Disorders - Eating Disorders
McMaster, C. M., Fong, M., Franklin, J., Hart, S.
CONTEXT: Eating disorders (EDs) are complex mental illnesses that
require medical, psychological, and dietetic intervention to assist patients achieve recovery. OBJECTIVE(S): Available evidence was reviewed
regarding dietetic intervention for adult outpatients with an ED and the quality of this evidence was assessed. DATA SOURCES: Systematic literature
searches were conducted using 5 databases (MEDLINE, PreMEDLINE, EMBASE, CINAHL, PsycINFO) for studies comparing adults with an ED receiving a
dietetic intervention with those receiving a psychological intervention alone, those receiving a combined dietetic and psychological intervention, or
a control group. DATA EXTRACTION: Literature searches returned 3078 results, with 10 articles reporting on 9 randomized controlled trials meeting the
inclusion criteria. The quality of evidence was assessed using the Cochrane Risk-of-Bias tool and Grading of Recommendations Assessment, Development
and Evaluation (GRADE) framework. DATA ANALYSIS: GRADE assessments for studies involving individuals with anorexia nervosa indicated very low quality
of evidence for outcomes including weight, ED psychopathology and ED behaviors , and no studies measured nutritional changes. For studies conducted
with participants with bulimia nervosa or binge eating disorder, only 1 study included a group receiving combined evidence-based psychological and
dietetic intervention. A combined intervention produced moderate-quality evidence for lower attrition, greater abstinence from ED behaviors, and more
meals eaten per week in comparison with a stand-alone psychological or dietetic intervention. CONCLUSION(S): There is currently limited evidence to
sufficiently assess the impact of incorporating dietetic interventions into outpatient treatment for adults with an ED; however, available evidence
supports clinical practice guidelines that dietetic intervention should not be delivered as a stand-alone treatment. Additional methodologically
sound studies in larger samples are required to fully inform dietetic treatment in EDs and incorporation of such interventions as part of a
multidisciplinary treatment approach. Copyright © The Author(s) 2021. Published by Oxford University Press on behalf of the International Life
Sciences Institute. All rights reserved. For permissions, please e-mail: [email protected].
Nutrition reviews., 05 :
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Dietary advice, dietary change
Maglia,
M., Corello, G., Caponnetto, P.
According to the WHO definition,
\"telemedicine is the provision of health services, where distance is a critical factor, by all health professionals who use information and
communication technologies for the exchange of valid information for the diagnosis, treatment and prevention of diseases, research and evaluation,
and for the continuous training of health professionals, all in the interest of advancing the health of individuals and their communities\". The
purpose of our review work is specifically to investigate the effects of telemedicine in the treatment and prevention of eating disorders in
adolescents. From June 2021 to (September 2021) in the databases of the Web of Science, EMBASE, PsycINFO and CINHAL, using search terms such as
telehealth, eating disorder, adolescents, Internet/online treatments CBT and FB-T, anorexia nervosa, bulimia nervosa and binge eating disorder. The
articles resulting from the search phases in the databases listed above produced a total of 176 items. Once the procedures for selecting the works
were completed, only four studies were included in the review. Modern e-health psychological approaches in the treatment of eating disorders provide
potential bases of continuous assistance that are decidedly less burdensome in the costs of territorial services in the case that they are not
identified as necessary. Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research and Public Health, 18(23) (no
pagination) :
- Year: 2021
- Problem: Eating Disorders
(any), Anorexia Nervosa, Binge Eating Disorders, Bulimia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any)
Luo, Y. J., Jackson, T., Stice, E., Chen, H.
Body image disturbances
are widespread in highly populated, rapidly developing Asian nations such as China, but there are severe shortages of practitioners qualified to
treat these issues. In such contexts, validated online interventions offer a potentially viable approach for addressing the lack of treatment
resources. In this study, we evaluated effects of the eBody Project, an online, dissonance-based eating disorder prevention program, on functioning
among body-dissatisfied young Chinese women. Participating women were randomly assigned to the 6-week eBody Project intervention (n = 191) versus an
education brochure control condition (n = 181). Self-report assessments of eating disorder risk factors (body dissatisfaction, thin ideal
internalization, depressive symptoms, restrained eating), self-esteem, body appreciation, and disordered eating were completed at baseline,
posttreatment, and a 6-month follow-up. There were no intervention differences on outcomes before treatment but eBody Project women experienced
significantly larger improvements on all outcomes following treatment and/or at follow-up compared to controls; corresponding effect sizes were small
to medium. Results indicated the eBody Project program is a promising intervention for young women at risk for eating disorders in China and provide
foundations for broad implementation in low- and middle-income countries where resources for in-person therapy and supervision are limited or
unavailable altogether.
, 52(1) : 221-233
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive dissonance
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Hudson, T. A., Amaral, A. C. S., Stice, E., Gau,
J., Ferreira, M. E. C.
A randomized controlled trial was
conducted to assess the efficacy of the Body Project eating disorder prevention program in reducing eating disorder risk factors and symptoms in
young Brazilian women. A total of 141 female university students aged 18-30 years old were randomly assigned to one of two conditions: assessment-
only condition (n = 78) and Body Project condition (n = 63). Participants completed scales assessing body dissatisfaction, sociocultural influence,
disordered eating attitudes and behaviors, eating disorders symptoms, body appreciation, depressive mood and negative affect at baseline, posttest,
and at 1- and 6-month follow-ups. Body Project participants showed significantly greater reductions in body dissatisfaction, sociocultural influence,
disordered eating, eating disorder symptoms, depressive symptoms, and negative affect, and greater increases in body appreciation (d = .35-.48)
compared to assessment-only participants. Most of the effects persisted through 6-month follow-up (d = .35-.74). Results provide evidence that the
Body Project is an effective intervention to reduce eating disorder risk factors and eating disorder symptoms among Brazilian young women, and that
this intervention is naturally culturally adaptive. Copyright © 2021 Elsevier Ltd. All rights reserved.
Body image, 38 : 1-9
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Haines, M. S., Kimball, A., Meenaghan, E., Bachmann, K. N., Santoso, K., Eddy, K. T., Singhal, V., Ebrahimi, S., Dechant, E., Weigel, T., Ciotti, L., Keane, R. J., Gleysteen, S., Mickley, D., Bredella, M. A., Tan, C. O., Gupta, R., Misra, M., Schoenfeld, D., Klibanski, A., Miller, K. K.
Anorexia nervosa is complicated by low
bone mineral density (BMD) and increased fracture risk associated with low bone formation and high bone resorption. The lumbar spine is most severely
affected. Low bone formation is associated with relative insulin-like growth factor 1 (IGF-1) deficiency. Our objective was to determine whether bone
anabolic therapy with recombinant human (rh)IGF-1 used off-label followed by antiresorptive therapy with risedronate would increase BMD more than
risedronate or placebo in women with anorexia nervosa. We conducted a 12-month, randomized, placebo-controlled study of 90 ambulatory women with
anorexia nervosa and low areal BMD (aBMD). Participants were randomized to 3 groups: 6months of rhIGF-1 followed by 6months of risedronate (\"rhIGF-
1/Risedronate\")(n = 33), 12months of risedronate (\"Risedronate\")(n = 33), or double placebo (\"Placebo\")(n = 16). Outcome measures were lumbar
spine [1degree endpoint: postero-anterior (PA) spine], hip, and radius aBMD by dual-energy x-ray absorptiometry (DXA) and vertebral, tibial, and
radial volumetric (v)BMD and estimated strength by high-resolution peripheral quantitative computed tomography (HR-pCT)(for extremity measurements)
and multi-detector computed tomography (for vertebral measurements). At baseline, mean age, body mass index (BMI), aBMD and vBMD were similar among
groups. At 12months, mean PA lumbar spine aBMD was higher in the rhIGF-1/Risedronate (p = 0.03) group, and trended towards being higher in the
Risedronate group, than Placebo. Mean lateral lumbar spine aBMD was higher in the rhIGF-1/Risedronate than the Risedronate or Placebo groups
(p<0.05). Vertebral vBMD was higher, and estimated strength trended toward being higher, in the rhIGF-1/Risedronate than Placebo group (p<0.05).
Neither hip or radial aBMD or vBMD, nor radial or tibial estimated strength, differed among groups. rhIGF-1 was well tolerated. Therefore, sequential
therapy with rhIGF-1 followed by risedronate increased lateral lumbar spine aBMD more than risedronate or placebo. Strategies that are anabolic and
antiresorptive to bone may be effective at increasing BMD in women with anorexia nervosa. This article is protected by copyright. All rights
reserved.
Journal of bone and mineral research : the official journal of the American Society
for Bone and Mineral Research., 06 :
- Year: 2021
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Hahn, S. L., Kaciroti, N., Eisenberg, D., Weeks, H. M., Bauer, K. W., Sonneville, K. R.
BACKGROUND: Strong
positive relationships between dietary self-monitoring and eating disorder risk are seen in population-based, observational studies. However, current
evidence cannot establish causality. Furthermore, little is known about other mental and behavioral health consequences of dietary self-monitoring
among college women, a population vulnerable to eating disorders. OBJECTIVE(S): To determine if introducing dietary self-monitoring via a popular
smartphone app to undergraduate women impacts eating disorder risk, other aspects of mental health, or health behaviors including dietary intake and
physical activity. DESIGN: Randomized controlled trial. PARTICIPANTS/SETTING: Undergraduate women who had not engaged in dietary self-monitoring in
the past year and who were at low-risk for an eating disorder participated between May and October 2019 (n = 200). INTERVENTION: Participants were
randomly assigned to engage in dietary self-monitoring via MyFitnessPal for approximately 1 month or to receive no intervention. MAIN OUTCOME
MEASURES: Self-report data on eating disorder risk, other mental health outcomes, and health behaviors were collected at baseline and post-
intervention. STATISTICAL ANALYSES PERFORMED: Linear and logistic regressions were utilized to test hypotheses. RESULT(S): Adherence to the
intervention was high, with participants recording their dietary intake via MyFitnessPal on average 89.1% of days between baseline and post-
intervention. Assignment to the intervention was not associated with changes in eating disorder risk, anxiety, depressive symptoms, body
satisfaction, quality of life, nutritional intake, physical activity, screen time, or other forms of weight-related self-monitoring (all P > .05).
CONCLUSION(S): Among dietary self-monitoring naive undergraduate women with low-risk of an eating disorder, dietary self-monitoring via MyFitnessPal
for 1 month did not increase eating disorder risk, impact other aspects of mental health, or alter health behaviors including dietary intake. The
null results in our study may be due to the selection of a low-risk sample; future research should explore whether there are populations for whom
dietary self-monitoring is contraindicated. Copyright © 2021 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Journal of the Academy of Nutrition and Dietetics, 121(12) : 2377-
2388
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Dietary advice, dietary change
Haderlein, T. P., Tomiyama, A. J.
Objective:
This study is a secondary analysis testing the effects of an internet eating disorder prevention program on reward-based eating drive in a high-risk
sample of college-aged women. Method(s): We analyzed data from 278 women who were randomized to internet dissonance-based intervention (DBI-I),
internet cognitive-behavioral treatment (CBT[sbnd]I), or no intervention (NI). Both active conditions consisted of self-guided activities completed
over the course of four weeks. Linear mixed effects modeling was used to test the effect of internet intervention on reward-based eating drive.
Result(s): DBI-I was associated with greater reductions in reward-based eating over time than NI. No other Condition x Time effects were found.
Discussion(s): The results provide preliminary support for DBI-I as a strategy for reducing reward-based eating drive in a high-risk population
relative to no intervention. Copyright © 2021
Eating Behaviors, 43 (no pagination) :
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Cognitive dissonance
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Garbett,
K. M., Lewis-Smith, H., Chaudhry, A., Shroff, H., Dhillon, M., White, P., Diedrichs, P. C.
This pilot study evaluated the
acceptability and preliminary efficacy of a culturally adapted school-based body image intervention, Dove Confident Me, for use in urban India. Two
private schools in New Delhi were randomly assigned at the school level to receive either the five-session intervention facilitated by trained
psychologists or lessons-as-usual (control). Participants were Year 7 students (N = 166; Mage = 11.9 years). Students, facilitators, and observing
teachers, provided acceptability feedback. Fidelity was assessed. Body image and related measures were completed by students in a classroom setting
at pre-intervention, post-intervention, and two-month follow-up. Most students enjoyed (73.7 %) and understood (84.2 %) the intervention.
Facilitators (90 %) and observing teachers (70 %) reported that the learning objectives were achieved. Adherence and facilitator competence were
rated as very good. Body esteem improved significantly among intervention students at post-intervention and follow-up (Cohen's ds = .45-.46),
relative to control students. Positive affect also improved at post-intervention (d = .58). No significant effects on internalisation, life
engagement, eating pathology, self-esteem, or negative affect emerged. This study provides evidence for the acceptability and preliminary efficacy of
Dove Confident Me in urban India. Intervention refinements to increase acceptability and efficacy are recommended. Copyright © 2021 Elsevier Ltd. All
rights reserved.
Body image, 37 : 282-
290
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Ciao, A. C., Munson, B. R., Pringle, K. D., Roberts, S. R., Lalgee, I. A., Lawley, K. A., Brewster, J.
Objectives: Two randomized-controlled studies explored the feasibility,
acceptability, and efficacy of the EVERYbody Project, a gender-inclusive, diversity-focused, dissonance-based body image intervention for college
students. Method: Trial 1 (N = 98; 80% female, 14% male, and 6% gender-expansive) piloted the two-session intervention delivered by an expert
(faculty or staff) and peer cofacilitators compared to a waitlist control. Trial 2 (N = 141; 79% female, 15% male, and 6% gender-expansive) utilized
peer leaders, comparing the EVERYbody Project to a video and expressive writing intervention. Around half of the participants in both trials self-
identified in one or more specific marginalized identity category. Changes in eating disorder symptoms and risk factors were assessed through 1-month
follow-up. Trial 1 also assessed the intervention's impact on students with marginalized identities through qualitative interviews. Results: In
Trial 1, the EVERYbody Project produced greater reductions in eating disorder symptoms, internalized appearance norms, body dissatisfaction, and
negative affect compared to the waitlist control through 1-month follow-up, with medium effect sizes. The impact was similar in students with
marginalized and majority identities, and qualitative interviews suggested specific positives of the intervention. In Trial 2, there were significant
changes in two of four outcomes for participants in the EVERYbody Project compared to the video and expressive writing intervention, but overall, the
intervention impact was modest. Conclusions: The EVERYbody Project is a feasible and acceptable inclusive dissonance-based body image program. It
appears to be beneficial when delivered via experts, but research is needed to establish whether the program can be delivered using peer leaders with
greater impact. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement Public Health Significance-A
dissonance-based body image program that is inclusive of all college students appears to be beneficial when diversity in cultural body image
pressures is directly discussed and groups are led by at least one expert. Additional research is needed to assess whether college peer facilitators
can successfully deliver inclusive body image programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Journal of Consulting and Clinical Psychology, 89(4) : 301-315
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Buerger, Arne, Vloet,
Timo D., Haber, Lisa, Geissler, Julia M.
Context: Third-wave therapies have demonstrated efficacy as a treatment option for EDs in adulthood.
Data on the suitability for EDs in adolescence are lacking.\rObjective: To estimate the efficacy of third-wave interventions to reduce ED symptoms in
adolescents in randomized controlled trials (RCTs) and uncontrolled studies.\rData sources: We systematically reviewed the databases PubMed (1976-
January 2021), PsycINFO (1943-January 2021), and the Cochrane database (1995-January 2021) for English-language articles on third-wave therapies.
References were screened for further publications of interest.\rStudy selection: RCTs and pre-post studies without control group, comprising patients
aged 11 - 21 years (mean age = 15.6 years) with an ED diagnosis (anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder not
otherwise specified) investigating the efficacy of third-wave psychological interventions were included. Efficacy had to be evaluated according to
the Eating Disorder Examination or Eating Disorder Examination-Questionnaire, the Eating Disorder Inventory-2, the Eating Disorder Inventory-3, or
the Structured Interview for Anorexic and Bulimic\rDisorders for DSM-IV and ICD-10. The outcome assessed in the meta-analysis was the EDE total
score.\rData extraction: Independent extraction of data by two authors according to a pre-specified data extraction sheet and quality indicators.
\rData synthesis: We identified 1000 studies after removal of duplicates, assessed the full texts of 48 articles for eligibility, and included 12
studies with a total of 487 participants (female 97.3%/male 2.6%) in the qualitative synthesis and seven studies in the meta-analysis. Articles
predominantly reported uncontrolled pre-post trials of low quality, with only two published RCTs. Treatments focused strongly on dialectical
behaviour therapy (n = 11). We found moderate effects of third-wave therapies on EDE total score interview/questionnaire for all EDs (d =
Borderline
Personality Disorder and Emotion Dysregulation Vol 8 2021, ArtID 20, 8 :
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Balciuniene, V., Jankauskiene, R., Baceviciene, M.
Purpose: The aim
of this study was to test the effectiveness of an 8-week classroom education and mindfulness-based physical activity intervention for the promotion
of positive body image in female students. Method(s): A quasi-experimental study was carried out with 110 Lithuanian female students (mean age 21.5
+/- 3.5, range 19-35 years). Thirty students voluntarily participated in the intervention programme and 80 students volunteered in the assessment-
only control group. The intervention comprised five cognitive behavioural therapy classroom education sessions and mindfulness-based exercise (one
exercise workout per week). The intervention group was evaluated with a pre-test and post-test and the control group completed measures at parallel
times. Result(s): Compared with the control group participants, the intervention group participants reported greater improvements in positive body
image and a reduction in body dissatisfaction and drive for thinness and internalisation of stereotyped beauty ideals, with medium to large effects.
There were significant time x group interactions for pre-test to post-test changes in internalisation of beauty ideals, body area satisfaction, body
dissatisfaction and body appreciation. In all cases, the interaction reflected greater pre-test to post-test changes in the intervention group
compared with the control group, whose scores remained stable. A decrease in appearance orientation, overweight preoccupation, disordered eating and
physical activity was observed in the control group, but the effect sizes were low. Conclusion(s): The preliminary findings of this study support the
efficacy of cognitive behavioural therapy methods and mindfulness-based exercise intervention aimed to promote positive body image in student-aged
women. Future studies should test the efficacy of the introduced programme in larger randomised samples of young women. Level IV: Evidence obtained
from multiple time series with or without an intervention. Copyright © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland
AG.
Eating and Weight
Disorders., :
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Physical activity, exercise
Atkinson, M. J., Diedrichs, P. C.
Objective: Brief self-guided activities designed for focused and immediate benefits, termed microinterventions, have the potential to
aid reach and engagement in mental health interventions; however further validation is needed. This study evaluated effects of two microinterventions
for responding to appearance-ideal media on risk and protective factors for disordered eating. Method: Undergraduate women (N = 202, Mage = 19.90, SD
= 2.75) were allocated quasi-randomly to one of three 15-min video-based microinterventions (mindfulness, cognitive dissonance, educational control)
in the lab and assessed on state outcomes at baseline and immediate posttest. One week later, trait factors were assessed and participants underwent
an appearance-ideal media exposure task. Results: Both mindfulness and dissonance groups reported significant immediate benefits to state
appearance-ideal internalization, perceived sociocultural pressures and related distress, and mood, compared to educational control (Glass's DELTA
effect sizes = .40-.94), but not state weight or appearance satisfaction. At 1-week follow-up, mindfulness and dissonance groups demonstrated
improved trait appearance-ideal internalization (DELTA = .40 and .42), weight and shape concerns (DELTA = .27 [ns] and .44), and body appreciation
(DELTA = .39 and .46) compared to the educational control. There were no effects on trait perceived pressures, negative affect, or body image
psychological flexibility, and no differential changes in state outcomes from premedia to postmedia exposure. Discussion: Microinterventions using
mindfulness and dissonance techniques show promise for improving some risk and potential protective factors for disordered eating in the immediate
and short-term. Further research is required to substantiate their place within the spectrum of eating disorder prevention, early intervention and
treatment techniques. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
International Journal of Eating Disorders, 54(5) : 708-
720
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Mindfulness based
therapy, Cognitive dissonance
therapy, Technology, interventions delivered using technology (e.g. online, SMS)