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PubMed1991

Dysfunctional family systems: relationships to disordered eating behaviors among university women.

Clinicians have speculated that the appearance and maintainance of eating-disordered behavior may be attributed to certain familial characteristics which predispose vulnerable individuals to the development of these behaviors. However, few empirical studies exist to substantiate these speculations. This study compared the responses of 190 female university students on three self-report instruments: the Disordered Eating and Weight Control Instrument (DEWCI), the Eating Disorders Instrument (EDI), and the Family Adaptability and Cohesion Evaluation Scale (FACES III) to identify potential relationships between eating-disordered behavior and family types. Subjects were classified, on the basis of their scores on the FACES III, into one of three family types: balanced, midrange, or extreme. A one-way analysis of variance with main effect for family type was applied to the eating-behavior subscales. A Turkey multiple comparison test was applied to the significant main effects. Women classified in the extreme family type scored significantly higher (p less than .05) on several measures of eating-disordered behavior. A Distance From Center (DFC) linear score also was computed and correlated with the eating-disordered subscales. All but 4 of the 18 measures correlated significantly (p less than .05). These findings support speculation, particularly that of family theorists, that eating-disordered behavior may be a symptom response and/or coping strategy for women in dysfunctional families.

Adaptation, Psychological↗

PubMed1996

Psychosocial predictors of binge eating and purging behaviors among adolescents with and without diabetes mellitus.

PURPOSE: This study aims to compare dieting, binge eating, and purging behaviors, and to examine predictors of binge eating and purging behaviors among adolescents with and without Diabetes Mellitus (DM). METHODS: The index group included 310 adolescents who reported that they had DM on a statewide population survey of 36,284 adolescents in grades 7-12 in Minnesota. The comparison group included a random sample matched for socioeconomic status (SES), of 850 adolescents without chronic illness. Disordered eating behaviors assessed in the present study included binge eating, vomiting, laxative use, and diuretic use. Potential predictor variables assessed included weight loss behaviors, body image, sexual abuse, sexual attractions, emotional well-being, family connectedness, poor school performance, age, race, Body Mass Index (BMI), and SES. RESULTS: Binge eating and purging were significantly more prevalent among adolescents with DM than among the comparison group. Different risk profiles were found for adolescents with and without DM and for males and females. Predictors of binge eating and purging among females with DM included weight dissatisfaction, bisexual/homosexual attractions, and younger age. Predictors among males with DM included bisexual/homosexual attractions, younger age, sexual abuse, and an interaction between sexual abuse and emotional well-being. CONCLUSIONS: Adolescents with DM should be screened for unhealthy weight control practices and eating disorders. If disordered eating is present, clinicians need to be sensitive to the variety of factors possibly associated with these behaviors among different individuals.

Adolescent↗

PubMed1999

Eating attitudes, body shape perceptions and mood of elite rowers.

The study assessed the influence of age, gender and weight category upon eating attitudes, body shape perceptions, and mood. Elite rowers (N = 103) participating in the 1996 World Championships or Great Britain National Championships completed the Eating Attitude Test (EAT), the Body Shape Questionnaire (BSQ), and a short form of the Profile of Mood States (POMS-C). Participants were grouped as lightweight (Female: < 59 kg, n = 19; Male: < 72.5 kg, n = 31) or heavyweight (Female: n = 25; Male: n = 28) competitors. Results showed higher EAT scores among the lightweight group, 12.0% of whom reported scores above the threshold associated with eating disorders. Body shape concerns were higher for heavyweights than lightweights and for females than males. The interaction effect was not significant. BSQ scores were negatively correlated with age. Depression, Confusion and Tension scores collectively predicted 37% of the variance in BSQ scores while Depression scores predicted 9% of the variance in EAT scores. The results provide further evidence that the risk of eating disorders among elite rowers is moderated by age, gender and weight category. Further, they suggest that measures of mood may help identify athletes at risk from eating disorders.

Adolescent↗

PubMedDate not supplied

Who we are and how we eat: a qualitative study of identities in food choice.

OBJECTIVE: The study sought to develop a theoretical understanding of identities related to eating. DESIGN: A grounded theory approach and open-ended, in-depth interviews were used to examine identity and eating from the perspectives of adults. PARTICIPANTS: Seventeen middle-class, white adults (nine women, eight men) were purposely recruited to vary in gender, age, household composition, and ways of eating using convenience and snowball sampling. DATA ANALYSIS: Interview transcripts were analyzed using the constant comparative method. RESULTS: Identities involved in participants' food choices related to usual or preferred eating behaviors, personal traits, reference groups, and social categories. Participants varied in the number, type, and complexity of identities involved in eating. Identities were reported to be both stable and dynamic over time and were shaped by participants' life course experiences. Participants varied in the attention they paid to evaluation and monitoring of identities related to eating, the extent to which they enacted identities in eating, and how they managed identity conflicts. IMPLICATIONS: The concept of identity may help researchers understand food choice processes and assist practitioners in recognizing the multiple meanings that people bring to and derive from eating.

Adult↗

PubMed2004

Cluster analysis of key diagnostic variables from two independent samples of eating-disorder patients: evidence for a consistent pattern.

INTRODUCTION: The optimal classification of eating disorders has been a matter of considerable debate. The present paper tackles this issue using cluster analysis with large independent samples of eating-disorder patients. METHOD: Two samples of adult female patients from Sweden (n = 631) and England (n = 472) were classified on the basis of 10 key clinical variables of primary significance for diagnosing eating disorders. A separate series of cluster analyses were conducted on each sample. RESULTS: Results suggested that a three-cluster solution was optimal in both samples. The first cluster ('generalized eating disorder') was characterized by high levels of eating-disorder psychopathology on all variables except weight and menstrual functioning. The second cluster ('anorexics') was typified by low weight, amenorrhoea and the absence of binge eating, and seemed to correspond to the clinical picture of anorexia nervosa. The third cluster ('overeaters') was characterized by high weight and moderate levels of binge eating and compensatory behaviour. CONCLUSIONS: Results suggest that patients presenting to eating-disorder services in different countries have clinical features that fall into very similar patterns. These patterns resemble, but are not identical to, existing diagnostic categories.

Adolescent↗

PubMedDate not supplied

Eating disorders and their correlates in high school adolescents of Northern Italy.

OBJECTIVE: The study investigated eating disordered behaviours and life-habits correlated in a large sample of Northern Italian adolescents of both sexes. METHODS: The study had a cross-sectional design. 2595 students (2,146 responders; mean age 17.2 +/- 1.7 years) attending high schools in Savona (Italy) in April and May 2001 were sampled. To assess eating attitudes, the Inventory for the Screening of Eating Disorders (ISED) was self-administered. Inquiries regarding possible risk factors for eating disorders were also made: socio-economic status, body weight, smoking and alcohol drinking habits, illegal drugs use. RESULTS: Females scored significantly higher than males at ISED (13.4 +/- 7.7 vs. 7.6 +/- 5.8). 28.5% of females had a total ISED score above the cut-off point (18/19). Unhealthy eating behaviours were strongly associated with higher BMI, body image disturbance and illegal drugs use in both sexes; age had significant role only in males. No significant association between disordered eating behaviours and socio-economic status, smoking habit and alcohol consumption were found. CONCLUSIONS: Symptoms of eating disorders are quite spread in the Northern Italian female adolescents and associate with illegal drugs use. These data, with not negligible frequency of unhealthy eating behaviours and attitudes in males too, suggest that primary and secondary preventive interventions for teen-agers should be got ready.

Adolescent↗

PubMed1999

Unhealthy eating behaviour in adolescents.

In recent years, eating disorders (Anorexia and Bulimia Nervosa) have increased and are appearing at increasingly younger ages. They affect predominantly adolescent females 12 to 25 years of age. The objective of this study of adolescents is to detect and discuss unhealthy eating behaviour, defined by either of two factors: (1) following a slimming diet not advised or supervised by any person trained in health care; or (2) eating very large quantities at irregular times, not related to anxiety or stress. A transversal study has been undertaken of 630 school children of 14-18 years of age (average: 15.9 years) in Cádiz (Andalucia, Spain), using an anonymous self-reporting questionnaire to collect data on personal and educational situation, on eating habits, on nutritive intake and knowledge of nutrition, and on dieting and physical exercise. The study has considered averages, ratios, statistical significance (chi2) and, as a measure of risk, the Disequality Ratio of Prevalence (DRP). Anomalous eating behaviour was detected in 46.3% (292), with females predominant by a ratio of 2:1. Comparing groups with anomalous and with normal eating habits, significant differences were detected in respect of: perception of body image (p < 0.001), frequency of weighing oneself (p < 0.05), periods of abstinence from eating (DRP 1.66; 95% confidence interval (CI): 1.66-2.37), provocation of vomiting (DRP 2.02; 95% CI: 1.13-3.65), use of laxatives (DRP 4.25: 95% CI: 1.08-9.63), and the exclusion of certain meals and types of food, mainly bread and cereals, fats and sugars. Conclusions are drawn on the substantial scale of unhealthy eating behaviour among adolescents in Cadiz. More adequate education on personal health and related social issues should be provided.

Adolescent↗

PubMed2002

Social desirability and eating disorders. A community study of an Italian school-aged sample.

OBJECTIVE: To explore the links between social desirability and eating disorders in a sample of adolescents in a north-east area of Italy. METHOD: A mixed male-female sample of 1000 school-aged adolescents, corresponding to 10% of the young population aged 15-19 years living in the district, were investigated with self-reported questionnaires, including the Eating Attitudes Test (EAT), the Bulimic Investigatory Test of Edinburgh (BITE), the Body Attitudes Questionnaire (BAT), and an Italian version of the Marlowe-Crowne Social Desirability Scale (MC-SDS). RESULTS: Females scored higher than males at all eating disorder inventories. In both genders there was a negative relationship (in all cases P < 0.01) between scores at the eating disorder inventories and those at the MC-SDS. When analysing eating disorder "caseness", as measured by cut-off, "cases" reported significantly lower scores than "non-cases" at the MC-SDS in both genders. CONCLUSION: Personality traits measured by the MC-SDS, such as defensiveness, self-esteem, and dependence from approval, might contribute to the development of abnormal eating patterns at risk of eating disorders.

Adolescent↗

PubMed1985

Anxiety and eating behavior in obese and nonobese American Indians and white Americans.

According to emotional arousal theory (EAT), when emotionally aroused, obese people overeat and nonobese people do not. Lower socioeconomic-status urban obese and nonobese American Indians and White Americans were compared on a test of EAT. Subjects were administered the trait anxiety form of the State-Trait Anxiety Inventory Scale (S-TAIS) and then assigned to a high-anxiety (HA) or low-anxiety (LA) condition. They were then administered the state form of the S-TAIS and given a taste task to determine whether EAT is preditive of eating behaviors for both ethnic groups. Assessment results indicated that women were more trait and state anxious than were men; HA women, all HA subjects, HA American Indians, and nonobese American Indians were more state anxious than were corresponding groups. Behavioral indicator results generally supported EAT: All obese and high-anxiety-condition obese subjects consumed more food than did nonobese and low-anxiety-condition obese subjects, respectively. The overall consumption of food was greater with American Indians than with White Americans. This indicates that EAT does not fully explain American Indian eating behavior. An alternative stress-reaction theory is proposed to more fully account for American Indian eating behavior. Obese and nonobese American Indians overeat in response to stress. When stress occurs more frequently, intensely, and for longer duration, the potential for becoming obese increases (given food availability).

Adult↗

PubMed2004

Restrained eating behavior and the metabolic response to dietary energy restriction in women.

OBJECTIVE: To determine whether prior eating behavior characterized by dietary restraint alters responses in energy expenditure and substrate oxidation associated with a short-term, energy-restricted diet. RESEARCH METHODS AND PROCEDURES: A repeated-measures, 3-day diet-intervention study of adequate (125 kJ/kg of body weight) or restricted (62.5 kJ/kg) energy intake was conducted with 30 women, 20 to 46 years, BMI 25 to 45 kg/m(2), whose prior eating behavior was "restrained" or "unrestrained." The Eating Inventory (cognitive restraint subscale) was used to measure restrained eating behavior. Energy expenditure and substrate oxidation were measured after a 12-hour fast and during the first and fourth hours after a standard meal. Plasma glucose, nonesterified fatty acids, and insulin were measured at corresponding times. Body composition was determined by total body electrical conductivity. RESULTS: Resting energy expenditure was not affected by 3 days of energy restriction. Short-term energy restriction resulted in lower respiratory-exchange ratios, higher rates of fat oxidation, and lower rates of carbohydrate oxidation. Subjects classified as restrained eaters had higher postprandial respiratory-exchange ratios and carbohydrate-oxidation rates compared with unrestrained eaters. Fasting insulin concentrations were lower in restrained eaters. These effects associated with prior eating behavior were independent of the diet intervention. DISCUSSION: Metabolic outcomes associated with a 3-day energy-restricted diet (i.e., increased fat oxidation and decreased carbohydrate oxidation) were not affected by prior restrained eating behavior. However, restrained eating behavior was associated with increased carbohydrate oxidation after a mixed meal. This effect of restrained eating behavior may be attributable to increased insulin sensitivity.

Adult↗

PubMed2001

Parental influences on laboratory eating behavior in obese and non-obese children.

OBJECTIVE: To determine parental influence on obesity, eating behavior of 80 obese and normal weight children (aged 8-12 y) was investigated in the laboratory. DESIGN: A controlled repeated measurement design was used. The mother was either present or absent while the child was eating in the laboratory. MEASUREMENTS: The eating style was measured by recording cumulative eating curves with a universal eating monitor, using yoghurt as a standardized experimental meal. RESULTS: The eating behavior of obese children differed significantly from normal weight children only when the mother was present in the laboratory. Overweight children ate faster with larger bites and showed an acceleration of their eating rate towards the end of the meal. CONCLUSION: Such an eating style can be hypothesized to explain an increased calorie intake in obese children, promoting a positive energy balance in the long-term. The data support a learning model of obesity in childhood, which also has implications for family treatment.

Child↗

PubMed2003

Eating difficulties after stroke.

BACKGROUND: Stroke is a common and enduring problem, producing a wide range of effects that may impact on all aspects of life. One area that has seldom been investigated is the effects of stroke on ability to eat and, particularly, stroke survivors' subjective experiences of eating-related difficulties. AIM: To investigate stroke survivors' reports of eating-related experiences 6 months after stroke. METHODS: Participants were 206 survivors of acute stroke who were admitted to hospital between March 1998 and April 1999. Those able to communicate and who gave informed consent participated in a semi-structured interview and assessment of eating abilities in their homes 6 months after their stroke. Interviews were tape recorded and transcribed and 113 interviews with eating disabled participants were entered onto QSR NUD*IST 4 for thematic analysis. Analyses were later checked independently. FINDINGS: At 6 months, 34%, 61% and 5% had no, slight and moderate eating disablements, respectively. A range and variety of difficulties were discussed, but relationships between degrees of disablement and handicap were not straightforward; effects seemed more closely related to participants' responses than objective difficulties. Eating and related activities were clearly important aspects of life for these stroke survivors, socially and psychologically, as well as functionally. Prestroke activities were sometimes maintained, with considerable effort. CONCLUSIONS: Findings indicated issues of relevance for those involved with early rehabilitation interventions and highlighted aspects of continuing care service delivery that warrant review. The relative lack of attention paid to eating-related aspects of care is an important oversight.

Aged↗

PubMed2001

An ethnic comparison of eating attitudes and associated body image concerns in adolescent South African schoolgirls.

OBJECTIVE: The purpose of this study was to investigate whether differences exist in eating attitudes and body shape concerns amongst adolescent schoolgirls representing South Africa's ethnically and culturally diverse population currently undergoing epidemiological transition. METHOD: A questionnaire survey, including the Eating Attitudes Test, Body Shape Questionnaire and a Body Silhouette Chart, was administered to 228 South African schoolgirls (60 black, 83 mixed race and 85 white) aged 15-18 years from five secondary schools in the greater Cape Town area. RESULTS: Black girls had significantly higher mean BMI values (24.1 (3.3)) than either white (21.9 (3.0)) or mixed race girls (22.1 (3.7)) (P < 0.05). Controlling for differences in BMI, white subjects scored significantly higher on the Body Shape Questionnaire than did mixed race or black subjects, whereas no ethnic differences were found for Eating Attitude Test scores. A comparable percentage (mean = 18.8%) of black, mixed race and white girls had scores indicative of eating disorder pathology on the Eating Attitudes Test, while a higher percentage of white, compared to mixed race and black, girls had abnormal scores on the Body Shape Questionnaire (33%, 26% and 20%, respectively; P < 0.05). The ideal body size desired by white girls was significantly smaller than that of the mixed race or black samples. Dissatisfaction with present body size was significantly higher in white, compared to black or mixed race girls (P < 0.001). CONCLUSION: These findings suggest that the prevalence of abnormal eating attitudes is equally common in South African schoolgirls from different ethnic backgrounds. White girls exhibit greater body image concerns and body image dissatisfaction than mixed race or black individuals. These findings reinforce the notion that eating disorders are culture-reactive rather than culture-bound phenomena and provide insight into the extent of eating-related problems and body image issues in developing societies.

Adolescent↗

PubMed2001

Possible genetic link between eating disorders and seasonal changes in mood and behavior.

Studies suggest that there is a seasonal pattern of mood fluctuations and eating behavior in patients with eating disorders. Multiple lines of evidence suggest that serotonergic pathways are involved in the mechanisms of eating disorders and seasonal changes in mood and behavior. Researchers have investigated whether variants of genes related to serotonergic transmission are associated with seasonal affective disorder (SAD) and eating disorders. There is evidence that the -1438G/A promoter polymorphism of the 5-HT2A gene plays a role in the development of SAD and eating disorders. Variation of the tryptophan hydroxylase gene may play a part in eating behavior and weight regulation in females with SAD. The author suggests that there may be a genetic link between SAD and eating disorders. It is possible that there are specific inherited personality types with a predisposition to both eating disorders and SAD.

Feeding and Eating Disorders↗

PubMed2006

Eating attitudes, body esteem, perfectionism and anxiety of judo athletes and nonathletes.

The aim of the study was to examine the prevalence and relationships between disordered eating, menstrual irregularity, musculoskeletal injuries and psychological characteristics in 24 judo athletes (12 females and 12 males) and 31 controls (14 females and 17 males). All these parameters were assessed by a health/medical, dieting and menstrual history questionnaire, the Eating Attitudes Test (EAT-26), the Multidimensional perfectionism scale, the Rosenberg Self-esteem, the Body esteem scale, and the Profile of Mood States. Body mass index (BMI) was also computed. Twenty-five percent of female athletes would be "at risk" of EDs (EAT-26 > 20) and 0 % in the other sample groups. Bone injuries sustained over the judo athlete career were reported by 25 % of females and 33.3 % of males, while 35.7 % of the female controls reported bone injuries. The total frequency of menstrual dysfunction among judo athletes was 58.3 %, while 7.1 % of female controls reported oligoamenorrhea. Regression analyses showed that BE-Weight Satisfaction and BMI contributed to 54.6 % and 17 % of the variance, respectively, in the prediction of log-transformed Global EAT scores among female judo athletes. These data indicate that while the prevalence of clinical eating disorders is low in judo athletes, many are "at risk" for an eating disorder, which places them at an increased risk for menstrual irregularity and bone injuries. This study also highlights the relevance of body esteem to eating disorder symptoms.

Adolescent↗

PubMed1994

Dissociative states and disordered eating.

To investigate the relationship between eating problems and dissociation, 142 college women completed the Eating Disorders Inventory, the Bulimia Test, the Dissociative Experiences Scale, the Perceptual Alteration Scale, and a demographic information worksheet. The two eating-disorder inventories were strongly correlated (rs = .71). The two dissociation scales, however, were only moderately correlated (rs = .32), suggesting they are measuring different underlying experiences. The pattern of the correlations of the subscales of the dissociation scales with the eating disorder scales suggested that cognitive distortions were not as important in the relationship with eating disorders (all correlations were less than .21) as were dissociation of feelings and loss of control (the correlations for eating related subscales ranged as high as .51). These results were interpreted to suggest that dissociation of feelings might underlie eating problems. These results indicate the value of the use of hypnotherapy in working with eating-disordered clients.

Adolescent↗

PubMed1991

From high school to college: changes in women's self-concept and its relationship to eating problems.

A longitudinal panel study of a sample of college women was undertaken to assess changes in women's self-concept from high school to college and during their college years and the relationship between changes in self-concept ratings and eating disorders. Self-concept was measured at Time Change 1 (senior year of high school to sophomore year of college), Time Change 2 (sophomore year of college to senior year of college), and Time Change 3 (senior year of high school to senior year of college) using Brownfain's (1952) self-rating scale. Eating behavior in college was measured at two points, sophomore and senior year, by the Eating Attitudes Test (Garner, Olmsted, Bohr, & Garfinkel, 1982). The women were placed into three eating groups: Group 1 (eating pattern becomes or remains abnormal). Group 2 (eating pattern gets better), and Group 3 (eating pattern remains normal). Results revealed that all women's self-concept ratings declined in Time 1 with only a slight increase on a few traits in Time 2. Analysis of variance (ANOVA) showed that Group 1 experienced a significant overall decline in self-concept ratings between Time 1 and Time 3 compared with Group 2 and Group 3. Group 2 reported significantly greater increases in assertiveness at Time 1 compared with Group 3. We suggest an interactional model for understanding the relationship between self-concept and eating problems.

Adolescent↗

PubMed1998

Functional gastrointestinal disorders and eating disorders. Relevance of the association in clinical management.

BACKGROUND: As functional gastrointestinal disorders (FGID) are common in eating disorder patients, we aimed to assess past eating disorders in patients referred for current FGID. METHODS: One hundred and twenty-seven consecutive FGID outpatients and 163 patients with gallstone disease (GD) were enrolled. All patients were interviewed to detect GI symptoms (by means of the GI Symptom Rating Scale), lifetime eating disorders (on the basis of DSM-IV criteria), and current psychologic distress (on the Hospital Anxiety and Depression Scale). RESULTS: Past eating disorders were significantly more prevalent in FGID (15.7%) than in GD patients (3.1%) (chi-square = 14.6, P < 0.001). FGID patients with past eating disorders were significantly younger, more educated, more psychologically distressed, more dyspeptic, and more were women than FGID patients without past eating disorders. CONCLUSIONS: This study confirms the previously found association between functional GI symptoms and eating disorders and shows that functional GI symptoms may still persist even after the recovery from eating disorders, particularly in psychologically distressed patients.

Abdominal Pain↗