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ABSTRACT Objective Method Results Discussion Individuals with anorexia nervosa persistently restrict their food intake while often severely underweight. This maladaptive food choice behavior and related decision‐making processes have mainly been investigated in adults. It is unknown whether the same decision‐making processes drive food choices in adolescents, given their more favorable treatment outcomes. This study investigated maladaptive food choice behavior in adolescents with AN and examined whether they display the same decision‐making processes as adults.Adolescents with AN (n = 42) and age‐matched controls (n = 42) completed a computer‐based food choice task, rating food images for healthiness and tastiness before choosing between two food items.Adolescents with AN chose high‐fat foods less frequently than controls, with food choices more influenced by their perceived “healthiness” and less by their “tastiness” than they did among controls. Relative to controls, adolescents with AN also reported lower overall tastiness ratings and greater habit strength of restrictive eating, which was, however, not related to food choices.Adolescents with AN display the same maladaptive food choice behavior as adults, namely the persistent restriction of high‐fat food choices. Their choices were more strongly influenced by the perceived healthiness of a food item, compared to the choices of controls. [ABSTRACT FROM AUTHOR]

Purpose: Previous research on obesity surgery (OS) showed that patients do not only experience weight loss but also improvements in certain mental health outcomes (e.g., depression) after OS. However, self-harm behaviors might increase after OS. Regarding self-harm, the literature is mostly limited to studies using data from hospital or emergency room charts. This longitudinal study examined self-reported self-harm behaviors and potential psychopathological correlates before and after OS. Materials and Methods: Pre-surgery patients (N = 220) filled out a set of questionnaires before and approximately six months after OS. Self-harm behaviors were captured with the Self-Harm Inventory. The assessments further included standardized instruments to measure symptoms of depression, anxiety, eating disorders, alcohol use, and suicidal ideations. Results: Any self-harm was reported by 24.6% before and by 25.0% after OS. No differences in the number of self-harm behaviors or prevalence of any self-harm before and after OS were found. Overall, 11.4% experienced self-harm behaviors at both times. A subset showed self-harm behaviors only before (13.2%) OS and another subset only after OS (13.6%). These two groups were about the same size. Self-harm behaviors showed strong associations with psychopathology after OS, especially with depression and suicidal ideation. Conclusion: No increase in self-harm behaviors after OS emerged. Still, a subgroup showed self-harm behaviors after OS closely linked to further psychopathology. This mirrors the need to implement screening for self-harm before and after OS into OS care. Further studies with longer follow up periods are needed to extend these findings. [ABSTRACT FROM AUTHOR]

Objective: Few studies investigated parenthood as a predictor of eating pathology in young adulthood. We studied the association between parenthood, in the first year after becoming a parent and beyond, and eating pathology. Furthermore, we examined whether moving in together with a partner affected this association. Method: This study used data of four measurement waves from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2229) from preadolescence into young adulthood. The Eating Disorder Diagnostic Scale (EDDS), a measure to assess eating pathology, was assessed at ages 22, 26, and 29. Risk for eating disorder was assessed at age 19. Pregnant participants were excluded. Results: Parenthood was not associated with an increase of eating pathology in the first year after becoming a parent and beyond. Instead, parents were more likely to report being free from eating pathology symptoms compared to childless individuals (OR 2.07, 95% CI: 1.11–3.84). Among those who reported experiencing at least one eating problem, parenthood was not associated with the number of eating problems. Moving in together with a partner did not alter the association between parenthood and eating problems and neither did this association differ between males and females. Discussion: Parenthood in young adulthood was associated with a decreased risk of having eating pathology. Public Significance Statement: In this longitudinal study among young adults, parenthood was not associated with the development of eating pathology. [ABSTRACT FROM AUTHOR]

Background: The present study examined the relative roles of approach and avoidance motivation in eating pathology using a multi-method approach combining self-report and physiological measures. The potential effect of internalized ideals and fears was also investigated. Methods: Fifty-seven undergraduate women completed a picture-viewing task in which they viewed images of women's bodies (thin and non-thin) and affective images. Self-report ratings of valence and arousal were measured along with physiological indicators of approach (postauricular reflex) and avoidance (startle blink reflex) motivation. Results: Greater eating pathology was associated with more negative valence ratings of both thin and non-thin images. There was a significant interaction between valence ratings of non-thin bodies and fear of the unattractive self in relation to eating pathology, such that eating pathology was highest in those who rated non-thin images as more unpleasant and internalized fears of being/becoming unattractive. Thin-ideal internalization did not significantly interact with ratings of thin images to predict eating pathology. There were no significant findings when examining physiological data. Conclusions: Results from self-report measures suggest that eating pathology is associated with avoidant reactions to both thin and non-thin bodies and highlight the importance of internalized appearance-related fears. [ABSTRACT FROM AUTHOR]

Preadolescence is a critical period for the onset of puberty and eating‐related psychopathology. More advanced pubertal status is associated with elevated eating pathology. However, it was unclear whether this association was moderated by self‐referential processing, an important, modifiable cognitive risk for various forms of psychopathology, including eating problems. Further, no study has examined the neural correlates of self‐referential processing in relation to eating pathology. To address these gaps, we examined how the association between pubertal status and disordered eating was moderated by self‐referential processing in a community sample of 115 nine‐to‐12‐year‐old preadolescents (66 girls; mean age/SD = 10.98/1.18 years; 87.5% White). Youths reported their pubertal status and disordered eating behaviors and completed an ERP version of the Self‐Referent Encoding Task (SRET) to assess self‐referential processing. A Principal Component Analysis of the ERP data identified an anterior late positive potential (LPP) in both the positive and negative SRET conditions. The LPP in the positive condition moderated the positive association between pubertal status and disordered eating behaviors, such that this association was significant for youths with a smaller LPP toward positive self‐referential cues, but non‐significant for those showing a larger LPP toward positive self‐referential cues. These results suggest that a deeper processing of positive self‐referential information, indicated by a potentiated LPP, may weaken the negative impact of pubertal status on disordered eating. Our findings also suggest that enhancing positive self‐referential processing may be a useful tool in preventing the development of eating pathology in preadolescents, especially for those with more advanced pubertal status. This study for the first time examined the neurophysiological correlates of self‐referential processing in association with puberty and eating pathology in preadolescents. In particular, we provided novel evidence on the moderating effect of the late positive potential (LPP) underlying positive self‐referential processing on the relationship between pubertal status and eating disordered behaviors in youths. [ABSTRACT FROM AUTHOR]

Objective: This study investigated whether mental health providers have different diagnostic impressions and treatment recommendations for patients with restrictive eating disorders, depending on the patient's body weight. Method: Participants were given one of three versions of a vignette depicting a patient who meets DSM‐5 criteria for anorexia nervosa (AN) or atypical AN with the patient's weight described as either below, within, or above the average range for her age and height. Participants were then asked to respond to a series of questions about diagnosis, symptoms, and treatment recommendations. Results were compared between the three weight conditions with the goal of better understanding how a patient's body weight may influence different aspects of participants' clinical impressions. Results: Participants given the low weight version of the vignette were more likely to identify the presenting problem as an eating disorder and to agree that the patient experienced dietary restriction and weight loss, weight gain avoidance, and body image concerns. Participants given the low weight description were also more likely to recommend specialized eating disorder treatment and medical follow‐up. Discussion: Findings suggest that mental health providers were generally more responsive to restrictive eating disorder symptoms when the patient was at a lower body weight. These results are concerning because they suggest patients with atypical AN may be less likely to receive an accurate diagnosis or adequate treatment compared to underweight patients with AN, despite experiencing the same symptoms. Public Significance: Restrictive eating disorders like AN and atypical AN can cause comparable physical and psychological symptoms in people of any body weight. Despite having the same symptoms, people with a higher body weight are less likely to receive a diagnosis or treatment. This study compared mental health providers' reactions to a description of a patient with an eating disorder at different body weights and found differences in diagnosis, detection of symptoms, and treatment recommendations. [ABSTRACT FROM AUTHOR]

This study examined the relationship between perfectionism and eating pathology, and investigated the mediating role of body dissatisfaction and alexithymia in the relationship. Two studies were employed in the current research. A large sample (N = 2420) with cross-sectional data was used to determine the relationship between perfectionism and eating pathology, whereas three-wave longitudinal data (N = 312) with three-month intervals were used to examine the mediation models. The results indicated that: (1) Perfectionism was significantly associated with eating pathology, after controlling for relevant demographic factors. (2) Both body dissatisfaction and alexithymia fully mediated the relationship between perfectionism and eating pathology in the single mediation models. (3) Body dissatisfaction emerged as the stronger mediator in the relationship in the parallel mediation model. The results indicated that among Chinese college students, perfectionism had an indirect effect on eating pathology, through body dissatisfaction and alexithymia, and body dissatisfaction was shown to be a stronger pathway. The current findings highlighted the need to focus on college students with higher levels of perfectionism and mitigate the risk of eating pathology by improving body image and enhancing emotion awareness and expression. [ABSTRACT FROM AUTHOR]

Disgust sensitivity refers to how unpleasant a disgusting experience is to an individual and is involved in the development of many psychiatric conditions. Given its link with food ingestion, there is an interest in understanding how an individual’s susceptibility to disgust relates to dietary habits. One possible mechanism giving rise to this association is through the effects negative emotions have on high-order cognitive processes, but few studies take this model into account. The aim of this study was to characterize general disgust sensitivity in a clinical binge eating disorder (BED) population, and explore whether disgust sensitivity relates to inhibitory control and eating pathology. Following a case-controlled study design, our results show that: (1) disgust sensitivity and its subscales do not differ between BED and healthy controls, (2) higher disgust sensitivity in BED relates to greater behavioural inhibition, (3) inhibitory control reaction times relate to aspects of eating pathology, and (4) inhibitory control does not mediate relationships between disgust sensitivity and BMI among participants with BED. Understanding the role of disgust sensitivity in BED may allow us to understand how negative emotion systems maintain dysregulated eating behaviours with the potential to inform emotion-regulation treatment approaches. Level of evidence: Level III: Evidence obtained from well-designed cohort or case–control analytic studies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the current study was to examine differences in binge eating and food addiction symptoms between Night Eating Syndrome (NES) latent subtypes: evening hyperphagia with nocturnal ingestions (EHNI), evening hyperphagia-only (EHO), and nocturnal ingestions-only (NIO). It was hypothesized that the EHNI group would report more binge eating behaviors and more food addiction symptoms than both the EHO and NIO groups. Further, it was hypothesized that the EHO and NIO groups would differ with the EHO group reporting more binge eating behaviors and the NIO group reporting more food addiction symptoms. Methods: Participants completed measures online relating to night eating, binge eating, and food addiction. Average age of the final sample was 34.3 (SD = 10.5) and 62.0% were men. Responses to the Night Eating Questionnaire (NEQ; Allison et al., 2008) were used to create an EHNI group (n = 65), an EHO group (n = 32), and a NIO group (n = 69). ANOVAs were conducted to examine between-group differences on disordered eating symptoms. Results: Participants in the EHNI group reported more severe binge eating and food addiction symptoms than those in the EHO and NIO groups. However, there were no significant differences in binge eating or food addiction between the EHO and NIO groups. Conclusion: Individuals who meet both NES core criteria (evening hyperphagia and nocturnal ingestions) are likely at a higher risk for experiencing other, more severe disordered eating pathologies. Implications concerning assessment and future research on NES typology are discussed. Level of evidence: Level V, cross-sectional descriptive study. [ABSTRACT FROM AUTHOR]

Objective: Little is known about the prevalence of DSM‐5 eating disorders (EDs) in adolescents. In Norway, the most recent community‐based prevalence study in adolescents was published more than 20 years ago. The aim of this study was to assess the prevalence of DSM‐5 EDs in Norwegian adolescents using a two‐phase design. Method: A total of 1558 upper secondary school students (827 girls and 730 boys) (ages 16–19) were screened for at‐risk ED pathology using the Eating Disorder Examination–Questionnaire short version (EDE‐QS). A sub‐sample of 99 adolescents (87 girls and 12 boys) subsequently participated in a clinical interview using the Eating Disorder Assessment for DSM‐5 (EDA‐5). Results: Eating pathology was common, with 19.9% of participants scoring at or above the applied EDE‐QS cut‐off. The estimated prevalence of any ED was 9.4% in the total sample, and 16.4% in girls. The number of boys who took part in the diagnostic interview was low, thus, diagnostic data from boys were not analyzed separately. Prevalence estimates of AN, BN, BED, and OSFED in girls were 2.7%, 1.1%, 1.9%, and 10.7%. Atypical AN was the most frequently assigned diagnosis in girls. Discussion: Sampling biases limit generalizability of results. Additional population‐based studies are warranted to assess the prevalence of EDs in Norwegian youth. Public Significance Statement: In this study, 1558 adolescents, aged 16–19, were screened for ED pathology. A subsample completed a diagnostic interview using DSM‐5 criteria. Results showed that one in five adolescents displayed problematic eating behaviors and cognitions. The estimated prevalence rate of any ED was 9.4%. Sampling biases limit generalizability of results. Additional population‐based studies are warranted to assess the prevalence of EDs in Norwegian youth. [ABSTRACT FROM AUTHOR]

Abstract Background There are well‐recognized benefits of behavioral interventions that include exercise for children and adolescents with obesity. However, such behavioral weight management programs may precipitate unintended consequences. It is unclear if different exercise modalities impact eating behaviors differently in youth with obesity. Objectives The purpose of this study was to examine the effects of aerobic, resistance, and combined aerobic and resistance exercise training on eating attitudes and behaviors (uncontrolled eating, restrained eating, emotional eating, external eating and food craving) among adolescents with overweight and obesity. Methods N = 304 (70% female) adolescents with overweight and obesity participated in the 6‐month Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) randomized controlled trial. All participants were inactive post‐pubertal adolescents (15.6 ± 1.4 years) with a mean BMI = 34.6 ± 4.5 kg/m2. The Food Craving Inventory (food cravings), Dutch Eating Behavior Questionnaire (restrained eating, emotional eating, external eating), and the Three‐Factor Eating Questionnaire (uncontrolled eating) were used to assess eating attitudes and behaviors. Results All exercise groups showed within‐group decreases in external eating and food cravings. Participants randomized to the Combined training group and were more adherent showed the greatest improvements in eating behaviors and cravings. Conclusions A 6‐month exercise intervention produced improvements in disordered eating behaviors and food cravings, but effects may be gender and modality‐specific. Findings highlight the need to tailor exercise intervention to participant characteristics for the promotion of healthier eating and weight management outcomes in youth with obesity. Clinical Trial Registration # and Date: ClinicalTrials.Gov NCT00195858, September 12, 2005

Despite elevated risk of eating pathology (EP) among athletes, utilization of EP-treatment among athletes is low. Factors that may inhibit EP-help-seeking among athletes include perceived social stigma, self-stigma, and perfectionism. Heightened stigma associated with EP and sport climates may be exacerbated by negative perfectionism characteristic of athletes and decrease intentions to seek help for EP. We tested the following moderated-mediation model among a sample of collegiate athletes (N = 201) via online questionnaires: EP indirectly relates to EP help-seeking intentions through perceived and self-stigma and these relations are conditional on negative perfectionism. EP help-seeking intentions were negatively associated with EP severity, stigma, and negative perfectionism. EP was related to eating-specific help-seeking intentions through perceived social stigma, influencing self-stigma, but this was not moderated by negative perfectionism. Targeting mental-health treatment stigma among athletes may reduce risk of untreated EP among collegiate athletes. [ABSTRACT FROM AUTHOR]

Objective: Cognitive behavioral therapy for Avoidant Restrictive Food Intake Disorder (ARFID; CBT‐AR) is an emerging treatment for ARFID. However, this treatment modality has yet to be examined among older adults (e.g., older than 50 years) or with adults presenting with feeding tubes. To inform future versions of CBT‐AR, we present the results of a singular case study (G) of an older male with the sensory sensitivity phenotype of ARFID who presented for treatment with a gastrostomy tube. Methods: G was a 71‐year‐old male who completed eight sessions of CBT‐AR in a doctoral training clinic. ARFID symptom severity and comorbid eating pathology changes were examined pre‐ and post‐treatment. Results: Posttreatment, G reported significant decreases in ARFID symptom severity and no longer met diagnostic criteria for ARFID. Furthermore, throughout treatment, G reported significant increases in his oral food consumption (vs. calories being pushed through the feeding tube), solid food consumption, and the feeding tube was ultimately removed. Discussion: This study provides proof of concept that CBT‐AR is potentially effective for older adults and/or those presenting for treatment with feeding tubes. Validation of patient efforts and severity of ARFID symptoms emerged as core to treatment success and should be emphasized when training clinicians in CBT‐AR. Public Significance: Cognitive behavior therapy for ARFID (CBT‐AR) is the leading treatment for this disorder; however, it has yet to be tested among older adults or those with feeding tubes. This single‐patient case study demonstrates that CBT‐AR may be efficacious in reducing ARFID symptom severity among older adults with a feeding tube. [ABSTRACT FROM AUTHOR]

Despite recent research suggesting body dissatisfaction and disordered eating are growing concerns in men, few studies have examined these trends. Self-compassion has been shown to have positive effects on women's outcomes in eating disorder diagnoses and in body image contexts. However, research investigating the association between self-compassion and body related outcomes in men has been lacking. Additionally, research suggests that men face societal pressure to conform to masculine norms which may impact their body image and eating behaviour. Thus, the present study was designed to study the relationship between self-compassion and body related outcomes in men (i.e., intuitive eating and body parts satisfaction). This study also explored conformity to masculine norms as a potential moderator of the relationship between self-compassion and body related outcomes. Data was collected from 249 men (Mage = 23.20, SD = 3.70). through an online survey. The survey included measures assessing intuitive eating, body (self)-compassion, body satisfaction, fear of self-compassion, self-esteem and conformity to masculine norms. Regression analysis using a mean centered predictor showed that self (body)- compassion was significantly and positively associated with intuitive eating and body parts satisfaction, however, conformity to masculine norms failed to moderate either relationship. These findings offer insight into the benefits of practicing selfcompassion for men. [ABSTRACT FROM AUTHOR]

Eating pathology is increasingly common among Indian adolescents. However, brief validated measures of disordered eating in Indian contexts are scarce. This study adapted and validated a culturally appropriate English language version of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) among 385 adolescents (mean age = 13.42 years; 47.3% girls) in urban India. Confirmatory factor analysis indicated that a two-factor eight-item solution had an acceptable fit to the data across gender: an 'Eating Concerns and Restraint' subscale and a 'Weight and Shape Concerns' subscale. Further, the questionnaire can be utilised as both a unidimensional and multidimensional tool. This allows for the computation of a total score on the primary factor of 'Child Eating Pathology', as well as the two subscales. Internal consistency of the 'Weight and Shape Concerns' subscale (α = 0.825) and 'Eating Concerns and Restraint' subscale (α = 0.649) was satisfactory. Concurrent validity was established through medium significant correlations with measures of body image and broader mental health. The results support the use of the ChEDE-Q for assessing disordered eating among urban Indian adolescents, thus providing the research community and practitioners with a measure to investigate the nature and scale of disordered eating among adolescents in India. [ABSTRACT FROM AUTHOR]

Clinical scientists have been investigating the relationships between sex hormones, personality, and eating disorders for decades. However, there is a lack of direct research that addresses whether personality mediates or moderates the relationships between sex hormones and eating pathology. Moreover, the neural mechanisms that underlie the interactive associations between these variables remain unclear. This review aims to summarize the associations between these constructs, describe a neural mechanism mediating these relationships, and offer clinical strategies for the early identification and intervention of eating disorders. The gathered evidence shows that aggressiveness, impulsivity, and obsessive-compulsiveness may mediate or moderate the relationships between sex hormones and eating pathology, but only among females. Furthermore, sex hormone receptor density in the mesocorticolimbic dopamine pathway may explain the neural mechanism of these associations. Future research should use more comprehensive personality measurements and assess the mediation and moderation effects of temperament while taking the hormone levels of women across menstrual cycles into account. Additionally, electroencephalography and functional magnetic resonance imaging should be implemented to directly assess brain activity and corroborate these findings. [ABSTRACT FROM AUTHOR]

Background: The emergence of eating problems during childhood increases the risk for eating disorders (EDs) during young adulthood. Previous studies highlight a relationship between poor self-regulation and onset of eating pathology. In this study, we investigated whether this association is mediated by decision-making difficulties. Methods: To test this hypothesis, we used data from the Millennium Cohort Study. Decision-making performance was assessed with the Cambridge Gambling Task at age 11. Principal components analysis was used to derive an index of ED symptoms at age 14. The trajectories of scores of two subscales of the Child Social Behaviour Questionnaire, Independence and Self-Regulation (ISR) and Emotional Dysregulation (EmotDy), were modelled from ages 3 to 7 years in a latent growth curve analysis. The individual predicted values of the intercept (set at baseline, 3 years) and the slope (rate of annual change) were then used in the mediation analysis. Results: In our sample of 11 303 individuals, there was evidence for mediation by three measures of decision-making at age 11 (poor quality of decision-making, delay aversion and low risk-adjustment) in the association between EmotDy across ages 3–7 and ED symptoms at age 14 even after the adjustment for relevant covariates. We found no evidence of association between ISR and ED symptoms. Conclusion: Our findings suggest that emotion regulation processes during childhood may be relevant for the future onset of ED symptoms via their association with decision-making skills. These findings, obtained from a large, representative, sample, shed light on the relationship between self-regulation, decision-making and symptoms of EDs. [ABSTRACT FROM AUTHOR]

The aims of this study were to determine the effectiveness of an adapted version of the Body Project for young Saudi women, and to determine the impact of compliance (i.e. adherence to homework and attendance) on outcomes. A randomized controlled trial was used, allocating Saudi undergraduate females (N = 92; mean age = 20.48 years; SD = 2.28) to either a culturally-adapted version of the Body Project or a health education control condition. Participants completed self-report measures of eating pathology, body image, depression and social anxiety before and following the interventions and at three-month follow-up. Interaction terms showed that, relative to the control group, the intervention group had significantly reduced levels of eating concerns, body dissatisfaction and depression, but social anxiety did not change significantly in either group. Levels of session attendance and homework completion did not influence outcomes. Thus, the Body Project was effective for Saudi women in reducing eating pathology, body image dissatisfaction, and depression, though not social anxiety. This outcome indicates the value of the Body Project as a prevention tool when adapted to non-Western cultures. • The Body Project was adapted successfully for a Saudi population. • The intervention was effective among a non-Western group of young women. • The intervention was effective for eating attitudes, body dissatisfaction and mood. • The RCT design and adequate power of the sample support the causal conclusions. • The sample was adequately powered. [ABSTRACT FROM AUTHOR]

Objective: This systematic review evaluates and summarizes existing eating disorder (ED) prevention programs in Latin American countries. Methods: A systematic literature search was conducted using the Cochrane Controlled Trial Register, PubMed, and Virtual Health Library databases up to and including July 31, 2022. All ED prevention studies published in English, Spanish or Portuguese were eligible, regardless of the study design, sample characteristics, and type of prevention programs. The Cochrane Collaboration Risk of Bias criteria were used to evaluate the quality of the included studies. Results: Twenty‐two studies were included. Most were pilot studies that were nonrandomized, had a high risk of bias, were from Mexico and Brazil, and employed selective interventions. Dissonance‐based programs and social cognitive theory were the commonly used approaches in interventions, and most of them were tested in adolescent girls and women. Short follow‐ups were used, varying from 1 to 6 months. Many found significant decreases after the intervention and/or at follow‐up in ED/disordered eating risk behaviors/symptoms, negative affect, body‐ideal internalization, and body image disturbances. Conclusions: This review highlights promising efforts to prevent EDs among Latin American countries. Some barriers in conducting research include funding restrictions, laws that do not allow remuneration or compensation for participants, and high costs of training. Nonetheless, the outcomes of the programs developed and evaluated so far are positive enough to merit further work on ED prevention. Efforts for future researchers should recruit samples with diverse characteristics, use robust designs and data analysis techniques, and expand the accessibility of prevention programs. Public Significance Statement: The development of effective eating disorder (ED) prevention programs that can be broadly implemented is a public health priority. Nevertheless, there is limited evidence regarding the characteristics of ED prevention programs and their efficacy among Latin American countries. In the present study, we reviewed existing ED prevention programs adopted in Latin America, described their characteristics and outcomes, noted the limitations of available programs, and discussed the implications of these findings for efforts to prevent the development of EDs in Latin America. The outcomes of the programs developed and evaluated so far are positive enough to merit the development and rigorous evaluation of future programs and their broad dissemination in Latin American countries. PROSPERO registration number CRD42021275245. [ABSTRACT FROM AUTHOR]

Objective: One of the most widely used assessment tools for disordered eating attitudes and behaviors, the Eating Disorder Examination Questionnaire (EDE‐Q), has not yet been evaluated in Brazilian cisgender gay and bisexual men—an at‐risk population given the extent of minority stressors in Brazilian culture. The present study aimed to assess the psychometric properties of the EDE‐Q among Brazilian cisgender gay and bisexual adult men. Method: The Brazilian EDE‐Q was administered to a sample of 1409 gay and bisexual adult men, along with measures of self‐objectification, body‐ideal internalization, drive for muscularity, muscle dysmorphia symptoms, and body appreciation. The factor structure of the Brazilian EDE‐Q was assessed using a two‐step, split‐sample exploratory (EFA; n = 704) and confirmatory factor analytic approach (CFA; n = 705). Additionally, convergent validity, internal consistency, and 2‐week test–retest reliability were assessed. Results: Findings from an EFA and CFA revealed a one‐factor structure with 22 items and adequate internal consistency (ω =.92, 95% CI = [.91,.93]). Moreover, the scale demonstrated good 2‐week test–retest reliability (ICC =.86, 95% CI = [.82,.88], p <.001). The EDE‐Q scores showed positive associations with self‐objectification, body‐ideal internalization, muscle dysmorphia symptoms, and drive for muscularity, as well as a negative association with body appreciation. Discussion: Results provide support for the use of the EDE‐Q using a one‐factor structure in Brazilian cisgender gay and bisexual adult men and give insights for future studies on eating disorders in sexual minorities in Latin America. Public Significance: The Eating Disorder Examination Questionnaire (EDE‐Q) is one of the most widely used self‐report measures of eating disorder symptoms. However, there is a lack of research on the validity and reliability of the EDE‐Q in Latin American countries. This study evaluated the validity and reliability of the EDE‐Q in Brazilian cisgender gay and bisexual adult men. Our findings give insights for future studies on eating disorders in sexual minorities in Latin America. [ABSTRACT FROM AUTHOR]

Background: There are well‐recognized benefits of behavioral interventions that include exercise for children and adolescents with obesity. However, such behavioral weight management programs may precipitate unintended consequences. It is unclear if different exercise modalities impact eating behaviors differently in youth with obesity. Objectives: The purpose of this study was to examine the effects of aerobic, resistance, and combined aerobic and resistance exercise training on eating attitudes and behaviors (uncontrolled eating, restrained eating, emotional eating, external eating and food craving) among adolescents with overweight and obesity. Methods: N = 304 (70% female) adolescents with overweight and obesity participated in the 6‐month Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) randomized controlled trial. All participants were inactive post‐pubertal adolescents (15.6 ± 1.4 years) with a mean BMI = 34.6 ± 4.5 kg/m2. The Food Craving Inventory (food cravings), Dutch Eating Behavior Questionnaire (restrained eating, emotional eating, external eating), and the Three‐Factor Eating Questionnaire (uncontrolled eating) were used to assess eating attitudes and behaviors. Results: All exercise groups showed within‐group decreases in external eating and food cravings. Participants randomized to the Combined training group and were more adherent showed the greatest improvements in eating behaviors and cravings. Conclusions: A 6‐month exercise intervention produced improvements in disordered eating behaviors and food cravings, but effects may be gender and modality‐specific. Findings highlight the need to tailor exercise intervention to participant characteristics for the promotion of healthier eating and weight management outcomes in youth with obesity. Clinical Trial Registration # and Date: ClinicalTrials.Gov NCT00195858, September 12, 2005 [ABSTRACT FROM AUTHOR]

Plain English Summary The International Classification of Diseases 11th Revision (ICD-11) contains a novel personality disorder model. We explored how this model’s components (i.e., personality dysfunction, five maladaptive personality traits) relate to eating pathology. The model components were significantly and complementarily related to a drive for thinness, bulimia, body dissatisfaction, orthorexia, and binge eating. Hence, the ICD-11 personality disorder model may potentially prove helpful in better understanding individual differences in eating pathology.

The Eating Disorder Examination Questionnaire (EDE-Q) is one of the most widely used self-reporting methods for assessing the behaviors and attitudes associated with eating disorders. Since recent studies have proposed alternative and shorter forms of the EDE-Q, the aim of this study is to compare the factor structure of the full-length version of the EDE-Q with several proposed models. A total of 600 participants (80.2% women) aged 18 to 52 years participated in the study. Among the four tested models, the abbreviated version of the questionnaire (EDE-Q7) showed the best fit for the data. The total score on the EDE-Q7 was highly correlated with the total score on the EDE-Q28 and the Eating Attitudes Test-26 (EAT-26), indicating good convergent validity. The findings indicate that the EDE-Q7 is a psychometrically acceptable and effective measure that can be used to assess symptoms of eating disorder behaviors in the Croatian community sample. [ABSTRACT FROM AUTHOR]

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with overactivity, inattention, and impulsivity as core characteristics. Recent studies suggest that 20 % of children with ADHD also develop eating disorders (EDs), including anorexia nervosa, bulimia nervosa and binge eating disorder. However, little is still known about the association between ADHD and EDs through childhood and adolescence. Therefore, in the present work, we aimed at summarizing the studies investigating ADHD and EDs in childhood and adolescence over the last 10 years.Methods: A bibliographic search on PubMed was performed and only studies that considered participants with a clinical diagnosis of ADHD, patients with an additional diagnosis of EDs and patients under 18 years old were included. A total of 7 studies were retrieved and included in the review.Results: The majority of the reviewed studies (N = 5) found an association between ADHD and EDs, while the remaining, which focused on EDs symptomatology, reported either lower ED symptoms in ADHD sample or no association between ADHD and EDs.Limitations: the majority of studies were cross-sectional and therefore did not allow to explore the longitudinal casual relation between ADHD and EDs in the developmental age range considered.Conclusions: This review suggests that children and adolescents with ADHD should be monitored for EDs. However, more work is still needed to better understand the clinical implications of the comorbidity between ADHD and EDs and its prospective impact on the life of children and adolescents with ADHD. [ABSTRACT FROM AUTHOR]

Objectives: Accumulated evidence from longitudinal studies indicated that higher self-compassion levels are associated with greater reductions in eating disorder symptoms over time. However, the nature of these associations is not fully understood. It is possible that these constructs are related in a reciprocal—rather than a unidirectional—fashion, serving to influence each other over time. This study tested for possible longitudinal reciprocal relations between self-compassion and eating disorder symptoms over the course of 8 months. Method: Participants were community-based adult women who were invited to complete study measures at baseline (T1; n = 3039), 4-month follow-up (T2; n = 1483), and 8-month follow-up (T3; n = 1361). Cross-lagged panel analyses were computed to test for the hypothesized reciprocal relationships. Results: Evidence for reciprocal, negative associations was found between these constructs. Higher (or lower) self-compassion scores at T1 predicted greater decreases (or increases) in global levels of eating pathology at T2 (β = − 0.06), which in turn predicted further increases (or decreases) in self-compassion at T3 (β = − 0.05). The same pattern emerged when modeling overvaluation with weight and shape as a construct of eating disorder symptoms. Conclusions: This study established reciprocal longitudinal associations between self-compassion and indices of eating pathology. Incorporating strategies designed to cultivate compassionate ways of responding within established eating disorder prevention programs may help to improve their potency. Preregistration: This study was not preregistered. [ABSTRACT FROM AUTHOR]

Coaches' role in athletes' eating pathology has been largely understood according to athletes' accounts of the coaching behaviors and practices that harmed them. Uniquely, this study engaged coaches as research participants to more fully inform future intervention efforts. Using a multiparadigm approach, this study explored how coaches' understood, constructed, and communicated sport-related body ideals with their female athletes through specific coaching behaviors and practices along with systems of influence and interaction that informed them. Ten coaches (Mage= 35.6) of female aesthetic sport athletes were interviewed. Data were analysed via interpretive description. Results indicated coaches' negative experiences as athletes themselves informed their intention to prevent harm with athletes they coached. Coaches nonetheless emphasized weight, shape, size, and appearance ideals steeped in sport tradition. Dissonance was salient between wanting to prevent harm using strategic approaches to body-related communication, while also reinforcing body ideals believed to promote high performance. Yet, neither athletes' performance goals nor prevention of harm were attained. Influences across coaches' ecosystems explained their behaviors and practices. A novel framework is proposed to describe five intersectional body ideal orientations embodied by the coaches, ranging from body ideal conformity to body diversity advocacy. This framework can inform coach-centered, systems-based education and research. • Preventing harm while maintaining sport body ideals led to dissonance for coaches. • Coaches' effort to resolve dissonance involved strategic body-related communication. • Neither athletes' performance goals nor prevention of harm were attained. • Various influences amid coaches' ecosystems explained their behaviors and practices. • Coach-centered, systems-based approaches must inform interventions in this area. [ABSTRACT FROM AUTHOR]

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

Male athletes are a subpopulation at risk for developing eating disorders and disordered eating concerns, primarily due to the presence of socioculturally-based factors, including body dissatisfaction. Self-compassion may alleviate this risk by improving body satisfaction. To date, no study has examined longitudinally self-compassion's effect on body satisfaction and, ultimately, disordered eating in male athletes. Across two time points separated by four months, we assessed self-compassion, body satisfaction, and disordered eating in 454 male collegiate athletes. Through cross-lagged, panel analysis, after controlling for the Time 1 scores, we determined that: (a) Time 1 self-compassion was neither directly related to Time 2 body satisfaction (β = 0.02, p =.755), nor indirectly to Time 2 disordered eating (β = −0.002, 95% BCaCI [−0.028, 0.014]), and (b) Time 1 body satisfaction directly predicted Time 2 disordered eating (β = −0.12, p < 0.05). Our findings extend past research, demonstrating that body satisfaction is a primary antecedent to disordered eating among male athletes. However, the proposed effects of self-compassion on the body satisfaction to disordered eating relationship were not supported and may be dependent on gender and athlete status. • Self-compassion did not predict disordered eating, directly or indirectly. • Male athletes' body satisfaction predicted decreases in disordered eating over time. • Body dissatisfaction is a risk factor for male athletes. [ABSTRACT FROM AUTHOR]

Research on body image and eating within the mother-daughter dyad tends to emphasize the influence that mothers may have on daughters, with little focus on the concomitant influence that daughters may have on mothers. Utilizing the Actor-Partner Interdependence Model (APIM) within a sample of mothers and their daughters within three age ranges (middle school, high school, and college, N = 356 dyads), we examined relations between mother and daughter body dissatisfaction and restrictive eating and bulimic symptoms. Results indicated that mother and daughter body dissatisfaction significantly predicted their own eating pathology (actor effects). Although no significant partner main effects occurred, a notable actor-partner interaction was obtained; mothers' body dissatisfaction significantly predicted higher levels of their own restrained eating only when their daughters were ages 16 and older. In addition, a moderated actor effect was found for bulimic symptoms, such that the relation between a daughter's body dissatisfaction and her own bulimic symptoms became progressively stronger as her age increased. Overall, the findings provide replication of actor effects, with partial support for mutuality of mother and daughter influence. • Mother and daughter body dissatisfaction predicted their own eating pathology. • Daughter age significantly predicted higher levels of her own restrained eating. • Two significant two-way interactions emerged and were examined. • Findings partially supported mutuality of mother/daughter body and eating influence. [ABSTRACT FROM AUTHOR]

Objective: The buffering role of the hijab as a protective factor against eating pathology has been questioned in countries where wearing the hijab is compulsory, such as Iran; and, cross-cultural comparisons of body image in Iranian and Western women are sparse. Consequently, we examined sociocultural correlates of eating pathology in US and Iranian women. Method: College women from the US (n = 709) and Iran (n = 331) completed the Eating Disorder Examination-Questionnaire (EDE-Q) and the Sociocultural Attitude Toward to Appearance Questionnaire-4 (SATAQ-4). Prior to examining main hypotheses, we evaluated whether the scales perform similarly (i.e., establish measurement invariance) by culture. Results: The EDE-Q and SATAQ-4 were not invariant by culture indicating that the scales performed differently across groups, so separate analyses were conducted in each sample. Thin-ideal internalization and pressures for thinness were significant positive predictors of eating pathology in both US and Iranian women. Conclusion: Both pressures for thinness and thin-ideal internalization appear to be relevant to eating pathology in women from both cultures. However, there may be important cross-cultural differences in the interpretation or experience of these constructs. Further understanding of this measurement non-invariance and the ways in which Iranian women may be uniquely impacted by Western values of appearance is a critical next step. [ABSTRACT FROM AUTHOR]

Background: Recently, the International Classification of Diseases 11th Revision (ICD-11) has introduced a paradigm shift in personality disorder conceptualization. The novel ICD-11 personality disorder model comprises a dimensional assessment of personality dysfunction and five maladaptive personality trait domains. Maladaptive personality plays a central role in eating pathology. Yet, relations between the ICD-11 personality disorder model and eating pathology are, to date, unclear. Thus, this study aimed to explore the bivariate, incremental, and interactive associations of the ICD-11 personality disorder model components with eating pathology domains. Methods: A predominantly female (85%) sample of 888 German-speaking community adults completed validated self-report measures of personality dysfunction, the ICD-11 personality trait domains, and five eating pathology domains (drive for thinness, bulimia, body dissatisfaction, orthorexia, binge eating). Bivariate and hierarchical regressions models were used to investigate bivariate, incremental, and interactive relations between the ICD-11 personality disorder model components and eating pathology. Results: Personality dysfunction and the ICD-11 personality trait domains showed statistically significant bivariate relations with eating pathology. Additionally, personality dysfunction and most ICD-11 personality trait domains displayed incremental links with eating pathology. Finally, the relations of the ICD-11 personality trait domains with eating pathology were largely independent of the severity of personality dysfunction. Conclusions: This study indicated that all ICD-11 personality disorder model components are uniquely linked to eating pathology. Beyond maladaptive personality trait domains, the strong and incremental relations of personality dysfunction with eating pathology have potential implications for theory building. Further research using longitudinal designs is needed to evaluate causal links between the ICD-11 personality disorder model components and eating pathology. Plain English Summary: The International Classification of Diseases 11th Revision (ICD-11) contains a novel personality disorder model. We explored how this model's components (i.e., personality dysfunction, five maladaptive personality traits) relate to eating pathology. The model components were significantly and complementarily related to a drive for thinness, bulimia, body dissatisfaction, orthorexia, and binge eating. Hence, the ICD-11 personality disorder model may potentially prove helpful in better understanding individual differences in eating pathology. [ABSTRACT FROM AUTHOR]

Objective: Self‐objectification is linked to disordered eating (DE) behaviors in women. However, the awareness of objectification by the self and others, not just the objectifying experiences themselves, may be differentially related to DE. The proposed study examines the development and validity of the Conscious Objectification Questionnaire (COQ), which seeks to evaluate awareness of objectification by others and intentional self‐objectification. Method: In Study 1, 24 participants who identify as women (≥18 years) will provide qualitative feedback on COQ items, and survey items will be updated based on participant feedback. In Study 2, separate participants will complete the COQ and questionnaires assessing DE, self‐objectification, and mental health correlates. Exploratory factor analyses will be conducted on the COQ, and reliability and convergent and divergent validity will be assessed. Results: Results will clarify whether the COQ is a reliable and valid instrument that measures the distinct construct of awareness of objectification. Discussion: If proven psychometrically sound, the COQ may be useful for future research on the link between awareness of objectification and disordered eating. Public Significance: The novel Conscious Objectification Questionnaire (COQ) assesses the degree to which women recognize and act upon being objectified. The COQ will be reviewed by self‐objectification experts and pilot participants before being psychometrically evaluated with data from a larger sample. The COQ is expected to differentially relate to disordered eating above and beyond existing self‐objectification measures and accurately represent the distinct construct of conscious awareness of societal and self‐objectification. [ABSTRACT FROM AUTHOR]

Plain English summary Research in the field of eating disorders has focused on females, and less is known about the symptom presentation and treatment outcomes in males and gender minority youths. This prospective study set out to assess gender differences in eating pathology and treatment outcomes. Muscularity concerns may be particularly relevant for male youths with eating disorders, yet there is limited research on gender differences in muscularity concerns in treatment-seeking youths with eating disorders. Participants include cisgender male youths, matched cisgender females, and gender diverse youths who did not identify with the sex assigned to them at birth. Youths completed measures of eating disorder symptoms, including muscularity concerns, and other psychiatric symptoms at baseline and end of treatment. Some gender differences in eating pathology appeared at baseline, with trans youths reporting higher levels of eating pathology than cisgender youths. There were no differences between cisgender males and females in eating disorder symptom presentation at baseline, and contrary to expectations, there were no gender differences in measures of muscularity concerns. However, males demonstrated greater eating disorder symptom improvements than females.

This study sought to investigate independent associations of impulsivity and compulsivity with eating disorder (ED) symptoms. Women (N = 81) with full or subthreshold Diagnostic and Statistical Manual of Mental Disorders IV anorexia nervosa (AN) completed a semi-structured interview and self-report questionnaires. Multiple regression analyses were conducted using ED symptoms as dependent variables and facets of impulsivity and compulsivity as predictor variables (controlling for body mass index and AN diagnostic subtype). For impulsivity facets, lack of perseverance was uniquely associated with eating concern, shape concern and restraint, whereas negative urgency was uniquely associated with eating concern and frequency of loss of control eating; neither sensation seeking nor lack of premeditation was uniquely associated with any ED variables. Compulsivity was uniquely associated with restraint, eating concern and weight concern. Results support independent associations of impulsivity and compulsivity with ED symptoms in adults with AN, suggesting potential utility in addressing both impulsive and compulsive processes in treatment. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

ObjectiveThe buffering role of the hijab as a protective factor against eating pathology has been questioned in countries where wearing the hijab is compulsory, such as Iran; and, cross-cultural comparisons of body image in Iranian and Western women are sparse. Consequently, we examined sociocultural correlates of eating pathology in US and Iranian women.MethodCollege women from the US (n = 709) and Iran (n = 331) completed the Eating Disorder Examination-Questionnaire (EDE-Q) and the Sociocultural Attitude Toward to Appearance Questionnaire-4 (SATAQ-4). Prior to examining main hypotheses, we evaluated whether the scales perform similarly (i.e., establish measurement invariance) by culture.ResultsThe EDE-Q and SATAQ-4 were not invariant by culture indicating that the scales performed differently across groups, so separate analyses were conducted in each sample. Thin-ideal internalization and pressures for thinness were significant positive predictors of eating pathology in both US and Iranian women.ConclusionBoth pressures for thinness and thin-ideal internalization appear to be relevant to eating pathology in women from both cultures. However, there may be important cross-cultural differences in the interpretation or experience of these constructs. Further understanding of this measurement non-invariance and the ways in which Iranian women may be uniquely impacted by Western values of appearance is a critical next step.

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment.

ObjectiveWe examined whether media exposure and media-induced stress contributed to eating disorder behaviors immediately and over the course of a day in women with anorexia nervosa (AN).MethodWomen with AN (N = 118) completed a 2-week ecological momentary assessment protocol during which they reported on exposure to food, shape, or weight-related media, associated stress, and eating behaviors.ResultsFood, weight, or shape-related media exposure alone did not predict more frequent daily eating disorder behaviors. However, stress associated with media exposure was prospectively associated with a greater likelihood of binge eating and vomiting at the next assessment point. In addition, media-induced stress increased the probability of restrictive eating and fluid intake, vomiting, and laxative abuse across the day.DiscussionMedia-induced stress may contribute to increased eating disorder behaviors in women with AN, as women who saw a media image and reported this experience as stressful were more likely to engage in momentary binge eating or vomiting. Reducing stress associated with viewing media images could be a potential target for therapeutic intervention with disordered eating. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:617-621).

The purpose of this systematic review is to evaluate the prevalence of disordered eating and eating disorders among women seeking fertility treatment. Observational studies were searched in Ovid MEDLINE, Web of Science, Embase, and PsycInfo. Studies published prior to September 2020 when the search was conducted were considered. Inclusion criteria included (1) original and empirical research, (2) published in a peer-reviewed journal, and (3) reported on disordered eating among women seeking fertility treatment in the sample or reported on prevalence of eating disorders among women seeking fertility treatment in the sample. Independent screening of abstracts was conducted by two authors (LH and AH). Ten studies met the inclusion criteria. Sample size, study location, measures, and results for each study in this review were reported. Among women pursuing fertility treatment, rates of current eating disorders ranged from 0.5 to 16.7%, while past eating disorder prevalence rates ranged from 1.4 to 27.5%. Current anorexia nervosa or bulimia nervosa was reported by up to 2% and 10.3% of women, respectively, while history of anorexia nervosa or bulimia nervosa was reported by up to 8.5% and 3.3% of women, respectively. Binge eating disorder or other eating disorders were reported by up to 18.5% and 9.1% of women, respectively. Disordered eating pathology was endorsed by 1.6 to 48% of women seeking fertility treatment. Endorsement of pathological eating attitudes was generally higher among women seeking fertility treatment with current or past eating disorders as compared to community samples, with the exception of dietary restraint. Rates of current and past eating disorders are higher among women seeking fertility treatment than in the general population. Providers treating women with infertility should be cognizant of these prevalence rates and consider screening for eating pathology in their patients as this may contribute to their likelihood of successful conception and/or subsequent pregnancy outcomes. [ABSTRACT FROM AUTHOR]

COVID-19 emerged in 2019 and has since killed more than two and a half million people worldwide. Several studies have investigated the role of COVID-19 on the prevalence of mental health outcomes, with general findings indicating elevated rates of mental health issues as compared to the pre-COVID-19 era. However, the effect of specific demographic features is less clear. As such, we investigated whether anxiety, depressive, and eating pathology symptoms varied by gender, age, status as a medical provider (compared to the general public), race, or region of origin. Forty-three effect sizes from 36 studies indicated that all three symptoms increased from pre- to peri‑COVID-19-eras across all regions. No symptom varied by age, status as a medical provider, or race, though females were significantly more likely to experience eating pathology than males. Findings from our study indicate that worldwide, regardless of age, status as a medical provider, race, or region of origin, respondents experienced significantly elevated rates of psychopathology symptoms during the onset of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Cortney S Warren,1,2 Liya M Akoury3 1Department of Psychology, University of Nevada - Las Vegas, Las Vegas, NV, USA; 2Choose Honesty, LLC., Las Vegas, NV, USA; 3Walden Behavioral Care, Amherst, MA, USACorrespondence: Cortney S WarrenChoose Honesty, LLC., 4044 N Lincoln Avenue, Unit 319, Chicago, IL 60618, USAEmail CortneyWarren@ChooseHonesty.comAbstract: A large body of research suggests that thin-ideal internalization is a robust predictor of eating pathology in women and, to some degree, in men. Recent research is exploring the relationships between thin-ideal internalization and culture-specific factors that may be salient to women and men who live in the US but are marginalized based on racial or ethnic background, such as acculturation. This systematic review summarizes published articles examining the relationships among thin-ideal internalization, acculturation-related constructs (including assimilation, marginalization, biculturalism, and acculturative stress), and eating pathology in US adults. Following the PRISMA method, 15 empirical studies met inclusion criteria. Although existing literature was sparse and conflicting in large part due to heterogeneity in acculturation measures, results yielded some support for positive correlational relationships between acculturative stress, thin-ideal internalization, and eating pathology for both men and women (in 4 out of 5 relevant studies). Research on other aspects of acculturation (eg, integration, assimilation) is mixed, with some existing research suggesting a positive relationship and other research finding no statistically significant relationship. Future research would particularly benefit from a gold-standard, multidimensional transcultural measure of acculturation to examine how the acculturation process relates to thin-ideal internalization and eating pathology in ethnic and racial minorities in the US.Keywords: eating pathology, thin-ideal internalization, acculturation, acculturative stress, biculturalism, generational status

There is evidence that gender as well as sexual orientation can affect body image. In particular, heterosexual women and homosexual men seem to be more vulnerable to a negative body image compared to homosexual women and heterosexual men. One reason for this may be derived from the fact that heterosexual women and homosexual men try to attract male romantic partners: As men place more importance on physical attractiveness than do women, the pressure to fulfill the sociocultural beauty ideal is thus increased. The present online study investigated differences in appearance-related partner preferences and their associations with measures of body image and eating pathology in homosexual and heterosexual women and men. The non-representative sample consisted of 893 participants (n = 201 lesbian women, n = 192 gay men, n = 349 heterosexual women, and n = 151 heterosexual men), who completed silhouette measures assessing their perception and expectations regarding body fat and muscularity of their own body and the body of a potential romantic partner, as well as questionnaires on drive for thinness, drive for muscularity, and eating pathology. Overall, few differences in appearance-related partner preferences emerged between the four groups. However, compared to heterosexual women, homosexual men appeared to prefer higher muscularity in potential romantic partners, which was also associated with increased drive for thinness and muscularity and increased eating pathology. The present findings indicate that, irrespective of sexual orientation, women and men tend to share similar standards regarding their own and a potential partner's physical appearance, potentially suggesting an increased hegemony of heteronormative beauty ideals in women and men in general. [ABSTRACT FROM AUTHOR]

In a social and sports world dominated by weight-centred beliefs and highly exigent and gendered athletic and beauty body standards, the vulnerability for eating pathology, i.e., disordered eating and eating disorders (EDs), is elevated among women athletes. The aim of this study was to explore body image facets and ED risk among female athletes in masculinised sports such as soccer. Forty-five federated amateur female soccer players from Spain participated in this study, voluntarily complying with an extensive evaluation protocol on attitudes towards body and appearance and eating practises. The participants overall reported self-representations of their bodies that corresponded to their reality as athletes, but their body ideals were also more demanding in terms of low fat and muscularity, in association with the functionality of their body and the physical demands of their athletic activity. Despite having a fairly high positive body image and body satisfaction, they also expressed negative attitudes towards their bodies. Around 2 out of 10 players were at risk of suffering from an ED. Players with negative attitudes towards their bodies had an odd 12 times likely to develop an ED compared to those with lower self-devaluation, after adjusting for BMI and body perceptions (OR = 12.3, p < 0.01). On the contrary, players who appreciate their bodies and hold a positive body image had an odd 83% lower to suffer from eating pathology, after adjusting for BMI and body satisfaction (OR = 0.17, p < 0.05). Our findings support the healthy and protective role of positive body image in sports contexts. Body attitudes should be addressed in preventive and therapeutic efforts for reducing the prevalence of EDs in women's sports, within both a “negative” and a “positive” paradigm of body image.

In a social and sports world dominated by weight-centred beliefs and highly exigent and gendered athletic and beauty body standards, the vulnerability for eating pathology, i.e., disordered eating and eating disorders (EDs), is elevated among women athletes. The aim of this study was to explore body image facets and ED risk among female athletes in masculinised sports such as soccer. Forty-five federated amateur female soccer players from Spain participated in this study, voluntarily complying with an extensive evaluation protocol on attitudes towards body and appearance and eating practises. The participants overall reported self-representations of their bodies that corresponded to their reality as athletes, but their body ideals were also more demanding in terms of low fat and muscularity, in association with the functionality of their body and the physical demands of their athletic activity. Despite having a fairly high positive body image and body satisfaction, they also expressed negative attitudes towards their bodies. Around 2 out of 10 players were at risk of suffering from an ED. Players with negative attitudes towards their bodies had an odd 12 times likely to develop an ED compared to those with lower self-devaluation, after adjusting for BMI and body perceptions (OR = 12.3, p < 0.01). On the contrary, players who appreciate their bodies and hold a positive body image had an odd 83% lower to suffer from eating pathology, after adjusting for BMI and body satisfaction (OR = 0.17, p < 0.05). Our findings support the healthy and protective role of positive body image in sports contexts. Body attitudes should be addressed in preventive and therapeutic efforts for reducing the prevalence of EDs in women's sports, within both a "negative" and a "positive" paradigm of body image. [ABSTRACT FROM AUTHOR]

Background: To address the gaps in the literature examining eating disorders among males and gender minority youths, a prospective study was designed to assess gender differences in eating disorder symptom presentation and outcomes. Muscularity concerns may be particularly relevant for male youths with eating disorders, and were included in assessment of eating disorder symptom presentation. Methods: All cisgender male youths who presented for specialized eating disorder treatment at one of two sites were invited to participate, along with a group of matched cisgender females, and all youths who did not identify with the sex assigned to them at birth. Youths completed measures of eating disorder symptoms, including muscularity concerns, and other psychiatric symptoms at baseline and end of treatment. Results: A total of 27 males, 28 females and 6 trans youths took part in the study. At baseline, Kruskal–Wallis tests demonstrated that trans youths reported higher scores than cisgender male and female youths on measures of eating pathology (Eating disorder examination-questionnaire (EDE-Q) and the body fat subscale of the male body attitudes scale (MBAS)). These analyses demonstrated that there were no differences between cisgender male and female youths on eating disorder symptoms at baseline. However, repeated measures ANOVA demonstrated that males had greater decreases in eating pathology at discharge than did females, based on self-reported scores on the EDE-Q, MBAS, and Body Change Inventory. Conclusions: Gender differences in eating pathology appeared at baseline, with trans youths reporting higher levels of eating pathology than cisgender youths, though no differences between cisgender males and females emerged at baseline for eating disorder symptom presentation. Contrary to expectations, there were no gender differences in measures of muscularity concerns. Males demonstrated greater eating disorder symptom improvements than females, suggesting that male adolescents may have better treatment outcomes than females in some domains. Plain English summary: Research in the field of eating disorders has focused on females, and less is known about the symptom presentation and treatment outcomes in males and gender minority youths. This prospective study set out to assess gender differences in eating pathology and treatment outcomes. Muscularity concerns may be particularly relevant for male youths with eating disorders, yet there is limited research on gender differences in muscularity concerns in treatment-seeking youths with eating disorders. Participants include cisgender male youths, matched cisgender females, and gender diverse youths who did not identify with the sex assigned to them at birth. Youths completed measures of eating disorder symptoms, including muscularity concerns, and other psychiatric symptoms at baseline and end of treatment. Some gender differences in eating pathology appeared at baseline, with trans youths reporting higher levels of eating pathology than cisgender youths. There were no differences between cisgender males and females in eating disorder symptom presentation at baseline, and contrary to expectations, there were no gender differences in measures of muscularity concerns. However, males demonstrated greater eating disorder symptom improvements than females. [ABSTRACT FROM AUTHOR]