Eating Disorders最新文献

Young cisgender sexual minority women (e.g. lesbian, queer) in the U.S. are at risk for disordered eating behaviors (DEB). Minority stress theory proposes sexual minority stressors (SMS; e.g. discrimination) related to marginalized statuses are culturally specific stressors that may explain engagement in these behaviors. However, little is known about daily SMS-DEB associations. We conducted a 14-day daily diary study of 321 U.S.-based sexual minority cisgender women ages 19-35 who were in a relationship with a woman. SMS were assessed using an 8-item daily measure of distal SMS (e.g. heard anti-LGBT talk, verbal harassment), and DEB with single items capturing dietary restraint, overeating, loss of control eating, and emotional eating. Multi-level models revealed on days when women experienced SMS, they were more likely to report dietary restraint and emotional eating, but not overeating or loss of control eating. Women who generally reported more frequent SMS were more likely to report all four DEB. There were no significant couple-level SMS-DEB associations. These findings expand our understanding of how SMS is associated with DEB in the daily lives of cisgender sexual minority women. Future studies are needed to explore the temporal sequencing of the associations. Findings may also help to inform the design of culturally tailored interventions aimed at reducing DEB among sexual minority women.

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 theoretical review paper offers a sociocultural-developmental framework for understanding LGBTQ+ adolescents' body image concerns and disordered eating risk. The Pride Framework integrates well-established sociocultural theories and extant empirical research, drawing from objectification theory, the tripartite influence model, minority stress theory, and intersectionality theory. The Pride Framework situates sociocultural appearance pressures within the adolescent developmental context, wherein biological, cognitive, and social transitions exacerbate the likelihood of body image disturbances and eating pathology. Various processes are then posited to link these sociocultural-developmental pressures to body image concerns and disordered eating. Crucially, this framework underscores that LGBTQ+ status itself does not pose a risk for body dissatisfaction and eating disorders. Instead, it is the experience of residing in a society that stigmatizes LGBTQ+ identities that increases youth's vulnerabilities. LGBTQ+ health researchers and practitioners are encouraged to engage in collaborative efforts with the aim of fostering acceptance for LGBTQ+ youth. This, in turn, could support normative adolescent identity exploration processes within sociocultural settings that are both affirming and inclusive, potentially mitigating adverse health consequences associated with body image disturbances.

Background: Self-stigma of seeking psychological help is a critical factor prohibiting individuals from seeking eating disorder (ED) treatment, but has been widely unexplored in racial/ethnic and sexual minority (SM) samples. The current study examined differences in ED pathology and self-stigma of help-seeking at the intersection of race and gender within a cisgender SM sample.

Methods: Cisgender SM participants (n = 354) identifying as Black, Indigenous, or People of Color (BIPOC; 52%), Asian American and Pacific Islander (AAPI; 24%), or White (24%) were recruited through Prolific Academic. One-way analyses of variance were used to examine differences in the Self-Stigma of Seeking Help Scale (SSOSH) and Eating Pathology Symptom Inventory (EPSI) subscales among men and women in each group. Pearson's correlations explored associations between SSOSH and EPSI subscales within each subgroup.

Results: Findings indicated significant between-group differences on the SSOSH and the EPSI subscales of Body Dissatisfaction, Purging, and Excessive Exercise. SSOSH was significantly positively correlated with Body Dissatisfaction in the White SM cis-women group and Binge Eating in the BIPOC SM cis-men group.

Conclusions: Results demonstrate unique, intersectional between-group differences in ED pathology and self-stigma among SM individuals. Further research on the impact of intersectionality on these constructs within larger samples is warranted.

Sociocultural factors play a significant role in the development of body image distress and disordered eating behavior in diverse populations, including men. One group which seems to be at increased risk, is sexual minority men. However, these factors have rarely been studied outside of Western populations. The present study sought to explore these factors in Greek and Greek-Cypriot men. Greek and Greek-Cypriot men (N = 367; n = 162 gay; n = 205 straight) completed measures of sociocultural pressures, appearance comparisons, body dissatisfaction, body appreciation and disordered eating. Results indicated that gay men were more likely to have disordered eating habits than straight men. Additionally, gay men had significantly lower scores on measures of body-image related wellbeing (i.e. satisfaction and appreciation), and higher on measures of societal pressures and appearance-related comparisons, appearance-related anxiety and disordered eating. Greek and Greek-Cypriot gay men had lower levels of muscularity internalization than straight men. Our findings extend research on body image distress and disordered eating in gay and straight men to Greek and Greek-Cypriot populations.

Transgender and gender-expansive (TGE) individuals suffer from eating disorders (EDs) at disproportionate rates relative to their gender-conforming counterparts. While literature on EDs in TGE populations is growing and evolving, best practice guidelines are scant. A framework for providing gender-affirming care (GAC) in an ED treatment setting was developed by integrating findings from a focused literature review and insights from leading experts. Following synchronous and asynchronous training, the protocol was implemented in a virtual ED treatment setting with a national reach serving patients ages 6-24 years. This paper offers a summary of best practices and approaches for providing GAC in ED treatment settings. The use of GAC practices has the potential to address underlying issues and inequities in treatment delivery and outcomes. We encourage ED treatment providers to consider the adoption/adaptation of GAC best practices to more effectively meet the needs of TGE patients. More research is needed to better understand the influence of individual and collective GAC practices on specific ED treatment outcomes.

Tattooed individuals often express the positive effects of wearing body art toward improved self-image and confidence. This research builds on prior data exploring the positive effects of tattooing and investigates how tattoos impact one's relationship to eating disorder (ED) recovery and body image. We held three focus groups lasting 60 minutes each, recruiting participants via purposive snowball sampling (n = 15), with additional opportunities to respond to focus group prompts asynchronously. Eligible participants were individuals with lived experience of an ED, self-identified as being in recovery, had three or more tattoos, and spoke English. Participants predominantly held gender-expansive (n = 4 Non-Binary, n = 3 Genderqueer, n = 3 Cisgender Women, n = 3 Transgender, n = 2 Transmasculine, n = 2 Gender Non-Conforming, n = 2 Intersex, n = 1 Cisgender Man) and non-heterosexual identities. Focus groups were held between April 2021 and July 2023 and followed a semi-structured interview format. Primary analyses focused on participants' responses to open-ended prompts regarding how they understood the relationships between tattooing, body image, and ED recovery. Thematic analysis identified four core themes: Tattooing allowing for embodiment, tattooing allowing for recovery-oriented behaviors, tattooing enabling positive body image, and tattooing facilitating empowerment. An overarching message was that tattooing is a therapeutic and transformative process, allowing for self-determination. Participants indicated that tattooing can be experienced as a powerful mechanism for behavioral change and shifts in relationship to one's body. Participants expressed that tattooing can be an effective route towards both gender euphoria and body liberation, enhancing one's ability to maintain ED recovery.

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.

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.

This study reports the outcome of a low intensity pre-treatment intervention (a guided e-health podcast) for patients with anorexia nervosa and bulimia nervosa, delivered between assessment and the start of the full outpatient treatment programme. A case series design was used. A total of 254 patients at a specialist eating disorder service were offered a pre-treatment three-week psychoeducational intervention (Keeping Myself Safe; KMS), and 203 undertook the intervention. The intervention consisted of six podcasts (107 mins), an accompanying workbook, and a follow-up review appointment. Body Mass Index and Eating Disorder Examination-Questionnaire scores were taken at assessment, end of the KMS intervention (mean duration = 21.9 days) and start of treatment (mean = 79.8 days post KMS intervention). Generalised Linear Mixed Models were used to test main and interaction effects (diagnosis x time). There were improvements on most variables following the KMS intervention. The effects were more pronounced for patients with bulimia nervosa across several measures. Pre-treatment guided e-health psychoeducational interventions can be associated with early attitudinal and behavioural change in patients with bulimia nervosa and anorexia nervosa whilst on the waiting list for treatment. They allow greater, affordable accessibility to effective psychoeducation and enhance potential engagement. More research is required to investigate the longer-term impact on retention and outcome, particularly in anorexia nervosa.