Changes in disordered eating behaviors over 10 or more years: A meta-analysis.

OBJECTIVE: The present meta-analysis evaluated changes in individuals' risk of engaging in distinct disordered eating behaviors (DEBs) in the long-term. METHOD: Longitudinal studies assessing changes in DEBs via ≥2 assessments with a time lag of ≥10 years were included. Risk ratios were calculated for baseline to 10-14.9-year (M = 11.04) follow-up and baseline to ≥15-year (M = 18.62) follow-up changes in the use of binge eating, multiple purging, self-induced vomiting, laxatives, diuretics, diet pills, compensatory exercising, fasting/dieting, and multiple DEBs; Cohen's d was used for continuous binge-eating plus purging variable changes. Subgroup and meta-regression analyses tested whether eating disorder (ED) clinical sample versus nonclinical sample status, female versus male sex/gender, higher versus lower study bias, and baseline mean age and body mass index influenced overall effect magnitude for analyses with sufficient data. RESULTS: Seventeen studies (26 [sub]samples) were included. Overall, individuals' risk of engaging in various restrictive eating and other compensatory behaviors decreased over time and the magnitudes of risk reductions for the use of certain compensatory DEBs were larger over longer follow-up durations. Specifically, for significant DEB change models, risk reductions spanned from 20.0-39.8% for 10-year follow-up and 24.7-74.8% for ≥15-year follow-up. However, nuances were found in the nature of these DEB changes as a function of DEB type, follow-up length, ED versus nonclinical sample composition, and baseline mean age. CONCLUSIONS: These findings provide important information that can help identify treatment priorities and suggest that targeted and tailored preventative ED treatments warrant consistent implementation at the community-level, particularly for youth.

OBJETIVO: El presente metaanálisis evaluó los cambios en el riesgo de los individuos de participar en distintas conductas alimentarias anormales (DEBs, por sus siglas en inglés) a largo plazo. MÉTODO: Se incluyeron los estudios longitudinales que evaluaban los cambios en las DEBs a través de evaluaciones ≥2 con un lapso de tiempo de ≥10 años. Se calcularon los cocientes de riesgo para los cambios de seguimiento basales a 10-14.9 años (M = 11.04) y basales a ≥15 años (M = 18.62) en el uso de atracones, purgaciones múltiples, vómitos autoinducidos, laxantes, diuréticos, píldoras de dieta, ejercicio compensatorio, ayuno/dieta y múltiples DEBs; Cohen's d se usó para atracones continuos más cambios variables de purgación. Los análisis de subgrupos y de metarregresión probaron si la muestra clínica del trastorno de la conducta alimentaria (TCA) versus el estado de la muestra no clínica, el sexo/género femenino versus masculino, el sesgo de estudio mayor versus menor, y la edad media basal y el índice de masa corporal influyeron en la magnitud del efecto general para los análisis con datos suficientes. RESULTADOS: Se incluyeron 17 estudios (26 [sub]muestras). En general, el riesgo de las personas de participar en diversas conductas alimentarias restrictivas y otros comportamientos compensatorios disminuyó con el tiempo y las magnitudes de las reducciones de riesgo por el uso de ciertos DEB compensatorios fueron mayores durante períodos de seguimiento más largos. Específicamente, para los modelos de cambio de DEB significativos, las reducciones de riesgo abarcaron desde 20.0-39.8% para 10 años y 24.7-74.8% para seguimientos de ≥15 años. Sin embargo, se encontraron matices en la naturaleza de estos cambios de DEB en función del tipo de DEB, la duración del seguimiento, TCA versus composición de la muestra no clínica y la edad media basal. CONCLUSIONES: Estos hallazgos brindan información importante que puede ayudar a identificar las prioridades de tratamiento y sugieren que los tratamientos preventivos de TCA específicos y personalizados justifican una implementación constante a nivel comunitario, particularmente para los jóvenes.

Rationale and Design of a Remote Web-Based Daily Diary Study Examining Sexual Minority Stress, Relationship Factors, and Alcohol Use in Same-Sex Female Couples Across the United States: Study Protocol of Project Relate.

BACKGROUND: The Healthy People 2020 initiative aims to reduce health disparities, including alcohol use, among sexual minority women (SMW; eg, lesbian, bisexual, queer, and pansexual). Compared with heterosexual women, SMW engage in more hazardous drinking and report more alcohol-related problems. Sexual minority stress (ie, the unique experiences associated with stigmatization and marginalization) has been associated with alcohol use among SMW. Among heterosexuals, relationship factors (eg, partner violence and drinking apart vs together) have also been associated with alcohol use. Negative affect has also been identified as a contributor to alcohol use. To date, most studies examining alcohol use among SMW have used cross-sectional or longitudinal designs. OBJECTIVE: Project Relate was designed to increase our understanding of alcohol use among young SMW who are at risk for alcohol problems. The primary objectives of this study are to identify daily factors, as well as potential person-level risk and protective factors, which may contribute to alcohol use in SMW. Secondary objectives include examining other physical and mental concerns in this sample (eg, other substance use, eating, physical activity, and stress). METHODS: Both partners of a female same-sex couple (aged 18-35 years; n=150 couples) are being enrolled in the study following preliminary screening by a market research firm that specializes in recruiting sexual minority individuals. Web-based surveys are being used to collect information about the primary constructs of interest (daily experiences of alcohol use, sexual minority stress, relationship interactions, and mood) as well as secondary measures of other physical and mental health constructs. Data are collected entirely remotely from women across the United States. Each member of eligible couples completes a baseline survey and then 14 days of daily surveys each morning. Data will be analyzed using multilevel structural equation modeling. RESULTS: To date, 208 women (ie, 104 couples) were successfully screened and enrolled into the study. In total, 164 women have completed the 14-day daily protocol. Compliance with completing the daily diaries has been excellent, with participants on average completing 92% of the daily diaries. Data collection will be completed in fall 2018, with results published as early as 2019 or 2020. CONCLUSIONS: Project Relate is designed to increase our understanding of between- and within-person processes underlying hazardous drinking in understudied, at-risk SMW. The study includes a remote daily diary methodology to provide insight into variables that may be associated with daily hazardous alcohol use. Before the development of programs that address hazardous alcohol use among young SMW, there is a need for better understanding of individual and dyadic variables that contribute to risk in this population. The unique challenges of recruiting and enrolling SMW from across the United States in a daily diary study are discussed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/11718.