Objective: It is often stated that a higher body mass index (BMI) at the beginning of treatment predicts a better weight outcome at the end of treatment in persons with anorexia nervosa (AN). However, this interpretation is based on the between-persons relationship of BMI at the two measurements, which primarily reflects the fact that the rank-ordering of persons according to their BMI is quite stable over time. In contrast, a lower BMI at baseline is related to a larger BMI change, which primarily reflects the fact that the variance of BMI at the end of treatment is larger than that at baseline. This study aimed to demonstrate these relationships empirically and caution against interpreting BMI at baseline as a predictor of BMI at discharge or BMI change.
Method: Changes of BMI from admission to discharge were analyzed based on 4863 persons with AN (97% female) who received inpatient treatment between 2015 and 2024.
Results: BMI at admission was positively related to BMI at discharge (r = 0.55) but negatively related to BMI change from admission to discharge (r = -0.39).
Discussion: While it is true that a higher BMI at baseline is associated with a higher BMI at the end of treatment, a lower BMI at baseline is actually related to a larger weight gain during treatment. Yet, concluding that the treatment is more effective for patients with low or high BMI at baseline would be incorrect in either case, as the independent and dependent variables are the same variables measured at different time points.
{"title":"Predictors of Treatment Outcome in Persons With Anorexia Nervosa: On the Practice of Regressing Body Mass Index at the End of Treatment on Body Mass Index at Baseline.","authors":"Adrian Meule, David R Kolar, Ulrich Voderholzer","doi":"10.1002/eat.24324","DOIUrl":"https://doi.org/10.1002/eat.24324","url":null,"abstract":"<p><strong>Objective: </strong>It is often stated that a higher body mass index (BMI) at the beginning of treatment predicts a better weight outcome at the end of treatment in persons with anorexia nervosa (AN). However, this interpretation is based on the between-persons relationship of BMI at the two measurements, which primarily reflects the fact that the rank-ordering of persons according to their BMI is quite stable over time. In contrast, a lower BMI at baseline is related to a larger BMI change, which primarily reflects the fact that the variance of BMI at the end of treatment is larger than that at baseline. This study aimed to demonstrate these relationships empirically and caution against interpreting BMI at baseline as a predictor of BMI at discharge or BMI change.</p><p><strong>Method: </strong>Changes of BMI from admission to discharge were analyzed based on 4863 persons with AN (97% female) who received inpatient treatment between 2015 and 2024.</p><p><strong>Results: </strong>BMI at admission was positively related to BMI at discharge (r = 0.55) but negatively related to BMI change from admission to discharge (r = -0.39).</p><p><strong>Discussion: </strong>While it is true that a higher BMI at baseline is associated with a higher BMI at the end of treatment, a lower BMI at baseline is actually related to a larger weight gain during treatment. Yet, concluding that the treatment is more effective for patients with low or high BMI at baseline would be incorrect in either case, as the independent and dependent variables are the same variables measured at different time points.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jason M Nagata, Karen Li, Angela E Kim, Iris Yuefan Shao, Christopher D Otmar, Kyle T Ganson, Alexander Testa, Jinbo He, Orsolya Kiss, Jason M Lavender, Fiona C Baker
Objective: To assess associations between multiple dimensions of gender diversity with eating disorder symptoms in a national cohort of U.S. early adolescents.
Method: This cross-sectional study utilized data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,092, Mage = 12.9 years, 2019-2021). Gender diversity was measured using multiple dimensions, including categorical gender identity (e.g., transgender, cisgender), categorical and continuous felt gender (congruence between gender identity and assigned sex), ordinal gender non-contentedness (dissatisfaction with one's gender), and ordinal gender expression (communication of gender through appearance and mannerisms). Multivariable logistic regression models were used to analyze the associations among gender diversity measures and eating disorder symptoms, adjusting for potential confounders.
Results: Greater felt gender diversity was associated with self-worth tied to weight (OR 1.30, 95% CI 1.11-1.53), binge eating (OR 1.24, 95% CI 1.06-1.46), and distress with binge eating (OR 1.32, 95% CI 1.09-1.59). Greater gender expression diversity was associated with self-worth tied to weight (OR 1.16, 95% CI 1.02-1.33), distress with binge eating (OR 1.26, 95% CI 1.04-1.51), and characteristics of binge eating episodes (OR 1.33, 95% CI 1.06-1.66). Gender non-contentedness was associated with self-worth tied to weight (OR 1.38, 95% CI 1.20-1.58) and compensatory behaviors related to weight gain (OR 1.12, 95% CI 1.01-1.26). Transgender identity was not significantly associated with any eating disorder symptoms.
Discussion: We found that greater gender diversity across multiple dimensions was associated with various eating disorder symptoms, and that measures beyond binary gender identity may be important to assess gender diversity in early adolescence.
目的评估美国早期青少年全国队列中性别多样性的多个维度与饮食失调症状之间的关联：这项横断面研究利用了青少年大脑认知发展（ABCD）研究（N = 10,092, Mage = 12.9 years, 2019-2021）的数据。性别多样性采用多个维度进行测量，包括分类性别认同（如跨性别、顺性别）、分类和连续感觉性别（性别认同与分配性别之间的一致性）、序数性别无内容（对自己的性别不满意）和序数性别表达（通过外表和举止传达性别）。在对潜在混杂因素进行调整后，我们使用多变量逻辑回归模型分析了性别多样性测量与饮食失调症状之间的关联：感觉到的性别多样性越大，与体重（OR 1.30，95% CI 1.11-1.53）、暴食（OR 1.24，95% CI 1.06-1.46）和暴食困扰（OR 1.32，95% CI 1.09-1.59）相关的自我价值越大。更大的性别表达多样性与与体重相关的自我价值（OR 1.16，95% CI 1.02-1.33）、暴食困扰（OR 1.26，95% CI 1.04-1.51）和暴食发作特征（OR 1.33，95% CI 1.06-1.66）相关。与性别无关与体重相关的自我价值（OR 1.38，95% CI 1.20-1.58）和与体重增加相关的补偿行为（OR 1.12，95% CI 1.01-1.26）有关。变性身份与任何饮食失调症状均无明显关联：讨论：我们发现，在多个维度上，性别多样性越大，各种进食障碍症状就越明显。
{"title":"Associations Between Gender Diversity and Eating Disorder Symptoms in Early Adolescence.","authors":"Jason M Nagata, Karen Li, Angela E Kim, Iris Yuefan Shao, Christopher D Otmar, Kyle T Ganson, Alexander Testa, Jinbo He, Orsolya Kiss, Jason M Lavender, Fiona C Baker","doi":"10.1002/eat.24317","DOIUrl":"10.1002/eat.24317","url":null,"abstract":"<p><strong>Objective: </strong>To assess associations between multiple dimensions of gender diversity with eating disorder symptoms in a national cohort of U.S. early adolescents.</p><p><strong>Method: </strong>This cross-sectional study utilized data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,092, M<sub>age</sub> = 12.9 years, 2019-2021). Gender diversity was measured using multiple dimensions, including categorical gender identity (e.g., transgender, cisgender), categorical and continuous felt gender (congruence between gender identity and assigned sex), ordinal gender non-contentedness (dissatisfaction with one's gender), and ordinal gender expression (communication of gender through appearance and mannerisms). Multivariable logistic regression models were used to analyze the associations among gender diversity measures and eating disorder symptoms, adjusting for potential confounders.</p><p><strong>Results: </strong>Greater felt gender diversity was associated with self-worth tied to weight (OR 1.30, 95% CI 1.11-1.53), binge eating (OR 1.24, 95% CI 1.06-1.46), and distress with binge eating (OR 1.32, 95% CI 1.09-1.59). Greater gender expression diversity was associated with self-worth tied to weight (OR 1.16, 95% CI 1.02-1.33), distress with binge eating (OR 1.26, 95% CI 1.04-1.51), and characteristics of binge eating episodes (OR 1.33, 95% CI 1.06-1.66). Gender non-contentedness was associated with self-worth tied to weight (OR 1.38, 95% CI 1.20-1.58) and compensatory behaviors related to weight gain (OR 1.12, 95% CI 1.01-1.26). Transgender identity was not significantly associated with any eating disorder symptoms.</p><p><strong>Discussion: </strong>We found that greater gender diversity across multiple dimensions was associated with various eating disorder symptoms, and that measures beyond binary gender identity may be important to assess gender diversity in early adolescence.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julia Pines, Kelsey Hagan, Caitlin Lloyd, Elizabeth Raffanello, Susie Hong, Jonathan Posner, B. Timothy Walsh, Joanna E. Steinglass
Objective
Anorexia nervosa (AN) is characterized by a tendency to limit intake of food, with specific restriction of foods that are generally considered highly palatable. This observation raises questions about whether reward processing is disturbed in AN. This study examined whether adolescents with AN differ from healthy control peers (HC) in anticipatory and consummatory reward processing.
Method
Adolescents with AN (n = 71) and HC (n = 41) completed the Temporal Experience of Pleasure Scale (TEPS). The TEPS Anticipatory Pleasure scale was divided into two further subscales (Food and Non-food). Anticipatory (Food and Non-food) and Consummatory Pleasure (Non-food) scores were compared between adolescents with AN and HC using independent t-tests.
Results
TEPS scores were significantly lower among adolescents with AN than HC in Anticipatory Pleasure Food (t(110) = 7.80, p < 0.001) and Non-food (t(110) = 4.36, p < 0.001), and Consummatory Pleasure (t(110) = 2.60, p = 0.01) subscales. When controlling for BDI score, there was no significant group difference in TEPS Consummatory Pleasure scores (t(108) = 0.88, p = 0.38). Among adolescents with AN, Food Anticipatory Pleasure was significantly negatively correlated with all EDE-Q subscales and global score (r(68) = −0.38, p = 0.002) and positively correlated with food intake at a laboratory buffet meal (r(61) = 0.53, p < 0.001).
Discussion
Measures of both anticipatory and consummatory reward were reduced among adolescents with AN with a short duration of illness. In this study, eating disorder symptoms were related to diminished reward responses in anticipation of food. Dampened anticipatory reward response may comprise a mechanism of illness in AN that should be subject to further study.
{"title":"Anticipatory and Consummatory Responses Across Reward Domains in Adolescents With Anorexia Nervosa","authors":"Julia Pines, Kelsey Hagan, Caitlin Lloyd, Elizabeth Raffanello, Susie Hong, Jonathan Posner, B. Timothy Walsh, Joanna E. Steinglass","doi":"10.1002/eat.24287","DOIUrl":"10.1002/eat.24287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Anorexia nervosa (AN) is characterized by a tendency to limit intake of food, with specific restriction of foods that are generally considered highly palatable. This observation raises questions about whether reward processing is disturbed in AN. This study examined whether adolescents with AN differ from healthy control peers (HC) in anticipatory and consummatory reward processing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Adolescents with AN (<i>n</i> = 71) and HC (<i>n</i> = 41) completed the Temporal Experience of Pleasure Scale (TEPS). The TEPS Anticipatory Pleasure scale was divided into two further subscales (Food and Non-food). Anticipatory (Food and Non-food) and Consummatory Pleasure (Non-food) scores were compared between adolescents with AN and HC using independent <i>t</i>-tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TEPS scores were significantly lower among adolescents with AN than HC in Anticipatory Pleasure Food (<i>t</i>(110) = 7.80, <i>p</i> < 0.001) and Non-food (<i>t</i>(110) = 4.36, <i>p</i> < 0.001), and Consummatory Pleasure (<i>t</i>(110) = 2.60, <i>p</i> = 0.01) subscales. When controlling for BDI score, there was no significant group difference in TEPS Consummatory Pleasure scores (<i>t</i>(108) = 0.88, <i>p</i> = 0.38). Among adolescents with AN, Food Anticipatory Pleasure was significantly negatively correlated with all EDE-Q subscales and global score (<i>r</i>(68) = −0.38, <i>p</i> = 0.002) and positively correlated with food intake at a laboratory buffet meal (<i>r</i>(61) = 0.53, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Measures of both anticipatory and consummatory reward were reduced among adolescents with AN with a short duration of illness. In this study, eating disorder symptoms were related to diminished reward responses in anticipation of food. Dampened anticipatory reward response may comprise a mechanism of illness in AN that should be subject to further study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 11","pages":"2269-2277"},"PeriodicalIF":4.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janet A. Lydecker, Zhijun Zhang, Nicole Larson, Katie A. Loth, Melanie Wall, Dianne Neumark-Sztainer
Objective
In cross-sectional and retrospective research, parental binge eating is associated with their children's eating psychopathology. The current study extended the evidence by cross-sectionally and longitudinally examining the relation between parental binge eating and binge eating and weight-control behaviors in the next generation of their adolescent children and young adult children in a population-based sample.
Methods
Adolescents (Time 1: M = 14.5, SD = 2.0 years) (n = 2367), followed into adulthood (Time 2: M = 22.1, SD = 2.0 years), and their parents (n = 3664) were enrolled in EAT 2010–2018 and Project F-EAT 2010. The current study examined parental binge eating, and child binge eating and weight-control behaviors. Adjusted models covaried for child gender, age, and race/ethnicity.
Results
Approximately 7% of adolescents at Time 1 had at least one parent who reported binge eating with no differences by child's age, gender, or race/ethnicity. Having at least one parent experiencing binge eating at Time 1 (vs. not) was associated cross-sectionally with adolescent children's use of extreme weight-control behaviors (9.6% vs. 4.8%; Risk Difference [RD] = 4.9%) and associated longitudinally with binge eating during young adulthood (21.1% vs. 11.6%; RD = 9.5%). Other associations did not reach statistical significance.
Conclusions
Children of parents with binge eating appear to have elevated risk of extreme weight-control behaviors during adolescence and binge eating in young adulthood. Clinicians should assess whether eating psychopathology extends to other family members, and offer additional support to parents with binge eating. Further research is needed to identify risk factors in the children of parents with binge eating and to assess strategies for prevention.
{"title":"Parental Binge Eating and Child Binge Eating and Weight-Control Behaviors: Cross-Sectional and Longitudinal Findings From the EAT 2010–2018 Study","authors":"Janet A. Lydecker, Zhijun Zhang, Nicole Larson, Katie A. Loth, Melanie Wall, Dianne Neumark-Sztainer","doi":"10.1002/eat.24284","DOIUrl":"10.1002/eat.24284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In cross-sectional and retrospective research, parental binge eating is associated with their children's eating psychopathology. The current study extended the evidence by cross-sectionally and longitudinally examining the relation between parental binge eating and binge eating and weight-control behaviors in the next generation of their adolescent children and young adult children in a population-based sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adolescents (Time 1: M = 14.5, SD = 2.0 years) (<i>n</i> = 2367), followed into adulthood (Time 2: M = 22.1, SD = 2.0 years), and their parents (<i>n</i> = 3664) were enrolled in EAT 2010–2018 and Project F-EAT 2010. The current study examined parental binge eating, and child binge eating and weight-control behaviors. Adjusted models covaried for child gender, age, and race/ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 7% of adolescents at Time 1 had at least one parent who reported binge eating with no differences by child's age, gender, or race/ethnicity. Having at least one parent experiencing binge eating at Time 1 (vs. not) was associated cross-sectionally with adolescent children's use of extreme weight-control behaviors (9.6% vs. 4.8%; Risk Difference [RD] = 4.9%) and associated longitudinally with binge eating during young adulthood (21.1% vs. 11.6%; RD = 9.5%). Other associations did not reach statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children of parents with binge eating appear to have elevated risk of extreme weight-control behaviors during adolescence and binge eating in young adulthood. Clinicians should assess whether eating psychopathology extends to other family members, and offer additional support to parents with binge eating. Further research is needed to identify risk factors in the children of parents with binge eating and to assess strategies for prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 11","pages":"2260-2268"},"PeriodicalIF":4.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Casey M. Stern, Haley Graver, Iman McPherson, Julia Gydus, P. Evelyna Kambanis, Lauren Breithaupt, Helen Burton-Murray, Lázaro Zayas, Kamryn T. Eddy, Jennifer J. Thomas, Kendra R. Becker
Objective
Despite substantial research indicating difficulties with emotion regulation across eating disorder presentations, emotion regulation has yet to be studied in adults with avoidant/restrictive food intake disorder (ARFID). We hypothesized that (1) those with ARFID would report greater overall emotion regulation difficulties than nonclinical participants, and (2) those with ARFID would not differ from those with other eating disorders on the level of emotion regulation difficulty.
Methods
One hundred and thirty-seven adults (age 18–30) from an outpatient clinic with ARFID (n = 27), with other primarily restrictive eating disorders (e.g., anorexia nervosa; n = 34), and with binge/purge eating disorders (e.g., bulimia nervosa; n = 51), as well as nonclinical participants (n = 25) recruited via Amazon Mechanical Turk (MTurk) completed the Difficulties in Emotion Regulation Scale (DERS). We compared DERS scores across groups.
Results
In line with expectations, patients with ARFID scored significantly higher than nonclinical participants on the DERS Total (p = 0.01) with a large effect size (d = 0.87). Also as hypothesized, those with ARFID did not differ from those with other primarily restrictive (p = 0.99) or binge/purge disorders (p = 0.29) on DERS Total.
Discussion
Adults with ARFID appear to exhibit emotion regulation difficulties which are greater than nonclinical participants, and commensurate with other eating disorders. These findings highlight the possibility of emotion regulation difficulties as a maintenance mechanism for ARFID.
{"title":"Difficulties in Emotion Regulation in Avoidant/Restrictive Food Intake Disorder","authors":"Casey M. Stern, Haley Graver, Iman McPherson, Julia Gydus, P. Evelyna Kambanis, Lauren Breithaupt, Helen Burton-Murray, Lázaro Zayas, Kamryn T. Eddy, Jennifer J. Thomas, Kendra R. Becker","doi":"10.1002/eat.24281","DOIUrl":"10.1002/eat.24281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite substantial research indicating difficulties with emotion regulation across eating disorder presentations, emotion regulation has yet to be studied in adults with avoidant/restrictive food intake disorder (ARFID). We hypothesized that (1) those with ARFID would report greater overall emotion regulation difficulties than nonclinical participants, and (2) those with ARFID would not differ from those with other eating disorders on the level of emotion regulation difficulty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and thirty-seven adults (age 18–30) from an outpatient clinic with ARFID (<i>n</i> = 27), with other primarily restrictive eating disorders (e.g., anorexia nervosa; <i>n</i> = 34), and with binge/purge eating disorders (e.g., bulimia nervosa; <i>n</i> = 51), as well as nonclinical participants (<i>n</i> = 25) recruited via Amazon Mechanical Turk (MTurk) completed the Difficulties in Emotion Regulation Scale (DERS). We compared DERS scores across groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In line with expectations, patients with ARFID scored significantly higher than nonclinical participants on the DERS Total (<i>p</i> = 0.01) with a large effect size (<i>d</i> = 0.87). Also as hypothesized, those with ARFID did not differ from those with other primarily restrictive (<i>p</i> = 0.99) or binge/purge disorders (<i>p</i> = 0.29) on DERS Total.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Adults with ARFID appear to exhibit emotion regulation difficulties which are greater than nonclinical participants, and commensurate with other eating disorders. These findings highlight the possibility of emotion regulation difficulties as a maintenance mechanism for ARFID.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 11","pages":"2156-2166"},"PeriodicalIF":4.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pilar Vázquez-Giraldo, Ainoa Muñoz-Sanjosé, Teresa López-Cuadrado
Objective
Limited evidence exists regarding the impact of the COVID-19 pandemic on the onset and trajectory of eating disorders (EDs) among young in Spain. This study aims to analyze the characteristics and recent trends in hospital admissions for EDs within the pediatric population.
Methods
A retrospective analysis was conducted on hospital admissions for EDs among patients aged 10–19 years between 2016 and 2022. The main outcomes examined included hospital rates (overall, stratified by ED type and age group), psychiatric comorbidities, and length of stay.
Results
A total of 8275 hospitalizations due to EDs were identified, constituting 1 in 6 hospital admissions for mental illness and behavioral disorders. Predominant characteristics of this population included female sex (93%), aged 15–19 years (58.3%), admission primarily for anorexia nervosa (71.6%), and psychiatric comorbidity (35.6%). Hospital admissions for EDs in the pediatric population showed an increasing trend, with an annual average increase of 11.1% (95% CI: 2.6, 22.6). This rise was led by children aged 10–14 years, with a yearly increase in EDs hospitalization rates of 28.4% (95% CI: 13.5, 56.3) since 2019. Each discharge related to EDs was associated with a median stay of 24 days (IQR: 10, 40).
Discussion
Efforts in community healthcare should prioritize early detection and intervention for symptoms indicative of EDs in the pediatric population, aiming to mitigate the severity of cases requiring hospitalization. These findings underscore the necessity for targeted health planning policies to address the growing burden of EDs among Spanish youth.
{"title":"Hospital Admissions for Eating Disorders in Children and Adolescents in Spain: A Population-Based Study","authors":"Pilar Vázquez-Giraldo, Ainoa Muñoz-Sanjosé, Teresa López-Cuadrado","doi":"10.1002/eat.24282","DOIUrl":"10.1002/eat.24282","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Limited evidence exists regarding the impact of the COVID-19 pandemic on the onset and trajectory of eating disorders (EDs) among young in Spain. This study aims to analyze the characteristics and recent trends in hospital admissions for EDs within the pediatric population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on hospital admissions for EDs among patients aged 10–19 years between 2016 and 2022. The main outcomes examined included hospital rates (overall, stratified by ED type and age group), psychiatric comorbidities, and length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8275 hospitalizations due to EDs were identified, constituting 1 in 6 hospital admissions for mental illness and behavioral disorders. Predominant characteristics of this population included female sex (93%), aged 15–19 years (58.3%), admission primarily for anorexia nervosa (71.6%), and psychiatric comorbidity (35.6%). Hospital admissions for EDs in the pediatric population showed an increasing trend, with an annual average increase of 11.1% (95% CI: 2.6, 22.6). This rise was led by children aged 10–14 years, with a yearly increase in EDs hospitalization rates of 28.4% (95% CI: 13.5, 56.3) since 2019. Each discharge related to EDs was associated with a median stay of 24 days (IQR: 10, 40).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Efforts in community healthcare should prioritize early detection and intervention for symptoms indicative of EDs in the pediatric population, aiming to mitigate the severity of cases requiring hospitalization. These findings underscore the necessity for targeted health planning policies to address the growing burden of EDs among Spanish youth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 11","pages":"2299-2305"},"PeriodicalIF":4.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eat.24282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wesley R. Barnhart, Yueyang Xiao, Yijing Li, Christina Gaggiano, Zexuan Jiang, Shijia Wu, Hongjian Cao, Jinbo He
Objective
Weight bias internalization (WBI) is a robust, positive correlate of negative health outcomes; however, this evidence base primarily reflects cisgender individuals from Western cultural contexts. Gender-diverse individuals from non-Western cultural contexts (e.g., China) are at potentially high risk for WBI. Yet, no research has examined WBI and associated negative health consequences in this historically underrepresented population.
Method
A cross-sectional, online survey sampled Chinese gender-diverse individuals (N = 410, Mage = 22.33 years). Variables were self-reported, including demographics, WBI, body shame, body dissatisfaction, disordered eating, physical and mental health status, and gender minority stress (e.g., internalized cisgenderism). Analyses included correlations and multiple hierarchical regressions.
Results
Pearson bivariate correlations demonstrated associations between higher WBI and more eating and body image disturbances and poor physical and mental health. After adjusting for age, BMI, gender identity, and gender minority stress, higher WBI was uniquely and positively associated with higher body shame, higher body dissatisfaction, higher disordered eating, and poor physical and mental health. Notably, WBI accounted for more unique variance in eating and body image disturbances (13%–25% explained by WBI) than physical and mental health (1%–4% explained by WBI).
Discussion
While replication with longitudinal and experimental designs is needed to speak to the temporal dynamics and causality, our findings identify WBI as a unique, meaningful correlate of eating and body image disturbances in Chinese gender-diverse adults.
{"title":"Beyond Age, BMI, Gender Identity, and Gender Minority Stress, Weight Bias Internalization Is Uniquely Associated With More Eating and Body Image Disturbances and Poor Physical and Mental Health in Chinese Gender-Diverse Adults","authors":"Wesley R. Barnhart, Yueyang Xiao, Yijing Li, Christina Gaggiano, Zexuan Jiang, Shijia Wu, Hongjian Cao, Jinbo He","doi":"10.1002/eat.24278","DOIUrl":"10.1002/eat.24278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Weight bias internalization (WBI) is a robust, positive correlate of negative health outcomes; however, this evidence base primarily reflects cisgender individuals from Western cultural contexts. Gender-diverse individuals from non-Western cultural contexts (e.g., China) are at potentially high risk for WBI. Yet, no research has examined WBI and associated negative health consequences in this historically underrepresented population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A cross-sectional, online survey sampled Chinese gender-diverse individuals (<i>N</i> = 410, <i>M</i>\u0000 <sub>age</sub> = 22.33 years). Variables were self-reported, including demographics, WBI, body shame, body dissatisfaction, disordered eating, physical and mental health status, and gender minority stress (e.g., internalized cisgenderism). Analyses included correlations and multiple hierarchical regressions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pearson bivariate correlations demonstrated associations between higher WBI and more eating and body image disturbances and poor physical and mental health. After adjusting for age, BMI, gender identity, and gender minority stress, higher WBI was uniquely and positively associated with higher body shame, higher body dissatisfaction, higher disordered eating, and poor physical and mental health. Notably, WBI accounted for more unique variance in eating and body image disturbances (13%–25% explained by WBI) than physical and mental health (1%–4% explained by WBI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>While replication with longitudinal and experimental designs is needed to speak to the temporal dynamics and causality, our findings identify WBI as a unique, meaningful correlate of eating and body image disturbances in Chinese gender-diverse adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 11","pages":"2246-2259"},"PeriodicalIF":4.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marianna L. Thomeczek, Kelsie T. Forbush, Yiyang Chen, Sonakshi Negi, Sarah Johnson-Munguia, Alexa M. L'Insalata, Samiya Rasheed, Emily Like, Jacquelyn McDonald
Objective
Only approximately 20% of college students with an eating disorder (ED) seek treatment. One barrier to seeking treatment is weight discrimination. Past research demonstrates that experiencing weight discrimination is associated with increased ED risk and decreased in-person treatment engagement. Weight discrimination may be a particularly relevant treatment barrier for students who have a higher body weight given their higher likelihood of experiencing weight discrimination.
Methods
College students with a probable ED diagnosis (N = 372; Mage = 23.94; 73.12% women, 18.55% men, 6.18% another gender; 11.29% Asian, 4.57% Black, 12.63% Hispanic, 83.60% White, 4.84% Native American, and 0.54% another race) completed an online self-report survey that included the Clinical Impairment Assessment (CIA), Experience of Weight Discrimination (EWD) Scale, and a 0–100 scale to indicate interest in participating in virtual guided self-help ED treatment.
Results
Linear regression showed significant positive relationships between weight discrimination and ED-related psychiatric impairment and treatment interest.
Discussion
Elevations in CIA scores corroborate past literature that suggested that weight discrimination was positively related to ED psychopathology. Contrary to past research, college students who experienced weight discrimination had greater treatment interest. Students who experience weight discrimination may view virtual self-guided treatment as less weight-stigmatizing due to the “do-it-yourself” approach and no in-person interactions. Findings highlight the potential impacts of weight discrimination on acceptability of ED-related care. Future research is needed to identify ways to reduce weight discrimination and promote weight-inclusive practices in the medical system.
目的：在患有饮食失调症（ED）的大学生中，只有约 20% 的人寻求治疗。寻求治疗的一个障碍是体重歧视。过去的研究表明，体重歧视与饮食失调风险的增加和现场治疗参与度的降低有关。体重歧视对于体重较重的学生来说可能是一个特别相关的治疗障碍，因为他们更有可能遭遇体重歧视：被诊断出可能患有 ED 的大学生（N = 372；Mage = 23.94；73.12% 为女性，18.55% 为男性，6.18% 为其他性别；11.29% 为亚裔，4.57% 为黑人，12.63% 为西班牙裔，83.60% 为白人，4.84% 为美国原住民，0.54% 为其他种族）完成了一项在线调查。54%为其他种族）完成了一项在线自我报告调查，调查内容包括临床损害评估（CIA）、体重歧视体验量表（EWD）和 0-100 分值，以表明他们是否有兴趣参加虚拟指导的自助 ED 治疗：线性回归结果显示，体重歧视与 ED 相关精神损害和治疗兴趣之间存在明显的正相关关系：讨论：CIA分数的升高证实了过去的文献表明体重歧视与ED精神病理学呈正相关。与过去的研究相反，经历过体重歧视的大学生对治疗更感兴趣。由于采用了 "自己动手 "的方法，而且没有面对面的互动，因此经历过体重歧视的学生可能会认为虚拟自我指导治疗对体重的侮辱较少。研究结果凸显了体重歧视对接受 ED 相关治疗的潜在影响。未来的研究需要找出减少体重歧视的方法，并在医疗系统中推广体重包容性实践。
{"title":"Associations Between Weight Discrimination, Eating-Disorder-Related Psychiatric Impairment, and Eating-Disorder Treatment Interest Across the Weight Spectrum","authors":"Marianna L. Thomeczek, Kelsie T. Forbush, Yiyang Chen, Sonakshi Negi, Sarah Johnson-Munguia, Alexa M. L'Insalata, Samiya Rasheed, Emily Like, Jacquelyn McDonald","doi":"10.1002/eat.24277","DOIUrl":"10.1002/eat.24277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Only approximately 20% of college students with an eating disorder (ED) seek treatment. One barrier to seeking treatment is weight discrimination. Past research demonstrates that experiencing weight discrimination is associated with increased ED risk and decreased in-person treatment engagement. Weight discrimination may be a particularly relevant treatment barrier for students who have a higher body weight given their higher likelihood of experiencing weight discrimination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>College students with a probable ED diagnosis (<i>N</i> = 372; M<sub>age</sub> = 23.94; 73.12% women, 18.55% men, 6.18% another gender; 11.29% Asian, 4.57% Black, 12.63% Hispanic, 83.60% White, 4.84% Native American, and 0.54% another race) completed an online self-report survey that included the Clinical Impairment Assessment (CIA), Experience of Weight Discrimination (EWD) Scale, and a 0–100 scale to indicate interest in participating in <i>virtual guided self-help</i> ED treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Linear regression showed significant positive relationships between weight discrimination and ED-related psychiatric impairment and treatment interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Elevations in CIA scores corroborate past literature that suggested that weight discrimination was positively related to ED psychopathology. Contrary to past research, college students who experienced weight discrimination had greater treatment interest. Students who experience weight discrimination may view virtual self-guided treatment as less weight-stigmatizing due to the “do-it-yourself” approach and no in-person interactions. Findings highlight the potential impacts of weight discrimination on acceptability of ED-related care. Future research is needed to identify ways to reduce weight discrimination and promote weight-inclusive practices in the medical system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 11","pages":"2292-2298"},"PeriodicalIF":4.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuan Zhou, Mia Pellizzer, Ella Keegan, Tracey D. Wade
Objective
This study examines the factorial structure and psychometric properties of the Eating Disorder-15 questionnaire (ED-15) in a large clinical sample, as well as the instrument's sensitivity to early clinical change in therapy and ability to measure remission.
Method
Participants with eating disorders (N = 278) referred to the Flinders University Services for Eating Disorders in South Australia completed the ED-15 as well as other measures of eating disorder symptoms and co-occurring psychopathology, including depression, anxiety, and stress.
Results
Confirmatory factor analysis (CFA) revealed a two-factor model for the ED-15. The ED-15 had good internal consistency. It showed satisfactory concurrent validity with moderate correlations with the EDE-Q global score and contribution of unique variance to that score. Correlations indicated good convergent validity with clinical impairment and good divergent validity from depression, anxiety, and stress. The ED-15 showed a significant medium effect size change within the first four sessions of therapy. Good discriminant validity was indicated by cut-off scores used for remission, with significantly different levels of ED psychopathology and other impairments between the two groups.
Discussion
This study adds to the four previous psychometric studies of the ED-15, confirming robustness of the English version in a clinical sample. The brevity and psychometric robustness of the ED-15 makes it a preferable measure to the Eating Disorder Examination for sessional assessment of progress in treatment.
{"title":"Factor Structure and Psychometric Properties of the ED-15 in People With an Eating Disorder","authors":"Yuan Zhou, Mia Pellizzer, Ella Keegan, Tracey D. Wade","doi":"10.1002/eat.24271","DOIUrl":"10.1002/eat.24271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examines the factorial structure and psychometric properties of the Eating Disorder-15 questionnaire (ED-15) in a large clinical sample, as well as the instrument's sensitivity to early clinical change in therapy and ability to measure remission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Participants with eating disorders (<i>N</i> = 278) referred to the Flinders University Services for Eating Disorders in South Australia completed the ED-15 as well as other measures of eating disorder symptoms and co-occurring psychopathology, including depression, anxiety, and stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Confirmatory factor analysis (CFA) revealed a two-factor model for the ED-15. The ED-15 had good internal consistency. It showed satisfactory concurrent validity with moderate correlations with the EDE-Q global score and contribution of unique variance to that score. Correlations indicated good convergent validity with clinical impairment and good divergent validity from depression, anxiety, and stress. The ED-15 showed a significant medium effect size change within the first four sessions of therapy. Good discriminant validity was indicated by cut-off scores used for remission, with significantly different levels of ED psychopathology and other impairments between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study adds to the four previous psychometric studies of the ED-15, confirming robustness of the English version in a clinical sample. The brevity and psychometric robustness of the ED-15 makes it a preferable measure to the Eating Disorder Examination for sessional assessment of progress in treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 11","pages":"2235-2245"},"PeriodicalIF":4.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eat.24271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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