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Kummer KK, Mangweth-Matzek B. Male eating disorders in midlife-possible links between excessive sports and hormones. Aging Male 2023; 26:2154571. [PMID: 36790384 DOI: 10.1080/13685538.2022.2154571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Although eating disorders were long considered a typical female disorder, it is now clear that men are also affected. However, the literature on eating disorders in men is still very limited, and the actual extent is not known. Even less is known about the epidemiology of eating disorders in older individuals. In this focused review, we will present an update of the available data on disordered eating and eating disorders in middle-aged and older males. In addition, we will highlight the relationship of eating disorders with excessive sports as a purging method of choice for this age group and discuss the impact of age-related hormonal imbalances in aging men.
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Affiliation(s)
- Kai K Kummer
- Institute of Physiology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Psychiatry, Psychotherapy, Psychosomatics and Psychological Medicine, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Mangweth-Matzek
- Department of Psychiatry, Psychotherapy, Psychosomatics and Psychological Medicine, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
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James DL, Larkey LK, Evans B, Sebren A, Goldsmith K, Ahlich E, Hawley NA, Kechter A, Sears DD. Mechanisms of improved body composition among perimenopausal women practicing Meditative Movement: a proposed biobehavioral model. Menopause 2023; 30:1114-1123. [PMID: 37788427 DOI: 10.1097/gme.0000000000002262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES Weight gain and unfavorable body composition are prevalent among midlife/older women throughout menopause. These shifts may negatively impact health, well-being, and longevity. Efforts to attenuate weight and body composition changes are traditionally driven by manipulation of diet and/or exercise; however, sustained results are limited, possibly because the full spectrum of biobehavioral systems is not addressed by diet and exercise alone. We propose a biobehavioral model detailing mechanisms of body composition decline among perimenopausal women and the associated components of Meditative Movement (ie, tai chi, qigong, yoga) that address each of these factors. METHODS Based on our previous work and extensive review of the literature, we developed a multifactorial and multidimensional biobehavioral model including factors that most directly relate to body composition among perimenopausal women: 1) psychological (ie, stress and mood, mindfulness and self-compassion, body awareness), 2) behavioral (ie, sleep, physical activity, eating behaviors), and 3) physiological (ie, cortisol, estrogen). Relationships between each factor, Meditative Movement practice components, and predicted effects on body composition were explored in detail. RESULTS Our model describes select psychological, behavioral, and physiological factors, and potential mechanistic pathways of Meditative Movement practice driving improved changes in body composition and weight outcomes for perimenopausal women. CONCLUSIONS The proposed model details a novel, evidence-supported means to reduce the risk of deleterious shifts in body composition throughout perimenopause and menopause thereafter. We suggest that these changes may occur directly and/or indirectly through psychological, behavioral, and physiological mechanisms that facilitate the desired changes in body composition.
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Affiliation(s)
| | - Linda K Larkey
- From the Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Bronwynne Evans
- From the Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Ann Sebren
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Kimberley Goldsmith
- Department of Biostatistics & Informatics, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Erica Ahlich
- Department of Psychology, University of South Alabama, Mobile, AL
| | - Nanako A Hawley
- Department of Psychology, University of South Alabama, Mobile, AL
| | | | - Dorothy D Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ
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Mangweth-Matzek B, Kummer KK, Hoek HW. Update on the epidemiology and treatment of eating disorders among older people. Curr Opin Psychiatry 2023; 36:405-411. [PMID: 37471308 PMCID: PMC10552830 DOI: 10.1097/yco.0000000000000893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
PURPOSE OF REVIEW We reviewed the recent literature on the epidemiology and treatment of eating disorders among middle-aged and older women and men. RECENT FINDINGS Recent studies show that among older female persons, the prevalence rates with full diagnoses of eating disorders based on DSM-IV or DSM-5 criteria are between 2.1 and 7.7%, and among older men less than 1%. These studies show that the prevalence of eating disorders decreases by age in women, but it does not get towards zero even in very high age. Middle age, with a peak around 50, is also a critical time for the occurrence of eating disorders in men. Women who reported severe menopausal symptoms showed more eating disorder pathology compared with those with low symptoms during menopausal transition. SUMMARY Eating disorders do occur in middle and older age of both sexes. Shame and stigmatization have decreased, and medical awareness and explicit assessment of eating behavior in all age groups have developed. What puberty is for eating disorders in adolescence and young age is menopausal transition for midlife women. Also in men, associations with hormonal disturbances are possible. Treatment approaches should consider treatment strategies tailored to older women and men, addressing the context of midlife and aging.
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Affiliation(s)
- Barbara Mangweth-Matzek
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology
| | - Kai K. Kummer
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology
- Institute of Physiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hans W. Hoek
- Parnassia Psychiatric Institute, The Hague
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, USA
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Thompson KA, Miller AJ, Walsh EC, Bardone-Cone AM. Social media and disordered eating among middle-aged women: Not just an adolescent concern. Eat Behav 2023; 50:101748. [PMID: 37253297 DOI: 10.1016/j.eatbeh.2023.101748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 06/01/2023]
Abstract
Evidence suggests social media use is strongly linked to disordered eating (e.g., binge eating and dietary restraint) among adolescent and young adult women, in part because it promotes engagement in social comparison (the tendency to evaluate one's own standing or ability by comparing it to another's). Yet no study has examined the impact of social media use and comparison on disordered eating among middle-aged women. Participants (N = 347), ages 40-63, completed an online survey about their social media use, social comparison, and disordered eating (bulimic symptoms, dietary restraint, and broad eating pathology). Results indicated that 89 % (n = 310) of middle-aged women used social media in the past year. Most participants (n = 260; 75 %) used Facebook, and at least a quarter used Instagram or Pinterest. Approximately 65 % (n = 225) used social media at least daily. Controlling for age and body mass index, social media-specific social comparison was positively associated with bulimic symptoms, dietary restriction, and broad eating pathology (all ps < 0.001). Multiple regression models evaluating frequency of social media use and social media-specific social comparison together revealed that social comparison explained a significant amount of unique variance in bulimic symptoms, dietary restriction, and broad eating pathology (all ps < 0.001) above and beyond frequency of social media use. Instagram explained a significant proportion of variance of dietary restraint compared to other social media platforms (p = .001). Findings suggest a large percentage of middle-aged women frequently engage with some type of social media. Further, social media-specific social comparison, rather than frequency of social media use, may be driving disordered eating in this age group of women.
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Affiliation(s)
- Katherine A Thompson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
| | - Alexandra J Miller
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
| | - Emily C Walsh
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA.
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Finch JE, Xu Z, Girdler S, Baker JH. Network analysis of eating disorder symptoms in women in perimenopause and early postmenopause. Menopause 2023; 30:275-282. [PMID: 36728103 PMCID: PMC9974533 DOI: 10.1097/gme.0000000000002141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Eating disorders (EDs) are often stereotyped as disorders of adolescence and young adulthood; however, they can occur at any age. Prevalence of EDs at midlife are approximately 3.5% and specific symptoms at midlife can have prevalences as high as 29.3%. Studies also inconsistently suggest that EDs and related symptoms may be more prevalent in midlife aged women during perimenopause compared with midlife aged women at pre-menopause. To date few studies have examined the structure of and associations between ED symptoms in women specifically during perimenopause and early postmenopause. Thus, the purpose of the current study is to investigate the structure of ED symptoms specifically during perimenopause and early postmenopause. METHODS Participants included 36 participants (45-61 y old) in a larger clinical trial who completed the Eating Disorder Examination Questionnaire (EDE-Q) at a baseline study visit. Network analysis statistical models were used to examine the structure of and associations between ED symptoms assessed via the EDE-Q. RESULTS Shape dissatisfaction and weight dissatisfaction were the top 2 central symptoms in the network. CONCLUSIONS Results corroborate previous studies and indicate that, similar to young adult samples, dissatisfaction with body image is a core feature of ED pathology across the lifespan.
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Affiliation(s)
- Jody E. Finch
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA 30302-5010, USA
| | - Ziqian Xu
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 235 E. Cameron Avenue, Chapel Hill, NC 27515, USA
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC 27599-7160, USA
| | - Jessica H. Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC 27599-7160, USA
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Kwon M, Li M, Chang OD. Examining the Role of Body Image Instability in Young Adult Women: Conceptualization, Development, and Psychometric Evaluation of the Vacillating Body Image Scale (VBIS). J Pers Assess 2023; 105:266-282. [PMID: 35377772 DOI: 10.1080/00223891.2022.2051532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The current study conceptualized body image instability as a maladaptive tendency to vacillate between different self-perceptions of one's overall body image and developed a corresponding measure to assess body image instability. Results from a series of studies of young adult women demonstrated the validity, reliability, and utility of the Vacillating Body Image Scale (VBIS) as a meaningful measure of body image instability. In Study 1, we found that body image instability, as assessed by the VBIS, represents a unidimensional and reliable construct. In Study 2, we found evidence for both the convergent and discriminant validity of the VBIS in relation to other individual differences measures (i.e., self-concept schema, broad personality factors). In Study 3, the concurrent criterion validity of the VBIS was supported for young adult women in relation to a range of adjustment measures. Finally, in Study 4, we found consistent evidence for the incremental validity of the VBIS in predicting subsequent variations in eating disturbances, even after controlling for global self-esteem and self-concept instability. Overall, our findings offer promising support for our contention that body image instability, as measured by the VBIS, represents an important construct for understanding eating-related disturbances and other health outcomes in young adult women.
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Affiliation(s)
- Misu Kwon
- Department of Psychology, Yonsei University, Seodaemun-gu, Korea (the Republic of)
| | - Mingqi Li
- Department of Psychology, DePaul University, Chicago, Illinois, USA
| | - Olivia D Chang
- Department of Psychology, University of Michigan, Ann Arbor, USA
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Vorlet J, Carrard I. Barriers and facilitators of intuitive eating in postmenopausal women: A qualitative study. Health Psychol Open 2023; 10:20551029231157515. [PMID: 36814441 PMCID: PMC9940212 DOI: 10.1177/20551029231157515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
This qualitative descriptive research explored barriers and facilitators of the intuitive eating (IE) implementation process, as experienced by six postmenopausal women classified as 'overweight' or 'obese'. The data was analysed using deductive and inductive thematic analysis and six themes were identified. IE implementation included developing scepticism about weight loss diets, dealing with hunger and satiety cues, making nutritious food choices for one's body, struggling with emotional eating, learning to accept one's body and challenging weight stigma and sociocultural norms of beauty and thinness. IE allowed women to develop a more peaceful relationship with their diet, and was accepted as a welcome alternative to dieting.
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Affiliation(s)
- Jeanne Vorlet
- Metabolic Center, Intercantonal Hopital De La Broye Site Payerne, Switzerland,Jeanne Vorlet, Metabolic Center, Hopital Intercantonal De La Broye, Payerne/Estavayer-le-Lac, Addiction Suisse, Avenue Louis-Ruchonnet 141003, Lausanne, Switzerland.
| | - Isabelle Carrard
- Department of Nutrition and Dietetics, HES-SO Genève, Switzerland
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Epidemiology of eating disorders: population, prevalence, disease burden and quality of life informing public policy in Australia-a rapid review. J Eat Disord 2023; 11:23. [PMID: 36793104 PMCID: PMC9933292 DOI: 10.1186/s40337-023-00738-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/22/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Understanding of the epidemiology and health burden of eating disorders has progressed significantly in the last 2 decades. It was considered one of seven key areas to inform the Australian Government commissioned National Eating Disorder Research and Translation Strategy 2021-2031, as emerging research had highlighted a rise in eating disorder prevalence and worsening burden-of-illness. The aim of this review was to better understand the global epidemiology and impact of eating disorders to inform policy decision-making. METHODS Using a systematic Rapid Review methodology, ScienceDirect, PubMed and Medline (Ovid) were searched for peer-reviewed studies published between 2009 and 2021. Clear inclusion criteria were developed in consultation with experts in the field. Purposive sampling of literature was conducted, which predominately focused on higher-level evidence (meta-analyses, systematic reviews, and large epidemiological studies), synthesised, and narratively analysed. RESULTS 135 studies were deemed eligible for inclusion in this review (N = 1324). Prevalence estimates varied. Global Lifetime prevalence of any eating disorder ranged from 0.74 to 2.2% in males, and 2.58-8.4% in females. Australian 3-month point-prevalence of broadly defined disorders was around 16% in females. Eating disorders appeared more prevalent in young people and adolescents, particularly females (in Australia: eating disorders ~ 22.2%; disordered eating ~ 25.7%). Limited evidence was found on sex, sexuality and gender diverse (LGBTQI +) individuals, particularly males, who had a six-fold increase in prevalence compared to the general male population, with increased illness impact. Similarly, limited evidence on First Australian's (Aboriginal and Torres Strait Islander) suggests prevalence rates similar to non-Indigenous Australians. No prevalence studies were identified specifically assessing culturally and linguistically diverse populations. Global disease burden of any eating disorder was 43.4 age-standardised disability-adjusted-life-years per 100,000; increasing by 9.4% between 2007 and 2017. Australian's total economic cost was estimated at $84 billion from years-of-life lost due to disability and death, and annual lost earnings ~ $1.646 billion." CONCLUSIONS There is no doubt that eating disorder prevalence and impact are on the rise, particularly in at-risk and understudied populations. Much of the evidence came from female-only samples, and Western, high-income countries which more readily have access to specialised services. Future research should examine more representative samples. There is an urgent need for more refined epidemiological methods to better understand these complex illnesses over time, to guide health policy and development-of-care.
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Anaya C, Culbert KM, Klump KL. Binge Eating Risk During Midlife and the Menopausal Transition: Sensitivity to Ovarian Hormones as Potential Mechanisms of Risk. Curr Psychiatry Rep 2023; 25:45-52. [PMID: 36565385 PMCID: PMC9974637 DOI: 10.1007/s11920-022-01405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Recent research suggests that binge eating may be more prevalent among women in midlife than previously believed. The menopausal transition, an important developmental stage during midlife, is characterized by substantial fluctuations and eventual decreases in ovarian hormones that may contribute to increased risk. This narrative review summarizes findings from studies of binge eating during midlife and menopause and discusses the potential role of ovarian hormones in binge eating risk. RECENT FINDINGS Studies are few in number and findings are mixed, with only some studies showing increased binge eating during midlife and the menopausal transition. Sensitivity to ovarian hormones, potentially through gene x hormone interactions, may influence who experiences increased binge eating risk and could help explain mixed findings in the field. Future studies of hormone sensitivity and gene x hormone interactions are needed to further elucidate midlife and menopausal risk for binge eating in women.
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Affiliation(s)
- Carolina Anaya
- Department of Psychology, Michigan State University, MI, 48824-1116, East Lansing, USA
| | - Kristen M Culbert
- Department of Psychology, Michigan State University, MI, 48824-1116, East Lansing, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, MI, 48824-1116, East Lansing, USA.
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Vincent C, Bodnaruc AM, Prud’homme D, Olson V, Giroux I. Associations between menopause and body image: A systematic review. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231209536. [PMID: 37994043 PMCID: PMC10666711 DOI: 10.1177/17455057231209536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/28/2023] [Accepted: 09/28/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND The menopausal transition involves multiple biological and psychosocial challenges that may render middle-aged women vulnerable to body image concerns. OBJECTIVE The aim of this study was to summarize evidence on the associations between menopause and body image perception in healthy middle-aged women. DESIGN This study is a systematic review of observational studies. DATA SOURCES AND METHODS Menopause-related exposure measures included menopausal stages, menopausal symptoms, and reproductive hormone levels during the menopausal transition. Studies investigating body image as an outcome, including through a positive (e.g. body self-esteem) or negative (e.g. body dissatisfaction) lens, were considered eligible. Articles published before March 2023 were identified through MEDLINE, PsycINFO, and Embase and underwent double screening, extraction, and quality assessment by two independent investigators. Characteristics and results were summarized using narrative synthesis. RESULTS A total of 820 non-duplicate records were identified, with 18 observational studies deemed eligible for inclusion after full-text screening. All studies investigating menopausal symptoms and body image (n = 6) found some significant association between them, with a higher frequency, intensity, or number of symptoms being associated with greater body image concern. Differences in body image perception between menopausal stages were inconsistent across studies (n = 12), while evidence of potential associations between reproductive hormones and body image was minimal (n = 2). Findings should be interpreted with caution as 17 of the included studies used a cross-sectional design, and not all studies adjusted their analyses for relevant confounders. CONCLUSION Overall, menopausal symptoms showed relatively consistent associations with a more negative body image perception. Additional research is required to understand the potential role of menopausal stages and reproductive hormone levels in the body image perception of middle-aged women and to confirm the direction of reported associations. REGISTRATION PROSPERO-CRD42021241637.
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Affiliation(s)
- Coralie Vincent
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
| | - Alexandra M Bodnaruc
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Denis Prud’homme
- Institut du Savoir Montfort, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Université de Moncton, Moncton, NB, Canada
| | - Viviane Olson
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
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Raynal P, Soccodato M, Fages M, Séjourné N. A comparative study of orthorexia between premenopausal, perimenopausal, and postmenopausal women. Eat Weight Disord 2022; 27:2523-2531. [PMID: 35357686 DOI: 10.1007/s40519-022-01392-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/07/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Studies suggested that menopause is a period of vulnerability for disordered eating behaviors, but whether menopause could be linked to orthorexia nervosa (ON) remains unexplored. METHODS A sample composed of 709 women aged between 30 and 71 years (mean age = 43.08 years, SD = 9.24) answered self-administered questionnaires assessing ON (Düsseldorfer Orthorexia Skala, DOS), body image, self-esteem, and psychopathological symptoms. The sample included a Premenopause group of 441 women reporting regular menses, a Perimenopause group of 94 women reporting the recent onset of amenorrhea or menstrual irregularities, and a Postmenopause group of 174 women reporting amenorrhea of natural onset for more than 12 months. RESULTS Group comparison using analysis of covariance with age as covariate showed that ON scores were statistically higher in the two groups of participants dealing with menopause (Peri- and Postmenopause) when compared with women not yet concerned by menopause (Premenopause). A Kendall's tau-b correlation performed between the menopausal status (Pre, Peri, or Postmenopause) and DOS categories (No ON; At risk of ON; Presence of ON) showed a weak but statistically significant positive correlation between the menopausal group and DOS categories (tau-b = 0.136, p < 0.001). In addition, Fisher's exact tests indicated that the percentages of participants in the "At risk of ON" and "Presence of ON" categories were statistically higher in the Postmenopause group in comparison with the Premenopause group (p < 0.001). Depressive symptoms were statistically higher in the Peri- and Post-groups, while anxiety symptoms were stronger in the Peri-group when compared with the Pre-group. CONCLUSIONS This study shows an increase of ON in women concerned with menopause, suggesting the existence of a relationship between menopause and ON. Further studies are necessary to identify factors involved in this association. LEVEL OF EVIDENCE Descriptive (cross-sectional) study, level V.
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Affiliation(s)
- Patrick Raynal
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France.
| | - Marine Soccodato
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Morgane Fages
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Natalène Séjourné
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
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12
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Hawrylyshen N, Lengyel C. Body Satisfaction and Associated Predictors Among Baby Boomer Women in Rural and Urban Manitoba. CAN J DIET PRACT RES 2022; 83:160-167. [PMID: 36004731 DOI: 10.3148/cjdpr-2022-013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: This study examines body satisfaction, weight attitudes, dieting behaviours, and aging concerns of baby boomer women (BBW; born 1946-1965) from rural and urban Manitoba.Methods: Primary data collection occurred November 2015, and 1083 participants completed the Body Image and Food Choice Survey. Four strata of BBW were represented to examine differences between older and younger BBW and location of residence. Multinomial logistic regression models were fit to determine predictors of weight and appearance satisfaction. Odds ratios and 95% confidence intervals were considered significant at p ≤ 0.05.Results: Fifty-three percent of participants were satisfied with their appearance, whereas only 34% were satisfied with their weight. Ninety-one percent desired to lose weight (29.9 ± 29.3 lbs). Aging anxiety was evident for 46% of participants and associated with appearance satisfaction (χ2 = 27.46, df = 4, p < 0.001). Body work and dieting behaviours were used to mitigate body dissatisfaction, and media influence was associated with both appearance (χ2 = 76.17, df = 6, p < 0.001) and weight satisfaction (χ2 = 67.90, df = 6, p < 0.001). Desired weight change, appearance stress, appearance importance, and self-rated health predicted both weight and appearance satisfaction.Conclusions: There is a need for greater awareness of aging women's body image concerns and the need for age-appropriate tools/resources to help dietitians support women achieve a healthy body image.
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Affiliation(s)
- Nikki Hawrylyshen
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences; Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, 35 Chancellors Circle, 417 Human Ecology Building, Winnipeg, MB
| | - Christina Lengyel
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, 35 Chancellors Circle, 405 Human Ecology Building, Winnipeg, MB
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Hooper SC, Marshall VB, Becker CB, LaCroix AZ, Keel PK, Kilpela LS. Mental health and quality of life in postmenopausal women as a function of retrospective menopause symptom severity. Menopause 2022; 29:707-713. [PMID: 35674651 PMCID: PMC9178181 DOI: 10.1097/gme.0000000000001961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Perimenopause is commonly viewed as a window of vulnerability for developing psychiatric and eating disorders, especially for women who experience severe symptoms. However, menopausal symptoms may have a lasting effect on older women's mental health and quality of life (QOL) into postmenopause. The current study examined older (60+) postmenopausal women's mental health and QOL as a function of retrospective menopausal symptom severity. METHODS Participants were recruited via public online postings and included 227 postmenopausal women, ages 60 to 94 years old (M = 68.84, SD = 6.53). Participants completed an online questionnaire to assess past menopausal symptoms as well as current depression, anxiety, sleep difficulties, binge eating, QOL, and demographics. The relation between the retrospective severity of menopausal symptoms and mental health/QOL was evaluated using linear regressions, while controlling for demographic covariates. RESULTS Retrospective menopause symptom severity was significantly associated with depression, sleep difficulties, binge eating severity, and most QOL measures. Regarding covariates, having a psychiatric history was significantly associated with all outcome variables, except for anxiety. Time since menopause and body mass index were significantly associated with binge eating severity. Regarding specific symptom subgroups, psychological and somato-vegetative symptoms were most associated with mental health and QOL. CONCLUSION The menopausal transition is a significant change in a woman's life and the challenges of menopausal symptoms can have lasting impacts on women's health. It is imperative that future research seeks to further understand the lasting impacts of this transition on the lives of older women to ensure proper interventions are implemented for successful aging.
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Affiliation(s)
- Savannah C. Hooper
- Barshop Institute, UT Health San Antonio, San Antonio, TX, United States
- ReACH Center, UT Health San Antonio, San Antonio, TX, United States
| | - Victoria B. Marshall
- Barshop Institute, UT Health San Antonio, San Antonio, TX, United States
- ReACH Center, UT Health San Antonio, San Antonio, TX, United States
| | - Carolyn B. Becker
- Department of Psychology, Trinity University, San Antonio, TX, United States
| | - Andrea Z. LaCroix
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, San Diego, CA, United States
| | | | - Lisa S. Kilpela
- Barshop Institute, UT Health San Antonio, San Antonio, TX, United States
- ReACH Center, UT Health San Antonio, San Antonio, TX, United States
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14
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Khalil J, Boutros S, Kheir N, Kassem M, Salameh P, Sacre H, Akel M, Obeid S, Hallit S. Eating disorders and their relationship with menopausal phases among a sample of middle-aged Lebanese women. BMC Womens Health 2022; 22:153. [PMID: 35538474 PMCID: PMC9092875 DOI: 10.1186/s12905-022-01738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 04/26/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives The objective of our study was to evaluate the association between the transition to menopause, body dissatisfaction, and abnormal eating habits (restrained eating, binge eating, and orthorexia nervosa) in a sample of middle-aged Lebanese women. Methods A cross-sectional study conducted between July 2019 and January 2020 enrolled 1001 women aged 40 years and above from all Lebanese governorates. Data were collected by face-to-face interviews with all participants. The Body dissatisfaction subscale of the Eating Disorder Inventory‑second version was used to assess body dissatisfaction, whereas the Binge Eating Scale, Dutch Restrained Eating Scale, ORTO-15, Dusseldorf Orthorexia Scale (DOS), and Teruel Orthorexia Scale (TOS) were used to assess eating disorders (binge eating, restrained eating and orthorexia nervosa respectively. Multivariable analysis of covariance (MANCOVA) was used to compare multiple measures among the three menopausal phases, after adjustment over potential confounding variables (age, monthly income, body mass index, marital status, education level, and body dissatisfaction). Results Postmenopause was significantly associated with more orthorexia nervosa tendencies (lower ORTO-15 scores) than premenopause (β = − 1.87; p = 0.022). Perimenopause was associated with more binge eating (β = 1.56; p = 0.031), and less orthorexia nervosa (as measured by the DOS) than premenopause, with this association tending to significance (β = − 1.10; p = 0.051). Furthermore, higher body dissatisfaction was significantly associated with higher restrained eating (β = 0.02; p < 0.001), binge eating (β = 0.48; p < 0.001), and orthorexia nervosa as measured by ORTO-15 (β = − 0.17; p < 0.001) and TOS (β = 0.08; p = 0.002), but not DOS. Conclusion Our study showed that menopausal stages are associated with some disordered eating behaviors (binge eating and orthorexia nervosa) among middle-aged women. Those results may serve as a first step towards spreading awareness among women within this age group regarding eating attitudes. Moreover, healthcare professionals should screen for the presence of disordered eating during those women’s routine visits to the clinics. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01738-6.
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Affiliation(s)
- Joe Khalil
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sarah Boutros
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Nelly Kheir
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon
| | - Maha Kassem
- Faculty of Medicine, New Vision University, Tbilisi, Georgia
| | - Pascale Salameh
- School of Medicine, Lebanese American University, Byblos, Lebanon.,Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon.,Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Hala Sacre
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
| | - Marwan Akel
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon. .,Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
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15
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Disorders of eating and body image during the menopausal transition: associations with menopausal stage and with menopausal symptomatology. Eat Weight Disord 2021; 26:2763-2769. [PMID: 33595812 DOI: 10.1007/s40519-021-01141-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/29/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Recent reports from our laboratory and others suggest that the menopausal transition may represent a window of vulnerability for eating disorders in women. Here, we present new findings regarding this issue. METHODS We surveyed 230 women aged 40-60 years using an anonymous questionnaire focused on eating-disorder and body-image symptomatology. We then compared groups of respondents based on (a) menopausal stage as assessed by World Health Organization (WHO) criteria and (b) menopausal symptomatology as assessed by the Menopause Rating Scale (MRS). RESULTS WHO-defined menopausal stage (premenopausal, perimenopausal, and postmenopausal) showed no significant associations with eating and body-image measures. However, MRS scores showed strong associations with most measures of the Eating Disorder Examination Questionnaire, as well as with questions regarding satisfaction with body image. These associations remained little changed even when removing the four psychological items from the MRS score and examining only the association of the MRS somato-vegetative and urogenital items with these outcome variables. DISCUSSION Our data augment existing evidence that the menopausal transition may be associated with eating and body-image disturbances. However, reported menopausal stage, which is difficult to define reliably, may be less informative than menopausal symptoms as a predictor of disordered eating and associated symptoms. LEVEL OF EVIDENCE V-descriptive survey study.
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16
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Modeling the associations between internal body orientation, body appreciation, and intuitive eating among early-adult and middle-adult men and women: A multigroup structural invariance analysis. Body Image 2021; 39:1-15. [PMID: 34119807 DOI: 10.1016/j.bodyim.2021.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 12/25/2022]
Abstract
This cross-sectional study investigated the associations among internal body orientation, body appreciation, intuitive eating, age, and BMI in men and women between 30 and 70 years old as delineated in the acceptance model of intuitive eating. Self-report measures were administered to a final sample of 522 individuals consisting of early-adult men (ages 30-44; n = 153), middle-adult men (ages 45-70; n = 108), early-adult women (ages 30-44; n = 135), and middle-adult women (ages 45-70; n = 126). Overall mean age was 45.03 (SD = 10.95). Structural equation modeling evidenced that, for both age groups of men and women, internal body orientation was positively associated with body appreciation and body appreciation was positively associated with intuitive eating. Internal body orientation was positively associated with intuitive eating in each group, except early-adult women. The associations among age and BMI with the aforementioned variables were inconsistent. Although evidencing measurement non-invariance among a number of parameters, multigroup structural invariance analyses showed that the associations among internal body orientation, body appreciation, intuitive eating, age, and BMI were invariant across each gender and age. These results further confirm components of the acceptance model of intuitive eating among men and women in early-adulthood and middle-adulthood.
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17
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Mikhail ME, Anaya C, Culbert KM, Sisk CL, Johnson A, Klump KL. Gonadal Hormone Influences on Sex Differences in Binge Eating Across Development. Curr Psychiatry Rep 2021; 23:74. [PMID: 34613500 PMCID: PMC8576863 DOI: 10.1007/s11920-021-01287-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Binge eating is a transdiagnostic symptom that disproportionately affects females. Sexually dimorphic gonadal hormones (e.g., estradiol, testosterone) substantially impact eating behavior and may contribute to sex differences in binge eating. We examine recent evidence for the role of gonadal hormones in binge eating risk across development. RECENT FINDINGS Both organizational (long-lasting impact on the central nervous system (CNS)) and activational (transient influences on the CNS) hormone effects may contribute to sex differences in binge eating. Gonadal hormones also impact within-sex variability in binge eating, with higher estradiol levels in females and higher testosterone levels in males protective across development. Emerging evidence suggests that the impact of gonadal hormones may be greatest for people with other risk factors, including genetic, temperamental (e.g., high negative affect), and psychosocial (e.g., exposure to weight-based teasing) risk. Gonadal hormones contribute to sex differences and within-sex variability in binge eating across development.
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Affiliation(s)
- Megan E. Mikhail
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA
| | - Carolina Anaya
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA
| | - Kristen M. Culbert
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Cheryl L. Sisk
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Alexander Johnson
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA,Corresponding author:
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18
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Dąbrowska-Galas M, Dąbrowska J. Physical Activity Level and Self-Esteem in Middle-Aged Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147293. [PMID: 34299744 PMCID: PMC8305857 DOI: 10.3390/ijerph18147293] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022]
Abstract
Background: Physical activity (PA) is a behavioral modality that may help decrease negative symptoms of menopause and enhance some positive aspects of mental health, including self-esteem. Reduced self-esteem may put menopausal women at higher risk of negative outcomes of menopause and result in a more unpleasant and stressful menopausal experience. The objective of this study was to examine the role of physical activity level on self-esteem in middle-aged women. Methods: Women aged 45-60 from Poland took part in this study. The Rosenberg Self-Esteem Scale, the International Physical Activity Questionnaire, the Menopause Rating Scale and Beck Depression Inventory were used in this study. Results: Among the 111 women, the mean age was 51.7 ± 4.7. The most severe symptoms among studied women concerned sexual problems (1.71 ± 1.5), irritability (1.58 ± 1.37) and joint and muscular discomfort (1.56 ± 1.55). Women with higher total PA level had better self-esteem (p = 0.001). Conclusions: The results of this study showed that physical activity levels can be associated with self-esteem. Most middle-aged women reported high physical activity levels. These results have clinical implications for the inclusion of PA in the lives of middle-aged women to improve self-esteem and mental health.
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Affiliation(s)
- Magdalena Dąbrowska-Galas
- Department of Kinesitherapy and Special Methods, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
- Correspondence:
| | - Jolanta Dąbrowska
- School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
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19
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Culbert KM, Sisk CL, Klump KL. A Narrative Review of Sex Differences in Eating Disorders: Is There a Biological Basis? Clin Ther 2021; 43:95-111. [PMID: 33375999 PMCID: PMC7902379 DOI: 10.1016/j.clinthera.2020.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Eating disorders and their core symptoms (eg, binge eating, body weight/shape concerns) disproportionately affect females, and these sex-differentiated effects become prominent during and after puberty. Although psychosocial influences such as heightened sociocultural pressures for thinness in girls and women contribute to this sex imbalance, biological factors could also play an important role. METHODS This narrative review summarizes evidence of biological factors underlying the sex-differentiated prevalence of eating pathology as well as within-sex variability in risk. FINDINGS There are sex differences in the pubertal emergence of genetic effects on eating pathology (adrenarche in males; gonadarche in females), and at least some genetic contributions to eating pathology seem to vary between the sexes. Furthermore, sex steroid hormones (eg, testosterone, estradiol, progesterone) are leading contributors to differential risk for eating pathology in males and females across the life span. Emerging data suggest that between-sex and within-sex variability in risk might occur via hormone-driven modulation (activation/deactivation) of genetic influences and neural responsiveness to food-related cues. IMPLICATIONS There is a biological basis to heightened risk for eating pathology in females, relative to males, as well as unique biological influences within each sex. Findings from this review highlight the importance of studying both sexes and considering sex-specific biological mechanisms that may underlie differential risk for eating pathology.
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Affiliation(s)
- Kristen M Culbert
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Cheryl L Sisk
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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20
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Ovarian hormones influence eating disorder symptom variability during the menopause transition: A pilot study. Eat Behav 2019; 35:101337. [PMID: 31726420 PMCID: PMC8248960 DOI: 10.1016/j.eatbeh.2019.101337] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 08/05/2019] [Accepted: 10/10/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Eating disorder symptoms change in a predictable pattern over the menstrual cycle such that changes in symptoms are triggered by changes in the ovarian hormones estradiol (E2) and progesterone (P4). To date, work in this area has focused exclusively on young adult women. The objective of this pilot study was to examine the effect of E2 and P4 on eating disorder symptom change in midlife women during early perimenopause. METHOD Participants included women aged 42-52 in early perimenopause (n=8). In-home self-assessments were completed for one menstrual cycle or 40-days, whichever occurred first. In-home self-assessments included collecting saliva samples each morning for E2 and P4 assays and completing online study questionnaires at the end of each day. Multilevel regression models examined the associations of E2 and P4 with daily symptoms of binge eating and body dissatisfaction. RESULTS E2 was positively associated with binge eating when P4 was high, but not when P4 was low. E2 was inversely associated with body dissatisfaction when P4 was low, but positively associated with body dissatisfaction when P4 was high. However, the simple slopes for the effect of E2 at both high and low P4 were not significant for body dissatisfaction. CONCLUSIONS Despite the pilot nature of this study, results are broadly consistent with the young adult literature indicating that P4 levels shape the impact of E2 on eating disorder symptoms. Larger studies with the inclusion of key moderators to account for individual heterogeneity are needed to confirm and extend these findings.
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21
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Kilpela LS, Verzijl CL, Becker CB. Body image in older women: a mediator of BMI and wellness behaviors. J Women Aging 2019; 33:298-311. [PMID: 31751189 DOI: 10.1080/08952841.2019.1692629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Negative body image is prevalent among mid- and late-life women. In younger women, negative body image is associated with reduced quality of life (QOL) when controlling for body mass index (BMI), and mediates the relationship between obesity and emotional wellbeing. Yet, much remains unknown about body image in older populations. In our sample of women aged 50-86 (N = 181), negative body image mediated the relationship between BMI and sleep, all four domains of QOL, negative affect, nutritious food consumption, and psychosocial impairment, but not enjoyment of physical activity. Findings suggest negative body image impacts the wellbeing of older women.
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Affiliation(s)
- Lisa Smith Kilpela
- Department of Psychiatry, Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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22
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Janjetic MA, Rossi ML, Acquavía C, Denevi J, Marcolini C, Torresani ME. Association Between Anxiety Level, Eating Behavior, and Nutritional Status in Adult Women. J Am Coll Nutr 2019; 39:200-205. [DOI: 10.1080/07315724.2019.1633970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Mariana A. Janjetic
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - María L. Rossi
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - Cintia Acquavía
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - Julieta Denevi
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - Cecilia Marcolini
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - María E. Torresani
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
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23
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Abstract
PURPOSE OF REVIEW We review the evidence for the reported increase in disordered eating and body image disturbance occurring in women in middle age and later life. We describe the contributing factors that relate to the unique experience of eating disorders (EDs) at midlife and beyond. We review evidence for several key factors in this observation, specifically the bio-psycho-social and relational components of later life EDs. We present treatment considerations, screening tools for evaluation, and treatment recommendations for this special population suffering with EDs. RECENT FINDINGS Eating disorder symptoms and body image preoccupation have been identified in increasing numbers of women over age 50. Reports indicate that women are seeking treatment for chronic, recurrent, or late onset EDs. However, health care providers generally have not screened for these conditions, and often pursue other medical diagnoses. Age does not immunize women from body image preoccupation, weight and shape concerns, disordered eating, and eating disorders.
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24
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Modica C. Facebook, body esteem, and body surveillance in adult women: The moderating role of self-compassion and appearance-contingent self-worth. Body Image 2019; 29:17-30. [PMID: 30818160 DOI: 10.1016/j.bodyim.2019.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 01/24/2023]
Abstract
This study examined how Facebook use and specific Facebook activities were associated with body esteem and body surveillance in adult women. This study also examined whether self-compassion and appearance-contingent self-worth moderated the relationship between Facebook appearance comparison and body esteem, and the relationship between Facebook appearance comparison and body surveillance. Self-report measures were administered to adult women (N = 232) between the ages of 20 and 72 (M = 35.91) recruited through MTurk. Results indicated that Facebook appearance-exposure and Facebook appearance comparison significantly related to body surveillance, whereas only Facebook appearance comparison significantly related to body esteem. Overall Facebook use and Facebook intensity were not significantly associated with either body esteem or body surveillance. Self-compassion and appearance-contingent self-worth significantly related to body esteem and body surveillance. However, neither self-compassion nor appearance-contingent self-worth significantly moderated the relationship between Facebook appearance comparison and body surveillance. Similarly, a lack of significant moderation was found for the relationship between Facebook appearance comparison and body esteem. The importance of studying body image and Facebook activities in adult women is discussed. Additionally, the importance for researchers to examine how specific Facebook activities, beyond Facebook use, are linked with body image in this population is also highlighted.
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Affiliation(s)
- Christopher Modica
- Ohio Wesleyan University, Department of Psychology, Phillips Hall 52, Delaware, OH, 43015, United States.
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25
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Thompson KA, Bardone-Cone AM. Evaluating attitudes about aging and body comparison as moderators of the relationship between menopausal status and disordered eating and body image concerns among middle-aged women. Maturitas 2019; 124:25-31. [PMID: 31097174 DOI: 10.1016/j.maturitas.2019.03.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/22/2019] [Accepted: 03/16/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Evidence suggests the menopausal period may be a unique window of vulnerability for the development or exacerbation of eating disorder symptoms among middle-aged women; however, it is unclear who is most at risk during this period. The goal of this study was to evaluate whether appearance-related aging concerns and body comparison, two sociocultural factors, moderated the association between menopausal status and disordered eating behaviors and body image concerns among middle-aged women. METHOD Participants (N = 310) completed an online survey about their menopausal status, aging concerns, body comparison, disordered eating, and body image concerns. RESULTS Tests of moderator models revealed that at low levels of aging concerns, peri-menopausal women reported greater dietary restraint than pre-menopausal or post-menopausal women. Additionally, among women with high scores for body comparison, post-menopausal women reported significantly more dietary restraint than either pre- or peri-menopausal women. DISCUSSION These findings suggest that the effects of menopause on dietary restraint may be stronger for some women than others.
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Affiliation(s)
- Katherine A Thompson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA.
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26
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Thompson KA, Bardone-Cone AM. Menopausal status and disordered eating and body image concerns among middle-aged women. Int J Eat Disord 2019; 52:314-318. [PMID: 30702172 DOI: 10.1002/eat.23030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 12/01/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Eating disorders are present among middle-aged women, yet most eating disorder knowledge comes from adolescents and young adults. There is arguably a need for research specific to middle-aged women and eating pathology. One biological factor that may contribute to eating disorder symptoms and is unique to middle-aged women is menopause, given the changes in body shape and weight that direct women's bodies away from the young, thin beauty standard. METHOD This study explored group differences in disordered eating and body image by menopausal status. Participants were 310 middle-aged women between the ages of 40 and 68. They completed an online survey about their menopausal status, disordered eating, and body image concerns. We compared disordered eating behaviors and attitudes across three groups: premenopausal women, perimenopausal women, and postmenopausal women. RESULTS Results indicated no group differences on either disordered eating or body image concerns by menopausal status. DISCUSSION These findings suggest the perimenopausal period may not be a window of vulnerability for women in general. Given these mixed findings, future research should examine moderators to determine when there are menopausal status group differences on eating pathology.
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Affiliation(s)
- Katherine A Thompson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Abstract
OBJECTIVE The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men. METHOD We distributed anonymous questionnaires to men aged 40-75 years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males' Symptoms scale (AMS), and classified respondents as "high-AMS" (AMS score ≥37; N = 82) or "low-AMS" (AMS score <37; N = 386). RESULTS High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men. DISCUSSION We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported "purging" via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.
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Affiliation(s)
- Kai K Kummer
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
| | - Harrison G Pope
- b McLean Hospital/Harvard Medical School , Belmont , MA , USA
| | - James I Hudson
- b McLean Hospital/Harvard Medical School , Belmont , MA , USA
| | - Georg Kemmler
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
| | | | - Barbara Mangweth-Matzek
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
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Fowler N, Vo PT, Sisk CL, Klump KL. Stress as a potential moderator of ovarian hormone influences on binge eating in women. F1000Res 2019; 8. [PMID: 30854192 PMCID: PMC6396839 DOI: 10.12688/f1000research.16895.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 12/30/2022] Open
Abstract
Previous research has demonstrated significant associations between increased levels of ovarian hormones and increased rates of binge eating (BE) in women. However, whereas all women experience fluctuations in ovarian hormones across the menstrual cycle, not all women binge eat in response to these fluctuations, suggesting that other factors must contribute. Stress is one potential contributing factor. Specifically, it may be that hormone-BE associations are stronger in women who experience high levels of stress, particularly as stress has been shown to be a precipitant to BE episodes in women. To date, no studies have directly examined stress as a moderator of hormone-BE associations, but indirect data (that is, associations between BE and stress and between ovarian hormones and stress) could provide initial clues about moderating effects. Given the above, the purpose of this narrative review was to evaluate these indirect data and their promise for understanding the role of stress in hormone-BE associations. Studies examining associations between all three phenotypes (that is, ovarian hormones, stress, and BE) in animals and humans were reviewed to provide the most thorough and up-to-date review of the literature on the potential moderating effects of stress on ovarian hormone-BE associations. Overall, current evidence suggests that associations between hormones and BE may be stronger in women with high stress levels, possibly via altered hypothalamic-pituitary-adrenal axis response to stress and increased sensitivity to and altered effects of ovarian hormones during stress. Additional studies are necessary to directly examine stress as a moderator of ovarian hormone-BE associations and identify the mechanisms underlying these effects.
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Affiliation(s)
- Natasha Fowler
- Department of Psychology, Michigan State University, 316 Physics Road, East Lansing, MI, 48824-1116, USA
| | - Phuong T Vo
- Department of Psychology, Michigan State University, 316 Physics Road, East Lansing, MI, 48824-1116, USA
| | - Cheryl L Sisk
- Neuroscience Program, Michigan State University, 293 Farm Lane, East Lansing, MI, 48824-1116, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, 316 Physics Road, East Lansing, MI, 48824-1116, USA
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Włodarczyk M, Dolińska-Zygmunt G. Searching for predictors of sense of quality of health: A study using neural networks on a sample of perimenopausal women. PLoS One 2019; 14:e0200129. [PMID: 30605472 PMCID: PMC6317781 DOI: 10.1371/journal.pone.0200129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 06/20/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We assumed that perimenopausal women's sense of quality of health (SQH) is a subjective evaluation of their psycho-physical health, and comprises three dimensions: sense of quality of life, menopausal symptoms, and the level of positive and negative affect. PURPOSE The aim of the study was to: 1) test a model about SQH, and 2) explore the role of personality traits, self-esteem, body self, and self-stereotype as predictors of SQH. METHODS The sample included 201 women aged between 45 and 55 (50.11±3.07). Participants filled out the Rosenberg Self-Esteem Scale, the Personality Inventory based on the Big Five Factor Model, the Body Self Questionnaire, and a survey querying perimenopausal women's self-stereotype. To determine the individual SQH dimensions we used the Sense of Quality of Life Questionnaire, the Menopause Symptom List, and the Positive and Negative Affect Schedule. To verify the assumptions of the SQH model and look for SQH predictors we conducted a neural networks analysis with structure optimization via genetic algorithms (a multivariate analysis). RESULTS The SQH model was verified in the course of several neural networks analyses with structure optimization via genetic algorithms (R = 0.849, R2 = 0.723, F = 133,232, p < 0.01). Moreover, we confirmed that SQH comprised three dimensions: quality of life, menopausal symptoms, and affect. SQH and menopausal symptoms were correlated. Similarly, positive and negative affect modified the women's global sense of quality of life. SQH predictors included: personality traits, self-esteem, the body-self, and menopausal woman's self-stereotype. CONCLUSION In practical terms, our findings may help raise awareness among women and medical practitioners, calling for a holistic approach to the health of menopausal women. Our findings may also facilitate the creation of both prevention and therapeutic programs for women transitioning through menopause, for example, cognitive-behavioral therapy.
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Séjourné N, Got F, Solans C, Raynal P. Body image, satisfaction with sexual life, self-esteem, and anxiodepressive symptoms: A comparative study between premenopausal, perimenopausal, and postmenopausal women. J Women Aging 2018; 31:18-29. [PMID: 30152729 DOI: 10.1080/08952841.2018.1510247] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Menopause is an important life transition in women, and it is associated with significant physical and psychological changes. This study aimed at examining how the menopausal transition influences body image and satisfaction with sexual life. To this aim, body image dissatisfaction, sexual dissatisfaction, and self-esteem were compared in three groups of women with distinct menopausal status (premenopausal n = 142, perimenopausal n = 66, or postmenopausal n = 149), while controlling for depressive and anxiety symptoms and BMI. Using ANOVA between these three groups, we observed that dissatisfaction with body image was significantly higher in the perimenopausal sample compared with its premenopausal counterpart. In the postmenopausal sample, body image improved, as this group displayed body image scores close to the premenopausal level. In addition, sexual dissatisfaction was significantly increased in the perimenopausal and postmenopausal samples, which is compatible with the concept that higher body appreciation positively predicted sexual function. We conclude that body image dissatisfaction reaches a maximum during the perimenopausal phase, before returning to a level nearly identical between the premenopausal and the postmenopausal phases.
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Affiliation(s)
- Natalène Séjourné
- a Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé , Université de Toulouse , Toulouse , France
| | - Fabrice Got
- a Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé , Université de Toulouse , Toulouse , France
| | - Catherine Solans
- a Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé , Université de Toulouse , Toulouse , France
| | - Patrick Raynal
- a Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé , Université de Toulouse , Toulouse , France
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Abstract
PURPOSE OF REVIEW We summarized recent literature on the epidemiology and treatment of eating disorders in middle-aged and older women and men. RECENT FINDINGS 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. SUMMARY 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.
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Schaumberg K, Welch E, Breithaupt L, Hübel C, Baker JH, Munn-Chernoff MA, Yilmaz Z, Ehrlich S, Mustelin L, Ghaderi A, Hardaway AJ, Bulik-Sullivan EC, Hedman AM, Jangmo A, Nilsson IAK, Wiklund C, Yao S, Seidel M, Bulik CM. The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2017; 25:432-450. [PMID: 28967161 PMCID: PMC5711426 DOI: 10.1002/erv.2553] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/16/2017] [Accepted: 08/18/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE 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'. METHODS The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elisabeth Welch
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lauren Breithaupt
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Christopher Hübel
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Linda Mustelin
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Public Health and Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andrew J Hardaway
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily C Bulik-Sullivan
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna M Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Jangmo
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ida A K Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Camilla Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Abstract
The aims of the study were (a) to identify predictors of body esteem and (b) to expand on previous research by examining the link between global self-esteem and body esteem in a community-based sample of women in midlife. We found that body esteem in midlife women was predicted by body mass index (BMI), optimism, self-esteem, and menopausal symptoms. Although BMI was the main predictor of body esteem in middle-aged women, global self-esteem was more strongly related to feelings about appearance and physical condition than feelings about body size.
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Baker JH, Peterson CM, Thornton LM, Brownley KA, Bulik CM, Girdler SS, Marcus MD, Bromberger JT. Reproductive and Appetite Hormones and Bulimic Symptoms during Midlife. EUROPEAN EATING DISORDERS REVIEW 2017; 25:188-194. [PMID: 28276114 DOI: 10.1002/erv.2510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 02/01/2017] [Accepted: 02/14/2017] [Indexed: 12/20/2022]
Abstract
Eating disorders and related symptoms occur during midlife; however, little is known about their aetiology. It has been hypothesised that perimenopause represents a window of vulnerability for the development or exacerbation of eating disorder symptomatology because, like puberty, perimenopause is a period of reproductive hormone change. We compared symptoms of bulimia nervosa (bulimic symptomatology) assessed via mean scores on a self-report questionnaire in premenopausal and perimenopausal women. We also examined the association between hormone concentrations (reproductive/appetite) and bulimic symptomatology. No mean differences in bulimic symptomatology were observed between premenopause and perimenopause. However, there was a significant positive association between leptin and binge eating. Although no significant associations between reproductive hormones and bulimic symptomatology were observed, additional research is needed to provide definitive information. It is essential to learn more about the aetiology of eating disorders and related symptomatology across the lifespan in order to develop age-relevant treatment and prevention programs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Jessica H Baker
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Claire M Peterson
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Kimberly A Brownley
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.,Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Baker JH, Runfola CD. Eating disorders in midlife women: A perimenopausal eating disorder? Maturitas 2016; 85:112-6. [PMID: 26857889 DOI: 10.1016/j.maturitas.2015.12.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/11/2015] [Accepted: 12/12/2015] [Indexed: 11/27/2022]
Abstract
Eating disorders afflict women across the lifespan with peak onset during critical or sensitive developmental periods of reproductive hormone change, such as puberty. A growing body of research supports the role of reproductive hormones, specifically estrogen, in the risk for eating disorders and related symptomatology in adolescence and young adulthood. Like puberty, perimenopause is characterized by estrogen change and may also present a window of vulnerability to eating disorder development. Here, we discuss the evidence that suggests perimenopause indeed may be a vulnerable period for the development or redevelopment of an eating disorder for midlife women. Drawing from what is known about the influence of estrogen on eating disorders at younger ages and from other psychiatric disorders with similar risk trajectories (i.e., perimenopausal depression), we describe a potential mechanism of risk for a perimenopausal eating disorder and how this can be explored in future research. Investigating vulnerability to perimenopausal eating disorders will clarify eating disorder etiology, identify reproductive stage-specific risk profiles, and guide future treatment directions.
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Affiliation(s)
- Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Cristin D Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Podfigurna-Stopa A, Czyzyk A, Katulski K, Smolarczyk R, Grymowicz M, Maciejewska-Jeske M, Meczekalski B. Eating disorders in older women. Maturitas 2015; 82:146-52. [DOI: 10.1016/j.maturitas.2015.06.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/22/2015] [Accepted: 06/23/2015] [Indexed: 11/26/2022]
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Culbert KM, Breedlove SM, Sisk CL, Keel PK, Neale MC, Boker SM, Burt SA, Klump KL. Age differences in prenatal testosterone's protective effects on disordered eating symptoms: developmental windows of expression? Behav Neurosci 2015; 129:18-36. [PMID: 25621790 DOI: 10.1037/bne0000034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Prenatal testosterone exposure may be protective against disordered eating. However, prior studies have produced mixed results. Developmental differences in prenatal testosterone's protective effects on disordered eating may explain these discrepancies. Indeed, studies have differed in the age of participants assessed, with data supporting prenatal testosterone effects on disordered eating in early adolescent and young adult samples but not in late adolescence. The present studies are the first to investigate age differences in prenatal testosterone's protective effects on disordered eating. Two indirect markers of higher prenatal testosterone were examined: (a) lower finger-length ratios (Study 1: index [2D]/ring [4D] finger [2D:4D]) and (b) lower disordered eating in female s from opposite-sex twin pairs (who are thought to be exposed to higher prenatal testosterone from their male co-twin) relative to female controls (Study 2). Participants were twins from the Michigan State University Twin Registry (Study 1: n = 409; Study 2: n = 1,538) in early adolescence, late adolescence, or young adulthood. Disordered eating was assessed with well-validated questionnaires. Finger-length ratios were measured from hand scans, using electronic computer calipers. Findings were consistent across both studies. Higher prenatal testosterone (lower 2D:4D; females from opposite-sex twin pairs vs. controls) predicted lower disordered eating in early adolescence and young adulthood only. Prenatal testosterone-disordered eating associations were not observed during late adolescence. Results point to the possibility of developmental windows of expression for prenatal testosterone's protective effects on disordered eating and suggest that prior discrepant results may reflect age differences across samples.
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Ginsberg RL, Tinker L, Liu J, Gray J, Sangi-Haghpeykar H, Manson JE, Margolis KL. Prevalence and correlates of body image dissatisfaction in postmenopausal women. Women Health 2015. [DOI: 10.1080/03630242.2015.1074636] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kilpela LS, Becker CB, Wesley N, Stewart T. Body Image in Adult Women: Moving Beyond the Younger Years. ACTA ACUST UNITED AC 2015; 3:144-164. [PMID: 26052476 DOI: 10.1080/21662630.2015.1012728] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In spite of copious literature investigating body dissatisfaction and its correlates in adolescents and young adult women, exploration of body image disturbances in adult women remains an underrepresented domain in the literature. Yet, there are many reasons to suspect that body image in adult women both may differ from and possibly be more complex than that of younger women. Adult women face myriad factors influencing body image beyond those delineated in the body image literature on adolescents and young adult women. For instance, aging-related physiological changes shift the female body further away from the thin-young-ideal, which is the societal standard of female beauty. Further, life priorities and psychological factors evolve with age as well. As such, adult women encounter changes that may differentially affect body image across the lifespan. This paper aims to provide an up-to-date review of the current literature on the relationship between body image and associated mental and physical health problems and behaviors in adult women. In addition, we explore factors that may influence body image in adult women. Lastly, we use this review to identify significant gaps in the existing literature with the aim of identifying critical targets for future research.
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Affiliation(s)
| | | | - Nicole Wesley
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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40
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Abstract
PURPOSE OF REVIEW To summarize the recent literature examining eating disorders, eating behavior, and body image in middle-aged and elderly women. RECENT FINDINGS A small but evolving literature has begun to address the epidemiology, features, and potential treatment of eating disorders and related body-image concerns in middle-aged and elderly women. Preliminary findings suggest that pathological eating behaviors and frank eating disorders are surprisingly common in older women, as are associated body-image disturbances. Older women appear less likely to exhibit anorexia and bulimia nervosa and more likely to exhibit binge eating disorder and eating disorder not otherwise specified. The prevalence of such conditions in older women has likely increased in recent decades. On many indices of disordered eating and body image, older women with eating disorder resemble younger women with similar conditions, although older women exhibit certain unique concerns, such as dealing with menopause and with aging. SUMMARY It appears that clinicians should be alert for eating and body-image disorder even in women well beyond the younger age range in whom these disorders have traditionally been described. Subsequent research should consider treatment strategies tailored for older women with eating disorders.
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Mangweth-Matzek B, Hoek HW, Rupp CI, Lackner-Seifert K, Frey N, Whitworth AB, Pope HG, Kinzl J. Prevalence of eating disorders in middle-aged women. Int J Eat Disord 2014; 47:320-4. [PMID: 24293379 DOI: 10.1002/eat.22232] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Little is known about the prevalence and correlates of eating disorders (ED) in middle-aged women. METHOD We mailed anonymous questionnaires to 1,500 Austrian women aged 40-60 years, assessing ED (defined by DSM-IV), subthreshold ED, body image, and quality of life. We broadly defined "subthreshold ED" by the presence of either (1) binge eating with loss of control or (2) purging behavior, without requiring any of the other usual DSM-IV criteria for frequency or severity of these symptoms. RESULTS Of the 715 (48%) responders, 33 [4.6%; 95% confidence interval (CI): 3.3-6.4%] reported symptoms meeting full DSM-IV criteria for an ED [bulimia nervosa = 10; binge eating disorder = 11; eating disorder not otherwise specified (EDNOS) = 12]. None displayed anorexia nervosa. Another 34 women (4.8%; CI: 3.4-6.6%) displayed subthreshold ED. These women showed levels of associated psychopathology virtually equal to the women with full-syndrome diagnoses. DISCUSSION ED appear common in middle-aged women, with a preponderance of binge eating disorder and EDNOS diagnoses as compared to the "classical" diagnoses of anorexia and bulimia nervosa. Interestingly, middle-aged women with even very broadly defined subthreshold ED showed distress and impairment comparable to women with full-scale ED.
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Affiliation(s)
- Barbara Mangweth-Matzek
- University Clinic of Psychosomatic Medicine, Innsbruck Medical University, Innsbruck, Austria
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Drobnjak S, Atsiz S, Ditzen B, Tuschen-Caffier B, Ehlert U. Restrained eating and self-esteem in premenopausal and postmenopausal women. J Eat Disord 2014; 2:23. [PMID: 25349697 PMCID: PMC4209048 DOI: 10.1186/s40337-014-0023-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 08/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been limited research about disordered eating in middle-aged women, and to date, few data exist about restrained eating behavior in postmenopausal women. Therefore, the aim of this study was to examine eating behavior with a specific focus on menopause as an associated factor in restrained eating. Beyond this, we were interested in how postmenopausal status and self-esteem would interact to determine eating patterns in women in middle age. METHODS We conducted an online survey in women aged between 40 and 66. Eating behavior was assessed with the Eating Disorder Examination-Questionnaire (EDE-Q) in premenopausal (N = 318) and postmenopausal women (N = 250). All participants rated their self-esteem using the Rosenberg Self-Esteem Scale (RSE) and reported their weight, height, waist circumference, and hip circumference. RESULTS 15.7% of all participants showed clinically meaningful scores on restrained eating. Postmenopausal women showed significantly higher scores on the EDE-Q subscale of restrained eating as compared to premenopausal women, but when controlling for body mass index, however, this finding was no longer significant. Further exploratory analyses suggest that particularly low or high self-esteem levels are associated with restrained eating. Self-esteem might serve as a mediator between menopausal status and restrained eating, however results of these additional analyses were inconsistent. CONCLUSIONS Restrained eating may appear in middle-aged women. Particularly in postmenopausal women, restrained eating might be associated with lower and higher self-esteem.
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Affiliation(s)
- Suzana Drobnjak
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland
| | - Semra Atsiz
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland
| | - Beate Ditzen
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland ; Institute of Medical Psychology in the Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, Heidelberg, 69115 Germany
| | - Brunna Tuschen-Caffier
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, Albert-Ludwigs University, Engelbergerstrasse 41, Freiburg, 79106 Germany
| | - Ulrike Ehlert
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland
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