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

Background: Preadolescence is a critical developmental stage marked by the start of significant physical and cognitive changes posing youths at risk for psychopathology. This study explores the association of Instagram usage with body dissatisfaction, drive for thinness and psychopathological symptoms among preadolescents.

Methods: We recruited 232 female preadolescents aged 9-10 years and their mothers using a snowball sampling technique. Participants were divided into two groups based on their Instagram addiction levels: no addiction (Group 1) and addiction (Group 2). Measures included the Eating Disorders Inventory-Referral Form (EDI-3-RF), Instagram Addiction Scale (IAS-15), and Child Behavior Checklist (CBCL).

Results: Results showed that Group 2 had significantly higher scores in body dissatisfaction, drive for thinness, emotional reactivity, and withdrawal compared to Group 1.

Conclusions: Limitations include the small, homogenous sample, reliance on self-report measures, and cross-sectional design, which limits causal inference. Future research should include more diverse samples, longitudinal designs, and a broader assessment of social media use to better understand these complex relationships. Addressing these limitations will enhance our understanding and contribute to developing effective interventions to support the mental health of preadolescents in the digital age.

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

Purpose: Feelings of shame can play a role in the development and maintenance of mental disorders. However, the role and measurement of shame in relation to eating disorders remain poorly understood. The current work presents the adaptation of a measure of external and internal shame in relation to eating disorders (EISS-ED) based on an integrative perspective that leverages the strengths of the biopsychosocial model and shame-pride cycle framework. Specifically, the EISS-ED accounts for how individuals believe they are perceived by others (external shame) and how they perceive themselves (internal shame) in relation to eating.

Methods: The study used confirmatory factor analyses to examine the factor structure and psychometric properties of the EISS-ED (N = 478), Spearman's correlations and Receiver Operator Characteristic curves were used for validity testing.

Results: The results supported the two-factor structure (including 12 items) of the EISS-ED and its factorial invariance by clinical history and gender. Concurrent validity analyses showed positive correlations between external and internal shame and eating disorder symptoms, negative affect, and detachment. Both external and internal shame measures provided fair classification accuracy of participants based on self-reported history of clinical assessment or treatment for eating disorders.

Conclusions: These findings improve the understanding of the role of shame in eating disorders and offer evidence on a valid assessment that can aid in identifying, measuring, and addressing this important construct, supporting targeted interventions.

Level of evidence: Level V, descriptive study.

Purpose: Obesity and overweight in children and adolescents are a growing concern. Treatments should be multidisciplinary, address the whole family and contain aspects of motivation. Motivation is a well-known impact factor in medical treatment but its role in the treatment of pediatric obesity is not clear. This systematic review aims to analyze the role of motivation by summarizing theoretical frameworks and synthesizing effects of weight reduction programs that assessed motivation as either outcome or predictor.

Methods: This systematic review was conducted according to PRISMA guidelines. Four databases (PubMed, Web of Science, PsycINFO, Cochrane) were searched, findings were screened by two authors and assessed according to pre-determined criteria. Risk of bias was assessed with the Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project.

Results: 1899 studies were found, whereof 32 were included. The most commonly used theoretical frameworks were the Transtheoretical Model and Self-Determination Theory. In 18 of the included studies, motivation was assessed as outcome. In most of them, motivation increased towards the end of the weight reduction program. 15 studies used motivation to predict different outcome variables, however, with no conclusive evidence on the predictive power of motivation on different outcomes.

Conclusion: Motivation can be enhanced over the course of a weight reduction program, mainly in pediatric patients. The predictive power of motivation on different outcomes is still not clear due to the heterogeneity of included studies. More research is needed to implement the current findings in future pediatric weight reduction programs.

Level of evidence: Level 1, systematic review.

Purpose: This paper examines transgressive eroticism-specifically the phenomenon of "Overlove"-as an experiential field that both constructs and dissolves embodied selfhood. It asks how hyper-intense erotic practices function not merely as psychopathological symptoms but as existential strategies that disrupt normative consciousness and enable novel forms of self-other relations.

Methods: Through phenomenological and conceptual analysis, the study draws on Georges Bataille's writings, clinical literature on psychopathology, and interpretive readings of literary and case-study material to map the experiential structures and effects of transgressive eroticism on bodily consciousness.

Results: Transgressive eroticism acts as an "anti-moral" force that dismantles subject-object binaries, revealing an elemental layer of being; it dissolves self-boundaries via dissipation and ecstatic union with others. These practices operate as existential praxis rather than mere pathological symptoms. The phenomenology of transgressive eroticism uncovers utopian potentials for new collective intimacies.

Conclusions: By reframing overlove as a dialectical engagement with the boundaries of selfhood, this study challenges entrenched psychiatric binaries and advocates for a clinical ethos attentive to both its hazards and its generative potential. Future research should investigate how the understanding of transgressive erotic practices can enrich therapeutic strategies, ethical frameworks, and theoretical models of identity, agency, and relationality.

Level of evidence: Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Background: Bariatric surgery (BS) is an effective treatment for obesity, but it often leads to significant changes in body composition, including loss of fat-free mass (FFM). Nutritional intake plays a crucial role in influencing these changes. This systematic review aims to assess the impact of nutritional strategies on body composition, specifically FFM preservation, following BS.

Methods: A systematic literature search was conducted across PubMed, Scopus, EMBASE, Web of Science, and Google Scholar using combinations of terms including ("bariatric surgery" OR "RYGB" OR "sleeve gastrectomy") AND ("nutritional intake" OR "dietary factors") AND ("lean body mass" OR "fat-free mass" OR "body composition"). We included studies examining adults who underwent bariatric surgery and reported quantitative relationships between postoperative nutritional intake (assessed through dietary records, recalls, or biomarkers) and changes in LBM/FFM. Data were extracted and synthesized to evaluate the effects of specific nutritional factors including protein quantity/quality, macronutrient distribution, and micronutrient status on body composition outcomes.

Results: Inadequate protein intake (< 60 g/day or < 1.2 g/kg ideal body weight) was common post-BS and associated with significant FFM loss (5-15% reduction). Higher protein intake (≥ 60 g/day or ≥ 1.2 g/kg) preserved FFM, particularly during the first 6 months, though results varied due to differences in study design and assessment methods. Macronutrient analysis revealed carbohydrate intake > 130 g/day correlated with poorer weight loss outcomes, while fat intake > 60 g/day was associated with greater FFM loss (2-4% additional reduction). Conversely, fiber intake > 25 g/day demonstrated protective effects. One trial of the Dietary Approaches to Stop Hypertension (DASH) diet demonstrated mixed body composition impacts.

Conclusion: Adequate protein intake is crucial for minimizing FFM loss after BS. Personalized nutrition plans, early counseling, and regular follow-ups are vital for improving long-term outcomes. However, variability in study results highlights the need for more research to develop standardized nutritional guidelines for post-surgery care.

Background: Psoriasis is a chronic skin disease affecting millions of people, with obesity being a common comorbidity. Many studies suggest that obesity may influence the onset and treatment efficacy of psoriasis. Currently, increasing evidence indicates that abdominal obesity is associated with various metabolic diseases, but research on the relationship between abdominal obesity and psoriasis remains limited. This study uses advanced obesity indicators such as the conicity index and body roundness index to explore the association between abdominal obesity and psoriasis.

Methods: This study is a cross-sectional analysis that uses univariate regression analysis and weighted multivariable logistic regression to investigate the relationship between conicity index, android percent fat, body roundness index, and psoriasis. Additionally, restricted cubic spline analysis was performed to explore the nonlinear association between these indicators and psoriasis. Subgroup analysis and interaction tests were also conducted.

Results: A total of 4873 participants were included in this study. After adjusting for confounding variables, the results showed a positive correlation between conicity index, android percent fat, body roundness index, and the risk of psoriasis. When conicity index, android percent fat, and body roundness index were converted into quartiles (Q1-Q4), the risk of psoriasis in the Q4 group was significantly higher compared to the Q1 group (conicity index: p = 0.032, android percent fat: p = 0.020, body roundness index: p = 0.003). In the subgroup analysis and interaction tests, no significant interaction between the conicity index, body roundness index, and the association with psoriasis was found (p > 0.05). The results only suggest that the poverty income ratio (PIR), marital status, and alcohol consumption may influence the relationship between android percent fat and psoriasis. In addition, subgroup analysis based on age shows that the association between abdominal obesity and psoriasis is more significant in the population over 40 years old.

Conclusions: After adjusting for covariates, the study found that three abdominal obesity indicators-conicity index, android percentage fat, and body roundness index-are positively correlated with psoriasis risk, suggesting that the association between abdominal obesity and psoriasis as a comorbidity is more likely to occur, emphasizing the clinical significance of this link.

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

One of the sustainable development goals (SDGs) of the United Nations is to enhance scientific research and substantially increase the number of public and private research and development spending (SDG Target 9.5). What types of research should be carried out in the field of orthorexia nervosa (ON)? Fundamental, applied, comparative, exploratory, laboratory, longitudinal or mixed research? How can we utilize our previous misinterpretations to develop a more accurate understanding of ON? Do we need more research in this field? These and other questions encourage us to publicly debate on ON, which is why we would like to express our position on this issue.Level of evidence: Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Overweight and obesity are substantial, growing public health concerns due to their huge direct and indirect negative impact on health. Obesity-associated complications and comorbid conditions include metabolic, cardiovascular, renal, liver and respiratory diseases, cancers, and functional limitations, leading to higher all-cause and cardiovascular mortality, and incident disability. The development of rigorous guidelines considering and comparing all possible therapeutic strategies is of critical importance, and a relevant tool for improving the quality of care and increasing the appropriateness of therapeutic choices. The Italian National Institute of Health (ISS-Istituto Superiore di Sanità) appointed the Italian Obesity Society (SIO-Società Italiana dell'Obesità) and other key scientific societies with a relevant stakeholder role on the theme issue to design and develop a new Italian guideline for the management of obesity in adult subjects, aimed at assisting healthcare professionals in the consideration of lifestyle, pharmacological, endoscopic, and surgical options for the treatment of overweight and obesity, as well as related conditions. We adopted Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology, strongly endorsed by Istituto Superiore di Sanità to develop trustworthy guidelines to be accepted onto Sistema Nazionale Linee Guida, the reference repository of national clinical practice guidelines for the Servizio Sanitario Nazionale.

Purpose: Eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), are complex psychiatric conditions with high morbidity and mortality. Neuroimaging and machine learning (ML) represent promising approaches to improve diagnosis, understand pathophysiological mechanisms, and predict treatment response. This systematic review aimed to evaluate the application of ML techniques to neuroimaging data in EDs.

Methods: Following PRISMA guidelines (PROSPERO registration: CRD42024628157), we systematically searched PubMed and APA PsycINFO for studies published between 2014 and 2024. Inclusion criteria encompassed human studies using neuroimaging and ML methods applied to AN, BN, or BED. Data extraction focused on study design, imaging modalities, ML techniques, and performance metrics. Quality was assessed using the GRADE framework and the ROBINS-I tool.

Results: Out of 185 records screened, 5 studies met the inclusion criteria. Most applied support vector machines (SVMs) or other supervised ML models to structural MRI or diffusion tensor imaging data. Cortical thickness alterations in AN and diffusion-based metrics effectively distinguished ED subtypes. However, all studies were observational, heterogeneous, and at moderate to serious risk of bias. Sample sizes were small, and external validation was lacking.

Conclusion: ML applied to neuroimaging shows potential for improving ED characterization and outcome prediction. Nevertheless, methodological limitations restrict generalizability. Future research should focus on larger, multicenter, and multimodal studies to enhance clinical applicability.

Level of evidence: Level IV, multiple observational studies with methodological heterogeneity and moderate to serious risk of bias.