A review of eating disorders research in Mexico

Psychiatric Comorbidity in Mexican Adolescents with a Diagnosis of Eating Disorders Its Relationship with the Body Mass Index

The prevalence of comorbid psychiatric disorders among patients with eating disorders (ED) is higher than the general population. Individuals diagnosed with eating disorders have changes in their body mass index which could promote severe metabolic disruptions. This study aimed (1) to report the prevalence of comorbid psychiatric disorders among a Mexican adolescent sample diagnosed with eating disorders, (2) to compare our results with the prevalence of psychiatric disorders reported from a national survey of mental health of adolescents, (3) to compare the presence of psychiatric comorbidities between ED diagnoses, and (4) to explore the relationship of these comorbidities with the body mass index. In the study, we included 187 Mexican adolescents diagnosed with eating disorders. The psychiatric comorbidities were evaluated using the Mini International Neuropsychiatric Interview for children/adolescents, and a revised questionnaire on eating and weight patterns. We found that 89% of the Mexican adolescents diagnosed with ED had another psychiatric comorbidity. Major depressive disorder (52.40%) and suicide risk (40%) were the most prevalent comorbidities. Attention and deficit hyperactivity disorder (ADHD) prevalence was different between ED diagnosis, and adolescents with binge-eating disorder and ADHD had the higher body mass index. Our results showed that in this sample of Mexican adolescents, the presence of comorbidities could impact body mass index. This emphasizes the importance that clinicians take into consideration the presence of psychiatric comorbidities to achieve an integrative treatment for adolescents diagnosed with ED.

Validation of eating disorders examination questionnaire in Mexican women

BACKGROUND

Efficient assessment of eating disorders (ED) is indispensable for research and clinical practice in Mexico. One of the most commonly used questionnaires, the EDE-Q, has a self-applicable questionnaire format with 28 questions and four subscales drawn from the Eating Disorder Examination (EDE), a semistructured interview developed to evaluate the specific symptomatology of eating disorders.

OBJECTIVE

Obtain the factorial structure and construct validity of the EDE-Q questionnaire in Mexican women.

METHOD

The language in the EDE-Q was adapted. It was applied to university students (N = 330) and a sample of patients with ED (N = 165) from two ED outpatient treatment services. The anthropometric data of the participants was obtained. Internal consistency was explored using the Cronbach's Alpha coefficient and a confirmatory factor analysis was conducted by group.

RESULTS

Cronbach's alpha was 0.9 for the full scale in all groups, while the reliability of each of the subscales fluctuated between 0.8 and 0.9. Confirmatory factor analysis showed that the fit of the seven-item model in three factors was better than that of the original 22-item one and that of the eight-item model for one factor.

CONCLUSIONS

This study provides information supporting the seven-item and three-factor version, rather than the original or eight-item versions of the EDE-Q. In the future, the adapted version of the EDE-Q will make it possible to draw comparisons between Mexican samples in other socio-cultural contexts. Future research is required to continue refining the instruments to achieve more representative results from the general ED population.

Association of obesity and eating in the absence of hunger among college students in a Mexican-USA border city

Few studies have examined disinhibited eating behaviors in Mexico. However eating in the absence of hunger (EAH), defined as eating in response to the presence of palatable foods in the absence of physiological hunger, is one of the more frequently examined behaviors. The purpose of this study was to assess the association between obesity and EAH among college students in a large Mexican-USA border city. Two-hundred and one sophomore college students completed the EAH questionnaire (EAH-C). Weight and height were measured. To assess reproducibility a test-retest was conducted in a subset sample (n = 20). Test-retest correlations ranged from ρ = 0.44 to 0.86, p < 0.01. Data obtained from the EAH-C were subjected to a principal components analysis with a varimax rotation. The mean age of participants was 21.0 ± 2.0 years, 52 % were female. The prevalence of overweight and obesity was 29 and 14 % respectively. The internal validity was assessed by Cronbach's alph. Internal consistency for all subscales was: external eating (α = 0.83), negative affect (α = 0.92) and fatigue/boredom (α = 0.86). Principal component analysis generated four subscales for the EAH-C: external eating, negative affect, fatigue and boredom. Comparing normal weight students versus obese students, normal weight students (57.1%) had higher scores on boredom subscale than obese students (p < 0.008). Female students had higher scores in the negative affect subscale than the males (p < 0.001). We conclude that the EAH-C had internal consistent subscales with good convergent validity. In this study population we found no association between EAH and obesity.

Eating Disorders Among a Community-based Sample of Chilean Female Adolescents

The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder. Multivariate logistic regression analyses revealed that those with higher symptoms of anxiety and who had tried cigarettes were significantly more likely to have been diagnosed with an eating disorder. Findings indicate that Chilean female adolescents are at risk of eating disorders and that eating disorders, albeit maladaptive, may be a means to cope with negative affect, specifically anxiety.

Association of socioeconomic status, problem behaviors, and disordered eating in Mexican adolescents: results of the Mexican National Health and Nutrition Survey 2006

PURPOSE

To explore the association of socioeconomic status (SES) with disordered eating behaviors (DEB) in Mexican adolescents, and the coexistence of DEB and other problem behaviors.

METHODS

Information about adolescents (10-19 years) was retrieved from the Mexican National Health and Nutrition Survey 2006 database. Associations were evaluated through ordinal regression.

RESULTS

Higher SES was associated with DEB (odds ratio [OR]: 2.05, 95% confidence interval [CI]: 1.52-2.75). Use of tobacco (OR: 2.10, 95% CI: 1.58-2.81), alcohol (OR: 2.03, 95% CI: 1.51-2.56), and suicide intent (OR: 5.13, 95% CI: 3.46-7.60) were associated with DEB.

CONCLUSION

DEB were more frequent among adolescents from higher SES households. The lack of association between SES and DEB reported by other studies might be because of the lack of variability in samples. The association of DEB and other problem behaviors highlights the importance of an integral approach to teenagers' mental health.

Thin ideal internalization in Mexican girls: a test of the sociocultural model of eating disorders

OBJECTIVE

We examined the influence of thin ideal internalization on body dissatisfaction and disordered eating in Mexican girls.

METHOD

We sampled 137 public school girls aged 12-15 from a small city in Mexico. Participants were given Spanish versions of the sociocultural attitudes toward appearance scale, two measures of body dissatisfaction, the eating attitudes test, and the attitudinal familism scale.

RESULTS

Thin ideal internalization mediated the relationship between thin ideal awareness and body dissatisfaction, and the relationship between thin ideal awareness and eating disorder symptoms. Attitudinal familism was negatively correlated with thin ideal internalization for girls outside of the normal weight range.

CONCLUSION

Mexican girls are at risk of eating disorder symptoms, and there is support for the sociocultural model of disordered eating in this population. Hispanic family values may mark protection from thin ideal internalization in Mexican girls outside of the normal weight range.