Further validation of the visceral sensitivity index: Psychometric properties and utility for predicting disordered eating in a diverse university sample
Gastrointestinal (GI) visceral sensitivity (i.e., anxiety/worry over GI sensations) may be a key maintaining factor for disordered eating; however, it is unknown whether GI visceral sensitivity predicts the range of disordered eating behaviors in nonclinical samples. The current preregistered study aimed to replicate previous construct validity findings of the Visceral Sensitivity Index (VSI; i.e., factor structure, convergent and discriminant validity) and examine its criterion-related validity for predicting a range of disordered eating attitudes and behaviors in a diverse undergraduate sample. A total of 591 university students were retained in the final analytic sample (53 % women; 23 % Hispanic [Any Race], 10 % Asian, 9 % Black) and completed the VSI, disordered eating, and additional validity measures. A confirmatory factor analysis tested the factor structure of the VSI, and correlations were used to examine convergent and discriminant validity. Hierarchical regressions and t-tests were used to examine criterion-related validity. Results replicated previous construct validity findings in a diverse undergraduate sample. Exploratory analyses supported invariance of the VSI across gender and the VSI discriminated between individuals at high- versus low-risk for an eating disorder and predicted a range of disordered eating attitudes (e.g., body dissatisfaction) and behaviors (e.g., restricting, binge eating, purging, compulsive exercise). GI-specific anxiety appears to be transdiagnostic across disordered eating behaviors and relevant across the spectrum of disordered eating severity. Future work may include developing transdiagnostic models of GI visceral sensitivity in disordered eating and investigating inclusion of the VSI in university screening efforts.
Maternal perceived stress, household disorder, eating behaviors and adiposity of women and their children
Stress is associated with physiological and behavioral adaptations that increase the risk for obesity and related diseases in adults and children. Mechanisms linking stress to chronic disease are diverse and not fully elucidated, but research suggests stress may impact eating behaviors and increase food intake and thereby, risk for obesity.
Eating competence is related to executive function skills in college students
This study aimed to determine the relationship between eating competence (EC) and executive function (EF) skills in college students.
A cross-sectional study on the prevalence of eating disorders in liver transplanted patients with type 2 diabetes and/or overweight/obesity
Liver transplantation (LT) associates with weight gain and metabolic complications. However, risk of eating disorders post-transplantation and factors influencing their onset remain poorly understood. This study aimed to fill this knowledge gap by characterizing the risk of having eating disorders or Orthorexia Nervosa (ON) according to the EAT-26, BES and Bratman screening questionnaires in 104 liver transplant recipients (mean age 62.5 years; median time from LT 6 years) with type 2 diabetes and/or overweight/obesity. Eighty-two patients (78.9 %) had diabetes; mean BMI was 30.1 ± 5.9 kg/m. Risk of eating disorders was observed in 6.9 %-10.8 % and the risk of orthorexia (Bratman test score > 4) was observed in 60.5 % of patients. A significant association was found between BMI and the likelihood of having eating disorders considering EAT-26 (OR = 0.17, p = .009). The absence of a direct link between diabetes and the risk of having eating disorders suggest multifactorial influences on post-transplant eating behaviors. The study highlights the importance of proactive screening to evaluate eating behaviors in liver transplant recipients to define tailored interventions and optimize post-transplant outcomes. Limitations refer to the observational nature of the study and the absence of pre-transplant data. Further research is warranted to validate these findings, elucidate temporal relationship between transplantation and the onset of eating disorders, and explore potential mechanisms underlying these associations. Such insights are crucial for developing effective strategies to mitigate the impact of eating disorders on post-transplant health and well-being.
Impact of an education intervention focusing on comprehensive mindful eating and chewing habits on daily eating practices: A mobile tool-based randomized controlled trial
Mindful eating (ME) emphasizes full awareness of food consumption, incorporating the practice of eating slowly. Traditional interventions targeting slower eating rates often concentrate on chewing behavior, leaving the impact of ME largely unexplored. The objective of this study was to evaluate the effectiveness of the ME program in improving eating rates and mindful eating compared to conventional education centered solely on chewing.
Development and validation of the modified Yale Food Addiction Scale for Children 2.0
Scientific interest in the concept of food addiction is growing, but more studies are needed in youth samples. Brief, psychometrically valid, and developmentally appropriate measures are needed to support the assessment of food addiction in large-scale studies of youth that need to minimize participant burden. While a brief version of the Yale Food Addiction Scale 2.0 (YFAS 2.0) exists for adults, no comparable scale exists for youth. Thus, the current study aimed to develop a brief and valid measure of food addiction for use in youth populations (the modified YFAS for children 2.0).
Exploring the longitudinal association between stress and unhealthy eating behaviors: The role of physical activity, BMI, and loneliness
Previous cross-sectional research indicates a link between stress and unhealthy eating, but the longitudinal association remains unknown. This study examined the longitudinal association between perceived stress over a longer time period and unhealthy eating (i.e., sweet and savory snack intake, uncontrolled eating) in a student population. Moreover, we examined whether physical activity buffers such association, and examined whether this buffering effect is stronger for individuals with higher Body Mass Index (BMI) or greater loneliness. Two timepoints of online survey data (Time 1 Oct-Nov 2021, Time 2 May-July 2022) of Dutch university students (n = 1325, 74.7 % female, mean age 22.45 (SD = 2.31)) were used. Results revealed no longitudinal link between stress and snack intake in the total sample, but this association was found in a subgroup of individuals with a higher BMI. Stress at Time 1 was associated with later uncontrolled eating. Physical activity did not moderate the link between stress and unhealthy eating. However, we found a negative longitudinal link between physical activity and uncontrolled eating among individuals with a higher BMI. Our findings suggest that stress does not play an important role in explaining snack intake in university students, but may be associated with uncontrolled eating. Physical activity seems to be linked with a reduction in uncontrolled eating among individuals with a higher BMI specifically. Replication and extension of current findings in a more diverse (e.g., eating disordered) sample would increase insights into the (combined) effects of stress, BMI and physical activity on uncontrolled eating.
Do premorbid weight parameters predict BMI 30 years after adolescent-onset anorexia nervosa?
To examine anthropometric predictors of BMI 30 years after the onset of adolescent AN.
Do impulse control difficulties moderate the relationship between intermittent fasting and disordered eating?
Recent findings suggest positive associations between intermittent fasting (IF, i.e., an eating pattern that consists of alternating between consuming and abstaining calories over specified periods of time) and disordered eating (DE), including binge eating, laxative use, and self-induced vomiting. However, as not all individuals who engage in IF present with DE, the current study aimed to investigate whether 1) IF was associated with elevated DE, and 2) impulse control difficulties differentially predict DE in intermittent fasters compared to non-intermittent fasters.
Associations of adverse childhood events with disordered eating behaviors among US adolescents
The purpose of our study was to use recent nationally-representative data to 1) determine whether reported adverse childhood experiences (ACEs) were associated with individual disordered eating behaviors (DEBs) for the US- based early and middle adolescent population; and 2) the extent to which individual ACE categories were associated with DEBs for this population. The study used cross-sectional data from the 2022 National Survey of Children's Health, which used parent-reported data. Inclusion criteria included all early (10-13 years of age) and middle-aged adolescents (14-17 years of age) (n = 24,173). Multiple logistic regressions were used to test the association between ACEs and DEBs while controlling for covariates. Both categories for ACEs (i.e. 1-2 ACEs and 3+ ACEs) exhibited a statistically significant association with three specific DEBs: skipping meals or fasting, low interest in food, and binge eating. Additionally, six of the seven ACE categories exhibited a statistically significant association with DEBs which included parent or guardian divorced, parent or guardian time in jail, adults slap, hit, kick, punch others, victim of violence, lived with mentally ill, and lived with person with alcohol/drug problem. Further studies are needed to examine mechanisms contributing to the increased risk of DEBs among those with ACE exposure.
High shape and weight importance in adolescence relates to worse body image in the first perinatal period
Understanding whether shape and weight importance in adolescence relates to body image during the perinatal period is essential to inform eating disorder prevention and intervention research. We longitudinally examined the relationship between weight and shape importance during adolescence and body image during (1) pregnancy and (2) the first postpartum year. Participants included 554 women from the Life-course Experiences and Pregnancy (LEAP) study, a longitudinal cohort of women participating since adolescence in Project EAT (Eating and Activity in Teens and Young Adults). Participants reported shape and weight importance during adolescence (11-18 years old) for Project EAT and retrospectively recalled body image during and after their first pregnancy for the LEAP study 20 years later. Separate linear regression models estimated the longitudinal associations between adolescent shape and weight importance and pregnancy and postpartum body image. After covariate adjustment, results showed small, positive associations between adolescent shape and weight importance and pregnancy (B = 0.07 95 % CI: 0.02, 0.11) and postpartum (B = 0.10, 95 % CI: 0.06, 0.14) body image. These findings indicate that high shape and weight importance in adolescence relates to worse body image across the perinatal period. Results highlight the importance of (1) targeting the years prior to adolescence for eating disorder prevention interventions and (2) providing support and interventions for people in the perinatal period, specifically targeting body image.
Using stereotype violation to shift causal understanding and attitudes about weight
We evaluated an approach to weight stigma reduction involving the provision of an exemplar inconsistent with belief systems underlying weight bias. Specifically, that people with higher weight eat unhealthy, high-calorie diets, and people with lower weight eat healthy, low-calorie diets. Providing exemplars that violate the stereotype's assumptions may lead to a change in beliefs, stereotypes, and ultimately, stigma.
Diet pills and deception: A content analysis of weight-loss, muscle-building, and cleanse and detox supplements videos on TikTok
The promotion of harmful dieting-related products, including weight-loss, muscle-building, and cleanse/detox supplements, is pervasive across TikTok. Use of these products has been associated with eating pathology, and in some instances, increased risk of an eating disorder diagnosis. To inform eating disorders prevention and public health intervention, a content analysis was conducted to analyze the promotional features of the most viewed videos as of June 2022 in the U.S. across popular dieting product-related hashtags (#dietpills, #preworkout, #detox) (N = 233 videos). Investigators watched and coded videos using a codebook that captured details about featured individuals, product claims and details, and other video elements (e.g., language, use of popular music). Descriptive statistics were obtained to analyze trends within and across product hashtags. A total of 78 #dietpills, 86 #preworkout, and 69 #detox videos met study criteria. Videos promoting weight-loss and cleanse/detox products overwhelmingly featured feminine-presenting (70.5 % and 71 %, respectively) and thin (35.9 % and 44.9 %) individuals, while #preworkout video subjects were mostly masculine-presenting (73.3 %) and muscular (61.6 %). Most did not disclose their credentials (93.6 %) nor identify whether the promotion of the product was sponsored by the retailer (95.7 %). The vast majority of videos (97 %) did not provide any scientific evidence to support health- and appearance-related claims. The most popular videos promoting dieting-related supplements on TikTok overwhelmingly make unsubstantiated health claims, posing substantial risks for social media users who are vulnerable to their usage and associated health risks, including engagement in disordered eating.
Validation of the Weight-Related Eating Questionnaire in pregnancy
The Weight-Related Eating Questionnaire (WREQ), designed for assessing distinct constructs of dietary restraint and disinhibition-related eating behaviors, has not been validated in pregnancy. This secondary data analysis aimed to evaluate the WREQ's psychometrics in a diverse sample of pregnant women from the eMoms randomized controlled trial (N = 1399), randomly split for exploratory (EFA, n = 691) and confirmatory factor analysis (CFA, n = 708). Cronbach's alpha and corrected item-total correlation was used to examine internal consistency reliability. Sequential multiple regression analyses were used to assess criterion validity. EFA revealed three factors - dietary restraint, susceptibility to external cues, and emotional eating - accounting for 65.6 % of total variances. Parallel analysis confirmed a combination of two restraint subtypes (routine restraint and compensatory restraint). CFA showed that item 3 for assessing routine restraint had the lowest squared multiple correlation (0.22). The overall Cronbach's alpha of 0.87 demonstrated good internal consistency. Dietary restraint was negatively associated with the intake of energy (p = .03) and carbohydrates (p = .02), whereas susceptibility to external cues was positively associated with the intake of energy (p < .001), carbohydrates (p < .001), and total fat (p = .003). Additionally, emotional eating was positively associated with early-pregnancy body mass index (BMI) after adjustment for covariates (p < .001). These findings confirmed the reliability of the WREQ, the construct validity for susceptibility to external cues and emotional eating, and demonstrated its criterion validity regarding nutritional intake in pregnant women.
Examining adverse life experiences, disordered eating behaviors and cognitions and weight loss treatment in Peru
Studies conducted in the US indicate that exposure to trauma, and stigma related to weight are environmental factors associated with the development of disordered eating. Few studies have explored psychosocial and contextual factors surrounding disordered eating in Latin American populations. This study examined everyday discrimination, verbal weight-related abuse, adverse childhood experiences, and disordered eating across individuals seeking versus not seeking weight loss treatment in Peru.
Body checking and avoidance among dancers
Dancers are at heightened risk for eating disorders (EDs) and have job and training demands that obscure ED assessment and likely impede treatment. Two behavioral manifestations of ED psychopathology that may present uniquely in a dance environment are body checking and body avoidance. The current study sought to provide a foundational understanding of the phenomenology of body checking and avoidance among dancers by assessing the reliability (i.e., internal consistency) of existing body checking and avoidance measures and the relationships, or convergent validity, between measures of body checking and avoidance and measures of related constructs. Eighty professional and pre-professional (i.e., conservatory level) dancers (78.8 % female) from seven dance genres completed self-report measures of body checking and avoidance, ED pathology, clinical perfectionism, depression, and anxiety. Across the dancer sample, body checking and avoidance measures demonstrated adequate internal consistency. More frequent body checking and body avoidance was strongly related to higher levels of ED pathology. There were moderate to strong correlations between body checking and body avoidance and clinical perfectionism, depression, and anxiety such that higher body checking and body avoidance was related to higher clinical perfectionism, depression, and anxiety. Exploratory analyses found no significant differences between ballet dancers and dancers of other dance genres; professional dancers scored in the normative range on measures of body checking and body avoidance. Dancers' qualitative descriptions of body checking and avoidance revealed behaviors not included in existing questionnaires, such as unique mirror use behaviors, technology-assisted body checking, and the checking and avoidance of body parts relevant to the dance-specific body ideal. Results support the inclusion of body checking and avoidance interventions in ED treatments for dancers (particularly pre-professional dancers) and emphasize the need for dancer-specific ED assessment methods.
Creatine monohydrate use is prospectively associated with muscle dysmorphia symptomatology
This study aimed to determine the prospective association between creatine monohydrate use and muscle dysmorphia symptomatology among adolescents and young adults in Canada. Data from 912 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Creatine monohydrate use in the past 12 months was assessed at Wave 1, and muscle dysmorphia symptomatology was measured using the Muscle Dysmorphic Disorder Inventory (MDDI) at Wave 1 and Wave 2. The prospective associations between creatine monohydrate use and the MDDI total score and subscale scores were determined using linear regression analyses. Regression analyses controlled for relevant demographic identifiers, prior substance use, and the corresponding Wave 1 MDDI variable. Creatine monohydrate use at Wave 1 was prospectively associated with both total muscle dysmorphia symptomatology (B 1.34, 95 % CI 0.27, 2.42) and greater Appearance Intolerance (B 0.52, 95 % CI 0.02, 1.03) at Wave 2. Importantly, these findings were independent of prior muscle dysmorphia symptomatology, lifetime anabolic-androgenic steroid use, lifetime cigarette use, and frequency of alcohol use. Creatine monohydrate is commonly used among adolescents and young adults. Findings from this study are among the first to document that creatine monohydrate use may be a risk factor for the development of muscle dysmorphia symptomatology among adolescents and young adults. Health and mental health care professionals may consider assessing for both creatine monohydrate use and muscle dysmorphia symptomatology among adolescents and young adults.
Attention-deficit/hyperactivity symptoms and loss of control eating in emerging adults: Role of psychological resilience
This study aimed to fill a gap in the literature regarding the role of resilience in the relationship between symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and loss of control (LOC) eating in a nonclinical sample of emerging adults. Resilience was examined as a potential moderator and as a potential mediator of ADHD symptoms and engagement in LOC eating behaviors. Improved understanding of this relationship may inform clinical intervention and risk screening methodologies for disordered eating behaviors in college students.
Opportunities lost? Rates and predictors of attrition in an eating disorders outpatient service
To examine rates and predictors of attrition from referral through to treatment completion in an outpatient public psychology service's eating disorder program in Perth, Western Australia.
Relation between ARFID symptomatology and picky eating onset and duration
Picky eating (PE) is common in early childhood, peaking between ages 1 and 5 years. However, PE may persist beyond this normative period and pose threats to health and psychosocial functioning. Avoidant/restrictive food intake disorder (ARFID) involves restrictive eating driven by appetite, preference/selectivity, and/or fear of eating, leading to significant medical and/or psychosocial impairment. This retrospective study examined the relation between early childhood PE onset/duration and ARFID eating restrictions and symptoms.
Negative emotional eating patterns in general Chinese adults: A replication and expansion study examining group differences in eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties
Previous research identified four patterns of negative emotional eating in American and Chinese university students and proposed future directions (e.g., exploring potential differences in emotion regulation across patterns and replicating the patterns in a general, non-student population). Furthermore, prior research has not explored group differences in muscularity-oriented eating disorder symptomatology or psychosocial impairment. Therefore, the present study addressed these gaps in a sample of general Chinese adults, further testing group differences in typical and muscularity-oriented eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties across patterns of negative emotional eating. A total of 600 Chinese adults were recruited. Latent class analysis (LCA) was used. Results replicated the four patterns of negative emotional eating in previous research, including non-emotional eating (non-EE), emotional over- and under-eating (EOE-EUE), emotional over-eating (EOE), and emotional under-eating (EUE). Significant class differences were identified in eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties. Specifically, individuals with EOE and EOE-EUE patterns exhibited higher eating disorder symptomatology, higher psychosocial impairment, and more emotion regulation difficulties than those with non-EE and EUE patterns. Therefore, these two classes (i.e., EOE and EOE-EUE), especially the poorly researched EOE-EUE group, should be further examined to elucidate research and clinical applications. Furthermore, findings underscore the role of emotion regulation difficulties in further describing the differences across these negative emotional eating patterns, which can be considered in future interventions for reducing negative emotional eating.
Loneliness as a moderator of the association of affective symptoms and binge eating among college women
Affective symptoms (e.g., depression, anxiety, shame) are a potent risk factor for binge eating. However, less is known on the role of loneliness as a moderator of affective symptoms and binge eating. This objective of the current study was to investigate main effects and interactions of affective symptoms and loneliness in relation to binge eating in college women. A sample of 556 undergraduate women completed self-report questionnaires of affective symptoms, loneliness, and binge eating. Results revealed significant interactions between each affective symptom variable and loneliness in relation to binge eating, such that loneliness strengthened the positive association of affective symptoms and greater binge eating. The findings of this study demonstrate an important role of loneliness to binge eating among college women, especially those with underlying affective vulnerabilities. More theoretical and treatment-oriented work on the role of loneliness in binge eating is needed to understand mechanisms and interventions/preventions.
Generalization of food devaluation following food-specific go/no-go training
The benefit of food-specific inhibition training on modulating food valuation and eating behaviors has been established, but generalization to untrained foods is seldomly examined. This study investigated whether stimulus variability and practice order, found to effect generalization in motor learning, can improve generalization following food-specific inhibition training. Ninety-three young adults practiced the Go/No-Go task online in three training conditions: 1) Constant (N = 30): inhibition practiced on one food stimulus; 2) Variable-Blocked (N = 32): inhibition practiced on 6 food stimuli, each in a separate block; and 3) Variable-Random (N = 31): inhibition practiced on 6 food stimuli in random order. Consistent with our hypothesis, the Variable-Random group showed better generalization of inhibition to untrained foods than the Constant and the Variable-Blocked groups immediately after training, demonstrating the benefit of stimulus variability and random practice order. This effect was not present 24 h after training. The Variable-Random group also showed decreased desire to eat untrained foods, exhibiting generalization of food devaluation. However, this effect was only present 24 h after training. The Constant group showed increased desire to eat untrained foods immediately and 24 h after training. The Variable-Blocked group did not differ from either group in the desire to eat to untrained foods, suggesting that random order is important for exposing the benefit of variability. The findings illustrate that presenting various training items in random order can improve generalization of food-specific inhibition training. However, inconsistencies found in the timing of generalization effects and modest effect sizes warrant additional investigation into generalization principles of food-specific inhibition training.
Availability and consumption of hyper-palatable foods in an all-you-can-eat cafeteria among college freshmen
College campuses provide an expansive food environment, which may contribute to elevated risk of excess energy intake and weight gain among college students. All-you-can-eat style cafeterias often expose students to hyper-palatable foods (HPF), which may promote overeating. This study aimed to examine the availability of HPF in an all-you-can-eat college cafeteria, and to examine HPF intake during meals among undergraduates.
How parent stress and COVID-19 impact on the family are associated with parental pressure to eat during COVID-19
This study aimed to assess how parent stress and COVID-19 impact on the family are associated with parental pressure to eat during the COVID-19 pandemic. Parents of healthy preschool-aged children completed measures including pressure to eat (Child Feeding Questionnaire), parent perception of their stress (Perceived Stress Scale), household food insecurity (Hunger Vital Sign) and effects of COVID-19 on families (COVID-19 Exposure and Family Impact). Children (N = 228) were racially, ethnically, and socioeconomically diverse (34 % Black, 15 % Hispanic, and 29 % with household income <$20,000). Bivariate analyses showed that parent stress at Year 1 (β 0.02; 95 % CI 0.006, 0.04) was significantly associated with pressure to eat at Year 1 and that COVID-19 impact at Year 1 (β 0.02; 95 % CI 0.001, 0.03) was also significantly associated with pressure to eat. Multivariable linear regression analyses showed that parent stress at Year 1 was significantly associated with pressure to eat at Year 1 (β 0.39; 95 % CI 0.16, 0.61) while COVID-19 impact was not significantly associated with pressure to eat at Year 1. This study, consisting of racially and socioeconomically diverse children, found that while parent stress was significantly associated with increased parental utilization of pressure to eat feeding practice, COVID-19 impact was not significantly associated with pressure to eat in adjusted analyses. This suggests that overall perceived stress by parents could be an important factor in parent pressuring feeding practices.
Measurement invariance of the Intuitive Eating Scale-2 across country, ethnicity, sex, and sexual orientation: A cross-cultural study between Brazil and the U.S
Intuitive eating is defined as being connected to internal hunger, satiety, and appetitive cues and flexibly using these cues to determine when, what, and how much to eat. The Intuitive Eating Scale-2 (IES-2) is a widely used measure of facets of intuitive eating. However, the scale has shown unstable factor structure in several validation studies and there is a lack of studies investigating the measurement invariance of the IES-2 beyond sex. We aimed to evaluate the psychometric properties of the IES-2, testing several factor structures among Brazilian and U.S. samples of men and women; to test measurement invariance across country of origin, ethnicity, sex, and sexual orientation; and to evaluate its internal consistency. Three models of the latent structure of the IES-2 were tested using confirmatory factor analyses (CFA) in a total of 1072 young adults (452 Brazilians and 620 Americans), aged 18-35 years. Results demonstrated that only a 3-factor solution with 11 items of the IES-2 showed adequate fit to the data for both countries. This model demonstrated scalar invariance across sex and sexual orientation, but only configural invariance was found across country of origin and ethnicity. Good internal consistencies were found for both the Brazilian and American samples. The present study provides support for a 3-factor solution with 11 items of the IES-2, to Brazilian and American samples. The study also offers evidence of internal consistency, and invariance between sex (i.e., male and female) and sexual orientation (i.e., heterosexual participants and sexual minority participants).
Stimulant medications in the management of bulimia nervosa and anorexia nervosa in patients with and without comorbid attention deficit hyperactivity disorder: A systematic review
People with attentional problems are at increased risk of eating disorders. This paper aimed to systematically review and synthesize the existing evidence on stimulant medication in the management of patients with bulimia nervosa (BN) or anorexia nervosa (AN) with or without comorbid attention deficit hyperactivity disorder (ADHD).
The relationship between gendered racism and binge eating symptoms among young adult U.S. Black women: Identity shifting as a mediator
Although research has illustrated that racial disparities in access to treatment for binge-eating disorder (BED) among Black women exist, little is known about the psychosocial related experiences of binge eating behaviors among Black women. Binge eating disorder is characterized by the recurrent consumption of large amounts of food within a brief period, accompanied by a loss of sense of control over the eating and distress over the eating behaviors. Past research has shown that race and gender related stressors are positively associated with emotional eating among Black young adult women and that they may engage in problem-solving coping strategies like identity shifting (conscious and unconscious alterations of thoughts, behaviors, perspective, and appearances) to manage these stressors. Considering the literature, the present study was developed to examine the mediating role of identity shifting in the relationship between gendered racism and binge eating symptoms among young adult Black women. To test this assertion, we administered an online survey to 239 Black women (M = 27.32). The results indicated that gender racism significantly predicted both identity shifting and binge eating and identity shifting significantly predicted binge eating. Additionally, identity shifting accounted for 34.5 % of the associations between gendered racism and binge eating symptoms. These findings highlight the importance of exploring experiences of discrimination and coping strategies when considering ways to reduce mental health concerns, such as binge eating symptoms, among young adult Black women.
Thought-shape fusion in residential eating disorder treatment: Cognitive defusion as a mediator between thought-action fusion and treatment outcome
An understudied cognitive bias within eating disorder (ED) psychopathology is Thought-Shape Fusion (TSF), which involves irrational beliefs about the likelihood and moral implications of feared outcomes related to shape, weight, and food. This phenomenon has received less attention within the context of ED treatment, with little known about potential processes of change to address TSF and ultimately promote ED recovery. We propose cognitive defusion as a process of change, a metacognitive process that emphasizes observing thoughts objectively rather than appraising thoughts as absolute truth. We explored whether cognitive defusion, that is, reductions in body image-related cognitive fusion, mediated the relationship between trait-level TSF and treatment outcomes in a transdiagnostic ED sample of adult and adolescent females (N = 130) presenting to residential care. We found that reductions in body image-related cognitive fusion mediates the association between trait-level TSF at baseline and ED severity at discharge. However, when the sample was separated into adolescent and adult subgroups, these results only remained significant for adolescents. These findings underscore the relevance of targeting cognitive defusion as a potential mechanism to address the impact of trait levels of TSF cognitions on ED psychopathology.
Compensatory eating disorder and full threshold DSM eating disorders: A comparison of eating-disorder-related psychiatric impairment and symptomatology
Compensatory eating disorder (CED) is a newly proposed 'other specified feeding and eating disorder' characterized by recurrent non-purging compensatory behaviors (e.g., compulsive exercise and/or food restriction), overvaluation of weight/shape, the absence of objective binge-eating episodes, and the absence of low weight or recent significant weight loss. This study compared individuals with CED to individuals with anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED) on measures of psychiatric impairment, eating-disorder (ED) symptomatology, and comorbid internalizing disorders.