What Facets of Picky Eating Relate To Eating Concerns in Undergraduate Students?: The Moderating Effects of Inflexible Eating and Mental Health Concerns

Purpose: Picky eating (PE) can occur in adulthood and is associated with mental health concerns. PE is often conceptualized as distinct from disordered eating, but recent research maps positive relationships between these maladaptive eating phenotypes. Relatedly, recent research suggests PE is more strongly related to eating concerns, a facet of disordered eating, via inflexible eating and mental health concerns, but precisely what PE facets explain these relations remain unknown.Methods: A large, undergraduate sample (N=509) completed an online survey assessing PE facets (Adult Picky Eating Questionnaire; meal presentation, food variety, meal disengagement, and taste aversion), disordered eating (Eating Disorder Examination Questionnaire), specifically eating concerns, mental health concerns (Depression, Anxiety and Stress Scale - 21 Items), and inflexible eating (Inflexible Eating Questionnaire).Results: Positive relationships emerged between PE facets, eating concerns, inflexible eating, and mental health concerns. Meal disengagement was more strongly associated with eating concerns when inflexible eating was higher, whereas food variety and meal presentation were more strongly associated with eating concerns when mental health concerns was higher. Inflexible eating and mental health concerns did not significantly interact with taste aversion to explain variance in eating concerns.Conclusions: Considering PE multidimensionally may yield important insights beyond the broader construct. Mental health concerns and inflexible eating may be treatment and research targets in addressing the overlap between PE facets such as meal presentation, meal disengagement, and food variety and eating concerns. Level of Evidence: Level V, cross-sectional descriptive study.

Childhood Onset Exercise Addiction or Atypical Anorexia Nervosa during Covid-19: Case Report

Background: Childhood-onset Anorexia Nervosa is recognised to be atypical in presentation, both in terms of extent and nature of eating pathology, exercise and compensatory behaviours with many falling short of full diagnostic criteria. Failure to consider an eating disorder diagnosis in youth who present with extreme weight loss may have serious immediate and long term implications. However, failure to consider other non-organic causes of weight loss may be equally detrimental to the child’s health. Case Presentation: This case reports on the acute presentation of a 12-year old boy with no prior eating concerns, who presented to hospital in a severely malnourished state eight weeks into lockdown. To compensate for Covid-19 induced restrictions on sporting activity, this boy had followed a self-imposed daily schedule of arduous exercise, without increasing his nutritional intake. This report examines the clinical features suggestive of Anorexia Nervosa and other differential diagnosis. A discussion on the specific diagnostic differential of exercise addiction and challenges faced by youth during Covid-19 restrictions are presented. Conclusion:Accepting that Anorexia Nervosa may present atypically in pre-pubertal youth, it is important that clinicians maintain an open mind in youth presenting without goal directed weight loss. Although weight loss was significant in this case, it was due to an excessive exercise regime. This may have commenced as a coping strategy in response to Covid-19 restrictions but subsequently became excessive and impairing in nature. The collateral damage of Covid-19 mandated restrictions, aimed at containing the spread of the virus, are evident in this case. Clinicians need to be alert to potentially maladaptive coping strategies and unusual or altered pathways of presentation, especially in younger children during these challenging times.

Does comparison of self with others influence body image among adult women? An experimental study in naturalistic settings

Background and Objectives It has been suggested that body comparison is a safety behavior in eating disorders. This experimental study investigates the causal impact of upward and downward body comparison on body image, eating pathology, self-esteem, anxiety and mood. It also considers whether trait body comparison and eating pathology are associated with responsiveness to upward and downward comparison. Methods Thirty-nine women participated. Each completed trait comparison and eating pathology measures. Following this, each participant spent an hour (on different days) making an upward, downward or neutral comparison in a naturalistic setting. After each condition, the participant completed measures of body satisfaction, self-esteem, anxiety, depression and eating pathology. Results Participants were significantly less satisfied with their bodies following upward comparison. Both upward and downward comparison were associated with particularly negative effects if an individual had greater trait eating concerns. The effects of downward comparison were correlated with increased anxiety. Limitations The sample was lacking in diversity. Compliance with the experimental tasks was not strictly monitored. Conclusions Upward comparison resulted in lower body satisfaction, but downward comparison did not result in positive effects. However, trait eating concerns and comparison influenced the impact of both forms of comparison. Body comparison should be a target for treatment in CBT for eating disorders, particularly where the individual has a strong tendency to make comparisons with other people. Level of evidence Level III: Evidence obtained from well-designed cohort or case–control analytic studies.

Moderation Effects of Ethnic-Racial Identity on Disordered Eating and Ethnicity Among Asian and Caucasian Americans

Background: The current study was designed to examine whether ethnic-racial identity (ERI) moderated the relationship between disordered eating and primary ethnic identification.Methods: Three hundred and ninety-eight undergraduate women (Mage = 19.95, SD = 3.09) were recruited from a large university in Hawai‘i. Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the ERI measure, and reported their primary ethnicity as an index of ethnicity.Results: There was a significant correlation between eating concerns and centrality, r(357) = 0.127, p < 0.05. Moderation analyses indicated that only ERI centrality moderated the predictive effect of ethnicity on the importance of eating concerns, b = 0.05, t(347) = 2.37, p = 0.018.Conclusions: The results suggest that the relationship between self-reported primary ethnicity and EDEQ scores is greater when ethnicity is more central to the individual's identity or when the in-group affect is important to an individual. Findings underscore the need for further research on the underlying mechanisms that account for the differing ways that ERI may affect eating concerns.

What Facets of Picky Eating Relate to Eating Concerns in Undergraduate Students?: The Moderating Effects of Negative Psychological Correlates

Purpose: Picky eating (PE) can occur in adulthood and is associated with mental health concerns. PE is often conceptualized as distinct from disordered eating (DE), but recent research maps positive relationships between these maladaptive eating phenotypes. Precisely what PE facets relate to DE remain unknown, as do factors such as negative psychological correlates that might explain relationships between PE facets and DE.Methods: A large, undergraduate sample (N=509) completed an online survey assessing PE facets (Adult Picky Eating Questionnaire; meal presentation, food variety, meal disengagement, and taste aversion), disordered eating (Eating Disorder Examination Questionnaire), specifically eating concerns, and negative psychological correlates such as mental health concerns (Depression, Anxiety and Stress Scale - 21 Items) and inflexible eating (Inflexible Eating Questionnaire).Results: Positive relationships emerged between PE facets, eating concerns, and negative psychological correlates. Negative psychological correlates moderated relationships between PE facets and eating concerns. Meal presentation, meal disengagement, and taste aversion were more strongly associated with eating concerns when mental health concerns and inflexible eating were higher. Food variety did not significantly explain variance in eating concerns.Conclusions: Considering PE multidimensionally may yield important insights beyond the broader construct. Mental health concerns and inflexible eating may be treatment and research targets in addressing the overlap between PE facets such as meal presentation, meal disengagement, and taste aversion and eating concerns. Level of Evidence: Level V, cross-sectional descriptive study.