Eating Disorder Diagnostic Scale Research Articles

Eating Disorder Symptomatology Among Adolescents Presenting for Bariatric Surgery Candidacy: Examining Differences by Sex and Racial Minority Status.

Research on adolescent bariatric surgery candidates is limited by insufficient inclusion of ethnic minorities and males, and lack of consideration of the full spectrum of disordered eating behaviors (i.e., restriction, compensatory behaviors [e.g., purging], overeating/binge eating behaviors). The current study investigated differences in the full range of disordered eating behaviors across sex and ethnicity among adolescents seeking bariatric surgery. Teaching hospital, United States. Data were collected using retrospective chart review of 79 adolescent bariatric surgery candidates (59% female, 46.8% Hispanic, MBMI = 50.2, SDBMI = 10.0, Mage = 17.3, SDage = 2.02) who had completed the self-reported Eating Disorder Diagnostic Scale for DSM-5 at intake. Approximately 33% of study participants met self-reported criteria for an eating disorder, with 35% endorsing binge eating behaviors and 50% endorsing compensatory behaviors. Few differences in behavior frequencies were observed across sex or racial/ethnic status. Findings underscore the importance of assessing the full spectrum of disordered eating behaviors among adolescent bariatric surgery candidates.

Exploring differential item functioning on eating disorder measures by food security status.

Food insecurity is associated with elevated eating disorder (ED) pathology, yet commonly used ED measures may not fully capture ED pathology in the context of food insecurity. The present study used differential item functioning (DIF) analyses to explore whether item endorsement on two commonly used ED questionnaires differed by food security status. Participants were 634 cisgender women recruited through Amazon's Mechanical Turk. DIF was explored for items on the Short Eating Disorder Examination Questionnaire (S-EDE-Q) and the Eating Disorder Diagnostic Scale for DSM-5 (EDDS-5). DIF analyses used a hybrid ordinal logistic regression/item response theory approach, with the presence of both statistical (p < .01) and clinical significance (pseudo ΔR2 ≥ .035) indicating DIF. There was no evidence of clinically significant DIF within the S-EDE-Q. Two items on the EDDS-5 exhibited statistically and clinically significant DIF, with moderate effect sizes. Specifically, compared to food-secure participants, food-insecure participants were more likely to report (1) eating large amounts of food when not physically hungry and (2) feeling disgusted, depressed, or guilty about overeating at lower levels of overall ED pathology but less likely to report these experiences at higher levels of overall ED pathology. Findings highlight a potential need to adapt ED measures to fully capture ED pathology in food-insecure populations. Level III, well-designed cohort study.

Predicting probable eating disorder case-status in men using the Clinical Impairment Assessment: Evidence for a gender-specific threshold

The Clinical Impairment Assessment (CIA) is a widely used self-report measure of the psychosocial impairment associated with eating-disorder symptoms. Past studies recommended a global CIA score of 16 to identify clinically significant impairment associated with a probable eating disorder (ED). However, to date, research on the properties of the CIA has been conducted in majority-women samples. Preliminary research on gender differences in CIA scores suggested men with EDs report less impairment on the CIA relative to women with EDs. Thus, the purpose of this study was to test if a different impairment threshold is needed to identify cases of men with EDs. We hypothesized that a lower CIA threshold, relative to that identified in majority-women samples, would most accurately identify men with EDs. Participants (N = 162) were men from our university-based and general community-based ED participant registry who completed the CIA and Eating Disorder Diagnostic Scale. Both precision-recall and receiver operating characteristic curves assessed what CIA global score threshold most accurately identified men with EDs. Both analytic approaches indicated that a CIA global score of 13 best predicted ED case-status in men. Consistent with past research, men with a clinically significant ED appear to report lower impairment on the CIA. Results have implications for screening and assessing for substantial ED-related impairment in men. Additionally, past research using the CIA to identify men with EDs may have under-identified men with clinically significant symptoms.

Associations between eating disorder symptoms, employment status, and occupational functioning among female veterans

BackgroundEating disorders (EDs) have been shown to negatively impact occupational functioning and may be associated with employment status. Findings have been inconsistent, and depression may mediate this relation. Further, prior research focuses mainly on binge eating disorder's (BED) impact on occupational functioning. We assessed the association between transdiagnostic ED symptoms and occupational functioning and employment status among female veterans, who tend to have high rates of EDs and unemployment but who remain understudied. MethodParticipants were 198 female veterans (Mage = 54.09) in the New England region who participated in a larger study. They completed a mailed survey including the Eating Disorder Diagnostic Scale, Center for Epidemiologic Studies-Depression Scale, employment status (employed vs. unemployed and out of the workforce), and the Inventory of Psychosocial Functioning to assess occupational functioning. ResultsED symptoms were not significantly related to employment status but were negatively associated with occupational functioning when controlling for body mass index. Depressive symptoms mediated the associations between ED symptoms and both being out of the workforce and occupational functioning, respectively. DiscussionHigher levels of ED symptoms were associated with worse occupational functioning in a female veteran sample. Further, comorbid depressive symptoms may be an important treatment target when addressing occupational health in women experiencing ED symptoms.

Eating disorders treatment experiences and social support: Perspectives from service seekers in mainland China.

This study explored treatment experiences and social support among individuals with eating disorders (EDs) in mainland China. Subscribers of a Chinese online social media platform (WeChat) focused on EDs were invited to complete a screening questionnaire that included the Eating Disorder Diagnostic Scale for the DSM-5. Of the 116 questionnaire responses, 31 met inclusion criteria for follow-up interviews. Individuals who never sought treatment were not eligible for follow-up interviews, but provided brief explanations about why they did not seek treatment. All eligible participants (n=31) completed a semi-structured interview about their experiences with ED treatment and social support. Qualitative data from the interviews and survey responses regarding not seeking treatment were subjected to inductive data-driven thematic analysis with deductive coding to illuminate treatment and social support experiences or reasons for not seeking treatment. Themes emerged from interviews revealed positive inpatient treatment experiences for anorexia nervosa, but negative outpatient treatment experiences, unaffordable care, and ineffective psychopharmacological treatments. Parents, friends, and partners were sources of social support, but participants largely felt misunderstood or blamed by these same entities. Shame, not recognizing ED as an illness, and financial constraints were listed as the primary reasons for not seeking treatment. The importance of hearing patients' perspectives, improving ED literacy in China, increasing knowledge of culturally specific manifestations of EDs, and developing culturally responsive services and dissemination of treatment resources are emphasized.

Food insecurity associated with elevated eating disorder symptoms, impairment, and eating disorder diagnoses in an American University student sample before and during the beginning of the COVID-19 pandemic.

ObjectiveThis study tested the association between food insecurity and eating disorder (ED) pathology, including probable ED diagnosis, among two cohorts of university students before and during the beginning of the COVID‐19 pandemic.MethodStudents (n = 579) from a large Midwestern American university completed self‐report questionnaires assessing frequency of ED behaviors, ED‐related impairment, and individual food insecurity as measured by the Eating Disorder Diagnostic Scale 5, Clinical Impairment Assessment, and Radimer/Cornell, respectively. Chi‐square tests and MANOVA with post‐hoc corrections were conducted to compare demographic characteristics, ED pathology, and probable ED diagnosis prevalence between students with and without individual food insecurity.ResultsPartially supporting hypotheses, MANOVA indicated significantly greater frequency of objective binge eating, compensatory fasting, and ED‐related impairment for students with food insecurity compared with individuals without food insecurity. Chi‐squared tests showed higher prevalence of ED diagnoses among individuals with food insecurity compared with those without food security (47.6 vs. 31.1%, respectively, p < .01, NNT = 6.06), specifically bulimia nervosa and other specified feeding and eating disorder. There were no differences in food insecurity before or during the beginning of the COVID‐19 pandemic.DiscussionConsistent with prior literature, food insecurity was associated with elevated ED psychopathology in this sample. Findings emphasize the importance of proper ED screening for college students vulnerable to food insecurity and EDs.

Attentional Bias to High-Calorie Food in Binge Eaters With High Shape/Weight Concern.

Individuals with high shape/weight concern (SWC) place disproportionate emphasis on shape and weight in evaluating their self-worth, making them more vulnerable to body-related cues. Binge eaters (BE), who are obsessed with devouring high-calorie foods, would show severe symptomatology, especially when they have clinically high SWC. The present study attempted to elucidate how SWC influences binging based on attentional patterns toward high-calorie food cues. A total of 120 participants were selected and divided into four groups: (1) BE with high SWC, (2) BE with low SWC, (3) healthy controls (HC) with high SWC, and (4) HC with low SWC. BE and SWC status were respectively determined using the Eating Disorder Diagnostic Scale (DSM-5) and the Eating Disorder Examination Questionnaire. All participants completed the same free-viewing task, measuring initial fixation latency and total fixation duration. BE with high SWC showed attentional bias toward high-calorie food cues in terms of significantly faster initial fixation latency and longer total fixation duration, whereas BE with low SWC and the HC groups did not show any differences. The results revealed that SWC level makes unique contributions to BE's initial orienting bias toward and difficulty disengaging from high-calorie food cues. This may indicate that BE with high SWC merely worry about eating high-calorie food in a cognitive way, but not controlling actual binging behavior. The current study of attentional bias elucidated the role of SWC as a potential maintenance factor of being concerned and binging in BE.

HOUSEHOLD FOOD INSECURITY IS ASSOCIATED WITH BINGE EATING DISORDER AMONG ADOLESCENT IN SEMAMPIR DISTRICT, SURABAYA, INDONESIA

Teenage phase is a critical period of psychosocial development. Adolescent eating patterns are formed in this phase. Household food security is among factors which may infl uence eating pattern. Adolescent who are exposed to food insecure condition tend to experience stress, which one of the coping mechanisms is overeating and may develop binge eating disorder. The purpose of this study is to analyze association between household food security status and binge eating disorder in adolescent. This case control study involved 74 adolescents aged 16-18 years and their parents in Semampir District, Surabaya, Indonesia who were selected randomly using simple random sampling. Household food security was assessed by using the Household Food Insecurity Access Scale (HFIAS) and binge eating disorder is assessed by using Eating Disorder Diagnostic Scale (EDDS). The association between household food security and binge eating disorder was analyzed by Spearman’s correlation test. There was an association between food security status (p = 0,001) and binge eating disorder. Further analysis showed that adolescents at risk of food insecurity were 5,625 times more likely to experience a binge eating disorder. This study recommends to increase food security through economic empowerment of housewives and socialization about coping strategy for both parent and adolescent.

The relationship between personality disorder, depression and eating disorder with treatment adherence in patients with type 2 diabetes; a cross-sectional study in diabetic patients in Iran

Adherence to treatment is of great importance in patients with diabetes mellitus due to its necessity and benefits. The purpose of this study was to evaluate the relationship between personality disorder, depression and eating disorder with appropriate treatment acceptance and follow-up in patients with type 2 diabetes. This cross-sectional study was performed in Imam Ali Medical Education Center in Karaj city of Alborz province of Iran. A total of 1320 patients were evaluated and were screened according to the inclusion criteria, including type 2 diabetes and those over 18years of age. Finally, considering the exclusion criteria, 600 patients with type 2 diabetes were included in the study. Patients were divided into 4 groups. 150 patients with type 2 diabetes in the control group, 150 patients with type 2 diabetes with major depressive disorder, 150 patients with type 2 diabetes with personality disorder and 150 patients with type 2 diabetes and eating disorder were studied. Questionnaires used in the study included Hamilton Depression Rating Scale(HAM-D) for depression, Minnesota Multiphasic Personality Inventory II (MMPI II) questionnaire for personality disorders and Eating Disorder Diagnostic Scale(EDDS) for eating disorder. The Murisky questionnaire also assessed adherence to treatment in patients, which included 8 questions. Scores measure the degree of adherence to treatment. 600 patients with type 2 diabetes were studied. Patients were divided into 4 groups (each group consisting of 150 patients) of control, depression, personality disorder and eating disorder. Mean age, sex, marital status and duration of diabetes were not significantly different in the study groups (P > 0.05). The mean Murisky score in patients with depression and personality disorder was significantly lower than the control group (P < 0.05) but the mean Murisky score in patients with eating disorder was not significantly different (P > 0.05). Patients with depression, paranoid, schizotypal, antisocial, borderline, avoidant and dependent personality disorder had less adherent to treatment than the control group. Early psychiatric evaluation of patients with diabetes and identification of possible disorders can help improve diabetes control.

Instruments and Diagnostic Criteria for Binge Eating Assessment in Adults: A Systematic Review

Objective: The aim of this study was to systematically review the methodologies used for BE evaluation/identification diagnosis in clinical trials (CT) with adults. Methods: The search was performed on PUBMED until July 2018. The PRISMA statement was used to improve the reporting of results.Results: 93 CTs were included among the 225 studies retrieved. The main BE evaluation/identification methods used in studies were: Binge Eating Scale; Diagnostic and Statistical Manual of Mental Disorders; Eating Disorder Diagnostic Scale; Eating Disorder Examination; Eating Disorder Examination Questionnaire; Eating Disorder Inventory; Loss of Control Over Eating Scale and Three-Factor Eating Questionnaire. Overlaps between methods were observed in studies, 61 used both DSM and an evaluation instrument, 06 only DSM and 26 only standardized questionnaires to assess BE disorder. Conclusions: The DSM-5 diagnostic criterion for binge eating disorder is considered excellent and widely used, however, when the objective of the study is to identify emotional, nutritional and qualitative issues, a questionnaire or interview about subjective perceptions can be used in a complementary way.

Eating disorders among Jordanian adolescents with and without dysglycaemia: a comparative study.

Studies on eating disorders among Jordanian adolescents have reported variable prevalence rates of 12-40%. This study aimed to determine the prevalence of eating disorders among Jordanian adolescents with and without dysglycaemia and determine the associated factors. A comparative cross-sectional study was conducted during the period November 2017-February 2018. The Eating Disorder Diagnostic Scale was used to assess the presence of different types of eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder. A typical anorexia nervosa and purging disorder were considered "other eating disorders" in this study. This study included 497 patients with dysglycaemia and 504 age-matched nondysglycaemic participants. Patients with dysglycaemia had a significantly higher prevalence of binge eating disorders compared with nondysglycaemic participants (11.9% vs 5.8%, P < 0.001). In dysglycaemia group, adolescents who were aged ≥ 14 years were more likely to have bulimia nervosa compared with those < 14 years old. Patients with a sedentary lifestyle were less likely to have bulimia nervosa and binge eating disorders. In the nondysglycaemic group, those aged 14-18 years were more likely to have other eating disorders. Those with dysglycaemia were more likely to have binge eating disorders than those in the nondysglycaemic group (OR = 2.1, 95% CI: 1.3-3.3; P = 0.002) after adjusting for possible confounders. Adolescents with dysglycaemia had higher prevalence of eating disorders compared with their nondysglycaemic peers. Screening for eating disorders is recommended among adolescents to secure early detection and subsequent intervention.

Evening chronotype, disordered eating behavior, and poor dietary habits in bipolar disorder.

Our aim was to evaluate the relationship between evening chronotype, a proxy marker of circadian system dysfunction, and disordered eating behavior and poor dietary habits in individuals with bipolar disorder (BD). In this cross-sectional study, we evaluated 783 adults with BD. Chronotype was determined using item 5 from the reduced Morningness-Eveningness Questionnaire. The Eating Disorder Diagnostic Scale (EDDS) and the Rapid Eating Assessment for Participants-Shortened Version (REAP-S) were used to assess disordered eating behavior and dietary habits respectively. General linear models and logistic regression models were utilized to evaluate differences between chronotype groups. Two hundred and eight (27%) BD participants self-identified as having evening chronotypes. Compared to non-evening types, evening types were younger (P<0.01) and, after controlling for age, had higher mean EDDS composite z-scores (P<0.01); higher rates of binge-eating (BE) behavior (P=0.04), bulimia nervosa (P<0.01), and nocturnal eating binges (P<0.01); and a higher body mass index (P=0.04). Compared to non-evening types, evening chronotypes had a lower REAP-S overall score (P<0.01) and scored lower on the 'healthy foods' and 'avoidance of unhealthy food' factors. Evening types also skipped breakfast more often (P<0.01), ate less fruit (P=0.02) and vegetables (P=0.04), and consumed more fried foods (P<0.01), unhealthy snacks (P=0.02), and soft drinks (P=0.01). Our findings suggest that the circadian system plays a role in the disordered eating and unhealthy dietary behaviors observed in BD patients. The circadian system may therefore represent a therapeutic target in BD-associated morbidity that warrants further investigation.

The relationship between body image and social pressure on eating disorders in obese female students

The trend of obesity is increasing among women of childbearing age, especially among female students. In addition to implications on health, obesity also has psychological implications that lead to eating disorders. Several factors that have influenced eating disorders in obese female students include age, body image, obesity level, stress level and social pressure. This study was aimed to analyze the factors that influence eating disorders (obesity level, body image, stress level and social pressure) in obese female students. A cross-sectional study design with ninety obese female students age 19-25 was conducted at Diponegoro University using the simple random sampling technique. Data of eight, height, waist circumference and hip circumference were collected. Eating disorders were measured by Eating Attitude Test-26 (EAT-26) and advanced modification questions adopted from the Eating Disorder Diagnostic Scale (EDDS). Body image was measured by the Body Shape Questionnaire (BSQ). The stress level was obtained by the Perceived Stress Scale (PSS) questionnaire. Social pressure was obtained using the Perceived Sociocultural Pressure Scale (PSPS) questionnaire. This data was analyzed on the Pearson correlation and multiple linear of regression. Significant relationships were observed between age (p = 0.009, r = 0.275), body image (p = 0.000, r = 0.649), and social pressure (p = 0,000, r = 0.461) on eating disorder. Otherwise, there was no significant relationship between obesity and stress level with eating disorder (p&gt;0.05). This study can be concluded that body image and social pressure were the factors that influenced eating disorder in obese female students.

Risk factors of eating disorders in young female athletes

Eating disorders in young female athletes is a serious psychological and health disease which could become an early problem on Female Athlete Triad. Eating disorders are influenced by internal and external factors. This study aimed to determine the risk factors for eating disorders in young female athletes. An observational study with a crosssectional design on eighty-six young female athletes was conducted with consecutive sampling method. Subjects in this study were athletes in athletics, weightlifting, volleyball, beach volleyball, swimming, rowing, fencing, Pencak Silat, karate, taekwondo, judo, sepak takraw, table tennis, and boxing. The inclusion criteria of the subject athletes were young female athletes aged 11-21 years registered at the study site, did not consume alcohol, and voluntary. The nutritional status of the subjects was measured by their Body Mass Index for age score. Eating disorder was measured using the Eating Attitude Test-26 questionnaire and Eating Disorder Diagnostic Scale for the type of eating disorders, Rosenberg Self Esteem for Self Confidence, Depression Anxiety Stress Scale-42 for stress level, and Body Shape Questionnaire for body image perception. This study used univariate analysis, bivariate analysis with chi-square and multivariate analysis with logistic regression test. The prevalence of eating disorders risk among the young female athletes in this study was approximately 37.2%, where 9.3% of subjects were bulimia, 5.8% were on the binge of eating disorder, and 22.1% subjects experienced eating disorder not otherwise specified (EDNOS). The multivariate analysis showed that the risk factor of eating disorders in young female athletes was the negative body image perception (p = &lt;0.001; RP:10.5) and stress (p = 0.023; RP:3.5). Nutritional status, self-confidence, and type of exercise were not proven as the risk factors of eating disorder among young female athletes. Based on this study, it can be concluded that the negative body image perception and stress are the risk factors of eating disorders among young female athletes.

Food insecurity & dietary restraint in a diverse urban population

ABSTRACT The primary aim of this study was to investigate self-reported reasons for engaging in dietary restraint (DR) in a food insecure urban population. It also tested whether DR was associated with increased eating disorder (ED) pathology when DR was broadly assessed. The initial sample (N = 503) consisted of adult clients visiting food pantries who completed the Eating Disorder Diagnostic Scale for DSM 5, the Radimer Cornell Food Insecurity Measure, and three items from the DR subscale of Eating Disorder Examination Questionnaire (EDE-Q); EDE-Q items were modified to allow participants to explain why they restricted. Analyses included participants (N = 259) who responded to one of the modified EDE-Q questions. Results indicated that participants engaged in DR for several reasons, including minimizing the effect of hunger for other family members (i.e., children), “stretching” food to make it last longer, and prioritizing medical expenses. Intentional efforts to limit food intake in this sample were correlated with increased ED pathology. Although it is not surprising that adults experiencing food insecurity engage in intentional DR, this study adds important information about why food insecure adults engage in DR and highlights the importance of assessing DR for reasons other than weight and shape concerns.

Temperament in preadolescence is associated with weight and eating pathology in young adulthood.

ObjectiveFew longitudinal studies have investigated the role of temperament traits on weight and eating problems thus far. We investigated whether temperament in preadolescence influences body weight and the development of eating pathology in adolescence and young adulthood.MethodThis study used data from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2,230) from preadolescence into adulthood. At age 11, the temperament dimensions negative affectivity and effortful control were measured with the Early Adolescent Temperament Questionnaire‐Revised. Body mass index (BMI) was measured at all assessment waves. At age 19, the prevalence of eating disorders was investigated by two‐stage screening including interviews by eating disorder experts. At age 22 and 26, the Eating Disorder Diagnostic Scale was used to assess the level of eating pathology.ResultsHigher negative affectivity in preadolescence was associated with higher BMI and eating pathology in young adulthood. Lower effortful control in preadolescence was found to be a risk factor for the development of obesity in young adulthood. No association was found between effortful control in preadolescence and eating pathology in later life.DiscussionBoth negative affectivity and effortful control play a role in the development of weight or eating problems during adolescence.

A Development and Validation Study of the Web-based Korean Version of the Eating Disorder Diagnostic Scale DSM-5

A Development and Validation Study of the Web-based Korean Version of the Eating Disorder Diagnostic Scale DSM-5

Depression subtypes, binge eating, and weight loss in bariatric surgerycandidates.

Depression and binge eating disorder (BED) are prevalent among bariatric surgery candidates. Depression subtypes may be differentially related to obesity, such that the atypical subtype predicts poorer outcomes. However, no research has examined depression subtypes, BED, and weight loss in bariatric candidates. To examine whether presurgical atypical depressive symptoms, compared with no depressive and melancholic depressive symptoms, were associated with higher rates of presurgical BED, binge eating severity, and poorer postsurgical weight loss trajectories among bariatric candidates. An outpatient Midwest bariatric clinic. Participants were 345 adults (aged 46.27 ± 12.78 yr, 76% female; body mass index = 49.84 ± 8.51 kg/m2) who received a presurgical evaluation. Depression subtypes (melancholic, atypical, and no depressive symptoms) were categorized using the Beck Depression Inventory-II. BED diagnosis and severity were evaluated using the Eating Disorder Diagnostic Scale and Binge Eating Scale, respectively. Weight loss trajectories were calculated as percent total weight loss postsurgery. Using no depression as the referent, participants reporting melancholic symptoms (odds ratio = 7.60, P < .001 confidence interval95 [2.59-22.28]) and atypical symptoms (odds ratio = 10.11, P < .01 confidence interval95 [2.69-37.94]) were more likely to meet criteria for BED. Patients with atypical depressive symptoms exhibited the highest binge eating severity scores (mean = 23.03). Depression subtypes did not predict percent total weight loss trajectories within 18-months postbariatric surgery. Patients reporting preoperative atypical depressive symptoms were more likely to meet criteria for co-morbid BED diagnosis and have greater binge eating severity but did not have poorer weight loss within 18 months postsurgery. Future studies with longer-term follow-up and corresponding measures of postsurgical depression and binge eating pathology are warranted.

Eating Disorder Symptoms in Australian Actors and Performing Artists.

Anecdotal evidence suggests that actors and other performing artists are under great pressure to conform to idealized appearances and body types. The pursuit of such appearances may trigger eating disorder symptoms, such as unhealthy attitudes towards body weight and shape. Thus far, there has been no dedicated empirical study of the prevalence of such problems in Australian actors and performing artists specifically. Therefore, this study sought to examine eating disorder symptomatology in Australian actors and performing artists. An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists, of whom 573 individuals completed the survey. This survey gauged demographic information and eating disorder symptoms using the psychometrically validated Eating Disorder Diagnostic Scale (EDDS). A large proportion of actors reported unhealthy attitudes such as 'feeling fat' even though they are of normal weight or underweight; reported an extreme fear of gaining weight; and evaluated their self-worth based on their body weight and shape, particularly women. Results also showed that 2.5% of women in the study met the diagnostic criteria for anorexia nervosa and 13% met diagnostic criteria for bulimia nervosa based on their scores on the EDDS. Performers may be a particularly at-risk population for the development and/or maintenance for a range of eating disorders.

The relationship between food addiction and patterns of disordered eating with exercise dependence: in amateur endurance athletes

PurposeExamine the prevalence and potential relationships among food addiction (FA)—as measured by Yale Food Addiction Scale 2.0 (YFAS 2.0), eating disorders (ED)—as measured by Eating Disorder Diagnostic Scale (EDDS)—and exercise dependence (EXD)—as measured by Questionnaire to Diagnose Exercise Dependence in Endurance Sports (FESA), for the first time worldwide, in amateur endurance athletes.MethodsA total of 1022 German-speaking endurance athletes (44% male, Ø 36 years, Ø BMI 23 kg/m2) replied to an online questionnaire consisting of demographics, related parameters, and the German versions of YFAS 2.0, EDDS, and FESA.ResultsPrevalence of FA, ED, and EXD was 6.2, 6.5, and 30.5%. The probability for FA increases with BMI, thoughts about food and EXD score, and decreases with age and when an ED is present. People with FA and people with ED vs. people with both, FA&ED, differed significantly in this cohort. Strong significant relationships were found between FA and EXD (X2 (1) = 15.117, p < 0.001, n = 1022).ConclusionsA considerable number of amateur endurance athletes may suffer from FA. The association between FA and EXD is stronger than between ED and EXD, indicating FA as a potentially more relevant subject—than ED—for prevention or therapy in people with EXD. Further studies are needed to investigate parameters and relationships between the possibly involved types of ED, FA, and EXD.Level of evidenceLevel III, well-designed cohort analytic study.