European Eating Disorders Review最新文献

Objective: Dancers are at an increased risk of developing eating disorders and health issues. The aim of this case-control study was to compare dietary intake, anthropometric indices and eating attitudes of adult professional dancers to their age- and sex-matched non-dancer females. 170 females (cases: n = 68, controls: n = 102) were voluntarily enroled.

Methods: Anthropometric, dietary characteristics and eating attitudes were derived through standard procedures. Eating Attitudes Test (EAT-26) and Eating Disorder Examination-Questionnaire (EDE-Q) were used to assess eating attitudes.

Results: Female dancers were more likely to have better body composition including body weight, handgrip strength and muscle mass, p < 0.05, as compared to non-dancer females. Besides, dancers had lower energy and fat intake but higher protein intake, as well as higher intake of several micronutrients (i.e., beta-carotene, vitamin D, B6, biotin, calcium, phosphorus, magnesium, manganese) but lower intake of iron and zinc (p < 0.05) compared to non-dancers. After adjustments, dancers had 5% higher score on EDE-Q-Restraint, but non-dancers had higher eating concerns when energy intake was taken into consideration (b = 0.61 ± 0.29, p = 0.038).

Conclusions: It is imperative to establish strategies to prevent eating disorders in dancers who exhibit restrictive behaviours and minimise the anxiety that women experience regarding food by establishing new social norms.

Objective: Eating disorders (EDs) and insomnia are prevalent among veterans. However, little is known about how ED and insomnia symptoms interact to maintain one, particularly in this population. We assessed associations between insomnia and ED symptoms (binge eating and restricting) for 6 months following military service separation. We hypothesised that: (a) greater insomnia symptoms would be associated concurrently with greater binge-eating/restricting symptoms across a 6-month period, and (b) the strength of the association between insomnia and binge-eating/restricting symptoms would be greater for individuals with ED vulnerability factors (i.e., body dissatisfaction, muscle-building concerns, depressed mood, and posttraumatic stress).

Method: U.S. veterans (N = 833) completed ED, body dissatisfaction, muscle-building concerns, mood, post-traumatic stress, and insomnia symptom assessments at baseline, 1-week, 3-month, and 6-month follow-up. We used linear mixed-effects models to test hypotheses.

Results: Greater insomnia symptoms were associated with greater binge-eating and restricting symptoms. Muscle-building concerns, depressed mood, and traumatic intrusion symptoms moderated the relationship between insomnia and binge-eating symptoms. None of the assessed ED vulnerability factors moderated the relationship between insomnia and restricting symptoms.

Discussion: Given that greater insomnia symptoms were associated with greater ED symptoms among veterans, future research should explore potential causal pathways to inform ED treatment approaches.

Objective: This scoping review seeks to evaluate the efficacy of teacher-led interventions in mitigating risk factors related to eating disorders, considering the necessity for universal prevention programmes that can be effectively administered by educators.

Methods: A literature search was conducted via ERIC, PubMed, and Scopus, following PRISMA guidelines. This search focused on peer-reviewed studies that evaluated teacher-led programmes among adolescents aged 11-16. Data was extracted on study design, sample characteristics, intervention content, and outcomes. Quality appraisal was conducted using CASP and CONSORT to enable evaluation. Results were synthesised and guided by PRISMA.

Results: From 16 studies, this review identified that teacher-led programmes could effectively reduce risk factors, including thin-ideal internalisation and body dissatisfaction. However, effectiveness requires an emphasis on teachers following program manuals, as deviations from the program often weaken outcomes, underscoring the need for comprehensive teacher training and support. The review also highlighted gender-specific challenges, with some programmes being less effective for boys.

Conclusions: Teacher-led interventions are important for scalable and sustainable eating disorder prevention in schools; however, success depends on rigorous adherence to intervention protocols and ongoing support for educators. Future research should focus on long-term efficacy, gender-specific adaptations, and the comparative cost-effectiveness of teacher-led versus clinician-led programmes.

Objective: To examine how eating-disorder symptoms vary by chronological age and sexual orientation in sexual minority adults.

Method: Cross-sectional data came from 2062 cisgender sexual minority participants (925 gay men, 573 lesbian women, 116 bi+ men, 448 bi+ women; age = 47.8 years, range = 18-96). Eight subscales from the Eating Pathology Symptoms Inventory were examined. A multivariate multivariable general linear model tested main and interaction effects of age and sexual orientation; significant multivariate multivariable findings were probed with false-discovery-rate-adjusted univariate regressions.

Results: Older age was associated with lower body dissatisfaction, binge eating, and muscle-building behaviours, but higher cognitive restraint and negative attitudes toward obesity. Age-by-group interactions indicated that body dissatisfaction and binge eating were higher among older cisgender bi+ women, whereas muscularity-oriented behaviours were lower in lesbian and bi+ women compared to gay men. Associations remained after socioeconomic covariate adjustment.

Conclusions: Findings suggested that levels of eating pathology varied based on age and across sexual minority groups. Bi+ women showed increasing body dissatisfaction and binge eating with age, while lesbian and bi+ women reported lower muscularity-oriented behaviours relative to gay men. Life-course prevention and treatment strategies should address identity-specific stress ecologies and the needs of adult sexual minority populations.

Background: Adolescence is period of social change during which peer relationships are prioritised. The desire for social approval, which heavily influences behaviour, is often linked to an increased risk of developing an eating disorder (ED). Social cognition is impaired in ED and both autism and social anxiety frequently co-occur. It is difficult to disentangle the contributing factors of cognitive and interpersonal difficulties in adolescents who present at children's ED services, and whether these relate to treatment response. We investigated whether baseline social measures predicted early treatment response after the initial 6-month period.

Methods: Adolescents aged 12-16 years (N = 983) treated by children's community ED services in England, UK, between 2017 and 2023, completed the Revised Child Anxiety and Depression Scales (RCADS) and/or the Strengths and Difficulties Questionnaire (SDQ) at assessment. Early weight restoration, defined as reaching at least 85% median-BMI adjusted for age and sex, at 6 months, was the primary outcome. A multiple linear regression was conducted using three measures: RCADS' Social Phobia, SDQ's Peer Problems and SDQ's Prosocial Behaviour to predict the degree of early weight restoration (85%medBMI), which was the primary outcome.

Results: The combined baseline social predictors: social phobia (standardised β = -0.382), peer problems (standardised β = -0.118) and prosocial behaviour (standardised β = -0.105) explained 20% of variance in weight restoration at 6-months post assessment (p < 0.001). Individual predictors regressed to %mBMI, were not moderated by age, with peer problems negatively predicting weight at 6 months and prosociality scores demonstrating significant skew because self-rated scores were high. Exploratory analyses showed that social anxiety was greater in those who did not reach early weight recovery at 6-months post assessment.

Conclusions: Assessing and addressing difficulties in social/peer group functioning might be a central consideration in treatment for AN in adolescents. Further research is needed to better understand the role of social functioning in recovery from AN.

Background: Autistic people with an eating disorder (ED) are at higher risk of poorer treatment outcomes and experiences, perhaps due to a lack of understanding surrounding underlying mechanisms. Several factors have been implicated, such as sensory processing and social camouflaging; however, there has been little empirical investigation into how such mechanisms group or cluster together, and if certain clusters place the individual at greater risk of ED severity.

Method: A secondary data analysis was conducted on an online survey of n = 180 Autistic adults (mean age = 38 years). Participants completed self-reported measures of sensory processing, social camouflaging and ED symptoms. Hierarchal clustering analyses (HCA) was conducted to explore clustering on sensory and social camouflaging behaviours, and a one-way ANOVA was conducted to explore between-cluster differences on ED symptoms.

Results: Three distinct clusters were identified: Cluster 1 (high camouflaging, low sensory); Cluster 2 (high camouflaging, high sensory); and Cluster 3 (low camouflaging, average sensory). Participants in Cluster 2 reported significantly higher ED symptoms that those in Cluster 3. There were no significant differences between remaining clusters.

Conclusion: Findings suggest the combination of these factors may place Autistic individuals at higher ED risk, although future longitudinal, mixed-method and more representative research, which considers a wider range of risk mechanisms, is urgently needed before conclusions can be drawn.

Objective: To critically appraise Sidari et al.'s pilot evaluation of the Strong Foundations programme - a 6-week pre-treatment, family-centred intervention that reconceptualises the waitlist as an active window for support, and to assess whether scalable caregiver interventions can improve clinical outcomes and treatment engagement.

Method: Critical synthesis of the pilot study's design, implementation, and outcomes. The programme delivered structured psychoeducation to parents alongside specialist medical oversight for adolescents during the pre-treatment period. We summarise reported process and clinical indicators, assess methodological strengths and limitations, and explore adaptations such as digital delivery, peer co-facilitation and primary care integration within stepped-care frameworks.

Results: Participating parents reported increased caregiving confidence and understanding of treatment pathways. Adolescents demonstrated preliminary improvements in BMI, affective symptoms and eating-disorder psychopathology. Strengths included focus on an overlooked treatment interval and integrated medical support; limitations included small sample size, absence of a control condition, selection bias, and brief follow-up. Proposed adaptations may increase scalability while preserving family-centred elements.

Conclusions: Reframing waitlists as active therapeutic intervals via brief, caregiver-focused interventions are promising for improving early outcomes, uptake and retention. Larger, controlled trials of condensed and digitally enabled formats are needed to establish effectiveness, cost-effectiveness, implementation feasibility and generalisability.

Objective: Risk for thiamine deficiency in individuals with anorexia nervosa (AN) remains uncertain due to significant heterogeneity in limited studies and given that current treatment recommendations are based on expert opinion and research in alcoholism. The purpose of this pilot study is to better understand thiamine deficiency in individuals with extreme AN.

Method: In this prospective, observational, pilot study, whole blood thiamine diphosphate (TDP) levels in 24 individuals with extreme AN, without nutritional rehabilitation or micronutrient supplementation for the preceding 30 days before admission, were compared to both a reference range and whole blood TDP levels in normal-weighted individuals. Individuals in the AN cohort were also provided 200 mg of oral thiamine for the first 10 days of hospitalisation, to better understand the impact of supplementation during refeeding.

Results: Mean whole blood TDP levels were within the standard reference range and not statistically different from the control group. Whole blood TDP levels did not significantly increase after 10 days of oral thiamine supplementation.

Conclusions: Individuals with AN may not be at high risk for thiamine deficiency. A larger follow-up study assessing whole blood TDP levels, without any recent thiamine supplementation, is required to fully understand the risk of thiamine deficiency.

Objective: Disturbances of glucose homoeostasis are claimed to act as both a consequence and maintaining factor in eating disorders (EDs). This study explored glucose trends and their association with real-time food intake and self-report eating psychopathology in a sample of patients with anorexia nervosa (AN) and binge-eating disorder (BED).

Method: 30 patients (AN, 15; BED, 15) wore continuous glucose monitoring (CGM) sensors while synchronously collecting data on daily food intake. CGM outputs were extracted and correlated with nutritional intake, daily meals composition and self-report eating psychopathology (BES, NEQ, GQ, Y-FAS).

Results: Up to 74% of participants experienced hypoglycaemia in the study period, with unique trends by diagnosis (prolonged, interprandial, nocturnal episodes in AN; brief, postprandial, daytime episodes in BED). Significant association between the average number of daily meals, glucose coefficient of variation, and symptomatic events was evident in AN. Self-report night eating and food addiction symptoms in AN, and self-report grazing in BED, associated, respectively, with daytime and symptomatic hypoglycaemia.

Conclusions: Hypoglycaemia is a frequent finding in patients with AN and BED and is associated with daily meals composition and dysfunctional eating behaviours. Theoretical explanations are provided for a diagnosis-specific effect on hypoglycemia events. CGM could valuably contribute to understanding, clinical staging, and customised treatments of EDs.

Objective: This research aimed to explore what women with lived experience of anorexia nervosa (AN) perceive as causal or contributing factors involved in the development of their AN.

Method: Sixteen participants were interviewed about their perceptions of the development of their AN. Interviews were analysed using thematic analysis.

Results: Participants described a strong role of relational factors in the perceived development of AN, including perception of unmet emotional needs, feelings of non-belonging, or significant emotional-relational injury, social difficulties, and exposure to conditional worth messaging about the body or eating. Relational factors were described in connection with internal factors of poor self-worth, disrupted emotion regulation ability, and emotional distress, which further linked to AN's development as an emotional coping strategy. Moreover, participants identified that experiences of prolonged or severe emotional distress had preceded AN symptoms, but opportunities for early prevention/intervention were missed.

Conclusions: These findings highlight relational factors, internal factors and emotional distress as potential targets for prevention and early intervention in AN, via improved screening for at-risk individuals, early intervention for emotional distress, and better support for families in building healthy emotion regulation skills. Additionally, the data indicates that working with emotional and relational wounds may be important treatment targets.