Prevalence and correlates of disordered eating at a large state university before and after the onset of the COVID-19 pandemic.

BACKGROUND: Emerging adulthood is a transitory period in which disordered eating (DE) manifests; collecting data on the prevalence of DE among this population as well as demographic and behavioral correlates are important public health goals. METHODS: Data from an annual survey of undergraduate students at a large state university from 2019 to 2022 were analyzed, allowing researchers to compare prevalence and correlates before and after the onset of the COVID-19 pandemic using two brief screeners: the SCOFF and Eating Disorder Screener for Primary Care (ESP). We hypothesized that rates of DE would be greater after the onset of COVID-19 as compared to before. We also hypothesized that those identifying as women, reporting higher alcohol or drug use, and contemplating suicide would have greater odds of reporting symptoms consistent with DE. RESULTS: DE was significantly lower in pre-pandemic years compared to pandemic years: ESP pre = 38.01%(n = 704), pandemic = 48.79%(n = 645), p < 0.001; SCOFF pre = 22.82%(n = 422), pandemic = 31.46%(n = 414), p < 0.001. Logistic regressions showed women and students who contemplated suicide reported significantly greater DE, regardless of screener or time period. Inconsistent relationships were found between DE and current substance use. CONCLUSION: These findings may inform targeted interventions for those most vulnerable to disordered eating.

It is important to track the rates of disordered eating (DE) in vulnerable populations like emerging adults (those who are between the ages of 18 and 25). Many emerging adults attend college, and during this time DE may occur. The COVID-19 pandemic has led to situations, like being isolated from friends and family, that we assume could increase DE. To present data on the rates of DE before and after the start of COVID-19, researchers collected data on whether college students engaged in DE two years before the start of COVID-19 (2019, 2020) and two after COVID-19 (2021, 2022). They considered whether characteristics of the student, like whether they were a man or woman or their race, were related to DE. DE increased significantly after COVID-19. Using one questionnaire, DE was about 38% before COVID-19 and increased to nearly 50% after COVID-19. Across all four years, women and students who thought about suicide were more likely to report DE. It is important to direct resources to students who are experiencing DE ­ which we now know could be as many as 50%. DE contributes to health problems and can worsen over time, leading to a life-threatening eating disorder.

Understanding the phenomenological experiences of schema therapy for those with an eating disorder.

Schema therapy expands traditional cognitive-behavioral models, weakening early maladaptive schemas and schema modes while strengthening adaptive modes. This study investigated participant experiences of schema therapy for eating disorders, focusing on schema modes and the eating disorder voice, how these maintained disordered eating, and how therapy helped. Semistructured online video interviews with clients receiving schema therapy for eating disorders (N=10) were analyzed using interpretative phenomenological analysis. Four group experiential themes were developed: (1) adverse experiences, typically in childhood and adolescence, (2) interpersonal relationships, especially with primary caregivers and the benefits of a good therapeutic relationship, (3) self-awareness of schema modes and the eating disorder voice and their impact on participants' eating disorders, and (4) recovery using schema concepts, including finding one's inner child, better self-management, and ambivalence about recovering. Overall, schema therapy was perceived as beneficial, specifically regarding participants' awareness of their inner child, development of their eating disorder, and awareness of their eating disorder voice. Participants expressed a growing positive sense of agency, connecting with their inner child's needs and developing a connection to their healthy adult mode. They also felt that schema therapy had equipped them with the tools to strengthen their healthy adult mode, while simultaneously weakening their maladaptive modes.

A Longitudinal Network Analysis of Emotion Regulation, Interpersonal Problems, and Eating Disorder Psychopathology in Chinese Adolescents.

OBJECTIVE: The present longitudinal study examined sex-specific, symptom-level relationships among emotion regulation (ER), interpersonal problems (IP), and eating disorder (ED) psychopathology in a large sample of Chinese adolescents. METHOD: Data were from a project with four waves of data collection (N = 1540; 710 boys and 830 girls) at 6-month intervals over 18 months. Questionnaires assessed ED psychopathology, ER, and IP at each wave of data collection. Longitudinal network analyses were conducted separately for boys and girls. Sex differences in the network structures were also examined. RESULTS: The results revealed pronounced heterogeneity in the presentation of ED psychopathology, ER, and IP across Chinese adolescent boys and girls longitudinally and intra-individually. For example, weight/shape preoccupation in ED psychopathology and awareness in ER emerged as important nodes in the temporal network for boys. However, weight/shape preoccupation and dissatisfaction in ED psychopathology were identified as the most important nodes in the temporal network for girls. Regarding bridge strength, awareness in ER emerged as the node with the highest connectivity in the temporal network for boys. At the same time, weight/shape dissatisfaction in ED psychopathology was the node with the highest connectivity for girls. DISCUSSION: The current study extended network theory to better understand the longitudinal interplay among ER, IP, and ED psychopathology in Chinese adolescents and their sex differences in the importance of symptoms. Such insights may pave the way for developing targeted prevention and treatment strategies for adolescent boys and girls in China.

Potential pathways to the onset and development of eating disorders in people with overweight and obesity: A scoping review.

OBJECTIVE: To describe pathways to eating disorder (ED) development that have been evaluated in people with overweight and obesity. METHODS: Four databases were searched to identify studies testing ED development models in adolescents (10-19 years) or adults (>19 years) with overweight and obesity. Explanatory variables were thematically grouped into constructs to describe pathways to each ED outcome. RESULTS: Of 2226 studies screened, 46 (10 adolescent; 36 adult) were included. Study samples were predominantly female, ranging from 22 to 2236 participants and mean age 12.3 to 56.0 years. In total, 207 explanatory variables were grouped into 18 constructs to summarize 107 pathways that were identified. The most common ED outcome was binge eating (n = 24 studies), followed by global ED psychopathology (n = 10 studies). Across pathways to ED development, negative affect was the most proposed construct, followed by preoccupation with weight/shape and weight stigma. CONCLUSION: Pathways to ED development in people with overweight and obesity are complex and may include more than 18 different explanatory factors of which negative affect, preoccupation with weight/shape, and weight stigma are the most common. More research on adolescents, males, and the spectrum of ED in diverse populations is required for early identification and intervention.

High-intensity interval training vs. yoga in improving binge eating and physical fitness in inactive young females.

Yoga is effective in binge eating disorder (BED) treatment, but it does not seem effective enough to improve low physical fitness. In contrast, high-intensity interval training (HIIT) is effective in improving physical fitness but has never been studied in the context of BED. In the study, 47 young inactive females with mild to moderate BED were recruited and randomly assigned to a HIIT group (HIIT), a Yoga group (YG), or a control group (CG; age, 19.47 ± 0.74, 19.69 ± 0.874, and 19.44 ± 0.63 years; BMI, 21.07 ± 1.66, 21.95 ± 2.67, and 20.68 ± 2.61 kg/m2, respectively). The intervention groups participated in 8-week specific exercises, while the CG maintained their usual daily activity. Before and after the training, participants were evaluated for BED using the binge eating scale (BES) and for physical fitness. The obtained data were compared within groups and between groups, and a correlation analysis between BES and physical fitness parameters was performed. After the training, the YG presented significant improvements in BES (- 20.25%, p = 0.006, ηp2 = 0.408), fat mass (FM, - 3.13%, p = 0.033, ηp2 = 0.269), and maximal oxygen consumption (VO2max, 11.51%, p = 0.000, ηp2 = 0.601), whereas the HIIT showed significant improvements in body weight (BW, - 1.78%, p = 0.006, ηp2 = 0.433), FM (- 3.94%, p = 0.033, ηp2 = 0.285), and BMI (- 1.80%, p = 0.006, ηp2 = 0.428), but not in BES. Comparisons between groups revealed that both HIIT and YG had significantly higher VO2max levels than CG (HIIT 12.82%, p = 0.006, ηp2 = 0.088; YG: 11.90%, p = 0.009, ηp2 = 0.088) with no difference between HIIT and YG. Additionally, YG presented significantly lower BES than both HIIT (15.45%, p = 0.02, ηp2 = 0.03) and CG (11.91%, p = 0.022, ηp2 = 0.03). In conclusion, Yoga is an effective treatment for BED, but HIIT is not, despite its high efficacy in improving physical fitness.

Experiences of externalisation in recovery from Anorexia Nervosa: a reflexive thematic analysis.

BACKGROUND: Many individuals perceive Anorexia Nervosa (AN) as a part of their personal identity. Externalisation of the problem is a practice that is often taken up within NICE recommended treatments for AN. Dominant understandings of externalisation are that this practice involves making the "problem" a separate entity, external to the individual. It is an attitude taken by the client and family, stimulated by the therapist to build engagement with treatment and supportive relationships around the individual. However, there is a paucity of research exploring the therapeutic effects of this approach. This research aims to address this gap by exploring the role of externalisation in treatment for AN to elicit an understanding of how this practice is experienced including how it can help and hinder recovery. METHODS: Thirteen adults with a current and/or past diagnosis of AN participated in semi-structured interviews. This qualitative study used a reflexive thematic analysis. ANALYSIS: Participants described their experience of externalisation as a journey which is depicted by four main themes. 'Separating the AN from the self' reflects the tensions inherent in learning to distinguish between one's perceived sense of "self" and "the AN". 'Making sense of the AN' describes the experience of language forms used to separate the AN from the individual's identity. 'Feeling seen, or unseen as a person beyond the AN' illustrates the helpful and harmful effects of externalising practices on relationships. 'Navigating a complex relationship with the AN' depicts the effects of one-, versus two-way externalisation on the individual's relationship to AN. CONCLUSIONS: The notion of separating one's internal dialogue from one's concept of self may initially be rejected by the individual experiencing AN. However, as the individual develops trust in the therapist and becomes socialised to common forms of externalising language, they may begin to realise two sides within them, a perceived "healthy self" and "the anorexia voice". However, social-cultural discourses around eating contribute to ambiguity during the differentiation between these two voices, thus elucidating the effects of an absence of problem deconstruction alongside externalisation within ED-focussed treatments. Externalising practices were most helpful when led by the individual using their own experience-near language and least helpful when they did not permit the individual to feel seen as a person beyond the AN. Therapists, treatment teams and family members should be cognisant of the emotional effects of language used to externalise AN. Importantly, they should ensure that externalisation is practiced within the spirit of narrative therapy from which it originates.

This research explores the experiences of individuals with current and/ or past experience of anorexia nervosa (AN) who received NICE approved psychological therapies in which their eating disorder (ED) was separated from their identity through externalisation. Within these therapies, externalisation is a therapeutic practice that involves viewing AN as an external entity or illness that is separate from the identity of the individual who is experiencing AN. Participants described how it was initially difficult to accept that their thoughts, feelings and behaviours were influenced by something external to them. However, over time, the individual experiencing AN began to trust in this idea which was proposed to them throughout treatment. This perception of their experiences had both positive and negative effects on their recovery. This research suggests that individuals experiencing AN, their therapists, treatment teams and family members should be curious about the emotional effects of the language forms used to separate AN from the person's identity. Language which empowered individuals in relation to their eating difficulties and which permitted individuals to feel seen, heard, and validated as a person beyond AN supported their recovery. The findings underpin the importance of individual-led externalisation and thus, practicing externalisation with adherence to the core narrative therapy principles which underlie this therapeutic practice. In doing so, externalisation may be used most helpfully to support recovery from AN.

Eating disorders and health literacy in Germany: results from two representative samples of adolescents and adults.

Introduction: Eating disorders are associated with substantial burden for the affected individuals including negative health outcomes and increased mortality. So far, prevention programs for eating disorders have yielded mixed results concerning their efficacy. Therefore, more targeted prevention programs need to be developed. Health literacy has been identified as a potential influencing factor of eating disorders. This study aimed at exploring the relationship between likely cases of eating disorders and health literacy, alongside additional sociodemographic factors. Materials and methods: Two large samples of adults (N = 3,011) and adolescents (N = 1,021) representative of the German-speaking population in Germany were recruited. Likely cases of eating disorders were identified using the SCOFF questionnaire. Health literacy was assessed with the HLS-EU-Q16 questionnaire. Sociodemographic information, including age, gender, social status and level of education, and subjective body image were obtained. χ2-tests of independence were calculated to determine the association between the investigated constructs. Results: Suspected eating disorders were more likely in female than male adolescents but were not related to gender in adults. Rates of suspected eating disorders increased with increasing age in adolescents and decreased with increasing age in adults. While levels of education were unrelated to suspected eating disorders, low social status was associated with higher rates of suspected eating disorders in adults but not adolescents. Inadequate or problematic health literacy and negative body image were associated with higher rates of suspected eating disorders compared to adequate health literacy and more positive body image. Discussion: Likely cases of eating disorders are related to health literacy and body image as well as sociodemographic factors. These constructs should therefore be addressed in future research to improve prevention programs.

"To exercise sustainably" - Patients' experiences of compulsive exercise in eating disorders and the Compulsive Exercise Activity Therapy (LEAP) as a treatment: a qualitative interview study.

BACKGROUND: Compulsive exercise is common in eating disorders (EDs), but a systematic treatment model is lacking. The CompuLsive Exercise Activity TheraPy (LEAP) is a cognitive behavioral therapy treatment for compulsive exercise in EDs, delivered by trained therapists in groups over four consecutive weeks (8 groupsessions and 1 individual session), aiming to promote healthy physical activity. LEAP is currently evaluated in a randomized efficacy trial. In parallel, it is crucial to learn more about how it is perceived by qualitatively investigating participants' subjective experiences. METHODS: Nine patients with various EDs participating in the LEAP trial were interviewed about their experiences of taking part in LEAP and about compulsive exercise as an ED symptom using a semi-structured interview guide. The interview transcripts were analyzed according to thematic analysis. RESULTS: The informants expressed that compulsive exercise had not been addressed in their standard ED treatment and that LEAP as such provided an important complement, spurring reflection, awareness, and changed feelings and behaviors in relation to compulsive exercise. Initially, increased PA was triggered for some, but this side effect was transitory. A wish for more treatment time, in terms of longer or additional sessions, was expressed. CONCLUSIONS: Overall, LEAP seemed to fill an important treatment need and seemed both acceptable and feasible to patients. However, treatment time and the initial increase in PA may need further investigation and attention in order to optimize this treatment. TRIAL REGISTRATION: The trial is registered with the ISRCTN registry (registration date 20200325), trial ID ISRCTN80711391.

Compulsive exercise (CE) is very common in individuals with eating disorders (EDs) often tightly connected with the eating pathology. Even so, most standard treatments do not specifically target CE, leaving patients without strategies to normalize their exercise. The CompuLsive Exercise Activity TheraPy (LEAP) is delivered as an adjunctive treatment to standard ED treatment (targeting CE in patients with EDs. In this study, nine former LEAP patients were interviewed about their experiences of taking part in LEAP and about CE as an ED symptom. The informants were in general satisfied with LEAP and indicated that participation had positive effects on their exercise-related thoughts and attitudes, as well as actual exercise behaviors. They all experienced that CE was not addressed in their standard treatment, although they were motivated to work towards changing it. LEAP was therefore viewed as an important complement. Participating in LEAP initially triggered some informants to exercise more, which fortunately ceased over time and is similar to the temporal negative effect (increased food occupation) often observed initially in cognitive behavioral therapy for eating disorders. The content of LEAP was experienced as valid, informative, and eye-opening, and being able to discuss CE-related topics in a group setting was for many a positive experience. The experiences expressed in this study are very useful for continued development of LEAP. Although preliminary, the results also suggest that LEAP may be a valuable add-on treatment within ED care.

A cross-sectional study on the prevalence of eating disorders in liver transplanted patients with type 2 diabetes and/or overweight/obesity.

Liver transplantation (LT) associates with weight gain and metabolic complications. However, risk of eating disorders post-transplantation and factors influencing their onset remain poorly understood. This study aimed to fill this knowledge gap by characterizing the risk of having eating disorders or Orthorexia Nervosa (ON) according to the EAT-26, BES and Bratman screening questionnaires in 104 liver transplant recipients (mean age 62.5 years; median time from LT 6 years) with type 2 diabetes and/or overweight/obesity. Eighty-two patients (78.9 %) had diabetes; mean BMI was 30.1 ± 5.9 kg/m2. Risk of eating disorders was observed in 6.9 %-10.8 % and the risk of orthorexia (Bratman test score > 4) was observed in 60.5 % of patients. A significant association was found between BMI and the likelihood of having eating disorders considering EAT-26 (OR = 0.17, p = .009). The absence of a direct link between diabetes and the risk of having eating disorders suggest multifactorial influences on post-transplant eating behaviors. The study highlights the importance of proactive screening to evaluate eating behaviors in liver transplant recipients to define tailored interventions and optimize post-transplant outcomes. Limitations refer to the observational nature of the study and the absence of pre-transplant data. Further research is warranted to validate these findings, elucidate temporal relationship between transplantation and the onset of eating disorders, and explore potential mechanisms underlying these associations. Such insights are crucial for developing effective strategies to mitigate the impact of eating disorders on post-transplant health and well-being.

Navigating the ethical complexities of severe and enduring (longstanding) eating disorders: tools for critically reflective practice and collaborative decision-making.

Decisions about the treatment of eating disorders do not occur in a socio-political vacuum. They are shaped by power relations that produce categories of risk and determine who is worthy of care. This impacts who gets access to care and recognition of rights in mental health services. Globally, there are calls for more human rights-based approaches in mental health services to reduce coercion, improve collaborative decision making and enhance community care. Treating individuals with longstanding, Severe and Enduring Eating Disorders (SEED) or Severe and Enduring Anorexia Nervosa (SE-AN) can be particularly problematic when it involves highly controversial issues such as treatment withdrawal and end-of-life decisions and, where legally permissible, medically assisted dying. In this article, we argue that the socio-political context in which clinical decision making occurs must be accounted for in these ethical considerations. This encompasses considerations of how power and resources are distributed, who controls these decisions, who benefits and who is harmed by these decisions, who is excluded from services, and who is marginalised in decision making processes. The article also presents tools for critically reflective practice and collaborative decision-making that can support clinicians in considering power factors in their practice and assisting individuals with longstanding eating disorders, SEED and SE-AN to attain their rights in mental health services.

National Case Volumes and Gender Disparities in Emergency Department Utilization for Psychiatric Emergencies: A Population-Based Claims Data Analysis.

Introduction The utilization of emergency departments (EDs) for managing psychiatric emergencies has significantly increased in the United States because of the increasing prevalence of mental health disorders. This study examined national case volumes and sex disparities in ED visits for psychiatric emergencies using data from the Nationwide Emergency Department Sample (NEDS). Methods This retrospective analysis included adult ED visits for psychiatric emergencies identified using relevant International Classification of Diseases, 10th Revision (ICD-10) codes. Primary endpoints included national case volumes by sex. Hospitalizations with age < 18 years and those with missing data on sex were excluded. Secondary endpoints included inpatient mortality, ED and inpatient costs, admission rates, discharge disposition, length of stay (LOS), and number of procedures. Results In 2021, there were approximately 143.5 million ED visits in the United States, with 7,978,490 of these being for psychiatric emergencies. The most common presentations were substance abuse and intoxication (5,119,086 (64.2%)), severe bipolar disorder (1,912,670 (24%)), and anxiety or panic attacks (1,015,486 (12.7%)). Approximately 3,997,223 (50.1%) were women, and 3,981,267 (49.9%) were men. Men were older (mean age: 45 versus 43 years; P<0.001), were more likely to be uninsured (712,647 (17.9%) versus 497,658 (12.5%); P<0.001), and had a higher Charlson Comorbidity Index (CCI) (CCI ≥ 2: 792,272 (19.9%) versus 643,552 (16.1%); P<0.001). More men than women presented to the ED with acute substance abuse or intoxication (3,196,945 (80.3%) versus 1,922,142 (48.1%)), bipolar disorder with or without psychosis (958,275 (24.1%) versus 954,395 (23.9%); P<0.001), and suicidal ideation (267,638 (6.7%) versus 208,989 (5.2%); P<0.001). More women than men presented with severe depression (455,683 (11.4%) versus 441,921 (11.1%)), anxiety and panic attacks (615,572 (15.4%) versus 402,108 (10.1%)), acute stress reaction (35,975 (0.9%) versus 23,888 (0.6%)), eating disorders (3,997 (0.1%) versus 27,869 (0.07%)), and a history of abuse (21,164 (0.53%) versus 19,569 (0.49%); P<0.001). Women had lower mortality rates (27,980 (0.7%) versus 63,956 (1.6%); P<0.001), lower mean ED costs (adjusted mean difference (AMD): $1,189; P<0.001), fewer in-hospital admissions (1,211,158 (30.3%) versus 1,453,162 (36.5%); P<0.001), and a higher number of prolonged hospitalizations (1,442,998 (36.1%) versus 1,194,380 (30%); P<0.001) compared with men. Conclusion This study highlights significant sex disparities in ED utilization for psychiatric emergencies. Men more frequently present with substance abuse and severe comorbidities, leading to higher healthcare costs and inpatient admissions. Women, while more likely to present with anxiety and depressive disorders, incur lower costs and have better overall outcomes.

The validation of short eating disorder, body dysmorphia, and Weight Bias Internalisation Scales among UK adults.

BACKGROUND: When collecting data from human participants, it is often important to minimise the length of questionnaire-based measures. This makes it possible to ensure that the data collection is as engaging as possible, while it also reduces response burden, which may protect data quality. Brevity is especially important when assessing eating disorders and related phenomena, as minimising questions pertaining to shame-ridden, unpleasant experiences may in turn minimise any negative affect experienced whilst responding. METHODS: We relied on item response theory to shorten three eating disorder and body dysmorphia measures, while aiming to ensure that the information assessed by the scales remained as close to that assessed by the original scales as possible. We further tested measurement invariance, correlations among different versions of the same scales as well as different measures, and explored additional properties of each scale, including their internal consistency. Additionally, we explored the performance of the 3-item version of the modified Weight Bias Internalisation Scale and compared it to that of the 11-item version of the scale. RESULTS: We introduce a 5-item version of the Eating Disorder Examination Questionnaire, a 3-item version of the SCOFF questionnaire, and a 3-item version of the Dysmorphic Concern Questionnaire. The results revealed that, across a sample of UK adults (N = 987, ages 18-86, M = 45.21), the short scales had a reasonably good fit. Significant positive correlations between the longer and shorter versions of the scales and their significant positive, albeit somewhat weaker correlations to other, related measures support their convergent and discriminant validity. The results followed a similar pattern across the young adult subsample (N = 375, ages 18-39, M = 28.56). CONCLUSIONS: These results indicate that the short forms of the tested scales may perform similarly to the full versions.

This manuscript introduces short versions of existing measures of eating disorders and body dysmorphia, specifically the Eating Disorder Examination Questionnaire, the SCOFF Questionnaire, and the Dysmorphic Concern Questionnaire. We further investigate the properties of the recently introduced 3-item short version of the modified Weight Bias Internalisation Scale. Across analyses including measurement invariance testing and bivariate correlations aiming to assess convergent and discriminant validity, we find support that the short scales may perform similarly to their longer versions. These short scales may contribute in meaningful ways to research where the brevity of questionnaire-type measures may make a difference by contributing to data quality.

Reward and Inhibitory Control as Mechanisms and Treatment Targets for Binge Eating Disorder.

PURPOSE OF REVIEW: Recent research has highlighted alterations in reward and inhibitory control among individuals with binge eating disorder, identifying both constructs as potential targets for treatment. Treatments targeting reward and inhibitory control for binge eating disorder are emerging. This review aims to summarize the recent literature evaluating reward and inhibitory control in binge eating disorder compared to weight-matched controls using behavioral paradigms and neuroimaging. This review also aims to summarize recent literature evaluating treatments for binge eating targeting these mechanisms and highlights additional work needed in these areas. RECENT FINDINGS: Reward hypersensitivity and impaired inhibitory control are mechanisms underlying binge eating disorder. Individuals with binge eating disorder experience higher initial reward to food, and later, higher anticipatory reward but lower experienced food reward which maintains binge eating behavior. Treatments targeting reward and inhibitory control for binge eating include behavioral, computerized trainings, pharmacological, and neuromodulation treatments. The majority of trials are small but demonstrate promise in reducing binge eating and targeting theorized mechanisms. Larger, randomized trials are needed. Changes in reward and inhibitory control are present in individuals with binge eating disorder and treatments targeting these mechanisms demonstrate initial promise. Greater research is needed evaluating reward and inhibitory control simultaneously and with weight-matched comparison groups, as well as larger randomized trials that target both processes simultaneously.

Unraveling the complexity and instability of negative emotional eating: A latent transition analysis.

The manifestations of emotional eating are complicated, encompassing both over- and under-eating. However, little is understood about how emotional over- and under-eating constitute individuals' eating patterns and how these patterns change over time. Employing latent transition analysis, a longitudinal and person-centered approach, this study examined the patterns and stability of emotional eating. Over six months, 755 participants completed two waves of self-reported questionnaires. Results revealed four distinct latent profiles: Low Emotional Eaters (11.5-15.8%), Emotional Eating-Undereaters (31.1-40.5%), Emotional Eating-Overeaters (15.9-18.3%), and Combined-Emotional Eaters (29.7-37.2%). Approximately 50% of participants in each profile maintained their behavioral patterns over time, with transitions often shifting towards Combined-Emotional Eaters. Individuals in the profile of Emotional Eating-Overeaters exhibited the highest level of anxiety, depression, stress, and disordered eating. Gender, self-esteem level, and self-esteem instability were associated with profile membership and transition probabilities. These findings highlight the presence of distinct and relatively unstable patterns of negative emotional eating, indicating the potential distinction between trait and state emotional eating. Recognizing these inherent characteristics is crucial for future studies and intervention programs addressing negative emotional eating.

Parasomnias and sleep-related movement disorders induced by drugs in the adult population: a review about iatrogenic medication effects.

Parasomnias and sleep-related movement disorders (SRMD) are major causes of sleep disorders and may be drug induced. The objective of this study was to conduct a systematic review of the literature to examine the association between drug use and the occurrence of parasomnias and SRMD. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting systematic reviews, we searched PubMed databases between January 2020 and June 2023. The searches retrieved 937 records, of which 174 publications were selected for full-text screening and 73 drugs were identified. The most common drug-induced parasomnias were nightmares and rapid eye movement (REM) sleep behaviour disorders and sleepwalking. In terms of drug-induced SRMD, restless legs syndrome, periodic limb movement disorders (PLMD), and sleep-related bruxism were most frequent. Medications that inhibit noradrenergic, serotonergic, or orexin transmission could induce REM sleep (e.g., nightmares). Regarding sleepwalking, dysregulation of serotoninergic neurone activity is implicated. Antipsychotics are mentioned, as well as medications involved in the gamma-aminobutyric acid (GABA) pathway. A mechanism of desensitisation-autoregulation of GABA receptors on serotoninergic neurones is a hypothesis. SRMD and PLMD could involve medications disrupting the dopamine pathway (e.g., antipsychotics or opioids). Opioids would act on mu receptors and increase dopamine release. The role of adenosine and iron is also hypothesised. Regarding bruxism, the hypotheses raised involve dysregulation of mesocortical pathway or a downregulation of nigrostriatal pathway, related to medications involving dopamine or serotonin. Parasomnias are rarely identified in drug product labels, likely due to the recent classification of their diagnoses. An analysis of pharmacovigilance data could be valuable to supplement existing literature data.

The Bidirectional Association between Internet Use, Sleep Quality and Eating Behavior: A Cross-Sectional Study in Northwestern Thrace Region in Türkiye.

OBJECTIVE: This study aimed to examine the complex associations between Internet addiction, sleep disturbances, and disordered eating behaviors. METHODS: This cross-sectional study included 646 students from 17 high schools in Edirne, Türkiye between December 2023 and May 2024. A face-to-face questionnaire was administered to assess demographic characteristics, Internet addiction (YIAT), sleep quality (PSQI), and eating behavior (TFEQ-R21). RESULTS: In total, 644 students completed the study. The prevalence of Internet addiction among adolescents was 16.3%, with a similar prevalence among male and female adolescents. The prevalence of poor sleep quality among adolescents was 6.4%, and this trend was more pronounced in male adolescents, with an incidence of 13.0%. A weak positive correlation was observed between Internet addiction and disordered eating behavior. Additionally, a moderate positive correlation was observed between poor sleep quality and disordered eating behavior. Gender, maternal education level, Internet addiction, and poor sleep quality were significant predictors of eating disorders in adolescents. CONCLUSION: The findings of our study are of significant value in providing insights into the development of programs designed to prevent undesired eating behaviors.

Two identical twin pairs discordant for longstanding anorexia nervosa and OSFED: lived experience accounts of eating disorder and recovery processes.

Research into the risk of anorexia nervosa (AN) has examined twin pairs to further the understanding of the contributions of genetics, trait inheritance, and environmental factors to eating disorder (ED) development. Investigations of twin experiences of EDs have been biologically-based and have not considered the qualitative, phenomenological aspects of twin experiences. A gap in the literature exists regarding understanding of discordant twins with EDs. This research was developed in response, with the aim to deepen understanding of AN in discordant twins and to create novel ideas for further research and testing. The case studies presented in this article provide lived experience insights of two identical discordant twin pairs: one twin pair discordant for longstanding AN and one twin pair discordant for 'atypical' AN (the twin with AN has recovered). The perspectives and experiences of each co-twin (one with AN and one without) explore a number of factors that may have contributed to twin discordance in these cases, and how each twin has responded to the impact of AN in their lives. Through use of first-person accounts in case study presentation, this article centres social justice values of lived experience leadership and involvement in research. This article aims to extend current knowledge and understanding of EDs in discordant twins, particularly regarding risk for ED development, ED duration, diagnosis and treatment, and recovery processes.

Co-occurring autism, ADHD, and gender dysphoria in children, adolescents, and young adults with eating disorders: an examination of pre- vs. post-COVID pandemic outbreak trends with real-time electronic health record data.

Background: Incidence rates of autism, attention-deficit/hyperactivity disorder (ADHD), and gender dysphoria (GD) are rising not only in the general population, but particularly among children, adolescents, and young adults with eating disorders (EDs). While ED rates have risen during the COVID pandemic, trends in co-occurring autism, ADHD, and GD have yet to be investigated in detail or at scale by way of large electronic medical record data. Objectives: To investigate trends in rates of co-occurring autism, ADHD, and GD among children, adolescents, and young adults with EDs in years prior to and during the COVID-19 pandemic. Methods: We utilized a de-identified multinational electronic health records database (TriNetX) with 48,558 individuals aged 5-26 diagnosed with eating disorders (EDs) at least twice between 2017 and 2022. The primary predictor variable differentiated between the years of each person's index (first) ED diagnosis (2017-2019 vs. 2020-2022). The primary outcome variable was the rate of new co-occurring psychiatric diagnoses of autism, ADHD, and GD in the year following each patient's first ED diagnosis. We applied propensity score-matched multivariable logistic regressions to compare primary outcomes between 2017-2019 and 2020-2022. Results: Our analysis included 17,445 individuals diagnosed with EDs in 2017-2019 (8% autism, 13.5% ADHD, 1.9% GD) and 31,113 diagnosed with EDs in 2020-2022 (8% autism, 14.6% ADHD, 3.2% GD). After 1:1 propensity score matching, 17,202 individuals from the 2017-2019 cohort were matched to peers mirroring the 2020-2022 cohort. Those diagnosed in 2020-2022 showed a 19% (aOR[95%CI]=1.19[1.07-1.33]), 25% (aOR=1.25[1.04-1.49]), and 36% (aOR=1.36[1.07-1.74]) increase in odds for autism, ADHD, and GD diagnoses, respectively, within the 365 days after the index EDs diagnosis, compared to the 2017-2019 cohort. Discussion: Rates of autism, ADHD, and GD are significantly higher in individuals with ED in the post-pandemic 2020-2022 cohort in comparison to the pre-pandemic 2017-2019 cohort, even after controlling for baseline levels of co-occurring psychiatric diagnoses. Such findings reveal a critical gap in our current understanding of the totality of ways in which COVID-19 may have impacted the onset and clinical course of EDs, autism, ADHD, and GD among children, adolescents, and young adults.

Prevalence of thiamine deficiency in anorexia nervosa: a systematic review and narrative synthesis.

Thiamine is an essential vitamin that plays a crucial role in many biochemical processes in the body. Anorexia nervosa (AN) is one potential cause of a state of deficiency which can result in grave medical sequelae. There is limited available evidence of the prevalence of thiamine deficiency in patients who suffer from AN. The current study aimed to systematically review all available evidence on the prevalence of thiamine deficiency in cohorts with AN. Studies were included where thiamine status in a group of participants with AN was measured, either through self-reporting or objective measurement. Eight databases (Scopus, CINAHL complete, Medline complete, EMBASE, WEB OF SCIENCE, PROSPERO, COCHRANE DATABASE OF SYSTEMATIC REVIEWS and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. PRISMA guidelines were followed. The study was registered on PROSPERO. A minimum of two researchers conducted each part of the review. The search identified 42 articles whose full texts were screened for eligibility, with 17 retained for qualitative synthesis. The prevalence rates of thiamine deficiency in AN varied from 5.9% to 100% when based on self-report dietary intake. When objective measurements were taken, rates ranged from 0% to 56.7%. The review suggested that age, body mass index (BMI), duration of illness and subtype of AN were not associated with thiamine status. The limited available evidence suggested that the use of supplements, prior treatment and higher energy intakes were associated with a reduced risk of developing a thiamine deficiency among individuals with AN. Poor study methodology including small sample size, inconsistent deficiency definition and study heterogeneity limits the conclusions that can be drawn. Ultimately, there is insufficient strength of evidence to draw definitive clinical recommendations. This review highlights the need for further studies with more robust methodology to help further inform clinical practice.

Trauma exposure proximity associated with eating disorder diagnosis in women with food insecurity.

Trauma exposure is a risk factor for both food insecurity (FI) and increased eating disorder (ED) pathology. The purpose of this study was to explore the relation between trauma and ED diagnosis in a sample of women experiencing FI. A cross-sectional analysis of surveys from 99 women with self-reported FI (54% White; mean [SD] age = 40.26 [14.33] years) in the United States was employed. Participants completed online surveys including the Life Events Checklist (LEC) questionnaire, General Anxiety Disorder-7, Patient Health Questionnaire-9, and an interview comprised of the Household Food Security Survey Module (HFSSM) and Eating Disorder Diagnostic Interview (EDDI). LEC traumatic events were weighted by proximity: events experienced directly were weighted by a factor of 3, witnessed by 2, learned about by 1, and summed to a total weighted score. ED diagnosis in the past 12 months was assessed via the EDDI using DSM-5 diagnostic criteria. A binary logistic regression model tested associations between weighted trauma score, FI, and ED diagnosis. Weighted trauma score significantly predicted any ED diagnosis (OR = 1.039, p = .016), but FI severity did not (OR = .746, p = .101). These results suggest trauma proximity predicts ED diagnosis beyond that of FI severity and may be an important component of the association between FI and ED pathology. Future work may consider evaluating longitudinal symptoms of trauma and trauma severity in relation to FI.