Symptoms Of Anorexia Nervosa Research Articles

The open versus blind weight conundrum: A multisite randomized controlled trial across multiple levels of patient care for anorexia nervosa.

Anorexia nervosa (AN) is a disorder characterized by a profound fear of weight gain, resulting in significant weight loss, as well as behavioral symptoms that interfere with weight normalization. In concert, weight gain remains a proximal goal of treatment, and patient weighing is a critical component of treatment. However, divergent approaches exist in how patient weighing is undertaken in clinical practice. The aim of this study is to investigate the impact of a brief course of open weighing (sharing weight data with patients) versus blind weighing (not sharing weight data with patients) on distress around being weighed and AN symptom severity. 216 patients with AN and atypical AN will be randomized to receive 4 weeks of open or blind weighing practices across residential, intensive outpatient, and outpatient treatment settings, within the context of manualized empirically supported treatment. Following 4 weeks of open or blind weighing, all patients will be enrolled into open weighing practices. Primary outcomes of interest will be patient-reported distress around being weighed at week 5 and eating disorder symptom severity at week 5. Secondary outcomes will assess weight prediction error, intolerance of uncertainty, and the fear of food. No best practice guidelines exist in determining optimal practices around weighing patients with AN. This multisite randomized controlled trial will provide the first known data on the impact of open versus blind weighing practices upon weight-related distress and AN symptom severity.

Perspectives on Involuntary Treatment of Anorexia Nervosa.

Involuntary treatment of anorexia nervosa is an option in cases in which the patient's life or other people's lives are at risk or, in some countries, to prevent the deterioration of the illness. Involuntary treatment is often regarded as controversial and has been intensely debated, although typically with few references to documented knowledge. This paper provides a research perspective of the topic by examine data in the field of the involuntary treatment of anorexia nervosa to pinpoint present knowledge as well as areas demanding clinical action or research attention. The prevalence of involuntary treatment in general as well as specific measures is described and possible early markers of patients at risk of involuntary treatment are discussed. Studies including patients' perspectives of involuntary treatment show the complexity of this treatment, its initiation, and its consequences. To qualify future discussions, improve current practice, and minimize involuntary treatment in general as well as on an individual level, at least four areas need attention: (i) the present specific symptoms of anorexia nervosa and their imminent consequences, (ii) illness history, (iii) overall psychiatric symptoms and general functioning, and (iv) contextual sphere of the patient. In particular, the last two require attention from both clinicians and researchers. Furthermore, critical evaluation of the attitudes of both patients and health care professionals toward each other and the treatment is recommended.

Reduced Environmental Stimulation in Anorexia Nervosa: An Early-Phase Clinical Trial.

Reduced Environmental Stimulation Therapy (REST) alters the balance of sensory input to the nervous system by systematically attenuating sensory signals from visual, auditory, thermal, tactile, vestibular, and proprioceptive channels. Previous research from our group has shown that REST via floatation acutely reduces anxiety and blood pressure (BP) while simultaneously heightening interoceptive awareness in clinically anxious populations. Anorexia nervosa (AN) is an eating disorder characterized by elevated anxiety, distorted body representation, and abnormal interoception, raising the question of whether REST might positively impact these symptoms. However, this approach has never been studied in eating disorders, and it is unknown whether exposure to floatation REST might worsen AN symptoms. To examine these possibilities, we conducted an open-label study to investigate the safety and tolerability of REST in AN. We also explored the acute impact of REST on BP, affective symptoms, body image disturbance, and interoception. Twenty-one partially weight-restored AN outpatients completed a protocol involving four sequential sessions of REST: reclining in a zero-gravity chair, floating in an open pool, and two sessions of floating in an enclosed pool. All sessions were 90 min, approximately 1 week apart. We measured orthostatic BP before and immediately after each session (primary outcome), in addition to collecting BP readings every 10 min during the session using a wireless waterproof system as a secondary outcome measure. Each participant’s affective state, awareness of interoceptive sensations, and body image were assessed before and after every session (exploratory outcomes). There was no evidence of orthostatic hypotension following floating, and no adverse events (primary outcome). Secondary analyses revealed that REST induced statistically significant reductions in BP (p < 0.001; Cohen’s d, 0.2–0.5), anxiety (p < 0.001; Cohen’s d, >1) and negative affect (p < 0.01; Cohen’s d, >0.5), heightened awareness of cardiorespiratory (p < 0.01; Cohen’s d, 0.2–0.5) but not gastrointestinal sensations, and reduced body image dissatisfaction (p < 0.001; Cohen’s d, >0.5). The findings from this initial trial suggest that individuals with AN can safely tolerate the physical effects of REST via floatation. Future randomized controlled trials will need to investigate whether these initial observations of improved anxiety, interoception, and body image disturbance occur in acutely ill AN populations.Clinical Trial RegistrationClinicalTrials.gov; Identifier: NCT02801084 (April 01, 2016).

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa.

Fear of gaining weight (FGW), body image disturbances, associated anxiety and body-related attentional bias are the core symptoms of anorexia nervosa (AN) and play critical roles in its development and maintenance. The aim of the current study is to evaluate the usefulness of virtual reality-based body exposure software for the assessment of important body-related cognitive and emotional responses in AN. Thirty female patients with AN, one of them subclinical, and 43 healthy college women, 25 with low body dissatisfaction (BD) and 18 with high BD, owned a virtual body that had their silhouette and body mass index. Full-body illusion (FBI) over the virtual body was induced using both visuo-motor and visuo-tactile stimulation. Once the FBI was induced, the FBI itself, FGW, body anxiety and body-related attentional bias toward weight-related and non-weight-related body areas were assessed. One-way analyses of covariance (ANCOVA), controlling for age, showed that AN patients reported higher FGW, body anxiety and body-related attentional bias than healthy controls. Unexpectedly, patients with AN reported significantly lower FBI levels than healthy participants. Finally, Pearson correlations showed significant relationships between visual analog scales and body-related attentional bias measures, compared to other eating disorder measures. These results provide evidence about the usefulness of virtual reality-based body exposure to elicit FGW and other body-related disturbances in AN patients. Thus, it may be a suitable intervention for reducing these emotional responses and for easing weight recovery.

Use of Stimulants in Patients with Comorbid Anorexia Nervosa and Attention-Deficit/Hyperactivity Disorder in a Structured Inpatient Setting.

Clinicians may be concerned about using psychostimulant medications in patients in whom weight gain is desired because of their potential side effects of appetite suppression and weight loss. This report depicts the successful treatment of 2 adolescent patients with anorexia nervosa (AN) and attention-deficit/hyperactivity disorder (ADHD) in an inpatient eating disorders unit. A report of 2 clinical cases (ages 19 and 20 years) was used to describe the management of comorbid AN and ADHD. Tolerance to stimulants, meal completion, and ability to restore weight were assessed over the course of hospitalization. Behaviorally focused refeeding combined with psychostimulants notably improved symptoms of AN and comorbid ADHD without adverse effects. Psychostimulant medications may be used successfully in patients with AN and ADHD in the context of structured behavioral treatment designed for weight restoration.

LA CLINICA DEI DISTURBI DEL COMPORTAMENTO ALIMENTARE: L’INTERVENTO PSICOLOGICO°

Eating disorders represent a field of investigation and intervention of considerable interest for psychology. This is an extraordinarily complex area. When working with these patients, it is crucial to consider a multifactorial etiopathogenetic framework. As anyone who has ever worked with eating disorder will know, the words “challenge” and “body image” have a particularly important role, both in research and clinical practice. appearance. Of all other Eating Disorders, Anorexia Nervosa (AN) will be presented today. Its prevalence ranges between 0,28% and 1%, with a high mortality rate and its onset is related to the presence of a multiplicity of genetic, neurobiological and psychosocial interrelated factors. One fundamental question is: what are the objectives to achieve for each specific individual who show AN symptoms? Treatment should be directed towards as many areas as possible in order to increase the chances of success and ensure the patient’s greater psychophysical well-being. A collaborative work between nutritionists, physicians, psychologists, psychiatrists, patients themselves and their families, could turn the cure into an aesthetic, ethical and political experience. The narration of their own personal experiences is an essential moment in the treatment of patients with eating disorders. Keeping in mind that the restrictive eating behavior, which is typical in AN, seems aimed at avoiding unpleasant emotion and that the real expert of the disorder is always the patient himself, it is essential to build a relationship that promotes change.

DNA methylation of ghrelin and leptin receptors in underweight and recovered patients with anorexia nervosa

Epigenetic mechanisms, which modulate gene expression, are becoming increasingly important in the research on anorexia nervosa (AN). Patients with AN have difficulties with the perception of hunger even though hormones like high ghrelin and low leptin signal the need for energy intake. Given the prominent role of the growth hormone secretagogue receptor (GHS-R1a) and the leptin receptor (LEPR) in appetite regulation, a dysregulation of the receptors’ expression levels, possibly resulting from altered DNA promoter methylation, may contribute to the pathophysiology of AN. Such alterations could be secondary effects of undernutrition (state markers) or biological processes that may play an antecedent, possibly causal, role in the pathophysiology (trait markers). Therefore, the objective of this study was to examine DNA promoter methylation of the GHS-R1a and LEPR gene promoter regions and investigate whether methylation levels are associated with AN symptoms. We studied medication-free underweight patients with acute AN as well as weight-recovered patients and normal-weight, healthy female control subjects. While DNA methylation of the LEPR gene was similar across groups, GHS-R1a promoter methylation was increased in underweight AN compared to healthy controls – a finding which can be interpreted within the framework of the “ghrelin-resistance” hypothesis in AN. The results of the current study suggest for the first time a potential epigenetic mechanism underlying altered GHS-R1a sensitivity or altered ghrelin signaling in acutely underweight AN. If a ghrelin-centered model of AN can be verified, a next step could be the search for a dietary or psychopharmacological modulation at the ghrelin receptor, potentially via epigenetic mechanisms.

Backstage of Eating Disorder-About the Biological Mechanisms behind the Symptoms of Anorexia Nervosa.

Anorexia nervosa (AN) represents a disorder with the highest mortality rate among all psychiatric diseases, yet our understanding of its pathophysiological components continues to be fragmentary. This article reviews the current concepts regarding AN pathomechanisms that focus on the main biological aspects involving central and peripheral neurohormonal pathways, endocrine function, as well as the microbiome–gut–brain axis. It emerged from the unique complexity of constantly accumulating new discoveries, which hamper the ability to look at the disease in a more comprehensive way. The emphasis is placed on the mechanisms underlying the main symptoms and potential new directions that require further investigation in clinical settings.

Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa-Caregivers' and Adolescents' Perspective.

High expressed emotion (EE) is common in caregivers of patients with anorexia nervosa (AN) and associated with poorer outcome for patients. In this study, we examined the prevalence of high EE in caregivers of adolescents with AN and analyzed predictors for EE using multivariate linear regression models. We further analyzed whether EE is reduced by the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) intervention using general linear mixed models and whether a reduction of EE predicts patients’ outcomes. Caregivers were randomly allocated to the SUCCEAT workshop (N = 50) or online intervention (N = 50) and compared to a comparison group (N = 49). EE and patients’ outcomes were assessed at the baseline, post-intervention, and at the 12-month follow-up. Up to 47% of caregivers showed high EE. Lower caregiver skills, higher AN symptom impact, higher levels of depression and motivation to change in caregivers were significant predictors for high EE. EE significantly decreased in the SUCCEAT groups and the comparison group according to the caregivers’, but not the patients’ perspective. The level of reduction could partially predict subjective improvement and improvement in clinically assessed AN symptoms and body mass index of patients. Implementing interventions for caregivers addressing EE in the treatment of adolescents with AN is strongly recommended.

Significados atribuídos ao alimento por pacientes com Anorexia Nervosa e por mulheres jovens eutróficas

Este estudo teve por objetivo identificar os significados atribuídos ao alimento por pacientes com Anorexia Nervosa (AN) e por jovens eutróficas sem sintomas de Transtornos Alimentares. Trata-se de um estudo qualitativo, comparativo e transversal. Foram entrevistadas 12 mulheres distribuídas em dois grupos focais: um composto por seis participantes com diagnóstico de AN, que frequentavam um serviço especializado (grupo de pacientes: GP) e outro, de comparação (GC), constituído por seis mulheres, eutróficas e sem sintomas de AN. Os encontros foram audiogravados e transcritos na íntegra. Para a análise de dados utilizou-se a técnica de análise de conteúdo temática e o marco teórico-conceitual da antropologia da alimentação, focalizando os significados do alimento e o valor simbólico das práticas alimentares. Verificou-se, em ambos os grupos, que os alimentos despertam uma gama de sentimentos paradoxais, variando desde prazer à repulsa, repúdio, nojo, culpa e medo. No GP, os significados são norteados pela importância capital atribuída ao conteúdo calórico em vez do valor nutricional dos alimentos. Para compreensão das práticas alimentares na anorexia, os profissionais devem estar atentos às determinações culturais, sociais e políticas que atravessam esse fenômeno, evitando a individualização do problema.

Visual attention to food cues and the course of anorexia nervosa

Previously, adolescents with anorexia nervosa (AN) showed reduced attentional engagement with food cues compared to adolescents without eating disorder (Jonker, Glashouwer, Hoekzema, Ostafin, & De Jong, 2019). This study tested whether (i) improvement in eating disorder symptoms and BMI are related to an increase in attentional engagement with food, and whether (ii) relatively low attentional engagement is related to persistent AN symptomatology, in the same sample of adolescents with AN (N = 69) from the study of Jonker et al. (2019). Eating disorder symptoms, BMI, and attention for food cues were measured during baseline and at one year follow-up. Adolescents with AN showed a substantial improvement in symptoms and BMI. However, their low attentional engagement with food cues remained unchanged. Change in attentional engagement with food was not related to change in symptoms, nor was low baseline attentional engagement with food predictive of symptom persistence. These findings indicate that improvement in AN symptoms does not seem to require an increase in attentional engagement with food.

Refeeding is not a treatment for the underlying symptoms of anorexia nervosa.

Refeeding is not a treatment for the underlying symptoms of anorexia nervosa.

Virtual Reality Body Exposure Therapy for Anorexia Nervosa. A Case Report With Follow-Up Results.

ObjectiveExposure-based therapies such as mirror exposure may help to improve the results of classic cognitive behavioral therapy in anorexia nervosa (AN). Virtual reality (VR)-based procedures provide interesting novelties for targeting body-related concerns. This study aimed to provide preliminary evidence of the usefulness of a VR body exposure therapy in a patient diagnosed with AN.MethodFear of gaining weight (FGW), body anxiety, drive for thinness, body image disturbances, body mass index and body-related attentional bias were assessed before and after the intervention, as well as 5 months later. Five sessions of VR body exposure therapy were included within the standard course of cognitive behavioral therapy. The sessions involved a systematic and hierarchical exposure of the patient to a virtual representation of her own silhouette, with the body mass index of the avatar progressively increasing in subsequent sessions.ResultsAfter the intervention, there was a clear reduction in AN symptoms such as the FGW, drive for thinness, body-related anxiety and dissatisfaction. Body mass index values rose continuously during the intervention and reached healthy levels. Finally, there was a notable change in the dysfunctional body-related attentional bias. Almost all these improvements were maintained after 5 months, except for the FGW.ConclusionTo the best of our knowledge, this study is the first to focus on treating the FGW and body-related concerns in AN using a VR-based paradigm. To pursue this study further and assess the effectiveness of this new VR software, larger controlled clinical trials are needed.

Identifying duration criteria for eating-disorder remission and recovery through intensive modeling of longitudinal data.

Outcome states, such as remission and recovery, include specific duration criteria for which individuals must be asymptomatic. Ideally, duration criteria provide predictive validity to outcome states by reducing symptom-return risk. However, available research is insufficient for deriving specific recommendations for remission or recovery duration criteria for eating disorders. We intensively modeled the relation between duration criteria length and rates of remission, recovery, and subsequent symptom return in longitudinal data from a treatment-seeking sample of women with anorexia nervosa (AN) and bulimia nervosa (BN). We hypothesized that the length of the duration criterion would be inversely associated with both rates of remission and recovery and with subsequent rates of symptom return. Generalized estimating equations supported our hypotheses for all investigated eating-disorder features except for symptom return when using the Psychiatric Status Rating for AN. We recommend that 6 months be used for remission definitions applied to binge eating, purging, and BN symptom composite measures, whereas no duration criteria be used for low weight and AN symptom composites. We further recommend that 6 months be used for recovery definitions applied to BN symptom composites and AN symptom composites, whereas 18 months be used for individual symptoms of binge eating, purging, and low weight. The adoption of these duration criteria into comprehensive definitions of remission and recovery will increase their predictive validity, which in turn, maximizes their utility.

Neural mechanisms of perceptive and affective processing of body stimuli in anorexia nervosa – are there developmental effects?

Different components of body image processing seem to be reflected by different neural mechanisms. A core symptom of Anorexia nervosa (AN) is a disturbance of body image with correlates found on a neural level. The present study focuses on the neural processing of visual body stimuli of different weight categories in adolescent and adult AN patients.Thirty-three adolescents aged 12–18 years (15 AN patients, 18 control participants) and 36 adult women (19 AN patients, 17 control participants) underwent functional magnetic resonance imaging (fMRI) while performing a perceptive and an affective body image task involving photographic stimuli of women belonging to different BMI categories.Differential effects on activation, depending on the BMI of the women shown in the pictures, were found in frontal brain regions, the thalamus, the caudate and the fusiform gyrus. Group effects differentiating between AN patients and control participants were seen mainly in the caudate and insula. No significant developmental effect was seen.During a perceptive task, diminished activation of regions involved in perceptive and evaluative functions as well as emotional reasoning was seen in AN. During an affective task there was a tendency towards activation differences reflecting reduced ability of size estimation and impaired integration of visual and body perception with emotions.

Increased plasma asprosin levels in patients with drug-naive anorexia nervosa

Asprosin is a centrally acting appetite-promoting hormone and promotes glucose production in the liver. This study is the first to investigate the difference in asprosin in the plasma between anorexia nervosa (AN) and healthy controls, and to explore the relationship between asprosin changes and plasma glucose levels and AN symptoms. Plasma asprosin and glucose concentrations were detected in AN patients (n = 46) and healthy control subjects (n = 47). Eating Disorder Inventory-2 (EDI-2) was used to assess subjects' eating disorder symptoms and related personality traits. The patient's concomitant levels of depression and anxiety were also measured using the beck depression inventory and beck anxiety inventory, respectively. Results indicate that AN patients had a higher asprosin concentration in their plasma compared to healthy controls (p = 0.033). Among AN patients, plasma asprosin levels correlated positively with EDI-2 interoceptive awareness subscale score (p = 0.030) and negatively with duration of illness (p = 0.036). Multiple linear regression analyses showed that increases in asprosin levels (p = 0.029), glucose levels (p = 0.024) and body mass index (p = 0.003) were associated with an increase of the score of EDI-2 bulimia subscale. Our findings suggest that the increase in plasma asprosin concentration in patients with AN may be a compensation for the body's energy shortage, and asprosin may be involved in the development of bulimia and lack of interoceptive awareness in AN patients. Level III, case-control analytic study.

Rethinking Therapeutic Strategies for Anorexia Nervosa: Insights From Psychedelic Medicine and Animal Models.

Anorexia nervosa (AN) has the highest mortality rate of any psychiatric disease, yet available pharmacological treatments are largely ineffective due, in part, to an inadequate understanding of the neurobiological drivers that underpin the condition. The recent resurgence of research into the clinical applications of psychedelic medicine for a range of mental disorders has highlighted the potential for classical psychedelics, including psilocybin, to alleviate symptoms of AN that relate to serotonergic signaling and cognitive inflexibility. Clinical trials using psychedelics in treatment-resistant depression have shown promising outcomes, although these studies are unable to circumvent some methodological biases. The first clinical trial to use psilocybin in patients with AN commenced in 2019, necessitating a better understanding of the neurobiological mechanisms through which psychedelics act. Animal models are beneficial in this respect, allowing for detailed scrutiny of brain function and behavior and the potential to study pharmacology without the confounds of expectancy and bias that are impossible to control for in patient populations. We argue that studies investigating the neurobiological effects of psychedelics in animal models, including the activity-based anorexia (ABA) rodent model, are particularly important to inform clinical applications, including the subpopulations of patients that may benefit most from psychedelic medicine.

Family-Based Treatment for Anorexia Nervosa Symptoms in High-Risk Youth: A Partially-Randomized Preference-Design Study.

This pilot study adapted family-based treatment (FBT) for youth with potentially prodromal anorexia nervosa (AN). Fifty-nine youth with clinically significant AN symptom constellations, but who never met full Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) (DSM-IV) criteria for AN, were enrolled in a partially randomized preference design study. Participants were offered randomization to FBT or supportive psychotherapy (SPT); those who declined to be randomized because of a strong treatment preference were entered into a parallel, non-randomized self-selected intervention study. Without accessing outcome data, an observational analysis with three diagnostic subclasses was designed based on AN symptom severity profiles, combining randomized and non-randomized participants, such that participants receiving FBT and SPT within each subclass were similar on key baseline characteristics. Outcomes of this pilot study were explored by calculating effect sizes for end-of-treatment values within each subclass, and also with a longitudinal mixed effect model that accounted for subclass. Weight trajectory was measured by percent expected body weight. Psychological outcomes were fear of weight gain, feeling fat, importance of weight, and importance of shape. Results show that the pattern of symptom observations over time was dependent on subclass of SAN (least symptomatic, moderately symptomatic, or most symptomatic) and on the target outcome variable category (weight or psychological). Results from this study, which should be considered in the context of the small sample sizes overall and within groups, can generate hypotheses for future, larger research trials on early treatment strategies. Feasibility findings illustrate how the innovative partially randomized preference design has potential broader application for AN intervention research.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT00418977.

Mindful Medical Practice Enabling the Management of Anorexia Nervosa, Alcohol Use Disorder and Separation Anxiety Disorder

This is a case report of comorbidity involving psychiatric disorders. The case could only be understood and managed effectively due to the combination of the therapeutic alliance as the cornerstone of mindful medical practice, psychotherapeutic approaches, and medication. A 27-year-old woman started a psychiatric treatment because of her alcohol problem. She drank daily until she passed out. After assessment, she was admitted into a detoxification facility for a month. As an outpatient, she remained abstinent for periods of time (1-9 months). She also struggled with binge eating, purging and disturbed perception of body image (perceiving herself as obese).The therapeutic alliance was the main component of treatment. She felt understood and not judged. She kept an open mind to understand her psychopathology. Psychoeducation was an important tool. It included sessions on addiction and the core symptoms of anorexia nervosa. Behavioural analysis and skills training helped to identify an anxiety disorder at the basis of all clinical presentation. The patient realized how ambivalent she was to change. After several episodes of alcohol use, binge eating and purging, she redefined her life goals. As a result, her motivation to change evolved. She became mindful of triggers and began to have fewer episodes of alcohol use. She could decrease her binge eating, purging behaviour, and became aware of her distorted perception of her body. She accepted to take medication to control her pathological anxiety, as well as started using paced breathing and muscle relaxation.

Eating disorders, body image and media exposure among adolescent girls in rural Burkina Faso.

ObjectiveBody dissatisfaction and eating disorders (ED) among young females may increase in limited‐resource settings as exposure to media and higher‐resource cultures increases. We examined ED prevalence and its predictors among adolescent girls in rural north‐western Burkina Faso.MethodsFieldworkers interviewed 696 female adolescents aged 12‐20 years in the Nouna Health and Demographic Surveillance System (HDSS). ED were evaluated using the Structured Clinical Interview for DSM‐5 (SCID‐5), self‐perceived appearance and body ideal were measured using Thompson and Gray’s Contour Drawing Rating Scale (CDRS) and eating disorder predictors by the Eating Disorder Examination Questionnaire (EDE‐Q). We assessed media exposure to magazines, radio, television, and the internet.Results16% of respondents had a BMI below WHO age‐standardised 5th percentile, while 4% were above the 85th percentile; most respondents wanted to be larger. DSM‐5 criteria for anorexia nervosa (AN) were fulfilled by four of 696 respondents (0.6%), those for bulimia nervosa by none, and those for binge eating disorder by two (0.3%). In multivariable regression, more AN symptoms were associated with greater EDE‐Q body dissatisfaction, desiring a thinner body and a history of sexual harassment or assault, but not with media exposure. A thinner desired body was associated with greater media exposure, higher BMI z‐score and greater EDE‐Q disordered eating.ConclusionED were very rare in rural Burkinabé female adolescents, but factors predictive of ED in higher‐resource settings were also predictive of ED precursor symptoms here. Our findings suggest that increasing media exposure in resource‐limited settings may lead to increased body dissatisfaction, and potentially to increased future ED prevalence.