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Miniati M, Lippi M, Palagini L, Conversano C, Orrù G, Gemignani A, Perugi G. Is Interoception Deficit Linking Alexithymia and Eating Spectrum Symptoms? Study on a Non-Clinical Sample of Young Adults. Healthcare (Basel) 2024; 12:586. [PMID: 38470697 PMCID: PMC10931238 DOI: 10.3390/healthcare12050586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
We investigated if interoceptive deficits could be the link between alexithymic traits and eating spectrum manifestations in a non-clinical sample. One-hundred sixty-one young adults (mean age: 23.2 ± 2.4 years) were evaluated with the Toronto Alexithymia Scale-20 (TAS-20), the Interoceptive Accuracy Scale (IAS), the Interoceptive Confusion Questionnaire (ICQ), and the Eating Attitudes Test-26 (EAT-26). Questionnaires were administered with an online procedure (Microsoft Form, Office 365 A1, Pisa, Italy) (Study Protocol #0012005/2023). We compared ICQ, IAS, and TAS-20 scores in subjects who met the threshold for a potential eating spectrum disorder according to EAT-26 scores ≥ 20 (n = 27) vs. subjects who scored <20 (n = 134), with an ANCOVA corrected for 'age' and 'gender'. Subjects with EAT-26 ≥ 20, scored significantly higher at ICQ (54.4 ± 13.2 vs. 50.2 ± 6.8; p = 0.011), TAS-20 'Total Score' (60.8 ± 11.9 vs. 58.1 ± 9.2; p = 0.006), and TAS-20 'Identifying Feelings' (21.5 ± 7.6 vs. 17.3 ± 5.8; p = 0.0001). A binary logistic regression analysis, with EAT-26 scores < 20 vs. ≥20 as the dependent variable, and ICQ, IAS, TAS-20 total scores and dimensions, age, and gender (categorical) as covariates, showed that the only variable predicting eating spectrum symptomatology was 'ICQ Total Score' (OR = 1.075, 95% CI: 1.016-1.139; p = 0.013). Interoceptive confusion was the dimension linking the occurrence of alexithymic traits and eating spectrum manifestations.
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Affiliation(s)
- Mario Miniati
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (G.P.)
| | - Maria Lippi
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.L.); (C.C.); (G.O.); (A.G.)
| | - Laura Palagini
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (G.P.)
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.L.); (C.C.); (G.O.); (A.G.)
| | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.L.); (C.C.); (G.O.); (A.G.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.L.); (C.C.); (G.O.); (A.G.)
| | - Giulio Perugi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (G.P.)
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Alrahili N, Alghamdi RA, Alqasem AA, Alhallafi AFS, AlFarraj AA, Alghanem SK, Alshalan LZ. Prevalence of Eating Disorders and Comorbidity With Depression Among Adolescents in Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e54366. [PMID: 38500927 PMCID: PMC10948164 DOI: 10.7759/cureus.54366] [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] [Accepted: 02/16/2024] [Indexed: 03/20/2024] Open
Abstract
Background Patients diagnosed with eating disorders (EDs) have demonstrated elevated levels of eating psychopathology, including distorted body image, and general psychopathology, encompassing depression, anxiety, impulsivity, and low self-esteem, surpassing anticipated levels. However, the measurement of EDs' prevalence related to depression and mental disorders in Saudi society remains insufficient. There is a clear need for additional studies to establish and substantiate the relationship between these issues and their frequency. In response to this gap, the current study delves into the psychosocial implications of disordered eating in Saudi Arabian adolescents and adults. The primary objective of this study is to contribute to an expanded understanding of the psychosocial effects associated with EDs, shedding light on their prevalence and interconnectedness with mental health concerns among adolescents in Saudi Arabia. Methodology A cross-sectional study was conducted in Saudi Arabia among adolescents based on self-report questionnaires, including the Patient Health Questionnaires for Eating Disorders and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for the presence of EDs. To analyze the obtained data, we calculated the responses from participants who met the following criteria: adolescents (ages 10 to 18 years) from all regions in Saudi Arabia who were ethnically Saudi and included both male and female individuals. Those older than 18 years were excluded from the study. Results We collected data from 422 participants; however, 43 responses were excluded because the respondent was under 10 years or over 18 years old. According to the Patient Health Questionnaire 9 (PHQ-9), the prevalence of depression was 83.9%; 36.7% of the participants had severe depression, 23.2% had moderate depression, and 24% had mild depression. According to the Patient Health Questionnaire Eating Disorders Scale, the prevalence of EDs was 23.5%, with the prevalence of binge eating disorder and bulimia nervosa being 14.8% and 8.7%, respectively. We found a significant correlation between EDs and depression, and the severity of depression (P=0.005). The prevalence of depression among patients with EDs was 93.3%: 17.9% of patients with EDs had mild depression, 21.3% had moderate depression, and 54.1% had severe depression. Conclusion There is an alarming finding of the high prevalence of both EDs and depression among young adolescents in elementary school, which requires urgent intervention. The study found a significant relationship between EDs and depression: the more severe the depressive symptoms, the higher the prevalence of EDs.
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Affiliation(s)
- Nader Alrahili
- Psychiatry, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Rayan A Alghamdi
- Medicine and Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Abdulmlk A Alqasem
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Asma A AlFarraj
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Shahad K Alghanem
- Medicine and Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Lina Z Alshalan
- Medicine and Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Eren N, Tunc P, Yücel B. Effect of a long-term art-based group therapy with eating disorders. MEDICAL HUMANITIES 2023; 49:576-582. [PMID: 37068943 DOI: 10.1136/medhum-2022-012573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
Eating disorders (EDs) affect the physical, psychological, emotional and interpersonal areas of the individual and cause serious medical and mental consequences. Their treatment should be handled in a multidisciplinary manner.The objective of this study was to investigate potential benefits of long-term art-based group therapy (ABGT) as an adjunct to treatment for a variety of EDs. This study examined the effects of ABGT on disease symptoms, difficulty regulating emotions, depression, anxiety, targeted problems, functioning of individuals with EDs and therapeutic efficiency of the group. The study was carried out as a pre-test-post-test, quasi-experimental study with a control group, with a small sample diagnosed with an ED. In addition to their standard treatment at the outpatient centre, participants were included in a 30-week long-term semistructured ABGT focused on raising awareness of their psychological problems. Participants who received ABGT had significantly better functioning and lower severity of target problems compared with the control group. The severity of the three most important problems reported by patients post-ABGT compared with pre-ABGT and the effects of these problems on their social/private lives reduction was observed. The participants mostly benefited from catharsis, universality, self-understanding, existential factors and family re-enactment in the group process. Through the artwork, participants recognised the mental conflicts causing the symptoms of their ED. We found that art-based interventions are useful in the treatment of EDs, as they positively changed the functioning and symptoms of people with EDs. We recommend that clinicians keep these interventions in mind in formulating treatment protocols for these disorders.
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Affiliation(s)
- Nurhan Eren
- Faculty of Medicine, Department of Mental Health and Diseases, Social Psychiatry Service, Istanbul Universitesi, Istanbul, Turkey
| | - Pervin Tunc
- Psychology Department, İstinye Üniversitesi, Istanbul, Turkey
| | - Başak Yücel
- Faculty of Medicine, Department of Mental Health and Diseases, Istanbul Universitesi, Istanbul, Turkey
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Yim SH, Schmidt U. The effectiveness and cultural adaptations of psychological interventions for eating disorders in East Asia: A systematic scoping review. Int J Eat Disord 2023; 56:2165-2188. [PMID: 37726977 DOI: 10.1002/eat.24061] [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: 04/01/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE There has been no review on eating disorder-focused psychological interventions in East Asia. The aims of this systematic scoping review were to summarize existing and forthcoming studies and to synthesize the cultural adaptations and effectiveness of the interventions identified. METHOD Five databases (PubMed, Embase, Global Health, Medline, PsychInfo) and seven trial registries were searched. Studies examining eating disorder (ED)-focused psychological interventions in East Asia were included. Narrative synthesis was used for the analysis. RESULTS Eighteen published studies and 14 ongoing/completed but unpublished studies were included. Most published studies were uncontrolled and five were feasibility studies. Among the ongoing studies, 71% are randomized controlled trials. Cognitive therapies were the main approach used, including individual cognitive behavioral therapy (CBT), internet CBT, group CBT, guided self-help, and cognitive remediation therapy. Cultural adaptations were mostly related to language, communication style and tailoring the dietary requirements to local diets. Interventions were shortened to increase acceptability and reduce financial and time burden to patients. Overall, studies showed good acceptability, completion rates and positive effects on ED symptoms (indicated by moderate to large effect sizes or statistical significance). DISCUSSION Studies were underpowered and uncontrolled, thus precluding meaningful interpretations of effectiveness to be made. However, the psychological interventions were acceptable and showed promise in delivery. Digital and group interventions seemed to be the most feasible given barriers in the local health systems. More controlled studies, as well as studies on children and adolescents, are needed in future. PUBLIC SIGNIFICANCE This is the first systematic scoping review examining psychological interventions for eating disorders in East Asia. Research in eating disorders has largely focused on White people and in Western countries. This review will be helpful for clinicians and researchers to understand the current state of the field through a non-Eurocentric lens, to identify gaps and plan future research.
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Affiliation(s)
- See Heng Yim
- Central and Northwest London NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Ulrike Schmidt
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Banna MHA, Akter S, Kabir H, Brazendale K, Sultana MS, Alshahrani NZ, Ahinkorah BO, Salihu T, Azhar BS, Hassan MN. Internet addiction, depressive symptoms, and anxiety symptoms are associated with the risk of eating disorders among university students in Bangladesh. Sci Rep 2023; 13:20527. [PMID: 37993471 PMCID: PMC10665554 DOI: 10.1038/s41598-023-47101-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023] Open
Abstract
The risk of developing an eating disorder among university students is higher than the general population in Bangladesh. Since psychiatric disorders (such as depression and anxiety) and addictive behaviors (e.g., internet addiction) predominantly exist among university students in the country, these may increase their vulnerability to developing an eating disorder. The association of internet addiction, depression, and anxiety with the risk of eating disorders among Bangladeshi university students is relatively unknown; therefore, this study investigates the association. This study was a cross-sectional design. Students (N = 700) from two public universities in Bangladesh completed the Patient Health Questionnaire (PHQ-9) scale, the Generalized Anxiety Disorder (GAD-7) tool, and Orman's Internet Addiction Survey (OIAS) to measure exposure variables. Eating Attitudes Test-26 (EAT-26) assessed the outcome variable. Multivariable logistic regression analysis showed that internet addiction [adjusted odds ratio (aOR) for moderate addiction = 2.15 and severe addiction = 3.95], depressive (aOR 3.04), and anxiety (aOR 2.06) symptoms were associated with an increased risk of eating disorder among study participants. Future longitudinal studies on university students are recommended to gain a better understanding about the causal factors of eating disorder to support intervention initiatives and strategies by public health practitioners and policy experts.
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Affiliation(s)
- Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
- Nutrition Initiative, Kushtia, Bangladesh.
| | - Shammy Akter
- Department of Applied Nutrition and Food Technology, Faculty of Biological Sciences, Islamic University, Kushtia, Bangladesh
| | - Humayun Kabir
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, USA
| | - Mst Sadia Sultana
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | - Tarif Salihu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Bably Sabina Azhar
- Department of Applied Nutrition and Food Technology, Faculty of Biological Sciences, Islamic University, Kushtia, Bangladesh
| | - Md Nazmul Hassan
- Department of Environmental Sanitation, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh
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Philip B, Poku O, Attoh-Okine ND, Presskreischer R. The need for epidemiological research on eating disorders in Africa and the Caribbean. Int J Eat Disord 2023; 56:1688-1693. [PMID: 37265119 PMCID: PMC10898680 DOI: 10.1002/eat.24002] [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: 12/01/2022] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
The eating disorders field acknowledges the need to include diverse populations in research. Although global diversity has increased in epidemiologic research, there is still a significant lack of research in Africa and the Caribbean. The objectives of this article are to highlight knowledge gaps in these regions and make recommendations to improve future research. We searched the literature about the epidemiology of eating disorders in Africa and the Caribbean and provided a brief summary of research findings and measures used to identify cases. There is a large knowledge gap about the epidemiology of eating disorders across African and Caribbean nations. Knowledge about the cultural appropriateness of measurement instruments and screening tools is also lacking. Inadequate information about the epidemiology of eating disorders in Africa and the Caribbean inhibits the eating disorders research field from identifying who is affected. Further, measures and screening instruments with uncertain cultural validity inhibit the ability to understand case presentations and treatment targets. We recommend that the field advocate for the inclusion of eating disorders in larger population health research and that future research should evaluate the appropriateness of measurement instruments to capture eating disorder cases in African and Caribbean countries. PUBLIC SIGNIFICANCE: There is a lack of eating disorder research in African and Caribbean countries. The limited studies that do exist show evidence of eating disorders in African and Caribbean countries. Research is needed to develop culturally relevant measures for screening and case identification, and to calculate incidence and prevalence.
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Affiliation(s)
| | - Ohemaa Poku
- Columbia-WHO Center for Global Mental Health, New York, New York, USA
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, New York, USA
| | - Naa-Djama Attoh-Okine
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, New York, USA
- Department of Surgery, Jamaica Hospital Medical Center, Jamaica, New York, USA
| | - Rachel Presskreischer
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
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Garbett KM, Craddock N, Saraswati LA, Diedrichs PC. Body Image among Girls in Indonesia: Associations with Disordered Eating Behaviors, Life Engagement, Desire for Cosmetic Surgery and Psychosocial Influences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6394. [PMID: 37510625 PMCID: PMC10378758 DOI: 10.3390/ijerph20146394] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
Body image is an important risk factor for mental and physical health during adolescence. Nonetheless, few studies have empirically investigated body image among girls in Southeast Asia. This cross-sectional study examined the prevalence of body esteem (a holistic measure of body image assessing the degree of satisfaction with one's appearance, weight, and shape), associated behavioral outcomes, and potential psychosocial influences on body image among Indonesian girls to inform future intervention efforts. Girls across Indonesia with internet access (N = 318, Mage = 13.59 years) completed a questionnaire that assessed body image, disordered eating behaviors, appearance-related life engagement, desire for cosmetic surgery, appearance ideal internalization, media literacy, appearance-related teasing, and self-esteem. The younger girls' (10-13 years) responses were analyzed separately from those of the older girls (14-17 years). Over half of the girls did not have high body esteem. Approximately a quarter of the girls across both age groups reported restricting their food intake, emotionally eating, and/or engaging in excessive exercise, and over half desired cosmetic surgery. Disordered eating behaviors and a desire for cosmetic surgery were negatively correlated with body esteem. Hierarchical regression analyses found BMI, internalization, appearance-related teasing, and self-esteem were uniquely associated with body esteem among younger girls. Appearance-related teasing and self-esteem were positively associated with body esteem among older girls. These findings suggest body image interventions may be important for this population, with appearance-related teasing and self-esteem potentially useful targets for intervention efforts. Further prospective research to investigate these findings would be beneficial for a deeper understanding of body image risk factors for girls across Indonesia.
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Affiliation(s)
- Kirsty May Garbett
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
| | - Nadia Craddock
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
| | - L Ayu Saraswati
- Department of Women, Gender, and Sexuality Studies, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
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Aldubayan K, Ghafouri K, Mutwalli H, Kutbi HA, Mumena WA. Validity and Consistency of the Arabic Version of the Eating Disorder Examination Questionnaire (EDE-Q) among Saudi Adults. Healthcare (Basel) 2023; 11:healthcare11071052. [PMID: 37046979 PMCID: PMC10094318 DOI: 10.3390/healthcare11071052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
The prevalence of eating disorders (EDs) is growing, and early screening is important to prevent related health complications. The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a diagnostic tool to identify cases of EDs; however, a validated Arabic version of the tool is needed to help in the screening process of EDs. The aim of this study was to validate the Arabic version of EDE-Q. A cross-sectional study included a sample of 549 adults, who were recruited mainly from the four major provinces in Saudi Arabia. A forward–backward translation method was conducted, and then the tool was validated using the confirmatory factor analysis (CFA). The dataset was split for further convergent analysis using exploratory factor analysis (EFA) and CFA. The results of CFA from the main dataset did not support the four-factor original EDE-Q. The results of EFA from the first data-split suggested a three-factor EDE-Q-14 Arabic version. This was supported by the results of CFA of the second data-split. A total of five items were allocated in each shape and weight concern, and restraint component, with correlations ranging from 0.969 and 0.462 and from 0.847 to 0.437, respectively. A total of four items were allocated in eating concern, with correlations ranging from 0.748 to 0.556. The internal consistency of the global and the three subscales were high, with Cronbach’s α ranging from 0.762 to 0.900. Findings of the current study suggest that the Arabic version of the EDE-Q-14 is a valid and reliable tool to screen for EDs among adults in Saudi Arabia.
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Affiliation(s)
- Khalid Aldubayan
- Department of Community Health Sciences, Collage of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Khloud Ghafouri
- Departmrnt of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, P.O. Box 715, Makkah 21955, Saudi Arabia
| | - Hiba Mutwalli
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Hebah A. Kutbi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah 21589, Saudi Arabia
| | - Walaa A. Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah 42353, Saudi Arabia
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Dane A, Bhatia K. The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001091. [PMID: 36962983 PMCID: PMC10032524 DOI: 10.1371/journal.pgph.0001091] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/23/2023] [Indexed: 03/24/2023]
Abstract
Background Eating disorders are a group of heterogenous, disabling and deadly psychiatric illnesses with a plethora of associated health consequences. Exploratory research suggests that social media usage may be triggering body image concerns and heightening eating disorder pathology amongst young people, but the topic is under-researched as a global public health issue. Aim To systematically map out and critically review the existing global literature on the relationship between social media usage, body image and eating disorders in young people aged 10–24 years. Methods A systematic search of MEDLINE, PyscINFO and Web of Science for research on social media use and body image concerns / disordered eating outcomes published between January 2016 and July 2021. Results on exposures (social media usage), outcomes (body image, eating disorders, disordered eating), mediators and moderators were synthesised using an integrated theoretical framework of the influence of internet use on body image concerns and eating pathology. Results Evidence from 50 studies in 17 countries indicates that social media usage leads to body image concerns, eating disorders/disordered eating and poor mental health via the mediating pathways of social comparison, thin / fit ideal internalisation, and self-objectification. Specific exposures (social media trends, pro-eating disorder content, appearance focused platforms and investment in photos) and moderators (high BMI, female gender, and pre-existing body image concerns) strengthen the relationship, while other moderators (high social media literacy and body appreciation) are protective, hinting at a ‘self-perpetuating cycle of risk’. Conclusion Social media usage is a plausible risk factor for the development of eating disorders. Research from Asia suggests that the association is not unique to traditionally western cultures. Based on scale of social media usage amongst young people, this issue is worthy of attention as an emerging global public health issue.
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Affiliation(s)
- Alexandra Dane
- Institute for Global Health, University College London, London, United Kingdom
| | - Komal Bhatia
- Institute for Global Health, University College London, London, United Kingdom
- * E-mail:
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10
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McCabe M, Alcaraz-Ibanez M, Markey C, Sicilia A, Rodgers RF, Aimé A, Dion J, Pietrabissa G, Lo Coco G, Caltabiano M, Strodl E, Bégin C, Blackburn MÉ, Castelnuovo G, Granero-Gallegos A, Gullo S, Hayami-Chisuwa N, He Q, Maïano C, Manzoni GM, Mellor D, Probst M, Fuller-Tyszkiewicz M. A longitudinal evaluation of a biopsychosocial model predicting BMI and disordered eating among young adults. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2023.2181686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Marita McCabe
- School of Health Sciences, Swinburne University, Hawthorn, Australia
| | - Manuel Alcaraz-Ibanez
- Health Research Center and Department of Education, University of Almeria, Almeria, Spain
| | - Charlotte Markey
- Department of Psychology, Health Sciences Centre, Rutgers University, Camden, NJ, USA
| | - Alvaro Sicilia
- Health Research Center and Department of Education, University of Almeria, Almeria, Spain
| | - Rachel F. Rodgers
- Department of Applied Psychology, North Eastern University, Boston, MA, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Jacinthe Dion
- Department of Health Sciences, Université du Québec á Chicoutimi, Chicoutimi, Canada
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Marie Caltabiano
- School of Psychology, James Cook University, Smithfield, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | | | | | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | - Salvatore Gullo
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | | | - Qiqiang He
- School of Health Sciences, Wuhan University, Wuhan, PR China
| | - Christoph Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
| | - David Mellor
- School of Psychology, Deakin University, Burwood, Australia
| | - Michel Probst
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
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11
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Barnhart WR, Cui T, Cui S, Han X, Lu C, He J. Examining appearance pressures, thinness and muscularity internalizations, and social comparisons as correlates of drive for muscularity and thinness-oriented disordered eating in Chinese heterosexual men and women: Testing an integrated model. Body Image 2022; 43:429-439. [PMID: 36345081 DOI: 10.1016/j.bodyim.2022.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Given existing empirical support for the tripartite influence and social comparison models to explain variance in body dissatisfaction and disordered eating across diverse populations in the Western context, research is needed to describe these models in non-Western populations. The present study tested an integrated model inclusive of appearance pressures, thinness and muscularity internalizations, and social comparisons in relation to drive for muscularity and thinness-oriented disordered eating in heterosexual Chinese adult men (n = 510) and women (n = 473). Separated by gender, two integrated models had good fit statistics per structural equation modeling. In men and women, higher appearance pressures were uniquely related to higher drive for muscularity and thinness-oriented disordered eating. In men and women, higher thinness and muscularity internalizations were uniquely related to higher thinness-oriented disordered eating and drive for muscularity, respectively. In men and women, higher upward body image comparisons were uniquely related to higher drive for muscularity, and in men only, higher downward body image comparisons were uniquely related to higher thinness-oriented disordered eating. The present findings, which extend theories of eating pathology, may aid in improving treatment efforts for body dissatisfaction and disordered eating in heterosexual Chinese adult men and women.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Tianxiang Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China; Department of Psychology, University of Macau, Taipa, Macau, China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Xinni Han
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Chen Lu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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12
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Monocello LT, Dressler WW. Cultural consonance, body image, and disordered eating among young South Korean men. Soc Sci Med 2022; 314:115486. [PMID: 36327628 PMCID: PMC9710247 DOI: 10.1016/j.socscimed.2022.115486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
Eating disorders are serious mental illnesses, but little research explores non-Western men's cultural experiences of body image and what affects their risks of disordered eating. Drawing on data collected over 17 months (August 2019 to January 2021) of fieldwork in Seoul, South Korea, the lens of intersectionality is employed alongside multiple regression and moderation analysis to understand how two axes of identity which emerged as important from the ethnography-sexual identity and university prestige-shape the ways in which young Korean men's cultural consonance with their local model of the ideal male body, influenced heavily by the kkonminam (flower boy), relates to risk for developing an eating disorder. Among young Korean men, intersections of university prestige and sexual identity frame embodiment of cultural models of male body image as a strategy for the making and maintenance of social relations and the advancement of social status in a precarious neoliberal economy.
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Affiliation(s)
- Lawrence T. Monocello
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, Missouri, 63110, USA,Corresponding author. (L.T. Monocello)
| | - William W. Dressler
- Department of Anthropology, The University of Alabama, Box 870210, Tuscaloosa, AL, 35487, USA
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13
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Zelkowitz RL, Cole DA, Sterba SK, Liu Q, Lau AS, Trung LT, Weiss B. Latent profile analyses of disordered eating behaviors and nonsuicidal self-injury among Vietnamese adolescents. Int J Eat Disord 2022; 55:1721-1732. [PMID: 36165444 DOI: 10.1002/eat.23813] [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: 01/03/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Comorbidity of disordered eating (DE) behaviors and nonsuicidal self-injury (NSSI) is linked to increased functional impairment. The present study identified subtypes of DE and NSSI comorbidity in a non-Western, low- and middle-income country where there has been particularly little research in this area. METHOD Latent profile analyses (LPA) were conducted to identify patterns of subgroup comorbidity in self-reported DE behaviors and NSSI behaviors, in a sample of Vietnamese high-school students (N = 1451, 51% female). Parallel-process LPA was used to predict NSSI subgroup membership from DE subgroup membership. RESULTS A seven-class LPA model was identified for DE: (1) Low frequencies of all DE behaviors; (2) Frequent levels of all DE behaviors; (3) Frequent fasting and purging behaviors; (4) Frequent binge eating only; (5) Moderate binge eating; (6) Moderate fasting and purging behaviors; (7) Exercise and fasting. A two-class (high versus low) model was identified for NSSI. Odds of membership in the high-NSSI class were significantly increased for all DE classes except the class characterized by moderate binge eating. Odds of belonging to the high-NSSI class were highest for those in DE classes involving purging behaviors. Males predominated in classes characterized by high behavior dysregulation. DISCUSSION DE and NSSI represent important clinical concerns among Vietnamese youth in urban contexts, and males may show particular vulnerability for certain risk behaviors. The association of classes of DE behaviors to NSSI was particularly strong for classes that involved purging, highlighting the importance of this specific behavior for understanding comorbidity of DE and NSSI. PUBLIC SIGNIFICANCE Disordered eating and nonsuicidal self-injury (NSSI; hurting oneself without intending to die) commonly co-occur. There has been less research on disordered eating and NSSI among individuals from non-Western or low/middle-income countries. We examined patterns of these behaviors in a school-based sample of Vietnamese adolescents. We found that patterns of disordered eating distinguished by purging showed particular links to NSSI, which could have implications for screening and treatment.
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Affiliation(s)
- Rachel L Zelkowitz
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - David A Cole
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
| | - Sonya K Sterba
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
| | - Qimin Liu
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
| | - Anna S Lau
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Lam T Trung
- Danang Psychiatric Hospital, Da Nang, Vietnam
| | - Bahr Weiss
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
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14
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Eating disorders among middle school students in a Chinese population: Prevalence and associated clinical correlates. J Psychiatr Res 2022; 154:278-285. [PMID: 35964346 DOI: 10.1016/j.jpsychires.2022.07.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/07/2022] [Accepted: 07/26/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Eating disorders are regarded to be associated with many psychological and behavioral problems. Moreover, adolescence has been reported to be the key period for developing eating habits, and eating disorders typically emerge in adolescence and early adulthood. This study aimed to investigate the prevalence of eating disorders and explore the associated factors among adolescents in Hunan province, China METHODS: A total of 1610 middle school students from Hunan province, China, were enrolled in this study. The participants were aged from 11 to 16 years old. The following data were collected: demographic variables, Body Mass Index (BMI), suicidal behaviors, non-suicidal self-injury, depression, anxiety, stress (depression - anxiety - stress scale, DASS-21), childhood trauma (Childhood Trauma Questionnaire, CTQ), symptoms of social anxiety (Social Anxiety Scale-Adolescents, SAS-A), and eating problems (Eating Attitudes Test, EAT-26). RESULTS The estimated prevalence of eating disorders was 8.9%. Compared with participants without eating disorders, participants with eating disorders were more likely to be at a younger age, obese and overweight, and have a history of non-suicidal self-injury, suicidal ideation, suicidal plans, suicide attempts, emotional abuse, physical abuse, emotional neglect, and physical neglect; more likely to experience stress, anxiety or depression as well as have high scores of social avoidance and distress related to general social contexts. Anxiety, emotional neglect, physical neglect, obesity, and overweight were still significant in the binary logistic regression model after controlling for confounding factors. Additionally, younger age, emotional abuse, physical abuse, stress, anxiety, depression, social avoidance, and distress related to general social contexts were significantly correlated with the EAT-26 scores in correlation analysis CONCLUSIONS: Eating disorders are quite common among middle school students. Moreover, eating disorders are associated with younger age, non-suicidal self-injury, suicidal ideation, suicide attempts, stress, anxiety, depression, emotional abuse, physical abuse, emotional neglect, physical neglect, social avoidance, and distress related to general social contents and BMI. This study provides a reference for school counselors and clinicians in the prevention and treatment of eating disorders.
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Alfalahi M, Mahadevan S, Balushi RA, Chan MF, Saadon MA, Al-Adawi S, Qoronfleh MW. Prevalence of eating disorders and disordered eating in Western Asia: a systematic review and meta-Analysis. Eat Disord 2022; 30:556-585. [PMID: 34486495 DOI: 10.1080/10640266.2021.1969495] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to systematically synthesize and appraise existing literature on the prevalence of eating disorders and disordered eating in Western Asia. A systematic literature search of major English and Arabic databases, i.e., PubMed/Medline, EMBASE, PsychInfo, Web of Science and Scopus (English), Al-Manhal (Arabic) and grey literature was done to obtain the prevalence of disordered eating and eating disorders in Western Asia. The literature search was conducted on June 12th, 2020, and included papers from 1990-2020. Out of the 249 unduplicated original studies reviewed, 27 were included in the final meta-analysis. Data were then categorized according to the tools used to identify the presence of disordered eating or eating disorders. The pooled prevalence of disordered eating as solicited by both the Eating Attitudes Scale 26 and the Eating Attitudes Scale 40 (N = 11841) was 22.07%, the Sick, Control, One stone, Fat, Food Questionnaire (n = 3160) was 22.28% and the Eating Disorder Examination-Questionnaire (n = 425) was 7.95%. The pooled prevalence obtained from those studies using semi-structured interviews for anorexia nervosa (n = 118190) was 1.59%, bulimia nervosa (n = 118513) was 2.41% and the estimated prevalence of Eating Disorder Not Otherwise Specified (EDNOS) (n = 118087) was 3.51%. Although the prevalence rate of eating disorders solicited using semi-structured interviews appeared to parallel the international range, the overall prevalence rate of disordered eating appeared to be slightly higher than the global rates of prevalence. A significant number of the suspected/detected cases of disordered eating appear to fulfill the criteria for EDNOS. This study is classified as evidence obtained from systematic reviews and meta-analyses (i.e. Level 1).
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Affiliation(s)
- Maryam Alfalahi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Sangeetha Mahadevan
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Rola Al Balushi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Moon Fai Chan
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, SultanQaboos University, Muscat, Oman
| | - Muna Al Saadon
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - M Walid Qoronfleh
- Research & Policy Department, Q3CG Research Institute (QRI) Research & Policy Division, Ypsilanti, Michigan, USA
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16
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Melisse B, Blankers M, de Beurs E, van Furth EF. Correlates of eating disorder pathology in Saudi Arabia: BMI and body dissatisfaction. J Eat Disord 2022; 10:126. [PMID: 36002864 PMCID: PMC9404570 DOI: 10.1186/s40337-022-00652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Saudi Arabia is undergoing rapid sociocultural changes, which may have led to an increase of body mass index and eating disorder pathology. The aim of this study is to investigate whether body dissatisfaction, self-esteem, having lived abroad, cultural orientation, perceived stress, media use, and socioeconomic status are correlates of eating disorder pathology with body mass index as a covariate. Additional aims are to investigate if cultural orientation is associated with symptomatology and if stress is a covariate in the association between eating disorder pathology and Western orientation. METHOD Self-report measures were administered in a convenience Saudi community sample (N = 1225) between April 2017 and May 2018. Hierarchical multiple linear regression analyses with eating disorder pathology as dependent variable were performed to establish the associations among the variables. RESULTS After adjusting for the effect of BMI, only body dissatisfaction and eating disorder pathology were moderately associated. Eating disorder pathology and body dissatisfaction were more severe among Saudi citizens with a higher BMI. DISCUSSION Several explanations for the lack of associations of westernization, self-esteem, and stress with eating disorder pathology are reviewed and discussed. The majority of this convenience sample existed of young unmarried Saudi females of high socioeconomic status. Of the total sample, 35% displayed eating disorder pathology which may be a reflection of the high rates of excess weight.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders & Obesity, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands
- Section Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- Rivierduinen Eating Disorders Ursula, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands
| | - Matthijs Blankers
- Research Department, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
| | - Edwin de Beurs
- Research Department, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
- Section Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Eric F. van Furth
- Rivierduinen Eating Disorders Ursula, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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Kwag KH, Kim YR, Lee YK, Lee HR, Lee JY, Lee J, Kim J, Kim Y, Treasure J. Feasibility and acceptability of a digital tele-guided intervention targeting components of the addictive appetite model for bulimia nervosa and binge-eating disorder in Korea. Int J Eat Disord 2022; 55:977-982. [PMID: 35686716 DOI: 10.1002/eat.23754] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We aimed to evaluate the feasibility, acceptability, and potential impact of a tele-guided digital-based intervention based on the addictive appetite model of recurrent binge eating. METHOD Female college students with bulimia nervosa (BN) or binge-eating disorder (BED) (n = 22) received a 6-week guided intervention targeting addictive processes and emotion regulation. The feasibility of the intervention was evaluated, and the outcomes were assessed at baseline, the end of the intervention, and 1-month follow-up. RESULTS Of the participants, 86.4% (n = 19) completed the intervention. The self-help materials were viewed 6.03 ± 3.06 times per week, and the duration of using the self-help materials was 113.16 ± 160.19 min/week. The intervention group experienced a significant reduction with a moderate effect on binge eating at the end of the intervention (Hedges' g = 0.58), and the effects lasted through follow-up (Hedges' g = 0.82). DISCUSSION The results suggest that the digital intervention targeting a maintenance mechanism of recurrent binge eating was feasible and acceptable for patients with BN and BED, proving the potential for symptom improvement. PUBLIC SIGNIFICANCE The addictive appetite model provides the framework for new interventions to improve treatments for BN and BED. This study found that the digital intervention based on the model was feasible and acceptable for patients with BN and BED.
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Affiliation(s)
- Kyung Hwa Kwag
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea.,Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, South Korea
| | - You Kyung Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Hye Rin Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Ja Youn Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Jihye Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Jione Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Youngkeun Kim
- Department of Counseling and Psychotherapy, Inje University, Gimhae, South Korea
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Melisse B, van Furth EF, de Beurs E. Eating disorder examination questionnaire (EDE-Q): validity and norms for Saudi nationals. Eat Weight Disord 2022; 27:139-150. [PMID: 33751466 DOI: 10.1007/s40519-021-01150-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 02/09/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The aim of this study was to develop an Arabic version of the EDE-Q and to assess its psychometric properties and utility as a screener in the Saudi population. An additional aim was to establish EDE-Q norms for Saudis. METHOD EDE-Q data were collected in a convenience sample of the Saudi community (N = 2690), of which a subset was also subjected to the EDE interview (N = 98). Various models for the factor structure were evaluated on their fit by CFA. With ROC analysis, the AUC was calculated to test how well the EDE-Q discriminated between Saudis at high and low risk for eating disorders. RESULTS The original four factor model of the EDE-Q was not supported. Best fit was found for a three factor model, including the weight/shape concern scale, dietary restraint scale and eating concern scale. The ROC analysis showed that the EDE-Q could accurately discriminate between individuals at high and low risk for an eating disorder according to the EDE interview. Optimal cut off of 2.93 on the global score yielded a sensitivity of 82% and specificity of 80%. EDE-Q scores were fairly associated with BMI. DISCUSSION Psychometric characteristics of the Saudi version of the EDE-Q were satisfactory and results support the discriminant and convergent validity. Severity level of eating disorder pathology can be determined by the EDE-Q global score. Global scores were high compared to what is found in Western community samples, leading to high prevalence estimates for Saudis at high risk for eating disorders. LEVEL OF EVIDENCE Not applicable, empirical psychometric study.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders and Obesity, Jacob Obrechtstraat 92, 1071 KR, Amsterdam, the Netherlands. .,GGZ Rivierduinen, Sandifortdreef 18, 2333 ZZ, Leiden, the Netherlands.
| | - Eric F van Furth
- GGZ Rivierduinen, Sandifortdreef 18, 2333 ZZ, Leiden, the Netherlands.,Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Edwin de Beurs
- Research Department, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, the Netherlands.,Section Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
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Characterization, epidemiology and trends of eating disorders. NUTR HOSP 2022; 39:8-15. [DOI: 10.20960/nh.04173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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20
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Gan JKE, Wu VX, Chow G, Chan JKY, Klainin-Yobas P. Effectiveness of non-pharmacological interventions on individuals with anorexia nervosa: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2022; 105:44-55. [PMID: 34059364 DOI: 10.1016/j.pec.2021.05.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 03/15/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study aimed to synthesize the best available evidence regarding the effectiveness of non-pharmacological interventions on body mass index (BMI), body dissatisfaction, depression and anxiety among individuals with anorexia nervosa (AN). METHODS Published studies in English were searched using seven databases (such as PubMed). Grey literature was searched using ProQuest and Scopus. Studies were screened, appraised and extracted by two independent reviewers. Meta-analysis was performed and standardized mean difference was used as an effect measure. Heterogeneity was determined by I2 statistics and Cochran χ2 test. Publication bias was appraised using funnel plots. Sensitivity and subgroup analyses were also conducted. RESULTS Nineteen RCTs from eight different countries were included in this review. Behavioral family system therapy (BFST) was found to enhance BMI while conjoint family therapy (CFT) was more effective in ameliorating depression. Studies implementing combined family and individual therapy and those with longer therapeutic durations produced larger effect sizes. CONCLUSION This review provided evidence to support BSFT, CFT and combined family and individual therapy for adolescents with AN. PRACTICAL IMPLICATIONS Healthcare professionals may offer the two interventions to adolescents with AN in clinical settings. Future research may further investigate the effectiveness of BSFT and CFT on BMI and depression.
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Affiliation(s)
- Javeil Ke En Gan
- Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore.
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, 10 Medical Drive, Singapore 117597, Singapore.
| | - Gigi Chow
- Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore.
| | | | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, 10 Medical Drive, Singapore 117597, Singapore.
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Fu J, Liang F, Wang Y, Qiu N, Ding K, Zeng J, Moore JB, Li R. Modeling Parental Influence on Food Consumption among Chinese Adolescents through Self-Efficacy: A Path Analysis. Nutrients 2021; 13:nu13124454. [PMID: 34960008 PMCID: PMC8705551 DOI: 10.3390/nu13124454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the associations between perceived parental control, perceived parental modeling and parent–teen co-decision making, and fruit and vegetable (F&V) and sugar-sweetened beverage and junk food (S&J) consumption among Chinese adolescents, and examine whether self-efficacy mediates the associations. Data were collected in a cross-sectional survey of Chinese adolescents carried out in the fall of 2019. The questionnaires were adapted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Ordinary least-squares regressions and a path analysis were performed to evaluate the hypothesized associations. The final sample included 3595 Chinese adolescents (mean (SD) age, 14.67 (1.73) years; 52.82% (n = 1899) males). Perceived parental control was positively associated with adolescents’ F&V consumption, and was negatively associated with adolescents’ S&J consumption. Perceived parental modeling and parent–teen co-decision making were both positively associated with adolescents’ F&V consumption and negatively associated with their S&J consumption. Adolescents’ self-efficacy was positively associated with F&V consumption and negatively associated with S&J consumption. These results suggest that serving as a positive role model, having adolescents participate in the decision-making process, and increasing adolescents’ self-efficacy can be feasible and efficacious strategies to improve the nutritional quality of Chinese adolescents’ diets.
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Affiliation(s)
- Jialin Fu
- Department of Healthcare Management, School of Public Health, Wuhan University, Wuhan 430071, China; (J.F.); (F.L.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Fang Liang
- Department of Healthcare Management, School of Public Health, Wuhan University, Wuhan 430071, China; (J.F.); (F.L.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Yechuang Wang
- Department of Healthcare Management, School of Public Health, Wuhan University, Wuhan 430071, China; (J.F.); (F.L.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Nan Qiu
- Department of Healthcare Management, School of Public Health, Wuhan University, Wuhan 430071, China; (J.F.); (F.L.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Kai Ding
- Department of Healthcare Management, School of Public Health, Wuhan University, Wuhan 430071, China; (J.F.); (F.L.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Jing Zeng
- Department of Healthcare Management, School of Public Health, Wuhan University, Wuhan 430071, China; (J.F.); (F.L.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Justin Brian Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA;
| | - Rui Li
- Department of Healthcare Management, School of Public Health, Wuhan University, Wuhan 430071, China; (J.F.); (F.L.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
- School of Nursing, Wuhan University, Wuhan 430071, China
- Correspondence: ; Tel.: +86-27-68759901; Fax: +86-27-68758648
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Ahamed SK, Barek MA, Roy UK, Kouser M, Reza MS, Mannan AB, Alam MA, Uddin SMN. A review on association and correlation of genetic variants with eating disorders and obesity. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2021. [DOI: 10.1186/s43094-021-00250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Now, eating disorders and obesity and their correlations are danger signal in worldwide which is caused by multifactor and associated with significant mortality and morbidity.
Main body
Every aspect of a patient’s life is influenced by eating disorders and obesity and their correlations. Due to frequent seeing of obese patients, eating disorders have been included in the review as they can sometimes be associated with obesity. However, it should be noted that most patients having eating disorder are at risk to be obese or overweight. This research explores the risk factors for the two disorders, as well as the assessment of medical complications and treatment recommendations for the disorders. In these two disorders, there is also a correlation. The essential consideration is that eating disorders are impulse-control disorders which are similar to addictive behaviors in some aspects. So it is a crying need to treat a patient with obesity and eating disorders simultaneously to ensure success. Genome-wide association studies (GWASs) have increased our knowledge of the pathophysiology of eating disorders (EDs) and obesity and their correlation.
Conclusion
This review enlightens on the summary of eating disorder, obesity, genotypic traits, molecular relations, interaction, correlation, and effect of eating disorder and obesity which outline potential future directions and clinical implications for patients with EDs and obesity.
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He J, Murray S, Compte EJ, Song J, Nagata JM. The Muscularity-Oriented Eating Test, Drive for Muscularity Scale, and Muscle Dysmorphic Disorder Inventory among Chinese Men: Confirmatory Factor Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111690. [PMID: 34770205 PMCID: PMC8582942 DOI: 10.3390/ijerph182111690] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022]
Abstract
Research on eating disorders (EDs) and body image disturbances has focused mostly on females from Western countries, and little is known about EDs in male populations in China, which is partially due to the lack of validated assessment measures. The current work aims to translate the Muscularity-Oriented Eating Test (MOET), Drive for Muscularity Scale (DMS) and Muscle Dysmorphic Disorder Inventory (MDDI) into Chinese and examine their psychometric properties. The factor structures, reliability and validity of the translated scales were examined with two samples: male university students (n = 295, Mage = 18.92 years) and general adult men (n = 406, Mage = 28.53 years). With confirmatory factor analyses, the original factor structures are replicated for the MOET, DMS and MDDI. The results also support the adequate internal consistency for both samples. Strong evidence of convergent and incremental validity for the three measures is also found in both samples. Overall, the three measures prove to be good instruments for use among Chinese male university students and general adult men.
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Affiliation(s)
- Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, China;
- Correspondence: or
| | - Stuart Murray
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Emilio J. Compte
- Eating Behavior Research Center, School of Psychology, Universidad Adolfo Ibáñez, Santiago 7941169, Chile;
- Research Department, Comenzar de Nuevo Treatment Center, Monterrey 66220, Mexico
| | - Jianwen Song
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, China;
| | - Jason M. Nagata
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, CA 94158, USA;
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Gu L, Zou Y, Huang Y, Liu Q, Chen H, Chen J. The effect of group cognitive behavior therapy on Chinese patients with anorexia nervosa: an open label trial. J Eat Disord 2021; 9:114. [PMID: 34526151 PMCID: PMC8444542 DOI: 10.1186/s40337-021-00469-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The high cost of treatment for anorexia nervosa (AN) and lack of trained specialists have resulted in limited accessibility of effective treatment to patients with AN, which is particularly problematic in China. To increase the accessibility of evidence-based treatment and reduce the cost of treatment, this study aimed to explore the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy for eating disorders (CBT-E) in Chinese AN patients. METHOD A total of 78 patients with AN were assigned to G-CBT or individual outpatient treatment (IOT) and received three months of treatment for AN in each condition. Measures of eating pathology, depression and anxiety were administrated to both intervention groups at three time points: baseline, one month of treatment, and end of treatment; results were compared between groups and over time. RESULTS There were 70 participants included in the final analysis. Both G-CBT and IOT groups showed significant improvement in eating pathology and associated psychopathology (ps < .001) over the course of treatment, but no significant difference in symptom improvement was found between the two groups (ps > .05). G-CBT resulted in additional significant improvement in ED psychopathology over the last two months of treatment, and its overall therapeutic effect was influenced by baseline weight and early symptom improvement. CONCLUSION Preliminary findings from this open label trial suggest that G-CBT adapted from CBT-E is feasible in an outpatient setting and as effective as IOT in facilitating weight regain and reducing psychopathology in Chinese AN patients with little evidence for the superiority of either intervention. TRIAL REGISTRATION The current study was registered at clinical trials.gov on September 23, 2018 (registration number NCT03684239). People with anorexia nervosa (AN) are known to be unmotivated for treatment and prone to relapse. Recovery from AN often needs intensive, long-term treatment from a specialized multidisciplinary team, which is not accessible for most people in China. Given the increasing incidence of AN and lack of eating disorder (ED) specialists in China, it is important to develop short-term cost-effective treatments for AN. In this study, we explored the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy (CBT-E) for people with AN from China. We found that G-CBT was as effective as individual outpatient treatment (IOT) typically provided to AN patients at the research site in facilitating weight regain, improving eating behaviors, and reducing ED and other symptoms. We also found that patients receiving G-CBT made more improvements in cognitive symptoms of the ED, which might help maintain treatment gains and prevent relapse in the long run. This potential long-term advantage of G-CBT needs to be verified in long-term follow-up.
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Affiliation(s)
- Lian Gu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China
| | - Yunling Zou
- Shanghai Changning Mental Health Center, Shanghai, China
| | - Yue Huang
- Counseling Services, University of Nevada, Reno, NV, USA
| | - Qiang Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China
| | - Han Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China.
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Tang C, Cooper M, Wang S, Song J, He J. The relationship between body weight and dietary restraint is explained by body dissatisfaction and body image inflexibility among young adults in China. Eat Weight Disord 2021; 26:1863-1870. [PMID: 33034869 DOI: 10.1007/s40519-020-01032-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/24/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Eating disorders and obesity are commonly recognized as key public health concerns worldwide. Although rates of obesity and disordered eating have traditionally been lower in China than Western countries, these rates are on the rise. As such, interest is growing in identifying mechanisms that may address these conditions. While associations between body weight and dissatisfaction are well established, burgeoning research aims to examine how these factors are related to dietary restraint and body image inflexibility. This study aimed to explore the possible mediation effect of body dissatisfaction and body image inflexibility between body weight (body mass index) and dietary restraint. Furthermore, we explored how these relationships differed across men and women. METHODS A sample of 1068 young adults (563 females and 505 males) in China participated in the study. Participants completed the Eating Disorder Inventory and Three-Factor Eating Questionnaire as well as the Body Image-Acceptance and Action Questionnaire. RESULTS Results showed that: (1) body dissatisfaction and body image inflexibility fully mediated the relationship between body mass index and dietary restraint; (2) this model fit both genders, although differences were found in the regression coefficients between the mediation model for men and women. CONCLUSION These findings support body image dissatisfaction and inflexibility as mediators of the relationship between body weight and dietary restraint, highlighting these as potential mechanisms for treatment. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Chanyuan Tang
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, China
| | - Marita Cooper
- Eating Disorders Program, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, US
| | - Saihai Wang
- College of Economics and Management, Northeast Forestry University, Harbin, China
| | - Jianwen Song
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, China
| | - Jinbo He
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, China.
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Obleada KT, Bennett BL. Moderation Effects of Ethnic-Racial Identity on Disordered Eating and Ethnicity Among Asian and Caucasian Americans. Front Psychol 2021; 12:594391. [PMID: 33935855 PMCID: PMC8085433 DOI: 10.3389/fpsyg.2021.594391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background: The current study was designed to examine whether ethnic-racial identity (ERI) moderated the relationship between disordered eating and primary ethnic identification. Methods: Three hundred and ninety-eight undergraduate women (M age = 19.95, SD = 3.09) were recruited from a large university in Hawai'i. Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the ERI measure, and reported their primary ethnicity as an index of ethnicity. Results: There was a significant correlation between eating concerns and centrality, r (357) = 0.127, p < 0.05. Moderation analyses indicated that only ERI centrality moderated the predictive effect of ethnicity on the importance of eating concerns, b = 0.05, t (347) = 2.37, p = 0.018. Conclusions: The results suggest that the relationship between self-reported primary ethnicity and EDEQ scores is greater when ethnicity is more central to the individual's identity or when the in-group affect is important to an individual. Findings underscore the need for further research on the underlying mechanisms that account for the differing ways that ERI may affect eating concerns.
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Affiliation(s)
- Katrina T. Obleada
- Department of Psychology, University of Hawai‘i at Manoa, Honolulu, HI, United States
| | - Brooke L. Bennett
- Department of Psychology, University of Hawai‘i at Manoa, Honolulu, HI, United States
- Department of Psychology, Yale University School of Medicine, New Haven, CT, United States
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Vu-Augier de Montgrémier M, Moro MR, Chen J, Lachal J. [Female patients with eating disorders and their parents experience in China: A qualitative study]. Encephale 2021; 48:43-51. [PMID: 33867140 DOI: 10.1016/j.encep.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/15/2020] [Accepted: 01/06/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Recent tendencies show a stabilization in Western countries of the incidence of anorexia nervosa but an increase in Asian countries where it used to be lower. The emergence of these diseases in non-Western countries suggests a culture change syndrome on an individual or societal scale. The great number of changes having occurred in China in the past decades would favor the occurrence of eating disorders. A variability of symptoms of eating disorders can be observed depending on the cultural background which also influences the treatment. There are few studies that exist within an Asian context, and they mostly focus on the care. OBJECTIVES In this study, we intend to explore the experience of Chinese female patients hospitalized for an eating disorder and the experience of their parents: their relationship with the symptoms, with their health and their understanding of the disease, in order to identify the impact of the Chinese cultural context upon the disorder. METHOD It is an observational, phenomenological and qualitative study. A purposive sampling was formed from a clinical population group of young teenagers and women, coming from various areas of China and hospitalized in the specialized Psychosomatic Department of Shanghai Mental Health Center, in August and December 2017. The degree of urbanization, the regions and ages categories were wide-ranging, allowing us to maximize the richness of the data assessing the disease and care representations. Two semi-structured interviews were realized with the participants, then with one or both parents. The interviews were realized with an evaluative interview guide by the same researcher together with a Chinese psychology student in order to clarify the translation and the interpretation of the cultural elements expressed by the participants. The analysis was based on the Interpretative Phenomenological Analysis. Two researchers read the interview transcripts several times, identified themes then connections between the themes to build a set of meta-themes depicting the narratives. Every meta-theme was linked with its corresponding themes which necessitated during the analysis constant back and forth between the analytical data and the source material. RESULTS Thirteen female patients and 11 parents took part in the study. The patients were between 12 and 31 years of age. They showed a wide range of eating disorders: restrictive anorexia, anorexia nervosa, or bulimia nervosa. Their Body Mass Index at the time of the interview ranged from 11 to 22. Three meta-themes emerged from the analysis: concerns about thinness and health are real catalysts for seeking care, the opposition between parental beliefs about factors of good health and eating symptoms in young girls, and changes in parenting and traditional educational methods induced by eating symptoms. These different themes highlight the fear of thinness and good health being powerful therapeutic levers in China, the intergenerational agreements and disagreements on the factors of good health with the parental experience of consideration around the eating disorder of their daughter, and an impact of traditional educational modalities on the family relational aspects that change with the disorder. DISCUSSION Exploring the experience of young Chinese girls or women suffering from eating disorders highlights the complex interactions between the cultural and clinical context of eating disorders. Weight loss is experienced with great difficulty by the young women of our study, who report somatic symptoms and worry about their thinness. Our results show the central position occupied by maintaining oneself in good health in China, for parents and teenagers alike. This allows a quick reliance on healthcare. The intergenerational differences in China are increased by the rapid changes occurring within Chinese society which can cause conflicts and particularly violent struggles. Its younger generations are becoming more and more globalized. These results provide further evidence that eating disorders are culture change syndromes. The therapeutic impact of our results is twofold. On the individual level, there are therapeutic cultural levers linked with Chinese culture, and they have to be sought in all cultures. The therapeutic education of Chinese patients must be centered on the somatic consequences of the disease in order to increase the adherence to the care. On the familial level, the therapeutic approaches centered on intergenerational conflicts must be developed. CONCLUSION The rapid sociocultural changes in China are causing important intergenerational differences, notably between traditional educational modalities and the need for independence of young people who require specific familial therapy. The cultural elements must be taken into account in order to understand eating disorders and to develop relevant therapeutic approaches.
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Affiliation(s)
- M Vu-Augier de Montgrémier
- Maison de Solenn, Hôpital Cochin, AP-HP, 97, boulevard de Port-Royal, 75014 Paris, France; Inserm, UVSQ, CESP, université Paris-Saclay, hôpital Paul-Brousse, bâtiment 15-16, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France; PCPP, centre Henri-Piéron, université Paris-Descartes, 71, avenue Edouard-Vaillant, 92774 Boulogne Billancourt cedex, France.
| | - M-R Moro
- Maison de Solenn, Hôpital Cochin, AP-HP, 97, boulevard de Port-Royal, 75014 Paris, France; Inserm, UVSQ, CESP, université Paris-Saclay, hôpital Paul-Brousse, bâtiment 15-16, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France; Université de Paris, 75005 Paris, France
| | - J Chen
- Clinical Psychology Department, Shanghai Mental Health Center, Shanghai, République populaire de Chine; School of Medicine, Shanghai Jiao-Tong University, Shanghai, République populaire de Chine
| | - J Lachal
- Maison de Solenn, Hôpital Cochin, AP-HP, 97, boulevard de Port-Royal, 75014 Paris, France; Inserm, UVSQ, CESP, université Paris-Saclay, hôpital Paul-Brousse, bâtiment 15-16, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France; Université de Paris, 75005 Paris, France
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Santomauro DF, Melen S, Mitchison D, Vos T, Whiteford H, Ferrari AJ. The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019. Lancet Psychiatry 2021; 8:320-328. [PMID: 33675688 PMCID: PMC7973414 DOI: 10.1016/s2215-0366(21)00040-7] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Anorexia nervosa and bulimia nervosa are the only eating disorders included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, yet binge-eating disorder and other specified feeding or eating disorder (OSFED) are more prevalent. This study sought to estimate the prevalence and burden of binge-eating disorder and OSFED globally and present a case for their inclusion in GBD. METHODS We sourced studies from the GBD 2019 anorexia nervosa and bulimia nervosa epidemiological databases, two systematic reviews that included studies with epidemiological estimates of binge-eating disorder and OSFED, and experts in the field. Studies, published between Jan 1, 1998, and March 1, 2019, were included if they reported non-zero prevalence of two or more eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder, or OSFED) and diagnosed cases according to DSM-IV or DSM-5. The proportions of total eating disorder cases that met diagnostic criteria for each individual eating disorder were estimated via network meta-regression and simulation using studies reporting eating disorder prevalence. The global cases unrepresented in GBD 2019 were estimated using the proportions from the simulation and the GBD 2019 eating disorder prevalence. Disability weights for binge-eating disorder and OSFED were then estimated along with disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs). FINDINGS 54 studies, of which 36 were from high-income countries, were included in the analysis. The number of global eating disorder cases in 2019 that were unrepresented in GBD 2019 was 41·9 million (95% UI 27·9-59·0), and consisted of 17·3 million (11·3-24·9) people with binge-eating disorder and 24·6 million (14·7-39·7) people with OSFED (vs 13·6 million [10·2-17·5] people with eating disorders in GBD 2019). Together, binge-eating disorder and OSFED caused 3·7 million (95% UI 2·0-6·5) DALYs globally, bringing the total eating disorder DALYs to 6·6 million (3·8-10·6) in 2019. INTERPRETATION Binge-eating disorder and OSFED accounted for the majority of eating disorder cases and DALYs globally. These findings warrant the inclusion of binge-eating disorder and OSFED in future iterations of GBD, which will bring the burden experienced by people living with these disorders to the attention of policy makers with the means to target this burden. FUNDING Queensland Health, Australian National Health and Medical Research Council, and Bill & Melinda Gates Foundation.
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Affiliation(s)
- Damian F Santomauro
- School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
| | - Sarah Melen
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW, Australia; Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Harvey Whiteford
- School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alize J Ferrari
- School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Psychological Risk Factors for the Development of Restrictive and Bulimic Eating Behaviors: A Polish and Vietnamese Comparison. Nutrients 2021; 13:nu13030910. [PMID: 33799636 PMCID: PMC8001869 DOI: 10.3390/nu13030910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/02/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Abstract
The aim of this paper is to identify psychological factors which are culture specific or common predictors for restrictive and bulimic behaviors towards eating for young women raised in different cultures. The study included 661 young women from Poland (n = 233) and Vietnam (n = 428). Subjects filled-in the Eating Disorders Inventory (EDI-3) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS), and body measurements were collected to calculate anthropometric indices. Women form Vietnam were less satisfied with their appearance than were their Polish peers, but Vietnamese showed a lower level of preoccupation with being overweight and fear of obesity. Intercultural differences indicate that Vietnamese women show greater intensities for psychological variables, connected with restrictive and bulimic eating behaviors, verified in the research model: low self-esteem, personal alienation, interpersonal insecurity, interpersonal alienation, emotional dysregulation, interoceptive deficits, perfectionism and asceticism, and anxiety.
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Aival-Naveh E, Rothschild-Yakar L, Kurman J. The moderating effects of self and other mentalizing on the relationship between distress and disordered eating: A cross-cultural examination. J Clin Psychol 2021; 77:1937-1953. [PMID: 33561313 DOI: 10.1002/jclp.23121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/21/2020] [Accepted: 01/21/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cross-cultural comparisons that focus on underlying psychological mechanisms in disordered eating (DE) are lacking. With the aim of addressing this gap, we investigated the interplay between mentalizing, distress, and DE in two cultural groups: the ultra-Orthodox and secular Jewish societies in Israel. METHOD A combination of performance-based and self-report measures of two mentalizing-related constructs (emotional awareness and alexithymia), along with self-report measures of distress, DE, and values preferences, were employed in a community sample (N = 300) of ultra-Orthodox and secular Jewish women. RESULTS Distress predicted DE in both cultural groups, yet there were cultural differences in the moderating role of mentalizing. Both mentalizing measures moderated the distress-DE link in the secular group, but not in the ultra-Orthodox group. Furthermore, there were cultural differences in the moderating effects of self versus other mentalizing. CONCLUSIONS The results suggest cultural differences in the underlying psychological mechanism of DE.
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Affiliation(s)
| | | | - Jenny Kurman
- Department of Psychology, University of Haifa, Haifa, Israel
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Pike KM, So M, Hilbert A, Maekawa H, Shimanouchi T, Wilfley D, Dohm FA, Fairburn CG, Weissman RS. Risk factors for anorexia nervosa and bulimia nervosa in Japan and compared to a U.S. sample. Int J Eat Disord 2021; 54:155-167. [PMID: 33355934 DOI: 10.1002/eat.23442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study provides the first systematic investigation of environmental exposure to putative psychosocial risk factors for eating disorders in individuals with AN and BN in Japan. It also provides a comparison of risk factors for the development of AN and BN in Japan versus the United States. METHOD Participants in Japan were 96 women with a current DSM-IV AN or BN primary diagnosis (AN, n = 60; BN, n = 36) and 57 women with no current psychiatric diagnosis (NC group). Participants in the United States were 137 women with a current DSM-IV AN or BN primary diagnosis (AN-U.S., n = 71; BN-U.S., n = 66). A standardized semi-structured interview retrospectively assessed exposure to risk factors prior to first symptom onset, which were analyzed using General Linear Model analyses. RESULTS Perfectionism and negative affectivity, family relationship issues, and, to a lesser degree, parental psychopathology predicted the emergence of AN and BN in Japan. Physical and sexual abuse and family eating and weight concerns were not significant risk factors in Japan. Compared to their respective diagnostic U.S. groups, the Japanese AN group reported higher levels of individual mental health factors and lower levels of family dieting and family overweight, and the Japanese BN group reported higher levels on individual mental health factors, lower exposure to problems with their parents, and lower exposure to family weight and eating concerns. DISCUSSION These country-specific data from Japan contribute to an increasingly nuanced and global understanding of risk factors for eating disorders.
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Affiliation(s)
- Kathleen M Pike
- Department of Psychiatry, Columbia University, New York, New York, USA.,Department of Epidemiology, Columbia University, New York, New York, USA.,Department of Health Policy and Management, Columbia University, New York, New York, USA
| | - Mirai So
- Department of NeuroPsychiatry, Tokyo Dental College, Tokyo, Japan
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Hiroko Maekawa
- Faculty of Humanities, Kanazawa Gakuin University, Kanazawa City, Japan
| | - Tomoko Shimanouchi
- Department of Psychiatry, St. Marianna University School of Medicine, Kawasaki City, Japan
| | - Denise Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Psychological & Brain Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Faith-Anne Dohm
- Department of Psychological and Educational Consultation, Fairfield University, Fairfield, Connecticut, USA
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Kim YR, Nakai Y, Thomas JJ. Introduction to a special issue on eating disorders in Asia. Int J Eat Disord 2021; 54:3-6. [PMID: 33340374 DOI: 10.1002/eat.23444] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE It is our pleasure to introduce a special issue of the International Journal of Eating Disorders on eating disorders (EDs) in Asia. METHOD We received such a robust response to the special edition that we were able to fill two issues. Contributions focused on seven main themes: (1) prevalence, (2) time trends, (3) healthcare systems, (4) treatment, (5) risk factors, (6) assessment, and (7) orthorexia. RESULTS New prevalence and time trend data from China, Iran, Singapore, Japan, and Taiwan suggest that EDs are increasingly common in Asia but are not always detected in healthcare settings. Only a minority of individuals with EDs in Singapore receive treatment, and psychosocial treatment and prevention interventions that are evidence-based in the West may require cultural adaptation before they can be fully implemented in Japan, Singapore, China, and South Korea. Psychological risk factors for EDs are more similar than different in Iran, India, Japan, and China, but biological risk factors are understudied across the continent. Psychometrically sound assessment tools are available in many Asian languages. DISCUSSION We hope this special issue provides a catalyst and blueprint for global collaboration to relieve the burden of suffering of EDs in Asia and beyond.
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Affiliation(s)
- Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea.,Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, South Korea
| | | | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Yao S, Zhang R, Thornton LM, Peat CM, Qi B, Du S, Wang H, Zhang B, Bulik CM. Screen-detected disordered eating and related traits in a large population sample of females in mainland China: China Health and Nutrition Survey. Int J Eat Disord 2021; 54:24-35. [PMID: 33191528 PMCID: PMC7855662 DOI: 10.1002/eat.23409] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We describe the prevalence and sociodemographic factors associated with screen-detected disordered eating and related traits in a population-based sample of women in China. We also explored prevalence trends over time. METHOD A total of 4,218 females aged 12-50 were sampled from 15 provinces as part of the China Health and Nutrition Survey (CHNS) in 2015. The SCOFF questionnaire screened for disordered eating and the selected questions from the Eating Disorders Examination-Questionnaire measured dietary restraint, shape concerns, and weight concerns. Body mass index (BMI) was measured and sociodemographic factors captured urban/rural residence, age, ethnicity, income, education, marital status, and occupational status. We calculated the prevalence of screen-detected disordered eating and related traits broadly and across several dimensions and compared prevalence estimates to 2009 and 2011 reports. RESULTS We detected 296 individuals who screened positive for disordered eating on the SCOFF (prevalence = 7.04%). Positive screens were associated with urban residence (p = .002) and higher education levels (p < .001). Scores on restraint, shape concerns, and weight concerns were all higher for individuals in urban versus village locations (all p's < .001), and with higher BMI (p < .001) for shape and weight concerns. The prevalence of screen-detected disordered eating increased numerically across 2009, 2011, and 2015. DISCUSSION The prevalence of screen-detected disordered eating in mainland China was comparable to other populations worldwide obtained from a recent meta-analysis. The distribution of disordered eating and related traits varied by several sociodemographic factors, which include age, BMI, urban/rural residence, education, and income, suggesting important directions for case detection and intervention in China.
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Affiliation(s)
- Shuyang Yao
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Ruyue Zhang
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Baiyu Qi
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Shufa Du
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and PreventionBeijingPR China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and PreventionBeijingPR China
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Chen J, Guo L, Gu L, Han H. The introduction of treatment and the cultural adaptability of western psychotherapies for eating disorders in China. Int J Eat Disord 2021; 54:102-106. [PMID: 33350490 DOI: 10.1002/eat.23437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 11/07/2022]
Abstract
In the past 40 years, the prevalence of eating disorders (ED) in China has shown an increasing trend, leading to an urgent need to develop efficient treatment modes and methods. Since the beginning of the new century, the diagnosis, treatment, and research of ED in China have been under development. This article gives an introduction and commentary on the treatment modes, treatment methods and their applications in ED in China. There are two main treatment forms for ED until now, that is, inpatient treatment and outpatient treatment. Inpatient treatment is recommended as the first choice. Since 2008, clinical psychotherapies such as cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and family-based treatment (FBT), which are effective for pathological symptoms of ED, have been introduced into China and developed clinically. Group CBT and group DBT for patients with ED and group FBT for caregivers might be the most efficient psychotherapy in China nowadays. A multi-family FBT support group could be developed as the basic treatment of ED patients. Although these new types of psychotherapy have observed effectiveness in clinical application, the Randomized Controlled Trials (RCT) are rare and need to be developed.
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Affiliation(s)
- Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian Gu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Han
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Chua SN, Fitzsimmons-Craft EE, Austin SB, Wilfley DE, Taylor CB. Estimated prevalence of eating disorders in Singapore. Int J Eat Disord 2021; 54:7-18. [PMID: 33314277 PMCID: PMC8011933 DOI: 10.1002/eat.23440] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/24/2020] [Accepted: 11/28/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is a lack of research on the prevalence of eating disorders (EDs) in Singapore. The aims of our study were to (a) estimate the prevalence of EDs, risk status, and help-seeking behaviors among adults in Singapore, (b) examine gender differences between ED status groups, and (c) characterize clinical profiles of ED status groups. METHOD We administered a cross-sectional survey that included a validated EDs screening tool to adults in Singapore. RESULTS A total of 797 Singaporean adults ages 21-77 years completed the ED screen. The majority of participants screened positive for a current DSM-5 clinical ED (6.2%), other specified feeding or ED (37.0%) or at high risk of developing an ED (19.5%). Only 1.6% of those who screened positive for an ED reported currently being in treatment. The ratio of males to females who screened positive for an ED was nearly 1:1. The clinical profiles of ED groups were consistent with the clinical presentations found in Western nations. DISCUSSION This is the first study in Singapore to estimate the prevalence of EDs in a large sample of adults. Results highlight the urgent need for more ED research and expansion of prevention and treatment programs to address the high prevalence of ED psychopathology in Singapore.
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Affiliation(s)
- Sook Ning Chua
- PCHD, National Institute of Education, Nanyang Technological University, Singapore
| | | | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - C. Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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Tu CY, Tseng MCM, Chang YT. Paths to the first-time diagnoses of anorexia nervosa and bulimia nervosa in Taiwan. Int J Eat Disord 2021; 54:59-68. [PMID: 32929755 DOI: 10.1002/eat.23379] [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: 03/26/2020] [Revised: 08/15/2020] [Accepted: 08/23/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to examine the characteristics of psychiatrists and the hospital settings in relation to the first-time diagnoses of anorexia nervosa (AN) and bulimia nervosa (BN) and depict medical utilization and the detection rate before diagnosis of patients with AN and BN. METHOD We extracted data of individuals with AN or BN, as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification, from a national health insurance database. Individuals with AN (n = 1,893) or BN (n = 10,542) who were first-time diagnosed by psychiatrists from 2002 to 2013 were included. Individuals with schizophrenia were selected as control groups that were matched with the incident AN and BN cases for sex, age stratum, and year of diagnosis. RESULTS AN was more likely to be diagnosed by female psychiatrists. Patients with AN were more frequently diagnosed in medical centers while patients with BN were mostly diagnosed in primary care clinics. Nearly all patients with AN and BN had sought treatment for physical problems but less than half had sought help for mental health problems in the year preceding the diagnosis. Individuals with AN, BN, and schizophrenia were all under-detected by nonpsychiatric medical professionals. Notably, BN was least likely to be recognized by both psychiatrists and other medical professionals. DISCUSSION Our findings underscore the importance of educational programs that are designed to improve the detection and management of eating disorders by medical professionals in Taiwan. Advanced educational programs that target differential diagnosis and the tailored management of different eating disorders should be highlighted among psychiatrists.
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Affiliation(s)
- Chao-Ying Tu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan
| | - Mei-Chih Meg Tseng
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yuan-Ting Chang
- National Taiwan University Health Data Research Center, Taipei, Taiwan
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Nakai Y, Nin K, Goel NJ. The changing profile of eating disorders and related sociocultural factors in Japan between 1700 and 2020: A systematic scoping review. Int J Eat Disord 2021; 54:40-53. [PMID: 33336841 PMCID: PMC8204748 DOI: 10.1002/eat.23439] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the changing profile of the phenotypic expression of eating disorders (EDs) and related sociocultural factors in Japan between 1700 and 2020. METHOD The authors conducted a systematic scoping review in accordance with the PRISMA statement guidelines for scoping reviews. RESULTS Findings indicate that Kampo doctors reported more than 50 patients with restrictive EDs in the 1700s, when Japan adopted a national isolation policy. On the other hand, only a few reports of EDs were found between 1868 and 1944, when rapid Westernization occurred. After World War II, providers began diagnosing patients with anorexia nervosa (AN) around 1960. Patients reported experiencing fat phobia, but did not engage in restriction for achieving slimness. However, after the 1970s, Japan experienced a rise in patients with AN who engaged in restriction to achieve thinness. Cases of patients who engaged in binge/purge symptomatology increased after the 1980s, followed by a steady increase in total ED cases after the 1990s. At various time points, providers attributed family conflicts, internalization of a thin ideal of beauty, changing food environments, and pressures associated with traditional gender roles to the onset and maintenance of EDs in Japan. DISCUSSION Findings reveal that restrictive EDs were present as early as the 18th century; Japanese patients may present with both "typical" and "atypical" forms of AN; ED symptoms can persist in the absence of Western influence; and sociocultural factors, such as gender-specific stressors and family dynamics, may contribute to EDs for Japanese populations.
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Affiliation(s)
| | - Kazuko Nin
- School of Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Neha J. Goel
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Tseng MCM, Tu CY, Chang YT. Healthcare use and costs of adults with anorexia nervosa and bulimia nervosa in Taiwan. Int J Eat Disord 2021; 54:69-80. [PMID: 33210331 DOI: 10.1002/eat.23419] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed to examine the health service use and healthcare costs of adults with anorexia nervosa (AN) and bulimia nervosa (BN) in Taiwan. METHOD AN and BN cases between 2002-2013 were extracted from a national health insurance database. For each AN and BN case, we randomly selected 10 controls with no eating disorder, matched for sex, age, urbanization of residence, and year of medical visit. The percentage and frequency of health services use and costs in the year preceding and after the diagnosis of AN/BN were compared between groups. We used generalized linear models with gamma distribution and log link function to determine the effects of age, sex, and psychiatric comorbidities on the total cost adjusting for physical comorbidities and to calculate the mean cost difference between groups by using marginal and incremental effects. RESULTS Both individuals with AN and BN had significantly elevated healthcare utilization and costs compared to controls during the baseline and one-year period after diagnosis. Patients with AN had more than three times higher total costs (US $792) and patients with BN had two times higher total costs (US $320) than individuals without eating disorders. Comorbidity of depressive disorder and older age significantly increased healthcare costs among both individuals with AN and BN. DISCUSSION There are high medical and economic burdens of care for individuals with AN and BN. Early diagnosis and integrated care for eating disorders are important tasks to reduce disease burden in Taiwan.
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Affiliation(s)
- Mei-Chih Meg Tseng
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chao-Ying Tu
- Department of Psychiatry, National Taiwan University Hospital, Yunlin, Taiwan
| | - Yuan-Ting Chang
- National Taiwan University Health Data Research Center, Taipei, Taiwan
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Yao S, Larsson H, Norring C, Birgegård A, Lichtenstein P, DʼOnofrio BM, Almqvist C, Thornton LM, Bulik CM, Kuja-Halkola R. Genetic and environmental contributions to diagnostic fluctuation in anorexia nervosa and bulimia nervosa. Psychol Med 2021; 51:62-69. [PMID: 31658910 PMCID: PMC7856409 DOI: 10.1017/s0033291719002976] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/12/2019] [Accepted: 09/26/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Anorexia nervosa and bulimia nervosa are two severe eating disorders associated with high premature mortality, suicidal risk and serious medical complications. Transition between anorexia nervosa and bulimia nervosa over the illness course and familial co-aggregation of the two eating disorders imply aetiological overlap. However, genetic and environmental liabilities to the overlap are poorly understood. Quantitative genetic research using clinical diagnosis is needed. METHODS We acquired a clinical diagnosis of anorexia nervosa (prevalence = 0.90%) and bulimia nervosa (prevalence = 0.48%) in a large population-based sample (N = 782 938) of randomly selected full-sisters and maternal half-sisters born in Sweden between 1970 and 2005. Structural equation modelling was applied to quantify heritability of clinically diagnosed anorexia nervosa and bulimia nervosa and the contributions of genetic and environmental effects on their overlap. RESULTS The heritability of clinically diagnosed anorexia nervosa and bulimia nervosa was estimated at 43% [95% confidence interval (CI) (36-50%)] and 41% (31-52%), respectively, in the study population, with the remaining variance explained by variance in unique environmental effects. We found statistically significant genetic [0.66, 95% CI (0.49-0.82)] and unique environmental correlations [0.55 (0.43-0.66)] between the two clinically diagnosed eating disorders; and their overlap was about equally explained by genetic and unique environmental effects [co-heritability 47% (35-58%)]. CONCLUSIONS Our study supports shared mechanisms for anorexia nervosa and bulimia nervosa and extends the literature from self-reported behavioural measures to clinical diagnosis. The findings encourage future molecular genetic research on both eating disorders and emphasize clinical vigilance for symptom fluctuation between them.
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Affiliation(s)
- Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Claes Norring
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Stockholm, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Andreas Birgegård
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Stockholm, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian M. DʼOnofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Trends in the prevalence and disability-adjusted life years of eating disorders from 1990 to 2017: results from the Global Burden of Disease Study 2017. Epidemiol Psychiatr Sci 2020; 29:e191. [PMID: 33283690 PMCID: PMC7737181 DOI: 10.1017/s2045796020001055] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AIM Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. METHODS We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. RESULTS The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59-0.71) and 0.66 (95% UI: 0.60-0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20-982.30; ASR of DALYs = 170.74, 95% UI: 113.43-244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14-2.32; EAPC for DALYs = 2.22, 95% UI: 2.13-2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). CONCLUSION The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.
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Melisse B, de Beurs E, van Furth EF. Eating disorders in the Arab world: a literature review. J Eat Disord 2020; 8:59. [PMID: 33292520 PMCID: PMC7646071 DOI: 10.1186/s40337-020-00336-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 10/07/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The prevalence of eating disorders has been assumed to be low in the Arab world, due to the alleged absence of the thin ideal. However, the Arab world is undergoing rapid sociocultural changes, and there are reports of an increase of the desire to be thin. This literature review therefore provides point-prevalence of Arabs at high risk for eating disorders, and a comprehensive synthesis of correlates of eating disorder symptoms, eating disorder-related variables and of a high risk for eating disorders. METHOD Several electronic databases were searched for published, peer-reviewed studies between 1986 and 2019 involving several key terms. From 317 screened studies, 81, mainly cross-sectional, were included. Preferred Reporting Items for Systematic reviews and meta-analyses was used as guidance and the quality of studies were assessed using the Newcastle-Ottawa scale. RESULTS Estimates of individuals at high risk for eating disorders ranged from 2 to 54.8%. The eating disorder-related variables identified were desire to be thin, body dissatisfaction, disturbed-, and dieting- eating behavior. Identified correlates were increased affluence, media use, western influences, and obesity. An additional finding was that in some cases eating disorders were expressed somatically rather than psychiatrically. DISCUSSION In the Arab world, females were most at risk for eating disorders and eating disorder symptoms. Sociocultural changes gave rise to the thin ideal and the prevalence of obesity, increasing the risk for the development of eating disorder-related variables and eating disorders. The literature on eating disorders in the Arab world suffers from potential limitations due to the use of non-validated assessment tools. Further research is necessary, particularly on the development and validation of a culturally sensitive assessment tool. Improved knowledge is likely to increase the number of people seeking treatment and decrease the stigma of psychotherapy.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders & Obesity, Jacob Obrechtstraat 92, 1071, KR, Amsterdam, the Netherlands.
- Rivierduinen Eating Disorders Ursula, Sandifortdreef 19, 2333 ZZ, Leiden, Netherlands.
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, Netherlands.
| | - Edwin de Beurs
- Arkin Mental Health Institute, research department, Klaprozenweg 111, 1033 NN, Amsterdam, the Netherlands
- Leiden University, Section Clinical Psychology, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
| | - Eric F van Furth
- Rivierduinen Eating Disorders Ursula, Sandifortdreef 19, 2333 ZZ, Leiden, Netherlands
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, Netherlands
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Krishnamurthy A, Gupta Y, Bhargava R, Sharan P, Tandon N, Jyotsna VP. Evaluation of eating disorders and their association with glycemic control and metabolic parameters in adult patients with type 2 diabetes mellitus. Diabetes Metab Syndr 2020; 14:1555-1561. [PMID: 32846368 DOI: 10.1016/j.dsx.2020.07.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND There is little data on the prevalence and effects of eating disorders in patients with T2DM. AIMS To evaluate the presence of eating disorders (ED) and their association with glycemic control and metabolic parameters in adult patients with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study was conducted in the endocrinology outpatient unit of our tertiary care centre between January 2017 to December 2018. Eating Attitudes Test (EAT-26) and Binge Eating Scale (BES) questionnaires were used to screen for ED in adults with T2DM (group 1) and controls without T2DM (group 2). Cut off scores ≥18 on BES was considered as a positive screen for Binge eating disorder in participants with and without T2DM. A score of ≥30 on EAT-26 was defined as abnormal for participants with T2DM and ≥20 for those without T2DM. Formal psychiatric assessment was done to diagnose ED in those who screened positive on the basis of scores on BES or EAT-26 or both. Demographic, anthropometric and relevant medical details like duration of treatment, glycemic control, complications were recorded. RESULTS A total of 512 individuals (256 in each group) participated in this study. Out of these, 10.9% of individuals with T2DM and 14.1% of those without T2DM screened positive for ED, with no significant difference in the two groups. After a detailed psychiatric assessment, two patients (0.8%) in each group were confirmed to have ED. Participants with T2DM who were on thiazolidinediones had higher odds (2.2) of screening positive for an ED.(p = 0.03). CONCLUSIONS Our study reveals that eating disorders are not very common in our clinical population of T2DM, and the prevalence is comparable to BMI matched individuals without T2DM. The prevalence rates of eating disorders are lower (in both controls and patients with T2DM) than those reported from developed western countries.
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Affiliation(s)
- Aishwarya Krishnamurthy
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Yashdeep Gupta
- Department of Department of Endocrinology and Metabolism, AIIMS, New Delhi, India
| | | | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, AIIMS, New Delhi, India
| | - Viveka P Jyotsna
- Department of Endocrinology and Metabolism, AIIMS, New Delhi, India.
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Wonderlich SA, Bulik CM, Schmidt U, Steiger H, Hoek HW. Severe and enduring anorexia nervosa: Update and observations about the current clinical reality. Int J Eat Disord 2020; 53:1303-1312. [PMID: 32359125 DOI: 10.1002/eat.23283] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 12/22/2022]
Abstract
Several objectives underlie the current article. First, to review historical diagnostic issues and clinical strategies for treating SE-AN. Second, to provide an overview of recent evidence informed strategies and clinical innovations for the treatment of SE-AN. Third, based on the authors' collective clinical and research experience, we offer eight observations that we believe capture the current clinical experience of patients with SE-AN. Some of these observations represent empirically testable hypotheses, but all are designed to generate a meaningful discussion about the treatment of this group of individuals with eating disorders. Finally, we hope to call clinicians, scientists, professional organizations, advocates, and policy makers to action to attend to critical issues related to the care of individuals with SE-AN. We believe that an international discussion could clarify areas of need for these patients and identify opportunities for clinical innovation that would enhance the lives of individuals with SE-AN and their families.
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Affiliation(s)
- Stephen A Wonderlich
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ulrike Schmidt
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Howard Steiger
- Eating Disorder Continuum, Douglas Mental Health University Institute, Montreal, Canada.,Psychiatry Department, McGill University, Montreal, Canada
| | - Hans W Hoek
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA.,Parnassia Psychiatric Institute, The Hague, The Netherlands
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Incidence of Anorexia Nervosa in Women: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113824. [PMID: 32481615 PMCID: PMC7312606 DOI: 10.3390/ijerph17113824] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 11/25/2022]
Abstract
Background: Anorexia nervosa (AN) among the general population is a rare but often fatal illness. Objective: To summarize the incidence of AN using a systematic review and meta-analysis. Methods: Four online databases (PubMed, Scopus, WoS and Embase) were consulted. The review was conducted according to with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was limited to women. The methodological quality of the studies was assessed by the Newcastle–Ottawa Scale (NOS). Results: A total of 31 articles were included in the study. The incidence rate of AN ranged from 0.5 to 318.0 cases per 100,000 women–years. The incidence in studies based on outpatient healthcare services (OHS) was higher than those based on hospital admissions (HA) (8.8 95% CI: 7.83–9.80 vs. 5.0 95% CI: 4.87–5.05). In young women, the incidence in OHS was higher than HA (63.7, 95% CI 61.21–66.12 vs. 8.1 95% CI 7.60–8.53). The linear trend in the incidence of AN was increasing in all ages of women and young women, both in studies with hospital admission records, and in those based on outpatient healthcare services. Conclusion: The incidence of AN depends on the methodology, the type of population and the diagnostic criteria used.
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Tseng MCM, Tu CY, Hsieh SF, Chang CH. Rates and trends in healthcare-detected incidence of anorexia nervosa and bulimia nervosa: A national health insurance claim data study in Taiwan, 2002-2013. Int J Eat Disord 2020; 53:331-338. [PMID: 31762080 DOI: 10.1002/eat.23203] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study aimed to examine the incidence rates of diagnosed anorexia nervosa (AN) and bulimia nervosa (BN) and their variations over time in Taiwan. METHOD The data of individuals with AN and BN, as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification's (ICD-9-CM), were extracted from merged databases by means of unique identification numbers. To fulfill the criteria of incident cases, individuals must not have had an AN or BN diagnosis in the preceding 2 years. The time trends were analyzed using Joinpoint regression analysis. RESULTS The overall AN and BN incidence rates were 1.1 and 6.1 per 100,000, respectively. There was no significant change in the overall incidence rate for AN or both sexes across the study period. A significant increase in AN incidence occurred in the age groups of 10-14 and 30-39 years. The overall incidence rate of BN increased significantly in the few years before 2009 and then decreased. A similar trend occurred among the females and groups aged above 20 years. There was no significant change in the overall BN incidence rate over the whole period. DISCUSSION Compared with Western countries, the AN incidence in Taiwan is very low, whereas the BN incidence is in the lower end of the range. The findings that the age of the first-time detected AN and BN is older in Taiwan and that the significant increases in age-specific incidence are mainly among adults suggest that more effort is needed to detect individuals with AN and BN at a younger age in Taiwan.
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Affiliation(s)
- Mei-Chih M Tseng
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Chao-Ying Tu
- Department of Psychiatry, National Taiwan University Hospital, Yunlin, Taiwan
| | - Shu-Feng Hsieh
- National Taiwan University Health Data Research Center, Taipei, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
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Izydorczyk B, Truong Thi Khanh H, Lizińczyk S, Sitnik-Warchulska K, Lipowska M, Gulbicka A. Body Dissatisfaction, Restrictive, and Bulimic Behaviours Among Young Women: A Polish-Japanese Comparison. Nutrients 2020; 12:E666. [PMID: 32121384 PMCID: PMC7146317 DOI: 10.3390/nu12030666] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 12/23/2022] Open
Abstract
The growing number of women, who are characterized by restrictive and bulimic behaviours towards their own body is observed especially in countries influenced by Westernalization. However, there is a lack of cross-cultural studies in this area. The main aim of the present study was to examine the psychological and socio-cultural risk factors for eating disorders in Polish and Japanese women. A cross-sectional research study was conducted among 18- to 29-year old Polish (n = 89) and Japanese (n = 97) women. The variables were measured using the Sociocultural Attitudes Towards Appearance Scale SATAQ-3, and the Eating Disorders Inventory EDI-3. The descriptive and comparative statistics, Spearman's rho, and the stepwise regression analysis were used. The global internalization of socio-cultural standards of body image proved to be a significant predictor of Body Dissatisfaction among Polish and Japanese women. The main analysis showed a significant relation between the Drive for Thinness and Interoceptive Deficits in the group of Japanese women, as well as a correlation between Drive for Thinness and Asceticism in the group of Polish women. The obtained results could improve the prevention aimed the dysfunctional eating behaviours. However, the cultural nuances need to be considered in understanding the risk factors for eating disorders.
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Affiliation(s)
- Bernadetta Izydorczyk
- Faculty of Management and Social Communication, Institute of Applied Psychology Jagiellonian University, 30-348 Krakow, Poland; (B.I.); (K.S.-W.)
| | - Ha Truong Thi Khanh
- Faculty of Psychology, University of Social Sciences and Humanities, Hanoi 336, Vietnam;
| | - Sebastian Lizińczyk
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, 40-326 Katowice, Poland;
| | - Katarzyna Sitnik-Warchulska
- Faculty of Management and Social Communication, Institute of Applied Psychology Jagiellonian University, 30-348 Krakow, Poland; (B.I.); (K.S.-W.)
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Vu-Augier de Montgrémier M, Moro MR, Chen J, Blanchet C, Lachal J. Eating disorders and representations of the role of women in China: A qualitative study. EUROPEAN EATING DISORDERS REVIEW 2020; 28:211-222. [PMID: 31981289 DOI: 10.1002/erv.2717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 11/08/2019] [Accepted: 11/25/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This qualitative study examines the representations of young Chinese girls and women with eating disorders (EDs) about the role of women in China, because conflicting societal values for women may foster the development of EDs there. METHOD Semistructured interviews were conducted with 11 adolescent girls or young women hospitalized for an ED and with eight of their parents. Interpretative phenomenological analysis was used to explore the data. RESULT Three superordinate themes emerged from the participants' narratives: the thin ideal in Chinese society; the experience of gender-related pressure; and independence and autonomization in a changing society. The ideal of thinness prevails, both in interpersonal relationships and in social roles. Highly codified representations persist, limiting women's opportunities. The participants and their parents show substantial ambivalence about independence; the young women have real difficulty in making decisions, thus failing to adopt roles that accord with their aspirations. DISCUSSION Young girls' and women's representations of their gender could have implications in the development of EDs, mediated by their focus on thinness and their difficulties in constructing their identity, in developing autonomy and self-esteem, as well as family conflict. These findings indicate that construction of femininity in China is unsettled by rapid societal changes.
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Affiliation(s)
- Marion Vu-Augier de Montgrémier
- AP-HP, Hopital Cochin, Maison de Solenn, Paris, France.,CESP, Université Paris-Sud, Faculté de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,PCPP, Université Paris Descartes, Boulogne-Billancourt, France
| | - Marie-Rose Moro
- AP-HP, Hopital Cochin, Maison de Solenn, Paris, France.,CESP, Université Paris-Sud, Faculté de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,PCPP, Université Paris Descartes, Boulogne-Billancourt, France
| | - Jue Chen
- Clinical Psychology Department, Shanghai Mental Health Center, Shanghai, People's Republic of China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Corinne Blanchet
- AP-HP, Hopital Cochin, Maison de Solenn, Paris, France.,CESP, Université Paris-Sud, Faculté de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,PCPP, Université Paris Descartes, Boulogne-Billancourt, France
| | - Jonathan Lachal
- AP-HP, Hopital Cochin, Maison de Solenn, Paris, France.,CESP, Université Paris-Sud, Faculté de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,PCPP, Université Paris Descartes, Boulogne-Billancourt, France
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Sun S, He J, Fan X, Chen Y, Lu X. Chinese media coverage of eating disorders: Disorder representations and patient profiles. Int J Eat Disord 2020; 53:113-122. [PMID: 31429978 DOI: 10.1002/eat.23154] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Eating disorders (EDs) are becoming more prevalent in China; however, no studies have been conducted to explore how Chinese media represented EDs, and how media representation of ED impacted public understanding of EDs. The aim of this study was to analyze articles about EDs in Chinese newspapers, and to identify any potential inaccuracies about EDs as represented in the media. METHOD Content analysis was employed to analyze a total number of 292 news articles over the span of two decades (1998-2019). Intercoder reliability was satisfactory for all the coded categories. The analysis was conducted on two different dimensions: for individual news article and for individual patient profile. RESULTS The bulk of news reporting on EDs was about anorexia nervosa and bulimia nervosa. A majority of individual patient profiles focused on young women. Anorexia nervosa was mentioned and discussed more frequently than bulimia nervosa. Chinese newspapers generally presented correct information concerning anorexia nervosa and bulimia nervosa, but conveyed shallow information about the etiology and treatment. There were also misconceptions of EDs as reported in Chinese media. DISCUSSION EDs have not received sufficient attention in Chinese media, as shown by the media coverage on EDs over the last two decades. Considering the increasing prevalence of EDs in China with its large population base, effective communication strategies are needed to call public attention to this health issue, and to galvanize the medical community and the society to devote more resources to improve the prevention and treatment of EDs in China.
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Affiliation(s)
- Shaojing Sun
- School of Journalism, Fudan University, Shanghai, China
| | - Jinbo He
- School of Humanities and Social Science, Chinese University of Hong Kong (Shenzhen), Shenzhen, China
| | - Xitao Fan
- School of Humanities and Social Science, Chinese University of Hong Kong (Shenzhen), Shenzhen, China
| | - Yibei Chen
- School of Journalism, Fudan University, Shanghai, China
| | - Xueke Lu
- School of Journalism, Fudan University, Shanghai, China
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Arts H, Lemetyinen H, Edge D. Readability and quality of online eating disorder information-Are they sufficient? A systematic review evaluating websites on anorexia nervosa using DISCERN and Flesch Readability. Int J Eat Disord 2020; 53:128-132. [PMID: 31589331 DOI: 10.1002/eat.23173] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Evaluate the quality and readability of United Kingdom-based websites on anorexia nervosa. METHOD First-page search results of three search engines (with search term "anorexia nervosa") were consulted. Websites were excluded if they were pro-ana, duplications, advertisements, Wikipedia, nonwritten/video, invalid addresses, non-English, book links, articles/news pages, and discussion forums. Fifteen websites were evaluated on information quality using DISCERN, and on readability using the Flesch Reading Ease (FRE) Scale. Spearman's correlations between quality and readability were calculated. RESULTS DISCERN-scores ranged from 34 to 71 (M = 49.27, SD = 9.16), representing "fair" information quality. FRE-scores ranged from 28 to 64 (M = 42.7, SD = 13.43), representing "difficult" readability. The Royal College of Psychiatrists website (https://www.rcpsych.ac.uk/) received the only "excellent" quality rating and was the only website that met the recommended reading level. The other websites' quality varied, and their reading levels ranged from fairly to very difficult. CONCLUSION Website quality scores varied. Oftentimes, information about treatment risks and benefits was lacking, and texts were too complex. Website quality seals could prove beneficial, and web developers should use quality and readability measures to ensure information accessibility. Future research should utilize DISCERN and FRE to evaluate quality and readability of websites pertaining to other eating disorders too. Video abstract: https://www.youtube.com/watch?v=a9DKS7qISSA&feature=youtu.be.
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Affiliation(s)
- Hanne Arts
- Department of Psychology, The University of Bath, Bath, UK
| | - Henna Lemetyinen
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Research and Innovation, Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Dawn Edge
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Research and Innovation, Greater Manchester Mental Health NHS Trust, Manchester, UK
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Abstract
PURPOSE OF REVIEW The aim of this study was to provide an update of the most recent (since January 2014) enhanced cognitive behavioural therapy (CBT-E) effectiveness studies (randomized controlled trials and open trials) on bulimia nervosa, binge eating disorder and transdiagnostic samples. RECENT FINDINGS Out of 451 screened studies, seven effectiveness studies (five randomized and two open trials) were included in this review: of these, three had a bulimia nervosa sample and four a transdiagnostic sample (all conducted in an outpatient setting). Substantial differences in posttreatment remission rates were found (range: 22.2-67.6%) due, in part, to differences in samples and operationalization of clinical significant change. SUMMARY There is robust evidence that CBT-E is an effective treatment for patients with an eating disorder. However, more studies on differential effects and working mechanisms are required to establish the specificity of CBT-E.
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