1
|
Christian C, Butler RM, Burr EK, Levinson C. An Intensive time series investigation of the relationships across eating disorder-specific fear responses and behavior urges in partially remitted anorexia nervosa. J Anxiety Disord 2024; 102:102804. [PMID: 38128286 PMCID: PMC10923000 DOI: 10.1016/j.janxdis.2023.102804] [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] [Received: 05/23/2023] [Revised: 09/25/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
Anorexia nervosa (AN) is a serious and persistent psychiatric illness. Many individuals with AN cycle between stages of remission (i.e., relapse), with research documenting that cognitive remission generally lags behind nutritional/weight restoration. Yet, little is known about which mechanisms promote movement from partial remission in AN (defined as nutritional, but not cognitive, recovery) to full remission. Fear-based processes, including avoidance and approach behaviors, likely contribute to the persistence of cognitive-behavioral AN symptoms after nutritional restoration. The current study used intensive longitudinal data to characterize these processes during partial remission (N = 41 participants with partially remitted AN; 4306 total observations). We aimed to a) characterize frequency of fear-based processes in real-time, b) investigate associations across fear-based processes and behavioral urges, and c) test if real-time associations among symptoms differed across commonly feared stimuli (e.g., food, social situations). On average, participants endorsed moderate fear and avoidance, with weight-gain fears rated higher than other feared stimuli. Momentary fear, avoidance, approach, and distress were all positively associated with AN behavior urges at one time-point and prospectively. Central symptoms and symptom connections differed across models with different feared stimuli. These findings provide empirical support for the theorized fear-avoidance-urge cycle in AN, which may contribute to the persistence of eating pathology during partial remission. Fear approach may be associated with temporary increases in urges, which should be considered during treatment. Future research should explore these associations in large, heterogeneous samples, and test the effectiveness of exposure-based interventions during partial remission.
Collapse
Affiliation(s)
- Caroline Christian
- University of Louisville, Department of Psychological & Brain Sciences, Louisville, KY, USA.
| | - Rachel M Butler
- University of Louisville, Department of Psychological & Brain Sciences, Louisville, KY, USA
| | - Emily K Burr
- University of Central Florida, Department of Psychology, Orlando, FL, USA
| | - Cheri Levinson
- University of Louisville, Department of Psychological & Brain Sciences, Louisville, KY, USA
| |
Collapse
|
2
|
Sala M, Levinson CA, Kober H, Roos CR. A Pilot Open Trial of a Digital Mindfulness-Based Intervention for Anorexia Nervosa. Behav Ther 2023; 54:637-651. [PMID: 37330254 DOI: 10.1016/j.beth.2023.01.003] [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: 01/20/2022] [Revised: 01/09/2023] [Accepted: 01/19/2023] [Indexed: 02/04/2023]
Abstract
Anorexia nervosa (AN) is a chronic and debilitating psychiatric disorder. Unfortunately, current treatments are lacking, with only 30-50% of individuals with AN recovering after treatment. We developed a beta-version of a digital mindfulness-based intervention for AN called Mindful Courage-Beta, which includes: (a) one foundational multimedia module; (b) 10 daily meditation mini-modules; (c) emphasis on a core skill set called the BOAT (Breathe, Observe, Accept, Take a Moment); and (d) brief phone coaching for both technical and motivational support. In this open trial, we aimed to evaluate (1) acceptability and feasibility; (2) intervention skill use and its association with state mindfulness in daily life; and (3) pre-to-post changes in target mechanisms and outcomes. Eighteen individuals with past-year AN or past-year atypical AN completed Mindful Courage-Beta over 2 weeks. Participants completed measures of acceptability, trait mindfulness, emotion regulation, eating disorder symptoms, and body dissatisfaction. Participants also completed ecological momentary assessment of skill use and state mindfulness. Acceptability ratings were good (ease-of-use: 8.2/10, helpfulness: 7.6/10). Adherence was excellent (100% completion for foundational module and 96% for mini-modules). Use of the BOAT in daily life was high (1.8 times/day) and was significantly associated with higher state mindfulness at the within-person level. We also found significant, large improvements in the target mechanisms of trait mindfulness (d = .96) and emotion regulation (d = .76), as well as significant, small-medium to medium-large reductions in eating disorder symptoms (ds = .36-.67) and body dissatisfaction (d = .60). Changes in trait mindfulness and emotion regulation had medium-large size correlations with changes in global ED symptoms and body dissatisfaction (rs = .43 - .56). Mindful Courage-Beta appears to be promising and further research on a longer, refined version is warranted.
Collapse
Affiliation(s)
- Margaret Sala
- Ferkauf Graduate School of Psychology, Yeshiva University.
| | | | | | | |
Collapse
|
3
|
Weight suppression and body mass index at admission interactively predict weight trajectories during inpatient treatment of anorexia nervosa. J Psychosom Res 2022; 158:110924. [PMID: 35487140 DOI: 10.1016/j.jpsychores.2022.110924] [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: 05/12/2021] [Revised: 04/05/2022] [Accepted: 04/16/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Weight suppression refers to the difference between an individual's current and highest body weight at their current height. Higher weight suppression has been found to predict weight gain in both non-clinical samples and patients with eating disorders. Few studies also have reported interactive effects between weight suppression and current body mass index when predicting weight gain. METHODS In this retrospective study, we analyzed clinical records of inpatients with anorexia nervosa (N = 2191, 97% female) and tested whether weight suppression and body mass index at admission would interactively predict different weight trajectories during treatment. RESULTS Body weight increased non-linearly during treatment. Higher weight suppression predicted larger weight gain but the nature of this effect depended on body mass index at admission. In patients with a relatively low body weight at admission, those with high weight suppression started at a lower weight and showed a nearly linear and steeper weight gain than those with low weight suppression. In patients with a relatively high body weight at admission, those with high weight suppression started at a similar weight and showed a non-linear and larger weight gain than those with low weight suppression. CONCLUSION Findings further support that weight suppression is a robust predictor of weight gain in addition to-and in interaction with-current body weight. As weight suppression can easily be assessed at admission, it may help to anticipate treatment course and outcome in patients with anorexia nervosa.
Collapse
|
4
|
Prevalence and psychiatric comorbidities of night-eating behavior in obese bariatric patients: preliminary evidence for a connection between night-eating and bipolar spectrum disorders. Eat Weight Disord 2022; 27:1695-1704. [PMID: 34617263 PMCID: PMC9122845 DOI: 10.1007/s40519-021-01306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/15/2021] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The co-occurrence of obesity, eating and mood disorders has been frequently reported in clinical and epidemiological settings. This study aimed to explore the prevalence of night-eating obese patients referred for bariatric surgery and to identify associated psychopathology and psychiatric comorbidity. METHODS The sample was composed of 121 obese patients consecutively enrolled between November 2010 and May 2012 during psychiatric evaluations for bariatric intervention. Clinical features and psychiatric diagnoses were collected. Night-eating was investigated through the administration of the Night-eating Questionnaires (NEQ) and was defined as the presence of self-reported evening hyperphagia and/or nocturnal ingestions. Binge-eating and purging behaviors and general psychopathology were respectively assessed using the Bulimic Investigatory Test, Edinburgh and the Symptom Checklist-90-Revised. RESULTS Night-eating was reported by twenty subjects (16.5%). Patients with night-eating behavior were significantly more frequently diagnosed with bipolar spectrum disorders and with comorbid eating and mood disorders in comparison with other patients. Night-eating patients showed significantly more binging/purging behaviors and greater severity of somatization, obsessive-compulsive symptoms, phobic anxiety, psychoticism and sleep disorders. Patients with bipolar disorder type 1 or 2 scored significantly higher than those without mood disorders at NEQ total score, mood/sleep and nocturnal ingestions subscales, but also scored significantly higher than other patients with mood disorders at the latter subscale. CONCLUSION Patients with evening hyperphagia and/or nocturnal ingestions should be carefully evaluated to detect possible bipolar spectrum disorders and other eating disorders. Prompt management of these conditions should be provided before bariatric interventions. LEVEL OF EVIDENCE V, cross-sectional descriptive study.
Collapse
|
5
|
Meule A, Furst Loredo A, Schrambke D, Schlegl S, Naab S, Voderholzer U. Adolescent inpatients with anorexia nervosa can roughly predict their own weight trajectories after discharge. Eat Disord 2022; 30:223-229. [PMID: 34370628 DOI: 10.1080/10640266.2021.1931647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Most adolescents with anorexia nervosa (AN) gain a substantial amount of weight during inpatient treatment, but many relapse after discharge. Therefore, there is a need to identify variables that predict weight changes after treatment. The current study tested whether such a variable may be patients' own predictions about their future weight. Data of 120 female adolescent inpatients with AN were available at discharge and one-year follow-up. Patients' own predictions about their future weight trajectories predicted their actual weight change after discharge: those who indicated that they would gain weight, gained weight, those who indicated that they would lose weight, lost weight, and those who indicated to maintain their weight, had no weight change on average. Similarly, expected weight change in kilograms correlated positively with actual weight change after discharge. Thus, patients who expect that they will lose weight again should receive intensified aftercare that fosters motivation to change.
Collapse
Affiliation(s)
- Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | | | | | - Sandra Schlegl
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Silke Naab
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
| |
Collapse
|
6
|
Peters K, Meule A, Voderholzer U, Rauh E. Effects of interval-based inpatient treatment for anorexia nervosa: An observational study. Brain Behav 2021; 11:e2362. [PMID: 34543514 PMCID: PMC8613410 DOI: 10.1002/brb3.2362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/24/2021] [Accepted: 09/02/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE After inpatient treatment for anorexia nervosa (AN), many patients relapse and need to be readmitted. To obtain a sustained improvement, a pre-planned multistep inpatient procedure might help to improve the patient's skills in dealing with symptoms and transdiagnostic problems, thus decreasing symptoms of AN. However, no data have been reported for such interval treatment yet. Therefore, this study examined effects of interval treatment in inpatients with AN. METHOD Data of adult women with AN (N = 304) who received inpatient treatment and either received interval treatment (n = 179) or not (n = 125) were analyzed. Of these, 225 patients completed a follow up measurement after an average of 25 months. Treatment outcome variables were body mass index and subscales of the Eating Disorder Inventory-2 at admission, discharge, and follow up. RESULTS Across measurements, the interval treatment group had larger increases in body mass index and larger decreases in drive for thinness and binge/purge symptoms than the no interval treatment group. These differences did not seem to be driven by longer treatment duration. DISCUSSION Our data suggest that interval treatment for AN is effective and may even be superior to conventional single inpatient treatment. Given the observational nature of this study, however, controlled studies are necessary to corroborate these findings.
Collapse
Affiliation(s)
- Kathrin Peters
- Schoen Clinic Bad Staffelstein, Bad Staffelstein, Germany.,Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
| | - Elisabeth Rauh
- Schoen Clinic Bad Staffelstein, Bad Staffelstein, Germany
| |
Collapse
|
7
|
Redgrave GW, Schreyer CC, Coughlin JW, Fischer LK, Pletch A, Guarda AS. Discharge Body Mass Index, Not Illness Chronicity, Predicts 6-Month Weight Outcome in Patients Hospitalized With Anorexia Nervosa. Front Psychiatry 2021; 12:641861. [PMID: 33716836 PMCID: PMC7946839 DOI: 10.3389/fpsyt.2021.641861] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/02/2021] [Indexed: 12/28/2022] Open
Abstract
Proposed treatments for severe and enduring anorexia nervosa (SE-AN) focus on quality of life, and psychological and social functioning. By de-emphasizing weight restoration as a priority, however, premature diagnosis of SE-AN may reduce potential for recovery. The present study assessed the effect of weight restoration, illness duration, and severity on treatment outcome 6 months after discharge from an intensive, meal-based behavioral treatment program. Participants included hospitalized adult women (N = 191) with AN or underweight other specified feeding and eating disorder (OSFED). Participants were characterized as short-term (ill <7 years; n = 74) or long-term ill (ill ≥ 7 years; n = 117). Compared with short-term ill, long-term ill patients were older, had lower lifetime body mass index (BMI), more prior admissions, and exhibited greater depression and neuroticism. Long-term vs. short-term ill patients gained weight at the same rate (~2 kg/wk) and were equally likely to be weight restored by discharge (>75% reached BMI ≥ 19 kg/m2 in both groups). At 6-month follow-up (n = 99), both groups had equivalent self-reported BMI, and depression, drive for thinness, body dissatisfaction, and bulimia scores. The only predictor of BMI ≥ 19 kg/m2 at follow-up was discharge BMI. The likelihood of a BMI ≥ 19 kg/m2 at follow-up was 5-fold higher for those with discharge BMI ≥ 19 kg/m2. Few studies of long-term ill inpatients with AN have examined the impact of full weight restoration on short-term outcomes. This study supports the therapeutically optimistic stance that, regardless of illness duration, hospitalized patients with AN benefit from gaining weight to a BMI ≥ 19 kg/m2.
Collapse
Affiliation(s)
- Graham W Redgrave
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Colleen C Schreyer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Janelle W Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Laura K Fischer
- Children's National Medical Center, Clinical and Translational Science Institute, Washington, DC, United States
| | - Allisyn Pletch
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Angela S Guarda
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| |
Collapse
|
8
|
Danielsen M, Bjørnelv S, Weider S, Myklebust TÅ, Lundh H, Rø Ø. The outcome at follow-up after inpatient eating disorder treatment: a naturalistic study. J Eat Disord 2020; 8:67. [PMID: 33292634 PMCID: PMC7709321 DOI: 10.1186/s40337-020-00349-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/03/2020] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Patients with eating disorders may experience a severe and enduring course of illness. Treatment outcome for patients provided with inpatient treatment is reported as poor. Research to date has not provided consistent results for predictors of treatment outcome. The aims of the study were to investigate rates of remission at follow-up after inpatient treatment, symptom change from admission to follow-up, and predictors of treatment outcome. METHODS The follow-up sample consisted of 150 female adult former patients (69.4% of all eligible female patients) with eating disorders. Mean age at admission was 21.7 (SD = 4.9) years. Diagnostic distribution: 66% (n = 99) anorexia nervosa, 21.3% (n = 32) bulimia nervosa and 12.7% (n = 19) other specified feeding or eating disorder, including binge eating. Data were collected at admission, discharge and follow-up (mean 2.7 (SD = 1.9) years). Definition of remission was based on the EDE-Q Global score, body mass index and binge/purge behavior. Paired T-tests were performed to investigate change over time. Univariate and multivariate logistic regressions were estimated to investigate predictors of remission. RESULTS At follow-up, 35.2% of the participants were classified as in remission. Significant symptom reduction (in all patients) (p < 0.001) and significant increase in body mass index (BMI) (in underweight participants at admission) (p < 0.001) was found. Increased BMI (p < 0.05), the level of core eating disorder symptoms at admission (p < 0.01) and reduced core eating disorder symptoms (p < 0.01) during inpatient treatment were found significant predictors of outcome in the multivariate model. CONCLUSIONS All participants had an eating disorder requiring inpatient treatment. Approximately one-third of all participants could be classified as in remission at follow-up. However, most participants experienced significant symptom improvement during inpatient treatment and the improvements were sustained at follow-up. Increased probability of remission at follow-up was indicated by lower core ED symptoms at admission for all patients, raised BMI during admission for patients with AN, and reduced core ED symptoms during inpatient treatment for all patients. This finding contributes important information and highlights the importance of targeting these core symptoms in transdiagnostic treatment programs.
Collapse
Affiliation(s)
- Marit Danielsen
- Eating Disorder Unit, Department of Psychiatry, Levanger Hospital, Hospital Trust Nord-Trøndelag, NO-7600, Levanger, Norway. .,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Sigrid Bjørnelv
- Eating Disorder Unit, Department of Psychiatry, Levanger Hospital, Hospital Trust Nord-Trøndelag, NO-7600, Levanger, Norway.,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Siri Weider
- Eating Disorder Unit, Department of Psychiatry, Levanger Hospital, Hospital Trust Nord-Trøndelag, NO-7600, Levanger, Norway.,Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tor Åge Myklebust
- Department of Research and Innovation, Møre og Romsdal Hospital Trust, Ålesund, Norway
| | - Henrik Lundh
- Eating Disorder Unit, Department of Psychiatry, Levanger Hospital, Hospital Trust Nord-Trøndelag, NO-7600, Levanger, Norway
| | - Øyvind Rø
- Regional Eating Disorder Service, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
9
|
Meule A, Schrambke D, Furst Loredo A, Schlegl S, Naab S, Voderholzer U. Inpatient treatment of anorexia nervosa in adolescents: A 1‐year follow‐up study. EUROPEAN EATING DISORDERS REVIEW 2020; 29:165-177. [DOI: 10.1002/erv.2808] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Adrian Meule
- Department of Psychiatry and Psychotherapy University Hospital LMU Munich Munich Germany
- Schoen Clinic Roseneck Prien am Chiemsee Germany
| | | | | | - Sandra Schlegl
- Department of Psychiatry and Psychotherapy University Hospital LMU Munich Munich Germany
- Schoen Clinic Roseneck Prien am Chiemsee Germany
| | - Silke Naab
- Schoen Clinic Roseneck Prien am Chiemsee Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy University Hospital LMU Munich Munich Germany
- Schoen Clinic Roseneck Prien am Chiemsee Germany
- Department of Psychiatry and Psychotherapy University Hospital of Freiburg Freiburg Germany
| |
Collapse
|
10
|
Murray HB, Tabri N, Thomas JJ, Herzog DB, Franko DL, Eddy KT. Will I get fat? 22-year weight trajectories of individuals with eating disorders. Int J Eat Disord 2017; 50:739-747. [PMID: 28188643 PMCID: PMC10395548 DOI: 10.1002/eat.22690] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/15/2016] [Accepted: 01/16/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE For some, fat phobia or fear of uncontrollable weight gain is diagnostic of eating disorders, often inhibiting treatment engagement and predicting symptom relapse. Prior research has reported weight changes at infrequent or long intervals, but rate, shape, and magnitude of long-term changes remain unknown. Our study examined 22-year longitudinal trajectories of body mass index (BMI) in women with anorexia nervosa (AN) and bulimia nervosa (BN). METHOD Participants were followed over 10 years (N = 225) and at 22-year follow-up (N = 175). Using latent growth curves, we examined: (1) shape and rate of intra-individual BMI change over 10 years; (2) predictors of BMI change over 10 years, (3) 22-year BMI outcomes; and (4) BMI changes over 10 years as predictors of 22-year BMI. RESULTS The best-fitting model captured overall intra-individual rates of BMI change in three intervals, showing moderate rate of BMI increase from intake to year 2, modest increase from year 2 to 5, and plateau from year 5 to 10. At 22 years, 14% were underweight, 69% were normal weight, and only 17% were overweight or obese. Greater increases from intake to year 2 predicted higher BMI at 22 years (β = 0.43, p < 0.01) and were predicted by intake diagnosis of AN-restricting (β = 0.31, p < 0.01) or AN-binge eating/purging (β = 0.29, p < 0.01). DISCUSSION BMI increased most rapidly during earlier years of the study for those with lower weight at study intake (i. e., AN) and plateaued over time, settling in the normal range for most. Psychoeducation about expected BMI trajectory may challenge patients' long-term fat phobic predictions.
Collapse
Affiliation(s)
- Helen B Murray
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA, 02114.,Psychology Department, Drexel University, 3141 Chestnut Street, Stratton Hall 119, Philadelphia, PA, 19104
| | - Nassim Tabri
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA, 02114.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA, 02114.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115
| | - David B Herzog
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA, 02114.,Department of Counseling and Applied Educational Psychology, Northeastern University, 120 Behrakis Health Sciences Center, 30 Leon Street, Boston, MA, 02115
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA, 02114.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115
| |
Collapse
|
11
|
Kirk KM, Martin FC, Mao A, Parker R, Maguire S, Thornton LM, Zhu G, McAloney K, Freeman JL, Hay P, Madden S, Morgan C, Russell J, Sawyer SM, Hughes EK, Fairweather-Schmidt AK, Fursland A, McCormack J, Wagg F, Jordan J, Kennedy MA, Ward W, Wade TD, Bulik CM, Martin NG. The Anorexia Nervosa Genetics Initiative: Study description and sample characteristics of the Australian and New Zealand arm. Aust N Z J Psychiatry 2017; 51:583-594. [PMID: 28378620 DOI: 10.1177/0004867417700731] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Anorexia nervosa is a severe psychiatric disorder with high mortality rates. While its aetiology is poorly understood, there is evidence of a significant genetic component. The Anorexia Nervosa Genetics Initiative is an international collaboration which aims to understand the genetic basis of the disorder. This paper describes the recruitment and characteristics of the Australasian Anorexia Nervosa Genetics Initiative sample, the largest sample of individuals with anorexia nervosa ever assembled across Australia and New Zealand. METHODS Participants completed an online questionnaire based on the Structured Clinical Interview Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) eating disorders section. Participants who met specified case criteria for lifetime anorexia nervosa were requested to provide a DNA sample for genetic analysis. RESULTS Overall, the study recruited 3414 Australians and 543 New Zealanders meeting the lifetime anorexia nervosa case criteria by using a variety of conventional and social media recruitment methods. At the time of questionnaire completion, 28% had a body mass index ⩽ 18.5 kg/m2. Fasting and exercise were the most commonly employed methods of weight control, and were associated with the youngest reported ages of onset. At the time of the study, 32% of participants meeting lifetime anorexia nervosa case criteria were under the care of a medical practitioner; those with current body mass index < 18.5 kg/m2 were more likely to be currently receiving medical care (56%) than those with current body mass index ⩾ 18.5 kg/m2 (23%). Professional treatment for eating disorders was most likely to have been received from general practitioners (45% of study participants), dietitians (42%) and outpatient programmes (42%). CONCLUSIONS This study was effective in assembling the largest community sample of people with lifetime anorexia nervosa in Australia and New Zealand to date. The proportion of people with anorexia nervosa currently receiving medical care, and the most common sources of treatment accessed, indicates the importance of training for general practitioners and dietitians in treating anorexia nervosa.
Collapse
Affiliation(s)
- Katherine M Kirk
- 1 Genetic Epidemiology Laboratory, QIMR Berghofer Institute of Medical Research, Brisbane, QLD, Australia
| | - Felicity C Martin
- 1 Genetic Epidemiology Laboratory, QIMR Berghofer Institute of Medical Research, Brisbane, QLD, Australia
| | - Amy Mao
- 2 Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Richard Parker
- 1 Genetic Epidemiology Laboratory, QIMR Berghofer Institute of Medical Research, Brisbane, QLD, Australia
| | | | - Laura M Thornton
- 4 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gu Zhu
- 1 Genetic Epidemiology Laboratory, QIMR Berghofer Institute of Medical Research, Brisbane, QLD, Australia
| | - Kerrie McAloney
- 1 Genetic Epidemiology Laboratory, QIMR Berghofer Institute of Medical Research, Brisbane, QLD, Australia
| | - Jeremy L Freeman
- 5 Australia & New Zealand Academy for Eating Disorders, Sydney, NSW, Australia
| | - Phillipa Hay
- 6 Western Sydney University, Sydney, NSW, Australia
| | - Sloane Madden
- 6 Western Sydney University, Sydney, NSW, Australia.,7 The Sydney Children's Hospital Network, Sydney, NSW, Australia
| | | | | | - Susan M Sawyer
- 9 The Royal Children's Hospital, Melbourne, VIC, Australia
| | | | | | - Anthea Fursland
- 11 Centre for Clinical Interventions, Perth, WA, Australia.,12 Curtin University, Perth, WA, Australia
| | - Julie McCormack
- 13 Princess Margaret Hospital for Children, Perth, WA, Australia
| | - Fiona Wagg
- 14 Royal Hobart Hospital, Hobart, TAS, Australia
| | | | | | - Warren Ward
- 2 Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,16 School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | | | - Cynthia M Bulik
- 4 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,17 Karolinska Institutet, Stockholm, Sweden
| | - Nicholas G Martin
- 1 Genetic Epidemiology Laboratory, QIMR Berghofer Institute of Medical Research, Brisbane, QLD, Australia
| |
Collapse
|
12
|
Duncan AE, Ziobrowski HN, Nicol G. The Prevalence of Past 12-Month and Lifetime DSM-IV Eating Disorders by BMI Category in US Men and Women. EUROPEAN EATING DISORDERS REVIEW 2017; 25:165-171. [PMID: 28127825 DOI: 10.1002/erv.2503] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/12/2016] [Accepted: 01/05/2017] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This study aims to determine whether the prevalence of lifetime and past 12-month DSM-IV eating disorders (ED) diagnoses differed by body mass index category among men and women in a general population sample. METHODS Data from the Collaborative Psychiatric Epidemiology Surveys (n = 12 337 adults) were analysed using logistic regression. Analyses were conducted separately by gender. RESULTS Lifetime ED prevalence was 2.22% in men and 4.93% in women. In both genders, the prevalence of any lifetime and past 12-month ED, binge eating disorder and recurrent binge eating was highest among obese individuals. Among obese men and women, lifetime and past 12-month ED prevalence was highest among those with class III obesity. CONCLUSION Eating disorders were most prevalent among high-weight individuals. This information is important for planning targeted public health ED and obesity prevention and intervention activities, as well as for informing the clinical care of obese individuals. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Collapse
Affiliation(s)
- Alexis E Duncan
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Hannah N Ziobrowski
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Ginger Nicol
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
13
|
Bergmann S, Schlesier-Michel A, Wendt V, Grube M, Keitel-Korndörfer A, Gausche R, von Klitzing K, Klein AM. Maternal Weight Predicts Children's Psychosocial Development via Parenting Stress and Emotional Availability. Front Psychol 2016; 7:1156. [PMID: 27559321 PMCID: PMC4978733 DOI: 10.3389/fpsyg.2016.01156] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/20/2016] [Indexed: 12/16/2022] Open
Abstract
Introduction: Maternal obesity has been shown to be a risk factor for obesity in children and may also affect children's psychosocial outcomes. It is not yet clear whether there are also psycho-emotional mechanisms explaining the effects of maternal weight on young children's weight and psychosocial development. We aimed to evaluate whether maternal body mass index (BMI), mother–child emotional availability (EA), and maternal parenting stress are associated with children's weight and psychosocial development (i.e., internalizing/externalizing symptoms and social competence) and whether these predictors interact with each other. Methods: This longitudinal study included three assessment points (~11 months apart). The baseline sample consisted of N = 194 mothers and their children aged 5–47 months (M = 28.18, SD = 8.44, 99 girls). At t1, we measured maternal weight and height to calculate maternal BMI. We videotaped mother–child interactions, coding them with the EA Scales (fourth edition). We assessed maternal parenting stress with the Parenting Stress Index (PSI) short form. At t1 to t3, we measured height and weight of children and calculated BMI–SDS scores. Children's externalizing and internalizing problems (t1–t3) and social competence (t3, N = 118) were assessed using questionnaires: Child Behavior Checklist (CBCL 1.5–5), Strengths and Difficulties Questionnaire (SDQ: prosocial behavior), and a checklist for behavioral problems at preschool age (VBV 3–6: social-emotional competence). Results: By applying structural equation modeling (SEM) and a latent regression analysis, we found maternal BMI to predict higher BMI–SDS and a poorer psychosocial development (higher externalizing symptoms, lower social competence) in children. Higher parenting stress predicted higher levels of externalizing and internalizing symptoms and lower social competence. Better maternal EA was associated with higher social competence. We found parenting stress to serve as a mediator in the association between maternal weight and children's psychosocial outcomes. Moreover, children of mothers with an elevated BMI were at greater risk of lower social competence only when their mothers showed low levels of maternal EA (moderation). Conclusion: Interventional studies are needed that investigate the causal pathways between parenting stress, mother–child interaction quality and child outcomes. These aspects might be targets to improve the psychosocial development of the offspring of overweight or obese mothers.
Collapse
Affiliation(s)
- Sarah Bergmann
- IFB AdiposityDiseases, Leipzig University Medical CenterLeipzig, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany
| | - Andrea Schlesier-Michel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany; Department of Developmental Psychology, Friedrich-Schiller-University of JenaJena, Germany
| | - Verena Wendt
- IFB AdiposityDiseases, Leipzig University Medical CenterLeipzig, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany
| | - Matthias Grube
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Leipzig, Germany
| | - Anja Keitel-Korndörfer
- IFB AdiposityDiseases, Leipzig University Medical CenterLeipzig, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany
| | - Ruth Gausche
- CrescNet gGmbH, University of Leipzig Leipzig, Germany
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Leipzig, Germany
| | - Annette M Klein
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Leipzig, Germany
| |
Collapse
|
14
|
Schmitz C, Schnicker K, Legenbauer T. Influence of Weight on Shared Core Symptoms in Eating Disorders. Behav Modif 2016; 40:777-96. [DOI: 10.1177/0145445516643487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In terms of the transdiagnostic model of eating disorders, Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED) share the same distinctive psychopathology. However, empirical evidence showing similarities between these eating disorder diagnoses for core symptoms is scarce, and the role of weight status is unclear. Data from a total of 168 female participants were collected between April 2004 and April 2008, at an outpatient unit specialized in eating disorder treatment. Core symptoms of eating disorders were measured via self-report questionnaires. In particular, women with BED and BN showed similar patterns of core symptomatology compared with AN. However, when body mass index (BMI) was considered in the analyses, there were no differences between the three diagnostic groups in relation to body image. Differences in eating behavior are not solely triggered by weight differences, whereas body image disturbances are a transdiagnostic phenomenon among EDs and should also be considered in the treatment of BED.
Collapse
|
15
|
Peterson CB, Pisetsky EM, Swanson SA, Crosby RD, Mitchell JE, Wonderlich SA, Le Grange D, Hill L, Powers P, Crow SJ. Examining the utility of narrowing anorexia nervosa subtypes for adults. Compr Psychiatry 2016; 67:54-8. [PMID: 27095335 PMCID: PMC5604313 DOI: 10.1016/j.comppsych.2016.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/14/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The purpose of this investigation was to examine whether narrowing the criteria of anorexia nervosa (AN) subtypes among adults based on further delineations of current binge eating and purging (i.e., binge eating only, purging only, binge eating and purging, and restricting only) improves the potential clinical utility of the current DSM-5 system that specifies two types (i.e., current binge eating and/or purging and restricting, specified as the absence of current binge eating and/or purging). METHOD Self-reported eating disorder and psychiatric symptoms based on the Eating Disorder Questionnaire were examined in 347 adults from a multisite clinical sample who met DSM-IV criteria for AN. Classification based on binge eating and purging symptoms yielded the following subtypes: 118 restricting only (AN-R; no current binge eating or purging); 133 binge eating and purging (AN-B & P; current binge eating and purging); 43 binge eating only (AN-B; current binge eating and no current purging); and 53 purging only (AN-P; current purging and no current binge eating). RESULTS The AN-R group had lower current body mass index compared to AN-B & P and AN-P with no group differences in highest, lowest, or desired body mass index. The probability of amenorrhea was higher for the AN-R and AN-B & P groups than the AN-P group. The probability of diet pill use was elevated for the AN-B & P and AN-P groups compared to the AN-R group. The AN-P group also had a higher probability of fasting than the AN-R group. The probability of substance use including tobacco was lower in the AN-R group than the other three groups. No group differences were found on measures of hospitalization, body image, physical symptoms, exercise, or dieting behaviors. CONCLUSIONS These findings do not support the validity or clinical utility of classifying AN into narrower subtypes based on current binge eating, purging, and binge eating with purging given that few differences were found among groups who reported any combination of current binge eating and purging. Future research is needed to replicate these findings and to further examine the AN subtype classification schemes.
Collapse
Affiliation(s)
- Carol B. Peterson
- University of Minnesota, Department of Psychiatry, Minneapolis, MN, 55454, USA,The Emily Program, St. Paul, MN, 55108, USA,Corresponding author at: Department of Psychiatry, University of Minnesota Medical School, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN, 55454, USA. Tel.: +1 612 273 9811
| | - Emily M. Pisetsky
- University of Minnesota, Department of Psychiatry, Minneapolis, MN, 55454, USA
| | - Sonja A. Swanson
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, the Netherlands
| | - Ross D. Crosby
- University of North Dakota School of Medicine and Health Sciences, Fargo, ND, 58102, USA,Neuropsychiatric Research Institute, Fargo, ND, 58103, USA
| | - James E. Mitchell
- University of North Dakota School of Medicine and Health Sciences, Fargo, ND, 58102, USA,Neuropsychiatric Research Institute, Fargo, ND, 58103, USA
| | - Stephen A. Wonderlich
- University of North Dakota School of Medicine and Health Sciences, Fargo, ND, 58102, USA,Neuropsychiatric Research Institute, Fargo, ND, 58103, USA
| | - Daniel Le Grange
- University of California, San Francisco, San Francisco, CA, 94113, USA.
| | - Laura Hill
- The Center for Balanced Living, Columbus, OH, 43235, USA.
| | | | - Scott J. Crow
- University of Minnesota, Department of Psychiatry, Minneapolis, MN, 55454, USA,The Emily Program, St. Paul, MN, 55108, USA
| |
Collapse
|
16
|
Groff Stephens S, Wilke DJ. Sexual violence, weight perception, and eating disorder indicators in college females. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:38-47. [PMID: 26502797 DOI: 10.1080/07448481.2015.1074237] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the relationships between sexual violence experiences, inaccurate body weight perceptions, and the presence of eating disorder (ED) indicators in a sample of female US college students. PARTICIPANTS Participants were 6,090 college females 25 years of age and younger. METHODS A secondary analysis of National College Health Assessment data gathered annually at one institution from 2004 to 2013 was utilized. A model predicting ED indicators was tested using logistic regression analyses with multiple categorical variables representing severity of sexual violence, accuracy of body weight perception, and an interaction between the two. RESULTS Sexual violence and inaccurate body weight perception significantly predicted ED indicators; sexual violence was the strongest predictor of purging behavior, whereas inaccurate body weight perception was best predicted by underweight status. CONCLUSIONS Findings provide support to the relationship between purging behavior and severity of sexual violence and also to the link between inaccurate body weight perception and being underweight.
Collapse
Affiliation(s)
- Sara Groff Stephens
- a College of Social Work, Florida State University , Tallahassee , Florida , USA
| | - Dina J Wilke
- a College of Social Work, Florida State University , Tallahassee , Florida , USA
| |
Collapse
|
17
|
Weigel A, Rossi M, Wendt H, Neubauer K, von Rad K, Daubmann A, Romer G, Löwe B, Gumz A. Duration of untreated illness and predictors of late treatment initiation in anorexia nervosa. J Public Health (Oxf) 2014. [DOI: 10.1007/s10389-014-0642-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
18
|
Zerwas SC, Von Holle A, Perrin EM, Cockrell Skinner A, Reba-Harrelson L, Hamer RM, Stoltenberg C, Torgersen L, Reichborn-Kjennerud T, Bulik CM. Gestational and postpartum weight change patterns in mothers with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2014; 22:397-404. [PMID: 25201473 DOI: 10.1002/erv.2314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/26/2014] [Accepted: 07/09/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although pregnancy can be associated with adaptive changes in weight and eating behaviour for women with eating disorders, less is known about whether these changes are maintained in the postpartum period. We used a longitudinal design to examine gestational and postpartum weight trajectories in mothers with and without eating disorders in the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. METHODS Fifty-six women reported anorexia nervosa (AN), 636 bulimia nervosa, 3327 binge eating disorder and 69 eating disorder not otherwise specified, purging type. The referent group included 61,233 mothers with no eating disorder. We used a mixed effects model to predict weight change over time by eating disorder subtype. RESULTS Mothers with AN, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified had greater increases in body mass index (BMI) during pregnancy and greater decreases in BMI over the first 6 months postpartum. Women with AN shifted from the underweight BMI range before pregnancy to the normal weight range at 36 months postpartum CONCLUSIONS Patterns of maternal weight gain and retention during the perinatal period vary across eating disorder subtype and warrant clinical attention.
Collapse
Affiliation(s)
- Stephanie C Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Kral TVE, Moore RH, Compher CW. Maternal concern about child weight in a study of weight-discordant siblings. Public Health Nurs 2014; 32:132-42. [PMID: 24612012 DOI: 10.1111/phn.12119] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study examined concern about child weight in mothers of weight-discordant siblings and determined the accuracy of maternal self-report versus measured child height, weight, and corresponding body mass index (BMI; kg/m(2) ) z-score. DESIGN AND SAMPLE Discordant sibling design. Forty-seven mothers of 5- to 12-year-old, weight-discordant siblings. MEASURES Mothers self-reported their concern about child weight for each child separately and for a subset of children, self-reported their heights and weights. Siblings' height, weight, waist circumference, and adiposity were measured. RESULTS The majority (83%) of mothers expressed concern about their overweight/obese child's weight and 20% of mothers expressed concern about their normal-weight child's weight (p < .001). Difference scores in maternal concern about child weight were positively associated with difference scores in sibling BMI z-score (r = 0.42; p = .01) and percent body fat (r = 0.56; p < .001). For overweight/obese children only, maternal-reported child heights and weights were significantly lower compared to the measured values (p < .03). CONCLUSIONS One fifth of mothers of weight-discordant siblings were unconcerned about their overweight/obese child's weight and for overweight/obese children only, mothers tended to underreport children's height and weight. Mothers' concern for their overweight/obese child's weight was greater for sibling pairs who were more discordant in their weight.
Collapse
Affiliation(s)
- Tanja V E Kral
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | | |
Collapse
|
20
|
Gunnare NA, Silliman K, Morris MN. Accuracy of self-reported weight and role of gender, body mass index, weight satisfaction, weighing behavior, and physical activity among rural college students. Body Image 2013; 10:406-10. [PMID: 23419637 DOI: 10.1016/j.bodyim.2013.01.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 01/15/2013] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
Abstract
This study measured accuracy of self-reported body mass index (BMI), particularly weight, in a college population. The main purpose was to examine the role of gender, BMI, body weight satisfaction, weighing frequency and physical activity level in accuracy (weight difference, percent weight difference, and absolute weight difference). Students (N=405; 56% female) completed a questionnaire and 325 agreed to have their height and/or weight measured. Gender, BMI and activity level were significantly associated with weight difference and percent weight difference while BMI, activity level and weighing frequency were associated with absolute weight difference. However, interactions between BMI and physical activity were found. Our findings indicate that women and heavier individuals underestimate weight.
Collapse
Affiliation(s)
- Nicole A Gunnare
- Department of Nutrition and Food Sciences, California State University, Chico, CA 95929-0002, USA.
| | | | | |
Collapse
|