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Hochgraf AK, Berge JM, Lanza ST. Age-varying associations between attempts to change weight and suicidal ideation among adolescents in the United States. Prev Med 2024; 182:107946. [PMID: 38574970 PMCID: PMC11084873 DOI: 10.1016/j.ypmed.2024.107946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/20/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE The goal of this study was to inform theory and suicide prevention efforts by examining how the link between attempts to change weight and suicidal ideation varies across adolescence, when it is strongest, and whether there are sex differences. METHODS Data were from 13,518 youth ages 14-18 years who participated in the 2019 Youth Risk Behavior Survey, a nationally representative study of U.S. high school students. Time-varying effect modeling was used to estimate associations between attempts to change weight and suicidal ideation as continuous functions of age and to test sex differences in these links. RESULTS The link between attempts to lose weight and suicidal ideation was positive and significant between ages 14.0-17.3 years, with the strongest association at age 15.0 (OR = 2.07). There were no sex differences in this age-varying association. The association between attempts to gain weight and suicidal ideation was positive and age-varying for girls, with the strongest association at age 17.2 years (OR = 2.79). This association was not significant for boys at any age. CONCLUSIONS Girls and boys who are trying to lose weight and girls who are trying to gain weight may be at elevated risk for suicidal ideation between ages 14 and 18 years. Findings illuminate patterns of association during adolescence and have implications for suicide prevention.
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Affiliation(s)
- Anna K Hochgraf
- Division of Epidemiology and Community Health, School of Public Health, The University of Minnesota, Minneapolis, MN, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, Medical School, The University of Minnesota, Minneapolis, MN, USA
| | - Stephanie T Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
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2
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Ganson KT, Nguyen L, Ali ARH, Nagata JM, Rodgers RF, Murray SB, Alaggia R. "Eat more protein, build more muscle": A grounded theory study of muscle-building behaviors among Canadian adolescents and young adults. Body Image 2023; 47:101635. [PMID: 37806066 DOI: 10.1016/j.bodyim.2023.101635] [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: 06/09/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
Unique risk factors for the development of muscle dissatisfaction and engagement in muscle-building behaviors have been described by theoretical frameworks and supported by empirical research. What remains unknown are the unique processes, including catalysts and facilitators, which underpin engagement in muscle-building behaviors. Therefore, this study used a grounded theory methodology to elucidate the process of engagement in muscle-building behaviors. Thirty-three individual semi-structured interviews with Canadian adolescents and young adults ages 16-30 years were conducted. Transcripts were analyzed using initial and focused coding to identify themes that explained the grounded theory. The core theme underpinning the grounded theory was balancing aesthetic, health, and functional goals in relation to participants' engagement in muscle-building behaviors. Participants described experiences that encompassed several unique phases of muscle-building engagement, including the initiation phase, beginner phase, preservation phase, and intensification phase. Participants also described unique methods of gathering information on muscle-building behaviors, and their own analysis and decision-making processes driving their behaviors. Findings from this study extend prior theory and research by conceptualizing a novel process theory of engagement in muscle-building behaviors among adolescent and young adults, resulting in important implications for research and practice.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Lynn Nguyen
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ali Raza Hasan Ali
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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3
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Wu J, Jiao B, Zhao J. Gender Disparities in Blood Pressure and the Role of Body Mass Index: A Birth Cohort Analysis in China. J Epidemiol Glob Health 2023; 13:485-494. [PMID: 37302107 PMCID: PMC10468457 DOI: 10.1007/s44197-023-00127-y] [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] [Received: 02/22/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The slow decline in cardiovascular disease (CVD) mortality and the stagnant or increasing hypertension prevalence in low- and middle-income countries necessitate investigation. Evolving gender disparities suggested that male cardiovascular health disadvantage may be preventable, offering potential for enhancing population cardiovascular health. Despite global body mass index (BMI) increases, its role in shaping the gender disparities remains underexplored. OBJECTIVE This study investigated the birth cohort dynamics of gender disparities in systolic/diastolic blood pressure (SBP/DBP) in China, one of the world's largest low- and middle-income countries, and explored the potential role of BMI in explaining the changing gender disparities. METHODS Data from the China Health and Nutrition Survey (1991-2015) were analyzed using multilevel growth-curve models to estimate gender- and cohort-specific SBP/DBP trajectories among individuals born between 1950 and 1975. RESULTS Men had higher SBP and DBP than women at the sample's mean age of 41.7 years. The gender disparities in SBP and DBP increased with each successive one-year cohort from 1950 to 1975 by 0.14 mm Hg and 0.09 mm Hg, respectively. Adjusting for BMI reduced the increasing gender disparities in SBP and DBP by 31.9% and 34.4%, respectively. CONCLUSION Chinese men experienced a greater increase in SBP/DBP across successive cohorts compared to women. The increasing gender disparities in SBP/DBP were partially attributable to a greater BMI increase across cohorts among men. Given these findings, prioritizing interventions that aim to reduce BMI, particularly among men, could potentially alleviate the burden of CVD in China through lowering SBP/DBP.
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Affiliation(s)
- Jinjing Wu
- Asian Demographic Research Institute, Shanghai University, Shanghai, 200444, China
| | - Boshen Jiao
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, 02115, USA
| | - Jiaying Zhao
- RSSS Building, 146 Ellery Crescent, School of Demography, ANU College of Arts and Social Sciences, The Australian National University, Acton ACT, Canberra, 2601, Australia.
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4
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Tran A, Darboe M, Goyal A, Birk N. Association between dating app use and unhealthy weight control behaviors and muscle enhancing behaviors in sexual minority men: a cross-sectional study. BMC Public Health 2023; 23:838. [PMID: 37161386 PMCID: PMC10170774 DOI: 10.1186/s12889-023-15715-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/19/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Body image concerns are prevalent and are viewed as risk factors for engaging in unhealthy weight control behaviors (UWCBs), such as purging, fasting, and the misuse of laxatives and diet pills. Studies have also linked UWCBs to the development of eating disorders. In the United States (U.S.), sexual minority men (e.g., bisexual, gay, and men who have sex with men) are prone to UWCBs often as a result of societal pressures to achieve certain standards of appearance - of which are often perpetuated through various media platforms. A growing number of studies have explored the possible role mobile dating applications ("dating apps") play in contributing to UWCBs. To our knowledge, such studies have not explored this possible relationship between dating apps and UWCBs in sexual minority men (SMM). To fill this gap in the scientific literature, the present study assessed the association between dating app use and UWCBs and muscle enhancing behaviors among a sample of adult SMM in the U.S. METHOD 549 SMM participated in an anonymous survey from Qualtrics Survey Panels. UWCBs and muscle enhancing behaviors were assessed through items adapted from national surveys. Body image dissatisfaction was assessed using the Male Body Attitudes Scales. Participants also reported their history of dating app use. We performed descriptive statistics, chi-square tests, and student's t-tests. Multivariable logistic regression models assessed the relationship between dating app use and UWCBs and muscle enhancing behaviors. RESULTS Dating app users had significantly higher body image dissatisfaction scores than non-users. Dating app users also demonstrated significantly elevated odds of engaging in four UWCBs and muscle enhancing behaviors: laxatives, diet pills, muscle-building supplements, and protein powders. CONCLUSIONS This is one of the first studies to assess dating app use and its association with UWCBs and muscle enhancing behaviors in SMM. Increased surveillance and detection for such behaviors among SMM, particularly those using dating apps, are needed.
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Affiliation(s)
- Alvin Tran
- Department of Population Health and Leadership, School of Health Sciences, University of New Haven, 300 Boston Post Road, West Haven, CT, 06516, USA.
| | - Mabintou Darboe
- Department of Population Health and Leadership, School of Health Sciences, University of New Haven, 300 Boston Post Road, West Haven, CT, 06516, USA
| | - Anirudh Goyal
- Department of Population Health and Leadership, School of Health Sciences, University of New Haven, 300 Boston Post Road, West Haven, CT, 06516, USA
| | - Nick Birk
- Harvard T.H. Chan School of Public Health, 67 Huntington Ave, Boston, MS, MA, 02115, USA
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5
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Bae EJ, Yoon JY. Unhealthy weight control behaviors and related factors by gender and weight status: Results from a nationally representative sample of Korean adolescents. Arch Psychiatr Nurs 2023; 42:75-83. [PMID: 36842832 DOI: 10.1016/j.apnu.2022.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/26/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
Given the serious consequences of unhealthy weight control behaviors (UWCB) among adolescents, identifying factors contributing to it in this population is crucial. Although gender differences have been reported as UWCB-related factors, studies on weight status remain limited. Hence, using a nationally representative sample, we investigated the differences in UWCB-related factors by gender and weight status. Most sociodemographic, health-related behavior, psychosocial, and school factors were remarkably correlated with UWCB in the normal-weight female group; however, they demonstrated most inconsistent correlations in the overweight female group. Overall, this study suggests that UWCB-preventing interventions in adolescents should be customized by gender and weight status.
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Affiliation(s)
- Eun Jung Bae
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, Republic of Korea; Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea; Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea.
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6
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Ganson KT, Testa A, Rodgers RF, Jackson DB, Nagata JM. Muscle-Building Exercise and Weapon Carrying and Physical Fighting Among U.S. Adolescent Boys. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2566-2584. [PMID: 35546543 PMCID: PMC9850380 DOI: 10.1177/08862605221101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study aimed to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting among adolescent boys. Cross-sectional data from the 2019 Youth Risk Behavior Survey (U.S.) were analyzed (N = 4120). Muscle-building exercise was assessed based on the number of days reported in the past 7 days, recategorized into four levels of engagement (no engagement [0 days], low engagement [1-2 days], moderate engagement [3-5 days], and high engagement [6-7 days]). Three forms of weapon carrying (general, on school grounds, gun carrying) and two forms of physical fighting (general, on school grounds) were assessed. Five logistic regression analyses with adjusted odds ratios (AOR) and 95% confidence intervals (CI) were used to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting, while adjusting for relevant demographic and control variables. Over 75% of participants reported engaging in muscle-building exercise. One in five (19.8%) participants reported any general weapon carrying in the past 30 days, 3.3% reported any weapon carrying at school in the past 30 days, 6.5% reported any gun carrying in the past 12 months, 28.0% reported any general physical fighting in the past 12 months, and 10.7% reported any physical fighting at school in the past 12 months. Logistic regressions showed that, compared to no engagement, participants who reported high engagement of muscle-building exercise had higher odds of general weapon carrying (AOR 2.18, 95% CI 1.54-3.07), gun carrying (AOR 2.12, 95% CI 1.23-3.64), and general physical fighting (AOR 2.07, 95% CI 1.53-2.79). These are novel findings that add to a growing literature related to engagement in muscularity-oriented behaviors among males. Prevention and intervention efforts are needed to ensure that adolescent boys engage in muscle-building exercise in ways that are not harmful and to reduce weapon carrying and physical fighting.
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Affiliation(s)
| | - Alexander Testa
- University of Texas Health Science Center at
Houston, Houston, TX, USA
| | - Rachel F. Rodgers
- Northeastern
University, Boston, MA, USA
- Lapeyronie
Hospital, CHRU Montpellier, France
| | - Dylan B. Jackson
- Johns Hopkins Bloomberg School of Public
Health, Baltimore, MD, USA
| | - Jason M. Nagata
- University of
California, San Francisco, San Francisco,
CA, USA
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7
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Cao R, Chen J, Wang Y, Peng X, Han M, Liu K, Zhang J, Yao R, Han H, Fu L. Associations between negative gender attitudes and eating behaviors in Chinese children and adolescents. Front Nutr 2023; 9:1053055. [PMID: 36687685 PMCID: PMC9854256 DOI: 10.3389/fnut.2022.1053055] [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] [Received: 09/25/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
Background Negative gender cognitive attitudes (disliking one's own gender or wanting to be the opposite gender) and unhealthy eating behaviors have become common in Chinese children and adolescents. The aim of this study was to analyze the associations between negative gender attitudes and eating behaviors among Chinese children and adolescents. Methods Primary and secondary school students aged 8-15 years were selected as participants using a stratified cluster random sampling method. The self-designed questionnaire was used to investigate the participants' negative gender cognitive attitudes. Eating frequency questionnaire was used to investigate participants' eating behaviors. Under the leading reading of standardized training investigators, the questionnaire for children aged 8-15 years was completed by themselves in the form of centralized filling. Results A total of 6.5% [43/657, boys: 6.1% (21/347), girls: 7.1% (22/310)] of children disliked their own gender, 8.8% [58/657, boys: 5.5% (19/347), girls: 12.6% (39/310)] of children wanted to be of the opposite gender, and the proportion of girls with negative gender attitudes was higher than that of boys (P < 0.05). Boys who disliked their own gender or wanted to be the opposite gender had higher frequencies of unhealthy eating behaviors and lower frequencies of healthy eating behaviors than boys who liked their own gender or did not want to be the opposite gender (P < 0.05). Girls who disliked their own gender or wanted to be the opposite gender had higher frequencies of protein eating behaviors than girls who liked their own gender or did not want to be the opposite gender (P < 0.05). There was a significant interaction between disliking one's own gender and wanting to be the opposite gender in midnight snack eating among boys (P < 0.05) and in carbonated drink and high protein eating behaviors among girls (P < 0.05). Conclusion Boys with negative gender cognitive attitudes express more unhealthy eating behaviors and fewer healthy eating behaviors; girls with negative gender cognitive attitudes exhibit more protein eating behaviors.
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8
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Lewis-Smith H, Hasan F, Ahuja L, White P, Diedrichs PC. A comic-based body image intervention for adolescents in semi-rural Indian schools: Study protocol for a randomized controlled trial. Body Image 2022; 42:183-196. [PMID: 35750013 DOI: 10.1016/j.bodyim.2022.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
Adolescents in India experience body dissatisfaction, however, empirically supported interventions are lacking. This paper describes the protocol for the development, acceptability testing, and cluster randomized controlled trial (RCT) of a six-session comic-based intervention, which aims to improve body image and related outcomes among adolescents in semi-rural Indian schools. If found to be acceptable and effective, UNICEF will disseminate the intervention across schools in eight states of India. The acceptability study will be conducted with 24 students in Classes 6-8 (age 11-14) and nine teachers from Hindi-medium government schools using interviews and focus groups. The subsequent RCT will be conducted with 2400 students, with schools randomized to either the comic-based intervention or lessons-as-usual (control) groups. The primary outcome is body esteem, and secondary outcomes are disordered eating, appearance ideal internalization, body-image-related life disengagement, self-esteem, negative affect, and positive affect. Additional exploratory outcome measures are skin colour dissatisfaction, body hair dissatisfaction, appearance-based teasing, and endorsement of traditional gender roles. These outcomes will be examined at three timepoints: baseline (T1), 1 week-post-intervention (T2), and 12-weeks follow-up (T3). Analyses will compare outcomes in the intervention with the control group. This will be the first study to evaluate a body image intervention for adolescents in semi-rural Indian schools.
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Affiliation(s)
| | - Farheen Hasan
- Centre for Appearance Research, University of the West of England, UK
| | - Latika Ahuja
- Centre for Appearance Research, University of the West of England, UK
| | - Paul White
- Applied Statistics Group, University of the West of England, UK
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9
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Reciprocal Peer Network Processes on Substance Use and Delinquent Behavior in Adolescence: Analysis from a Longitudinal Youth Cohort Study. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00904-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Ganson KT, Testa A, Rodgers RF, Jackson DB, Nagata JM. Associations between muscle-building exercise and alcohol use behaviors among adolescent boys: Results from the 2019 Youth Risk Behavior Survey. Am J Addict 2022; 31:251-255. [PMID: 35347808 DOI: 10.1111/ajad.13284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To explore the association between muscle-building exercise (MBE) and alcohol use behaviors among adolescent boys. METHODS Data from the 2019 Youth Risk Behavior Survey (N = 4120) were analyzed using multiple logistic regressions. RESULTS A greater number of days of MBE in the past week was associated with higher odds of four alcohol use behaviors, including recent alcohol use and binge drinking. DISCUSSION AND CONCLUSIONS Findings extend prior research showing relationships between team sports participation and alcohol use behaviors. SCIENTIFIC SIGNIFICANCE This study is the first to examine associations between MBE and alcohol use behaviors among adolescent boys.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
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11
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Nagata JM, Hazzard VM, Ganson KT, Bryn Austin S, Neumark-Sztainerx D, Eisenberg ME. Muscle-building behaviors from adolescence to emerging adulthood: a prospective cohort study. Prev Med Rep 2022; 27:101778. [PMID: 35402151 PMCID: PMC8987401 DOI: 10.1016/j.pmedr.2022.101778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 12/28/2022] Open
Abstract
Muscle-building behaviors in adolescence to emerging adulthood were studied. Starting muscle-building behaviors is common from adolescence to emerging adulthood. Prevalence of any protein powder/shakes use was 55.1% in males and 33.0% in females. Prevalence of any steroids use was 6.7% in males and 5.4% in females. Protein powder consumption was associated with future use of steroids.
This study aimed to identify patterns of change in muscle-building behaviors from adolescence to emerging adulthood and determine what adolescent factors predict new-onset muscle-building behavior in emerging adulthood. Prospective cohort data from a diverse sample of 1,535 participants followed from adolescence (baseline, Mage = 14.4 ± 2.0 years) to emerging adulthood (follow-up, Mage = 22.1 ± 2.0 years) from the population-based EAT 2010–2018 (Eating and Activity over Time) study were analyzed. Changes in muscle-building behavior were identified (starting, stopping, persistent use, or never use). Log-binomial regression models examined adolescent predictors of starting (i.e., new-onset) muscle-building behaviors in emerging adulthood. Prevalence of any use in adolescence (EAT 2010) and/or emerging adulthood (EAT 2018) was 55.1% (males) and 33.0% (females) for protein powder/shakes, 6.7% (males) and 5.4% (females) for steroids, and 19.4% (males) and 6.5% (females) for other muscle-building substances (e.g., creatine, amino acids). In particular, 22.6% (males) and 13.7% (females) started protein powder/shakes, 2.2% (males) and 1.0% (females) started steroid use, and 9.0% (males) and 2.0% (females) started other muscle-building substances during emerging adulthood. Adolescent protein powder/shake consumption was associated with starting steroids/other muscle-building substances use in emerging adulthood in males (adjusted risk ratio [ARR] 2.09, 95% confidence interval [CI] 1.29–3.39) and females (ARR 4.81, 95% CI 2.01–11.48). Adolescent use of protein powders/shakes may lead to a two- to five-fold higher risk of new use of steroids and other muscle-building products in emerging adulthood. Clinicians, parents, and coaches should assess for use of muscle-building behaviors in adolescents and emerging adults and discourage use of harmful products.
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12
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Gonzalez-Nahm S, Ames ML, Benjamin-Neelon SE. Formative evaluation of a portion control and calorie reduction campaign: Insights from focus groups with target audience. Prev Med Rep 2021; 24:101614. [PMID: 34976670 PMCID: PMC8684014 DOI: 10.1016/j.pmedr.2021.101614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/15/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022] Open
Abstract
Healthy eating campaigns can increase awareness of healthful foods and eating patterns and prompt behavior change. Portion control can be a useful strategy in weight management efforts, and new, innovative campaigns can help invigorate messages related to portion control and weight management. This qualitative study presents results of formative testing of portion control and calorie reduction messages and infographics for a proposed campaign. We conducted 17 focus groups with 113 adults ages 18-65 years in 3 US cities. We conducted separate focus groups by weight status (overweight/healthy weight) and gender (male/female) and analyzed coded data and categorized emerging themes. Participants, especially those with healthy weights, gravitated toward specific, and achievable messages to encourage portion control and calorie reduction. Men with overweight and women with healthy weights preferred messages that had a positive, supportive tone. Participants favored messages that addressed overeating and allowed for autonomy. In particular, women and those with healthy weights preferred messages that encouraged calorie budgeting. Many participants, in particular men, provided positive feedback on messages encouraging a "fresh start" on Mondays. Additionally, participants preferred messages that were colorful, informative, realistic, attractive, and relatable. With regard to message dissemination, participants suggested that messages and infographics be positioned in high-traffic areas and men generally suggested places where food decisions are made. Moreover, participants suggested message dissemination through trusted health professionals and credible research organizations. Health organizations planning a portion control or calorie reduction campaign should consider these factors early in the development process to help ensure acceptance and success.
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Affiliation(s)
- Sarah Gonzalez-Nahm
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | - Meghan L Ames
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
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13
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Nagata JM, Peebles R, Hill KB, Gorrell S, Carlson JL. Associations between ergogenic supplement use and eating behaviors among university students. Eat Disord 2021; 29:599-615. [PMID: 32129729 PMCID: PMC7483647 DOI: 10.1080/10640266.2020.1712637] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Ergogenic supplements to improve athletic performance are commonly used among college athletes, but little is known about their association with eating disorder symptoms. The objective of this study was to examine associations between ergogenic supplement use and disordered eating attitudes and behaviors among university students, and to compare differences by sex. Undergraduate students from 10 top-ranked National College Athletics Association (NCAA) Division I colleges completed an online survey on supplement use, athletic activities, and eating attitudes and behaviors. Among 1633 university students, males (38.9%) reported higher rates of current supplement use than females (15.2%) (p < .001). In linear regression models adjusting for athletic status and body mass index, current supplement use was associated with higher Eating Disorders Examination-Questionnaire (EDE-Q) Global, Shape Concern, and Restraint scores in both males and females. Supplement use was associated with driven/compelled exercise (OR 2.00, 95% CI 1.33-2.99) in males and diuretic (OR 6.39, 95% CI 2.02-20.22) and diet pill use (OR 3.07, 95% CI 1.79-5.27) in females. Results suggest ergogenic supplement use is common in undergraduates and associated with disordered eating attitudes and behaviors. Clinicians should screen for disordered eating behaviors particularly in young adults who use ergogenic supplements.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Rebecka Peebles
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Katherine B Hill
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sasha Gorrell
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Jennifer L Carlson
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
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14
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Community norms for the eating disorder examination questionnaire (EDE-Q) among cisgender bisexual plus women and men. Eat Weight Disord 2021; 26:2227-2239. [PMID: 33270173 PMCID: PMC8437880 DOI: 10.1007/s40519-020-01070-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Cisgender bisexual plus (including bisexual, pansexual, and polysexual) women and men experience unique health concerns including eating disorders. The purpose of this study was to develop community norms for eating disorder attitudes and disordered eating behaviors in cisgender bisexual plus women and men using the Eating Disorders Examination Questionnaire (EDE-Q). METHODS Participants were cisgender bisexual plus women (n = 462) and men (n = 93) participants in The PRIDE Study, an existing study of sexual and gender minority people. RESULTS Mean and standard deviation of EDE-Q scores among cisgender bisexual plus women and men, respectively, were: Global (1.75 ± 1.26, 1.56 ± 1.18), Restraint (1.34 ± 1.44, 1.42 ± 1.53), Eating Concern (0.96 ± 1.13, 0.63 ± 0.96), Weight Concern 2.27 ± 1.55, 1.89 ± 1.46), and Shape Concern 42 ± 1.62, 2.30 ± 1.57). Among cisgender bisexual plus women and men, respectively, 27.5% and 22.6% scored in the clinically significant range on the Global score. Bisexual plus women and men reported any occurrence (≥ 1/28 days) of dietary restraint (19.3%, 23.7%), objective binge episodes (11.1%, 10.8%), excessive exercise (4.5%, 5.4%), self-induced vomiting (1.7%, 0.0%), and laxative misuse (0.4%, 1.1%), respectively. A lower percentage of age-matched cisgender bisexual plus women (18-25 years) reported any occurrence of objective binge episodes, self-induced vomiting, laxative misuse, and excessive exercise than previously published in young women. Age-matched cisgender bisexual plus men (18-26 years) reported higher weight concern subscale scores than previously published in young men. CONCLUSIONS These norms should aid clinicians in applying and interpreting the EDE-Q scores of cisgender bisexual plus women and men. LEVEL OF EVIDENCE Level V: cross-sectional descriptive study.
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Weight Goals, Disordered Eating Behaviors, and BMI Trajectories in US Young Adults. J Gen Intern Med 2021; 36:2622-2630. [PMID: 33876378 PMCID: PMC8390712 DOI: 10.1007/s11606-021-06702-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 03/07/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Community sample data indicate that weight control efforts in young adulthood may have associations with greater increases in body mass index (BMI) over time. OBJECTIVE To determine the prospective associations between weight goals and behaviors in young adults and BMI trajectories over 15-year follow-up using a nationally representative sample. DESIGN Longitudinal cohort data collected from 2001 to 2018 of the National Longitudinal Study of Adolescent to Adult Health. PARTICIPANTS Young adults aged 18-26 years old at baseline stratified by gender and BMI category. MAIN MEASURES Predictors: weight goals, any weight loss/maintenance behaviors, dieting, exercise, disordered eating behaviors. OUTCOMES BMI at 7- and 15-year follow-up. KEY RESULTS Of the 12,155 young adults in the sample (54% female, 32% non-White), 33.2% reported a goal to lose weight, 15.7% to gain weight, and 14.6% to maintain weight. In unadjusted models, all groups have higher mean BMI at 7- and 15-year follow-up. In mixed effect models, goals to lose weight in men with BMI < 18.5 (5.94 kg/m2; 95% CI 2.58, 9.30) and goals to maintain weight in men with BMI ≥ 25 (0.44; 95% CI 0.15, 0.72) were associated with greater BMI increase compared to no weight goal. Engaging in disordered eating behaviors was associated with greater BMI increase in men with BMI < 18.5 (5.91; 2.96, 8.86) and women with 18.5 ≤ BMI < 25 (0.40; 0.16, 0.63). Dieting (- 0.24; - 0.41, - 0.06) and exercise (- 0.31; - 0.45, - 0.17) were associated with lower BMI increase in women with 18.5 ≤ BMI < 25. In women with BMI < 18.5, dieting was associated with greater BMI increase (1.35; 0.33, 2.37). CONCLUSIONS Weight control efforts may have variable effects on BMI over time by gender and BMI category. These findings underscore the need to counsel patients on the effectiveness of weight control efforts and long-term weight management.
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Ganson KT, Rodgers RF, Murray SB, Nagata JM. Prevalence and demographic, substance use, and mental health correlates of fasting among U.S. college students. J Eat Disord 2021; 9:88. [PMID: 34289904 PMCID: PMC8293526 DOI: 10.1186/s40337-021-00443-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Fasting is an unhealthy behavior that has been frequently used as part of weight loss attempts. To date, little research has been conducted to determine the prevalence and substance use and mental health correlates of fasting among college students. Therefore, the aim of this study was to estimate the prevalence and associations between any (≥ 1 time) and regular (≥ 13 times) occurrences of fasting in the past 4 weeks and substance use and mental health correlates among a large sample of college students from 2016 to 2020. METHODS Data from four academic survey years (2016-2020; N = 8255) of the national (USA) Healthy Minds Study were analyzed. Unadjusted prevalence of any and regular fasting by survey year and gender was estimated. Multiple logistic regression analyses were conducted to estimate the associations between any and regular fasting and the demographic (age, body mass index, race/ethnicity, sexual orientation, highest parental education), substance use (cigarette use, marijuana use, other illicit drug use, alcohol use), and mental health (depression, anxiety, eating disorder symptoms, suicidal ideation, non-suicidal self-injury) correlates. RESULTS Any fasting in the past 4 weeks was common among both men (14.77%) and women (18.12%) and significantly increased from 2016 (10.30%) to 2020 (19.81%) only among men. Regular fasting significantly increased among both men and women from 2016 (men: 1.46%; women: 1.79%) to 2020 (men: 3.53%; women: 6.19%). Among men and women, both any and regular fasting in the past 4 weeks were associated with higher odds of all mental health symptoms, including a positive depression, anxiety, and eating disorder screen, suicidal ideation, and non-suicidal self-injury. Among women, but not men, any and regular fasting in the past 4 weeks were associated with higher odds of marijuana use and other illicit drug use (e.g., cocaine, ecstasy). CONCLUSIONS The results from this study underscore both the high and increasing prevalence of fasting among a national sample of college students, as well as the substance use and mental health symptoms associated with this behavior. Healthcare professionals both on and off campus should consider screening for fasting behaviors among college students and provide appropriate intervention when needed.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA.,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, 550 16th Street, Box 0110, San Francisco, San Francisco, CA, 94158, USA.
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Nagata JM, Compte EJ, McGuire FH, Lavender JM, Brown TA, Murray SB, Flentje A, Capriotti MR, Lubensky ME, Obedin-Maliver J, Lunn MR. Community norms of the Muscle Dysmorphic Disorder Inventory (MDDI) among gender minority populations. J Eat Disord 2021; 9:87. [PMID: 34261536 PMCID: PMC8278632 DOI: 10.1186/s40337-021-00442-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/02/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Representing the pathological extreme pursuit of muscularity, muscle dysmorphia (MD) is characterized by a pervasive belief or fear around insufficient muscularity and an elevated drive for muscularity. Despite evidence of heightened body image-related concerns among gender minority populations, little is known about the degree of MD symptoms among gender minorities, particularly based on Muscle Dysmorphic Disorder Inventory (MDDI) scores. The objective of this study was to assess community norms of the MDDI in gender-expansive people, transgender men, and transgender women. METHOD Data from participants in The PRIDE Study, an existing study of health outcomes in sexual and gender minority people, were examined. We calculated means, standard deviations, and percentiles for the MDDI total and subscale scores among gender-expansive people (i.e., those who identify outside of the binary system of man or woman; n = 1023), transgender men (n = 326), and transgender women (n = 177). The Kruskal-Wallis test was used to assess group differences and post hoc Dunn's tests were used to examine pairwise differences. RESULTS Transgender men reported the highest mean MDDI total score (30.5 ± 7.5), followed by gender-expansive people (27.2 ± 6.7), then transgender women (24.6 ± 5.7). The differences in total MDDI score were driven largely by the Drive for Size subscale and, to a lesser extent, the Functional Impairment subscale. There were no significant differences in the Appearance Intolerance subscale among the three groups. CONCLUSIONS Transgender men reported higher Drive for Size, Functional Impairment, and Total MDDI scores compared to gender-expansive people and transgender women. These norms provide insights into the experience of MD symptoms among gender minorities and can aid researchers and clinicians in the interpretation of MDDI scores among gender minority populations.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94158, USA.
| | - Emilio J Compte
- Eating Behavior Research Center, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Research Department, Comenzar de Nuevo Treatment Center, Monterrey, Mexico
| | - F Hunter McGuire
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Annesa Flentje
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, USA
- Alliance Health Project, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
| | - Matthew R Capriotti
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
- Department of Psychology, San José State University, San Jose, CA, USA
| | - Micah E Lubensky
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among gender-expansive populations. J Eat Disord 2020; 8:74. [PMID: 33292636 PMCID: PMC7722313 DOI: 10.1186/s40337-020-00352-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Gender-expansive individuals (i.e., those who identify outside of the binary system of man or woman) are a marginalized group that faces discrimination and have a high burden of mental health problems, but there is a paucity of research on eating disorders in this population. This study aimed to describe the community norms for the Eating Disorder Examination Questionnaire (EDE-Q) in gender-expansive populations. METHODS The participants were 988 gender-expansive individuals (defined as neither exclusively cisgender nor binary transgender) from The PRIDE study, an existing longitudinal cohort study of health outcomes in sexual and gender minority people. RESULTS We present the mean scores, standard deviations, and percentile ranks for the Global score and four subscale scores of the EDE-Q in this group as a whole and stratified by sex assigned at birth. Gender-expansive individuals reported any occurrence (≥1/28 days) of dietary restraint (23.0%), objective binge episodes (12.9%), excessive exercise (7.4%), self-induced vomiting (1.4%), or laxative misuse (1.2%). We found no statistically significant differences by sex assigned at birth. Compared to a prior study of transgender men and women, there were no significant differences in eating attitudes or disordered eating behaviors noted between gender-expansive individuals and transgender men. Transgender women reported higher Restraint and Shape Concern subscale scores compared to gender-expansive individuals. Compared to a prior study of presumed cisgender men 18-26 years, our age-matched gender-expansive sample had higher Eating, Weight, and Shape Concern subscales and Global Score, but reported a lower frequency of objective binge episodes and excessive exercise. Compared to a prior study of presumed cisgender women 18-25 years, our age-matched gender-expansive sample had a higher Shape Concern subscale score, a lower Restraint subscale score, and lower frequencies of self-induced vomiting, laxative misuse, and excessive exercise. CONCLUSIONS Gender-expansive individuals reported lower Restraint and Shape Concern scores than transgender women; higher Eating, Weight, and Shape Concern scores than presumed cisgender men; and lower Restraint but higher Shape Concern scores than presumed cisgender women. These norms can help clinicians in treating this population and interpreting the EDE-Q scores of their gender-expansive patients.
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Abstract
PURPOSE OF REVIEW To review the recent literature on eating disorders, disordered eating behaviors (DEB), and body image dissatisfaction among sexual and gender minority populations, including, but not limited to, gay, lesbian, bisexual, and transgender people. RECENT FINDINGS Overall, eating disorders, DEB, and body dissatisfaction are common among sexual and gender minority populations. Lifetime prevalence for anorexia nervosa (1.7%), bulimia nervosa (1.3%), and binge-eating disorder (2.2%) diagnoses are higher among sexual minority adults compared with cisgender heterosexual adults in the United States. Lifetime prevalence of eating disorders by self-report of a healthcare provider's diagnosis are 10.5% for transgender men and 8.1% for transgender women in the United States, including anorexia nervosa (4.2 and 4.1%) and bulimia nervosa (3.2 and 2.9%), respectively. DEB may be perpetuated by minority stress and discrimination experienced by these individuals. Body dissatisfaction may be a core stressor experienced by transgender people; gender dysphoria treatment has been shown to increase body satisfaction. A particular clinical challenge in caring for transgender youth with eating disorders is the standard use of growth charts based on sex. SUMMARY Novel research demonstrates that sexual and gender minorities with eating disorders have unique concerns with regards to disordered eating and body image.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Cunningham ML, Nagata JM, Frederick D, Rodgers RF, Lavender JM, Szabo M, Murray SB. Who's the 'bigger' man? Parsing the relationships between masculinity and men's muscularity dissatisfaction. Body Image 2020; 34:94-100. [PMID: 32659680 DOI: 10.1016/j.bodyim.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 02/08/2023]
Abstract
Muscularity dissatisfaction is documented to be a pervasive phenomenon among men. While previous studies have examined theoretically relevant predictors of muscularity dissatisfaction, such as adherence to traditional masculine norms, to the best of our knowledge we are not aware of empirical research that has assessed how perceived discrepancies in one's level of masculinity may also be associated with these concerns. Therefore, the objective of this study was to determine whether perceived deficits in masculinity bear predictive utility over and above adherence to traditional masculine norms in the context of muscularity dissatisfaction. An online survey that included measures assessing the aforementioned constructs was completed by 390 university and community adult men. A hierarchical regression analysis showed that while adherence to masculine norms was associated with increased muscularity dissatisfaction, masculine role discrepancy (and attendant stress) were particularly strong predictors of muscularity dissatisfaction. Our findings make a novel contribution to the male body image literature by demonstrating the relative importance of perceived discrepancies in masculinity, and related stress, in the context of muscularity dissatisfaction. Pending replication in relevant clinical samples using prospective designs, this study provides preliminary evidence that masculine role discrepancies may be promising targets to help allay muscularity concerns among men.
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Affiliation(s)
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, USA
| | - David Frederick
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, USA; The Metis Foundation, San Antonio, USA
| | - Marianna Szabo
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, USA
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Abstract
PURPOSE OF REVIEW To review the recent literature on eating disorders and disordered eating behaviors among adolescent boys and young men, including epidemiology, assessment, medical complications, treatment outcomes, and special populations. RECENT FINDINGS Body image concerns in men may involve muscularity, and muscle-enhancing goals and behaviors are common among adolescent boys and young men. Recent measures, such as the Muscularity Oriented Eating Test (MOET) have been developed and validated to assess for muscularity-oriented disordered eating. Medical complications of eating disorders can affect all organ systems in male populations. Eating disorders treatment guidance may lack specificity to boys and men, leading to worse treatment outcomes in these population. Male populations that may have elevated risk of eating disorders and disordered eating behaviors include athletes and racial/ethnic, sexual, and gender minorities. SUMMARY Eating disorders and disordered eating behaviors in boys and men may present differently than in girls and women, particularly with muscularity-oriented disordered eating. Treatment of eating disorders in boys and men may be adapted to address their unique concerns.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T. Ganson
- School of Social Work, Simmons University, Boston, MA, USA
| | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among transgender men and women. Eat Behav 2020; 37:101381. [PMID: 32416588 PMCID: PMC7447532 DOI: 10.1016/j.eatbeh.2020.101381] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 11/21/2022]
Abstract
Transgender men and women may be at risk for eating disorders, but prior community norms of the Eating Disorders Examination Questionnaire (EDE-Q) are based on presumed cisgender men and woman and have not intentionally included transgender people. The objective of this study was to develop community norms for eating disorder attitudes and disordered eating behaviors in transgender men and women using the EDE-Q. Participants were 312 transgender men and 172 transgender women participants in The PRIDE Study, an existing cohort study of sexual and gender minority people. We present mean scores, standard deviations, and percentile ranks for the Global score and four subscale scores of the EDE-Q in transgender men and women. Transgender men and women reported any occurrence (≥1/week) of dietary restraint (25.0% and 27.9%), objective binge episodes (11.2% and 12.8%), excessive exercise (8.0% and 8.1%), self-induced vomiting (1.6% and 1.7%), and laxative misuse (.3% and .6%), respectively. Compared to a prior study of presumed cisgender men 18-26 years (Lavender, De Young, & Anderson, 2010), our age-matched subsample of transgender men reported lower rates of objective binge episodes and excessive exercise. Compared to a prior study of presumed cisgender women 18-42 years (Mond, Hay, Rodgers, & Owen, 2006), we found that an age-matched sample of transgender women reported higher rates of dietary restraint but lower rates of excessive exercise. These norms should aid clinicians in applying and researchers in investigating and interpreting the EDE-Q scores of transgender men and women.
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Irwin CE. Centering Gender in Our Clinical, Public Health, and Research Programs. J Adolesc Health 2020; 66:8-9. [PMID: 31866058 DOI: 10.1016/j.jadohealth.2019.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
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Greene ME, Patton G. Adolescence and Gender Equality in Health. J Adolesc Health 2020; 66:S1-S2. [PMID: 31866032 PMCID: PMC6928587 DOI: 10.1016/j.jadohealth.2019.10.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 11/24/2022]
Affiliation(s)
| | - George Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia
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