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

Purpose

The main research aim was to inspect whether pre-operative body shape concerns and discomfort as Body Shape Questionnaire (BSQ) scores moderate post-operative weight loss trajectory in bariatric patients.

Methods

Two studies were conducted. Study 1 analyzed cross-sectional data and verified the structural validity of the 34-item BSQ questionnaire on a sample of 327 candidates for bariatric surgery. Study 2 examined longitudinal data, with objective Body Mass Index (BMI) recorded every 6 months, from surgery intervention on, with 5 measurement occasions, from 111 patients who initially completed BSQ as bariatric surgery candidates and then underwent periodic medical post-operative follow-ups, over 2 years.

Results

In Study 1, confirmatory factor analysis of a single-dimension model yielded acceptable fit indices and high internal consistency levels. Study 2 showed that post-operative excess BMI reduction trend was not linear and pre-operative BSQ scores moderated it, with a higher risk of weight regain in patients who initially were less concerned with their body shape.

Conclusions

The present findings support the structural validity of the BSQ questionnaire in bariatric candidates and call attention on the role of pre-operative body shape concerns on post-operative weight loss trajectories over 2 years, in accordance with a pathoplasty model. They suggest the need for systematic attention on perceived body image and psychological paths aimed to help bariatric patients regain positive attitudes towards their own body.

Level of evidence III, well-designed cohort

Purpose

The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested.

Methods

The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool’s original authors.

Results

180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use.

Conclusion

This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested.

Level of evidence

Level I.

Purpose

Although a number of investigations have been carried out on the marketing outcomes of parasocial relationships (PSR) with food influencers on social media, little attention has been paid to the potential contribution of these one-sided emotional bonds to followers’ eating attitudes and habits. Drawing on the Parasocial Theory, the role of parasocial attachment with food influencers was investigated in predicting eating disorders, food addiction, and grazing. To increase the accuracy of PSR measurement, a brief self-report scale was developed to gauge social media users’ feelings of mutual awareness, attention, and adjustment with their favorite food influencer at a distance through social media.

Methods

Participants were a convenience sample of 405 Iranian social media users (231women; M_age = 28.16, SD_age = 9.40), who followed a favorite food influencer on social media.

Results

The 8-item Parasocial Relationship with Favorite Food Influencer Scale (PSRFFIS) revealed a unidimensional structure with excellent content and construct validity and internal consistency. Regarding gender differences, men showed stronger parasocial attachment to their favorite food influencers. Adjusting age, gender, and subjective social status as control variables, PSR with favorite food influencers partially contributed to the explanation of eating disorder symptom severity, food addiction, and grazing.

Conclusion

These findings show that PSR with favorite food influencers appears to be associated with followers’ craving for food, which, in turn, may contribute to maladaptive eating habits. This highlights media-related factors, such as PSR with food influencers, as potential drivers of dysfunctional eating habits in the digital age, particularly in countries like Iran where disordered eating is prevalent.

Level of evidence

Level V—based on cross-sectional data (correlational study; scale development)

Purpose

Perfectionism is a transdiagnostic risk factor for eating disorders. Treating perfectionism can reduce symptoms of eating disorders. No research has examined an indicated prevention trial using internet-based Cognitive-Behavioural Therapy for Perfectionism (ICBT-P) in adolescent girls at elevated risk for eating disorders. Our aim was to conduct a preliminary feasibility trial using a co-designed ICBT-P intervention. It was hypothesised that a higher proportion of participants in the ICBT-P condition would achieve reliable and clinically significant change on perfectionism, eating disorders, anxiety and depression, compared to waitlist control.

Methods

Twenty-one adolescent girls with elevated symptoms of eating disorders (M age = 16.14 years) were randomised to a 4-week online feasibility trial of a co-designed ICBT-P prevention program or waitlist control. Qualitative surveys were used to gain participant perspectives.

Results

The ICBT-P condition had a higher proportion of participants achieve reliable change and classified as recovered on perfectionism and symptoms of eating disorders and anxiety, compared to waitlist control. Qualitative findings indicated that 100% of participants found the program helpful.

Conclusion

The results indicate ICBT-P is a feasible and acceptable program for adolescent girls with elevated eating disorder symptoms. Future research is required to examine outcomes in a randomised controlled trial.

Level of evidence

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

Trial registration number

This trial was prospectively registered with Australian and New Zealand Clinical Trials Registry (ACTRN12620000951954P) on 23/09/2020.

Purpose: The aim of the present review is to analyze dynamic interactions between nutrigenomics, environmental cues, and parental influence, which can all lead to children's neophobic reactions and its persistence in time.

Methods: We reviewed studies available on electronic databases, conducted on children aged from birth to 18 years. We also considered official websites of Italian Institutions, providing advice on healthy eating during infancy.

Results: Modern day societies are faced with an eating paradox, which has severe and ever-growing implications for health. In face of a wider availability of healthy foods, individuals instead often choose processed foods high in fat, salt and sugar content. Economic reasons surely influence consumers' access to foods. However, there is mounting evidence that food choices depend on the interplay between social learning and genetic predispositions (e.g., individual eating traits and food schemata). Neophobia, the behavioral avoidance of new foods, represents an interesting trait, which can significantly influence children's food refusal. Early sensory experiences and negative cognitive schemata, in the context of primary caregiver-child interactions, importantly contribute to the priming of children's food rejection.

Conclusions: As neophobia strongly affects consumption of healthy foods, it will be relevant to rule definitively out its role in the genesis of maladaptive food choices and weight status in longitudinal studies tracking to adulthood and, in meanwhile, implement early in life effective social learning strategies, to reduce long-term effects of neophobia on dietary patterns and weight status.

Level of evidence: Level II, controlled trials without randomization.

Purpose: Eating disorder recovery is a poorly defined concept, with large variations among researchers' definitions. Weight maintenance is a key aspect of recovery that remains relatively underexplored in the literature. Understanding the role of weight maintenance may help guide the development of treatments. This paper aims to address this by (1) investigating the factors predicting long-term weight maintenance in anorexia nervosa (AN) patients; (2) exploring differences in predictive factors between adolescent and adult populations; and (3) exploring how weight maintenance is conceptualised in the literature.

Methods: We conducted a systematic review following PRISMA guidelines to address our research questions. Five databases were searched and filtered according to our exclusion criteria.

Results: From the search, 1059 studies were yielded, and 13 studies were included for review. A range of weight, biological and psychological factors were found to predict weight maintenance among these papers. BMI at admission and discharge from inpatient treatment was the most common predictor among the papers. Few studies investigated biological factors and mixed evidence was found for psychological factors. We found no observable differences between adult and adolescent populations. Finally, weight maintenance was defined and measured differently across studies.

Conclusion: This review's findings can help contribute to a well-rounded understanding of weight maintenance, and ultimately, of recovery. This can help support clinicians in tailoring interventions to improve long-term outcomes in AN. Future research should aim to replicate studies to better understand the relationship between the factors identified and weight maintenance.

Level i: Systematic review.

Purpose: Treatment resistance is a significant challenge in addressing eating disorders (EDs). The Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ) has been previously validated in ED populations to assess patients' motivation for treatment. This study aimed to validate the ACMTQ in the Italian language (ACMTQ-ITA) and evaluate its psychometric properties.

Methods: We recruited a clinical sample of adults aged 18 or older, diagnosed with EDs, proficient in the Italian language, and providing written informed consent. Participants with psychiatric comorbidities such as schizophrenia, bipolar disorder, and substance use disorder were excluded from the study. Validity of the ACMTQ-ITA was assessed using reliability analysis with Cronbach's α and McDonald's ω estimates, and Confirmatory Factor Analysis (CFA).

Results: Results from the reliability analysis confirmed the internal consistency of the Autonomous Motivation (AM) factor (α = 0.82, ω = 0.82), the Controlled Motivation (CM) factor (α = 0.76, ω = 0.77), and the ACMTQ-ITA overall score (α = 0.79). The CFA confirmed the two-factor solution (i.e., AM and CM) identified in the original validation of the ACMTQ (Comparative Fit Index = 0.92, Akaike Information Criterion = 3427.26, Bayesian Information Criterion = 3486.82; Root Mean Square Error of Approximation = 0.08, Standardized Root Mean Square Residual = 0.09).

Conclusion: The ACMTQ-ITA emerged as a valid and reliable tool for measuring motivation for treatment in individuals with EDs. Its implementation may facilitate the comprehension of treatment motivation, offering valuable clinical insights and implications for health management practices.

Level of evidence: Level V, descriptive studies.

Purpose: Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) frequently exhibit Non-Suicidal Self-Injury (NSSI), yet their co-occurrence is still unclear. To address this issue, the aim of this study was to elucidate the role of impairments in interoception in explaining the NSSI phenomenon in AN and BN, providing an explanatory model that considers distal (insecure attachment/IA and traumatic childhood experiences/TCEs) and proximal (dissociation and emotional dysregulation) risk factors for NSSI.

Method: 130 patients with AN and BN were enrolled and administered self-report questionnaires to assess the intensity of NSSI behaviors, interoceptive deficits, IA, TCEs, emotional dysregulation and dissociative symptoms.

Results: Results from structural equation modeling revealed that impairments in interoception acted as crucial mediators between early negative relational experiences and factors that contribute to NSSI in AN and BN, particularly emotional dysregulation and dissociation. Precisely, both aspects of IA (anxiety and avoidance) and various forms of TCEs significantly exacerbated interoceptive deficits, which in turn are associated to the emergence of NSSI behaviors through the increase in levels of dissociation and emotional dysregulation.

Conclusions: The proposed model provided a novel explanation of the occurrence of NSSIs in patients with AN and BN by accounting for the significance of interoception.

Level of evidence: Level V-Cross-sectional observational study.

Background: There is a strong association between perfectionism and eating disorders. In a cognitive-behavioural model of compulsive exercise it has been suggested there are reciprocal associations between perfectionism, eating disorder pathology, and compulsive exercise. No study has examined if there is an indirect association between perfectionism and compulsive exercise through eating disorder pathology, which would inform a preliminary understanding of the cognitive-behavioural model of compulsive exercise.

Methods: The sample included 301 adolescent females diagnosed with eating disorders (age M = 14.89, SD = 0.85, range 13-17). We tested models of direct and indirect associations of compulsive exercise in the relationship between perfectionism and eating disorder pathology, and direct and indirect associations of eating disorder pathology in the relationship between compulsive exercise and perfectionism.

Results: Perfectionism was directly associated with eating disorder pathology and compulsive exercise. Perfectionism was indirectly associated with eating disorder pathology through compulsive exercise. Perfectionism also had an indirect association with compulsive exercise through eating disorder pathology.

Discussion: The findings suggest it would be useful for future prospective research to examine the cognitive-behavioural model of compulsive exercise in adolescents with eating disorders. Compulsive exercise and perfectionism may be useful targets for future research to improve eating disorder treatment. Level of evidence Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Abstract