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Article ; Online: Pragmatic clinical trials to advance research in children and adolescents with eating disorders.

Norris, Mark L / Spettigue, Wendy / Obeid, Nicole

The International journal of eating disorders

2024

Abstract: Objective: To discuss the utility of pragmatic clinical trials (PCTs) to help advance research in eating disorders (EDs).: Methods: We describe challenges associated with traditional explanatory research trials and examine PCTs as an alternative, ... ...

Abstract	Objective: To discuss the utility of pragmatic clinical trials (PCTs) to help advance research in eating disorders (EDs). Methods: We describe challenges associated with traditional explanatory research trials and examine PCTs as an alternative, including a review of the PRECIS-2 tool. Results: There are many challenges associated with the design and completion of traditional RCTs within the field of EDs. Pragmatic clinical trials are studies that closely align with conditions available in everyday practice and focus on outcomes that are relevant to patients and clinicians. Results of PCTS maximize applicability and generalizability to clinical settings. Discussion: Available therapies established for the treatment of EDs provide remission rates that rarely exceed 50%, implying a need for additional research on new or adjunctive treatments. In addition to a general overview of PCTs, we draw upon published literature and our own experiences involving adjunctive olanzapine for the treatment of children and youth with anorexia nervosa to help highlight challenges associated with randomized controlled trial (RCT) design and implementation, and offer pragmatic suggestions that would allow patients greater choice in treatment trials, while at the same time capturing outcomes that are most likely to advance treatment efforts. Conclusions: Pragmatic clinical trials provide alternatives to RCT design that can help bolster research in EDs that aims to explore real-world effects of interventions. Public significance: Available therapies established for the treatment of eating disorders (EDs) in children and adolescents provide remission rates that rarely exceed 50%, implying a need for additional research on new or adjunctive treatments. In this article, we discuss the utility of pragmatic trials to help promote research that can help advance knowledge that is relevant to clinical care settings.
Language	English
Publishing date	2024-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	603170-5
ISSN	1098-108X ; 0276-3478
ISSN (online)	1098-108X
ISSN	0276-3478
DOI	10.1002/eat.24209
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Article ; Online: Examining the role of artificial intelligence to advance knowledge and address barriers to research in eating disorders.

Norris, Mark L / Obeid, Nicole / El-Emam, Khaled

The International journal of eating disorders

2024

Abstract: Objective: To provide a brief overview of artificial intelligence (AI) application within the field of eating disorders (EDs) and propose focused solutions for research.: Method: An overview and summary of AI application pertinent to EDs with focus ... ...

Abstract	Objective: To provide a brief overview of artificial intelligence (AI) application within the field of eating disorders (EDs) and propose focused solutions for research. Method: An overview and summary of AI application pertinent to EDs with focus on AI's ability to address issues relating to data sharing and pooling (and associated privacy concerns), data augmentation, as well as bias within datasets is provided. Results: In addition to clinical applications, AI can utilize useful tools to help combat commonly encountered challenges in ED research, including issues relating to low prevalence of specific subpopulations of patients, small overall sample sizes, and bias within datasets. Discussion: There is tremendous potential to embed and utilize various facets of artificial intelligence (AI) to help improve our understanding of EDs and further evaluate and investigate questions that ultimately seek to improve outcomes. Beyond the technology, issues relating to regulation of AI, establishing ethical guidelines for its application, and the trust of providers and patients are all needed for ultimate adoption and acceptance into ED practice. Public significance: Artificial intelligence (AI) offers a promise of significant potential within the realm of eating disorders (EDs) and encompasses a broad set of techniques that offer utility in various facets of ED research and by extension delivery of clinical care. Beyond the technology, issues relating to regulation, establishing ethical guidelines for application, and the trust of providers and patients are needed for the ultimate adoption and acceptance of AI into ED practice.
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	603170-5
ISSN	1098-108X ; 0276-3478
ISSN (online)	1098-108X
ISSN	0276-3478
DOI	10.1002/eat.24215
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Article: The financial and social impacts of the COVID-19 pandemic on youth with eating disorders, their families, clinicians and the mental health system: a mixed methods cost analysis.

Obeid, Nicole / Silva-Roy, Patricia / Booij, Linda / Coelho, Jennifer S / Dimitropoulos, Gina / Katzman, Debra K

Journal of eating disorders

2024 Volume 12, Issue 1, Page(s) 43

Abstract: Background: The onset of the COVID-19 pandemic has had an adverse impact on children, youth, and families with eating disorders (EDs). The COVID-19 pandemic exacerbated pre-existing personal and financial costs to youth, caregivers, and health ... ...

Abstract	Background: The onset of the COVID-19 pandemic has had an adverse impact on children, youth, and families with eating disorders (EDs). The COVID-19 pandemic exacerbated pre-existing personal and financial costs to youth, caregivers, and health professionals accessing or delivering ED services. The objectives of this mixed methods study were to (1) understand the indirect, direct medical and non-medical costs reported by youth, caregivers, and clinicians; (2) understand how the COVID-19 pandemic may have impacted these costs, and (3) explore implications of these costs with regards to barriers and resources to inform future decisions for the ED system of care. Methods: Youth (aged 16-25 years) with lived/living experience, primary caregivers, clinicians, and decision-makers were recruited with support from various partners across Canada to complete group specific surveys. A total of 117 participants responded to the survey. From those respondents, 21 individuals volunteered to further participate in either a discussion group or individual interview to provide additional insights on costs. Results: Youth and primary caregivers reported costs relating to private services, transportation and impacts of not attending school or work. Additionally, primary caregivers reported the top direct medical cost being special food or nutritional supplements (82.8%). In discussion groups, youth and caregivers elaborated further on the challenges with long waitlists and cancelled services, impact on siblings and effect on family dynamics. Clinicians and decision-makers reported increased work expectations (64.3%) and fear/isolation due to COVID-19 in the workplace (58.9%). Through discussion groups, clinicians expanded further on the toll these expectations took on their personal life. Approximately 1 in 3 health professionals reported contemplating leaving their position in 1-2 years, with greater than 60% of this group stating this is directly related to working during the pandemic. Conclusions: Findings demonstrate the need for increased support for youth and caregivers when accessing ED services both during crisis and non-crisis times. Additionally, attention must be given to acknowledging the experience of health professionals to support better retention and resource management as they continue to navigate challenges in the health care system.
Language	English
Publishing date	2024-03-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2699357-0
ISSN	2050-2974
ISSN	2050-2974
DOI	10.1186/s40337-024-00986-1
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Article: The economic impact of eating disorders in children and youth in Canada: a call to action to improve youth eating disorder research and care.

Coelho, Jennifer S / Booij, Linda / Katzman, Debra K / Dimitropoulos, Gina / Obeid, Nicole

Journal of eating disorders

2023 Volume 11, Issue 1, Page(s) 74

Abstract: The COVID-19 pandemic has led to an unprecedented rise in rates and symptoms of eating disorders among Canadian youth. To date, there is a lack of national surveillance and costing data in Canada to inform policymakers and healthcare leaders on how to ... ...

Abstract	The COVID-19 pandemic has led to an unprecedented rise in rates and symptoms of eating disorders among Canadian youth. To date, there is a lack of national surveillance and costing data in Canada to inform policymakers and healthcare leaders on how to best address the surge in new and existing cases. This has resulted in the Canadian healthcare system being unprepared to adequately respond to the increased needs. Therefore, clinicians, researchers, policymakers, decision-makers, and community organizations across Canada are collaborating to compare pre-and post-pandemic costing data from national and province-level healthcare systems in an effort to address this gap. Results from this economic cost analysis will be an important first step in informing and guiding policy on possible adaptations to services to better fulfill the needs of youth with eating disorders in Canada. We highlight how gaps in surveillance and costing data can impact the field of eating disorders in an international context.
Language	English
Publishing date	2023-05-13
Publishing country	England
Document type	Letter
ZDB-ID	2699357-0
ISSN	2050-2974
ISSN	2050-2974
DOI	10.1186/s40337-023-00794-z
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Article: Appearance satisfaction mediates the relationship between recreational screen time and depressive symptoms in adolescents.

Murray, Marisa A / Obeid, Nicole / Gunnell, Katie E / Buchholz, Annick / Flament, Martine F / Goldfield, Gary S

Child and adolescent mental health

2022 Volume 28, Issue 1, Page(s) 12–21

Abstract: Background: Research suggests there is an association between high levels of recreational screen time and depression among adolescents; however, mechanisms driving this association remain unknown. The present study examined appearance and weight ... ...

Abstract	Background: Research suggests there is an association between high levels of recreational screen time and depression among adolescents; however, mechanisms driving this association remain unknown. The present study examined appearance and weight satisfaction and disordered eating behaviors as mediators in the relationship between recreational screen time and depressive symptoms in adolescents. Method: Longitudinal data on screen time, depressive symptoms, disordered eating behaviors, and appearance and weight satisfaction from 304 adolescents (194 females, M Results: Results revealed appearance dissatisfaction mediated the direct effect of recreational screen time on depressive symptoms (Estimate = 0.48, SE = .18, 95% CI [0.12, 0.84]), and that recreational screen time was significantly related to lower appearance satisfaction (Estimate = -0.06, SE = .02, 95% CI [-0.10, -0.01]), which was significantly predictive of more severe depressive symptoms (Estimate = -1.49, SE = .62, 95% CI [-2.71, -0.28]). Conclusions: These findings suggest that modulating screen time may be an efficacious strategy to reduce appearance dissatisfaction and depressive symptoms during adolescence.
MeSH term(s)	Female ; Humans ; Adolescent ; Depression/epidemiology ; Screen Time ; Personal Satisfaction ; Feeding and Eating Disorders
Language	English
Publishing date	2022-07-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2073663-0
ISSN	1475-3588 ; 1475-357X
ISSN (online)	1475-3588
ISSN	1475-357X
DOI	10.1111/camh.12576
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Article: Body image mediates the relationship between recreational screen time and depressive symptoms in adolescents

Murray, Marisa A. / Obeid, Nicole / Gunnell, Katie E. / Buchholz, Annick / Flament, Martine F. / Goldfield, Gary S.

Eating behaviors. 2022 Mar. 13,

2022

Abstract: Adolescence is a developmental period that can place individuals at heightened risk of engaging in disordered eating patterns. Stress and coping have been included as etiological factors of eating pathology, yet the mechanism of this relationship in ... ...

Abstract	Adolescence is a developmental period that can place individuals at heightened risk of engaging in disordered eating patterns. Stress and coping have been included as etiological factors of eating pathology, yet the mechanism of this relationship in adolescent males and females remains understudied. This study investigated the role of coping as a mediator in the stress-disordered eating relationship in a sample of adolescents. Participants included 2262 grade 7–12 students from a larger cross-sectional study entitled, Research on Eating and Adolescent Lifestyles (REAL). Participants completed measures of perceived stress, life stressors, coping style, and disordered eating. Multiple mediator models of coping were analyzed to examine the extent to which coping mediated the stress-disordered eating relationship, for males and females separately. Emotion-oriented coping was a significant partial mediator in the relationship between stress (perceived stress, life stressors) and disordered eating in male and female adolescents. Findings suggest adolescents experiencing high stress tend to engage in emotion-oriented coping, which may lead to greater levels of disordered eating. Interventions targeting effective coping strategies for dealing with different stress types may prevent youth from disordered eating, thus reducing their risk of eating disorders during a vulnerable period in development.
Keywords	adolescence ; adolescents ; body image ; cross-sectional studies ; etiology ; females ; males ; risk ; youth
Language	English
Dates of publication	2022-0313
Publishing place	Elsevier Ltd
Document type	Article
Note	Pre-press version
ZDB-ID	2073366-5
ISSN	1471-0153
ISSN	1471-0153
DOI	10.1016/j.eatbeh.2022.101626
Database	NAL-Catalogue (AGRICOLA)

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Article: Estimating additional health and social costs in eating disorder care for young people during the COVID-19 pandemic: implications for surveillance and system transformation.

Obeid, Nicole / Coelho, Jennifer S / Booij, Linda / Dimitropoulos, Gina / Silva-Roy, Patricia / Bartram, Mary / Clement, Fiona / de Oliveira, Claire / Katzman, Debra K

Journal of eating disorders

2024 Volume 12, Issue 1, Page(s) 52

Abstract: Background: The impact of the COVID-19 pandemic on young people with eating disorders (EDs) and their families was profound, with surging rates of hospitalizations and referrals reported internationally. This paper provides an account of the additional ... ...

Abstract	Background: The impact of the COVID-19 pandemic on young people with eating disorders (EDs) and their families was profound, with surging rates of hospitalizations and referrals reported internationally. This paper provides an account of the additional health and social costs of ED care for young people living in Canada incurred during the COVID-19 pandemic, drawing attention to the available data to inform these estimates while noting gaps in data capacities to account for a full view of the ED system of care. Methods: Three methodologies were used to capture costs: (1) provincial administrative data holdings available at the Canadian Institute of Health Information (CIHI) were used by Deloitte Access Economics to conduct analyses on costs related to hospitalizations, emergency room visits, outpatient visits with physicians and loss of well-being from being on a waitlist. These were examined across three fiscal years (April 1 to March 31, 2019-2022) to compare costs from one year before to two years after the onset of the pandemic, (2) data collected on support-based community ED organizations and, (3) costs identified by young people, caregivers and health care professionals. Results: Estimates of additional health care costs and social costs arising from ED care waitlists were estimated to have increased by 21% across the two years after the onset of the pandemic and is likely to represent an underestimate of costs. Costs related to some standard ED care services (e.g. day treatment programs) and support-based community ED organizations that saw a 118% increase in services during this time, are some examples of costs not captured in the current cost estimate. Conclusions: This paper provides a first account of the additional health and social ED care costs associated with the pandemic, which indicate at minimum, a 21% increase. The results invite discussion for more investments in ED services for young people in Canada, as it is unclear if needs are expected to remain elevated. We suggest a call for a national surveillance strategy to improve data holdings to aid in managing services and informing policy. A robust strategy could open the door for much-needed, data-informed, system transformation efforts that can improve ED care for youth, families and clinicians.
Language	English
Publishing date	2024-04-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2699357-0
ISSN	2050-2974
ISSN	2050-2974
DOI	10.1186/s40337-024-01003-1
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Article: Examining Shared Pathways for Eating Disorders and Obesity in a Community Sample of Adolescents: The REAL Study.

Obeid, Nicole / Flament, Martine F / Buchholz, Annick / Henderson, Katherine A / Schubert, Nick / Tasca, Giorgio / Thai, Helen / Goldfield, Gary

Frontiers in psychology

2022 Volume 13, Page(s) 805596

Abstract: Several psychosocial models have been proposed to explain the etiology of eating disorders (EDs) and obesity separately despite research suggesting they should be conceptualized within a shared theoretical framework. The objective of the current study ... ...

Abstract	Several psychosocial models have been proposed to explain the etiology of eating disorders (EDs) and obesity separately despite research suggesting they should be conceptualized within a shared theoretical framework. The objective of the current study was to test an integrated comprehensive model consisting of a host of common risk and protective factors (socio-environmental, psychological, and behavioral) expected to explain both eating and weight disorders simultaneously in a large school-based sample of adolescents. Data were collected from 3,043 youth (60% female, 14.00 ± 1.61) from 41 schools in the Ottawa region, Canada. Working with interested school staff, validated self-report scales in the form of a questionnaire booklet were administered to participating students to assess several understood risk and protective factors common to both eating disorders and obesity. Anthropometric measurements of weight and height were taken at the end of the questionnaire administration period by trained research staff. Structural equation modeling with cross-validation was used to test the hypothesized model. Findings demonstrated that dysregulated eating was associated with both eating disorder and weight status with diet culture and emotion dysregulation directly associated with some of these disordered eating patterns. It equally pointed to how lifestyle made up of high sedentary behaviors, low vigorous exercise and varied eating patterns contributed to both emotion dysregulation and poor body image which subsequently affected eating issues and weight status simultaneously, signaling the complex interplay of psychosocial factors that underlie these concerns. This study provides evidence for an integrated psychosocial model consisting of socio-environmental, psychological, and behavioral factors may best explain the complex interplay of risk and protective factors influencing eating disorders and obesity. It equally highlights understanding the direct and indirect effects of some of the most salient risk factors involved in eating and weight-related concerns, including the strong effects of diet culture and stressors such as weight-based teasing, providing interventionalists evidence of important risk factors to consider targeting in eating disorder and weight-based prevention efforts.
Language	English
Publishing date	2022-03-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2563826-9
ISSN	1664-1078
ISSN	1664-1078
DOI	10.3389/fpsyg.2022.805596
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Article ; Online: Coping in adolescents: A mediator between stress and disordered eating.

Henderson, Katherine A / Obeid, Nicole / Buchholz, Annick / Schubert, Nicholas / Flament, Martine F / Thai, Helen / Goldfield, Gary S

Eating behaviors

2022 Volume 47, Page(s) 101626

Abstract: Background: Adolescence is a developmental period that can place individuals at heightened risk of engaging in disordered eating patterns. Stress and coping have been included as etiological factors of eating pathology, yet the mechanism of this ... ...

Abstract	Background: Adolescence is a developmental period that can place individuals at heightened risk of engaging in disordered eating patterns. Stress and coping have been included as etiological factors of eating pathology, yet the mechanism of this relationship in adolescent males and females remains understudied. Aims: This study investigated the role of coping as a mediator in the stress-disordered eating relationship in a sample of adolescents. Demographics/settings: Participants included 2262 grade 7-12 students from a larger cross-sectional study entitled, Research on Eating and Adolescent Lifestyles (REAL). Methodology/analyses: Participants completed measures of perceived stress, life stressors, coping style, and disordered eating. Multiple mediator models of coping were analyzed to examine the extent to which coping mediated the stress-disordered eating relationship, for males and females separately. Findings: Emotion-oriented coping was a significant partial mediator in the relationship between stress (perceived stress, life stressors) and disordered eating in male and female adolescents. Findings suggest adolescents experiencing high stress tend to engage in emotion-oriented coping, which may lead to greater levels of disordered eating. Implications: Interventions targeting effective coping strategies for dealing with different stress types may prevent youth from disordered eating, thus reducing their risk of eating disorders during a vulnerable period in development.
MeSH term(s)	Adolescent ; Male ; Female ; Humans ; Cross-Sectional Studies ; Feeding and Eating Disorders ; Adaptation, Psychological ; Students ; Emotions
Language	English
Publishing date	2022-03-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2073366-5
ISSN	1873-7358 ; 1471-0153
ISSN (online)	1873-7358
ISSN	1471-0153
DOI	10.1016/j.eatbeh.2022.101626
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Article ; Online: Asceticism, perfectionism and overcontrol in youth with eating disorders.

Obeid, Nicole / Valois, Darcie D / Bedford, Shannon / Norris, Mark L / Hammond, Nicole G / Spettigue, Wendy

Eating and weight disorders : EWD

2020 Volume 26, Issue 1, Page(s) 219–225

Abstract: Purpose: Personality traits such as perfectionism and asceticism, and combinations of these traits (i.e., overcontrol) have been related to eating disorder (ED) diagnosis, symptoms, and chronicity in adult patients with EDs. However, as limited evidence ...

Abstract	Purpose: Personality traits such as perfectionism and asceticism, and combinations of these traits (i.e., overcontrol) have been related to eating disorder (ED) diagnosis, symptoms, and chronicity in adult patients with EDs. However, as limited evidence exists in adolescents, the aim of the present study was to examine these links in a clinical sample of adolescents with EDs. Method: A retrospective chart review was conducted on 178 adolescents (91% females; M Results: Results indicated that adolescents with binge-purge symptoms had higher levels of perfectionism, asceticism and overcontrol compared to those with restrictive symptoms, and that greater levels of perfectionism, asceticism and overcontrol were associated with elevated depression and anxiety symptoms. Additionally, overcontrol predicted greater LOS in the inpatient ED program. Conclusion: Results suggest the importance of assessing, monitoring and targeting overcontrol in treatment for adolescents with EDs given its impact on comorbid symptoms and LOS. Level of evidence: Level III, evidence obtained from case-control analytic studies.
MeSH term(s)	Adolescent ; Adult ; Anxiety ; Anxiety Disorders ; Child ; Feeding and Eating Disorders ; Female ; Humans ; Male ; Perfectionism ; Retrospective Studies
Language	English
Publishing date	2020-01-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2038625-4
ISSN	1590-1262 ; 1124-4909
ISSN (online)	1590-1262
ISSN	1124-4909
DOI	10.1007/s40519-019-00837-y
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