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Eating Disorders and Obesity: A Comprehensive Handbook
Abstract
[This volume] is devoted to a comprehensive and current review of all aspects of obesity and the eating disorders—including the interface of these with factors affecting weight regulation.
Section I . . . covers such factors as genetic influences and physiological, psychological, and energy related factors. Section II focuses on the importance of dieting in our world today; social and cultural influences and their relation to body image and the eating disorders are covered in some detail, as is the entire controversy over dieting itself. Section III highlights the issue of measurement and covers everything from assessments of body energy stores to food intake, energy expenditure, and measures of psychopathology. Sections IV through VII cover all aspects of the eating disorders including history, clinical features, theories of pathogenesis and complications, as well as detailed views on approaches to treatments. Sections VIII and IX cover obesity in a similar fashion.
This book contains . . . information on all aspects of eating disorders and obesity so that professionals with clinical or research questions in this area [and students] will have the . . . information at hand in one volume. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Higher morbidity in association with overweight and obesity has been observed for hypertension, 2 [107][108][109][110][111][112][113][114][115] Obesity is also associated with complications of pregnancy, menstrual irregularities, hirsutism, stress incontinence, and psychological disorders (depression). 112,[116][117][118][119][120][121][122][123][124][125][126][127][128] The nature of obesity-related health risks is similar in all populations, although the specific level of risk associated with a given level of overweight or obesity may vary with race/ethnicity, and also with age, gender, and societal conditions. For example, the absolute risk of morbidity in chronic conditions such as CHD is highest in the aged population, while the relative risk of having CHD in obese versus nonobese individuals is highest in the middle adult years. ...
... A number of reviews have been published on the psychosocial aspects of obesity. [124][125][126][127][128]183 The specific topics that will be reviewed here include social stigmatization, psychopathology, binge eating, and body image perceptions. ...
... In American and other Westernized societies there are powerful messages that people, espe-cially women, should be thin, and that to be fat is a sign of poor self-control. 125,126,128,184,185 Negative attitudes about the obese have been reported in children and adults, [186][187][188][189][190][191] in health care professionals, [192][193][194] and in the overweight themselves. 195,196 People's negative attitudes toward the obese often translate into discrimination in employment opportunities, [197][198][199] college acceptance, 200 less financial aid from their parents in paying for college, 195,201 job earnings, 202 rental availabilities, 203 and opportunities for marriage. ...
Background:
Obesity is a public health issue worldwide. Conversational agents (CAs), also frequently called chatbots, are computer programs that simulate dialogue between people. Owing to better accessibility, cost-effectiveness, personalization, and compassionate patient-centered treatments, CAs are expected to have the potential to provide sustainable lifestyle counseling for weight management.
Objective:
This systematic review aimed to critically summarize and evaluate clinical studies on the effectiveness and feasibility of CAs with unconstrained natural language input for weight management.
Methods:
PubMed, Embase, the Cochrane Library (CENTRAL), PsycINFO, and ACM Digital Library were searched up to December 2022. Studies were included if CAs were used for weight management and had a capability for unconstrained natural language input. No restrictions were imposed on study design, language, or publication type. The quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool or the Critical Appraisal Skills Programme checklist. The extracted data from the included studies were tabulated and narratively summarized as substantial heterogeneity was expected.
Results:
In total, 8 studies met the eligibility criteria: 3 (38%) randomized controlled trials and 5 (62%) uncontrolled before-and-after studies. The CAs in the included studies were aimed at behavior changes through education, advice on food choices, or counseling via psychological approaches. Of the included studies, only 38% (3/8) reported a substantial weight loss outcome (1.3-2.4 kg decrease at 12-15 weeks of CA use). The overall quality of the included studies was judged as low.
Conclusions:
The findings of this systematic review suggest that CAs with unconstrained natural language input can be used as a feasible interpersonal weight management intervention by promoting engagement in psychiatric intervention-based conversations simulating treatments by health care professionals, but currently there is a paucity of evidence. Well-designed rigorous randomized controlled trials with larger sample sizes, longer treatment duration, and follow-up focusing on CAs' acceptability, efficacy, and safety are warranted.
... Intestinal disturbances usually occur when the body tries to compensate for the lack of food, increasing the likelihood of constipation, bloating and abdominal discomfort (Campbell & Peebles, 2014). Fairburn and Brownell (2002) pointed out some strange behaviors in AN as using a dessert spoon to eat soup, dirtying the plate, and hiding food. On the other hand, it is common for individuals with AN to develop a curiosity for cooking justified by the need to control what they eat (Fairburn & Brownell, 2002). ...
... Fairburn and Brownell (2002) pointed out some strange behaviors in AN as using a dessert spoon to eat soup, dirtying the plate, and hiding food. On the other hand, it is common for individuals with AN to develop a curiosity for cooking justified by the need to control what they eat (Fairburn & Brownell, 2002). This sense of self-mastery works as an escape, showing that if they control their body and weight, they also control their weaknesses (Fairburn & Brownell, 2002). ...
... On the other hand, it is common for individuals with AN to develop a curiosity for cooking justified by the need to control what they eat (Fairburn & Brownell, 2002). This sense of self-mastery works as an escape, showing that if they control their body and weight, they also control their weaknesses (Fairburn & Brownell, 2002). ...
Anorexia is an eating disorder characterized by a morbid fear of gaining weight, excessive restriction of food and intense and exaggerated practice of physical exercise. There are two subtypes of anorexia: restrictive and purgative. Its prevalence is mainly in female adolescents aged 15 to 19 and entails multiple harmful physical, psychological, social, and emotional consequences. Anorexia is portrayed as a multifactorial disorder, requiring a biopsychosocial perspective and a multidisciplinary intervention to address all the affected areas of the individual. In this article, we approach the appliance of Narrative Therapy by White and Epston (1989), which advocates that the psychotherapeutic treatment can be carried out together – psychologist, client and family – with the literature supporting it. Anorexia is an egosyntonic disorder associated with a high mortality rate. It should be noted that the cure for anorexia is not granted since there is an increased number of relapses and treatment dropouts. For this reason, an innovative approach like narrative therapy can be approached with promising results.
... Eating disorders have detrimental implications for the physical health and well-being of individuals (Mond et al., 2012). The literature has indicated that eating disorders are often associated with other disorders of normal mental functioning, the most commonly reported being depression and anxiety (Fairburn & Brownell, 2002). These psychological disorders are predominantly accompanied by negative emotions, which can have a significant negative impact on life and thus on well-being. ...
... These psychological disorders are predominantly accompanied by negative emotions, which can have a significant negative impact on life and thus on well-being. For example, intense negative emotional states have been reported in individuals who engage in strict dieting or caloric restriction to control body weight (Fairburn & Brownell, 2002). These associations between depressive symptoms and eating disorders have significant implications for well-being (Kenny et al., 2023). ...
The aim of this study is to analyze the relationship between eating disorders and well-being. Furthermore, we seek to explore whether the relationship between these variables may be modetaed by a variable such as emotional selfregulation. The study was attended by 143 people aged between 18 and 74, M = 27.85, SD = 13.42, of which 18 men (13%) and 125 women (87%). The instruments used were the Emotion Regulation Questionnaire (Gross & John, 2003), the Eating Disorder Inventory – 3 (EDI-3) (Garner et al., 2010), and the Satisfaction with Life Scale (SWLS) (Diener et al., 1985). The results showed that eating disorders are significantly negatively associated with wellbeing. Additionally, emotional self-regulation manages to moderate the relationship between body dissatisfaction and well-being through its expressive suppression dimension. The practical implications of the study were discussed, in terms of development of psychoeducational programs to raise awareness of the risk of developing eating disorders and their direct implications for well-being, so that individuals seek to learn the most effective ways of emotional regulation strategies for themselves, and use them appropriately.
... For AN and BN, the monozygote/dizygote ratio is approximately 3/1, and the monozygote ratio is above 50%. These rates show that the contribution of genetic factors is more than expected, at a rate of 50% (Fairburn & Brownell, 2002). In this context, it has been observed that more specific results regarding eating disorders have been obtained in studies conducted on twins to measure the biological and genetic context. ...
... Only a small proportion of people more susceptible to the disease are at risk of developing AN. These factors are considered insufficient to explain AN, but these sociocultural factors may be more effective in Bulimia Nervosa than AN (Fairburn & Brownell, 2002). ...
... More generally, there is a substantial overlap between eating disorders and depressive (12,13) and anxiety disorders (14,15). There are different explanatory models for this observation. ...
... It has been hypothesized that depression and anxiety disorders are sequelae of eating disorders, or vice versa. Further, eating disorder symptoms could be manifestations of depression and anxiety disorders (depending on an individual's age and gender), or they could share common etiological factors (12,16). Eating disorder, depression and anxiety symptoms belong to an internalizing phenotype of psychopathology that is much more common in women (17)(18)(19). ...
Background: Evidence shows that anxiety and depressive disorders play an important role in eating disorder behavior. However, given the epidemiology of eating disorders, there is a need to investigate potentially gender-specific connections.
Method: This study tested the associations of anxiety and depression symptoms with eating disorder symptoms and behaviors and explored whether they differed between men and women. Within a population-representative survey (N = 2,510; ages 14–94), participants completed measures of depression symptoms (PHQ-2), anxiety symptoms (GAD-2), and eating disorder symptoms (EDE-Q8). We conducted linear regression analyses of the EDE-Q8 sum score and General Linear Models on the three behaviors overeating, binge eating, and compensatory behaviors (self-induced vomiting/use of laxatives/excessive exercising).
Results: Depression and anxiety symptoms were related to more eating disorder symptoms in men and women (irrespective of BMI, age, and income). The association of depression and eating disorder symptoms was slightly stronger in women. Overeating was more common in men and in depressed individuals, whereas compensatory behaviors were more common among anxious individuals, especially anxious women.
Conclusion: The study extends previous research by using gender-specific methods in a representative sample. It indicates similarities and differences between men and women regarding disordered eating on a population level.
... Rahatsızlığın tekrarının önlenebilmesi için yeterli kilo alımının sağlanmasının ardından psikoterapiye devam ettirilmelidir.Tıkanırcasına yeme bozukluğu yeme atakları il baş gösterir. Bulimiya Nervozadaki gibi fazla miktarda alınan kaynakların ağırlık etkisini gidermek için başvuırulan telafi edecek davranışları yoktur(Grilo 2002). Tıkanırcasına yeme bozukluğu hastalığı olan olgular seviyelerine göre gözlenen beden kilosunun üzerindedir ve genelde obezite hastalığı tanısı da alırlar. ...
The aim of this study is to examine the effectiveness of cognitive behavioral therapy on eating disorder with systematic review method by using field spelling screening. In this systematic review, a systematic review was used in this study of the CIS, and no field studies or scales were used. Turkish English and Turkish articles have been discussed in this systematic review. This research includes individuals who are in the adult group. January September 2022 and January 2023, this study has been carried out in two stages. Although the years of the articles examining the effects on Eating Disorders were not taken into account, they were examined; 3 articles that fit the exclusion and inclusion criteria were reviewed. Of these studies, 1 is a systematic review and 2 is a case report. 3 of these studies have also been published in Turkey. In the 3 articles examined, the effectiveness of cognitive behavioral therapy on eating disorder was mentioned. Cognitive behavioral therapy applied in individuals with eating disorders greatly helps to reduce the symptoms of the individual. We can see eating disorder as a serious psychiatric illness that can lead to a negative quality of life of the individual, which can bring physical, psychosocial and economic factors that are not only focused on food and body relationship in people, but also bring physical, psychosocial and economic factors. Since the rate of re-infection of a person with eating disorders is quite high, the methods to be used in treatment are important. We can also see CBT from the front lines as the most effective method in terms of psychotherapy. It is observed that Cognitive Behavioral Therapy's examination of the rejecting ideas in the mind, shaping these ideas again and supporting healing with attitude-oriented techniques will have a beneficial effect on the improvement of symptoms. The main point of psychopathology in Eating Disorder is cognitive and finding the sources of self-importance of the individual by making sense of body weight and body shape, compromising attitudes arise in the individual for these reasons. Keywords: Eating disorder, CBT, Review
... Tablo 1: Ortoreksiya Nervoza İçin Tanı Kriterleri (Moroze vd., 2015) A. Aşağıdakilerden ikisinin ya da daha fazlasının olmasıyla belirli, sağlıklı yiyecekler yemeye yönelik olarak öğünlerin bileşimine ve kalitesine yönelik saplantılı meşguliyet ve kaygı 1. Besinlerin saflığına yönelik inanışlar doğrultusunda besin değeri açısından dengesiz bir diyet uygulama Mükemmeliyetçilik, yaygın olarak kullanılan bir tabir olmasına rağmen klinik anlamdaki yeri ve önemi halen inceleme konusudur (Shafran vd., 2002). Klinik anlamda mükemmeliyetçilik, kişinin öz değerinin -tüm olumsuz sonuçlarına rağmen-kendi talepkâr standartları doğrultusunda belirlenmiş zorlu hedefler için çabalama ve bu hedefleri başarmaya bağlı olarak derecelendirildiği bir düşünce sistemi olarak tanımlanmakta, işlevsiz bir öz değerlendirme örüntüsü olduğu vurgulanmaktadır (Fairburn ve Brownell, 2005;Shafran vd., 2002). ...
... Regards attitudes towards obesity, in spite of the positive attitude notice by good proportion of the participants in some areas, however, this study showed that more than 70% of the studied sample had negative attitudes towards obesity and consider obese people to be lazier and more self indulgent than normal weight people, and think that obesity is a stigma. This finding is important, since stigmatizing obese subjects with any undesirable characteristic is ethically unacceptable and may have negative impact on their emotional health [16]. It should be noted here that negative societal attitude toward obesity and obese people had been reported before [17]. ...
This study aimed to assess knowledge, attitude and practices among sample of adults in Baghdad Iraq; Ascertain relationship between the knowledge, attitude and practices about obesity and some independent variables and determine the sources of information. Cross sectional study was carried out during the period from 1st of April to the end of October 2021, in Baghdad City in different places where people from different Sociodemographic characteristics, about 253 samples collected from people from different age groups, occupation, education, and residence, data was collected by using a questionnaire. Current study showed male (45.5%) more than females(54.5%), so high frequency of overweight and obesity had been noticed as (11.1%) Moreover, high frequency of central obesity had been found among the studied females & males (depending on waist/ hip ratio as indicatoras (61.1& 51.4) % respectively.so the knowledge for risk factors, weight management food regimen, treatment & success in treatment, diagnosis of obesity, and the lowest score was for the complication of obesity. The difference between the mean score values was significant, as well as lower mean knowledge score values were found among males, participants aged 50+, occupational group including students & housewives, lower educational level, thin participants, rural and not married in comparison to their counterparts in other; gender, age, occupation, educational level, body mass index, residence and marital status categories respectively, also current study showed negative attitude towards obesity, so subjects with normal BMI had significantly highest score of good attitudes toward obesity. High frequency of overweight and obesity had been noticed among the studied sample, Moreover, high frequency of central obesity had been found among the studied females & males, so the knowledge for risk factors, weight management food regimen, treatment & success in treatment, diagnosis of obesity, as well as negative attitude towards obesity had been found in more than two third of the participants. Subjects with normal BMI had significantly highest score of good attitudes toward obesity, while, the lowest score was noticed in the thin subjects, so significant correlation was noticed between total knowledge score and; educational level, knowledge scores about; risk factor, diagnosis, weight management food regimen, treatment, complication and with scores for good attitudes.
... Rigid control refers to an "all-or-nothing approach to eating, dieting, and weight, " and flexible control refers to a "more graduated approach to eating, dieting, and weight, in which "fattening" foods are eaten in limited quantities without feeling guilty" (58). Fairburn et al. (59) report that eating behavior adaptation to "all or nothing" can lead to unintentional overeating. Beaulieu et al. (29) found that ADF causes greater rigid restraint and CR causes more flexible restraint. ...
Fasting diets (FDs) have drawn great attention concerning their contribution to health and disease over the last decade. Despite considerable interest in FDs, the effect of fasting diets on eating behaviors, sleep, and mood-essential components of diet satisfaction and mental health- has not been addressed comprehensively. Understanding the critical role that fasting plays in these elements will open up potential treatment avenues that have not yet been explored. The aim of the present paper was to conduct a comprehensive critical review exploring the effects of fasting on eating behaviors, sleep, and mood. There is currently a lack of clarity regarding which fasting option yields the most advantageous effects, and there is also a scarcity of consistent trials that assess the effects of FDs in a comparable manner. Similarly, the effects and/or treatment options for utilizing FDs to modify eating and sleep behaviors and enhance mood are still poorly understood. Further researches aiming at understanding the impacts of various fasting regimes, providing new insights into the gut-brain axis and offering new treatment avenues for those with resistant anxiety and depression, are warranted. Alteration of eating behaviors can have lasting effects on various physiological parameters. The use of fasting cures can underpin ancient knowledge with scientific evidence to form a new approach to the prevention and treatment of problems associated with co-morbidities or challenges pertaining to eating behaviors. Therefore, a thorough examination of the various fasting regimens and how they impact disease patterns is also warranted.
... Body Mass Index (BMI) was calculated by dividing weight in kilograms by the square of height in meters (kg/meters squared) (Keys, Fidanza, Karvonen, Kimura & Taylor, 1972). In some analyses, BMI scores were dichotomized to categorize women as average or underweight (BMI Ͻ 27.3) or as overweight (BMI Ն 27.3;Brownell, 1995). In others, women were grouped as underweight or normal weight (BMI Ͻ 27.3), overweight (BMI Ն 27.3), severely overweight (BMI Ն 32.3), or morbidly obese (BMI Ն 39; Williamson, 1995). ...
Cultural stereotypes might help explain why smoking is less prevalent among Hispanic than non-Hispanic White women, whereas obesity is more prevalent. Hispanic (n = 130) and non-Hispanic White (n = 114) women rated their thoughts and feelings regarding a female smoker and an overweight woman. Ethnicity did not influence evaluations, but attitudes toward smokers were more positive among more acculturated Hispanic women, F(1, 66) = 9.9, p < .01. Less acculturated women evaluated an overweight woman more positively than a smoker, F(1, 28) = 5.65, p < .05; more acculturated women did the opposite, F(1, 36) = 5.92, p < .05. Smokers evaluated smokers more positively than overweight women, F(1, 86) = 40.8, p < .01; nonsmokers did the opposite, F(1, 138) = 7.7, p < .01. Personal body weight did not influence evaluations. Acculturation and smoking status appear to have a greater influence than ethnicity or weight status on women's attitudes toward smoking and weight.
... Further, it was found that overweight preoccupation is the component of body image that affects DE behavior most significantly than any other component that accounted for 16% variance (see Table 4). DE behaviors, unhealthy dieting practices, and obesity share common psychopathology, and can have adverse serious effects on physical as well as psychological health (Fairburn, 2008;Fairburn & Brownell, 2002). Evidences suggest that obesity can eventuate in individuals with DE behaviors (Fairburn, Cooper, Doll, & O'Connor, 2000) and higher levels of body dissatisfaction exists in obese population as compared to populations with other eating disorders (Ciliska, 1998;Polivy & Herman, 1992). ...
... Comprendre les TCA. Les troubles du comportement alimentaire chez les jeunes sont souvent associés à des traits de caractère et à des caractéristiques comme l'obsession, le perfectionnisme, l'anxiété et la dépression 15 A. Restriction des apports énergétiques conduisant à une perte de poids significative B. Peur intense de prendre du poids ou de devenir gros, ou comportement persistant interférant avec la prise de poids dirigé vers la perte pondérale est souvent compulsif, comme restreindre les calories, se purger ou faire trop d'exercice 16 . À mesure que la perte pondérale se poursuit, le cerveau mal nourri devient de plus en plus focalisé et obsédé, ce qui, à son tour, exacerbe le trouble et donne de l'essor à un comportement compulsif accru, axé sur la perte de poids 16 présyncope, les palpitations, la douleur thoracique, la faiblesse, la fatigue, le lanugo, la sécheresse cutanée, la perte de cheveux, les crampes musculaires, la douleur aux articulations, la pâleur, la tendance aux ecchymoses et l'intolérance au froid 22 . ...
... Eating disorders in young people are often associated with personality traits and characteristics such as obsessiveness, perfectionism, anxiety, and depression. 15 With AN and AAN, individuals experience obsessive thoughts that they are eating too much, that they will gain weight, or that they must compensate in some way for consumed calories. The behaviour directed at weight loss is often compulsive-for example, calorie restriction, purging, or overexercising. ...
Objective:
To address screening, diagnosis, and treatment of adolescents with anorexia nervosa and atypical anorexia nervosa in primary care.
Sources of information:
A literature search was conducted in PubMed using the subject headings anorexia nervosa, adolescents, COVID-19, review, guidelines, and primary care. Applicable articles were reviewed, with key recommendations summarized. Most evidence is level I.
Main message:
Recent studies suggest that the global COVID-19 pandemic contributed to an increase in the incidence of eating disorders, particularly among teenagers. This has resulted in increasing responsibility for primary care providers regarding the assessment, diagnosis, and management of these disorders. Moreover, primary care providers are in ideal positions to identify adolescents at risk of eating disorders. Early intervention is of utmost importance for avoiding long-term health consequences. High rates of atypical anorexia nervosa indicate a need for providers to have awareness of weight biases and stigmas. Treatment primarily involves a combination of renourishment and psychotherapy, generally through family-based therapy, with pharmacotherapy playing a lesser role.
Conclusion:
Anorexia nervosa and atypical anorexia nervosa are serious, potentially life-threatening illnesses that are best addressed through early detection and treatment. Family physicians are in an optimal position to screen for, diagnose, and treat these illnesses.
... Genellikle hızlı bir şekilde iyileşme beklentileri vardır. İleri yaştaki hastalarda antidepresanların, özellikle fluoksetin grubu ilaçların fayda sağladığını gösteren çalışmalar mevcuttur [27]. Tedavi planı oluşturulurken her bir bulgu tek tek kapsamlı şekilde incelenmelidir. ...
Anorexia nervosa and bulimia nervosa are psychiatric diseases that usually affect women between the ages of 13 and 20, with frequent recurrences of vomiting and disrupt the physiological development process, may even result in death, so early diagnosis and treatment are very important. A multidisciplinary approach is required for the diagnosis, treatment and follow-up of the diseases. In these patients, due to vomiting attacks, tooth erosion, defined as chemical dissolution of tooth tissue without bacteria or loss of substance in non-carious tooth hard tissues, can be seen. Although erosive lesions are usually first seen on the palatal surfaces of the maxillary incisors and first molars, they can adversely affect all hard and soft tissues in the mouth. In this case report, the systemic and dental effects of Anorexia Nervosa and Bulimia Nervosa were discussed and the dental treatment process of a patient diagnosed with Anorexia Nervosa was examined.
... Cognitive anxiety is a difficulty in concentrating, thinking, and disturbances in thinking or cognitive distortions. Another advantage of this therapy is that the implementation mechanism can be developed as a form of innovative treatment strategy and the results are more effective, efficient and cost-effective (Fairburn, 2002). Oemarjoedi (2004) adds that the goal of thinking therapy is also to invite clients to challenge wrong thoughts (and emotions) by presenting evidence that contradicts their beliefs about the problem at hand. ...
This study aims to determine the effect of giving cognitive therapy in reducing anxiety in people with HIV/AIDS. The research subjects were 8 women with HIV/AIDS. Data collection was carried out using an anxiety scale, interviews and observations. The research design used was the Pretest-Posttest Control Group Design. The research analysis used is quantitative and qualitative analysis. Quantitative analysis by testing the hypothesis using the Mann-Whitney test analysis to determine whether there is an effect of cognitive therapy in reducing anxiety in HIV/AIDS sufferers in the study group before being given training and after being given training. Qualitative analysis was carried out based on the results of observations, interviews, worksheets. The results of the study, namely the pre-test and post-test anxiety showed that there were differences in anxiety after being given training with a value of Z = -2.309, p = 0.021, p <0.05. In the post-test and follow-up study groups there was a difference in anxiety with a value of Z = -2.323, p = 0.020, p <0.05. The conclusion of this study is that there are differences in the level of anxiety in the study subjects after follow-up.
... A study addressing psychiatric disorders in the preoperative period of bariatric surgery conducted in northeastern Brazil detected a 56.7% prevalence rate of binge eating among the different disorders 6 , which is a higher frequency than that found for obese individuals who seek specialized services for the treatment of obesity 13,14,15,16 . The age of the participants in the study ranged from 19 to 57 years, 73.1% were women, 35.8% had less than ten years of schooling, 43.3% were homemakers, and mean preoperative BMI was 48.51 kg/m². ...
Introduction: Bariatric surgery is considered the most effective obesity treatment. Obese patients have a high prevalence of eating disorders. Objectives: Evaluate the occurrence of eating disorders and eating patterns in candidates for bariatric surgery and associate eating disorders with sociodemographic and clinical characteristics. Methods: A retrospective study was conducted using electronic charts of candidates for bariatric surgery. Data were collected on sex, age, marital status, schooling, occupation, non-communicable diseases, body mass index (BMI), eating disorders, and eating patterns. Results: Among the 281 patients evaluated, eating disorders were detected in 26.7%; 10.3% had binge eating disorder, 6.6% had bulimia nervosa, and 5.3% had the night-eating syndrome. The specific eating patterns were overeating (46.6%), binge eating during periods of stress (9.3%), eating sweets (4%), and snaking (1.3%). BMI ranged from 35.38 to 59.03 kg/m² (mean: 44.37 ± 5.89). All individuals (100%) had systemic arterial hypertension, and 23.3% had type 2 diabetes mellitus or dyslipidemia. Conclusions: The frequency of eating disorders was low in the sample studied, the most common of which was binge eating disorder. Non-communicable diseases were associated with eating disorders. Among the eating patterns observed, the most frequent was overeating.
... This is an important consideration for practitioners when recommending dietary interventions, given that an individual's capacity to selfregulate may be limited. Furthermore, given the tendency of individuals to adopt an 'all-ornothing' approach to dieting, a dietary lapse can often lead to reactionary overeating [44], compromising weight loss. CER provides a greater opportunity for this to occur than IF, which could be exacerbated if this type of dieting also causes poorer mood. ...
(1) Background: Excess weight in the form of adiposity plays a key role in the pathogenesis of cardiometabolic diseases. Lifestyle modifications that incorporate continuous energy restriction (CER) are effective at inducing weight loss and reductions in adiposity; however, prescribing daily CER results in poor long-term adherence. Over the past decade, intermittent fasting (IF) has emerged as a promising alternative to CER that may promote increased compliance and/or improvements in cardiometabolic health parameters independent of weight loss. (2) Methods: This paper presents a secondary analysis of data from a 12-week intervention investigating the effects of a twice-weekly fast (5:2 IF; IFT group) and CER (CERT group) when combined with resistance exercise in 34 healthy participants (17 males and 17 females, mean BMI: 27.0 kg/m2, mean age: 23.9 years). Specifically, changes in cardiometabolic blood markers and ratings of hunger, mood, energy and compliance within and between groups were analysed. Dietary prescriptions were hypoenergetic and matched for energy and protein intake. (3) Results: Both dietary groups experienced reductions in total cholesterol (TC; mean reduction, 7.8%; p < 0.001), low-density lipoprotein cholesterol (LDL-C; mean reduction, 11.1%; p < 0.001) and high-density lipoprotein cholesterol (mean reduction 2.6%, p = 0.049) over the 12 weeks. Reductions in TC and LDL-C were greater in the IFT group after adjustment for baseline levels and change in weight. No significant changes in markers of glucose regulation were observed. Both groups maintained high levels of dietary compliance (~80%) and reported low levels of hunger over the course of the intervention period. (4) Conclusions: Secondary data analysis revealed that when combined with resistance training, both dietary patterns improved blood lipids, with greater reductions observed in the IFT group. High levels of compliance and low reported levels of hunger throughout the intervention period suggest both diets are well tolerated in the short-to-medium term.
... Anoreksiya nervoza tanılı bireylerde aşırı kontrolcülük ve mükemmeliyetçilik özellikleri baskınken; bulimia nervoza tanısına daha çok dürtü kontrolünde yaşanan zorluk eşlik eder (Kanel, 2014). DSM-5'e yeni eklenen tıkınırcasına yeme bozukluğunda ise bulimia nervozada olduğu gibi çok kısa bir sürede normalin çok üzerinde yiyecek tüketimi ve yeme davranışı üzerinde kontrolün tamamen kaybedildiği hissi olmakla birlikte bu tanıyı alan hastalarda kusma, laksatif kullanımı gibi telafi edici davranışlar görülmez (APA, 2013;Grilo, 2002). Tıkınırcasına yeme bozukluğu hastaları yemekten keyif alırlarken devamında yoğun bir suçluluk duygusu ve aşırı yemek yemenin verdiği fiziksel rahatsızlıkla karşı karşıya kalırlar ve genelde aşırı kiloludurlar (APA, 2013;Özyurt ve ark., 2017). ...
Anahtar kelimeler: Yeme bozukluğu, aile odaklı terapi, farkındalık terapisi, diyalektik davranış terapisi
Keywords: Eating disorders, family-based therapy, mindfulness-based therapy, dialectical behavior therapy
Öz
Yeme bozuklukları, bireylerin bedenlerine yönelik çarpıtılmış algılarını ve düzensiz yeme alışkanlıklarını içeren bir tanı grubudur. Çeşitli tıbbi sorunları beraberinde getiren yeme bozukluğunda tamamen iyileşmenin güç olduğu ve yüksek oranlarda hastalığın tekrarladığı bilinmektedir. Erken tanı ve tedavinin öneminin sıkça vurgulandığı yeme bozukluklarında uygulanan tedavi yönteminin etkililiği ve tanıya uygunluğu da oldukça önemlidir. Bu nedenle, günümüzde pratikte de yaygınlaşan güncel psikoterapi yaklaşımlarının yeme bozuklukları alt türleri ile nasıl çalışılabileceği, psikolojik sağlık hizmeti veren uzmanlar tarafından buna dair bilgilerin öğrenilmesi ve değerlendirilmesi önemli bir konudur. Bu derleme çalışmasında, yaygın yeme bozukluğu tanılı bireylerle çalışılırken dikkate alınması gereken güncel terapi yaklaşımları aktarılmıştır. Aile odaklı terapi, farkındalık temelli terapiler ve diyalektik davranış terapisinin yeme bozukluğu olgularıyla çalışma yöntemleri, başlıca teknikleri ve terapi hedefleri üzerinde durulmuştur. Ayrıca, bu yaklaşımların etkililiği incelendiğinde alanyazındaki etkililik çalışmalarının hem sayıca hem de yöntemsel kısıtlılıkları göze çarpmıştır. Buna rağmen bu yöntemlerin farklı uygulamalar içermeleri ve yeme bozukluğu belirtilerini azaltmaları yönünden tercih edilebilir yaklaşımlar olduğu düşünülmüştür.
Family-Based Therapies, Mindfullnes-Based Therapies and Dialectical Behavior Therapy in Common Eating Disorders
Abstract
Eating disorders are characterized by individuals' distorted perceptions and irregular eating habits. Evidence obtained from clinical practices shows that eating disorders bring along various medical problems, and complete recovery is difficult; thus, relapse rates are high. In eating disorders, the importance of early diagnosis and treatment is emphasized; however, the effectiveness and suitability of the treatment method are also crucial. Accordingly, increasing knowledge about the contemporary psychotherapy approaches used in the treatment of eating disorders subtypes is significant for those who work in the field of mental health. In this review, contemporary therapy approaches that should be taken into consideration when working with individuals diagnosed with eating disorders are presented. Family-based therapies, mindfulness-based therapies, and dialectical behavioral therapies are emphasized with their underlying assumptions about eating disorders as well as their main techniques and therapy goals. In addition, effectiveness of these approaches was examined, and previous studies are found to be limited based on their amount and methodology. However, these psychotherapies were considered as useful approaches in terms of reducing the symptoms of eating disorders and providing different methods in treatment.
... The experiences of exercise for overweight individuals may have been negative ones, such as being teased or selected last for teams. In adulthood, overweight individuals may feel inexperienced in sports and exercise, embarrassed by a lack of co ordination, fear being ridiculed by others or concerned about their appearance in exercise clothing (Brownell, 1995). Being 'fat' and unfit is viewed as socially unacceptable and may lead to a decreased evaluation and satisfaction with one's body (Fallon, 1990;Tucker, 1987). ...
The main aim of this study was to examine the efficacy of exercise in the treatment of body image and mood disturbance in overweight women. The impact of exercise on self-esteem, physical self-efficacy and efficacy for weight control was also investigated. A second aim of the study was to explore factors which may contribute to the development of body image dissatisfaction in those who are overweight or obese, including an examination of the association between habitual levels of exercise and body image in the baseline data. Overweight and obese women were recruited to the study through newspaper advertisements. Three hundred and fifty questionnaires were sent to interested respondents, of which 66% were returned completed. Fifty six subjects who were eligible to participate in the experimental phase of the study, completed baseline assessments and were assigned either to the exercise (n=28) or waiting-list control (n=28) group. During the second phase of the study, subjects in the waiting-list control group were crossed over to the exercise condition and re-assessed at completion. In the exercise condition, women were instructed on a brisk walking program, requiring them to walk for up to 30 minutes on 5 days a week, over a period of 8 weeks. Program completers and waiting-list controls were compared on both physical (fitness and body measurements) and psychological variables (body image satisfaction, mood, self-esteem, physical self-efficacy, efficacy for weight control) during the experimental phase of the study. Data from the waiting-list controls, when they were crossed over to the exercise condition, were compared with data from the first exercise group. Participants were followed up 2 months after completing the exercise phase. Attrition was high in the exercise phase (35%-46%). Results for completers indicated significantly greater improvements in fitness, mood, physical self-efficacy and efficacy for weight control for those in the experimental group relative to the waiting-list controls. These findings were observed without any significant changes in weight and were replicated when the waiting-list control group were assigned to the exercise condition. There was an improvement on most measures of body image over time, in both groups, suggesting that aspects of the procedure other than exercise were responsible for the effect. The high rates of attrition limit the generalisability of the findings, which are discussed in the wider context of the development of body image dissatisfaction in those who are overweight or obese.
... There was no evidence that stay-at-home orders amplified the observed links between COVID-19 stress and eating among U.S. adults; yet, the association between COVID-19 stress and greater drinking frequency was stronger among individuals who resided in states with stay-at-home orders. It is possible that stay-athome orders did not amplify eating in response to stress because the U.S. already has a "toxic" food environment that encourages overeating (Brownell, 2002). On the other hand, under stay-at-home orders, J o u r n a l P r e -p r o o f individuals may have experienced a more noticeable shift in alcohol environments or more disrupted norms around typical days of the week and times of the day for drinking (Reich et al., 2015) As predicted, the strength of associations between COVID-19 stress and eating and drinking behaviors differed for certain groups of U.S. adults. ...
The coronavirus SARS-CoV-2 (COVID-19) pandemic has created widespread stress. Since many people cope with stress by eating, the current study investigated whether eating behaviors shifted among U.S. adults after the emergence of the pandemic. Data from national, crowdsourced surveys conducted on March 31st, 2020 and February 13th, 2019 were compared. Average levels of eating to cope and food addiction symptoms did not appear to shift during the early stages of the pandemic; however, U.S. adults ate about 14% more added sugars. Moreover, greater stress in response to the pandemic was associated with greater eating to cope, added sugars intake, food addiction symptoms, drinking to cope, and drinking frequency. These associations differed by the presence of state-level stay-at-home orders, perceived vulnerability to disease, age, U.S. political party affiliation, and gender. Although eating behaviors did not appear to majorly shift during the early stages of the pandemic, stress from the pandemic may intensify some maladaptive coping tendencies among U.S. adults.
Background/Objectives: Pressure to stay lean may lead adolescent athletes to dietary restraint and disordered eating. Lack of nutrition awareness can also contribute to suboptimal dietary habits, increasing the risk of eating disorders and Relative Energy Deficiency in Sport [RED-S], though evidence in competitive athletes is limited. This study explored eating disorder symptoms and RED-S knowledge in adolescent artistic gymnasts. Methods: Eighty-four female artistic gymnasts, thirty-nine international and national level gymnasts [high-level; 14 [14, 15] y] and forty-five recreational and club level gymnasts [low-level; 14 [13, 15] y] completed the Eating Disorder Examination Questionnaire [EDE-Q 6.0], the RED-S knowledge Questionnaire and provided training details. Results: Seventeen gymnasts (20.2%) scored above the cutoff point on the EDE-Q. In addition, high-level gymnasts scored higher than low-level on EDE-Q [2.21 ± 1.37 (35.9%) vs. 1.19 ± 0.79 (6.7%), respectively; p < 0.001] and on its subscales: Restraint, Eating Concerns, Weight Concerns, and Shape Concerns [p < 0.001 to 0.009], thus indicating more severe disordered eating symptoms. No group differences were found in binge eating and compensatory behaviors. An important percentage of gymnasts reported at least one episode of binge eating and excessive training [39.3–58.3%], while four gymnasts reported self-induced vomiting. RED-S knowledge did not differ between groups. On average, gymnasts were unaware of correct answers related to RED-S [51.5%], its definitions [79.8–92.9%], and its association with menstrual disturbances and bone health [54.8–86.9%]. However, gymnasts reported better awareness of the impact of food restriction on illness and performance [47.6–84.5%]. Conclusions: Elite artistic gymnasts exhibited a higher prevalence of eating disorder symptoms than lower-level peers. Gymnasts at all levels demonstrated limited knowledge of the effects of RED-S on menstrual and bone health. Failure to recognize these risks may influence gymnasts’ eating behaviors and delay RED-S detection and management.
U radu su predstavljeni pravni akti, odnonso zakoni i pravilnik, koji regulišu institut učeničke
zadruge. Izvršena je analiza pojedinih odredaba koje iz teorijskog ugla zavređuju posebnu pažnju.
Akcenat je stavljen na određene odredbe Pravilnika o učeničkim zadrugama, imajući u vidu da on u
pojedinostima reguliše pomenuti institut, pri čemi je u pogledu određenih pitanja napravljena uporedna
analiza važećeg Pravilnika iz 2021. giodine i Pravilnika koji je prethodno bio na snazi, a koji je donet
2018. godine.
Ključne reči: Pravilnik o učeničkim zadrugama, Zakon o zadrugama, Zakon o osnovama sistema
obrazovanja i vaspitanja, Zakon o osnovnom obrazovanju i vaspitanju, Zakon o srednjem obrazovanju i
vaspitanju
Conosci i Bad Effort Disorder in Allenamento? BED è l'acronimo utilizzato dalla comunità scientifica per identifica-re i Binge-Eating Disorder, quegli atti compulsivi che alcune persone compiono durante il loro rigoroso comportamento alimentare. All'improvviso qualcosa li turba e vengono colti da un raptus famelico che li porta a divorare tutto ciò che è nel frigo e in casa. Avviliti dall'abbuffata, cadono in catalessi per tutto il tempo della digestione, immobilizzati dal senso di colpa. Per sillogismo, mi piace adottare l'acronimo BED anche per descrivere i Bad-Effort Disorder, un'altra tipologia di atti compulsivi, del tutto simili a quelli alimentari, la cui premeditazione pervade alcuni atleti mentre svolgono il loro rigoroso programma di allenamento. Nelle sessioni di allenamento in cui viene loro richiesto un progressivo incremento del sovraccarico, ma non riescono a mantenere stabile la qualità tecnica delle esercitazioni, un raptus folle li sorprende e iniziano a macinare ripetizioni su ripetizioni, serie su serie, altalenando spasmodicamente l'uso dei sovraccarichi, da quelli per il riscaldamento a quelli delle competizioni. In tali circostanze, il volume di allenamento accumulato non si conta più, si aspetta solo la resa per esaurimento muscolare e l'insediarsi del senso di frustrazione. Così come l'eccesso di cibo prodotto dai Binge Eating Disorder lascia traccia nel programma dietologico, anche l'eccesso di volume realizzato con i Bad-Eating Disorder lascia traccia nel programma di allenamento. Se siete atleti contenete i BED, a tavola e in allenamento! Se siete allenatori rendete consapevoli i vostri atleti sugli effetti negativi che i BED comportano sulla prestazione, sulla salute e sull'autostima!
A psychiatric diagnosis of Anorexia Nervosa is characterised by low weight, fear of fatness and body image disturbance. Anorexia nervosa is associated with significant morbidity and mortality, which may result in patients becoming very physically unwell and needing medical treatment. Body image can be distorted in anorexia which may lead to refusal of treatment in some cases. As a result of this, involuntary treatment is sometimes used in severe cases of anorexia, which may include tube feeding to restore weight. Given the intrusive nature of this treatment, there are a plethora of associated ethical and legal issues. Can severely unwell patients with anorexia nervosa have capacity to refuse treatment? Is involuntary treatment for anorexia morally justifiable? Is force-feeding ever in a patient’s best interests, and if so, what is the legal mechanism to allow such treatment?
Using multiple sources, both ethical and legal, an attempt will be made to answer these questions and synthesize a coherent narrative on the topic. Capacity and the legal mechanisms for involuntary treatment, namely the Mental Health Act 2001 and the Wardship system, are explored. The main ethical conflicts arising in involuntary treatment are analysed, with the struggle between beneficence and respect for autonomy emerging as the core ethical issue at stake. The dissertation concludes by reflecting on how proposed changes to Irish legislation on capacity and mental health law may affect treatment of eating disorders in Ireland.
Intuitive eating (IE) is a non-dieting approach that promotes listening to internal cues of hunger and satiety, rather than adhering to external dietary restrictions aimed at weight loss. However, the role of IE in dieting behaviors related to weight-loss approaches is still unclear. To address this issue, the aim of this study was to compare IE levels between dieting and non-dieting individuals, exploring the relationship between IE and dieting-related psychological and physical factors. A sample of 2059 females was recruited via social media and self-reported questionnaires were administered to measure IE, eating psychopathology, self-efficacy, and quality of life. Individuals with a history of dieting exhibited lower IE levels, a higher BMI, and a greater eating psychopathology, as well as a reduced self-efficacy and quality of life, compared to non-dieters. IE showed a protective effect against dieting behaviors, with higher IE levels being associated with a lower likelihood of dieting. Additionally, higher BMI and eating psychopathology were predictors of dieting. Promoting IE could represent a relevant clinical target strategy to address disordered eating and enhance overall well-being, underscoring the need for interventions that foster a healthier relationship with food and bodily internal sensations.
Los ensayos de Re-vuelta psicoanalítica dan cuenta del espíritu crítico que caracteriza el ámbito académico y de la experiencia de pensar en libertad para renovar y crear, en torno del psicoanálisis, un movimiento de revuelta, como lo denominaría la filósofa y psicoanalista Julia Kristeva. Los artículos, escritos por un grupo de alumnos de la primera promoción de la Maestría en Estudios Teóricos en Psicoanálisis de la Pontificia Universidad Católica del Perú, reflejan el carácter interdisciplinario de la maestría y la versatilidad de la teoría psicoanalítica cuando se aplica a los fenómenos culturales, históricos, sociales y clínicos.
Feeding and eating disorders (FEDs) are psychological disorders that are characterized by abnormal eating, dysfunctional relationships with food, and a preoccupation with one’s weight and shape. Among others, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes two specific FEDs: anorexia nervosa (AN) and bulimia nervosa (BN), although there are subtypes associated with each. The DSM-5 and the International Classification of Diseases (ICD-10) have different criteria for diagnosing AN and BN. Early identification of a FED is associated with shorter duration and fewer medical complications. Yet it is estimated that only about 33% of AN patients and 6% of BN are receiving proper treatment for their illnesses. Gastrointestinal upset, fluid, and electrolyte imbalances are common with AN and may lead to complications such as, pernicious anemia, osteoporosis, and heart disease. On the other hand, BN can cause adverse effects, such as erosion of the teeth, enlargement of the parotid salivary glands, and acidic stomachs leading to heartburn. Long-term adverse effects caused by BN are gynecological problems, hormonal disturbances, hypercholesterolemia, and hypertension. Successful treatment of FEDs should be managed with a team-based approach including the physician, psychologist, and registered dietitian.
The biobehavioral model of food insecurity and chronic disease posits that stress perpetuates the cycle of food insecurity and chronic disease, in part, through changes in eating behaviors and weight gain. The current study conducted a preliminary test of the biobehavioral model in a sample of Hispanic older adolescents. It was hypothesized that older adolescents experiencing food insecurity would report greater depressive symptoms, which would be associated with more disordered eating, which would be associated with worse cardiometabolic indicators. Hispanic older adolescents (N = 113; 60% female; 15-21 years with mean age of 19.1; BMImean = 24.4) completed self-report baseline measures of food insecurity, depression, and disordered eating behaviors as part of a larger experimental study. Anthropometrics and body composition, blood pressure, heart rate, and resting metabolic rate were objectively measured. Hypotheses were tested using structural equation modeling. Experiencing food insecurity was associated with more disordered eating (b = 2.20, p = 0.032). Greater depressive symptoms were associated with more disordered eating (b = 0.28, p = 0.025) and worse cardiometabolic indicators (b = 0.15, p = 0.017). The full biobehavioral model, however, was not supported. Findings underscore the complex interaction of social and psychological functioning and physical health.
Abstract
Introduction: Suicidal in teenagers has increased. Although uncommon, the use of sodium nitrate has also increased, stimulated by online information of unpainful death and easy acquisition. It is an oxidant that converts hemoglobin into methemoglobin, causing asphyxia, vasodilation and hypotension, with high mortality when consumed in high doses. There is effective therapy, if early initiated.
Clinical case: This is a case of sodium nitrate voluntary ingestion, bought online as a fertilizer, in a previously healthy 17-year-old boy. The boy called 911 due to vomiting and lower limb paresthesia. At the arrival of the rescuers, the boy was dizzy, reactive, hypotensive, tachycardic, hypoxemic and cyanotic. During transportation, he entered cardiorespiratory arrest and basic life support was initiated.
In emergency room he was intubated and ventilated effectively (PaO2 293 mmol/L), maintaining exuberant cyanotic extremities. The initial rhythm was electrical activity without pulse, followed by ventricular fibrillation, with approach following the algorithms. The Antivenom Information Center was contacted and methylene blue was started. He did not recover spontaneous circulation after 35 minutes of resuscitation. His sister was evaluated by the Hospital Organization for Child and Youth Risk Management and started having pedopsychiatric appointments, due to suicidal ideation.
Abstract
Background: SARS-CoV-2 pandemic has led to socioeconomic and family changes. During lockdown, due to increased intrafamily conflict and lack of contact with other protective adults, there was an increased risk of child physical abuse. Concomitantly, with school closures, there was a decrease in the risk of physical aggression at school.
Objective: To compare pediatric emergency admissions due to physical abuse at the beginning of the school year before and during SARS-CoV-2 pandemic.
Methods: Retrospective and descriptive study. Children observed in the emergency department due to physical abuse between September and November of four consecutive years (2018 to 2021) were included.
Results: Included 169 emergency admissions (102 pre-pandemic vs. 67 during the pandemic). In 33% (n=56) there was a previous history of physical abuse. School aggression was the main form of aggression (46% vs. 40%), followed by family aggression (30% vs. 31%) and delinquency (23,5% vs. 28% during). The episodes were considered moderate to severe in 17% before the pandemic versus 27% during the pandemic. During the pandemic, there was a greater referral to the Hospital Center for Children and Teenagers at Risk (p=0.011), a greater number of children/teenagers referred to an institution (p=0.013) and to the Public Ministry (p=0.023).
Conclusions: There was a decrease in emergency admissions due to physical abuse during the pandemic. There was a decrease in school aggression and an increase in cases of delinquency. There was no increase in intrafamilial physical abuse. There is greater awareness of health care professionals of these cases, with more referral.
Eating disorders overlap with each other and many other psychological issues. Criteria for the most common diagnosis, OSFED, are quite vague. Addressing eating concerns is salient for many clients who do not have an eating disorder. Perhaps eating ‘issues’ should replace ‘disorders’.
Amaç: Bu çalışma, üniversite kampüslerindeki gıda otomatlarında bulunan yiyecek ve içecek çeşitlerinin belirlenmesi ve enerji ve besin ögesi içeriklerinin değerlendirilmesi amacıyla gerçekleştirilmiştir. Gereç ve Yöntem: Çalışmada, Ankara’da yer alan üç büyük devlet üniversitesinin merkez kampüslerinde bulunan yiyecek ve içecek otomatları incelenmiştir. Araştırmada, lokasyon olarak kütüphaneler, idari binalar ve derslik binalarında bulunan ve aynı alanda yanyana konumlandırılan 15 içecek otomatı, 16 yiyecek otomatı olmak üzere toplam 31 gıda ve içecek otomatı (n=31) değerlendirilmiştir. Bulgular: Porsiyondaki medyan enerji içeriği en yüksek olan gıdalar kruvasanlar (227.5 kkal), gofretler (205.2 kkal), kekler (173.2 kkal), tatlı bisküviler (144.6 kkal) ve çikolatalar (126.6 kkal) olarak sıralanmıştır. Porsiyonundaki enerji içeriği en düşük olan gıdalar ise tuzlu krakerler (68.4 kkal), tuzlu bisküviler (68.6 kkal) ve sandviçler (77.5 kkal) olarak bulunmuştur. Gıda gruplarında yer alan farklı ürün çeşitlerinin trafik ışığı etiketleme sistemine göre yağ, doymuş yağ, şeker ve tuz içeriklerine bakıldığında her dört parametre için yapılan değerlendirmede “yeşil” olarak kategorize edilen gıdanın yalnızca sandviçler olduğu belirlenmiştir. Trafik ışığı etiketleme sistemine göre değerlendirmesi yapılan yağ, doymuş yağ, şeker ve tuz içeriklerine göre en çok “kırmızı” kategoride yer alan gıda grupları kekler, tatlı bisküviler, kruvasanlar ve çikolatalar olarak belirlenmiştir. Sonuç: Bu çalışmada, üniversite kampüslerinde bulunan gıda otomatlarında yer alan yiyecek ve içecek çeşitliliğinin, özellikle sağlıklı gıdalar açısından, çok sınırlı olduğu anlaşılmıştır. Konuyla ilgili eğiticiler olarak diyetisyenlerin ve mevzuat geliştirilmesi noktasında politika yapıcıların farkındalıklarının artırılması gerekmektedir.
One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE.
p>Lacey and Evans' (1986) Multi-Impulsivist Theory suggests that impulsivity is a key factor underlying the propensity to binge eat, and it may be equally or more closely associated with the core features of binge eating psychopathology such as negative affect and cognitive restraint. Theoretical perspectives are discussed and the literature review examines the relationship between binge eating and impulsivity by discussing the co-morbid symptomatologies mat exist between binge eating and other impulse dysregulated disorders. A specific focus addresses the multi-dimensional nature of impulsivity and its inherent methodological and theoretical considerations. The literature review suggests that the use of a behavioural delay discounting procedure to measure impulsivity would elucidate the relationship between binge eating and impulsivity. The empirical study used a behavioural delay-discounting task to measure levels of impulsivity in a group of binge eaters and a group of controls. It also investigated the utility of using a delay discounting procedure to understand the 'loss of control' phenomenon in binge eating behaviour. In line with previous research, both self-report and delay-discounting measures evidenced significantly higher levels of impulsivity in binge-eaters, although a lack of correlations between behavioural and self-report measures were identified. The study provides preliminary evidence suggesting that the delay-discounting model may be a useful utility to predict the 'loss of control' phenomenon inherent in binge eaters, although future research is required to consolidate and support this utility. These findings have implications for clinical interventions, which may lead to the development of more effective treatments.</p
In the study, it is aimed to examine the eating attitude test (EAT) and the variables of gender, sports branch, financial situation, and chronic disease in students studying in the field of physical education and sports. The sample of the study, in which the relational screening method was used, consisted of 316 (215 male, 101 female) students, whose average age was 21.76, studying at Erzincan Binali Yıldırım University. Data were collected on a voluntary basis from students studying at the faculty of sports sciences in the 2021-2022 academic year. An eating attitude test and a personal information form containing demographic information to define the participants were used as data collection tools. The obtained data were transferred to the SPSS package program, the significance level was adopted as p
A imagem corporal é um importante componente da identidade pessoal, não sendo apenas a maneira que um indivíduo percebe seu próprio corpo, mas também como se sente, pensa e age em relação a ele. O objetivo do estudo foi avaliar a associação do grau de satisfação corporal dos acadêmicos do curso de medicina ao estado nutricional. Estudo transversal com uso de dados primários por meio de formulário eletrônico. Foram avaliados dados sociodemográficos, de autoimagem corporal por meio da escala de silhuetas de Kakeshita e o estado nutricional por meio do índice de massa corporal. O estado nutricional foi categorizado pela World Health Organization (1998). As análises foram realizadas no software Stata 16.1. Verificou-se que 239 (68,88%) dos alunos foram classificados como eutróficos. Verificou-se ainda que 233 (67,15%) dos alunos superestimaram seu tamanho real e que 208 (60,11%) gostariam de perder peso. A pesquisa identificou elevada prevalência de acadêmicos que apresentaram insatisfação com a imagem corporal. Isso pode trazer como consequência o comprometimento das relações sociais e da qualidade de vida dos universitários, interferindo diretamente em sua funcionalidade.
Bu araştırma bireylerin beslenme alışkanlıklarındaki farklılığın, duygusal yeme davranışının ve vücut kitle indeksinin finansal risk iştahı üzerindeki etkilerini ortaya çıkarmayı amaçlamaktadır. Araştırmanın analizinde kullanılacak veriler anket formları aracılığıyla basit tesadüfi örneklem yöntemi ile elde edilmiştir. Araştırmanın örneklemini Türkiye’de yaşayan 18 yaş ve üzerindeki finansal yatırım yapan ya da finansal yatırım yapabilecek potansiyel yatırımcı adayları oluşturmaktadır. Anket verileri Covid-19 tedbirleri nedeniyle online olarak Nisan-Mayıs 2021 tarihleri arasında 1217 katılımcıya yaptırılmıştır. Çalışmada yer alan analizlerden elde edilen sonuçlara göre, cinsiyetin, medeni durumun, yaş faktörünün, bütçeden yatırım için ayrılan payın, beslenme alışkanlığının, vücut kitle indeksinin ve duygusal yeme davranışının bireysel yatırımcıların finansal risk iştahlarını farklılaştırdığı görülmektedir. Bunun yanında Akdeniz diyet kalite indeksi ile finansal risk iştahı arasında anlamlı ve pozitif; duygusal yeme davranışının finansal risk iştahı üzerinde anlamlı ve negatif yönlü; vücut kitle indeksinin finansal risk iştahı üzerinde ise literatürle paralel olarak anlamlı ve pozitif yönlü bir etkisi olduğu belirlenmiştir. Binomial lojistik regresyon analizi ile kurulan; cinsiyet, medeni hal, bütçeden yatırıma ayrılan pay, aylık gelir seviyesi, Akdeniz diyet kalite indeksine göre beslenme puanları ve vücut kitle indeksinin dahil edildiği modelin anlamlı olduğu bulunmuştur. Cinsiyet, medeni hal, eğitim düzeyi, yaş, gelir seviyesi, vücut kitle indeksi, duygusal yeme davranışı ve finansal risk iştahları dahil edildiğinde katılımcıların dört ayrı kümeye ayrılabilecekleri kümeleme analizi ile belirlenmiştir. Araştırmanın kısıtları, elde edilen sonuçlardan yapılan çıkarımlar ve sonraki çalışmalar için öneriler tartışılmıştır.
Nowadays, obesity is a pandemic, and some people seek slimming diets to guarantee their health and quality of life. However, the cult of the healthy body has been an ongoing concern since the beginning of time. Irrespective of the century to which they belong, these cults reflect no empirical knowledge about physiology, nutrients or kilocalories, with some of them being quantitative diets in contrast to qualitative diets, or even simple food recommendations. On the other hand, some of these treatments might have led to the death of a patient, meaning that it is important for people seeking to lose weight to be followed by a nutrition professional until the individual reaches a desirable body weight. In this article, we highlight that each century and each decade have devised different treatments with the aim of improving health, but it will be science and history that will judge whether the results of these treatments have been adequate.
Minority children living in under-resourced communities are at the greatest risk for obesity and poor diet quality. Child involvement in meal preparation may be a helpful strategy to improve diet quality. This paper explores minority children’s perspectives regarding this. Eighteen children participated in a mixed methods study (online surveys, telephone interviews). Descriptive statistics were calculated for child demographic and psychosocial factors. Thematic analysis was used to code and analyze the interviews. Most children reported having cooking experience (83%) and cooking with family (94%) and exhibited high cooking self-efficacy (21.8 ± 2.9) and positive cooking attitudes (25.7 ± 4.4). Children reported helping with meal preparation (50%) and grocery shopping (41%) sometimes. The qualitative data further supported the results obtained from the children’s psychosocial factors. Most children noted the importance of learning to cook with an emphasis on life skills. Children also shared their level of involvement in cooking and grocery shopping. Most children reported using technology when cooking to find demonstration videos and recipes. These findings highlight that minority children participate in meal preparation and grocery shopping. Their perspectives are important for the development of nutrition education programs to achieve equitable dietary outcomes in minority families living in under-resourced communities.
It is widely recognized that body dissatisfaction is an important public health concern. In the past, being a fashion model was almost synonymous with anorexia/bulimia, and even today, there are cases of eating disorders in young women whose ambition is to become a top model. Moreover, stress can play a substantial role within ill health via related behaviors such as smoking, substance abuse, and inappropriate eating. In our study, we examined 112 aspiring fashion models aged between 15 and 24 years (M = 19.5, SD = 2.08) from 32 different countries of the world during an international contest, and 100 students (control group), aged between 16 and 22 years (M = 18.6, SD = 1.39). The purpose of this cross-sectional study was to examine whether stress mediated the relationship between body dissatisfaction and eating disorders. The study included the administration of stress and self-efficacy and the locus of control dimensions, body (image) dissatisfaction, and eating attitude disorder. Results indicated higher scores on body dissatisfaction, stress level, and eating attitudes disorder among the group of fashion models compared to the control. Mediational analyses showed that body dissatisfaction was partially mediated by stress level on eating disorders. Especially in the aspiring fashion models, there are often many possibilities that competitive stress causes candidates to exacerbate attempts to maintain their body weight below normal weight/height parameters. These results indicated that appropriate intervention for the management of stress level could possibly defend against the negative impact of body dissatisfaction on eating disorder symptoms. The presence of skilled health workers in the field of nutrition and psychology can be extremely important in the field of fashion to maintain an adequate quality of life.
Families living in under-resourced communities are at risk of obesity and obesity-related chronic diseases. To develop effective interventions, it is important to identify parent and child perspectives of factors that influence food-related choices and decisions. This paper reports qualitative findings from a larger mixed method study investigating this topic. Hybrid thematic analysis was used to code and analyze the interviews. Family-generated photographs of factors influencing food choices were discussed during the interviews. Qualitative findings were organized by the socio-ecological model. Verbatim quotes and photographs were used to support themes. Thirty-six interviews were conducted (18 parents, 18 children). Findings from parents revealed personal (e.g., culture, beliefs, time), family (e.g., mother, child, father, health, finances, cohesiveness), environmental (e.g., availability, convenience, cost), and other (e.g., school food) factors influenced food choices. Similarly, child-reported influences were personal (e.g., preferences, beliefs, taste), family (e.g., mother, family encouragement, father, family time), social (e.g., school, friends), environmental (e.g., availability), and other (e.g., media, sports). The socio-ecological model provided a useful framework for identifying factors that influence food choices and decisions of families living in under-resourced communities. A deeper understanding of these factors could enhance both responsiveness and effectiveness of interventions to enhance diet and reduce obesity risk in families living in under-resourced communities.
To the extent that severe and lasting anorexia nervosa (SE-AN) is defined in terms of refractoriness to the best treatments available, it is mandatory to scrutinize the proven effectiveness of the treatments offered to patients. The array of so-called current evidence-based treatments for anorexia nervosa (AN) encompasses the entire spectrum of treatments ranging from specialized brand-type treatments to new treatments adapted to the specific characteristics of people suffering from AN. However, after several randomized control trials, parity in efficacy is the characteristic among these treatments. To further complicate the landscape of effective treatments, this “tie score” extends to the treatment originally conceived as control conditions, or treatment as usual conditions. In retrospection, one can understand that treatments considered to be the best treatments available in the past were unaware of their possible iatrogenic effects. Obviously, the same can be said of the theoretical assumptions underpinning such treatments. In either case, if the definition of chronicity mentioned above is applied, it is clear that the responsibility for the chronicity of the disorder says more about the flagrant inefficacy of the treatments and the defective assumptions underpinning them, than the nature of the disorder itself. A historical analysis traces the emergence of the current concept of “typical” AN and Hilde Bruch's contribution to it. It is concluded that today's diagnostic criteria resulting from a long process of acculturation distort rather than capture the essence of the disorder, as well as marginalizing and invalidating patients' perspectives.
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