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Jouppi RJ, Emery Tavernier RL, Call CC, Kolko Conlon RP, Levine MD. Furthering development of the Eating Disorder Examination-Pregnancy Version (EDE-PV): Exploratory factor analysis and psychometric performance among a community sample of pregnant individuals with body mass index ≥ 25. Eat Disord 2024; 32:43-59. [PMID: 37997951 PMCID: PMC10841290 DOI: 10.1080/10640266.2023.2259674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Psychometrically sound measures of disordered eating during pregnancy are needed, particularly for pregnant individuals with body mass index (BMI) ≥ 25, who are at high risk for disordered eating attitudes/behaviors. We previously adapted the Eating Disorder Examination (EDE) for use among pregnant individuals with BMI ≥ 25. This study examined the factor structure of the EDE-Pregnancy Version (EDE-PV) in a community sample of pregnant individuals with BMI ≥ 25. The EDE-PV was administered to 257 pregnant individuals with pre-pregnancy BMI ≥ 25 between 12 and 20 weeks gestation. The EDE-PV factor structure was determined using an exploratory factor analysis with oblique geomin rotation, internal consistency coefficients were calculated, and convergent and discriminant validity of the EDE-PV factors were assessed. An 11-item, two-factor solution produced an acceptable model fit. The subscales did not replicate those of the EDE and were interpreted as Pregnancy Eating and Weight Change Concerns and Pregnancy Shape and Weight Concerns (αs=.67 and .85; ωs=.70 and .85, respectively). These subscales showed small-to-moderate, positive correlations with weight and psychosocial distress measures and differentiated between participants with and without lifetime histories of any eating disorder diagnosis, demonstrating adequate convergent and discriminant validity. The results indicate that the EDE-PV can more reliably identify factors associated with disordered eating attitudes/behaviors among pregnant individuals with BMI ≥ 25 compared to the EDE and support our call for the development and use of new and/or adapted measures to appropriately assess disordered eating during pregnancy.
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Affiliation(s)
- Riley J Jouppi
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Rebecca L Emery Tavernier
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
| | - Christine C Call
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, USA
| | | | - Michele D Levine
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, USA
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Iglesias López MT, Marchena-Giráldez CA, Bernabéu-Brotons E. Nutrient intake, alcohol consumption, emotional eating and anxiety in women nursing students. Heliyon 2023; 9:e22903. [PMID: 38144331 PMCID: PMC10746424 DOI: 10.1016/j.heliyon.2023.e22903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Objective The aim of the study was to analyze dietary habits, alcohol habits, emotional eating and anxiety in a sample of Spanish nursing students. These students appear to be essential to the field of public health and to teaching their future patients about their own good practices. Methods A cross-sectional investigation was conducted. Participants completed the Emotional Eater Questionnaire, the Alcohol Use Disorder Identification Test (AUDIT) test to evaluate alcohol intake, the State-Trait anxiety Inventory (STAI) test to measure levels of anxiety as a state and anxiety as a trait, and self-reported sociodemographic data. Following classroom instruction, three-day food records were used to gauge food intake. Results The calorie intake for the macronutrients Ca, Mg, K, and Fe were below the Recommended Dietary Intakes (DRI) and imbalanced. The percentage E of proteins was 132.7 % more than recommended, while the percentage of carbohydrates is below the recommended level. Dietary energy consumption barely equaled 78 % of the total energy consumed by this sex and age group. With respect to emotional eating, nursing women students were low emotional eater (44 %) > emotional eater (30 %) > non-emotional eater (22.7 %). The students' emotional eating is substantially connected with fast food and sweets, or less healthy food intake behaviors. According to the Alcohol Use Disorder Identification Test (AUDIT), 82.7 % of female students used alcohol on a regular basis in a low-risk manner. Conclusion The findings demonstrated a link between anxiety and dietary fat intake. Trait anxiety was negatively connected with emotional eating (EE), whereas state anxiety was positively correlated with meat consumption. It is crucial to consider these findings when creating prevention/intervention plans and profiles of harmful eating behaviors.
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Weinstock M, Thornton LM, Raynor HA, Mazzeo SE, LaRose JG, Caccavale LJ, Tatum KL, Bean MK. Parent involvement approach and changes in eating pathology within an adolescent obesity intervention. Eat Behav 2023; 51:101807. [PMID: 37659210 PMCID: PMC10840818 DOI: 10.1016/j.eatbeh.2023.101807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Although adolescents with obesity have heightened risk for eating pathology, the impact of differential parent involvement on eating pathology after obesity treatment is unknown. We examined differences in eating pathology in adolescents whose parents were randomized to distinct interventions within adolescent obesity treatment. METHODS Participants were 82 adolescent/parent dyads (adolescents: 63 % female; 55 % racial/ethnically marginalized) enrolled in TEENS+, a 4-month behavioral weight loss intervention. Parents were randomized to either a parent weight loss treatment (TEENS+PWL) or parent skills training (TEENS+PAC). Adolescents completed the Eating Disorder Examination-Questionnaire with Instructions (EDE-Q-I) and Child Depression Inventory (CDI) at baseline, 4 m, and 7 m. Group differences in eating pathology (global score; eating concern, weight concern, shape concern, restraint) and depression across time points were evaluated with linear mixed models. RESULTS No significant differences were observed between TEENS+PAC and TEENS+PWL in eating pathology or depression, nor were there group by time interactions. Time point differences were observed for all EDE-Q-I and CDI outcomes, except eating concerns; pairwise contrasts revealed a variety of change patterns. Weight and shape concerns decreased from 0 to 4 m; observed reductions were maintained at 7 m. Restraint was highest at 4 m and decreased at 7 m but did not return to baseline. EDE-Q-I global scores significantly declined over time. Depression decreased over time, but a significant difference was only observed between 0 and 7 m. CONCLUSIONS Neither parent intervention yields harm related to eating pathology in adolescents engaged in obesity treatment. Obesity treatment does not appear to have iatrogenic effects on eating pathology in adolescents.
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Affiliation(s)
- Madison Weinstock
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica Gokee LaRose
- Department of Health and Behavior Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
| | - Laura J Caccavale
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Kristina L Tatum
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Melanie K Bean
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA.
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de Macêdo PFC, Brito E, de Magalhães Cunha C, da Purificação Nazaré Araújo M, Martins PC, de Santana MLP. Weight stigma and disordered eating behaviors during the COVID-19 pandemic: the mediating role of weight gain concern and psychological distress. Eat Weight Disord 2023; 28:78. [PMID: 37759035 PMCID: PMC10533574 DOI: 10.1007/s40519-023-01608-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES The purpose of this study is to investigate whether the relationship between weight stigma experiences and disordered eating behaviors during the COVID-19 pandemic is mediated by weight gain concern and psychological distress among university students with and without overweight. METHODS A cross-sectional study was conducted with university students from five regions of Brazil who participated in the baseline assessment of the Online Cohort on Eating Behavior and Health (July/August 2020). Information on the frequency of binge eating episodes, food restriction, and purging, as well as experienced weight stigma, weight gain concern, and psychological distress, were recorded in an online questionnaire. Stratified structural equation modeling (SEM) analyses were performed to address the research questions of interest. RESULTS Out of the total sample (n = 2511), 33.5% of participants reported experiencing weight stigma. The prevalence of binge eating episodes, food restriction, and purging was 43.7%, 24.1%, and 5.4%, respectively. These behaviors were more prevalent in individuals with overweight than in those without this condition. Furthermore, it was observed that weight gain concern and psychological distress mediated the relationship between weight stigma and disordered eating behaviors regardless of body weight status. CONCLUSIONS Experiences of weight stigma and disordered eating behaviors were prevalent among Brazilian university students, especially among those with overweight. Weight gain concern and psychological distress appear to be important factors underlying the relationship between these constructs during the pandemic, and they can contribute to the development of targeted strategies for the prevention and management of disordered eating. LEVEL OF EVIDENCE Level V, cross-sectional study.
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Affiliation(s)
| | - Edleide Brito
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Carla de Magalhães Cunha
- School of Nutrition, Federal University of Bahia, Campus Canela, Rua Basílio da Gama, Salvador, BA, 40110-907, Brazil
| | | | - Poliana Cardoso Martins
- School of Nutrition, Federal University of Bahia, Campus Canela, Rua Basílio da Gama, Salvador, BA, 40110-907, Brazil
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McLean SA, Rodgers RF, Slater A, Jarman HK, Gordon CS, Paxton SJ. Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls. Eur Child Adolesc Psychiatry 2022; 31:1921-1932. [PMID: 34129105 DOI: 10.1007/s00787-021-01824-4] [Citation(s) in RCA: 18] [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: 10/28/2020] [Accepted: 06/08/2021] [Indexed: 01/26/2023]
Abstract
Body dissatisfaction is distressing and a risk factor for adverse consequences including eating disorders. However, data pertaining to the prevalence of body dissatisfaction in adolescence, a key period for its emergence, are lacking. This is a substantial barrier to tailored assessment and early intervention. This study addresses this gap and provides the prevalence of body dissatisfaction and associations with depressive symptoms and body change strategies. Adolescent boys (n = 367; Mage = 12.8, SD = 0.7) and girls (n = 368; Mage = 12.7, SD = 0.7) completed measures of body dissatisfaction and depressive symptoms with established cut-off levels. They also completed measures of dietary restraint and strategies to increase muscle size. Of boys and girls, 37.9% and 20.7%, respectively experienced moderate, and 6.8% and 19.6% experienced clinically significant body dissatisfaction, with higher rates among girls than boys and among adolescents aged 13 and 14 than aged 12. More than one-quarter of boys (26.70%) and one-third of girls (33.15%) reported subthreshold depressive symptoms or possible, probable or major depressive episodes. Girls revealed a higher prevalence of possible-, probable-, or major depressive episode than boys. Relative to those with no or low body dissatisfaction, adolescents with clinically significant body dissatisfaction were 24 times more likely to also report possible-, probable-, or major depressive episodes. Among boys and girls, clinically significant body dissatisfaction was associated with higher levels of dietary restraint and engagement in strategies to increase muscle size. Greater attention to identification and early intervention for body dissatisfaction is needed, especially for girls.
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Affiliation(s)
- Siân A McLean
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Melbourne, 3056, Australia.
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Amy Slater
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Hannah K Jarman
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Melbourne, 3056, Australia
| | - Chloe S Gordon
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Melbourne, 3056, Australia
- ACU Engagement, Australian Catholic University, Melbourne, Australia
| | - Susan J Paxton
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Melbourne, 3056, Australia
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6
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Silva-Breen H, Schneider J, Tinoco A, Matheson EL, LaVoi NM. Development and preliminary validation of the Coach Self-Efficacy Body Image Scale (CSEBIS). Body Image 2022; 43:408-419. [PMID: 36345079 DOI: 10.1016/j.bodyim.2022.10.008] [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: 05/17/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022]
Abstract
Body image concerns are a commonly cited reason for sport drop out. Researchers have begun to explore the influence of coaches on athletes' body image. However, no measure exists to accurately and easily assess interventions or predict coaches' body image supportive behaviors. Using Self-Efficacy Theory as a conceptual framework, the Coach Self-Efficacy Body Image Scale (CSEBIS) was developed. Content validity was judged by a panel of experts (N = 3) and through interviews with coaches (N = 4) across various sports and experience levels. Following initial item iteration, the CSEBIS was assessed with 682 coaches for reliability and validity. The 27 items across four subscales (knowledge, recognition, engagement, disengagement) showed good reliability (internal consistency, test-retest reliability, inter-item and item-total correlations), validity (convergent and discriminant validity, differentiation between known groups), factor structure, and model invariance across gender. Developing and initially validating the CSEBIS contributes to the existing literature by providing researchers with a novel scale to measure coaches' confidence in identifying and addressing body image concerns among their athletes. Following further testing, this instrument may be used to assess the effectiveness of body image education and intervention efforts in sport, and the impact of coaches' attitudes and behaviors on athletes' body image.
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Affiliation(s)
- Hannah Silva-Breen
- The Tucker Center for Research on Girls & Women in Sport, University of Minnesota, 1900 University Avenue SE, Minneapolis, MN 55455, United States
| | - Jekaterina Schneider
- Centre for Appearance Research, School of Social Sciences, College of Health, Science and Society, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom.
| | - Aline Tinoco
- Centre for Appearance Research, School of Social Sciences, College of Health, Science and Society, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Emily L Matheson
- Centre for Appearance Research, School of Social Sciences, College of Health, Science and Society, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Nicole M LaVoi
- The Tucker Center for Research on Girls & Women in Sport, University of Minnesota, 1900 University Avenue SE, Minneapolis, MN 55455, United States
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7
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Day S, Bussey K, Trompeter N, Mitchison D. The Impact of Teasing and Bullying Victimization on Disordered Eating and Body Image Disturbance Among Adolescents: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:985-1006. [PMID: 33461439 DOI: 10.1177/1524838020985534] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Adolescence is a developmental period in which disordered eating and negative body image are highly prevalent, yet their risk factors are insufficiently understood and targeted. Despite research implicating both teasing and bullying victimization in the development of eating disorders, these strands of research are yet to be integrated. This systematic review hence aimed to identify whether teasing and bullying victimization are associated with greater risk of eating disorders and body image disturbance for adolescents. Systematic searches of PsycINFO and PubMed databases identified 79 papers that included quantitative analyses of the relationship between weight-related or nonspecific teasing or bullying victimization and disordered eating or body image disturbance. Overall, studies indicated that adolescents who are teased or bullied are more likely to experience disordered eating and negative body image compared to nonvictimized adolescents. This was more consistently observed in cross-sectional studies than in longitudinal findings. We identify several methodological limitations of the literature, including the infrequent consideration of potential mediating and moderating variables. Finally, we outline future directions such as temporal sequencing of the complex interrelationships among teasing and bullying, disordered eating, and body image disturbance in adolescents.
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Affiliation(s)
- Sinead Day
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kay Bussey
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Nora Trompeter
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- School of Medicine, Blacktown Clinical School, Translational Health Research Institute, Western Sydney University, Penrith, Australia
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8
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Dougherty EN, Goldschmidt AB, Johnson NK, Badillo K, Engel SG, Haedt-Matt AA. Gender differences in the relation between interpersonal stress and momentary shape and weight concerns in youth with overweight/obesity. Body Image 2022; 40:249-255. [PMID: 35074653 PMCID: PMC8891090 DOI: 10.1016/j.bodyim.2022.01.006] [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: 08/29/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to examine relations between interpersonal stress and momentary shape and weight concerns among pre-adolescent and early adolescent boys and girls with overweight/obesity, using ecological momentary assessment (EMA). We also aimed to determine whether interpersonal stress was differentially related to shape/weight concerns in boys versus girls. Forty youth, ages 8-14 years (53% female), with overweight or obesity reported their state-level shape/weight concerns and negative affect and their recent interpersonal stress (i.e., stress experienced since the last EMA assessment) multiple times a day, for two weeks. Results indicated that interpersonal stress predicted shape/weight concerns in girls but was not related to shape/weight concerns in boys. At the between-person level, higher overall feelings of loneliness and social rejection and a higher overall desire for more friends predicted higher average levels of shape/weight concerns. At the within-person level, higher momentary ratings of loneliness, social rejection, and desire for more friends predicted lower shape/weight concerns. These data suggest that the tendency to experience interpersonal stress may be more detrimental to body satisfaction for girls with overweight/obesity than for boys with overweight/obesity. Interventions that focus on reducing interpersonal stress may be effective in ameliorating shape/weight concerns in girls with overweight/obesity.
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Affiliation(s)
| | | | | | | | - Scott G. Engel
- Sanford Research,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences
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Stewart TM, Martin CK, Williamson DA. The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:491. [PMID: 35010751 PMCID: PMC8745028 DOI: 10.3390/ijerph19010491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.
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Affiliation(s)
- Tiffany M. Stewart
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (C.K.M.); (D.A.W.)
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10
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Banna MHA, Dewan MF, Tariq MR, Sayeed A, Kundu S, Disu TR, Akter S, Sahrin S, Khan MSI. Prevalence and determinants of eating disorder risk among Bangladeshi public university students: A cross-sectional study. Health Psychol Res 2021; 9:24837. [PMID: 34746487 DOI: 10.52965/001c.24837] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/28/2020] [Indexed: 11/06/2022] Open
Abstract
Eating disorders among university students have been increasing day by day in developing countries. However, there is a dearth of existing literature that assessed eating disorder risk among this population group in Bangladesh. Thus, this study aimed to assess the prevalence of eating disorder risk and its associated factors among university students. A cross-sectional study was conducted among 365 Bangladeshi public university students from October to December 2019. Data were collected by self-reported questionnaire on socio-demographic characteristics, risk of eating disorder, and nutritional status of study participants. The respondents' eating disorder risk and nutritional status were assessed using the validated eating attitudes test-26 (EAT-26) tool and anthropometric measurement, respectively. A cut-off score of ≥ 20 based on EAT-26 indicates the presence of an eating disorder risk. Finally, a binary logistic regression was employed to identify the determinants of an eating disorder. The prevalence of 'eating disorder risk' was 23.0% (95% confidence interval [CI]: 18.6 to 27.4). Being female (adjusted odds ratio [AOR] = 2.4, 95% CI: 1.4 to 4.2), aged between 17-21 years (AOR = 2.0, 95% CI: 1.2 to 3.6), overweight (AOR = 4.9; 95% CI: 1.6 to 14.9) and obese (AOR = 7.7, 95% CI: 1.9 to 31.4) showed a higher odds of having an eating disorder risk in the present study. The higher prevalence of eating disorders in the study indicates that psychological intervention and health awareness programs, particularly to younger age, female, and overweight and obese students at the university level, would effectively prevent the eating disorder risk.
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Affiliation(s)
- Md Hasan Al Banna
- Patuakhali Science and Technology University, Patuakhali- 8602, Bangladesh
| | - Md Forshed Dewan
- Patuakhali Science and Technology University, Patuakhali- 8602, Bangladesh
| | | | - Abu Sayeed
- Patuakhali Science and Technology University, Patuakhali- 8602, Bangladesh
| | - Satyajit Kundu
- Patuakhali Science and Technology University, Patuakhali- 8602, Bangladesh
| | - Tasnim Rahman Disu
- Medical Officer, Institute of Public Health Nutrition, Mohakhali, Dhaka-1212, Bangladesh
| | - Sumaiya Akter
- Patuakhali Science and Technology University, Patuakhali- 8602, Bangladesh
| | - Sumaia Sahrin
- Patuakhali Science and Technology University, Patuakhali- 8602, Bangladesh
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Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls. Nutrients 2021; 13:nu13113825. [PMID: 34836084 PMCID: PMC8674763 DOI: 10.3390/nu13113825] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/24/2022] Open
Abstract
Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants (n = 892; Mage = 12.77, SD = 0.74; range 11–15; 49.5% male) were randomized by school (n = 8) to receive either weekly SoMe (n = 483) or control sessions (lessons as usual; n = 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.
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12
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Cohrdes C, Santos-Hövener C, Kajikhina K, Hölling H. The role of weight- and appearance-related discrimination on eating disorder symptoms among adolescents and emerging adults. BMC Public Health 2021; 21:1751. [PMID: 34565379 PMCID: PMC8474924 DOI: 10.1186/s12889-021-11756-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorder symptoms (EDs) have been discussed as a prominent problem among late adolescent girls with serious health risks and long-term consequences. However, there is a lack of population-based evidence on EDs comprising the age range from early adolescence to emerging adulthood as well as considering both females and males equally. Additionally, the differential role of a comprehensive set of several relevant risk factors and particularly weight- and appearance-related discrimination warrants further attention. Thus, we aimed to contribute to a better understanding of sex- and age-related differences in associations between discrimination experience and other relevant personal risk factors (body image, social media use, self-efficacy, social support) with EDs. Furthermore, we were interested in the exploration of underlying mechanisms enhancing the risk of EDs by taking discrimination experience into account. METHODS Based on a logistic regression model, we investigated associations between weight- and appearance-related discrimination and EDs while controlling for other relevant personal risk factors in a subsample of N = 8504 adolescents and emerging adults (54.4% female, mean age = 20.71 years, SD = 4.32 years) drawn from a German representative health survey (KiGGS Wave 2). In a second step, we investigated the mediating role of discrimination experience between the other risk factors and EDs with the help of a path model. RESULTS While controlling for other relevant personal risk factors, weight- and appearance-related discrimination was significantly related to EDs. Whereas the risk of EDs was significantly enhanced in males and emerging adults frequently experiencing weight-related discrimination, adolescents showed a higher risk of EDs when experiencing appearance-related discrimination. Moreover, discrimination experience partly explained the associations between body image dissatisfaction, low self-efficacy, high media use and ED symptoms. CONCLUSIONS The results highlight weight- and appearance-related discrimination as one central factor to be considered in the pathogeneses of EDs and underpin the need for discrimination prevention as well as the promotion of adaptive coping with discrimination experience to reduce the risk of developing ED symptoms. Males and emerging adults need particular attention when facing weight-related discrimination whereas risk constellations and EDs particularly affecting females need further investigation.
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Affiliation(s)
- Caroline Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
| | - Claudia Santos-Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Katja Kajikhina
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
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13
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Lister NB, Baur LA, Paxton SJ, Jebeile H. Contextualising Eating Disorder Concerns for Paediatric Obesity Treatment. Curr Obes Rep 2021; 10:322-331. [PMID: 33970441 DOI: 10.1007/s13679-021-00440-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW Eating disorders are complex mental health conditions that share risk factors with obesity. This review outlines the context for concerns that paediatric obesity treatment presents a risk for eating disorder development. RECENT FINDINGS Most children and adolescents undergoing professionally supervised obesity treatment will have improvements or no change to eating disorder risk profiles. However, some may subsequently develop a clinical eating disorder, and this is proposed to relate to weight-focussed dietary interventions that are standard in paediatric obesity treatment. Nevertheless, dietary restraint may not be a strong predictor of eating disorder risk in the context of paediatric obesity treatment. Most international guidelines recommend weight maintenance or weight loss as a treatment goal, and weight loss is related to improvements in cardiometabolic health but not eating disorder risk in the short term. The risk of inducing or exacerbating an eating disorder during paediatric weight management is likely to be low; however, the serious consequences combined with increasing scale of obesity treatment, and lack of empirical evidence, are of concern. There is a need for further research to identify long-term predictors of eating disorder development for children and adolescents who seek treatment for their obesity.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia.
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia
- Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
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14
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Dietary Patterns, Weight Perception and Obesity Status, among 10-12-Year-Old Children; an Epidemiological Study in Greece. CHILDREN-BASEL 2021; 8:children8080626. [PMID: 34438517 PMCID: PMC8393401 DOI: 10.3390/children8080626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022]
Abstract
Adherence to certain dietary patterns influences obesity status in both children and adults. Weight perception influences dietary habits. The aim of this study was to examine children’s dietary habits and obesity status, in relation to weight perception. One thousand seven hundred Greek students enrolled in this study during 2014–2016. Children’s characteristics were assessed through validated questionnaires, and weight status was classified according to the criteria of the International Obesity Task Force. Dietary patterns were assessed through exploratory factor analysis. Overall, 52.2% of children characterized themselves as normal weight, 34.5% as low weight, and 13.3% as overweight/obese; 52.5% of children were in accordance with their actual weight status, with girls being more likely to overestimate their weight. Children followed three dietary patterns, i.e., starchy and protein foods, unhealthy/high-fat foods, and healthy foods. Children who followed the healthy dietary pattern and had accurate weight perception (in accordance with their actual weight), had lower odds of being overweight/obese (p < 0.001). Accurate weight perception in conjunction with healthy dietary habits may play a determinant role in the prevention of obesity. From a public health perspective, early identification of children’s weight misperception along with healthy dietary habit promotion shape a crucial role in childhood obesity confrontation.
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15
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Jebeile H, Lister NB, Baur LA, Garnett SP, Paxton SJ. Eating disorder risk in adolescents with obesity. Obes Rev 2021; 22:e13173. [PMID: 33410207 DOI: 10.1111/obr.13173] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/22/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023]
Abstract
The intersection between adolescent obesity and eating disorder risk is one that requires urgent attention. This review aimed to synthesize the literature on the risk of clinical eating disorders in adolescents with obesity, discuss challenges with assessing risk, and examine implications for clinical practice and future research. Obesity and eating disorders can coexist resulting in exacerbated physical and psychological health issues. Recognized eating disorder risk factors, including body dissatisfaction, poor self-esteem, depression, and engaging in dieting behaviors, are elevated and frequently reported in adolescents with obesity, highlighting a vulnerability to the development of eating disorders. Unsupervised dieting to manage weight may exacerbate eating disorder risk, while structured and supervised weight management is likely to reduce eating disorder risk for most adolescents. However, some adolescents may present to an obesity service with an undiagnosed eating disorder or may develop an eating disorder during or following treatment. We conclude that a risk management approach, with screening or monitoring for eating disorder-related risk factors and behaviors, should be utilized to identify those at risk. Future research to identify eating disorder risk factors specific to adolescents with obesity is required to inform screening and monitoring protocols, patient care, and address current knowledge gaps.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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16
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Balantekin KN, Grammer AC, Fitzsimmons-Craft EE, Eichen DE, Graham AK, Monterubio GE, Firebaugh ML, Karam AM, Sadeh-Sharvit S, Goel NJ, Flatt RE, Trockel MT, Taylor CB, Wilfley DE. Overweight and obesity are associated with increased eating disorder correlates and general psychopathology in university women with eating disorders. Eat Behav 2021; 41:101482. [PMID: 33609964 PMCID: PMC8131224 DOI: 10.1016/j.eatbeh.2021.101482] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/26/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Examine how eating disorder (ED) correlates, ED-related clinical impairment, general psychopathology, and ED diagnoses differ across weight statuses in a sample of university women with EDs. METHOD Participants were 690 women from 28 U.S. universities who screened positive for an ED (with the exception of anorexia nervosa [AN]) and participated in the Healthy Body Image Program study. ED correlates, ED-related clinical impairment, general psychopathology (i.e., depression and anxiety), and ED diagnoses were compared across weight statuses (i.e., healthy weight, overweight, obesity) using analyses of variance and chi-square tests. RESULTS Women with EDs and overweight or obesity had higher levels of, perceived benefit of thinness, depressive symptoms, anxiety, and weight/shape concerns (obesity only) than those with healthy weight (ps ≤ .017). Compared to those with healthy weight, those with obesity had higher rates of clinical and sub-clinical binge eating disorder and lower rates of bulimia nervosa (p < .001). DISCUSSION Overweight and obesity in individuals with EDs, excluding AN, are associated with greater severity of ED correlates, ED-related clinical impairment, and co-morbid general psychopathology. The current study highlights the need to consider weight status in ED treatment and for optimization of ED treatments to address shared risk factors between EDs and overweight and obesity.
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Affiliation(s)
| | - Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Dawn E Eichen
- Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Grace E Monterubio
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Anna M Karam
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Shiri Sadeh-Sharvit
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for m(2)Health, Palo Alto University, Palo Alto, CA, USA; Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel
| | - Neha J Goel
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Institute for Inclusion, Inquiry and Innovation (iCubed), Virginia Commonwealth University, Richmond, VA, USA
| | - Rachael E Flatt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mickey T Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for m(2)Health, Palo Alto University, Palo Alto, CA, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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17
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Thompson-Brenner H, Singh S, Gardner T, Brooks GE, Smith MT, Lowe MR, Boswell JF. The Renfrew Unified Treatment for Eating Disorders and Comorbidity: Long-Term Effects of an Evidence-Based Practice Implementation in Residential Treatment. Front Psychiatry 2021; 12:641601. [PMID: 33746797 PMCID: PMC7973044 DOI: 10.3389/fpsyt.2021.641601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The Renfrew Unified Treatment for Eating Disorders and Comorbidity (UT) is a transdiagnostic, emotion-focused treatment adapted for use in residential group treatment. This study examined the effect of UT implementation across five years of treatment delivery. Methods: Data were collected by questionnaire at admission, discharge (DC), and 6-month follow-up (6MFU). Patient outcomes were measured by the Eating Disorder Examination-Questionnaire, Center for Epidemiologic Studies-Depression Scale, Brief Experiential Avoidance Questionnaire (BEAQ), Anxiety Sensitivity Index, and Southampton Mindfulness Scale. Data were analyzed for N = 345 patients treated with treatment-as-usual (TAU), and N = 2,763 treated with the UT in subsequent years. Results: Results from multilevel models demonstrated a significant interaction between implementation status (TAU vs. UT) and time, both linear and quadratic, for the depression, experiential avoidance, anxiety sensitivity, and mindfulness variables. Patients treated with the UT showed more improvement in these variables on average, as well as more rebound between DC and 6MFU. Results from multilevel models examining eating disorder outcome showed no significant difference between the TAU and UT for the full sample, but a significant three-way interaction indicated that the UT produced more improvement in the EDE-Q relative to the TAU particularly for patients who entered treatment with high levels of experiential avoidance (BEAQ score). Conclusion: This long-term study of a transdiagnostic, evidence-based treatment in residential care for eating disorders and comorbidity suggests implementation was associated with beneficial effects on depression and emotion function outcomes, as well as eating disorder severity for patients with high levels of baseline emotion regulation problems. These effects did not appear to diminish in the 5 years following initial implementation.
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Affiliation(s)
| | - Simar Singh
- Department of Psychology, Drexel University, Philadelphia, PA, United States
| | | | | | | | - Michael R. Lowe
- Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - James F. Boswell
- Department of Psychology, University at Albany, Albany, NY, United States
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18
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House ET, Gow ML, Lister NB, Baur LA, Garnett SP, Paxton SJ, Jebeile H. Pediatric weight management, dietary restraint, dieting, and eating disorder risk: a systematic review. Nutr Rev 2021; 79:1114-1133. [PMID: 33608718 DOI: 10.1093/nutrit/nuaa127] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
CONTEXT Whether dietary restraint and dieting are risk factors associated with eating disorders has not been explored in the context of pediatric weight management. OBJECTIVE To review associations between dietary pediatric weight management, dietary restraint, dieting, and eating disorder risk. DATA SOURCES, SELECTION, AND EXTRACTION Four databases - MEDLINE, EMBASE, Cochrane Library, and PsycINFO - were searched to May 2020 to identify pediatric weight management interventions with a dietary component for children and adolescents with overweight or obesity. The review was limited to studies reporting dietary restraint and/or dieting at preintervention, postintervention, and/or follow-up. Screening and quality assessment were conducted in duplicate, and data extraction was completed by 1 reviewer and cross-checked for accuracy. Data extracted included study characteristics, dietary restraint/dieting, and eating disorder-related outcomes (including disordered eating, body image, self-esteem, depression, and anxiety). RESULTS A total of 26 papers, representing 23 studies, were included. Of these, 20 studies reported on dietary restraint, which increased (10 postintervention, 6 follow-up) or remained unchanged (7 postintervention, 5 follow-up), and 5 studies reported on dieting, which increased (1 study), remained unchanged (2 studies) or decreased (2 studies) postintervention. All studies that reported on other eating disorder risk factors (eg, binge eating, body dissatisfaction, and depression) and weight-related outcomes found improvement or no change postintervention or at follow-up. CONCLUSION The results of this review suggest that current measures of dietary restraint and dieting are not associated with eating disorder risk within the context of pediatric weight management; however, long-term data is limited. In addition, those current measures may not be suitable risk markers. Concerns about dietary restraint and dieting leading to eating disorders should not prevent access to quality care for young people with obesity. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. 2017 CRD42017069488.
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Affiliation(s)
- Eve T House
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Megan L Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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19
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Naveed A, Dang N, Gonzalez P, Choi SH, Mathew A, Wardle M, Garey L, Hamidovic A. E-Cigarette Dependence and Weight-Related Attitudes/Behaviors Associated With Eating Disorders in Adolescent Girls. Front Psychiatry 2021; 12:713094. [PMID: 34526923 PMCID: PMC8437144 DOI: 10.3389/fpsyt.2021.713094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Although numerous motivations for vaping have been identified in adolescents, no study to date has examined a possible link between vaping and attitudes/behaviors that are associated with eating disorders in adolescent females. Examining this question in adolescent females is especially relevant given the higher prevalence of eating disorders in adolescent girls and women compared to adolescent boys and men. Methods: We recruited 299 girls (between 13 to 17 years old) via Facebook advertisement to complete a REDCap survey, which included the Electronic Cigarette Dependence Index (ECDI), Minnesota Eating Behavior Survey (MEBS), and demographic questions. Data were analyzed using nonparametric Spearman rank correlation test in R. Results: Electronic Cigarette Dependence Index (ECDI) scores were correlated with weight preoccupation (WP), binge eating (BE) and compensatory behavior (CB), but not body dissatisfaction (BD). The following were the results of Spearman correlation tests: (1) WP: rho = 0.13, p = 0.02; (2) BD: rho = 0.06, p = 0.28; (3) BE: rho = 0.15, p = 0.0095; (4) CB: rho = 0.021, p = 0.00027. Conclusion: The present study adds to the current literature examining motivations for e-cigarette use in adolescent girls. As eating disorders and e-cigarette dependence are significant public health concerns, our results highlight the need for intervention development.
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Affiliation(s)
- Aamina Naveed
- Department of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Nhan Dang
- Department of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | - Pierina Gonzalez
- Department of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - So Hee Choi
- Department of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Amanda Mathew
- Department of Preventive Medicine, Rush University, Chicago, IL, United States
| | - Margaret Wardle
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Ajna Hamidovic
- Department of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
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20
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An application of psychosocial frameworks for eating disorder risk during the postpartum period: A review and future directions. Arch Womens Ment Health 2020; 23:625-633. [PMID: 32613296 DOI: 10.1007/s00737-020-01049-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/23/2020] [Indexed: 02/06/2023]
Abstract
The postpartum period may be a particular window of vulnerability for eating disorder symptoms given changes to body shape and weight that women experience. However, no quantitative studies have identified risk factors for postpartum eating disorder symptoms, and current psychosocial frameworks of risk may be missing key elements unique to this period. This manuscript reviews existing quantitative and qualitative literature regarding the developmental trajectory of eating disorder symptoms during the perinatal period and proposes an application of three psychosocial models of eating disorder risk (objectification theory, the tripartite influence model of body image and eating disturbances, and social comparison theory) to the postpartum period. Drawing on quantitative and qualitative literature, this paper identifies novel postpartum-specific factors that should be included for consideration in psychosocial models (e.g., self-oriented body comparison and pressure to achieve a prepregnancy weight and shape). This review is the first to theorize potential postpartum-specific risk factors for postpartum eating disorder symptoms. Prior models of eating disorder risk omit key psychosocial factors that are unique to the postpartum period. Other limitations of prior research relate to measurement and methodology. This critical window of vulnerability has been largely ignored in the quantitative literature and necessitates further research.
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21
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Romano KA, Heron KE, Amerson R, Howard LM, MacIntyre RI, Mason TB. Changes in disordered eating behaviors over 10 or more years: A meta-analysis. Int J Eat Disord 2020; 53:1034-1055. [PMID: 32415907 DOI: 10.1002/eat.23288] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The present meta-analysis evaluated changes in individuals' risk of engaging in distinct disordered eating behaviors (DEBs) in the long-term. METHOD Longitudinal studies assessing changes in DEBs via ≥2 assessments with a time lag of ≥10 years were included. Risk ratios were calculated for baseline to 10-14.9-year (M = 11.04) follow-up and baseline to ≥15-year (M = 18.62) follow-up changes in the use of binge eating, multiple purging, self-induced vomiting, laxatives, diuretics, diet pills, compensatory exercising, fasting/dieting, and multiple DEBs; Cohen's d was used for continuous binge-eating plus purging variable changes. Subgroup and meta-regression analyses tested whether eating disorder (ED) clinical sample versus nonclinical sample status, female versus male sex/gender, higher versus lower study bias, and baseline mean age and body mass index influenced overall effect magnitude for analyses with sufficient data. RESULTS Seventeen studies (26 [sub]samples) were included. Overall, individuals' risk of engaging in various restrictive eating and other compensatory behaviors decreased over time and the magnitudes of risk reductions for the use of certain compensatory DEBs were larger over longer follow-up durations. Specifically, for significant DEB change models, risk reductions spanned from 20.0-39.8% for 10-year follow-up and 24.7-74.8% for ≥15-year follow-up. However, nuances were found in the nature of these DEB changes as a function of DEB type, follow-up length, ED versus nonclinical sample composition, and baseline mean age. CONCLUSIONS These findings provide important information that can help identify treatment priorities and suggest that targeted and tailored preventative ED treatments warrant consistent implementation at the community-level, particularly for youth.
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Affiliation(s)
- Kelly A Romano
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.,Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Kristin E Heron
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.,Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Rachel Amerson
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Lindsay M Howard
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Rachel I MacIntyre
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
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22
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Gordon CS, Rodgers RF, Slater AE, McLean SA, Jarman HK, Paxton SJ. A cluster randomized controlled trial of the SoMe social media literacy body image and wellbeing program for adolescent boys and girls: Study protocol. Body Image 2020; 33:27-37. [PMID: 32086189 DOI: 10.1016/j.bodyim.2020.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 01/28/2020] [Accepted: 02/05/2020] [Indexed: 01/21/2023]
Abstract
Youth spend substantial time on social media, which can foster self-critical processes that increase risk of body dissatisfaction, disordered eating, and depressed mood. To date, there have been few investigations of interventions to decrease the negative impacts of social media engagement in adolescent boys and girls. This paper outlines the protocol for a cluster randomized controlled trial (RCT) of a four-lesson social media literacy program that was developed based on pilot results and aims to decrease body dissatisfaction, dietary restraint, and strategies to increase muscles. The RCT will be conducted with grades 7-8 students from Australian secondary schools. Using block randomization, grade levels within schools will be assigned to either the SoMe program (intervention) or health lessons as usual (control). Primary outcomes will be body satisfaction, dietary restraint, and strategies to increase muscles. Secondary outcomes will be self-esteem and depressed mood. Participants will complete assessments on four occasions - baseline, five-weeks post-baseline, and six- and 12-month post-baseline. Analyses will compare outcomes in the intervention compared to the control group. This study will be the first to implement a RCT design to evaluate the impact of a school-based social media literacy program designed to mitigate negative impacts of social media.
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Affiliation(s)
| | - Rachel F Rodgers
- Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Amy E Slater
- Centre for Appearance Research, University of West of England, Bristol, England, United Kingdom
| | - Siân A McLean
- La Trobe University, Victoria, Australia; Victoria University, Australia
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23
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Hirsch KE, Blomquist KK. Community-Based Prevention Programs for Disordered Eating and Obesity: Updates and Current Limitations. Curr Obes Rep 2020; 9:81-97. [PMID: 32445131 DOI: 10.1007/s13679-020-00373-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW To review the status of community-based disordered eating and obesity prevention programs from 2014 to 2019. RECENT FINDINGS In the last 5 years, prevention programs have found success in intervening with children and parental figures in wellness centers, physical activity centers, childcare centers, workplaces, online, and over-the-phone through directly reducing disordered eating and obesity or by targeting risk factors of disordered eating and obesity. Community-based prevention programs for disordered eating and programs targeting both disordered eating and obesity were scarce, highlighting the critical need for the development of these programs. Qualities of the most effective programs were those in which parents and children were educated on physical activity and nutrition via multiple group-based sessions. Limitations of current prevention programs include few programs targeting high-risk populations, a dearth of trained community members serving as facilitators, inconsistent reporting of adherence rates, and few direct measurements of disordered eating and obesity, as well as few long-term follow-ups, precluding the evaluation of sustained effectiveness.
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Affiliation(s)
- Katherine E Hirsch
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4, Canada
| | - Kerstin K Blomquist
- Department of Psychology, Furman University, 3300 Poinsett Highway, Greenville, SC, 29613, USA.
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24
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Thapliyal P, Mitchison D, Mond J, Hay P. Gender and help-seeking for an eating disorder: findings from a general population sample. Eat Weight Disord 2020; 25:215-220. [PMID: 30066257 DOI: 10.1007/s40519-018-0555-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 07/24/2018] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to compare gender differences in eating disorder (ED) features and to examine the role of gender as a predictor of ED help-seeking controlling for other putative determinants, namely weight/shape overvaluation, age, BMI, and impairment in role functioning. METHODS Demographic, ED symptoms, and related data were collected during household interviews of individuals aged ≥ 15 years. One hundred and forty-eight participants (164 after data were weighted) with an ED syndrome were identified. RESULTS Compared to women, men with an ED were younger and had lower levels of purging and overvaluation. However, men and women with an ED had similar levels of functional impairment, binge eating and strict dieting. In univariate analyses, males in general, but not males with an ED, were significantly less likely than females to seek help for an ED. In multivariate analysis of people with an ED, only BMI was significantly associated with treatment-seeking. CONCLUSION Functional health impairment and common ED behaviours were similar for men and women with EDs. Gender may not be a primary reason to be more or less likely to seek help for an ED. Rather, other features, most notably, a higher BMI, appear to be stronger predictors of ED-specific help-seeking. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Priyanka Thapliyal
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Deborah Mitchison
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Jonathan Mond
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
- Centre for Rural Health, School of Health Sciences, Faculty of Health, University of Tasmania, Hobart, Australia
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, NSW, Australia
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Higgins Neyland MK, Shank LM, Burke NL, Schvey NA, Pine A, Quattlebaum M, Leu W, Gillmore D, Morettini A, Wilfley DE, Stephens M, Sbrocco T, Yanovski JA, Jorgensen S, Klein DA, Olsen CH, Quinlan J, Tanofsky-Kraff M. Parental deployment and distress, and adolescent disordered eating in prevention-seeking military dependents. Int J Eat Disord 2020; 53:201-209. [PMID: 31593352 PMCID: PMC7028444 DOI: 10.1002/eat.23180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/13/2019] [Accepted: 09/13/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Parental military deployment can lead to stress in the family system due to concerns about the deployed service-member's safety and increased responsibilities for those not deployed. Parent-related stress can impact adolescent disordered eating. Given the important role that stress plays in disordered eating and obesity, it is crucial to understand the impacts of unique stressors to which vulnerable populations are exposed. METHOD We studied 126 adolescent (14.3 ± 1.6 years; 59.5% girls; 44.4% non-Hispanic White; BMI-z, 1.91 ± .39) military dependents prior to entering an obesity and binge-eating disorder prevention trial. The Eating Disorder Examination was used to assess adolescent disordered eating. Parents self-reported their own distress and family deployment history that occurred during the adolescent's lifetime. RESULTS Parental distress interacted with frequency of parental deployments such that for those with high parental distress, more frequent deployment was associated with greater adolescent shape and weight concerns (β = .21, p = .012) and global eating pathology (β = .18, p = .024). DISCUSSION In this hypothesis-generating study, the combination of number of deployments and parental distress may be associated with disordered eating among adolescent military dependents seeking prevention of binge-eating disorder and adult obesity. If these preliminary findings are supported longitudinally, interventions to reduce parental stress related to deployment may be warranted to reduce disordered eating in adolescent dependents.
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Affiliation(s)
- M K Higgins Neyland
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland
- Metis Foundation, San Antonio, Texas
- Department of Medicine, Military Outcomes Cardiovascular Research (MiCOR), USU, Bethesda, Maryland
| | - Natasha L Burke
- Department of Psychology, Fordham University, Bronx, New York
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland
| | - Abigail Pine
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Mary Quattlebaum
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - William Leu
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Dakota Gillmore
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Alexandria Morettini
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Mark Stephens
- Department of Family and Community Medicine, Pennsylvania State University, University Park, Pennsylvania
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland
| | - Sarah Jorgensen
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | - David A Klein
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
- Department of Family Medicine, USU, Bethesda, Maryland
| | - Cara H Olsen
- Preventative Medicine and Biometrics Department, USU, Bethesda, Maryland
| | | | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland
- Department of Medicine, Military Outcomes Cardiovascular Research (MiCOR), USU, Bethesda, Maryland
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Comparison of Factors Associated with Disordered Eating between Male and Female Malaysian University Students. Nutrients 2020; 12:nu12020318. [PMID: 31991785 PMCID: PMC7071321 DOI: 10.3390/nu12020318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/18/2020] [Accepted: 01/22/2020] [Indexed: 12/11/2022] Open
Abstract
Disordered eating is prevalent among university students, especially females. Whilst literature suggests that factors associated with disordered eating may differ according to gender, such an association has not been studied in Malaysia. This cross-sectional study aims to compare factors associated with disordered eating between male and female university students. A total of 716 university students (male: 27.4%; female: 72.6%) were recruited in Kuala Lumpur and Selangor, Malaysia. All participants completed a set of self-administered questionnaires and their body weight and height were recorded. About one in five of the university students (20.3%) were found to have disordered eating. There were more female students (22.9%) disordered eating compared to males (13.3%, χ² = 8.16, p < 0.05). In male students (β = 0.228, p < 0.01), depressive symptoms were the only significant predictor for disordered eating. In females, the strongest predictor was depressive symptoms (β = 0.214, p < 0.001), followed by body size satisfaction (β = -0.145, p < 0.01) and body appreciation (β = -0.101, p < 0.05). These findings suggest that there are gender differences in the factors associated with disordered eating among Malaysian university students. Intervention programmes that address disordered eating should take into account these sex differences and its contributing factors.
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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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Kansra AR, Lakkunarajah S, Jay MS. Childhood and Adolescent Obesity: A Review. Front Pediatr 2020; 8:581461. [PMID: 33511092 PMCID: PMC7835259 DOI: 10.3389/fped.2020.581461] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a complex condition that interweaves biological, developmental, environmental, behavioral, and genetic factors; it is a significant public health problem. The most common cause of obesity throughout childhood and adolescence is an inequity in energy balance; that is, excess caloric intake without appropriate caloric expenditure. Adiposity rebound (AR) in early childhood is a risk factor for obesity in adolescence and adulthood. The increasing prevalence of childhood and adolescent obesity is associated with a rise in comorbidities previously identified in the adult population, such as Type 2 Diabetes Mellitus, Hypertension, Non-alcoholic Fatty Liver disease (NAFLD), Obstructive Sleep Apnea (OSA), and Dyslipidemia. Due to the lack of a single treatment option to address obesity, clinicians have generally relied on counseling dietary changes and exercise. Due to psychosocial issues that may accompany adolescence regarding body habitus, this approach can have negative results. Teens can develop unhealthy eating habits that result in Bulimia Nervosa (BN), Binge- Eating Disorder (BED), or Night eating syndrome (NES). Others can develop Anorexia Nervosa (AN) as they attempt to restrict their diet and overshoot their goal of "being healthy." To date, lifestyle interventions have shown only modest effects on weight loss. Emerging findings from basic science as well as interventional drug trials utilizing GLP-1 agonists have demonstrated success in effective weight loss in obese adults, adolescents, and pediatric patients. However, there is limited data on the efficacy and safety of other weight-loss medications in children and adolescents. Nearly 6% of adolescents in the United States are severely obese and bariatric surgery as a treatment consideration will be discussed. In summary, this paper will overview the pathophysiology, clinical, and psychological implications, and treatment options available for obese pediatric and adolescent patients.
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Affiliation(s)
- Alvina R Kansra
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sinduja Lakkunarajah
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, United States
| | - M Susan Jay
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
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The risk of eating disorders and bone health in young adults: the mediating role of body composition and fitness. Eat Weight Disord 2019; 24:1145-1154. [PMID: 29134506 DOI: 10.1007/s40519-017-0458-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To analyze the independent relationship between the risk of eating disorders and bone health and to examine whether this relationship is mediated by body composition and cardiorespiratory fitness (CRF). METHODS In this cross-sectional study, bone-related variables, lean mass, fat mass (by DXA), risk of eating disorders (SCOFF questionnaire), height, weight, waist circumference and CRF were measured in 487 university students aged 18-30 years from the University of Castilla-La Mancha, Spain. ANCOVA models were estimated to test mean differences in bone mass categorized by body composition, CRF or risk of eating disorders. Subsequently, linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis. RESULTS The marginal estimated mean ± SE values of total body bone mineral density for the categories "no risk of eating disorders" and "risk of eating disorders" were 1.239 ± 0.126 < 1.305 ± 0.089, P = 0.021. However, this relationship disappeared after adjustment for any of the parameters of body composition or CRF. Therefore, all body composition parameters (except for lean mass) and CRF turned out to be full mediators in the association between the risk of eating disorders and bone health in young adults. CONCLUSIONS Body composition and CRF mediate the association between the risk of eating disorders and bone health. These findings highlight the importance of maintaining a healthy weight and good CRF for the prevention of the development of eating disorders and for the maintenance of good bone health in young adults. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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30
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West CE, Goldschmidt AB, Mason SM, Neumark-Sztainer D. Differences in risk factors for binge eating by socioeconomic status in a community-based sample of adolescents: Findings from Project EAT. Int J Eat Disord 2019; 52:659-668. [PMID: 30939228 PMCID: PMC6555672 DOI: 10.1002/eat.23079] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/15/2019] [Accepted: 03/17/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Binge eating is prevalent across socioeconomic status (SES) groups, but it is unclear whether risk factors for binge eating vary by SES. This study examined the prevalence of several risk factors for binge eating by SES and SES as a potential moderator of these risk factors. METHOD Participants included 2,179 individuals involved in Project EAT during early/middle adolescence (EAT-I) and 5 years later during late adolescence/emerging adulthood (EAT-II). Risk ratios were computed using modified Poisson regression of incident EAT-II binge eating on EAT-I risk factors among participants of high and low SES. Interactions between each risk factor and SES were tested. RESULTS Among higher SES adolescents, overweight/obesity (RR = 3.2; 95% CI: 1.8, 5.7), body dissatisfaction (RR = 2.6; 95% confidence intervals (CI): 1.2, 5.5), dieting (RR = 4.0; 95% CI: 2.0, 8.2), and family weight-teasing (RR = 2.3; 95% CI: 1.3, 4.3) predicted increased risk for binge eating. Among adolescents from low-SES backgrounds, overweight/obesity (RR = 1.5; 95% CI: 0.9, 2.5), dieting (RR = 2.2; 95% CI: 1.2, 3.9), and food insecurity (RR = 1.4; 95% CI: 0.7, 2.7) predicted increased risk for binge eating. Moderator analyses revealed that overweight/obesity, body dissatisfaction, dieting, and family weight-teasing were stronger risk factors in the high-SES group than the low-SES group; interactions with food insecurity could not be examined given the low prevalence of food insecurity in the high-SES group. DISCUSSION Risk factors for binge eating may vary by SES, suggesting the potential utility of modifying intervention and prevention methods based on SES. In particular, the role of food insecurity must be addressed.
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Affiliation(s)
- Caroline E. West
- Department of Psychological Sciences, Kent State University, Kent, OH
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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31
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Miller K, Kelly A, Stephen E. Exposure to body focused and non-body focused others over a week: A preliminary investigation of their unique contributions to college women's eating and body image. Body Image 2019; 28:44-52. [PMID: 30580168 DOI: 10.1016/j.bodyim.2018.12.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 01/25/2023]
Abstract
This study investigated how exposure to non-body focused others (i.e., those who are not preoccupied with their body weight/shape or appearance) and exposure to body focused others uniquely affect young women's eating and body image over a week, within a day, and from one day to the next. For seven consecutive days, 92 female college students completed nightly online questionnaires about their daily experiences. Between-persons, multilevel modelling revealed that higher average levels of exposure to non-body focused others over the week uniquely predicted greater intuitive eating, greater body appreciation, and less dietary restraint, whereas higher average exposure to body focused others predicted these outcomes in the opposite direction. Within-persons, exposure to body focused others did not predict eating and body image, but exposure to non-body focused others did. On days when women had more exposure to non-body focused others than their personal average level or than the previous day's level, eating and body image were better. These findings are the first to suggest that independent of exposure to body focused others, level of exposure to non-body focused others - within and across days - contribute positively to eating and body image.
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Affiliation(s)
- Kathryn Miller
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Allison Kelly
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Elizabeth Stephen
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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32
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Leme ACB, Philippi ST, Thompson D, Nicklas T, Baranowski T. "Healthy Habits, Healthy Girls-Brazil": an obesity prevention program with added focus on eating disorders. Eat Weight Disord 2019; 24:107-119. [PMID: 29730727 DOI: 10.1007/s40519-018-0510-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/24/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the immediate post-intervention and 6-month post-intervention effects of a Brazilian school-based randomized controlled trial for girls targeting shared risk factors for obesity and disordered eating. METHODS Total of 253 girls, mean of 15.6 (0.05) years from 1st to 3rd grades of high school participated in this 6-month school-based cluster randomized controlled trial. "Healthy Habits, Healthy Girls-Brazil (H3G-Brazil)", originally developed in Australia, emphasized 10 key nutrition and physical activity (PA) messages delivered over 6 months. Disordered eating prevention procedures, i.e., prevention of weight-teasing, body satisfaction, and unhealthy weight control behavior, were added to the intervention. Body dissatisfaction, unhealthy weight control behaviors and social cognitive-related diet, and physical activity variables were assessed at baseline, immediate post-intervention, and 6-month post-intervention. Intervention effects were determined by one-way analysis of covariance or logistic regression, after checking for the clustering effects of school. The control group did not receive intervention prior to follow-up assessment. A conservative significance level was set at p < 0.01. RESULTS Beneficial effects were detected for PA social support (F = 6.005, p = 0.01), and healthy eating strategies (F = 6.08, p = 0.01) immediate post-intervention; and healthy eating social support (F = 14.731, p = 0.00) and healthy eating strategies (F = 5.812, p = 0.01) at 6-month post-intervention. Intervention group was more likely to report unhealthy weight control behaviors (OR = 1.92, 95% CI 1.15-3.21, p = 0.01) at 6-month post-intervention. No other significant immediate or 6-month post effects were detected. CONCLUSION H3G-Brazil demonstrated positive 6-month effects on some social cognitive variables but an adverse effect on unhealthy weight control behaviors. Thus, this study was not able to achieve synergy by combining obesity and disordered eating prevention procedures in an intervention among low-income girls in Brazil. TRIAL REGISTRATION Level I: cluster randomized controlled trial.
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Affiliation(s)
- Ana Carolina Barco Leme
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA. .,Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | | | - Debbe Thompson
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA
| | - Theresa Nicklas
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Tom Baranowski
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Figueiredo RADO, Simola-Ström S, Isomaa R, Weiderpass E. Body dissatisfaction and disordered eating symptoms in Finnish preadolescents. Eat Disord 2019; 27:34-51. [PMID: 30040544 DOI: 10.1080/10640266.2018.1499335] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To evaluate whether body dissatisfaction is associated with disordered eating symptoms in Finnish preadolescents, and to assess the moderator effects of gender and body mass index on this association. We included 10,526 9- to 12-year-old preadolescents at baseline from the Finnish Health in Teens cohort. We used the Children's Eating Attitudes Test for assessing disordered eating symptoms and a pictoral instrument for evaluating body dissatisfaction, comparing self-assessment of wanted and current body shape. Odds ratio (OR) for disordered eating symptoms were estimated using unconditional logistic regression. A high percentage of preadolescents reported body dissatisfaction: 30.0% wanted a smaller body and 9.3% wanted a larger body. Only 2.2% of the participants had disordered eating symptoms. Preadolescents who wanted a larger (OR = 2.83; 95% confidence intervals (CI): 1.68-4.78) or smaller body (OR = 4.48; 95% CI: 3.20-6.26) had a higher risk of having disordered eating symptoms, compared to preadolescents satisfied with their body. Among preadolescents who wanted a smaller body, the effect of body dissatisfaction was more pronounced among girls (OR = 5.00; 95% CI: 3.25-7.70) than boys, and among normal-weight (OR = 6.82; 95% CI: 4.53-10.25) and underweight (OR = 23.23; 95% CI: 5.31-101.61) than overweight preadolescents. Body dissatisfaction is associated with disordered eating symptoms especially among girls, and those who are underweight and normal-weight. Our study suggests that, in the prevention of eating disorders, special attention should be given to preadolescents with body dissatisfaction.
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Affiliation(s)
| | - Sabina Simola-Ström
- a Genetic Epidemiology Group, Folkhälsan Research Center , Helsinki , Finland
| | - Rasmus Isomaa
- c Department of Social Services and Health Car , Åbo Akademi University , Jakobstad , Finland
| | - Elisabete Weiderpass
- a Genetic Epidemiology Group, Folkhälsan Research Center , Helsinki , Finland.,b Faculty of Medicine , University of Helsinki , Helsinki , Finland.,d Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden.,e Department of Research, Cancer Registry of Norway , Institute of Population Based Cancer Research Oslo, Tromsø , Norway.,f Department of Community Medicine, Faculty of Health Sciences , University of Tromsø, The Arctic University of Norway , Tromsø , Norway
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Neumark-Sztainer D, Watts AW, Rydell S. Yoga and body image: How do young adults practicing yoga describe its impact on their body image? Body Image 2018; 27:156-168. [PMID: 30292082 PMCID: PMC6691728 DOI: 10.1016/j.bodyim.2018.09.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 09/05/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Abstract
This study explored the perceived impact of yoga on body image. Young adults (n= 34 female, 12 male; Mage = 30.6 [SD = 1.6]) practicing yoga were interviewed and data were analyzed for emerging themes across weight status. In general, participants discussed the positive impact of yoga on their body image, but some described both a positive and negative impact. Yoga was perceived as having a positive impact on body image via perceived physical changes, gratitude for one's body, a sense of accomplishment within one's yoga practice, self-confidence, and witnessing different types of bodies practicing yoga. Yoga was perceived to have a negative impact on body image via comparative critique (e.g., upward comparisons with others) and inner critique (e.g., negative self-talk). Themes were generally similar across weight status; exceptions were that participants at higher weight status were more likely than those at lower weight status to discuss accomplishment within one's yoga practice as a positive impact on body image and comparative critique as a negative impact on body image. Yoga studios and instructors can take steps to further enhance the positive impact of yoga and to provide environments that are inclusive of participants with diverse body shapes and sizes.
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Affiliation(s)
- Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, United States.
| | - Allison W. Watts
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN 55454
| | - Sarah Rydell
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, United States.
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35
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Disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents. Eat Weight Disord 2018; 23:621-628. [PMID: 29189978 DOI: 10.1007/s40519-017-0466-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/21/2017] [Indexed: 01/15/2023] Open
Abstract
PURPOSE The aim of this study was to examine the relationship between disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents as well as the moderating role of gender and body mass index (BMI) in this relationship. METHODS Ninety adolescents, 11-18 years old, were assessed using anthropometric measurements; demographics, eating attitudes and level of emotional/behavioral adjustment were examined via self-reported questionnaires. RESULTS Disordered eating attitudes were prevalent in 17.8% of the sample. A significant relationship was found between disordered eating attitudes and Youth Self-Report (YSR) anxiety score (r = .22, p < .05). Gender significantly moderated the relationship between YSR anxiety symptoms and Eating Attitudes Test (EAT) scores (b = .59, p = .01) and this effect held true for the EAT bulimia subscale (b = .20, p = .03), but not for the dieting or the oral control subscales. Contrary to our hypothesis, BMI did not moderate the relationship between EAT and YSR anxiety sub-scores (b = .13, p > .05). CONCLUSION Girls with elevated anxiety levels appear to be at risk for exhibiting disordered eating attitudes, especially bulimic behaviors. This finding highlights the importance of developing gender-based preventive interventions tailored to these specific emotional/behavioral aspects. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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36
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Barrack MT, West J, Christopher M, Pham-Vera AM. Disordered Eating Among a Diverse Sample of First-Year College Students. J Am Coll Nutr 2018; 38:141-148. [PMID: 30247991 DOI: 10.1080/07315724.2018.1487345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE A cross-sectional study of first-year college students was conducted to identify the prevalence and predictors of disordered eating (DE). METHODS College freshmen students, aged 18 years, (n = 106) completed the Eating Disorder Examination Questionnaire (EDE-Q) and a supplemental survey. A subset of the sample (n = 77) underwent measurements of height, weight, and body composition. DE was defined as an elevated (3) weight, shape, eating concern, or dietary restraint EDE-Q subscale score. RESULTS The sample, consisting of 56.6%, 15.1%, 11.3%, and 11.3% Latino/a, Asian, African American, and Caucasian students, respectively (37% male), reported a 31.1% prevalence of DE. The current desire to lose weight was the strongest predictor of DE (odds ratio = 15.3; 95% confidence interval = 2.8, 82.5). Other variables linked to DE or elevated EDE-Q subscale scores included body mass index (BMI) 25.0 kg/m2, vegetarianism, weight loss in the past year, female gender, and eating breakfast < 5 d/wk. Participants with BMI 25.0 kg/m2 and the current desire to lose weight (n = 23) or following a vegetarian diet (n = 5) exhibited the highest prevalence of DE (78.3% and 80.0%, respectively). A higher proportion of Latinas reported binge episodes compared to female Caucasian, Asian, and African American students (36.4% vs. 0.0%, 6.7%, and 28.6%, respectively, p = 0.056, χ2 = 7.6). Males, versus females, were more likely to report excessive exercise (56.4% vs. 37.3%, p = 0.056, χ2 = 3.6). CONCLUSIONS This study adds to the current body of literature on DE by providing a diverse sample and potentially novel predictors and risk factors for DE.
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Affiliation(s)
- Michelle T Barrack
- a Department of Family and Consumer Sciences , California State University , Long Beach , California , USA
| | - Jazmine West
- a Department of Family and Consumer Sciences , California State University , Long Beach , California , USA
| | - Michele Christopher
- b Department of Family and Consumer Sciences , California State University , Northridge , California , USA
| | - Ann-Marie Pham-Vera
- b Department of Family and Consumer Sciences , California State University , Northridge , California , USA
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37
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Burnette CB, Simpson CC, Mazzeo SE. Relation of BMI and weight suppression to eating pathology in undergraduates. Eat Behav 2018; 30:16-21. [PMID: 29753283 DOI: 10.1016/j.eatbeh.2018.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/04/2018] [Accepted: 05/04/2018] [Indexed: 02/01/2023]
Abstract
Weight suppression (WS), the difference in one's highest and current adult weight excluding pregnancy, is associated with eating disorder (ED) symptom onset and maintenance. There is increasing evidence that WS is related to ED symptoms in non-clinical samples, but there are no known studies examining the interaction of WS and current body mass index (BMI) in this group. History of overweight is common in those with EDs, and higher weight status often delays identification and treatment. This study examined the interaction of WS and current BMI on body dissatisfaction and eating pathology in undergraduate men and women. Undergraduates (N = 476) completed online surveys assessing current height and weight, weight history, and eating attitudes and behaviors. In women (n = 333), both BMI and WS were positively associated with body dissatisfaction, restraint, and global ED symptoms. In men (n = 143), there were no significant associations with BMI, but WS was related to greater body dissatisfaction, restraint, global ED symptoms, and loss-of-control eating. Moderation analyses revealed that the effect of current BMI on shape concern (p = .005), weight concern (p = .002), global ED symptoms (p = .01), and purging behaviors (p = .04) in women and restraint (p = .03) in men weakened at the highest levels of WS. Results suggest that WS is salient in a non-clinical sample and underscore the need to evaluate both weight history and the presence of disordered eating in individuals across the BMI spectrum.
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Affiliation(s)
- C Blair Burnette
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA.
| | - Courtney C Simpson
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA.
| | - Suzanne E Mazzeo
- Departments of Psychology & Pediatrics, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA.
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Nagata JM, Garber AK, Tabler J, Murray SB, Vittinghoff E, Bibbins-Domingo K. Disordered eating behaviors and cardiometabolic risk among young adults with overweight or obesity. Int J Eat Disord 2018; 51:931-941. [PMID: 30030944 PMCID: PMC6230303 DOI: 10.1002/eat.22927] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To determine if unhealthy weight control behaviors or binge-eating behaviors among young adults with overweight/obesity are associated with body mass index (BMI) change and cardiometabolic risk at 7-year follow-up. METHODS We used longitudinal cohort data from 5,552 young adults with overweight/obesity at baseline (18-24 years) with 7-year follow-up (24-32 years) from the National Longitudinal Study of Adolescent to Adult Health. Baseline predictors were: (a) unhealthy weight control behaviors such as vomiting, fasting, skipping meals, or laxative/diuretic use to lose weight; or (b) binge-eating behaviors. Participants reporting either unhealthy weight control behaviors or binge-eating behaviors were considered to engage in any disordered eating behavior (DEB). Outcomes at 7-year follow-up were BMI change, incident diabetes, incident hypertension, and incident hyperlipidemia. RESULTS Young adults with overweight/obesity reporting unhealthy weight control behaviors at baseline had higher BMI and weight at 7-year follow-up than those without unhealthy weight control behaviors. In regression models adjusting for baseline BMI, race/ethnicity, age, and education, unhealthy weight control behaviors were associated with greater change in BMI in both sexes and binge-eating behavior at baseline was associated with greater odds of incident hyperlipidemia (odds ratio 1.90, 95% CI 1.29-2.79) at 7-year follow-up in males. CONCLUSIONS The higher risk for increased BMI (in both males and females) and incident hyperlipidemia (in males) over time in young adults with overweight/obesity who engage in DEBs underscores the need to screen for DEBs in this population and provide referrals and tailored interventions as appropriate.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | - Andrea K. Garber
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | - Jennifer Tabler
- Department of Sociology and Anthropology, University of Texas Rio Grande Valley, Edinburg, TX
| | - Stuart B. Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA,Department of Medicine, University of California, San Francisco, San Francisco, CA
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Leme ACB, Thompson D, Lenz Dunker KL, Nicklas T, Tucunduva Philippi S, Lopez T, Vézina-Im LA, Baranowski T. Obesity and eating disorders in integrative prevention programmes for adolescents: protocol for a systematic review and meta-analysis. BMJ Open 2018; 8:e020381. [PMID: 29674372 PMCID: PMC5914714 DOI: 10.1136/bmjopen-2017-020381] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Obesity and eating disorders are public health problems that have lifelong financial and personal costs and common risk factors, for example, body dissatisfaction, weight teasing and disordered eating. Obesity prevention interventions might lead to the development of an eating disorder since focusing on weight may contribute to excessive concern with diet and weight. Therefore, the proposed research will assess whether integrating obesity and eating disorder prevention procedures ('integrated approach') do better than single approach interventions in preventing obesity among adolescents, and if integrated approaches influence weight-related outcomes. METHODS AND ANALYSIS Integrated obesity and eating disorder prevention interventions will be identified. Randomised controlled trials and quasi-experimental trials reporting data on adolescents ranging from 10 to 19 years of age from both sexes will be included. Outcomes of interest include body composition, unhealthy weight control behaviours and body satisfaction measurements. MEDLINE/PubMed, PsycINFO, Web of Science and SciELO will be searched. Data will be extracted independently by two reviewers using a standardised data extraction form. Trial quality will be assessed using the Cochrane Collaboration criteria. The effects of integrated versus single approach intervention studies will be compared using systematic review procedures. If an adequate number of studies report data on integrated interventions among similar populations (k>5), a meta-analysis with random effects will be conducted. Sensitivity analyses and meta-regression will be performed only if between-study heterogeneity is high (I2 ≥75%). ETHICS AND DISSEMINATION Ethics approval will not be required as this is a systematic review of published studies. The findings will be disseminated through conference presentations and peer-reviewed journals.
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Affiliation(s)
| | - Debbe Thompson
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Theresa Nicklas
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Tabbetha Lopez
- Department of Health and Human Performance, College of Liberal Arts and Social Sciences, University of Houston, Houston, Texas, USA
| | - Lydi-Anne Vézina-Im
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
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40
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Thompson-Brenner H, Boswell JF, Espel-Huynh H, Brooks G, Lowe MR. Implementation of transdiagnostic treatment for emotional disorders in residential eating disorder programs: A preliminary pre-post evaluation. Psychother Res 2018; 29:1045-1061. [DOI: 10.1080/10503307.2018.1446563] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
| | - James F. Boswell
- Department of Psychology, University at Albany, SUNY, Albany, NY, USA
| | | | | | - Michael R. Lowe
- Department of Psychology, Drexel University, Philadelphia, PA, USA
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41
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Rodgers RF, Watts AW, Austin SB, Haines J, Neumark-Sztainer D. Disordered eating in ethnic minority adolescents with overweight. Int J Eat Disord 2017; 50:665-671. [PMID: 27987207 PMCID: PMC5459664 DOI: 10.1002/eat.22652] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/20/2016] [Accepted: 11/04/2016] [Indexed: 11/08/2022]
Abstract
High rates of disordered eating exist among adolescents with overweight and among ethnic/racial minority adolescents. Given the lack of research examining how eating disorder risk is moderated by both overweight and ethnicity/race, this study aimed to explore interactions between ethnicity/race and overweight status on disordered eating behaviors in a population-based adolescent sample. Cross-sectional data from adolescents (n = 2,271; 52% females) of White (23%), Black (34%), Hispanic (20%), and Asian (23%; 82% Hmong) ethnicity/race participating in the EAT 2010 study were used to examine associations between overweight status and disordered eating behaviors across ethnic/racial groups. Disordered eating behaviors occurred more frequently among adolescents with overweight compared with those without overweight across all ethnic/racial groups. Although some differences in the prevalence of disordered eating were found by ethnicity/race, particularly in girls, no consistent patterns of interaction emerged. Overweight White and Hispanic girls reported the highest risk for dieting, while the highest risk for unhealthy weight control behaviors was among overweight Black girls, and for overeating among overweight White and Asian girls. Within a society in which thinness is highly valued and being overweight is stigmatized, across diverse cultural groups, adolescents with overweight are at risk for disordered eating.
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Affiliation(s)
- Rachel F. Rodgers
- Department of Applied Psychology, Northeastern University, Boston, USA,Laboratoire de Stress Traumatique, Université Toulouse Paul Sabatier, Toulouse, France
| | - Allison W. Watts
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA,Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Canada
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
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42
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Kass AE, Jones M, Kolko RP, Altman M, Fitzsimmons-Craft EE, Eichen DM, Balantekin KN, Trockel M, Taylor CB, Wilfley DE. Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses. Eat Behav 2017; 25:74-80. [PMID: 27090854 PMCID: PMC5042805 DOI: 10.1016/j.eatbeh.2016.03.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/16/2016] [Accepted: 03/22/2016] [Indexed: 12/30/2022]
Abstract
PURPOSE Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight. METHODS 1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses. RESULTS Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns. CONCLUSIONS Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students.
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Affiliation(s)
- Andrea E. Kass
- Department of Medicine, The University of Chicago, Chicago, IL, USA,Corresponding author at: Department of Medicine, The University of Chicago, 5841 S. Maryland Avenue, MC 1000, Chicago, IL 60637, USA. (A.E. Kass)
| | - Megan Jones
- Lantern, San Francisco, CA, USA,Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Rachel P. Kolko
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Myra Altman
- Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Dawn M. Eichen
- Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | | | - Mickey Trockel
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - C. Barr Taylor
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA,Center for mHealth, Palo Alto University, Palo Alto, CA, USA
| | - Denise E. Wilfley
- Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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43
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Kass AE, Wilfley DE, Eddy KT, Boutelle KN, Zucker N, Peterson CB, Le Grange D, Celio-Doyle A, Goldschmidt AB. Secretive eating among youth with overweight or obesity. Appetite 2017; 114:275-281. [PMID: 28365476 DOI: 10.1016/j.appet.2017.03.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 03/20/2017] [Accepted: 03/28/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Secretive eating, characterized by eating privately to conceal being seen, may reflect eating- and/or body-related shame, be associated with depression, and correlate with binge eating, which predicts weight gain and eating disorder onset. Increasing understanding of secretive eating in youth may improve weight status and reduce eating disorder risk. This study evaluated the prevalence and correlates of secretive eating in youth with overweight or obesity. METHODS Youth (N = 577) presented to five research/clinical institutions. Using a cross-sectional design, secretive eating was evaluated in relation to eating-related and general psychopathology via linear and logistic regression analyses. RESULTS Secretive eating was endorsed by 111 youth, who were, on average, older than youth who denied secretive eating (mean age = 12.07 ± 2.83 versus 10.97 ± 2.31). Controlling for study site and age, youth who endorsed secretive eating had higher eating-related psychopathology and were more likely to endorse loss of control eating and purging than their counterparts who did not endorse secretive eating. Groups did not differ in excessive exercise or behavioral problems. Dietary restraint and purging were elevated among adolescents (≥13y) but not children (<13y) who endorsed secretive eating; depression was elevated among children, but not adolescents, who endorsed secretive eating. CONCLUSIONS Secretive eating may portend heightened risk for eating disorders, and correlates of secretive eating may differ across pediatric development. Screening for secretive eating may inform identification of problematic eating behaviors, and understanding factors motivating secretive eating may improve intervention tailoring.
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Affiliation(s)
- Andrea E Kass
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, MC 1000, Chicago, IL, 60637, USA.
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| | - Kamryn T Eddy
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Kerri N Boutelle
- Department of Pediatrics and Psychiatry, University of California, San Diego, 9500 Gilman Drive, MC 0874, La Jolla, CA, 92093, USA
| | - Nancy Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, P.O. Box 3842, Durham, NC, 27710, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota Medical School, F282/2A West, 2450 Riverside Avenue South, Minneapolis, MN, 55454, USA
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA
| | - Angela Celio-Doyle
- Eating Disorders Center at the Evidence Based Treatment Centers of Seattle, 1200 5th Avenue, Suite 800, Seattle, WA, 98101, USA; Department of Psychology, University of Washington, Guthrie Hall (GTH), 119A 98195-1525, Seattle, WA, 98105, USA
| | - Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
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44
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Moreira H, Canavarro MC. Is body shame a significant mediator of the relationship between mindfulness skills and the quality of life of treatment-seeking children and adolescents with overweight and obesity? Body Image 2017; 20:49-57. [PMID: 27936409 DOI: 10.1016/j.bodyim.2016.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
Abstract
This study aimed to examine (a) whether mindfulness skills were associated with higher quality of life through lower body shame for treatment-seeking children/adolescents with overweight and obesity and (b) whether this indirect effect was moderated by children/adolescents' age and gender. The sample included 153 children/adolescents with overweight/obesity followed in individual nutrition consultations. Participants completed self-report measures of mindfulness, body shame, and quality of life. Moderated mediation analyses showed that higher levels of mindfulness were associated with better perceived quality of life through lower body shame, but only among girls. For boys, higher levels of body shame did not translate into a poorer perception of quality of life, and the indirect effect of mindfulness on quality of life via lower body shame was not significant. These results suggest that body shame is an important mechanism to explain why mindfulness may help girls with overweight/obesity perceive a better quality of life.
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Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
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45
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Hoffmann S, Warschburger P. Weight, shape, and muscularity concerns in male and female adolescents: Predictors of change and influences on eating concern. Int J Eat Disord 2017; 50:139-147. [PMID: 27739586 DOI: 10.1002/eat.22635] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the impact of age and weight status on adolescents' body dissatisfaction and its change over 20 months in a gender-comparing design. The influence of body image concern on eating concern was also investigated. METHOD In a prospective study, 675 male and female adolescents aged 12-16 were assessed using self-report questionnaires on weight, shape, muscularity, and eating concerns. Height and weight measurements were taken by trained personnel. Data were analyzed using structural equation modeling. RESULTS Analyses of latent means revealed more pronounced weight/shape concern in females than males and more pronounced muscularity concern in males than females. Weight/shape concern increased in females over time, whereas muscularity concern remained stable in both genders. Baseline levels of weight/shape concern could be predicted by age and weight status in females and by weight status in males. The only predictor of change in weight/shape concern was weight status in males. Baseline levels of muscularity concern could be predicted by age in females and by weight status in males. Similar effects were found for changes in muscularity concern in both genders. Increases in weight/shape and muscularity concern were associated with more pronounced eating concern. DISCUSSION The results confirm gender differences in distinctive facets of body image concern and its prediction. The relevance of increase in body image concern in adolescents is underlined by its association with eating concern in both genders. Further explanatory variables for change in body dissatisfaction should be examined in future studies. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:139-147).
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Affiliation(s)
- Svenja Hoffmann
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Straße 24/25, Potsdam, 14476, Germany
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Straße 24/25, Potsdam, 14476, Germany
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