Pub Date : 2025-10-18DOI: 10.1016/j.eatbeh.2025.102044
Max Z. Roberts , Caitrin Murphy , Ashley A. Moskovich , Francesca A. Scheiber , Rhonda M. Merwin
Individuals with type 1 diabetes (T1D) are at elevated risk for disordered eating behaviors (DEBs). When DEBs occur in someone with T1D, they have severe consequences, including increased risk of diabetes-related medical complications and early mortality related to poor glycemic control. Fear of hypoglycemia (FoH) is a diabetes-specific factor that is assumed to play a role in DEBs in T1D, but this has not been adequately tested. The current study examined FoH as a predictor of DEBs in the natural environment in adults with T1D who met criteria for clinically significant DEBs. Participants (n = 59) completed the 18 item FoH worry subscale of the Hypoglycemia Fear Survey II and reported on their eating behavior over three days of ecological momentary assessment. A total of 737 eating episodes were reported; 235 (31.89%) eating episodes involved DEBs (overeating or binge eating). The proportion of eating episodes that involved DEBs was regressed on FoH, controlling for age. Every one-point increase in the FoH worry subscale score was associated with a 2% increase in the odds of DEB (OR = 1.02; 95% CI [1.01, 1.03], p < .001). Results suggest that FoH may be an important clinical factor when addressing DEBs in T1D.
1型糖尿病（T1D）患者发生饮食失调（DEBs）的风险较高。当糖尿病1型糖尿病患者发生deb时，会产生严重后果，包括糖尿病相关并发症的风险增加以及与血糖控制不良相关的早期死亡。对低血糖的恐惧（FoH）是一种糖尿病特异性因素，被认为在T1D患者的deb中起作用，但尚未得到充分的验证。目前的研究检查了FoH作为自然环境中符合临床显著DEBs标准的T1D成人DEBs的预测因子。参与者（n = 59）完成了低血糖恐惧调查II的18项FoH担忧子量表，并报告了他们在三天的生态瞬时评估中的饮食行为。共报告了737例进食事件；235例（31.89%）进食事件涉及DEBs（暴饮暴食或暴食）。在控制年龄的情况下，进食事件中涉及DEBs的比例在FoH上回归。FoH忧虑亚量表得分每增加1分，DEB的几率就增加2% （OR = 1.02; 95% CI [1.01, 1.03], p < 0.001）。结果表明，FoH可能是解决T1D患者DEBs的重要临床因素。
{"title":"Fear of hypoglycemia and disordered eating behavior in type 1 diabetes","authors":"Max Z. Roberts , Caitrin Murphy , Ashley A. Moskovich , Francesca A. Scheiber , Rhonda M. Merwin","doi":"10.1016/j.eatbeh.2025.102044","DOIUrl":"10.1016/j.eatbeh.2025.102044","url":null,"abstract":"<div><div>Individuals with type 1 diabetes (T1D) are at elevated risk for disordered eating behaviors (DEBs). When DEBs occur in someone with T1D, they have severe consequences, including increased risk of diabetes-related medical complications and early mortality related to poor glycemic control. Fear of hypoglycemia (FoH) is a diabetes-specific factor that is assumed to play a role in DEBs in T1D, but this has not been adequately tested. The current study examined FoH as a predictor of DEBs in the natural environment in adults with T1D who met criteria for clinically significant DEBs. Participants (<em>n</em> = 59) completed the 18 item FoH worry subscale of the Hypoglycemia Fear Survey II and reported on their eating behavior over three days of ecological momentary assessment. A total of 737 eating episodes were reported; 235 (31.89%) eating episodes involved DEBs (overeating or binge eating). The proportion of eating episodes that involved DEBs was regressed on FoH, controlling for age. Every one-point increase in the FoH worry subscale score was associated with a 2% increase in the odds of DEB (OR = 1.02; 95% CI [1.01, 1.03], <em>p</em> < .001). Results suggest that FoH may be an important clinical factor when addressing DEBs in T1D.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102044"},"PeriodicalIF":2.6,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358080","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}
Although the association between health values and eating behaviors has been shown in previous research, its underlying mechanism remains unclear, especially among US college students. Guided by Self-Determination Theory, this cross-sectional study examined direct and indirect associations between health values and eating behaviors through body appreciation. In total, 2425 students (58 % women; mean age = 20.3 years) participated during Fall 2022 and Spring 2023. Pearson's correlation coefficient and PROCESS macro were applied to assess relationships between health values, body appreciation and eating behaviors (intuitive eating and emotional eating). Health values were divided into values for physical health (VPH) and values for social and emotional health (VSEH). Results indicated that VPH was positively related to intuitive eating and negatively related to emotional eating, both directly (intuitive eating = 0.15, emotional eating = −0.08, P < 0.001) and indirectly via body appreciation (intuitive eating = 0.09 (95 % confidence interval (CI): 0.08, 0.12; emotional eating = −0.09, 95 %CI: −0.11, −0.07). VPSH was directly (intuitive eating = 0.11, P < 0.001) and indirectly (intuitive eating = 0.09, 95 %CI: 0.07, 0.11) related to higher intuitive eating, while indirectly reducing emotional eating via body appreciation (emotional eating = −0.09, 95 %CI: −0.12, −0.08), with no direct association. This study highlights that health values were positively related to intuitive eating and negatively related to emotional eating, and body appreciation explained at least some of these relationships. These findings provide foundation for future longitudinal studies to investigate whether health values predict the development of eating behaviors through changes in body appreciation.
{"title":"Body appreciation as an indirect pathway in the association between health values and eating behaviors among college students","authors":"Sheida Zeraattalab-Motlagh , Cynthia Yoon , Craig Johnston , Aliye B. Cepni , Tracey Ledoux","doi":"10.1016/j.eatbeh.2025.102043","DOIUrl":"10.1016/j.eatbeh.2025.102043","url":null,"abstract":"<div><div>Although the association between health values and eating behaviors has been shown in previous research, its underlying mechanism remains unclear, especially among US college students. Guided by Self-Determination Theory, this cross-sectional study examined direct and indirect associations between health values and eating behaviors through body appreciation. In total, 2425 students (58 % women; mean age = 20.3 years) participated during Fall 2022 and Spring 2023. Pearson's correlation coefficient and PROCESS macro were applied to assess relationships between health values, body appreciation and eating behaviors (intuitive eating and emotional eating). Health values were divided into values for physical health (VPH) and values for social and emotional health (VSEH). Results indicated that VPH was positively related to intuitive eating and negatively related to emotional eating, both directly (<span><math><mi>β</mi></math></span><sub>intuitive eating</sub> = 0.15, <span><math><mi>β</mi></math></span><sub>emotional eating</sub> = −0.08, <em>P</em> < 0.001) and indirectly via body appreciation (<span><math><mi>β</mi></math></span><sub>intuitive eating</sub> = 0.09 (95 % confidence interval (CI): 0.08, 0.12; <span><math><mi>β</mi></math></span><sub>emotional eating</sub> = −0.09, 95 %CI: −0.11, −0.07). VPSH was directly (<span><math><mi>β</mi></math></span><sub>intuitive eating</sub> = 0.11, <em>P</em> < 0.001) and indirectly (<span><math><mi>β</mi></math></span><sub>intuitive eating</sub> = 0.09, 95 %CI: 0.07, 0.11) related to higher intuitive eating, while indirectly reducing emotional eating via body appreciation (<span><math><mi>β</mi></math></span><sub>emotional eating</sub> = −0.09, 95 %CI: −0.12, −0.08), with no direct association. This study highlights that health values were positively related to intuitive eating and negatively related to emotional eating, and body appreciation explained at least some of these relationships. These findings provide foundation for future longitudinal studies to investigate whether health values predict the development of eating behaviors through changes in body appreciation.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102043"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145388107","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 : 2025-10-17DOI: 10.1016/j.eatbeh.2025.102042
Jiajia Zhang , Zheyu Lin , Ning Zhang , Huifen Qiao , Changjun Teng
Objective
Diagnoses of eating disorders often evolve over time, yet research in China is scarce. Thus, this study aims to explore the evolution of eating disorder diagnoses and symptom development characteristics in the Chinese cultural context through high-quality retrospective examination, and to analyze risk factors for common symptom development.
Method
A retrospective analysis of patients diagnosed with eating disorders from 2019 to 2024 with a disease course exceeding two years. Data on age at onset, BMI, symptom onset, and other relevant variables were collected by reviewing outpatient medical records to determine longitudinal symptom progression and diagnostic shifts. A multifactorial cox proportional hazards model was constructed incorporating variables such as age of onset, sex, family history, self-harm, and amenorrhea to predict binge eating in restrictive eating disorder.
Result
Among 128 outpatients with eating disorders, 50.8 % experienced diagnostic shifts, predominantly from restrictive anorexia to binge-purge types, with complex symptom evolution in the majority. Survival analysis indicates that self-harm behavior significantly affects survival time compared to no self-harm (HR = 1.534, 95 %CI = 1.012–2.325, p = 0.044), and amenorrhea significantly affects survival time compared to no amenorrhea (HR = 0.565, 95 % CI = 0.373–0.855, p = 0.007).
Conclusion
In the Chinese cultural context, diagnostic shifts and symptom overlaps across eating disorder subtypes are observed, potentially indicating a natural progression of clinical phenomena. Assessment of self-harm and amenorrhea is crucial in the early diagnosis and treatment of eating disorders, particularly in patients with restrictive eating behaviors.
饮食失调的诊断往往随着时间的推移而发展，但在中国的研究很少。因此，本研究旨在通过高质量的回顾性调查，探讨中国文化背景下饮食失调诊断和症状发展特征的演变，并分析常见症状发展的危险因素。方法回顾性分析2019 - 2024年诊断为饮食失调且病程超过2年的患者。通过回顾门诊病历，收集发病年龄、BMI、症状发作和其他相关变量的数据，以确定纵向症状进展和诊断转变。建立多因素cox比例风险模型，纳入发病年龄、性别、家族史、自残、闭经等变量，预测限制性饮食障碍患者的暴食行为。结果128例进食障碍门诊患者中，50.8%的患者出现了从限制性厌食症到暴泻型的诊断转变，以复杂的症状演变为主。生存分析显示，自残行为与无自残行为相比显著影响生存时间（HR = 1.534, 95% CI = 1.012-2.325, p = 0.044），闭经与无闭经相比显著影响生存时间（HR = 0.565, 95% CI = 0.373-0.855, p = 0.007）。结论在中国文化背景下，饮食失调亚型的诊断转变和症状重叠，可能表明临床现象的自然发展。自我伤害和闭经的评估在饮食失调的早期诊断和治疗中是至关重要的，特别是在有限制性饮食行为的患者中。
{"title":"Diagnostic evolution and symptomatic development of eating disorders: A retrospective study","authors":"Jiajia Zhang , Zheyu Lin , Ning Zhang , Huifen Qiao , Changjun Teng","doi":"10.1016/j.eatbeh.2025.102042","DOIUrl":"10.1016/j.eatbeh.2025.102042","url":null,"abstract":"<div><h3>Objective</h3><div>Diagnoses of eating disorders often evolve over time, yet research in China is scarce. Thus, this study aims to explore the evolution of eating disorder diagnoses and symptom development characteristics in the Chinese cultural context through high-quality retrospective examination, and to analyze risk factors for common symptom development.</div></div><div><h3>Method</h3><div>A retrospective analysis of patients diagnosed with eating disorders from 2019 to 2024 with a disease course exceeding two years. Data on age at onset, BMI, symptom onset, and other relevant variables were collected by reviewing outpatient medical records to determine longitudinal symptom progression and diagnostic shifts. A multifactorial cox proportional hazards model was constructed incorporating variables such as age of onset, sex, family history, self-harm, and amenorrhea to predict binge eating in restrictive eating disorder.</div></div><div><h3>Result</h3><div>Among 128 outpatients with eating disorders, 50.8 % experienced diagnostic shifts, predominantly from restrictive anorexia to binge-purge types, with complex symptom evolution in the majority. Survival analysis indicates that self-harm behavior significantly affects survival time compared to no self-harm (HR = 1.534, 95 %CI = 1.012–2.325, <em>p</em> = 0.044), and amenorrhea significantly affects survival time compared to no amenorrhea (HR = 0.565, 95 % CI = 0.373–0.855, <em>p</em> = 0.007).</div></div><div><h3>Conclusion</h3><div>In the Chinese cultural context, diagnostic shifts and symptom overlaps across eating disorder subtypes are observed, potentially indicating a natural progression of clinical phenomena. Assessment of self-harm and amenorrhea is crucial in the early diagnosis and treatment of eating disorders, particularly in patients with restrictive eating behaviors.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102042"},"PeriodicalIF":2.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516770","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 : 2025-10-09DOI: 10.1016/j.eatbeh.2025.102040
Madison Hannapel , Jamie M. Lawler , Eamonn Arble , Chong Man Chow
Objective
Adolescent girls and mothers are vulnerable to poor body image outcomes, which are often reinforced through fat talk, a self-disparaging body-related conversation. Depression may exacerbate this risk, particularly among those engaging in fat talk. This study examined the associations, among mother-daughter dyads, between fat talk and restrictive, emotional, and external disordered eating, eating disorder symptoms, and body dissatisfaction, as well as whether depression moderated these associations.
Method
104 mother-daughter dyads completed online measures. Adolescent daughters (M = 15.73 years old; SD = 2.51) and their mothers (M = 43.17 years old; SD = 8.58) were primarily white/Caucasian.
Results
Actor effects of fat talk significantly predicted all body image outcomes. Partner effects emerged only for daughters' fat talk predicting mothers' body dissatisfaction. Depression moderated the association between fat talk and restrictive eating but did not moderate other associations. However, depression did independently predict poorer body image outcomes.
Discussion
Findings highlight the importance of studying mother-daughter dyads and capturing how psychopathology contributes to subclinical eating disordered behaviors, informing risk identification for eating disorder development.
{"title":"Depressive symptoms as a moderator of fat talk and body image outcomes within mother-daughter dyads","authors":"Madison Hannapel , Jamie M. Lawler , Eamonn Arble , Chong Man Chow","doi":"10.1016/j.eatbeh.2025.102040","DOIUrl":"10.1016/j.eatbeh.2025.102040","url":null,"abstract":"<div><h3>Objective</h3><div>Adolescent girls and mothers are vulnerable to poor body image outcomes, which are often reinforced through fat talk, a self-disparaging body-related conversation. Depression may exacerbate this risk, particularly among those engaging in fat talk. This study examined the associations, among mother-daughter dyads, between fat talk and restrictive, emotional, and external disordered eating, eating disorder symptoms, and body dissatisfaction, as well as whether depression moderated these associations.</div></div><div><h3>Method</h3><div>104 mother-daughter dyads completed online measures. Adolescent daughters (M = 15.73 years old; SD = 2.51) and their mothers (M = 43.17 years old; SD = 8.58) were primarily white/Caucasian.</div></div><div><h3>Results</h3><div>Actor effects of fat talk significantly predicted all body image outcomes. Partner effects emerged only for daughters' fat talk predicting mothers' body dissatisfaction. Depression moderated the association between fat talk and restrictive eating but did not moderate other associations. However, depression did independently predict poorer body image outcomes.</div></div><div><h3>Discussion</h3><div>Findings highlight the importance of studying mother-daughter dyads and capturing how psychopathology contributes to subclinical eating disordered behaviors, informing risk identification for eating disorder development.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102040"},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299248","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 : 2025-10-09DOI: 10.1016/j.eatbeh.2025.102041
Aditya Thakur , Lisa Y. Zhu , Lindsay P. Bodell
Food insecurity (FI) is a serious public health concern linked to negative physical and mental outcomes, including eating disorder symptoms. However, little is known about its relationship with muscularity-oriented disordered eating (MODE), which involves eating behaviours aimed at increasing muscle mass and decreasing body fat. This study examined the association between FI and MODE, as well as the potential indirect effects of depression and anxiety. A sample of 394 undergraduate students (72.34 % women) from a Canadian university completed online self-report measures of FI, MODE, depression, and anxiety. Linear regression analyses indicated that FI was significantly positively associated with MODE, even when controlling for gender. Indirect effects analyses further revealed that this association was partially explained by depression and anxiety in women, suggesting that psychological distress may play a key role in linking FI to MODE. Importantly, our findings provide evidence that MODE is not limited to individuals with greater financial resources to access high-protein diets and supplements. Food insecurity does not preclude engagement in MODE, emphasizing the need for theoretical models and interventions that consider FI as a potential risk factor. Future research should employ longitudinal designs to clarify the temporal relationship between FI, MODE, and mental health factors, as well as explore these associations in more diverse populations.
{"title":"Examining associations among food insecurity, muscularity-oriented disordered eating, and internalizing symptoms in undergraduate students","authors":"Aditya Thakur , Lisa Y. Zhu , Lindsay P. Bodell","doi":"10.1016/j.eatbeh.2025.102041","DOIUrl":"10.1016/j.eatbeh.2025.102041","url":null,"abstract":"<div><div>Food insecurity (FI) is a serious public health concern linked to negative physical and mental outcomes, including eating disorder symptoms. However, little is known about its relationship with muscularity-oriented disordered eating (MODE), which involves eating behaviours aimed at increasing muscle mass and decreasing body fat. This study examined the association between FI and MODE, as well as the potential indirect effects of depression and anxiety. A sample of 394 undergraduate students (72.34 % women) from a Canadian university completed online self-report measures of FI, MODE, depression, and anxiety. Linear regression analyses indicated that FI was significantly positively associated with MODE, even when controlling for gender. Indirect effects analyses further revealed that this association was partially explained by depression and anxiety in women, suggesting that psychological distress may play a key role in linking FI to MODE. Importantly, our findings provide evidence that MODE is not limited to individuals with greater financial resources to access high-protein diets and supplements. Food insecurity does not preclude engagement in MODE, emphasizing the need for theoretical models and interventions that consider FI as a potential risk factor. Future research should employ longitudinal designs to clarify the temporal relationship between FI, MODE, and mental health factors, as well as explore these associations in more diverse populations.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102041"},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299172","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 : 2025-09-29DOI: 10.1016/j.eatbeh.2025.102039
Bridget A. Owens , Julianna M. Jayne , Renee E. Cole , J. Philip Karl
Body composition requirements for U.S. Army Soldiers may increase risk of negative body image and unhealthy dietary behaviors, which may in turn lead to poor nutrition. This study aimed to determine whether negative body image was associated with worse diet quality in U.S. Army Soldiers and whether dietary restraint and emotional eating served as mediators. A cross-sectional study of U.S. Army Soldiers who completed the Military Eating Behavior Survey was conducted (N = 427, 93 % male, 23 ± 5 years of age). Diet quality was calculated using the Healthy Eating Index 2015 (HEI-2015) to assess total HEI, adequacy, and moderation components. Linear regression models were used to examine associations between body image, dietary restraint, emotional eating, and diet quality. Mediation models were tested to measure the indirect effect of dietary restraint and emotional eating on the association between body image and diet quality. Results demonstrated that higher concern with body image was associated with higher dietary restraint (B = 0.12, p < .0001) and higher emotional eating (B = 0.07, p = .0001). Dietary restraint was positively associated with Total HEI-2015 score (B = 1.10, p < .0001) and HEI-2015 moderation (B = 0.32, p < .0001) and adequacy (B = 0.78, p < .0001) scores. In mediation analyses, there was a significant indirect effect of body image on diet quality through restraint (a:0.25, b:0.41, c’:-0.12, ab:0.10; 95 % bootstrap CI: 0.06, 0.15) and emotional eating (a:0.18, b:-0.15, c’:0.05, ab:-0.04; 95 % bootstrap CI: −0.07, −0.01). Findings suggest that dietary restraint and emotional eating may be differentially associated with body image and diet quality. Whether these relationships persist over time is unclear.
美国陆军士兵的身体成分要求可能会增加负面身体形象和不健康饮食行为的风险，这可能反过来导致营养不良。本研究旨在确定美国陆军士兵的负面身体形象是否与较差的饮食质量有关，以及饮食限制和情绪化饮食是否起到中介作用。本研究对完成军队饮食行为调查的美国陆军士兵进行了横断面研究（N = 427, 93%为男性，23±5岁）。使用健康饮食指数2015 （HEI-2015）计算饮食质量，以评估总HEI、充足性和适度成分。线性回归模型用于检验身体形象、饮食限制、情绪性进食和饮食质量之间的关系。通过中介模型检验饮食约束和情绪性饮食对身体形象与饮食质量关系的间接影响。结果表明，对身体形象的高度关注与较高的饮食限制相关(B = 0.12, p
{"title":"Dietary restraint and emotional eating mediate the relationship between negative body image and diet quality in U.S. Army Soldiers","authors":"Bridget A. Owens , Julianna M. Jayne , Renee E. Cole , J. Philip Karl","doi":"10.1016/j.eatbeh.2025.102039","DOIUrl":"10.1016/j.eatbeh.2025.102039","url":null,"abstract":"<div><div>Body composition requirements for U.S. Army Soldiers may increase risk of negative body image and unhealthy dietary behaviors, which may in turn lead to poor nutrition. This study aimed to determine whether negative body image was associated with worse diet quality in U.S. Army Soldiers and whether dietary restraint and emotional eating served as mediators. A cross-sectional study of U.S. Army Soldiers who completed the Military Eating Behavior Survey was conducted (<em>N</em> = 427, 93 % male, 23 ± 5 years of age). Diet quality was calculated using the Healthy Eating Index 2015 (HEI-2015) to assess total HEI, adequacy, and moderation components. Linear regression models were used to examine associations between body image, dietary restraint, emotional eating, and diet quality. Mediation models were tested to measure the indirect effect of dietary restraint and emotional eating on the association between body image and diet quality. Results demonstrated that higher concern with body image was associated with higher dietary restraint (<em>B</em> = 0.12, <em>p</em> < .0001) and higher emotional eating (<em>B</em> = 0.07, <em>p</em> = .0001). Dietary restraint was positively associated with Total HEI-2015 score (<em>B</em> = 1.10, <em>p</em> < .0001) and HEI-2015 moderation (<em>B</em> = 0.32, <em>p</em> < .0001) and adequacy (<em>B</em> = 0.78, <em>p</em> < .0001) scores. In mediation analyses, there was a significant indirect effect of body image on diet quality through restraint (<em>a:</em>0.25, <em>b:</em>0.41<em>, c’:</em>-0.12, <em>ab:</em>0.10; 95 % bootstrap CI: 0.06, 0.15) and emotional eating (<em>a:</em>0.18, <em>b:</em>-0.15, <em>c’:</em>0.05<em>, ab:</em>-0.04; 95 % bootstrap CI: −0.07, −0.01). Findings suggest that dietary restraint and emotional eating may be differentially associated with body image and diet quality. Whether these relationships persist over time is unclear.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102039"},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211778","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 : 2025-09-18DOI: 10.1016/j.eatbeh.2025.102038
G. Rogier , C. Ameglio , G. Penco , C.S. Pace , S. Muzi , A. Cornil , P. Velotti
Background
Epidemiological and clinical studies highlighted that food addiction is a clinically relevant phenomenon. A large number of studies investigated its link with personality traits. However, a systematic overview and a meta-analysis of these results is lacking.
Methods
We systematically searched for studies investigating the link between food addiction and personality traits on several academic databases. For each personality trait, we performed a three-level meta-analysis estimating the strength of its association with food addiction severity. The role of moderators was tested employing meta-regression.
Results
The screening process led to the selection of 37 studies. Most contributions investigate impulsivity or the Cloninger's dimensions with the Impulsive Behavior Scale or the Temperament and Character Inventory respectively. An insufficient number of observations were retrieved to evaluate the association between food addiction severity and some personality traits such as those measured by the five-factor model. The highest effect sizes observed linked food addiction to low levels of self-directedness (r = −0.26), to high levels of both negative (r = 0.33) and positive (r = 0.27) urgency and to attentional impulsiveness (r = 0.31). Age and gender significantly moderated some of the effect sizes.
Conclusions
More research is needed to increase our knowledge regarding the association between food addiction severity and some personality traits. Results suggested that food addiction may be associated to the same personality traits that characterized addictions and eating disorders (e.g. harm avoidance and impulsivity), also revealing its specificity (i.e. the lack of significant association with reward dependence).
{"title":"Food addiction and personality traits: A three-levels meta-analysis of correlational studies","authors":"G. Rogier , C. Ameglio , G. Penco , C.S. Pace , S. Muzi , A. Cornil , P. Velotti","doi":"10.1016/j.eatbeh.2025.102038","DOIUrl":"10.1016/j.eatbeh.2025.102038","url":null,"abstract":"<div><h3>Background</h3><div>Epidemiological and clinical studies highlighted that food addiction is a clinically relevant phenomenon. A large number of studies investigated its link with personality traits. However, a systematic overview and a meta-analysis of these results is lacking.</div></div><div><h3>Methods</h3><div>We systematically searched for studies investigating the link between food addiction and personality traits on several academic databases. For each personality trait, we performed a three-level meta-analysis estimating the strength of its association with food addiction severity. The role of moderators was tested employing meta-regression.</div></div><div><h3>Results</h3><div>The screening process led to the selection of 37 studies. Most contributions investigate impulsivity or the Cloninger's dimensions with the Impulsive Behavior Scale or the Temperament and Character Inventory respectively. An insufficient number of observations were retrieved to evaluate the association between food addiction severity and some personality traits such as those measured by the five-factor model. The highest effect sizes observed linked food addiction to low levels of self-directedness (<em>r</em> = −0.26), to high levels of both negative (<em>r</em> = 0.33) and positive (<em>r</em> = 0.27) urgency and to attentional impulsiveness (<em>r</em> = 0.31). Age and gender significantly moderated some of the effect sizes.</div></div><div><h3>Conclusions</h3><div>More research is needed to increase our knowledge regarding the association between food addiction severity and some personality traits. Results suggested that food addiction may be associated to the same personality traits that characterized addictions and eating disorders (e.g. harm avoidance and impulsivity), also revealing its specificity (i.e. the lack of significant association with reward dependence).</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102038"},"PeriodicalIF":2.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184960","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 : 2025-09-16DOI: 10.1016/j.eatbeh.2025.102036
Julia Yermash , Tatyana Bidopia , Yvette Karvay , Haruka Minami , Shane W. Kraus , Natasha L. Burke
Youth from immigrant families navigate multiple cultures concurrently, and culture largely influences how disordered eating behaviors and cognitions (DEBC) present. Enculturation (i.e., maintaining one's heritage traditions, values, beliefs, etc. while living within the dominant culture) may – in contrast to acculturation – function as a protective factor against DEBC and body-image issues. Considering eating disorders' deleterious outcomes, understanding whether enculturation can be leveraged to protect against DEBC is important; however, there is a dearth of research in this area. To address this gap, associations among generational status, enculturation, and DEBC (assessed by the Eating Pathology Symptoms Inventory (EPSI)) were investigated in 467 college students using analysis of covariance and multiple linear regression models. Enculturation and generational status were associated as hypothesized, but positively, which was contrary to hypotheses. Generational status and enculturation did not individually influence DEBC, but generational status moderated the relationship between enculturation and Negative Attitudes toward Obesity, an EPSI subscale. Among the first-generation group, enculturation was positively associated with Negative Attitudes toward Obesity while for the third- and fourth-generation groups, enculturation was negatively associated with Negative Attitudes toward Obesity. The association between generational status, enculturation, and DEBC is nuanced and complex, but certain aspects of DEBC may be particularly important factors for first-generation individuals. Future research should investigate these relationships within specific cultural, racial, and ethnic groups and among non-college populations.
{"title":"An exploration of generational status and enculturation as putative protective factors for disordered eating behaviors and cognitions among college students","authors":"Julia Yermash , Tatyana Bidopia , Yvette Karvay , Haruka Minami , Shane W. Kraus , Natasha L. Burke","doi":"10.1016/j.eatbeh.2025.102036","DOIUrl":"10.1016/j.eatbeh.2025.102036","url":null,"abstract":"<div><div>Youth from immigrant families navigate multiple cultures concurrently, and culture largely influences how disordered eating behaviors and cognitions (DEBC) present. Enculturation (i.e., maintaining one's heritage traditions, values, beliefs, etc. while living within the dominant culture) may – in contrast to acculturation – function as a protective factor against DEBC and body-image issues. Considering eating disorders' deleterious outcomes, understanding whether enculturation can be leveraged to protect against DEBC is important; however, there is a dearth of research in this area. To address this gap, associations among generational status, enculturation, and DEBC (assessed by the Eating Pathology Symptoms Inventory (EPSI)) were investigated in 467 college students using analysis of covariance and multiple linear regression models. Enculturation and generational status were associated as hypothesized, but positively, which was contrary to hypotheses. Generational status and enculturation did not individually influence DEBC, but generational status moderated the relationship between enculturation and Negative Attitudes toward Obesity, an EPSI subscale. Among the first-generation group, enculturation was positively associated with Negative Attitudes toward Obesity while for the third- and fourth-generation groups, enculturation was negatively associated with Negative Attitudes toward Obesity. The association between generational status, enculturation, and DEBC is nuanced and complex, but certain aspects of DEBC may be particularly important factors for first-generation individuals. Future research should investigate these relationships within specific cultural, racial, and ethnic groups and among non-college populations.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102036"},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091075","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 : 2025-09-16DOI: 10.1016/j.eatbeh.2025.102037
Eva Trujillo-ChiVacuán , Emilio J. Compte , Glenn Waller
Objective
This study aimed to validate the Eating Disorders-15 (ED-15) in a clinically diverse sample of Mexican patients with eating disorders (EDs). Given the increasing prevalence of EDs in Latin America and the need for validated assessment tools, this study evaluated the psychometric properties of the ED-15 in this specific cultural and clinical context.
Method
A total of 286 individuals diagnosed with EDs were recruited from a specialized treatment center in Mexico. Participants completed the ED-15, alongside the Eating Disorder Examination-Questionnaire 7, the Body Shape Questionnaire-8, the Body Appreciation Scale-2, the Patient Health Questionnaire-9, and the Clinical Impairment Assessment. Confirmatory factor analyses tested four models, including the original two-factor model, a higher-order model, and a bi-factor model. Internal consistency, as well as convergent validity, were assessed.
Results
The original two-factor model showed excellent fit and was retained as the final solution based on model parsimony, goodness-of-fit indices, and theoretical considerations. The ED-15 demonstrated high internal consistency (ω > 0.80), strong positive associations with ED psychopathology, body dissatisfaction, depressive symptoms, and clinical impairment, and strong negative associations with body appreciation.
Discussion
These findings support the reliability and validity of the ED-15 in a Mexican clinical sample. The study provides robust psychometric evidence for the use of the ED-15 in clinical and research settings in Latin America and highlights the importance of culturally validated brief instruments for assessing eating disorder symptoms.
{"title":"Validation of the Eating Disorders-15 (ED-15) in Mexican patients across levels of care: Psychometric properties in a clinical sample","authors":"Eva Trujillo-ChiVacuán , Emilio J. Compte , Glenn Waller","doi":"10.1016/j.eatbeh.2025.102037","DOIUrl":"10.1016/j.eatbeh.2025.102037","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to validate the Eating Disorders-15 (ED-15) in a clinically diverse sample of Mexican patients with eating disorders (EDs). Given the increasing prevalence of EDs in Latin America and the need for validated assessment tools, this study evaluated the psychometric properties of the ED-15 in this specific cultural and clinical context.</div></div><div><h3>Method</h3><div>A total of 286 individuals diagnosed with EDs were recruited from a specialized treatment center in Mexico. Participants completed the ED-15, alongside the Eating Disorder Examination-Questionnaire 7, the Body Shape Questionnaire-8, the Body Appreciation Scale-2, the Patient Health Questionnaire-9, and the Clinical Impairment Assessment. Confirmatory factor analyses tested four models, including the original two-factor model, a higher-order model, and a bi-factor model. Internal consistency, as well as convergent validity, were assessed.</div></div><div><h3>Results</h3><div>The original two-factor model showed excellent fit and was retained as the final solution based on model parsimony, goodness-of-fit indices, and theoretical considerations. The ED-15 demonstrated high internal consistency (ω > 0.80), strong positive associations with ED psychopathology, body dissatisfaction, depressive symptoms, and clinical impairment, and strong negative associations with body appreciation.</div></div><div><h3>Discussion</h3><div>These findings support the reliability and validity of the ED-15 in a Mexican clinical sample. The study provides robust psychometric evidence for the use of the ED-15 in clinical and research settings in Latin America and highlights the importance of culturally validated brief instruments for assessing eating disorder symptoms.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102037"},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096432","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 : 2025-09-13DOI: 10.1016/j.eatbeh.2025.102034
Liyun Zheng , Shuang Zhang
Objective
Compared to psychosocial factors, medications remain less well recognized as precipitating factors for eating disorders. This study aims to identify medications potentially associated with eating disorders using the U.S. Food and Drug Administration's Adverse Event Reporting System (FAERS) database.
Methods
FAERS reports related to potential eating disorders from January 2004 to December 2024 were retrieved. Reporting odds ratios (RORs) were calculated to detect disproportionate signals, with Fisher's exact test and Bonferroni correction applied for adjustments in multiple comparisons. Drugs exhibiting significant positive signals (ROR 95 % confidence interval lower bound >1, adjusted p-value < 0.01) with over 100 reports were selected for LASSO regression analysis. Logistic regression, adjusted for age, sex, and reporter type, was employed to identify precipitating drugs.
Results
Among 20,145 reports, 62.7 % involved females, with a median age of 59 years (interquartile range: 42–71). Thirty drugs showed significant positive signals. Nine potential precipitating medications were identified through LASSO and logistic regression, including octreotide, ribociclib, sunitinib, rivastigmine, everolimus, quetiapine, palbociclib, esomeprazole, and pregabalin.
Conclusion
This study identifies certain medications that may act as precipitating factors for potential eating disorders, particularly in middle-aged and older populations. Clinicians should monitor these medications that affect appetite, weight, or carry abuse potential to prevent harm, especially in patients with eating disorders or at-risk populations.
{"title":"Medications as precipitating factors for potential eating disorders: A disproportionality analysis using FDA adverse event reports","authors":"Liyun Zheng , Shuang Zhang","doi":"10.1016/j.eatbeh.2025.102034","DOIUrl":"10.1016/j.eatbeh.2025.102034","url":null,"abstract":"<div><h3>Objective</h3><div>Compared to psychosocial factors, medications remain less well recognized as precipitating factors for eating disorders. This study aims to identify medications potentially associated with eating disorders using the U.S. Food and Drug Administration's Adverse Event Reporting System (FAERS) database.</div></div><div><h3>Methods</h3><div>FAERS reports related to potential eating disorders from January 2004 to December 2024 were retrieved. Reporting odds ratios (RORs) were calculated to detect disproportionate signals, with Fisher's exact test and Bonferroni correction applied for adjustments in multiple comparisons. Drugs exhibiting significant positive signals (ROR 95 % confidence interval lower bound >1, adjusted <em>p</em>-value < 0.01) with over 100 reports were selected for LASSO regression analysis. Logistic regression, adjusted for age, sex, and reporter type, was employed to identify precipitating drugs.</div></div><div><h3>Results</h3><div>Among 20,145 reports, 62.7 % involved females, with a median age of 59 years (interquartile range: 42–71). Thirty drugs showed significant positive signals. Nine potential precipitating medications were identified through LASSO and logistic regression, including octreotide, ribociclib, sunitinib, rivastigmine, everolimus, quetiapine, palbociclib, esomeprazole, and pregabalin.</div></div><div><h3>Conclusion</h3><div>This study identifies certain medications that may act as precipitating factors for potential eating disorders, particularly in middle-aged and older populations. Clinicians should monitor these medications that affect appetite, weight, or carry abuse potential to prevent harm, especially in patients with eating disorders or at-risk populations.</div></div>","PeriodicalId":11476,"journal":{"name":"Eating behaviors","volume":"59 ","pages":"Article 102034"},"PeriodicalIF":2.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091072","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}
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