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The relationship between diabetes mellitus and attention deficit hyperactivity disorder: A systematic review and meta-analysis.
Ai, Y, Zhao, J, Liu, H, Li, J, Zhu, T
Frontiers in pediatrics. 2022;10:936813
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Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder characterised by inattention and/or hyperactivity/impulsivity. Several studies have found bidirectional associations between ADHD and diabetes mellitus (DM). The aims of this study were to assess the prevalence of ADHD in DM patients as well as the prevalence of DM in ADHD patients compared with those without ADHD, and to explore the impacts of ADHD on glycaemic control in patients with DM. This study is a systematic review and meta-analysis of 17 articles; five were cohort studies, three were case-control studies, and nine were cross-sectional studies. Results through the pooled analyses suggest an important comorbid relationship between diabetes and ADHD. Overall, there was an increase in T2DM of 166% and 51% in children and adults with ADHD, respectively, relative to those without ADHD. Furthermore, there was an overall 37% increase in T1DM in children with ADHD. Authors conclude that further studies are needed to better understand the relationship between ADHD and DM. Additionally, it is important to take into consideration the type of DM if this association is different in various age groups (children and adults).
Abstract
BACKGROUND This study aims to investigate the prevalence estimate of diabetes mellitus (DM) among people with attention deficit hyperactivity disorder (ADHD) as well as the prevalence of ADHD among those with DM. In addition, the impact of ADHD on glycemic control in patients with DM was also assessed using a systematic review and meta-analysis of currently available published data. MATERIALS AND METHODS The PubMed, Embase, Web of Science, and PsycInfo databases were searched for potential studies. Two reviewers independently selected studies according to the inclusion and exclusion criteria. All pooled analyses were conducted using the random-effects models on Review Manager 5.3. RESULTS Seventeen observational studies were included. The pooled results showed an increase in the prevalence of DM among patients with ADHD versus those without ADHD [type 1 DM OR 1.37 (95% CI: 1.17-1.61); type 2 DM OR 2.05 (95% CI: 1.37-3.07)]. There was an overall 35% increase in the prevalence of ADHD among patients with type 1 DM [OR: 1.35 (95% CI: 1.08-1.73)]. Children with type 1 DM and ADHD had higher levels of hemoglobin A1c [standardized mean of differences: 0.67 (95% CI: 0.48-0.86)], and prevalence of hypoglycemic and ketoacidosis index compared with those without ADHD. CONCLUSION Our study revealed the bidirectional associations between ADHD and DM. Patients with ADHD and type 1 DM comorbidities were more likely to have poorer diabetes control. More studies are needed to confirm this association and elucidate the underlying mechanism.
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Evaluation of the effects of fear and anxiety on nutrition during the COVID-19 pandemic in Turkey.
Kaya, S, Uzdil, Z, Cakiroğlu, FP
Public health nutrition. 2021;24(2):282-289
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The current treatment for COVID-19 is mainly focused on infection control and effective vaccine therapy because of extensive measures to reduce person-to-person transmission. However, the psychosocial repercussions of the COVID-19 pandemic have not yet been fully considered. The aim of this study was to evaluate the nutritional attitudes and habits that changed during the COVID-19 pandemic due to fear and anxiety status. The study included 1012 individuals (n=827 female, n=185 male) living in Turkey with an age range between 18 and 65 years. Results indicate: - that 26·7 % of the participants used nutritional supplements in particular vitamin C, vitamin D, vitamin B12 and zinc. - an inverse association between anxiety, fear and nutrition habits during the COVID-19 pandemic. - differences in shopping preferences, processes applied to foods and vegetables and fruits due to the fear of virus contamination from the surfaces. Authors conclude that continuous surveillance of the psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide.
Abstract
OBJECTIVE The aim of this study was to evaluate effects of fear and anxiety on nutrition during the COVID-19 pandemic. DESIGN Participants were recruited by an online survey in this cross-sectional study. The questionnaire included general demographic characteristics, level of fear and anxiety, and nutritional habits. The Fear of COVID-19 Scale (FCV-19S) and Generalized Anxiety Disorder-7 test (GAD-7) were used to determine fear and anxiety. SETTING Turkey. PARTICIPANTS A total sample consisted of 1012 adults. RESULTS In pandemic, fear and anxiety caused individuals to skip breakfast and snacks less, but more at lunch. A positive significant correlation was observed between the increased consumption of yoghurt, cheese and water and FCV-19S scores. There was a positive significant correlation between cheese, legume, nuts-seeds, cake-cookies, dessert and tea consumption and GAD-7 scores. A 1-unit increase in FCV-19S scores affected 1·04 times of increased consumption of yoghurt, kefir, cheese, nuts-seeds, fruit (dry) and rice-pasta. A 1-unit increase in GAD-7 scores affected 1·03 times of increased consumption of egg and fruit (fresh); 1·04 times of increased consumption of cheese and other vegetables; 1·05 times of increased consumption of milk, meat, poultry, fish, legume, nuts-seeds, fruit (dry), cake-cookies and tea; 1·07 times of increased consumption of rice-pasta and coffee and 1·08 times of increased consumption of bread and dessert. CONCLUSIONS In pandemic, anxiety and fear led to changes in individuals' nutritional habits and food preferences. Continuous surveillance of psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide. In addition, the effects of these psychological problems on nutrition should be evaluated.
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Effects of Probiotics on Anxiety, Stress, Mood and Fitness of Badminton Players.
Salleh, RM, Kuan, G, Aziz, MNA, Rahim, MRA, Rahayu, T, Sulaiman, S, Kusuma, DWY, Adikari, AMGCP, Razam, MSM, Radhakrishnan, AK, et al
Nutrients. 2021;13(6)
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Exercise has been shown to improve fitness, wellbeing, and health. However, strenuous exercise may be detrimental physiologically, as well as affecting psychological health. The aim of this study was to determine the effects of daily probiotic supplementation on anxiety, stress, mood and fitness levels among competitive badminton players. This study was a randomised, placebo-controlled study. Recruited participants (n=30) were randomly divided into the probiotic group and the control group. The participants were given treatments for six weeks without altering the training schedule of the athletes. Results showed that stress and anxiety in badminton players could be alleviated with the daily consumption of probiotics for six weeks. Additionally, probiotics supplementation increased aerobic capacity. Authors conclude that probiotic supplements could be beneficial for athletes to enhance their mental state and physical performance. Thus, probiotic supplementation that may influence the regulation of pathways (neuro-endocrine) and mechanism of action in response to physical and psychological stressors encountered by badminton players should further studied.
Abstract
BACKGROUND Reports of probiotic consumption on athletes' performance are debatable due to their equivocal results. There is a need for more evidence on the effects of probiotic intake on psychological state and fitness level. Thus, this study determined the effects of daily probiotic consumption on competitive anxiety, perceived stress and mood among university badminton players, besides their fitness like aerobic capacity, strength, speed, leg power and agility. METHODS Thirty university badminton players aged from 19 to 22 years old were randomly divided equally into two groups, where the probiotic group (PG; n = 15) received a drink that contained Lactobacillus casei Shirota (3 × 1010 CFU) and placebo group (CG; n = 15) a placebo drink for six weeks. Anxiety, stress and mood levels were determined using the CSAI-2R, PSS and BRUMS questionnaires, respectively. Fitness levels were measured using by subjecting the players to 20-m shuttle runs (aerobic capacity), handgrips (muscular strength), vertical jumps (leg power), 40-m dash (speed) and T-test (agility). The Student's t-test (p < 0.05) was used to determine the differences between PG and CG players. RESULTS After six weeks, the anxiety and stress levels of PG players significantly decreased by 16% (p < 0.001) and 20% (p < 0.001), respectively, but there were no significant changes detected in CG players. Supplementation of probiotics also improved aerobic capacity in PG players by 5.9% (p < 0.001) but did not influence the speed, strength, leg power and agility. CONCLUSIONS Probiotics supplementation showed improved aerobic capacity and relieve anxiety and stress. However, further studies need to be carried out to determine the mechanisms through which probiotic intake produces these effects.
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Pilot trial of a group cognitive behavioural therapy program for comorbid depression and obesity.
Lores, T, Musker, M, Collins, K, Burke, A, Perry, SW, Wong, ML, Licinio, J
BMC psychology. 2020;8(1):34
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Depression and obesity are significant global health concerns. Depression can significantly impact physical health and reduced immune function. The aim of this study was to examine the potential benefits of a novel group psychological intervention program. The study is a preliminary quasi-experimental (single-arm) before-after pilot trial of a newly developed group-based psychological intervention program for people with depression and comorbid obesity. The program consisted of 10 two-hour group sessions held weekly. A total of 24 participants were recruited to the program across two pilot groups. Results indicate that there was a significant reduction in participants’ depression and anxiety scores by program-end. Some evidence also shows improvements in weight-related negative cognitions. Authors conclude that the group therapy program therefore has considerable potential to be effective in helping people enjoy better mental health and improve health outcomes.
Abstract
BACKGROUND Depression and obesity are significant global health concerns that commonly occur together. An integrated group cognitive behavioural therapy program was therefore developed to simultaneously address comorbid depression and obesity. METHODS Twenty-four participants (63% women, mean age 46 years) who screened positively for depression with a body mass index ≥25 were recruited from a self-referred general population sample. The group therapy program (10 two-hour weekly sessions) was examined in a single-arm, before-after pilot trial, conducted in a behavioural health clinic in Adelaide, Australia. Primary outcomes included survey and assessment-based analyses of depression, anxiety, body image, self-esteem, and weight (kg), assessed at four time-points: baseline, post-intervention, three-months and 12-months post program. Eighteen participants (75%) completed the program and all assessments. RESULTS Significant improvements in depression, anxiety, self-esteem and body shape concern scores, several quality of life domains, eating behaviours and total physical activity (among others) - but not weight - were observed over the course of the trial. CONCLUSIONS Results from this pilot trial suggest that combining interventions for depression and obesity may be useful. Further development of the program, particularly regarding the potential for physical health benefits, and a randomised controlled trial, are warranted. TRIAL REGISTRATION Trial registration: ANZCTR, ACTRN12617001079336, 13 July 2017. Retrospectively registered after date of the first consent (6 July 2017), but before the date of the first intervention session (20 July 2017).
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Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial.
Lycett, D, Aveyard, P, Farmer, A, Lewis, A, Munafò, M
BMJ open. 2020;10(1):e032271
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Weight gain is a well-known consequence of smoking cessation. The aim of this study was to compare standard stop smoking behavioural support with an intervention that, in addition to providing standard stop smoking support, included personalised weight management support, provided by Slimming World. This study is a parallel group, individually randomised controlled trial. Participants were randomised (1:1) to usual care or Slimming World with usual care. Stop smoking advisors were unaware of the randomisation sequence. Results showed that referral to the Slimming World programme plus usual stop smoking support achieved significantly less weight gain than usual stop smoking support alone. Furthermore, percentage quit was no worse in the treatment than the control group. Authors conclude that referral to a behavioural weight loss programme may be a pragmatic option within stop smoking clinics.
Abstract
INTRODUCTION Most people who stop smoking gain weight. Dietary modification may seem an obvious solution, but food restriction may increase cigarette craving and smoking relapse. TRIAL DESIGN An unblinded parallel randomised controlled trial. METHODS Participants were adult smokers with a body mass index greater or equal to 23 kg/m2. Setting was National Health Service commissioned Stop Smoking Services, interventions were referral to a commercial weight management programme, plus stop smoking support (treatment group), compared with stop smoking support alone (control group). Objective was to compare weight change between interventions in smoking abstainers and not abstinent rates in all. Primary outcome was change in weight (kg) at 12 weeks. Randomisation sequence was computer generated and concealed until allocation. RESULTS Seventy-six participants were recruited, 37 were randomised to the treatment group and 39 to the control group. Change in weight was analysed in long-term abstainers (13 treatment, 14 control) only because the aim was to prevent weight gain associated with smoking cessation. Abstinence was analysed on an intention-to-treat basis (37 treatment, 39 control). At 12 weeks weight gain was less in the treatment than the control group with an adjusted mean difference of -2.3 kg 95% CI (-4.4 to -0.1). Craving scores were lower (Mood and Physical Symptoms Scale craving domain -1.6 (-2.7 to -0.5)) and quit rates were higher in the treatment than the control group (32% vs 21%), although the trial was not powered to superiority in cravings and quit rates. No adverse events or side effects were reported. CONCLUSION In people who are obese and want to quit smoking, these data provide modest encouragement that providing weight management at the time of quitting may be helpful. Those who are not obese, but who are informed about potential weight gain during their quit attempt, were uninterested in a weight management programme. TRIAL REGISTRATION NUMBER ISRCTN65705512.
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People with Suspected COVID-19 Symptoms Were More Likely Depressed and Had Lower Health-Related Quality of Life: The Potential Benefit of Health Literacy.
Nguyen, HC, Nguyen, MH, Do, BN, Tran, CQ, Nguyen, TTP, Pham, KM, Pham, LV, Tran, KV, Duong, TT, Tran, TV, et al
Journal of clinical medicine. 2020;9(4)
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COVID-19 has been spreading to a growing number of countries and is recognized as a global health concern that has set global public health institutions on high alert. Improving health literacy is a strategic approach to preventing and controlling diseases. The aim of this study was to investigate the association of suspected COVID-19 symptoms (S-COVID-19-S) with depression and health related quality of life (HRQoL), and the effect modification of health literacy on the associations among people who visited outpatient departments. This is a cross-sectional study which recruited participants (aged between 18 and 85 years) from outpatient departments of six hospitals and three health centers across Vietnam. Results indicate that participants with S-COVID-19-S had a higher likelihood of depression and lower HRQoL. Whereas, those participants having S-COVID-19-S and with higher health literacy had a low occurrence of depression and better HRQoL compared to those people with lower health literacy. Authors conclude that health literacy can help to protect the mental health and HRQoL of people with S-COVID-19-S during the pandemic.
Abstract
The coronavirus disease 2019 (COVID-19) epidemic affects people's health and health-related quality of life (HRQoL), especially in those who have suspected COVID-19 symptoms (S-COVID-19-S). We examined the effect of modifications of health literacy (HL) on depression and HRQoL. A cross-sectional study was conducted from 14 February to 2 March 2020. 3947 participants were recruited from outpatient departments of nine hospitals and health centers across Vietnam. The interviews were conducted using printed questionnaires including participants' characteristics, clinical parameters, health behaviors, HL, depression, and HRQoL. People with S-COVID-19-S had a higher depression likelihood (OR, 2.88; p < 0.001), lower HRQoL-score (B, -7.92; p < 0.001). In comparison to people without S-COVID-19-S and low HL, those with S-COVID-19-S and low HL had 9.70 times higher depression likelihood (p < 0.001), 20.62 lower HRQoL-score (p < 0.001), for the people without S-COVID-19-S, 1 score increment of HL resulted in 5% lower depression likelihood (p < 0.001) and 0.45 higher HRQoL-score (p < 0.001), while for those people with S-COVID-19-S, 1 score increment of HL resulted in a 4% lower depression likelihood (p = 0.004) and 0.43 higher HRQoL-score (p < 0.001). People with S-COVID-19-S had a higher depression likelihood and lower HRQoL than those without. HL shows a protective effect on depression and HRQoL during the epidemic.
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Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: a systematic review.
Toumpanakis, A, Turnbull, T, Alba-Barba, I
BMJ open diabetes research & care. 2018;6(1):e000534
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Diabetes can cause a number of health complications if not well managed and treated and has the potential to have a huge impact on people’s physical and psychological wellbeing. The aims of this review are to systematically analyse the available literature on plant-based diet interventions targeting and/or including adults with diabetes and to clearly define the benefits on well-being of such interventions. This study is a systemic review of 11 controlled trials, of which 7 were randomised. Results demonstrate that a plant-based diet can significantly improve psychological well-being, quality of life, control of type 2 diabetes measured by glycated haemoglobin [is a form of haemoglobin that is measured primarily to know the average plasma glucose concentration over a three-month period] and a number of physical characteristics in people with type 2 diabetes. Authors conclude that future studies could explore ways of delivering proper nutritional education in order to support participants to follow healthier dietary patterns.
Abstract
Diet interventions have suggested an association between plant-based diets and improvements in psychological well-being, quality of life and glycated hemoglobin (HbA1c) control in populations with diabetes. The aims of this review are to systematically analyze the available literature on plant-based diet interventions targeting diabetes in adults and to clearly define the benefits on well-being of such interventions. This is a systematic review of controlled trials. A computerized systematic literature search was conducted in the following electronic databases: Allied and Complementary Medicine, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, E-Journals, Excerpta Medica Database, MEDLINE, Health Management Information Consortium, PsycARTICLES, PsycINFO, PubMed, SocINDEX and Web of Science. The search strategy retrieved 1240 articles, of which 11 met the inclusion criteria (n=433; mean sample age 54.8 years). Plant-based diets were associated with significant improvement in emotional well-being, physical well-being, depression, quality of life, general health, HbA1c levels, weight, total cholesterol and low-density lipoprotein cholesterol, compared with several diabetic associations' official guidelines and other comparator diets. Plant-based diets can significantly improve psychological health, quality of life, HbA1c levels and weight and therefore the management of diabetes.
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The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial.
Järvelä-Reijonen, E, Karhunen, L, Sairanen, E, Muotka, J, Lindroos, S, Laitinen, J, Puttonen, S, Peuhkuri, K, Hallikainen, M, Pihlajamäki, J, et al
The international journal of behavioral nutrition and physical activity. 2018;15(1):22
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Acceptance and commitment therapy is one promising method in changing behaviour towards a person’s own value and goals. It aims to strengthen positive psychological processes related to commitment, behaviour change, mindfulness, and acceptance, which can be applied to promote healthy behaviour pattern. The aim of this study was to investigate the effects of acceptance and commitment therapy intervention delivered in two different ways i.e., via face-to-face group sessions and via mobile app, on reported eating behaviour and diet quality among adults with psychological distress and overweight or obesity. The study is a secondary analysis of the parallel-arm randomised controlled trial in which 3 different psychological interventions were studied. 219 individuals participated in the study with a mean body mass index of 31.3kg/m2, and a mean age of 49.5 years. Results indicate that acceptance and commitment therapy-based were able to change the reasons for eating from emotional or environmental triggers towards hunger and satiety cues, increase the acceptance of a variety of foods, and help the individual to perceive healthy eating more consistently. Authors conclude that acceptance and commitment therapy-based interventions delivered in the face-to-face group sessions or by the Mobile app showed beneficial effects on several aspects of eating behaviour.
Abstract
BACKGROUND Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. METHODS Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. RESULTS Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. CONCLUSIONS ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. TRIAL REGISTRATION ClinicalTrials.gov ( NCT01738256 ), registered 17 August, 2012.
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Changes in Eating Behaviors of Children with Obesity in Response to Carbohydrate-Modified and Portion-Controlled Diets.
Kirk, S, Woo, JG, Brehm, B, Daniels, SR, Saelens, BE
Childhood obesity (Print). 2017;13(5):377-383
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Paediatric obesity has been shown to be managed most effectively when interventions with multiple components, such as dietary changes, physical activity, supportive parental involvement, and behavioural strategies are included. The aim to the study was to evaluate whether baseline or changes in psychological dimensions of eating behaviours could account for variability in weight status outcomes. For this study, children aged between 7 – 12 years with a fasting blood glucose level of ≤100mg/dl and with a BMI z-score of 1.60 – 2.65 were recruited. The participants were randomly assigned to one of the three diet groups (low carbohydrate, reduced glycaemic load or portion-controlled diet). The study results show that eating behaviours improved significantly with all diets, and increased cognitive restraint and decreased hunger were sustained at 12 months. Disinhibition also remained significantly lower at 12 months for the reduced glycaemic load group. Authors conclude that targeting diets to youth with obesity who have specific characteristics such as sex, race, and/or lower baseline hunger or higher baseline cognitive restraint scores may lead to better outcomes.
Abstract
OBJECTIVE This study's objective was to determine whether two distinct carbohydrate (CHO)-modified diets and a standard portion-controlled (PC) diet differentially impacted children's eating behaviors and whether eating behavior scores predicted lower BMI among children with obesity. METHODS Children (n = 102) aged 7-12 years with obesity were randomly assigned to a 12-month intervention of a low-carbohydrate (LC), reduced glycemic load (RGL), or standard PC diet. The Three-Factor Eating Questionnaire (TFEQ) was completed at baseline, 3, 6, and 12 months by parents to characterize their child's hunger (H), disinhibition (D), and cognitive restraint (CR). Baseline and follow-up TFEQ scores by diet were evaluated relative to BMI status over time. RESULTS All diet groups showed increased CR and decreased H and D from baseline to 3 months, with differences from baseline remaining at 12 months for CR and H. Lower BMI status during study follow-up was associated with different TFEQ scores by diet group (LC and RGL: higher CR; PC: lower H), adjusting for sex, age, and race. Higher CR at follow-up was predicted by race and higher baseline CR; only lower H at baseline predicted lower H at follow-up. CONCLUSION Eating behaviors improved significantly with all diets during the initial 3 months; higher CR and lower H were sustained at treatment's end. BMI outcomes were associated with different eating behaviors in CHO-modified diet groups compared with PC diets. Targeting diets of children with obesity with specific baseline characteristics may lead to improved outcomes.
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Patterns of Eating Disorder Pathology are Associated with Weight Change in Family-Based Behavioral Obesity Treatment.
Balantekin, KN, Hayes, JF, Sheinbein, DH, Kolko, RP, Stein, RI, Saelens, BE, Hurst, KT, Welch, RR, Perri, MG, Schechtman, KB, et al
Obesity (Silver Spring, Md.). 2017;25(12):2115-2122
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Children who are overweight or obese have higher rates of eating disorder pathology (extreme dietary restraint, loss of control eating and emotional eating) than their peers who are not overweight or obese, thus having an increased risk of developing a clinical eating disorder. The aim of the study is to classify overweight or obese children entering family-based treatment into groups with distinct patterns of eating disorder pathology and then examine eating disorder pattern differences in 3 categories. The study includes data from a multi-site randomised controlled trial. The analysis focused on data from the initial weight loss phase which included 241 obese or overweight children aged between 7 to 11 years. Results showed that eating disorders are more common among females than males, yet males also experience high levels of eating disorder pathology. Levels of eating disorder pathology decreased after family-based behavioural weight-loss treatment and so decreased the risk of the development of a clinical eating disorder. Authors conclude that eating disorder pathology is prevalent among children with overweight or obesity but has varying presentations.
Abstract
OBJECTIVE Children with overweight or obesity have elevated eating disorder (ED) pathology, which may increase their risk for clinical EDs. The current study identified patterns of ED pathology in children with overweight or obesity entering family-based behavioral weight loss treatment (FBT) and examined whether children with distinct patterns differed in their ED pathology and BMI z score (zBMI) change across FBT. METHODS Before participating in a 16-session FBT, children (N = 241) completed surveys or interviews assessing ED pathology (emotional eating, shape/weight/eating concerns, restraint, and loss of control [LOC]). Shape and weight concerns (SWC) and LOC were also assessed post treatment. Child height and weight were measured at baseline and post treatment. Latent class analysis identified patterns of ED pathology. Repeated-measures ANOVA examined changes in zBMI and ED pathology. RESULTS Four patterns of ED pathology were identified: low ED pathology, SWC, only loss of control, and high ED pathology. SWC decreased across treatment, with the highest decreases in patterns characterized by high SWC. All groups experienced significant decreases in zBMI; however, children with the highest ED pathology did not achieve clinically significant weight loss. CONCLUSIONS ED pathology decreased after FBT, decreasing ED risk. While all children achieved zBMI reductions, further research is needed to enhance outcomes for children with high ED pathology.