ABSTRACT
BACKGROUND: Weight-related stigma and discrimination are prevalent in our society with adverse biopsychosocial outcomes to people with obesity and morbid obesity. Studies suggest that weight bias in healthcare settings are quite prevalent, but there have been, as far as we know, lack of studies examining prevalence and correlates of weight bias experiences among bariatric surgery candidates in Israel. We aim to understand the nature and prevalence of weight stigma among bariatric surgery candidates. To identify differences between Jewish and Arab candidates. To examine the impact of weight stigma experiences on weight bias internalization (WBI). METHODS: A cross-sectional study was performed among 117 adult bariatric surgery candidates from three hospitals in northern Israel (47.8% Jews, 82.4% females, average BMI 42.4 ± 5.2 Kg/meter2). Patients who agreed to participate completed a structured questionnaire on the same day that the bariatric surgery committee met. WBI was measured using a validated 10-item scale. Experiences of weight stigma were measured using items adapted from prior international studies. RESULTS: About two thirds of the participants had at least one experience of weight stigma (teased, treated unfairly, or discriminated against because of their weight). As many as 75% of participants reported that weight served as a barrier to getting appropriate health care and as many as half of participants felt in the last year that a doctor judged them because of their weight. No significant differences were found between Arabs and Jews in the prevalence of weight stigma experiences and WBI. However, a trend towards more stigma experiences among Jews was noted. WBI was predicted by female gender and experiences of weight stigma, both in general and within healthcare settings. CONCLUSIONS: Weight stigma towards bariatric surgery candidates in Israel is quite prevalent, and specifically in healthcare settings. It is important to adopt policy actions and intervention programs to improve awareness to this phenomenon among the general public and specifically among healthcare providers, as many healthcare providers may be unaware of the adverse effect of weight stigma and of ways in which they are contributing to the problem. Future studies may validate our findings using larger sample size and longitudinal design.
Subject(s)
Bariatric Surgery , Weight Prejudice , Adult , Female , Humans , Male , Arabs , Cross-Sectional Studies , Israel/epidemiology , Jews , Stereotyping , Social StigmaABSTRACT
This study presents an initial effort to develop disordered eating pathology (DEP) prevention program with an emphasis on maternal involvement. Disordered eating pathology representing a range of behaviors and attitudes, from negative body image to full-blown eating disorder. It appears mainly in adolescent females and related to psychological and familial factors, including maternal modeling of thinness. A sample of 118 Israeli girls (11-12) was divided into three groups: participants in the program in parallel with their mothers, participants without their mothers, and control. Participants completed self-report questionnaires. Groups were tested three times: pre-intervention, post-intervention, and follow-up. For those girls who participated in parallel with their mothers, higher self-esteem was associated with fewer pathological diet behaviors. Findings deepen understanding of the risk factors involved in the development of DEP. The main study contribution is the important role mothers play in preventing DEP among their daughters.
Subject(s)
Body Image , Nuclear Family , Female , Adolescent , Humans , Body Image/psychology , Nuclear Family/psychology , Mother-Child Relations/psychology , Mothers/psychology , Self ConceptABSTRACT
BACKGROUND: Preoperative binge eating behavior has been associated with difficulties in weight loss maintenance among patients pursuing bariatric surgery. However, limited data exists on the relationship between interpersonal difficulties and binge eating. OBJECTIVES: To identify interpersonal factors linked with binge eating among bariatric surgery candidates. SETTING: One hundred and seventeen adult bariatric surgery candidates (BMI = 42.2 ± 5.2) from three different hospitals completed questionnaires on the day of their bariatric committee meeting for operation approval. METHODS: Binge eating was assessed using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) as a dichotomous variable. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES), and interpersonal characteristics were evaluated using the short version of the Inventory of Interpersonal Problems (IIP-32). Sociodemographic variables (age, gender, income, education) and BMI were considered as confounders. RESULTS: Approximately 25% of bariatric surgery candidates reported experiencing binge eating episodes within the previous three months. Participants with binge eating exhibited significantly lower self-esteem and more interpersonal difficulties, particularly in the domains of aggressiveness and dependence, compared to those without binge eating. Logistic regression analysis revealed that aggressiveness was a significant predictor of binge eating in this sample. CONCLUSIONS: This study is the first, to the best of our knowledge, to investigate the relationship between interpersonal difficulties and binge eating among bariatric surgery candidates. The findings highlight the significant contribution of aggressiveness to binge eating and emphasize the importance of clinicians assessing patients' interpersonal functioning, particularly with regard to aggressiveness, as a factor that may contribute to the maintenance and occurrence of binge eating behaviors.
ABSTRACT
In recent years, the diagnostic definitions of eating disorders (EDs) have undergone dramatic changes. The Eating Attitudes Test-26 (EAT-26), which is considered an accepted instrument for community ED studies, has shown in its factorial structure to be inconsistent in different cultures and populations. The aim of the present study was to compare the factor structure of the EAT-26 among clinical and non-clinical populations. The clinical group included 207 female adolescents who were hospitalized with an ED (mean age 16.1). The non-clinical group included 155 female adolescents (mean age 16.1). Both groups completed the EAT-26. A series of factorial invariance models was conducted on the EAT-26. The results indicate that significant differences were found between the two groups regarding the original EAT-26 dimensions: dieting, bulimia and food preoccupation, and oral control. Additionally, the factorial structure of the EAT-26 was found to be significantly different in both groups compared to the original version. In the clinical group, the factorial structure of the EAT-26 consisted of four factors, whereas in the non-clinical sample, five factors were identified. Additionally, a 19-item version of the EAT-26 was found to be considerably more stable and well suited to capture ED symptoms in both groups, and a cutoff point of 22 (not 20) better differentiated clinical samples from non-clinical samples. The proposed shortening of the EAT from 40 to 26 and now to 19 items should be examined in future studies. That said, the shortened scale seems more suited for use among both clinical and non-clinical populations. These results reflect changes that have taken place in ED psychopathology over recent decades.
Subject(s)
Bulimia Nervosa , Bulimia , Feeding and Eating Disorders , Humans , Female , Adolescent , Israel , Feeding and Eating Disorders/diagnosis , Psychological Tests , Bulimia/diagnosisABSTRACT
The effectiveness of mental health care can be improved through coordinated and wide-scale outcome measurement. The International Consortium for Health Outcomes Measurement has produced collaborative sets of outcome measures for various mental health conditions, but no universal guideline exists for eating disorders. This Position Paper presents a set of outcomes and measures for eating disorders as determined by 24 international experts from professional and lived experience backgrounds. An adapted Delphi technique was used, and results were assessed through an open review survey. Final recommendations suggest outcomes should be tracked across four domains: eating disorder behaviours and cognitions, physical health, co-occurring mental health conditions, and quality of life and social functioning. Outcomes are collected using three to five patient-reported measures. For children aged between 6 years and 12 years, the measures include the Children's Eating Attitude Test (or, for those with avoidant restrictive food intake disorder, the Eating Disorder in Youth Questionnaire), the KIDSCREEN-10, and the Revised Children's Anxiety and Depression Screener-25. For adolescents aged between 13 years and 17 years, the measures include the Eating Disorder Examination Questionnaire (EDE-Q; or, for avoidant restrictive food intake disorder, the Nine-Item Avoidant Restrictive Food Intake Disorder Screener [NIAS]), the two-item Patient Health Questionnaire (PHQ-2), the nine-item Patient Health Questionnaire (PHQ-9), the two-item Generalised Anxiety Disorder (GAD-2), the seven-item Generalised Anxiety Disorder (GAD-7), and the KIDSCREEN-10. For adults older than 18 years, measures include the EDE-Q (or, for avoidant restrictive food intake disorder, the NIAS), the PHQ-2, the PHQ-9, the GAD-2, the GAD-7, the Clinical Impairment Assessment, and the 12-item WHO Disability Assessment Schedule 2.0. These questionnaires should be supplemented by information on patient characteristics and circumstances (ie, demographic, historical, and clinical factors). International adoption of these guidelines will allow comparison of research and clinical interventions to determine which settings and interventions work best, and for whom.
Subject(s)
Feeding and Eating Disorders , Quality of Life , Adult , Child , Adolescent , Humans , Consensus , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/therapy , Surveys and Questionnaires , Outcome Assessment, Health CareABSTRACT
Background: Young Jewish Ultra-Orthodox women usually show less disturbances in body image and eating in comparison to less religious communities. By contrast, problems with eating are highly unknown and unrecognized in Jewish Ultra-Orthodox males. Aim: To investigate whether in Ultra-Orthodox males, restricting-type AN (AN-R) with highly obsessional physical activity and unspecified restricting eating disorder (ED) in the context of obsessive-compulsive disorder (OCD) would lead to severe physical and emotional morbidity. Results: The study included two groups: the first, 3 adolescents with AN-R developing severely increased ritualized obsessional physical activity in addition to restricting eating, requiring inpatient treatment because of severe bradycardia. These youngsters ignored the severity of their obsessional physical activity, continuing with it in hospital despite their grave medical condition. One student began extensive training for triathlon, whereas another student, upon remitting from AN, developed severe muscle dysmorphia. These findings suggest that young Ultra-Orthodox males with AN may develop obsessional physical activity to increase their muscle mass rather than to lose weight Another four Jewish Ultra-Orthodox males developed malnutrition in the context of severe OCD, with no evidence of dieting or body-image disturbances. These individuals developed highly obsessional adherence to different Jewish religious rules, including prolonged praying, asceticism, and overvalued strict adherence to Jewish Kashrut rules of eating, leading in all cases to severe food restriction. They were highly unaware of their severe weight loss and required hospitalization because of severe physical disturbances associated with malnutrition. Moreover, most did not cooperate with their treatment, and their ED-related obsessionality was mostly resistant to psychopharmacotherapy. Conclusion: Owing to their highly ritualistic rigid way of life, combined with the need for excellency in studying, Jewish Ultra-Orthodox adolescent males with AN might be at a specific risk of developing severe physical disturbances if their illness is associated with highly perfectionistic obsessional physical activity. Second, Jewish Ultra-Orthodox religious males with OCD might be at a specific risk for severe undernutrition, as their rigid relentless observance of Jewish everyday laws might highly interfere with their eating.
ABSTRACT
BACKGROUND: During the COVID-19 pandemic in Israel, the number of patients with eating disorders (EDs) seeking treatment increased significantly. The present study sought to evaluate whether, during the pandemic (2020-21), patients with anorexia nervosa (AN) would show more ED-related, comorbid, and COVID-19-related symptoms in comparison to a naturalistic control group, and whether differences would be found between adult and adolescent patients with AN. We also examined attitudes to telemedicine use during the pandemic in patients receiving long-distance interventions. METHODS: Using online self-report questionnaires, we assessed general and COVID-19-specific symptoms with a secure digital platform (REDCap®) in 36 female adolescents with AN, 35 female adults with AN, and 25 female controls. RESULTS: Compared with controls, patients with AN showed more symptoms of EDs, anxiety, depression, and post-traumatic stress disorder (PTSD), elevated suicidal ideation, more COVID-related emotional-behavioral disturbances, and lower resilience. Adult patients with AN fared worse than adolescent patients on most of these measures. Adult patients using telemedicine during the COVID-19 pandemic showed fewer positive attitudes toward this treatment than adolescents (telemedicine was offered to all, but used by 18/35 adolescents and 21/36 adults with AN). Last, elevated COVID-19-related symptomatology was correlated with more symptoms of ED, anxiety, depression and PTSD, and with lower resilience. CONCLUSIONS: Our findings suggest that the emotional-behavioral state of Israeli females with AN, particularly adults, was worse during the COVID-19 pandemic in comparison to controls. Many patients did not use telemedicine for their treatment. Adult patients using telemedicine were less satisfied with it than adolescent patients.
The recent COVID-19 pandemic has been associated with increased rates of eating disorders in many countries around the globe, including Israel. Our study evaluated whether Israeli patients with anorexia nervosa would fare worse than a control group during the COVID-19 pandemic, and whether adults and adolescents with anorexia nervosa would differ. For this purpose, we administered questionnaires to 71 females with anorexia nervosa36 adolescents and 35 adultsand to a control group of 25 adolescent and young adult women. We found that females with anorexia nervosa showed not only more eating-disordered and psychiatrically-related symptoms, but also more pandemic-related disturbances than the control group. Among the patients with anorexia nervosa, adults fared worse than adolescents. Fifty-one percent of adolescents and 58% of adults with anorexia nervosa received treatment via telemedicine, although all were offered this treatment. Adults treated with telemedicine showed fewer positive attitudes toward it than adolescents. Last, more disordered eating and other psychiatric symptoms were associated with more COVID-19-specific disturbances. Our findings suggest that the emotional-behavioral state of female Israeli patients with anorexia nervosa is worse than that of control females during the COVID-19 pandemic, especially in adults.
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PURPOSE: This study aimed to explore the psychopathological variables that may predict bariatric surgery outcomes after 3 years. METHODS: One hundred ninety-six candidates for bariatric surgery completed self-report questionnaires to assess eating attitudes, eating disorder (ED)-related psychopathology, affective symptoms, interpersonal and psycho-social functioning. One-hundred patients repeated this assessment 3 years after bariatric surgery. A network analysis was run including the pre-surgical measurements in the network. A composite score derived from the combination of the most central network nodes, as well as clinical and socio-demographical variables, was included in a multivariate regression analysis with weight loss, ED psychopathology and psycho-social functioning as outcomes. RESULTS: Depression, stress, and shape concerns were the most central network nodes. The composite network score predicted higher ED psychopathology and worse psycho-social functioning at 3-year follow-up, but not weight loss. Higher age, restricting type of bariatric surgery and higher pre-operative BMI were further predictors of reduced weight loss and greater ED psychopathology. CONCLUSIONS: Affective symptoms and shape concern play a central role in the psychopathology of candidates to bariatric surgery and predict post-surgery ED psychopathology and psycho-social functioning. These variables may allow to identify patients with higher pre-operative risk and in need of further psycho-social interventions. LEVEL OF EVIDENCE: III, evidence obtained from well-designed cohort study.
Subject(s)
Bariatric Surgery , Feeding and Eating Disorders , Obesity, Morbid , Humans , Cohort Studies , Bariatric Surgery/psychology , Weight Loss , Surveys and Questionnaires , Obesity, Morbid/surgery , PsychopathologyABSTRACT
PURPOSE: Childhood maltreatment (CM) experiences are associated with heightened risk of Eating disorders (EDs). The psychopathological pathways promoting this association in people with Bulimia nervosa (BN) and in those with Binge eating disorder (BED) are under-investigated. METHODS: One hundred and eighty-one people with BN and 144 with BED filled in the Eating Disorder Inventory-2, to measure ED psychopathology, and the Childhood Trauma Questionnaire, to assess their early traumatic experiences. Network analysis was conducted to investigate the interplay between those variables. The shortest pathways function was employed to investigate the shortest out of all routes conveying the association between CM and ED-specific symptoms. RESULTS: In both people with BN and with BED, all CM types were connected to the ED psychopathology through the emotional abuse node. The association between emotional abuse and ED-specific symptoms (bulimia and body dissatisfaction) differed in the two groups: in people with BN, it included ineffectiveness, while in people with BED, it involved impulsivity. Interoceptive awareness, an indirect measure of emotion regulation, was included in these pathways in both groups. CONCLUSION: In the light of literature showing that emotional abuse has a connecting role between CM and ED psychopathology also in anorexia nervosa, the present findings support the idea that emotional abuse conveys such association in all the main ED diagnoses. Ineffectiveness and impulsivity may represent the specific psychopathological dimensions connected to emotional abuse and promoting the maintenance of ED-specific symptoms in BN and in BED, respectively. These findings are worth of attention by clinicians. LEVEL OF EVIDENCE: Level III: evidence obtained from well-designed cohort or case-control analytic studies.
Subject(s)
Anorexia Nervosa , Binge-Eating Disorder , Bulimia Nervosa , Child Abuse , Feeding and Eating Disorders , Anorexia Nervosa/psychology , Binge-Eating Disorder/psychology , Bulimia Nervosa/psychology , Child , Child Abuse/psychology , HumansABSTRACT
Preventing the onset of eating disorders and disordered eating pathology is crucial. While these conditions have a multi-factorial etiology, socio-cultural norms, particularly the media, contribute greatly. Policy and legislative action are warranted to change harmful media images. To the best of our knowledge, Israel was the first country to tackle the problem of unrealistic and unhealthy images in the media through legislation by initiating and passing an innovative law. The "Knesset," the Israeli Parliament, voted in December 2012 to pass new legislation that forbids the appearance of underweight models (BMI of 18.5 or less) in commercial advertising. The law further requires that if a graphic editing program has been used to reduce the dimensions of a model in advertising photographs, this fact must be clearly indicated. The purpose of this article is to describe the law; the process and obstacles to creating and passing the law in the Knesset; national and international reactions to this Israeli law; and the challenges of implementing (enacting and enforcing) this law in Israel. Given that other countries are implementing similar policies, additional legal approaches are described, including ideas for further research on how to enact, enforce, and evaluate the impact of such laws.
ABSTRACT
Night eating syndrome (NES) is an eating disorder (ED) characterized by nocturnal ingestion (NI), evening hyperphagia, morning anorexia, as well as mood and sleep disturbances. This study compared subjective and objective sleep quality and ED-related psychopathologies in patients seeking treatment for ED. Method: The sample was composed of 170 women, aged 18-68, who were referred for an ED assessment from 2011 to 2020. The participants were divided into three subgroups: NES-NI only (n = 30), NES+ binge eating (BE) (including binge eating disorders or bulimia nervosa (n = 52), and BE-only (n = 88). The measures consisted of a psychiatric evaluation, objective sleep monitoring measured by an actigraph for 1 week, a subjective sleep self-report, and ED-related psychopathology questionnaires. Results: Objective sleep monitoring revealed significant group differences, with higher sleep efficiency in participants with BE-only and longer sleep durations for the NES-NI only group. Subjectively, the BE-only group described a significantly lower sleep quality than either the NES-NI only or the NES+BE groups. ED-related psychopathology was lower in the NES-NI-only group. A stepwise linear regression revealed that general psychopathology (the brief symptom inventory total score) was a significant predictor of subjective sleep quality. Conclusion: NES-NI-only was correlated with less psychopathology, but with more subjective and objective sleep disturbances. These results lend weight to the supposition that NES lies on a continuum of ED psychopathologies, and that NES-NI-only appears to be a separate entity from NES+BE and BE-only in terms of its psychopathology.
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Research exploring the impact of fasting in Ramadan on eating behaviors has focused on Muslim-majority countries and has neglected to examine impacts beyond the month when "normal" eating patterns resume. This study aimed to explore the experiences of United Kingdom-residing young adult Muslim women who were fasting in Ramadan to understand its impact on their body image and eating behaviors both during and 1-month following Ramadan. In-depth, semi-structured interviews were conducted with 14 Muslim women aged between 18 and 35 (Mage = 27.3) at two distinct time-points: during the last week of Ramadan and 1-2 months later. The interviews explored questions related to motivations for fasting, experience of fasting in Ramadan, and eating behaviors and thoughts related to body image and appearance. Thematic Analysis revealed three themes: (1) family and community expectations to fast (2) exertion of control of on eating behaviors and (3) preoccupation with weight and appearance. The results suggest that family and community play a strong role in motivating women to fast during Ramadan, alongside the need to feel a sense of belonging to their community. This can conflict with the pressure and desire to assimilate with Western culture and associated appearance ideals, thus putting women at greater risk of disordered eating and body image concerns. These findings suggest important implications for increased support in the Muslim community, and the need for further research to explore this topic across longer time-points and in different cultural groups.
Subject(s)
Islam , Motivation , Body Image , Child, Preschool , Fasting , Female , Humans , Infant , United Kingdom , Young AdultABSTRACT
Background: With the outbreak of the COVID-19 pandemic, the need arose to maintain treatment continuity for religious Jewish Ultra-Orthodox young women with eating disorders (EDs) previously hospitalized in the ED department at the Ultra-Orthodox "Mayanei Hayeshua" medical center in Israel. This need led to the development of home-based online treatment channels, previously unfamiliar, and unaccepted in this population. The implementation of this model had to take into consideration many of the difficulties inherent in the use of online treatment in Jewish Ultra-Orthodox mental health patients. Aims: We sought to investigate our online home-based treatment model implemented during the COVID-19 pandemic in previously hospitalized young Ultra-Orthodox women with EDs. Method: We briefly review the literature on: (1) The Jewish Israeli Ultra-Orthodox culture; (2) Young women in Ultra-Orthodox society; and (3) EDs in Jewish Israeli Ultra-Orthodox women. We then present the inpatient ED department for Ultra-Orthodox young women and describe the online treatment model adapted to this population during the COVID-19 pandemic. We highlight the difficulties, dilemmas, and advantages of our online model with the description of three patients. Findings: Online therapy can serve as a barrier to treatment in some cases, due to physical (lack of suitable online devices except phones), familial (over-crowded families), and religious circumstances, as well as because of the patients' reluctance to take part in this treatment. In other cases, virtual home-based treatment can lead to a positive change. This may be the case in patients who find the distancing online model suitable for them, and in parents who are committed to treatment, using their greater physical and emotional presence at home during the COVID-19 pandemic for the good if their ill-daughters. Discussion: This paper highlights the difficulties and possibilities inherent in a virtual home-based treatment during the COVID-19 pandemic for Ultra-Orthodox young women previously hospitalized because of an ED. This model can be effective for some patients and families if undertaken by a multidisciplinary team that is not only knowledgeable about the treatment of EDs and the use of online strategies but also knowledgeable and culturally sensitive to the specific needs and codes of Ultra-Orthodox populations.
ABSTRACT
BACKGROUND: In recent years, there has been a shift in the clinical presentation and, hence, diagnostic definitions of eating disorders (EDs), reflected in a dramatic change in the diagnostic criteria of EDs in the DSM-5. The Eating Attitudes Test-26 (EAT-26) is currently considered an accepted instrument for community studies of EDs, although it features an inconsistent factorial structure in different cultures. Therefore, it is essential to investigate whether the EAT-26 can still be considered an adequate instrument for identifying the risk of developing EDs in different cultures. The aim of the present study was to examine the construct validity and internal consistency of the EAT-26. METHOD: The study used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) among different cultural populations in Israel. RESULTS: Findings indicated different factors in different ethnic groups, most of which do not correspond with the original EAT-26 three-factor structure. RESULTS: The analysis yielded two main factors among Israeli Jews, four main factors among Israeli Muslim Arabs, and three main factors among Israeli Christian Arabs. CONCLUSION: These findings shed light on cultural factors affecting perceptions of the EAT-26 items. This calls for a reconsideration of the generalization of the original three-factor structure of the questionnaire in different cultures.
Subject(s)
Arabs/psychology , Christianity/psychology , Cross-Cultural Comparison , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/psychology , Jews/psychology , Surveys and Questionnaires/statistics & numerical data , Adolescent , Adult , Arabs/statistics & numerical data , Attitude to Health , Factor Analysis, Statistical , Female , Humans , Islam/psychology , Israel , Jews/statistics & numerical data , Male , Young AdultABSTRACT
The Eating Disorder Examination Interview Bariatric Surgery Version (EDE-BSV) assesses eating pathology after bariatric surgery but requires significant training and time to administer. Consequently, we developed a questionnaire format called the Eating Disorders After Bariatric Surgery Questionnaire (EDABS-Q). This study evaluates the consistency of responsiveness between the two formats. After surgery, 30 patients completed the EDE-BSV and EDABS-Q in a restricted randomized design. Patient reported behavior for each item which was converted to a score following the Eating Disorder Examination-Questionnaire (EDE-Q) scoring scheme. Responses fell into three distributions: (1) dichotomous, (2) ordinal, or (3) unimodal. Distributions of items were not different between the two formats and order did not influence response. Tests of agreement (normal approximation of the binomial test) and association (χ2 analyses on binary data and spearman rank order correlations on ordinal items) were performed. Percent concordance was high across items (63-100%). Agreement was significant in 31 of 41 items (Bonferroni-P < 0.001). Association was significant in 10 of 21 in χ2-appropriate items (Bonferroni-P < 0.002), and the ordinal items had highly significant correlations between formats (Bonferroni-P < 0.0125). The EDABS-Q is an adequate substitute for the EDE-BSV and may be useful for research and clinical evaluation of eating pathology after bariatric surgery.
ABSTRACT
This study compared women with binge eating disorders or bulimia nervosa with and without night eating syndrome regarding childhood maltreatment and psychopathology relative to healthy controls. The 426 participants (aged 18-60) were divided into two groups: eating disorders (n = 158) and healthy controls (n = 268). Eating disorders was divided into bulimia nervosa, binge eating disorder, and night eating syndrome with binge eating. Participants completed questionnaires: childhood trauma, eating disorders, self-esteem, and psychopathology. No significant differences were found for most variables in the eating disorders subgroups except physical neglect, which was more prevalent in night eating syndrome with binge eating. All variables differed significantly between eating disorders and healthy controls. Significant correlations emerged between childhood maltreatment, psychopathology, emotional abuse, and self-esteem in eating disorders. Regression showed that emotional abuse significantly predicted self-esteem in eating disorders, and group significantly moderated the effect of emotional abuse on psychopathology. Results emphasize that in this specific sample and variables, night eating syndrome with binge eating may be a variant of binge eating disorder or bulimia nervosa and not a separate diagnostic entity. The results highlight the importance of early assessment of childhood maltreatment, particularly emotional abuse, in patients with night eating syndrome.
Subject(s)
Adult Survivors of Child Abuse/psychology , Binge-Eating Disorder/psychology , Bulimia/psychology , Child Abuse/psychology , Adolescent , Adult , Binge-Eating Disorder/complications , Bulimia Nervosa/psychology , Case-Control Studies , Child , Child Abuse, Sexual/psychology , Feeding and Eating Disorders , Female , Humans , Middle Aged , Night Eating Syndrome/epidemiology , Self Concept , Surveys and Questionnaires , Young AdultABSTRACT
OBJECTIVE: This study aimed to compare dietary patterns (timing and frequency of binge episodes, caloric intake and macronutrient composition) of patients with binge eating disorders (BE) with and without night eating syndrome (NES). DESIGN: The study includes 59 women (18-60) who sought treatment for Eating Disorders (EDs) and were diagnosed with BED or BN (BE) with or without NES. They were divided into two groups: NES-BE and BE-only. The participants kept 7-day, 24-h food diaries and completed demographic and depression questionnaires. RESULTS: NES-BE reported significantly a higher frequency of binge days and binge episodes during the week, and more energy and fat consumption than BE-only. CONCLUSIONS: Individuals with NES-BE exhibit higher levels of eating pathology than individuals with BE-only. Thus, NES-BE may not be simply a variant of BED or BN but rather a separate entity that may lead to a more severe disorder and require early assessment and more intensive and suitable treatment. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.
Subject(s)
Binge-Eating Disorder/physiopathology , Dietary Fats , Energy Intake , Night Eating Syndrome/physiopathology , Adolescent , Adult , Binge-Eating Disorder/psychology , Case-Control Studies , Depression/psychology , Female , Humans , Middle Aged , Night Eating Syndrome/psychology , Young AdultABSTRACT
Disordered eating pathology (DEP) represents a range of behaviors and attitudes, from negative body image to full blown eating disorders, appearing mainly in adolescent females. DEP is related to a plethora of biological and psychological factors, including various coping strategies. Sense of coherence (SOC) is a coping mechanism defined as an external and internal ability to adapt to stress and has been found to be associated with better mental health outcomes. However, SOC has not been examined in relation to DEP. Therefore, the aim of this study is to examine the relationship between SOC, DEP and body image disturbances among adolescent girls. The sample consisted of 248 Israeli girls (12-18), who completed self-reported questionnaires. SOC was negatively associated with DEP and body dissatisfaction. The overall rate of those in the high risk group for EDs was found to be higher than previously seen among samples from a similar population (22.5% vs. 19.5%), and was found to have a significantly lower levels of SOC and more negative body image than those at lower risk. Greater SOC was found to be associated with lower levels of DEP. It is suggested that strengthening SOC be incorporated into eating disorder prevention and treatment. Results emphasize the importance of SOC to well-being and mental health.
Subject(s)
Body Image/psychology , Feeding and Eating Disorders/psychology , Sense of Coherence , Adaptation, Psychological , Adolescent , Child , Feeding and Eating Disorders/epidemiology , Female , Humans , Israel/epidemiology , Schools , Surveys and QuestionnairesABSTRACT
Movement therapy emphasizes that intervention with the body may have a therapeutic impact on emotional, cognitive, and social levels. Movement therapy with individuals with eating disorders (EDs) is associated with many difficulties, owing to the fear and shame that these patients feel with their body. The persistent resistance occurring in group-movement therapy with patients with EDs has led us to implement a novel multidyadic movement group therapy, consisting of an equal number of participants and staff. This model enables the work of patient-staff dyads, using body-related modeling and adequate containment from the staff to assist patients in dealing with their body-related fear and shame. In this article, we use case studies to illustrate the implications-derived from the unexpected highly positive impact of multidyad movement group therapy and discuss the clinical relevance of this treatment in EDs.
Subject(s)
Exercise Movement Techniques/methods , Feeding and Eating Disorders/therapy , Psychotherapy, Group/methods , Adolescent , Adult , Female , HumansABSTRACT
A failure to maintain improvement achieved during acute treatment, followed by a "revolving door syndrome," is a common phenomenon in eating disorders (EDs). As a result, many patients develop a chronic course that is difficult to treat. To target these difficulties, we established a novel rehabilitation treatment model in Israel for patients with severe and enduring EDs, based on the "recovery theory" in mental health treatment. This paper describes the process of conceiving this model and specifies the components of this rehabilitation house, "Zeida Laderech" (Provisions for the Journey), that aims to provide a home-like environment, while assisting in developing a healthy and balanced lifestyle. Finally, the model is discussed in light of other residential programs established in the world. With the hope to improve the overall prognosis of individuals with EDs, it is suggested that the similar programs and ongoing innovation will continue to emerge internationally.