Adolescent Eating Disorder Literature Review

October 28, 2022

CNS 786

Elizabeth Simmons
Literature Review

Eating disorders among teens is a complex issue. All of the articles reviewed points to females

having higher prevalence of feeding dysfunction. Two of the articles pointed to social media

consumption as a risk factor. Understanding who is at risk, being able to recognize warning

signs, and having a collaborative care team are all important aspects of teen eating disorders.

Title: Targeting the link between social media and eating disorder risk: A randomized

controlled pilot study (deValle & Wade, 2022)

General Summary: This article diggs into the link between negative body image and eating

disorders in relation to social media (deValle & Wade, 2022). The target population was 17-25

year olds that were currently enrolled at a university. The participants had to report using social

media for appearance related reasons and could not be in current treatment for body issues. The

participants also had to be fluent in English. The researchers were assessing the effectiveness of

interventions aimed at decreasing self criticism as a result of consuming images and ideals the

participants encounter on social media. The study was set up with a control group of wait-listed

participants, a self-criticism focus group, and a social media curation focus group.

Synthesis with readings: The researchers started with 5 previously researched interventions

plus 2 novel interventions. The researchers were also focused on the feasibility, acceptability,

and large scale repetition of the interventions. The results showed that both the self-criticism and

social media curation groups showed improvement over the wait-list group The self-criticism

group had the most favorable outcomes. The research made an interesting point of possible

higher level of participation if reimbursement were offered to the participants.

Limitations: Participants needed phone/computer and online access. Participants felt some of

the modules took too long, they requested an outline of modules with a timeline, they desired

email reminders to complete modules, and they would have prefered replacing text portions with

interactive media. The sample was predominantly female college students.

Implications for consultants: The participants were divided into a self-criticism intervention

group and a social media curation intervention group. This model of delivery gives me the

flexibility to choose the type of intervention and the ability to apply them virtually. Because of

the flexibility of these modules, I could collaborate with a school system or a community

organization to deliver services. These interventions would work well with the “client-centered

case consultation” model (Dougherty, 2014). The consultant could meet with the client then

recommend the most fitting intervention group to the school system.

Implications for consultees: Consultees could complete this course of treatment on their own

timeline in the space that is most comfortable for them. Because there was documented success

with both approaches, the consultee could pick either self-criticism or the social media curation

group. It might even be possible for the consultee to do both groups. Overall this is a flexible

model of care.

Title: Health outcomes of eating disorder clients in a rural setting (Sheridan & et. al, 2013)

General summary: This article was a chart review of 74 medical records spanning 5 years. The

sample was made of 73 females and 1 male that all lived in rural areas of Australia. The average

length of treatment was 10 months. The researchers were looking for the impact of living in a

rural area on treatment of eating disorders. The most common approach is “triadic” (Sheridan &
et. al, 2013). When a person is given an eating disorder diagnosis, they have a care team of

medical services, psychology, and dietary providers (Sheridan & et. al, 2013). Because rural

areas may lack one or more of these “triadic” components, the long term outcomes may not be

optimal (Sheridan & et. al, 2013).

Synthesis with reading: The article was set in Tamworth, South Wales. It mentions a

combination of “public and private” health care implying that residents have the choice to seek

services outside of what is government provided (Sheridan & et. al, 2013). To achieve the

“triadic” approach a person may have to combine their government services with purchased

supplementary services. In rural parts of the country, services are limited. A person may have to

choose to go to a larger town or city to receive all 3 prongs of care. The authors mentioned that

in some rural places, if the condition is severe enough, they would be transferred to a higher

level of care for stabilization. The chart reviews showed that the 47% of the participants that

received “triadic” care, showed more favorable outcomes than those that did not receive this

team approach (Sheridan & et. al, 2013).

Limitations: This data was collected completely from medical chart reviews. Just looking at

medical records does not take the person’s story in their own words into account, only the

information the recorder included. The facts are based on the documentor’s bias.

Implications for consultants: The data collected reinforced the existing concept of “triadic”

care producing the most favorable outcomes. A person diagnosed with an eating disorder should

have a care team composed of a medical doctor, mental health services, and a dietary

professional. I would feel more comfortable knowing the consultee is getting regular medical

check ups because eating disorders can be very damaging to organ systems. I also like working

with a registered dietitian because they understand the complexities of nutrients in the human
body and can provide detailed menu plans. This model is a great example of collaboration

according to the Caplan definition (Dougherty, 2014). As the mental health expert, I would take

responsibility for the mental health of the client with an eating disorder while the other members

of the team are responsible for their area of expertise.

Implications for consultees: People living in rural areas may have to travel or impoy telehealth

to receive “triadic” care. Having a care team can be a protective factor leading to long term

remission.

Title: Factors associated with disordered eating and eating disorder symptoms in

adolescent elite athletes (Walter, Heinen, & Elbe, 2022)

General summary: Research points to 45% of adult female and 19% adult male elite athletes

are diagnosed with an eating disorder (Walter, Heinen, & Elbe, 2022). This article is looking at

13-18 year old elite athletes. The sample was a mix of males and females. The participants were

separated into “high risk”, weight class/endurance/appearance sports, and “low risk”,

team/technical sports (Walter, Heinen, & Elbe, 2022). The goal of data collection among the

study subjects was to develop an teen eating disorder prediction algorithm. The adolescents were

given 6 paper and pencil questionnaires at their annual sports eligibility exam. The

questionnaires covered eating habits, body image, personality characteristics,

sociodemographics, and media consumption.

Synthesis with reading: This article was set in Germany. Elite adolescent athletes were

described as those attending sport based schools, those that participate in elite club sports, or

those that are competing on a national level. This study found that female athletes ages 15-18
participating in “high risk” sports were at the highest risk for disordered eating (Walter, Heinen,

& Elbe, 2022). The type of the sport and social pressure were the 2 most impactful factors for

both females and males (Walter, Heinen, & Elbe, 2022). Personality type was a significant

predictor for females but not males (Walter, Heinen, & Elbe, 2022). Social media consumption

was a stronger predictor for males than females (Walter, Heinen, & Elbe, 2022).

Limitations: The authors state the surveys were given out in 2020 and the covid epidemic could

have impacted the athletes’ answers. They suggest the study be repeated when covid is “over”

(Walter, Heinen, & Elbe, 2022). They point out the questions surrounding eating habits do not

account for trend or speciality diets and thus causing the athletes to score in the disordered eating

category. They would like to dig more into social media and male masculinity aspects of the

questionnaires.

Implications for consultants: Based on this article’s results, it would be beneficial for me to

consult with elite sport coaches. This could be in psychoeducation sessions of the warning signs,

the impact of coach language used when talking with athletes, or administering the

questionnaires mentioned in the research. This approach would work well with the “consultee-

centered case consultation” (Dougherty, 2014).

Implications for consultees: Coaches can learn how to effectively communicate with the

athletes and learn how to look out for eating dysfunctions. Heading off eating related issues

early, can improve the overall health of the athletes and improve long term sports performance

thus making the coaches successful on and off the field.

References:

de Valle, M. K., & Wade, T. D. (2022). Targeting the link between social media and eating

disorder risk: A randomized controlled pilot study. International Journal of Eating Disorders,

55(8), 1066–1078. https://doi-org.wake.idm.oclc.org/10.1002/eat.23756

Dougherty, A. M. (2014). Psychological consultation and collaboration in school and

community settings. Brooks/Cole Cengage Learning.

Sheridan, T., Brown, L. J., Moy, S., & Harris, D. (2013). Health outcomes of eating disorder

clients in a rural setting. The Australian Journal of Rural Health, 21(4), 232–233. https://doi-

org.wake.idm.oclc.org/10.1111/ajr.12042

Walter, N., Heinen, T., & Elbe, A.-M. (2022). Factors associated with disordered eating and

eating disorder symptoms in adolescent elite athletes. Sports Psychiatry: Journal of Sports and

Exercise Psychiatry, 1(2), 47–56. https://doi-org.wake.idm.oclc.org/10.1024/2674-0052/a000012