Abstract: Treatment dropout is a significant challenge in the treatment of eating disorders. In day hospital/partial hospitalization program settings, little is known about factors associated with treatment dropout. The purpose of the present study was to assess factors associated with treatment dropout in a partial hospitalization program for adolescents and young adults with anorexia nervosa. Patients and parents completed self-report and interview-based measures at baseline and at end of treatment in the partial hospitalization program. Few factors were found that differentiated the two groups. Those who dropped out had lower body weight at end of treatment, were less likely to have purged in the previous month, and had fathers who scored higher on the criticism subscale of expressed emotion. Patients who are purging may be seen as having more severe symptoms, thus possibly reducing the chances of parents prematurely discontinuing treatment. Parental criticism is a potentially modifiable factor in treatment. Further research is needed to identify effective ways to reduce parental criticism, and to identify additional modifiable factors associated with treatment dropout to reduce dropout rates in this population. Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies. PubDate: 2018-07-19
Abstract: Purpose To give an overview of existing studies on the short- and long-term outcome for males treated for anorexia nervosa and to compare the outcome between adolescents and adults as well as between males and females. Methods A systematic literature search was conducted in PubMed, PsycINFO and PSYNDEX and complemented by a manual search of the references from all relevant studies. Results Out of 1064 search results, 18 studies met our inclusion criteria. A combined total of 1129 males of varying age groups were followed 0.5–27 years post-treatment. For 1009 individuals, only vital status was ascertained. Length of follow-up and outcome definitions varied considerably. Limited data—especially in adults—prevented adequate age comparisons. In both adolescents and adults outcome and mortality differed widely across studies with no firm evidence for gender differences. Outcome in mixed samples of adolescents and adults was inconsistent. Studies rarely compared the genders statistically, and when they did, the results were nonsignificant. Conclusions Knowledge on the outcome of males treated for anorexia nervosa is scarce. Only few studies comprising insufficient numbers of males exist. Results based on these findings are inconclusive and in part contradicting. Further research is needed, including large sample sizes of reliably diagnosed males, adequate follow-up intervals, follow-up assessments with carefully defined outcome criteria, and comparisons to matched female patient samples. Level of Evidence Level I, Systematic review. PubDate: 2018-07-19
Authors:Igor da Rosa Finger; Breno Irigoyen de Freitas; Margareth da Silva Oliveira Abstract: Purpose To identify the psychological inflexibility (PI) processes (experiential avoidance, cognitive fusion, poor contact with the present moment, unclear personal values and lack of commitment to action) associated with body mass index (BMI), depression, anxiety and stress symptoms and binge eating in overweight and obese people by drawing on the acceptance and commitment therapy (ACT) framework. Methods A cross-sectional study of 243 people with a BMI of at least 25 and aged from 18 to 60 years old. The following instruments were used: Acceptance and Action Questionnaire II (AAQ-II), Acceptance and Action Questionnaire—Weight (AAQ—W), Valued Living Questionnaire (VLQ), Cognitive Fusion Questionnaire (CFQ-7), Cognitive Fusion Questionnaire-Body Image (CFQ-BI), Mindful Eating Questionnaire (MEQ), Binge Eating Scale (BES) and Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed using one-way ANOVA and t tests. Results There were no differences between BMI categories with respect to PI variables, but PI was positively related to the severity of binge eating and to symptoms of depression, anxiety and stress. Conclusion The development of interventions focused on psychological inflexibility can be useful for the treatment of symptoms associated with overweight and obesity. Level of Evidence Level V, cross-sectional descriptive study. PubDate: 2018-07-17 DOI: 10.1007/s40519-018-0541-y
Authors:Samantha Wilson; Frederick Aardema; Kieron O’Connor Abstract: Cognitive confidence, a type of metacognition referring to confidence in one’s cognitive abilities (e.g., memory, perception, etc.), has been identified as relevant to eating disorders (EDs) using self-report measures. Repeated checking has been found to elicit decreases in perceptual confidence in obsessive compulsive disorder (OCD). The purpose of the present study was to experimentally investigate perceptual confidence, a type of cognitive confidence, in EDs. Specifically, this construct was investigated in the context of body checking, a behaviour with similarities to compulsive checking as observed in OCD. Women with bulimia nervosa (BN; n = 21) and healthy controls (HC; n = 24) participated in the study. There were no group differences with regards to perceptual confidence at baseline F(1, 43) = 0.5, p = 0.48, ηp2 = 0.01, but a significant difference was observed post-checking F(1, 43) = 7.79, p = 0.008, ηp2 = 0.15, which was accounted for by significant decreases in perceptual confidence in the BN group F(1, 43) = 13.31, p < 0.001, ηp2 = 0.24. Similar to compulsive checking in OCD, body checking may paradoxically decrease confidence regarding one’s appearance. Level of Evidence Level I, experimental study. PubDate: 2018-07-17 DOI: 10.1007/s40519-018-0542-x
Authors:Lauren M. Schaefer; Natasha L. Burke; Lisa M. Anderson; J. Kevin Thompson; Leslie J. Heinberg; Anna M. Bardone-Cone; Mary K. Higgins Neyland; David A. Frederick; Drew A. Anderson; Katherine Schaumberg; Amanda Nerini; Cristina Stefanile; Helga Dittmar; Kelly L. Klump; Allison C. Vercellone; Susan J. Paxton Abstract: Researchers have observed variation in levels of body image disturbance and eating pathology among women from different Western countries. Examination of cross-cultural differences in the established risk factors (i.e., thin-ideal internalization, muscular-ideal internalization, and appearance pressures from family, peers, and media) for negative outcomes may help to elucidate the prominence of specific risk factors within a given Western society and guide associated interventions. Women from the United States (US), Italy, England, and Australia completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4). Analysis of covariance controlling for age and BMI indicated significant cross-country differences for all SATAQ-4 subscales. Results typically indicated higher levels of appearance-ideal internalization and appearance pressures in the US and lower levels in Italy; however, associated effect sizes were generally small. A medium effect of country was observed for peer-appearance pressures, which were highest in the US compared with all other countries. Repeated-measures analysis of variance and paired samples t tests conducted within each country identified thin-ideal internalization and media appearance pressures as the predominant risk factors for all four countries. Overall, findings suggest more cross-country similarities than differences, and highlight the importance of delivering interventions to address thin-ideal internalization and media appearance pressures among women from Western backgrounds. Level of evidence Descriptive study, Level V. PubDate: 2018-07-17 DOI: 10.1007/s40519-018-0544-8
Authors:Silvia Cerolini; Rachel F. Rodgers; Caterina Lombardo Abstract: Sleep deprivation consistently increases food intake. This study aimed to evaluate the effect of partial sleep deprivation on food intake in individuals reporting binge eating, controlling for self-reported depressive emotional eating. Fourteen young adults reporting binge eating symptoms and 14 controls denying any eating disorders symptoms were offered a large and varied breakfast after a night of habitual sleep (HN) and after a night of partial sleep deprivation (DN). Food intake was unobtrusively measured while daily food intake was measured via a food diary. Results revealed only a significant effect of the Night on fibre consumed at breakfast and on the amount of daily snacks: both groups consumed less fibre and more snacks after DN compared to after HN. However, when controlling for depressive emotional eating, results showed that individuals reporting low depressive emotional eating ate less after DN than after HN at breakfast, but then they ate more throughout the day. Partial sleep deprivation may decrease fibre consumption and increase daily snacks regardless of binge eating symptoms, while daily food intake may increase only in individuals who do not report emotional eating. Level of evidence Experimental study, Level 1. PubDate: 2018-07-17 DOI: 10.1007/s40519-018-0547-5
Authors:Lara Palmeira; Marina Cunha; José Pinto-Gouveia Abstract: Weight stigma plays a damaging role in the life of the individuals with overweight and obesity who may internalise the widespread stigmatisation messages. Weight self-stigma is defined as personal experiences of shame, negative self-evaluations as well as perceived discrimination. It has been found to be related to experiential avoidance patterns and poorer outcomes. The current study aims to conduct a confirmatory factor analysis (CFA) on the Weight Self-Stigma Questionnaire (WSSQ) and explore its psychometric properties. Furthermore, the mediator role of weight-related experiential avoidance on the relationship between weight self-stigma and unhealthy eating behaviour was analysed. Concerning the CFA, the sample comprised 331 women with overweight and obesity seeking nutritional treatment. A second independent sample of 58 overweight and obese women was used to assess WSSQ’s temporal validity and internal responsiveness. Results supported the WSSQ two-factor structure and good psychometric properties and responsiveness to change. Also, evidence was found for the mediator role of weight-related experiential avoidance on the relationship between BMI, weight self-stigma and unhealthy eating patterns in women with overweight and obesity. Overall, the current study showed that WSSQ is a reliable measure and highlights the important role of weight self-stigma and weight-related experiential avoidance in women with overweight and obesity. Level of evidence: Level V, descriptive studies. PubDate: 2018-07-17 DOI: 10.1007/s40519-018-0540-z
Authors:Yafit Kessler; Liraz Olmer; Asnat Raziel; David Goitein; Rachel Dankner Abstract: Purpose To examine associations of patients’ attendance to follow-up meetings with a registered dietitian (RD) and physical exercise practices with weight loss during the 1 year following laparoscopic sleeve gastrectomy (SG). Methods Of 241 patients with obesity who underwent SG during 2012, 184 (76.3%) participated in a 1-year follow-up telephone interview and had information on number of RD follow-up meetings. Clinical information was available from computerized patient files. Multiple logistic regression analysis, adjusting for propensity score, was computed to reveal factors associated with greater weight loss. Results The mean %TWL was 31.4 ± 6.1 and the mean number of reported RD meetings during the year following SG was 4.6. The proportion of physically active patients increased by 15% (from 23 to 42) among those who attended at least 3 RD follow-up meetings (n = 123), and by 5% (from 18 to 23) among those who attended fewer than 3 meetings (n = 61) (p = 0.05). Patients conducting physical exercise reported a lower level of pain/discomfort on the EQ5D quality-of-life questionnaire (p = 0.03). The adjusted regression model revealed no association between the number of RD follow-up meetings and weight-reduction success, but physical exercise during the year following SG conferred a 2.6 times greater odds of belonging to the upper two tertiles of the % excess body weight loss ( 95% CI 1.2–5.3). Conclusions Patients with better adherence to RD follow-up meetings were also more physically active. Patients on physical exercise also achieved greater weight reduction following SG, and reported less pain or discomfort. Nutritional counselling and physical exercise are necessary to ensure maximal and sustainable benefits from SG. Level of Evidence Level III, Cohort study. PubDate: 2018-07-10 DOI: 10.1007/s40519-018-0531-0
Authors:Luisella Vigna; Amelia Brunani; Agostino Brugnera; Enzo Grossi; Angelo Compare; Amedea S. Tirelli; Diana M. Conti; Gianna M. Agnelli; Lars L. Andersen; Massimo Buscema; Luciano Riboldi Abstract: Objective The metabolic syndrome (MS) is a multifactorial disorder associated with a higher risk of developing cardiovascular diseases and type 2 diabetes. However, its pathophysiology and risk factors are still poorly understood. In this study, we investigated the associations among gender, psychosocial variables, job-related stress and the presence of MS in a cohort of obese Caucasian workers. Methods A total of 210 outpatients (142 women, 68 men) from an occupational medicine service was enrolled in the study. Age, BMI, waist circumference, fasting glucose, blood pressure, triglycerides and HDL cholesterol were collected to define MS. In addition, we evaluated eating behaviors, depressive symptoms, and work-related stress. Data analyses were performed with an artificial neural network algorithm called Auto Semantic Connectivity Map (AutoCM), using all available variables. Results MS was diagnosed in 54.4 and 33.1% of the men and women, respectively. AutoCM evidenced gender-specific clusters associated with the presence or absence of MS. Men with a moderate occupational physical activity, obesity, older age and higher levels of decision-making freedom at work were more likely to have a diagnosis of MS than women. Women with lower levels of decision-making freedom, and higher levels of psychological demands and social support at work had a lower incidence of MS but showed higher levels of binge eating and depressive symptomatology. Conclusion We found a complex gender-related association between MS, psychosocial risk factors and occupational determinants. The use of these information in surveillance workplace programs might prevent the onset of MS and decrease the chance of negative long-term outcomes. Level of evidence Level V, observational study. PubDate: 2018-07-10 DOI: 10.1007/s40519-018-0536-8
Authors:Isabelle Mack; Helene Sauer; Katja Weimer; Dirk Dammann; Stephan Zipfel; Paul Enck; Martin Teufel Abstract: Purpose Portion size influences energy intake and is an important factor when developing weight management strategies. The effect of tableware on food intake is less clear, especially in children. To date, the relationship between the body weight of individuals and the tableware used in their households has not been investigated. The aim of this study was to analyze the sizes of tableware in households of children and adolescents with obesity (OBE) in comparison to participants with normal-weight matched for age and gender (NW). Methods 60 OBE (32 female, 26 male) and 27 NW (12 female, 15 male) aged between 9 and 17 years participated in a structured interview on the tableware used at home. Responses were standardized based on the selection of different sizes of tableware and everyday objects presented to the children. Results In households of NW, larger plates and bowls were used during meals and desserts compared to OBE. OBE drank out of larger bottles. Shapes and sizes of drinkware, the number of children drinking out of bottles and the cutlery used during dessert did not differ between the groups. Conclusions Drinking out of large bottles may be an unfavourable habit of OBE if they contain sugar-rich liquids. The use of smaller plates and bowls of OBE may result in multiple helpings being consumed and so contribute to an overall increased portion size. Level of evidence Level V, Descriptive study. PubDate: 2018-07-06 DOI: 10.1007/s40519-018-0537-7
Authors:Nazli Namazi; Shirin Djalalinia; Armita Mahdavi-Gorabi; Hamid Asayesh; Morteza Mansourian; Mehdi Noroozi; Mostafa Qorbani Abstract: Background and aims The association of Wrist Circumference (WrC) with cardio-metabolic risk factors is still contradictory. We aimed to systematically review the association of WrC with cardio-metabolic diseases among the general populations. Methods We systematically searched electronic databases such as PubMed/Medline, Web of Sciences, and Scopus without language restriction until March 2017. Observational studies that examined the association of WrC with any cardio-metabolic risk factors were included. Pooled association of WrC with metabolic syndrome (MetS) was estimated using a random-effect model, and heterogeneity among studies was assessed by I2 index and Q test. Results A total of 14 papers including cohort study (n = 9), cross-sectional study (n = 4), and case–control study (n = 1) met the criteria and included. The eligible papers have been examined the association of WrC with any cardiovascular disorders (n = 8), metabolic syndrome (n = 4), insulin resistance (IR) (n = 5), diabetes mellitus (n = 2), impaired glucose tolerance (n = 1), cardio-metabolic risk factors (n = 2) and obesity/overweight (n = 1). In the whole population (both adults and pediatric population), high WrC increased the risk of MetS by 33% (Pooled OR = 1.33; 95% CI 1.20, 1.48; I2 = 60.2%, p = 0.04), while the pooled OR in adult populations was 1.27 (95% CI 1.15–1.41; I2: 32.8%, p = 0.21). Qualitative synthesis showed that associations of WrC with other cardio-metabolic risk factors are conflicting. Conclusion High WrC increased the risk of MetS and other cardio-metabolic risk factors. However, due to limited studies, particularly in children, results should be declared with great caution. Further cohort studies are needed to clarify whether WrC is a suitable anthropometric index to predict cardio-metabolic disorders in adult and children populations in different societies. Level of evidence Level 1, systematic review and meta-analysis PubDate: 2018-07-03 DOI: 10.1007/s40519-018-0534-x
Authors:Rebecca Reynolds Abstract: Purpose To survey Australian adults at a Sydney university about: their tendencies towards the proposed health food eating disorder, orthorexia nervosa (and to estimate the prevalence of this condition), their eating behaviours, and their body image. Methods A pilot, cross-sectional and descriptive online survey was conducted on staff and students at the University of New South Wales, Sydney. The primary outcome was the score on the most commonly used and validated measure of orthorexic behaviours, the ORTO-15. The point prevalence of orthorexia nervosa was estimated using the ORTO-15 cut-off score of < 35. Other outcomes were the Eating Attitudes Test-26 and the Body Shape Questionnaire-34. Results In the sample of 92 Australian adults recruited at a university, there was a point prevalence rate for orthorexia nervosa of 21% when using the ORTO-15 cut-off value of < 35. If criteria A and B of proposed diagnostic criteria for the condition were also taken into consideration (i.e. someone with orthorexia nervosa would display disordered healthy eating tendencies; as well as were: underweight, or had marked concern with their body shape, or had significant impairment of functioning in work life or social life), the true prevalence rate could be considered to be 6.5%. Conclusions Using the ORTO-15 tool alone may overestimate the true prevalence of orthorexia nervosa. Further research into the accurate diagnosis and treatment of orthorexia nervosa is needed. Level of evidence Level V, descriptive study. PubDate: 2018-06-28 DOI: 10.1007/s40519-018-0535-9
Authors:Carlo Manno; Nicla Campobasso; Adele Nardecchia; Vincenzo Triggiani; Roberta Zupo; Loreto Gesualdo; Franco Silvestris; Giovanni De Pergola Abstract: Background The accumulation of visceral body fat, has been shown to be associated with higher risk of metabolic and cardiovascular disease. This study was addressed to examine whether para- and perirenal fat thickness and epicardial fat thickness were correlated with anthropometric- and cardiometabolic risk factors. Methods A cohort of 102 uncomplicated overweight and obese patients was examined. BMI, waist circumference, blood pressure, fasting insulin, glucose, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol serum levels, and insulin resistance (assessed by HOMAIR) were measured. Para- and perirenal fat thickness (PUFT) and epicardial fat thickness (EUFT) were measured by ultrasounds. Results PUFT was positively correlated with BMI (p < 0.001), waist circumference (p < 0.001), insulin (p < 0.001), HOMAIR (p < 0.001), triglycerides (p < 0.05), systolic (p < 0.05) and diastolic (p < 0.05) blood pressure, and negatively correlated with HDL-cholesterol (p < 0.01). EUFT was positively associated with age (p < 0.01), BMI (p < 0.001), waist circumference (p < 0.001), systolic (p < 0.01) and diastolic (p < 0.001) blood pressure, and LDL-cholesterol (p < 0.05). A multivariate analysis by multiple linear regression was performed, and the final model showed a direct association of waist circumference with both PUFT and EUFT, a correlation of PUFT with HOMAIR (positive) and HDL-cholesterol (negative), and a direct association of EUFT (both long axis and short axis) with LDL-cholesterol. All these correlations were independent of other anthropometric, metabolic and hemodynamic parameters. Conclusions This study shows that accumulation of central fat in apparently healthy overweight and obese subjects is associated to a simultaneous increase of pararenal, perirenal and epicardial fat. Moreover, it shows that only para- and perirenal fat is independently associated to insulin resistance and lower HDL-cholesterol, and only epicardial fat is independently associated to higher LDL cholesterol. Level of evidence Level V, cross-sectional descriptive study. PubDate: 2018-06-28 DOI: 10.1007/s40519-018-0532-z
Authors:Christopher Rodrigue; Anne-Sophie Ouellette; Simone Lemieux; André Tchernof; Laurent Biertho; Catherine Bégin Abstract: Food addiction (FA) has recently emerged as a new field in the study of obesity. Previous studies have contributed to identifying psychological correlates of FA. However, few researchers have examined the cognitive profile related to this condition; up until now, attentional biases related to food cues and a poorer performance monitoring have been observed. The present study aimed to examine the psychological profile and executive functioning related to FA in individuals with severe obesity and awaiting bariatric surgery. Participants (N = 86) were split into two groups, according to their level of FA symptoms (low FA vs high FA). Groups were compared on questionnaires measuring binge eating, depression and anxiety symptoms, and impulsivity as well as on measures reflecting executive functioning (D-KEFS and BRIEF-A). The relationship between FA groups and patterns of errors during the D-KEFS’ Color-Word Interference Test was further analyzed. Individuals within the high FA group reported significantly more binge eating, depressive and anxiety symptoms, and more metacognitive difficulties. They also tended to show a poorer inhibition/cognitive flexibility score and a typical pattern of errors, characterized by an increased number of errors as the tasks’ difficulty rose as opposed to a decreased number of errors, which characterizes an atypical pattern of errors. The present results show that the inability to learn from errors or past experiences is related to the severity of FA and overall impairments. Level of evidence Level V, descriptive study. PubDate: 2018-06-26 DOI: 10.1007/s40519-018-0530-1
Authors:Iris Lee; Laura G. Cooney; Shailly Saini; Mary D. Sammel; Kelly C. Allison; Anuja Dokras Abstract: Purpose We aimed to identify the risk of eating disorders (ED) in women with polycystic ovary syndrome (PCOS) compared to controls. Methods We performed a systematic review and meta-analysis of studies that included women with well-defined PCOS and controls and used validated ED screening/diagnostic tools to measure mean ED score, prevalence of abnormal ED scores, and/or prevalence of specific ED diagnoses such as bulimia nervosa and binge eating disorder. Results Eight studies, including 470 women with PCOS and 390 controls, met inclusion criteria for the systematic review. Meta-analysis of seven of those studies found that the odds of an abnormal ED score (OR 3.05; 95% CI 1.33, 6.99; four studies) and the odds of any ED diagnosis (OR 3.87; 95% CI 1.43, 10.49; four studies) were higher in women with PCOS compared to controls. Conclusions Our study suggests that women with PCOS are at increased odds of having abnormal ED scores and specific ED diagnoses. Given the potential implications of an ED on weight management strategies, our findings support routine screening for ED in this population. Level of evidence Level I, systematic review and meta-analysis. PubDate: 2018-06-26 DOI: 10.1007/s40519-018-0533-y
Authors:Marjan Mansourian; Akram Yazdani; Elham Faghihimani; Ashraf Aminorraya; Masoud Amini; Tohid Jafari-Koshki Abstract: Aims Pre-diabetes is a strong risk factor for type 2diabetes (T2D). The aim of this study was to explore factors associated with normal glucose maintenance and pre-diabetes prevention or delay. Methods Data of 1016 first-degree relatives of T2D patients were retrieved from the Isfahan Diabetes Prevention Study (IDPS). Association of various variables including nutrients, serum tests and physical activity with the risk of pre-diabetes was assessed using recurrent events approach. Results Cumulative incidence of diabetes was 8.17, 9.44, and 4.91% for total sample and individuals with and without pre-diabetes experience in the follow-up. Risk of progression to pre-diabetes was higher in women and older people (p < 0.01). Additionally, BMI and blood pressure had significant association with the risk (p < 0.01) and individuals with higher intake of fat were at higher risk (HR = 2.26; 95% CI 1.66–3.07 for high-intake and HR = 1.52; 95% CI 1.27–1.83 for medium-intake compared to low-intake group). Carbohydrates and protein intake were positively associated with the risk of pre-diabetes with HR = 8.63 per 49 g extra carbohydrates per day and HR = 1.32 per 6 g extra protein per day (p < 0.01). The association was also significant for triglyceride (TG) with 7% risk increase per 1 SD = 1.14 increase in TG level. Conclusion Despite frequent studies on lifestyle modification for pre-diabetes prevention, less information is available about the role of nutritional components. We observed direct effects for intake of macronutrients including fat, carbohydrates, and protein in first-degree relatives. Further research is warranted to assess these associations in general populations. Level of evidence Level III: Evidence obtained from a single-center cohort study. PubDate: 2018-06-22 DOI: 10.1007/s40519-018-0529-7
Authors:Márton Kiss-Leizer; Adrien Rigó Abstract: Purpose Our aim was to measure the personality profile of people with high orthorexic tendency using an assessment method which is acknowledged in the research of the classical eating disorders (anorexia nervosa, bulimia nervosa) and obsessive–compulsive disorder (OCD). Methods In our research, 739 participants completed a self-administered, online questionnaire consisting of two measures: Temperament and Character Inventory-56 (TCI-56) and Ortho-11-Hu. Results The orthorexia nervosa (ON) grouping variable has a significant effect on three factors of TCI: MANOVA revealed higher harm avoidance (F (2, 736) = 19.01, p < 0.001, η2 = 0.05), lower self-directedness (F (2, 736) = 22.55, p < 0.001, η2 = 0.06), and higher transcendence (F (2, 736) = 3.05, p = 0.048, η2 = 0.01) in the higher ON group, compared to the lower ON group, regardless of the effect of the risk groups. Conclusions According to earlier studies, high harm avoidance and low self-directedness are relevant factors of anorexia nervosa, bulimia nervosa, and OCD, but now it also seems to be an important parameter of orthorexia. Nevertheless, higher transcendence may be a unique feature, which suggests that orthorexia seems to be an independent phenomenon. Level of evidence V, descriptive cross-sectional study. PubDate: 2018-06-22 DOI: 10.1007/s40519-018-0527-9
Authors:Simona Calugi; Giulio Marchesini; Marwan El Ghoch; Ilaria Gavasso; Riccardo Dalle Grave Abstract: Objective The aim of this study was to assess the association between weight-loss maintenance and weight-loss satisfaction, adherence to diet and weight loss, all measured session-by-session during the weight-loss phase of cognitive behavioral therapy. Methods The present exploratory study examined a subgroup of fifty-eight patients who participated in a randomized controlled trial and who lost at least the 10% of their baseline weight. Patients were grouped into weight-loss ‘Maintainers’ (i.e., those who maintained a weight loss of ≥ 10% of baseline body weight at 6 months after the weight-loss phase) and ‘Regainers’ (i.e., those who did not maintain > 10% weight loss at 6 months after the weight-loss phase). Body weight, adherence to diet and weight-loss satisfaction were measured session-by-session during the weight-loss phase. Results Thirteen patients (22.4%) were classified as ‘Regainers’, and 45 (77.6%) as ‘Maintainers’. Compared to ‘Maintainers’, ‘Regainers’ had a lower adherence to diet after the initial 11 weeks, and a progressively declining weight loss and weight-loss satisfaction from week 15 or 19 of the weight-loss phase. 11-week dietary adherence and 15-week weight loss were significantly associated with weight maintenance. Similar results were obtained using the amount of weight change as dependent variable. Conclusions Adherence to diet, weight loss and weight-loss satisfaction, measured during the late weight-loss phase, are associated with weight-loss maintenance. Level of evidence Level III, evidence obtained from well-designed cohort or case–control analytical studies. PubDate: 2018-06-21 DOI: 10.1007/s40519-018-0528-8
Authors:Daniel Frings; Guleser Eskisan; Gabriele Caselli; Ian P. Albery; Antony C. Moss; Marcantonio M. Spada Abstract: Purpose Food craving has been shown to induce states of psychological challenge, indexed by increases in adrenaline but not cortisol production. The study aimed to test the relationship between challenge and (1) desire thinking (the active processing of the pleasant consequences of achieving a desired target and planning how to do so) and (2) craving. Methods Participants (N = 61) self-reported their levels of craving and desire thinking. They were then presented with situations in which their craving would be fulfilled or not via a false feedback practice task (a wordsearch task). During this period psycho-physiological measures of challenge and threat were taken. Results Higher levels of craving were linked to challenge only when the craved object was likely to be obtained. Whilst anticipating reward fulfillment, higher levels of craving were linked to higher levels of desire thinking. In turn, higher levels of desire thinking were related to lower levels of challenge. In contrast, during the processes of reward fulfillment, desire thinking was linked to increased challenge (i.e., a positive indirect effect). Conclusions Craving is linked to increased levels of psychological challenge when the object of the craving can be obtained, but it is unrelated to craving when it is not. The research also highlights the importance of desire thinking as an important, but complex, mediator in the relationship between craving and motivational states: desire thinking inhibited challenge when anticipating craving fulfillment, but encouraging it during the process of fulfillment itself. Level of evidence I: Evidence obtained from at least one properly designed randomized controlled trial. PubDate: 2018-06-21 DOI: 10.1007/s40519-018-0525-y
Authors:Lorena Gasparini Caran; Danilo Dias Santana; Luana Silva Monteiro; Gloria Valeria da Veiga Abstract: Purpose To estimate the prevalence of disordered eating behaviors and the association with energy and nutrient intake and nutritional status in adolescents. Methods A school-based cross-sectional study was performed involving a probabilistic sample of 487 teenagers (aged 15–19 years) from public schools in the Metropolitan area of Rio de Janeiro, Brazil. The Eating Attitude Test and the Bulimic Investigatory Test Edinburgh questionnaires were applied to identify abnormal eating patterns and unusual dietary patterns, respectively. Nutritional status was defined by sex- and age-specific body mass index cutoffs. Energy and nutrient intake were assessed by a 3-day food record. The association between variables was assessed by the prevalence ratio and 95% confidence intervals, Pearson’s Chi-square test, and linear regression. Results The prevalence of abnormal eating patterns was 7.4% and that of unusual dietary patterns was 18.9%. Vitamin C intake was higher among girls with abnormal dietary patterns, with a consequent lower frequency of vitamin C deficiency when compared to those with normal dietary patterns. Calcium intake was lower in boys with unusual dietary pattern than in those without this behavior. Excess weight was associated with the presence of unusual dietary pattern in girls (PR: 2.4, 95% CI 1.6–3.5). Conclusions The prevalence of disordered eating behaviors was high, mainly in those who were overweight. It was associated with lower calcium intake in boys and with higher Vitamin C intake in girls. Level of evidence Level V, descriptive studies. PubDate: 2018-06-12 DOI: 10.1007/s40519-018-0519-9
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