Emotional dysregulation and eating symptoms in gender dysphoria and eating disorders: the mediating role of body uneasiness

emotional dysregulation is a key transdiagnostic dimension of several clinical conditions, including eating disorders (EDs) and gender dysphoria (GD). Not only is there frequent comorbidity between EDs and GD, but GD individuals also commonly experience ED symptoms and body-image disturbances. however, more research is needed to understand how specific body-related experiences may differently interact with difficulties in emotion regulation and dysfunctional eating behaviors in EDs and GD. thus, the present study aimed at exploring potential associations between emotional dysregulation and ED symptomatology in individuals diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or gender dysphoria (GD), also considering the mediating role of specific dimensions of body uneasiness. a national sample of N = 96 help-seekers assigned female at birth (n = 32 with AN, n = 32 with BN, n = 32 with GD) was recruited from two specialized care centers. participants completed the eating disorder Inventory-3 (EDI-3) and the Body uneasiness Test (BUT), while the shedler-westen assessment procedure–200 (SWAP-200) was used to evaluate emotional dysregulation. findings showed that several body uneasiness dimensions mediated the relationship between emotional dysregulation and ED symptoms, in both AN-BN and GD participants. In GD individuals, body avoidance emerged as a significant mediator of the relationship between emotional dysregulation and ED symptoms, whereas in both AN-BN patients and GD individuals, depersonalization toward the body emerged as a significant mediator. the results suggest that the interplay between emotional dysregulation, body uneasiness, and ED symptoms may be crucial for the development of comprehensive and tailored prevention strategies

Eating Disorders and Disturbed Eating Behaviors Underlying Body Weight Differences in Patients Affected by Endometriosis: Preliminary Results from an Italian Cross-Sectional Study

Abstract: This study aimed to characterize the prevalence of eating disorders(EDs), disturbed eating behaviors (DEBs), and emotional eating attitudes (EEAs) among patients affected by endometriosis in order to understand a potential crosslink between this impacting gynecological disease and a Body Mass Index shift. A total of 30 patients were recruited at an endometriosis outpatient clinic in Bologna and were assessed by using standardized instruments and specific questionnaires for EDs, DEBs, and EEAs. Sociodemographic information and endometriosis clinical features and history information were collected by adopting a specific questionnaire. Retrospective reports of lifetime Body Mass Index (BMI) changes, current BMI, peak pain severity during the last menstrual period, and the average of pain intensity during the last intermenstrual period were used for a correlation with the mean score from eating-behavior scales’ assessment. The preliminary results indicate that, although only 3.33% of endometriosis patients are affected by ED, statistically significant differences at the mean scores of DEBs and EEAs assessment scales were found by strati-fying patients on the basis of BMI levels at risk for infertility and coronary heart disease and on the basis ofmoderate/severe pain levels. The enrichment of the sample size and the recruitment of the control group to complete the study enrollment will allow us to investigate more complex and strong correlation findings and to assess the prevalence of EDs among endometriosis patients. Keywords: endometriosis; BMI; pain; eating disorders;disturbed eating behaviors; emotional eating attitude

Capivasertib in Hormone Receptor-Positive Advanced Breast Cancer.

Background: AKT pathway activation is implicated in endocrine-therapy resistance. Data on the efficacy and safety of the AKT inhibitor capivasertib, as an addition to fulvestrant therapy, in patients with hormone receptor-positive advanced breast cancer are limited. Methods: In a phase 3, randomized, double-blind trial, we enrolled eligible pre-, peri-, and postmenopausal women and men with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer who had had a relapse or disease progression during or after treatment with an aromatase inhibitor, with or without previous cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor therapy. Patients were randomly assigned in a 1:1 ratio to receive capivasertib plus fulvestrant or placebo plus fulvestrant. The dual primary end point was investigator-assessed progression-free survival assessed both in the overall population and among patients with AKT pathway-altered (PIK3CA, AKT1, or PTEN) tumors. Safety was assessed. Results: Overall, 708 patients underwent randomization; 289 patients (40.8%) had AKT pathway alterations, and 489 (69.1%) had received a CDK4/6 inhibitor previously for advanced breast cancer. In the overall population, the median progression-free survival was 7.2 months in the capivasertib-fulvestrant group, as compared with 3.6 months in the placebo-fulvestrant group (hazard ratio for progression or death, 0.60; 95% confidence interval [CI], 0.51 to 0.71; P<0.001). In the AKT pathway-altered population, the median progression-free survival was 7.3 months in the capivasertib-fulvestrant group, as compared with 3.1 months in the placebo-fulvestrant group (hazard ratio, 0.50; 95% CI, 0.38 to 0.65; P<0.001). The most frequent adverse events of grade 3 or higher in patients receiving capivasertib-fulvestrant were rash (in 12.1% of patients, vs. in 0.3% of those receiving placebo-fulvestrant) and diarrhea (in 9.3% vs. 0.3%). Adverse events leading to discontinuation were reported in 13.0% of the patients receiving capivasertib and in 2.3% of those receiving placebo. Conclusions: Capivasertib-fulvestrant therapy resulted in significantly longer progression-free survival than treatment with fulvestrant alone among patients with hormone receptor-positive advanced breast cancer whose disease had progressed during or after previous aromatase inhibitor therapy with or without a CDK4/6 inhibitor. (Funded by AstraZeneca and the National Cancer Institute; CAPItello-291 ClinicalTrials.gov number, NCT04305496.)