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Eating disorders (EDs) are more common among younger women compared to older women and in women compared to men. As such, most ED research focuses on late adolescent and young adult females resulting in limited prospective research on gender differences in eating disorder psychopathology across the life span. The present study addresses this gap by examining gender differences in ED diagnoses, eating pathology, and the impact of putative risk factors on eating pathology in women (n = 624) and men (n = 276) over a 30-year period from late adolescence (M (SD) = 20[2] years) to later midlife (M (SD) = 50[2] years). Four assessment waves were conducted, beginning with baseline participation during college and subsequent 10-, 20-, and 30-year follow-up. Retention at 30-year follow-up was 72% (n = 440) for women and 67% (n = 181) for men. Prevalence of DSM-5 ED diagnoses decreased over the 30-year span for women and remained stable for men, with no significant gender difference in point prevalence by age 50. Drive for thinness decreased for women through age 50 and increased for men, while bulimic symptoms decreased as both genders aged. Multilevel models demonstrated that the impact of dieting as a risk factor on drive for thinness decreased prospectively as men aged and remained stable as women aged. Results imply that current risk models require refinement to account for developmental trajectories in which dramatic gender differences observed in late adolescence diminish over time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Research supports increasing cultural pressures for leanness among young men; however, few studies have examined whether weight dissatisfaction or efforts to alter weight have become more prevalent for men over time. The present study evaluated secular trends in weight dissatisfaction and related behaviors among college-age men across 4 decades; 1,097 men completed surveys while they were in college in 1982 (n = 276), 1992, (n = 233), 2002 (n = 241), and 2012 (n = 347). In 1982, men with a body mass index (BMI) between 18.5 and 25 kg/m2 were more likely to describe themselves as being overweight compared with men in all other cohorts, whereas in 1992, 2002, and 2012, men with a BMI between 18.5 and 25 kg/m2 were more likely to describe themselves as underweight compared with men in all other cohorts. Overall, 57-62% of men reported weight dissatisfaction, although there were no significant differences in the proportion of men wanting to lose, maintain, or gain weight across cohorts. There was no significant difference in the amount of weight gain desired across cohorts despite increasing BMI from 1982 to subsequent cohorts; however, desired BMI and endorsement of fad diets differed across cohorts, with higher desired BMI in 1992 and 2002 and high-protein diets being the most common in 2012. These results suggest that weight dissatisfaction has remained substantial and relatively stable among young men over time. Trends relating to weight perception, dieting, and exercise are consistent with an increasing focus on leanness and muscularity for men in recent years. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Interoceptive awareness (IA), or the awareness of internal body states, is known to be impaired in individuals with eating disorders (EDs); however, little is understood about how IA and ED symptoms are connected. Network analysis is a statistical approach useful for examining how symptoms interrelate and how comorbidities may be maintained. The present study used network analysis to (1) test central symptoms within an IA-ED network, (2) identify symptoms that may bridge the association between IA and ED symptoms, and (3) explore whether central and bridge symptoms predict ED remission at discharge from intensive treatment. A regularized partial correlation network was estimated in a sample of 428 adolescent (n = 187) and adult (n = 241) ED patients in a partial hospital program. IA was assessed using items from the Multidimensional Assessment of Interoceptive Awareness, and ED symptoms were assessed using items from the Eating Disorder Examination-Questionnaire. Central symptoms within the network were strong desire to lose weight, feeling guilty, and listening for information from the body about emotional state. The most central symptom bridging IA and ED symptoms was (not) feeling safe in one's body. Of the central symptoms, greater desire to lose weight predicted lower likelihood of remission at treatment discharge. Bridge symptoms did not significantly predict remission. Body mistrust may be a mechanism by which associations between IA and EDs are maintained. Findings suggest targeting central and bridge symptoms may be helpful to improve IA and ED symptoms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Weight suppression predicts the onset and maintenance of bulimic syndromes. Despite this finding, no study has examined psychological mechanisms contributing to these associations using a longitudinal design. Given societal pressures to be thin and an actual history of higher weight, it is possible that greater weight suppression contributes to increased fear of gaining weight and preoccupation with being thin, which increase vulnerability to eating disorders. The present study investigated whether greater drive for thinness mediates associations between weight suppression and bulimic symptoms over long-term follow-up. Participants were women (n = 1,190) and men (n = 509) who completed self-report surveys in college and 10- and 20-years later. Higher weight suppression at baseline predicted higher bulimic symptoms at 20-year follow-up (p < .001), while accounting for demographic variables and baseline bulimic symptoms, body mass index, and drive for thinness. Increased drive for thinness at 10-year follow-up mediated this effect. Findings highlight the long-lasting effect of weight suppression on bulimic symptoms and suggest that preoccupation with thinness may help maintain this association. Future studies would benefit from incorporating other hypothesized consequences of weight suppression, including biological factors, into risk models. (PsycINFO Database Record

Research supports both concurrent and prospective associations between peer behaviors and disordered eating levels in late adolescent and young adult men and women. However, no study has examined peer influence after a follow-up duration over which peer groups change dramatically. This study examined how college roommates' dieting predicted disordered eating levels in women (n = 566) and men (n = 233) at 10-year follow-up. For women, college roommates' dieting significantly predicted Eating Disorder Inventory Drive for Thinness and Bulimia scores and purging at 10-year follow-up. Findings highlight the potential for school-based, peer-led interventions to have long-term benefits in women.