Etiological model of disordered eating behaviors in Brazilian adolescent girls

An update on the underlying risk factors of eating disorders onset during adolescence: a systematic review

Introduction

Eating disorders (EDs) are serious psychological problems that affect not only the individual, but also their entire environment. The prevalence rates of EDs are higher among the adolescent population. A better understanding of ED risk factors is essential to design effective prevention and intervention programs that focus beyond the areas of weight and appearance.

Methods

The main objective of this systematic review was to identify the risk factors of EDs and provide a comprehensive approach, analyzing the interplay between individuals, their inner circle, and the society characteristics. The Web of Science, Scopus, CENTRAL and PsycInfo databases were searched.

Results

The initial search produced 8,178 references. After removing duplicates and performing the selection process by three independent reviewers, 42 articles were included in the systematic review according to the pre-specified inclusion criteria. The results suggest the relevance of society and the inner circle on the development of EDs.

Discussion

The internalization of the thin ideal, promoted by the current society, and living in an unsupportive, unaffectionate, non-cohesive environment were associated with the onset of EDs symptomatology. Other associated variables with this ED indicator were poor-quality relationships and feeling judged about appearance. These aspects seem to be essential for the development of individual characteristics like self-esteem or adaptative coping during adolescence. This systematic review has shown the complex etiology of EDs and the relevance of the interplay between the different areas involved. Furthermore, this information could be relevant to improve the design of innovative and more effective prevention and intervention programs.

Systematic review registration

PROSPERO, identifier CRD42022320881.

Is There an Association between Food Consumption According to the Degree of Processing and Body Image (Dis)satisfaction in Adolescents?

(1) Background: Adolescence is characterized by changes in eating habits, with increased consumption of ultra-processed foods and reduced intake of unprocessed or minimally processed foods, which can affect body image satisfaction. Thus, this study aims to verify the association of food consumption according to the degree of processing with body image (dis)satisfaction in adolescents from the 1997/1998 birth cohort of São Luís, Maranhão. (2) Methods: A cross-sectional study was conducted with 2515 adolescents aged between 18 and 19. Food consumption was stratified based on the NOVA classification in culinary preparations, processed foods, and ultra-processed foods, categorized into tertiles. Body image (dis)satisfaction was evaluated based on the Stunkard Body Scale and was classified as satisfaction, dissatisfaction with thinness, and dissatisfaction with excess weight. Multinomial logistic regression was used for associations. (3) Results: Among the adolescents, 77% considered themselves dissatisfied with their body image, with 42.8% dissatisfied with being thin and 34.2% dissatisfied with excess weight. However, food consumption, according to the degree of processing, was not associated with body image (dis)satisfaction. (4) Conclusion: This work highlighted the prevalence of body image dissatisfaction among adolescents but found no association between body (dis)satisfaction and food consumption according to the degree of processing.

Examining gender difference in disordered eating behaviour and its associated factors among college and university students in Sarawak

Background: Disordered eating is common among late adolescents and young adults who pursue an idealised body image. Aims: This study aims to determine the prevalence of disordered eating between males and females and its associated factors among college and university students in Sarawak. Methods: A cross-sectional study involving 20 public and private colleges and universities in Sarawak, from September 2017 to March 2020. Respondents completed self-administered questionnaires both in the English and Malay language. Data about sociodemographic characteristics, body mass index, eating attitude, body dissatisfaction, perceived sociocultural pressure, self-esteem, drive for muscularity and perfectionism were collected. Results: A total of 776 respondents (male: 30.9%; female: 69.1%) aged 19 to 25 years old took part in the study. The overall prevalence of disordered eating was 25.2% (95% confidence interval (CI) 21.9; 28.7) with females (28.6%, 95% CI 24.6; 32.9) higher than males (15.6%, 95% CI 10.5; 21.9). Multivariate analysis showed for both male and female models, perceived sociocultural pressure (male: β = 1.125, p < 0.01; female: β = 1.052, p = 0.003), drive for muscularity (male: β = 1.033, p = 0.017; female: β = 1.032, p < 0.01) and perfectionism (male: β = 1.098, p = 0.02; female:β = 1.119, p < 0.01) were predictors for disordered eating. Conclusion: The prevalence of disordered eating among college and university students in Sarawak was high. The findings suggest that although there were gender differences in the prevalence of disordered eating, its associated factors were the same. The findings of this study will be useful for designing and implementing disordered eating prevention and intervention programme.

Online media exposure and weight and fitness management app use correlate with disordered eating symptoms: evidence from the mainland of China

BACKGROUND

The relationship between online media exposure and disordered eating symptoms has been reported in western regions. Though the prevalence of eating disorders and access to the Internet increased substantially in recent years, relevant evidence is rare in mainland China. This study aims to evaluate the association between online media exposure or weight and fitness management app use and disordered eating symptoms in Chinese mainland young adults, and the mediation effect of disordered eating cognition.

METHODS

353 Chinese mainland female and 142 male young adults completed online questionnaires consisting of demographic information, Eating Disorder Examination-Questionnaire 6.0 (EDE-Q 6.0), and items relating to online media exposure and weight and fitness management app use. Through correlation analysis, the relationship between online media exposure or weight and fitness management app use and disordered eating symptoms was examined, separately by sex. The mediation effect of disordered eating cognition on the relationship between online media exposure or weight and fitness management app use on disordered eating behaviors was investigated with two moderated mediation models.

RESULTS

Young female adults in the Chinese mainland presented higher disordered eating symptoms and were more engaged in online media and weight and fitness management app use than males. Online media exposure and weight and fitness management app use showed a significant correlation with disordered eating behaviors in males and females. Disordered eating cognition mediated the relationship between online media exposure or weight and fitness management app use and disordered eating behaviors. This effect was significantly higher in females.

CONCLUSION

Online media exposure and weight and fitness management app use play a crucial role in the generation of disordered eating symptoms in Chinese mainland young adults, especially in females. The mediation analysis suggested the importance of prevention and intervention of disordered eating cognition. Monitoring and scientific guidance of online media are necessary.

Disordered eating and body change behaviours: support for the Tripartite Influence Model among Brazilian male university students

The Tripartite Influence Model posits that sociocultural influences mediated by internalization and social comparison are predictors of disordered eating and body change behaviours. This study aimed to test the Tripartite Influence Model among Brazilian male university students, which has not been tested yet. 707 undergraduate students of the five Brazilian regions, completed measures of sociocultural influences, internalization, social comparison, body and muscularity dissatisfaction, disordered eating and body change behaviours. Structural equation modelling analyses showed good model-fitting. Parental influence was related to internalization, while peer influence with social comparison. Media influences were related to both internalization and social comparison. Internalization and social comparison are mediating variables that are related to body dissatisfaction and muscularity dissatisfaction. Finally, muscularity dissatisfaction was associated with body change behaviours.

The relationship between perfectionism and eating-related symptoms in adolescents: A systematic review

The clinical significance of two major aspects of perfectionism, perfectionistic strivings (PS) and perfectionistic concerns (PC), in eating disorders (EDs) symptoms was well-established among adults. However, no systematic review has assessed evidence examining associations between both unidimensional and multidimensional perfectionism and EDs in early and middle adolescence. For this aim, three online databases (PsycINFO, Medline and PsycArticle) were searched for articles published until January 2019, and observational studies were considered. Study quality was systematically appraised, and results were summarized using a narrative synthesis approach. Fifty-one cross-sectional and 28 longitudinal studies were included. Most studies supported the relationship between perfectionism and EDs, with the majority adopting a unidimensional approach for assessing perfectionism. Among studies that employed multidimensional measures of perfectionism, the majority (n = 11) of evidence supported the relationship between eating symptoms and PC, while fewer (n = 5) studies provided significant unique associations with PS. These findings are consistent with the body of research suggesting the strength of the relationship between PC and EDs was greater than between PS and EDs. It was recommended that preventive interventions should be primarily focused on reducing self-critical perfectionism, since it resulted to be the most relevant perfectionistic dimension in the development of eating symptoms in adolescents.

O tema “imagem corporal” nas publicações do Scientific Electronic Library Online – SciELO: revisão integrativa

A imagem corporal é um tema que vem se ampliando nos últimos anos. Por isso, a partir de uma revisão integrativa da literatura efetuada na plataforma Scientific Eletronic Library Online, realizou-se uma pesquisa em 26 artigos publicados no ano de 2016, com o objetivo de identificar as principais características dos textos sobre imagem corporal. Os resultados apontam para três tipos de estudo predominantes: a) artigos de revisão; b) validação de instrumentos e protocolos e; c) análise dos níveis de satisfação/insatisfação com a imagem corporal de grupos distintos. A partir dessas informações, também foi possível concluir que são necessários novos estudos, sobretudo, vinculados às possíveis determinações sociais sobre a imagem corporal.

Body dissatisfaction, addiction to exercise and risk behaviour for eating disorders among exercise practitioners

OBJECTIVE

This study investigated the association between body dissatisfaction (BD), addiction to exercise and risk behaviors to eating disorders (EDs) among Brazilian exercise practitioners, besides comparing the variables according to sex, age group and modality.

METHODS

Participants were 60 exercice practitioners of fitness (n = 44) and crossfit (n = 16), with mean age of 26.58 ± 7.76 years. Data collection was conducted through Eating Attitudes Test-26 (EAT-26), Diagnosis of Orthorexia Questionnaire (ORTO-15), Body Shape Questionnaire (BSQ) and Scale of Dedication to Exercise (SDE). Data analysis was conducted through Kolmogorov-Smirnov and independent t tests, Pearson correlation, and Path Analysis (p < .05).

RESULTS

Main results showed the association between BD, addiction to exercise and risk behaviour for EDs. Further, individuals dissatisfied with their bodies showed higher level of addiction to exercise and risk behavior for EDs. Furthermore, women showed higher presence of BD than men, and fitness participants reported higher presence of addiction to exercise than crossfit practitioners.

CONCLUSIONS

This study revealed that BD seems to be a determinant factor for risk behavior for ED's and addiction to exercise among fitness and crossfit particpants.

Fatores de risco para transtornos alimentares em graduandos de enfermagem

Resumo Objetivo: Identificar a presença de fatores de risco em estudantes de enfermagem para o desenvolvimento de transtornos alimentares. Métodos: Estudo transversal, com graduandos de enfermagem de universidade pública, onde foi utilizado questionário de caracterização, Teste de Atitudes Alimentares (EAT) e Questionário de Imagem Corporal (BSQ). Para análise dos dados foi utilizado análise descritiva, correlação de Pearson e regressão linear. Resultados: de 120 graduandos, 30 (25%) apresentaram alteração do comportamento alimentar, 55 (45,8%) insatisfação com imagem corporal. Observou-se correlação simples positiva entre os instrumentos EAT e BSQ (p<0,001) onde 20 (66,7%) dos 55 graduandos com alterações de BSQ apresentaram também alterações de EAT; associação significativa entre comportamento alimentar de risco (EAT) e o índice de massa corpórea (IMC) acima do estado de eutrofia; associação significativa entre preocupação com a imagem corporal (BQS) e o ano de graduação, com destaque para terceiro e quarto anos. Houve diferença significativa entre os instrumentos utilizados e idade, a mostrar que, na amostra estudada, os graduandos mais jovens apresentaram-se com maior risco para o desenvolvimento de transtornos alimentares. Conclusão: Graduandos de enfermagem apresentaram fatores de risco para o desenvolvimento de transtornos alimentares com a presença de preocupação com imagem corporal e alteração de comportamento alimentar. Etiologia multifatorial dos transtornos alimentares sugere que pesquisas devem focalizar prevenção, com foco na construção, em jovens, de conceito positivo sobre autoimagem e sobre si mesmos, a desenvolver o pensamento crítico sobre padrões de imagem e imposições midiáticas e sociais.