Abnormal Eating Behavior Research Articles

Validation of the Chinese version of the abnormal eating behavior questionnaire in people with dementia

Abnormal eating behaviors are common in patients with dementia. To comprehensively assess and understand these issues, we validated the Chinese version of the Abnormal Eating Behaviour Questionnaire. Data for psychometric property evaluation were obtained from 129 patients with dementia. Internal consistency, test-retest reliability, dimensionality, and concurrent validity of the instrument were tested. The instrument showed acceptable internal consistency (Cronbach's alpha 0.73), time stability (Intra-class correlation coefficient 0.88, 95% CI: 0.77–0.94), and concurrent validity (ρ = 0.60, P < 0.001). Six factors (eigenvalues > 1, factor loading ≥ 0.3) explaining 55.1% of the variance were obtained through exploratory factor analysis. Overall, 86.8% of the participants showed at least one abnormal eating behavior. The instrument is reliable and valid for assessing abnormal eating behaviors in patients with dementia. Patients with dementia had a high prevalence of abnormal eating behaviors.

Preventing Nutritional Disorders in Adolescents by Encouraging a Healthy Relationship With Food

Nutritional disorders, including overweight, underweight, and/or nutrient deficiency, are a significant cause of morbidity and mortality. These disorders are frequently related to abnormal patterns of eating and/or physical activity, which commonly begin in adolescence and persist into adulthood. Abnormal eating and exercise behaviors may stem from an unhealthy relationship with food, which often takes root in preadolescence or early adolescence. To prevent eating disorders, overweight, underweight, and nutritional deficiencies in adolescence and beyond, health care providers need to proactively support early adolescents and their caregivers to develop a healthy relationship with food and their bodies. Anticipatory guidance, nutrition and exercise counseling, and encouragement of body positivity and healthy self-image during the vulnerable period of early adolescence can prevent maladaptive behaviors from emerging later on. Advocacy beyond the health care setting is also needed to ensure that adolescents are exposed to consistent and positive nutritional messaging. In this position article, authors from both the Nutrition/Obesity Committee and the Eating Disorder Committee of the Society of Adolescent Health and Medicine provide practical recommendations for health care professionals to guide their young patients and caregivers toward a flexible, balanced, and satisfying approach to nutrition that will lead to physical and emotional wellness throughout their lifetimes.

Examining simultaneous associations of four emotion regulation strategies with abnormal eating behaviors/attitudes in early adolescents

Previous research has suggested that emotion regulation strategies (ERSs) are associated with abnormal eating behaviors and attitudes (AEBs). Available data have demonstrated that frequent rumination, a major maladaptive ERS, is associated with elevated AEBs, whereas adaptive ERSs, such as problem-solving and cognitive reappraisal, showed negative associations with AEBs. Most previous studies examined the association of a single ERS with AEBs. Therefore, any significant associations between an individual ERS and AEB reported in previous research might stem from spurious correlations. The current cross-sectional study sought to examine simultaneous associations of four ERSs (rumination, problem-solving, distraction, and cognitive reappraisal) with two categories of ED symptoms (i.e., drive for thinness and bulimic symptoms) in early adolescents in Japan (ages 10–15, N = 5301). Participants self-reported their use of the different ERSs and the ED symptoms. We found certain ERSs were uniquely associated with levels of drive for thinness and bulimic symptoms even after controlling for body mass index, depression, and socioeconomic status. Particularly, frequent rumination in both boys and girls was associated with a severe drive for thinness and bulimic symptoms. Regarding adaptive strategies, frequent uses of problem-solving was associated with decreased bulimic symptoms only in girls, with the effect size being small. In addition, contrary to our expectation, greater use of distraction was associated with elevated AEBs, except the association with drive for thinness in boys. Although this study extended findings of previous research, prospective studies are required to clarify the causal relationship between ERSs and eating pathology.

Hospitalization following eating disorder diagnosis: The buffering effect of marriage and childbearing events.

Eating Disorders (ED) are defined as abnormal eating behaviors, stemming from an obsession with food, body weight, or body shape. EDs affect 10 million men and 20 million women in the US, with an estimated 15% lifetime prevalence among women. An ED diagnosis is often accompanied with a host of adverse physical and mental health outcomes, including a heightened risk for suicidality. Given the complex comorbidities associated with EDs, treatment occurs in inpatient and outpatient settings. This study used linked administrative and health records from the Utah Population Database to create a cohort of women n = 4183 and men n = 423 who had a known diagnosis of ED between 1995 and 2015. Cox proportional hazard regression was used to model ED-related hospitalization trajectories, including subsequent risk for suicidality/self-injurious behavior-related hospitalization. To better estimate the risk profiles associated with different health care utilization patterns, models explored how family-related life course events (childbirth, marriage transitions) and sociodemographic characteristics (race, sex, and median income at census-block) modify hospitalization trajectories following initial diagnosis. Results suggested that increased outpatient treatment was associated with reduced risk of initial ED-related hospitalization, but higher risk for subsequent ED-related hospital readmission. In addition, transition to marriage (i.e., getting married) was associated with reduced risk of ED-related and suicidality/self-injurious behavior-related hospitalizations (initial hospitalization and subsequent readmission). Increased number of children was only associated with reduced risk of initial ED-hospitalization, but not readmission. When assessing individuals' risk for ED-related hospitalizations, social and health services researchers should contextualize treatment trajectories within the individual's life experiences, particularly marital transitions, while simultaneously considering sociodemographic characteristics and utilization of outpatient care. Future research should further examine whether marriage represents an important turning point in the health trajectories of individuals with EDs.

The Potential Roles of Ghrelin in Metabolic Syndrome and Secondary Symptoms of Alzheimer’s Disease

Although the major causative factors of Alzheimer’s disease (AD) are the accumulation of amyloid β and hyperphosphorylated tau, AD can also be caused by metabolic dysfunction. The major clinical symptom of AD is cognitive dysfunction. However, AD is also accompanied by various secondary symptoms such as depression, sleep–wake disturbances, and abnormal eating behaviors. Interestingly, the orexigenic hormone ghrelin has been suggested to have beneficial effects on AD-related metabolic syndrome and secondary symptoms. Ghrelin improves lipid distribution and alters insulin sensitivity, effects that are hypothesized to delay the progression of AD. Furthermore, ghrelin can relieve depression by enhancing the secretion of hormones such as serotonin, noradrenaline, and orexin. Moreover, ghrelin can upregulate the expression of neurotrophic factors such as brain-derived neurotrophic factor and modulate the release of proinflammatory cytokines such as tumor necrosis factor α and interleukin 1β. Ghrelin alleviates sleep–wake disturbances by increasing the levels of melatonin, melanin-concentrating hormone. Ghrelin reduces the risk of abnormal eating behaviors by increasing neuropeptide Y and γ-aminobutyric acid. In addition, ghrelin increases food intake by inhibiting fatty acid biosynthesis. However, despite the numerous studies on the role of ghrelin in the AD-related pathology and metabolic disorders, there are only a few studies that investigate the effects of ghrelin on secondary symptoms associated with AD. In this mini review, our purpose is to provide the insights of future study by organizing the previous studies for the role of ghrelin in AD-related pathology and metabolic disorders.

Rare genetic forms of obesity: From gene to therapy

Monogenic non-syndromic obesity is characterized by severe early-onset obesity with abnormal eating behaviour and endocrine disorders. Genes contributing to these rare forms of obesity are mainly located in the leptin/melanocortin pathway, with typically an autosomal additive inheritance of obesity. The normal function of this hypothalamic pathway is essential for the control of energy balance. Genetic variants are involved in 5–30 % of severe early-onset obesity depending on explored populations. Compared to other genes in the pathway especially leptin (LEP), leptin receptor (LEPR), pro-opiomelanocortin (POMC) and prohormone convertase subtilisin/kexin type 1 (PCSK1), Melanocortin 4 receptor (MC4R)-linked obesity is characterized by obesity of variable severity with no notable endocrine phenotypes. Managing patients with monogenic non-syndromic obesity is clinically challenging since they display complex phenotypes and the obesity is often morbid and refractory to classical treatments. Until recent years, there has been a lack of effective and targeted pharmaceutical molecules except for leptin therapy that was available for leptin deficiency. The picture has changed and new promising molecules acting on the leptin-melanocortin pathway such as setmelanotide -a new MC4R agonist- are now emerging as novel targeted therapeutic opportunities.

Evaluating different versions of the Body Shape Questionnaire and invariance across age in Mexican women.

To analyze the factorial structure of the eight short versions of the Body Shape Questionnaire (BSQ) and analyze the factorial invariance of the best model, its convergent validity and its internal consistency in three age groups of Mexican women. Women attending middle school (n = 261), high school (n = 245) and university (n = 296) participated in the study; their average age was 16.52years (SD = 2.98), and they completed the BSQ, the Eating Attitudes Test (EAT-40) and the Questionnaire on the Influences of the Aesthetic Body Ideal (CIMEC, its acronym in Spanish). The BSQ-8D model showed the best goodness-of-fit indices and evidence for configural, metric, scalar and structural invariance. Both the Cronbach's alpha coefficient and the Omega coefficient for the BSQ-8D were .89. Likewise, the BSQ-8D was correlated with the EAT-40 (r = .60, p < .001) and the CIMEC (r = .77, p < .001), and both the total score and its items discriminated between women with and without abnormal eating behaviors (p < .001). The BSQ-8D has the best psychometric properties for the measurement of body dissatisfaction in the general population of Mexican women. Level V, cross-sectional descriptive study.

Disordered Eating and Eating Disorders in Adolescent Athletes

CONTEXTTo summarize available literature to date and discuss the importance of Disordered Eating (DE) in adolescent athletes, with special attention to the female athlete triad. In this paper, the authors will review the literature regarding adolescent athletes who intentionally engage in abnormal eating behaviors and focus on adolescent athletes of all training levels who may be affected by both DE and eating disorders (ED).METHODSIn 2019, the authors completed a systematic literature search on PubMed using the search term variations of “Feeding and Eating Disorders” and “athletes” with “high school.”RESULTSA total of 20 pertinent articles were identified concerning DE in adolescent athletes. ED have been shown to impose higher rates of comorbidity than other psychological disorders and only a small number of individuals with ED seek treatment. ED tend to be more prevalent in adolescent elite athletes than non-athletes of both genders in all sports and levels of competition.CONCLUSIONSMore rigorous tools for family practice physicians, nurses, and coaches to use when working with at-risk adolescent athletes are needed to identify DE behaviors. Healthcare and school professionals need to be educated and trained to detect DE and the components of the female athlete triad. Additional research with adolescent males or those associating with alternative gender roles is also required to help them prevent physical and mental health consequences associated with DE.

Emotional depersonalization in persons with feeding and eating disorders

In a previous paper, we discussed a model that considers abnormal eating behaviour epiphenomena of a more profound disorder of lived corporeality and identity (Stanghellini and Mancini, this issue). The core idea is that persons with FEDs experience their own body first and foremost as an object being looked at by another, rather than coenaesthetically or from a first-person perspective. In this paper, alienation from one’s own emotions, disgust and shame for one’s body of persons with FED, will be discussed in the light of the embodiment and identity model of FED.

Body experience, identity and the other’s gaze in persons with feeding and eating disorders

The purpose of this paper is to define and describe the main phenomenological dimensions of the life-world of persons prone to Feeding and Eating Disorders (FEDs), within the framework of a model that considers abnormal eating behaviour an epiphenomenon of a more profound disorder of lived corporeality and identity. The core idea is that persons with FEDs experience their own body first and foremost as an object being looked at by another, rather than coenaesthetically or from a first-person perspective. Alienation from one’s own body and the need to feel oneself only through the gaze of the others can be illuminated by looking at it in the light of the Sartrean concept of feeling a lived-body-for-others.

Üniversite Öğrencilerinde Stres ve Sosyal Medya Kullanımının Yeme Davranışları Üzerine Etkisi

Aim: It is possible to be phisicially and mentally healthy and maintain health at every stage of life with adequate and balanced nutrition. Stress, social media, family and peer influence are also factors affecting the nutrition attitude. The aim of this study is to investigate the effects of stress and social media usage on eating behaviors in university students. Methods: Retrospective-descriptive study data were collected by using the interview form consisted of four parts. Those four parts were “general informations” for demographic informations, “Eating Attitudes Test” for eating attitudes diagnosis, “Depression, Anxiety, Stress Scale” for diagnosis of psychological disorders and “Social Media Use”. Results: A total of 422 people, 329 women and 93 men participated in the survey conducted at the Faculty of Health Sciences of Trakya University. There was a statistically significant difference between stress degree and eating behavior disorder and it was determined that the increase in stress severity caused abnormal eating behavior. There was a statistically significant difference between the time allocated to social media and eating behavior disorder, and it was determined that increased time allocated to social media caused eating behavior disorder. Conclusion: In our study, it was determined that stress and social media use had significant negative effects on students' eating behaviors. Keywords: students, stress, social media, feeding behavior

Relationship between Eating Disorder, Body Fat Percentage, and Physical Activity among Sarawak Female National Athletes

Purpose: This study aimed to examine the eating disorder and physical activity in relation to type of sports and body fat percentages among national female athletes in Sarawak (N=150). Methodology: Eating Attitude Test (EAT-26) and Global Physical Activity Questionnaire (GPAQ) were employed to measure the eating disorders and physical activity. Anthropometric measurement and body composition (body fat percentage) were obtained. Results: Majority of the athletes were at low risk of an eating disorder (91.4%). Only a few indicated as high risk (8.6%). Moderately active athletes explained higher eating disorders in dieting, bulimia nervosa and food preoccupation. The non-weight sports athletes also exhibited higher eating disorders compared to its counterpart. Younger athletes were at higher eating disorder, but age was not significant in the subscales measured; except for food preoccupation where it was prominent in age 16 to 18 years old. Oral control did not associate with all the independent variables. Some relationships observed between body fat percentage and eating disorder and the subscales. Conclusion: There is a need for coaches’ attention and intervention on these athletes to prevent abnormal eating behavior among the young female athletes. This study highlights interesting findings where the less active athletes and the non-weight sports category athletes exhibit higher eating disorders issues.

Adipokines, cortisol and cytokine alterations in recent onset anorexia nervosa. A case–control study

IntroductionPsychological and neuroendocrine alterations are typical characteristics in anorexia nervosa patients. The role of adipokines and cytokines as mediators of body systems’ adaptations to the patients’ abnormal eating behavior is not well understood. The duration of disease seems to be a determinant of nutritional status and associated hormone changes. We aimed to assess whether alterations in adipokines, cytokines and cortisol do already exist in patients with a recent disease onset by means of a case–control study. MethodsForty-one adolescent female patients on their first-episode and diagnosed with anorexia nervosa, were matched by age and socioeconomic status (SES) (1:1) with healthy girls. Leptin, soluble leptin receptor (sOB-R), adiponectin, cortisol, and the cytokines IL-1β, IL-2, IL-6 and TNF-α were examined. ResultsThe results showed reduced leptin and increased sOB-R and cortisol levels in AN patients. Adiponectin was also increased but opposite to the previous biomarkers did not correlate with BMI Z-score. Serum TNF-α and IL-2 showed significantly lower and higher values, respectively, in the AN patients than in the controls. Cortisol showed the strongest correlation with sOB-R (r=0.436; P=0.005). ConclusionsOur study confirms previous findings on adipokine and cortisol alterations in AN patients, while overall cytokine results did not show a clear disruption in AN patients with short disease duration. The results highlight the need to disentangle the role of the sOB-R in the interactions between leptin and cortisol secretion.

Establishing links between abnormal eating behaviours and semantic deficits in dementia.

The hypothesis that semantic deficits in dementia may contribute in producing changes in eating preferences has never been experimentally investigated despite this association has been clinically observed. We administered tasks assessing semantic memory and the Appetite and Eating Habits Questionnaire (APEHQ) to 23 patients with dementia (behavioural frontotemporal dementia, primary progressive aphasia, and Alzheimer's disease) and to 21 healthy controls. We used voxel-based morphometry and diffusion tensor imaging to identify regions and white matter tracts of significant atrophy associated with the performance at the semantic tasks and the pathological scores at the APEHQ. We observed that the lower the patients' scores at semantic tasks, the higher their changes in eating habits and preferences. Both semantic disorders and eating alterations correlated with atrophy in the temporal lobes and white matter tracts connecting the temporal lobe with frontal regions such as the arcuate fasciculus, the cingulum, and the inferior longitudinal fasciculus. These results confirm that semantic deficits underlie specific eating alterations in dementia patients.

Neural correlates of body composition in frontotemporal dementia

Frontotemporal dementia (FTD) is associated with complex changes in eating behaviour and metabolism, which potentially affect disease pathogenesis and survival. It is currently not known if body composition changes also exist in FTD, the relationship of these changes to eating behaviour, and whether these changes are centrally mediated. In 28 behavioural variant frontotemporal dementia (bvFTD), 16 Alzheimer’s disease (AD) and 19 controls, body composition was measured using dual x-ray absorptiometry. Changes in body composition were correlated to grey matter atrophy using voxel-based morphometry on high resolution MRI. Behavioural variant frontotemporal dementia was characterised by changes in body composition, with increased total fat mass, visceral adipose area, and android: gynoid ratio compared to control and AD subjects (all p values < .05). Changes in body composition correlated to abnormal eating behaviour and behavioural change (p < .01) and functional decline (p < .01). Changes in body composition also correlated to grey matter atrophy involving a distributed network of neural structures including the hippocampus, the amygdala, nucleus accumbens, insula, cingulate and cerebellum, known to be to central to autonomic control, and also areas involved in reward processing including the thalamus, putamen, accumbens and caudate. Changes in body composition extend the clinical phenomenology in bvFTD beyond cognition and behaviour, with changes potentially mediated by changes in reward and autonomic processing suggesting that these deficits may be central in FTD, and providing targets to modify the neurodegenerative process.

Interests and behaviors toward dietary guidelines and abnormal eating behavior in Japanese undergraduates

Interests and behaviors toward dietary guidelines and abnormal eating behavior in Japanese undergraduates

Neural networks associated with body composition in frontotemporal dementia.

BackgroundFrontotemporal dementia (FTD) is associated with complex changes in eating behavior and metabolism, which potentially affect disease pathogenesis and survival. It is currently not known if body composition changes and changes in fat deposition also exist in FTD, the relationship of these changes in eating behavior and appetite, and whether these changes are centrally mediated.MethodsBody composition was measured in 28 people with behavioral‐variant frontotemporal dementia (bvFTD), 16 with Alzheimer’s disease (AD), and 19 healthy controls, using dual energy x‐ray absorptiometry. Changes in body composition were correlated to brain grey matter atrophy using voxel‐based morphometry on high‐resolution magnetic resonance imaging.ResultsBehavioral‐variant FTD was characterized by changes in body composition, with increased total fat mass, visceral adipose tissue area (VAT area), and android: gynoid ratio compared to control and AD participants (all P values < 0.05). Changes in body composition correlated to abnormal eating behavior and behavioral change (P < 0.01) and functional decline (P < 0.01). Changes in body composition also correlated to grey matter atrophy involving a distributed neural network that included the hippocampus, amygdala, nucleus accumbens, insula, cingulate, and cerebellum – structures known to be central to autonomic control – as well as the thalamus, putamen, accumbens, and caudate, which are involved in reward processing.ConclusionsChanges in body composition and fat deposition extend the clinical phenomenology in bvFTD beyond cognition and behavior, with changes associated with changes in reward and autonomic processing suggesting that these deficits may be central in FTD

Weight bias and eating behaviours of persons with overweight and obesity attending a general medical practice in Durban, South Africa

Background: The consequences of obesity for physical health and non-communicable illnesses are well established, but the impact on psychosocial well-being in persons with obesity is much less understood. This study aimed to assess psychosocial constructs such as weight bias affecting the eating behaviours of persons with overweight and obesity attending a general practice in South AfricaMethods: An observational study was conducted at a private general medical practice situated in a peri-urban area of Durban, KwaZulu-Natal, South Africa. A sample of 100 persons with overweight and obesity, and with a BMI ≥ 25 kg/m2, were recruited by a convenience sampling method. Frequency tables for BMI, sociodemographic factors, perceptions and eating behaviours were described. Spearman’s rank-order correlation was run to assess the relationship between sociodemographic factors, perceptions, knowledge, attitudes and eating behaviours.Results: About 90% were below 60 years and 83% were females. The mean BMI of males was 41.7 kg/m2 (SD = 7.38) and of females was 39.9 kg/m2 (SD = 7.91). It was found that weight stigma (are overweight people discriminated against) and the average household income were associated with abnormal eating behaviours such as compulsive eating, obsession with eating and psychological problems. A significant correlation was demonstrated between ‘Are people with overweight discriminated against?’ and abnormal eating behaviours such as compulsive eating (p = 0.049), obsession with eating (p = 0.009) and psychological problems (p = 0.051)Conclusion: Psychosocial factors such as weight bias affect the eating behaviours of persons with overweight and obesity in South Africa. Research should be done exploring promotion of the psychosocial well-being of patients while trying to manage their obesity.

Eating Behaviour and Its Associations with Overweight among Nurses on Shift Duty in Teaching Hospital

Overweight and obesity have become a global concern and estimated with more than 1.9 billion adults worldwide were overweight and more than 650 million were obese in 2016. Nurses in Malaysia were no exception to overweight and obesity. This research was conducted with the aim to identify the prevalence of overweight among nurses on shift duty in a teaching hospital and to understand the relationship between abnormal eating behavior and body mass index. A total of 280 respondents participated in this research and Dutch Eating Behavior Questionnaire was used. Body Mass Index (BMI) score was categorized according to Clinical Practice Guidelines 2004. Results showed that 68.5% of the nurses were either overweight (37.1%) or obese (31.4%). The nurses’ BMI does not showed any association with socio-demographic data except age (r=0.156). As age increases, the nurses’ BMI also increase. This research also showed that there was no association between emotional and external eating behavior to BMI. However, there was a statistically significant differences in BMI for restraint eating (F=6.056, p=0.003). In conclusion, restraint eating behavior was the most practiced form of eating behavior in an attempt to achieve the ideal body weight but unfortunately lead to overweight among the nurses. Overweight or obese nurses will have a negative impression to the society and even reduce their confidence towards nurses’ health education. Overweight or obesity also ruined the nurses’ working performance and quality of care for patients. This issue requires immediate action and interventions to promote healthy lifestyles and eating habits among nurses should be conducted in the hospital.

More Frequent Family Meals Associated with Greater Risk of Obesity in Youth with and Without ADHD (P11-115-19)

ObjectivesResearch suggests that attention-deficit/hyperactivity disorder (ADHD) is associated with increased obesity in youth likely driven by deficits in self-regulation, increased impulsivity, and abnormal eating behavior. It has been hypothesized that increasing the frequency with which families share meals may mitigate these risk behaviors. However, some families that share frequent meals together may participate in federal nutrition assistance, which has been linked with consuming less healthy foods and with increased risk for obesity. The current study aims to investigate the relationships between ADHD, overweight/obesity, and shared family meals with federal nutrition assistance as a potential moderator. MethodsData were drawn from a nationally representative sample of United States youth ages 10–17 whose parent or guardian participated in the 2016 National Survey of Children’s Health (N = 45,309). All measures were determined based on parent recall. Ordinal regression analyses with moderation were used to evaluate study hypotheses. ResultsAs hypothesized, youth with ADHD were more likely to be overweight/obese than those without ADHD (P < .05) and federal nutrition assistance was associated with more overweight/obesity (P < .001). Contrary to study hypotheses, frequent family meals were associated with more, rather than less, overweight/obesity among youth with ADHD (P < .001). Moderation analyses indicate that federal nutrition assistance was more strongly linked to obesity risk for youth with ADHD, than for those without (P < .05). Remarkably, eating more family meals together increased rather than protected against risk for obesity (P < .05) regardless of ADHD status. ConclusionsThe current study presents an unusual finding which is that more frequent family meals were associated with greater risk of obesity in youth with and without ADHD. The authors hypothesize this may be due to the food choices made by families who share frequent meals and also participate in federal nutrition assistance. This work has important implications for federal nutrition assistance policy reform and for the obesity epidemic. Funding SourcesNone. Supporting Tables, Images and/or Graphs▪