Eating disorders are complex mental health conditions that typically develop during adolescence or early adulthood and may have a significant adverse impact on both physical and mental health. The main types of eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder, all of which are characterized by altered eating behaviours and associated health problems (Robatto et al., 2024). Eating disorders may be associated with a range of psychological and somatic complications, including depression, anxiety, cardiovascular and endocrine disorders, as well as an increased risk of mortality (Mushtaq et al., 2023). The effects of these disorders may also manifest in the oral cavity. Therefore, in dental hygiene practice, particular importance should be placed on the early recognition of potential oral health changes, individualized assessment of the patient’s oral health status, and the selection of appropriate preventive measures. Dental hygienists may play an important role not only in the prevention of oral diseases but also in the early recognition of oral manifestations potentially associated with eating disorders and in encouraging patients to seek timely multidisciplinary professional care.
Objective. The aim of this paper was to examine the association between appearance-based social comparison and eating disorder symptoms, body satisfaction, depressive symptoms, drive for muscularity, self-esteem, and physical activity in Brazilian college women. Method. The participants were 542 college women aged 18 to 30. A questionnaire was used to collect information on appearance comparisons, eating disorders symptoms, body satisfaction, depressive symptoms, drive for muscularity, self-esteem, and physical activity. A multiple linear regression was conducted adjusted by age, marital status, body mass index, and economic level. Results. The model that best explained the appearance comparisons scores variation included eating disorders symptoms (β= .385; p< .001), body satisfaction (β= -.200; p< .001), depressive symptoms (β= .169; p< .001), and drive for muscularity (β= .091; p< .05). Conclusion. Eating disorders, depressive symptoms, drive for muscularity, and body satisfaction were associated with appearance comparisons.
Background Achieving early glycemic control in adolescents with diabetes is associated with improved short- and long-term health outcomes. The aim of this study was to examine the relationship between eating attitudes and glycemic control, as well as the factors associated with eating attitudes and glycemic control, in adolescents with diabetes. Methods This descriptive cross-sectional study included 143 adolescents with diabetes, aged 10–19 years, who attended a research hospital between February and April 2024. The data were collected using a Descriptive Information Form, Eating Attitudes Test (EAT) and an information form questioning the values of some metabolic variables. Results The mean age of the participants was 14 ± 2.3 years and 49.7% had diabetes between 1–5 years. The mean total score of the EAT scale was 16.62 ± 8.30. The mean score of the “Dieting” subscale of the EAT scale was 10.39 ± 5.58, the mean score of the “Bulimia food preoccupation” subscale was 2.33 ± 3.03 and the mean score of the “Oral Control” subscale was 3.79 ± 3.08. There was no significant difference between the mean EAT total score and glycemic control. Conclusions The mean EAT-26 total score was below the commonly used cutoff score, and no significant association was found between EAT-26 scores and HbA1c. Differences in EAT-26 total and subscale scores were observed according to selected demographic and clinical characteristics, including BMI, treatment modality, and treatment adherence. These findings describe self-reported eating attitudes in the study sample and support the inclusion of eating-related assessment within the holistic care of adolescents with Type 1 DM.
Objective: To investigate the relationship between orthorexia dimensions, specifically healthy orthorexia (HeOr) and orthorexia nervosa (OrNe), and hematological inflammatory markers.Methods: This cross-sectional, analytical study included 218 healthy volunteers (73.9% male, median age: 25.0 years) who were evaluated between February 2026 and April 2026.Sociodemographic profiles and the Teruel Orthorexia Scale scores were obtained.Complete blood count parameters and inflammatory indices, including the monocyte-to-lymphocyte ratio (MLR) and systemic inflammation response index (SIRI), were analyzed.Results: HeOr scores demonstrated significant negative correlations with white blood cell count (r = -0.163,P = 0.016), neutrophil count (r = -0.160,P = 0.019), monocyte count (r = -0.244,P < 0.001), platelet count (r = -0.168,P = 0.013), MLR (r = -0.134,P = 0.049), and SIRI (r = -0.185,P = 0.006).Conversely, OrNe scores exhibited a significant negative correlation only with monocyte count (r = -0.171,P = 0.012) and showed no significant associations with other hematological parameters or systemic inflammatory indices.Conclusion: Individuals with higher HeOr tendencies display a healthier systemic inflammatory profile, likely reflecting beneficial dietary choices.Despite being characterized by more rigid cognitions and behaviors toward healthy eating, OrNe tendencies do not manifest a healthier inflammatory profile.
Orthorexia Nervosa (ON) is widely regarded as an emerging eating disorder although it is not currently recognised as a formal diagnosis. It is characterised by a strict adherence to “pure” eating which becomes excessive and can lead to nutritional deficiencies, psychological distress, and impaired daily functioning. Restrictive eating behaviour in ON shows overlap with Restricted Repetitive Behaviours (RRBs) observed in autism. However, the conceptual relationship between ON and autism remains underexplored. This perspective article synthesises existing literature to explore potential overlapping and diverging mechanisms of RRBs across ON and autism. Intolerance for Uncertainty is highlighted as a possible shared mechanism that may contribute to RRBs observed in both ON and autism, whereas Cognitive Inflexibility and Perfectionism may mechanistically differentiate the conditions. We consider that autistic RRBs reflect neurodevelopmental divergence, whereas orthorexic RRBs may be influenced by evaluative belief-centred cognitions. We propose a conceptual model outlining how cognitive, affective and functional factors may interact to produce and maintain RRBs. Clarifying these distinctions is important in supporting clinicians to appropriately consider the drivers and mechanisms underlying RRBs across ON and autism, therefore supporting accurate diagnosis, formulation and treatment.
Background Eating-related behavioural factors may contribute to the complexity of glycaemic management in type 2 diabetes mellitus (T2DM), but their relationships with treatment context remain insufficiently understood. This study examined hedonic hunger and eating-disorder symptom dimensions in relation to glycaemic control across different treatment regimens in adults with T2DM. Methods This cross-sectional study included 203 adults with T2DM attending an outpatient diet clinic in southeastern Turkey between March and September 2025. Participants were receiving oral antidiabetic medication only ( n = 108), insulin only ( n = 32), or combined oral medication plus insulin therapy ( n = 63). Hedonic hunger was assessed using the Power of Food Scale (PFS), and eating-disorder symptom dimensions using the 13-item Eating Disorder Examination Questionnaire–Short Form (EDE-Q-13). Anthropometric measurements, 24-h dietary recall data, fasting plasma glucose (FPG), and glycated haemoglobin (HbA1c) were obtained. Hierarchical linear regression was used to examine factors associated with HbA1c. Results HbA1c differed substantially across treatment groups and was highest in the insulin-only group ( p < 0.001). Several PFS subscales and EDE-Q-13 symptom dimensions also differed between groups, although their effect sizes were small. Selected PFS dimensions were weakly positively correlated with glycaemic indicators, whereas the EDE-Q-13 eating-restraint subscale and total score showed weak inverse correlations with HbA1c. In the fully adjusted model, insulin-only and combination therapy were associated with higher HbA1c compared with oral medication only, while body mass index (BMI) was inversely associated with HbA1c. Neither the PFS food available subscale nor the EDE-Q-13 total score remained independently associated with HbA1c. The final model explained 27.2% of the variance in HbA1c (adjusted r 2 = 0.230). Conclusion Treatment context was more strongly related to glycaemic status than the behavioural measures assessed, although modest differences in hedonic hunger and eating-disorder symptom dimensions were evident across treatment regimens. These findings suggest that eating-related behavioural characteristics may provide complementary information in nutritional assessment and should be interpreted alongside the broader clinical context of T2DM management.
Abstract According to expectancy theory, people eat food that they expect will bring positive emotions. The present research aimed to identify food and non-alcoholic beverages UK adults most expected to bring positive emotions; test influences of high fat, salt and/or sugar (HFSS) and branding on expectancies; and investigate associations of expectancies with diet quality and comfort eating (i.e. eating induced by negative emotions). A representative sample of UK adults (n 1203; M age = 47 years; 52 % women; 87 % white) viewed food and non-alcoholic beverage images and completed the Anticipated Effects of Food Scale-Brief, a food frequency questionnaire, and questions about comfort eating and sociodemographic background. We ranked means of positive expectancies, conducted multilevel modelling to test influences of HFSS and branding on expectancies and examined correlations among expectancies, diet quality and comfort eating. Participants more strongly expected eating branded HFSS (e.g. Cadbury Twirl chocolate) v. generic non-HFSS (e.g. prawn curry) would result in positive emotions [b = 0·10, se = 0·04, p = ·02, 95 % CI (0·02, 0·18)]. Greater positive expectancies for HFSS – branded and generic – were associated with worse diet quality, especially positive expectancies for ice cream sundaes, fizzy drinks and chocolate (rs = –0·14 to −0·19, ps < ·001). Greater positive expectancies for HFSS and negative expectancies for HFSS and non-HFSS were associated with more frequent comfort eating (rs = 0·08 to 0·30, ps < ·05). Targeting positive HFSS expectancies through food environment policy and behavioural programmes may be a promising strategy for improving diet quality and reducing comfort eating in the UK adult population. Adults who comfort eat may also benefit from challenging negative expectancies for all foods.
Background: Anorexia nervosa (AN) is associated with chronic energy deficiency and endocrine adaptations affecting multiple organ systems involving bone meta bolism and hematological homeostasis.However, early alterations in peripheral blood counts of adolescents with a clinically homogeneous AN phenotype remain in sufficiently characterized.Purpose: To examine the differences in blood counts and associated bone and endocrine parameters between adolescent girls with newly diagnosed restrictive AN and secondary amenorrhea and healthy agematched controls. Methods:The study included 59 patients and 20 controls.Hematological indices, anthropometric characteristics, body composition, bone mineral status, bone turnover, and endocrine status markers were compared, and a multivariate analysis was used to identify the predictors of blood counts.Results: Compared to controls, patients had significantly lower leukocyte, erythrocyte, and platelet counts (all P< 0.01), and 29% had cytopenia in at least one parameter.Bone formation markers (osteocalcin, aminoterminal propeptide of human procollagen type I, and alkaline phosphatase) and key endocrine parameters (insulin like growth factor1, estradiol, and free thyroxine) were suppressed.These alterations were also observed in pati ents with a normal bone mineral density and adequate vitamin B12 and folate levels.A multivariate analysis iden tified endocrine and bonerelated predictors of blood counts in controls but no consistent pattern of predictors in patients.Conclusion: Adolescent girls with restrictive AN and secondary amenorrhea demonstrated hematological al tera tions at the time of diagnosis despite the absence of a measurable skeletal impairment or micronutrient defici ency.These findings suggest that a chronic energy defici ency and endocrine adaptation are associated with early disturbances in hematological homeostasis.Peripheral blood count may represent an accessible clinical marker of systemic disturbances.
زمینه: بیاشتهایی عصبی (AN) با کمبود مزمن انرژی و سازگاریهای غدد درونریز همراه است که بر چندین دستگاه بدن از جمله متابولیسم استخوان و هموستاز هماتولوژیک تأثیر میگذارد. با این حال، تغییرات اولیه در شمارش سلولهای خونی محیطی نوجوانان با فنوتیپ بالینی همگن AN به اندازه کافی توصیف نشده است. هدف: بررسی تفاوتهای شمارش سلولهای خونی و پارامترهای مرتبط با استخوان و غدد درونریز بین دختران نوجوان با تشخیص جدید بیاشتهایی عصبی محدودکننده و آمنوره ثانویه و افراد سالم همسن. روشها: این مطالعه شامل ۵۹ بیمار و ۲۰ فرد کنترل بود. شاخصهای هماتولوژیک، ویژگیهای آنتروپومتریک، ترکیب بدن، وضعیت مواد معدنی استخوان، گردش استخوان و نشانگرهای وضعیت غدد درونریز مقایسه شد و از تحلیل چندمتغیره برای شناسایی پیشبینیکنندههای شمارش سلولهای خونی استفاده گردید. نتایج: در مقایسه با گروه کنترل، بیماران به طور معناداری شمارش لکوسیت، اریتروسیت و پلاکت پایینتری داشتند (همه P<0.01) و ۲۹٪ در حداقل یکی از پارامترها سیتوپنی داشتند. نشانگرهای تشکیل استخوان (استئوکلسین، آمینوترمینال پروپپتید پروکلاژن نوع I انسانی و آلکالین فسفاتاز) و پارامترهای کلیدی غدد درونریز (فاکتور رشد شبه انسولین ۱، استرادیول و تیروکسین آزاد) سرکوب شده بودند. این تغییرات همچنین در بیمارانی با تراکم مواد معدنی استخوان طبیعی و سطوح کافی ویتامین B12 و فولات مشاهده شد. تحلیل چندمتغیره، پیشبینیکنندههای مرتبط با غدد درونریز و استخوان را در گروه کنترل شناسایی کرد اما الگوی ثابتی از پیشبینیکنندهها در بیماران مشاهده نشد. نتیجهگیری: دختران نوجوان مبتلا به AN محدودکننده و آمنوره ثانویه در زمان تشخیص، تغییرات هماتولوژیک را علیرغم عدم وجود اختلال قابل اندازهگیری اسکلتی یا کمبود ریزمغذیها نشان دادند. این یافتهها نشان میدهد که کمبود مزمن انرژی و سازگاری غدد درونریز با اختلالات زودهنگام در هموستاز هماتولوژیک مرتبط است. شمارش سلولهای خونی محیطی میتواند به عنوان یک نشانگر بالینی قابل دسترس برای اختلالات سیستمیک مطرح شود.
Abstract Aims Coexistence of binge eating disorder (BED) and type 2 diabetes is linked to poor health outcomes, but data on the prevalence and clinical profile of BED symptoms remain limited and inconsistent. We estimated the prevalence of BED symptoms and examined their associated clinical characteristics in Danish adults with type 2 diabetes. Methods We conducted a cross‐sectional study within the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Adults with type 2 diabetes completed the Binge Eating Disorder Questionnaire (BED‐Q) to determine the presence of BED symptoms. Data on well‐being, comorbidities, treatment and biomarkers were retrieved from national health registers. Associations between participant characteristics and BED symptoms were examined using Poisson regression to estimate prevalence ratios (PRs). Results Among 2459 individuals, 72 (2.9%) screened positive for BED symptoms, and 76 (3.1%) showed subclinical BED symptoms. Individuals with BED symptoms had an earlier age at diagnosis of type 2 diabetes (median 51.8 years, IQR: 41.3–57.6) than adults without BED symptoms (median 59.5 years, IQR: 52.1–66.2). BED symptoms were also associated with severe obesity (BMI ≥35 kg/m 2 ) (PR 11.37, 95% CI: 2.78–46.49), female sex (PR 1.54, 95% CI: 1.12–2.10), and lower well‐being (PR 1.83, 95% CI: 1.15–2.92). Conclusions BED symptoms were associated with a distinct clinical and psychosocial profile in Danish adults with type 2 diabetes. These findings support clinical awareness of BED symptoms in this population, particularly among women, individuals with obesity, those with lower well‐being and those diagnosed with diabetes at a younger age.
اهداف: همزمانی اختلال پرخوری افراطی (BED) و دیابت نوع ۲ با پیامدهای نامطلوب سلامت مرتبط است، اما دادهها درباره شیوع و نمایه بالینی علائم BED محدود و ناسازگار باقی ماندهاند. ما شیوع علائم BED را برآورد کردیم و ویژگیهای بالینی مرتبط با آنها را در بزرگسالان دانمارکی مبتلا به دیابت نوع ۲ بررسی نمودیم. روشها: یک مطالعه مقطعی در چارچوب کوهورت مرکز دانمارکی پژوهش راهبردی در دیابت نوع ۲ (DD2) انجام شد. بزرگسالان مبتلا به دیابت نوع ۲ پرسشنامه اختلال پرخوری افراطی (BED-Q) را برای تعیین وجود علائم BED تکمیل کردند. دادههای مربوط به سلامت روان، همبودیها، درمان و نشانگرهای زیستی از سامانههای ملی ثبت سلامت استخراج شد. ارتباط بین ویژگیهای شرکتکنندگان و علائم BED با استفاده از رگرسیون پواسون برای برآورد نسبتهای شیوع (PRs) بررسی شد. نتایج: در میان ۲۴۵۹ نفر، ۷۲ نفر (۲٫۹٪) غربالگری مثبت برای علائم BED داشتند و ۷۶ نفر (۳٫۱٪) علائم زیر بالینی BED نشان دادند. افراد دارای علائم BED سن پایینتری در زمان تشخیص دیابت نوع ۲ داشتند (میانه ۵۱٫۸ سال، IQR: ۴۱٫۳–۵۷٫۶) نسبت به بزرگسالان بدون علائم BED (میانه ۵۹٫۵ سال، IQR: ۵۲٫۱–۶۶٫۲). علائم BED همچنین با چاقی شدید (BMI ≥35 kg/m2) (PR 11.37، 95% CI: 2.78–46.49)، جنسیت مؤنث (PR 1.54، 95% CI: 1.12–2.10) و سلامت روان پایینتر (PR 1.83، 95% CI: 1.15–2.92) مرتبط بود. نتیجهگیری: علائم BED با نمایه بالینی و روانی-اجتماعی متمایزی در بزرگسالان دانمارکی مبتلا به دیابت نوع ۲ همراه بود. این یافتهها بر اهمیت توجه بالینی به علائم BED در این جمعیت، بهویژه در میان زنان، افراد چاق، افراد با سلامت روان پایینتر و کسانی که در سنین پایینتر مبتلا به دیابت شدهاند، تأکید میکند.
