Gender difference in the prevalence of eating disorder symptoms

Body Image, Weight, and Self-Concept in Men

In the traditional debate between biological and environmental determinants of body weight, the body has most often been explored in terms of its anatomical, genetic, or hormonal influences on personality, experience, and behavior. While obesity has been identified as a threat to our public health, correlating attitudes toward body image and self-concept have been explored within women to a limited extent, and even less so in relation to men. Consequently, men's body image will be discussed in light of current literature reveals for women. For men, as for women, as the social pressure to attain an "ideal" physique increases, the discrepancy between that ideal and one's body increases as well. This dynamic is more readily recognized for women than for men. As men are socialized not to discuss their body image concerns, negative self-concept and esteem may reinforce behaviors resulting in weight gain. In recent years, the proliferation of media has served to reinforce messaging related to one's body. This review of existing data and literature suggests that body image and self-concept are related to body weight in men (as with women) and need to be addressed as part of healthy weight management practices.

Breaking the Silence: Disordered Eating and Big Five Traits in College Men

Men remain largely underrepresented in the eating disorder literature and few studies have investigated risk factors for disordered eating among men. The current study examined associations between Big Five personality traits and eating disorder symptoms in a sample of college men (N = 144). Participants completed the Eating Disorder Diagnostic Scale and Ten Item Personality Inventory online. Results suggested that openness was positively associated with purging-type behaviors and that emotional stability was positively related to symptoms of anorexia nervosa and global eating pathology. Findings highlight the prevalence of eating disorder symptoms among college men and suggest that these symptoms are associated with a different constellation of personality traits than is typically reported among women. Implications for targeted prevention and intervention programs and future research are discussed.

Cloninger's temperament and character traits in medical students of Korea with problem eating behaviors

BACKGROUND AND OBJECTIVE

The personality profiles of patients with eating disorder have been extensively investigated, but those of people in the general population with eating behavior problems need to be evaluated to assess the relationship between personality, health behavior and level of overall well-being in non-clinical samples.

DESIGN

Temperament and character traits, reasons for over-eating, and the negative influence of functional dyspepsia on quality of life were measured by the Temperament and Character Inventory (TCI), Dutch Eating Behavior Questionnaire (DEBQ), and Functional Dyspepsia Quality of Life (FDQOL) inventory, respectively, in 199 Korean medical students. The associations among TCI, FDQOL, DEBQ and body mass index (BMI) were examined by correlational analysis. Multiple regression analysis was carried out to measure how well personality (TCI) accounted for patterns of overeating (DEBQ) and impaired quality of life from functional dyspepsia (FDQOL).

RESULTS

Individual differences in personality (especially harm-avoidance, self-transcendence, and self-directedness) were weakly associated with overeating and impaired quality of life from functional dyspepsia. Gender, social desirability and body mass index also played important roles in predicting eating behavior problems in the nonclinical population.

DISCUSSION AND CONCLUSION

We found that the personality traits observed in clinical patients with eating disorders are also found in people with eating behavior problems in the nonclinical population of Korea. The ways that personality traits affect eating behaviors were discussed along with recommendations for future studies in light of the limitations of available data.

Stigmatizing attitudes and beliefs toward bulimia nervosa: the importance of knowledge and eating disorder symptoms

Widely held stigmatizing attitudes and beliefs toward bulimic eating disorders may lead to self-blame and reduced treatment seeking. Knowledge and familiarity with mental disorders may help decrease associated stigma. However, these relationships are not well understood in bulimia nervosa (BN). A community sample of 1828 adults aged 18 to 70 years completed a survey assessing stigmatizing attitudes and beliefs toward BN, knowledge and familiarity with the disorder, as well as levels of eating disorder symptoms. Knowledge of BN was negatively associated with three dimensions of stigmatization, personal responsibility (ρ = -0.28), unreliability (ρ = -0.19), and advantages of BN (ρ = -0.23). Familiarity revealed no association with stigmatization. Both men and women with high levels of eating disorder symptoms perceived BN as less serious than the participants with low levels of symptoms. Increasing community knowledge about bulimia may help mitigate stigmatization and perceived barriers to treatment.

Sex difference in using the SCOFF questionnaire to identify eating disorder patients at a psychiatric outpatient clinic

OBJECTIVE

Patients with eating disorder (ED) often remain unrecognized in many settings. Few studies have explored the use of eating measures in an adult male population. This study aimed to examine the comparative validity of the SCOFF questionnaire for detecting ED cases in men and women in the psychiatric outpatient setting.

METHOD

Psychiatric outpatients, including 605 men and 936 women, aged 18-45years, completed the paper form SCOFF and were interviewed using the ED Module of the Structured Clinical Interview for the DSM-IV-TR. A subgroup of patients completed several additional self-reported questionnaires concerning eating and general psychopathology.

RESULTS

Scores of 2 and 3 on the SCOFF were the optimal cutoff values for determining ED among men (sensitivity 86% and specificity 74%) and women (sensitivity 80% and specificity 86%), respectively. While age did not significantly affect the validity indices, the SCOFF as a screening tool for ED in obese men was underperformed.

CONCLUSIONS

The Mandarin Chinese version of the SCOFF is a potentially valid tool to detect ED in both genders in the psychiatric outpatient settings. By helping to detect hidden ED morbidity, the SCOFF can enhance diagnostic accuracy and facilitate comprehensive treatment among psychiatric outpatients.

An ecological framework for sexual minority women's health: factors associated with greater body mass

In recent years, many studies have focused on the body of sexual minority women, particularly emphasizing their larger size. These studies rarely offer theoretically based explanations for the increased weight, nor study the potential consequences (or lack thereof) of being heavier. This article provides a brief overview of the multitude of factors that might cause or contribute to larger size of sexual minority women, using an ecological framework that elucidates upstream social determinants of health as well as individual risk factors. This model is infused with a minority stress model, which hypothesizes excess strain resulting from the stigma associated with oppressed minority identities such as woman, lesbian, bisexual, woman of color, and others. We argue that lack of attention to the upstream social determinants of health may result in individual-level victim blaming and interventions that do not address the root causes of minority stress or increased weight.

Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: a narrative review

Challenges to epidemiological studies of eating and related body image disturbance disorders in males include, in addition to low base rates and the predominance of residual diagnostic categories, the female-centric nature of current classification schemes and the consequent lack of appropriate assessment instruments. In this narrative review, we summarise epidemiological data regarding the prevalence and correlates of eating disorders, related body image disturbance disorders, and eating disorder features in males. Attention is focused on disorders most likely to be observed among males, such as muscle dysmorphia and muscularity-oriented excessive exercise. It is argued that, given the multiple challenges involved in research of this kind, a focus on features is more likely to advance the field than a focus on diagnoses. In terms of correlates, we focus on impairment and help-seeking, since these issues are most relevant in informing public health burden, service provision, and related issues. We end with some thoughts about current gaps in the knowledge base and directions for future research that we consider to be most promising.

COMT met allele differentially predicts risk versus severity of aberrant eating in a large community sample

Prefrontal dopamine (DA) transmission participates in the reinforcement of reward-driven behaviors like eating. Because catechol-O-methyltransferase (COMT) degrades DA and is expressed in the prefrontal cortex, variation in the COMT gene may modulate eating behavior. Previous studies have shown that the met allele of the COMT val158met single nucleotide polymorphism (SNP) is associated with Bulimia Nervosa (BN). The specific aim of this study was to test whether the met allele increased risk for, and severity of, eating disorder symptomatology in community volunteers. Caucasian adults (N=1003; 51.2% female) from the University of Pittsburgh Adult Health and Behavior Project (AHAB) were genotyped and completed the Eating Disorders Inventory (EDI). Logistic and Poisson regression analyses assessed genotype-dependent presence and severity of eating disorder symptomatology. The met allele was significantly associated with the presence of symptoms on the Bulimia subscale and the severity of Body Dissatisfaction scores. All EDI subscales significantly predicted BMI. To our knowledge, these are the first data indicating that the COMT met allele increases risk for some symptoms of disordered eating, while increasing severity of others, in a community sample. These novel findings may have important implications for understanding the etiology of heterogeneous disordered eating phenotypes.

College women eating disorder diagnostic profile and DSM-5

A consistent diagnostic profile describing college women with eating disorders has been well established in the college health and mental health literature. This diagnostic framework traditionally has been associated with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision Eating Disorders Not Otherwise Specified category. In this article, the authors discuss implications of the recently revised Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition eating disorder diagnostic categories for the existing college women eating disorder profile.

Association of eating disorder symptoms with internalizing and externalizing dimensions of psychopathology among men and women

OBJECTIVE

A large body of factor analytic research supports the idea that common mental disorders are organized along correlated latent dimensions termed internalizing and externalizing. Eating disorders (EDs) have been associated with both internalizing (mood and anxiety disorders) and externalizing (substance use, antisocial personality disorder) forms of psychopathology. Previous studies found that EDs are most strongly related to internalizing disorders. However, no previous factor analytic studies of EDs and the internalizing/externalizing dimensions have evaluated if EDs align with these spectra similarly for men and women. We examined the location of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) symptoms within this model of psychopathology among a sample of veterans, a population traditionally understudied in EDs.

METHOD

Data were from two studies of veterans and their intimate partners (N = 453 men and 307 women). Participants were administered the Structured Clinical Interview for DSM-IV without skip-outs. Lifetime symptom severity scores were used in confirmatory factor analytic models.

RESULTS

A model with AN, BN, and BED symptoms loading onto the distress subfactor of the internalizing domain fit the data best in the full sample and the male and female subsamples. This model was statistically equivalent for men and women.

DISCUSSION

All three EDs loaded onto distress, indicating that these conditions overlap with psychopathology characterized by negative affect. Investigating latent dimensions of psychopathology is one approach to identifying common factors that partially account for patterns of comorbidity among psychiatric disorders, which may aid in translating research findings into clinical practice.

Gender differences in exercise dependence and eating disorders in young adults: a path analysis of a conceptual model

The purpose of our study was to study the prevalence of exercise dependence (EXD) among college students and to investigate the role of EXD and gender on exercise behavior and eating disorders. Excessive exercise can become an addiction known as exercise dependence. In our population of 517 college students, 3.3% were at risk for EXD and 8% were at risk for an eating disorder. We used Path analysis the simplest case of Structural Equation Modeling (SEM) to investigate the role of EXD and exercise behavior on eating disorders. We observed a small direct effect from gender to eating disorders. In females we observed significant direct effect between exercise behavior (r = −0.17, p = 0.009) and EXD (r = 0.34, p < 0.001) on eating pathology. We also observed an indirect effect of exercise behavior on eating pathology (r = 0.16) through EXD (r = 0.48, r² = 0.23, p < 0.001). In females the total variance of eating pathology explained by the SEM model was 9%. In males we observed a direct effect between EXD (r = 0.23, p < 0.001) on eating pathology. We also observed indirect effect of exercise behavior on eating pathology (r = 0.11) through EXD (r = 0.49, r² = 0.24, p < 0.001). In males the total variance of eating pathology explained by the SEM model was 5%.

The changing demographic profile of eating disorder behaviors in the community

BACKGROUND

The perception that eating disorders occur predominantly in young white upper-class women has been challenged. This study examined temporal differences to the demographic correlates of eating disorder behaviors over a 10-year period.

METHODS

Data from cross-sectional general population surveys in 1998 (n = 3010) and 2008 (n = 3034) were collected on demographics (sex, age, income, residency), current eating disorder behaviors (binge eating, extreme dieting, purging), and health-related quality of life (SF-36).

RESULTS

Below-median annual household income was associated with increased prevalence rates from 1998 to 2008 in binge eating, extreme dieting, and purging. Male sex was associated with increased prevalence rates in extreme dieting and purging. Age over 45 years was associated with increased prevalence rates in purging. In 2008 versus 1998, binge eating was associated with greater mental health-related quality of life impairment in males but not females; and greater physical health-related quality of life impairment in regional but not metropolitan areas. Extreme dieting was also associated with greater physical health-related quality of life impairment in 2008 versus 1998 in the lower but not the higher socioeconomic sector.

CONCLUSIONS

Findings suggest the 'democratization' of disordered eating, with greatest levels of associated impairment being within marginalized demographic sectors. Implications include the need for broader intervention programs and recruitment of demographically representative samples in eating disorder research.

Publicizing female athletes' weights: implications for female psychology undergraduates acting as spectators

PURPOSE

The purpose of this study was to examine the effects of including female athletes' weights in athletic event programs on female spectators' body image, eating disorder symptoms, self-esteem, and affective state and to investigate whether the magnitude of the athletes' reported weights had differential effects on female spectators (i.e., do female spectators who view heavier athletes respond differently than those who view less heavy athletes?).

METHOD

We used an experimental design to examine hypotheses derived from competing theories to determine whether exposure to female athletes of varying weight would adversely or beneficially impact female undergraduates (N = 152) who served as athletic event spectators.

RESULTS

Analyses indicated that in this simulated study, female spectators' body image, eating disorder symptoms, self-esteem, and affective states were not impacted by the presence or by the magnitude of female athletes' weights in athletic event programs.

CONCLUSION

The results imply that including athletes' weights in game-day programs at women's athletic events does not affect female spectators on an individual level.

Chocolate craving and disordered eating. Beyond the gender divide?

Chocolate craving in women has previously been linked to disordered eating behaviors. A relatively higher prevalence of eating disorder pathology may account for the fact that chocolate craving is significantly more common in women in North America, compared to many other countries. While support for a causal role of disordered eating in the etiology of craving in women is growing, little is known about the extent to which food cravings are associated with disordered eating behaviors in men. This study was designed to systematically assess the impact of gender and chocolate craving on measures of attitudes to chocolate, responsiveness to food cues in the environment, body shape dissatisfaction, dietary restraint, and eating disorder and general pathology. Undergraduate men and women (n = 645, 37.2% male) were invited to complete self-report questionnaires assessing demographics, height and weight, food cravings, dietary attitudes and behaviors, along with eating disorder and general pathology. Data suggest that the relationship between chocolate craving and disordered eating behaviors in men is the opposite of what has previously been observed in women: compared to non-cravers, male chocolate cravers reported significantly more guilt related to craving, but were significantly less likely to diet and reported lower levels of dietary restraint, less frequent weight fluctuations, and fewer symptoms of eating disorders. Findings indicate that a positive relationship between disordered eating behaviors and chocolate craving may be unique to women (and potentially women in North America). Findings have important implications for our understanding of cultural and psychosocial factors involved in the etiology of food cravings.

Sex differences and eating disorder risk among psychiatric conditions, compulsive behaviors and substance use in a screened Canadian national sample

OBJECTIVE

This study examined sex differences and eating disorder risk among psychiatric conditions, compulsive behaviors (i.e., gambling, suicide thoughts and attempts) and substance use in a nationally representative sample.

METHOD

Data from participants of the Canadian Community Health Survey Cycle 1.2 who completed the Eating Attitudes Test (n=5116) were analyzed. Sex differences were compared among psychiatric comorbidities according to eating disorder risk, binging, vomiting and dieting behavior. Poisson regression analysis provided prevalence ratios (PRs) of disordered eating adjusting for age, marital status, income, body mass index and recent distress.

RESULTS

Pronounced sex differences were associated with eating disorder risk (PRs 4.89-11.04; all P values <.0001). Findings of particular interest included significantly higher PRs for eating disorder risk in males associated with gambling (PR 5.07, P<.0001) and for females associated with steroid and inhalant use as well as suicide thoughts and attempts (PRs 5.40-5.48, all P values <.0001).

DISCUSSION

The findings from this detailed exploration of sex differences and eating disorder risk among psychiatric conditions, compulsive behaviors and substance use suggest that problem gambling, the use of inhalants and steroids and suicidal ideation in relationship to eating disorder risk warrant further investigation.

Development and validation of the Male Body Talk Scale: a psychometric investigation

This paper details the development of the Male Body Talk (MBT) scale and five studies supporting the psychometric soundness of scores on this new measure. Participants were 18-65-year-old men recruited via Amazon's Mechanical Turk, introductory psychology courses, and snowball sampling. The MBT scale assesses the frequency with which men engage in negatively valenced body-related conversations with others. Two subscales were identified through a combination of exploratory and confirmatory factor analysis. The Muscle Talk subscale assesses men's tendency to express concerns regarding degree of muscularity and being too small. The Fat Talk subscale assesses men's tendency to express concerns regarding level of body fat and being overweight. Scores on the MBT scale demonstrated strong internal consistency and moderate test-retest reliability. Evidence of convergent, discriminant, and incremental validity of scores on the MBT scale is presented. This new measure is a useful tool for examining how often men engage in negative body talk.

Stigmatizing attitudes and beliefs about bulimia nervosa: gender, age, education and income variability in a community sample

OBJECTIVE

Stigmatizing attitudes towards eating disorders negatively impacts treatment seeking. To determine the effect of interventions to reduce stigma, a measure of stigma that is simple to implement is required. This study aimed to develop a measure of stigmatizing attitudes and beliefs towards bulimia nervosa (SAB-BN) and evaluate the distribution of beliefs across gender, age, education, and income groups.

METHOD

Participants were 1828 community adults (890 men; 938 women) aged 18-65 sampled from the Australian Electoral Roll responded to a mailed questionnaire. Participants provided demographic information and completed the SAB-BN questionnaire.

RESULTS

Five components of stigmatizing attitudes and beliefs were identified; advantages of BN, minimization/low seriousness, unreliability, social distance, and personal responsibility. Stigma was low except on social distance and personal responsibility sub-scales, which indicated negative attitudes toward people with bulimia. Men compared with women and lower compared with higher education and income groups held significantly higher stigmatizing attitudes and beliefs. There were few differences between age groups in stigma. Differences between demographic groups provides evidence for known-groups validity.

DISCUSSION

The SAB-BN questionnaire provides a potentially useful tool for evaluating stigma in relation to BN. Results provide insight into components of stigma and the demographic groups to whom interventions should be targeted.

Relationships between depression, gender, and unhealthy weight loss practices among overweight or obese college students

INTRODUCTION

Unhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices among overweight or obese college students.

METHODS

Students (body mass index between 25.0 and 34.9 kg/m(2)) from three Southern California universities (M(age) = 22 years, SD = 4; 70% women) were recruited from May 2011 to May 2012 for participation in a weight loss clinical trial (N = 404). Logistic regressions were performed with baseline data to assess the cross-sectional relationship between self-reported unhealthy weight loss practices and gender and depression as measured by the Center for Epidemiologic Studies Depression short form.

RESULTS

Twenty-nine percent of participants reported engaging in at least one unhealthy weight loss behavior (e.g., fasting, purging) over the last 30 days, with no differences by gender. Self-report of at least one unhealthy weight loss behavior was associated with report of symptoms of depression (e(B) = 1.14 [confidence interval, CI: 1.08-1.20]), adjusting for potential confounders. Interactions between gender and depression were not significant (e(B) = 1.04 [CI: 0.93-1.16]).

CONCLUSION

Among an overweight or obese sample of college students, unhealthy weight loss practices were equally common in both genders, and students with depressive symptomatology were at greatest risk. Obesity interventions targeting overweight or obese college students should educate both men and women about the dangers of unhealthy weight loss practices. In addition, screening for depression can help identify students who would benefit from additional supportive and coping strategies and resources.

Body Dissatisfaction and Eating Disorder Symptomatology: A Latent Structural Equation Modeling Analysis of Moderating Variables in 18-to-28-Year-Old Males

Although body dissatisfaction is recognized as the strongest risk factor for eating disturbances, a majority of young males are body dissatisfied, but do not concomitantly report severe levels of eating disorder symptomatology. The present investigation was designed to examine five theoretically relevant variables (i.e., body checking, emotional dysregulation, perfectionism, insecure-anxious attachment, and self-esteem) as potential moderators of the relationship between body dissatisfaction and two critical components of male eating disorder symptomatology: drive for muscularity and bulimic behaviors. Data collected from 551 Italian males between 18 and 28 years old were analyzed using latent structural equation modeling. The authors found that emotional dysregulation, body checking, insecure-anxious attachment and perfectionism intensified the relationship between body dissatisfaction and each criterion variable representing male eating disorder symptomatology; the interactions accounted respectively for an additional 2%, 7%, 4% and 5% of variance in drive for muscularity and for an additional 6%, 4%, 5%, and 2% of the variance in bulimic behaviors. By contrast self-esteem weakened this relationship and the interactions accounted for an additional 3% of the variance in both drive for muscularity and bulimic behaviors. Implications of these findings for prevention and treatment of male eating disturbances are discussed.

The epidemiology of eating disorders: genetic, environmental, and societal factors

Background

The aim of this review was to summarize the literature to date regarding the sociodemographic, environmental, and genetic correlates of eating disorders (EDs) in adults.

Method

A keyword search was entered into Scopus (SciVerse, Elsevier) to identify relevant articles published in English up until June 2013. Articles were assessed against a range of a priori inclusion and exclusion criteria.

Results

A total of 149 full-text articles were found to be eligible for the review and included 86 articles with data on sociodemographic correlates, 57 on environmental correlates, and 13 on genetic correlates. Female sex, younger age, sexual and physical abuse, participation in esthetic or weight-oriented sports, and heritability were found to be most consistently associated with higher ED prevalence and incidence. Conversely, ethnicity, socioeconomic status, education, and urbanicity did not appear to have strong associations with ED epidemiology.

Conclusion

More community-based research, with an equal representation of males, needs to be conducted to confirm the current findings and provide evidence for emerging factors that may be related to EDs.

Comprehensive examination of the trans-diagnostic cognitive behavioral model of eating disorders in males

The Trans-diagnostic Model (TM) of eating pathology describes how one or more of four hypothesized mechanisms (i.e., mood intolerance, core low self-esteem, clinical perfectionism and interpersonal difficulties) may interrelate with each other and with the core psychopathology of eating disorders (i.e., over-evaluation of weight and shape) to maintain the disordered behaviors. Although a cognitive behavioral treatment based on the TM has shown to be effective in treating eating disorders, the model itself has undergone only limited testing. This is the first study to both elaborate and test the validity of the TM in a large sample (N=605) of undergraduate men. Body mass index was controlled within structural equation modeling analyses. Although not all expected associations for the maintenance variables were significant, overall the validity of the model was supported. Concern about shape and weight directly led to exercise behaviors. There was a direct path from binge eating to exercise and other forms of compensatory behaviors (i.e., purging); but no significant path from restriction to binge eating. Of the maintaining factors, mood intolerance was the only maintaining variable directly linked to men's eating disorder symptoms. The other three maintaining factors of the TM indirectly impacted restriction through concerns about shape and weight, whereas only interpersonal difficulties predicted low self-esteem and binge eating. Potential implications for understanding and targeting eating disturbances in men are discussed.

Eating disorder symptoms and comorbid psychopathology among male and female veterans

OBJECTIVE

Eating disorder (ED) symptoms have gone mostly unexamined among veterans. The current study assessed rates of bulimia nervosa (BN) and binge eating disorder (BED) symptoms and diagnoses and their associations with common comorbidities among male and female veterans.

METHOD

Participants were US military veterans who screened positive for trauma histories and/or a probable Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) posttraumatic stress disorder (PTSD) diagnosis (n=499). Symptoms of PTSD were assessed using the Clinician-Administered PTSD Scale, and symptoms of EDs, mood, and substance use disorders were assessed using the Structured Clinical Interview for the DSM-IV.

RESULTS

Lifetime rates of BN and BED diagnoses were comparable to civilian populations, and a considerable range of lifetime and current BN and BED symptoms were identified. In multivariate models, PTSD and depression severity were most consistently associated with BN and BED symptom severity, with depression most strongly associated with EDs for women.

CONCLUSIONS

Findings highlight the importance of screening for ED symptoms among male and female veterans, particularly those that present with PTSD and depression symptomatology. Future examinations of the temporal order of such relationships and the degree to which ED symptoms and associated symptoms impact veteran functioning are warranted.

Eating disorder risk and body dissatisfaction based on muscularity and body fat in male university students

OBJECTIVE

To investigate the relationship between risk of eating disorders, body dissatisfaction, and perceptual attractiveness in male university students.

PARTICIPANTS

Research was conducted January-April 2012 and involved 339 male and 441 female students.

METHODS

Eating disorder risk was assessed with the Eating Attitudes Test (EAT) and body dissatisfaction and perceptual attractiveness determined with the Bodybuilder Image Grid (BIG).

RESULTS

There was a positive correlation (r=.16, p<.01) between the EAT and fat dissatisfaction and a negative correlation (r=-.14, p<.05) for muscle dissatisfaction, 28% of the males had an EAT score indicating that they were at risk for an eating disorder. Males chose a significantly more muscular and leaner body type than what females chose to be attractive.

CONCLUSION

College-aged males may be at risk for eating disorders based on distortions in their perceived ideal body image, both for fat and muscle.

Longitudinal predictors of dieting and disordered eating among young adults in the U.S

OBJECTIVE

To assess longitudinal associations between cognitive and behavioral characteristics in adolescence and dieting and eating pathology in young adulthood.

METHOD

Data from the National Longitudinal Study of Adolescent Health and multivariate logistic regressions were used to examine the unique and cumulative effects of adolescent behavior and cognition on four weight-related health indicators in young adulthood: dieting, extreme weight loss behaviors (EWLB), binge eating, and eating disorder (ED) diagnosis (N = 14,322).

RESULTS

Early dieting, depression, and body image distortion (BID) prospectively predicted dieting or EWLB at Wave 3. In addition, early depression and dieting were associated with binge eating in young adulthood, and early BID was associated with ED diagnosis. Gender differences were observed. In the prospective models, the effect of depression on the onset of EWLB was stronger for women than men; while association between early depression and ED diagnosis was significantly stronger for men than women. Findings supported a cumulative risk effect. Among women, each additional correlate was associated with greater odds of eating pathology in young adulthood; among men, each additional correlate was associated with greater odds of ever reporting ED diagnosis. Overall prevalence of dieting and eating pathology among young adults was higher among women than men and increased over time for both sexes.

DISCUSSION

Early weight control behavior and cognition affect long term eating patterns and are salient for both young adult men and women. Transition to young adulthood is a critical period for assessing and preventing weight and eating-related health problems.

The relationship of sex and sexual orientation to self-esteem, body shape satisfaction, and eating disorder symptomatology

There is increasing interest in understanding what role, if any, sex and sexual orientation play in body dissatisfaction, its correlates to distress, and its relationship to disordered eating. The goals of the present study were to examine: (a) differences in sex and sexual orientation in internalization of societal pressure to modify physical appearance, components of body image dissatisfaction, self-esteem, and eating disorder symptomatology and (b) whether the internalization-eating disorder symptomatology was mediated by the different components of body image dissatisfaction and low self-esteem. The present data support several key trends in the literature: men generally reported less body dissatisfaction, internalization of socio-cultural standards of beauty, drive for thinness, and disordered eating, but a greater drive for muscularity than women; results also indicated that different components of body image dissatisfaction and low self-esteem partially mediated the relationship between internalization and eating disorder symptomatology. Gay men reported significantly more body dissatisfaction, internalization, eating disorder symptomatology, drive for thinness, and drive for muscularity than heterosexual men. Compared to heterosexual women, lesbians reported increased drive for muscularity, lower self-esteem, and lower internalization; however, they did not significantly differ on body dissatisfaction, drive for thinness or disordered eating. Correlation coefficients between body shape dissatisfaction and several aspects of mental distress were significantly larger for gay men than heterosexual men; the same coefficients did not differ between lesbian women and heterosexual women. Results of path analyses indicated that the relationship between internalization and disordered eating differs for gay and heterosexual men but not for lesbian and heterosexual women. These results call attention to lesbians as a generally understudied population.

Sex differences in binge eating patterns in male and female adult rats

OBJECTIVE

Several efforts are underway to model binge eating in animals in order to advance neurobiological models of risk. However, knowledge of sex differences in these models is currently lacking. The goal of the present study was to examine sex differences in binge eating phenotypes using a well-established rodent model (i.e., the binge eating resistant/binge eating prone model).

METHOD

Thirty male and 30 female adult Sprague-Dawley rats were exposed to feeding tests consisting of intermittent access to palatable food (PF). Rats were then categorized as binge eating prone (BEP) based on the amount and consistency of PF consumption across tests.

RESULTS

Across multiple methods for BEP classification, rates of BEP phenotypes were two to six times higher in female than male rats.

DISCUSSION

Findings provide support for sex differences in rodent models of binge eating and highlight the promise of the BER/BEP model for understanding neurobiological mechanisms underlying sex differences in risk.

Examination of food reward and energy intake under laboratory and free-living conditions in a trait binge eating subtype of obesity

Background/Aims: Trait binge eating has been proposed as a “hedonic subtype” of obesity characterized by enhanced food liking and wanting, and a preference for high-fat sweet foods in the laboratory. The current study examined the influence of trait binge eating in overweight or obese women on eating behavior under laboratory and free-living conditions over a 48-h period.

Methods: In a matched pairs design, 24 overweight or obese females (BMI: 30.30 ± 2.60 kg/m²; Age: 25.42 ± 3.65 years) with high or low scores on the Binge Eating Scale (BSE) were divided into one of two groups; Obese Binge (O-B) and Obese Non-binge (O-NB). Energy intake was assessed using combined laboratory energy intake measures and 24-h dietary recall procedures. Liking and wanting were assessed using the Leeds Food Preference Questionnaire (LFPQ).

Results: There was a significant association between overall energy consumed, and energy consumed from snack foods under laboratory and free-living conditions. O-B exhibited a greater preference for sweet snack foods in their laboratory and free-living eating behavior. These findings were supported by greater laboratory-based measures of wanting and craving for this food type in O-B. In addition, O-B consumed significantly more energy than their estimated daily energy requirements in the laboratory suggesting that they over-consumed compared to O-NB.

Conclusions: The measurement concordance between laboratory and free-living based energy intake supports the validity of laboratory-based test meal methodologies Variation in trait binge eating was associated with increased craving and wanting for high-fat sweet foods and overconsumption in the laboratory. These findings support the use of trait binge eating as a common hedonic subtype of obesity and extend the relevance of this subtype to habitual patterns of energy intake.

Gender differences in food craving among overweight and obese patients attending low energy diet therapy: a matched case-control study

This case-control study examined gender differences in food craving among a sample of overweight and obese patients attending low energy diet therapy. To disentangle the specific role of gender from the role of confounders, we paired groups for BMI, age and severity of binge eating as assed by the Binge Eating Scale (BES). The participants were 73 pairs of patients who were attending low energy diet therapy. All the participants were administered the State and Trait Food Cravings Questionnaire, trait version (FCQ-T) and the BES. Female patients had higher mean scores on six out of nine dimensions of the FCQ-T. When controlling for the effect of other variables, obese and overweight female patients were 1.1 times more likely to report higher anticipation of relief of negative states and feelings from eating than their male pairs. Obese and overweight female patients experience more cravings for food than their male pairs despite comparable severity of binge eating and obesity suggesting the need for tailored interventions.

Eating disorders and anabolic androgenic steroids in males--similarities and differences in self-image and psychiatric symptoms

Background

Body dissatisfaction is common among both females and males. Dissatisfaction with the body is a risk factor both for onset of eating disorders and for abuse of anabolic androgenic steroids (AAS). Few studies have however investigated if there are other similarities in respect to self-image or psychiatric symptoms between clinical samples of eating disordered males and males in treatment for negative effects of AAS use.

Aim

The aim of this study was to compare two clinical samples, one of males with ED and one of males who used AAS, regarding self-image and psychiatric symptoms.

Methods

This study compared males with eating disorders (n = 13) and males who recently stopped AAS use (n = 29) on self-image and psychiatric symptoms, using The Structural Analysis of Social Behavior self-questionnaire and a shortened version of The Symptom Check List.

Results

The eating disorder group reported significantly lower scores for Self-emancipation and Active self-love and higher scores for Self-blame and Self-hate. Both groups reported serious psychiatric symptoms. The common denominator between groups was serious psychiatric symptomatology rather than negative self-image.

Conclusions

The negative self-image profile, especially self-hate, found among males with Eating Disorders may indicate that the studied groups differ in aetiology of the underlying problems. The serious psychiatric symptoms in both groups call staff to pay attention to any thoughts of suicide due to severe depressive symptoms where by specialized psychiatric treatment may be needed.

Eat for life: a work site feasibility study of a novel mindfulness-based intuitive eating intervention

PURPOSE

To examine the efficacy of a novel intervention for problematic eating behaviors and body dissatisfaction.

DESIGN

Participants enrolled in the intervention or waitlist comparison group were assessed at pre and post 10 weeks.

SETTING

Midwestern university.

SUBJECTS

One hundred twenty-four female employees or partners/spouses.

INTERVENTION

Eat for Life is a 10-week group intervention integrating mindfulness and intuitive eating skills.

MEASURES

Self-report questionnaires included the Intuitive Eating Scale, Body Appreciation Scale, Five-Facet Mindfulness Questionnaire, Questionnaire for Eating Disorder Diagnoses, and an author-constructed supplemental and demographic questionnaire.

ANALYSIS

Analyses of covariance and ordinal regression measured group differences. Structural equation modeling examined mediation effects. Results . Significant differences between groups were observed for body appreciation (F1,121 = 40.17, p = .000, partial eta squared = .25), intuitive eating (F1,121 = 67.44, p = .000, partial eta squared = .36), and mindfulness (F1,121 = 30.50, p = .000, partial eta squared = .20), with mean scores significantly higher in the intervention group than waitlist comparison group after 10 weeks. The intervention group was 3.65 times more likely to be asymptomatic for disordered eating than the comparison group. Mindfulness served as a partial mediator.

CONCLUSION

The study provides support for an intervention combining intuitive eating and mindfulness for treatment of problematic eating behaviors and body dissatisfaction, with limitations including self-selection and lack of active control group.

Effect of BMI and binge eating on food reward and energy intake: further evidence for a binge eating subtype of obesity

BACKGROUND

The psychological characteristics of binge eating have been proposed as a phenotype to further understanding of overconsumption and susceptibility to obesity. This study examined the influence of trait binge eating in lean and overweight or obese women on appetite, food reward and energy intake.

METHODS

25 lean and 25 overweight or obese women were categorised as either 'binge type' or 'non-binge type' based on their scores on the Binge Eating Scale. Food reward and food intake were assessed in fasted and fed conditions.

RESULTS

Overweight or obese binge types (O-B) consumed more energy than overweight or obese non-binge types (O-NB) and lean binge (L-B) and non-binge types (L-NB). Both L-B and O-B exhibited greater preference for sweet foods. In O-NB, L-B and L-NB, lower liking and wanting for sweet foods was exhibited in the fed condition compared to the fasted condition. However, in O-B wanting for sweet foods was greater when they were fed compared to when they were in a fasted state.

CONCLUSIONS

These findings provide further support for trait binge eating as a hedonic subtype of obesity. Binge types were characterised by greater intake of high-fat sweet foods and increased wanting for these foods when satiated. Additionally, these findings highlight the potential for separation in liking and wanting for food as a marker of susceptibility to overeat.

The moderating role of negative urgency on the prospective association between dietary restraint and binge eating

It is well documented that negative urgency, a personality trait characterized by a tendency to act impulsively in the face of negative emotions, and dietary restraint independently increase risk to binge eat; however, it is unclear how these factors interact to alter risk for such behavior. It may be that individuals high on negative urgency, who also engage in dietary restraint, are at a greater risk to binge eat than individuals low on negative urgency. Accordingly, we sought to investigate whether negative urgency moderated the prospective association between dietary restraint and binge eating frequency among a sample of college women. We hypothesized that women who engaged in dietary restraint would report higher binge eating frequencies across the first semester of college and that this effect would be strengthened among individuals higher on negative urgency. Results indicated that negative urgency moderated the prospective association between dietary restraint and binge eating frequency. This effect was found to be "protective but reactive," such that low levels of dietary restraint protected against binge eating frequency at low to moderate levels of negative urgency, but this buffering effect was lost at high levels of negative urgency where binge eating frequency was equal across all levels of dietary restraint. These findings demonstrate that negative urgency and dietary restraint interact to differentially alter risk for binge eating frequency, and individuals high on negative urgency are at the greatest risk to engage in more frequent binge eating regardless of level of dietary restraint.

Exploration of "food addiction" in overweight and obese treatment-seeking adults

There is growing interest in conceptualizing obesity as a "food addiction." The current study investigated the prevalence and correlates of "food addiction" (FA), as defined by the Yale Food Addiction Scale (YFAS) in 178 (133 F, 45M) persons seeking weight loss treatment. Participants had a mean age of 51.2±11.7years and a body mass index of 36.1±4.8kg/m(2). Fifteen percent of individuals met the YFAS proposed diagnostic criteria for FA. Those who met criteria for FA reported significantly greater depressive symptomatology. There were no differences in BMI, age, race, or gender between participants with and without FA. Among those not meeting criteria, 35% reported 3 or more symptoms in the absence of self-reported clinical distress or impairment. YFAS symptom count was also significantly correlated with depressive symptoms. These findings suggest that 15% of adults presenting for weight loss treatment meet YFAS criteria for FA. The clinical significance of this classification is unknown and needs to be validated in prospective studies.

Sex differences in the physiology of eating

Hypothalamic-pituitary-gonadal (HPG) axis function fundamentally affects the physiology of eating. We review sex differences in the physiological and pathophysiological controls of amounts eaten in rats, mice, monkeys, and humans. These controls result from interactions among genetic effects, organizational effects of reproductive hormones (i.e., permanent early developmental effects), and activational effects of these hormones (i.e., effects dependent on hormone levels). Male-female sex differences in the physiology of eating involve both organizational and activational effects of androgens and estrogens. An activational effect of estrogens decreases eating 1) during the periovulatory period of the ovarian cycle in rats, mice, monkeys, and women and 2) tonically between puberty and reproductive senescence or ovariectomy in rats and monkeys, sometimes in mice, and possibly in women. Estrogens acting on estrogen receptor-α (ERα) in the caudal medial nucleus of the solitary tract appear to mediate these effects in rats. Androgens, prolactin, and other reproductive hormones also affect eating in rats. Sex differences in eating are mediated by alterations in orosensory capacity and hedonics, gastric mechanoreception, ghrelin, CCK, glucagon-like peptide-1 (GLP-1), glucagon, insulin, amylin, apolipoprotein A-IV, fatty-acid oxidation, and leptin. The control of eating by central neurochemical signaling via serotonin, MSH, neuropeptide Y, Agouti-related peptide (AgRP), melanin-concentrating hormone, and dopamine is modulated by HPG function. Finally, sex differences in the physiology of eating may contribute to human obesity, anorexia nervosa, and binge eating. The variety and physiological importance of what has been learned so far warrant intensifying basic, translational, and clinical research on sex differences in eating.

Early Life Loss and Trauma

The onset of an eating disorder in middle-age men is poorly researched as are eating disorders in men generally. Therefore, life events that influence eating disorders in men, including delayed onset of an eating disorder remains unknown. Given the limited understanding of males with eating disorders and limited access to large samples of men with eating disorders, an in-depth analysis of a single case of a male in middle age with an eating disorder was chosen to gain insight and understanding into this phenomenon. A Life History approach explored the case of Joseph (pseudonym), who was diagnosed at age 44 years with an Eating Disorder Not Otherwise Specified. Data were collected through (a) life course open-ended questioning through interviews, (b) written statements, and (c) comments on transcripts. Three themes emerged, loss and unworthiness, becoming bigger, and wanting to change reflecting eating behaviors associated with attachment disruption, loss and trauma, body dissatisfaction, and negative affect. Later in life, an emotional “tipping point” precipitated an eating disorder. Results indicate traumatic loss leading to early attachment disruption as influential in Joseph’s delayed onset of an eating disorder. The value of thorough narrative life histories during therapy when eating disorders occur late in life is discussed as well as the significance for men.

Body talk among college men: content, correlates, and effects

Though researchers are beginning to examine body-related talk in women (often referred to as fat talk), little work has examined how men talk about their bodies with peers. The two studies presented in this article explore body talk among U.S. college men. First, an online survey examined the frequency with which college men engage in negative body talk, the content of these conversations, and the body image variables associated with engaging in this type of talk. Negative body talk in men was associated with drive for muscularity, eating disordered behavior, and appearance investment. Study 2 experimentally examined the effects of hearing male peers engage in negative body talk. Hearing muscle talk or fat talk caused decreased state appearance self-esteem and increased state body dissatisfaction. The correlates and consequences of negative body talk among men appear no less troubling than those identified among women.

Prevalence of adolescents' self-weighing behaviors and associations with weight-related behaviors and psychological well-being

PURPOSE

To examine the relationships between self-weighing frequency, and weight-related behaviors and psychological well-being in a population-based sample of adolescents.

METHODS

This study compared weight-related behaviors between infrequent and frequent self-weighers, stratified by weight status and gender. Data were from Project EAT 2010 (Eating and Activity in Teens), a population-based study of 2,778 adolescents.

RESULTS

Approximately 14% of girls and boys weighed themselves frequently (weekly or more). In comparison to girls who were infrequent self-weighers, girls who were frequent self-weighers were more likely to diet, engage in unhealthy and extreme weight control behaviors, use unhealthy muscle-enhancing behaviors, and have lower self-esteem and greater body dissatisfaction. In comparison to boys who were infrequent self-weighers, boys who were frequent self-weighers were more likely to diet, engage in unhealthy and extreme weight control behaviors, use unhealthy muscle-enhancing behaviors, and report greater depressive symptoms. Among overweight adolescents, in addition to being associated with these harmful outcomes, frequent self-weighing was associated with the use of healthy weight control behaviors and with higher levels of moderate-to-vigorous activity.

CONCLUSIONS

Findings indicate that adolescents who frequently self-weigh themselves are at increased risk for a number of problematic health behaviors and poorer psychological outcomes. For overweight adolescents, frequent self-weighing was additionally associated with a number of positive outcomes. Based upon these findings, any recommendations for weight monitoring should be made cautiously; all adolescents, including overweight adolescents, should be advised not to engage in frequent self-weighing behaviors. Furthermore, any adolescents engaging in frequent self-weighing behaviors should be monitored for problematic outcomes.