Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.
Department of Psychology, Old Dominion University, Norfolk, Virginia, USA.
Int J Eat Disord. 2020 Jul;53(7):1034-1055. doi: 10.1002/eat.23288. Epub 2020 May 16.
The present meta-analysis evaluated changes in individuals' risk of engaging in distinct disordered eating behaviors (DEBs) in the long-term.
Longitudinal studies assessing changes in DEBs via ≥2 assessments with a time lag of ≥10 years were included. Risk ratios were calculated for baseline to 10-14.9-year (M = 11.04) follow-up and baseline to ≥15-year (M = 18.62) follow-up changes in the use of binge eating, multiple purging, self-induced vomiting, laxatives, diuretics, diet pills, compensatory exercising, fasting/dieting, and multiple DEBs; Cohen's d was used for continuous binge-eating plus purging variable changes. Subgroup and meta-regression analyses tested whether eating disorder (ED) clinical sample versus nonclinical sample status, female versus male sex/gender, higher versus lower study bias, and baseline mean age and body mass index influenced overall effect magnitude for analyses with sufficient data.
Seventeen studies (26 [sub]samples) were included. Overall, individuals' risk of engaging in various restrictive eating and other compensatory behaviors decreased over time and the magnitudes of risk reductions for the use of certain compensatory DEBs were larger over longer follow-up durations. Specifically, for significant DEB change models, risk reductions spanned from 20.0-39.8% for 10-year follow-up and 24.7-74.8% for ≥15-year follow-up. However, nuances were found in the nature of these DEB changes as a function of DEB type, follow-up length, ED versus nonclinical sample composition, and baseline mean age.
These findings provide important information that can help identify treatment priorities and suggest that targeted and tailored preventative ED treatments warrant consistent implementation at the community-level, particularly for youth.
本荟萃分析评估了个体在长期内从事不同饮食失调行为（DEB）的风险变化。
纳入了通过≥2 次评估，且两次评估之间的时间间隔≥10 年，来评估 DEB 变化的纵向研究。计算了从基线到 10-14.9 年（M=11.04）随访和基线到≥15 年（M=18.62）随访的暴食、多次催吐、自我诱导呕吐、泻药、利尿剂、减肥药、补偿性运动、禁食/节食和多种 DEB 使用的风险比；使用 Cohen's d 来评估连续暴食加催吐变量的变化。亚组和荟萃回归分析检验了饮食障碍（ED）临床样本与非临床样本状态、女性与男性性别/性别、更高与更低的研究偏倚，以及基线平均年龄和体重指数是否影响具有足够数据的分析的总体效果大小。
纳入了 17 项研究（26 个亚组）。总体而言，个体从事各种限制饮食和其他补偿行为的风险随着时间的推移而降低，且在较长的随访期间，某些补偿性 DEB 的风险降低幅度更大。具体而言，对于有显著 DEB 变化的模型，10 年随访的风险降低幅度为 20.0-39.8%，15 年随访的风险降低幅度为 24.7-74.8%。然而，作为 DEB 类型、随访时间、ED 与非临床样本组成和基线平均年龄的函数，这些 DEB 变化的性质存在细微差别。
这些发现提供了重要信息，可以帮助确定治疗重点，并表明有针对性和量身定制的预防 ED 治疗需要在社区层面持续实施，特别是针对青少年。
