Gender differences in symptom presentation and treatment outcome in children and youths with eating disorders

Background To address the gaps in the literature examining eating disorders among males and gender minority youths, a prospective study was designed to assess gender differences in eating disorder symptom presentation and outcomes. Muscularity concerns may be particularly relevant for male youths with eating disorders, and were included in assessment of eating disorder symptom presentation. Methods All cisgender male youths who presented for specialized eating disorder treatment at one of two sites were invited to participate, along with a group of matched cisgender females, and all youths who did not identify with the sex assigned to them at birth. Youths completed measures of eating disorder symptoms, including muscularity concerns, and other psychiatric symptoms at baseline and end of treatment. Results A total of 27 males, 28 females and 6 trans youths took part in the study. At baseline, Kruskal–Wallis tests demonstrated that trans youths reported higher scores than cisgender male and female youths on measures of eating pathology (Eating disorder examination-questionnaire (EDE-Q) and the body fat subscale of the male body attitudes scale (MBAS)). These analyses demonstrated that there were no differences between cisgender male and female youths on eating disorder symptoms at baseline. However, repeated measures ANOVA demonstrated that males had greater decreases in eating pathology at discharge than did females, based on self-reported scores on the EDE-Q, MBAS, and Body Change Inventory. Conclusions Gender differences in eating pathology appeared at baseline, with trans youths reporting higher levels of eating pathology than cisgender youths, though no differences between cisgender males and females emerged at baseline for eating disorder symptom presentation. Contrary to expectations, there were no gender differences in measures of muscularity concerns. Males demonstrated greater eating disorder symptom improvements than females, suggesting that male adolescents may have better treatment outcomes than females in some domains.

Gender Differences in Symptom Presentation and Treatment Outcome in Children and Youths With Eating Disorders

Background. To address the gaps in the literature examining eating disorders among males and gender minority youths, a prospective study was designed to assess gender differences in eating disorder symptom presentation and outcomes. Muscularity concerns may be particularly relevant for male youths with eating disorders, and were included in assessment of eating disorder symptom presentation. Methods. All male youths who presented for specialized eating disorder treatment at one of two sites were invited to participate, along with a group of matched females, and all youths who did not identify with the sex assigned to them at birth. Youths completed measures of eating disorder symptoms, including muscularity concerns, and other psychiatric symptoms at baseline and end of treatment.Results. A total of 27 males, 28 females and 6 trans youths took part in the study. At baseline, Kruskal-Wallis tests demonstrated that trans youths reported higher scores than cisgender male and female youths on measures of eating pathology (Eating Disorder Examination – Questionnaire (EDE-Q) and the body fat subscale of the Male Body Attitudes Scale (MBAS)). These analyses demonstrated that there were no differences between cisgender male and female youths on eating disorder symptoms at baseline. However, repeated measures ANOVA demonstrated that males had greater decreases than did females in eating pathology at discharge than did females, based on self-reported scores on the EDE-Q, MBAS, and Body Change Inventory. Conclusions. Gender differences in eating pathology appeared at baseline, with trans youths reporting higher levels of eating pathology than cisgender youths, though no differences between cisgender males and females emerged at baseline for eating disorder symptom presentation. Contrary to expectations, there were no gender differences in measures of muscularity concerns. Males demonstrated greater eating disorder symptom improvements than females, suggesting that male adolescents may have better treatment outcomes than females in some domains.

Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

ObjectiveTo document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.MethodWe re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).ResultsThree important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.ConclusionsThe COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.Significant Outcomes and LimitationsIndividuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental healthEven individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptomsA large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across SwedenLimitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.Data Availability StatementFully anonymized data are available from the corresponding author upon request.

Feeling Fat’ is Associated with Specific Eating Disorder Symptom Dimensions in Young Men and Women

Purpose: ‘Feeling fat,’ the somatic experience of having excess body weight that is not fully explained by true adiposity, correlates with eating pathology in clinical and non-clinical samples. It is unknown whether ‘feeling fat’ more strongly relates to specific eating disorder symptom dimensions that typically characterize anorexia nervosa, bulimia nervosa, and/or binge eating disorder. Understanding the significance of ‘feeling fat’s relationship with specific eating disorder symptom dimensions - cognitive restraint, dietary restriction, binge eating, and purging - may suggest its relevance to particular forms of eating pathology and elucidate treatment directions for addressing ‘feeling fat’. Methods: Questionnaires were completed by 989 undergraduates (54.3% female). Results: Path analyses indicated significant associations between feeling fat and all symptom dimensions; these paths were not moderated by gender. The best fitting model was the model including paths from ‘feeling fat’ to all symptom dimensions; no other model had equivalent fit. Conclusion: ‘Feeling fat’ relates to all examined symptoms of eating disorders in a mixed-gender non-clinical population. These results indicate that ‘feeling fat’ is associated with multiple core symptoms of eating pathology, pointing to ‘feeling fat’s significance to eating pathology maintenance across the spectrum of eating pathology. Future research should compare the influence of ‘feeling fat’ on these symptoms in mixed-gender clinical samples.