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

Purpose: We provide the first systematic review and meta-analysis of research examining multidimensional perfectionism-perfectionistic strivings and perfectionistic concerns-and orthorexia.

Methods: The systematic review and meta-analysis was pre-registered and conducted using a search of PsycINFO, MEDLINE, Education Abstracts, and Oxford Academic, and ScienceDirect up to April 2023. PRISMA guidelines were also followed. Meta-analysis using random-effects models was used to derive independent and unique effects of perfectionism, as well as total unique effects (TUE), and relative weights. Moderation of effects were examined for age, gender, domain, perfectionism and orthorexia instruments, and methodological quality.

Results: Eighteen studies, including 19 samples (n = 7064), met the eligibility criteria with 12 of these studies (with 13 samples; n = 4984) providing sufficient information for meta-analysis. Meta-analysis revealed that perfectionistic strivings (r⁺  = 0.27, 95% CI [0.21, 0.32]) and perfectionistic concerns (r⁺  = 0.25, 95% CI [0.18, 0.31]) had positive relationships with orthorexia. After controlling for the relationship between perfectionism dimensions, only perfectionistic strivings predicted orthorexia which also contributed marginally more to an overall positive total unique effect of perfectionism (TUE = 0.35; 95% CI [0.28, 0.42]). There was tentative evidence that orthorexia instrument moderated the perfectionistic concerns-orthorexia relationship.

Discussion: Research has generally found that both dimensions of perfectionism are positively related to orthorexia. More high-quality research is needed to examine explanatory mechanisms while also gathering further evidence on differences in findings due to how orthorexia is measured, as well as other possible moderating factors.

Level of evidence: Level 1, systematic review and meta-analysis.

Background: Orthorexia is a complex phenomenon comprising distinct dimensions, including orthorexia nervosa (ON) and healthy orthorexia (HO). However, little is known about the factors influencing these dimensions, their disparities, and the psychological factors underlying orthorexia behaviours.

Objectives: This study aims to explore ON versus HO dimensions and the predictive role of adverse childhood experiences (ACEs) in a nationally representative sample of Polish individuals. In addition, we aim to investigate the mediating roles of alexithymia, embodiment, and experiential avoidance levels in this association.

Methods: A representative sample of Polish adults (n = 3557) participated in this study. Dimensions of orthorexia (HO, ON) were assessed using the Teruel Orthorexia Scale, while ACEs were evaluated using the Adverse Childhood Experiences Questionnaire. Levels of alexithymia were measured using the Toronto Alexithymia Scale, experiential avoidance through the Acceptance and Action Questionnaire, and embodiment intensity via the Experience of Embodiment Scale.

Results: Cluster analysis identified two distinctive orthorexia profiles in the whole sample, i.e., HO (n = 469) and ON (n = 1217), alongside three intermediate HO/ON profiles (n = 1871). The number of ACEs predicted ON tendencies as opposed to HO behaviours in participants. The mediating role of alexithymia, experiential avoidance, and embodiment in the association between ACEs and ON was also observed.

Conclusions: Our study suggests that orthorexia is a multidimensional eating style shaped by socio-cultural factors. Adverse childhood experiences may be related to ON behaviours by mediating psychological factors such as experiential avoidance, alexithymia, and embodiment. Effective education and collaborative support are necessary for addressing ON tendencies.

Introduction: Previous studies have focused on understanding the biopsychosocial implications of obesity stigma and have made proposals to minimize its negative consequences, as well as recommendations to eliminate or reduce this stigma; however, knowing which individuals stigmatize obesity and why will allow us to have a broader picture of stigmatization and thus help in planning interventions with greater impact.

Objective: The aims were to describe the stigmatization toward obesity in preadolescents and adolescents and to determine whether there are differences in body dissatisfaction, abnormal eating behaviors and self-esteem among those with and without stigma toward obesity.

Methods: A total of 307 preadolescents and 349 adolescents answered a set of questionnaires that evaluated abnormal eating behaviors, body dissatisfaction, self-esteem and stigma.

Results: Fifty-nine percent of the participants stigmatized individuals with obesity, with preadolescents having the greatest stigma levels. Differences were observed only in body dissatisfaction, where the group of preadolescents who stigmatized individuals with obesity and the group of adolescents who did not stigmatize individuals with obesity reported higher levels of body dissatisfaction.

Conclusion: Obesity is stigmatized at early ages, regardless of sex; however, preadolescents with stigma toward obesity and adolescents without stigma toward obesity have greater body dissatisfaction, indicating that body dissatisfaction plays a crucial role in the stigmatization of obesity.

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

Objectives: The objective of this study was to evaluate the effectiveness of the combined use of empagliflozin (EMPA) and topiramate (TPM) versus a placebo in overweight/obese individuals without diabetes on a calorie-restricted diet.

Methods: In this study, 44 non-diabetic and overweight/obese subjects who were on a calorie restricted diet were randomly assigned into 2 groups: (1) Participants received a 10 mg EMPA tablet daily plus TPM tablet (at the 1st week 25 mg once a day and from the second week 25 mg twice a day); (2) Participants received an empagliflozin placebo (daily) plus a topiramate placebo (as mentioned for topiramate tablet in group 1), for 12 weeks. At baseline and weeks 4, 8, 12, weight, height, body mass index (BMI), waist circumference (WC), and body composition were evaluated. Before and after the intervention, blood pressure, C reactive protein, and glucose and lipid profile parameters were measured.

Results: The EMPA/TPM group, compared to placebo, had a greater percent change of weight at week 12 (- 8.92 ± 1.80 vs. - 4.93 ± 1.17). The intervention group had a greater percent change of fat mass and fat percent at week 12 (P < 0.05). However, there was no difference in the percent of change in fat-free percent between the two groups at week 12 (P = 0.577). Within-group analysis found a significant reduction in SBP, DBP, FBS, insulin, HOMA-IR, TC, LDL, HDL, TG, and CRP in both groups (P < 0.05). At week 12, no statistically significant difference was observed between the two groups in any of mentioned variables (P > 0.05).

Conclusion: In non-diabetic overweight/obese individuals, the combination of EMPA/TPM and calorie restriction led to a notable decrease in body weight and was generally well-tolerated. Further research is required to evaluate the potential advantages of utilizing this combination for sustained weight management in the long run.

Level i: Randomized clinical trial.

Purpose: Developing personal goals beyond weight and shape, and promoting the agency to pursue those goals, could aid in treatment and recovery from anorexia nervosa (AN). This research explores the strengths, interests and goals of individuals currently receiving treatment for AN and evaluates how treatment services are supporting them to work towards personal goals across all areas of everyday life.

Method: A total of 58 community-dwelling adults currently receiving treatment for anorexia nervosa at any stage of recovery completed the Client Assessment of Strengths, Interests and Goals Self-Report (CASIG-SR). Participants reported their goals for accommodation, work and study, interpersonal relationships, recreational activities, spirituality, religion or life purpose, physical health and mental health, and the personal strengths and supports needed to achieve those goals. Concordance scores were calculated between importance of personal goals and level of support from current services regarding these goals.

Results: Themes identified across goals, strengths and supports were Connection, Independence & Confidence, Meaning & Self: The Real Me, and Stability & Balance. Work and study goals and strengths were identified strongly. The key support needed was stability from the current treatment team to provide a stable base for change. Concordance scores indicate support provided for personal goals was less than the importance of the goal to the individual.

Conclusion: Results suggest goals for everyday living are critical to recovery in anorexia nervosa. Specific clinical considerations to increase motivation and hope are increased access to peer support, a focus on increasing positive affect, supporting safe exercise and promoting outdoor experiences and connection with nature.

Level iii: Evidence obtained from well-designed cohort or case-control analytic studies.

Aims: The aim was to translate and culturally adapt the Yale Food Addiction Scale 2.0 (YFAS 2.0) to the Chilean population, evaluate its psychometric properties in a non-clinical sample, and assess the correlations between symptoms count of food addiction (FA) with demographic and anthropometric variables.

Methods and participants: We evaluated 301 participants (59.1% women) with a mean age of 29.7 ± 12.4 years recruited from two universities and two businesses (non-clinical sample). The Chilean YFAS 2.0 was administered, and anthropometric measurements were carried out. The internal consistency of the items was estimated, and factor structure was tested by confirmatory factor analysis. Test-retest reliability was also examined. The correlations between symptoms count of FA and weight, waist circumference (WC), Body Mass Index (BMI), percentage of body fat (BF%), and lean mass were evaluated.

Results: The Chilean YFAS 2.0 presented good internal consistency, and confirmatory factor analysis supported the one-factor structure, in accordance with the original version. The ICC indicated excellent test-retest reliability. The prevalence of FA was 10.3%, and the symptom count of FA was 2.1 ± 2.8. A small positive correlation between WC, BMI, and BF % and FA symptom count was found.

Conclusion: The Chilean YFAS 2.0 may be a useful tool to investigate FA in Chile. Level of evidence Level V, cross-sectional descriptive study.

Purpose: Gestational obesity (GO) presents a multifaceted challenge to maternal and fetal health, with an escalating prevalence and far-reaching consequences extending beyond pregnancy. This perspective statement by the Italian Society of Obesity (SIO) provides current insights into the diagnosis, maternal and fetal impacts, and treatment strategies for managing this pressing condition.

Methods: This article provides a comprehensive review of the maternal and fetal effects of GO and provides suggestions on strategies for management. Comprehensive review was carried out using the MEDLINE/PubMed, CINAHL, EMBASE, and Cochrane Library databases.

Results: The diagnosis of GO primarily relies on pre-pregnancy body mass index (BMI), although standardized criteria remain contentious. Anthropometric measures and body composition assessments offer valuable insights into the metabolic implications of GO. Women with GO are predisposed to several health complications, which are attributed to mechanisms such as inflammation and insulin resistance. Offspring of women with GO face heightened risks of perinatal complications and long-term metabolic disorders, indicating intergenerational transmission of obesity-related effects. While nutritional interventions are a cornerstone of management, their efficacy in mitigating complications warrants further investigation. Additionally, while pharmacological interventions have been explored in other contexts, evidence on their safety and efficacy specifically for GO remains lacking, necessitating further investigation.

Conclusion: GO significantly impacts maternal and fetal health, contributing to both immediate and long-term complications. Effective management requires a multifaceted approach, including precise diagnostic criteria, personalized nutritional interventions, and potential pharmacological treatments. These findings underscore the need for individualized care strategies and further research to optimize outcomes for mothers and their offspring are needed. Enhanced understanding and management of GO can help mitigate its intergenerational effects, improving public health outcomes.

Level of evidence: Level V narrative review.

Purpose

This study investigated the associations between retrospective reports of body image victimization (i.e. body shaming) perpetrated by peers and by parents during childhood or adolescence, and food and alcohol disturbance (FAD) in young adulthood, considering the possible mediating role of psychological distress (i.e. subthreshold symptoms of anxiety and depression).

Methods

The study involved 1624 young adults aged between 18 and 30 (69% women), who completed an online survey.

Results

Our findings revealed that participants who reported more frequent body image victimization episodes during childhood and adolescence exhibited higher levels of psychological distress and, in turn, higher scores of FAD in young adulthood.

Conclusions

This result represents a novel contribution to understanding the psychological correlates of FAD in youths. Limitations and implications are discussed.

Level of evidence Level V, descriptive study.

Purpose

This research identified whether adolescent religiosity was associated with body satisfaction and disordered eating in adolescence and early adulthood and explored gender/sex differences in these associations.

Methods

Project EAT (Eating and Activity in Teens and Young Adults) is a longitudinal cohort study following participants from adolescence into young adulthood. For this analysis (N = 1620), religiosity (importance of religion and frequency of religious service participation) during adolescence was examined as a correlate of body satisfaction and disordered eating (binge eating, maladaptive behaviors intended to lose or maintain weight, eating to cope, and dieting) at the same life stage (EAT-II, 2003–2004, M_age = 19.4 years) and during young adulthood (EAT-IV, 2015–2016, M_age = 31.5 years). Analyses used linear and logistic regression models adjusted for demographics and adolescent body mass index.

Results

During adolescence, females who placed greater importance on religion had higher body satisfaction, 22% higher odds of binge eating, and 19% greater odds of dieting in the past year, while more frequent attendance of religious services was associated with higher body satisfaction and 37% greater odds of dieting past year. Among males, only frequent attendance of religious services was associated with higher adolescent body satisfaction. Longitudinally, among females, only frequent attendance of religious services in adolescence predicted higher levels of body satisfaction in young adulthood. No significant longitudinal associations were observed among males.

Conclusions

Our findings contribute to understanding the complex interplay between religiosity, gender, and body satisfaction. Further research should explore cultural factors influencing these associations and qualitative aspects of religious experiences to inform nuanced interventions.

Level of evidence: Level III, cohort study.