Authors:Pixie G. Turner; Carmen E. Lefevre Pages: 277 - 284 Abstract: Purpose Social media use is ever increasing amongst young adults and has previously been shown to have negative effects on body image, depression, social comparison, and disordered eating. One eating disorder of interest in this context is orthorexia nervosa, an obsession with eating healthily. High orthorexia nervosa prevalence has been found in populations who take an active interest in their health and body and is frequently comorbid with anorexia nervosa. Here, we investigate links between social media use, in particularly Instagram and orthorexia nervosa symptoms. Methods We conducted an online survey of social media users (N = 680) following health food accounts. We assessed their social media use, eating behaviours, and orthorexia nervosa symptoms using the ORTO-15 inventory. Results Higher Instagram use was associated with a greater tendency towards orthorexia nervosa, with no other social media channel having this effect. In exploratory analyses Twitter showed a small positive association with orthorexia symptoms. BMI and age had no association with orthorexia nervosa. The prevalence of orthorexia nervosa among the study population was 49%, which is significantly higher than the general population (<1%). Conclusions Our results suggest that the healthy eating community on Instagram has a high prevalence of orthorexia symptoms, with higher Instagram use being linked to increased symptoms. These findings highlight the implications social media can have on psychological wellbeing, and the influence social media ‘celebrities’ may have over hundreds of thousands of individuals. These results may also have clinical implications for eating disorder development and recovery. PubDate: 2017-06-01 DOI: 10.1007/s40519-017-0364-2 Issue No:Vol. 22, No. 2 (2017)
Authors:Katrin Elisabeth Giel; Eva Speer; Kathrin Schag; Elisabeth Johanna Leehr; Stephan Zipfel Pages: 345 - 351 Abstract: Purpose Impulsivity might contribute to the development and maintenance of obesity and eating disorders. Patients suffering from binge eating disorder (BED) show an impulsive eating pattern characterized by regular binge eating episodes. Novel behavioral interventions increasing inhibitory control could improve eating behavior in BED. We piloted a novel food-specific inhibition training in individuals with BED. Methods N = 22 BED patients according to SCID-I were randomly assigned to three sessions of a training or control condition. In both conditions, pictures of high-caloric food items were presented in peripheral vision on a computer screen while assessing gaze behavior. The training group had to suppress the urge to turn their gaze towards these pictures (i.e., to perform antisaccades). The control group was allowed to freely explore the pictures. We assessed self-reported food craving, food addiction, and wanting/liking of food pictures pre- and post-intervention. Results Twenty participants completed the study. The training proved to be feasible and acceptable. Patients of the training group significantly improved inhibitory control towards high-caloric food stimuli. Both groups reported a significantly lower number of binge eating episodes in the last four weeks after termination of the study. No changes were found in food craving, food addiction, liking, and wanting ratings. Conclusions A food-specific inhibition training could be a useful element in the treatment of BED and other eating disorders; however, larger efficacy studies in patient samples are needed to investigate the efficacy of this and similar training approaches. PubDate: 2017-06-01 DOI: 10.1007/s40519-017-0371-3 Issue No:Vol. 22, No. 2 (2017)
Authors:Giada Pietrabissa; Angela Sorgente; Alessandro Rossi; Susan Simpson; Giuseppe Riva; Gian Mauro Manzoni; James O. Prochaska; Janice M. Prochaska; Roberto Cattivelli; Gianluca Castelnuovo Pages: 361 - 367 Abstract: Purpose To examine the factorial structure of the University of Rhode Island Change Assessment Scale (IT-URICA) for weight management in a sample of Italian overweight and obese patients enrolled in a nutritional rehabilitation program. Methods 334 inpatients completed the translated and adjusted version of the IT-URICA at admission to the hospital. Psychometric testing included confirmatory factor analysis and internal consistency (Cronbach’s α). Results The IT-URICA for weight management was successfully translated into Italian, and the factorial analysis confirmed the four-factor solution of the commonly accepted version of the measure. Conclusion High levels of RTC are considered critical to the long-term success of weight management, and the IT-URICA may be an appropriate measure of motivational readiness for use among Italian overweight and obese patients. Its use is, therefore, recommended for clinical and research purposes. PubDate: 2017-06-01 DOI: 10.1007/s40519-016-0289-1 Issue No:Vol. 22, No. 2 (2017)
Abstract: Objective This manuscript explores the characteristics of individuals diagnosed with an eating disorder who dropped out of treatment, compared with those who completed it. Method The participants were 196 patients diagnosed with eating disorders (according to DSM-IV-TR criteria) who consecutively began treatment for the first time in an eating disorders unit. They were assessed at baseline with a set of questionnaires evaluating eating habits, temperament, and general psychopathology. During the follow-up period, patients who dropped out were re-assessed via a telephone interview. Results In the course of a 2-year follow-up, a total of 80 (40.8%) patients were labeled as dropouts, and 116 (59.2%) remaining subjects were considered completers. High TCI scores in the character dimensions of Disorderliness (NS4) (p < .01) and total Novelty Seeking (NST), along with low scores in Dependency (RD4), were significantly associated with dropout in the course of 2 years. Once the results were submitted to logistic regression analysis, dropout only remained associated with high scores in Disorderliness (NS4) and, inversely, with an initial Anorexia Nervosa (AN) diagnosis (p < .05). Reasons for dropout stated by the patients included logistic difficulties, subjective improvement of their condition, and lack of motivation. Discussion Clinicians should handle the first therapeutic intervention with particular care in order to enhance their understanding of clients and their ability to rapidly identify those who are at risk of dropping out of treatment. Level of evidence Level III: Cohort Study. PubDate: 2017-07-17
Abstract: Objective To investigate the predictive value of weight restoration trajectories for relapse within the first year after discharge from inpatient treatment among adolescents with AN. Methods Forty four inpatient adolescents (5 boys, 39 girls) aged 11–18 (M 14.85, SD 1.87) diagnosed with anorexia were assessed at admission and discharge from a general hospital inpatient ward. Re-hospitalizations within 1 year of discharge were recorded. Factors assessed included 1/BMI at admission, 2/BMI at discharge, 3/percent from target weight (PFTW) at discharge, 4/length of hospitalization, and 5/a weight restoration trajectory measuring weight drops during inpatient weight restoration (rates of negative cubic variation in body weight (NCV). Results Logistic regression indicated that negative cubic variation rates (NCV) predicted re-hospitalization. PFTW was found only marginally significant. Conclusion Variations in weight restoration during inpatient treatment may be used to identify patients at risk for relapse. NCV can alert clinicians to initiate early relapse prevention interventions before discharge. Level of Evidence Level III, cohort study. PubDate: 2017-07-14
Abstract: Purpose This study aimed to estimate the prevalence of eating disorders (EDs) in musicians, and to evaluate their relation to perfectionism, stress, anxiety and depression. Methods It examined: (1) the prevalence of EDs using the Eating Disorder Examination Questionnaire (EDE-Q), body mass index (BMI) and self-reports, (2) psychological risk factors using the Depression Anxiety Stress Scale (DASS-21) and perfectionism inventory and (3) demographic details, information about musical and career development, lifestyle, eating habits and health. A survey was distributed worldwide and a total of 301 English-speaking musicians aged 18 years and older participated. Results Our screening tools for EDs showed a high prevalence of EDs in musicians: the EDE-Q Global Score (EDE-QGS) showed pathological values in 18.66% of the musicians and when questioned about lifetime prevalence, 32.3% of the musicians answered positively. The median BMI was within the normal range. Regarding general mental health, the DASS-21 showed that depression and stress were severe, anxiety was extremely severe and the perfectionism inventory composite score was 26.53. There was no significant difference on the EDE-QGS between musicians who perform different types of music, but music students, professionals, soloists and musicians travelling overseas had a higher percentage of pathological EDE-QGS. Perfectionism was higher in classical musicians and there was a low positive correlation between EDE-QGS and the risk factors: perfectionism, depression, anxiety, stress, peer pressure and social isolation. Conclusion EDs are prevalent in musicians and possible risk factors are their increased perfectionism, depression, anxiety and stress due to the demands of their job. PubDate: 2017-07-14
Authors:K. Anusha; U. P. K. Hettiaratchi; L. V. Athiththan; P. P. R. Perera Abstract: Purpose Association between serum leptin levels and anthropometric parameter is well established in western countries according to the specific WHO cut-off values assigned for those populations, whereas it is not clearly defined for Asians especially with respect to gender. Thus, the objectives of this study were to determine the relationship of serum leptin levels with body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) to identify the variations of serum leptin levels with gender and to evaluate the serum leptin levels in risk and non-risk groups based on their anthropometric values. Subjects/methods A cross-sectional study was carried out among 226 apparently healthy subjects (non-diabetics, age 20–70 years). Height, weight, WC, hip circumference (HC) and mid arm circumference (MAC) were measured. BMI, WHR, waist to height ratio (WHtR) were calculated. Fasting blood samples were collected. Serum leptin levels were measured using human leptin ELISA kits. Results Majority of the participants were females (59.3%). Serum leptin levels were significantly higher in females (24.8 ± 17.1 ng/mL) compared to males (9.3 ± 7.9 ng/mL). Significant positive correlations (P < 0.05) were observed between serum leptin levels and all anthropometric parameters except height in both genders. The risk groups according to BMI, WC and WHR in females were hyperleptinaemic and had significantly (P < 0.05) higher serum leptin levels than the non-risk groups. Conclusions Linear trend was observed for serum leptin levels with weight, BMI, WC, HC, WHR, MAC and WHtR in both genders. Though the serum leptin levels were higher among risk groups, according to WHR, WC and BMI, the hyperleptinaemia was observed only among females. Level of evidence A descriptive cross-sectional study, Level V PubDate: 2017-07-07 DOI: 10.1007/s40519-017-0413-x
Authors:Claudia Cruzat-Mandich; Fernanda Díaz-Castrillón; Cristhian E. Pérez-Villalobos; Paula Lizana; Catalina Moore; Susan Simpson; Camila Oda-Montecinos Abstract: The aim of this study was to ascertain the psychometric properties of the Multidimensional Body–Self Relations Questionnaire (MBSRQ) for a sample of youth in Chile. Cross-sectional survey was conducted with 451 participants. A non-clinical sample of adolescents and young adults between 15 and 25 years responded the MBSRQ and a sociodemographic questionnaire. Factorial analysis identified seven factors and provided empirical evidence that supports the use of these factors to evaluate body perception in Chilean youth. Scores exhibited good reliability in three factors (over 0.80) and acceptable reliability in the other four (over 0.70). Findings suggest that the Spanish MBSRQ was psychometrically sound, with 7 factors which are largely consistent with those identified in the original version and validation study of this scale. These factors possess sufficient internal consistency to make it plausible for use in research and screening with Chilean youth, and potentially useful as an adjunctive measure in the context of clinical decision making. PubDate: 2017-07-07 DOI: 10.1007/s40519-017-0411-z
Authors:Tyler B. Mason; Kathryn E. Smith; Ross D. Crosby; Stephen A. Wonderlich; Scott J. Crow; Scott G. Engel; Carol B. Peterson Abstract: The eating disorder examination questionnaire (EDE-Q) Global score is a self-report measure of global eating disorder (ED) psychopathology. This study used ecological momentary assessment (EMA) to evaluate the ecological validity of EDE-Q Global scores among obese adults. Fifty obese adults completed the EDE-Q and 2 weeks of EMA ratings prior to initiating eating episodes and subsequently after eating episodes. EMA items assessed behavioral symptoms [i.e., loss of control (LOC) eating and overeating] and cognitive symptoms (i.e., weight/shape concerns, eating concerns, and restraint). EDE-Q Global was associated with increased EMA weight/shape concerns and fear of LOC at pre-eating recordings. EDE-Q Global was associated with increased EMA post-episode weight/shape concerns, eating concerns, LOC eating, and overeating. There was no association between EDE-Q Global and EMA restraint. Results generally supported the ecological validity of EDE-Q Global scores. Future studies of ED psychopathology in obese adults may benefit from considering EDE-Q Restraint separately. Level of Evidence Level V, descriptive study. PubDate: 2017-06-22 DOI: 10.1007/s40519-017-0410-0
Authors:Greet S. Kuipers; Sandra den Hollander; L. Andries van der Ark; Marrie H. J. Bekker Abstract: Purpose To investigate whether recovery from an eating disorder is related to pre-treatment attachment and mentalization and/or to improvement of attachment and mentalization during treatment. Method For a sample of 38 anorexia nervosa (AN) and bulimia nervosa (BN) patients receiving treatment the relations between attachment security, mentalization, comorbidity and recovery status after 12 months (not recovered or recovered), and after 18 months (persistently ill, relapsed, newly recovered, or persistently recovered) were investigated. Attachment security and mentalization were assessed by the Adult Attachment Interview at the start of the treatment and after 12 months. Besides assessing co-morbidity—for its effect on treatment outcome—we measured psycho-neuroticism and autonomy because of their established relations to both eating disorder symptoms and to attachment security. Results Recovery both at 12 months and at 18 months was related to higher levels of mentalization; for attachment, no significant differences were found between recovered and unrecovered patients. Patients who recovered from AN or BN also improved on co-morbid symptoms: whereas pre-treatment symptom severity was similar, at 12 months recovered patients scored lower on co-morbid personality disorders, anxiety, depression, self-injurious behaviour and psycho-neuroticism than unrecovered patients. Improvement on autonomy (reduced sensitivity to others; greater capacity to manage new situations) in 1 year of treatment was significantly higher in recovered than in unrecovered patients. Conclusion A focus on enhancing mentalization in eating disorder treatment might be useful to increase the chances of successful treatment. Improvement of autonomy might be the mechanism of change in recovering from AN or BN. Level of Evidence Level III cohort study. PubDate: 2017-06-22 DOI: 10.1007/s40519-017-0405-x
Authors:C. James; A. Harrison; A. Seixas; M. Powell; S. Pengpid; K. Peltzer Abstract: Purpose The primary objective of this study was to explore if self-reported food avoidance (fats, carbohydrates and protein) exists among college students in low- and middle-income countries (LMICs) and its relationship with body mass index (BMI), dieting, mood/anxiety symptoms, physical activities and general health knowledge. Methods This study is a subset (N = 6096) of a larger 26 LMICs cross-sectional survey, which consisted of 21,007 college students. We ascertained socio-demographic information, food avoidance, physical activities, dieting behaviours, depressive and PTSD symptoms, and recorded anthropometric measurements. Chi-square analyses assessed the relationship between predictor variables and food categories eliminated from participants’ diet. Multiple logistic regression assessed if food avoidance predicts outcome variables such as binge drinking, high physical activity, being underweight, exhibiting significant depressive and PTSD symptoms. Results Food avoidance exists in as many as one-third of college students in low- and middle-income countries, with this being more likely in persons who are trying to lose weight whether by dieting or otherwise. Food avoidance was associated with higher BMI, depressive symptoms, and high intensity exercises, as well as the level of health knowledge influencing the types of food avoided. A significant difference was noted between lower middle-income and upper middle-income countries with respect to the foods they avoided. Conclusion Despite being knowledgeable about health-related behaviours, we found that college students in our sample were not that different from those in developed countries and may be influenced by a similar advice given by non-experts about macronutrients. These results hold implications for intervention programmes and policy makers. Level of evidence Level V, descriptive cross-sectional survey. PubDate: 2017-06-14 DOI: 10.1007/s40519-017-0407-8
Authors:Maria Ana Falcão; Rita Francisco Abstract: Purpose The purpose of this study was to compare disordered eating (DE) and body image dissatisfaction (BID) among young adults with type 1 diabetes and their peers without diabetes, to investigate the consequences of diabetes for food, body image and weight in individuals with diabetes and to identify the behavior of insulin omission as a weight loss strategy. Methods Fifty-five young adults with diabetes and 73 without diabetes (ages 18–30) completed self-report questionnaires to evaluate their behaviors, attitudes and feelings related to eating disorders and their perceptions about body image. The participants with diabetes were asked to answer a questionnaire with open and closed questions developed specifically for this study. Results No significant differences between participants with and without diabetes in relation to BID and DE were found. The results demonstrated several changes resulting from diabetes in terms of food, body image and weight that interfere with the day-to-day life of individuals with diabetes; 7.3% of these participants reported insulin omission as a weight loss strategy. Conclusions This study emphasizes the importance of research on DE in the population with diabetes and their prevention, screening and treatment. In particular, it is essential to give more attention to insulin omission as a compensatory behavior that is inappropriate and harmful to health. Level of evidence Level III, case-control analytic study. PubDate: 2017-06-08 DOI: 10.1007/s40519-017-0406-9
Authors:Shae-Leigh C. Vella; Nagesh B. Pai Abstract: The concept of food addiction (FA) remains controversial with research being in the nascent stages; FA like any addiction can have a devastating impact on the lives of those afflicted. There exists a clinical need for treatment strategies for those affected. This article reviews potential treatment strategies for FA. The treatment strategies target four core behaviours of the addiction phenotype specifically craving through the opioid system, impulsivity as a personality trait, compulsivity through the serotonergic system and lastly motivation through the dopaminergic system. A range of pharmacological and psychological interventions are reviewed. Future research should seek to test and validate the proposed clinical treatment strategies. PubDate: 2017-06-06 DOI: 10.1007/s40519-017-0400-2
Authors:Tyler B. Mason; Jason M. Lavender; Stephen A. Wonderlich; Ross D. Crosby; Scott G. Engel; James E. Mitchell; Scott J. Crow; Daniel Le Grange; Carol B. Peterson Abstract: Purpose Appearance-related stress may result from appearance-focused events such as seeing one’s reflection, seeing media images, and shopping for clothes. The purpose of this study was to examine the prospective association between momentary appearance-related stress and eating disorder (ED) behaviors (i.e., binge eating and vomiting) among women with anorexia nervosa (AN) using ecological momentary assessment (EMA). We hypothesized that appearance-related stress at Time 1 would predict binge eating and vomiting at Time 2, and that this prospective association would be mediated by momentary anxiety at Time 2 (controlling for anxiety at Time 1). Methods Women with AN completed a 2-week EMA protocol involving repeated daily assessments of experiences and behaviors. Results Momentary appearance-related stress preceded binge eating and vomiting, and momentary anxiety mediated the prospective association between appearance-related stress and ED behaviors. Conclusions Targeted momentary interventions delivered in the natural environment that address appearance-related stress may have utility in the treatment of ED behaviors. PubDate: 2017-06-06 DOI: 10.1007/s40519-017-0404-y
Authors:Najat Yahia; Carrie Brown; Stacey Potter; Hailey Szymanski; Karen Smith; Lindsay Pringle; Christine Herman; Manuela Uribe; Zhuxuan Fu; Mei Chung; Allan Geliebter Abstract: Background Night eating syndrome (NES) is characterized by evening hyperphagia and/or nocturnal ingestion. Objective The main objective of this study was to assess the percentage of students complying with symptoms and behaviors consistent with the diagnostic criteria for NES, and explore its association with body mass index (BMI), dietary habits, physical activity, smoking status, and sleep patterns, among a sample of college students. Methods A cross-sectional survey was conducted among a sample of 413 undergraduate students, mean age of 20.6 ± 1.68 SD, at Central Michigan University. Students completed an online survey including demographic information and the Night Eating Diagnostic Questionnaire (NEDQ) and Pittsburgh Sleep Quality Index Questionnaire (PSQI). Participants were grouped based on self-reporting of the presence and frequency of night eating-related symptoms and behaviors related to the diagnostic criteria for NES as follows: normal, mild night eater, moderate night eater, and full-syndrome night eater. Pearson’s Chi-squared, Student’s t test, and Wilcoxon rank-sum test were used to test the association between students with and without any night eating behavior in relation to BMI, lifestyle variables, and sleep duration/quality. Results Results showed that the proportion of students complying with symptoms and behaviors consistent with full-syndrome of NES was 1.2%. There were no significant differences between students complying with symptoms and behaviors consistent with any level of NES and those without any night eating behavior regarding BMI, eating habits, physical activity, and smoking status. NES was significantly related to sleep duration (P = 0.023). Students complying with symptoms consistent with any level of NES reported shorter sleep time and had higher total PSQI score (6.73 ± 4.06) than students without the syndrome (5.61 ± 2.61) (P = 0.007). Conclusion Although the percentage of students complying with full-syndrome NES was relatively low in our student sample, those students had shorter sleep time and poorer sleep quality than the other groups. However, it is unclear whether evening hyperphagia is a response to a lack of sleep or vice versa, and further research is needed. Level of Evidence Level III, case-control analytic study. PubDate: 2017-06-02 DOI: 10.1007/s40519-017-0403-z
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