Eating Disorders and Pregnancy: The Case of Anorexia

The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.

Eating Disorders among Students in Northern Benin (2023)

Introduction: From their earliest hours, human beings are able to identify a source of food and to feed themselves. Feeding is therefore one of the most instinctive human functions. It is regulated by several factors (physiological, psycho-affective and environmental) whose disruption can lead to eating disorders. Objective: The aim of this study was to investigate eating disorders among students in the town of Parakou in 2023. Method: Descriptive cross-sectional study conducted from January to July 2023 in various universities in the city of Parakou, Benin. The study population consisted of all students in grades 1 to 7 at these universities. A two-stage non-proportional stratified sampling technique combined with a simple random draw was adopted. The Eating Attitude Test-26, Bulimia Inventory Test Edinburgh and a set of questions focusing on the diagnostic criteria for pica were used to screen for pica and other disorders such as anorexia, bulimia nervosa and binge eating disorder. Data were analyzed using SPSS (Statistical Package for Social Sciences) version 25. Results: A total of 607 students were surveyed, 323 of whom had eating disorders. A prevalence of 53.21% of students at risk of eating disorders was found. In relation to the total population, the prevalences of anorexia, bulimia nervosa, binge eating disorder and pica were 45.96%, 0.82%, 15.48% and 12.68% respectively. In multivariate analysis, seven factors explained the risk to develop at least one eating disorder among the students surveyed. These were: urban area of residence (OR (95% CI) = 5.059 (1.75 - 14.65);p = 0.003);year of study (OR (95% CI) = 0.47 (0.28 - 0.79);p = 0.035);type of university attended (private university: OR (95% CI) = 1.63 (1.08 - 2.44);p = 0.019);parents’ marital status (couple or not) (OR (95% CI) = 1.50 (1.01 - 2.24);p = 0.046);father’s level of education: secondary (OR (CI 95%) = 3.85 (1.96 - 7.54);p 0.001)/higher (OR (CI 95%) = 2.83 (1.36 - 5.86);p = 0.005);mother’s one: secondary (OR (CI 95%) = 0.30 (0.18 - 0.51);p 0.001)/superior (OR (CI 95%) = 0.31 (0.16 - 0.61);p = 0.001);the presence of doubtful (OR (CI95% = 1.69 (1.11 - 2.58);p = 0.009) or certain anxiety symptomatology (OR (CI 95%) = 1.69 (1.11 - 2.58);p = 0.009). Conclusion: More than half the students in Parakou had at least one eating disorder. Diagnostic studies are needed, even if preventive actions are already necessary.

Biopsychosocial Review of Eating Disorders

Eating disorders are among the deadliest mental illnesses known to occur. Eating disorders directly cause 10,200 deaths each year, which is one death every 52 minutes. About 9% of the global population is affected by eating disorders at some point during their lifetime. This paper aims to provide a better understanding of the factors that contribute to the onset of eating disorders. Specifically, we examine biological factors, such as genetics, family history and the neuroscience behind eating disorders;furthermore, we explore psychological factors including other mental health conditions and their correlation, personality traits and behavioral risk factors;lastly, we consider social factors related to the onset of eating disorders, such as childhood and social environment, the media, and demographic factors.

Prevalence of functional dyspepsia and its subgroups in patients with eating disorders

AIM:To study the prevalence of functional dyspepsia(FD)(Rome Ⅲ criteria) across eating disorders(ED),obese patients,constitutional thinner and healthy volunteers.METHODS:Twenty patients affected by anorexia nervosa,6 affected by bulimia nervosa,10 affected by ED not otherwise specified according to diagnostic and statistical manual of mental disorders,4th edition,nine constitutional thinner subjects and,thirtytwo obese patients were recruited from an outpatients clinic devoted to eating behavior disorders.Twentytwo healthy volunteers matched for age and gender were enrolled as healthy controls.All participants underwent a careful clinical examination.Demographic and anthropometric characteristics were obtained from a structured questionnaires.The presence of FD and,its subgroups,epigastric pain syndrome and postprandial distress syndrome(PDS) were diagnosed according to Rome Ⅲ criteria.The intensity-frequency score of broader dyspeptic symptoms such as early satiety,epigastric fullness,epigastric pain,epigastric burning,epigastric pressure,belching,nausea and vomiting were studied by a standardized questionnaire(0-6).Analysis of variance and post-hoc Sheffè tests were used for comparisons.RESULTS:90% of patients affected by anorexia nervosa,83.3% of patients affected by bulimia nervosa,90% of patients affected by ED not otherwise specified,55.6% of constitutionally thin subjects and 18.2% healthy volunteers met the Postprandial Distress Syndrome Criteria(χ 2,P < 0.001).Only one bulimic patient met the epigastric pain syndrome diagnosis.Postprandial fullness intensity-frequency score was significantly higher in anorexia nervosa,bulimia nervosa and ED not otherwise specified groups compared to the score calculated in the constitutional thinner group(4.15 ± 2.08 vs 1.44 ± 2.35,P = 0.003;5.00 ± 2.45vs 1.44 ± 2.35,P = 0.003;4.10 ± 2.23vs 1.44 ± 2.35,P = 0.002,respectively),the obese group(4.15 ± 2.08vs 0.00 ± 0.00,P < 0.001;5.00 ± 2.45vs 0.00 ± 0.00,P < 0.001;4.10 ± 2.23 vs 0.00 ± 0.00,P < 0.001,respectively) and healthy volunteers(4.15 ± 2.08 vs 0.36 ± 0.79,P < 0.001;5.00 ± 2.45 vs 0.36 ± 0.79,P < 0.001;4.10 ± 2.23 vs 0.36 ± 0.79,P < 0.001,respectively).Early satiety intensity-frequency score was prominent in anorectic patients compared to bulimic patients(3.85 ± 2.23 vs 1.17 ± 1.83,P = 0.015),obese patients(3.85 ± 2.23 vs 0.00 ± 0.00,P < 0.001) and healthy volunteers(3.85 ± 2.23 vs 0.05 ± 0.21,P < 0.001).Nausea and epigastric pressure were increased in bulimic and ED not otherwise specified patients.Specifically,nausea intensity-frequencyscore was significantly higher in bulimia nervosa and ED not otherwise specified patients compared to anorectic patients(3.17 ± 2.56 vs 0.89 ± 1.66,P = 0.04;2.70 ± 2.91 vs 0.89 ± 1.66,P = 0.05,respectively),constitutional thinner subjects(3.17 ± 2.56 vs 0.00 ± 0.00,P = 0.004;2.70 ± 2.91 vs 0.00 ± 0.00,P = 0.005,respectively),obese patients(3.17 ± 2.56 vs 0.00 ± 0.00,P < 0.001;3.17 ± 2.56 vs 0.00 ± 0.00,P < 0.001 respectively) and,healthy volunteers(3.17 ± 2.56 vs 0.17 ± 0.71,P = 0.002;3.17 ± 2.56 vs 0.17 ± 0.71,P = 0.001,respectively).Epigastric pressure intensityfrequency score was significantly higher in bulimic and ED not otherwise specified patients compared to constitutional thin subjects(4.67 ± 2.42 vs 1.22 ± 1.72,P = 0.03;4.20 ± 2.21 vs 1.22 ± 1.72,P = 0.03,respectively),obese patients(4.67 ± 2.42 vs 0.75 ± 1.32,P = 0.001;4.20 ± 2.21vs 0.75 ± 1.32,P < 0.001,respectively) and,healthy volunteers(4.67 ± 2.42 vs 0.67 ± 1.46,P = 0.001;4.20 ± 2.21vs 0.67 ± 1.46,P = 0.001,respectively).Vomiting was referred in 100% of bulimia nervosa patients,in 20% of ED not otherwise specified patients,in 15% of anorexia nervosa patients,in 22% of constitutional thinner subjects,and,in 5.6% healthy volunteers(χ 2,P < 0.001).CONCLUSION:PDS is common in eating disorders.Is it mandatory in outpatient gastroenterological clinics to investigate eating disorders in patients with PDS?

The ethics of exercise in eating disorders:Can an ethical principles approach guide the next generation of research and clinical practice?

1.Introduction Eating disorders(ED)are the most common psychiatric disorders afflicting young women^1 and contribute to great detriments in psychological,social,and physical health.^(2,3)Unfortunately,ED treatments tend to be long lasting,intensive,and expensive.~4Additionally,individuals with ED seeking treatment use healthcare services more frequently than non-ED individu-

Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders

AIM:To evaluate gastrointestinal(GI) symptoms and breath hydrogen responses to oral fructose-sorbitol(F-S) and glucose challenges in eating disorder(ED) patients.METHODS:GI symptoms and hydrogen breath concentration were monitored in 26 female ED inpatients for 3 h,following ingestion of 50 g glucose on one day,and 25 g fructose/5 g sorbitol on the next day,after an overnight fast on each occasion.Responses to F-S were compared to those of 20 asymptomatic healthy females.RESULTS:F-S provoked GI symptoms in 15 ED patients and one healthy control(P < 0.05 ED vs control) .Only one ED patient displayed symptom provocation to glucose(P < 0.01 vs F-S response) .A greater symptom response was observed in ED patients with a body mass index(BMI) ≤ 17.5 kg/m 2 compared to those with a BMI > 17.5 kg/m 2(P < 0.01) .There were no differences in psychological scores,prevalence of functional GI disorders or breath hydrogen responses between patients with and without an F-S response.CONCLUSION:F-S,but not glucose,provokes GI symptoms in ED patients,predominantly those with low BMI.These findings are important in the dietary management of ED patients.

Disorders of the brain-gut interaction and eating disorders

BACKGROUND Eating disorders(ED)involve both the nervous system and the gastrointestinal tract.A similar double involvement is also found in disorders of the brain-gut interaction(DGBI)and symptoms are sometimes similar.AIM To find out where there is an association and a cause-effect relationship,we looked for the comorbidity of DGBI and ED.METHODS A systematic review was undertaken.A literature search was performed.Inclusion criteria for the articles retained for analysis were:Observational cohort population-based or hospital-based and case-control studies,examining the relationship between DGBI and ED.Exclusion criteria were:Studies written in other languages than English,abstracts,conference presentations,letters to the Editor and editorials.Selected papers by two independent investigators were critically evaluated and included in this review.RESULTS We found 29 articles analyzing the relation between DGBI and ED comprising 13 articles on gastroparesis,5 articles on functional dyspepsia,7 articles about functional constipation and 4 articles on irritable bowel syndrome.CONCLUSION There is no evidence for a cause-effect relationship between DGBI and ED.Their common symptomatology requires correct identification and a tailored therapy of each disorder.

The Contribution of BMI,Body Image Inflexibility,and Generalized Anxiety to Symptoms of Eating Disorders and Exercise Dependence in Exercisers

1)Background:The common factors which potentially contribute to the development of eating disorders and exercise dependence during early adulthood are still relatively unclear.The present study aimed to examine the role of BMI,body image inflexibility,and generalized anxiety in these two behavioral problems in a sample of college students.2)Methods:In total,878 habitual exercisers(58.1%male with BMI=22.12±2.39;41.9%female with BMI=20.55±2.21)with age of 20.09±1.76 years participated in this study.The main outcomes of interest are exercise dependence symptoms,eating disorders symptoms,body image inflexibility,and symptoms of generalized anxiety(as measured by Exercise Dependence Scale-Revised,Eating Disorder Examination-Questionnaire-Short Form,Body Image Acceptance and Action Questionnaire,and Generalized Anxiety Disorder-7,respectively).Pearson correlation,path analysis,and model fit information were tested.3)Results:After controlling for age,gender,and field of study,lower BMI was linked to more exercise dependence symptoms but this association was not statistically significant,while a greater BMI was significantly associated with a higher risk of developing eating disorders(β=−0.08,p<0.001).Moreover,higher body image inflexibility significantly and positively contributed to severe exercise dependence(β=0.26,p<0.001)as well as abnormal eating attitudes and behaviors(β=0.74,p<0.001).Furthermore,generalized anxiety is a significant contributor to exercise dependence symptoms(β=0.14,p<0.001)but not eating disorders symptoms.4)Conclusion:Based on our finding that body image inflexibility is a common risk factor for the development of exercise dependence and eating disorders,the prevention and treatment of these two disorders should involve the improvement of psychological flexibility.In addition,the individual with a higher BMI is more vulnerable to developing eating disorders,while those who have severer generalized anxiety symptoms should be given more attention when screening for exercise dependence.

Classification of subtypes of patients with eating disorders by correspondence analysis

BACKGROUND Grouping eating disorders(ED)patients into subtypes could help improve the establishment of more effective diagnostic and treatment strategies.AIM To identify clinically meaningful subgroups among subjects with ED using multiple correspondence analysis(MCA).METHODS A prospective cohort study was conducted of all outpatients diagnosed for an ED at an Eating Disorders Outpatient Clinic to characterize groups of patients with ED into subtypes according to sociodemographic and psychosocial impairment data,and to validate the results using several illustrative variables.In all,176(72.13%)patients completed five questionnaires(clinical impairment assessment,eating attitudes test-12,ED-short form health-related quality of life,metacognitions questionnaire,Penn State Worry Questionnaire)and sociodemographic data.ED patient groups were defined using MCA and cluster analysis.Results were validated using key outcomes of subtypes of ED.RESULTS Four ED subgroups were identified based on the sociodemographic and psychosocial impairment data.CONCLUSION ED patients were differentiated into well-defined outcome groups according to specific clusters of compensating behaviours.

Premature Termination of Treatment among Adults Attending Treatment for Eating Disorders: A Critical Review

The article presents a critical review regarding the premature termination of eating disorder’s treatment among inpatients and outpatients, with the aim of identifying—emotional, psychodynamic and family-related aspects involved. The search strategy used the following MeSH terms combined by Boolean operators: “eating disorders” AND “treatment” OR “patient dropouts” OR “drop-out/dropouts” OR “attrition” OR “premature termination” AND “empirical study” OR “qualitative research”, for on Medline/PUBMED, PsycINFO and EMBASE databases. This article follows the PRISMA Guidelines. A total of 26 studies composed this review, of which 24 were original research articles, 1 was a review and 1 a theoretical article. Only two articles applied qualitative methods analyzing categories of content obtained by in-depth interviews, three combine quantitative and qualitative methods and other three present qualitative analyses while discussing quantitative studies. Further qualitative studies should be carried out to clarify meanings of dropout, premature termination of treatment, and attrition. Different expectations held by patients and by therapeutic teams, and the interpersonal difficulties of these types of patients, stand out as difficulties in constructing “therapeutic alliances”, with impacts on dropout, premature termination and attrition rates.

The Impact of Eating Disorders and Self-Disorders on Women’s Behavior in Kuwait

The purpose of this study is to examine the impact of eating disorders and self-disorders (self-esteem, selflessness, self-efficacy, self-concept clarity, and self-compassion) on women’s behavior in Kuwait. This study used a quantitative approach based on a survey questionnaire by the online survey has been used as the main technique for data collection. The survey was sent to a group of 500 women in Kuwait. The survey was administrated through an online survey tool. 212 women completed the full questionnaire, resulting in a response rate of 42.2 percent. The results indicated that eating disorders have a direct effect on women’s behavior in Kuwait. Moreover, self-disorders (self-esteem, selflessness, self-efficacy, self-concept clarity, and self-compassion) have a direct effect on women’s behavior in Kuwait.

Socio-Demographic,Biopsychosocial and Lifestyle Behaviors Related with Eating Disorders of Children and Adolescents of Costa Rica

The objective of the study was to evaluate the association of sociodemographic, biopsychosocial and lifestyle behaviors (diet, sedentarism and physical activity) with eating disorders (ED) in a national sample of Costa Rican children and adolescents. This was a cross-sectional and descriptive study. A total of 2667 students of elementary, middle and high school from sixty-four educative centers (40 schools and 24 high schools) of Costa Rica participated in the study. The predictive factors associated with ED are: body image dissatisfaction (β = 0.367;p β = 0.131;p β = 0.109;p 0.001), intentionally hurt or harm itself (β = 0.074;p β = 0.053;p β = 0.052;p β = 0.051;p β = -0.071;p β = -0.068;p = 0.010) and the age (β = -0.064;p = 0.001) are not related with the development of ED. Psychosocial factors (body image dissatisfaction and intentionally self-injure) had the greatest influence (near 27%) of the global variance of the regression model that explained the association with ED. Programs should be promoted to monitor children and adolescents with excess weight, as well as, the coexistence of erroneous weight and body image perceptions in these population. This could protect against the development of ED in children and adolescents. Evidence-Based Medicine: Level V of evidence (descriptive study).

Childhood Adversities Associated with Eating Disorders Reported by Adults

Background: It has been suggested that childhood events increase the risk of suffering from an eating disorder (ED) in adolescence or young adulthood. Our study here aimed at investigating whether there was an association between stressful childhood events and eating disorders later in life. Methods: Our population-based study was a part of the HeSSup (The Health and Social Support) postal survey in 2003, a follow-up survey with a random sample of working-aged subjects drawn from the Finnish Population Register in 1998. Participants in this study reported having been suffering from ED (N = 374), while controls (N = 18,639) reported no history of eating disorder in the questionnaire both in 1998 and 2003. The questionnaire included six questions related to childhood adversities. Results: Each childhood stressor increased the risk of developing ED cumulatively (one adversity OR 1.7 versus all six OR 8.3). Intrafamiliar conflicts (OR 2.0), being afraid of a family member (OR 1.5) or long-term illnesses in the family (OR 1.4) increased the ED-risk statistical significantly. Conclusion: Children exposed to stress are more likely to suffer from eating disorders as adults than those not exposed.

Racial and Ethnic Differences in Orthorexia Nervosa Symptomatology and Other Disordered Eating

While some research has explored racial and ethnic differences in disordered eating, this study may be the first to examine these differences in orthorexia nervosa, involving obsessive-compulsive thoughts and behaviors concerning healthy eating, which negatively impact one’s life. Adult participants, recruited from college courses and social media, completed an online survey with the Orthorexia Nervosa Inventory (ONI) and the Eating Attitudes Test-26 (EAT-26). Regarding racial and ethnic background, 743 were White, 249 were Hispanic, 87 were Black, 61 were Asian or Pacific Islander, and 110 were biracial/multiracial. A MANCOVA revealed that the racial and ethnic groups did not differ on the ONI subscales assessing orthorexic behaviors, impairments, and emotions, after accounting for gender, BMI, and EAT-26 total scores that were covariates. In contrast, a second MANCOVA did reveal group differences on the EAT-26 subscales, after accounting for gender, BMI, and ONI total scores that were covariates. Black participants scored significantly lower than the other racial and ethnic groups on the subscale assessing dieting behaviors characteristic of anorexia nervosa, and the subscale assessing binge-eating and purging behaviors characteristic of bulimia nervosa. Further, Hispanic participants scored significantly lower than White participants on the latter subscale. These findings suggest that while orthorexic symptomatology does not differ based on race and ethnicity, a Black race and Hispanic ethnicity may be protective factors against disordered eating, perhaps related either to cultural norms concerning body image or to the resiliency and social support among the Black and Hispanic communities.

Functional gastrointestinal disorders in eating disorder patients:Altered distribution and predictors using ROME Ⅲ compared to ROME Ⅱ criteria

AIM:To compare the prevalence of Functional gastrointestinal disorders(FGIDs)using ROMEⅢand ROMEⅡand to describe predictors of FGIDs among eating disorder(ED)patients.METHODS:Two similar cohorts of female ED inpatients,aged 17-50 years,with no organic gastrointestinal or systemic disorders,completed either the ROMEⅢ(n=100)or the ROMEⅡ(n=160)questionnaire on admission for ED treatment.The two ROME cohorts were compared on continuous demographic variables(e.g.,age,BMI)using Student’s t-tests,and on categorical variables(e.g.,ED diagnosis)usingχ2-tests.The relationship between ED diagnostic subtypes and FGID categories was explored usingχ2-tests.Age,BMI,and psychological and behavioural predictors of the common(prevalence greater than 20%)ROMEⅢFGIDs were tested using logistic regression analyses.RESULTS:The criteria for at least one FGID were fulfilled by 83%of the ROMEⅢcohort,and 94%of the ROMEⅡcohort.There were no significant differences in age,BMI,lowest ever BMI,ED diagnostic subtypes or ED-related quality of life(QOL)scores between ROMEⅡand ROMEⅢcohorts.The most prevalent FGIDs using ROMEⅢwere postprandial distress syndrome(PDS)(45%)and irritable bowel syndrome(IBS)(41%),followed by unspecified functional bowel disorders(U-FBD)(24%),and functional heartburn(FH)(22%).There was a 29%or 46%increase(depending on presence or absence of cyclic vomiting)in functional gastroduodenal disorders because of the introduction of PDS in ROMEⅢcompared to ROMEⅡ.There was a 35%decrease in functional bowel disorders(FBD)in RomeⅢ(excluding U-FBD)compared to ROMEⅡ.The most significant predictor of PDS was starvation(P=0.008).The predictor of FH(P=0.021)and U-FBD(P=0.007)was somatisation,and of IBS laxative use(P=0.025).Age and BMI were not significant predictors.The addition of the 6-mo duration of symptoms requirement for a diagnosis in ROMEⅢadded precision to many FGIDs.CONCLUSION:ROMEⅢconfers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting.Psychological factors appear to be more influential in ROMEⅡthan ROMEⅢ.

Prevalence and Associated Factors of Eating Disorders in Weight Management Centers in Tanta, Egypt

Background： Eating disorders （EDs） are serious illnesses associated with medical complications and have been increased, especially among societies with an excessive concern about weight, shape, or appearance. This study aimed to investigate the prevalence of EDs among the individuals attending weight management centers and its associated factors. Methods： A cross-sectional study was carried out among individuals attending four weight management centers in Tanta, Gharbia Governorate, Egypt during the period from July to December 2016. Precoded interview questionnaires were used to identify the following data： sociodemographic characteristics and medical history of depression or psychological disorders and the Eating Attitude Test （EAT-40） was used to assess the attitudes, behavior, and traits associated with the EDs. Results： A total of 400 participants （I 12 males and 288 females） were included in the study. According to EAT-40 questionnaires, the prevalence of positive and negative EDs was 65.0% （n = 260） and 35.0% （n = 140）, respectively. EDs were more likely reported by females, married singles, rural residents, those with higher education, and nonworking or part-time working patients, those who were overweight or obese, and who were suffering from depression or any psychological problems. Logistic regression analysis revealed that the independent predictors of EDs were age （adjusted odds ratio [OR]： 1.06）, nonworking （adjusted OR： 2.32） or part-time working （adjusted OR： 2,18）, increased body weight （adjusted OR： 2.66 for overweight and adjusted OR： 1.24 for obese）, and having a history of depression or any psychological problem （adjusted OR： 2.76）. Factor analysis of EAT-40 revealed four factors （eating behavior, diet-related lifestyle, weight concern, and food preoccupation） that were responsible for 33.2% of the total variance. Conclusions： EDs are prevalent among individuals attending the weight management centers in a northern city in Egypt. Specific management strategies are warranted to address this commonly prevalent disease.

Validity and reliability of eating disorder assessments used with athletes： A review

Background： Prevalence of eating disorders （EDs） among college-aged athletes has risen in recent years. Although measures exist for assessing EDs, these measures have not been thoroughly reviewed in athletes. This study reviewed the validity and reliability evidence of the commonly used measures for assessing EDs in athlete populations aged 18--26 years. Methods： Databases were searched for studies of regarding ED on male and/or female athletes. Inclusion criteria stated the study （a） assessed EDs in an athlete population 18--26 years of age and （b） investigated EDs using a psychometric measure found valid and/or reliable in a non- athlete population and/or athlete population. Results： Fifty studies met the inclusion criteria. Seven and 22 articles, respectively, studied EDs behaviors in male and female athletes whereas 21 articles studied EDs in combined-gender samples. The five most commonly used measures were the Eating Attitudes Test （EAT）, Eating Disorder Inventory （EDI）, Bulimia Test-Revised （BULIT-R）, Questionnaire for Eating Disorder Diagnosis （QEDD）, and the Eating Disorder Examination Questionnaire （EDE-Q）. Conclusion： Only seven studies calculated validity coefficients within the study whereas 47 cited the validity coefficient. Twenty-six calculated a reliability coefficient whereas 47 cited the reliability of the ED measures. Four studies found validity evidence for the EAT, EDI, BULIT-R, QEDD, and EDE-Q in an athlete population. Few studies reviewed calculated validity and reliability coefficients of ED measures. Cross- validation of these measures in athlete populations is clearly needed.

Anhedonia and functional dyspepsia in obese patients:Relationship with binge eating behaviour

BACKGROUND Obese patients(Ob)with a binge eating disorders(BED)behavior pattern have a higher prevalence of postprandial distress syndrome(PDS)compared to Ob without a BED behavior pattern,while an increase of PDS has been described in Ob after sleeve gastrectomy(SG).Hedonic response to a meal is dissociable from satiation in healthy subjects.Anhedonia is the lowered ability to experience pleasure.There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms.AIM To assess the relationship among anhedonia,BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG.METHODS Eighty-one Ob without SG,45 Ob with SG and 55 healthy controls(HC)were studied.All subjects fulfilled the binge eating scale(BES)to investigate BED,the validated 14 items Snaith-Hamilton pleasure scale(SHAPS)to assess Anhedonia as well as the Beck Depression Inventory-II(BDI II)and State Trait Anxiety Inventory(STAI)questionnaires to screen for depression and anxiety.All patients underwent a standardized questionnaire investigating the intensity-frequency scores(0-6)of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia(FD)and its subtypes according to ROME IV criteria.RESULTS Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED(OR:4.7;95.0%CI 1.23-18.24;P=0.02).STAI-Y2 scores were significantly higher in Ob without SG positive for BED(42.2±1.5 vs Ob negative for BED:39.6±1.0,P=0.04),while SHAPS scores and BDI II did not differ in the two groups(1.16±1.30 vs 0.89±1.02,P=0.49).A lower prevalence of BED(BES>17:11.4%vs 40.7%,P=0.001)and BDI-II(6.8±1.2 vs 13.8±1.9,P=0.005)was reported in Ob with SG than Ob without SG,on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG.Thirty-five percent of Ob with SG fulfilled the diagnosis of FD.SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups(18.2 vs 8.1%,P=0.2).Fifty-four percent of Ob with SG achieved surgical success excess weight loss>50%.Excess weight loss was negatively related to SHAPS total mean scores[adjusted B:-7.099(95%CI:-13.91 to-0.29),P=0.04].CONCLUSION Ob without SG showed a higher prevalence of PDS,mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior,whereas no differences were found in SHAPS score.Ob with SG showed a higher prevalence of PDS compared to Ob without SG.Concerning psychological aspect,BED and depression are less frequent in the Ob with SG,while both state and trait anxiety are significantly higher.Moreover,the more an Ob with SG is anhedonic,less surgical success was achieved.

Mapping the landscape and structure of global research on binge eating disorder:Visualization and bibliometric analysis

BACKGROUND Binge-eating disorder(BED)is a clinical syndrome and is considered the most common type of eating disorder.However,our understanding of the global performance and progress of BED research is limited.AIM To describe and perform a bibliometric analysis of the state of BED research.METHODS The term‘Binge eating’was searched in the title throughout the previous year’s up to December 31,2020.We searched the Scopus and Reference Citation Analysis for publications on Binge eating.The VOSviewer software version 1.6.17 was used to produce the network visualization map of the most frequent author,collaborative relationships between countries/regions,and to determine the hotspots related to binge eating research.In addition,conventional bibliometric indicators were generated.RESULTS The search strategy found 2713 total articles and an average of 62 articles per year.Among them,‘Article’represented 82.49%of the publications(n=2238 articles)and was the most frequent type,followed by reviews(n=243;8.96%).The number of publications increased steadily during the last decade of the study period.One hundred and thirty-two countries contributed to binge eating research,with 1495(55.11%)articles published in the United States,followed by Italy with 256(9.44%),the United Kingdom with 183(6.75%),and Germany with 182(6.71%).Currently,the main hot topics related to BED are‘type of treatment and management and treatment provided to BED”;“processes and pathways to binge eating”;and‘diagnosis,signs and symptoms,comorbidities and prevalence and associated factors with BED’.CONCLUSION The number of publications has increased noticeably during the previous decade.There are indeed relatively few publications on BED from low-and middle-income nations,so much is to be learned from the experience of all countries.Studies on this topic are critical in all countries to discover risk factors and effective intervention measures.Although our findings are preliminary,they imply that the future prospects for interventions aimed at BED management are bright,focusing on complex models of care and long-term maintenance of therapeutic gains.

Prevalence of Disordered Eating among Non-elite Multisport Endurance Athletes

The prevalence of concerns about food and body weight among non-elite multisport endurance athletes is unknown. This study aimed to evaluate the prevalence of symptoms and concerns related to disordered eating and their association with performance among 162 non-elite athletes involved in multisport endurance summer and winter events. Self-reported symptoms and concerns related to disordered eating were assessed using the Eating Attitudes Test-26 （EAT-26） questionnaire. The mean EAT-26 score （~ SEM） was 6.5 ~ 0.5 and only 9 athletes （5.6%） scored 20 arbitrary units or above. In multivariate regression stepwise analyses, the EAT-26 score （~ = 0.145, P = 0.0003） significantly predicted percent ranking. These findings suggest that the prevalence of self-reported symptoms of disordered eating is low among non-elite multisport endurance athletes. However, greater concerns regarding food intake and body weight may be associated with poorer performance even among non-elite athletes with normal BMI values and at the lower end of the EAT-26 score.