Sabrina S. Schröder, Unna N. Danner, Joanna Steinglass, Karin Foerde
Objective
Individuals with anorexia nervosa persistently restrict their food intake while often severely underweight. This maladaptive food choice behavior and related decision-making processes have mainly been investigated in adults. It is unknown whether the same decision-making processes drive food choices in adolescents, given their more favorable treatment outcomes. This study investigated maladaptive food choice behavior in adolescents with AN and examined whether they display the same decision-making processes as adults.
Method
Adolescents with AN (n = 42) and age-matched controls (n = 42) completed a computer-based food choice task, rating food images for healthiness and tastiness before choosing between two food items.
Results
Adolescents with AN chose high-fat foods less frequently than controls, with food choices more influenced by their perceived “healthiness” and less by their “tastiness” than they did among controls. Relative to controls, adolescents with AN also reported lower overall tastiness ratings and greater habit strength of restrictive eating, which was, however, not related to food choices.
Discussion
Adolescents with AN display the same maladaptive food choice behavior as adults, namely the persistent restriction of high-fat food choices. Their choices were more strongly influenced by the perceived healthiness of a food item, compared to the choices of controls.
{"title":"Maladaptive Restrictive Food Choice Behavior in Adolescents With Anorexia Nervosa","authors":"Sabrina S. Schröder, Unna N. Danner, Joanna Steinglass, Karin Foerde","doi":"10.1002/eat.24312","DOIUrl":"10.1002/eat.24312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Individuals with anorexia nervosa persistently restrict their food intake while often severely underweight. This maladaptive food choice behavior and related decision-making processes have mainly been investigated in adults. It is unknown whether the same decision-making processes drive food choices in adolescents, given their more favorable treatment outcomes. This study investigated maladaptive food choice behavior in adolescents with AN and examined whether they display the same decision-making processes as adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Adolescents with AN (<i>n</i> = 42) and age-matched controls (<i>n</i> = 42) completed a computer-based food choice task, rating food images for healthiness and tastiness before choosing between two food items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adolescents with AN chose high-fat foods less frequently than controls, with food choices more influenced by their perceived “healthiness” and less by their “tastiness” than they did among controls. Relative to controls, adolescents with AN also reported lower overall tastiness ratings and greater habit strength of restrictive eating, which was, however, not related to food choices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Adolescents with AN display the same maladaptive food choice behavior as adults, namely the persistent restriction of high-fat food choices. Their choices were more strongly influenced by the perceived healthiness of a food item, compared to the choices of controls.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"248-253"},"PeriodicalIF":4.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607271","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}
{"title":"In Memoriam: Professor Ross Crosby","authors":"Tracey D. Wade, Scott J. Crow","doi":"10.1002/eat.24321","DOIUrl":"10.1002/eat.24321","url":null,"abstract":"","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"37-39"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eat.24321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607227","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}
Clara Sophie Beer, Luisa Marie Lüken, Jessica Eggendorf, Martin Holtmann, Tanja Legenbauer
Objective
Eating disorders (EDs) represent a significant public health concern, with a high prevalence among adolescent girls. The COVID-19 pandemic has led to a marked increase in EDs, underlining the need for a brief screening tool in clinical settings. The present study compared ICD-10-based ED-diagnoses with SCOFF-identified at-risk female patients in a clinical setting and assessed the tool's reliability.
Method
Routine data (n = 955 participants) from a child and adolescent psychiatric hospital were evaluated regarding the incidence of ED-diagnoses before (n = 312) and during the pandemic (n = 643) and compared with SCOFF results. The SCOFF's sensitivity and specificity were examined.
Results
ED-diagnoses significantly increased, almost doubling from before to during the pandemic. The number of at-risk patients identified by the SCOFF likewise differed between the two time points. The SCOFF showed high sensitivity at cut-offs of 2 (pre-pandemic) and 3 (peri-pandemic) but low specificity. Internal consistency was poor.
Discussion
The findings align with previous research indicating an elevated rate of admission to clinical care for ED-diagnoses during the pandemic, a trend also reflected in the SCOFF results. However, the SCOFF's low specificity and poor internal consistency raise concerns about its applicability among adolescent psychiatric inpatients.
{"title":"Validation of the SCOFF as a Simple Screening Tool for Eating Disorders in an Inpatient Sample Before and During COVID-19","authors":"Clara Sophie Beer, Luisa Marie Lüken, Jessica Eggendorf, Martin Holtmann, Tanja Legenbauer","doi":"10.1002/eat.24318","DOIUrl":"10.1002/eat.24318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Eating disorders (EDs) represent a significant public health concern, with a high prevalence among adolescent girls. The COVID-19 pandemic has led to a marked increase in EDs, underlining the need for a brief screening tool in clinical settings. The present study compared ICD-10-based ED-diagnoses with SCOFF-identified at-risk female patients in a clinical setting and assessed the tool's reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Routine data (<i>n</i> = 955 participants) from a child and adolescent psychiatric hospital were evaluated regarding the incidence of ED-diagnoses before (<i>n</i> = 312) and during the pandemic (<i>n</i> = 643) and compared with SCOFF results. The SCOFF's sensitivity and specificity were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ED-diagnoses significantly increased, almost doubling from before to during the pandemic. The number of at-risk patients identified by the SCOFF likewise differed between the two time points. The SCOFF showed high sensitivity at cut-offs of 2 (pre-pandemic) and 3 (peri-pandemic) but low specificity. Internal consistency was poor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings align with previous research indicating an elevated rate of admission to clinical care for ED-diagnoses during the pandemic, a trend also reflected in the SCOFF results. However, the SCOFF's low specificity and poor internal consistency raise concerns about its applicability among adolescent psychiatric inpatients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"243-247"},"PeriodicalIF":4.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584920","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}
Kathina Ali, Marcela Radunz, Siân A. McLean, Anne O'Shea, Teri Mavrangelos, Daniel B. Fassnacht, Laura Hart
Objective
A minority of individuals with eating disorders seek help from health professionals qualified to provide eating disorder care. This review assessed the proportion of individuals with eating disorders who had sought help or received treatment, as an update to an earlier review conducted more than a decade ago.
Method
Three databases were searched for studies that: (1) included a community sample of help-seekers and non-help seekers, (2) used a standardized eating disorder screening instrument, and (3) assessed the percentage of participants who had sought help specifically for eating disorder concerns.
Results
Of 972 articles, 21 studies met inclusion criteria, representing 37,423 participants. The pooled proportion reporting help-seeking from any source (e.g., helpline, support groups, chat rooms as well as health professionals) was 30% and the pooled proportion reporting formal treatment seeking from health professionals (e.g., psychologist) specifically for eating disorder concerns was 32%. However, there was evidence of publication bias across studies.
Discussion
These rates suggest little to no improvement in the unmet need for treatment since the last review with studies continuing to focus on white adult women. Help-seeking rates among other populations remain unclear and there is an urgent need to understand reasons for overall low help-seeking rates. Clear definitions and measures of help-seeking with appropriate distinctions between sources of help are needed to improve our understanding of help-seeking pathways and identify solutions to facilitate help-seeking. Better visibility of health professionals qualified to provide safe and effective eating disorder care could help reduce the substantial treatment gap.
{"title":"The Unmet Treatment Need for Eating Disorders: What Has Changed in More Than 10 Years? An Updated Systematic Review and Meta-Analysis","authors":"Kathina Ali, Marcela Radunz, Siân A. McLean, Anne O'Shea, Teri Mavrangelos, Daniel B. Fassnacht, Laura Hart","doi":"10.1002/eat.24306","DOIUrl":"10.1002/eat.24306","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>A minority of individuals with eating disorders seek help from health professionals qualified to provide eating disorder care. This review assessed the proportion of individuals with eating disorders who had sought help or received treatment, as an update to an earlier review conducted more than a decade ago.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Three databases were searched for studies that: (1) included a community sample of help-seekers and non-help seekers, (2) used a standardized eating disorder screening instrument, and (3) assessed the percentage of participants who had sought help specifically for eating disorder concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 972 articles, 21 studies met inclusion criteria, representing 37,423 participants. The pooled proportion reporting help-seeking from any source (e.g., helpline, support groups, chat rooms as well as health professionals) was 30% and the pooled proportion reporting formal treatment seeking from health professionals (e.g., psychologist) specifically for eating disorder concerns was 32%. However, there was evidence of publication bias across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These rates suggest little to no improvement in the unmet need for treatment since the last review with studies continuing to focus on white adult women. Help-seeking rates among other populations remain unclear and there is an urgent need to understand reasons for overall low help-seeking rates. Clear definitions and measures of help-seeking with appropriate distinctions between sources of help are needed to improve our understanding of help-seeking pathways and identify solutions to facilitate help-seeking. Better visibility of health professionals qualified to provide safe and effective eating disorder care could help reduce the substantial treatment gap.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"46-65"},"PeriodicalIF":4.7,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559364","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}
Johanne H. Pettersen, Laura Hegemann, Kristin Gustavson, Ingunn Olea Lund, Pia Jensen, Cynthia M. Bulik, Ole A. Andreassen, Alexandra Havdahl, Ragnhild E. Brandlistuen, Laurie Hannigan, Helga Ask
Objective
Studies suggest that adolescents reported more eating problems during the pandemic. Using a population-based sample, we compared eating problems—and how they associate with a range of personal characteristics and genetic factors—among adolescents before (June 2017–April 2020) versus during (April 2020–December 2022) the pandemic.
Method
Based on a preregistered analysis plan, we used cross-sectional data collected from 22,706 14–16-year-olds over 6 years (55% during the pandemic) in the Norwegian Mother, Father, and Child Cohort. We used measurement invariance analyses to compare the level of eating restraint and body concern before and during the pandemic, and multi-group structural equation models to estimate pre-pandemic and pandemic patterns of associations.
Results
Pandemic responders generally reported more eating problems than pre-pandemic responders, specifically on dieting and body dissatisfaction. However, after adjusting for a general linear increase in eating problems across all 6 years of data collection, the pandemic itself seems to be associated with more eating problems only among girls, reporting more eating restraints (meanΔ = 0.14 [CI: 0.07, 0.20]) and body concern (meanΔ = 0.17 [CI: 0.11, 0.23]). Associations between eating problems and a range of other characteristics did not differ across the pandemic and pre-pandemic groups.
Conclusions
There was a general increase in eating problems among 14–16-year-olds over time. Adjusting for this trend, the pandemic seems to exacerbate problems among girls. Although the mechanisms are unclear, our results point to factors susceptible to change that could have been intensified during the pandemic (e.g., screen time, mental distress). Our results highlight the importance of recognizing sex-specific differences in eating problems.
{"title":"Eating Problems Among Adolescent Boys and Girls Before and During the Covid-19 Pandemic","authors":"Johanne H. Pettersen, Laura Hegemann, Kristin Gustavson, Ingunn Olea Lund, Pia Jensen, Cynthia M. Bulik, Ole A. Andreassen, Alexandra Havdahl, Ragnhild E. Brandlistuen, Laurie Hannigan, Helga Ask","doi":"10.1002/eat.24314","DOIUrl":"10.1002/eat.24314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Studies suggest that adolescents reported more eating problems during the pandemic. Using a population-based sample, we compared eating problems—and how they associate with a range of personal characteristics and genetic factors—among adolescents before (June 2017–April 2020) versus during (April 2020–December 2022) the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Based on a preregistered analysis plan, we used cross-sectional data collected from 22,706 14–16-year-olds over 6 years (55% during the pandemic) in the Norwegian Mother, Father, and Child Cohort. We used measurement invariance analyses to compare the level of eating restraint and body concern before and during the pandemic, and multi-group structural equation models to estimate pre-pandemic and pandemic patterns of associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pandemic responders generally reported more eating problems than pre-pandemic responders, specifically on dieting and body dissatisfaction. However, after adjusting for a general linear increase in eating problems across all 6 years of data collection, the pandemic itself seems to be associated with more eating problems only among girls, reporting more eating restraints (meanΔ = 0.14 [CI: 0.07, 0.20]) and body concern (meanΔ = 0.17 [CI: 0.11, 0.23]). Associations between eating problems and a range of other characteristics did not differ across the pandemic and pre-pandemic groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was a general increase in eating problems among 14–16-year-olds over time. Adjusting for this trend, the pandemic seems to exacerbate problems among girls. Although the mechanisms are unclear, our results point to factors susceptible to change that could have been intensified during the pandemic (e.g., screen time, mental distress). Our results highlight the importance of recognizing sex-specific differences in eating problems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"193-205"},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548818","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}
Mor Ben Zaken Linn, Eyal Kalanthroff, Noam Weinbach
Objective
Body checking is considered a behavioral expression of the core psychopathology of eating disorders (EDs), namely, overvaluation of body weight and shape. Compulsive checking is motivated by a desire to increase a sense of certainty regarding feared outcomes. Paradoxically, studies showed that repeated checking acts to reduce certainty, forming a vicious cycle. No previous study examined whether the same principle applies for body checking. This study filled this gap by examining the causal effect of repeated body checking on memory certainty regarding checked body parts.
Method
In a laboratory-based study, 77 female participants without an ED checked the size and shape of six body parts. Their objective memory regarding which body part was last checked, and subjective certainty about this memory were assessed. Then, one group of participants continued to engage in repeated body checking, and another group repeatedly checked a neutral object. Finally, all participants completed the six body parts checking procedure again, and their objective memory and memory certainty were re-assessed.
Results
In both checking groups, objective memory regarding the last body part checked was unaffected by the type of checking performed. Importantly, certainty about memory dropped considerably only among those in the repeated body-checking group.
Discussion
The findings provide the first empirical evidence of a paradoxical effect demonstrating that repeated body checking reduces certainty about checked body parts. The study implies that repeated body checking reduces the quality of information obtained through checking and, as such, could potentially motivate further checking.
目的：身体检查被认为是进食障碍（EDs）核心心理病理学的一种行为表现，即高估体重和体形。强迫性检查的动机是希望增加对所担心结果的确定感。矛盾的是，研究表明，反复检查会降低确定感，形成恶性循环。以前的研究没有探讨同样的原理是否适用于身体检查。本研究填补了这一空白，研究了重复检查身体对被检查身体部位记忆确定性的因果效应：在一项以实验室为基础的研究中，77 名未患 ED 的女性参与者检查了六个身体部位的大小和形状。对她们关于最后一次检查哪个身体部位的客观记忆以及对这一记忆的主观确定性进行了评估。然后，一组参与者继续重复检查身体，另一组参与者重复检查一个中性物体。最后，所有参与者再次完成六个身体部位的检查程序，并重新评估他们的客观记忆和记忆确定性：结果：在两个检查组中，关于最后检查的身体部位的客观记忆不受检查类型的影响。重要的是，只有在重复检查身体组中，记忆的确定性才会显著下降：讨论：研究结果首次提供了一种自相矛盾效应的实证证据，表明重复身体检查会降低被检查身体部位的确定性。这项研究表明，重复身体检查会降低通过检查获得的信息的质量，因此有可能促使进一步的检查。
{"title":"The Paradoxical Effect of Repeated Body Checking on Subjective Uncertainty","authors":"Mor Ben Zaken Linn, Eyal Kalanthroff, Noam Weinbach","doi":"10.1002/eat.24315","DOIUrl":"10.1002/eat.24315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Body checking is considered a behavioral expression of the core psychopathology of eating disorders (EDs), namely, overvaluation of body weight and shape. Compulsive checking is motivated by a desire to increase a sense of certainty regarding feared outcomes. Paradoxically, studies showed that repeated checking acts to reduce certainty, forming a vicious cycle. No previous study examined whether the same principle applies for body checking. This study filled this gap by examining the causal effect of repeated body checking on memory certainty regarding checked body parts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In a laboratory-based study, 77 female participants without an ED checked the size and shape of six body parts. Their objective memory regarding which body part was last checked, and subjective certainty about this memory were assessed. Then, one group of participants continued to engage in repeated body checking, and another group repeatedly checked a neutral object. Finally, all participants completed the six body parts checking procedure again, and their objective memory and memory certainty were re-assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In both checking groups, objective memory regarding the last body part checked was unaffected by the type of checking performed. Importantly, certainty about memory dropped considerably only among those in the repeated body-checking group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings provide the first empirical evidence of a paradoxical effect demonstrating that repeated body checking reduces certainty about checked body parts. The study implies that repeated body checking reduces the quality of information obtained through checking and, as such, could potentially motivate further checking.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"238-242"},"PeriodicalIF":4.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523622","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}
Two recent systematic reviews provide important insights into the current state of the eating disorder literature regarding autistic traits, ASD prevalence, and experience with accessing treatment, with a specific focus on anorexia nervosa (AN). The extant literature provides converging evidence for elevated autistic traits in individuals with AN, while evidence for increased prevalence of ASD in AN is less robust. Presence of autistic traits or a formal ASD diagnosis both appear to elevate the potential for a more complicated experience during eating disorder treatment. Together, this work provides compelling justification to expand the breadth of inquiry regarding eating disorders and ASD, with a specific call for increased methodological rigor when designing and conducting future research. My commentary calls for specific steps to advance our understanding of ASD and eating disorders.
{"title":"Systematic Reviews on Eating Disorders and Autism Spectrum Disorder Emphasize a Call to Further Expand High-Quality Research","authors":"William G. Sharp","doi":"10.1002/eat.24316","DOIUrl":"10.1002/eat.24316","url":null,"abstract":"<div>\u0000 \u0000 <p>Two recent systematic reviews provide important insights into the current state of the eating disorder literature regarding autistic traits, ASD prevalence, and experience with accessing treatment, with a specific focus on anorexia nervosa (AN). The extant literature provides converging evidence for elevated autistic traits in individuals with AN, while evidence for increased prevalence of ASD in AN is less robust. Presence of autistic traits or a formal ASD diagnosis both appear to elevate the potential for a more complicated experience during eating disorder treatment. Together, this work provides compelling justification to expand the breadth of inquiry regarding eating disorders and ASD, with a specific call for increased methodological rigor when designing and conducting future research. My commentary calls for specific steps to advance our understanding of ASD and eating disorders.</p>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"168-170"},"PeriodicalIF":4.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512477","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}
Johannes Hebebrand, Jochen Seitz, Abigail Matthews
Background
Because premorbid BMI strongly predicts the amount of weight loss in anorexia nervosa (AN)/atypical AN, we hypothesize that weight loss triggers both disorders by inducing the endocrine adaptation to starvation.
Method
We propose research to capture the onset of AN/atypical AN following intentional, otherwise behaviorally motivated, or unintentional weight loss in relationship to premorbid weight.
Results
We propose retrospective and prospective studies to examine the temporal development of symptoms in AN/atypical AN. Given a greater frequency of weight loss behaviors in individuals with high BMIs, patients with intentionally driven weight loss should demonstrate a higher mean weight loss and greater premorbid weight and shape concerns. Practice guidelines necessitate weight gain for AN recovery, yet how weight gain induces improvements is unspecified and warrants systematic elucidation. Finally, we highlight implications for the current conceptualization of genetic and environmental contributors of AN/atypical AN in twin and molecular genetic studies.
Conclusion
We propose separating the starvation-induced mechanisms relevant for AN/atypical AN development from the reasons/mechanisms inherent to weight loss.
{"title":"Considering Sufficient Weight Loss as a Prerequisite for Development of Anorexia Nervosa and Atypical Anorexia Nervosa","authors":"Johannes Hebebrand, Jochen Seitz, Abigail Matthews","doi":"10.1002/eat.24313","DOIUrl":"10.1002/eat.24313","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Because premorbid BMI strongly predicts the amount of weight loss in anorexia nervosa (AN)/atypical AN, we hypothesize that weight loss triggers both disorders by inducing the endocrine adaptation to starvation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We propose research to capture the onset of AN/atypical AN following intentional, otherwise behaviorally motivated, or unintentional weight loss in relationship to premorbid weight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We propose retrospective and prospective studies to examine the temporal development of symptoms in AN/atypical AN. Given a greater frequency of weight loss behaviors in individuals with high BMIs, patients with intentionally driven weight loss should demonstrate a higher mean weight loss and greater premorbid weight and shape concerns. Practice guidelines necessitate weight gain for AN recovery, yet how weight gain induces improvements is unspecified and warrants systematic elucidation. Finally, we highlight implications for the current conceptualization of genetic and environmental contributors of AN/atypical AN in twin and molecular genetic studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We propose separating the starvation-induced mechanisms relevant for AN/atypical AN development from the reasons/mechanisms inherent to weight loss.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 1","pages":"162-167"},"PeriodicalIF":4.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512472","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}
Dang et al.'s review concludes that atypical anorexia nervosa (atypical AN), purging disorder (PD), and night eating syndrome (NES) are clinically significant and severe eating disorders (EDs). However, findings are unlikely to alter their status in future editions of the DSM due to limitations in the literature to date. Guidelines are offered to promote rigorous and reproducible research on other specified feeding or eating disorder OSFED. First, published research diagnostic criteria for atypical AN, PD, and NES should be consistently used to ensure findings across studies reflect the same conditions. Second, operational definitions are recommended for “recurrent” as at least twice within a 3-month period, minimum duration as at least 1 month, and “significant weight loss” as >5% BMI reduction within 1 month. Third, Thomas's and Gydus's trumping scheme for differential diagnosis of OSFED subcategories is endorsed but should prioritize identifying treatment targets based on medical morbidity over mirroring existing diagnostic algorithms. Fourth, a systematic approach for establishing clinical significance is recommended that explicitly notes medical risk associated with malnutrition, purging and nonpurging behaviors, and relevance of marked distress related to binge eating and body image disturbance. Adoption of these guidelines will facilitate necessary research on clinical utility.
{"title":"Guidelines for Rigorous and Reproducible Research on Other Specified Feeding or Eating Disorder: Commentary on Dang et al. (2024)","authors":"Pamela K. Keel","doi":"10.1002/eat.24262","DOIUrl":"10.1002/eat.24262","url":null,"abstract":"<div>\u0000 \u0000 <p>Dang et al.'s review concludes that atypical anorexia nervosa (atypical AN), purging disorder (PD), and night eating syndrome (NES) are clinically significant and severe eating disorders (EDs). However, findings are unlikely to alter their status in future editions of the DSM due to limitations in the literature to date. Guidelines are offered to promote rigorous and reproducible research on other specified feeding or eating disorder OSFED. First, published research diagnostic criteria for atypical AN, PD, and NES should be consistently used to ensure findings across studies reflect the same conditions. Second, operational definitions are recommended for “recurrent” as at least twice within a 3-month period, minimum duration as at least 1 month, and “significant weight loss” as >5% BMI reduction within 1 month. Third, Thomas's and Gydus's trumping scheme for differential diagnosis of OSFED subcategories is endorsed but should prioritize identifying treatment targets based on medical morbidity over mirroring existing diagnostic algorithms. Fourth, a systematic approach for establishing clinical significance is recommended that explicitly notes medical risk associated with malnutrition, purging and nonpurging behaviors, and relevance of marked distress related to binge eating and body image disturbance. Adoption of these guidelines will facilitate necessary research on clinical utility.</p>\u0000 </div>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"57 10","pages":"2041-2044"},"PeriodicalIF":4.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512474","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}
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