Disordered eating behaviours and attitudes in Jamaican adolescents: does the media play a role?

OBJECTIVE: The purpose of this study was to identify the prevalence of disordered eating behaviours and attitudes in Jamaican high school students and to determine the impact of media exposure. DESIGN AND METHODS: A cross-sectional survey of 524 Jamaican adolescents aged 11-19 years, identified using stratified random sampling, was conducted. Data was collected on sociodemographic factors, eating behaviours and attitudes (Eating Attitudes Test: EAT-26) self-esteem and media influence and anthropometric measurements were taken. Descriptive and inferential statistical analyses were performed at the 5% significance level. RESULTS: Most participants were normal weight (n=385, 76.7%) and males had lower mean body mass index (BMI) than females (females 20.7 ñ 4.2, males 19.4 ñ 3.2; p<0.01) with more females being overweight or obese (females n=46, 16.2%; males 21, 9.6%; p<0.05). Females had higher mean EAT-26 scores than males (females 15.0 ñ9.3, males 12.4 ñ 9.4; p<0.01). The mean media impact score (MIS) was higher in females (females 22.6, CI 21.7, 23.4; males 21.0, CI 20.1, 21.9; p=0.02) and in late adolescence (early adolescence 21.0, CI 20.1, 21.9, late adolescence 22.6, CI 21.7, 23.5; p=0.01). The MIS correlated positively with the EAT 26 score (p<0.001), the negative affect score (p<0.05) and BMI (p<0.05) and negatively with the self-esteem score (p<0.05). CONCLUSION: One in 5 Jamaican adolescents were deemed at risk of developing an eating disorder with an increasing prevalence of more severe disordered eating behaviours such as self-induced vomiting. There is a positive relationship between media influence and disordered eating behaviours and negative affect and a negative relationship with self-esteem.

Presence of Anorexia Nervosa and Bulimia Nervosa in Jamaica

We could find no previous data describing the extent to which eating disorders are a public health problem in Jamaica, and so we carried out two exercises to assess this. We investigated the number of cases of anorexia nervosa (AN) and bulimia nervosa (BN) presenting at the University Hospital of the West Indies (UHWI) between 1985 and 1988, using case records, and carried out a survey among health professionals (psychiatrists, clinical psychologists, paediatricians and nutritionists/dietitians) to determine the number of patients with eating disorders seen by them between 1996 and 1998. We also examined the diagnostic criteria used and correlates of eating disorders. Only two cases of AN were treated at UHWI. Eleven cases each of AN and BN (two males) had presented to the health professionals surveyed, chiefly the psychiatrists. The AN patients ranged in age from 14 to 28 years (mean 20.9 years), and the BN patients from 11 to 35 years (mean 22.2 years). Eating disorders were reported primarily among urban dwellers (76 percent), and half of the cases were among students. Limiting food intake, excessive exercise and vomiting were the most frequently used metdods of weight control. Nine eating disorder patients (41 percent) were also diagnosed with depression, and five (23 percent) patients reported previous emotional trauma. The occurrence of eating disorders in Jamaica appears to be very low. (AU)

Two eating disorders in Jamaica

OBJECTIVES: The aims were to assess the public health importance of anorexia nervosa (AN) and bulimina nervosa (BN) in Jamaica, the diagnostic criteria used and their correlates. METHODS: Information was collected from hospital records and from a survey of health professionals. Hospital records from the University Hospital of the West Indies (UHWI) from 1985 to 1998 were searched and all cases that included a diagnosis An or Bn were noted. A questionnaire was given to psychiatrists, clinical psychologists, paediatricians and nutritionists/dietitians requesting information of all An or Bn cases seen between 1996 and 1998, including gender, age, residence, weight, height, occupation, martial status, educational attainment and weight control activity. RESULTS: Only two cases of An were admitted to UHWI during the period studied. Eleven cases of An and 11 cases of BN (only two males) were seen by the health professionals (primarily psychiatrists). DSM-IV was specified as the diagnostic criterion used by the psychiatrists. The mean age of the anorexic patients was 20.9 years (range 14-28 years) and of the bulimic patients was 22.2 years (range 11-35 years). Cases occurred primarily among urban dwellers (76 percent) and 50 percent of the cases were among students. Limiting food intake, excessive exercise and vomiting were the most frequently used methods of weight control. Nine eating disorder patients (40.9 percent) were also diagnosed with depression and 5 (22 percent) patients reported previous emotional trauma. CONCLUSION: The reported incidence of the eating disorders is very low, but the characteristics of the patients seen were similar those in industrialised countries.(Au)

Abnormal eating attitudes and behaviours in two ethnic groups from a female British urban population

African-Caribbean (N=136) and White British (N=192) female family planning clinic attenders were administered the Bulimic Investigatory Test, Edinburgh (BITE) and the General Health Questionnaire (GHQ-28). A proportion of the participants were subsequently interviewed. The African-Caribbeans were found to have both significantly more disordered eating attitudes and a significantly higher level of abnormal eating behaviour than the White British. Although the African-Caribbean group had a significantly higher mean Body Mass Index this did not mediate the difference in levels of eating attitudes. When compared with the White British group more African-Caribbean women reported feelings of failure, guilt, abnormality and self consciousness concerning their eating habits. The results indicate that eating problems may be highly prevalent in this ethnic minority population and suggest that there may be differences in the nature of eating disorder psychopathology between ethnic groups. (AU)

Clinical nutrition: metabolic disorders and eating disorders

Advises on the treatment of obesity, eating disorders, and diabetes mellitus by dietetics

Extraversion and stimulation-seeking as factors in overeating and obesity

A clinical impression concerning overeating and obesity led to a review of the relevant research and culmination in a research hypothesis. This stated that eating was in many people not only a means of satiating hunger, but a means of obtaining stimulation and part of a general tendency to 'overindulge'. In the research, overeating was found to be linked to high external responsiveness, and sensation seeking to low basal arousal level. Eating as a form of sensation seeking was the subject of this study. The role of arousal level and externality were also examined. Three measures were chosen: a measure of extraversion, of sensation seeking and of basal arousal level (resting pulse rate). These were administered to a small randomly selected sample of subjects, who were then divided into a normal weight and an overweight group, using a 5 percent overweight cutoff point. In addition, a questionnaire was administered, and a standard structured interview given to a subgroup. Results showed the overweight group to be significantly higher on extraversion. The overweight group were found to be differentiated into two groups, the mildly overweight and the very overweight. The mildly overweight were the most extraverted and the highest sensation seeking of all three groups. The overweight group had a lower mean pulse rate than the normal group. The overweight group were higher on the Boredom Susceptibility and Experience Seeking factors of the sensation seeking measure. The mildly overweight smoked and drank more than any other group, suggesting a general pattern of overindulgence. The overweight group as a whole preferred non-physical and non-risk activities. They disliked monotonous activities. It appeared that whereas eating provided stimulation, it appeared to be stimulation of a low intensity type that is easily obtained. Implications were that overeating is a 'normal' response to prevalent food cues in the society, given man's genetic adaptations over the centuries. Treatment should be both curative and preventative, and should take the whole individual into account as obesity is the result of physiological, psychological and environmental factors (AU)

Clinical trial of Hycanthone in Schistomiasis mansoni in St. Lucia

A clinical trial of a new antischistosomal drug, hycanthone methanesulfonate, was undertaken in 103 patients with schistosomiasis mansoni hospitalized in St. Lucia, West Indies. The drug was administered in a single intramuscular dose of 3mg per kg of body weight. The commonest side effect, vomiting, occurred in 48 patients (47 percent); 33 other patients complained of nausea, anorexia, or abdominal pain. In general, these symptoms ceased within 24 hours after treatment. Quantitative examination for Schistosoma mansoni eggs was carried out on three fecal specimens before treatment and at 6 weeks, 4 months, and 6 months after treatment. At 6 months after treatment, 26 of 94 patients (28 percent) were no longer excreting eggs, and 76 patients (81 percent) had sustained a greater than 90 percent reduction in egg-excretion level; for these 94 as a group, the total number of eggs excreted had been reduced by 97 percent. The efficacy of the drug did not appear to vary with severity of infection as measured by number of eggs excreted or by enlargement of the liver or spleen, or both. In this group of patients, two-thirds of whom were under 20 years of age, enlargement of the liver or spleen was frequently found to regress after treatment.(AU)