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

Purpose: Cisgender sexual minority adults are at elevated risk for eating disorders; however, community norms for certain eating disorder measures are lacking for this population. This study aimed to establish community norms for the Eating Pathology Symptom Inventory (EPSI) among cisgender gay, lesbian, bisexual + (individuals who identify as bisexual or pansexual; bi +) adults.

Methods: Cross-sectional data were analyzed from 2062 cisgender participants-including 925 gay men, 573 lesbian women, 116 bi + men, and 448 bi + women-enrolled in The PRIDE Study, a national longitudinal cohort of sexual and gender minority adults in the United States. Participants completed the EPSI, and descriptive statistics were calculated for the eight EPSI scales.

Results: We report mean scores, standard deviations, medians, interquartile ranges, and percentile ranks for the eight EPSI scales within cisgender sexual minority populations. Distinct patterns of eating-pathology symptoms were evidenced among the cisgender sexual minority groups. Cisgender bi + women exhibited the highest scores for Body Dissatisfaction, Binge Eating, and Restricting compared to other groups, whereas cisgender bi + men reported the highest scores for Excessive Exercise. Cisgender gay men had significantly higher scores for Muscle Building and Negative Attitudes Toward Obesity compared to other groups.

Conclusion: These findings offer valuable benchmarks for interpreting EPSI scores in the assessment and treatment of eating disorders among cisgender sexual minority individuals.

Level of evidence: Level V: based on descriptive results.

Background: Previous observational studies have indicated that circulating micronutrients may influence obesity risk. This study aimed to explore the causal relationship between micronutrient levels and obesity through multivariable Mendelian randomization (MR) analysis.

Methods: Single nucleotide polymorphisms (SNPs) significantly associated with 15 micronutrients (selenium, zinc, copper, calcium, beta-carotene, folate, iron, magnesium, potassium, and vitamins A, B6, B12, C, D, and E) from published genome-wide association studies (GWAS) were used as instrumental variables (IVs). Three obesity-related datasets were obtained from the GWAS. Inverse variance weighted (IVW) is the main method used for MR analysis. Leave-one-out analysis, MR-Pleiotropy Residual Sum and Outlier method (MR-PRESSO), weighted median, and MR-Egger method were used to assess pleiotropy and heterogeneity.

Results: Genetically predicted levels of circulating selenium and calcium are causally related to the risk of obesity (calcium odds ratio [OR]: 1.478, 95% confidence interval [CI] 1.128-1.935, p = 0.005; selenium OR: 1.478, 95% CI 1.128-1.935, p = 0.005). Multivariate MR analysis suggested a causal relationship between circulating selenium and calcium levels and obesity risk (calcium OR: 1.625, 95% CI 1.260-2.097; selenium OR: 1.080, 95% CI 1.003-1.163, p = 0.041). The p-value obtained in the Cochrane Q test, MR-Egger intercept test, and MR-PRESSO were > 0.05, suggesting no significant evidence of pleiotropy or heterogeneity.

Conclusion: Our study revealed, for the first time, a positive correlation between elevated circulating calcium and selenium levels and an increased obesity risk. These findings provide valuable insights into obesity's underlying mechanisms. Nevertheless, further large-scale clinical studies are required to confirm our results.

Level of evidence: Level III, Mendelian randomization.

Anorexia Nervosa (AN) is a mental health condition marked by reduced food consumption, intense fear of weight gain, and distorted body experience. Virtual Reality (VR)-based techniques-i.e., Body-Swapping and Mirror Exposure techniques-offer promising avenues for addressing body disturbance in AN, allowing patients to embody virtual bodies varying in size and shape. We used a single-subject experimental design to explore the potential of virtual reality multisensory experiences for mitigating body disturbance in AN. We examine the case of a 24-year-old female hospitalized with restrictive Anorexia Nervosa who underwent a novel body-focused VR intervention alongside the hospital's standard care. The intervention included six bi-weekly sessions, wherein the patient was immersed in a VR environment that allowed her to embody a virtual body that matched a healthy weight range. Through interactions with a virtual mirror, the patient was encouraged to concentrate on the body's positive aspects and functional abilities, thinking about its significance in her past, current, and anticipated future activities (Functional Mirror Exposure). The patient reported reduced body dissatisfaction, negative beliefs, and body misperception. These changes endorse using immersive, multisensory, and embodied experiences to alter body consciousness and body-self relationship. Results preliminary support the transformative potential of VR in improving traditional approaches to assess and alter body disturbance.Level of evidence Level IV.

Purpose: Research has shown that self-compassion and body appreciation are associated with less disordered eating. However, previous literature has mostly examined between-person associations, which do not account for fluctuations in these constructs within individuals over time. Understanding such fluctuations could inform future tailored interventions to better address individuals' needs by targeting times when they are most vulnerable. The aim of this study was to examine dynamic within-person associations between self-compassion, body appreciation, and disordered eating in young adults who self-reported trying to lose weight.

Methods: Fifty-seven 18-30-year-old adults aiming to lose weight reported their levels of self-compassion, using items from the Short Form Self-Compassion Scale (SCS-SF), body appreciation, using items from the Body Appreciation Scale-2 (BAS-2) and disordered eating, using items derived from previous diary research, twice daily over a 1-week period. Generalised Linear Mixed Modelling (GLMM) was used with three levels: observations (level 1), nested within days (level 2), nested within individuals (level 3). Each GLMM included three nominal random effects (participant, day, time of day) and controlled for age, gender, and Body Mass Index (BMI). Effect sizes, represented by squared semi-partial correlation coefficients (sr2), were calculated for each GLMM via multiple linear regression analyses to represent the unique amount of variance explained by each predictor variable.

Results: The findings showed that after controlling for age, BMI, and gender, negative associations between self-compassion and disordered eating, and body appreciation and disordered eating were found, while a positive association was found between self-compassion and body appreciation.

Conclusions: The findings suggest that further research should examine whether fostering self-compassion and body appreciation may be putative targets to reduce disordered eating in young adults who aim to lose weight.

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

Purpose: There is no consensus regarding the optimal target weight for discharge during the hospitalization of children with eating disorders (EDs). We attempted to identify the ideal discharge weight for children receiving their first inpatient treatment for anorexia nervosa (AN) or avoidant/restrictive food intake disorder (ARFID).

Patients and methods: Sixty children (mean age: 12.8 years) diagnosed with either AN (49 children) or ARFID (11 children) were followed for 1 year after discharge from a psychiatric ward. We analyzed the percent of ideal body weight (%IBW) at discharge, along with physical and social factors, to predict weight outcomes and rehospitalization risk during the first year after discharge. Longitudinal weight trends were assessed, and Cox proportional hazards modeling was used to analyze the time to rehospitalization.

Results: Single and multiple regression analyses identified the %IBW at discharge as the sole significant predictor of %IBW at 1 year. A receiver operating characteristic curve determined that 86.4%IBW at discharge was the optimal predictor of achieving 90%IBW by 1-year post-discharge. Patients who had achieved ≥ 86.4%IBW at discharge showed better weight trajectories compared with those discharged at < 86.4%IBW. A higher discharge %IBW was associated with prolonged time to rehospitalization, indicating a reduced risk of readmission.

Conclusions: Discharging pediatric patients at a higher weight is associated with improved weight recovery and a reduced risk of rehospitalization. A target discharge weight of 86.4%IBW may serve as an effective criterion for children with EDs.

Level of evidence: III, case-control analytic studies.

Purpose: The aim of this study was to analyze data of children and adolescents in Germany insured according to legal requirements (statutorily insured) regarding epidemiology, comorbidities, and care of bulimia nervosa (BN) pre- vs. intra-COVID-19 pandemic.

Methods: The study is based on anonymized claims data of 10-17.9 years old children and adolescents statutorily insured in Germany from the InGef Berlin GmbH research database. The database combines data of more than 50 statutory health insurances and is representative of the German population. Prevalence, (quarterly) incidence, comorbidities and in- and outpatient treatment of BN (ICD-10: F50.2/F50.3) pre-COVID (01/2018-03/2020; N = 282,711) vs. intra-COVID (04/2020-12/2021; N = 282,738) was compared using descriptives and χ² tests, Welch-tests and interrupted time series analysis. The analysis was stratified by age groups (children: 10-13 years; adolescents: 14-17 years).

Results: Prevalence of BN was 0.09% pre-COVID and 0.07% intra-COVID (OR = 0.78 [0.65, 0.93]). After pandemic onset, a positive trend in the quarterly incidence among adolescents was observed (p = .016). Outpatient visits to general practitioners decreased (OR = 0.59 [0.35, 0.98]).

Conclusion: The observed decline in diagnosed and treated BN cases and the positive trend in quarterly incidence could be attributed to an increase in unregistered cases due to the overburdened care situation that emerged with the onset of the COVID-19 pandemic. Researchers and healthcare providers need to be aware of the potential for a backlash and deterioration/chronification of BN symptoms in children and adolescents. Level of evidence No level of evidence.

Purpose: The Modified Weight Bias Internalization Scale (WBIS-M) is perhaps the most frequently used measure of internalised weight bias and has growing support for its psychometric properties. However, there is a lack of clarity regarding how many items are necessary for adequate interpretation of the WBIS-M and limited study of internalised weight bias in young adults. The aims of this study are to evaluate different versions of the WBIS-M, assessing structural and convergent validity.

Methods: The current study recruited 205 university students (aged 18-46, mean body mass index = 22.60 kg/m²) in the UK and examined the factor structure, reliability, and convergent validity of the WBIS-M, looking at 11-item, 10-item, and 9-item versions.

Results: Confirmatory factor analysis suggested that a 10-item version of the WBIS-M showed acceptable structural validity and expected correlations with relevant constructs (depression, anxiety, weight status, and eating pathology). Estimates of internal consistency reliability were high for all three versions.

Conclusion: Given potential problems with one item, the 10-item WBIS-M presents a measure of internalised weight bias with sound psychometric properties in young adults.

Level of evidence: Level III, well-designed cohort study.

Orthorexia nervosa (OrNe) is an eating disorder characterised by a pathological interest and preoccupation with healthy foods and a healthy diet. Evidence suggests that tendencies towards OrNe may be prevalent across diet groups, and this is particularly the case in vegans and vegetarians. Our previous work has identified that alongside individual differences in obsessive compulsiveness and perfectionism, cognitive biases (attentional preference for healthy-related cues) are associated with OrNe, whereas explicit identity (as a vegan/vegetarian) is only associated with a healthy orthorexia form. No work has assessed whether one's known identity (explicit identity) or that form of identity which is based on fast acting cognitive associations (implicit identity) further differentiate healthy orthorexia from OrNe tendencies in addition to compulsiveness and perfectionism. One hundred and forty-four self-identified vegans (n = 45), vegetarians (n = 50) and meat-eaters (omnivores) (n = 49) (66 females, 74 males, 4 non-binary; M age = 35.09) completed measures of current hunger status, obsessive compulsivity, perfectionism, the Teruel Orthorexia Scale, perceived identity centrality as a vegan/vegetarian (explicit identity) and a "self as vegan/vegetarian" implicit association test (implicit identity). Results showed increased orthorexia tendencies in both vegans and vegetarians compared to meat eaters (omnivores) but only in terms of healthy orthorexia. In addition, no differences were shown for OrNe suggesting the diet type is not influential in pathological orthorexia. Explicit identity and current hunger status were both shown to be associated with healthy orthorexia and not OrNe. Implicit identity as a vegan/vegetarian was unrelated to both dimensions, while compulsiveness and perfectionism predicted OrNe. Despite individuals implicitly associating the self with being a vegan/vegetarian, this identity does not serve as a maker of orthorexia nervosa.

Purpose: To examine the psychometric characteristics of the Italian language versions of the child eating disorder examination (ChEDE) interview and child eating disorder examination questionnaire (ChEDE-Q).

Methods: ChEDE (from EDE 17th edition) and ChEDE-Q were first translated, and then administered to 147 patients with eating disorders under the age of 18, along with 80 age-matched controls. Their internal consistency (Cronbach alpha), inter-rater reliability (Spearman rho), short-term (7-23 days) test-retest reliability (Spearman rho), and criterion validity (group differences by Mann-Whitney U) were evaluated.

Results: Patients with eating disorders displayed significantly higher ChEDE/ChEDE-Q scores than age-matched controls, demonstrating the adequate criterion validity of the instrument (all subscales and global scores significant at p < 0.001). Internal consistency was high for all original ChEDE/ChEDE-Q subscales (minimum Cronbach alpha 0.752), apart from Eating Concerns (minimum Cronbach alpha 0.591). Inter-rater reliability was excellent for global ChEDE/ChEDE-Q scores and each subscale (minimum Spearman rho 0.999). Test-retest reliability was excellent for global ChEDE/ChEDE-Q scores and each subscale (minimum Spearman rho 0.791).

Conclusions: The Italian versions of the ChEDE interview and ChEDE-Q exhibited excellent psychometric properties and may, therefore, be recommended for the assessment of Italian patients with eating disorders less than 18 years old, both in clinical practice and research settings. Level of evidence III evidence obtained from cohort or case-control analytic studies.