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

Background: Weight regain (WR) and insufficient weight loss (WL) occur in 20-25% of patients after bariatric surgery due to various factors. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promise in promoting WL; however, evidence regarding their effectiveness in managing WL and preventing WR post-bariatric surgery remains limited.

Objective: This study aims to evaluate the role of GLP-1RAs in treating and preventing WR following bariatric surgery.

Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science for studies assessing the impact of GLP-1RAs on WR after bariatric surgery.

Results: Our search identified 27 original studies, with 10 included in the meta-analysis involving 769 participants (392 treated with GLP-1RAs). The mean age was 44.05 years, with 30.47% male. The time interval from surgery to the initiation of GLP-1RAs treatment ranged from 1.5 to 86.7 months, with treatment durations between 4 and 12 months. The analysis showed significantly greater WL in the GLP-1RAs group compared to placebo (SMD = 0.82, 95% CI 0.23 to 1.42). Subgroup analysis for treatment durations ≤ 6 months indicated a higher WL in the GLP-1RAs group (SMD = 0.79, 95% CI 0.25 to 1.34). Adverse events were primarily gastrointestinal, with nausea significantly more frequently in the GLP-1RAs group (OR = 2.01, 95% CI 1.24 to 3.27).

Conclusion: GLP-1RAs effectively promote WL among participants experiencing WR after bariatric surgery. Initiating GLP-1RAs therapy shortly after surgery may help prevent WR. Further research is warranted to explore long-term outcomes and optimize treatment protocols for this patient population.

Purpose: Eating disorders, encompassing a spectrum of conditions, significantly affect individuals throughout their lifespan, especially children and adolescents. Because of their rising incidence, misdiagnosis remains a challenge in paediatrics.

Methods: This study presents an educational case series documenting organic disorders that were initially misdiagnosed as feeding and eating disorders.

Results: Through comprehensive assessments, including medical history, physical examinations, and specialized evaluations, we stress the importance of ruling out medical conditions that can mimic an eating disorder at presentation. Timely recognition and referral to specialized care are essential for improved outcomes.

Conclusion: We highlight the crucial role of continuous reassessment, particularly in cases of evolving symptoms or inadequate response to treatments. A multidisciplinary approach in diagnosing and managing paediatric feeding and eating disorders is of fundamental importance to ensure prompt identification and adequate referral.

Level of evidence iv:

Objective: This study examines the prevalence of family dysfunction and food addiction among tertiary students in Ghana and investigates the moderating role of psychological resilience in this relationship.

Background: Food addiction is an emerging behavioural health concern among tertiary students, particularly in environments characterised by family dysfunction.

Methods: A cross-sectional survey was conducted among a random sample of 553 tertiary students at the University of Education, Winneba. Pearson Product-Moment correlation and the Hayes Process Macro were employed to examine relationships among the study variables and test for moderation effects.

Results: The study found that 26.9% of students experienced high family dysfunction, 39.0% had food addiction, 31.3% were overeaters, and 40.0% had low psychological resilience. Correlation analysis showed weak to moderate positive associations between resilience, family dysfunction, and food addiction. Psychological resilience also buffered the relationship between family dysfunction and food addiction.

Conclusion: The study underscores the interplay between family dysfunction, psychological resilience, and food addiction among tertiary students.

Implication: Universities should implement mental health support services, resilience training programmes, and nutritional education to address food addiction risks among students.

Level of evidence: This study contributes cross-sectional data from Ghana showing that psychological resilience may mitigate the negative effects of family dysfunction on food addiction, providing culturally grounded insight into protective factors in tertiary education settings.

Purpose: Mukbang, defined as an audio-visual broadcast in which broadcasters commonly eat large portions of tasty food, is a sociocultural trend that can be associated with eating disorders. This study was conducted to evaluate the effect of watching mukbang on eating attitudes through uncontrolled eating, cognitive restriction, and emotional eating.

Methods: Questionnaire was included the mukbang addiction scale to assess problematic mukbang viewing, the eating attitude test (EAT-26) to assess eating attitudes, and the three-factor eating scale to assess eating behaviours. The direct and indirect effects of mukbang addiction on eating attitudes were evaluated by meditation analysis. Statistical analyses of the data were conducted using IBM SPSS version 24 and PROCESS v4.0 by Andrew Hayes.

Results: This study was carried out with a total of 329 university students. Mukbang addiction scale, uncontrolled eating, and emotional eating factor scores were found to be significantly higher in those with disordered eating attitudes than those with normal eating attitudes (p < 0.05). Mukbang addiction score had a significant direct effect on the eating attitudes score (β = 0.772, p < 0.001), but "uncontrolled eating" and "emotional eating" factors did not have a significant mediator role in this effect. An increase of a one-unit in the mukbang addiction score causes an increase of 0.82 units in the eating attitudes score (p < 0.001). There was no significant relationship between the "cognitive restriction" factor and the scales used (p > 0.05); therefore, it is not included in the mediator variable analysis.

Conclusions: These findings suggest an association between problematic mukbang viewing and eating attitudes; however, it remains unclear whether this relationship is causal or a consequence of underlying conditions. The absence of significant mediation of uncontrolled and emotional eating in this effect suggests that further studies are needed to understand the possible mechanisms. This study is based on a cross-sectional design and is classified as level of evidence 4.

Background: Scientific evidence has demonstrated that psychosocial factors can influence hedonic hunger (HH). Moreover, HH can be a predictor of metabolic and bariatric surgery (MBS) outcomes. The Mediterranean Diet (MD) has been used as a model approach for managing excess weight. In this study, we assessed the association between anxiety and depression levels, HH, and adherence to MD in candidates to MBS and post-MBS subjects.

Methods: This was a cross-sectional observational study that included individuals who were candidates and who were submitted to MBS. Data analysis included anthropometric measurements, assessment of anxiety and depression levels, HH, and adherence to MD.

Results: Of the 64 included individuals, 68.8% were female, with a mean age of 48.39 years. A significant positive correlation was observed between HH and anxiety and depression levels. No statistically significant relationship was found between adherence to MD and HH, nor with anxiety and depression levels.

Conclusion: Psychological status largely contributes to weight control. Therefore, patients should be carefully assessed before and after surgery to ensure treatment and adequate follow-up. Future studies are needed to better determine the complex relationship between psychological factors, HH, food intake, and weight.

Level v: Cross-sectional observational study.

Background: Anorexia nervosa is a complex psychiatric pathology with limited therapeutic tools to reduce morbidity and mortality. Equine-assisted therapy could provide additional therapeutic benefits.

Objectives: We aimed to explore the effects of equine-assisted therapy on the experience of adolescents with anorexia nervosa.

Methods: Using a qualitative approach based on Interpretative Phenomenological Analysis, we conducted semi-structured interviews with nine participants who had taken part in equine-assisted therapy sessions.

Results: Three superordinate themes were found. Participants initially described an experience of insecurity when meeting the horses which were perceived as a source of fear within a displaced spatiotemporal framework. Equine therapy led to the development of emotional regulation through interactions that allowed for investment without fear of perceived social judgment, a reassuring experience through relational adjustment with the horse, and an experience of support from the humans present. Finally, equine therapy was a transformative learning experience, enabling participants to embody their physicality and care for someone other than themselves.

Conclusion: Equine-assisted therapy was found to provide bodily, emotional, and relational therapeutic benefits in anorexia nervosa. The setting, place, and function of the equine therapist, the participants' previous experience with horses, and the interaction with other care areas seem to be essential to ensure therapeutic benefit. Level of Evidence Level III.

Purpose: The objective of this study is to assess the validity of the German version of the Children's Eating Attitudes Test (ChEAT), an internationally used tool for the detection of eating disorder (ED) symptoms, in a clinical sample.

Methods: The ChEAT self-report questionnaire, comprising 26 items, was employed to examine eating behaviors of a clinical sample of 342 adolescents (aged 12-18 years) undergoing inpatient treatment at a child and adolescent psychiatric clinic in Germany. The ChEAT was validated through an exploratory factor analysis (EFA), followed by a confirmatory factor analysis (CFA) and an examination of internal consistency. Subsequent analyses were conducted to identify differences associated with participant characteristics, including age, gender, body mass index (BMI), and diagnosis. Furthermore, additional eating behaviors, depression, and anxiety symptoms were documented via supplementary questionnaires and correlated to the ChEAT to evaluate the convergent and discriminant validity.

Results: The factorial validity of the ChEAT was confirmed through EFA and CFA, resulting in a five-factor structure with the following dimensions: 'Body and Weight Concern,' 'Dieting,' 'Social Pressure,' 'Purging and Binge Eating,' and 'Food Preoccupation'. The 24-item model showed high internal consistency and demonstrated an acceptable fit to the data. Convergent and discriminant validity of the ChEAT was supported by significant correlations with other self-report questionnaires. Higher ChEAT average scores were observed in females and those with a history of eating or depressive disorders, whereas age or BMI showed no correlation.

Conclusion: The data demonstrate that the German version of the ChEAT appears to be a reliable and valid instrument for identifying ED symptoms in clinical samples. However, further studies are necessary to evaluate the factor structure and validity.

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

Objective: Eating disorders (EDs), including binge eating disorders (BEDs), bulimia nervosa (BN) and anorexia nervosa (AN), can inflict adverse effects on well-being, daily functioning, and workplace performance, presenting significant occupational, social, and economic challenges. This systematic review seeks to explore the relationship between ED symptomatologies and their impacts on work performance.

Methods: This systematic review adhered to The Preferred Reporting Items for Systematic Reviews and Meta-analyses. Formal methods of critical appraisal for both qualitative and quantitative studies were utilized. Six studies were included.

Results: Participants across all studies (n = 20,367) exhibited heightened levels of presenteeism, absenteeism, work productivity impairment, and higher annual burden costs compared to their non-ED counterparts.

Conclusion: Impaired decision-making, cognitive inflexibility, and poor executive functioning significantly impact work participation and performance, underscoring the need for workplace policies that reduce stigma and stress, and calls for further research into how environmental factors and interventions affect ED recovery.

Level of evidence: Level I, systematic review.

Purpose: This study examined how eating disorder symptoms, assessed by the Eating Pathology Symptoms Inventory (EPSI), vary across chronological age in a large national (USA) sample of transgender and gender-diverse (TGD) adults.

Method: Participants were 2098 TGD adults-including transgender men (n = 599), transgender women (n = 293), and gender-diverse individuals (n = 1,206, including nonbinary and those who identified with "another gender identity")-enrolled in The PRIDE Study. A multivariate general linear model tested the effects of chronological age, gender group (with gender-diverse as the reference), and their interaction on the eight EPSI scales.

Results: Multivariate analyses showed significant main effects of age (V = .045, p < .001) and gender group (V = .098, p < .001), but no significant age-by-group interaction. Older age was associated with greater Cognitive Restraint (β = .22, p < .001), Negative Attitudes toward Obesity (β = .22, p < .001), and Excessive Exercise (β = .12, p = .001). Compared to gender-diverse individuals, transgender men exhibited higher Muscle Building, Cognitive Restraint, and Excessive Exercise scores, whereas transgender women reported higher Binge Eating, Purging, Cognitive Restraint, and Negative Attitudes toward Obesity, but lower Muscle Building. A single significant interaction indicated that transgender women showed stronger age-related differences in Purging.

Conclusions: These findings contribute to growing evidence that disordered eating symptoms may not simply resolve with age among TGD individuals and necessitate lifespan-sensitive approaches to eating disorder care. These patterns likely capture a mix of aging processes and cohort-specific exposures to weight-normative and cis-normative ideals. Level of evidence Level V: based on descriptive studies.