Predictors of disordered eating and acceptance of cosmetic surgery among drag queen performers

Eating Disorders and Aesthetic Plastic Surgery: A Systematic Review of the Literature

INTRODUCTION

Eating disorders (ED) and plastic surgery are two areas of healthcare that have gained significant attention in recent years. The goal of this review is to provide an overview of the existing literature concerning the interplay between ED and aesthetic surgery, identifying existing questionnaires and providing suggestions for the future research on the psychological aspects of these group of patients.

METHODS

We conducted a systematic review on PubMed. We included studies that examined the type of ED, surgical procedure, outcome measures used, patients' motivations as well as physical and psychological outcomes of individuals with ED seeking or undergoing aesthetic surgery. Three independent reviewers examined each potential study.

RESULTS

Eleven studies met the inclusion criteria. These studies involved 5510 patients, addressing a spectrum of ED such as Anorexia nervosa, Bulimia nervosa, and Binge eating. The primary focus was on body contouring procedures like liposuction, breast surgery, and abdominoplasty. The assessment tools employed in these studies for evaluating ED included the Eating Attitude Test (EAT), Eating Disorder Inventory (EDI), Eating Disturbance Scale (EDS), Sociocultural Attitudes Toward Appearance Questionnaire-Eating Disorder (SATAQ-ED), and the Eating Disorder Examination Questionnaire.

CONCLUSIONS

There is a complex interplay between ED and aesthetic surgery, underscoring the significance of comprehending and dealing with the psychological and sociocultural factors that impact patients in this context. The optimal management for these patients and the most effective tool for plastic surgeons to assess their psychological condition remain unclear. It is, therefore, crucial to standardize the evaluation and approach to this patient subgroup, closely aligned with psychological support, to achieve the best outcomes.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A scoping review of the research literature on eating and body image for transgender and nonbinary adults

BACKGROUND

Eating disorder treatment approaches and outcome studies have historically centered almost exclusively on cisgender populations. Transgender and nonbinary (TGNB) adults are underrepresented in general and intervention research despite being at increased risk for eating and body image-related problems.

AIMS

This scoping review was designed to gather and examine the research with TGNB adults who experience eating and body image related problems, as well as clinical studies on the effectiveness of treatment approaches.

METHOD

Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used for reporting this review. MEDLINE and PsychInfo were used as electronic databases for searching subject terms. Inclusion criteria for studies required the quantitative measurement or qualitative exploration of body image or eating for TGNB adults. The relevant data were extracted and summarized based on quantitative findings and qualitative themes.

RESULTS

After review of over 1258 articles, 59 studies met criteria and data were extracted and summarized. Factors associated with eating disorders and body image problems across studies suggests gender-affirming medical interventions are effective and emphasized treatment for an eating disorder is warranted alongside gender affirming medical care. Body image was associated with eating patterns aimed at meeting gendered ideals of body shape and size. There was variation in guiding theories and absence of consensus in the definition of transgender in the review studies. This likely demonstrates the changing language, social acceptance of TGNB people and identities, diagnostic criteria, and clinical conceptualizations of eating and body image.

CONCLUSIONS

Future research should consider the use of theory for guiding inclusion of salient social factors influencing eating patterns, body image, and treatment outcomes. In addition, future research is needed that centers on nonbinary and genderqueer populations, as well as those from minoritized racial and ethnic groups to inform culturally appropriate concerns, needs, and treatment modalities.