Psychosocial Factors in Adolescence and Risk of Development of Eating Disorders

Background: current findings in the etiopathogenesis of eating disorders (ED) do not allow the formulation of a unique causal model. Currently, the main hypotheses about the etiopathogenesis are based on a multifactorial approach, considering both genetic and environmental factors. The aim of this study is to analyze the relationship between sociodemographic and behavioral factors, as well as self-esteem, in students of the first cycle of middle school and the probability of belonging to the risk group of eating disorders (ED) measured through the EAT-26 scale. Methods: The study target population consists of students of the first cycle of middle school. The instruments applied to the population consisted in: (1) a survey of sociodemographic data and behavioral variables; (2) Rosenberg’s self-esteem test; and (3) EAT Test (Eating Attitudes Test 26). Results: Of a total of 656 students belonging to eight educational centers in Madrid who were offered to participate in the study, 88.6% (n = 579) answered the whole questionnaire. The mean age of the participants was 13.7 years old. Of the participating adolescents, 57.3% were male and the remaining 42.7% (n = 260) were female. A significant relationship was observed between self-esteem and belonging to an ED risk group, with an OR = 0.910 (CI 95% 0.878–0.943). Hence, each one-point increase on the self-esteem dimension decreased the risk of belonging to an ED risk group by 9.5%. In the variables considered in the area of dysfunctional feeding patterns, the variables ‘number of meals’ (p < 0.01), ‘dieting’ (p < 0.01), and ‘drug consumption to lose weight’ (p < 0.01) were found to be related to the risk of belonging to the ED group. Conclusions: The results obtained in our research can help to establish explanatory models that include the understanding of the interaction of the different factors that influence the appearance and development of EDs. Therefore, these should be taken into consideration when developing ED preventive programs.     

Should night eating syndrome be included in the DSM?

OBJECTIVE: This article examines the status of the literature on night-eating syndrome (NES) according to five criteria that have been proposed by Blashfield, Sprock, and Fuller(1) (Compr Psychiatry 1990; 31:15-19) to determine whether NES warrants inclusion in the psychiatric nosology as a distinct eating disorder. METHOD: Relevant research papers were identified in Medline and PsychInfo using the search term "night-eating syndrome." RESULTS: None of the five criteria was met. Specifically, at the time of review, there were not yet 25 empirical papers on NES; no commonly accepted definition of or assessment approach to NES has been adopted; the utility and validity of NES need to be established, and NES needs to be differentiated more clearly from other eating disorder syndromes. CONCLUSION: This review suggests that the most pressing step toward clarifying the status of NES is to develop a uniform definition of NES. Once accomplished, research can progress to accumulating the necessary evidence to determine whether NES should be included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.     

Reliability of the Eating Disorder Examination in patients with binge eating disorder

OBJECTIVE: This study examined the interrater and test-retest reliabilities of the Eating Disorder Examination (EDE) in patients with binge eating disorder (BED). METHOD: Interrater reliability and short-term (6-14 days) test-retest reliability of the EDE were examined in two study groups of 18 patients with BED. RESULTS: Interrater reliability was excellent for objective bulimic episodes and days (correlations above .98) and very good for the EDE scales, albeit somewhat variable (correlations range from .65 to .96). Test-retest reliabilities were very good for objective bulimic episodes (.70) and days (.71) and were good (significant) for the EDE scales, albeit somewhat variable (correlations range from .50 to .88). Interrater reliability was excellent for subjective bulimic episodes and days but test-retest reliabilities were unacceptable. CONCLUSIONS: These findings support the reliability of the EDE for patients with BED. The EDE has utility for assessing the number of large binge episodes (objective bulimic episodes), as well as the number of days during which large binge episodes occurred. The EDE also demonstrates very good interrater and test-retest reliabilities for assessing the associated features of eating disorders in patients with BED. The results for subjective bulimic episodes are consistent with previous studies, suggesting that these eating behaviors may not be reliable indicators of eating disorders.     

Evaluating the effects of eating disorder memoirs on readers' eating attitudes and behaviors

OBJECTIVE: More than 50 individuals have published eating disorder (ED) memoirs. The current study was the first to test whether memoirs affect readers' eating attitudes and behaviors, and whether they normalize and/or glamorize EDs. METHOD: Fifty female undergraduates read an ED or control memoir. Before and afterward, participants completed the 26-item Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI) Drive for Thinness subscale, a measure of perceived ED symptom prevalence, and an Implicit Association Test (IAT) measuring associations between anorexia and glamour/danger. RESULTS: Participants in the ED condition did not demonstrate significant changes in the EAT-26, the EDI Drive for Thinness subscale, perceived symptom prevalence, or IAT associations compared with controls. Before reading, the EAT-26 and EDI Drive for Thinness subscale correlated positively with perceived symptom prevalence and strength of the IAT association between anorexia and glamour. CONCLUSION: ED memoirs appear to have little effect on undergraduates' eating attitudes and behaviors. Future research should investigate whether memoirs affect individuals with preexisting eating pathology, who may normalize and glamorize ED symptoms.     

Satiety and test meal intake among women with binge eating disorder

OBJECTIVE: The purpose of the study was to measure test meal consumption and the changes in hunger and fullness during a test meal in obese individuals with and without binge eating disorder (BED) and normal-weight controls. METHOD: Twelve women with BED, 12 obese control participants, and 12 normal-weight control participants participated in two single-item test meal sessions. In one session participants were instructed to "binge," and the other eat a normal meal. Participants made ratings of hunger and fullness on visual analog scales after every 75-g increment of food. RESULTS: In comparison to obese or normal-weight controls, patients with BED consumed significantly more food to reach a similar level of fullness or hunger. CONCLUSION: Individuals with BED consumed significantly more food and showed blunted changes in hunger and fullness during both the binge and nonbinge meals. These findings suggest that individuals with BED may have disturbances in satiety that in some ways resemble those described among individuals with bulimia nervosa.     

Vegetarianism and weight status: What are the differences in eating styles,impulsivity, and emotional competences? A preliminary study

Recent studies suggest that vegetarian diets may be recommended to promote weight loss in individuals living with obesity. However, limited studies have examined psychological factors (e.g., eating styles, impulsivity) among individuals who have adopted this type of diet, even though these factors are known to play a role in being overweight. The primary objective of the present study was to compare these characteristics in participants living with obesity or those with normal-weight across diet types. Participants were recruited from two hospital nutrition departments and the general population. They completed a diagnostic interview assessing the presence of an eating disorder, followed by self-administered questionnaires measuring dysfunctional eating styles (DEBQ), impulsivity (UPPS), and emotional competence (PEC). Vegetarian participants living with obesity engaged in more dysfunctional eating styles than did normal-weight omnivores and experienced more emotional difficulties than did both normal-weight omnivores and vegetarians. In contrast, there were no significant differences between omnivore participants living with obesity and those in the other groups. Moreover, participants living with obesity had comparable emotion regulation abilities to normal-weight participants. These results suggest that emotion regulation deficits can more likely be explained by the presence of psychopathological traits than by being overweight or one’s choice of diet.     

Time-Restricted Eating Alters Food Intake Patterns,as Prospectively Documented by a Smartphone Application

Time-restricted eating (TRE) can facilitate weight loss, yet its effect on eating patterns remains unknown. Twenty adults with BMI ≥ 25 kg/m² underwent a 12-week randomized trial, examining the effect of an 8-h, time-restricted eating intervention on dietary patterns. Oral intake was documented using a smartphone. Dietary patterns, assessed as frequency of eating occasions (EOs) and types of meals/snacks and beverages, were compared between baseline (T0), early-intervention (T1), and end-intervention (T2). At T1 and T2, both groups had less EOs compared to T0, with greater reduction seen in the TRE group (−28%) than the non-TRE group (−12%) at T2 (p = 0.01 vs. non-TRE). Comparing T1 to T0, the TRE group documented less incomplete meals (−32.5%: p = 0.02), high quality snacks (−23.6%: p = 0.03), and low quality snacks (−36.6%: p = 0.004). Comparing T2 to T0, the TRE group documented less incomplete meals (−33.9%: p = 0.03), high quality snacks (−28.1%: p < 0.001) and low quality snacks (−51.2%: p < 0.001). Caffeinated beverage intake was reduced in the TRE group at T1 (−20.2%) and T2 (−28.8%) vs. T0, but remained unaltered in the non-TRE group. By using a smartphone application to document dietary intake, TRE significantly reduced the number of EOs, snacks, and caffeinated beverages, relative to baseline and relative to the non-TRE.     

Emotional Eating and Dietary Patterns: Reflecting Food Choices in People with and without Abdominal Obesity

Emotional eating (EE) is food consumption in response to feelings rather than hunger. EE is related to unhealthy food intake and abdominal obesity (AO). However, little evidence exists about the association between EE and dietary patterns (DPs) and EE–AO interaction related to DPs. DPs allow describing food combinations that people usually eat. We analyzed the association of EE with DPs in adults (≥18 years) with AO (WC ≥ 80/90 cm in women/men, respectively; n = 494; 66.8% women;) or without AO (n = 269; 74.2% women) in a cross-sectional study. Principal component analysis allowed identifying four DPs from 40 food groups (validated with a semiquantitative food frequency questionnaire). Among the subjects presenting AO, being “emotional/very-emotional eater” (emotional eating questionnaire) was negatively associated with the “Healthy” DP (fruits, vegetables, olive oil, oilseeds, legumes, fish, seafood) (OR:0.53; 95% CI: 0.33, 0.88, p = 0.013) and positively with the “Snacks and fast food” DP (sweet bread, breakfast cereal, corn, potato, desserts, sweets, sugar, fast food) (OR:1.88; 95% CI: 1.17, 3.03, p = 0.010). Emotional eaters with AO have significantly lower fiber intake, folic acid, magnesium, potassium, vitamin B1, and vitamin C, while they had a higher intake of sodium, lipids, mono and polyunsaturated fatty acids, and saturated fats. In non-AO participants, EE was not associated with any DP (p > 0.05). In conclusion, EE is associated with unhealthy DPs in subjects with AO.