Body image, eating distress and emotional-behavioral difficulties among adolescents in Mbarara, Southwestern Uganda.

BACKGROUND: Adolescents frequently have emotional and behavioral difficulties as they struggle with the challenges of transition from childhood to adulthood. Many struggle with issues of body image and eating distress as they deal with the difficult and frequently perplexing changes that occur with puberty. Yet there is surprisingly little research on the emotional and behavioral challenges, as well as body image and eating distress among this sizable population in Uganda. This study sought to assess attitudes and behaviors related to body image and eating distress, as well as emotional and behavioral difficulties among adolescents in Mbarara, Southwestern Uganda. METHODS: This was a cross-sectional study among 788 adolescents aged 13 to 19 years in secondary schools in Mbarara city and Mbarara district in south-western Uganda. The study employed the Body Image and Eating Distress scale to assess attitudes and behaviors about dieting and body shape and the extended version of the Strengths and Difficulties Questionnaire (SDQ) to assess for perceived emotional and behavioral difficulties. Logistic regression was used to identify the association between body image and eating distress and perceived difficulties. RESULTS: The prevalence of high body image and eating distress was 10.8% while that of perceived emotional and behavioral difficulties was 45.8%. Some of the adolescents (16.1%) were dissatisfied with their body shape, 24.6% exercised a lot to avoid gaining weight, 15.0% were terrified to gain even a little weight, and 12.1% could not control their eating. More males reported eating large amounts of food at one time (p = < 0.001). Having emotional and behavioral difficulties (aOR: 1.89; 95% CI: 1.18 - 3.02; p = 0.019) and coming from a two-parent household (aOR: 1.79; 95% CI: 1.10 - 2.92; p = 0.019) increased the odds of high body image and eating distress. CONCLUSION: High levels of body image and eating distress are linked to behavioral and emotional problems and adolescent's family structure. Clinicians who treat adolescents should use a holistic care strategy and be aware of the high prevalence and close association between emotional and behavioral difficulties, concerns about weight, and dieting. It is important to encourage parental involvement and support in providing information about mental health issues among adolescents.

Eating disorders among queer and trans individuals: Implications for conceptualization, assessment, and treatment.

Eating disorders (EDs) have been traditionally viewed as a disorder affecting cisgender, heterosexual women. Yet, the prevalence of EDs among queer and trans (QnT) individuals, coupled with the lack of interventions that attend to contextual factors related to sexual orientation and gender identity, underscore a critical health disparity issue requiring urgent attention. Here, we first review factors pertaining to QnT individuals' minoritized sexual and gender identities that are important to consider in ED conceptualization for this population (e.g., minority stressors, identity-based body image standards). Next, we describe problematic assumptions present in existing ED assessment and propose more inclusive approaches. Lastly, we provide suggestions for practices that providers can implement within their treatment of EDs among QnT individuals.

Adolescents' perspectives on a novel digital treatment targeting eating disorders: a qualitative study.

BACKGROUND: Eating disorders in adolescence are associated with high psychological distress, impaired function and high comorbidity. Despite the severity, eating disorders remain highly underdiagnosed and untreated. Digital technology provides promising opportunities for treatment, however studies focusing on digital treatments for adolescents with eating disorders are lacking. The main aim of this study was to explore the perspectives of adolescents with lived experience of eating disorders on factors they deemed to be relevant in the development of a novel digital treatment. METHODS: A qualitative intervention development study using semi-structured individual interviews. Data collection, coding and analysis were conducted using the principles of reflexive thematic analysis. Participants were adolescents aged 16-19 years, with a self-reported diagnosis of anorexia nervosa, bulimia nervosa or binge eating disorder, currently in the final phase or completed psychological treatment for an eating disorder within the last five years. RESULTS: A total of 16 adolescents participated in the study, all females. Mean age was 17 ½ years (SD = 1.01). An in-depth understanding of the adolescents' perspectives was developed into three themes: Facilitating self-awareness and readiness to change; Strengthening interpersonal relationships and decreasing social isolation; Ensuring feeling seen and motivating regular use. CONCLUSIONS: This study provides a unique insight into the perspectives of adolescents with lived experience of eating disorders. The uptake and engagement can be optimized in a novel digital treatment for eating disorders by taking the adolescents perspectives into consideration.

Factors associated with food label use: focus on healthy aspects of orthorexia and orthorexia nervosa.

PURPOSE: This study aimed to investigate the potential relationships between the use of different section of food label, and healthy and pathological aspects of orthorexia among adults. METHODS: This cross-sectional study was conducted using an online survey (n = 1326). Inclusion criteria were being 19-64 years and graduated from at least primary school. Pregnant and lactating women were excluded. Data were collected using questionnaire including socio-demographic variables, lifestyle factors, body weight and height, frequency of reading different sections of food label ("always", "when buying a food for the first time", "when comparing similar packaged foods", "rarely", "never"), food label literacy, and Teruel Orthorexia Scale. Participants were categorized as nutrition facts panel-users, ingredients list-users or claim-users if they read at least one item from the relevant parts. RESULTS: The proportions of nutrition facts, ingredients list, and claims sections users were 72.3%, 76.3%, and 79.9%, respectively. Both healthy and pathological aspects of orthorexia were associated with reading food labels. The healthy orthorexia had the strongest association with using the ingredients list (OR 1.76, 95% CI 1.41-2.20), whereas the orthorexia nervosa showed the highest association with using nutrition facts panel (OR 1.48, 95% CI 1.20-1.81). While women, physically active participants and those with higher food label literacy were more likely to use all sections of food labels; older age, having children, and chronic disease increased the likelihood of using claims and ingredients list (p < 0.05). Besides, following a diet was associated with higher use of nutrition facts and ingredients list (p < 0.05). CONCLUSIONS: The study demonstrates that food label users have higher orthorexia tendencies compared to non-users. Of the food label sections, healthy orthorexia showed the strongest association with use of the list of ingredients, while pathological orthorexia showed the strongest association with use of the nutrition facts panel. LEVEL OF EVIDENCE: Level V, cross-sectional study.

An adolescent case of ASXL3-related disorder with delayed onset of feeding difficulty.

BACKGROUND: ASXL3-related disorder, first described in 2013, is a genetic disorder with an autosomal dominant inheritance that is caused by a heterozygous loss-of-function variant in ASXL3. The most characteristic feature is neurodevelopmental delay with consistently limited speech. Feeding difficulty is a main symptom observed in infancy. However, no adolescent case has been reported. CASE PRESENTATION: A 14-year-old girl with ASXL3-related syndrome was referred to our hospital with subacute onset of emotional lability. Limbic encephalitis was ruled out by examination; however, the patient gradually showed a lack of interest in eating, with decreased diet volume. Consequently, she experienced significant weight loss. She experienced no symptoms of bulimia, or food allergy; therefore, avoidant/restrictive food intake disorder (ARFID) was clinically suspected. CONCLUSIONS: We reported the first case of ASXL3-related disorder with adolescent onset of feeding difficulty. ARFID was considered a cause of the feeding difficulty.

Supportive Interventions in Managing Eating Disorders: A Review of the Evolving Medical Professional Landscape.

Background: The landscape of healthcare for medical professionals is undergoing significant changes during a global rise in obesity and mental health issues, particularly in the context of eating disorders. The COVID-19 pandemic, coupled with sedentary lifestyles and job loss, has exacerbated food obsession and mental health challenges, highlighting the need for effective treatments. Objective: This review aims to explore the impact of supportive interventions in managing eating disorders within the evolving landscape of medical professionals' approaches, focusing on the adoption of new tools and approaches. Methods: A comprehensive analysis of current literature and data sources was conducted to examine the healthcare landscape's transformation and its implications for treating eating disorders. Various treatment modalities, including therapy, education, medication, and support groups, were evaluated in light of recent changes in medical practice. Results: The review identified a growing body of research highlighting the effectiveness of supportive interventions, such as cognitive behavior therapy, mindfulness, and participation in peer support groups in improving emotional eating patterns and facilitating long-term weight management. The findings underscore the growing prevalence of obesity and mental health issues, with a significant portion of individuals experiencing food obsession and overeating. Despite this, recognition and treatment of obesity-related psychological issues remain inadequate, partly due to a shortage of mental health professionals. Treatment options for eating disorders may include bariatric surgery, therapy, education, medication, and supportive interventions. Support groups such as Overeaters Anonymous (OA) have shown promise in helping individuals manage eating disorders and achieve healthier lifestyles. Conclusions: The shifting healthcare landscape necessitates a proactive approach from medical professionals to address the complex relationship between obesity, mental health, and eating disorders. Integrating peer support groups and holistic treatment approaches alongside traditional medical interventions can enhance outcomes and promote long-term weight management.

Validation and assessment of psychometric properties of the Greek Eating Behaviors Assessment for Obesity (GR-EBA-O).

INTRODUCTION: With increasing morbidity and risk of death, obesity has become a serious health problem largely attributable to difficulties in finding proper treatments for related diseases. Many studies show how detecting abnormal eating behaviors could be useful in developing effective clinical treatments. This study aims at validating the Greek version of the Eating Behaviors Assessment for Obesity (EBA-O). METHOD: After a double English/Greek forward/backward translation of the EBA-O, 294 participants completed the Greek version (GR-EBA-O), the Eating Disorder Examination Questionnaire, the Binge Eating Scale, and the Yale Food Addiction Scale. Confirmatory factor analysis (CFA) and construct validity were calculated, and Two-way MANOVA was computed with the factors of GR-EBA-O controlling for sex and BMI categories. RESULTS: CFA confirmed the second-order five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia) structure of the original EBA-O with excellent fit indices. GR-EBA-O factors were highly correlated. The GR-EBA-O subscales were also significantly correlated with the remaining measures, demonstrating good concurrent validity. CONCLUSION: The Greek version of the EBA-O has demonstrated sound psychometric properties and appears a reliable and user-friendly tool to identify pathological eating behaviors in obesity. LEVEL OF EVIDENCE: V, descriptive research.

Cognitive training via mobile app for addressing eating disorders' cognitions in adolescents: a randomized control trial protocol.

During adolescence, individuals are particularly vulnerable to developing eating disorders (EDs). To address the dysfunctional beliefs linked to these disorders, a new mobile app has been developed. This app, called GG eating disorders-Adolescents (GGED-AD), was created based on CBT to help adolescents work on their self-dialogue related to the core beliefs of eating disorders. The objective is to present the protocol for a randomized controlled trial to explore the efficacy of GGED-AD.Methods The study will be carried out in adolescents aged 13 to 16 from an educational center in the Valencian Community. The participants will be randomized into two groups: the experimental group will use the GGED-AD app during 14 consecutive days for approximately 5 min each day; and the control group will use a neutral app (GGNEUTRAL) during the same time. Both groups will complete instruments that assess dysfunctional beliefs related to eating disorders, eating symptoms, symptoms of depression and anxiety, body satisfaction and self-esteem before and after the intervention. A follow-up will be conducted one month later.Results A decrease in the degree of ascription to dysfunctional beliefs associated with eating disorders and eating symptomatology is expected, as well as an increase in body satisfaction and the self-esteem of the participants of the experimental group.Discussion The app in this study could help tackle and prevent ED-related symptoms in adolescents.Trial registration NCT06039514.

Eating Disorder Risks Associated with Time Spent Using Social Media at an AMREC Population in the Coal Mining Region of Santa Catarina.

Comparing one's appearance to other people's and believing in an ideal body shape can negatively impact an individual. The probability of developing ED in individuals with high body dissatisfaction is higher than in the general population, leading to long-term emotional and metabolic damage. Populational studies on the prevalence of ED in Brazil are scarce in the literature. The research was carried out through the Google Forms website and evaluated risk of eating disorders through the Eating Attitude Test, degree of body dissatisfaction in the sample through the Body Shape Questionnaire and the Internet Addiction Test was used to evaluate time spent on the internet. The results showed that 84.5% of the sample were female and 62.3% of the individuals had eutrophic by the Body Mass Index. About 40.2% of the population studied had abnormal attitudes towards food, indicating a possible risk of developing ED, and 62.5% of the sample did not show body dissatisfaction. Regarding internet use, 10.8% had problematic internet use. The presence of risky eating attitudes was more prevalent in participants dissatisfied with their bodies. In addition, participants with problematic internet use had a higher risk for EDs.

Effect of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school age children.

BACKGROUND & AIMS: Feeding problems in pre-school children are common and negative maternal feeding practices may even worsen the child's problematic eating behavior. Therefore, investigating the effects of maternal eating behaviors and attitudes towards the feeding process on pre-school children's feeding problems may be helpful for preventing feeding problems. This study sought to investigate the effects of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school children. METHODS: Mothers of 373 children aged 3-6 were included in this cross-sectional study and data was collected by an online questionnaire including the scales of three-factor eating questionnaire (TFEQ), mother's attitudes towards the feeding process (MATFPS) and behavioral pediatric feeding assessment (BPFAS), as well as demographics and anthropometric measures (height and weight). Spearman's rho test was used to calculate correlation coefficients between the TFEQ, MATFP and BPFA scales. In order to identify independent predictors of child feeding behaviors, a multiple linear regression model was used. RESULTS: Results showed that uncontrolled eating subscale was positively (r = 0.160, p < 0.001) and cognitive restriction subscale negatively (r = -0.126, p < 0.05) correlated with MATFP. MATFP was also positively correlated with BPFA (r = 0.368, p < 0.001). Regression analysis indicated that BPFA was significantly predicted by MATFP which was the most important contributor of child feeding problems (ß = 0.24, t = 4.88, p < 0.001). CONCLUSIONS: This study indicated that maternal eating behaviors were related to maternal attitudes towards the feeding process and, mothers' attitudes were associated with feeding problems of their pre-school children.

Prevention of eating disorders: 2023 in review.

This review of 16 prevention-related publications in Eating Disorders during 2022 is framed by three models: (1) Mental Health Intervention Spectrum: health promotion → types of prevention → case identification/referral → treatment; (2) the prevention cycle: rationale and theory, shaped by critical reviews → clarifying risk and protective factors → program innovation and feasibility studies → efficacy and effectiveness research → program dissemination; and (3) definitions of and links between disordered eating (DE) and eating disorders (EDs). Seven articles fell into the category of prevention rationale (including screening studies) and relevant reviews, while nine articles addressed correlates of/risk factors (RFs) for various aspects of DE and EDs. One implication of the 16 articles reviewed is that RF research toward construction of selective and indicated prevention programs for an expanding array of diverse at-risk groups needs to address, from a nuanced, intersectional framework, a broad range of factors beyond negative body image and internalization of beauty ideals. Another implication is that, to expand and improve current and forthcoming prevention programs, and to shape effective advocacy for prevention-oriented social policy, the field in general and Eating Disorders in particular need more scholarship in the form of critical reviews and meta-analyses; protective factor research; prevention program development and multi-stage evaluation; and case studies of multi-step activism at the local, state (province, region), and national levels.

Updates in the treatment of eating disorders in 2023: a year in review in eating disorders: the Journal of treatment & Prevention.

Empirical evidence is unequivocal in illustrating that the majority of patients with eating disorders will not fully recover during treatment. To that end, the need for optimized treatment approaches and improved patient outcomes cannot be overstated. While empirical efforts are underway to optimize outcomes, this article reviews treatment-related research findings published in Eating Disorders: The Journal of Treatment & Prevention during 2023. Importantly, this review encapsulates research addressing (i) between-session patient behaviors, (ii) the integration of technology into treatment approaches, (iii) methods to augment emotional regulation in the context of eating disorder treatment, (iv) methods to measure progress, and potentially risk markers for patient dropout, during treatment, (v) optimizing treatment approaches for inpatient settings, and (vi) augmenting family therapy-based approaches. Incorporating novel technological advances may be critical in enhancing the scalability of eating disorder treatments, since treatment uptake remains an ongoing challenge for the field. Moreover, expanding the scope of non-outpatient eating disorder treatment settings, while ensuring fidelity to theoretical models developed in outpatient settings, is critical as treatment is effectively administer across the spectrum of levels of patient care.

Eating attitudes of migraine patients in Turkey: a prospective multi-center study.

BACKGROUND: Migraine is a disease characterized by headache attacks. The disease is multifactorial in etiology and genetic and environmental factors play role in pathogenesis. Migraine can also be accompanied by psychiatric disorders like neurotism and obsessive compulsive disorder. Stress, hormonal changes and certain food intake can trigger attacks in migraine. Previous studies showed that eating attitudes and disorders are prevalant in patients with migraine. Eating disorders are psychiatric disorders related to abnormal eating habits. Both migraine and eating disorders are common in young women and personality profiles of these patient groups are also similar. A possible relationship which shows that migraine and eating habits are related can lead to a better understanding of disease pathogenesis and subsequently new therapeutic options on both entities. Association of migraine in relation to severity, depression and anxiety and eating habits and disorders were aimed to be investigated in this study. METHODS: The study was designed as a prospective, multi-center, case control study. Twenty-one centers from Turkey was involved in the study. The gathered data was collected and evaluated at a single designated center. From a pool of 1200 migraine patients and 958 healthy control group, two groups as patient group and study group was created with PS matching method in relation to age, body-mass index, marital status and employment status. Eating Attitudes Test-26 (EAT-26), Beck's Depression Inventory (BDI) and Beck's Anxiety Inventory (BAI) were applied to both study groups. The data gathered was compared between two groups. RESULTS: EAT-26 scores and the requirement for referral to a psychiatrist due to symptoms related to eating disorder were both statistically significantly higher in patient group compared to control group (p = 0.034 and p = 0.0001 respectively). Patients with migraine had higher scores in both BDI and BAI compared to control group (p = 0.0001 and p = 0.0001 respectively). Severity of pain or frequency of attacks were not found to be related to eating attitudes (r:0.09, p = 0.055). CONCLUSIONS: Migraine patients were found to have higher EAT-26, BDI and BAI scores along with a higher rate of referral to a psychiatrist due to symptoms. Results of the study showed that eating habits are altered in migraine patients with higher risk of eating disorders. Depression and anxiety are also found to be common amongst migraine patients.

The Intuitive Eating Scale-3: Development and psychometric evaluation.

Intuitive eating has been found to protect against disordered eating and preserve well-being. Yet, there are methodological (length), conceptual (inconsideration of medical, value-based, and access-related reasons for food consumption), and psychometric (item wording) concerns with its most common measure, the Intuitive Eating Scale-2 (IES-2). To address these concerns, we developed the IES-3 and investigated its psychometric properties with U.S. community adults. Across three online studies, we evaluated the IES-3's factorial validity using exploratory factor analysis (EFA; Study 1; N = 957; Mage = 36.30), as well as confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), bifactor-CFA, and bifactor-ESEM (Study 2; N = 1152; Mage = 40.95), and cross-validated the optimal model (Study 3; N = 884; Mage = 38.54). We examined measurement invariance across samples and time, differential item functioning (age, body mass index [BMI], gender), composite reliability, and validity. Study 1 revealed a 12-item, 4-factor structure (unconditional permission to eat, eating for physical reasons, reliance on hunger and satiety cues, body-food choice congruence). In Study 2, a bifactor-ESEM model with a global intuitive eating factor and four specific factors best fit the data, which was temporally stable across three weeks. This model also had good fit in Study 3 and, across Studies 2 and 3, and was fully invariant and lacked measurement bias in terms of age, gender, and BMI. Associations between latent IES-3 factors and age, gender, and BMI were invariant across Studies 2 and 3. Composite reliability and validity (relationships with disordered eating, embodiment, body image, well-being, and distress; negligible relationship with impression management) of the retained model were also supported. The 12-item IES-3 demonstrates strong psychometric properties in U.S. community adults. Research is now needed using the IES-3 in other cultural contexts and social identity groups.

Comparison between Physical Activity and Stress-Related Lifestyle between Orthorexic and Non-Orthorexic University Students: A Case-Control Study.

(1) Background: The literature regarding orthorexia nervosa (ON) has well documented the association with other mental disorders, such as obsessive-compulsive and eating disorders. However, the research has not taken into account stress-related behavior and the conduction of physical activity (PA), both structured and unstructured. (2) Methods: In this cross-sectional study, 165 students of the University of Parma (92 females and 74 males) aged between 18 and 49 years old (mean = 24.62 ± 4.81) were consecutively recruited. The ORTO-15 questionnaire was used to divide the total sample into a group without orthorexia (score > 40) and a group with orthorexia (score < 40). All subjects completed the P Stress Questionnaire, and specific items were extrapolated from the Eating Habits Structured Interview (EHSI) to investigate lifestyle, including structured and unstructured PA. (3) Results: Subjects with orthorexia represented 83% of the total sample and reported higher levels of stress-related risk behaviors (i.e., sense of responsibility (t = -1.99, p = 0.02), precision (t = -1.99, p = 0.03), stress disorders (t = -1.38, p = 0.05), reduced spare time (t = -1.97, p = 0.03), and hyperactivity (t = -1.68, p = 0.04)) and a higher frequency of PA (i.e., hours spent training in structured PA, daily (t = -1.68, p = 0.05), weekly (t = -1.91, p = 0.03), and monthly (t = -1.91, p = 0.03), the tendency to carry out physical exercise even if tired (t = -1.97, p = 0.02), and to adhere to unstructured PA (i.e., moving on foot or by bike rather than using transport (t = 1.27, p = 0.04)). (4) Conclusions: The results confirmed the presence of hyperactivity at a motor and behavioral level in people with orthorexia. Further studies are necessary to highlight the causality between ON, stress, and physical activity but it may be possible to hypothesize that "obsessive" physical exercise may not generate the benefits generally known by the literature.

The loneliness factor in eating disorders: Implications for psychopathology and biological signatures.

OBJECTIVES: Eating disorders (ED) are severe psychiatric conditions. While the biological consequences of EDs are well established, including an increase in inflammatory biomarkers, the influence of psychological factors, such as loneliness, has only recently gained attention in research. Loneliness has been associated with more severe psychopathology in ED patients, while its association with inflammatory biomarkers has only been explored in the general population. For these reasons, we aimed to investigate any possible associations between psychological features, trauma, and inflammatory biomarkers with loneliness in people with ED. METHODS: This study examined the interaction between loneliness, eating psychopathology, and biological markers in people with EDs. A group of 97 female patients with various diagnoses of ED was assessed for loneliness, general and eating psychopathology, traumatic history during childhood, and clinical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and urinary-free cortisol (UFC). RESULTS: The results indicated that individuals with ED who reported moderate to severe loneliness also displayed greater general psychopathology (p = 0.001), weight concerns (p = 0.007), and physical neglect during childhood (p = 0.006). Furthermore, people with higher levels of loneliness also had higher inflammatory indexes (ESR p = 0.001, CRP p = 0.027) and were positively correlated with markers of stress reaction such as UFC (p < 0.05). CONCLUSION: The findings underscore the importance of considering loneliness in the assessment of individuals with an ED. We observed notable associations between loneliness and increased psychopathology (both general and specific to eating), as well as higher levels of inflammation and childhood physical neglect. Addressing loneliness may contribute to improving overall well-being and potentially support recovery. This consideration encompasses both psychological and physical factors that interplay in the clinical presentation of individuals.

The impact of oxytocin on emotion recognition and trust: Does disordered eating moderate these relationships?

OBJECTIVES: The current study aimed to investigate the impact of oxytocin on emotion recognition, trust, body image, affect, and anxiety and whether eating disorder (ED) symptoms moderated any of these relationships. METHOD: Participants (n = 149) were female university students, who were randomly allocated to receive in a double-blind nature, a single dose of oxytocin intranasal spray (n = 76) or a placebo (saline) intranasal spray (n = 73). Participants were asked to complete an experimental measure of emotion recognition and an investor task aimed to assess trust. RESULTS: The oxytocin group exhibited better overall performance on the emotion recognition task (especially with recognising positive emotions), and a decline in state positive affect than the control group at post-intervention. However, these effects were not moderated by ED symptom severity, nor were effects found for state anxiety, negative affect, body image and recognising negative emotions in the emotion recognition task. CONCLUSION: The current findings contribute to the growing literature on oxytocin, emotion recognition and positive affect and suggest that ED pathology does not moderate these relationships. Future research would benefit from examining the efficacy of an oxytocin intervention using a within-subjects, cross-over design, in those with sub-clinical and clinical EDs, as well as healthy controls.

Factor structure, group invariance, and concurrent validity of scores from the college eating and drinking behavior scale among U.S. college students.

Food and alcohol disturbance (FAD) refers to the intersection of alcohol- and eating-related motives and behaviors, such as restricting food intake before or during alcohol use to offset caloric intake or to enhance intoxication. Valid assessment is critical for advancing research on FAD. We tested the factor structure, group invariance, and concurrent validity of the College Eating and Drinking Behavior Scale (CEDBS) in a large college student sample (n = 2610; Mage = 20.95, SD = 4.65; 71.8% female; 77% White; 86% non-Hispanic). Participants completed measures assessing antecedents of alcohol use (i.e., protective behavioral strategies and drinking motives), negative alcohol-related consequences, alcohol use severity, and risk for eating disorder. The 3-factor model of the 21-item CEDBS provided an adequate fit to the data (e.g., CFI = 0.916). These factors include Alternative Methods (4 items; "Use laxative prior to drinking alcohol"), Offset Calories (7 items; "Restrict calories prior to drinking to help maintain your figure"), and Quicker Intoxication (10 items; "Not eating before drinking alcohol because it gives you the best buzz"). The CEDBS was scalar invariant across subgroups of participants based on age, sex, race/ethnicity, socioeconomic status, sexual orientation, and political orientation. Quicker Intoxication was most strongly related to risk factors and negative consequences for alcohol (r = 0.204-0.379, all ps < 0.01), and Offset Calories was most strongly related to risk for eating disorders (r = 0.349, p < .01). These findings further support the CEDBS to assess FAD among college students.

The relationship among disordered eating behavior, power of food scale and sensitization of the reinforcing value of food.

INTRODUCTION: Disordered eating behaviors are a current public health concern since their progression can lead to the development of a full criteria eating disorder. Sensitization to repeated intake of high energy density (HED) foods is associated with excess weight gain over time, but less is known about relationships with assessments of disordered eating. Thus, this study aims to understand how disordered eating behaviors refunlate to the influence of the food environment and sensitization. METHOD: 163 adolescents - 50 % female and 13.2 mean age - were followed for 24 months. Sensitization was assessed by comparing the relative reinforcing value (RRV) of HED food at baseline and after two weeks of daily intake; sensitization was defined as RRV of food after repeated intake. Study participants also completed the EDE-Q, and Power of Food Scale (PFS). We conducted multivariate general linear models to examine these associations. RESULTS: Sensitization status and PFS scores at baseline were positively associated with EDE-Q subscale scores cross-sectionally, but not longitudinally, at baseline and 24 months. We found that sensitization to HED food and higher susceptibility to food cues relates to increased disordered eating behaviors and both at baseline and at 24-months. DISCUSSION: These findings suggest that sensitization to repeated HED food intake and the food environment might be a risk factor for later engagement in disordered eating behaviors. Future studies should address the temporal relationships among these factors and the role that social norms around body weight and weight stigma may play in the development of these behaviors.