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

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.

Purpose: Clinical studies describe a higher risk in individuals with Gender Dysphoria (GD) to engage in disordered eating practices, as well as dietary restraint. To the present day, clinical assessments on eating psychopathology in GD are principally oriented towards assessing behaviors, rather than the lived experience underlying these behaviors.

Methods: A sample of 141 individuals with GD (40 assigned male at birth-AMAB, 101 assigned female-AFAB), 153 individuals from the general population and 294 patients with AN were enrolled. Body Uneasiness Test (BUT), the Eating Disorders Examination Questionnaire (EDE) and the Identity and Eating Disorders questionnaire (IDEA) were administered. Analysis of variance and linear models were employed to estimate group differences, adjusted for age, education, and body mass index.

Results: Body uneasiness (BUT global severity index: F value 47.44, p < 0.001), and eating behaviors (EDE total score: F value 66.19, p < 0.001) lied on a spectrum of severity between patients with AN (highest), individuals with GD (elevated) and the general population. Patients with AN reported markedly greater embodiment disturbances in comparison with both the general population and AMAB or AFAB individuals with GD (IDEA total score: minimum T value 4.03, p < 0.001). However, AMAB individuals with GD also reported moderate embodiment disturbances in comparison with the general population (IDEA total score: T value 3.41, p < 0.01).

Discussion: Lived experiences may better highlight core differences between GD and clinical populations of patients with eating disorders. Embodiment disturbances were also reported by AMAB individuals, suggesting a role for gendered expectations in embodiment.

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

Purpose: The causal relationship between childhood obesity and polycystic ovary syndrome (PCOS) risk remains unclear, despite established links between adult obesity and PCOS. This study employed a two-sample Mendelian randomization approach to examine whether childhood obesity might have a causal effect on PCOS development.

Methods: A genome-wide association study (GWAS) identifies SNPs associated with childhood obesity based on 13848 individuals of European ancestry. Data at the summary level for PCOS were obtained from a GWAS conducted by the FinnGen consortium, which included a large sample size of 118870 individuals, consisting of 642 cases and 118228 controls. MR methods including inverse variance weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode analysis were performed in this study. Sensitivity analyses were conducted to evaluate the precision and robustness of the findings.

Results: The impact of genetically determined childhood obesity on PCOS is substantial, as evidenced by the IVW analysis (OR = 1.507, 95% CI 1.193-1.903; P = 5.77 × 10^-4) and the weighted median analysis (OR = 1.578, 95% CI 1.183-2.104; P = 1.91 × 10^-3). The main findings were supported by sensitivity analyses, which yielded consistent estimates using the IVW and MR-Egger methods.

Conclusions: It is suggested that an elevated prevalence of childhood obesity could be associated with an increased risk of PCOS. The prevention of PCOS should be promoted in childhood populations with high obesity. Additional investigation is necessary to confirm these discoveries and explore the underlying biological processes.

Purpose: Eating disorder (ED) symptoms are common psychopathological manifestations, with significant impacts on quality of life, particularly among female adolescents. Despite the high mortality rates of full-blown EDs (5-20%), the mechanisms underlying vulnerability remain poorly understood. Traditional approaches primarily examine probabilistic sufficient factors (i.e., regression coefficients); however, these models fail to accurately predict ED symptoms onset in non-clinical populations. This study shifts focus to necessary conditions-factors whose absence precludes the development of the outcome-using necessary condition analysis (NCA), a novel methodological approach.

Methods: We examined whether lower self-esteem is a necessary condition for restriction-oriented cognitions (Drive for Thinness), dissatisfaction about one's body (Body Dissatisfaction), and dysregulated eating behaviors (Bulimia) in female adolescents (N = 84; mean age = 15.74 ± 1.30 years) after 12 months.

Results: Results preliminarily indicated that lower self-esteem emerged as a necessary condition for restriction-oriented cognitions (d = 0.25, p < 0.003) and for dissatisfaction with the body (d = 0.22, p < 0.003). However, it was not a necessary condition for dysregulated eating behavior.

Conclusions: These findings highlight the potential of NCA to refining theoretical models and clinical interventions by distinguishing necessary conditions from sufficient factors. The study underscores the importance of integrating necessity logic into ED research, offering insights for targeted prevention and personalized care.

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

Purpose: To evaluate the efficacy of a 7-session manualised group intervention for Compulsive Exercise (NEAT) as an adjuvant to inpatient treatment for adolescents with Anorexia Nervosa (AN).

Methods: Adolescents aged 12-17 consented to the study (N = 75). Using a randomised control design, they were allocated to the NEAT group with treatment as usual (NEAT + TAU) (N = 43), or to treatment as usual alone (TAU) (N = 32). Self-report measures of compulsive exercise and eating disorder psychopathology were administered at two timepoints to assess the efficacy of the intervention.

Results: 51 participants completed the study (NEAT + TAU N = 27; TAU N = 24). Both groups saw a significant decrease in compulsive exercise and eating disorder psychopathology between timepoints. There were no significant differences between treatment groups on the outcome measures.

Conclusions: Intensive, multidisciplinary TAU, and NEAT group added to TAU were effective at reducing compulsive exercise and eating disorder symptoms. Clinical opinion and recommendations for further study are discussed. Treatment manual is made available below.

Level of evidence: Level I Evidence obtained from: at least one properly designed randomised controlled trials; systematic reviews and meta-analyses; experimental studies.

Background: Anorexia nervosa (AN) is a severe psychiatric disorder associated with extreme malnutrition and multi-organ complications, including cutaneous manifestations.

Case presentation: We report an 11-year-old girl with restrictive-type AN who presented with a critically low BMI (7.7-9.0 kg/m²), who presented with striking cutaneous findings. These included widespread striae distensae with a translucent, "cellophane-like" appearance, desquamative lesions reminiscent of the "flaky paint" dermatosis seen in kwashiorkor, and sacral pressure ulcers. Laboratory findings revealed severe protein-energy deficiency, anemia, electrolyte imbalance, and endocrine alterations. A structured refeeding program with close monitoring led to substantial clinical improvement. Over 8 weeks, her weight increased by 6 kg, and the skin gradually regained thickness, elasticity, and integrity.

Discussion: This case highlights the interplay of nutritional deficiency, catabolism, cortisol elevation, and mechanical stress in producing rare dermatoses in anorexia nervosa. The co-occurrence of glassy striae and flaky desquamation suggests a marasmic-kwashiorkor phenotype of malnutrition. The reversibility of these lesions further underscores the remarkable regenerative capacity of the skin under restored nutritional conditions.

Purpose: ADHD and Autism are overrepresented in adults with bulimic-spectrum eating disorders (EDs) and are associated with unique underlying mechanisms and poorer treatment outcomes. This qualitative study explores how Neurodivergent and potentially Neurodivergent individuals with bulimic-spectrum EDs make sense of their (potential) Neurodivergence, its impact on their ED, and their treatment needs.

Methods: Sixteen adults with bulimic-spectrum EDs who either self-reported a diagnosis of ADHD and/or Autism or scored highly on screeners (ASRS-Screener > 3; AQ-10 > 5) were interviewed. Data was analysed using reflexive thematic analysis, with cross-group comparisons between ADHD-only and ADHD + Autism presentations. Reflexivity was strengthened through critical friend discussions, and member reflections.

Results: We developed four themes and 12 sub-themes: 1. Difficulty making sense of potential Neurodivergence: participants expressed mixed feelings about identifying as Neurodivergent. While some found the label helpful, others felt uncertain about whether they were Neurodivergent or had concerns around stigma. Participants struggled to distinguish features of Neurodivergence from those of their ED. 2. Bingeing as ADHD self-regulation: bingeing was used to manage emotional overwhelm or under-stimulation linked to ADHD, and often became compulsive over time. 3. Restriction shaped by Autistic traits: restriction was associated with interoceptive and exteroceptive sensory differences, preference for sameness, and social disconnect, particularly among those with co-occurring Autism. 4. Balancing personalised and structured care: participants wanted flexible, personalised care that also provided structure to support recovery.

Conclusions: ADHD and Autistic traits may influence bulimic-spectrum EDs in distinct ways. Helping Neurodivergent individuals and clinicians understand these connections can guide personalised treatment priorities and adaptations, improving treatment engagement and outcomes for Neurodivergent individuals.

Level of evidence: Level IV, qualitative exploratory study.

Objective: Despite several studies assessing the impact of resveratrol on obesity indices, previous meta-analyses show conflicting results. Therefore, we conducted this critical umbrella review of interventional meta-analyses on the effect of resveratrol supplementation on body mass index (BMI), body weight (BW), waist circumference (WC), and body fat.

Methods: Searches were conducted across multiple databases to identify all relevant meta-analyses up to September 30th, 2025. Reported pooled effect sizes (ESs) and 95% confidence intervals (CIs) were extracted from each included study and synthesized using a random-effects model. Methodological quality was assessed using the AMSTAR 2 tool.

Results: Ultimately, 18 meta-analyses were included, with results showing a small but statistically significant reduction in BW (ES: - 0.18 kg, 95% CI - 0.32 to - 0.03, p = 0.02), BMI (ES: - 0.14 kg/m², 95% CI - 0.2 to - 0.08, p < 0.001), WC (ES - 0.43 cm, 95% CI - 0.64 to - 0.22, p < 0.001), and body fat (ES: - 0.3 kg, 95% CI - 0.48 to - 0.12, p = 0.001) in the resveratrol group compared to the control group, with subgroup analysis revealing statistical significance only in subgroups with doses > 400 mg/day and study duration ˃ 12 weeks.

Conclusion: Our review confirms that resveratrol supplementation reduces BW, BMI, WC, and body fat, particularly on doses > 400 mg/day and interventions lasting ˃12 weeks, with small effect sizes. Based on our findings, resveratrol supplementation could be considered as a complementary therapy in the management of obesity.