Identifying eating disorders in adolescents and adults with overweight or obesity: A systematic review of screening questionnaires

House, Eve T; Lister, Natalie B.; Seidler, Anna Lene; Li, Haozhen; Ong, Wee Yee; McMaster, Caitlin M.; Paxton, Susan J.; Jebeile, Hiba

doi:10.1002/eat.23769

Cited by 31 publications

(24 citation statements)

References 87 publications

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“…Current assessment of risk for atypical anorexia nervosa and bulimia nervosa in individuals with overweight and obesity may be limited as assessment tools designed to detect restrictive eating disorders have been developed in lower weight populations and may not have adequate sensitivity when used for individuals with overweight or obesity 78 . Additionally, there is a lack of guidance for clinicians as to how best to assess and monitor eating disorder risk in people with overweight and obesity.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, case reports in adolescents have shown that recognition and diagnosis of atypical anorexia nervosa can be delayed during weight loss attempts as complications may occur at a higher body weight 77. Future trials of behavioral weight management should monitor for the emergence or disordered eating behaviors across the full spectrum of eating disorders.Current assessment of risk for atypical anorexia nervosa and bulimia nervosa in individuals with overweight and obesity may be limited as assessment tools designed to detect restrictive eating disorders have been developed in lower weight populations and may not have adequate sensitivity when used for individuals with overweight or obesity 78. Additionally, there is a lack of guidance for clinicians as to how best to assess and monitor eating disorder risk in people with overweight and obesity.…”

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confidence: 99%

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Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta‐analysis

et al. 2023

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This systematic review examined change in eating disorder risk during weight management interventions. Four databases and clinical trials registries were searched in March and May 2022, respectively, to identify behavioral weight management intervention trials in adults with overweight/obesity measuring eating disorder symptoms at pre-and post-intervention or follow-up. Random effects meta-analyses were conducted examining within group change in risk. Of 12,023 screened, 49 were eligible (n = 6337, mean age range 22.1 to 59.9 years, mean (SD) 81(20.4)% female).Interventions ranged from 4 weeks to 18 months, with follow-up of 10 weeks to 36 months post-intervention. There was a within group reduction in global eating disorder scores (20 intervention arms; Hedges' g = À0.27; 95% CI À0.36, À0.17; I 2 67.1%) and binge eating (49 intervention arms; À0.66; 95% CI À0.76, À0.56; I 2 82.7%) post-intervention, both maintained at follow-up. Of 14 studies reporting prevalence or episodes of binge eating, all reported a reduction. Four studies reported

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta‐analysis

et al. 2023

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“…The EDE was originally published more than three decades ago, and remains among the most widely used interviews for assessing ED symptoms, particularly in ED-focused research. 218 , 219 Core benefits of using the EDE interview among adolescents include: the ability to clarify complex concepts with interviewees who may find certain abstract concepts difficult to comprehend; potentially improving recall via careful orientation to the timeframe captured by the interview; ability to mitigate inattentive or impulsive responding; accounting for external factors that could impact responding (eg, family and cultural context, parent/guardian-influenced food/eating rules); and improved diagnostic accuracy over self-report questionnaires. However, as with any semi-structured interview-based assessment, the EDE requires more extensive training and is associated with greater burden given the time necessary to complete the interview.…”

Section: Discussionmentioning

confidence: 99%

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents

Parker¹,

Lavender²,

Schvey³

et al. 2023

AHMT

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Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).

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“…There is a paucity of literature to guide the assessment of and change in eating disorder risk in individuals with overweight or obesity. Few studies have validated self-report eating disorder questionnaires against a structured clinical interview in people with overweight or obesity (38). Thus, it is challenging to identify normative data in this population to ascertain appropriate cut-points indicating someone may be at risk of, or may meet diagnostic criteria for an eating disorder.…”

Section: Defining Change In Eating Disorder Risk [H3]mentioning

confidence: 99%

Eating Disorders In weight-related Therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management

Jebeile

Lister

Libesman

et al. 2022

Preprint

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The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.

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Identifying eating disorders in adolescents and adults with overweight or obesity: A systematic review of screening questionnaires

Cited by 31 publications

References 87 publications

Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta‐analysis

Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta‐analysis

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents

Eating Disorders In weight-related Therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management

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