Social network media exposure and adolescent eating pathology in Fiji

Eating Disorders in Bangladesh: A Narrative Review

BACKGROUND AND AIMS

Eating disorders are complex psychiatric illnesses mostly prominent in Western countries. Little has been researched about these disorders in countries like Bangladesh. The purpose of this narrative review was to summarize the studies on eating disorders in Bangladesh, focusing on rates and associated factors.

METHODS

A search was performed in PubMed, Scopus, Google, Google Scholar, and BanglaJOL on February 20, 2024, to identify the available studies on eating disorders in Bangladesh. After considering the inclusion and exclusion criteria, 10 articles were included in this review.

RESULTS

Studies were published between 2015 and 2023 with a sample size ranging from 196 to 4076. All the studies were conducted among university students and used screening tools to assess eating disorders where the majority of the studies utilized the Eating Attitudes Test-26. The rate of at risk of eating disorders varies between 20.4% and 38%. Sociocultural factors, age, sex, academic attainment, marital status, family income, smoking, nutritional status, anxiety, depression, internet addiction, high religious practice, previous cosmetic surgery, and binge drinking were associated with eating disorder risk. However, all studies focused on a single population group, and no nationwide studies or research involving community populations or clinical samples were identified.

CONCLUSION

Although there has been an increase in research on eating disorders in Bangladesh since 2015, community-based studies using diagnostic tools are warranted. Adaptation and development of culture sensitive instruments could be an important necessity along with an enduring collaboration among researchers, stakeholders, and clinicians.

Internet addiction, depressive symptoms, and anxiety symptoms are associated with the risk of eating disorders among university students in Bangladesh

The risk of developing an eating disorder among university students is higher than the general population in Bangladesh. Since psychiatric disorders (such as depression and anxiety) and addictive behaviors (e.g., internet addiction) predominantly exist among university students in the country, these may increase their vulnerability to developing an eating disorder. The association of internet addiction, depression, and anxiety with the risk of eating disorders among Bangladeshi university students is relatively unknown; therefore, this study investigates the association. This study was a cross-sectional design. Students (N = 700) from two public universities in Bangladesh completed the Patient Health Questionnaire (PHQ-9) scale, the Generalized Anxiety Disorder (GAD-7) tool, and Orman's Internet Addiction Survey (OIAS) to measure exposure variables. Eating Attitudes Test-26 (EAT-26) assessed the outcome variable. Multivariable logistic regression analysis showed that internet addiction [adjusted odds ratio (aOR) for moderate addiction = 2.15 and severe addiction = 3.95], depressive (aOR 3.04), and anxiety (aOR 2.06) symptoms were associated with an increased risk of eating disorder among study participants. Future longitudinal studies on university students are recommended to gain a better understanding about the causal factors of eating disorder to support intervention initiatives and strategies by public health practitioners and policy experts.

Rapid review of factors influencing dietary behaviors in Fiji

Introduction

In Fiji, multiple burdens of malnutrition including undernutrition, overweight/obesity, and micronutrient deficiencies coexist at the individual, household, and population levels. The diets of children, adolescents, and adults are generally unhealthy. The objective of this review was to understand how the dietary behaviors of children, adolescents, and women in Fiji are influenced by individual, social, and food environment factors.

Methods

This rapid review was conducted to synthesize existing evidence, identify research gaps in the evidence base, and make recommendations for future research. The Cochrane Rapid Reviews Methods and the updated guideline for reporting systematic reviews were used. The search strategy for this rapid review was based on the Population Context Outcome [P(E)CO] framework, including search terms for population (children, adolescents, and adults), context (Fiji), and outcome (dietary behaviors). Searches were conducted in PubMed, Scopus, PsycINFO, and Google Scholar.

Results

The 22 studies included in this review identified different factors influencing dietary behaviors in Fiji. Individual preferences for processed and imported foods, especially of younger generations, and social dynamics, especially gender norms and social pressure, to serve meat and overeat appeared to be prominent in driving dietary habits. The ongoing nutrition transition has led to increasing availability and affordability of ultra-processed and fast foods, especially in urban areas. Concerns about food safety and contamination and climate change and its effect on local food production also appear to influence dietary choices.

Discussion

This review identified different dynamics influencing dietary behaviors, but also research gaps especially with regard to the food environment, calling for an integrated approach to address these factors more systemically.

Risk of eating disorders and the relationship with interest in modern culture among young female students in a university in Bangladesh: a cross-sectional study

BACKGROUND

Eating disorders (EDs) emerge most often in adolescent girls. While the basic neural and psychiatric mechanisms of ED development remain unknown, their incidence has increased with sociocultural modernization. To determine what aspects of modern culture are related to EDs, we examined the relationship between predisposition to EDs and interest in several modern cultural factors among young female university students in Bangladesh.

METHODS

A cross-sectional study was conducted in a population of 196 female students aged 18-29 years in a university in Bangladesh. Their predisposition to EDs was examined using the Eating Attitudes Test-26 (EAT-26), and their interest in modern culture was evaluated by grading interest in fashionable clothes, Indian TV shows/serials, luxury food and social network activities, and by examining involvement in cultural activities such as playing, dancing, parties and singing. The relationship between predisposition to EDs and interest in modern culture was then examined. The relation between EAT-26 score and body mass index (BMI) was also examined.

RESULTS

The EAT-26 revealed that 37% of the participants were at risk of developing an ED. Correlation analyses showed that a high EAT-26 score was correlated with a high interest in fashionable clothes and Indian TV shows/serials, but not with a high interest in luxury food or social network activities, or involvement in cultural activities, such as playing, dancing, parties and singing. Further, EAT-26 questions in the dieting category and oral control category, but not the bulimia and food preoccupation category, were correlated with interest in cultural factors. EAT-26 score showed no significant correlation with BMI.

CONCLUSIONS

The results of this study indicate that the risk of EDs is related to an interest in several facets of modern culture. Monitoring the cultural interests of adolescent females, who are continually exposed to modern culture and highly susceptible to EDs, will contribute to the prevention of EDs.

Sociocultural drivers of body image and eating disorder risk in rural Nicaraguan women

OBJECTIVE

Technological and economic globalisation has been suggested as a cause of increasing rates of body dissatisfaction and eating disorders globally, especially as regards the impact of mass media on internalised body ideals. This process is rarely observed in action, however. The current work investigates multiple aspects of body ideals, body image, sociocultural attitudes and eating attitudes in 62 Creole and Mestizo women living in communities at differing stages of technological development on the Caribbean coast of Nicaragua METHOD/RESULTS: In Study 1, women used 3D avatar software to create their own 'ideal' body without the constraints of ready-made stimuli. Analyses of resulting avatars showed that components of the ideal body shape (upper and lower body curvaceousness) but not body size (body mass) were associated with levels of film and television consumption. In Study 2, women completed measures of variables in the sociocultural model of eating disorder risk. As expected, body dissatisfaction mediated the relationship between internalisation of sociocultural body ideals and pathological eating attitudes. In contrast, body appreciation reduced pathological eating attitudes, via reduced body dissatisfaction. Finally, Study 3 measured sociocultural influences, body image and eating attitudes at 2 or 3 timepoints per woman; body dissatisfaction covaried with pathological eating attitudes across time. Ethnicity varied in its effects across studies.

DISCUSSION

Together these data show that even at early stages of media acculturation, women may show similar patterns of association between sociocultural internalisation, body dissatisfaction and eating disorder risk as in high income nations. However, they also demonstrate unique aspects of this population's body shape ideals, and the independent protective effect of body appreciation.

Online media exposure and weight and fitness management app use correlate with disordered eating symptoms: evidence from the mainland of China

BACKGROUND

The relationship between online media exposure and disordered eating symptoms has been reported in western regions. Though the prevalence of eating disorders and access to the Internet increased substantially in recent years, relevant evidence is rare in mainland China. This study aims to evaluate the association between online media exposure or weight and fitness management app use and disordered eating symptoms in Chinese mainland young adults, and the mediation effect of disordered eating cognition.

METHODS

353 Chinese mainland female and 142 male young adults completed online questionnaires consisting of demographic information, Eating Disorder Examination-Questionnaire 6.0 (EDE-Q 6.0), and items relating to online media exposure and weight and fitness management app use. Through correlation analysis, the relationship between online media exposure or weight and fitness management app use and disordered eating symptoms was examined, separately by sex. The mediation effect of disordered eating cognition on the relationship between online media exposure or weight and fitness management app use on disordered eating behaviors was investigated with two moderated mediation models.

RESULTS

Young female adults in the Chinese mainland presented higher disordered eating symptoms and were more engaged in online media and weight and fitness management app use than males. Online media exposure and weight and fitness management app use showed a significant correlation with disordered eating behaviors in males and females. Disordered eating cognition mediated the relationship between online media exposure or weight and fitness management app use and disordered eating behaviors. This effect was significantly higher in females.

CONCLUSION

Online media exposure and weight and fitness management app use play a crucial role in the generation of disordered eating symptoms in Chinese mainland young adults, especially in females. The mediation analysis suggested the importance of prevention and intervention of disordered eating cognition. Monitoring and scientific guidance of online media are necessary.

Prevalence and determinants of eating disorder risk among Bangladeshi public university students: A cross-sectional study

Eating disorders among university students have been increasing day by day in developing countries. However, there is a dearth of existing literature that assessed eating disorder risk among this population group in Bangladesh. Thus, this study aimed to assess the prevalence of eating disorder risk and its associated factors among university students. A cross-sectional study was conducted among 365 Bangladeshi public university students from October to December 2019. Data were collected by self-reported questionnaire on socio-demographic characteristics, risk of eating disorder, and nutritional status of study participants. The respondents' eating disorder risk and nutritional status were assessed using the validated eating attitudes test-26 (EAT-26) tool and anthropometric measurement, respectively. A cut-off score of ≥ 20 based on EAT-26 indicates the presence of an eating disorder risk. Finally, a binary logistic regression was employed to identify the determinants of an eating disorder. The prevalence of 'eating disorder risk' was 23.0% (95% confidence interval [CI]: 18.6 to 27.4). Being female (adjusted odds ratio [AOR] = 2.4, 95% CI: 1.4 to 4.2), aged between 17-21 years (AOR = 2.0, 95% CI: 1.2 to 3.6), overweight (AOR = 4.9; 95% CI: 1.6 to 14.9) and obese (AOR = 7.7, 95% CI: 1.9 to 31.4) showed a higher odds of having an eating disorder risk in the present study. The higher prevalence of eating disorders in the study indicates that psychological intervention and health awareness programs, particularly to younger age, female, and overweight and obese students at the university level, would effectively prevent the eating disorder risk.

A School Intervention Helps Decrease Daily Stress While Enhancing Social Integration in Children

Stress coping is highly relevant during childhood. This study analyses how the participation in a behavioral intervention involving mindfulness-based practices and empathic collaboration activities impact on diurnal cortisol rhythm and social integration in children. In both experimental and waitlist groups, we evaluated before and after the intervention: daily stress, by sampling salivary cortisol at three measurement time-points, and social integration, assessed by a social preference index. Daily average cortisol (DAC) and the area under the curve (AUC) differed when comparing pre-post intervention values in both groups: in the experimental group these measures decreased while in the waitlist group DAC and AUC increased. At the end of the intervention, the experimental group showed an enhancement in the social preference index whereas this parameter diminished in the waitlist group. This kind of behavioral intervention seems to be effective at reducing daily stress and improving social integration in Primary School children.

Anorexia Nervosa Caused by Polymicrobial Tick-Borne Infections: A Case Study

The etiology of anorexia nervosa (AN) is multifactorial, and infections may play a contributory and possibly a prominent role. A case is presented which is indicative of a causal association between tick-borne infections and AN. This adolescent female was diagnosed with AN at an eating disorder clinic after excessive food restriction and an irrational fear of weight gain necessitating nasogastric tube feeding. Her history was consistent with systemic infections and she tested serologically positive to Borrelia burgdorferi, Babesia microti, and Mycoplasma pneumoniae; in addition, her clinical presentation was consistent with a Bartonella infection. After treatment with oral and intravenous antimicrobials, she stopped food restriction and no longer had body image concerns. Physicians should be aware of the possibility that tick-borne infections could underly a diagnosis of AN. The role of tick-borne infections in the etiology of AN warrants further study.

Validation of a Farsi version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (F-SATAQ-4) in Iranian men and women

Understanding sociocultural factors (i.e., thin-ideal internalization and pressures for thinness) is a key step in managing disordered eating risk. Although sociocultural factors may vary across cultures and nations, studies on populations outside of Europe and North America are sparse, and psychometric data are often lacking. The purpose of this study was to validate a Farsi version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (F-SATAQ-4) in Iranian college students. Participants (age 18-30) were recruited from Iranian universities, resulting in two separate convenience samples for Study 1 (n = 328 men, n = 342 women) and Study 2 (n = 336 men, n = 331 women). In Study 1, which followed back-translation procedure, exploratory factor analyses supported a 5-factor structure of the F-SATAQ-4 for men and women (i.e., thin-ideal internalization, athletic-ideal internalization, family pressure, media pressure, and peers pressure). In Study 2, confirmatory factor analyses confirmed the same structure for men and women. The F-SATAQ-4 subscales scores demonstrated excellent reliability, internal consistency, and weak convergent validity for men and women, as evidenced by significant Pearson's correlations with shape/weight concerns (EDE-Q), appearance evaluation (MBSRQ-AE), social comparison (PACS-R), perceived pressures for thinness (PSPS), BMI, as well as a partial discriminant validity with self-esteem (RSES) in women. Women scored higher on thin-ideal internalization, while men scored higher on athletic-ideal internalization. Participants with higher weights had higher scores on thin-ideal internalization and on family and peers pressures. The Farsi SATAQ-4 is a useful measure of internalization and pressures for thinness among Iranian college men and women.

Approach and avoidance bias for thin-ideal and normal-weight body shapes in anorexia nervosa

OBJECTIVE

The two studies aimed to examine implicit affective evaluations of thin-ideal and normal-weight body shapes in women with anorexia nervosa (AN), taking identification with body shapes into account.

METHOD

In study 1, approach-avoidance bias for thin-ideal and normal-weight bodies was assessed in 40 women with AN and 40 healthy women by using an Approach-Avoidance Task and female avatar bodies with a standard face as stimuli. In study 2, 39 women with AN and 38 healthy women underwent a similar task but identification with bodies was manipulated by presenting bodies once with the participant's own face and once with another woman's face.

RESULTS

In study 1, patients with AN did not differ from healthy participants in their automatic approach-avoidance tendencies towards thin-ideal and normal-weight bodies. In study 2, no definite approach bias for a thin self and no avoidance bias for thin other women or for a normal-weight self were found. However, as compared to healthy women, those with AN showed a less positive implicit evaluation of thin other women, and an implicit preference for thin bodies depicted as themselves over thin bodies depicted as another woman.

CONCLUSIONS

The findings suggest that intra-sexual competition for being slim is increased in AN.

Muscles and the Media: A Natural Experiment Across Cultures in Men's Body Image

An increasing number of studies are evidencing relationships between the drive for muscularity and potentially harmful behavioral strategies, such as unhealthy dieting and steroid use amongst men in WEIRD (Western, Educated, Industrialized, Rich, Democratic) populations. As such Western appearance standards proliferate around the world via the media, men who live in other cultural contexts are also at risk of potentially negative effects from aspiring to the “muscular ideal.” However, few studies have explored these relationships in non-WEIRD populations. We investigated men’s body ideals and body image in two non-WEIRD, non-White populations, Uganda (Africa) and Nicaragua (Central America), and compared them with an ethnically diverse sample of men in the United Kingdom. We also examined whether socio-cultural factors including media and ethnicity, predicted the drive for muscularity and body change behaviors among our participants. Results showed that Ugandan men had the least desire for muscularity relative to men in the United Kingdom. Supporting the Tripartite model we found that media and peer influences significantly predicted the drive for muscularity, particularly among men from White British and Nicaraguan Miskitu ethnic groups. By contrast, Creole / Garifuna and Mestizo men from Nicaragua were more likely to want to increase muscularity relative to Black African men from Uganda. Overall, our findings support previous research in demonstrating that there are cultural differences in the kind of body men desire, and that men from WEIRD and non-WEIRD populations may experience similar pressures to aspire to and attain a muscular body type.

Tendency Towards Eating Disorders and Associated Sex-specific Risk Factors Among University Students

Introduction

Eating disorders have frequently been reported among young adults including university students. Detailed information on the prevalence and associated gender-specific determinants of eating disorders are lacking, particularly among students in the north western region of Pakistan. The current cross-sectional study was designed to fill this gap in the literature.

Methods

Total of 672 students (female: 56%, age range: 18-26 years) were enrolled and data collected between October 2016 and December 2017. The 26 items Eating Attitude Test (EAT-26), Diet quality Index-International (DQI-I), 10 items Rosenberg's self-esteem scale (SES), Stunkard Figure Rating Scale, 19-items Pittsburgh Sleep Quality Index (PSQI) and Global Physical Activity Questionnaire (GPAQ) were used. Body composition and anthropometry were determined using standardized tools. A cut-off of ≥20 EAT-26 score was used to assess the tendency towards eating disorders (EDT). Data was analyzed using appropriate statistical tests.

Results

Mean (SD) age of the respondents was 21.7±2 years. Total of 103 (15.3%) students showed EDT with no statistical difference between sexes. Students with EDT had a much lower diet quality than normal students (p<0.001). Risk factors for EDT, in female students included young age (<20 years), on-campus residency, discordant body image and poor sleep quality, while those for males were vigorous lifestyle, insufficient monthly allowance, poor sleep quality and peer pressure.

Conclusions

A significant number of students showed a tendency towards an unhealthy eating attitude with some sex-specific risk factors. These students had poorer diet quality than normal students. Support to encourage healthy attitudes to eating and better diet quality could help to avert the development of clinical eating disorders.

On body economics and fitting in: upward mobility and obesity stigma in Jamaica

Introduction: Jamaican culture is considered 'fat-loving,' and thus less likely to foster obesity stigma. However, the importance of tourism to Jamaica's economy, global trends toward a thinness aesthetic and extant ethos' of both bodily self-acceptance and status-based bodily critique suggest that obesity stigma may exist in Jamaica - particularly in the context of class status aspiration.Objective: This pilot study examined the relationship between upward mobility and fat stigma in Kingston, Jamaica in two samples.Design: The first sample - nineteen college-enrolled 18-25 year olds - completed an online survey. Responses were grouped by perceived wealth status.Results: No relationship was found between wealth status and obesity stigma. There was no association between wealth group and body ideal - whether slender or curvaceous. However, responses to questions concerning the value of having an ideal body differed by wealth grouping. Those with lower perceived wealth tended to cite 'fitting in to society' as a benefit of having an ideal body. Half (5 of 10) the lower wealth group ranked having an ideal body 'very important;' one person in the higher wealth group did so. Findings from twenty ethnographic interviews conducted in Kingston's public spaces with 18-25 year olds confirmed the obesity stigma/social aspiration relationship. Having an ideal body was associated with greater economic and social opportunity and a sense of 'fitting in.'Conclusion: These findings suggest that though (1) there seems to be no singular, size-related aesthetic in Jamaica; (2) obesity stigma does exist; and (3) experience of stigma may be affected by socio-economic status and socio-economic aspiration.

Social Norms and Smoking Risk in iTaukei Fijian Adolescent Women

OBJECTIVE

To investigate the association of a variety of social smoking exposures with cigarette smoking among iTaukei adolescent women in Fiji.

METHODS

Self-report data were collected in a representative sample of school-going iTaukei adolescent women (n=523). We fitted logistic regression models of current cigarette smoking with school, peer, media, and other social exposures to smoking as predictors.

RESULTS

Current cigarette smoking was associated with exposure to close friend, peer, and routine social smoking as well as higher prevalence of school peer smoking, but not parent tobacco use and media smoking exposures-in our fully adjusted model.

CONCLUSIONS

Peer and school-based smoking exposures may increase cigarette smoking risk in school-going iTaukei adolescent women and may be strategic interventional targets to augment existing preventive approaches.

Digital technologies for promotion of healthy eating habits in teenagers

OBJECTIVE

Identify and analyze the scientific literature on digital technologies for promotion of healthy eating habits in teenagers.

METHOD

Integrative review of articles published in English and Spanish, available in full on four databases. The descriptors used were (Adolescent health) OR (Teen health) AND (Healthy diet) OR (Healthy eating) AND (Educational technology) OR (Instructional technology), respectively, from which eight articles were selected.

RESULTS

Among the studies included, three were digital games; two web-based nutrition interventions; two using online programs to prevent obesity; and one nutritional advice using multimedia. They showed experiences of digital technology and its effects on knowledge improvement and/or behavior of participants when developing healthy eating habits.

CONCLUSION

Digital technologies are innovative tools present in the lives of teenagers, with the possibility of being used for education and promotion of healthy eating, contributing to the empowerment of the subject for his/her self-care.

The Role of Sociocultural Factors in the Etiology of Eating Disorders

Most theories emphasize the role of sociocultural factors in the etiology of eating disorders (EDs). This article uses a broad search strategy to identify current etiologic studies. Women with an ED outnumber men in each diagnosis, but gender differences vary by diagnosis. Men were underrepresented in study samples, and information about variable risk factors in men is sparse. Findings suggest transdiagnostic risk factors and disorder-specific risk factors. Extracting data from population-based registers represents a major advance. Novel analytic approaches suggest complex pathways to ED. Although used in several studies, reliance on a transdiagnostic ED category (vs diagnosis-specific groupings) is premature.

Disordered eating in three different age groups in Cyprus: a comparative cross-sectional study

OBJECTIVE

The objective of this study was to evaluate disordered eating behaviours (DEBs) in different age groups in a Cypriot non-clinical population sample.

STUDY DESIGN

Comparative cross-sectional study.

METHOD

A total of 1716 participants from the Cyprus component of the I.Family study completed the Eating Attitudes Test-26 (EAT-26). The EAT-26 score ≥20 was used to define participants at risk for DEBs. Participants were divided according to age: adolescence (12-18 years old), young adulthood (25-45 years old) and middle adulthood (46-60 years old).

RESULTS

Mean EAT-26 total scores were higher for middle adulthood men and women compared with the two younger age groups. Young adulthood women had the highest percentage of behavioural symptoms of DEBs: binge eating (35%) and laxatives/diet pills/diuretics (12%) compared with the other age groups. Men and women in young adulthood had the highest percentage of participants with EAT-26 scores ≥20. In logistic regression analysis, age group did not prove a significant predictor of DEB risk in a model adjusting for sex, body mass index and physical activity.

CONCLUSION

DEB can present at any age and was not confined to adolescence.

Analyzing big data in social media: Text and network analyses of an eating disorder forum

OBJECTIVE

Social media plays an important role in everyday life of young people. Numerous studies claim negative effects of social media and media in general on eating disorder risk factors. Despite the availability of big data, only few studies have exploited the possibilities so far in the field of eating disorders.

METHOD

Methods for data extraction, computerized content analysis, and network analysis will be introduced. Strategies and methods will be exemplified for an ad-hoc dataset of 4,247 posts and 34,118 comments by 3,029 users of the proed forum on Reddit.

RESULTS

Text analysis with latent Dirichlet allocation identified nine topics related to social support and eating disorder specific content. Social network analysis describes the overall communication patterns, and could identify community structures and most influential users. A linear network autocorrelation model was applied to estimate associations in language among network neighbors. The supplement contains R code for data extraction and analyses.

DISCUSSION

This paper provides an introduction to investigating social media data, and will hopefully stimulate big data social media research in eating disorders. When applied in real-time, the methods presented in this manuscript could contribute to improving the safety of ED-related online communication.

Risk of disordered eating attitudes and its relation to mental health among university students in ASEAN

PURPOSE

Since there is a lack of information on eating disorders attitudes in Association of Southeast Asian Nations (ASEAN), the aim of this study was to explore the prevalence of eating disorder attitude and its relation to mental distress among university student populations in Indonesia, Malaysia, Myanmar, Thailand and Vietnam.

METHODS

A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate university students that were randomly recruited. The Eating Attitudes Test (EAT-26) was utilized to determine the prevalence of disordered eating attitudes. The sample included 3148 university students, with a mean age of 20.5 years, SD = 1.6.

RESULTS

Using the EAT-26, 11.5% of the students across all countries were classified as being at risk for an eating disorder, ranging from below 10% in Indonesia, Thailand and Vietnam to 13.8% in Malaysia and 20.6% in Myanmar. In multivariable logistic regression analysis, sociodemographic factors (wealthier subjective economic status, and living in a lower middle income country), underweight and overweight body weight perception, psychological factors (depression symptoms and pathological internet use), and being obese were associated with eating disorder risk.

CONCLUSIONS

Relatively high rates of eating disorder risk were found. This result calls for increased awareness, understanding of eating disorders and related risk factors and interventions in university students in ASEAN.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional survey.

Media, Technology Use, and Attitudes: Associations With Physical and Mental Well-Being in Youth With Implications for Evidence-Based Practice

BACKGROUND

Previous research has shown that the use of technology and media, in their different available forms, may have detrimental effects on the physical and mental well-being of adolescents and young adults.

AIMS

The present study aimed to investigate the use of different types of technology and media, attitudes toward them, and how they relate to physical and mental well-being in Lebanese university students.

METHODS

A descriptive, correlational, cross-sectional design was used. A sample of 244 undergraduates completed a self-report measuring media and technology use and attitudes, eating-related variables (e.g., healthy eating, body image dissatisfaction [BID], and eating disorders [EDs] risk), trait emotional intelligence (TEI), and psychopathology indicators (stress, anxiety, and depression).

RESULTS

The use of mobile phone multimedia (music, pictures, and videos) correlated with unhealthy eating and stress. Social media use was associated with BID, EDs risk, and the self-control construct of TEI. Anxiety of separation from technological devices and dependence on them was associated with increased BID, EDs risk, depression, and anxiety.

LINKING EVIDENCE TO ACTION

Practical implications are discussed in terms of setting limits and boundaries on technology use during childhood and adolescence, and encouraging healthy eating and physical activity at home and on college campuses. Moreover, social media could be used as a platform for intervention and prevention programs to decrease BID, EDs, depression, and anxiety.

"I Can/Should Look Like a Media Figure": The Association Between Direct and Indirect Media Exposure and Teens' Sexualizing Appearance Behaviors

Prior research has examined the influence of media exposure on adolescents' sexualized self-concept, but engagement in sexualizing appearance behaviors remains understudied, especially among a younger age group (i.e., early adolescents). This three-wave panel study among 971 nine- to 14-year-olds (M_age = 12.99, SD = 1.03) showed that discussing media content with friends (i.e., indirect media exposure) was indirectly related to sexualizing appearance behaviors through perceived attainability of the appearance ideal. Direct media exposure was not significantly related to sexualizing appearance behaviors, nor to perceived pressure or perceived attainability. Direct and indirect media exposure influenced boys and girls in similar ways, although the model showed a better fit among the girls. In addition, reward sensitivity did not moderate the examined relations.

Regional and district peer effects in obesity: A UK panel data analysis

Most research concerning the causes of obesity has focused on macroeconomic trends or individual-level determinants relating to socioeconomic status. There is now growing interest in the psychosocial determinants of obesity. Little research has been conducted into wide-scale peer effects and so the aim of this study was to determine whether regional and district peer effects determine individual-level obesity in the UK. Data from the British Household Panel Survey (for the years 2004 and 2006) were used to model individual-level BMI and probability of obesity as a function of regional and district BMI, controlling for a variety of other variables. Instrumental variable techniques were used to investigate simultaneity bias. We found no statistically significant regional peer effect in the UK. For men, we found that a 1 point increase in average district BMI increased individual BMI by 0.640 and probability of being obese by 1.9% points; for women, BMI increased by 0.230 and probability of being obese by 1.6% points. Men appear to be more susceptible to these effects than women. Peer effects at the district level may have played a significant role in the rise of obesity in the UK. Further research must aim to disentangle the two routes by which these processes are theorised to function.

René Girard and the Mimetic Nature of Eating Disorders

French historian and literary critic René Girard (1923-2015), most widely known for the concepts of mimetic desire and scapegoating, also engaged in the discussion of the surge of eating disorders in his 1996 essay Eating Disorders and Mimetic Desire. This article explores Girard's ideas on the mimetic nature and origin of eating disorders from a clinical psychiatric perspective and contextualizes them within the field of eating disorders research as well as in relation to broader psychological, sociological and anthropological models of social comparison and non-consumption. Three main themes in Girard's thinking on the topic of eating disorders are identified and explored: the 'end of prohibitions' as a driving force in the emergence of eating disorders, eating disorders as a phenomenon specific to modernity, and the significance of 'conspicuous non-consumption' in the emergence of eating disorders.

Life course, sociocultural factors and disordered eating in adult Mexican women

Disordered eating (DE) can appear in women of all ages and in diverse sociocultural contexts, however most research focuses on younger women in higher income countries. The purpose of this article was to explore the association of life course markers with DE, considering the effects of sociocultural factors, in a sample of adult women in Tijuana, Mexico. We employed data from a household survey (n = 2322) conducted in 2014, to evaluate the associations of DE with age, occupation, marital status and having children (life course markers), and indicators of social position and exposure to modernization (sociocultural factors). The prevalence of weight preoccupation was 69.2% (CI95% 67.3,71.1), the prevalence of dieting 24.8% (CI95% 22.4,27.3), and 2.0% (CI95% 1.4,3.0) had a probable eating disorder according to the questionnaire cutoff score. In the adjusted model, younger age, being employed, higher social position and indicators of exposure to modernization had positive associations with DE. There were interactions between marital status and body mass index, and between age and region of birth. The interaction terms showed that overweight was positively associated with DE among single and cohabiting participants, but not among the married ones; and that the negative association between DE and age was apparent from younger age groups in women born in less developed regions of Mexico. Our results replicate others in showing DE to be present in women through the life course, and point to at-risk groups in the confluences of life course, social position and modernization.

Dysfunctional eating behaviors, anxiety, and depression in Italian boys and girls: the role of mass media

Objective:

Extensive research has implicated identification with characters in mass media in the emergence of disordered eating behavior in adolescents. We explored the possible influence of the models offered by television (TV) on adolescents’ body image, body uneasiness, eating-disordered behavior, depression, and anxiety.

Methods:

Three hundred and one adolescents (aged 14-19) from southern Italy participated. They completed a questionnaire on media exposure and body dissatisfaction, the Eating Disorder Inventory-2, the Body Uneasiness Test, the Beck Depression Inventory, and the State-Trait Anxiety Inventory – Form Y.

Results:

The main factors contributing to females’ eating-disordered behaviors were their own desires to be similar to TV characters, the amount of reality and entertainment TV they watched, and the discrepancy between their perceptions of their bodies and those of TV characters. Friends’ desire to be similar to TV characters contributed most to depression, anxiety, body uneasiness, and eating disorders for both males and females.

Conclusion:

Our data confirm that extensive watching of reality and entertainment TV correlates with eating-disordered behavior among females. Moreover, the well-known negative effects of the media on adolescents’ eating-disordered behaviors may also be indirectly transmitted by friends who share identification with TV characters.

Updates in the epidemiology of eating disorders in Asia and the Pacific

PURPOSE OF REVIEW

This review summarizes and contextualizes the recent epidemiologic data on eating disorders in the Asia and Pacific regions.

RECENT FINDINGS

Gaps in epidemiologic data on eating disorders from the Asia and Pacific regions stem, in part, from omission of eating disorder-specific assessments in large nationally representative cohort studies of mental disorders. Available data - often from clinical and school-going cohorts - support that the prevalence of both eating disorders and associated attitudes and behaviors in many Asian and Pacific regions studied may be comparable to those reported in Europe and North America. Moreover, the prevalence of eating disorders in some regions of Asia may be increasing. Some of the national and subnational regions with the highest annual percent increases in disability-adjusted life years per 100 000 caused by eating disorders over the past two decades are located in Asia.

SUMMARY

Notwithstanding sparse epidemiologic data concerning eating disorders in Asia and the Pacific, available evidence supports comparable prevalence to other global regions and that associated health burdens in some regions of Asia may be rising. This further supports that eating disorders are trans-national in distribution and challenges the previous understanding that they were primarily culture-bound to the Global North.

Media exposure and associated stress contribute to eating pathology in women with Anorexia Nervosa: Daily and momentary associations

OBJECTIVE

We examined whether media exposure and media-induced stress contributed to eating disorder behaviors immediately and over the course of a day in women with anorexia nervosa (AN).

METHOD

Women with AN (N = 118) completed a 2-week ecological momentary assessment protocol during which they reported on exposure to food, shape, or weight-related media, associated stress, and eating behaviors.

RESULTS

Food, weight, or shape-related media exposure alone did not predict more frequent daily eating disorder behaviors. However, stress associated with media exposure was prospectively associated with a greater likelihood of binge eating and vomiting at the next assessment point. In addition, media-induced stress increased the probability of restrictive eating and fluid intake, vomiting, and laxative abuse across the day.

DISCUSSION

Media-induced stress may contribute to increased eating disorder behaviors in women with AN, as women who saw a media image and reported this experience as stressful were more likely to engage in momentary binge eating or vomiting. Reducing stress associated with viewing media images could be a potential target for therapeutic intervention with disordered eating. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:617-621).

Association of biological, psychological and lifestyle risk factors for eating disturbances in adolescents

We aimed to assess the association of several risk factors for eating disturbances in adolescents. Participants were 448 girls and boys aged 12-15 years. Being female, higher body mass index, internalisation of standard of appearance, perfectionism, body dissatisfaction, number of lifetime addictive behaviours and lower self-esteem were associated with higher eating disturbance scores, whereas frequency of sedentary behaviours and physical activity were not (R(2) ⩾ 41%). Findings suggest the need to guide prevention efforts towards the broad spectrum of individual potentially modifiable factors. A non-specific comprehensive perspective may be adequate to prevent problems related to weight, body image and drug use.

Internet and smartphone application usage in eating disorders: A descriptive study in Singapore

Eating disorders are associated with significant morbidity and mortality. The Internet is a popular medium for individuals with eating disorders to discuss and reinforce their affliction. However, the available literature on Internet usage and eating disorders is scarce, especially in the area of social media and smartphone application ("app") usage. This study looked at the Internet and smartphone app usage patterns of participants who presented with an eating disorder in Singapore, and whether it corresponded to severity of illness. Individuals who presented to the Eating Disorders clinic at the Singapore General Hospital completed a self-reported questionnaire on Internet and app usage. They also completed the EDE-Q, EAT-26 and CIA 3.0. 55 participants completed the study. 41.8% had anorexia nervosa, 34.5% had bulimia nervosa, and 9.1% were ED-NOS. 41.8% felt that apps helped to perpetuate their illness while 32.7% felt that the apps were helpful for recovery. Overall, any smartphone application usage was associated with younger age and greater eating disorder psychopathology and psychosocial impairment. While 30.9% had encountered eating disorder-related content on Facebook, only 12.7% visited Facebook groups related to eating disorders. For YouTube, "Cooking and Food" and "Beauty and Fashion" videos were among the top 3 types of videos that participants watched. In conclusion, Internet and smartphone app usage is significant, and they are associated with greater severity of illness. It is necessary to include interventions in this aspect as part of treatment of eating disorders.

The rise of eating disorders in Asia: a review

Once concentrated among adolescent Caucasian females in high-income Western countries, today, eating disorders (EDs) are truly global. Building upon previous work describing the rise of EDs among cultures in transition, we contextualize the emergence of EDs in Asia by locating this development within the broader discourse about the processes of change that have radically transformed Asian societies over the last three decades. By identifying where EDs are emerging in the region, and by examining their particular expression, our aim is to explicate a fuller story of the relationship between culture and eating disorders. Much of the discussion of EDs in non-Western societies is predicated upon the assumption that an increase in EDs is the by-product of "Westernization", the term used to describe the process by which increased cultural contact with the West results in the transmission of so-called 'Western' ideas and cultural norms to a non-Western culture. While the Westernization literature represents a historical anchor in our understanding of EDs in Asia, we propose that this analysis is incomplete in that societal change in the form of industrialization and urbanization occurring independently from, or in tandem with, "Western" influence are critical factors contributing to the rise of EDs in Asia. Further, our review of eating disorders in Asia suggests that an understanding of the diversity and distinctiveness of the individual countries and cultures that comprise 'Asia' is crucial to understanding the emergence and rise of EDs across this vast region, suggesting that eating disorders are not culture-bound or culture-specific, but rather culture-reactive. Taking into account both the historical influence of Western culture and the more contemporary effects of Asian industrialization and urbanization, key distinctions among respective Asian cultures expands our understanding of the development and expression of EDs globally.

Neural correlates of eating disorders: translational potential

Eating disorders are complex and serious psychiatric illnesses whose etiology includes psychological, biological, and social factors. Treatment of eating disorders is challenging as there are few evidence-based treatments and limited understanding of the mechanisms that result in sustained recovery. In the last 20 years, we have begun to identify neural pathways that are altered in eating disorders. Consideration of how these pathways may contribute to an eating disorder can provide an understanding of expected responses to treatments. Eating disorder behaviors include restrictive eating, compulsive overeating, and purging behaviors after eating. Eating disorders are associated with changes in many neural systems. In this targeted review, we focus on three cognitive processes associated with neurocircuitry differences in subjects with eating disorders such as reward, decision-making, and social behavior. We briefly examine how each of these systems function in healthy people, using Neurosynth meta-analysis to identify key regions commonly implicated in these circuits. We review the evidence for disruptions of these regions and systems in eating disorders. Finally, we describe psychiatric and psychological treatments that are likely to function by impacting these regions.

Globalization and eating disorder risk: peer influence, perceived social norms, and adolescent disordered eating in Fiji

OBJECTIVE

The increasing global health burden imposed by eating disorders warrants close examination of social exposures associated with globalization that potentially elevate risk during the critical developmental period of adolescence in low- and middle-income countries (LMICs). The study aim was to investigate the association of peer influence and perceived social norms with adolescent eating pathology in Fiji, a LMIC undergoing rapid social change.

METHOD

We measured peer influence on eating concerns (with the Inventory of Peer Influence on Eating Concerns; IPIEC), perceived peer norms associated with disordered eating and body concerns, perceived community cultural norms, and individual cultural orientations in a representative sample of school-going ethnic Fijian adolescent girls (n = 523). We then developed a multivariable linear regression model to examine their relation to eating pathology (measured by the Eating Disorder Examination-Questionnaire; EDE-Q).

RESULTS

We found independent and statistically significant associations between both IPIEC scores and our proxy for perceived social norms specific to disordered eating (both p < .001) and EDE-Q global scores in a fully adjusted linear regression model.

DISCUSSION

Study findings support the possibility that peer influence as well as perceived social norms relevant to disordered eating may elevate risk for disordered eating in Fiji, during the critical developmental period of adolescence. Replication and extension of these research findings in other populations undergoing rapid social transition--and where globalization is also influencing local social norms--may enrich etiologic models and inform strategies to mitigate risk.

Cultural trends and eating disorders

PURPOSE OF REVIEW

Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures.

RECENT FINDINGS

While historically, eating disorders were conceptualized as primarily afflicting Caucasian adolescent or young adult women within high-income, industrialized Western Europe and North America, eating disorders are increasingly documented in diverse countries and cultures worldwide. This study highlights recent trends that reflect the changing landscape of culture and eating disorders: stabilization of the incidence of anorexia nervosa and possibly lower incidence rates of bulimia nervosa in Caucasian North American and Northern European groups; increasing rates of eating disorders in Asia; increasing rates of eating disorders in the Arab region; and increasing rates of binge eating and bulimia nervosa in Hispanic and Black American minority groups in North America.

SUMMARY

The changing face of eating disorders calls for a new conceptualization of culture in both the emergence and spread of eating disorders across the globe.

Perceived social and media influences on tobacco use among Samoan youth

Background

Tobacco use among young Pacific populations continues to undermine efforts to reduce the escalating rates of non-communicable disease in the region. Reducing tobacco use to less than 5 percent by 2025 is now a World Health Organisation (WHO) mandated target for the Pacific region. Yet, little is known about the drivers to uptake of tobacco use among young people in the Pacific. Family and peers are expected to be important in this process, but similarly, tobacco marketing may also play an important role. The tobacco industry has been highly adaptive to the changing media environment across the Pacific Islands. The aim of this study was to develop an understanding of the social cultural and media drivers to tobacco uptake and use among young Samoans to contribute to the design of effective tobacco control intervention.

Methods

We examined high school students (aged 16 and 17 years) perceptions of tobacco use in their community, access and use of media channels and the extent to which they are cognizant of both pro and anti-tobacco imagery across a range of media. Data was collected through in-depth semi-structured interviews. A thematic analysis of the interview data identified common and divergent beliefs, attitudes and behaviours surrounding tobacco use and the influence of the media.

Results

Family is critically important for representing normative tobacco use in Samoa. The use of media, in particular digital media, was found to be conditioned by parental views on the use of media in the home. Media access remains highly regulated within more traditional households. Loyalty to traditional cultural practices (Fa’a Samoa) underpinned views on the limited influence of media on social norms around tobacco use. Parents were thought to have the greatest influence on youth smoking. Tobacco use was viewed as a personal, or family issue, and not a problem that was amendable to change at a societal level.

Conclusion

In order to develop effective and culturally relevant tobacco control policies, the public health community must consider social norms around tobacco use as well as patterns of media use among young Samoans.

Anorexia nervosa and bulimia nervosa: brains, bones and breeding

Recent research has modified both the conceptualization and treatment of eating disorders. New diagnostic criteria reducing the "not otherwise specified" category should facilitate the early recognition and treatment of anorexia nervosa (AN) and bulimia nervosa (BN). Technology-based studies identify AN and BN as "brain circuit" disorders; epidemiologic studies reveal that the narrow racial, ethnic and income profile of individuals no longer holds true for AN. The major organs affected long term-the brain and skeletal system-both respond to improved nutrition, with maintenance of body weight the best predictor of recovery. Twin studies have revealed gene x environment interactions, including both the external (social) and internal (pubertal) environments of boys and of girls. Family-based treatment has the best evidence base for effectiveness for younger patients. Medication plays a limited role in AN, but a major role in BN. Across diagnoses, the most important medicine is food.

Eating Behaviours and Body Weight Concerns among Adolescent Girls

This paper presents a global review of research done on adolescent eating behaviours and food choices and the probable factors underlying it. Worldwide adolescent girls tend to develop moderate to high level of disordered eating behaviour as a result of their excessive concern with body weight or obsession with thinness. The objective of the review is to understand the concerns over body weight and the current eating patterns of adolescent girls in the developed and developing countries.

O que é comportamento de risco para transtornos alimentares em adolescentes?

OBJETIVO: Caracterizar comportamento de risco para transtornos alimentares (TA) e sua frequência entre adolescentes em uma revisão da literatura nacional e internacional. MÉTODOS: Foi realizada uma busca bibliográfica por meio de uma revisão integrativa nas bases de dados PubMed (US National Library of Medicine)e Lilacs e no portal SciELO,utilizando-se os descritores relacionados à "eating disorder risk behavior". Foram selecionados artigos publicados nos últimos 10 anos, nos idiomas português, espanhol e inglês, e especificamente com adolescentes. Foram avaliados 76 artigos e analisados a nomenclatura e os instrumentos utilizados para avaliar comportamento de risco para TA e sua prevalência. RESULTADOS: Encontrou-se uma série de termos para avaliar risco para TA. A metodologia mais utilizada foi a de questionários e escalas, destacando-se o EAT-26 ou 40 e o BITE, dentre os mais frequentes; a prevalência de risco variou de 0,24% a 58,4%. CONCLUSÃO: Diferentes nomenclaturas e instrumentos são utilizados para avaliar comportamento de risco para TA entre adolescentes, com grande amplitude nos resultados de prevalência. Maior padronização de termos e metodologia de avaliação permitiriam melhor comparação entre estudos epidemiológicos em diferentes localidades.

Anorexia nervosa in a Thai adolescent

In Thailand, anorexia nervosa (AN) has rarely been reported. We report a 13- year-old female adolescent with AN restrictive type, the first from Thailand to meet all Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition - Text Revision (DSM IVTR) criteria for AN. The emergence of a patient with AN in Khon Kaen, a province from the region with the lowest gross domestic product, accentuates the existence of eating disorders in adolescents beyond Thailand capital. Future studies considering sociocultural issues on normal eating attitudes, eating behaviors and body image in Thailand should be conducted.

Children, adolescents, and the media: health effects

The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media.

Epidemiological approaches to measure childhood stress

The prevalence of childhood stress has repeatedly been shown to be high, with 'parental separation' and 'being bullied at school' as the most frequently reported stressors in the child's everyday life. This is quite alarming as children are most vulnerable to the adverse psychological and physiological health consequences of chronic stress exposure. Despite growing research interest in this field over the last years, literature falls short in providing an overview of methods to adequately assess stress in elementary school children (6-12 years old). This review describes questionnaires and interviews, as well as laboratory measurements of cortisol in biological samples (serum, urine, saliva and hair) as stress assessment methods in children, with the emphasis on epidemiological research settings. Major characteristics, strengths and limitations of these methods are established, examples of child-specific stressor questionnaires and interviews are provided and specific recommendations with respect to epidemiological research are formulated. In addition, hair cortisol as a potential biomarker for chronic stress (in children) is discussed more thoroughly. This review is meant to serve as a preliminary guide for health researchers new to this research area by reflecting on theoretical and methodological aspects in childhood stress assessment.

Low social interactions in eating disorder patients in childhood and adulthood: A multi-centre European case control study

The objective of this article was to examine lifestyle behaviours in eating disorder (ED) patients and healthy controls. A total of 801 ED patients and 727 healthy controls from five European countries completed the questions related to lifestyle behaviours of the Cross-Cultural Questionnaire (CCQ). For children, the ED sample exhibited more solitary activities (rigorously doing homework [p<0.001] and watching TV [p<0.05] and less socializing with friends [p<0.05]) than the healthy control group and this continued in adulthood. There were minimal differences across ED sub-diagnoses and various cross-cultural differences emerged. Reduced social activities may be an important risk and maintaining factor for ED symptomatology.

Epidemiology of eating disorders: incidence, prevalence and mortality rates

Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15-19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.

Change in binge eating and binge eating disorder associated with migration from Mexico to the U.S

Exposure to Western popular culture is hypothesized to increase risk for eating disorders. This study tests this hypothesis with respect to the proposed diagnosis of binge eating disorder (BED) in an epidemiological sample of people of Mexican origin in Mexico and the U.S. Data come from the Mexico National Comorbidity Survey, National Comorbidity Survey Replication, and National Latino and Asian American Survey (N = 2268). Diagnoses were assessed with the WMH-CIDI. Six groups were compared: Mexicans with no migrant family members, Mexicans with at least one migrant family member, Mexican return-migrants, Mexican-born migrants in the U.S., and two successive generations of Mexican-Americans in the U.S. The lifetime prevalence of BED was 1.6% in Mexico and 2.2% among Mexican-Americans. Compared with Mexicans in families with migrants, risk for BED was higher in US-born Mexican-Americans with two U.S.-born parents (aHR = 2.58, 95% CI 1.12-5.93). This effect was attenuated by 24% (aHR = 1.97, 95% CI 0.84-4.62) with adjustment for prior-onset depressive or anxiety disorder. Adjustment for prior-onset conduct disorder increased the magnitude of association (aHR = 2.75, 95% CI 1.22-6.20). A similar pattern was observed for binge eating. Among respondents reporting binge eating, onset in the U.S. (vs. Mexico) was not associated with prevalence of further eating disorder symptoms. Migration from Mexico to the U.S. is associated with an increased risk for BED that may be partially attributable to non-specific influences on internalizing disorders. Among respondents reporting binge eating in either country, similar levels of further symptoms were endorsed, suggesting some cross-cultural generalizability of criteria.

Social psychological theories of disordered eating in college women: review and integration

Because peer interaction, weight/shape, and self-concept formation are particularly salient to college women, the implications of social psychological theories may be especially far-reaching during the college years. College women may be particularly vulnerable to the effects of social comparison, objectification, and uses and gratifications theories, which describe social-cognitive mechanisms that provide an individual with information regarding her own view of her body and how she perceives that others perceive her body. The current paper will review and integrate findings related to these three theories of disordered eating in college women in an effort to present a more comprehensive understanding of the social psychological mechanisms that play a role in the development and maintenance of such pathology for this group of young women. Limitations of and future directions for research on these theories will be discussed, as will their potential integration with other factors that contribute to disordered eating and implications for treatment and prevention.