A Plea for Diversity in Eating Disorders Research

Frontiers in Psychiatry, Год журнала: 2022, Номер 13

Опубликована: Фев. 18, 2022

Eating disorders (EDs) are often stereotyped as affecting the SWAG, that is, mostly skinny, White, affluent girls. Over last decade, however, significant progress has been made toward increasing diversity in ED research. There is consensus EDs affect individuals of all genders, ages, sexual orientations, ethnic, and socio-economic backgrounds, with recent studies exploring social determinants etiology, presentation, developing diversity-affirming assessments. This article provides a brief summary current developments related to research theme, proposes different perspectives further improving Specifically, we argue for role treatment settings outcomes, pursuing diversity-oriented pro-actively rather than reaction issues under-representation, integrating across areas medical education trainings psychotherapy. Limitations respect paucity research, link between theme ED-related workforce discussed.

Язык: Английский

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A systematic review of sociodemographic reporting and representation in eating disorder psychotherapy treatment trials in the United States

International Journal of Eating Disorders, Год журнала: 2022, Номер 55(4), С. 423 - 454

Опубликована: Март 14, 2022

Abstract Objective Eating disorders (EDs) were once conceptualized as primarily affecting affluent, White women, a misconception that informed research and practice for many years. Abundant evidence now discredits this stereotype, but it is unclear if prevailing “evidence‐based” treatments have been evaluated in samples representative of the diversity individuals affected by EDs. Our goal was to evaluate reporting, inclusion, analysis sociodemographic variables ED psychotherapeutic treatment randomized controlled trials (RCTs) US through 2020. Methods We conducted systematic review RCTs examined reporting inclusion gender identity, age, race/ethnicity, sexual orientation, socioeconomic status (SES) enrolled participants, well recruitment methods, power analyses, discussion limitations generalizability. Results search yielded 58 studies meeting criteria dating back 1985. Reporting at times incomplete, absent, or centered on racial/gender majority group. No reported diverse men people color underrepresented generally, with differences noted across diagnoses. A minority papers considered analyses acknowledged related sample characteristics. Some progress made decades, increasingly providing full racial ethnic data, more included over time. Although improved somewhat, appeared stall last decade. Discussion summarize findings, consider context challenges RCT researchers, offer suggestions journal editors, reviewers improving representation, analytic practices. Public Significance Randomized eating disorder are race/ethnicity information SES inconsistent orientation absent. women still comprise overwhelming few color, no gender‐diverse individuals. Findings underscore need improve increase representation ensure evidence‐based effective within groups.

Язык: Английский

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Socioeconomic status and eating disorder prevalence: at the intersections of gender identity, sexual orientation, and race/ethnicity

Psychological Medicine, Год журнала: 2022, Номер 53(9), С. 4255 - 4265

Опубликована: Май 16, 2022

Longstanding biases have fostered the erroneous notion that only those of higher socioeconomic status (SES) experience eating disorders (EDs); however, EDs present across all SES strata. Considering dearth ED research among lower SES, this study examined (1) overall association between and prevalence, (2) prevalence in context four relevant social identities (i.e. gender identity, sexual orientation, race/ethnicity) from an intersectional perspective, as unique combinations multiple may differentially influence risk.

Язык: Английский

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The need for more inclusive measurement to advance equity in eating disorders prevention

Eating Disorders, Год журнала: 2024, Номер 32(6), С. 798 - 816

Опубликована: Март 15, 2024

Eating disorder (ED) research and practice have been shaped by prevailing stereotypes about who EDs are most likely to affect. Subsequently, the field has prioritized needs concerns of affluent, cisgender, heterosexual, white girls women exclusion others, especially people marginalized based on their race, ethnicity, sexual orientation, and/or gender identity. However, exist across diverse groups actually occur with elevated prevalence in several groups. Growing points differences drivers such (e.g. desire attain curvy rather than thin ideal; dietary restraint due food insecurity weight/shape concerns), yet tools typically used for screening intervention evaluation do not capture eating pathology driven factors. In this commentary, we describe gaps existing ED assessment argue these underestimate among groups, bias is invited, participates in, benefits from prevention programs, obscure potential group efficacy programs. We also discuss ramifications exacerbate inequities EDs. Finally, outline recommendations overcome measurement and, consequently, advance equity realm prevention.

Язык: Английский

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A Mixed Method Systematic Review Into the Impact of ED Treatment in Autistic People and Those With High Autistic Traits

International Journal of Eating Disorders, Год журнала: 2024, Номер 58(1), С. 117 - 138

Опубликована: Ноя. 14, 2024

Our understanding of the impact eating disorders (ED) treatment in Autistic people remains elusive. Research has begun to explore ED outcomes and experiences this population, however current understandings are poorly integrated. The review therefore sought on those with higher traits. A convergent, segregated approach was used, independently evaluating quantitative then qualitative studies before integrating findings into a coherent narrative synthesis. traits report poorer may be at increased risk inpatient admission prolonged treatment, possibly explained by difficulties timeframes lack autism-informed support. Both groups reported similar improvements symptoms BMI. Higher rates psychosocial pre-and post-treatment were traits, emotion-focused interventions felt particularly relevant presentations EDs. Concerns as how well aligned group-based programs cognitive-based for individuals reporting Future research diagnosed autism samples is urgently needed develop more robust experiences. Review demonstrate need possible adaptations, or

Язык: Английский

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Associations between parental socioeconomic‐, family‐, and sibling status and risk of eating disorders in offspring in a Danish national female cohort

International Journal of Eating Disorders, Год журнала: 2022, Номер 55(8), С. 1130 - 1142

Опубликована: Июль 9, 2022

Abstract Objective Studies on parental socioeconomic status (SES) and family risk factors for eating disorders (EDs) have yielded inconsistent results; however, several studies identified high educational attainment as a factor. The aim was to evaluate associations of SES composition with anorexia nervosa (AN), bulimia (BN), not otherwise specified (EDNOS) in the offspring, adjusting age mental health. Methods cohort included women born Denmark between January 1, 1989 December 31, 2010, derived from Danish national registers. Each person followed their sixth birthday until onset disorder interest or 2016. Exposure variables were: childhood SES, defined individually evaluated level income, occupation, education; sibling status; composition. Outcomes AN, BN, EDNOS, major depressive (MDD), psychiatric comparison disorder. Risks were estimated using Cox proportional hazards. Results High associated increased especially less so BN offspring. In comparison, low higher MDD. No differences maternal paternal found. Family showed limited influence ED risk. Discussion shows opposite AN than MDD, whereas EDNOS are intermediate. backdrop differs markedly that reported other disorders. Whether is due genetic and/or environmental remains unknown. Public Significance statement Parental background may offspring somewhat differently Denmark, of, particularly, (AN). Importantly does strike across spectrum. We must ensure individuals all backgrounds equal access care equally likely be detected treated appropriately

Язык: Английский

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Pathways to eating disorder care: A European multicenter study

European Psychiatry, Год журнала: 2023, Номер 66(1)

Опубликована: Янв. 1, 2023

Abstract Background The aim of this study was to assess barriers and facilitators in the pathways toward specialist care for eating disorders (EDs). Methods Eleven ED services located seven European countries recruited patients with an ED. Clinicians administered adapted version World Health Organization “Encounter Form,” a standardized tool care. unadjusted overall time needed access unit described using Kaplan–Meier curve. Results Four-hundred-nine were recruited. median between onset current episode specialized 2 years. Most participants did not directly unit: primary “points access” mental health professionals general practitioners. involvement different pathway, seeking help psychiatric symptoms, lack support from family members associated delayed units. Conclusions Educational programs aiming promote early diagnosis treatment EDs should pay particular attention practitioners, addition professionals, increase awareness these illnesses their initiation process.

Язык: Английский

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The social epidemiology of binge-eating disorder and behaviors in early adolescents

Journal of Eating Disorders, Год журнала: 2023, Номер 11(1)

Опубликована: Окт. 13, 2023

Abstract Background Binge-eating disorder (BED) is the most common eating phenotype and linked to several negative health outcomes. Yet, little known about social epidemiology of BED, particularly in early adolescence. The objective this study was examine associations between sociodemographic characteristics BED binge-eating behaviors a large, national cohort 10–14-year-old adolescents United States (U.S.) Methods We conducted cross-sectional analysis two-year follow-up data from Adolescent Brain Cognitive Development (ABCD) Study (2018 − 2020) that included 10,197 (10 14 years, mean 12 years) U.S. Multivariable logistic regression models were used assess behaviors, defined based on Kiddie Schedule for Affective Disorders Schizophrenia. Results In adolescent sample (48.8% female, 54.0% White, 19.8% Latino/Hispanic, 16.1% Black, 5.4% Asian, 3.2% Native American, 1.5% Other), prevalence 1.0% 6.3%, respectively. Identifying as gay or bisexual (compared heterosexual; adjusted odds ratio [AOR]: 2.25, 95% CI 1.01–5.01) having household income less than $75,000 (AOR: 2.05, CI: 1.21–3.46) associated with greater BED. Being male 1.28, 1.06–1.55), American 1.60, 1.01–2.55) descent, 1.34, 1.08–1.65), identifying (AOR ‘Yes’ Response: 1.95, 1.31–2.91 AOR ‘Maybe’ 1.81, 1.19–2.76) all higher behaviors. Conclusion Several variables showed significant which can inform targeted screening, prevention, education campaigns among adolescents.

Язык: Английский

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Weighing in: qualitative explorations of weight restoration as recovery in anorexia nervosa

Journal of Eating Disorders, Год журнала: 2023, Номер 11(1)

Опубликована: Янв. 31, 2023

Abstract Background Anorexia Nervosa (AN) continues to capture the public’s imagination, centered around physical appearance, particularly weight. Clinical conceptions of AN also emphasize The objective this study was explore how individuals with lived experience thought about role weight in illness and recovery. Methods current employed a grounded theory approach through qualitative inductive inquiry analysis 150 anonymous narratives, exploring firsthand recovery adult individuals, based United States America. Results Individuals histories contested intersecting popular cultural medical presumptions their health positioned Respondents indicated that while does not measure recovery, it matters unanticipated ways. Others’ expectations for low served as gatekeeper various forms social institutional support. felt obsessions other people made difficult earn legitimacy access sufficient care. Conclusions Research findings bear implications future research, advocacy, clinical practice, respondents pivot research emphasis from sociocultural motivation AN, obstacle

Язык: Английский

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Health disparities among youth admitted for an eating disorder in an inpatient hospital setting

Children s Health Care, Год журнала: 2025, Номер unknown, С. 1 - 12

Опубликована: Янв. 26, 2025

The rise of eating disorders (EDs) in youth has become increasingly studied and understood among the health care community recent years. With frequency at which these youths are requiring medical stabilization, importance further examining factors that may contribute to rates, such as disparities, primary concern for prevention treatment efforts. Health disparities related hospitalized stabilization secondary an ED examined expand provider knowledge about this population identify areas improvement. Electronic record (EMR) retrospective (2017–2022) review was conducted within a southeast metropolitan children's hospital (N = 91, ages 9–19 years) comparisons between Latinx non-Latinx youth, insurance type, previous admissions similar presentation, ED-related characteristics. Results show patients were found be admitted (p .013, p .002) discharged .003, < .001) with higher scores on measures body composition than patients. Additionally, rates public readmission observed. Authors provide suggestions improving screening practices advocacy efforts help increase options have limited access.

Язык: Английский

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