Mariana Valdez Aguilar

This theoretical essay aims to explain how the interaction between gender, food insecurity, and migratory conditions contributes to the onset and maintenance of eating disorders (EDs) among migrant women, and to derive implications for public health and clinical intervention. Drawing on scientific literature, we in­tegrate Krieger’s ecosocial model with an intersectional perspective to analyze three main pathways mediating the emergence and course of EDs in this population: 1) gender as a mechanism of the migratory experience; 2) food insecurity as structural violence; and 3) EDs as the embodiment of historical inequalities. The synthesis demonstrates that migrant women’s bo­dies materialize conditions of exclusion (historical, economic, and symbolic) that regulate their access to food, mental health, and social recognition. Implications are derived for policy, research, and clinical practice: strengthening culturally relevant networks and environments; adopting participatory approaches that recognize migrant women as knowledge producers; and redesigning clinical care to integrate social determinants, trauma, and food security.

This case report describes the clinical course of two adolescent females (ages 12 and 14) with severe restrictive-type anorexia nervosa (AN) and comorbid anxiety and depressive symptoms. Both presented with extreme malnutrition (BMI-for-age <1st percentile), amenorrhea, distorted body image, and marked ambivalence toward weight restoration. Their families, characterized as structured, were engaged with the treatment. Care involved short-term hospitalization followed by intensive outpatient multidisciplinary treatment integrating cognitive-behavioral and dialectical behavior therapy strategies, nutritional rehabilitation, psychopharmacology, and structured caregiver involvement, alongside a psychodynamic-systemic family intervention informed by initial assessment. This model provided a framework to identify relational and emotional processes underlying motivational ambivalence. Over 6 months, both patients achieved weight restoration (approximately 50th–60th percentile BMI-for-age), with reduced eating disorder (ED) symptoms and improved emotional awareness, accompanied by changes in family functioning. However, residual anxiety, perfectionism, fluctuating insight, family conflict, and treatment fatigue persisted. One patient discontinued treatment prematurely despite clinical stabilization, with family and couple conflict. These cases highlight the complicated interaction between symptom remission, motivational ambivalence, and family dynamics in adolescent AN, emphasizing that weight restoration represent positive response, but alone does not constitute full recovery multidisciplinary, and family-focused interventions are essential.

We examined associations between potentially traumatic events (PTEs) and lifetime eating disorders (EDs) in the Eating Disorders Genetics Initiative-Mexico [EDGI-MX; N = 298; 174 cases, 124 controls, ages 13-78 years (M = 28.9 SD = 11.3), 81% cisgender women]. ED diagnoses and symptoms were from an online questionnaire capturing DSM-5 diagnoses via algorithm; PTEs were assessed with the Life Events Checklist for DSM-5; and depression, anxiety, and obsessive-compulsive (OC) symptoms with validated self-report measures. Logistic regressions and analyses of covariance were adjusted for age and gender. PTEs were reported by 75% of cases and 53% of controls (adjusted odds ratio [aOR] 3.6; 95% confidence interval [CI] 2.04, 6.62), including fire/explosions (13.6; 1.30, 141.76), transportation accident (2.1; 1.13, 4.06), serious accidents (10.0; 2.03, 49.64), sexual assault (5.9; 2.57, 13.91), other uncomfortable sexual experiences (3.2; 1.68, 6.41), and other stressful event (4.3; 1.95, 9.76). Although PTEs were not significantly associated with greater depression, anxiety, or OC symptoms in cases, these co-occurring symptoms may still be relevant clinically. Results highlight the importance of assessing PTEs in Mexican individuals with EDs and encourage exploration of timing of PTE exposure to clarify their role in ED development and course.

Objective: to evaluate the long-term effectiveness of an intensive outpatient treatment program combined with partial hospitalization for eating disorders (ED). The program consisted of three 28-week phases in a clinical setting. Methods: the total sample was 502 patients, which included 438 women and 64 men, with an age range of 13 to 73 years (M = 22.08, SD = 11.29), with four ED diagnosis: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and EDNOS. The initial weight had an average of 54.89 kg with an average BMI of 21.01. Weight, eating disorder symptoms and cognitions, as well as anxiety and depression symptoms, were assessed; at the beginning, at the end and 6 and 12 months later. Results: significant differences were found at the beginning of treatment in all scales except the SCL-90 total score (F (3,498)=.94 p =.41). The comparison of demographic variables also showed significant differences between the ED diagnostic groups. All patients showed significant changes from the time of initial evaluation to the end of treatment. Results indicate small to moderate effect sizes on the EAT, HADS, and SCL-90 scales, except for the EDI, where a high effect size was found. Conclusions: our findings add to existing studies on outpatient treatment. and support the encouraging effects previously found on this type of programs that combine outpatient and inpatient treatment for eating psychopathologies.

Objetivo: Evaluar la factibilidad de una intervención multidisciplinar (psicológica, nutricional y actividad física) en línea en un hombre con trastorno por atracón (TPA). Método: Recibió el tratamiento un varón de 24 años de edad con TPA desde los 18 años. La intervención consistió en 24 sesiones de dos horas a la semana en las que se abordó contenidos de psicoeducación, inteligencia emocional y modificación del estilo de vida. Se aplicaron instrumentos psicométricos y medidas antropométricas a través de tres momentos de evaluación: pre, post y un seguimiento dos meses después. Resultados: Hubo una disminución mayor al 20% de la frecuencia de atracones y de la sintomatología de ansiedad y depresión. En cuanto a la inteligencia emocional se observó mejoró tanto en la post evaluación como en el seguimiento.Respecto a los hábitos alimentarios, el paciente disminuyó su consumo de cereales, grasas y azúcares y aumentó la ingesta diaria de frutas y verduras, además introdujo la actividad física en su rutina diaria. Discusión: El tratamiento fue efectivo en las variables clínicas intervenidas, lo que implica la posibilidad de abordar el trastorno de manera integral y personalizada, prevenir recaídas y mejorar la calidad de vida del paciente a largo plazo. Los hallazgos son relevantes ya que es uno de los primeros estudios de tratamiento en México y sobretodo en hombres, ayudándolos en el reconocimiento del vínculo emoción y alimentación.

Eating disorders are serious medical illnesses affecting multiple aspects of an individual’s life. Psychological factors such as perfectionism, body dissatisfaction, and emotional distress are commonly found in eating disorder patients. Understanding how some of these variables can predict eating disorders is crucial for developing effective interventions and prevention treatments. In this study, we aim to examine the relationship between perfectionism, body dissatisfaction, maturity fears, depression, and anxiety in a sample of Mexican patients with eating disorders. The sample was 335 women with an age range of 18 to 40 years (M = 21.73, S.D = 3.633). Patients answered two self-report questionnaires: Eating Disorder Inventory and the Hospital Anxiety and Depression Scale. Multiple linear regressions analysis was performed. The regression model for the dependent variable "perfectionism" explained 44% of the variance with a greater presence of body dissatisfaction, maturity fears, feelings of ineffectiveness, as well as greater anxiety symptoms and older age. We observed a significant increase in maladaptive perfectionism; this was attenuated in the presence of depression symptoms. In this sample, the greatest predictor of maladaptive perfectionism was maturity fears. These issues should be addressed among young people from the general population and carry out prevention and intervention programs related to eating disorders.

Introducción: la validación de un instrumento de evaluación familiar para pacientes con trastornos alimentarios es un proceso crucial para garantizar la confiabilidad y validez de los resultados. Esta herramienta ayuda a comprender la dinámica familiar, siendo fundamental para una intervención efectiva y personalizada. Objetivo: validar un instrumento basado en el "modelo psicodinámico sistémico de evaluación familiar" para pacientes con trastorno de la conducta alimentaria. Material y métodos: la muestra fue no probabilística constituida por 272 pacientes (90% mujeres) y sus familias con un rango de edad de nueve a 73 años (18.07 ± 7.01); se incluyeron pacientes con anorexia nerviosa, bulimia, trastorno por atracón, otro trastorno de alimentación específico y trastorno de alimentación no especificado. Todos los participantes contestaron dos instrumentos que evaluaban el funcionamiento familiar. Resultados: se observó una adecuada consistencia interna del instrumento y el análisis factorial exploratorio (AFE) mostró una estructura unidimensional explicando el 30.29% de la variabilidad total. Se analizó la validez convergente, la cual fue positiva y significativa con el APGAR-familiar en las diferentes subescalas y en la puntuación total de los instrumentos. Conclusión: estos resultados contribuyen al desarrollo de una medida de evaluación de la estructura familiar en pacientes con trastornos alimentarios y proporcionan una herramienta confiable y válida para el trabajo clínico con las familias de estos pacientes.

Objetivo: Evaluar las propiedades psicométricas del Cuestionario de Influencias Socioculturales en el Modelo Estético Corporal (CIMEC-26), en una población de mujeres jóvenes. Método: La muestra estuvo conformada por 799 mujeres con un rango de edad de 12 a 30 años (M = 20.29, D.E. = 2.84). Se incluyeron dos grupos: control y clínico. Resultados: Se observó una adecuada consistencia interna del instrumento (α = .90). El Análisis factorial exploratorio arrojó cuatro factores: 1) Influencia de la publicidad; 2) Influencia de los modelos sociales; 3) Influencia de mensajes y situaciones sociales; 4) Malestar por la imagen corporal. Los cuales fueron ratificados en el análisis factorial confirmatorio, presentando un buen ajuste de los datos: 1) Chi-cuadrado significativo (X² (274) = 727.45, p = .001); 2) GFI = .925; 3) AGFI = .976; 4) CFI = .935; 5) RMSEA = .075; 6) RMR = .043. Se exploraron diferentes puntos de corte, observando el 22 como el más adecuado de acuerdo con los valores de sensibilidad (66 %) y especificidad (100%). Conclusión: Esta versión mostró adecuada consistencia y validez de constructo, se observó que es un cuestionario que puede ser utilizado por profesionales de la salud mental, por lo que el estudio es una importante contribución al área de los trastornos alimentarios en México.

Background: Binge eating disorder (BED) is the most frequent eating behavior among the general population (Guerdjikova in Med Clin 103:669–680, 2019). Many studies on interventions and BED treatments have been carried out in the United States and Europe, few have been reported in Latin American populations. People with this disorder not only have physical consequences of it but also social and psychological ones, therefore a multidisciplinary treatment approach is a good option to treat this condition. Objective: To evaluate the feasibility of a multidisciplinary online intervention (i.e., psychological, nutritional, and physical activity) in patients with BED. Method: The design was a case series study of two clinical treatment groups, with pre-test and post-test psychometric measures along with two follow-ups (at 2 and 6 months). Fifteen people diagnosed with BED (2 men and 13 women), with a mean age of 34.93 years (SD=11.91) and a mean initial BMI of 42, participated in this study. The treatment was carried out over the span of 28 sessions, each one being two hours per week consisting of 1 hour of group therapy and 1 hour of individual therapy. There were four evaluations: pre, post and two follow-ups. Results: Five patients did not complete the treatment (30%). The comparisons were made through the non-parametric Friedman test, finding a statistically significant decrease in binge eating symptoms (x2=15.57; p=.001), anxiety symptoms (x2=15.96; p=.001) and depression (x2=15.03; p=.002). There was an improvement in clarity (x2=11.60; p=.010) and emotional regulation (x2=7.75; p=.050), only in women. The patients reduced their body weight, and improved their eating and exercise habits by introducing fruits and vegetables and including 20-30 minutes of physical activity into their daily routine. Regarding the Objective Clinical Change Index, in terms of the objective clinical change, a positive change was observed in all the variables addressed. Conclusions: The data presented allowed us to conclude that the online multidisciplinary intervention was effective in the treatment of BED. Trial registration Retrospectively registered

Introducción: el trastorno por atracón (TpA) es la psicopatología alimentaria más prevalente entre la población, por lo que son necesarios instrumentos validados de tamizaje para su detección y diagnóstico oportuno. Objetivo: confirmar la estructura factorial de la Escala de Atracón Alimentario (BES) a través del análisis factorial confirmatorio (AFC) y proponer un punto de corte en una muestra mexicana. Método: la muestra fue no probabilística constituida por 421 personas (66.7% mujeres) con un rango de edad de 18 a 57 años (M = 23.92, DE = 7.38) provenientes de la ciudad de México y zona metropolitana. Todos los participantes contestaron dos instrumentos que evaluaban sintomatología de TpA y aquellos que puntuaron alto fueron entrevistados para diagnóstico del trastorno. Resultados: de las 421 personas, se diagnosticaron 60 con TpA. Se observó una adecuada consistencia interna del instrumento y el AFC ratificó la estructura de la versión original de dos factores: 1) manifestaciones cognitivas y 2) manifestaciones conductuales, presentando un buen ajuste de los datos. Se exploraron diferentes puntos de corte, observando el 17 como el más adecuado de acuerdo con los valores de sensibilidad (98%) y especificidad (93%). Conclusión: estos resultados contribuyen al desarrollo de una medida de evaluación de atracón alimentario en la población mexicana y proporciona una exploración del BES válida para la detección de sintomatología de TpA tanto en hombres como en mujeres.