Eating disorders are currently not considered to be limited to Western culture. We systematically reviewed the existing literature on the prevalence of eating disorders in Latin America. Of 1583 records screened, 17 studies from Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela were included in the analysis. Most studies reported point-prevalence rates and only three studies provided lifetime and 12-month prevalence rates. We found a mean point-prevalence rate of 0.1% for anorexia nervosa, 1.16% for bulimia nervosa, and 3.53% for binge-eating disorder (BED) in the general population. Heterogeneity for bulimia nervosa and BED was large. This meta-analysis indicates that the prevalence of anorexia nervosa seems to be lower, whereas the prevalence of bulimia nervosa and especially of BED seems to be higher in Latin America than in Western countries. Our findings show that eating disorders are common mental disorders in Latin America. However, some facets of Latin American culture might be protective for the development of anorexia nervosa and increase the risk for bulimia nervosa and BED. Further studies investigating the epidemiology of eating disorders and their relation to culture in Latin America are needed. http://links.lww.com/YCO/A35 http://links.lww.com/YCO/A36

Objective: Adolescents with anorexia nervosa (AN) often show increased levels of exercise and physical activity. Psychological models suggest that physical activity in AN might attenuate momentary negative affect. However, this has not been directly tested in adolescents with AN, and it remains unclear whether this is a distinct mechanism of physical activity in AN compared with healthy controls (HCs).Method: In a 1‐day ecological momentary assessment, 32 adolescent inpatients with AN and 30 HCs responded to hourly questions on momentary affect while wearing an actigraph to objectively assess physical activity.Results: Linear mixed models identified that adolescents with AN experienced more aversive tension, more negative affect, and less positive affect throughout the day than HCs. Preliminary evidence for a momentary association of higher levels of physical activity with positive affect were found for both groups, whereas higher levels of physical activity were associated with less negative affect in adolescents with AN only. When correcting for multiple testing, interactions did not hold statistical significance.Discussion: Our results indicate a down‐regulation effect of physical activity on negative affect for AN and a more general up‐regulation effect of positive affect. However, our sample size was small, and replication of our findings is needed.

We aimed to compare the clinical data at first presentation to inpatient treatment of children (<14 years) vs. adolescents (≥14 years) with anorexia nervosa (AN), focusing on duration of illness before hospital admission and body mass index (BMI) at admission and discharge, proven predictors of the outcomes of adolescent AN. Clinical data at first admission and at discharge in 289 inpatients with AN (children: n = 72; adolescents: n = 217) from a German multicenter, web-based registry for consecutively enrolled patients with childhood and adolescent AN were analyzed. Inclusion criteria were a maximum age of 18 years, first inpatient treatment due to AN, and a BMI <10th BMI percentile at admission. Compared to adolescents, children with AN had a shorter duration of illness before admission (median: 6.0 months vs. 8.0 months, p = 0.004) and higher BMI percentiles at admission (median: 0.7 vs. 0.2, p = 0.004) as well as at discharge (median: 19.3 vs. 15.1, p = 0.011). Thus, in our study, children with AN exhibited clinical characteristics that have been associated with better outcomes, including higher admission and discharge BMI percentile. Future studies should examine whether these factors are actually associated with positive long-term outcomes in children.

Driven exercise (i.e., feeling compelled to exercise to control one's weight or shape, to obtain other positive consequences of exercising, or to avoid other negative consequences of not exercising) is a common phenomenon in individuals with eating disorders (EDs), typically associated with negative clinical outcomes. Current theoretical models of driven exercise highlight the short‐term affect‐regulating outcome of acute driven exercise, which is implicated to maintain this symptom either by positive or negative reinforcement. However, few studies have actually investigated cognitive, affective, and psychobiological mechanisms related to acute driven exercise. In particular, experimental studies that directly test mechanisms leading to the short‐term affective improvement after acute driven exercise are scarce. In this article, we therefore propose potential cognitive, affective, and psychobiological mechanisms that could explain the affect‐regulating function of driven exercise in individuals with EDs. In addition, we suggest examples of experimental studies that could directly test these mechanisms in individuals with EDs, as recent studies have demonstrated the safety of supervised exercise in EDs research. Our aim of stimulating research on the underlying causes and maintenance factors of driven exercise in EDs has the potential to critically inform treatment development for this high‐risk population.

Current models of Anorexia Nervosa (AN) emphasize the role of emotion regulation. Aversive tension, described as a state of intense arousal and negative valence, is considered to be a link between emotional events and disordered eating. Recent research focused only on adult patients, and mainly general emotion regulation traits were studied. However, the momentary occurrence of aversive tension, particularly in adolescents with AN, has not been previously studied. 20 female adolescents with AN in outpatient treatment and 20 healthy adolescents aged 12 to 19 years participated in an ecological momentary assessment using their smartphones. Current states of aversive tension and events were assessed hourly for two consecutive weekdays. Mean and maximum values of aversive tension were compared. Multilevel analyses were computed to test the influence of time and reported events on aversive tension. The effect of reported events on subsequent changes of aversive tension in patients with AN were additionally tested in a multilevel model. AN patients showed higher mean and maximum levels of aversive tension. In a multilevel model, reported food intake was associated with higher levels of aversive tension in the AN group, whereas reported school or sport-related events were not linked to specific states of aversive tension. After food intake, subsequent increases of aversive tension were diminished and decreases of aversive tension were induced in adolescents with AN. Aversive tension may play a substantial role in the psychopathology of AN, particular in relation with food intake. Therefore, treatment should consider aversive tension as a possible intervening variable during refeeding. Our findings encourage further research on aversive tension and its link to disordered eating. German register of clinical trials (DRKS): DRKS00005228 (Date of registration: September 2, 2013).

Objective: Body image is a construct highly dependent on culture and ethnicity. Furthermore, recent studies reveal that body image is not only a trait, but also a momentary state subject to change in diverse situational contexts. However, cultural influences on momentary body image have not been sufficiently investigated. To assess the influence of Latin American culture on momentary body image and to enable its comparison to Western countries, the Spanish translation of an existing state body image scale such as the Body Image States Scale (BISS) is needed. In addition, the factor structure, reliability and general validity of the Spanish BISS (S-BISS) should be evaluated prior to its application in diverse situational contexts. Method: We conducted a cross-sectional study evaluating 1137 individuals between the ages of 18 and 28 years from Barranquilla, Colombia, South America. The original BISS, which assesses body satisfaction, was translated from English to Spanish. Factorial structure, scale score reliability and convergent/divergent validity were assessed. Results: Exploratory and confirmatory factor analyses revealed that a one-factor model with correlated items best described the factorial structure present in the BISS questionnaire. The coefficient of scale score reliability was α = 0.92 (McDonalds ω = 0.93), with similar results for men and women. Significant differences between males and females were found with lesser body satisfaction in females (W = 163260, p = 0.016). Lower S-BISS scores indicating less body satisfaction were associated with higher BMI (r = −0.287, p < 0.001) and obtained in participants who were currently on a diet (t₁₁₃₅ = −3.98, p < 0.001). The S-BISS was negatively correlated with a trait body image measurement assessing body dissatisfaction (Body Shape Questionnaire, r = −0.577, p < 0.001) and a psychopathology questionnaire (Brief Symptom Inventory 53, r = −0.331, p < 0.001). Conclusion: The S-BISS is a valid and reliable instrument to assess body image in the Colombian population, and exhibits similar psychometric properties to those of the original version. Future studies should examine whether the S-BISS captures change in state body image when applied in diverse situational contexts.