A loss of consciousness in a teenage girl with anorexia nervosa, due to polydipsia: case report and a minireview The original article can be found online.

Correction to: Confirmatory factor analyses of the ORTO 15-, 11- and 9-item scales and recommendations for suggested cut-off scores Due to an unfortunate error, interpretation of the ORTO-7 cut-off score is incorrect.

Socioeconomic characteristics and obesity-related psycho-social profiles

Socioeconomic characteristics and obesity-related psycho-social profiles

Negative affect and eating psychopathology: the moderator effect of gender Abstract Purpose This study examined the moderator role of gender in the relationship between negative affect and eating psychopathology as well as gender differences in these variables. Methods A community sample of 285 students (61.8% females), aged 13–25, was recruited in middle and high schools and universities. They filled instruments that assess negative affect and eating disordered symptoms (restraint, eating concern, shape concern, weight concern, and global scale). Results Females scored higher both in all subscales and the global scale of eating psychopathology. The restraint subscale was the only subscale showing non-significant differences between females and males. Controlling for BMI, moderation analyses revealed that gender moderated the relationship between negative affect and eating psychopathology, except for restraint behavior. Conclusions To deal with negative affect, females engage in more cognitive symptoms associated with disordered eating than males, but both endorse equally in eating restraint. These findings suggest that interventions focused on emotion regulation could help to reduce eating disordered symptoms among females and males. Level of evidence Level V, cross-sectional descriptive study.

Thin-ideal internalization: How much is too much? Abstract Internalization of the thin-ideal is a risk factor for eating disorders that frequently persists into recovery and increases patient risk for relapse. Addressing thin-ideal internalization as a core element of eating disorder prevention and treatment produces significant reductions in eating pathology. However, research has not yet quantified levels of thin-ideal internalization that may signal increased versus decreased risk for disordered eating. To address this gap in the literature, receiver operating characteristic (ROC) curve analysis was used to identify a thin-ideal internalization cutoff score that signified clinically-meaningful eating disorder pathology. 787 college women (age M = 20.17, SD = 2.41; BMI M = 23.58, SD = 5.29) were classified as “healthy” (N = 717) or those with significant disordered eating (N = 70) using established clinical cutoffs for the Eating Disorder Examination-Questionnaire. ROC curve analysis was used to test the performance of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) Internalization: Thin/Low Body Fat subscale in predicting disordered eating status, and to identify a cutoff score that maximized sensitivity and specificity to discriminate between healthy and disordered eating samples. Mean SATAQ-4 internalization scores were 3.29 (SD = 0.92) and 4.27 (SD = 0.62) for healthy and disordered eating participants, respectively. The SATAQ-4 internalization scores were good predictors of disordered eating status (area under the curve = 0.81, 95% CI: 0.76–0.86). The optimal cutoff of 3.78 (measured on a 1–5 Likert scale) yielded a sensitivity of 0.81 and specificity of 0.64. Overall, results provide preliminary support for the discriminant validity of SATAQ-4 thin internalization scores and suggest that even moderate levels of thin-ideal internalization may be predictive of clinically-significant eating pathology. It may be important for prevention and intervention work to actively seek to reduce internalization levels below this clinical cutoff, though future work is needed to bear this out.

Hoop training: a pilot study assessing the effectiveness of a multisensory approach to treatment of body image disturbance in anorexia nervosa Abstract Purpose We tested in a pilot study a new intervention for body image disturbance in anorexia nervosa (AN). Unlike common treatment approaches our hoop training targeted not only cognitive-emotional and visual aspects of body image, but also tactile and body-scaled action components. Methods We assessed cognitive, visual, tactile and body-scaled action aspects of body image disturbance before and after completion of hoop training. Twelve AN patients completed treatment as usual (TAU) for body image, 14 completed hoop training in addition to TAU. Results Results show that patients who completed the 8-week individual hoop training in addition to TAU improved more on body image disturbance tasks from baseline to follow-up than patients who completed only TAU. Hoop training specifically seems to affect tactile body image and body-scaled action. Conclusions Taken together, a treatment approach in which the full spectrum of body image disturbances in AN is targeted has a unique added effect over treatment as usual. Level of evidence Level II, non-randomized controlled study.

Effect of parental criticism on disordered eating behaviors in male and female university students in Mexico City Abstract Purpose The aim of this study was to analyze the effect of parental criticism of their offspring’s bodies in the development of disordered eating behaviors (DEBs) in university students in Mexico City. Methods A sample of 892 freshmen (502 women and 390 men) was included. The prevalence of the internalization of the aesthetic thin ideal, body dissatisfaction, self-esteem, depressive symptoms, and body mass index was estimated by sex. For each sex, the effect of parental criticism on DEBs, together with that of the other covariates, was measured through ordinal regression models. Results It was found that women received more criticism from their mothers than men. Among the participants, the likelihood of DEBs is increased in the presence of criticism from both parents (OR = 2.5), criticism from the mother alone (OR = 2.0), overweight (OR = 1.7), obesity (OR = 2.1), wanting a slimmer body (OR = 8.3), and depressive symptoms (OR = 3.3). Among men, this risk is increased in the presence of criticism from both parents (OR = 2.7), being obese (OR = 2.4), wanting a slimmer body (OR = 3.4), and depressive symptoms (OR = 2.8). Conclusions It is essential to include issues linked to parental criticism of their bodies in interventions to prevent eating disorders in college students. Level of evidence V, cross-sectional descriptive study.

“There’s nothing there for guys”. Do men with eating disorders want treatment adaptations? A qualitative study Abstract Purpose Men with eating disorders may experience unique issues compared to their female counterparts, and there is a growing interest in how these differences should be addressed in clinical practice. However, the views of male patients on potential treatment adaptations remain under-explored. The purpose of this study was to explore the experiences of men who have experienced treatment for eating disorders. Methods Men who had experienced eating disorder treatment were recruited through UK National Health Service eating disorder services and online advertising. 14 participants took part in semi-structured interviews discussing their experiences of treatment, and their views on the need for adaptations. Interviews were analysed using thematic analysis. Results Three main themes were identified from the analysis: a preference for person-centred, rather than gender-centred treatment, a feeling of being “the odd one out” as men in current treatment environments, and recommendations for treatment adaptations. Conclusions Participants described wanting to be treated as individuals and not defined by their gender. Whilst existing treatment approaches were mostly felt to achieve this individual focus, the actual treatment setting may inadvertently reinforce a perception of atypicality due to being men in a female-dominated environment. Adaptations may therefore be required to make the treatment environment more male friendly. Clinical recommendations are outlined. Level of evidence V. Qualitative study.

Genetic and environmental relationships between eating behavior and symptoms of anxiety and depression Abstract Purpose To assess gender-specific genetic and environmental correlations between depressive and anxiety symptoms, and concurrent and follow-up eating behavior in Korean twins and their family members. Methods Center for Epidemiological Studies Depression Scale and State-Trait Anxiety Inventory were used to measure depressive and anxiety symptoms in subjects. To assess concurrent and follow-up relationships of the symptoms with eating behavior domains (restrained, emotional, and external eating), the Dutch Eating Behavior Questionnaire was administered to 2359 subjects at baseline (men, 48.5%; 42.0 ± 12.7 years; monozygotic twins, 33.7%) and to 1169 subjects at follow-up (men, 45.9%; 44.9 ± 11.6 years; monozygotic twins, 41.0%). A mixed linear model and bivariate analysis were applied. Results After adjusting for age, twin and family effects, income, education, smoking status, alcohol use, exercise, and body mass index, depressive and anxiety symptoms were positively associated with concurrent and follow-up emotional and external eating, but not with restrained eating. The effect size of association with emotional eating increased in men in men over time, but decreased in women. Common genetic and environmental correlations showed a difference between genders, and their strength changed with time. Nevertheless, common genetic correlations were found between depressive and anxiety symptoms, and concurrent emotional eating, in both genders. There were common environmental correlations between anxiety symptoms, and concurrent restrained and emotional as well as follow-up emotional eating, in both genders. Conclusions There are similarities and differences in genetic and environmental relationships between depressive and anxiety symptoms and eating behaviors, based on gender and time of assessment. Level of evidence Level III, cohort study.