Search

The Body Project (BP) intervention for body image issues is supported by extensive efficacy and effectiveness research, most of which has been conducted in the United States. The BP uses cognitive dissonance to help participants critique the ideal appearance through written, verbal, and behavioral exercises. This reduces the internalization of the appearance ideal, which in turn decreases body dissatisfaction symptoms and, in some individuals, the onset of eating disorders. To broadly implement this program in Mexico and Latin America, Comenzar de Nuevo (CdN), a non-profit organization for eating disorder treatment, partnered with the Body Project Collaborative in 2014. Together, they created a training and implementation infrastructure. This paper explores the adaptation of BP and its implementation in Mexico and Latin America. We used sustainable business, marketing, and educational models to fulfill CdN's mission to reduce eating disorder risk factors, including weight stigma, in the Latin American region. By integrating strategies to combat weight stigma within our program delivery, we strive to contribute to a more inclusive and supportive environment. We trained master trainers, regular trainers, and/or group facilitators from Argentina, Bolivia, Colombia, Costa Rica, Chile, Dominican Republic, El Salvador, Guatemala, Mexico, Panama, and Spain; and implemented the BP in 15 public schools supported by sponsorship programs. This paper provides crucial lessons learned, future directions, and implications for dissemination and implementation efforts in this region of the world. [ABSTRACT FROM AUTHOR]

Eating disorder (ED) risk is elevated among college populations in the United States. However, current research assessing the relative risk of ED symptomatology within Greek life has been mixed. We aimed to assess whether Greek Life Affiliation (GA) was associated with a greater risk for ED among college students in the United States as measured on the SCOFF questionnaire. Data were extracted from the Healthy Minds Study, which surveyed 44,785 American college students across 79 schools. The survey asked about GA, Greek life housing, and included the SCOFF questionnaire. This study utilized multiple logistic regressions and chi-square analyses (n = 44785) to analyze the data. GA failed to predict ED-risk in both women (aOR = 0.98 [95% CI = 0.90, 1.06]) and men (aOR = 1.07 [95% CI = 0.92, 1.24]). Similarly, among female [aOR = 1.00 [95% CI = 0.46, 2.12]) and male participants (aOR = 1.06 [95% CI = 0.59, 1.98]), sorority/fraternity housing also failed to predict ED-risk. Greek Life Affiliation is not associated with greater ED-risk among US college students. [ABSTRACT FROM AUTHOR]

Objective: The Eating Disorder Examination‐Questionnaire (EDE‐Q) is one of the most widely used self‐report assessments of eating disorder symptoms. However, evidence indicates potential problems with its original factor structure and associated psychometric properties in a variety of populations, including gender minority populations. The aim of the current investigation was to explore several previously published EDE‐Q factor structures and to examine internal consistency and measurement invariance of the best‐fitting EDE‐Q model in a large community sample of gender minority adults. Methods: Data were drawn from 1567 adults (337 transgender men, 180 transgender women, and 1050 gender‐expansive individuals) who participated in The PRIDE Study, a large‐scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE‐Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi‐group CFA) were subsequently evaluated. Results: A brief seven‐item, three‐factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE‐Q consistently evidenced the best fit across gender minority groups (transgender men, transgender women, gender‐expansive individuals). The internal consistencies of the three subscales were adequate in all groups, and measurement invariance across the groups was supported. Discussion: Taken together, these findings support the use of the seven‐item, three‐factor version of the EDE‐Q for assessing eating disorder symptomatology in gender minority populations. Future studies can confirm the current findings in focused examinations of the seven‐item, three‐factor EDE‐Q in diverse gender minority samples across race, ethnicity, socioeconomic status, and age ranges. Public Significance Statement: Although transgender individuals have greater risk of developing an eating disorder, the factor structure of the Eating Disorder Examination‐Questionnaire, one of the most widely used eating disorder assessment measures, has not been explored in transgender adults. We found that a seven‐item model including three factors of dietary restraint, shape and weight overvaluation, and body dissatisfaction had the best fit among transgender and nonbinary adults. Key PointsWe assessed the Eating Disorder Examination‐Questionnaire in transgender men, transgender women, and gender‐expansive people.Confirmatory factor analysis of a seven‐item model had the best fit among gender minority people.The three factors included dietary restraint, shape and weight overvaluation, and body dissatisfaction.Internal consistencies of the three subscales and measurement invariance were adequate in all groups. [ABSTRACT FROM AUTHOR]

Objective: Research on muscularity‐oriented disordered eating has grown in recent years. However, the bulk of this research has focused on men and Western populations. Limited research is available in non‐Western populations of women (e.g., China) which is likely due to the lack of valid instruments in these populations. Thus, the current study aimed to describe the validity and reliability of the Muscularity‐Oriented Eating Test (MOET) in Chinese women. Method: Two online surveys (survey one: n = 599, Mage = 29.49, SD = 7.36; survey two: n = 201, Mage = 28.42, SD = 7.76) were conducted to explore the psychometric properties of the MOET in Chinese women. In survey one, the factor structure of the MOET was examined via exploratory and confirmatory factor analyses (EFA and CFA). Internal consistency reliability and convergent and incremental validity of the MOET were also assessed. In survey two, test–retest reliability across a 2‐week interval was examined. Results: EFA and CFA provided support for the unidimensional factor structure of the MOET in Chinese adult women. The MOET presented good internal consistency and test–retest reliability and convergent validity via large, positive associations with theoretically related constructs (e.g., thinness‐oriented disordered eating, drive for muscularity, and psychosocial impairment). Finally, muscularity‐oriented disordered eating described unique variance in psychosocial impairment, providing support for the incremental validity of the MOET. Discussion: The sound psychometric structure of the MOET was supported in Chinese women. Continued research is needed to describe muscularity‐oriented disordered eating in Chinese women to contribute to this significant gap in the literature. Public Significance: The Muscularity‐Oriented Eating Test (MOET) is a measure specifically developed for assessing muscularity‐oriented disordered eating. This study examined the validity and reliability of the MOET in Chinese women. The results showed that the MOET had sound validity and reliability in Chinese women. Thus, the MOET is a valuable tool for advancing the understanding of the muscularity‐oriented disordered eating of women from the Chinese context. [ABSTRACT FROM AUTHOR]

Objective: The Eating Disorder‐15 (ED‐15) is a brief measure developed for the routine assessment of eating disorder (EDs), despite its use in research settings having increased over the last few years. To assess the psychometric properties of the ED‐15 in a nonclinical sample of Chilean women. Method: A multicultural Spanish‐language version was developed through combined translation techniques. University female students (N = 380) (Mage 22.32, SD = 2.48) were recruited through social media. After providing their informed consent, participants completed a battery of questionnaires online. Results: A bi‐factor model replicating the bi‐factor structure and providing support for the general factor showed the best fit to the data. Moderate‐to‐strong correlations with measures of EDs, physical comparison, body appreciation, social physique anxiety, and depressive symptoms are presented as evidence of concurrent and convergent validity. Items analyses revealed strong correlations between manifest variables, their correspondent latent variable and the general factor (rs =.60 to.89, ps <.001). Additionally, current findings provide support for the internal consistency of the scale (Cronbach's alpha and Omega values were ≥.80) and test–retest reliability (ICCs =.84 to.89, ps <.001). Discussion: Like previous findings, the current study provides validity to the original bi‐factor structure of the ED‐15 and additional validity to a general factor. The availability of this multicultural Spanish‐language version would provide session‐by‐session assessment, providing crucial information throughout treatment. Also, the availability of the current measure would contribute to further research efforts in a yet understudied population such as Hispanic women. Public Significance: The Eating Disorder‐15 (ED‐15) is a promising measure meant to assess session‐by‐session change for clinical and research purposes. The availability of a Multicultural Spanish language version of the ED‐15 allows for routine clinical assessment and represents a contribution for research efforts in a yet understudied populations such as Hispanic women. [ABSTRACT FROM AUTHOR]

Objective: The Muscularity‐Oriented Eating Test (MOET) is a 15‐item unidimensional scale, designed to assess eating practices that occur in the pursuit of a muscular body. The aim of the present study was to describe the translation and cultural adaptation of the MOET to Brazilian Portuguese, to explore its factor structure and measurement invariance, and to evaluate its internal consistency, three‐week test–retest reliability, and convergent validity in a community sample of Brazilian men and women. Method: After the back‐translation procedure, the Brazilian MOET was administered online to a sample of 1246 adults (634 men and 612 women), along with measures of drive for muscularity, muscle dysmorphia symptoms, muscular/athletic‐ideal internalization, disordered eating behaviors, and exercise dependence. Results: Findings from an exploratory factor analysis and a confirmatory factor analysis revealed a one‐factor structure and adequate internal consistency for men (ω = 0.86; α = 0.86) and women (ω =.84; α =.83). Measurement invariance across gender was supported. In addition, the scale demonstrated good three week test–retest reliability for both men (ICC =.96; p <.001) and women (ICC =.92; p <.001), and the subscales revealed moderate to large associations with drive for muscularity, muscle dysmorphia symptoms, muscular/athletic‐ideal internalization, disordered eating, and exercise dependence. Conclusion: This study supports the validity and reliability of the MOET in a community sample of Brazilian men and women and represents an advance in measures of muscularity‐oriented disordered eating in Brazilian adults, allowing for future cross‐cultural studies in this field. Public Significance: The Muscularity‐Oriented Eating Test (MOET) is a measure of muscularity‐oriented disordered eating, which assess strict adherence to diet rules, including the food's macronutrient content, regulation of protein intake, and eating less or more to influence muscle gain. This study evaluated the validity and reliability of the MOET in a community sample of Brazilian men and women. Our findings represent an advance in measures of muscularity‐oriented disordered eating in Brazilian adults. [ABSTRACT FROM AUTHOR]

Objective: Appearance and performance‐enhancing drugs and supplements (APEDS) can be used to enhance muscle growth, athletic performance, and physical appearance. The aim of this study was to examine the lifetime use of APEDS and associations with eating disorder and muscle dysmorphia symptoms among gender minority people. Method: Participants were 1653 gender minority individuals (1120 gender‐expansive [defined as a broad range of gender identities that are generally situated outside of the woman–man gender binary, e.g., genderqueer, nonbinary] people, 352 transgender men, and 181 transgender women) recruited from The Population Research in Identity and Disparities for Equality Study in 2018. Regression analyses stratified by gender identity examined associations of any APEDS use with eating disorder and muscle dysmorphia symptom scores. Results: Lifetime APEDS use was common across groups (30.7% of gender‐expansive people, 45.2% of transgender men, and 14.9% of transgender women). Protein supplements and creatine supplements were the most commonly used APEDS. Among gender‐expansive people and transgender men, lifetime use of any APEDS was significantly associated with higher eating disorder scores, dietary restraint, binge eating, compelled/driven exercise, and muscle dysmorphia symptoms. Any APEDS use was additionally associated with laxative use among gender‐expansive people. Among transgender women, use of any APEDS was not significantly associated with eating disorder or muscle dysmorphia symptoms. Discussion: APEDS use is common and associated with eating disorder and muscle dysmorphia symptoms in gender‐expansive people and transgender men, thus highlighting the importance of assessing for these behaviors and symptoms among these populations, particularly in clinical settings. Public Significance: This study aimed to examine APEDS use among gender minority people. We found that 30.7% of gender‐expansive (e.g., nonbinary) people, 45.2% of transgender men, and 14.9% of transgender women reported lifetime APEDS use, which was associated with eating disorder and muscle dysmorphia symptoms in transgender men and gender‐expansive people. Clinicians should assess for these behaviors in gender minority populations. [ABSTRACT FROM AUTHOR]

The present study was aim to evaluate the acceptability and preliminary effectiveness of a mobile-health application, CALMA, based on dialectical behavioral therapy skills. CALMA was proposed as an adjunct to therapy for the reduction of non-suicidal and suicidal self-injury behaviors. A parallel design was used to compare the intervention group (DBT + CALMA) and the comparison group (DBT). Patients were randomized based on their groups following a randomized cluster design. After treatment, patients completed a follow-up assessment four weeks later. Each cluster was represented by a different DBT Skills Training Group offered weekly at FORO Foundation for Mental Health. Six DBT Skills Training groups were randomized to the intervention or comparison group. Twenty-one individuals met inclusion criteria and eighteen were included in the analysis. Acceptability was measured with the User Experience Questionnaire short version (UEQ-s) and preliminary efficacy with the Self-injurious thoughts and behaviors interview (SITBI). CALMA shows good acceptability to be used as an adjunct to therapy specific to the reduction of suicidal and non-suicidal self-directed violence. Evidence for preliminary efficacy included a high probability of decreased in more behaviors evaluated with the SITBI pre- and post-intervention for the group that received CALMA as compared to the comparison group. Our study provides initial evidence for the effectiveness and acceptability of CALMA. Future studies scaling up this intervention in a larger number of participants are necessary. CALMA may be especially useful in low and middle-income Latin American countries to improve access to evidence-based interventions openly available in Spanish and free to download. CALMA is a DBT-based app aimed to reduce non-suicidal and suicidal self-directed violence. The app showed good acceptability by users A high probability of decrease in suicidal ideation, suicidal plan, suicidal gesture, thoughts about NSSI and NSSI pre- and post-intervention was observed [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the psychometric properties of the Eating Disorder Inventory (EDI)-3 test to evaluate eating disorders in young Chilean population. Methods: The sample consisted of 1,091 Chilean adolescents and young people (i.e., 476 men and 615 women) between 15 and 28 years old, from the metropolitan region, and four regions from the coast and south-central zone of the country. The reliability and factorial structure of the instrument were analyzed, replicating the confirmatory factor analyses of Brookings et al. (2020), evaluating four additional models that included bifactor exploratory structural equation modeling (ESEM), bifactor, and two-bifactor. Results: A majority of the subscales presented alphas and omegas equal to or greater than 0.70, with the exception of asceticism (α = 0.543, ω = 0.552) and interpersonal alienation (α = 0.684, ω = 0.695) scales, which are consistent with the values of the Spanish and Mexican non-clinical samples. The best fit indices were obtained by the ESEM two-bifactor model, with twelve specific factors corresponding to the EDI-3 subscales and two general orthogonal factors (i.e., risk subscales and psychological subscales), consistently with the theoretical basis. [ABSTRACT FROM AUTHOR]

Objective: Anorexia nervosa (AN) is a disorder characterized by a profound fear of weight gain, resulting in significant weight loss, as well as behavioral symptoms that interfere with weight normalization. In concert, weight gain remains a proximal goal of treatment, and patient weighing is a critical component of treatment. However, divergent approaches exist in how patient weighing is undertaken in clinical practice. The aim of this study is to investigate the impact of a brief course of open weighing (sharing weight data with patients) versus blind weighing (not sharing weight data with patients) on distress around being weighed and AN symptom severity. Method: 216 patients with AN and atypical AN will be randomized to receive 4 weeks of open or blind weighing practices across residential, intensive outpatient, and outpatient treatment settings, within the context of manualized empirically supported treatment. Following 4 weeks of open or blind weighing, all patients will be enrolled into open weighing practices. Primary outcomes of interest will be patient‐reported distress around being weighed at week 5 and eating disorder symptom severity at week 5. Secondary outcomes will assess weight prediction error, intolerance of uncertainty, and the fear of food. Discussion: No best practice guidelines exist in determining optimal practices around weighing patients with AN. This multisite randomized controlled trial will provide the first known data on the impact of open versus blind weighing practices upon weight‐related distress and AN symptom severity. [ABSTRACT FROM AUTHOR]

A large body of knowledge already exists on muscle dysmorphia. However, the results are limited to studies with male bodybuilders and competitive weightlifters. Systematic reviews and meta-analyses have pointed out limitations in several studies in which muscle dysmorphia symptoms are not assessed by valid and reliable instruments. Thus, this study aimed to describe the translation and cultural adaptation of the Muscle Dysmorphic Disorder Inventory (MDDI) to Brazilian Portuguese and to evaluate its psychometric properties when applied to a total of 351 physically active Brazilian college men. Confirmatory factor analysis, convergent validity, estimated internal consistency, and test-retest reliability of the MDDI scores were examined. The results of the confirmatory factor analysis upheld the original 3-factor structure (13 items) of the MDDI for Brazilian men. The MDDI scores presented a significant moderate association with male body dissatisfaction and drive for muscularity. A significant small association was observed between MDDI scores and depressive symptoms and exercise dependence. Adequate internal consistency and 2-week test-retest reliability were found. The Brazilian version of MDDI showed adequate psychometric properties among physically active college men. [ABSTRACT FROM AUTHOR]

Male body dissatisfaction has been associated with drive for muscularity and, in extreme cases, with the clinical condition referred to as muscle dysmorphia (MD). Although recent research suggests that MD is closely linked to eating disorders (EDs), it is classed as a subtype of body dysmorphic disorder. A cross-sectional study was conducted among 402 university male students in Buenos Aires to examine common factors in the development of EDs and MD. Multiple regression analyses were performed to assess the predictive value of the investigated variables. For both conditions, the models accounted for 48 percent of the variance and were predicted by a similar set of variables. The results support the inclusion of MD within the EDs spectrum. [ABSTRACT FROM AUTHOR]

Despite the effectiveness of CBT in reducing shape/weight concerns and dietary restraint, research suggests that patients considered recovered may still exhibit emotional difficulties related to eating disorders (EDs). Dialectical behavior therapy (DBT) has been adapted for a variety of mental disorders characterized by emotion dysregulation and, more recently, for EDs specifically. The current review found that the majority of the research studies employed one of the following three adaptations of DBT for EDs: The Stanford Model, Radically Open-DBT (RO-DBT), or Multidiagnostic ED-DBT (MED-DBT). Therefore, this review sought to review and update the empirical research on each adaptation and (2) offer preliminary recommendations for when and which adaptation of DBT to use when treating adults with EDs. Findings from the empirical literature on DBT and EDs indicate that the Stanford Model has the most rigorous and numerous studies demonstrating efficacy and effectiveness in those diagnosed with binge eating disorder. Fewer studies have been conducted using the Stanford Model with bulimia nervosa; therefore, less strong assertions can be made about DBT with those diagnosed with bulimia. The MED-DBT model has been evaluated in several open trials within higher levels of care with promising results, but the lack of randomized clinically-controlled trials prevents a definitive statement about its efficacy. Finally, research on applying the RO-DBT model to anorexia-nervosa, restricting subtype is in its infancy, prohibiting solid conclusions or recommendations regarding its efficacy or effectiveness. [ABSTRACT FROM AUTHOR]

Objective: Treatment outcomes for anorexia nervosa (AN) remain modest, and recent research suggests that clinical trials may be of limited methodological quality. With increasing evidence illustrating the irreproducibility of psychological research, no research to date has systematically examined the cumulative effect of bias in research relating to the treatment of AN. Method: We identified all AN trials listed on ClinicalTrials.gov between 2000 and 2018 and examined rates of (a) the noncompletion of clinical trials, the (b) nonpublication of trials once listed as completed, (c) the nonprospective registration of clinical trials, and (d) the nonreplication of findings. Results: We note that of 201 trials listed on ClinicalTrials.gov, only 101 have been completed, and of those, only 41 have been published. Moreover, of these 41 published trials, only eight demonstrated evidence of prospective trial registration, and only seven have had their primary findings replicated in other studies. Discussion: These results illustrate the profound cumulative effect of methodological bias in registered trials for AN, which may have a significant impact both on what appears in the current evidence base, and on the reproducibility of studies comprising this evidence base. [ABSTRACT FROM AUTHOR]

Objective: Prior norms of the Eating Disorders Examination Questionnaire (EDE‐Q) among men have not considered sexual orientation. This study's objective was to assess EDE‐Q community norms among cisgender gay men. Method: Participants were 978 self‐identified cisgender gay men from The PRIDE Study recruited in 2018. Results: We present mean scores and standard deviations for the EDE‐Q among cisgender gay men ages 18–82. Among cisgender gay men, 4.0% scored in the clinically significant range on the global score, 5.7% on the restraint, 2.1% on the eating concern, 10.5% on the weight concern, and 21.4% on the shape concern subscales of the EDE‐Q. The global score as well as weight and shape concerns in a young adult subsample (18–26 years) from The PRIDE Study were higher than previously reported norms in young men (Lavender, 2010). Participants reported any occurrence (≥1/28 days) of dietary restraint (19.8%), objective binge episodes (10.9%), excessive exercise (10.1%), laxative misuse (1.1%), and self‐induced vomiting (0.6%). Binge eating, excessive exercise, and self‐induced vomiting in The PRIDE Study subsample were lower than previously reported in young men. Discussion: We provide EDE‐Q norms among cisgender gay men, which should aid clinicians and researchers to interpret the EDE‐Q scores of cisgender gay men. [ABSTRACT FROM AUTHOR]

Objective: Body dissatisfaction is intricately linked to the development of disordered eating. However, as male body dissatisfaction appears more oriented toward muscularity, versus thinness per se, existing measures of eating disorder psychopathology may lack sensitivity in capturing disordered eating that is muscularity‐focused. The aim of the present study was to develop a specific measure of muscularity‐oriented disordered eating—the muscularity‐oriented eating test (MOET). Method: Candidate items were generated and refined in consultation with eating disorder‐focused researchers and focus groups of men with eating disorders. Examination of the MOET comprised two studies, consisting of 511 undergraduate men, divided into two component samples. In Study 1 (n = 307), candidate items were generated and refined via exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was then used to confirm the single factor structure in Study 2 (n = 204). Results: EFA revealed a 15‐item single factor structure, which was later confirmed through CFA in a separate sample of undergraduate men. Furthermore, the MOET yielded evidence of internal consistency (Study 1: omega = 0.93, 95% CI [0.91, 0.94]; Study 2: omega = 0.92, 95% CI [0.90, 0.93]), 7‐day (Study 1) and 21‐days (Study 2) test‐retest correlation (rs =.75, for Study 1 and 2) and convergent and divergent validity. Discussion: The MOET represents a psychometrically sound, novel measure of muscularity‐oriented disordered eating. Future research should examine its utility in clinical samples and research into muscularity‐oriented disordered eating. [ABSTRACT FROM AUTHOR]

Most studies of eating disorders (ED) among adolescents have relied on the use of self-report questionnaires given its cost-effectiveness compared to interviews approaches. The Eating Disorders Examination Questionnaire (EDE-Q) is one of the most commonly used self-report measures of eating psychopathology, despite issues regarding the underlying latent structure and its validity in this population. Given the lack of validated measures among Hispanic clinical samples, the current study aimed to validate previously suggested models for the adolescent version (EDE-Q-A) among female teenage patients with ED in Spain (Mage = 15.45, SD = 1.59). Results failed to replicate the theoretical 4-factor structure, and a 2-factor model previously validated in a Hispanic-American community sample showed best fit over a 3-factor and a single-factor model. Excellent levels of internal consistency were observed for the two dimensions of the retained model and for the Global Score of the EDE-Q-A. Significant correlations with well-established measures of ED (Eating Disorders Inventory; EDI-2) and self-esteem are presented as evidence for convergent and concurrent validity. Sensitivity analyses showed a similar pattern of association between the retained model of the EDE-Q-A and the EDI-2. Current findings may contribute to development of evidence-based knowledge on ED among Hispanic clinical populations. [ABSTRACT FROM AUTHOR]

Objective: The eating disorder examination‐questionnaire (EDE‐Q) is among the most widely used instruments in eating disorder research and clinical practice. However, the underlying structure remains a source of confusion, and contradictory results have emerged in studies among male populations. In the current study, we examined previously proposed models of EDE‐Q structure in four community samples of Argentinian men. Method: A series of confirmatory factor analyses (CFAs) were performed for five previous factor structure models of the EDE‐Q among 232 Argentinian male university students, 277 weightlifters, 275 cross‐fit users, and 202 athletes. A multigroup CFA was conducted in the model we retained, to assess measurement invariance across groups. Results: A respecified model of the brief eight‐item one‐factor proposal provided acceptable fit to the data over the original four‐factor structure and three other proposed models. Results from the multigroup CFA showed that the retained model was invariant across samples. Conclusion: Our results provide support for retaining a one‐factor EDE‐Q structure over a multifactor solution for research purposes among male community samples in Argentina. These data underscore the importance of undertaking psychometric assessment of eating disorder symptom measures before their utilization in specific populations. [ABSTRACT FROM AUTHOR]