Search

Background: Pregnancy can be experienced as a significant transition for many women with associated body dissatisfaction, depression, pregnancy-related anxiety, and disordered eating attitudes. Problematic Social Media Use (PSMU) creates abundant opportunities for women to compare themselves with others and expose themselves to sociocultural influences which may increase body dissatisfaction and psychological distress., Aims: This study examined whether the relationship between PSMU and psychological distress (defined as depression, pregnancy-related anxiety and disordered eating attitudes) was mediated by negative social comparisons and body dissatisfaction., Method: A sample of 225 pregnant Australian women (M age  = 31.91 years, SD age  = 4.39) recruited online, completed self-report measures related to the variables of interest., Results: PSMU was associated with higher levels of depression, pregnancy-related anxiety, and disordered eating attitudes. Negative social comparisons and body dissatisfaction partially mediated the relationship between PSMU and pregnancy-related anxiety and depression, and fully mediated the relationship between PSMU and disordered eating attitudes., Limitations: Cross-sectional nature of the study limited our ability to determine the direction of the relationships. Moreover, the recruitment method via social media led to high rates of non-completion., Conclusion: The findings of this study suggest that problematic social media usage during pregnancy may increase depression, pregnancy-related anxiety and disordered eating attitudes. This study identified potential pathways that may explain this relationship, (via social comparisons and body dissatisfaction). This study highlights the potentially negative impact of social media use amongst expectant mothers and the importance of screening for body dissatisfaction in routine antenatal care., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background and Aim: Recent studies have shown that up to 53% of patients with inflammatory bowel disease [IBD] screen positive for avoidant/restrictive food intake disorder [ARFID]. There is however concern that ARFID screening rates are over-inflated in patients with active disease. We aimed to evaluate the frequency and characteristics of ARFID symptoms using the Nine Item ARFID Screen [NIAS], and to use another eating disorder measure, the Eating Disorder Examination-Questionnaire 8 [EDE-Q8], to rule-out/characterise other eating disorder cognitive and behavioural symptoms., Methods: Participants included adults with UC who are enrolled in an ongoing cohort study with quiescent UC (Simple Clinical Colitis Activity Index [SCCAI] ≤2 or faecal calprotectin <150 µg/g with corticosteroid-free clinical remission for ≥3 months) at baseline. We used self-reported data on demographics, gastrointestinal medications, medical comorbidities, NIAS scores, and EDE-Q-8 scores., Results: We included 101 participants who completed the NIAS at their baseline cohort assessment [age 49.9 ± 16.5 years; 55% female]. Eleven participants [11%] screened positively for ARFID on at least one NIAS subscale [n = 8 male]. Up to 30 participants [30%] screened positive for other eating disorder symptoms [EDE-Q-8 Global ≥2.3]. Overall score distributions on the EDE-Q-8 showed that participants scored highest on the Weight Concern and Shape Concern subscales., Conclusions: Among adults with UC in remission, we found a low rate of ARFID symptoms by the NIAS but a high rate of positive screens for other eating disorder symptoms., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This study examined a set of background psychological and other variables of orthorexic (ON) tendency in a sample of young women with special interest in healthy lifestyle. The sample consisted of female young adults ( N  = 310; aged 18-35 years; mean age = 24.3 years; SD = 4.97 years) who were recruited through social media health sites. Besides Orthorexia Nervosa Questionnaire (ORTO‑15), BMI, regular sporting activity, the following scales were used: Eating Disorder Inventory (EDI, drive for thinness, ineffectiveness and maturity fears); Bergen Social Media Addiction Scale (BSMAS); and The Proactive Coping Inventory. In this sample, 37.7% were at risk for ON. Eating disorder attitudes, regular sporting and social media addiction were the most relevant predictors of orthorexic tendency with drive for thinness being the strongest contributor (β = 0.54, p  < 0.001). For young women with a special interest in healthy lifestyle, drive for thinness together with regular sporting, ON tendency may serve as a tool for achieving their goal. Social media addiction and other psychological problems (feeling of ineffectiveness or maturity fears) can also contribute to orthorexic rendency. It would be important to ask for support from qualified health professionals when changing nutritional practices.

Purpose: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. A positive association between ADHD and obesity has been observed, especially in adult samples. In this study, prevalence and correlates of self-reported symptoms indicative of a positive screening for ADHD were examined in patients seeking bariatric treatment., Material and Methods: The study sample was composed of 260 adult patients with obesity referred for bariatric surgery to the Obesity Center of the Endocrinology Unit in Pisa University Hospital between January 2006 and November 2016 (BMI ≥ 30 kg/m 2 ; mean ± standard deviation = 46.27 ± 7.45 kg/m 2 ). ADHD symptoms were identified using ADHD Symptom Check-List-90-R Screening Scale. Night-eating, binge-eating/purging behaviors, and temperamental and character traits were assessed in a subsample of 95 patients., Results: Thirty participants had a positive screening for ADHD (11.5%, 95% CI = 7.9-16.1%). Patients with a positive screening showed significantly higher rates of anxiety disorders (40% vs. 16.5%, χ 2  = 7.97, p = 0.005) panic disorder (40% vs. 14.3%, χ 2  = 10.48, p = 0.001), and a higher severity of psychopathological symptoms and sleep disturbances than those without. In subsample analyses, ADHD symptoms severity was associated with more bulimic behaviors (r = 0.31-0.46), greater harm avoidance (r = 0.45-0.66), less self-directedness (r =  - 0.44-0.63), and cooperativeness (r =  - 0.26-0.42)., Conclusion: ADHD symptoms may be common in patients with obesity seeking bariatric treatment and are positively associated with disordered eating, internalizing features, and maladaptive character traits., Level of Evidence: V, cross sectional descriptive study., (© 2024. The Author(s).)

Importance: Hospitalizations for eating disorders rose dramatically during the COVID-19 pandemic. Public health restrictions, or stringency, are believed to have played a role in exacerbating eating disorders. Few studies of eating disorders during the pandemic have extended to the period when public health stringency restrictions were lifted., Objective: To assess the association between hospitalization rates for eating disorders and public health stringency during the COVID-19 pandemic and after the easing of public health restrictions., Design, Setting, and Participants: This Canadian population-based cross-sectional study was performed from April 1, 2016, to March 31, 2023, and was divided into pre-COVID-19 and COVID-19-prevalent periods. Data were provided by the Canadian Institute for Health Information and the Institut National d'Excellence en Santé et Services Sociaux for all Canadian provinces and territories. Participants included all children and adolescents aged 6 to 20 years., Exposure: The exposure was public health stringency, as measured by the Bank of Canada stringency index., Main Outcomes and Measures: The primary outcome was hospitalizations for a primary diagnosis of eating disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code F50), stratified by region, age group, and sex. Interrupted time series analyses based on Poisson regression were used to estimate the association between the stringency index and the rate of hospitalizations for eating disorders., Results: During the study period, there were 11 289 hospitalizations for eating disorders across Canada, of which 8726 hospitalizations (77%) were for females aged 12 to 17 years. Due to low case counts in other age-sex strata, the time series analysis was limited to females within the 12- to 17-year age range. Among females aged 12 to 17 years, a 10% increase in stringency was associated with a significant increase in hospitalization rates in Quebec (adjusted rate ratio [ARR], 1.05; 95% CI, 1.01-1.07), Ontario (ARR, 1.05; 95% CI, 1.03-1.07), the Prairies (ARR, 1.08; 95% CI, 1.03-1.13), and British Columbia (ARR, 1.11; 95% CI, 1.05-1.16). The excess COVID-19-prevalent period hospitalizations were highest at the 1-year mark, with increases in all regions: Quebec (RR, 2.17), Ontario (RR, 2.44), the Prairies (RR, 2.39), and British Columbia (RR, 2.02)., Conclusion and Relevance: In this cross-sectional study of hospitalizations for eating disorders across Canada, hospitalization rates for eating disorders in females aged 12 to 17 years were associated with public health measure stringency. The findings suggest that future pandemic preparedness should consider implications for youths at risk for eating disorders and their resource and support needs.

Background: This study aimed to describe the nutrition knowledge, food security risk and eating disorder risk of development male rugby league players., Methods: Sixty athletes from one Australian professional rugby league club volunteered. A cross sectional online survey questionnaire consisted of three sections (Eating Disorders Inventory (EDI-3), Nutrition Knowledge and Food Security). All athletes completed the online survey without assistance using a personal electronic device., Results: The mean total knowledge score was 65.7±13.1%. There was a positive relationship between age and knowledge score, P=0.050, r 2 =0.06. The majority of players had breakfast everyday (N.=45, 73.8%), took pack lunches (N.=33, 55.0%), and had homemade evening meals (N.=55, 91.7%). The majority of players ate more than 1 hour before training (N.=45, 75%) and all players (n=60, 100%) ate within half an hour of training finishing. The majority of participants agreed that nutrition could influence physical and cognitive aspects of nutrition however, skill-based activities were perceived by fewer participants to be influenced by nutrition. The majority (N.=38, 63.3%) had high food security, six (10.0%) had marginal food security, whereas 10 (16.7%) and six (10.0%) had low and very low security respectively., Conclusions: These results show a concerning levels of eating disorder risk, food insecurity and poor nutrition knowledge amongst male development rugby league players. However, it does show that they believe nutrition can impact their health and performance, and they do mostly appear to adhere to the nutrition principals for optimising health and performance.

Purpose: Migrants may have elevated exposure to stressors, which can affect their physical and mental well-being. However, migrants often experience a healthy immigrant effect, the applicability of this phenomena to eating disorders is unknown. We aimed to synthesize the available literature and estimate a summary measure of prevalence odds ratio for eating disorders in migrant populations compared to local populations., Methods: A literature search was conducted using MEDLINE, Embase, PsycINFO, and Web of Science with keywords on migration and eating disorders. Inclusion criteria involved using a validated eating disorder scale and having a comparator group. Two independent reviewers performed study screening and data extraction. The NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess risk of bias. Random-effects models of meta-analysis were applied to compare eating disorder prevalence between migrants and local populations., Results: There were 10 studies included in our review (meta-analysis = 6, narrative synthesis = 4). Studies provided prevalence estimates for: any eating disorder, binge eating disorder, anorexia nervosa, and bulimia nervosa. Among studies with a diagnostic instrument, the pooled prevalence odds ratio (POR) between migrants and local populations for any eating disorder was 0.45 (95%CI: 0.35-0.59). However, a subgroup analysis of eating disorder instruments among studies using risk assessment tools demonstrated inconsistent findings, with both increases and decreases in prevalence., Conclusion: Migrants were found to have a lower prevalence of eating disorders compared to local populations, supporting the healthy immigrant hypothesis. However, this effect differs between diagnostic and risk assessment tools., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

An emerging body of research has evidenced the negative influence of using and being exposed to social networking sites (SNSs) on body image. Furthermore, it has been postulated that SNS use might be related with onset and persistence of eating disorders (EDs) psychopathology. The aim of the present study is to evaluate the complex interplay between problematic Instagram use (PIU) (conceptualized as a potential behavioral addiction comprising withdrawal, conflict, tolerance, salience, mood modification and relapse) and ED psychopathology, by means of an explanatory structural equation model. We hypothesized that PIU would be associated with ED symptoms through the mediating role of appearance comparison, individual psychological investment in physical appearance, and body uneasiness. A sample of 386 young female participants (M age  = 26.04 ± 6.73) was recruited, of which 152 had received a diagnosis of ED. ED patients used Instagram more than the control group and showed higher levels of PIU. Results from structural equation modeling (fit indices: χ 2  = 44.54, df = 19, p < 0.001; RMSEA = 0.059; CFI = 0.98; SRMR = 0.02) showed that PIU predicted appearance comparison and psychological investment in physical appearance, which in turn predicted body uneasiness. In turn, body uneasiness predicted ED psychopathology and interpersonal difficulties. Our model provides a useful account of how eating disorder symptoms could be triggered and maintained by an addictive use of Instagram., (© 2023. The Author(s).)

Background: Personality traits have been associated with eating disorders (EDs) and comorbidities. However, it is unclear which personality profiles are premorbid risk rather than diagnostic markers., Methods: We explored associations between personality and ED-related mental health symptoms using canonical correlation analyses. We investigated personality risk profiles in a longitudinal sample, associating personality at age 14 with onset of mental health symptoms at ages 16 or 19. Diagnostic markers were identified in a sample of young adults with anorexia nervosa (AN, n = 58) or bulimia nervosa (BN, n = 63) and healthy controls (n = 47)., Results: Two significant premorbid risk profiles were identified, successively explaining 7.93 % and 5.60 % of shared variance (R c 2 ). The first combined neuroticism (canonical loading, r s  = 0.68), openness (r s  = 0.32), impulsivity (r s  = 0.29), and conscientiousness (r s  = 0.27), with future onset of anxiety symptoms (r s  = 0.87) and dieting (r s  = 0.58). The other, combined lower agreeableness (r s  = -0.60) and lower anxiety sensitivity (r s  = -0.47), with future deliberate self-harm (r s  = 0.76) and purging (r s  = 0.55). Personality profiles associated with "core psychopathology" in both AN (R c 2  = 80.56 %) and BN diagnoses (R c 2  = 64.38 %) comprised hopelessness (r s  = 0.95, 0.87) and neuroticism (r s  = 0.93, 0.94). For BN, this profile also included impulsivity (r s  = 0.60). Additionally, extraversion (r s  = 0.41) was associated with lower depressive risk in BN., Limitations: The samples were not ethnically diverse. The clinical cohort included only females. There was non-random attrition in the longitudinal sample., Conclusions: The results suggest neuroticism and impulsivity as risk and diagnostic markers for EDs, with neuroticism and hopelessness as shared diagnostic markers. They may inform the design of more personalised prevention and intervention strategies., Competing Interests: Declaration of competing interest Dr. Banaschewski served in an advisory or consultancy role for ADHS digital, Infectopharm, Lundbeck, Medice, Neurim Pharmaceuticals, Oberberg GmbH, Roche, and Takeda. He received conference support or speaker's fee by Medice and Takeda. He received royalties from Hogrefe, Kohlhammer, CIP Medien, Oxford University Press. Dr. Poustka served in an advisory or consultancy role for Roche and Viforpharm and received speaker's fee by Shire. She received royalties from Hogrefe, Kohlhammer and Schattauer. The present work is unrelated to these relationships. The other authors report no biomedical financial interests or potential conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Competing Interests: Competing interests: I have read and understood BMJ policy on declaration of interests and have no interests to declare. Patient consent: Not required (patient anonymised or hypothetical).

Eating disorders are common disorders that cause significant suffering and functional impairment for those affected. They often emerge in adolescence and can go undetected for many years before an individual presents to services. Early diagnosis and treatment have been shown to significantly improve the prognosis, highlighting the need for proactive screening. This study compared the frequency of self-reported eating disorder symptoms in (n = 2137) outpatients at the Child and Adolescent Psychiatry Clinic (BUP) in Region Västmanland, Sweden between 2018 and 2022. The results showed that the proportion of young people reporting frequent eating disorder symptoms increased from 16% to 28% over this time period. This result is in line with previous research describing an increase in the prevalence of eating disorder symptoms among different groups in relation to the Covid-19 pandemic. It underscores the importance of screening for eating disorder symptoms to better address care needs.

Extensive knowledge on nutrition and dieting has been associated with an increased risk of orthorexia (an obsession with food that one considers healthy) within the research literature. A systematic review was conducted to identify the prevalence of orthorexia in individuals who were employed in, or studying, health careers. The databases Psychinfo and Pubmed were searched to obtain research articles. Studies assessing orthorexia and either students or workers within health-related fields were included. A study merit rating system was utilised to assess the quality of each study included. In total, 26 articles were included in the current review after applying inclusion and exclusion criteria. The prevalence of orthorexia was the greatest in dietetic students. Research findings consistently demonstrated that the prevalence of orthorexia was higher in those working or studying in health fields than the general population. Individuals in their early stages of study or career appear most at risk. Orthorexia prevalence, however, does not appear to differ by sex or BMI. Orthorexia is novel research area. The trends in the current review suggest that individuals in health-related careers appear to be more at risk of orthorexic patterns. More research in this area is needed through the use of scales with greater psychometric properties.

Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric comorbidities, including eating disorders (EDs). We aimed to investigate the potential association between key disease characteristics, including psychological features, and the development of EDs in a clinical sample of adolescents with IBDs. We enrolled 52 adolescents with IBDs, 83% of whom were in clinical remission, and systematically collected additional information on disease duration, the total number of relapses, the use of steroids, and the number of hospital admissions. All participants completed a validated psychometric battery assessing psychological symptoms (Symptom Checklist-90-Revised, SCL-90-R), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and ED symptomatology (Eating Disorders Inventory-3rd edition, EDI-3). About one in ten patients (9.6%) reported Eating Disorder Risk scores higher than the cut-off on the EDI-3 subscale, specifically addressing the risk of developing EDs. According to the EDI-3 scores, the risk of developing EDs directly correlated with the number of total relapses of IBDs ( p < 0.05). The TAS-total scores also correlated with the number of total relapses ( p < 0.01), as well as with the number of steroid cycles ( p < 0.05), the number of hospital admissions ( p < 0.05), and overall disease duration ( p < 0.05). Our findings suggest that disease relapses increase the risk of developing both EDs and alexithymia in adolescents with IBDs. The recurrence of disease relapses should be identified and screened early on to prevent the onset of psychiatric disorders, including EDs. Research should be conducted on larger samples with different IBD phenotypes to further investigate the characteristics of patients with IBDs at risk of developing EDs.

Background: Psychopathological disorders are often comorbid diagnosis in eating disorders (EDs). We aimed to assess the presence of psychopathological traits and symptoms associated with EDs in an Italian high school adolescent population., Methods: A sample of high school adolescents was enrolled, and demographic and clinical data were collected. Two self-report questionnaires, the Eating Disorder Inventory-3 (EDI-3) and the Questionnaire for the Assessment of Psychopathology in Adolescence (Q-PAD), were administered., Results: 548 adolescents (333 F/215 M; 16.89 ± 0.85 years) were included. Symptoms associated with EDs of clinical or high clinical concern were prevalent in a range of individuals, with percentages varying from 26.82% for body dissatisfaction to 51.83% for Interoceptive Deficits. The findings from the Q-PAD assessment indicated the presence of psychological distress, leading to discomfort or challenging situations requiring potential intervention in a percentage of adolescents ranging from 2.93% for psychosocial risks to 23.77% for anxiety. These percentages showed differences between genders (F > M, p < 0.001). Our study also highlighted an association between symptoms of EDs and lifestyle factors within families. We observed correlations between Q-PAD measures and EDI-3 scores, including a positive correlation between Q-PAD and EDI-3 body dissatisfaction (r = 0.7), Q-PAD interpersonal conflicts and EDI-3 interpersonal problems (r = 0.6) and a negative correlation between Q-PAD self-esteem and well-being and EDI-3 ineffectiveness Composite (r=-0.7)., Conclusions: a substantial prevalence of ED symptoms and psychological distress among high school adolescents were recorded. These conditions are interrelated, suggesting the importance of addressing them comprehensively. Early detection is essential to improve treatment outcomes and to implement preventive strategies., (© 2024. The Author(s).)

Background: Evidence assessing the relationship between chronotype and disordered eating in adolescents is scarce. The current study tried to evaluate the association between chronotype and disordered eating in a sample of Spanish adolescents., Methods: This secondary cross-sectional study analyzed data from the Eating Healthy and Daily Life Activities (EHDLA) study. The sample consisted of 703 adolescents (56.3% girls) aged between 12 and 17 years from the Valle de Ricote (Region of Murcia, Spain). Chronotype was assessed using the Morningness/Eveningness Scale in Children (MESC). Disordered eating was evaluated by two psychologists using the Sick, Control, One, Fat, and Food (SCOFF) questionnaire., Results: Adolescents with an eveningness chronotype showed a higher SCOFF score (estimated marginal mean [ M ] = 1.1; 95% confidence interval [CI] 0.7 to 1.5) in comparison with adolescents with a morningness chronotype ( M = 0.7; 95% CI 0.5 to 0.8) ( p = 0.010), as well as with those with an intermediate chronotype ( M = 0.6; 95% CI 0.5 to 0.8) ( p = 0.032). A higher predictive probability of having disordered eating was identified in adolescents with an eveningness chronotype (39.5%; 95% CI 22.8% to 59.1%), compared to adolescents with an intermediate chronotype (14.9%; 95% CI 10.8% to 20.1%) ( p = 0.008) and with their counterparts with a morningness chronotype (16.9%; 95% CI 11.6% to 24.0%) ( p = 0.021)., Conclusions: This study reveals that adolescents with an eveningness chronotype are more likely to exhibit disordered eating behaviors compared to those with morningness or intermediate chronotypes. These findings highlight the importance of considering chronotype in adolescent health, particularly in developing targeted interventions to prevent eating disorders.

Although previous research has linked disordered eating to physical activity involvement, more recent studies suggest that sports participation may be protective against disordered eating; however, due to inconsistent findings on how physical activity affects disordered eating and limited research comparing types of physical activity across weight control behaviours, our aim was to validate physical activity categorization across disordered eating components in both men and women. In this online study, 209 men and 539 women completed questionnaires assessing various components of disordered eating and overall physical activity participation. Pearson correlation coefficients, independent samples t-tests, multiple response crosstabulations, and linear regressions were calculated to achieve the aims of this study. Participation in various types of physical activity significantly predicted various components of disordered eating attitudes, behaviours, and cognitions. Specifically, for women, purging and restricting eating were associated with participation in ball games, while a focus on muscle building was associated with both ball games and weight-class physical activity. For men, body dissatisfaction and excessive exercise were associated with weight-class physical activity participation, while cognitive restraint and muscle building were related to aesthetic sports participation. Purging was associated with both aesthetic and weight-class physical activity, whereas restricting eating was related to weight-class physical activity and ball games. These inconsistencies underscore the need for further research to fully elucidate the relationship between participation in different types of physical activity and the various components of disordered eating., (© 2024. The Author(s).)

Background: Deteriorated eating attitudes have emerged as a prominent psychiatric illness with increasing prevalence in industrialized societies. This research endeavors to investigate the relationships between deteriorated eating patterns and mental health among Saudi high school students after the COVID-19 outbreak., Methods: A sample of 2817 students from two high schools in Jeddah, Saudi Arabia, completed a questionnaire about their demographic characteristics and symptoms of anxiety (GAD-7), depression (PHQ-9), and deteriorated eating patterns (Eating Attitudes Test 26) via convenience sampling technique. Multiple regression analysis was carried out to predict the potential associations between deteriorated eating patterns and levels of anxiety and depression among the study participants., Results: The findings demonstrated a moderate and statistically significant correlation between deteriorated eating patterns and levels of anxiety and depression among the participants in the study. In evaluating the three dimensions of deteriorated eating patterns through regression analysis, it is observed that dieting (anxiety: β = 0.275, depression: β = 0.287) exhibits the highest potential in predicting the levels of anxiety and depression, followed by oral control (anxiety: β = 0.240, depression: β = 0.232) and bulimia & food preoccupation (anxiety: β = 0.218, depression: β = 0.186)., Conclusions: The findings highlight the necessity to place additional emphasis on students displaying deteriorated eating patterns and symptoms, as these individuals may potentially be experiencing accompanying mental health concerns warranting further assessment., (© 2024. The Author(s).)

Introduction: The popularity of vegetarian and vegan diets is linked to various motivations, such as health, ethics, ecology, and social and religious influence. India has the highest proportion of vegetarians and vegans. The practise of these diets is linked to moral and health reasons and environmental concerns. Vegetarianism may also be associated with eating disorders such as orthorexia (ON)., Aim: The main aim of this study was to determine the psychosocial aspects of vegetarian diets. Understanding these aspects is crucial for identifying potential risks and developing effective interventions. This study investigated the reasons for following vegetarian diets, the duration of dietary adherence, the occurrence of feelings of restriction in selected situations, and the risk of orthorexia and other eating disorders., Methods: A questionnaire survey was conducted among 186 individuals (82 vegetarians and 104 traditional dieters) between October 2023 and April 2024. The survey was administered via a Computer-Assisted Web Interview (CAWI) using Google Forms, distributed through social media, forums, and private messages. The inclusion criteria for the study group included consent, an age over 18, and a vegetarian diet, excluding those with eating disorders or diseases requiring strict diet therapy. The control group criteria were similar, excluding vegetarians and those requiring special diets. Four unreliable questionnaires were excluded from the analysis. The survey consisted of four sections: metric data, the ORTO-15 questionnaire, the EAT-26 questionnaire, and the TFEQ-13 questionnaire., Results: The main motivations for following vegetarian diets were ethical and environmental (86.9%) and health (32.1%) reasons. Over half of the vegetarians had been following a plant-based diet for over five years. Vegetarians were more likely to feel restricted in restaurants and when grocery shopping. The ORTO-15 results indicate a higher risk of orthorexia among vegetarians (48.8% vs. 29.4% in the control group; p = 0.00673). The EAT-26 questionnaire showed a higher, but not statistically significant, risk of eating disorders among vegetarians (23.8% vs. 14.7%; p = 0.11391). The TFEQ-13 showed no significant differences between groups (Subscale 1: food restriction, p = 0.77279; Subscale 2: lack of control in overeating, p = 0.91935; Subscale 3: eating under the influence of emotions, p = 0.16612)., Conclusions: This study concluded that ethical and environmental considerations and a belief in health benefits mainly drive vegetarians. An analysis of BMI revealed no significant differences between groups. The ORTO-15 results suggest a higher risk of orthorexia among vegetarians. The EAT-26 indicated a higher, but not statistically significant, risk of eating disorders among vegetarians and vegans. The TFEQ-13 showed no significant differences in restrictive eating, lack of control in overeating, and emotional eating. Vegetarians were likelier to encounter dietary difficulties in restaurants and shopping but less likely to feel socially excluded.

Competing Interests: We declare no competing interests.

Background: Although studies have suggested a high risk of suicide in people with eating disorders, most studies have focused on suicidal ideation and attempts. There is little research on the characteristics of people with eating disorders who died by suicide, nor investigation of trends over time. We aimed to compare the characteristics of patients with eating disorders who died by suicide versus patients with other mental health diagnoses who died by suicide in England and to examine the trends in rates., Methods: In this national retrospective cohort study, data on all people (aged ≥10 years) who died by suicide in England, UK, between Jan 1, 1997, and Dec 31, 2021, while under the care (within the previous 12 months) of mental health services were obtained from the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), in which clinical information is collected via a questionnaire completed by the mental health professional responsible for the patient's care. Incidence of suicide in, and demographic, clinical, and treatment characteristics of, patients with a diagnosis of eating disorder (as recorded by the treating clinician) who died by suicide were compared with patients with other mental health diagnoses who died by suicide within the same timeframe using univariable logistic regression analysis. People with related lived experience were involved in the study design, implementation, interpretation, and writing of the manuscript., Findings: Of 119 446 people for whom NCISH were notified of dying by suicide in England, 30 795 were under the recent care of mental health services, of whom 30 246 had known diagnoses and were included in analyses. Of these individuals, 10 373 (34%) were female and 19 873 (66%) were male; 2236 (8%) were of minority ethnicity; 382 (1%) had a diagnosis of eating disorder and 29 864 (99%) had another mental health diagnosis. Compared with patients with other mental health diagnoses who died by suicide, patients with eating disorders were younger (median age 33 years [range 15-90] vs 45 years [10-100]), more often female (343 [90%] female and 39 [10%] male in the eating disorders group; 10 030 [34%] female and 19 834 [66%] male in the other diagnoses group), and less likely to have evidence of conventional risk factors for suicide such as living alone (odds ratio [OR] 0·68, 95% CI 0·55-0·84). 22 (6%) of 382 were from a minority ethnic group. Patients with an eating disorder were characterised by a greater clinical complexity (eg, self-harm [OR 2·31, 95% CI 1·78-3·00], comorbidity [9·79, 6·81-14·1], and longer duration of illness [1·95, 1·56-2·43]), and were more likely to have died following overdoses (2·00, 1·62-2·45) than patients with other diagnoses. Childhood abuse (52 [37%] of 140) and domestic violence (18 [20%] of 91) were common in patients with eating disorders. Similar to patients with other diagnoses, most (244 [75%] of 326) of those with eating disorders who died by suicide were rated as low risk by clinicians at last contact. The number of suicide deaths in patients with eating disorders rose between 1997 and 2021 (incidence rate ratio [IRR] 1·03, 95% CI 1·02-1·05; p<0·0001), but rates fell when accounting for the greater number of patients entering mental health services (IRR 0·97, 0·95-1·00; p=0·033)., Interpretation: This study was focused on people who sought help from mental health services. It did not consider subtypes of eating disorders or include a control group, but it does highlight possible areas for intervention. The comprehensive provision of evidence-based treatment for eating disorders and underlying conditions to address the clinical complexity in these patients might help to reduce suicide. Recognising limitations in clinical risk assessment, addressing early life experiences and current adversities, and appropriate prescribing might also be of benefit. Suicide prevention must remain a priority for eating disorder services and mental health care more widely., Funding: The Healthcare Quality Improvement Partnership., Competing Interests: Declaration of interests NK works with NHS England on national quality-improvement initiatives for suicide and self-harm; is on the Department of Health and Social Care (DHSC) National Suicide Prevention Strategy Advisory Group for England; chaired the guideline development group for the 2012 UK National Institute for Health and Clinical Excellence (NICE) guidelines on the longer-term management of self-harm; chaired the guideline development group for the 2022 NICE guideline on depression in adults; and was a topic advisor for the 2022 NICE guideline Self-Harm: Assessment, Management and Preventing Recurrence. LA is Chair of the DHSC National Suicide Prevention Strategy Advisory Group. NK, LA, and PT report grants from the Healthcare Quality Improvement Partnership, NHS England, the Department for Education, and the Medical Research Council. PT reports a grant from the Gambling Research Exchange Ontario. All other authors declare no competing interests., (Copyright Crown Copyright © 2024 Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.)

Although childhood trauma and posttraumatic stress disorder (PTSD) have been well-researched in eating disorder epidemiology, prevalence rates are unavailable for complex PTSD (CPTSD). Under recently introduced ICD-11 criteria, individuals with CPTSD have both PTSD symptoms and additional disturbances in self-organization (DSO). Using ICD-11 criteria, this study aimed to determine the prevalence of PTSD and DSO symptoms, diagnostic rates of PTSD and CPTSD, and childhood trauma exposure in eating disorder treatment-seekers. Participants (N = 217) were individuals attending residential, partial hospitalization, and outpatient services who completed measures of eating disorder- and trauma-related symptoms and childhood adverse experiences. One third of participants reported PTSD symptoms, and over half reported DSO symptoms, with probable ICD-11 diagnostic rates of 3.8% for PTSD and 28.4% for CPTSD. CPTSD was significantly more prevalent than PTSD and more common in higher levels of care. Both PTSD and DSO symptom severity were positively correlated with eating disorder symptoms and impairment, rs = .285-.642. DSO symptom severity was a significant and unique explanatory factor of eating disorder severity and impairment. The findings highlight the prevalence of CPTSD in eating disorder populations and the association between DSO symptoms and eating psychopathology independent of PTSD symptoms. Implications are discussed for adjunct treatment approaches for individuals with comorbid eating disorders and PTSD or CPTSD., (© 2024 The Authors. Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for Traumatic Stress Studies.)

This study aimed to describe the frequency of dieting practices among adolescents and young adults in Canada, as well as determine the association between dieting and eating disorder attitudes and behaviors. Data from 2762 Canadian adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Frequencies were used to determine the prevalence of 11 different diets among the sample, and chi-square tests were used to assess gender differences. Multiple modified Poisson and linear regression analyses were conducted to determine the associations between any dieting and eating disorder attitudes and behaviors. Among the sample, 15.7 % of girls and women, 10.4 % of boys and men, and 13.0 % of transgender/gender expansive (TGE) participants reported any dieting in the past 12 months, with the Ketogenic diet being most common among all genders. Results from regression analyses showed that engaging in any dieting in the past 12 months was associated with greater eating disorder psychopathology among girls, women, boys, and men, but not TGE participants. There were varying trends in association between specific types of dieting practices and eating disorder behaviors among girls, women, boys, and men. Dieting is relatively common among a national sample of Canadian adolescents and young adults, and engagement is associated with greater eating disorder psychopathology and behaviors. Healthcare and public health professionals should consider screening for eating disorders among adolescents and young adults who report engaging in dieting practices., Competing Interests: Declaration of competing interest All authors report no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: COVID-19 saw an increase in child mental health presentations internationally. Clinicians analogised the exponential increase in anorexia nervosa to a 'tsunami' or 'outbreak', raising parallel concerns regarding medical and psychological risks (Marsh in The Guardian, 2021; Leask in NZ Herald, 2021; Monteleone et al. in Eat Weight Disord 26(8):2443-2452, 2021) . It is unclear whether Ireland emulated this picture of increased referrals with increased medical compromise., Aims: This paper examines both rates and clinical profiles of child eating disorder presentations in the Republic of Ireland (ROI), across different clinical settings., Methods: Following ethical approval, retrospective chart reviews were conducted in a community eating disorder service and in two paediatric hospital settings. The time frame of the different studies ranged from January 2016 to December 2022., Results: Community eating disorder services saw significantly higher referral rates post COVID-19 (3.78/month vs. 2.31/month, p = 0.02), with a shorter duration of illness (4.8 months vs. 7.4 months, p = 0.001), but no significant difference in ideal body weight % (IBW%) at referral (85.32% vs. 83.7%, p = 0.1). Both paediatric hospitals witnessed significantly increased referrals post-COVID-19 (hospital 1; 4.38/month vs. 1.93/month, p = 0.0001; hospital 2; 2.8/month vs. 0.92/month, p < 0.0001), but no significant difference in IBW% at assessment (hospital 1; 82.7% vs. 81.39%, p = 0.673; hospital 2; 81.5% vs. 83%, p = 0.563). There was no significant difference in clinical profile, management, or duration of hospital stay., Conclusions: This study supports the growing consensus of a pandemic specific increase in eating disorder referrals to both medical and psychiatry services. However, there was little to indicate a change in clinical profile or severity. Ongoing monitoring of referrals is necessary to ensure adequate service availability and expertise., (© 2024. The Author(s).)

Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13-16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males., (© 2024. The Author(s).)

Objective: Despite unique experiences that may increase eating disorder risk, U.S. military service members are an understudied population. The current study examined incidence and prevalence of eating disorder diagnoses in U.S. military personnel., Method: This retrospective cohort study utilized Military Health System Data Repository (MDR) data on eating disorder diagnoses (2016-2021). Active duty, Reserve, and National Guard U.S. military service members who received care via TRICARE Prime insurance were identified by ICD-10 eating disorder diagnostic codes., Results: During the 6-year surveillance period, 5189 Service members received incident eating disorders diagnoses, with a crude overall incidence rate of 6.2 cases per 10,000 person-years. The most common diagnosis was other/unspecified specified eating disorders, followed by binge-eating disorder, bulimia nervosa, and anorexia nervosa. There was an 18.5% overall rise in total incident cases across the surveillance period, but this trend was not statistically significant (p = 0.09). Point prevalence significantly increased across the 6-year timeframe for total eating disorders (p < 0.001). Period prevalence for 6-year surveillance period was 0.244% for total eating disorders, 0.149% for other/unspecified eating disorder, 0.043% for bulimia nervosa, 0.038% for binge-eating disorder, and 0.013% for anorexia nervosa., Discussion: Overall crude incidence estimates for total eating disorders were higher than reported in prior research that included only active duty Service members and required an eating disorder diagnosis code in the first or second diagnostic position of the medical record. Comprehensive and confidential studies are needed to more thoroughly characterize the nature and scope of eating disorder symptomatology within U.S. military personnel., Public Significance: U.S. military service members are a vulnerable population with regard to eating disorder symptoms. Previously reported incidence and prevalence estimates using data from the Military Health System may have been underestimated due to overly stringent case definitions. Given personal and occupational barriers (e.g., career consequences), confidential studies of military personnel may provide more complete data on the scope of eating disorders to inform screening and clinical practice guidelines for military populations., (© 2024 Wiley Periodicals LLC.)

Objective: To identify patients presenting to an acute medical hospital with common signs and symptoms that occur in people with eating disorders (EDs), and determine by retrospective file audit if these are diagnosed cases of an ED., Method: The investigators screened electronic medical records of people 16 years and older for common signs and symptoms of an ED such as hypokalemia, in patients presenting to an acute hospital in Sydney, Australia from 2018 to 2020. Cases where the clinical finding was unexplained had their file audited. Cases with a known ED diagnosis or coded with an ED were also retrieved to audit., Results: Investigators identified 192 definite ED cases with a total of 598 episodes of care from 2018 to 2020 presenting to the hospital. Eighty-three cases were identified as possible EDs due to unexplained clinical signs consistent with an ED, but were not confirmed cases due to lack of clinical history in the file. Only 19.1% of presentations were diagnostically coded with an ED in the electronic medical record., Discussion: Our study revealed a large number of definite ED cases presenting to an acute medical hospital via the emergency department, who were not recognized as having an ED. Greater awareness of clinical signs and symptoms of an ED, such as unexplained low body mass index and hypokalemia, is necessary among acute care clinicians. Correctly identifying EDs in those seeking somatic care should be a public health priority, to facilitate timely and equitable access to diagnostic assessment and evidence based treatment., Public Significance: People with eating disorders (EDs) present to acute care settings and have a relatively high utilization of generalist health services with nonspecific problems such as abdominal pain. An enhanced understanding of healthcare utilization by people with EDs, who may not disclose their symptoms, is crucial for improving access to treatment., (© 2024 Wiley Periodicals LLC.)

Background: Inflammatory bowel disease (IBD) is a chronic, autoimmune disorder that affects the gastrointestinal tract. Disordered eating describes irregular eating behaviors that may be a precursor to an eating disorder diagnosis. Higher rates of disordered eating have been described in chronic diseases. Screening for disordered eating is not performed in pediatric patients with IBD. The goal of this longitudinal study was to use the Eating Attitudes Test (EAT-26) to screen pediatric patients with IBD for disordered eating, estimate our population's prevalence, identify potential risk factors, and correlate positive EAT-26 screen results with evaluation in adolescent medicine clinic., Methods: Eighty patients with IBD between 10 and 21 years completed the EAT-26 questionnaire during gastroenterology clinic visit. Disease activity was measured using Pediatric Ulcerative Colitis Activity Index (PUCAI) and Pediatric Crohn's Disease Activity Index (PCDAI). Patients also rated their own disease activity on a numerical scale., Results: Five patients had a positive EAT-26 screen and were evaluated in the adolescent medicine clinic. One hundred percent of those who screened positive were diagnosed with a concomitant eating disorder once evaluated. Only 20% of those who screened positive had active IBD. Higher weight, body mass index, and patient perception of disease activity were associated with increased EAT-26 score., Conclusion: Pediatric patients with IBD are at risk for disordered eating, with a prevalence of 6% in our population, which is twice the prevalence of disordered eating in the general population. The EAT-26 questionnaire is a feasible tool to screen pediatric IBD patients for disordered eating., (© 2024 American Society for Parenteral and Enteral Nutrition.)

Background: There have been several published studies on the prevalence of low energy availability (LEA) risk amongst North American and European endurance athletes. Yet the prevalence and risk factors amongst rugby league players are less well understood. This study assessed the prevalence of low energy availability risk, eating disorder risk, and food security amongst players from a female National Rugby League squad in Australia., Methods: Players from one Australian professional rugby league club volunteered to participate in the study. An online questionnaire was conducted to determine the prevalence of low energy availability (Low Energy Availability in Females Questionnaire [LEAF-Q]), eating disorder risk (Eating Disorders Inventory [EDI-3]), and food security., Results: Differences between those "at risk" and "not at risk" based on their total LEAF-Q score were determined. Of the 28 players, 64% (N.=18) were at risk of LEA. Raw scores for the EDI-3 subscales, body dissatisfaction (P=0.043), bulimia (P=0.002), composite score (P=0.038), were significantly higher for those at risk and not at risk of LEA. Forty percent of players had some level of food insecurity., Conclusions: The results suggest LEA risk is similar to other populations and those at risk of LEA are more likely to have an elevated clinical risk of eating disorders. Food security is also an issue in this population and could contribute to LEA risk for some. Future research is needed amongst team sports athletes to understand interplay between eating disorder risk and food insecurity with LEA risk.

Objective: This study aimed to examine the relationship between food insecurity (FI) and eating disorder psychopathology in a large sample of rural Chinese adolescents., Methods: Analyses included 1654 adolescents (55.4% girls; M age  = 16.54 years, SD = 1.45) from a rural high school in southwestern China. FI, eating disorder psychopathology, and psychological distress (i.e., symptoms of depression, anxiety, and stress) were assessed. Data were analyzed by sex. Pearson correlation analysis was performed to investigate the zero-order association between FI and eating disorder psychopathology. Hierarchical linear regressions were used to explore whether FI could explain meaningful variance in eating disorder psychopathology beyond psychological distress and demographic covariates (e.g., socioeconomic status)., Results: FI was significantly associated with higher eating disorder psychopathology for boys (r = 0.44, p < 0.001) and girls (r = 0.43, p < 0.001), with medium-to-large effect sizes. FI accounted for significant unique variance in eating disorder psychopathology beyond psychological distress and demographic covariates for boys (ΔR 2  = 0.14, p < 0.001) and girls (ΔR 2  = 0.10, p < 0.001)., Discussion: Using a large sample of rural Chinese adolescents, this study extends the connection between FI and eating disorder pathology in adolescents beyond the Western context. Future investigations on the mechanisms underlying FI and eating disorder psychopathology are warranted for developing prevention strategies for eating disorders among rural Chinese adolescents., Public Significance: This is the first investigation that examined the link between FI and eating disorder psychopathology among rural Chinese adolescents. Our findings highlight the importance of incorporating FI as a potential risk factor to screen for the prevention and intervention of eating disorders among rural Chinese adolescents., (© 2024 Wiley Periodicals LLC.)

Objective: To examine rates and predictors of attrition from referral through to treatment completion in an outpatient public psychology service's eating disorder program in Perth, Western Australia., Method: The proportion (number) of clients (N = 671; mean age = 23.8 years) transitioning between stages of pre-treatment and treatment was identified. Associations between demographic, treatment and clinical variables and attrition were investigated using logistic regression., Results: Only 34% (n = 230) of referred patients started treatment and 16% (n = 107) completed treatment. Referral acceptance was correlated with provisional diagnoses that meet the service's inclusion criteria, and attendance at an initial assessment was correlated with younger age. Treatment commencement was correlated with the presence of a co-occurring depressive or anxiety disorder, and no previous suicide attempts. Completing a full course of treatment was correlated with no previous hospitalisation for psychiatric issues, no previous suicide attempts, a history of psychiatric medication use, and treatment with family-based therapy., Discussion: High rates of attrition were found from referral to treatment completion. A suggested framework for defining the different stages of attrition is proposed to allow for consistency of attrition reporting across the mental health field. Future studies are needed to identify why clients disengage following referral, assessment, and treatment commencement, to inform strategies to engage and sustain engagement and to optimise outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The COVID-19 pandemic has sparked or amplified many mental health problems. The aim of this study was to compile evidence from existing systematic reviews to provide an overall assessment of the impact of social restrictions during the COVID-19 pandemic on people affected by eating disorders (EDs). PubMed and Scopus were searched up to August 16, 2023. Systematic reviews and meta-analyses were selected using the PRISMA 2020 statement. The quality assessment of the included studies was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Eleven studies were included in this umbrella review. Six main categories emerged from the studies described in the review: dietary changes and psychopathological effects showed an overall worsening of symptomatology; in studies concerning the impact of isolation and restrictive measures, it was found that social distancing was associated with feelings of loneliness, anxiety, and depression; limited access to direct care was found and therapeutic changes were made; the influence of mass media negatively impacted people with ED; several studies reported positive findings regarding symptomatology; finally, studies regarding 'impact on vulnerable populations showed that vulnerable people are more at risk of reporting body image distortion and eating disorders. The COVID-19 pandemic has negatively impacted most of the population with ED leading to a worsening of specific symptomatology. In addition, this worsening of the condition may be caused by limited access to care and treatment, changes in routine, or to the negative influence of the media., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction. The COVID-19 pandemic has had a profound impact on the health of young people worldwide, especially on people with eating disorders (EDs) due to the stress, anxiety, and changes experienced in access to health care. Objective. To explore adolescents' perceptions on changes in their social ties and the modalities of health care for patients with EDs. Population and methods. Qualitative study using in-depth interviews with adolescents with EDs seen at a teaching hospital during the COVID-19 pandemic. Results. Fifteen adolescents were interviewed; their mean age was 18 years; 93% were girls. Anorexia nervosa was observed in 86.6%. The most relevant negative aspects perceived were discomfort with family life (80%) and dissatisfaction with social media content regarding body image and dieting (73%). The aspects perceived as positive were peer support (66%) and improvements in eating habits (66%). The main change identified regarding the management before the COVID-19 pandemic was online followup by the mental healthcare team (73%). Conclusion. The adolescent population with EDs during the mandatory social isolation period reported discomfort with family life and dissatisfaction with social media content regarding body image and dieting. Notwithstanding this, adolescents highlighted peer support and improvements in their eating habits as positive aspects., (Sociedad Argentina de Pediatría.)

Postpartum women present a high risk of disordered eating behaviors, but the heterogeneity between groups was not identified. This cross-sectional study aimed to identify eating styles profiles in postpartum women and explore the correlates based on demographic characteristics and psychosocial factors. Questionnaires were administered to 507 Chinese postpartum women. Latent profile analysis (LPA) was conducted to identify eating styles profiles. Multinomial logistic regression was used to investigate the correlates of these profiles among postpartum women. The LPA identified three eating styles profiles: postpartum women with low emotional, external, and restrained eating (Profile 1, 6.9%); postpartum women with medium emotional, external, and restrained eating (Profile 2, 66.1%); and postpartum women with high emotional, external, and restrained eating (Profile 3, 27.0%). Compared to Profile 1, higher postpartum depression (PPD) and body mass index (BMI) were more likely to be associated with Profile 2 and Profile 3, whereas higher postpartum weight retention (PPWR) was more likely to be associated with Profile 1. Compared to Profile 2, higher PPD and BMI were more likely associated with Profile 3. Disordered eating behaviors in postpartum women with three eating styles were associated with BMI, PPD, and PPWR. This study can guide healthcare professionals in developing targeted interventions to improve maternal and child health globally.

Background: Due to cognitive impairments, people with dementia (PWD) often have difficulties in eating and drinking. This study aimed to assess the nutritional status, dietary quality and eating disturbance issues among PWD in Vietnam., Methods: We conducted a cross-sectional study at the Vietnamese National Geriatric Hospital from April to December 2022. We used Mini-Mental State Exam (MMSE) to classify the severity levels of dementia. Mini Nutritional Assessment (MNA), 24-hour recall, eating disturbance questionnaires, and anthropometric indicators were used to evaluate the nutritional status, dietary quality, and eating disorders of study subjects., Results: Overall, among 63 study participants, 74.6 per cent of PWD were at risk of or having malnutrition. By dementia classification according to MMSE scale, people with moderate and severe dementia accounted for 53.3 per cent of those who met the recommended energy levels, compared to 42.4 per cent of people with mild dementia and normal people. In the above two groups, around three per cent of participants reached the recommended amount of fibre. Calcium (50-70%), vitamin A (80-90%), and D (90%) were found to be the most severe deficiency forms of minerals and vitamins in both male and female participants. The majority of participants (90.5%) had at least one form of eating disorders with the most frequent issue being appetite changes (76.2%) and swallowing issues (50.8%)., Conclusions: PWD in our sample frequently experienced malnutrition, a lack of essential nutrients, difficulties swallowing, changes in eating habits and appetite. It is neccesary to early screen and assess nutritional status and swallowing disturbance in PWD, and instruct their caregivers to prepare nutritious meals for them., (© 2024. The Author(s).)

Objective: Borderline personality disorder (BPD) and eating disorders (EDs) both cause significant distress and co-occur at rates higher than expected, signifying potential overlapping regulatory mechanisms between both disorders. More specifically, both disorders involve emotion regulation deficits, suggesting they may share specific maladaptive regulatory components. The present study sought to examine the predictive role of emotion dysregulation within the comorbidity between EDs and BPD., Methods: A sample of psychiatric outpatients (N = 872) collected from a longitudinal study spanning the mid-1990s to 2015 completed the Structured Clinical Interview for DSM-IV for Axis I Disorders as well as a measure of emotion regulation strategies, the Difficulties in Emotion Regulation Scale, in order to assess overall functioning., Results: In a regression analysis, BPD was significantly predicted by emotion regulation deficits and was strongly related to categories of emotion dysregulation. EDs were not significantly predicted by emotion regulation deficits but did predict BPD diagnoses (B = -0.14, P < .001). Overall, BPD demonstrated strong relationships to emotion regulation deficits., Conclusions: Results indicate that targeted treatment focusing on emotion regulation deficits may be particularly indicated with co-occurring BPD and ED diagnoses., (© Copyright 2024 Physicians Postgraduate Press, Inc.)

The risk of DEB is more prevalent in girls, particularly during adolescence. The onset of DEB can be triggered by many inter-related factors, including biological, social, parental, and psychosocial. To date, very little is known about the determinants of DEBs in Saudi adolescent girls. Using a qualitative analysis, this study explored potential determinants of DEB among adolescent girls in Riyadh. Eighteen semi-structured interviews were carried out with adolescent girls (mean age = 14.06, SD = 0.87) who reported a high risk of DEB (EAT-26 ≥ 20) in intermediate and secondary schools in Riyadh. The mean weight was 51 kg (SD = 11.8) with BMI ranging from 14.18 kg/m 2 to 27.51 kg/m 2 . EAT-26 scores ranged from 21 to 42 (M = 26.8, SD = 5.6). Data were transcribed and revised, then themes and sub-themes were assigned using MAXQDA 24. The most common DEBs reported were dieting and binging, followed by induced vomiting. Major themes were related to negative cognitions, conscious imitation/copying behaviours, bullying, comparisons, and negative comments. Some participants identified the possibility of biological and familial factors in increasing the likelihood of DEB. Our findings provide a framework that could be used to increase understanding of DEB and inform the development of interventions to address underlying causes of DEB in Saudi adolescent girls.

Affiliated athletes are frequently subject to higher levels of anxiety due to the intensity of training, competition and many other factors. This anxiety can cause alterations in their health, both physically and mentally, such as menstrual irregularities, eating disorders, etc. In this work we have analysed the anxiety levels of a population of female affiliated paddlers and the possible consequences for their health. The results showed that a third of the female paddlers analysed have a moderate/high risk of suffering from anxiety; and within this group, the less sporting experience the athlete has, the greater the probability is of suffering from anxiety. Moreover, almost half the total of the female paddlers suffers from menstrual dysfunction before an important competition, with this number rising among high performance athletes, even though three out of every four adjust their training schedule to their menstrual cycle. Less-experienced female athletes, who show higher anxiety levels, also present a greater risk of suffering from eating disorders., (© 2024. The Author(s).)

Background: The minority of people with an eating disorder receive treatment. Little is known about predictors of receiving treatment., Methods: Using data from the Growing Up Today Study we identified correlates of receiving treatment for an eating disorder among the 1237 U.S. women who answered questions on treatment history in 2013 and reported meeting criteria for subthreshold eating disorder in ≥ 1 year between 1996 and 2013. Logistic regression models using generalized estimating equations were used to estimate the relative odds of receiving treatment., Results: Approximately 11% of the women reported receiving treatment for an eating disorder. Independent of type of eating disorder, those who had received a diagnosis of depression or anxiety were more likely (odds ratio (OR) = 3.05 95% confidence interval (CI) 1.87-4.97) to receive treatment for an eating disorder. Women with obesity were approximately 85% less likely to receive treatment (OR = 0.13, 95% CI 0.04-0.46) regardless of their type of eating disorder or history of depression of anxiety diagnosis., Conclusions: Most women meeting criteria for an eating disorder do not receive treatment. Women with BED or obesity are the least likely to receive treatment., (© 2024. The Author(s).)

Introduction: Stunting is the most prevalent form of malnutrition among infants and young children population, both globally and locally. It refers to low height-for-age children and is primarily caused by chronic under nutrition. The objective of this study is to determine the association between stunting and feeding problems and to explore the risk factors for stunting among children aged 6 to 59 months attending health clinics in the Kuantan district., Materials and Methods: A case-control study involving 160 children that attended six health clinics in Kuantan from August to October 2021 with a ratio of 1 case: 3 controls. Data were collected from mothers using a questionnaire consisting of sociodemographic and feeding assessment adapted from a validated World Health Organization (WHO) integrated management of childhood illness (IMCI) assessment form. The data was analysed using IBM SPSS version 26.0. Binary logistic regression analysis was used to identify factors associated with stunting. The odds ratio was used to measure the strength of the association between outcome and predictor variables. The significance value was set at p<0.05., Results: Children with identified feeding problems have more than four-time significantly higher risk of becoming stunted (Odds Ratios, OR: 4.2; 95% Confidence Intervals, 95%CI: 1.4, 12.8) as compared to children with no feeding problems. Specifically, children with inadequacy in feeding components; amount, variety and frequency of meal each have significantly six-time higher risk (OR: 6.2; 95%CI: 2.7, 14.5), four-time higher risk (OR: 4.2; 95%CI: 1.4, 12.3), and three-time higher risk (OR: 2.8; 95%CI: 1.1, 6.9), of becoming stunted as compared to children with adequate feeding. Additionally, with a decrease of one week in delivery week, one kilogram in birth weight and one centimetre in maternal height, there is a respectively significant 40.0% (OR: 0.6; 95%CI: 0.4, 0.9), 80.0% (OR: 0.2; 95%CI: 0.1, 0.7) and 11.0% (OR: 0.89; 95%CI: 0.82, 0.98) increase in the risk of become stunted among children., Conclusion: Feeding problems specifically inadequate food amount, food variety and meal frequency not following the recommendation contribute to stunting in young children. Other factors identified are lower maternal height and children with lower birth weight and delivery week. This highlights the need for more excellent detection and intervention of nutritional concerns and risk factors to prevent stunting.

Objective: This study aims to explore the prevalence, characteristics, and psychopathology related to Problematic Use of Internet (PUI), including Internet Addiction (IA), within a sample of psychiatric outpatients., Methods: 143 psychiatric stable outpatients (18-65, mean age: 49; F=84) were included in this study, regardless of their categorical diagnosis. Socio-demographic, clinical, psychopathological, and Internet use-related data (PIU-Scale, Internet Addiction Test, devices, use, activities) were collected across the sample., Results: The prevalence of PUI ranged between 1% (IAT) and 25% (PIU-S), with a homogeneous distribution of PUI symptoms' severity among the four main psychopathological areas (depressive, bipolar, anxiety, and psychotic disorders). PUI was correlated with age and was higher in students as in the general population. Significant associations were found between PUI symptoms and both personality and eating disorders; PUI was also positively correlated with the presence of other addictions (e.g., alcohol and/or substances). A greater proportion of patients with PUI presented other forms of behavioural addiction compared to non-symptomatic patients. Social media and online shopping, as well as video-streaming, resulted to be the main forms of PUI among patients with problematic use of the Internet., Discussion: More studies are required among students diagnosed with eating and personality disorders. The association between PUI and other addictive disorders would support the hypothesis of their common shared pathophysiology., Conclusion: Healthcare providers and educators should be made aware of such risks. More studies are needed to confirm such preliminary findings.

Objective: Experiences of menopause and quality of life during menopause can vary extensively among women. While menopause has been associated with negative impacts on eating and body image, it is unclear to what extent quality of life differs by eating disorder risk status. The aim of this study was to explore how menopause symptoms and quality of life differ between those women at high- or low-risk of an eating disorder and the potential protective role of body appreciation., Method: This cross-sectional survey study explored differences in menopausal quality of life, body appreciation, and body dissatisfaction among women classified as high- or low-risk of an eating disorder as part of a wider survey on aging, health, and psychological complaints during midlife. Participants were 255 females aged between 40 and 60 years. Participants were classified as high-risk and low-risk of an eating disorder based on Eating Attitudes Test-26 (EAT-26) scores. Differences between groups on the Menopause-Specific Quality of Life Questionnaire (MENQOL), Body Shape Questionnaire (BSQ-16), and Body Appreciation Scale-2 were analyzed. The predictive relationship between menopausal quality of life and body appreciation was also explored., Results: Participants in the high-risk group (n = 111) reported significantly poorer menopausal quality of life compared to the low-risk group (n = 144), scoring significantly higher on the sexual, physical, and psychosocial subscales of the MENQOL. The high-risk group also had significantly greater body dissatisfaction and less body appreciation than the low-risk group. Overall, menopausal quality of life was a significant predictor of body appreciation., Discussion: Women with greater eating disorder risk may be faring less well with menopause. Treating and preventing menopause-related eating disorders will benefit from interventions aimed at not only reducing body dissatisfaction, but actively bolstering body appreciation and supporting the sexual, physical, and psychosocial aspects of the menopausal transition., (© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.)

Introduction: Eating disorders (EDs) develop more frequently in young females. Following the COVID-19 pandemic, there has been evidence of an increase in children and adolescents, with an earlier onset and a worse body weight and nutritional status. The aim of this study was to determine whether this trend has also been observed in our region over the past 6 years., Material and Methods: We conducted a retrospective and descriptive cohort study in paediatric patients with a diagnosis of ED, referred during the 3 years preceding and following the declaration of the state of alarm due to the pandemic. We analysed and compared clinical, anthropometric and laboratory variables and bioelectrical impedance and bone density data., Results: Of the 129 patients in the sample, 28 were referred before the lockdown period and 101 after. When we compared these groups, we found a longer time elapsed from onset to the initial assessment (mean delay, 11.87 [SD, 6.75] vs. 6.64 [SD, 4.36] months), a greater hospitalization rate (14.1% vs. 10.1%), and lower vitamin D values (mean level, 28.19 [SD, 9.95] vs. 34.39 [SD, 11.87] ng/mL) in the post-lockdown group. We also found a greater frequency of self-harm suicide attempts in these patients., Conclusions: This study confirms the increasing trend in EDs in children and adolescents in our area. Moreover, we found differences in the clinical characteristics and time elapsed to diagnosis compared to the patients referred to the hospital before the pandemic., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Importance: The COVID-19 pandemic resulted in multiple socially restrictive public health measures and reported negative mental health impacts in youths. Few studies have evaluated incidence rates by sex, region, and social determinants across an entire population., Objective: To estimate the incidence of hospitalizations for mental health conditions, stratified by sex, region, and social determinants, in children and adolescents (hereinafter referred to as youths) and young adults comparing the prepandemic and pandemic-prevalent periods., Design, Setting, and Participants: This Canadian population-based repeated ecological cross-sectional study used health administrative data, extending from April 1, 2016, to March 31, 2023. All youths and young adults from 6 to 20 years of age in each of the Canadian provinces and territories were included. Data were provided by the Canadian Institute for Health Information for all provinces except Quebec; the Institut National d'Excellence en Santé et en Services Sociaux provided aggregate data for Quebec., Exposures: The COVID-19-prevalent period, defined as April 1, 2020, to March 31, 2023., Main Outcomes and Measures: The main outcome measures were the prepandemic and COVID-19-prevalent incidence rates of hospitalizations for anxiety, mood disorders, eating disorders, schizophrenia or psychosis, personality disorders, substance-related disorders, and self-harm. Secondary measures included hospitalization differences by sex, age group, and deprivation as well as emergency department visits for the same mental health conditions., Results: Among Canadian youths and young adults during the study period, there were 218 101 hospitalizations for mental health conditions (ages 6 to 11 years: 5.8%, 12 to 17 years: 66.9%, and 18 to 20 years: 27.3%; 66.0% female). The rate of mental health hospitalizations decreased from 51.6 to 47.9 per 10 000 person-years between the prepandemic and COVID-19-prevalent years. However, the pandemic was associated with a rise in hospitalizations for anxiety (incidence rate ratio [IRR], 1.11; 95% CI, 1.08-1.14), personality disorders (IRR, 1.21; 95% CI, 1.16-1.25), suicide and self-harm (IRR, 1.10; 95% CI, 1.07-1.13), and eating disorders (IRR, 1.66; 95% CI, 1.60-1.73) in females and for eating disorders (IRR, 1.47; 95% CI, 1.31-1.67) in males. In both sexes, there was a decrease in hospitalizations for mood disorders (IRR, 0.84; 95% CI, 0.83-0.86), substance-related disorders (IRR, 0.83; 95% CI, 0.81-0.86), and other mental health disorders (IRR, 0.78; 95% CI, 0.76-0.79)., Conclusions and Relevance: This cross-sectional study of Canadian youths and young adults found a rise in anxiety, personality disorders, and suicidality in females and a rise in eating disorders in both sexes in the COVID-19-prevalent period. These results suggest that in future pandemics, policymakers should support youths and young adults who are particularly vulnerable to deterioration in mental health conditions during public health restrictions, including eating disorders, anxiety, and suicidality.

Because very few prospective studies have identified risk factors that predicted future onset of threshold/subthreshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD), we analyzed prospective data collected from a large cohort of adolescent girls followed over an 8-year period to advance knowledge about risk factor specificity. Adolescent girls recruited from middle schools in Texas (N = 492; M age = 13.02 [SD = 0.73], age range = 11-15) completed questionnaires assessing risk factors at baseline and diagnostic interviews assessing eating disorders annually over 8 years. Only low BMI predicted future AN onset. Pressure to be thin, thin-ideal internalization, body dissatisfaction, negative emotionality, low parent support, and modeling of eating pathology predicted future BN onset. Pressure to be thin, thin-ideal internalization, negative emotionality, low parent support, and modeling of eating pathology predicted future BED onset. Pressure to be thin, body dissatisfaction, dietary restraint, low parent support, modeling of eating pathology, and high BMI predicted future PD onset. Predictive effects were medium-to-large. Results support etiological theories of eating disorders that postulate the pursuit of the thin ideal, body dissatisfaction, negative affect, dietary restraint, and interpersonal issues increase risk for most eating disorders. The evidence that girls with low body weight are at risk for AN, whereas girls with high body weight are at risk for PD are novel. Although several risk factors predicted future onset of BN, BED, and PD, results suggest that risk factors for AN are qualitatively distinct and should be investigated further., (Copyright © 2024 Association for Behavioral and Cognitive Therapies. Published by Elsevier Ltd. All rights reserved.)

Research suggests a link between autoimmune illnesses (AI) and eating disorders (ED). We retrospectively reviewed charts of adolescent patients presenting for eating disorder treatment. We compared the presentation and treatment course for those with an ED and comorbid AI [with (GI-AI, N  = 59) or without (non-GI, N  = 21) gastrointestinal inflammation] with matched ED-only cases. The sample was overwhelmingly female, with an average age of 15.40. Weight gain trajectories differed across groups, with similar rates of weight gain between controls and non GI-AI cases and with a lower rate of weight gain for individuals with comorbid GI-AI. Over half (56%) of patients reported an AI diagnosis prior to ED; 38% reported an AI diagnosis following ED, and 6% reported ED and AI simultaneous diagnosis. On presentation, ED-only controls had higher rates of comorbid anxiety than cases in either AI group, while those with non-GI AI were more likely to report depression. Mean total GI symptoms, % goal weight at presentation, vital sign instability, and markers of refeeding syndrome did not differ across groups. Health care professionals treating patients with either condition should have a low threshold for asking additional questions to identify the presence of the other condition.

Objective: The association between eating disorders (EDs) and harmful substance use (substance use that causes psychosocial impairment) is well recognized in the literature, and military veterans may be at heightened risk for both issues due to deployment-related stressors. However, little is known about which ED-related symptoms are associated with harmful substance use in veterans, and whether gender plays a differential role in this relationship. Our aims were to: (1) examine gender differences in ED-related symptoms; and (2) examine whether ED-related symptoms differentially predict harmful substance use in US veteran men and women who had recently separated from service., Method: This study was based on a nationally representative four-wave longitudinal sample of post-9/11 veterans (N = 835; 61.2% female). Longitudinal mixed modeling was used to test whether specific ED-related behaviors at baseline predicted harmful substance use at follow-ups., Results: We replicated gendered patterns of ED-related symptoms observed in civilian populations, wherein men had higher weight-and-body-related concerns (including excessive exercise and muscle building) and negative attitude toward obesity, and women had higher bulimic and restricting symptoms. For women, alcohol, drug, and marijuana problems were predicted by higher bulimic symptoms, whereas for men, these problems were predicted by higher restricting symptoms., Conclusion: Gender played a differential role in the relationship between EDs and harmful substance use. Bulimic symptoms were the most robust predictor for harmful substance use among veteran women, whereas restricting was the most robust predictor for harmful substance use among veteran men., Public Significance: The current study found that veteran women had higher bulimic symptoms (characterized by binge eating and purging) and restricting than veteran men. In women, bulimic symptoms predicted future harmful use of alcohol, marijuana, and other drugs. In contrast, veteran men had higher weight-and-body-related concerns (characterized by excessive exercise and muscle building) than veteran women. In men, restricting symptoms predicted future harmful use of alcohol, marijuana, and other drugs., (© 2024 Wiley Periodicals LLC.)

Eating disorders are a group of severe and potentially enduring psychiatric disorders associated with increased mortality. Compared to other severe mental illnesses, they have received relatively limited research attention. Epidemiological studies often only report relative measures despite these being difficult to interpret having limited practical use. The aims of this study were to evaluate the incidence and prevalence of diagnosed anorexia nervosa (AN), bulimia nervosa, and eating disorder not otherwise specified recorded in Danish hospital registers and estimate both relative and absolute measures of subsequent mortality - both all-cause and cause-specific in a general nationwide population of 1,667,374 individuals. In a smaller, genetically informed case-cohort sample, the prediction of polygenic scores for AN, body fat percentage, and body mass index on AN prevalence and severity was estimated. Despite males being less likely to be diagnosed with an eating disorder, those that do have significantly increased rates of mortality. AN prevalence was highest for individuals with high AN and low body fat percentage/body mass index polygenic scores., Competing Interests: Declaration of competing interest CMB is an author and royalty recipient of Pearson. BJV is a member of the scientific advisory board for Allelica. All other authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Background: Rumination is characterized by the repeated regurgitation of food. Rumination syndrome is a disorder of gut-brain interaction diagnosed by Rome criteria, whereas rumination disorder is a feeding and eating disorder diagnosed by DSM-5 criteria. We aimed to determine the global prevalence of rumination according to these criteria across all age groups., Methods: We performed a systematic review and meta-analysis of studies reporting the prevalence of rumination syndrome according to Rome III and Rome IV and rumination disorder according to the following validated DSM-5 assessments: PARDI, EDA-5, EDY-Q, STEP, and STEP-CHILD. We searched MEDLINE, EMBASE, and PsychINFO (from January 1, 2006, to June 1, 2023) to identify studies reporting the prevalence of rumination in community settings in participants of any age. We did a meta-analysis to estimate the pooled prevalence and odds ratio (OR) of rumination according to diagnostic criteria, country, and characteristics such as age and sex., Key Results: The search strategy generated 1243 studies, of which 147 studies appeared to be relevant. Thirty studies were included, with a total of 114,228 participants, of whom 61,534 of these were adults and 52,694 were children. The pooled prevalence of rumination syndrome in children of all ages according to Rome III criteria was 1.0% (95% CI 0.3-1.6; I 2 91.1%), but no data were available for adults. According to Rome IV criteria, the pooled prevalence of rumination syndrome in children of all ages was 0.4% (95% CI 0.2-0.6; I 2 56.4%) and 3.7% in adults (95% CI 2.3-5.1; I 2 91.4%). The pooled prevalence of rumination disorder in children of all ages according to EDY-Q was 2.1% (95% CI 0.9-3.4; I 2  = 78.1%), but only one study utilizing EDY-Q in adults was included (0.7% [95% CI 0.4-1.0]). No data were available for children or adults using any other validated DSM-5 assessments for rumination disorder. Irrespective of diagnostic criteria, the pooled prevalence of rumination was higher in adults compared to children and adolescents (3.0% [95% CI 1.4-4.7; I 2  = 98.1%] vs. 0.8% [95% CI 0.4-1.3; I 2  = 90.8%]), but higher in adolescents than in children (1.1% [95% CI 0.3-2.0; I 2  = 92.8%] vs. 0.1% [95% CI 0.0-0.2; I 2  = 24.5%]). In adults, factors independently associated with rumination were female gender (OR 1.4 [95% CI 1.0-2.0]), anxiety (OR 2.3 [95% CI 2.1-2.6]), and depression (OR 1.8 [95% CI 1.2-2.9]). No association between gender and rumination was seen in children., Conclusions and Inferences: The prevalence of rumination is more common in adults than in children. In adults, rumination is associated with female gender, anxiety, and depression. Future population studies should aim to better understand why this behavior is more common in adults and also compare validated DSM-5 assessments for rumination disorder with Rome criteria for rumination syndrome as prevalence may differ., (© 2024 The Authors. Neurogastroenterology & Motility published by John Wiley & Sons Ltd.)

Background: The COVID-19 pandemic has resulted in adverse effects on individuals' physical and mental health worldwide, with university students also being adversely affected by this process., Objectives: This research aimed to determine the mental condition, sleep quality, and eating behaviors of university students during the COVID-19 process., Method: This cross-sectional study was conducted with 1,065 university students. Study data were collected with an online questionnaire including a personal information form, the Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Dutch Eating Behavior Scale., Results: Students' poor sleep quality was determined to be 69.5%. It was also determined that students' depression and stress levels were moderate that their anxiety levels were low, their eating behaviors were generally problematic, and more than half had poor sleep quality. In addition, eating disorders and poor sleep quality increased as depression, anxiety, and stress levels increased, and eating disorders increased as poor sleep quality increased ( p < .05)., Conclusions: The results emphasize the importance of the strengthening of students' mental health, particularly by improving their sleep quality and eating habits. Evidence-based interventions regarding the effects of the pandemic should be made for students under the leadership of a psychiatric nurse, and effective strategies must be developed accordingly., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.