Search Results (38)

Workplace violence (WV) is a ubiquitous risk in healthcare settings where it has been associated with physical and mental health problems. We aimed to investigate the relationship between the violence experienced by healthcare workers (HCWs) and the presence of eating disorders (EDs). During routine health surveillance, 1215 HCWs were questioned about their experience of WV and the short version of the Eating Disorder Examination Questionnaire (EDE-QS) was used to assess their eating behaviors. Sleep quality, stress, and the presence of common mental illnesses and metabolic disorders were also evaluated. HCWs who had experienced one or more assaults in the previous year had a significantly higher EDE score than their colleagues. In a multivariate model, WV doubled the risk of EDs (odds ratio 2.33, confidence intervals 95% 1.30; 4.18, p < 0.01). A very significant association was observed between common mental disorders and EDs (OR 1.13, CI 95% 1.04; 1.23, p < 0.01), while low sleep quality almost reached a significant level (OR 1.09, CI 95% 0.99; 1.20). The higher frequency of EDs among workers subjected to violence may result from maladaptive coping mechanisms used when stress and mental health problems caused by WV lead to compensatory overeating. However, reverse causation, where WV is induced by stigmatization, cannot be ruled out. Because of the considerable impact EDs have on physical and mental health, productivity, and patient care, healthcare organizations should adopt programs designed to prevent these disorders in HCWs. Full article

Background/Objectives: Substance use disorders and eating disorders frequently co-occur and are both associated with increased aggression. As a result, individuals with these conditions are overrepresented in prison populations. The present study investigated whether symptoms of eating disorders in male forensic psychiatric inpatients with substance use disorders are associated with heightened aggression. To this end, various forms of aggressive behavior—including spontaneous and reactive aggression, excitability, and violent offenses—were analyzed. Methods: Fifty-six male patients from two forensic psychiatric hospitals in Germany participated in the study. Symptoms of eating disorders were evaluated with the German version of the Eating Disorder Examination Questionnaire (EDE-Q), and aggression was measured with the Short Questionnaire for the Assessment of Aggression Factors (K-FAF) and by considering the violent index offense. Data were analyzed by generalized linear models, with age and body mass index (BMI) included as covariates. Results: Higher EDE-Q scores significantly predicted increased spontaneous aggression and excitability. However, no significant association was found between eating disorder symptoms and reactive aggression or the likelihood of a violent index offense. Age and BMI did not significantly influence any aggression subscales. Conclusions: The findings suggest that in patients with substance use disorder, eating disorder symptoms may be linked to heightened internalized forms of aggression. These results support the clinical relevance of screening for eating disorder symptoms in forensic psychiatric settings and integrating dietary interventions into therapeutic efforts to manage aggression. Full article

Background/Objectives: Although eating disorders (EDs) affect a large portion of the population and have a significant impact on health and productivity, they are understudied in the workplace. We assessed the frequency of EDs and studied the relationship between EDs and occupational and individual factors. Methods: All workers undergoing health surveillance were invited to fill in the Eating Disorder Examination Questionnaire, short form (EDE-QS) and, before their routine medical examination that included metabolic tests, measure their level of health literacy, stress, quality of sleep, anxiety, depression, and happiness. Out of a total of 2085 workers, 1912 (91.7%) participated. Results: Suspected EDs affected 4.9% (CI95% 3.9; 5.9) of workers, with no notable difference in gender (5.3% CI95% 4.1; 6.7 in female workers vs. 4.2%, CI95% 2.9; 5.9 in male). Cases were significantly associated with trauma and emotional factors (anxiety, depression, unhappiness), but also with work-related stress and poor sleep quality, and negatively associated with health literacy. Using a hierarchical logistic regression model, suspected cases of EDs were significantly predicted in Model II by life trauma (OR 2.21 CI95% 1.40; 3.48, p < 0.001) and health literacy (OR 0.94 CI95% 0.90; 0.98, p < 0.001), in Model III also by work-related stress (OR 2.57 CI95% 1.68; 3.94, p < 0.001), and in Model IV by depression (OR 1.19 CI95% 1.02; 1.38, p < 0.05) and happiness (OR 0.88 CI95% 0.78; 0.99, p < 0.05). An association was also found between EDs and overweight, obesity, increased abdominal circumference, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, arterial hypertension, atherogenic index of plasma, and metabolic syndrome. Conclusions: The workplace is an ideal setting for the prevention of EDs and their consequences. Occupational health intervention should promote health literacy, improve sleep quality, and reduce work-related stress. Full article

Background and Objectives: During exam sessions, many students experience high levels of stress caused by the large volume of material to study, tight deadlines, and pressure to achieve top grades. This study aimed to examine the relationship between academic stress, sleep disturbances, and eating behaviors by using validated questionnaires administered to a student sample. As stress levels increased, the data revealed a higher frequency of insomnia symptoms and disordered eating, including behaviors such as compulsive eating and irregular meal patterns. Materials and Methods: This cross-sectional, correlational study was conducted on a convenience sample of 317 university students from various academic centers across Romania. Participants were recruited via online distribution of a self-administered questionnaire during a four-month period, including exam sessions. The survey included the Perceived Stress Scale (PSS), the Insomnia Severity Index (ISI), and the Eating Disorder Examination Questionnaire (EDE-Q), alongside additional items assessing perceived links between stress, sleep, and eating behaviors, and the use of medication. Data were analyzed using SPSS with Spearman correlations, t-tests, and linear regression. Results: Statistical analyses revealed significant and positive associations between perceived stress levels and insomnia, as indicated by Spearman’s correlation (p < 0.01). A similar significant correlation was identified between perceived stress and disordered eating behaviors among students. Specifically, the feeling of being overwhelmed by academic workload showed a strong positive correlation with a lack of control over eating behaviors (r = 0.568). Furthermore, linear regression analysis confirmed a significant predictive relationship between feeling overwhelmed and the tendency to eat excessively beyond initial intentions, with a standardized regression coefficient B = 0.581 (p < 0.001). A separate regression analysis focusing on exam-related stress and episodes of compulsive eating behavior demonstrated a comparable result (B = 0.573, p < 0.001), indicating a robust positive association. Additionally, independent samples t-tests demonstrated that students experiencing high levels of stress during the exam period reported significantly greater difficulties with sleep initiation and higher levels of disordered eating compared to their peers with lower stress levels. The difference in insomnia scores was highly significant (t = 11.516, p < 0.001), as was the difference in eating behavior scores (t = 10.931, p < 0.001). Conclusions: These findings underscore the need for emotional support services and effective stress management strategies, enabling students to navigate academic demands without compromising their mental or physical well-being. Full article

Major Depressive Disorder (MDD) is a chronic mental disorder characterized by anhedonia, loss of desire, guilt, suicidal thoughts, and appetite changes. It is reported that individuals with MDD resort to binge eating to escape from negative feelings. In this study, we aimed to determine the relationship between binge eating behavior and the concept of psychological pain associated with emotions such as shame, guilt, and anger in individuals with MDD. We conducted the study in the Psychiatry Outpatient Clinics of Balcalı Hospital, Çukurova University Faculty of Medicine. The sample consisted of 147 individuals with MDD without psychotic symptoms and 128 healthy controls with sociodemographic characteristics similar to the MDD group. We administered a sociodemographic data form, the Hamilton Depression Rating Scale (HDRS), Psychache Scale (PS), Tolerance for Mental Pain Scale-10 (TMPS-10), Barratt Impulsiveness Scale (BIS-11), and Eating Disorder Examination Questionnaire (EDE-Q-13). Eighty-two (55.7%) of the patients with MDD were diagnosed with binge eating disorder (BED). In the group of MDD patients with BED comorbidity, the EDE-Q-13 total, binging subscale, and HDRS scores were significantly higher than those of the other groups (p < 0.05 for each group), with large to very large effect sizes (e.g., EDE-Q-13 binging d = 1.04; HDRS d = 1.91; PS d = 1.22). There was no significant difference between the MDD groups (with and without BED) regarding the BIS and BIS subscales’ subscores, PS, and TMPS scores. For participants with MDD, there was a significant same-directional correlation between EDE-Q-13 binging, HDRS, BIS, and PS scores (p < 0.05 for each), with moderate to strong effect sizes (EDE-Q-13 binging and HDRS: r = 0.398, p < 0.001; binging and PS: r = 0.273, p < 0.001; binging and BIS: r = 0.233, p = 0.005; binging and TMPS-10: r = –0.257, p = 0.002). Additionally, a negative correlation was observed between TMPS and the scores for EDE-Q-13 binging, HDRS, BIS, and PS. A linear regression analysis indicated that depression severity and BMI were the strongest predictors of binge eating behavior (R² = 0.243; f² = 0.32). Based on our results, we concluded that the presence of binge eating behavior in patients with MDD is associated with more severe depressive symptoms, psychological pain, impulsivity, and lower tolerance to psychological pain. The finding that binge eating behavior was most strongly associated with depression severity and body mass index (BMI) supports the notion that binge eating behavior is a maladaptive attitude. Longitudinal studies comparing individuals with different BMIs in different clinical samples are needed to confirm our results. Full article

Background/Objectives: Pressure to stay lean may lead adolescent athletes to dietary restraint and disordered eating. Lack of nutrition awareness can also contribute to suboptimal dietary habits, increasing the risk of eating disorders and Relative Energy Deficiency in Sport [RED-S], though evidence in competitive athletes is limited. This study explored eating disorder symptoms and RED-S knowledge in adolescent artistic gymnasts. Methods: Eighty-four female artistic gymnasts, thirty-nine international and national level gymnasts [high-level; 14 [14, 15] y] and forty-five recreational and club level gymnasts [low-level; 14 [13, 15] y] completed the Eating Disorder Examination Questionnaire [EDE-Q 6.0], the RED-S knowledge Questionnaire and provided training details. Results: Seventeen gymnasts (20.2%) scored above the cutoff point on the EDE-Q. In addition, high-level gymnasts scored higher than low-level on EDE-Q [2.21 ± 1.37 (35.9%) vs. 1.19 ± 0.79 (6.7%), respectively; p < 0.001] and on its subscales: Restraint, Eating Concerns, Weight Concerns, and Shape Concerns [p < 0.001 to 0.009], thus indicating more severe disordered eating symptoms. No group differences were found in binge eating and compensatory behaviors. An important percentage of gymnasts reported at least one episode of binge eating and excessive training [39.3–58.3%], while four gymnasts reported self-induced vomiting. RED-S knowledge did not differ between groups. On average, gymnasts were unaware of correct answers related to RED-S [51.5%], its definitions [79.8–92.9%], and its association with menstrual disturbances and bone health [54.8–86.9%]. However, gymnasts reported better awareness of the impact of food restriction on illness and performance [47.6–84.5%]. Conclusions: Elite artistic gymnasts exhibited a higher prevalence of eating disorder symptoms than lower-level peers. Gymnasts at all levels demonstrated limited knowledge of the effects of RED-S on menstrual and bone health. Failure to recognize these risks may influence gymnasts’ eating behaviors and delay RED-S detection and management. Full article

Background/objective: Weight regain has serious health consequences after bariatric surgery, and disordered eating behaviors (EBs) may be involved in it. We compared disordered EB symptoms in post-bariatric patients according to low vs. high ratio of weight regain (RWR) and investigated associations between disordered EB symptoms with weight regain and time since surgery. Method: We recruited ninety-four patients who had undergone laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy. All of them had not attended follow-up with the multidisciplinary healthcare team (including psychological assessment) for at least one year. RWR was calculated with respect to maximal weight loss by the nadir weight achieved after surgery. Patients were divided into two groups: high RWR (≥20%) or low RWR (<20%). At their first visit, we had them complete the Eating Disorder Examination and Repetitive Eating Questionnaires (EDE-Q and Rep(eat)-Q). Results: Patients with high RWR reported higher EDE-Q global, dietary restraint and weight concerns without significant group differences in eating and shape concerns. Compared to those patients with low RWR, these patients also indicated greater Rep(eat)-Q global, compulsive grazing and repetitive eating. Global EDE-Q score, eating concern, shape concern, weight concern and all Rep(eat)-Q indexes were positively associated with higher RWR. Conclusions: Disordered EBs occurred more frequently in the group with high RWR. In these patients, eating behavior symptoms and grazing behavior were both correlated to the RWR, suggesting a possible involvement of both conditions in weight regain. Full article

This study investigated the association between the risk of low energy availability, disordered eating, and anxiety in collegiate female athletes. Female athletes (n = 115) completed questionnaires that assessed disordered eating (Disordered Eating Screen for Athletes, DESA-6; and the Eating Disorder Examination Questionnaire Short, EDE-QS), anxiety (Generalized Anxiety Disorder-7) and the risk of low energy availability (Low Energy Availability in Females Questionnaire; LEAF-Q). The athletes were 19.9 ± 0.1 years old and presented with no anxiety (14.8%), mild (33.0%), moderate (24.3%), and severe (27.8%) anxiety. The EDE-QS scores revealed that 22.6% of the participants had a high risk of an eating disorder, while the DESA-6 scores revealed that 31.3% of the participants scored positive for a risk of disordered eating. The LEAF-Q total scores revealed that 68.7% of the participants were at risk of low energy availability. Increased GAD-7 scores were associated (p < 0.001) with measures of disordered eating (EDE-QS and DESA-6) and the risk of low energy availability (LEAF-Q total score). Non-parametric partial correlations demonstrated that anxiety (increased GAD-7 scores) correlated with the risk of low energy availability (increased LEAF-Q total scores) while controlling for eating disorder scores (EDE-QS) (r (112) = 0.353, p < 0.001), or while controlling for the risk of disordered eating (DESA-6 scores) (r (112) = 0.349, p < 0.001). In female collegiate athletes, both disordered eating and the risk of low energy availability were positively associated with increased anxiety. Full article

Background/Objectives: The previous literature on purging behavior in eating disorders (EDs) suggests an overall more complicated clinical picture for individuals with this symptomatology. So far, no studies have analyzed the possible differences between the specific types of purging among ED inpatients. Methods: A clinical sample of 302 inpatients with EDs was classified according to no purging behaviors, vomiting, the abuse of laxatives, and both vomiting and the abuse of laxatives. Participants completed the following questionnaires: the Eating Disorder Examination Questionnaire (EDE-Q), Frost Multidimensional Perfectionism Scale (F-MPS), State–Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). Clinical information was collected for each individual. Results: Significant differences in the four groups were evidenced in age (p < 0.001), years of illness (p < 0.001), BMI at discharge (p < 0.001), STAI state anxiety (p < 0.001), STAI trait anxiety (p < 0.001), BDI (p < 0.001), EDE-Q eating concerns (p < 0.001), EDE-Q shape concerns (p < 0.001), EDE-Q weight concerns (p < 0.001), EDE-Q global score (p < 0.001), and F-MPS parental criticism (p < 0.001). ED inpatients with purging behaviors were older, had a longer duration of illness, higher parental criticism, and worse general and eating psychopathology. No differences emerged between the specific types of purging behavior. Conclusions: Purging behavior is a marker of severity in EDs independently of the specific type of purging. The appearance of any purging behavior must be regarded as a considerable red flag and be followed by an intensification of the cure. Full article

Eating disorders are serious health issues among young people that contribute to increased morbidity rates. The prevalence and severity of eating disorders among Latvian youth aged 18–24 and their relationship with the Healthy Eating Index, dietary habits, and BMI were analyzed in the present study. At the beginning of the study, 190 respondents participated by completing the SCOFF questionnaire, from which the sample group was selected based on the criterion of SCOFF ≥ 2. For the next stage of the study, the responses of 74 participants who completed the EDE-Q-6 questionnaire and the Canadian Food Intake Screener were analyzed. The symptoms of eating disorders were identified in 38.9% of the respondents (SCOFF ≥ 2). The global score of the EDE-Q-6 was 2.00 ± 1.81 where subscales such as body shape concerns (2.93 ± 1.44) and weight concerns (2.68 ± 1.36) were the most important factors that young people paid attention to. The severity of eating disorders was 3.20 for males and 2.62 for females, where a score of 4 and above is classified as an eating disorder. Participants with eating disorder symptoms had a higher BMI, with females having a BMI of 22.5 (normal weight) and 25.5 for males (overweight). The study sample had a poor diet, as the Healthy Eating Index was 8.7 with a maximum score of 24. Weak negative correlations were found between eating disorder severity and eating habits. The issue of eating disorders is topical among young people in Latvia, which requires solutions such as the inclusion of educational programs on healthy nutrition and eating disorders, and psychological support for young people. Full article

Links between premorbid physical activity (PA) and disease onset/course in patients with anorexia nervosa (AN) remain unclear. The aim was to assess self-reported PA as a predictor of change in percent median BMI (%mBMI) and length of hospital stay (LOS). Five PA domains were assessed via semi-structured interview in adolescents with AN at hospitalization: premorbid PA in school grades 1-6 (PA1-6); PA before AN onset (PA-pre) and after AN onset (PA-post); new, pathological motivation for PA (PA-new); and high intensity PA (PA-high). Eating disorder psychopathology was measured via the Eating Disorder Examination Questionnaire (EDE-Q), and current PA (steps/day) with accelerometry. PA1-6 was also assessed in healthy controls (HCs). Using stepwise backward regression models, predictors of %mBMI change and LOS were examined. Compared with 22 HCs (age = 14.7 ± 1.3 years, %mBMI = 102.4 ± 12.1), 25 patients with AN (age = 15.1 ± 1.7 years, %mBMI = 74.8 ± 6.0) reported significantly higher PA1-6 (median, AN = 115 [interquartile range IQR = 75;200] min vs. HC = 68 [IQR = 29;105] min; p = 0.017). PA-post was 244 ± 323% higher than PA-pre. PA1-6 was directly associated with PA-pre (p = 0.001) but not with PA-post (p = 0.179) or change in PA-pre to PA-post (p = 0.735). Lower %mBMI gain was predicted by lower baseline %mBMI (p = 0.001) and more PA-high (p = 0.004; r² = 0.604). Longer LOS was predicted by higher PA-pre (p = 0.003, r² = 0.368). Self-reported PA may identify a subgroup of youth with AN at risk of less weight gain and prolonged LOS during inpatient treatment for AN. Full article

Background: Eating disorders (EDs) have become a global public health concern among adolescents and young adults. However, Chinese university students exhibit a high prevalence of eating disorders. This study aims to investigate the effects of self-esteem (SE) and body shape (BS) on ED behaviors among Chinese university students. Methods: Using random sampling, 946 Chinese university students (aged 18 to 24, M = 19.94, SD = 1.04) participated in a survey comprising the Sick, Control, One, Fat, and Food Questionnaire (SCOFF-Q), the Body Shape Questionnaire (BS-Q), and the Rosenberg Self-Esteem Scale (RS-S) to assess their eating disorder or non-eating disorder (NED) behavior. Results: There was a significant positive correlation between body shape and eating disorder behaviors (r = 0.19, p < 0.01), while there was a significant negative correlation between self-esteem and eating disorder behaviors (r = −0.14, p = 0.001 < 0.01). Gender was a moderating factor in the relationship between body shape and eating disorder behaviors (t = 3.14, p = 0.002 < 0.01), while parents’ marital status was a moderating factor in the relationship between self-esteem and eating disorder behavior (t = 2.72, p = 0.007 < 0.01). Body shape (z = 6.47, p = 0.001 < 0.01), self-esteem (z = −2.81, p = 0.005 < 0.05), and gender (z = 3.06, p = 0.002 < 0.01) significantly influenced eating disorder behavior among Chinese university students aged 18–24 years. Conclusions: There was a direct effect between body shape and self-esteem and eating disorder behaviors among Chinese university students aged 18–24 years. Alarmingly, female university students are becoming susceptible to external influences on self-esteem and body shape, leading to eating disorder behaviors at an increasingly younger age in China. Full article

In the context of the contemporary accelerated pace of life, emphasizing the importance of sleep quality is essential for enhancing overall well-being and health. Historically underestimated, recent studies highlight sleep’s vital importance for physical, mental, and emotional well-being. Chronic sleep deprivation is connected to numerous health problems such as cardiovascular disease, diabetes, and weakened immune response. Additionally, lack of sleep can worsen stress, depression, and anxiety, impairing daily life and overall quality of life. This study investigates the link between poor sleep quality and key factors affecting wellness, such as mental health and eating disorders. Through a cross-sectional analysis involving 407 participants, utilizing established measures including the Depression Anxiety Stress Scale (DASS-21), the Eating Disorder Examination Questionnaire Short (EDE-QS), and the single-item Sleep Quality Scale (SQS), data were collected and analyzed using SPSS v28 and R-Statistics. The findings reveal a significant correlation (p < 0.05) between DASS-21, EDE-QS, and SQS, indicating that individuals experiencing poor sleep quality exhibit higher levels of depression, anxiety, and stress. Furthermore, multinomial logistic regression analysis highlights low sleep quality as a risk factor for both mental health (OR: 1.071, 95% CI: 1.042, 1.102, p < 0.05, low vs. high sleep quality) and eating disorders (OR: 1.047, 95% CI: 1.004, 1.092, p < 0.05, low vs. high sleep quality). Overall, these results underscore the critical role of sleep quality in mental health and suggest that insomnia is a predictive factor for both poor mental well-being and disordered eating habits. The main contribution of this study is its identification of poor sleep quality as a common risk factor linking mental health issues and eating disorders, which emphasizes the need for integrated treatment strategies focusing on sleep improvement. Further research through randomized controlled trials is warranted to validate the findings of this cross-sectional study. Full article

This study aimed to examine the potential predictors of improvement in mental health outcomes following participation in an intensive non-surgical outpatient weight management program (WMP) in an Australian public hospital. This was a retrospective cohort study of all adults with Class 3 obesity (BMI ≥ 40 kg/m²) who enrolled in the WMP from March 2018 to June 2021. The participants completed the Eating Disorder Examination Questionnaire Short Version (EDE-QS), Kessler-10 Psychological Distress Scale, and 36-Item Short-Form Survey (SF-36) at baseline and 12-month follow-up. A total of 115 patients completed 12 months in the WMP and were included in the study, with 76.5% being female, a mean ± SD age at baseline of 51.3 ± 13.8 years, a weight of 146 ± 26 kg, and a BMI of 51.1 ± 8.6 kg/m². The participants lost an average of 8.6 ± 0.2 kg over 12 months, and greater weight loss at follow-up was significantly associated with improved global EDE-QS scores, psychological distress, and improved mental health quality of life. However, improvements in most mental health outcomes were not predicted by weight loss alone. Notably, a lower eating disorder risk at baseline was associated with less psychological distress at follow-up and greater weight loss at follow-up. Our results also found an association between reduced psychological distress and reduced binge eating frequency. These findings support the inclusion components of obesity interventions that target the psychological correlates of obesity to support improved outcomes in people with Class 3 obesity. Future studies should aim to identify which aspects of the WMP helped improve people’s psychological outcomes. Full article

This study aimed to explore the dietetic treatment experiences of individuals with high eating disorder (ED) symptomatology attending a metabolic and bariatric clinic. An exploratory mixed methods cross-sectional study was conducted. Eighteen participants completed the survey, which included an adapted version of the Eating Disorders Treatment Experience Survey (EDTES), the Eating Disorder Examination Questionnaire Short (EDE-QS), and quantitative and qualitative questions relating to the roles and helpfulness of a dietitian in treatment. Data regarding the most and least helpful dietitians were collected. Differences between groups were tested with the Wilcoxon signed ranks test. A reflexive thematic analysis was used to analyse open-ended responses. The mean EDE-QS score reported by participants was 20.9 (SD = 6.0). The dietitians who were perceived as the most helpful were those who took into consideration an individual’s treatment preferences and choices (Z = −1.96, p = 0.05). Three themes were constructed: (1) nutrition knowledge and skills, (2) person-centred care, and (3) roles of the multidisciplinary team. Although further research is required, our findings suggest that the role of a dietitian in this setting may extend beyond weight-loss advice, and with additional training, could include individualised and collaborative supportive care that overlaps with ED treatment. Full article