Psychometric Evaluation of the Food Life Questionnaire-Short Form among Brazilian Adult Women

Measures of beliefs and attitudes toward food have generally been limited to the measurement of more pathological eating attitudes (e.g., disordered eating). The Food Life Questionnaire (FLQ) and its short form (FLQ-SF) were developed to examine attitudes toward a broader range of foods; however, the factor structure of the FLQ-SF was not confirmed in any study with young women. In the present study, we performed a psychometric evaluation of the Brazilian Portuguese translation of the FLQ-SF in a sample of 604 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach. Results supported a four-factor structure (i.e., weight concern, diet-health orientation, belief in a diet-health linkage, and food and pleasure) with 18 items (χ2/df = 2.09; CFI = 0.95; TLI = 0.94; RMSEA = 0.05 (90% CI = 0.04; 0.06; p > 0.05); and SRMR = 0.08). Additionally, we found good internal consistency for all FLQ-SF subscales (McDonald's ω = 0.79-0.89) and convergent validity with measures of feelings, beliefs, and behaviors involved in food attitudes. Collectively, these results support the use of the FLQ-SF in Brazilian women and provide a foundation to expand the literature on beliefs and attitudes toward food in this population.

Predictors of body image dissatisfaction in kinesiology students

Introduction

This research aimed to examine predictors of discrepancies between actual and ideal body images, specifically body fat and muscularity discrepancies, in kinesiology students.

Methods

Volunteer participants (N = 174, men = 112, women = 62) filled out the sex-specific Somatomorphic Matrices (NSM-M and SM-F) as well as The Positive and Negative Perfectionism Scale (PNPS), Rosenberg Self-esteem Scale (RSE), and the Eating Attitudes Test (EAT-26) using paper and pencil tools.

Results

The median and Mann-Whitney U tests were used to determine sex differences, and regression analyses were used to determine the contribution of sex, perfectionism, self-esteem, and eating attitudes in explaining the variances in body fat and muscularity dissatisfaction. The results showed no sex differences in body fat discrepancy, while men showed more discrepancy between actual and ideal muscularity than women. In regression analyses, sex was the only significant predictor of muscularity discrepancy, while disordered eating attitudes were a positive, and positive perfectionism was a negative predictor of body fat discrepancy.

Discussion

This study showed that while muscularity dissatisfaction is linked to the male sex, body fat dissatisfaction is not related to sex but to psychological variables of disordered eating attitudes and positive perfectionism in a population of youths that may be above average when it comes to physical activity.

The impact of generalized joint hypermobility on eating behavior of students: A case-control study

OBJECTIVE

To investigate the impact of generalized joint hypermobility (GJH) on eating behavior.

PARTICIPANTS

Physical therapy and rehabilitation students.

METHODS

The Beighton evaluation (a cutoff of 5/9) for defining GJH. The Eating Attitudes Test (EAT-40) was used for eating disorders. Smoking habits and alcohol use were also questioned.

RESULTS

Compared with 51 non-GJH students (mean age 20.5 years, 73% female), 46 students with asymptomatic GJH (20.6 years, 89% female) were more likely to have greater median EAT-40 scores (9 vs. 6, p = .002). There was no statistically significant difference between the groups in terms of the susceptibility to eating behavior disorders (6.5% vs. 2.0%), smoking habits (6.5% vs. 9.8%), and alcohol use (15.2% vs. 11.8%) (p > .05). Positive correlation (r = .221, p = .029) and positive effect (R = 0.221, R2 = 0.049; p < .05) between Beighton scores and EAT-40 scores were found.

CONCLUSION

The more joint hypermobility the greater the risk for eating disorders.

The Demographic Variation in Nutrition Knowledge and Relationship with Eating Attitudes among Chinese University Students

There is a noticeable absence of health education among college students. This study aimed to evaluate the extent of general nutrition knowledge among Chinese university students and explore its association with eating attitudes. Data were collected from a group of 273 students in Spring of 2023, using a valid and reliable research instrument consisting of three sections: demographic variables, the General Nutrition Knowledge Questionnaire (GNKQ), and the Eating Attitudes Test (EAT-26). The results were analyzed using SPSS, with correlations and t-tests to examine the relationships between nutritional knowledge and dietary attitudes. Furthermore, the present study employed the random forest (RF) algorithm, a machine learning technique, utilizing the Mean Decrease Impurity (MDI) method to investigate the influence of various features on participants' eating attitudes. The findings revealed that Chinese university students had an average accuracy of over 60% in their nutritional knowledge, but their understanding of the relationship between diet and disease still needs improvement. Moreover, male students had significantly lower nutritional knowledge than female students, and there was a positive correlation between nutritional knowledge and parents' income. The study also found a significant correlation between the level of nutritional knowledge and eating attitudes. RF results indicated that the family income level exhibited the most substantial impact on the eating attitudes of the participants. The study highlights the need for nutrition education curriculum developers to focus more on improving students' nutritional knowledge, with particular attention given to male students, low-income individuals, and those with an abnormal BMI.

The Effect of Sociocultural Attitudes on Developing Eating Disorders Among Young Females in Almadinah Almunawarah, Saudi Arabia

BACKGROUND

Eating disorders (ED) are believed to be more susceptible in women due to varied factors involving dissatisfaction with their body and appearance. The exact cause of ED isn't known. But it may be triggered by biological, psychological, environmental, and social factors.

OBJECTIVES

The current literature aims to explore the body dissatisfaction of women from Almadinah Almunawarah and factors that may contribute to developing risk of ED and assess the discrepancies between desired and healthy BMI.

METHODS

The Sociocultural Attitudes Toward Appearance Questionnaire-4 (SATAQ-4) questionnaire surveyed 384 females to explore family, peer, and media pressure, followed by the Eating Attitudes Test-26 (EAT-26) questionnaire to recognize those at risk of developing ED. The body dissatisfaction of the sample was measured by the difference between the healthy BMI and the desired BMI.

RESULTS

A total of 127 of the participants, who were reported to have a high probability of developing an ED, had the highest factor scored in the SATAQ-4 questionnaire being media exposure with a p-value less than 0.001. The study showed a difference in the ideal body and what is considered a healthy BMI. Results showed no correlation between BMI and developing ED.

DISCUSSION

Women of younger age groups are more vulnerable to being under the influence of sociocultural attitudes, thus they are more susceptible to developing risky eating behaviors. This can be affected by family, peers, and media factors.

CONCLUSION

The findings of this study show a high prevalence of risky eating behaviors, particularly among those who experience family and media pressure toward body shape and weight. Peer pressure was also identified as a significant risk factor. These findings emphasize the need for interventions that target sociocultural attitudes and provide support for vulnerable individuals.

Eating Attitudes of Patients with Celiac Disease in Brazil: A Nationwide Assessment with the EAT-26 Instrument

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. In this sense, a gluten-free diet is the only safe treatment available. Due to the restrictions resulting from this eating pattern, this treatment may impair the relationship of the people with CD with food, increasing the risk of a disordered eating attitude, which is associated with eating disorders. The EAT-26 is a validated instrument already applied worldwide in different populations, and higher scores are suggestive of eating attitudes prone to evolve into eating disorders. Studies carried out in other countries have already shown that people with CD are prone to developing eating disorders; however, no study has been carried out with this theme in the population with CD in Brazil. We carried out a nationwide cross-sectional study in three steps: (i) study design and instrument; (ii) recruitment of participants and ethics; (iii) statistical analysis. A total of 385 participants were included in our sample, 96.36% of them being women. The internal consistency of the applied self-administered Brazilian version of the EAT-26 online questionnaire presented a satisfactory Cronbach's alpha of 0.812, and in total, 36.1% of the respondents were classified with a disordered eating attitude. No differences were found among the scores of participants when divided by categories regarding gender, average monthly income, age, and educational level. However, scores classified as a disordered eating attitude were found in respondents with a body mass index classified as overweight and obese. Our study highlights that disordered eating attitudes are present in overweight and obese women with celiac disease; thus, public health politics are needed to prevent and treat these attitudes.

Gender and Work Experience as Moderators of Relations between Management Level, Physical Activity, Eating Attitudes, and Social Skills of Managers during the COVID-19 Pandemic

Being employed in a managerial position is often associated with maintaining high standards in many aspects of life. Many leaders pay attention to their physical activity, eating habits, and social skills. The onset of the COVID-19 pandemic brought additional difficulties to the already-demanding job of managing people and forced managers to make many changes to their daily functioning at work. The main goal of this study was to establish whether Gender, Experience, and Management Level influenced respondents' healthy behaviors (eating attitudes and physical activity) or soft skills during the COVID-19 pandemic. This study was carried out during the COVID-19 pandemic with a sample of 348 managers from a variety of companies (n = 222 women, n = 126 men) with different levels of experience and responsibility. The authors used the 26-item Eating Attitudes Test (EAT-26), four questions from the Physical Activity Objectives Questionnaire, and a self-authored soft skills questionnaire. The results showed that, compared to females, males were characterized by lower levels on all three EAT-26 scales: Bulimia and Food Preoccupation, Oral Control, and Dieting. On the other hand, male respondents who held high managerial positions were characterized by high levels of Dieting, Oral Control, Bulimia, and Food Preoccupation. This analysis provides insights that may help improve the quality of life of employees; however, further research is needed to investigate the direct influence of managers on employees in different industries.

Disordered eating and eating competence in members of online irritable bowel syndrome support groups

BACKGROUND

This study seeks to evaluate eating competence and disordered eating likelihood among members of online support groups for irritable bowel syndrome (IBS) and determine whether eating competence and disordered eating likelihood varies according to IBS symptom severity and subtype.

METHODS

This cross-sectional study is based on an anonymous survey conducted from August to September 2021. Adults with IBS (N = 225) were recruited from online and social media IBS support forums. IBS symptom severity was assessed using the validated IBS Severity Scoring System (IBS-SSS), likelihood of disordered eating was assessed using the validated Eating Attitudes Test (EAT-26), and eating competence was assessed using the validated Satter Eating Competence Inventory (ecSI 2.0™). Multiple linear regression was used to predict EAT-26 total score from IBS-SSS score, age, and IBS subtype. ANOVAs were used to examine the relationships between IBS severity level, IBS subtype, and ecSI 2.0™ total score.

KEY RESULTS

Eating competence among the sample was low at 17% while 27% was classified as likely or very likely disordered eating. IBS severity was positively associated with EAT-26 score (p = 0.011) and ecSI 2.0™ score was significantly lower in the severe IBS group compared to the moderate IBS group (p = 0.016). No relationship was detected between IBS subtype and EAT-26 or ecSI 2.0™ scores.

CONCLUSIONS & INFERENCES

IBS severity was positively associated with disordered eating likelihood and negatively associated with eating competence. This sheds light on the importance of assessing eating competence and screening for disordered eating prior to selecting therapies for patients with IBS, particularly in females with severe symptoms.

Turkish Version of the New Instrument for Orthorexia Nervosa-Test of Orthorexia Nervosa (TON-17): A Validity and Reliability Study

This study aimed to adapt the Test of Orthorexia Nervosa- (TON-17) into Turkish and verify its validity and reliability. The study included 539 adults with a mean age of 30.2 ± 12.26 years. A reliability analysis was performed, along with a confirmatory factor analysis to test its construct validity. The time-invariance of the scale was examined by test-retest analysis, and its convergent validity was evaluated by a correlation analysis conducted to test the relationships between the scale and Eating Attitudes Test-26 and Obsessive Beliefs Questionnaire-9. Analyses were conducted using SPSS Version 28 and the AMOS-24 software. The Cronbach's α internal consistency coefficient of the total scale was found to be 0.82, suggesting a strong internal consistency. The Cronbach's α values of its factors were 0.68 for the "control of food quality", 0.64 for the "fixation on health and a healthy diet", and 0.73 for the "disorder symptoms". In addition, the test-retest reliability was found to be 0.87 for the total scale, suggesting excellent reliability. Most of the fit indices (CMIN/df, RMSEA, AGFI, NFI, and TLI) of the scale were acceptable, and the GFI indicated a good model fit. This study shows that the Turkish version of TON-17, which is a new tool with a three-factor structure to evaluate orthorexia, is a valid and reliable scale.

The Mediating Role of Eating Attitudes in Sociocultural Attitudes toward the Body in Predicting Obligatory Exercise among Young People: A Polish and Chinese Comparison

The main aims of this study were to determine which sociocultural predictors of obligatory exercise are universal for young men or women and which are specific to particular cultural conditions (Polish or Chinese culture) and to examine the mediating role of eating attitudes. A cross-sectional study was conducted among Poles (n = 259) and Chinese (n = 208) aged 18 to 30. Descriptive and comparative statistics, Spearman's rho, and multiple regression analysis were used. The main analyses showed that Internalization-Athlete was a common positive direct predictor of obligatory exercise among young Polish and Chinese women; Information and Internalization-Athlete were only specific direct positive predictors of obligatory exercise in young Chinese men; some variables in eating attitudes mediated the development of obligatory exercise in young Polish and Chinese men and women and indicated that there were cross-cultural differences. In understanding obligatory exercise among young people, attention should be paid to their sociocultural attitudes toward the body and eating, and cultural and gender differences need to be considered.

The Relationship Between Eating-Attitudes and Clinical Characteristics, Agouti-Related Peptide, and Other Biochemical Markers in Adult-Attention Deficit Hyperactivity Disorder

OBJECTIVE

In our study, we aimed to evaluate eating-attitudes in adult-ADHD, and to examine its relationship with sociodemographic, clinical, AgRP, and biochemical parameters.

METHOD

The study included 70 adult-patients and 47 healthy-controls. The DIVA2.0, SCID-1 was administered to the participants. Eating-Attitudes Test (EAT), Night-Eating Questionnaire (NEQ), Barratt Impulsivity Scale (BIS-11) were filled by the participants.

RESULTS

We found that psychological state affect eating-attitudes in adult-ADHD (p = .013), emotional eating is more common, nocturnal chronotype is dominant (p < .001), NES is more frequent (p < .001), waist circumference measurement is higher (p = .030), and lipid profile is deteriorated (p < .001). AgRP levels were significantly lower in patients treated with methylphenidate (p = .021). Those who received methylphenidate treatment had less NES than those who did not. Deterioration in eating-attitudes and symptom severity of night eating in ADHD, it was positively correlated with clinical severity of ADHD and impulsivity. In addition, age and increase in night eating symptoms were predictors of deterioration in eating attitudes in adult-ADHD. We found that impaired eating-attitudes and impulsivity severity were also predictors of NES (p = .006, p = .034).

CONCLUSION

The necessity of adult-ADHD treatment has been demonstrated by the deterioration in eating-attitudes and cardiometabolic risk dimensions and the underlying mechanisms.

[Eating attitudes among Hungarian adolescents]

INTRODUCTION

According to the literature, mentalizing difficulties and insecure emotional attachment styles occur more frequently among adolescents with eating disorders. The role of mentalization in the relationship between emotional attachment styles and eating attitudes has not been investigated among Hungarian adolescents.

OBJECTIVE

We investigated the relationship between mentalization, emotional attachment and eating attitudes among adolescents between 14 and 18 years of age.

METHOD

After informed consent, 143 adolescents filled out the Reflective Functioning Questionnaire, the Experience in Close Relationship Scale, and the Eating Attitudes Test in our study.

RESULTS

The direct path between the emotional attachment total score and dieting was not significant (c' = 0.01, p = 0.31, β = 0.09), while the indirect path between emotional attachment and eating attitudes through mentalization uncertainty proved to be significant (∑ab = 0.01 [0.01-0.02], β = 0.07).

DISCUSSION

Our results suggest that the attachment style plays a role in dieting through mentalizing among adolescents.

CONCLUSION

We recommend mentalization-based methods to change attitudes about dieting among adolescents. Orv Hetil. 2023; 164(2): 64-69.

Effect of Mid-Adolescent Dietary Practices on Eating Behaviors and Attitudes in Adulthood

This paper aimed to clarify the association of mid-adolescent dietary practices and experiences with adult eating behavior and attitudes using individual data from the "Survey of Attitudes toward Shokuiku (food and nutrition education), 2019" put forth by the Ministry of Agriculture, Forestry and Fisheries of Japan. We applied conditional mixed-process models to estimate the parameters simultaneously, and used them to predict current eating consciousness, current eating behaviors in a balanced diet, dietary behavior, and attitudes toward preventing or improving lifestyle-related diseases as dependent variables. As a result, compared to those who did not have good dietary practices and experiences in mid-adolescence, participants who had good dietary practices and experiences in the same period displayed greater interest in practicing a healthier diet. These participants frequently consumed a combination of staple foods, main dishes, and side dishes, and were more concerned about preventing or improving lifestyle-related diseases. In conclusion, mid-adolescent dietary practices and experiences had a lasting influence on adult eating behaviors and attitudes in Japanese participants.

Psychological factors in functional hypothalamic amenorrhea: A systematic review and meta-analysis

BACKGROUND

Psychological factors have been found to be associated with functional hypothalamic amenorrhea (FHA); however, their role in the onset or persistence of FHA is still understudied. The study aims to assess the associations of psychological factors with the presence vs the absence of FHA.

METHODS

A systematic literature search has been conducted across the major databases (PubMed, PsycINFO, Scopus, and Embase) to explore the psychological factors associated with FHA. The search was limited to English-written articles published from 2000 onwards. Articles were selected based on stringent inclusion/exclusion criteria. After data extraction, meta-analysis and meta-synthesis were conducted.

RESULTS

Of 349 retrieved articles, eight studies were included. Findings indicate that the main psychological factors associated to FHA seem to be depression and eating attitudes, especially drive for thinness. FHA women present higher levels of anxiety, sleep disorders, dysfunctional attitudes, and alexithymia. The meta-analysis on drive for thinness revealed that the pooled MD across the studies was statistically significant both in the fixed 0.63 (95% CI: 0.31-0.95) and random model 0.70 (95% CI: 0.13-1.26). Likewise, as for depression, the pooled MD across the studies was statistically significant both in the fixed 0.60 (95% CI: 0.36-0.84) and random model 0.61 (95% CI: 0.20-1.01).

DISCUSSION

Findings showed the association of psychological factors and FHA and recognized their involvement in the persistence of the disorder. A multidisciplinary approach should involve a collaborative process between gynecologists, clinical psychologists, and psychiatrists, from diagnosis to treatment. Longitudinal studies should be implemented with a comparison/control group or by including clinical psychologists in the psychological assessment and study design.

Well-Being of High-Level Managers during the Pandemic: The Role of Fear of Negative Appearance, Anxiety, and Eating Behaviors

(1) Background: The COVID-19 pandemic has caused unprecedented changes in the contemporary world, significantly affecting the work of companies, especially management staff. This study investigated whether fear about one's health (caused by the pandemic, disordered eating attitudes, or concerns about one's body image) has a negative relationship with the well-being of managers. (2) Methods: N = 354 managers (222 women, 126 men, and 6 people with no gender identity) participated in the study. The following psychometric instruments were used: the psychological well-being scale, the coronavirus anxiety scale, the fear of negative appearance evaluation scale, and the eating attitude test-26. Results: the fear of negative appearance influenced the well-being of the studied managers. However, this relation was mediated by dieting as well as bulimia and food preoccupation. (4) Conclusions: the well-being level depended on the managers' positive body images, but only when mediated by healthy dieting and eating attitudes. While the well-being level of managers was high, it is worth further exploring how they can flourish and develop in life and work, which can also transfer to the quality of life of their co-workers and companies. However, the subject of the well-being of managers warrants more research; for example, by considering different moderators, such as job experience, gender, and age. Moreover, experimental studies examining the effectiveness of different interventions for the physical and mental health of managers could be worth investigating.

Mediators of weight change in underserved patients with obesity: exploratory analyses from the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) cluster-randomized trial

BACKGROUND

Intensive lifestyle interventions (ILIs) stimulate weight loss in underserved patients with obesity, but the mediators of weight change are unknown.

OBJECTIVES

We aimed to identify the mediators of weight change during an ILI compared with usual care (UC) in underserved patients with obesity.

METHODS

The PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) trial randomly assigned 18 clinics (n = 803) to either an ILI or UC for 24 mo. The ILI group received an intensive lifestyle program; the UC group had routine care. Body weight was measured; further, eating behaviors (restraint, disinhibition), dietary intake (percentage fat intake, fruit and vegetable intake), physical activity, and weight- and health-related quality of life constructs were measured through questionnaires. Mediation analyses assessed whether questionnaire variables explained between-group variations in weight change during 2 periods: baseline to month 12 (n = 779) and month 12 to month 24 (n = 767).

RESULTS

The ILI induced greater weight loss at month 12 compared with UC (between-group difference: -7.19 kg; 95% CI: -8.43, -6.07 kg). Improvements in disinhibition (-0.33 kg; 95% CI: -0.55, -0.10 kg), percentage fat intake (-0.25 kg; 95% CI: -0.50, -0.01 kg), physical activity (-0.26 kg; 95% CI: -0.41, -0.09 kg), and subjective fatigue (-0.28 kg; 95% CI: -0.46, -0.10 kg) at month 6 during the ILI partially explained this between-group difference. Greater weight loss occurred in the ILI at month 24, yet the ILI group gained 2.24 kg (95% CI: 1.32, 3.26 kg) compared with UC from month 12 to month 24. Change in fruit and vegetable intake (0.13 kg; 95% CI: 0.05, 0.21 kg) partially explained this response, and no variables attenuated the weight regain of the ILI group.

CONCLUSIONS

In an underserved sample, weight change induced by an ILI compared with UC was mediated by several psychological and behavioral variables. These findings could help refine weight management regimens in underserved patients with obesity.This trial was registered at clinicaltrials.gov as NCT02561221.

The relationship between self-esteem, body dissatisfaction, and eating attitudes in bariatric surgery candidates

Objectives

Considering the effects of self-esteem, eating attitudes and body satisfaction on obesity and bariatric surgery outcomes, psychiatric evaluation is important for the identification and treatment of psychopathology, improvement of self-esteem, eating attitudes and body satisfaction. In this study, it was aimed to determine the relation between eating behaviors, body dissatisfaction, self-esteem and psychological symptoms in patients seeking bariatric surgery. Our second aim was to determine whether depressive symptoms and anxiety had a mediating role in the relationship between body satisfaction and self-esteem and eating attitudes.

Material and Methods

The study included 200 patients. Patients' data were retrospectively evaluated. Psychometric evaluation performed during the preoperative period included psychiatric examination and administration of the Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg SelfEsteem Scale, Body-Cathexis Scale, and Dutch Eating Behaviors Questionnaire.

Results

There was a positive correlation between self-esteem and body satisfaction and a negative correlation between self-esteem and emotional eating (r= 0.160, p= 0.024; r= -0.261, p <0.001 respectively). Body satisfaction had an effect on emotional eating mediated by depression and an effect on external and restrictive eating mediated by anxiety. Furthermore, anxiety mediated the relations between self-esteem and external and restrictive eating behaviors.

Conclusion

Our finding indicating that depression and anxiety have mediator effects on the relation between self-esteem, body dissatisfaction, and eating attitudes is significant since screening for these entities and their treatment is relatively more practical in clinical settings.

Maladaptive Cognitive Schemas as Predictors of Disordered Eating: Examining the Indirect Pathway through Emotion Regulation Difficulties

A scarcity of research has looked into the association of maladaptive core beliefs with dysfunctional eating patterns. Moreover, no prior study has considered the potential role of difficulties in negative emotion regulation when disentangling the complex correlations between early maladaptive schemas and disturbed eating habits. Our study aimed at exploring the distinct relationships between early maladaptive schemas and disordered eating, while investigating the indirect role of emotion regulation difficulties within these associations. We collected data from 982 Lebanese young adults (18-30 years old), distributed across the five Lebanese governorates, who completed the Eating Attitudes Test (EAT-26), the Young Schema Questionnaire-Short Form 3 (YSQ-SF3), and the Difficulties in Emotion Regulation Scale-16 Item Version (DERS-16). The results showed that the disconnection and rejection schema domain, under which the early maladaptive schema of mistrust was the most predictive of disordered/inappropriate eating attitudes. All the remaining maladaptive schema domains (i.e., the impaired autonomy/performance, impaired limits, other-directedness, and overvigilance/inhibition schema domains) exerted significant indirect effects on disordered eating attitudes through difficulties in emotion regulation. Our findings gave prominence to a potential intrinsic mechanism through which maladaptive cognitive schemas are linked to disordered eating behaviors, emphasizing the role of emotion dysregulation as a cardinal actor within this model. They sustain the surmise that cognitively and emotionally vulnerable individuals exhibit stronger propensities for inappropriate dietary patterns, as a means to offset their inner weakness. This study broadens the medical community's insights into the underpinning processes behind eating disorder psychopathology and could therefore make a step towards the adoption of innovative therapeutic approaches that promote emotion regulation skills in the context of schema therapy.

Psychosocial Factors in Adolescence and Risk of Development of Eating Disorders

Background: current findings in the etiopathogenesis of eating disorders (ED) do not allow the formulation of a unique causal model. Currently, the main hypotheses about the etiopathogenesis are based on a multifactorial approach, considering both genetic and environmental factors. The aim of this study is to analyze the relationship between sociodemographic and behavioral factors, as well as self-esteem, in students of the first cycle of middle school and the probability of belonging to the risk group of eating disorders (ED) measured through the EAT-26 scale. Methods: The study target population consists of students of the first cycle of middle school. The instruments applied to the population consisted in: (1) a survey of sociodemographic data and behavioral variables; (2) Rosenberg’s self-esteem test; and (3) EAT Test (Eating Attitudes Test 26). Results: Of a total of 656 students belonging to eight educational centers in Madrid who were offered to participate in the study, 88.6% (n = 579) answered the whole questionnaire. The mean age of the participants was 13.7 years old. Of the participating adolescents, 57.3% were male and the remaining 42.7% (n = 260) were female. A significant relationship was observed between self-esteem and belonging to an ED risk group, with an OR = 0.910 (CI 95% 0.878−0.943). Hence, each one-point increase on the self-esteem dimension decreased the risk of belonging to an ED risk group by 9.5%. In the variables considered in the area of dysfunctional feeding patterns, the variables ‘number of meals’ (p < 0.01), ‘dieting’ (p < 0.01), and ‘drug consumption to lose weight’ (p < 0.01) were found to be related to the risk of belonging to the ED group. Conclusions: The results obtained in our research can help to establish explanatory models that include the understanding of the interaction of the different factors that influence the appearance and development of EDs. Therefore, these should be taken into consideration when developing ED preventive programs.

Eating attitudes and depressive symptoms in a LGBTIQ sample in Turkey

BACKGROUND

Lesbian, gay, bisexual, transgender, intersexual and queer (LGBTIQ) individuals are often stigmatized due to their minority status. Sexual-minority stress is often discussed as a risk factor for the increased mental health problems reported in this population.

OBJECTIVE

The current study (1) investigated eating attitudes and depressive symptoms in a sexual minority sample from Turkey who identify themselves as LGBTIQ and (2) explored the role of sexual minority stressors beyond the potential predictors of eating attitudes and depressive symptoms in this population.

METHODS

Recruitment was supported and streamlined by several Turkish NGOs and LGBTIQ community networks. Sociodemographic measures, eating attitudes, depressive symptoms, sexual minority stressors (e.g., heterosexist experiences, internalized homophobia), and the potential predictors of eating attitudes and depressive symptoms were assessed with an anonymous online survey between February 2022 and June 2022. The sample consisted of 440 participants. The mean age was 31.92 (SD = 11.82). The majority of the participants reported their current gender identity as male (64.3%; n = 440) and their sexual orientation as attracted to men (62.8%; n = 439). For 79.7% of the participants, the assigned sex at birth was man (n = 439).

RESULTS

Two separate three-stage multiple hierarchical regression analyses were conducted, controlling for sociodemographic characteristics and the risk and protective factors of eating attitudes and depressive symptoms. Disturbed eating attitudes were predicted by assigned female sex at birth, higher scores for depression, social isolation, and the total number of heterosexist experiences, and lower distress related to heterosexist experiences. Depressive symptoms were predicted by assigned female sex at birth, lesbian sexual orientation, disturbance in eating attitudes, increases in generalized anxiety, and distress related to daily heterosexist experiences.

CONCLUSION

The current study demonstrated the significant role of sexual minority stressors in the prediction of disturbed eating attitudes and depressive symptomatology beyond the general psychosocial vulnerability factors. These findings emphasize the need for developing strategies to reduce prejudicial attitudes at the societal level and to enhance the skills of LGBTIQ individuals in coping with sexual minority stressors in Turkey.

Examination of Self-Esteem, Body Image, Eating Attitudes and Cardiorespiratory Performance in Adolescents

Self-esteem, body image and eating attitudes are important characteristics regarding adolescent mental health. In our present work, we aimed to investigate these psychological items in adolescent boys and girls examining gender differences and correlations with the BMI-for-age and cardiorespiratory performance. 374 students (209 girls with an average age of 16.4 ± 1.08 years, and 165 boys with an average age of 16.5 ± 1.03 years) underwent investigation using the Rosenberg self-esteem scale, EAT-26 and BAT questionnaires. The BMI-for-age was calculated with BMI growth charts and the cardiorespiratory performance was measured with the 20 m shuttle run test. Our results showed that adolescent girls scored lower self-esteem and higher values for BAT and each scale of eating behaviors, such as uncontrolled eating, cognitive restraints and emotional eating compared to boys despite the fact, that obesity and overweight were more common among boys. No significant correlation was found between BMI and psychological test results in either boys or girls, however, subjective body shape and gender predicted self-esteem and BAT scores and the cognitive restraints in the eating attitudes. Uncontrolled and emotional eating were primarily influenced by gender, in which BMI played only a weaker role. Cardiorespiratory performance was positively associated with self-esteem and body image among boys, and it had a negative correlation regarding BMI in both genders.

Examining Eating Attitudes and Behaviors in Collegiate Athletes, the Association Between Orthorexia Nervosa and Eating Disorders

Purpose: Orthorexia nervosa (Orthorexia) is an eating attitude and behavior associated with a fixation on healthy eating, while eating disorders (EDs) are clinically diagnosed psychiatric disorders associated with marked disturbances in eating that may cause impairment to psychosocial and physical health. The purpose of this study was to examine risk for Orthorexia and EDs in student-athletes across sex and sport type and determine the association between the two.

Methods: Student-athletes (n = 1,090; age: 19.6 ± 1.4 years; females = 756; males = 334) completed a survey including demographics, the ORTO-15 test (<40 and <35 threshold values), the Eating Attitudes Test-26 (EAT-26; >20 score), and additional questions about pathogenic behaviors to screen for EDs.

Results: Using a <40 threshold value for the ORTO-15, 67.9% were at risk for Orthorexia, a more restrictive threshold value of <35 determined 17.7% prevalence across student-athletes with significant differences across sex [ <40: χ(1,1,090)2 = 4.914, p = 0.027; <35: χ(1,1,090)2 = 5.923, p = 0.015). Overall, ED risk (EAT-26 and/or pathogenic behavior use) resulted in a 20.9% prevalence, with significant differences across sex (χ² = 11.360, p < 0.001) and sport-type category (χ² = 10.312, p = 0.035). Multiple logistic regressions indicated a significant association between EAT-26 subscales scores and Orthorexia, and between Orthorexia positivity, ORTO-15 scores, and risk for EDs.

Conclusions: Risk for Orthorexia and ED is present in collegiate student-athletes. While healthy and balanced eating is important, obsessive healthy eating fixations may increase the risk for EDs in athletes. More education and awareness are warranted to minimize the risk for Orthorexia and EDs in student-athletes.

A cross-sectional study on the correlates of food addiction symptoms in adolescents seeking treatment for obesity: eating attitudes and gender differences

BACKGROUND AND OBJECTIVES

Multidisciplinary approach including psychiatric support, have come to the fore in the treatment of obesity. Food addiction and disordered eating behaviors are among major psychiatric problems that have important effects on both clinical manifestation and response to treatment. This study aimed to investigate correlates of food addiction among adolescents who are seeking treatment for obesity.

METHOD

This study included 126 adolescents between 11 and 18 years of age, 48 patients in the "study group" who are seeking treatment for obesity (BMI for age greater than 95th percentile) and 78 adolescents (BMI for age under 85th percentile) in the "control group" who were reached via online survey. All participants were requested to complete self-report based measurement tools of Yale Food Addiction Scale (YFAS) and Eating Attitude Test-40 (EAT-40).

RESULTS

47.9% adolescents (n = 23) in the study group met food addiction diagnosis according to diagnostic evaluation of YFAS; which was significantly higher than 5.1% (n = 4) adolescents in the control group (p < 0.001). EAT-40 total scores and the scores in subscales of "anxiety of gaining weight," "dieting," and "thin body preoccupation" were significantly higher in the study group. Gender differences were observed when food addiction symptoms were correlated with eating attitudes among the study group.

CONCLUSIONS

Comparing to the controls, food addiction and disordered eating behaviors were more common in adolescents seeking treatment for obesity. Gender differences in the correlates of food addiction symptoms imply that different approaches might be needed for psychological interventions.

Self-Compassion, Mindful Eating, Eating Attitudes and Wellbeing Among Emerging Adults

Mindful eating behavior and self-compassion have been individually shown to contribute to healthy eating. Evidence suggests that they may interact and that interaction may increase our understanding of eating behavior. The aim of the current study was to explore the relationship between mindful eating behavior, self-compassion, healthy/unhealthy weight, eating disorder and wellbeing in a sample of university students. An online survey using questionnaire data collection in a sample of 349 students (105 males and 244 females). Variables measured included body mass index (BMI), mindful eating behavior, eating attitudes, self-compassion and mental wellbeing. Regression and path analysis show mindful eating behavior and self-compassion to individually and interaction predict eating attitudes and wellbeing. BMI was shown to have a curvilinear relationship with mindful eating behavior, self-compassion and wellbeing with both the underweight and obese reporting lower self-compassion, less Mindful eating behavior, lower wellbeing and more likely to exhibit disordered eating. These results indicate that self-compassion and mindful eating behavior might be usefully targeted in interventions to prevent both obesity and eating disorder.

The eating attitudes in patients with obstructive sleep apnea syndrome

AIM

Obstructive sleep apnea syndrome (OSAS) patients show multiple physiological deficits and several neuropsychological comorbidities. The aim of this study was to investigate the eating attitudes in OSAS patients.

MATERIAL AND METHODS

Polysomnography records of 157 were performed. Eating Attitudes Test (EAT), Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were applied to all participants.

RESULTS

The mean age of the 157 individuals included in the study was 47.2 ± 11.4 (18-76) years and 36% (n = 56) of the individuals were female and 64% (n = 101) were male. When the patients were ranked according to the severity of OSAS, 38.2% (n = 60) were severe, 20.4% (n = 32) were moderate, 24.2% (n = 38) were mild, and 17.2% (n = 27) were OSAS negative. There was a significant difference in terms of the age-and-BMI-adjusted EAT score according to OSAS severity (p = .042). There was a significant difference in the age-and-BMI-adjusted value of the EAT according to the presence of OSAS (p = .011). After controlling age and BMI, no significant correlation was found between the EAT and the BDI (r = 0.012, p = .890) in patients with OSAS while there was a significant positive correlation EAT and the BAI (r = 0.177, p = .046).

CONCLUSIONS

Considering the association of OSAS with psychiatric disorders, the presence of eating disorders (EDs) becomes an important and special topic. Treatment of patients with OSAS should not only aim to improve the patient's sleep apnea, but also to improve the patient's quality of life by evaluating the patient's psychological and physical functions.

Examination of the Eating Behavior of the Hungarian Population Based on the TFEQ-R21 Model

Several theories have emerged to study types of eating behavior leading to obesity, but most of the applied models are mainly related to food choice decisions and food consumer behavior. The purpose of this paper was to examine the eating attitudes of Hungarian consumers by applying the Three-Factor Eating Questionnaire (TFEQ-R21). The national representative questionnaire involved 1000 individuals in Hungary in 2019. Several multivariate statistical techniques were applied for the data analysis: exploratory and confirmatory factor analyses, multivariate data reduction techniques, and cluster analysis. This study successfully managed to distinguish the following factors: emotional eating, uncontrolled eating, and cognitive restraint. By using the factors, five clusters were identified: Uncontrolled Emotional Eaters; Overweight, Uncontrolled Eaters; Controlled, Conscious Eaters; the Uninterested; and the Rejecters; all of these could be addressed by public health policy with individually tailored messages. The empirical results led to rejection of the original Three-Factor Eating Questionnaire (TFEQ-R21), while the TFEQ-R16 model could be validated on a representative sample of adults, for the first time in Hungary.

Prevalence of Disordered Eating Among International Sport Lead Rock Climbers

Disordered eating (DE) is characterized as a range of irregular eating patterns or behaviors, which may lead to pathological eating or a clinical eating disorder diagnosis. DE patterns are associated with a variety of negative health outcomes. The prevalence of DE is highest in female athletes who participate in aesthetic or weight dependent sports. Elite rock climbers tend to be strong, small and lean, but the prevalence of DE in rock climbers is unknown. The purpose of the present study was to assess DE prevalence in a large group of international rock climbers and to explore the relationship between sport rock climbing ability and DE. A web-based survey assessed both DE (Eating Attitudes Test-26) and climbing ability based on the International Rock Climbing Research Association's position statement on comparative grading scales. The survey was distributed to international climbing communities; 810 individuals attempted the survey; 604 completed all questions; 498 identified as sport lead climbers. The majority of sport lead climbers were lower grade/intermediate (57.8%), compared to advanced (30.7%) and elite/higher elite (11.4%), and male (76.9%). Forty-three sport lead climbers reported a score of 20 or above on the EAT-26 indicating an 8.6% prevalence of DE in this sample. Male climbers had a DE prevalence of 6.3% (24 of 383) and female climbers more than doubled that with 16.5% (19 of 115). Chi-square analysis revealed that DE was associated with climbing ability level [χ2 (2, n = 498, 8.076, p = 0.02)], and when analyzed by sex, only the female climbers had a significant relationship of DE with climbing ability [χ2 (2, n = 115, 15.640, p = 0.00)]. These findings suggest sport lead rock climbers are not immune to DE and that the risk is elevated in female climbers, particularly at the elite/high elite climbing ability level. Our research indicates further investigations are warranted to determine if and how disordered eating behaviors affect health and performance of adult rock climbers.

Association of Orthorexic Tendencies with Obsessive-Compulsive Symptoms, Eating Attitudes and Exercise

PURPOSE

The term orthorexia nervosa is used to describe the pathological fixation associated with consuming healthy food. It is assumed that orthorexia nervosa shares some phenomenological features with anorexia nervosa, obsessive-compulsive disorder (OCD), and other mental disorders. Individuals with orthorexic tendencies may have high physical activity as well as a healthy diet. This study aimed to investigate the relationship of orthorexia nervosa with obsessive-compulsive symptoms, eating attitudes, and several sociodemographic features.

PATIENTS AND METHODS

We included 63 patients diagnosed with OCD, 63 healthy volunteers who perform physical exercises at least three days a week, at least 30 minutes a day, and 63 healthy volunteers who do not perform physical exercises regularly. Sociodemographic data form, Yale-Brown Obsessive Compulsive Scale, ORTO-11 Scale, Eating Attitude Test, Hamilton Anxiety Scale, and Structured Clinical Interview for DSM-5 Disorders (SCID-5 CV) were administered to all participants. OCD data form was also applied to patients with OCD diagnosis.

RESULTS

We found a statistically significant relationship between current order-symmetry obsessions and orthorexic tendencies in patients with OCD (p<0.05). There was no relationship between the severity of the disorder and orthorexia nervosa in patients with OCD (p>0.05). Orthorexic tendencies were found to increase as impaired eating attitudes increased in participants who regularly performed physical exercises and patients with OCD (p<0.05). The orthorexic tendencies of participants who regularly performed physical exercises were higher than those diagnosed with OCD and healthy individuals who did not perform physical exercises.

CONCLUSION

The absence of a significant relationship between disorder severity and orthorexia nervosa in patients diagnosed with OCD and the increase in orthorexic tendencies as the deterioration in eating attitudes increases in both patients with OCD and the participants who regularly perform physical exercises suggest that orthorexia nervosa may be closer to the eating disorders group than obsessive-compulsive spectrum. Studies with large samples and different diagnoses are needed to determine the place of orthorexia nervosa in diagnosis and classification systems.

Assessment of Dietary Intake and Eating Attitudes in Recreational and Competitive Adolescent Rock Climbers: A Pilot Study

The dietary intake and eating attitudes of adolescent climbers has not previously been studied. To fill this knowledge gap, we administered three surveys to 22 rock climbers (13 males, 9 females, age 14.2 ± 1.9 years): climbing ability, three-day dietary recall, and Eating Attitude Test-26 (EAT-26). The majority (82%) of climbers did not meet their target energy intake (target = 2,471 ± 493 kcal·day⁻¹; actual = 1,963 ± 581 kcal·day⁻¹) (p = 0.003) and 86% of climbers consumed below their target carbohydrate intake (target = 283 ± 67 g·day⁻¹; actual intake = 226 ± 72 g·day⁻¹) (p = 0.009). Average dietary protein intake was 95 ± 51 g·day⁻¹, with the majority of climbers meeting their target intake of 88 ± 21 g (p = 0.580). Seventy-three percent of climbers consumed below their target dietary fat intake (target = 90 ± 21 g·day⁻¹; actual = 69 ± 20 g·day⁻¹) (p = 0.001). Average EAT-26 scores were 5.3 ± 4.1, indicating minimal risk of disordered eating attitudes/behaviors. There were no significant differences in boulderers vs. top rope climbers for energy/macronutrient intake, BMI, and EAT-26 score. There were no associations between energy intake and EAT-26 score (R² = 0.245, p = 0.271) or climbing ability and EAT-26 score (R² = p = 0.217). These data suggest that, with the exception of dietary protein intake, adolescent climbers fail to meet target dietary intakes, and exhibit minimal risk of disordered eating.

Psychological Predictors of Unhealthy Eating Attitudes in Young Adults

The objective of this study was to determine the predictive role of psychological risk factors for restrained and compulsive eating in young women and men. We examined the relationship between resilience, impulsivity, emotional intelligence and self-esteem, and restrained and compulsive eating. It was assumed that resilience and impulsivity can directly explain unhealthy eating attitudes (restrained and compulsive: both emotional eating and external eating). The study group comprised 211 individuals (105 men and 106 women) aged 20-29, all of whom were living in southern Poland. Measures included the Resilience Measurement Scale (SPP-25), the Eysenck's Impulsivity Inventory (IVE), the Multidimensional Self-Esteem Inventory (MSEI), the Emotional Intelligence Questionnaire (INTE), and the Polish adaptation of the Dutch Eating Behavior Questionnaire (DEBQ). The statistical analysis showed significant and positive correlations between emotional eating and general self-esteem, impulsivity, and weaker (but still significant) correlations with physical attractiveness. External eating was positively and significantly correlated with impulsivity and self-esteem (including physical attractiveness). Restrained eating was also positively and significantly correlated with general self-esteem. Both types of compulsive eating attitudes (emotional and external eating) were significantly and negatively correlated with resilience. Women showed a significantly higher positive correlation between impulsivity and external eating compared to men. The level of intensity of other measures proved similar across the entire study group regardless of sex. Impulsivity had the strongest and most direct significant influence on both emotional eating and external eating, and a negative effect on emotional intelligence. Resilience proved to have a significant impact on all three examined types of eating attitude (a direct negative effect on emotional eating and external eating, and positive direct effect on restrained eating), self-esteem, and emotional intelligence. An important psychological intervening variable in generating unhealthy eating attitudes proved to be self-esteem among both men and women. Emotional intelligence, which remains correlated with resilience, proved independent, with no effect on unhealthy eating attitudes. These results suggest that preventive treatment and educational programs implemented particularly among adolescents and young adults may support development of their psychological resources.

Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!

Background Current literature suggests that diet is involved in either the development of premenstrual syndrome (PMS) or contributes to symptom severity, but to date, there are no studies evaluating eating attitudes of adolescents with PMS. The aim of this study was to evaluate dietary intake and eating attitudes in adolescents with PMS. Methods This study was conducted with 383 adolescents (214 with and 169 without PMS), aged 13-19 years. PMS was diagnosed using the premenstrual syndrome scale (PMSS). The Food Frequency Questionnaire (FFQ) and 24-h dietary recall were used to assess dietary intake. The Eating Attitudes Test-26 (EAT-26) and Three Factor Eating Questionnaire-Revised 18 (TFEQ-R18) were used to evaluate eating attitudes. Anthropometrical measurements and bone mineral content were measured. Results PMS prevalence was 55.9% according to PMSS subscales. Disordered eating attitudes determined by EAT-26 was detected in 23.8% in the PMS group and 11.8% of the control group (p<0.05). In the PMS group, total TFEQ-R18 score, emotional eating behavior and uncontrolled eating behavior scores were significantly higher (p<0.001). Whereas no significant difference in dietary intake, anthropometrical measurements or bone mineral content was observed between the two groups. Conclusions This is the first study documenting that not dietary intake but eating attitudes can be associated with PMS in adolescents. It is important to understand the relationship between disordered eating behaviors and PMS as both conditions may trigger the other.

Association between athletic participation and the risk of eating disorder and body dissatisfaction in college students

OBJECTIVE

Given that females exhibit a greater prevalence of eating disorders, there is of yet no conclusive evidence whether participation in college athletics exacerbates eating disorders or body shape dissatisfaction. This study assessed how gender and participation in collegiate athletics are associated with increased risk for disordered eating attitudes and body shape concerns in college students.

METHODS

This study used a cross-sectional research design. A total of 302 students at a Southern US university fully completed the eating attitudes test and the body shape questionnaire during class time or team meetings. Logistic regression was conducted to determine risk differentials for each group.

RESULTS

Of 302 students, 65.6% were females and 63.2% were non-athletes. Athletic status was significant as well but became slightly less so with adjustment (unadjusted at OR = 3.14, P < 0.001 vs. adjusted OR = 3.22, P < 0.001). Moreover, it was found that that non-athletic female students are slightly more at risk for disordered eating and significantly more dissatisfied with their body shape (OR = 5.95, P < 0.001).

CONCLUSIONS

Although there seems to still be many unresolved issues regarding eating disorders, one thing is clear females are at higher risk, and it remains a significant challenge to college health services. College health practitioners should be made aware of the significant effect stress has on freshman in particular.

Longitudinal relationships between financial difficulties and eating attitudes in undergraduate students

OBJECTIVE

Previous research has shown a relationship between financial difficulties and poor mental health in students, but there has been no research examining such a relationship for eating attitudes.

METHOD

A group of 444 British undergraduate students completed the Index of Financial Stress and the Eating Attitudes Test (26-item version) at up to four time points across a year at university.

RESULTS

Higher baseline financial difficulties significantly predicted higher eating attitudes scores at Times 3 and 4 (up to a year), after adjusting for demographic variables and baseline eating attitudes score. Lower family affluence also predicted higher eating attitudes scores at Time 4 (up to a year). A higher eating attitudes score at baseline also significantly predicted greater financial difficulties at Time 2 (3-4 months). When considering these relationships by gender, they were significant for women only.

DISCUSSION

Greater financial difficulties and lower family affluence predict a worsening in eating attitudes over time in female students. The relationship appears to be partially bi-directional, with financial difficulties driving poorer eating attitudes in the shorter term.

Risk of disordered eating attitudes among male adolescents in five Emirates of the United Arab Emirates

OBJECTIVE

The aim of this study was to highlight the prevalence of disordered eating attitudes among male adolescents in the United Arab Emirates (UAE).

METHOD

A multistage stratified sampling method was used to select 731 male students aged 15-18 years from five Emirates of the UAE. The Eating Attitudes Test (EAT-26) was used to determine the prevalence of disordered eating attitudes in students.

RESULTS

The findings revealed that the proportion of disordered eating attitudes in the UAE was relatively high compared with many developing and developed countries and ranged from 33.1% to 49.1%. Moreover, students living in the Emirates of Dubai and Al-Fujairah have double the risk of having disordered eating attitudes compared with students living in the other Emirates.

DISCUSSION

The results suggest the need for screening adolescents for eating disorders, as well as for increased awareness and understanding of eating disorders and their associated risk factors in all male adolescents in the UAE.

Clinical outcomes of enjoying sexualization among lesbian women

The Enjoyment of Sexualization Scale (ESS) was given to 150 lesbians in addition to measures of self-objectification, negative eating attitudes, and depression. The ESS was found to have acceptable levels of internal consistency reliability with a lesbian sample. Scores on the ESS were lower in this sample than in previously reported research with heterosexual women. Enjoying sexualization was found to moderate the relationship between body shame and both depressive symptomatology and negative eating attitudes. In contrast to findings from a heterosexual sample, lesbians who enjoyed sexualization had smaller relationships between these negative clinical outcomes and body shame than lesbians who did not. For lesbians, enjoying sexualization may serve a protective function against the negative effects of self-objectification. Findings are discussed in terms of body image and perceptions of ideal beauty among lesbians.

Psychological well-being in out-patients with eating disorders: a controlled study

OBJECTIVE

Positive functioning is widely neglected in research on eating disorders (EDs). The aim of this exploratory study was to assess psychological well-being (PWB) in out-patients with ED and in controls.

METHOD

The authors assessed PWB in 245 out-patients with EDs [105 with bulimia nervosa (BN), 57 with anorexia nervosa (AN), and 83 with binge eating disorder (BED) who met DSM-IV-TR] and 60 controls. They tested whether PWB was associated with eating attitude test (EAT) scores and if such associations differed among ED groups while taking into account confounding variables.

RESULTS

Significant differences between groups in all PWB scales were found. While individuals with BN reported significantly lower scores in all PWB dimensions than healthy controls, patients with BED scored significantly lower than controls in PWB autonomy, environmental mastery, and self-acceptance scales. Patients with AN showed similar scores to controls in all PWB dimensions, except for positive relationships and self-acceptance. In all ED groups, most PWB dimensions resulted significantly and negatively associated with EAT scales, except for AN where oral control was found to positively correlate with a high sense of purpose in life. All results were maintained even after adjusting for possible confounding variables.

DISCUSSION

Patients with EDs reported an impairment in PWB. The paucity of PWB was not necessarily dependent on the presence of high levels of psychological distress and on the severity of the disorder. Such assessments may therefore yield a more comprehensive evaluation in this clinical population.

Eating attitudes and food intakes of elite adolescent female figure skaters: a cross sectional study

BACKGROUND

Elite adolescent female figure skaters compete in an aesthetic-based sport that values thin builds and lithe figures. To conform to the sport's physical requirements, skaters may alter their eating patterns in unhealthful directions. This study assesses the eating attitudes and dietary intakes of elite adolescent female figure skaters to assess the potential nutritional risks among them.

METHODS

Thirty-six elite competitive adolescent female figure skaters (mean age 16 ± 2.5 SD years) completed self-administered three-day records of dietary intake and simultaneous physical activity records during training season. Two months later, they attended a national training camp during which they completed the Eating Attitudes Test (EAT-40), provided fasting blood samples, and had heights and weights measured.

RESULTS

Participants' mean body mass index (BMI) was 19.8 ± 2.1 SD. Their BMIs were within the normal range, and the majority (70%) did not report a history of recent weight loss. The mean EAT-40 score was normal (19.5 ± 13.5 SD) and below the cut-off score of 30 that indicates clinically significant eating pathology. However, one-quarter of the skaters had EAT-40 scores above 30. The skaters reported a mean energy intake of 1491 ± 471 SD kcal/day (31 ± 10 SD kcal/kg), with 61.6% of calories from carbohydrate, 14.6% from protein, and 23.7% from fat. Their reported dietary intakes were high in carbohydrates but low in total energy, fat, and bone-building nutrients.

CONCLUSIONS

Although these highly active young women compete in a sport that prizes leanness, they had appropriate weights. The athletes reported dietary intakes that were far below estimated energy needs and were at moderate risk of disordered eating. Anticipatory guidance is warranted to improve their dietary intakes, particularly of bone-building nutrients.

Structure analysis of the Children's Eating Attitudes Test in overweight and at-risk for overweight children and adolescents

BACKGROUND

In school-based samples of children, the Children's Eating Attitudes Test (ChEAT) has a four-factor structure; however, previous studies have not examined its factor structure in samples restricted to overweight youth.

METHODS

The ChEAT was administered to 220 overweight (BMI>or=95th percentile) and 45 at-risk for overweight (BMI 85th-<95th percentile) children and adolescents. Factors were identified by a principal component analysis with varimax rotation. ChEAT factor scores of children with BMI>or=85th percentile were contrasted with those of 152 non-overweight (BMI 5th to <85th percentile) children and adolescents.

RESULTS

Factor analysis generated four subscales described as 'body/weight concern,' 'food preoccupation,' 'dieting,' and 'eating concern.' ChEAT total score, body/weight concern, and dieting subscale scores were positively related to BMI-Z and body fat mass (p's<.05). Compared to non-overweight children, overweight and at-risk for overweight children had higher ChEAT total (9.9+/-7.4 vs. 6.6+/-7.8, p<.001), body/weight concern (3.2+/-3.1 vs. 1.3+/-3.0, p<.001), and dieting (1.8+/-2.2 vs. .8+/-2.3, p<.001) subscale scores.

CONCLUSIONS

The previously elucidated factor structure of the ChEAT was primarily supported in a sample of overweight children. The emergence of separate body/weight concern and dieting subscales may relate to these children's experiences with attempted weight reduction.

A cross-cultural study of eating attitudes in adolescent South African females

Eating disorders were first described in black females in South Africa in 1995. A subsequent community based study of eating attitudes amongst adolescent females in an urban setting suggested that there would be increasing numbers of sufferers from within the black community. The current study sought to extend these findings using a larger, more representative urban sample. The results support those of the preliminary study. The underlying basis for the emerging phenomenon is discussed.