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

Purpose: This study examined whether eating disorder (ED) psychopathology related to weight loss medication and over-the-counter weight loss supplement use over time in women. It was hypothesized that ED psychopathology at baseline would relate to the following 6-months later: (1) use of any weight loss medications or supplements; and specific use of: (2) over-the-counter weight loss supplements, (3) prescription weight loss medications, (4) glucagon-like peptide 1 (GLP-1) agonist medications used for weight loss.

Methods: Women in the United States were recruited for a 6-month long online study. Questionnaire data were provided, including the 7-item version of the Eating Disorder Examination Questionnaire.

Results: Baseline ED psychopathology was related to use of weight loss medications and supplements 6-months later, controlling for baseline use and body mass index (BMI). Analyses found greater odds of using over-the-counter weight loss supplements, prescription weight loss medications, and GLP-1 medications, at 6 months associated with higher baseline ED psychopathology, controlling for baseline weight loss medication/supplement use and BMI.

Conclusion: Medications such as GLP-1s can benefit chronic disease management when used appropriately but these, and other weight loss medications and supplements, may also be appealing to those with ED psychopathology to promote restriction and weight loss. ED symptom screening is important prior to, and during, medication use. These data are relevant for prescribers and suggest that evaluation of ED symptoms, especially "atypical" anorexia nervosa presentations, may be warranted among those seeking weight loss medications.

Level of evidence: Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.

Purpose: This study aimed to translate and validate the Arabic version of the Orthorexia Nervosa Inventory (ONI) scale to assess orthorexia nervosa (OrNe) among young Arabic-speaking adults in the UAE and explore the relationship between OrNe and various sociodemographic factors.

Methods: A total of 625 young adult participants (88.2% female) completed a questionnaire comprising the ONI scale and sociodemographic questions. The study assessed internal reliability using Cronbach's α, external reliability using intraclass correlation coefficient (ICC), content validity using a panel of 12 experts, Known-Group validity using associations between OrNe classification and demographics, and structural validity using confirmatory factor analysis.

Results: The Arabic ONI scale showed high internal (Cronbach's α = 0.934) and external (ICC = 0.849) reliability. Content validity was excellent (scale-level content validity index = 0.96). Vegetarians had significantly higher ONI scores, indicating good Known-Group validity. The model fit indices (χ²/df = 1.663, comparative fit index = 0.993, Tucker-Lewis index = 0.992, goodness-of-fit index = 0.989, root mean square error of approximation = 0.033, standardized root mean square residual = 0.049) reflected excellent structural validity.

Conclusions: The Arabic ONI scale is a reliable and valid tool for assessing OrNe tendencies in young Arabic-speaking adults. Future studies should explore its applicability to broader populations and investigate predictors of OrNe tendencies.

Level of evidence: Level V, descriptive cross-sectional study.

Purpose: Based on the presence of early satiety in anorexia nervosa (AN), which may delay recovery, and given the dramatic impact of GLP-1 and GIP analog treatment on satiety and weight reduction in obesity by diminishing the sensation of hunger, we initiated this cross-sectional pilot study to explore fasting incretin levels in AN and to identify possible correlations between these hormones and psychiatric symptoms.

Methods: 17 female subjects aged 18-35 were enrolled; 10 previously diagnosed with AN (5 weight restored, 5 non-weight restored) and 7 healthy controls (HC). Fasting blood samples were analyzed for incretin levels using ELISA. Psychiatric symptoms were evaluated using self-assessment scales for eating disorders (EDI-3, EDE-Q), anxiety (STAI-S + T), depression (MADRS-S), and obsessive-compulsive disorder (OCI-R).

Results: Subjects with AN scored overall higher on psychiatric scales, indicating poorer psychological well-being than HC. In non-weight restored AN (non-WRAN) subjects both serum GLP-1 levels (29 (15-85) vs 16 (15-21) pg/mL; p = 0.048) as well as serum GIP levels (37 (14-163) vs 5 (2-58) pmol/L; p = 0.048) were elevated compared to HC. No differences were found in glucagon or PYY levels between groups. A strong correlation between serum GLP-1 levels and EDI-perfectionism independent of BMI (r = 0.768, p = 0.001) was found in the entire group.

Conclusions: Independent of BMI, GLP-1 levels were associated with perfectionism, a typical characteristic of AN. Fasting GLP-1 levels were elevated in subjects with non-WRAN. Elevated GLP-1 levels may perpetuate AN symptoms, emphasizing the need for further research into their role in the metabolic and psychiatric dimensions of AN.

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

Introduction: Eating disorders (EDs) often emerge in adolescence and are influenced by family factors. Parental eating attitudes, including orthorexic tendencies, may be associated with adolescent ED severity. We examined parental orthorexic tendencies, cognitive rigidity, and nutritional knowledge in relation to adolescents' ED symptoms.

Methods: The sample comprised 59 adolescents (93.2% female; mean age = 18.34 ± 3.78 years) and their parents (36 dyads; 23 single parents). Parents completed measures of orthorexia (ORTO-R), cognitive rigidity (D-FLEX), and an ad hoc nutritional knowledge questionnaire; adolescents completed the EDE-Q. Analyses were conducted in the full sample and repeated in anorexia nervosa (AN).

Results: In the full sample, higher maternal ORTO-R scores were associated with greater EDE-Q restraint (β = 0.29, p = 0.042) and shape concern (β = 0.31, p = 0.030). In fathers, older age was associated with adolescents' shape (β = 0.32, p = 0.037) and weight concerns (β = 0.36, p = 0.018), whereas paternal ORTO-R was not significant. Mothers showed higher nutritional knowledge than fathers (U = 821.0, p = 0.013). No parent-child concordance emerged for BMI or eating psychopathology. Associations were no longer significant in AN-only analyses.

Conclusion: Parental orthorexic tendencies showed small associations with adolescent ED severity in the full sample, with limited robustness in AN. Findings are preliminary and warrant replication in larger diagnostically stratified cohorts.

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

Orthorexia nervosa (ON) is characterised by an excessive preoccupation with eating healthy foods. This disorder shares similarities with various pathological conditions, including anorexia nervosa and addictive behaviours. This research aimed to determine whether ON is primarily driven by a fear of unhealthy foods, similar to anorexia nervosa, or craving for healthy foods, akin to the patterns observed in addictive disorders. In an online study (Study 1), participants (n = 166 adults, mean age = 24.8 years, SD = 7.6 years, 48.8% female) reported their liking, wanting, and frequency of consumption of 20 healthy and 20 unhealthy foods. Additionally, they completed the Düsseldorf Orthorexia Scale, while BMI, hunger level, and risk of eating disorders were collected. In Study 2, participants (n = 73 adults, mean age = 23.4 years, SD = 3.5 years, 37% female) completed questionnaires on ON and the risk of eating disorders, as well as a visual probe task with images of healthy and unhealthy foods. Eye movements were also recorded for a subset of participants in the laboratory. The results suggest that individuals with more pronounced levels of orthorexic features exhibit decreased sensitivity to food rewards and an attentional avoidance of unhealthy foods. This indicates that ON behaviours may be driven by a fear of unhealthy foods. These results underscore the importance of elucidating the role of attentional and motivational mechanisms in ON and their clinical implications.

Purpose: High consumption of ultra-processed food (UPF) has been consistently linked to negative health outcomes, but existing tools for assessing UPF consumption are often lengthy, culturally specific, or psychometrically underdeveloped. The present research aimed to develop and validate the Ultra-Processed Food Consumption Scale (UPFCS); that is, a brief, psychometrically sound, and cross-culturally applicable measurement.

Methods: In Study 1 (n = 325), exploratory factor analysis (EFA) was conducted to examine the factorial structure and internal consistency of the 30-item UPFCS. Study 2 (n = 129) evaluated test-retest reliability across a 2-week interval, and Study 3 (n = 144) assessed convergent validity by examining associations to Mediterranean diet adherence, body mass index (BMI), and food addiction, as well as testing the moderating role of Mediterranean diet adherence.

Results: EFA and internal consistency supported a unidimensional structure, while test-retest reliability was moderate to strong. UPFCS scores were positively associated with food addiction symptoms, but not with BMI or Mediterranean diet adherence. Exploratory moderation analysis indicated that adherence to a Mediterranean diet attenuated the relationship between UPF consumption and food addiction symptoms, with the effect strongest among those with low Mediterranean dietary adherence.

Conclusions: The UPFCS demonstrates robust psychometric properties and practical utility for assessing ultra-processed food consumption in behavioural and nutritional research.

Purpose: To investigate sex differences in prospective associations between eating disorder (ED) symptoms and changes in body mass index (BMI) percentile in early adolescence.

Methods: This prospective study used survey data from 7111 participants aged 10-12 years at Year 1 from the Adolescent Brain Cognitive Development (ABCD) Study-a diverse, national sample of adolescents from 21 sites across the United States (US). Multivariable linear regression models were used to assess the prospective associations between ED symptoms at Year 1 and BMI percentile at Year 2, adjusting for covariates and BMI percentile at Year 1. Effect moderation was explored in sex-stratified models.

Results: Sex modified the relationship between ED symptoms and changes in BMI percentile. Having binge eating symptoms (B = 3.65, 95% CI 1.80-5.51, p <0.001), distress related to binge eating (B = 2.79, 95% CI 0.05-5.53, p = 0.046), inappropriate compensatory behaviors (B = 6.39, 95% CI 2.16-10.62, p = 0.005), and fear of weight gain (B = 5.26, 95% CI 3.18-7.33, p < 0.001) at Year 1 were significantly associated with higher BMI percentile at Year 2 among males. In the overall sample, distress related to binge eating (B = 2.09, 95% CI 0.40-3.69, p = 0.017) was significantly associated with a higher BMI percentile 1 year later; the interaction by sex was not statistically significant.

Discussion: ED symptoms were associated with higher BMI percentiles 1 year later in early adolescents, although sex-stratified findings revealed that many associations were significant only for males. Clinicians caring for early adolescents should consider evaluating for ED symptoms as potential risk factors for elevated weight.

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

Purpose: Childhood obesity is a growing public health concern, associated with severe physical and psychological consequences. This study investigates the relationship between self-conscious emotions, specifically shame and guilt, and their impact on eating behaviors, physical activity levels, and screen time in children aged 10-18 years. Understanding these relationships may help design more effective obesity management strategies.

Methods: The study included 100 children with obesity and 90 children without obesity. Participants were evaluated using the Test of Self-Conscious Affect for Adolescents (TOSCA-A), the Dutch Eating Behavior Questionnaire (DEBQ), the Physical Activity Questionnaire for Children (PAQ-C), and the Revised Children's Anxiety and Depression Scale (RCADS). Comparative analysis was conducted between the two groups to assess emotional and behavioral patterns.

Results: Children with obesity reported higher levels of anxiety, depression, emotional eating, and restrictive eating, along with lower physical activity levels and increased screen time compared to children without obesity. While guilt was positively correlated with emotional eating in both groups, shame was significantly associated with problematic eating patterns only in children without obesity. The relationship between physical activity and these emotions was minimal, with only guilt showing a modest negative association with school-based activity in the control group.

Conclusions: These findings highlight the need to address emotional well-being as part of childhood obesity interventions. Psychological approaches focusing on guilt and emotional eating may improve the effectiveness of treatment strategies. Future research is warranted to explore developmental variations in the impact of shame and guilt on children's behaviors.

Level of evidence: Level III, well-designed cross-sectional analysis.

Purpose: The aim of this study was to assess body mass index (BMI) category as a predictor of substance craving in people with substance use disorder (SUD) participating in 5 clinical trials.

Methods: BMI was categorized into 4 groups: underweight, healthy weight, overweight, and obesity. Craving assessments were harmonized to calculate comparable craving scores for each participant across trials. General linear mixed effects regression models were fit to final craving score where BMI was considered a main effect and clinical trials as a random effect while also controlling for demographic and clinical characteristics of the participants.

Results: 1,418 participants were included in the final sample. Participants were primarily male (68.97%), and mean age was 39.73 years (SD: 11.38). Obesity (β = 0.59; p = 0.73) and overweight (β = 1.65; p = 0.29) were not significantly associated with final craving score while controlling for covariates. Baseline depression, age, and concomitant SUD medications were significantly associated with final craving score.

Conclusions: Although results indicate participants with obesity and SUD do not experience significantly higher craving for substances, more research is needed to uncover how this varies across different patient populations. Future studies should seek to include more comprehensive measures of obesity and eating behaviors to assess how these may impact substance craving and other SUD treatment outcomes. Level of Evidence Level III (Evidence obtained from well-designed cohort or case-control analytic studies).