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Rienecke RD, Mehler PS, Duffy A, Le Grange D, Blalock DV. A brief examination of treatment outcomes in higher levels of care for individuals with eating disorders across age groups. EUROPEAN EATING DISORDERS REVIEW 2024; 32:431-439. [PMID: 38013216 DOI: 10.1002/erv.3054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Although eating disorders (EDs) occur throughout the lifespan, little research has been conducted with midlife/older adults, particularly those in higher levels of care (HLOC). The current study examined outcomes among 2009 patients with EDs receiving HLOC treatment at a large multisite facility between January 2020 and June 2022, across different age groups (ages <18, 18-25, 26-39 and ≥40). It was hypothesised that patients aged 40+ would exhibit less improvement on measures of ED psychopathology and depression than other age groups. METHOD Participants completed the eating disorder examination-questionnaire (EDE-Q) and the patient health questionnaire-9 (PHQ-9) at admission and discharge. RESULTS Changes for all outcomes from admission to discharge were statistically significant at p < 0.001 across all age groups. Changes in the EDE-Q Restraint subscale were significantly less in patients ages 26-39 than in patients ages 18-25 (p < 0.01). Changes in PHQ-9 were significantly greater in patients ages 40+ than patients ages 18-25 (p = 0.03). CONCLUSIONS Contrary to hypotheses, patients ages 40+ did not show worse outcomes than younger patients, and showed greater improvements in depression than young adults. The therapeutic needs of midlife/older adults with EDs may be favourably met by a HLOC regimen as described in this study.
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Affiliation(s)
- Renee D Rienecke
- Eating Recovery Center and Pathlight Mood and Anxiety Centers, Denver, Colorado, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Philip S Mehler
- Eating Recovery Center and Pathlight Mood and Anxiety Centers, Denver, Colorado, USA
- ACUTE at Denver Health, Denver, Colorado, USA
- Department of Medicine, University of Colorado, Denver, Colorado, USA
| | - Alan Duffy
- Eating Recovery Center and Pathlight Mood and Anxiety Centers, Denver, Colorado, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
| | - Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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de Oliveira J. The role of body image in lipedema. Maturitas 2024; 182:107884. [PMID: 37989642 DOI: 10.1016/j.maturitas.2023.107884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
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Does Age Impact the Clinical Presentation of Adult Women Seeking Specialty Eating Disorder Treatment? J Nerv Ment Dis 2020; 208:742-745. [PMID: 32868689 DOI: 10.1097/nmd.0000000000001160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent evidence suggests that eating disorders (EDs) are becoming increasingly common in older women. Previous research examining differences between younger and older women with EDs has been mixed, making it unclear whether older women with EDs represent a distinct group. We sought to determine whether there are age differences in the clinical presentation of women seeking specialty treatment for an ED. We examined the linear relationship between age and clinical constructs among adult women (N = 436) diagnosed with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, ED. Across analyses, there was no impact of age on most measures of ED symptoms, comorbid psychopathology, self-esteem, quality of life, and motivation to change. However, older age was associated with fewer interoceptive awareness difficulties, maturity fears, anxiety symptoms, and body image concerns. These findings suggest that the clinical presentation of older ED cases is largely similar, although somewhat less severe than in younger women. The implications of this research for future research and treatment are discussed.
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Mandelli L, Arminio A, Atti AR, De Ronchi D. Suicide attempts in eating disorder subtypes: a meta-analysis of the literature employing DSM-IV, DSM-5, or ICD-10 diagnostic criteria. Psychol Med 2019; 49:1237-1249. [PMID: 30488811 DOI: 10.1017/s0033291718003549] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Quantification of suicidal risk in specific populations is important for the adoption of targeted prevention and harm reduction measures. Though there remains little systematic evidence, risk of suicide attempts for bulimia nervosa (BN) and binge-purging anorexia nervosa (AN-bp) appears higher than restrictive AN (AN-r); risk in binge eating disorder (BED) is still unclear. The aim of this meta-analysis was to compare proportions of suicide attempts in eating disorder (ED) subgroups. METHODS A literature search using combinations of key-words for ED and suicide attempts was performed. Studies reporting proportions of suicide attempters in at least two ED groups, diagnosed according to DSM-IV or -5 and ICD-10 diagnostic criteria were considered. ED subgroups were analyzed in pairs using a binary random effect model for proportions. Publication bias, meta-regression, and sensitivity analyses were performed. RESULTS In BN, attempted suicide was more frequent (21%) than in AN (12.5%), but the difference was statistically significant only when BN was compared with AN-r (9-10%). In BED, the proportion of suicide attempts was as high as in AN (10-12%). CONCLUSIONS Though limited by heterogeneity across the studies in terms of methodology and aims, inability to control for relevant confounding variables, exclusion of ED not otherwise specified, this study supports suicide attempts as a major issue in EDs, especially in binge-purging subtypes, i.e. BN and AN-bp. Similar suicidal proportions were observed in AN and BED. The reasons for a greater proportion of attempted suicide in binge/purging subtypes need to be explored in future studies.
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Affiliation(s)
- Laura Mandelli
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - Angelo Arminio
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - Anna-Rita Atti
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
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Abstract
OBJECTIVE The incidence of cases of older onset anorexia nervosa (AN) has increased in recent years. However, the literature on late-onset AN has been inconclusive. The goal of this study was to compare late-onset with early-onset cases of AN. METHODS Cases of AN presenting to an eating disorders treatment service were identified and the associated medical records were studied retrospectively. RESULTS Of the 577 cases of AN that were studied, 7.1% were late-onset. Unlike the early-onset cases of AN, the late-onset cases reported less teasing and more relationship problems as a trigger for the illness. They were also less likely to join the eating disorders treatment program. Otherwise, the late-onset AN cases were largely similar to the early-onset cases. CONCLUSIONS Although differences exist between early-onset and late-onset cases of AN, these are few. Until stronger evidence emerges over time, there currently seems to be minimal justification to accord late-onset AN a unique position in psychiatric nosology.
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Valente S, Di Girolamo G, Forlani M, Biondini A, Scudellari P, De Ronchi D, Atti AR. Sex-specific issues in eating disorders: a clinical and psychopathological investigation. Eat Weight Disord 2017; 22:707-715. [PMID: 28853004 DOI: 10.1007/s40519-017-0432-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/14/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To highlight the characteristics of eating disorders (ED) in males, with particular attention to sex-related clinical features and psychiatric co-morbidities. METHOD Out of 280 persons, referred to our outpatients ED clinic between January 2011 and June 2014, 267 with complete information were included in this retrospective observational study. RESULTS The men/women ratio was one to five (male 16.5% vs female 83.5%) with an increasing proportion of male patients over the years. The most frequent ED in males was binge eating disorder, whereas in females anorexia nervosa and bulimia nervosa prevailed. Excessive exercising and fasting were the most common compensation behaviours in males; while self-induced vomiting and laxative-diuretic abuse were more typical in females. Among women, the most represented psychiatric co-morbidities were mood and somatoform disorders, whereas among men, anxiety and psychosis spectrum disorders were the most frequent ones. Borderline and histrionic personality disorders were prevalent in female ED, while narcissistic and antisocial personality disorders prevailed in males. DISCUSSION ED in men is a growing phenomenon. Male ED, compared to female ED, show differences in clinical presentation, symptoms and co-morbidities. Despite the use of clinical and psychometric evaluating tools targeting female patients, sex differences do exist and additional studies are required to investigate male specific issues in ED. Level of Evidence Level V, cross-sectional descriptive study.
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Affiliation(s)
- Stefano Valente
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy.
| | - Giulia Di Girolamo
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Martina Forlani
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Anna Biondini
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Paolo Scudellari
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Diana De Ronchi
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Anna Rita Atti
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
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Shian Ming T, Kah Foo VK, Zainal KA, Hui Yen L. Late- vs. early-onset anorexia nervosa in Asia: Nosological, aetiological, and therapeutic implications. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2017. [DOI: 10.1080/00207411.2017.1308294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Molendijk ML, Hoek HW, Brewerton TD, Elzinga BM. Childhood maltreatment and eating disorder pathology: a systematic review and dose-response meta-analysis. Psychol Med 2017; 47:1402-1416. [PMID: 28100288 DOI: 10.1017/s0033291716003561] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Meta-analyses have established a high prevalence of childhood maltreatment (CM) in patients with eating disorders (EDs) relative to the general population. Whether the prevalence of CM in EDs is also high relative to that in other mental disorders has not yet been established through meta-analyses nor to what extent CM affects defining features of EDs, such as number of binge/purge episodes or age at onset. Our aim is to provide meta-analyses on the associations between exposure to CM (i.e. emotional, physical and sexual abuse) on the occurrence of all types of EDs and its defining features. METHOD Systematic review and meta-analyses. Databases were searched until 4 June 2016. RESULTS CM prevalence was high in each type of ED (total N = 13 059, prevalence rates 21-59%) relative to healthy (N = 15 092, prevalence rates 1-35%) and psychiatric (N = 7736, prevalence rates 5-46%) control groups. ED patients reporting CM were more likely to be diagnosed with a co-morbid psychiatric disorder [odds ratios (ORs) range 1.41-2.46, p < 0.05] and to be suicidal (OR 2.07, p < 0.001) relative to ED subjects who were not exposed to CM. ED subjects exposed to CM also reported an earlier age at ED onset [effect size (Hedges' g) = -0.32, p < 0.05], to suffer a more severe form of the illness (g = 0.29, p < 0.05), and to binge-purge (g = 0.31, p < 0.001) more often compared to ED patients who did not report any CM. CONCLUSION CM, regardless of type, is associated with the presence of all types of ED and with severity parameters that characterize these illnesses in a dose dependent manner.
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Affiliation(s)
- M L Molendijk
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
- Department of Epidemiology, Columbia University, New York, USA
| | - T D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - B M Elzinga
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
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Madowitz J, Matheson BE, Liang J. The relationship between eating disorders and sexual trauma. Eat Weight Disord 2015; 20:281-93. [PMID: 25976911 DOI: 10.1007/s40519-015-0195-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/29/2015] [Indexed: 01/01/2023] Open
Abstract
Research aimed at understanding the causes and comorbidities of eating disorders (ED) identifies sexual trauma as one potential pathway to the development and maintenance of eating disorders. Based on current literature, there are two main etiological pathways between sexual trauma and ED-body perceptions and psychological difficulties. However, previously published reviews on this topic are outdated and have not yielded consistent findings. Therefore, authors completed a literature review covering years 2004-2014 to examine the relationship between sexual trauma and ED according to both proposed pathway models. Authors utilized PubMed, GoogleScholar, and PsychINFO as search engines. Search terms included "sexual assault", "sexual abuse", "sexual trauma", and "rape" in conjunction with relevant ED terminology. Thirty-two studies met inclusion criteria for this review. Current data indicate an increased prevalence of sexual trauma for individuals with ED. Although limited, recent evidence suggests that sexual trauma precedes and contributes to the development of ED. Existing literature indicates that the body perceptions pathway may impact ED through body dissatisfaction, shame, sexual dysfunction, and fear of future sexual trauma. The psychological difficulties pathway indicates a link between ED and the desire to cope with the failure of the average expected environment, psychological diagnoses, the need for control, and the regulation of emotions. However, further research is needed to assess the potential causal role that sexual trauma may play in the etiology of ED.
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Affiliation(s)
- Jennifer Madowitz
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University / University of California, San Diego, California, USA,
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Luca A, Luca M, Calandra2 C. Eating Disorders in Late-life. Aging Dis 2015; 6:48-55. [PMID: 25657852 PMCID: PMC4306473 DOI: 10.14336/ad.2014.0124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 12/16/2022] Open
Abstract
Eating disorders are a heterogeneous group of complex psychiatric disorders characterized by abnormal eating behaviours that lead to a high rate of morbidity, or even death, if underestimated and untreated. The main disorders enlisted in the chapter of the Diagnostic and Statistic Manual of Mental Disorders-5 dedicated to "Feeding and Eating Disorders" are: anorexia nervosa, bulimia nervosa and binge eating disorder. Even though these abnormal behaviours are mostly diagnosed during childhood, interesting cases of late-life eating disorders have been reported in literature. In this review, these eating disorders are discussed, with particular attention to the diagnosis and management of those cases occurring in late-life.
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Affiliation(s)
- Antonina Luca
- Department “G.F. Ingrassia” Section of Neuroscience, University of Catania (Sicily), Italy
| | - Maria Luca
- Department of Medical and Surgery Specialties, Psychiatry Unit of the University Hospital “Policlinico-Vittorio Emanuele” of Catania (Sicily), Italy. Via S. Sofia 78, 95100 Catania
| | - Carmela Calandra2
- Department of Medical and Surgery Specialties, Psychiatry Unit of the University Hospital “Policlinico-Vittorio Emanuele” of Catania (Sicily), Italy. Via S. Sofia 78, 95100 Catania
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Drobnjak S, Atsiz S, Ditzen B, Tuschen-Caffier B, Ehlert U. Restrained eating and self-esteem in premenopausal and postmenopausal women. J Eat Disord 2014; 2:23. [PMID: 25349697 PMCID: PMC4209048 DOI: 10.1186/s40337-014-0023-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 08/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been limited research about disordered eating in middle-aged women, and to date, few data exist about restrained eating behavior in postmenopausal women. Therefore, the aim of this study was to examine eating behavior with a specific focus on menopause as an associated factor in restrained eating. Beyond this, we were interested in how postmenopausal status and self-esteem would interact to determine eating patterns in women in middle age. METHODS We conducted an online survey in women aged between 40 and 66. Eating behavior was assessed with the Eating Disorder Examination-Questionnaire (EDE-Q) in premenopausal (N = 318) and postmenopausal women (N = 250). All participants rated their self-esteem using the Rosenberg Self-Esteem Scale (RSE) and reported their weight, height, waist circumference, and hip circumference. RESULTS 15.7% of all participants showed clinically meaningful scores on restrained eating. Postmenopausal women showed significantly higher scores on the EDE-Q subscale of restrained eating as compared to premenopausal women, but when controlling for body mass index, however, this finding was no longer significant. Further exploratory analyses suggest that particularly low or high self-esteem levels are associated with restrained eating. Self-esteem might serve as a mediator between menopausal status and restrained eating, however results of these additional analyses were inconsistent. CONCLUSIONS Restrained eating may appear in middle-aged women. Particularly in postmenopausal women, restrained eating might be associated with lower and higher self-esteem.
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Affiliation(s)
- Suzana Drobnjak
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland
| | - Semra Atsiz
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland
| | - Beate Ditzen
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland ; Institute of Medical Psychology in the Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, Heidelberg, 69115 Germany
| | - Brunna Tuschen-Caffier
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, Albert-Ludwigs University, Engelbergerstrasse 41, Freiburg, 79106 Germany
| | - Ulrike Ehlert
- Department of Psychology, Division of Clinical Psychology & Psychotherapy, University of Zurich, Binzmuehlestrasse 14/26, Zurich, 8050 Switzerland
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Disordered eating behaviors in adolescents and adults living in the same household in metropolitan area of Rio de Janeiro, Brazil. Psychiatry Res 2013; 210:612-7. [PMID: 23838420 DOI: 10.1016/j.psychres.2013.06.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 06/07/2013] [Accepted: 06/15/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the prevalence of disordered eating behaviors among adolescents and adults living in the same household. METHODS We conducted a population-based cross-sectional study developed with a probabilistic sample of 511 adolescents and 1254 adults living in the metropolitan area of Rio de Janeiro, Brazil. The frequency of binge eating, purging, and strict dieting or fasting over the previous 6 months was ascertained using a self-report questionnaire. RESULTS Binge eating (20.0% vs. 8.4%), strict dieting or fasting (18.9% vs. 2.4%), and purging (3.3% vs. 2.2%) were more frequent among adolescents than adults. There was a significant association between frequency of binge eating and strict dieting or fasting in adults and in adolescents living in the same household. CONCLUSION The presence of disordered eating behaviors in adults may be a risk factor for the development of eating disorders in adolescents living in the same household. Thus, the development and implementation of eating disorder interventions should consider incorporating a family component.
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Bueno B, Krug I, Bulik CM, Jiménez-Murcia S, Granero R, Thornton L, Penelo E, Menchón JM, Sánchez I, Tinahones FJ, Fernández-Aranda F. Late onset eating disorders in Spain: clinical characteristics and therapeutic implications. J Clin Psychol 2013; 70:1-17. [PMID: 23801539 DOI: 10.1002/jclp.22006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The literature on later age of onset (LAO) in women with eating disorders is scarce. We compared the severity of eating disorders, eating disorder subtype, and personality profiles in a clinical sample of consecutively assessed women with eating disorders with later age of onset (LAO, > = 25 years) to women with typical age of onset (TAO, <25 years). METHOD All eating disorder patients met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria and were admitted to the Eating Disorder Unit of the University Hospital of Bellvitge in Barcelona, Spain. Ninety-six patients were classified as LAO and 759 as TAO. ASSESSMENT Measures included the Eating Attitude Test-40 (EAT-40), Eating Disorders Inventory-2 (EDI-2), Bulimic Investigatory Test Edinburgh (BITE), Symptom Checklist Revised (SCL-90-R), and the Temperament and Character Inventory-Revised (TCI-R), as well as other clinical and psychopathological indices. RESULTS LAO individuals reported significantly fewer weekly vomiting episodes, fewer self-harming behaviours, less drug abuse, and lower scores on the BITE symptoms, the EDI-2 drive for thinness, and the TCI-R harm avoidance scales than TAO individuals. Conversely, the LAO group reported more current and premorbid obesity than the TAO group. CONCLUSION LAO eating disorder patients in this sample presented with milder symptomatology and less extreme personality traits. Premorbid obesity may be more relevant to LAO than TAO eating disorders and should be routinely assessed and considered when planning treatment.
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Affiliation(s)
- B Bueno
- Department of Psychiatry, University Hospital of Bellvitge; CIBER Salud Mental (CIBERSAM), ISCIII
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Gagne DA, Von Holle A, Brownley KA, Runfola CD, Hofmeier S, Branch KE, Bulik CM. Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: results of the Gender and Body Image (GABI) study. Int J Eat Disord 2012; 45:832-44. [PMID: 22729743 PMCID: PMC3459309 DOI: 10.1002/eat.22030] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Limited research exists on eating disorder symptoms and attitudes and weight and shape concerns in women in midlife to older adulthood. We conducted an online survey to characterize these behaviors and concerns in women ages 50 and above. METHOD Participants (n = 1,849) were recruited via the Internet and convenience sampling. RESULTS Eating disorder symptoms, dieting and body checking behaviors, and weight and shape concerns were widely endorsed. Younger age and higher body mass index (BMI) were associated with greater endorsement of eating disorder symptoms, behaviors, and concerns. DISCUSSION Weight and shape concerns and disordered eating behaviors occur in women over 50 and vary by age and BMI. Focused research on disordered eating patterns in this age group is necessary to develop age-appropriate interventions and to meet the developmental needs of an important, growing, and underserved population.
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Affiliation(s)
- Danielle A. Gagne
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | | | | | - Sara Hofmeier
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | | | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, Department of Nutrition, University of North Carolina, Chapel Hill, NC
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Slevec J, Tiggemann M. Media Exposure, Body Dissatisfaction, and Disordered Eating in Middle-aged Women. PSYCHOLOGY OF WOMEN QUARTERLY 2011. [DOI: 10.1177/0361684311420249] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The primary aim of our study was to examine the influence of media exposure on body dissatisfaction and disordered eating in middle-aged women. A sample of 101 women, aged between 35 and 55 years, completed questionnaire measures of media exposure, thin-ideal internalization, social comparison, appearance investment, aging anxiety, body dissatisfaction, and disordered eating. Television, but not magazine exposure, was positively related to body dissatisfaction and disordered eating. In contrast, both television and magazine exposure were positive correlates of all four proposed media-processing variables (internalization, social comparison, appearance investment, and aging anxiety), which were themselves positive correlates of both body dissatisfaction and disordered eating. Structural equation modelling revealed that the influence of media exposure was fully mediated by the proposed media processes. The analyses also indicated that our proposed sociocultural model of disordered eating provided a reasonably good fit to the data, suggesting that sociocultural theory can be extended to women of middle-age. An important practical implication of this finding is that strategies aimed at challenging and minimizing these media processes may reduce some of the negative impact of media exposure in middle-aged women.
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Affiliation(s)
- Julie Slevec
- Department of Psychology, Flinders University, Adelaide, SA, Australia
| | - Marika Tiggemann
- Department of Psychology, Flinders University, Adelaide, SA, Australia
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Predictors of body dissatisfaction and disordered eating in middle-aged women. Clin Psychol Rev 2011; 31:515-24. [DOI: 10.1016/j.cpr.2010.12.002] [Citation(s) in RCA: 155] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2010] [Revised: 11/23/2010] [Accepted: 12/08/2010] [Indexed: 11/19/2022]
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Long CG, Fitzgerald KA, Hollin CR. Treatment of chronic anorexia nervosa: a 4-year follow-up of adult patients treated in an acute inpatient setting. Clin Psychol Psychother 2011; 19:1-13. [DOI: 10.1002/cpp.738] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gratacòs M, Escaramís G, Bustamante M, Saus E, Agüera Z, Bayés M, Cellini E, de Cid R, Fernández-Aranda F, Forcano L, González JR, Gorwood P, Hebebrand J, Hinney A, Mercader JM, Nacmias B, Ramoz N, Ribasés M, Ricca V, Romo L, Sorbi S, Versini A, Estivill X. Role of the neurotrophin network in eating disorders' subphenotypes: body mass index and age at onset of the disease. J Psychiatr Res 2010; 44:834-40. [PMID: 20219210 DOI: 10.1016/j.jpsychires.2010.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 01/15/2010] [Accepted: 01/25/2010] [Indexed: 01/06/2023]
Abstract
Eating disorders (ED) are severe psychiatric diseases that most likely result from, and are sustained by socio-cultural, psychological and biological factors. We explored whether members of the neurotrophin family are disease-modifying factors of quantitative traits, potentially contributing to the outcome or prognosis of the disease. We studied lifetime minimum and maximum body mass index (minBMI and maxBMI) and age at onset of the disease in a sample of 991 ED patients from France, Germany, Italy and Spain and analysed 183 genetic variants located in 10 candidate genes encoding different neurotrophins and their receptors. We used a hierarchical model approach to include prior genetic knowledge of the specific and found that variants in CNTF, in its receptor CNTFR, and in NTRK2 were significantly associated with a lower age at onset of the ED. In addition, one variant in NTRK1 was associated with a higher minBMI. The results suggest that for these two subphenotypes, CNTF, CNTFR, NTRK1 and NTRK2 might act as disease-modifying factors and add preliminary evidence to the global hypothesis that EDs are the result of complex interactions and reciprocal controls between the immune, endocrine and central nervous systems.
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Affiliation(s)
- Mònica Gratacòs
- CIBER en Epidemiología y Salud Pública (CIBERESP), Genes and Disease Program, Center for Genomic Regulation (CRG-UPF), Barcelona, Catalonia, Spain
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