Pub Date : 2025-04-01DOI: 10.1016/j.eatbeh.2025.101988
Rafael Moreton Alves da Rocha , Nelson Hauck-Filho , Nathália Bonugli Caurin , Andrea Phillipou
The present study aims to test a new theoretical model for grouping Anorexia nervosa (AN), bulimia nervosa (BN), body dysmorphic disorder (BDD), and muscle dysmorphia (MD) as Body Image Disorders. In a sample composed of 579 individuals from the community, we used exploratory bifactor modeling to investigate the presence of a higher-order general component in these disorders and identify shared and unique components within each condition. Additionally, we explored the relationships between the assessment instruments' total scores and external variables to assess the distinctiveness of the factors in our model. Our findings indicate the existence of a common general factor encompassing body image disturbance across these disorders. Furthermore, the factor decomposition reveals distinct factors for BDD, MD, and AN/BN, supporting the notion that these are separate conditions despite their shared central element. Other commonalities and differentiation points between the disorders are also identified through decomposition analysis. The external correlations examined provide further support for the bifactor modeling findings. Our evidence supports the recommendation for reclassification of AN, BN, BDD, and MD as Body Image Disorders, which may enable a more precise theoretical understanding that emphases this central component of these conditions.
{"title":"Body image disorders: A new theoretical model supporting the reclassification","authors":"Rafael Moreton Alves da Rocha , Nelson Hauck-Filho , Nathália Bonugli Caurin , Andrea Phillipou","doi":"10.1016/j.eatbeh.2025.101988","DOIUrl":"10.1016/j.eatbeh.2025.101988","url":null,"abstract":"<div><div>The present study aims to test a new theoretical model for grouping Anorexia nervosa (AN), bulimia nervosa (BN), body dysmorphic disorder (BDD), and muscle dysmorphia (MD) as Body Image Disorders. In a sample composed of 579 individuals from the community, we used exploratory bifactor modeling to investigate the presence of a higher-order general component in these disorders and identify shared and unique components within each condition. Additionally, we explored the relationships between the assessment instruments' total scores and external variables to assess the distinctiveness of the factors in our model. Our findings indicate the existence of a common general factor encompassing body image disturbance across these disorders. Furthermore, the factor decomposition reveals distinct factors for BDD, MD, and AN/BN, supporting the notion that these are separate conditions despite their shared central element. Other commonalities and differentiation points between the disorders are also identified through decomposition analysis. The external correlations examined provide further support for the bifactor modeling findings. Our evidence supports the recommendation for reclassification of AN, BN, BDD, and MD as Body Image Disorders, which may enable a more precise theoretical understanding that emphases this central component of these conditions.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101988"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to provide an empirical foundation for selecting optimal models of the Eating Disorder Examination Questionnaire (EDE-Q) full-scale and short forms in Japanese female clinical and nonclinical populations.
Method
The sample comprised 526 female patients with eating disorders and 744 female controls. The analysis systematically compared psychometric properties, including factor structures, internal consistency, and discriminative capabilities across five full-scale models and three short-form models of the EDE-Q. Furthermore, factorial estimates were evaluated across diagnostic subgroups: anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED).
Results
Confirmatory factor analysis (CFA) did not support the proposed factor structure for any of the EDE-Q models, except for the 7-item (EDE-Q7) and 9-item (EDE-Q9) forms. The three-factor EDE-Q7 model, comprising dietary restraint, shape/weight overvaluation, and body dissatisfaction, was validated in the clinical sample but not in the nonclinical sample. Conversely, the four-factor EDE-Q9 model, comprising dietary restraint, shape/weight overvaluation, body dissatisfaction, and preoccupation, demonstrated structural validity across both clinical and nonclinical samples. CFA results indicated optimal model fit for the EDE-Q9 in the AN, BN, and BED groups, whereas for the EDE-Q7 in the BN and BED groups. Both short forms exhibited robust internal consistency and effectively differentiated between clinical and nonclinical samples.
Conclusions
The findings indicate that specific short forms of the EDE-Q offer viable alternatives in time-constrained settings, exhibiting more consistent structural validity compared to the full-scale version.
{"title":"Psychometric properties of the eating disorder examination questionnaire full-scale and short forms in Japanese female clinical and nonclinical samples","authors":"Yoshikatsu Nakai , Mitsuko Nakata , Kazuko Nin , Shun'ichi Noma , Satoshi Teramukai","doi":"10.1016/j.eatbeh.2025.101981","DOIUrl":"10.1016/j.eatbeh.2025.101981","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to provide an empirical foundation for selecting optimal models of the Eating Disorder Examination Questionnaire (EDE-Q) full-scale and short forms in Japanese female clinical and nonclinical populations.</div></div><div><h3>Method</h3><div>The sample comprised 526 female patients with eating disorders and 744 female controls. The analysis systematically compared psychometric properties, including factor structures, internal consistency, and discriminative capabilities across five full-scale models and three short-form models of the EDE-Q. Furthermore, factorial estimates were evaluated across diagnostic subgroups: anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED).</div></div><div><h3>Results</h3><div>Confirmatory factor analysis (CFA) did not support the proposed factor structure for any of the EDE-Q models, except for the 7-item (EDE-Q7) and 9-item (EDE-Q9) forms. The three-factor EDE-Q7 model, comprising dietary restraint, shape/weight overvaluation, and body dissatisfaction, was validated in the clinical sample but not in the nonclinical sample. Conversely, the four-factor EDE-Q9 model, comprising dietary restraint, shape/weight overvaluation, body dissatisfaction, and preoccupation, demonstrated structural validity across both clinical and nonclinical samples. CFA results indicated optimal model fit for the EDE-Q9 in the AN, BN, and BED groups, whereas for the EDE-Q7 in the BN and BED groups. Both short forms exhibited robust internal consistency and effectively differentiated between clinical and nonclinical samples.</div></div><div><h3>Conclusions</h3><div>The findings indicate that specific short forms of the EDE-Q offer viable alternatives in time-constrained settings, exhibiting more consistent structural validity compared to the full-scale version.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101981"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.eatbeh.2025.101985
McKenzie L. Miller , Christina M. Sanzari , Julia M. Hormes
Objective
Drive for muscularity, a concern with meeting societal standards for a highly muscular physique, is a rising concern among men. Dysfunctional exercise is associated with drive for muscularity and leads to a myriad of negative physical and psychosocial outcomes. Cognitive inflexibility, a difficulty adapting to changing circumstances, is a transdiagnostic mechanism across psychiatric conditions, including dysfunctional exercise. This study evaluated cognitive inflexibility as a moderator of the relationship between drive for muscularity and dysfunctional exercise in men.
Methods
Undergraduate men (n = 243, 53.5% White) completed self-report measures assessing drive for muscularity, dysfunctional exercise, and general and domain-specific cognitive inflexibility. Moderation analyses assessed whether cognitive inflexibility moderated the relationship between drive for muscularity and dysfunctional exercise.
Results
Cognitive inflexibility specific to food/exercise and weight/shape moderated the relationship between drive for muscularity behaviors and dysfunctional exercise (R2 = 0.01, 0.03 respectively). General cognitive inflexibility did not moderate the relationship. Attitudes (r(237) = 0.25, p < .001) and behaviors (r(237) = 0.53, p < .001) related to a drive for muscularity were positively associated with dysfunctional exercise.
Conclusion
Results suggest that domain-specific cognitive inflexibility amplifies the risk of dysfunctional exercise in men with a high drive for muscularity. Findings suggest that interventions targeting cognitive inflexibility may help mitigate the risk of problematic exercise in this population.
对肌肉的追求，即对高肌肉体格的社会标准的关注，越来越受到男性的关注。功能失调的运动与肌肉的驱动有关，并导致无数负面的身体和心理后果。认知缺乏灵活性，即难以适应不断变化的环境，是一种跨精神疾病的跨诊断机制，包括功能失调的运动。本研究评估了认知不灵活性作为男性肌肉动力和功能障碍运动之间关系的调节因素。方法大学生男性（n = 243，白人53.5%）完成了自我报告测量，评估肌肉力量驱动、功能障碍运动、一般和特定领域认知不灵活性。适度分析评估了认知不灵活性是否调节了肌肉动力和功能障碍运动之间的关系。结果特定于食物/运动和体重/体型的认知不灵活性调节了肌肉行为驱动与功能障碍运动之间的关系（R2分别= 0.01,0.03）。一般的认知不灵活性并没有缓和这种关系。态度(r(237) = 0.25, p <；.001)和行为(r(237) = 0.53, p <；.001)与肌肉化驱动相关，与功能障碍运动呈正相关。结论：研究结果表明，特定领域的认知不灵活性增加了高肌肉动力男性运动功能障碍的风险。研究结果表明，针对认知不灵活性的干预措施可能有助于减轻这一人群中有问题的运动的风险。
{"title":"Cognitive inflexibility moderates the association between drive for muscularity and dysfunctional exercise in men","authors":"McKenzie L. Miller , Christina M. Sanzari , Julia M. Hormes","doi":"10.1016/j.eatbeh.2025.101985","DOIUrl":"10.1016/j.eatbeh.2025.101985","url":null,"abstract":"<div><h3>Objective</h3><div>Drive for muscularity, a concern with meeting societal standards for a highly muscular physique, is a rising concern among men. Dysfunctional exercise is associated with drive for muscularity and leads to a myriad of negative physical and psychosocial outcomes. Cognitive inflexibility, a difficulty adapting to changing circumstances, is a transdiagnostic mechanism across psychiatric conditions, including dysfunctional exercise. This study evaluated cognitive inflexibility as a moderator of the relationship between drive for muscularity and dysfunctional exercise in men.</div></div><div><h3>Methods</h3><div>Undergraduate men (<em>n</em> = 243, 53.5% White) completed self-report measures assessing drive for muscularity, dysfunctional exercise, and general and domain-specific cognitive inflexibility. Moderation analyses assessed whether cognitive inflexibility moderated the relationship between drive for muscularity and dysfunctional exercise.</div></div><div><h3>Results</h3><div>Cognitive inflexibility specific to food/exercise and weight/shape moderated the relationship between drive for muscularity behaviors and dysfunctional exercise (R<sup>2</sup> = 0.01, 0.03 respectively). General cognitive inflexibility did not moderate the relationship. Attitudes (<em>r</em>(237) = 0.25, <em>p</em> < .001) and behaviors (<em>r</em>(237) = 0.53, <em>p</em> < .001) related to a drive for muscularity were positively associated with dysfunctional exercise.</div></div><div><h3>Conclusion</h3><div>Results suggest that domain-specific cognitive inflexibility amplifies the risk of dysfunctional exercise in men with a high drive for muscularity. Findings suggest that interventions targeting cognitive inflexibility may help mitigate the risk of problematic exercise in this population.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101985"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-24DOI: 10.1016/j.eatbeh.2025.101970
Isabel R. Rooper , Chidiebere Azubuike , Adrian Ortega , Graham C. Miller , Leah M. Parsons , Lindsay D. Lipman , Macarena Kruger , Rebecca L. Flynn , Basia Silverberg , Jennifer E. Wildes , Andrea K. Graham
Objective
Individuals from minoritized and under-resourced subpopulations, such as individuals with food insecurity, are sometimes considered “harder to reach.” Instead, tailored dissemination pathways may be required to reach them. We sought to learn how best to reach individuals with food insecurity seeking digital intervention for binge eating.
Method
As part of continued design work in two ongoing trials testing a digital intervention for binge eating, we conducted a secondary exploratory analysis of individuals' preferred dissemination channels, modes, and materials. We assessed individuals' preferences at baseline via a pre-intervention questionnaire. Adults (n = 90) with binge eating and food insecurity or at risk of food insecurity completed the questionnaire. We also compared their preferences to adults (n = 106) with binge eating and without food insecurity, and highlighted differences of p < 0.10.
Results
Individuals with or at risk of food insecurity preferred dissemination via community organizations and events, healthcare centers, fitness centers, and online sources, more than trusted sources (e.g., clinicians). They preferred websites over other dissemination modes (e.g., videos). They were most interested in useful promotional materials (e.g., grocery bags). Compared to those without food insecurity, individuals with or at risk of food insecurity were more interested in dissemination via community organizations and events, and less interested in dissemination through doctors.
Discussion
Findings indicate tailored dissemination strategies could improve reach to individuals with or at risk of food insecurity. This study is a first step toward better engaging this subpopulation. Future work should disseminate through the preferred channels, assess their reach, and iterate as needed.
{"title":"‘Harder to reach’ versus reaching harder: Exploring preferred dissemination pathways to a digital binge-eating intervention for adults with or at risk of food insecurity","authors":"Isabel R. Rooper , Chidiebere Azubuike , Adrian Ortega , Graham C. Miller , Leah M. Parsons , Lindsay D. Lipman , Macarena Kruger , Rebecca L. Flynn , Basia Silverberg , Jennifer E. Wildes , Andrea K. Graham","doi":"10.1016/j.eatbeh.2025.101970","DOIUrl":"10.1016/j.eatbeh.2025.101970","url":null,"abstract":"<div><h3>Objective</h3><div>Individuals from minoritized and under-resourced subpopulations, such as individuals with food insecurity, are sometimes considered “harder to reach.” Instead, tailored dissemination pathways may be required to reach them. We sought to learn how best to reach individuals with food insecurity seeking digital intervention for binge eating.</div></div><div><h3>Method</h3><div>As part of continued design work in two ongoing trials testing a digital intervention for binge eating, we conducted a secondary exploratory analysis of individuals' preferred dissemination channels, modes, and materials. We assessed individuals' preferences at baseline via a pre-intervention questionnaire. Adults (<em>n</em> = 90) with binge eating and food insecurity or at risk of food insecurity completed the questionnaire. We also compared their preferences to adults (<em>n</em> = 106) with binge eating and without food insecurity, and highlighted differences of <em>p</em> < 0.10.</div></div><div><h3>Results</h3><div>Individuals with or at risk of food insecurity preferred dissemination via community organizations and events, healthcare centers, fitness centers, and online sources, more than trusted sources (e.g., clinicians). They preferred websites over other dissemination modes (e.g., videos). They were most interested in useful promotional materials (e.g., grocery bags). Compared to those without food insecurity, individuals with or at risk of food insecurity were more interested in dissemination via community organizations and events, and less interested in dissemination through doctors.</div></div><div><h3>Discussion</h3><div>Findings indicate tailored dissemination strategies could improve reach to individuals with or at risk of food insecurity. This study is a first step toward better engaging this subpopulation. Future work should disseminate through the preferred channels, assess their reach, and iterate as needed.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101970"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-24DOI: 10.1016/j.eatbeh.2025.101971
Dorthe Dalstrup Pauls , Loa Clausen , Jens Meldgaard Bruun
Lifestyle interventions are the preferred treatment option for childhood obesity, but the effectiveness varies among individuals, and not all children benefit from treatment which may be explained by different eating behavior profiles. This study aimed to identify eating behavior latent profiles in 7–14 year olds with overweight/obesity and low quality of life (QoL) referred to a 10-week multicomponent lifestyle camp, characterize the profiles, and explore treatment effect across profiles. In total, 174 children with overweight/obesity were included. At baseline, 10 and 52-weeks, participants answered questionnaires on eating behavior traits, QoL, and overeating (OE)/loss-of-control (LOC) eating, while anthropometry was measured. Latent profile analysis was performed to identify eating behavior profiles upon entering. A three-profile solution was identified: Low Food Approach (LFA) showing a low degree of Food Responsiveness (FR) and Emotional Overeating (EOE), Medium Food Approach (MFA) characterized with a moderate FR and EOE, and High Food Approach (HFA) showing the highest degree of FR and EOE. The HFA profile (42 %) was younger, had lowest QoL, and highest body mass index standard deviation score (BMI-SDS) compared to the remaining profiles. The HFA profile showed superior improvements in QoL and OE after 10-weeks, despite no differences in BMI-SDS changes between the profiles. Additionally, the HFA profile showed greater improvements in QoL after 52-weeks but continued to have the highest BMI-SDS. This study emphasizes the importance of personalized approaches in childhood obesity treatment, and identifying eating behavior profiles may be a simple tool for tailoring future intervention strategies.
{"title":"Eating behavior profiles in children following a 10-week lifestyle camp due to overweight/obesity and low quality of life: A latent profile analysis on eating behavior","authors":"Dorthe Dalstrup Pauls , Loa Clausen , Jens Meldgaard Bruun","doi":"10.1016/j.eatbeh.2025.101971","DOIUrl":"10.1016/j.eatbeh.2025.101971","url":null,"abstract":"<div><div>Lifestyle interventions are the preferred treatment option for childhood obesity, but the effectiveness varies among individuals, and not all children benefit from treatment which may be explained by different eating behavior profiles. This study aimed to identify eating behavior latent profiles in 7–14 year olds with overweight/obesity and low quality of life (QoL) referred to a 10-week multicomponent lifestyle camp, characterize the profiles, and explore treatment effect across profiles. In total, 174 children with overweight/obesity were included. At baseline, 10 and 52-weeks, participants answered questionnaires on eating behavior traits, QoL, and overeating (OE)/loss-of-control (LOC) eating, while anthropometry was measured. Latent profile analysis was performed to identify eating behavior profiles upon entering. A three-profile solution was identified: Low Food Approach (LFA) showing a low degree of Food Responsiveness (FR) and Emotional Overeating (EOE), Medium Food Approach (MFA) characterized with a moderate FR and EOE, and High Food Approach (HFA) showing the highest degree of FR and EOE. The HFA profile (42 %) was younger, had lowest QoL, and highest body mass index standard deviation score (BMI-SDS) compared to the remaining profiles. The HFA profile showed superior improvements in QoL and OE after 10-weeks, despite no differences in BMI-SDS changes between the profiles. Additionally, the HFA profile showed greater improvements in QoL after 52-weeks but continued to have the highest BMI-SDS. This study emphasizes the importance of personalized approaches in childhood obesity treatment, and identifying eating behavior profiles may be a simple tool for tailoring future intervention strategies.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101971"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-19DOI: 10.1016/j.eatbeh.2025.101969
Maria Coimbra , Marina Cunha , Ana Ganho-Ávila , Cláudia Ferreira
Body image flexibility concerns the willingness to tolerate undesirable body-related experiences, while remaining committed to valued goals and actions, and plays an important role in the development and maintenance of the body and eating-related disorders. However, the known limitations of current assessment measures represent a major barrier to the adequate study of this construct. Recently, a novel brief psychological flexibility measure was successfully developed (Psy-Flex). The present study aimed to adapt and validate the Psy-Flex for Body Image (Psy-Flex-BI) and to explore its psychometric properties. Additionally, we aimed to support this scale as an important tool in the fields of disordered eating and body dysmorphia, by testing its ability to differentiate the severity levels of these symptoms in the general population. The study comprised 1031 participants who completed online questionnaires. The Psy-Flex-BI (6 items) was successfully adapted, and the one-dimensional factorial structure of the scale was confirmed. The scale presented robust psychometric properties, including a Cronbach's alpha of 0.89, and was invariant across sex. It also correlated in expected directions and strengths with similar constructs and maladaptive psychological indicators. Finally, Psy-flex-BI scores successfully corresponded to distinctive disordered eating and body dysmorphia symptomatology severity levels, presenting two distinct patterns supported by the literature. This data supports the scale's screening potential. Indeed, the Psy-Flex-BI is a brief and sound measure of body image flexibility, encompassing the six core ACT dimensions, and can differentiate the severity of eating and body dysmorphia symptoms in the general population.
{"title":"Navigating body image flexibility: Psy-Flex scale for body image and its utility in differentiating severity levels of disordered eating and body dysmorphia symptomatology","authors":"Maria Coimbra , Marina Cunha , Ana Ganho-Ávila , Cláudia Ferreira","doi":"10.1016/j.eatbeh.2025.101969","DOIUrl":"10.1016/j.eatbeh.2025.101969","url":null,"abstract":"<div><div>Body image flexibility concerns the willingness to tolerate undesirable body-related experiences, while remaining committed to valued goals and actions, and plays an important role in the development and maintenance of the body and eating-related disorders. However, the known limitations of current assessment measures represent a major barrier to the adequate study of this construct. Recently, a novel brief psychological flexibility measure was successfully developed (Psy-Flex). The present study aimed to adapt and validate the Psy-Flex for Body Image (Psy-Flex-BI) and to explore its psychometric properties. Additionally, we aimed to support this scale as an important tool in the fields of disordered eating and body dysmorphia, by testing its ability to differentiate the severity levels of these symptoms in the general population. The study comprised 1031 participants who completed online questionnaires. The Psy-Flex-BI (6 items) was successfully adapted, and the one-dimensional factorial structure of the scale was confirmed. The scale presented robust psychometric properties, including a Cronbach's alpha of 0.89, and was invariant across sex. It also correlated in expected directions and strengths with similar constructs and maladaptive psychological indicators. Finally, Psy-flex-BI scores successfully corresponded to distinctive disordered eating and body dysmorphia symptomatology severity levels, presenting two distinct patterns supported by the literature. This data supports the scale's screening potential. Indeed, the Psy-Flex-BI is a brief and sound measure of body image flexibility, encompassing the six core ACT dimensions, and can differentiate the severity of eating and body dysmorphia symptoms in the general population.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101969"},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-17DOI: 10.1016/j.eatbeh.2025.101966
Carmen Jiménez-Padilla, Antonio J. Vázquez Morejón, Samuel Arias-Sánchez
Eating disorders (EDs) are a group of disorders characterized by altered eating behaviors and/or the emergence of behaviors pertaining to weight control. Some studies report a relationship between coping strategies adopted in the face of stress and EDs. However, the latest review on this topic was carried out in 2008 by Quiles & Terol. A systematic review of studies that have investigated the relationship between coping strategies and EDs in clinical (anorexia nervosa, bulimia nervosa, or binge eating disorder) and non-clinical populations, aged 12–25 years has been conducted. Articles in English and Spanish were selected from Web of Science and Psycinfo databases in the last 15 years. Eighteen articles were finally included in the review. The results show a higher use of negative, avoidant, and emotion-focused coping strategies in populations with eating disorders or with high scores on questionnaires; additionally, results uncovered a higher use of positive coping strategies in populations without eating disorders or with low scores on questionnaires measuring ED symptomatology.
饮食失调（EDs）是一组以改变饮食行为和/或出现与体重控制有关的行为为特征的疾病。一些研究报告了在面对压力时所采取的应对策略与ed之间的关系。然而，关于这一主题的最新综述是在2008年由Quiles &；Terol。对临床（神经性厌食症、神经性贪食症或暴食症）和非临床人群（12-25岁）应对策略与EDs之间关系的研究进行了系统回顾。英语和西班牙语的文章选自Web of Science和Psycinfo数据库中过去15年的文章。18篇文章最终被纳入综述。结果显示，在饮食失调或问卷得分高的人群中，消极、回避和情绪聚焦应对策略的使用频率更高；此外，研究结果还发现，在没有饮食失调或ED症状调查问卷得分较低的人群中，积极应对策略的使用率更高。
{"title":"Coping strategies adopted when faced with stress and eating disorders: A systematic review","authors":"Carmen Jiménez-Padilla, Antonio J. Vázquez Morejón, Samuel Arias-Sánchez","doi":"10.1016/j.eatbeh.2025.101966","DOIUrl":"10.1016/j.eatbeh.2025.101966","url":null,"abstract":"<div><div>Eating disorders (EDs) are a group of disorders characterized by altered eating behaviors and/or the emergence of behaviors pertaining to weight control. Some studies report a relationship between coping strategies adopted in the face of stress and EDs. However, the latest review on this topic was carried out in 2008 by Quiles & Terol. A systematic review of studies that have investigated the relationship between coping strategies and EDs in clinical (anorexia nervosa, bulimia nervosa, or binge eating disorder) and non-clinical populations, aged 12–25 years has been conducted. Articles in English and Spanish were selected from Web of Science and Psycinfo databases in the last 15 years. Eighteen articles were finally included in the review. The results show a higher use of negative, avoidant, and emotion-focused coping strategies in populations with eating disorders or with high scores on questionnaires; additionally, results uncovered a higher use of positive coping strategies in populations without eating disorders or with low scores on questionnaires measuring ED symptomatology.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101966"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-17DOI: 10.1016/j.eatbeh.2025.101968
Silvia Tempia Valenta , Federica Marcolini , Miriam Scalise , Marco Verrastro , Michele Rugo , Fabio Panariello , Diana De Ronchi , Anna Rita Atti
Background
Eating disorders (EDs) are prevalent psychopathological conditions with significant psycho-physical consequences. Despite advances in diagnostic tools and treatment approaches, many patients experience barriers to accessing specialized ED care (SEDC). This study aimed to (1) examine the timeline of the care pathway from symptom onset to referral to a regional SEDC; (2) assess the association between referral to SEDC and factors such as the initial healthcare provider and clinical symptoms; and (3) investigate the relationship between the care pathway and clinical severity at the time of referral.
Methods
This study analyzed data from 174 patients accessing the SEDC in Bologna, Italy, between 2022 and 2024. Chi-square tests and Kendall Tau correlations were used to assess the associations between referral patterns, healthcare professionals, symptom severity, and healthcare contacts prior to referral.
Results
On average, participants took 26.3 months from symptom onset to seek help and 53.7 months before reaching the SEDC. General practitioners and psychiatric services had higher referral rates to SEDC. Weight loss and amenorrhea were positively associated with referrals, while depressed mood and fear of weight gain showed negative associations. No significant link was found between the care pathway and clinical severity at the time of referral.
Conclusion
Referral to SEDC is associated with the type of healthcare provider initially consulted and the presence of specific symptoms, particularly weight loss and amenorrhea. These findings highlight the importance of enhancing awareness among frontline healthcare providers to promote earlier recognition and referral of ED cases.
{"title":"Still waiting: referral patterns, delays, and key factors in accessing specialized eating disorder treatment in an Italian cohort","authors":"Silvia Tempia Valenta , Federica Marcolini , Miriam Scalise , Marco Verrastro , Michele Rugo , Fabio Panariello , Diana De Ronchi , Anna Rita Atti","doi":"10.1016/j.eatbeh.2025.101968","DOIUrl":"10.1016/j.eatbeh.2025.101968","url":null,"abstract":"<div><h3>Background</h3><div>Eating disorders (EDs) are prevalent psychopathological conditions with significant psycho-physical consequences. Despite advances in diagnostic tools and treatment approaches, many patients experience barriers to accessing specialized ED care (SEDC). This study aimed to (1) examine the timeline of the care pathway from symptom onset to referral to a regional SEDC; (2) assess the association between referral to SEDC and factors such as the initial healthcare provider and clinical symptoms; and (3) investigate the relationship between the care pathway and clinical severity at the time of referral.</div></div><div><h3>Methods</h3><div>This study analyzed data from 174 patients accessing the SEDC in Bologna, Italy, between 2022 and 2024. Chi-square tests and Kendall Tau correlations were used to assess the associations between referral patterns, healthcare professionals, symptom severity, and healthcare contacts prior to referral.</div></div><div><h3>Results</h3><div>On average, participants took 26.3 months from symptom onset to seek help and 53.7 months before reaching the SEDC. General practitioners and psychiatric services had higher referral rates to SEDC. Weight loss and amenorrhea were positively associated with referrals, while depressed mood and fear of weight gain showed negative associations. No significant link was found between the care pathway and clinical severity at the time of referral.</div></div><div><h3>Conclusion</h3><div>Referral to SEDC is associated with the type of healthcare provider initially consulted and the presence of specific symptoms, particularly weight loss and amenorrhea. These findings highlight the importance of enhancing awareness among frontline healthcare providers to promote earlier recognition and referral of ED cases.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101968"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-17DOI: 10.1016/j.eatbeh.2025.101967
Meg G. Salvia , Manu Onteeru , Sarah K. Lipson , Paula A. Quatromoni
Introduction
Vegan and vegetarian diets are increasingly popular, though there is concern that disordered eating can drive, emerge, or intensify from the choice to adopt dietary restrictions.
Objective
We sought to ascertain whether disordered eating or weight-control behaviors are associated with newly adopting a vegetarian/vegan diet during college and to assess symptom awareness and treatment utilization.
Methods
Data came from 11,503 students in the Healthy Minds Study spanning 2015–2021. We examined associations between (i) the SCOFF eating disorder screener and (ii) symptom-specific items from the Eating Disorder Examination Questionnaire, and recent adoption of a vegan/vegetarian diet. Participants' knowledge of eating disorder symptoms and experiences with treatment utilization were also assessed.
Results
Five-hundred thirty-two participants (∼5 %) reported adopting a vegan/vegetarian diet. Compared to students who did not change eating patterns, those who adopted vegetarianism/veganism had higher past-month prevalence of binge eating (25 % vs, 16 %), compulsive exercise (18 % vs. 9 %), and fasting (12 % vs. 8 %). Each behavior was significantly associated with greater odds of having recently adopted a vegetarian/vegan diet. A positive SCOFF screen (2+ items) was associated with 1.79-times (95 % CI: 1.48, 2.16) greater odds of newly adopting a vegetarian/vegan diet. There were no observed differences between groups with respect to knowledge of eating disorder symptoms or treatment-seeking attitudes and behaviors.
Discussion
Disordered eating or weight-control behaviors were prevalent in this population of young adults and were associated with adopting a vegetarian/vegan diet, though awareness and help-seeking were not elevated among those with higher eating disorder risk.
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Pub Date : 2025-03-12DOI: 10.1016/j.eatbeh.2025.101964
Naomi G. Hill, K. Jean Forney
“Feeling fat” is the subjective sensation of being overweight, which is not fully explained by one's body weight. Disruptions in emotion differentiation and gastric interoception may contribute to feeling fat. We hypothesized that poor negative emotion differentiation and poor gastric interoceptive accuracy would each be associated with higher levels of feeling fat after adjusting for negative affect intensity and body fat percentage. Cisgender female university students (N = 69; M(SD) age = 20.3(3.7), 60.9 % heterosexual, 91.3 % white) completed questionnaires and the two-step water load test. Regression analyses, which adjusted for negative affect intensity and body fat percentage, found that neither negative emotion differentiation (B < 0.001, p = .52) nor gastric interoceptive accuracy (B = 0.01, p = .97) were related to feeling fat. Post hoc, eating pathology severity moderated the relationship between negative emotion differentiation and feeling fat (B = −6.97, p = .03); poorer negative emotion differentiation was associated with greater feeling fat for those with Eating Disorder Examination Questionnaire Global Scores above 1.47 (B = −5.79, p = .050). The relationship between gastric interoception and feeling fat did not vary by eating pathology severity (B = −0.04, p = .79). Self-reported feeling full also contributed to feeling fat after consuming water to perceived maximum fullness (p < .001); however, changes in feeling full were not associated with changes in feeling fat across the task (p = .09). Poorer negative emotion differentiation is associated with feeling fat for those with elevated eating pathology. Individuals with elevated eating pathology may benefit from improving their ability to label and understand emotions to reduce feeling fat. Future research should test whether changes in feeling full cause feeling fat.
“感觉胖”是超重的主观感觉，不能完全用体重来解释。情绪分化和胃内感受的中断可能导致感觉肥胖。我们假设，在调整负面情绪强度和体脂率后，不良的负面情绪分化和不良的胃内感受准确性都与较高的感觉肥胖水平有关。顺性别女大学生(N = 69；M（SD）年龄= 20.3(3.7)，异性恋60.9%，白人91.3%)完成问卷调查和两步水负荷测试。对负面情绪强度和体脂率进行调整的回归分析发现，负面情绪分化(B <；0.001, p = 0.52)与胃内感受准确度（B = 0.01, p = 0.97）无关。事后，进食病理严重程度调节了负性情绪分化与感觉肥胖的关系（B = - 6.97, p = .03）；对于饮食失调检查问卷整体得分高于1.47的患者，较差的负面情绪分化与更大的肥胖感相关（B = - 5.79, p = 0.050）。胃内感受与感觉肥胖之间的关系不因进食病理严重程度而变化（B = - 0.04, p = .79）。自我报告的饱腹感也有助于在喝水到最大饱腹感后感到肥胖(p <；措施);然而，在整个任务中，饱腹感的变化与感觉肥胖的变化无关（p = .09）。对于那些饮食病理升高的人来说，较差的负面情绪分化与感觉肥胖有关。饮食病理升高的个体可能会受益于提高他们标记和理解情绪的能力，以减少感觉肥胖。未来的研究应该测试饱腹感的变化是否会导致肥胖。
{"title":"Negative emotion differentiation, but not gastric interoception, is linked to “feeling fat” among women with elevated eating pathology","authors":"Naomi G. Hill, K. Jean Forney","doi":"10.1016/j.eatbeh.2025.101964","DOIUrl":"10.1016/j.eatbeh.2025.101964","url":null,"abstract":"<div><div>“Feeling fat” is the subjective sensation of being overweight, which is not fully explained by one's body weight. Disruptions in emotion differentiation and gastric interoception may contribute to feeling fat. We hypothesized that poor negative emotion differentiation and poor gastric interoceptive accuracy would each be associated with higher levels of feeling fat after adjusting for negative affect intensity and body fat percentage. Cisgender female university students (N = 69; M(SD) age = 20.3(3.7), 60.9 % heterosexual, 91.3 % white) completed questionnaires and the two-step water load test. Regression analyses, which adjusted for negative affect intensity and body fat percentage, found that neither negative emotion differentiation (B < 0.001, <em>p</em> = .52) nor gastric interoceptive accuracy (B = 0.01, <em>p</em> = .97) were related to feeling fat. Post hoc, eating pathology severity moderated the relationship between negative emotion differentiation and feeling fat (B = −6.97, <em>p</em> = .03); poorer negative emotion differentiation was associated with greater feeling fat for those with Eating Disorder Examination Questionnaire Global Scores above 1.47 (B = −5.79, <em>p</em> = .050). The relationship between gastric interoception and feeling fat did not vary by eating pathology severity (B = −0.04<em>, p</em> = .79). Self-reported feeling full also contributed to feeling fat after consuming water to perceived maximum fullness (<em>p</em> < .001); however, <em>changes</em> in feeling full were not associated with changes in feeling fat across the task (<em>p</em> = .09). Poorer negative emotion differentiation is associated with feeling fat for those with elevated eating pathology. Individuals with elevated eating pathology may benefit from improving their ability to label and understand emotions to reduce feeling fat. Future research should test whether changes in feeling full cause feeling fat.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"57 ","pages":"Article 101964"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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