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Robinson K, Egan SJ, Shafran R, Wade TD. A randomised controlled evaluation of an online perfectionism intervention for people with disordered eating - how perfect does it need to be? Cogn Behav Ther 2024; 53:286-301. [PMID: 38328877 DOI: 10.1080/16506073.2024.2313739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024]
Abstract
Less help-seeking for an eating disorder is predicted by higher levels of denial of, and failure to perceive, illness severity. This research evaluates a "backdoor" approach to early intervention by investigating whether internet cognitive behaviour therapy for perfectionism can significantly improve disordered eating. Additionally, we investigated whether a more interactive intervention impacted outcomes. Participants were recruited worldwide online; 368 were screened, 172 (46.7%) met inclusion criteria (endorsed high shape, weight, or eating concerns) and randomised to an interactive (Focused Minds Program; FMP) or static PDF intervention (Centre for Clinical Intervention; CCI-P) or waitlisted (control condition). Participants completed assessments on disordered eating, perfectionism, and a range of secondary variables at the end of treatment, and 1- and 3-month follow-up. Intent-to-treat analyses indicated that, compared to control, FMP resulted in significantly lower levels of disordered eating at each assessment and CCI-P at the 1- and 3-month follow-up (respective 3-month follow-up between group effect sizes of 0.78 and 0.54). There were no significant differences between the two active interventions on any measure except depression and hated self. Results suggest an alternative approach to directly tackling disordered eating that is low-cost is effective, with a more interactive intervention producing a more rapid effect.Trials Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) Trial Number: ACTRN12621001448831.
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Affiliation(s)
- Katherine Robinson
- Institute of Mental Health and Wellbeing, Flinders University, Adelaide, Australia
| | - Sarah J Egan
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Roz Shafran
- Institute of Child Health, University College London, London, UK
| | - Tracey D Wade
- Institute of Mental Health and Wellbeing, Flinders University, Adelaide, Australia
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2
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Joshi V, Graziani P, Del-Monte J. Bodily sensations and bariatric surgery: Links between interoceptive sensibility, intuitive and disordered eating behaviour in obesity and obesity surgery. Eur Eat Disord Rev 2024; 32:514-523. [PMID: 38288998 DOI: 10.1002/erv.3066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/30/2023] [Accepted: 01/13/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE This study evaluated interoceptive sensibility, intuitive and disordered eating among bariatric candidates, operated individuals and individuals with obesity seeking non-surgical treatment. METHOD We recruited 57 individuals with obesity seeking nonsurgical weight-loss (IOB), 84 bariatric candidates (Pre) and 22 individuals post-bariatric surgery (Post) who responded to questionnaires: Multidimensional Assessment of Interoceptive Awareness, Intuitive Eating Scale-2 (IES-2), Dutch Eating Behaviour Questionnaire, Binge Eating Scale, State-Trait Anxiety Inventory, Beck's Depression Inventory. RESULTS Overall, the Post group manifested higher scores on 'Body-Listening' (F = 4.95, p = 0.01), 'Emotional Awareness' (F = 8.83, p < 0.001) and 'Trusting' (F = 6.71, p = 0.002) interoceptive dimensions, on the IES-2 total score (F = 5.48, p = 0.007) and 'Reliance on hunger and satiety cues' (F = 31.3, p < 0.001) when age was controlled. The IOB group presented higher scores on emotional (F = 3.23, p = 0.047) and binge eating (F = 5.99, p = 0.004). Among operated individuals, intuitive eating mediated the relationship between interoceptive sensibility dimensions and binge eating: 'Attention regulation' (54%) 'Self-regulation' (75.1%), 'Body listening' (94.09%) and 'Trusting' (84.9%). CONCLUSIONS Our results suggest the therapeutic potential of interoceptive sensibility and intuitive eating in obesity management in/beyond the bariatric context.
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Affiliation(s)
- Vrutti Joshi
- Team ENACT, University of Nîmes, France
- Laboratoire de Psychologie Sociale, Aix-Marseille University, France
| | - Pierluigi Graziani
- Team ENACT, University of Nîmes, France
- Laboratoire de Psychologie Sociale, Aix-Marseille University, France
| | - Jonathan Del-Monte
- Team ENACT, University of Nîmes, France
- Laboratoire de Psychologie Sociale, Aix-Marseille University, France
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3
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Kaul I, Burton-Murray H, Musaad S, Mirabile Y, Czyzewski D, van Tilburg MAL, Sher AC, Chumpitazi BP, Shulman RJ. Avoidant/restrictive food intake disorder prevalence is high in children with gastroparesis and functional dyspepsia. Neurogastroenterol Motil 2024; 36:e14777. [PMID: 38454301 DOI: 10.1111/nmo.14777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Avoidant/restrictive food intake disorder (ARFID) prevalence in children with gastroparesis (Gp) and/or functional dyspepsia (FD) is unknown. We aimed to identify ARFID prevalence and trajectory over 2 months in children with Gp, FD, and healthy children (HC) using two screening questionnaires. We also explored the frequency of a positive ARFID screen between those with/without delayed gastric emptying or abnormal fundic accommodation. METHODS In this prospective longitudinal study conducted at an urban tertiary care hospital, patients ages 10-17 years with Gp or FD and age- and gender-matched HC completed two validated ARFID screening tools at baseline and 2-month follow-up: the Nine Item ARFID Screen (NIAS) and the Pica, ARFID, and Rumination Disorder Interview-ARFID Questionnaire (PARDI-AR-Q). Gastric retention and fundic accommodation (for Gp and FD) were determined from gastric emptying scintigraphy. KEY RESULTS At baseline, the proportion of children screening positive for ARFID on the NIAS versus PARDI-AR-Q was Gp: 48.5% versus 63.6%, FD: 66.7% versus 65.2%, HC: 15.3% versus 9.7%, respectively; p < 0.0001 across groups. Of children who screened positive at baseline and participated in the follow-up, 71.9% and 53.3% were positive 2 months later (NIAS versus PARDI-AR-Q, respectively). A positive ARFID screen in Gp or FD was not related to the presence/absence of delayed gastric retention or abnormal fundic accommodation. CONCLUSIONS & INFERENCES ARFID detected from screening questionnaires is highly prevalent among children with Gp and FD and persists for at least 2 months in a substantial proportion of children. Children with these disorders should be screened for ARFID.
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Affiliation(s)
- Isha Kaul
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA
- Texas Children's Hospital, Houston, Texas, USA
| | - Helen Burton-Murray
- Harvard Medical School, Boston, Massachusetts, USA
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Salma Musaad
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA
| | - Yiming Mirabile
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA
| | - Danita Czyzewski
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Texas Children's Hospital, Houston, Texas, USA
| | - Miranda A L van Tilburg
- Cape Fear Valley Health, Fayetteville, North Carolina, USA
- University of North Carolina, Chapel Hill, North Carolina, USA
- University of Washington, Seattle, Washington, USA
- Marshall University, Huntington, West Virginia, USA
- Campbell University, Lillington, North Carolina, USA
| | - Andrew C Sher
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Texas Children's Hospital, Houston, Texas, USA
| | - Bruno P Chumpitazi
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Robert J Shulman
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA
- Texas Children's Hospital, Houston, Texas, USA
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Harrison A, Konstantara E, Zaremba N, Brown J, Allan J, Pillay D, Hopkins D, Treasure J, Ismail K, Stadler M. A cognitive behavioural model of the bidirectional relationship between disordered eating and diabetes self care in adult men with Type 1 diabetes mellitus. Diabet Med 2024; 41:e15287. [PMID: 38379243 DOI: 10.1111/dme.15287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/11/2023] [Accepted: 01/09/2024] [Indexed: 02/22/2024]
Abstract
AIMS This qualitative study aimed to develop the first cognitive behavioural (CBT) model outlining the development and maintenance of disordered eating in adult men living with Type 1 diabetes to improve on previous theoretical models of Type 1 diabetes and disordered eating and to draw comparisons to women with Type 1 diabetes and disordered eating. METHODS Twenty-seven men (n = 16 with Type 1 diabetes and disordered eating, n = 11 with Type 1 diabetes without disordered eating) participated in semi-structured interviews. Data were analysed using thematic analysis and individual CBT formulations were developed for each participant to inform the model. RESULTS Men with Type 1 diabetes and disordered eating experience negative thoughts about food, insulin, weight/shape and diabetes itself, which cause negative emotions such as fear and vulnerability and difficulties with diabetes self care such as problems with hyper and hypoglycaemia and problems accessing structured education and technology result in men feeling more dissatisfied about their body weight/shape. CONCLUSIONS This CBT model of disordered eating in men with Type 1 diabetes can guide new interventions.
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Affiliation(s)
- Amy Harrison
- Department of Psychological Medicine, Diabetes, Psychology and Psychiatry Research Group, King's College London, London, UK
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
- Department of Psychology and Human Development, Institute of Psychiatry, University College London, London, UK
| | - Emmanouela Konstantara
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - Natalie Zaremba
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - Jennie Brown
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
- Diabetes Centre, King's College Hospital, London, UK
| | - Jacqueline Allan
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - Divina Pillay
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - David Hopkins
- Diabetes Centre, King's College Hospital, London, UK
| | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Khalida Ismail
- Department of Psychological Medicine, Diabetes, Psychology and Psychiatry Research Group, King's College London, London, UK
- Diabetes Centre, King's College Hospital, London, UK
| | - Marietta Stadler
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
- Diabetes Centre, King's College Hospital, London, UK
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Fatt SJ, George E, Hay P, Jeacocke N, Day S, Mitchison D. A systematic review and meta-synthesis of qualitative research investigating disordered eating and help-seeking in elite athletes. Int J Eat Disord 2024. [PMID: 38619220 DOI: 10.1002/eat.24205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/21/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Elite athletes are at elevated risk for disordered eating and eating disorders; however, little is known about risk and maintaining factors, or barriers and facilitators of help-seeking in this cohort. This systematic review synthesized qualitative findings regarding possible risk and maintaining factors for disordered eating, as well as barriers to and facilitators of help-seeking in elite athletes. METHOD We conducted a search for qualitative studies that included experiences with body image concerns or disordered eating in elite athletes. A systematic search of CINAHL, PsychINFO, MEDLINE, and Scopus databases identified 828 articles, with 87 retained after title and abstract screening, and 38 included in the review. Quality appraisal was conducted using the checklist for appraising qualitative research (CASP). Data were extracted from each article, including demographic information (e.g., biological sex, age, sport type, level of competition, current, or former athlete) and the text under the "results" or "findings" section. Meta-themes were identified using inductive thematic meta-synthesis. RESULTS The extracted data indicated that most studies sampled female athletes from the United States and UK. Eight meta-themes were identified: (1) the power imbalance; (2) hyperfocus on body, food, and exercise; (3) rigidity; (4) the athlete's balance; (5) the athlete identity; (6) overvaluation and oversimplification; (7) shame, fear, and stigma; and (8) knowledge, education, and self-identification. DISCUSSION These findings highlighted gaps in the demographic representation of specific groups in this research (e.g., males, para-athletes, and ethnic diversity) and propose hypotheses of how sport pressure might contribute to athletes' experiences with disordered eating. PUBLIC SIGNIFICANCE Disordered eating and body image concerns are prevalent and can have debilitating impacts for elite athletes; however, help-seeking is rare for this population. It remains unclear what factors contribute to disordered eating and/or inhibit help-seeking among elite athletes versus the general population. Understanding athletes' perspectives will inform the modification of prevention and treatment strategies to address athlete-specific factors.
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Affiliation(s)
- Scott J Fatt
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Emma George
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Mental Health Services, SWSLHD, Camden and Campbelltown Hospital, Campbelltown, Australia
| | - Nikki Jeacocke
- AIS Performance, Australian Sports Commission, Canberra, Australia
| | - Sinead Day
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
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Myntti WW, Parnell L, Valledor V, Chow CM. Adolescent-perceived parent-child negative body talk and disordered eating: Evidence for behavior-specific affective mediators. J Adolesc 2024. [PMID: 38594877 DOI: 10.1002/jad.12323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION This study examined the mediating role of general negative affect and body-specific negative affect between the association between negative body talk occurring within the mother-daughter relationship and restrained and disinhibited disordered eating. METHODS Adolescent girls (N = 100; Mage = 14.25; 49.5% White) completed self-report measures of general negative affect (depression and anxiety), body-specific negative affect (body dissatisfaction), and perceptions of the frequency that negative body talk occurred in interactions with their mother (initiated by the mother or daughter) as part of a cross-sectional study. While the same set of questionnaires was administered to both mothers and daughters, only the data reported by the daughters were analyzed and included in this study. Data were gathered in the Ann Arbor/Ypsilanti area of Michigan, USA, around the year 2015. RESULTS Path analysis showed that general negative affect, but not body-specific negative affect, mediated the association from mother-daughter negative body talk to disinhibited eating behaviors (emotional and external eating). Conversely, body-specific negative affect, but not general negative affect, mediated the association from negative body talk to restrained eating behaviors. CONCLUSIONS Our findings suggest there are distinct affective mechanisms that mediate the relationship between mother-daughter negative body talk and restrained versus disinhibited eating behavior. Future work should continue to explicate the role of general and body-related negative affect in different eating behaviors.
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Affiliation(s)
- Warner W Myntti
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Lucas Parnell
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Valerie Valledor
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Chong Man Chow
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
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Abstract
Most people start experimenting with and/or initiating health-compromising behaviors and establishing behavioral patterns during adolescence. Possible selves and episodic future thinking have been used to foster behavioral changes. In this study, we aimed to (1) develop a program incorporating possible selves and episodic future thinking to decrease the risks associated with health-compromising behaviors, and (2) examine the feasibility and fidelity of implementing this intervention among Taiwanese adolescents. A novel combination of existing intervention approaches tailored for the Taiwanese context was applied to develop a school-based intervention, which we named the Future Mapping Master program. This program contains four core units: exploring the self, setting goals, developing strategies and problem solving, and understanding the threats of health-compromising behaviors. It includes daily episodic future thinking visualization exercises. The feasibility evaluation was conducted with 88 adolescents aged 12-14 years. Feedback from teachers and students supported the proposed program's feasibility and revealed favorable reactions to the intervention. The Future Mapping Master program is feasible and offers promising strategies for implementation in Taiwanese school settings.
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Affiliation(s)
- Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan
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8
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Thomas KS, Jones CRG, Williams MO, Vanderwert RE. Associations between disordered eating, internalizing symptoms, and behavioral and neural correlates of response inhibition in preadolescence. Dev Psychobiol 2024; 66:e22477. [PMID: 38433461 DOI: 10.1002/dev.22477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
Response inhibition difficulties are reported in individuals with eating disorders (EDs), anxiety, and depression. Although ED symptoms and internalizing symptoms co-occur in preadolescence, there is limited research examining associations between these symptoms and response inhibition in this age group. This study is the first to investigate the associations between behavioral and neural markers of response inhibition, disordered eating (DE), and internalizing symptoms in a community sample of preadolescents. Forty-eight children (M age = 10.95 years, 56.3% male) completed a Go/NoGo task, whereas electroencephalography was recorded. Self-report measures of DE and internalizing symptoms were collected. Higher levels of anxiety and depression were associated with neural markers of suboptimal response inhibition (attenuated P3NoGo amplitudes) in preadolescence. In contrast, higher levels of depression were associated with greater response inhibition at a behavioral level. These findings suggest internalizing symptoms in preadolescence are associated with P3-indexed difficulties in evaluation and monitoring, but these are not sufficient to disrupt behavioral performance on a response inhibition task. This pattern may reflect engagement of compensatory processes to support task performance. DE was not significantly associated with response inhibition, suggesting that difficulties in response inhibition may only be reliably observed in more chronic and severe DE and ED presentations.
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Affiliation(s)
- Kai S Thomas
- School of Psychology, Cardiff University, Cardiff, UK
| | | | | | - Ross E Vanderwert
- School of Psychology, Cardiff University, Cardiff, UK
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK
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Harrington MP, Satherley RM, John M, O'Donnell N, Read R, Wakelin K, Jones CJ. Reliability and validity of a parent-reported screening tool for disordered eating in children and young people with type 1 diabetes. Diabet Med 2024; 41:e15256. [PMID: 37925592 DOI: 10.1111/dme.15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/08/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND There is a high prevalence and complex overlap between type 1 diabetes (T1D) and disordered eating. However, screening for disordered eating in children and young people (CYP) with T1D is not routinely conducted, with reluctance reported by both professionals and parents. This study aimed to validate a parent-reported version of a validated disordered eating screening tool for CYP with T1D (the Diabetes Eating Problems Survey-Revised; DEPS-R). METHODS The existing DEPS-R was adapted for parental use. Eighty-nine parents of CYP with T1D aged 11-14 years completed the parent-reported DEPS-R and other questionnaires related to demographics, child eating behaviours and parental well-being. CYP of parents were invited to participate, with 51 CYP completing the validated CYP-reported DEPS-R for comparison. RESULTS The parent-reported DEPS-R demonstrated good internal consistency (Cronbach's α = 0.89). Moderate to good inter-rater reliability was found between the parent-reported DEPS-R and CYP-reported DEPS-R (ICC 0.746, 95% CI = 0.554-0.855, p < 0.001), indicating good convergent validity. Construct validity with hypothesised variables, including specific eating behaviours, diabetes-related distress, well-being, CYP BMI, gender and parental worry about CYP disordered eating, suggested validity of the measure. However, some hypothesised variables did not significantly correlate with the parent-reported DEPS-R as expected. CONCLUSIONS The parent-reported DEPS-R has demonstrated good reliability and validity, and it may provide clinical benefit by increasing screening and early detection of disordered eating in CYP with T1D. Whilst novel and providing stepped increase in our knowledge, these findings would benefit from further validation (e.g. in a larger sample and responsiveness).
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Affiliation(s)
- Megan P Harrington
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rose-Marie Satherley
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Mary John
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, UK
| | - Nicola O'Donnell
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rebecca Read
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Katherine Wakelin
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
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Jones CJ, Read R, O'Donnell N, Wakelin K, John M, Skene SS, Stewart R, Hale L, Cooke D, Kanumakala S, Satherley RM. PRIORITY Trial: Results from a feasibility randomised controlled trial of a psychoeducational intervention for parents to prevent disordered eating in children and young people with type 1 diabetes. Diabet Med 2024; 41:e15263. [PMID: 38100228 DOI: 10.1111/dme.15263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 03/16/2024]
Abstract
AIMS Children and young people (CYP) with type 1 diabetes (T1D) are at increased risk of disordered eating. This study aimed to determine the feasibility and acceptability of a novel, theoretically informed, two-session psychoeducational intervention for parents to prevent disordered eating in CYP with T1D. METHODS Parents of CYP aged 11-14 years with T1D were randomly allocated to the intervention or wait-list control group. Self-reported measures including the Diabetes Eating Problem Survey-Revised (DEPS-R), Problem Areas in Diabetes Parent Revised (PAID-PR), Child Eating Behaviour Questionnaire subscales (CEBQ), Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), clinical outcomes (e.g. HbA1c, BMI, medication and healthcare utilisation) and process variables, were collected at baseline, 1-and 3-month assessments. Acceptability data were collected from intervention participants via questionnaire. RESULTS Eighty-nine parents were recruited, which exceeded recruitment targets, with high intervention engagement and acceptability (<80% across domains). A signal of efficacy was observed across outcome measures with moderate improvements in the CEBQ subscale satiety responsiveness (d = 0.55, 95% CI 0.01, 1.08) and child's BMI (d = -0.56, 95% CI -1.09, 0.00) at 3 months compared with controls. Trends in the anticipated direction were also observed with reductions in disordered eating (DEPS-R) and diabetes distress (PAID-PR) and improvements in wellbeing (WEMWBS). CONCLUSIONS This is the first study to have co-designed and evaluated a novel parenting intervention to prevent disordered eating in CYP with T1D. The intervention proved feasible and acceptable with encouraging effects. Preparatory work is required prior to definitive trial to ensure the most relevant primary outcome measure and ensure strategies for optimum outcome completion.
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Affiliation(s)
- Christina J Jones
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Rebecca Read
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Nicola O'Donnell
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Katherine Wakelin
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Mary John
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
- Sussex Partnership NHS Foundation Trust, Research and Development Department, Sussex Education Centre, Hove, UK
| | - Simon S Skene
- Surrey Clinical Trials Unit, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Rose Stewart
- Betsi Cadwaladr University Health Board, Wrexham, UK
| | - Lucy Hale
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Shankar Kanumakala
- Royal Alexandra Children's Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Rose-Marie Satherley
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
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11
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Pascoe LA, Mikhail ME, Burt SA, Culbert KM, Klump KL. Shared genetic influences between eating disorders and gastrointestinal disease in a large, population-based sample of adult women and men. Psychol Med 2024; 54:1184-1195. [PMID: 37920985 DOI: 10.1017/s003329172300301x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND Some preliminary research suggests higher rates of gastrointestinal disease in individuals with eating disorders (EDs). However, research is limited, and it remains unknown what etiologic factors account for observed associations. This was the first study to examine how EDs and dimensional ED symptoms (e.g. body dissatisfaction, binge eating) are phenotypically and etiologically associated with gastrointestinal disease in a large, population-based twin sample. METHODS Adult female (N = 2980) and male (N = 2903) twins from the Michigan State University Twin Registry reported whether they had a lifetime ED (anorexia nervosa, bulimia nervosa, or binge-eating disorder) and completed a measure of dimensional ED symptoms. We coded the presence/absence of lifetime gastrointestinal disease (e.g. inflammatory bowel disease) based on responses to questions regarding chronic illnesses and medications. We first examined whether twins with gastrointestinal disease had higher rates of EDs and ED symptoms, then used correlated factors twin models to investigate genetic and environmental contributions to the overlap between disorders. RESULTS Twins with gastrointestinal disease had significantly greater dimensional ED symptoms (β = 0.21, p < 0.001) and odds of a lifetime ED (OR 2.90, p = 0.001), regardless of sex. Shared genetic factors fully accounted for the overlap between disorders, with no significant sex differences in etiologic associations. CONCLUSIONS Comorbidity between EDs and gastrointestinal disease may be explained by overlap in genetic influences, potentially including inflammatory genes implicated in both types of disorders. Screening for gastrointestinal disease in people with EDs, and EDs in those with gastrointestinal disease, is warranted.
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Affiliation(s)
- Laura A Pascoe
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Megan E Mikhail
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kristen M Culbert
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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Chakkour E, Simone M, Askew AJ, Blashill AJ. The association between gender-affirming care and disordered eating in transgender and gender diverse individuals: Exploring appearance congruence and gender-related motivating factors for weight loss. Int J Eat Disord 2024. [PMID: 38549493 DOI: 10.1002/eat.24202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/21/2024] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE The objective of this study is to explore between-group differences across different stages of gender-affirming care, and associations between appearance congruence, gender-related motivations for weight loss, and disordered eating in transgender and gender expansive (TGE) individuals. METHOD A total of 160 TGE adults (aged 18-30) were recruited across the United States. Participants completed a comprehensive online survey. Data were analyzed using generalized linear models and bivariate correlations. RESULTS Significant differences in appearance congruence among participants at different transition stages were revealed, with the group that achieved their desired transition reporting the highest appearance congruence compared to all other groups. Furthermore, gender-related motivations for weight loss were significantly lower in individuals who achieved their desired transition compared to those with no plans to transition. DISCUSSION Findings suggest significantly higher appearance congruence in those who achieved their desired transition compared to other groups, and individuals who attained their desired transition exhibited significantly reduced gender-related motivations for weight loss compared to those with no plans to transition. These findings underscore the potential psychological benefits associated with successful gender-affirming care, highlighting its role not only in fostering appearance congruence but also in mitigating gender-related motivations for weight loss among TGE individuals. Future research should include larger and more diverse samples, longitudinal designs, and considerations of other factors influencing body image outcomes in this population. PUBLIC SIGNIFICANCE This study sheds light on the crucial relationship between gender-affirming care and body image outcomes in TGE individuals. Understanding how appearance congruence and gender-related motivations for weight loss are associated with disordered eating can inform tailored support and interventions. By recognizing the association of gender affirming care and well-being, healthcare providers can enhance care for TGE individuals.
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Affiliation(s)
- Em Chakkour
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Melissa Simone
- Department of Psychology, University of Colorado Denver, Denver, Colorado, USA
| | - Autumn J Askew
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
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13
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Joshi V, Graziani P, Del-Monte J. Interoceptive sensibility, intuitive eating, binge, and disordered eating behavior among individuals with obesity: A comparative study with the general population. J Health Psychol 2024:13591053241237900. [PMID: 38532256 DOI: 10.1177/13591053241237900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
The present study assessed the links between interoceptive sensibility, binge, disordered (emotional, restrained, and external) and intuitive eating among individuals with obesity (n = 57) and normal weight (n = 29). Individuals with obesity presented lower "attention regulation," "body-listening," and "trusting" interoceptive dimensions. When age was controlled, group differences on "trusting" remained significant. Individuals with obesity showed lower intuitive eating, higher emotional, and binge eating compared to controls. Higher "body listening," "eating for physical rather than emotional reasons," and "reliance on hunger and satiety cues" predicted lower binge eating whereas "external eating" predicted higher binge eating among individuals with obesity. Eating for physical reasons and reliance on hunger and satiety had protective mediating roles in the relationship between external and binge eating in both groups. Interoceptive sensibility and intuitive eating should conjointly serve as psychotherapeutic targets for disordered eating, obesity, and weight management.
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Affiliation(s)
- Vrutti Joshi
- Université de Nîmes, France
- Aix-Marseille Université, France
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14
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Marshall TE, Thomas KS, Weinstein N, Vanderwert RE. Disordered eating behaviours and basic psychological need satisfaction: the mediating role of anxiety symptoms in preadolescents. J Child Adolesc Ment Health 2024:1-11. [PMID: 38504657 DOI: 10.2989/17280583.2023.2277763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Objective: According to self-determination theory, satisfied basic psychological needs can be a protective factor for psychopathology, including eating disorders and anxiety symptomatology. However, most research has focused on adolescent and adult populations, with less work examining perceived basic psychological need satisfaction from parents in younger samples who report anxiety and disordered eating. This cross-sectional study aimed to investigate whether basic psychological need satisfaction from parents was associated with disordered eating in preadolescents and whether anxiety mediated this relation.Method: A total of 211 preadolescents were recruited from primary schools across south Wales (mean age = 10.27 years, age range = 9-11 years; 49.3% female). Children completed self-report questionnaires on their basic psychological need satisfaction when with parents, as well as disordered eating and anxiety symptoms.Results: It was found that higher needs satisfaction was associated with lower disordered eating and anxiety, with stronger relations found in girls compared with boys. Furthermore, anxiety was found to mediate this relationship.Conclusions: Results suggest that basic psychological needs satisfaction may play an important role in the early emergence of co-occurring disordered eating and anxiety symptoms in boys and girls. The importance of considering anxiety symptoms in future work investigating needs satisfaction in the context of disordered eating and eating disorders is discussed.
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Affiliation(s)
| | - Kai S Thomas
- School of Psychology, Cardiff University, UK
- Cardiff University Centre for Human Developmental Science, Cardiff University, UK
| | - Netta Weinstein
- School of Psychology, Cardiff University, UK
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Ross E Vanderwert
- School of Psychology, Cardiff University, UK
- Cardiff University Centre for Human Developmental Science, Cardiff University, UK
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15
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Chen Y, Christensen Pacella KA, Forbush KT, Thomeczek ML, Negi S, Doan AE, Wendler AM, Morgan RW, Rasheed SI, Johnson-Munguia S, Sharma AR. Examining associations between disordered eating and harmful substance use in a nationally representative sample of US veterans. Int J Eat Disord 2024. [PMID: 38469980 DOI: 10.1002/eat.24194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/20/2024] [Accepted: 03/01/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE The association between eating disorders (EDs) and harmful substance use (substance use that causes psychosocial impairment) is well recognized in the literature, and military veterans may be at heightened risk for both issues due to deployment-related stressors. However, little is known about which ED-related symptoms are associated with harmful substance use in veterans, and whether gender plays a differential role in this relationship. Our aims were to: (1) examine gender differences in ED-related symptoms; and (2) examine whether ED-related symptoms differentially predict harmful substance use in US veteran men and women who had recently separated from service. METHOD This study was based on a nationally representative four-wave longitudinal sample of post-9/11 veterans (N = 835; 61.2% female). Longitudinal mixed modeling was used to test whether specific ED-related behaviors at baseline predicted harmful substance use at follow-ups. RESULTS We replicated gendered patterns of ED-related symptoms observed in civilian populations, wherein men had higher weight-and-body-related concerns (including excessive exercise and muscle building) and negative attitude toward obesity, and women had higher bulimic and restricting symptoms. For women, alcohol, drug, and marijuana problems were predicted by higher bulimic symptoms, whereas for men, these problems were predicted by higher restricting symptoms. CONCLUSION Gender played a differential role in the relationship between EDs and harmful substance use. Bulimic symptoms were the most robust predictor for harmful substance use among veteran women, whereas restricting was the most robust predictor for harmful substance use among veteran men. PUBLIC SIGNIFICANCE The current study found that veteran women had higher bulimic symptoms (characterized by binge eating and purging) and restricting than veteran men. In women, bulimic symptoms predicted future harmful use of alcohol, marijuana, and other drugs. In contrast, veteran men had higher weight-and-body-related concerns (characterized by excessive exercise and muscle building) than veteran women. In men, restricting symptoms predicted future harmful use of alcohol, marijuana, and other drugs.
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Affiliation(s)
- Yiyang Chen
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | | | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | | | - Sonakshi Negi
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Alesha E Doan
- Department of Women, Gender, and Sexuality Studies, University of Kansas, Lawrence, Kansas, USA
- School of Public Affairs and Administration, University of Kansas, Lawrence, Kansas, USA
| | | | - R William Morgan
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Samiya I Rasheed
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | | | - Anjali R Sharma
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
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16
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Nicoletta J, Mosco R, Enouy S, Tabri N. Momentary appearance focused self-concept is associated with dietary restraint and binge eating in female university students: An experience sampling study. Int J Eat Disord 2024. [PMID: 38450762 DOI: 10.1002/eat.24170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Appearance focused self-concept (i.e., overvaluing the importance of appearance for self-definition and self-worth) is theorized to predict dietary restraint and binge eating in the short-term (e.g., daily life). Yet, no research has examined whether appearance focused self-concept increases within-persons during a day and if such increases are linked to greater dietary restraint and binge eating for that day. We addressed this gap in knowledge. METHOD Sixty-three female university students completed four items from the Beliefs About Appearance Scale as a measure of appearance focused self-concept six times per day (9 am, 11 am, 1 pm, 3 pm, 5 pm, and 7 pm) for 14 days. Daily at 9 pm, they completed measures of dietary restraint and binge eating for that day. RESULTS Analyzing data from 555 days, latent growth curve analyses revealed a small-to-moderate linear increase in appearance focused self-concept from 9 am to 3 pm that plateaued from 3 to 7 pm. A more rapid linear increase in appearance focused self-concept from 9 am to 3 pm was associated with greater binge-eating frequency during that day, but not with dietary restraint. The findings were observed when adjusting for between-day appearance focused self-concept at 9 am, which was positively associated with dietary restraint and binge-eating frequency. DISCUSSION Findings are discussed in relation to research on appearance focused self-concept as a risk factor for disordered eating. Findings are also discussed in relation to how sociocultural factors may increase appearance focused self-concept over time. Future research should delve into the within-day dynamic interplay between appearance focused self-concept and disordered eating. PUBLIC SIGNIFICANCE Our study revealed a noteworthy increase in the importance women attach to their appearance over the course of a day, correlating with increased binge eating during that day. Additionally, heightened appearance importance at the onset of a day was associated with more dietary restraint and binge eating during that day. These findings suggest a shorter timescale for the connection between appearance importance and disordered eating than previously understood.
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Affiliation(s)
- Juliana Nicoletta
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Rose Mosco
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Sarah Enouy
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
- Mental Health and Well-being Research and Training Hub (MeWeRTH), Carleton University, Ottawa, Ontario, Canada
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
- Mental Health and Well-being Research and Training Hub (MeWeRTH), Carleton University, Ottawa, Ontario, Canada
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17
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Paranjothy SM, Wade TD. A meta-analysis of disordered eating and its association with self-criticism and self-compassion. Int J Eat Disord 2024; 57:473-536. [PMID: 38366726 DOI: 10.1002/eat.24166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Future treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self-criticism and self-critical perfectionism act as key mechanisms exacerbating ED, and self-compassion protects against self-criticism. This meta-analysis examines associations between self-criticism and self-critical perfectionism on disordered eating (DE), and reviews how self-compassion and self-criticism relate to each other with respect to DE. METHOD Searches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self-criticism measures, self-compassion measures, between clinical and nonclinical samples, and between cross-sectional and experimental studies were also conducted. RESULTS Random-effects models showed a medium positive link between self-criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self-criticism utilized in literature showed small to large positive links with DE (r = .20-.52). Preliminary evidence also suggests negative relationships between self-compassion and DE (r = -.40 to -.43) and negative relationships between self-compassion and self-criticism (r = -.04 to -.88). DISCUSSION Greater levels of self-criticism is linked with greater levels of DE and reduced levels of self-compassion, suggesting a need to tackle self-criticism and nurture self-compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self-criticism and self-compassion for people with DE. PUBLIC SIGNIFICANCE STATEMENT Higher levels of self-criticism are linked with higher levels of DE and lower self-compassion. Self-compassion interventions could be more effective and efficient in reducing ED symptoms if self-criticism is tackled early in such treatments.
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Affiliation(s)
- Sarah Marie Paranjothy
- Flinders University, Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Tracey D Wade
- Flinders University, Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
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18
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Portingale J, Kenny J, Fuller-Tyszkiewicz M, Krug I. Effects of videoconferencing use on momentary changes in disordered eating urges, body dissatisfaction, and mood. Eur Eat Disord Rev 2024; 32:201-214. [PMID: 37805970 DOI: 10.1002/erv.3036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/11/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic led to a global surge in videoconferencing use for work/study-related reasons. Although these platforms heighten exposure to one's image, the implications of videoconferencing use on body image and eating concerns remain scantly examined. This study sought to investigate, in an Australian sample, whether videoconferencing for work/study-related reasons predicted increases in body dissatisfaction (BD), urge to engage in disordered eating (DE; restrictive eating, exercise, overeating/purging), and negative mood at the state level. Participants (N = 482, 78.8% women, Mage = 20.5 years [SD = 5.3]) completed baseline demographic measures, accompanied by an ecological momentary assessment (EMA) of videoconferencing for work/study-related reasons, BD, DE urges, and negative mood six times a day for 7 days via a smartphone application. Most participants (n = 429; 89.0%) reported state-based videoconferencing use during the EMA phase. Consistent with expectations, state-based videoconferencing use was associated with an increase in state-level urges to engage in exercise. However, contrary to predictions, state-based videoconferencing use was linked to a decrease in state-level BD at the next assessment point and failed to predict negative mood and urges to engage in restrictive eating or overeating/purging at the state level. Given the simplified measure of videoconferencing use, the current research is considered preliminary and future replication and extension, using more nuanced measures, is warranted.
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Affiliation(s)
- Jade Portingale
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jesy Kenny
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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19
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Mörö S, Kosola S, Holopainen E. Girls referred for amenorrhea: analysis of a patient series from a specialist center. Front Public Health 2024; 12:1304277. [PMID: 38435281 PMCID: PMC10906086 DOI: 10.3389/fpubh.2024.1304277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
Objective Among adolescents, amenorrhea is a common reason for medical consultation. Despite the variety of underlying etiologies, the prevalence of the causes is incompletely understood. This study aimed to assess the demographic and etiological factors among patients with amenorrhea treated in a single specialist unit of adolescent gynecology. Design Retrospective register study. Methods Medical records of 438 girls evaluated for primary or secondary amenorrhea in a single tertiary care center between 2015 and 2019 were retrospectively reviewed. In all, 423 patients-171 with primary amenorrhea and 252 with secondary amenorrhea-were included in the study. Data on underlying conditions, anthropometric variables, and selected hormonal markers were analyzed. Results Functional hypogonadotropic hypogonadism was the most frequent reason for primary (56%) and secondary (78%) amenorrhea. It was mostly explained by lifestyle-related functional hypothalamic amenorrhea caused by disordered eating, intense exercise, energy deficiency, psychological stress, and their combinations. Conclusion Menstrual pattern is a significant indicator of overall health and well-being among adolescent girls and young women. Functional reasons behind primary and secondary amenorrhea are important to recognize. Treatment often requires long-term lifestyle modifications. The frequency of functional causes also implies that most amenorrhea cases are preventable.
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Affiliation(s)
- Sara Mörö
- Children’s Hospital and Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Silja Kosola
- Children’s Hospital and Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research, Development and Innovations, Western Uusimaa Wellbeing Services County, Espoo, Finland
| | - Elina Holopainen
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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20
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Mittertreiner EJE, Hunter A, Lacroix E. Nutritional considerations for gender-diverse people: a qualitative mini review. Front Nutr 2024; 11:1332953. [PMID: 38419847 PMCID: PMC10899494 DOI: 10.3389/fnut.2024.1332953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Dietitians working with gender-diverse people may require different skills and knowledge than those caring for cisgender men and women, as indicated by a growing body of literature that highlights gender-diverse people's unique experiences with and relationships to nutrition and eating behaviors. To provide insight into how dietitians can best serve this population, this mini review identifies and summarizes qualitative studies that investigate gender-diverse people's lived experiences and perspectives regarding nutrition, eating disorders, and access to eating-related healthcare services. Fourteen studies examining nutrition or eating behaviors among gender-diverse samples were selected through a systematic search and screening process: 11 focused on disordered eating or eating disorders and the remaining three focused on nutritional needs, nutritional knowledge, and food insecurity. Extracted themes included: using dietary restriction to suppress secondary sex characteristics or conform to societal norms; the impact of gender-affirming care on disordered eating; negative experiences with, and beliefs about, nutrition and eating disorders healthcare services; and suggestions for clinicians. Recommendations discuss the need for increased trans literacy among clinicians, the creation of safe spaces for gender-diverse people with eating disorders, and the importance of dual competencies in eating disorders treatment and gender-affirming care.
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Affiliation(s)
- Em Jun Eng Mittertreiner
- Maritime Eating and Appearance Lab, Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
| | - Abbey Hunter
- School of Education, St. Thomas University, Fredericton, NB, Canada
| | - Emilie Lacroix
- Maritime Eating and Appearance Lab, Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
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21
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Grunewald W, Waitz-Kudla SN, Levinson CA, Brown TA, Smith AR. Development and Psychometric Validation of the Body Trust Scale. Assessment 2024:10731911231225200. [PMID: 38311906 DOI: 10.1177/10731911231225200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Interoception (e.g., abilities to recognize/attend to internal sensations) is robustly associated with psychopathology. One form of interoception, body trust, is relevant for the development of disordered eating and suicidal thoughts/behaviors. However, measures of body trust are narrow, despite research suggesting body trust is multifaceted. The aim of this study was to develop a comprehensive measure of body trust: The Body Trust Scale (BTS). 479 U.S. adults completed self-report surveys containing the BTS and psychopathology measures. Exploratory and confirmatory factor analyses revealed a three-factor structure: Comfort with One's Body, Physical Attractiveness, and Comfort with Internal Sensations. Factors showed strong construct, convergent, and divergent validity, as well as moderate predictive validity for suicidal thoughts/non-suicidal self-injury. Furthermore, factors showed strong internal consistency, test-retest reliability, and were invariant across the gender binary. The BTS can be used in research and clinical settings to understand how specific facets of body trust relate to psychopathology.
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22
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Speed S, Ward RM. Drunkorexia and trait mindfulness among college students. J Am Coll Health 2024; 72:571-577. [PMID: 35298361 DOI: 10.1080/07448481.2022.2048837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/07/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p < .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p < .001). Drunkorexia motivations are significantly correlated with AA (r = -.13, p = .01) and NJ (r = -.18, p = .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.
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Affiliation(s)
- Shannon Speed
- Department of Kinesiology, Nutrition & Health, Miami University, Oxford, Ohio, USA
| | - Rose Marie Ward
- Department of Kinesiology, Nutrition & Health, Miami University, Oxford, Ohio, USA
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23
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Van Swearingen KM, Noel NE. Impulsivity traits associated with disordered eating and binge drinking among female college students. J Am Coll Health 2024; 72:509-514. [PMID: 35271428 DOI: 10.1080/07448481.2022.2047696] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 12/26/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Objective: Disordered eating and problematic alcohol use may negatively impact women's health, and the two issues frequently occur together. We assessed the interaction between negative urgency and disordered eating variables on binge drinking frequency. We also examined impulsivity facets in relation to binge eating, purging, and restrictive eating using multiple linear regression. Methods: Undergraduate women (M age 19.02; SD 1.51; n 262) from a mid-sized southeastern university, reported quantity and frequency of alcohol use over the past 90 days, disordered eating measured by the Multifactorial Assessment of Eating Disorder Symptoms (MAEDS), and impulsivity on the UPPS-P. Results: Negative urgency was the best impulsivity predictor of binge eating and restrictive eating. Negative urgency was a significant predictor of binge drinking frequency (negative binomial regression, p values < .01), but no interaction was found. Conclusions: To reduce these behaviors, college students may benefit from campus programs offering adaptive strategies to cope with negative affect.
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Affiliation(s)
- Kristen M Van Swearingen
- Department of Psychology, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Nora E Noel
- Department of Psychology, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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Bachner-Melman R, Lev-Ari L, Tiram H, Zohar AH. Self-Objectification, Disordered Eating and Sexual Orientation in Men. Int J Environ Res Public Health 2024; 21:106. [PMID: 38248568 PMCID: PMC10815722 DOI: 10.3390/ijerph21010106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
The interplay between disordered eating, depressive symptoms and self-objectification differs between genders and sexual orientations, and merits further study in homosexual and heterosexual men. We examined disordered eating, depressive symptoms and self-objectification in a sample of Israeli heterosexual and homosexual men. Participants were 215 men aged 19-65, 108 of whom were classified by the Kinsey scale as being heterosexual and 107 as homosexual. They completed online measures of self-objectification, disordered eating and depressive symptoms. Heterosexual men reported lower levels of disordered eating and self-objectification than homosexual men, however the difference in depressive symptoms was not statistically significant. Correlations between disordered eating, self-objectification and depressive symptoms when controlling for age, BMI and number of children were all significant, with similar patterns of association for heterosexual and homosexual men. Self-objectification partially mediated the association between sexual orientation and disordered eating. However, contrary to our hypothesis, sexual orientation (homosexual/heterosexual) did not moderate the association between disordered eating and self-objectification. The tendency of homosexual men towards self-objectification is linked to unhealthy eating habits. Self-objectification helps explain the propensity of homosexual versus heterosexual men to develop disordered eating and possibly eating disorders. It should therefore be targeted in prevention and in therapy.
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Affiliation(s)
- Rachel Bachner-Melman
- Clinical Psychology Graduate Program, Ruppin Academic Center, Emek Hefer 4025000, Israel; (L.L.-A.); (H.T.); (A.H.Z.)
- School of Social Work, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Lilac Lev-Ari
- Clinical Psychology Graduate Program, Ruppin Academic Center, Emek Hefer 4025000, Israel; (L.L.-A.); (H.T.); (A.H.Z.)
- Lior Tsfaty Suicide and Mental Pain Research Center, Ruppin Academic Center, Emek Hefer 4025000, Israel
| | - Hadar Tiram
- Clinical Psychology Graduate Program, Ruppin Academic Center, Emek Hefer 4025000, Israel; (L.L.-A.); (H.T.); (A.H.Z.)
| | - Ada H. Zohar
- Clinical Psychology Graduate Program, Ruppin Academic Center, Emek Hefer 4025000, Israel; (L.L.-A.); (H.T.); (A.H.Z.)
- Lior Tsfaty Suicide and Mental Pain Research Center, Ruppin Academic Center, Emek Hefer 4025000, Israel
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Lindgreen P, Willaing I, Clausen L, Ismail K, Grønbæk HN, Andersen CH, Persson F, Cleal B. "I Haven't Told Anyone but You": Experiences and Biopsychosocial Support Needs of People With Type 2 Diabetes and Binge Eating. Qual Health Res 2024:10497323231223367. [PMID: 38183221 DOI: 10.1177/10497323231223367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
Up to 25% of people with type 2 diabetes (T2D) may binge eat which is almost 10 times as many as in the general population. Binge eating is associated with depression, anxiety, and social isolation. Moreover, binge eating may increase the risk of obesity and high blood glucose levels, both of which can accelerate the onset of complications to diabetes and death in people with T2D. Still, little is known about the experiences, needs, and preferences of people with T2D and binge eating that can inform and develop current and future treatment efforts. The aim of the study was therefore to gain in-depth insights into the experiences and biopsychosocial support needs of women and men with T2D and binge eating. Twenty semi-structured individual interviews (65% with females) were conducted and analyzed according to the methodology of Interpretive Description. Four themes were identified: (a) T2D and binge eating: Feeling trapped in a vicious circle; (b) Unwanted outcasts: Responding to continuous criticism; (c) Biomedical relief: Blaming and adjusting the body; and, (d) Silent struggles: Wanting to cease the secrecy. Pertinent to all themes were the guilt, shame, and worries about developing complications that the participants experienced when binge eating despite having T2D. Although binge eating triggered emotional distress, binge eating was at the same time a way of coping with such distress. Implications for treatment and future research are discussed, including the need to systematically assess and address binge eating in routine T2D care.
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Affiliation(s)
| | - Ingrid Willaing
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Loa Clausen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Khalida Ismail
- Department of Psychological Medicine, King's College London, London, UK
| | | | | | | | - Bryan Cleal
- Steno Diabetes Center Copenhagen, Herlev, Denmark
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Vaidyanathan S, Menon V. Research on feeding and eating disorders in India: A narrative review. Indian J Psychiatry 2024; 66:9-25. [PMID: 38419929 PMCID: PMC10898522 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_782_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 03/02/2024] Open
Abstract
Despite growing evidence of their prevalence, research on feeding and eating disorders (FEDs) in India has been sporadic. This narrative review aimed to summarize the research on FED in India and set priorities for future research and translation of evidence. An electronic search was conducted in the MEDLINE, PsycINFO, and Google Scholar databases to identify relevant English peer-reviewed articles from April 1967 to July 2023. The extracted data from these studies included author names, publication year, research location, type of intervention (for interventional studies), nature of comparator treatments, and main outcomes or findings. We found a rising trend in the prevalence of EDs in India. Adolescent age group, female sex, higher socioeconomic status, family history of mental illness or disordered eating, and borderline personality pattern were risk factors for EDs. For feeding disorders (FDs), childhood age group, malnutrition, pregnancy, psychosis, intellectual disability (ID), and obsessive-compulsive disorder (OCD) were putative risk factors. Both physical and psychiatric comorbidities were common in FEDs. Culture appears to exert a pathoplastic effect on symptom presentation in FEDs; an illustrative example is the documented nonfat phobic variant of anorexia nervosa (AN) in India. Research on management has focused on using assessment tools, investigations to rule out medical comorbidities, psychosocial and family-based psychotherapies, nutritional rehabilitation, pharmacotherapy, and neuromodulation approaches. Whereas the publication output on FEDs in India has increased over the last decade, it remains an under-researched area, with a striking paucity of original research. Future research priorities in FEDs include conducting country-wide registry-based studies to offer real-world insights, longitudinal research to identify culturally relevant risk factors, and developing brief, culturally sensitive diagnostic instruments for FEDs in the Indian context. This will help generate locally relevant epidemiological data on FEDs and inform treatment and prevention strategies.
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Affiliation(s)
- Sivapriya Vaidyanathan
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Simone M, Askew AJ, Beccia AL, Cusack CE, Pisetsky EM. 'Let the ladies know': queer women's perceptions of how gender and sexual orientation shape their eating and weight concerns. Cult Health Sex 2024; 26:108-125. [PMID: 37000045 PMCID: PMC10544670 DOI: 10.1080/13691058.2023.2189931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/08/2023] [Indexed: 04/01/2023]
Abstract
This exploratory study aimed to describe the lived experiences of queer women affected by eating and weight-related concerns. Qualitative data from young queer women (n = 105; Age = 23.6 ± 3.4 years) with eating and weight-related concerns in response to open-ended questions related to the influence of gender identity and body image on weight concern, behaviours, and perception were analysed using reflexive thematic analysis. Nine themes were created to describe participants' experiences: (1) compensation for other internalised stigma, (2) to suppress body parts that can be gendered or sexualised, (3) comparisons to romantic partners' bodies, (4) media representations, (5) queer signalling, (6) queerness as protective, (7) gender expression and dysphoria, (8) societal expectations of women's bodies, and (9) internalisation of body/beauty ideals. Seven sub-themes were created to represent beauty ideals for specific subcultural communities (e.g. femme, butch). Findings suggest that queer women attribute individual, interpersonal and social factors to weight concerns, behaviours and perceptions. Findings highlight how complex tensions between the beauty/body ideals experienced in cisheteronormative and queer spaces influence eating and weight concerns among queer women. Gender, sexual orientation and subcultural ideals intersect in important ways, and may be useful to consider when screening, treating and preventing eating and weight concerns among queer women.
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Affiliation(s)
- Melissa Simone
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Autumn J. Askew
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Ariel L. Beccia
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Claire E. Cusack
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Emily M. Pisetsky
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA
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28
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O'Connell S, Brenner I, Scheid JL, West SL. Disordered eating is not associated with musculoskeletal injury in university athletes. Appl Physiol Nutr Metab 2024; 49:87-92. [PMID: 37639728 DOI: 10.1139/apnm-2023-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
TAKE HOME MESSAGE Musculoskeletal injuries and disordered eating are prevalent in varsity-level athletes but are not associated in our participants.
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Affiliation(s)
- S O'Connell
- Department of Biology, Trent University, Peterborough, ON K9L 0G2, Canada
| | - I Brenner
- Department of Kinesiology, Trent University, Peterborough, ON K9L 0G2, Canada
- Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada
| | - J L Scheid
- Department of Physical Therapy, Daemen University, Amherst, NY 14226, USA
| | - S L West
- Department of Biology, Trent University, Peterborough, ON K9L 0G2, Canada
- Department of Kinesiology, Trent University, Peterborough, ON K9L 0G2, Canada
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29
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Kalami VS, David JG, Futornick S, Yeh AM. Weighing the scales: Taking a balanced approach to diet therapies in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024; 78:4-7. [PMID: 38291683 DOI: 10.1002/jpn3.12083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 02/01/2024]
Affiliation(s)
- Venus S Kalami
- Stanford Medicine Children's Health, Palo Alto, California, USA
| | | | | | - Ann M Yeh
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Stanford University, Stanford, California, USA
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30
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Damiri B, Hamayel D, Wael M. Energy drinks and waterpipe smoking associated with disordered eating habits among male Palestinian refugees. J Ethn Subst Abuse 2023:1-15. [PMID: 38148666 DOI: 10.1080/15332640.2023.2283767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
This cross-sectional study highlights the concerning relationship between stimulants, alcohol use, and weight-related problems among Palestinian refugee men in the West Bank. Self-administered questionnaires were used to gather data on stimulants and alcohol use and eating attitudes and behaviors (EAT-26). The findings revealed that many refugee men were daily cigarette (61.4%) and waterpipe smokers (15.5%), while 30.6% and 2.3% were daily energy drink and alcohol users, respectively. Moreover, most refugee men (67.3%) were obese, and 23.5% were terrified about being obese. They had disordered eating habits, including the impulse to vomit after meals (63.3%). Moreover, 30.7% scored ≥20 using EAT-26 scale, and 44.4% scored at least one positive behavior, including binge eating (40.4%), purging (10.0%), using laxatives or diet pills (8.3%), excessive exercise (30.9%), and losing weight (24.6%). The results of the adjusted binary logistic regression indicated that risk factors associated with self-induced vomiting were daily (OR = 2.71, p-value = 0.004) and weekly energy drink intake (OR = 2.41, p-value = 0.023), weekly alcohol intake (OR = 10.83, p-value = 0.036), and obesity (OR = 2.57, p-value = 0.002), while inversely associated with weekly waterpipe smoking (OR = 0.297, p-value = 0.007). Obesity was inversely associated with daily (OR = 0.146, p-value < 0.01) and weekly waterpipe smoking (OR = 0.259, p-value = 0.002), and weekly cigarette smoking (OR = 0.251, p-value < 0.01). The study underscores the urgent need for community awareness, professional evaluation, and treatment for obesity and disordered eating habits among Palestinian refugee men. It is essential to address the detrimental effects of alcohol and energy drink intake and tobacco smoking to improve the health outcomes of this vulnerable population.
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Affiliation(s)
- Basma Damiri
- Medicine & Health Sciences Faculty, Drug, and Toxicology Division, An-Najah National University, Nablus, Palestine
| | - Dalia Hamayel
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, Palestine
| | - Muhannad Wael
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, Palestine
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Dover S, Ahmet A, Bluth K, Feldman BM, Goldbloom EB, Goldfield GS, Hamilton S, Imran O, Khalif A, Khatchadourian K, Lawrence S, Leonard A, Liu K, Ouyang Y, Peeters C, Shah J, Spector N, Zuijdwijk C, Robinson ME. Teaching Adolescents With Type 1 Diabetes Self-Compassion (TADS) to Reduce Diabetes Distress: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e53935. [PMID: 38048480 PMCID: PMC10777281 DOI: 10.2196/53935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Adolescents living with type 1 diabetes (T1D) often experience diabetes distress (DD), a construct distinct from depression or anxiety that refers to the negative emotions that arise from living with and managing diabetes. Self-compassion, which involves being open to one's own suffering and treating oneself with the same care one would show to loved ones, is associated with better psychological and clinical outcomes among individuals with T1D. Self-compassion is a skill that can be taught and therefore represents an opportunity for intervention. OBJECTIVE The overall aim of this study is to assess the effectiveness of a web-based mindful self-compassion for teens (MSC-T) intervention on improving DD, anxiety, depression, diabetes-related disordered eating, and suicidal ideation experienced by youth with T1D (aged between 12 and 17 years) compared with a waitlist control group (standard of care). We will also explore (1) if the effect of the MSC-T intervention changes over time, (2) if the MSC-T intervention has a positive impact on measures of glycemic control, and (3) if the effect of the MSC-T intervention differs based on self-reported gender. METHODS We will conduct a single-center, parallel-group randomized controlled trial of 140 adolescents with T1D followed for 12 months. Participants will be randomly allocated (using hidden allocation) in a 1:1 ratio to either the MSC-T intervention or the waitlist control group. Our primary outcome is DD, as measured by the Problem Areas in Diabetes-Teen (PAID-T) version at 3 months. Secondary outcomes, assessed at 3 and 12 months, include anxiety (Generalized Anxiety Disorder 7-item [GAD-7] scale), depression (Patient Health Questionnaire-9 [PHQ-9]), diabetes-related disordered eating (Diabetes Eating Problem Survey-Revised [DEPS-R] version), and suicidal ideation (using 1 question from the PHQ-9). RESULTS Study recruitment began in October 2022 and was completed in March 2023, with a total of 141 participants enrolling. Data collection will be ongoing until March 2024. The first results are expected in June 2024. CONCLUSIONS This study will be the first randomized trial to assess the effectiveness of the web-based MSC-T intervention on adolescents with T1D. Given that adolescence is a period where individuals are typically required to assume more responsibility for their diabetes care, providing adolescents with the tools they need to better manage the stress that often accompanies T1D management is paramount. TRIAL REGISTRATION ClinicalTrials.gov NCT05463874; https://clinicaltrials.gov/study/NCT05463874. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53935.
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Affiliation(s)
- Saunya Dover
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Alexandra Ahmet
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Division of Endocrinology & Metabolism, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Karen Bluth
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Brian M Feldman
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Ellen B Goldbloom
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Division of Endocrinology & Metabolism, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Gary S Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sarah Hamilton
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Omar Imran
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Adam Khalif
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Karine Khatchadourian
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Division of Endocrinology & Metabolism, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sarah Lawrence
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Division of Endocrinology & Metabolism, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Andrew Leonard
- Harvard Extension School, Harvard University, Cambridge, MA, United States
| | - Kuan Liu
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Yongdong Ouyang
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Corien Peeters
- Development & Rehabilitation, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Jai Shah
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - Noah Spector
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Eating Disorders Program, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Caroline Zuijdwijk
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Division of Endocrinology & Metabolism, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Marie-Eve Robinson
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Division of Endocrinology & Metabolism, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Dambacher L, Pritchett K, Pritchett R, Larson A. Risk of Low Energy Availability, Disordered Eating, and Menstrual Dysfunction in Female Collegiate Runners. J Athl Train 2023:497831. [PMID: 38116873 DOI: 10.4085/1062-6050-0454.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
CONTEXT Collegiate female distance runners may be at risk for low energy availability (LEA) due to increased exercise energy expenditure with or without decreased energy intake. Furthermore, this population has increased risk of disordered eating (DE), which can lead to LEA and negative health consequences, such as menstrual dysfunction (MD). OBJECTIVE 1) investigate risk of LEA and DE, 2) compare DE, training volume, and weight dissatisfaction among female collegiate runners at risk vs not at risk for LEA, and 3) compare risk for LEA between NCAA (National Collegiate Athletics Association) Division I, II, and III female collegiate runners. DESIGN Cross-sectional study. SETTING Free-living. PATIENTS OR OTHER PARTICIPANTS Female runners (n = 287) who competed on an NCAA (National Collegiate Athletics Association) Division I, II, or III cross-country and/or track team. MAIN OUTCOME MEASURE(S) A 45 question questionnaire was completed which included the Low Energy Availability in Females Questionnaire (LEAF-Q) and the Disordered Eating Screening Assessment (DESA-6). RESULTS 54.5% (n = 156) of runners were at risk for LEA (score ≥ 8 on LEAF-Q), and 40.8% (n = 117) were at risk for DE (DESA-6 score ≥ 3), and 56.5% (n = 162) reported MD (LEAF-Q subsection MD score ≥ 4). Athletes "at risk" for LEA had significantly higher DESA-6 scores than athletes "not at risk" for LEA (p < 0.001). Athletes "at risk" for LEA had significantly greater weight dissatisfaction than those not at risk for LEA (X23, 156 = 15.92, p = 0.001). Higher weekly training volumes was not associated with risk for LEA (X22, 156 = 4.20, p = 0.112). CONCLUSIONS A substantial percentage of collegiate female runners were found to be at risk for LEA, DE, and report MD. These findings demonstrate that risk for DE, MD, and weight dissatisfaction are associated with risk for LEA.
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Affiliation(s)
- Leah Dambacher
- Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA 98926, USA
| | - Kelly Pritchett
- Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA 98926, USA
| | - Robert Pritchett
- Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA 98926, USA
| | - Abigail Larson
- Department of Kinesiology and Outdoor Recreation, Southern Utah University, 351 W. University Blvd, Cedar City, UT 84720
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Cialdella-Kam L, Bloedon TK, Stone MS. Body composition as a marker of performance and health in military personnel. Front Sports Act Living 2023; 5:1223254. [PMID: 38169866 PMCID: PMC10759214 DOI: 10.3389/fspor.2023.1223254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Body composition standards are set to ensure operational readiness in active-duty military personnel. To meet body composition standards, some individuals, however, may engage in unhealthy weight control behaviors (i.e., weight cycling and disordered eating). The objectives of this review are to: (1) evaluate the evidence regarding body composition and the associations to physical and military specific performance; (2) discuss body composition and potential health consequences; and (3) examine the evidence of weight cycling and disordered eating behaviors in military personnel for weight control. Methods A systematic search to identify peer-reviewed research articles was conducted in PubMed on 2/20/2023 using Medical Subject Headings (MeSH) including but not limited to "Military Personnel", "Tactical Athlete", "Weight Loss", "Body Composition", and "Weight Cycling". Results A total of 225 research articles were identified. The list was narrowed down to articles from the last 20 years (2003-2023) in military personnel. Only studies in which percent body fat was directly measured were included resulting in 17 research articles for this review. Discussion Evidence-based research is limited on the relationship between body composition and operational readiness. Weight cycling and disordered eating behaviors also has been reported for weight control, yet additional research is needed. Specifically, future research should focus on female service members, racial and ethnic differences, age, and postpartum status and include other service branches (i.e., Air Force and Navy). A comprehensive survey on weight cycling, disordered eating, and weight management would be valuable to determine the prevalence and extent of this issue. This information along with performance data would guide policy makers on the relevance and appropriateness of existing body composition standards.
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Affiliation(s)
- Lynn Cialdella-Kam
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA, United States
| | - Taylor K. Bloedon
- School of Applied Health, Cal Poly Humboldt, Arcata, CA, United States
| | - Michael S. Stone
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA, United States
- Military and Veterans Health Solutions, Leidos, San Diego, CA, United States
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Cserép M, Szabó B, Tóth-Heyn P, Luczay A, Dezsőfi-Gottl A, Cseh Á, Várnai N, Pászthy B, Szabó JA, Szumska I. [The role of cognitive emotion regulation in disordered eating among chronically ill adolescents]. Orv Hetil 2023; 164:1895-1903. [PMID: 38043080 DOI: 10.1556/650.2023.32877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/08/2023] [Indexed: 12/05/2023]
Abstract
Bevezetés: A krónikus betegségek evészavartünetekkel való
társulása fokozott figyelmet igényel a súlyos szövődmények lehetősége és a
mortalitási rizikó növekedése miatt. Az evészavarok és a szubklinikai
evészavarok maladaptív érzelemszabályozással járnak együtt, melyek kiváltó és
fenntartó tényezői is lehetnek a betegségnek. Ismereteink szerint a gyulladásos
bélbetegséggel és 1-es típusú diabetesszel élő serdülők kognitív
érzelemszabályozásának szerepét az evészavartüneteikben ez idáig még nem
vizsgálták. Célkitűzés: 14 és 18 év közötti serdülők körében
elemeztük a kognitív érzelemszabályozás és az evészavartünetek kapcsolatát,
különös tekintettel az 1-es típusú diabetesben és gyulladásos bélbetegségben
érintett fiatalokra. Kutatásunk arra irányult, hogy krónikus betegek
csoportjaiban kimutatható-e egyes kognitív érzelemszabályozó stratégiák szerepe
az evészavartünetekben. Módszer: Vizsgálatunkban 300 serdülő
töltötte ki tájékozott beleegyezés után a Kognitív Érzelemreguláció Kérdőívet és
a Pszichopatológiai Tünetlista Gyermekek és Serdülők Számára kérdőívet. A négy
vizsgálati csoportot 157, testileg egészséges serdülő, 51, gyulladásos
bélbetegség diagnózisával élő serdülő, 61, 1-es típusú diabetes diagnózisú
serdülő és 31, anorexia nervosa diagnózissal rendelkező serdülő alkotta.
Eredmények: Vizsgálatunk eredményei alapján a gyulladásos
bélbetegséggel élő fiatalok esetében a ruminatio és a pozitív átértékelés, az
1-es típusú diabetes diagnózisú serdülőknél pedig az önvád és a ruminatio
közvetett úton szignifikáns kapcsolatban állt az evészavartünetekkel.
Megbeszélés: Eredményeink arra utalnak, hogy a kognitív
érzelemszabályozó stratégiák a vizsgált krónikus betegséggel élő serdülők
körében indirekt módon kapcsolatban állnak az evészavartünetekkel. Az önvád és
ruminatio negatív érzelemszabályozó stratégiák gyakoribb alkalmazása növeli az
evészavartünetek előfordulását, ugyanakkor kisebb mértékű használatuk kevesebb
evészavartünettel jár együtt. A pozitív átértékelés nagyobb mértékű alkalmazása
kevesebb evészavartünettel jár együtt. Következtetés: A
kognitív érzelemszabályozó stratégiák vizsgálatát és fejlesztését javasoljuk
beépíteni a krónikus beteg serdülők komplex ellátásába. Orv Hetil. 2023;
164(48): 1895–1903.
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Affiliation(s)
- Melinda Cserép
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Magatartástudományi Intézet Budapest Magyarország
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - Brigitta Szabó
- 3 ELTE Eötvös Loránd Tudományegyetem, Pszichológiai Doktori Iskola Budapest Magyarország
- 4 ELTE Eötvös Loránd Tudományegyetem, Pszichológiai Intézet, Fejlődés- és Klinikai Gyermekpszichológia Tanszék Budapest Magyarország
- 5 Semmelweis Egyetem, Általános Orvostudományi Kar, Klinikai Pszichológiai Tanszék Budapest Magyarország
| | - Péter Tóth-Heyn
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - Andrea Luczay
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - Antal Dezsőfi-Gottl
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - Áron Cseh
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - Nikoletta Várnai
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - Bea Pászthy
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - J Attila Szabó
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika, MTA Kiváló Kutatóhely Budapest, Bókay János u. 53., 1083 Magyarország
| | - Irena Szumska
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Magatartástudományi Intézet Budapest Magyarország
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35
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Goetz TG, Wolk CB. Moving toward targeted eating disorder care for transgender, non-binary, and gender expansive patients in the United States. Int J Eat Disord 2023; 56:2210-2222. [PMID: 37638738 DOI: 10.1002/eat.24055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Literature suggests that transgender, non-binary, and/or gender expansive (TNG) people are more likely than cisgender peers to experience eating disorders (EDs) and engage in dangerous weight control behaviors. TNG individuals with EDs are dramatically higher risk for self-harm behaviors, suicidal ideation, and suicidal behaviors than cisgender peers with EDs or TNG peers without EDs, and often engage in ED symptoms/behaviors to alleviate gender dysphoria. Yet, no treatment paradigms have yet been adapted for TNG-specific ED care. This qualitative study aims to identify stakeholder needs from such care to inform future clinical interventions. METHODS We elicited patient (n = 12) and mental health clinician (n = 9) stakeholder needs and preferences regarding TNG-specific ED care. Semi-structured interview guides informed by the Consolidated Framework for Implementation Research (CFIR) and a behavioral insights framework, EAST, were developed to ensure uniform inclusion and sequencing of topics and allow for valid comparison across interviews. Using a rapid analysis procedure, we produced a descriptive analysis for each group identifying challenges of and opportunities in providing ED care for TNG adults. RESULTS Stakeholders expressed needs and preferences for TNG-specific treatment including that it be: (1) TNG-affirming, weight-inclusive, trauma-informed, and anti-racist; (2) delivered by an interdisciplinary team, including gender-affirming care clinicians; (3) focused on parsing gender dysphoria from other body image concerns, building distress tolerance, and working toward gender euphoria (rather than body acceptance). DISCUSSION Future work is needed exploring ED care delivery models that integrate gender-affirming care services with mental health care. Such models may improve TNG access to ED treatment and recovery. PUBLIC SIGNIFICANCE Transgender, non-binary, and/or gender expansive (TNG) experience disproportionately high rates of eating disorders and have unique barriers to accessing care. In individual interviews, TNG adults with eating disorders and mental health clinicians who provide psychotherapy for eating disorders voiced desire for greater availability of TNG-affirming, weight-inclusive eating disorder care, integrated with other gender-affirming care services. This informs future research developing eating disorder care for TNG individuals.
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Affiliation(s)
- Teddy G Goetz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Courtney Benjamin Wolk
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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36
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Smith AD, Sanchez N, Harrison K, Bourne C, Clark ELM, Miller RL, Melby CL, Johnson SA, Lucas-Thompson RG, Shomaker LB. Observations of parent-adolescent interactions relate to food parenting practices and adolescent disordered eating in adolescents at risk for adult obesity. Fam Process 2023; 62:1687-1708. [PMID: 36347267 PMCID: PMC11045300 DOI: 10.1111/famp.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 05/03/2023]
Abstract
Adolescent disordered eating and obesity are interrelated and adversely relate to mental and metabolic health. Parental feeding practices have been associated with adolescent disordered eating and obesity. Yet, observable interactions related to food parenting have not been well characterized. To address this gap, N = 30 adolescents (M ± SD 14 ± 2 year) at risk for adult obesity due to above-average body mass index (BMI ≥70th percentile) or parental obesity (BMI ≥30 kg/m2 ) participated in a video-recorded parent-adolescent task to discuss a food/eating-related disagreement. Interactions were coded for individual/dyadic affect/content using the Interactional Dimensions Coding System. We examined associations of interaction qualities with parent-reported food practices, adolescent disordered eating behaviors/attitudes, and insulin resistance. Reported parenting practices were correlated with multiple interaction qualities (p-values <0.05), with the most consistent correspondence between parent-reported pressure to eat (e.g., pressure to eat more healthy foods) and negative aspects of parent-adolescent interactions. Also, after accounting for adolescent age, sex, and BMI-standard score, parent-adolescent interaction qualities were associated with adolescents' disordered eating and insulin resistance. Specifically, greater adolescent problem-solving related to less adolescent global disordered eating, shape, and weight concern (p-values <0.05); adolescent autonomy related to less weight concern (p = 0.03). Better parent communication skills were associated with less adolescent eating concern (p = 0.04), and observed dyadic mutuality related to adolescents' lower insulin resistance (p = 0.03). Parent-adolescent interaction qualities during food/eating-related disagreements show associations with parent-reported food practices and adolescent disordered eating. This method may offer a tool for measuring the qualities of parent-adolescent food/eating-related interactions. A nuanced understanding of conversations about food/eating may inform family-based intervention in youth at-risk for adult obesity.
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Affiliation(s)
- Amy D. Smith
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Natalia Sanchez
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Kadyn Harrison
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Caitlin Bourne
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Emma L. M. Clark
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Reagan L. Miller
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Christopher L. Melby
- Colorado School of Public Health, Fort Collins, Colorado, USA
- Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado, USA
| | - Sarah A. Johnson
- Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado, USA
| | | | - Lauren B. Shomaker
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Colorado School of Public Health, Fort Collins, Colorado, USA
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37
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Leung CW, Parnarouskis L, Slotnick MJ, Gearhardt AN. Food Insecurity and Food Addiction in a Large, National Sample of Lower-Income Adults. Curr Dev Nutr 2023; 7:102036. [PMID: 38174213 PMCID: PMC10761353 DOI: 10.1016/j.cdnut.2023.102036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 01/05/2024] Open
Abstract
Background Growing research has highlighted associations between food insecurity and eating-related problems. Food addiction is one important, clinically significant pattern of problematic eating, which is related to, but distinct from, eating disorders. To date, there is only one study examining the association between food insecurity and food addiction, to our knowledge. Additional research is needed to understand the complexities of this association. Objective We examined the association between food insecurity and food addiction in a large, national convenience sample of lower-income adults and potential heterogeneity in this association by age, gender, race, and ethnicity. Design A cross-sectional, web-based study was conducted among 1780 US adults (≥18 y) with household incomes <250% of the federal poverty guideline. Household food security was assessed using the Household Food Security Survey Module. Food addiction was assessed using the modified Yale Food Addiction Scale (mYFAS), version 2.0. Multivariate logistic regression models examined the associations between food insecurity and food addiction, adjusting for sociodemographic covariates. Results The prevalence of food addiction was 7.3%, and the prevalence of food insecurity was 51%. Compared with adults with food security, adults with food insecurity endorsed each mYFAS symptom with significantly greater frequency, including failure to fulfill major role obligations (20%), continued use despite social or interpersonal problems (18%), and craving or strong desire to use (16%). After adjustment, food insecurity was associated with 3.82-fold higher odds of food addiction (95% CI 2.36, 6.19), with no significant heterogeneity by age, gender, or race and ethnicity. The most problematic foods reported by adults with food insecurity were chips, nondiet soda, chocolate, pizza, and ice cream. Conclusion These findings provide additional support for the association between food insecurity and food addiction. Mechanistic studies are needed to explore the role of psychosocial factors, eating behaviors, and the food environment in contributing to these associations.
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Affiliation(s)
- Cindy W. Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Melissa J. Slotnick
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ashley N. Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
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38
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St Clair L, Grady A, Mahmut MK. Investigating the Link between Eating Attitudes, Taste and Odour Preferences and the Chemical Senses. Biology (Basel) 2023; 12:1415. [PMID: 37998014 PMCID: PMC10669679 DOI: 10.3390/biology12111415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES To examine if higher degrees of pathological eating attitudes in a non-clinical sample are associated with odour and taste perception and preferences based on psychophysical ratings. PARTICIPANTS AND METHODS A total of 80 female university students completed the eating attitudes test (EAT-26), followed by four chemosensory measures including olfactory and gustatory perception plus perceptual ratings and preferences for food odours and tastes. RESULTS There were no significant correlations between EAT-26 scores and measures of olfactory and gustatory perception. However, a significant interaction effect indicated higher degrees of pathological eating attitudes may be associated with differential sensitivity to sweet and fatty food odours compared to those with lower levels of pathological eating attitudes. CONCLUSIONS This was the first study to examine pathological eating attitudes using food stimuli with a non-clinical sample. The results remain preliminary until replication. However, the findings highlight the need for development of measures of disordered eating attitudes and behaviours that go beyond caloric restriction.
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Affiliation(s)
| | | | - Mehmet K. Mahmut
- Food, Flavour and Fragrance Lab, School of Psychological Sciences, Macquarie University, Sydney, NSW 2109, Australia
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39
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Cosh SM, Olson J, Tully PJ. Exploration of orthorexia nervosa and diagnostic overlap with eating disorders, anorexia nervosa and obsessive-compulsive disorder. Int J Eat Disord 2023; 56:2155-2161. [PMID: 37615059 DOI: 10.1002/eat.24051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Orthorexia nervosa (ON) is characterized as obsessional healthy eating that results in malnutrition and/or psychosocial impairment. Yet, ON shares theoretical overlap with eating disorders (EDs), especially anorexia nervosa (AN), as well as obsessive-compulsive disorder (OCD). This study aimed to further understand ON and its overlap with related disorders by assessing the ability of ON for detecting the presence/absence of threshold ED, AN, and OCD symptoms. METHOD An observational survey was completed by 197 participants recruited through eating disorder, dieting, and mental health support groups. Receiver operating characteristic (ROC) curve analyses determined the predictive ability of ON symptoms (assessed by Eating Habits Questionnaire [EHQ] orthorexia nervosa [OrNe] and healthy orthorexia [HeOr] subscales, and the Orthorexia Nervosa Inventory [ONI]) for detecting disordered eating symptoms (determined by Eating Disorder Examination Questionnaire [EDE-Q] global cut-scores), probable AN (determined by EDE-Q cut-scores and body mass index [BMI] <18.5), and OCD symptoms and obsessional thinking (assessed by the Revised Obsessive-Compulsive Inventory [OCI-R]). RESULTS Results showed both the ONI and EHQ OrNe measures are able to adequately predict ED symptoms and AN; however, both were poor to moderate at detecting OCD symptoms and obsessional thinking. Healthy orthorexia was poor to moderate at detecting outcomes. DISCUSSION These results suggest that ON, as it is currently operationalized, may be more closely related to EDs than OCD, and that ON may represent a subtype of AN. Results also support healthy orthorexia as a distinct construct to ON. While results are limited by the lack of definitive ON diagnostic criteria, findings suggest that treatments developed for EDs might be most suited to ON. PUBLIC SIGNIFICANCE ON has been proposed as a psychiatric disorder, and it shares theoretical overlap with several existing disorders. This study adopts a novel approach to assessing and exploring the overlap of ON with EDs, AN and OCD. Results suggest that ON shares more overlap with EDs and might best be understood as a subtype of EDs or AN.
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Affiliation(s)
- Suzanne M Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Jemma Olson
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Phillip J Tully
- School of Psychology, University of New England, Armidale, New South Wales, Australia
- Freemasons Centre for Male Health and Wellbeing, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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40
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Bourke M, Pila E. Body-related self-conscious emotions, self-compassion, and dietary restraint in Canadian undergraduate university students: A multilevel mediation and moderation analysis. Int J Eat Disord 2023; 56:2131-2141. [PMID: 37610052 DOI: 10.1002/eat.24049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Self-compassion has an inverse association with dietary restraint however, the mechanisms linking self-compassion and dietary restraint are not clear. This study aimed to determine to what extent self-compassion was inversely concurrently related to dietary restraint, indirectly through body-related self-conscious emotions, and to what extent trait self-compassion moderated the concurrent within-person association between body-related self-conscious emotions and dietary restraint. METHOD Data was collected from 224 Canadian university students who reported on trait self-compassion at baseline and body-related shame, guilt, envy, and embarrassment, and dietary restraint biweekly between November 2020 and August 2021. RESULTS Results from a 2-1-1 multilevel mediation model showed that trait self-compassion was indirectly concurrently related to dietary restraint through body-related shame, guilt, envy, and embarrassment. Results from the moderation model showed that there was a significant positive concurrent within-person association between body-related shame, envy, and embarrassment, but not guilt, with dietary restraint. These relationships were not moderated by trait self-compassion. DISCUSSION This study adds to our understanding of the concurrent association between body-related self-conscious emotions and dietary restraint, and the mechanisms through which self-compassion is related to dietary restraint. Given body-related self-conscious emotions were related to dietary restraint at both the within-person and between-person level, both compassion-focused interventions that aim to improve general levels of body-related self-conscious emotions and interventions that aim to overcome spikes in these emotions compared with one's usual level are warranted. PUBLIC SIGNIFICANCE STATEMENT Negative body-related self-conscious emotions were related to higher levels of dietary restraint both across individuals and within individuals over time; and may play a mechanistic role in linking self-compassion with dietary restraint. Interventions aimed at reducing negative body-related self-conscious emotions are warranted in the prevention of eating disorder psychopathology.
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Affiliation(s)
- Matthew Bourke
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Eva Pila
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
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41
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Eisenstadt BE, Murchison GR, Soulliard ZA, Gordon AR. Body Image and High-Risk Weight and Shape Control Behaviors Among Transgender and Nonbinary Young Adults: The Role of Sexual Assault. LGBT Health 2023; 10:586-594. [PMID: 37410994 PMCID: PMC10712357 DOI: 10.1089/lgbt.2022.0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Purpose: Transgender and nonbinary (TNB) populations experience disproportionate rates of sexual assault. Despite evidence from cisgender samples linking sexual assault exposure to body image concerns and disordered eating behaviors, such as weight and shape control behaviors (WSCBs), little is known about these relationships in TNB people. The purpose of this study was to assess associations among past-year sexual assault exposure, body areas satisfaction, body weight esteem, and high-risk WSCBs in a sample of TNB young adults. Methods: A sample of 714 participants completed a cross-sectional online survey. Multivariable linear and logistic models were fit to determine associations between constructs of interest. Natural effects mediation analyses assessed for potential mediation of the relationship between sexual assault and WSCBs by body areas satisfaction and body weight esteem. Analyses were stratified by three gender identity categories. Results: Past-year sexual assault exposure was associated with significantly decreased body areas satisfaction, but only for nonbinary participants. No significant association was found between sexual assault and body weight esteem. Sexual assault was associated with significantly increased risk for WSCBs across gender identity categories. No mediation of these relationships by body areas satisfaction and body weight esteem was observed. Conclusion: Findings support clinical consideration of WSCBs in TNB survivors of sexual assault. Results suggest that multiple factors, including body image and sexual assault, may contribute separately to disordered eating behaviors in TNB young adults.
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Affiliation(s)
- Benjamin E. Eisenstadt
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Gabriel R. Murchison
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | | | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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42
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Ferrero EM, Yunker AG, Cuffe S, Gautam S, Mendoza K, Bhupathiraju SN, Mattei J. Nutrition and Health in the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning Community: A Narrative Review. Adv Nutr 2023; 14:1297-1306. [PMID: 37536566 PMCID: PMC10721458 DOI: 10.1016/j.advnut.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/16/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023] Open
Abstract
Sexual and gender minorities have a higher risk for health and nutrition-related disparities across the life course compared to the heterosexual or cisgender population. Experiences of stigmatization and discrimination are associated with diminished mental health quality and psychological distress, which are risk factors for developing various eating disorders. Other nutrition disparities include increased risk for food insecurity, body dissatisfaction, and weight complications, such as those experienced by the transgender population in association with gender-affirming hormone therapies. Despite the need for tailored nutrition recommendations that address the unique needs of the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) community, there are currently no such guidelines in North America. The purpose of this review is to summarize major LGBTQ+ nutrition disparities and highlight the need for tailored recommendations. We examine the evidence on mental health and social disparities in this group, including vulnerabilities to disordered eating, food insecurity, and healthcare provider discrimination. Importantly, we identify a scarcity of literature on dietary concerns and nutrition care guidelines for LGBTQ+ groups, including studies that address intersectionality and differences among specific gender and sexual orientations. These gaps underline the urgency of prioritizing nutrition for LGBTQ+ health needs and for developing tailored public health nutrition recommendations for this underserved population. Our review suggests that future LGBTQ+ health and nutrition research agendas should include personalized and precision nutrition, social determinants of health, diet quality, body image, and healthcare provider cultural competency and responsiveness. Moreover, the current evidence on LGBTQ+ nutrition and health will be strengthened when research studies (including clinical trials) with robust methodologies amplify inclusion and representation of this community to elucidate health and nutrition disparities in sexual and gender minorities.
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Affiliation(s)
- Elisabetta M Ferrero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Alexandra G Yunker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sherri Cuffe
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Saloni Gautam
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Kenny Mendoza
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
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Pacanowski CR, Dominick G, Crosby RD, Engel SG, Cao L, Linde JA. Daily self-weighing compared with an active control causes greater negative affective lability in emerging adult women: A randomized trial. Appl Psychol Health Well Being 2023; 15:1695-1713. [PMID: 37339756 DOI: 10.1111/aphw.12463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023]
Abstract
Age-related weight gain prevention may reduce population overweight/obesity. Emerging adulthood is a crucial time to act, as rate of gain accelerates and health habits develop. Evidence supports self-weighing (SW) for preventing weight gain; however, how SW impacts psychological states and behaviors in vulnerable groups is unclear. This study assessed daily SW effects on affective lability, stress, weight-related stress, body satisfaction, and weight-control behaviors. Sixty-nine university females (aged 18-22) were randomized to daily SW or temperature-taking (TT) control. Over 2 weeks, participants completed five daily ecological momentary assessments with their intervention behavior. A graph of their data with a trendline was emailed daily, with no other intervention components. Multilevel mixed models with random effect for day assessed variability in positive/negative affect. Generalized linear mixed models assessed outcomes pre- and post-SW or TT and generalized estimating equations assessed weight-control behaviors. Negative affective lability was significantly greater for SW versus TT. While general stress did not differ between groups, weight-related stress was significantly higher and body satisfaction was significantly lower post-behavior for SW but not TT. Groups did not significantly differ in the number or probability of weight-control behaviors. Caution is advised when recommending self-weighing to prevent weight gain for emerging adults.
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Affiliation(s)
- C R Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - G Dominick
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - R D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - S G Engel
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - L Cao
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - J A Linde
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
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Kaylor SK, Allen I, Crim AD, Callihan ML. Calories and control: Eating habits, behaviors, and motivations of Generation Z females. J Am Coll Health 2023; 71:2578-2586. [PMID: 35077340 DOI: 10.1080/07448481.2021.1978465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/02/2021] [Accepted: 09/03/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This qualitative phenomenological study explored eating habits, behaviors, and motivations of Gen Z females (born 1996-2002). PARTICIPANTS Ten participants met selection criteria: female aged 18-24 (thus, part of Gen Z), enrolled full-time at the University and able to share experiences. Maximum variation was sought for race/ethnicity, Greek life/sorority involvement and hometown regional area. METHODS Semi-structured interviews elicited detailed descriptions of lived experiences. Data consisted of five face-to-face interviews and five Internet-based teleconferenced interviews. Saldana's First Cycle/Second Cycle constant comparative method was used for data analysis. RESULTS Four themes and four subthemes were identified: Blurred Lines (healthy versus disordered behaviors), Rationalizing Behaviors (Denial), Technological Influences (Social Media; Self-Worth), and Pandemic Influence. CONCLUSION Gen Z represents a pivotal population with diverse characteristics. These findings are helpful to health professionals, faculty, academic administrators, and others with vested interests in promoting healthier living, learning and work environments for this population.
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Affiliation(s)
- Sara K Kaylor
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Isabel Allen
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Anna Dailey Crim
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Michael L Callihan
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
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Zelkowitz RL, Sienkiewicz ME, Vogt DS, Smith BN, Mitchell KS. Gender differences in direct and indirect associations of trauma types with disordered eating in a national U.S. veteran sample. Psychol Trauma 2023; 15:1280-1287. [PMID: 36074630 PMCID: PMC10283316 DOI: 10.1037/tra0001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Disordered eating (DE) in military veterans has been linked to trauma exposure, but the mechanisms underlying this association remain unclear. The current study documented the direct associations of DE with multiple trauma types in a gender-balanced sample of veterans and examined indirect associations of trauma and DE via self-reported PTSD symptoms and concerns about shape and weight. METHOD Participants included 1,187 veterans (50% women, 46% men, 4% another) from multiple service eras. Sampling weights were applied to enhance representativeness to the national veteran population. RESULTS Gender-stratified, weighted models revealed associations of premilitary, warfare, and postseparation trauma with DE in men and associations of premilitary, military sexual (MST), and postseparation trauma with DE in women. Monte Carlo estimation of indirect effects showed support for indirect associations of premilitary, warfare, and postseparation-related trauma/stressor exposure with DE via PTSD symptoms among men; postseparation stressors were also indirectly associated with DE via shape and weight concerns. Among women, each trauma type was indirectly associated with DE via shape and weight concerns but not PTSD symptoms. When trauma exposures were examined concurrently, MST and postseparation trauma exposure were uniquely associated with DE via shape and weight concerns among women. Only the indirect association of postseparation trauma/stressor exposure with DE via shape and weight concerns was significant among men. CONCLUSIONS Findings support the need for gender-specific interventions that target different mechanisms contributing to DE symptoms among veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Rachel L. Zelkowitz
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Massachusetts, USA
| | - Megan E. Sienkiewicz
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Massachusetts, USA
| | - Dawne S. Vogt
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Massachusetts, USA
| | - Brian N. Smith
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Massachusetts, USA
| | - Karen S. Mitchell
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Massachusetts, USA
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Martenstyn JA, Maguire S, Griffiths S. A descriptive analysis of scoring patterns on clinically relevant questionnaires in 26 adults with diagnosed muscle dysmorphia. Eur Eat Disord Rev 2023; 31:737-751. [PMID: 37337333 PMCID: PMC10947593 DOI: 10.1002/erv.3001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/17/2023] [Accepted: 06/04/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE Few studies have recruited adults with a formal diagnosis of muscle dysmorphia (MD), a psychological illness defined by preoccupation that one lacks muscularity and/or leanness, combined with significant functional impairment. This study presented descriptive statistics for a range of clinically relevant questionnaires in one of the largest samples of adults with confirmed diagnoses of MD. METHOD We recruited 29 adults who met diagnostic criteria for MD as determined by semi-structured diagnostic interviews and administered a battery of questionnaires assessing MD symptomology, compulsive exercise, and disordered eating. Descriptive statistics were calculated for both total and subscale scores for each questionnaire. Raincloud plots are included to show the distribution of total scores. RESULTS Of the 29 participants, 26 completed all questionnaires. Mean scores were high across all questionnaires and broadly consistent with results in past studies that also recruited a clinical MD sample. Most participants scored above proposed clinical cut-off scores for questionnaires assessing compulsive exercise and disordered eating. CONCLUSIONS This study adds to the small body of published questionnaire data in clinical MD samples. We stress that questionnaire scores should not be used alone to infer the presence of MD, but could be considered as a useful adjunct to a comprehensive clinical interview.
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Affiliation(s)
- Jordan A. Martenstyn
- Clinical Psychology UnitSchool of PsychologyThe University of SydneyCamperdownNSWAustralia
- InsideOut Institute for Eating DisordersCharles Perkins CentreThe University of SydneyCamperdownNSWAustralia
| | - Sarah Maguire
- InsideOut Institute for Eating DisordersCharles Perkins CentreThe University of SydneyCamperdownNSWAustralia
- Sydney Local Health DistrictNSW HealthSydneyNSWAustralia
| | - Scott Griffiths
- Melbourne School of Psychological SciencesFaculty of MedicineDentistry and Health SciencesThe University of MelbourneParkvilleAustralia
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Cosh SM, Eshkevari E, McNeil DG, Tully PJ. Classifying excessive exercise: Examining the relationship between compulsive exercise with obsessive-compulsive disorder symptoms and disordered eating symptoms. Eur Eat Disord Rev 2023; 31:769-780. [PMID: 37353901 DOI: 10.1002/erv.3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/11/2023] [Accepted: 06/10/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE There remains a lack of consensus around nosology for compulsive exercise (CE). Although widely observed in eating disorders (ED), CE shares theoretical overlap with obsessive-compulsive disorder (OCD), where exercise compulsions occur in response to obsessions. Yet, there is limited and mixed evidence of a relationship between CE with OCD. This study aims to explore the appropriate diagnostic classification of CE through examination of CE in relation to OCD, obsessional thinking, and ED symptoms. METHOD Two hundred and eighty one adults with mental health symptoms, dieting, and exercise behaviour completed measures of OCD, CE, and disordered eating symptoms. Regression and Receiver Operating Characteristic analyses examined relationships between dimensions of CE with OCD and ED symptoms, and the predictive ability of CE assessment for detecting threshold OCD and ED symptoms. RESULTS CE assessment was poor at predicting threshold OCD symptoms, probable Anorexia Nervosa, and Binge Eating Disorder and moderate at detecting probable disordered eating and Bulimia Nervosa. Associations between CE and OCD symptoms were not significant after adjustment for ED symptoms. Obsessional thinking was associated only with lack of exercise enjoyment. CONCLUSIONS Results indicate that excessive exercise might represent a distinct disorder, with some shared traits across CE, OCD and ED symptoms. Findings question the utility of adaptation of OCD diagnostic criteria for CE. Assessment and treatment implications are considered.
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Affiliation(s)
- Suzanne M Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Ertimiss Eshkevari
- Statewide Eating Disorder Service, South Australian Department of Health and Wellbeing, Government of South Australia, Adelaide, South Australia, Australia
| | - Dominic G McNeil
- Institute for Health and Wellbeing, Federation University, Ballarat, Victoria, Australia
| | - Phillip J Tully
- School of Psychology, University of New England, Armidale, New South Wales, Australia
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Liang G, Cheng Y, Barnhart WR, Song J, Lu T, He J. A network analysis of disordered eating symptoms, big-five personality traits, and psychological distress in Chinese adults. Int J Eat Disord 2023; 56:1842-1853. [PMID: 37337937 DOI: 10.1002/eat.24012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/07/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE Previous studies have revealed associations between disordered eating symptoms, big-five personality traits, and psychological distress. However, limited research has explored these relationships as a network, including their interconnections, and even less has done so in non-Western populations. We employed network analysis to investigate the co-occurrence of disordered eating symptoms, big-five personality traits, and psychological distress in Chinese adults. METHOD A sample of 500 Chinese adults (256 men) completed measures assessing big-five personality traits, psychological distress, and disordered eating symptoms. The network of personality traits, psychological distress, and disordered eating symptoms was estimated, including its central and bridge nodes. RESULTS The central nodes in the network were the facets of openness (like adventure), extraversion (like going to social and recreational parties), and disordered eating symptoms (dissatisfaction with body weight or shape). Moreover, certain facets of neuroticism (always worrying something bad will happen), psychological distress (feeling worthless), and an inverse facet of extraversion (bored by parties with lots of people) were identified as essential bridge nodes in maintaining the structure of the network. CONCLUSION Our findings suggest that personality traits (e.g., openness and extraversion) and body dissatisfaction are important in maintaining the network in a community sample of Chinese adults. While future replication is needed, findings from this study suggest that individuals with negative self-thinking, predisposed neuroticism, and extraversion may be at risk of developing disordered eating symptoms. PUBLIC SIGNIFICANCE The present study contributes to existing knowledge by employing a network perspective to examine the associations between disordered eating symptoms, big-five personality traits, and psychological distress in a Chinese adult community sample. The identified facets of neuroticism and extraversion and symptoms of psychological distress may be worthy of targeting in the prevention and treatment of disordered eating in the Chinese context.
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Affiliation(s)
- Guangsheng Liang
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Yawei Cheng
- Department of Mathematics and Statistics, Texas Tech University, Lubbock, Texas, USA
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Jianwen Song
- Department of Educational Psychology, Baylor University, Waco, Texas, USA
| | - Tom Lu
- Department of Mathematics and Statistics, Texas Tech University, Lubbock, Texas, USA
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, People's Republic of China
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49
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Law R, Jevons EFP. Exploring the perceived influence of social media use on disordered eating in nutrition and dietetics students. J Hum Nutr Diet 2023; 36:2050-2059. [PMID: 37475206 DOI: 10.1111/jhn.13212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Social media use (SMU) is increasingly widespread. More recently, SMU has been associated with increases in disordered eating; however, few qualitative studies have explored this issue in nutrition and dietetics students specifically, where susceptibility to disordered eating may be particularly high. The present study therefore aimed to investigate the perceived impact of SMU on disordered eating in nutrition and dietetics students. METHODS One-to-one, in-depth, semi-structured interviews were conducted with nutrition and dietetics students from universities across the UK. Interviews explored students' views on the potential influence of SMU on their eating-related thoughts, feelings and behaviours. Data were thematically analysed to identify key themes. RESULTS The findings suggested that SMU may provide students with a useful tool for the exploration of new recipes, ingredients and health-related information, thus enabling them to improve their eating behaviour and diet quality. However, students also showed high levels of objective awareness regarding the problems associated with SMU, including the presence of misinformation, body image dissatisfaction, social pressures and disordered eating. Interestingly, despite enabling them to detect sources of misinformation, students also discussed the negative impact that their course had on their eating habits, suggesting course content may be an additional risk factor for the development of disordered eating for this particular group. CONCLUSIONS Future research should investigate ways to mitigate the negative impact of SMU and course content on disordered eating in nutrition and dietetics students.
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Affiliation(s)
- Rebecca Law
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK
| | - Emily F P Jevons
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK
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50
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Torres-McGehee TM, Uriegas NA, Hauge M, Monsma EV, Emerson DM, Smith AB. Eating Disorder Risk and Pathogenic Behaviors Among Collegiate Student-Athletes. J Athl Train 2023; 58:803-812. [PMID: 37459386 DOI: 10.4085/1062-6050-0539.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
CONTEXT Eating disorders (EDs) are a cluster of behavioral conditions characterized by uneasy thoughts and behaviors that grow into severe or persistent eating disturbances. The demands on student-athletes may create mental and physical stressors that increase the likelihood of EDs and disordered eating. OBJECTIVE To examine the ED risk through eating attitudes and behaviors in male and female student-athletes and across various sport types (endurance, aesthetic, power, ball or team, or technical sports). DESIGN Cross-sectional study. SETTING Collegiate athletics. PATIENTS OR OTHER PARTICIPANTS National Collegiate Athletic Association Division I and II student-athletes (n = 2054; males = 631; females = 1423) from 40 institutions. MAIN OUTCOME MEASURE(S) Participants completed a web-based demographic survey and the Eating Attitudes Test-26 (EAT-26). Multiple χ2 analyses examined participants classified as at risk for EDs. Independent-samples t tests and a 1-way analyses of variance compared sex and sport type across EAT-26 totals and subscale (Dieting, Bulimia, and Oral Control) scores. RESULTS Overall, 25.3% (n = 520/2054) of student-athletes were classified as at risk for EDs. Differences were found between sex and ED risk (χ21,2054 = 32.9, P ≤ .01; 17.3% [n = 109/631] males, 28.9% [n = 411/1423] females) and across ED risk and sport type (χ24,2054 = 13.4, P = .01). When examining females only, we observed differences across ED risk and sport type (χ24,1423 = 13.4, P ≤ .01). No differences were evident across ED risk and sport type for males. Differences were seen between sex and binge eating (χ21,2054 = 6.8, P = .009), sex and diet pill use (χ21,2054 = 19.6, P ≤ .01), and sport type and diet pill use (χ24,2054= 12.2, P = .016), excessive exercise (χ24,2054 = 32.1, P ≤ .01), and losing more than 20 lb (9 kg) in the last 6 months (χ24,2054 = 10.2, P ≤ .037). CONCLUSIONS Student-athletes in the collegiate setting are at risk for EDs. Medical professionals, such as athletic trainers, need to be educated on the potential risk factors that may lead to EDs. Protocols for prevention, screening and recognition, and referral should be developed for student-athletes at risk for EDs.
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