Treatment Outcomes and Trajectories of Change in Patients Attributing Their Eating Disorder Onset to Anti-obesity Messaging. Issue 7 (19th September 2021)

• Record Type: Journal Article
• Authors: Mensinger, Janell L.; Cox, Shelbi A.; Henretty, Jennifer R.
• Is Part Of: Psychosomatic medicine. Volume 83:Issue 7(2021)
• Page Start: 777
• Page End: 786
• Publication Date: 2021-09-19
• Subjects: anti-obesity messaging -- eating disorders -- weight stigma -- weight-inclusive care -- higher levels of care -- eating disorder treatment outcomes -- BMI = body mass index -- CI = confidence interval -- EDE-Q = Eating Disorder Examination—Questionnaire -- ED(s) = eating disorder(s) -- EM = estimated marginal -- EMM = estimated marginal mean -- EMM Δ = estimated marginal mean differences -- %TBW = percent target body weight -- SE = standard error -- TBW = target body weight; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000962
• Languages: English
• ISSNs: 0033-3174

Abstract

Abstract : Supplemental digital content is available in the text. ABSTRACT: Objective: Given the increased prevalence of eating disorders (EDs) among individuals higher on the weight spectrum, we aimed to 1) report the prevalence of ED patients in higher levels of care (residential, partial hospitalization, and intensive outpatient) attributing the onset of their ED to anti-obesity messaging, 2) report the most commonly recollected sources of those messages, and 3) determine if those attributing the onset of their ED to anti-obesity messaging a) enter, b) exit, and c) respond to treatment differently from peers who did not. Methods: This retrospective cohort study used data from 2901 patients receiving ED treatment in higher levels of care at a US-based center between 2015 and 2018. Multilevel models examined differences in ED symptoms and trajectories of change over time. NVivo was used to analyze the patients' comments about sources of messages. Results: Eighteen percent attributed their ED onset to anti-obesity messaging, 45% did not, and 37% were unsure. Of those providing comments, the most common sources included the following: educational curriculum/school context (45.9%), media/Internet (24.7%), health care (10.4%), family (9%), and peer bullying (3.7%). At admission, patients attributing their ED onset to anti-obesity messaging had more severe ED symptoms than those who did not (γ = 0.463, standard error [SE] = 0.086, p < .001) and those who were unsure (γ = 0.288, SE = 0.089, p < .001); no differences were evident at discharge ( p > .483). During phase 2 of treatment, patients attributing their ED onset to anti-obesity messaging improved faster than those who did not (γ = 0.003, SE = 0.001, p = .008) and those who were unsure (γ = 0.003, SE = 0.001, p = .014). Conclusions: Anti-obesity messaging may put vulnerable individuals at risk for EDs. We recommend increasing weight bias training for school personnel and health care professionals. To reduce health disparities, we also suggest the promotion of weight-neutral health-enhancing self-care practices in media and public health campaigns, legislative policies, and health care overall.