Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
INSPECT-LB: National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.
BMC Pediatr. 2021 Jun 1;21(1):257. doi: 10.1186/s12887-021-02728-7.
Restrained eating disorder is prevalent worldwide across both ethnic and different cultural groups, and most importantly within the adolescent population. Additionally, comorbidities of restrained eating present a large burden on both physical and mental health of individuals. Moreover, literature is relatively scarce in Arab countries regarding eating disorders, let alone restrained eating, and among adolescent populations; hence, the aim of this study was to (1) validate the Dutch Restrained Eating Scale in a sample of Lebanese adolescents and (2) assess factors correlated with restrained eating (RE), while taking body dissatisfaction as a moderator between body mass index (BMI) and RE.
This cross-sectional study, conducted between May and June 2020 during the lockdown period imposed by the Lebanese government, included 614 adolescents aged between 15 and 18 years from all Lebanese governorates (mean age of 16.66 ± 1.01 years). The scales used were: Dutch Restrained Eating Scale, body dissatisfaction subscale of the Eating Disorder Inventory-Second version, Rosenberg Self-Esteem Scale, Beirut Distress Scale (for psychological distress), Hamilton Anxiety Rating Scale and Patient Health Questionnaire (for depression).
The factor analysis yielded a one-factor solution with Eigen values > 1 (variance explained = 59.65 %; α = 0.924). Female gender (B = 0.19), higher BMI (B = 0.49), higher physical activity index (B = 0.17), following a diet to lose weight (B = 0.26), starving oneself to lose weight (B = 0.13), more body dissatisfaction (B = 1.09), and higher stress (B = 0.18) were significantly associated with more RE, whereas taking medications to lose weight (B=-0.10) was significantly associated with less RE. The interaction body mass index (BMI) by body dissatisfaction was significantly associated with RE; in the group with low BMI, higher body dissatisfaction was significantly associated with more RE.
Our study showed that the Dutch Restrained Eating scale is an adapted and validated tool to be used among Lebanese adolescents and revealed factors associated with restrained eating in this population. Since restrained eating has been associated with many clinically-diagnosed eating disorders, the results of this study might serve as a first step towards the development of prevention strategies targeted towards promoting a healthy lifestyle in Lebanese adolescents.
限制型进食障碍在全球范围内普遍存在于不同种族和文化群体中，尤其是在青少年群体中。此外，限制型进食的共病给个人的身心健康带来了巨大负担。此外，关于饮食失调，尤其是限制型进食，在阿拉伯国家的文献相对较少，更不用说在青少年群体中了；因此，本研究的目的是：(1) 在黎巴嫩青少年样本中验证荷兰限制进食量表；(2) 评估与限制进食相关的因素，同时将身体不满作为身体质量指数 (BMI) 和限制进食之间的调节因素。
这是一项横断面研究，于 2020 年 5 月至 6 月期间在黎巴嫩政府实施封锁期间进行，包括来自黎巴嫩所有省份的 614 名 15 至 18 岁的青少年（平均年龄为 16.66±1.01 岁）。使用的量表有：荷兰限制进食量表、饮食失调问卷第二版的身体不满分量表、罗森伯格自尊量表、贝鲁特痛苦量表（用于心理困扰）、汉密尔顿焦虑量表和患者健康问卷（用于抑郁）。
因素分析产生了一个特征值大于 1（方差解释率为 59.65%；α=0.924）的单因素解。女性（B=0.19）、较高的 BMI（B=0.49）、较高的身体活动指数（B=0.17）、为减肥而节食（B=0.26）、节食减肥（B=0.13）、更高的身体不满（B=1.09）和更高的压力（B=0.18）与更高的限制进食显著相关，而服用药物减肥（B=-0.10）与更低的限制进食显著相关。BMI 与身体不满的交互作用与 RE 显著相关；在 BMI 较低的组中，较高的身体不满与更多的 RE 显著相关。
本研究表明，荷兰限制进食量表是一种适用于黎巴嫩青少年的经过验证的工具，并揭示了该人群中与限制进食相关的因素。由于限制型进食与许多临床诊断的饮食失调有关，因此本研究的结果可能是朝着制定针对促进黎巴嫩青少年健康生活方式的预防策略迈出的第一步。
