Carrino Emily, Flatt Rachael, Pawar Pratiksha, Sanzari Christina, Tregarthen Jenna, Argue Stuart, Thornton Laura, Bulik Cynthia, Watson Hunna
University of North Carolina at Chapel Hill.
Dr. D.Y. Patil Vidyapeeth, Pune.
Res Sq. 2023 May 10:rs.3.rs-2899349. doi: 10.21203/rs.3.rs-2899349/v1.
Eating disorders affect millions of people worldwide, but most never receive treatment. The majority of clinical research on eating disorders has focused on individuals recruited from treatment settings, which may not represent the broader population of people with eating disorders. This study compared the characteristics of individuals with eating disorders based on whether they self-reported accessing treatment or not, to identify potential differences and contribute to a better understanding of the diverse needs and experiences of individuals with eating disorders. The study population included 762 community-recruited individuals (85% female, M ± SD age = 30 ± 7 y) with bulimia nervosa and/or binge eating disorder (BN/BED) enrolled in the Binge-Eating Genetics Initiative (BEGIN) United States study arm. Participants completed self-report surveys on demographics, treatment history, past and current eating disorder symptoms, weight history, and current mental health and gastrointestinal comorbidity. Untreated participants ( = 291, 38%) were compared with treated participants ( = 471, 62%) who self-reported accessing BN/BED treatment at some point in their lives. Untreated participants disproportionately self-identified as male and as a racial or ethnic minority compared with treated participants. Treated participants reported a more severe illness history, specifically, an earlier age at onset, more longstanding and frequent ED symptoms over their lifetime, and higher body dissatisfaction and comorbid mental health symptoms (i.e., depression, anxiety, ADHD) at the time of the study. Those who reported a history of inpatient or residential treatment displayed the most severe illness history, whereas those who reported outpatient treatment had a less severe illness history, and untreated individuals had the mildest illness history. Individuals from historically overlooked or marginalized populations were less likely to access treatment. Those who accessed treatment had more severe ED and comorbid symptoms, which may have motivated them to seek treatment. Clinic-based recruitment samples may not accurately represent all individuals with EDs, particularly those with milder symptoms and those with gender or racial/ethnic diversity. The results of this study indicate that community-based recruitment is crucial for improving the ability to apply research findings to broader populations and to reduce disparities in medical research. : ClinicalTrials.gov NCT04162574 (https://clinicaltrials.gov/ct2/show/NCT04162574).
饮食失调影响着全球数百万人，但大多数人从未接受过治疗。关于饮食失调的大多数临床研究都集中在从治疗机构招募的个体身上，而这些个体可能并不代表更广泛的饮食失调人群。本研究根据个体是否自我报告接受过治疗，对饮食失调个体的特征进行了比较，以确定潜在差异，并有助于更好地了解饮食失调个体的不同需求和经历。研究人群包括762名通过社区招募的神经性贪食症和/或暴饮暴食症（BN/BED）患者（85%为女性，年龄M±SD = 30±7岁），他们参与了美国暴饮暴食遗传学倡议（BEGIN）研究组的研究。参与者完成了关于人口统计学、治疗史、过去和当前饮食失调症状、体重史以及当前心理健康和胃肠道合并症的自我报告调查。将未接受治疗的参与者（n = 291，38%）与在生命中的某个时刻自我报告接受过BN/BED治疗的接受治疗的参与者（n = 471，62%）进行比较。与接受治疗的参与者相比，未接受治疗的参与者中男性以及少数族裔或种族的比例过高。接受治疗的参与者报告有更严重的病史，具体而言，发病年龄更早，一生中饮食失调症状更持久、更频繁，并且在研究时身体不满以及合并心理健康症状（即抑郁、焦虑、注意力缺陷多动障碍）程度更高。那些报告有住院或住院治疗史的人显示出最严重的病史，而那些报告接受门诊治疗的人病史较轻，未接受治疗的个体病史最轻。历史上被忽视或边缘化人群中的个体接受治疗的可能性较小。接受治疗的人有更严重的饮食失调和合并症状，这可能促使他们寻求治疗。基于诊所的招募样本可能无法准确代表所有饮食失调个体，特别是那些症状较轻以及具有性别或种族/民族多样性的个体。本研究结果表明，基于社区的招募对于提高将研究结果应用于更广泛人群的能力以及减少医学研究中的差异至关重要。试验注册编号：ClinicalTrials.gov NCT04162574（https://clinicaltrials.gov/ct2/show/NCT04162574） 。
