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

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


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

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Available from: Marian Tanofsky-Kraff, May 07, 2014
    • "A sample of one hundred four 12-to 20-year-old adolescents were included in the study. The sample comprised 52 (50.0%) adolescents with sub-and fullthreshold BED (DSM-5) [23] (DSM-IV-TR) [24] with adaptation according to age, i.e., including both objectively and subjectively large binge-eating episodes [25] [26], who sought cognitive-behavioral treatment (BED group) [27]. In addition, 52 (50.0%) adolescents from the community without an eating disorder diagnosis were recruited schooland population-based (HC group). "
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    ABSTRACT: Perceived expressed emotion is a valuable predictor of clinical outcome in psychiatric and community samples, but its assessment is limited to few instruments. A recent development to briefly assess expressed emotion from the patient's perspective is the 14-item Brief Dyadic Scale of Expressed Emotion (BDSEE). Although psychometric properties of the BDSEE have been provided for adult eating disorders, validity for adolescents is still lacking. In this study, BDSEE's factorial, convergent, and divergent validity was tested in an adolescent sample with binge-eating disorder and a matched community sample.
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    • "The impact of particular exposures is likely to depend on the presence of other vulnerabilities or conditions. Overweight is a wellestablished risk factor for body dissatisfaction and disordered eating (Eddy et al., 2007; Goldschmidt, Aspen, Sinton, Tanofsky-Kraff, & Wilfley, 2008). We conducted post hoc analysis examining the moderator effect of overweight status on the relationship between dietary practices on disordered eating. "
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    ABSTRACT: Objective China is undergoing dramatic Westernization, hence may be able to provide unique insights into the role of sociocultural factors in disease. The purpose of this exploratory study was two-fold: to describe the prevalence of screening-detected eating disorders and disordered eating in China at the first occasion of assessment in the large-scale China Health and Nutrition Survey (CHNS) and to explore the associations between dietary practices and disordered eating. Regarding the first objective, participants are provincially representative and in subsequent waves will be followed longitudinally.MethodCHNS participants were recruited using multistage, cluster random sampling, beginning in 1989. In this study, participants comprised 259 female adolescents (12–17 years) and 979 women (18–35 years) who participated in the CHNS 2009 survey, which is the first CHNS survey to assess disordered eating. Dietary practice-disordered eating associations were investigated with logistic regression adjusting for age, body mass index, and urbanization.ResultsOf the participants, 6.3% (95% CI: 4.8, 8.2) of adults and 7.8% (95% CI: 5.0, 12.0) of adolescents had a screening-detected eating disorder. Dietary practices had non-significant associations with disordered eating at the general population level, except for protein consumption among women. There was evidence that skipping meals and a high-fat diet may confer risk.DiscussionScreening-detected eating disorders in China are lower in prevalence than in developed countries. Dietary practices had fairly limited associations with disordered eating at the general population level; protein consumption, skipping meals, and a high-fat diet are candidate dietary practice exposures for disordered eating. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    Preview · Article · Nov 2014 · European Eating Disorders Review
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    • "For example, in a study of female undergraduates, Shatford and Evans (1986) found that self-esteem and mastery were associated with environmental stress and depressive symptoms, which were indirectly associated with bulimia through the mediating effect of coping. More recent research has also shown that negative affect, a construct which is conceptually similar to depressive symptoms and low self-esteem, mediates the relation between teasing and eating pathology (Eddy et al., 2007;Hutchinson et al., 2010;Suisman et al., 2008;van den Berg et al., 2002;Womble et al., 2001). Based on the few studies that exist on the association between daily hassles and eating pathology, it appears that negative affect and low self-esteem may act as mediators (Barker et al., 2006;Fryer et al., 1997). "
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    ABSTRACT: This study examined the associations of weight-related teasing and daily hassles with eating pathology, as well as potential mediators of these relations, among a racially diverse sample of adolescents. Participants were 92 primarily African American 11-17-year-olds seeking treatment for obesity. Data were collected at baseline. Both daily hassles and weight-related teasing were significantly correlated with eating pathology at r = .22 and r = .25, respectively. Feeling upset about teasing mediated the associations of daily hassles (PE = .0093, SE = .0054, 95% BCa bootstrap CI of .0001-.0217) and teasing (PE = .0476, SE = .0198, 95% BCa bootstrap CI of .0093-.0873) with eating pathology. These results highlight the importance of psychological interventions in the treatment of weight-loss among adolescents, as stressors may impact eating behaviors.
    Preview · Article · Jul 2013 · Journal of Pediatric Psychology
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