Information about the types of eating disorders, some reasons why the military community are at risk, warning signs and how to get help. The Missouri Eating Disorders Council (MOEDC) created this document so support service members, veterans and their families.

This dataset comprises survey and interview results from an investigation into the efficacy of motivational interviewing in engaging individuals with anorexia nervosa in treatment. Responses from 47 participants (2 male and 45 female aged between 16 and 37 years) are arranged in a database.Participants were part of an inpatient anorexia nervosa population, assessed over three waves; at admission to hospital (baseline), and at 2 and 6 week follow up. Assessment were conducted face to face for participants in hospital and via the telephone for those who had been discharged.The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) was used for the study.Date coverage: 2005-10-01 - 2008-08-01Location: Adelaide, South Australia, Australia

Introduction: Eating Disorders (EDs) are serious psychiatric disorders, impacting physical and psychosocial functioning, often with a chronic course and high mortality rates. The two continua model of mental health states that mental health is a complete state, that is, not merely the absence of mental illness, but also the presence of mental health. This model was studied among ED patients by examining the presence and correlates of well-being and psychopathology. In addition, the levels of well-being were compared to the Dutch general population.Method: A total of 468 female ED patients participated in this study during application and intake at a specialized ED treatment Center in the Netherlands. They filled out questionnaires about well-being (MHC-SF), general psychopathology (OQ-45), and ED psychopathology (EDE-Q). Categorical andmean well-being levels were calculated. Also, the relationships between these variables were examined with Pearson correlation and multiple hierarchical regression analysis.Results: ED patients showed lower levels of emotional, psychological, and social well-being on average compared to the general population. About 26% of the ED patients experienced low levels of well-being (languishing). However, also 13% experienced high levels of well-being (flourishing), varying between 9% in Anorexia Nervosa to 25% in Binge Eating Disorder. ED psychopathology and general well-being showed a moderate negative correlation. For patients with Bulimia Nervosa and Binge Eating Disorder however no such correlation was found. Lower general psychopathology, not having a history of hospitalization for the ED, and adaptive personal functioning were correlated with well-being among ED patients.Conclusion: This study shows initial support for the two continua model of mental health among ED patients. Psychopathology and well-being should be considered as related, but distinct dimensions of mental health in ED patients. Further research should focus on the possible reciprocal relationships between psychopathology and well-being during recovery. It is recommended to monitor well-being during treatment and to implement interventions for well-being to realize complete recovery for those patients with inadequate levels of well-being.

Age-Standardized incidence rates of anorexia nervosa for Alberta, expressed as per 100,000 population.

Age-Standardized incidence rates of anorexia nervosa for Alberta, expressed as per 100,000 population.

BackgroundEvidence for anorexia and bulimia in relation to the risk of ulcerative colitis (UC) is limited and inconsistent. The objective of this research was to utilize bi-directional, two-sample Mendelian randomization (MR) analysis to predict the causal association between anorexia nervosa and bulimia nervosa with UC.MethodsThe genome-wide association studies (GWAS) provided data for anorexia and bulimia from the UK Biobank, utilizing single-nucleotide polymorphisms (SNP) as instrumental variables. Additionally, genetic associations with UC were collected from various sources including the FinnGen Biobank, the UK Biobank and the International Inflammatory Bowel Disease Genetics Consortium (IIBDGC). The main analytical approach utilized in this study was the inverse-variance-weighted (IVW) method. To evaluate horizontal pleiotropy, the researchers conducted MR-Egger regression and MR-PRESSO global test analyses. Additionally, heterogeneity was assessed using the Cochran’s Q test.ResultsThis study found a negative association between genetically predicted bulimia (OR = 0.943, 95% CI: 0.893–0.996; p = 0.034) and the risk of UC in the IIBDGC dataset, indicating that individuals with bulimia have approximately a 5.7% lower risk of developing UC. No association was observed in the other two datasets. Conversely, genetically predicted anorexia was not found to be causally associated with UC. In bi-directional Mendelian randomization, UC from the IIBDGC dataset was negatively associated with the risk of anorexia (OR = 0.877, 95% CI: 0.797–0.965; p = 0.007), suggesting that UC patients have approximately a 12.3% lower risk of developing anorexia, but not causally associated with bulimia.ConclusionGenetically predicted bulimia may have a negative association with the onset of UC, while genetically predicted anorexia does not show a causal relationship with the development of UC. Conversely, genetically predicted UC may have a negative association with the development of anorexia.

BackgroundEvidence for anorexia and bulimia in relation to the risk of ulcerative colitis (UC) is limited and inconsistent. The objective of this research was to utilize bi-directional, two-sample Mendelian randomization (MR) analysis to predict the causal association between anorexia nervosa and bulimia nervosa with UC.MethodsThe genome-wide association studies (GWAS) provided data for anorexia and bulimia from the UK Biobank, utilizing single-nucleotide polymorphisms (SNP) as instrumental variables. Additionally, genetic associations with UC were collected from various sources including the FinnGen Biobank, the UK Biobank and the International Inflammatory Bowel Disease Genetics Consortium (IIBDGC). The main analytical approach utilized in this study was the inverse-variance-weighted (IVW) method. To evaluate horizontal pleiotropy, the researchers conducted MR-Egger regression and MR-PRESSO global test analyses. Additionally, heterogeneity was assessed using the Cochran’s Q test.ResultsThis study found a negative association between genetically predicted bulimia (OR = 0.943, 95% CI: 0.893–0.996; p = 0.034) and the risk of UC in the IIBDGC dataset, indicating that individuals with bulimia have approximately a 5.7% lower risk of developing UC. No association was observed in the other two datasets. Conversely, genetically predicted anorexia was not found to be causally associated with UC. In bi-directional Mendelian randomization, UC from the IIBDGC dataset was negatively associated with the risk of anorexia (OR = 0.877, 95% CI: 0.797–0.965; p = 0.007), suggesting that UC patients have approximately a 12.3% lower risk of developing anorexia, but not causally associated with bulimia.ConclusionGenetically predicted bulimia may have a negative association with the onset of UC, while genetically predicted anorexia does not show a causal relationship with the development of UC. Conversely, genetically predicted UC may have a negative association with the development of anorexia.

The HealthLink BC Mental Health and Substance Use (MHSU) data set includes the following: Programs that offer early intervention, transitional care or other services that supplement and facilitate primary and adjunctive therapies; which offer community mental health education programs; or which link people who are in need of treatment with appropriate providers. Programs that provide preventive, diagnostic and treatment services in a variety of community and hospital-based settings to help people achieve, maintain and enhance a state of emotional well-being, personal empowerment and the skills to cope with everyday demands without excessive stress or reliance on alcohol or other drugs. Treatment may include emotional support, introspection and problem-solving assistance using a variety of modalities and approaches, and medication, as needed, for individuals who have a substance use disorder involving alcohol and/or other drugs or for people who range from experiencing difficult life transitions or problems in coping with daily living to those with severe, chronic mental illnesses that seriously impact their lives. Multidisciplinary programs, often offered on an inpatient basis with post-discharge outpatient therapy, that provide comprehensive diagnostic and treatment services for individuals who have anorexia nervosa, binge-eating disorder, bulimia or a related eating disorder. Treatment depends on the specific type of eating disorder involved but typically involves psychotherapy, nutrition education, family counseling, medication and hospitalization, if required, to stabilize the patient's health. Alliance of Information & Referral Systems (AIRS) / 211 LA County taxonomy is the data classification used for all HealthLink BC directory data, including this MHSU data set (https://www.airs.org/i4a/pages/index.cfm?pageid=1). AIRS taxonomy and data definitions are protected by Copyright by Information and Referral Federal of Los Angeles County, Inc (https://211taxonomy.org/subscriptions/#agreement)

Eating disorders (EDs) are characterized by disturbances in eating behavior and occur worldwide, with a lifetime prevalence of 2 to 5%. Their etiology is complex and multifactorial, involving a complex interplay between genetic, biological, psychological, sociocultural, and environmental factors. They are more common among females than males and may be associated with medical and psychiatric complications, impaired functioning, and decreased quality of life. This narrative review aims at providing an updated contribution to the current understanding of gender differences in eating disorders (EDs) focusing on male population to foster more targeted and effective clinical interventions. A comprehensive review of the scientific literature was conducted by analyzing several major databases, including PubMed, PsycINFO, and Google Scholar. Only in recent years, there has been increased attention on the male population, revealing multiple differences between genders in terms of prevalence, onset, phenomenology, diagnosis, comorbidities, and outcomes of EDs. Moreover, the relationship between different sexual orientations and/or gender identities and EDs is an emerging field of study. Data suggest an increase in eating disorders (EDs) also among the male population underlines the importance that healthcare personnel of all specialties acquire basic competencies for adequately tackling these disorders in a gender perspective. In particular, prevention and early intervention, especially during critical developmental periods like puberty and adolescence, are crucial to avoid permanent damage. Future research and public health initiatives involving schools and families and targeting males should be addressed to promote a healthy relationship with food and body image, reduce stigma, and encourage people to seek help when needed.

IntroductionRestrictive type of anorexia nervosa (AN) is still one of the most severe eating disorders worldwide with an uncertain prognosis. Patients affected by AN should be encouraged to undertake psychiatric care and psychotherapy, but whether they should necessarily be included in careful dental care or not may still be questionable. Even though there is a constantly increasing number of AN studies, there are just a few data about the youngest group of AN children and adolescents aged < 18.MethodologyThis case-control study aimed to compare the dental health and gingival inflammation level in female adolescent inpatients affected by severe AN restrictive subtype vs. controls. Based on clinically confirmed 117 AN cases (hospitalized in years 2016–2020 in public Psychiatric Unit, BMI < 15 kg/m2, mean age 14.9 ± 1.8), the dental status has been examined regarding the occurrence of caries lesions using Decay Missing Filling Teeth (DMFT), erosive wear as Basic Erosive Wear Examination (BEWE), gingival condition as Bleeding on Probing (BOP) and plaque deposition as Plaque Control Record (PCR). The results were compared with age-matched 103 female dental patients (BMI 19.8 ± 2.3 kg/m2, age 15.0 ± 1.8, p = 0.746) treated in a public University dental clinic.ResultsAN patients were found to present a higher incidence of oral-related complications according to dental status (DMFT 3.8 ± 4.5 vs. 1.9 ± 2.1, p = 0.005), erosive tooth wear (BEWE 18.9 vs. 2.9%, p < 0.001), less efficient in controlling plaque (PCR 43.8 vs. 13.7%, p < 0.001) and gingival inflammation (BOP 20.0 vs. 3.9%, p < 0.001) compared with female adolescents. In the AN group, a significant correlation between BOP, BEWE, and duration of AN disease (p < 0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected (p < 0.05).ConclusionsAlthough the obtained results did not reveal any severe oral status, our findings indicated impaired dental and gingival conditions in young anorexics. Considering AN's potential role in oral health, it is essential to monitor dental treatment needs and oral hygiene levels in their present status to prevent forward complications in the future.

ObjectiveAnorexia nervosa (AN) is a disorder characterized by atypical patterns of reward valuation (e.g. positive valuation of hunger). Atypical reward processing may extend into social domains. If so, such findings would be of prognostic significance as impaired social functioning predicts worse outcome. We explore neural circuits implicated in social reward processing in individuals with a history of AN who are weight-restored relative to controls and examine the effects of illness course on the experience of social value.Method20 weight-restored individuals with a history of AN (AN-WR) and 24 healthy control (HC) participants were assessed using fMRI tasks that tapped social reward: smiling faces and full human figures that varied in attractiveness and weight.ResultsAN-WR differed from HC in attractiveness ratings by weight (negatively correlated in AN-WR). While there were no significant differences when viewing smiling faces, viewing full figures resulted in decreased activation in regions implicated in reward valuation (the right caudate) for AN-WR and this region was negatively correlated with a sustained course of the disorder. Exploratory whole brain analyses revealed reduced activation in regions associated with social reward, self-referential processing, and cognitive reappraisal (e.g., medial prefrontal cortex, striatum, and nucleus accumbens) with sustained disorder course.DiscussionThe rewarding value of full body images decreases with a sustained disorder course. This may reflect an extension of atypical reward processing documented in AN-WR, perhaps as a function of starvation dampening visceral motivational signals; the deployment of cognitive strategies that lessen the experience of reward; and/or the nature of the stimuli themselves as provocative of eating disorder symptoms (e.g., thin bodies). These findings did not extend to smiling face stimuli. Advances in technology (e.g., virtual avatars, text messaging) may provide novel means to build relationships, including therapeutic relationships, to support improved social connections without threats to symptom provocation.

Body image disturbance is a core characteristic of anorexia nervosa which might be grounded in distortions in schematic body representations. In line with this, several studies showed that when walking through door-like apertures of different widths individuals with anorexia nervosa move as if their bodies are larger than they actually are. They turn their body at a higher aperture/shoulder width ratio than healthy individuals. We examined whether oversized body-scaled motoric behaviors may not be restricted to anorexia nervosa but concern a general feature of negative body image attitudes. Therefore, we investigated the relation between negative body image as assessed with shape and weight concerns subscales of the Eating Disorder Examination Questionnaire and aperture/shoulder width turning ratios in women with a healthy weight (N = 62). We found that a more negative body image was unrelated to higher aperture/shoulder width turning ratios. Bayes analysis provided moderate evidence for the null hypothesis that spontaneous body-scaled motoric behaviors are not involved in negative body image. Future studies should disentangle whether being underweight per se is related to distinctive spontaneous body-scaled motoric behaviors or whether an ‘oversized’ body schema is a unique characteristic of anorexia nervosa, potentially contributing to the persistence of this disorder.

The HealthLink BC Mental Health and Substance Use (MHSU) data set includes the following: Programs that offer early intervention, transitional care or other services that supplement and facilitate primary and adjunctive therapies; which offer community mental health education programs; or which link people who are in need of treatment with appropriate providers. Programs that provide preventive, diagnostic and treatment services in a variety of community and hospital-based settings to help people achieve, maintain and enhance a state of emotional well-being, personal empowerment and the skills to cope with everyday demands without excessive stress or reliance on alcohol or other drugs. Treatment may include emotional support, introspection and problem-solving assistance using a variety of modalities and approaches, and medication, as needed, for individuals who have a substance use disorder involving alcohol and/or other drugs or for people who range from experiencing difficult life transitions or problems in coping with daily living to those with severe, chronic mental illnesses that seriously impact their lives. Multidisciplinary programs, often offered on an inpatient basis with post-discharge outpatient therapy, that provide comprehensive diagnostic and treatment services for individuals who have anorexia nervosa, binge-eating disorder, bulimia or a related eating disorder. Treatment depends on the specific type of eating disorder involved but typically involves psychotherapy, nutrition education, family counseling, medication and hospitalization, if required, to stabilize the patient's health. Alliance of Information & Referral Systems (AIRS) / 211 LA County taxonomy is the data classification used for all HealthLink BC directory data, including this MHSU data set (https://www.airs.org/i4a/pages/index.cfm?pageid=1). AIRS taxonomy and data definitions are protected by Copyright by Information and Referral Federal of Los Angeles County, Inc (https://211taxonomy.org/subscriptions/#agreement)

The aim of this publication is to provide information about the key differences in healthcare between people with a learning disability and those without. It contains aggregated data on key health issues for people who are recorded by their GP as having a learning disability, and comparative data about a control group who are not recorded by their GP as having a learning disability. Six new indicators were introduced in the 2022-23 reporting year for patients with and without a recorded learning disability. These relate to: • Patients with an eating disorder • Patients with both an eating disorder and autism diagnosis • Patients with a diagnosis of autism who are currently treated with antidepressants More information on these changes can be found in the Data Quality section of this publication. Data has been collected from participating practices using EMIS and Cegedim Healthcare Systems GP systems.

Statistical analyses: Normal distribution was determined by Kolmogorov-Smirnov test. Differences between groups:a Mann-Whitney-U-test, data expressed as median (25th percentile/75th percentile)b t-test, data expressed as mean ± standard deviationc χ2-tests.Demographic and socioeconomic characteristics, duration of disease and subtypes of anorexia nervosa of the anorexia nervosa study population.

Eating disorders (EDs) are a complex group of psychiatric conditions that involve dysfunctional eating patterns, nutritional alterations, and other comorbid psychopathologies. Some women with EDs may develop problematic internet use while they attempt to get information on dieting/weight control or get online support from people with similar problems. They may also drift toward tobacco smoking as a method to regulate their weight or to cope with their weight-related dysphoria. The occurrence of these conditions in EDs may prolong disease course and impede recovery. This study used structural equation modeling to investigate nutritional status (noted by body mass index, BMI), depression psychopathology, internet addiction (depicted by the Internet Addiction Test), Facebook addiction (depicted by the Bergen Facebook Addiction Scale), and smoking among 123 Spanish women diagnosed with EDs (mean age = 27.3 ± 10.6 years). History of hospitalization, marital status, age, and the level of education predicted BMI in certain ED groups. BMI did not predict depression, but it predicted internet addiction, Facebook addiction, and smoking in certain ED groups. Depression did not predict BMI, internet/Facebook addition, or smoking in any ED group. Some sociodemographic and clinical variables had indirect effects on depression, internet addiction, and Facebook addiction while age was the only variable expressing a direct effect on all outcome measures. Age, education, and history of prolonged treatment predicted smoking in certain ED patients. The findings signify that a considerable target for interventional strategies addressing nutritional and addictive problems in EDs would be women with high BMI, history of hospitalization, history of prolonged treatment, who are particularly young, single, and less educated. Replication studies in larger samples, which comprise various subtypes of EDs from both genders, are warranted to define the exact interaction among the addressed variables.

Body checking is a common behavior in both the general population and individuals with body image disturbances. Cognitive-behavioral theories postulate that body checking reduces negative emotions in the short term, but over time contributes to the development and maintenance of eating disorder pathology. So far, few experimental studies have assessed these longer-term consequences, mostly under laboratory conditions, yielding inconsistent findings, and without considering individual vulnerability and specific personality traits. In a naturalistic experimental cross-over design, women with low (n = 76) vs. high (n = 103) body concern completed an online survey on trait characteristics (e.g., intolerance of uncertainty). After a two-day baseline to assess the daily amount of habitual body checking, participants underwent two three-day experimental conditions in randomized order, in which they were asked to exhibit typical vs. threefold increased body checking. Before and after conditions, participants completed state measures of eating disorder symptoms, body dissatisfaction, affect, and general pathology online. In women with high body concern, body image-related symptoms (i.e., drive for thinness, body dissatisfaction) and negative affect worsened in the increased body checking condition, whereas in the typical body checking condition, positive affect increased and no negative impact emerged. Conversely, women with low body concern remained unaffected, except for higher drive for thinness following the increased condition. Bulimic and depressive symptoms did not change in either group. The inclusion of intolerance of uncertainty from an exploratory perspective generally did not impact the results. Our findings regarding the high-risk group underscore the potential etiological relevance of body checking for body image disturbances and eating disorders. For individuals at risk and those already affected by eating disorders, it seems important to address individual body checking as early as possible within psychoeducation to prevent a presumably harmful increase in this behavior. Personality factors influencing vulnerability to body checking need to be further examined.

Introduction: Orthorexia nervosa (ON) is a condition that is characterized by a pathological obsession with eating foods one considers healthy and has recently been suggested as a new possible diagnosis. However, there is limited published research on health professionals’ recognition, ideas and opinions regarding the diagnosis and classification of ON.Purpose: The aim of this mixed-methods study was to gain insight into the perspectives of clinically active health professionals on ON, and into their opinions on if and how the disorder should be classified.Results: Psychologists, psychiatrists, dietitians and physiotherapists in the Netherlands (n = 160) participated by responding to a self-administered questionnaire. Most health professionals (78%) reported that they thought that ON should have its own diagnosis. This opinion was more common in physical health professionals than in mental health professionals. A majority (74%) agreed that ON fits within the Diagnostic and Statistical Manual of Mental Disorders (DSM) category Eating and Feeding Disorders. Interviews with 15 mental health professionals were analyzed using code frequencies and continuous comparisons. Mental health professionals reported believing that ON is prevalent in the general population and that a separate diagnosis would have both advantages and disadvantages for health professionals and patients. Interview participants described the typical ON patient as being young, female, and highly educated; characteristics that overlap with typical anorexia nervosa and obsessive compulsive disorder cases.Conclusion: The results suggest that some health professionals from a heterogenous sample in the Netherlands think ON should have a separate diagnosis in the DSM, however, the study needs to be replicated to allow for further generalization. Methodological design of this study may be utilized in future research with similar aims. The findings can serve as a foundation for investigation of individuals’ experiences of distress caused by ON, and further refinement of the diagnostic criteria.

BackgroundAnorexia nervosa (AN) can significantly affect cognitive well-being. Cognitive remediation therapy (CRT) is regarded as one of the effective treatments for cognitive impairment in some mental illnesses such as schizophrenia, bipolar disorder, and attention deficit. For this reason, this systematic review and meta-analysis aim to assess the effectiveness of CRT in patients with AN.MethodsWe conducted a search of Medline, ClinicalTrials.gov, and the Cochrane Database of Systematic Reviews from the inception of each database through April 8, 2023. Randomized clinical trials evaluating the effectiveness of CRT in comparison to placebo or other psychological treatments in patients with AN were included. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool. For meta-analysis, effect sizes were measured using mean difference (MD) utilizing the random-effects model and inverse variance (IV) technique. To evaluate the certainty of the evidence, we applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. The study was registered in PROSPERO, ID: CRD42023411784.ResultsIn the systematic review, six studies were included, of which four underwent meta-analysis. Among these, three trials encompassing 413 participants showed that CRT was associated with improved cognitive flexibility compared to control at the end of treatment (MD = -0.21, 95% CI [-0.44, 0.02], P=0.81, I2 = 0%). In two trials with 143 patients, those who received CRT showed similar effects on the severity of AN symptoms compared to the control group in the self-reporting questionnaires: EDE-Q (MD = -0.25, 95% CI [-0.76, 0.27], P=0.77, I2 = 0%) and EDEQOL (MD = -0.19, 95% CI [-0.41, 0.03], P=0.84, I2 = 0%).ConclusionCRT did not show a statistically significant difference compared to the control group in improving abstract thinking skills and quality of life in individuals with AN. That indicates that CRT’s efficacy remains inconclusive. Further research with larger, more diverse samples is needed to determine its long-term effects and potential benefits.Systematic review registrationPROSPERO, identifier CRD42023411784.