Eating Disorder Mental Health Research Articles

Acceptability and perceived harm of calorie labeling and other obesity policies: A cross-sectional survey study of UK adults with eating disorders and other mental health conditions.

We assessed perceptions of recently proposed UK obesity policies (mandatory calorie labeling, banning of advertisements of unhealthy food and drinks online and before 9 pm on TV, and banning "buy one get one free" deals for unhealthy food and drinks) in people with an eating disorder (ED) and other mental health conditions. A total of 1273 participants with a self-reported lifetime mental health condition (N = 583 with an ED) completed an online survey in September-November 2022. Multinomial logistic regression was used to examine support for and potential adverse effects of policies in participants with and without an ED. A qualitative analysis of the potential effects of the policy on current ED symptoms was also conducted to better understand how and why policies may be damaging or beneficial. Participants with an ED had a lower level of support for the implementation of the calorie labeling policy compared to those without an ED (43% vs. 58%). Half of the participants with an ED (55%) reported that labeling may worsen their ED symptoms. Qualitative data indicated perceived potential harm (e.g., a gateway to relapse, negative effects on mood) and perceived benefits (e.g., feeling informed and reassured) of calorie labeling in participants with an ED. No differences in support or perceived harms of the other two policies were observed between participants with versus without an ED. Future studies are warranted to explore the potential effects of calorie labeling and how to mitigate negative impacts on people with an ED. This research is the first to assess the perceptions of UK obesity-related policies in people with an ED and other mental health conditions. Participants with an ED (vs. without) were more likely to disagree with the government implementing the calorie labeling policy. These findings highlight the potentially harmful effects of calorie labeling in people with an ED and the need for future research to understand how to mitigate negative impacts.

Eating disorder mental health literacy: A national survey of clinical social workers in the United States

Summary Social workers’ eating disorder mental health literacy (ED-MHL) is essential to the detection, assessment, and treatment of eating disorders (EDs) and disordered eating (DE) in clinical practice. This study explored social workers’ ED-MHL, particularly the assessment practices of EDs on intake forms, and within the first two therapy sessions. Participants in this national survey were N = 316 outpatient masters-level social workers in the United States. Participants completed an online survey measuring ED assessment practices in clinical practice. Findings Results showed that 42.4% ( n = 133) of respondents did not routinely assess for EDs/DE on clinical intake forms, and 53.2% ( n = 165) did not assess within the first two therapy sessions. However, those with recent training related to EDs were more likely to assess. Participants reported low to moderate perceived comfort levels with the assessment of EDs, and training and education were identified as needed resources. Social workers reported deficits in their own assessment practices of EDs. Barriers included: lack of training about EDs/DE; uncertainty about process questions to ask; and perceptions that EDs/DE are rarely the client's primary presenting problem. Applications Difficulties with detection and screening practices appeared contingent on gaps in existing education and training related to EDs/DE. These findings suggest that future research may serve to increase social workers’ ED-MHL, as underscored by the noteworthy finding that 86.1% ( n = 229) of the sample reported that they would make proactive changes in their clinical practice, as a direct result of participating in this study.

Knowledge and Myths about Eating Disorders in a German Adolescent Sample: A Preliminary Investigation.

Eating disorder mental health literacy (ED-MHL) refers to knowledge about the symptoms, causes, and treatment of eating disorders (EDs) and is an important factor in people’s attitudes towards individuals with EDs and help-seeking for EDs. Associations between ED-MHL, stigma, ED symptomatology, and gender were investigated in a sample of N = 194 German high school students. Knowledge and myths about EDs were assessed with 18 factual statements about EDs and agreement/disagreement with common myths about ED. Students also completed the Universal Stigma Scale (USS), the Weight Concerns Scale (WCS), and demographic items. Students judged M = 8.39 (SD = 3.40) statements correctly, while the average agreement with all ED myths was low (M = 0.19, SD = 0.14). Greater ED-MHL was associated with lower stigmatization of EDs. Male participants were less knowledgeable and more likely to agree with the ED myths. Participants displayed moderate ED-MHL; however, certain aspects such as ED risk factors or symptoms of specific disorders such as anorexia nervosa and bulimia nervosa were less well known. These results can inform the design of future MHL interventions for adolescents.

Stigmatising views towards individuals with eating disorders: trends and associations from 1998 to 2008 using a repeated cross-sectional design.

Eating disorders are stigmatised. Little is known about whether stigma has decreased over time and which groups hold more stigmatising beliefs. To explore whether stigma towards eating disorders has changed between 1998 and 2008 and whether it varies by sociodemographic characteristics. We used the Office for National Statistics Omnibus surveys 1998 and 2008. As outcomes, we selected four questions eliciting participants' views on issues of blame and ability to recover, and compared their mean scores across eating disorders, depression and alcohol dependence in both years. We used multivariable linear regressions to investigate associations between sociodemographic characteristics and each stigma domain. In total, 2720 participants had data on all variables of interest. Compared with 1998, in 2008 stigmatising views towards eating disorders improved. In both years, participants believed it was easier to recover from eating disorders than depression or alcohol dependence. Respondents believed people with eating disorders were more to blame for their condition than those with depression, but less than those with alcohol dependence. Men, those with less formal education, and those from ethnic minority backgrounds were more likely to place greater blame on individuals for their mental illness. Men were more likely than women to think it was possible to recover from an eating disorder. Stigmatising attitudes towards people with eating disorders have improved over time, but are still greater than those observed for other mental illnesses. Improving eating disorder mental health literacy could help to reduce these negative views and lead to improved quality of life, greater help-seeking and better prognosis.

Predictors of healthcare use in community women with eating disorder symptoms: a longitudinal study.

This study aimed to investigate associations between eating disorder mental health literacy (EDMHL), defense style, eating disorder (ED) symptom severity, psychological distress and mental-health-related quality of life (MHRQoL) and the likelihood of formal and informal healthcare use (HCU) across multiple time points. A community sample of 445 young women with ED symptoms were followed over 7 years. Questionnaires were distributed via email and postal mail across multiple time points; this study includes data from years 2 (baseline in this study), 4 and 9. The inclusion criteria was provision of HCU data at year 2. ED symptom severity at baseline was significantly associated with greater HCU two and seven years later. Accurate identification of an ED by participants (i.e. EDMHL) at baseline was associated with greater HCU seven years later. Defense style, psychological distress, MHRQoL and other aspects of EDMHL were not significantly associated with HCU over time. Individuals with more severe ED symptoms, and with greater EDMHL, may be more likely to seek help over time. However, individuals with EDs may not seek help directly for poorer MHRQoL and higher levels of psychological distress. This reinforces the importance of ED screening, particularly in primary care settings.

Disordered Eating, Body Image Dissatisfaction, and Associated Healthcare Utilization Patterns for Sexual Minority Youth

PurposeTo determine the prevalence of disordered eating behaviors (DEBs) and body image dissatisfaction (BID) according to sexual minority youth (SMY) status and describe healthcare utilization patterns by SMY status. MethodsRetrospective data from 107,528 adolescents, who had a Well Check in Kaiser Permanente Northern California in 2016, were used to compare DEB and BID by SMY status. Multivariate logistic models were used to examine the associations of SMY, birth-assigned sex, age, race/ethnicity, and body mass index on DEB and BID. The utilization of specialized eating disorder (ED) medical and mental health services and general mental health services was described at one Kaiser Permanente Northern California facility. ResultsBID was reported in 20,763 (19.3%) adolescents, DEB in 1,458 (1.7%) adolescents, and 5,363 (5%) adolescents identified as SMY. SMY had higher odds of having DEB and BID than non-SMY, respectively (adjusted odds ratio 2.0 95% confidence interval [1.9–2.2] and adjusted odds ratio 3.8 [3.4–4.2]). Regardless of SMY status, adolescents with older age, female sex, nonwhite race, and elevated body mass index had higher odds of ED risk factors. SMY with ED risk factors had higher ED medical utilization than non-SMY with ED risk factors (4.6% vs. 1.6%). However, SMY status was not associated with utilization of specialized ED mental health services. ConclusionsSMY had increased rates of DEB and BID but had underutilization of specialized ED mental health services. Future targeted efforts to prevent eating disorder-related mortality and morbidity for SMY should include targeted eating disorder screening and referral to specialized ED medical and mental health services.

Practitioner eating disorder detection: The influence of health mindset, thin-ideal internalization, orthorexia and gender role.

The current study sought to determine what factors inhibited psychologists, naturopaths and fitness instructors from detecting an eating disorder (ED), and the discipline differences across these factors. Participants of the online study were 115 health practitioners who consisted of 35 psychologists, 50 naturopathic and 30 fitness practitioners. A vignette describing a female experiencing a sub-threshold bulimic variant without purging was presented alongside ED mental health literacy items such as assessing one's ability to detect a problem. Additional items examined factors that may inhibit detection, including practitioners' level of: thin-ideal internalization, orthorexia, health or fitness mindset (a newly developed scale measuring health and fitness obsessiveness) and gender role identity. A significant number of naturopaths and fitness instructors (20% and 33.3%, respectively) were found to have elevated orthorexia scores. Similarly, psychologists had the greatest tendency to internalize the thin-ideal (M = 3.60), which was comparable to levels seen in recent research for 20- to 21-year-old females with EDs. The two largest factors inhibiting ED detection were the strength of a health mindset and gender role identity. Practitioners who had higher health mindset scores or who associated with gender identities higher in masculinity traits (ie, either androgynous or masculine gender roles) were more likely to miss detecting an ED. While many present ED studies focus upon assessing and changing client cognitions, this study emphasizes the need for further research regarding training interventions to address practitioner cognitions and gender role biases, which may in turn improve ED detection.

Eating disorder mental health literacy: What do psychologists, naturopaths, and fitness instructors know?

ABSTRACTAt present, there are no known studies investigating the eating disorder mental health literacy (ED-MHL) of common frontline health providers such as psychologists, naturopaths, and fitness instructors. Little research also exists around practitioner knowledge for the spectrum of eating disorders. The current study sought to fill these research gaps and comprised 115 health practitioners who completed an online survey. A fictional vignette describing a female (Sarah) experiencing a subthreshold bulimic variant without purging was presented alongside common ED-MHL items. Almost 4 in 10 psychologists, 7 in 10 natural therapists, and 8 in 10 fitness instructors failed to detect a general eating disorder, with the latter two groups more likely to believe the problem was a self-esteem issue. Perceived helpfulness of people and interventions varied from best practice clinical guidelines, with physical/medical risk management not prioritized, pharmacotherapy viewed poorly, and doctors seen as one of the least helpful people. Although Sarah’s problem was seen as severe and highly common (which may speak to the volume of undetected eating disorders), alarmingly 36.7% of fitness instructors viewed her predicament as desirable given weight lost. This novel study highlights the need for specific training interventions to improve health practitioners’ ED-MHL, particularly around atypical eating disorder presentations, which may facilitate earlier detection and help-seeking for evidence-based interventions rather than expenditure on unhelpful or even harmful treatments, leading to improved community health and lives saved.

Attitudes towards anorexia nervosa: volitional stigma differences in a sample of pre-clinical medicine and psychology students

Background: Anorexia nervosa (AN) is a highly stigmatised condition, with treatment often involving multidisciplinary care. As such, understanding and comparing the attitudes of emerging mental health and medical professionals towards AN, within the content of sex-based differences, is pertinent to facilitate the development of targeted stigma interventions.Aims: Examine the volitional stigmatisation of AN in emerging medical and mental health professionals.Method: Participants (N = 126) were medical (n = 41) and psychology students (n = 85) who completed a range of attitudinal outcome measures (e.g. Causal Attributions Scale, Eating Disorder Stigma Scale, Opinions Scale, Characteristics Scale and Affective Reaction Scale).Results: Across both disciplines, men were found to exhibit significantly higher eating disorder (ED) stigma, considered AN to be a more trivial and weak illness, and attributed greater levels of blame and responsibility to AN sufferers. Men also had significantly lower biogenetic causal attributions. Compared with psychology students, medicine students exhibited slightly greater anticipation of negative reactions in response to AN, obtained higher selfish/vain scores and considered sociocultural factors to contribute “a lot” in the development and maintenance of AN.Conclusions: Overall, results indicate interventions aimed at improving ED mental health literacy are needed, specifically targeting males and potentially medical students.

Knowledge and Attitudes of Psychiatrists Towards Eating Disorders

This study examined the eating disorder mental health literacy of psychiatrists. A sample of psychiatrists completed a questionnaire measuring knowledge of and attitudes towards eating disorders. Knowledge questions were based on the academic literature, standard diagnostic criteria and national guidelines on the management of eating disorders. Attitude items covered beliefs about the aetiology and treatment of eating disorders, confidence levels in diagnosis and management and the use of compulsory measures in anorexia nervosa. Psychiatrists’ knowledge of eating disorders was variable with specific gaps in both diagnosis and management. Psychiatrists felt more confident in diagnosing eating disorders than managing these conditions. Attitudes towards eating disorders were less stigmatizing than those seen in other health professionals. There is a clear need for greater education of psychiatrists regarding the diagnosis and management of eating disorders. Implementing training programmes and making information readily available could contribute to addressing these issues.