Anita Darby

Eating disorder behaviors are increasing: findings from two sequential community surveys in South Australia

Background Evidence for an increase in the prevalence of eating disorders is inconsistent. Our aim was to determine change in the population point prevalence of eating disorder behaviors over a 10-year period. Methodology/Principal Findings Eating disorder behaviors were assessed in consecutive general population surveys of men and women conducted in 1995 (n = 3001, 72% respondents) and 2005 (n = 3047, 63.1% respondents). Participants were randomly sampled from households in rural and metropolitan South Australia. There was a significant (all p<0.01) and over two-fold increase in the prevalence of binge eating, purging (self-induced vomiting and/or laxative or diuretic misuse) and strict dieting or fasting for weight or shape control among both genders. The most common diagnosis in 2005 was either binge eating disorder or other “eating disorders not otherwise specified” (EDNOS; n = 119, 4.2%). Conclusions/Significance In this population sample the point prevalence of eating disorder behaviors increased over the past decade. Cases of anorexia nervosa and bulimia nervosa, as currently defined, remain uncommon.

Disordered eating behaviours and cognitions in young women with obesity: relationship with psychological status

Objective:To examine levels of eating disorder behaviours and cognitions of young women with obesity in the Australian Capital Territory, Australia and assess the impact upon psychological status.Design:General population cross-sectional survey.Subjects:A total of 4891 young women from the community aged 18–42 years, of which 630 were in the obese weight range.Measurements:Body mass index (BMI), eating disorder psychopathology (eating disorder examination questionnaire), and psychological distress (K-10).Results:Women with obesity had significantly higher levels of dietary restraint, eating concern, weight concern, shape concern, binge eating, misuse of diuretics, use of diet pills and fasting compared to other women in the community. These eating disorder cognitions and behaviours were associated with increased levels of psychological distress. In women with obesity, eating concern, weight concern, shape concern, dietary restraint and decreased age predicted psychological distress in a multivariate model. Among other women in the community, behaviours such as laxative misuse, ‘hard’ exercise and subjective bulimic episodes also contributed to the model predicting psychological distress.Conclusion:As disordered eating psychopathology is high in young obese women and negatively impacts upon psychological status, obesity prevention and treatment should consider eating disorder psychopathology and mental health outcomes.

The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005

OBJECTIVE To measure the cooccurrence of obesity and eating disorder (ED) behaviors in the South Australian population and assess the change in level from 1995 to 2005. METHOD Two independent cross-sectional single stage interview based population surveys were conducted a decade apart. Self-reported height, weight, ED behaviors, and sociodemographics were assessed. Changes between the two time points were analyzed. RESULTS From 1995 to 2005 the population prevalence of comorbid obesity and ED behaviors increased from 1 to 3.5%. Comorbid obesity and ED behaviors increased more (prevalence odds ratio (POR) = 4.5; 95% confidence interval (CI) = 95% CI = [2.8, 7.4]; p < .001) than either obesity (POR = 1.6; 95% CI = [1.3, 2.0]; p < .001) or ED behaviors (POR = 3.1; 95% CI = [2.3, 4.1]; p < .001) alone. DISCUSSION Comorbid obesity and ED behaviors are an increasing problem in our society. Prevention and treatments efforts for obesity and EDs must consider and address this increasing comorbidity.

Obesity and Impairment in Psychosocial Functioning in Women: The Mediating Role of Eating Disorder Features

Objective: The objective was to test the hypothesis that, in women, the association between obesity and impairment in psychosocial functioning is mediated by levels of weight and shape concerns and/or binge‐eating frequency.

Community recognition and beliefs about anorexia nervosa and its treatment.

OBJECTIVE Mental Health Literacy (MHL), namely recognition, and beliefs about treatment concerning Anorexia Nervosa (AN) were examined in a community sample of male and female (n = 983) aged 15-94 years. METHOD A vignette describing a women suffering from the symptoms of AN was presented, followed by a respondent-based structured interview concerning recognition of the problem and treatment beliefs. RESULTS The majority of participants could identify the problem as that of an eating disorder, although only 16.1% could specifically identify it as AN. Many also believed the problem was primarily one of low self-esteem (32.5%). General practitioners and psychiatrists or psychologists were considered the most helpful treatment providers, while obtaining information about the problem and available services, followed by family therapy, were considered the most helpful treatments. Less than one-third of participants believed complete recovery was possible. Better AN MHL was found in younger, higher educated, and metropolitan domiciled females. DISCUSSION This study offers encouraging results in regard to AN MHL. In particular, there was moderate regard for the use of mental health specialists in the treatment of the disorder. However, there appears to be a misconception that AN is largely the manifestation of low self-esteem and confusion concerning the distinction between AN and bulimia nervosa. AN MHL was poorer in males and those with higher social and health disadvantage.

What are the effects of providing evidence‐based information on eating disorders and their treatments? A randomized controlled trial in a symptomatic community sample

Aim: We hypothesize that a reason for the infrequent uptake of treatments by people with eating disorders is poor knowledge about treatments and outcomes for eating disorders (ED‐Mental Health Literacy; ED‐MHL). Our aim was to test putative health benefits of a brief ED‐MHL intervention.

Better psychological health is associated with weight stability in women with eating disorders

AIM: To explore the associations between changes in weight, eating disorder psychopathology and psychological distress in a community sample of women with eating disorders over two years. METHOD: One hundred and twenty two women identified with disordered eating in a baseline population survey agreed to participate in a follow-up study, of whom 87 (71%), mean age 28±6.2, completed the two-year follow-up. Body mass index, eating disorder psychopathology, psychological distress, and demographic details were assessed at both time points. RESULTS: Over the two years there was a mean weight gain of 1.76 kg (SD=7.03), 11 (13%) women lost ≧5 kg, 25 (29%) gained ≧5 kg, and 49 (58%) remained weight stable (i.e., within 5 kg of baseline weight). Comparisons between those who had lost, gained and remained weight stable showed few significant differences, however, women who remained weight stable were the least psychologically distressed at baseline and those who lost weight had the greatest reduction in shape concern. Body mass index at baseline, and change in level of binge eating episodes were not associated with weight change. CONCLUSIONS: Disordered eating behaviours have little influence on weight change over two years in community women with disordered eating. Low levels of psychological distress at baseline may promote weight stability. Concerns about shape are likely to increase with increased weight.