Eating Disorders最新文献

Ethics consultation's (EC) role in supporting healthcare professionals, patients, and families confronted by eating disorders (ED) is under-described in the literature. We used qualitative conceptual content analysis to characterize the ethical issues and contextual features of EC involving patients with Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge-Eating Disorder (BED), Avoidant Restrictive Food Intake Disorder (ARFID), or Other Specified Feeding or Eating Disorder (OSFED) and compared adult vs. pediatric settings at a single institution from 2015 to 2024. We identified 40 consultations (14 adult, 26 pediatric) for 25 patients (12 adult, 13 pediatric). Most were female (n = 18, 72%), White (n = 20, 80%), non-Hispanic (n = 23, 92%), and diagnosed with AN (n = 13, 52%); none were diagnosed with BED or OSFED. The primary ethical issue overall (n = 23, 57%) and in the pediatric setting (n = 20, 77%) was patient assent/treatment over objection. No single ethical issue was prominent in the adult setting. The most common contextual feature overall (n = 21, 52%) and within adult (n = 7, 50%) and pediatric (n = 14, 53%) settings was legal involvement. EC patterns suggest differences in ethical concerns based on setting and age; a tailored approach may be warranted. Our results raise concerns that EC is underutilized within subsets of the ED population, necessitating further research.

Hypothermia is frequently observed in anorexia nervosa (AN) but is often overlooked clinically. External heat application has been proposed as a supportive adjunct. We conducted a retrospective study to determine the frequency of hypothermia in a highly selected inpatient population with AN admitted to a specialized medical (somatic) unit because of low BMI and/or somatic complications, and to explore clinical correlates and implications. In this naturalistic clinical setting, we retrospectively reviewed routinely collected clinical and biochemical data from admissions. Hypothermia was defined as tympanic temperature < 35.8°C. Clinical and biochemical variables were compared between normothermic and hypothermic patients, and multivariable logistic regression was used to identify factors associated with hypothermia. Among 111 patients, 10.8% had tympanic temperature < 35.8°C. During short-term hospitalization with supported meals, fluid and electrolyte correction, and partial weight restoration, most hypothermic patients achieved normothermia. However, persistent hypothermia may represent an underrecognized treatment target; future studies should assess its impact on outcomes and evaluate whether adjunctive warming interventions improve recovery.

Transgender and gender-diverse (TGD) individuals face a heightened risk of emotion dysregulation and eating disorders (EDs) compared to their cisgender counterparts. However, limited research has investigated the relation between emotion dysregulation and ED symptoms among TGD adults, particularly within the Chinese cultural context. The present study aimed to employ network analysis to examine symptom-level associations between emotion dysregulation and thinness- and muscularity-oriented ED symptoms in a sample of Chinese TGD adults. Participants included 410 TGD individuals (142 transgender women, 92 transgender men, and 176 gender-diverse adults [e.g. non-binary individuals]). Separate network analyses by TGD groups revealed distinct symptom interaction patterns, each with four identified communities. Regarding central symptoms, shape/weight preoccupation emerged as the most central node in transgender women and gender-diverse adults, whereas nonacceptance of emotional responses was the most central node in transgender men. Bridge node analysis identified specific symptoms connecting emotion dysregulation to ED symptoms, with the use of meal replacement supplements when full and nutrition anxiety when eating out as the most essential in transgender women; food/eating/calorie preoccupation in transgender men; and food restriction for shape or weight concerns and nutrition anxiety when eating out in gender-diverse individuals. Findings provide empirical support for meaningful heterogeneity in the interplay between emotion dysregulation and ED symptoms across transgender women, transgender men, and gender-diverse individuals. This underscores the critical need to move beyond one-size-fits-all approaches and develop tailored interventions that address the unique emotional and body image regulation challenges faced by transgender women, transgender men, and gender-diverse individuals.

Enhanced Cognitive Behavioral Therapy (CBT-E) outcomes for binge-spectrum eating disorders (EDs) are suboptimal, thus new treatment targets should be identified. One potential target is sleep disturbance (i.e. increased sleep latency, decreased efficiency, duration, or quality) which may impact self-regulation abilities necessary for reducing binge eating. However, it is not yet known whether sleep disturbance predicts poorer outcomes from CBT-E. We examined the relation between pre-treatment sleep disturbance and treatment outcome among adults (N = 79; 84.81% White; 89.87% female) with binge-spectrum EDs receiving CBT-E. Multiple regression models examined the effect of sleep disturbance on both frequency of any loss of control (LOC) eating and objective binge episodes (OBE), and odds of remission from LOC and OBEs at post-treatment. Pre-treatment sleep efficiency was significantly negatively related to LOC frequency at post-treatment (Est = -5.807, p = .047). No other pre-treatment sleep characteristics were significantly associated with post-treatment LOC/OBE frequency or remission. ED diagnosis (bulimia- or binge eating disorder-spectrum) did not moderate associations of sleep disturbance with treatment outcome. Interventions aimed at improving sleep efficiency may merit testing in ED populations. Future research should assess whether changes in sleep efficiency during treatment are associated with increased reductions in binge eating at post-treatment.

Objectification theory posits that self-objectification can lead to disordered eating, with significant positive correlations between self-objectification and eating disorder (ED) psychopathology found in women in both clinical and non-clinical samples. Maladaptive rumination is another process frequently associated with EDs, but its relationship with self-objectification and ED psychopathology needs further investigation. Our aim was to conduct a preliminary test to investigate whether maladaptive rumination mediated the relationship between self-objectification and ED psychopathology in women. Data were collected online from a general community sample of 243 women. Correlation and mediation analyses were undertaken. Significant positive associations were found between rumination, self-objectification, and ED psychopathology. Rumination significantly mediated the relationship between self-objectification and ED psychopathology, accounting for 20.52% of the variance, suggesting that a greater tendency to ruminate may contribute to ED vulnerability in those with high self-objectification. These preliminary findings may inform assessment and formulation of women presenting with ED psychopathology in addition to supporting psychological interventions (e.g. CBT or acceptance-based approaches), which can target both self-objectification and rumination processes. Future research involving replication with clinical samples is warranted to corroborate the relationship between these constructs, their impact on ED psychopathology over time and to investigate their utility in assessment and treatment approaches.

Subjective eating disorder (ED) recovery has important clinical relevance. However, studies have focused on the perspectives of cisgender heterosexual individuals, which is notable given that sexual and gender minority (SGM) people often describe feelings misrepresented by prevailing ED conceptualizations. We examined eating pathology and psychosocial functioning across subjective recovery stages in SGM individuals (N = 196). Analyses of variance tested differences between active ED (n = 106, 54.1%), partial recovery (n = 82, 41.8%), and full recovery (n = 8, 4.1%) groups. Groups differed in body dissatisfaction, binge eating, restricting, clinical impairment, autonomy, environmental mastery, and self-acceptance. Most differences were observed between the full recovery and active ED groups and the full recovery and partial recovery groups, such that subjectively higher levels of ED recovery were generally associated with lower transdiagnostic ED symptoms and better psychosocial functioning. Clinical profiles appear similar between SGM and cisgender heterosexual individuals across subjective ED recovery stages.

Anorexia nervosa (AN) is an eating disorder that is significantly associated with severely impaired physiological functions, multiple organ failure, and suicidal ideation. This study aims to estimate the global, regional, and national secular trends of AN burden based on Global Burden of Diseases (GBD) 2019 data. The pertinent data for AN were collected from the GBD Study 2019. The long-term trends of the burden of AN were analyzed in different Social Demographic Index (SDI) regions by Joinpoint regression, Age-Period-Cohort analysis, and the Estimated Annual Percentage Changes. This study found that the global burden of AN gradually increased over the past 30 years, with the highest burden remaining in high-income countries, but the biggest increasing trend was observed in Asian region. AN was more common in adolescents and young women, but it was growing rapidly in adolescents and young men. Disability-adjusted life years (DALYs) caused by AN was the highest in the age group of 15-24 years among all SDI levels. The risk of AN rapidly increased since the beginning of the twenty-first century apart from high SDI regions, and it was higher in later-born cohorts than the earlier ones in various SDI areas. Future studies could verify our findings by using individual-level data. Our findings could help policy makers around the world understand the burden of AN in their countries and develop appropriate health policies for prevention and early intervention for high-risk populations.

Purpose: The aim of this study was to map which instruments are currently being used to measure disordered eating in adolescent boys as part of a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis.

Method: Utilizing the PRISMA review protocol, 174 journal articles were reviewed.

Results: Sixty-seven articles used versions of the Eating Attitudes Test to measure adolescent boys' disordered eating, 32 used versions of the Eating Disorder Examination-Questionnaire, 30 used versions of the Eating Disorder Inventory, 25 used SCOFF, and 10 used the Drive for Muscularity Scale. A plethora of other instruments for measuring disordered eating were utilized as well.

Conclusion: Studying adolescent boys' disordered eating by using instruments primarily developed and validated for girls may provide unreliable estimates of the numbers of boys who suffer from disordered eating, which would preclude early intervention. One strength of the reviewed studies was that several used multiple measurements to validate their results. One of the weaknesses was the lack of distinguishing genders among certain groups, such as athletes or patients. Among the opportunities identified was the possibility of expanding on research on the association between puberty and disordered eating, with sports and parents potentially acting as buffers against the onset of disordered eating. A clear threat to research on disordered eating among adolescent boys was the (in)accuracy of the measurements.

This study aimed to evaluate the efficacy of Acceptance and Commitment Therapy (ACT) in mitigating perceived stress, rumination, and distress tolerance among women diagnosed with Bulimia Nervosa (BN) in Ahvaz, Iran. A quasi-experimental pre-test-post-test design with a control group was employed. The target population consisted of all female BN patients referred to the Ahvaz Binge Eaters Association between February and May 2022. Patients were definitively diagnosed with BN by a clinical specialist using a structured clinical interview adhering to DSM-5 criteria. From an initial pool of 91 patients, 50 were randomly selected for participation and subsequently assigned to either the experimental or control group, with each group comprising 25 individuals. Pre-test analysis revealed no significant group differences in perceived stress, rumination, or distress tolerance among women with BN. However, post-test scores indicated a significant decrease in both perceived stress and rumination within the experimental group compared to the control group (p < .01). Furthermore, the post-test analysis demonstrated that ACT intervention significantly improved distress tolerance in women with BN (p < .01). These findings suggest that ACT may be a promising therapeutic approach for alleviating psychological distress and enhancing emotional regulation in individuals grappling with BN.

There is a notable overlap between autism and eating disorders (EDs), and autistic individuals may experience poorer ED treatment outcomes than non-autistic peers. To make meaningful change in this field, it is imperative that we actively engage in co-production of research, however there are currently no guidelines to support co-production with autistic people with eating disorders. This paper reports on best practice guidelines that were co-produced across a series of workshops bringing together autistic people with EDs, researchers, clinicians, third-sector organisations, and parents/carers. The guidelines are intended to be used as a foundation for future co-produced autism and ED research. By creating a trusted, ethical co-production relationship, we hope to generate more clinically meaningful and translatable research.