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

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.

Background and objective: Suicidal ideation (SI) poses a significant public health challenge, and understanding its predictors, especially modifiable factors like visceral obesity, is essential for prevention. The purpose of this study is to investigate the association between the visceral adiposity index (VAI) and suicidal ideation (SI) among adults in the United States.

Methods: A cross-sectional study using NHANES data from 2005-2018 included adults aged 18 and above with complete SI and VAI data. Suicidal thoughts were evaluated using item 9 from the Patient Health Questionnaire-9 (PHQ-9), while VAI was calculated using gender-specific formulas based on waist circumference, body mass index (BMI), total triglycerides (TG), and high-density lipoproteins (HDL-C). Multivariate logistic regression analysis was implemented after adjusting for several factors to assess the relationship between VAI and SI. Additionally, subgroup analysis and interaction testing were employed to investigate the consistency of this relationship with other demographic parameters.

Result: Our study included a cohort of 15,830 participants, of whom 3.59% exhibited signs of suicidal ideation. Following multivariate logistic regression analysis, we observed a significant positive association between VAI and SI (odds ratio [OR] = 1.03; 95% CI 1.01, 1.04; P = 0.0057), which remained significant after adjusting for various confounding factors. Moreover, utilizing a two-segment linear regression approach, we uncovered a nonlinear relationship between VAI and SI, demonstrating a U-shaped pattern with a critical point at 5.28.

Conclusion: Elevated levels of VAI were consistently associated with an increased probability of SI, and this association remained consistent across various demographic variables. Level of evidence Level V-cross-sectional observational study.

Purpose: Food addiction involves excessive consumption of highly processed foods rich in salt, sugar, and fats driven by hedonic eating behaviors. Increased food addiction, especially among young adults, could potentially lead to eating disorders. Hence, the current study aimed to assess the magnitude and lifestyle determinants of food addiction in young adults from Mumbai, India METHODS: Healthy young adults (n = 354) aged 18-25 years were recruited using convenience sampling. Utilizing web-based platforms, the Yale Food Addiction Scale 2.0 was administered. Statistical analysis was performed with significance at a p value of ≤ 0.05.

Results: The mean age of participants was (20.99 ± 1.94) years, and the magnitude of food addiction was 11.3%. Sociodemographic determinants such as age (p = 0.000), socio-economic status (p = 0.000), and education (p = 0.000), and lifestyle determinants such as BMI (p = 0.012), dietary habits (p = 0.000), sleep (p = 0.001), physical activity (p = 0.001), anxiety (p = 0.001), and depression (p = 0.000) were significantly associated with food addiction. However, after adjusting for sociodemographic factors, the relationship between lifestyle factors and food addiction became evident. The frequent consumption of specific unhealthy foods increased the risk (OR ≥ 1.0, p value ≤ 0.05), while the consumption of healthy foods reduced the risk (OR<1.0, p value ≤ 0.05) of food addiction.

Conclusion: The present study revealed a rising magnitude of food addiction and its determinants among Indian youth, highlighting the urgency of sensitization and designing targeted nutrition interventions to combat food-related addiction and hence reducing the risk of eating disorders.

Level of evidence: Level V, Descriptive Study.

Purpose: Avoidant Restrictive Food Intake Disorder (ARFID) is a relatively new diagnostic classification, and the DSM-5 has called for further studies and evidence in this field. This study explored the role of maternal-adult-child relationship, early maladaptive schemas, and difficulties in the emotion regulation of ARFID symptoms and their presentations, such as sensory sensitivity, lack of interest in eating and food, and fear of aversive consequences. We also investigated the role of demographic characteristics in predicting ARFID symptoms.

Methods: In this cross-sectional study, 791 college students (females = 74.8%, mean age = 21.3, SD = 2.26, male = 25.2%, mean age = 21.1, SD = 1.97) were selected through cluster random sampling in 2024 from a major university in the northwest of Iran (Urmia University). ARFID symptoms was assessed using the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS), the quality of parent-adult-child relationship (PACR) was evaluated using the Parent-Child Relationship Questionnaire (PCRS), difficulties in emotion regulation (DER) were measured using the Difficulty in Emotion Regulation Scale (DERS) and early maladaptive schemas (EMS) through the Young Schema Questionnaire-Short Form (YSQ-SF).

Results: Hierarchical regression analysis revealed that gender and field of study 3.9%, maternal-adult-child relationship (MACR) (1.3%), DER 7.3% and EMS 7.6% were identified as factors in predicting ARFID symptoms. The field of study and EMS predicted 11.3% variance of sensory sensitivity. Gender, field of study, DER, and EMS were significant in predicting lack of interest in food or eating, with a variance of 14.2%. The field of study, MACR, and EMS predicted 12.6% variance of fear of adverse consequences.

Discussion: Our findings suggest that ARFID symptoms is related to parental and emotional factors. EMS formed during development, along with adverse parent-child relationships and psychological factors, such as difficulty in emotion regulation, may be associated with ARFID symptoms. In addition, DER played the biggest role in predicting ARFID symptoms, fewer variables were able to predict sensory sensitivity, demographic characteristics, SEM, and DER had the biggest role in predicting the presentation lack of interest in eating or food. Effective treatment and collaborative support are essential to address ARFID.

Purpose: Observational studies suggest white matter (WM) microstructural anomalies are linked to bulimia nervosa (BN), but a direct causal relationship remains unestablished. This study aimed to investigate the causal impact of BN on WM microstructure.

Methods: We analyzed genome-wide association study (GWAS) summary data from 2442 individuals to identify genetically predicted BN. Diffusion MRI were obtained from the UK Biobank. After assessing instrumental variable validity, we conducted Mendelian randomization (MR) using inverse variance weighting (IVW) as the primary method, followed by pleiotropy and heterogeneity tests.

Results: The MR analysis from BN to brain imaging-derived phenotypes showed that BN had significant causal effects on a union set of nine tracts (including a total of 18 image-derived phenotypes) (IVW, P < 0.05): brainstem tracts (pontine crossing tract, bilateral medial lemniscus, left superior cerebellar peduncle, and middle cerebellar peduncle), sensory-related tracts (right retrolenticular part of the internal capsule and left inferior longitudinal fasciculus), and emotion-related tracts (left anterior corona radiata and right cingulum hippocampus).

Conclusion: This study revealed that BN has a causal effect on WM microstructure, which extends the reports of association to causation for WM and BN. These causal effects may explain the deficits in feeding, taste, vision, and emotion regulation that are often observed in patients with BN. Level of evidence III well-designed cohort analytic study.

Objective: Studies have reported associations between perinatal factors (obstetric and neonatal factors) and later eating disorder risk. However, previous findings have been partly conflicting. Here, we analyzed associations between perinatal factors and disordered eating in a large cohort of Finnish children and adolescents.

Method: The participants were 8- to 14-year-old children and adolescents (N = 11,357) from The Finnish Health in Teens study. Disordered eating was assessed using the Children's Eating Attitudes Test (ChEAT). Perinatal data were obtained from the Finnish Birth Registry. Perinatal variables were initially analyzed using Chi-square analyses and linear regressions. Variables associated with disordered eating (p < .10) were entered into a multinomial logistic regression model. The regression analysis was conducted both including and excluding maternal BMI, as this information was missing for > 80% of the participants.

Results: Of the participants, 56.6% reported disordered eating (ChEAT score ≥ 11) or partial disordered eating (1-10) symptoms. Including maternal BMI in the analyses (n = 1921), higher levels of disordered eating were independently associated with maternal pre-pregnancy BMI (OR 1.07, 95% CI [1.02, 1.12]), maternal smoking during pregnancy (OR 2.64, 95% CI [1.49, 4.68]), urgent or emergency cesarean birth (OR 2.16, 95% CI [1.10, 4.05]). Assisted reproduction was associated with lower levels of disordered eating (OR 0.39, 95% CI [0.20, 0.76]).

Discussion: The results suggest that pregnancy and childbirth are vulnerable developmental periods, associated with later eating pathology. Further studies disentangling genetic and environmental mechanisms of associations between perinatal factors and later eating pathology are needed.

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

Purpose: This study examined how weight and race impact mental health stigma, weight stigma, perceived need for treatment, and perceived severity of anorexia nervosa We experimentally manipulated weight and race, replicating and extending Varnado-Sullivan et al. (Eat Weight Disord 25:601-608, 2020).

Methods: 336 participants were recruited from Prolific. Participants self-reported pre-existing exposure to and attitudes regarding mental illness. Participants were randomly assigned to read an anorexia nervosa vignette that manipulated race (White or Black) and weight ("underweight" or "obese"). Participants self-reported attitudes about the woman in the vignette (mental health stigma), weight stigma, and perceived need for treatment and severity of the condition (mental health literacy). We hypothesized that greater mental health stigma, weight stigma, and lower mental health literacy would be present for Black and higher-weight vignettes, controlling for covariates.

Results: Analyses found that only vignette weight significantly predicted mental health stigma, mental health literacy, and weight stigma; vignette race did not significantly predict mental health stigma, mental health literacy, or weight stigma. A significant Race x Weight interaction predicted weight stigma and two mental health stigma items.

Conclusion: Replicating and extending Varnado-Sullivan et al. (Varnado-Sullivan et al. in Eat Weight Disord 25:601-608, 2020), we found weight-based bias for those with eating disorders, with some interactions between weight and race on weight stigma.

Purpose: The aim of this study was to adapt the Orthorexia Nervosa Inventory for use in Hungarian (ONI-Hu), and explore its associations with disordered eating, intuitive eating and mental health measures.

Methods: 944 participants completed a test battery, including ONI-Hu, the Three Factor Eating Questionnaire, the Intuitive Eating Scale-2 and the Mental Health Continuum Short-Form. Confirmatory Factor Analysis (CFA) was used to assess the validity of ONI-Hu. Correlation and regression analyses were conducted to evaluate the convergent and discriminant validity.

Results: CFA confirmed the original three-factor structure of ONI-Hu. Positive associations were found between ONI scores and restrictive eating behaviors, and negative associations with intuitive eating measures. Furthermore, the ONI composite factor score displayed no significant relationship with mental health indicators.

Conclusions: ONI-Hu exhibits strong reliability and validity, and provides a deeper understanding of ON. Results suggest that orthorexic behaviors may serve as a coping mechanism, offering an illusion of control and emotional security. Inconsistent findings about the relationship between ON tendencies and mental health indicators propose that the sense of control might provide a false sense of well-being to the individual, distorting their perceptions of their overall health. Level of evidence Level V, descriptive cross-sectional study.