Eating disorders prevention programs in Latin American countries: A systematic review.

OBJECTIVE: This systematic review evaluates and summarizes existing eating disorder (ED) prevention programs in Latin American countries. METHODS: A systematic literature search was conducted using the Cochrane Controlled Trial Register, PubMed, and Virtual Health Library databases up to and including July 31, 2022. All ED prevention studies published in English, Spanish or Portuguese were eligible, regardless of the study design, sample characteristics, and type of prevention programs. The Cochrane Collaboration Risk of Bias criteria were used to evaluate the quality of the included studies. RESULTS: Twenty-two studies were included. Most were pilot studies that were nonrandomized, had a high risk of bias, were from Mexico and Brazil, and employed selective interventions. Dissonance-based programs and social cognitive theory were the commonly used approaches in interventions, and most of them were tested in adolescent girls and women. Short follow-ups were used, varying from 1 to 6 months. Many found significant decreases after the intervention and/or at follow-up in ED/disordered eating risk behaviors/symptoms, negative affect, body-ideal internalization, and body image disturbances. CONCLUSIONS: This review highlights promising efforts to prevent EDs among Latin American countries. Some barriers in conducting research include funding restrictions, laws that do not allow remuneration or compensation for participants, and high costs of training. Nonetheless, the outcomes of the programs developed and evaluated so far are positive enough to merit further work on ED prevention. Efforts for future researchers should recruit samples with diverse characteristics, use robust designs and data analysis techniques, and expand the accessibility of prevention programs. PUBLIC SIGNIFICANCE STATEMENT: The development of effective eating disorder (ED) prevention programs that can be broadly implemented is a public health priority. Nevertheless, there is limited evidence regarding the characteristics of ED prevention programs and their efficacy among Latin American countries. In the present study, we reviewed existing ED prevention programs adopted in Latin America, described their characteristics and outcomes, noted the limitations of available programs, and discussed the implications of these findings for efforts to prevent the development of EDs in Latin America. The outcomes of the programs developed and evaluated so far are positive enough to merit the development and rigorous evaluation of future programs and their broad dissemination in Latin American countries. PROSPERO registration number CRD42021275245.

OBJETIVO: Esta revisión sistemática evalúa y resume los programas de prevención de trastornos de la conducta alimentaria (TCA) existentes en los países de América Latina. MÉTODOS: Se realizó una búsqueda bibliográfica sistemática utilizando las bases de datos del Registro Cochrane de Ensayos Controlados (Cochrane Controlled Trial Register), PubMed y Virtual Health Library hasta el 31 de julio de 2022 inclusive. Todos los estudios de prevención de TCA publicados en inglés, español o portugués fueron elegibles, independientemente del diseño del estudio, las características de la muestra y el tipo de programas de prevención. Se utilizaron los Criterios de Riesgo de Sesgo de la Colaboración Cochrane para evaluar la calidad de los estudios incluidos. RESULTADOS: Se incluyeron veintidós estudios. La mayoría eran estudios piloto no aleatorizados, tenían un alto riesgo de sesgo, eran de México y Brasil, y empleaban intervenciones selectivas. Los programas basados en la disonancia y la teoría cognitiva social fueron los enfoques comúnmente utilizados en las intervenciones, y la mayoría de ellos se probaron en niñas y mujeres adolescentes. Se utilizaron seguimientos cortos, que variaron de uno a 6 meses. Muchos encontraron disminuciones significativas después de la intervención y / o en el seguimiento en los síntomas de TCA/Conductas Alimentarias de Riesgo, afecto negativo, internalización de la figura ideal y trastornos de la imagen corporal. CONCLUSIONES: Esta revisión destaca los esfuerzos prometedores para prevenir los TCA entre los países de América Latina. Algunas barreras en la realización de investigaciones incluyen restricciones de financiamiento, leyes que no permiten la remuneración o compensación para los participantes y los altos costos de capacitación. No obstante, los resultados de los programas desarrollados y evaluados hasta ahora son lo suficientemente positivos como para merecer un mayor trabajo en la prevención de los TCA. Los esfuerzos para futuros investigadores deben reclutar muestras con características diversas, utilizar diseños robustos y técnicas de análisis de datos, y ampliar la accesibilidad de los programas de prevención.

Psychometric properties of the Eating Disorder Examination Questionnaire among Brazilian cisgender gay and bisexual adult men.

OBJECTIVE: One of the most widely used assessment tools for disordered eating attitudes and behaviors, the Eating Disorder Examination Questionnaire (EDE-Q), has not yet been evaluated in Brazilian cisgender gay and bisexual men-an at-risk population given the extent of minority stressors in Brazilian culture. The present study aimed to assess the psychometric properties of the EDE-Q among Brazilian cisgender gay and bisexual adult men. METHOD: The Brazilian EDE-Q was administered to a sample of 1409 gay and bisexual adult men, along with measures of self-objectification, body-ideal internalization, drive for muscularity, muscle dysmorphia symptoms, and body appreciation. The factor structure of the Brazilian EDE-Q was assessed using a two-step, split-sample exploratory (EFA; n = 704) and confirmatory factor analytic approach (CFA; n = 705). Additionally, convergent validity, internal consistency, and 2-week test-retest reliability were assessed. RESULTS: Findings from an EFA and CFA revealed a one-factor structure with 22 items and adequate internal consistency (ω = .92, 95% CI = [.91, .93]). Moreover, the scale demonstrated good 2-week test-retest reliability (ICC = .86, 95% CI = [.82, .88], p < .001). The EDE-Q scores showed positive associations with self-objectification, body-ideal internalization, muscle dysmorphia symptoms, and drive for muscularity, as well as a negative association with body appreciation. DISCUSSION: Results provide support for the use of the EDE-Q using a one-factor structure in Brazilian cisgender gay and bisexual adult men and give insights for future studies on eating disorders in sexual minorities in Latin America. PUBLIC SIGNIFICANCE: The Eating Disorder Examination Questionnaire (EDE-Q) is one of the most widely used self-report measures of eating disorder symptoms. However, there is a lack of research on the validity and reliability of the EDE-Q in Latin American countries. This study evaluated the validity and reliability of the EDE-Q in Brazilian cisgender gay and bisexual adult men. Our findings give insights for future studies on eating disorders in sexual minorities in Latin America.

What position do you play? Eating disorder pathology among rugby players, and the understudied role of player position.

OBJECTIVE: Male athletes appear to be at high risk for Eating Disorders (ED), given sport-related pressures. Although in some sports weight loss confers a competitive advantage, men also participate in sports where a large body is considered to enhance performance. In rugby a heavier body has been associated with sports success, however, physical demands vary given the position in the field (forward or back). We aimed to investigate whether ED pathology varied as a function of player position. METHOD: A cross-sectional study was conducted among 203 rugby players (Mage = 21.78, SD = 3.54) in order assess associations between elevated eating pathology given the players' position, and with ED mediating mechanisms (physical comparison and exercise dependence). RESULTS: 8.9% (95% CI: 4.9, 12.8) of the participants presented elevated eating pathology. Players' position, physical comparison and exercise dependence were associated with elevated eating pathology. Forwards tended to endorse binge eating more frequently, and showed higher levels of eating concerns. DISCUSSION: Our findings suggest that ED symptoms differ as a function of player position, and that elevated eating pathology in rugby players is associated with appearance comparison and exercise dependence. Despite the possible implications for prevention and treatment efforts, the clinical validity of the current findings must be confirmed with further research.