Orthorexia nervosa and disordered eating attitudes among Lebanese adults: Assessing psychometric proprieties of the ORTO-R in a population-based sample

Background Previous research demonstrated a relationship between ON and disordered eating symptoms (eating concern, restraint, cognitive preoccupations about body shape and weight) and disordered eating attitudes (DEA). Since screening for orthorexia nervosa is now part of clinical practice, the measurement instruments to be used must be clinically significant, reliable, valid and sensitive to our target population. The main objective of the present study was to confirm the factor structure of the Arabic version of the ORTO-R using a first sample of Lebanese adults and confirm those results on another sample. The secondary objective was to assess sex differences in terms of ON and DEA, as well as to examine whether symptoms of ON were related to DEA in Lebanese adults. Methods A total of 783 Lebanese adults was selected to participate in this cross-sectional study (January-May 2018) using a proportionate random sample from all Lebanese governorates. Results The mean age of the total sample was 27.78 ± 11.60 years (Min. 18 –Max. 84) (33.5% females) and their mean BMI was 24.36 ± 5.31 kg/m2. All items of the ORTO-R were extracted during the factor analysis and yielded a two-factor solution with Eigenvalues > 1 (variance explained = 50.07%; KMO = 0.570; Bartlett’s sphericity test p<0.001; αCronbach = 0.755). This factor structure was confirmed by a confirmatory factor analysis; the Maximum Likelihood Chi-Square = 26.894 and Degrees of Freedom = 8, which gave a χ2/df = 3.36. The Tucker Lewis Index (TLI) value was 0.914, whereas the standardized root mean square residual (SRMR) value was 0.032. The root mean square error of approximation (RMSEA) value was 0.077 [95% CI 0.046–0.111] (pclose = 0.07) and comparative fit index (CFI) value was 0.967 respectively, indicating a good fit of the model. There was also no measurement invariance between genders. Female gender was significantly associated with lower ORTO-R scores (more orthorexia nervosa) compared to males (B = -0.65; p = 0.026, 95% CI -1.22- -0.08; ɳ2 = 0.006). However, no significant difference was found between genders in terms of EAT-26 scores (B = 0.23; p = 0.813, 95% CI -1.66–2.12; ɳ2 = 0.0001). Higher ORTO-R scores (lower/ less pathological ON tendencies and behaviors) were significantly related to higher EAT-26 total scores (higher levels of DEA) as well as higher dieting, bulimia and oral control scores in both females (from a weak to a moderate positive correlation) and males (a weak positive correlation). Conclusion This cross-sectional population-based study confirmed the factor structure of the Arabic version of the ORTO-R, demonstrated an association between ON and DEA and revealed more ON among females compared to males.

Validation of the Arabic version of the Disordered Eating Attitudes in Pregnancy Scale (A- DEAPS) among Lebanese pregnant women: A step closer to Pregorexia Awareness

Background Lately, there has been an upsurge in the prevalence of eating disorders (including anorexia, bulimia, orthorexia and recently, pregorexia), mainly due to changes in sociocultural factors. Pregnancy may serve as a propitious basis for the flourishing of “Pregorexia”: a notion of popular psychology designating a newly emerging eating disorder. Bannatyne et al. generated a brief pregnancy-specific instrument in furtherance of screening for antenatal eating disorders: the DEAPS (Disordered Eating Attitudes in Pregnancy Scale), which demonstrated a high level of internal consistency and good validity. Our study's objective was to linguistically validate and examine the reliability and psychometric properties of the Arabic version of this previously established pregnancy-specific scale among Lebanese pregnant women. Methods We conceived and implemented a cross-sectional survey between June and July 2021 (N = 433). The sample was randomly divided in two as per the SPSS data selection option; the first was used to conduct the DEAPS items factor analysis, whereas the second was used for the confirmatory analysis. Multiple indices of goodness-of-fit were described: the Relative Chi-square (χ2/df), Root Mean Square Error of Approximation (RMSEA), Tucker Lewis Index (TLI) and Comparative Fit Index (CFI). Results A factor analysis was conducted on Sample 1 (N = 207) chosen randomly from the original sample. With the exception of item 8, all other items converged over a two-factor solution (Factor 1: Self-Objectification (Body Control, Body Shame and Esteem) and Factor 2: Pregorexia), explaining a total variance of 39.3%. In sample 2 (N = 226), the one-factor model (Factor 2) that derived from the factor analysis conducted on sample 1, fitted well accordingly to CFI, TLI and χ2/df values, but fitted modestly according to RMSEA. The estimates obtained for Models 1 (original scale) and 2 (according to the two-factor solution obtained from the FA in sample 1) fitted less than the third model. The results showed that 28 (6.6%) of the participants were at risk of having disordered eating during pregnancy, whereas 25 (5.8%) had possible presence of disordered eating. Conclusion This study was able to show that the A-DEAPS seems to be a good and reliable tool for the assessment of disordered eating among Lebanese pregnant women.

GENDER WISE COMPARISON OF DISORDERED EATING ATTITUDES IN PHYSICAL EDUCATION PROFESSIONALS OF INDIA: A CROSS-SECTIONAL STUDY

Motivation/Background: Eating disorders (ED) are serious psychological disorders characterized by unhealthy eating habits. There are a limited number of studies on eating disorders among male and female physical education professionals like teachers, coaches, and trainers. Therefore, the objective of this study was to examine the prevalence of disordered eating attitudes (EA) among the ones that are more or less associated with fitness, training and counseling the students and public in general. Method: A survey study on 83 such professionals with at least 5 years of experience was being conducted through online questionnaire. The Eating Attitudes Test (EAT-26) was used. Results: Of the 83 participants, 20% scored ≥ 20 on the EAT-26. A significant positive correlation (p&lt;.01) was found between age and body mass index (BMI) on EAT-26 scores. Conclusions: Awareness regarding appropriate nutrition in relation to body weight is needed among professionals themselves before they counsel others to begin with and must therefore be cautious about their own eating patterns in the first place.

Disordered Eating Attitudes, Demographics, and Snack Patterns in Overweight and Obese US College Students

Objectives An unhealthy snack pattern may impact a person's overall health and quality of life. College students are at risk for disordered eating attitudes (DEA) due the elevated mental and physical demands of higher education. This could lead to a greater snack intake that could replace meals. DEA could also be influenced by demographics. Our objective was to evaluate the association between DEA, snack patterns, stress level, and demographics. Methods We analyzed the baseline data from the Snackability Trial, a trial among overweight and obese students from US colleges to test the effects of using the Snackability app to choose healthier snacks compared to controls (no access to the app). Students are being recruited using flyers sent via email by college professors/staff and social media since June 2020. Participants completed questionnaires at baseline (before randomization) on demographics (age, gender, race, ethnicity, income), snack eating patterns, stress level (scale from 1–10 with 10 being the most stressed), and DEA Score (a validated score assessing eating attitudes with 25 questions related to perceptions of food; higher DEA scores indicate higher DEA with the minimum possible score of 37 and maximum of 190). Descriptive statistics included frequency and mean/standard deviation of all variables. ANOVA and Pearson Correlations were used to evaluate the associations between variables. Results A total of 135 have completed thus far all baseline questionnaires. The average age was 21.5 ± 2.01 years, most students were female (83.7%), Hispanic/Latino (52.6%), and with a household income of &lt;$50,000 (60.0%). Average DEAS was 90.4 ± 19.1, daily snack intake was 2.33 ± 1.08, and stress score was 6.78 ± 1.97. DEAS score was not associated with demographic variables or snack intake, but there was a significant correlation between DEAS and stress level (r = 0.3; P &lt; 0.001). Conclusions Students who have a higher level of stress are more likely to have DEA. Disordered eating is an umbrella of irregular eating behaviors that may or may not warrant a diagnosis of a specific eating disorder. Based on these findings, universities may need to develop interventions for college students to manage stress as well as promoting awareness and programs for students with high levels of disordered eating. Funding Sources Internal funds from Florida International University.

Drunkorexia and Emotion Regulation and Emotion Regulation Difficulties: The Mediating Effect of Disordered Eating Attitudes

Drunorexia refers to food calorie intake restriction to prevent weight gain and the desire to enhance the more extensive intoxicating effects of alcohol. The present study aimed to investigate the association of drunkorexia with emotion regulation as well as emotion regulation difficulties across the Lebanese population, and assess disordered eating attitudes as a potential mediator of these relationships. The cross-sectional study enrolled participants (n = 258) from all Lebanese districts. The study was performed through an online survey based on a self-designed and structured questionnaire. The Drunkorexia Motives and Behaviors Scales (DMBS), the College Life Alcohol Salience Scale (CLASS), the Difficulties in Emotion Regulation Scale (DERS-16), the Emotion Regulation Questionnaire (ERQ) and the Eating Attitudes Test (EAT-26) were used in the present study. The results showed that higher EAT-26 total scores (more disordered eating attitudes) (B = 0.16) and higher DERS-16 total score (B = 0.30) were significantly associated with more drunkorexia motives. Also, higher EAT-26 total scores (B = 0.09) and higher DERS-16 total score (B = 0.17) were significantly associated with more drunkorexia behaviors. In addition, higher EAT-26 total scores (B = 0.10) and higher DERS-26 total score (B = 0.36) were significantly associated with more drunkorexia fails. Furthermore, higher EAT-26 total scores (B = 0.07), and higher DERS-16 total score (B = 0.37) were significantly associated with more drunkorexia during an alcohol consumption event. Higher EAT-26 total scores (B = 0.09), and higher DERS-16 total score (B = 0.22) were significantly associated with more post-drinking compensation. Higher EAT-26 total scores (B = 0.21), higher DERS-16 total scores (B = 0.65) and higher emotion regulation (B = 0.33) were significantly associated with higher CLASS scores. The results showed that EAT-26 total scores partially mediated the association between DERS-16 total score and drunkorexia motives (25.20%), between DERS-16 total score and drunkorexia behaviors (25.16%), between DERS-16 total score and drunkorexia fails (106.87%), between DERS-16 total score and drunkorexia during an alcohol consumption event (11.84%), between DERS-16 total score and post-drinking compensation (22.55%), between ERQ total score and college life alcohol salience (8.35%) and between DERS-16 total score and college life alcohol salience (20.14%). This study highlighted that only emotional regulation difficulties were associated with drunkorexia, whereas emotional regulation was not significantly associated with such behavior.