Eating Disorder Behaviors Research Articles

Assessment of diabetes-specific eating disorder risk in adult patients with diabetes

PurposeAdults with type 1 diabetes (T1D) are reported to be at higher risk for clinical eating disorders (ED) and other disordered eating behaviors (DEB) than their peers without diabetes. On the other hand, there is insufficient data on DEB in adults with type 2 diabetes (T2D). Our study aimed to investigate the prevalence of DEB in patients with T1D and T2D on intensive insulin therapy followed in our outpatient clinic.MethodsDiabetes Eating Problem Survey-Revised (DEPS-R), electronically delivered to the patients with T1D and T2D who were on an intensive insulin regimen followed up in the diabetes outpatient clinic in our center for the evaluation of DEB. A total of 120 participants, 80 patients with T1D and 40 patients with T2D, were included in the study. DEB was defined as a DEPS-R score ≥ 20 according to the answers given to the questionnaire.ResultsRisk of DEB was observed in 35% of all individuals with diabetes and was higher in T2D (55% (n = 22)) than in T1D (25% (n = 20)) (p < 0.001). In patients with T1D, BMI was similar between the risk and normal groups in terms of DEB (p = 0.15), whereas in patients with T2D, BMI was significantly higher in the risk group in terms of DEB compared to the non-risk group (p < 0.001). There was a positive correlation between the risk of DEB and HbA1c and a negative correlation with the duration of diabetes in the T1D group (p < 0.05). Weight loss was an important goal for more than 50% of individuals with diabetes in both groups, more than 60% said they skipped a main meal or snack. 13.8% of those with T1D and 27.5% of those with T2D preferred being thin to having their diabetes better controlled.ConclusionIn our study, 35% of patients with diabetes were found to have a risk of DEB, with the risk being higher in the T2D group. Our results emphasize the importance of increasing awareness among physicians and patients about DEB, which is prevalent among patients with diabetes. Early detection of individuals at risk for DEB should be considered a crucial aspect of treatment.

‘Captivating voices’: evaluation of a patient-centred animated video on excessive physical exercise and eating disorders

This project aimed to evaluate the acceptance of a short, animated video addressing excessive exercise within the context of eating disorder (ED) behaviours among diverse target groups, assess its impact...

Current Practices and Perspectives of Artificial Intelligence in the Clinical Management of Eating Disorders: Insights From Clinicians and Community Participants.

Artificial intelligence (AI) could revolutionize the delivery of mental health care, helping to streamline clinician workflows and assist with diagnostic and treatment decisions. Yet, before AI can be integrated into practice, it is necessary to understand perspectives of these tools to inform facilitators and barriers to their uptake. We gathered data on clinician and community participant perspectives of incorporating AI in the clinical management of eating disorders. A survey was distributed internationally to clinicians (n = 116) with experience in eating disorder treatment (psychologists, psychiatrists, etc.) and community participants (n = 155) who reported occurrence of eating disorder behaviors. 59% of clinicians reported use of AI systems (most commonly ChatGPT) for professional reasons, compared to 18% of community participants using them for help-related purposes. While more than half of clinicians (58%) and community participants (53%) were open for AI to help support them, fewer were enthusiastic about their integration (40% and 27%, respectively) and believed that they would significantly improve client outcomes (28% and 13%, respectively). Nine in 10 agreed that AI may be improperly used if individuals are not adequately trained, and could pose new data privacy and security concerns. Most agreed that AI will be convenient, beneficial for administrative tasks, and an avenue for continuous support, but will never outperform human clinicians on relational skills. While many clinicians and community participants are open to the use of AI in eating disorder treatment and recognize its possible wide-ranging benefits, most remain cautious and uncertain about its implementation.

Role of neuropeptide Y in development of valproate-induced eating behaviour disorder

Background. Eating behaviour disorder (EBD) induced by valproic acid (VPA) is one of the components of the pathogenesis of a serious complication of therapy with VPA and its salts such as VPA-induced metabolic syndrome (MetS). About 20% of patients receiving VPA have weight gain, which is also a consequence of altered eating behaviour in such patients. Substances such as neuropeptide Y (NPY), leptin, orexin and ghrelin are involved in the regulation of eating behaviour. NPY has received special attention in recent years because it is one of the most potent brain orexigenic peptides and its expression level directly affects the quantity and quality of food intake. NPY overexpression is associated with EBD, food preferences, obesity, and MetS.Objective: to review preclinical and clinical studies of NPY role as a potential sensitive and specific serum biomarker of VPA-EBD, secondary weight gain and VPA-MetS development in children and adults with epilepsy.Material and methods. We analyzed Russian and foreign publications submitted to eLibrary, PubMed/MEDLINE, Scopus, and Google Scholar databases between 2014 and 2024. The full-text articles in Russian and English (original studies, systematic reviews, meta-analyses, Cochrane reviews, and clinical cases) were analyzed. After the selection procedure, 53 out of 1105 publications retrieved by query keywords were included in the analysis.Results. VPA-EDB refers to multifactorial diseases, requiring to take into account the additive contribution of external (food education, eating habits of the patient and family members) and internal (key hormones and neuropeptides regulating appetite and food preferences, the dose and duration of VPA intake, the metabolic rate of VPA) factors while assessing a risk of its development. NPY-associated VPA-EDB affects dietary preferences in favor of high-calorie food and beverages, increases the frequency of meals, the risks of insulin resistance, hyperglycemia as one of the major domains in MetS pathogenesis.Conclusion. VPA-EBD requires timely diagnosis, as it can cause VPA-MetS. NPY is an important biomarker of VPA-EBD, because recent studies have convincingly demonstrated that this neuropeptide is involved in the regulation of eating behavior in patients with epilepsy.

User Experiences of and Preferences for Self-Guided Digital Interventions for the Treatment of Mild to Moderate Eating Disorders: Systematic Review and Metasynthesis.

Digital interventions typically involve using smartphones or PCs to access online or downloadable self-help and may offer a more accessible and convenient option than face-to-face interventions for some people with mild to moderate eating disorders. They have been shown to substantially reduce eating disorder symptoms, but treatment dropout rates are higher than for face-to-face interventions. We need to understand user experiences and preferences for digital interventions to support the design and development of user-centered digital interventions that are engaging and meet users' needs. This study aims to understand user experiences and user preferences for digital interventions that aim to reduce mild to moderate eating disorder symptoms in adults. We conducted a metasynthesis of qualitative studies. We searched 6 databases for published and unpublished literature from 2013 to 2024. We searched for studies conducted in naturalistic or outpatient settings, using primarily unguided digital self-help interventions designed to reduce eating disorder symptoms in adults with mild to moderate eating disorders. We conducted a thematic synthesis using line-by-line coding of the results and findings from each study to generate themes. A total of 8 studies were included after screening 3695 search results. Overall, 7 metathemes were identified. The identified metathemes included the appeal of digital interventions, role of digital interventions in treatment, value of support in treatment, communication at the right level, importance of engagement, shaping knowledge to improve eating disorder behaviors, and design of the digital intervention. Users had positive experiences with digital interventions and perceived them as helpful for self-reflection and mindfulness. Users found digital interventions to be convenient and flexible and that they fit with their lifestyle. Overall, users noticed reduced eating disorder thoughts and behaviors. However, digital interventions were not generally perceived as a sufficient treatment that could replace traditional face-to-face treatment. Users have individual needs, so an ideal intervention would offer personalized content and functions. Users found digital interventions for eating disorders practical and effective but stressed the need for interventions to address the full range of symptoms, severity, and individual needs. Future digital interventions should be cocreated with users and offer more personalization. Further research is needed to determine the appropriate balance of professional and peer support and whether these interventions should serve as the first step in the stepped care model. PROSPERO CRD42023426932; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=426932.

Sexual minority stressors and disordered eating behaviors in daily life: a daily diary study of sexual minority cisgender female couples

ABSTRACT Young cisgender sexual minority women (e.g. lesbian, queer) in the U.S. are at risk for disordered eating behaviors (DEB). Minority stress theory proposes sexual minority stressors (SMS; e.g. discrimination) related to marginalized statuses are culturally specific stressors that may explain engagement in these behaviors. However, little is known about daily SMS-DEB associations. We conducted a 14-day daily diary study of 321 U.S.-based sexual minority cisgender women ages 19–35 who were in a relationship with a woman. SMS were assessed using an 8-item daily measure of distal SMS (e.g. heard anti-LGBT talk, verbal harassment), and DEB with single items capturing dietary restraint, overeating, loss of control eating, and emotional eating. Multi-level models revealed on days when women experienced SMS, they were more likely to report dietary restraint and emotional eating, but not overeating or loss of control eating. Women who generally reported more frequent SMS were more likely to report all four DEB. There were no significant couple-level SMS-DEB associations. These findings expand our understanding of how SMS is associated with DEB in the daily lives of cisgender sexual minority women. Future studies are needed to explore the temporal sequencing of the associations. Findings may also help to inform the design of culturally tailored interventions aimed at reducing DEB among sexual minority women.

The association between social comparison in social media, body image concerns and eating disorder symptoms: A systematic review and meta-analysis.

Research has found that high social media use is associated with a greater tendency to compare oneself with others, which in turn may heighten body image concerns and problematic eating behaviours. The aim of this systematic review and meta-analysis was to examine the mean association between online social comparison and body image concerns, eating disorder behaviours and positive body image. Eligible articles published between 2008 and 2024 were searched for in scientific databases. A random-effects meta-analysis was conducted to investigate the direct correlation between social comparison and body image and eating disorder outcomes. Results from 83 studies with 55,440 participants indicated that the weighted average correlation between higher online social comparison and greater body image concerns was significant (r = .454; 95 % CI = 0.409-0.498), as was the correlation between higher social comparison and eating disorder symptoms (r = 0.36; 95 % CI: 0.28-0.43). The mean association between higher social comparison and lower positive body image was also significant (r = -0.242; 95 % CI: -0.329 to -0.155). Meta-regression analysis revealed that the quality of studies, type of social media, country, type of social comparison, percentage of female participants moderated the associations. Findings revealed a moderate size association between higher online social comparison tendencies and worse body image and eating disorder symptoms outcomes, highlighting the need to develop interventions and policies to minimize appearance comparisons on social media.

Body shape concerns and behavioral intentions on eating disorders: a cross-sectional study of Chinese female university students using an extended theory of reasoned action model.

Weight and body shape concerns have become increasingly common among adolescents. Chinese university students show a high risk of eating disorder behaviors. This study aims to analyze the moderating effect of BMI on the relationships between body shape, attitudes, subjective norms, and eating disorder behavioral intentions among Chinese female university students using the Theory of Reasoned Action (TRA) model. A stratified random sample of 679 female Chinese university students (age, mean ± SD = 19.792 ± 1.007) participated in the study. The surveys comprised the Theory of Reasoned Action Questionnaire (TRA-Q) and the Body Shape Questionnaire (BS-Q) to assess their body shape concerns and behavioral intentions regarding eating disorders. Structural equation modeling was used to test the extended TRA model, with body shape as an additional predictor and BMI as a moderator. Body shape positively affected attitudes (β = 0.444, p < 0.001), subjective norms (β = 0.506, p < 0.001), and intentions (β = 0.374, p < 0.001). BMI significantly moderated the relationships between attitudes (t = -3.012, p < 0.01), subjective norms (t = -2.678, p < 0.01), and body shapes (t = -4.485, p < 0.001) toward eating disorder intentions. Body shape and BMI directly influence eating disorder behavioral intentions among Chinese female university students. The findings suggest that young Chinese women's eating disorder intentions are increasingly influenced by external factors related to body shape and BMI.

Disordered eating attitudes and behaviours among older adults with type 1 diabetes: An exploratory study.

We explored the prevalence of disordered eating behaviours (DEBs) and attitudes among older adults with type 1 diabetes (T1D) and associations with demographic and clinical variables. Adults aged ≥65 years with T1D from a university-affiliated hospital system completed an electronic survey (September to November 2023) including the Diabetes Eating Problem Survey-Revised (DEPS-R). Clinical data were extracted from medical records. Seventy-seven older adults (mean [SD] age: 71.8 [4.1]; mean [SD] HbA1c [mmol/mol]: 51 [12]; BMI [kg/m2]: 27.3 [4.7]) with T1D completed the DEPS-R. Mean DEPS-R score was 11.5 (6.0), with 5.2% (n = 4) having clinically significant DEBs (score ≥ 20). We found a positive linear association between DEPS-R score and BMI (adjusted p = 0.002). There was no significant association with HbA1c. Older adults with T1D endorsed variable degrees of DEBs. Greater DEBs were associated with higher BMI; more research is needed to characterise this relationship.

A core beliefs model of disordered eating: processes and pathways to eating disorder symptomatology

ObjectiveAt present there is no clear, cohesive, and comprehensive theoretical understanding of the role of core beliefs in the development of disordered eating. The present study aimed to develop and test a theoretical model outlining important processes and pathways from core beliefs to eating disorder (ED) behaviours. It also aimed to explore potential differences (or similarities) in contributions of four core belief dimensions to the development and maintenance of ED symptomatology.MethodData were collected from a sample of 800 non-clinical participants. Path analysis was conducted to test general and multi-dimensional models. Indirect effects were calculated for all possible pathways from ED core beliefs to dietary restraint, objective binge eating, and compensatory behaviours.ResultsThe hypothesised model demonstrated poor to acceptable fit to the data. Modifications were made to the general model to improve fit, remove non-significant paths and add theoretically and statistically relevant paths. All indirect effects of possible pathways from core beliefs to ED behaviours were significant. A multi-dimensional version of the model was tested with four core belief dimensions. This model identified differences in pathways from each core belief dimension to ED symptoms.DiscussionThis study extends the current understanding of the role of core beliefs in the development and maintenance of disordered eating, by building upon previous theoretical models and empirical literature. We present a general core beliefs model of disordered eating, and preliminary findings regarding differences in the processes and pathways from four key core belief dimensions to ED behaviours.

Eating Disorders in Adolescents and Young Adults: A Program Evaluation of a Canadian Eating Disorder Treatment Program.

Current treatments for adolescents with eating disorders (ED) show limited effectiveness, emphasizing the need for enhanced therapeutic approaches. Cognitive behavioral therapy (CBT) has emerged as a potential alternative. A derivative of this approach, group cognitive behavioral therapy (G-CBT), has been shown to reduce treatment costs and increase treatment accessibility when compared to CBT. This program evaluation aimed to assess the effectiveness of G-CBT in adolescents and young adults diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and experiencing comorbid anxiety and depression within a Canadian mental health facility. The specific objectives were to determine if participants increased their knowledge about eating normalization and coping strategies after participating in the eating disorder(ED) treatment program and examine if participants experienced changes in eating-disordered behavior, anxiety, and mental health. We conducted a program evaluation using secondary data collected at admission and discharge from 44 adolescents and young adults (16-39 years) with AN or BN participating in the EDprogram at a Canadian health center. Outcome measures were eating psychopathology, depression, anxiety, and illness cognitions assessed using validated tools: Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Illness Cognition Scale (ICS). The mean age of participants was 24.1 years (standard deviation (SD) = 5.8). All outcome measures showed statistically significant improvement from admission to discharge (p < 0.001). Specifically, subscales of the EDE-Q (eating concern, weight concern, shape concern, and restraint) and the global score indicated a significant reduction in ED behaviors (p < 0.001). Findings suggest that G-CBT is effective in reducing eating-disordered behavior, depression, anxiety, and maladaptive illness cognitions in adolescents and young adults with EDs. These results underscore the potential of G-CBT to address both behavioral and psychological aspects of ED recovery, although further studies with control groups are warranted to confirm these findings.

Multivariate patterns linking brain microstructure to temperament and behavior in adolescent eating disorders.

Eating disorders (EDs) are multifaceted psychiatric disorders characterized by varying behaviors, traits, and cognitive profiles thought to drive symptom heterogeneity and severity. Non-invasive neuroimaging methods have been critical to elucidate the neurobiological circuitry involved in ED-related behaviors, but often focused on a limited set of regions of interest and/or symptoms. The current study harnesses multivariate methods to map microstructural and morphometric patterns across the entire brain to multiple domains of behavior and symptomatology in patients. Diffusion-weighted images, modeled with restriction spectrum imaging, were analyzed for 91 adolescent patients with an ED and 48 healthy controls. Partial least squares analysis was applied to map 38 behavioral measures (encompassing cognition, temperament, and ED symptoms) to restricted diffusion in white matter tracts and subcortical structures across 65 regions of interest. The first significant latent variable explained 46.9% of the covariance between microstructure and behavior. This latent variable retained a significant brain-behavior correlation in held-out data, where an 'undercontrolled' behavioral profile (e.g., higher emotional dysregulation, novelty seeking; lower effortful control and interoceptive awareness) was linked to increased restricted diffusion across white matter tracts, particularly those joining frontal, limbic, and thalamic regions. Individually-derived brain and behavior scores for this latent variable were higher in patients with binge-purge symptoms, compared to those with only restrictive eating symptoms. Findings demonstrate the value of applying multivariate modeling to the array of brain-behavior relationships inherent to the clinical presentation of EDs, and their relevance for providing a neurobiologically-informed model for future clinical subtyping and prediction efforts.

Using youth-engaged research methods to develop a measure of disordered eating in transgender, non-binary, and gender-diverse youth: Research protocol.

Transgender, non-binary, and gender-diverse (TNG) youth experience disordered eating behaviors (DEBs) for reasons unique to their sociocultural positioning and the specific challenges they face, including gender dysphoria and societal beauty expectations of gender, cissexism, and lack of access to gender affirming medical care. The prevalence of DEBs is considerably and consistently higher in TNG youth compared to their cisgender peers. Nonetheless, there are no DEBs measures tailored to this population. Although the field of TNG DEBs research is quickly growing, gaps in knowledge remain, due, in part, to a lack of TNG input on research protocols focused on this population, and underrepresentation of TNG people in DEBs research. The goal of this research protocol is to develop and evaluate a community informed DEBs measure specific for TNG youth. We will implement youth-engaged research methods to create affirming, inclusive research protocols and optimize recruitment of subpopulations of TNG youth historically excluded from research (i.e., transfeminine youth of color and non-binary youth). A TNG youth advisory board of 5-7 members will participate in all research activities, including developing recruitment matrices, conducting qualitative analyses, developing survey items, interpreting results, and disseminating the scientific findings.

The Relationship Between Picky Eater and The Nutrional Status of Preschool Children at Gotong Royong Kindergarden in Surabaya, Indonesia

One of the eating behavior disorders in preschool children is picky eater, a behavior that is picky about food so that children experience limited consumption of a variety of foods. This impacts the nutritional status of children, which can affect their health. Therefore, this study aims to determine the relationship between children's eating behavior disorders (picky eaters) and the nutritional status of preschool children at Kindergarten Gotong Royong Surabaya, Indonesia. This was an observational analytical research with a cross-sectional research design. The sampling method used purposive sampling technique. Data were collected by filling out the CEBQ (Child Eating Behavior Questionnaire) questionnaire and anthropometric measurements of body weight and height, as well as measuring nutritional status using the indicators BB/TB (0-6 months) and BMI/U (&gt;60 months). All data were processed using IBM SPSS v25.0 software with the Spearman rank correlation test. The results of the study showed that 53.6% of preschool children at KB-TK Gotong Royong Surabaya had eating behavior disorders (picky eaters), 46.4% of the children were non-picky eaters, 41.0% had poor nutritional status, and 43.6% had normal nutrition who were mostly non-picky eaters. The bivariate analysis results of the correlation test obtained a p-value of 0.001 (α&gt;0.05). These data showed a relationship between picky eating disorders and the nutritional status of preschool children at Kindergarten Gotong Royong Surabaya.

Core psychopathology underlying disordered eating behaviors and nonsuicidal self-injury in university students: a network analysis

Objective Disordered eating behaviors (DEBs) and nonsuicidal self-injury (NSSI) frequently co-occur in university students, yet what underlies this co-occurrence remains unknown. Network analysis was used to identify psychosocial correlates that may link DEBs and NSSI in university students and test whether networks were similar across gender. Participants Four hundred and seventy college women and 473 college men (aged 18–25 years). Methods Participants completed online questionnaires. Networks were estimated for men, women, and a combined sample. Results The networks for men and women were invariant. The most central nodes in the combined network were difficulties in emotion regulation and body dissatisfaction. Interoception and difficulties in emotion regulation were directly associated with past-month NSSI and strongly associated with body dissatisfaction, linking DEBs and NSSI in the network. Conclusions Difficulties in emotion regulation, interoception, and body dissatisfaction may play critical roles in the comorbidity of DEBs and NSSI in university students.

Increased bolus overrides and lower time in range: Insights into disordered eating revealed by insulin pump metrics and continuous glucose monitor data in Australian adolescents with type 1 diabetes

AimsTo determine the prevalence of disordered eating behaviors (DEB) in a population of Australian adolescents with T1D and to investigate clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) data trends, and psychological attributes associated with DEB. Methods50 participants (27 female, 23 male, average age 15.2 years, average duration of diabetes 6.2 years) were recruited. Diabetes Eating Problem Survey-Revised (DEPS-R) and Strengths and Difficulties Questionnaires were completed. Prevalence of disordered eating was reported, and associations with clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) metrics were assessed. ResultsTwenty-four participants (48 %) had an elevated DEPS-R score. Participants with elevated DEPS-R were more likely to be female (75 % vs 31.6 %, p = 0.004), have a higher HbA1c (8.2 %/67 mmol/mol vs. 6.9 %/51 mmol/mol, p < 0.002) and BMI Z-score (+1.28 SD vs +0.76 SD, p = 0.040). They had lower time in range, 3.9–10 mmol/L (50.3 % vs. 63.8 %, p = 0.01) and higher mean glucose (10.0 mmol/L vs. 8.3 mmol/L, p = 0.005). Of the 60 % using IPT, participants with elevated DEPS-R had increased meal bolus overrides (7.9 % vs 3.8 %, p = 0.047). Reported difficulties on SDQ were higher in the elevated DEPS-R group (18.3 vs 10.5, p < 0.002). ConclusionsDEB are common in Australian adolescents with T1D and associated with increased dysglycemia. Diabetes technology cannot be solely relied upon for detection of DEB and there remains a need for routine screening.

ASSOCIATION BETWEEN DISORDERED EATING BEHAVIOURS AND SOCIAL MEDIA USAGE IN YOUNG ADULTS A CROSS SECTIONAL STUDY

Background: Disordered eating behaviours(DEB) have increased significantly in recent times, especially among young adults. These behaviours are the result of several variables, including conventional beauty ideals. Social media plays a significant role by popularizing unrealistic beauty standards. The correlation between DEB and the use of social media has not been adequately explored in young adults. Methodology: Data from engineering students (n = 690 mean age = 19.5) was collected. Eating Attitudes Test (EAT-26) was used to determine DEB and social media disorder (SMD) scale was used to determine disordered social media usage. Chi-square test was applied to find the association between DEB and problematic usage of social media. Results: Out of 690 sample size, 53.6 % of the sample were female and 46.4% were male. DEB were reported by 44.2% of which 15.2% were female and 29.0% were male with dieting being the most common disordered eating behavior. A total of 31.9% reported problematic or disordered social media usage of which 15.2% were female and 16.7% were male. A Significant association was found between DEB and disordered social media usage with p value=0.000 and ᵡ² value= 15.06. A Significant association was also found between DEB and male sex with p value=0.000 and ᵡ² value= 16.2. Conclusion: The results of this study point to a correlation between DEB and problematic usage of social media in young adults.

Evaluation of Eating Behavior in Children with Psoriasis: Retrospective Cross Sectional Study

Background. Patients with psoriasis have increased thickness of visceral fat, including epicardial adipose tissue (EAT) that has wide spectrum of biological effects. Its thickness can be affected by the presence of obesity and eating behavior (EB) changes. Studying the associations between EB and markers of adipose tissue functional activity in children with psoriasis may help to better understand this variables correlations in the scope of comorbidities. Objective. Aim of the study is to analyze the relationship between Psoriasis Area and Severity Index (PASI), Children’s Dermatology Life Quality Index (CDLQI), EAT thickness, and leptin levels in pediatric patients with psoriasis and EB disorders. Methods. Retrospective cross sectional single-center study was conducted. 72 medical records of children with psoriasis (with varying body mass index level) who were examined and treated in dermatology department in the period from December 2021 to January 2024. All included patients have underwent dietician consultation and survey with DEBQ and CEBQ questionnaires, as a result predominant EB type was determined. EAT thickness (via two-dimensional echocardiography) and leptin levels were also measured. Psoriasis severity was evaluated via PASI and CDLQI indices. Patients were divided into three groups: with external, emotiogenic, and restrictive EB. The medians of the obtained values were calculated with determination of the confidence interval, all results were compared with each other via Kruskall-Wallis test. Results. Group of patients with external EB has shown following results: median EAT thickness was 2.5 mm (Q1–Q3: 2.1–2.8), median leptin level — 17.3 ng/ml (Q1–Q3: 14.4–26.4), median of PASI — 17 points (Q1–Q3: 12.5–20.5), median of CDLQI — 7 points (Q1–Q3: 4–13.5). Group of patients with emotionogenic EB has median EAT thickness of 2.2 mm (Q1–Q3: 1.85–2.55), median leptin level — 20.1 ng/ml (Q1–Q3: 14.5–23.95), median of PASI — 14 points (Q1–Q3: 12–16.5), median of CDLQI — 6 points (Q1–Q3: 3–12). Group of patients with restrictive EB has median EAT thickness of 3.4 mm (Q1–Q3: 3.1–3.9), median leptin level — 28.2 ng/ml (Q1–Q3: 26.1–33.5), median of PASI — 24 points (Q1–Q3: 21–27), median of CDLQI — 13 points (Q1–Q3: 9–21). Statistically significant (p = 0.0014) increase in PASI and CDLQI points was observed at comparison of different groups via Kruskall-Wallis test. Patients from restrictive EB group have shown higher values of EAT thickness, leptin levels, PASI, and CDLQI scores compared to patients with emotionogenic and external EB. No statistically significant differences were observed when comparing leptin levels and EAT thickness in the remaining groups. Conclusion. Patients with restrictive EB had higher PASI and CDLQI scores compared to patients with emotionogenic and external EB. No statistically significant differences were observed when comparing EAT thickness and leptin levels. Small study sample was the only research limitation.

Promotion included in prevention (PIP)

Abstract Issue/problem Every year in Europe more than 20 million visits are carried out on workers. The opportunity to integrate health promotion into prevention is now under the attention of large companies, according to the American model known as Total Worker Health©. Description of the problem The main critical points of this strategy are the correct balance between promotion and prevention efforts and the extension of the projects to small companies. Furthermore, coordination is necessary between all the figures who promote health, particularly in the national health service. Results Occupational risk prevention activities, mandatory in all European countries, have been integrated with health promotion campaigns, addressing health topics chosen in a participatory way. The costs of designing the campaign, information material for employees and data processing are borne by the university, which covers the costs with research funds. No costs are borne by workers or companies. During their medical check-up in the workplace, workers are invited to fill in a questionnaire regarding the project topic, its outcome, and some related factors. Workers receive advice on how to improve their lifestyles and are referred to the National Health Service for any necessary tests or treatments. In the last 15 years, as many annual campaigns have been conducted. Projects have dealt with: Eating behavior disorders; Post-COVID syndrome; Syncope and presyncope; Headache; Musculoskeletal disorders; Work engagement; Sleep health promotion; Aging; Violence at work; Work organization; Indoor air quality; Mediterranean Diet; Hand skin disorders; Teleworking; Work Ability. More than 30,000 workers from 38 companies participated. Lessons The participatory character of the projects, their simplicity and cost-effectiveness, the integration between occupational medicine and basic medicine demonstrate that PIP projects are economical, sustainable, and effective. Key messages • Health promotion can be integrated into the prevention of occupational risks, without additional costs. • The creation of a network of occupational physicians who are involved in PIP projects respects corporate and professional independence and improves the work culture, health, and safety of workers.

Experiences of discrimination in healthcare settings, trust in providers and disordered eating behaviors in LGBTQ+ college students

ABSTRACT Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals report more experiences of healthcare discrimination and disordered eating behaviors (DEBs), and less trust in physicians than their cisgender and heterosexual counterparts. Although research supports a link between discrimination and DEBs among LGBTQ+ populations, few studies have specifically investigated healthcare discrimination and DEBs in this population. This study examined whether LGBTQ+ status moderated the relation between negative healthcare experiences and DEBs in undergraduates. Undergraduates (n = 322) from a Southeastern (United States) university completed measures of healthcare discrimination, trust in physicians, and DEBs. Analyses investigated whether LGBTQ+ status moderated the relation between healthcare discrimination and DEBs; trust in physicians and DEBs. LGBTQ+ individuals (35% of sample), reported less trust in physicians (p < .001), and more body dissatisfaction (p = .007) and shape/weight overvaluation (p = .008). Among all undergraduates, experiences of healthcare discrimination were associated with higher body dissatisfaction (p = .003) and shape/weight overvaluation (p = .008). Less trust in physicians was associated with greater shape/weight overvaluation (p = .005). LGBTQ+ status did not moderate either relation. It is important to reduce healthcare discrimination and foster patient–provider trust for all young adults. Future research should examine factors influencing patient–provider trust among LGBTQ+ individuals.