Developing the "single-session mindset" in eating disorder research: Commentary on Schleider et al., 2023 "Realizing the untapped promise of single-session interventions for eating disorders".

Schleider and colleagues' paper on the application of single-session interventions (SSIs) to eating disorders is timely given the broader focus in mental health on flexible approaches to delivering support at the time the person needs it most. The eating disorder field needs to embrace these innovations including developing a "single-session mindset" with greater attention paid to testing the relevance of SSI for eating disorders. The use of well-powered trials of brief, focused and rapidly scalable interventions is an ideal vehicle for generation and evaluation of new and longer interventions. Our future research agenda needs to carefully consider our target audience, the primary outcome variable of most relevance, and the SSI topic that would be most likely to effect change. Research in prevention might focus on weight concern and evaluation of SSIs that focus on self-compassion or cognitive dissonance related to appearance ideals in the media. Work in early intervention could target denial and disordered eating using SSIs on growth mindset, behavioral activation, and imagery rescripting. Treatment waitlists provide another suitable opportunity, evaluating SSIs that aim to increase hope for change, treatment retention, and kick start early change in therapy, a robust predictor of better treatment outcome.

Mindfulness, disordered eating, and impulsivity in relation to glycemia among adolescents with type 1 diabetes and suboptimal glycemia from the Flexible Lifestyles Empowering Change (FLEX) intervention trial.

OBJECTIVE: To assess the relationship between mindfulness and glycemia among adolescents with type 1 diabetes (T1D) with suboptimal glycemia, and evaluate the potential mediation by ingestive behaviors, including disordered eating, and impulsivity. RESEARCH DESIGN AND METHODS: We used linear mixed models for hemoglobin A1c (HbA1c) and linear regression for continuous glucose monitoring (CGM) to study the relationship of mindfulness [Child and Adolescent Mindfulness Measure (CAMM)] and glycemia in adolescents with T1D from the 18-month Flexible Lifestyles Empowering Change (FLEX) trial. We tested for mediation of the mindfulness-glycemia relationship by ingestive behaviors, including disordered eating (Diabetes Eating Problem Survey-Revised), restrained eating, and emotional eating (Dutch Eating Behavior Questionnaire); and impulsivity (total, attentional, and motor, Barrett Impulsiveness Scale). RESULTS: At baseline, participants (n = 152) had a mean age of 14.9 ± 1.1 years and HbA1c of 9.4 ± 1.2% [79 ± 13 mmol/mol]. The majority of adolescents were non-Hispanic white (83.6%), 50.7% were female, and 73.0% used insulin pumps. From adjusted mixed models, a 5-point increase in mindfulness scores was associated with a -0.19% (95%CI -0.29, -0.08, p = 0.0006) reduction in HbA1c. We did not find statistically significant associations between mindfulness and CGM metrics. Mediation of the relationship between mindfulness and HbA1c by ingestive behaviors and impulsivity was not found to be statistically significant. CONCLUSIONS: Among adolescents with T1D and suboptimal glycemia, increased mindfulness was associated with lower HbA1c levels. Future studies may consider mindfulness-based interventions as a component of treatment for improving glycemia among adolescents with T1D, though more data are needed to assess feasibility and efficacy.

Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link.

Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanisms overlying the interaction including environmental and individual ones, and different are the approaches to reduce the consequences. Evidence-based treatments for obesity and eating disorders in childhood include as first line approaches weight loss with nutritional management and lifestyle modification via behavioral psychotherapy, as well as treatment of psychiatric comorbidities if those are not a consequence of the eating disorder. Drugs and bariatric surgery need to be used in extreme cases. Future research is necessary for early detection of risk factors for prevention, more precise elucidation of the mechanisms that underpin these problems and, finally, in the cases requiring therapeutic intervention, to provide tailored and timely treatment. Collective efforts between the fields are crucial for reducing the factors of health disparity and improving public health.

[Nutritional education protocol in the treatment of eating disorders in the clinical and care settings]. / Protocolo de educación nutricional en el tratamiento de los trastornos de la conducta alimentaria en el ámbito clínico y asistencial.

INTRODUCTION: Nutrition education (NE), as part of the treatment of eating disorders (EDs), plays a crucial role in helping patients to change their food attitudes and routines, lose fears, and recover a healthy eating pattern. All these changes may contribute to improving their nutritional status. However, there is a lack of consensus and standardization concerning the procedures to teach it. This work's objective was to elaborate a consensual protocol for NE implementation in the treatment of EDs to help in decision-making regarding which patients are appropriate candidates to receive NE, the agents (family, school community) and professionals involved, and the areas in the healthcare system that are best suited for implementation. Moreover, it would help in selecting the the topics to be imparted, and in following up treatment progression.

INTRODUCCIÓN: La educación nutricional (EN), dentro del tratamiento de los trastornos de la conducta alimentaria (TCA), juega un papel fundamental ya que contribuye a que el paciente modifique sus actitudes y rutinas en relación con la comida, pierda miedos y restablezca un patrón de alimentación saludable, favoreciendo de este modo su recuperación nutricional. Sin embargo, existe falta de consenso y estandarización acerca de los procedimientos para llevarla a cabo. El objetivo de este trabajo es elaborar un protocolo consensuado de EN en el contexto del tratamiento de los TCA que permita ayudar a la toma de decisiones sobre: los pacientes candidatos a recibirla, los agentes (familia, comunidad escolar) y profesionales implicados, los ámbitos de implementación de la intervención, la información sobre los pacientes que es necesario conocer, los temas, objetivos y contenidos a trabajar, y la necesidad de evaluación de la progresión del paciente y los programas desarrollados.

A Systematic Review of Scientific Studies on the Effects of Music in People with or at Risk for Eating Disorders.

BACKGROUND: The prevalence of the three main eating disorders (EDs) anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) is increasing, and a growing number of patients with EDs is seeking professional help. Thus, there is a need for additional treatment strategies in EDs. The aim of this review was to summarize the literature on the benefits and risks of music as well as the evidence for its therapeutic application in people with EDs. METHODS: Following the PRISMA guidelines, we performed a systematic literature review on scientific studies on the effect of music in people with or at risk for EDs using PubMed and the Web of Science database. The search terms used were: "music", "music therapy", "eating disorders", "anorexia nervosa", "bulimia nervosa" and "binge eating disorder". RESULTS: 16 out of 119 identified and screened articles qualified as scientific studies involving a total of 3,792 participants. They reported on the use of music or music therapy in individuals with or at risk of AN and BN, but not BED. In inpatients with AN, listening to classical music was beneficial to food consumption. Singing in a group reduced post-prandial anxiety in AN inpatients and outpatients. Vodcasts which also included positive visual or autobiographical stimuli helped BN patients with anxiety and body image perception. Songwriting and sessions with a Body Monochord helped with the processing of therapeutically relevant topics in AN. Watching music videos, however, reinforced body dissatisfaction, drive for thinness, bodyweight concerns, preoccupation with physical appearance in pre-teenage and teenage girls, and drive for muscularity in adolescent boys. CONCLUSIONS: These findings suggest that the therapeutic application of music may be beneficial in patients with AN and BN. However, the availability of studies with a rigorous randomized controlled trial (RCT) design is scarce.

Eating disorders, embodiment, and yoga: a conceptual overview.

Yoga and its relation to embodiment and disordered eating has only recently received research attention. Nevertheless, early research indicates that yoga is an effective tool in the prevention and treatment of eating disorders. It is assumed that yoga ameliorates eating disorder symptoms and facilitates a shift from negative towards positive body image and well-being by cultivating positive embodiment (i.e., the ability to feel a sense of connection between mind and body). In order to provide the context of the constructs of disordered eating, embodiment, and yoga, this article presents a brief overview and conceptualization of these constructs. The three major eating disorders and current treatment methods are described. Further, the philosophical roots and theoretical models of embodiment are delineated and their communal core features are outlined. Lastly, the origin, basic principles, and modern interpretations of yoga are discussed.

Online imagery rescripting among young women at risk of developing an eating disorder: A randomized controlled trial.

OBJECTIVE: This study compared the effectiveness of two approaches to imagery rescripting (body versus general) among young women with an elevated risk of developing an eating disorder. METHOD: University students (N = 130 females) were randomly assigned to one of the four conditions: body or general imagery rescripting, psychoeducation, control. After initial brief laboratory training delivered online, participants in the imagery rescripting conditions were asked to practice imagery rescripting for 5 min each day for a week. Primary (global eating psychopathology, eating disorder behaviors, and body image acceptance) and secondary outcomes (self-compassion, fear of self-compassion, and dysfunctional attitudes) were measured at baseline and one-week follow up. RESULTS: Completer analyses showed both imagery rescripting conditions and psychoeducation had significant impact on global eating psychopathology and body acceptance (d = 0.60-0.78). Psychoeducation did not impact secondary variables, whereas body imagery rescripting improved self-compassion and fear of self-compassion (d = 0.61-0.80) and general imagery rescripting improved dysfunctional attitudes (d = 0.82) compared to control. Intent to treat analyses had similar but slightly less robust results. DISCUSSION: While three active groups had significant impact on the primary variables, imagery rescripting approaches had impact on other variables that maintain disordered eating. Future research should investigate the impact of combining psychoeducation and imagery rescripting in terms of impact on disordered eating.

Eating behaviours related to psychological stress are associated with functional hypothalamic amenorrhoea in exercising women.

Functional hypothalamic amenorrhoea (FHA) can occur due to the independent or combined effects of psychogenic and energetic stressors. In exercising women, research has primarily focused on energy deficiency as the cause of FHA while psychological stressors have been ignored. To assess both psychological and metabolic factors associated with FHA in exercising women, we performed across-sectional comparison of 61 exercising women (≥2 hours/week, age 18-35 years, BMI 16-25kg/m2), who were eumenorrheic or amenorrhoeic confirmed by daily urine samples assayed for reproductive hormone metabolites. Psychological factors and eating behaviours were assessed by self-report questionnaires. Exercising women with FHA had lower resting metabolic rate (p=0.023), T3 (p<0.001), T4 (p=0.013), leptin (p=0.002), higher peptide YY (p<0.001), greater drive for thinness (p=0.017), greater dietary cognitive restraint (p<0.001), and displayed dysfunctional attitudes, i.e., need for social approval (p=0.047) compared to eumenorrheic women. Amenorrhoeic women displayed asignificant positive correlation between the need for social approval and drive for thinness with indicators of stress, depression, and mood, which was not apparent in eumenorrheic women. In exercising women with FHA, eating behaviours are positively related to indicators of psychological stress and depression.

A brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating: a feasibility study.

AIM: To examine the feasibility and acceptability of a brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating behaviour. METHODS: Twenty-seven adolescents with type 1 diabetes were recruited and randomized to receive the brief (two 2.5-h sessions) self-compassion intervention, either in the intervention group (n=11) or in a waitlist control group (n=8). The intervention was adapted from the standardized eight-session 'Making Friends with Yourself' programme, and sessions were delivered 1 week apart. Acceptability was assessed through qualitative questionnaires and feasibility was assessed based on session attendance and recruitment metrics. Possible changes to disordered eating behaviour, self-care behaviours, diabetes-related distress, self-compassion, stress and glycaemic control were also assessed. RESULTS: Nineteen participants completed the study, and they reported an increased sense of common humanity (acknowledging that we are not alone), mindfulness, and coping resources. In terms of feasibility, recruitment took longer than expected (8 months) and not all participants were able to attend both sessions (nine could only attend one of the two sessions). CONCLUSIONS: While self-compassion is a strong conceptual fit for the issues of type 1 diabetes and disordered eating behaviour in adolescence, and the intervention content appears acceptable, feasibility issues were such that brief self-compassion programmes will probably need to be adapted into digital interventions for future research. (Trial registration number: ANZCTR 12619000541101).

Effects of Mindfulness-Based Intervention on the Treatment of Problematic Eating Behaviors: A Systematic Review.

Objectives: Emerging research interest focused on mindfulness-based interventions (MBIs) as a complementary approach for the treatment of problematic eating behaviors. This systematic review aims to comprehensively evaluate current evidence from randomized-controlled trials (RCTs) that have used the MBIs as the treatment for problematic eating concerns. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method for systematic reviews, electronic databases, including Ovid MEDLINE, Ovid Embase, AMED, Web of Knowledge, PsycINFO, Scopus, and The Cochrane Library, were systematically searched to identify up to June 2017. Hand search of the reference lists of related systematic reviews was also conducted for detecting additional studies. Eligible studies were RCTs that employed MBIs as the primary intervention for people with problematic eating or body image concerns. Results: A total of nine RCTs were included in this systematic review. In the majority of included studies, participants in MBI groups showed significant reduction in emotional eating, external eating, binge eating, and weight and shape concern. Findings also suggest that increasing mindful awareness of internal experiences and automatic patterns could be effective for the improvement of self-acceptance and emotional regulation, thereby reducing the problematic eating behaviors. Conclusion: This systematic review advances the understanding of MBIs as an complementary approach for problematic eating behavior treatment. Despite the variable trial qualities and some small sample sizes, this study provides initial evidence supporting the efficacy of the application of MBIs to a range of problematic eating concerns. The application of MBIs remains a promising approach for the treatment of problematic eating and merits further investigations.

A yoga-based therapy program designed to improve body image among an outpatient eating disordered population: program description and results from a mixed-methods pilot study.

Poor body image is a critical barrier to eating disorder recovery. This pilot project was designed as a feasibility study to examine a novel group-based, therapeutic yoga and body image program (YBI) for addressing negative body image in those clinically diagnosed with an eating disorder (anorexia, bulimia nervosa, and other specified feeding or eating disorder) receiving outpatient level treatment at an eating disorder treatment center located in Minneapolis-St. Paul, Minnesota. Self-administered questionnaires were completed by 67 participants at the beginning and end of the 8-week series, to better understand the acceptability of the YBI program and its potential effects on body image and self-worth during outpatient eating disorder treatment. Quantitative survey questions assessed participants' body image concerns, while open-ended questions probed participants' experiences and the perceived impact of the yoga program on their body image. After completion of the yoga program, mean item scores on the body image concern survey improved: increases ranged from 0.3 to 0.8 points on a 5-point scale. In open-ended questions, participants described many positive changes to their body image. Participants reported that the yoga program improved their self-acceptance, self-awareness, confidence, emotional and physical strength, and was a positive form of release. Participants also discussed physical and emotional challenges of the yoga program and how they contributed to self-judgment, vulnerability, and confrontation of uncomfortable feelings. The results of this pilot study are promising and warrant consideration of more rigorous study designs to explore the potential of a body image specific therapeutic yoga program to aid those in eating disorder treatment to improve body image disturbances.

Use of dietary supplements among nursing students in Turkey in the last 12 months and its relation with orthorexia nervosa.

PURPOSE: This study was aimed at investigating the use of dietary supplements among nursing students in Turkey in the last 12 months and its relation with orthorexia nervosa (ON). DESIGN AND METHODS: This cross-sectional study was conducted in Balikesir, a province in northwestern Turkey, between November and December 2019 included 560 nursing students. FINDINGS: Almost a fifth of the students had used dietary supplements in the last 12 months and the use of dietary supplements was associated with ON. PRACTICE IMPLICATIONS: Students should be screened for ON symptoms and attempts to reduce ON symptoms in students at risk should be implemented.

Mindfulness and eating disorder psychopathology: A meta-analysis.

OBJECTIVE: Mindfulness is implicated in eating disorder (ED) psychopathology. However, this literature has not been synthesized to date. The current meta-analysis examined the associations between mindfulness and ED psychopathology. METHODS: A total of 74 independent samples (effects = 576) were included. We used a multilevel random-effects model to estimate summary study-level effect sizes, and multilevel mixed-effects models to examine moderator effects. RESULTS: Mindfulness was negatively associated with ED psychopathology (r = -.25, p < .001), both concurrently (r = -.25, p < .001) and prospectively (rs = -.22 to -.24, ps < .001). Associations were strongest for binge eating, emotional/external eating, and body dissatisfaction as well as the acting with awareness and nonjudging facets. DISCUSSION: Mindfulness may be an important process in ED psychopathology. Future research should prospectively and experimentally examine the relation between mindfulness and ED psychopathology.

OBJETIVO: La atención plena (mindfulness) está implicada en la psicopatología de los trastornos de la conducta alimentaria (TCA). Sin embargo, esta literatura no ha sido sintetizada a la fecha. El presente meta-análisis examinó las asociaciones entre la atención plena y la psicopatología de los TCA. MÉTODOS: Se incluyeron un total de 74 muestras independientes (efectos = 576). Utilizamos un modelo de efectos aleatorios multinivel para estimar la síntesis de los tamaños de efecto por nivel de estudio, y los modelos de efecto mixto multinivel para examinar los efectos moderadores. RESULTADOS: La atención plena fue asociada negativamente con la psicopatología de TCA (r = −.25, p < .001), tanto concurrentemente (r = −.25, p < .001) como prospectivamente (rs = −.22-−.24, ps < .001). Las asociaciones fueron más fuertes para trastorno por atracón, alimentación emocional/externa, e insatisfacción corporal, así como también el actuar con conciencia y sin juzgar las facetas. DISCUSIÓN: La atención plena (mindfulness) puede ser un proceso importante en la psicopatología de los TCA.

Labels to prevent the detrimental effects of media on body image: A systematic review and meta-analysis.

OBJECTIVE: Most advertisements contain thin-ideal imagery enhanced by digital modification. The deleterious effects on body image and eating disorder risk of exposure to such images have been well documented. One of the proposed macro-level solutions to mitigate these effects has been the use of labels on images, primarily disclaimer labels. A growing number of studies have explored the usefulness of such labels in protecting body image against the detrimental effects of media exposure; however, findings have been divergent. METHODS: The current study aimed to conduct a systematic review and meta-analysis of the existing literature investigating the effects of including labels on media images on body image. RESULTS: The systematic review identified n = 22 studies that were included in a narrative review, n = 18 were included in the meta-analysis. Overall, findings provided little support for the use of disclaimer or warning labels as a means of protecting against the detrimental effects of media exposure on body image. Furthermore, findings suggested that such labels might increase state appearance comparison when exposed to media images. DISCUSSION: These findings are especially concerning in light of recent legislative efforts to mitigate media effects through the use of labels on imagery, as well as industry initiatives based on image labeling. Additional research examining alternative strategies for universal prevention of body image and eating concerns is warranted.

La mayoría de las imágenes de los anuncios publicitarios presentan una figura ideal delgada que ha sido retocada digitalmente. Los efectos nocivos en la imagen corporal y el riesgo de trastorno alimentario por la exposición a dichas imágenes han sido bien documentados. Una de las soluciones a gran escala que se han propuesto para mitigar estos efectos ha sido el uso de etiquetas en las imágenes, básicamente etiquetas de exención de responsabilidad. Un número creciente de estudios ha explorado la utilidad de dichas etiquetas para proteger la imagen corporal contra los efectos perjudiciales de la exposición a los medios de comunicación; sin embargo, los hallazgos han sido divergentes. El presente estudio tuvo como objetivo realizar una revisión sistemática y un meta-análisis de la literatura existente que investiga los efectos de incluir estas etiquetas en las imágenes sobre imagen corporal en los medios de comunicación. La revisión sistemática identificó n = 22 estudios que se incluyeron en una revisión narrativa, n = 18 se incluyeron en el meta-análisis. En general, los hallazgos proporcionaron poco soporte para el uso de descargos de responsabilidad o etiquetas de advertencia como un medio de protección contra los efectos perjudiciales de la exposición de los medios en la imagen corporal. Además, las investigaciones han demostrado que dichas etiquetas pueden aumentar la comparación al ser expuestas a las imágenes mediáticas. Estos hallazgos son especialmente preocupantes a la luz de los recientes esfuerzos legislativos para mitigar los efectos de los medios mediante el uso de etiquetas en las imágenes, así como las iniciativas de la industria basadas en el etiquetado de imágenes. Se justifica una investigación adicional que examine las estrategias alternativas para la prevención universal de la imagen corporal y las preocupaciones alimentarias.

Body image, self-esteem, and behavioral risk for chronic disease among college students: Additional evidence for integrated prevention.

Objective: To examine associations between two body image constructs (body appreciation and body satisfaction) and five health behaviors (diet, physical activity, weight management, tobacco exposure, and alcohol intake) associated with risk for chronic disease, controlling for self-esteem. Participants: Three hundred and forty-four college students enrolled at a large, public university in the southeastern US. Methods: Students completed an online survey composed of measures of body appreciation, body satisfaction, self-esteem, and frequency of engagement in preventive health behaviors. Hierarchical linear regression models were used to assess relationships between constructs. Results: Body appreciation, but not body satisfaction or self-esteem, significantly and positively predicted engagement in diet-, physical activity-, and weight-related health behaviors. No associations were found for substance use outcomes. Conclusions: Results illuminate health risks among college students and provide additional evidence to support the development of holistic preventive interventions that simultaneously address aspects of mental and physical health among college students.

Interventions for Feeding and Swallowing Disorders in Adults with Intellectual Disability: A Systematic Review of the Evidence.

Feeding and swallowing disorders are prevalent in adults with Intellectual Disability (ID) and can potentially lead to discomfort, malnutrition, dehydration, aspiration, and choking. Most common interventions include: diet modification, compensatory strategies, swallowing therapy, and non-oral feeding. Despite their common use, the research evidence for these interventions is lacking. The current study aimed to systematically review the evidence for the safety and the effectiveness of interventions for feeding and swallowing disorders in adults with ID. Seven electronic databases, conference proceedings, and reference lists of relevant studies were reviewed from online availability to March 2019, with no language restrictions. Eligibility criteria encompassed experimental or non-experimental study design, adults (> 18 years) with ID and feeding and/or swallowing disorders (any etiology and severity) and any intervention for feeding and/or swallowing disorders. Methodological quality was assessed by two independent reviewers using the Downs and Black checklist. Four articles met the inclusion criteria. All included studies considered enteral feeding as an intervention strategy and had a retrospective observational design. Overall, included studies reported positive change in nutritional status and a high incidence of adverse events following enteral feeding initiation. Risk of bias was high with variability in methodological quality. The safety and effectiveness of interventions for feeding and swallowing in adults with ID is unclear. This review highlights the lack of evidence-based practice in this area. Directions for further research are provided. Before enteral feeding initiation, risks and benefits should be appropriately balanced on an individual basis, and caregivers should be involved in the decision-making process.

An exploratory study of experiences with conventional eating disorder treatment and ceremonial ayahuasca for the healing of eating disorders.

PURPOSE: Ayahuasca is a traditional Amazonian medicine that is currently being researched for its potential in treating a variety of mental disorders. This article reports on exploratory qualitative research relating to participant experiences with ceremonial ayahuasca drinking and conventional treatment for eating disorders (EDs). It also explores the potential for ayahuasca as an adjunctive ED treatment. METHODS: Thirteen individuals previously diagnosed with an ED participated in a semi-structured interview contrasting their experiences with conventional ED treatment with experiences from ceremonial ayahuasca. The interviews were analyzed using thematic analysis. RESULTS: Participant reports were organized with key themes including that ayahuasca: led to rapid reductions in ED thoughts and symptoms; allowed for the healing of the perceived root of the ED; helped to process painful feelings and memories; supported the internalization of greater self-love and self-acceptance; and catalyzed spiritual elements of healing. CONCLUSIONS: The results suggest that ayahuasca may have potential as a valuable therapeutic tool, and further research-including carefully controlled clinical trials-is warranted. LEVEL OF EVIDENCE: Level V, qualitative descriptive study.

Yoga Practice in a College Sample: Associated Changes in Eating Disorder, Body Image, and Related Factors Over Time.

Yoga practice is associated with improvements in eating disorder (ED) symptoms and body dissatisfaction. This study continued to evaluate this relationship while also assessing changes in variables negatively associated with ED symptoms (self-compassion, mindfulness, body appreciation, self-efficacy) that are emphasized throughout yoga. Men were also included in this study given studies have predominantly focused on women. Participants (N = 99, 77.8% women) were recruited from a university-implemented yoga course and completed assessments at the beginning (Time 1 (T1)) and end (Time 2 (T2)) of an eight-week yoga course meeting three times a week for fifty minutes. Body dissatisfaction (ps <.05) and ED pathology (p = .02) were lower at T2. Body appreciation (p < .001), self-compassion (p = .01), yoga self-efficacy (p = .004) were higher at T2. Some gender differences emerged. Men reported greater reductions in concern with being overweight, (Overweight Preoccupation) from T1 (M = 2.46, SD = 0.61) to T2 (M = 2.13, SD = 0.61) compared to women, T1 (M = 2.75, SD = 0.98) to T2 (M = 2.69, SD = 0.97) associated with yoga practice. Men also reported greater improvements in body satisfaction (Appearance Evaluation) from T1 (M = 3.60, SD = 0.49) to T2 (M = 3.90, SD = 0.34) compared with women, T1 (M = 3.48, SD = 0.58) to T2 (M = 3.39, SD = 0.52) associated with yoga practice. Results suggest yoga may be associated with concurrent changes in protective and risk factors for ED in a college population.

Can Participants' Characteristics Predict Benefit from a Multimodal Burnout Prevention Program? Secondary Analysis of a Randomized Controlled Trial Conducted in Germany.

Chronic psychological distress appears to be increasing markedly among the working population. A recent randomized controlled trial (RCT) supported the effectiveness of a three-week outpatient burnout prevention program-comprised of stress management interventions, relaxation, physical exercise, and moor baths followed by massage-in reducing perceived stress and emotional exhaustion. However, the effectiveness of treatments in the real world that were shown to be efficacious in RCTs is related to the appropriate selection of individuals who are most likely to yield sustainable gains. Therefore, factors predicting the intensity of response and nonresponse of individuals to treatment are of interest. This secondary data analysis aims to explore predictors of response to the outpatient burnout prevention program in a sample of eighty employed persons at high risk of burnout. Hierarchical linear regression was performed to identify predictors of successful response-defined by lower perceived stress at last follow up. Nutritional behavior, symptoms of eating disorder syndrome, and well-being were significant predictors of perceived stress at last follow up, when adjusted for age, sex, education level, baseline stress values, and timing of intervention. Persons with low levels of well-being, poor nutritional behavior, and higher symptoms of eating disorders should be given special care and attention to ensure that they respond well to the outpatient burnout prevention program.

The effects of bariatric surgery on psychological aspects of eating behaviour and food intake in humans.

Bariatric surgery has emerged as an increasingly popular weight loss intervention, with larger and more endurable weight loss compared to pharmacological and behavioural interventions. The degree of weight loss patients experience varies, between individuals, surgeries and over time. An explanation as to why differing weight loss trajectories exist post-surgery could be due to the complex interplay of individual differences in relation to eating behaviours and appetite. Thus the aim of this narrative review is to explore literature between 2008 and 2018, to assess the impact of impact of bariatric surgery on food selection and nutrient status, on eating behaviour traits and on disturbed and disordered eating behaviour, to determine their impact of weight loss success and weight loss trajectories. Immediately post-surgery, up until 1-2 years post-surgery, there is a reliance upon the surgery's alteration of the gastrointestinal tract to control food intake and subsequently lose weight. Energy intake is reduced, dietary adherence is higher, supplement intake is higher, appetite ratings are lower, there is a reduction in psychopathology, and an increase in wellbeing. After this point, patients become more susceptible to weight regain, as this is the point where passive observation of the weight reducing action of surgery, moves into more cognitive effort, on the part of the individual, to control energy intake. There are various factors which influence an individual's ability to successfully regulate their energy intake post-surgery, such as their level of Disinhibition, Restraint, Hunger, Emotional Eating, Uncontrolled Eating, psychopathology and wellbeing. The need for continued psychological and nutritional support post-surgery is necessary to reduce weight regain susceptibility.