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

Purpose: The aim of this study was to analyze data of children and adolescents in Germany insured according to legal requirements (statutorily insured) regarding epidemiology, comorbidities, and care of bulimia nervosa (BN) pre- vs. intra-COVID-19 pandemic.

Methods: The study is based on anonymized claims data of 10-17.9 years old children and adolescents statutorily insured in Germany from the InGef Berlin GmbH research database. The database combines data of more than 50 statutory health insurances and is representative of the German population. Prevalence, (quarterly) incidence, comorbidities and in- and outpatient treatment of BN (ICD-10: F50.2/F50.3) pre-COVID (01/2018-03/2020; N = 282,711) vs. intra-COVID (04/2020-12/2021; N = 282,738) was compared using descriptives and χ² tests, Welch-tests and interrupted time series analysis. The analysis was stratified by age groups (children: 10-13 years; adolescents: 14-17 years).

Results: Prevalence of BN was 0.09% pre-COVID and 0.07% intra-COVID (OR = 0.78 [0.65, 0.93]). After pandemic onset, a positive trend in the quarterly incidence among adolescents was observed (p = .016). Outpatient visits to general practitioners decreased (OR = 0.59 [0.35, 0.98]).

Conclusion: The observed decline in diagnosed and treated BN cases and the positive trend in quarterly incidence could be attributed to an increase in unregistered cases due to the overburdened care situation that emerged with the onset of the COVID-19 pandemic. Researchers and healthcare providers need to be aware of the potential for a backlash and deterioration/chronification of BN symptoms in children and adolescents. Level of evidence No level of evidence.

Purpose: The Modified Weight Bias Internalization Scale (WBIS-M) is perhaps the most frequently used measure of internalised weight bias and has growing support for its psychometric properties. However, there is a lack of clarity regarding how many items are necessary for adequate interpretation of the WBIS-M and limited study of internalised weight bias in young adults. The aims of this study are to evaluate different versions of the WBIS-M, assessing structural and convergent validity.

Methods: The current study recruited 205 university students (aged 18-46, mean body mass index = 22.60 kg/m²) in the UK and examined the factor structure, reliability, and convergent validity of the WBIS-M, looking at 11-item, 10-item, and 9-item versions.

Results: Confirmatory factor analysis suggested that a 10-item version of the WBIS-M showed acceptable structural validity and expected correlations with relevant constructs (depression, anxiety, weight status, and eating pathology). Estimates of internal consistency reliability were high for all three versions.

Conclusion: Given potential problems with one item, the 10-item WBIS-M presents a measure of internalised weight bias with sound psychometric properties in young adults.

Level of evidence: Level III, well-designed cohort study.

Orthorexia nervosa (OrNe) is an eating disorder characterised by a pathological interest and preoccupation with healthy foods and a healthy diet. Evidence suggests that tendencies towards OrNe may be prevalent across diet groups, and this is particularly the case in vegans and vegetarians. Our previous work has identified that alongside individual differences in obsessive compulsiveness and perfectionism, cognitive biases (attentional preference for healthy-related cues) are associated with OrNe, whereas explicit identity (as a vegan/vegetarian) is only associated with a healthy orthorexia form. No work has assessed whether one's known identity (explicit identity) or that form of identity which is based on fast acting cognitive associations (implicit identity) further differentiate healthy orthorexia from OrNe tendencies in addition to compulsiveness and perfectionism. One hundred and forty-four self-identified vegans (n = 45), vegetarians (n = 50) and meat-eaters (omnivores) (n = 49) (66 females, 74 males, 4 non-binary; M age = 35.09) completed measures of current hunger status, obsessive compulsivity, perfectionism, the Teruel Orthorexia Scale, perceived identity centrality as a vegan/vegetarian (explicit identity) and a "self as vegan/vegetarian" implicit association test (implicit identity). Results showed increased orthorexia tendencies in both vegans and vegetarians compared to meat eaters (omnivores) but only in terms of healthy orthorexia. In addition, no differences were shown for OrNe suggesting the diet type is not influential in pathological orthorexia. Explicit identity and current hunger status were both shown to be associated with healthy orthorexia and not OrNe. Implicit identity as a vegan/vegetarian was unrelated to both dimensions, while compulsiveness and perfectionism predicted OrNe. Despite individuals implicitly associating the self with being a vegan/vegetarian, this identity does not serve as a maker of orthorexia nervosa.

Purpose: To examine the psychometric characteristics of the Italian language versions of the child eating disorder examination (ChEDE) interview and child eating disorder examination questionnaire (ChEDE-Q).

Methods: ChEDE (from EDE 17th edition) and ChEDE-Q were first translated, and then administered to 147 patients with eating disorders under the age of 18, along with 80 age-matched controls. Their internal consistency (Cronbach alpha), inter-rater reliability (Spearman rho), short-term (7-23 days) test-retest reliability (Spearman rho), and criterion validity (group differences by Mann-Whitney U) were evaluated.

Results: Patients with eating disorders displayed significantly higher ChEDE/ChEDE-Q scores than age-matched controls, demonstrating the adequate criterion validity of the instrument (all subscales and global scores significant at p < 0.001). Internal consistency was high for all original ChEDE/ChEDE-Q subscales (minimum Cronbach alpha 0.752), apart from Eating Concerns (minimum Cronbach alpha 0.591). Inter-rater reliability was excellent for global ChEDE/ChEDE-Q scores and each subscale (minimum Spearman rho 0.999). Test-retest reliability was excellent for global ChEDE/ChEDE-Q scores and each subscale (minimum Spearman rho 0.791).

Conclusions: The Italian versions of the ChEDE interview and ChEDE-Q exhibited excellent psychometric properties and may, therefore, be recommended for the assessment of Italian patients with eating disorders less than 18 years old, both in clinical practice and research settings. Level of evidence III evidence obtained from cohort or case-control analytic studies.

Purpose: This study aimed to understand the relationship between night eating symptoms, chronotype, and depressive symptoms among Italian university students.

Methods: The study assessed 905 students using self-report questionnaires, including the night eating questionnaire (NEQ), the Morningness-Eveningness Questionnaire (MEQ), and the Beck depression Inventory (BDI). The correlation between variables was analyzed using Pearson correlation analysis, and mediation analysis was conducted using SPSS PROCESS Macro to estimate the association between variables.

Results: Among the students' sample, the mean age was 25.54 years, with an age range between 18 and 35, 68.7% were women, 15% were morning types with MEQ scores of 59 and above, 64.8% were intermediate types with MEQ scores between 42 and 58, 20.3% were evening types with MEQ scores of 41 and below, and 3.6% reached the criteria for night eating syndrome (NES). There was an inverse correlation between MEQ and BDI scores, higher BDI and lower MEQ scores, and a significant inverse correlation between NEQ and MEQ scores, higher NEQ and lower MEQ scores. Individuals with higher NEQ scores had higher BDI scores, indicating a significant positive correlation between night eating symptoms and depressive symptoms. MEQ had a statistically significant negative direct effect on BDI and NEQ variables. The direct impact of BDI on NEQ was positive and statistically significant. The indirect negative effect of MEQ on NEQ through BDI was also determined to be statistically significant.

Conclusion: The study found that depressive symptoms played a significant mediating role in the link between eveningness and night eating, with a partial mediation. Evening chronotype was associated with an elevated night eating score. The findings emphasize the importance of chronotherapeutic approaches in treating night eating. However, further research is necessary to elucidate the intricate relationship between these variables.

Level of evidence: Level III. Evidence obtained from well-designed cohort or case-control analytic studies.

Purpose: This study aimed to develop and evaluate the Newbridge Prognosis Score (NPS), a prognostic questionnaire designed for use by a multidisciplinary team (MDT) when an anorexia nervosa (AN) patient is discharged from an inpatient treatment facility for eating disorders. The tool integrates the collective judgment of MDT members to predict short-term outcomes in adolescents with AN, focusing on physical, psychological, and behavioural factors and systematically assessing psychopathology, weight, and continued treatment needs. This information is intended to guide individualized community support, enhance post-discharge recovery, and aid in the allocation of limited community-based resources.

Methods: A group of adolescent girls and boys undergoing inpatient treatment for AN participated in the study. In addition, a matched control sub-sample was created. Upon discharge, the multidisciplinary team scored the Newbridge Prognosis Score (NPS), and follow-up data were collected 6 months later from the young person and/or their parents or carers.

Results: The NPS significantly correlates with key recovery items, such as weight maintenance, lower eating disorder psychopathology, subsequent need for readmission and engagement in follow-up. Higher NPS scores predict poorer outcomes, such as more severe psychopathology, lower weight or weight loss and higher readmission risk at follow-up. Psychological factors are strong predictors of post-discharge prognosis, with the suggestion that those sufferers may require enhanced psychological support. The NPS is more effective at predicting long-term readmission risk than short-term outcomes. However, the NPS explained only a proportion of the variance in these outcomes and sensitivity in predicting readmission within the matched control sample was mixed.

Conclusions: The NPS shows promise as a potential tool for predicting short-term outcomes following AN treatment. While promising, further refinement of the tool is needed, prior to being validated for use in clinical practice.

Level of evidence: Level III. Evidence obtained from a well-designed cohort or case-controlled analytic studies.

Objectives: Diverse analysis has analyzed the potential efficacy of consuming foods created through the fermentation of dairy in mitigating abdominal obesity. The current meta-analysis aims to determine the impacts of consuming fermented dairy foods and the occurrence of abdominal obesity.

Methods: Web of Science, PubMed, and Scopus databases were queried for records published before January 13, 2023, to investigate proportionate cohort studies. We employed a random-effects model to appraise the relative risk (RR); effect size was assessed through the 95% confidence interval (CI). Additionally, a one-stage dose-response analysis was executed, quality assessment was conducted through the ROBINS-E tool.

Results: Consequently, five publications, comprising 41,430 cases, were included as selected studies. The pooled effect shows an effect on the abdominal obesity risk; however, the effect was not significant. Subgroup analyses revealed a potential risk reduction effect in high- and low-fat and fermented dairy productions, although the findings were not statistically significant. Furthermore, the dose-response analysis indicated a linear decrease in risk with increasing consumption of high-fat fermented yogurt, with an HR of 0.84 (95% CI 0.71, 0.99) by 8 servings/week and an HR of 0.37 (95% CI 0.19, 0.71) by 21 servings/week.

Conclusion: These findings imply the potential effectiveness of fermented dairy products, particularly high-fat yogurt, in diminishing the obesity risk. However, further research addressing the limitations of previous studies is essential to confirm these results. Evidence-based medicine level: No level of evidence: Level of evidence III. PROSPERO registration number: CRD42023387538 ( http://www.crd.york.ac.uk/PROSPERO ).

Introduction: Non-suicidal self-injury (NSSI) is frequent in eating disorders (ED). The aim of this study was to describe NSSI among subjects hospitalised for anorexia nervosa (AN) who self-harm and factors associated with NSSI in this population.

Methods: This study was part of a larger French longitudinal multi-centre study. Two hundred and two women with AN were recruited from inpatient treatment facilities for ED from 2009 to 2011. All participants fulfilled the DSM-5 diagnostic criteria of AN. Subjects with and without NSSI were compared for clinical characteristics and comorbidities in bivariate analyses. Logistic regression analysis was then used to identify factors associated with NSSI.

Results: The mean age of the sample was 20.8 years (± 6.6). The mean BMI was 14.3 (± 1.5). Overall 36.1% had self-harmed in the past 6 months. The main factors that triggered NSSI were a feeling of physical or psychological unease (45.2%), feelings of anger (24.7%), an attempt to relieve discomfort (19.2%), and low self-esteem (16.4%). Lifetime major depressive disorder, suicide attempts and eating concerns were independently associated with NSSI.

Discussion: ED symptoms were linked to NSSI, but psychiatric history also played a key role. This is consistent with hypotheses of common underlying transdiagnostic mechanisms linking emotional dysregulation to NSSI and ED.

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

Purpose: Anorexia nervosa (AN) is a major concern in adolescents. Attachment problems contribute to its pathogenesis and maintenance. This research explores the relationship between parent-daughter emotional dyssynchrony and the psychopathology of AN daughters.

Methods: One hundred and fourteen female adolescents with AN and their parents participated in this study. The daughters completed the youth self-report (YSR) and other self-report measures of personality, eating, and general psychopathology. The parents completed the Child Behavior Checklist (CBCL). The YSR and CBCL ratings were compared and the difference was considered a measure of emotional dyssynchrony. Dyssynchrony scores were correlated with daughters' personality and psychopathology.

Results: Mothers scored lower on 15/21 (71%), and fathers scored lower on 11/21 (52%). Mothers scored higher than fathers did in thought problems. Mothers' dyssynchrony was positively related to their daughters' harm avoidance and negatively related to their self-directedness. Both parents' dyssynchrony correlated with their daughters' eating habits and general psychopathology. Dyssynchrony in each psychopathological measure of YSR was positively correlated with specific daughters' psychopathological traits.

Conclusions: Parents' perceptions underestimate the suffering of adolescents with AN. Mothers' perception was worse than that of fathers, possibly because of greater overinvolvement. Parent-daughter dyssynchrony is largely related to daughters' psychopathology. This cross-sectional study could not confirm whether dyssynchrony contributed to the onset of AN or follows it. Interventions that promote emotional synchronization may aid in the treatment of adolescents with AN.

Level of evidence: III.