Journal of Eating Disorders最新文献

Background: This cross-sectional study aimed to address the gap in understanding how night eating behavior impacts gastrointestinal health and psychological well-being in adult populations.

Method: This descriptive and cross-sectional study was conducted with 1372 adults aged 19-65 between September 2023 and November 2023. The research data were collected with the help of a web-based survey form (Google form) created by the researchers using the snowball sampling method. The demographic characteristics (sex, age, education level, marital status, income status), eating behaviors (number of main meals and snacks), and anthropometric measurements (body weight and height). Gastrointestinal symptoms observed in individuals were evaluated with the Gastrointestinal Symptom Rating Scale. The Night Eating Questionnaire (NEQ) was used to quantify the severity of night eating syndrome, and The Psychological Well-Being Scale was used to measure psychological well-being. All analyses were performed using the Statistical Package for the Social Sciences (version 27.0) software.

Results: A statistically significant negative correlation was found between the Psychological Well-Being Scale total score and Gastrointestinal Symptom Rating Scale subdimensions (r=-0.067, r=-0.067, r=-0.109, r=-0.068, r=-0.129, respectively). Also, a statistically significant negative correlation was found between the Psychological Well-Being Scale total score and the Night Eating Questionnaire total score (r=-0.287) (p < 0.05).

Conclusion: This study found a relationship between night eating syndrome, psychological well-being, and gastrointestinal symptoms. Nutritional strategies for night eating syndrome, an eating disorder, may have important consequences on the psychological well-being of individuals with night eating. Our study highlights the significant relationships between night eating behavior, gastrointestinal symptoms, and psychological well-being, suggesting that night eating may contribute to both physical and mental health challenges.

Improvements to eating disorder (ED) care are urgently needed in the United Kingdom (UK) and around the world. Informed by my lived experiences, independent research, and involvement in the underappreciated field of quality improvement (QI), I have written this article to offer ideas on how to improve individuals' access to and experiences of ED care. As I live in the UK, my lived and QI experiences are of the UK's National Health Service (NHS). However, much of this article's content can be applied broadly to healthcare providers around the world, as similar ED care improvements are needed internationally. Furthermore, this commentary is informed by the latest international research.In this paper, I will identify and discuss 12 groups of individuals whom I believe are more likely to be underserved in ED care. The 12 'underserved groups' (USGs) are as follows: [USG. 1] People with longstanding EDs and/or older-age ED sufferers; [USG. 2] Younger children/preadolescents; [USG. 3] People with under-recognised/underappreciated EDs; [USG. 4] People with higher weights; [USG. 5] People with comorbidities; [USG. 6] People with neurodevelopmental conditions (neurodiverse people); [USG. 7] Digitally excluded people; [USG. 8] Socioeconomically and/or sociogeographically disadvantaged people; [USG. 9] Ethnic/racial minorities; [USG. 10] Sexual and gender-diverse people; [USG. 11] Males; [USG. 12] Caregivers/loved ones.ED sufferers/caregivers are also an underserved group as a whole in general mental health care, so broader considerations for improving ED care will be explored in a future publication; these include stigma, research biases, inadequate clinical monitoring and diagnosing, poor-quality treatments, disorganised service transitions, systemic problems/inefficiencies, and underfunding/under-resourcing. Specific recommendations for USGs 1-12 must be considered alongside these and other broader issues. Throughout both articles, I advocate a humanistic care model/approach based on the inexpensive principles of compassion, hope, empathy, appreciation (of identity), and patience ('CHEAP').

Purpose: Adults with type 1 diabetes (T1D) are reported to be at higher risk for clinical eating disorders (ED) and other disordered eating behaviors (DEB) than their peers without diabetes. On the other hand, there is insufficient data on DEB in adults with type 2 diabetes (T2D). Our study aimed to investigate the prevalence of DEB in patients with T1D and T2D on intensive insulin therapy followed in our outpatient clinic.

Methods: Diabetes Eating Problem Survey-Revised (DEPS-R), electronically delivered to the patients with T1D and T2D who were on an intensive insulin regimen followed up in the diabetes outpatient clinic in our center for the evaluation of DEB. A total of 120 participants, 80 patients with T1D and 40 patients with T2D, were included in the study. DEB was defined as a DEPS-R score ≥ 20 according to the answers given to the questionnaire.

Results: Risk of DEB was observed in 35% of all individuals with diabetes and was higher in T2D (55% (n = 22)) than in T1D (25% (n = 20)) (p < 0.001). In patients with T1D, BMI was similar between the risk and normal groups in terms of DEB (p = 0.15), whereas in patients with T2D, BMI was significantly higher in the risk group in terms of DEB compared to the non-risk group (p < 0.001). There was a positive correlation between the risk of DEB and HbA1c and a negative correlation with the duration of diabetes in the T1D group (p < 0.05). Weight loss was an important goal for more than 50% of individuals with diabetes in both groups, more than 60% said they skipped a main meal or snack. 13.8% of those with T1D and 27.5% of those with T2D preferred being thin to having their diabetes better controlled.

Conclusion: In our study, 35% of patients with diabetes were found to have a risk of DEB, with the risk being higher in the T2D group. Our results emphasize the importance of increasing awareness among physicians and patients about DEB, which is prevalent among patients with diabetes. Early detection of individuals at risk for DEB should be considered a crucial aspect of treatment.

Background: Historically, eating disorder (ED) research has largely focused on White girls and women, with minority ethnic populations underrepresented. Most research exploring EDs in minority ethnic populations has been conducted in the United States (US). The aim of this scoping review, the first of its kind, was to systematically examine research on disordered eating and EDs among minority ethnic populations in Australia, Canada, Aotearoa New Zealand and the United Kingdom (UK), four countries with shared sociocultural and healthcare characteristics. An inequity lens was applied to highlight gaps in research, access, and treatment experiences.

Method: Five databases (Medline, Embase, PsycINFO, CINHAL and Web of Science) were searched up to March 7, 2024. Two independent reviewers screened titles and abstracts and full texts against eligibility criteria resulting in the inclusion of 87 records (76 peer-reviewed articles and 11 theses). Included studies were charted according to their focus, study design, sample characteristics and findings, with a particular focus placed on prevalence, access to treatment and treatment experience.

Results: The majority of identified studies were conducted in the UK (61%, 53 studies). There was a notable lack of studies investigating assessment, diagnosis and intervention. Methodologies varied, though most studies utilised cross-sectional survey designs. Most samples were non-clinical, exclusively or predominantly girls and women, and focused on adolescents and young adults. Asian populations were the most frequently studied minority ethnic group. Understanding of prevalence and treatment experience amongst minority ethnic groups was limited.

Conclusion: There is a need for further research addressing inequities in ED prevalence, service access, and treatment experiences among minority ethnic and Indigenous groups, especially in Australia, Canada and Aotearoa New Zealand. Improved ethnicity data collection and culturally sensitive approaches to assessment, diagnosis and treatment are essential. Recommendations for future research and clinical practice are provided.

Objective: The Eating Attitudes Test-26 (EAT-26) is considered the screening instrument of choice to identify eating disorders (ED) symptoms in clinical and community populations, showing a classical three-factor structure. This study assessed whether the factor structure of the EAT-26 in patients with ED was stable at admission and discharge from inpatient treatment.

Methods: We administered the EAT-26 to 207 female adolescents with ED at both admission and discharge.

Results: Factor structure of the EAT-26 at admission comprised of four factors and at discharge three factors and 15-item version of the EAT, producing two factors, was considerably more stable at both admission and discharge. Cutoff score of 23 in the EAT-15 better defined patients as improved at discharge than the cutoff score of 20 in the EAT-26.

Conclusion: Different factor structures of the EAT are found in the same population of young females with ED during the acute stage of illness vs. symptomatic improvement. In addition, shorter versions of the EAT with higher cutoff scores may better differentiate between improved and not improved patients at discharge. Findings suggest that using the EAT-15 is more effective for evaluating a population with clinical characteristics of ED.

Background: Poor quality of life in adults with anorexia nervosa (AN) and persistent high rates of readmission highlight the necessity of developing interventions to optimize treatment outcomes. ECHOMANTRA is a novel online intervention based on interventions for carers (Experienced Carers Helping Others, ECHO) and patients (Maudsley Model of Anorexia Nervosa Treatment for Adults, MANTRA) with anorexia nervosa. The objective of this paper is to describe the study protocol of a randomized control trial (RCT) aimed at evaluating the efficacy of an adaptation of the ECHOMANTRA for adults AN inpatients and outpatients, and their carers, to be implemented as an add-on to treatment-as-usual (TAU).

Methods: In a multi - center pilot randomized controlled trial (RCT), 148 adult AN patients, and their carers, will be randomized to receive treatment as usual (TAU) or TAU plus ECHOMANTRA. Assessments will take place at baseline (T0), post-intervention (2-month) (T1), 6-month follow-up (T2), and 12-month follow-up (T3). Primary outcomes will be eating disorder psychopathology and psychological well-being. For carers, outcome variables will include psychological well-being, accommodation and enabling behaviors, expressed emotion, illness burden, quality of life and care skills.

Discussion: This study will provide evidence of the efficacy of this novel, online and protocolized intervention in facilitating the recovery of these patients.

Trial registration: ISRCTN registry (Identifier: 80253157 https://doi.org/10.1186/ISRCTN80253157 ).

Background: Despite being the most prevalent eating disorder, Binge eating disorder (BED) remains largely unrecognized and lacks awareness among the general public, where it is also highly stigmatized. Common stigma surrounding BED includes the belief that individuals with this disorder are responsible for their condition and lack willpower and self-control. Research on BED recognition and stigma among lay adults is scarce. Enhancing public recognition of BED and reducing the stigma associated with it is crucial, as this could significantly improve access to treatment. The aim of the present study was to examine BED recognition and stigma within an adult community sample, and to identify associated respondent characteristics, including sociodemographic and psychosocial factors.

Methods: A sample of 894 adults (88.6% women; M_age = 35.20 ± 14.52) completed an online survey. Participants were presented with a vignette depicting a woman with BED and obesity, followed by questionnaires assessing BED recognition, stigma, and other respondent characteristics. Independent samples t-tests were performed to compare participants who recognized BED in the vignette with those who did not, based on sociodemographic characteristics (i.e., gender, age, income, education) and psychosocial variables (i.e., explicit and internalized weight bias, familiarity with BED). A multiple linear regression analysis was performed to identify the sociodemographic and psychosocial variables that were the most important in explaining the variance in stigma towards BED.

Results: Results indicated that 33% of participants identified BED as the main problem in the vignette. Those who recognized BED were younger, more educated, more familiar with BED, and exhibited lower levels of stigma towards BED. The most significant factor in explaining stigma towards BED was explicit weight bias, particularly attributing obesity to a lack of willpower and disliking people with obesity. Identifying as a man and older age were also associated with greater stigma towards BED.

Conclusion: The findings of the current study highlight the importance of comprehensive public awareness campaigns to improve recognition of BED and to reduce associated stigma.

Background: Current research on the transmission of trauma and eating disorders across generations is limited. However, quantitative studies suggest that the influence of parents' and grandparents' eating disorders and their prior exposure to trauma are associated with the development of eating disorders in future generations. Qualitative research exploring personal accounts of the impact of transgenerational trauma on the development of eating disorders has been largely unexplored. The aim of the current qualitative study was to explore the meaning that participants ascribed to their eating disorders in the context of transgenerational trauma across three generations.

Methods: Six adult female participants who had received a diagnosis of anorexia nervosa and/or bulimia nervosa completed multiple unstructured interviews, informed by a psychoanalytical methodology.

Results: Four themes were developed from the material that emerged from the interviews: (1) The toll of undigested emotions (2), A need for safety (3), "It's not just me" - making connections with the past, and (4) "Last link" in the chain?

Conclusions: The themes were discussed in respect of previous literature, with a particular emphasis on Gerson's concept of the dead third, which emphasises an unconscious compulsion to repeat unprocessed transgenerational traumas. Clinical implications of the research underscores the importance of a holistic approach to the treatment of eating disorders, recognising both individual and familial traumas within the family system. Moreover, the research demonstrates the significant impact that mental health clinicians can have in eating disorder treatment by fostering a supportive, safe and trusting therapeutic relationship.