Sex and Body Mass Index differences after one-year follow-up of an eating disorders risk factors universal prevention intervention in university students in Mexico City / Diferencias por sexo e índice de masa corporal a un año de seguimiento de una intervención de prevención universal para disminuir factores de riesgo para los trastornos de la conducta alimentaria en estudiantes universitarios de la Ciudad de México

Abstract Introduction Interventions based on cognitive dissonance theory are the most effective for preventing eating disorders. Objective To identify the changes at one year follow-up of a universal prevention intervention in disordered eating behaviors (DEB), thin-ideal internalization (TII), and drive for muscularity (DM). Method A pre-experimental, pretest-posttest study was conducted on 602 university student subjects (76.1% women and 23.9% men) with an average age of 20.74 years at a public (30.6%) and a private university (69.4%) in Mexico City. A Split Plot ANOVA was performed with the intrasubject variable equal to each measurement (pretest, posttest, and follow-up), as well as the sex and body mass index (BMI) intersubject variables to analyze whether there was a significant interaction between these variables and the changes in dependent variables, as well as the changes through each measurement by group. Results In the intrasubject analyses, statistically significant differences were found for DEB through the various measurements, without taking the interactions into account. Statistically significant interactions were observed between each measurement and BMI, and between each measurement and sex and BMI for the DM variable. Discussion and conclusion Since a reduction of TII in women and DM in men was achieved, together with a decrease in DEB in women, the workshop can be said to have fully achieved its objectives for women and partly so for men.

Resumen Introducción Las intervenciones basadas en la teoría de la disonancia cognoscitiva son las más efectivas para la prevención de los trastornos de la conducta alimentaria. Objetivo Conocer los cambios a un año de seguimiento de una intervención de prevención universal en las conductas alimentarias de riesgo (CAR), interiorización del ideal estético de la delgadez (IED) y la motivación por la musculatura (MM). Método Se llevó a cabo un estudio pre-experimental pretest-postest en 602 (76.1% mujeres y 23.9% hombres) sujetos estudiantes universitarios con una edad promedio de 20.74 años en una universidad pública (30.6%) y una privada (69.4%) de la Ciudad de México. Se realizó un ANOVA split plot con la variable intrasujetos igual a cada medición (pretest, postest y seguimiento) así como el sexo y el índice de masa corporal (IMC) variables intersujetos, para analizar si existía una interacción significativa entre dichas variables y los cambios sobre las variables dependientes, así como los cambios a través de cada medición por grupo. Resultados en los análisis intrasujetos se encontraron diferencias estadísticamente significativas para las CAR a través de las distintas mediciones, sin tomar en cuenta las interacciones. Se observaron interacciones estadísticamente significativas entre cada medición y el IMC, y entre cada medición con el sexo y el IMC para la variable MM. Discusión y conclusión Se logró la reducción de la IED en las mujeres y de la MM en los hombres, así como la disminución de las CAR en las mujeres por lo que se considera que el taller logra sus objetivos para las mujeres y parcialmente para los varones.

Validation of a new screening questionnaire for disordered eating behaviors in men.

PURPOSE: The aim of this study was to develop an instrument to identify disordered eating behaviors (DEB) in college men (hereafter, DEBM-Q). METHODS: A two-stage project consisting of a diagnostic scale construction (n1 = 9 for interviews, n2 = 9 for cognitive laboratory) and a validation study with a cross-sectional sample (N = 570) was carried out. Both semi-structured interviews and a cognitive laboratory with nine participants were conducted to obtain DEBM-Q items. DEBM-Q was applied to 570 freshmen male in Mexico City. Psychometric characteristics and internal consistency (Cronbach's alpha) were analyzed. An item-total correlation value greater than 0.30 was determined, and factor loads greater than 0.40 were considered valid. Exploratory factor analysis (EFA, n1 = 297) and confirmatory factor analysis (CFA, n2 = 273) were performed. RESULTS: Two fixed factors explaining 55.08% of the total variance were extracted. Factor 1, "Drive for Thinness" (8 items), explained 30.84% of the variance, whereas factor 2, "Drive for Muscularity" (8 items), explained 24.23% of the variance. Cronbach's alpha for the whole questionnaire was 0.84. DEBM-Q was correlated with the Dutch Food Restriction Scale (RS) (r = 0.52, p < 0.001), Eating Disorder Examination-Questionnaire (EDE-Q) (r = 0.46, p < 0.001), Emotional Eating Scale (EES) (r = 0.18, p < 0.001), and Negative Affect Subscale (PANAS-X) (r = 0.11, p < 0.005). CONCLUSION: DEBM-Q is a valid and practical short screening tool (16 items) allowing early identification of disordered eating in young men, thereby facilitating clinical management. LEVEL OF EVIDENCE: Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Parental negative weight/shape comments and their association with disordered eating behaviors: A systematic review / Comentarios negativos paternos acerca de peso/forma corporal y su asociación con las conductas alimentarias de riesgo: Una revisión sistemática

Abstract The purpose of this study was to find the association between receiving negative parental weight and shape comments, and the presence of disordered eating behaviors (DEBs) in young adults. A systematic review was conducted answering the following PECO question: Population / young adults; Exposure / negative comments, criticism or teasing about weight and shape by parents; Comparison groups / not applicable; and Outcome / DEBs. Due to the use of different statistical measurements, a narrative was chosen to present the results. An association between negative comments and DEBs was found in male and female university students. Women reported more negative comments, higher body dissatisfaction and DEBs than men. Body dissatisfaction was found as a mediator of negative comments and DEBs, and sex as a moderator between body dissatisfaction and DEBs. The results have implications for the influence social pressure has on the internalization of the thin-ideal and on body dissatisfaction as risk factors for the development of disordered eating behaviours.

Resumen El objetivo de este estudio fue examinar la asociación entre ser receptor de comentarios negativos paternos acerca del peso y la figura corporal, y la presencia de conductas alimentarias de riesgo (CAR) en adultos jóvenes. Se llevó a cabo una revisión sistemática respondiendo a la pregunta PECO siguiente: Población / adultos jóvenes; Exposición / comentarios negativos, críticas o ridiculización por parte de los padres por el peso y la figura corporal; Comparación / no aplicó; y Resultado / CAR. Debido a las diferentes medidas estadísticas utilizadas, se eligió un formato narrativo para presentar los resultados. Estos indicaron asociación entre los comentarios negativos paternos y las CAR en hombres y mujeres estudiantes universitarios. Las mujeres reportaron recibir más comentarios negativos, así como presentar mayor insatisfacción corporal y CAR que los hombres. Entre los comentarios negativos y las CAR se encontró como mediadora a la imagen corporal, y al sexo como un moderador entre la insatisfacción corporal y las CAR. Los resultados tienen implicaciones acerca de la influencia de la presión sociocultural en la interiorización del ideal estético de delgadez y de la insatisfacción corporal como factores de riesgo para el desarrollo de CAR.

Dissonance-based Program for Eating Disorders Prevention in Mexican University Students / Un programa de prevención de los trastornos de la conducta alimentaria basado en la técnica de disonancia cognitiva en alumnos universitarios mexicanos

The purpose of this study was to identify changes in the risk of eating disorders after a one-year follow-up of a dissonance-based eating disorders prevention program. The Body Project was implemented in a sample of male and female university students: 133, 110, and 74 at baseline, post-test, and follow-up respectively, and we tested the change in disordered eating behaviors (DEB) over time, and by levels of variables that according to the theoretical model lie on the path between the intervention and DEB, with one-way MANOVA analyses of repeated measures for the associations between internalization of the esthetic thin ideal, depressive symptoms, and DEB. The average value of DEB was 5.23 at pre-test, 3.45 at post-test, and 2.80 at follow-up. The model with DEB at each time point, as dependent variables, and internalization of the esthetic thin ideal and depressive symptoms, as independent variables, showed a significant effect of internalization of the esthetic thin ideal, F(2, 136) = 7.66, p = .0011, while there was no significant effect of depressive symptoms, F(2, 136) = 0.45, p = .6191, indicating that the intervention exerted its effect on DEB via the former variable. The intervention proved to produce effects after a one-year follow-up. These findings support the implementation of universal prevention programs using dissonance-based techniques

El objetivo de este trabajo fue identificar los cambios en el riesgo de desarrollar trastornos de la conducta alimentaria después de un año de seguimiento de un programa de prevención basado en la técnica de la disonancia cognitiva para trastornos de la conducta alimentaria. El Body Project fue implementado en una muestra de estudiantes universitarios, hombres y mujeres: 133, 110 y 74 en el pre-test, post-test y seguimiento, respectivamente. Se comprueba el cambio en las conductas alimentarias de riesgo (CAR) a lo largo del tiempo y según las variables que, de acuerdo con el modelo teórico, se encuentran entre la intervención y las CAR, con un análisis MANOVA de medidas repetidas para las asociaciones entre interiorización del ideal estético de delgadez, los síntomas depresivos y las CAR. El valor promedio de las CAR en el pre-test fue 5.23, 3.45 en el post-test y 2.80 en el seguimiento. El modelo de las CAR como variable dependiente e interiorización del ideal estético de delgadez y los síntomas depresivos como variables independientes mostró un efecto significativo de la internalización del ideal estético de delgadez, F(2, 136) = 7.66, p = .0011, mientras que no hubo un efecto significativo de los síntomas depresivos, F(2, 136) = 0.45, p = .6191, lo que indica que la intervención tuvo un efecto en las CAR por vía de la variable antecedente. Se mostró que la intervención produce efectos después de un año de seguimiento. Este hallazgo sustenta la implementación de programas universales de prevención que utilicen la técnica de disonancia cognoscitiva

Validation of eating disorders examination questionnaire in Mexican women.

BACKGROUND: Efficient assessment of eating disorders (ED) is indispensable for research and clinical practice in Mexico. One of the most commonly used questionnaires, the EDE-Q, has a self-applicable questionnaire format with 28 questions and four subscales drawn from the Eating Disorder Examination (EDE), a semistructured interview developed to evaluate the specific symptomatology of eating disorders. OBJECTIVE: Obtain the factorial structure and construct validity of the EDE-Q questionnaire in Mexican women. METHOD: The language in the EDE-Q was adapted. It was applied to university students (N = 330) and a sample of patients with ED (N = 165) from two ED outpatient treatment services. The anthropometric data of the participants was obtained. Internal consistency was explored using the Cronbach's Alpha coefficient and a confirmatory factor analysis was conducted by group. RESULTS: Cronbach's alpha was 0.9 for the full scale in all groups, while the reliability of each of the subscales fluctuated between 0.8 and 0.9. Confirmatory factor analysis showed that the fit of the seven-item model in three factors was better than that of the original 22-item one and that of the eight-item model for one factor. CONCLUSIONS: This study provides information supporting the seven-item and three-factor version, rather than the original or eight-item versions of the EDE-Q. In the future, the adapted version of the EDE-Q will make it possible to draw comparisons between Mexican samples in other socio-cultural contexts. Future research is required to continue refining the instruments to achieve more representative results from the general ED population.

Conductas alimentarias de riesgo y correlatos psicosociales en estudiantes universitarios de primer ingreso con sobrepeso y obesidad / Disordered eating behaviors and psychological correlates among overweight and obese freshmen College students

Resumen: INTRODUCCIÓN: El comienzo de los estudios universitarios es un estresor importante para los jóvenes que se asocia con un incremento en la incidencia de depresión, ansiedad, abuso de alcohol y CAR. OBJETIVO: Analizar la relación entre CAR e IMC, su asociación con variables demográficas y psicológicas y la interacción con el IMC. MÉTODO: En una muestra de 892 estudiantes universitarios de nuevo ingreso (502 mujeres y 390 hombres) (Xedad=19.7; DE=2.9) se midió peso y estatura y se utilizaron cuestionarios validados. RESULTADOS: La prevalencia de CAR fue de 6.1% en mujeres y de 4.1% en hombres. La prevalencia de sobrepeso y obesidad en mujeres fue de 22.6% y de 7.4%, y en hombres fue de 26.6% y de 9.3%, respectivamente. Las mujeres y los hombres con obesidad 10.8% y 11.1% presentaron CAR de frecuencia alta, y las mujeres y hombres con sobrepeso 13.2% y 3.8%, respectivamente. En las mujeres el IMC aumenta el riesgo de CAR 1.6 veces (p < 0.05) y en los hombres 1.4 veces (p > 0.05). No se encontró interacción del IMC en la asociación de CAR con el resto de las variables. DISCUSIÓN Y CONCLUSIÓN: En ambos sexos, las variables relacionadas con la imagen corporal aumentan el riesgo de CAR significativamente (p < 0.05). Los síntomas depresivos, la baja autoestima y el IMC aumentan el riesgo entre las mujeres, y el deseo por la musculatura, nivel socioeconómico y el área de estudio entre los hombres. Se recomienda llevar a cabo una investigación específica sobre CAR en varones, para evitar el subregistro de casos.

Abstract: INTRODUCTION: The beginning of college studies involves important stress, which is related to an increase in the incidence of depression, anxiety, alcohol abuse and DEB. OBJECTIVE: To analyze the relationship between DEB and nutritional status measured with BMI, its association with demographic and psychological variables, and the interaction with BMI. METHOD: A sample of 892 college students in their freshman year (502 females and 390 males) (Xage=19.7; SD=2.9) was studied. Weight and height were measured, and validated questionnaires were used. RESULTS: The prevalence of DEB was 6.1% in females and 4.1% in males. The prevalence of overweight and obesity in females was 22.6%, and 7.4% and 26.6% and 9.3% in males, respectively. Among women and men with obesity 10.8% and 11.1% showed high-DEB, whilst among overweight women and men 13.2% and 3.8% showed high-DEB, respectively. BMI increases the risk for DEB 1.6 times among women (p < 0.05), 1.4 times among men (p > 0.05). There was no interaction found between BMI and the other variables. DISCUSSION AND CONCLUSION: The variables related with body image increase the risk of DEB significantly (p < 0.05) in both sexes. Depressive symptoms, low self-steem increase the risk among women, and socioeconomic status and study area increase the risk of DEB among men. The specific research of DEB among males is highly recommended to avoid the under registration of cases.