Eating Disorders Among a Community‐Based Sample of Chilean Female Adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88044/1/jora733.pd

Eating pathology in midlife women: similar or different to younger counterparts?

Objective This study examined potential similarities and differences between women with eating disorders (EDs) in midlife and their younger counterparts. Method Seven hundred and three women assessed by a specialist eating disorder service were divided into three groups based on age (18–25, 25–40, and 40+) and compared on a number of clinical and demographic measures. Distribution of ED diagnoses was also examined between groups. Results Midlife women were less likely to receive a diagnosis of anorexia nervosa and more likely to receive a diagnosis of binge‐eating disorder than their younger counterparts. Duration of illness was longer and age of ED onset later in the midlife group but no differences were seen on measures of global ED pathology, psychosocial impairment, or psychological distress. Discussion This study adds to the developing literature concerning EDs in midlife women, although further work is needed to support the findings presented here and to examine profiles of males presenting to treatment centers

A systematic review of interventions on body image and disordered eating outcomes among women in midlife

Objective: Body dissatisfaction and disordered eating are widely recognised as issues that warrant attention among women in midlife, particularly the development and delivery of effective interventions. This paper systematically reviews existing research on interventions among midlife women on body image and disordered eating outcomes, in order to inform intervention delivery and provide strategic directions for future research.Method: Fourteen electronic databases were searched for articles published between 1992-2015 that evaluated interventions with non-clinical samples of women (M age 35-55 years) in controlled trials with at least one body image measure. Data were extracted and evaluated, and the methodological quality of studies was assessed using the Cochrane Collaboration tool for assessing risk of bias.Results: From 7,475 records identified, 9 articles evaluating 11 interventions met the inclusion criteria. Seven interventions significantly improved body image at post-test (ds = 0.19-2.22), with significant improvements on disordered eating achieved by two of these interventions (ds = 0.90-1.72). Sustained improvements were achieved by three interventions that employed a multi-session, therapeutically based, group intervention format; two with sustained body image and disordered eating improvements, and one with sustained body image improvements only (ds = 0.55-1.21; 2 weeks-6 months). Methodological quality varied between studies. Discussion: To date, three interventions have demonstrated sustained improvements and are indicated for practitioners aiming to improve body image and disordered eating among women in midlife. Replication and more rigorous randomised controlled trials are required to enhance the methodological quality of intervention studies in this field

Self-esteem and peer-perceived social status in early adolescence and prediction of eating pathology in young adulthood

OBJECTIVE: Self-esteem is implied as a factor in the development of eating disorders. In adolescence peers have an increasing influence. Support for the role of self-esteem in eating disorders is ambiguous and little is known about the influence of social status as judged by others. The present study investigates whether self-esteem and peer status in early adolescence are associated with eating pathology in young adulthood. METHOD: This study is part of TRAILS, a longitudinal cohort study on mental health and social development from preadolescence into adulthood. At age 11, participants completed the Self-Perception Profile for Children, assessing global self-esteem and self-perceptions regarding social acceptance, physical appearance, and academic competence. At age 13, peer status among classmates was assessed regarding likeability, physical attractiveness, academic performance, and popularity in a subsample of 1,007 participants. The Eating Disorder Diagnostic Scale was administered at age 22. The present study included peer-nominated participants with completed measures of self-perception at age 11 and eating pathology at age 22 (N = 732; 57.8% female). RESULTS: In a combined model, self-perceived physical attractiveness at age 11 and peer popularity at age 13 were inversely correlated with eating pathology at 22 years, while likeability by peers at age 13 was positively related to eating pathology. DISCUSSION: Both self-perceptions and peer status in early adolescence are significant predictors of eating pathology in young adults. Specific measures of self-esteem and peer-perceived status may be more relevant to the prediction of eating pathology than a global measure of self-esteem

Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa

Objective: Patients with atypical anorexia nervosa (AN) are often in the normal-weight range at presentation; however, signs of starvation and medical instability are not rare. White matter (WM) microstructural correlates of atypical AN have not yet been investigated, leaving an important gap in our knowledge regarding the neural pathogenesis of this disorder. Method: We investigated WM microstructural integrity in 25 drug-naïve adolescent patients with atypical AN and 25 healthy controls, using diffusion tensor imaging (DTI) with a tract-based spatial statistics (TBSS) approach. Psychological variables related to the eating disorder and depressive symptoms were also evaluated by administering the eating disorder examination questionnaire (EDE-Q) and the Montgomery–Åsberg depression rating scale (MADRS-S) respectively, to all participants. Results: Patients and controls were in the normal-weight range and did not differ from the body mass index standard deviations for their age. No between groups difference in WM microstructure could be detected. Discussion: Our findings support the hypothesis that brain structural alterations may not be associated to early-stage atypical AN. These findings also suggest that previous observations of alterations in WM microstructure in full syndrome AN may constitute state-related consequences of severe weight loss. Whether the preservation of WM structure is a pathogenetically discriminant feature of atypical AN or only an effect of a less severe nutritional disturbance, will have to be verified by future studies on larger samples, possibly directly comparing AN and atypical AN

Update on the epidemiology and treatment of eating disorders among older people

Purpose of review: We reviewed the recent literature on the epidemiology and treatment of eating disorders among middle-aged and older women and men.Recent findings: Recent studies show that among older female persons, the prevalence rates with full diagnoses of eating disorders based on DSM-IV or DSM-5 criteria are between 2.1 and 7.7%, and among older men less than 1%. These studies show that the prevalence of eating disorders decreases by age in women, but it does not get towards zero even in very high age. Middle age, with a peak around 50, is also a critical time for the occurrence of eating disorders in men. Women who reported severe menopausal symptoms showed more eating disorder pathology compared with those with low symptoms during menopausal transition.Summary: Eating disorders do occur in middle and older age of both sexes. Shame and stigmatization have decreased, and medical awareness and explicit assessment of eating behavior in all age groups have developed. What puberty is for eating disorders in adolescence and young age is menopausal transition for midlife women. Also in men, associations with hormonal disturbances are possible. Treatment approaches should consider treatment strategies tailored to older women and men, addressing the context of midlife and aging.</p

Male eating disorders in midlife—possible links between excessive sports and hormones

AbstractAlthough eating disorders were long considered a typical female disorder, it is now clear that men are also affected. However, the literature on eating disorders in men is still very limited, and the actual extent is not known. Even less is known about the epidemiology of eating disorders in older individuals. In this focused review, we will present an update of the available data on disordered eating and eating disorders in middle-aged and older males. In addition, we will highlight the relationship of eating disorders with excessive sports as a purging method of choice for this age group and discuss the impact of age-related hormonal imbalances in aging men