Cases Of Eating Disorders Research Articles

Eating disorder debut cases during COVID-19 lockdown in adults. Exploring differences in treatment outcome contrasting with pre-pandemic onset cases.

Despite an increase in eating disorder (ED) cases during the COVID-19 pandemic, there are limited longitudinal studies exploring treatment outcomes. The aims of the present study were: (1) to compare the clinical features of patients with EDs whose onset was during the COVID-19 lockdown (pandemic cohort) against patients with EDs whose onset was prior to the pandemic (pre-pandemic cohort) and, (2) to compare therapy responses between the cohorts. The sample consisted of 115 adult women with an ED. N=37 new ED cases (pandemic cohort) were diagnosed and included in the study during the pandemic (May 2020-May 2021); these patients did not have any previous history of an ED. We also included N=78 ED cases (pre-pandemic cohort) diagnosed prior to the COVID-19 pandemic breakout (prior to March 2020). All ED subtypes were considered in both groups and several clinical variables were assessed. At baseline, pandemic cohort reported lower levels of impulsivity and higher emotional regulation capacities than the pre-pandemic cohort; however, no differences were found in aspects of general psychopathology and ED related severity. Following treatment, the pandemic cohort showed higher rates of good outcome and lower rates of dropouts than the pre-pandemic cohort. Although both cohorts showed similar ED-related symptoms and general psychopathology scores, treatment outcomes were more favourable in the pandemic cohort.

Descriptives and genetic correlates of eating disorder diagnostic transitions and presumed remission in the Danish registry.

Eating disorders (EDs) are serious psychiatric disorders with an estimated 3.3 million healthy life-years lost worldwide yearly. Understanding the course of illness, diagnostic transitions and remission, and their associated genetic correlates could inform both ED etiology and treatment. The authors investigated occurrences of ED transitions and presumed remission and their genetic correlates as captured by polygenic scores (PGSs) in a large Danish register-based cohort. The sample compromised of 10,565 individuals with a diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS) with at least two registered hospital contacts between 1995 and 2018. Based on medical records, occurrence of diagnostic transitions and periods of presumed remission were identified. Associations between 422 PGS and diagnostic transitions and presumed remission were evaluated using Cox proportional hazard models. A minority of ED cases (14.1%-23.1%) experienced a diagnostic transition. Presumed remission ranged between 86.9%-89.8%. Higher (one SD increase) PGS for major depressive disorder and multisite chronic pain were positively associated with transitioning from AN to either BN or EDNOS. Higher PGS on a measure of body fat percentage and financial difficulties were positively associated with presumed remission from AN. Higher PGS for mood swings was positively associated with presumed remission from EDNOS whereas higher PGS for health rating showed the opposite. The authors found that most ED patients did not experience diagnostic transitions but were more likely to experience a period of presumed remission. Both diagnostic transitions and presumed remission have significant polygenic component.

Eating Disorders Among Saudi Dietitians: Prevalence and Analysis

Eating disorders (EDs) involve persistently disturbed eating and related behaviors that result in altered consumption or absorption of food with potential physical or psychological function impairment. There are four major types of EDs: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified. This investigation aimed to study the prevalence of EDs by assessing the nutritional status of nutrition students and dietitians from multiple provinces in Saudi Arabia. A cross-sectional study included 175 male and female nutrition students and dietitians. EDs were diagnosed using the Eating Attitudes Test – 26 item (EAT-26) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Dietary intake was estimated using repeated 24-hour recall records. Diets were analyzed using food processor nutrition and fitness software. The intakes were compared with the recommended dietary allowances (RDA). The mean participant age was 24.62 ± 4 years. According to EAT-26 diagnostic criteria, the prevalence of EDs was 15.4%. The ED participants had normal body mass index values of 23.6 ± 3.47kg/m2. The diet analysis showed that these subjects had a lower intake of energy, macronutrients, and micronutrients but higher intakes of other micronutrients than the RDA. Nine (33.3%) of the subjects were students and 18 (66.7%) were dietitians. l EDs were more prevalent among dietitians than students. The EDs included a high number of other specified feeding or eating disorders and unspecified eating disorder cases. Subjects with ED had an unbalanced diet and poor nutrition. Our investigation concluded that the prevalence of EDs in Saudi Arabia was 15.4% among nutrition students and dietitians. Moreover, EDs were more prevalent in some provinces of Saudi Arabia. Intakes of energy, macronutrients, and some micronutrients were low, while those of other micronutrients were higher than the RDA.

Identifying potential cases of eating disorders in an acute medical hospital.

To identify patients presenting to an acute medical hospital with common signs and symptoms that occur in people with eating disorders (EDs), and determine by retrospective file audit if these are diagnosed cases of an ED. The investigators screened electronic medical records of people 16 years and older for common signs and symptoms of an ED such as hypokalemia, in patients presenting to an acute hospital in Sydney, Australia from 2018 to 2020. Cases where the clinical finding was unexplained had their file audited. Cases with a known ED diagnosis or coded with an ED were also retrieved to audit. Investigators identified 192 definite ED cases with a total of 598 episodes of care from 2018 to 2020 presenting to the hospital. Eighty-three cases were identified as possible EDs due to unexplained clinical signs consistent with an ED, but were not confirmed cases due to lack of clinical history in the file. Only 19.1% of presentations were diagnostically coded with an ED in the electronic medical record. Our study revealed a large number of definite ED cases presenting to an acute medical hospital via the emergency department, who were not recognized as having an ED. Greater awareness of clinical signs and symptoms of an ED, such as unexplained low body mass index and hypokalemia, is necessary among acute care clinicians. Correctly identifying EDs in those seeking somatic care should be a public health priority, to facilitate timely and equitable access to diagnostic assessment and evidence based treatment. People with eating disorders (EDs) present to acute care settings and have a relatively high utilization of generalist health services with nonspecific problems such as abdominal pain. An enhanced understanding of healthcare utilization by people with EDs, who may not disclose their symptoms, is crucial for improving access to treatment.

Pandemic Effects on the Perception of Eating Disorder X Posts Among Adolescents and Transitional Age Youth

Eating disorders (EDs) are serious mental health conditions that can have devastating physical and psychological effects. They are significantly underdiagnosed and undertreated, and many individuals suffer in silence due to stigma, shame, and lack of access to appropriate care. Adolescents and transitional age youth (TAY) suffer from high prevalence of EDs, highlighting the need for effective prevention and intervention strategies, and improved access to evidence-based treatment options. Estimates suggest that at least 9% of the global population suffers from EDs, with the average age of onset being 18 years.1 Adolescents aged 13 to 18 are particularly vulnerable, with approximately 2.7% affected. TAY likely have an even higher number of ED cases.2 EDs have the highest fatality rates of any mental illness, with an estimated 4% of patients with anorexic nervosa dying from complications.3

The impact of genetic risk for schizophrenia on eating disorder clinical presentations

A growing body of literature recognizes associations between eating disorders (EDs) and schizophrenia and suggests that familial liability to schizophrenia in individuals with anorexia nervosa (AN) reveals distinct patterns of clinical outcomes. To further investigate the influence of schizophrenia genetic liability among individuals with EDs, we evaluated the associations between schizophrenia polygenic risk scores (PRS) and clinical presentations of individuals with EDs including their overall health condition and ED-related symptoms. Using data from two previous studies of the genetics of EDs comprising 3,573 Anorexia Nervosa Genetics Initiative (ANGI) cases and 696 Binge Eating Genetics Initiative (BEGIN) cases born after 1973 and linked to the Swedish National Patient Register, we examined the association of schizophrenia PRS on ED clinical features, psychiatric comorbidities, and somatic and mental health burden. Among ANGI cases, higher schizophrenia PRS was statistically significantly associated with higher risk of major depressive disorder (MDD) measured by hazard ratio (HR) with 95% confidence interval (CI) (HR [95% CI]: 1.07 [1.02, 1.13]) and substance abuse disorder (SUD) (HR [95% CI]: 1.14 [1.03, 1.25]) after applying multiple testing correction. Additionally, higher schizophrenia PRS was associated with decreased clinical impairment assessment scores (−0.56, 95% CI: [−1.04, −0.08]) at the conventional significance level (p < 0.05). Further, in BEGIN cases, higher schizophrenia PRS was statistically significantly associated with earlier age at first ED symptom (−0.35 year, 95% CI: [−0.64, −0.06]), higher ED symptom scores (0.16, 95% CI: [0.04, 0.29]), higher risk of MDD (HR [95% CI]: 1.18 [1.04, 1.34]) and SUD (HR [95% CI]: 1.36 [1.07, 1.73]). Similar, but attenuated, patterns held in the subgroup of exclusively AN vs other eating disorder (OED) cases. These results suggest a similar pattern of influence of schizophrenia PRS for AN and OED cases in terms of psychiatric comorbidities, but a different pattern in terms of ED-related clinical features. The disparity of the effect of schizophrenia PRS on AN vs OED merits further investigation.

Exploring Demographic and Clinical Characteristics of Racially and Ethnically Diverse Youth With Eating Disorders Using California Medicaid Claims Data

To explore the scope of diagnosed eating disorders among Medicaid-insured youth in California, and to describe the demographic characteristics of this population in a repeated annual cross-sectional study design. California Medicaid claims data were extracted for youth aged 7 to 18 years between January 2014 and December 2016. Participants included all youth who received an eating disorder diagnosis at any point in the study period (N= 8,075). Additional analyses compared youth with eating disorders who were continuously enrolled across all 3 years (n= 4,500) to random subsamples of continuously enrolled youth diagnosed with a mood or anxiety disorder (n= 4,128), a disruptive behavior disorder (n= 4,599), or a psychotic disorder (n= 4,290). About one-half of youth with eating disorders were Latinx (58.5%, n= 2,634) and indicated Spanish as their preferred language (48.9%, n= 2,199). About one-half (51%, n= 2,301) of eating disorder diagnoses were unspecified. Latinx ethnicity and Spanish language were significantly more frequent among youth with eating disorders than among those with other disorders (F11.97, F362.75, p values<.0005). The first examination of publicly insured youth with eating disorders revealed a highly diverse group of individuals among whom Latinx youth were particularly prevalent. However, past-year national prevalence estimates suggest that most eating disorder cases were undiagnosed. Eating disorders affect approximately 10% of the US population and lead to serious mental health and medical problems. This study used California Medicaid claims data from 2014 to 2016 to characterize the population of youth aged 7 to 18 years with diagnosed with an eating disorder (N = 8,075). The authors found the prevalence of eating disorders among youth aged 13 to 18 years was about 0.20% across all 3 years of the study, which is far below the expected prevalence and suggests that most eating disorders in youth go undiagnosed. About half of eating disorder diagnoses provided to youth with Medicaid insurance are unspecified, which may hinder receipt of appropriate treatment. Of youth with an eating disorder, about half were Latinx and reported Spanish as their preferred language. The authors also found differences in the prevalences of eating disorder diagnoses when analyzing youth by age, sex, and ethnicity. These results suggest that more standardized screening and assessment is needed to improve eating disorders detection and diagnosis, particularly for minoritized youth.

Going deeper into eating and body image pathology in males: Prevalence of muscle dysmorphia and eating disorders in a university representative sample.

Disorders associated with body dissatisfaction such eating disorders (ED) and muscle dysmorphia (MD) in males are understudied and surrounded by controversy regarding their nosological aspects. The current study examined the prevalence rates of clinical cases of ED and MD through a two-phase study with gold standard clinical interview in a representative sample of 850 Spanish undergraduate men, of whom 141 were interviewed. Levels of body dissatisfaction, compulsive exercise, anxious-depressive symptoms and the amount of physical activity were also explored. A prevalence rate for ED of 1.4% and 1.3% for MD was found. No differences were observed between the clinical groups on scales related to body image, supporting the current perspective that MD as well as ED and Body Dysmorphic Disorder could be clustered in a new spectrum of body image disorders, where the behaviours performed to achieve body change could range from restriction or muscularity-oriented eating alterations to pathological exercise or cosmetic surgery. The usefulness of the cut-off points of the screening questionnaires in MD and ED in males are discussed.

Eating disorders occur at high rates in adolescents with epilepsy and are associated with psychiatric comorbidities and suicidality.

To assess the occurrence rate, characteristics, and impact of eating disorders (EDs) in adolescents with epilepsy. In this observational study, adolescents with epilepsy seen in a single center between 2013 and 2022 who had comorbid EDs were compared to two control groups of adolescents with only epilepsy and only EDs. Patients with intellectual disability or autism spectrum disorder were excluded. Data retrieved included demographic and anthropometric details and clinical variables relating to seizure types, EDs, and psychiatric disorders and behaviors. A total of 376 subjects were included in the study: 84 adolescents with both epilepsy and eating disorders, 135 with only epilepsy, and 157 with only EDs. The rate of EDs in adolescents with epilepsy was 7.0% (95% confidence interval [CI] 5.6%-8.5%) overall, 11.3% (95% CI 8.8%-14.3%) in females, and 3.1% (95% CI 1.9%-4.8%) in males. The median (interquartile range [IQR]) time difference between the onset of epilepsy to an ED was 1.6 (.5-3.6) years. Among adolescents with epilepsy, those with an ED were more likely to be female (p = .001) and have a lower body mass index z-score (zBMI) percentile (p < .001). Epilepsy type, seizure frequency, or seizure duration were not specific for having or not having EDs. Among adolescents with EDs, those with epilepsy had a younger onset of their EDs (p < .001), included relatively more males (p = .007), and consisted of more cases of anorexia-nervosa-restrictive type (p < .001), and fewer cases of bulimia nervosa (p = .04) and binge eating disorder (p = .003). Adolescents with epilepsy and a comorbid ED were more likely to have psychiatric comorbidities such as depression, anxiety, and suicidality than adolescents with only epilepsy or EDs. EDs should be suspected and screened for in intellectually intact female and male adolescents with epilepsy, irrespective of their epilepsy type. If disturbed eating behaviors or EDs are identified, further evaluation should be directed at detecting other psychopathologies, including suicidality.

Incidence and prevalence of eating disorders among active duty US military-dependent youth from 2016 to 2021.

The offspring of US military service members may be at increased risk for eating disorders. However, no epidemiological studies to date have evaluated eating disorder incidence rates and prevalence estimates among military-dependent youth. This retrospective cohort study examined eating disorder diagnoses in the military healthcare system (MHS) from 2016 through 2021. Active duty and national guard military-dependent youth, aged 10-17 years, who received care in the MHS via TRICARE Prime insurance, were identified by one or more ICD-10 codes indicative of an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, binge-eating disorder, and other-specified eating disorders). During the 6-year surveillance period, 2534 dependents received incident diagnoses of eating disorders, with a crude overall incidence rate of 1.75 cases per 10,000 person-years. The most common diagnosis was other-specified eating disorder, followed by anorexia nervosa, bulimia nervosa, and binge-eating disorder. The crude annual incidence rate of all eating disorder diagnoses increased by nearly 65% from 2016 to 2021. Rates for all diagnoses were highest in 2020 and 2021. Period prevalence estimateswere .08% for any eating disorder diagnosis, .01% for anorexia nervosa, .004% for bulimia nervosa, .004% for binge-eating disorder, and .06% for other-specified eating disorders. The observed increase in eating disorder diagnoses during the surveillance period appeared to be driven by female dependents. More military dependents experienced a new-onset diagnosis during the COVID-19 pandemic compared to previous years. These findings highlight the need for eating disorder screening, identification, and treatment for dependents within the MHS. Children of US military service members may be at increased risk for eating disorders. Results indicate new-onset eating disorder cases increased 65% from 2016 to 2021, primarily among girls compared to boys. The most diagnosed and fastest growing diagnosis was other-specified eating disorder. Rates of anorexia nervosa increased following the COVID-19 pandemic. Findings highlight the need for eating disorder screening, identification, and treatment within the military healthcare system.

The sequential approach in eating disorders: A scoping systematic review.

The sequential model has been defined as an intensive, two-stage approach that comprises administering two types of treatment consecutively to improve treatment outcomes in cases of non-optimal or absence of treatment response. A psychiatric population that would potentially benefit from the application of the sequential model is the eating disorders (EDs) population. The current scoping review aimed to explore the emerging literature on the application of sequential treatments in EDs. Using PRISMA and Population intervention comparison outcomes study guidelines, Pubmed and PsycINFO were systematically searched for studies which applied temporally sequential treatments in patients diagnosed with EDs from inception to April 2022 using a combination of keywords. Studies utilising combined or integrated approaches were excluded. A total of 12 studies were selected and reviewed. Studies included Bulimia Nervosa, Binge Eating Disorder (BED), or mixed ED samples with a majority of female patients. No studies on AN samples were identified. The majority of studies contained a Cognitive-Behavioural Therapy module of treatment, were conducted on BED patients, were in outpatient settings, and included a group format in one or more treatment conditions. Studies varied in number of comparison groups and study design. Secondary and sequentially applied treatment modules were consistent with treatment recommendations of clinical guidelines. The available data on sequential treatments in EDs is scarce and exhibits methodological limitations that should be addressed in future studies. Definition of sequential treatments in EDs should be further developed to guide robust clinical research and improve empirical support of sequential treatment for complex ED cases and for non-optimal ED treatment response.

The need for epidemiological research on eating disorders in Africa and the Caribbean.

The eating disorders field acknowledges the need to include diverse populations in research. Although global diversity has increased in epidemiologic research, there is still a significant lack of research in Africa and the Caribbean. The objectives of this article are to highlight knowledge gaps in these regions and make recommendations to improve future research. We searched the literature about the epidemiology of eating disorders in Africa and the Caribbean and provided a brief summary of research findings and measures used to identify cases. There is a large knowledge gap about the epidemiology of eating disorders across African and Caribbean nations. Knowledge about the cultural appropriateness of measurement instruments and screening tools is also lacking. Inadequate information about the epidemiology of eating disorders in Africa and the Caribbean inhibits the eating disorders research field from identifying who is affected. Further, measures and screening instruments with uncertain cultural validity inhibit the ability to understand case presentations and treatment targets. We recommend that the field advocate for the inclusion of eating disorders in larger population health research and that future research should evaluate the appropriateness of measurement instruments to capture eating disorder cases in African and Caribbean countries. PUBLIC SIGNIFICANCE: There is a lack of eating disorder research in African and Caribbean countries. The limited studies that do exist show evidence of eating disorders in African and Caribbean countries. Research is needed to develop culturally relevant measures for screening and case identification, and to calculate incidence and prevalence.

Validity and Consistency of the Arabic Version of the Eating Disorder Examination Questionnaire (EDE-Q) among Saudi Adults

The prevalence of eating disorders (EDs) is growing, and early screening is important to prevent related health complications. The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a diagnostic tool to identify cases of EDs; however, a validated Arabic version of the tool is needed to help in the screening process of EDs. The aim of this study was to validate the Arabic version of EDE-Q. A cross-sectional study included a sample of 549 adults, who were recruited mainly from the four major provinces in Saudi Arabia. A forward-backward translation method was conducted, and then the tool was validated using the confirmatory factor analysis (CFA). The dataset was split for further convergent analysis using exploratory factor analysis (EFA) and CFA. The results of CFA from the main dataset did not support the four-factor original EDE-Q. The results of EFA from the first data-split suggested a three-factor EDE-Q-14 Arabic version. This was supported by the results of CFA of the second data-split. A total of five items were allocated in each shape and weight concern, and restraint component, with correlations ranging from 0.969 and 0.462 and from 0.847 to 0.437, respectively. A total of four items were allocated in eating concern, with correlations ranging from 0.748 to 0.556. The internal consistency of the global and the three subscales were high, with Cronbach's α ranging from 0.762 to 0.900. Findings of the current study suggest that the Arabic version of the EDE-Q-14 is a valid and reliable tool to screen for EDs among adults in Saudi Arabia.

Transgender congruence, body appreciation, body dissatisfaction, and disordered eating in Chinese transgender adults.

Ample evidence shows that transgender congruence is negatively associated with body dissatisfaction and disordered eating in the Western context; however, limited research has explored these relationships in non-Western populations (e.g., Chinese transgender adults). Moreover, to our knowledge, there has been no research describing disordered eating in Chinese transgender adults. Thus, this study aimed to explore group differences in and relationships between transgender congruence, body appreciation, body dissatisfaction, and disordered eating in Chinese transgender adults. This study examined transgender congruence, body appreciation, body dissatisfaction, and disordered eating in a sample of Chinese transgender adults (N=200). Chi-square, F tests, and correlation analyses were conducted to examine group differences and relationships between study variables. Of the transgender adults, 31.0% screened positive as probable eating disorder (ED) cases. There were no gender identity differences in the study variables. Transgender congruence was positively associated body appreciation (r=.40, p < .001) and negatively associated with body dissatisfaction (r=-.26, p < .001) and disordered eating (r=-.15, p=.031). Chinese transgender adults may be at high risk of EDs. Transgender congruence and body appreciation may serve a protective role in the context of eating pathology in Chinese transgender adults. Future research is needed to validate the observed relationships between transgender congruence, body appreciation, body dissatisfaction, and disordered eating in Chinese transgender adults. Research on disordered eating and body image in Chinese transgender adults is limited. This study describes disordered eating and its relations with transgender congruence, body appreciation, and body dissatisfaction in Chinese transgender adults. Findings highlight the need for and implications of ED intervention in Chinese transgender adults.

Evaluation of Psychological and Nutritional Interventions for Eating Disorders in Nigeria: A Scoping Review

The objective of this scoping review is to map and analyze literature which utilized any kind of psychological or nutritional intervention in treating patients with eating disorders (ED) in Nigeria as well as to assess the effectiveness of such interventions in helping ED patients. This study follows the methodology provided by the Joanna Briggs Institute (JBI) for scoping reviews. A database search of Google Scholar, PubMed, PsychINFO and Cochrane, from where 68 articles were selected using carefully developed search terms. Six studies were finally selected after two reviewers read the full text to ensure they ticked all the boxes stipulated in the inclusion criteria, while other papers were excluded. Findings revealed that psychological and nutritional interventions were used in treating eating disorders in Nigeria, and the interventions proved effective. Findings indicate that anorexia nervosa is the most frequently diagnosed and treated ED in Nigeria. This is because the majority of studies reviewed focused on anorexia nervosa, only two of the studies analysed eating disorders in general, and none of the studies focused on bulimia nervosa. This finding showed that psychological and nutritional interventions have been used to treat various patients in Nigeria, including adolescents, pupils and undergraduates. Findings from this study build on existing research to assert that psychological and nutritional interventions have proven highly effective in treating eating disorders. This is because the majority of eating disorder cases were treated using either or both of these interventions and, in the end, succeeded in helping patients overcome the disorder.

The impact of the COVID-19 pandemic on referral numbers, diagnostic mix, and symptom severity in Eating Disorder Early Intervention Services in England.

First Episode Rapid Early Intervention for Eating Disorders (FREED) is a service model and care pathway which aims to provide timely, well-coordinated, developmentally informed and evidence-based care for young people with eating disorders (EDs). This article investigates the impact of the COVID-19 pandemic on FREED patient presentations and service provision in England. Data from three services spanning the pre- to post-pandemic period were included (January 2019-September 2021; n= 502 patients). Run charts were created to analyze changes in monthly baseline patient data (e.g., referral numbers, duration of an untreated ED, diagnostic mix, and average body mass index for patients with anorexia nervosa [AN]). Significant increases in referral numbers were found from September 2020 onward, coinciding with the end of the first UK national lockdown. The percentage of AN presentations significantly increased after the onset of the first national lockdown (April 2020-December 2020). No other significant change patterns were identified. There have been substantial increases in referral numbers and presentations of AN to FREED services whereas illness severity seems largely unchanged. Together, this suggests that increased referrals cannot be attributed to milder presentations being seen. Implications for the implementation, funding, and sustainability of the model are discussed. Our research suggests that early intervention eating disorder services across England faced significant increases in patient referrals and presentations of anorexia nervosa over the COVID-19 pandemic. This increase in referrals is not due to a rise in milder eating disorder cases, as baseline symptom severity remained stable across the pandemic. Investment in early intervention for eating disorders must therefore match increased referral trends.

Screening for eating disorders across genders in college students: Initial validation of the brief assessment of stress and eating.

The purpose of the current study was to validate a brief, 10-item screening tool for the identification of EDs-the brief assessment of stress and eating (BASE). Participants were college students (N=596; 68.2% cisgender women) from a large Midwestern university who completed the BASE and SCOFF. The Eating Disorders Diagnostic Survey was used to generate DSM-5 ED diagnoses. We evaluated area under the curve (AUC) for both receiver operating curves (ROC) and precision-recall curves (PRC). Both the BASE and SCOFF performed significantly better than chance at identifying probable EDs in cisgender women (BASE AUC: ROC=.787, PRC=.633, sensitivity=.733, specificity=.697; SCOFF AUC: ROC=.810, PRC=.684, sensitivity=.793, specificity=.701). However, the BASE (AUC: ROC=.821, PRC=.605, sensitivity=.966, specificity=.495) significantly outperformed the SCOFF (AUC: ROC=.710, PRC=.354, sensitivity=.828, specificity=.514) for identifying probable EDs in cisgender college men. The BASE is appropriate for student healthcare and college research settings. Because the BASE outperforms the SCOFF in college men, results from the current study are expected to contribute to improved identification of EDs on college campuses. The BASE is a new screening tool to identify eating disorders. The BASE performed as well as, if not better than, the SCOFF (particularly in men). Given the need for brief, psychometrically strong, and unbiased ED screening tools in college students, the current study helps address an unmet student healthcare need that we expect will contribute to improved identification of EDs on college campuses.

Investigating the Multidimensional Comorbidity of ObsessiveCompulsive Disorder, Body Dysmorphic Disorders, and Eating Disorders: Theoretical and Practical Approaches to Treatment

Research on obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), and eating disorders (EDs), including anorexia and bulimia, has shown appreciable two-way comorbidity between these conditions, especially OCD and BDD. There are few, if any, however, assessments of the multidimensional comorbidity of OCD, BDD, and EDs. Here, we review the literature on prevalence and comorbidity of these disorders and estimate their three-way comorbidity. We calculate that multidimensional comorbidity of OCD, BDD, and EDs is present in about 1.5% of cases of primary OCD, 3.7% of cases of primary BDD and 9.8% of cases of primary EDs. We further provide recommendations for treatment of cases in which all three disorders appear together, beginning with the advice to treat that disorder first which poses the highest danger to the patient upon check in. for LVM.

The importance of an eating disorder treatment support center in Japan: A survey from 2017 to 2020

We investigated the impact of medical collaboration between the Chiba Eating Disorder (ED) Treatment Support Center (CSC) in Chiba Prefecture and the ED treatment center at Kohnodai Hospital. We calculated the number of consultations performed by the CSC and referral rate to other medical facilities from October 2017 to March 2020, as well as the clinical characteristics of the patients treated at our hospital from April 2016 to March 2020. Data on duration of hospitalization and increase in body mass index (BMI) during hospitalization were recorded. Patients were divided into all of the Japan and Chiba Prefecture groups. Data were evaluated by Poisson's regression analysis or one-way analysis of variance. A p-value < 0.05 was considered significant. The 2019 data served as reference values. Our data demonstrated that while the number of CSC consultations increased (2017:201, 2018:547, 2019:552) annually, the number of hospitalizations for EDs decreased (197, 194, 134, respectively). In comparison, the number of outpatient consultations for EDs across all of Japan peaked in 2018 and decreased significantly thereafter (2016:110, 2017:139, 2018:193, 2019:142). After the CSC was established, the number of patients treated in our department decreased as expected. Patients with anorexia nervosa (AN) who were treated on an outpatient basis across all of Japan were younger in 2019 (27.0 ± 1.2) than in 2018 (31.9 ± 1.2). Severe cases had better outcomes, and there was a significant increase in BMI of inpatients with AN in both groups. Overall, the activities of such ED treatment support center promoted successful treatment of severe ED cases.

Social media and eating disorder recovery: An exploration of Instagram recovery community users and their reasons for engagement

ObjectiveOnline recovery communities offer support for people with eating disorders who may not otherwise seek professional help. Instagram is a popular platform that is widely used for eating disorder recovery, but little is known about the population that uses it or its potential benefits. MethodA mixed-methods study surveyed 163 users of the Instagram recovery community to identify their descriptive characteristics, their reasons for using the community, and what they perceived to be helpful or unhelpful about the platform. ResultsThe community included users who were diverse in gender, ethnicity and eating disorder presentation and severity, with cases of potential anorexia nervosa, bulimia nervosa and binge eating disorder identified. Reasons for engaging in the community included to see representations of diverse individuals and as an alternative to professional treatment. Results indicate that the community may provide benefits for recovery such as social support and validation, but that its lack of moderation and potential for harmful content can also prevent recovery. ConclusionsThese findings highlight the need for better recognition of diverse eating disorder presentations and improved accessibility to professional treatment in the wider community. Moderated use of the platform should be considered in order to minimize risks and increase benefits.