Development Of Eating Disorders Research Articles

Socio-cultural factors contributing to eating disorder development amongst women of South Asian ethnicity: a meta-synthesis

Purpose The purpose of this study is to synthesize published empirical qualitative evidence which explores the socio-cultural influences on the development of eating disorders from the perspective of South Asian women. Design/methodology/approach A systematic search of the databases CINAHL, MEDLINE, Scopus and APA PsycINFO was conducted to identify relevant journal articles published up to August 2023. The quality of the included studies was appraised using the Critical Appraisal Skills Programme Qualitative Tool. Data was synthesized and analysed using thematic synthesis. Findings Four studies from the UK, USA and Canada were included in the meta-synthesis. Three main themes were found: gratifying others, negative childhood experiences and shame and stigma. Practical implications South Asian women report many socio-cultural factors that can influence eating disorder development. Findings of this meta-synthesis highlight the importance of cultural awareness, and health-care professionals should be aware of the nuanced socio-cultural factors that can influence a South Asian woman’s relationship with food and body image. Originality/value South Asian communities are understudied in the context of mental health, including eating disorders. To the best of the authors’ knowledge, this is the first study to synthesize the available qualitative evidence on socio-cultural influences on eating disorder development among South Asian women. These findings have revealed insights that can be harnessed by health-care professionals to better understand factors that contribute to eating disorder development and support cultural awareness.

Orthorexia Nervosa - unhealthy obsession on healthy lifestyle

Introduction: Eating disorders have expanded rapidly in recent years, with social media platforms like Instagram and TikTok playing a significant role. These platforms often showcase idealized images of healthy eating and body image, exposing young people to an overwhelming amount of information. This overstimulation can contribute to the development of various eating disorders. In our study, we focus particularly on orthorexia nervosa. Review methods: Our study was conducted as a literature review, with data gathered from PubMed and Embase. The state of knowledge: Orthorexia Nervosa (ON), introduced by Steven Bratman in 1997, could be defined as an unhealthy obsession with healthy eating. This obsession leads to strict dietary restrictions, where individuals often exclude certain food types, such as preservatives and GMOs, and experience significant stress and anxiety over food choices, planning, and preparation methods. The fixation on food purity can result in social isolation, anxiety, and major disruptions to daily life. In comparison to other eating disorders like anorexia nervosa and obsessive-compulsive disorder (OCD), ON is characterized by its focus on food quality rather than body image or weight. Conclusions: The classification of orthorexia as a mental disorder and the need for its recognition in DSM-5 are still debated. However, growing concern about its impact on mental and physical health has led to increased research and awareness.

Potential pathways to the onset and development of eating disorders in people with overweight and obesity: A scoping review.

To describe pathways to eating disorder (ED) development that have been evaluated in people with overweight and obesity. Four databases were searched to identify studies testing ED development models in adolescents (10-19 years) or adults (>19 years) with overweight and obesity. Explanatory variables were thematically grouped into constructs to describe pathways to each ED outcome. Of 2226 studies screened, 46 (10 adolescent; 36 adult) were included. Study samples were predominantly female, ranging from 22 to 2236 participants and mean age 12.3 to 56.0 years. In total, 207 explanatory variables were grouped into 18 constructs to summarize 107 pathways that were identified. The most common ED outcome was binge eating (n= 24 studies), followed by global ED psychopathology (n= 10 studies). Across pathways to ED development, negative affect was the most proposed construct, followed by preoccupation with weight/shape and weight stigma. Pathways to ED development in people with overweight and obesity are complex and may include more than 18 different explanatory factors of which negative affect, preoccupation with weight/shape, and weight stigma are the most common. More research on adolescents, males, and the spectrum of ED in diverse populations is required for early identification and intervention.

Two identical twin pairs discordant for longstanding anorexia nervosa and OSFED: lived experience accounts of eating disorder and recovery processes

Research into the risk of anorexia nervosa (AN) has examined twin pairs to further the understanding of the contributions of genetics, trait inheritance, and environmental factors to eating disorder (ED) development. Investigations of twin experiences of EDs have been biologically-based and have not considered the qualitative, phenomenological aspects of twin experiences. A gap in the literature exists regarding understanding of discordant twins with EDs. This research was developed in response, with the aim to deepen understanding of AN in discordant twins and to create novel ideas for further research and testing. The case studies presented in this article provide lived experience insights of two identical discordant twin pairs: one twin pair discordant for longstanding AN and one twin pair discordant for ‘atypical’ AN (the twin with AN has recovered). The perspectives and experiences of each co-twin (one with AN and one without) explore a number of factors that may have contributed to twin discordance in these cases, and how each twin has responded to the impact of AN in their lives. Through use of first-person accounts in case study presentation, this article centres social justice values of lived experience leadership and involvement in research. This article aims to extend current knowledge and understanding of EDs in discordant twins, particularly regarding risk for ED development, ED duration, diagnosis and treatment, and recovery processes.

Maternal perspectives on the intergenerational transmission of eating disorders

BackgroundStudies indicate that the children of mothers who have eating disorders are at an increased risk of developing eating disorders themselves. The aim of this qualitative study was to broaden and extend current understandings of the experiences of mothers with eating disorders. The present report focuses on maternal perspectives, experiences, and support needs in relation to the intergenerational transmission of eating disorders.MethodSemi-structured online interviews were conducted with parents living in the UK, USA, and Australia. Participants were eighteen mothers with a self-reported lifetime diagnosis of one or more eating disorders, who had experienced symptoms since becoming a parent, and who had at least one child aged 2 years or older. Data were analysed using reflexive thematic analysis.ResultsFour major themes relating to the impacts of having an eating disorder on children and intergenerational transmission were identified. These were: impacts (maternal perspectives on the ways having an eating disorder impacted their children, and their reflections around having been impacted by their own parents); breaking the cycle (strategies employed by mothers in efforts to prevent their children developing eating disorders of their own); communicating about the eating disorder (maternal experiences around disclosing or not disclosing having an eating disorder to their children); and support needs (maternal and perceived familial support needs in relation to breaking cycles of intergenerational transmission).ConclusionsFor mothers with eating disorders, concerns about the potential impacts on their children and fears about intergenerational transmission are salient, and these may vary for children at different ages. The mothers who participated in our study described engaging in a number of conscious strategies in efforts to manage the risks of eating disorder development in their children, but implementing these strategies was not without challenges. Implications for preventative programs to reduce the intergenerational transmission of eating disorders are discussed.

Prevalence and Risk Factors for the Development of Bulimia Nervosa and Binge Eating Disorder in a Large U.S. Military Cohort.

While bulimia nervosa (BN) and binge eating disorder (BED) are prevalent in military populations, an understanding of risk and protective factors is limited by a lack of longitudinal population-based epidemiological research. This study examined the prevalence of BN and BED among active duty service members and identified military and psychosocial factors associated with their development. Millennium Cohort Study participants were followed for up to 15 years and prevalence was ascertained using survey and electronic medical record data. Longitudinal multivariable logistic regression models evaluated risk factors associated with the development of bulimia nervosa (n=96,245) or binge eating disorder (n=113,733). Weighted prevalence estimates from survey data (range, 0.80%-4.80%) were higher than those from medical records (0.04%-0.14%). Military factors significantly associated with increased risk for BN and BED included active duty component (vs Reserve/Guard); serving in the Army, Marines, or Navy/Coast Guard (vs Air Force); and combat deployment (vs deployment without combat). Associated psychosocial factors included lack of social support, experiencing at least one life stressor, and screening positive for posttraumatic stress disorder or problem drinking. Findings highlight the critical need for disordered eating screening and prevention efforts that bolster coping skills, which can ultimately improve service member functioning and readiness.

Patient experiences of a 10-weeks weight-neutral treatment program for clinical binge eating disorder in a higher weight population

BackgroundWeight based stigma might drive the development of both higher weight and binge eating disorder (BED). To improve treatment and outcomes, a deeper understanding of how stigma and shame are correlated in clinical encounters is needed. The current study was designed to gain insight into how participating in a 10-weeks weight-neutral treatment program for patients with binge eating disorder and higher weight was experienced.MethodsSemi-structured interviews were conducted with 10 patients who had completed the BED treatment. The intervention was group based, addressing stigma and shame, using models of attachment and affect regulation in the presentation of BED. Interviews were analyzed guided by van Manen’s hermeneutic-phenomenological approach.ResultsA profound feeling of inferiority due to weight stigma and adverse childhood experiences appeared to have kept the participants stuck in a shame driven carousel of dieting, weight loss, bingeing, and weight regain. Participants and health care professionals’ mutual acknowledgement of driving elements of binge eating appeared to support participants feeling more equal. Feeling equal was described as facilitating increased awareness and tolerance of bodily sensations and emotions, and a deeper understanding and self-caring attitude towards themselves. Feeling less shame was described as important for self-disclosure in family relationships, leading to increased understanding and support from others. Simultaneously, unchanged stigmatizing surroundings were described to relate to challenges with eating patterns and weight after end of treatment.ConclusionOur findings indicate that relational symmetry, by patients experienced as being met with recognition, compassionate acceptance, and mutual investigation of subjective experience, can contribute to reduction of weight stigma and shame, and the burdensome notion of inferiority experienced by the participants in everyday life, hence improving treatment outcomes.Trail registration The study was approved and registered by the Data Access Committee at Nord-Trøndelag Hospital Trust August 8th, 2019, registration number 2019_2335.

Diversity of Binge-Eating Disorder Symptoms Is Associated with Anxiety about Getting Fat Rather Than Body Image: A Clinical Study of Women in Poland.

Anxiety about gaining weight is strongly related to body image. Evidence indicates that body dissatisfaction is a strong predictor of eating disorder development. Although not included in DSM-V diagnostic criteria, body image dissatisfaction, and concern are clearly relevant also for individuals with binge-eating disorder (BED). Weight gain anxiety is associated with psychopathological behaviors, but existing research in this area is primarily focused on bulimia nervosa and anorexia nervosa. The goal of this present study was to investigate body image and body mass anxiety in people with BED. Women diagnosed with BED (n = 105) aged 18 to 66 were surveyed using the questionnaire developed by the authors evaluating the presence of BED symptoms based on DSM-V criteria, and two other instruments: the Body Esteem Scale (BES), and the Body Mass Anxiety Scale (BMAS-20). Statistical analyses were conducted to examine the correlations of BED with body image and body mass anxiety (Pearson's r), to test differences between groups with greater and lesser BED symptom diversity (Student's t-test or the Mann-Whitney U test), and to assess differences among mild-, moderate- and severe-BED groups (ANOVA with a post-hoc test). A medium positive relationship was found between anxiety about getting fat (AGF) and the diversity of BED, measured as the number of BED symptoms. A larger number of BED symptoms was shown to be associated with a higher level of AGF. However, no significant differences in AGF levels were observed among BED-severity groups, specified with the frequency of binge eating episodes. No correlations were found between BED and body image. There were also no significant differences in body image between groups with a larger and a smaller number of BED symptoms. The only significant difference in body image observed among BED-severity groups was the level of weight concern. People with mild BED displayed a higher level of weight concern than those with severe BED. Women who binge eat experience high levels of AGF. In the present study, AGF was primarily associated with the number of BED symptoms and not the rate of recurrence of binge-eating episodes. The frequency of BED episodes, however, was linked with weight concern. On the other hand, the hypothesized relationship between disturbed body image and BED was not confirmed. The findings indicate that anxiety about getting fat should be viewed as one of the psychological costs incurred by women experiencing BED symptoms, and it should be mentioned in the next DSM version.

Psychological effects of the COVID-19 pandemic - what do we know about them?

The coronavirus disease 2019 (COVID-19) pandemic was a shock to the whole world. This pandemic caused not only many deaths of people of all ages and health effects that are still difficult to assess, but also economic, and psychological ones. Numerous studies have shown that chronic stress related to social isolation and fear of contagion increased the rates of development of anxiety, depression syndrome, emotional eating, and posttraumatic stress disorder (PTSD). The increased rate of substance use and antidepressant drugs has also been observed. Depression is included in the symptoms of long-COVID syndrome. The data on the deterioration of mental states of children and adolescents during the COVID-19 pandemic are particularly worrying. Some studies have shown increased suicide rates during and after the COVID-19 pandemic. The deterioration of mental health can also have long-term consequences in terms of physical health, for example, emotional eating (EE) associated with depressed mood and anxiety may increase the incidence of binge eating disorder (BED) and addictive eating. Consequently, the number of patients with overweight and obesity and its complications will increase. Problems related to the deterioration of the mental and physical health of the population will increase the burden on the healthcare system. Another important problem is psychological disturbances related to the COVID-19 pandemic developed in healthcare workers. It is necessary to take systemic actions aimed at improving mental health, although it will not be easy in the era of the general global economic crisis, which may deepen the psychological problems from the time of the pandemic. Therefore, the aim of our manuscript is to analyze the available data on the psychological effects of the COVID-19 pandemic on the general population and healthcare workers.

Childhood maltreatment, shame, psychological distress, and binge eating: testing a serial mediational model

ObjectiveDespite evidence of causal relationships between childhood maltreatment and the development of binge eating disorder (BED), research on mediating mechanisms is lacking. The present study sought to understand the childhood maltreatment-binge eating relationship more fully by examining three types of shame (internal, external, body) and psychological distress as mediators in this relationship. There is evidence that shame and psychological distress are associated with both childhood maltreatment and binge eating pathology. It was hypothesised that shame stemming from childhood maltreatment would contribute to psychological distress, and to binge eating as a dysfunctional emotion regulation strategy, in a serial mediational model.MethodFive hundred and thirty adults with self-reported binge eating symptoms completed an online survey, which included measures of childhood maltreatment, internal shame, external shame, body shame, psychological distress, and binge eating and other eating disorder symptoms.ResultsPath analyses showed three specific relationships: (1) a relationship between childhood emotional maltreatment and binge eating, which was serially mediated by internal shame and psychological distress; (2) a relationship between childhood sexual abuse and binge eating, which was mediated by body shame; and (3) a relationship between childhood physical maltreatment and binge eating, which was mediated by psychological distress. We also found a feedback loop, whereby binge eating might lead to increased overvaluation of body shape and weight (possibly due to increased weight) and then to an increase in internal shame and body shame. The final model showed excellent fit for the data.DiscussionFindings extend our understanding of the link between childhood maltreatment and BED. Future intervention research should focus on examining the efficacy of interventions for different forms of childhood maltreatment, based on the key mediating factors.

Binge Eating Disorder: Formation and Impact

This article provides a detailed understanding of binge eating disorder (BED), its causes, symptoms, and treatment options. A serious condition called binge eating disorder can cause both physical and psychological discomfort. A summary of past and current literature describes the symptoms, etiology of binge eating disorder, social influence, treatment, and future research directions. A serious mental disease known as binge eating disorder is characterized by frequent episodes with binge eating. A sense of lack of control over its food is a common factor in binge eating episodes, which are frequently accompanied by emotions of shame, guilt, and anxiety. The disorder is related to several psychological and physical health problems and can significantly negatively impact the quality of life. Binge eating disorder is assumed to be the result of a complex combination of psychological, biological, and societal factors, while the specific origin is unknown. Treatment for binge eating disorder typically involves a combination of psychotherapy, medication, and lifestyle changes. Finally, the paper discusses suggestions for future research directions, exploring whether social norms influence the incidence of binge eating disorders. This article suggests that future research should focus on how social norms can influence the development of binge eating disorders to develop more effective interventions.

Developing the Eating Disorder Online Activity Questionnaire (EDOAQ) for Adolescents in Eating Disorder Services; A Qualitative Study

Background and Objective: Patients aged 12 – 18 years presenting to Community Eating Disorders Services (CEDS) commonly describe problematic use of the internet (PUI). Time spent on the internet, internet experiences of social comparison, looking at food and sites offering weight and shape and fitness advice are all described during the onset of eating disorders and continue through treatment. We found that there is a lack of a clinical tool to assess PUI and its role in the development of eating disorders, and thus developed the Eating Disorder Online Activity Questionnaire (EDOAQ). Methods: This qualitative study involved 10 adolescents accessing community treatment for eating disorders, who were invited to engage in a brief semi-structured interview inquiring about their completion of the EDOAQ and experiences of the internet. Five clinicians working with the patients were also invited to participate in a similar process. Interview data was thematically analysed. Results: All participants described high use of the internet. Patient and clinician experience was generally positive regarding the clinical use of the EDOAQ, and modifications for the questionnaire were suggested. Participants also reported the necessity of online activity and the easy access to harmful content. Participants found the EDOAQ improved self-awareness of this and led to healthier online use. Conclusions: Patients presenting with eating disorder need to be screened for PUI. Assessing clinicians found a questionnaire inquiring about the use of the internet useful in assessment and treatment for eating disorder. Most patients found completing a questionnaire less intrusive and easier than talking.

The Relationship between Eating Disorders and Self-regulation among Adolescent

Eating disorders are one of the key topics in today's research. Self-regulation is essential in eating disorders development including anorexia and bulimia. The paper mainly discusses the influence of self-regulation and eating disorders on adolescents. With the improvement of technology, adolescents are more susceptible to eating and lifestyle that lead to unhealthy social stigma and unstable emotions such as body dissatisfaction, especially in women. Due to the lack of a unified understanding of eating disorders, the prevalence rate of eating disorders has rapidly increased. Willpower is suggested to be an essential mechanism that influences one's self-regulation in eating behaviors. A high level of willpower can help them better regulate their emotions control their eating behaviors. This paper also discusses social cultural difference as one of the influencing factors. Eating disorders are a controversial topic, and there is still no unified conclusion that plays a role through the self-regulation ability. Further studies should review the effectiveness to improve self-regulation ability.

A Cross-Sectional Survey of Emotional Intelligence Relating to Binge Eating Disorder in Unemployed Population

Aim: To examine the associations between emotional intelligence (EI) and Binge Eating Disorder (BED) with a mediating role played by post-traumatic stress disorder (PTSD) in the unemployed population, thus performance in an integrated manner. Study design: A Cross-sectional study Place and duration of Study: Rural and urban areas of Punjab, Pakistan during the months of December 2020-2021 Methodology: For this purpose, Wong and Law Emotional Intelligence Scale, Binge Eating Scale and PTSD Check List–Civilian Version was used to measure EI, BED, and PTSD score, respectively. The assumptions were tested using non-linear regression-based partial least squares path modelling (PLS-SEM). Results: The results revealed that unemployed individuals are at enhanced risk to develop BED. High levels of EI help to cope the stress of unemployment and overcome BED and vice versa. In this study, PTSD, a cause of unemployment, was found to be negatively related to EI and positively related to BED. However, no mediation of PTSD between EI and BED was observed. Conclusions: Our findings suggest that enhanced emotional abilities are directly associated with lower levels of work-related stress and BED. However, a diagnostic study is needed to validate the findings and establish BED diagnosis in individuals with low EI. This study helps in validation of emotional intelligence as a factor in the development of binge eating disorder. It helps in the development of programs based on prevention of binge eating disorder in unemployed population on the basis of emotional intelligence level understanding. Keywords: Unemployment, eating behaviour, emotional stability, stress disorder, mediation analysis

Development of restrictive eating disorders in children and adolescents with long-COVID-associated smell and taste dysfunction.

Absent or abnormal senses of smell and taste have been frequently reported during both acute and long COVID in adult patients. In contrast, pediatric patients who test positive for SARS-CoV-2 are often asymptomatic and the loss of smell and/or taste has been infrequently reported. After observing several young patients with COVID-associated anosmia and ageusia at our clinic, we decided to investigate the incidence of subsequent eating disorders in these patients and in SARS-CoV-2 positive patients who did not experience anosmia and ageusia during the same period. A single-site retrospective cohort study of 84 pediatric patients with suspected long COVID who were treated in the Pediatric Infectious Diseases Outpatient Clinic at the University Hospital Essen were evaluated for persistent symptoms of COVID-19. Smell and taste dysfunction as well as eating behaviors were among the signs and symptoms analyzed in this study. 24 out of 84 children and adolescents described smell and taste dysfunction after confirmed or suspected SARS-CoV-2 infections. A large number of these patients (6 out of 24) demonstrated increased fixation on their eating behavior post-COVID and over time these patients developed anorexia nervosa. In this study we saw a possible association of long-lasting post-COVID smell and taste dysfunction with subsequent development of eating disorders. This observation is worrisome and merits further investigation by healthcare providers at multiple clinical sites.

Internalization of muscularity and thinness ideals: Associations with body dissatisfaction, eating disorder symptoms, and muscle dysmorphic symptoms in at risk sexual minority men.

In the tripartite influence model, appearance-ideal internalization is identified as a prominent risk factor for the development of body dissatisfaction and subsequent eating disorder (ED) behaviors. For men, prior research has emphasized the importance of both thin-ideal internalization and muscular-ideal internalization in explaining later ED behaviors and muscle dysmorphia (MD) symptoms. Previous research in heterosexual men has shown that the associations between muscular-ideal internalization and ED or MD symptoms may depend on whether the individual has also internalized the thin ideal. However, this interaction has not been examined in research with sexual minority men (SMM). The current study collected self-report data from 452 at risk SMM (i.e., endorsed body dissatisfaction), with ages ranging from 18 to 35 years. Linear regression models were conducted to test the interaction effects between thinness and muscularity internalization on ED symptoms, MD behaviors, and general body dissatisfaction. Simple slopes and the Johnson-Neyman technique were used to investigate significant interaction terms. Thin- and muscular-ideal internalization were positively associated with muscular appearance intolerance and dietary restriction with no significant interaction. Muscular drive for size was highest when both muscularity internalization and thinness internalization were high. Muscular-ideal internalization was positively associated with both cognitive restraint and general body dissatisfaction, but only at lower levels of thinness internalization. Given the interacting association between thinness and muscularity internalization and aspects of body dissatisfaction, attitudes, and behavior, prevention and intervention programs for EDs and MDs in SMM should seek to dismantle both thinness and muscularity internalization. Internalizing-or adopting as one's own-the ideal of a body with low body fat and high muscularity has been shown to lead to muscle dysmorphia and eating disorder symptoms in men. The current study examines whether the combination of thin-ideal and muscular-ideal internalization is associated with worse symptoms than either facet alone in sexual minority men. Treatment efforts in sexual minority men should address both types of internalization.

Relationship between Mental Health and Emotional Eating during the COVID-19 Pandemic: A Systematic Review.

Obesity is one of the most dangerous epidemics of the 21st century. In 2019, the COVID-19 pandemic began and caused many deaths among patients with obesity with and without complications. Simultaneously, the lockdown related to the COVID-19 pandemic caused a host of emotional problems including anxiety, depression, and sleep disturbances. Many people began to cope with their emotions by increasing food (emotional eating) and alcohol consumption and in combination with decreased physical activity, promoted the development of overweight and obesity. Emotional eating, also known as stress eating, is defined as the propensity to eat in response to positive and negative emotions and not physical need. It should be noted that emotional eating may be the first step in the development of binge eating disorder and its extreme subtypes such as food addiction. Interestingly in some post-bariatric surgery patients, an increased frequency of addictive disorders has been observed, for example food addiction replaced by alcohol addiction called: “cross addiction” or “addiction transfer”. This data indicates that obesity should be treated as a psychosomatic disease, in the development of which external factors causing the formation of negative emotions may play a significant role. Currently, one of these factors is the COVID-19 pandemic. This manuscript discusses the relationships between the COVID-19 pandemic and development of emotional eating as well as potential implications of the viral pandemic on the obesity pandemic, and the need to change the approach to the treatment of obesity in the future.

A qualitative study of gendered psychosocial processes in eating disorder development.

Gender and sexual identity constitute social categories that have been found to be important when identifying persons at risk for eating disorders (ED), since prevalence rates are especially high for women as well as persons of gender and sexual minorities. The objective of this study is to enhance the understanding of how these social categories relate to ED development. A qualitative, inductive approach was used in order to develop empirically grounded hypotheses about gendered aspects in ED development. Data are 14 narrative interviews with persons of diverse sexual and gender identities who recovered from anorexia or bulimia nervosa. Interviews were analyzed in depth using Grounded Theory Methodology and Voice Centered Listening. Results suggest that social experiences related to female gender, as well as social experiences related to non-compliance with social gender norms, can be important for ED development. Those social experiences were described as influencing participants' self-worth, body image and self-regulatory strategies, which were connected to ED symptomatology. Future research should further validate the gendered aspects presented in this paper, since including a broader array of gendered social aspects in ED research might help to improve etiological understanding and prevention methods. This study contributes a special perspective to research on eating disorders and gender, because it is based on first-person perspectives of formerly affected persons and integrates the experiences of persons with different gender and sexual identities. Participants described four categories of gendered social experiences relevant for their eating disorders. We discuss the potential of these categories to guide future research on the development of eating disorders and their prevention.

From efficacy to effectiveness: child and adolescent eating disorder treatments in the real world (part 1)\u2014treatment course and outcomes

BackgroundFindings from randomised control trials inform the development of evidence-based eating disorder (ED) practice guidelines internationally. Only recently are data beginning to emerge regarding how these treatments perform outside of research settings. This study aimed to evaluate treatment pathways and outcomes for a specialist child and adolescent ED service across a five-year period.MethodsAll consecutive referrals between August 2009 and January 2014 seen at the Maudsley Centre for Child and Adolescent Eating Disorders in London were included. Data are reported on for all young people who were offered treatment (N = 357).ResultsMost young people referred to the service were diagnosed with anorexia nervosa (AN)/Atypical AN (81%). Treatment for AN/Atypical AN (median 11 months) was predominantly ED focused family therapy (99%). Treatment for bulimia nervosa (BN)/Atypical BN (median seven months) was most commonly a combination of cognitive behavioural therapy and ED focused family therapy (87%). At discharge, 77% of the AN/Atypical AN group had a good or intermediate outcome and 59% of the BN/Atypical BN group reported no or fewer than weekly bulimic episodes. 27% of the AN/Atypical AN group had enhanced treatment with either day- and/or inpatient admissions (AIM group). The %mBMI at 3 months of treatment was strongest predictor of the need for treatment enhancement and more modestly EDE-Q and age at assessment. The AIM group at assessment had significantly lower weight, and higher ED and comorbid symptomatology and went on to have significantly longer treatment (16 vs. 10 months). At discharge, this group had significantly fewer good and more poor outcomes on the Morgan Russell criteria, but similar outcomes regarding ED and comorbid symptoms and quality of life. When analysis was adjusted for %mBMI at assessment, 1 and 3 months of treatment, differences in Morgan Russell outcomes and %mBMI were small and compatible with no difference in outcome by treatment group.ConclusionsThis study shows that outcomes in routine clinical practice in a specialist community-based service compare well to those reported in research trials. The finding from research trials that early weight gain is associated with improved outcomes was also replicated in this study. Enhancing outpatient treatment with day treatment and/or inpatient care is associated with favourable outcome for most of the young people, although a longer duration of treatment is required.

Relationship between Binge Eating Disorder (BED) and Development of Metabolic Syndrome (METs): A Systematic Review

Binge Eating Disorder (BED) or uncontrolled food consumption is strongly associated with metabolic syndrome as a significant risk factor for health. Metabolic Syndrome (MetS) is characterized by central adiposity, high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and increased fasting blood glucose. Approximately 9% of the general population suffer from Binge eating disorder (BED), a significant risk factor for Metabolic Syndrome (MetS). This study evaluates the association between Binge Eating disorder (BED) and Metabolic Syndrome (MetS) development through a systematic review. Through analysis of previous studies, we discovered that 93 percent of those with BED had metabolic syndrome parameters in a series of investigations on BED conducted in general care. This systematic review aims to connect the frequency of binge-eating episodes and the development of metabolic syndrome. We have extracted five major studies (n = 5) through screening following systematic review standards.