Survey on Eating Disorder–Related Thoughts, Behaviors, and Their Relationship with Food Intake and Nutritional Status in Female High School Students in Taiwan

Role of peer support on the cycle of weight teasing, psychological distress and disordered eating in Taiwanese adolescents: A moderated mediation analysis

BACKGROUND

Several studies have reported the beneficial role of social support on adolescent health. However, few studies have explored the role of peer support on the cycle of weight teasing, psychological distress, and disordered eating.

METHODS

A total of 689 adolescents aged between 13 and 16 years recruited from 37 classes in three middle schools in New Taipei City from March to June 2019 were included for analysis. Path analysis was performed using Hayes' PROCESS module.

RESULTS

The study found that weight teasing is directly and indirectly associated with disordered eating through psychological distress. Peer support plays a role in moderating the relationship between weight teasing and psychological distress; however, it is not significantly associated with decreased risk of disordered eating among adolescents experiencing weight teasing.

CONCLUSION

While peer support can be used against the adverse effects of weight teasing, it is not the absolute solution, and additional interventions are warranted.

Differential pathways to disordered eating for immigrant and native adolescents in Taiwan

BACKGROUND

Few studies have investigated disparities in disordered eating between new immigrant and native adolescents in Taiwan. This study examines the differential pathways to disordered eating in these two populations.

METHODS

This cross-sectional study analyzed data collected from March to June 2019. In total, 729 adolescents aged between 13 and 16 years recruited from 37 classes in 3 middle schools in New Taipei City were included in the final analysis. Standardized assessment tools measured disordered eating (EAT-26) and psychological distress (BSRS-5). Generalized structural equation modeling was used to conduct the path analysis.

RESULTS

The prevalence of disordered eating was significantly higher in immigrant adolescents than in their native counterparts. Multipath models indicated that weight-teasing driven by overweight and obese status and weight overestimation could lead to disordered eating through psychological distress; however, the pathways differed for the two groups studied. Family weigh-teasing indirectly leads to disordered eating through psychological distress for native adolescents; by contrast, for immigrant adolescents, friend weigh-teasing indirectly leads to disordered eating through psychological distress. Additionally, weight overestimation directly leads to disordered eating and indirectly through psychological distress to disordered eating for immigrant adolescents.

CONCLUSION

This study offers a plausible explanation of the differences in the paths to disordered eating between immigrant and native adolescents in Taiwan, which was not reported previously. The study urges the need for school-based prevention programs to improve immigrant students' mental health.

Eating Disorders among Adolescent Female Students in Jeddah, Saudi Arabia

Background

Eating disorders (EDs) are characterised by an abnormal attitude towards food that causes someone to change their eating habits and behaviour. This study aimed to investigate the prevalence of EDs and their associated factors among female going-school adolescents in Jeddah, Saudi Arabia.

Methods

A cross-sectional study was conducted in five schools in Jeddah, Saudi Arabia, among a representative random sample of female adolescent students aged 13 years old-18 years old. A simple random sampling method was used to select the participants. An online self-administered questionnaire, the Arabic version of eating attitude test (EAT-26) and socio-cultural attitudes toward appearance questionnaire (SATAQ-4), was used.

Results

More than half (53.6%) of adolescent girls scored at or above the cut-off point of EAT-26. Around 45% of the participants had experienced family influence on their appearance and body shape, 36.7% had experienced peer influence on these factors, and 49.4% had experienced media influence. Family influence was significantly associated with EDs (P = 0.013).

Conclusion

The high prevalence of EDs among female going-school adolescents in Jeddah, Saudi Arabia, is of great concern. To mitigate this problem, effective programmes must be designed to change their dietary habits while considering the effects of family, peer and media influence, as well as focusing on the importance of eating breakfast and practising physical activity.

Evaluation of Eating Habits and Nutrient Intake in Adolescents with and without Suspected Eating Disorders in Iran

Objective: Increasing the incidence of eating disorder (ED) attitude during adolescence may lead to inadequate nutrient intake and consequently to growth disorders. This study aimed to compare eating habits and nutrient intakes of adolescents with high risk and low risk of developing eating disorders in high schools in Tehran, Iran. Methods: In the current cross-sectional study, the Eating Attitude Test (EAT-26) was applied to 299 students (185 females and 114 males) aged 15-18 years for the determination of ED attitudes. Food habits and nutrient intake were assessed by a self-administered questionnaire and a validated Food Frequency Questionnaire (FFQ), respectively. Nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) were calculated using nutrient’s Dietary Reference Intake (DRI) for age and sex. Results: Of all students, 17.7% were at risk of developing ED. The results showed that girls, unlike boys, consumed more energy than they needed, but this difference between the ED group in both sexes was not significant. The distribution of sweetened drinks, candy, chocolate, and fast food frequency was significantly different between the two groups of girls (P

Restrained eating behaviour, anorexia nervosa and food consumption between children and adolescents: a scoping review

Anorexia nervosa (AN) and restrained eating behaviour (REB) are characterised by reduced food intake to achieve body weight loss. This scope review aimed to describe the existing evidence on the association between AN, restrictive eating behaviour and food consumption. Studies with children and adolescents of both sexes of all races and ethnicities were included. Experimental and observational studies, systematic reviews, meta-analysis, case reports or series, conference abstracts, dissertations and theses were also included. The search was conducted in ten electronic databases and grey literature without language restriction on 14 November 2020. Twenty-four studies met the inclusion criteria. Most studies included girls and identified lower intake of energy content, fat and certain micronutrients. There was also a higher intake of caffeine, fibre, vegetables, legumes and fruits and a lower intake of low-quality snack, fast food, sweets and foods with high carbohydrate and fat contents. The need to improve the quality of the diet among study participants was also identified. Thus, it is recommended that the evaluation of food consumption be careful to develop effective prevention strategies for the development of AN/REB and minimise nutritional deficiencies in these individuals.

Gender-specific responses to multifaceted factors associated with disordered eating among adolescents of 7th to 9th grade

BACKGROUND

The prevalence of disordered eating is increasing among adolescents in Asia. The prevalence and predictors of disordered eating in boys have often gone unrecognized. This study examined gender-specific responses to multifaceted factors associated with disordered eating, including personal, behavioral, family, and school-related characteristics.

METHODS

After excluding responses with incomplete information, a sample of 729 adolescents (48.97% boys) between the ages of 13 and 16 were surveyed through convenience sampling from 37 classrooms in three junior high schools in New Taipei City of Taiwan were analyzed. The Eating Attitudes Test-26 questionnaire was used to identify disordered eating.

RESULTS

No difference in the prevalence of disordered eating between the genders was found. Adolescent girls exhibit a preoccupation with fatness and a desire to be thinner, whereas boys are more likely to engage in extreme dieting behaviors such as vomiting, keeping the stomach empty, and avoiding sweets. Girls engaging in disordered eating reported relatively high levels of interpersonal stress involving family member weight-teasing, low peer acceptance, and high peer pressure to control weight. High intensity of regular exercise was found in girls with disordered eating. The perception of body weight is a more critical factor of engaging in disordered eating for boys than girls. Adolescents with immigrant parents were associated with disordered eating among both genders.

CONCLUSIONS

Changing gender-specific weight-related norms in schools and families is essential to reduce the prevalence of disordered eating, particularly among girls. Future studies using representative samples to confirm this study's findings are warranted.

Serum lipid profiles of young Japanese women with iron deficiency without anemia

PURPOSE

We aimed to evaluate the association between iron deficiency without anemia (IDNA) and serum lipid profiles in young women of around 20 years of age.

METHODS

This study included non-anemic (hemoglobin ≥ 12 g/dL) female volunteers aged 18 to 22 years who were not taking mineral/vitamin supplements and living in the metropolitan area of Tokyo, Japan. These volunteers were classified into two groups based on their sFer (serum ferritin) levels: normal group (sFer ≥ 20 ng/mL, n = 36) and IDNA group (sFer < 20 ng/mL, n = 29). Venous blood samples were obtained from the antecubital veins of these volunteers after 10-12-h fasting to measure the hematological and biochemical parameters, including lipid levels and iron status. The results of each group were compared using Student's t-test or the Mann-Whitney U test (for inhomogeneous variance).

RESULTS

The serum cholesterol levels varied depending on the iron status in the women. Serum high-density lipoprotein cholesterol (HDL-C) levels in the IDNA group were significantly higher (P = 0.006) than that in the normal group. However, the levels of total cholesterol (T-CHO), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) were not significantly different between the groups. Serum LDL-C levels were positively and significantly correlated with sFer levels in the IDNA group (Kendall's rank correlation 0.264, P = 0.044), but not in the normal group. The sFer level was not correlated with serum HDL-C in both groups. The reason for the high serum HDL-C levels in young women with IDNA is not yet clear. Compared to the normal group, the frequency of eating bread containing bran was significantly higher (P = 0.031) and that for yogurt was significantly lower (P = 0.040) in the IDNA group. The proportion of the women who were susceptible to infection, which was measured using the Cornell Medical Index, was significantly higher in the IDNA group than in the normal group. Among those susceptible to infection, the serum HDL-C level of the volunteers in the IDNA group was significantly higher than that of the volunteers in the normal group (P = 0.024).

CONCLUSIONS

Our findings suggest that lipid parameters may be associated with IDNA and susceptibility to infection. Further research is needed to elucidate the mechanisms underlying the changes in the serum cholesterol levels in individuals with IDNA and the clinical significance of these findings.

Linking body esteem to eating disorders among adolescents: A moderated mediation model

This study explored the roles of social appearance anxiety and emotional intelligence in the relationship between body esteem and eating-disorder risk among adolescents. A total of 2509 high-school students were sampled to participate in the study. Statistical methods mainly involved descriptive statistics, Bootstrapping, and structural equation modeling analyses. The results showed that social appearance anxiety partially mediated the relationship between body esteem and eating-disorder risk among adolescents; meanwhile, emotional intelligence moderated the effects of body esteem on social appearance anxiety and eating-disorder risk among adolescents.

"Our daily life was mainly comprised of eating and sitting:" a qualitative analysis of adolescents' experiences of inpatient eating disorder treatment in China

BACKGROUND

Some individuals with Eating Disorders (EDs) require hospitalization to stabilize and improve life-threatening physical complications. The experiences of those receiving inpatient treatment for EDs are well-documented in western samples, but less is known about the experiences of those in China, the world's most populous country in which the incidence of EDs may be increasing.

METHODS

This qualitative study aimed to use Interpretative Phenomenological Analysis to understand the experiences of four adolescents receiving inpatient treatment for EDs in China. Individual, semi-structured interviews were conducted.

RESULTS

Four themes emerged from the data: perceptions of the treatment received, peer influences during admission, the impact of treatment on wellbeing and participants' sense of self.

CONCLUSIONS

This is the first published study on the experience of Chinese participants with EDs. Their experiences share commonalities with those reported by participants in Western studies and also illuminate differences in how EDs are understood and managed in inpatient settings in China. Cross-cultural collaborations will be important to share knowledge and practice.

National population-based data on the incidence, prevalence, and psychiatric comorbidity of eating disorders in Taiwanese adolescents and young adults

OBJECTIVE

Nationwide data on eating disorders (EDs) among East Asian populations are scarce. This study aimed to estimate the prevalence, incidence, and psychiatric comorbidities of EDs in Taiwan.

METHOD

Drawing from the National Health Research Institute database, we identified the study subjects aged 11-34 years who received an ED diagnosis during ambulatory visits or hospitalization from 2001 to 2012. We analyzed the subjects by age and gender. Diagnoses for comorbid psychiatric disorders were entered in the analysis only if they occurred within 1 year before or after the ED diagnosis date. Rates were age- and sex-adjusted to the average population within the study period.

RESULTS

The estimated mean annual incidence was approximately 11.11 (95% CI 10.51-11.72) per 100,000 residents, and the 1 year prevalence was 20.87 (95% CI 20.05-21.70) per 100,000 residents, with evidence of female predominance (female/male ratio = 10.95, 95% CI = 8.97-13.36). Incidence and prevalence peaked at ages 20-24 in females and at ages 25-29 in males. Both rates nearly doubled within a decade. Specifically, the anorexia nervosa trend recently stabilized in females and decreased in males, while that for bulimia nervosa increased in both females and males. The most common comorbid diagnoses were anxiety (53%) and major depressive disorders (22%).

DISCUSSION

The incidence and prevalence of EDs were lower in Taiwan than in Western countries. However, these rates were rapidly rising, notably in males. The majority of Taiwanese ED patients also received a diagnosis for various psychiatric comorbidities, a finding worthy of clinical attention.

Body image dissatisfaction and dietary patterns according to nutritional status in adolescents

OBJECTIVE

There is a lack of data on the association between body self-perception and eating patterns in Brazil. Thus, this study aimed to explore the relationship between body image dissatisfaction and eating patterns by the anthropometric status in adolescents.

METHODS

A cross-sectional study of 1496 adolescents was conducted. The participants completed the Body Shape Questionnaire. Demographic, anthropometric, and socioeconomic data were collected, as well as information regarding the pubertal development and dietary intake. Logistic regression was performed to evaluate the associations of interest.

RESULTS

Body image dissatisfaction was identified in 19.5% of the adolescents. Three dietary patterns were identified: (1) the Western pattern was composed of sweets and sugars, soft drinks, typical dishes, pastries, fast food, beef, milk, and dairy products; (2) the Traditional pattern was composed of oils, chicken, fish, eggs, processed meat products, cereals (rice, cassava flour, pasta, etc.), baked beans, and bread; and (3) the Restrictive pattern was composed of granola, roots, vegetables, and fruit. Among overweight/obese adolescents, the data indicated a negative association of slight body image dissatisfaction (OR: 0.240 [0.100; 0.576]) and moderate body image dissatisfaction (OR: 0.235 [0.086; 0.645]) with the Western dietary pattern. Additionally, in this group, there was a positive association between high body image dissatisfaction and the Restrictive pattern (OR: 2.794 [1.178; 6.630]).

CONCLUSION

Amongst overweight/obese adolescents, those with slight and moderate body image dissatisfaction were less likely to follow a Western-like dietary pattern when compared with those satisfied with their body image. Additionally, in this group, adolescents with high body image dissatisfaction was more likely to follow a restrictive pattern.

Relationship between Peer Pressure and Risk of Eating Disorders among Adolescents in Jordan

BACKGROUND

The prevalence of disordered eating behaviors (DEBs) have increased worldwide. It is estimated that about 31.6% of Jordanian adolescents developed DEB. Engaging in peer groups is a prominent event in which adolescents try to belong to peers as part of exploring their social identity.

PURPOSE

To assess the relationship between risk of eating disorders and peer pressure among adolescents.

METHODS

A descriptive, correlational, cross-sectional design utilized multistage cluster sampling technique was used to recruit students from 8th to 10th grades from both sexes from schools in northern Jordan. Data were collected from a self-administered, online questionnaire which was given to 738 participants.

RESULTS

The difference in overall mean of the Inventory of Peer Influence on Eating Concerns (I-PIEC) between adolescents with disordered eating behaviors and normal eating behaviors states was statistically significant. Scores for interaction peer pressure means were statistically higher for girls than for boys; conversely, likeability mean scores were statistically higher for boys than girls.

CONCLUSIONS

The current findings suggest that healthcare professionals are encouraged to conduct appropriate school-based primary prevention for disordered eating behaviors.

Eating behaviour disorders among adolescents in a middle school in Dongfanghong, China

BACKGROUND

Disordered eating behaviours (DEB) are significant public health challenges among adolescents. DEB are prevalent among Chinese young people and replication epidemiological studies in DEB are needed due to ongoing rapid modernization and socio-economic change. In addition, there has been no prevention or intervention programs for DEB in most of rural areas in China and research in DEB in rural China is limited. More research in DEB in rural China is needed for increased awareness of prevention strategies. The objectives of the study are to examine the prevalence and associated factors of DEB among rural Chinese adolescents.

METHODS

Four hundred and sixty-six students aged 11-18 years old from a middle school in rural China were invited to complete a self-reported questionnaire that included measures on DEB and psychosocial factors. The SCOFF questionnaire was applied to measure DEB (i.e., a score of > = 2 indicates a likely case of DEB). Logistic regression models were applied for data analyses. A p-value <0.05 was regarded as statistically significant.

RESULTS

There were 389 adolescents (11-18 years) included in this study with the prevalence of DEB being 28.8%. No significant differences were found between male adolescents (30.5%) and female adolescents (27.1%). Independently, perceived overweight (OR = 2.80, 95% CI = 1.05-7.48), negative affect (OR = 1.07, 95% CI = 1.03-1.12), body dissatisfaction (OR = 0.96, 95% CI = 0.93-0.99), and watching TV (OR = 2.40, 95% CI = 1.11-5.18) were significantly (p < 0.05) associated with DEB.

CONCLUSION

This study indicates a high prevalence rate of DEB among rural adolescents and associated factors of DEB from a school-based sample. Such findings imply that local public health systems should pay more attention to DEB and design prevention and intervention strategies for DEB.

The rise of eating disorders in Asia: a review

Once concentrated among adolescent Caucasian females in high-income Western countries, today, eating disorders (EDs) are truly global. Building upon previous work describing the rise of EDs among cultures in transition, we contextualize the emergence of EDs in Asia by locating this development within the broader discourse about the processes of change that have radically transformed Asian societies over the last three decades. By identifying where EDs are emerging in the region, and by examining their particular expression, our aim is to explicate a fuller story of the relationship between culture and eating disorders. Much of the discussion of EDs in non-Western societies is predicated upon the assumption that an increase in EDs is the by-product of "Westernization", the term used to describe the process by which increased cultural contact with the West results in the transmission of so-called 'Western' ideas and cultural norms to a non-Western culture. While the Westernization literature represents a historical anchor in our understanding of EDs in Asia, we propose that this analysis is incomplete in that societal change in the form of industrialization and urbanization occurring independently from, or in tandem with, "Western" influence are critical factors contributing to the rise of EDs in Asia. Further, our review of eating disorders in Asia suggests that an understanding of the diversity and distinctiveness of the individual countries and cultures that comprise 'Asia' is crucial to understanding the emergence and rise of EDs across this vast region, suggesting that eating disorders are not culture-bound or culture-specific, but rather culture-reactive. Taking into account both the historical influence of Western culture and the more contemporary effects of Asian industrialization and urbanization, key distinctions among respective Asian cultures expands our understanding of the development and expression of EDs globally.

Dietary intake and nutritional risk in Mediterranean adolescents in relation to the severity of the eating disorder

OBJECTIVE

To assess the relationship between the degree of severity of eating disorders (ED) and energy and nutrient intakes and nutritional risk in a mixed-sex adolescent population without clinical symptoms.

DESIGN

Cross-sectional study.

SETTING

Data were collected in schools.

SUBJECTS

Adolescents (n 495) aged 14·2 (sd 1·0) years. The Eating Attitudes Test was used to detect adolescents at risk of ED (rED) and a structured interview based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, was used to diagnose eating disorder not otherwise specified (EDNOS). Dietary intake was quantified using the 24 h recall method over three days and the probability of inadequate intake was determined.

RESULTS

Females presented lower intakes of energy, macronutrients and micronutrients (Ca, Fe, Mg, K, P, Na, thiamin, vitamins E, C, B6, B12, pantothenic acid, folic acid) because the severity of their ED was greater. These lower dietary intakes led to nutritional risk (for Ca, Fe, Mg, P, vitamins A, D, B6) in more than 80 % and 60 % of females with EDNOS and rED, respectively. The multiple linear regression models showed that the rED and EDNOS groups presented a lower energy intake of 1597·4 kJ/d (381·8 kcal/d) and 3153·0 kJ/d (753·6 kcal/d), respectively. In contrast, little difference was observed in the nutritional intakes of males.

CONCLUSIONS

The female adolescents showed lower energy and nutrient intakes as the ED became more severe, which led to energy, vitamin and mineral deficiencies in a high percentage of females with ED. These nutritional risks could hinder adequate physical and psychological development and lead to chronic ED.

Disordered eating attitudes, alexithymia and suicide probability among Turkish high school girls

We aimed to examine association between disordered eating attitudes (DEAs), alexithymia and suicide probability among adolescent females and to explore potential link between alexithymia and suicide probability in subjects with DEAs. 381 female students completed Eating Attitude Test (EAT-26), Toronto Alexithymia Scale (TAS-20) and Suicide Probability Scale (SPS). It was found that 13.2% (n=52) of the subjects have DEAs. Results indicated that total TAS-20 score and scores of Difficulty in Identifying Feelings (DIF) and Difficulty in Describing Feelings (DDF) subscales were significantly higher in DEAs group than in those non DEAs group (p<0.05). Additionally, total SPS score (p<0.001), Hopelessness (p=0.001), Suicide Ideation (p<0.001) and Hostility (p=0.003) subscales scores of SPS were significantly higher in the alexithymic DEAs than the non-alexithymic DEAs group. In order to control potential effect of depression, SPS subscales were used as covariate factors in ANCOVA. Negative Self-Evaluation subscale yielded a statistically significant difference between groups, other subscales did not. Results point out these; DEAs are relatively frequent phenomenon among female students in Turkey and presence of alexithymia was associated with an increased suicide probability in adolescents with DEAs. The results should be evaluated taking into account that depressive symptomatology was not assessed using a depression scale.

Cultural trends and eating disorders

PURPOSE OF REVIEW

Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures.

RECENT FINDINGS

While historically, eating disorders were conceptualized as primarily afflicting Caucasian adolescent or young adult women within high-income, industrialized Western Europe and North America, eating disorders are increasingly documented in diverse countries and cultures worldwide. This study highlights recent trends that reflect the changing landscape of culture and eating disorders: stabilization of the incidence of anorexia nervosa and possibly lower incidence rates of bulimia nervosa in Caucasian North American and Northern European groups; increasing rates of eating disorders in Asia; increasing rates of eating disorders in the Arab region; and increasing rates of binge eating and bulimia nervosa in Hispanic and Black American minority groups in North America.

SUMMARY

The changing face of eating disorders calls for a new conceptualization of culture in both the emergence and spread of eating disorders across the globe.

Iron deficiency without anemia is associated with anger and fatigue in young Japanese women

Iron deficiency without anemia (IDNA), the most prevalent nutritional deficiency worldwide, affects young women of reproductive age. This study aimed to elucidate the relationship between IDNA and mental and somatic symptoms including anger and fatigue using the Japanese version of the Cornell Medical Index Health Questionnaire (CMI-J). Data regarding demographic characteristics, anthropometry, hematological, and biochemical indices of the iron status, frequencies of selected food intakes assessed by self-administered food frequency questionnaires (FFQs), frequencies of nonspecific symptoms, and grades of neurotic tendencies assessed by CMI-J were collected from 76 young women aged 18-22 years living in the metropolitan area of Tokyo, Japan. The subjects were classified as having IDNA (hemoglobin (Hb)≥12 g/dL and serum ferritin<20 ng/mL; n=29), having iron deficiency anemia (IDA) (Hb<12 g/dL and serum ferritin<20 ng/mL; n=10), or having a normal iron status (Hb≥12 g/dL and serum ferritin≥20 ng/mL; n=36). One subject was excluded from the analyses because of Hb<12 g/dL and serum ferritin≥20 ng/mL. Fisher's protected least significant difference and the Dwass-Steel-Chritchlow-Fligner multiple comparison tests were used to compare the data of the three groups. P values<0.05 were considered significant. Sections M-R (mental complaints) were significantly higher in the IDNA subjects than in the normal subjects. No significant difference in CMI scores was found between the normal and IDA subjects. Sections I (fatigability), Q (anger), and R (tension) were significantly higher in the IDNA subjects than in the normal subjects, regardless of no significant differences between the normal and IDA subjects in those sections. Young women with IDNA demonstrated a significantly higher proportion of neurotic tendencies (grades II-IV). The intake frequency score of canned or bottled green tea fortified with vitamin C was significantly higher in the IDNA subjects than the IDA subjects. The findings suggest that IDNA may be a risk factor for anger, fatigue, and tension in women of childbearing age.

Eating Behaviours and Body Weight Concerns among Adolescent Girls

This paper presents a global review of research done on adolescent eating behaviours and food choices and the probable factors underlying it. Worldwide adolescent girls tend to develop moderate to high level of disordered eating behaviour as a result of their excessive concern with body weight or obsession with thinness. The objective of the review is to understand the concerns over body weight and the current eating patterns of adolescent girls in the developed and developing countries.

Body image and eating patterns among adolescents

BACKGROUND

Data on the association between body self-perception and eating patterns among adolescents are scarce. This study assessed the association between body image and eating patterns among normal-weight, overweight and obese adolescents.

METHODS

A cross-sectional survey (n = 1231; 12-17 years old) was carried out in the Balearic Islands, Spain. Anthropometry, body image, socio-economic determinants, and food consumption were studied.

RESULTS

Fifty-one percent of boys and sixty percent of girls that wished to be thinner had less than or equal to 3 eating occasions per day. Overfat girls that wish to be thinner skipped breakfast more frequently than normal-fat girls. Overfat boys and girls that wished a thinner body reported lower consumption of several food groups than normal-fat adolescents and overfat boys satisfied with their own body image (i.e. breakfast cereals, pasta and rice dishes, other oils and fats, high fat foods, soft drinks and chocolates in boys; and dairy products and chocolates in girls).A restriction of Western diet foods and energy intake was associated with a wish to be thinner among overfat adolescents.

CONCLUSIONS

Many overfat boys were satisfied with their body image while practically all overfat girls reported wishing a thinner body. Meal patterns and food consumption were associated with body dissatisfaction and overfat status among adolescents.

Risk of disordered eating attitudes among adolescents in seven Arab countries by gender and obesity: a cross-cultural study

The objectives were to discover the prevalence of disordered eating attitudes (EAs) among adolescent males and females, and the association of obesity with EA in seven Arab countries. A multistage stratified sampling technique was used to select secondary students aged 15-18 years from cities in Algeria, Jordan, Kuwait, Libya, Palestine, Syria and Sharijah Emirate (United Arab Emirates). The total sample was 4698 (2240 males and 2458 females). The Eating Attitudes Test (EAT-26) was used to measure those at risk of disordered EA. Obesity was calculated according to the International Obesity Taskforce criteria. Participants were grouped into two categories, non-obese and obese (overweight and obese). The risk of disordered EA was twice as high among females as in males in Jordan, Libya, Palestine and Syria. Kuwaiti adolescents (males and females) showed higher prevalence of disordered EA than their counterparts in other countries. The risk of disordered EA among obese adolescents was two to three times higher than that of non-obese adolescents, in both genders. Excepting Kuwaiti females and Palestinian males. The association of obesity with disordered EA was statistically significant. This study highlighted the magnitude of the risk of disordered eating attitudes among both male and female adolescents in Arab countries and identified the need for programmes to prevent and control these disorders in the Arab region.