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Two hundred one non-treatment seeking women with alcoholism, anxiety disorders, alcoholism and anxiety disorders, or neither alcoholism nor anxiety disorders were interviewed to assess core psychopathology associated with eating disorders using the Eating Disorders Examination and DSM-IIIR psychiatric diagnoses using the Schedule of Affective Disorders and Schizophrenia-Lifetime version. Alcoholic women had significantly higher mean scores on each of the Eating Disorders Examination subscales of Restraint, Overeating, Eating Concern, Shape Concern, and Weight Concern compared with nonalcoholic women. Women with anxiety disorders had significantly elevated scores on subscales of Overeating, Eating Concern, and Weight Concern compared with women without anxiety disorders. Women with both alcoholism and anxiety disorders had higher rates of bulimia nervosa and/or eating disorder NOS compared with women with either disorder alone. Implications of these findings are discussed in the context of the co-morbid association between alcoholism, eating disorders, and anxiety disorders. [ABSTRACT FROM AUTHOR]

Introduction: Bulimia nervosa (BN) is a disorder primarily affecting adolescent females, characterized by episodes of binge eating followed by inappropriate compensatory behaviors aimed at preventing weight gain, including self-induced vomiting and the misuse of diuretics, laxatives, and insulin. The precise etiology of BN remains unknown, with factors such as genetics, biological influences, emotional disturbances, societal pressures, and other challenges contributing to its prevalence. First-line treatment typically includes pharmacotherapy, which has shown moderate effectiveness. Neuroimaging evidence suggests that altered brain activity may contribute to the development of BN, making interventions that directly target the brain extremely valuable. One such intervention is repetitive transcranial magnetic stimulation (rTMS), a non-invasive stimulation technique that has been garnering interest in the medical community for many years. Methods: This review explores the use of rTMS in the treatment of BN. Searches were conducted in the PubMed/Medline, ResearchGate, and Cochrane databases. Results: Twelve relevant studies were identified. Analysis of the results from these studies reveals promising findings, particularly regarding key parameters in the pathophysiology of BN. Several studies assessed the impact of rTMS on binge episodes. While some studies did not find significant reductions, most reported decreases in binge eating and purging behaviors, with some cases showing complete remission. Reductions in symptoms of depression and food cravings were also demonstrated. However, results regarding cognitive improvement were mixed. The discussion focused heavily on potential mechanisms of action, including neuromodulation of brain networks, induction of neuroplasticity, impact on serotonergic dysfunction, anti-inflammatory action, and HPA axis modulation. rTMS was found to be a safe intervention with no serious side effects. Conclusions: rTMS in the treatment of BN appears to be a promising intervention that alleviates some symptoms characteristic of the pathophysiology of this disorder. An additional effect is a significant reduction in depressive symptoms. However, despite these findings, further research is required to confirm its effectiveness and elucidate the mechanisms of action. It is also recommended to further investigate the potential mechanisms of action described in this review. [ABSTRACT FROM AUTHOR]

Disordered eating (DE) is associated with elevated cardiometabolic risk (CMR) factors, yet little is known about this association in non-Western countries. We examined the association between DE characteristics and CMR and tested the potential mediating role of BMI. This cross-sectional study included 2005 Chinese women (aged 18–50 years) from the 2015 China Health and Nutrition Survey. Loss of control, restraint, shape concern and weight concern were assessed using selected questions from the SCOFF questionnaire and the Eating Disorder Examination-Questionnaire. Eight CMR were measured by trained staff. Generalised linear models examined associations between DE characteristics with CMR accounting for dependencies between individuals in the same household. We tested whether BMI potentially mediated significant associations using structural equation modelling. Shape concern was associated with systolic blood pressure (β (95 % CI) 0·06 (0·01, 0·10)), diastolic blood pressure (DBP) (0·07 (95 % CI 0·03, 0·11)) and high-density lipoprotein (HDL)-cholesterol (–0·08 (95 % CI –0·12, −0·04)). Weight concern was associated with DBP (0·06 (95 % CI 0·02, 0·10)), triglyceride (0·06 (95 % CI 0·02, 0·10)) and HDL-cholesterol (–0·10 (95 % CI –0·14, −0·07)). Higher scores on DE characteristics were associated with higher BMI, and higher BMI was further associated with lower HDL-cholesterol and higher other CMR. In summary, we observed significant associations between shape and weight concerns with some CMR in Chinese women, and these associations were potentially partially mediated by BMI. Our findings suggest that prevention and intervention strategies focusing on addressing DE could potentially help reduce the burden of CMR in China, possibly through controlling BMI. [ABSTRACT FROM AUTHOR]

Background/Objectives: Several systematic reviews and meta-analyses have been conducted to date indicating a high prevalence of disordered eating in elite athletes and associated risk factors. However, the substantial time burden associated with locating and comparing these reviews, which are varied in methodology and sampling focus, may be a barrier for informing policy and best practice as well as directing future research. This umbrella review aimed to provide a summary of evidence across published reviews regarding the prevalence and risk factors for disordered eating (including body image concerns and eating disorders) in elite athletes. Methods: Five databases (CINAHL, PsycINFO, MEDLINE, Scopus, and SPORTDiscus) were systematically searched for peer-reviewed systematic reviews and meta-analyses that met the following inclusion criteria: (1) investigated prevalence and risk factors for disordered eating, (2) included a sample of elite athletes, and (3) available in English. The included studies underwent data extraction and risk of bias assessment using the AMSTAR 2. Results: The initial search identified 1828 articles that were screened for title and abstract and then full text, leaving 24 systematic reviews (including 10 meta-analyses). Disordered eating was prevalent across elite athletes, including males and females and across sport type. Elite athletes were at elevated risk for disordered eating and eating disorders but at lower risk for body image concerns versus non-athlete controls. Several risk factors were identified, including female gender, competing in lean sports, and experiencing career changes. Few reviews or meta-analyses examined perceived pressures within the sporting environment, and most had substantial risk of bias concerns. Conclusions: Elite athletes are at risk for the spectrum of disordered eating, and all should be considered for primary prevention and screening. Further research is needed regarding sport-specific versus general pressures and mediators of risk to better inform interventions. [ABSTRACT FROM AUTHOR]

Background: Avoidant Restrictive Food Intake Disorder (ARFID) is a newly classified eating disorder that requires further understanding of its presentation. There is no previous report of ARFID in a child post-tonsillectomy. ARFID may be a potential negative outcome for children following oropharyngeal surgery. Case presentation: A female child aged 10 years and 2 months presented with ARFID associated with depression, anxiety and nutritional deficiency following tonsillectomy. She had more difficulty in swallowing solids than fluids and had repeated vomiting and spitting food after chewing it. She became dehydrated and malnourished with a BMI of 10.5 and was misdiagnosed with myasthenic gravis. Conclusions: To our knowledge, this is the first case report of ARFID in a child post-tonsillectomy. We discuss the pathophysiology of ARFID, which remains elusive, and recommend psychiatric assessment when evaluating children post operative tonsillectomy. [ABSTRACT FROM AUTHOR]

Background: Some studies have examined the relationship between internalization of media appearance ideals and eating disorders. However, few have discussed the relationship between eating disorder tendencies. To fill this research gap, this study was to explore the influencing mechanisms of internalization of media appearance ideals on adolescents' eating disorder tendencies in Chinese cultural context. Method: The Sociocultural Attitudes Towards Appearance Questionnaire, Eating Attitude Test-26, Physical Self-Description Questionnaire, Body Image Depression Questionnaire and Multidimensional Scale of Perceived Social Support were employed in this study to investigate 1523 adolescents. The collected data were analyzed using SPSS 26.0 and AMOS 24.0. Result: The results showed that: (1) internalization of media appearance ideals had a significant positive predictive effect on adolescents' eating disorder tendencies; (2) internalization of media appearance ideals significantly influenced adolescents' eating disorder tendencies through the mediating role of body esteem and body image disturbance respectively, and also influenced eating disorder tendencies through the chain mediating of both; and (3) social support played a moderating role between body image disturbance and eating disorder tendency. Conclusion: Our findings suggest distinct pathways through which internalization of media appearance ideals may influence adolescents' eating disorder tendencies. It is suggested that reducing body image disturbance and enhancing social support can help reducing eating disorder tendency. [ABSTRACT FROM AUTHOR]

Background: The ability to recognize one's own emotions is associated with one's ability to recognize others' emotions. Beyond the domain of emotion, however, the relationship between recognition of one's own internal states (interoception) and others' interoceptive states has not been investigated, either in the typical population or clinical groups with interoceptive difficulties (e.g. eating disorders; EDs). Method: This study investigated recognition of one's own and others' internal states in adults with and without eating disorders, using a high frequency visual noise paradigm. Participants completed self-report measures of interoception, alexithymia (difficulties recognising one's own emotional internal states) and ED symptomatology, and the Heartbeat Counting Task measure of cardiac interoceptive accuracy. Results: Alexithymia was significantly negatively correlated with recognition of others' interoceptive states. EDs were not associated with difficulties recognising others' interoceptive states. Conclusions: The ability to recognise one's own emotional internal states is associated with the recognition of others' interoceptive states, which may contribute to social skills and the ability to care for others. [ABSTRACT FROM AUTHOR]

Anorexia Nervosa (AN) is a psychological disorder involving body manipulation, self-inflicted hunger, and fear of gaining weight.We performed an overview of the existing literature in the field of AN, highlighting the main intrafamilial risk factors for anorexia. We searched the PubMed database by using keywords such as "anorexia" and "risk factors" and "family". After appropriate selection, 16 scientific articles were identified. The main intrafamilial risk factors for AN identified include: increased family food intake, higher parental demands, emotional reactivity, sexual family taboos, low familial involvement, family discord, negative family history for Eating Disorders (ED), family history of psychiatric disorders, alcohol and drug abuse, having a sibling with AN, relational trauma. Some other risk factors identified relate to the mother: lack of maternal caresses, dysfunctional interaction during feeding (for IA), attachment insecurity, dependence. Further studies are needed, to identify better personalized intervention strategies for patients suffering from AN. Highlights: This systematic review aims at identifying the main intrafamilial risk factors for anorexia nervosa, including maternal ones. Intrafamilial risk factors identified mostly regard family environment and relational issues, as well as family history of psychiatric diseases. Family risk factors identified may interact with genetic, environmental, and personal risk factors. These findings may help develop tailored diagnostic procedures and therapeutic interventions. [ABSTRACT FROM AUTHOR]

Eating disorders are a global burden and present personal, family, and societal costs. Most evidence in the literature is based on the relationship between a poor family environment and eating disorders, and the evidence of gender interaction in eating disorders is inconsistent. This study aimed to investigate the relationship between family environment and eating disorder symptoms, the mediating role of negative automatic thoughts, and the moderating role of gender using a non-clinical sample of students. A sample of 440 (70.9% females, aged 18–21) participated in this study. They completed the Eating Attitudes Test (EAT-26), the Automatic Thoughts Questionnaire (ATQ negative), and the Brief Family Relationship Scale (BFRS). PROCESS MACRO was used to study these relationships. The main findings revealed that family environment was negatively associated with eating disorder symptoms and that this relationship was mediated by automatic thoughts. Moreover, gender moderated those relationships, and more intensely in females. The results of this study indicate that the prevention of eating disorders should be directed at training individuals to challenge negative thoughts and encourage healthy individuals to be gender mindful. [ABSTRACT FROM AUTHOR]

Background: Although the etiology of eating disorders (ED) and disorder eating (DE) is multifactorial, exposure to highly visual social media (HVSM) may be an important contributor to the onset or worsening of DE and ED symptoms. We aim to understand HVSM use, ED, and DE with a particular focus on gender differences, as well as details of engagement on "selfies" in adolescents and young adults (AYA) through a scoping review of the literature. Methods: We conducted a literature search in Psycho ED, PubMed, MEDLINE of articles, including participants with DE/ED and users of HVSM, focused on AYA. Studies in which the study population did not include AYA, the SM platforms used did not include HVSM platforms, and the methodology to assess ED/HVSM use was not robust were excluded. Results: We found a strong relationship between HVSM and ED and DE with existing gender differences related to the nature of engagement and preference of content. The literature also shows effects of the specific mechanisms of use of these platforms involving "selfie" preparation and posting. Existing research is limited and consists of mostly cross-sectional studies with no uniform methodology and with participant populations that are not well-defined. Conclusions: The use of unregulated and profit-driven SM platforms can increase risk for ED. To use these HVSM platforms for positive influence, there is a need to have more transparency, and involvement of clinicians, researchers, and educators. Public significance: Due to HVSM's popularity among the AYA population, it is important to identify its effects on the development of DE and ED, as well as recognize any gender differences. Clinicians, parents, and other adults working with youth should be aware of HVSM's impact on DE/ED, as described in this review. Plain English summary: We reviewed existing literature considering the effects of highly visual social media (HVSM) on the development of eating disorders (ED) and disordered eating (DE) in the adolescent and young adult (AYA) population. There are gender differences in the use of HVSM and its associations with DE/ED through females' and males' distinct engagement styles. The main individual drivers for DE/ED are worsened body image, low self-esteem, and low body dissatisfaction, and these are influenced by other individual, family, and social factors. In addition, maladaptive use of HVSM leads to tolerance, withdrawal, and craving and is linked to anxiety and depression. Total time spent on HVSM, preoccupation with photo editing, and posting with blurred demarcation of real vs. virtual presentations is associated with DE/ED development. Given HVSM's popularity among the AYA and the risk for ED/DE in this population, it is important for clinicians, parents and other adults working with youth to be aware of HVSM's impacts. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (EDs) impact multiple domains in a person's life including interpersonal interactions. Although a considerable amount of literature has evaluated social comparison and ED pathology, less has focussed on the influence of competitiveness on eating behaviours within ED and community samples. To address this, a systematic scoping review was conducted to evaluate current knowledge on this topic. Method: PRISMA guidelines for scoping reviews were utilised to identify relevant articles in three databases without limits to date or publication type. Results: A total of 2952 articles were identified. After removing duplicates and books, 1782 articles were evaluated against inclusion criteria, and 91 articles were included. Results were synthesised under six differing conceptualisations of competitiveness: competition in pro‐eating disorder communities (n = 28), general personality competitiveness (n = 20), sexual competition hypothesis (n = 18), interpersonal competitiveness with peers (n = 17), familial competitiveness (n = 8) and competitiveness to avoid inferiority (n = 5). Conclusion: Varying conceptualisations of competitiveness were identified within the ED literature, and preliminary evidence suggests competitiveness may be associated with ED pathology in ED and community samples, although results were not uniform. Future research is needed to clarify these relationships and to identify possible clinical implications. Highlights: The literature on competitiveness and eating disorders is fractured by various conceptualisations of competitiveness.Preliminary evidence across conceptualisations suggests competitiveness is associated with disordered eating pathology in clinical and community samples.More peer‐reviewed empirical research is needed to extend the existing literature, which heavily features non‐systematic reviews, theoretical articles and dissertations. [ABSTRACT FROM AUTHOR]

Background: Eating disorders negatively influence athletes' health and performance. To achieve a high level of performance and conform to cultural expectations regarding an athletic body type, female athletes often restrict their diets, which can lead to eating disorders. In addition to factors related to the sports environment, adolescent athletes are subject to changes caused by the maturation process. Therefore, the same factors may have different effects on eating disorder risk among adolescent and adult athletes. This study examined the relationship between eating disorder risk, specific aspects of the sports environment (sport type, level of competition [national and international], and training background), and individual aspects (body satisfaction and body mass index) in two groups of athletes: adolescents and adults. Methods: The sample included 241 highly trained female athletes aged 12–30 years (M = 20.68, SD = 4.45) recruited from different sports clubs in Poland. The subgroup of adolescents consisted of 82 athletes, while the number of adult athletes was 159. The Eating Attitudes Test questionnaire was used to assess the eating disorder risk among the athletes. Body satisfaction was measured using the Feelings and Attitudes Toward Body Scale incorporated into the Body Investment Scale. Results: Eating disorder risk was prevalent among 14.6% of the adolescent and 6.9% of the adult athletes. Significant associations between eating disorder risk and the studied variables were noted only among adolescent athletes. Univariate logistic regression analysis revealed that the occurrence of eating disorder risk was associated with participation in lean non-aesthetic sports (OR = 11.50, 95% CI: 3.58–37.09). Moreover, eating disorder risk was associated with athletes' lower body satisfaction (OR = 0.80, 95% CI: 0.70–0.92). Body mass index was not included in the final regression model. Conclusions: The study indicated that eating disorder risk in adolescent female athletes was related to sport type and body satisfaction. The findings showed that, in adolescent athletes, eating disorder risk was the most associated with practicing lean non-aesthetic sports. Coaches and athletes should be aware that eating disorder risk increases among individuals with a lower body image. [ABSTRACT FROM AUTHOR]

Introduction: The number of young adults with eating disorders or subthreshold eating disorders has increased recently. Although disordered eating behaviors persist once they appear, there have been relatively few studies on factors that might cause disordered eating behaviors. The purpose of this study was to investigate how the eating attitudes of young adults change over time and the risk factors that increase disordered eating behaviors. Methods: A total of 1,141 college students, 639 males and 502 females, participated. We investigated changes in eating attitudes (using EAT-26 and BITE), depressive symptoms (using BDI-II), and stress coping (using CISS, which has three subscales) between 2 time points: at college entrance and in the fourth year of college. We divided the students into three groups (clinical, subthreshold, and healthy) based on EAT-26 scores and compared their BDI-II and CISS scores. Next, we identified students who developed disordered eating behaviors, both clinical and subthreshold, during their time at college (exacerbated students) and compared depressive symptoms and stress coping styles between exacerbated students and healthy students (unchanged students). Results: The students in the subthreshold group (both males and females) scored significantly higher on the BDI-II and emotion-oriented coping (CISS-E) than the students in the healthy group at college entrance. Additionally, the exacerbated students (both males and females) scored significantly higher on the CISS-E in the fourth year than unchanged students. The female exacerbated students scored significantly higher on the BDI-II than female unchanged students at both time points. Conclusions: Our results show that depressive symptoms and nonadaptive stress coping are associated with an increased risk of disordered eating behaviors. This study suggests that early intervention may be necessary for both the clinical and subthreshold groups. The key to early intervention may be to manage not only eating behaviors but also depressive symptoms and stress coping. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to develop a scale to screen for eating disorders in female athletes. Methods: Preliminary survey: A total of 275 female athletes (mean age: 19.4 ± 1.0 years) and 7 female athletes diagnosed with eating disorders (mean age: 20.1 ± 2.5 years) were administered screening items prepared based on an existing scale, followed by exploratory factor analysis. Main survey: Six items, relating to three factors, were extracted, and 201 female athletes (mean age: 22.3 ± 4.8 years) and 6 female athletes diagnosed with current or a history of eating disorders (mean age: 18.8 ± 2.9 years) were queried. The diagnostic validity of the scale was then evaluated. Results: Preliminary survey: Questions (α = 0.71) were extracted from six items, relating to three factors, and collectively termed the University of Tokyo's eating disorders inventory in female athletes (TEDIFA). To determine the scale cut‐off score, ROC analysis was performed with the total score, and the cut‐off and gray zone scores were set at 13 and 11, respectively. Main survey: At the cut‐off score of 13, AUC, sensitivity, and specificity were 0.83 (p < 0.05), 75%, and 90%, respectively. Conclusions: The scale that was developed, TEDIFA, consisted of six items. The cut‐off scores were set at 11 for the gray zone (sensitivity: 75%; specificity: 56%; accurate diagnosis rate: 60%), and 13 for positivity (sensitivity: 75%; specificity: 90%; accurate diagnosis rate: 87%), demonstrating the reliability and validity of the scale. [ABSTRACT FROM AUTHOR]

Objective: To compare participants with current food insecurity and different psychopathology profiles on shame, guilt, anxiety, and depression using a cross‐sectional design. Method: Women with current food insecurity (n = 99; 54% White) were placed into four groups based on their endorsement of symptoms of psychopathology: eating disorder with depression/anxiety comorbidity (ED‐C group; n = 17), depression/anxiety only (Depression/anxiety group; n = 34), eating disorder only (ED group; n = 12), and No‐diagnosis group (n = 36). Groups were compared on self‐report measures of shame, guilt, depression, and anxiety using analysis of covariance. Results: The presence of an eating disorder was associated with quadruple the risk of screening positive for comorbid depression and anxiety. The ED‐C group reported elevated shame relative to the ED and No‐diagnosis groups. The ED‐C group reported the highest levels of anxiety, followed by the Depression/anxiety group, and the ED and No‐diagnosis groups. Discussion: The presence of an eating disorder with comorbidity among women with food insecurity is associated with heightened shame. Given shame's status as a transdiagnostic predictor of psychopathology, it may serve as a putative mechanism underlying the relationship between food insecurity and eating disorder comorbidity. Public Significance Statement: Women with food insecurity and an ED were more likely to also screen positive for depression and/or anxiety than women with food insecurity and no ED. Overlap between ED, depression, and anxiety was associated with elevated shame, a harmful, maladaptive emotion with negative psychosocial consequences. [ABSTRACT FROM AUTHOR]

Prevalence rates of disordered eating behaviors impact 13% of young women and 7% of young men in the United States. Most existing research emphasizes the significant impact that the family of origin, namely parents, has on the children's relationship with food, their body, and exercise. Yet, little research exists on the parents' experience healing from disordered eating and its impact on their approach to parenting. Accordingly, this paper presents an in-depth exploration of the lived experiences and personal meaning of mothers' experience healing from disordered eating and its impact on their childrearing approach. Semistructured interviews were conducted and analyzed as per interpretative phenomenological analysis. Four themes emerged my upbringing and its impact on my relationship with my body, removing shame and changing my family tree, reparenting ourselves alongside our children, and it's bigger than food. The findings highlight the importance of supporting parents in their healing process specific to disordered eating as well as their parenting approach to change their family's relationships with food, bodies, and movement. [ABSTRACT FROM AUTHOR]

Introduction: Episodes of eating great quantities of extremely sweet and often aversive tasting food are a hallmark of bulimia nervosa. This unique eating pattern led researchers to seek and find differences in taste perception between patients and healthy control subjects. However, it is currently not known if these originate from central or peripheral impairment in the taste perception system. In this cross sectional study, we compare brain response to sweet and sour stimuli in 5 bulimic and 8 healthy women using functional magnetic resonance imaging (fMRI). Materials and methods: Sweet, sour and neutral (colorless and odorless) taste solutions were presented to subjects while undergoing fMRI scanning. Data were analyzed using a block design paradigm. Results: Between-group differences in brain activation in response to both sweet and sour tastes were found in 11 brain regions, including operculum, anterior cingulate cortex, midbrain, and cerebellum. These are all considered central to perception and processing of taste. Conclusion: Our data propose that sweet and sour tastes may have reward or aversion eliciting attributes in patients suffering from bulimia nervosa not found in healthy subjects, suggesting that alteration in taste processing may be a core dysfunction in bulimia nervosa (BN). [ABSTRACT FROM AUTHOR]

Purpose: Individuals with body image distortions tend to develop an obsession with calorie intake and weight, leading to compounded coping strategies such as modified eating behaviors, supplement use, and excessive exercise. In the local context, little is known about the equation connecting body image to improper eating behaviors and other potential coping mechanisms. This study primarily aims at critically identifying the nexus between features of disordered eating behavior including supplement use, and body image. Methodology: A probabilistic randomized sample of 305 gym members was assessed based on their level of body satisfaction and its influence on their eating habits and supplement use through a structured survey. Findings: Only 37% of the participants were satisfied with their body image. The results concurred with the notion of a poor body image influencing body esteem (χ2 (10) = 137.21, p < 0.05; Cramer V = 0.474). While exercise motivated the use of supplements, a significant relationship was also observed between disordered eating habits and supplement use (χ2 (4) = 48.63, p < 0.05; Cramer V = 0.399). A predictive model was successfully drawn inclusive of the disordered eating behaviors dimensions as a potent predictor of body image (χ2 (56) = 397.12, p < 0.001. Implications: This study presents an in-depth analysis of the magnitude of disordered eating behaviors with respect to individuals in the local fitness industry, and the need for professional support programs toward the re-alignment of body image in an effort to curtail the development of eating disorders in Mauritian gym-goers. [ABSTRACT FROM AUTHOR]

Improvements in the clinical management of anorexia nervosa (AN) are urgently needed. To do so, the search for innovative approaches continues at laboratory and clinical levels to translate new findings into more effective treatments. In this sense, modern learning theory provides a unifying framework that connects concepts, methodologies and data from preclinical and clinical research to inspire novel interventions in the field of psychopathology in general, and of disordered eating in particular. Indeed, learning is thought to be a crucial factor in the development/regulation of normal and pathological eating behaviour. Thus, the present review not only tries to provide a comprehensive overview of modern learning research in the field of AN, but also follows a transdiagnostic perspective to offer testable explanations for the origin and maintenance of pathological food rejection. This narrative review was informed by a systematic search of research papers in the electronic databases PsycInfo, Scopus and Web of Science following PRISMA methodology. By considering the number and type of associations (Pavlovian, goal-directed or habitual) and the affective nature of conditioning processes (appetitive versus aversive), this approach can explain many features of AN, including why some patients restrict food intake to the point of life-threatening starvation and others restrict calorie intake to lose weight and binge on a regular basis. Nonetheless, it is striking how little impact modern learning theory has had on the current AN research agenda and practice. [ABSTRACT FROM AUTHOR]

Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic Matrix‐Female (SM‐F), a new bidimensional female figural rating scale which can be used to gauge actual and desired levels of both body fat and muscularity in a consolidated measure, as well as providing an index of actual‐desired body discrepancy based on these measures. Across two studies undergraduate women (n Study 1 = 481; n Study 2 = 391) completed the Eating Disorder Examination‐Questionnaire, the Body Shape Questionnaire‐34, and the Depression Anxiety Stress Scales‐21 (Study 1) and the Drive for Thinness Scale and the Drive for Muscularity Scale (Study 2), as well as the SM‐F. Overall, the SM‐F demonstrated sound content, concurrent, and convergent validity for actual and desired body fat, actual and desired muscularity, and their respective discrepancy scores. [ABSTRACT FROM AUTHOR]

Background: Eating disorders (EDs) emerge most often in adolescent girls. While the basic neural and psychiatric mechanisms of ED development remain unknown, their incidence has increased with sociocultural modernization. To determine what aspects of modern culture are related to EDs, we examined the relationship between predisposition to EDs and interest in several modern cultural factors among young female university students in Bangladesh. Methods: A cross-sectional study was conducted in a population of 196 female students aged 18–29 years in a university in Bangladesh. Their predisposition to EDs was examined using the Eating Attitudes Test-26 (EAT-26), and their interest in modern culture was evaluated by grading interest in fashionable clothes, Indian TV shows/serials, luxury food and social network activities, and by examining involvement in cultural activities such as playing, dancing, parties and singing. The relationship between predisposition to EDs and interest in modern culture was then examined. The relation between EAT-26 score and body mass index (BMI) was also examined. Results: The EAT-26 revealed that 37% of the participants were at risk of developing an ED. Correlation analyses showed that a high EAT-26 score was correlated with a high interest in fashionable clothes and Indian TV shows/serials, but not with a high interest in luxury food or social network activities, or involvement in cultural activities, such as playing, dancing, parties and singing. Further, EAT-26 questions in the dieting category and oral control category, but not the bulimia and food preoccupation category, were correlated with interest in cultural factors. EAT-26 score showed no significant correlation with BMI. Conclusions: The results of this study indicate that the risk of EDs is related to an interest in several facets of modern culture. Monitoring the cultural interests of adolescent females, who are continually exposed to modern culture and highly susceptible to EDs, will contribute to the prevention of EDs. [ABSTRACT FROM AUTHOR]

Despite that disordered eating has been repeatedly associated with perfectionism, the results are inconsistent as to which exact dimensions of perfectionism it is related to. Moreover, the increasing evidence that perfectionism is best conceptualized as a domain-specific, as opposed to a global, trait contribute to the lack of clarity. Therefore, the aim of this study was to examine which dimensions of global and physical appearance perfectionism statistically predict disordered dieting in a non-clinical adult female sample. In total 437 participants completed the Short Almost Perfect Scale, which distinguishes between adaptive and maladaptive perfectionism, the Physical Appearance Perfectionism Scale, which distinguishes between hope for perfection and worry about imperfection, and the Dieting subscale of the Eating Attitudes Test-26. A hierarchical regression analysis revealed that only maladaptive, as opposed to adaptive, global perfectionism statistically predicted disordered dieting. Furthermore, both dimensions of physical appearance perfectionism statistically predicted disordered dieting, although worry about imperfection, its maladaptive dimension, was the strongest statistical predictor. The present results demonstrate that worry about imperfection is an effective statistical predictor of disordered dieting among women, possibly serving as a starting point for further research investigating the utility of its incorporation in prevention and treatment protocols for disordered eating. [ABSTRACT FROM AUTHOR]

Individuals with an eating disorder (ED) often report to be disgusted by their body. Body‐related self‐disgust could play an important role in the development and maintenance of EDs. We investigated if women with relatively high ED symptom scores indeed respond with disgust upon exposure to their body as indexed by facial electromyography (fEMG) of the m. levator labii superioris and self‐report. Given that one's self‐disgust may increase/decrease depending on the relative distance of the own body to the thin ideal, we also assessed women's disgust for overweight‐ and thin‐morphs of their body. Female undergraduate students (N = 104) were photographed and presented with their (morphed) body pictures, next to disgust‐relevant and overweight body control pictures. Higher levels of ED symptoms were associated with stronger self‐reported disgust to unedited body‐pictures and overweight‐morphs. Disgust to thin‐morphs was unrelated to ED symptoms. Participants generally showed heightened facial disgust towards overweight morphs, yet the strength of facial disgust was unrelated to ED symptoms. Thus, the findings provide evidence for the involvement of heightened body‐related self‐disgust in ED symptomatology, albeit only on the basis of self‐report. Key points: Eating disorder symptoms were related to stronger subjective disgust to unedited and morphed overweight self‐pictures.This relationship was not evident for morphed underweight self‐pictures.Eating disorder symptoms were not associated with stronger fEMG activation to unedited and morphed self‐pictures. [ABSTRACT FROM AUTHOR]

Two-hundred and three college women participated in a 16-minute strength and conditioning group fitness class. Participants were randomly assigned to a class that featured either appearance-focused motivational comments by the instructor (e.g., "Blast that cellulite!") or function-focused comments (e.g., "Think of how strong you are getting!"). Body satisfaction from pre-test to post-test increased overall, but those in the function-focused (as opposed to appearance-focused) condition experienced a significantly greater increase in body satisfaction. A similar pattern was observed for positive affect. Additionally, those in the function-focused condition described the class in more positive terms and reported experiencing less body surveillance during the class. These findings are consistent with research suggesting that exercise can improve mood and body satisfaction, but also suggest that a more function-focused class can lead to even greater improvements. The motivational comments fitness instructors use may have a notable impact on women's mood, body satisfaction, and body surveillance. [ABSTRACT FROM AUTHOR]

Purpose: The current study evaluated associations between exercise identity (Exercise Identity Scale; EIS), compulsive exercise (Compulsive Exercise Test; CET), and their association with Eating Disorder Examination – Questionnaire (EDE-Q) scores among adult runners registered for mid- and long-distance races (N = 282, 48.2% male). Methods: Runners of half and full marathon races completed the EIS, CET, and EDE-Q. Results: Regression analyses indicated that increased EIS, b = −.21, and CET, b = −3.25, scores contribute to decreased eating pathology amongst half-marathon runners; a significant interaction effect emerged for EIS × CET scores, b =.08, such that relations between EIS and EDEQ scores were significant among runners reporting either lower or higher CET scores. These associations were not demonstrated in marathon runners. Conclusions: Results suggest that it is beneficial to consider running status when addressing the effect that exercise identity and compulsive exercise may have on eating pathology in competitive runners. [ABSTRACT FROM AUTHOR]

The novel coronavirus has a great impact over mental health, individuals with eating disorders may be particularly affected by the distancing measures, quarantine thus to a difficult access to professional mental health services, this exacerbating phenomenology. Eating behaviour disorders include anorexia nervosa, bulimia nervosa and binge-eating disorder in which individuals express abnormal eating behaviours, often resulting in either insufficient or excessive food intake. Multiple implication factors such as genetic, biological, behavioural, and psycho-social have been incriminated. Multiple psychiatric comorbidities can be associated like anxiety, depression, obsessive-compulsive disorder, substance abuse, personality disorders, attentiondeficit and an increased risk of suicide. Anaemia, hydro-electrolytic disturbances, cardiovascular diseases, gastrointestinal and endocrine dysfunctions may occur as medical complications. The challenge regarding eating disorders is to understand their mechanism of occurrence, in an attempt to prevent them, as well as to treat them so that they do not put the individual's life in danger. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to examine the association between indicators of social adversity, including socioeconomic status and race/ethnicity, and children's disordered eating behaviors and attitudes. Methods: Children ages 8–10 years old (n = 183) were recruited from Michigan. Data were collected through in‐home surveys. The Children's Eating Attitudes Test (ChEAT‐24) measured disordered eating attitudes and behaviors in the sample. Cumulative social adversity was considered the sum of four binary variables: caregiver race/ethnicity, caregiver education, household income, and child‐reported food security status. Linear mixed models examined the association between social adversity indicators and ChEAT‐24 scores. Results: Children of primary caregivers of color had significantly higher ChEAT‐24 scores than children of white caregivers (p =.03). Children who reported food insecurity had significantly higher ChEAT‐24 scores compared to children who reported food security (p =.01). Compared to children with the lowest social adversity score, children with the highest score had a 4.8‐unit higher ChEAT‐24 score (95% CI.3–9.4), after adjusting for covariates. A significant trend was observed for greater social adversity and higher ChEAT‐24 score (p‐trend =.02). Conclusion: A linear association was observed between greater social adversity and more disordered eating behaviors and attitudes among children in this sample. These findings emphasize the need for eating disorder research in children from racial/ethnic minorities and socioeconomically disadvantaged populations to support future prevention efforts. Public Significance: Greater exposure to social adversity was associated with more disordered eating behaviors among preadolescent children. Given that eating disorders are understudied in lower‐income and minority racial/ethnic populations, this study highlights the need for additional research to better support prevention and treatment efforts among children from socioeconomically diverse backgrounds. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders are one of the deadliest mental health conditions, yet most individuals with eating disorders never receive treatment. Previous research has explored barriers to treatment among individuals diagnosed with eating disorders, but little is known about general adolescent and emerging adult perceptions of eating disorders, as compared to other mental health illnesses, a population at greatest risk for developing an eating disorder, and a population that may be important sources of information or support for peers. Method: A sample of adolescents and emerging adults aged 14–24 years (mean age 19 years) from MyVoice, a national text‐message‐based cohort (53% female, 38% male, 9% other, race/ethnicity 63% White, 10% Black or African American, 13% Asian, 9% Mixed Race, and 5% Other) provided open‐ended responses to questions on the severity of eating disorders as compared to other mental health diagnoses, others' perceptions of eating disorders and potential treatment barriers. Responses were collected using a secure online platform and analyzed using content analysis. Results: Among respondents (n = 792/1283), 91% felt that eating disorders were a mental health condition and 65% felt that eating disorders were as serious as other mental health conditions, while 21% said they were more serious than other mental health conditions. Responses to questions related to perception and barriers illustrated that beliefs of eating disorders involve blame, stigma, and overall lack of understanding. Discussion: Findings from this study illustrate that there is a lack of understanding around eating disorders that could be addressed in youth‐focused initiatives. Public Significance: Adolescents and emerging adults understand that eating disorders are severe mental illnesses that are not taken seriously by others, especially in comparison with other mental health diagnoses. Adolescents and emerging adults report that individuals with eating disorders are blamed for their condition and face shame and stigma. The lack of understanding around eating disorders should be addressed in youth‐focused prevention initiatives. [ABSTRACT FROM AUTHOR]

Background: Exercise is a prominent feature of most eating disorders, and has been shown to have a number of detrimental effects on treatment outcome. There is some disagreement in the literature regarding the construct of compulsive exercise, and assessment and treatment varies significantly. This study therefore aimed to aggregate expert clinicians' and researchers' views on how to define and measure compulsive exercise in eating disorder patients. The expert panel was also asked about questionnaire design, and possible problems when measuring compulsive exercise. Method: This study used the Delphi method to establish consensus amongst an expert panel. Three successive rounds of questionnaires were distributed to the panel over a period of six months. The first round consisted of four open-ended questions regarding the definition and measurement of compulsive exercise in eating disorder patients. For Round 2, 70 statements were derived from the answers, and panelists were asked to rate each item on a Likert-based scale. An 85% consensus level was chosen. In Round 3, 44 statements were re-rated by the panel. Results: Seventeen of 24 participants completed all three rounds of the study. Consensus was achieved for 63% of the items, while 18.5% reached near consensus, and 18.5% did not reach consensus after Round 3. The panel agreed on a number of important aspects of compulsive exercise. Several suggestions regarding the format of a questionnaire assessing this behavior were also endorsed. The panel further identified common difficulties when assessing compulsive exercise in eating disorder patients, notably a lack of consensus still apparent in the literature. Conclusion: The current findings constitute a further step towards a unified definition of compulsive exercise, and contribute important suggestions to the measurement of this behavior. Plain English summary: Exercise is an important feature of most eating disorders. Researchers have found that people with an eating disorder exercise because they feel driven to do so, or because it helps them cope with negative emotions. This type of exercise is called 'compulsive exercise', and it can have detrimental physical and mental effects. There is some disagreement in the literature about how to define compulsive exercise, and there are many ways to measure and treat it. The aim of this study is to collect expert researchers' and clinicians' views of compulsive exercise, and elicit suggestions regarding how to reliably measure this behaviour in order to promote consensus in the field. [ABSTRACT FROM AUTHOR]

Direct and indirect body-focused self-damaging behaviors are highly prevalent and associated with negative outcomes. Despite progress in understanding the expected consequences (i.e., expectancies) that motivate individuals to engage in these behaviors, less is known about the co-occurrence of, and specific expectancies for, body-focused self-damaging behaviors. The goal of this study was to develop a self-report measure to assess the frequency and co-occurrence of, and individuals' average expectancies for, body-focused self-damaging behaviors. An initial draft of the Body-focused Self-damaging Behavior Expectancies Questionnaire (BSBEQ) was developed and refined through expert feedback and pilot testing in a student sample (n = 11). The specific body-focused self-damaging behaviors selected for assessment included nonsuicidal self-injury, disordered eating behavior, body-focused repetitive behaviors, and problematic exercise. The factor structure of the BSBEQ was examined initially through exploratory factor analysis in a student sample (n = 349) and then through confirmatory factor analysis in a community sample (n = 443). The final BSBEQ comprised 17 items across five subscales: Control, Self-Improvement, Coping with Emotional Pain, Positive Emotion Down-regulation, and Interpersonal Influence. The internal consistency, test–retest reliability, and convergent and divergent validity of the subscales were generally supported. The BSBEQ represents a flexible tool for assessing the frequency of and average expectancies for body-focused self-damaging behaviors, and can be used for assessment and/or treatment planning by researchers and clinicians working with individuals with a variety of self-damaging behaviors that have a direct or indirect physical effect on the body. [ABSTRACT FROM AUTHOR]

Aim: To understand the earliest parent reported signs suggesting their child may have an eating disorder (ED), and to quantify time from symptom onset to specialist assessment. Methods: This is a secondary analysis of data derived from parents of 78 young people presenting to a British community ED service who completed a questionnaire asking when they first noticed their child displaying (a) a change in eating pattern, (b) weight concerns, (c) shape concerns. Parents were also asked to describe the first thing they noticed in terms of possible ED symptoms. Results: Mean age was 14.9 (SD: 1.58), 94% were female with diagnoses of anorexia nervosa (n = 50), bulimia nervosa (n = 10) and atypical anorexia nervosa (n = 18). Weight and shape concerns were most often noticed over a year prior to assessment (mean 12.7 months [SD: 12.8] and 13.3 months [SD: 13.2], respectively), with eating pattern change observed a mean of 9.7 months (SD: 7.6) before referral to specialist care. Seven main themes were developed from parents' descriptions of their child's symptoms: (1) eating pattern change, (2) shape concern, (3) weight concern, (4) observed weight loss, (5) binge eating/compensatory behaviours, (6) other mental health concerns and (7) physical symptoms. Conclusions: The most common parental concerns were eating pattern change, specifically their child becoming more rigid/rule‐bound with regard to eating and dietary restraint. Such external changes are likely observed before physical changes such as weight loss, offering potential for early identification by parents, primary care and other professionals, with implications for improved prognosis. [ABSTRACT FROM AUTHOR]

The normal physical changes associated with pregnancy may increase the risk of body dissatisfaction, which is associated with negative mental health outcomes including depression and disordered eating. The purpose of this study was to explore body image and eating concerns among a sample of participants in pregnancy and postpartum and to assess interest and suggestions for a relevant intervention. This was a cross-sectional survey study requiring 10–15 min to complete. Individuals were eligible to participate in the study if they were pregnant or within 1 year postpartum, between the ages of 18 and 45, able to read and write in English, and provided online informed consent. The survey included measures and open-text questions to explore body image, eating behaviors, and related concerns in the perinatal period and to inform the development of an intervention. There were 161 participants, and over 50% were dissatisfied with their body image; 52% were among pregnant participants and 56.2% of postpartum participants. Approximately 80% reported that they would have appreciated the opportunity to participate in a program focused on body acceptance or expectations of body changes in pregnancy and postpartum. We identified intervention preferences as well as commonly reported themes regarding experiences of body image and eating concerns in pregnancy and postpartum. Body dissatisfaction and eating concerns are prevalent issues in pregnancy and postpartum, and our findings underscore an opportunity to tailor an intervention relevant to body image and disordered eating for the perinatal population. [ABSTRACT FROM AUTHOR]

Background: People unknowingly mimic the behaviors of others, a process that results in feelings of affiliation. However, some individuals with eating disorders describe feeling "triggered" when mimicked. This study explores the effects of implicit non-verbal mimicry on individuals with a history of an eating disorder (ED-His) compared to healthy controls (HCs). Method: Women (N = 118, nED-His = 31; Mage = 21 years) participated in a laboratory task with a confederate trained to either discreetly mimic (Mimicry condition) or not mimic (No-Mimicry condition) the mannerisms of the participant. Participants rated the likability of the confederate and the smoothness of the interaction. Results: Participants in the No-Mimicry condition rated the confederate as significantly more likable than in the Mimicry condition, and ED-His rated the confederate as more likable than HCs. ED-His in the Mimicry condition rated the interaction as less smooth than HCs, whereas this pattern was not found in the No-Mimicry condition. Among ED-His, longer disorder duration (≥ 3.87 years) was associated with less liking of a confederate who mimicked and more liking of a confederate who did not mimic. Conclusions: We discuss the implications of these findings for interpersonal therapeutic processes and group treatment settings for eating disorders. Plain English summary: Our study on subtle, nonverbal mimicry revealed differences in social behavior for women with a history of an eating disorder compared to healthy women. For participants with an eating disorder history, a longer duration of illness was associated with a worse pattern of affiliation, reflected in lower liking of a mimicker. Further research on how diverging processes of affiliation may function to perpetuate the chronicity of eating disorders and implications for treatment is needed. [ABSTRACT FROM AUTHOR]

Background: It is important to target body image in individuals with an eating disorder (ED). Acceptance and commitment therapy (ACT) has been trialed in a few studies for individuals with an ED. Although ACT outcomes in ED patients hold promise, studies of predictors are scarce. The aim of the present study was to explore differences in ED symptom outcome at two-year follow-up in subgroups of participants attending either treatment as usual (TAU), or a group intervention based on ACT targeting body image. Additionally, we aimed to compare subjective recovery experiences between groups. Methods: The study took place at a specialized ED outpatient clinic, and included patients diagnosed with an ED that had received prior treatment and achieved a somewhat regular eating pattern. Study participants were randomly assigned to continue TAU or to participate in a group intervention based on ACT for body image issues. Only participants that completed the assigned intervention and had completed follow up assessment by two-years were included. The total sample consisted of 77 women. Results: In general, ACT participants showed more favorable outcomes compared to TAU, and results were more pronounced in younger participants with shorter prior treatment duration and lower baseline depression ratings. Participants with restrictive ED psychopathology had three times higher ED symptom score change if participating in ACT in comparison to TAU. Conclusions: An ACT group intervention targeting body image after initial ED treatment may further enhance treatment effects. There is a need for further investigation of patient characteristics that might predict response to body image treatment, particularly regarding ED subtypes and depression ratings. [ABSTRACT FROM AUTHOR]

Objective: Gender and sexual identity constitute social categories that have been found to be important when identifying persons at risk for eating disorders (ED), since prevalence rates are especially high for women as well as persons of gender and sexual minorities. The objective of this study is to enhance the understanding of how these social categories relate to ED development. Method: A qualitative, inductive approach was used in order to develop empirically grounded hypotheses about gendered aspects in ED development. Data are 14 narrative interviews with persons of diverse sexual and gender identities who recovered from anorexia or bulimia nervosa. Interviews were analyzed in depth using Grounded Theory Methodology and Voice Centered Listening. Results: Results suggest that social experiences related to female gender, as well as social experiences related to non‐compliance with social gender norms, can be important for ED development. Those social experiences were described as influencing participants' self‐worth, body image and self‐regulatory strategies, which were connected to ED symptomatology. Discussion: Future research should further validate the gendered aspects presented in this paper, since including a broader array of gendered social aspects in ED research might help to improve etiological understanding and prevention methods. Public Significance Statement: This study contributes a special perspective to research on eating disorders and gender, because it is based on first‐person perspectives of formerly affected persons and integrates the experiences of persons with different gender and sexual identities. Participants described four categories of gendered social experiences relevant for their eating disorders. We discuss the potential of these categories to guide future research on the development of eating disorders and their prevention. [ABSTRACT FROM AUTHOR]

In recent decades, the prevalence of eating disorders (EDs), and related symptoms have been increasing in the Western world, including Israel. The etiology is multifactorial, while increased exposure to harmful messages, related to beauty has a significant harmful impact, especially on children and adolescents. Studies have indicated that most prevention programs in schools are ineffective, and some are even harmful. Studies have shown that eating disorders can be influenced by social pressure, friends, family, or media. Therefore, prevention programs have focused on challenging the major risk factors associated with EDs, such as poor body-image, low self-esteem, peer pressure, and media influence. Findings indicated a significant improvement in psychopathology, associated with disturbed eating. This article describes the varies of types of EDs among adolescents, presents the main prevention programs in schools, and highlights programs that may be harmful compared to those found to be effective for middle and high school students. [ABSTRACT FROM AUTHOR]

Positive body image is a contemporary construct, having only received research attention within the past two decades in an effort to elicit a more holistic, comprehensive account of the concept of body image. Nevertheless, emerging literature has suggested its direct and indirect association with improved outcomes, including indicators of well‐being (e.g. self‐compassion) and feelings towards the self (e.g. self‐esteem). Positive body image has therefore been suggested as both a potential technique and a target of actionable therapeutic work for cultivating both physical and psychological well‐being. First, through insights from quantitative and qualitative seminal works, this paper demonstrates that positive body image is: (i) a multidimensional construct, distinct from negative body image; (ii) a confluence of theoretical disciplines and influences; (iii) protective, with therapeutic capacities; (iv) a positive outcome; (v) young, yet flourishing; and (vi) socially and politically relevant. Thus, complementing what positive body image is, this paper further situates therapeutic practice within the field of positive body image by delineating and contextualising their reciprocal capacities and relevant techniques. [ABSTRACT FROM AUTHOR]

Copyright of Orvosképzés is the property of Semmelweis Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective During the college transition, vulnerability to disordered eating and exercise behaviors and cognitions may increase. We studied how behaviors and cognitions change differentially over time, in the context of gender, athletic participation, and contingencies of self-worth. Participants: 229 diverse, first-year students at a competitive liberal arts college. Methods: Three-wave longitudinal study employing surveys before, during, and following the first semester, using linear mixed model analyses. Results: There were changes over time in one measure of disordered exercise-related cognitions and exercise frequency; disordered eating showed no significant changes over time. Athletic participation and basing a lower amount of self-worth on appearance were protective against subclinical disordered cognitions and behaviors; gender was not predictive. Conclusion: Health personnel should consider athletic participation and contingencies of self-worth when assessing students' risk for ED symptoms, in both genders. Early interventions may be useful, as changes were observed within the first three months of college. [ABSTRACT FROM AUTHOR]

Recent studies have shed light on how the COVID-19 pandemic changed our lives, and most of them have documented its detrimental effect on eating habits. Until now, the effects of this global crisis on negative body image and its association with disordered eating behaviors remain largely understudied. This study aimed to investigate changes in frequency of disordered eating behaviors (i.e., restrictive eating, emotional eating, and overeating) and negative body image (i.e., shape and weight concern, and body dissatisfaction) among a community sample of women during the COVID-19 pandemic (October 2020–May 2021). Furthermore, we explored the possible relation between body image-related variables and changes in the frequency of disordered eating behaviors in the context of the pandemic. A total of 161 self-identified female participants enrolled in an online-based survey. Descriptive statistics showed that women did not report clinically significant levels of weight and body shape concerns, but participants reported being dissatisfied with their body. One sample Wilcoxon Signed Rank tests revealed a tendency toward an increasing of the frequency of all disordered eating behaviors during the COVID-19 pandemic. Multinomial logistic regressions showed that weight concerns predicted an overall increase in the frequency of restrictive eating behaviors, whereas higher body dissatisfaction was associated with a moderate self-perceived increase in the frequency of emotional eating. These results shed light on a risk pattern of phenomena in a non-clinical sample of women, as they represent the key risk factors for the development of eating disorders. Findings could have implications for designing and implementing prevention programs. [ABSTRACT FROM AUTHOR]

Personality factors can make individuals more susceptible to society's beauty ideals and can explain the differences between people who do and do not develop eating disorders and concerns about their body shape. This study has two main aims. First, we investigated the degree to which self-objectification mediated the associations between trait anxiety, self-esteem, and eating attitudes in a sample of 698 undergraduate students (375 women, 323 men). Second, we evaluated whether these associations showed analogous patterns across the genders. Our results demonstrated that self-esteem and trait anxiety might contribute to the internalization processes of societal beauty ideals, which may, in turn, lead to dysfunctional eating attitudes in both women and men. The findings suggested the importance of identifying the roles personality factors play in self-objectification for practitioners seeking to improve intervention and prevention strategies. These results are valuable in social contexts where women and men can learn functional and dysfunctional models of culture and behavior. Additionally, the results are useful in a clinical context for a more complete understanding of the etiological factors and outcomes associated with eating disorders. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether childhood maltreatment is a risk factor for two eating disorders (anorexia nervosa and bulimia nervosa) using objective and subjective case definitions. Methods: Using a prospective cohorts design, children with documented cases of physical abuse, sexual abuse, and neglect (ages 0–11) from 1967 to 1971 in a Midwestern metropolitan county area were matched on age, race, sex, and approximate family socioeconomic status with non-maltreated children. Both groups were followed up. Retrospective self-reports about childhood maltreatment were collected at age 29. DSM-IV anorexia nervosa (AN) and bulimia nervosa (BN) disorders were assessed at age 41 (N = 807). Logistic and linear regression results are reported. Results: Using documented cases, childhood maltreatment was not a significant risk factor for AN or BN diagnoses or symptoms in adulthood. However, adults who retrospectively reported any maltreatment and physical and sexual abuse reported significantly more symptoms of AN than those who did not. Conclusions: The prediction that childhood maltreatment is a risk factor for anorexia nervosa and bulimia nervosa was partially supported in this longitudinal study. While misattribution of cases might have occurred, these results suggest that researchers and clinicians should use caution in drawing inferences about these relationships and designing interventions. [ABSTRACT FROM AUTHOR]

Background: The ability to move joints beyond the normal range of motion is called Joint Hypermobility (JHM). JHM has been associated with a plethora of physical problems and is a frequent sign of hereditary disorders of connective tissue. Neuropsychiatric conditions such as eating disorders (ED) have also been related to JHM. However, little is known about the clinical profile of people with ED and JHM. The aim of this study was to explore JHM in patients with ED and to compare the clinical characteristics of hypermobile ED patients with non-hypermobile ED patients. Method: Fifty-three outpatients diagnosed with ED were assessed using the Beighton score for JHM, the Eating Disorders Inventory 2, the Eating Disorder Examination, and the Detail and Flexibility Questionnaire. Information relating to patients' psychiatric and somatic comorbidities/symptoms was also collected. Results: Using the traditional Beighton score's cutoff of ≥4, 41.5% of the sample presented with JHM. Our results indicate that compared with non-hypermobile ED patients, those with JHM are significantly younger, suffer at a greater extent from joint pain and easy bruising, have a shorter duration of the ED, and have lower scores for cognitive rigidity. In addition, for those with anorexia nervosa, the restricting subtype represents a significantly lower proportion of hypermobile ED patients compared to non-hypermobile ED patients. Multivariate analyses showed that cognitive rigidity, age, and duration of the ED could predict the JHM status in this sample. Conclusion: These results suggest that JHM is frequent in patients with ED and is accompanied by signs of tissue fragility. Patients with ED and JHM seem to present a specific profile characterized by less cognitive rigidity and restricting behavior in the case of anorexia nervosa. Further research is needed in order to confirm these results. [ABSTRACT FROM AUTHOR]

In this article, the researchers report findings on how food meanings, culture and gender intersect in the experiences of Italian-Australian women. In-depth narrative interviews were thematically analyzed using a feminist social constructionist framework informed by anthropological theories about "foodways" and culture. Three core themes were identified in the women's narratives: "il cibo e' tutto, il cibo e amore" – "food is everything, food is love"; "fare la bella figura" – "to make a good impression"; and "il mio piatto" – "it's my plate". The researchers demonstrate how gendered expectations of women in Italian-Australian culture intersect with food meanings, cultural ideals and practices to produce distinct experiences of disordered eating and restricted access to formal support. The relevance of the findings are likely to be applicable to other migrant communities across the world. Particularly where ethnic communities retain distinctive food related meanings and practices post migration, that may intersect with cultural ideals venerating female thinness and the psycho-medical models and practices that pathologize disordered eating. [ABSTRACT FROM AUTHOR]

Background: Despite common misconceptions, an individual may be seriously ill with a restrictive eating disorder without an outwardly recognizable physical sign of the illness. The aim of this qualitative study was to investigate the perspectives of individuals who have previously battled a restrictive eating disorder who were considered "not sick enough" by others (e.g., peers, families, healthcare professionals) at some point during their illness, and to understand the perceived impact on the illness and recovery. Such misconceptions are potentially damaging, and have been previously linked with delayed help-seeking and poorer clinical outcomes. Methods: Seven women who had recovered from anorexia nervosa or atypical anorexia nervosa participated in semi-structured interviews. Interviews were transcribed and interpretive phenomenological analysis was used. Results: Three main themes emerged: (1) dealing with the focus upon one's physical appearance while battling a mental illness, (2) "project perfect": feeling pressure to prove oneself, and (3) the importance of being seen and understood. Participants reported that their symptoms were occasionally met with trivialization or disbelief, leading to shame, confusion, despair, and for some, deterioration in eating disorder symptoms which drove further weight loss. In contrast, social support and being understood were viewed as essential for recovery. Conclusion: To facilitate treatment seeking and engagement, and to optimize chances of recovery, greater awareness of diverse, non-stereotypical presentations of restrictive eating disorders is needed which challenge the myth that weight is the sole indicator of the presence or severity of illness. Plain English Summary: A persistent myth is that restrictive eating disorders are outwardly recognizable due to severely low body weight or emaciation. Atypical anorexia nervosa (AAN) and anorexia nervosa (AN) are both characterized by restrictive eating behavior. Individuals with AAN do not have current low body weight, although some research suggests they have higher levels of impairment and eating disorder pathology than their peers with AN, and their physical health may be equally compromised. Despite this, individuals with AAN are more likely to have a longer duration of illness and less likely to receive inpatient care, suggesting their illness is not always recognized by others. Additionally, thinness is highly valued in today's society and restrictive eating behavior or "dieting" is commonplace, which may promote trivialization, or even reinforcement, of initial weight loss by friends or family. With this in mind, our study aimed to explore the experiences of seven recovered individuals recovered from AN or AAN who were directly or indirectly told by peers, families, or healthcare professionals that they were "not sick enough" at some point during their course of illness. We explored the perceived effects on symptoms, motivation for treatment, mental health and well-being. Participants reported their symptoms were occasionally trivialized or dismissed, leading to shame, confusion, and self-doubt regarding the seriousness of their symptoms. For some, a deterioration in eating disorder symptoms ensued that led to additional weight loss, sometimes in a competitive or perfectionist pursuit to "succeed" at eating restrictively. Findings demonstrated the value of being seen and understood, as well as the potential damage of being considered as "not sick enough" by others when battling a restrictive eating disorder. [ABSTRACT FROM AUTHOR]

Comments on the development of eating disorders, amenorrhea and osteoporosis among female athletes, collectively known as the female athlete triad. Components of the triad and its effect on the health and athletic performance of female athletes; Risk factors; Prevention and treatment.

'Feeling fat' has received little empirical attention despite clinical recognition as an eating disorder maintenance factor. This experience also occurs in non-clinical populations and may relate to elements of subclinical eating pathology. The present study examined whether 'feeling fat' independently contributes to eating pathology and eating pathology-related impairment, over and above over-evaluation of weight and shape and dysphoria. University students (N = 990; 54.3% female) completed questionnaires measuring these constructs. Moderated multiple hierarchical regression analyses evaluated 'feeling fat''s unique contribution to eating pathology and impairment, and the moderating effects of gender and eating disorder symptom severity. 'Feeling fat' accounted for significant unique variance in eating pathology, but not eating pathology-related impairment, over and above over-evaluation of weight and shape and dysphoria. The relationship between 'feeling fat' and eating pathology-related impairment was stronger in women than in men. Symptom severity did not moderate the relationship between 'feeling fat' and either dependent variable. 'Feeling fat' distinctly relates to eating pathology in a sample of young adults, suggesting that 'feeling fat' deserves attention in individuals without eating disorders. Future research should longitudinally investigate the direction of the relationship between 'feeling fat' and eating pathology and examine mechanisms of gender differences in 'feeling fat.' [ABSTRACT FROM AUTHOR]

Treating anorexia nervosa is one of the greatest challenges faced by current health policies. This paper reflects on the social and cultural aspects of this type of eating disorder and proposes an intervention approach based on narrative therapy as a complement to existing treatments. This type of therapy requires a holistic and coordinated vision of the socio‐cultural and community aspects that surround both the person dealing with anorexia and their closest social circle of friends and family. The effects of anorexia, when it becomes the dominant voice in a person's narrative, need to be understood within a broader and more inclusive social context without putting all the responsibility on the person who is being bullied by anorexia. Based on the qualitative results of the Archive of Resistance presented by the Anti‐Anorexia League, narrative therapy is shown to have great potential for transforming the current approach to treating anorexia in English. This paper recommends use of the poststructuralist approach of narrative therapy to collaborate with the person affected by anorexia in Spanish‐speaking cultures. At the same time, it opens a discussion on the need to establish a document database, an Archive of Resistance, in Spanish, to help mitigate the effects of anorexia. [ABSTRACT FROM AUTHOR]

Background: Resilience research to date has been criticised for its consideration of resilience as a personal trait instead of a process, and for identifying individual factors related to resilience with no consideration of the ecological context. The overall aim of the current study was to explore the multi-level process through which adults recovering from EDs develop resilience, from the perspectives of clients and clinicians. The objective of this research was to outline the stages involved in the process of developing resilience, which might help to inform families and services in how best to support adults with EDs during their recovery. Method: Thirty participants (15 clients; 15 clinicians) took part in semi-structured interviews, and responded to questions relating to factors associated with resilience. Using an inductive approach, data were analysed using reflexive thematic analysis. Results: The overarching theme which described the process of developing resilience was 'Bouncing back to being me', which involved three stages: 'Who am I without my ED?', 'My eating disorder does not define me', and 'I no longer need my eating disorder'. Twenty sub-themes were identified as being involved in this resilience process, thirteen of which required multi-level involvement. Conclusion: This qualitative study provided a multi-level resilience framework for adults recovering from eating disorders, that is based on the experiences of adults with eating disorders and their treating clinicians. This framework provided empirical evidence that resilience is an ecological process involving an interaction between internal and external factors occurring between adults with eating disorder and their most immediate environments (i.e. family and social). Plain English summary: Anorexia nervosa, bulimia nervosa and binge-eating disorder demonstrate high rates of symptom persistence across time and poor prognosis for a significant proportion of individuals affected by these disorders, including health complications and increased risk of mortality. Many researchers have attempted to explore how to improve recovery outcomes for this population. Eating disorder experts have emphasised the need to focus not only on the weight indicators and eating behaviours that sustain the eating disorder during recovery, but also on the psychological well-being of the person recovering. One way to achieve this is to focus on resilience, which was identified as a fundamental aspect of eating disorder recovery in previous research. This study conceptualises resilience as a dynamic process that is influenced not only at a personal level but also through the environment in which the person lives. This study gathered data from adults with eating disorders and their treating clinicians, to devise a framework for resilience development for adults recovering from eating disorders. The paper discussed ways in which these findings and the framework identified can be easily implemented in clinical practice to facilitate a better understanding of eating disorder resilience and to enhance recovery outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Eating Disorders is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)