The Follow-Up of Eating Disorders from Adolescence to Early Adulthood: A Systematic Review

Eating disorder risks and psychopathological distress in Italian high school adolescents

BACKGROUND

Psychopathological disorders are often comorbid diagnosis in eating disorders (EDs). We aimed to assess the presence of psychopathological traits and symptoms associated with EDs in an Italian high school adolescent population.

METHODS

A sample of high school adolescents was enrolled, and demographic and clinical data were collected. Two self-report questionnaires, the Eating Disorder Inventory-3 (EDI-3) and the Questionnaire for the Assessment of Psychopathology in Adolescence (Q-PAD), were administered.

RESULTS

548 adolescents (333 F/215 M; 16.89 ± 0.85 years) were included. Symptoms associated with EDs of clinical or high clinical concern were prevalent in a range of individuals, with percentages varying from 26.82% for body dissatisfaction to 51.83% for Interoceptive Deficits. The findings from the Q-PAD assessment indicated the presence of psychological distress, leading to discomfort or challenging situations requiring potential intervention in a percentage of adolescents ranging from 2.93% for psychosocial risks to 23.77% for anxiety. These percentages showed differences between genders (F > M, p < 0.001). Our study also highlighted an association between symptoms of EDs and lifestyle factors within families. We observed correlations between Q-PAD measures and EDI-3 scores, including a positive correlation between Q-PAD and EDI-3 body dissatisfaction (r = 0.7), Q-PAD interpersonal conflicts and EDI-3 interpersonal problems (r = 0.6) and a negative correlation between Q-PAD self-esteem and well-being and EDI-3 ineffectiveness Composite (r=-0.7).

CONCLUSIONS

a substantial prevalence of ED symptoms and psychological distress among high school adolescents were recorded. These conditions are interrelated, suggesting the importance of addressing them comprehensively. Early detection is essential to improve treatment outcomes and to implement preventive strategies.

Thyroid dysfunction in children and adolescents affected by undernourished and overnourished eating disorders

Eating disorders (ED) are one of the most prevalent chronic disorders in adolescents and young adults, with a significantly increasing prevalence in younger children, particularly in girls. Even if obesity in essence is not framed as an eating disorder and has always been considered a separate pathology, ED and obesity could be considered part of a continuum. It has become evident that one condition can lead to another, such as binge eating disorder (BED) and bulimia nervosa, and that they share the same repercussions in terms of psychosocial, metabolic, and nutritional health. This narrative review aims to investigate the hypothalamic-pituitary-thyroid axis in undernourished and overnourished patients with ED, including obesity, in order to highlight the relationship between weight control and thyroid function and its effects and to consider therapeutic and preventive strategies in children and adolescents. Literature data report that thyroid alterations occur in patients with ED, both underweight and overweight, and represent a continuum of changes depending on the severity and time course of the disease involving the endocrine system. Considering the relevant role thyroid hormones (TH) play not only in energy expenditure (EE) but also in metabolic control and cardiovascular risks related to dysmetabolism and mood regulation, continuous monitoring of thyroid homeostasis in patients with ED is mandatory to prevent severe complications and to start early treatment when necessary.

Eating Disorders and Addictive Behaviors: Implications for Human Health

Eating disorders (EDs) are mental health diseases characterized by dysfunctional eating patterns, including restrictive eating, avoidance of foods, binge eating, and compensative behaviors to avoid weight increases and promote thinness (purging, vomiting, laxative/diuretics misuse, and compulsive exercise) [...].

Risk factors of disordered eating in adolescent girls from a community sample: a multidimensional approach

BACKGROUND

Eating disorders (ED) are severe, chronic, and complex in nature mental illnesses that are difficult to treat. One of the ways to stave off EDs is by screening among adolescents to preempt the development of clinical forms of ED in risk groups.

AIM

1) to investigate the prevalence of ED risk among adolescent girls and compare subgroups at high and low risk of ED; 2) to investigate using a multidimensional approach those variables that can interact with temperament and character traits to predict ED symptomatology.

METHODS

The cross-sectional observational self-report study of a community sample of adolescent girls 1217 years old (n=298; M=14.771.13) was carried out in the city of Ryazan, Russia. The Russian versions of Eating Attitudes Test and Cloningers Temperament and Character Inventory-Revised were used. In addition, an original questionnaire (Risk Factors of Eating Disorders) was developed. Regression models (to test for significant moderation) and path analysis (to test for significant mediations) were used.

RESULTS

Girls at risk of developing EDs are characterized by a heightened level of concern about weight and dissatisfaction with their body, tend to suffer from low self-directedness, higher novelty seeking and tendency to higher harm avoidance, display high alexithymia, experience self-distrust, negative emotionality and are dissatisfied with family relationships. They also suffer from low self-esteem and tend to be perfectionism and engage in risk behavior. Significant moderating effects were uncovered between the following ED risk factors: (1) self-distrust/risk behavior and BMI; (2) alexithymia/negative emotionality/self-esteem and cooperativeness; and (3) negative emotionality/risk behavior and self-transcendence. Family relationship dissatisfaction mediates the association between self-directedness/cooperativeness/self-transcendence and disordered eating.

CONCLUSION

There are various mutual influences between the numerous ED risk and prevention factors, which all together determine the paths between the predictors and final outcome.

Eating Disorder Attitudes and Body Self-Image of Urban Mediterranean Adolescents

BACKGROUND

Early detection tools for eating disorders play an essential role in their prevention. The aim of this study was to analyze different variables associated with the risk of eating disorders and their relation to anthropometric parameters, nutritional status and body self-image.

METHODS

The Eating Disorder Invetory-3 Referral Form (EDI-3 RF) and the Body Shape Questionnaire (BSQ) were administered to 809 adolescents (413 boys and 396 girls), aged 11 to 17 years, from three randomly chosen schools in a big Mediterranean city. Anthropometric measurements were taken following standardized methods. Overweight and obesity were determined according to the International Obesity Task Force (IOTF).

RESULTS

Overweight (23%) prevailed over obesity (9.37%). Girls registered a higher score in the Obsession for Thinness EDI-3 RF subscale and in the body dissatisfaction section of the BSQ. The only statistically significant differences in the Obsession for Thinness and Body Dissatisfaction levels among the different ages were seen in boys. In this series, body dissatisfaction assessed by the EDI-3 RF was not correlated with BSQ body dissatisfaction. Sex and age in adolescence determine the relationship between eating disorder attitudes and body shape dissatisfaction.

CONCLUSIONS

It is necessary to look for other parameters to investigate to determine body dissatisfaction.