Abstract
Introduction: Cardiovascular disease risk factors and eating disorders are both common in young women. There is scant research regarding eating disorder behaviors within the context of cardiovascular health interventions focused on nutrition, physical activity, and weight reduction. This project explored eating disorder behaviors while developing a cardiovascular health promotion tool for young women. Methods: We used an exploratory sequential mixed-methods approach. We interviewed 10 young women about an existing adult cardiovascular risk assessment tool. Three independent coders analyzed the interview data for themes pertaining to weight, food, exercise, and eating disorder behaviors. We used this qualitative data to inform modifications to the adult tool and create the new tool, HerHeart, focusing on teen-friendly language that deprioritized feedback surrounding weight. We then recruited 60 young women ages 13-21 years to complete HerHeart during a clinical visit; 12 participants returned for a three-month follow-up visit. Participants completed the Eating Disorder Diagnostic Scale (EDDS; score ranges from 0-128) at the baseline and follow-up visits. Hypothesis: We hypothesized that there would be no deterioration in EDDS scores over the intervention phase of HerHeart. Results: We identified themes in interviews, such as the importance of word choice when discussing weight (“words can hurt […] especially if you're overweight”, "when you're telling somebody they [are] obese, I feel like [you] should word it differently”), influences on body image and dieting (“some people see people who are […] very fit and they're like, okay, I'm going to starve myself”), and emotional eating (“I shouldn’t be eating this much because I am emotional eater […] When I do get sad […] I mostly eat”). At baseline, one participant met criteria for binge eating disorder and one met criteria for night eating syndrome. At follow-up, a separate individual met criteria for night eating syndrome. The median EDDS composite score for these 12 participants changed from 19 (IQR 10.5, 24) to 21 (IQR 10.5, 26). Conclusion: In conclusion, there was no significant change in EDDS composite score for young adult participants in a cardiovascular health intervention; very few participants met criteria for eating disorders. This emphasizes the importance of thoughtful language surrounding weight, eating habits, and body image in interventions involving adolescents.
Published Version
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