Negative childhood experiences and disordered eating in adolescents in a weight management program: The role of depressive symptoms

Potential pathways to the onset and development of eating disorders in people with overweight and obesity: A scoping review

OBJECTIVE

To describe pathways to eating disorder (ED) development that have been evaluated in people with overweight and obesity.

METHODS

Four databases were searched to identify studies testing ED development models in adolescents (10-19 years) or adults (>19 years) with overweight and obesity. Explanatory variables were thematically grouped into constructs to describe pathways to each ED outcome.

RESULTS

Of 2226 studies screened, 46 (10 adolescent; 36 adult) were included. Study samples were predominantly female, ranging from 22 to 2236 participants and mean age 12.3 to 56.0 years. In total, 207 explanatory variables were grouped into 18 constructs to summarize 107 pathways that were identified. The most common ED outcome was binge eating (n = 24 studies), followed by global ED psychopathology (n = 10 studies). Across pathways to ED development, negative affect was the most proposed construct, followed by preoccupation with weight/shape and weight stigma.

CONCLUSION

Pathways to ED development in people with overweight and obesity are complex and may include more than 18 different explanatory factors of which negative affect, preoccupation with weight/shape, and weight stigma are the most common. More research on adolescents, males, and the spectrum of ED in diverse populations is required for early identification and intervention.

Absent mindfulness: mediation analyses of the relationship between adverse childhood experiences and disordered eating among young adults

Recent evidence has indicated that adverse childhood experiences (ACEs) involving abuse, neglect, and other potentially traumatic occurrences are predictive of disordered eating among young adults. Previous findings have suggested that ACEs and disordered eating were both inversely related to mindfulness. No known studies have examined the extent to which mindfulness mediates the link between ACEs and disordered eating. This study was conducted among a sample of 144 young adults in the U.S. between the ages of 18 and 26 years. Primary study variables included ACEs, mindfulness, and disordered eating. Univariate and multivariable regression analyses assessed the link between ACEs and disordered eating. Mediation analyses examined whether mindfulness mediated the link between ACEs and disordered eating. Multivariable analyses statistically adjusted for the covariates of age, sex, race/ethnicity, and income. Findings suggested ACEs were inversely related to mindfulness (B = -0.04, SE = 0.01; 95% CI = -0.07, -0.01; p < 0.05), mindfulness was inversely related to disordered eating (B = -1.27, SE = 0.23; 95% CI = -1.74, -0.80; p < 0.0001), and ACEs were positively related to disordered eating before (B = 0.17, SE = 0.04; 95% CI = 0.09, 0.26; p = 0.0001) and after (B = 0.13, SE = 0.04; 95% CI = 0.05, 0.21; p = 0.002) adjusting for mindfulness. Mediation analysis results indicated that the link between ACEs and disordered eating was significantly mediated by mindfulness (B = 0.05, SE = 0.02; 95% CI = 0.01, 0.09; p < 0.05). Evidence produced in this study confirmed existing findings concerning the positive association between ACEs and disordered eating among young adults, and these outcomes helped fill a knowledge gap regarding whether mindfulness mediates the link between ACEs and disordered eating. Future intervention studies should identify health-enhancing mindfulness approaches and then test whether the adoption of mindfulness practices can alleviate and prevent disordered eating among young adults with high ACEs.

Effects of chronic psychosocial stress on 'binge-like' sucrose intake in mice

Binge eating episodes are persistent and are essential features of numerous eating disorders (EDs). Susceptibility to EDs is largely presumed to be associated with early life stress. In fact, converging evidence from preclinical animal studies have implicated stress as a driver of binge eating. Still, literature examination indicates that vulnerability to EDs may depend on factors such as severity, time, and the type of stressor. Therefore, we aimed at exploring the link between chronic psychosocial stress and 'binge-like' sucrose intake in adolescent mice. To this aim, intruders' experimental mice were exposed to the chronic subordinate colony (CSC) housing, in the presence of a resident aggressive mouse for 2 weeks. At the end of the stress period, mice were tested for anxiety-like behavior then assessed for 'binge-like' intake of sucrose using a long-term drinking in the dark (DID) method that successfully replicates binge eating in humans. As expected, and compared to single housed colony controls (SHC), CSC exposure elicited an anxiogenic-like response in the open field (OF) and elevated-plus maze (EPM) tests and reduced weight gain. Most importantly, we report here for the first time, that mice exposed to chronic psychosocial stress displayed a 'binge-like' consumption of sucrose. However, neither quinine (bitter) nor saccharin (sweet) intakes were affected by CSC exposure. Finally, using Pearson's correlation, results showed a strong correlation between anxiety-like behavior parameters and sucrose intake. Overall these findings support the validity of our chronic psychosocial stress to model binge EDs and establish the long-term consequences of stress on 'binge-like' eating in male mice. These data suggest that chronic psychosocial stress is a risk factor for developing anxiety-associated EDs.

Orthorexia Nervosa in Adolescents and Young Adults: A Literature Review

Adolescents are a nutritionally vulnerable population; eating disorders are more common among adolescents and young adults. Orthorexia nervosa (ON) is a non-formally recognized condition characterized by an obsessive preoccupation with eating healthy and "pure" foods; the quality and not the quantity of food is pivotal in ON. ON is a complex entity which can be associated with severe diet restrictions, a negative impact on social relationships, and with physical and mental health conditions, including obsessive-compulsive disorder. In light of this, a literature review regarding the background, diagnosis, features, risk factors, interplay with the social media, and management of ON is presented in this article, with a focus on adolescents and young adults.

Stressful life events among individuals with a history of eating disorders: a case-control comparison

BACKGROUND

Experiencing stressful life events (SLEs) can negatively impact mental health and increase risk for psychiatric disorders including eating disorders (EDs). Previous research has shown that childhood sexual abuse is associated with some EDs, but less is known about the association between other non-sexual SLEs and EDs.

METHOD

A case-control study of individuals with (n = 495, age mean ± SD = 29.1 ± 9.8 years) and without (n = 395, age = 30.2 ± 11.7) self-reported lifetime history of EDs was conducted to compare history of self-reported SLEs. Participants reported history of sexual (e.g., rape, other sexual assault) and non-sexual (e.g., emotional abuse, assault, bereavement) life events using an adaptation of the Stressful Life Events Screening Questionnaire. Individuals with EDs were divided into ED subtypes along the restricting - binge eating/purging spectrum to examine subtype differences. Logistic regressions were conducted for each SLE and ED subtype to obtain odds ratios (ORs). We report p-values corrected for multiple comparisons.

RESULTS

Exposure to any SLE was significantly more common in individuals with EDs than in controls (OR = 2.47, p < .001). Specifically, rape, other sexual assault, and emotional abuse were significantly more common among individuals with a history of binge-eating/purging ED subtypes (ORs = 2.15-3.58, p's < .01) compared with controls. Furthermore, history of life-threatening disease and loss of a close relative/partner/friend were associated with some ED subtypes. The association between SLEs and EDs was stronger for individuals who had experienced multiple SLEs.

CONCLUSION

By investigating a range of different SLEs, we showed that both sexual and non-sexual SLEs were more common in individuals with a history of EDs (binge-eating/purging subtypes) than controls. Results highlight the importance of assessing a variety of past SLEs in risk assessment for different EDs.