Eating disorder pathology among overweight treatment-seeking youth: Clinical correlates and cross-sectional risk modeling

Center for Anxiety and Related Disorders, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215, USA.
Behaviour Research and Therapy (Impact Factor: 3.85). 11/2007; 45(10):2360-71. DOI: 10.1016/j.brat.2007.03.017
Source: PubMed


Preliminary research suggests that pediatric overweight is associated with increased eating disorder pathology, however, little is known about which overweight youth are most vulnerable to eating disorder pathology. We therefore investigated 122 overweight treatment-seeking youth to describe eating disorder pathology and mental health correlates, and to identify psychopathological constructs that may place overweight youth at increased risk for eating disorder pathology. Youth participated in a comprehensive assessment of eating disorders, mood and anxiety disorders, general psychopathology, and risk variables involving semi-structured clinical interviews and self- and parent-report questionnaires prior to the initiation of weight-loss treatment. Ten youth met criteria for an eating disorder, and over one-third endorsed recent binge eating. Eating disorder pathology was associated with depressive and anxious symptoms (p's<0.001). Structural equation modeling indicated increased negative affect, teasing experience, and thin-ideal internalization, and decreased perfectionism were associated with increased eating disorder pathology. Findings corroborate earlier work indicating that eating disorder pathology is elevated and clinically significant in overweight treatment-seeking youth, bolstering the need for mental health assessment of such individuals. Cross-sectional modeling proposed key variables that relate to eating disorder pathology in overweight treatment-seeking youth, which following prospective replication, may inform the development of effective interventions for overweight and eating disorders.


Available from: Marian Tanofsky-Kraff, May 07, 2014
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    • "The impact of particular exposures is likely to depend on the presence of other vulnerabilities or conditions. Overweight is a wellestablished risk factor for body dissatisfaction and disordered eating (Eddy et al., 2007; Goldschmidt, Aspen, Sinton, Tanofsky-Kraff, & Wilfley, 2008). We conducted post hoc analysis examining the moderator effect of overweight status on the relationship between dietary practices on disordered eating. "
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    ABSTRACT: Objective China is undergoing dramatic Westernization, hence may be able to provide unique insights into the role of sociocultural factors in disease. The purpose of this exploratory study was two-fold: to describe the prevalence of screening-detected eating disorders and disordered eating in China at the first occasion of assessment in the large-scale China Health and Nutrition Survey (CHNS) and to explore the associations between dietary practices and disordered eating. Regarding the first objective, participants are provincially representative and in subsequent waves will be followed longitudinally.MethodCHNS participants were recruited using multistage, cluster random sampling, beginning in 1989. In this study, participants comprised 259 female adolescents (12–17 years) and 979 women (18–35 years) who participated in the CHNS 2009 survey, which is the first CHNS survey to assess disordered eating. Dietary practice-disordered eating associations were investigated with logistic regression adjusting for age, body mass index, and urbanization.ResultsOf the participants, 6.3% (95% CI: 4.8, 8.2) of adults and 7.8% (95% CI: 5.0, 12.0) of adolescents had a screening-detected eating disorder. Dietary practices had non-significant associations with disordered eating at the general population level, except for protein consumption among women. There was evidence that skipping meals and a high-fat diet may confer risk.DiscussionScreening-detected eating disorders in China are lower in prevalence than in developed countries. Dietary practices had fairly limited associations with disordered eating at the general population level; protein consumption, skipping meals, and a high-fat diet are candidate dietary practice exposures for disordered eating. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    European Eating Disorders Review 11/2014; 23(1). DOI:10.1002/erv.2334 · 2.46 Impact Factor
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    • "Nevertheless, although binge eating is defined identically in children, adolescents and adults, converging evidence indicates that it is difficult to systematically diagnose BED in young children with accepted adult criteria [105,130]. Factors considered of particular relevance for this diagnostic ambiguity are the inclination of children either not to understand the meaning of loss of control when it comes to binge-eating, or to frankly deny such behaviors when asked, out of shame and embarrassment [46,109,127]. Moreover, parents also tend to deny binge-eating in their children for similar reasons. "
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    ABSTRACT: Childhood obesity is on the rise in both industrialized and developing countries. The investigation of the psychosocial aspects of childhood obesity has been the focus of long- standing theoretical and empirical endeavor. Overweight in children and adolescents is associated with a host of psychological and social problems such as reduced school and social performance, less favorable quality of life, societal victimization and peer teasing, lower self-and body-esteem, and neuropsychological dysfunctioning. Whereas community samples of obese youngsters usually do not show elevated psychopathology, clinically-referred overweight children show elevated depression, anxiety, behavior problems, attention deficit hyperactivity disorder and disordered eating. Parents’ perceptions of their child’s overweight highly influence the well-being of obese children and the way in which they perceive themselves. The present review paper aims to broaden the scope of knowledge of clinicians about several important psychosocial and familial dimensions of childhood obesity: the psychosocial functioning, self and body esteem and psychopathology of overweight youngsters, the influence of children’s perceptions of overweight, including those of the obese children themselves on their well being, and the influence of parental attitudes about weight and eating on the psychological condition of the obese child.
    Journal of Eating Disorders 02/2013; 1(1). DOI:10.1186/2050-2974-1-7
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    • "Two prospective studies suggest that dieters most at risk for developing clinically significant eating disturbances are those with severe disordered eating symptoms and cognitions [9] [10]; however, there has been limited exploration of other psychosocial factors that may be involved in the relationship between dieting and binge eating. Depression symptoms, poor selfesteem , and teasing experiences have been identified as potential moderators in adolescents and young adults based on crosssectional research [15] [16] [17] [18] [19] and prospective studies of up to 2 years [12] [20], with most theoretical models implicating binge eating as a method of coping with negative affect related to these factors [12]. The generalizability of study findings could be enhanced by examining the relation between these psychosocial variables and binge eating over longer time frames, and using large, community-based samples, including both males and fe- males. "
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    ABSTRACT: Dieting is a well-established risk factor for binge eating, yet the majority of dieters do not develop binge eating problems. The purpose of the current study was to examine psychosocial factors involved in the relation between dieting and binge eating over a 10-year follow-up period. A population-based sample (n = 1,827) completed surveys assessing eating habits, psychological functioning, and weight status at 5-year intervals spanning early/middle adolescence (time 1), late adolescence/early young adulthood (time 2), and early/middle young adulthood (time 3). Dieting, along with depression symptoms, self-esteem, and teasing experiences at time 1 and time 2, was used to predict new onset binge eating at time 2 and time 3, respectively. Interactions between dieting status and varying degrees of these psychosocial factors in relation to binge eating onset were also tested. Dieters were two to three times more likely than nondieters to develop binge eating problems over 5-year follow-ups. At most time points, depression symptoms and self-esteem predicted binge eating onset beyond the effects of dieting alone. Detrimental levels of these factors among dieters (relative to nondieters) increased the likelihood of binge eating onset only during the later follow-up period. Depression and self-esteem appear to be particularly salient factors involved in the relation between dieting and binge eating onset among adolescents and young adults. Early identification of these factors should be a priority to prevent the development of binge eating problems among already at-risk individuals.
    Journal of Adolescent Health 07/2012; 51(1):86-92. DOI:10.1016/j.jadohealth.2011.11.001 · 3.61 Impact Factor
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