Weight loss practices and eating behaviours among female physique athletes: Acquiring the optimal body composition for competition

Little is known about weight loss practices and eating behaviours in female physique athletes. This study investigated the weight loss history, practices, and key influences during the pre-competition period in a large cohort of female physique athletes stratified by division and experience level. Eating attitudes and behaviours were assessed to identify whether athletes were at risk of developing an eating disorder. Using a cross-sectional research design, female physique athletes (n = 158) were recruited and completed an anonymous online self-reported survey consisting of two validated questionnaires: Rapid Weight Loss Questionnaire and Eating Attitudes Test-26. Irrespective of division or experience, female physique athletes used a combination of weight loss practices during the pre-competition phase. Gradual dieting (94%), food restriction (64%) and excessive exercise (84%), followed by body water manipulation via water loading (73%) were the most commonly used methods. Overall, 37% of female physique athletes were considered at risk of developing an eating disorder. Additionally, 42% of female physique athletes used two pathogenic weight control methods with 34% of Figure novice athletes indicating binge eating once a week or more. The coach (89%) and another athlete (73%) were identified as key influences on athletes’ dieting practices and weight loss. The prevalence of athletes identified with disordered eating symptoms and engaging in pathogenic weight control methods is concerning. In future, female physique athletes should seek advice from registered nutritionists to optimise weight management practices and minimise the risk of developing an eating disorder.

Gender-specific responses to multifaceted factors associated with disordered eating among adolescents of 7th to 9th grade

Background The prevalence of disordered eating is increasing among adolescents in Asia. The prevalence and predictors of disordered eating in boys have often gone unrecognized. This study examined gender-specific responses to multifaceted factors associated with disordered eating, including personal, behavioral, family, and school-related characteristics. Methods After excluding responses with incomplete information, a sample of 729 adolescents (48.97% boys) between the ages of 13 and 16 were surveyed through convenience sampling from 37 classrooms in three junior high schools in New Taipei City of Taiwan were analyzed. The Eating Attitudes Test-26 questionnaire was used to identify disordered eating. Results No difference in the prevalence of disordered eating between the genders was found. Adolescent girls exhibit a preoccupation with fatness and a desire to be thinner, whereas boys are more likely to engage in extreme dieting behaviors such as vomiting, keeping the stomach empty, and avoiding sweets. Girls engaging in disordered eating reported relatively high levels of interpersonal stress involving family member weight-teasing, low peer acceptance, and high peer pressure to control weight. High intensity of regular exercise was found in girls with disordered eating. The perception of body weight is a more critical factor of engaging in disordered eating for boys than girls. Adolescents with immigrant parents were associated with disordered eating among both genders. Conclusions Changing gender-specific weight-related norms in schools and families is essential to reduce the prevalence of disordered eating, particularly among girls. Future studies using representative samples to confirm this study’s findings are warranted.

“Can A Ballerina Eat Ice Cream?”: A Mixed-Method Study on Eating Attitudes and Body Image in Female Ballet Dancers

Aim: We aimed to explore how a group of classical ballet dancers perceived their eating attitudes and their bodies, with special attention to the potential presence of eating disorders (EDs) symptoms and body image (dis)satisfaction.Methods: A cross-sectional, mixed-method study was conducted on fourteen trained classical ballet dancers (18–30 years old). Their experiences, perceptions, and feelings regarding eating attitudes and body image concerning classical ballet were acquired through qualitative focus groups. The presence of EDs symptoms and perception and (dis)satisfaction with body image was analyzed quantitatively through self-report questionnaires.Results: Participants reported concerning eating attitudes during the focus groups, such as the regular practice of several restrictive popular diets, constant restriction of foods considered “heavy” or “fatty,” meal skipping and ignoring signs of hunger, presence of overeating episodes due to stress and anxiety, feeling guilty about breaking their usual diet, classifying foods as “good” and “bad” or “lean” and “fat,” and excluding some of those foods from their usual diets. These reports were partially reflected in the questionnaires, with 50% of the ballerinas showing bulimic symptoms indicative of an unusual eating pattern (only two of them with a significant risk index), 7.1% showing symptoms of moderate binge eating, and 14.3% symptoms of EDs in general. Additionally, when considering their bodies in the context of everyday life, participants were satisfied; however, in the “classical ballet” context, they reported feeling dissatisfied with their shape. These findings were in line with results from the Stunkard's Scale, which revealed that 50% of the sample was dissatisfied with their current body shape and 57.1% indicated that their desired body shape was a leaner figure than one they considered healthy.Conclusions: The constant practice of restrictive diets and other weight-loss strategies to achieve a leaner body were associated with symptoms of EDs and body dissatisfaction in this sample. Importantly, the questionnaires used seemed to underestimate the presence of a disordered eating pattern reported by the participants during focus groups. These data could help to inform psychological and nutritional strategies aimed at improving performance, physical and psychological well-being, and quality of life of ballet dancers.

Decrease in Salivary Serotonin in Response to Probiotic Supplementation With Saccharomyces boulardii in Healthy Volunteers Under Psychological Stress: Secondary Analysis of a Randomized, Double-Blind, Placebo-Controlled Trial

BackgroundBacterial probiotics are thought to exert a serotonergic effect relevant to their potential antidepressant and pro-cognitive action, but yeast probiotics have not been tested. The aim of the present study was to determine whether 30-day supplementation with Saccharomyces boulardii affects the level of salivary serotonin under psychological stress and identify the factors associated with it.MethodsHealthy medical students were randomized to ingest Saccharomyces boulardii CNCM I-1079 or placebo before a stressful event. Salivary serotonin concentration was assessed before and at the end of supplementation. Moreover, obtained results were compared to psychological, biochemical, physiological and sociodemographic study participants data.ResultsData of thirty-two participants (22.8 ± 1.7 years of age, 16 males) was available for the main analysis. Supplementation with Saccharomyces boulardii decreased salivary serotonin concentration under psychological stress by 3.13 (95% CI 0.20 to 6.07) ng/mL, p = 0.037, as compared to placebo. Salivary serotonin was positively correlated with salivary metanephrine (β = 0.27, 95% CI 0.02 to 0.52, p = 0.031) and pulse rate (β = 0.28, 95% CI 0.05 to 0.50, p = 0.018), but insignificantly with anxiety, depression, eating attitudes and information retrieval.ConclusionsSaccharomyces boulardii CNCM I-1079 may be distinct from bacterial probiotics in its salivary serotonergic effect, which appears positively linked to symapathoadrenal markers. The study requires cautious interpretation, and further investigation.

Are People with Poor Differentiation of Self at Risk of Developing Eating Disorders? A Study of Jewish and Arab Participants

Purpose: In light of findings that Israeli Arabs report higher prevalence of eating disorders (EDs) than Israeli Jews and that higher rates of the risk of EDs have been reported by females than males, the first aim of this study was to further investigate the cultural and gender differences in differentiation of self (DoS) and risk of developing EDs among Israeli young adults. The second aim was to examine whether DoS is associated with the risk of EDs. Methods: Of the 859 participants (670 females, mean age 26.8), 440 were Jewish and 419 were Arab. Participants took the Eating Attitudes Test (EAT-26) and completed the Differentiation of Self-Revised (DSI-R) questionnaire.Results: Results revealed that Jewish participants had significantly lower diet, bulimia, and total EAT-26 scores than their Arab counterparts, while Jewish female participants had higher dieting and lower emotional cutoff scores than Jewish male participants. In addition, Jews who reported higher levels of risk of EDs showed higher levels of BMI, emotional reactivity, emotional cutoff, and fusion with others. Arabs who reported higher levels of risk of EDs reported higher levels of BMI and emotional cutoff and lower levels of I-position. Conclusion: People with high risk of EDs may have difficulty maintaining intimate family relationships. In distressing situations, they tend to disconnect rather than share with or gain support from significant others. In each culture, the risk of EDs increases for differently: among the Arab participants, when feelings and needs remain unexpressed; among the Jewish participants, even when they have symbiotic family relationships.Level of evidence: Level V, cross-sectional descriptive study

The light and the dark side of social media use: Depression, anxiety, and eating attitudes among adolescents

In the current study, we explored the links between social networking activity, eating attitudes (EA), anxiety, and depression among adolescents. We used a cross-sectional design. Our sample consisted of 532 males and females, aged 12 to 15 (M = 13.55, SD = 0.90), from the Eastern side of Romania. We analyzed our data using three different pathways to explore these relationships on the overall sample, as well as the at-risk for eating disorders (ED) group (n = 134), and the non-ED-risk (n = 398) samples. The results suggested that depressive and anxiety symptoms partially mediated the relationship between social networking and eating attitudes in the overall group and in the not-at-risk for ED group, but not in the at-risk for ED sample. When controlling for gender, social networking use partially mediated the relationship between anxiety and depressive symptoms and eating attitudes in the overall group and the not-at-risk for ED group, and a total mediating effect within this relationship in the at-risk ED sample was also found. In adolescents with symptoms of potential ED, social networking use seemed to have a protective role compared to the not-at-risk sample. The present study suggested that social networking use might increase the chances of developing unhealthy eating attitudes in adolescents who are not-at risk to develop an eating disorder, but, at the same time, it might play a protective role (instead of a harmful one) for adolescents who already developed such symptoms. Results are discussed concerning their clinical and practical implication for adolescents' physical and mental health, especially during the COVID-19 pandemic, and the potential protective role of social media use for adolescents with ED symptoms.

The Relationship between Body Appreciation Levels, Eating Attitudes and Physical Profiles of Turkish Elite Artistic Gymnasts

Body dissatisfaction and disordered eating behavior in athletes may occur when sports and social pressures require an ideal body standard, if the athlete perceives that his or her body does not conform to this ideal. For this reason, the aim of this study is to investigate the relationship between artistic gymnasts’ (AG) physical profiles, body appreciation levels and eating attitudes. A total of 32 elite AG (Turkish National Team), 13 women and 19 men, participated in this study. Height and body analyzes of the participants were measured. Body appreciation levels were determined by the Body Appreciation Scale (BAS), and eating attitudes were determined by the Eating Attitudes Test (EAT-26). With the Training Information Form, information about training frequencies and durations was provided. Comparative analyzes of the BAS and EAT-26 results of elite female and male gymnasts were performed. The physical profiles, eating attitudes and body appreciation levels of female AG were evaluated and the relationship between them was determined. While no significant correlation was found between the BAS, EAT-26 and physical profiles of the elite male AG, a negative significant correlation was found between the BAS and body mass index (BMI) of female elite AG (p < 0.05). It was concluded that while BMI rates of elite female AG increased, their body appreciation levels decreased. The BAS results of elite AG’ were found to be significantly higher than those of elite female AGs (p < 0.05).

Psychometric Properties of The 26-Item Eating Attitudes Test (EAT-26): An Application of Rasch Analysis

Background: The 26-item Eating Attitudes Test (EAT-26) is a commonly used tool to assess eating disorder risk. The purpose of this study was to examine the psychometric properties of the EAT-26 with a sample of adults (n=469; age=36.17±17.83 years; female =72.5%; white=66.3%; obese BMI category=58%).Methods: Rasch analysis of the EAT-26 assessed model-data fit, an item-person map to evaluate relative distribution items and persons, item difficulty, and person’s eating disorder (ED) risk level, differential item functioning (DIF), and rating scale functioning. Results: A total of 7 misfit items were removed from the final analysis due to unacceptable Infit and Outfit mean square residual values. The item-person map showed that the items were biased toward participants with moderate to high levels of ED risk and did not cover those who had low risk for having an ED (< -1 logits). The DIF analyses results showed that none of the items functioned differently across sex, but 5 items were flagged based on obesity status. The six-category Likert-type rating scale did not function well indicating a different response format may be needed.Conclusion: Several concerns were identified with the psychometric evaluation of the EAT-26 that may question its utility in assessing ED risk. Because the EAT-26 is a frequently used screening tool for nonclinical populations, future work should focus on developing screening tools that are more effective at assessing ED risk in people with overweight and obesity.