ABSTRACT
Pregnancy represents a crucial timepoint to screen for disordered eating due to the significant adverse impact on the woman and her infant. There has been an increased interest in disordered eating in pregnancy since the COVID-19 pandemic, which has disproportionately affected the mental health of pregnant women compared to the general population. This systematic review is an update to a previous review aiming to explore current psychometric evidence for any new pregnancy-specific instruments and other measures of disordered eating developed for non-pregnant populations. Systematic searches were conducted in PubMed, ProQuest, PsycInfo, CINAHL, Scopus, MEDLINE, and Embase from April 2019 to February 2024. A total of 20 citations met criteria for inclusion, with most studies of reasonable quality. Fourteen psychometric instruments were identified, including two new pregnancy-specific screening instruments. Overall, preliminary psychometric evidence for the PEBS, DEAPS, and EDE-PV was promising. There is an ongoing need for validation in different samples, study designs, settings, and administration methods are required. Similar to the original review on this topic, we did not find evidence to support a gold standard recommendation.
ABSTRACT
OBJECTIVE: Mealtimes are a period of heightened distress for individuals with eating disorders. Patients frequently display maladaptive coping strategies, such as hiding food and using distraction techniques to avoid eating. The aim of this systematic review is to evaluate the evidence for meal support interventions as a first-line intervention for eating disorders. METHOD: Six databases were systematically searched in January 2024. Papers including patients with an eating disorder, and meal support or meal supervision, were examined. Quality appraisal was conducted. RESULTS: Ten studies met inclusion criteria. Meal support was conducted individually and in group settings. Two studies examined the practical or interpersonal processes of meal support. Carers and trained clinicians implemented meal support. Individuals across the lifespan were examined. Settings included inpatient units, community clinics, and the home. Studies were heterogeneously evaluated with retrospective chart audits, pre- and post- cohort studies, semi-structured interviews, video analysis, and surveys. DISCUSSION: Meal support intervention is potentially suitable and beneficial for patients of various age groups and eating disorder diagnoses. Due to the lack of consistent approaches, it is apparent there is no standardised framework and manualised approach. This highlights the need for the development of a co-designed approach, adequate training, and rigorous evaluation.
Previous research indicates that meal support may be potentially beneficial as an independent intervention in the treatment of eating disorders, but inconsistent approaches and a lack of standardization make evaluations challenging. The current study aims to provide an overview of current meal support interventions, how they are implemented, and their impacts on health outcomes and hospital admissions in people experiencing an eating disorder. Gaps in current knowledge and research highlight the need for further investigation, and the development of a co-designed approach, adequate training, and rigorous evaluation.