Abnormal Eating Habits Research Articles

Relação entre stress, índice de massa corporal e risco de transtornos alimentares

Introduction: Eating disorders are characterized by a persistent disturbance in eating or related behaviors, involving insufficient or excessive food intake, which is considered abnormal eating habits, with harmful effects on physical health and psychosocial function, divided into three main types, anorexia nervosa, bulimia nervosa and binge eating. The development of eating disorders is multifactorial and may be related to stress and BMI. Objectives: To analyze the relationship between stress and BMI with the risk of eating disorders in adult individuals. Methodology: Quantitative, observational, analytical and cross-sectional study. Sample of 302 individuals, adults over 18 years of age. A questionnaire was used to obtain data, using the Perceived Stress Scale (PSS-10) and the Eating Attitudes Test (EAT-26) instruments. Data processing was performed using SPSS, version 29. Results: Most individuals were at normal weight (62,6%), at a moderate stress level (64%) and with a low risk of eating disorders (79%). A statistically significant relationship was found between stress and eating disorders and between BMI and eating disorders. Conclusion: Both stress and BMI influence eating attitudes and after obtaining statistically significant evidence that proves the correlation between the variables, we can conclude that the existing relationship cannot be neglected.

Eating attitudes of migraine patients in Turkey: a prospective multi-center study

BackgroundMigraine is a disease characterized by headache attacks. The disease is multifactorial in etiology and genetic and environmental factors play role in pathogenesis. Migraine can also be accompanied by psychiatric disorders like neurotism and obsessive compulsive disorder. Stress, hormonal changes and certain food intake can trigger attacks in migraine. Previous studies showed that eating attitudes and disorders are prevalant in patients with migraine. Eating disorders are psychiatric disorders related to abnormal eating habits. Both migraine and eating disorders are common in young women and personality profiles of these patient groups are also similar. A possible relationship which shows that migraine and eating habits are related can lead to a better understanding of disease pathogenesis and subsequently new therapeutic options on both entities. Association of migraine in relation to severity, depression and anxiety and eating habits and disorders were aimed to be investigated in this study.MethodsThe study was designed as a prospective, multi-center, case control study. Twenty-one centers from Turkey was involved in the study. The gathered data was collected and evaluated at a single designated center. From a pool of 1200 migraine patients and 958 healthy control group, two groups as patient group and study group was created with PS matching method in relation to age, body-mass index, marital status and employment status. Eating Attitudes Test-26 (EAT-26), Beck’s Depression Inventory (BDI) and Beck’s Anxiety Inventory (BAI) were applied to both study groups. The data gathered was compared between two groups.ResultsEAT-26 scores and the requirement for referral to a psychiatrist due to symptoms related to eating disorder were both statistically significantly higher in patient group compared to control group (p = 0.034 and p = 0.0001 respectively). Patients with migraine had higher scores in both BDI and BAI compared to control group (p = 0.0001 and p = 0.0001 respectively). Severity of pain or frequency of attacks were not found to be related to eating attitudes (r:0.09, p = 0.055).ConclusionsMigraine patients were found to have higher EAT-26, BDI and BAI scores along with a higher rate of referral to a psychiatrist due to symptoms. Results of the study showed that eating habits are altered in migraine patients with higher risk of eating disorders. Depression and anxiety are also found to be common amongst migraine patients.

EDBase: Generating a Lexicon Base for Eating Disorders Via Social Media

Eating disorders (EDs) are characterised by abnormal eating habits and obsessive thought about food, weight, shape, and body image. EDs are experienced by a significant portion of our population. Social media is identified as a possible source of influence for EDs, and there is growing evidence of a large amount of ED-related discussions on the Web via social media platforms, such as Twitter. With this growing trend, automatic content analysis for EDs is becoming increasingly important. To date, there does not exist any comprehensive benchmark ED lexicon to identify ED-related conversations that would, in turn, facilitate these content analysis tasks. In this paper, we propose a novel method for generating a lexicon base for ED language, called <monospace xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>EDBase</b></monospace> . The method starts with collecting over 3.7 million ED-focused tweets. In order to semantically represent potential ED terminology in a vector space, an ED word embedding model ( <monospace xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>EDModel</b></monospace> ) is trained. Then we develop a novel multi-seeded hierarchical density-based algorithm with contrasting corpora for ED lexicon expansion. The <monospace xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>EDModel</b></monospace> is queried by the proposed lexicon expansion algorithm to expand the seed terms to a comprehensive lexicon base. Our <monospace xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>EDBase</b></monospace> consists of a (further expandable) list of 3794 high-quality ED terms, quantified by an ED score, and linked to their parent terms. The proposed method significantly outperforms all existing alternative baseline methods and models by over 25% in terms of precision and 1500 in terms of true positives. This research is expected to be impactful in the health data science and healthcare community.

Analysis of Dietary Habits and Nutritional Status of Children with Down Syndrome in the Context of Lipid and Oxidative Stress Parameters.

Introduction: The risk of obesity in children with Down syndrome is high. Undoubtedly, proper nutrition plays an important role in the prevention of excess body weight and is associated with a reduction of metabolic complications. The aim of the study was to assess the problem of disturbances in the nutritional status and eating habits of children with DS. Methods: A total of 39 patients were included in the study. The nutritional status was assessed by anthropometric tests and Dual X-ray Absorptiometry. Eating habits were assessed using the Child Eating Behavior Questionnaire and the Food Frequency Questionnaire. Blood samples were taken to determine the oxidative stress and lipid parameters. Results: Obesity was recognized in 15% of subjects and 23% were overweight. Children that were overweight were characterized by higher levels of triglycerides, atherogenic index of plasma, and apoA2 and apoE levels. Fat mass, fat mass/height2 index, and visceral fat mass correlated with thiobarbituric acid reactive substances and advanced oxidative protein product level. The analysis of the Child Eating Behavior Questionnaire showed that children struggling with being overweight were more interested in food compared to those with normal body weight. A positive correlation was identified between waist circumference and food interest categories. Insufficient consumption of dairy products, vegetables, whole grain products, as well as fruits, seeds, nuts, and fatty fish was noted. Patients were less likely to consume products that are a good source of mono- and polyunsaturated fatty acids. Conclusions: In children with Down syndrome and obesity, disturbances in lipid and oxidative stress parameters are observed. Abnormal eating habits in all children with Down syndrome regardless of their nutritional status were noted. Proper nutritional education, nutritional control, and management of metabolic problems are essential in this group of patients.

Eating habits during quarantine: Investigating the role of emotions and loneliness in a sample of adults in Greece

Introduction Imposing quarantine as a measure to manage the coronavirus pandemic is a stressful event that is often associated with negative psychological effects. Eating habits seemed to be significantly affected during the quarantine, while strong negative emotions were triggered as the feeling of loneliness increased at the same time.ObjectivesThis study aims to investigate the eating habits of individuals during quarantine and the role of positive and negative emotions and loneliness in shaping these habits.MethodsAn online cross-sectional study was performed using 3 validated scales, EAT-26 (3 subscales: Dieting, Bulimia and Food Preoccupation, Oral Control), Modified Differential Emotions Scale and UCLA Loneliness Scale. Data was collected between April and May 2021 mainly from social media platforms. Statistical analyses included linear regression and mediation analyses.ResultsAbnormal eating habits were detected in 25% of the participants (N= 450, ages 18-74) while the majority reported medium rates of negative/positive emotions and loneliness. Female sex is associated with abnormal eating habits (p=0.010) and mainly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) seem to be predictive factors of eating habits in general and bulimic behaviors. Negative emotions correlate directly with eating habits. However, we found a significant mediation of loneliness (p=0.032). Furthermore, the observed association between negative emotions and bulimia is partly mediated by loneliness (p=0.018).ConclusionsNegative emotions and loneliness seemed to play an important role in shaping eating habits during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemic in general.DisclosureNo significant relationships.

The translation and psychometric assessment of the SCOFF eating disorder screening questionnaire: the Persian version

BackgroundEating Disorders (EDs) are defined by abnormal eating habits. The SCOFF (Sick-Control-One stone-Fat-Food) is a simple screening questionnaire for EDs. This study was conducted to translate and evaluate the psychometric properties of the SCOFF questionnaire in Iranian university students.MethodsA total of 310 Iranian students of the Shahid Beheshti University of Medical Sciences completed a test battery of questionnaires including the well-known screener of eating disorder symptoms, the SCOFF. All measures were presented to the participants in Persian. The 5-item SCOFF questionnaire was translated to Persian using the forward–backward method. The face, content, criterion, and construct validity of the Persian version of the SCOFF were assessed. The validity and reliability of the Persian version of the SCOFF was assessed and factor analysis was conducted.ResultsAll five items of the translated questionnaire were approved after face validity. Content validity ratio was 0.73 (range 0.66–0.83) and content validity index was 0.96 (range 0.91–1), so all items were approved. Exploratory factor analysis revealed a 2-factor structure, which explained 52.47% of the variance. Confirmatory factor analysis showed a very good goodness-of-fit for the 2-factor model. 2-factor and 1-factor models indicate a very good goodness-of-fit in females and adequate goodness-of-fit in males. Criterion validity showed an acceptable correlation between the SCOFF and the EDE-Q. Reliability was acceptable based on the stability [ICC = 0.905(95% CI .760–.962 p < 0.001)] and the internal consistency (KR20 = 0.4).ConclusionAppropriate psychometric properties of the 5-item Persian version of the SCOFF (both models) were confirmed, suggesting its use as a valid questionnaire in EDs screening.

Screening For Risk of Eating Disorders: A Study among Students from Selected Colleges In Benguluru

Background: Eating disorders refer to a group of conditions characterized by abnormal eating habits. It has impact on both physical and socio-emotional health of young people. The study will help in early identification of eating disorders. Addressing eating disorders at the early stage can prevent further physical and psychological complications. Objectives: To assess the risk of eating disorders among college students using Eating Attitudes Test- 26(EAT-26) screening tool. To determine their behaviors and its association with eating disorders. Method: A cross sectional study was conducted among students studying in pre-university and degree colleges. The colleges were selected by simple random sampling technique. A total of 500 students participated in the study. Eating Attitudes Test-26(EAT-26) screening tool developed by Garner et al was used to collect the data. The questionnaire was self administered to the students to assess the risk of eating disorders and behavior pattern. Results: The mean age of the students was 17.60±1.13years.Risk of disorders was present among 94(18.8%) students. Behavior patterns for development of eating disorders were present among 313(62.1%) students. Among 313 students 73(23.3%) had eating disorder risk .The association between the risk of eating disorders and behavior patterns was found to be statistically significant (p&lt;0.05). Conclusion: The study concludes that there is an existence of eating disorders among college students and was significantly associated with behavioral domain. This shows the necessity of initiating routine screening and intervention programs to control eating disorders.

A case-control study of the lipid profile of women with breast cancer

Purpose: Neoplastic diseases remain the second most common cause of death, behind cardiovascular diseases, and breast cancer is the leading cause of death among women worldwide. Increased incidence of neoplastic diseases is also known to be accompanied by lipid metabolism disorders.Method: Blood samples for lipid profile testing were taken from the two studied groups, which comprised 110 women with breast cancer and 70 healthy women. Lipid profile testing was conducted on venous blood samples collected among both groups of women on an empty stomach. Statistical analyses were performed using the IBM SPSS Statistics 20 software package.Results: A statistically significant (p&lt;0.05) majority of women with breast cancer had abnormal TC results (67.3%). A statistically significant (p&lt;0.05) majority of control group women (90.0%) had normal HDL-C results. More women with breast cancer (87.3%) had abnormal LDL-C results than healthy women (62.9%), which represented a statistically significant difference (p&lt;0.05). Conclussions: Abnormal lipid profile significantly impacts breast cancer incidence. At the same time it is under influence of abnormal eating habits and low physical activity. Community and oncology nurses, having considerable knowledge about health and lifestyle of their patients, should be more involved in basic education to decrease cancer risk, especially by women with alarming LDL-C level.

The Opioid System and Food Intake: Use of Opiate Antagonists in Treatment of Binge Eating Disorder and Abnormal Eating Behavior

Eating disorders (EDs) and substance use disorders (SUDs) commonly co-occur, especially in conjunction with affective syndromes, yet little is known about opiate abuse and ED symptoms in patients on naltrexone-bupropion therapy. Moreover, evidence suggests that the opioid system can also be regarded as one of the major systems regulating the anticipatory processes preceding binge eating episodes. The lack of evidence in the effectiveness of psychotherapy treatment in addition to psychotropic mediations compounds the difficulties in stabilizing individuals with EDs. This article aims to exhaustively review literature relating to the use of opioid antagonists in the management of binge eating disorder (BED) and other abnormal eating habits and how this can be augmented by the use of psychological approaches to come up with the most effective therapy or combination of therapies to manage these conditions. Although this approach is promising, it has not been evaluated. A review of the literature pertaining to the use of naltrexone in patients with EDs was performed through PubMed, PsycINFO and MEDLINE. We selected 63 relevant articles published between 1981 and 2018 and those written in English. Search terms included “Opioid antagonists”, “naltrexone”, “bupropion” and “Psychotherapy” each combined with “Binge Eating Disorder”, “Bulimia Nervosa”, “Anorexia Nervosa”, “Eating Disorder”, “EDNOS” and “Obesity”. While working with these articles, we also identified several problems related to use of these methods in real clinical practice. Seventy-seven articles were reviewed, and 63 were selected for inclusion. Data obtained from these sources confirmed that the blockade of opioid receptors diminishes food intake. More recent findings also indicate that the combination of bupropion and naltrexone can induce weight loss. Augmentation of this by introducing psychotherapy may lead to better outcomes. Cognitive behavioral therapy (CBT) was the most frequently recommended psychotherapy intervention, showing efficacy for EDs and chemical addictions as documented by most of the studies, but with uncertain efficacy when utilized as augmentation strategy. There are limited data supporting the use of psychotherapy in augmentation of standard therapy in ED; however, there is evidence to support that psychotherapy is safe in this population and has been effective in cases of patients with opiate addiction with and without psychiatric comorbidities as well as BED. More research is needed to establish treatment guidelines. Combining pharmacotherapeutic and psychotherapeutic interventions leads to the achievement of a better outcome in managing patients with EDs. Involving families or the use of support groups increases chances of adherence to the prescribed interventions resulting in higher rates of remission. However, it is clear that all of these interventions must occur in the context of a comprehensive treatment program. We believe that patient-specific psychotherapy may not only facilitate the treatment process, but also cause significant alterations in eating pattern. This approach for BED may lead to more significant treatment outcomes, but this possibility must be tested in larger samples.

197 Role of a Dietitian in a Specialist Memory Assessment and Support Service - Improving Brain Health

Abstract Background Dementia cases are rising nationally due to our ageing population and is associated with a multitude of nutritional consequences. Both obesity and malnutrition are strongly implicated in the progression of cognitive decline. From diagnosis onwards, nutritional intervention is important to improve patient outcomes. Methods In order to highlight the important role of a dietitian, a retrospective analysis of 142 patients attending the tertiary memory assessment and support service from 2018 to 2019 was performed. Demographic, cognitive, anthropometric, and nutritional data was compiled from the case note review and biochemical laboratory results. This data was analysed using Microsoft Excel (2013) to study prevalence and relationships of variables in this cohort. Results A significant proportion of this population were overweight (41.2%) and obese (18.6%). Nearly half the population were at risk of malnutrition (44.1%) or malnourished (3.9%). In this cohort, 18.6% were characterised as frail. Only one individual had a severe clinical dementia rating score (CDR), 19.2% had a moderate and 28.2% had a mild CDR. Half (50.5%) of participants had some level of abnormal eating habits. Higher prevalence of malnutrition, frailty and higher CDR was associated with increased age. Up to 60% of those with normal nutritional status had a CDR of 0 or 0.5. As MNA score worsened, the incidence of robust individuals decreased linearly. Prevalence of frailty increased as CDR score increased. Of those with a mild CDR, 70% were overweight or obese. Those with high Cambridge Behavioural-Inventory (CBI-R) eating habit scores generally had lower CDRs. Conclusion Patients attending the memory service are experiencing a multitude of nutritional challenges such as disordered eating habits, overweight and obesity, malnutrition risk and frailty which are associated with cognitive decline and worse health outcomes. Nutritional support and dietetic input as part of the post-diagnostic care-pathway is required to promote brain health and mitigate unnecessary decline.

Study Of Relation Between Autism And Overweight In Center Of Care Of Childern With Special Need In Ain Shams University

Study Of Relation Between Autism And Overweight In Center Of Care Of Childern With Special Need In Ain Shams University

Recognition and management of eating disorders in children and young people.

Eating disorders form a group of mental health conditions characterised by abnormal eating habits and are associated with high mortality rates. This article provides nurses working in various settings with evidence-based strategies to identify, manage and refer children and young people with eating disorders. It explores what eating disorders are, and their association with physical and psychiatric co-morbidities. Eating disorders have a significant effect on children and young people's health and development, and nurses have a vital role in managing them. This article presents a case study that illustrates some of the challenges nurses may experience when managing children and young people with eating disorders.

EMDR therapy on trauma-based restrictive eating cases

IntroductionEating Disorders (ED) affect an individual's physical and mental health with abnormal eating habits. Traumatic life events may underlie the development of ED as many studies document [1]. In the present study, we examined the effectiveness of EMDR therapy that was originally used to treat Post-Traumatic Stress Disorder (PTSD) [2], on restrictive eating symptoms associated with trauma. Cases B.Ö. (18) and B.S. (20) came to the clinic consecutively for resembling complaints about the sense of food sticking in their throat, breathing difficulties, raised heart beatings, unease to swallow, and choking fear. The patients revealed past traumatic events about being out of breath while swallowing their bites. Then, they have started to restrict their food intake and the types of food consumed, which led to emaciation with health problems, interrupted daily routines, and social isolation; meeting the diagnosis of avoidant/restrictive food intake disorder (ARFID) in DSM-5. Due to traumatic experiences, EMDR therapy was applied.DiscussionAfter five EMDR therapy sessions, patients turned back to healthy eating habits, normal BMI, and effective daily life. As expected, EMDR therapy made significant improvements in the treatment of ARFID.ConclusionEMDR can be useful to treat ED with traumatic background.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Health-related quality of life and its association with alexithymia and difficulties in emotion regulation in patients with psoriasis

BackgroundHealth-related quality of life (HRQoL) in psoriasis patients could be negatively affected by medical (e.g., obesity) and psychological (e.g., depression, anxiety, and alexithymia) conditions the presence of which suggests difficulties in understanding and regulating inner states and emotions. Thus, the aim of this study was to investigate HRQoL and its association with obesity and difficulties in understanding and regulating inner states and emotions in patients with psoriasis. A second objective was to examine whether the presence of difficulties in understanding and regulating inner states and emotions may mediate the association between psoriasis and poor HRQoL. MethodOne hundred adult outpatients and 97 healthy controls were administered a checklist assessing major socio-demographic variables, and measures of HRQoL, difficulties in emotion regulation, alexithymia, anxiety, depression, and food craving. ResultsPsoriasis patients (compared to controls) reported more frequently obesity, alexithymia, anxiety, depression and food craving, and reported lower scores on the mental and physical components of HRQoL. A mediation model, with mental health as the dependent variable, indicated significant direct and indirect (through BMI, difficulties in emotion regulation, anxiety, depression, and food craving) effects of psoriasis on the quality of life, so that psoriasis was associated with worse mental health. A second mediation model with physical health as dependent variable indicated only a significant indirect effect (through BMI and depression) of psoriasis on the quality of life. ConclusionsPsoriasis is characterized by poor HRQoL and the presence of difficulties in understanding and regulating inner states and emotions. In patients with psoriasis the possible influence of food craving on abnormal eating habits should be carefully assessed.

A clinical case of a patient with anorexia nervosa and bizarre behavior

Eating disorders (EDs) are mental illnesses, defined by abnormal eating habits. EDs are chronic, severe and difficult to treat, and cause psychological, social and physical consequences. It occurs predominantly in adolescents and young adults women (around 90%), causing severely disability, major biopsychosocial losses, and high morbidity and mortality. EDs are considered by WHO as a public health problem, affecting different ages, genres, times, regions and contexts.ObjectiveCase report of a patient with Anorexia Nervosa and bizarre behavior.MethodsClinical observation in hospital.ResultsWoman with 43 years old, with a peace of 65 years, who was hospitalized in Psychiatric Service – Eating Disorders, in August 2015, because of its extreme thinness, with difficulty to walk and with severe edema of the feet, ankles and legs. At the entrance, she weighed 29 kg, after 4 days her weight reduced to 23 kg, reaching a BMI of 8.5 kg/m2. In the first week, she showed a high cognitive impairment, confusional state and detailed and ruminative speech about food. She had developed multiple techniques to hide food and to hide and take dietary supplements for weight loss. Furthermore, she had a bizarre behavior and marked social isolation, not interacting with other patients.ConclusionAlthough the low prevalence of EDs, these have a high morbidity, and are one of the psychiatric disorders that most often leads to a fatal outcome. Treatment is lengthy and cumbersome, requiring serious investments under the personal point of view, family and clinical, yet still, these patients can have a full life and quality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depression among adolescent students in South India: How serious is the issue?

Byline: Divya. Trivedi, Neha. Dhakappa, Parul. Ghildiyal, Shravya. Deekonda, Sumitha. Subramaniam, J. Iyer, M. Kotiyan Sir, An adolescent student experiences several biological, cognitive, social, and psychological changes. These developments, coupled with peer pressure, parental pressure, and the students' own expectations of themselves, make this a very volatile and turbulent phase. As teenaged undergraduate medical students ourselves, we felt that we could reach out to high-school students in a way that adults may not be able to as they would relate better to us and be more forthcoming in their responses. Hence, we conducted this study in an attempt to understand the issues that could lead to depression among adolescent students. We distributed 392 copies of the Beck's depression inventory [sup][1] and a semi-structured questionnaire to the students of classes seven, eight, and nine from three unaided schools. The questionnaire contained questions pertaining to the social factors that could lead to depression. The Chi-square test and SPSS version 17.0 were used for analysis. We found that 88 (22.45%) students were depressed. There were 27 (6.9%) students with borderline depression, 35 (8.9%) with moderate depression, 16 (4.1%) with severe depression, 10 (2.6%) with extreme depression, and mood disturbances among 71 (18.1%). Depression was detected among a significant number ( P = 0.012) of older adolescents (ages 14 and 15 years), and girls were significantly more depressed ( P = 0.016). Students who were comfortable with friends and those who received moral support from their families were significantly less depressed ( P = 0.022 and P = 0.014, respectively). Moderately and severely depressed students displayed abnormal eating habits ( P = 0.014) and those whose families did not spend enough time with them were more susceptible to get depressed ( P Prior studies aimed at assessing the prevalence of depression among adolescent students found relatively lesser numbers of students depressed.[sup][2],[3] Our study found that 22.45% of the students were depressed, and girls were significantly more depressed. The 2007 India Global School-based Student Health Survey found that high levels of reported parental involvement were significantly associated with a decreased likelihood of poor mental health.[sup][4] Negative life events and parent-adolescent attachment relationship quality were associated with mental health problems in adolescents. …

Analysis of the EAT-26 in a non-clinical sample

Aim of the studyThe Eating Attitudes Test (EAT) is one of the most commonly used measures of abnormal eating habits; however, it has been criticized for its unstable factorial structure. Different studies proposed different solutions; however, up to date there is no consensus whether three-, five-, or seven-factor solution is appropriate.Subject or material and methodsIn the current study, we examined the cues provided by studies that investigated the structure of the EAT-26, and analyzed our expectations in a nonclinical group of 617 women.ResultsBased upon bi-factor confirmatory factor analyses, we demonstrated that the EAT measures general eating pathology, but it also measures more specific factors, such as social pressure, food awareness, food preoccupation and purging behaviours.DiscussionAmong distinguished specific factors, social pressure seems to be promising scale to be used for screening purposes. The food awareness factor could be interpreted in terms of orthorexia nervosa; however, further evidence is required to support this conclusion. We also provided evidence that bulimia and food preoccupation factors should be maintained within the EAT-26 as an important behavioural aspects of eating pathology.ConclusionsThese results shed new light on this measure and provide the bases for a discussion of its psychometric issues.

Appropriate care for children with eating disorders and obesity.

Eating disorders are essentially psychological diseases that are characterised by abnormal eating habits. Anorexia nervosa and bulimia are the most common forms of eating disorders. There is an increased recognition of eating disorders among both men and women, and growing numbers of children and teenagers seeking help for eating disorders. Fear of body-weight gain is central to both anorexia nervosa and bulimia. Before the diagnosis of an eating disorder is made, it is essential to exclude organic diseases that may present with similar symptoms to eating disorders. Management initially should focus on correcting the nutritional deficiencies and dehydration at a paediatric or paediatric gastroenterology department, followed by a multidisciplinary approach. At the other extreme, the prevalence of obesity in children is increasing at an alarming rate, and presents a serious public health challenge.

Ambivalence and Resistance in a Patient with Anorexia Binge-purging: a Case Report

Introduction Eating disorders (ED) are long-term psychiatric illnesses defined by abnormal eating habits and associated with a number of psychological and environmental factors. The underlying psychological components of ED are difficult to detect and patients frequently can be strongly ambivalent about changing, although their apparent willingness to recover. Objectives The study of the subjective meanings of the patients' ambivalence has a positive function to address treatment resistance. Aims To consider patients' perspectives on pervading ambivalence supports the empathically comprehension of the feelings, defenses and thoughts that underpin ED. Methods We describe a clinical case of an out-patient attending at the Department of Psychiatry, University of Sassari. Results I.O. is a 36 years-old woman, with anorexia (AN) binge/purging since she was 19, with low academic and social functioning. She made a residential treatment for 6 months when she stopped binge/purging behavior. In outpatient setting the binge/purging behavior restarted with blame, incapacity and resignation feelings. Empathic comprehension of ambivalent motivation contributes during treatment to disclose the adaptive function of AN, the interior conflict between need and fear of autonomy, need of differentiation from her mother and her mother's endorsement, with reduction of blame feelings and binge/purging behavior. Conclusions Weight restoration should be considered the starting point of a treatment whose main goal should be the modification of the inner world, the defenses and the thoughts that underpin ED.

The Association of 5-HTTLPR Gene Polymorphisms and Eating Disorder: A Meta-Analysis

Background: Eating disorders (EDs), are characterized by abnormal eating habits, including insufficient or excessive food intake, and are detrimental to an individual’s physical and mental health. In this paper, we focus on AN (anorexia nervosa) and BN (bulimia nervosa), which are included in EDs. Some studies reported that there may be an association of 5-HTTLPR gene and eating disorders but without clear conclusion to solidify this relationship. Therefore, the goal of this study is to summarize on the reported data and meta-analytically investigate the relationship between the 5-HTTLPR gene polymorphisms and eating disorders. Method: We searched through all published papers indexed in MEDLINE, EMBASE, and CNKI from inception to May 2015. All studies that we examined regarding the relationship between 5-HTTLPR polymorphisms and EDs were identified to perform this meta-analysis. Odds ratio (OR) and 95% confidence intervals (CIs) were used to evaluate the EDs risk. Results: Fourteen studies met the inclusion criteria. We performed this meta-analysis involving 2238 subjects in total (including 1832 EDs patients, 779 AN patients, 722 BN patients and 406 control subjects). The 5-HTTLPR S allele was significantly more common in all EDs patients comparing to controls (S vs. L allele: OR=1.25, 95% CI: 1.02- 1.53, P=0.03). This significance was also revealed through the recessive model (SS vs. SL+LL: P=0.008) and the additive model (SS vs. LL: P=0.03). When the comparison was stratified by ethnicity (Caucasian and Asian), it shows that the significance only exists in recessive model among Caucasian population (P=0.03). Subsequently, the EDs patients were divided into two groups (AN and BN) to analyze the association between 5-HTTLPR polymorphism and AN or BN. The results showed that S allele was significantly more frequently discovered in the AN group than in the control group (P=0.006). Other comparison models suggest similar results. Ethnically stratified analysis suggested that 5-HTTLPR polymorphism only correlates with AN among Caucasians, but not Asians. However, no statistical difference was found between BN patients and controls in any comparative analysis. Conclusion: The 5-HTTLPR S allele can result in increased risk for AN but not BN. Of all the ethnical groups that we studied, Caucasian females appear to be the most likely to become susceptible to EDs/AN under the influence of 5-HTTLPR S allele. These results may be helpful to our clinical practice. However, further studies with larger sample sizes are needed for more reliable and conclusive results.