Eating Distress Research Articles

Disordered eating behaviors, body dissatisfaction and their determinants in Indian adolescents: A cross-sectional observational study

Objective: Although the prevalence of disordered eating is maximum in high-income countries, the most significant rise occurred in East Asia and South Asia over the last three decades. Body dissatisfaction and disordered eating behaviors (DEBs) are more common than full-blown eating disorders. The cognitive distortion leading to these manifestations mainly occurs during adolescence and early adulthood. In this study, we assess the burden of DEBs in a cohort of Indian adolescents and determine their correlation with body dissatisfaction, calorie intake, and clinicosocial determinants. Methods: The study was conducted from November 2016 to November 2020 and enrolled 180 adolescents of 10-18 years attending the outpatient department of a tertiary-care hospital. Subjects were screened for DEBs, using a 15-item Screening Questionnaire for Eating Distress Syndromes, and for body dissatisfaction, using Photographic-Figure-Rating-Scale. Clinicosocial interviews, dietary and anthropometric evaluation, and psychiatric screening using a Mini-International Neuropsychiatric Interview (MINI-KIDS screen) were conducted. Results: DEB was present in 17.2% of adolescents, while 81.1% had body dissatisfaction and 32.2% had some psychiatric symptoms. The prevalence of DEBs in females was much higher than in males (OR = 7.89, 95%CI: 2.25-27.75, P = 0.001). More males (84.1%) reported body dissatisfaction than females (76.7%) [χ² =9.2, P = 0.010]. However, while females wished to lose weight, males desired weight gain, as measured by body dissatisfaction score (t = 2.9, P = 0.004). Apart from sex, other factors found significant in predicting DEBs in multivariate analysis were education, body dissatisfaction, BMI, and the number of siblings. Conclusion: We conclude that, unlike overt eating disorders, DEBs are common in Indian adolescents. The development of DEBs is influenced by gender, education, body dissatisfaction, BMI, and the number of siblings.

Prevalence of eating disorders in adolescent girls in Siberia

IntroductionEating disorders (ED) are an urgent public health problem, however, many adolescents with clinical symptoms fail to meet stringent diagnostic criteria.ObjectivesTo estimate the prevalence of eating disorders (ED) and subthreshold eating disorders (SED) in adolescent girls.MethodsA cross-sectional study of girls attending secondary schools (n = 917) was carried out. The sample comprised of 18.3% early adolescents (aged 12-13), 51% middle adolescents (aged 14-15), and 30.6% late adolescents (aged 16-17). We used the Body Image and Eating Distress scale (Koskelainen et al., 2001) coded on a 1-3 scale. The answers were scored on a scale of 1-3. Adolescents scoring 12 or above on four items measuring body dissatisfaction were considered as dissatisfied with their bodies and were further divided into two subgroups: girls scoring 10 or above on three items measuring eating distress were considered as having ED, whereas girls scoring less than 10 were considered as having SED.ResultsThe prevalence of ED was 2.1% (CI 1.4-3.3), the prevalence of SED was 9.6% (CI 7.8-11.7). In early adolescence, the prevalence of SED was 1.6% (CI 0.9-2.7). In middle adolescence, the prevalence of SED was 5.1% (CI 3.9-6.7), the prevalence of ED was 0.9% (CI 0.5-1.8). In late adolescence, the prevalence of SED was 2.8% (CI 1.9-4.1), the prevalence of ED was 1.2% (CI 0.7-2.1).ConclusionsIn adolescent girls, the SED are 4.6 times commoner than overt above-threshold ED. During adolescence, the prevalence of SED decreases, while the prevalence of ED increases with age.DisclosureThe reported study was funded by grant RNF according to the research project № 21-15-00033

What service users want: A qualitative study exploring the experience of inpatients with eating distress

Eating distress presents a complex challenge, associated with poor treatment engagement and high rates of relapse. In line with best practice for ‘experts by experience’, we conducted a qualitative exploration of client feedback regarding inpatient care to help refine clinical and research priorities.

The effect of peer support in adults with insulin pump-treated type 1 diabetes: a pilot study of a flexible and participatory intervention

AimThe aim of this study was to explore the effects of a flexible and participatory peer support intervention in a clinical setting for adults with type 1 diabetes treated with an insulin pump, focusing on enhancing diabetes-specific social capital. The key questions were as follows: 1) what effects are appropriate to expect, according to participants? and 2) to what extent did these effects occur?MethodsTwo peer support intervention programs were conducted in a diabetes specialist clinic (N=30). A participatory and adaptable approach allowed flexibility in the content of peer support meetings, which were facilitated by a diabetes nurse. Individual interviews explored participants’ perception of effects of the intervention. Interview data were analyzed qualitatively. Participants (n=27) completed a baseline and postintervention questionnaire that included items assessing diabetes empowerment, diabetes distress, diabetes-specific social support, and diabetes loneliness. HbA1c levels were compared before and after the intervention.ResultsParticipants experienced enhanced diabetes-specific social capital, diabetes motivation, awareness of personal diabetes practices, and serenity and openness in life with diabetes. They also became more aware of treatment and support possibilities. Negative effects included feeling sad or upset after the meetings or feeling different than and not as well-controlled as other participants. Quantitative analyses showed enhanced social support, decreased eating distress and trends toward enhanced diabetes empowerment, decreased diabetes loneliness, and decreased diabetes distress (powerlessness). We found fewer positive and/or negative outcomes among participants who felt no need for peer support or felt that the group was not a unit or that important issues were not addressed.ConclusionThe study indicated that flexible and participatory peer support can strengthen diabetes-specific social capital and improve participants’ well-being and diabetes empowerment. Awareness of participants’ incentives for attending peer support, as well as the risk of people feeling isolated within peer support groups, is essential to creating effective diabetes-specific social support.

Understanding the sources of diabetes distress in adults with type 1 diabetes

AimsTo identify the unique sources of diabetes distress (DD) for adults with type 1 diabetes (T1D). MethodsSources of DD were developed from qualitative interviews with 25 T1D adults and 10 diabetes health care providers. Survey items were then developed and analyzed using both exploratory (EFA) and confirmatory CFA) analyses on two patient samples. Construct validity was assessed by correlations with depressive symptoms (PHQ8), complications, HbA1C, BMI, and hypoglycemia worry scale (HWS). Scale cut-points were created using multiple regression. ResultsAn EFA with 305 U.S. participants yielded 7 coherent, reliable sources of distress that were replicated by a CFA with 109 Canadian participants: Powerlessness, Negative Social Perceptions, Physician Distress, Friend/Family Distress, Hypoglycemia Distress, Management Distress, Eating Distress. Prevalence of DD was high with 41.6% reporting at least moderate DD. Higher DD was reported for women, those with complications, poor glycemic control, younger age, without a partner, and non-White patients. ConclusionsWe identified a profile of seven major sources of DD among T1D using a newly developed assessment instrument. The prevalence of DD is high and is related to glycemic control and several patient demographic and disease-related patient characteristics, arguing for a need to address DD in clinical care.

Culture-specific influences on body image and eating distress in a sample of urban Bulgarian women: The roles of faith and traditional fasting

The purpose of this study was to examine the influence of local culture on body image and eating distress in a sample of urban Bulgarian women. Specifically, we focused on two affiliated factors unique to the Bulgarian context: faith and traditional fasting. Findings revealed that women could be divided into two groups who behaved differently based on the severity of their eating disorder symptomatology. For women with higher EAT-40 scores (i.e., vulnerable women), faith seemed to have harmful effects, perhaps by virtue of motivating or reinforcing asceticism and dietary restraint. For these women fasting was likely but one strategy for weight management and the achievement of a desired thin figure consistent with the socio-cultural models. In contrast, among women with lower EAT-40 scores, faith seemed to have a protective effect against excessive dieting. These women were more likely to use fasting in the way intended by religious scripture, for faith-related reasons that have nothing to do with body image. This study contributes to the literature by emphasizing the importance of culturally unique factors that may be implicated in the relationship between body dissatisfaction and overt eating distress in the trans-cultural context. When expanded, this research can be of use in helping formulate custom interventions and public health policies aimed at preventing such conditions in Bulgaria and possibly in similar post-communist cultures.

Parental eating disorder symptoms and observations of mealtime interactions with children

Objective To examine relationships between parental eating disorder symptomatology and observed feeding interactions with children. Method Twenty-three mother–father pairs of children between 18 months and 5 years completed a self-report measure of eating disorders and were observed during a family mealtime. Results Parental reports of eating disorder symptoms were related to observations of greater pressurizing by both parents, maternal restriction of children's food intake and use of incentives to eat, more mouthfuls of food eaten by the child, and less food refusal. Discussion Observed controlling feeding practices are related to symptoms of eating disorders in nonclinical groups of mothers and fathers, highlighting one mechanism by which eating distress may be transmitted within families.

Systemic therapy for eating distress

This paper describes the work of a recently established interdisciplinary systemic therapy team who work as part of a service for adults experiencing eating distress.