Cases Of Eating Disorders Research Articles

Indicated Web-Based Prevention for Women With Anorexia Nervosa Symptoms: Randomized Controlled Efficacy Trial.

BackgroundAlthough preventive interventions for eating disorders in general have shown promise, interventions specifically targeting individuals at risk for anorexia nervosa (AN) are lacking.ObjectiveThe aim of this study was to determine the efficacy of a guided, indicated web-based prevention program for women at risk for AN.MethodsWe conducted a randomized controlled efficacy trial for women at risk for AN. Assessments were carried out at baseline (before the intervention), after the intervention (10 weeks after baseline), and at 6- and 12-month follow-ups (FUs). A total of 168 women with low body weight (17.5 kg/m2≤BMI≤19 kg/m2) and high weight concerns or with normal body weight (19 kg/m2<BMI≤25 kg/m2), high weight concerns, and high restrained eating were recruited from 3 German universities as well as on the web and randomized to Student Bodies-AN (SB-AN; intervention group [IG]) or a wait-list control group (CG). The exclusion criteria were current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition–based full-syndrome eating disorders and serious medical or mental problems. The interventions were a cognitive-behavioral guided web-based prevention program (SB-AN) over 10 weeks (IG) and a wait-list CG. The primary outcomes were clinically significant changes in disordered eating attitudes and behaviors and change in BMI at 12-month FU in the group of participants who were underweight. The secondary outcomes were new onset of eating disorders, symptoms of disordered eating, and associated psychopathology.ResultsData were available for 81.5% (137/168) of the women after the intervention and for 69% (116/168) of the women at 12-month FU. At 12-month FU, the IG participants showed larger decreases in Eating Disorder Examination total scores (38/48, 79% vs 33/58, 57%) than the CG participants and the IG participants who were underweight also showed larger clinically relevant increases in BMI (15/31, 49% vs 10/32, 32%) than the CG participants, but these differences were not significant. In addition, after the intervention and at 12-month FU, we found a significant increase in continuously measured BMI for the participants who were underweight and significant improvements in disordered eating attitudes and behaviors (eg, restrained eating as well as weight and shape concerns). At all time points, the rates of new-onset eating disorder cases were (nonsignificantly) lower in the IG than in the CG and the reductions in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition–based eating disorder syndromes were (nonsignificantly) higher in the IG than in the CG.ConclusionsSB-AN is the first preventive intervention shown to significantly reduce specific risk factors for, and symptoms of, AN and shows promise for reducing full-syndrome AN onset.Trial RegistrationISRCTN Registry ISRCTN70380261; https://www.isrctn.com/ISRCTN70380261

Potential Triggers for Risking the Development of Eating Disorders in Non-Clinical Higher-Education Students in Emerging Adulthood.

Nowadays, eating disorders (ED) among individuals during emerging adulthood have become a crucial challenge to public health, taking into account the fact that the global prevalence of the ED risk in student-aged populations already stands at 10.4% and has been sharply increasing during the COVID-19 pandemic. In all, from 50% to 80% of all the ED cases go undetected or are not correctly diagnosed; moreover, these individuals do not receive specialized treatment. Therefore, early diagnosis detected via screening questionnaires for ED is highly recommended. This study aimed to identify the triggers for ED risk development in emerging-adulthood individuals and to reveal the factors significant not only for ED prevention but also for assessing individuals with subthreshold symptoms. This cross-sectional study provides the results for the ED symptom screening in 1716 Lithuanian higher-education students aged 21.2 ± 3.9, during emerging adulthood. According to the results of this study, 19.2% of students were at risk for ED. Potential risk factors such as sex (odds ratio (OR): 3.1, 95% CI: 1.9–4.9), body weight (self-reported body mass index) (adjusted (A) OR: 1.4; 95% CI: 1.2–1.7) and comorbidities such as smoking (AOR: 2.1; 95% CI: 1.6–2.8), and perceived stress during the pandemic (AOR: 1.4; 95% CI: 1.1–1.8) are involved in anticipating the symptomatology of ED during emerging adulthood. Regular initial screenings with universally adopted questionnaires and further referral to a psychiatrist must be applied to promote both the diagnosis of early-onset symptomatology and the treatment of these ED in student-aged populations. Preventive programs for reducing the prevalence of overweight or obesity among students during emerging adulthood should focus on integration directions for the development of a positive body image.

Polygenic association with severity and long-term outcome in eating disorder cases

About 20% of individuals with anorexia nervosa (AN) remain chronically ill. Therefore, early identification of poor outcome could improve care. Genetic research has identified regions of the genome associated with AN. Patients with anorexia nervosa were identified via the Swedish eating disorder quality registers Stepwise and Riksät and invited to participate in the Anorexia Nervosa Genetics Initiative. First, we associated genetic information longitudinally with eating disorder severity indexed by scores on the Clinical Impairment Assessment (CIA) in 2843 patients with lifetime AN with or without diagnostic migration to other forms of eating disorders followed for up to 16 years (mean = 5.3 years). Second, we indexed the development of a severe and enduring eating disorder (SEED) by a high CIA score plus a follow-up time ≥5 years. We associated individual polygenic scores (PGSs) indexing polygenic liability for AN, schizophrenia, and body mass index (BMI) with severity and SEED. After multiple testing correction, only the BMI PGS when calculated with traditional clumping and p value thresholding was robustly associated with disorder severity (βPGS = 1.30; 95% CI: 0.72, 1.88; p = 1.2 × 10–5) across all p value thresholds at which we generated the PGS. However, using the alternative PGS calculation method PRS-CS yielded inconsistent results for all PGS. The positive association stands in contrast to the negative genetic correlation between BMI and AN. Larger discovery GWASs to calculate PGS will increase power, and it is essential to increase sample sizes of the AN GWASs to generate clinically meaningful PGS as adjunct risk prediction variables. Nevertheless, this study provides the first evidence of potential clinical utility of PGSs for eating disorders.

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

A systematic scoping review of research on COVID-19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field.

ObjectiveResearch investigating the effects of COVID‐19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature.MethodEmpirical research on COVID‐19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings (n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID‐19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic‐related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID‐19.ResultsPandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during―and due to―the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at‐risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID‐19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective.DiscussionEvidence for COVID‐19 effects is mostly limited to participant self‐report or retrospective recall, cross‐sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.

Toward a Biological, Psychological and Familial Approach of Eating Disorders at Onset: Case-Control ANOBAS Study.

Eating disorders (ED) are considered as heterogeneous disorders with a complex multifactor etiology that involves biological and environmental interaction.Objective: The aim was to identify specific ED bio-psychological-familial correlates at illness onset.Methods: A case-control (1:1) design was applied, which studied 50 adolescents diagnosed with ED at onset (12–17 years old) and their families, paired by age and parents’ socio-educational level with three control samples (40 with an affective disorder, 40 with asthma, and 50 with no pathology) and their respective families. Biological, psychological, and familial correlates were assessed using interviews, standardized questionnaires, and a blood test.Results: After performing conditional logistic regression models for each type of variable, those correlates that showed to be specific for ED were included in a global exploratory model (R2 = 0.44). The specific correlates identified associated to the onset of an ED were triiodothyronine (T3) as the main specific biological correlate; patients’ drive for thinness, perfectionism and anxiety as the main psychological correlates; and fathers’ emotional over-involvement and depression, and mothers’ anxiety as the main familial correlates.Conclusion: To our knowledge, this is the first study to use three specific control groups assessed through standardized interviews, and to collect a wide variety of data at the illness onset. This study design has allowed to explore which correlates, among those measured, were specific to EDs; finding that perfectionism and family emotional over-involvement, as well as the T3 hormone were relevant to discern ED cases at the illness onset from other adolescents with or without a concurrent pathology.

Establishing the optimal male cut-off point: confirmatory factor analysis of the eating disorder examination-questionnaire (EDE-Q) in a representative sample of Spanish university students.

Although the EDE-Q is derived from the "gold standard" for the assessment of eating disorders (ED), its factor structure is controversial, particularly in male samples. The aim of the study was to examine the psychometric properties and factor structure of the EDE-Q, as well as to establish a sensitive and specific cut-off point validated by EDE clinical interview. A series of Confirmatory Factor Analyses were performed among a representative sample of 796 male university students, of whom 139 were interviewed. Sensitivity and specificity were calculated by receiver-operating characteristic (ROC) analysis to determinate the most appropriate cut-off value. The original factor structure was not confirmed, showing a better fit with a 2-factor solution. For the Spanish male sample, a cut-off ≥ 1.09 for at-risk of ED cases and ≥ 2.41 for clinical cases presents an optimal balance between sensitivity and specificity. The establishment of specific cut-off points for males may help to reduce the under-diagnosis of ED in this population. III: evidence obtained from well-designed case-control study.

A safety signal of somnambulism with the use of antipsychotics and lithium: A pharmacovigilance disproportionality analysis

Antipsychotics and lithium are widely used in psychiatry, particularly in schizophrenia and bipolar disorders. Recently, some cases of somnambulism or sleep-related eating disorder (SRED) have been reported in patients treated with these drugs. This study investigated the risk of reporting somnambulism or SRED associated with the use of antipsychotics and lithium. The World Health Organization pharmacovigilance database (VigiBase), comprising >18million adverse events, was queried. All somnambulism or SRED reports related to antipsychotics or lithium were identified. The association between antipsychotics or lithium and somnambulism or SRED was computed using the proportional reporting ratio (PRR) and information component. Among the 5784 cases reporting somnambulism or SRED, 508 suspected at least 1 antipsychotic or lithium. Most patients were aged 18-64 years (62.0%), and 37.0% were men. In most cases (77.6%), antipsychotic or lithium were the only drug class involved, and 53.3% of cases suspected quetiapine. Somnambulism was reported in 88.6% of cases and SRED in 18.1%. A significant association was found for second-generation antipsychotics (PRR 3.44, 95% confidence interval 3.13) and lithium (PRR 2.03, [1.22; 3.37]), but not for first-generation antipsychotics (PRR 0.99, [0.68; 1.44]). We found a significant signal of somnambulism or SRED related to second-generation antipsychotics and lithium. While case reports mentioned mostly quetiapine and olanzapine, almost all second-generation antipsychotics were associated with somnambulism or SRED.

The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019

SummaryBackgroundAnorexia nervosa and bulimia nervosa are the only eating disorders included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, yet binge-eating disorder and other specified feeding or eating disorder (OSFED) are more prevalent. This study sought to estimate the prevalence and burden of binge-eating disorder and OSFED globally and present a case for their inclusion in GBD.MethodsWe sourced studies from the GBD 2019 anorexia nervosa and bulimia nervosa epidemiological databases, two systematic reviews that included studies with epidemiological estimates of binge-eating disorder and OSFED, and experts in the field. Studies, published between Jan 1, 1998, and March 1, 2019, were included if they reported non-zero prevalence of two or more eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder, or OSFED) and diagnosed cases according to DSM-IV or DSM-5. The proportions of total eating disorder cases that met diagnostic criteria for each individual eating disorder were estimated via network meta-regression and simulation using studies reporting eating disorder prevalence. The global cases unrepresented in GBD 2019 were estimated using the proportions from the simulation and the GBD 2019 eating disorder prevalence. Disability weights for binge-eating disorder and OSFED were then estimated along with disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs).Findings54 studies, of which 36 were from high-income countries, were included in the analysis. The number of global eating disorder cases in 2019 that were unrepresented in GBD 2019 was 41·9 million (95% UI 27·9–59·0), and consisted of 17·3 million (11·3–24·9) people with binge-eating disorder and 24·6 million (14·7–39·7) people with OSFED (vs 13·6 million [10·2–17·5] people with eating disorders in GBD 2019). Together, binge-eating disorder and OSFED caused 3·7 million (95% UI 2·0–6·5) DALYs globally, bringing the total eating disorder DALYs to 6·6 million (3·8–10·6) in 2019.InterpretationBinge-eating disorder and OSFED accounted for the majority of eating disorder cases and DALYs globally. These findings warrant the inclusion of binge-eating disorder and OSFED in future iterations of GBD, which will bring the burden experienced by people living with these disorders to the attention of policy makers with the means to target this burden.FundingQueensland Health, Australian National Health and Medical Research Council, and Bill & Melinda Gates Foundation.

The changing profile of eating disorders and related sociocultural factors in Japan between 1700 and 2020: A systematic scoping review.

The purpose of this study was to investigate the changing profile of the phenotypic expression of eating disorders (EDs) and related sociocultural factors in Japan between 1700 and 2020. The authors conducted a systematic scoping review in accordance with the PRISMA statement guidelines for scoping reviews. Findings indicate that Kampo doctors reported more than 50 patients with restrictive EDs in the 1700s, when Japan adopted a national isolation policy. On the other hand, only a few reports of EDs were found between 1868 and 1944, when rapid Westernization occurred. After World War II, providers began diagnosing patients with anorexia nervosa (AN) around 1960. Patients reported experiencing fat phobia, but did not engage in restriction for achieving slimness. However, after the 1970s, Japan experienced a rise in patients with AN who engaged in restriction to achieve thinness. Cases of patients who engaged in binge/purge symptomatology increased after the 1980s, followed by a steady increase in total ED cases after the 1990s. At various time points, providers attributed family conflicts, internalization of a thin ideal of beauty, changing food environments, and pressures associated with traditional gender roles to the onset and maintenance of EDs in Japan. Findings reveal that restrictive EDs were present as early as the 18th century; Japanese patients may present with both "typical" and "atypical" forms of AN; ED symptoms can persist in the absence of Western influence; and sociocultural factors, such as gender-specific stressors and family dynamics, may contribute to EDs for Japanese populations.

Eating disorder symptoms among adolescent boys and girls in Iran.

Few studies of eating disorder (ED) symptoms among young people in Iran have been conducted. This cross-sectional study examined ED symptoms, assessed by the Eating Disorder Examination Questionnaire (EDE-Q). Adolescent boys (n = 498) and girls (n = 607) aged 12-19 years, recruited from schools in four different regions of Iran, completed a survey that included the EDE-Q. ED symptoms, namely, EDE-Q global scores and the occurrence of specific ED behaviors, were compared between boys and girls. Girls had higher global scores and were more likely to report regular extreme dietary restriction than boys (16.6 vs. 12.0%). The effect sizes for these differences were small. The regular occurrence of other behaviors (girls vs. boys-binge eating: 21.1 vs. 18.8%; self-induced vomiting: 3.3 vs. 5.4%; laxative misuse: 6.1 vs. 7.6%; excessive exercise: 5.3 vs. 4.4%) did not significantly differ by gender. Twelve percent of boys and 12.9% of girls met criteria for an operational definition of "probable ED case." ED symptoms appear to be relatively common among Iranian adolescent boys and girls. Programs designed to reduce the occurrence and adverse impact of these symptoms may therefore be increasingly important.

Does Age Impact the Clinical Presentation of Adult Women Seeking Specialty Eating Disorder Treatment?

Recent evidence suggests that eating disorders (EDs) are becoming increasingly common in older women. Previous research examining differences between younger and older women with EDs has been mixed, making it unclear whether older women with EDs represent a distinct group. We sought to determine whether there are age differences in the clinical presentation of women seeking specialty treatment for an ED. We examined the linear relationship between age and clinical constructs among adult women (N = 436) diagnosed with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, ED. Across analyses, there was no impact of age on most measures of ED symptoms, comorbid psychopathology, self-esteem, quality of life, and motivation to change. However, older age was associated with fewer interoceptive awareness difficulties, maturity fears, anxiety symptoms, and body image concerns. These findings suggest that the clinical presentation of older ED cases is largely similar, although somewhat less severe than in younger women. The implications of this research for future research and treatment are discussed.

COVID‐19 and implications for eating disorders

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Further development of the 12-item EDE-QS: identifying a cut-off for screening purposes

BackgroundThe Eating Disorder Examination – Questionnaire Short (EDE-QS) was developed as a 12-item version of the Eating Disorder Examination Questionnaire (EDE-Q) with a 4-point response scale that assesses eating disorder (ED) symptoms over the preceding 7 days. It has demonstrated good psychometric properties at initial testing. The purpose of this brief report is to determine a threshold score that could be used in screening for probable ED cases in community settings.MethodsData collected from Gideon et al. (2016) were re-analyzed. In their study, 559 participants (80.86% female; 9.66% self-reported ED diagnosis) completed the EDE-Q, EDE-QS, SCOFF, and Clinical Impairment Assessment (CIA). Discriminatory power was compared between ED instruments using receiver operating characteristic (ROC) curve analyses.ResultsA score of 15 emerged as the threshold that ensured the best trade-off between sensitivity (.83) and specificity (.85), and good positive predictive value (.37) for the EDE-QS, with discriminatory power comparable to other ED instruments.ConclusionThe EDE-QS appears to be an instrument with good discriminatory power that could be used for ED screening purposes.

A Safety Signal of Somnambulism with the Use of Antipsychotics and Lithium: A Pharmacovigilance Disproportionality Analysis

Background: Antipsychotics and lithium are widely used in psychiatry, particularly in schizophrenia and bipolar disorders. Recently, some cases of somnambulism or sleep-related eating disorder (SRED) have been reported in patients treated with these drugs. This study investigates the risk of reporting of somnambulism or SRED associated to the use of antipsychotics and lithium. Methods: The World Health Organization pharmacovigilance database (VigiBase), comprising more than 18 million adverse events, was queried. All somnambulism or SRED reports related to antipsychotics or lithium were identified. The association between antipsychotics or lithium and somnambulism or SRED was computed using proportional reporting ratio (PRR) and information component (IC). Outcomes Among the 5,784 cases reporting a somnambulism or SRED, 508 suspected at least one antipsychotic or lithium. Most of patients were aged 18-64 years (62·0%), and 37·0% were men. In most of cases (77·6%), antipsychotic or lithium were the only drug class involved, and 53·3% of cases suspected the quetiapine. Somnambulism was reported in 88·6% of ICSRs, and SRED in 18·1%. A significant association were found for second-generation antipsychotic (PRR 3·44, 95% CI 3·13) and lithium (PRR 2·03, [1·22; 3·37]), yet not for first-generation antipsychotics (PRR 0·99, [0·68; 1·44]). Interpretation: The present study found a significant signal of somnambulism or SRED related to second-generation antipsychotics and lithium. If case reports mentioned mostly quetiapine and olanzapine, almost all second-generation antipsychotics were associated with somnambulism or SRED. Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Declaration of Interests: Dr A. Gouverneur, Dr A. Ferreira, Dr C. Morival, Dr C. Pageot, and Pr M. Tournier have no conflict of interest to disclose. Pr. A. Pariente reports and acting as an independant expert towards the French Medicines Agency (Agence Nationale de Securite du Medicament et des Produits de Sante, ANSM) and the European Medicines Agency (EMA). AP coordinates the DRUGS Systematised Assessment in real-liFe EnviRonment (DRUGS-SAFER ) programme funded by the Agence Nationale de Securite du Medicament et des Produits de Sante (ANSM). This program aims at providing an integrated system allowing the concomitant monitoring of drug use and safety in France. The present study was not included in the DRUGS-SAFER programme. Ethics Approval Statement: Not required.

New data finds bias in people diagnosed with eating disorders

The number of 12‐month diagnosed prevalent cases of binge eating disorder (BED) was higher in women than in men across seven major markets, officials of GlobalData, a data analytics and consulting company, announced Sept. 18.

Epidemiology of eating disorders in primary care in children and young people: a Clinical Practice Research Datalink study in England

ObjectivesExamination of current temporal trends and clinical management patterns of eating disorders (ED) in primary care is lacking. We aimed to calculate annual incidence rates of EDs in primary care...

Is bullying and teasing associated with eating disorders? A systematic review and meta-analysis.

Involvement in bullying and teasing has been associated with adverse health outcomes, including eating disorders (EDs). The purpose of this systematic review and meta-analysis was to examine the association between bullying/teasing and EDs. A systematic search was conducted. We included research articles that examined the association between bullying/teasing (victimization and perpetration) and EDs. Studies were required to compare ED cases with a reference group. We performed a qualitative synthesis of included studies. Additionally, a random-effects meta-analysis of odds ratios were performed to compare rates of bullying/teasing victimization between cases and healthy controls. A total of 22 studies were included for review. Compared to healthy controls, those with EDs were significantly more likely to have been bullied and teased. Evidence of this association was particularly strong for bulimia nervosa and binge-eating disorder, but was more mixed for anorexia nervosa. It was unclear whether such victimization was more common in EDs compared to psychiatric controls. The meta-analysis showed that compared to healthy controls, those with EDs were twofold to threefold significantly more likely to have been teased about their appearance and bullied prior to onset of their ED. Few studies examined bullying perpetration. A number of methodological shortcomings of studies were noted. Being victimized through bullying and teasing is associated with EDs, and may constitute a risk factor. Our review underscores the need for more studies, and highlights gaps in the literature. As many patients have been victims of bullying and teasing, addressing such experiences in treatment may be valuable.

Integrative analysis of shared genetic pathogenesis by obsessive‑compulsive and eating disorders.

A number of common pathological features have been observed in obsessive‑compulsive disorder (OCD) and eating disorders (EDs). The present study examined the association between OCD and EDs at the genetic level in order to gain an improved understanding of the shared genetic basis of the diseases and identify novel potential risk genes for the two diseases. An integrated analysis using large‑scale disease‑gene association data and gene expression data was conducted. Disease‑gene association data were acquired from the Pathway Studio Mammalian database. Gene expression data were acquired from samples of 133 subjects, including 15 ED cases, 16 OCD cases and 102 normal controls. Genes associated with OCD and ED presented significant overlap (21genes, P=6.70x10‑34), serving roles within multiple common genetic pathways (top 10 pathway enrichment P<4.30x10‑7) that were implicated in the two diseases. A genetic network of 17genes was constructed, through which OCD and ED were observed to influence each other. Expression analysis revealed four novel common significant genes for OCD and ED (oxytocin receptor, glutamate decarboxylase 2, neuropeptide Y and glutamate ionotropic receptor kainate type subunit 3). These genes demonstrated a strong functional association with the two diseases. The results of the present study supported the presence of complex genetic associations between OCD and ED. Genes associated with one disease are worthy of further investigation as potential risk factors for the other. The findings of the present study may provide novel insights into the understanding of the pathogenesis of OCD and ED.

Sociodemographic correlates of eating disorder subtypes among men and women in France, with a focus on age

BackgroundOn the population level, the association of age and other sociodemographic factors with eating disorders (ED) is unclear.MethodsWe used cross-sectional data from the French general population-based NutriNet-Santé e-cohort (n=49 603...