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  1. Sien PLM, Jamaludin NIA, Samrin SNA, S NS, Ismail R, Anuar Zaini A, et al.
    J Health Psychol, 2020 08;25(9):1310-1318.
    PMID: 31755316 DOI: 10.1177/1359105319890397
    Adolescents with type 1 diabetes mellitus are prone to have eating problems. This study aimed to determine factors of eating problems among this population in University Malaya Medical Centre. Fifteen adolescents who scored more than 20 marks in the Diabetes Eating Problem Survey - Revised questionnaire were invited for an in-depth interview. Questions were asked based on their questionnaire's response. The interview sessions were recorded, transcribed verbatim, and thematic analysis was used. Five main themes emerged: pressure, physiological factor, psychological factor, patient's low compliances to insulin intake and food control and fear. Early referral to child psychologist would prevent it from developing.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
  2. Swami V
    Int J Eat Disord, 2016 07;49(7):695-700.
    PMID: 26876737 DOI: 10.1002/eat.22509
    OBJECTIVE: The purpose of this investigation was to examine change in risk for eating disorders in higher education students sojourning in the United Kingdom (UK), as well as associations between such risk and experiences in the host culture.

    METHOD: Participants were 98 female students from Malaysia, who completed a measure of risk factors for eating disorder symptomatology (the Eating Disorder Inventory-3 subscales of drive for thinness, body dissatisfaction, and bulimia symptoms) at two time points: two months prior to beginning their sojourn in the UK (Time 1) and four months after the sojourn began (Time 2). At Time 2, participants also completed measures of sociocultural adjustment, cultural distance between home and host cultures, and perceived discrimination in the host culture.

    RESULTS: Analyses indicated that, compared to scores at Time 1, participants had significantly higher drive for thinness (d = 0.64), body dissatisfaction (d = 0.54), and bulimia symptoms (d = 0.29) at Time 2. Poorer sociocultural adjustment and greater perceived discrimination significantly predicted greater risk of eating disorders at Time 2.

    DISCUSSION: The stress associated with culture change may place sojourning students at risk for disordered eating. Further research is needed to determine the extent to which this risk is related to culture-change specifically, as opposed to a general set of factors associated with transition-related psychopathology more broadly. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:695-700).

    Matched MeSH terms: Feeding and Eating Disorders/psychology
  3. Swami V
    Body Image, 2017 Jun;21:30-33.
    PMID: 28285176 DOI: 10.1016/j.bodyim.2017.02.001
    The present study compared the rates of negative body image and risk for disordered eating in young women who identify as part of goth subculture and a matched sample. Participants were 80 women who identified as part of goth subculture and a matched sample of 82 women from London, United Kingdom. Participants completed measures of self-ideal body size discrepancy, body appreciation, appearance investment, and eating disorder symptomatology. Between-group comparisons indicated that goth women reported significantly higher drive for thinness (d=0.51), body dissatisfaction (d=0.62), and dysfunctional appearance investment (d=0.52), as well as lower body appreciation (d=0.55), than the matched sample. Heightened expectations about appearance and self-presentation, alongside appearance competitiveness, may result in more negative body image and disordered eating in young women who identify with goth subculture, but further research is necessary on this under-studied youth subculture.
    Matched MeSH terms: Feeding and Eating Disorders/psychology*
  4. Swami V, Tudorel O, Goian C, Barron D, Vintila M
    Body Image, 2017 Dec;23:61-68.
    PMID: 28863282 DOI: 10.1016/j.bodyim.2017.08.001
    We examined the psychometric properties of a Romanian translation of the 10-item Body Appreciation Scale-2 (BAS-2). A total of 453 university students from Romania completed the BAS-2, along with measures of disordered eating, self-esteem, satisfaction with life, and subjective happiness. In addition, a separate sample of university students (N=109) completed only the BAS-2 at two time-points three weeks apart. Principal-axis factor analysis indicated that BAS-2 scores had a one-dimensional factor structure in both women and men. Confirmatory factor analysis indicated that this factor structure had adequate fit, but invariance across sex was not supported. Further analyses indicated that BAS-2 scores evidenced internal consistency, convergent validity, and test-retest reliability in both women and men. These results suggest that BAS-2 scores reduce to one dimension in Romanian adults, but the lack of sex invariance may indicate that the same latent construct is not being measured in women and men.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
  5. Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS
    Appetite, 2011 Jun;56(3):778-83.
    PMID: 21435366 DOI: 10.1016/j.appet.2011.03.005
    This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18-24 years old (M=20.6, SD=1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial.
    Matched MeSH terms: Feeding and Eating Disorders/psychology*
  6. Tsai G
    Eat Weight Disord, 2000 Dec;5(4):183-97.
    PMID: 11216126
    OBJECTIVE: To investigate eating disorders (EDs) prevalence rates among Asian populations and identify characteristics that distinguish them from their Western counterparts.

    METHOD: Potential references were identified through an English-language literature search using Medline, Psychinfo, Dissertation Abstracts (1966 to 1999) and through extensive manual searching of textbooks, reviews and reference lists.

    RESULTS: The majority of studies related to EDs were conducted in Japan and China and a few were conducted in Singapore, Malaysia, Taiwan, and Korea whereas there was none in the Philippines, Laos, Vietnam, Cambodia, Myanmar, Indonesia and Thailand. Prevalence rates in Japan range from 0.025 to 0.030% for anorexia nervosa (AN) and from 1.9 to 2.9% for bulimia nervosa (BN). Community studies in China have found the AN prevalence to be 0.01% and BN rates ranging from 0.5% to 1.3%. These rates are lower than ED rates in the West (particularly the U.S. and Britain). Body dissatisfaction (BD) and dieting rates, however, were similar to those in the West. BD rates ranged from 68% (Taiwan) to 81% (Korea) and dieting rates ranged from 34% (Taiwan) to 68% (Japan). Sociocultural and developmental risk factors were relevant to this population.

    CONCLUSIONS: EDs in Asian populations have received little attention because they have been predominantly viewed as associated with Western culture. Classified by many as a "culture-bound syndrome" of the West, they may really be a culture-change syndrome.

    Matched MeSH terms: Feeding and Eating Disorders/psychology
  7. Vintilă M, Todd J, Goian C, Tudorel O, Barbat CA, Swami V
    Body Image, 2020 Dec;35:225-236.
    PMID: 33157397 DOI: 10.1016/j.bodyim.2020.09.009
    The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2). Here, we examined the psychometrics of a Romanian translation of the IES-2. Eight-hundred-and-thirty Romanian adults completed the IES-2 along with measures of positive body image, symptoms of disordered eating, and psychological well-being. Exploratory factor analyses (EFAs) with a split-half subsample (n = 420) indicated that IES-2 scores reduced to three factors in women and four in men, both of which diverged from the parent model. Confirmatory factor analysis with a second split-half sample (n = 410) indicated that the parent model had poor fit indices, whereas fit of the EFA-derived models were acceptable but not uniformly ideal. Scores on the 3-factor model - which had comparatively better fit of the models tested - had adequate internal consistency and evidenced scalar invariance across gender. However, evidence of test-retest reliability after four weeks (n = 205) was poor and evidence of construct validity, assessed through correlations with additional measures included in the survey, was weak at best. Based on these results, we question the degree to which the construct of intuitive eating can be applied to nations undergoing nutrition transitions.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
  8. Pengpid S, Peltzer K
    Eat Weight Disord, 2018 Jun;23(3):349-355.
    PMID: 29681011 DOI: 10.1007/s40519-018-0507-0
    PURPOSE: Since there is a lack of information on eating disorders attitudes in Association of Southeast Asian Nations (ASEAN), the aim of this study was to explore the prevalence of eating disorder attitude and its relation to mental distress among university student populations in Indonesia, Malaysia, Myanmar, Thailand and Vietnam.

    METHODS: A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate university students that were randomly recruited. The Eating Attitudes Test (EAT-26) was utilized to determine the prevalence of disordered eating attitudes. The sample included 3148 university students, with a mean age of 20.5 years, SD = 1.6.

    RESULTS: Using the EAT-26, 11.5% of the students across all countries were classified as being at risk for an eating disorder, ranging from below 10% in Indonesia, Thailand and Vietnam to 13.8% in Malaysia and 20.6% in Myanmar. In multivariable logistic regression analysis, sociodemographic factors (wealthier subjective economic status, and living in a lower middle income country), underweight and overweight body weight perception, psychological factors (depression symptoms and pathological internet use), and being obese were associated with eating disorder risk.

    CONCLUSIONS: Relatively high rates of eating disorder risk were found. This result calls for increased awareness, understanding of eating disorders and related risk factors and interventions in university students in ASEAN.

    LEVEL OF EVIDENCE: Level V, descriptive cross-sectional survey.

    Matched MeSH terms: Feeding and Eating Disorders/psychology*
  9. Tung SEH, Mohd Nasir MT, Chin YS, Zalilah MS, Zubaidah JO, Yim HS
    Child Obes, 2019 01;15(1):56-62.
    PMID: 30339034 DOI: 10.1089/chi.2018.0066
    BACKGROUND: Recent research suggests that a negative relationship exists between adiposity and cognitive function in children. However, limited information is known on how they are related. This study aimed to examine the mediators of the relationship between overweight/obesity and cognitive function among school children in Kuala Lumpur, Malaysia.

    METHODS: This is a cross-sectional comparison study whereby 225 overweight/obese children matched for age, sex, and ethnicity with 225 normal weight children participated in this study. Body image dissatisfaction, disordered eating, and depressive symptoms were assessed through a self-administered questionnaire. Blood pressure was measured, whereas blood was drawn to determine insulin, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid profiles. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated using glucose and insulin levels. Wechsler's Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess cognitive function in children. Ordinary least square regression analysis was conducted to determine the direct and indirect relationships between weight status and cognitive function.

    RESULTS: A negative relationship was found between overweight/obesity with cognitive function. Overweight/obese children were on average 4.075 units lower in cognitive function scores compared to normal weight children. Such difference was found through mediators, such as body image dissatisfaction, disordered eating, depression, systolic blood pressure, triglycerides, HOMA-IR, and hs-CRP, contributing 22.2% of the variances in cognitive function in children.

    CONCLUSION: Results highlight the important mediators of the relationship between overweight/obesity and cognitive function. Consequently, future interventions should target to improve psychological well-being and reduce cardiovascular disease risk for the prevention of poorer cognitive performance in overweight/obese children.

    Matched MeSH terms: Feeding and Eating Disorders/psychology
  10. Chin YS, Appukutty M, Kagawa M, Gan WY, Wong JE, Poh BK, et al.
    Nutrients, 2020 Jan 25;12(2).
    PMID: 31991785 DOI: 10.3390/nu12020318
    Disordered eating is prevalent among university students, especially females. Whilst literature suggests that factors associated with disordered eating may differ according to gender, such an association has not been studied in Malaysia. This cross-sectional study aims to compare factors associated with disordered eating between male and female university students. A total of 716 university students (male: 27.4%; female: 72.6%) were recruited in Kuala Lumpur and Selangor, Malaysia. All participants completed a set of self-administered questionnaires and their body weight and height were recorded. About one in five of the university students (20.3%) were found to have disordered eating. There were more female students (22.9%) disordered eating compared to males (13.3%, χ² = 8.16, p < 0.05). In male students (β = 0.228, p < 0.01), depressive symptoms were the only significant predictor for disordered eating. In females, the strongest predictor was depressive symptoms (β = 0.214, p < 0.001), followed by body size satisfaction (β = -0.145, p < 0.01) and body appreciation (β = -0.101, p < 0.05). These findings suggest that there are gender differences in the factors associated with disordered eating among Malaysian university students. Intervention programmes that address disordered eating should take into account these sex differences and its contributing factors.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
  11. Czepczor-Bernat K, Swami V, Modrzejewska A, Modrzejewska J
    Nutrients, 2021 Apr 20;13(4).
    PMID: 33924010 DOI: 10.3390/nu13041384
    To limit the spread of the novel coronavirus (COVID-19), many countries have introduced mandated lockdown or social distancing measures. Although these measures may be successful against COVID-19 transmission, the pandemic and attendant restrictions are a source of chronic and severe stress and anxiety which may contribute to the emergence or worsening of symptoms of eating disorders and the development of negative body image. Therefore, in this study, we aimed to: (1) classify different conditions associated with COVID-19-related stress, COVID-19-related anxiety, and weight status; and (2) analyze and compare the severity of dimensions typically related to eating disorders symptomatology and body image in individuals with different COVID-19-related stress, COVID-19-related anxiety, and weight status. Polish women (N = 671, Mage = 32.50 ± 11.38) completed measures of COVID-19-related stress and anxiety along with body dissatisfaction, drive for thinness, and bulimia symptomatology subscales of the Eating Disorders Inventory, and the appearance evaluation, overweight preoccupation, and body areas satisfaction subscales of the Multidimensional Body-Self Relations Questionnaire. The following four clusters were identified through cluster analysis: (a) Cluster 1 (N = 269), healthy body weight and low COVID-related stress (M = 3.06) and anxiety (M = 2.96); (b) Cluster 2 (N = 154), healthy body weight and high COVID-related stress (M = 5.43) and anxiety (M = 5.29); (c) Cluster 3 (N = 127), excess body weight and high COVID-related stress (M = 5.23) and anxiety (M = 5.35); (d) Cluster 4 (N = 121), excess body weight and low COVID-related stress (M = 2.69) and anxiety (M = 2.83). Our results showed that Clusters 3 and 4 had significantly greater body dissatisfaction and lower appearance evaluation and body areas satisfaction than Clusters 1 and 2. Cluster 3 also had a significantly higher level of drive for thinness, bulimia, and overweight preoccupation than Clusters 1 and 2. These preliminary findings may mean that the COVID-19 pandemic and attendant anxiety and stress caused by the pandemic are exacerbating symptoms of eating disorders and negative body image, with women with excess weight particularly at risk.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
  12. Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS
    Appetite, 2012 Dec;59(3):679-87.
    PMID: 22885453 DOI: 10.1016/j.appet.2012.08.002
    The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.
    Matched MeSH terms: Feeding and Eating Disorders/psychology*
  13. Soo KL, Shariff ZM, Taib MN, Samah BA
    Percept Mot Skills, 2008 Jun;106(3):833-44.
    PMID: 18712205 DOI: 10.2466/pms.106.3.833-844
    This cross-sectional study was undertaken with 489 secondary school girls, ages 15-17 years, to examine disordered eating behaviours of adolescent girls in Malaysia and to estimate associations with body weight, body-size discrepancy, and self-esteem. Dietary restraint, binge eating, body image, and self-esteem were assessed using the Restrained Eating scale of the Dutch Eating Behaviour Questionnaire, the Binge Scale Questionnaire, the Contour Drawing Rating Scale, and the Rosenberg Self-Esteem Scale, respectively. Pearson correlations estimated associations between variables. There were 3.1% underweight, 9.8% at risk of being overweight, and 8.6% overweight girls. A total of 87.3% were dissatisfied with their own body size. Dietary restraint and binge eating were reported by 36.0% and 35.4%, respectively. Body Mass Index (r = .34, p < .01) and body-size dissatisfaction (r = .24, p < .01) were significantly associated with dietary restraint and binge eating, but self-esteem (r = -.20, p < .001) was significantly associated only with binge eating.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
  14. Swarna Nantha Y, Abd Patah NA, Ponnusamy Pillai M
    Clin Nutr ESPEN, 2016 Dec;16:42-47.
    PMID: 28531454 DOI: 10.1016/j.clnesp.2016.08.001
    BACKGROUND AND AIMS: Researchers suggest that the rise in obesity rates may be explained by the addictive properties of certain types of food. In view of the growing obesity epidemic in South-East Asia, there is a need for a psychometric tool to assess the concept of food addiction amongst high-risk populations. The objective of this study is to translate the Yale Food Addiction Scale (YFAS) into the Malay language and subsequently validate its use in an obese population.

    METHODS: Between the year 2014 and 2015, a total of 250 obese adults were assessed for food addiction utilizing the Malay version of the YFAS at a primary care clinic. An assessment of the psychometric properties of the scale was performed to determine the factor structure, item statistics and internal consistency of the scale.

    RESULTS: A one factorial structure of YFAS was confirmed in this study through factor analysis. All items except 4 (items 19, 22, 24 and 25) had factor loadings >0.42. The internal reliability (KR-20) coefficient of the one-factor solution was α = 0.76. The mean YFAS symptom count was M = 2.74 (SD = 1.57) with 10.4% (N = 26) of the participants received the diagnosis of food addiction.

    CONCLUSIONS: The determination of construct validity and the identification of other latent variables in the Malay food addiction model is necessary prior to the formal utilization of the scale as a tool to detect addictive eating patterns in the community.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
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