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Raffoul A, Turner SL, Salvia MG, Austin SB. Population-level policy recommendations for the prevention of disordered weight control behaviors: A scoping review. Int J Eat Disord 2023; 56:1463-1479. [PMID: 37096990 DOI: 10.1002/eat.23970] [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: 12/02/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE The aim of this scoping review was to identify recommendations and gaps in knowledge surrounding the prevention of disordered weight control behaviors (DWCBs) through policy. METHOD A search was conducted in several databases to identify English language articles that described an active policy, recommendation, guideline, or educational curriculum that could be implemented by governments or regulatory bodies to prevent DWCBs or related constructs (e.g., weight stigma, body dissatisfaction). Two researchers independently screened articles with oversight from a third researcher. Data were extracted from the final sample (n = 65) and analyzed qualitatively across all articles and within the domains of education, public policy, public health, industry regulation, and media. RESULTS Only a single empirical evaluation of an implemented policy to reduce DWCBs was identified. Over one-third of articles proposed recommendations relating to industry regulation and media (n = 24, 36.9%), followed by education (n = 21, 32.3%), public policy (n = 19, 29.2%), and public health (n = 10, 15.4%). Recommendations included school-based changes to curricula, staff training, and anti-bullying policies; legislation to ban weight discrimination; policies informed by strategic science; collaboration with researchers from other fields; de-emphasizing weight in health communications; diversifying body sizes and limiting modified images in media; and restricting the sale of weight-loss supplements. DISCUSSION The findings of this review highlight gaps in empirically evaluated policies to reduce DWCBs but also promising policy recommendations across several domains. Although some policy recommendations were supported by empirical evidence, others were primarily based on experts' knowledge, highlighting the need for greater research on population-level DWCBs prevention through policy. PUBLIC SIGNIFICANCE Our scoping review of the evidence on policies for the prevention of disordered weight control behaviors identified several recommendations across the domains of education, public policy, public health, and industry regulation and media. Although few empirical investigations of implemented policies have been conducted, expert recommendations for policies to prevent disordered weight control behaviors among populations are plentiful and warrant future consideration by researchers and policymakers alike.
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Affiliation(s)
- Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Samantha L Turner
- Tan Chingfen Graduate School of Nursing, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Meg G Salvia
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Doley JR, McLean SA. Engagement with body image health promotion videos in adult men and women: differences between narrative, informational, and persuasive appeal approaches. BMC Psychol 2023; 11:86. [PMID: 36991488 DOI: 10.1186/s40359-023-01120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Body dissatisfaction is a public health issue, however, low awareness of its seriousness, and stigma, may inhibit treatment seeking. The current study evaluated engagement with videos promoting awareness of body dissatisfaction using a persuasive communication approach. METHOD Men (n = 283) and women (n = 290) were randomly allocated to view one of five videos; (1) Narrative, (2) Narrative plus persuasive appeal, (3) Informational, (4) Informational plus persuasive appeal and (5) Persuasive appeal only. Engagement (relevance, interest, and compassion) was examined post-viewing. RESULTS Among both men and women, superior engagement ratings (in compassion for women, and relevance and compassion for men) were demonstrated for the persuasive appeal and informational videos relative to narrative approaches. CONCLUSION Videos using clear and factual approaches may promote engagement in body image health promotion videos. Further work should be done to examine interest in such videos specific to men.
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Affiliation(s)
- Jo R Doley
- Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.
| | - Siân A McLean
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
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McLean CP, Kulkarni J, Sharp G. The 26-Item Eating Attitudes Test (EAT-26): Psychometric Properties and Factor Structure in Vegetarians and Vegans. Nutrients 2023; 15:nu15020297. [PMID: 36678167 PMCID: PMC9864971 DOI: 10.3390/nu15020297] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The eating disorder screener, Eating Attitudes Test (EAT), has been used widely; however, its usability in specific dietary groups such as vegetarians and vegans remain unknown. Considering the rising popularity of vegetarianism and veganism, the current study aimed to assess the psychometric properties and theoretical assumptions of the 26-item EAT in separate groups of vegetarians (n = 278), vegans (n = 580), and omnivores (n = 413). Confirmatory factor analysis of four models from previous literature revealed inadequate fit of the data, with the exception of a 16-item four-factor model in vegetarians and vegans. Further assessment of the original three-factor model and 16-item four-factor model demonstrated poor psychometric properties. The primarily inadequate test-retest reliability discovered in this study, independent of whether a shortened version was used, raises concerns around the utility and stability of the EAT-26 in vegetarians and vegans. Future research should potentially investigate novel ways of measuring eating disorder pathology in these groups.
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Affiliation(s)
- Courtney P. McLean
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
| | - Jayashri Kulkarni
- Department of Psychiatry, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
| | - Gemma Sharp
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
- Correspondence:
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Binge Eating in a Slovenian Population-based Sample of Adults. Zdr Varst 2022; 62:39-47. [PMID: 36694796 PMCID: PMC9837812 DOI: 10.2478/sjph-2023-0006] [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: 09/05/2022] [Accepted: 11/17/2022] [Indexed: 12/30/2022] Open
Abstract
Introduction Binge eating is the most common form of disordered eating associated with obesity, reduced quality of life, and medical and psychological comorbidities. It therefore affects the well-being of individuals. This underscores the fact that it is a serious public health problem. The study aimed to investigate binge eating and anxiety across gender, age and body mass index in a large population sample of adults in Slovenia. Methods A total of 3,310 adult volunteers participated in this cross-sectional study. Questionnaires, including a binge eating and anxiety scale and an eating behaviour questionnaire, were completed by 1,487 subjects (90.9% female, ages 18 to 69). Results The frequency of reported binge eating was 29.9%, with 9.8% of participants reporting severe binge eating, and the presence of overweight and obesity was high (41.8%). BMI was associated with this problematic eating, and explained 5.4% of the variation in binge eating. Importantly, anxiety was the most important factor related to binge eating, with younger participants and women reporting significantly more anxiety. Conclusion The high presence of binge eating, obesity and anxiety in the Slovenian population-based sample is worrying. Anxiety is clearly an important factor in understanding the relationship between negative affect and binge eating, as it accounts for a greater proportion of the variance in binge eating symptoms than BMI. Particularly concerning was the fact that the youngest participants showed the greatest anxiety. Targeting anxious adolescents and females is important from a health perspective because it can impact the physical and mental health of the population in the long term.
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Latzer Y, Adatto R, Neumark-Sztainer D. Addressing eating disorders through legislation: The Israeli 'Models' Law'-process, enactment, and dilemmas. DIALOGUES IN HEALTH 2022; 1:100001. [PMID: 38515890 PMCID: PMC10953929 DOI: 10.1016/j.dialog.2022.100001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 03/23/2024]
Abstract
Preventing the onset of eating disorders and disordered eating pathology is crucial. While these conditions have a multi-factorial etiology, socio-cultural norms, particularly the media, contribute greatly. Policy and legislative action are warranted to change harmful media images. To the best of our knowledge, Israel was the first country to tackle the problem of unrealistic and unhealthy images in the media through legislation by initiating and passing an innovative law. The "Knesset," the Israeli Parliament, voted in December 2012 to pass new legislation that forbids the appearance of underweight models (BMI of 18.5 or less) in commercial advertising. The law further requires that if a graphic editing program has been used to reduce the dimensions of a model in advertising photographs, this fact must be clearly indicated. The purpose of this article is to describe the law; the process and obstacles to creating and passing the law in the Knesset; national and international reactions to this Israeli law; and the challenges of implementing (enacting and enforcing) this law in Israel. Given that other countries are implementing similar policies, additional legal approaches are described, including ideas for further research on how to enact, enforce, and evaluate the impact of such laws.
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Affiliation(s)
- Yael Latzer
- School of Social Work, Faculty of Social Welfare and Health Science, University of Haifa, Haifa, Israel
- Eating Disorders Institution, Rambam, Health Care Campus, Haifa, Israel
| | | | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, USA
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Deligiannidou GE, Kyrgou C, Nena E, Manolopoulos VG, Bezirtzoglou E, Kontogiorgis CA, Constantinidis TC. Use of Edible, Medicinal, and Aromatic Plants in Various Health Disorders: A Cross-Sectional Evaluation among Inhabitants in the Area of Thrace, North-Eastern Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12576. [PMID: 36231876 PMCID: PMC9566107 DOI: 10.3390/ijerph191912576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Medicinal and aromatical plants (MAPs) have been historically used as traditional remedies in many cultures in Europe and globally. The aim of this study was to evaluate the use of MAPs in various health disorders in association to dietary habits and other lifestyle factors among residents in Thrace, NE Greece. METHODS Data were collected through anonymous and voluntary responses to a structured online questionnaire, via convenience (snowball) sampling. RESULTS The 561 responders (age: 39.7 ± 11.6 y) were mostly female (59.7%), with higher education (69.8%), working as state or private employees (55.4%), and having low/medium income (77.1%). Overall, more than 70% were using MAPs in various symptoms and common health disorders, such as chamomile against common cold and the flu. More than 20 different MAPs were being used in smaller frequencies against various conditions. Key contributing factors to the consumption of MAPs were sex (female over male), employment (employed vs. unemployed), education (higher education vs. lower) and higher Body Mass Index (overweight and obese vs. normal), while consumption of fruit, fish, and vegetables was mainly associated with the use of MAPs as common items of diet and in health disorders. CONCLUSIONS The use of MAPs as part of the diet and as traditional remedy is present in the examined population, while particular choices seem to be affected by sociodemographic and lifestyle factors.
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Affiliation(s)
- Georgia-Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Chrysoula Kyrgou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Vangelis G. Manolopoulos
- Laboratory of Pharmacology, Democritus University of Thrace-School of Medicine, 68100 Alexandroupolis, Greece
| | - Eugenia Bezirtzoglou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Christos A. Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Theodoros C. Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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Ioannidis K, Hook RW, Wiedemann A, Bhatti J, Czabanowska K, Roman-Urrestarazu A, Grant JE, Goodyer IM, Fonagy P, Bullmore ET, Jones PB, Chamberlain SR. Associations between COVID-19 pandemic impact, dimensions of behavior and eating disorders: A longitudinal UK-based study. Compr Psychiatry 2022; 115:152304. [PMID: 35306448 PMCID: PMC8916988 DOI: 10.1016/j.comppsych.2022.152304] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/23/2022] [Accepted: 03/07/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is growing concern about how people with eating disorders are impacted by the widespread societal restructuring during the COVID-19 crisis. AIMS We aimed to examine how factors relating to the impact of the pandemic associate with eating disorders and quantify this relationship while adjusting for concurrent and longitudinal parameters of risk. METHODS We gathered demographic, behavioral and clinical data pre- and mid-pandemic as well as childhood trauma history from a longitudinal online survey of 489 adults (mean age 23.4 years) recruited from the Neuroscience in Psychiatry Network (NSPN). Using pre-pandemic (T1) and concurrent (T2) data we aimed to predict eating disorders at mid-pandemic (T2). We deployed hierarchical generalized logistic regression to ascertain the strength of longitudinal and concurrent associations. RESULTS Pre-pandemic eating disorder scores strongly associated with concurrent eating disorder (z = 5.93). More conflict at home mid-pandemic (z = 2.03), pre- (lower sensation seeking z = -2.58) and mid-pandemic (higher lack of perseverance z = 2.33) impulsivity traits also associated with mid-pandemic eating disorder. CONCLUSION Conflict at home mid-pandemic and specific aspects of impulsiveness significantly associated with concurrent eating disorder when adjusted for pre-pandemic eating disorder symptoms, baseline demographics, behavioral traits, history of traumatic experiences and concurrent psychopathology. These results provide insight into the struggles of those suffering with eating disorders during the COVID-19 pandemic and highlight the importance of impulsiveness traits and the immediate family environment in their experience of illness during the pandemic.
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Affiliation(s)
- Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK; Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
| | | | - Anna Wiedemann
- Department of Psychiatry, University of Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Junaid Bhatti
- Department of Psychiatry, University of Cambridge, UK
| | - Katarzyna Czabanowska
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands,Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
| | - Andres Roman-Urrestarazu
- Department of Psychiatry, University of Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK,Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Jon E. Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Ian M. Goodyer
- Department of Psychiatry, University of Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Peter Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Edward T. Bullmore
- Department of Psychiatry, University of Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, UK,Department of Psychiatry, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK
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Ghafouri S, Abdollahi A, Suksatan W, Chupradit S, Asmundson AJN, Thangavelu L. Psychometric comparison of the Persian Salzburg Emotional Eating Scale and Emotional Eater Questionnaire among Iranian adults. J Eat Disord 2022; 10:17. [PMID: 35123581 PMCID: PMC8817508 DOI: 10.1186/s40337-022-00541-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/24/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Salzburg Emotional Eating Scale (SEES) and the Emotional Eater Questionnaire (EEQ) are self-reported measures developed to evaluate emotional eating in adults in Western countries. To date, the psychometric properties of the SEES and the EEQ have not been studied among Iranian adults. The aim of the current study is to translate the SEES and the EEQ from English to Persian and examine the psychometric properties of the SEES and EEQ. METHOD The sample of this study comprised of 489 Iranian adults who completed the SEES and the EEQ questionnaires online. RESULTS Findings of face, content, and construct validity tests confirmed that the SEES and the EEQ had acceptable validity and appropriate reliability. The results from confirmatory factor analysis showed acceptable goodness-of-fit indices for two measures. CONCLUSION Results of Average Variance Extracted, Construct Reliability, and goodness-of-fit indices showed that the SEES was better for evaluating emotional eating among Iranian adults than the EEQ.
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Affiliation(s)
- Sahar Ghafouri
- Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Abbas Abdollahi
- Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Supat Chupradit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | | | - Lakshmi Thangavelu
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, India
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Sangiorgio C, Blackstone SR, Herrmann LK. College student attitudes and strategies for intervention with a hypothetical peer exhibiting disordered eating. Int J Eat Disord 2021; 54:1486-1492. [PMID: 33999435 DOI: 10.1002/eat.23532] [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: 10/19/2020] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study assesses stigma, attitudes, and strategies of college students in intervening with peers demonstrating disordered eating behaviors. METHOD Four hundred and eighty nine college students (384 women) completed questionnaires that assessed eating disorder symptoms and bystander attitudes adapted for disordered eating. Participants read one of three vignettes of a 20-year-old hypothetical peer displaying symptoms of disordered eating aligned with bulimia nervosa, anorexia nervosa, or binge-eating disorder; participants then described whether the vignette subject had a problem, what the problem was, and strategies for intervention. Relationships among eating disorder history, bystander attitudes, demographics, and intention to intervene in disordered eating were assessed using descriptive and regressive analyses; peer intervention strategies were organized and evaluated for frequencies of responses. RESULTS Demographics (female-identification) and familiarity with disordered eating were associated with likelihood to intervene in disordered eating. Most students recognized that the peer had a problem, but fewer than half believed the problem was disordered eating; nearly a quarter (22%) of the students stated that they would be uncomfortable talking to a peer about disordered eating. The majority of students cited vague or nonproblem-related intervention strategies (62%), followed by emotion-focused strategies (22.5%), or body and behavior-focused strategies (15%). DISCUSSION College students, particularly women and those with previous exposure to eating disorders, are likely to intervene peers disordered eating. However, students tend to use vague or body-focused intervention strategies. Bystander intervention training that provides rationale and rehearsal for supportive communication strategies is needed to address students' lack of intervention skills, particularly among men.
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Affiliation(s)
- Celeste Sangiorgio
- Department of Psychology, St. John's University-Queens Campus, New York, New York, USA
| | - Sarah R Blackstone
- College of Health and Behavioral Studies, James Madison University, Harrisonburg, Virginia, USA
| | - Lynn K Herrmann
- Department of Public Health and Health Education, Northern Illinois University, DeKalb, Illinois, USA
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Abstract
PURPOSE OF REVIEW We aimed to accrue recent evidence exploring effects of modern online activities (e.g., Internet use) on feeding and eating disorder symptoms, and related traits. We examined available evidence to ascertain any direct influences from online activities on feeding and eating disorders, thereby shedding light on putative mechanisms by which those influences may occur. RECENT FINDINGS Many facets of problematic usage of the Internet correlate cross sectionally with eating disorder and related psychopathology. There is evidence to suggest that significant effects do exist in the direction of specific Internet activities contributing to eating disorder symptoms, viewed dimensionally. Putative mechanisms are discussed. However, a significant number of eating disorder phenotypes and Internet-related activities remain under-researched. Specific facets of engagement with the online environment appear to confer risk for feeding and eating problems, evidence being strongest for non-clinical studies using dimensional measures. More research is required to rigorously confirm causal effects, including in patients meeting formal diagnostic criteria for eating disorders. We also highlight the need for high-quality evidence to explore how eating disorder phenotypes are commonly as well as uniquely affected by different online activities. Such research is needed in order that scientific understanding in this area can be translated to protect those most at risk of disordered eating, including through changes in public health approaches and clinical practice.
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Affiliation(s)
- Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK.
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
- Eating Disorder Service, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
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Barnhart WR, Braden AL, Dial LA. Understanding the relationship between negative emotional eating and binge eating: The moderating effects of acting with awareness and non-reactive mindfulness. J Clin Psychol 2021; 77:1954-1972. [PMID: 33561322 DOI: 10.1002/jclp.23123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/08/2021] [Accepted: 01/21/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Negative emotional eating and binge eating are positively related, occur in diverse populations, and may be driven by similar mechanisms. Mindfulness facets such as acting with awareness, describe, non-judgement, non-reactive, and observe may moderate the relationship between these maladaptive eating phenotypes. METHOD A cross-sectional study assessed emotional eating-depression (Emotional Eating Scale-Revised, depression subscale), trait mindfulness facets (Five Facet Mindfulness Questionnaire-Short Form), and binge eating severity (Binge Eating Scale) in adults (N = 258). RESULTS Emotional eating-depression was less strongly associated with binge eating severity in participants with higher acting with awareness mindfulness. Emotional eating-depression was more strongly associated with binge eating severity in participants with higher non-reactive mindfulness. CONCLUSIONS Acting with awareness and non-reactive mindfulness may be important treatment targets in concurrent presentations of emotional eating-depression and binge eating.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Lauren A Dial
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
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Eik-Nes TT, Vrabel K, Raman J, Clark MR, Berg KH. A Group Intervention for Individuals With Obesity and Comorbid Binge Eating Disorder: Results From a Feasibility Study. Front Endocrinol (Lausanne) 2021; 12:738856. [PMID: 34803910 PMCID: PMC8597950 DOI: 10.3389/fendo.2021.738856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE A common challenge among a subgroup of individuals with obesity is binge eating, that exists on a continuum from mild binge eating episodes to severe binge eating disorder (BED). BED is common among bariatric patients and the prevalence of disordered eating and ED in bariatric surgery populations is well known. Conventional treatments and assessment of obesity seldom address the underlying psychological mechanisms of binge eating and subsequent obesity. This study, titled PnP (People need People) is a psychoeducational group pilot intervention for individuals with BED and obesity including patients with previous bariatric surgery. Design, feasibility, and a broad description of the study population is reported. MATERIAL AND METHODS A total of 42 patients were from an obesity clinic referred to assessment and treatment with PnP in a psychoeducational group setting (3-hour weekly meetings for 10 weeks). Of these, 6 (14.3%) patients had a previous history of bariatric surgery. Feasibility was assessed by tracking attendance, potentially adverse effects and outcome measures including body mass index (BMI), eating disorder pathology, overvaluation of shape and weight, impairment, self-reported childhood difficulties, alexithymia, internalized shame as well as health related quality of life (HRQoL). RESULTS All 42 patients completed the intervention, with no adverse effects and a high attendance rate with a median attendance of 10 sessions, 95% CI (8.9,9.6) and 0% attrition. Extent of psychosocial impairment due to eating disorder pathology, body dissatisfaction and severity of ED symptoms were high among the patients at baseline. Additionally, self-reported childhood difficulties, alexithymia, and internalized shame were high among the patients and indicate a need to address underlying psychological mechanisms in individuals with BED and comorbid obesity. Improvement of HRQoL and reduction of binge eating between baseline and the end of the intervention was observed with a medium effect. CONCLUSION This feasibility study supports PnP as a potential group psychoeducational intervention for patients living with BED and comorbid obesity. Assessments of BED and delivery of this intervention may optimize selection of candidates and bariatric outcomes. These preliminary results warrant further investigation via a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.
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Affiliation(s)
- Trine T. Eik-Nes
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
- *Correspondence: Trine T. Eik-Nes,
| | | | - Jayanthi Raman
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Melinda Rose Clark
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Kjersti Hognes Berg
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
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Ambwani S, Sellinger G, Rose KL, Richmond TK, Sonneville KR. "It's Healthy Because It's Natural." Perceptions of "Clean" Eating among U.S. Adolescents and Emerging Adults. Nutrients 2020; 12:E1708. [PMID: 32517342 PMCID: PMC7352986 DOI: 10.3390/nu12061708] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/21/2020] [Accepted: 06/04/2020] [Indexed: 12/23/2022] Open
Abstract
Definitions for the culturally trendy "clean" eating phenomenon vary: whereas some characterize it as natural and healthy, others adopt more restrictive, moralizing, and affectively-laden definitions that may reflect disordered eating. We examined levels of familiarity with "clean" eating, sources of information, and perceptions of this dietary trend among a large, diverse sample of U.S. adolescents and emerging adults recruited from the National MyVoice Text Message Cohort (n = 1266; ages 14-24 years). Participants answered five questions assessing knowledge of "clean" eating, definitions, perceived healthiness vs. harm, and willingness to adopt "clean" eating, and responses were coded by three trained researchers. Results indicate that 55% of respondents had previously heard of "clean" eating, most commonly through social media, other online sources, and peers. Definitions were heterogeneous, with 40% offering "non-processed" or "whole foods" and 13% noting "non-GMO" or "organic" components. Few respondents (0.6%) expressed outright skepticism about "clean" eating, but many (30%) identified dietary avoidance and restriction as part of the definition. Overall, 71% characterized "clean" eating as a healthy approach, whereas 6% flagged it as "unhealthy", and 18% noted elements of both healthfulness and harm. Notably, 41% reported they "probably would" try "clean" eating themselves, with greater willingness to try "clean" eating among cisgender women. Present findings highlight high levels of awareness and positive attitudes toward "clean" eating among young people in the U.S., with little recognition of the potential risks of dietary restriction. Further research should examine actual dietary behaviors to clarify potential risks of "clean" eating and related trends and thus inform strategies for eating disorder prevention.
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Affiliation(s)
- Suman Ambwani
- Department of Psychology, Dickinson College, P.O. Box 1773, Carlisle, PA 17013, USA
| | - Gina Sellinger
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (G.S.); (K.L.R.); (K.R.S.)
| | - Kelsey L. Rose
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (G.S.); (K.L.R.); (K.R.S.)
| | - Tracy K. Richmond
- Division of Adolescent Medicine, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Kendrin R. Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (G.S.); (K.L.R.); (K.R.S.)
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McLean SA. Impact of viewing body image health promotion videos in adult men and women: Comparison of narrative and informational approaches. Body Image 2020; 33:222-231. [PMID: 32334146 DOI: 10.1016/j.bodyim.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 01/26/2023]
Abstract
Body dissatisfaction is a serious public health issue, however, low awareness of its seriousness, and stigma, may inhibit treatment seeking. Social marketing videos using narrative-entertainment or documentary-informational style approaches may enhance awareness but little research has evaluated their impact, particularly potentially harmful effects. The current study addressed this gap. Men (n = 226) and women (n = 229), were randomly allocated to view one of four videos; (1) Narrative, (2) Narrative plus persuasive appeal, (3) Informational, and (4) Informational plus persuasive appeal. Outcome variables were assessed before and after viewing. A time-by-video interaction indicated an increase in perception of the importance of body dissatisfaction as a public health problem following informational, but not narrative videos. Time by gender interactions showed that women, but not men, experienced increased body weight satisfaction and reduced intentions to engage in body-talk after video viewing. Time main effects revealed improvements in perceptions of the problematic nature of body dissatisfaction related behaviours, in shape and muscularity satisfaction, and reduced anxiety and intentions to use body-talk and appearance comparison. Findings suggest that social marketing can increase awareness of body dissatisfaction without inadvertently causing harm. Results from this study provide preliminary support for dissemination through social marketing.
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Affiliation(s)
- Siân A McLean
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Institute for Health and Sport, Victoria University, Melbourne, Australia.
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15
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Beccia AL, Jesdale WM, Lapane KL. Associations between perceived everyday discrimination, discrimination attributions, and binge eating among Latinas: results from the National Latino and Asian American Study. Ann Epidemiol 2020; 45:32-39. [PMID: 32340835 DOI: 10.1016/j.annepidem.2020.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/07/2020] [Accepted: 03/27/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of the study was to quantify the association between perceived everyday discrimination and binge eating among Latinas in the United States. METHODS Participants included 1014 Latinas from the 2002-2003 National Latino and Asian American Study. Modified Poisson models with robust standard errors were used to estimate sociodemographic-adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) of binge eating associated with overall and attribution-specific discrimination. RESULTS Approximately 7% of Latinas reported binge eating. Increased frequency of discrimination was associated with a higher prevalence of binge eating (aPR, 1.59; 95% CI, 1.23-2.06), and Latinas reporting frequencies of discrimination in the top tertile had the greatest prevalence elevation (aPR, 3.63; 95% CI, 1.32-10.00). There were important differences by discrimination attribution: Latinas experiencing primarily height/weight-based or skin color-based discrimination had the greatest prevalence elevation relative to those reporting no discrimination (aPR, 10.24; 95% CI, 2.95-35.51; and aPR, 8.83; 95% CI, 2.08-37.54, respectively), whereas Latinas reporting primarily race-based discrimination had the lowest prevalence elevation (aPR, 1.64; 95% CI, 0.47-5.69). CONCLUSIONS Discrimination may be an important social determinant of Latinas' binge eating. Future research should incorporate expanded conceptual models that account for Latinas' complex social environment, focusing on intersecting dimensions of identity.
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Affiliation(s)
- Ariel L Beccia
- Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester.
| | - William M Jesdale
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
| | - Kate L Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
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16
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Lipson SK, Sonneville KR. Understanding suicide risk and eating disorders in college student populations: Results from a National Study. Int J Eat Disord 2020; 53:229-238. [PMID: 31639232 DOI: 10.1002/eat.23188] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/20/2019] [Accepted: 09/22/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine suicide risk by eating disorder severity and symptom presentation in a nationwide sample of college students. METHOD The Healthy Minds Study is the largest mental health survey of college populations in the United States. We analyzed the most recent available data (2015-2017) with 71,712 randomly selected students from 77 campuses. We estimated associations between two measures of suicidality (ideation and attempts) and three validated measures of eating disorder symptoms (the SCOFF, weight concerns scale, and the eating disorder examination questionnaire binge and purge items). Importantly, we also controlled for co-occurring symptoms of depression and anxiety, based on validated screening tools. The large, diverse sample provided a unique opportunity to assess whether certain individual characteristics were associated with increased risk. RESULTS Eating disorder symptoms, even at subthreshold levels, were highly predictive of suicidality. Relative to students with no apparent eating disorder symptoms, students with the highest symptom levels (a SCOFF score of 5) had 11 times higher odds of attempting suicide, while those with subthreshold symptoms had two times higher odds. We also observed a strong association between suicide attempts and eating disorder presentations that included purging. Students from marginalized backgrounds, particularly gender and sexual minorities, were at increased risk for suicide and eating disorders. DISCUSSION In the largest known study to date, findings suggest that eating disorders should be a priority within broader campus suicide prevention efforts, should be assessed along a continuum of severity and symptom presentation, and should focus on reaching vulnerable students.
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Affiliation(s)
- Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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17
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Thériault J, Otis J, Hébert M, Gurreri S, Lambert J. Exploring the mediating and moderating roles of body-related concerns and social interactions on the association between early puberty and psychological distress in young adult women. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2019; 110:606-615. [PMID: 31066011 PMCID: PMC6964570 DOI: 10.17269/s41997-019-00213-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 04/02/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the mechanisms through which early puberty is associated with psychological distress in women aged 18-25. This cross-sectional study aims to investigate whether body-related concerns and social interactions moderate or mediate this association. METHODS Participants were compared on measures evaluating psychological distress, body image dysphoria, bulimic symptomatology and negative intimacy with best friend according to three pubertal timing groups: (1) "very early" puberty (menarche at 9 years old or less), (2) "early" puberty (menarche at 10 years old), and (3) "on-time" puberty (menarche between 11 and 13 years old). Forward stepwise multiple regressions and multiple mediation analysis were successively performed to see whether body-related concerns and peer interactions mediate or moderate the relationship between premature puberty and psychological distress. RESULTS Controlling for age and ethnicity, results indicated (1) that women who began puberty "very early" had significantly higher levels of psychological distress than their "on-time" counterparts; (2) the association found between very early puberty and psychological distress was mediated by body image dysphoria and negative intimacy with best friend and was moderated by bulimic symptomatology. No mediational effect was found in women whose puberty was "early". CONCLUSION These findings highlight the importance of using more than one group of early pubertal timing and the role of body and intimacy concerns in the explanation of psychological distress in women. Intervention strategies addressing the increased risk of psychological distress in women who begin puberty very early should target their body image and ability to form intimate friendships.
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Affiliation(s)
- Jocelyne Thériault
- Department of Sexology, Université du Québec à Montréal, C.P. 8888, succ. Centre-Ville, Montréal, Québec H3C 3P8 Canada
| | - Joanne Otis
- Department of Sexology, Université du Québec à Montréal, C.P. 8888, succ. Centre-Ville, Montréal, Québec H3C 3P8 Canada
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, C.P. 8888, succ. Centre-Ville, Montréal, Québec H3C 3P8 Canada
| | - Stella Gurreri
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Jean Lambert
- Department of Social and Preventive Medecine, Faculty of Medecine, Université de Montréal, C.P. 6128, succ. Centre-ville, Montréal, Québec H3C 3J7 Canada
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18
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Effects of yoga on eating disorders—A systematic review. Complement Ther Med 2019; 46:73-80. [DOI: 10.1016/j.ctim.2019.07.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 12/20/2022] Open
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Craddock N, Ramsey M, Spotswood F, Halliwell E, Diedrichs PC. Can big business foster positive body image? Qualitative insights from industry leaders walking the talk. Body Image 2019; 30:93-106. [PMID: 31228774 DOI: 10.1016/j.bodyim.2019.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/10/2019] [Accepted: 06/10/2019] [Indexed: 12/26/2022]
Abstract
The fashion, beauty, and advertising industries have been positioned as key contributors to body dissatisfaction through the promotion of unrealistic and homogenous appearance ideals. Recently, some businesses within these industries have started to disrupt the status quo by taking actions that can be seen to be fostering positive body image (e.g., through representative and diverse imagery, body acceptance messages, and inclusive product ranges). The aim of this study was to explore the opportunities and challenges to foster positive body image from a business perspective. Participants were purposively selected based on their experience of leading business actions to foster positive body image in fashion, beauty, and/or advertising. In total, 45 individuals (82% women) took part in semi-structured interviews, which were transcribed and then analysed using thematic analysis. Four themes were identified: (1) Personal motivations for championing change, (2) Industry ingrained appearance standards, (3) Business barriers to fostering positive body image, and (4) Fostering positive body image as an effective corporate social responsibility (CSR) strategy. This study provides future directions for research aimed at creating healthier body image environments in addition to considerations for businesses seeking to foster positive body image.
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Affiliation(s)
- Nadia Craddock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
| | | | - Fiona Spotswood
- Economics, Finance and Management, University of Bristol, United Kingdom
| | - Emma Halliwell
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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20
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Beccia AL, Baek J, Jesdale WM, Austin SB, Forrester S, Curtin C, Lapane KL. Risk of disordered eating at the intersection of gender and racial/ethnic identity among U.S. high school students. Eat Behav 2019; 34:101299. [PMID: 31153023 DOI: 10.1016/j.eatbeh.2019.05.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 03/31/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Gender and racial/ethnic disparities in disordered eating among youth exist, although whether having multiple marginalized identities disproportionately increases risk is unclear. Therefore, we aimed to quantify the risk of disordered eating associated with intersecting gender and racial/ethnic identities of U.S. adolescents. METHODS We analyzed data from 11,514 U.S. high school students identifying as White, Black/African American, or Hispanic/Latino who participated in the 2013 National Youth Risk Behavior Surveillance System. Age-adjusted relative risks (RR) of purging, fasting, diet pill use, and any disordered eating were estimated using log-binomial models. Relative excess risk due to interaction (RERI) was estimated to evaluate the degree to which the combined effect of marginalized gender and racial/ethnic identity was larger than the sum of their individual effects. RESULTS Disordered eating was prevalent (girls: 20.4% Black/African American, 29.2% Hispanic/Latina, 21.4% White; boys: 13.4% Black/African American, 12.4% Hispanic/Latino; 8.1% Whites). Girls of all racial/ethnic identities and racial/ethnic minority boys had elevated risks of purging, fasting, and any disordered eating compared to White boys (RR range = 1.57-7.43); Hispanic/Latina and White girls also had elevated risk of diet pill use (RR range = 1.98-3.20). Among Hispanic/Latina girls, positive interaction between gender and race/ethnicity produced excess risk of any disordered eating and purging (RERI: any = 0.42 (95% confidence interval (CI) = -0.02, 0.87); purging = 1.74 (95% CI = 0.06, 3.42). CONCLUSIONS Findings illustrate the advantages of adopting an intersectional approach to disordered eating research. Future research should investigate the mechanisms of these disparities.
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Affiliation(s)
- Ariel L Beccia
- Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, United States of America; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America.
| | - Jonggyu Baek
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America.
| | - William M Jesdale
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America.
| | - S Bryn Austin
- Division of Adolescent Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA 02115, United States of America; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States of America.
| | - Sarah Forrester
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America.
| | - Carol Curtin
- Department of Family Medicine & Community Health, E.K. Shriver Center, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, United States of America.
| | - Kate L Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America.
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Stiles-Shields C, Holmbeck GN. Health behaviors and disordered eating in adolescents and young adults with spina bifida: results from a national survey. Disabil Rehabil 2019; 42:2910-2916. [PMID: 30978107 DOI: 10.1080/09638288.2019.1575483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Youth with disabilities are at higher risk for obesity, disordered eating, and poor body image but are often excluded from research on these domains. The current study is the first to characterize health behaviors, body mass index, and disordered eating cognitions and behaviors in a national sample of adolescent and young adult males and females with spina bifida.Methods: Participants were recruited nationally through the support of a national spina bifida-related organization to complete an anonymous survey assessing health behaviors and disordered eating.Results: Participants were primarily Caucasian, had myelomeningocele, and were between 15-24 years of age. Body mass indices ranged from underweight to Class Three obesity. Health behaviors (e.g., healthy food consumption, physical activity) were often subthreshold compared to Centers for Disease Control recommendations made to the general public. Both male and female respondents endorsed higher purging and restricting behaviors than norms established with typically-developing college aged peers.Conclusions: Findings revealed that there are few sex-based differences. Additionally, the need for thorough assessment of disordered eating behaviors in this population is warranted, including those with a lower body mass index who might be overlooked for assessment of unhealthy attempts to lose or maintain their weight.Implications for rehabilitationAdolescents and young adults with spina bifida are often advised to lose weight without clear guidelines on how to do so, putting them at risk for disordered eating.Professionals should expect variable body mass indices in this population, with some health behaviors falling short of recommendations made for the general public by the Centers for Disease Control.Professionals should fully assess disordered eating behaviors in youth with disabilities, even when at a healthy weight.
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22
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Shared Concerns and Opportunity for Joint Action in Creating a Food Environment That Supports Health. Nutrients 2018; 11:nu11010041. [PMID: 30585215 PMCID: PMC6357161 DOI: 10.3390/nu11010041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/17/2018] [Accepted: 12/21/2018] [Indexed: 11/21/2022] Open
Abstract
The food industry is a for-profit industry with high relevance to universal eating disorders prevention. To date, policy which targets the food industry and food environment has been underutilized in efforts to decrease the incidence of eating disorders and associated risk factors. In contrast, food policy has been extensively leveraged with the aim of reducing the incidence of obesity. While philosophical misalignments with these later efforts may have constituted an obstacle to identifying the food environment as a key target for eating disorders prevention, food policy is an area where shared interests can be found. Specifically, a shared goal of obesity and eating disorders prevention efforts is creating a food environment that supports health, while minimizing the influence of the food industry that profits from the sale of highly palatable, processed foods and “diet” foods and from increasing portions of foods served and eaten.
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Kwan MY, Haynos AF, Blomquist KK, Roberto CA. Warning labels on fashion images: Short- and longer-term effects on body dissatisfaction, eating disorder symptoms, and eating behavior. Int J Eat Disord 2018; 51:1153-1161. [PMID: 30480830 PMCID: PMC6289689 DOI: 10.1002/eat.22951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Fashion warning labels that caution readers about digitally altered images have been recommended and adopted by several countries to prevent body dissatisfaction and eating disorders. This study investigated the short- and longer-term influence of fashion warning labels on affect, body dissatisfaction, eating disorder symptoms, and snack consumption using a randomized-controlled experiment. METHOD Female undergraduates (n = 118) were randomized to view and rate responses to fashion images either with or without a warning label. They then consumed snacks and completed questionnaires. Sixty-four participants (54%) completed follow-up online surveys asking them to view and rate new fashion images with or without warning labels once per week for 4 weeks. Primary outcomes were affect, body dissatisfaction, eating disorder symptoms, and kilocalories consumed. RESULTS Overall, fashion warning labels had no short-term effects on affect, body dissatisfaction, or kilocalories consumed in the lab. However, individuals who reported engaging in restrictive eating consumed fewer kilocalories when exposed to advertisements with warning labels (M = 170.33, SD = 120.78) versus no labels (M = 286.46, SD = 166.30), p = .008. Warning labels also had no protective effects after repeated exposure over 4 weeks on affect or eating disorder symptoms, and significantly increased appearance orientation (p = .001). DISCUSSION Warning labels on media images are unlikely to be an effective policy tool to prevent negative affect, body dissatisfaction, and eating disorder symptoms, and, in some cases, may exacerbate these concerns.
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Affiliation(s)
- Mun Yee Kwan
- Department of Psychology, Sociology, and Social Work, West Texas A&M University, Canyon, Texas
| | - Ann F. Haynos
- Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, Minnesota
| | | | - Christina A. Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Holland K, Dickson A, Dickson A. ‘To the horror of experts’: reading beneath scholarship on pro-ana online communities. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1382681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kate Holland
- Faculty of Arts & Design, News & Media Research Centre, University of Canberra , Canberra, Australia
| | - Andrew Dickson
- School of Management, Massey Business School, Massey University , Palmerston North, New Zealand
| | - Anna Dickson
- Independent Academic , Palmerston North, New Zealand
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Reducing the burden of suffering from eating disorders: Unmet treatment needs, cost of illness, and the quest for cost-effectiveness. Behav Res Ther 2017; 88:49-64. [PMID: 28110676 DOI: 10.1016/j.brat.2016.09.006] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 01/27/2023]
Abstract
Eating disorders are serious mental disorders as reflected in significant impairments in health and psychosocial functioning and excess mortality. Despite the clear evidence of clinical significance and despite availability of evidence-based, effective treatments, research has shown a paradox of elevated health services use and, yet, infrequent treatment specifically targeting the eating disorder (i.e., high unmet treatment need). This review paper summarizes key studies conducted in collaboration with G. Terence Wilson and offers an update of the research literature published since 2011 in three research areas that undergirded our collaborative research project: unmet treatment needs, cost of illness, and cost-effectiveness of treatments. In regards to unmet treatment needs, epidemiological studies find that the number of individuals with an eating disorder who do not receive disorder-specific treatment continues to remain high. Cost-of-illness show that eating disorders are associated with substantial financial burdens for individuals, their family, and society, yet comprehensive examination of costs across public sectors is lacking. Cost measures vary widely, making it difficult to draw firm conclusions. Hospitalization is a major driver of medical costs incurred by individuals with an eating disorder. Only a handful of cost-effectiveness studies have been conducted, leaving policy makers with little information on which to base decisions about allocation of resources to help reduce the burden of suffering attributable to eating disorders.
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Calzo JP, Blashill AJ, Brown TA, Argenal RL. Eating Disorders and Disordered Weight and Shape Control Behaviors in Sexual Minority Populations. Curr Psychiatry Rep 2017; 19:49. [PMID: 28660475 PMCID: PMC5555626 DOI: 10.1007/s11920-017-0801-y] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE OF REVIEW This review summarized trends and key findings from empirical studies conducted between 2011 and 2017 regarding eating disorders and disordered weight and shape control behaviors among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations. RECENT FINDINGS Recent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are transgender or ethnic minorities. Dissonance-based eating disorder prevention programs may hold promise for sexual minority males. Continued research must examine the intersections of sexual orientation, gender, and ethnic identities, given emergent data that eating disorder risk may be most prominent among specific subgroups. More research is needed within sexual minorities across the lifespan. There is still a lack of eating disorder treatment and prevention studies for sexual minorities.
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Affiliation(s)
- Jerel P Calzo
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182-4162, USA.
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, CA, USA.
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, CA, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Tiffany A Brown
- Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA
| | - Russell L Argenal
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182-4162, USA
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Forrest LN, Smith AR, Swanson SA. Characteristics of seeking treatment among U.S. adolescents with eating disorders. Int J Eat Disord 2017; 50:826-833. [PMID: 28323350 DOI: 10.1002/eat.22702] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/20/2017] [Accepted: 02/26/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The majority of persons with eating disorders (EDs) do not seek ED treatment, yet little is known about treatment-seeking barriers or facilitators. The aim of the study is to describe the characteristics associated with seeking ED treatment among U.S. adolescents with EDs. METHOD Data from a nationally representative cross-sectional study of U.S. adolescents ages 13-18 years were used for these analyses. Specifically, adolescents who met criteria for lifetime EDs (N = 281) were included. Sociodemographic information, characteristics of EDs, psychiatric comorbidities, and other mental health service use were assessed via interview. RESULTS Only 20% of adolescents sought ED treatment. Females were 2.2 (95% CI 0.8, 6.4) times more likely to seek treatment than males (19.9% vs. 8.9%). Adolescents who met criteria for anorexia nervosa or bulimia nervosa were 2.4 (95% CI 0.9, 6.3) and 1.9 (95% CI 1.0, 3.8) times more likely to seek treatment than adolescents who met criteria for binge-eating disorder (27.5% and 22.3% vs. 11.6%). Specific ED behaviors (restriction and purging), ED-related impairment, and any mental health service use were also associated with adolescent treatment seeking. DISCUSSION Adolescent treatment seeking was infrequent overall, with individuals with counter-stereotypic ED presentations least likely to have sought treatment. Adolescent treatment seeking could be promoted through increasing awareness among the public and healthcare professionals that EDs affect a heterogeneous group of people. More generally, research involving both treatment-seeking and non-treatment-seeking individuals holds great potential to refine the field's knowledge of ED etiology, prevalence, treatment, and prevention.
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Affiliation(s)
| | - April R Smith
- Department of Psychology, Miami University, Oxford, Ohio
| | - Sonja A Swanson
- Erasmus MC, Rotterdam, The Netherlands.,Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Adametz L, Richter F, Strauss B, Walther M, Wick K, Berger U. Long-term effectiveness of a school-based primary prevention program for anorexia nervosa: A 7-to 8-year follow-up. Eat Behav 2017; 25:42-50. [PMID: 27260298 DOI: 10.1016/j.eatbeh.2016.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE This is the first study to evaluate the long-term effectiveness of a school-based prevention program in Germany. The aim is to determine the long-term effects of the primary prevention program PriMa (Primary prevention of anorexia nervosa in preadolescent girls) on disordered eating and body self-esteem from childhood to young adulthood. METHODS PriMa was conducted and successfully evaluated in a quasi-experimental pre-post design with a control group from 2007 to 2008 consisting of 11-13year old girls (N=1508) from Thuringian schools in Germany. Seven to eight years after the intervention, the same cohort (mean age 19.8years) was invited to complete an online survey. Disordered eating (EAT-26), body self-esteem (FBeK) and BMI were assessed via self-report. The response rate at seven-to-eight-year follow-up was very low (7%). Data of N=100 girls were analyzed. RESULTS Concerning changes in disordered eating, results revealed no significant long-term effect of PriMa seven to eight years after the intervention. During this time, disordered eating remained stable without a significant increase or decrease. Regarding changes in body self-esteem, group courses differed significantly from each other. The results revealed a significant main effect of group, indicating significant differences in changes of body self-esteem between the intervention and the control group. Following the analysis of these changes of body self-esteem over time, it was found that the intervention group revealed an increase of body self-esteem after program participation and remained stable over time. By contrast, the control group revealed a decrease of body self-esteem over time. CONCLUSIONS Long-term intervention effects of PriMa could be found for body self-esteem but not for disordered eating. The findings suggest that PriMa prevented a decrease of body self-esteem from childhood to young adulthood. For a broader dissemination it is necessary to implement prevention programs consistently in school settings. In order to maintain the prevention effects, it would be interesting to investigate the effects of booster sessions which refresh the programs content on a regular basis. Furthermore, the results of this study revealed the implementation difficulties of primary prevention programs especially concerning the retention of the sample size.
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Affiliation(s)
- Luise Adametz
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07743 Jena, Germany.
| | - Felicitas Richter
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07743 Jena, Germany.
| | - Bernhard Strauss
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07743 Jena, Germany.
| | - Mario Walther
- Jena University Hospital, Institute of Medical Statistics, Computer Sciences und Documentation, Bachstr. 18, D-07743 Jena, Germany.
| | - Katharina Wick
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07743 Jena, Germany.
| | - Uwe Berger
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07743 Jena, Germany.
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Bell MJ, Rodgers RF, Paxton SJ. Towards successful evidence-based universal eating disorders prevention: The importance of zooming out. Eat Behav 2017; 25:89-92. [PMID: 27816412 DOI: 10.1016/j.eatbeh.2016.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Megan Jones Bell
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA; Lantern, San Francisco, CA 94105, USA.
| | - Rachel F Rodgers
- Department of Counseling and Applied Educational Psychology, Northeastern University, Boston, MA, USA
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Rodgers RF, Ziff S, Lowy AS, Yu K, Austin SB. Results of a strategic science study to inform policies targeting extreme thinness standards in the fashion industry. Int J Eat Disord 2017; 50:284-292. [PMID: 28138974 DOI: 10.1002/eat.22682] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/05/2017] [Accepted: 01/07/2017] [Indexed: 11/08/2022]
Abstract
The appearance pressures experienced by fashion models have been criticized as harmful to their health, as well as increasing eating disorder risk among youth by promoting ideals of extreme thinness. Given recent legislation to protect models, we undertook a strategic science study to assess professional fashion models' perceptions of the potential impact and feasibility of seven policy proposals. A sample of 85 female fashion models, mean age = 22.7 years (SD 3.7) completed an online survey assessing unhealthy weight control behaviors (UWCB), perceived pressure from agencies to lose weight, as well as the perceived impact and feasibility of seven potential policy actions. Chi-squared analyses and multivariable logistic regressions compared UWCB among models who were asked to lose weight and those who were not. Friedman and Kendall's W tests were conducted to examine differences in impact and feasibility ratings across the seven policy proposals. Models reported high levels of pressure to lose weight, which was associated with higher odds of engaging in UWCB. The policy approaches rated as most impactful were those to increase worker protections, though they were rated as only moderately feasible. Requiring employers to provide food and a 30-min break for jobs longer than 6 h was rated as both impactful and feasible. Imposing restrictions on minimum BMI was rated as the least impactful. Approaches providing employment protections and healthier working conditions are most supported by professional models. These findings help to illuminate viable policy approaches from the perspective of key stakeholders.
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Affiliation(s)
- Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts
| | | | - Alice S Lowy
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts
| | - Kimberly Yu
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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31
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Weissman RS. Fifty volumes of scholarship on eating disorders. Int J Eat Disord 2017; 50:3-8. [PMID: 28025874 DOI: 10.1002/eat.22653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/08/2022]
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32
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Shaban H, O’Connor R, Ovsepian SV, Dinan TG, Cryan JF, Schellekens H. Electrophysiological approaches to unravel the neurobiological basis of appetite and satiety: use of the multielectrode array as a screening strategy. Drug Discov Today 2017; 22:31-42. [DOI: 10.1016/j.drudis.2016.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/03/2016] [Accepted: 09/06/2016] [Indexed: 01/10/2023]
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Robinson E, Aveyard P. Emaciated mannequins: a study of mannequin body size in high street fashion stores. J Eat Disord 2017; 5:13. [PMID: 28469913 PMCID: PMC5412053 DOI: 10.1186/s40337-017-0142-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/22/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is concern that the body size of fashion store mannequins are too thin and promote unrealistic body ideals. To date there has been no systematic examination of the size of high street fashion store mannequins. METHODS We surveyed national fashion retailers located on the high street of two English cities. The body size of 'male' and 'female' mannequins was assessed by two blinded research assistants using visual rating scales. RESULTS The average female mannequin body size was representative of a very underweight woman and 100% of female mannequins represented an underweight body size. The average male mannequin body size was significantly larger than the average female mannequin body size. Only 8% of male mannequins represented an underweight body size. CONCLUSIONS The body size of mannequins used to advertise female fashion is unrealistic and would be considered medically unhealthy in humans.
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Affiliation(s)
- Eric Robinson
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool, L69 7ZA UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG UK
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Lee-Winn AE, Townsend L, Reinblatt SP, Mendelson T. Associations of neuroticism-impulsivity and coping with binge eating in a nationally representative sample of adolescents in the United States. Eat Behav 2016; 22:133-140. [PMID: 27289518 PMCID: PMC4983245 DOI: 10.1016/j.eatbeh.2016.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/09/2016] [Accepted: 06/01/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Binge eating behavior is a public health concern due to its negative physical and mental health consequences. Little is known about the interplay of personality traits, coping styles, and binge eating in the general adolescent population. We examined the associations among the combination of neuroticism and impulsivity (NI), maladaptive coping styles (poor problem solving, distraction, and escape-avoidance), and lifetime prevalence of binge eating in a nationally representative sample of U.S. adolescents. We also explored coping as a moderator of the NI-lifetime binge eating association and gender as a moderator of the NI-coping associations and coping-lifetime binge eating associations. METHODS We used data from the National Comorbidity Survey: Adolescent Supplement (NCS-A: 2001-2004), a cross-sectional nationally representative study of adolescents aged 13 to 18years (n=10,028). We studied the associations of NI and coping with lifetime binge eating using multivariate regression models. RESULTS High NI was significantly associated with all three coping styles, especially escape-avoidance (β=3.96, confidence interval [CI]=3.62, 4.29, p<0.001). Gender was a significant moderator of the NI-distraction coping association (β=-0.68, CI=-1.33, -0.03, p=0.041), indicating a stronger association in males (β=1.20, CI=0.81, 1.58, p<0.001) than females (β=0.53, CI=0.02, 1.03, p=0.042). Lifetime prevalence of binge eating was 1.13 times higher with increased escape-avoidance coping (CI=1.10, 1.18, p<0.001). DISCUSSION Our findings indicate significant associations among high NI, increased escape-avoidance coping, and higher lifetime prevalence of binge eating in adolescents. Findings of our study have potential to inform development of interventions that target modification of maladaptive personality traits and coping styles to reduce problematic eating.
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Affiliation(s)
- Angela E. Lee-Winn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Hampton House, Baltimore, MD 21205, USA
| | - Lisa Townsend
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Hampton House, Baltimore, MD 21205, USA.
| | - Shauna P. Reinblatt
- The Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, 550 North Broadway, Room 206D, Baltimore, MD 21205 USA
| | - Tamar Mendelson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Hampton House, Baltimore, MD 21205, USA.
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35
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Puhl RM, Neumark-Sztainer D, Bryn Austin S, Suh Y, Wakefield DB. Policy Actions to Address Weight-Based Bullying and Eating Disorders in Schools: Views of Teachers and School Administrators. THE JOURNAL OF SCHOOL HEALTH 2016; 86:507-515. [PMID: 27246675 DOI: 10.1111/josh.12401] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/11/2015] [Accepted: 02/15/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Weight-related bullying is prevalent among youth and associated with adverse health consequences, including increased risk for body dissatisfaction and disordered eating behaviors, which are risk factors for eating disorders. Although concerns about these problems have stimulated calls for broader intervention efforts in schools, actions thus far have been limited. This study examined educators' perspectives about potential policy actions to address these issues in schools. METHODS Educators (N = 240) completed an online questionnaire assessing their support for 11 potential school-based policy actions to address weight-related bullying and eating disorders. Participants also rated policies according to their feasibility and potential for positive impact. RESULTS Forty-eight percent of participants observed weight-related bullying in their school and 99% expressed the importance of intervening in such incidents. A large majority (75%-94%) supported 8 of the 11 policies, especially actions requiring school-based health curriculum to include content on eating disorder prevention (94%), and addressing weight-bullying through antibullying policies (92%), staff training (89%), and school curriculum (89%). Strongly supported policies were viewed by participants as being the most impactful and feasible to implement. CONCLUSIONS Educators recognize weight-related bullying and eating disorders as problems in their schools that warrant improved prevention and intervention efforts at the policy level.
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Affiliation(s)
- Rebecca M Puhl
- University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT 06103.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454.
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard School of Public Health, 333 Longwood Avenue, 6th Floor, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA 02115.
| | - Young Suh
- Rudd Center for Food Policy & Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT 06103.
| | - Dorothy B Wakefield
- Center for Public Health & Health Policy, University of Connecticut, 195 Farmington Avenue, Suite 2100, Farmington, CT 06032.
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36
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Lee-Winn AE, Townsend L, Reinblatt SP, Mendelson T. Associations of Neuroticism and Impulsivity with Binge Eating in a Nationally Representative Sample of Adolescents in the United States. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016; 90:66-72. [PMID: 26705374 DOI: 10.1016/j.paid.2015.10.042] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Binge eating behavior is a public health concern with serious physical and mental health consequences. Certain personality traits have been found to contribute to the development of eating disorders in clinical samples of youth, but little is known about associations between personality traits and binge eating in the general adolescent population. We examined the associations of neuroticism and impulsivity-both independently and in combination-with lifetime prevalence of binge eating, using nationally representative, cross-sectional data from the National Comorbidity Survey: Adolescent Supplement (n=437). Neuroticism and impulsivity were each significantly associated with lifetime prevalence of binge eating (adjusted prevalence ratio [aPR]=1.11, confidence interval [CI]=1.07, 1.15, p<0.001; aPR=1.06, CI=1.04, 1.09, p<0.001, respectively). The combination of high neuroticism and high impulsivity was associated with higher lifetime binge eating than the combination of low neuroticism and low impulsivity (aPR=3.72, CI=2.45, 5.65, p<0.001), and this association was stronger for female than male adolescents (females: aPR=5.37, CI=3.24, 8.91, p<0.001 vs. males: aPR=2.45, CI=1.43, 4.22, p=0.002). Our findings have implications for informing theories of etiology and interventions to target binge eating behaviors.
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Affiliation(s)
- Angela E Lee-Winn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Hampton House, Room 782 Baltimore, MD 21205, USA
| | - Lisa Townsend
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Hampton House, Room 898 Baltimore, MD 21205, USA,
| | - Shauna P Reinblatt
- The Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, 5300 Alpha Commons Drive 4th Floor Baltimore, MD 21224 USA,
| | - Tamar Mendelson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway Hampton House, Room 853 Baltimore, MD 21205, USA,
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Austin SB. Accelerating Progress in Eating Disorders Prevention: A Call for Policy Translation Research and Training. Eat Disord 2016; 24:6-19. [PMID: 25880718 DOI: 10.1080/10640266.2015.1034056] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The public health burden of eating disorders is well documented, and over the past several decades, researchers have made important advances in the prevention of eating disorders and related problems with body image. Despite these advances, however, several critical limitations to the approaches developed to date leave the field far from achieving the large-scale impact that is needed. This commentary provides a brief review of what achievements in prevention have been made and identifies the gaps that limit the potential for greater impact on population health. A plan is then offered with specific action steps to accelerate progress in high-impact prevention, most compellingly by promoting a shift in priorities to policy translation research and training for scholars through the adoption of a triggers-to-action framework. Finally, the commentary provides an example of the application of the triggers-to-action framework as practiced at the Strategic Training Initiative for the Prevention of Eating Disorders, a program based at the Harvard T. H. Chan School of Public Health and Boston Children's Hospital. Much has been achieved in the nearly 30 years of research carried out for the prevention of eating disorders and body image problems, but several critical limitations undermine the field's potential for meaningful impact. Through a shift in the field's priorities to policy translation research and training with an emphasis on macro-environmental influences, the pace of progress in prevention can be accelerated and the potential for large-scale impact substantially improved.
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Affiliation(s)
- S Bryn Austin
- a Department of Social and Behavioral Sciences , Harvard T. H. Chan School of Public Health , Boston , Massachusetts , USA.,b Division of Adolescent and Young Adult Medicine, Boston Children's Hospital , Boston , Massachusetts , United States
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38
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Goldschmidt AB, Wall M, Choo THJ, Becker C, Neumark-Sztainer D. Shared risk factors for mood-, eating-, and weight-related health outcomes. Health Psychol 2015; 35:245-52. [PMID: 26690639 DOI: 10.1037/hea0000283] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Given the overlap among depressive symptoms, disordered eating, and overweight, identifying shared risk factors for these conditions may inform public health interventions. This study aimed to examine cross-sectional and prospective relationships among these 3 conditions, and identify potential shared eating-related and psychosocial variable risk factors (i.e., body dissatisfaction, dieting, teasing experiences). METHOD A population-based sample (n = 1,902) self-reported depressive symptoms, disordered eating (binge eating, extreme weight control behaviors), weight status, and several putative risk factors (body satisfaction, dieting frequency, weight-related teasing) at 5-year intervals spanning early/middle adolescence, middle adolescence/early young adulthood, and early/middle young adulthood. RESULTS There was moderate overlap among depressive symptoms, disordered eating, and overweight at each time point, and moderate stability in each condition over time. Body dissatisfaction and dieting were the most potent shared risk factors for later depressive symptoms, disordered eating, and overweight among males and females (ps < .05). CONCLUSIONS Depressive symptoms, disordered eating, and overweight share several risk factors, including dieting and body dissatisfaction, which may be effective targets for interventions aiming to simultaneously prevent these 3 conditions.
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Affiliation(s)
| | - Melanie Wall
- Department of Biostatistics, Columbia University
| | | | | | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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Zeiler M, Waldherr K, Philipp J, Nitsch M, Dür W, Karwautz A, Wagner G. Prevalence of Eating Disorder Risk and Associations with Health-related Quality of Life: Results from a Large School-based Population Screening. EUROPEAN EATING DISORDERS REVIEW 2015; 24:9-18. [PMID: 26010077 DOI: 10.1002/erv.2368] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/13/2015] [Accepted: 04/20/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the prevalence of eating disorder (ED) risk as well as associated psychopathology and health-related quality of life (HrQoL) in a large population sample of Austrian adolescents. METHOD A sample of 3610 adolescents aged 10-18 years was recruited from 261 schools representative for the Austrian population. The SCOFF questionnaire was used to identify participants at risk for EDs, and the Youth Self-Report and KIDSCREEN were used to assess general psychopathology and HrQoL. RESULTS In total, 30.9% of girls and 14.6% of boys were screened at risk for EDs. SCOFF scores were significantly associated with internalising and externalising behavioural problems as well as HrQoL after controlling for sex, age and body mass index. The SCOFF score further turned out to be an independent predictor of HrQoL. DISCUSSION The high prevalence of ED risk among Austrian adolescents points out the need for prevention in this field. Variables indicating eating pathology should be included in general mental health screenings.
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Affiliation(s)
- Michael Zeiler
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Karin Waldherr
- Ludwig Boltzmann Institute Health Promotion Research, Austria.,Ferdinand Porsche Distance University of Applied Sciences (FernFH), Austria
| | - Julia Philipp
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Martina Nitsch
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Wolfgang Dür
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Andreas Karwautz
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Gudrun Wagner
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
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Puhl RM, Neumark-Sztainer D, Austin SB, Luedicke J, King KM. Setting policy priorities to address eating disorders and weight stigma: views from the field of eating disorders and the US general public. BMC Public Health 2014; 14:524. [PMID: 24884645 PMCID: PMC4046055 DOI: 10.1186/1471-2458-14-524] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 05/23/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The prevalence and health consequences of eating disorders and weight stigmatization have prompted increasing discussion of potential policy actions to address these public health issues. The present study aimed to assess support for policy strategies to address eating disorders and weight stigmatization among the general public and relevant health professionals. METHODS An Internet survey was fielded to a national sample of 944 US adults and 1,420 members of professional organizations specializing in eating disorders to examine their support for 23 potential policy strategies to address eating disorders and weight stigma. Participants also rated policy actions according to their potential for positive impact and feasible implementation. RESULTS Support for the majority of health and social policies was high in both samples. For example, strategies to 1) improve school-based health curriculum to include content aimed at preventing eating disorders, 2) require training for educators and health providers on the prevention and early identification of eating disorders, and 3) implement school-based anti-bullying policies that that protect students from being bullied about their weight, were supported by over two-thirds of participants. CONCLUSIONS Our findings suggest that both health and social policy actions will be important in broader policy initiatives to address eating disorders and weight stigma.
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Affiliation(s)
- Rebecca M Puhl
- Rudd Center for Food Policy & Obesity, Yale University, 309 Edwards Street, New Haven CT 06520, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard School of Public Health, and Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, USA
| | - Joerg Luedicke
- Rudd Center for Food Policy & Obesity, Yale University, 309 Edwards Street, New Haven CT 06520, USA
| | - Kelly M King
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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42
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Changing the course of comorbid eating disorders and depression: what is the role of public health interventions in targeting shared risk factors? J Eat Disord 2014; 2:15. [PMID: 24914411 PMCID: PMC4049372 DOI: 10.1186/2050-2974-2-15] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/19/2014] [Indexed: 11/24/2022] Open
Abstract
Public health has a productive history of improving global health due to its focus on reaching large populations using effective and scalable interventions. Yet, the marriage between evidence-based science and the implementation of community/public health interventions within mental illness remains underdeveloped. Research suggests that major depression is the most commonly cited comorbidity for eating disorders (EDs). Thus, identification of public health strategies that jointly impact depression and EDs, including shared risk factors, has the potential to significantly impact mental health suffering. The primary aim of this paper is to examine and discuss such public health approaches as well as explore cues taken from public health efforts to inform future directions in research and clinical practice. As a comprehensive review of all public health initiatives that address EDs and depression is beyond the scope of this paper, this paper reviews a series of programs/approaches that either are of large scale and/or have received empirical support. In particular, public health related interventions that aim to reduce variable risk factors associated with EDs and depression, as well as interventions that aim to reduce continuous measures of ED and depression symptoms are reviewed. To date, despite significant progress in modifying risk factors for EDs and depression, the field still lacks a public health study that has been appropriately designed and/or adequately powered to assess true ED/depression prevention effects. Further, although several programs show promise, many widely disseminated approaches lack empirical support, raising concerns about the potential for waste of limited resources. In summary, although the combination of prevention and public health based approaches appear to have merit when trying to move the needle on risk factors and symptoms associated with EDs and/or depression, further research is needed to investigate the reach and effectiveness of large scale dissemination efforts of such endeavors.
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Austin SB, Gordon AR, Kennedy GA, Sonneville KR, Blossom J, Blood EA. Spatial distribution of cosmetic-procedure businesses in two U.S. cities: a pilot mapping and validation study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:6832-62. [PMID: 24322394 PMCID: PMC3881144 DOI: 10.3390/ijerph10126832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/21/2013] [Accepted: 11/22/2013] [Indexed: 11/16/2022]
Abstract
Cosmetic procedures have proliferated rapidly over the past few decades, with over $11 billion spent on cosmetic surgeries and other minimally invasive procedures and another $2.9 billion spent on U.V. indoor tanning in 2012 in the United States alone. While research interest is increasing in tandem with the growth of the industry, methods have yet to be developed to identify and geographically locate the myriad types of businesses purveying cosmetic procedures. Geographic location of cosmetic-procedure businesses is a critical element in understanding the public health impact of this industry; however no studies we are aware of have developed valid and feasible methods for spatial analyses of these types of businesses. The aim of this pilot validation study was to establish the feasibility of identifying businesses offering surgical and minimally invasive cosmetic procedures and to characterize the spatial distribution of these businesses. We developed and tested three methods for creating a geocoded list of cosmetic-procedure businesses in Boston (MA) and Seattle (WA), USA, comparing each method on sensitivity and staff time required per confirmed cosmetic-procedure business. Methods varied substantially. Our findings represent an important step toward enabling rigorous health-linked spatial analyses of the health implications of this little-understood industry.
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Affiliation(s)
- S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA; E-Mail:
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +1-617-355-8194
| | - Allegra R. Gordon
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA; E-Mail:
| | - Grace A. Kennedy
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
| | - Kendrin R. Sonneville
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Jeffrey Blossom
- Center for Geographic Analysis, Harvard University, Boston, MA 02115, USA; E-Mail:
| | - Emily A. Blood
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Clinical Research Center, Boston Children’s Hospital, Boston, MA 02115, USA
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Bauer S, Papezova H, Chereches R, Caselli G, McLoughlin O, Szumska I, van Furth E, Ozer F, Moessner M. Advances in the prevention and early intervention of eating disorders: The potential of Internet-delivered approaches. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.mhp.2013.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Paxton SJ. Dissemination in the internet age: taming a wild thing. Int J Eat Disord 2013; 46:525-8. [PMID: 23658105 DOI: 10.1002/eat.22116] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/01/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Susan J Paxton
- School of Psychological Science, La Trobe University, Melbourne, Australia.
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Austin SB, Sonneville KR. Closing the "know-do" gap: training public health professionals in eating disorders prevention via case-method teaching. Int J Eat Disord 2013; 46:533-7. [PMID: 23658107 DOI: 10.1002/eat.22111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2012] [Indexed: 11/10/2022]
Abstract
Expansion of our societies' capacity to prevent eating disorders will require strategic integration of the topic into the curricula of professional training programs. An ideal way to integrate new content into educational programs is through the case-method approach, a teaching method that is more effective than traditional teaching techniques. The Strategic Training Initiative for the Prevention of Eating Disorders has begun developing cases designed to be used in classroom settings to engage students in topical, high-impact issues in public health approaches to eating disorders prevention and screening. Dissemination of these cases will provide an opportunity for students in public health training programs to learn material in a meaningful context by actively applying skills as they are learning them, helping to bridge the "know-do" gap. The new curriculum is an important step toward realizing the goal that public health practitioners be fully equipped to address the challenge of eating disorders prevention.
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Affiliation(s)
- S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA.
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