Eating disorders: assessment and treatment

Prevalence and Associated Factors of Eating Disorders Among Female Students at Jazan University, Kingdom of Saudi Arabia: A Survey Study

BACKGROUND AND OBJECTIVE

Concerns about the incidence of eating disorders (EDs) among university students are spreading throughout the world. In Saudi Arabia, little is known about the prevalence and associated factors of EDs among female university students. Thus, this study investigated the prevalence, common types, and potential associated factors of EDs among female students of Jazan University.  Methods: A cross-sectional survey was conducted between August 31, 2020, and November 2, 2020. The snowball technique was used to recruit female students via an electronic survey distributed in Arabic. The survey collected information about demographic characteristics, and SCOFF (Sick, Control, One, Fat, Food) and Eating Attitudes Test (EAT-26) scales. Cronbach's alpha for the SCOFF and EAT-26 scales was calculated to be 0.78 and 0.58, respectively, in this study.

RESULTS

A total of 566 female students participated in the survey, with a mean age of 22.12 ± 2.93 years. The results showed that 47.9% of participants were at risk for EDs based on SCOFF scores, while 26.5% were at risk based on EAT-26 scores. The most common types of EDs were bulimia nervosa and binge eating disorder. Furthermore, the study identified several sociodemographic characteristics, including year of study (p = 0.042), college type (p = 0.004), body weight (p = 0.001), and BMI (p = 0.001), that are significantly associated with EDs. However, no significant relationships were observed between marital status (p = 0.103), age (p = 0.147), and height (p = 0.509) with SCOFF scores. Some students reported frequent binge eating, purging, or laxative/diet pill misuse.

CONCLUSIONS

The study revealed a moderate to high prevalence of risk for EDs among female university students in Jazan, Saudi Arabia, associated with higher study years, college majors, and body weight and BMI. Dangerous ED behaviors reported by some students signal an urgent need for resources to identify and support those suffering from these disorders. Targeted interventions and services may help address this critical issue on campuses and support vulnerable students in need. Continued research and public health action are needed to curb the spread of these disorders.

Effects of social comparisons with peers on women's body satisfaction and exercise behavior

OBJECTIVE

Although exposure to thin-ideal females in the media has been shown to increase women's body dissatisfaction, only a few studies have examined the effects of comparisons with peers, and no prior work has studied the effects of peer comparisons in a naturalistic setting or on objective behavior.

METHOD

Female undergraduates (n = 45) in a campus gym who exercised on a target apparatus were assigned to have a fit-peer, unfit-peer, or no-peer (control) exercise within their view on a nearby apparatus. Objective time spent exercising and body satisfaction reports were collected.

RESULTS

Exposure to a fit peer had undermining effects on women's body satisfaction and exercise duration, whereas an unfit peer produced no compensating greater body satisfaction but did elicit longer exercise duration relative to controls.

CONCLUSION

Incidental comparisons with fit versus unfit peers can affect women's body satisfaction and fitness-related behavior in a naturalistic setting.

Adolescent girls with high body satisfaction: who are they and what can they teach us?

PURPOSE

The purpose of this study was 2-fold: (1) to determine the prevalence of high body satisfaction in a multi-ethnic, urban population of adolescent females, and (2) to examine the demographic, socioenvironmental, personal, and behavioral factors associated with high body satisfaction among adolescent girls.

METHODS

The study population included 2,357 female middle and high school students who completed surveys in 1998-1999. High body satisfaction and its association with a range of socioenvironmental, personal, and behavioral factors were assessed. Associations were examined through comparisons of means (unadjusted and adjusted for grade level, race, socioeconomic status, and body mass index [BMI]) for continuous variables, and percentages and odds ratios for dichotomized variables.

RESULTS

Over a quarter (26.7%) of adolescent girls reported high body satisfaction. High body satisfaction was most common among African-American (40.1%) and underweight girls (39.0%). In adjusted analyses, girls with high body satisfaction were more likely to report parental and peer attitudes that encouraged healthy eating and exercising to be fit (p < .001) versus dieting, and less likely to report personal weight-related concerns and behaviors (p < .001).

CONCLUSIONS

The immediate subculture in which adolescent girls exist may play an important role in fostering high body satisfaction. Parents and health care providers often struggle with how to address the topic of weight management in teens without causing further injury to body image. Findings from the present study suggest the importance of providing a social environment that focuses on health and fitness, rather than on weight control, to increase adolescent girls' likelihood of being satisfied with their bodies.

Group therapy for anorexic and bulimic patients. Some aspects on the conduction of group therapy and a critical review of some recent studies

Group psychotherapy for Anorexia Nervosa (AN) and Bulimia Nervosa (BN) patients may be a major therapeutic challenge. The cognitive-behavioural approach may seem promising and some important stages in the conduction of cognitive-behavioural group therapy in particular are discussed. Furthermore, some problems concerning inpatient versus outpatient groups are mentioned. Studies on group therapy that have appeared between 1984 and 1989 are briefly reviewed and some recommendations concerning the improvement of methodology for future studies are put forward.

Physical illness encountered in patients with eating disorders

Careful evaluation for medical illness with a severity rating scale of 276 eating-disorder patients admitted to hospital revealed that patients with anorexia and bulimia were at risk for developing medical complications. Severe cardiovascular complications were most likely to occur in eating-disorder patients who were also diuretic and/or laxative abusers. Forty percent of patients with bulimia had significant medical complications. The findings suggest that a medical work-up should be carefully undertaken in both anorexic and bulimic patients admitted to hospital. A mixed history of severe anorexia nervosa alternating with periods of bulimia was most likely to lead to severe life-threatening illness. Seventy percent of the bulimic patients admitted required some medical treatment. Five percent were considered severely medically ill, while 34% suffered from a significant medical disorder. Ten percent of patients with restrictive anorexia or anorexia alternating with binge/purge required intensive care unit (ICU) placement. Most illnesses requiring medical treatment were unknown to the patient and the patient's physician at the time of admission.

Innovative treatment approaches to bulimia nervosa

The available evidence indicates that behavioral interventions for bulimia nervosa are effective in many cases; yet a significant proportion of patients are not symptom-free and others relapse following termination of treatment. Explanations for the nonresponsiveness to behavioral treatment and relapse are offered, including characteristics of certain patients and the scope and implementation of behavioral interventions. The conceptual basis and therapeutic implementation of two alternate behavioral interventions, namely, temptation with exposure and response prevention (TERP) and implosive therapy (IT), are presented and reviewed for their potential utility in nonresponsive and relapsing cases.