Some of the burden of eating disorders is still hidden

Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis

Background

Eating disorders are illnesses that can seriously impair the health and wellbeing of patients. Written emotional disclosure has been recognized as a therapeutic technique that may be helpful in aiding patients' emotional and psychological adjustment. However, it is unclear what favorable effects eating disorder patients can derive from written emotional disclosure therapy. This study aimed to review the effectiveness of written emotional disclosure in treating eating disorders using a systematic review and meta-analysis.

Objective

This study was to examine the validity of written emotional disclosure intervention for eating disorders as well as to provide guidelines for the management of eating disorders in patients.

Methods

Researchers independently developed inclusion and exclusion criteria according to the PICOS principle and systematically searched English literature databases such as PubMed, Medline, Web of Science, Cochrane Library, CINAHL, EBSCO, Embase, and so on, from the time of library construction to December 2023. Cochrane Risk of Bias version 2 (RoB 2) was used to evaluate studies included in this review. All the studies included in this study were randomized controlled trials. Accurate information was extracted and then subjected to meta-analysis with Review Manager 5.4 software. The credibility of the evidence of the studies was assessed using GRADEprofiler 3.6 software.

Results

The final analysis included 13 randomized controlled trials involving 1,444 participants. The written emotional disclosure intervention can decrease eating disorder symptoms scores (SMD = -0.20, 95% CI [-0.34, -0.05], Z = 2.59, p = 0.01), body dissatisfaction scores (SMD = 0.37, 95% CI [0.21, 0.52], Z = 4.59, p < 0.001), and thin ideal internalization score (SMD = 0.42, 95% CI [0.22, 0.62], Z = 4.12, p < 0.001). Anxiety scores (MD = 0.43, 95% CI [-0.77, 1.63], Z = 0.70, p = 0.48), depression scores (MD = -0.66, 95% CI [-1.78, 0.47], Z = 1.14, p = 0.25) and negative affect scores (SMD = 0.51, 95% CI [-0.24, 1.27], Z = 1.33, p = 0.18), with no statistically significant differences.

Conclusion

In conclusion, this systematic review analyzed the existing literature and showed that written emotional disclosure intervention is effective in alleviating eating disorder symptoms and patients' body image problems, but there is insufficient evidence in alleviating depression, anxiety, and negative affect. However, the evidence is limited. Therefore, more research is needed in the future to further enrich the evidence for written emotional disclosure intervention in the field of eating disorders.

Systematic review registration

https://www.crd.york.ac.uk/prospero/,CRD42023445577.

Worldwide prevalence of DSM-5 eating disorders among young people

PURPOSE OF REVIEW

Eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders) affect young people worldwide. This narrative review summarizes key studies conducted on the prevalence of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) eating disorders among young people in 2013-22.

RECENT FINDINGS

In Western settings, a substantial proportion of young people have reported an eating disorder. Overall, 5.5--17.9% of young women and 0.6-2.4% of young men have experienced a DSM-5 eating disorder by early adulthood. Lifetime DSM-5 anorexia nervosa was reported by 0.8-6.3% of women and 0.1-0.3% of men, bulimia nervosa by 0.8-2.6% of women and 0.1-0.2% of men, binge eating disorder by 0.6-6.1% of women and 0.3-0.7% of men, other specified feeding or eating disorders by 0.6-11.5% of women and 0.2-0.3% of men, and unspecified feeding or eating disorders 0.2-4.7% of women and 0-1.6% of men. Gender and sexual minorities were at particularly high risk. Emerging studies from Eastern Europe, Asia, and Latin America show similar high prevalences. During the COVID-19 pandemic, the incidence of eating disorders has still increased.

SUMMARY

Eating disorders are a global health concern among young people. Improved detection, management, and prevention methods are urgently needed.