Janell L Mensinger1, Shelbi A Cox, Jennifer R Henretty. 1. Villanova University, M. Louise Fitzpatrick College of Nursing, Villanova, PA Center For Discovery, Discovery Behavioral Health, Los Alamitos, CA.
Abstract
OBJECTIVE: Given 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 than peers who did not. METHODS: This retrospective cohort study utilized data from 2,901 patients receiving ED treatment in higher levels of care at a US-based center between 2015 and 2018. Multi-level 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: 18% attributed their ED onset to anti-obesity messaging, 45% did not, 37% were unsure. Of those providing comments, the most common sources included: educational curriculum/school context (45.9%), media/internet (24.7%), healthcare (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, 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 values > .483). During phase two 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). CONCLUSION: Anti-obesity messaging may put vulnerable individuals at risk for EDs. We recommend increasing weight bias training for school personnel and healthcare 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 healthcare overall.
OBJECTIVE: Given 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 than peers who did not. METHODS: This retrospective cohort study utilized data from 2,901 patients receiving ED treatment in higher levels of care at a US-based center between 2015 and 2018. Multi-level 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: 18% attributed their ED onset to anti-obesity messaging, 45% did not, 37% were unsure. Of those providing comments, the most common sources included: educational curriculum/school context (45.9%), media/internet (24.7%), healthcare (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, 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 values > .483). During phase two 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). CONCLUSION: Anti-obesity messaging may put vulnerable individuals at risk for EDs. We recommend increasing weight bias training for school personnel and healthcare 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 healthcare overall.
Authors: James Kite; Bo-Huei Huang; Yvonne Laird; Anne Grunseit; Bronwyn McGill; Kathryn Williams; Bill Bellew; Margaret Thomas Journal: EClinicalMedicine Date: 2022-05-20