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Naumann E, Svaldi J. Effects of exposure to plus-size fashion models on weight-related attitudes in bulimia nervosa: Findings from an exploratory study. J Behav Ther Exp Psychiatry 2024; 85:101976. [PMID: 38955021 DOI: 10.1016/j.jbtep.2024.101976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/20/2024] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND AND OBJECTIVES Eating disorders are often linked to the internalization of the thin-ideal and weight stigma. The present exploratory study investigates the effects of plus-sized fashion media on weight-related attitudes in bulimia nervosa (BN). METHODS Women with BN (n=27) and without an eating disorder (n=28) were exposed to 17 pictures of plus-size fashion models. Participants rated the attractiveness of the models. Before and after the exposure task, participants completed questionnaires on their attitudes towards people with higher weight as well as thin-ideal media. RESULTS The BN group rated the bodies of the plus-size fashion models as less attractive than controls, whereas no group differences were found in attractiveness ratings for the models' faces or full images. In both groups, negative attitudes about people with higher weight significantly decreased after viewing plus-size model pictures. Attitudes toward thin-ideal media remained unchanged, with scores higher for BN than controls. LIMITATIONS This exploratory study has several limitations, such as the lack of a control condition, small sample size, and reliance on only self-report data. CONCLUSIONS These exploratory results imply that the positive effects of plus-sized model images on reducing negative assumptions about people with high weight may not be limited to healthy individuals but also seem to extend to women with BN. Further controlled studies with larger samples and long-term assessments are needed to confirm these findings.
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Affiliation(s)
- Eva Naumann
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Schleichstraße 4, 72076, Tuebingen, Germany.
| | - Jennifer Svaldi
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Schleichstraße 4, 72076, Tuebingen, Germany.
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2
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Srivastava P, Giannone A, Lampe EW, Clancy OM, Fitzpatrick B, Juarascio AS, Manasse SM. A naturalistic examination of feeling fat: Characteristics, predictors, and the relationship with eating disorder behaviors. Int J Eat Disord 2024. [PMID: 38829201 DOI: 10.1002/eat.24232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE Although literature implicates feeling fat in the maintenance of binge-spectrum eating disorders (EDs; e.g., bulimia nervosa, binge-ED), research in this area is small, nascent, and relies on retrospective self-report. The current study sought to understand the temporal pattern of feeling fat and its role as a precipitant and consequence of ED behaviors. METHODS Totally 106 treatment-seeking adults with binge-spectrum EDs completed 7-14-day ecological momentary assessments. They rated feeling fat, negative affect states, and reported on ED behaviors six times per day. Multilevel models evaluated whether feeling fat mediates prospective links between negative affect states and ED behaviors, assessed if negative affect states mediate the prospective association of feeling fat on ED behaviors, and examined the bidirectional prospective association between feeling fat and ED behaviors. RESULTS Feeling fat was highest in the early morning (6-8:59 a.m.). Individuals with binge-ED-spectrum EDs demonstrated greater variability in feeling fat than those with bulimia nervosa-spectrum EDs who had stable and high levels of feeling fat. Guilt, sadness, anxiety, and the overall NA at Time 2 mediated the prospective associations between at Time 1 feeling fat and Time 3 dietary restraint, actual dietary restriction, and compensatory exercise. There was a bidirectional prospective association between feeling fat and binge eating. DISCUSSION Feeling fat serves as a proximal predictor and mediator of the prospective association between guilt and binge eating. Feeling fat and binge eating mutually reinforce each other. PUBLIC SIGNIFICANCE Little is understood regarding the experience of feeling fat in natural environments among individuals with binge-spectrum eating disorders. We found that the risk for having the experience of feeling fat is high in the morning and evening. Feeling fat triggers guilt, anxiety, and sadness which in turn, increases engagement in dietary restraint/restriction and compensatory exercise. Feeling fat also triggers binge eating, and binge eating leads to feelings of fatness.
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Affiliation(s)
- Paakhi Srivastava
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Alyssa Giannone
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Elizabeth W Lampe
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Olivia M Clancy
- Department of Psychology, Auburn University, Auburn, Alabama, USA
| | - Brighid Fitzpatrick
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
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3
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Dunford A, Ivezaj V, Grilo CM. Shape discrepancy, weight bias internalization, and eating-disorder psychopathology in patients with loss-of-control eating after bariatric surgery. Surg Obes Relat Dis 2024; 20:291-296. [PMID: 37926627 PMCID: PMC10922050 DOI: 10.1016/j.soard.2023.09.028] [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: 04/24/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Postoperative loss-of-control (LOC) eating is associated with eating-disorder psychopathology, poorer weight loss, and mental health outcomes following bariatric surgery. The nature and significance of shape discrepancy has not been examined in patients with LOC eating following bariatric surgery. OBJECTIVES To examine shape discrepancy, WBI (weight bias internalization) and ED (eating-disorder) psychopathology in patients with LOC eating after bariatric surgery. SETTING Yale University School of Medicine, United States. METHODS Participants (N = 148, 84.5% female) seeking treatment for eating and weight concerns and with recurrent LOC eating approximately 6 months after bariatric surgery were assessed with the Eating Disorder Examination-Bariatric Surgery Version Interview and completed questionnaires measuring WBI and depression. Participants selected body shapes representing their current and ideal shapes, and a shape discrepancy score was calculated. RESULTS Most participants (N = 142/148) reported an ideal shape smaller than their current shape; shape discrepancy scores ranged from 0 to 5 (M = 1.89, SD = .82). Greater shape discrepancy was significantly correlated with greater current body mass index (BMI; r = .271, p=<.001) and percent weight loss (%WL) since surgery (r = -.19, p = .023). After adjusting for %WL, shape discrepancy was significantly correlated with greater WBI (r = .37, p < .001), depression (r = .27, p < .001), and ED psychopathology (r = .25, p = .002). CONCLUSIONS Nearly all participants preferred a significantly smaller shape than their current shape. Greater discrepancy between current and ideal shape was associated with higher levels of a range of behavioral (ED psychopathology), cognitive (WBI), and psychological/somatic (depression) concerns. These findings, which persisted after adjusting for %WL, highlight the importance of addressing body image in postoperative interventions.
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Affiliation(s)
- Ashley Dunford
- Department of Psychiatry, Yale University School of Medicine, Program for Obesity, Weight, and Eating Research, New Haven, Connecticut.
| | - Valentina Ivezaj
- Department of Psychiatry, Yale University School of Medicine, Program for Obesity, Weight, and Eating Research, New Haven, Connecticut
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, Program for Obesity, Weight, and Eating Research, New Haven, Connecticut
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4
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Goldstein SP, Olson KL, Thomas JG. Association of weight and shape concern with weight change and weight-related behaviors in behavioral weight loss treatment. J Behav Med 2023; 46:1049-1056. [PMID: 37740874 PMCID: PMC10577101 DOI: 10.1007/s10865-023-00451-5] [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: 04/11/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
Weight and shape concern (WSC) is a facet of negative body image that is common among individuals with overweight/obesity seeking behavioral weight loss treatment (BWL), but remains understudied. This secondary analysis evaluates associations between WSC, weight change, and weight-related behaviors among individuals in a 24-week BWL. Adults (n = 32) with body mass index 25-50 kg/m2 completed a baseline WSC questionnaire, measured weight at 12 and 24 weeks, measured physical activity via accelerometer, and completed 24-hour dietary recalls. Adherence to self-monitoring dietary intake and weight were assessed. A series of linear mixed models were used to evaluate associations between baseline WSC and weight change, as well as weight-related behaviors. Results revealed no significant effect of WSC on weight change. There were significant WSC x time interactions, such that those rating WSC "very important" decreased self-weighing and the "low importance" group decreased their caloric intake during treatment. The "pretty important" group had greater minutes of activity than the "low importance" group. Findings indicated that WSC may impact weight-related behaviors that contribute to BWL success. This trial was pre-registered on ClinicalTrials.gov (NCT03739151).
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Affiliation(s)
- Stephanie P Goldstein
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, 196 Richmond St, Providence, RI, 02903, USA.
| | - KayLoni L Olson
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, 196 Richmond St, Providence, RI, 02903, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, 196 Richmond St, Providence, RI, 02903, USA
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5
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Platta AM, Mikulec AT, Radzymińska M, Ruszkowska M, Suwała G, Zborowski M, Kowalczewski PŁ, Nowicki M. Body image and willingness to change it-A study of university students in Poland. PLoS One 2023; 18:e0293617. [PMID: 37910539 PMCID: PMC10619780 DOI: 10.1371/journal.pone.0293617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
The present study aimed to identify declared patterns of ideal appearance among students at selected higher education institutions in Poland. In the present study, we set out to identify the body image and the propensity to change it. In order to achieve the goal of the study, a nationwide survey was carried out using a voluntary diagnostic survey. A total of 810 respondents took part in the survey. The study was conducted using a custom-made self-designed survey questionnaire with an indirect interview technique via a web-based platform (CAWI). The study results indicate that women were far more eager to maintain an attractive appearance through dieting than men. Importantly, the respondents, both women and men, did not identify influencers as role models of attractive appearance. Results of the present survey reveal that attitudes towards one's physical appearance are diverse and influenced by the considered factors. The attributes that determined the perception of oneself as an attractive person included height, weight, and body build. Normal body weight is a key feature of an attractive appearance, according to the respondents; nevertheless, students show a higher tolerance for being overweight than for being underweight. Furthermore, preferences in this respect are largely conditioned by individual personal characteristics. According to young people, a person with an attractive appearance is one who eats and exercises regularly, and who does not fall into extremes in terms of their appearance. On the other hand, the fear of growing fat and losing one's attractive appearance was frequently indicated among the concerns over personal appearance. Only one in five respondents expressed complete satisfaction with how they looked, with men and those with a normal BMI significantly more likely to do so. Respondents expressed readiness to undertake a range of activities related to increased exercise regime, changes in their eating habits, or seeking assistance (e.g., of a personal trainer) to achieve the desired body shape. Our findings can be used as a basis for discussion and consideration in developing educational activities on nutrition, as well as on overweight- and obesity-related health issues.
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Affiliation(s)
- Anna M. Platta
- Faculty of Management and Quality Science, Gdynia Maritime University, Gdynia, Poland
| | - Anna T. Mikulec
- Faculty of Engineering Sciences, University of Applied Science in Nowy Sącz, Nowy Sącz, Poland
| | - Monika Radzymińska
- Faculty of Economic Sciences, Institute of Management Science and Quality, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Millena Ruszkowska
- Faculty of Management and Quality Science, Gdynia Maritime University, Gdynia, Poland
| | - Grzegorz Suwała
- Department of Food Product Quality, Krakow University of Economics, Kraków, Poland
| | - Marek Zborowski
- Faculty of Health Sciences, University of Applied Science in Nowy Sącz, Nowy Sacz, Poland
| | | | - Marcin Nowicki
- Department of Entomology and Plant Pathology, University of Tennessee, Knoxville TN, United States of America
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Lewandowska K, Klinkosz W, Styk W, Kowalczyk M. Diversity of Binge-Eating Disorder Symptoms Is Associated with Anxiety about Getting Fat Rather Than Body Image: A Clinical Study of Women in Poland. Nutrients 2023; 15:4572. [PMID: 37960225 PMCID: PMC10647494 DOI: 10.3390/nu15214572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Anxiety about gaining weight is strongly related to body image. Evidence indicates that body dissatisfaction is a strong predictor of eating disorder development. Although not included in DSM-V diagnostic criteria, body image dissatisfaction, and concern are clearly relevant also for individuals with binge-eating disorder (BED). Weight gain anxiety is associated with psychopathological behaviors, but existing research in this area is primarily focused on bulimia nervosa and anorexia nervosa. The goal of this present study was to investigate body image and body mass anxiety in people with BED. METHODS Women diagnosed with BED (n = 105) aged 18 to 66 were surveyed using the questionnaire developed by the authors evaluating the presence of BED symptoms based on DSM-V criteria, and two other instruments: the Body Esteem Scale (BES), and the Body Mass Anxiety Scale (BMAS-20). Statistical analyses were conducted to examine the correlations of BED with body image and body mass anxiety (Pearson's r), to test differences between groups with greater and lesser BED symptom diversity (Student's t-test or the Mann-Whitney U test), and to assess differences among mild-, moderate- and severe-BED groups (ANOVA with a post-hoc test). RESULTS A medium positive relationship was found between anxiety about getting fat (AGF) and the diversity of BED, measured as the number of BED symptoms. A larger number of BED symptoms was shown to be associated with a higher level of AGF. However, no significant differences in AGF levels were observed among BED-severity groups, specified with the frequency of binge eating episodes. No correlations were found between BED and body image. There were also no significant differences in body image between groups with a larger and a smaller number of BED symptoms. The only significant difference in body image observed among BED-severity groups was the level of weight concern. People with mild BED displayed a higher level of weight concern than those with severe BED. CONCLUSIONS Women who binge eat experience high levels of AGF. In the present study, AGF was primarily associated with the number of BED symptoms and not the rate of recurrence of binge-eating episodes. The frequency of BED episodes, however, was linked with weight concern. On the other hand, the hypothesized relationship between disturbed body image and BED was not confirmed. The findings indicate that anxiety about getting fat should be viewed as one of the psychological costs incurred by women experiencing BED symptoms, and it should be mentioned in the next DSM version.
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Affiliation(s)
- Karolina Lewandowska
- Institute of Psychology, The Cardinal Stefan Wyszyński University in Warsaw, 01-938 Warsaw, Poland; (K.L.); (W.K.)
| | - Waldemar Klinkosz
- Institute of Psychology, The Cardinal Stefan Wyszyński University in Warsaw, 01-938 Warsaw, Poland; (K.L.); (W.K.)
| | - Wojciech Styk
- Department of Psychology, Medical University in Lublin, 20-059 Lublin, Poland
| | - Magdalena Kowalczyk
- Mental Health Clinic, Complex of Provincial Specialty Clinics in Katowice, 40-038 Katowice, Poland;
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Quittkat HL, Voges MM, Kisker J, Schöne B, Düsing R, Vocks S. One body, two faces: How double standards influence body evaluation in women with binge-eating disorder compared to mentally healthy women with higher weight and average weight. Int J Eat Disord 2023; 56:1752-1763. [PMID: 37272205 DOI: 10.1002/eat.23998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Research has found evidence that women with anorexia nervosa (AN) and bulimia nervosa (BN) apply different standards for themselves than for others when evaluating bodies, an aspect of a disturbed body image. This study investigates whether women with binge-eating disorder (BED) likewise show self-deprecating double standards (DS). METHODS Women with BED (n = 40), women with higher weight (n = 40) and women with average weight (n = 40) viewed a presentation of different builds, including their individual ideal body, which were presented once with participants' own and once with an unknown woman's face. After each presentation, participants rated their emotional response regarding arousal and valence, and evaluated the body's attractiveness, body fat and muscle mass. DS were defined as the difference in ratings of the same body with one's own and the unknown face. RESULTS Women with BED showed a higher degree of negative emotions in response to a thin and a high-weight build, rated lower levels of body attractiveness for an athletic build, and displayed more arousal for almost all builds presented with their own compared to with another face. While women with BED showed a higher burden on measures of eating pathology and body image than the other groups, DS were not more pronounced in women with BED. DISCUSSION The findings contradict DS as a characteristic feature of BED, but underline "normative" DS for higher-weight/high-weight builds, reflecting weight stigmatization. Psychoeducation on these DS might complement cognitive-behavioral therapy in BED in order to reduce negative emotions. PUBLIC SIGNIFICANCE A bias in body evaluation has been proven in women with anorexia and BN, but no research has examined this in women with BED. This study provides evidence of DS in body evaluation in women with BED, compares the extent of DS between women with BED, higher weight, and average weight, and investigates individual body ideals in women with BED and higher weight.
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Affiliation(s)
- Hannah L Quittkat
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Mona M Voges
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Joanna Kisker
- Institute of Psychology, Department of Experimental Psychology I, Osnabrück University, Osnabrück, Germany
| | - Benjamin Schöne
- Institute of Psychology, Department of Experimental Psychology I, Osnabrück University, Osnabrück, Germany
| | - Rainer Düsing
- Institute of Psychology, Department of Research Methodology, Diagnostics and Evaluation, Osnabrück University, Osnabrück, Germany
| | - Silja Vocks
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
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8
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Birgegård A, Mantilla EF, Breithaupt LE, Borg S, Sanzari CM, Padalecki S, Hedlund E, Bulik CM. Proposal for increasing diagnostic clarity in research and clinical practice by renaming and reframing atypical anorexia nervosa as "Restrictive Eating Disorder" (RED). Eat Behav 2023; 50:101750. [PMID: 37263139 DOI: 10.1016/j.eatbeh.2023.101750] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/25/2023] [Accepted: 05/18/2023] [Indexed: 06/03/2023]
Abstract
Atypical anorexia nervosa (AAN) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), is characterized by meeting all criteria for anorexia nervosa (AN) except for weight being within or above the "normal" range despite significant weight loss. The current definition is plagued by several problems, resulting in widely heterogeneous operationalizations in research and clinical practice. As such, the poorly defined diagnosis of AAN negatively impacts affected individuals and frustrates research attempts to better understand the syndrome. We consider conceptual flaws in the AAN description and contend that the undefined weight range and nature of weight loss renders these two factors functionally inapplicable in research and practice. They also represent a departure from the originally intended use of the AAN category, i.e., arresting a negative weight trajectory likely to result in AN, making the target population, and the application of the label, unclear. We propose revised criteria and a new name, restrictive eating disorder (RED), intended to reduce stigma and encompass a wide but better-defined range of presentations. The RED criteria focus on clinically significant restrictive behavior that disrupts normal living (i.e., impairment), and cognitive symptoms of overevaluation, disturbed experience, and lack of recognition of illness seriousness. We believe that RED may enable more appropriate clinical application, but also inspire coordinated research toward a more valid psychiatric nosology in the eating disorders field.
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Affiliation(s)
- Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Emma Forsén Mantilla
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lauren E Breithaupt
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stina Borg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christina M Sanzari
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sophie Padalecki
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Public Health, College of Arts and Sciences, Elon University, NC, USA
| | - Elin Hedlund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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9
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Clemente-Suárez VJ, Ramírez-Goerke MI, Redondo-Flórez L, Beltrán-Velasco AI, Martín-Rodríguez A, Ramos-Campo DJ, Navarro-Jiménez E, Yáñez-Sepúlveda R, Tornero-Aguilera JF. The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions. Nutrients 2023; 15:2594. [PMID: 37299557 PMCID: PMC10255390 DOI: 10.3390/nu15112594] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Anorexia nervosa is a psychiatric disorder with an unknown etiology that is characterized by an individual's preoccupation with their weight and body structure while denying the severity of their low body weight. Due to the fact that anorexia nervosa is multifaceted and may indicate the coexistence of genetic, social, hormonal, and psychiatric disorders, a description of non-pharmacological interventions can be used to ameliorate or reduce the symptoms of this condition. Consequently, the purpose of the present narrative review is to describe the profile's context in the anorexic person as well as the support they would require from their family and environment. In addition, it is aimed at examining preventative and non-pharmacological interventions, such as nutritional interventions, physical activity interventions, psychological interventions, psychosocial interventions, and physical therapy interventions. To reach the narrative review aims, a critical review was conducted utilizing both primary sources, such as scientific publications, and secondary sources, such as bibliographic indexes, web pages, and databases. Nutritional interventions include nutritional education and an individualized treatment for each patient, physical activity interventions include allowing patients to perform controlled physical activity, psychological interventions include family therapy and evaluation of the existence of other psychological disorders, psychosocial interventions include management of the relationship between the patient and social media and physical therapy interventions include relaxation massages and exercises to relieve pain. All these non-pharmacological interventions need to be individualized based on each patient's needs.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Maria Isabel Ramírez-Goerke
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Ana Isabel Beltrán-Velasco
- Psychology Department, Facultad de Ciencias de la Vida y la Naturaleza, Universidad Antonio de Nebrija, 28240 Madrid, Spain;
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Rodrigo Yáñez-Sepúlveda
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile;
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
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10
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Srivastava P, Felonis CR, Piers AD, Nunez N, Fitzpatrick B, Juarascio A, Manasse S. Reward mediates the association between engagement in noneating activities and state body dissatisfaction: An ecological momentary assessment study. Int J Eat Disord 2023; 56:562-573. [PMID: 36444116 DOI: 10.1002/eat.23862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/27/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Momentary worsening (i.e., greater than one's average levels) of state body dissatisfaction (BD) has been implicated as a proximal risk factor for eating disorder (ED) behaviors in binge-spectrum EDs. Yet, research exploring the prospective association between noneating activities in daily life (e.g., chores, self-care/coping) and momentary state BD remains limited. Understanding the momentary link between engagement in noneating activities and state BD, and pathways through which engagement in said activities influences momentary state BD is critical to informing treatments. The current ecological momentary assessment (EMA) study examined whether (1) engagement in noneating activities at Time 1 prospectively predicted momentary state BD at Time 2 and (2) reward drawn from noneating activities at Time 1 mediates the prospective association between engagement in noneating activities at Time 1 and momentary state BD at Time 2. METHOD Sixty-six adults with transdiagnostic binge eating completed an EMA protocol over 7-14 days. Participants received six EMA signals per day (total EMA observations = 4038). Multilevel modeling was used to examine the research questions. RESULTS Engagement in an indoor hobby, outdoor recreation, socializing, and self-care/coping strategies prospectively predicted momentary state BD improvements, while using TV/social media and cooking prospectively predicted momentary state BD worsening. Reward drawn from engagement in these noneating activities mediated the associations. DISCUSSION If replicated, these findings suggest that increasing the frequency of certain noneating activities and enhancing their rewarding aspects to improve state BD and decrease ED behavior risk during treatment may be worthy of further exploration. PUBLIC SIGNIFICANCE Momentary worsening of state body dissatisfaction (BD) is a risk factor for eating disorder behaviors in individuals with binge eating. This study found that engaging in certain noneating activities (e.g., socializing) prospectively predicted momentary improvements in state BD, while other noneating activities (e.g., cooking) predicted momentary worsening of state BD. Reward drawn from activities mediated these relations. To improve state BD, treatments should target the frequency of, and reward obtained from these noneating activities.
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Affiliation(s)
- Paakhi Srivastava
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christina R Felonis
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amani D Piers
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Nicole Nunez
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Brighid Fitzpatrick
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne Juarascio
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie Manasse
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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11
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Mohsenpour MA, Karamizadeh M, Barati-Boldaji R, Ferns GA, Akbarzadeh M. Structural equation modeling of direct and indirect associations of social media addiction with eating behavior in adolescents and young adults. Sci Rep 2023; 13:3044. [PMID: 36810365 PMCID: PMC9942059 DOI: 10.1038/s41598-023-29961-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023] Open
Abstract
Social media (SM) exerts important effects on health-related behaviors such as eating behaviors (EB). The present study was designed to determine the direct and indirect association of SM addiction with EB in adolescents and young adults through body image (BI). In this cross-sectional study, 12-22 years old adolescents and young adults, with no history of mental disorders or psychiatric medications usage were studied through an online questionnaire shared via SM platforms. Data were gathered about SM addiction, BI, and EB in its sub-scales. A single approach and multi-group path analyses were performed to find possible direct and indirect associations of SM addiction with EB through BI concerns. Overall, 970 subjects, 55.8% boys, were included in the analysis. Both multi-group (β = 0.484, SE = 0.025, P < 0.001) and fully-adjusted (β = 0.460, SE = 0.026, P < 0.001) path analyses showed higher SM addiction is related to disordered BI. Furthermore, the multi-group analysis showed one unit increment in SM addiction score was associated with 0.170 units higher scores for emotional eating (SE = 0.032, P < 0.001), 0.237 for external stimuli (SE = 0.032, P < 0.001), and 0.122 for restrained eating (SE = 0.031, P < 0.001). The present study revealed that SM addiction is associated with EB both directly and also indirectly through deteriorating BI in adolescents and young adults.
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Affiliation(s)
- Mohammad Ali Mohsenpour
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Malihe Karamizadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Barati-Boldaji
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, England, UK
| | - Marzieh Akbarzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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12
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Brandt G, Halbeisen G, Braks K, Huber TJ, Paslakis G. Gender differences in individuals with obesity and binge eating disorder: A retrospective comparison of phenotypical features and treatment outcomes. EUROPEAN EATING DISORDERS REVIEW 2023; 31:413-424. [PMID: 36802088 DOI: 10.1002/erv.2972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 01/06/2023] [Accepted: 02/06/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE Phenotypical comparisons between individuals with obesity without binge eating disorder (OB) and individuals with obesity and comorbid binge eating disorder (OB + BED) are subject to ongoing investigations. At the same time, gender-related differences have rarely been explored, raising the question whether men and women with OB and OB + BED may require differently tailored treatments. METHOD We retrospectively compared pre- versus post-treatment data in a matched sample of n = 180 men and n = 180 women with OB or OB + BED who received inpatient treatment. RESULTS We found that men displayed higher weight loss than women independent of diagnostic group. In addition, men with OB + BED showed higher weight loss than men with OB after 7 weeks of treatment. CONCLUSIONS The present findings add to an emerging yet overall still sparse body of studies comparing phenotypical features and treatment outcomes in men and women with OB and OB + BED; implications for further research are discussed. CLINICAL TRIAL REGISTRATION The study was prospectively registered with the German Clinical Trial Register as part of application DRKS00028441.
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Affiliation(s)
- Gerrit Brandt
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Karsten Braks
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Thomas J Huber
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
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13
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Sahlan RN, Sala M. Eating disorder psychopathology and resilience in Iranian college students: A network analysis. J Clin Psychol 2023; 79:497-513. [PMID: 35975401 DOI: 10.1002/jclp.23428] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Eating disorder (ED) psychopathology is common among Iranian college students. Resilience (i.e., the ability to bounce back and adapt in the face of adverse and stressful conditions) has been found to be a protective factor against ED psychopathology in the West. However, no research to date has examined resilience as a protective factor against ED psychopathology in Iran. The current study used network analysis to examine an ED and resilience network in an Iranian sample. METHOD Participants were Iranian college students (N = 478) who completed the Farsi-Eating Disorder Examination-Questionnaire and Farsi-Brief Resilience Scale. We estimated a network of ED symptoms and resilience processes and identified central and bridge symptoms. RESULTS Central ED and resilience nodes were discomfort in seeing one's own body, feeling guilty about eating due to shape/weight, and thinking about shape and weight making it difficult to concentrate. Having a hard time making it through stressful events bridged with binge eating and fear of losing control over eating. CONCLUSION Processes related to managing stress and binge eating appear to maintain the association between ED symptoms and resilience processes.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Margaret Sala
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
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14
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Prnjak K, Jukic I, Mitchison D, Griffiths S, Hay P. Body image as a multidimensional concept: A systematic review of body image facets in eating disorders and muscle dysmorphia. Body Image 2022; 42:347-360. [PMID: 35926364 DOI: 10.1016/j.bodyim.2022.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 10/16/2022]
Abstract
Body image disturbance is core to the psychopathology of eating disorders (EDs), and related disorders such as muscle dysmorphia (MD). Global measures of body image fail to quantify specific aspects of body image disturbance that characterizes EDs, and may be differentially associated to outcomes. The aim of this systematic review was to provide an overview of specific body image facets and synthesize findings from controlled studies that compared clinical ED/MD and control-comparison groups in body image disturbance. One-hundred sixty-seven studies met inclusion criteria, and reported on comparisons among 30,584 individuals in 28 body image facets, which were more broadly grouped into evaluative, perceptual, cognitive-affective and motivational categories for the purpose of the present review. Effect sizes were calculated as Cohen's d for every comparison between ED and control groups. Body dissatisfaction (evaluative category) was the most prevalent facet assessed across studies (62 %), and differences between clinical and control groups were the largest in this category, especially for bulimia nervosa (d = 1.37). Scarcity of studies with male and MD clinical samples, and use of single-item and non-validated measures, should encourage development of instruments for body image facets pertinent to EDs and MD that can be validly applied across gender.
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Affiliation(s)
- Katarina Prnjak
- School of Medicine, Western Sydney University, Sydney, Australia.
| | - Ivan Jukic
- Sport Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand; School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Deborah Mitchison
- School of Medicine, Western Sydney University, Sydney, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Scott Griffiths
- School of Psychology, University of Melbourne, Melbourne, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, Australia; Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, Australia
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15
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Caretto A, Pintus S, Petroni ML, Osella AR, Bonfiglio C, Morabito S, Zuliani P, Sturda A, Castronuovo M, Lagattolla V, Maghetti A, Lapini E, Bianco AM, Cisternino M, Cerutti N, Mulas CA, Hassan O, Cardamone N, Parillo M, Sonni L. Determinants of weight, psychological status, food contemplation and lifestyle changes in patients with obesity during the COVID-19 lockdown: a nationwide survey using multiple correspondence analysis. Int J Obes (Lond) 2022; 46:1280-1287. [PMID: 35306529 PMCID: PMC8933751 DOI: 10.1038/s41366-022-01100-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The corona virus disease 2019 (COVID-19) pandemic forced most of the Italian population into lockdown from 11 March to 18 May 2020. A nationwide survey of Italian Clinical Nutrition and Dietetic Services (Obesity Centers or OCs) was carried out to assess the impact of lockdown restrictions on the physical and mental wellbeing of patients with obesity (PWO) who had follow-up appointments postponed due to lockdown restrictions and to compare determinants of weight gain before and after the pandemic. METHODS We designed a structured 77-item questionnaire covering employment status, diet, physical activity and psychological aspects, that was disseminated through follow-up calls and online between 2 May and 25 June 2020. Data were analyzed by multiple correspondence analysis (MCA) and multiple linear regression. RESULTS A total of 1,232 PWO from 26 OCs completed the questionnaires (72% female, mean age 50.2 ± 14.2 years; mean BMI 34.7 ± 7.6 kg/m2; 41% obesity class II to III). During the lockdown, 48.8% gained, 27.1% lost, while the remainder (24.1%) maintained their weight. The mean weight change was +2.3 ± 4.8 kg (in weight gainers: +4.0 ± 2.4 kg; +4.2% ± 5.4%). Approximately 37% of participants experienced increased emotional difficulties, mostly fear and dissatisfaction. Sixty-one percent reduced their physical activity (PA) and 55% experienced a change in sleep quality/quantity. The lack of online contact (37.5%) with the OC during lockdown strongly correlated with weight gain (p < 0.001). Using MCA, two main clusters were identified: those with unchanged or even improved lifestyles during lockdown (Cluster 1) and those with worse lifestyles during the same time (Cluster 2). The latter includes unemployed people experiencing depression, boredom, dissatisfaction and increased food contemplation and weight gain. Within Cluster 2, homemakers reported gaining weight and experiencing anger due to home confinement. CONCLUSIONS Among Italian PWO, work status, emotional dysregulation, and lack of online communication with OCs were determinants of weight gain during the lockdown period.
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Affiliation(s)
- A Caretto
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy.
| | - S Pintus
- Bariatric Surgery Center, ARNAS Brotzu, Cagliari, Italy
| | - M L Petroni
- Metabolism and Clinical Nutrition Unit, IRCCS Policlinico S. Orsola, Alma Mater University of Bologna, Bologna, Italy
| | - A R Osella
- Epidemiology and Statistics, IRCCS Saverio De Bellis, Castellana Grotte, BA, Italy
| | - C Bonfiglio
- Epidemiology and Statistics, IRCCS Saverio De Bellis, Castellana Grotte, BA, Italy
| | | | - P Zuliani
- Obesity Day Center, Sorrento, NA, Italy
| | - A Sturda
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy
| | | | - V Lagattolla
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy
| | - A Maghetti
- Metabolism and Clinical Nutrition Unit, IRCCS Policlinico S. Orsola, Alma Mater University of Bologna, Bologna, Italy
| | - E Lapini
- Obesity Rehab Unit, Ospedali Privati Forli, Forlì, Italy
| | - A M Bianco
- U.O.C. Igiene degli Alimenti e della Nutrizione ASP, Potenza, Italy
| | - M Cisternino
- Clinical Nutrition, IRCCS "S. De Bellis", Castellana Grotte, BA, Italy
| | - N Cerutti
- UOSD Medicina Generale a Indirizzo Dietologico ASST, Pavia, Italy
| | - C A Mulas
- Clinical Dietary Service "Holy Spirit" Hospital Casale Monferrato ASLAL, Alessandria, Italy
| | - O Hassan
- UOSD Diabetology, San Camillo Hospital -, Roma, Italy
| | | | - M Parillo
- Azienda ospedaliera S. Anna S. Sebastiano, Caserta, Italy
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16
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Forrest LN, Grilo CM. Change in eating-disorder psychopathology network structure in patients with binge-eating disorder: Findings from treatment trial with 12-month follow-up. J Consult Clin Psychol 2022; 90:491-502. [PMID: 35482651 PMCID: PMC9247034 DOI: 10.1037/ccp0000732] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Effective treatments exist for binge-eating disorder (BED), although roughly 50% of patients fail to attain binge-eating abstinence. Evidence on how to refine treatments is lacking. Conceptualizing BED as arising from a network of symptom-to-symptom interactions allows for the identification of the most strongly connected symptoms, which could inform intervention targets. This study assessed how BED symptom centrality changed with behaviorally based weight-loss treatments (BBWLTs). METHODS Participants were 191 adult patients (71% female, 79% White) with BED with comorbid obesity participating in a randomized controlled trial testing 6-month BBWLTs for BED. Independent assessments of BED symptoms were performed at pretreatment, posttreatment, and 12 months after treatment. Strength centrality indicated how strongly and frequently symptoms were associated with each other in the network. Significant changes in centrality between timepoints were determined using permutation tests. RESULTS At pretreatment, overvaluation of shape/weight and preoccupation with shape/weight and food/eating had the highest strength centrality. At posttreatment and 12-month follow-up, dissatisfaction with shape/weight had the highest centrality, which significantly increased from pretreatment. CONCLUSIONS The relations among symptoms of BED are not static and change over time with treatment. BBWLTs do not appear to reduce connectivity of overvaluation of shape/weight (the most central BED symptom prior to treatment), but instead increase connectivity of dissatisfaction with shape/weight with other symptoms following treatment. The observed network structure of symptoms following BBWLTs resembles network analyses of people without eating disorders. Findings highlight the importance of understanding how treatments impact symptom relationships, not just symptom intensities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Lauren N. Forrest
- Penn State College of Medicine, Department of Psychiatry and Behavioral Health, Hershey, PA. USA
| | - Carlos M. Grilo
- Yale School of Medicine, Department of Psychiatry, New Haven, CT. USA
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17
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Gordon EL, Terrill AL, Smith TW, Ibele AR, Martinez P, McGarrity LA. Overvaluation of Shape and Weight (Not BMI) Associated with Depressive Symptoms and Binge Eating Symptoms Pre- and Post-bariatric Surgery. Obes Surg 2022; 32:2272-2279. [DOI: 10.1007/s11695-022-06062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
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18
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Manasse SM, Lampe EW, Srivastava P, Payne-Reichert A, Mason TB, Juarascio AS. Momentary associations between fear of weight gain and dietary restriction among individuals with binge-spectrum eating disorders. Int J Eat Disord 2022; 55:541-552. [PMID: 35088433 PMCID: PMC9377790 DOI: 10.1002/eat.23686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Fear of weight gain (FOWG) is increasingly implicated in the maintenance of binge-spectrum eating disorders (EDs; e.g., bulimia nervosa [BN], binge-eating disorder [BED]) through the pathway of increased dietary restriction. However, particularly in binge-spectrum EDs, research is nascent and based on retrospective self-report. To improve treatment outcomes, it is critical to better understand the momentary relations between FOWG and dietary restriction. METHOD Sixty-seven adults with binge spectrum EDs completed a 7-14-day ecological momentary assessment protocol that included items regarding FOWG, ED behaviors, and types of dietary restriction (e.g., attempted restraint vs. actual restriction) several times per day. Multilevel models were used to evaluate reciprocal associations between FOWG and dietary restriction, and to evaluate the indirect of effects of dietary restriction on the relation between FOWG and binge eating. RESULTS While main effects were not statistically significant, ED presentation significantly moderated the association between increases in FOWG at time1 and both attempted and actual avoidance of enjoyable foods at time2 such that those with BN-spectrum EDs were more likely to avoid enjoyable foods following increased FOWG compared to those with BED-spectrum EDs. Engagement in restriction at time1 was not associated with decreased FOWG at time2. DISCUSSION Prospective associations between FOWG and restriction suggest that individuals with BN may be more likely to restrict their eating following increased FOWG. These findings suggest FOWG may be an important target for future treatments.
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Affiliation(s)
- Stephanie M Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Elizabeth W Lampe
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Paakhi Srivastava
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adam Payne-Reichert
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Adrienne S Juarascio
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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19
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Lydecker JA, Simpson L, Smith SR, White MA, Grilo CM. Preoccupation in bulimia nervosa, binge-eating disorder, anorexia nervosa, and higher weight. Int J Eat Disord 2022; 55:76-84. [PMID: 34713460 PMCID: PMC8963447 DOI: 10.1002/eat.23630] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 09/15/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Preoccupation (excessive and constant thoughts) about shape/weight and food/eating is thought to be prominent in individuals with eating disorders but has received much less research than overt behavioral features. This study examined the significance and distinctiveness of different foci of preoccupation in individuals categorized with different forms of eating disorders and in individuals with higher weight. METHOD Participants (N = 1,363) completed a web-based survey with established measures of eating-disorder psychopathology and depression. The current study compared preoccupation among individuals with core features of bulimia nervosa (BN; n = 144), binge-eating disorder (BED; n = 576), anorexia nervosa (AN; n = 48), and higher body weight (body mass index [BMI] ≥ 25) without eating-disorder features (higher weight [HW]; n = 595). Associations of each type of preoccupation with other eating-disorder psychopathology and depression were examined both between and within study groups. RESULTS Preoccupation with shape/weight and with food/eating showed a graded pattern of statistically significant differences: AN and BN had higher preoccupation than BED, which was higher than HW. Within BN, BED, and AN study groups, correlation magnitudes of shape/weight and food/eating preoccupation with eating-disorder psychopathology and depression did not differ significantly. Within the HW group, shape/weight preoccupation was significantly more strongly correlated than food/eating preoccupation with overvaluation, body dissatisfaction, and depression. DISCUSSION The preoccupation cognitive style, as well as focus, appears associated with other facets of eating-disorder psychopathology and depression. If results are confirmed among individuals with formal diagnoses, clinicians addressing maladaptive cognitions in cognitive-behavioral therapy should consider the role of preoccupation. Future research should investigate whether preoccupation predicts or moderates eating disorder treatment outcomes.
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Affiliation(s)
- Janet A. Lydecker
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Lauren Simpson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Amherst College, Amherst, MA USA
| | - Shannon R. Smith
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Marney A. White
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
| | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Psychology, Yale University, New Haven, CT
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20
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Messer M, Linardon J. Exploring the role of feeling fat in individuals categorized with bulimia nervosa, binge-eating disorder and overweight/obesity. Eat Weight Disord 2021; 26:2617-2623. [PMID: 33570744 DOI: 10.1007/s40519-021-01119-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Despite featuring in prominent theoretical models, the role of "feeling fat" in certain eating and weight disorder presentations remains poorly understood. This study compared levels of feeling fat between people categorized with referable bulimia nervosa (BN) symptoms, binge-eating disorder (BED) symptoms, and overweight/obesity, and examined the unique associations of feeling fat on measures of eating pathology and functional impairment within each of these subgroups. METHODS Data were analyzed from 977 participants who met criteria referable to BN symptoms (n = 419), BED symptoms (n = 346), or overweight/obesity without ED psychopathology (n = 212) based on self-report symptom frequency. RESULTS Analysis of variance revealed that feeling fat levels were highest in the referable BN group, followed by the referable BED group, and then the overweight/obese subgroup. Multiple regressions revealed that feeling fat contributed additional variance to functional impairment and key cognitive (e.g., eating concerns) and behavioural (e.g., dietary restraint) symptoms only among those who met criteria referable to BN. CONCLUSION Overall, findings suggest that the experience of feeling fat may be an important component of body image particularly among individuals with BN-type symptoms. Present findings may also have implications for the assessment and treatment of feeling fat among different eating and weight disorder presentations. LEVEL OF EVIDENCE Cross-sectional descriptive study, Level V.
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Affiliation(s)
- Mariel Messer
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
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21
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Bennett BL, Grilo CM, Alperovich M, Ivezaj V. Body Image Concerns and Associated Impairment Among Adults Seeking Body Contouring Following Bariatric Surgery. Aesthet Surg J 2021; 42:275-282. [PMID: 34463702 PMCID: PMC8845003 DOI: 10.1093/asj/sjab327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The current study examined a range of body image concerns and associated distress and impairment in patients who have undergone bariatric surgery and are seeking subsequent body contouring surgery. OBJECTIVES The aim of this study was to investigate the hypotheses that individuals seeking body contouring endorse a broad pattern of body image concerns and that overall body image concern is associated with greater impairment and disability. METHODS The participants were 56 adults seeking body contouring surgery after bariatric surgery. All participants completed a self-report questionnaire designed for the present study to assess body image concerns specific to patients who have undergone bariatric surgery and a battery of established measures of disability, impairment, and eating-disorder psychopathology. RESULTS The most commonly endorsed concerns were related to loose skin (body dissatisfaction, feeling embarrassed in public, and skin rashes) whereas the least endorsed items included concerns related to scars from bariatric surgery (body dissatisfaction, avoidance of social situations, and difficulty concentrating). Participants endorsed a broad pattern of frequent distress and impairment related to physical body image changes post-bariatric surgery. Greater body image concerns were associated significantly with higher levels of disability, work-related impairment, and eating-disorder psychopathology. CONCLUSIONS Patients seeking body contouring surgery reported a range of body image concerns with significant associated distress, disability, and impairment related to physical changes post-bariatric surgery. The present findings underscore that although bariatric surgery is effective for reducing weight and metabolic disturbances, additional interventions for addressing body image concerns that are frequently distressing and impairing may be needed.
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Affiliation(s)
- Brooke L Bennett
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Michael Alperovich
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Valentina Ivezaj
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Corresponding Author: Dr Valentina Ivezaj, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA. E-mail: ; Twitter: @bbennettphd
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22
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The Relation between Fat Phobia and Body Image Perception and Their Effects on Healthy Lifestyle Behaviors. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.874312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yu B, Chen Y, Qin H, Chen Q, Wang J, Chen P. Using multi-disciplinary teams to treat obese patients helps improve clinical efficacy: the general practitioner's perspective. Am J Transl Res 2021; 13:2571-2580. [PMID: 34017416 PMCID: PMC8129361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This paper aims to explore the influences of multi-disciplinary teams (MDT) from the general practitioner's (GP's) perspective on the clinical efficacy of treating obese patients. METHODS Admitted to our hospital from January 2018 to October 2019, 127 obese patients were divided into two groups based on the different models of diagnosis and treatment each underwent. The routine diagnostic and treatment model was administered to the patients in the control group (60 cases), and the MDT model was administered to the patients in the research group (67 cases). The weight loss success rates in both groups were observed. Before and after the treatment, the blood glucose, blood lipid, tumor necrosis factor-α (TNF-α), adiponectin (APN), leptin (LP), and recombinant human fibroblast growth factor 21 (FGF-21) levels were measured. The SAS and SDS scores were evaluated. RESULTS After the treatment, the weight loss success rate in the research group was significantly higher than it was in the control group, and the FPG and the 2hPBG levels were significantly lower in the research group. Compared with the control group, the TC, TG, and LDL-C levels were remarkably lower in the study group, and the HDL-C levels were remarkably higher in the research group. The TNF-α, LP, and FGF-21 levels were significantly lower in the research group, and the APN levels were significantly higher. The research group had significantly lower SAS and SDS scores and higher GSES scores. CONCLUSION MDTs from the GP's perspective are conducive to increasing the weight loss success rate and improving the blood glucose, blood lipid and adipokine levels in obese patients.
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Affiliation(s)
- Bijun Yu
- Department of General Medicine, Tiantai County People's Hospital of Zhejiang Tiantai 317200, Zhejiang Province, China
| | - Yingting Chen
- Department of General Medicine, Tiantai County People's Hospital of Zhejiang Tiantai 317200, Zhejiang Province, China
| | - Huazhen Qin
- Department of General Medicine, Tiantai County People's Hospital of Zhejiang Tiantai 317200, Zhejiang Province, China
| | - Qi Chen
- Department of General Medicine, Tiantai County People's Hospital of Zhejiang Tiantai 317200, Zhejiang Province, China
| | - Jinwei Wang
- Department of General Medicine, Tiantai County People's Hospital of Zhejiang Tiantai 317200, Zhejiang Province, China
| | - Ping Chen
- Department of General Medicine, Tiantai County People's Hospital of Zhejiang Tiantai 317200, Zhejiang Province, China
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Lydecker JA, Cotter EW, Grilo CM. Distinctiveness and significance of body dissatisfaction and overvaluation among Latinx/Hispanic and White men and women. Int J Eat Disord 2021; 54:354-364. [PMID: 33247450 PMCID: PMC7956228 DOI: 10.1002/eat.23413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To examine the distinctiveness and significance of two body image constructs, dissatisfaction with weight and shape and overvaluation of weight and shape, with respect to eating disorder psychopathology, weight, and depression in White and Latinx/Hispanic men and women. METHODS Participants were White (n = 1,941) and Latinx/Hispanic (n = 568) adults living in the United States who completed an online battery of established measures of body image, eating disorder psychopathology and behaviors, and depression. RESULTS Two body image constructs, dissatisfaction with weight and shape and overvaluation of weight and shape, were related to each other but showed some important distinctions in their associations with eating- and weight-related variables. Significantly greater proportions of White than Latinx/Hispanic individuals reported co-occurring dissatisfaction and overvaluation, and significantly greater proportions of Latinx/Hispanic than White individuals reported dissatisfaction alone. Ethnicity moderated the association of dissatisfaction and overvaluation with body mass index (BMI), and the association of overvaluation with depression. Ethnicity also had a main effect on binge-eating frequency. CONCLUSIONS Dissatisfaction and overvaluation were distinct among both Latinx/Hispanic and White individuals. However, associations with eating- and weight-related variables varied between ethnicities, suggesting a need for further research on the influence of cultural variables on body image and eating disorder psychopathology.
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Affiliation(s)
| | | | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Psychology, Yale University, New Haven, CT
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25
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Bȩtkowska-Korpała B, Ćwiȩk A, Izydorczyk B, Starowicz-Filip A, Major P. Predictive Role of Body Image in Bulimic Behaviors Among Obese Patients Qualified for Bariatric Surgery. Front Psychiatry 2021; 12:781323. [PMID: 34899436 PMCID: PMC8656395 DOI: 10.3389/fpsyt.2021.781323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/04/2021] [Indexed: 11/20/2022] Open
Abstract
Bulimic behavior and the associated experience of one's own body are of great importance in the course of surgical treatment for obesity. This study determined the predictive role of multidimensional body image on bulimic-type eating behaviors among individuals scheduled for the surgical treatment of obesity. This study was conducted in a clinical setting on a group of 100 obese patients who were treated at the Centre for the Surgical Treatment of Obesity at the University Hospital in Krakow (Poland) and were qualified for bariatric surgery. Body image was examined with Cash's Multidimensional Body-Self Relations Questionnaire (MBSRQ) and bulimic behavior with David M. Garner's Eating Attitudes Test (EAT-26). Part A of the EAT-26 focused only on the bulimia and food preoccupation scale. Part B included sex, age, and body mass index (BMI) in the predictive model. A stepwise multiple regression analysis was conducted to assess psychological predictors of eating behavior. For binary variables, a logistic regression analysis was conducted for the whole group and for the women's group alone. Owing to the small sample size of men, regression analyses were not conducted. Higher values were observed in the Appearance Orientation dimension among women when compared to men. Appearance evaluation and age were found to be significant predictors for bulimic behaviors in the whole group. In regression models for behavior in the last 6 months, the predictors were found to be Health Evaluation and Appearance Orientation for laxative use, and Overweight Preoccupation for vomiting for weight control. Health-promoting behaviors in obesity treatment were conditioned as follows: for exercise, the predictors were sex and Fitness Orientation and for weight loss, they were Overweight Preoccupation and Body Areas Satisfaction. Our study shows that different bulimic behaviors are variously conditioned by body image dimensions, some of which are predictors of behaviors that are risk factors for obesity and poor outcomes of bariatric treatment, whereas others increase the chance of pro-health behaviors among obese individuals.
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Affiliation(s)
- Barbara Bȩtkowska-Korpała
- Department of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Krakow, Poland.,Department of Clinical Psychology, University Hospital in Krakow, Krakow, Poland
| | - Aleksandra Ćwiȩk
- Department of Clinical Psychology, University Hospital in Krakow, Krakow, Poland.,Department of General, Oncological, Metabolic and Emergency Surgery, Centre for the Surgical Treatment of Obesity, University Hospital in Krakow, Krakow, Poland
| | | | - Anna Starowicz-Filip
- Department of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Krakow, Poland.,Department of Clinical Psychology, University Hospital in Krakow, Krakow, Poland
| | - Piotr Major
- Department of General, Oncological, Metabolic and Emergency Surgery, Centre for the Surgical Treatment of Obesity, University Hospital in Krakow, Krakow, Poland.,2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
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26
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Dalle Grave R, Misconel A, Fasoli D, Calugi S. Overvaluation of Shape and Weight and Associated Features in Patients Without Eating Disorders Seeking Treatment for Obesity. Obesity (Silver Spring) 2020; 28:733-739. [PMID: 32108444 DOI: 10.1002/oby.22750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/01/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study aimed to evaluate the presence of the overvaluation of shape and weight and its associated features in patients with obesity but no eating disorder who were seeking treatment from a specialist unit. METHODS Overall, 1,134 patients with obesity but no Diagnostic and Statistical Manual of Mental Disorders eating disorder diagnosis were included. The Eating Disorder Examination interview was administered by expert clinicians to assess the eating disorder psychopathology and overvaluation of shape and weight. Patients also completed the Symptom Check List-90-Revised and the 36-Item Short Form Health Survey to assess general psychopathology and quality of life, respectively. RESULTS Roughly 20% of the patients with obesity presented with clinical overvaluation of shape and weight, which was associated with the female gender, higher expected weight loss, more severe eating-related psychopathology, higher general psychopathology, and lower mental quality of life. Linear and logistic regression analyses indicated that the clinical variables independently correlated with overvaluation of shape and weight in these patients were female gender, Eating Disorder Examination Eating Concern subscale score, and 36-Item Short Form Health Survey mental component summary score. CONCLUSIONS These findings are sufficient to justify routine assessment of overvaluation of shape and weight in patients seeking treatment for obesity.
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Affiliation(s)
- Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - Arianna Misconel
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - Deborah Fasoli
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
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Zaccagni L, Rinaldo N, Bramanti B, Mongillo J, Gualdi-Russo E. Body image perception and body composition: assessment of perception inconsistency by a new index. J Transl Med 2020; 18:20. [PMID: 31937320 PMCID: PMC6961355 DOI: 10.1186/s12967-019-02201-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/28/2019] [Indexed: 12/13/2022] Open
Abstract
Background A correct perception of the body image, as defined by comparison with actual anthropometric analyses, is crucial to ensure the best possible nutritional status of each individual. Bioimpedance analysis (BIA) represents a leading technique to assess body composition parameters and, in particular, the fat mass. This study examined the self-perception of body image at various levels of adiposity proposing a new index. Methods We investigated 487 young Italian adults (mean age of males: 21.9 ± 2.4 years; mean age of females: 21.0 ± 2.2 years). Each subject could choose, on the Contour Drawing Rating Scale, the silhouette that he/she considered most resembling his/her perceived body image as well as his/her ideal body image. On each subject, we performed anthropometric measurements and determined the values of Fat mass and %Fat with BIA. A new index, FAIFAT (Feel fat status minus Actual fat status Inconsistency), was developed to evaluate possible fat status perception inconsistencies by BIA. Results Based on ideal and feel body image comparison, women showed higher dissatisfaction than men and preferred slimmer silhouettes. FAIFAT values indicated that the fat status perception was correct in the majority of the examined individuals and only three subjects showed a serious misperception. Conclusions Our findings suggest that FAIFAT is an appropriate index for assessing the perceived fat status from the body image when compared with data obtained by BIA. In a population, the use of this index will allow the correct identification of groups at risk for eating disorders.
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Affiliation(s)
- Luciana Zaccagni
- Department of Biomedical Sciences and Surgical Specialties, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121, Ferrara, Italy.,Biomedical Sport Studies Center, University of Ferrara, Ferrara, Italy
| | - Natascia Rinaldo
- Department of Biomedical Sciences and Surgical Specialties, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121, Ferrara, Italy.
| | - Barbara Bramanti
- Department of Biomedical Sciences and Surgical Specialties, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121, Ferrara, Italy. .,University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy.
| | - Jessica Mongillo
- Department of Biomedical Sciences and Surgical Specialties, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121, Ferrara, Italy
| | - Emanuela Gualdi-Russo
- Department of Biomedical Sciences and Surgical Specialties, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121, Ferrara, Italy.,Biomedical Sport Studies Center, University of Ferrara, Ferrara, Italy
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28
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Abstract
Overvaluation of shape and weight (OSW), or self-evaluation based primarily on body shape and weight, is associated with cognitive and behavioral aspects of eating disorders (including dietary restraint; concerns about eating, shape, and weight; and loss of control eating (LOC-eating), as well as psychological distress. We explored associations among OSW, depressive symptoms, and various forms of eating-related psychopathology, including whether frequency of LOC-eating mediates observed associations, among 88 bariatric surgery candidates. OSW was positively correlated with LOC-eating frequency, eating-related psychopathology, and depressive symptoms. There was a direct effect of OSW on depressive symptoms and eating-related psychopathology. LOC-eating frequency partially mediated the association between OSW and eating-related psychopathology. These findings demonstrate that OSW is important to assess as a marker of psychosocial distress.
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Ziser K, Finklenburg C, Behrens SC, Giel KE, Becker S, Skoda EM, Teufel M, Mack I, Zipfel S, Junne F. Perceived Stress Mediates the Relationship of Body Image and Depressive Symptoms in Individuals With Obesity. Front Psychiatry 2019; 10:852. [PMID: 31824352 PMCID: PMC6880609 DOI: 10.3389/fpsyt.2019.00852] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/30/2019] [Indexed: 11/30/2022] Open
Abstract
Obesity is a world-wide increasing condition classified by a BMI ≥ 30 kg/m2 that is frequently accompanied by various somatic comorbidities as well as an increased risk for mental comorbidities. Studies show associations of obesity with symptoms of depression, lower quality of life, and higher (perceived) stress compared to the general population. Body image has also been shown to play an important role in eating and weight disorders. The present study therefore aims to contribute to the understanding of the relationship of body image, perceived stress, and symptoms of depression in a morbidly obese population. N = 579 individuals with obesity were included upon presentation at a university clinic. The hypothesized mediating role of perceived stress in the relationship of body image dimensions and symptoms of depression could be confirmed. The results underline the importance of identifying promising stress management techniques and addressing perceived stress e.g. through mindfulness based approaches in the (lifestyle and/or weight) interventions for obesity taking into account the specific stressors of obesity affected individuals such as body image.
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Affiliation(s)
- Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Carina Finklenburg
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Simone Claire Behrens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Sandra Becker
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Eva-Maria Skoda
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University Duisburg-Essen, Essen, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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