eating disorders

The perception of body weight seems to have an impact on weight-control behaviors and is associated with an increased risk of eating disorders EDs). The study aims to examine the perceptions of body weight, anthropometric characteristics, and the risk of EDs in female students in Zanjan, Iran.

Using a cross-sectional design, the data of 359 students aged 16-19 year attending secondary high schools in Zanjan, during the school year 2017-2018 were collected and analyzed.

The results revealed a significant association between being overweight and having obese body shape, high levels of stress, and the odds of EDs. Additionally, there was a significant inverse relationship between being overweight and obese body mass index (BMI), overweight and obese body shape, and the odds of oral control subscale of EDs.

The results of this study demonstrated a relationship between BMI, stress level, body shape, and an elevated risk of EDs. Further prospective studies are needed to validate and expand upon these findings.

We aimed to evaluate the relationship between social media addiction and eating disorders in the followers of social media influencer.

The study (n=561) was conducted with 112 men and 449 women, who follow a social media influencer and volunteered to participate in the study. Social media addiction scale for adults form (SMAS-AF) was used to evaluate the social media addiction, and ORTO-15 scale was used to determine the eating disorders.

80.9% of the participants had orthorexia nervosa and 19.1% were normal. BMI and social media addiction scale total score were significantly higher than optimal rates and ORTO-15 total score was significantly low (P<0.05). Age, anthropometric measurements, sub-scores of SMAS-AF and clinical domain sub-score of orthorexia nervosa were significantly different between the groups (P<0.05). It was significantly found that the emotional domain sub-score increased as the virtual tolerance score and virtual communication score increased (P<0.05). A relationship was found between the total score of the social media addiction scale and the emotional domain sub-score (P<0.05).

Social media use may negatively affect individuals’ eating behaviors and contribute to body image dissatisfaction.

This study aimed to investigate the concurrent relationships between weight self-stigma and disordered eating behaviors, mediated by weight- and body-related shame and guilt, fear of negative appearance evaluation, and eating self-efficacy, among women with overweight and obesity.

This study was a cross-sectional study. The sample consisted of 228 Iranian women, aged 18-70 years, with overweight and obesity (BMI≥ 25), who were purposively selected. Participants responded to online demographic questions and research measurement tools (Dutch Eating Behavior Questionnaire, Weight Self-Stigma Questionnaire, Weight- and Body-Related Shame and Guilt Scale, Weight Efficacy Lifestyle-Short Form, Fear of Negative Appearance Evaluation Scale). Statistical methods of descriptive statistics, Pearson correlation matrix, structural equation modeling and bootstrapping mediation analysis were used to analyze the data, through SPSS 23 and AMOS 23.

The results showed that weight self-stigma had significant paths to all research variables in a structural model (P< 0.05). Furthermore, mediation analysis showed that eating self-efficacy mediated the relationships between weight self-stigma and emotional (P< 0.001), external (P< 0.001), and restrained eating behaviors (P< 0.002). Additionally, weight and body-related guilt mediated the relationship between weight self-stigma and restrained eating behavior (P< 0.001). Totally, the research model explained 14.9% of the variance of emotional and external eating behaviors, and 36.2% of the variance of restrained eating behavior.

The findings highlight the importance of considering weight self-stigma in obesity research. Additionally, improving eating self-efficacy and addressing guilt through psychological interventions are crucial for managing eating behaviors in this population.

Obesity is a health concern with complex dimensions. This study aimed to investigate the predictive roles of psychological factors, including weight self-stigma, weight- and body-related shame and guilt, eating self-efficacy, and fear of negative appearance evaluation, on disordered eating behaviors in Iranian women with overweight and obesity.  This descriptive cross-sectional research was carried out in 2020-2021 among 228 Iranian women, aged 18 to 70 years, with overweight and obesity who were selected by purposive sampling method. Data were collected through online standard questionnaires. SPSS-23 was used to analyze the data.  All the predictor variables had significant associations with disordered eating behaviors (P<0.05, P<0.01). In addition, the results of multiple regression analysis showed that eating self-efficacy was a predictor of emotional eating behavior (β = -0.534, P<0.001). Additionally, fear of negative appearance evaluation and eating self-efficacy were predictors of external eating behavior (βf = -0.416, βs-e = -0.416, P< 0.001). Moreover, weight and body related guilt and eating self-efficacy were predictors of restrained eating behavior (βg = 0.442, βs-e = 0.300, P< 0.001).  These findings emphasize the importance of psychological variables in obesity. Specifically, self-efficacy, fear of negative evaluation, and guilt were important constructs in predicting disordered eating behaviors. Thus, in clinical weight loss programs, considering psychological treatments based on strengthening self-efficacy and self-compassion in this group is helpful to improve their healthy eating behaviors.

 The aim of this study is to evaluate the validity and reliability of the Food Craving Acceptance and Action Questionnaire (FAAQ) in university students.

 The study included 394 undergraduate students at Ankara Yıldırım Beyazıt University. The study included individuals who volunteered to participate, were at least 18 years old, and did not have any severe psychological issues. Explanatory and confirmatory factor analyses of the scale were conducted by dividing the data set into two groups. Cronbach’s α coefficient was analyzed and a test-retest was conducted with 94 students.

 It was determined that the Food Craving Acceptance and Action Questionnaire had 2 factors (acceptance and willingness). The fit values of the scale were found to be CMIN/df=2.26; GFI=0.92; AGFI=0.87; CFI=0.85; RMSEA=0.08. The acceptance, willingness subscales and total Cronbach α coefficients of the scale were 0.761, 0.716 and 0.761, respectively. Intraclass correlation coefficient (ICC) values were 0.84, 0.81 and 0.80 for acceptance, willingness and total scale score, respectively. Statistically significant negative correlations were found between the ‘acceptance’, ‘willingness’ subscale and total DEBQ, FCQ-T scores, subscale scores and mYFAS 2.0 symptom count (P<0.05).

 The FAAQ was found to have a two-factor structure and the fit values were found to be within the acceptable range. The age range for university students is considered to be that of adults, and this scale can also be applied to adults in general.

Eating disorders are debilitating, life-threatening, and costly mental disorders that significantly impair physical health and adversely affect psychosocial functioning. Nowadays, six main feeding and eating disorders are identified in diagnostic systems, and Bulimia nervosa is one of them. The aim of this paper is twofold: First, it seeks to shed light on the concept of bulimia as understood by the Persian school of medicine. This study has attempted to consider the roots of this disease within this tradition. It will compare the concept of bulimia nervosa in conventional medicine with that of Canine appetite disease in Persian medicine in the Islamic Golden Era (9th-12th centuries). Secondly, it will analyze and show the evolution of the term bulimia throughout history. For this purpose, Avicenna’s Canon of Medicine, primary PM resources, and important databases were reviewed using the related keywords. Although these diseases are in the category of emerging mental illness, evidence suggests that its roots can be found in Persian medicine. The comparison made between the definition of Canine appetite in this school and modern definitions of Bulimia nervosa shows striking similarities between the two diseases, suggesting that both are the same disease.

 This cross-sectional study aimed to evaluate perceived stress (PS) and eating disorders (ED) among a sample of Iranian nurses.

 149 nurses in the hospitals of Bojnurd city, Iran were studied. ED and PS were examined by the valid Persian version of eating disorders scale and the valid Persian version of PS scale respectively.

 The nurses had moderate or high PS levels. Overall eating disorders (OED) and Anorexia nervosa (AN) scores were higher in the single subjects than married ones. OED scores were higher in the persons without experience of getting diseases themselves or without experience of losing their families due to diseases, while Bulimia scores were greater in the nurses with experience of losing their families due to diseases than ones without this experience. Significant correlations were observed between OED score (r= 0.20, p= 0.01) and AN (r= 0.38, p<0.001) with physical activity level and age of persons (OED score: r= -0.23, p= 0.005; AN score: r= -0.20, p= 0.01).

 The nurses had moderate or high PS levels. OED and AN scores were greater in the single persons than married ones. OED scores were higher in the persons without experience of getting diseases themselves or without experience of losing their families due to diseases, while Bulimia scores were greater in the nurses with experience of losing their families due to diseases than ones without this experience. Significant correlations were found between OED score and AN score with physical activity level and age of persons.

Female dancers are at risk of negative energy balance and its adverse effects. However, there is no evidence regarding the energy balance of Iranian female dancers in the literature.

In a cross-sectional study of 25 female nonprofessional dancers, dietary intake was assessed using self-reported food diaries and recall interviews on three different days: One dance day, one workday without dance, and one weekend day without dance. Nutrient intake was analyzed and converted into protein, carbohydrate, and fat components, and subsequently into energy equivalents. Total energy expenditure was calculated based on physical activity measurements taken on dance, work, and rest days. The average daily energy intake and expenditure over a 7-day period were then compared.

Significant daily energy deficiency was observed based on the average over 7 days (- 772.7 kcal +/- 450 kcal, P-value < 0.05). Dancers consumed less protein and carbohydrates and more fat than the recommended daily values (P-value < 0.05).

It appears that Iranian female dancers suffer from negative energy balance and nutritional malpractice. This may be related to underlying eating disorders or perceptions of body image, as well as inadequate nutritional knowledge. Consulting experienced sports nutritionists and other necessary specialists is recommended.

Celiac disease is a chronic autoimmune disease of the small intestine, related to gluten intolerance occurring in genetically predisposed patients. This study aimed to evaluate Mediterranean diet adherence, screen eating disorders and establish the relationship between Mediterranean diet and eating disorders.

This study included 81 adults with celiac disease, and 85 without celiac disease from Rabat-Sale-Kenitra hospitals between May 2022 and Nov 2022. The Mediterranean Diet Serving Score (MDSS) questionnaire was used to determine adherence to the Mediterranean diet and SCOFF questionnaire was used to screen eating disorders.

The results showed a significant difference between the two groups in age (P=0.000), weight (P=0.041), height (P=0.000) and non-adherence to Mediterranean diet (P=0.032). Participants without celiac disease reported a significantly (P=0.032) lower adherence score to the Mediterranean diet (62.35%) than participants with celiac disease (29.62%). Additionally, the results of the Khi2 test which revealed a significant association between MDSS and SCOFF (P=0.024). In addition, based on logistic regression the Mediterranean diet Serving Score was significantly associated with eating disorders (P=0.025) in adults with celiac disease, on the other hand, weight, height, BMI and MDSS were significantly associated with eating disorders in adults without celiac disease.

Our study showed good adherence to the Mediterranean diet by celiac adults so it can be assumed that the Mediterranean diet could have a protective effect against eating disorders in celiac patients.

 It was argued that the coronavirus disease 2019 (COVID-19) lockdown could affect eating disorders (EDs) by triggering EDs behaviors and exacerbating existing symptoms. This study was carried out to examine the effectiveness of emotion-focused therapy (EFT) on body image of women with EDs during the COVID-19 pandemic lockdown.

 This was a quasi-experimental study with pretest-posttest and a control group. The statistical population included all people with physical image disorder from September to October 2021. Thirty-four were selected using a purposeful sampling method. They were randomly assigned to experimental (n = 17) and control (n = 17) groups. The experimental group underwent eight sessions of 120-minute online treatment, one session per week. The control group did not receive any intervention until the end of the experimental group. Measurement tool was Cash Multidimensional Body-Self Relations Questionnaire (MBSRQ). The experimental group received eight sessions of EFT; however, the control group did not receive such training. The research data were examined through multivariate analysis of covariance (MANCOVA) in SPSS software.

 The intervention yielded more substantial outcomes concerning the variables mentioned in the experimental group, surpassing the impact observed in the control group. Based on the scores from the appearance assessment scales (F = 0.39, P < 0.001), appearance orientation (F = 196.71, P < 0.001), and satisfaction with body area (F = 0.25, P = 0.61), there was a significant difference between the two groups. According to the eta-squared (η2), the appearance orientation scale had the most significant impact on the effectiveness of EFT. This means that only 0.87% of the difference in appearance orientation scores after the test could be attributed to the therapy's effectiveness.

 Given the results of the current study and the research background, EFT can be recommended as an efficient interventional method to improve women’s body image.

Cerebral palsy (CP) can cause motor, sensory, cognitive, and communicative problems and poor feeding performances in children. Feeding problems could be life-threatening and negatively affect cognitive and physical growth. This study investigates the frequency of response to oral motor skills, the frequency and severity of feeding problems, and the relationship between age and oral motor skills with feeding problems in children with CP aged 2 to 7 years.

This was an observational and cross-sectional study. The participants were 60 children (26 girls and 34 boys) with CP with a mean age of 4.76±1.71 years. The screening tool for eating problems and oral motor assessment scale assessed participants’ feeding and oral motor skills. The Spearman test determined the correlation between age and oral motor dysfunctions with feeding problems.

The present study revealed that 80% of participants indicated feeding problems in the screening tool of the eating problems test. Problems with feeding skills (51.5%) were the most frequent. Furthermore, the most frequent response of participants to “closing the lips while feeding with a spoon” was 46.7%, and “sucking with straw,” equaled 55.0%,” which was passive. For other items, the most frequent response of the examinees was “functional.” Finally, the results showed no significant correlation (P<0.05) between age and mean scores of frequency and severity of feeding problems. A significant negative correlation was found between mean scores of oral motor skill with frequency (P<0.001, r=-0.476) and severity (P=0.001, r=-0.424) of feeding problems.

The majority of children with CP have problems with feeding and oral motor skills. Some skills in the fields of feeding and oral motor should be noticed more by speech-language pathologists and included in their therapeutic program, especially “feeding skills,” “closing the lips while feeding with a spoon,” and “sucking with straw.”

To understand the consequences of an invalidating environment, it is essential to have a measurement tool with appropriate statistical properties. Thus, the primary aim of this study was to render the ICES (Invalidating Childhood Environment Scale) into Persian and subsequently evaluate the psychometric attributes of this translated version.

Data were collected from 1221 nonclinical participants, including 1053 females and 168 males, who were students at medical universities in Tehran, Iran. Several questionnaires, such as the ICES, CTQ (Childhood Trauma Questionnaire), DTS (Distress Tolerance Scale), BIS-11 (Barratt Impulsiveness Scale), Self-Compassion Questionnaire, Dutch Eating Behavior Questionnaire, and EAT-26 (Eating AttitudesTest) were used in the study. The data sets were investigated through SPSS and R language to evaluate the ICES' reliability and construct validity. Additionally, Item Response Theory (IRT) was employed with the Graded Response Model (GRM) to measure the psychometric properties of each item in terms of difficulty and discrimination parameters.

Confirmatory factor analysis indicated that both single-factor and two-factor models fit well for both maternal and paternal versions of the ICES. The internal consistency, as assessed by Cronbach's alpha, was high and satisfactory for both maternal (0.87) and paternal (0.87) versions. Notably, the IRT analysis revealed that item 9 performed poorly in both maternal and paternal versions. Compared to the one-factor model, the two-factor model demonstrated a superior fit. Additionally, the test-retest reliability of the ICES over two months demonstrated good reliability for both maternal and paternal versions (0.98). Divergent and convergent validity analysis revealed a significant negative relationship between childhood invalidation environment and distress tolerance (r = 0.175, P < 0.01) as well as self-compassion (r = 0.142, P < 0.01), which were inversely related to the ICES. Furthermore, there was a considerably positive correlation between the invalidating environment experienced during childhood and impulsivity, as evidenced by r = 0.196 and P < 0.01.

This study established the favorable psychometric properties of the Persian version of the ICES, indicating that this version is reliable and valid to assess the Invalidating Childhood Environment in the Iranian population. However, further investigations are warranted to reevaluate its validity and reliability.

Binge eating disorder is a type of eating behavior disorder that occurs with voluntary limitations in eating food. It has a psychological and social origin and is one of the concerns of the World Health Organization. The present study explains the relationship between perfectionism and binge eating disorder in female college students and the mediating role of cognitive emotion regulation.

In this descriptive-correlation study, data were analyzed using the structural equation modeling (SEM) method. The statistical population of this research consisted of all the female college students of Isfahan City, Iran, in October and November 2022. A total of 214 students were selected by the available sampling method. The participants answered the perfectionism inventory (PI, 2004), the cognitive emotion regulation questionnaire (CERQ, 2001), and the binge eating severity (BES, 1982). The data were analyzed using EMOS 22 software and SEM.

The results showed that adaptive cognitive regulation strategies could negatively mediate the relationship between adaptive perfectionism and eating disorder (P<0.01, β= -0.113) while positively and significantly mediating the relationship between maladaptive perfectionism and eating disorder (P<0.01, β=0.124).

Based on the results, physicians and therapists can incorporate cognitive regulation techniques into eating disorder treatments and help individuals manage perfectionism and negative thoughts. Additionally, educational programs can be developed in counseling centers, schools, and universities to empower individuals to recognize signs and seek help promptly.

Eating disorders (EDs) are characterized by severe difficulties with eating behavior and emotions, increasing among medical students.

Since social support can play a preventive role, this study aimed to evaluate the relationship between these conditions considering COVID-19-related anxiety.

This analytical cross-sectional study was conducted in 2022 at Alborz medical science university, Iran, on 282 medical students who were selected randomly. The Eating Attitude Test (EAT-26), Corona Disease Anxiety Scale (CDAS), and the Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire were used to collect data. The chi-square and Fisher’s exact tests were utilized via SPSS software version 23. The level of significance is below 0.05.

In this study, 153 (51.1%) participants were men. The average age (SD) of respondents was 22.06 (1.65). The prevalence of medical students was 17% at risk for eating disorders. Logistic regression indicated that a low level of perceived social support (OR, 14.91; 95% CI, 3.49 – 63.64), a moderate level of COVID-19-related anxiety (OR, 6.36; 95% CI, 2.96 – 13.63), being obese (OR, 6.31; 95% CI, 1.75 – 22.68), and being female (OR, 5.58; 95% CI, 2.13 – 14.62) were significantly related to being at risk of EDs.

Based on the results, the high prevalence of tendency to eating disorders should be taken seriously among medical students. Strong evidence was provided regarding the need for screening and enhancing the perceived social support of medical students.