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My Fitness Pal Usage in Men: Associations with Eating Disorder Symptoms and Psychosocial Impairment

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... Further, like those with a rigid-restraint mindset being "on or off" a meal plan-based diet, competitors may view macronutrient targets in similar black and white terms. Regardless of whether meal plans based around eating specific foods at specific times in specific amounts are implemented or whether specific targets for protein, carbohydrate, and fat are used to construct diets, the attitude towards restraint [11] and the process of tracking [8,84] are potential factors which could possibly exacerbate disordered eating symptoms in some. Additionally, monitoring one's progress, via regular self-weighing [85], visual assessment, or comparison-making [10,86], could also play a role in the many mental health problems experienced in this population. ...
... Some professionals have raised concerns that these self-monitoring behaviors-irrespective of who engages in them-have the potential to precipitate or maintain eating disorder symptoms (e.g., binge eating, rigid dietary control, shape, and weight overvaluation) [100]. In particular, it has been theorized that these self-monitoring behaviors can negatively impact an individual's self-worth (i.e., where judgements of self-worth become almost exclusively based on weight, shape, and eating, and the ability for one to control them) and induce a pattern of perfectionistic, dichotomous, and obsessive thinking around weight, shape, food, and dieting [8,84]. ...
... However, research examining the role of these self-monitoring behaviors on eating disorder symptoms is mixed. For example, several cross-sectional studies have found positive associations between each of these self-monitoring behaviors and a range of eating disorder symptoms (e.g., binge eating, eating concerns, shape/weight overvaluation) in those with and without clinically significant eating disorders, including athletic populations [84,86,[100][101][102], and mixed evidence for a potential causal link between shape checking and body dissatisfaction has been found in some experimental studies [103] but not others [104] in non-bodybuilding populations. Prospective studies have also documented positive associations between self-weighing behaviors and binge eating in young adolescent females [105], yet several randomized controlled trials have found no evidence that some monitoring behaviors are associated with adverse outcomes. ...
Article
Full-text available
Physique athletes strive for low body fat with high lean mass and have higher body image and eating disorder rates than the general population, and even other weightlifting populations. Whether athletes with a background or tendency to develop these issues are drawn to the sport, or whether it drives these higher incidences, is unknown. However, the biological drive of cyclical energy restriction may contribute to binge-eating behavior. Additionally, requisite monitoring, manipulation, comparison, and judgement of one’s physique may contribute to body image concerns. Contest preparation necessitates manipulating body composition through energy restriction and increased expenditure, requiring dietary restraint and nutrition, exercise, and physique assessment. Thus, competitors are at mental health risk due to (1) pre-existing or predispositions to develop body image or eating disorders; (2) biological effects of energy restriction on eating psychology; and (3) dietary restraint attitudes and resultant physique, exercise, and nutrition monitoring behavior. In our narrative review we cover each factor, concluding with tentative best-practice recommendations, including dietary flexibility, slower weight loss, structured monitoring, gradual returns to offseason energy intakes, internal eating cues, appropriate offseason body compositions, and support from nutrition and mental health professionals. A mental health focus is a needed paradigm shift in bodybuilding nutrition practice and research.
... Reducing this complexity, three studies have focused on the use of one application, MyFitnessPal, in relation to eating psychopathology (Jospe et al., 2018;Levinson, Fewell, & Brosof, 2017;Linardon & Messer, 2019). The main functions of MyFitnessPal enable users to set goals concerning weight, and calorie intake and macronutrient intake, and assess their goal progress by (a) estimating and tracking their calorie intake and nutrient intake (e.g., consulting a food database, scanning barcodes, creating their own entries for foods); (b) estimating and tracking calorie expenditure (e.g., logging exercises, tracking steps); and (c) recording their weight with optional photos of their body (Under Armour Inc., 2019). ...
... In two cross-sectional studies focusing on MyFitnessPal, 73% (57/78) of predominantly female patients with eating disorders who had used the application viewed it as, at a minimum, having somewhat contributed to their condition (Levinson et al., 2017). A smaller proportion (47%, 26/55) of male users recruited from health and fitness websites described it as, at least, somewhat contributing to disordered eating (Linardon & Messer, 2019). However, in contrast to these cross-sectional studies, an experimental study found no evidence for a causal effect of using MyFitnessPal on eating disorder symptomatology (Jospe et al., 2017(Jospe et al., , 2018. ...
... However, in relation to eating psychopathology, the previously outlined research has assessed a narrow conceptualization of engagement. Specifically, the self-report studies either assessed use dichotomously (i.e., user vs. nonuser;Embacher Martin et al., 2018;Levinson et al., 2017;Linardon & Messer, 2019;Simpson & Mazzeo, 2017;Tan et al., 2016) or assessed the frequency of use (Hefner et al., 2016;Plateau et al., 2018). The risk of such narrow assessment of engagement is that patterns of use that are particularly indicative of eating disorders might remain undetected. ...
Article
Objective: Using calorie-counting and fitness-tracking technologies is concerning in relation to eating disorders. While studies in this area typically assess one aspect of use (e.g., frequency), engagement with a device or application is more complex. Consequently, important relationships between the use of these technologies and the eating disorder symptomatology might remain undetected. The current study therefore used comments from online eating disorder-related forums to generate comprehensive qualitative insights into engagement with a popular calorie-counting and fitness-tracking application, MyFitnessPal. Method: First, we extracted every comment mentioning MyFitnessPal made on three eating disorder-related forums between May 2015 and January 2018 (1,695 comments from 920 commenters). Then, we conducted an inductive thematic analysis using these comments to identify important aspects of engagement with MyFitnessPal. Results: The analyses resulted in three themes: Preventing misuse, describing ways in which MyFitnessPal attempts to prevent pathological use and actions taken by users to circumvent its interventions; Accuracy, outlining distrust of MyFitnessPal's accuracy and ways in which perceived inaccuracy is reduced or compensated for; and Psychosocial factors, comprising cognitive, behavioral, and social factors that influence, or are influenced by, engagement with MyFitnessPal. Discussion: The qualitative insights provide a detailed overview of how people with high levels of eating disorder symptomatology likely engage with MyFitnessPal. The insights can be used as a basis to develop valid, quantitative assessment of pathological patterns of engagement with calorie-counting and fitness-tracking technologies. The findings can also provide clinicians with insight into how their patients likely engage with, and are affected by, these devices and applications.
... Despite their popularity, there is growing concern that the use of calorie tracking apps has the potential to precipitate or perpetuate eating disorder symptoms. It has been proposed that certain app functionality could encourage a pattern of obsessional, dichotomous, or perfectionistic thinking related to eating, weight, and shape (Linardon & Messer, 2019). For instance, "warning signals" delivered to users who are approaching their daily calorie limit may create a heightened sense of food preoccupation, while detailed "food analyses" may prompt users to avoid specific food types, a known trigger for binge eating (Fairburn, 2008). ...
... Two prior studies in mixed-gender university students found that those who were currently using a calorie tracking app reported higher levels of disordered eating attitudes than those who were not using a calorie tracking app (Plateau et al., 2018;Simpson & Mazzeo, 2017). Likewise, a recent study found that adult men who were using a calorie tracking app reported more severe eating, weight, and shape concerns, dichotomous thinking, and binge eating tendencies than non-users (Linardon & Messer, 2019). ...
... Third, end-user perceptions of the impact of using a calorie tracking app are largely unknown. Two recent studies, one in a clinical sample (Levinson et al., 2017) and the other in a community sample (Linardon & Messer, 2019), found more than one-third of participants retrospectively reported the perceptions that use of a calorie tracking app at least "somewhat" contributed to their disordered eating patterns. However, it is not yet clear whether, from the perspective of the user, there are specific behaviours (e.g., binge eating, secret eating, compulsive exercise etc.) or attitudes (e.g., anxiety around food, preoccupation with eating, dichotomous thinking etc.) that are perceived to be more or less affected by calorie tracking apps. ...
Article
The number of people counting calories through apps is increasing, yet concerns have been raised that this could trigger symptoms of eating disorders. Although associations between calorie tracking and eating disorder symptomatology have been identified, further research is needed to understand motives for, and the perceived impact of, using a calorie tracking app. This study addressed these gaps with data collected from 1357 adults. A high percentage of participants (n = 964; 71%) had used a calorie tracking app; 531 participants (39%) reported currently using a calorie tracking app. Prior users reported higher levels of thinness- and muscularity-oriented disordered eating than non-users. Those using a calorie tracking app for weight-control/shape reasons were more likely to report that the app had contributed to several eating disorder symptoms (i.e., food preoccupation, all-or-none thinking around food, food anxiety, purging behaviours) than those using an app for health/disease prevention reasons. Engaging in a calorie tracking app for weight/shape reasons was associated with higher perceived helpfulness of calorie tracking app ratings and higher symptom severity. Findings suggest that underlying motives may be important to consider in research investigating the use of calorie tracking apps, as well as for health professionals working with clients engaging in these dietary monitoring tools.
... 34 Among a non-clinical sample of males, those that used of MyFitnessPal experienced higher risk of eating disorders and also endorsed that the use of MyFitnessPal contributed to their eating disorder behaviors. 35 However, when looking specifically at college students, there have only been three studies examining the relationship between dietary or physical activity self-monitoring and eating disorder risk. Simpson and Mazzeo found that calorie tracking was associated with eating concern and dietary restraint, and that fitness tracking was associated with eating disorder risk and symptomology among college students. ...
... MyFitnessPal in the development of their eating disorder 34,35 suggest that some individuals are more susceptible to the potential consequences of calorie counting. Therefore, an important future research direction is understanding whether there are some sub-populations among whom calorie counting is harmful. ...
... The present research indicates that among self-monitoring naïve undergraduate females, introducing dietary self-monitoring did not increase risk of eating disorders. However, given the strong cross-sectional findings from Chapters 1 and 2, and that many individuals with an eating disorder attribute their eating disorder to dietary self-monitoring, 34,35 future work is needed to examine if there are sub-populations for which weight-related self-monitoring may be harmful or if the discrepancy between the cross-sectional randomized controlled trial findings is due to confounding factors such as shared underlying causes such as preoccupation with food and weight and/or shape, and other potential confounders as described in Chapter 1 and conceptual model (Figure 1.1). For example, those who are initially at high risk for an eating disorder may be more susceptible to becoming preoccupied with food, exercise, or weight when engaging in weight-related self-monitoring due to the combination of the increased attention brought to these factors by weight-related self-monitoring and preexisting weight or food concern. ...
Thesis
Weight-related self-monitoring involves tracking one’s weight, physical activity, and/or dietary intake. Millions of individuals engage in weight-related self-monitoring, with college students among the most likely users. Despite widespread weight-related self-monitoring, there is little research evaluating its consequences. Of particular concern is the potential for weight-related self-monitoring to increase eating disorder risk. The aims of this dissertation were to: 1) understand how undergraduate and graduate college students use methods of dietary self-monitoring and self-weighing with one another, and examine whether certain patterns of weight-related self-monitoring methods are associated with eating disorder risk, 2) examine how college freshmen use technology-based weight-related self-monitoring, and determine how patterns of technology-based weight-related self-monitoring are associated with eating disorder behaviors, and 3) identify the extent to which technology-based dietary self-monitoring increases eating disorder risk among female undergraduate students. Aim 1 drew from a large cohort of students from 12 universities across the United States and used latent class analysis to identify patterns of weight-related self-monitoring. Methods of weight-related self-monitoring that were assessed included knowing nutrition facts, knowing calorie facts, counting calories, and self-weighing. Eating disorder risk was measured using the Eating Disorder Examination Questionnaire. Results of Aim 1 suggest differences in patterns of weight-related self-monitoring by gender. Among females, four patterns were identified: “no weight-related self-monitoring”, “all weight-related self-monitoring” methods, “knowing nutrition/calorie facts”, and “self-weigh only”. For females, all patterns of weight-related self-monitoring were associated with higher eating disorder risk compared to “no weight-related self-monitoring”. Among males, three patterns were identified: “no weight-related self-monitoring”, “all weight-related self-monitoring” methods, and “all weight-related self-monitoring but calorie counting”. Among males, only those represented by the “all weight-related self-monitoring” pattern demonstrated elevated risk for eating disorders. For Aim 2, latent class analysis was again used to identify patterns in use of the following weight-related self-monitoring tools: apps for a specific diet or exercise plan, wearable fitness tracker, online fitness tracker, online food journal, self-weighing, and a weight tracking app. Three patterns of technology-based weight-related self-monitoring were identified among females: “no weight-related self-monitoring”, “all weight-related self-monitoring”, and “food and exercise self-monitoring”. Those categorized by the “all weight-related self-monitoring” pattern were more likely to engage in eating disorder behaviors than those in the “no weight-related self-monitoring” pattern. Among males, three patterns were also identified: “no weight-related self-monitoring”, “all weight-related self-monitoring”, and “exercise self-monitoring”. There were no relationships between these patterns and eating disorder behaviors among males. Finally, for Aim 3, undergraduate female students were randomly assigned to either monitor their eating for 30 days using the MyFitnessPal app or continue to be naïve to dietary self-monitoring. Eating disorder risk was measured using the EDE-QS at baseline and post-intervention. No difference in eating disorder risk was seen between groups at post-intervention, suggesting that participating in a 30-day trial of dietary self-monitoring did not affect eating disorder risk among undergraduate females. Overall, findings from this dissertation indicate that specific patterns of weight-related self-monitoring are associated with concurrent eating disorder risk, particularly among women. Assessing methods of weight-related self-monitoring among young adults may be useful to identify individuals at elevated risk for eating disorders. However, a short-term trial of dietary self-monitoring among college women naïve to dietary self-monitoring did not increase eating disorder risk immediately post-intervention. Future research is needed to understand whether there are any specific sub-populations for whom weight-related self-monitoring is problematic.
... Prior research using online forums found that many users felt that their thoughts around meeting goals set by the apps are obsessive and felt shame when they did not meet specified goals (McCaig et al., 2020). Research conducted among those with eating disorders found that many reported believing that using WRSM apps led to the development of their eating disorder (Levinson et al., 2017;Linardon and Messer, 2019). Cross-sectional associations between WRSM app use and disordered eating have also been observed among college students (Simpson and Mazzeo, 2017;Hahn et al., 2021b). ...
... The present study is also the first to our knowledge that has adjusted for engagement in disordered eating earlier in life when examining the relationships between WRSM and disordered eating. Our results are consistent with qualitative research that indicates that individuals who are suffering with eating disorders believe WRSM apps contributed to the development of their eating disorder (Levinson et al., 2017;Linardon and Messer, 2019). Our findings also provide some evidence contrary to the belief that WRSM apps may be a symptom rather than a risk factor for eating disorders (Simpson and Mazzeo, 2017). ...
Article
Use of weight-related self-monitoring (WRSM) apps is common among emerging adults, as are weight and shape concerns. The present study aimed to examine (1) whether emerging adult use of dietary-focused (e.g., MyFitnessPal) and physical activity-focused (e.g., Fitbit) WRSM apps was associated with weight-control and muscle-building behaviors, including commonly recommended/conventional behaviors and disordered behaviors and (2) whether prior use of weight-control and muscle-building behaviors in adolescence might explain such relationships. Data were collected as part of the EAT (Eating and Activity over Time) 2010–2018 study (n = 1446) and analyzed using gender-stratified logistic regression models adjusted for demographic characteristics and body mass index. Among women and men, physical activity- and dietary-focused app use were associated with greater adjusted prevalence of disordered weight-control behaviors (e.g., fasting, purging), and disordered muscle-building behaviors (e.g., using steroids). Physical activity- and dietary-focused app use were also associated with a higher adjusted prevalence of commonly recommended weight-control and conventional muscle-building behaviors (e.g., exercising, changing eating habits), but only among those who were also engaging in disordered behaviors. The observed associations remained statistically significant in models that further adjusted for adolescent use of the respective behaviors. Findings suggest that emerging adults who use physical activity- and dietary-focused WRSM apps are more likely to engage in disordered weight-control and muscle-building behaviors and that these associations are not explained by engagement in these behaviors during adolescence. Future research is needed to examine if there are aspects of WRSM apps that could be modified to reduce potential harm.
... The app allows users to monitor daily food intake and set personalized weight-related goals, providing feedback on calorie and micronutrient content and delivering warnings when preset limits are being approached. While some research has indicated the app may be effective in enhancing weight loss following bariatric surgery [49], promoting a sense of accountability [50], or aiding users in dietary modifications like sodium reduction [51], other studies have suggested the app may precipitate or intensify eating disorder symptoms or induce obsessive preoccupation with weight, calories, and micronutrients in some users [50,52,53]. As with other reporting methods, adherence declines rapidly over time [54], and consistent use of the app is highest among married, non-Hispanic Whites with high health literacy [55,56]. ...
... The app allows users to monitor daily food intake and set personalized weight-related goals, providing feedback on calorie and micronutrient content and delivering warnings when preset limits are being approached. While some research has indicated the app may be effective in enhancing weight loss following bariatric surgery [49], promoting a sense of accountability [50], or aiding users in dietary modifications like sodium reduction [51], other studies have suggested the app may precipitate or intensify eating disorder symptoms or induce obsessive preoccupation with weight, calories, and micronutrients in some users [50,52,53]. As with other reporting methods, adherence declines rapidly over time [54], and consistent use of the app is highest among married, non-Hispanic Whites with high health literacy [55,56]. ...
Article
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Purpose of Review Underreporting of dietary intake is common in obesity treatment programs. Accurate reporting through daily food diaries is essential for organizing and personalizing treatment. This review explores key concerns for clinicians, summarizes the state of research on causes of underreporting and ways to promote consistency and accuracy, and identifies areas of need for future research. Recent Findings Dietary underreporting is a cross-cultural phenomenon, and obesity is the most consistent correlate. The association with BMI may be mediated by factors like socioeconomic status, gender, and body image. People with obesity—particularly women—tend to underreport high energy foods and those considered socially undesirable. Underreporting may be due to conscious or unconscious processes and is also influenced by literacy issues and the features of reporting tools. Perceived social pressure plays a role in underreporting, as does inconvenience of reporting. Web- and smartphone-based reporting options offer alternatives to paper-based reporting, but are prone to the same underreporting issues and may not accurately capture energy and micronutrient content. Some evidence indicates frequency and consistency of reporting are more important for weight loss than accuracy. Summary Dietary underreporting remains a major issue in weight management for obesity. The majority of studies are descriptive, identifying associations but not incorporating psychometric tests or qualitative methods like interviews or focus groups to explore underlying issues. Multidisciplinary research is needed to better understand why people underreport and inform strategies to improve quality and consistency of reporting and aid patients with obesity in adhering to dietary goals.
... In another study, eating disorder psychopathology was associated with visits to weight loss websites (Almenara et al., 2019), whereas following Instagram 'Health and Fitness' accounts was moderately correlated with drive for thinness . In a male only cohort, EDE-Q scores were much higher among fitness App users (n=122, Australia) (Linardon and Messer, 2019), whereas in females the use of My Fitness Pal was correlated significantly with degree of ED psychopathology . Finally, self-reported eating disorder was associated with consumption of fitness, weight loss and fitspiration content (Carrotte et al., 2015). ...
Preprint
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Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorders. The meta-analysis comprised n=32,295 participants, in which PUI was correlated with significant eating disorder psychopathology Pearson r=0.22 (s.e.=0.04, p<0.001), body dissatisfaction r=0.16 (s.e.=0.02, p<0.001), drive-for-thinness r=0.16 (s.e.=0.04, p<0.001) and dietary restraint r=0.18 (s.e.=0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting significantly on vulnerable populations towards the development or maintenance of eating disorder psychopathology; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder psychopathology.
... (Strober et al., 1997). Excessive exercise has been linked with the consumption of "thinspiration" or "fitspiration" online content (Carrotte et al., 2015;Quesnel et al., 2018), appearance anxiety (Corazza et al., 2019), as well as weight loss and fitness applications (Apps), in both males and females (Almenara et al., 2019;Embacher Martin, McGloin and Atkin, 2018;Levinson et al., 2017;Linardon and Messer, 2019;Simpson and Mazzeo, 2017). No previous study has examined how eating disorders with heightened exercise present in respect to their degree and correlations of problematic internet use behaviors. ...
Article
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Eating disorders are widespread illnesses with significant global impact. There is growing concern about how young people overuse online resources leading to mental health sequelae. We gathered data from 639 individuals from a population cohort. Participants were all young adults at the point of contact and were grouped as having probable eating disorder with excessive exercise (n=37) or controls (n=602). We measured obsessionality, compulsivity, impulsivity, and problematic internet use. Group differences in these domains were evaluated; and structural equation modelling (SEM) was used to assess structural relationships between variables. Cases had higher scores of obsessional thoughts of threat (Cohen’s d=0.94, p <0.001), intolerance towards uncertainty (Cohen’s d=0.72; p <0.001), thoughts of importance and control (Cohen’s d=0.65, p <0.01), compulsivity (Cohen’s d=0.72; p <0.001), negative urgency (Cohen’s d=0.75, p<0.001), and higher problematic usage of the internet (Cohen’s d=0.73; p-corrected <0.001). Our SEM showed significant partial mediation of problematic internet use on both the effect of obsessionality latent factor on cases (z-value=2.52, p<0.05), as well as of sensation seeking latent factor on cases (z-value=2.09, p<0.05). Youth with eating disorder and heightened exercise levels have increased obsessive thoughts of threat, compulsivity traits and sensation seeking impulsivity. The association between obsessive thoughts and eating disorders, as well as sensation seeking and eating disorders were partially mediated by problematic internet use. Problematic internet use may be playing a role in the development or maintenance of eating disorder symptoms in the background of obsessional thoughts and sensation seeking impulsive traits.
... In another study, eating disorder psychopathology was associated with visits to weight loss websites (Almenara et al., 2019), whereas following Instagram 'Health and Fitness' accounts was moderately correlated with drive for thinness (Cohen et al., 2017). In a male only cohort, EDE-Q scores were much higher among fitness App users (n = 122, Australia) (Linardon and Messer, 2019), whereas in females the use of My Fitness Pal was correlated significantly with degree of ED psychopathology (Levinson et al., 2017). Finally, self-reported eating disorder was associated with consumption of fitness, weight loss and fitspiration content (Carrotte et al., 2015). ...
Article
Full-text available
Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorder and related psychopathology. The meta-analysis comprised n = 32,295 participants, in which PUI was correlated with significant eating disorder general psychopathology Pearson r = 0.22 (s.e. = 0.04, p < 0.001), body dissatisfaction r = 0.16 (s.e. = 0.02, p < 0.001), drive-for-thinness r = 0.16 (s.e. = 0.04, p < 0.001) and dietary restraint r = 0.18 (s.e. = 0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting on eating disorder symptoms; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder and related psychopathology.
... An unexpected finding was that calorie tracking was significantly negatively associated with binge eating. This contradicts findings from Linardon and Messer [34], who found a positive association between the usage of calorie-tracking apps and objective binge eating in men. This result could be explained by the fact that our model was adjusted for drive for thinness. ...
Article
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Plain English summary Muscle dysmorphia is a mental disorder in which those affected are constantly preoccupied with being insufficiently muscular. Although there is initial evidence that binge eating may play a role in the clinical presentation of muscle dysmorphia (MD), this has not been investigated. In addition, MD has rarely been studied in women. We conducted a study involving 5905 men (n = 422) and women (n = 5483) using self-report questionnaires to examine the association between binge eating and symptoms of MD. We found that symptoms of MD and binge eating are positively associated. According to our model, two-thirds of women and one-quarter of men at-risk for MD exhibit binge eating. Binge eating episodes should therefore form part of the clinical assessment of MD.
... Additionally, problematic usage of the Internet was found to partially mediate the link between obsessionality and eating disorders with high exercise levels [37]. Usage of fitness and calorie-tracking apps has correlated with eating disorder and related psychopathology both in males and females [38][39][40]. It is possible that in the background of particular latent traits of impulsivity or obsessionality/compulsivity, exposure to calorie or fitness apps may trigger problematic behaviors (e.g., excessive exercise) and potentially contribute to the development of clinically significant levels of ED in those who are vulnerable. ...
Article
Full-text available
Purpose of review: We aimed to accrue recent evidence exploring effects of modern online activities (e.g. Internet use) on feeding and eating disorder symptoms, and related traits. We examined available evidence to ascertain any direct influences from online activities on feeding and eating disorders, thereby shedding light on putative mechanisms by which those influences may occur. Recent findings: Many facets of problematic usage of the internet correlate cross sectionally with eating disorder and related psychopathology. There is evidence to suggest that significant effects do exist in the direction of specific internet activities contributing to eating disorder symptoms, viewed dimensionally. Putative mechanisms are discussed. However a significant number of eating disorder phenotypes and internet-related activities remain under-researched. Summary: Specific facets of engagement with the online environment appear to confer risk for feeding and eating problems, evidence being strongest for non-clinical studies using dimensional measures. More research is required to rigorously confirm causal effects, including in patients meeting formal diagnostic criteria for eating disorders. We also highlight the need for high quality evidence to explore how eating disorder phenotypes are commonly as well as uniquely affected by different online activities. Such research is needed in order that scientific understanding in this area can be translated to protect those most at risk of disordered eating, including through changes in public health approaches and clinical practice. <br/
... Currently, some popular nutrition software are using the balancing method with the aim of nutritional self-management that could be good evidence that society is ready to replace food groups with nutrients balance (at least macronutrients) [5,6]. The other outcomes of using this software shown not only they are widely accepted tools but also could be effective in the community to control some eating disorders, weight control and depression [5,7,8]. However, their assessed effect is limited to public health, eating disorders and weight loss studies. ...
Preprint
One of the first lines in controlling diseases and malnutrition is diet therapy and currently, due to tool limitations, for designing the patients’ diet plan, the food groups and the list of food substitutes are being used while suitable databases of foods composition are available. Methods of designing individuals’ diet and total of 8791 foods are reviewed to calculate the nutrients of mixed foods and design a suitable method of diet therapy with more freedom for the patients in the future. Food groups because of their simplicity are suitable for public health educations but have limitations that could be better covered using nutrient balances. The main cause of developing the list of food substitutes was the limitations in calculating nutrients in a designed diet that currently could be run using applications. Patients also by using self-management nutrition applications that based on the nutrient balancing method shown they are ready to accept this method. A well-designed application can make using nutrient balancing method which is the future of diets possible. However, the main limitation is still the needs for a big, validated, and accurate foods composition database that needs to be developed. Keywords : Diet, Food Groups, Nutrients, Diet therapy, Nutrition
... In another study, eating disorder psychopathology was associated with visits to weight loss websites (Almenara et al., 2019), whereas following Instagram 'Health and Fitness' accounts was moderately correlated with drive for thinness (Cohen et al., 2017). In a male only cohort, EDE-Q scores were much higher among fitness App users (n = 122, Australia) (Linardon and Messer, 2019), whereas in females the use of My Fitness Pal was correlated significantly with degree of ED psychopathology (Levinson et al., 2017). Finally, self-reported eating disorder was associated with consumption of fitness, weight loss and fitspiration content (Carrotte et al., 2015). ...
Article
Full-text available
Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorder and related psychopathology. The meta-analysis comprised n = 32,295 participants, in which PUI was correlated with significant eating disorder general psychopathology Pearson r = 0.22 (s.e. = 0.04, p < 0.001), body dissatisfaction r = 0.16 (s.e. = 0.02, p < 0.001), drive-for-thinness r = 0.16 (s.e. = 0.04, p < 0.001) and dietary restraint r = 0.18 (s.e. = 0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting on eating disorder symptoms; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder and related psychopathology.
... It is not clear if eating disorders develop from using these apps or if those who have eating disorders tend to use them. In any case, due to the great variability that exists, it is advisable to take these data with caution and educate people before encouraging their use [52]. ...
Article
Full-text available
In recent years, the promotion of healthy habits, and especially diet-oriented habits, has been one of the priority interests of our society. There are many apps created to count calories based on what we eat, or to estimate calorie consumption according to the sport we do, or to recommend recipes, but very few are capable of giving personalized recommendations. This review tries to see what studies exist and what recommendation systems are used for this purpose, over the last 5 years in the main databases. Among the results obtained, it is observed that the existing works focus on the recommendation system (usually collaborative filtering), and not so much on the description of the data or the sample analyzed; the indices used for the calculation of calories or nutrients are not specified. Therefore, it is necessary to work with open data, or well-described data, which allows the experience to be reproduced by third parties, or at least to be comparable. In recent years, the promotion of healthy habits, and especially diet-oriented habits, has been one of the priority interests of our society.
... Currently, some popular nutrition softwares are using the balancing method with the aim of nutritional self-management that could be good evidence that society is ready to replace food groups with nutrients balance (at least macronutrients) (5,6). The other outcomes of using this softwares shown not only they are widely accepted tool but also could be effective in the community to control some eating disorders, weight control and depression (5,7,8). However, their assessed effect is limited to public health, eating disorders and weight loss studies. ...
Preprint
Abstract : One of the first lines in controlling diseases and malnutrition is diet therapy and currently, due to tool limitations, for designing the patients’ diet plan, the food groups and the list of food substitutes are being used while suitable databases of foods composition are available. Methods of designing individuals’ diet and total of 8791 foods are reviewed to calculate the nutrients of mixed foods and design a suitable method of diet therapy with more freedom for the patients in the future. Food groups because of their simplicity are suitable for public health educations but have limitations that could be better covered using nutrient balances. The main cause of developing the list of food substitutes was the limitations in calculating nutrients in a designed diet that currently could be run using applications. Patients also by using self-management nutrition applications that based on the nutrient balancing method shown they are ready to accept this method. A well-designed application can make using nutrient balancing method which is the future of diets possible. However, the main limitation is still the needs for a big, validated, and accurate foods composition database that needs to be developed.
Article
Purpose Of the 3 major eating disorders, anorexia nervosa, bulimia nervosa, and binge eating disorder (BED), BED is the most common and exists in the practices of most primary care and psychiatric clinicians. However, BED often goes unrecognized and thus untreated. Methods Reviewed in this commentary are the basic elements in the diagnosis of BED, demographic and clinical characteristics, screening options, the importance of comorbidities, pathophysiology, and available treatments. Findings Psychological treatments, including cognitive-behavioral therapy, interpersonal therapy, and behavioral weight loss, have been recommended as first-line options and are supported by several different meta-analytic reviews. Lisdexamfetamine is currently the only medication approved by the US Food and Drug Administration for the treatment of BED. Effect sizes for lisdexamfetamine versus placebo for response, remission, and avoidance of relapse in BED are robust, but its use may be limited by tolerability. This is also the case for topiramate, an anticonvulsant that has been used “off-label” to treat BED. Implications Additional medication choices approved by the US Food and Drug Administration for the treatment of BED are needed. Moving forward, opportunities to leverage modern technology to broaden access to treatment are highly desirable.
Article
Background Strong positive relationships between dietary self-monitoring and eating disorder risk are seen in population-based, observational studies. However, current evidence cannot establish causality. Furthermore, little is known about other mental and behavioral health consequences of dietary self-monitoring among college women, a population vulnerable to eating disorders. Objective To determine if introducing dietary self-monitoring via a popular smartphone app to undergraduate women impacts eating disorder risk, other aspects of mental health, or health behaviors including dietary intake and physical activity. Design Randomized controlled trial. Participants/setting Undergraduate women who had not engaged in dietary self-monitoring in the past year and who were at low-risk for an eating disorder participated between May and October 2019 (n = 200). Intervention Participants were randomly assigned to engage in dietary self-monitoring via MyFitnessPal for approximately 1 month or to receive no intervention. Main outcome measures Self-report data on eating disorder risk, other mental health outcomes, and health behaviors were collected at baseline and post-intervention. Statistical analyses performed Linear and logistic regressions were utilized to test hypotheses. Results Adherence to the intervention was high, with participants recording their dietary intake via MyFitnessPal on average 89.1% of days between baseline and post-intervention. Assignment to the intervention was not associated with changes in eating disorder risk, anxiety, depressive symptoms, body satisfaction, quality of life, nutritional intake, physical activity, screen time, or other forms of weight-related self-monitoring (all P > .05). Conclusions Among dietary self-monitoring naive undergraduate women with low-risk of an eating disorder, dietary self-monitoring via MyFitnessPal for 1 month did not increase eating disorder risk, impact other aspects of mental health, or alter health behaviors including dietary intake. The null results in our study may be due to the selection of a low-risk sample; future research should explore whether there are populations for whom dietary self-monitoring is contraindicated.
Article
In order to better understand the functional significance of pro-eating disorder (pro-ED) online spaces for users, the current study investigates identity performance as it plays out on pro-ED Tumblr and Instagram account bios. We used data scraping methodologies to illuminate key facets of pro-ED social media culture beyond thinspiration, and found that pro-ED Tumblr and Instagram bios commonly utilize self-tracking and self-quantification (e.g., self-tracking data regarding exercise and food intake, lowest weight, current weight) to represent online personas. Drawing from this data, we suggest the importance of understanding pro-ED social media use as a mode of enacting eating disorder practices and articulating eating-disordered identities online. More specifically, we posit that self-quantification and self-tracking on social media can be seen as a way that individuals with eating disorders extend practices of self-containment and control online in a world that increasingly blends online and offline life. By understanding the multifaceted psychological functions of pro-ED social media use we can build more informed interventions aimed at minimizing individuals’ needs to engage in such spaces in the first place, which in turn might have a preventive impact.
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The popularity of physique sports is increasing, yet there are currently few comprehensive nutritional guidelines for these athletes. Physique sport now encompasses more than just a short phase before competition and offseason guidelines have recently been published. Therefore, the goal of this review is to provide an extensive guide for male and female physique athletes in the contest preparation and recovery period. As optimal protein intake is largely related to one’s skeletal muscle mass, current evidence supports a range of 1.8-2.7 g/kg. Furthermore, as a benefit from having adequate carbohydrate to fuel performance and activity, low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the “energy budget” to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. For nutrient timing, we recommend consuming four or five protein boluses per day with one consumed near training and one prior to sleep. During competition periods, slower rates of weight loss (≤0.5% of body mass per week) are preferable for attenuating the loss of fat-free mass with the use of intermittent energy restriction strategies, such as diet breaks and refeeds, being possibly beneficial. Additionally, physiological and psychological factors are covered, and potential best-practice guidelines are provided for disordered eating and body image concerns since physique athletes present with higher incidences of these issues, which may be potentially exacerbated by certain traditional physique practices. We also review common peaking practices, and the critical transition to the post-competition period.
Article
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Objectives Although monitoring is considered a key component of effective behaviour change, the development of apps has allowed consumers to constantly evaluate their own diet, with little examination of what this might mean for eating behavior. The aim of this study was to investigate whether self‐monitoring of diet using the app MyFitnessPal or daily self‐weighing increases the reported occurrence of eating disorders in adults with overweight/obesity following a weight loss program. Methods Two hundred and fifty adults with BMI≥27kg/m² received diet and exercise advice and were randomised to one of four monitoring strategies (daily self‐weighing, MyFitnessPal, brief monthly consults, or self‐monitoring hunger) or control for 12 months. The Eating Disorders Examination Questionnaire (EDE‐Q 6.0) was used to assess eating disorder symptoms and behaviours for the previous 28 days at 0 and 12 months. Results There were no significant differences in the global EDE‐Q score or the subscales between those in the four monitoring groups and the control at 12 months (all p≥0.164), nor were there differences in binge eating, self‐induced vomiting, laxative misuse or excessive exercise at 12 months (p≥0.202). The overall prevalence of one or more episodes of binge eating was 53.6% at baseline and 50.6% at 12 months, with no change over time (p=0.662). Conclusions There was no evidence that self‐monitoring, including using diet apps like MyFitnessPal or daily self‐weighing, increases the reported occurrence of eating disorder behaviours in adults with overweight/obesity who are trying to lose weight.
Article
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Psychologists typically rely on self-report data when quantifying mobile phone usage, despite little evidence of its validity. In this paper we explore the accuracy of using self-reported estimates when compared with actual smartphone use. We also include source code to process and visualise these data. We compared 23 participants' actual smartphone use over a two-week period with self-reported estimates and the Mobile Phone Problem Use Scale. Our results indicate that estimated time spent using a smartphone may be an adequate measure of use, unless a greater resolution of data are required. Estimates concerning the number of times an individual used their phone across a typical day did not correlate with actual smartphone use. Neither estimated duration nor number of uses correlated with the Mobile Phone Problem Use Scale. We conclude that estimated smartphone use should be interpreted with caution in psychological research.
Article
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Challenges to epidemiological studies of eating and related body image disturbance disorders in males include, in addition to low base rates and the predominance of residual diagnostic categories, the female-centric nature of current classification schemes and the consequent lack of appropriate assessment instruments. In this narrative review, we summarise epidemiological data regarding the prevalence and correlates of eating disorders, related body image disturbance disorders, and eating disorder features in males. Attention is focused on disorders most likely to be observed among males, such as muscle dysmorphia and muscularity-oriented excessive exercise. It is argued that, given the multiple challenges involved in research of this kind, a focus on features is more likely to advance the field than a focus on diagnoses. In terms of correlates, we focus on impairment and help-seeking, since these issues are most relevant in informing public health burden, service provision, and related issues. We end with some thoughts about current gaps in the knowledge base and directions for future research that we consider to be most promising.
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The perception that eating disorders occur predominantly in young white upper-class women has been challenged. This study examined temporal differences to the demographic correlates of eating disorder behaviors over a 10-year period. Data from cross-sectional general population surveys in 1998 (n = 3010) and 2008 (n = 3034) were collected on demographics (sex, age, income, residency), current eating disorder behaviors (binge eating, extreme dieting, purging), and health-related quality of life (SF-36). Below-median annual household income was associated with increased prevalence rates from 1998 to 2008 in binge eating, extreme dieting, and purging. Male sex was associated with increased prevalence rates in extreme dieting and purging. Age over 45 years was associated with increased prevalence rates in purging. In 2008 versus 1998, binge eating was associated with greater mental health-related quality of life impairment in males but not females; and greater physical health-related quality of life impairment in regional but not metropolitan areas. Extreme dieting was also associated with greater physical health-related quality of life impairment in 2008 versus 1998 in the lower but not the higher socioeconomic sector. Findings suggest the ‘democratization’ of disordered eating, with greatest levels of associated impairment being within marginalized demographic sectors. Implications include the need for broader intervention programs and recruitment of demographically representative samples in eating disorder research.
Article
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Background The Eating Disorder Examination-Questionnaire (EDE-Q), a widely used self-report instrument, is often used for measuring change in eating disorder symptoms over the course of treatment. However, limited data exist about test-retest reliability, particularly for men. The current study evaluated EDE-Q 7-day test-retest reliability in male (n = 47) and female (n = 44) undergraduate students together and separately by gender. Results Internal consistency was consistently higher for women and at Time 2, but remained acceptable for both men and women at both time points. Cronbach’s α ranged from .75 (Restraint at Time 1) to .93 (Shape Concern at Time 2) for women and from .73 (Eating Concern at Time 2) to .89 (Shape Concern at Time 2) for men. With the exception of some of the eating disorder behaviors, test re-test reliability was fairly strong for both men and women. Shape Concern and the global EDE-Q score were highest for both men and women (Spearman’s rho > 0.89 with the exception of Shape Concern for women for which Spearman’s rho = .86). Test re-test reliability was lower for the eating disorder behavior measures, particularly for men, for whom Kendall’s tau-b for frequency and phi for occurrence was less than 0.70 for all but objective bulimic episodes. Conclusions Results were consistent with past research for women, indicating strong test re-test reliability in attitudinal features of eating disorders, but lower test re-test reliability in behavioral features. Internal consistency and test re-test reliability was good for the attitudinal features of eating disorder in men, but tended to be lower for men compared to women. The EDE-Q appears to be a reliable instrument for assessing eating disorder attitudes in both male and female undergraduate students, but is less reliable for assessing ED behaviors, particularly in men.
Article
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Objective To examine temporal trends in the burden of eating disorder (ED) features, as estimated by the composite of their prevalence and impact upon quality of life (QoL) over a period of 10 years. Methodology Representative samples of 3010 participants in 1998 and 3034 participants in 2008 from the South Australian adult population were assessed for endorsement of ED features (objective binge eating, extreme dieting, and purging were assessed in both years; subjective binge eating and extreme weight/shape concerns were also assessed in 2008) and QoL using the Medical Outcomes Study Short Form (SF-36). Principal Findings From 1998 to 2008 significant increases in the prevalence of objective binge eating (2.7% to 4.9%, p<0.01) and extreme dieting (1.5% to 3.3%, p<0.01), but not purging, were observed. Lower scores on the SF-36 were significantly associated with endorsement of any of these behaviors in both 1998 and 2008 (all p<0.001). No significant difference was observed in the effect of the endorsement of these ED behaviors on QoL between 1998 and 2008 (all p>0.05). Multiple linear regressions found that in 1998 only objective binge eating significantly predicted scores on the mental health summary scale of the SF-36; however, in 2008 extreme weight/shape concerns, extreme dieting, and subjective binge eating were also significant predictors. Objective binge eating and extreme dieting were significant predictors of scores on the physical health summary scale of the SF-36 in both 1998 and 2008. Conclusions and Significance The prevalence of ED behaviors increased between 1998 and 2008, while their impact on QoL remained stable. This suggests an overall increase in the burden of disordered eating from 1998 to 2008. Given that binge eating and extreme dieting predict impairment in QoL, the necessity of interventions to prevent both under- and over-eating is reinforced.
Article
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The rapid growth in the use of smartphones has opened a new world of opportunities for use in behavioral health care. Mobile phone software applications (apps) are available for a variety of useful tasks to include symptom assessment, psychoeducation, resource location, and tracking of treatment progress. The latest two-way communication functionality of smartphones also brings new capabilities for telemental health. There is very little information available, however, regarding the integration of smartphone and other mobile technology into care. In this paper, we provide an overview of smartphone use in behavioral health care and discuss options for integrating mobile technology into clinical practice. We also discuss limitations, practical issues, and recommendations. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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This article provides a survey of eating disorders in men, highlights the dramatic rise in eating disorders, identifies issues specific to males, and suggests areas for research and intervention. This survey concludes that men with eating disorders are currently under-diagnosed, undertreated, and misunderstood by many clinicians who encounter them. Ongoing research addressing these issues is expected to result in assessment tools and treatment interventions that will advance positive outcomes for men with eating disorders.
Article
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Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for bulimia nervosa. A new "enhanced" version of the treatment appears to be more potent and has the added advantage of being suitable for all eating disorders, including anorexia nervosa and eating disorder not otherwise specified. This article reviews the evidence supporting CBT in the treatment of eating disorders and provides an account of the "transdiagnostic" theory that underpins the enhanced form of the treatment. It ends with an outline of the treatment's main strategies and procedures.
Article
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Eating disorders have a profound and highly specific impact on psychosocial functioning. The aim of this research was to develop a measure of such secondary impairment. A 16-item, self-report instrument was developed, the Clinical Impairment Assessment (CIA), which was designed to measure such impairment overall and in three specific domains (personal, cognitive, social). The psychometric properties of the instrument were evaluated using data collected in the context of a transdiagnostic treatment trial. The findings consistently supported the utility of the instrument with the CIA being shown to have high levels of internal consistency, construct and discriminant validity, test-retest reliability, and sensitivity to change. The CIA should be of value to clinicians when assessing patients with eating disorders and their response to treatment. It should also help inform epidemiological research.
Article
Mobile phone and tablet usage has become a part of modern life. Mobile applications that count calories, such as My Fitness Pal, are frequently employed on a daily basis. Recent research has shown that in undergraduates, calorie tracking is associated with eating disorder pathology. In the current study (N=105 individuals diagnosed with an eating disorder), we assessed usage of My Fitness Pal to track calories. We also assessed perceptions that My Fitness Pal contributed to eating disorder symptoms and if these perceptions were associated with eating disorder symptoms. We found that a substantial percentage (~75%) of participants used My Fitness Pal and that 73% of these users perceived the app as contributing to their eating disorder. Furthermore, we found that these perceptions were correlated with eating disorder symptoms. This research suggests that My Fitness Pal is widely used in an eating disorder population and is perceived as contributing to eating disorder symptoms. Further research is needed to clarify the role calorie tracking applications play within a sample of individuals with eating disorders.
Article
The use of online calorie tracking applications and activity monitors is increasing exponentially. Anecdotal reports document the potential for these trackers to trigger, maintain, or exacerbate eating disorder symptomatology. Yet, research has not examined the relation between use of these devices and eating disorder-related attitudes and behaviors. This study explored associations between the use of calorie counting and fitness tracking devices and eating disorder symptomatology. Participants (N=493) were college students who reported their use of tracking technology and completed measures of eating disorder symptomatology. Individuals who reported using calorie trackers manifested higher levels of eating concern and dietary restraint, controlling for BMI. Additionally, fitness tracking was uniquely associated with ED symptomatology after adjusting for gender and bingeing and purging behavior within the past month. Findings highlight associations between use of calorie and fitness trackers and eating disorder symptomatology. Although preliminary, overall results suggest that for some individuals, these devices might do more harm than good.
Article
Despite significant advances in the development of prevention and treatment interventions for eating disorders and disordered eating over the last decade, there still remains a pressing need to develop more effective interventions. In line with the 2008 Medical Research Council (MRC) evaluation framework from the United Kingdom for the development and evaluation of complex interventions to improve health, the development of sound theory is a necessary precursor to the development of effective interventions. The aim of the current review was to identify the existing models for disordered eating and to identify those models which have helped inform the development of interventions for disordered eating. In addition, we examine the variables that most commonly appear across these models, in terms of future implications for the development of interventions for disordered eating. While an extensive range of theoretical models for the development of disordered eating were identified (N = 54), only ten (18.5%) had progressed beyond mere description and to the development of interventions that have been evaluated. It is recommended that future work examines whether interventions in eating disorders increase in efficacy when developed in line with theoretical considerations, that initiation of new models gives way to further development of existing models, and that there be greater utilisation of intervention studies to inform the development of theory.
Article
Purpose of review: Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Recent findings: Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition has outlined more sex-neutral diagnostic criteria for eating disorders. Data of socioeconomic factors, prenatal influences, clinical characteristics, assessment, and mortality for eating disorders have been reported independently for males. Unlike in females, higher parental education showed no association with eating disorders in males, but twin or triplet status and lower gestational age at birth had an independent association with anorexia nervosa in males. Contrary to earlier suggestions, no differences in eating disorder symptoms such as binging, vomiting, or laxative abuse were observed between the sexes. Yet, males tended to score lower on eating disorder symptom measures than females. High rates of premorbid overweight and higher BMIs at various stages of eating disorders have been confirmed repeatedly. Higher age and lower BMI at admission, and restrictive anorexia nervosa subtype predicted fatal outcome for anorexia nervosa in males. Summary: Contemporary research provides grounds for improved recognition, diagnosis, and treatment for males suffering from eating disorders.
Article
The field of behavioral science has produced myriad data on health behavior change strategies and leveraged such data into effective human-delivered interventions to improve health. Unfortunately, the impact of traditional health behavior change interventions has been heavily constrained by patient and provider burden, limited ability to measure and intervene upon behavior in real time, variable adherence, low rates of implementation, and poor third-party coverage. Digital health technologies, including mobile phones, sensors, and online social networks, by being available in real time, are being explored as tools to increase our understanding of health behavior and to enhance the impact of behavioral interventions. The recent explosion of industry attention to the development of novel health technologies is exciting but has far outpaced research. This Special Section of Translational Behavioral Medicine, Smartphones, Sensors, and Social Networks: A New Age of Health Behavior Change features a collection of studies that leverage health technologies to measure, change, and/or understand health behavior. We propose five key areas in which behavioral science can improve the impact of digital health technologies on public health. First, research is needed to identify which health technologies actually impact behavior and health outcomes. Second, we need to understand how online social networks can be leveraged to impact health behavior on a large scale. Third, a team science approach is needed in the developmental process of health technologies. Fourth, behavioral scientists should identify how a balance can be struck between the fast pace of innovation and the much slower pace of research. Fifth, behavioral scientists have an integral role in informing the development of health technologies and facilitating the movement of health technologies into the healthcare system.
Article
This study aimed to establish normative and reliability data for the Eating Disorder Examination-Questionnaire (EDE-Q) in a sample of high school and university men. A total of 250 men aged 15 to 30 years (mean = 19.7; SD = 2.3) with an average BMI of 23.1 (SD = 3.1) were administered the EDE-Q. Mean global EDE-Q was 0.44 (SD = 0.52), with subscale means ranging from 0.15 (SD = 0.38) for eating concern to 0.70 (SD = 0.81) for shape concern. EDE-Q scores among this non-clinical sample of normal-weight young men were significantly, and almost invariably, lower than similarly aged young women. The EDE-Q performed less reliably among men than women, and this is an important caveat. Owing to the overall pattern of low item endorsement, reliance upon this single instrument is unlikely to provide a comprehensive assessment of shape, weight, and eating concerns among normal-weight young men in the community.
Article
Identifying measures that reliably and validly assess clinical impairment has important implications for eating disorder (ED) diagnosis and treatment. The current study examined the psychometric properties of the Clinical Impairment Assessment (CIA) in women at high risk for ED onset. Participants were 543 women (20.6 ± 2.0 years) who were classified into one of three ED categories: clinical ED, high risk for ED onset, and low risk control. Among high risk women, the CIA demonstrated high internal consistency (α = 0.93) and good convergent validity with disordered eating attitudes (rs = 0.27-0.68, ps < 0.001). Examination of the CIA's discriminant validity revealed that CIA global scores were highest among women with a clinical ED (17.7 ± 10.7) followed by high risk women (10.6 ± 8.5) and low risk controls (3.0 ± 3.3), respectively (p < 0.001). High risk women reporting behavioral indices of ED psychopathology (objective and/or subjective binge episodes, purging behaviors, driven exercise, and ED treatment history) had higher CIA global scores than those without such indices (ps < 0.05), suggesting good criterion validity. These data establish the first norms for the CIA in a United States sample. The CIA is psychometrically sound among high risk women, and heightened levels of impairment among these individuals as compared to low risk women verify the relevance of early intervention efforts.
Article
The purpose of this study was to systematically review the reliability of scores on the Eating Disorder Examination (EDE) and the Eating Disorder Examination-Questionnaire (EDE-Q) and to examine the validity of their use as measures of eating disorder symptoms. Articles describing the psychometric properties of the EDE and EDE-Q were identified in a systematic search of major computer databases and a review of reference lists. Articles were selected based on a priori inclusion and exclusion criteria. Fifteen studies were identified that examined the psychometrics of the EDE, whereas 10 studies were found that examined the psychometrics of the EDE-Q. Both instruments demonstrated reliability of scores. There is evidence that scores on the EDE and EDE-Q correlate with scores on measures of similar constructs and support for using the instruments to distinguish between cases and non-cases. Additional research is needed to broaden the generalizability of the findings.
Article
Normative data on the Eating Disorder Examination Questionnaire for samples of undergraduate men in the United States are presented. Participants were 404 undergraduate men aged 18-26 who completed the EDE-Q as part of two larger survey studies. Mean scores, standard deviations, and percentile ranks for the Global score and four subscale scores are provided. Data regarding the frequency of objective binge eating episodes and compensatory behaviors also are reported. Although the overall prevalence of full threshold eating disorders remains lower in men than in women, body dissatisfaction and disordered eating behaviors are fairly common among young men. These results will help researchers and clinicians interpret the EDE-Q scores of undergraduate men.
Article
This study aimed to investigate the initial psychometric properties and to establish norms for the Clinical Impairment Assessment (CIA v. 3.0) among a nonclinical sample of young adult women. The CIA is a brief, 16-item self-report measure designed to assess psychosocial impairment due to eating disorder features over the past 28 days. We administered the CIA and the Eating Disorder Examination-Questionnaire (EDE-Q v. 6.0) to 438 university women (mean age = 25 years). Participants' mean global CIA score was 6.4 (SD = 7.5; range 0-40). Acceptable levels of internal consistency (Cronbach's alpha = 0.94) and 1-week test-retest reliability were observed. Significant correlations were found between the CIA and the EDE-Q total and subscale scores (Spearman rhos = 0.58-0.79), indicating that greater levels of impairment were associated with higher levels of eating disorder psychopathology. Results demonstrated satisfactory psychometric properties of the CIA among a sample of young adult women, suggesting the utility of the CIA to measure impairment due to eating disorder features in nonclinical samples.
Article
A detailed comparison was made of two methods for assessing the features of eating disorders. An investigator-based interview was compared with a self-report questionnaire based directly on that interview. A number of important discrepancies emerged. Although the two measures performed similarly with respect to the assessment of unambiguous behavioral features such as self-induced vomiting and dieting, the self-report questionnaire generated higher scores than the interview when assessing more complex features such as binge eating and concerns about shape. Both methods underestimated body weight.
Article
The Dichotomous Thinking in Eating Disorders Scale (DTEDS) is a short, self-report measure that can be used to assess the presence of a rigid, "black-and-white" cognitive thinking style. It was originally developed for use in a study of psychological predictors of weight regain in obesity. The DTEDS consists of two subscales. Items on the Eating subscale assess dichotomous thinking with regards to eating, dieting or weight, and items on the General subscale assess dichotomous thinking more generally. This study aimed to examine the factor structure and psychometric properties of the DTEDS in a sample of treatment-seeking eating disordered (N=87) and overweight/obese (N=111) women. Confirmatory factor analysis demonstrated that a two-factor model provided a better fit to the data than a one-factor model. The psychometric properties of the final scale were excellent, with evidence being provided for the reliability and validity of the two subscales. Overall, the results indicated that the DTEDS is a reliable instrument that can be used to assess eating-specific as well as more general aspects of dichotomous thinking.
Diet plan buying guide
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Assessment of eating disorders: Interview or selfreport questionnaire?
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Sports and fitness app market to expand by more than 60 percent in five years
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Norms for the Eating Disorder Examination
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