Disordered eating behavior, health and motives to exercise in young men: cross-sectional population-based MOPO study

Eating Attitudes, Stress, Anxiety, and Depression in Dietetic Students and Association with Body Mass Index and Body Fat Percent: A Cross-Sectional Study

University students face challenges impacting psychology and dietary choices. The present work examined the association between eating attitudes, stress, anxiety, and depression to body mass index (BMI) and body fat percentage in Dietetics students. Respondents completed the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS), a validated Food Frequency Questionnaire, and the Hellenic Physical Activity Questionnaire (HPAQ). Anthropometry and a bioimpedance analysis were performed. The EAT-26 score was 11 (8-16) and the DASS score was 20 (11-36) (medians and interquartile ranges). Disordered eating was detected in 20% of men and 15% of women. Depressive symptomatology was detected in 30% of males and 23% of females, anxiety in 35% of males and 40% of females, and stress in 29% of males and 35% of females. EAT-26 and DASS scores were highly correlated (r = 0. 0.221, p = 0.001). The EAT-26 oral control subscale (B = 0.430, SE = 0.184, p = 0.026) was positively correlated with BMI in men in the models, adjusted for age, physical activity, and Mediterranean Diet Score, while no association was documented for % body fat. The DASS depression score was not related to BMI in multi-adjusted models. In conclusion, disordered eating, depression, stress, and anxiety are present in this sample of university students. The relationship between disordered eating and BMI needs consideration in programs targeting overweight or underweight in Dietetics students.

The use and misuse of the SCOFF screening measure over two decades: a systematic literature review

PURPOSE

The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested.

METHODS

The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors.

RESULTS

180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use.

CONCLUSION

This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested.

LEVEL OF EVIDENCE

Level I.

The association between sport type and eating/body image concerns in high school students: a cross-sectional observational study

PURPOSE

Disordered eating and body image concerns are increasingly common among adolescents, possibly representing the underpinning of eating disorders (EDs). This cross-sectional observational study aimed at investigating the relationship between various patterns of sports involvement or inactivity, and the abovementioned psychopathological dimensions.

METHODS

All adolescents attending their 3rd-5th Italian grade in a single high school reported their sociodemographic and anthropometric data, their weekly sports involvement, and filled the Eating Disorders Examination Questionnaire 6.0 (EDE-Q), the Body Uneasiness Test, and the Muscle Dysmorphia Disorder Inventory (for boys). Comparisons were performed considering sex, weekly hours of activity, and different sports type (none, individual, or team sports).

RESULTS

Of 744 enrolled students, 522 (70.2%) completed the survey. Girls showed higher underweight rates, preference for inactivity or individual sports, and higher psychometric scores compared to boys. Among girls, no differences were found based on time spent exercising or sports type. Inactive boys displayed worse weight- and shape-based psychopathology, higher body uneasiness, and higher appearance intolerance compared to those who devoted more time to exercise. Among boys, individual and team sports were associated with lower EDE-Q scores compared to inactivity, whereas body uneasiness and appearance intolerance were lower only in team sports.

CONCLUSIONS

The study confirms the presence of remarkable sex differences in eating and body concerns of adolescents. Among boys, sports involvement is tied to lower ED psychopathology, and preference for team sports may be associated with reduced concerns. Wider longitudinal studies on will clarify the direction and specificity of these findings.

LEVEL OF EVIDENCE

Level V-Cross-sectional observational study.

Attentional vigilance of food information in disordered eating behaviors

INTRODUCTION

Disordered eating behaviors (DEBs) are very common among female college students, which seriously endanger their health and well-being. Therefore, the study of the mechanism of DEBs can provide effective evidence for early detection and intervention.

METHODS

In total of 54 female college students were recruited and assigned to DEB group (n = 29) and healthy control (HC) group (n = 25) according to their scores in the Eating Attitudes Test-26 (EAT-26). Then, the Exogenous Cueing Task (ECT) was used to evaluate their reaction time (RT) to the location of a target dot preceded by a food or neutral cue.

RESULTS

The study found that compared with HC group, DEB group showed more attentional engagement to food stimuli, indicating that attentional vigilance to food information could be considered as a specific attentional bias of DEBs.

DISCUSSION

Our findings not only provide evidence of the potential mechanism of DEBs from the perspective of attentional bias, but also can be considered as an effective and objective indicator for early screening of subclinical eating disorders (EDs).

Eating Disorders in U.S. Active Duty Military Members and Veterans: A Systematic Review

INTRODUCTION

Feeding and eating disorders can be difficult to treat and frequently co-occur with other mental health conditions. The last systematic review of eating disorders in a military and veteran population was published in 2015. An updated review is warranted to re-examine the current literature on eating disorders in the active duty and veteran populations.

MATERIALS AND METHODS

A systematic review that described the prevalence, co-occurrence of other disorders and/or events, and health care utilization of U.S. active duty members and veterans was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Databases and Medical Subject Headings (MeSH) terms used are listed in Appendix A. Each category of the literature was extracted and graded using the Oxford Centre for Evidence-Based Medicine Levels of Evidence.

RESULTS

Twenty-one studies revealed prevalence estimates with varying rates based on demographic information. Trauma exposure is consistently associated with eating disorder development. Individuals diagnosed with eating disorders had greater health care utilization.

CONCLUSIONS

Research on eating disorders in the military and veteran populations has expanded in recent years. Limitations of the evidence included in this review stem from the use of self-reported questionnaires, changes to medical record systems, and limited generalizability to the overall population of patients with eating disorders. Further research should investigate the impact of demographic factors and trauma exposure on the development of an eating disorder within the military and veteran populations.

Changes in eating and exercise behaviors during the COVID-19 pandemic in a community sample: A retrospective report

OBJECTIVE

The COVID-19 pandemic has generated extreme physical, psychological, and social consequences across the world, many of which have the potential to exacerbate disordered eating and exercise behaviors. The purpose of this study was to retrospectively assess changes in eating pathology and exercise behaviors as a result of the COVID-19 pandemic in a community sample.

METHOD

Participants (n = 159, M_age = 27.59 years, 90.6% female) were individuals in the United States surveyed during COVID-19. Participants completed measures quantifying eating pathology, exercise behaviors, and motives for exercise both prior to and during the pandemic.

RESULTS

All results compare variables prior to and during COVID-19. Overall, individuals with a prior eating disorder (ED) diagnosis did not report significantly different changes in eating or exercise pathology compared to the non-ED group. Participants had significantly fewer episodes of overeating (p < .05, d = -0.23) and eating with loss of control (p < .05, d = -0.23), but not objective binge episodes. Respondents also indicated an overall decrease in time spent on strength/weight activity (p < .05, d = -0.34) and increase in cardiovascular activity (p < .05, d = 0.19), as well as significant changes in motives for exercise.

DISCUSSION

Our results suggest that in a sample of primarily young adult females, with and without a prior ED, exercise behaviors and motives, but not eating pathology, shifted significantly in the first few months of the COVID-19 pandemic. Further longitudinal studies examining the maintenance and potential risk of these changes are warranted, particularly in individuals at high risk, as the pandemic continues.

Depression symptoms and night eating in young adulthood

PURPOSE

We estimated cross-sectional and longitudinal associations between depression symptoms and night eating in young adults.

METHODS

Data were drawn from a longitudinal investigation of students age 12-13 years at inception in 1999-2000, in Montreal, Canada. Depression symptoms were measured with the Depressive Symptoms Scale (DSS) 20 times from age 12 to 17, and with the Major Depression Inventory (MDI) post-high school at ages 20 and 24. Night eating was measured at age 24. The association between depression symptoms and night eating was estimated in multivariable logistic regression models adjusted for sex, age and mother university-educated.

RESULTS

9% of 829 participants (n = 77) reported night eating. In cross-sectional analysis, the adjusted odds ratio (OR) estimate for MDI scores (range 0-50) was 1.04 (1.01, 1.07). In longitudinal analyses, the OR estimates were 1.75 (1.20, 2.55) for DSS scores (range 1-4) and 1.03 (1.002, 1.06) for the MDI.

CONCLUSIONS

Depression symptoms are associated with night eating in young adults cross-sectionally and possibly longitudinally. Treatment of depression symptoms may be important in preventing night eating, a core symptom of the Night Eating Syndrome.

LEVEL OF EVIDENCE

Level III, cohort analytic study.

Мотиви за свързани с външния вид поведения при млади мъже с различен статус на телесното тегло: Качествено изследване

Изследването проучва мотивите за свързаните с външния вид поведения при млади мъже във възникваща зрелост (18-29 г.) с различен статус на телесното тегло. Проведени са 15 дълбинни полу-структурирани интервюта с мъже и 15 с жени, анализирани чрез тематичен анализ и интерпретативен феноменологичен анализ. Седем от петнадесетте млади мъже са с наднормено тегло или затлъстяване, като този статус на телесното тегло оказва значимо влияние върху съдържанието на мотивите за свързаните с външния вид поведения. Идентифицирани са девет мотива: да бъдеш с нормално тегло (по-слаб или по-едър, в зависимост от актуалния статус на телесното тегло); да не ти се подиграват другите; да имаш красиво/мускулесто тяло (стегнато, спортно тяло, или добре развито, мускулесто тяло); за здраве; за да се чувстваш добре; за висока самооценка; за да те харесват момичетата; за да можеш да победиш във физически сблъсък (включва да бъдеш физически силен и да предизвикваш уважение/респект у другите мъже); за (професионално) развитие в спорта. Първите пет мотива са свързани с поведенията на хранене (специален хранителен режим/диета) и с поведенията на физическа активност (спорт, физически упражнения, фитнес), а мотивът да имаш красиво/мускулесто тяло – и с прекомерни физически тренировки, прием на хранителни добавки и анаболни стероиди. Останалите мотиви са свързани с поведенията спорт, фитнес, прекомерни физически тренировки, прием на хранителни добавки и анаболни стероиди. Първите два мотива се отнасят до лицата със свръхтегло, третият – почти изцяло до мъжете с нормално тегло. Мотивите за здраве и да се чувстваш добре са сред най-универсалните (значими при всички статуси на телесното тегло). Последните 4 мотива могат да бъдат отнесени най-вече към нормалното тегло и добре развитата мускулатура.

Characterization and correlates of exercise among adolescents with anorexia nervosa and bulimia nervosa

OBJECTIVE

To characterize exercise behaviors among adolescents with anorexia nervosa (AN), atypical AN, or bulimia nervosa (BN), and determine associations between exercise and medical risk.

STUDY DESIGN

Cross-sectional electronic medical records of all patients evaluated by the Eating Disorder Program at Stanford between January 1997 and February 2011 were retrospectively reviewed.

RESULTS

1,083 subjects (961 females, 122 males; mean age 15.6) met eligibility criteria. Most patients (89.7%) reported exercise (mean 7.0 h per week over mean 5.4 days per week) prior to presentation. Running (49.9%), calisthenics (40.7%), walking (23.4%), soccer (20.9%), and swimming (18.2%) were the most common exercises; a majority (60.6%) reported team sport participation. Males were less likely to report team exercise (p = .005). Bradycardia (heart rate <50) at presentation was associated with team sport participation (adjusted odds ratio [AOR] 1.66, 95% confidence interval [CI] 1.02-2.72) and hours of exercise per week (AOR 1.05, 95% CI 1.02-1.09), controlling for diagnosis, sex, age, duration of illness, rate of weight loss, and percent median body mass index (%mBMI).

DISCUSSION

Adolescents with AN, atypical AN, and BN reported high levels of exercise. Females reported more team sport participation. Greater exercise frequency and team sport participation were associated with bradycardia. Further studies assessing the relationship between exercise and bradycardia may help inform the medical management of adolescents with these eating disorders who are more physically active.

Do Disordered Eating Behaviours Have Long-term Health-related Consequences?

OBJECTIVE

Long-term health-related consequences of disordered eating behaviours of young adults remain poorly understood. We examined whether disordered eating behaviours in mid-20s are associated with physical and mental health 10 years later.

METHODS

Women (n = 2631) and men (n = 2394) from a population-based FinnTwin16 cohort were assessed using three subscales of the Eating Disorder Inventory-2 at age 24. Self-rated health, body mass index (BMI), waist circumference and psychological distress were assessed at age 24 and reassessed 10 years later.

RESULTS

In crude models, disordered eating behaviours at age 24 were associated cross-sectionally and prospectively with poor self-rated health, higher BMI, larger waist circumference and psychological distress in both sexes. In models adjusted for baseline BMI and potential confounders, disordered eating behaviours predicted increased psychological distress in both sexes and poor self-rated health in men.

CONCLUSIONS

Among young adults, disordered eating behaviours are associated with long-term health-related consequences, particularly psychological distress. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.