Eating Disorder Risk Research Articles

Eating Disorders In weight-related Therapy (EDIT) Collaboration: rationale and study design.

The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.

Life Events in the Etiopathogenesis and Maintenance of Restrictive Eating Disorders in Adolescence.

Life events (traumatic and protective) may be critical factors associated with eating disorders and their severity. To date, there is little literature concerning the role of life events in adolescence. The main goal of this study was to explore in a sample of adolescent patients with restrictive eating disorders (REDs) the presence of life events in the year before enrolment and to characterize them according to timing. Furthermore, we investigated correlations between REDs severity and the presence of life events. In total, 33 adolescents completed the EDI-3 questionnaire to assess RED severity using EDRC (Eating Disorder Risk Composite), GPMC (General Psychological Maladjustment Composite), and the Coddington Life Events Scales-Adolescent (CLES-A) questionnaires to define the presence of life events in the last year. Of these, 87.88% reported a life event in the past year. A significant association emerged between elevated clinical GPMC and the presence of traumatic events: patients who had experienced at least one traumatic life event in the year before enrolment presented higher clinically elevated GPMC compared to patients who had not. These results suggest that obtaining early information about traumatic events in clinical practice may help prevent the occurrence of new events and improve patient outcomes.

Sex-specific mechanisms for eating disorder risk in men and women with autistic traits: the role of alexithymia

BackgroundA poorly understood relationship exists between eating disorders (ED) and autism spectrum conditions (ASC: henceforth ‘autism’). ED are more prevalent in autistic people and people with high autistic traits, and autistic features are prognostic of longer illness. Aiming to understand what increases the risk of ED in relation to autism and autistic traits, previous research has implicated alexithymia as a causal mechanism in this relationship. These studies could not, however, disentangle whether alexithymia explains the relationship between ED pathology and autistic traits directly or through its impact on anxious/depressive symptoms, which in turn result in higher ED symptomatology. Moreover, despite evidence for sex differences in the aetiology of ED, little research has examined the impact of sex on these relationships.MethodsFocusing on the association between autistic traits and ED psychopathology, we examined independent mediating effects of alexithymia and anxious/depressive symptoms, as well as sequential mediation effects where alexithymia affects ED psychopathology via its impact on anxious/depressive symptoms. Participants were 198 men and 265 women with formally diagnosed and suspected ED, who completed an online survey of standardised scales.ResultsIn men, higher autistic traits were associated with ED psychopathology sequentially via greater alexithymia and through that, greater depressive/anxious symptoms. In women, alexithymia mediated the relationship between autistic traits and ED psychopathology both directly and sequentially through its impact on anxious/depressive symptoms. Interestingly, depressive/anxious symptoms also mediated that relationship independently from alexithymia.ConclusionsWhile cross-sectional, these findings suggest that the relationship between autistic traits and ED symptomatology is mediated by other variables. In support of its proposed role in the aetiology of ED, alexithymia was directly associated with ED symptoms in women. It also affected ED symptoms indirectly, in all participants, via its effect on depressive/anxious symptoms. Interventions focusing on alexithymia may facilitate recovery not only via their effect on ED, but via their effect on other forms of state psychopathology which contribute to the maintenance and development of ED. Sex differences, however, reflect that alternative therapeutic targets for men and women may be beneficial.

Efficacy of an integrated program (PIA-2) to reduce the risk for problems related to eating, weight and body image in female adolescents from Argentina.

This study aimed to examine the efficacy of an integrated program (PIA-2) to reduce the risk for problems related to eating, weight and body image in female adolescents from Argentina. A quasi-experimental study was conducted by comparing an experimental group versus a control group. The final sample included 509 girls aged 13-18 (M= 15.39 and SD= 1.30) from nine schools located in three geographical regions. They provided data at three assessment time points: baseline, post-intervention and a 3-month follow-up. Dependent variables included skipping breakfast, physical activity, eating disorder risk and thin-ideal internalization. The program was carried out in three 90-minute sessions within usual school hours, at 1-week intervals. Participants who received the intervention decreased more than the control group in skipping breakfast month by month. However, a significant effect of the intervention was not found on physical activity, eating disorder risk, and thin-ideal internalization. The presence of mixed findings shows the need to adjust the intervention to enhance the results. The importance of working jointly with other Latin American countries is emphasized, in order to promote the growth of the field of prevention, regarding cultural particularities shared by our societies. Integrated programs aimed at reducing risk factors for the entire spectrum of problems related to eating, weight and body image could lead to beneficial and more efficient effects. However, their development is still incipient in Latin America. PIA-2 Program, designed for female adolescents, produced positive results in one of the four variables studied, decreasing the weekly frequency of skipping breakfast among adolescents. This is pioneering research in Argentina and the region since very few studies on integrated prevention have been published in Latin America. It is crucial to continue with efforts aimed at developing programs that are suited to the specific needs of the population of Latin American countries. In this aspect, our study is undoubtedly an important contribution.

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents.

Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).

The Family Caregiving Environment Associates with Adolescent Patients’ Severity of Eating Disorder and Interpersonal Problems: A Cross-Sectional Study

The quality of family interactions may be a critical factor for restrictive eating disorders (REDs). Adolescent patients with RED have interpersonal problems that can be inferred by observing their behaviours during family interactions. To date, the assessment of the association among RED severity, interpersonal problems, and patients' interactive behaviours in the family is partially explored. This cross-sectional study aimed to explore how adolescent patients' interactive behaviours observed during the Lausanne Trilogue Play-clinical version (LTPc) were associated with both RED severity and interpersonal problems. Sixty adolescent patients completed the EDI-3 questionnaire to assess RED severity using the Eating Disorder Risk Composite (EDRC) and Interpersonal Problems Composite (IPC) subscales. Moreover, patients and their parents took part in the LTPc, and patients' interactive behaviours were coded as participation, organization, focal attention, and affective contact in all the LTPc four phases. A significant association emerged between patients' interactive behaviours during the LTPc triadic phase and both EDRC and IPC. Better patients' organization and affective contact significantly correlated with lower RED severity and fewer interpersonal problems. These findings suggest that investigating the quality of family relationships and patients' interactive behaviours may contribute to better identifying adolescent patients at risk for more severe conditions.

A DIET AND LIFESTYLE-FACTOR INTERVENTION PROGRAM TO IMPROVE NUTRITIONAL STATUS, SYMPTOMS, AND QUALITY OF LIFE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract BACKGROUND This study sought to evaluate the impact of an evidence-based diet and lifestyle-factor intervention program on nutrition status, symptoms and quality of life of patients with IBD. METHODS In this retrospective observational study, de-identified medical records from patients with a self-reported diagnosis of IBD were analyzed. All patients included in the study completed an intervention program consisting of 12 to 24 one-on-one counseling sessions with an IBD-focused registered dietitian in a group-practice setting. Measures collected at baseline and at the conclusion of the program were SIBDQ, MUST, patient-reported symptoms, bowel movement frequency and consistency, measures of stress, fatigue, sleep quality as well as risk of eating and feeding disorders (NIAS-9, EAT-26). RESULTS 67 patients met the inclusion criteria for the study. Patients with MUST scores >0 at baseline had significantly decreased MUST scores at the end of the program (p=0.004). IBD-related quality of life scores were significantly higher (mean improvement of 18.6 points) at the end of the program compared to baseline (p<0.001). 67 out of 67 patients (100%) reported fewer symptoms at the end of the program with the most improvements related to cramping (97.1%), nausea (94.4%), and fatigue (93.8%). 96.4% of patients experiencing >3 bowel movements per day (BMPD) at baseline decreased their BMPD by the end of the program with 75% experiencing ≤ 3 BMPD. Patients also significantly improved their sleep quality (p<0.001), fatigue level (p<0.001), and stress levels (p<0.001). CONCLUSIONS This study demonstrates the potential of a nutrition and lifestyle-factor intervention program to improve IBD patient outcomes. Further study is needed to validate these outcomes alongside a comparable control population and in other patient populations such as those associated with a health plan or employer.

The need for future research into the assessment and monitoring of eating disorder risk in the context of obesity treatment.

In adolescents and adults, the co-occurrence of eating disorders and overweight or obesity is continuing to increase, and the prevalence of eating disorders is higher in people with higher weight compared to those with lower weight. People with an eating disorder with higher weight are more likely to present for weight loss than for eating disorder treatment. However, there are no clinical practice guidelines on how to screen, assess, and monitor eating disorder risk in the context of obesity treatment. In this article, we first summarize current challenges and knowledge gaps related to the identification and assessment of eating disorder risk and symptoms in people with higher weight seeking obesity treatment. Specifically, we discuss considerations relating to the validation of current self-report measures, dietary restraint, body dissatisfaction, binge eating, and how change in eating disorder risk can be measured in this setting. Second, we propose avenues for further research to guide the development and implementation of clinical and research protocols for the identification and assessment of eating disorders in people with higher weight in the context of obesity treatment. PUBLIC SIGNIFICANCE: The number of people with both eating disorders and higher weight is increasing. Currently, there is little guidance for clinicians and researchers about how to identify and monitor risk of eating disorders in people with higher weight. We present limitations of current research and suggest future avenues for research to enhance care for people living with higher weight with eating disorders.

Is mindful eating higher in individuals with orthorexia nervosa?: a cross-sectional study

The present study aimed to investigate the relationship between mindful eating and orthorexia nervosa (ON) among adults and contribute to establishing ON diagnostic criteria. In the current cross-sectional study, 105 women and 92 men (aged 19–64 years) were enrolled whose scores on the Orthorexia Nervosa Questionnaire-15 (ORTO-15), the Eating Attitudes Test-26 (EAT-26), and SCOFF scales indicated a prevalence of ON and eating disorder risk. In addition, the Mindful Eating Questionnaire (MEQ) was applied to participants to determine mindful eating. Descriptive and inferential statistics were computed using the Statistical Package for Social Sciences (SPSS) version 25. In participants with ON, the scores of emotional eating and conscious eating scores, which are MEQ sub-factors, and the total score of MEQ are higher than those who do not have ON (p < 0.05). There was a negative correlation between MEQ and ORTO-15 scores (r = –0.269; p < 0.01). In addition, the one-point increase in the ORTO-15 scores of the participants led to 0.094 decrease in MEQ scores (B = –0.094; SE = 0.021; p < 0.001) and 0.175 decrease in EAT-26 scores (B = –0.175; SE = 0.033; p < 0.001). The data obtained from our study show that mindful eating of individuals with ON is higher than those who do not have ON, and this is important in determining the diagnostic criteria of ON.

Adolescents at risk of eating disorders: The mediating role of emotional distress in the relationship between differentiation of self and eating disorders.

Adolescents may feel dissatisfied with their bodies, which may lead to a risk of eating disorders (EDs) due to several factors, with emotional distress being one of the most important. Evidence suggests that family might be one of the most significant factors that may increase or decrease emotional distress. An important family pattern found to contribute to mental and physical health is the differentiation of self (DoS). The primary purpose of the current study was to map the complex relationships between DoS, emotional distress, and EDs among adolescents. We hypothesized that emotional distress would mediate the relationship between DoS and the risk of EDs among adolescents. Moreover, based on findings indicating a higher risk of EDs among females, we expected sex differences in the research indices and the mediation model. The sample included 194 non-clinical adolescents (mean age 15.15; mean BMI 21.66). Preliminary analyses examined differences between males and females using t-tests. In addition, Pearson correlations were run to assess the association between background variables and the study metrics among males and females. To examine the mediation effect, we ran SEM. Due to a sex moderation effect, two mediation models were run (SEM), one for females and one for males. Results indicated that emotional distress partially mediated the relationships between DoS and the risk of EDs. In addition, sex differences were found in the mediated indices, showing that among female adolescents, perfectionism is the only dimension of EDs that was associated with DoS through the mediation of emotional distress. While the relationship between emotional distress and the risk of EDs is well documented. It is concluded that high DoS may reduce emotional distress, which may, in turn, decrease the risk of EDs. In addition, the results enable an in-depth understanding of specific risk factors of EDs that characterize each sex.

Associations of smartphone addiction, chronotype, sleep quality, and risk of eating disorders among university students: A cross-sectional study from Sharjah/United Arab Emirates

ObjectivesAs smartphone addiction (SA) becomes more prevalent among young adults, there is growing concern over its impact on dietary and lifestyle habits, such as disturbed sleep and eating patterns. However, limited literature exists particularly on the association between SA and eating disorders (ED). Thus, this study aims to study the prevalence of SA risk, poor sleeping quality, evening chronotype, and ED risk among university students in the UAE. It also aims to assess the associations between them, emphasizing the one between ED and SA risks. MethodsIn this cross-sectional study, a self-administered online questionnaire was disseminated via convenience sampling. Pittsburgh Sleep Quality Index, Morningness-Eveningness Questionnaire, Eating Attitude Test-26 items, and Smartphone Addiction Scale-Short Version were used to measure sleep quality, chronotype, ED risk, and SA risk, respectively. Descriptive and analytical statistics were applied, and P < 0.05 was considered for statistical significance. ResultsOut of 552 students (mean age: 21.2 ± 5.1 years), 71% had poor sleep quality, 33.9% reported evening chronotype, 37.9% had ED risk, and 56.2% had SA risk. SA risk was significantly associated with both poor sleep quality (OR = 2.93; 95% CI: 2.01–4.29; p < 0.001) and evening chronotype (p = 0.005). ED risk was significantly associated with poor sleep quality (p < 0.001). Poor sleep quality predicted ED risk best. ConclusionHigh prevalence of SA, ED risk, and poor sleep quality was reported among university students in the UAE. Associations between poor sleep quality, evening chronotype, SA risk, and ED risk were further confirmed, with sleep quality predicting ED risk.

Myths Regarding Gender Differences in Eating Disorders in Adolescents.

Factors predicting eating disorder (ED) may vary among genders. This study investigated the gender specific influence of adolescents' social media use, body perception, depression and anxiety symptoms on eating disorder risk. The sample consisted of 183 adolescents aged 14 to 18 years (mean: 15.65±0.89). Sociodemographic information and data from the, Children's Depression Inventory (CDI), Social Media Attitude Scale (SMAS), Eating Disorder Examination Scale (EDES), Eating Attitudes Test (EAT), Screen for Child Anxiety Related Emotional Disorders Child Version (SCARED), and Body Cathexis Scale (BCS) were collected. In this study, women have higher scores in SCARED (p<0.001), and lower scores in social competence subscale of SMAS (p=0.008) in comparison to men. Adolescents at risk for eating attitudes had higher scores in the CDI, the BCS, and the SMAS-Social Competence subscale, while adolescents at risk for eating disorder had higher scores in all scales except the SMAS-Relationship with Teachers subscale. Although depression and body perception influence women's' eating attitudes directly, social media revealed its effect on ED by the mediation of depressive symptoms. In men, social isolation, anxiety, and depression directly predicts ED, while social media enhanced the risk of ED by aggravating anxiety. It is important to know the factors that influence the risk of ED in terms of gender, and effectively address adolescence's psychological and medical burden.

Examination of eating disorder risk and effective factors in university students

The aim of this study; determine the eating attitudes and behaviors of university students, who are a sensitive population in terms of eating disorders, and to examine some related factors. A structured questionnaire and face-to-face interviews collected the data. The data collection form has two sections: one for sociodemographics and health behaviors, and one for dietary habits and eating disorders using eating disorders scale (REZZY). The questionnaire explained voluntary study participation. The mean age of the 762 university students included in the study was 23.44±5.33 years and 58.40% were female. Variables that one-off analyses suggested might be connected to the risk of developing eating disorders were examined using the logistic regression model. There was a significant and positive correlation between the REZZY-Total (REZZY-T) score, bulimia and food preoccupation (EAT-1) and dieting (EAT-2) (p&lt;0.01). The study group's female had an eating disorder risk that was 2.1 times greater than that of the male. As students advance through their educational phase, the risk of eating disorders significantly declines (p&lt;0.001). Positive factors reduced the risk of eating disorders by 1.4 times, whereas negative factors roughly doubled it (p&lt;0.001). Impaired eaters eat when they're not hungry, restrict their diet, obsess over their diet, and use food to cope with negative emotions. This will cause emotional, physical, and social problems and lower their quality of life. To prevent disease, improve mental health, and reduce social issues, examine eating behavior.

Düzenli Egzersiz Yapan Üniversite Öğrencilerinde Kaslı Olma Dürtüsü, Kaslılık Odaklı Yeme Davranışı ve Egzersiz Bağımlılığı ile Beden Algısı, Yeme Bozukluğu Riski ve Fiziksel Aktivite Düzeyi İlişkisi: Tanımlayıcı Araştırma

Amaç: Bu çalışmanın amacı, düzenli egzersiz yapan üniversite öğrencilerinin kaslı olma dürtüsü, kaslılık odaklı yeme davranışı ve egzersiz bağımlılığı ile beden algısı, yeme bozukluğu riski ve fiziksel aktivite düzeyi ilişkilerinin araştırılmasıdır. Gereç ve Yöntemler: Kesitsel, tanımlayıcı tipte olan bu çalışma gönüllülük esasına dayalıdır. İstanbul ilinde 2021-2022 akademik yılında çeşitli üniversitelerde eğitim gören ve spor takımlarına/salonlarına kayıtlı olup düzenli egzersiz yapan 664 katılımcı ile yürütülmüştür. Google Formlar aracılığıyla Bilgi Formu, Kaslı Olma Dürtüsü Ölçeği, Kaslılık Odaklı Yeme Testi, REZZY Yeme Bozuklukları Ölçeği, Uluslararası Fiziksel Aktivite Anketi, Egzersiz Bağımlılığı Ölçeği ve Stunkard Beden Memnuniyeti Ölçeği 'online' olarak uygulanmıştır. Araştırma verileri IBM SPSS v26® paket programıyla değerlendirilmiştir. Bulgular: Çalışmaya katılan 664 üniversite öğrencisinin %51,1'i erkektir. Yaş ortalaması 22,12±3,43 yıl olan öğrencilerin, beden kitle indeksi ortalaması 23,29±3,97 kg/m2 'dir. Bu çalışmada, beden memnuniyetsizliği arttıkça kaslı olma dürtüsünün (p<0,001) ve egzersiz bağımlılığının (p=0,524) azaldığı, kaslılık odaklı yeme davranışının ise (p=0,664) arttığı bulunmuştur. Yeme bozukluğu riski arttıkça; kaslı olma dürtüsünün (p=0,350), kaslılık odaklı yeme davranışının (p=0,002) ve egzersiz bağımlılığının (p=0,051) arttığı bulunmuştur. Fiziksel aktivite düzeyi arttıkça ise kaslı olma dürtüsünün, kaslılık odaklı yeme davranışının ve egzersiz bağımlılığının arttığı bulunmuştur (<0,001). Sonuç: Genç erişkinlerde kaslı olma dürtüsü; beden memnuniyeti ve fiziksel aktivite düzeyi ile anlamlı ilişkilidir. Kaslılık odaklı yeme davranışı, yeme bozukluğu riski ve fiziksel aktivite düzeyi ile anlamlı ilişkilidir. Egzersiz bağımlılığı ise fiziksel aktivite düzeyi ile anlamlı ilişkilidir.

Tıp Fakültesi Öğrencilerinin COVID-19 Pandemisi Sırasında Korku, Travma Sonrası Stres ve Beslenme Alışkanlıklarının İrdelenmesi

Aim: This study aimed to determine the effects of fear of coronavirus disease 2019 (COVID-19) and post-traumatic stress disorder on eating disorders and eating habits. Material and Methods: A cross-sectional descriptive study employed 562 (167 males, and 395 females) medical students, utilizing the fear of COVID-19 scale, COVID-19 peritraumatic distress index (CPDI), SCOFF (REZZY) eating disorders scale and Mediterranean diet adherence screener (MEDAS) scale. Results: Of the participants, 292 (52.0%) had an adequate/balanced diet, and 339 (60.3%) students had an average sleep time of &amp;lt;8 hours. The REZZY scale score showed 198 (35.2%) students had an eating disorder risk, and MEDAS scores exhibited 320 (56.9%) students had incompatible diets. A significant correlation was detected between the REZZY score and the fear of COVID-19 scale score (p=0.003) and CPDI score (p&amp;lt;0.001). The CPDI scores of the underweight participants and those with normal body mass index (BMI) class were significantly higher (p=0.009). A significant difference was spotted in respecting REZZY scores according to BMI classes (p&amp;lt;0.001). The ones with normal BMI class had significantly higher MEDAS score (p=0.031). Females were 2.315 times more likely to develop eating disorders. BMI value affected the risk of eating disorders (p&amp;lt;0.001). When BMI (kg/m2) increased by 1 unit, the risk of eating disorders would increase by 1.220 times. Adequate and balanced nutrition had a significant impact on the risk of eating disorders (p=0.018). Conclusion: Assuring adequate and balanced nutrition and eliminating fears and stresses experienced during epidemics are essential.

Testing the efficacy of the Virtual Body Project in a sample of Turkish female university students using a Randomized Controlled Trial

The current study aimed to test the effectiveness of the Virtual Body Project (vBP) on self-esteem, disordered eating attitudes, and psychological symptoms in young females. A pretest posttest control group design was used in the study. The intervention (vBP, N = 40) and placebo (Expressive Writing, N=33) groups were determined using random assignment. The Body Mass Index (BMI), Brief Symptom Inventory (BSI), Eating Disorder Examination Questionnaire (EDE-Q), Body Image Quality of Life (BIQLI), and Rosenberg Self-Esteem Scale (RSES) were administered. The groups did not differ in terms of pretest scores. However, the intervention group had significantly lower EDE-Q, BIQLI, BSI scores, and higher RSES scores than the placebo group in the post-test assessment. Within-subjects comparisons showed that the placebo group’s pretest and post-test scores were not significantly different. However, the EDE-Q, BIQLI, and BSI posttest scores were found to be significantly lower than the pretest scores in the intervention group. In addition, the RSES post-test scores were significantly higher than the RSES pretest scores in the intervention group. The current study indicated that the Virtual Body Project was found to be an effective intervention on eating disorder risk factors, psychological symptoms, and self-esteem in young females. It is thought that the Virtual Body Project, which is applied to groups online, makes an extremely important contribution to preventive mental health studies.

The association between social media addiction and orthorexia nervosa, eating attitudes, and body image among adolescents.

This study was planned to determine the relationship between social media addiction and orthorexia nervosa (ON), eating attitude and body image among adolescents. This cross-sectional study was conducted with 1232 high school-going adolescents. Data were collected using the Social Media Addiction Scale for Adolescents, Eating Attitude Test-26 (EAT-26), Body Image Scale (BIS) and ORTO-11 questionnaire. Social media addiction levels were higher in girls than in boys (p < 0.05). Multiple linear regression analysis showed that a better body image was associated with lower social media addiction scores (β = - 0.268, p < 0.001). Social media addiction was significantly associated with a greater risk of eating behavior disorders (OR: 1.07, 95% Cl: 1.04-1.10) and ON tendency (OR: 1.02, 95% Cl = 1.00-1.04). Adolescents who stated that they always or often read nutrition-related posts on social media had an increased likelihood of eating behavior disorder risk (OR: 6.77, 95% CI: 3.84-11.94) and ON tendency (OR: 5.49, 95% CI: 3.39-8.88). This study demonstrated that social media addiction was associated with a higher eating behavior disorder risk, ON tendency and lower body image. Moreover, frequent reading of posts about nutrition on social media was positively associated with ON tendency and eating behavior risk. These results highlight that adolescents should be educated about social media use and its content to minimize the negative effects of constant exposure to unrealistic body images and nutrition-related misinformation and reduce the risk of eating disorders and ON among adolescents. Level of evidence Level V, cross-sectional descriptive study.

General psychopathological symptoms in children, adolescents, and young adults with anorexia nervosa-a naturalistic study on follow-up and treatment.

Recent research has assessed the role of general psychopathological symptoms in the natural history of mental health conditions, including anorexia nervosa (AN) in adults and obesity in children.Nevertheless, literature assessing general psychopathological symptoms in young patients with AN and their potential prognostic role in long-term outcomes is lacking. Observational, naturalistic study, involving young patients hospitalized for AN. General psychopathological symptoms were assessed by administering Symptom Check List-90-R (SCL-90-R) at admission (T0) and discharge (T1). AN-specific psychopathology was assessed with Eating Disorders Inventory-3 Eating Disorder Risk (EDRC) and Body Uneasiness Test Global Severity Index (BUT-GSI). Potential T0-T1 modifications of general psychopathological symptoms and their possible associations with baseline psychopathological, weight, and psychopharmacological variables were assessed with a generalized linear model (GLM), corrected for baseline SCL-90-R scores. Then, possible associations between T0 general psychopathological symptoms and the risk of re-hospitalization at 1year were assessed with the Kaplan-Meier method and Cox regression. This study enrolled 133 patients (mean age 16.9 ± 2.9years, F = 91.8%). A significant T0-T1 reduction (p < 0.001) in almost all the general psychopathological symptoms (except paranoia) emerged. The GLM revealed that higher EDI-3 EDRC scores were associated with higher T1 SCL-90-R scores in multiple domains. Cox regressions revealed a predictive role of SCL-90-R interpersonal sensitivity (B = 0.113, hazard ratio = 1.119, p = 0.023) on the risk of re-hospitalization at 1year. Conclusion: General psychopathological symptoms in young patients with AN may be influenced by hospital treatment interventions and have a potential prognostic role on post-discharge outcomes. Further longitudinal studies are required. What is Known: • General psychopathological symptoms represent a relevant feature that clinicians should consider in the diagnosis, treatment, and prognosis of multiple psychiatric conditions. Co-occurring psychiatric comorbidities, moreover, have been documented to impact individuals diagnosed with Anorexia Nervosa (AN) in the developmental age.Despite this evidence, the literature lacks studies assessing the occurrence and impact of general psychopathological symptoms in young patients with AN. What is New: • The clinical picture of children, adolescents, and young adults with AN mays be impacted by multiple general psychopathological symptoms, including Somatization, Obsession-compulsion, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobia, Paranoia, and Psychoticism, which may improve with a multidisciplinary hospital intervention.The occurrence of these symptoms, particularly "interpersonal sensitivity", may negatively impact the prognosis of the affected patients.

Adverse childhood experiences increase the risk for eating disorders among adolescents.

Traumatic events often feature prominently in eating disorders. A questionnaire survey to assess the relation of eating disorder risk to the frequency of adverse childhood experiences (ACEs) and the possible association of eating disorder risk with a particular type of ACE was conducted in a community sample of Hungarian adolescents. Demographic and anthropometric data, risk for eating disorders (by SCOFF questionnaire), and ACEs (by ACE score calculator) were collected from 432 adolescents aged 12-17 years. Adolescents who had undergone four or more ACEs were 5.7 times more likely to be in the high eating disorder risk group than those who did not report any ACEs. Cumulative maltreatment showed a greater association with overall risk for eating disorders than cumulative family dysfunction. There is an increased risk of eating disorders from emotional maltreatment (OR = 3.475), physical maltreatment (OR = 3.440), sexual maltreatment (OR = 10.973), and emotional neglect (OR = 3.331). Dysfunctional family circumstances revealed an association with household mental illness (OR = 3.401). Our study of the connection between eating disorder risk and ACE is the first of its kind in Central and Eastern Europe. Maltreatments had a greater role than family dysfunctions in increasing the risk of eating disorders. Our findings contribute to a more precise understanding of the role that ACEs play in eating disorders. It is important to bring to clinicians' attention the importance of ACEs in the diagnosis and therapy of eating disorders and their potentially fundamental significance for therapy.

Evaluating the impact of COVID-19 on severity at admission and response to inpatient treatment for adult and adolescent patients with eating disorders.

The COVID-19 pandemic has been associated with increased hospitalization rates and worsened symptom severity in patients with eating disorders (ED), but most studies focused exclusively on adolescents. Further, research evaluating the impact of COVID-19 on response to inpatient treatment for ED is limited. This study aimed to compare demographic characteristics, symptom severity at admission, and discharge outcomes for adult and adolescent inpatients with EDs admitted before and after onset of the COVID-19 pandemic. We expected the post-COVID cohort would report elevated symptomatology and poorer response to treatment compared to the pre-COVID cohort and that this effect would be amplified for adolescents. Patients were consecutively hospitalized adults and adolescents treated in a specialized behavioral integrated inpatient-partial hospitalization program for eating disorders between March 2018 and March 2022 (N=261). The effect of COVID-19 on symptomatology was moderated by age group such that adolescents in the post-COVID cohort, but not adults, reported higher levels of eating disorder and depressive symptoms compared to the pre-COVID cohort. No group differences were observed for discharge outcomes (rate of weight gain, length of stay, or percent target weight). Findings with respect to elevated symptomatology in adolescents but not adults may reflect the particularly negative impact of social isolation on adolescents. Future research is needed to assess the impact of COVID-19 on long-term treatment outcomes including relapse at 1-year, as well as the potential impact of COVID-19 on treatment availability for chronically ill adults or those with public insurance. Patients with eating disorders (ED) admitted to a specialty inpatient program after the start of the COVID-19 pandemic were younger and more likely to be male than those admitted pre-pandemic. Adolescents admitted post-COVID, but not adults, reported elevated ED and depressive symptoms compared to the pre-COVID cohort. Group differences were not observed for treatment response. Future research should evaluate the impact of COVID-19 on relapse risk in EDs.