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

Purpose: Observational studies suggest white matter (WM) microstructural anomalies are linked to bulimia nervosa (BN), but a direct causal relationship remains unestablished. This study aimed to investigate the causal impact of BN on WM microstructure.

Methods: We analyzed genome-wide association study (GWAS) summary data from 2442 individuals to identify genetically predicted BN. Diffusion MRI were obtained from the UK Biobank. After assessing instrumental variable validity, we conducted Mendelian randomization (MR) using inverse variance weighting (IVW) as the primary method, followed by pleiotropy and heterogeneity tests.

Results: The MR analysis from BN to brain imaging-derived phenotypes showed that BN had significant causal effects on a union set of nine tracts (including a total of 18 image-derived phenotypes) (IVW, P < 0.05): brainstem tracts (pontine crossing tract, bilateral medial lemniscus, left superior cerebellar peduncle, and middle cerebellar peduncle), sensory-related tracts (right retrolenticular part of the internal capsule and left inferior longitudinal fasciculus), and emotion-related tracts (left anterior corona radiata and right cingulum hippocampus).

Conclusion: This study revealed that BN has a causal effect on WM microstructure, which extends the reports of association to causation for WM and BN. These causal effects may explain the deficits in feeding, taste, vision, and emotion regulation that are often observed in patients with BN. Level of evidence III well-designed cohort analytic study.

Objective: Studies have reported associations between perinatal factors (obstetric and neonatal factors) and later eating disorder risk. However, previous findings have been partly conflicting. Here, we analyzed associations between perinatal factors and disordered eating in a large cohort of Finnish children and adolescents.

Method: The participants were 8- to 14-year-old children and adolescents (N = 11,357) from The Finnish Health in Teens study. Disordered eating was assessed using the Children's Eating Attitudes Test (ChEAT). Perinatal data were obtained from the Finnish Birth Registry. Perinatal variables were initially analyzed using Chi-square analyses and linear regressions. Variables associated with disordered eating (p < .10) were entered into a multinomial logistic regression model. The regression analysis was conducted both including and excluding maternal BMI, as this information was missing for > 80% of the participants.

Results: Of the participants, 56.6% reported disordered eating (ChEAT score ≥ 11) or partial disordered eating (1-10) symptoms. Including maternal BMI in the analyses (n = 1921), higher levels of disordered eating were independently associated with maternal pre-pregnancy BMI (OR 1.07, 95% CI [1.02, 1.12]), maternal smoking during pregnancy (OR 2.64, 95% CI [1.49, 4.68]), urgent or emergency cesarean birth (OR 2.16, 95% CI [1.10, 4.05]). Assisted reproduction was associated with lower levels of disordered eating (OR 0.39, 95% CI [0.20, 0.76]).

Discussion: The results suggest that pregnancy and childbirth are vulnerable developmental periods, associated with later eating pathology. Further studies disentangling genetic and environmental mechanisms of associations between perinatal factors and later eating pathology are needed.

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

Purpose: This study examined how weight and race impact mental health stigma, weight stigma, perceived need for treatment, and perceived severity of anorexia nervosa We experimentally manipulated weight and race, replicating and extending Varnado-Sullivan et al. (Eat Weight Disord 25:601-608, 2020).

Methods: 336 participants were recruited from Prolific. Participants self-reported pre-existing exposure to and attitudes regarding mental illness. Participants were randomly assigned to read an anorexia nervosa vignette that manipulated race (White or Black) and weight ("underweight" or "obese"). Participants self-reported attitudes about the woman in the vignette (mental health stigma), weight stigma, and perceived need for treatment and severity of the condition (mental health literacy). We hypothesized that greater mental health stigma, weight stigma, and lower mental health literacy would be present for Black and higher-weight vignettes, controlling for covariates.

Results: Analyses found that only vignette weight significantly predicted mental health stigma, mental health literacy, and weight stigma; vignette race did not significantly predict mental health stigma, mental health literacy, or weight stigma. A significant Race x Weight interaction predicted weight stigma and two mental health stigma items.

Conclusion: Replicating and extending Varnado-Sullivan et al. (Varnado-Sullivan et al. in Eat Weight Disord 25:601-608, 2020), we found weight-based bias for those with eating disorders, with some interactions between weight and race on weight stigma.

Purpose: The aim of this study was to adapt the Orthorexia Nervosa Inventory for use in Hungarian (ONI-Hu), and explore its associations with disordered eating, intuitive eating and mental health measures.

Methods: 944 participants completed a test battery, including ONI-Hu, the Three Factor Eating Questionnaire, the Intuitive Eating Scale-2 and the Mental Health Continuum Short-Form. Confirmatory Factor Analysis (CFA) was used to assess the validity of ONI-Hu. Correlation and regression analyses were conducted to evaluate the convergent and discriminant validity.

Results: CFA confirmed the original three-factor structure of ONI-Hu. Positive associations were found between ONI scores and restrictive eating behaviors, and negative associations with intuitive eating measures. Furthermore, the ONI composite factor score displayed no significant relationship with mental health indicators.

Conclusions: ONI-Hu exhibits strong reliability and validity, and provides a deeper understanding of ON. Results suggest that orthorexic behaviors may serve as a coping mechanism, offering an illusion of control and emotional security. Inconsistent findings about the relationship between ON tendencies and mental health indicators propose that the sense of control might provide a false sense of well-being to the individual, distorting their perceptions of their overall health. Level of evidence Level V, descriptive cross-sectional study.

Background: Eating disorders (EDs) have traditionally been viewed as a Western phenomenon, but their prevalence in South Asia has risen due to urbanization, globalization, and Westernized beauty ideals. This systematic analysis examines trends and prevalence of Anorexia nervosa (AN) and Bulimia nervosa (BN) using the Global Burden of Disease (GBD) data from 1990 to 2021.

Methods: This analysis used data from the GBD study on age-standardized prevalence rates (ASPRs) for AN and BN, as well as their total percentage changes (TPCs) from 1990 to 2021. Trends were analyzed using Joinpoint regression to identify changes over time and calculate annual percent changes (APCs) and average annual percent changes (AAPCs). Geospatial patterns and temporal changes were visualized using QGIS software. The correlation between the Sociodemographic Index (SDI) and the DALY rate was assessed using R software.

Results: The ASPR of EDs increased significantly from 1990 to 2021, with BN peaking in the 20-24 age group and AN in the 15-19 and 20-24 age groups. Females exhibited the highest rates of increase, while notable rises were also observed in males. Bhutan recorded the highest ASPR for both AN and BN, with varying temporal percentage changes across countries. A significant positive correlation was found between the SDI and DALY rates across 21 global regions, with anorexia nervosa showing the strongest correlation (r = 0.75, p < 0.001).

Conclusions: The rising burden of EDs in South Asia underscores an urgent need for culturally sensitive prevention strategies and public health policies. Targeted interventions addressing sociocultural drivers are essential to mitigate the growing impact of EDs in this region.

Level of evidence: Level V, Descriptive study.

Purpose: While the impact of Covid-19 lockdowns on family dynamics and eating behaviors has been widely studied, there is limited and conflicting evidence regarding families of children and adolescents with restrictive eating disorders (EDs). This study examines differences in eating psychopathology and perceptions of family functioning in pediatric patients with anorexia nervosa (AN; restrictive and atypical) and avoidant/restrictive food intake disorder (ARFID) before and after the pandemic.

Methods: A total of 640 children and adolescents with restrictive EDs and their parents, assessed from January 2018 to December 2022, were grouped into pre-Covid-19, Covid-19, and post-Covid-19 periods. Measures included the Family Assessment Device, the Eating Disorders Inventory-III, and the Eating Disorders Questionnaire in Childhood. Data were analyzed using ANOVA (p < .05).

Results: Children and adolescents with AN showed greater difficulties compared to children and adolescents with ARFID both in family functioning and eating psychopathology. In particular, children with AN in the COVID-19 group exhibited higher scores in Affective and Mood Disorders, Obsessive-Compulsive Disorder, Pica, and Selective Eating compared to the pre-Covid-19 group. Adolescents with AN reported worse eating psychopathology in Post-COVID-19 group compared to others.

Conclusions: Patients with restrictive EDs show more dysfunctional family functioning and greater eating psychopathology after the pandemic compared to preceding periods but results varied by age and diagnosis. These findings highlight the need for diagnosis-specific, tailored interventions to address the evolving clinical and family dynamics in pediatric ED populations.

Level of evidence: Level V Evidence obtained from a cross-sectional descriptive study.

Purpose: Cisgender sexual minority adults are at elevated risk for eating disorders; however, community norms for certain eating disorder measures are lacking for this population. This study aimed to establish community norms for the Eating Pathology Symptom Inventory (EPSI) among cisgender gay, lesbian, bisexual + (individuals who identify as bisexual or pansexual; bi +) adults.

Methods: Cross-sectional data were analyzed from 2062 cisgender participants-including 925 gay men, 573 lesbian women, 116 bi + men, and 448 bi + women-enrolled in The PRIDE Study, a national longitudinal cohort of sexual and gender minority adults in the United States. Participants completed the EPSI, and descriptive statistics were calculated for the eight EPSI scales.

Results: We report mean scores, standard deviations, medians, interquartile ranges, and percentile ranks for the eight EPSI scales within cisgender sexual minority populations. Distinct patterns of eating-pathology symptoms were evidenced among the cisgender sexual minority groups. Cisgender bi + women exhibited the highest scores for Body Dissatisfaction, Binge Eating, and Restricting compared to other groups, whereas cisgender bi + men reported the highest scores for Excessive Exercise. Cisgender gay men had significantly higher scores for Muscle Building and Negative Attitudes Toward Obesity compared to other groups.

Conclusion: These findings offer valuable benchmarks for interpreting EPSI scores in the assessment and treatment of eating disorders among cisgender sexual minority individuals.

Level of evidence: Level V: based on descriptive results.

Background: Previous observational studies have indicated that circulating micronutrients may influence obesity risk. This study aimed to explore the causal relationship between micronutrient levels and obesity through multivariable Mendelian randomization (MR) analysis.

Methods: Single nucleotide polymorphisms (SNPs) significantly associated with 15 micronutrients (selenium, zinc, copper, calcium, beta-carotene, folate, iron, magnesium, potassium, and vitamins A, B6, B12, C, D, and E) from published genome-wide association studies (GWAS) were used as instrumental variables (IVs). Three obesity-related datasets were obtained from the GWAS. Inverse variance weighted (IVW) is the main method used for MR analysis. Leave-one-out analysis, MR-Pleiotropy Residual Sum and Outlier method (MR-PRESSO), weighted median, and MR-Egger method were used to assess pleiotropy and heterogeneity.

Results: Genetically predicted levels of circulating selenium and calcium are causally related to the risk of obesity (calcium odds ratio [OR]: 1.478, 95% confidence interval [CI] 1.128-1.935, p = 0.005; selenium OR: 1.478, 95% CI 1.128-1.935, p = 0.005). Multivariate MR analysis suggested a causal relationship between circulating selenium and calcium levels and obesity risk (calcium OR: 1.625, 95% CI 1.260-2.097; selenium OR: 1.080, 95% CI 1.003-1.163, p = 0.041). The p-value obtained in the Cochrane Q test, MR-Egger intercept test, and MR-PRESSO were > 0.05, suggesting no significant evidence of pleiotropy or heterogeneity.

Conclusion: Our study revealed, for the first time, a positive correlation between elevated circulating calcium and selenium levels and an increased obesity risk. These findings provide valuable insights into obesity's underlying mechanisms. Nevertheless, further large-scale clinical studies are required to confirm our results.

Level of evidence: Level III, Mendelian randomization.

Anorexia Nervosa (AN) is a mental health condition marked by reduced food consumption, intense fear of weight gain, and distorted body experience. Virtual Reality (VR)-based techniques-i.e., Body-Swapping and Mirror Exposure techniques-offer promising avenues for addressing body disturbance in AN, allowing patients to embody virtual bodies varying in size and shape. We used a single-subject experimental design to explore the potential of virtual reality multisensory experiences for mitigating body disturbance in AN. We examine the case of a 24-year-old female hospitalized with restrictive Anorexia Nervosa who underwent a novel body-focused VR intervention alongside the hospital's standard care. The intervention included six bi-weekly sessions, wherein the patient was immersed in a VR environment that allowed her to embody a virtual body that matched a healthy weight range. Through interactions with a virtual mirror, the patient was encouraged to concentrate on the body's positive aspects and functional abilities, thinking about its significance in her past, current, and anticipated future activities (Functional Mirror Exposure). The patient reported reduced body dissatisfaction, negative beliefs, and body misperception. These changes endorse using immersive, multisensory, and embodied experiences to alter body consciousness and body-self relationship. Results preliminary support the transformative potential of VR in improving traditional approaches to assess and alter body disturbance.Level of evidence Level IV.