Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity最新文献

Purpose: The relationship between dietary nutrient intake and metabolically healthy obesity (MHO) remains poorly understood. This study aimed to construct machine learning models to predict MHO based on dietary nutrient profiles and to identify the most influential nutrients contributing to this phenotype.

Methods: Data were derived from the U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2018. Forty-five dietary nutrients, along with demographic and lifestyle variables, were included in two predictive frameworks: a dietary-only model and a complete model. Feature preprocessing involved assessing mixture effects, removing multicollinear variables, addressing class imbalance, and selecting important predictors. Six machine learning algorithms-random forest (RF), light gradient-boosting machine, k-nearest neighbor, Naive Bayes, support vector machine, and eXtreme Gradient Boosting (XGBoost)-were developed and benchmarked to compare performance. Model interpretability was examined using SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME).

Results: A total of 8914 participants, including 475 classified as having MHO, were analyzed. The Random Forest model exhibited the best predictive performance in the complete model, achieving training and validation AUCs of 0.986 and 0.991, respectively. In contrast, XGBoost demonstrated superior performance in the dietary-only model, with AUCs of 0.971 and 0.988. SHAP and LIME analyses revealed that added vitamin B12, lycopene, caffeine, theobromine, and lutein/zeaxanthin were the strongest positive predictors in the complete model. When only dietary factors were considered, lycopene, lutein/zeaxanthin, magnesium, potassium, and selenium emerged as the most influential nutrients.

Conclusions: RF and XGBoost models provided the highest predictive accuracy for MHO using complete and dietary feature sets, respectively. The consistent findings from SHAP and LIME analyses emphasized lycopene and lutein/zeaxanthin as reliable and biologically relevant key predictors of metabolically healthy obesity.

Level of evidence: Level III, well-designed cohort or case-control analytic study.

Purpose: The growing use of social media has increased access to online health and nutrition information, which may influence individuals' eating behaviors. This study examined the relationship between digital healthy diet literacy, social media addiction, and eating behaviors among adults.

Methods: This cross-sectional study included 554 adults aged 18-64 years in Kırklareli, Türkiye. Data were collected through face-to-face interviews using a Personal Information Form, the Social Media Addiction Scale (SESMEB), the Bergen Social Media Addiction Scale (BSMAS), and the Digital Healthy Diet Literacy Scale (DHDL). Anthropometric measurements were obtained by the researchers.

Results: The participants' mean age was 31.5 ± 10.4 years; 52% were female and 43.5% university graduates. SESMEB and BSMAS scores were higher among younger, single, and more educated individuals but lower among obese participants (p < 0.05). DHDL scores were higher in those with higher education, regular exercise, and sufficient income, but lower in obese participants (p < 0.05). Significant relationships were found between all scales and social media use characteristics (number of accounts, duration, importance of likes, participation in nutrition groups, and exposure to advertisements). Strong positive correlations were observed among SESMEB, BSMAS, and DHDL scores.

Conclusions: Social media addiction and digital healthy diet literacy are inter-related and may influence eating behaviors. Enhancing digital health and nutrition literacy may help reduce negative effects of social media and promote healthier eating habits.

Level of evidence: Level III, cross-sectional analytic study.

This study employed a network analysis approach to model the complex interplay of risk and protective factors for body image dissatisfaction in young French women, with the objective of mapping the psychological system connecting these variables and identifying the most central factors. A sample of 233 female students completed an online questionnaire assessing 11 constructs, including risk factors like perfectionism, thin-ideal internalization, appearance comparison, and weight stigma, alongside protective factors such as self-compassion, intuitive eating, and body appreciation. This study also presents the first psychometric validation of the Physical Appearance Related Teasing Scale (PARTS) in the French language. A Gaussian Graphical Model (GGM) network analysis revealed that body dissatisfaction (BSQ-8C) has the highest strength and betweenness centrality, confirming its role as the core hub in the model's architecture and underscoring the relevance of the chosen variables for this study. The network showed strong direct positive links to body dissatisfaction from weight stigma (WSSQ) and appearance comparison (PACS-5), and strong negative links from the protective factors of body appreciation (BAS-2) and intuitive eating (IES-2). Weight-related teasing (PARTS) was established as a significant secondary risk factor through its robust connection with weight stigma. Sociocultural pressures (SATAQ-3) were identified as a critical bridging node, while variables such as self-compassion, social media use, and perfectionism occupied peripheral positions. This research advocates for a targeted, multi-component approach that actively works to dismantle the pillars of weight stigma and comparison while simultaneously building the distinct foundations of body appreciation and intuitive eating.Level of evidence; Level V, descriptive studiesOur manuscript describes a cross-sectional design that uses a network analysis approach to map the existing correlations between variables. As this methodology is a descriptive study and does not involve an intervention (ruling out Levels I & II) or a longitudinal/case-control design (ruling out Level III), it aligns with the journal's criteria for Level V.

Purpose: People living with obesity are susceptible to weight gain during periods of extreme stress. Identifying modifiable risk factors is crucial in regions affected by frequent conflict.

Methods: We therefore sent a survey to patients followed in a weight management clinic shortly after the 2023 onset of the Israel-Hamas war.

Results: Responses (n = 285) were collected for analysis a median of 58 days (IQR 48-58) after the conflict erupted and compared between subjects who did and did not experience acute, significant weight gain (≥ 3%). Median age was 57 (IQR 46-67) and 66.5% were female. Baseline median BMI was 33.2 kg/m² (IQR 29.8-39.0), and 67.6% were taking anti-obesity medications (AOMs). Roughly two-thirds reported reduced sleep quality and increased stress or anxiety. Approximately half reported both reduced exercise and more anxiety-driven eating, whereas roughly 40% reported consuming more sweets or snacks, and these behaviors were associated with significant weight gain, experienced by 25.4% of respondents. According to multivariate analysis, anxiety-driven eating and less exercise were associated with weight gain (OR 4.48, p < 0.001 and OR = 2.50, p = 0.020, respectively), whereas AOMs were protective (OR = 0.39, p = 0.015).

Conclusion: Given that one quarter of subjects with overweight or obesity reported significant weight gain within two months of the outbreak of war, and that we identified modifiable risk factors, emphasis must be placed on maintaining healthy exercise and eating behaviors with consideration of AOMs. Level of evidence IV- cross-sectional retrospective study.

Background: Binge-eating disorder (BED) frequently co-occurs with dissociative symptoms and psychiatric comorbidities, yet potential neurological underpinnings remain underexplored.

Case presentation: We report an 18-year-old female with BED presenting with frequent binge episodes accompanied by memory lapses and altered consciousness. Initially attributed to dissociation, comprehensive evaluation revealed previously undiagnosed absence epilepsy, confirmed by EEG and neuroimaging. Neuropsychological assessment demonstrated significant impairments in working memory, processing speed, and divided attention. Treatment with lamotrigine (200 mg/day) resulted in complete remission of binges occurring during absence seizures and substantial cognitive improvements across multiple domains.

Conclusions: This case highlights the critical importance of neurological evaluation in eating disorder patients presenting with altered consciousness or memory lapses. The temporal relationship between seizures and binge episodes, coupled with treatment response, suggests potential neurobiological mechanisms linking epileptic activity to disinhibited eating behaviors. Clinicians should maintain heightened awareness of possible epilepsy-eating disorder comorbidity and consider integrated treatment approaches addressing both neurological and psychiatric components.

Non-communicable diseases have become a global public health challenge, with excessive intake of sugar-sweetened beverages (SSBs) identified as a major dietary risk factor. To promote healthier consumption, front-of-package (FoP) nutrition labels has been widely implemented worldwide. Although China has not yet established a standardized FoP system, the Healthy China 2030 initiative demonstrates the government's willingness to implement FoP labeling strategies as part of its effort to improve nutrition literacy and encourage healthier food choices. However, limited research has explored how the visual design of FoP warning labels (WLs) affects consumer perception and behavioral intention. To address this gap, the present study employed a 2 × 2 between-subjects quasi-experiment among Chinese Generation Z consumers, manipulating color (black and red) and shape (octagon and shield) of WLs on SSBs. Three dependent variables were measured: perceived attractiveness, perceived healthfulness, and purchase intention. Results showed significant main and interaction effects across all outcomes: red-octagon WLs were most visually attractive, black-octagon WLs most effectively conveyed unhealthfulness, and black-shield WLs most strongly discouraged purchase intention. These findings demonstrate that color and shape jointly shape the perceptual and behavioral impact of FoP WLs. Theoretically, based on cue utilization theory and food label information processing models, this study conceptually explains how visual warning cues influence consumers' perceptions and purchase intentions, and provides practical insights for developing evidence-based FoP policies to reduce SSBs consumption in China.

Purpose: LGBTQ + people have shown health disparities compared to heterosexual and cisgender people in eating disorders. How these disparities are determined, however, is an understudied area. Through the use of a psychological mediation framework, this study aims to explore how daily heterosexist experiences related to one's LGBTQ + identity may determine eating disorder risk.

Methods: 376 LGBTQ + people from Italy responded to self-report questionnaires regarding daily heterosexist experiences, eating behaviors and associated factors in an online anonymous survey. Descriptive, bivariate and mediation analyses were conducted using the "PROCESS" macro, including distress scores for heterosexist experiences, emotion dysregulation, self-esteem, shame, and eating disorder risk, controlling for body-mass index, age and socioeconomic status.

Results: Statistically significant positive associations were found between distress related to heterosexist experiences, emotion dysregulation, shame and eating disorder risk. Mediation analyses found that the direct effect of heterosexist experiences on eating disorder risk was nonsignificant. The indirect effects of heterosexist experiences on eating disorder risk through emotion dysregulation (B = 0.041, β = 0.304, BootSE = 0.017, 95% CI [0.006, 0.078]) and low self-esteem (B = 0.092, β = 0.089, BootSE = 0.023, 95% CI [0.049, 0.145]) were significant. The indirect effect through shame was nonsignificant.

Conclusions: Heterosexist experiences seem to have significant indirect effects on eating disorder risk through emotion dysregulation and low self-esteem. Policies for reducing harassment, discrimination and violence related to sexual orientation and gender identity in institutional, organizational and social contexts may help prevent negative health outcomes in LGBT + people. Clinical contexts may benefit from considering the effects of minority stress.

Level of evidence: Level 3-Observational cross-sectional study.

Obesity is a chronic relapsing disease associated with increased morbidity and mortality and reduced quality of life. The present GRADE-based guidelines have been commissioned by the Italian Society of Obesity (SIO) by the Italian National Health Institute to provide evidence-based recommendations on obesity diagnosis and treatment. The panel identified 13 clinical questions, organised into four domains: A. diagnostic criteria (4 questions); B. medical nutrition therapy (4 questions); C. pharmacological, surgical, and endoscopic treatments (4 questions); and D. miscellaneous (1 question). The expert panel recommends adopting at least one anthropometric index of abdominal visceral fat distribution beyond body mass index (BMI) for better clinical risk stratification. A structured lifestyle intervention (i.e., medical-nutritional treatment-MNT), preferably based on cognitive-behavioural therapeutic approach and including physical activity and a balanced diet, should be offered to all subjects living with obesity. Pharmacological or surgical treatment should be offered in addition to MNT when MNT is unable to reach clinical goals. In particular, pharmacological treatment should be considered as the preferred option for subjects with BMI > 27 kg/m² with comorbidities, and for those with BMI 30-39.9 kg/m², based on individual therapeutic goals and needs, adopting surgical treatment in selected cases or in case of OMM failure to reach clinical goals. For subjects with a BMI > 40 kg/m², surgical treatment may be considered conversely as a preferable option. Reduction of at least 10% of the initial body weight is associated with a better quality of life and a reduced risk of incident depression. The current guideline is endorsed by the Italian National Institute of Health, providing the new, updated clinical and legal reference for professionals involved in the management of subjects living with obesity in Italy.

Background: Several versions of the Nine-Item ARFID Screen (NIAS) have been developed in recent years to adapt the questionnaire to different languages and clinical samples. An Italian version is still lacking. From the perspective of a highly specialized Eating Disorder Unit in Milano, ARFID's phenomenology may be mimicked by other peculiar dietary habits or other eating disorders. Screening for this pathological conduct is necessary to assess a correct treatment frame for potentially serious disordered feeding behavior.

Methods: Clinical experts in Psychiatry, Psychology, and Dietetics collaborated in the translation process. The whole methodology involved several steps: (I) Italian translation; (II) backward translation from Italian to English; (III) assessing the conformity between the original English and retranslated questionnaires; (IV) testing the translated version on patients; (V) evaluating the degree of comprehensibility of the translated scale.

Key points: The Italian version of the NIAS (NIAS-IT) was administered online to 23 consecutive outpatients of a Dietetic department. For the most part, the sample of Italian native speakers found the translated version of the questionnaire to be comprehensible and easy to read.

Conclusions: The Italian version of the NIAS is perfectly comprehensible and can be applied to the Italian population for both clinical and research purposes.

Level of evidence: Level IV, evidence obtained from multiple time series with or without intervention.

Purpose: This study examined the association between dopaminergic genetic variants and environmental factors in young children with disordered eating and their parents.

Methods: Single nucleotide polymorphisms of DRD2 (rs1800497) and COMT (rs4680) were analyzed in 57 undereating, 51 overeating, and 44 control children, and in their parents. The quality of mother-child interactions during feeding was evaluated by the Italian adaptation of the scale for the assessment of feeding interaction. Child externalizing, internalizing and dysregulation symptoms were assessed with the child behavior checklist, and parental psychological distress with the General Severity Index. Data were analyzed by χ2 tests, ANOVAs, and odds ratios.

Results: Children's undereating was associated with their DRD2 polymorphism; under- and over-eating patterns with DRD2 and COMT polymorphisms, including a gene x gene interaction. Eating behavior was strongly associated with the quality of mother-child interaction but not associated with parent's genotypes. Finally, parent's psychological distress correlated with children's eating behavior but not with genetic variables.

Conclusions: Our findings suggest that DRD2 and COMT polymorphisms contribute to early vulnerability to disordered eating, while mother-child relational dynamics act independently of parental genetic factors. Level of evidence III Evidence obtained from well-designed case-control analytic study.