavior may represent an ideal target for population-based prevention. Theoretical and empirical evidence suggests that a population-wide reduction in dieting may be a justifiable and effective strategy for prevention of eating pathology. Copyright 2001 American Health Foundation and Academic Press.

Multidisciplinary Treatment of Eating Disorders - Part 2: Primary Goals and Content of Treatment

ERIC Educational Resources Information Center

Stewart, Tiffany M.; Williamson, Donald A.

2004-01-01

This article describes the program content of a multidisciplinary, hospital-based program for severe eating disorders. Common goals for treatment of patients with eating disorders are discussed. Details about the specific therapeutic strategies used in individual and group therapy are provided. Also, information about dietary counseling and…

Transdiagnostic Theory and Application of Family-Based Treatment for Youth with Eating Disorders

PubMed Central

Loeb, Katharine L.; Lock, James; Le Grange, Daniel; Greif, Rebecca

2010-01-01

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. PMID:22328808

Prevalence and correlates of eating disorders among Asian Americans: results from the National Latino and Asian American Study.

PubMed

Nicdao, Ethel G; Hong, Seunghye; Takeuchi, David T

2007-11-01

Our study examines lifetime and 12-month prevalence estimates of eating disorders in Asian American men and women. We also report on the association between social factors and eating disorders, BMI categories, treatment, and impairment. We use data from the National Latino and Asian American Study, a nationally representative survey of the U.S. household population of Latino and Asian Americans. Our present study is based on data from the sample of Asian Americans (N = 2,095). Overall, Asian Americans present with low prevalence for eating disorders. Only lifetime prevalence for binge eating disorder (BED) is significantly higher for Asian women compared to Asian men. Our results show that age is strongly associated with BED and any binge eating. High current BMI of 30-39.9 and >or=40 is strongly associated with BED and any binge eating. Treatment utilization is low, and respondents reported some role impairment. Our findings show that despite low prevalence estimates, eating disorders are present among Asian American men and women. Our data suggest that researchers consider more flexibility in defining and classifying eating disorders, to better detect and measure the prevalence of eating disorders among Asian Americans. (c) 2007 by Wiley Periodicals, Inc.

Eating disorder risk, exercise dependence, and body weight dissatisfaction among female nutrition and exercise science university majors.

PubMed

Harris, Natalie; Gee, David; d'Acquisto, Debra; Ogan, Dana; Pritchett, Kelly

2015-09-01

Past research has examined eating disorder risk among college students majoring in Nutrition and has suggested an increased risk, while other studies contradict these results. Exercise Science majors, however, have yet to be fully examined regarding their risk for eating disorders and exercise dependence. Based on pressures to fit the image associated with careers related to these two disciplines, research is warranted to examine the potential risk for both eating disorder and exercise dependence. The purpose of this study is to compare eating disorder risk, exercise dependence, and body weight dissatisfaction (BWD) between Nutrition and Exercise Science majors, compared to students outside of these career pathways. Participants (n = 89) were divided into three groups based on major; Nutrition majors (NUTR; n = 31), Exercise Science majors (EXSC; n = 30), and other majors (CON; n = 28). Participants were given the EAT-26 questionnaire and the Exercise Dependence Scale. BWD was calculated as the discrepancy between actual BMI and ideal BMI. The majority of participants expressed a desire to weigh less (83%) and EXSC had significantly (p = .03) greater BWD than NUTR. However, there were no significant differences in eating disorder risk or exercise dependence among majors. This study suggested there was no significant difference in eating disorder risk or exercise dependence between the three groups (NUTR, EXSC, and CON).

Eating disorder risk, exercise dependence, and body weight dissatisfaction among female nutrition and exercise science university majors

PubMed Central

Harris, Natalie; Gee, David; D’Acquisto, Debra; Ogan, Dana; Pritchett, Kelly

2015-01-01

Background and Aims Past research has examined eating disorder risk among college students majoring in Nutrition and has suggested an increased risk, while other studies contradict these results. Exercise Science majors, however, have yet to be fully examined regarding their risk for eating disorders and exercise dependence. Based on pressures to fit the image associated with careers related to these two disciplines, research is warranted to examine the potential risk for both eating disorder and exercise dependence. The purpose of this study is to compare eating disorder risk, exercise dependence, and body weight dissatisfaction (BWD) between Nutrition and Exercise Science majors, compared to students outside of these career pathways. Methods Participants (n = 89) were divided into three groups based on major; Nutrition majors (NUTR; n = 31), Exercise Science majors (EXSC; n = 30), and other majors (CON; n = 28). Participants were given the EAT-26 questionnaire and the Exercise Dependence Scale. BWD was calculated as the discrepancy between actual BMI and ideal BMI. Results The majority of participants expressed a desire to weigh less (83%) and EXSC had significantly (p = .03) greater BWD than NUTR. However, there were no significant differences in eating disorder risk or exercise dependence among majors. Discussion and Conclusions This study suggested there was no significant difference in eating disorder risk or exercise dependence between the three groups (NUTR, EXSC, and CON). PMID:26551912

Comorbidity of mood and substance use disorders in patients with binge-eating disorder: Associations with personality disorder and eating disorder pathology.

PubMed

Becker, Daniel F; Grilo, Carlos M

2015-08-01

Binge-eating disorder (BED) is associated with elevated rates of mood and substance use disorders, but the significance of such comorbidity is ambiguous. We compared personality disorder and eating disorder psychopathology in four subgroups of BED patients: those with mood disorders, those with substance use disorders, those with both, and those with neither. Subjects were 347 patients who met DSM-IV research criteria for BED. Semistructured interviews evaluated lifetime DSM-IV axis I disorders, DSM-IV personality disorder features, and eating disorder psychopathology. Among these patients, 129 had co-occurring mood disorder, 34 had substance use disorder, 60 had both, and 124 had neither. Groups differed on personality disorder features, with those having mood disorder and both mood and substance use disorders showing the highest frequencies. Although groups did not differ in body mass index or binge eating frequency, they did differ on eating disorder psychopathology-with the groups having mood disorder and both comorbidities demonstrating higher eating, weight, and shape concerns. No differences were observed between groups with respect to ages of onset for specific eating behaviors, but some differences were observed for ages of disorder onset. Mood and substance use disorders co-occur frequently among patients with BED. Compared with a previous work, the additional comparison group (those with both mood and substance use disorders) and the control group (those with neither) afforded better discrimination regarding the significance of these comorbidities. Our findings suggest approaches to subtyping BED based on psychiatric comorbidity, and may also have implications for treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

The role of perfectionism, dichotomous thinking, shape and weight overvaluation, and conditional goal setting in eating disorders.

PubMed

Lethbridge, Jessica; Watson, Hunna J; Egan, Sarah J; Street, Helen; Nathan, Paula R

2011-08-01

This study examined the role of perfectionism (self-oriented and socially prescribed), shape and weight overvaluation, dichotomous thinking, and conditional goal setting in eating disorder psychopathology. Perfectionism and shape and weight overvaluation have had longstanding implication in the development and maintenance of eating disorders. A leading evidence-based theory of eating disorders (Fairburn, Cooper & Shafran, 2003) outlines perfectionism as a maintaining mechanism of eating disorder psychopathology and as a proximal risk factor for the development of shape and weight overvaluation. These constructs have been linked to other cognitive processes relevant to eating disorders, specifically, dichotomous thinking and conditional goal setting. Women with DSM-IV eating disorders (N=238) were compared to women in the general community (N=248) and, as hypothesised, scores on measures of these constructs were pronounced in the clinical sample. Hierarchical regression analyses predicting eating disorder psychopathology showed that for both groups, dichotomous thinking and conditional goal setting significantly improved model fit beyond perfectionism and shape and weight overvaluation alone. Self-oriented perfectionism, but not socially prescribed perfectionism, was relevant to eating disorder psychopathology. We discuss the implications for current treatment protocols and early intervention. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Adolescents with Type 1 Diabetes--The Impact of Gender, Age, and Health-Related Functioning on Eating Disorder Psychopathology.

PubMed

Wisting, Line; Bang, Lasse; Skrivarhaug, Torild; Dahl-Jørgensen, Knut; Rø, Øyvind

2015-01-01

To investigate correlates of eating disorder psychopathology in adolescent males and females with type 1 diabetes. A total of 105 adolescents with type 1 diabetes (42% males), aged 12-20 years, were recruited from the Norwegian Childhood Diabetes Registry in this population-based study. All participants were interviewed with the Child Eating Disorder Examination. Additionally, the Brief Illness Perception Questionnaire, the Adolescent Coping Orientation for Problem Experiences and the Beliefs about Medicines Questionnaire were administered to assess health-related functioning. Clinical data were obtained from the Norwegian Childhood Diabetes Registry. Significant gender differences were demonstrated in the pattern of correlates of eating disorder pathology. Among females, eating disorder psychopathology was significantly associated with body mass index adjusted for age and gender, age, insulin restriction, coping, illness perceptions, and perceptions of insulin concern. In a regression model, age, illness perceptions, and insulin restriction remained significantly associated with eating disorder psychopathology, explaining 48% of the variance. None of the variables were associated with eating disorder psychopathology among males. Greater clinical awareness of illness perceptions, attitudes toward insulin, and insulin restriction may potentially decrease the risk of developing eating disorders among female adolescents with type 1 diabetes, and the subsequent increased morbidity and mortality associated with comorbid type 1 diabetes and eating disorders.

Evaluation of the DSM-5 Severity Indicator for Anorexia Nervosa.

PubMed

Machado, Paulo P P; Grilo, Carlos M; Crosby, Ross D

2017-05-01

This study tested the new DSM-5 severity criterion for anorexia nervosa (AN) based on proposed body mass index (BMI) cut-points. Participants were a clinical sample of 201 treatment-seeking patients diagnosed with DSM-5 AN in Portugal. Participants were categorised based on DSM-5 severity levels and were compared on demographic and clinical variables assessed with the Eating Disorder Examination-Questionnaire. Based on DSM-5 severity definitions for AN, 73 (36.3%) participants were categorised as mild (≥17.0 BMI), 40 (19.9%) as moderate (16-16.99 BMI), 30 (14.9%) as severe (15-15.99 BMI) and 58 (28.9%) as extreme (<15 BMI). The severity groups did not differ significantly in age or gender. Analyses comparing the severity groups on measures of eating-disorder psychopathology revealed no significant differences on the Eating Disorder Examination-Questionnaire global or subscale scores. The groups also did not differ significantly on the frequency of binge eating or purging episodes within the past 28 days. Our findings, in this clinical sample of patients with AN in Portugal, provide no evidence for the new DSM-5 severity ratings based on BMI level. Further research on the validity of the DSM-5 specifiers is needed and should test additional clinical or functional variables and especially prognostic utility for course and outcome across eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Effects of Tailored and ACT-Influenced Internet-Based CBT for Eating Disorders and the Relation Between Knowledge Acquisition and Outcome: A Randomized Controlled Trial.

PubMed

Strandskov, Sandra Weineland; Ghaderi, Ata; Andersson, Hedvig; Parmskog, Nicole; Hjort, Emelie; Wärn, Anna Svanberg; Jannert, Maria; Andersson, Gerhard

2017-09-01

This is the first trial to investigate the outcome of tailored and ACT-influenced, cognitive behavioral Internet treatment for eating disorder psychopathology, and the relation between knowledge acquisition and outcome. This study utilized a randomized controlled design, with computer-based allocation to treatment or waiting list control group. Participants were recruited via advertisements in social media and newspapers in Sweden. Participants fulfilling the criteria for bulimia nervosa (BN), or Eating Disorder Not Otherwise Specified (EDNOS), with a BMI above 17.5, were enrolled in the study (N = 92). The treatment group received an Internet-based, ACT-influenced CBT intervention, developed by the authors, for eating disorders. The treatment lasted 8 weeks, and was adapted to the participant's individual needs. A clinician provided support. The main outcome measures were eating disorder symptoms and body shape dissatisfaction. Intent-to-treat analysis showed that the treatment group (n = 46) improved significantly on eating disorder symptoms and body dissatisfaction, compared with the waiting list control group (n = 46), with small to moderate effect sizes (between group effects, d = 0.35-0.64). More than a third of the participants in the treatment group (36.6%), compared to 7.1% in the waiting list control condition, made clinically significant improvements. Results showed a significant increase in knowledge in the treatment group compared to the waiting list control group (between group effect, d = 1.12), but we found no significant correlations between knowledge acquisition and outcome (r= -0.27 to -r = 0.23). The results provide preliminary support for Internet-based, tailored, and ACT-influenced treatment, based on CBT for participants with eating disorder psychopathology. Copyright © 2017. Published by Elsevier Ltd.

Cost-effectiveness of achieving clinical improvement with a dissonance-based eating disorder prevention program.

PubMed

Akers, Laura; Rohde, Paul; Stice, Eric; Butryn, Meghan L; Shaw, Heather

2017-01-01

Using data from an effectiveness trial delivered by college clinicians, we examined the cost-effectiveness of the dissonance-based Body Project program for reducing eating disorder symptoms in women with body dissatisfaction. The outcome of interest was individual-level change; 14.9% of Body Project participants attained clinically meaningful improvement vs. 6.7% of controls. Delivering the intervention costs approximately $70 (2012 U.S. dollars) per person. Incremental cost-effectiveness was $838 for each additional at-risk person reducing eating disorder symptomology to a clinically meaningful degree. These analyses demonstrate the economic value of the Body Project for college-age women with symptoms below the eating disorder diagnosis threshold.

Randomized Controlled Pilot Trial of a Novel Dissonance-Based Group Treatment for Eating Disorders

PubMed Central

Stice, Eric; Rohde, Paul; Butryn, Meghan; Menke, Katharine S.; Marti, C. Nathan

2015-01-01

Objective Conduct a pilot trial of a new dissonance-based group eating disorder treatment designed to be a cost-effective front-line transdiagnostic treatment that could be more widely disseminated than extant individual or family treatments that are more expensive and difficult to deliver. Method Young women with a DSM-5 eating disorder (N = 72) were randomized to an 8-week dissonance-based Body Acceptance Therapy group treatment or a usual care control condition, completing diagnostic interviews and questionnaires at pre, post, and 2-month follow-up. Results Intent-to-treat analyses revealed that intervention participants showed greater reductions in outcomes than usual care controls in a multivariate multilevel model (χ2[6] = 34.1, p < .001), producing large effects for thin-ideal internalization (d = 0.79), body dissatisfaction (d = 1.14), and blinded interview-assessed eating disorder symptoms (d = .95), and medium effects for dissonance regarding perpetuating the thin ideal (d = .65) and negative affect (d = .55). Midway through this pilot we refined engagement procedures, which was associated with increased effect sizes (e.g., the d for eating disorder symptoms increased from .51 to 2.30). Conclusions This new group treatment produced large reductions in eating disorder symptoms, which is encouraging because it requires about 1/20th the therapist time necessary for extant individual and family treatments, and has the potential to provide a cost-effective and efficacious approach to reaching the majority of individuals with eating disorders who do not presently received treatment. PMID:25577189

Eating Disorders, Autoimmune, and Autoinflammatory Disease.

PubMed

Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte; Thornton, Laura M; Quaranta, Michela; Koch, Susanne Vinkel; Pisetsky, David; Mortensen, Preben Bo; Bulik, Cynthia M

2017-12-01

Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that autoimmune and autoinflammatory diseases would be associated with eating disorders in children and adolescents and that family history of these illnesses would be associated with eating disorders in probands. In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930 977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations. We found significantly higher hazards of eating disorders for children and adolescents with autoimmune or autoinflammatory diseases: 36% higher hazard for anorexia nervosa, 73% for bulimia nervosa, and 72% for an eating disorder not otherwise specified. The association was particularly strong in boys. Parental autoimmune or autoinflammatory disease history was associated with significantly increased odds for anorexia nervosa (odds ratio [OR] = 1.13, confidence interval [CI] = 1.01-1.25), bulimia nervosa (OR = 1.29; CI = 1.08-1.55) and for an eating disorder not otherwise specified (OR = 1.27; CI = 1.13-1.44). Autoimmune and autoinflammatory diseases are associated with increased risk for eating disorders. Ultimately, understanding the role of immune system disturbance for the etiology and pathogenesis of eating disorders could point toward novel treatment targets. Copyright © 2017 by the American Academy of Pediatrics.

Using real-time fMRI brain-computer interfacing to treat eating disorders.

PubMed

Sokunbi, Moses O

2018-05-15

Real-time functional magnetic resonance imaging based brain-computer interfacing (fMRI neurofeedback) has shown encouraging outcomes in the treatment of psychiatric and behavioural disorders. However, its use in the treatment of eating disorders is very limited. Here, we give a brief overview of how to design and implement fMRI neurofeedback intervention for the treatment of eating disorders, considering the basic and essential components. We also attempt to develop potential adaptations of fMRI neurofeedback intervention for the treatment of anorexia nervosa, bulimia nervosa and binge eating disorder. Copyright © 2018 Elsevier B.V. All rights reserved.

Prevalence of eating disorder risk and body image distortion among National Collegiate Athletic Association Division I varsity equestrian athletes.

PubMed

Torres-McGehee, Toni M; Monsma, Eva V; Gay, Jennifer L; Minton, Dawn M; Mady-Foster, Ashley N

2011-01-01

Participation in appearance-based sports, particularly at the collegiate level, may place additional pressures on female athletes to be thin, which may increase the likelihood of their resorting to drastic weight control measures, such as disordered eating behaviors. (1) To estimate the prevalence and sources of eating disorder risk classification by academic status (freshman, sophomore, junior, or senior) and riding discipline (English and Western), (2) to examine riding style and academic status variations in body mass index (BMI) and silhouette type, and (3) to examine these variations across eating disorder risk classification type (eg, body image disturbances). Cross-sectional study. Seven universities throughout the United States. A total of 138 participants volunteered (mean age = 19.88 ± 1.29 years). They represented 2 equestrian disciplines English riding (n = 91) and Western riding (n = 47). Participants self-reported menstrual cycle history, height, and weight. We screened for eating disorder risk behaviors with the Eating Attitudes Test and for body disturbance with sex-specific BMI silhouettes. Based on the Eating Attitudes Test, estimated eating disorder prevalence was 42.0% in the total sample, 38.5% among English riders, and 48.9% among Western riders. No BMI or silhouette differences were found across academic status or discipline in disordered eating risk. Overall, participants perceived their body images as significantly larger than their actual physical sizes (self-reported BMI) and wanted to be significantly smaller in both normal clothing and competitive uniforms. Disordered eating risk prevalence among equestrian athletes was similar to that reported in other aesthetic sports and lower than that in nonaesthetic sports. Athletic trainers working with these athletes should be sensitive to these risks and refer athletes as needed to clinicians knowledgeable about disordered eating. Professionals working with this population should avoid making negative comments about physical size and appearance.

Poor self-recognition of disordered eating among girls with bulimic-type eating disorders: cause for concern?

PubMed

Gratwick-Sarll, Kassandra; Bentley, Caroline; Harrison, Carmel; Mond, Jonathan

2016-08-01

Bulimic-type eating disorders are common among young women and associated with high levels of distress and disability and low uptake of mental health care. We examined self-recognition of disordered eating and factors associated with this among female adolescents with bulimic-type eating disorders (n = 139) recruited from a large, population-based sample. A vignette of a fictional character with bulimia nervosa was presented, followed by a series of questions addressing the nature and treatment of the problem described. One of these questions required participants to indicate whether they currently had a problem such as the one described. Self-report measures of eating disorder symptoms, general psychological distress and quality of life were also completed. More than half of participants (58%) did not believe that they currently had a problem with their eating. In multivariable analysis, impairment in emotional well-being and self-induced vomiting were the only variables independently associated with self-recognition. Participants who recognized a problem with their eating were more likely to have sought treatment for an eating problem than those who did not. Recognition of disordered eating among adolescents with bulimic-type eating disorders may be poor and this may be a factor in low uptake of mental health care. Health promotion efforts may need to address the misconception that only bulimic-type disorders involving self-induced vomiting are pathological. © 2014 Wiley Publishing Asia Pty Ltd.

Disordered eating attitude and associated factors among high school adolescents aged 12-19 years in Addis Ababa, Ethiopia: a cross-sectional study.

PubMed

Yirga, Belachew; Assefa Gelaw, Yalemzewod; Derso, Terefe; Wassie, Molla Mesele

2016-12-07

Eating disorders are very complex, frequently developed and have a public health impact on adolescents. Different studies revealed that eating disorders is a pressing public health problem among adolescents. Eating disorders may also lead to mortality due to their physiological sequelae. There is no previous study regarding disordered of eating attitude in Ethiopian adolescents. Therefore, this study aimed to assess prevalence of disordered eating attitude and its associated factors among adolescents in Addis Ababa high schools. A school-based cross sectional study was conducted. Data were collected among 836 high school adolescents aged 12-19 years from May to June, 2015 in Addis Ababa city. The data were collected by self-administered questionnaire containing eating attitudes test-26 items (EAT-26) and socio-demographic factors. Binary logistic regression analysis was carried out to identify factors associated with disordered eating attitude. Both crude odds ratio and adjusted odds ratio were calculated to show the strength of association. In multivariable analysis, variables with a P value of <0.05 were considered statistically significant. The prevalence of disordered eating attitude among adolescents was 8.6% [95% CI 4.9, 12.3]. Being female [AOR = 1.75, 95% CI 1.03, 3.00], Mother's educational status (Primary [AOR = 0.28, 95% CI 0.11, 0.78], Certificate/diploma [AOR = 0.22, 95% CI 0.07, 0.58] and first degree and above [AOR = 0.16, 95% CI 0.07, 0.40]) were found to be significantly associated with disordered eating attitude. The finding of this study revealed that a significant number of adolescents were susceptible to developing disordered eating attitude. Being female and Mothers' education status were significantly associated with disordered eating attitude among adolescents. Provision of screening test for eating disorders focusing on female adolescents is highly recommended.

Readiness and motivation for change among young women with broadly defined eating disorders.

PubMed

Ålgars, Monica; Ramberg, Carin; Moszny, Josefine; Hagman, Jessica; Rintala, Hanna; Santtila, Pekka

2015-01-01

Readiness and motivation for change were examined in 32 women with broadly defined eating disorders who took part in a 10-week Cognitive Behavioral Therapy (CBT)-based group intervention. Readiness for change and eating disorder psychopathology were assessed before and after the intervention. The results revealed significant negative associations between degree of eating disorder symptoms and degree of readiness for change before the intervention started. In particular, higher levels of eating concern, shape concern, and body dissatisfaction were associated with lower motivation for change. No significant associations between degree of readiness for change before the intervention started and changes in eating disorder symptoms at the end of intervention were found. Readiness for change increased from the beginning to the end of the intervention, indicating that group CBT may be a cost-effective and time-efficient way of enhancing readiness and motivation for change in individuals with eating psychopathology.

Women with Bulimic Eating Disorders: When Do They Receive Treatment for an Eating Problem?

ERIC Educational Resources Information Center

Mond, J. M.; Hay, P. J.; Darby, A.; Paxton, S. J.; Quirk, F.; Buttner, P.; Owen, C.; Rodgers, B.

2009-01-01

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…

Policy Actions to Address Weight-Based Bullying and Eating Disorders in Schools: Views of Teachers and School Administrators

ERIC Educational Resources Information Center

Puhl, Rebecca M.; Neumark-Sztainer, Dianne; Bryn Austin, S.; Suh, Young; Wakefield, Dorothy B.

2016-01-01

Background: Weight-related bullying is prevalent among youth and associated with adverse health consequences, including increased risk for body dissatisfaction and disordered eating behaviors, which are risk factors for eating disorders. Although concerns about these problems have stimulated calls for broader intervention efforts in schools,…

Fostering a Healthy Body Image: Prevention and Intervention with Adolescent Eating Disorders

ERIC Educational Resources Information Center

Giles, Michelle; Hass, Michael

2008-01-01

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…

Risk Factors for Full- and Partial-Syndrome Early Adolescent Eating Disorders: A Population-Based Pregnancy Cohort Study

ERIC Educational Resources Information Center

Allen, Karina L.; Byrne, Susan M.; Forbes, David; Oddy, Wendy H.

2009-01-01

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…

Policy Actions to Address Weight-Based Bullying and Eating Disorders in Schools: Views of Teachers and School Administrators.

PubMed

Puhl, Rebecca M; Neumark-Sztainer, Dianne; Bryn Austin, S; Suh, Young; Wakefield, Dorothy B

2016-07-01

Weight-related bullying is prevalent among youth and associated with adverse health consequences, including increased risk for body dissatisfaction and disordered eating behaviors, which are risk factors for eating disorders. Although concerns about these problems have stimulated calls for broader intervention efforts in schools, actions thus far have been limited. This study examined educators' perspectives about potential policy actions to address these issues in schools. Educators (N = 240) completed an online questionnaire assessing their support for 11 potential school-based policy actions to address weight-related bullying and eating disorders. Participants also rated policies according to their feasibility and potential for positive impact. Forty-eight percent of participants observed weight-related bullying in their school and 99% expressed the importance of intervening in such incidents. A large majority (75%-94%) supported 8 of the 11 policies, especially actions requiring school-based health curriculum to include content on eating disorder prevention (94%), and addressing weight-bullying through antibullying policies (92%), staff training (89%), and school curriculum (89%). Strongly supported policies were viewed by participants as being the most impactful and feasible to implement. Educators recognize weight-related bullying and eating disorders as problems in their schools that warrant improved prevention and intervention efforts at the policy level. © 2016, American School Health Association.

One-year outcome and incidence of anorexia nervosa and restrictive eating disorders among adolescent girls treated as out-patients in a family-based setting

PubMed Central

Rosling, Agneta; Salonen Ros, Helena; Swenne, Ingemar

2016-01-01

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

One-year outcome and incidence of anorexia nervosa and restrictive eating disorders among adolescent girls treated as out-patients in a family-based setting.

PubMed

Rosling, Agneta; Salonen Ros, Helena; Swenne, Ingemar

2016-01-01

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.

Negative affective experiences in relation to stages of eating disorder recovery.

PubMed

Harney, Megan B; Fitzsimmons-Craft, Ellen E; Maldonado, Christine R; Bardone-Cone, Anna M

2014-01-01

The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n=53), partially recovered (n=15; psychological criteria not met), and fully recovered (n=20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal functioning and social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this, in turn, has salutatory effects on depression, anxiety, and perceived stress. © 2013.

Negative Affective Experiences in Relation to Stages of Eating Disorder Recovery

PubMed Central

Harney, Megan B.; Fitzsimmons-Crafr, Ellen E.; Maldonado, Christine R.; Bardone-Cone, Anna M.

2013-01-01

The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n =53), partially recovered (n =15; psychological criteria not met), and fully recovered (n =20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal, social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this, in turn, has salutatory effects on depression, anxiety, and perceived stress. PMID:24411745

Innovation in eating disorders research and practice: Expanding our community and perspectives at the 2018 International Conference on Eating Disorders: Editorial to accompany IJED Virtual Issue in honor of the 2018 International Conference on Eating Disorders.

PubMed

Diedrichs, Phillippa C; von Ranson, Kristin M; Thomas, Jennifer J

2018-06-01

This virtual issue of the International Journal of Eating Disorders (IJED) highlights the excellent and innovative research and practice discussed at the 2018 International Conference on Eating Disorders held in Chicago, Illinois, USA. The virtual issue contains a series of articles recently published in IJED, which we have curated to reflect and expand on the insights delivered during the conference keynote and plenary presentations. In line with the conference theme of Innovation in Research and Practice: Expanding our Community and Perspectives, we hope this collection of articles will spark new ideas for research, practice, and collaboration to accelerate knowledge on eating disorder risk factors and recovery, and the reach and impact of evidence-based treatment, prevention, and policy efforts. © 2018 Wiley Periodicals, Inc.

Reducing the burden of suffering from eating disorders: Unmet treatment needs, cost of illness, and the quest for cost-effectiveness.

PubMed

Striegel Weissman, Ruth; Rosselli, Francine

2017-01-01

Eating disorders are serious mental disorders as reflected in significant impairments in health and psychosocial functioning and excess mortality. Despite the clear evidence of clinical significance and despite availability of evidence-based, effective treatments, research has shown a paradox of elevated health services use and, yet, infrequent treatment specifically targeting the eating disorder (i.e., high unmet treatment need). This review paper summarizes key studies conducted in collaboration with G. Terence Wilson and offers an update of the research literature published since 2011 in three research areas that undergirded our collaborative research project: unmet treatment needs, cost of illness, and cost-effectiveness of treatments. In regards to unmet treatment needs, epidemiological studies find that the number of individuals with an eating disorder who do not receive disorder-specific treatment continues to remain high. Cost-of-illness show that eating disorders are associated with substantial financial burdens for individuals, their family, and society, yet comprehensive examination of costs across public sectors is lacking. Cost measures vary widely, making it difficult to draw firm conclusions. Hospitalization is a major driver of medical costs incurred by individuals with an eating disorder. Only a handful of cost-effectiveness studies have been conducted, leaving policy makers with little information on which to base decisions about allocation of resources to help reduce the burden of suffering attributable to eating disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mindfulness-based prevention for eating disorders: A school-based cluster randomized controlled study.

PubMed

Atkinson, Melissa J; Wade, Tracey D

2015-11-01

Successful prevention of eating disorders represents an important goal due to damaging long-term impacts on health and well-being, modest treatment outcomes, and low treatment seeking among individuals at risk. Mindfulness-based approaches have received early support in the treatment of eating disorders, but have not been evaluated as a prevention strategy. This study aimed to assess the feasibility, acceptability, and efficacy of a novel mindfulness-based intervention for reducing the risk of eating disorders among adolescent females, under both optimal (trained facilitator) and task-shifted (non-expert facilitator) conditions. A school-based cluster randomized controlled trial was conducted in which 19 classes of adolescent girls (N = 347) were allocated to a three-session mindfulness-based intervention, dissonance-based intervention, or classes as usual control. A subset of classes (N = 156) receiving expert facilitation were analyzed separately as a proxy for delivery under optimal conditions. Task-shifted facilitation showed no significant intervention effects across outcomes. Under optimal facilitation, students receiving mindfulness demonstrated significant reductions in weight and shape concern, dietary restraint, thin-ideal internalization, eating disorder symptoms, and psychosocial impairment relative to control by 6-month follow-up. Students receiving dissonance showed significant reductions in socio-cultural pressures. There were no statistically significant differences between the two interventions. Moderate intervention acceptability was reported by both students and teaching staff. Findings show promise for the application of mindfulness in the prevention of eating disorders; however, further work is required to increase both impact and acceptability, and to enable successful outcomes when delivered by less expert providers. © 2015 Wiley Periodicals, Inc.

Eating Disorders, Pregnancy, and the Postpartum Period: Findings from the Norwegian Mother and Child Cohort Study (MoBa)

PubMed Central

Watson, Hunna J.; Torgersen, Leila; Zerwas, Stephanie; Reichborn-Kjennerud, Ted; Knoph, Cecilie; Stoltenberg, Camilla; Siega-Riz, Anna Maria; Von Holle, Ann; Hamer, Robert M.; Meltzer, Helle; Ferguson, Elizabeth H.; Haugen, Margaretha; Magnus, Per; Kuhns, Rebecca; Bulik, Cynthia M.

2016-01-01

This review summarizes studies on eating disorders in pregnancy and the postpartum period that have been conducted as part of the broader Norwegian Mother and Child Cohort Study (MoBa). Prior to the 2000s, empirical literature on eating disorders in pregnancy was sparse and consisted mostly of studies in small clinical samples. MoBa has contributed to a new era of research by making population-based and large-sample research possible. To date, MoBa has led to 19 studies on diverse questions including the prevalence, course, and risk correlates of eating disorders during pregnancy and the postpartum. The associations between eating disorder exposure and pregnancy, birth and obstetric outcomes, and maternal and offspring health and well-being, have also been areas of focus. The findings indicate that eating disorders in pregnancy are relatively common and appear to confer health risks to mother and her child related to sleep, birth outcomes, maternal nutrition, and child feeding and eating. PMID:27110061

Earlier predictors of eating disorder symptoms in 9-year-old children. A longitudinal study.

PubMed

Parkinson, Kathryn N; Drewett, Robert F; Le Couteur, Ann S; Adamson, Ashley J

2012-08-01

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. Copyright © 2012 Elsevier Ltd. All rights reserved.

Convergent dysregulation of frontal cortical cognitive and reward systems in eating disorders.

PubMed

Stefano, George B; Ptáček, Radek; Kuželová, Hana; Mantione, Kirk J; Raboch, Jiří; Papezova, Hana; Kream, Richard M

2013-05-10

A substantive literature has drawn a compelling case for the functional involvement of mesolimbic/prefrontal cortical neural reward systems in normative control of eating and in the etiology and persistence of severe eating disorders that affect diverse human populations. Presently, we provide a short review that develops an equally compelling case for the importance of dysregulated frontal cortical cognitive neural networks acting in concert with regional reward systems in the regulation of complex eating behaviors and in the presentation of complex pathophysiological symptoms associated with major eating disorders. Our goal is to highlight working models of major eating disorders that incorporate complementary approaches to elucidate functionally interactive neural circuits defined by their regulatory neurochemical phenotypes. Importantly, we also review evidence-based linkages between widely studied psychiatric and neurodegenerative syndromes (e.g., autism spectrum disorders and Parkinson's disease) and co-morbid eating disorders to elucidate basic mechanisms involving dopaminergic transmission and its regulation by endogenously expressed morphine in these same cortical regions.

The Latent Class Structure of Chinese Patients with Eating Disorders in Shanghai.

PubMed

Zheng, Yuchen; Kang, Qing; Huang, Jiabin; Jiang, Wenhui; Liu, Qiang; Chen, Han; Fan, Qing; Wang, Zhen; Chen, Jue; Xiao, Zeping

2017-08-25

Eating disorder is culture related, and the clinical symptoms are different between eastern and western patients. So the validity of feeding and eating disorders in the upcoming ICD-11 guide for Chinese patients is unclear. To explore the latent class structure of Chinese patients with eating disorder and the cross-cultural validity of the eating disorder section of the new ICD-11 guide in China. A total of 379 patients with eating disorders at Shanghai Mental Health Center were evaluated using the EDI questionnaire and a questionnaire developed by researchers from 2010 to 2016. SPSS 20.0 was used to enter data and analyze demographic data, and Latent GOLD was employed to conduct latent profile analysis. According to the results of latent profile analysis, patients with eating disorder were divided into five classes: low-weight fasting class (23.1%), non-fat-phobic binge/purge class (21.54%), low-fat-phobic binge class (19.27%), fat-phobic binge class (19.27%), and non-fat-phobic low-weight class (16.76%). Among the clinical symptoms extracted, there were significant differences in Body Mass Index (BMI), binge eating behavior, self-induced vomiting, laxative use and fat-phobic opinion; while there was no significant difference in restrictive food intake. Based on the clinical symptoms, there are five latent classes in Chinese patients with eating disorder, which is in accordance with the diagnostic categories of feeding and eating disorder in ICD-11. However, further work is needed in improving the fat-phobic opinion of patients with eating disorder and clarifying the BMI standard of thinness in the Chinese population.

Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: a narrative review.

PubMed

Mitchison, Deborah; Mond, Jonathan

2015-01-01

Challenges to epidemiological studies of eating and related body image disturbance disorders in males include, in addition to low base rates and the predominance of residual diagnostic categories, the female-centric nature of current classification schemes and the consequent lack of appropriate assessment instruments. In this narrative review, we summarise epidemiological data regarding the prevalence and correlates of eating disorders, related body image disturbance disorders, and eating disorder features in males. Attention is focused on disorders most likely to be observed among males, such as muscle dysmorphia and muscularity-oriented excessive exercise. It is argued that, given the multiple challenges involved in research of this kind, a focus on features is more likely to advance the field than a focus on diagnoses. In terms of correlates, we focus on impairment and help-seeking, since these issues are most relevant in informing public health burden, service provision, and related issues. We end with some thoughts about current gaps in the knowledge base and directions for future research that we consider to be most promising.

Defining Features of Unhealthy Exercise Associated with Disordered Eating and Eating Disorder Diagnoses

PubMed Central

Holland, Lauren A.; Brown, Tiffany A.; Keel, Pamela K.

2013-01-01

Objectives The current study sought to compare different features of unhealthy exercise on associations with disordered eating and their ability to identify individuals with eating disorders. A secondary aim of the study was to compare prevalence and overlap of different aspects of unhealthy exercise and potential differences in their gender distribution. Design Cross-sectional epidemiological study. Methods A community-based sample of men (n=592) and women (n=1468) completed surveys of health and eating patterns, including questions regarding exercise habits and eating disorder symptoms. Results Compulsive and compensatory features of exercise were the best predictors of disordered eating and eating disorder diagnoses compared to exercise that was excessive in quantity. Further, compulsive and compensatory aspects of unhealthy exercise represented overlapping, yet distinct qualities in both men and women. Conclusions Including the compulsive quality among the defining features of unhealthy exercise may improve identification of eating disorders, particularly in men. Results suggest that the compensatory aspect of unhealthy exercise is not adequately captured by the compulsive aspect of unhealthy exercise. Thus, interventions that target unhealthy exercise behaviors among high-risk individuals, such as athletes, may benefit from addressing both the compulsive and compensatory aspects of unhealthy exercise. Future prospective longitudinal studies will aid in determining the direction of the association between these features of unhealthy exercise and the onset of eating pathology. PMID:24391457

[Self-esteem: a comparison study between eating disorders and social phobia].

PubMed

Eiber, R; Vera, L; Mirabel-Sarron, C; Guelfi, J-D

2003-01-01

Eating disorder patients evidenced very often a low self-esteem. Self-esteem in eating disorder patients is excessively based on body dissatisfaction. In eating disorders there seems to be a link between body image dissatisfaction and social anxiety. We hypothesised: self-esteem would be as low in eating disorder patients as in social phobia patients; self-esteem would be lower in eating disorder patients with social phobia than in patients with social phobia alone; self-esteem would be lower in eating disorder patients with depressive cognitions than in social phobia patients with depressive cognitions; self-esteem could have different characteristics in the two disorders; self-esteem would be as low in anorexia as in bulimia; 103 eating disorder patients (33 restrictive anorectics, 34 anorectics-bulimics, 36 bulimics) and 26 social phobia patients diagnosed according to DSM IV and ICD-10 criteria have been investigated by the Self-Esteem Inventory of Coopersmith, the Assertiveness Schedule of Rathus, the Fear Survey Schedule of Wolpe (FSS III) and the Beck Depression Inventory (BDI). Patients were free of medication and presented no episode of major depression according to DSM IV criteria. Evaluations took place before any psychotherapy. Self-esteem in eating disorder patients is reduced at the same level as in social phobia patients; 86.1% of the total sample and 84.5% of the eating disorder patients have a very low self-esteem (score 33 in the SEI). Eating disorder patients have significantly higher scores in the Social (p=0.016) and Professional (p=0.0225) sub-scales of the SEI than social phobia patients. Eating disorder patients show higher scores on the Assertiveness Schedule of Rathus (p=0.0013) than social phobia patients. Eating disorder patients disclose higher scores on the BDI (p=0.0003) but eating disorder patients with depressive cognitions do not differ from social phobia patients with depressive cognitions in the level of self-esteem. The FSS III scores are significantly lower in eating disorder patients (p<0.0001). There is a difference in the nature of the deficit of self-esteem between the two patient populations. Self-esteem is not influenced by the Body Mass Index (BMI) and is identically reduced in all groups of eating disorder patients. Whereas eating disorder patients have the same complaints compared to social phobia, they differ significantly from social phobia patients in their characteristics of social phobia and self-esteem.

Cognitive-behavioural therapy for outpatients with eating disorders: effectiveness for a transdiagnostic group in a routine clinical setting.

PubMed

Turner, Hannah; Marshall, Emily; Stopa, Lusia; Waller, Glenn

2015-05-01

Whilst there is a growing evidence to support the impact of cognitive-behavioural therapy (CBT) in the treatment of adults with eating disorders, much of this evidence comes from tightly controlled efficacy trials. This study aimed to add to the evidence regarding the effectiveness of CBT when delivered in a routine clinical setting. The participants were 203 adults presenting with a range of eating disorder diagnoses, who were offered CBT in an out-patient community eating disorders service in the UK. Patients completed measures of eating disorder pathology at the start of treatment, following the sixth session, and at the end of treatment. Symptoms of anxiety, depression, and psychosocial functioning were measured pre- and post-treatment. Approximately 55% of patients completed treatment, and there were no factors that predicted attrition. There were significant improvements in eating disorder psychopathology, anxiety, depression and general functioning, with particular changes in eating attitudes in the early part of therapy. Effect sizes were medium to large for both completer and intention to treat analyses. These findings confirm that evidence-based forms of CBT can be delivered with strong outcomes in routine clinical settings. Clinicians should be encouraged to deliver evidence-based treatments when working in these settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are the Gut Bacteria Telling Us to Eat or Not to Eat? Reviewing the Role of Gut Microbiota in the Etiology, Disease Progression and Treatment of Eating Disorders

PubMed Central

Lam, Yan Y.; Maguire, Sarah; Palacios, Talia; Caterson, Ian D.

2017-01-01

Traditionally recognized as mental illnesses, eating disorders are increasingly appreciated to be biologically-driven. There is a growing body of literature that implicates a role of the gut microbiota in the etiology and progression of these conditions. Gut bacteria may act on the gut–brain axis to alter appetite control and brain function as part of the genesis of eating disorders. As the illnesses progress, extreme feeding patterns and psychological stress potentially feed back to the gut ecosystem that can further compromise physiological, cognitive, and social functioning. Given the established causality between dysbiosis and metabolic diseases, an altered gut microbial profile is likely to play a role in the co-morbidities of eating disorders with altered immune function, short-chain fatty acid production, and the gut barrier being the key mechanistic links. Understanding the role of the gut ecosystem in the pathophysiology of eating disorders will provide critical insights into improving current treatments and developing novel microbiome-based interventions that will benefit patients with eating disorders. PMID:28613252

Are the Gut Bacteria Telling Us to Eat or Not to Eat? Reviewing the Role of Gut Microbiota in the Etiology, Disease Progression and Treatment of Eating Disorders.

PubMed

Lam, Yan Y; Maguire, Sarah; Palacios, Talia; Caterson, Ian D

2017-06-14

Traditionally recognized as mental illnesses, eating disorders are increasingly appreciated to be biologically-driven. There is a growing body of literature that implicates a role of the gut microbiota in the etiology and progression of these conditions. Gut bacteria may act on the gut-brain axis to alter appetite control and brain function as part of the genesis of eating disorders. As the illnesses progress, extreme feeding patterns and psychological stress potentially feed back to the gut ecosystem that can further compromise physiological, cognitive, and social functioning. Given the established causality between dysbiosis and metabolic diseases, an altered gut microbial profile is likely to play a role in the co-morbidities of eating disorders with altered immune function, short-chain fatty acid production, and the gut barrier being the key mechanistic links. Understanding the role of the gut ecosystem in the pathophysiology of eating disorders will provide critical insights into improving current treatments and developing novel microbiome-based interventions that will benefit patients with eating disorders.

Internet-based motivation program for women with eating disorders: eating disorder pathology and depressive mood predict dropout.

PubMed

von Brachel, Ruth; Hötzel, Katrin; Hirschfeld, Gerrit; Rieger, Elizabeth; Schmidt, Ulrike; Kosfelder, Joachim; Hechler, Tanja; Schulte, Dietmar; Vocks, Silja

2014-03-31

One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology. The aim of the present study was to identify predictors of dropout from this Web program. A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants' age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method. The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout. Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.

Internet-Based Motivation Program for Women With Eating Disorders: Eating Disorder Pathology and Depressive Mood Predict Dropout

PubMed Central

Hirschfeld, Gerrit; Rieger, Elizabeth; Schmidt, Ulrike; Kosfelder, Joachim; Hechler, Tanja; Schulte, Dietmar; Vocks, Silja

2014-01-01

Background One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology. Objective The aim of the present study was to identify predictors of dropout from this Web program. Methods A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants’ age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method. Results The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout. Conclusions Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment. PMID:24686856

Disordered eating in college sorority women: A social network analysis of a subset of members from a single sorority chapter.

PubMed

Becker, Kendra R; Stojek, Monika M; Clifton, Allan; Miller, Joshua D

2018-06-07

Disordered eating attitudes and behaviors are prevalent among college women, and peers appear to influence current and future eating pathology. Social network analysis (SNA) is an innovative quantitative method to examine relationships (i.e., ties) among people based on their various attributes. In this study, the social network of one sorority was modeled using exponential random graph model (ERGM) to explore if homophily, or the tendency for relationship ties to exist based on shared attributes, was present according to sorority members' disordered eating behaviors/attitudes and their body mass index (BMI). Participants included members of one sorority at a large Southeastern university. All members were included on a roster unless they elected to opt out during the consent process, and 41 (19%) of the members completed the study measures. Participants completed the Social Network Questionnaire developed for this study (degree of "liking" of every member on the roster), the Eating Disorder Examination-Questionnaire (EDE-Q), and a demographics questionnaire in exchange for 1 h of community service credit. The final sample consisted of mostly White women with an average age of 20. Homophily across liking ties was examined based on the EDE-Q Global scale, episodes of binge eating, and BMI. The greater the difference in EDE-Q scores, the more likely the participants were to like one another. The greater the difference in BMI, the less likely the participants were to like one another. Binge eating was unrelated to homophily. College sorority women appear to prefer other women with dissimilar levels of disordered eating attitudes, suggesting complex interactions between stigmatized or valued disordered eating attributes. Women with similar BMI were more likely to like one another, confirming past findings. Copyright © 2018. Published by Elsevier Ltd.

Clinician-led, peer-led, and internet-delivered dissonance-based eating disorder prevention programs: Acute effectiveness of these delivery modalities.

PubMed

Stice, Eric; Rohde, Paul; Shaw, Heather; Gau, Jeff M

2017-09-01

Because independent trials have provided evidence for the efficacy and effectiveness of the dissonance-based Body Project eating disorder prevention program, the present trial tested whether clinicians produce the largest intervention effects, or whether delivery can be task-shifted to less expensive undergraduate peer educators or to Internet delivery without effect size attenuation, focusing on acute effects. In this study, 680 young women (M age = 22.2 years, SD = 7.1) recruited at colleges in 2 states were randomized to clinician-led Body Project groups, peer-led Body Project groups, the Internet-based eBody Project, or an educational video control condition. Participants in all 3 variants of the Body Project intervention showed significantly greater reductions in eating disorder risk factors and symptoms than did educational video controls. Participants in clinician-led and peer-led Body Project groups showed significantly greater reductions in risk factors than did eBody Project participants, but effects for the 2 types of groups were similar. Eating disorder onset over 7-month follow-up was significantly lower for peer-led Body Project group participants versus eBody Project participants (2.2% vs. 8.4%) but did not differ significantly between other conditions. The evidence that all 3 dissonance-based prevention programs outperformed an educational video condition, that both group-based interventions outperformed the Internet-based intervention in risk factor reductions, and that the peer-led groups showed lower eating disorder onset over follow-up than did the Internet-based intervention is novel. These acute-effects data suggest that both group-based interventions produce superior eating disorder prevention effects than does the Internet-based intervention and that delivery can be task-shifted to peer leaders. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The role of body awareness and mindfulness in the relationship between exercise and eating behavior.

PubMed

Martin, Rachel; Prichard, Ivanka; Hutchinson, Amanda D; Wilson, Carlene

2013-12-01

This study examined the potential mediating roles of mindfulness and body awareness in the relationship between exercise and eating behavior. Female exercisers (N = 159) recruited from fitness centers, yoga centers, and the community completed a questionnaire incorporating measures of exercise behavior, body awareness, trait mindfulness, mindful eating, dietary intake, and disordered eating symptoms. Participation in yoga was associated with significantly lower disordered eating (mediated by body awareness), whereas the amount of time spent participating in cardio-based exercise was associated with greater eating disturbance. The relationships between amount of exercise and actual food intake were not mediated by trait mindfulness or body awareness. The differential findings for dietary intake and disordered eating indicate that the body awareness cultivated in different forms of exercise may be more beneficial for clinical populations or those at risk for eating disorders than for modifying actual dietary intake in the general population.

Does the stress generation hypothesis apply to eating disorders?: an examination of stress generation in eating, depressive, and anxiety symptoms.

PubMed

Bodell, Lindsay P; Hames, Jennifer L; Holm-Denoma, Jill M; Smith, April R; Gordon, Kathryn H; Joiner, Thomas E

2012-12-15

The stress generation hypothesis posits that individuals actively contribute to stress in their lives. Although stress generation has been studied frequently in the context of depression, few studies have examined whether this stress generation process is unique to depression or whether it occurs in other disorders. Although evidence suggests that stress contributes to the development of eating disorders, it is unclear whether eating disorders contribute to subsequent stress. A prospective design was used to examine the influence of eating disorder symptoms on negative life stressors. Two hundred and ninety female undergraduates completed questionnaires at two time points that examined eating disorder, depressive and anxiety symptoms and the presence of negative life events. Regression analyses found that while eating disorder symptoms (i.e. bulimic symptoms and drive for thinness) were independent, significant predictors of negative life events, they did not predict negative life events above and beyond symptoms of depression. Limitations include the use of self-report measures and a college-based sample, which may limit generalizability of the results. Findings suggest that if stress generation is present in individuals with symptoms of eating disorders, it is likely attributable to symptoms of depression. Thus, it may be important for clinicians to target depressive symptoms in order to reduce the frequency of negative life stressors among individuals with eating disorders. Copyright © 2012 Elsevier B.V. All rights reserved.

An Effectiveness Trial of a Selected Dissonance-Based Eating Disorder Prevention Program for Female High School Students: Long-Term Effects

PubMed Central

Stice, Eric; Rohde, Paul; Shaw, Heather; Gau, Jeff

2011-01-01

Objective Efficacy trials found that a dissonance-based eating disorder prevention program in which female high school and college students with body image concerns critique the thin-ideal reduced eating disorder risk factors, eating disorder symptoms, and future eating disorder onset. The present effectiveness trial tested whether this program produces effects through long-term follow-up when high school clinicians recruit students and deliver the intervention under real-world conditions. Method Female high school students with body image concerns (N = 306; M age = 15.7 SD = 1.1) were randomized to the dissonance intervention or an educational brochure control condition and completed assessments through 3-year follow-up. Results Dissonance participants showed significantly greater decreases in body dissatisfaction at 2-year follow-up and eating disorder symptoms at 3-year follow-up than controls; effects on other risk factors, risk for eating disorder onset, and other outcomes (e.g., body mass) were marginal or non-significant. Conclusions Although it was encouraging that some key effects persisted over long-term follow-up, effects were on average smaller in this effectiveness trial than previous efficacy trials, which could be due to (a) facilitator selection, training, and supervision, (b) the lower risk status of participants, or (c) the use of a control condition that produces some effects. PMID:21707136

Cognitive-behavioral treatment of adult rumination behavior in the setting of disordered eating: A single case experimental design.

PubMed

Thomas, Jennifer J; Murray, Helen B

2016-10-01

The integration of feeding and eating disorders into a single DSM-5 chapter introduces an opportunity to explore common mechanisms and transdiagnostic treatment approaches. In contrast to a robust literature on the evidence-based treatment of eating disorders, very few data guide the treatment of rumination disorder (RD). In a single case experimental design, we describe the treatment of a 27-year-old woman who presented to an eating-disorder clinic with a 15-year history of untreated rumination and intermittent binge eating. According to time series analysis, she reduced rumination frequency at trend-level during the initial baseline phase (self-monitoring only), and exhibited significant reductions during the active intervention phase (self-monitoring + cognitive-behavioral techniques including diaphragmatic breathing and behavioral experimentation). She maintained these gains at 23 weeks post-intervention. Although more rigorous systematic investigation is needed, these data suggest that selected cognitive and behavioral techniques already familiar to eating-disorder clinicians may have heuristic value for RD treatment. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:967-972). © 2016 Wiley Periodicals, Inc.

Holocaust exposure and disordered eating: a study of multi-generational transmission.

PubMed

Zohar, Ada H; Giladi, Lotem; Givati, Timor

2007-01-01

To test the hypothesis that disordered eating in second- and third-generation women would be related to their levels of Holocaust exposure and family dysfunction. One hundred eight mother-daughter dyads were ascertained through the daughters, all Israeli college students 18-35 years of age. Mothers and daughters assessed themselves on family function, Holocaust exposure and disordered eating. The disordered eating of women of the third generation was partially predicted by their mothers' disordered eating and by their mothers' Holocaust exposure. The second generation reported more maternal over-protection and emotional over-involvement than did the third generation. Contrary to expectation, the third-generation women were more Holocaust exposed than were the second generation. The nature of Holocaust exposure for second and third generations needs further study and clarification in relation to disordered eating. There is considerable disparity between the results of clinical and qualitative studies which tend to find a strong relationship between Holocaust exposure and psychopathology, and population-based quantitative studies which tend to find a much weaker relationship. 2006 John Wiley & Sons, Ltd and Eating Disorders Association

The Efficacy of a Universal School-Based Prevention Program for Eating Disorders among German Adolescents: Results from a Randomized-Controlled Trial.

PubMed

Warschburger, Petra; Zitzmann, Jana

2018-06-01

Disordered eating is highly prevalent during adolescence and has a detrimental effect on further development. Effective prevention programs are needed to prevent unhealthy developmental trajectories. This study evaluated the efficacy of the POPS-program (POtsdam Prevention at Schools), a universal school-based eating disorder prevention program for adolescents. In a cluster-randomized design, we compared the intervention group receiving the prevention program to a waiting control group. Outcomes included indicators of disordered eating and relevant risk factors for eating disorders (body dissatisfaction, internalization of the thin ideal, perceived media pressure, perfectionism, emotional element of exercise, social comparison, and perceived teasing). Questionnaires were administered at the start of the intervention, 3 and 12 months post intervention. At baseline, 1112 adolescents aged 10 to 16 years participated (49% girls; 51% intervention group). Intention-to-treat analyses with the complete data set and per-protocol analyses as a completer analysis were performed. The intervention group showed a more favorable course compared to the control group regarding all observed risk factors for eating disorders except for perceived teasing. Effect sizes were small but comparable to other primary prevention programs. At 1-year follow-up, a small but significant effect on disordered eating was observed. Results of the per-protocol analyses were mostly confirmed by the intention-to-treat analyses. Results were promising for both genders although girls benefited more regarding disordered eating and internalization of the thin ideal. Further studies are warranted examining successful program elements and whether gender-specific programs are needed.

Competitive Memory Training (COMET) for Treating Low Self-Esteem in Patients with Eating Disorders: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Korrelboom, Kees; de Jong, Martie; Huijbrechts, Irma; Daansen, Peter

2009-01-01

This study evaluates a short stepwise cognitive-behavioral intervention for the treatment of low self-esteem in patients with eating disorders. Competitive memory training (COMET) for low self-esteem is based on insights and findings from experimental psychology. A total of 52 patients with eating disorders and low self-esteem were treated with…

Body Image, Dieting and Disordered Eating and Activity Practices among Teacher Trainees: Implications for School-Based Health Education and Obesity Prevention Programs

ERIC Educational Resources Information Center

Yager, Zali; O'Dea, Jennifer

2009-01-01

The aim was to investigate and compare body image, body dissatisfaction, dieting, disordered eating, exercise and eating disorders among trainee health education/physical education (H&PE) and non-H&PE teachers. Participants were 502 trainee teachers randomly selected from class groups at three Australian universities who completed the…

Eating disorders among professional fashion models.

PubMed

Preti, Antonio; Usai, Ambra; Miotto, Paola; Petretto, Donatella Rita; Masala, Carmelo

2008-05-30

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.

Screening for DSM-5 Other Specified Feeding or Eating Disorder in a Weight-Loss Treatment–Seeking Obese Sample

PubMed Central

Gorman, Mark J.; Sogg, Stephanie; Lamont, Evan M.; Eddy, Kamryn T.; Becker, Anne E.; Thomas, Jennifer J.

2014-01-01

Objective: To evaluate the effectiveness of specific self-report questionnaires in detecting DSM-5 eating disorders identified via structured clinical interview in a weight-loss treatment–seeking obese sample, to improve eating disorder recognition in general clinical settings. Method: Individuals were recruited over a 3-month period (November 2, 2011, to January 10, 2012) when initially presenting to a hospital-based weight-management center in the northeastern United States, which offers evaluation and treatment for outpatients who are overweight or obese. Participants (N = 100) completed the Structured Clinical Interview for DSM-IV eating disorder module, a DSM-5 feeding and eating disorders interview, and a battery of self-report questionnaires. Results: Self-reports and interviews agreed substantially in the identification of bulimia nervosa (DSM-IV and DSM-5: tau-b = 0.71, P < .001) and binge-eating disorder (DSM-IV and DSM-5: tau-b = 0.60, P < .001), modestly for subthreshold binge-eating disorder (tau-b = 0.44, P < .001), and poorly for other subthreshold conditions (night-eating syndrome: tau-b = –0.04, P = .72, r = 0.06 [DSM-5]). Discussion: Current self-report assessments are likely to identify full syndrome DSM-5 eating disorders in treatment-seeking obese samples, but unlikely to detect DSM-5 other specified feeding or eating disorders. We propose specific content changes that might enhance clinical utility as suggestions for future evaluation. PMID:25667810

Temperament and personality in eating disorders.

PubMed

Rotella, Francesco; Fioravanti, Giulia; Ricca, Valdo

2016-01-01

In the last decades, three main different personality domains have been investigated in the field of eating disorders: personality traits, temperament, and personality disorders. The use of a wide range of instruments and the presence of many different approaches in the definition of personality dimensions make it difficult to summarize the emerging results from different studies. The aim of this narrative review is to critically highlight and discuss all interesting developments in this field, as reflected in the recent literature. The study of personality and temperament in eating disorders seems to be in line with the recently suggested dimensional approach, which highlights the importance of symptoms aggregation, rather than the categorical diagnoses. Recent literature seems to confirm that specific personality and temperamental profiles can be drawn for patients with eating disorders, which can discriminate different eating disorders' diagnoses/symptoms. These observations have relevant clinical implications as treatment of eating disorders is largely based on psychotherapeutic interventions. However, large longitudinal studies are needed to better clarify the suggested relationships and to identify more defined therapeutic strategies.

Eating Disorder Symptomatology, Body Image, and Mindfulness: Findings in a Non-Clinical Sample

ERIC Educational Resources Information Center

Prowse, Emma; Bore, Miles; Dyer, Stella

2013-01-01

Background: There has been increasing interest in the use of mindfulness-based interventions in treating various disorders and conditions; however, evidence to support the application of mindfulness-based treatments for eating disorders is limited. The current study was designed as a preliminary investigation of the relationship between…

Trait and State Craving as Indicators of Validity of VR-based Software for Binge Eating Treatment.

PubMed

Pla-Sanjuanelo, Joana; Ferrer-Garcia, Marta; Gutiérrez-Maldonado, José; Vilalta-Abella, Ferran; Andreu-Gracia, Alexis; Dakanalis, Antonios; Fernandez-Aranda, Fernando; Fusté-Escolano, Adela; Ribas-Sabaté, Joan; Riva, Giuseppe; Saldaña, Carmina; Sánchez, Isabel

2015-01-01

The aim of this study was to establish whether virtual reality (VR) exposure to food cues is able to produce craving levels consistent with state-craving and trait-craving as assessed by the Spanish and Italian versions of the State and Trait Food Craving Questionnaires (FCQ-T/S). The results were compared in 40 patients with eating disorders (17 with binge eating disorder, 23 with bulimia nervosa) and 78 healthy control subjects without eating disorders. Controls and patients with higher levels of trait-craving and state-craving both showed a greater desire to eat during VR exposure. Results also showed that trait and state craving assessed by FCQ-T/S were able to predict the total mean craving experienced during exposure to the VR software in both clinical and control samples. These findings present preliminary evidence about the validity of a new virtual reality-based application for cue-exposure treatment in patients with eating disorders.

Randomized controlled pilot trial of a novel dissonance-based group treatment for eating disorders.

PubMed

Stice, Eric; Rohde, Paul; Butryn, Meghan; Menke, Katharine S; Marti, C Nathan

2015-02-01

The authors conducted a pilot trial of a new dissonance-based group eating disorder treatment designed to be a cost-effective front-line transdiagnostic treatment that could be more widely disseminated than extant individual or family treatments that are more expensive and difficult to deliver. Young women with a DSM-5 eating disorder (N = 72) were randomized to an 8-week dissonance-based Counter Attitudinal Therapy group treatment or a usual care control condition, completing diagnostic interviews and questionnaires at pre, post, and 2-month follow-up. Intent-to-treat analyses revealed that intervention participants showed greater reductions in outcomes than usual care controls in a multivariate multilevel model (χ(2)[6] = 34.1, p < .001), producing large effects for thin-ideal internalization (d = .79), body dissatisfaction (d = 1.14), and blinded interview-assessed eating disorder symptoms (d = .95), and medium effects for dissonance regarding perpetuating the thin ideal (d = .65) and negative affect (d = .55). Midway through this pilot we refined engagement procedures, which was associated with increased effect sizes (e.g., the d for eating disorder symptoms increased from .51 to 2.30). This new group treatment produced large reductions in eating disorder symptoms, which is encouraging because it requires about 1/20th the therapist time necessary for extant individual and family treatments, and has the potential to provide a cost-effective and efficacious approach to reaching the majority of individuals with eating disorders who do not presently received treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparing men and women with binge-eating disorder and co-morbid obesity.

PubMed

Lydecker, Janet A; Grilo, Carlos M

2018-05-01

This study examined differences in clinical presentation of men and women with binge-eating disorder (BED) who participated in treatment research at a medical-school based program. Participants were 682 adults (n = 182 men, n = 500 women) with DSM-IV-defined BED. Doctoral-level research clinicians assessed eating-disorder psychopathology, including BED diagnosis, using the Structured Clinical Interview for DSM-IV Disorders (SCID) and Eating Disorder Examination (EDE) interview. Research clinicians measured height and weight and participants completed a battery of established self-report measures. Men had significantly higher body mass index (BMI) than women; women had significantly higher eating-disorder psychopathology (EDE scales and global score) and depression than men. Differences in eating-disorder psychopathology and depression remained higher for women than men after adjusting for race/ethnicity and BMI. Frequency of binge-eating episodes, subjective binge-eating episodes, and overeating episodes did not differ significantly by sex. Women had younger ages of onset for dieting and binge-eating behaviors than men but ages of onset for obesity and BED did not significantly differ between men and women. There are some sex differences in clinical presentation and age-of-onset timeline of adults with BED. Men and women develop obesity and BED (at diagnostic threshold) around the same age but women begin dieting and binge-eating behaviors earlier than men. At presentation for treatment for BED, men and women did not differ in binge-eating frequency and although men and women differed significantly on BMI and eating-disorder psychopathology, the magnitude of these differences was quite modest. © 2018 Wiley Periodicals, Inc.

Understanding bulimia.

PubMed

Hay, Phillipa J

2007-09-01

Bulimia nervosa (BN) and related eating disorders such as binge eating disorder are common. General practitioners can play a key role in the identification and management of BN and related eating disorders. This article describes the presenting and associated features of BN and overviews evidence based treatment approaches. Key features are recurrent episodes of binge eating, extreme weight control behaviours and over concern about weight and shape issues. By definition people are not underweight. Risk factors include being from a western culture, obesity, exposure to a restrictive dieting environment and low self esteem. People are more likely to present asking for help in weight control or a physical problem secondary to the eating disorder. Evidenced based therapies with good outcomes in current use are cognitive behaviour therapy (in full or guided self help forms), high dose fluoxetine, and interpersonal psychotherapy. It is important to convey optimism about treatment efficacy and outcomes.

Risk of eating disorders in immigrant populations.

PubMed

Mustelin, L; Hedman, A M; Thornton, L M; Kuja-Halkola, R; Keski-Rahkonen, A; Cantor-Graae, E; Almqvist, C; Birgegård, A; Lichtenstein, P; Mortensen, P B; Pedersen, C B; Bulik, C M

2017-08-01

The risk of certain psychiatric disorders is elevated among immigrants. To date, no population studies on immigrant health have addressed eating disorders. We examined whether risk of eating disorders in first- and second-generation immigrants differs from native-born Danes and Swedes. All individuals born 1984-2002 (Danish cohort) and 1989-1999 (Swedish cohort) and residing in the respective country on their 10th birthday were included. They were followed up for the development of eating disorders based on out-patient and in-patient data. The risks of all eating disorder types were lower among first-generation immigrants compared to the native populations: Incidence-rate ratio (95% confidence interval) was 0.39 (0.29, 0.51) for anorexia nervosa, 0.60 (0.42, 0.83) for bulimia nervosa, and 0.62 (0.47, 0.79) for other eating disorders in Denmark and 0.27 (0.21, 0.34) for anorexia nervosa, 0.30 (0.18, 0.51) for bulimia nervosa, and 0.39 (0.32, 0.47) for other eating disorders in Sweden. Likewise, second-generation immigrants by both parents were at lower risk, whereas those with only one foreign-born parent were not. The decreased risk of eating disorders among immigrants is opposite to what has been observed for other psychiatric disorders, particularly schizophrenia. Possible explanations include buffering sociocultural factors and underdetection in health care. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Eating disorders and depressive symptoms: an epidemiological study in a male population].

PubMed

Valls, M; Callahan, S; Rousseau, A; Chabrol, H

2014-06-01

The objective of the study was to evaluate the incidence of eating disorders, including not otherwise specified eating disorders (EDNOS) and subthreshold disorders, inappropriate compensatory behaviors (such as self-induced vomiting, strict dieting, fasting) along with depressive symptoms among young French adult males. The sample was composed of 458 young men in age ranging from 18 to 30 years (mean age=21.9±2.4). The average body mass index was 22.8±3. Participants completed two questionnaires: the Questionnaire for Eating Disorders Diagnoses (Q-EDD) assessing full-criteria eating disorder symptoms based on DSM-IV criteria (i.e. clinical eating disorders) and subthreshold disorders, and the Center for Epidemiological Studies-Depression scale (CES-D) assessing depressive symptoms. Out of the 458 surveyed respondents, eating disorders were reported by approximately 17% of the overall sample, with 1.5% meeting diagnostic criteria for serious clinical disorders, 3% meeting diagnostic criteria for EDNOS and 12% meeting diagnostic criteria for subthreshold disorders. Exercise bulimia represented 1% of the overall sample and binge-eating disorder 2%. The most frequent subthreshold disorder was subthreshold nonbinging bulimia (7%). Participants with eating disorders were equally divided between those desiring weight gain, those desiring weight loss and those wanting to keep their current weight. Participants without eating disorders were more likely to want to gain weight compared to participants with eating disorders (45.5% versus 30% respectively; P<0.05). After controlling for body mass index, 30% of participants tended to perceive themselves as thinner than they actually were and 6% tended to perceive themselves as fatter. Regarding normal-weight participants, 28% perceived themselves as thinner and 8% as fatter than in reality. Overeating episodes were reported by 19% of participants. Binge-eating episodes (recurrent or not) were reported by 8% of young men, including 32% of participants with eating disorders and 3% of participants without eating disorder. Six percent reported repeated binging (at least twice a week for at least once a month). Inappropriate compensatory behaviors were mostly used by participants with eating disorders, except for excessive exercise (34% versus 35% for participants without eating disorders). The most typical compensatory behavior was fasting (11%). According to the cut-off score of 22, 18% of young men had a moderate to severe depressive symptomatology, including 5% of participants who also reported an eating disorder (i.e. 30 participants). A one-way ANOVA was conducted to examine differences in depressive symptoms as a function of eating disorder groups, namely the clinical eating disorders sample (n=22), the subthreshold disorders sample (n=54) and the asymptomatic sample (participants without eating disorder; n=382). Results were statistically significant, (F(2,455)=7.27, P<0.001) and post-hoc tests (Scheffé tests) were used to examine the group differences. The mean CES-D scores for the clinical eating disorders sample (19.45±8.2; P<0.05) and the subthreshold disorders sample (18.15±10.9; P<0.05) were significantly higher than for the asymptomatic sample (14.19±8.9). There was no significant difference between the two eating disorder groups (P>0.05). The results demonstrate that a significant proportion of men with eating disorders manifest comorbid depressive symptomatology. These results suggest that EDNOS and subthreshold disorders should be taken into consideration, as they represent 15% of the total sample. Participants reported high rate of excessive exercise and fasting, which could reflect the importance of muscle tone or strategies to increase muscle mass. Further research is necessary in order to better understand male eating behaviors and disorders. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

The natural course of bulimia nervosa and binge eating disorder in young women.

PubMed

Fairburn, C G; Cooper, Z; Doll, H A; Norman, P; O'Connor, M

2000-07-01

Little is known about the relative course and outcome of bulimia nervosa and binge eating disorder. Two community-based cohorts were studied prospectively over a 5-year year period. One comprised 102 participants with bulimia nervosa and the other 48 participants with binge eating disorder (21% [9/42] of whom had comorbid obesity). All participants were female and aged between 16 and 35 years at recruitment. The assessments were at 15-month intervals and addressed eating disorder features, general psychiatric symptoms, and social functioning. Both cohorts showed marked initial improvement followed by gradual improvement thereafter. Between half and two thirds of the bulimia nervosa cohort had some form of eating disorder of clinical severity at each assessment point, although only a minority continued to meet diagnostic criteria for bulimia nervosa. Each year about a third remitted and a third relapsed. The outcome of the binge eating disorder cohort was better, with the proportion with any form of clinical eating disorder declining to 18% (7 of 40) by the 5-year follow-up. The relapse rate was low among this cohort. There was little movement of participants across the 2 diagnostic categories and few sought treatment. Both groups gained weight, with 39% of the binge eating disorder cohort (14 of 36) meeting criteria for obesity at 5-year follow-up. These findings suggest that, among young women in the community, bulimia nervosa and binge eating disorder have a different course and outcome. Whereas the prognosis of those with bulimia nervosa was relatively poor, the great majority of those with binge eating disorder recovered.

Development and Psychometric Validation of the EDE-QS, a 12 Item Short Form of the Eating Disorder Examination Questionnaire (EDE-Q)

PubMed Central

Gideon, Nicole; Hawkes, Nick; Mond, Jonathan; Saunders, Rob; Tchanturia, Kate; Serpell, Lucy

2016-01-01

Objective The aim of this study was to develop and validate a short form of the Eating Disorder Examination Questionnaire (EDE-Q) for routine, including session by session, outcome assessment. Method The current, 28-item version (6.0) of the EDE-Q was completed by 489 individuals aged 18–72 with various eating disorders recruited from three UK specialist eating disorder services. Rasch analysis was carried out on factors identified by means of principal component analysis, which in combination with expert ratings informed the development of an EDE-Q short form. The shortened questionnaire’s reliability, validity and sensitivity was assessed based on online data collected from students of a UK university and volunteers with a history of eating disorders recruited from a national eating disorders charity aged 18–74 (N = 559). Results A 12-item short form, the Eating Disorder Examination Questionnaire Short (EDE-QS) was derived. The new measure showed high internal consistency (Cronbach’s α = .913) and temporal stability (ICC = .93; p < .001). It was highly correlated with the original EDE-Q (r = .91 for people without ED; r = .82 for people with ED) and other measures of eating disorder and comorbid psychopathology. It was sufficiently sensitive to distinguish between people with and without eating disorders. Discussion The EDE-QS is a brief, reliable and valid measure of eating disorder symptom severity that performs similarly to the EDE-Q and that lends itself for the use of sessional outcome monitoring in treatment and research. PMID:27138364

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

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 from this trial will enhance availability of evidence-based treatment of adolescent binge eating disorder. Trial registration German Clinical Trials Register: DRKS00000542 PMID:24066704

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial.

PubMed

Hilbert, Anja

2013-09-25

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. 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. 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 from this trial will enhance availability of evidence-based treatment of adolescent binge eating disorder. German Clinical Trials Register: DRKS00000542.

Feeding and eating disorders in the DSM-5 era: a systematic review of prevalence rates in non-clinical male and female samples.

PubMed

Lindvall Dahlgren, Camilla; Wisting, Line; Rø, Øyvind

2017-01-01

The objective of this study was to systematically review the literature on the prevalence of eating disorders (EDs) during the DSM-5 era, and to report rates of point- and lifetime prevalence. A PubMed search was conducted targeting articles on the epidemiology of EDs, in particular, reported rates of prevalence. The review was performed in accordance with PRISMA guidelines, and was limited to DSM-5 based eating disorder diagnoses published between 2012 and 2017. A total of 19 studies fulfilled inclusion criteria and were included in the study. Following the transition to DSM-5, it is evident that the prevalence of eating disorder not otherwise specified (EDNOS)/other specified feeding and eating disorders (OSFED) has decreased as intended, and there is preliminary evidence suggesting that rates of anorexia nervosa (AN) and bulimia nervosa (BN) and binge eating disorder (BED) have increased. Further, we observed higher rates of BED prevalence among females compared to males, with rates increasing with age. A limitation to the study was the search date, and that none of the included studies investigated the "new" DSM-5 feeding disorders avoidant restrictive food intake disorder (ARFID), pica or rumination disorder warranting attention in future studies investigating the epidemiology of feeding and eating disorders.

Study Protocol for a randomized controlled trial of mentalization based therapy against specialist supportive clinical management in patients with both eating disorders and symptoms of borderline personality disorder

PubMed Central

2014-01-01

Background The NOURISHED study: Nice OUtcomes for Referrals with Impulsivity, Self Harm and Eating Disorders. Eating Disorders (ED) and Borderline Personality Disorder (BPD) are both difficult to treat and the combination presents particular challenges. Both are associated with vulnerability to loss of mentalization (awareness of one’s own and others’ emotional state). In BPD, Mentalization Based therapy (MBT) has been found effective in reducing symptoms. In this trial we investigate the effectiveness and cost-effectiveness of MBT adapted for Eating disorders (Mentalization Based Therapy for Eating Disorders (MBT-ED)) compared to a standard comparison treatment, Specialist Supportive Clinical Management (SSCM-ED) in patients with a combination of an Eating Disorder and either a diagnosis of BPD or a history of self-harm and impulsivity in the previous 12 months. Methods/Design We will complete a multi-site single-blind randomized controlled trial (RCT) of MBT-ED vs SSCM-ED. Participants will be recruited from three Eating Disorder Services and two Borderline Personality Disorder Services in London. Participants allocated to MBT-ED will receive one year of weekly group and individual therapy and participants allocated to SSCM-ED will receive 20 sessions of individual therapy over 1 year. In addition, participants in both groups will have access to up to 5 hours of dietetic advice. The primary outcome measure is the global score on the Eating Disorders Examination. Secondary outcome measures include total score on the Zanarini BPD scale, the Object Relations Inventory, the Depression Anxiety Stress Scales, quality of life and cost-effectiveness. Measures are taken at recruitment and at 6 month intervals up to 18 months. Discussion This is the first Randomised Controlled Trial of MBT-ED in patients with eating disorders and symptoms of BPD and will provide evidence to inform therapy decisions in this group of patients. During MBT-ED mentalization is encouraged, while in SSCM-ED it is not overtly addressed. This study will help elucidate mechanisms of change in the two therapies and analysis of therapy and interview transcripts will provide qualitative information about the conduct of therapy and changes in mentalization and object relations. Trial registration ISRCTN51304415 PMID:24555511

A comparison of disordered eating attitudes and behaviors among Filipino and American college students.

PubMed

Madanat, H N; Hawks, S R; Novilla, M L

2006-09-01

The purpose of this study was to compare the levels of eating disordered attitudes and behaviors among college students in the United States and the Philippines. A convenience-based cross-sectional survey. General education classes in one college in Manila and another in the Western US. 340 college students. A paper-pencil survey was given to the students in the classroom consisting of Eating Attitudes Test (EAT-26) and demographic variables. Eating disordered attitudes and behaviors (scoring 20 or more on EAT-26) was the dependent variable, while gender and country of residence were the two main independent variables. Frequency distributions, chi-squares, and logistic regression analysis were employed to summarize and analyze the data. Filipino students were 10.9 times (p-value <0.0001) more likely to have eating disordered attitudes and behaviors than their American counterparts controlling for the demographics collected. This relationship remained significant when regression models were done for each gender separately. In addition, married students and more specifically married female students were more likely to have eating disordered attitudes and behaviors than single students or single females. Arguments are made as to why higher levels of eating disordered attitudes and behaviors are observed among Filipino college students. These results provide important information about the levels of eating disordered attitudes and behaviors in the Philippines and may be useful for developing future education programs.

Evaluating the Real-World Effectiveness of Cognitive-Behavior Therapy Efficacy Research on Eating Disorders: A Case Study from a Community-based Clinical Setting

PubMed Central

Lowe, Michael R.; Bunnell, Douglas W.; Neeren, Amy M.; Chernyak, Yelena; Greberman, Laurel

2009-01-01

Objective There is a growing consensus that there is a need to test the real-world effectiveness of eating disorder therapies that show promise in efficacy research. The current paper provides a narrative account of an NIMH-funded study that attempted to apply efficacy findings from CBT research to an Intensive Outpatient Program (IOP) at the largest community-based eating disorder program in the United States. Method We describe the study as originally envisioned as well as the various challenges that the researchers and the IOP staff encountered in implementing this study. Results The different training, assumptions, and “ways of knowing” of the research team and the treatment staff in regard to the nature of eating disorders and their treatment created multiple challenges for both groups during the study period. We describe valuable lessons learned about how to - and how not to -implement effectiveness designs in clinical settings that are relatively unfamiliar with empirically-based research findings. Discussion It is hoped that our experience in attempting to apply efficacy-based research findings on eating disorders treatment in a community-based clinical setting will prove helpful to other researchers and service providers engaging in such translational research. PMID:20063375

Are we really delivering evidence-based treatments for eating disorders? How eating-disordered patients describe their experience of cognitive behavioral therapy.

PubMed

Cowdrey, Natasha D; Waller, Glenn

2015-12-01

Psychotherapists report routinely not practising evidence-based treatments. However, there is little research examining the content of therapy from the patient perspective. This study examined the self-reported treatment experiences of individuals who had been told that they had received cognitive-behavior therapy (CBT) for their eating disorder. One hundred and fifty-seven such sufferers (mean age = 25.69 years) were recruited from self-help organisations. Participants completed an online survey assessing demographics, clinical characteristics, and therapy components. The use of evidence-based CBT techniques varied widely, with core elements for the eating disorders (e.g., weighing and food monitoring) used at well below the optimum level, while a number of unevidenced techniques were reported as being used commonly. Cluster analysis showed that participants received different patterns of intervention under the therapist label of 'CBT', with evidence-based CBT being the least common. Therapist age and patient diagnosis were related to the pattern of intervention delivered. It appears that clinicians are not subscribing to a transdiagnostic approach to the treatment of eating disorders. Patient recollections in this study support the conclusion that evidence-based practice is not routinely undertaken with this client group, even when the therapy offered is described as such. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of an online training program in eating disorders for health professionals in Australia.

PubMed

Brownlow, Rachel S; Maguire, Sarah; O'Dell, Adrienne; Dias-da-Costa, Catia; Touyz, Stephen; Russell, Janice

2015-01-01

Early detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals-representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery. One-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants' levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders. Significant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about eating disorders. The results of this study demonstrated that the online training program was an effective tool in increasing health professionals' level of knowledge, skill and confidence to treat people with eating disorders. The results also demonstrated that online training reduced health professionals' personal bias towards people with eating disorders. Limitations of this study include the use of self-report measures rather than observation of the health professional in clinical practice. As a result, it is not possible to make determinations regarding the translation of these results to clinical settings. The findings of this study suggest that online training programs may present an innovative solution to the considerable workforce development challenges faced by clinicians needing training in eating disorders.

The Unique and Additive Associations of Family Functioning and Parenting Practices with Disordered Eating Behaviors in Diverse Adolescents

PubMed Central

Berge, Jerica M.; Wall, Melanie; Larson, Nicole; Eisenberg, Marla E.; Loth, Katie A.; Neumark-Sztainer, Dianne

2012-01-01

Objective To examine the unique and additive associations of family functioning and parenting practices with adolescent disordered eating behaviors (i.e., dieting, unhealthy weight control behaviors, binge eating). Methods Data from EAT (Eating and Activity in Teens) 2010, a population-based study assessing eating and activity among racially/ethnically and socio-economically diverse adolescents (n = 2,793; mean age = 14.4, SD = 2.0; age range = 11–19) was used. Logistic regression models were used to examine associations between adolescent dieting and disordered eating behaviors and family functioning and parenting variables, including interactions. All analyses controlled for demographics and body mass index. Results Higher family functioning, parent connection, and parental knowledge about child’s whereabouts (e.g. who child is with, what they are doing, where they are at) were significantly associated with lower odds of engaging in dieting and disordered eating behaviors in adolescents, while parent psychological control was associated with greater odds of engaging in dieting and disordered eating behaviors. Although the majority of interactions were non-significant, parental psychological control moderated the protective relationship between family functioning and disordered eating behaviors in adolescent girls. Conclusions Clinicians and health care providers may want to discuss the importance of balancing specific parenting behaviors, such as increasing parent knowledge about child whereabouts while decreasing psychological control in order to enhance the protective relationship between family functioning and disordered eating behaviors in adolescents. PMID:23196919

Diagnosing, Conceptualizing, and Treating Eating Disorders Not Otherwise Specified: A Comprehensive Practice Model

ERIC Educational Resources Information Center

Schwitzer, Alan M.

2012-01-01

This article presents research and evidence-based practices for identifying, understanding, diagnosing, conceptualizing, and providing a continuum of treatment for the most commonly experienced types of eating-related counseling concerns--namely, eating disorders not otherwise specified--among the population most likely to present these types of…

Eating Disorder Symptomatology: Prevalence among Latino College Freshmen Students

PubMed Central

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

2010-01-01

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

Are improvements in shame and self-compassion early in eating disorders treatment associated with better patient outcomes?

PubMed

Kelly, Allison C; Carter, Jacqueline C; Borairi, Sahar

2014-01-01

Compassion-focused therapy (CFT; Gilbert, 2005, 2009) is a transdiagnostic treatment approach focused on building self-compassion and reducing shame. It is based on the theory that feelings of shame contribute to the maintenance of psychopathology, whereas self-compassion contributes to the alleviation of shame and psychopathology. We sought to test this theory in a transdiagnostic sample of eating disorder patients by examining whether larger improvements in shame and self-compassion early in treatment would facilitate faster eating disorder symptom remission over 12 weeks. Participants were 97 patients with an eating disorder admitted to specialized day hospital or inpatient treatment. They completed the Eating Disorder Examination-Questionnaire, Experiences of Shame Scale, and Self-Compassion Scale at intake, and again after weeks 3, 6, 9, and 12. Multilevel modeling revealed that patients who experienced greater decreases in their level of shame in the first 4 weeks of treatment had faster decreases in their eating disorder symptoms over 12 weeks of treatment. In addition, patients who had greater increases in their level of self-compassion early in treatment had faster decreases in their feelings of shame over 12 weeks, even when controlling for their early change in eating disorder symptoms. These results suggest that CFT theory may help to explain the maintenance of eating disorders. Clinically, findings suggest that intervening with shame early in treatment, perhaps by building patients' self-compassion, may promote better eating disorders treatment response. Copyright © 2013 Wiley Periodicals, Inc.

Binge Eating, Purging, or Both: Eating Disorder Psychopathology Findings from an Internet Community Survey

PubMed Central

Roberto, Christina A.; Grilo, Carlos M.; Masheb, Robin M.; White, Marney A.

2010-01-01

Objective This study aimed to compare bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) on clinically significant variables and examine the utility of once versus twice-weekly diagnostic thresholds for disturbed eating behaviors. Method 234 women with BN, BED, or PD were identified through self-report measures via an online survey and categorized based on either once-weekly or twice-weekly disturbed eating behaviors. Results BN emerged as a more severe disorder than BED and PD. The three groups differed significantly in self-reported restraint and disinhibition and the BN and BED groups reported higher levels of depression than PD. For BN, those engaging in behaviors twice-weekly versus once-weekly were more symptomatic. Discussion The BN, BED, and PD groups differed in clinically meaningful ways. Future research need to clarify the relationship between mood disturbances and eating behaviors. Reducing the twice-weekly behavior threshold for BN would capture individuals with clinically significant eating disorders, though the twice-weekly threshold may provide important information about disorder severity for both BN and BED. PMID:19862702

Examining weight and eating behavior by sexual orientation in a sample of male veterans.

PubMed

Bankoff, Sarah M; Richards, Lauren K; Bartlett, Brooke; Wolf, Erika J; Mitchell, Karen S

2016-07-01

Eating disorders are understudied in men and in sexual minority populations; however, extant evidence suggests that gay men have higher rates of disordered eating than heterosexual men. The present study examined the associations between sexual orientation, body mass index (BMI), disordered eating behaviors, and food addiction in a sample of male veterans. Participants included 642 male veterans from the Knowledge Networks-GfK Research Panel. They were randomly selected from a larger study based on previously reported trauma exposure; 96% identified as heterosexual. Measures included the Eating Disorder Diagnostic Scale, the Yale Food Addiction Scale, and self-reported height and weight. Heterosexual and sexual minority men did not differ significantly in terms of BMI. However, gay and bisexual men (n=24) endorsed significantly greater eating disorder symptoms and food addiction compared to heterosexual men. Our findings that sexual minority male veterans may be more likely to experience eating disorder and food addiction symptoms compared to heterosexual male veterans highlight the importance of prevention, assessment, and treatment efforts targeted to this population. Published by Elsevier Inc.

Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: results of the Gender and Body Image (GABI) study.

PubMed

Gagne, Danielle A; Von Holle, Ann; Brownley, Kimberly A; Runfola, Cristin D; Hofmeier, Sara; Branch, Kateland E; Bulik, Cynthia M

2012-11-01

Limited research exists on eating disorder symptoms and attitudes and weight and shape concerns in women in midlife to older adulthood. We conducted an online survey to characterize these behaviors and concerns in women ages 50 and above. Participants (n = 1,849) were recruited via the Internet and convenience sampling. Eating disorder symptoms, dieting and body checking behaviors, and weight and shape concerns were widely endorsed. Younger age and higher body mass index (BMI) were associated with greater endorsement of eating disorder symptoms, behaviors, and concerns. Weight and shape concerns and disordered eating behaviors occur in women over 50 and vary by age and BMI. Focused research on disordered eating patterns in this age group is necessary to develop age-appropriate interventions and to meet the developmental needs of an important, growing, and underserved population. Copyright © 2012 Wiley Periodicals, Inc.

Thinking through the body: the conceptualization of yoga as therapy for individuals with eating disorders.

PubMed

Douglass, Laura

2011-01-01

Yoga has historically been viewed as a discipline that increases self-awareness through body based practices, meditation, self-study, and the reading of philosophical texts. In the 21st century the mindfulness techniques of yoga have been adapted as an adjunct to the treatment of individuals with eating disorders. In an effort to understand the conceptualization of yoga as therapy for individuals with eating disorders, this article juxtaposes how mindfulness based yoga is regarded in three disciplines: sociology, neuroscience, and the "spiritual texts" of yoga.

Effectiveness trial of a selective dissonance-based eating disorder prevention program with female college students: Effects at 2- and 3-year follow-up.

PubMed

Stice, Eric; Rohde, Paul; Butryn, Meghan L; Shaw, Heather; Marti, C Nathan

2015-08-01

An efficacy trial found that a dissonance-based prevention program reduced risk factors, eating disorder symptoms, and future eating disorder onset, but smaller effects emerged when high school clinicians recruited students and delivered the program under real-world conditions in an effectiveness trial. The current report describes results at 2- and 3-year follow-up from an effectiveness trial that tested whether a new enhanced dissonance version of this program produced larger effects when college clinicians recruit students and deliver the intervention using improved train and supervision procedures. Young women from eight universities (N = 408, M age = 21.6, SD = 5.64) were randomized to the prevention program or an educational brochure control condition. Dissonance participants showed greater decreases in risk factors, eating disorder symptoms, and psychosocial impairment by 3-year follow-up than controls, but not healthcare utilization, BMI, or eating disorder onset. This novel multisite effectiveness trial found that the enhanced dissonance intervention and improved training and supervision procedures produced an average effect size at 3-year follow-up that was 290% and 160% larger than effects observed in the high school effectiveness trial and efficacy trial respectively. Yet, the lack of eating disorder onset effects may imply that factors beyond pursuit of the thin ideal now contribute to eating disorder onset. Copyright © 2015 Elsevier Ltd. All rights reserved.

Behavioral and Psychophysiological Responsiveness During Child Feeding in Mothers with Histories of Eating Disorders: A Pilot Study

PubMed Central

Hoffman, Elizabeth R.; Hodges, Eric A.; Propper, Cathi; Postage, Pamela L.; Zipkin, Elana C.; Bentley, Margaret E.; Ward, Dianne S.; Hamer, Robert M.; Bulik, Cynthia M.

2013-01-01

The aim of this pilot project was to describe maternal responsiveness during child feeding in mothers with eating disorder histories through the combined use of observational, self-report, and physiologic methods. For this non-randomized cohort pilot study, 25 mothers with histories of eating disorders and 25 mothers with no history of an eating disorder with children ages 6–36 months were selected such that the groups were similar based on child age group (within 6 months) and child sex. Maternal behavioral responsiveness to child cues was assessed by video-recording and behavioral coding of both a free-play and feeding episode. Physiologic engagement was assessed through measurement of respiratory sinus arrhythmia (RSA) reactivity during free-play and feeding episodes. No differences were detected in observed behavioral responsiveness during feeding or free-play in mothers with eating disorder histories compared with controls. Mothers with eating disorder histories did report more parenting stress, increased anxiety, and exhibited a blunted physiologic stress response (less RSA reactivity) during both feeding and free-play interactions with their children. These results support future larger-scale investigations of RSA reactivity in mothers with eating disorders. PMID:24511180

Evaluation of the DSM-5 Severity Indicator for Binge Eating Disorder in a Community Sample

PubMed Central

Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

2015-01-01

Research has examined various aspects of the diagnostic criteria for binge-eating disorder (BED) but has yet to evaluate the DSM-5 severity criterion. This study examined the DSM-5 severity criterion for BED based on binge-eating frequency and tested an alternative severity specifier based on overvaluation of shape/weight. 338 community volunteers categorized with DSM-5 BED completed a battery of self-report instruments. Participants were categorized first using DSM-5 severity levels and second by shape/weight overvaluation and were compared on clinical variables. 264 (78.1%) participants were categorized as mild, 67 (19.8%) as moderate, 6 (1.8%) as severe, and 1 (0.3%) as extreme. Analyses comparing mild and moderate severity groups revealed no significant differences in demographic variables or BMI; moderate severity group had greater eating-disorder psychopathology (small effect-sizes) but not depression than mild group. Participants with overvaluation (N=196; 60.1%) versus without (N=130; 39.9%) did not differ significantly in age, sex, BMI, or binge-eating frequency. Overvaluation group had significantly greater eating-disorder psychopathology and depression than non-overvaluation group. The greater eating-disorder and depression levels (medium-to-large effect-sizes) persisted after adjusting for ethnicity/race and binge-eating severity/frequency, without attenuation of effect-sizes. Findings from this non-clinical community sample provide support for overvaluation of shape/weight as a specifier for BED as it provides stronger information about severity than the DSM-5 rating based on binge-eating. Future research should include treatment-seeking patients with BED to test the utility of DSM-5 severity specifiers and include broader clinical validators. PMID:25701802

Eating disorders: a hidden phenomenon in outpatient mental health?

PubMed

Fursland, Anthea; Watson, Hunna J

2014-05-01

Eating disorders are common but underdiagnosed illnesses. Help-seeking for co-occurring issues, such as anxiety and depression, are common. To identify the prevalence of eating problems, using the SCOFF, and eating disorders when screening positive on the SCOFF (i.e., ≥2), among patients seeking help for anxiety and depression at a community-based mental health service. Patients (N = 260) consecutively referred and assessed for anxiety and depression treatment were administered the SCOFF screening questionnaire and a semi-structured standardized diagnostic interview during routine intake. 18.5% (48/260) scored ≥2 on the SCOFF, indicating eating problems. Of these, 41% (19/48) met criteria for an eating disorder. Thus, overall, 7.3% (19/260) of the sample met criteria for a DSM-IV eating disorder. Those scoring ≥2 on the SCOFF were more likely to: be female (p = 0.001), younger (p = 0.003), and have a history of self-harm (p < 0.001). This study confirms that eating disorders are a hidden phenomenon in general outpatient mental health. By using a standardized diagnostic interview to establish diagnosis rather than self- or staff-report, the study builds on limited previous findings. The naturalistic study setting shows that screening for eating disorders can be easily built into routine intake practice, and successfully identifies treatment need. Copyright © 2013 Wiley Periodicals, Inc.

Psychiatric outcomes after childbirth: can posttraumatic growth protect me from disordered eating symptoms?

PubMed

Ayache, Raphael; Benticha, Sarah; Goutaudier, Nelly; Chabrol, Henri

2016-06-01

While many studies on mood disorder and posttraumatic stress disorder (PTSD) following childbirth have been conducted, little is known regarding posttraumatic growth (PTG) and disordered eating in the postpartum period. This study aims to (a) identify the typology of women following childbirth based on anxiety, depressive, PTSD symptoms and level of PTG and (b) evaluate whether these profiles differ on disordered eating symptoms. Up to 2 years after childbirth, 306 French-speaking mothers [mean age (SD) = 29.4 (4.6) years] completed questionnaires assessing PTSD, depressive, anxiety and disordered-eating symptoms and level of posttraumatic growth. Four profiles were highlighted: a first one labeled growing cluster (22.2 % of the sample, n = 68), a second one labeled low level of symptoms cluster (37.6 % of the sample, n = 115), a third one labeled vulnerable cluster (21.6 % of the sample, n = 66) and a last one labeled anxious-depressed-traumatized cluster (18.6 % of the sample, n = 57). Our findings also highlight an impact of these profiles on disordered eating symptoms, suggesting that disordered eating in postpartum would not be the result of pregnancy. Consistent with our expectation, our findings suggest a potential protective role of posttraumatic growth on the development of disordered eating symptoms. Further researches focusing on traumatic experience, disordered eating and posttraumatic growth in postpartum are warranted.

Incorporating food addiction into disordered eating: the disordered eating food addiction nutrition guide (DEFANG).

PubMed

Wiss, David A; Brewerton, Timothy D

2017-03-01

Although not formally recognized by the DSM-5, food addiction (FA) has been well described in the scientific literature. FA has emerged as a clinical entity that is recognized within the spectrum of disordered eating, particularly in patients with bulimia nervosa, binge-eating disorder and/or co-occurring addictive disorders and obesity. Integrating the concept of FA into the scope of disordered eating has been challenging for ED treatment professionals, since there is no well-accepted treatment model. The confusion surrounding the implications of FA, as well as the impact of the contemporary Westernized diet, may contribute to poor treatment outcomes. The purpose of this review is twofold. The first is to briefly explore the relationships between EDs and addictions, and the second is to propose a new model of conceptualizing and treating EDs that incorporates recent data on FA. Since treatment for EDs should vary based on individual assessment and diagnosis, the Disordered Eating Food Addiction Nutrition Guide (DEFANG) is presented as a tool for framing treatment goals and helping patients achieve sustainable recovery.

Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up.

PubMed

Stice, Eric; Marti, C Nathan; Rohde, Paul; Shaw, Heather

2011-06-01

Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Data were drawn from a randomized effectiveness trial in which 306 female high school students (mean age = 15.7 years, SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Dissonance-intervention participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Findings provided support for the intervention theory of this eating disorder prevention program over longer term follow-up, extending the evidence base for this effective intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management.

PubMed

Joy, Elizabeth; Kussman, Andrea; Nattiv, Aurelia

2016-02-01

Eating disorders, such as anorexia nervosa and bulimia nervosa, can have devastating effects on both the health and performance of athletes. Compared to non-athletes, both female and male athletes are at higher risk of developing an eating disorder. This is especially true for athletes participating in sports where low body weight or leanness confers a competitive advantage. Screening for disordered eating behaviours, eating disorders and for related health consequences should be a standard component of preparticipation examinations, and team physicians should be knowledgeable of the updated diagnostic criteria for eating disorders in the Diagnostic and Statistical Manual-V. Athletes with eating disorders should undergo thorough evaluation and treatment by an experienced multidisciplinary team. Team physicians play a critical role in decision-making on clearance for participation and return to play. Using evidence-based guidelines for clearance and return to play encourages transparency and accountability between the sports medicine care team and the athlete. Efforts to prevent eating disorders should be aimed at athletes, coaches, parents and athletic administrators, and focused on expanding knowledge of healthy nutrition in support of sport performance and health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A Mindfulness-Based Health Wellness Program for an Adolescent with Prader-Willi Syndrome

ERIC Educational Resources Information Center

Singh, Nirbhay N.; Lancioni, Giulio E.; Singh, Ashvind N.; Winton, Alan S. W.; Singh, Judy; McAleavey, Kristen M.; Adkins, Angela D.

2008-01-01

Individuals with Prader-Willi syndrome have hyperphagia, a characteristic eating disorder defined by a marked delay in the satiety response when compared to controls. This eating disorder has been particularly difficult to control. The authors taught and evaluated effectiveness of regular exercise alone, regular exercise plus healthy eating, and…

An Effectiveness Trial of a Dissonance-Based Eating Disorder Prevention Program for High-Risk Adolescent Girls

ERIC Educational Resources Information Center

Stice, Eric; Rohde, Paul; Gau, Jeff; Shaw, Heather

2009-01-01

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…

Weight stigma and eating behaviours in elementary school children: A prospective population-based study.

PubMed

Jendrzyca, Anna; Warschburger, Petra

2016-07-01

The relevance of weight stigma as an important factor in disordered eating has been supported by research. However, because most of the studies were cross-sectional and focussed on older children, the causal relationships could not be fully determined in childhood. The current study explores the role of weight stigma in body dissatisfaction and eating behaviours. The sample consisted of 773 girls and 713 boys, aged 6-11 years, who completed surveys assessing weight stigma experiences, body dissatisfaction and eating behaviours at two points of measurement, approximately one year apart. The children's external and disordered eating was rated via parental questionnaires. As expected, the pattern of the associations between weight status, weight stigma, body dissatisfaction and eating behaviours differed by gender. Experience of weight stigma in girls led to external and restrained eating one year later, whereas in boys no such association was observed. Body dissatisfaction mediated the association between weight stigma and restrained eating behaviours in girls, whereas in boys, body dissatisfaction directly influenced restrained eating behaviours. However, in both girls and boys weight status predicted body dissatisfaction and disordered eating, while weight stigma did not have a direct effect on disordered eating. Results suggest that interventions involving weight stigma should be a part of eating disorder prevention programmes, and gender-specific pathways should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

Disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents.

PubMed

Bacopoulou, Flora; Foskolos, Elizabeth; Stefanaki, Charikleia; Tsitsami, Eleni; Vousoura, Eleni

2017-11-30

The aim of this study was to examine the relationship between disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents as well as the moderating role of gender and body mass index (BMI) in this relationship. Ninety adolescents, 11-18 years old, were assessed using anthropometric measurements; demographics, eating attitudes and level of emotional/behavioral adjustment were examined via self-reported questionnaires. Disordered eating attitudes were prevalent in 17.8% of the sample. A significant relationship was found between disordered eating attitudes and Youth Self-Report (YSR) anxiety score (r = .22, p < .05). Gender significantly moderated the relationship between YSR anxiety symptoms and Eating Attitudes Test (EAT) scores (b = .59, p = .01) and this effect held true for the EAT bulimia subscale (b = .20, p = .03), but not for the dieting or the oral control subscales. Contrary to our hypothesis, BMI did not moderate the relationship between EAT and YSR anxiety sub-scores (b = .13, p > .05). Girls with elevated anxiety levels appear to be at risk for exhibiting disordered eating attitudes, especially bulimic behaviors. This finding highlights the importance of developing gender-based preventive interventions tailored to these specific emotional/behavioral aspects. Level V, cross-sectional descriptive study.

Attention-deficit/hyperactivity disorder and eating disorders across the lifespan: A systematic review of the literature.

PubMed

Levin, Rivka L; Rawana, Jennine S

2016-12-01

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. Copyright © 2016 Elsevier Ltd. All rights reserved.

Decision-making processes for the uptake and implementation of family-based therapy by eating disorder treatment teams: a qualitative study.

PubMed

Kimber, Melissa; Couturier, Jennifer; Jack, Susan; Niccols, Alison; Van Blyderveen, Sherry; McVey, Gail

2014-01-01

To explore the decision-making processes involved in the uptake and implementation of evidence-based treatments (EBTs), namely, family-based treatment (FBT), among therapists and their administrators within publically funded eating disorder treatment programs in Ontario, Canada. Fundamental qualitative description guided sampling, data collection, and analytic decisions. Forty therapists and 11 administrators belonging to a network of clinicians treating eating disorders completed an in-depth interview regarding the decision-making processes involved in EBT uptake and implementation within their organizations. Content analysis and the constant comparative technique were used to analyze interview transcripts, with 20% of the data independently double-coded by a second coder. Therapists and their administrators identified the importance of an inclusive change culture in evidence-based practice (EBP) decision-making. Each group indicated reluctance to make EBP decisions in isolation from the other. Additionally, participants identified seven stages of decision-making involved in EBT adoption, beginning with exposure to the EBT model and ending with evaluating the impact of the EBT on patient outcomes. Support for a stage-based decision-making process was in participants' indication that the stages were needed to demonstrate that they considered the costs and benefits of making a practice change. Participants indicated that EBTs endorsed by the Provincial Network for Eating Disorders or the Academy for Eating Disorders would more likely be adopted. Future work should focus on integrating the important decision-making processes identified in this study with known implementation models to increase the use of low-cost and effective treatments, such as FBT, within eating disorder treatment programs. Copyright © 2013 Wiley Periodicals, Inc.

An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders.

PubMed

Gale, Corinne; Gilbert, Paul; Read, Natalie; Goss, Ken

2014-01-01

This study explored the outcome of introducing Compassion Focused Therapy (CFT) into a standard treatment programme for people with eating disorders. In particular, the aim was to evaluate the principle that CFT can be used with people with eating disorders and improve eating disorder symptomatology. Routinely collected questionnaire data were used to assess cognitive and behavioural aspects of eating disorders and social functioning/well being (n = 99). There were significant improvements on all questionnaire measures during the programme. An analysis by diagnosis found that people with bulimia nervosa improved significantly more than people with anorexia nervosa on most of the subscales. Also, in terms of clinical significance, 73% of those with bulimia nervosa were considered to have made clinically reliable and significant improvements at the end of treatment (compared with 21% of people with anorexia nervosa and 30% of people with atypical eating disorders). This study demonstrates the potential benefits of using CFT with people with eating disorders and highlights the need for further research on this new approach. CFT offers new ways to conceptualize and formulate some of the self-critical and shame-based difficulties associated with eating disorders. CFT offers a framework that can enable people with eating disorders to conceptualize their difficulties in different ways. CFT can be combined with standard therapies especially cognitive behavioural therapy. CFT can be especially useful in a group context where the relationships between members can become increasingly compassionate, validating, supportive and encouraging. Copyright © 2012 John Wiley & Sons, Ltd.

Efficacy trial of a selective prevention program targeting both eating disorders and obesity among female college students: 1- and 2-year follow-up effects.

PubMed

Stice, Eric; Rohde, Paul; Shaw, Heather; Marti, C Nathan

2013-02-01

Evaluate the effects of a prevention program targeting both eating disorders and obesity at 1- and 2-year follow-ups. Female college students at risk for these outcomes because of body image concerns (N = 398) were randomized to the Healthy Weight 2 group-based 4-hr prevention program, which promotes lasting healthy improvements to dietary intake and physical activity and nutrition science health behavior change principles, or an educational brochure control condition. Intervention participants showed significantly less body dissatisfaction and eating disorder symptoms and lower eating disorder onset through 2-year follow-up versus controls, but the former 2 effects were small. There were no main effects for body mass index (BMI), depressive symptoms, dieting, caloric intake, physical activity, or obesity onset. Moderator analyses revealed stronger eating disorder symptom effects for youths with initially elevated symptoms and lower pressure to be thin, stronger BMI effects for youths with initially elevated symptoms and BMI scores, and weaker eating disorder symptom effects for youths with initially elevated pressure to be thin. The 60% reduction in eating disorder onset over the 2-year follow-up was clinically significant and a novel effect for a prevention program, but the main effects on continuous outcomes were small, suggesting that adding nutrition science principles weakened the intervention efficacy. Effects on both eating disorder symptoms and BMI were greater for those with elevated eating disorder symptoms and BMI at pretest, implying that it might be useful to target these individuals in future trials.

Fathers and mothers with eating-disorder psychopathology: Associations with child eating-disorder behaviors.

PubMed

Lydecker, Janet A; Grilo, Carlos M

2016-07-01

A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child's weight, and more monitoring of their child's eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child's diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. Copyright © 2016 Elsevier Inc. All rights reserved.

Fathers and mothers with eating-disorder psychopathology: Associations with child eating-disorder behaviors

PubMed Central

Lydecker, Janet A.; Grilo, Carlos M.

2016-01-01

Objective A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. Methods The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Results Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child’s weight, and more monitoring of their child’s eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child’s diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Conclusion Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. PMID:27302549

A comprehensive model of food addiction in patients with binge-eating symptomatology: The essential role of negative urgency.

PubMed

Wolz, Ines; Granero, Roser; Fernández-Aranda, Fernando

2017-04-01

Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction. 315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model. The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction. Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Loss-of-Control Eating Following Sleeve Gastrectomy Surgery

PubMed Central

Ivezaj, Valentina; Kessler, Erin E.; Lydecker, Janet A.; Barnes, Rachel D.; White, Marney A.; Grilo, Carlos M.

2016-01-01

Background Post-operative loss-of-control (LOC) eating is related to poorer weight loss outcomes following bariatric surgery, but little is known about LOC eating following sleeve gastrectomy surgery. Objectives To examine LOC eating severity and weight loss following sleeve gastrectomy. Setting University School of Medicine, U.S. Methods Participants were 71 individuals (84.5% female; n=60) who underwent sleeve gastrectomy surgery within the previous 4–9 months and reported LOC eating at least once weekly during the previous 28 days. LOC eating was assessed using the Eating Disorder Examination (EDE) Bariatric Surgery Version. Current mean age and body mass index were 47.3 (SD=10.1) years and 37.9 (SD=8.2) kg/m2. Two groups, bariatric binge-eating disorder (Bar-BED) and loss-of-control eating only (LOC-Only) were created based on modified binge-eating disorder (BED) criteria, which excluded the “unusually large quantity of food” criterion due to limited gastric capacity post-surgery. Bar-BED criteria mirrored BED criteria and consisted of the following: at least 12 LOC eating episodes over the prior three months (once weekly), 3 of 5 associated symptoms, marked distress over LOC eating, and lack of regular compensatory behaviors. Results Based on these revised criteria, 49.3% (n=35) were classified as the Bar-BED group and 50.7% (n=36) as the LOC-Only group. Compared to the LOC-Only group, the Bar-BED group had significantly greater EDE global and subscale scores and lower percent weight loss by six months post-surgery. Conclusions Findings suggest LOC eating that parallels BED post-surgery is associated with poorer outcomes following sleeve gastrectomy including poorer weight loss and greater severity of eating-disorder psychopathology. PMID:27913121

Predictors of outcome for cognitive behaviour therapy in binge eating disorder.

PubMed

Lammers, Mirjam W; Vroling, Maartje S; Ouwens, Machteld A; Engels, Rutger C M E; van Strien, Tatjana

2015-05-01

The aim of this naturalistic study was to identify pretreatment predictors of response to cognitive behaviour therapy in treatment-seeking patients with binge eating disorder (BED; N = 304). Furthermore, we examined end-of-treatment factors that predict treatment outcome 6 months later (N = 190). We assessed eating disorder psychopathology, general psychopathology, personality characteristics and demographic variables using self-report questionnaires. Treatment outcome was measured using the bulimia subscale of the Eating Disorder Inventory 1. Predictors were determined using hierarchical linear regression analyses. Several variables significantly predicted outcome, four of which were found to be both baseline predictors of treatment outcome and end-of-treatment predictors of follow-up: Higher levels of drive for thinness, higher levels of interoceptive awareness, lower levels of binge eating pathology and, in women, lower levels of body dissatisfaction predicted better outcome in the short and longer term. Based on these results, several suggestions are made to improve treatment outcome for BED patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Eating disorders and food addiction in men with heroin use disorder: a controlled study.

PubMed

Canan, Fatih; Karaca, Servet; Sogucak, Suna; Gecici, Omer; Kuloglu, Murat

2017-06-01

We aimed to determine the prevalence estimates of binge eating disorder, bulimia nervosa, anorexia nervosa, and food addiction in men with heroin use disorder and a matched sample of control participants. A group of 100 men with heroin use disorder, consecutively admitted to a detoxification and therapy unit, were screened for DSM-5 eating disorders, along with a group of 100 male controls of similar age, education, and body mass index. The Yale Food Addiction Scale (YFAS), the Barratt Impulsivity Scale-version 11, and the Eating Attitudes Test were used for data collection. Patients were also evaluated for various aspects of heroin use disorder (e.g., craving) using the Addiction Profile Index. Binge eating disorder that met DSM-5 criteria was more prevalent in patients with heroin use disorder (21%) than in control subjects (8%) (odds ratio 3.1, 95% confidence interval 1.3-7.3; p < 0.01). Food addiction based on the YFAS was also more common among men with heroin use disorder (28%) than among control participants (12%) (odds ratio 2.9, 95% confidence interval 1.4-6.1; p < 0.01). A current food addiction was associated with more severe craving and having a history of suicide attempts in the patients. Co-occurring binge eating disorder and food addiction are highly frequent in men with heroin use disorder. Screening for binge eating disorder and food addiction in patients with substance use disorder is important, as interventions may improve treatment outcome in this patient group.

Dissonance-based prevention of eating disorder risk factors in middle school girls: results from two pilot trials.

PubMed

Rohde, Paul; Auslander, Beth A; Shaw, Heather; Raineri, Kate M; Gau, Jeff M; Stice, Eric

2014-07-01

Although several eating disorder prevention programs reduce eating disorder risk factors and symptoms for female high school and college students, few efficacious prevention programs exist for female middle school students, despite the fact that body image and eating disturbances often emerge then. Two pilot trials evaluated a new dissonance-based eating disorder prevention program for middle school girls with body image concerns. Female middle school students with body dissatisfaction from two sites [Study 1: N = 81, M age = 12.1, standard deviation (SD) = 0.9; Study 2: N = 52, M age = 12.5, SD = 0.8] were randomized to a dissonance intervention (MS Body Project) or educational brochure control; Study 2 included a 3-month follow-up. Intervention participants showed significant post-test reductions in only one of the six variables with both Studies 1 and 2 (i.e., pressure to be thin and negative affect, respectively), though post-test effect sizes suggested medium reductions in eating disorder risk factors and symptoms (Study 1: M d = .40; Study 2: M d = .65); reductions at 3-month follow-up in Study 2 were not evident (M d = .19). Results suggest that this new middle school version of the Body Project is producing medium magnitude reductions in eating disorder risk factors at post-test but that effects are showing limited persistence. Continued refinement and evaluation of this intervention appears warranted to develop more effective prevention programs for this age group. © 2014 Wiley Periodicals, Inc.

Reward and punishment sensitivity in dysfunctional eating and hazardous drinking women: associations with family risk.

PubMed

Loxton, Natalie J; Dawe, Sharon

2006-11-01

Biologically based personality traits such as reward and punishment sensitivity, and family factors, such as maternal dysfunctional eating and parental alcohol abuse, have been linked to hazardous drinking and disordered eating. However, specific relationships between personality and family factors in the development of these disorders are still unclear. A total of 443 women completed measures of reward and punishment sensitivity, family environment, maternal eating and parental drinking. Reward sensitivity was directly associated with both dysfunctional eating and drinking. Punishment sensitivity was associated with dysfunctional eating but not hazardous drinking. Punishment sensitivity mediated a chaotic family environment and daughters' dysfunctional eating. It is suggested that reward and punishment sensitivity are key traits to examine when investigating vulnerability to risky behaviour. Future research into disordered eating is likely to be advanced by an active search for mediators and moderators of family risk.

Compulsive exercise as a mediator between clinical perfectionism and eating pathology.

PubMed

Egan, Sarah J; Bodill, Kate; Watson, Hunna J; Valentine, Emily; Shu, Chloe; Hagger, Martin S

2017-01-01

The aim of this study was to examine whether compulsive exercise mediates the relationship between clinical perfectionism and eating pathology, based on the cognitive behavioral model of compulsive exercise. Participants were 368 adults who participated regularly in sport/exercise and completed online measures of perfectionism, compulsive exercise and eating disorders. In support of the well-established link between perfectionism and eating disorders, clinical perfectionism predicted eating pathology both directly and indirectly mediated by compulsive exercise. In addition, there were also direct effects of clinical perfectionism on the avoidance/rule-driven behavior, weight control, and mood improvement subscales of the Compulsive Exercise Test (CET). There was a direct effect of the CET weight control subscale on eating pathology and a negative direct effect of the CET subscale mood improvement on eating pathology. Findings lend support to the cognitive behavioral model of compulsive exercise in which clinical perfectionism is conceptualized as related to eating disorders directly and indirectly through the mediation of compulsive exercise. Compulsive exercise was also found to have a direct effect on eating disorders. Compulsive exercise may be a symptom of eating pathology, rather than an antecedent, however causal inferences could not be established given the correlational design. Longitudinal research using cross-lagged panel designs to examine a bidirectional relationship between compulsive exercise and eating disorders is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

A pilot study of maudsley family therapy with group dialectical behavior therapy skills training in an intensive outpatient program for adolescent eating disorders.

PubMed

Johnston, Jennifer A Y; O'Gara, Jesine S X; Koman, Stuart L; Baker, Christina Wood; Anderson, Drew A

2015-06-01

The goal of this study was to provide pilot clinical data on the effectiveness of an intensive outpatient treatment model for adolescent eating disorders that combines Maudsley-based family therapy and group dialectical behavior therapy skills training. Measures of physical and psychological status were gathered upon admission, discharge, and at 3 follow-up intervals. Adolescents who completed the program gained a significant amount of weight and experienced a significant decrease in eating disorder psychopathology. At the 1-year follow-up, 64% of adolescents were weight restored and menstruating normally. Measures of eating disorder psychopathology continued to improve up to a year after treatment. This pilot, multimodal program warrants further investigation and may be an effective intermediate level of care treatment option for adolescent eating disorders. © 2015 Wiley Periodicals, Inc.

Reciprocal Influence of Alliance to the Group and Outcome in Day Treatment for Eating Disorders

ERIC Educational Resources Information Center

Tasca, Giorgio A.; Lampard, Amy M.

2012-01-01

The nature of the alliance-outcome relationship is still emerging. This study examined the reciprocal influence of change in alliance to the group and change in urge to restrict in eating-disordered individuals attending a group-based day treatment. Participants (N = 238) were a transdiagnostic or mixed diagnostic sample of eating-disordered…

Are food restriction and pressure-to-eat parenting practices associated with adolescent disordered eating behaviors?

PubMed

Loth, Katie A; MacLehose, Richard F; Fulkerson, Jayne A; Crow, Scott; Neumark-Sztainer, Dianne

2014-04-01

To examine associations between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors, within a sample of parent-adolescent pairs. Adolescents (N = 2,231) and their parents (N = 3,431) participated in two, coordinated, population-based studies designed to examine factors associated with weight and weight-related behaviors in adolescents. Overall, higher levels of pressure-to-eat or food restriction were 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 ≤ .01). Examination of the association between food-related parenting practices and disordered eating behaviors among girls revealed fewer significant associations. However, analyses revealed 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 = .04). 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. Copyright © 2013 Wiley Periodicals, Inc.

Are food restriction and pressure-to-eat parenting practices associated with adolescent disordered eating behaviors?

PubMed Central

Loth, Katie A.; MacLehose, Richard F.; Fulkerson, Jayne A.; Crow, Scott; Neumark-Sztainer, Dianne

2014-01-01

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

Food for thought: a pilot study of the pros and cons of changing eating patterns within cognitive-behavioural therapy for the eating disorders.

PubMed

Waller, Glenn; Evans, Jane; Pugh, Matthew

2013-09-01

Evidence-based cognitive-behavioural therapy (CBT) for the eating disorders has an early focus on behavioural changes around food intake. However, patients' anxiety around such change might account for why they often seem unmotivated in treatment. In order to determine the impact of changing intake, this pilot study of patients with bulimic disorders (N = 19) or anorexia nervosa (N = 9) used a mixed quantitative and qualitative design to retrospectively examine their perspectives of the short- and long-term pros and cons of such change. As expected, change was seen negatively in the short-term (with particularly high numbers reporting anxiety), but there were few reports of long-term negative outcomes. In contrast, there were both short- and long-term benefits of changing eating. The patients described what was helpful in making changes and what they had learned as a result. In both cases, their descriptions mapped closely onto the content and process of evidence-based CBT for the eating disorders. Although there is a need for more extensive research, these findings suggest that patients (and therapists) might benefit from being aware of the contrast between the short- and the long-term pros and cons of changing eating within CBT for the eating disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

Acceptance and commitment therapy as a novel treatment for eating disorders: an initial test of efficacy and mediation.

PubMed

Juarascio, Adrienne; Shaw, Jena; Forman, Evan; Timko, C Alix; Herbert, James; Butryn, Meghan; Bunnell, Douglas; Matteucci, Alyssa; Lowe, Michael

2013-07-01

Eating disorders are among the most challenging disorders to treat, with even state-of-the-art cognitive-behavioral treatments achieving only modest success. One possible reason for the high rate of treatment failure for eating disorders is that existing treatments do not attend sufficiently to critical aspects of the disorder such as high experiential avoidance, poor experiential awareness, and lack of motivation. These variables are explicit targets of Acceptance and Commitment Therapy (ACT). The current study examined the efficacy of an ACT-based group treatment for eating disorders by examining whether the addition of ACT groups to treatment-as-usual (TAU) at a residential treatment facility for eating disorders would improve treatment outcomes. TAU patients received an intensive residential treatment, while ACT patients received these services but additionally attended, depending on diagnosis, either ACT for anorexia nervosa groups or ACT for bulimia nervosa groups. Although individuals in both treatment conditions demonstrated large decreases in eating pathology, there were trends toward larger decreases among those receiving ACT. ACT patients also showed lower rates of rehospitalization during the 6 months after discharge. Overall, results suggest that ACT is a viable treatment option for individuals with eating pathology and further outcome research is warranted.

Ghrelin and Eating Disorders

PubMed Central

Atalayer, Deniz; Gibson, Charlisa; Konopacka, Alexandra; Geliebter, Allan

2012-01-01

There is growing evidence supporting a multifactorial etiology that includes genetic, neurochemical, and physiological components for eating disorders above and beyond the more conventional theories based on psychological and sociocultural factors. Ghrelin is one of the key gut signals associated with appetite, and the only known circulating hormone that triggers a positive energy balance by stimulating food intake. This review summarizes recent findings and several conflicting reports on ghrelin in eating disorders. Understanding these findings and inconsistencies may help in developing new methods to prevent and treat patients with these disorders. PMID:22960103

Distinguishing Between Risk Factors for Bulimia Nervosa, Binge Eating Disorder, and Purging Disorder.

PubMed

Allen, Karina L; Byrne, Susan M; Crosby, Ross D

2015-08-01

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, this significant indirect effect was not moderated by eating disorder group. The results support a prospective model of risk that applies to bulimia nervosa, binge eating disorder and purging disorder. Common prevention approaches may be possible for bulimia nervosa, binge eating disorder and purging disorder.

Pathological and non-pathological variants of restrictive eating behaviors in middle childhood: A latent class analysis.

PubMed

Schmidt, Ricarda; Vogel, Mandy; Hiemisch, Andreas; Kiess, Wieland; Hilbert, Anja

2018-08-01

Although restrictive eating behaviors are very common during early childhood, their precise nature and clinical correlates remain unclear. Especially, there is little evidence on restrictive eating behaviors in older children and their associations with children's shape concern. The present population-based study sought to delineate subgroups of restrictive eating patterns in N = 799 7-14 year old children. Using Latent Class Analysis, children were classified based on six restrictive eating behaviors (for example, picky eating, food neophobia, and eating-related anxiety) and shape concern, separately in three age groups. For cluster validation, sociodemographic and objective anthropometric data, parental feeding practices, and general and eating disorder psychopathology were used. The results showed a 3-cluster solution across all age groups: an asymptomatic class (Cluster 1), a class with restrictive eating behaviors without shape concern (Cluster 2), and a class showing restrictive eating behaviors with prominent shape concern (Cluster 3). The clusters differed in all variables used for validation. Particularly, the proportion of children with symptoms of avoidant/restrictive food intake disorder was greater in Cluster 2 than Clusters 1 and 3. The study underlined the importance of considering shape concern to distinguish between different phenotypes of children's restrictive eating patterns. Longitudinal data are needed to evaluate the clusters' predictive effects on children's growth and development of clinical eating disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

Gender-related risk and protective factors for depressive symptoms and disordered eating in adolescence: a 4-year longitudinal study.

PubMed

Ferreiro, Fátima; Seoane, Gloria; Senra, Carmen

2012-05-01

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 depressive symptoms, disordered eating and the co-occurrence of both problems from preadolescence to mid-adolescence and to identify gender-specific risk and protective factors of depressive symptoms and disordered eating. A Spanish community-based sample initially comprising 942 early adolescents (49% females) was assessed at baseline (T1; X (age) = 10.8 years) and at 2 and 4-year follow-up (T2 and T3). Gender differences emerged at T2 for disordered eating and at T3 for depressive symptoms and for co-occurring depressive symptoms and disordered eating. Predictors of depressive symptoms were body dissatisfaction, low self-esteem and fear of getting fat, for girls, and body dissatisfaction and low self-esteem, for boys. Predictors of disordered eating were body dissatisfaction, depressive symptoms, BMI and perfectionism, for girls, and low social support and BMI, for boys. In addition, for boys only, social support moderated the effect of body dissatisfaction on depressive symptoms and the effect of depressive symptoms on disordered eating. The hypotheses of the study were partially supported. Clinical implications are derived regarding the components that should be included in programs for preventing depression and eating disorders in both girls and boys.

The role of impulsivity traits and delayed reward discounting in dysregulated eating and drinking among heavy drinkers

PubMed Central

Stojek, Monika M.; Fischer, Sarah; Murphy, Cara M.; MacKillop, James

2016-01-01

Impulsivity is a multifaceted construct that has been linked to dysregulated eating and problematic alcohol use. The UPPS model identifies five personality-based impulsivity traits that have unique predictive utility: Negative Urgency, Perseverance, Premeditation, Sensation Seeking, and Positive Urgency. Delayed reward discounting (DRD) is an index of impulsive decision making characterized by preference for smaller immediate gains at the cost of larger delayed gains. In the current study, we sought to refine the influence of impulsive personality traits and DRD on disordered eating patterns and problematic drinking. One hundred and eight treatment-seeking heavy drinkers were assessed for UPPS impulsivity traits, DRD, disordered eating, alcohol use, and demographic information. With regard to disordered eating patterns, DRD predicted higher levels of Dietary Restraint and Weight and Shape Concerns. Negative Urgency predicted binge eating and Weight and Shape Concerns. Positive Urgency predicted Eating Concerns. Female sex predicted Eating, Weight, and Shape Concerns. When considering problematic alcohol use, only Negative Urgency and Sensation Seeking were predictive. This is the first study to examine both personality-based impulsivity and DRD in relation to pathological eating and drinking behavior. The results suggest the importance of disentangling the contributions of various impulsivity constructs on dysregulated eating. PMID:24816318

The role of impulsivity traits and delayed reward discounting in dysregulated eating and drinking among heavy drinkers.

PubMed

Stojek, Monika M; Fischer, Sarah; Murphy, Cara M; MacKillop, James

2014-09-01

Impulsivity is a multifaceted construct that has been linked to dysregulated eating and problematic alcohol use. The UPPS model identifies five personality-based impulsivity traits that have unique predictive utility: Negative Urgency, Perseverance, Premeditation, Sensation Seeking, and Positive Urgency. Delayed reward discounting (DRD) is an index of impulsive decision making characterized by preference for smaller immediate gains at the cost of larger delayed gains. In the current study, we sought to refine the influence of impulsive personality traits and DRD on disordered eating patterns and problematic drinking. One hundred and eight treatment-seeking heavy drinkers were assessed for UPPS impulsivity traits, DRD, disordered eating, alcohol use, and demographic information. With regard to disordered eating patterns, DRD predicted higher levels of Dietary Restraint and Weight and Shape Concerns. Negative Urgency predicted binge eating and Weight and Shape Concerns. Positive Urgency predicted Eating Concerns. Female sex predicted Eating, Weight, and Shape Concerns. When considering problematic alcohol use, only Negative Urgency and Sensation Seeking were predictive. This is the first study to examine both personality-based impulsivity and DRD in relation to pathological eating and drinking behavior. The results suggest the importance of disentangling the contributions of various impulsivity constructs on dysregulated eating. Copyright © 2014. Published by Elsevier Ltd.

What's eating the internet? Content and perceived harm of pro-eating disorder websites.

PubMed

Steakley-Freeman, Diana M; Jarvis-Creasey, Zachary L; Wesselmann, Eric D

2015-12-01

The internet is a popular tool for information dissemination and community building, serving many purposes from social networking to support seeking. However, there may be a downside to using some online support communities. For individuals with eating disorders (EDs), it is possible that certain online communities may reinforce the negative social aspects that encourage these disorders, rather than positive aspects that would facilitate treatment and recovery. Previous research identified several linguistic themes present on pro-eating disorder websites in an attempt to better understand the web-based conversation in the pro-eating disorder movement. We hypothesized that differences in theme presentation may predict changes in perceived harm. The present study sought to understand the perceived harm, and presentation patterns of pro-eating disorder (Pro-ED) website content. We replicated and extended previous research by having laypersons code these websites' content using previously identified linguistic themes and rate perceived harm. Our data replicate and extend the previous research by finding the same associations between co-occurring themes, and investigating associated perceived harm. We found that themes of Sacrifice, Control, Deceit, and Solidarity were associated with the highest perceived harm scores. In addition, we suggest an initial conceptualization of the "Eating Disorder Lifestyle", and its associations with the themes of Isolation, Success, and Solidarity. This research may provide clinicians with information to better understand the potential influence these sites have on eating disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors influencing the utilization of empirically supported treatments for eating disorders.

PubMed

Simmons, Angela M; Milnes, Suzanne M; Anderson, Drew A

2008-01-01

This study expands upon previous research investigating the use of empirically supported treatments (ESTs) for eating disorders by surveying a large sample of clinicians who specialize in treating eating disorders. Surveys developed for this study were sent to 698 members of a large, professional, eating disorder organization who were listed as treatment providers on the organization's website. Despite clinicians reporting frequently using CBT techniques, most identified something other than CBT or IPT as their primary approach to treatment. In contrast with previous research, the majority had received prior training in the use of manual-based treatments. However, consistent with previous investigations, most denied regular use of such treatments. Although manual-based CBT and IPT are referred to as "treatments of choice," professional clinicians in the field are not consistently using them. Responses suggest several barriers to the utilization of ESTs in practice.

Attitudes towards psychotherapy manuals among clinicians treating eating disorders.

PubMed

Waller, Glenn; Mountford, Victoria A; Tatham, Madeleine; Turner, Hannah; Gabriel, Chloe; Webber, Rebecca

2013-12-01

Clinicians have relatively low uptake and implementation of evidence-based psychotherapies for the eating disorders, and this problem appears to be associated with low use of manualized approaches. This study examines clinicians' positive and negative attitudes to manuals, and possible beliefs and emotional factors that might drive those attitudes. The participants were 125 psychological therapists working with eating-disordered patients. Each completed standardised measures of attitudes to manuals and emotional states. A number of beliefs about the content of manuals were associated with both positive attitudes to the outcome of treatment and negative attitudes to their impact on the treatment process. In addition, a more positive mood was associated with more positive attitudes. Suggestions are made regarding how attitudes might be made more positive, in order to facilitate the use of evidence-based therapies for eating disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

Testing Mediators Hypothesized to Account for the Effects of a Dissonance Eating Disorder Prevention Program Over Longer-Term Follow-Up

PubMed Central

Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

2011-01-01

Objective Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method Data were drawn from a randomized effectiveness trial in which 306 female high school students (M age = 15.7 SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Results Dissonance participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Conclusions Findings provided support for the intervention theory of this eating disorder prevention program over longer-term follow-up, extending the evidence base for this effective intervention. PMID:21500884

Parents of children with eating disorders: developing theory-based health communication messages to promote caregiver well-being.

PubMed

Patel, Sheetal; Shafer, Autumn; Brown, Jane; Bulik, Cynthia; Zucker, Nancy

2014-01-01

Parents of children with eating disorders experience extreme emotional burden because of the intensity and duration of the recovery process. While parental involvement in a child's eating disorder treatment improves outcomes, parents often neglect their own well-being, which can impede their child's recovery. This study extends the research on caregivers and on health theory in practice by conducting formative research to develop a theory-based communication intervention encouraging parents to engage in adaptive coping and self-care behaviors. The Transactional Model of Stress and Coping and the Transtheoretical Model guided qualitative assessments of the determinants of parents' coping behaviors. Three focus groups with 19 parents of children with eating disorders and 19 semi-structured interviews with experts specializing in eating disorders were conducted. Findings indicate that parents and experts see parents' need for permission to take time for themselves as the main barrier to self-care. The main motivator for parents to engage in coping behaviors is awareness of a connection between self-care and their child's health outcomes. Participant evaluation of six potential messages for main themes and effectiveness revealed that theory-based elements, such as certain processes of change within the Transtheoretical Model, were important to changing health behavior.

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

PubMed

DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William

2013-06-01

Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed.

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors

PubMed Central

DeBate, Rita D.; Severson, Herbert H.; Cragun, Deborah L.; Gau, Jeff M.; Merrell, Laura K.; Bleck, Jennifer R.; Christiansen, Steve; Koerber, Anne; Tomar, Scott L.; McCormack Brown, Kelli R.; Tedesco, Lisa A.; Hendricson, William

2013-01-01

Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51–0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed. PMID:23564725

Binge Eating Disorder and Night Eating Syndrome: A Comparative Study of Disordered Eating

ERIC Educational Resources Information Center

Allison, Kelly C.; Grilo, Carlos M.; Masheb, Robin M.; Stunkard, Albert J.

2005-01-01

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…

A randomized, comparative pilot trial of family-based interpersonal psychotherapy for reducing psychosocial symptoms, disordered-eating, and excess weight gain in at-risk preadolescents with loss-of-control-eating.

PubMed

Shomaker, Lauren B; Tanofsky-Kraff, Marian; Matherne, Camden E; Mehari, Rim D; Olsen, Cara H; Marwitz, Shannon E; Bakalar, Jennifer L; Ranzenhofer, Lisa M; Kelly, Nichole R; Schvey, Natasha A; Burke, Natasha L; Cassidy, Omni; Brady, Sheila M; Dietz, Laura J; Wilfley, Denise E; Yanovski, Susan Z; Yanovski, Jack A

2017-09-01

Preadolescent loss-of-control-eating (LOC-eating) is a risk factor for excess weight gain and binge-eating-disorder. We evaluated feasibility and acceptability of a preventive family-based interpersonal psychotherapy (FB-IPT) program. FB-IPT was compared to family-based health education (FB-HE) to evaluate changes in children's psychosocial functioning, LOC-eating, and body mass. A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC-eating. Youth-parent dyads were randomized to 12-week FB-IPT (n = 15) or FB-HE (n = 14) and evaluated at post-treatment, six-months, and one-year. Changes in child psychosocial functioning, LOC-eating, BMI, and adiposity by dual-energy-X-ray-absorptiometry were assessed. Missing follow-up data were multiply imputed. FB-IPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow-up assessments were completed by 73% FB-IPT and 86% FB-HE at post-treatment, 60% and 64% at six-months, and 47% and 57% at one-year. At post-treatment, children in FB-IPT reported greater decreases in depression (95% CI -7.23, -2.01, Cohen's d = 1.23) and anxiety (95% CI -6.08, -0.70, Cohen's d = .79) and less odds of LOC-eating (95% CI -3.93, -0.03, Cohen's d = .38) than FB-HE. At six-months, children in FB-IPT had greater reductions in disordered-eating attitudes (95% CI -0.72, -0.05, Cohen's d = .66) and at one-year, tended to have greater decreases in depressive symptoms (95% CI -8.82, 0.44, Cohen's d = .69) than FB-HE. There was no difference in BMI gain between the groups. Family-based approaches that address interpersonal and emotional underpinnings of LOC-eating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered-eating or excess weight gain requires further study. © 2017 Wiley Periodicals, Inc.

Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED)

PubMed Central

Simpson, Susan G.; Pietrabissa, Giada; Rossi, Alessandro; Seychell, Tahnee; Manzoni, Gian Mauro; Munro, Calum; Nesci, Julian B.; Castelnuovo, Gianluca

2018-01-01

Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population. Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population. PMID:29740379

Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED).

PubMed

Simpson, Susan G; Pietrabissa, Giada; Rossi, Alessandro; Seychell, Tahnee; Manzoni, Gian Mauro; Munro, Calum; Nesci, Julian B; Castelnuovo, Gianluca

2018-01-01

Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population. Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population.

Imagery rescripting and cognitive dissonance: A randomized controlled trial of two brief online interventions for women at risk of developing an eating disorder.

PubMed

Pennesi, Jamie-Lee; Wade, Tracey D

2018-05-01

This pilot study compared two brief online interventions, imagery rescripting and cognitive dissonance, to an assessment-only control condition in a sample of body-dissatisfied young women at risk of developing an eating disorder. We examined the degree to which each intervention reduced disordered eating and modified risk and protective factors for eating disorders. Female university students (N = 107, 17-28 years of age) completed a screening questionnaire, followed by random allocation to one of the three conditions, followed by a baseline assessment, body dissatisfaction induction, and brief online intervention. Participants in the active conditions then completed online daily home practice and a postintervention questionnaire. Findings provide qualified support for the imagery rescripting intervention, with participants reporting higher body image acceptance (Cohen's d = 0.49) than the cognitive dissonance condition, and higher self-compassion (d = 0.59) and lower levels of disordered eating (d = 0.59) than the control condition, at postintervention. There was no significant impact of cognitive dissonance on any factors. Change in body image acceptance and self-compassion mediated the relationship between allocated condition and change in disordered eating at postintervention. These findings provide preliminary support for the use of online-adapted imagery-based techniques (e.g., imagery rescripting) to reduce risk for the development of an eating disorder by strengthening protective factors (i.e., body image acceptance and self-compassion) and reducing disordered eating. Further exploration of the use of imagery strategies in the prevention of disordered eating is required, including prospective tests of the mechanisms of action. © 2018 Wiley Periodicals, Inc.

Attention-deficit/hyperactivity disorder symptoms and psychological comorbidity in eating disorder patients.

PubMed

Sala, L; Martinotti, G; Carenti, M L; Romo, L; Oumaya, M; Pham-Scottez, A; Rouillon, F; Gorwood, P; Janiri, L

2017-05-22

There is some evidence that eating disorders (ED) and Attention-deficit/hyperactivity disorder (ADHD) share common clinical features and that ADHD might contribute to the severity of eating disorders. A greater understanding of how the presence of comorbid ADHD may affect the psychopathological framework of eating disorder seems of primary importance. The aim of our study was to evaluate rates of ADHD in three ED subgroups of inpatients: anorexia nervosa restricting type (AN-R), anorexia nervosa binge-eating/purging type (AN-BP) and bulimia nervosa (BN). The secondary aim was the evaluation of the associated psychological characteristics. The sample consisted of 73 females inpatients (mean age 28.07 ± 7.30), all with longstanding histories of eating disorder (ED). The presence of a diagnosis of ADHD was evaluated in a clinical interview based on DSM-IV-TR criteria. The following psychometric instruments were used: the eating attitude test (EAT-40), the Bulimic Investigatory Test, Edinburgh (BITE), the Eating Disorder Inventory (EDI-2), the Wender Utah Rating Scale (WURS), the Brown Attention Deficit Disorder Scale (BADDS), the Hamilton scales for Anxiety (HAM-A) and Depression (HAM-D), and the Barrat Impulsivity Scale (BIS-10). Among the three ED subgroups, 13 patients reported comorbidity with ADHD; three in the AN-R subtype, nine in the AN-BP and one in the BN. The remaining 60 patients (n = 34 AN-R; n = 19 AN-BP; n = 7 BN) presented only a diagnosis of ED. The EAT (p = 0.04) and HAM-A (p = 0.02) mean scores were significantly higher in patients with comorbid ADHD. In our study the comorbidity between ADHD and ED appeared to be frequent, particularly among patients with AN-BP. ED inpatients with higher level of anxiety and more abnormal eating attitudes and bulimic symptoms should be assessed for potentially associated ADHD.

Novel and ultra-rare damaging variants in neuropeptide signaling are associated with disordered eating behaviors

PubMed Central

Bahl, Ethan; Hannah, Claire; Hofammann, Dabney; Acevedo, Summer; Cui, Huxing; McAdams, Carrie J.

2017-01-01

Objective Eating disorders develop through a combination of genetic vulnerability and environmental stress, however the genetic basis of this risk is unknown. Methods To understand the genetic basis of this risk, we performed whole exome sequencing on 93 unrelated individuals with eating disorders (38 restricted-eating and 55 binge-eating) to identify novel damaging variants. Candidate genes with an excessive burden of predicted damaging variants were then prioritized based upon an unbiased, data-driven bioinformatic analysis. One top candidate pathway was empirically tested for therapeutic potential in a mouse model of binge-like eating. Results An excessive burden of novel damaging variants was identified in 186 genes in the restricted-eating group and 245 genes in the binge-eating group. This list is significantly enriched (OR = 4.6, p<0.0001) for genes involved in neuropeptide/neurotrophic pathways implicated in appetite regulation, including neurotensin-, glucagon-like peptide 1- and BDNF-signaling. Administration of the glucagon-like peptide 1 receptor agonist exendin-4 significantly reduced food intake in a mouse model of ‘binge-like’ eating. Conclusions These findings implicate ultra-rare and novel damaging variants in neuropeptide/neurotropic factor signaling pathways in the development of eating disorder behaviors and identify glucagon-like peptide 1-receptor agonists as a potential treatment for binge eating. PMID:28846695

The direct health care costs of eating disorders among hospitalized patients: A population-based study.

PubMed

de Oliveira, Claire; Colton, Patricia; Cheng, Joyce; Olmsted, Marion; Kurdyak, Paul

2017-12-01

To estimate the direct health care costs of eating disorders in Ontario, Canada, in 2012, using a prevalence-based cost-of-illness approach. We selected a population-based sample of all patients eligible for public health care insurance over the age of 4 with a hospitalization for an eating disorder at any point since 1988. We estimated total and mean direct net costs per patient in 2012, from the third public payer perspective, by sex, age group, and health service type. In 2012, there were 6,326 patients ever hospitalized for an eating disorder. They had a mean age of 31 at hospitalization, were mostly female (93%), and generally from high-income, urban neighborhoods. Direct total costs were just under $63 million CAD; direct net costs were roughly $48 million CAD. Mean net costs per patient were higher for females than males ($7,743.40 and $6,340.50, respectively), and higher for patients under 20 and patients 65+ ($17,961.50 and $14,953.90, respectively). The main cost drivers were psychiatric hospitalizations and physician visits, although this varied by age group. For younger patients, net costs were mainly because of psychiatric hospitalizations, while for older patients net costs were mainly because of psychiatric and nonpsychiatric hospitalizations, and other care. The cost of eating disorders is substantial and varies by sex and age group. Our findings suggest that, from a health care utilization/cost perspective, the effect of eating disorders is likely to persist over the lifespan. © 2017 Wiley Periodicals, Inc.

The Development of Eating Behavior - Biology and Context

PubMed Central

Gahagan, Sheila

2012-01-01

Eating is necessary for survival, gives great pleasure and can be perturbed leading to undernutrition, overnutrition and eating disorders. The development of feeding in humans relies on complex interplay between homeostatic mechanisms; neural reward systems; and child motor, sensory and socio-emotional capability. Furthermore, parenting, social influences and the food environment influence the development of eating behavior. The rapid expansion of new knowledge in this field, from basic science to clinical and community-based research, is expected to lead to urgently needed research in support of effective, evidence-based prevention and treatment strategies for undernutrition, overnutrition and eating disorders in early childhood. Using a biopsychosocial approach, this review covers current knowledge of the development of eating behavior from the brain to the individual child, taking into account important contextual influences. PMID:22472944

Transdiagnostic Theory and Application of Family-Based Treatment for Youth with Eating Disorders

ERIC Educational Resources Information Center

Loeb, Katharine L.; Lock, James; Greif, Rebecca; le Grange, Daniel

2012-01-01

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…

Paternal age at childbirth and eating disorders in offspring.

PubMed

Javaras, K N; Rickert, M E; Thornton, L M; Peat, C M; Baker, J H; Birgegård, A; Norring, C; Landén, M; Almqvist, C; Larsson, H; Lichtenstein, P; Bulik, C M; D'Onofrio, B M

2017-02-01

Advanced paternal age at childbirth is associated with psychiatric disorders in offspring, including schizophrenia, bipolar disorder and autism. However, few studies have investigated paternal age's relationship with eating disorders in offspring. In a large, population-based cohort, we examined the association between paternal age and offspring eating disorders, and whether that association remains after adjustment for potential confounders (e.g. parental education level) that may be related to late/early selection into fatherhood and to eating disorder incidence. Data for 2 276 809 individuals born in Sweden 1979-2001 were extracted from Swedish population and healthcare registers. The authors used Cox proportional hazards models to examine the effect of paternal age on the first incidence of healthcare-recorded anorexia nervosa (AN) and all eating disorders (AED) occurring 1987-2009. Models were adjusted for sex, birth order, maternal age at childbirth, and maternal and paternal covariates including country of birth, highest education level, and lifetime psychiatric and criminal history. Even after adjustment for covariates including maternal age, advanced paternal age was associated with increased risk, and younger paternal age with decreased risk, of AN and AED. For example, the fully adjusted hazard ratio for the 45+ years (v. the 25-29 years) paternal age category was 1.32 [95% confidence interval (CI) 1.14-1.53] for AN and 1.26 (95% CI 1.13-1.40) for AED. In this large, population-based cohort, paternal age at childbirth was positively associated with eating disorders in offspring, even after adjustment for potential confounders. Future research should further explore potential explanations for the association, including de novo mutations in the paternal germline.

An Internet-based intervention for eating disorders consisting of automated computer-tailored feedback with or without supplemented frequent or infrequent support from a coach: study protocol for a randomized controlled trial.

PubMed

Aardoom, Jiska J; Dingemans, Alexandra E; Spinhoven, Philip; Hakkaart-van Roijen, Leona; Van Furth, Eric F

2013-10-17

Several Internet-based interventions for eating disorders have shown their effectiveness. Still, there is a need to refine such interventions given that most existing programs seem to be limited by their static 'one-size-fits-all' approach. 'Featback', an Internet-based intervention for symptoms of eating disorders provides a more individualized approach. It consists of several components (psychoeducation, a fully automated monitoring and feedback system, and support from a coach), which can be matched to participants' needs and preferences. Until now, it is unclear whether online self-help interventions for eating disorders with support are more effective than those without. The aims of the current study are i) to examine the relative effectiveness of (the different components of) Featback; ii) to examine predictors, moderators and mediators of intervention responses; iii) to report on practical experiences with Featback; and iv) to examine the cost-effectiveness of Featback. Individuals aged 16 years or older, with mild to severe eating disorder symptoms will be randomized to one of the four study conditions. In condition one, participants receive the basic version of Featback, consisting of psychoeducation and a fully automated monitoring and feedback system. In conditions two and three, participants receive the basic version of Featback supplemented with the possibility of infrequent (weekly) or frequent (three times a week) e-mail, chat, or Skype support from a coach, respectively. The fourth condition is a waiting list control condition. Participants are assessed at baseline, post-intervention (8 weeks), and at 3- and 6-month follow-up (the latter except for participants in the waiting list control condition). Primary outcome measures are disordered eating behaviors and attitudes. Secondary outcome measures are (eating disorder-related) quality of life, self-stigma of seeking help, self-esteem, mastery and support, symptoms of depression and anxiety, repetitive negative thinking, motivation to change, user satisfaction, compliance, and help-seeking attitudes and behaviors. This study aims to provide more insight into the (cost-) effectiveness of Internet-based interventions for eating disorders, particularly those with and without professional support, as well as different levels of support. NTR3646.

Eating disorders among patients incarcerated only for repeated shoplifting: a retrospective quasi-case-control study in a medical prison in Japan.

PubMed

Asami, Tomokuni; Okubo, Yoshiro; Sekine, Mizuho; Nomura, Toshiaki

2014-06-07

Shoplifting is a serious problem among patients with eating disorders. For more than a decade, we have treated many patients with eating disorders incarcerated in Hachioji Medical Prison only for repeated shoplifting. We analyzed the prison records and medical records of female psychiatric patients transferred to Hachioji Medical Prison between 2002 and 2011. Based on the offense listed at the time of sentencing, we extracted a shoplifting group and a drug-offense group from among all patients with eating disorders. One patient from the former group who had used substances and two from the latter group who had never shoplifted were excluded from the study. The groups had 41 and 14 patients, respectively. A control group comprised patients with other mental disorders (n = 34). We compared eating disorder histories and subtypes, weight changes, comorbidities, life histories, past behavioral problems, and clinical behavioral problems among the three groups. The shoplifting group exhibited less impulsive behavior, substance abuse, antisocial features, borderline personality disorder, and past bulimia than did the drug-offense and control groups. The shoplifting group had higher educational achievement and steadier employment; however, their eating disorder histories and interpersonal dysfunction were more severe, and they had a higher psychiatric treatment dropout rate. There were also significant relationships with low body weight, anorexia nervosa-restricting type, obsessive-compulsive behaviors, and obsessive-compulsive personality disorder in the shoplifting group. During the clinical course, food refusal, excessive exercise, food hoarding, and falsification of dietary intake amounts were more frequently observed in the shoplifting group. Conversely, drug requests and occurrences of self-harm were less frequent in the shoplifting group than in the drug-offense group. Although these results may be associated with specific characteristics of patients with eating disorders in the medical prison setting, we concluded that the repeated shoplifting by these patients is unrelated to antisocial or impulsive characteristics but is deeply rooted in these patients' severe and undertreated eating disorder psychopathology. Strong supportive treatment should be considered for patients with eating disorders who develop shoplifting behaviors. Further research is required to elucidate the mechanisms responsible for the relationship between shoplifting and eating disorders.

Eating styles in major depressive disorder: Results from a large-scale study.

PubMed

Paans, Nadine P G; Bot, Mariska; van Strien, Tatjana; Brouwer, Ingeborg A; Visser, Marjolein; Penninx, Brenda W J H

2018-02-01

Depressed persons have been found to present disturbances in eating styles, but it is unclear whether eating styles are different in subgroups of depressed patients. We studied the association between depressive disorder, severity, course and specific depressive symptom profiles and unhealthy eating styles. Cross-sectional and course data from 1060 remitted depressed patients, 309 currently depressed patients and 381 healthy controls from the Netherlands Study of Depression and Anxiety were used. Depressive disorders (DSM-IV based psychiatric interview) and self-reported depressive symptoms (Inventory of Depressive Symptomatology) were related to emotional, external and restrained eating (Dutch Eating Behavior Questionnaire) using analyses of covariance and linear regression. Remitted and current depressive disorders were significantly associated with higher emotional eating (Cohen's d = 0.40 and 0.60 respectively, p < 0.001) and higher external eating (Cohen's d = 0.20, p = 0.001 and Cohen's d = 0.32, p < 0.001 respectively). Little differences in eating styles between depression course groups were observed. Associations followed a dose-response association, with more emotional and external eating when depression was more severe (both p-values <0.001). Longer symptom duration was also associated to more emotional and external eating (p < 0.001 and p = 0.001 respectively). When examining individual depressive symptoms, neuro-vegetative depressive symptoms contributed relatively more to emotional and external eating, while mood and anxious symptoms contributed relatively less to emotional and external eating. No depression associations were found with restrained eating. Intervention programs for depression should examine whether treating disordered eating specifically in those with neuro-vegetative, atypical depressive symptoms may help prevent or minimize adverse health consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Eating Disorders Glossary

MedlinePlus

... Inventory for Children (EDI-C) Kids' Eating Disorders Survey (KEDS) Questionnaire for Eating Disorder Diagnosis (Q-EDD) ... Inventory for Children (EDI-C) Kids' Eating Disorders Survey (KEDS) Questionnaire for Eating Disorder Diagnosis (Q-EDD) ...

Evaluate, assess, treat: development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues.

PubMed

DeBate, R D; Cragun, D; Gallentine, A A; Severson, H H; Shaw, T; Cantwell, C; Christiansen, S; Koerber, A; Hendricson, W; Tomar, S L; McCormack Brown, K; Tedesco, L A

2012-11-01

Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues whilst interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e. early detection of oral manifestations of disordered eating behaviours, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviours. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and seven dental (D) classes from eight institutions were randomized to either the intervention or control conditions. Both groups completed pre- and post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention whilst controlling for baseline levels. Statistically significant improvements from pre- to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all P < 0.01). Effect sizes ranged from 0.57 to 0.95. No statistically significant differences in outcomes were observed by type of student. Although the EAT Framework was developed as part of a larger study on secondary prevention of eating disorders, the procedures and skills presented can be applied to other sensitive oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication. © 2012 John Wiley & Sons A/S.

Evaluate, Assess, Treat: Development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues

PubMed Central

DeBate, Rita D.; Cragun, Deborah; Gallentine, Ashley A.; Severson, Herbert H.; Shaw, Tracey; Cantwell, Carley; Christiansen, Steve; Koerber, Anne; Hendricson, William; Tomar, Scott L.; Brown, Kelli McCormack; Tedesco, Lisa A.

2012-01-01

Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues while interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e., early detection of oral manifestations of disordered eating behaviors, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviors. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and 7 dental (D) classes from 8 institutions were randomized to either the intervention or control conditions. Both groups completed preand post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention while controlling for baseline levels. Statistically significant improvements from pre-to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all p < .01). Effect sizes ranged from .57–.95. No statistically significant differences in outcomes were observed by type of student. Although the EAT Framework was developed as part of a larger study on secondary prevention of eating disorders, the procedures and skills presented can be applied to other sensitive oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication. PMID:23050505

What Drives the Association between Weight Conscious Peer Groups and Disordered Eating? Disentangling Genetic and Environmental Selection from Pure Socialization Effects

PubMed Central

O’Connor, Shannon M.; Burt, S. Alexandra; VanHuysse, Jessica L.; Klump, Kelly L.

2015-01-01

Previous studies suggest strong associations between exposure to weight conscious peer groups and increased levels of disordered eating. This association has been attributed to socialization effects (i.e., membership leads to disordered eating); however, selection effects (i.e., selecting into peer groups based on genetic and/or environmental predispositions toward disordered eating) could contribute to or even account for these associations. The current study was the first to use a co-twin control design to disentangle these types of selection factors from socialization effects. Participants included 610 female twins (ages 8–14) drawn from the Michigan State University Twin Registry. To comprehensively examine a range of eating pathology, several disordered eating attitudes and behaviors (e.g., body dissatisfaction, binge eating) were examined via self-report questionnaires. Questionnaires also were used to assess peer group emphasis on body weight and shape. Replicating previous results, significant individual-level associations were found between membership in weight conscious peer groups and disordered eating. However, co-twin control analyses indicated that these associations were largely due to genetic and/or shared environmental selection factors rather than pure socialization effects. Importantly, results remained unchanged when controlling for pubertal status, suggesting that effects do not vary across developmental stage. Overall, these findings question whether associations between weight conscious peer groups and disordered eating are due entirely to socialization processes. Future studies are needed to identify the specific genetic and/or shared environmental factors that may drive selection into weight conscious peer groups. PMID:27043917

Reciprocal associations between depressive symptoms and disordered eating among adolescent girls and boys: a multiwave, prospective study.

PubMed

Ferreiro, Fátima; Wichstrøm, Lars; Seoane, Gloria; Senra, Carmen

2014-01-01

Symptoms of depression and eating disorders increase during adolescence, particularly among girls, and they tend to co-occur. Despite this evidence, there is meager research on whether depression increases the risk of future eating pathology, or vice versa, and we do not know whether these processes are different for adolescent girls and boys. Accordingly, this study explored the prospective reciprocal associations between depressive symptoms and disordered eating at different time points from preadolescence to mid-adolescence and tested the moderator effect of gender on these associations. A community-based sample of Spanish youth (N = 942, 49 % female) was assessed at ages of approximately 10-11 (T1), 12-13 (T2), 14-15 (T3), and 16-17 (T4) years. The bidirectional relationships between depressive symptoms and disordered eating were estimated in an autoregressive cross-lagged model with latent variables. A unidirectional, age-specific association between depressive symptoms at T1 and disordered eating at T2 was found. No other significant cross-lagged effect emerged, but the stability of the constructs was considerable. Gender did not moderate any of the links examined. Regardless of gender, the transition from childhood to adolescence appears to be a key period when depressive symptoms foster the development of disordered eating. These findings suggest that early prevention and treatment of depression targeting both girls and boys may result in lower levels of depressive symptoms and disordered eating in adolescence.

Longitudinal associations between parenting style and adolescent disordered eating behaviors.

PubMed

Zubatsky, Max; Berge, Jerica; Neumark-Sztainer, Dianne

2015-06-01

The main purpose of this study was to identify the longitudinal association between specific parenting styles (authoritarian, authoritative, permissive, and neglectful) and adolescent disordered eating behaviors. The current study uses longitudinal data from a 5-year study to examine the associations between parenting style and disordered eating behaviors among adolescents. Data from adolescents (n = 2516) participating in Project EAT (Eating Among Teens), a population-based study from 31 Minnesota schools, were used in the analysis. Time 1 data were collected using in-class assessments of adolescents from Minneapolis/St. Paul schools, and Time 2 data were collected using mailed surveys 5 years later. General Linear Models were used to predict adolescent-reported disordered eating behaviors at Time 2 from adolescent-reported parenting style at Time 1. Adolescent boys and girls who had authoritarian mothers at Time 1 had a higher probability of extreme weight control behaviors 5 years later compared to adolescents with authoritative, permissive, or neglectful mothers. Adolescent girls with authoritarian mothers at Time 1 had a higher probability of engaging in binge-eating behaviors at Time 2 compared to adolescent girls with authoritative or permissive mothers. There were no significant associations between paternal parenting style and adolescent disordered eating behaviors. Although authoritarian parenting style served as a possible risk factor for disordered eating behaviors in adolescents, the findings were not conclusive. Future studies should investigate further the association between parenting style and weight control behaviors in adolescents.

Is childhood bullying involvement a precursor of eating disorder symptoms? A prospective analysis

PubMed Central

Copeland, William E.; Bulik, Cynthia M.; Zucker, Nancy; Wolke, Dieter; Lereya, Suzet Tanya; Costello, E. Jane

2015-01-01

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

Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence.

PubMed

Weinbach, Noam; Sher, Helene; Bohon, Cara

2017-11-04

Emotion regulation appears to play a key role in eating disorders. However, prior attempts to associate specific emotion regulation abilities with specific types of eating disorders resulted in inconsistent findings. Moreover, far less is known about emotion regulation in eating disorders during adolescence, a critical period of emotional development. The current study addresses this gap, comparing emotion regulation characteristics between adolescents with restrictive types of eating disorders and those with binge eating or purging types of eating disorders. Ninety-eight adolescents with eating disorders (49 with restrictive and 49 with binge eating/purging eating disorders) completed a set of questionnaires including the Difficulties in Emotion Regulation Scale (DERS). The results revealed that binge eating/purging types of eating disorders were associated with greater difficulties in a variety of emotion regulation dimensions including impulse control, goal-directed behavior and access to effective emotion regulation strategies. Awareness and clarity of emotions were also worse in the binge eating/purging types of eating disorders, but this difference did not remain when comorbid psychopathology measures were controlled for. Moreover, the emotion regulation profile of adolescents with anorexia nervosa-binging/purging type was more similar to that of adolescents with bulimia nervosa than to that of adolescents with anorexia nervosa-restrictive type. While both restrictive and binge eating/purging eating disorders have been associated with emotion regulation difficulties, the current study shows that the presence of binge eating or purging episodes is linked with greater severity of emotion regulation deficits among adolescents with eating disorders.

Urbanisation and the incidence of eating disorders.

PubMed

van Son, Gabriëlle E; van Hoeken, Daphne; Bartelds, Aad I M; van Furth, Eric F; Hoek, Hans W

2006-12-01

The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose-response relation with degree of urbanisation and was five times higher in cities than in rural areas. Remarkably, anorexia nervosa showed no association with urbanisation. We conclude that urban life is a potential environmental risk factor for bulimia nervosa but not for anorexia nervosa. These findings provide a promising avenue for further research into the aetiology of eating disorders.

Feminist identity, body image, and disordered eating

PubMed Central

Borowsky, Hannah M.; Eisenberg, Marla E.; Bucchianeri, Michaela M.; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors. PMID:26694553

Feminist identity, body image, and disordered eating.

PubMed

Borowsky, Hannah M; Eisenberg, Marla E; Bucchianeri, Michaela M; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors.

Medication Use before, during, and after Pregnancy among Women with Eating Disorders: A Study from the Norwegian Mother and Child Cohort Study

PubMed Central

Lupattelli, Angela; Spigset, Olav; Torgersen, Leila; Zerwas, Stephanie; Hatle, Marianne; Reichborn-Kjennerud, Ted; Bulik, Cynthia M.; Nordeng, Hedvig

2015-01-01

Introduction Little is known about medication use among women with eating disorders in relation to pregnancy. Aims To explore patterns of and associations between use of psychotropic, gastrointestinal and analgesic medications and eating disorders in the period before, during and after pregnancy. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa). A total of 62,019 women, enrolled at approximately 17 weeks' gestation, had valid data from the Norwegian Medical Birth Registry and completed three MoBa questionnaires. The questionnaires provided diagnostic information on broadly defined anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and recurrent self-induced purging in the absence of binge eating (EDNOS-P), along with self-reported use of medication six months before, during, and 0–6 months after pregnancy. Results The prevalence of eating disorder subtypes before and/or during pregnancy was: 0.09% AN (n = 54), 0.94% BN (n = 585), 0.10% EDNOS-P (n = 61) and 5.00% BED (n = 3104). The highest over-time prevalence of psychotropic use was within the AN (3.7–22.2%) and EDNOS-P (3.3–9.8%) groups. Compared to controls, BN was directly associated with incident use of psychotropics in pregnancy (adjusted RR: 2.25, 99% CI: 1.17–4.32). Having AN (adjusted RR: 5.11, 99% CI: 1.53–17.01) or EDNOS-P (adjusted RR: 6.77, 99% CI: 1.41–32.53) was directly associated with use of anxiolytics/sedatives postpartum. The estimates of use of analgesics (BED) and laxatives (all eating disorders subtypes) were high at all time periods investigated. Conclusions Use of psychotropic, gastrointestinal, and analgesic medications is extensive among women with eating disorders in the period around pregnancy. Female patients with eating disorders should receive evidence-based counseling about the risk of medication exposure versus the risk of untreated psychiatric illness during pregnancy and postpartum. PMID:26200658

Do schema processes mediate links between parenting and eating pathology?

PubMed

Sheffield, Alex; Waller, Glenn; Emanuelli, Francesca; Murray, James; Meyer, Caroline

2009-07-01

Adverse parenting experiences are commonly linked to eating pathology. A schema-based model of the development and maintenance of eating pathology proposes that one of the potential mediators of the link between parenting and eating pathology might be the development of schema maintenance processes--mechanisms that operate to help the individual avoid intolerable emotions. To test this hypothesis, 353 female students and 124 female eating-disordered clients were recruited. They completed a measure of perceived parenting experiences as related to schema development (Young Parenting Inventory-Revised (YPI-R)), two measures of schema processes (Young Compensatory Inventory; Young-Rygh Avoidance Inventory (YRAI)) and a measure of eating pathology (Eating Disorders Inventory (EDI)). In support of the hypothesis, certain schema processes did mediate the relationship between specific perceptions of parenting and particular forms of eating pathology, although these were different for the clinical and non-clinical samples. In those patients where parenting is implicated in the development of eating pathology, treatment might need to target the cognitive processes that can explain this link. 2009 John Wiley & Sons, Ltd and Eating Disorders Association

Positive and negative eating expectancies in disordered eating among women and men.

PubMed

Hayaki, Jumi; Free, Sarah

2016-08-01

Deficits in emotion regulation are known to characterize disordered eating patterns including binge eating, purging, and dietary restraint, though much of this work has been conducted exclusively on women. Eating expectancies, or expectations regarding reinforcement from food and eating, constitute one cognitive mechanism that is thought to serve as a proximal influence on eating behavior. Previous research shows that eating to manage negative affect (a negative eating expectancy) is associated with eating pathology in women, but less is known about eating as a reward or for pleasure (a positive eating expectancy). In addition, no prior work has examined eating expectancies among men. This study examines the role of emotion regulation and eating expectancies on disordered eating in women and men. Participants were 121 female and 80 male undergraduates who completed self-report measures of emotion regulation, eating expectancies, and disordered eating. In women, body mass index (BMI), emotion regulation, and eating to manage negative affect directly predicted disordered eating in the final multivariate model, whereas eating for pleasure or reward was inversely associated with disordered eating. However, in men, emotion regulation predicted disordered eating, but not when eating expectancies were added to the model. In the final model, only BMI and eating to manage negative affect contributed significantly to the variance in disordered eating. These findings suggest that some correlates of eating pathology, particularly eating expectancies, may vary by gender. Future research should continue to examine gender differences in the explanatory mechanisms underlying disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

A comparison of infant and toddler feeding practices of mothers with and without histories of eating disorders

PubMed Central

Hoffman, Elizabeth R.; Bentley, Margaret E.; Hamer, Robert M.; Hodges, Eric A.; Ward, Dianne S.; Bulik, Cynthia M.

2012-01-01

This preliminary study surveyed the feeding practices of mothers with eating disorder histories through evaluation of mothers’ reported feeding styles, child diet composition, and restrictive special approaches to feeding. For this non-randomized cohort study, 25 mothers with eating disorder histories and 25 mothers with no history of an eating disorder with children ages 6–36 months were selected such that the groups were similar based on child age group and child sex. Mothers were compared on self-reported feeding style using the Infant Feeding Styles Questionnaire and on child diet composition and special feeding approaches using a modified version of the Toddler Diet Questionnaire from the Women, Infants, and Children program. Mothers with eating disorder histories scored lower on the restrictive feeding style subscale than controls. No significant differences were detected between groups in child diet including the percentage of mothers who breastfed, duration of breastfeeding, age at solid food introduction, daily number of meals or snacks, or daily frequency of consumption of fruits, vegetables, or protein foods. Mothers with eating disorder histories were more likely to report taking a restrictive special approach to feeding such as limiting processed foods or feeding organic foods only. Although mothers with eating disorder histories may not differ greatly from control mothers in terms of child diet composition (smaller effects may not have been detected due to limited sample size), they may be more likely to take restrictive special approaches to feeding which mirror dietary rules common in individuals with eating disorders. PMID:22784046

Symptoms of Eating Disorders and Depression in Emerging Adults with Early-Onset, Long-Duration Type 1 Diabetes and Their Association with Metabolic Control.

PubMed

Bächle, Christina; Lange, Karin; Stahl-Pehe, Anna; Castillo, Katty; Scheuing, Nicole; Holl, Reinhard W; Giani, Guido; Rosenbauer, Joachim

2015-01-01

This study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control. In a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9) for symptoms of depression and severity of depressive symptoms (PHQ-9 score). Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c. A total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation) was 5.3 (4.4) among women and 3.9 (3.6) among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001). However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006). Because of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes.

Symptoms of Eating Disorders and Depression in Emerging Adults with Early-Onset, Long-Duration Type 1 Diabetes and Their Association with Metabolic Control

PubMed Central

Bächle, Christina; Lange, Karin; Stahl-Pehe, Anna; Castillo, Katty; Scheuing, Nicole; Holl, Reinhard W.; Giani, Guido; Rosenbauer, Joachim

2015-01-01

Background This study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control. Methods In a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9) for symptoms of depression and severity of depressive symptoms (PHQ-9 score). Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c. Results A total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation) was 5.3 (4.4) among women and 3.9 (3.6) among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001). However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006). Conclusions Because of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes. PMID:26121155

A comparison of infant and toddler feeding practices of mothers with and without histories of eating disorders.

PubMed

Hoffman, Elizabeth R; Bentley, Margaret E; Hamer, Robert M; Hodges, Eric A; Ward, Dianne S; Bulik, Cynthia M

2014-07-01

This preliminary study surveyed the feeding practices of mothers with eating disorder histories through evaluation of mothers' reported feeding styles, child diet composition and restrictive special approaches to feeding. For this non-randomised cohort study, 25 mothers with eating disorder histories and 25 mothers with no history of an eating disorder with children ages 6-36 months were selected such that the groups were similar based on child age group and child sex. Mothers were compared on self-reported feeding style using the Infant Feeding Styles Questionnaire and on child diet composition and special feeding approaches using a modified version of the Toddler Diet Questionnaire from the Women, Infants, and Children program. Mothers with eating disorder histories scored lower on the restrictive feeding style subscale than controls. No significant differences were detected between groups in child diet including the percentage of mothers who breastfed, duration of breastfeeding, age at solid food introduction, daily number of meals or snacks or daily frequency of consumption of fruits, vegetables or protein foods. Mothers with eating disorder histories were more likely to report taking a restrictive special approach to feeding such as limiting processed foods or feeding organic foods only. Although mothers with eating disorder histories may not differ greatly from control mothers in terms of child diet composition (smaller effects may not have been detected due to limited sample size), they may be more likely to take restrictive special approaches to feeding which mirror dietary rules common in individuals with eating disorders. © 2012 John Wiley & Sons Ltd.

Understanding Eating Disorders, Anorexia, Bulimia, and Binge-Eating

MedlinePlus

... Javascript on. Photo: iStock Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating , are among ... There are three main types of eating disorders: anorexia nervosa, bulimia nervosa, and binge-eating disorder. People ...

Management of Child and Adolescent Eating Disorders: The Current Evidence Base and Future Directions

ERIC Educational Resources Information Center

Gowers, Simon; Bryant-Waugh, Rachel

2004-01-01

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…

Therapists' self-reported drift from dialectical behavior therapy techniques for eating disorders.

PubMed

Wisniewski, Lucene; Hernandez Hernandez, Maria Elena; Waller, Glenn

2018-01-01

Research has shown that clinicians underuse or omit techniques that constitute an essential part of evidence-based therapies. However, it is not known whether this is the case in DBT for eating disorders. The aims of this study were; 1) exploring the extent to which DBT techniques were used by self-identified DBT clinicians treating eating disorders; 2) determining whether therapists fell into distinct groups, based on their usage of DBT techniques; and 3) examining whether clinician characteristics were related to the use of such techniques. Seventy-three clinicians offering DBT for eating disorders completed an online survey about their use of specific DBT techniques. They also completed measures of personality and intolerance of uncertainty. In relation to the first aim, the pattern of use of DBT techniques showed a bimodal distribution - most were used either a lot or a little. Considering the second aim, clinicians fell into two groups according to the techniques that they delivered - one characterized by a higher use of DBT techniques and the other by a higher use of techniques that were specific to the treatment of eating disorders, rather than DBT methods. Finally, more experienced clinicians were more likely to be in the 'DBT technique-focused' group. DBT clinicians are encouraged to implement both sets of techniques (DBT techniques and standard techniques for the treatment of eating disorders) in an integrated way. Training, supervision and the use of manuals are recommended to decrease therapist drift in DBT. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predictors of Disordered Eating in Adolescence and Young Adulthood: A Population-Based, Longitudinal Study of Females and Males in Norway

ERIC Educational Resources Information Center

Abebe, Dawit Shawel; Torgersen, Leila; Lien, Lars; Hafstad, Gertrud S.; von Soest, Tilmann

2014-01-01

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…

[Effects of inpatient treatment on eating disorder symptoms, health-related quality of life and personal resources in anorexia and bulimia nervosa].

PubMed

Tagay, Sefik; Düllmann, Sonja; Schlegl, Sandra; Nater-Mewes, Ricarda; Repic, Nevena; Hampke, Christian; Brähler, Elmar; Gerlach, Gabriele; Senf, Wolfgang

2011-07-01

The aim of the present prospective-naturalistic study was the evaluation of psychosomatic inpatient treatment for anorexia nervosa (AN) and bulimia nervosa (BN). 128 patients with eating disorders (n=59 AN and n=69 BN) were investigated on admission and discharge using the following standardized questionnaires: eating disorder symptoms (EDI), general psychopathology (BSI), quality of life (SF-12), and personal resources (SOC-13, SWE). Moderate to large effect sizes were achieved for the eating disorder symptoms; in addition, general psychopathology was substantially reduced at the end of treatment, and quality of life as well as personal resources were enhanced. Personal resources were found to be the strongest predictors for therapy outcome. Based on our data, important insights and recommendations may be gained for the inpatient treatment of eating disorders, especially with regard to the potential influence of personal resources. © Georg Thieme Verlag KG Stuttgart · New York.

Psychosocial Correlates of Shape and Weight Concerns in Overweight Pre-Adolescents

PubMed Central

Sinton, Meghan M.; Goldschmidt, Andrea B.; Aspen, Vandana; Theim, Kelly R.; Stein, Richard I.; Saelens, Brian E.; Epstein, Leonard H.; Wilfley, Denise E.

2013-01-01

Shape and weight concerns among overweight pre-adolescents heighten risk for eating disorders and weight gain. Treatment and prevention efforts require consideration of psychosocial factors that co-occur with these concerns. This study involved 200 overweight pre-adolescents, aged 7–12 years (M age = 9.8; SD = 1.4), presenting for family-based weight control treatment. Hierarchical regression was used to examine the influence of pre-adolescents’ individual characteristics and social experiences, and their parents’ psychological symptoms, on shape and weight concerns as assessed by the Child Eating Disorder Examination. Findings revealed that higher levels of dietary restraint, greater feelings of loneliness, elevated experiences with weight-related teasing, and higher levels of parents’ eating disorder symptoms predicted higher shape and weight concerns among overweight pre-adolescents. Interventions addressing overweight pre-adolescents’ disordered eating behaviors and social functioning, as well as their parents’ disordered eating behaviors and attitudes, may be indicated for those endorsing shape and weight concerns. PMID:21695562

Disordered eating practices in gastrointestinal disorders.

PubMed

Satherley, R; Howard, R; Higgs, S

2015-01-01

To systematically review evidence concerning disordered eating practices in dietary-controlled gastrointestinal conditions. Three key questions were examined: a) are disordered eating practices a feature of GI disorders?; b) what abnormal eating practices are present in those with GI disorders?; and c) what factors are associated with the presence of disordered eating in those with GI disorders? By exploring these questions, we aim to develop a conceptual model of disordered eating development in GI disease. Five key databases, Web of Science with Conference Proceedings (1900-2014) and MEDLINE (1950-2014), PubMed, PsycINFO (1967-2014) and Google Scholar, were searched for papers relating to disordered eating practices in those with GI disorders. All papers were quality assessed before being included in the review. Nine papers were included in the review. The majority of papers reported that the prevalence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls. Disordered eating patterns in dietary-controlled GI disorders may be associated with both anxiety and GI symptoms. Evidence concerning the correlates of disordered eating was limited. The presence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls, but the direction of the relationship is not clear. Implications for further research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Not all my fault”: Genetics, stigma, and personal responsibility for women with eating disorders

PubMed Central

Easter, Michele M.

2012-01-01

Medical researchers and clinicians increasingly understand and present eating disorders (anorexia and bulimia nervosa) as biologically-based psychiatric disorders, with genetic risk factors established by high heritability estimates in twin studies. But there has been no research on interpretation of genetic involvement by people with eating disorders, who may hold other views. Their interpretations are particularly important given the frequent presumption that biogenetic framing will reduce stigma, and recent findings that it exacerbates stigma for other mental illnesses. To identify implications of genetic framing in eating disorders, I conducted semi-structured interviews with 50 US women with a history of eating disorders (half recovered, half in treatment; interviewed 2008–9 in the USA). Interviews introduced the topic of genetics, but not stigma per se. Analysis followed the general principles of grounded theory to identify perceived implications of genetic involvement; those relevant to stigma are reported here. Most anticipated that genetic reframing would help reduce stigma from personal responsibility (i.e., blame and guilt for eating disorder as ongoing choice). A third articulated ways it could add stigma, including novel forms of stigma related to genetic essentialist effacing of social factors. Despite welcoming reductions in blame and guilt, half also worried genetic framing could hamper recovery, by encouraging fatalistic self-fulfilling prophecies and genetic excuses. This study is the first to elicit perceptions of genetic involvement by those with eating disorders, and contributes to an emerging literature on perceptions of psychiatric genetics by people with mental illness. PMID:22819736

Eating disorder pathology among overweight treatment-seeking youth: clinical correlates and cross-sectional risk modeling.

PubMed

Eddy, Kamryn T; Tanofsky-Kraff, Marian; Thompson-Brenner, Heather; Herzog, David B; Brown, Timothy A; Ludwig, David S

2007-10-01

Preliminary research suggests that pediatric overweight is associated with increased eating disorder pathology, however, little is known about which overweight youth are most vulnerable to eating disorder pathology. We therefore investigated 122 overweight treatment-seeking youth to describe eating disorder pathology and mental health correlates, and to identify psychopathological constructs that may place overweight youth at increased risk for eating disorder pathology. Youth participated in a comprehensive assessment of eating disorders, mood and anxiety disorders, general psychopathology, and risk variables involving semi-structured clinical interviews and self- and parent-report questionnaires prior to the initiation of weight-loss treatment. Ten youth met criteria for an eating disorder, and over one-third endorsed recent binge eating. Eating disorder pathology was associated with depressive and anxious symptoms (p's<0.001). Structural equation modeling indicated increased negative affect, teasing experience, and thin-ideal internalization, and decreased perfectionism were associated with increased eating disorder pathology. Findings corroborate earlier work indicating that eating disorder pathology is elevated and clinically significant in overweight treatment-seeking youth, bolstering the need for mental health assessment of such individuals. Cross-sectional modeling proposed key variables that relate to eating disorder pathology in overweight treatment-seeking youth, which following prospective replication, may inform the development of effective interventions for overweight and eating disorders.

An 8-item short form of the Eating Disorder Examination-Questionnaire adapted for children (ChEDE-Q8).

PubMed

Kliem, Sören; Schmidt, Ricarda; Vogel, Mandy; Hiemisch, Andreas; Kiess, Wieland; Hilbert, Anja

2017-06-01

Eating disturbances are common in children placing a vulnerable group of them at risk for full-syndrome eating disorders and adverse health outcomes. To provide a valid self-report assessment of eating disorder psychopathology in children, a short form of the child version of the Eating Disorder Examination (ChEDE-Q) was psychometrically evaluated. Similar to the EDE-Q, the ChEDE-Q provides assessment of eating disorder psychopathology related to anorexia nervosa, bulimia nervosa, and binge-eating disorder; however, the ChEDE-Q does not assess symptoms of avoidant/restrictive food intake disorder, pica, or rumination disorder. In 1,836 participants ages 7 to 18 years, recruited from two independent population-based samples, the factor structure of the recently established 8-item short form EDE-Q8 for adults was examined, including measurement invariance analyses on age, gender, and weight status derived from objectively measured weight and height. For convergent validity, the ChEDE-Q global score, body esteem scale, strengths and difficulties questionnaire, and sociodemographic characteristics were used. Item characteristics and age- and gender-specific norms were calculated. Confirmatory factor analysis revealed good model fit for the 8-item ChEDE-Q. Measurement invariance analyses indicated strict invariance for all analyzed subgroups. Convergent validity was provided through associations with well-established questionnaires and age, gender, and weight status, in expected directions. The newly developed ChEDE-Q8 proved to be a psychometrically sound and economical self-report assessment tool of eating disorder psychopathology in children. Further validation studies are needed, particularly concerning discriminant and predictive validity. © 2017 Wiley Periodicals, Inc.

Epidemiology and treatment of eating disorders in men and women of middle and older age.

PubMed

Mangweth-Matzek, Barbara; Hoek, Hans W

2017-11-01

We summarized recent literature on the epidemiology and treatment of eating disorders in middle-aged and older women and men. The prevalence of eating disorders according to DSM-5 criteria is around 3.5% in older (>40 years) women and around 1-2% in older men. The majority of those eating disordered persons are not in treatment. There are new terms like 'perimenopausal eating disorders' and 'muscularity-oriented eating disorders' indicating the impact of the aging process and sex-specific differences. Disordered eating and eating disorders occur in both women and men of all ages. Medical complications because of age, the stigma of eating disorders in a still 'untypical' age, and the glorification of sports activity often hinder the recognition of eating disorders in midlife and older persons. Treatment approaches should consider treatment strategies tailored for older women and men, addressing the context of midlife and aging.

[Eating disorders].

PubMed

Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Shishida, Kazuhiro; Okamoto, Yasumasa

2015-02-01

Eating disorders are characterized by aberrant patterns of eating behavior, including such symptoms as extreme restriction of food intake or binge eating, and severe disturbances in the perception of body shape and weight, as well as a drive for thinness and obsessive fears of becoming fat. Eating disorder is an important cause for physical and psychosocial morbidity in young women. Patients with eating disorders have a deficit in the cognitive process and functional abnormalities in the brain system. Recently, brain-imaging techniques have been used to identify specific brain areas that function abnormally in patients with eating disorders. We have discussed the clinical and cognitive aspects of eating disorders and summarized neuroimaging studies of eating disorders.

Examining Affect and Perfectionism in Relation to Eating Disorder Symptoms among Women with Anorexia Nervosa

PubMed Central

Lavender, Jason M.; Mason, Tyler B.; Utzinger, Linsey M.; Wonderlich, Stephen A.; Crosby, Ross D.; Engel, Scott G.; Mitchell, James E.; Le Grange, Daniel; Crow, Scott J.; Peterson, Carol B.

2016-01-01

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment. PMID:27208513

Effectiveness of peer-led dissonance-based eating disorder prevention groups: results from two randomized pilot trials.

PubMed

Stice, Eric; Rohde, Paul; Durant, Shelley; Shaw, Heather; Wade, Emily

2013-05-01

The present preliminary trials tested whether undergraduate peer leaders can effectively deliver a dissonance-based eating disorder prevention program, which could facilitate broad dissemination of this efficacious intervention. In Study 1, female undergraduates (N=171) were randomized to peer-led groups, clinician-led groups, or an educational brochure control condition. In Study 2, which improved a design limitation of Study 1 by using completely parallel outcome measures across conditions, female undergraduates (N=148) were randomized to either immediate peer-led groups or a waitlist control condition. In Study 1, participants in peer- and clinician-led groups showed significantly greater pre-post reductions in risk factors and eating disorder symptoms than controls (M d=.64 and .98 respectively), though clinician- versus peer-led groups had higher attendance and competence ratings, and produced stronger effects at posttest (M d=.32) and at 1-year follow-up (M d=.26). In Study 2, participants in peer-led groups showed greater pre-post reductions in all outcomes than waitlist controls (M d=.75). Results provide novel evidence that dissonance-based eating disorder prevention groups led by undergraduate peers are feasible and produce greater reductions in eating disorder risk factors and symptoms than minimal-intervention control conditions, but indicate that effects are smaller for peer- versus clinician-led groups. Copyright © 2013 Elsevier Ltd. All rights reserved.

Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population.

PubMed

Hay, Phillipa; Mitchison, Deborah; Collado, Abraham Ernesto Lopez; González-Chica, David Alejandro; Stocks, Nigel; Touyz, Stephen

2017-01-01

Little is known about the epidemiology and health related quality of life (HRQoL) of the new DSM-5 diagnoses, Binge Eating Disorder (BED) and Avoidant/Restrictive Food Intake Disorder (ARFID) in the Australian population. We aimed to investigate the prevalance and burden of these disorders. We conducted two sequential population-based surveys including individuals aged over 15 years who were interviewed in 2014 ( n  = 2732) and 2015 ( n =3005). Demographic information and diagnostic features of DSM-5 eating disorders were asked including the occurrence of regular (at least weekly over the past 3 months) objective binge eating with levels of distress, extreme dietary restriction/fasting for weight/shape control, purging behaviors, overvaluation of shape and/or weight, and the presence of an avoidant/restrictive food intake without overvaluation of shape and/or weight. In 2014 functional impact or role performance was measured with the 'days out of role' question and in 2015, Health Related Quality of Life (HRQoL) was assessed with the Short Form -12 item questionnaire (SF-12v1). The 2014 and 2015 3-month prevalence of eating disorders were: anorexia nervosa-broad 0.4% (95% CI 0.2-0.7) and 0.5% (0.3-0.9); bulimia nervosa 1.1% (0.7-1.5) and 1.2% (0.9-1.7); ARFID 0.3% (0.1-0.5) and 0.3% (0.2-0.6). The 2015 3-month prevalence rates were: BED-broad 1.5% (1.1-2.0); Other Specified Feeding or Eating Disorder (OSFED) 3.2 (2.6-3.9); and Unspecified Feeding or Eating Disorder (UFED) 10.4% (0.9-11.5). Most people with OSFED had atypical anorexia nervosa and majority with UFED were characterised by having recurrent binge eating without marked distress. Eating disorders were represented throughout sociodemographic groups and those with bulimia nervosa and BED-broad had mean weight (BMI, kg/m 2 ) in the obese range. Mental HRQoL was poor in all eating disorder groups but particularly poor for those with BED-broad and ARFID. Individuals with bulimia nervosa, BED-broad and OSFED-Purging Disorder also had poor physical HRQoL. ARFID and bulimia nervosa groups had lower role performance than those without an eating disorder. Whilst full spectrum eating disorders, including ARFID, were less common than OSFED or UFED, they were associated with poor mental HRQoL and significant functional impairment. The present study supports the movement of eating disorders in to broader socio demographic groups including men, socio-economic disadvantaged groups and those with obesity.

Internet-delivered eating disorder prevention: A randomized controlled trial of dissonance-based and cognitive-behavioral interventions.

PubMed

Chithambo, Taona P; Huey, Stanley J

2017-10-01

The current study evaluated two web-based programs for eating disorder prevention in high-risk, predominantly ethnic minority women. Two hundred and seventy-one women with elevated weight concerns were randomized to Internet dissonance-based intervention (DBI-I), Internet cognitive-behavioral intervention (CBI-I), or no intervention (NI). Both interventions consisted of four weekly online sessions. Participants were assessed at pre- and post intervention. Outcome measures included eating pathology, body dissatisfaction, dieting, thin-ideal internalization, and depression. At postintervention, DBI-I and CBI-I led to greater reductions in body dissatisfaction, thin-ideal internalization, and depression than NI. In addition, CBI-I was effective at reducing dieting and composite eating pathology relative to NI. No outcome differences were found between the active conditions. Moderation analyses suggested that both active conditions were more effective for ethnic minorities than Whites relative to NI. Results suggest that both DBI-I and CBI-I are effective at reducing eating disorder risk factors in a high-risk, predominantly minority population relative to no intervention. © 2017 Wiley Periodicals, Inc.

Pro-eating disorder search patterns: the possible influence of celebrity eating disorder stories in the media.

PubMed

Lewis, Stephen P; Klauninger, Laura; Marcincinova, Ivana

2016-01-01

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.

Aspects of disordered eating continuum in elite high-intensity sports.

PubMed

Sundgot-Borgen, J; Torstveit, M K

2010-10-01

Dieting is an important risk factor for disordered eating and eating disorders. Disordered eating occurs on a continuum from dieting and restrictive eating, abnormal eating behavior, and finally clinical eating disorders. The prevalence of eating disorders is increased in elite athletes and for this group the cause of starting to diet is related to (a) perception of the paradigm of appearance in the specific sport, (b) perceived performance improvements, and (c) sociocultural pressures for thinness or an "ideal" body. Athletes most at risk for disordered eating are those involved in sports emphasizing a thin body size/shape, a high power-to-weight ratio, and/or sports utilizing weight categories, such as in some high-intensity sports. In addition to dieting, personality factors, pressure to lose weight, frequent weight cycling, early start of sport-specific training, overtraining, injuries, and unfortunate coaching behavior, are important risk factors. To prevent disordered eating and eating disorders, the athletes have to practice healthy eating, and the medical staff of teams and parents must be able to recognize symptoms indicating risk for eating disorders. Coaches and leaders must accept that disordered eating can be a problem in the athletic community and that openness regarding this challenge is important. © 2010 John Wiley & Sons A/S.

Eating disorders during pregnancy.

PubMed

Cardwell, Michael S

2013-04-01

Eating disorders during pregnancy, once thought to be rare, occur in a significant number of women. The incidences of the major eating disorders-anorexia nervosa and bulimia nervosa-are increasing because of cultural pressures on the drive for thinness. Because the age range for these major eating disorders overlaps with the age range for reproductive function, it is not unusual for a clinician to encounter a pregnant patient with a major eating disorder. Eating disorders attributable to the pregnant state include pregnancy sickness, pica, and ptyalism. The diagnostic criteria, etiology, nutritional behavioral influences, evolutionary psychological considerations where elucidated, and treatment of these disorders will be presented. Obstetricians and gynecologists, family physicians After completing this CME activity, physicians should be better able to review how the major eating disorders impact pregnancy, to diagnose eating disorders during pregnancy using the diagnostic criteria, and to treat eating disorders during pregnancy.

Treatment preferences of patients with binge eating disorder.

PubMed

Brody, Michelle L; Masheb, Robin M; Grilo, Carlos M

2005-05-01

The current study examined the treatment preferences of obese patients with binge eating disorder (BED). Participants were 103 consecutive patients with BED who responded to advertisements for treatment studies looking for persons who wanted to "stop binge eating and lose weight." In addition to completing comprehensive assessment batteries, participants were provided descriptions of cognitive-behavioral therapy (CBT) and behavioral weight loss therapy (BWL) after which they were asked to choose and rate their preferred treatment. Sixty-three percent of participants stated they preferred CBT. Treatment preferences were not associated with (1) histories of obesity, dieting, binge eating, or weight cycling, (2) current obesity or eating disorder features, or (3) psychological features such as depression or self-esteem levels. In contrast, participants' stated treatment preferences were aligned with their perception of their primary problem (eating disorder vs. obesity) and their primary goals for treatment (stop binge eating vs. lose weight). The patients who preferred CBT based their treatment selection more on their problem perception than on their primary treatment goal, whereas the patients who preferred BWL selected treatment based more on their primary treatment goal (weight loss) than on their problem perception. Obese patients with BED express treatment preferences that are not associated with variability in their clinical characteristics but are aligned with their perception of their primary problem and with their primary goals for treatment. Copyright 2005 by Wiley Periodicals, Inc

Eating disorders in Austrian men: an intracultural and crosscultural comparison study.

PubMed

Mangweth, B; Pope, H G; Hudson, J I; Olivardia, R; Kinzl, J; Biebl, W

1997-01-01

We compared 30 male university students with eating disorders and 30 male comparison subjects without eating disorders recruited by advertisement at Innsbruck University, Austria. Subjects were interviewed using instruments that we had previously used in a controlled study of college men with eating disorders in the United States. The Austrian men with eating disorders differed sharply from Austrian comparison subjects, but closely resembled their American counterparts, on prevalence of personal and familial psychopathology, adverse family experiences, and scores on rating scales for eating disorder. Interestingly, dissatisfaction with body image was consistently greater among American subjects regardless of eating disorder status. Our data suggest a weak association between eating disorders and homosexual or bisexual orientation in men and no consistent association between eating disorders and childhood sexual abuse.

Self-compassion training for binge eating disorder: a pilot randomized controlled trial.

PubMed

Kelly, Allison C; Carter, Jacqueline C

2015-09-01

The present pilot study sought to compare a compassion-focused therapy (CFT)-based self-help intervention for binge eating disorder (BED) to a behaviourally based intervention. Forty-one individuals with BED were randomly assigned to 3 weeks of food planning plus self-compassion exercises; food planning plus behavioural strategies; or a wait-list control condition. Participants completed weekly measures of binge eating and self-compassion; pre- and post-intervention measures of eating disorder pathology and depressive symptoms; and a baseline measure assessing fear of self-compassion. Results showed that: (1) perceived credibility, expectancy, and compliance did not differ between the two interventions; (2) both interventions reduced weekly binge days more than the control condition; (3) the self-compassion intervention reduced global eating disorder pathology, eating concerns, and weight concerns more than the other conditions; (4) the self-compassion intervention increased self-compassion more than the other conditions; and (5) participants low in fear of self-compassion derived significantly more benefits from the self-compassion intervention than those high in fear of self-compassion. Findings offer preliminary support for the usefulness of CFT-based interventions for BED sufferers. Results also suggest that for individuals to benefit from self-compassion training, assessing and lowering fear of self-compassion will be crucial. Individuals with BED perceive self-compassion training self-help interventions, derived from CFT, to be as credible and as likely to help as behaviourally based interventions. The cultivation of self-compassion may be an effective approach for reducing binge eating, and eating, and weight concerns in individuals with BED. Teaching individuals with BED CFT-based self-help exercises may increase their self-compassion levels over a short period of time. It may be important for clinicians to assess and target clients' fear of self-compassion for clients to benefit from self-compassion training interventions. © 2014 The British Psychological Society.

Sleep and Eating Disorders.

PubMed

Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M

2016-10-01

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.

Depression and coping in subthreshold eating disorders.

PubMed

Dennard, E Eliot; Richards, C Steven

2013-08-01

The eating disorder literature has sought to understand the role of comorbid psychiatric diagnoses and coping in relation to eating disorders. The present research extends these findings by studying the relationships among depression, coping, and the entire continuum of disordered eating behaviors, with an emphasis on subthreshold eating disorders. 109 undergraduate females completed questionnaires to assess disordered eating symptoms, depressive symptoms, and the use of active and avoidant coping mechanisms. Hypotheses were tested using bivariate linear regression and multivariate linear regression. Results indicated that depression was a significant predictor of disordered eating symptoms after controlling for relationships between depression and coping. Although avoidant coping was positively associated with disordered eating, it was not a significant predictor after controlling for depression and coping. Previous research has found associations between depression and diagnosable eating disorders, and this research extends those findings to the entire continuum of disordered eating. Future research should continue to investigate the predictors and correlates of the disordered eating continuum using more diverse samples. Testing for mediation and moderation among these variables may also be a fruitful area of investigation. Published by Elsevier Ltd.

Residents' and Fellows' Knowledge and Attitudes About Eating Disorders at an Academic Medical Center.

PubMed

Anderson, Kristen; Accurso, Erin C; Kinasz, Kathryn R; Le Grange, Daniel

2017-06-01

This study examined physician residents' and fellows' knowledge of eating disorders and their attitudes toward patients with eating disorders. Eighty physicians across disciplines completed a survey. The response rate for this survey across disciplines was 64.5 %. Participants demonstrated limited knowledge of eating disorders and reported minimal comfort levels treating patients with eating disorders. Psychiatry discipline (p = 0.002), eating disorder experience (p = 0.010), and having ≥4 eating disorder-continuing medical education credits (p = 0.037) predicted better knowledge of anorexia nervosa but not bulimia nervosa. Psychiatry residents (p = 0.041), and those who had treated at least one eating disorder patient (p = 0.006), reported significantly greater comfort treating patients with eating disorders. These results suggest that residents and fellows from this sample may benefit from training to increase awareness and confidence necessary to treat patients with eating disorders. Sufficient knowledge and comfort are critical since physicians are often the first health care provider to have contact with patients who have undiagnosed eating disorders.

Eating disorders need more experimental psychopathology.

PubMed

Jansen, Anita

2016-11-01

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. Copyright © 2016. Published by Elsevier Ltd.

Like mother, like daughter? An examination of the emotive responses to food.

PubMed

Lewis, Sarah; Katsikitis, Mary; Mulgrew, Kate

2015-06-01

The modelling of sub-clinical eating disorders and emotive responses to food between mothers and their early adolescent daughters was investigated. Twenty dyads viewed images of food and rated their levels of happiness, fear and disgust. Results suggest similarities between mothers' and daughters' emotive responses, but the exact nature of this relationship differed across food type and response type. Disordered eating was only related to responses to the low-calorie foods. Furthermore, mother's eating disorders symptoms were related to concerns about shape and weight in the daughters (all ps < .05). These results suggest a transmission of emotive responses to food within the dyad which may inform family-based intervention efforts in the prevention of eating disorders in young women. © The Author(s) 2015.

Future Directions: How Virtual Reality Can Further Improve the Assessment and Treatment of Eating Disorders and Obesity.

PubMed

Gutiérrez-Maldonado, José; Wiederhold, Brenda K; Riva, Giuseppe

2016-02-01

Transdisciplinary efforts for further elucidating the etiology of eating and weight disorders and improving the effectiveness of the available evidence-based interventions are imperative at this time. Recent studies indicate that computer-generated graphic environments-virtual reality (VR)-can integrate and extend existing treatments for eating and weight disorders (EWDs). Future possibilities for VR to improve actual approaches include its use for altering in real time the experience of the body (embodiment) and as a cue exposure tool for reducing food craving.

Different yet similar: Examining race and ethnicity in treatment-seeking adults with binge eating disorder.

PubMed

Lydecker, Janet A; Grilo, Carlos M

2016-01-01

This study examined racial/ethnic differences in demographic variables and the clinical presentation of treatment-seeking adults with binge eating disorder (BED) who participated in treatment research at a medical school-based program. Participants were 775 (n = 195 men, n = 560 women) treatment-seeking adults with DSM-IV-defined BED who self-identified as Black (n = 121), Hispanic (n = 54), or White (n = 580). Doctoral-level research clinicians assessed participants for BED and for eating disorder psychopathology using the Structured Clinical Interview for DSM-IV Disorders and the Eating Disorder Examination (EDE) interview, and measured height and weight. Participants also completed established self-report measures. Black participants had a greater proportion of women than White participants and White participants had higher education than Black and Hispanic participants. Black participants had higher body mass index (BMI) and reported more frequent binge eating episodes than White participants but eating-disorder psychopathology (EDE scales and Global Severity) did not significantly differ across racial/ethnic groups. Black participants had lower levels of depression than Hispanic and White participants. These differences in clinical presentation remained unchanged after adjusting for age, education, sex, and BMI. White participants had younger ages of onset for dieting, binge eating, and obesity, but not BED, than Black and Hispanic participants. There are some racial/ethnic differences in the developmental trajectories and clinical presentation of treatment-seeking adults with BED that remain unchanged after adjusting for demographic differences. Black participants presented for treatment with higher BMI and binge eating frequency than White participants and with lower depression than White and Hispanic groups, but associated eating disorder psychopathology levels were similar across racial/ethnic groups. (c) 2015 APA, all rights reserved).

A Systematic Review of Bright Light Therapy for Eating Disorders.

PubMed

Beauchamp, Marshall T; Lundgren, Jennifer D

2016-10-27

Bright light therapy is a noninvasive biological intervention for disorders with nonnormative circadian features. Eating disorders, particularly those with binge-eating and night-eating features, have documented nonnormative circadian eating and mood patterns, suggesting that bright light therapy may be an efficacious stand-alone or adjunctive intervention. The purpose of this systematic literature review, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, was (1) to evaluate the state of the empirical treatment outcome literature on bright light therapy for eating disorders and (2) to explore the timing of eating behavior, mood, and sleep-related symptom change so as to understand potential mechanisms of bright light therapy action in the context of eating disorder treatment. A comprehensive literature search using PsycInfo and PubMed/MEDLINE was conducted in April 2016 with no date restrictions to identify studies published using bright light therapy as a treatment for eating disorders. Keywords included combinations of terms describing disordered eating (eating disorder, anorexia nervosa, bulimia nervosa, binge eating, binge, eating behavior, eating, and night eating) and the use of bright light therapy (bright light therapy, light therapy, phototherapy). After excluding duplicates, 34 articles were reviewed for inclusion. 14 published studies of bright light therapy for eating disorders met inclusion criteria (included participants with an eating disorder/disordered-eating behaviors; presented as a case study, case series, open-label clinical trial, or randomized/nonrandomized controlled trial; written in English; and published and available by the time of manuscript review). Results suggest that bright light therapy is potentially effective at improving both disordered-eating behavior and mood acutely, although the timing of symptom response and the duration of treatment effects remain unknown. Future research should systematically control for placebo response, assess symptom change frequently and across a broad range of systems, and evaluate the longer-term efficacy of bright light therapy for eating disorders. © Copyright 2016 Physicians Postgraduate Press, Inc.

Parent Conversations about Healthful Eating and Weight: Associations with Adolescent Disordered Eating Behaviors

PubMed Central

Berge, Jerica M.; MacLehose, Rich; Loth, Katie A.; Eisenberg, Marla; Bucchianeri, Michaela M.; Neumark-Sztainer, Dianne

2013-01-01

Objective The prevalence of weight-related problems in adolescents is high. Parents of adolescents may wonder whether talking about eating habits and weight is useful or detrimental. This study aimed to examine the associations between parent conversations about healthful eating and weight and adolescent disordered eating behaviors. Design Cross-sectional analysis using data from two linked multi-level population-based studies. Setting Anthropometric assessments and surveys completed at school by adolescents and surveys completed at home by parents in 2009–2010. Participants Socio-economically and racially/ethnically diverse sample (81% ethnic minority; 60% low income) of adolescents from EAT (Eating and Activity in Teens) 2010 (n = 2,793, mean age=14.4) and parents from F-EAT (Families and Eating and Activity in Teens) (n = 3,709, mean age = 42.3). Main Exposure Parent conversations about healthful eating and weight/size. Outcome Measures Adolescent dieting, unhealthy weight control behaviors, and binge eating. Results Mothers and fathers who engaged in weight-related conversations had adolescents who were more likely to diet, use unhealthy weight control behaviors, and engage in binge eating. Overweight/obese adolescents whose mothers engaged in conversations that were focused only on healthful eating behaviors were less likely to diet and use unhealthy weight control behaviors. Additionally, sub-analyses with adolescents with data from two parents showed that when both parents engaged in healthful eating conversations, their overweight/obese adolescent children were less likely to diet and use unhealthy weight control behaviors. Conclusion Parent conversations focused on weight/size are associated with increased risk for adolescent disordered eating behaviors, whereas conversations focused on healthful eating are protective against disordered eating behaviors. PMID:23797808

Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review.

PubMed

Katterman, Shawn N; Kleinman, Brighid M; Hood, Megan M; Nackers, Lisa M; Corsica, Joyce A

2014-04-01

Mindfulness-based approaches are growing in popularity as interventions for disordered eating and weight loss. Initial research suggests that mindfulness meditation may be an effective intervention for binge eating; however, no systematic review has examined interventions where mindfulness meditation was the primary intervention and no review has examined its effect on subclinical disordered eating or weight. Using the PRISMA method for systematic reviews, we reviewed 14 studies that investigated mindfulness meditation as the primary intervention and assessed binge eating, emotional eating, and/or weight change. Results suggest that mindfulness meditation effectively decreases binge eating and emotional eating in populations engaging in this behavior; evidence for its effect on weight is mixed. Additional research is warranted to determine comparative effectiveness and long-term effects of mindfulness training. Copyright © 2014. Published by Elsevier Ltd.

Validation of the French Version of the DSM-5 Yale Food Addiction Scale in a Nonclinical Sample

PubMed Central

Courtois, Robert; Gearhardt, Ashley N.; Gaillard, Philippe; Journiac, Kevin; Cathelain, Sarah; Réveillère, Christian; Ballon, Nicolas

2016-01-01

Objective: The Yale Food Addiction Scale (YFAS) is the only questionnaire that assesses food addiction (FA) based on substance dependence criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, Text Revision. Following recent updating of addiction criteria, a new DSM-5 version (YFAS 2.0) has been developed. Our study tested the psychometric properties of the French YFAS 2.0 in a nonclinical population. Method: We assessed 330 nonclinical participants for FA (French YFAS 2.0), eating behaviour, and eating disorder (Binge Eating Scale, Emotional Overeating Questionnaire, Three-Factor Eating Questionnaire-R18, Questionnaire on Eating and Weight Patterns-Revised, Eating Disorder Diagnostic Scale). We tested the scale’s factor structure (confirmatory factor analysis based on 11 diagnostic criteria), internal consistency, and construct and incremental validity. Results: Prevalence of FA was 8.2%. Our results supported a 1-factor structure similar to the US version. In both its diagnostic and symptom count versions, the YFAS 2.0 had good internal consistency (Kuder-Richardson alpha was 0.83) and was associated with body mass index (BMI), binge eating, uncontrolled and emotional eating, binge eating disorder, and cognitive restraint. FA predicted BMI above and beyond binge eating frequency. Females had a higher prevalence of FA than males but not more FA symptoms. Conclusions: We validated a psychometrically sound French version of the YFAS 2.0 in a nonclinical population, in both its symptom count and diagnostic versions. Future studies should investigate psychometric properties of this questionnaire in clinical populations potentially at risk for FA (that is, patients with obesity, diabetes, hypertension, or other metabolic syndrome risk factors). PMID:28212499

Validation of the French Version of the DSM-5 Yale Food Addiction Scale in a Nonclinical Sample.

PubMed

Brunault, Paul; Courtois, Robert; Gearhardt, Ashley N; Gaillard, Philippe; Journiac, Kevin; Cathelain, Sarah; Réveillère, Christian; Ballon, Nicolas

2017-03-01

The Yale Food Addiction Scale (YFAS) is the only questionnaire that assesses food addiction (FA) based on substance dependence criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, Text Revision. Following recent updating of addiction criteria, a new DSM-5 version (YFAS 2.0) has been developed. Our study tested the psychometric properties of the French YFAS 2.0 in a nonclinical population. We assessed 330 nonclinical participants for FA (French YFAS 2.0), eating behaviour, and eating disorder (Binge Eating Scale, Emotional Overeating Questionnaire, Three-Factor Eating Questionnaire-R18, Questionnaire on Eating and Weight Patterns-Revised, Eating Disorder Diagnostic Scale). We tested the scale's factor structure (confirmatory factor analysis based on 11 diagnostic criteria), internal consistency, and construct and incremental validity. Prevalence of FA was 8.2%. Our results supported a 1-factor structure similar to the US version. In both its diagnostic and symptom count versions, the YFAS 2.0 had good internal consistency (Kuder-Richardson alpha was 0.83) and was associated with body mass index (BMI), binge eating, uncontrolled and emotional eating, binge eating disorder, and cognitive restraint. FA predicted BMI above and beyond binge eating frequency. Females had a higher prevalence of FA than males but not more FA symptoms. We validated a psychometrically sound French version of the YFAS 2.0 in a nonclinical population, in both its symptom count and diagnostic versions. Future studies should investigate psychometric properties of this questionnaire in clinical populations potentially at risk for FA (that is, patients with obesity, diabetes, hypertension, or other metabolic syndrome risk factors).

Eating disorder symptoms and parenting styles.

PubMed

Haycraft, Emma; Blissett, Jackie

2010-02-01

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. 2009 Elsevier Ltd. All rights reserved.

Eating disorder symptoms in middle-aged and older men.

PubMed

Mangweth-Matzek, Barbara; Kummer, Kai K; Pope, Harrison G

2016-10-01

Few studies have assessed symptoms of eating disorders in older men. We administered anonymous questionnaires to 470 men, aged 40-75 years, in and around Innsbruck, Austria, to assess eating behavior, body image, and exercise activities. We defined current eating disorder symptoms (EDS) as (1) BMI < 18.5; (2) binge eating; (3) binge eating and purging; or (4) purging without binge eating. Of the 470 men, 32 (6.8%) reported one of the four eating disorder symptoms. The 32 men with eating disorder symptoms, compared to the 438 men with normal eating, showed significantly greater pathology on scales assessing eating behavior, exercise addiction, satisfaction with body shape, and weight. However, the EDE-Q cutoff score for eating disturbance identified only three (9%) of the EDS men. Symptoms of disordered eating, sometimes involving purging via excessive exercise, do occur in older men, and may be missed by conventional instruments. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:953-957). © 2016 Wiley Periodicals, Inc.

High- and Low-Level Dissonance-Based Eating Disorder Prevention Programs with Young Women with Body Image Concerns: An Experimental Trial

ERIC Educational Resources Information Center

McMillan, Whitney; Stice, Eric; Rohde, Paul

2011-01-01

Objective: As cognitive dissonance is theorized to contribute to the effects of dissonance-based eating disorder prevention programs, we evaluated a high-dissonance version of this program against a low-dissonance version and a wait-list control condition to provide an experimental test of the mechanism of intervention effects. Method: Female…

Generic and eating disorder-specific impairment in binge eating disorder with and without overvaluation of weight or shape.

PubMed

Harrison, Carmel; Mond, Jonathan; Rieger, Elizabeth; Rodgers, Bryan

2015-09-01

We sought to elucidate the nature and extent of impairment in quality of life among individuals with binge eating disorder (BED) with and without the overvaluation of weight or shape ("overvaluation"). Subgroups of women - probable BED with overvaluation (n = 102), probable BED without overvaluation (n = 72), obese individuals reporting no binge eating ("obese control", n = 40), and "normal weight" individuals reporting no binge eating ("healthy control," n = 40) - were recruited from a community-based sample in which individuals with eating disorder symptoms were over-represented. They were compared on measures of eating disorder psychopathology and generic and disease-specific measures of quality of life. Scores on these measures among individuals with BED receiving specialist treatment were also considered. Participants with BED and overvaluation had high levels of eating disorder psychopathology and impairment in both generic and disease-specific quality of life, comparable to those of BED patients receiving specialist treatment, and significantly higher than all other subgroups, whereas participants with BED in the absence of overvaluation did not differ from obese controls on any of these measures. The findings provide further evidence for the need to consider reference to overvaluation among the diagnostic criteria for BED. The relative merits of the inclusion of overvaluation as a diagnostic criterion or as a diagnostic specifier for BED warrant greater consideration. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Randomized, Comparative Pilot Trial of Family-Based Interpersonal Psychotherapy for Reducing Psychosocial Symptoms, Disordered-eating, and Excess Weight Gain in At-Risk Preadolescents with Loss-of-control-eating

PubMed Central

Shomaker, Lauren B.; Tanofsky-Kraff, Marian; Matherne, Camden E.; Mehari, Rim D.; Olsen, Cara H.; Marwitz, Shannon E.; Bakalar, Jennifer L.; Ranzenhofer, Lisa M.; Kelly, Nichole R.; Schvey, Natasha A.; Burke, Natasha L.; Cassidy, Omni; Brady, Sheila M.; Dietz, Laura J.; Wilfley, Denise E.; Yanovski, Susan Z.; Yanovski, Jack A.

2018-01-01

Objective Preadolescent loss-of-control-eating (LOC-eating) is a risk factor for excess weight gain and binge-eating-disorder. We evaluated feasibility and acceptability of a preventive family-based interpersonal psychotherapy (FB-IPT) program. FB-IPT was compared to family-based health education (FB-HE) to evaluate changes in children’s psychosocial functioning, LOC-eating, and body mass. Method A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC-eating. Youth-parent dyads were randomized to 12-week FB-IPT (n=15) or FB-HE (n=14) and evaluated at post-treatment, six-months, and one-year. Changes in child psychosocial functioning, LOC-eating, BMI, and adiposity by dual-energy-X-ray-absorptiometry were assessed. Missing follow-up data were multiply imputed. Results FB-IPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow-up assessments were completed by 73% FB-IPT and 86% FB-HE at post-treatment, 60% and 64% at six-months, and 47% and 57% at one-year. At post-treatment, children in FB-IPT reported greater decreases in depression (95% CI −7.23, −2.01, Cohen’s d=1.23) and anxiety (95% CI −6.08, −0.70, Cohen’s d=.79) and less odds of LOC-eating (95% CI −3.93, −0.03, Cohen’s d=.38) than FB-HE. At six-months, children in FB-IPT had greater reductions in disordered-eating attitudes (95% CI −0.72, −0.05, Cohen’s d=.66) and at one-year, tended to have greater decreases in depressive symptoms (95% CI −8.82, 0.44, Cohen’s d=.69) than FB-HE. There was no difference in BMI gain between the groups. Discussion Family-based approaches that address interpersonal and emotional underpinnings of LOC-eating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered-eating or excess weight gain requires further study. PMID:28714097

An Examination of Participants Who Develop an Eating Disorder Despite Completing an Eating Disorder Prevention Program: Implications for Improving the Yield of Prevention Efforts

PubMed Central

Stice, Eric; Rohde, Paul

2014-01-01

Numerous trials provide support for the Body Project, an eating disorder prevention program wherein young women with body image concerns critique the thin ideal. Despite medium to large effects, some participants subsequently develop an eating disorder, suggesting that intervention or recruitment procedures could be improved. This study investigated baseline and acute intervention predictors of DSM-5 eating disorder development during a 3-year follow-up among Body Project participants. Combined data from two trials compare participants who experienced eating disorder onset during follow-up (n=20) to those who did not (n=216). Participants who did versus did not develop an eating disorder started the intervention with higher eating disorder symptoms (η2=0.08), negative affect (η2=0.06), thin-ideal internalization (η2=0.02), and body dissatisfaction (η2=0.02); the same baseline predictors of eating disorder onset emerged in controls. Attenuated pre–post reductions in eating disorder symptoms (η2=0.01) predicted eating disorder onset but not after controlling for baseline levels. Given that Body Project and control participants who later developed an eating disorder started with initial elevations in risk factors and eating disorder symptoms, it might be useful to develop a more intensive variant of this program for those exhibiting greater risk at baseline and to deliver the prevention program earlier to prevent initial escalation of risk. The fact that nonresponders also showed greater negative affect and eating disorder symptoms suggests that it might be useful to add activities to improve affect and increase dissonance about disordered eating. PMID:25342026

Eating Disorders: Facts about Eating Disorders and the Search for Solutions.

ERIC Educational Resources Information Center

Spearing, Melissa

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…

Examining affect and perfectionism in relation to eating disorder symptoms among women with anorexia nervosa.

PubMed

Lavender, Jason M; Mason, Tyler B; Utzinger, Linsey M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Mitchell, James E; Le Grange, Daniel; Crow, Scott J; Peterson, Carol B

2016-07-30

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Lack of assertiveness in patients with eating disorders].

PubMed

Behar A, Rosa; Manzo G, Rodrigo; Casanova Z, Dunny

2006-03-01

Low self-assertion has been noted as an important feature among patients with eating disorders. To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders. An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems. Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p <0.001) and showed a lower level of assertiveness on the RAS (p <0.001). Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder. Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.

René Girard and the Mimetic Nature of Eating Disorders.

PubMed

Strand, Mattias

2018-03-07

French historian and literary critic René Girard (1923-2015), most widely known for the concepts of mimetic desire and scapegoating, also engaged in the discussion of the surge of eating disorders in his 1996 essay Eating Disorders and Mimetic Desire. This article explores Girard's ideas on the mimetic nature and origin of eating disorders from a clinical psychiatric perspective and contextualizes them within the field of eating disorders research as well as in relation to broader psychological, sociological and anthropological models of social comparison and non-consumption. Three main themes in Girard's thinking on the topic of eating disorders are identified and explored: the 'end of prohibitions' as a driving force in the emergence of eating disorders, eating disorders as a phenomenon specific to modernity, and the significance of 'conspicuous non-consumption' in the emergence of eating disorders.

Factor analysis of the adolescent version of the Eating Disorders Examination Questionnaire (EDE-Q): results from Swedish general population and clinical samples.

PubMed

Forsén Mantilla, Emma; Birgegård, Andreas; Clinton, David

2017-01-01

Although the Eating Disorder Examination Questionnaire (EDE-Q) is perhaps the single most widely used self-report measure of eating disorder (ED) symptoms, important questions remain about its validity and applicability in relation to particular groups of individuals, especially adolescents of both genders. The present study investigated the factor structure of the adolescent version of the Eating Disorder Examination Questionnaire (EDE-Q) in samples of Swedish girls and boys from the general population and girls with a diagnosed eating disorder. Girls ( N  = 239) and boys ( N  = 248) aged between 13 and 15 years who were attending school, and girls ( N  = 570) aged between 12 and 14 years who were in treatment for an eating disorder at a specialist eating disorder clinic were assessed on the adolescent version of the EDE-Q. The adolescent version of the EDE-Q demonstrated satisfactory levels of internal consistency. However, confirmatory factor analysis (CFA) failed to support the four-factor model of the EDE-Q. Parallel analysis (PA) and subsequent exploratory factor analysis (EFA) suggested that the adolescent version of the EDE-Q comprises one underlying factor in young adolescent girls (both clinical and general population), centred on Dissatisfaction with Shape and Weight. In boys three factors were found: Weight-related Concerns, Body Discomfort and Restraint. The EDE-Q appears to measure different underlying aspects of eating disorder psychopathology in young teenagers compared to adults. The dimensions underlying disordered eating in young girls may become increasingly differentiated with time. There appear to be important gender-based differences in the dimensions underlying the EDE-Q in young teenagers. Therapists should be alert to beliefs that girls have about the importance of shape and weight, while in boys it may be more important to be attentive to how they feel about their bodies in relation to weight.

The empirical status of the third-wave behaviour therapies for the treatment of eating disorders: A systematic review.

PubMed

Linardon, Jake; Fairburn, Christopher G; Fitzsimmons-Craft, Ellen E; Wilfley, Denise E; Brennan, Leah

2017-12-01

Although third-wave behaviour therapies are being increasingly used for the treatment of eating disorders, their efficacy is largely unknown. This systematic review and meta-analysis aimed to examine the empirical status of these therapies. Twenty-seven studies met full inclusion criteria. Only 13 randomized controlled trials (RCT) were identified, most on binge eating disorder (BED). Pooled within- (pre-post change) and between-groups effect sizes were calculated for the meta-analysis. Large pre-post symptom improvements were observed for all third-wave treatments, including dialectical behaviour therapy (DBT), schema therapy (ST), acceptance and commitment therapy (ACT), mindfulness-based interventions (MBI), and compassion-focused therapy (CFT). Third-wave therapies were not superior to active comparisons generally, or to cognitive-behaviour therapy (CBT) in RCTs. Based on our qualitative synthesis, none of the third-wave therapies meet established criteria for an empirically supported treatment for particular eating disorder subgroups. Until further RCTs demonstrate the efficacy of third-wave therapies for particular eating disorder subgroups, the available data suggest that CBT should retain its status as the recommended treatment approach for bulimia nervosa (BN) and BED, and the front running treatment for anorexia nervosa (AN) in adults, with interpersonal psychotherapy (IPT) considered a strong empirically-supported alternative. Copyright © 2017 Elsevier Ltd. All rights reserved.

Feeding and eating disorders in children.

PubMed

Bryant-Waugh, Rachel

2013-11-01

The past few years have seen a steep increase in journal articles relating to feeding and eating disorders in children, making a succinct overview timely. The relevance of this review is enhanced by the recent publication of revised feeding and eating disorder diagnostic criteria in DSM-5. These have significant implications for younger patients, in particular through the inclusion of the new diagnostic category Avoidant/Restrictive Food Intake Disorder (ARFID). It is likely that this will encourage increased research interest in this field. Recent publications included in this article cover a broad range of topics relevant to childhood feeding and eating disorders, to include: presentation, diagnosis and classification; epidemiology; risk factors; assessment measures; treatment, prognosis and outcome. The area of feeding and eating disorders in children remains relatively under-researched, with significant gaps in knowledge about epidemiology, course and prognosis as well as a limited evidence base for treatment. However, important and promising avenues are increasingly being explored. In relation to clinical practice, there is now a much better recognition of these disorders and a greater awareness of their complexity, severity and potential impact in both the short and the longer term if not appropriately managed.

[Eating Disorders in Female High School Students: Educational and Migration Background, School-Related Stress and Performance-Orientated Classes].

PubMed

Grüttner, M

2018-02-01

Many adolescents and young adults, especially young females, suffer from eating disorders or problematic nutrition behavior. Children and adolescents with migration background as well as from a lower social class are more likely to have eating disorders 1. Although schools are an important context in these age groups, there is a lack of scientific inquiry concerning the relationship between schooling and eating disorders. The present study investigates the relationship between performance-related stress at school and eating disorders while controlling for personnel and familial resources. Interview data on the 7 th grade high school students from the National Educational Panel Study (NEPS)* starting cohort 3 are used. The dependent variable is based on the SCOFF questionnaire. Logistic regressions are calculated using information from students and parents. Performance-related stress at school is operationalized by the negative deviation of realistic from idealistic educational aspirations (EA) and unfulfilled social expectations (SE), performance-oriented class climate is operationalized by students' perception of the performance-orientation of the teacher (PT) and the expectations of classmates (EC). The results point towards an increased risk of suffering from an eating disorder due to performance-related school stress (EA: AME: 0.18; p<0.001; SE: AME: 0.12; p<0.05) and performance-oriented class climate (PT: AME: 0.05; p<0.1; EC: AME: 0.15, p<0.01). They partly explain the relation between both migration background and educational background and eating disorders. In order to prevent eating disorders in female high school students, attention should be paid to performance-orientation experienced at school and in the social background, and improved individual support for disadvantaged students should be made available. © Georg Thieme Verlag KG Stuttgart · New York.

ATTACHMENT AS A PREDICTOR OF RISK FOR EATING DISORDERS ON A REPRESENTATIVE HUNGARIAN ADULT SAMPLE.

PubMed

Szalai, Tamás Dömötör; Czeglédi, Edit

2015-11-30

Many studies confirm the relationship between attachment disturbances and (the severity of) eating disorders, however among them only one Hungarian study can be found. The exact predisposing traits of attachment and the strength of relationship is still uncleared. Our aim was to explore these aspects. Study was based on a cross-sectional nationally representative survey, called "Hungarostudy 2013" (N = 2000, 46.9% males, mean age 46.9 years, SD = 18.24 years). Measures: Sociodemographic and self-reported anthropometric data (weight and height), short Hungarian version of Relationship Scale Questionnaire, SCOFF questionnaire and short Hungarian version of Beck Depression Inventory. The frequency of risk for eating disorders (anorexia or bulimia nervosa) was 3.9% (N = 76) among the respondents (N = 1860). Attachment anxiety was significantly higher in the risk for eating disorders group (t (1888) = -3.939, p < 0.001), and significantly predicted the risk or eating disorders after adjusting for the potential background variables (OR = 1.09, p = 0.040). Detachment was not a significant predictor of risk for eating disorders (OR = 0.98, p = 0.515). Younger age (OR = 0.97, p < 0.001), higher level of depression (OR = 1.09, p < 0.001) and higher body mass index (OR = 1.08, p < 0.001) were also significant cross-sectional predictors of risk for eating disorders. The explained variance of the model was 10.7%. The study supported, that higher attachment anxiety is associated with the increased risk of eating disorders, with a possible therapeutic relevance. Assessment of attachment's further aspects and creating multivariable models are required for more thorough understanding and optimising of intervention points.

Enhanced cognitive behavioral therapy for eating disorders adapted for a group setting.

PubMed

Wade, Stephanie; Byrne, Sue; Allen, Karina

2017-08-01

This randomized control trial is an evaluation of the effectiveness of enhanced cognitive behavioral treatment (CBT-E) for eating disorders adapted for a group setting. The study aimed to examine the effects of group CBT-E on eating disorder psychopathology and additional maintaining pathology. A transdiagnostic sample of individuals with eating disorders with a BMI ≥ 18 kg/m 2 (N = 40) were randomized to an immediate-start or delayed-start condition so as to compare therapeutic effects of group CBT-E with a waitlist control. Global Eating Disorder Examination Questionnaire (EDE-Q) scores, BMI, and measures of Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were measured across the 8-week control period, throughout the group treatment and at 3-months post-treatment. Over 70% of those who entered the trial completed treatment. The first eight weeks of group CBT-E were more effective at reducing Global EDE-Q scores than no treatment (waitlist control). By post-treatment, good outcome (a Global EDE-Q within 1 SD of Australian community norms plus BMI ≥ 18.5) was achieved by 67.9% of treatment completers and 66.7% of the total sample. Symptom abstinence within the previous month was reported by 14.3% of treatment completers and 10.3% of the total sample. Significant reductions in Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were also observed. This study demonstrated that a group version of CBT-E can be effective at reducing eating disorder psychopathology in a transdiagnostic sample of individuals with eating disorders. Group CBT-E could provide a means of increasing availability of evidence-based treatment for eating disorders. © 2017 Wiley Periodicals, Inc.

Eating disorders among patients incarcerated only for repeated shoplifting: a retrospective quasi-case-control study in a medical prison in Japan

PubMed Central

2014-01-01

Background Shoplifting is a serious problem among patients with eating disorders. For more than a decade, we have treated many patients with eating disorders incarcerated in Hachioji Medical Prison only for repeated shoplifting. Methods We analyzed the prison records and medical records of female psychiatric patients transferred to Hachioji Medical Prison between 2002 and 2011. Based on the offense listed at the time of sentencing, we extracted a shoplifting group and a drug-offense group from among all patients with eating disorders. One patient from the former group who had used substances and two from the latter group who had never shoplifted were excluded from the study. The groups had 41 and 14 patients, respectively. A control group comprised patients with other mental disorders (n = 34). We compared eating disorder histories and subtypes, weight changes, comorbidities, life histories, past behavioral problems, and clinical behavioral problems among the three groups. Results The shoplifting group exhibited less impulsive behavior, substance abuse, antisocial features, borderline personality disorder, and past bulimia than did the drug-offense and control groups. The shoplifting group had higher educational achievement and steadier employment; however, their eating disorder histories and interpersonal dysfunction were more severe, and they had a higher psychiatric treatment dropout rate. There were also significant relationships with low body weight, anorexia nervosa-restricting type, obsessive–compulsive behaviors, and obsessive–compulsive personality disorder in the shoplifting group. During the clinical course, food refusal, excessive exercise, food hoarding, and falsification of dietary intake amounts were more frequently observed in the shoplifting group. Conversely, drug requests and occurrences of self-harm were less frequent in the shoplifting group than in the drug-offense group. Conclusions Although these results may be associated with specific characteristics of patients with eating disorders in the medical prison setting, we concluded that the repeated shoplifting by these patients is unrelated to antisocial or impulsive characteristics but is deeply rooted in these patients’ severe and undertreated eating disorder psychopathology. Strong supportive treatment should be considered for patients with eating disorders who develop shoplifting behaviors. Further research is required to elucidate the mechanisms responsible for the relationship between shoplifting and eating disorders. PMID:24907848

Attention-deficit/hyperactivity disorder-specific stimulant misuse, mood, anxiety, and stress in college-age women at high risk for or with eating disorders.

PubMed

Gibbs, Elise L; Kass, Andrea E; Eichen, Dawn M; Fitzsimmons-Craft, Ellen E; Trockel, Mickey; Wilfley, Denise E

2016-01-01

To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Four hundred forty-eight college-age women aged 18-25 at high risk for or with a clinical or subclinical eating disorder. Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Greater eating disorder pathology, objective binge eating, purging, eating disorder-related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.

The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders.

PubMed

Schaumberg, Katherine; Welch, Elisabeth; Breithaupt, Lauren; Hübel, Christopher; Baker, Jessica H; Munn-Chernoff, Melissa A; Yilmaz, Zeynep; Ehrlich, Stefan; Mustelin, Linda; Ghaderi, Ata; Hardaway, Andrew J; Bulik-Sullivan, Emily C; Hedman, Anna M; Jangmo, Andreas; Nilsson, Ida A K; Wiklund, Camilla; Yao, Shuyang; Seidel, Maria; Bulik, Cynthia M

2017-11-01

In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Current and Emerging Directions in the Treatment of Eating Disorders

PubMed Central

Brown, Tiffany A.; Keel, Pamela K.

2012-01-01

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

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among adult eating disorder patients.

PubMed

Svedlund, Nils Erik; Norring, Claes; Ginsberg, Ylva; von Hausswolff-Juhlin, Yvonne

2017-01-17

Very little is known about the prevalence of ADHD symptoms in Bulimia Nervosa and Binge Eating Disorder and even less in other eating disorders. This knowledge gap is of clinical importance since stimulant treatment is proven effective in Binge Eating Disorder and discussed as a treatment possibility for Bulimia Nervosa. The objective of this study was to explore the prevalence and types of self-reported ADHD symptoms in an unselected group of eating disorder patients assessed in a specialized eating disorder clinic. In total 1165 adults with an eating disorder were assessed with a battery of standardized instruments, for measuring inter alia ADHD screening, demographic variables, eating disorder symptoms and psychiatric comorbidity. Chi-square tests were used for categorical variables and Kruskal-Wallis tests for continuous variables. Almost one third (31.3 %) of the patients scored above the screening cut off indicating a possible ADHD. The highest prevalence rates (35-37 %) were found in Bulimia Nervosa and Anorexia Nervosa bingeing/purging subtype, while Eating Disorder Not Otherwise Specified type 1-4 and Binge Eating Disorder patients reported slightly below average (26-31 %), and Anorexia Nervosa restricting subtype patients even lower (18 %). Presence of binge eating, purging, loss of control over eating and non-anorectic BMI were related to results indicating a possible ADHD. Psychiatric comorbidity correlated to ADHD symptoms without explaining the differences between eating disorder diagnoses. There is a high frequency of ADHD symptoms in patients with binge eating/purging eating disorders that motivates further studies, particularly concerning the effects of ADHD medication. The finding that the frequency of ADHD symptoms in anorexia nervosa with binge eating/purging is as high as in bulimia nervosa highlights the need also for this group.

Questionnaire-Based Maladaptive Decision-Coping Patterns Involved in Binge Eating Among 1013 College Students

PubMed Central

Yan, Wan-Sen; Zhang, Ran-Ran; Lan, Yan; Li, Zhi-Ming; Li, Yong-Hui

2018-01-01

Binge Eating Disorder (BED), considered a public health problem because of its impact on psychiatric, physical, and social functioning, merits much attention given its elevation to an independent diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Similar with substance use disorders, some neuropsychological and personality constructs are potentially implicated in the onset and development of BED, in which poor decision-making has been suggested to facilitate overeating and BED. The objective of this study was to investigate the associations between decision-coping patterns, monetary decision-making, and binge-eating behavior in young adults. A sample of 1013 college students, equally divided into binge-eating and non-binge-eating groups according to the scores on the Binge Eating Scale (BES), were administered multiple measures of decision-making including the Melbourne Decision-Making Questionnaire (MDMQ), the Delay-discounting Test (DDT), and the Probability Discounting Test (PDT). Compared with the non-binge-eating group, the binge-eating group displayed elevated scores on maladaptive decision-making patterns including Procrastination, Buck-passing, and Hypervigilance. Logistic regression model revealed that only Procrastination positively predicted binge eating. These findings suggest that different dimensions of decision-making may be distinctly linked to binge eating among young adults, with Procrastination putatively identified as a risk trait in the development of overeating behavior, which might promote a better understanding of this disorder. PMID:29765343

Dysregulation of Brain Reward Systems in Eating Disorders: Neurochemical Information from Animal Models of Binge Eating, Bulimia Nervosa, and Anorexia Nervosa

PubMed Central

Avena, Nicole M.; Bocarsly, Miriam E.

2012-01-01

Food intake is mediated, in part, through brain pathways for motivation and reinforcement. Dysregulation of these pathways may underlay some of the behaviors exhibited by patients with eating disorders. Research using animal models of eating disorders has greatly contributed to the detailed study of potential brain mechanisms that many underlie the causes or consequences of aberrant eating behaviors. This review focuses on neurochemical evidence of reward-related brain dysfunctions obtained through animal models of binge eating, bulimia nervosa, or anorexia nervosa. The findings suggest that alterations in dopamine (DA), acetylcholine (ACh) and opioid systems in reward-related brain areas occur in response to binge eating of palatable foods. Moreover, animal models of bulimia nervosa suggest that while bingeing on palatable food releases DA, purging attenuates the release of ACh that might otherwise signal satiety. Animal models of anorexia nervosa suggest that restricted access to food enhances the reinforcing effects of DA when the animal does eat. The activity-based anorexia model suggests alterations in mesolimbic DA and serotonin occur as a result of starvation coupled with excessive wheel running. These findings with animal models complement data obtained through neuroimaging and pharmacotherapy studies of clinical populations. Finally, information on the neurochemical consequences of the behaviors associated with these eating disorders will be useful in understanding these complex disorders and may inform future therapeutic approaches, as discussed here. PMID:22138162

A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes.

PubMed

Holland, Grace; Tiggemann, Marika

2016-06-01

A large body of literature has demonstrated mass media effects on body image and disordered eating. More recently, research in this area has turned to 'new' forms of media, such as the Internet, and particularly Social Networking Sites (SNSs). A systematic search for peer-reviewed articles on SNS use and body image and eating disorders resulted in 20 studies meeting specific inclusion criteria. As a whole, these articles demonstrated that use of SNSs is associated with body image and disordered eating. Specific SNS activities, such as viewing and uploading photos and seeking negative feedback via status updates, were identified as particularly problematic. A small number of studies also addressed underlying processes and found that appearance-based social comparison mediated the relationship between SNS use and body image and eating concerns. Gender was not found to be a moderating factor. It was concluded that, although there is a good deal of correlational research supporting the maladaptive effect of SNS use on body image and disordered eating, more longitudinal and experimental studies are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Binge eating disorder

MedlinePlus

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, ...

Eating disorders in children: is avoidant-restrictive food intake disorder a feeding disorder or an eating disorder and what are the implications for treatment?

PubMed

Kennedy, Grace A; Wick, Madeline R; Keel, Pamela K

2018-01-01

Avoidant-restrictive food intake disorder (ARFID) is a current diagnosis in the "Feeding and Eating Disorders" section of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) and captures a heterogeneous presentation of eating disturbances. In recent years, ARFID has been studied primarily within the context of eating disorders despite having historical roots as a feeding disorder. The following review examines ARFID's similarities with and differences from feeding disorders and eating disorders, focusing on research published within the last three years. Implications of this differentiation for treatment are discussed.

The effect of exercise absence on affect and body dissatisfaction as moderated by obligatory exercise beliefs and eating disordered beliefs and behaviors

PubMed Central

LePage, Marie L.; Price, Matthew; O’Neil, Patrick; Crowther, Janis H.

2012-01-01

Aim Research suggests that exercise absence is frequently associated with greater guilt and negative affect, particularly when obligatory exercise beliefs and eating disordered psychopathology are considered. Two separate studies used ecological momentary assessment (EMA) to examine differences in mood on exercise and non-exercise days and the moderating impact of obligatory exercise beliefs and eating disordered beliefs and behaviors. Method Both studies recruited female university students who endorsed frequent exercise behavior and study two also recruited based on level of eating disordered psychopathology. Participants completed the Obligatory Exercise Questionnaire at baseline and EMA measures of affect and exercise behavior for approximately one week. Study two participants also completed measures of body dissatisfaction and cognitions. Results Results of study one suggest that obligation to exercise appears to have a greater impact on general level of affect than does exercise absence or the interaction of these two. In addition, in study two, eating disorder symptomatology was significantly associated with affect and cognition while exercise absence and obligatory exercise beliefs were not. Conclusions The present studies suggest that the absence of exercise is not associated with significant changes in affect or cognitions. However, obligation to exercise and eating disorder symptomatology do impact affect and cognitions. PMID:22930654

"Not all my fault": genetics, stigma, and personal responsibility for women with eating disorders.

PubMed

Easter, Michele M

2012-10-01

Medical researchers and clinicians increasingly understand and present eating disorders (anorexia and bulimia nervosa) as biologically-based psychiatric disorders, with genetic risk factors established by high heritability estimates in twin studies. But there has been no research on interpretation of genetic involvement by people with eating disorders, who may hold other views. Their interpretations are particularly important given the frequent presumption that biogenetic framing will reduce stigma, and recent findings that it exacerbates stigma for other mental illnesses. To identify implications of genetic framing in eating disorders, I conducted semi-structured interviews with 50 US women with a history of eating disorders (half recovered, half in treatment; interviewed 2008-9 in the USA). Interviews introduced the topic of genetics, but not stigma per se. Analysis followed the general principles of grounded theory to identify perceived implications of genetic involvement; those relevant to stigma are reported here. Most anticipated that genetic reframing would help reduce stigma from personal responsibility (i.e., blame and guilt for eating disorder as ongoing choice). A third articulated ways it could add stigma, including novel forms of stigma related to genetic-essentialist effacing of social factors. Despite welcoming reductions in blame and guilt, half also worried genetic framing could hamper recovery, by encouraging fatalistic self-fulfilling prophecies and genetic excuses. This study is the first to elicit perceptions of genetic involvement by those with eating disorders, and contributes to an emerging literature on perceptions of psychiatric genetics by people with mental illness. Copyright © 2012 Elsevier Ltd. All rights reserved.

Military sexual trauma is associated with eating disorders, while combat exposure is not.

PubMed

Breland, Jessica Y; Donalson, Rosemary; Li, Yongmei; Hebenstreit, Claire L; Goldstein, Lizabeth A; Maguen, Shira

2018-05-01

There are strong associations among trauma and eating disorders. However, while trauma and eating disorders are more common among veterans than other populations, there is little information on how military-specific stressors affect eating disorder risk. This study's objective was to determine whether military sexual trauma and combat exposure were independent predictors of eating disorders among women veterans, a high-risk group. Participants were women age 18-70, using VA medical center services, without psychotic disorders or suicidal ideation (N = 407). We estimated a cross-sectional logistic regression model to predict eating disorders (anorexia, bulimia, binge eating disorder) as a function of military sexual trauma and combat exposure, adjusting for demographic variables. Sixty-six percent of participants reported military sexual trauma, 32% reported combat exposure, and 15% met eating disorder criteria. Mean age was 49 years (SD = 13); 40% were veterans of color. Women reporting military sexual trauma had twice the odds of an eating disorder compared to women who did not (odds ratio [OR]: 2.03; 95% CI [1.03-3.98]). Combat exposure was not associated with eating disorders. Asian race (OR: 3.36; 95% CI [1.26-8.97]) and age (OR: 1.03; 95% CI [1.01-1.06]) were associated with eating disorders. The high rates of military sexual trauma and eating disorders highlight a need for continued work. Results suggest that it may be useful to focus on women reporting military sexual trauma when implementing eating disorder screening and treatment programs. Given associations among trauma, eating disorders, obesity, and mortality, such efforts could greatly improve veteran health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Assisted reproductive technology treatment in women with severe eating disorders: a national cohort study.

PubMed

Assens, Maria; Ebdrup, Ninna H; Pinborg, Anja; Schmidt, Lone; Hougaard, Charlotte O; Hageman, Ida

2015-11-01

This national retrospective cohort study investigates the prevalence of women with severe eating disorders in assisted reproductive technology (ART) treatment compared with an age-matched background population without ART treatment. It assesses the frequency distribution of the first and last eating disorder diagnosis before, during, and after ART treatment, and evaluates differences in obstetric outcomes between women with and without a severe eating disorder. Hospital-diagnosed eating disorders among 42,915 women in the Danish National ART cohort (DANAC), registered during 1994-2009 in the mandatory Psychiatric Central Research Register, were compared with a non-eating disorder ART cohort of 42,644 women and an age-matched background population of 215,290 women without a history of ART treatment for the main outcome measures prevalence of eating disorders, frequency distribution of diagnoses before/during/after ART treatment, as well as ART treatment and obstetric outcomes. In the ART cohort, 271 women (0.63%) had an eating disorder diagnosis compared with 0.73% in the background population (p = 0.025). The prevalence of ovulatory disorder was significantly higher in women with a severe eating disorder compared with the ART cohort without eating disorders. Obstetric outcomes were similar in ART-treated women with and without an eating disorder. Women with severe eating disorders were identified in the ART cohort, although significantly less often than in the age-matched background population. Women with severe eating disorders suffered more often from anovulatory infertility than the ART comparison cohort without this disease. Obstetric outcomes appeared reassuring in the ART cohort with eating disorders. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Demographic, psychiatric, and personality correlates of adults seeking treatment for disordered gambling with a comorbid binge/purge type eating disorder.

PubMed

Kim, Hyoun S; von Ranson, Kristin M; Hodgins, David C; McGrath, Daniel S; Tavares, Hermano

2018-05-24

Preliminary evidence suggests that binge/purge type eating disorders and gambling disorder may commonly co-occur. However, this dual-diagnosis population remains understudied. The present research examined the prevalence rates and correlates of binge/purge type eating disorders (i.e., bulimia nervosa, binge-eating disorder, and anorexia nervosa binge/purge type) among adults seeking treatment for their gambling (N = 349). In total, 11.5% of the sample (n = 40) met criteria for a binge/purge type eating disorder, most commonly bulimia nervosa (n = 33). There was a higher preponderance of binge/purge type eating disorders in women. People with a comorbid binge/purge type eating disorder reported more days gambling, gambling-related cognitive distortions, impulsivity, suicidality, and other current psychiatric comorbidities including addictive behaviours. These findings suggest that binge/purge type eating disorders in people seeking treatment for gambling may be more common than previously believed. Furthermore, the increased psychopathology among people with binge/purge type eating disorder and gambling disorder identify vulnerabilities of this dual-diagnosed population that may require clinical attention. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

Eating Disorders and Disordered Eating in Type 1 Diabetes: Prevalence, Screening, and Treatment Options

PubMed Central

Hanlan, Margo E.; Griffith, Julie; Patel, Niral

2013-01-01

This review is focused on the prevalence of eating disorders and disordered eating behaviors in individuals with type 1 diabetes. Recent research indicates higher prevalence rates of eating disorders among people with type 1 diabetes, as compared to their peers without diabetes. Eating disorders and disordered eating behaviors – especially insulin omission – are associated with poorer glycemic control and serious risk for increased morbidity and mortality. Screening should begin in pre-adolescence and continue through early adulthood, as many disordered eating behaviors begin during the transition to adolescence and may persist for years. Available screening tools and treatment options are reviewed. Given the complexity of diabetes management in combination with eating disorder treatment, it is imperative to screen early and often, in order to identify those most vulnerable and begin appropriate treatment in a timely manner. PMID:24022608

Life beyond the eating disorder: education, relationships, and reproduction.

PubMed

Maxwell, Millie; Thornton, Laura M; Root, Tammy L; Pinheiro, Andrea Poyastro; Strober, Michael; Brandt, Harry; Crawford, Steve; Crow, Scott; Fichter, Manfred M; Halmi, Katherine A; Johnson, Craig; Kaplan, Allan S; Keel, Pamela; Klump, Kelly L; LaVia, Maria; Mitchell, James E; Plotnicov, Kathy; Rotondo, Alessandro; Woodside, D Blake; Berrettini, Wade H; Kaye, Walter H; Bulik, Cynthia M

2011-04-01

We investigated the sociodemographic characteristics in women with and without lifetime eating disorders. Participants were from a multisite international study of eating disorders (N = 2,096). Education level, relationship status, and reproductive status were examined across eating disorder subtypes and compared with a healthy control group. Overall, women with eating disorders were less educated than controls, and duration of illness and age of onset were associated with educational attainment. Menstrual status was associated with both relationship and reproductive status, but eating disorder subtypes did not differ significantly from each other or from healthy controls on these dimensions. Differences in educational attainment, relationships, and reproduction do exist in individuals with eating disorders and are differentially associated with various eating disorder symptoms and characteristics. These data could assist in educating patients and family members about long-term consequences of eating disorders. Copyright © 2010 Wiley Periodicals, Inc.

Beliefs about excessive exercise in eating disorders: the role of obsessions and compulsions.

PubMed

Naylor, Heather; Mountford, Victoria; Brown, Gary

2011-01-01

This study aimed to develop an understanding of excessive exercise in eating disorders by exploring the role of exercise beliefs, obsessive beliefs and obsessive-compulsive behaviours. Sixty-four women were recruited from eating disorder services and 75 non-clinical women were recruited from a university. Exercise beliefs and behaviours, obsessive beliefs and behaviours and eating disorder psychopathology were assessed using self-report questionnaires. There was an association between exercise beliefs, obsessive beliefs and obsessive-compulsive behaviours in the eating-disordered group, but not in the non-eating-disordered group. In the eating-disordered group obsessive beliefs and obsessive-compulsive behaviours were associated with a significant proportion of variance in exercise beliefs after controlling for eating disorder psychopathology and BMI. In the non-eating-disordered group obsessive beliefs and behaviours were associated with beliefs about exercise as a method of affect regulation after controlling for BMI. The results are compatible with a model in which obsessive beliefs and exercise beliefs could maintain exercise in eating disorders. This has implications for the assessment and treatment of excessive exercise. Further research is necessary to determine the causality of these relationships. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

Increased mortality in bulimia nervosa and other eating disorders.

PubMed

Crow, Scott J; Peterson, Carol B; Swanson, Sonja A; Raymond, Nancy C; Specker, Sheila; Eckert, Elke D; Mitchell, James E

2009-12-01

Anorexia nervosa has been consistently associated with increased mortality, but whether this is true for other types of eating disorders is unclear. The goal of this study was to determine whether anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified are associated with increased all-cause mortality or suicide mortality. Using computerized record linkage to the National Death Index, the authors conducted a longitudinal assessment of mortality over 8 to 25 years in 1,885 individuals with anorexia nervosa (N=177), bulimia nervosa (N=906), or eating disorder not otherwise specified (N=802) who presented for treatment at a specialized eating disorders clinic in an academic medical center. Crude mortality rates were 4.0% for anorexia nervosa, 3.9% for bulimia nervosa, and 5.2% for eating disorder not otherwise specified. All-cause standardized mortality ratios were significantly elevated for bulimia nervosa and eating disorder not otherwise specified; suicide standardized mortality ratios were elevated for bulimia nervosa and eating disorder not otherwise specified. Individuals with eating disorder not otherwise specified, which is sometimes viewed as a "less severe" eating disorder, had elevated mortality risks, similar to those found in anorexia nervosa. This study also demonstrated an increased risk of suicide across eating disorder diagnoses.

The Prevalence and Inter-Relationship of Negative Body Image Perception, Depression and Susceptibility to Eating Disorders among Female Medical Undergraduate Students

PubMed Central

Manaf, Nurajirahbt Abdul; Zuhrah, Beevi

2016-01-01

Introduction Female students are thought to be more negatively impacted by body image ideals and often more susceptible to various eating related disorders compared to men. A previous study using a sample of female students in Malaysia did not identify whether the increase in susceptibility to eating disorders can be explained by the level of body image acceptance. Aim To identify the prevalence of depression and susceptibility to eating disorders among a sample of 206 female students in one of the private universities in Malaysia and explore the relationship between depression, body image and susceptibility to eating disorders. In addition, this study aimed to determine whether depression is a mediator between body image and susceptibility to eating disorders among female college students. Materials and Methods The Body Image Acceptance and Action Questionnaire were used to assess body image acceptance, the Patient Health Questionnaire to measure depression and the Eating Attitude Test- 26 was used to assess susceptibility to eating disorders. Results The results showed that 65.5% (n=135) of the students were depressed and 6.3% (n=13) were susceptible to eating disorders. There was a significant positive relationship between depression and eating disorders and a negative relationship between body image and depression as well as between body image and eating disorder. Further, the regression model showed that depression was partially mediating the effect of body image on eating disorders. Conclusion Body image and depression contribute to eating disorders and treating depression could reduce susceptibility to eating disorders. PMID:27134977

Does being overweight or male increase a patient's risk of not being referred for an eating disorder consult?

PubMed

MacCaughelty, Chelsea; Wagner, Rebecca; Rufino, Katrina

2016-10-01

To examine whether sex, age, body mass index (BMI), and eating disorder diagnosis were associated with referral rates for eating disorder consults in a general inpatient psychiatric facility. An inpatient sample of 136 individuals with a current eating disorder diagnosis were utilized for this study. Chi square and logistic regression were used to identify variables affecting the likelihood of having an eating disorder consult. More women than men were identified as having a current eating disorder diagnosis. For both women and men, eating disorder not otherwise specified (EDNOS) was the most common diagnosis, followed by binge-eating disorder (BED). Compared to women, there were more men who did not receive an eating disorder consult. Specifically, overweight men were less likely to be referred for a consult. Results highlight the need of healthcare providers to ask all individuals about their eating habits, which could then provide an opportunity to explore eating disorder symptoms. Due to historical biases, the less distinct nature of some diagnoses or the absence of symptoms that have been considered indicators of clinical severity, providers may be more likely to overlook individuals with diagnoses of EDNOS and BED for consults, especially men. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:963-966). © 2016 Wiley Periodicals, Inc.

Re-examination of chewing and spitting behavior: characteristics within and across eating disorder diagnoses.

PubMed

Durkin, Nora E; Swanson, Sonja A; Crow, Scott J; Mitchell, James; Peterson, Carol B; Crosby, Ross

2014-01-01

Chewing and spitting (CS) out food is a relatively understudied eating disorder behavior. The aim of this study was to examine lifetime and current frequencies of CS across eating disorder diagnostic groups and to compare the severity of eating disorder symptomatology between participants who did and did not endorse CS. A total of 972 individuals presenting for outpatient eating disorder treatment between 1985 and 1996 completed a questionnaire that included items regarding current and lifetime eating disorder behaviors, including CS. Results indicated that both lifetime and current prevalence estimates of CS varied cross-diagnostically, with CS being more common among those with anorexia nervosa and bulimia nervosa compared to those with eating disorder not otherwise specified. CS was significantly associated with several eating disorder symptoms, including compensatory behaviors, meal restriction, and lower BMI. Those who reported CS were also younger in age compared to those who did not report CS. These findings indicate that CS is associated with more severe eating and weight pathology and is not equally prevalent across eating disorder diagnoses. These results also support the relatively high occurrence of CS and the importance of targeting this behavior in eating disorder treatment. Future research should clarify the correlates, mechanisms, and function of CS in eating disorders.

Gestational and postpartum weight change patterns in mothers with eating disorders.

PubMed

Zerwas, Stephanie C; Von Holle, Ann; Perrin, Eliana M; Cockrell Skinner, Asheley; Reba-Harrelson, Lauren; Hamer, Robert M; Stoltenberg, Camilla; Torgersen, Leila; Reichborn-Kjennerud, Ted; Bulik, Cynthia M

2014-11-01

Although pregnancy can be associated with adaptive changes in weight and eating behaviour for women with eating disorders, less is known about whether these changes are maintained in the postpartum period. We used a longitudinal design to examine gestational and postpartum weight trajectories in mothers with and without eating disorders in the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Fifty-six women reported anorexia nervosa (AN), 636 bulimia nervosa, 3327 binge eating disorder and 69 eating disorder not otherwise specified, purging type. The referent group included 61,233 mothers with no eating disorder. We used a mixed effects model to predict weight change over time by eating disorder subtype. Mothers with AN, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified had greater increases in body mass index (BMI) during pregnancy and greater decreases in BMI over the first 6 months postpartum. Women with AN shifted from the underweight BMI range before pregnancy to the normal weight range at 36 months postpartum Patterns of maternal weight gain and retention during the perinatal period vary across eating disorder subtype and warrant clinical attention. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

The impact of early symptom change and therapeutic alliance on treatment outcome in cognitive-behavioural therapy for eating disorders.

PubMed

Turner, Hannah; Bryant-Waugh, Rachel; Marshall, Emily

2015-10-01

The present study explored the impact of early symptom change (cognitive and behavioural) and the early therapeutic alliance on treatment outcome in cognitive-behavioural therapy (CBT) for the eating disorders. Participants were 94 adults with diagnosed eating disorders who completed a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment, following the 6th session and at the end of treatment. They also completed a measure of therapeutic alliance following the 6th session. Greater early reduction in dietary restraint and eating concerns, and smaller levels of change in shape concern, significantly predicted later reduction in global eating pathology. The early therapeutic alliance was strong across the three domains of tasks, goals and bond. Early symptom reduction was a stronger predictor of later reduction in eating pathology than early therapeutic alliance. The early therapeutic alliance did not mediate the relationship between early symptom reduction and later reduction in global eating pathology. Instead, greater early symptom reduction predicted a strong early therapeutic alliance. Early clinical change was the strongest predictor of treatment outcome and this also facilitated the development of a strong early alliance. Clinicians should be encouraged to deliver all aspects of evidence-based CBT, including behavioural change. The findings suggest that this will have a positive impact on both the early therapeutic alliance and later change in eating pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dysregulation of brain reward systems in eating disorders: neurochemical information from animal models of binge eating, bulimia nervosa, and anorexia nervosa.

PubMed

Avena, Nicole M; Bocarsly, Miriam E

2012-07-01

Food intake is mediated, in part, through brain pathways for motivation and reinforcement. Dysregulation of these pathways may underlay some of the behaviors exhibited by patients with eating disorders. Research using animal models of eating disorders has greatly contributed to the detailed study of potential brain mechanisms that many underlie the causes or consequences of aberrant eating behaviors. This review focuses on neurochemical evidence of reward-related brain dysfunctions obtained through animal models of binge eating, bulimia nervosa, or anorexia nervosa. The findings suggest that alterations in dopamine (DA), acetylcholine (ACh) and opioid systems in reward-related brain areas occur in response to binge eating of palatable foods. Moreover, animal models of bulimia nervosa suggest that while bingeing on palatable food releases DA, purging attenuates the release of ACh that might otherwise signal satiety. Animal models of anorexia nervosa suggest that restricted access to food enhances the reinforcing effects of DA when the animal does eat. The activity-based anorexia model suggests alterations in mesolimbic DA and serotonin occur as a result of restricted eating coupled with excessive wheel running. These findings with animal models complement data obtained through neuroimaging and pharmacotherapy studies of clinical populations. Information on the neurochemical consequences of the behaviors associated with these eating disorders will be useful in understanding these complex disorders and may inform future therapeutic approaches, as discussed here. This article is part of a Special Issue entitled 'Central Control of Food Intake'. Copyright © 2011 Elsevier Ltd. All rights reserved.

It would not have happened to me at home: qualitative exploration of sojourns abroad and eating disorders in young Czech women.

PubMed

Pavlova, Barbara; Uher, Rudolf; Papezova, Hana

2008-05-01

Eating disorders can be triggered by life events involving migration and acculturation. To explore associations between sojourns abroad and the onset and course of eating disorders. Six semi-structured interviews with women with an eating disorder and history of sojourn abroad and seven first-person Internet testimonies were analysed using interpretative phenomenological analysis (IPA). We identified three trajectories relating eating disorders to sojourns abroad: (I) weight-gain when abroad associated with later development of an eating disorder; (II) development or worsening of an eating disorder when abroad; (III) stay abroad as an attempt to escape the illness. Three topics informed on the impact of sojourns abroad on mental health: (A) different food and eating habits; (B) negative emotions; (C) illness as attempt to achieve something valuable. The importance of the identified trajectories and topics relating eating disorders to sojourns abroad needs to be estimated in an epidemiological study. (c) 2007 John Wiley & Sons, Ltd and Eating Disorders Association

Mindfulness-Based Cognitive Therapy Applied to Binge Eating: A Case Study

ERIC Educational Resources Information Center

Baer, Ruth A.; Fischer, Sarah; Huss, Debra B.

2005-01-01

Binge eating is a common problem associated with distress and dysfunction. Mindfulness-based interventions are attracting increasing attention, and the recent empirical literature suggests that they may be effective for a variety of disorders. Current theories about the etiology and maintenance of binge eating suggest that mindfulness training may…

Emotional Eating among Individuals with Concurrent Eating and Substance Use Disorders

ERIC Educational Resources Information Center

Courbasson, Christine Marie; Rizea, Christian; Weiskopf, Nicole

2008-01-01

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…

Eating Disorder Intervention, Prevention, and Treatment: Recommendations for School Counselors

ERIC Educational Resources Information Center

Bardick, Angela D.; Bernes, Kerry B.; McCulloch, Ariana R. M.; Witko, Kim D.; Spriddle, Jennifer W.; Roest, Allison R.

2004-01-01

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…

Clinical utility of subtyping binge eating disorder by history of anorexia or bulimia nervosa in a treatment sample.

PubMed

Utzinger, Linsey M; Mitchell, James E; Cao, Li; Crosby, Ross D; Crow, Scott J; Wonderlich, Stephen A; Peterson, Carol B

2015-09-01

This study examined whether having a history of anorexia nervosa (AN) or bulimia nervosa (BN) is associated with response to treatment in adults with binge eating disorder (BED). Data from 189 adults diagnosed with BED who were randomly assigned to one of three group cognitive-behavioral (CBT) treatments were analyzed to compare those with and without a history of AN/BN. A total of 16% of the sample had a history of AN/BN. The BED subgroup with a history of AN/BN presented with higher rates of mood disorders and greater eating-related symptom severity at baseline. Participants with a history of AN/BN also had higher global eating disorder (ED) symptoms at end of treatment (EOT), and more frequent objective binge-eating episodes at EOT and 12-month follow-up. These findings suggest that in adults with BED, a history of AN/BN is predictive of greater eating-related symptom severity following group-based CBT and poorer short- and long-term binge-eating outcomes. These findings suggest that considering ED history in the treatment of adults with BED may be clinically useful. © 2015 Wiley Periodicals, Inc.

Eating disorders in children: is avoidant-restrictive food intake disorder a feeding disorder or an eating disorder and what are the implications for treatment?

PubMed Central

Kennedy, Grace A.; Wick, Madeline R.; Keel, Pamela K.

2018-01-01

Avoidant-restrictive food intake disorder (ARFID) is a current diagnosis in the “Feeding and Eating Disorders” section of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) and captures a heterogeneous presentation of eating disturbances. In recent years, ARFID has been studied primarily within the context of eating disorders despite having historical roots as a feeding disorder. The following review examines ARFID’s similarities with and differences from feeding disorders and eating disorders, focusing on research published within the last three years. Implications of this differentiation for treatment are discussed. PMID:29399331

Randomized controlled trial of a 12-month computerized mindfulness-based intervention for obese patients with binge eating disorder: The MindOb study protocol.

PubMed

Ruffault, Alexis; Carette, Claire; Lurbe I Puerto, Kàtia; Juge, Nicolas; Beauchet, Alain; Benoliel, Jean-Jacques; Lacorte, Jean-Marc; Fournier, Jean F; Czernichow, Sébastien; Flahault, Cécile

2016-07-01

Mindfulness-based interventions for healthy behaviors such as exercise and dietary modifications have aroused growing interest. This study aims to test the effectiveness of a mindfulness-based intervention for the reduction of impulsive eating and the improvement of motivation to exercise among obese individuals. One-hundred and twenty obese outpatients, aged 18 to 65years, diagnosed with a binge eating disorder, will be randomly assigned to one of the three following groups: mindfulness practice, sham meditation, or treatment as usual control. The tested intervention consists of a 1-year computerized mindfulness-based program. Mindfulness sessions are audio recordings that the patients are asked to listen to, 10min every day. Self-reported questionnaires measuring impulsive eating, motivation to exercise, physical activity level, mood, and mindfulness skills are filled in at baseline, 1, 6, and 12months. Physical activity, calories consumption, and biomarkers are measured with more objective measurement tools at baseline, 6months and 12months. Mindfulness, as both a de-automation element and as a moderator of motivation to exercise, can lead to the reduction of impulsive eating and also to an increase in levels of physical activity. These effects could cause weight loss in obese patients suffering from binge eating disorder. clinicaltrials.gov: NCT02571387. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program at 1- and 2-Year Follow-up

PubMed Central

Stice, Eric; Durant, Shelley; Rohde, Paul; Shaw, Heather

2014-01-01

Objective A group-based eating disorder prevention program wherein young women explore the costs of pursuing the thin ideal reduces eating disorder risk factors and symptoms. However, it can be challenging to identify school clinicians to effectively deliver the intervention. The present study compares the effects of a new Internet-based version of this prevention program, which could facilitate dissemination, to the group-based program and to educational video and educational brochure control conditions at 1- and 2-year follow-up. Method Female college students with body dissatisfaction (N = 107; M age = 21.6 SD = 6.6) were randomized to these four conditions. Results Internet participants showed reductions in eating disorder risk factors and symptoms relative to the two control conditions at 1- and 2-year follow-up (M d = .34 and .17 respectively), but the effects were smaller than parallel comparisons for the group participants (M d = .48 and .43 respectively). Yet the Internet intervention produced large weight gain prevention effects relative to the two control conditions at 1- and 2-year follow-up (M d = .80 and .73 respectively), which were larger than the parallel effects for the group intervention (M d = .19 and .47 respectively). Conclusions Although the effects for the Internet versus group intervention were similar at posttest, results suggest that the effects faded more quickly for the Internet intervention. However, the Internet intervention produced large weight gain prevention effects, implying that it might be useful for simultaneously preventing eating disordered behavior and unhealthy weight gain. PMID:25020152

Maternal and family factors and child eating pathology: risk and protective relationships

PubMed Central

2014-01-01

Background Previous studies have found associations between maternal and family factors and child eating disorder symptoms. However, it is not clear whether family factors predict eating disorder symptoms specifically, or relate to more general child psychopathology, of which eating disorder symptoms may be one component. This study aimed to identify maternal and family factors that may predict increases or decreases in child eating disorder symptoms over time, accounting for children’s body mass index z-scores and levels of general psychological distress. Methods Participants were 221 mother-child dyads from the Childhood Growth and Development Study, a prospective cohort study in Western Australia. Participants were assessed at baseline, 1-year follow-up and 2-year follow-up using interview and self-report measures. Children had a mean age of 10 years at baseline and 46% were male. Linear mixed models and generalised estimating equations were used to identify predictors of children’s eating disorder symptoms, with outcome variables including a global index of eating disorder psychopathology, levels of dietary restraint, levels of emotional eating, and the presence of loss of control (‘binge’) eating. Results Children of mothers with a current or past eating disorder reported significantly higher levels of global eating disorder symptoms and emotional eating than other children, and mothers with a current or past eating disorder reported significantly more concern about their children’s weight than other mothers. Maternal concern about child weight, rather than maternal eating disorder symptoms, was significant in predicting child eating disorder symptoms over time. Family exposure to stress and low maternal education were additional risk factors for eating disorder symptoms, whilst child-reported family satisfaction was a protective factor. Conclusions After adjusting for relevant confounding variables, maternal concern about child weight, children’s level of family satisfaction, family exposure to stress, and maternal education are unique predictors of child eating disorder symptoms. PMID:24808944

Eating disorder features and quality of life: Does gender matter?

PubMed

Wagner, Allison F; Stefano, Emily C; Cicero, David C; Latner, Janet D; Mond, Jonathan M

2016-10-01

This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.

Psychometric Evaluation and Norms for the Multidimensional Assessment of Interoceptive Awareness (MAIA) in a Clinical Eating Disorders Sample.

PubMed

Brown, Tiffany A; Berner, Laura A; Jones, Michelle D; Reilly, Erin E; Cusack, Anne; Anderson, Leslie K; Kaye, Walter H; Wierenga, Christina E

2017-09-01

Altered interoceptive awareness (IA) has been implicated in the pathophysiology of eating disorders; however, few comprehensive self-report measures of IA exist in eating disorders. The present study sought to validate the Multidimensional Assessment of Interoceptive Awareness (MAIA), originally developed to assess IA in individuals practicing mind-body therapies, in an eating disorder sample. Adult and adolescent patients (n = 376) completed assessments upon admission to a partial hospital programme. Analyses examined the factor structure of the MAIA, scale means, scale-scale correlations, internal consistency and construct validity. Analyses also examined associations between MAIA subscales and eating disorder symptoms. Results supported the original eight-factor structure of the MAIA. Internal consistency was acceptable, and the scales converged with associated measures. Importantly, Not Distracting, Self-regulation, Body Listening and Trusting were most strongly associated with eating disorder symptoms. Results support use of the MAIA among eating disorders and provide further support for the relevance of IA in eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Associations Among Meaning in Life, Body Image, Psychopathology, and Suicide Ideation in Spanish Participants With Eating Disorders.

PubMed

Marco, José H; Cañabate, Montserrat; Pérez, Sandra; Llorca, Ginés

2017-12-01

The aims of this study were to (a) analyze whether participants with eating disorders have lower meaning in life than the nonclinical population; (b) discover whether participants with eating disorders with low meaning in life have more body image disturbances, more psychopathology, and higher suicide ideation than participants with high meaning in life; (c) analyze whether meaning in life is associated with eating disorder psychopathology; and (d) analyze whether meaning in life is able to predict eating disorder psychopathology and suicide ideation, when body image is controlled. The clinical sample comprised 247 Spanish participants diagnosed with eating disorders, and the nonclinical sample comprised Spanish 227 participants. Participants with eating disorders had lower meaning in life than the nonclinical population. Patients with low meaning in life had higher psychopathology and suicide ideation than participants with high meaning in life. Meaning in life was a significant predictor of the eating disorder psychopathology and suicide ideation. Low meaning in life is associated with eating disorder psychopathology in a Spanish sample with eating disorders. © 2017 Wiley Periodicals, Inc.

Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder in Midlife and Beyond.

PubMed

Elran-Barak, Roni; Fitzsimmons-Craft, Ellen E; Benyamini, Yael; Crow, Scott J; Peterson, Carol B; Hill, Laura L; Crosby, Ross D; Mitchell, James E; Le Grange, Daniel

2015-08-01

We examined eating disorders in midlife and beyond by comparing frequency of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or eating disorder (OSFED) among midlife eating disorder treatment-seeking individuals and younger controls. We also compared demographic and eating disorder-related characteristics across diagnoses and age groups. Participants included 2,118 treatment-seeking adults who self-reported their eating-related symptoms on the Eating Disorder Questionnaire. Results showed that percent of patients with BN was significantly lower whereas percent of patients with BED and OSFED was significantly higher among midlife relative to younger patients. Percent of patients with AN did not differ between midlife and younger patients. Additionally, midlife and younger patients with BED and OSFED differed on several demographic (e.g., marital status) and eating disorder-related characteristics (e.g., BMI, compulsive exercising). This study suggests that BN is less common whereas BED and OSFED are more common among midlife eating disorder treatment-seeking individuals relative to younger controls. In addition, AN and BN present fairly similarly whereas BED and OSFED present fairly differently among midlife patients relative to younger controls. Attention to these differences and similarities is necessary to understand eating disorders in midlife.

[The perception of values in food commercials on the part of young people with and without eating disorders].

PubMed

Mas-Manchón, Lluís; Rodríguez-Bravo, Ángel; Montoya-Vilar, Norminanda; Morales-Morante, Fernando; Lopes, Elaine; Añaños, Elena; Peres, Rafaella; Martínez, María Eugenia; Grau, Antoni

2015-09-01

Advertising uses stereotyped body images to promote physical ideals and unhealthy eating habits related to food products which are targeted especially at young people. The purpose of this study, carried out in Barcelona (Spain) in May 2013, was to test the perception of 139 young people of university age - with and without eating disorders - regarding 25 values in seven food commercials that did and did not use body image strategies. Results show that only the group of young people with eating disorders considered commercials using body image strategies to have a very negative influence on values such as health, well-being, family and effort. In contrast, the assessment of the two groups regarding the rest of the commercials greatly coincided. These results show that today’s university youth have accepted as normal a beauty canon based on the prevailing social and economic order, while young people in treatment for eating disorders have learned to denaturalize such messages.

Incidence, prevalence, and risk of eating disorder behaviors in military academy cadets.

PubMed

Beekley, Matthew D; Byrne, Robert; Yavorek, Trudy; Kidd, Kelli; Wolff, Janet; Johnson, Michael

2009-06-01

Eating disorders are a particular problem for college students, as well as college athletes and military personnel. We examined the incidence, prevalence, and risk of eating disorders at the United States Military Academy (USMA) over a 7-year period (total population 12,731 cadets). The incidence per year for females was 0.02% for anorexia, 0.17% for bulimia, and 0.17% for eating disorders not otherwise specified (EDNOS) and for males was 0.0% for anorexia, 0.003% for bulimia, and 0.02% for eating disorders not otherwise specified. The total prevalence of diagnosed eating disorders for females was 5% and for males was 0.1%. For females over the 7-year period, we found a prevalence of 0.2% for anorexia, 1.2% for bulimia, 1.2% for eating disorders not otherwise specified, and for males we found a prevalence of 0.0% for anorexia, 0.02% for bulimia, and 0.03% for eating disorders not otherwise specified. Nineteen percent of females and 2% of males scored a 20 or higher on the Eating Attitudes Test (EAT)-26 survey indicating they were at risk for developing an eating disorder. We conclude that the prevalence of eating disorders at USMA is comparable to civilian colleges.

Driven exercise in the absence of binge eating: Implications for purging disorder.

PubMed

Lydecker, Janet A; Shea, Megan; Grilo, Carlos M

2018-02-01

Purging disorder (PD) is characterized by recurrent purging without objectively large binge-eating episodes. PD has received relatively little attention, and questions remain about the clinical significance of "purging" by exercise that is driven or compulsive (i.e., as extreme compensatory or weight-control behavior). The little available research suggests that individuals who use exercise as a compensatory behavior might have less eating-disorder psychopathology than those who purge by vomiting or laxatives, but those studies have had smaller sample sizes, defined PD using low-frequency thresholds, and defined exercise without weight-compensatory or driven elements. Participants (N = 2,017) completed a web-based survey with established measures of eating-disorder psychopathology, depression, and physical activity. Participants were categorized (regular compensatory driven exercise, PD-E, n = 297; regular compensatory vomiting/laxatives, PD-VL, n = 59; broadly defined anorexia nervosa, AN, n = 20; and no eating-disordered behaviors, NED, n = 1,658) and compared. PD-E, PD-VL, and AN had higher eating-disorder psychopathology and physical activity than NED but did not significantly differ from each other on most domains. PD-VL and AN had higher depression than PD-E, which was higher than NED. Findings suggest that among participants with regularly compensatory behaviors without binge eating, those who use exercise alone have similar levels of associated eating-disorder psychopathology as those who use vomiting/laxatives, although they have lower depression levels and overall frequency of purging. Findings provide further support for the clinical significance of PD. Clinicians and researchers should recognize the severity of driven exercise as a compensatory behavior, and the need for further epidemiological and treatment research. © 2017 Wiley Periodicals, Inc.

A Naturalistic Examination of Social Comparisons and Disordered Eating Thoughts, Urges, and Behaviors in College Women

PubMed Central

Fitzsimmons-Craft, Ellen E.; Ciao, Anna C.; Accurso, Erin C.

2015-01-01

Objective We examined the effects of body, eating, and exercise social comparisons on prospective disordered eating thoughts and urges (i.e., restriction thoughts, exercise thoughts, vomiting thoughts, binge eating urges) and behaviors (i.e., restriction attempts, exercising for weight/shape reasons, vomiting, binge eating) among college women using ecological momentary assessment (EMA). Method Participants were 232 college women who completed a two-week EMA protocol, in which they used their personal electronic devices to answer questions three times per day. Generalized estimating equation models were used to assess body, eating, and exercise comparisons as predictors of disordered eating thoughts, urges, and behaviors at the next report, adjusting for body dissatisfaction, negative affect, and the disordered eating thought/urge/behavior at the prior report, as well as body mass index. Results Body comparisons prospectively predicted more intense levels of certain disordered eating thoughts (i.e., thoughts about restriction and exercise). Eating comparisons prospectively predicted an increased likelihood of subsequent engagement in all disordered eating behaviors examined except vomiting. Exercise comparisons prospectively predicted less intense thoughts about exercise and an increased likelihood of subsequent vomiting. Discussion Social comparisons are associated with later disordered eating thoughts and behaviors in the natural environment and may need to be specifically targeted in eating disorder prevention and intervention efforts. Targeting body comparisons may be helpful in terms of reducing disordered eating thoughts, but eating and exercise comparisons are also important and may need to be addressed in order to decrease engagement in actual disordered eating behaviors. PMID:26610301

A review of eating disorders in males.

PubMed

Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W

2014-11-01

Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition has outlined more sex-neutral diagnostic criteria for eating disorders. Data of socioeconomic factors, prenatal influences, clinical characteristics, assessment, and mortality for eating disorders have been reported independently for males. Unlike in females, higher parental education showed no association with eating disorders in males, but twin or triplet status and lower gestational age at birth had an independent association with anorexia nervosa in males. Contrary to earlier suggestions, no differences in eating disorder symptoms such as binging, vomiting, or laxative abuse were observed between the sexes. Yet, males tended to score lower on eating disorder symptom measures than females. High rates of premorbid overweight and higher BMIs at various stages of eating disorders have been confirmed repeatedly. Higher age and lower BMI at admission, and restrictive anorexia nervosa subtype predicted fatal outcome for anorexia nervosa in males. Contemporary research provides grounds for improved recognition, diagnosis, and treatment for males suffering from eating disorders.

Dental erosion in patients seeking treatment for gastrointestinal complaints: a case series.

PubMed

Bruno, Vincenzo; Amato, Massimo; Catapano, Santo; Iovino, Paola

2015-10-30

Eating disorders which embrace anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified can be life-threatening due to general medical complications; however, the diagnosis of eating disorder is often delayed due to a low suspicion index. Gastroenterologists are health care providers who may come into contact with patients with undiagnosed eating disorders; it has been previously demonstrated that patients with eating disorders frequently have a significant association with functional dyspepsia. Signs of dental erosion have been described in patients with eating disorders; hence, they may help to identify eating disorders in patients who present with functional dyspepsia and deny having an eating disorder. In this report we describe three cases (a 25-year-old white woman, a 24-year-old white woman, and a 40-year-old white man) with undiagnosed eating disorders, in which a more comprehensive approach, such as the recognition of dental erosion joined with a careful gastrointestinal investigation, was performed to reach a final diagnosis of an eating disorder. The screening for dental erosion in patients seeking or receiving medical treatment for dyspeptic symptoms in a gastrointestinal out-patient clinic could be an aid for gastroenterologists to recognize the presence of an underlying eating disorder. A close collaboration with dentists, in addition to psychiatrists, could provide a more favorable treatment outcome.

[State of health, eating and body image disorders among employees in the beauty industry].

PubMed

Lukács-Márton, Réka; Szabó, Pál

2013-04-28

Beauticians are considered as risk populations for eating disorders and body image disorders, as their work is closely related to beauty and fashion. The aim of the authors was to examine whether eating and body image disorders occur more frequently among beauticians than in control subjects. Eating disorders were assessed using the Eating Attitudes Test, Eating Behaviour Severity Scale, and body image measures included the Human Figure Drawings Test, the Body Dissatisfaction Subscale of the Eating Disorders Inventory, the Body Attitudes Test, and the Body Investment Scale. The study sample included 56 beauticians from Transylvania and 59 from Hungary. These groups were compared with control groups including 57 subjects from Transylvania and 54 subjects from Hungary. Questionnaire data were analysed. The occurrence of weight reducing methods such as binge eating was significantly more prevalent in the beautician groups than in controls. Subclinical eating disorders were more frequent in the Transylvanian beautician group. Clinical and subclinical eating disorders occur more frequently in beauticians than in control subjects.

Culturally Adapted Cognitive Behavioral Guided Self-Help for Binge Eating: A Feasibility Study with Mexican Americans

PubMed Central

Cachelin, Fary M.; Shea, Munyi; Phimphasone, Phoutdavone; Wilson, G. Terence; Thompson, Douglas R.; Striegel, Ruth H.

2014-01-01

Objective was to test feasibility and preliminary efficacy of a culturally adapted cognitive-behavioral self-help program to treat binge eating and related problems in Mexican Americans. Participants were 31 women recruited from the Los Angeles area and diagnosed with binge eating disorder, recurrent binge eating or bulimia nervosa. Participants completed a culturally adapted version of a CBT-based self-help program with 8 guidance sessions over a 3-month period. Treatment efficacy was evaluated in terms of binge eating, psychological functioning, and weight loss. Intent-to-treat analyses revealed 35.5% abstinence from binge eating at post-treatment and 38.7% diagnostic remission. Results indicated significant pre-treatment to post-treatment improvement on distress level, BMI, eating disorder psychopathology, and self-esteem. Satisfaction with the program was high. Findings demonstrate that the program is acceptable, feasible, and efficacious in reducing binge eating and associated symptoms for Mexican American women. Study provides “proof of concept” for implementation of culturally adapted forms of evidence-based programs. PMID:25045955

Surfing for thinness: a pilot study of pro-eating disorder Web site usage in adolescents with eating disorders.

PubMed

Wilson, Jenny L; Peebles, Rebecka; Hardy, Kristina K; Litt, Iris F

2006-12-01

Pro-eating disorder Web sites are communities of individuals who engage in disordered eating and use the Internet to discuss their activities. Pro-recovery sites, which are less numerous, express a recovery-oriented perspective. This pilot study investigated the awareness and usage of pro-eating disorder Web sites among adolescents with eating disorders and their parents and explored associations with health and quality of life. This was a cross-sectional study of 698 families of patients (aged 10-22 years) diagnosed with an eating disorder at Stanford between 1997 and 2004. Anonymous surveys were mailed and offered in clinic. Survey content included questions about disease severity, health outcomes, Web site usage, and parental knowledge of eating disorder Web site usage. Surveys were returned by 182 individuals: 76 patients and 106 parents. Parents frequently (52.8%) were aware of pro-eating disorder sites, but an equal number did not know whether their child visited these sites, and only 27.6% had discussed them with their child. Most (62.5%) parents, however, did not know about pro-recovery sites. Forty-one percent of patients visited pro-recovery sites, 35.5% visited pro-eating disorder sites, 25.0% visited both, and 48.7% visited neither. While visiting pro-eating disorder sites, 96.0% reported learning new weight loss or purging techniques. However, 46.4% of pro-recovery site visitors also learned new techniques. Pro-eating disorder site users did not differ from nonusers in health outcomes but reported spending less time on school or schoolwork and had a longer duration of illness. Users of both pro-eating disorder and pro-recovery sites were hospitalized more than users of neither site. Pro-eating disorder site usage was prevalent among adolescents with eating disorders, yet parents had little knowledge of this. Although use of these sites was not associated with other health outcomes, usage may have a negative impact on quality of life and result in adolescents' learning about and adopting disordered eating behaviors.

Contributions of cognitive inflexibility to eating disorder and social anxiety symptoms.

PubMed

Arlt, Jean; Yiu, Angelina; Eneva, Kalina; Taylor Dryman, M; Heimberg, Richard G; Chen, Eunice Y

2016-04-01

Eating disorders and social anxiety are highly co-occurring. These disorders share fears of social evaluation, possibly maintained by similar cognitive content and styles, including an inability to adapt or flexibly respond to unexpected conditions. However, the role of cognitive inflexibility in eating disorders in relation to social anxiety has not been explored. In this study, the link between eating disorder symptoms and cognitive inflexibility, while accounting for social anxiety, is examined. Participants (N=461) were undergraduates who completed the Detail and Flexibility Questionnaire 12-item Cognitive Rigidity subscale, the Eating Disorders Diagnostic Scale, and the Social Interaction Anxiety Scale. Eating disorder symptoms and social anxiety were both positively correlated with cognitive inflexibility. After controlling for social anxiety, the relationship between eating disorder symptoms and cognitive inflexibility remained robust. Further examination of cognitive inflexibility in eating disorders and comorbid social anxiety in clinical samples is warranted. We suggest future directions for examining cognitive inflexibility as a trans-diagnostic construct important to eating disorders and frequently comorbid disorders, consistent with NIMH Research Domain Criteria. Copyright © 2015. Published by Elsevier Ltd.

Contributions of cognitive inflexibility to eating disorder and social anxiety symptoms

PubMed Central

Yiu, Angelina; Eneva, Kalina; Dryman, M. Taylor; Heimberg, Richard G.; Chen, Eunice Y.

2017-01-01

Eating disorders and social anxiety are highly co-occurring. These disorders share fears of social evaluation, possibly maintained by similar cognitive content and styles, including an inability to adapt or flexibly respond to unexpected conditions. However, the role of cognitive inflexibility in eating disorders in relation to social anxiety has not been explored. Objective In this study, the link between eating disorder symptoms and cognitive inflexibility, while accounting for social anxiety, is examined. Method Participants (N = 461) were undergraduates who completed the Detail and Flexibility Questionnaire 12-item Cognitive Rigidity subscale, the Eating Disorders Diagnostic Scale, and the Social Interaction Anxiety Scale. Results Eating disorder symptoms and social anxiety were both positively correlated with cognitive inflexibility. After controlling for social anxiety, the relationship between eating disorder symptoms and cognitive inflexibility remained robust. Discussion Further examination of cognitive inflexibility in eating disorders and comorbid social anxiety in clinical samples is warranted. We suggest future directions for examining cognitive inflexibility as a trans-diagnostic construct important to eating disorders and frequently comorbid disorders, consistent with NIMH Research Domain Criteria. PMID:26735392

Eating and Exercise Disorders in Young College Men.

ERIC Educational Resources Information Center

O'Dea, Jennifer A.; Abraham, Suzanne

2002-01-01

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,…

Binge eating disorder should be included in DSM-IV: a reply to Fairburn et al.'s "the classification of recurrent overeating: the binge eating disorder proposal".

PubMed

Spitzer, R L; Stunkard, A; Yanovski, S; Marcus, M D; Wadden, T; Wing, R; Mitchell, J; Hasin, D

1993-03-01

Extensive recent research supports a proposal that a new eating disorder, binge eating disorder (BED), be included in DSM-IV. BED criteria define a relatively pure group of individuals who are distressed by recurrent binge eating who do not exhibit the compensatory features of bulimia nervosa. This large number of patients currently can only be diagnosed as eating disorder not otherwise specified (EDNOS). Recognizing this new disorder will help stimulate research and clinical programs for these patients. Fairburn et al.'s critique of BED fails to acknowledge the large body of knowledge that indicates that BED represents a distinct and definable subgroup of eating disordered patients and that the diagnosis provides useful information about psychopathology, prognosis, and outcome (Fairburn, Welch, & Hay [in press]. The classification of recurrent overeating: The "binge eating disorder" proposal. International Journal of Eating Disorders.) Against any reasonable standard for adding a new diagnosis to DSM-IV, BED meets the test.

Alexithymia and eating disorders: a critical review of the literature

PubMed Central

2013-01-01

Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed. PMID:24999402

Eating disorders in college men.

PubMed

Olivardia, R; Pope, H G; Mangweth, B; Hudson, J I

1995-09-01

This study was designed to assess the characteristics of men with eating disorders in the community. The authors recruited 25 men meeting DSM-IV criteria for eating disorders and 25 comparison men through advertisements in college newspapers. A second comparison group comprised 33 women with bulimia nervosa who were recruited and interviewed with virtually identical methods. The men with eating disorders closely resembled the women with eating disorders but differed sharply from the comparison men in phenomenology of illness, rates of comorbid psychiatric disorders, and dissatisfaction with body image. Homosexuality did not appear to be a common feature of men with eating disorders in the community. Childhood physical and sexual abuse appeared slightly more common among the eating-disordered men than among the comparison men. Eating disorders, although less common in men than in women, appear to display strikingly similar features in affected individuals of the two genders.

The effect of parental monitoring on trajectories of disordered eating attitudes and behaviors among adolescents: An individual growth curve analysis.

PubMed

Martinson, Laura E; Esposito-Smythers, Christianne; Blalock, Dan V

2016-12-01

The primary aim of the present study was to examine whether parental monitoring, as reported by adolescents and their parents, predicts more or less favorable trajectories of disordered eating behavior and attitudes over the course of one year in a sample of adolescent males and females. An additional aim was to explore whether these trajectories vary when study analyses are limited to females. Participants included 87 adolescents (mean age = 15.5 ± 1.4) in mental health treatment and their parents. Self-report measures included the Parental Monitoring Questionnaire, completed at baseline, and the Eating Attitudes Test-Dieting Subscale, completed at baseline as well as 6-month and 12-month follow-ups. Individual growth curve (IGC) analyses were used to examine change in disordered eating behavior and attitudes. Adolescents who reported lower parental monitoring showed trajectories characterized by increases in disordered eating attitudes and behaviors. The same pattern emerged when using parent report of monitoring, though only a trend was evident. When analyses were restricted to females, the main effect of parental and adolescent report of monitoring on disordered eating were equally strong. Results may suggest that parents who are less knowledgeable about their adolescents' daily lives, may be less aware of potential disordered eating attitudes and behaviors, and thus less likely to intervene. Findings could be used to inform family-based interventions for this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

A review on eating disorders and adolescence.

PubMed

Kirkcaldy, B D; Siefen, G R; Kandel, I; Merrick, J

2007-06-01

Eating disorders in adolescence are a public health concern with both personal costs and a financial burden for the community health services. This paper is a review of incidence and gender differences of eating disorders; comorbid psychopathology, including substance abuse, mood disorders, anxiety disorders and personality disorders; developmental and intellectual factors; family, socio-cultural functioning and birth order; self-injury and suicidal behaviour with health outcome and therapy success rate. We have also asked several questions from our clinical experience and tried to answer them with our clinical knowledge and based on literature review. Overall, there is an indication that therapy success is significantly correlated with (low) manifestation, specifically for social problems and aggressivity. Due to the complexity of factors involved in the manifestation of eating disorders, the inclusion of cognitive-behavioural therapy as well as family-oriented therapeutic concepts coupled with medical treatment would appear to offer an intervention inventory, which would be most effective in offering adolescents optimal treatment programmes. The implications of our review is discussed in terms of psychotherapeutic treatment plans for adolescents in clinical care.

Dropout from cognitive-behavioral therapy for eating disorders: A meta-analysis of randomized, controlled trials.

PubMed

Linardon, Jake; Hindle, Annemarie; Brennan, Leah

2018-05-01

Cognitive-behavioral therapy (CBT) is efficacious for a range of eating disorder presentations, yet premature dropout is one factor that might limit CBTs effectiveness. Improved understanding of dropout from CBT for eating disorders is important. This meta-analysis aimed to study dropout from CBT for eating disorders in randomized controlled trials (RCTs), by (a) identifying the types of dropout definitions applied, (b) providing estimates of dropout, (c) comparing dropout rates from CBT to non-CBT interventions for eating disorders, and (d) testing moderators of dropout. RCTs of CBT for eating disorders that reported rates of dropout were searched. Ninety-nine RCTs (131 CBT conditions) were included. Dropout definitions varied widely across studies. The overall dropout estimate was 24% (95% CI = 22-27%). Diagnostic type, type of dropout definition, baseline symptom severity, study quality, and sample age did not moderate this estimate. Dropout was highest among studies that delivered internet-based CBT and was lowest in studies that delivered transdiagnostic enhanced CBT. There was some evidence that longer treatment protocols were associated with lower dropout. No significant differences in dropout rates were observed between CBT and non-CBT interventions for all eating disorder subtypes. Present study dropout estimates are hampered by the use of disparate dropout definitions applied. This meta-analysis highlights the urgency for RCTs to utilize a standardized dropout definition and to report as much information on patient dropout as possible, so that strategies designed to minimize dropout can be developed, and factors predictive of CBT dropout can be more easily identified. © 2018 Wiley Periodicals, Inc.

Body image disturbance in binge eating disorder: a comparison of obese patients with and without binge eating disorder regarding the cognitive, behavioral and perceptual component of body image.

PubMed

Lewer, Merle; Nasrawi, Nadia; Schroeder, Dorothea; Vocks, Silja

2016-03-01

Whereas the manifestation of body image disturbance in binge eating disorder (BED) has been intensively investigated concerning the cognitive-affective component, with regard to the behavioral and the perceptual components of body image disturbance in BED, research is limited and results are inconsistent. Therefore, the present study assessed body image disturbance in BED with respect to the different components of body image in a sample of obese females (n = 31) with BED compared to obese females without an eating disorder (n = 28). The Eating Disorder Inventory-2, the Eating Disorder Examination-Questionnaire, the Body Image Avoidance Questionnaire and the Body Checking Questionnaire as well as a Digital Photo Distortion Technique based on a picture of each participant taken under standardized conditions were employed. Using two-sample t tests, we found that the participants with BED displayed significantly greater impairments concerning the cognitive-affective component of body image than the control group. Concerning the behavioral component, participants with BED reported more body checking and avoidance behavior than the controls, but group differences failed to reach significance after the Bonferroni corrections. Regarding the perceptual component, a significant group difference was found for the perceived "ideal" figure, with the individuals suffering from BED displaying a greater wish for a slimmer ideal figure than the control group. These results support the assumption that body image disturbance is a relevant factor in BED, similar to other eating disorders.

A school-based program implemented by community providers previously trained for the prevention of eating and weight-related problems in secondary-school adolescents: the MABIC study protocol.

PubMed

Sánchez-Carracedo, David; López-Guimerà, Gemma; Fauquet, Jordi; Barrada, Juan Ramón; Pàmias, Montserrat; Puntí, Joaquim; Querol, Mireia; Trepat, Esther

2013-10-12

The prevention of eating disorders and disordered eating are increasingly recognized as public health priorities. Challenges in this field included moving from efficacy to effectiveness and developing an integrated approach to the prevention of a broad spectrum of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. The main aim of this effectiveness trial protocol is to test whether this program has effects when incorporating an integrated approach to prevention and when previously-trained community providers implement the intervention. The research design involved a multi-center non-randomized controlled trial with baseline, post and 1-year follow-up measures. Six schools from the city of Sabadell (close to Barcelona) participated in the intervention group, and eleven schools from four towns neighboring Sabadell participated in the control group. A total of 174 girls and 180 boys in the intervention group, and 484 girls and 490 boys in the control group were registered in class lists prior to baseline. A total of 18 community providers, secondary-school class tutors, nurses from the Catalan Government's Health and School Program, and health promotion technicians from Sabadell City Council were trained and delivered the program. Shared risk factors of eating and weight-related problems were assessed as main measures. It will be vital for progress in disordered eating prevention to conduct effectiveness trials, which test whether interventions are effective when delivered by community providers under ecologically valid conditions, as opposed to tightly controlled research trials. The MABIC project will provide new contributions in this transition from efficacy to effectiveness and new data about progress in the integrated approach to prevention. Pending the results, the effectiveness trial meets the effectiveness standards set down by the Society for Prevention Research. This study will provide new evidence to improve and enhance disordered eating prevention programs. Current Controlled Trials ISRCTN47682626.

A randomized controlled trial of a peer co-led dissonance-based eating disorder prevention program for gay men.

PubMed

Brown, Tiffany A; Keel, Pamela K

2015-11-01

Gay males have increased risk for eating disorders compared to heterosexual males, establishing a need to develop and empirically evaluate programs to reduce risk for this population. The present study investigated the acceptability and efficacy of a cognitive dissonance-based (DB) intervention (The PRIDE Body Project(©)) in reducing eating disorder risk factors among gay males in a university-based setting. Eighty-seven gay males were randomized to either a 2-session DB intervention (n = 47) or a waitlist control condition (n = 40). Participants completed eating disorder risk factor assessments pre-intervention, post-intervention, and at 4-week follow-up, and those receiving the intervention completed post-treatment acceptability measures. Acceptability ratings were highly favorable. Regarding efficacy, the DB condition was associated with significantly greater decreases in body dissatisfaction, drive for muscularity, self-objectification, partner-objectification, body-ideal internalization, dietary restraint, and bulimic symptoms compared to waitlist control from pre- to post-intervention. Improvements in the DB group were maintained at 4-week follow-up, with the exception of body-ideal internalization. Body-ideal internalization mediated treatment effects on bulimic symptoms. Results support the acceptability and efficacy of The PRIDE Body Project(©) and provide support for theoretical models of eating pathology in gay men. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review.

PubMed

Conviser, Jenny H; Fisher, Sheehan D; McColley, Susanna A

2018-03-01

Pediatric chronic illnesses (CI) can affect a child's mental health. Chronic illnesses with treatment regimens that specify a therapeutic diet may place the child at increased risk for disordered eating and specific eating disorders (ED). The aim of this review is to examine the relation between diet-treated CI and disordered eating and to determine the order of onset to infer directionality. Diet-treated CI is hypothesized to precede and to be associated with disordered eating. A comprehensive search of empirical articles that examine the relation between diet-treated CI (diabetes, cystic fibrosis, celiac disease, gastrointestinal disorders, and inflammatory bowel diseases) and disordered eating was conducted in Medline and PsycINFO using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A table of the sample's characteristics, ED measures, major pertinent findings, and the onset of CI in relation to ED were provided. Diet-treated CI was associated with disordered eating and ED. Diet-treated CI had onset prior to disordered eating in most studies, except for inflammatory bowel diseases. Disordered eating and unhealthy weight management practices put children at risk for poor medical outcomes. Interventions for diet-treated CI require a focus on diet and weight, but may increase the risk for disordered eating. Future research is needed to elucidate the mechanisms that transform standard treatment practices into pathological eating, including characteristics and behaviors of the child, parents/care providers, family, and treatment providers. © 2018 Wiley Periodicals, Inc.

The Impact of DSM-5 on Eating Disorder Diagnoses.

PubMed

Vo, Megen; Accurso, Erin C; Goldschmidt, Andrea B; Le Grange, Daniel

2017-05-01

Eating disorder diagnostic criteria were revised from the fourth to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and -5, respectively). This study examines the impact of these revisions on rates of eating disorder diagnoses in treatment-seeking youth. Participants were 651 youth, ages 7-18 years, presenting to an outpatient eating disorders program who met criteria for a DSM-IV eating disorder diagnosis on intake. Patients completed well-validated semi-structured interviews to assess eating disorder psychopathology and psychiatric comorbidity. Participants were predominantly female (n = 588; 90.3%) with an average age of 15.28 years (SD = 2.21), mean percent of median Body Mass Index (mBMI) of 101.91 (SD = 31.73), and average duration of illness of 16.74 months (SD = 17.63). Cases of DSM-IV Eating Disorder Not Otherwise Specified (EDNOS), now most consistent with DSM-5 Other Specified Feeding or Eating Disorder, decreased from 47.6% to 39.0%, Anorexia Nervosa increased from 29.6% to 33.5%, and Bulimia Nervosa increased from 22.7% to 24.7%. Consistent with previous studies, and in keeping with the aims of the DSM-5 for eating disorders, the revised diagnostic criteria reduced cases of DSM-IV EDNOS and increased cases of specified eating disorders. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:578-581). © 2016 Wiley Periodicals, Inc.

Diagnostic classification of eating disorders in children and adolescents: How does DSM-IV-TR compare to empirically-derived categories?

PubMed Central

Eddy, Kamryn T.; le Grange, Daniel; Crosby, Ross D.; Hoste, Renee Rienecke; Doyle, Angela Celio; Smyth, Angela; Herzog, David B.

2009-01-01

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 compare these latent profile (LP) groups to the DSM-IV-TR eating disorder categories. Method Eating disorder symptom data collected from 401 youth (ages 7–19; mean 15.14 ± 2.35y) seeking eating disorder treatment were included in LPA; general linear models were used to compare LP groups to DSM-IV-TR eating disorder categories on pre-treatment and outcome indices. Results Three LP groups were identified: LP1 (n=144), characterized binge eating and purging (“Binge/purge”); LP2 (n=126), characterized by excessive exercise and extreme eating disorder cognitions (“Exercise-extreme cognitions”); and LP3 (n=131), characterized by minimal eating disorder behaviors and cognitions (“Minimal behaviors/cognitions”). Identified LPs imperfectly resembled DSM-IV-TR eating disorders. LP1 resembled bulimia nervosa; LP2 and LP3 broadly resembled anorexia nervosa with a relaxed weight criterion, differentiated by excessive exercise and severity of eating disorder cognitions. LP groups were more differentiated than the DSM-IV-TR categories across pre-treatment eating disorder and general psychopathology indices, as well as weight change at follow-up. Neither LP nor DSM-IV-TR categories predicted change in binge/purge behaviors. Validation analyses suggest these empirically-derived groups improve upon the current DSM-IV-TR categories. Conclusions In children and adolescents, revisions for DSM-V should consider recognition of patients with minimal cognitive eating disorder symptoms. PMID:20410717

Risk Factors for Eating Disorder Psychopathology within the Treatment Seeking Transgender Population: The Role of Cross-Sex Hormone Treatment.

PubMed

Jones, Bethany Alice; Haycraft, Emma; Bouman, Walter Pierre; Brewin, Nicola; Claes, Laurence; Arcelus, Jon

2018-03-01

Many transgender people experience high levels of body dissatisfaction, which is one of the numerous factors known to increase vulnerability to eating disorder symptoms in the cisgender (non-trans) population. Cross-sex hormones can alleviate body dissatisfaction so might also alleviate eating disorder symptoms. This study aimed to explore risk factors for eating disorder symptoms in transgender people and the role of cross-sex hormones. Individuals assessed at a national transgender health service were invited to participate (N = 563). Transgender people not on cross-sex hormones reported higher levels of eating disorder psychopathology than people who were. High body dissatisfaction, perfectionism, anxiety symptoms, and low self-esteem were risk factors for eating psychopathology, but, after controlling for these, significant differences in eating psychopathology between people who were and were not on cross-sex hormones disappeared. Cross-sex hormones may alleviate eating disorder psychopathology. Given the high prevalence of transgender identities, clinicians at eating disorder services should assess for gender identity issues. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

Eating attitudes among adolescents.

PubMed

Maor, Noga Roguin; Sayag, Shlomit; Dahan, Rachel; Hermoni, Doron

2006-09-01

Israeli youth lead 27 western countries in dieting. The prevalence of eating disorders has been rising in the last 30 years, causing social problems and medical complications. To examine the prevalence of eating disorders among high school students in a region in northern Israel (Misgav) and to examine the relationship between the parents' employment status and the subject's eating disorder. A structured questionnaire was administered to collect demographic data. The short version of the Eating Attitudes Test (EAT-26) was used to evaluate the subject's attitudes toward and preoccupation with food, dieting, eating, physical appearance, and personal control over eating. Of 360 students approached, 283 (78%) completed the self-report EAT-26. One of every 5 females and one in every 20 males had an abnormal eating attitude. The rate of pathologic EAT-26 results, 20.8%, falls within the high range of similar community-based samples of female adolescents. There were no differences in EAT-26 score between students with an employed or unemployed mother; however, there was a trend for higher EAT-26 scores among those whose father was unemployed (21.4% vs. 12.7%, chi2 = 0.14). The findings support our hypothesis of a relatively high rate of abnormal eating attitudes (as reflected by high EAT-26 score) in this population. Another possible risk factor is having an unemployed father, which warrants further research and attention. Our next step is to introduce an intervention program in the school and to study its effect.

An Evaluation of the Reliability and Construct Validity of Eating Disorder Measures in White and Black Women

ERIC Educational Resources Information Center

Kelly, Nichole R.; Mitchell, Karen S.; Gow, Rachel W.; Trace, Sara E.; Lydecker, Janet A.; Bair, Carrie E.; Mazzeo, Suzanne

2012-01-01

Most measures of eating disorder symptoms and risk factors were developed in predominantly White female samples. Yet eating disorders affect individuals of all racial and ethnic backgrounds. Black women appear more vulnerable to certain forms of eating pathology, such as binge eating, and less susceptible to other eating disorder symptoms and risk…

Short-term intensive family therapy for adolescent eating disorders: 30-month outcome.

PubMed

Marzola, Enrica; Knatz, Stephanie; Murray, Stuart B; Rockwell, Roxanne; Boutelle, Kerri; Eisler, Ivan; Kaye, Walter H

2015-05-01

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. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

A Meta-Analysis Examining the Influence of Pro-Eating Disorder Websites on Body Image and Eating Pathology.

PubMed

Rodgers, Rachel F; Lowy, Alice S; Halperin, Daniella M; Franko, Debra L

2016-01-01

Previous research has indicated that exposure to pro-eating disorder websites might increase eating pathology; however, the magnitude of this effect is unknown. This study aimed to conduct a systematic review and meta-analysis to examine the effect of exposure to pro-eating disorder websites on body image and eating pathology. Studies examining the relationship between exposure to pro-eating disorder websites and eating pathology-related outcomes were included. The systematic review identified nine studies. Findings revealed significant effect sizes of exposure to pro-eating disorder websites on body image dissatisfaction (five studies), d = .41, p = .003; dieting (six studies), d = .68, p < .001, and negative affect (three studies), d = 1.00, p < .001. No effect emerged for bulimic symptoms (four studies), d = .22, p = .73. Findings confirmed the effect of pro-eating disorder websites on body image and eating pathology, highlighting the need for enforceable regulation of these websites. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Low weight gain at the start of a family-based intervention for adolescent girls with restrictive eating disorders predicted emergency hospital admission.

PubMed

Swenne, Ingemar; Ros, Helena Salonen

2017-10-01

This study examined predictors of emergency hospitalisation of adolescent girls with restrictive eating disorders and weight loss treated by a family-based intervention programme. We studied 339 girls aged 10-17 years treated in a specialist unit at Uppsala University Children's Hospital, Sweden, from August 2010 to December 2015. Historical weight data were obtained from school health services, and other weight data were determined at presentation. Weight controlling behaviour was recorded, and patients were evaluated using the Eating Disorder Examination Questionnaire. A family-based intervention started after assessment and the early weight gain after one week, one month and three months was assessed. There were 17 emergency admissions of 15 patients for refusing food, progressive weight loss and medical instability. Logistic regression analysis showed that emergency admissions were predicted by a low body mass index standard deviation score at presentation (odds ratio 2.57), a high rate of weight loss before presentation (odds ratio 4.38) and a low rate of weight gain at the start of treatment (odds ratio 4.59). Poor weight gain at the start of a family-based intervention for adolescent girls with restrictive eating disorders predicted emergency hospital admission. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Addressing the Spectrum of Adolescent Weight-Related Problems: Engaging Parents and Communities

ERIC Educational Resources Information Center

Neumark-Sztainer, Dianne

2007-01-01

Weight-related problems, including eating disorders, disordered eating, and obesity, are prevalent among adolescents. School and community-based educators and health care providers have an important role to play in the prevention of weight-related problems in youth. This article includes: 1) a brief overview of weight-related problems in…

Convergence of Scores on the Interview and Questionnaire Versions of the Eating Disorder Examination: A Meta-Analytic Review

ERIC Educational Resources Information Center

Berg, Kelly C.; Peterson, Carol B.; Frazier, Patricia; Crow, Scott J.

2011-01-01

Significant discrepancies have been found between interview- and questionnaire-based assessments of psychopathology; however, these studies have typically compared instruments with unmatched item content. The Eating Disorder Examination (EDE), a structured interview, and the questionnaire version of the EDE (EDE-Q) are considered the preeminent…

The Treatment of Eating Disorder Clients in a Community-Based Partial Hospitalization Program.

ERIC Educational Resources Information Center

Levitt, John L.; Sansone, Randy A.

2003-01-01

Outlines a multi-faceted treatment approach to eating disorders within a partial hospital program that is affiliated with a community mental health hospital. Although empirical confirmation is not currently available, initial clinical impressions indicate that the program is facilitating the recovery of these difficult-to-treat individuals.…

Manualized-Group Treatment of Eating Disorders: Attunement in Mind, Body, and Relationship (AMBR)

ERIC Educational Resources Information Center

Cook-Cottone, Catherine; Beck, Meredith; Kane, Linda

2008-01-01

This article describes a manualized-group treatment of eating disorders, the attunement in mind, body, and relationship (AMBR) program. The cognitive behavioral and dialectic behavioral research as well as the innovative prevention interventions upon which the program is based (e.g., interactive discourse, yoga, and mediation) are introduced. The…

Clarifying the prospective relationships between social anxiety and eating disorder symptoms and underlying vulnerabilities

PubMed Central

Levinson, Cheri A.; Rodebaugh, Thomas L.

2016-01-01

Social anxiety and eating disorders are highly comorbid. Several explanations for these high levels of comorbidity have been theorized. First, social anxiety might be a vulnerability factor for eating disorders. Second, eating disorders might be a vulnerability factor for social anxiety. Third, the two kinds of disorders may have common, shared psychological vulnerabilities. The current study (N = 300 undergraduate women) investigates a model of social anxiety and eating disorder symptoms that examines each of these possibilities across two time points (Time 1 and six months later). We do not find support for either social anxiety or eating disorder symptoms per se predicting each other across time. Instead, we find that some underlying vulnerabilities prospectively predict symptoms of both disorders, whereas other vulnerabilities are specific to symptoms of one disorder. Specifically we find that maladaptive perfectionism is a shared prospective vulnerability for social anxiety and eating disorder symptoms. Alternatively, we find that social appearance anxiety is specific for eating disorder symptoms, whereas high standards is specific for social anxiety symptoms. These data help clarify our understanding of how and why social anxiety and eating disorder symptoms frequently co-occur. PMID:27444957

Disordered Eating Attitudes Among University Students in Kuwait: The Role of Gender and Obesity

PubMed Central

Musaiger, Abdulrahman O.; Al-Kandari, Fawzia I.; Al-Mannai, Mariam; Al-Faraj, Alaa M.; Bouriki, Fajer A.; Shehab, Fatima S.; Al-Dabous, Lulwa A.; Al-Qalaf, Wassin B.

2016-01-01

Background: This study aimed to highlight the proportion of disordered eating attitudes among university students in Kuwait by gender and obesity. Methods: A sample of 530 Kuwaiti university students was selected from four universities in Kuwait (203 men and 327 women). The eating attitudes test-26 was used to determine disordered eating attitudes. Results: The prevalence of disordered eating attitudes was 31.8% and 33.6% among men and women respectively. Obese students of both genders had doubled the risk of disordered eating attitudes compared to nonobese students (odds ratio 1.99 and 1.98, respectively). Conclusions: About one third of university students in Kuwait had disordered eating attitudes. There is an urgent need to prevent and treat disordered eating attitudes in university students in Kuwait. PMID:27141286

Seasonality of hospital admissions and birth dates among inpatients with eating disorders: a nationwide population-based retrospective study.

PubMed

Liang, Chih-Sung; Chung, Chi-Hsiang; Tsai, Chia-Kuang; Chien, Wu-Chien

2018-04-01

Seasonal variation exists in the psychopathology of eating disorders. However, it is still unknown whether there is seasonal variation in eating disorder symptom severity. This study investigated seasonal trends in hospital admissions and birth dates among patients with eating disorders in Taiwan (25°N). Subgroup analyses by gender and comorbid affective disorders were also of interest. Data on all hospital admissions between 2000 and 2013 were collected from the Taiwan National Health Insurance Research Database, and 1954 patients with eating disorders were identified. Hospital admissions and birth dates were recorded by day. The four seasons and cross-seasons were defined by solstices and equinoxes. The expected distribution of births was determined using data from all patients hospitalized from 2000 to 2013 (n = 13,139,306). Hospital admissions among patients with eating disorders exceeded the rate of expected hospital admissions in the summer season (p < 0.001) and the autumn cross-season (p < 0.001). However, the seasonal (p = 0.421) and cross-seasonal (p = 0.24) distributions of birth dates among these patients did not differ from the expected distributions. Interestingly, hospital admissions among patients with comorbid affective disorders exceeded the rates of hospital admissions among non-affective patients during the spring (p = 0.004). Moreover, the number of non-affective patients born during autumn exceeded the birth rates of affective patients during this season (p = 0.001). Gender and comorbid affective disorders were not associated with cross-seasonal differences in either hospitalizations or dates of birth. Affective psychopathology in inpatients with eating disorders may substantially contribute to symptom severity that waxes and wanes with the seasons. Moreover, the seasonal distribution of birth dates was significantly different in patients without comorbid affective disorders.

Rapid response in psychological treatments for binge eating disorder.

PubMed

Hilbert, Anja; Hildebrandt, Thomas; Agras, W Stewart; Wilfley, Denise E; Wilson, G Terence

2015-06-01

Analysis of short- and long-term effects of rapid response across 3 different treatments for binge eating disorder (BED). In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral therapy guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; APA, 1994) criteria for BED, the predictive value of rapid response, defined as ≥70% reduction in binge eating by Week 4, was determined for remission from binge eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-ups. Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge eating than nonrapid responders, which was sustained over the long term. Rapid and nonrapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge eating than nonrapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than nonrapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and nonrapid responders in each treatment. Rapid responders in BWL did not differ from nonrapid responders in CBTgsh and IPT. Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge eating in CBTgsh. Regarding an evidence-based, stepped-care model, IPT, equally efficacious for rapid and nonrapid responders, could be investigated as a second-line treatment in case of nonrapid response to first-line CBTgsh. (c) 2015 APA, all rights reserved).

Classifying eating disorders based on "healthy" and "unhealthy" perfectionism and impulsivity.

PubMed

Slof-Op't Landt, Margarita C T; Claes, Laurence; van Furth, Eric F

2016-07-01

Perfectionism and impulsivity are associated with eating disorders (EDs). The current study examines whether clinically relevant subgroups of women with EDs can be identified based on "healthy" and "unhealthy" perfectionism and impulsivity. Latent profile analyses (LPA) were performed on data of 844 patients (DSM-IV diagnosis: 381 anorexia nervosa, 146 bulimia nervosa, 56 binge-eating disorder, 261 ED not otherwise specified). "Healthy" and "unhealthy" forms of perfectionism and impulsivity were assessed by the Frost Multidimensional Perfectionism Scale and the Dickman Impulsivity Inventory, respectively. The Eating Disorder Examination Questionnaire was completed to assess ED psychopathology. Furthermore, in 229 patients additional ED symptoms, depression, self-esteem, obsessive-compulsive symptoms, and personality features were assessed. The LPA revealed four profiles; 1. "Healthy Impulsivity" (HI; n = 191), 2. "Unhealthy Impulsivity" (UI; n = 238), 3. "Healthy and Unhealthy Perfectionism" (HP + UP; n = 153), 4. "Healthy Perfectionism" (HP; n = 262). Patients belonging to the "HP + UP" and the "UI" classes reported higher levels of ED psychopathology. More severe comorbid symptoms (depressive, obsessive-compulsive and self-esteem) were found in the patients belonging to the "HP + UP" class. Patients from the "HP + UP" and "HP" classes had higher scores for the personality features Harm Avoidance, Persistence and Cooperativeness. Women with EDs could be meaningfully grouped according to perfectionism and impulsivity. These findings can be used to improve treatment matching and intervention strategies. The use of dimensional features, like perfectionism and impulsivity, in ED research, may enable the identification of fundamental underlying mechanisms and provide more insight into potential mechanisms that may drive or maintain disordered eating. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:673-680). © 2016 Wiley Periodicals, Inc.

Adaptation and Evaluation of the Clinical Impairment Assessment to Assess Disordered Eating Related Distress in an Adolescent Female Ethnic Fijian Population

PubMed Central

Becker, Anne E; Thomas, Jennifer J; Bainivualiku, Asenaca; Richards, Lauren; Navara, Kesaia; Roberts, Andrea L; Gilman, Stephen E; Striegel-Moore, Ruth H

2010-01-01

Objective: Measurement of disease-related impairment and distress is central to diagnostic, therapeutic, and health policy considerations for eating disorders across diverse populations. This study evaluates psychometric properties of a translated and adapted version of the Clinical Impairment Assessment (CIA) in an ethnic Fijian population. Method: The adapted CIA was administered to ethnic Fijian adolescent schoolgirls (N = 215). We calculated Cronbach's α to assess the internal consistency, examined the association between indicators of eating disorder symptom severity and the CIA to assess construct and criterion validity, and compared the strength of relation between the CIA and measures of disordered eating versus with measures of generalized distress. Results: The Fijian version of the CIA is feasible to administer as an investigator-based interview. It has excellent internal consistency (α = 0.93). Both construct and criterion validity were supported by the data, and regression models indicated that the CIA predicts eating disorder severity, even when controlling for generalized distress and psychopathology. Discussion: The adapted CIA has excellent psychometric properties in this Fijian study population. Findings suggest that the CIA can be successfully adapted for use in a non-Western study population and that at least some associated distress and impairment transcends cultural differences. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord, 2010 PMID:19308992

Attention deficit hyperactivity disorder and disordered eating behaviors: links, risks, and challenges faced.

PubMed

Ptacek, Radek; Stefano, George B; Weissenberger, Simon; Akotia, Devang; Raboch, Jiri; Papezova, Hana; Domkarova, Lucie; Stepankova, Tereza; Goetz, Michal

2016-01-01

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists in adulthood. It is defined by inattention and/or hyperactivity-impulsivity. ADHD is associated with many comorbidities, including eating disorders (EDs). In the last decade, studies have reported that ADHD is linked with binge EDs, bulimia nervosa, and anorexia nervosa. Many postulates have been proposed to explain the association: 1) impulsive behavior in ADHD patients leads to disordered eating behavior; 2) other psychologic comorbidities present in ADHD patients account for eating behavior; 3) poor eating habits and resulting nutritional deficiencies contribute to ADHD symptoms; and 4) other risk factors common to both ADHD and EDs contribute to the coincidence of both diseases. Additionally, sex differences become a significant issue in the discussion of EDs and ADHD because of the higher incidence of bulimia nervosa and anorexia nervosa in females and the ability of females to mask the symptoms of ADHD. Interestingly, both EDs and ADHD rely on a common neural substrate, namely, dopaminergic signaling. Dopaminergic signaling is critical for motor activity and emotion, the latter enabling the former into a combined motivated movement like eating. This linkage aids in explaining the many comorbidities associated with ADHD. The interconnection of ADHD and EDs is discussed from both a historical perspective and the one based on the revealing nature of its comorbidities.

Family Therapy for Child and Adolescent Eating Disorders: A Critical Review.

PubMed

Jewell, Tom; Blessitt, Esther; Stewart, Catherine; Simic, Mima; Eisler, Ivan

2016-09-01

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. © 2016 Family Process Institute.

E-therapy in the treatment and prevention of eating disorders: A systematic review and meta-analysis.

PubMed

Loucas, Christina E; Fairburn, Christopher G; Whittington, Craig; Pennant, Mary E; Stockton, Sarah; Kendall, Tim

2014-12-01

The widespread availability of the Internet and mobile-device applications (apps) is changing the treatment of mental health problems. The aim of the present study was to review the research on the effectiveness of e-therapy for eating disorders, using the methodology employed by the UK's National Institute for Health and Care Excellence (NICE). Electronic databases were searched for published randomised controlled trials of e-therapies, designed to prevent or treat any eating disorder in all age groups. Studies were meta-analysed where possible, and effect sizes with confidence intervals were calculated. The GRADE approach was used to determine the confidence in the effect estimates. Twenty trials met the inclusion criteria. For prevention, a CBT-based e-intervention was associated with small reductions in eating disorder psychopathology, weight concern and drive for thinness, with moderate confidence in the effect estimates. For treatment and relapse prevention, various e-therapies showed some beneficial effects, but for most outcomes, evidence came from single studies and confidence in the effect estimates was low. Overall, although some positive findings were identified, the value of e-therapy for eating disorders must be viewed as uncertain. Further research, with improved methods, is needed to establish the effectiveness of e-therapy for people with eating disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interventions for preventing eating disorders in children and adolescents.

PubMed

Pratt, B M; Woolfenden, S R

2002-01-01

Eating disorders represent an extremely difficult condition to treat and patients consume an enormous amount of mental health energy and resources. Being young, female, and dieting are some of the few identified risk factors that have been reliably linked to the development of eating disorders, and several prevention eating disorder prevention programs have been developed and trialed with children and adolescents. The purpose of this systematic review is to evaluate the effectiveness of eating disorder prevention programs for children and adolescents both in the general population and those determined to be at risk. 1. To determine if eating disorder prevention programs are effective in promoting healthy eating attitudes and behaviours in children and adolescents; 2. To determine if eating disorder prevention programs are effective in promoting psychological factors that protect children and adolescents from developing eating disorders; 3. To determine if eating disorder prevention programs are effective in promoting satisfactory physical health in children and adolescents; 4. To determine if eating disorder prevention programs have a long-term, sustainable, and positive impact on the mental and physical health of children and adolescents; and, 5. To determine the safety of eating disorder prevention programs in terms of possible harmful consequences on the mental or physical health of children and adolescents. Relevant trials are identified through searching the Cochrane Controlled Trial Register (CCTR) and relevant biomedical and social science databases. All terms necessary to detect prevention programs and the participant groups are used. A strategy to locate randomised controlled trials is used. Other sources of information are the bibliographies of systematic and non-systematic reviews and reference lists from articles identified through the search strategy. In order to identify unpublished studies, experts in the field are contacted by letter and/or electronic mail. Randomised controlled trials (RCT) with a major focus on eating disorder prevention programs for children and adolescents, where there is no known DSM-IV diagnosis of an eating disorder, are eligible for inclusion in the review. Trials must include a control group and at least one objective outcome measure (eg. BMI) or a standardised psychological measure used with the intervention and control group, pre- and post-intervention. A total of 1379 titles have been identified through the search to date. 13 studies were located that reported use of a randomised controlled trial methodology and were critically appraised by two independent reviewers. Five (5) studies were excluded as data were not reported in a useable form or useable data could not be obtained from the trial authors, one dissertation could not be obtained, one study had no "true" no-treatment or usual treatment control group, and one study did not use a pre-test outcome measure. Eight (8) studies met the selection criteria outlined above. Only one of eight pooled comparisons of two or more studies using similar outcome measures and similar intervention types demonstrated the statistically significant effect of a particular type of eating disorder prevention program for children and adolescents. Combined data from two eating disorder prevention programs based on a media literacy and advocacy approach indicate a reduction in the internalisation or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (Kusel, unpublished; Neumark-Sztainer2000) [SMD -0.28, -0.51 to -0.05, 95% CI]. However, there is insufficient evidence to conclude that this approach also demonstrated a significant impact on awareness of societal standards relating to appearance. There is insufficient evidence to support the effect of four programs designed to address eating attitudes and behaviours and other adolescent issues on body weight, eating disorder symptoms, associated eating disorder psychopathology or general psychological and physical well-being in the general sample or those classified as being at high risk for eating disorder (Buddeberg-F 1998; Killen 1993/1996; Santonastaso 1999; Zanetti 1999). Given only one program used a psychoeducation approach to prevent bulimia nervosa (Jerome, unpublished) and only one program adopted a focus on self-esteem (O'Dea 2000), the effect of these approaches could not be evaluated via meta-analyses. In relation to potential harmful effects, there is not sufficient evidence to suggest that harm resulted from any of the prevention programs included in the review. The one significant pooled effect in the current review does not allow for any firm conclusions to be made about the impact of prevention programs for eating disorders in children and adolescents, although none of the pooled comparisons indicated evidence of harm. From a clinical perspective, the development and refinement of prevention programs is complicated by a lack of knowledge about risk factors associated with eating disorders and the need to strike a balance between delivering preventive interventions for eating disorders and considering the potential to cause harm. From a research perspective, the idea of "thresholds" for identifying young people at risk of developing eating disorders has been raised, and denial of concern or denial of illness represents a further issue complicating early identification in relation to eating disorder symptomatology. Longer-term effects of the intervention approaches will need to be monitored across development in order to demonstrate a decline in the incidence of eating disorders and associated risk factors.

Parental representation in eating disorder patients with suicide.

PubMed

Yamaguchi, N; Kobayashi, J; Tachikawa, H; Sato, S; Hori, M; Suzuki, T; Shiraishi, H

2000-08-01

We examined parental, personality, and symptomatological characteristics in relation to suicide attempts among eating disorder patients. Fifty-one eating disorder inpatients, divided into two groups according to lifetime suicide attempts, and 107 non-psychiatric subjects were compared on the following variables: Parental Bonding Instrument (PBI), Global Clinical Score (GCS), Eating Disorder Inventory-91 (EDI-91), Eating Attitudes Test-26 (EAT), clinical and personality characteristics, and family backgrounds. Suicidal patients reported significantly higher overprotection by both parents than non-suicidal patients and non-psychiatric subjects. Suicidal patients had a more prevalent history of child abuse, affective instability, unstable self-image, avoidance of abandonment, maladaptive perfectionism, personality disorder, and mood disorder. There were no differences in symptomatological factors or the severity of the eating disorders. The results suggest that high overprotection is associated with suicidal behaviour in eating disorder patients. The association between overprotective parenting and personality characteristics, and methods of suicide prevention are discussed briefly.

The impact of indicated prevention and early intervention on co-morbid eating disorder and depressive symptoms: a systematic review.

PubMed

Rodgers, Rachel F; Paxton, Susan J

2014-01-01

Depressive and eating disorder symptoms are highly comorbid. To date, however, little is known regarding the efficacy of existing programs in decreasing concurrent eating disorder and depressive symptoms. We conducted a systematic review of selective and indicated controlled prevention and early intervention programs that assessed both eating disorder and depressive symptoms. We identified a total of 26 studies. The large majority of identified interventions (92%) were successful in decreasing eating disorder symptoms. However fewer than half (42%) were successful in decreasing both eating disorder and depressive symptoms. Intervention and participant characteristics did not predict success in decreasing depressive symptoms. Indicated prevention and early intervention programs targeting eating disorder symptoms are limited in their success in decreasing concurrent depressive symptoms. Further efforts to develop more efficient interventions that are successful in decreasing both eating disorder and depressive symptoms are warranted.

Body esteem and eating disorder symptomatology: the mediating role of appearance-motivated exercise in a non-clinical adult female sample.

PubMed

Vinkers, Charlotte D W; Evers, Catharine; Adriaanse, Marieke A; de Ridder, Denise T D

2012-08-01

Low body esteem poses a risk for the development of eating disorder symptomatology. Appearance-motivated exercise, as opposed to health-motivated exercise, has been associated with both low body esteem and eating disorder symptomatology. The aim of this study was to investigate the mediating role of appearance-motivated exercise in the link between body esteem and eating disorder symptomatology. Female fitness club members (N=81) reported their body esteem, eating disorder symptomatology and exercise motives. Appearance-motivated exercise partially mediated the link between low body esteem and eating disorder symptomatology. In contrast, health-motivated exercise was unrelated to both body esteem and eating disorder symptomatology. Results indicate that the motives underlying exercise in response to low body esteem have differential consequences for the potential development of eating disorders, signifying the clinical relevance of considering motives behind exercise. Copyright © 2012 Elsevier Ltd. All rights reserved.

Associations of disordered eating behavior with the family diabetes environment in adolescents with Type 1 diabetes.

PubMed

Caccavale, Laura J; Nansel, Tonja R; Quick, Virginia; Lipsky, Leah M; Laffel, Lori M B; Mehta, Sanjeev N

2015-01-01

To examine associations of disordered eating behaviors with aspects of the family eating and diabetes management environments among adolescents with Type 1 diabetes (T1D). Data were collected from 151 adolescents (mean age = 15.6 years) with T1D and their parents. Adolescents and parents completed self-report measures of the family eating environment (priority, atmosphere and structure/rules surrounding family meals, and the presence of restricted and special foods in the household) and diabetes family management environment (diabetes family conflict and responsibility sharing). Adolescents completed measures of parent modeling of healthy eating and disordered eating behaviors. Linear regression models were used to assess the relationship of disordered eating behaviors with aspects of the family eating and diabetes management environments. In unadjusted models, adolescent, but not parent, report of aspects of the family eating environment was associated with adolescents' disordered eating behaviors. Both adolescent and parent report of diabetes family conflict were positively associated with disordered eating behaviors. The adjusted adolescent model including all family eating and diabetes management variables accounted for 20.8% of the variance in disordered eating behaviors (p < .001, R² = .208). Factors associated with greater risk of disordered eating included being female (β = .168, p = .029), lower priority placed on family meals (β = -.273, p = .003), less parental modeling of healthy eating (β = -.197, p = .027), more food restrictions in the household β = .223, (p = .005), and greater diabetes family conflict (β = .195, p = .011). Findings suggest that aspects of the family eating environment and diabetes family conflict may represent important factors for disordered eating risk in adolescents with T1D.

Associations of disordered eating behavior with the family diabetes environment in adolescents with type 1 diabetes

PubMed Central

Caccavale, Laura J.; Nansel, Tonja R.; Quick, Virginia; Lipsky, Leah M.; Laffel, Lori M.B.; Mehta, Sanjeev N.

2014-01-01

Objective To examine associations of disordered eating behaviors with aspects of the family eating and diabetes management environments among adolescents with type 1 diabetes (T1D). Method Data were collected from 151 adolescents (M age = 15.6 years) with T1D and their parents. Adolescents and parents completed self-report measures of the family eating environment (priority, atmosphere and structure/rules surrounding family meals, and presence of restricted and special foods in the household), and diabetes family management environment (diabetes family conflict and responsibility sharing). Adolescents completed measures of parent modeling of healthy eating and disordered eating behaviors. Linear regression models were used to assess the relationship of disordered eating behaviors with aspects of the family eating and diabetes management environments. Results In unadjusted models, adolescent, but not parent, report of aspects of the family eating environment were associated with adolescents' disordered eating behaviors. Both adolescent and parent report of diabetes family conflict were positively associated with disordered eating behaviors. The adjusted adolescent model including all family eating and diabetes management variables accounted for 20.8% of the variance in disordered eating behaviors (p<.001, R2=.208). Factors associated with greater risk of disordered eating included being female (β=.168, p=.029), lower priority placed on family meals (β=-.273, p=.003), less parental modeling of healthy eating (β=-.197, p=.027), more food restrictions in the household β=.223, (p=.005), and greater diabetes family conflict (β=.195, p=.011). Conclusions Findings suggest that aspects of the family eating environment and diabetes family conflict may represent important factors for disordered eating risk in adolescents with T1D. PMID:25493461

Recognising the symptoms: how common are eating disorders in pregnancy?

PubMed

Easter, Abigail; Bye, Amanda; Taborelli, Emma; Corfield, Freya; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

2013-07-01

This study aimed to investigate eating disorder diagnostic status and related symptoms in early pregnancy. Pregnant women (n=739), attending their first routine antenatal scan, were assessed using an adapted version of the Eating Disorder Diagnostic Scale (EDDS). Prevalence estimates and eating disorder symptoms were assessed during the first 3 months of pregnancy and, retrospectively, in the 6 to 12 months prior to pregnancy. During pregnancy 7.5% of women met diagnostic criteria for an eating disorder, compared to prepregnancy prevalence of 9.2%. Approximately one quarter (23.4%) of women reported high weight and shape concern during pregnancy; binge eating was endorsed by 8.8%, and 2.3% of women engaged in regular compensatory behaviours. Eating disorders are more common than previously thought in pregnancy. There is a clinical need for increased understanding of eating disorder symptomatology during pregnancy and for appropriate screening tools to be incorporated into antenatal care. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Is there evidence that religion is a risk factor for eating disorders?

PubMed

Abraham, N K; Birmingham, C L

2008-12-01

Is there evidence that religion is a risk factor for eating disorders? A literature search was performed to examine whether there is an association between religion and eating disorders. There were some cross-sectional studies, case studies, and anthropological commentaries reporting eating disorders in various cultures and religions. Religious affiliation was usually reported as an incidental finding but not analyzed. A number of prevalence studies were reported from Islamic communities. This raises the possibility that young Muslim women have a higher prevalence of elevated EAT scores compared to non-Islamic women. This literature search raises the possibility that there is an association between Islamic affiliation and positive screening for eating disorder behaviors. This supports the hypothesis that the effect of culture on eating disorders may be religious as well as secular. Carefully designed studies of the prevalence of eating disorders in multicultural populations with multiple religious affiliations may help further clarify the relationship between religion and eating disorders.

Help-seeking intentions in college students: an exploration of eating disorder specific help-seeking and general psychological help-seeking.

PubMed

Tillman, Kathleen S; Sell, Darcie M

2013-04-01

This study investigated help-seeking intentions for eating disorders and general psychological problems in college students. Participants reported that they would be more likely to seek help for a friend with an eating disorder than for themselves if they were experiencing an eating disorder. Multiple factors (i.e., sex, year in college, knowledge of eating disorders, and knowledge of available resources) were assessed to determine the prediction of help-seeking intentions. Only the knowledge of eating disorders significantly predicted whether or not a student would be willing to seek help for a friend with a general psychological disorder. None of these factors predicted willingness to seek help for friends with an eating disorder. Copyright © 2013 Elsevier Ltd. All rights reserved.

The impact of DSM-5 on the diagnosis and severity indicator of eating disorders in a treatment-seeking sample.

PubMed

Nakai, Yoshikatsu; Nin, Kazuko; Noma, Shun'ichi; Teramukai, Satoshi; Fujikawa, Kei; Wonderlich, Stephen A

2017-11-01

To examine the impact of the DSM-5 on the diagnoses and severity indicators of eating disorders, we conducted a comparative study on the classification of eating disorders including subtypes of anorexia nervosa (AN) between the DSM-IV and DSM-5 criteria. In addition, we studied the association of the DSM-5 severity criteria and clinical variables. Participants were 304 outpatients, aged 16-45 years, with eating disorders, diagnosed using semi-structured clinical interviews and the eating disorder examination questionnaire (EDE-Q). The severity of AN, bulimia nervosa (BN), and binge-eating disorder (BED) was rated from mild to extreme using the DSM-5 severity criteria. The DSM-5 remarkably reduced the number of diagnoses in the residual category from 37.5% to 9.2% and effectively differentiated the diagnostic groups in eating disorder psychopathology. Unexpectedly, however, the scores of all the EDE-Q subscales significantly decreased as severity ratings increased in the DSM-5 AN. Furthermore, while the AN binge-eating/purging group reported significantly lower severity ratings than the AN restricting group, the former displayed more severe eating disorder psychopathology than the latter. In the BN and BED groups, the level of eating concern increased as severity ratings increased, but the severity groups did not differ on other eating pathology variables. The DSM-5 effectively reduced the reliance on residual categories and differentiated the diagnostic groups in eating disorder psychopathology. However, our findings show limited support for the DSM-5 severity specifiers for eating disorders. It is necessary to test additional clinical or functional variables for severity specifiers across eating disorders. © 2017 Wiley Periodicals, Inc.

Eating Disorders in Paraguayan Adolescents

ERIC Educational Resources Information Center

Ramirez, Maria E.; McIntosh, David E.; Kruczek, Theresa

2013-01-01

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…

Influence of depressive and eating disorders on short- and long-term course of weight after surgical and nonsurgical weight loss treatment.

PubMed

Legenbauer, Tanja; Petrak, Frank; de Zwaan, Martina; Herpertz, Stephan

2011-01-01

To investigate the influence of depressive and eating disorders on short- and long-term weight loss after surgical and non-surgical weight-reduction treatment. Covariations between the disorders were considered. In a longitudinal naturalistic study, current diagnoses at baseline and lifetime diagnoses of depressive and eating disorders were assessed in participants who were undertaking a very-low-calorie diet (n = 250) and in bariatric surgery patients (n = 153). Lifetime diagnosis of a mental disorder was defined as presence of a mental disorder only in the past. Body weight was measured at baseline, 1 year after baseline, and 4 years after baseline. Mental comorbidity was assessed through use of standardized interviews at baseline. A structural equation modeling procedure was applied to test the associations between course of weight and mental disorders. Analyses were based on the intention to treat samples. Missing values were replaced by use of multiple imputation procedures. Neither depression nor eating disorders were associated with weight changes at the 1-year follow-up, but a specific effect emerged for bariatric surgery patients after 4 years: depression (current and lifetime) predicted smaller body mass index loss, whereas lifetime diagnosis of eating disorder was associated with greater weight loss. Individuals who report depressive disorders prior to bariatric surgery should be monitored more closely in order to identify patients who would benefit from additional therapy with the goal of improving weight-loss outcome. Copyright © 2011 Elsevier Inc. All rights reserved.

Disordered Eating Attitudes and Their Correlates among Iranian High School Girls

PubMed Central

Pourghassem Gargari, Bahram; Kooshavar, Deniz; Seyed Sajadi, Neda; Safoura, Safoura; Hamed Behzad, Mahdiyeh; Shahrokhi, Hassan

2011-01-01

Background: Disordered eating attitudes are contributing factors to the development of eating disorders. Adolescent girls are at high risk for eating diseases. In Iran, there is few data on the subject, especially in Azarian adolescent girls, so we did this study for assessing disordered eating attitudes and their correlates among Iranian Azarbaijani high school girls. Methods: In a cross-sectional study, 1887 high school girls were selected. Eating Attitude Test-26 (EAT-26) and socio economical questionnaires were used. The EAT-26 score of 20 or higher defined as disordered eating attitudes. Data were analyzed using the Statistical Program for Social Sciences, by using from descriptive and analytical statistics. Results: Reliability and validity of the translated EAT-26 were 0.80, 0.76, respectively. In studied subjects, mean (SD) of EAT-26 was 11.71(8.48). Totally, 16.7% (C.I with 95%: 15.1- 18.3%) of students had disordered eating attitudes. About half of the participants were unhappy with their body weight and considered themselves as obese. Mean of EAT-26 was higher in this group. Groups, who intent to weight loss, were smoker, and who had age of menarche less than 11 years, also had higher EAT-26 scores. Parent’s literacy or job, birth order, family size or income and house ownership had not any significant effect on EAT-26 score. Conclusions: Persian version of EAT-26 has good reliability and validity for assessing disordered eating attitudes in Azarian girl adolescents. Prevalence of disordered eating attitudes among Azarian adolescent girls are in the range of some studies, but are less than Arabian countries, and some European ones. In adolescent girls, body weight dissatisfaction, smoking and early menarche has important role in eating attitudes. PMID:24688898

Insidious: The relationship patients have with their eating disorders and its impact on symptoms, duration of illness, and self-image.

PubMed

Forsén Mantilla, Emma; Clinton, David; Birgegård, Andreas

2017-10-28

In published clinical and autobiographical accounts of eating disorders, patients often describe their disorder in personified ways, that is, relating to the disorder as if it were an entity, and treatment often involves techniques of externalization. By encouraging patients to think about their eating disorder as a relationship, this study aimed to examine how young female patients experience their eating disorder as acting towards them, how they react in response, and whether these interactions are associated with symptoms, illness duration, and self-image. Structural Analysis of Social Behavior (SASB) was used to operationalize how patients experience the actions of their eating disorder and their own reactions to the disorder. The relationship between patients (N = 150) and their eating disorders was examined with respect to symptoms, duration of illness, and self-image. Patients were also compared on their tendency to react with affiliation in relation to their disorder. Patients' responses on the SASB indicated that they tended to conceptualize their eating disorders as blaming and controlling, and they themselves as sulking and submitting in response. Greater experience of the eating disorder as being controlling was associated with higher levels of symptomatology. Patients reacting with more negative affiliation towards their disorder were less symptomatic. When encouraging patients to think about their eating disorder as a relationship, comprehensible relationship patterns between patients and their eating disorders emerged. The idea that this alleged relationship may resemble a real-life relationship could have theoretical implications, and its exploration may be of interest in treatment. Patients were able to conceptualize their eating disorder as a significant other to whom they relate when encouraged to do so. Patients tended to experience their disorder as controlling and domineering. Exploring the hypothetical patient-eating disorder relationship may prove helpful in understanding dysfunctional relational patterns. Helping patients to rebel against their eating disorder could potentially aid in symptom reduction. © 2017 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Associations between specific components of compulsive exercise and eating-disordered cognitions and behaviors among young women.

PubMed

Taranis, Lorin; Meyer, Caroline

2011-07-01

To explore the associations between specific elements of compulsive exercise and both eating-disordered cognitions and eating-disordered behaviors in a nonclinical sample of young women. A sample of young women (n = 498) completed self-report measures of eating pathology (The Eating Disorders Examination Questionnaire) and a relatively new measure of Compulsive Exercise Test. Specific elements of compulsive exercise were associated with elevated levels of eating-disordered cognitions and increased frequency of eating-disordered behaviors. These results support a multifunctional conceptualization of compulsive exercise, suggesting that some of the functionality of compulsive exercise may be akin to other forms of purging, and further supporting the notion of a possible functional equivalence between compulsive exercise and specific eating-disordered behaviors in terms of affect regulation. Copyright © 2010 Wiley Periodicals, Inc.

Fear of food prospectively predicts drive for thinness in an eating disorder sample recently discharged from intensive treatment.

PubMed

Levinson, Cheri A; Brosof, Leigh C; Ma, Jackie; Fewell, Laura; Lenze, Eric J

2017-12-01

Fears of food are common in individuals with eating disorders and contribute to the high relapse rates. However, it is unknown how fears of food contribute to eating disorder symptoms across time, potentially contributing to an increased likelihood of relapse. Participants diagnosed with an eating disorder (N=168) who had recently completed intensive treatment were assessed after discharge and one month later regarding fear of food, eating disorder symptoms, anxiety sensitivity, and negative affect. Cross lagged path analysis was utilized to determine if fear of food predicted subsequent eating disorder symptoms one month later. Fear of food-specifically, anxiety about eating and feared concerns about eating-predicted drive for thinness, a core symptom domain of eating disorders. These relationships held while accounting for anxiety sensitivity and negative affect. There is a specific, direct relationship between anxiety about eating and feared concerns about eating and drive for thinness. Future research should test if interventions designed to target fear of food can decrease drive for thinness and thereby prevent relapse. Copyright © 2017 Elsevier Ltd. All rights reserved.

Personality, emotion-related variables, and media pressure predict eating disorders via disordered eating in Lebanese university students.

PubMed

Sanchez-Ruiz, Maria Jose; El-Jor, Claire; Abi Kharma, Joelle; Bassil, Maya; Zeeni, Nadine

2017-04-18

Disordered eating behaviors are on the rise among youth. The present study investigates psychosocial and weight-related variables as predictors of eating disorders (ED) through disordered eating (DE) dimensions (namely restrained, external, and emotional eating) in Lebanese university students. The sample consisted of 244 undergraduates (143 female) aged from 18 to 31 years (M = 20.06; SD = 1.67). Using path analysis, two statistical models were built separately with restrained and emotional eating as dependent variables, and all possible direct and indirect pathways were tested for mediating effects. The variables tested for were media influence, perfectionism, trait emotional intelligence, and the Big Five dimensions. In the first model, media pressure, self-control, and extraversion predicted eating disorders via emotional eating. In the second model, media pressure and perfectionism predicted eating disorders via restrained eating. Findings from this study provide an understanding of the dynamics between DE, ED, and key personality, emotion-related, and social factors in youth. Lastly, implications and recommendations for future studies are advanced.

Eating Disorder Not Otherwise Specified in Adolescents

ERIC Educational Resources Information Center

Eddy, Kamryn T.; Doyle, Angela Celio; Hoste, Renee Rienecke; Herzog, David B.; Le Grange, Daniel

2008-01-01

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.

Integrative Response Therapy for Binge Eating Disorder

PubMed Central

Robinson, Athena

2014-01-01

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

Binge eating disorder and night eating syndrome in adults with type 2 diabetes

USDA-ARS?s Scientific Manuscript database

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...

Childhood adverse life events, disordered eating, and body mass index in US Military service members.

PubMed

Bakalar, Jennifer L; Barmine, Marissa; Druskin, Lindsay; Olsen, Cara H; Quinlan, Jeffrey; Sbrocco, Tracy; Tanofsky-Kraff, Marian

2018-03-02

US service members appear to be at high-risk for disordered eating. Further, the military is experiencing unprecedented prevalence of overweight and obesity. US service members also report a high prevalence of childhood adverse life event (ALE) exposure. Despite consistent links between early adversity with eating disorders and obesity, there is a dearth of research examining the association between ALE exposure and disordered eating and weight in military personnel. An online survey study was conducted in active duty personnel to examine childhood ALE history using the Life Stressor Checklist - Revised, disordered eating using the Eating Disorder Examination - Questionnaire total score, and self-reported body mass index (BMI, kg/m 2 ). Among 179 respondents, multiple indices of childhood ALE were positively associated with disordered eating. Traumatic childhood ALE and subjective impact of childhood ALE were associated with higher BMI and these associations were mediated by disordered eating. Findings support evaluating childhood ALE exposure among service members with disordered eating and weight concerns. Moreover, findings support the need for prospective research to elucidate these relationships. © 2018 Wiley Periodicals, Inc.

A public health approach to eating disorders prevention: it's time for public health professionals to take a seat at the table.

PubMed

Austin, S Bryn

2012-10-09

The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders.

A public health approach to eating disorders prevention: It’s time for public health professionals to take a seat at the table

PubMed Central

2012-01-01

Background The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. Discussion The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. Summary There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders. PMID:23043459

Eating Disorders and Epigenetics.

PubMed

Thaler, Lea; Steiger, Howard

2017-01-01

Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs). The chapter then summarizes the emerging body of literature on epigenetics and EDs-mainly studies on DNA methylation in samples of anorexia and bulimia. The available evidence base suggests that an epigenetically informed perspective contributes in valuable ways to the understanding of why people develop EDs.

Pharmacological Treatment of Binge Eating Disorder: Update Review and Synthesis

PubMed Central

Reas, Deborah L.; Grilo, Carlos M.

2015-01-01

Introduction Binge-eating disorder (BED), a formal eating-disorder diagnosis in the DSM-5, is characterized by recurrent binge-eating, marked distress about binge-eating, and the absence of extreme weight compensatory behaviors. BED is more prevalent than other eating-disorders, with broader distribution across age, sex, and ethnic/racial groups, and is associated strongly with obesity and heightened risk for psychiatric/medical comorbidities. Areas Covered This article provides an overview of pharmacotherapy for BED with a focus on III randomized controlled trials (RCTs). The search with minimal methodological inclusion requirements yielded 22 RCTs investigating several different medication classes; most were pharmacotherapy-only trials with eight trials testing combination approaches with psychological-behavioral methods. Expert Opinion The evidence base regarding pharmacotherapy for BED remains limited, although this year the FDA approved the first medication (i.e., lisdexamfetamine dimesylate; LDX) specifically for moderate-to-severe BED. Data from RCTs suggests certain medications are superior to placebo for reducing binge-eating over the short-term; almost no data exist regarding longer-term effects of pharmacotherapy for BED. Except for topiramate, which significantly reduces both binge-eating and weight, tested medications yield minimal weight loss and LDX is not indicated for weight loss. Psychological-behavioral and combination approaches with certain medications yield superior outcomes to pharmacotherapy-only acutely and over longer-term follow-up. PMID:26044518

Effect of management of patients with Anorexia and Bulimia nervosa on symptoms and impulsive behavior.

PubMed

Sernec, Karin; Tomori, Martina; Zalar, Bojan

2010-12-01

The aim of the study was to provide further and up to date information on the evaluation of the management of Anorexia and Bulimia nervosa at the Eating Disorders Unit (EDU) of the Ljubljana Psychiatric Clinic, based upon detailed assessment of the eating disorders specific and non specific symptoms of impulsive behaviors, highly correlated with these entities. 34 female patients with anorexia (restrictive or purgative type) and 38 female patients with Bulimia nervosa (purgative or non-purgative type) undergoing hospital treatment at the EDU were evaluated upon admission, as well as upon discharge and three and six months after discharge, using the Eating Disorder Questionnaire. Upon discharge a marked decrease in the overall symptoms was noted. The differences in symptoms incidences between the two groups were significantly specific for the individual form of eating disorder, especially upon admission, and were more pronounced in anorexia group. In later measurements, performed during the period of three and six months after discharge, a mild trend of increase in the disorder specific symptoms was detected in both groups, but was not statistically significant. In addition to binging on food, striking, quarreling and spending sprees are characteristics of patients with eating disorders, which in particular apply to the Bulimia nervosa group. Apart from the disorder specific symptoms, impulsive behavior was also reduced during study period, while the difference in its occurrence between the two groups gradually became non-significant. The management of patients with eating disorders at the EDU was successful in both groups, confirmed by an intense reduction of the disorder specific symptoms, impulsive behavior and increased stability recorded three and six months after discharge. The study strongly suggests that the effect of treatment regime for eating disorders can be predicted by careful assessment of the relevant symptoms and impulsive behavioral patterns.

Emerging Treatments in Eating Disorders.

PubMed

Lutter, Michael

2017-07-01

Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, and binge-eating disorder, constitute a class of common and deadly psychiatric disorders. While numerous studies in humans highlight the important role of neurobiological alterations in the development of ED-related behaviors, the precise neural substrate that mediates this risk is unknown. Historically, pharmacological interventions have played a limited role in the treatment of eating disorders, typically providing symptomatic relief of comorbid psychiatric issues, like depression and anxiety, in support of the standard nutritional and psychological treatments. To date there are no Food and Drug Administration-approved medications or procedures for anorexia nervosa, and only one Food and Drug Administration-approved medication each for bulimia nervosa (fluoxetine) and binge-eating disorder (lisdexamfetamine). While there is little primary interest in drug development for eating disorders, postmarket monitoring of medications and procedures approved for other indications has identified several novel treatment options for patients with eating disorders. In this review, I utilize searches of the PubMed and ClinicalTrials.gov databases to highlight emerging treatments in eating disorders.

Disordered eating behavior, health and motives to exercise in young men: cross-sectional population-based MOPO study.

PubMed

Nurkkala, Marjukka; Keränen, Anna-Maria; Koivumaa-Honkanen, Heli; Ikäheimo, Tiina M; Ahola, Riikka; Pyky, Riitta; Mäntysaari, Matti; Korpelainen, Raija

2016-06-08

Being overweight is an increasing problem among young people, among whom disordered eating behavior is linked with weight problems as well as unhealthy weight control. The aim of the present study was to investigate whether health factors and motives to exercise differ in young men by the type of disordered eating behavior. The population-based, cross-sectional MOPO study consisted of 2,096 young Finnish men (mean age 17.9, SD 0.7) attending compulsory call-ups for military service in the Oulu area in 2010, 2011, and 2013. They responded to a questionnaire that included two subscales of the Eating Disorder Inventory-3 indicating drive for thinness and bulimic behavior and questions on health, physical activity, and motives to exercise. The association between disordered eating behavior and related factors was analyzed by binary logistic regression. Altogether, 6.9 % (n = 145) of the men had symptoms of disordered eating, i.e., 5.4 % had a drive for thinness (n = 114) and 3.7 % had bulimic behavior (n = 77). Drive for thinness was associated with a perception of being overweight (OR 3.7; 95 % CI 2.2-6.1), poor self-rated health (2.3; 1.2-4.4), more leisure sitting time (1.1; 1.0-1.2), and body-related exercise motives (body acceptance: 3.0; 1.7-5.2; weight loss: 2.5; 1.4-4.4). Bulimic behavior was positively associated with poor self-rated health (2.6; 1.1-5.8) and several motives to exercise, i.e., due to another person's suggestion (2.8; 1.6-4.8), competitive sports (2.1; 1.2-3.7), body acceptance (2.1; 1.1-3.9), and weight loss (1.9; 1.1-3.3), but inversely associated with health/fitness-related exercise motives (health promotion: 0.3; 0.1-0.5; muscular strength or physical performance: 0.5; 0.2-0.9). In young men, disordered eating behavior was associated with being overweight, having poor self-rated health, and having a greater amount of leisure sitting time as well as non-health-related motives to exercise. In order to recognize those at risk for disordered eating behavior, evaluating these factors could be beneficial.

The Eating Disorder Assessment for DSM-5 (EDA-5): Development and Validation of a Structured Interview for Feeding and Eating Disorders

PubMed Central

Sysko, Robyn; Glasofer, Deborah R.; Hildebrandt, Tom; Klimek, Patrycja; Mitchell, James E.; Berg, Kelly C.; Peterson, Carol B.; Wonderlich, Stephen A.; Walsh, B. Timothy

2016-01-01

Objective Existing measures for DSM-IV eating disorder diagnoses have notable limitations, and there are important differences between DSM-IV and DSM-5 feeding and eating disorders. This study developed and validated a new semi-structured interview, the Eating Disorders Assessment for DSM-5 (EDA-5). Method Two studies evaluated the utility of the EDA-5. Study 1 compared the diagnostic validity of the EDA-5 to the Eating Disorder Examination (EDE) and evaluated the test-retest reliability of the new measure. Study 2 compared the diagnostic validity of an EDA-5 electronic application (“app”) to clinician interview and self-report assessments. Results In Study 1, the kappa for EDE and EDA-5 eating disorder diagnoses was 0.74 across all diagnoses (n= 64), with a range of κ=0.65 for Other Specified Feeding or Eating Disorder (OSFED)/Unspecified Feeding or Eating Disorder (USFED) to κ=0.90 for Binge Eating Disorder (BED). The EDA-5 test-retest kappa coefficient was 0.87 across diagnoses. For Study 2, clinical interview versus “app” conditions revealed a kappa of 0.83 for all eating disorder diagnoses (n=71). Across individual diagnostic categories, kappas ranged from 0.56 for OSFED/USFED to 0.94 for BN. Discussion High rates of agreement were found between diagnoses by EDA-5 and the EDE, and EDA-5 and clinical interviews. As this study supports the validity of the EDA-5 to generate DSM-5 eating disorders and the reliability of these diagnoses, the EDA-5 may be an option for the assessment of Anorexia Nervosa, Bulimia Nervosa, and BED. Additional research is needed to evaluate the utility of the EDA-5 in assessing DSM-5 feeding disorders. PMID:25639562

New treatment approaches for severe and enduring eating disorders.

PubMed

Treasure, Janet; Cardi, Valentina; Leppanen, Jenni; Turton, Robert

2015-12-01

The aim of this paper is to map the possibility of new treatment approaches for eating disorders. Eating disorders have a protracted trajectory with over 50% of cases developing a severe and enduring stage of illness. Although a good response to family-based interventions occurs in the early phase, once the illness has become severe and enduring there is less of a response to any form of treatment. Neuroprogressive changes brought about by poor nutrition and abnormal eating patterns contribute to this loss of treatment responsivity. We have summarised the profile of symptoms at the various stages of illness and considered new treatments that might be applied. In the enduring stage of illness in addition to problems with body image, food and eating, there are additional problems of low mood, high anxiety and compulsivity and problems in social functioning. This suggests that there are dysfunctions in circuits subsuming reward, punishment, decision-making and social processes. New approaches have been developed targeting these areas. New interventions targeting both the primary and secondary symptoms seen in the enduring stage of eating disorders may improve the response to treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

The accuracy of symptom recall in eating disorders.

PubMed

Peterson, Carol B; Miller, Kathryn B; Johnson-Lind, Joy; Crow, Scott J; Thuras, Paul

2007-01-01

The purpose of this study was to assess how accurately patients with eating disorders recall their symptoms after 6 to 12 months, to evaluate whether more recent symptoms are remembered more accurately, and to determine the extent to which the accuracy of recall impacts diagnostic classification. Seventy women who were enrolled in a longitudinal study of eating disorder symptoms were asked to recall their eating patterns, behaviors, and attitudes from 6 or 12 months earlier using semistructured interviews (Eating Disorders Examination and McKnight Longitudinal Follow-up Interview for Eating Disorders). Results indicated that correlations between the original and recalled data for frequency of objective binge eating episodes and vomiting ranged from r = .534 to .898 (average, r = .772), with lower correlations for subjective binge eating episodes (average, r = .335). Attitudes toward shape and weight were recalled more accurately at 6 months (average, r = .907) than 12 months (average, r = .620). kappa Coefficients were higher for eating disorder diagnoses using broad than narrow definitions, with no differences between 6- and 12-month recall. Overall, agreement for depression recall was low but better at 6 months (kappa = .423) than 12 months (kappa = .296). These findings suggest that patients with eating disorders are at least moderately accurate when recalling most symptoms from 6 to 12 months earlier. Although broadly defined eating disorder diagnoses remained consistent, depression and narrower eating disorder diagnostic classifications showed more variability.

Mexican American Women’s Perspectives on a Culturally Adapted Cognitive-Behavioral Therapy Guided Self-Help Program for Binge Eating

PubMed Central

Shea, Munyi; Cachelin, Fary M.; Gutierrez, Guadalupe; Wang, Sherry; Phimphasone, Phoutdavone

2015-01-01

The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)—a low-cost minimal intervention—has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Post-treatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: 1) eating behavior and body ideals are socially and culturally constructed, 2) multifaceted support system is crucial to Mexican American women’s treatment engagement and success, and 3) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women’s experience, but it can be strengthened with increased family and peer support. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings. PMID:26462112

Nonspecific eating disorders - a subjective review.

PubMed

Michalska, Aneta; Szejko, Natalia; Jakubczyk, Andrzej; Wojnar, Marcin

2016-01-01

The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbidities, clinical implications and treatment. All of the included disorders may have dangerous consequences, both somatic and psychological. They are often comorbid with other psychiatric disorders. Approximately a few percent of general population can be diagnosed with each disorder, from 0.5-4.7% (SRED) to about 7% (orthorexia). With the growing literature on the subject and changes in DSM-5, clinicians recognise and treat those disorders more often. More studies have to be conducted in order to differentiate disorders and treat or prevent them appropriately.

The developmental association between eating disorders symptoms and symptoms of depression and anxiety in juvenile twin girls.

PubMed

Silberg, Judy L; Bulik, Cynthia M

2005-12-01

We investigated the role of genetic and environmental factors in the developmental association among symptoms of eating disorders, depression, and anxiety syndromes in 8-13-year-old and 14-17-year-old twin girls. Multivariate genetic models were fitted to child-reported longitudinal symptom data gathered from clinical interview on 408 MZ and 198 DZ female twin pairs from the Virginia Twin Study of Adolescent Behavioural Development (VTSABD). Model-fitting revealed distinct etiological patterns underlying the association among symptoms of eating disorders, depression, overanxious disorder (OAD), and separation anxiety disorder (SAD) during the course of development: 1) a common genetic factor influencing liability to all symptoms - of early and later OAD, depression, SAD, and eating symptoms; 2) a distinct genetic factor specifically indexing liability to early eating disorders symptoms; 3) a shared environmental factor specifically influencing early depression and early eating disorders symptoms; and 4) a common environmental factor affecting liability to symptoms of later eating disorders and both early and later separation anxiety. These results suggest a pervasive genetic effect that influences liability to symptoms of over-anxiety, separation anxiety, depression, and eating disorder throughout development, a shared environmental influence on later adolescent eating problems and persistent separation anxiety, genetic influences specific to early eating disorders symptoms, and a shared environmental factor influencing symptoms of early eating and depression.

Test-retest reliability of the proposed DSM-5 eating disorder diagnostic criteria

PubMed Central

Sysko, Robyn; Roberto, Christina A.; Barnes, Rachel D.; Grilo, Carlos M.; Attia, Evelyn; Walsh, B. Timothy

2012-01-01

The proposed DSM-5 classification scheme for eating disorders includes both major and minor changes to the existing DSM-IV diagnostic criteria. It is not known what effect these modifications will have on the ability to make reliable diagnoses. Two studies were conducted to evaluate the short-term test-retest reliability of the proposed DSM-5 eating disorder diagnoses: anorexia nervosa, bulimia nervosa, binge eating disorder, and feeding and eating conditions not elsewhere classified. Participants completed two independent telephone interviews with research assessors (n=70 Study 1; n=55 Study 2). Fair to substantial agreements (κ= 0.80 and 0.54) were observed across eating disorder diagnoses in Study 1 and Study 2, respectively. Acceptable rates of agreement were identified for the individual eating disorder diagnoses, including DSM-5 anorexia nervosa (κ’s of 0.81 to 0.97), bulimia nervosa (κ=0.84), binge eating disorder (κ’s of 0.75 and 0.61), and feeding and eating disorders not elsewhere classified (κ’s of 0.70 and 0.46). Further, improved short-term test-retest reliability was noted when using the DSM-5, in comparison to DSM-IV, criteria for binge eating disorder. Thus, these studies found that trained interviewers can reliably diagnose eating disorders using the proposed DSM-5 criteria; however, additional data from general practice settings and community samples are needed. PMID:22401974

Family-based treatment of eating disorders in adolescents: current insights

PubMed Central

Rienecke, Renee D

2017-01-01

Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment. PMID:28615982

Family-based treatment of eating disorders in adolescents: current insights.

PubMed

Rienecke, Renee D

2017-01-01

Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment.

Symptoms of muscle dysmorphia, body dysmorphic disorder, and eating disorders in a nonclinical population of adult male weightlifters in Australia.

PubMed

Nieuwoudt, Johanna E; Zhou, Shi; Coutts, Rosanne A; Booker, Ray

2015-05-01

The current study aimed to (a) determine the rates of symptoms of muscle dysmorphia (MD), body dysmorphic disorder (BDD), and eating disorder; (b) determine the relationships among symptoms of MD, BDD, and eating disorders; and (c) provide a comprehensive comparison of symptoms of MD, BDD, and eating disorders in a nonclinical population of adult male weightlifters in Australia. The participants (N = 648, mean age = 29.5 years, SD = 10.1) participated in an online survey, consisting of Muscle Appearance Satisfaction Scale, the Body Dysmorphic Disorder Questionnaire, and the Eating Attitude Test-26. Results indicated that 110 participants (17%) were at risk of having MD, 69 participants (10.6%) were at risk of having BDD, and 219 participants (33.8%) were at risk of having an eating disorder. Furthermore, 36 participants (5.6%) were found at risk of having both MD and BDD, and 60 participants (9.3%) were at risk of having both MD and an eating disorder. Significant correlations and associations were found between symptoms of MD and BDD, and symptoms of MD and eating disorders. Support was provided for the comorbidity of, and symptomatic similarities between, symptoms of MD and BDD, and symptoms of MD and eating disorders. This may reflect a shared pathogenesis between symptoms of MD, BDD, and eating disorders. Strength and conditioning professionals, exercise scientists, athletic trainers, and personal trainers should be aware that adult males who are working out with weights (i.e., free weights or machines) may be at increased risk of having MD, BDD, and eating disorders.

White public regard: associations among eating disorder symptomatology, guilt, and White guilt in young adult women.

PubMed

Lydecker, Janet A; Hubbard, Rebecca R; Tully, Carrie B; Utsey, Shawn O; Mazzeo, Suzanne E

2014-01-01

As a novel investigation of the role of White racial identity, the current study explored the link between White guilt and disordered eating. Young adult women (N=375), 200 of whom self-identified as White. Measures assessed disordered eating, trait guilt, White guilt, and affect. White guilt is interrelated with disordered eating, particularly bulimic symptomatology. Distress tolerance and tendency to experience negative affect moderated the relation between White guilt and several disordered eating variables. Exploration of White guilt in clinical and research settings can inform understanding and treatment of disordered eating. © 2013.

Race, Ethnicity, and Eating Disorder Recognition by Peers

PubMed Central

Sala, Margarita; Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M.; Bardone-Cone, Anna

2013-01-01

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

Social anxiety and disordered eating: The influence of stress reactivity and self-esteem.

PubMed

Ciarma, Jessica Lyn; Mathew, Jaya Miriam

2017-08-01

While previous research indicates a strong link between social anxiety and disordered eating, more research is needed in order to understand the mechanisms that underlie this relationship. Given that stress is often implicated in disordered eating, it was hypothesised that ones reaction to stress (i.e. stress reactivity) would mediate the relationship between social anxiety and disordered eating. Similarly, given that low self-esteem is commonly reported in both those with social anxiety and eating disorders, it was hypothesised that self-esteem would also mediate the relationship between social anxiety and disordered eating. In order to test this, an online survey measuring social anxiety, disordered eating, stress reactivity and self-esteem, was administered to 282 participants in the community, aged between 18 and 35years. Results showed that self-esteem and a reactivity to stress during social conflict - but not during negative social evaluations - partially mediated the relationship between social anxiety and disordered eating. These findings demonstrate that low self-esteem and interpersonal conflict are powerful mechanisms that can maintain eating disorder psychopathology in those who are socially anxious. This highlights the importance of ensuring that these mechanisms are sufficiently addressed in eating disorder prevention and treatment programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

The prevalence and predictors of disordered eating in women with coeliac disease.

PubMed

Satherley, Rose-Marie; Howard, Ruth; Higgs, Suzanne

2016-12-01

The need for dietary management in coeliac disease may lead to the development of disordered eating. This study examined the prevalence of disordered eating and factors predicting disordered eating in women with coeliac disease, compared with other dietary-controlled conditions. A cross-sectional, online survey assessing psychological well-being, disordered eating behaviours (Eating Attitudes Test 26 (EAT-26); Binge Eating Scale (BES)) was distributed using online forums, to those with coeliac disease (N = 157), inflammatory bowel disease (N = 116), type two diabetes (N = 88) and healthy controls (N = 142). Hierarchical regressions were conducted to explore and compare the predictors of EAT-26 and BES scores across all groups. Within the coeliac disease group, a cluster analysis was conducted to examine types of disordered eating. Higher EAT-26 scores were found in those with coeliac disease and inflammatory bowel disease compared with healthy controls and type two diabetes; participants with a chronic health condition had higher BES than healthy control participants. The factors associated with EAT-26 scores differed across the dietary-controlled health conditions, with dietary management being important for those with coeliac disease. Psychological distress was associated with binge-eating behaviour across all groups. Cluster analyses found two types of disordered eating in coeliac disease; a binge eating type and a restrictive type. Disordered eating attitudes and behaviours are more prevalent in participants with chronic health conditions relative to healthy controls. The presence of binge eating behaviours in coeliac disease may be related to non-coeliac disease specific factors such as the distress associated with dietary-controlled illness. EAT-26 scores in coeliac disease are associated with disease specific factors, unique to following the gluten-free diet. These factors are important for identifying and supporting those with coeliac disease and disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Eating disorders.

PubMed

Erzegovesi, Stefano; Bellodi, Laura

2016-08-01

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.

The reasons why eating disorder patients drink.

PubMed

Hart, Susan; Abraham, Suzanne; Franklin, Richard C; Russell, Janice

2011-01-01

To explore the reasons why eating disorder patients consume non-alcoholic fluids and to examine variables associated with poor and excessive drinking. A sample of 115 patients admitted for inpatient treatment to a specialist eating disorder facility completed a semi-standardised retrospective fluid intake history of type and amount of fluid and of reasons for drinking. ANOVA, chi-square and factor analysis were performed. The main reasons for consuming fluids were for fullness and appetite suppression; for feelings of control including feeling empty; to assist with purging; and for physiological reasons such as drinking when thirsty, after exercising and to increase energy levels via caffeine ingestion. An eating disorder needs to be considered a disorder of fluid intake, as much as a disorder of food intake. Factors affecting the fluid intake of eating disorder patients are related to the presence of eating disorder behaviours. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.

Tooth erosion and eating disorders: a systematic review and meta-analysis.

PubMed

Hermont, Ana Paula; Oliveira, Patrícia A D; Martins, Carolina C; Paiva, Saul M; Pordeus, Isabela A; Auad, Sheyla M

2014-01-01

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. 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? 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. 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). 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 erosion.

Updates in the epidemiology of eating disorders in Asia and the Pacific.

PubMed

Thomas, Jennifer J; Lee, Sing; Becker, Anne E

2016-11-01

This review summarizes and contextualizes the recent epidemiologic data on eating disorders in the Asia and Pacific regions. Gaps in epidemiologic data on eating disorders from the Asia and Pacific regions stem, in part, from omission of eating disorder-specific assessments in large nationally representative cohort studies of mental disorders. Available data - often from clinical and school-going cohorts - support that the prevalence of both eating disorders and associated attitudes and behaviors in many Asian and Pacific regions studied may be comparable to those reported in Europe and North America. Moreover, the prevalence of eating disorders in some regions of Asia may be increasing. Some of the national and subnational regions with the highest annual percent increases in disability-adjusted life years per 100 000 caused by eating disorders over the past two decades are located in Asia. Notwithstanding sparse epidemiologic data concerning eating disorders in Asia and the Pacific, available evidence supports comparable prevalence to other global regions and that associated health burdens in some regions of Asia may be rising. This further supports that eating disorders are trans-national in distribution and challenges the previous understanding that they were primarily culture-bound to the Global North.

Posttraumatic stress disorder in women with binge eating disorder in primary care.

PubMed

Grilo, Carlos M; White, Marney A; Barnes, Rachel D; Masheb, Robin M

2012-11-01

To examine the frequency and significance of comorbid posttraumatic stress disorder (PTSD) in ethnically diverse obese patients with binge eating disorder (BED) seeking treatment for obesity and binge eating in primary care. Participants were a consecutive series of 105 obese women with BED; 43% were African- American, 36% were Caucasian, and 21% were Hispanic-American/other. Participants were evaluated with reliable semi-structured interviews and established measures. Of the 105 women, 25 (24%) met criteria for PTSD. PTSD was associated with significantly elevated rates of mood, anxiety, and drug use disorders, significantly elevated eating disorder psychopathology (Eating Disorder Examination global score and scales), greater depressive affect, and lower self-esteem, even though the patients with comorbid PTSD did not have higher body mass indexes (BMIs) or greater frequency of binge eating. The heightened eating disorder psychopathology and depression and the lower self-esteem among patients with comorbid PTSD persisted even after controlling for anxiety disorder comorbidity. Our findings suggest that among ethnically/ racially diverse obese women with BED who present for obesity and binge eating treatment in primary care settings, PTSD is common and is associated with heightened psychiatric comorbidity, greater eating disorder psychopathology, and poorer psychological functioning.

[Investigation of the Safety of and Patient Satisfaction with iEat®, the Support Food for the Recovery of Eating Function in Patients with Carcinomatosis - Related Gastrointestinal Passage Disorder].

PubMed

Matsuoka, Mio; Shinoki, Keiji; Makari, Yoichi; Iijima, Shohei

2015-12-01

iEat®, a support food for the recovery of eating function, is food that can be easily masticated with little power and has suitable fluidity for enzyme processing, regardless of its normal appearance. We provided iEat® to 5 patients with carcinomatosis-related gastrointestinal passage disorder who could take fluid foods and investigated the stability of iEat® and patient satisfaction with the food. We provided regular diets for lunch on the first and 7th day, and provided iEat® from the 2nd to the 6th day. The stability of iEat(R) was evaluated based on the presence and grade of abdominal pain, diarrhea, sense of abdominal distension, nausea, and vomiting, according to the Common Terminology Criteria for Adverse Events (CTCAE v4.0, JCOG). The patients assessed their satisfaction by using 6 grades of taste, appearance, amount, difficulty of intake, and overall valuation. One patient could not continue the study because of vomiting from overeating of iEat(R). In the other patients, iEat(R) induced approximately the same adverse events as did the regular diets. All of the patients expressed better satisfaction with iEat® than with the regular diets. Although patient management for overeating is necessary, iEat® might provide good quality of life in terms of eating satisfaction to the patients with carcinomatosis-related gastrointestinal passage disorder.

Pharmacotherapy of eating disorders.

PubMed

Davis, Haley; Attia, Evelyn

2017-11-01

Medications are commonly prescribed in the treatment of eating disorders. In this review, we discuss relevant medications used for the treatment of bulimia nervosa, binge eating disorder (BED), and anorexia nervosa. We focus on recent research developments, where applicable, in addition to discussing important findings from older studies to provide a complete synopsis of the current evidence base for eating disorder treatment using pharmacologic agents. Medications are generally useful for patients with bulimia nervosa and BED. For bulimia nervosa, antidepressant medications are the primary pharmacologic treatment and limited new research has been completed. For BED, lisdexamfetamine is reported to be generally well tolerated and effective, and is the first medication to be indicated by the US Food and Drug Administration for treatment of BED. For anorexia nervosa, there is limited evidence supporting benefits of medications. Second-generation antipsychotics, particularly olanzapine, appear to demonstrate some benefit for weight gain in anorexia nervosa, although are not advised as a stand-alone treatment. Transdermal administration of hormonal agents is also being explored for improving bone health in anorexia nervosa. Although pharmacotherapy has established utility in bulimia nervosa and BED, further research on medications for the treatment of eating disorders, particularly anorexia nervosa, is necessary.

Social skills: a factor of protection against eating disorders in adolescentes.

PubMed

Uzunian, Laura Giron; Vitalle, Maria Sylvia de Souza

2015-11-01

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.

Bridging the gap: does a specialist eating disorder service, aimed at developing a continuum of community care, make a difference?

PubMed

Newton, John; Bosanac, Peter; Mancuso, Sam; Castle, David

2013-08-01

In 2010, the authors identified in a separate publication, Mind the evidence gap, the sparse evidence-base for the treatment of adult anorexia nervosa and barriers to accessing care. We report on the ensuing development, implementation and first 18-month results of a novel eating disorder service bridging the primary and specialist continuum of care in Victoria, Australia. Using literature review, stakeholder, and consumer and carer consultation, a model for a community eating disorder service was developed and then implemented. All patients entering the service were then assessed at intake and, if they gave consent, at 12 month follow-up. From December 2010 to July 2012, 208 patients accessed The Body Image Eating Disorders Treatment and Recovery Service (BETRS). Fifty-three per cent had a diagnosis of anorexia nervosa and the mean number of co-morbid psychiatric diagnoses was two. Twenty-three per cent attended a day patient programme and showed a significant improvement in their body mass index. Measures of depression, anxiety and eating disorder symptomatology showed a concomitant, significant decrease. The development of BETRS has led to markedly improved access and effectiveness of specialist services in the region.

Subtyping adolescents with bulimia nervosa.

PubMed

Chen, Eunice Y; Le Grange, Daniel

2007-12-01

Cluster analyses of eating disorder patients have yielded a "dietary-depressive" subtype, typified by greater negative affect, and a "dietary" subtype, typified by dietary restraint. This study aimed to replicate these findings in an adolescent sample with bulimia nervosa (BN) from a randomized controlled trial and to examine the validity and reliability of this methodology. In the sample of BN adolescents (N=80), cluster analysis revealed a "dietary-depressive" subtype (37.5%) and a "dietary" subtype (62.5%) using the Beck Depression Inventory, Rosenberg Self-Esteem Scale and Eating Disorder Examination Restraint subscale. The "dietary-depressive" subtype compared to the "dietary" subtype was significantly more likely to: (1) report co-occurring disorders, (2) greater eating and weight concerns, and (3) less vomiting abstinence at post-treatment (all p's<.05). The cluster analysis based on "dietary" and "dietary-depressive" subtypes appeared to have concurrent validity, yielding more distinct groups than subtyping by vomiting frequency. In order to assess the reliability of the subtyping scheme, a larger sample of adolescents with mixed eating and weight disorders in an outpatient eating disorder clinic (N=149) was subtyped, yielding similar subtypes. These results support the validity and reliability of the subtyping strategy in two adolescent samples.

Identification and Evolutionary Analysis of Potential Candidate Genes in a Human Eating Disorder.

PubMed

Sabbagh, Ubadah; Mullegama, Saman; Wyckoff, Gerald J

2016-01-01

The purpose of this study was to find genes linked with eating disorders and associated with both metabolic and neural systems. Our operating hypothesis was that there are genetic factors underlying some eating disorders resting in both those pathways. Specifically, we are interested in disorders that may rest in both sleep and metabolic function, generally called Night Eating Syndrome (NES). A meta-analysis of the Gene Expression Omnibus targeting the mammalian nervous system, sleep, and obesity studies was performed, yielding numerous genes of interest. Through a text-based analysis of the results, a number of potential candidate genes were identified. VGF, in particular, appeared to be relevant both to obesity and, broadly, to brain or neural development. VGF is a highly connected protein that interacts with numerous targets via proteolytically digested peptides. We examined VGF from an evolutionary perspective to determine whether other available evidence supported a role for the gene in human disease. We conclude that some of the already identified variants in VGF from human polymorphism studies may contribute to eating disorders and obesity. Our data suggest that there is enough evidence to warrant eGWAS and GWAS analysis of these genes in NES patients in a case-control study.

Associations of Adolescent Emotional and Loss of Control Eating with 1-year Changes in Disordered Eating, Weight and Adiposity

PubMed Central

Stojek, Monika M. K.; Tanofsky-Kraff, Marian; Shomaker, Lauren B.; Kelly, Nichole R.; Thompson, Katherine A.; Mehari, Rim D.; Marwitz, Shannon E.; Demidowich, Andrew P.; Galescu, Ovidiu A.; Brady, Sheila M.; Yanovski, Susan Z.; Yanovski, Jack A.

2016-01-01

Objective Adolescent emotional-eating, referring to eating in response to negative affective states, is frequently reported by those with loss of control (LOC) eating. Although LOC eating has been shown to predict exacerbated disordered eating and excess weight/adiposity gain, the extent to which emotional-eating, either alone or in combination with LOC, predicts adverse outcomes has not been determined. Thus, we examined associations of baseline emotional-eating with changes in disordered eating, BMI, and adiposity over 1-year, and to what degree the presence or absence of baseline LOC moderated these associations. Methods 189 non-treatment-seeking youth (15.4±1.4y; 66% female; 67% non-Hispanic White, 38% overweight [BMI ≥85th %ile]) completed the emotional-eating Scale for Children/Adolescents and the Eating Disorder Examination interview at baseline and again at 1-year. Air displacement plethysmography assessed adiposity at both time points. Results Baseline emotional-eating alone was not significantly associated with the development of objective binge eating or changes in disordered eating attitudes, BMI or adiposity 1-year later. However, baseline emotional-eating interacted with the presence of baseline LOC in the prediction of 1-year outcomes. Among adolescents with LOC eating, greater baseline emotional-eating was related to increased disordered eating attitudes (p=.03), BMI (p=.04), and adiposity (p=.04) at 1-year, after correcting for false discovery rate. Discussion Emotional-eating among youth also reporting LOC was associated with adverse outcomes over 1-year. Adolescents who report both behaviors may represent a subset of individuals at especially high risk for exacerbated disordered eating and excess weight gain. PMID:27753140

More than half of high school students report disordered eating: a cross sectional study among Norwegian boys and girls.

PubMed

Torstveit, Monica Klungland; Aagedal-Mortensen, Kjersti; Stea, Tonje Holte

2015-01-01

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.

Prevention of Obesity and Eating Disorders: A Consideration of Shared Risk Factors

ERIC Educational Resources Information Center

Haines, Jess; Neumark-Sztainer, Dianne

2006-01-01

In response to the high prevalence of obesity, eating disorders and disordered eating behaviors among youth, researchers in both the obesity and eating disorders fields have proposed using an integrated approach to prevention that addresses the spectrum of weight-related disorders within interventions. The identification of risk factors that are…

Attribution and Eating Disorders: An Investigation of the Attribution Styles of College Women.

ERIC Educational Resources Information Center

Forsyth, John P.; And Others

Current research on eating disorders places considerable emphasis upon cognitive components of those disorders. The possibility of a specific eating disorder attributional style is suggested by attributional analyses of clinical depression. This study was conducted to examine attributional style and eating disorders among 55 college women who…

Regional grey matter volume abnormalities in bulimia nervosa and binge-eating disorder.

PubMed

Schäfer, Axel; Vaitl, Dieter; Schienle, Anne

2010-04-01

This study investigated whether bulimia nervosa (BN) and binge-eating disorder (BED) are associated with structural brain abnormalities. Both disorders share the main symptom binge-eating, but are considered differential diagnoses. We attempted to identify alterations in grey matter volume (GMV) that are present in both psychopathologies as well as disorder-specific GMV characteristics. Such information can help to improve neurobiological models of eating disorders and their classification. A total of 50 participants (patients suffering from BN (purge type), BED, and normal-weight controls) underwent structural MRI scanning. GMV for specific brain regions involved in food/reinforcement processing was analyzed by means of voxel-based morphometry. Both patient groups were characterized by greater volumes of the medial orbitofrontal cortex (OFC) compared to healthy controls. In BN patients, who had increased ventral striatum volumes, body mass index and purging severity were correlated with striatal grey matter volume. Altogether, our data implicate a crucial role of the medial OFC in the studied eating disorders. The structural abnormality might be associated with dysfunctions in food reward processing and/or self-regulation. The bulimia-specific volume enlargement of the ventral striatum is discussed in the framework of negative reinforcement through purging and associated weight regulation. Copyright 2009 Elsevier Inc. All rights reserved.

The Medical Complications Associated with Purging

PubMed Central

Forney, K. Jean; Buchman-Schmitt, Jennifer M.; Keel, Pamela K.; Frank, Guido K.W.

2015-01-01

Objective Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders. Here we review the major medical complications of these behaviors. Method Although we identified over 100 scholarly articles describing medical complications associated with purging, most papers involved case studies or small, uncontrolled samples. Given the limited evidence base, we conducted a qualitative (rather than systematic) review to identify medical complications that have been attributed to purging behaviors. Results Medical conditions affecting the teeth, esophagus, gastrointestinal system, kidneys, skin, cardiovascular system, and musculoskeletal system were identified, with self-induced vomiting causing the most medical complications. Conclusions Purging behavior can be associated with severe medical complications across all body systems. Mental health professionals should refer patients with purging behaviors to medical providers for screening and treatment as needed. The medical work-up for individuals with eating disorders should include a comprehensive metabolic panel, complete blood count, and a full body exam including the teeth to prevent severe complications. Medical providers should screen patients for purging behaviors and associated medical complications, even in the absence of an eating disorder diagnosis, to increase the detection of eating disorders. Recognizing the link between purging and medical complications can aid in identifying potential eating disorders, particularly those that often elude detection such as purging disorder. PMID:26876429

Snaps, Selfies, and Shares: How Three Popular Social Media Platforms Contribute to the Sociocultural Model of Disordered Eating Among Young Women.

PubMed

Saunders, Jessica F; Eaton, Asia A

2018-06-01

The current study aimed to integrate and test the sociocultural model of disordered eating with theories explaining the impact of mass media on the development of disordered eating for users of three popular social networking platforms. Young women social networking site (SNS) users (age 18-24) who had never received an eating disorder diagnosis (N = 637) completed questions capturing their SNS gratifications and usage, body surveillance, social comparisons, body dissatisfaction, and eating pathology. Measures were administered in one online session. Model relationships were similar across users of all three SNS platforms: Facebook, Instagram, and Snapchat. Users of all platforms demonstrated a significant positive relationship between upward comparisons and disordered eating outcomes, and between body surveillance and disordered eating outcomes, although differences between models did emerge. Empirical findings support extending the sociocultural model of disordered eating to include SNS uses and gratifications.

Psychosocial correlates of disordered eating in female collegiate athletes: validation of the ATHLETE questionnaire.

PubMed

Hinton, Pamela S; Kubas, Karen L

2005-01-01

Female athletes may be at greater risk for disordered eating than their nonathletic peers, but the psychological antecedents of this dysfunctional behavior in athletes have yet to be elucidated. The objective of this study was to develop an athletics-oriented measure of psychological predictors of disordered eating and to test its initial reliability and validity. Female athletes from 3 National Collegiate Athletics Association (NCAA) Division I universities completed the ATHLETE, a written questionnaire designed to assess psychosocial factors associated with disordered eating in athletes. Five distinct and internally consistent factors (Drive for Thinness and Performance, Social Pressure on Eating, Performance Perfectionism, Social Pressure on Body Shape, and Team Trust) were positively associated with and predictive of disordered eating behaviors in female athletes. The ATHLETE is a reliable and valid measure of psychological predictors of disordered eating in athletics and will be useful in studying the etiology of disordered eating in female athletes.

Attention Deficit Hyperactivity Disorder (ADHD) and disordered eating behaviour: A systematic review and a framework for future research.

PubMed

Kaisari, Panagiota; Dourish, Colin T; Higgs, Suzanne

2017-04-01

Preliminary findings suggest that Attention Deficit Hyperactivity Disorder (ADHD) may be associated with disordered eating behaviour, but whether there is sufficient evidence to suggest an association between ADHD and specific types of disordered eating behaviour is unclear. Furthermore, it is uncertain whether specific features associated with ADHD are differentially associated with disordered eating behaviour. A systematic review of seventy-five studies was conducted to evaluate the potential association between ADHD symptomatology and disordered eating behaviour and to provide an estimate of the strength of evidence for any association. Overall, a moderate strength of evidence exists for a positive association between ADHD and disordered eating and with specific types of disordered-eating behaviour, in particular, overeating behaviour. There is consistent evidence that impulsivity symptoms of ADHD are positively associated with overeating and bulimia nervosa and more limited evidence for an association between hyperactivity symptoms and restrictive eating in males but not females. Further research is required to assess the potential direction of the relationship between ADHD and disordered eating, the underlying mechanisms and the role of specific ADHD symptoms in the development and/or maintenance of disordered eating behaviour. We propose a framework that could be used to guide the design of future studies. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Eating disorders and the media.

PubMed

Giordano, Simona

2015-11-01

In June 2015, the newspapers in England once again pointed at the media industry as responsible for the spread of eating disorders. This article reviews this argument and previous research on the role of the media industry in the perpetration of images that may foster eating disorders. It has been recently argued, coherently with previous research, that the media may be responsible for the spread of eating disorders. This article reviews this literature, and evaluates what the real role of the media in the spread of eating disorders is. The article argues that considering the portrait of thin models in the media industry as responsible for eating disorders is a misanalysis of the problem and evaluates some of the more profound reasons that may lead to the adoption of the disordered eating symptomatology.

Acculturation, out-group positivity and eating disorders symptoms among Emirati women.

PubMed

Thomas, Justin; O'Hara, Lily; Quadflieg, Susanne; Weissgerber, Sophia Christin

2018-04-01

Western acculturation has been implicated in the development of eating disorders among populations living outside Europe and North America. This study explored the relationship between Western acculturation, in-group/out-group evaluations and eating disorders symptoms among female citizens of the United Arab Emirates (UAE). Emirati college women (N = 209) completed an affective priming task, designed to implicitly assess in-group (Emirati) and out-group (American) evaluations. Participants also completed the Westernization Survey, a widely used self-report measure of acculturation, and the Eating Attitudes Test (EAT-26). Across the whole sample, out-group positivity was correlated with higher levels of eating disorder symptoms. Participants classified as at risk for eating disorders showed a clear out-group preference (out-group positivity greater than in-group positivity). Western acculturation was also positively correlated with eating disorder symptoms. Overall, these findings lend further support to the acculturation hypothesis of eating disorders in the context of Emirati college women.

Risk of disordered eating attitudes among male adolescents in five Emirates of the United Arab Emirates.

PubMed

Musaiger, Abdulrahman O; Al-Mannai, Mariam; Al-Lalla, Osama

2014-12-01

The aim of this study was to highlight the prevalence of disordered eating attitudes among male adolescents in the United Arab Emirates (UAE). A multistage stratified sampling method was used to select 731 male students aged 15-18 years from five Emirates of the UAE. The Eating Attitudes Test (EAT-26) was used to determine the prevalence of disordered eating attitudes in students. The findings revealed that the proportion of disordered eating attitudes in the UAE was relatively high compared with many developing and developed countries and ranged from 33.1% to 49.1%. Moreover, students living in the Emirates of Dubai and Al-Fujairah have double the risk of having disordered eating attitudes compared with students living in the other Emirates. The results suggest the need for screening adolescents for eating disorders, as well as for increased awareness and understanding of eating disorders and their associated risk factors in all male adolescents in the UAE. © 2014 Wiley Periodicals, Inc.

Cognitive-behavioral therapy for eating disorders in primary care settings: Does it work, and does a greater dose make it more effective?

PubMed

Rose, Charlotte; Waller, Glenn

2017-12-01

This study aimed to determine whether cognitive-behavioral therapy (CBT) for eating disorders can be effective in a routine, primary care clinical setting, and to assess dose response. The participants were 47 patients who commenced treatment with a publicly-funded primary care eating disorder service. They attended 7-33 sessions of individual CBT (mean = 17), using an evidence-based approach. Routine measures were collected pre- and post-therapy. Three-quarters of the patients completed treatment. Using intention to treat analysis (multiple imputation), the patients showed substantial improvements in eating attitudes, bulimic behaviors, and depression. However, there was no association between the level of improvement and the length of therapy past the 8th to 12th session. The level of effectiveness shown here is comparable to that previously demonstrated by more specialist services in secondary and tertiary care. The nonlinear association between number of sessions and recovery highlights the importance of early change, across the eating disorders. © 2017 Wiley Periodicals, Inc.

Eating Behaviors and Obesity in African American and Caucasian Women

DTIC Science & Technology

2010-08-16

Disorder Diagnostic Scale [23] is a 22-item scale that is useful as a screening tool for Anorexia Nervosa , Bulimia Nervosa , and Binge Eating Disorder...Agreement between eating disorder diagnoses from the Eating Disorder Diagnostic Scale and those by clinical interview is high: 99% for Anorexia , 96...Diagnostic Scale revealed that only 24% of the total sample met criteria for Bulimia Nervosa or Binge Eating Disordered behavior (sub- or threshold

Eating disorder symptom trajectories in adolescence: effects of time, participant sex, and early adolescent depressive symptoms

PubMed Central

2013-01-01

Background Adolescence is a period of developmental risk for eating disorders and eating disorder symptoms. This study aimed to describe the prevalence and trajectory of five core eating disorder behaviours (binge eating, purging, fasting, following strict dietary rules, and hard exercise for weight control) and a continuous index of dietary restraint and eating, weight and shape concerns, in a cohort of male and female adolescents followed from 14 to 20 years. It also aimed to determine the effect of early adolescent depressive symptoms on the prevalence and trajectory of these different eating disorder symptoms. Participants (N = 1,383; 49% male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a prospective cohort study that has followed participants from pre-birth to age 20 years. An adapted version of the Eating Disorder Examination-Questionnaire was used to assess eating disorder symptoms at ages 14, 17 and 20 years. The Beck Depression Inventory for Youth was used to assess depressive symptoms at age 14. Longitudinal changes in the prevalence of eating disorder symptoms were tested using generalised estimating equations and linear mixed models. Results Symptom trajectories varied according to the eating disorder symptom studied, participant sex, and the presence of depressive symptoms in early adolescence. For males, eating disorder symptoms tended to be stable (for purging, fasting and hard exercise) or decreasing (for binge eating and global symptom scores) from 14 to 17 years, and then stable to 20 years. For females, fasting and global symptom scores increased from age 14 to peak in prevalence at age 17. Rates of binge eating in females were stable from age 14 to age 17 and increased significantly thereafter, whilst rates of purging and hard exercise increased from age 14 to age 17, and then remained elevated through to age 20. Depressive symptoms at age 14 impacted on eating disorder symptom trajectories in females, but not in males. Conclusions Prevention, screening and intervention initiatives for adolescent eating disorders need to be tailored to gender and age. Purging behaviour appears to be an important target for work with early to middle adolescent females. PMID:24999411

Eating disorder symptom trajectories in adolescence: effects of time, participant sex, and early adolescent depressive symptoms.

PubMed

Allen, Karina L; Crosby, Ross D; Oddy, Wendy H; Byrne, Susan M

2013-01-01

Adolescence is a period of developmental risk for eating disorders and eating disorder symptoms. This study aimed to describe the prevalence and trajectory of five core eating disorder behaviours (binge eating, purging, fasting, following strict dietary rules, and hard exercise for weight control) and a continuous index of dietary restraint and eating, weight and shape concerns, in a cohort of male and female adolescents followed from 14 to 20 years. It also aimed to determine the effect of early adolescent depressive symptoms on the prevalence and trajectory of these different eating disorder symptoms. Participants (N = 1,383; 49% male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a prospective cohort study that has followed participants from pre-birth to age 20 years. An adapted version of the Eating Disorder Examination-Questionnaire was used to assess eating disorder symptoms at ages 14, 17 and 20 years. The Beck Depression Inventory for Youth was used to assess depressive symptoms at age 14. Longitudinal changes in the prevalence of eating disorder symptoms were tested using generalised estimating equations and linear mixed models. Symptom trajectories varied according to the eating disorder symptom studied, participant sex, and the presence of depressive symptoms in early adolescence. For males, eating disorder symptoms tended to be stable (for purging, fasting and hard exercise) or decreasing (for binge eating and global symptom scores) from 14 to 17 years, and then stable to 20 years. For females, fasting and global symptom scores increased from age 14 to peak in prevalence at age 17. Rates of binge eating in females were stable from age 14 to age 17 and increased significantly thereafter, whilst rates of purging and hard exercise increased from age 14 to age 17, and then remained elevated through to age 20. Depressive symptoms at age 14 impacted on eating disorder symptom trajectories in females, but not in males. Prevention, screening and intervention initiatives for adolescent eating disorders need to be tailored to gender and age. Purging behaviour appears to be an important target for work with early to middle adolescent females.

Eating disorder-specific risk factors moderate the relationship between negative urgency and binge eating: A behavioral genetic investigation.

PubMed

Racine, Sarah E; VanHuysse, Jessica L; Keel, Pamela K; Burt, S Alexandra; Neale, Michael C; Boker, Steven; Klump, Kelly L

2017-07-01

Theoretical models of binge eating and eating disorders include both transdiagnostic and eating disorder-specific risk factors. Negative urgency (i.e., the tendency to act impulsively when distressed) is a critical transdiagnostic risk factor for binge eating, but limited research has examined interactions between negative urgency and disorder-specific variables. Investigating these interactions can help identify the circumstances under which negative urgency is most strongly associated with binge eating. We examined whether prominent risk factors (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint) specified in well-established etiologic models of eating disorders moderate negative urgency-binge eating associations. Further, we investigated whether phenotypic moderation effects were due to genetic and/or environmental associations between negative urgency and binge eating. Participants were 988 female twins aged 11-25 years from the Michigan State University Twin Registry. Appearance pressures, thin-ideal internalization, and body dissatisfaction, but not dietary restraint, significantly moderated negative urgency-binge eating associations, with high levels of these risk factors and high negative urgency associated with the greatest binge eating. Twin moderation models revealed that genetic, but not environmental, sharing between negative urgency and binge eating was enhanced at higher levels of these eating disorder-specific variables. Future longitudinal research should investigate whether eating disorder risk factors shape genetic influences on negative urgency into manifesting as binge eating. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Implicit out-group preference is associated with eating disorders symptoms amongst Emirati females.

PubMed

Thomas, Justin; Quadflieg, Susanne; O'Hara, Lily

2016-04-01

Studies exploring the relationship between acculturation and eating disorders symptoms have proven equivocal. Socially desirable responding associated with the use of explicit measures may account for these mixed findings. This study explores the relationship between in-group identity, acculturation and eating disorders symptoms using both implicit and explicit assessments. Emirati female college students (N=94) completed an affective priming task (APT) designed to implicitly assess Emirati in-group evaluations. Participants also completed explicit measures, including the Westernization Survey and the Multicomponent In-group Identification Scale. Eating disorders symptoms were assessed using the Eating Attitudes Test. Only implicit in-group evaluations were correlated with eating disorders symptoms. Specifically, increases in in-group preference were associated with lower levels of eating disorders symptomatology. Furthermore, participants with an actual out-group preference had significantly higher levels of eating disorders symptomatology compared with those demonstrating an in-group preference. These findings support the acculturative stress hypothesis, and suggest that the relationship between eating disorders and acculturation may be better understood with reference to implicit rather than explicit in-group evaluations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study

PubMed Central

Neumark-Sztainer, Dianne; Wall, Melanie; Larson, Nicole I.; Eisenberg, Marla E.; Loth, Katie

2011-01-01

Background Disordered eating behaviors are prevalent in adolescence and can have harmful consequences. An important question is whether use of these behaviors in adolescence sets the pattern for continued use into young adulthood. Objective To examine the prevalence and tracking of dieting, unhealthy and extreme weight control behaviors, and binge eating from adolescence to young adulthood. Design Population-based, 10-year longitudinal study (Project EAT-III: Eating Among Teens and Young Adults, 1999–2010). Participants/setting The study population includes 2,287 young adults (55% female, 52% non-white). The sample includes a younger group (mean age = 12.8±0.7 years at baseline and 23.2±1.0 years at follow-up) and an older group (mean age = 15.9±0.8 at baseline and 26.2±0.9 years at follow-up). Statistical analyses performed Longitudinal trends in prevalence of behaviors were tested using generalized estimating equations. Tracking of behaviors were estimated using the relative risk of behaviors at follow-up given presence at baseline. Results In general, the prevalence of dieting and disordered eating was high and remained constant, or increased, from adolescence to young adulthood. Furthermore, behaviors tended to track within individuals and, in general, participants who engaged in dieting and disordered eating behaviors during adolescence were at increased risk for these behaviors ten years later. Tracking was particularly consistent for the older females and males transitioning from middle adolescence to middle young adulthood. Conclusions Study findings indicate that disordered eating behaviors are not just an adolescent problem, but continue to be prevalent among young adults. The tracking of dieting and disordered eating within individuals suggests that early use is likely to set the stage for ongoing use. Findings suggest a need for both early prevention efforts prior to the onset of harmful behavioral patterns, as well as ongoing prevention and treatment interventions to address the high prevalence of disordered eating throughout adolescence and young adulthood. PMID:21703378

Disordered Eating among Female Adolescents: Prevalence, Risk Factors, and Consequences

ERIC Educational Resources Information Center

Bryla, Karen Y.

2003-01-01

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…

Understanding the roles of self-esteem, self-compassion, and fear of self-compassion in eating disorder pathology: an examination of female students and eating disorder patients.

PubMed

Kelly, Allison C; Vimalakanthan, Kiruthiha; Carter, Jacqueline C

2014-08-01

The present study examined the relative contributions of self-compassion, fear of self-compassion, and self-esteem in eating disorder pathology. One-hundred and fifty-five female undergraduate students and 97 females entering eating disorder treatment completed the Self-Compassion Scale, Fears of Compassion Scale, Rosenberg Self-Esteem Inventory, and Eating Disorder Examination Questionnaire. T-tests revealed that the patient group had lower mean self-compassion and higher mean fear of self-compassion than the student group. When controlling for self-esteem, high fear of self-compassion emerged as the strongest predictor of eating disorder pathology in the patient group, whereas low self-compassion was the strongest predictor in the student group. These preliminary results suggest that targeting fear of self-compassion may be important when intervening with individuals suffering from an eating disorder, whereas building self-compassion may be a valuable approach for eating disorder prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Food for thought: comparison of citations received from articles appearing in specialized eating disorder journals versus general psychiatry journals.

PubMed

Soh, Nerissa; Walter, Garry; Touyz, Stephen; Russell, Janice; Malhi, Gin S; Hunt, Glenn E

2012-12-01

To conduct a bibliometric analysis of eating disorder journals to guide journal readers and researchers when submitting their manuscripts. Several indices were used to compare journal impact and citations of articles appearing between 1996 and 2010 in six eating disorders journals and six leading general psychiatry journals. The International Journal of Eating Disorders (IJED) had the highest journal impact factor (JIF, 2.278) of the six eating disorders' journals. The general psychiatry journals had higher JIFs and received more citations per eating disorder article than the specialized journals. However, IJED published the highest number of eating disorder articles between 1996 and 2010, and 35 of these articles received at least 100 citations. Using the JIF alone to decide where to submit a manuscript is a poor strategy, as this does not take into consideration the impact an article can have within the eating disorder's field over time. Copyright © 2012 Wiley Periodicals, Inc.

Adolescent eating disorder behaviours and cognitions: gender-specific effects of child, maternal and family risk factors

PubMed Central

Micali, N.; De Stavola, B.; Ploubidis, G.; Simonoff, E.; Treasure, J.; Field, A. E.

2015-01-01

Background Eating disorder behaviours begin in adolescence. Few longitudinal studies have investigated childhood risk and protective factors. Aims To investigate the prevalence of eating disorder behaviours and cognitions and associated childhood psychological, physical and parental risk factors among a cohort of 14-year-old children. Method Data were collected from 6140 boys and girls aged 14 years. Gender-stratified models were used to estimate prospective associations between childhood body dissatisfaction, body mass index (BMI), self-esteem, maternal eating disorder and family economic disadvantage on adolescent eating disorder behaviours and cognitions. Results Childhood body dissatisfaction strongly predicted eating disorder cognitions in girls, but only in interaction with BMI in boys. Higher self-esteem had a protective effect, particularly in boys. Maternal eating disorder predicted body dissatisfaction and weight/shape concern in adolescent girls and dieting in boys. Conclusions Risk factors for eating disorder behaviours and cognitions vary according to gender. Prevention strategies should be gender-specific and target modifiable predictors in childhood and early adolescence. PMID:26206865

[Consensus document about the nutritional evaluation and management of eating disorders: bulimia nervosa, binge eating disorder, and others].

PubMed

Gómez Candela, Carmen; Palma Milla, Samara; Miján-de-la-Torre, Alberto; Rodríguez Ortega, Pilar; Matía Martín, Pilar; Loria Cohen, Viviana; Campos Del Portillo, Rocío; Virgili Casas, M ª Nuria; Martínez Olmos, Miguel Á; Mories Álvarez, M ª Teresa; Castro Alija, M ª José; Martín-Palmero, Ángela

2018-03-07

Bulimia nervosa and binge eating disorder are unique nosological entities. Both show a large variability related to its presentation and severity which involves different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. Patients with bulimia nervosa may suffer from malnutrition and deficiency states or even excess weight, while in binge eating disorders, it is common overweight or obesity, which determine other comorbidities. Many of the symptoms and complications are associated with compensatory behaviors. There are many therapeutic tools available for the treatment of these patients. The nutritional approach contemplates the individualized dietary advice which guarantees an adequate nutritional state and nutritional education. Its objective is to facilitate the voluntary adoption of eating behaviors that promote health and allow the long-term modification of eating habits and the cessation of purgatory and bingeing behaviors. Psychological support is a first-line treatment and it must address the frequent disorder of eating behavior and psychiatric comorbidities. Psychotropic drugs are effective and widely used although these drugs are not essential. The management is carried out mainly at an outpatient level, being the day hospital useful in selected patients. Hospitalization should be reserved to correct serious somatic or psychiatric complications or as a measure to contain non-treatable conflict situations. Most of the guidelines' recommendations are based on expert consensus, with little evidence which evaluates clinical results and cost-effectiveness.

Eating disorder symptomatology among ballet dancers.

PubMed

Ringham, Rebecca; Klump, Kelly; Kaye, Walter; Stone, David; Libman, Steven; Stowe, Susan; Marcus, Marsha

2006-09-01

The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders. Copyright (c) 2006 by Wiley Periodicals, Inc.

Picking or nibbling: frequency and associated clinical features in bulimia nervosa, anorexia nervosa, and binge eating disorder.

PubMed

Conceição, Eva M; Crosby, Ross; Mitchell, James E; Engel, Scott G; Wonderlich, Stephen A; Simonich, Heather K; Peterson, Caroline B; Crow, Scott J; Le Grange, Daniel

2013-12-01

Picking or ribbling (P&N) is a newly studied eating behavior characterized by eating in an unplanned and repetitious manner in between meals and snacks. This behavior seems to be related to poorer weight loss outcomes after bariatric surgery for weight loss in severely obese patients, but clarification is still required regarding its value in other clinical samples. The purpose of this study was to investigate the frequency of P&N across different eating disorder samples, as well as to examine its association with psychopathological eating disorder features. Our sample included treatment-seeking adult participants, recruited for five different clinical trials: 259 binge eating disorder (BED); 264 bulimia nervosa (BN), and 137 anorexia nervosa (AN). Participants were assessed using the Eating Disorders Examination interview before entering the clinical trials. P&N was reported by 44% of the BED; 57.6% of the BN; and 34.3% of the AN participants. No association was found between P&N and BMI, the presence of compensatory behaviors, binge eating, or any of the eating disorder examination subscales. This study suggests that P&N behavior is highly prevalent across eating disorder diagnoses, but it is not associated with psychopathology symptoms or other eating disordered behaviors. Copyright © 2013 Wiley Periodicals, Inc.

VREPAR 2: VR in eating disorders.

PubMed

Riva, G; Bacchetta, M; Baruffi, M; Defrance, C; Gatti, F; Galimberti, C; Nugues, P; Ferretti, G S; Tonci, A

1999-01-01

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.

Self-esteem, diet self-efficacy, body mass index, and eating disorders: modeling effects in an ethnically diverse sample.

PubMed

Saunders, Jessica F; Frazier, Leslie D; Nichols-Lopez, Kristin A

2016-09-01

Disordered eating patterns, particularly binge eating, are prevalent in Hispanic samples, yet the biopsychosocial risk factors remain understudied in minority populations. The relationship between diet self-efficacy and bulimic symptoms has been established in non-Hispanic white samples but not yet in Hispanics. This study sought to identify the direct role of diet self-efficacy on eating disorder risk and symptomology in a multicultural Hispanic sample, and to investigate the potential indirect relations among diet self-efficacy, self-esteem, body mass index (BMI), and eating disorder risk and symptomology in Hispanics and non-Hispanic whites. The present study surveyed 1339 college students from diverse ethnic backgrounds. Participants completed four standardized scales to assess acculturation, diet self-efficacy, global self-esteem, and eating disorder symptomology and risk. Self-reported height and weight were used for BMI calculations, and the data were analyzed in a robust maximum-likelihood structural equation modeling (SEM) framework. The findings highlighted diet self-efficacy as a predictor of eating disorder risk and symptomology. Diet self-efficacy partially explained the covariation between self-esteem and eating disorder risk and symptomology, and between BMI and eating disorder risk and symptomology for the entire sample. Diet self-efficacy emerged as an important construct to consider in developing eating disorder prevention and treatment models.

Prevalence of eating disorders amongst dancers: a systemic review and meta-analysis.

PubMed

Arcelus, Jon; Witcomb, Gemma L; Mitchell, Alex

2014-03-01

Eating disorders in dancers are thought to be common, but the exact rates remain to be clarified. The aim of this study is to systematically compile and analyse the rates of eating disorders in dancers. A literature search, appraisal and meta-analysis were conducted. Thirty-three relevant studies were published between 1966 and 2013 with sufficient data for extraction. Primary data were extracted as raw numbers or confidence intervals. Risk ratios and 95% confidence intervals were calculated for controlled studies. The overall prevalence of eating disorders was 12.0% (16.4% for ballet dancers), 2.0% (4% for ballet dancers) for anorexia, 4.4% (2% for ballet dancers) for bulimia and 9.5% (14.9% for ballet dancers) for eating disorders not otherwise specified (EDNOS). The dancer group had higher mean scores on the EAT-26 and the Eating Disorder Inventory subscales. Dancers, in general, had a higher risk of suffering from eating disorders in general, anorexia nervosa and EDNOS, but no higher risk of suffering from bulimia nervosa. The study concluded that as dancers had a three times higher risk of suffering from eating disorders, particularly anorexia nervosa and EDNOS, specifically designed services for this population should be considered. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Are Eating Disorders Related to Attention Deficit/Hyperactivity Disorder?

PubMed Central

Reinblatt, Shauna P.

2016-01-01

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

Identification and Management of Eating Disorders in Integrated Primary Care: Recommendations for Psychologists in Integrated Care Settings.

PubMed

Buchholz, Laura J; King, Paul R; Wray, Laura O

2017-06-01

Eating disorders are associated with deleterious health consequences, increased risk of mortality, and psychosocial impairment. Although individuals with eating disorders are likely to seek treatment in general medical settings such as primary care (PC), these conditions are often under-detected by PC providers. However, psychologists in integrated PC settings are likely to see patients with eating disorders because of the mental health comorbidities associated with these conditions. Further, due to their training in identifying risk factors associated with eating disorders (i.e., comorbid mental health and medical disorders) and opportunities for collaboration with PC providers, psychologists are well-positioned to improve the detection and management of eating disorders in PC. This paper provides a brief overview of eating disorders and practical guidance for psychologists working in integrated PC settings to facilitate the identification and management of these conditions.

Eating Attitudes Test and Eating Disorders Inventory: Norms for Adolescent Girls and Boys.

ERIC Educational Resources Information Center

Rosen, James C.; And Others

1988-01-01

Collected normative data on 1,373 high school boys and girls in grades 9 through 12, on the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI), used to measure symptoms of eating disorders. Obtained significant sex, but not age, differences, and some racial and socioeconomic differences among the girls. (Author/KS)

Obstetric and Gynecologic Problems Associated with Eating Disorders

PubMed Central

Kimmel, M.C.; Ferguson, E.H.; Zerwas, S.; Bulik, C.M.; Meltzer-Brody, S.

2017-01-01

Objective This article summarizes the literature on obstetric and gynecologic complications associated with eating disorders. Method We performed a comprehensive search of the current literature on obstetric and gynecologic complications associated with eating disorders using PubMed. More recent randomized-controlled trials and larger data sets received priority. We also chose those that we felt would be the most relevant to providers. Results Common obstetric and gynecologic complications for women with eating disorders include infertility, unplanned pregnancy, miscarriage, poor nutrition during pregnancy, having a baby with small head circumference, postpartum depression and anxiety, sexual dysfunction and complications in the treatment for gynecologic cancers. There are also unique associations by eating disorder diagnosis, such as earlier cessation of breastfeeding in anorexia nervosa; increased polycystic ovarian syndrome in bulimia nervosa; and complications of obesity as a result of binge eating disorder. Discussion We focus on possible biological and psychosocial factors underpinning risk for poor obstetric and gynecological outcomes in eating disorders. Understanding these factors may improve both our understanding of the reproductive needs of women with eating disorders and their medical outcomes. We also highlight the importance of building multidisciplinary teams to provide comprehensive care to women with eating disorders during the reproductive years. PMID:26711005

Social and emotional processing as a behavioural endophenotype in eating disorders: a pilot investigation in twins.

PubMed

Kanakam, Natalie; Krug, Isabel; Raoult, Charlotte; Collier, David; Treasure, Janet

2013-07-01

Emotional processing difficulties are potential risk markers for eating disorders that are also present after recovery. The aim of this study was to examine these traits in twins with eating disorders. The Reading the Mind in the Eyes test, Emotional Stroop task and the Difficulties in Emotion Regulation Scale were administered to 112 twins with and without eating disorders (DSM IV-TR eating disorder criteria). Generalised estimating equations compared twins with eating disorders against unaffected co-twins and control twins, and within-pair correlations were calculated for clinical monozygotic (n = 50) and dizygotic twins (n = 20). Emotion recognition difficulties, attentional biases to social threat and difficulties in emotion regulation were greater in twins with eating disorders, and some were present in their unaffected twin siblings. Evidence for a possible genetic basis was highest for emotion recognition and attentional biases to social stimuli. Emotion recognition difficulties and sensitivity to social threat appear to be endophenotypes associated with eating disorders. However, the limited statistical power means that these findings are tentative and require further replication. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

The role of body image psychological flexibility on the treatment of eating disorders in a residential facility.

PubMed

Bluett, E J; Lee, E B; Simone, M; Lockhart, G; Twohig, M P; Lensegrav-Benson, Tera; Quakenbush-Roberts, Benita

2016-12-01

The purpose of this study was to test whether pre-treatment levels of psychological flexibility would longitudinally predict quality of life and eating disorder risk in patients at a residential treatment facility for eating disorders. Data on body image psychological flexibility, quality of life, and eating disorder risk were collected from 63 adolescent and 50 adult, female, residential patients (N=113) diagnosed with an eating disorder. These same measures were again collected at post-treatment. Sequential multiple regression analyses were performed to test whether pre-treatment levels of psychological flexibility longitudinally predicted quality of life and eating disorder risk after controlling for age and baseline effects. Pre-treatment psychological flexibility significantly predicted post-treatment quality of life with approximately 19% of the variation being attributable to age and pre-treatment psychological flexibility. Pre-treatment psychological flexibility also significantly predicted post-treatment eating disorder risk with nearly 30% of the variation attributed to age and pre-treatment psychological flexibility. This study suggests that levels of psychological flexibility upon entering treatment for an eating disorder longitudinally predict eating disorder outcome and quality of life. Copyright © 2016 Elsevier Ltd. All rights reserved.

A narrative review of schemas and schema therapy outcomes in the eating disorders.

PubMed

Pugh, Matthew

2015-07-01

Whilst cognitive-behavioural therapy has demonstrated efficacy in the treatment of eating disorders, therapy outcomes and current conceptualizations still remain inadequate. In light of these shortcomings there has been growing interest in the utility of schema therapy applied to eating pathology. The present article first provides a narrative review of empirical literature exploring schemas and schema processes in eating disorders. Secondly, it critically evaluates outcome studies assessing schema therapy applied to eating disorders. Current evidence lends support to schema-focused conceptualizations of eating pathology and confirms that eating disorders are characterised by pronounced maladaptive schemas. Treatment outcomes also indicate that schema therapy, the schema-mode approach, and associated techniques are promising interventions for complex eating disorders. Implications for clinical practice and future directions for research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intensive enhanced cognitive behavioural therapy for severe and enduring anorexia nervosa: A longitudinal outcome study.

PubMed

Calugi, Simona; El Ghoch, Marwan; Dalle Grave, Riccardo

2017-02-01

This study aimed to evaluate short- and long-term outcomes in patients with severe and enduring anorexia nervosa (SE-AN), as compared with those with non SE-AN (NSE-AN), both treated via an inpatient programme based on a "recovery model" approach. Sixty-six adult patients with anorexia nervosa (AN) were recruited from among consecutive referrals to a community-based eating disorder clinic offering inpatient enhanced cognitive behavioural therapy for eating disorders (CBT-E). Body mass index (BMI), and Eating Disorder Examination (EDE) and Brief Symptom Inventory (BSI) scores were recorded at admission, at the end of treatment, and at 6- and 12-month follow-ups. Thirty-two patients (48.5%) were classified as SE-AN (i.e., duration of illness >7 years), and 34 (51.5%) as NSE-AN. During the treatment, both groups displayed similarly large increases in BMI, as well as improvements in eating-disorder and general psychopathology. After discharge minor deterioration did occur, but both NSE-AN and SE-AN groups showed similar rates of 'good BMI outcome' (BM ≥ 18.5; 44.0% and 40.7%, respectively) and 'full response' (BMI ≥ 18.5 and minimal eating-disorder psychopathology; 32.0% and 33.3%, respectively) at 12-month follow-up. These findings suggest that inpatient CBT-E is well accepted by patients with AN, and could also be a viable and promising treatment for those with SE-AN. Copyright © 2016 Elsevier Ltd. All rights reserved.

A commentary on the "eating addiction" versus "food addiction" perspectives on addictive-like food consumption.

PubMed

Schulte, Erica M; Potenza, Marc N; Gearhardt, Ashley N

2017-08-01

The food addiction construct posits that vulnerable individuals may experience an addictive-like response to certain foods, such as those high in fat and refined carbohydrates. Recently, an alternative model to food addiction was proposed, suggesting that the act of eating may be a behavioral addiction that can trigger an addictive-like response in susceptible individuals. One major rationale for the eating addiction framework is that the assessment of food addiction is based on behavioral indicators, such as consuming greater quantities of food than intended and eating certain foods despite negative consequences. It is also suggested that the lack of investigation into which foods and food attributes (e.g., sugar) may have an addictive potential is evidence that food addiction does not parallel a substance-based addiction and more closely resembles a behavioral addiction. The present paper provides a commentary suggesting that the substance-based, food-addiction framework is more appropriate than the behavioral-addiction, eating-addiction perspective to conceptualize addictive-like food consumption. In order to illustrate this point, this manuscript will discuss behavioral components characteristic of all substance-use disorders, preliminary evidence to suggest that all foods are not equally associated with addictive-like eating, and key differences between the hypothesized eating addiction phenotype and the only existing behavioral addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder. Further, this paper will consider implications of applying an addiction label to food versus eating and suggest future research directions to evaluate whether food addiction is a valid and clinically useful construct. Copyright © 2016 Elsevier Ltd. All rights reserved.

Facebook Use and Disordered Eating in College-Aged Women.

PubMed

Walker, Morgan; Thornton, Laura; De Choudhury, Munmun; Teevan, Jaime; Bulik, Cynthia M; Levinson, Cheri A; Zerwas, Stephanie

2015-08-01

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 eating 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. 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. 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. 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. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Network analysis of pediatric eating disorder symptoms in a treatment-seeking, transdiagnostic sample.

PubMed

Goldschmidt, Andrea B; Crosby, Ross D; Cao, Li; Moessner, Markus; Forbush, Kelsie T; Accurso, Erin C; Le Grange, Daniel

2018-02-01

Classifying eating disorders in youth is challenging in light of developmental considerations and high rates of diagnostic migration. Understanding the transactional relationships among eating disorder symptoms, both across the transdiagnostic spectrum and within specific diagnostic categories, may clarify which core eating disorder symptoms contribute to, and maintain, eating-related psychopathology in youth. We utilized network analysis to investigate interrelationships among eating disorder symptoms in 636 treatment-seeking children and adolescents (90.3% female) ages 6-18 years (M age = 15.4 ± 2.2). An undirected, weighted network of eating disorder symptoms was created using behavioral and attitudinal items from the Eating Disorder Examination. Across diagnostic groups, symptoms reflecting appearance-related concerns (e.g., dissatisfaction with shape and weight) and dietary restraint (e.g., a desire to have an empty stomach) were most strongly associated with other eating disorder symptoms in the network. Binge eating and compensatory behaviors (e.g., self-induced vomiting) were strongly connected to one another but not to other symptoms in the network. Network connectivity was similar across anorexia nervosa, bulimia nervosa, and otherwise specified feeding or eating disorder subgroups. Among treatment-seeking children and adolescents, dietary restraint and shape- and weight-related concerns appear to play key roles in the psychopathology of eating disorders, supporting cognitive-behavioral theories of onset and maintenance. Similarities across diagnostic categories provide support for a transdiagnostic classification scheme. Clinical interventions should seek to disrupt these symptoms early in treatment to achieve maximal outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Eating Disorder Symptomatology and Identity Formation in Adolescence: A Cross-Lagged Longitudinal Approach.

PubMed

Verschueren, Margaux; Claes, Laurence; Bogaerts, Annabel; Palmeroni, Nina; Gandhi, Amarendra; Moons, Philip; Luyckx, Koen

2018-01-01

Introduction: Eating disorder symptomatology, comprising both psychological and behavioral aspects of subclinical eating concerns, constitutes a clear precursor of developing eating disorders. It is crucial to investigate its antecedents and correlates to subsequently inform eating disorder prevention programs. The present study focused on identity formation, a core developmental task in adolescence, that has increasingly been linked to eating disorder development. Our main aim was to examine the temporal sequence between eating disorder symptomatology and identity formation. Methods: Data on eating disorder symptomatology and identity formation were collected in 530 high school students (at Time 1: mean age = 15 years; SD = 1.84; range: 12-18 years; 50.6% females) using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modeling was performed to examine the directionality of effects. Results: Results indicated bidirectional effects between eating disorder symptomatology and identity formation. Identity confusion seemed to increase vulnerability to body dissatisfaction and bulimia symptoms, whereas identity synthesis seemed to protect against their development. Additionally, identity synthesis seemed to protect against the development of drive for thinness as well. At the same time, body dissatisfaction and bulimia symptoms positively predicted identity confusion and negatively predicted identity synthesis over time. Conclusion: The present study adds to the growing body of literature on identity and eating disorders by focusing on their temporal interplay in a community sample of adolescents. As bidirectional effects emerged, a greater emphasis on identity formation in eating disorder prevention programs is advocated.

Eating Disorder Symptomatology and Identity Formation in Adolescence: A Cross-Lagged Longitudinal Approach

PubMed Central

Verschueren, Margaux; Claes, Laurence; Bogaerts, Annabel; Palmeroni, Nina; Gandhi, Amarendra; Moons, Philip; Luyckx, Koen

2018-01-01

Introduction: Eating disorder symptomatology, comprising both psychological and behavioral aspects of subclinical eating concerns, constitutes a clear precursor of developing eating disorders. It is crucial to investigate its antecedents and correlates to subsequently inform eating disorder prevention programs. The present study focused on identity formation, a core developmental task in adolescence, that has increasingly been linked to eating disorder development. Our main aim was to examine the temporal sequence between eating disorder symptomatology and identity formation. Methods: Data on eating disorder symptomatology and identity formation were collected in 530 high school students (at Time 1: mean age = 15 years; SD = 1.84; range: 12–18 years; 50.6% females) using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modeling was performed to examine the directionality of effects. Results: Results indicated bidirectional effects between eating disorder symptomatology and identity formation. Identity confusion seemed to increase vulnerability to body dissatisfaction and bulimia symptoms, whereas identity synthesis seemed to protect against their development. Additionally, identity synthesis seemed to protect against the development of drive for thinness as well. At the same time, body dissatisfaction and bulimia symptoms positively predicted identity confusion and negatively predicted identity synthesis over time. Conclusion: The present study adds to the growing body of literature on identity and eating disorders by focusing on their temporal interplay in a community sample of adolescents. As bidirectional effects emerged, a greater emphasis on identity formation in eating disorder prevention programs is advocated. PMID:29915548

"It's exercise or nothing": a qualitative analysis of exercise dependence

PubMed Central

Bamber, D; Cockerill, I; Rodgers, S; Carroll, D

2000-01-01

Objectives—To explore, using qualitative methods, the concept of exercise dependence. Semistructured interviews were undertaken with subjects screened for exercise dependence and eating disorders. Methods—Female exercisers, four in each case, were allocated a priori to four groups: primary exercise dependent; secondary exercise dependent, where there was a coincidence of exercise dependence and an eating disorder; eating disordered; control, where there was no evidence of either exercise dependence or eating disorder. They were asked about their exercise and eating attitudes and behaviour, as well as about any history of psychological distress. Their narratives were taped, transcribed, and analysed from a social constructionist perspective using QSR NUD*IST. Results—Participants classified as primary exercise dependent either showed no evidence of exercise dependent attitudes and behaviour or, if they exhibited features of exercise dependence, displayed symptoms of an eating disorder. Only the latter reported a history of psychological distress, similar to that exhibited by women classified as secondary exercise dependent or eating disordered. For secondary exercise dependent and eating disordered women, as well as for controls, the narratives largely confirmed the a priori classification. Conclusions—Where exercise dependence was manifest, it was always in the context of an eating disorder, and it was this co-morbidity, in addition to eating disorders per se, that was associated with psychological distress. As such, these qualitative data support the concept of secondary, but not primary, exercise dependence. Key Words: exercise dependence; eating disorders; psychological distress; anorexia; bulimia PMID:11131229

The effects of restaurant menu calorie labeling on hypothetical meal choices of females with disordered eating.

PubMed

Haynos, Ann F; Roberto, Christina A

2017-03-01

Concerns have been raised that obesity public policy measures may have harmful effects on individuals with eating disorders. However, little research has investigated this topic. We examined the impact of a popular obesity public policy, menu calorie labeling, on hypothetical food choices of women with disordered eating. Seven hundred sixteen adult females completed an online survey in which they were randomly assigned to receive a restaurant menu with or without calorie information listed. Participants selected foods representative of a meal they would choose to consume and answered questions on restaurant ordering and menu labeling. Participants completed the Eating Disorder Examination Questionnaire (Fairburn & Beglin, ) to assess global eating pathology. Diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) were also derived from this measure. Generalized linear modeling examined the impact of menu label condition, disordered eating, and the menu label by disordered eating interaction on hypothetical food selection and related variables. When disordered eating was examined continuously, menu labeling did not differentially affect food selections of those with elevated disordered eating (p = .45). However, when examined by eating disorder diagnosis, participants with AN or BN ordered significantly fewer (p < .001) and participants with BED ordered significantly more (p = .001) calories in the menu label versus no label condition. Menu labeling may decrease the calories ordered among individuals with AN or BN and increase calories ordered among individuals with BED. © 2017 Wiley Periodicals, Inc.

The Role of Ghrelin, Salivary Secretions, and Dental Care in Eating Disorders

PubMed Central

Yagi, Takakazu; Ueda, Hirotaka; Amitani, Haruka; Asakawa, Akihiro; Miyawaki, Shouichi; Inui, Akio

2012-01-01

Eating disorders, including anorexia and bulimia nervosa, are potentially life-threatening syndromes characterized by severe disturbances in eating behavior. An effective treatment strategy for these conditions remains to be established, as patients with eating disorders tend to suffer from multiple relapses. Because ghrelin was originally discovered in the stomach mucosa, it has been widely studied over the past decade in an effort to uncover its potential roles; these studies have shed light on the mechanism by which ghrelin regulates food intake. Thus, studying ghrelin in the context of eating disorders could improve our understanding of the pathogenesis of eating disorders, possibly resulting in a promising new pharmacological treatment strategy for these patients. In addition, early detection and treatment of eating disorders are critical for ensuring recovery of young patients. Oral symptoms, including mucosal, dental, and saliva abnormalities, are typically observed in the early stages of eating disorders. Although oral care is not directly related to the treatment of eating disorders, knowledge of the oral manifestations of eating disorder patients may aid in early detection, resulting in earlier treatment; thus, oral care might contribute to overall patient management and prognosis. Moreover, ghrelin has also been found in saliva, which may be responsible for oral hygiene and digestion-related functions. This review discusses the pharmacological potential of ghrelin in regulating food-intake and the role of saliva and oral care in young patients with eating disorders. PMID:23016127

The effects of restaurant menu calorie labeling on hypothetical meal choices of females with disordered eating

PubMed Central

Haynos, Ann F.; Roberto, Christina A.

2017-01-01

Objective Concerns have been raised that obesity public policy measures may have harmful effects on individuals with eating disorders. However, little research has investigated this topic. We examined the impact of a popular obesity public policy, menu calorie labeling, on hypothetical food choices of women with disordered eating. Methods 716 adult females completed an online survey in which they were randomly assigned to receive a restaurant menu with or without calorie information listed. Participants selected foods representative of a meal they would choose to consume and answered questions on restaurant ordering and menu labeling. Participants completed the Eating Disorder Examination Questionnaire (Fairburn & Beglin, 1994) to assess global eating pathology. Diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) were also derived from this measure. Generalized linear modeling examined the impact of menu label condition, disordered eating, and the menu label by disordered eating interaction on hypothetical food selection and related variables. Results When disordered eating was examined continuously, menu labeling did not differentially affect food selections of those with elevated disordered eating (p = .45). However, when examined by eating disorder diagnosis, participants with AN or BN ordered significantly fewer (p < .001) and participants with BED ordered significantly more (p = .001) calories in the menu label versus no label condition. Discussion Menu labeling may decrease the calories ordered among individuals with AN or BN and increase calories ordered among individuals with BED. PMID:28130796

Nonnormative eating behavior and psychopathology in prebariatric patients with binge-eating disorder and night eating syndrome.

PubMed

Baldofski, Sabrina; Tigges, Wolfgang; Herbig, Beate; Jurowich, Christian; Kaiser, Stefan; Stroh, Christine; de Zwaan, Martina; Dietrich, Arne; Rudolph, Almut; Hilbert, Anja

2015-01-01

Binge-eating disorder (BED) as a distinct eating disorder category and night eating syndrome (NES) as a form of Other Specified Feeding or Eating Disorders were recently included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study sought to investigate the prevalence of BED and NES and associations with various forms of nonnormative eating behavior and psychopathology in prebariatric patients. Within a consecutive multicenter registry study, patients in 6 bariatric surgery centers in Germany were recruited. Overall, 233 prebariatric patients were assessed using the Eating Disorder Examination and self-report questionnaires. Assessment was unrelated to clinical procedures. Diagnostic criteria for full-syndrome BED and NES were currently met by 4.3% and 8.2% of prebariatric patients, respectively. In addition, 8.6% and 6.9% of patients met subsyndromal BED and NES criteria, respectively. Co-morbid BED and NES diagnoses were present in 3.9% of patients. In comparison to patients without any eating disorder symptoms, patients with BED and NES reported greater emotional eating, eating in the absence of hunger, and more symptoms of food addiction. Moreover, differences between patients with BED and NES emerged with more objective binge-eating episodes and higher levels of eating concern, weight concern, and global eating disorder psychopathology in patients with BED. BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with nonnormative eating behavior and psychopathology point to their clinical significance and discriminant validity. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Disordered eating behavior and mental health correlates among treatment seeking obese women.

PubMed

Altamura, M; Rossi, G; Aquilano, P; De Fazio, P; Segura-Garcia, C; Rossetti, M; Petrone, A; Lo Russo, T; Vendemiale, G; Bellomo, A

2015-01-01

Previous research has suggest that obesity is associated with increased risk for psychopathological disorders, however, little is known about which obese patients are most vulnerable to psychopathological disorders. We therefore investigated 126 treatment-seeking obese women to describe eating disorder pathology and mental health correlates, and to identify disordered eating behaviors that may place obese at increased risk for psychopathological disorders. The Structured Clinical Interview for DSM-IV (SCID) was used to identify Eating Disorders (ED). A battery of psychological tests, including the Anxiety Scale Questionnaire (ASQ,) Clinical Depression Questionnaire (CDQ), Eating Disorder Inventory-2 (EDI-2) Eating Attitudes Test-26 (EAT-26) scales and structured clinical interview were administered to all the patients. We analyzed the link between psychopathological disorders and eating attitudes by using both multiple regression analysis and non-parametric correlation. Disordered eating behaviors and emotional behavioral aspects related to Anorexia Nervosa, such as ineffectiveness, are strongly linked to the depression and anxiety in obese subjects. No correlation was found between psychopathological disorders and age or anthropometric measurements. Findings corroborate earlier work indicating that psychological distress is elevated in obese treatment seeking, bolstering the need for mental health assessment of such individuals. The feeling of ineffectiveness constitutes the major predictor of psychopathological aspects. This is an important result which may inform the development of effective interventions for obese patients and prevention of psychopathological disorders.

Food addiction and bulimia nervosa.

PubMed

Meule, Adrian; von Rezori, Vittoria; Blechert, Jens

2014-09-01

In individuals with obesity and binge eating disorder (BED), eating patterns can show addictive qualities, with similarities to substance use disorders on behavioural and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for substance use disorders, and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being 'food addicted'. Based on self-reported eating disorder symptoms, women with current (n=26) or remitted (n=20) BN, and a control group of women matched for age and body mass index (n=63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behaviour and suggest that food addiction most likely improves when BN symptoms remit. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Religiosity, spirituality in relation to disordered eating and body image concerns: A systematic review.

PubMed

Akrawi, Daniel; Bartrop, Roger; Potter, Ursula; Touyz, Stephen

2015-01-01

This systematic review aims to critically examine the existing literature that has reported on the links between aspects of religiosity, spirituality and disordered eating, psychopathology and body image concerns. A systematic search of online databases (PsycINFO, Medline, Embase and Web of Science) was conducted in December 2014. A search protocol was designed to identify relevant articles that quantitatively explored the relationship between various aspects of religiosity and/or spirituality and disordered eating, psychopathology and/or body image concerns in non-clinical samples of women and men. Twenty-two studies were identified to have matched the inclusion criteria. Overall, the main findings to emerge were that strong and internalised religious beliefs coupled with having a secure and satisfying relationship with God were associated with lower levels of disordered eating, psychopathology and body image concern. Conversely, a superficial faith coupled with a doubtful and anxious relationship with God were associated with greater levels of disordered eating, psychopathology and body image concern. While the studies reviewed have a number of evident limitations in design and methodology, there is sufficient evidence to make this avenue of enquiry worth pursuing. It is hoped that the direction provided by this review will lead to further investigation into the protective benefits of religiosity and spirituality in the development of a clinical eating disorder. Thus a stronger evidence base can then be utilised in developing community awareness and programs which reduce the risk.

["Pro Ana": Psychodynamic References for Anorexia Nervosa].

PubMed

Siefert, Linda

2017-02-01

"Pro Ana": Psychodynamic References for Anorexia Nervosa The internet-based phenomenon "Pro Ana" refers to the eating disorder anorexia nervosa in a positive way. To understand what the phenomenon "Pro Ana" represents, the websites are used as a starting point of the current analysis. Based on these results, similarities and differences between "Pro Ana" and the eating disorder anorexia nervosa are discussed. Furthermore psychodynamic references for anorexia nervosa are derived and finally their importance for treatment motivation will be considered.

[Impact of eating psychopathology, obsessive-compulsion and depression on self-harm behavior in patients with eating disorders].

PubMed

Kong, Seong Sook

2009-08-01

The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

Eating disorders and disordered eating in Israel: an updated review.

PubMed

Latzer, Yael; Witztum, Eliezer; Stein, Daniel

2008-09-01

Israel presents a unique opportunity to study the role of socio-cultural parameters in the development of mental disturbances because of the exceptional diversity of the Israeli society. In the present review, we aimed to analyse the current state of disordered eating in Israel by means of an extensive literature review. The following are the main findings of our review: The frequency of maladaptive eating among female and male Israeli Jewish adolescents is higher in comparison to many other Westernized countries. Among different Jewish sub-populations, Kibbutz women have been found until recently to show higher rates of disordered eating in comparison to other Israeli samples. Recent studies show no such difference between Kibbutz members and the general Israeli population. No clear-cut findings emerge with respect to the influence of immigration and degree of Jewish religious affiliation on the occurrence of disordered eating. In contrast, disordered eating is less prevalent in Israeli-Arabs compared with Israeli-Jews. Moreover, diverse Israeli-Arab groups show different rates of disordered eating. We discuss the high rate of disordered eating in Israeli youth in light of Israel being a culture in transition that is constantly exposed to the risk of terrorism. The changes in the rates of disordered eating in the Kibbutzim are discussed in light of the dramatic societal changes occurring in these communities within a relatively brief period of time. The low rates of disordered eating in Israeli-Arabs reflect the traditional non-Westernized characteristics of their society, whereas the differences between diverse Arab sub-populations depend upon the degree of exposure to Westernized influences and the presence of conflicts between modern and traditional values. (c) 2008 John Wiley & Sons, Ltd and Eating Disorders Association.

Children of parents with BED have more eating behavior disturbance than children of parents with obesity or healthy weight.

PubMed

Lydecker, Janet A; Grilo, Carlos M

2017-06-01

A limited literature suggests an association between parental eating disorders and child eating-disorder behaviors although this research has focused primarily on restrictive-type eating disorders and very little is known about families with binge-eating disorder (BED). The current study focused on parents (N = 331; 103 fathers and 226 mothers), comparing parents with core features of BED (n = 63) to parents with obesity and no eating disorder (OB; n = 85) and parents with healthy-weight and no eating disorder (HW; n = 183). Parents with BED were significantly more likely than OB and HW parents to report child binge eating, and more likely than HW parents to report child overeating. Parents with BED felt greater responsibility for child feeding than OB parents, and felt more concern about their child's weight than OB and HW parents. Dietary restriction of the child by the parents was related to child binge eating, overeating, and child overweight, and parental group was related to child binge eating (parental BED), overeating (parental BED), and child weight (parental OB). Parents with BED report greater disturbance in their children's eating than OB and HW parents, and OB parents report higher child weight than HW parents. This suggests that it is important to consider both eating-disorder psychopathology and obesity in clinical interventions and research. Our cross-sectional findings, which require experimental and prospective confirmations, provide preliminary evidence suggesting potential factors in families with parental BED and obesity to address in treatment and prevention efforts for pediatric eating disorders and obesity. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:648-656). © 2016 Wiley Periodicals, Inc.

Targeted prevention of excess weight gain and eating disorders in high-risk adolescent girls: a randomized controlled trial12345

PubMed Central

Shomaker, Lauren B; Wilfley, Denise E; Young, Jami F; Sbrocco, Tracy; Stephens, Mark; Ranzenhofer, Lisa M; Elliott, Camden; Brady, Sheila; Radin, Rachel M; Vannucci, Anna; Bryant, Edny J; Osborn, Robyn; Berger, Sarah S; Olsen, Cara; Kozlosky, Merel; Reynolds, James C; Yanovski, Jack A

2014-01-01

Background: The high prevalence and incidence of obesity and eating disorders in US adolescent girls are serious health problems. Because of the shared risk factors for obesity and eating disorders, a targeted prevention of both conditions is a priority. Objective: We determined whether an adapted interpersonal psychotherapy prevention program is more efficacious for reducing excess weight gain and worsening disordered eating than health education in adolescent girls at high risk of obesity and eating disorders. Design: A parallel-group, randomized controlled trial was conducted between September 2008 and January 2013 in a university-based laboratory and a federal research hospital. The study included 113 adolescent (12–17-y-old) girls deemed at high risk of adult obesity and eating disorders because of a body mass index (BMI) between the 75th and 97th percentiles and reports of episodes of a loss of control over their eating. Girls were randomly assigned to participate in an adapted interpersonal psychotherapy or a health-education group program for 12 weekly 90-min group sessions. Follow-up assessments occurred immediately after group programs and at 6 and 12 mo. Results: Participation in both conditions was associated with decreases in expected BMI gain, age-adjusted BMI metrics, the percentage of fat by using dual-energy X-ray absorptiometry, symptoms of depression and anxiety, and the frequency of loss-of-control eating over 12 mo of follow-up (Ps < 0.001) with no group difference. In follow-up analyses, interpersonal psychotherapy was more efficacious than health education at reducing objective binge eating at the 12-mo follow-up (P < 0.05). Conclusions: The intervention with adolescent girls with loss-of-control eating is associated with lower age-adjusted BMI and percentage of adiposity as well as improved mood symptoms over 1 y. Interpersonal psychotherapy further reduced objective binge eating. Additional research is needed to elucidate the mechanisms by which physical and psychological improvements were observed. This trial was registered at clinicaltrials.gov as NCT00680979. PMID:25240070

Electrolyte and acid-base abnormalities associated with purging behaviors.

PubMed

Mehler, Philip S; Walsh, Kristine

2016-03-01

Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors. They vary depending on the mode and frequency of purging behaviors. They can all potentially cause dangerous medical complications and are in need of definitive medical treatment. Eating disorders that are associated with purging behaviors are associated with a number of electrolyte and acid-base changes which are complex in their origin, documented to be medically dangerous and this definitive treatment is necessary to help achieve a successful treatment outcome, and in need of definitive treatment as described herein. © 2016 Wiley Periodicals, Inc.

Eating disorder pathology in elite adolescent athletes.

PubMed

Giel, Katrin Elisabeth; Hermann-Werner, Anne; Mayer, Jochen; Diehl, Katharina; Schneider, Sven; Thiel, Ansgar; Zipfel, Stephan

2016-06-01

We aimed to investigate eating disorder pathology in German elite adolescent athletes. Evidence suggests that eating disorder pathology is more common in adult elite sports, especially in female athletes and in sports emphasizing leanness. There is a scarcity of studies in elite adolescent athletes who are in a vulnerable developmental stage and are affected by general as well as sport-specific risk factors. Our data was derived from the German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL) which conducted a survey in 1138 elite adolescent athletes. In this sample, we assessed body weight, weight control behavior, body acceptance and screened overall for core symptoms of eating disorders, depression and anxiety. We performed a tree analysis to identify high risk groups for eating disorder pathology. High risk groups comprised (a) athletes competing in weight dependent sports, and among athletes competing in disciplines other than weight dependent sports (b) athletes who are high on negative affectivity, (c) female athletes and (d) male athletes competing in endurance, technical or power sports. Athletes competing in weight dependent disciplines reported wide spread use of compensatory behaviors to influence body weight. Athletes reporting eating disorder pathology showed higher levels of depression and anxiety than athletes without eating disorder pathology. Increased psychosocial burden in athletes with eating disorder pathology suggests that eating disorder symptoms should not be accepted as an unproblematic and functional part of elite sports. The prevention and management of eating disorder pathology is especially important in weight dependent sports. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:553-562). © 2016 Wiley Periodicals, Inc.

Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices.

PubMed

Rodino, Iolanda S; Byrne, Susan M; Sanders, Katherine A

2017-02-01

To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. Cross-sectional study. Fertility clinics. Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. None. Responses to an anonymously completed online questionnaire. Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Youth internalizing symptoms, sleep-related problems, and disordered eating attitudes and behaviors: A moderated mediation analysis.

PubMed

Chardon, Marie L; Janicke, David M; Carmody, Julia K; Dumont-Driscoll, Marilyn C

2016-04-01

Internalizing symptoms increase the risk for disordered eating; however, the mechanism through which this relationship occurs remains unclear. Sleep-related problems may be a potential link as they are associated with both emotional functioning and disordered eating. The present study aims to evaluate the mediating roles of two sleep-related problems (sleep disturbance and daytime sleepiness) in the relationship between youth internalizing symptoms and disordered eating, and to explore if age moderates these relations. Participants were 225 youth (8-17years) attending a primary care appointment. Youth and legal guardians completed questionnaires about youth disordered eating attitudes and behaviors, internalizing symptoms, sleep disturbance, and daytime sleepiness. Mediation and moderated mediation analyses were utilized. The mediation model revealed both youth sleep disturbance and daytime sleepiness independently mediated the association between internalizing symptoms and disordered eating attitudes and behaviors, and explained 18% of the variance in disordered eating. The moderated mediation model including youth age accounted for 21% of the variance in disordered eating; youth age significantly interacted with sleep disturbance, but not with daytime sleepiness, to predict disordered eating. Sleep disturbance only mediated the relationship between internalizing symptoms and disordered eating in youth 12years old and younger, while daytime sleepiness was a significant mediator regardless of age. As sleep-related problems are frequently improved with the adoption of health behaviors conducive to good sleep, these results may suggest a relatively modifiable and cost-effective target to reduce youth risk for disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Inter-relationships between Vegetarianism and Eating Disorders among Females

PubMed Central

Bardone-Cone, Anna M.; Fitzsimmons-Craft, Ellen E.; Harney, Megan B.; Maldonado, Christine R.; Lawson, Melissa A.; Smith, Roma; Robinson, D. Paul

2012-01-01

When individuals with a suspected or diagnosed eating disorder adopt a vegetarian diet, health care professionals may worry that this choice may function as a socially acceptable way to legitimize food avoidance. Yet, limited research has examined vegetarianism in relation to eating disorders. Study objectives were to compare individuals with and without an eating disorder history, and individuals at different stages of eating disorder recovery, on past and current vegetarianism and motivations for and age at becoming vegetarian. Participants were females seen at some point for an eating disorder (n=93) as well as controls who never had an eating disorder (n=67). Recruitment and data collection for this cross-sectional study occurred in 2007-2008. Chi square analyses and analyses of variance and covariance were used to examine the research questions. Compared to controls, individuals with an eating disorder history were significantly more likely to ever have been vegetarian (52% vs. 12%), to be currently vegetarian (24% vs. 6%), and to be primarily motivated by weight-related reasons (42% vs. 0%). The three recovery status groups (fully recovered, partially recovered, active eating disorder) did not differ significantly in percentiles endorsing a history of vegetarianism or weight-related reasons as primary, but they differed significantly in current vegetarianism (33% of active cases, 13% of partially recovered, 5% of fully recovered). Most perceived that their vegetarianism was related to their eating disorder (68%) and emerged after its onset. Results shed light on the vegetarianism-eating disorders relation and suggest intervention considerations for clinicians (e.g., investigating motives for vegetarianism). PMID:22818732

Self-reported interoceptive deficits in eating disorders: A meta-analysis of studies using the eating disorder inventory.

PubMed

Jenkinson, Paul M; Taylor, Lauren; Laws, Keith R

2018-07-01

An impairment of the ability to sense the physiological condition of the body - interoception - has long been proposed as central to the onset and maintenance of eating disorders. More recent attention to this topic has generally indicated the presence of interoceptive deficits in individuals with an eating disorder diagnosis; however, possible links with specific diagnosis, BMI, age, illness duration, depression, and alexithymia remain unclear from individual studies. This meta-analysis aimed to provide a necessary quantitative overview of self-reported interoceptive deficits in eating disorder populations, and the relationship between these deficits and the previously mentioned factors. Using a random effects model, our meta-analysis assessed the magnitude of differences in interoceptive abilities as measured using the Eating Disorder Inventory in 41 samples comparing people with eating disorders (n = 4308) and healthy controls (n = 3459). Follow-up and moderator analysis was conducted, using group comparisons and meta-regressions. We report a large pooled effect size of 1.62 for eating disorders with some variation between diagnostic groups. Further moderator analysis showed that BMI, age and alexithymia were significant predictors of overall effect size. This meta-analysis is the first to confirm that large interoceptive deficits occur in a variety of eating disorders and crucially, in those who have recovered. These deficits may be useful in identifying and distinguishing eating disorders. Future research needs to consider both objective and subjective measures of interoception across different types of eating disorders and may fruitfully examine interoception as a possible endophenotype and target for treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

The Use of Virtual Reality in Patients with Eating Disorders: Systematic Review

PubMed Central

Clus, Damien; Larsen, Mark Erik; Lemey, Christophe

2018-01-01

Background Patients with eating disorders are characterized by pathological eating habits and a tendency to overestimate their weight and body shape. Virtual reality shows promise for the evaluation and management of patients with eating disorders. This technology, when accepted by this population, allows immersion in virtual environments, assessment, and therapeutic approaches, by exposing users to high-calorie foods or changes in body shape. Objective To better understand the value of virtual reality, we conducted a review of the literature, including clinical studies proposing the use of virtual reality for the evaluation and management of patients with eating disorders. Methods We searched PubMed, PsycINFO, ScienceDirect, the Cochrane Library, Scopus, and Web of Science up to April 2017. We created the list of keywords based on two domains: virtual reality and eating disorders. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify, select, and critically appraise relevant research while minimizing bias. Results The initial database searches identified 311 articles, 149 of which we removed as duplicates. We analyzed the resulting set of 26 unique studies that met the inclusion criteria. Of these, 8 studies were randomized controlled trials, 13 were nonrandomized studies, and 5 were clinical trials with only 1 participant. Most articles focused on clinical populations (19/26, 73%), with the remainder reporting case-control studies (7/26, 27%). Most of the studies used visual immersive equipment (16/26, 62%) with a head-mounted display (15/16, 94%). Two main areas of interest emerged from these studies: virtual work on patients’ body image (7/26, 27%) and exposure to virtual food stimuli (10/26, 38%). Conclusions We conducted a broad analysis of studies on the use of virtual reality in patients with eating disorders. This review of the literature showed that virtual reality is an acceptable and promising therapeutic tool for patients with eating disorders. PMID:29703715

Association between eating disorders and migraine may be explained by major depression.

PubMed

Mustelin, Linda; Raevuori, Anu; Kaprio, Jaakko; Keski-Rahkonen, Anna

2014-12-01

The association between eating disorders and migraine remains unclear. We identified women with lifetime diagnoses of anorexia nervosa (AN) (N = 55) and bulimia nervosa (BN) (N = 60) and their co-twins from the FinnTwin16 cohort born in 1975-1979 (N = 2,825 women). Eating disorder and major depressive disorder (MDD) diagnoses were obtained from clinical interviews and data on migraine by self-report questionnaire. The women with eating disorders were compared with their unaffected co-twins and with unrelated women from the same birth cohorts. The prevalence of migraine was 12% in the general female population, but 22% for both AN and BN (odds ratio 2.0, p = .04). The prevalence of MDD was high in women with an eating disorder (42%). MDD was strongly associated with migraine (odds ratio 3.0, p < .0001) and explained the association between eating disorders and migraine. The highest migraine prevalence (36%) was found in women with both an eating disorder and MDD. Pairwise twin analyses also supported the clustering of migraine, MDD and eating disorders. Women with a lifetime diagnosis of an eating disorder were twice as likely to report a history of migraine as unrelated women from the same cohort; this relationship was explained by comorbid MDD. © 2014 Wiley Periodicals, Inc.

[The relationship of attachment features and multi-impulsive symptoms in eating disorders].

PubMed

Szalai, Tamás Dömötör

2017-07-01

Attachment dysfunctions determine borderline personality disorder, which is a frequent background factor of multi-impulsivity; however, the relationship between attachment and multi-impulsive eating disorders is almost unexplored. To compare attachment features of multi-impulsive and classical eating disorder patients with individuals without eating disorders, and to test attachment as a predictor of multi-impulsivity. A cross-sectional survey (148 females, mean age: 30.9 years) investigated maternal, paternal and adult attachment, depression, anxiety, eating disorder and multi-impulsive symptoms in these groups. Altogether 41.3% of the individuals without eating disorders, 17.6% of classical and 11.8% of multi-impulsive eating disorder patients had secure attachment. Multi-impulsive patients had the most severe eating disorder symptoms (F (2) = 17.733) and the lowest paternal care (F (2) = 3.443). Preoccupied and fearful attachment explained 14.5% of multi-impulsive symptoms; however, with adjustment for depression only latter one remained the predictor of multi-impulsivity (t = 5.166, p<0.01). Multi-impulsives are a distinct subgroup of eating disorder patients from the aspects of both symptoms and attachment. Handling their negative moods may hold therapeutic potentials. Longitudinal studies are required to investigate the therapeutic value of paternal care, attachment preoccupation and fearfulness. Orv Hetil. 2017; 158(27): 1058-1066.

[Anorexia and borderline personality disorder : bonds pathology].

PubMed

Cayn, Delphine; Pham-Scottez, Alexandra

Comorbidity with a borderline personality disorder is far from rare in patients suffering from eating disorders. Clinically, this presents as chronic instability in many areas: interpersonal relationships, self-image, emotions, mood and acting out. Treatment is mainly based on a containing and reassuring therapeutic framework. A care plan may be put in place that incorporates reducing impulsive harmful, eating and self-harming behaviours. Dialectical behaviour therapy is intended in particular to prevent suicide risk in borderline personality disorder patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Identification and management of eating disorders in children and adolescents.

PubMed

Rosen, David S

2010-12-01

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.

Food for Thought: Eating Disorders and Outdoor Adventure.

ERIC Educational Resources Information Center

Richards, Kaye; Allin, Linda

2001-01-01

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…