Cognitive training via mobile app for addressing eating disorders' cognitions in adolescents: a randomized control trial protocol.

During adolescence, individuals are particularly vulnerable to developing eating disorders (EDs). To address the dysfunctional beliefs linked to these disorders, a new mobile app has been developed. This app, called GG eating disorders-Adolescents (GGED-AD), was created based on CBT to help adolescents work on their self-dialogue related to the core beliefs of eating disorders. The objective is to present the protocol for a randomized controlled trial to explore the efficacy of GGED-AD.Methods The study will be carried out in adolescents aged 13 to 16 from an educational center in the Valencian Community. The participants will be randomized into two groups: the experimental group will use the GGED-AD app during 14 consecutive days for approximately 5 min each day; and the control group will use a neutral app (GGNEUTRAL) during the same time. Both groups will complete instruments that assess dysfunctional beliefs related to eating disorders, eating symptoms, symptoms of depression and anxiety, body satisfaction and self-esteem before and after the intervention. A follow-up will be conducted one month later.Results A decrease in the degree of ascription to dysfunctional beliefs associated with eating disorders and eating symptomatology is expected, as well as an increase in body satisfaction and the self-esteem of the participants of the experimental group.Discussion The app in this study could help tackle and prevent ED-related symptoms in adolescents.Trial registration NCT06039514.

Posttraumatic growth in eating disorder recovery.

OBJECTIVE: To investigate posttraumatic growth in individuals recovering from an eating disorder. DESIGN: A convergent parallel mixed methods design was used. PARTICIPANTS: The sample consisted of 28 participants who completed the entire study and an additional 10 who completed only the quantitative portion of this mixed methods study. METHODS: The National Eating Disorders Association (NEDA) provided a link to the electronic survey via their website. Participants were asked to complete the Posttraumatic Growth Inventory (PTGI) and the Core Beliefs Inventory (CBI) in the quantitative strand. For the qualitative strand, participants were asked to describe any positive changes in their beliefs or life as the result of their eating disorder (ED). RESULTS: Participants reported a high amount of posttraumatic growth as indicated by their mean score on the CBI (30.39, SD 7.89) and (71.26, SD 16.58) on the PTGI. Qualitative categories included relating to others, personal strength, new possibilities, appreciation of life, and spiritual change. CONCLUSION: Participants described the transformation they experienced in the recovery process, with recovery from an eating disorder facilitating an opportunity for growth. Providing posttraumatic growth interventions may have the potential to help individuals with eating disorders find meaning in their pathway through recovery.

Validation and assessment of psychometric properties of the Greek Eating Behaviors Assessment for Obesity (GR-EBA-O).

INTRODUCTION: With increasing morbidity and risk of death, obesity has become a serious health problem largely attributable to difficulties in finding proper treatments for related diseases. Many studies show how detecting abnormal eating behaviors could be useful in developing effective clinical treatments. This study aims at validating the Greek version of the Eating Behaviors Assessment for Obesity (EBA-O). METHOD: After a double English/Greek forward/backward translation of the EBA-O, 294 participants completed the Greek version (GR-EBA-O), the Eating Disorder Examination Questionnaire, the Binge Eating Scale, and the Yale Food Addiction Scale. Confirmatory factor analysis (CFA) and construct validity were calculated, and Two-way MANOVA was computed with the factors of GR-EBA-O controlling for sex and BMI categories. RESULTS: CFA confirmed the second-order five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia) structure of the original EBA-O with excellent fit indices. GR-EBA-O factors were highly correlated. The GR-EBA-O subscales were also significantly correlated with the remaining measures, demonstrating good concurrent validity. CONCLUSION: The Greek version of the EBA-O has demonstrated sound psychometric properties and appears a reliable and user-friendly tool to identify pathological eating behaviors in obesity. LEVEL OF EVIDENCE: V, descriptive research.

The loneliness factor in eating disorders: Implications for psychopathology and biological signatures.

OBJECTIVES: Eating disorders (ED) are severe psychiatric conditions. While the biological consequences of EDs are well established, including an increase in inflammatory biomarkers, the influence of psychological factors, such as loneliness, has only recently gained attention in research. Loneliness has been associated with more severe psychopathology in ED patients, while its association with inflammatory biomarkers has only been explored in the general population. For these reasons, we aimed to investigate any possible associations between psychological features, trauma, and inflammatory biomarkers with loneliness in people with ED. METHODS: This study examined the interaction between loneliness, eating psychopathology, and biological markers in people with EDs. A group of 97 female patients with various diagnoses of ED was assessed for loneliness, general and eating psychopathology, traumatic history during childhood, and clinical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and urinary-free cortisol (UFC). RESULTS: The results indicated that individuals with ED who reported moderate to severe loneliness also displayed greater general psychopathology (p = 0.001), weight concerns (p = 0.007), and physical neglect during childhood (p = 0.006). Furthermore, people with higher levels of loneliness also had higher inflammatory indexes (ESR p = 0.001, CRP p = 0.027) and were positively correlated with markers of stress reaction such as UFC (p < 0.05). CONCLUSION: The findings underscore the importance of considering loneliness in the assessment of individuals with an ED. We observed notable associations between loneliness and increased psychopathology (both general and specific to eating), as well as higher levels of inflammation and childhood physical neglect. Addressing loneliness may contribute to improving overall well-being and potentially support recovery. This consideration encompasses both psychological and physical factors that interplay in the clinical presentation of individuals.

Factors associated with food label use: focus on healthy aspects of orthorexia and orthorexia nervosa.

PURPOSE: This study aimed to investigate the potential relationships between the use of different section of food label, and healthy and pathological aspects of orthorexia among adults. METHODS: This cross-sectional study was conducted using an online survey (n = 1326). Inclusion criteria were being 19-64 years and graduated from at least primary school. Pregnant and lactating women were excluded. Data were collected using questionnaire including socio-demographic variables, lifestyle factors, body weight and height, frequency of reading different sections of food label ("always", "when buying a food for the first time", "when comparing similar packaged foods", "rarely", "never"), food label literacy, and Teruel Orthorexia Scale. Participants were categorized as nutrition facts panel-users, ingredients list-users or claim-users if they read at least one item from the relevant parts. RESULTS: The proportions of nutrition facts, ingredients list, and claims sections users were 72.3%, 76.3%, and 79.9%, respectively. Both healthy and pathological aspects of orthorexia were associated with reading food labels. The healthy orthorexia had the strongest association with using the ingredients list (OR 1.76, 95% CI 1.41-2.20), whereas the orthorexia nervosa showed the highest association with using nutrition facts panel (OR 1.48, 95% CI 1.20-1.81). While women, physically active participants and those with higher food label literacy were more likely to use all sections of food labels; older age, having children, and chronic disease increased the likelihood of using claims and ingredients list (p < 0.05). Besides, following a diet was associated with higher use of nutrition facts and ingredients list (p < 0.05). CONCLUSIONS: The study demonstrates that food label users have higher orthorexia tendencies compared to non-users. Of the food label sections, healthy orthorexia showed the strongest association with use of the list of ingredients, while pathological orthorexia showed the strongest association with use of the nutrition facts panel. LEVEL OF EVIDENCE: Level V, cross-sectional study.

Comparison between Physical Activity and Stress-Related Lifestyle between Orthorexic and Non-Orthorexic University Students: A Case-Control Study.

(1) Background: The literature regarding orthorexia nervosa (ON) has well documented the association with other mental disorders, such as obsessive-compulsive and eating disorders. However, the research has not taken into account stress-related behavior and the conduction of physical activity (PA), both structured and unstructured. (2) Methods: In this cross-sectional study, 165 students of the University of Parma (92 females and 74 males) aged between 18 and 49 years old (mean = 24.62 ± 4.81) were consecutively recruited. The ORTO-15 questionnaire was used to divide the total sample into a group without orthorexia (score > 40) and a group with orthorexia (score < 40). All subjects completed the P Stress Questionnaire, and specific items were extrapolated from the Eating Habits Structured Interview (EHSI) to investigate lifestyle, including structured and unstructured PA. (3) Results: Subjects with orthorexia represented 83% of the total sample and reported higher levels of stress-related risk behaviors (i.e., sense of responsibility (t = -1.99, p = 0.02), precision (t = -1.99, p = 0.03), stress disorders (t = -1.38, p = 0.05), reduced spare time (t = -1.97, p = 0.03), and hyperactivity (t = -1.68, p = 0.04)) and a higher frequency of PA (i.e., hours spent training in structured PA, daily (t = -1.68, p = 0.05), weekly (t = -1.91, p = 0.03), and monthly (t = -1.91, p = 0.03), the tendency to carry out physical exercise even if tired (t = -1.97, p = 0.02), and to adhere to unstructured PA (i.e., moving on foot or by bike rather than using transport (t = 1.27, p = 0.04)). (4) Conclusions: The results confirmed the presence of hyperactivity at a motor and behavioral level in people with orthorexia. Further studies are necessary to highlight the causality between ON, stress, and physical activity but it may be possible to hypothesize that "obsessive" physical exercise may not generate the benefits generally known by the literature.

The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research.

Extensive research exists on the association between self-reported emotional eating (EE) and disordered eating (DE) behaviors. Heterogeneity exists by type (e.g., unidimensional vs. multidimensional) and valence (e.g., negative vs. positive) of self-reported EE, and no previous meta-analyses have examined the association between self-reported EE and DE behaviors. A total of 67 studies (N = 26,289; 43 reporting relations in one model, and 24 reporting relations in more than one model) met inclusion criteria; ranges for age and publication date were 18.0-61.8 years old and 1995 to 2022. Five models quantified relations between DE behaviors and 1) broad negative EE, 2) EE in response to depression, 3) EE in response to anger and anxiety, 4) EE in response to boredom, and 5) EE in response to positive emotions. Using random-effects models, pooled Cohen's d effect sizes suggested small, positive relations between DE behaviors and self-reported broad negative EE (d = 0.40, p < 0.001), EE-depression (d = 0.41, p < 0.001), EE-anger/anxiety (d = 0.35, p < 0.001), and EE-boredom (d = 0.38, p < 0.001). A significant, but very small, positive relation was observed between DE behaviors and self-reported EE-positive (d = 0.08, p = 0.01). Subgroup analyses suggested a medium, positive relation between self-reported broad negative EE and binge eating (d = 0.53, p < 0.001) and a small, positive relation between self-reported broad negative EE and dietary restraint (d = 0.20, p < 0.001). Significant heterogeneity was identified across all models except for the EE-boredom and DE behaviors model. Higher BMI, but not age, clinical status, or type of DE behavior strengthened the positive relation between self-reported broad negative EE and DE behaviors. Findings support previous research suggesting that negative and positive EE are distinct constructs, with negatively valenced EE being more closely associated with DE behaviors, especially binge eating.

Passive social networking sites use and disordered eating behaviors in adolescents: The roles of upward social comparison and body dissatisfaction and its sex differences.

Previous research has indicated a link between social networking site (SNS) use and eating behaviors, but the underlying mechanisms have not been well explored. This study investigated the role of upward social comparison and body dissatisfaction in the relationship between passive SNS use and disordered eating (DE) behaviors, as well as sex differences. A total of 744 middle school students (51.6% female, Mage = 12.87 years, SD = 0.68) completed self-report questionnaires regarding passive SNS use, upward social comparison, body dissatisfaction, and DE behaviors. Results revealed that: 1) girls reported significantly higher levels of passive SNS use, body dissatisfaction, and DE behaviors than boys; 2) passive SNS use was a significant predictor of DE behaviors both sexes; 3) body dissatisfaction mediated the relationship between passive SNS use and DE behaviors for girls; 4) the chain mediating effects of upward social comparison and body dissatisfaction between passive SNS use and DE behaviors were found only among adolescent girls; 5) Compared to boys, body dissatisfaction in girls is more significantly related to DE behaviors, and upward social comparison is more closely related to body dissatisfaction in girls. These findings suggest that passive SNS use, rather than general SNS use, was related to body dissatisfaction and eating concerns. Interventions targeting specific passive SNS users may be an effective avenue for the prevention and management of body-related concerns and disordered eating behavior in adolescent girls.

Toward a memory perspective on eating psychopathology: An investigation of the types of childhood and adolescence memories that are associated with eating disorder symptoms.

The cognitive mechanisms through which specific life events affect the development and maintenance of eating disorders (ED) have received limited attention in the scientific literature. The present research aims to address this gap by adopting a memory perspective to explore the type of life events associated with eating psychopathology and how these events are encoded and reconstructed as memories. Two studies (n = 208 and n = 193) were conducted to investigate the relationship between specific memories and eating disorder psychopathology. Study 1 focused on parent-related memories, while Study 2 examined childhood/adolescence memories. Results from both studies revealed that need thwarting and shame in memories were associated with eating disorder symptoms, but only when individuals drew symbolic connections between these memories and food or eating behavior. Moreover, need thwarting and shame in such memories were associated with other eating and body image outcomes, including uncontrolled eating and body esteem. These results also held after controlling for a host of known predictors of eating disorder psychopathology, such as BMI, perfectionism, or thin ideal internalization. Overall, the present findings suggest that the reprocessing of memories symbolically and idiosyncratically linked to food and eating behavior might be a fruitful clinical intervention.

Examining Teacher Concerns and Anxiety on the Implementation of a Universal Body Image Program.

In the past 30 years, there have been numerous positive body image and eating disorder prevention programs targeting youth developed for school-based settings. Frequently, teachers are used as interventionists to increase dissemination, decrease costs relative to researchers, and increase scalability. However, little is known about teacher concerns and barriers that may hinder successful uptake and implementation. The current study recruited a total of 269 teachers who consented to implement a universal body image and appearance-related bullying and teasing prevention program in their classrooms as part of a randomized controlled trial. Teachers expressed some worry that they may say the wrong thing, and concern about feeling uncomfortable teaching the program due to their own body dissatisfaction. Teacher's ethnicity, gender, years teaching, dieting behaviors and other weight control behaviors, and self-efficacy were not associated with concerns related to teaching the curriculum. Teachers with lower body esteem reported higher concerns and anxiety related to teaching a body image curriculum. In free response items, teachers worried about handling student comments that were beyond the scope of the curriculum. Teacher self-efficacy was the only variable associated with the number of program sessions implemented. Findings suggest avenues to increase implementation.

Psychometric properties of the Eating Attitudes Test-26 in Spanish schoolchildren.

INTRODUCTION: Disordered Eating Attitudes and Behaviours (DEABs) can impact both the mental and physical health of children. Early detection is crucial to prevent complications and improve outcomes. The Eating Attitudes Test-26 (EAT-26) is a widely used, cost-effective tool for assessing DEABs. OBJECTIVE: To evaluate the psychometric properties of the EAT-26 by analysing its factor structure, internal consistency, convergent validity, and measurement invariance across sexes in Spanish schoolchildren. METHOD: Validation study in a sample of 718 schoolchildren. The sample was randomly divided into 2 groups, each with 359 participants, and we carried out an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) of the instrument. Subsequently, we assessed the internal consistency by means of the ordinal alpha, the convergent validity with the SCOFF questionnaire and the measurement invariance across the sexes. RESULTS: The results of the EFA and CFA supported a multidimensional structure of the EAT comprising 6 factors and 21 items. These factors underlie a second-order model of DEABs. The internal consistency was adequate for most factors. The SCOFF questionnaire showed a moderate convergent validity for most of the EAT-21 factors. We found measurement invariance across the sexes. CONCLUSIONS: The abbreviated EAT-21 scale exhibited modest and promising psychometric properties, making it a suitable instrument for assessing DEABs in both sexes in educational settings.

Testing general sociocultural and coach-related appearance pressures as the factors associated with disordered eating in competitive female athletes participating in various sports.

The aim of the present study was to test the sociocultural Petrie and Greenleaf's (2007) model of disordered eating (DE) in competitive female athletes. Specifically, we tested a model of general sociocultural and coach-related pressures towards body weight and appearance of female athletes as the factors associated with athletes' DE through the mediators such as internalization of appearance ideals and overweight preoccupation. 515 athletes participated in this study. The mean age of the sample was 19.0 ± 5.9 years. Athletes were provided with study measures on general sociocultural and coach-related appearance and body weight pressures, internalization of appearance ideals, overweight preoccupation and DE. Path analyses showed that general sociocultural pressures were associated with DE directly and through internalization of appearance ideals and overweight preoccupation. Pressures from coaches were associated with DE through overweight preoccupation and through the internalization of appearance ideals and overweight preoccupation. The models were invariant across body weight sensitivity in sports and age groups. These results inform DE prevention for female athletes. It is important to increase resistance to sociocultural pressures and pressures from coaches in DE prevention programmes for female competitive athletes of all ages and participating in sports irrespective of sports group (weight-sensitive or less weight-sensitive).

"That's not at all what I needed" trans adults' perspectives on trans-affirming primary care and eating disorders.

Transgender and gender diverse adults, referred to collectively as trans, experience eating disorders (EDs) at high rates and struggle to find primary care providers (PCPs) knowledgeable in both gender-affirming care and EDs. Most research regarding healthcare experiences of trans people with EDs focuses on specialized treatment. This qualitative study explored the experiences of trans patients with ED symptoms in trans-affirming primary care, which offers clinical support for gender affirmation in the context of interpersonally gender-affirming primary care services. Twenty-two participants were recruited via social media to participate in focus groups (n = 5). Researchers utilized thematic analysis. Participants reported gender-affirming and non-affirming experiences, experienced unwelcome comments from providers regarding bodies and gender, encountered barriers to disclosing their ED symptoms, felt transition-related medical care supported recovery but did not always resolve their ED symptoms, felt they had to self-advocate, and wanted their providers to recognize them as whole people (beyond their ED and transness) who experience joy. Importantly, despite being trans-affirming, participants critiqued trans-affirming primary care as perpetuating weight stigma and binary gender norms. Participants recommended providers receive ED training, implement universal ED screening, and explore how sociocultural norms regarding weight and gender negatively impact trans health outcomes.

Motivations matter: moral and health-related motives indirectly relate to differential psychological health indicators among vegetarians.

Due to rising popularity of vegetarianism in recent years, research interest has surged in examining the relationship between vegetarianism and psychological health. However, given inconsistent findings in prior research, the answer to whether practicing vegetarianism is associated with better or worse psychological health is still elusive. The present investigation aimed to demonstrate that vegetarians are not homogeneous in terms of psychological experiences, such that it is crucial to consider the motives behind vegetarians' dietary choice when examining their psychological health. In a survey study with 266 vegetarians and 104 omnivores, it was shown that health vegetarians displayed higher levels of disordered eating as compared to moral vegetarians and omnivores. Mediation analyses further revealed that, among vegetarians, health motivation was positively correlated with disordered eating tendencies, indirectly linking it with poorer psychological health; moral motivation was positively correlated with prosocial behavior, which in turn predicted better psychological health. These findings have implications for understanding the psychological health of vegetarians with different dietary motives and for developing interventions to promote their psychological health.

A comprehensive investigation of the association between menopause symptoms and problematic eating behavior in peri- and post-menopause cisgender women.

Midlife individuals assigned female at birth are at risk for problematic eating behavior, associated with negative health outcomes. Little is known about how menopausal symptoms may increase risk in this population. The current study aimed to understand how a comprehensive range of menopause symptoms were globally associated with problematic eating behaviors. A total of 281 cisgender women (176 post-menopause, 105 peri-menopause) from the United States aged 40 to 64 were recruited utilizing Prolific, an online survey platform. Participants answered questionnaires about menopause symptoms and problematic eating. Participants were selected using demographic and health information provided in a screener survey. Participants also completed the Eating Disorder Questionnaire (EDE-Q), Women's Health Questionnaire (WHQ), Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Using Structural Equation Modeling, menopause symptoms explained 16.7 percent of the variance in problematic eating. Higher frequency and severity of anxiety, depression, sleep concerns, cognitive complaints, pain, and vasomotor symptoms was associated with greater frequency and severity of problematic eating behaviors, ß = .40, p < .001. Invariance testing showed no significant differences between peri- and postmenopausal women. These findings support the association between menopause symptoms and problematic eating in Midlife cisgender women and highlight the need for continued investigation.

Body Image, Nutrition, and Mental Health.

Classical examples of disorders associated with body image disturbances are eating disorders (EDs) such as anorexia nervosa (AN) and bulimia nervosa (BN), as well as body dysmorphic disorder (BDD) [...].

Orthorexia Nervosa and Healthy Orthorexia in a Physically Active North American Population.

The Teruel Orthorexia Scale (TOS) defines two related but distinct constructs: Orthorexia Nervosa (OrNe), a pathological fixation on a healthy diet, and Healthy Orthorexia (HeOr), an interest in a healthy diet independent of psychopathology. Here, we (a) assessed both types of Orthorexia in a large North American sample using the TOS and (b) explored if engaging in regular physical activity was associated with a greater risk of Orthorexia. A cohort of physically active adults (n = 927; 41% men) completed the TOS, as well as the Rapid Assessment of Physical Activity (RAPA), to broadly assess aerobic physical activity level and participation in strength and/or flexibility training. As expected, scores for HeOr and OrNe differed between participants, with lower scores for Orthorexia Nervosa in our physically active non-clinical sample. Higher HeOr scores were associated with lower BMI, and this was true for both men and women. We also found that measures of Orthorexia were associated with self-reported physical activity: active adults reporting more aerobic physical activity had higher HeOr scores, with the most active men having the highest scores. Notably, adults who reported regular strength training had higher scores for both HeOr and OrNe, with men who strength trained showing higher OrNe scores than women. Here, those who participate in regular strength training are more likely to exhibit orthorexic behaviors, and this effect was more pronounced for men than women. Prior work has validated the TOS in young, primarily female samples of non-English speakers outside the United States: present data from an age-diverse, physically active, gender balanced sample support the use of TOS for measurement of Orthorexia Nervosa and Healthy Orthorexia in English speakers and suggest that more work is needed to assess potential gender differences in these constructs.

Food Beliefs and the Risk of Orthorexia in Patients with Inflammatory Bowel Disease.

Patients with inflammatory bowel disease (IBD) believe that diet plays a significant role in the pathogenesis of their disease and the exacerbation of their symptoms. They often adopt restrictive diets that can lead to malnutrition, anxiety, and stress. Recent studies have found a correlation between IBD and eating disorders, such as anorexia nervosa and ARFID (Avoidant Restrictive Food Intake Disorder). None of these studies report an association with orthorexia nervosa, which is an obsession with healthy and natural foods. The aim of this study was to assess the risk of orthorexia nervosa in patients with IBD. A total of 158 consecutive subjects were recruited, including 113 patients with IBD and 45 controls. The standardized Donini questionnaire ORTO-15 was administered to assess the risk of orthorexia, and clinical and demographic data were collected. The results showed that patients with IBD had a risk of developing orthorexia nervosa of 77%. This was significantly higher than the 47% observed in the control group. In the patients with IBD, the risk of orthorexia was associated with a lower BMI, at least in patients older than 30 years, and it was also associated with marital status in patients younger than 30. In conclusion, many patients with IBD are at increased risk of developing orthorexia nervosa, which may have a negative impact on their psychological wellbeing and social sphere, expose them to a high risk of nutritional deficiencies, and affect their overall quality of life. Further high-quality studies are needed to assess the clinical impact of orthorexia and its correlation with clinical features and classified eating disorders.

From Restriction to Intuition: Evaluating Intuitive Eating in a Sample of the General Population.

Intuitive eating (IE) is a non-dieting approach that promotes listening to internal cues of hunger and satiety, rather than adhering to external dietary restrictions aimed at weight loss. However, the role of IE in dieting behaviors related to weight-loss approaches is still unclear. To address this issue, the aim of this study was to compare IE levels between dieting and non-dieting individuals, exploring the relationship between IE and dieting-related psychological and physical factors. A sample of 2059 females was recruited via social media and self-reported questionnaires were administered to measure IE, eating psychopathology, self-efficacy, and quality of life. Individuals with a history of dieting exhibited lower IE levels, a higher BMI, and a greater eating psychopathology, as well as a reduced self-efficacy and quality of life, compared to non-dieters. IE showed a protective effect against dieting behaviors, with higher IE levels being associated with a lower likelihood of dieting. Additionally, higher BMI and eating psychopathology were predictors of dieting. Promoting IE could represent a relevant clinical target strategy to address disordered eating and enhance overall well-being, underscoring the need for interventions that foster a healthier relationship with food and bodily internal sensations.

Downloading appetite? Investigating the role of parasocial relationship with favorite social media food influencer in followers' disordered eating behaviors.

PURPOSE: Although a number of investigations have been carried out on the marketing outcomes of parasocial relationships (PSR) with food influencers on social media, little attention has been paid to the potential contribution of these one-sided emotional bonds to followers' eating attitudes and habits. Drawing on the Parasocial Theory, the role of parasocial attachment with food influencers was investigated in predicting eating disorders, food addiction, and grazing. To increase the accuracy of PSR measurement, a brief self-report scale was developed to gauge social media users' feelings of mutual awareness, attention, and adjustment with their favorite food influencer at a distance through social media. METHODS: Participants were a convenience sample of 405 Iranian social media users (231women; Mage = 28.16, SDage = 9.40), who followed a favorite food influencer on social media. RESULTS: The 8-item Parasocial Relationship with Favorite Food Influencer Scale (PSRFFIS) revealed a unidimensional structure with excellent content and construct validity and internal consistency. Regarding gender differences, men showed stronger parasocial attachment to their favorite food influencers. Adjusting age, gender, and subjective social status as control variables, PSR with favorite food influencers partially contributed to the explanation of eating disorder symptom severity, food addiction, and grazing. CONCLUSION: These findings show that PSR with favorite food influencers appears to be associated with followers' craving for food, which, in turn, may contribute to maladaptive eating habits. This highlights media-related factors, such as PSR with food influencers, as potential drivers of dysfunctional eating habits in the digital age, particularly in countries like Iran where disordered eating is prevalent. LEVEL OF EVIDENCE: Level V-based on cross-sectional data (correlational study; scale development).