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Background: Eating disorders as term includes several diagnoses that often result in serious conditions related to eating-habits, weight and body image. Early detection, confirmed diagnosis and initiated treatment significantly increases the chance of recovery. There is a lack of knowledge regarding how physiotherapists identify and treat eating disorders in primary care. Objective: To examine the physiotherapists’ experiences of identifying and treating eating disorders as well as problems related to them, within primary care. Methods: A qualitative method with semi structured interviews with five participants, based on convenience sampling was used. Qualitative content analysis was used for data analysis. Results: This study showed experienced difficulty in both identifying and treating eating disorders among physiotherapists. They pointed out that it was important to have an awareness about the diagnoses, and that plenty of different factors can complicate the process of identifying them. They also experienced an uncertainness regarding the role of the physiotherapist. Treatment was described to be individualized and applied with a biopsychosocial approach. Conclusion: Eating disorders and problems related to them were experienced as complicated and hard to treat. This study shows an uncertainness regarding the role of the physiotherapist when it comes to these patients. Previous research indicates that physiotherapeutic methods could have a positive effect as a part of the treatment. However, further research and knowledge are needed to establish the utility of physiotherapy when it comes to eating disorders in primary care. / Bakgrund: Begreppet ätstörningar inkluderar ett flertal diagnoser och tillstånd som ofta leder till allvarliga tillstånd kopplade till ätbeteende, vikt och kroppsuppfattning. Tidig upptäckt, ställd diagnos och påbörjad behandling ökar chansen för tillfrisknande hos drabbade individer. Det finns en tydlig kunskapslucka i hur fysioterapeuter upptäcker och behandlar ätstörningar inom primärvården. Syfte: Att undersöka fysioterapeuters upplevelser och erfarenheter av att upptäcka och behandla ätstörningar samt problem relaterade till dessa inom primärvården. Metod: I studien användes kvalitativ design i form av semistrukturerade intervjuer med fem deltagare utifrån ett bekvämlighetsurval. Databearbetning utfördes genom kvalitativ innehållsanalys. Resultat: Studien visade att fysioterapeuter upplevde att det var svårt att upptäcka och behandla ätstörningar. De påpekade att det var viktigt att ha en medvetenhet om sjukdomarnas existens och att många olika faktorer kan försvåra identifieringen. De upplevde också en oklarhet i om fysioterapeuten bör ha en aktiv roll i efterföljande behandling. Gällande behandlingen fanns uppfattningen att den bör individanpassas och tillämpas med ett biopsyko-socialt synsätt. Slutsats: Ätstörningar och problem relaterade till dessa upplevs i många fall komplicerade och svårbehandlade. Studien visar på en osäkerhet i vilken roll fysioterapeuten bör ta vid mötet av dessa patienter. Tidigare forskning tyder på att fysioterapeutiska åtgärder kan ha en positiv inverkan på behandlingen. Ytterligare forskning och kunskap behövs dock för att tydliggöra fysioterapeutens roll och kompetens gällande ätstörningar inom primärvården.

The purpose of this study was to determine which NCAA Division I universities have an eating disorder policy specific to collegiate athletes. Demographic factors were also assessed for their relationship to whether or not a university has a specific policy. An additional goal of the study was to examine currently existing policies, assess common themes between them, and determine which themes are most appropriate and beneficial for future policies. The study used both qualitative and quantitative data analysis. Participants of the study were the 128 NCAA Division I Football Bowl Subdivision universities. The research design involved a documentary analysis to determine which universities currently have a policy specific to athletes with eating disorders. An online search for policies yielded 13 official policies, primarily found through a general Google search. For the universities in which an online search did not provide results, athletic department personnel were contacted by email requesting the status of their policies in relation to athletes with eating disorders. Of the 115 universities that were contacted, 50 universities replied. Through analysis of the email responses, the researcher found an additional 20 universities with a specific policy regarding athletes with eating disorders. In total, the researcher found 33 of the 128 universities (26%) to have an official policy specific to athletes with eating disorders. Existing policies were analyzed and coded into themes. The researcher found 16 major themes that were recurring throughout existing policies. Each theme was analyzed individually to determine recurring patterns. The researcher found between four and six recurring patterns per major theme. / Kinesiology

Background: Individuals with binge eating disorder (BED) experience a loss of control (i.e., poor inhibitory control) during binge eating, where stress is a common antecedent for binge episodes. However, few studies examine acute stress in BED and, to date, psychosocial stress relationships with inhibitory control are unexamined. Purpose: The current study investigated acute psychosocial stress effects on inhibitory control in BED. Additionally, inhibitory control relationships with BED treatment outcome were explored. Methods: Thirty-three individuals with BED were randomized to a stress (n = 17) or no stress condition (n = 16). All completed self-report measures including the Profile of Mood States and the Binge Urge Scale. Following the stressor, individuals completed the Stop-Signal Task (SST), a well-validated measure of inhibitory control. Relationships between post-stress anxiety with inhibitory control and eating pathology were explored. Furthermore, treatment outcome relationships with levels of inhibitory control, and negative urgency (an impulsive personality trait) were explored. Results: In the stress condition, individuals reported increased state anxiety immediately following stress, but experienced a decrease back to baseline levels of anxiety by the end of the SST. Stress resulted in impaired inhibitory control performance on the SST. Binge urges increased across both conditions over time. Measures of inhibitory control and negative urgency did not relate to treatment outcome. Conclusion: This study is novel in directly examining psychosocial stress effects on inhibitory control, which has not been studied in BED. These results show subjective stress effects in BED are short-lived; however, behaviourally, stress has a lingering effect on inhibitory control. Increasing binge urges across the experimental session in the no stress condition suggests a role for generalized anxiety on this impulse. These findings have clinical implications for binge urges as a therapeutic target, and for informing individuals with BED about the implications of stress on their binge eating. / Thesis / Master of Science (MSc)

Research suggests that the associations between femininity, body image and eating disorders are intricate. How these constructs are linked to each other still needs to be determined. The purpose of this study was to gain a deeper understanding of these links, examining the mediational relationship among these constructs. Also, the prediction that bulimia and binge eating disorder symptoms have a similar origin was tested and compared. Some researchers have suggested that the pathways leading to these disorders are equivalent and the main difference between the two is the dietary restriction, while others see them as distinct disorders with different etiology. A total of 355 female college students (ages 18 to 26) completed a set of questionnaires that assessed femininity, feminine gender role stress, body dissatisfaction, bulimia, and binge eating disorder. Results showed that body dissatisfaction mediates the relationship between femininity or feminine gender role stress with bulimia symptoms, as well as the relationship between feminine gender role stress and binge eating disorder symptoms. Results indicate that body dissatisfaction related to femininity or to feminine gender role stress may contribute to higher levels of bulimia symptoms. The findings also suggest that body dissatisfaction related to feminine gender role stress may contribute to higher levels of binge eating disorder symptoms. Results did not support the mediational role of body dissatisfaction between femininity and binge eating disorder. However, the mediational role of feminine gender role stress between femininity and body dissatisfaction was partially supported, suggesting that feminine gender role stress might only be one pathway by which femininity may have an impact on body dissatisfaction. / Master of Science

Although evidence demonstrated efficacy of cognitive-behavioral therapy (CBT) in adolescents with binge-eating disorder (BED), treatment response is heterogeneous. This study uniquely examined baseline predictors of symptom trajectories in N = 73 adolescents (12–20 years) with an age-adapted diagnosis of BED (i.e., based on objective and subjective binge-eating episodes). Based on evidence from adult BED, dietary restraint, overvaluation of weight/shape, and depressive symptoms were used to predict changes in abstinence from binge eating and eating disorder psychopathology after 4 months of individual, face-to-face CBT using growth models. Longitudinal trajectories of abstinence from objective and subjective binge eating and global eating disorder psychopathology assessed via the Eating Disorder Examination were modeled for five time points (pre- and posttreatment, 6-, 12-, and 24-month follow-up). Beyond significant, positive effects for time, no significant predictors for abstinence from binge eating emerged. In addition to significant decreases in eating disorder psychopathology over time, higher pretreatment dietary restraint and overvaluation of weight/shape significantly predicted greater decreases in eating disorder psychopathology over time. Consistent with research in adult BED, adolescents with higher than lower eating disorder-specific psychopathology especially benefit from CBT indicating that restrained eating and overvaluation of weight/shape may be BED-specific prognostic characteristic across developmental stages. Future predictor studies with an additional focus on potential age-specific predictors, such as family factors, and within-treatment processes may be critical in further evaluating treatment-related symptom trajectories in adolescent BED.

People exercise for various reasons. Some do it to become physically strong, others to improve their cardio fitness, and some to promote their mental health. It is unclear to what extent; but there are those who work out in a way that becomes harmful to them. Exercise can go from being the ultimate expression of health, to becoming a symptom of an eating disorder. Fitness instructors’ and personal trainers’ are responsible for the safety of members at gyms and fitness facilities and for ensuring that they do not injure themselves during a workout session. What is included in the concept of safety is arbitrary and fitness facilities around Sweden approach this in different ways. The purpose of this study is to investigate fitness instructors' and personal trainers' perceptions of their knowledge, competence and responsibility when dealing with eating disorders or suspected eating disorders in the fitness context. Semi-structured interviews were conducted with eight participants consisting of personal trainers and fitness instructors from four different gyms and fitness facilities in the county of Västerbotten, Sweden. Collected data was analysed through reflexive thematic analysis (Braun & Clarke, 2022). The analysis resulted in three themes and ten sub-themes. The results suggest that a majority of the interviewed fitness instructors and personal trainers perceive their theoretical knowledge about eating disorders as good/sufficient, but insufficient regarding practical knowledge to manage eating disorders in the fitness environment. Responding to a concern regarding eating disorders among gym members presents a range of challenges that are described as emotionally stressful. Furthermore, fitness instructors and personal trainers need more practical knowledge in dealing with eating disorders as well as clear guidelines and policies regarding where their responsibilities begin and end.

Clinical and subclinical eating pathology are common, especially among female undergraduates. Such problems are often chronic and associated with a range of negative medical and psychological outcomes. Thus, it is important to develop effective prevention programs to reduce eating disorder risk. Numerous studies suggest that dissonance-based prevention programs are the most successful in reducing eating disorder risk factors, however, such programs might not be convenient for students limited by scheduling restraints or geographic proximity. Further, some students may be reluctant to attend such groups due to lack of anonymity. One way to address these potential barriers is to adapt dissonance-based programs for online use. However, no extant studies have examined the feasibility of this mode of delivery for dissonance-based programs. The current study examined the effectiveness of an online dissonance-based program, and compared it with traditional face-to-face delivery and assessment-only control conditions. It was hypothesized that: 1) online and face-to-face dissonance programs would produce comparable results; and 2) both of these active treatments would yield improvements in eating disorder outcomes (e.g. reduced thin ideal internalization, body dissatisfaction, dieting, negative affect, and eating disorder symptoms) compared with an assessment-only control condition. Results partially supported the original hypotheses. Modified intent-to-treat analyses (MITT) indicated that participants in both the face-to-face and online intervention groups showed less body dissatisfaction at post-intervention assessment compared to assessment only participants. Further, when analyses were conducted using a non-intent-to-treat (non-ITT) approach (examining only the outcomes of participants who completed the intervention), significant post-intervention differences were observed for all outcome variables. Specifically, individuals in both intervention groups showed lower thin-ideal internalization, body dissatisfaction, restraint, negative affect, and fewer eating disorder symptoms compared to assessment only participants. This study indicates that there may be some promise in adapting dissonance-based eating disorder prevention programs for online use. Future studies should continue to refine online adaptations of such programs and examine the effects of such programs with different populations.