The transition to college has been identified as a critical period for weight gain; however, only a limited number of studies have examined this phenomenon. The college setting may promote weight gain, thus the purpose of the present study was to quantify changes in BMI in first year students during their first semester of college and to understand factors associated with weight gain, such as eating behaviors, physical activity, and body shape ideals. Significant changes in weight were detected between Time 1 and 2 with a mean weight gain of 1.24 kg. The majority of participants (73.1 %) gained weight and the percentage of participants categorized as overweight increased from 23.1 % to 3 1.4%. Regression models did not reveal significant predictors of weight gain. Paired t-tests revealed significant decreases in disinhibition, binge eating, and number of days of physical activity over the semester. Participants who gained weight had greater body image dissatisfaction than those who did not gain weight. These findings underscore the need for more studies on factors related to weight gain and prevention efforts in the college population.

Can the built environment positively influence the treatment of an eating disorder? Does the built environment play a role in the quality of care, the rehabilitation process and the lasting affects of treatment in eating disorders and if so, what role does it play? What are the important parameters to consider in designing such a space? Currently there are few facilities designed specifically for the treatment of this disorder. Of those facilities, there is a lack of research regarding the effects of the built environment. Therefore, the process of answering these questions must begin by assessing parameters in architectural precedents that have a strong, therapeutic environment. After studying several therapeutic environments, certain parameters emerged as common elements in each project. Therefore, the following parameters were chosen and used to systematize research: spatial triad (group, therapeutic, and solitude spaces), connection between interior and exterior, natural light, and sensory qualities (acoustic intimacy, space and scent, shape and touch, skeleton and muscle). While several architectural precedents exist; La Tourette, a monastery near Lyon, France designed by architect Le Corbusier, became the most significant structure studied. Research of this monastery included a two night stay with complete access to the facility. Spending full days in the monastery provided an opportunity to absorb the therapeutic qualities of the space. After analyzing common parameters across several chosen architectural precedents, a design solution was developed as a means to check the analysis. The solution involved re-purposing a warehouse building in an urban setting. Spatial connections and current treatment research drove the conceptual process which included diagramming, model building, and sketching. Key criteria for spatial development involved privacy, security, and circulation. The final design incorporated each precedent, creating an interior type that addresses the specific needs of a residential eating disorder clinic.

Background: The incidence of eating psychopathology in athletes is considerably higher than in the general population. Facilitating the early identification and successful management of eating problems in this group is therefore essential. Objectives: The thesis aimed to improve our empirical understanding of the identification and management of eating problems in athletes. Three areas were investigated. First, a measure of compulsive exercise was evaluated as a method of identification of eating psychopathology in athletes. Second, the thesis explored coach methods of identification and management of eating problems among their athletes. Finally, athlete experiences of disclosing and seeking treatment for eating disorders were explored. Main findings: The Compulsive Exercise Test was found to be a useful measure in screening for eating psychopathology in athletes. Track and field coaches relied heavily on the physical symptoms of disordered eating when identifying potential eating problems in athletes. Coaches described difficulties in identifying eating psychopathology in athletes, and in signposting athletes to appropriate support. Individual differences in the perceived value of disclosing an eating disorder were discovered among athletes currently seeking treatment. Lastly, athletes described struggling to engage with their eating disorder treatment programme, particularly where exercise was restricted or reduced. Implications: The findings suggest a need for greater support, education and resources for coaches and sports professionals in identifying and facilitating treatment access among their athletes. The Compulsive Exercise Test may be one way to assist sports professionals in identifying athletes with elevated levels of eating psychopathology. Athletes may be more willing to engage with treatment programmes when they are closely involved in goal setting and their exercise and sporting commitments are incorporated where possible.

Background: Eating disorders are more common among adolescents and younger adults and are formed through body images and beauty standards from the society. This study focuses on anorxia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified (EDNOS). Aim: The aim of this study was to illuminate patients' experiences of living with an eating disorder. Method: This study is a literature study where eleven articles were analysed and formed into a new result. Results: This study revealed four main themes and eight sub themes. The main themes were negative experiences and feelings, with the subthemes shame over the disease and guilt and responsibility. To handle life with the subthemes to be controlled or to be in control and to conceal or to not conceal. To search for understanding and confirmation with the subthemes social isolation and understanding and helplessness or confirmation. The way to health with the subthemes to see the person behind the disease and to allow oneself to recover. Conclusion: The patients’ experiences revealed both positive and negative aspects of living with an eating disorder. Patients’ experiences showed that healthcare professionals have little knowledge about eating disorders and have to increase their knowledge on the subject in order to know how to properly guide and care for patients with an eating disorder.

Orthorexia Nervosa (ON) is the term for a proposed new eating disorder, used to describe a pathological obsession with healthy or ‘clean’ eating. For individuals with ON, the obsession with eating ‘healthy’ foods, and the elimination of foods considered ‘unhealthy’ or ‘impure’, results in impairment to social, physical, occupational and/or other areas of functioning. Whilst there is still debate as to whether ON describes a distinct eating disorder, and there is no consensus around diagnostic criteria as yet, ON is an emerging topic for research, with more cases coming to light both clinically, and in the media. Although some quantitative research has been carried out in ON, particularly focusing on the measurement and prevalence rates of this proposed disorder, no qualitative studies have been published to date to explore individuals’ personal experiences of ON. Thus, for this project, 40 pre-existing blog entries describing first-person experiences of ON from fifteen women bloggers were analysed using thematic analysis. Five key themes were identified: 1) confusion around diagnosis, 2) initial motivations for a healthier lifestyle, 3) fuelling the problem- social influences, 4) when healthy becomes unhealthy ..., and 5) avoidance, isolation and compensation. The clinical implications of these findings were explored, particularly focusing on the social context of ON, diagnostic crossover between ON and other eating disorders, and the role of fear, perfectionism and perceived control. Whilst the debate around the diagnosis of ON continues, these bloggers’ accounts suggest that ON is experienced as a legitimate and debilitating disorder, worthy of clinical and research investigation in its own right.

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2016-04-08T13:55:08Z No. of bitstreams: 1 PDF - Mielle Neiva Santos.pdf: 1770622 bytes, checksum: 763f433b505a4065e3ce458785efed2b (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2016-04-12T17:22:57Z (GMT) No. of bitstreams: 1 PDF - Mielle Neiva Santos.pdf: 1770622 bytes, checksum: 763f433b505a4065e3ce458785efed2b (MD5) / Made available in DSpace on 2016-04-12T17:23:52Z (GMT). No. of bitstreams: 1 PDF - Mielle Neiva Santos.pdf: 1770622 bytes, checksum: 763f433b505a4065e3ce458785efed2b (MD5) Previous issue date: 2014-02-25 / Goal: Assess the feeding behavior, the occurrence of binge eating and its relationship with nutritional status and cardiovascular risk score Pathobiological Determinants of Atherosclerosis in Youth (PDAY) in school adolescents. Methodology: Study of 540 teenagers between 15 and 19 years of high school public schools. Students were interviewed for the evaluation of cardiovascular risk, through PDAY score and other related variables, answered questionnaires auto applied to identification of binge eating (Dutch Food frequency Questionnaire-QHCA) and were evaluated by Anthropometry. Results: PDAY score was ranked low risk (58.5%) and intermediate/high risk cardiovascular risk (41.5%). Obtained 13.9% of adolescents with some level of binge eating. There was substantial consumption of unhealthy food markers. He was also the high prevalence of physical inactivity (79.1%) and of inactivity/lack in physical activity (58.9%). According to the simple linear regression, the abdominal circumference is the variable that most interferes in BMI (51.7%), relationship that remained in multivariate regression (54.3%). Conclusions: The nutritional status was related to the score of binge eating and this was related to increased levels of total cholesterol, LDL cholesterol and lower levels of physical activity. PDAY score and score of compulsion not shown associates. He was the high prevalence of adolescents with some level of binge eating, pointing out that the maintenance of nutritional status mechanisms need to be further studied, to configure how eating disorders. / Objetivo: Avaliar o comportamento alimentar, a ocorrência de compulsão alimentar e sua relação com o estado nutricional e com o risco cardiovascular pelo escore Pathobiological Determinants of Atherosclerosis in Youth (PDAY) em escolares adolescentes. Metodologia: Estudo realizado com 540 adolescentes entre 15 e 19 anos de escolas públicas de ensino médio. Os estudantes foram entrevistados para avaliação do risco cardiovascular, através do escore PDAY e outras variáveis relacionadas, responderam questionários auto aplicados para identificação de compulsão alimentar (Questionário Holandês de Frequência AlimentarQHCA) e foram avaliados por antropometria. Resultados: O escore PDAY foi classificado em baixo risco (58,5%) e risco intermediário/alto risco cardiovascular (41,5%). Obteve-se 13,9% de adolescentes com algum nível de compulsão alimentar. Houve o consumo substancial de marcadores de alimentação não saudável. Destacou-se também a alta prevalência de sedentarismo (79,1%) e de inatividade/insuficiência na atividade física (58,9%). De acordo com a regressão linear simples, a circunferência abdominal é a variável que mais interfere no IMC (51,7%), relação que permaneceu na regressão multivariada (54,3%). Conclusões: O estado nutricional mostrou-se relacionado ao escore de compulsão alimentar e esta esteve relacionada com maiores níveis de colesterol total, colesterol LDL e com menores níveis de atividade física. O escore PDAY e escore de compulsão não se mostraram associados. Destacou-se a elevada prevalência de adolescentes com algum nível de compulsão alimentar, apontando que os mecanismos de manutenção do estado nutricional precisam ser mais bem estudados, para que não se configurem como transtornos alimentares futuros.

Pro-anorexia content, or content that promotes the development and sustainment of eating disorders, is an important topic that has been understudied in the literature. Previous research has primary examined the content featured on pro-anorexia websites, but few researchers have conducted experimental studies examining the direct impact viewing pro-anorexia content has on individuals struggling with an eating disorder. The current study was an experimental study that exposed participants to three conditions: proanorexia content, pro-recovery content, and a control group. The researcher examined the impact that viewing the three levels of content for 10 minutes had on individuals who met criteria and who did not meet criteria for an eating disorder on the Eating Disorder Diagnostic Scale. Participants were examined using the Eating Attitudes Test to examine eating disorder symptomology and the Body Assessment Scale to examine body satisfaction after every condition. The results of this study showed that participants who met criteria for an eating disorder reported increased eating disorder symptomology after viewing the pro-anorexia condition.

Although the research on expectancy theory and body image and eating disturbance is very limited, it appears to be an extremely useful and promising line of study. It appears likely that the application of expectancy theory would lend itself well to the area of body image disturbance and eating disorders. Within the field of body image disturbance and eating disorders research, expectancies would most likely refer to the anticipated consequences of being thin. Such expectancies may be established by an individual's direct experience with weight loss and dieting or through the observation of the messages concerning the societal "thin ideal" projected by the media, parents, and peers. The current study attempted to develop and validate a measure of women's expectancies, or anticipated consequences of being thin. The Thinness Expectancy Questionnaire (TEQ) was developed in a series of three studies: Item Generation, Item Analysis, and Validity and Reliability Analysis. First, a pilot study was conducted in order to generate a broad range of items regarding expectancies about being thin. Second, the initial measure was administered to 355 undergraduate females. A factor analysis and item analysis produced a final version of the TEQ. Last, reliability and validity analyses were conducted. Overall, results indicate that positive thinness expectancies are related to body image and eating problems whereas negative expectancies appear to have a limited connection with or are unrelated to body image/eating disorders. Although hypothesized models indicated poor to mediocre fits of the data, they represent an initial attempt at examining the role of thinness expectancies in the development of body image concerns and eating disturbance. The results indicate that positive expectancies of thinness are related to women's body dissatisfaction and eating disturbance. In other words, women's positive expectations and assumptions about being thin may put them at risk for developing difficulties with body image and eating concerns. As a result, preventative interventions that incorporate techniques that challenge or modify these cognitions would seem to be most effective.

Essstörungen, wie Anorexia Nervosa oder Bulimia Nervorsa, gehen mit einer hohen psychischen Belastung einher und können gesundheitliche Schäden zur Folge haben. Bei Athleten mit einer Essstörung kann es darüber hinaus zu Einbußen in der Sportleistung kommen. Gerade für den Hochleistungssport ist es daher wichtig zu wissen, welches Risiko für Essstörungen besteht und wodurch das Risiko bedingt wird. Bisherige Studien zeigen deutliche Unterschiede zwischen den Sportarten. Eliteathleten aus ästhetischen Sportarten, wie rhythmische Sportgymnastik oder Eiskunstlauf, scheinen ein besonders hohes Essstörungsrisiko aufzuweisen. Deutlich geringere Prävalenzraten finden sich in Ballsportarten, wie Handball oder Basketball. Um zu verstehen, welche Aspekte der Sportart das Essstörungsrisiko beeinflussen, beschäftigt sich die vorliegende Arbeit mit der Rolle sportbezogener Variablen. In die Studien einbezogen wurden insgesamt 171 Athleten zwischen 11 und 18 Jahren (im Mittel 14.1 ± 1.8 Jahre) aus ästhetischen Sportarten und Ballsportarten, die einen Fragebogenpaket mit Instrumenten zu gestörtem Essverhalten, allgemeiner Körperunzufriedenheit, sozialem Druck im Sport, sportbezogener Körperunzufriedenheit, Schlankheitsstreben zur Leistungssteigerung und negativen Gefühle bei Trainingsausfall ausfüllten. Nach einem Jahr wieder befragt wurden 65 Athleten aus ästhetischen Sportarten. Nach Kontrolle von Alter, Geschlecht, BMI und allgemeiner Körperunzufriedenheit trugen sportbezogene Variablen signifikant zur weiteren Varianzaufklärung gestörten Essverhaltens bei. Die Längsschnittanalysen bestätigten einen Risikofaktorstatus für Schlankheitsstreben zur Leistungssteigerung. Zusammenhänge zwischen sportbezogenen Aspekten und gestörtem Essverhalten zeigten sich sowohl in Hochrisikosportarten für gestörtes Essverhalten (ästhetischen Sportarten), als auch in Niedrigrisikosportarten für gestörtes Essverhalten (Ballsportarten). Mit Ausnahme von negativen Gefühlen nach Trainingsausfall traten die sportbezogenen Variabeln häufiger in den ästhetischen Sportarten auf als in den Ballsportarten. Die eigenen Befunde verdeutlichen somit, dass der Einbezug potentieller sportbezogener Risikofaktoren − zusätzlich zu den allgemeinen Risikofaktoren − zum besseren Verständnis der Essstörungssymptomatik von Athleten beiträgt. Vor allem die Bedeutung von Gewicht für die Leistung beeinflusst das Essstörungsrisiko bei Athleten und ist stärker ausgeprägt in Hochrisikosportarten für Essstörungssymptomatik. / Eating disorders such as Anorexia Nervosa and Bulimia Nervosa are serious, difficult-to-treat psychiatric disorders. For elite athletes, in addition to impairment in health and everyday life, an eating disorder can lead to a decline in sports performance. Knowledge of the risk for eating disorders in sports is therefore important. Prevalence rates for disordered eating vary depending on the type of sport. A particularly high risk was found in elite athletes from aesthetic sports such as figure skating or dance. Prevalence rates are lower in ballgame sports, such as handball or basketball. The purpose of this study was to focus on sport-specific variables in different sport types and to examine their relation to disordered eating. One hundred and seventy-one aesthetic and ballgame sports athletes participated in this study (mean age 14.1 ± 1.8 years). At a follow-up survey one year later, 65 athletes from aesthetic sports participated again. The questionnaire package included disordered eating, general body dissatisfaction, social pressure to be lean from sports environment, sports-related body dissatisfaction, desire to be leaner to improve sports performance and emotional distress resulting from missed exercise sessions. In predicting eating disorder symptoms in athletes from aesthetic sports, we observed that after controlling for sex, age, BMI, and body dissatisfaction, sports-related variables were able to account for an additional variance in disordered eating. The longitudinal analyses indicated that a desire to be leaner to improve sports performance is predictive of disordered eating in aesthetic sports. Sports-related variables were associated with disordered eating also in ballgame sports, but some risk factors, such as the desire to be leaner to improve sports performance, were less prevalent. In conclusion of these results, sports-related parameters are relevant for understanding eating disorder symptomatology in sports. Athletes seem to be more at risk if they perceive the possibility to enhance sports performance through weight-regulation, which is more prevalent in aesthetic sports.

En terapeutisk relation är viktig i omvårdnaden av patienter med ätstörningar och det är viktigt att sjuksköterskan är medveten om dess betydelse i omvårdnaden. Syftet var att undersöka hur en terapeutisk relation skapas samt dess betydelse i omvårdnaden mellan sjuksköterskan och patienten med ätstörning. För sjuksköterskor kan det vara utmanande att etablera en terapeutisk relation till patienter med ätstörningar, då det är vanligt att dessa patienter inte har sjukdomsinsikt. Sjuksköterskan kan använda sig av olika strategier och verktyg för att skapa en terapeutisk relation och en vårdande miljö. Studien genomfördes som en litteraturstudie och 12 vetenskapliga artiklar analyserades. Studiens resultat visar att om en terapeutisk relation ska kunna etableras krävs det kunskap, tid, respekt samt kontinuerlig information från sjuksköterskan till patienten. Mer forskning efterfrågas om den terapeutiska relationens betydelse i omvårdnaden kring patienter med ätstörning, då det inte fanns mycket forskning i ämnet. Även mer utbildning i sjuksköterskeprogrammet om omvårdnad vid psykisk ohälsa efterfrågas. / A therapeutic relationship is important in nursing care of patients with eating disorders and it is significant that the nurse is aware of the importance in the nursing care. The purpose was to investigate how a relationship is created and its significance in the care between the nurse and the patient with an eating disorder. It can be challenging for nurses to establish a therapeutic relationship with patients with eating disorders, because it is common that these patients do not have illness insight. The nurse can make use of different strategies and tools to develop a therapeutic relationship and a caring environment. The study was conducted as a litterature study and 12 scientific articles were analyzed. The result of the study shows that if a therapeutic relationship is going to be established it demands knowledge, time, respect and continuous information from the nurse to the patient. More scientific research about the therapeutic significance in the nursing care around patients with eating disorders is requested, since there was not much research on the subject. Even more education in the nursing programme for nursing care in mental health is enquired.