Eating Disorder Risk Research Articles

Exploring eating disorder risk among Thai transfeminine youth: a comparative study with cisgender females.

Adolescents, particularly vulnerable during puberty, often face heightened concerns about dieting and body image. Transfeminine youth, especially in Asian cultures, are understudied in this context. This study investigates eating disorder risks among Thai transfeminine youth and compares to cisgender females, focusing on the association with body dissatisfaction. This study aims to explore 3 objectives: (1) to assess and compare the prevalence of eating disorder risks between Thai transfeminine youth and cisgender females; (2) to examine the link between body dissatisfaction and eating disorder risks; (3) to identify risk factors associated with abnormal eating disorder screening outcomes. This is a cross-sectional comparative study conducted between September 2021 and October 2022. The study questionnaire includes Thai version of the Eating Attitude Test-26 (EAT-26) to assess the risks of eating disorders and Thai version of the Body Image Concern Inventory (BICI) to assess body dissatisfaction. The questionnaire was distributed through social media platforms to transfeminine and cisgender females, aged 12-25 years. The correlation between eating disorder risks and body dissatisfaction was analyzed with linear regression, while the comparisons between transfeminine individuals and cisgender female groups were analyzed with Wilcoxon rank-sum test. The study included 241 transfeminine individuals and 388 cisgender females, median age 19.0 years (interquartile range [IQR] 18-21) and 18 years (IQR 16-20), respectively. Ninety (37.3%) transfeminine individuals had an EAT-26 score ≥ 20, suggesting concerns for dieting and eating behaviors, compared to 70 (18%) cisgender females (p < 0.001). Risk factors for EDs included obesity (odds ratio [OR] 3.22, confidence interval [CI] 1.36-7.6) and low income (OR 3.66, CI 1.59-8.4). Protective factors were negligible exercise (OR 0.24, CI 0.09-0.66), gender identity disclosure (OR 0.27, CI 0.1-0.77), and high levels of happiness (OR 0.85, CI 0.73-0.98). There is a significant correlation between the positive eating behavior screening and the body dissatisfaction scores. Transfeminine youths show significantly higher concerns about dieting, body weight, and eating behaviors than their cisgender females, highlighting the unique challenges they face. These results emphasize the needs for targeted screening, health care access for treatment and support for eating disorders in transfeminine youths.

Beyond body image: Self-face recognition and negative self-face evaluations in women at high risk for an eating disorder.

Although one's face represents a core aspect of one's physical appearance, it remains underexplored in eating disorder (ED) populations. The current study examined whether self-face recognition accuracy and evaluations differ in those at high (vs. low) ED risk. We also explored whether recognition accuracy and evaluations are related, and whether this relationship is moderated by ED risk status. Participants included 222 women of East/Southeast Asian (61%) and Caucasian (39%) ethnicity, stratified into low-ED-risk (n=124) and high-ED-risk (n=98). Participants completed measures of self-face recognition accuracy (difficulty recognizing their face and sensitivity to seeing their facial image) and evaluations (including perceived facial adiposity and attractiveness, and head dissatisfaction). Partially consistent with hypotheses, regression analyses revealed that participants at high (vs. low) risk showed poorer self-face recognition accuracy (greater difficulty) and more negative self-face evaluations (higher perceived adiposity, lower perceived attractiveness, greater head dissatisfaction). However, ED risk was not significantly associated with self-face recognition sensitivity. Inconsistent with expectations, whilst greater self-face recognition difficulty was associated with more negative self-face evaluations, ED risk failed to moderate such effects. Findings suggest the potential value of considering face and body image disturbances in ED research and interventions. Further research is encouraged.

More than Body Appearance! Improving body image in young women through a functionality-focused intervention combined with psychoeducation: A randomized controlled trial.

Body dissatisfaction is a public health concern, prevalent among women. This study aims to investigate the efficacy of a 2-week online functionality-focused intervention combined with psychoeducation on improving body image among young women at both high and low risk of Body Image Disorders (BIDs). A randomized controlled trial was conducted among young women at high risk and low risk of developing BIDs. In total, 231 young women (n = 64 at high risk of BIDs) were randomized into: experimental (n = 113) and waitlist (n = 118) groups. The experimental group underwent the intervention at baseline (T0) for 15 days (T1), while the waitlist group started the intervention at T1 for 15 days (T2). Participants completed questionnaires about body and functionality appreciation, eating disorders (EDs) risk and extreme body dissatisfaction at baseline, 15 days from baseline and 30 days from baseline. Mixed linear models revealed enhancements in body and functionality appreciation post-intervention for women at both high risk and low risk of BIDs. Reductions in EDs risk and body dissatisfaction were observed in participants at high risk. The intervention proves to be useful in promoting a positive body image (i.e. body and functionality appreciation) in women at both high and low risk of BIDs, while the results concerning the risk of developing EDs and extreme body dissatisfaction are more nuanced.

Risk of eating disorders and body image in adolescents in Belgium: is migration status a modifier?

Abstract Background The risk of eating disorders (ED) has been linked to body image (BI) dissatisfaction in adolescents. In addition, the origin and host country culture may influence BI dissatisfaction. Our objective was to assess the modifying effect of migratory status on the association between BI and risk of ED in Belgium, a setting characterized by a large proportion of migrant adolescents. Methods In the 2022 cross-sectional “Health Behaviour in School-aged Children” (HBSC) study in French-speaking schools, 7,267 adolescents aged 12 to 20 self-completed questionnaires. Risk of ED was determined by an Eating Attitude Test (EAT-7), score ≥5. BI was categorised into 3 groups: “too thin”, “about the right size” and “too fat”. Migratory status was divided into “native”, “2nd generation” and “1st generation” migrants. The association between BI and ED was estimated using logistic regressions adjusted for socioeconomic and psychosocial characteristics. After the inclusion of the “migration*BI” interaction term, migration-stratified logistic regressions were conducted. Results Overall, 13.0% of students were at risk of ED. Percentages of ED were 15.7% among those who perceived themselves as “too fat” (vs. “about the right size”: aOR=1.67 [95%CI: 1.34-2.08]) and 19.4% in the “too thin” group (aOR=3.36 [2.54-4.45]). Despite non-significant interaction terms, perceiving themselves as “too fat” (vs. “about the right size”) was not associated with the risk of ED in 1st generation migrants (aOR: 1.24 [0.67-2.29]). Compared with the overall estimation, it was lower in 2nd generation migrants (aOR: 1.43 [1.00-2.03]) while it was slightly higher in natives (aOR: 1.95 [1.45-2.62]). Conclusions These findings suggest complex interrelations between BI and risk of ED according to migratory status in adolescents with potential underlying mechanisms involving cultural norms. Promoting positive BI as a possible way for preventing the development of eating disorders need to be further investigated. Key messages • This study shows differences of body image dissatisfaction according to the migratory status in adolescents, inducing potential impacts on the risk of eating disorders. • Better understanding differences in body perception related to cultural background could help prevent risk of eating disorders in adolescents, by promoting positive body image for example.

Prevalence of potential risk of eating disorders among young, unprofessional European athletes: results of the ERASMUS+ project SCAED.

Adolescent athletes are at higher risk of developing eating disorders (ED) due to sports environment pressures and developmental characteristics. The ERASMUS+ project Sports Community against Eating Disorders (SCAED) aims to assess the prevalence of the potential risk of eating disorders among young, unprofessional European athletes and to provide them with easier access to professional support and knowledge. The online survey included 462 unprofessional athletes from six European countries aged 12-25 (average age 18.49 ± 5.50) on their socio-demographics, sports and lifestyle habits, behaviors, concerns, and perceived pressure from coaches and teammates regarding body weight and shape. The eating disorder potential risk was assessed using the Eating Disorder Examination for Adolescents (EDE-A) and Eating Disorders Screen for Athletes (EDSA). Every seventh (14.9%, EDE-A) and fifth (19.9%, EDSA) of young, unprofessional European athletes were at possible risk for developing eating disorders. Overall potential risk (18.7% EDE-A, 26.6% EDSA), dietary restraint (12.9%), and concerns about eating (9.5%), shape (23.7%), and weight (19.6%) were significantly more prevalent among female athletes. Younger athletes showed a slightly higher prevalence and avoidance of food. Athletes training in weight-sensitive sports exhibited more behaviors related to eating disorders. Females (p = 0.003), younger, and those athletes training in less weight-sensitive sports noted higher weight- and shape-related pressure from coaches. Dissatisfaction with their current weight was expressed by 44.6% of athletes, while 46.1% thought that they needed to lose weight to improve performance. The observed prevalence of the potential risk of ED among young, unprofessional European athletes is concerning, particularly due to limited access to support. Efforts to reduce the prevalence should target female and younger athletes in weight-sensitive sports. The SCAED Erasmus+ project aims to decrease ED prevalence among young, unprofessional European athletes, their families, and coaches by supporting them through education and professional consultation.

Assessment of Eating Disorder Risk According to Sport Level, Sex, and Social Media Use among Polish Football Players: A Cross-Sectional Study

Background/Objectives: Eating disorders (EDs) pose a significant health issue affecting athletes, with risk factors varying by sport level, sex, and social media use. This study assesses the risk of EDs among professional and amateur football players, considering these factors, and compares findings with a control group of non-athletes. Methods: The study involved 170 participants, including non-athletes as a control group, categorized by sex and sport level. The mean age of participants was 24.3 ± 4.20, with an age range of 18–36. The Eating Attitudes Test (EAT-26) and body mass index (BMI) assessments were used to determine ED risk. Results: Results showed a higher prevalence of ED risk among professional athletes, especially women, compared to amateurs and non-athletes. Social media use and body comparisons were linked to increased ED risk, with professional athletes exhibiting higher vulnerability due to performance pressures. Women, particularly those in professional sports, showed a higher risk of EDs than men, influenced by social and aesthetic pressures. Conclusions: The findings highlight the need for targeted interventions, promoting healthier body image perceptions and addressing social media’s role in shaping body dissatisfaction. Psychological support and sex-specific strategies should be integrated into athlete care programs to mitigate these risks.

Orthorexia nervosa tendencies and risk of eating disorders among culinary arts students: A comparative study with dietetics students.

Students pursuing food-related academic fields such as dietetics have higher orthorexia nervosa (ON) tendencies and are at a greater risk of developing eating disorders (EDs). However, there is limited research available on ON tendencies and on the risk of EDs in the culinary arts field, which also revolves around food. The present study explored ON tendencies and the risk of EDs among culinary arts students and compared them with those of dietetics students. A cross-sectional study was conducted in France, using the eating habits questionnaire (EHQ) to measure ON tendencies, and the SCOFF as well as the eating disorders examination questionnaire (EDEQ) to evaluate the risk of EDs and ED symptoms. The study also included questions about sports practice. In total, 267 students participated in the study, including 144 culinary arts students (51 women, 92 men and one other) and 123 dietetics ones (106 women, 15 men and two others). Culinary arts students exhibited similar means of EHQ scores as dietetics ones (32.99 vs. 33.34) but higher SCOFF scores (52.8% vs.39.8%). In addition, a gender difference was evidenced: women in culinary arts showed higher EHQ, SCOFF and EDEQ scores than men in culinary arts. Linear regression models showed no effect of the type of academic field (culinary arts vs. dietetics) on the EDEQ score but revealed effects of gender, body mass index and hours of sports practice. The study emphasises the need to monitor culinary students and implement interventions to prevent EDs. It also suggests a correlation between food-related education and the risk of EDs, which requires further research.

Examination Of Energy Availability, Eating Disorder Risk, Carbohydrate Availability Among Collegiate Rotc Cadets

Examination Of Energy Availability, Eating Disorder Risk, Carbohydrate Availability Among Collegiate Rotc Cadets

Examination Of Energy Availability And Eating Disorder Risk Among Ethnically Diverse Physically Active Females

Examination Of Energy Availability And Eating Disorder Risk Among Ethnically Diverse Physically Active Females

Eating Disorders in Children, Adolescents, and Young Adults During and After the COVID-19 Pandemic: ADanishNationwide Register-Based Study.

To assess incidence rates of clinically diagnosed eating disorders among Danish youth before, during, and after the COVID-19 pandemic. This study used a population-based time series analysis with individual-level data from Danish healthcare registries. Participants included all Danish individuals aged 6-24 years from January 1, 2015, to December 31, 2023. Monthly incident cases of any eating disorder, anorexia nervosa, and bulimia nervosa were analyzed using interrupted time-series analysis. We estimated the cumulative number of excess cases of incident eating disorder diagnoses and risk ratios (RR) associated with the pandemic and post-pandemic periods compared with pre-pandemic predictions. The study population encountered a mean of 1,310,542 individuals during the study period. The study included 11,693 individuals diagnosed with an eating disorder, median age 17 (IQR 14-20 years). Incident cases increased during the pandemic (RR 1.29, 95% CI 1.15-1.45) and normalized post-pandemic (RR 1.07, 95% CI 0.91-1.25) compared with pre-pandemic predictions. Similar patterns were seen for anorexia and bulimia. Increases were significant for ages 13-16 (RR 1.19, 95% CI 1.02-1.38), 17-19 (RR 1.51, 95% CI 1.25-1.83), and 20-24 (RR 1.35, 95% CI 1.12-1.64). Post-pandemically, a continued increase was observed only for ages 20-24 (RR 1.32, 95% CI 1.02-1.71). The study documents a temporary increase in diagnosed eating disorders among Danish youths during the COVID-19 pandemic, with rates later returning to pre-pandemic levels. These results provide insights into the pandemic's impact on adolescents and youths.

Eating Disorders Risk and Intuitive Eating Behavior Among Brazilian Military College Students

Eating Disorders Risk and Intuitive Eating Behavior Among Brazilian Military College Students

Eating disorder risk among Australian youth starting a diet in the community

Dieting is a potent risk factor for eating disorder (ED) symptoms and development, which typically occur in late adolescence. However, as diets are often motivated by body image concerns (another core ED risk factor), dieters may already carry heightened ED risk. Thus, the current study aimed to document ED risk among young people starting a diet in the community. Young people (16–25 years) starting or intending to start a self-initiated diet (N = 727) provided data via a screener questionnaire, assessing containing sociodemographic factors, past and current ED symptoms and behaviours. Over a third (36.9%) screened using a validated instrument were found to be at-risk of a current ED, with 10% above the clinical cut-off. Consistent with this finding, over 10% of the sample self-reported experiencing a lifetime ED, while nearly a quarter reported symptoms consistent with an ED diagnosis with no reported formal diagnosis. Findings suggest a high level of ED risk among young people starting a diet in the community and point to the need for more proactive measures targeted at this cohort (e.g., screening, monitoring). Further education on the risks of dieting and encouragement for help-seeking in young people is indicated.

Eating disorder risk assessment and sociocultural attitudes toward body image among Polish and Turkish professional female football players.

IntroductionFootball requires high physical fitness and often involves maintaining a specific physique, leading to harmful eating behaviors due to internal and external pressures. Cultural norms influence the prevalence and types of eating disorders (ED), with differences in eating habits, beauty standards, and socio-cultural pressures affecting ED development. This study assesses ED risk and analyzes socio-cultural attitudes toward body image among Polish and Turkish female football players.MethodsThe study was conducted from April to June 2024 and included 103 professional female football players aged 18–35 from Polish (n = 49) and Turkish (n = 54) clubs. Data were collected using the CAWI method via Google Forms. Participants completed EAT-26 and SATAQ-3 questionnaires, assessing ED risk and socio-cultural attitudes toward body image.Results40.8% of participants were at risk for ED. No differences in ED prevalence were found between groups of different nationalities. Polish footballers at risk of ED scored higher on the Internalization-Pressure and Information subscales and the overall SATAQ-3 score. A weak but significant positive correlation was found between SATAQ-3 and EAT-26 scores.DiscussionThe study finds no nationality-based differences in ED prevalence among professional female football players, but ED is widespread, affecting about 40% of players. Nutritional status impacts ED risk, with higher risk among underweight and overweight players. Polish players are more influenced by socio-cultural standards of body image promoted by mass media. The study underscores the need for regular screening and psychological support.

Are Sleep Parameters and Chronotype Associated with Eating Disorder Risk? A Cross-Sectional Study of University Students in Spain.

Objectives: Eating disorders (EDs) have emerged as a growing public health concern. However, the role of sleep in this context remains underexplored. The aim of this cross-sectional study was to determine the associations between sleep parameters and chronotype with ED risk in a sample of university students in Spain. Methods: ED risk was assessed via the Sick, Control, One stone, Fat, Food Questionnaire, and sleep quality was assessed via the Pittsburgh Sleep Quality Index. Other sleep parameters and chronotypes were self-reported. Sociodemographic, body composition, lifestyle, and depressive symptom data were collected. Logistic and linear regression models adjusted for the main confounders were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the study associations. Results: A total of 403 students (70.2% female) aged 18 to 30 years participated in the study. Those reporting poor sleep quality (OR = 1.85, 95% CI 1.08-3.17, p = 0.025) and ≤6 h of night-time sleep duration (OR = 4.14, 95% CI 2.00-8.57, p < 0.01) were more likely to be at risk of EDs in the adjusted analyses. The association between night-time sleep duration and the risk of ED did not remain significant when we adjusted for sleep quality. In addition, an evening chronotype was associated with an increased risk of EDs (OR = 1.68, 95% CI 1.07-2.66, p = 0.039) only before adjustment for confounders. Conclusions: Among university students, poorer sleep quality was cross-sectionally associated with EDs. Future prospective studies are needed to examine whether promoting sleep quality may serve as an effective strategy for preventing the risk of EDs.

14 - Effects of GLP-1 Receptor Agonist Therapy on Eating Disorder Risk and Psychological Distress in Adults with Class 3 Obesity.

14 - Effects of GLP-1 Receptor Agonist Therapy on Eating Disorder Risk and Psychological Distress in Adults with Class 3 Obesity.

Association of OPRD1 Gene Variants with Changes in Body Weight and Psychometric Indicators in Patients with Eating Disorders.

Objectives: This study aimed to investigate whether genetic variations in the OPRD1 gene affect psychopathological symptoms and personality dimensions in eating disorders (ED) patients and/or contribute to ED risk. Methods: The study involved 221 female patients with anorexia nervosa (AN), 88 with bulimia nervosa (BN), and 396 controls. Sixteen tag-single nucleotide polymorphisms (SNPs) in OPRD1 were identified. Psychometric evaluations were conducted using the Symptom Checklist 90 Revised (SCL-90R) and the Eating Disorders Inventory Test-2 (EDI-2). p-values obtained by regression models were corrected for multiple testing by the False Discovery Rate (FDR) method. Results: In AN patients, genotypes rs204077TT and rs169450TT were linked to lower body-mass index (BMI) values (FDR-q = 0.035 and 0.017, respectively), as was rs2234918 in a log-additive model (BMI: 18.0 ± 0.28, 17.22 ± 0.18 and 16.59 ± 0.39 for TT, TC and CC carriers, FDR-q = 0.012). Additionally, AN patients carrying the rs72665504AA genotype had higher scores in interpersonal distrust (FDR-q = 0.030), whilst BN carriers of rs513269TT and rs2873795TT showed lower scores in ineffectiveness (FDR-q = 0.041 and FDR-q = 0.021). In the AN group, BMI correlated with variability in a distal haplotype (rs508448/rs204077/rs223491, FDR-q = 0.028), which was also associated with the global positive symptom total (PST) index of SCL-90R (FDR-q = 0.048). Associations were more noticeable in BN patients; again, the distal region of the gene was linked to EDI-2 total scores (FDR-q = 0.004-0.048 for the four last haplotypes) and two global SCL-90R indices (GSI: FDR-q = 0.011 and positive symptom distress index (PSDI): FDR-q = 0.003 for the last s204077/rs2234918/rs169450 combination). No associations with ED risk were observed. Conclusions: Genetic variation in the OPRD1 gene, particularly in its distal region, is associated with BMI and psychopathological comorbidities in ED patients.

A cross-sectional study to estimate the prevalence of eating disorders and ascertain factors for eating disorder risk among senior college students in a metropolitan city

A cross-sectional study to estimate the prevalence of eating disorders and ascertain factors for eating disorder risk among senior college students in a metropolitan city

Internalized weight bias and eating disorder risk: The moderating role of self-construal among culturally diverse female young adults.

Internalized weight bias and eating disorder risk: The moderating role of self-construal among culturally diverse female young adults.

Risk Factors for the Development of Eating Disorders in Adolescents with Early-Onset Inflammatory Bowel Diseases.

Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric comorbidities, including eating disorders (EDs). We aimed to investigate the potential association between key disease characteristics, including psychological features, and the development of EDs in a clinical sample of adolescents with IBDs. We enrolled 52 adolescents with IBDs, 83% of whom were in clinical remission, and systematically collected additional information on disease duration, the total number of relapses, the use of steroids, and the number of hospital admissions. All participants completed a validated psychometric battery assessing psychological symptoms (Symptom Checklist-90-Revised, SCL-90-R), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and ED symptomatology (Eating Disorders Inventory-3rd edition, EDI-3). About one in ten patients (9.6%) reported Eating Disorder Risk scores higher than the cut-off on the EDI-3 subscale, specifically addressing the risk of developing EDs. According to the EDI-3 scores, the risk of developing EDs directly correlated with the number of total relapses of IBDs (p < 0.05). The TAS-total scores also correlated with the number of total relapses (p < 0.01), as well as with the number of steroid cycles (p < 0.05), the number of hospital admissions (p < 0.05), and overall disease duration (p < 0.05). Our findings suggest that disease relapses increase the risk of developing both EDs and alexithymia in adolescents with IBDs. The recurrence of disease relapses should be identified and screened early on to prevent the onset of psychiatric disorders, including EDs. Research should be conducted on larger samples with different IBD phenotypes to further investigate the characteristics of patients with IBDs at risk of developing EDs.

Associations Between Weight Discrimination, Eating-Disorder-Related Psychiatric Impairment, and Eating-Disorder Treatment Interest Across the Weight Spectrum.

Only approximately 20% of college students with an eating disorder (ED) seek treatment. One barrier to seeking treatment is weight discrimination. Past research demonstrates that experiencing weight discrimination is associated with increased ED risk and decreased in-person treatment engagement. Weight discrimination may be a particularly relevant treatment barrier for students who have a higher body weight given their higher likelihood of experiencing weight discrimination. College students with a probable ED diagnosis (N = 372; Mage = 23.94; 73.12% women, 18.55% men, 6.18% another gender; 11.29% Asian, 4.57% Black, 12.63% Hispanic, 83.60% White, 4.84% Native American, and 0.54% another race) completed an online self-report survey that included the Clinical Impairment Assessment (CIA), Experience of Weight Discrimination (EWD) Scale, and a 0-100 scale to indicate interest in participating in virtual guided self-help ED treatment. Linear regression showed significant positive relationships between weight discrimination and ED-related psychiatric impairment and treatment interest. Elevations in CIA scores corroborate past literature that suggested that weight discrimination was positively related to ED psychopathology. Contrary to past research, college students who experienced weight discrimination had greater treatment interest. Students who experience weight discrimination may view virtual self-guided treatment as less weight-stigmatizing due to the "do-it-yourself" approach and no in-person interactions. Findings highlight the potential impacts of weight discrimination on acceptability of ED-related care. Future research is needed to identify ways to reduce weight discrimination and promote weight-inclusive practices in the medical system.