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PurposeMuscle dysmorphia is generally classified as a specific form of body dysmorphic disorder characterized by a pathological drive for muscularity and the preoccupation that one is too small or not sufficiently muscular. The majority of research on the condition has been conducted in cisgender men with a paucity of literature on gender minority people, a population that is at risk for muscle dysmorphia. One of the most widely used measures of muscle dysmorphia symptoms, the Muscle Dysmorphic Disorder Inventory (MDDI), has not been psychometrically validated for use in gender minority samples, the aim of the present study.MethodsWe evaluated the psychometric properties of the MDDI in a sample of 1031 gender-expansive individuals (gender minority people whose gender identity differs from that assumed for their sex assigned at birth and is not exclusively binary man or woman) aged 18-74 who were part of The PRIDE Study, a large-scale, U.S., longitudinal cohort study.ResultsUsing a two-step, split-sample exploratory and confirmatory factor analytic approach, we found support for the original three-factor structure of the measure. The subscales showed adequate internal consistency, and convergent validity was supported based on significant associations of the MDDI subscale scores with theoretically related scores on a widely used measure of disordered eating.ConclusionsThese findings provided novel support for adequate psychometric properties of the MDDI in a sample of gender-expansive individuals, facilitating the use of this measure in future research on muscle dysmorphia in this understudied and at-risk population.

BackgroundRepresenting the pathological extreme pursuit of muscularity, muscle dysmorphia (MD) is characterized by a pervasive belief or fear around insufficient muscularity and an elevated drive for muscularity. Despite evidence of elevated body image-related concerns among sexual minority populations, little is known about the degree of muscle dysmorphia (MD) symptoms among sexual minorities, particularly based on Muscle Dysmorphic Disorder Inventory (MDDI) scores. The objective of this study was to examine the nature and severity of MD symptoms in cisgender sexual minority men and women and provide community norms of the MDDI for these populations.MethodsData from participants in The PRIDE Study, an existing study of health outcomes in sexual and gender minority people from the United States, were examined. Participants included cisgender gay men (N = 1090), cisgender bisexual plus (bisexual, pansexual, and/or polysexual) men (N = 100), cisgender lesbian women (N = 563), and cisgender bisexual plus women (N = 507). We calculated means, standard deviations (SD), and percentiles for the MDDI total and subscale scores for cisgender sexual minority men and women. We compared MDDI scores by sexual orientation using linear regression models, both unadjusted and adjusted for sociodemographics.ResultsOverall, the sample was 85.2% White, 3.0% Asian or Pacific Islander, 2.0% Black, 0.5% Native American, 3.9% multiracial, and 6.6% Hispanic/Latino/a. The mean age was 38.6 (SD = 14.3) and 69.4% had a college degree or higher. Means (SD) for the MDDI total score were 27.4 (7.7) for cisgender gay men, 26.4 (6.4) for cisgender bisexual plus men, 24.3 (6.1) for cisgender lesbian women, and 24.6 (5.5) for cisgender bisexual plus women. There were no significant differences in MDDI scores between cisgender gay and bisexual plus men, or between cisgender lesbian women and bisexual plus women in unadjusted or adjusted models.ConclusionsThese normative data provide insights into the experience of MD symptoms among cisgender sexual minority men and women and can aid researchers and clinicians in the evaluation of MD symptoms and interpretation of MDDI scores in sexual minority populations.

Despite increasing empirical interest in muscle dysmorphia (MD), a dearth of research has assessed this construct in sexual minority populations. In particular, the psychometric properties of one of the most widely used measures of MD symptoms-the Muscle Dysmorphic Disorder Inventory (MDDI)-have not been evaluated in sexual minority populations despite emerging evidence suggesting differential risk for MD symptoms across sexual orientation groups. In this study, we assessed the psychometric properties of the MDDI in a sample of 715 cisgender gay men and 404 cisgender lesbian women ages 18-50 years who participated in a large-scale national longitudinal cohort study of sexual and gender minority adults. The factor structure of the MDDI was examined in each sample using a two-step, split-sample exploratory and confirmatory factor analytic approach. Exploratory factor analysis supported a three-factor structure in both samples, which were confirmed by confirmatory factor analysis. Moreover, results supported the internal consistency reliability and convergent validity of the MDDI subscales in both samples. Cumulatively, these findings suggest that the MDDI is an appropriate measure of MD symptoms among cisgender gay men and cisgender lesbian women.

ObjectiveAnorexia 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.Method216 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.DiscussionNo 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.

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]

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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]