The environment and eating disorders: developing novel measures and hypotheses through inter-disciplinary collaborations.

饮食失调是一种严重的心理健康障碍，往往始于童年和青春期。大约6%的女性和2%的男性患有神经性厌食症、神经性贪食症、暴食症或其他特定的进食障碍。多达五分之一的年轻人有这些症状。目前尚不清楚有多少人患有逃避性/限制性食物摄入障碍（ARFID）、异食癖和反刍障碍，这些疾病最近被纳入进食障碍诊断。总的来说，我们仍然对人群中谁患有饮食失调症以及导致这些疾病的原因知之甚少。工作包1。对饮食失调的研究有限。很少有大型研究收集了饮食失调的数据。在某些情况下，这是因为我们没有足够的措施。我们的第一个目标是提高饮食失调数据的可用性，以促进未来的研究。我们将:1。包括一份简短的饮食失调调查问卷，这是一项针对3万名青少年的大型普通人群研究。2. 为ARFID、异食癖和反刍障碍制作一份简短的问卷。将人口研究与临床数据联系起来，以便更好地了解谁被诊断患有或未被诊断患有饮食失调症，以及未被诊断患有饮食失调症的人的长期健康结果是什么。工作包2。与20年前相比，现在有更多的年轻人患有饮食失调症。这一时期发生的社会变化可能导致了这种增长。有证据表明，城市环境的某些方面——如缺乏公园、污染加剧、贫困、快餐供应——与年轻人的心理和身体健康状况恶化有关。这可能是因为睡眠问题增加，社交和体育活动的机会减少，以及体重增加。睡眠障碍、孤独和体重增加也会出现在饮食失调的人群中，但没有强有力的证据表明它们是否是饮食失调的原因，如果解决了这些问题，就可以帮助预防它们。同样，社交媒体被认为导致了年轻人饮食失调的增加，但没有强有力的证据证明这一点。了解社交媒体参与的内容和类型是否以及哪些内容和类型可能导致饮食失调症状，有助于识别有风险的青少年，并采取措施降低这种风险。我们的第二个目标是开发新的方法来研究这些社会风险因素。我们将建立一个由不同背景的年轻人和研究人员组成的网络，以发展研究假设，并试点收集数据的新方法，以帮助研究人员在未来研究这些问题。我们将：使用智能手表收集250名青少年的位置、睡眠、身体活动、压力、情绪、食欲等信息。5. 探索从这些青少年那里收集社交媒体数据的不同方法。了解我们如何使用来自大型社交媒体平台TalkLife的数据来识别有饮食失调风险的青少年。工作包3。年轻人每天大部分时间都在学校度过，这使得学校成为研究饮食失调的重要环境。我们知道，一些学校的饮食失调率较高，因此，更好地了解学校文化的哪些方面可能导致饮食失调，有助于制定预防性干预措施。我们的第三个目标是建立一个由在青少年心理健康和学校环境的不同方面具有专业知识的研究人员组成的网络，与年轻人、父母和老师一起工作，以便：生成一份学校饮食失调的潜在风险因素清单，并确定调查这些问题的措施和数据集。这些信息将有助于未来的研究人员在这一重要领域测试假设并进行新的研究。

Eating disorders are severe mental health disorders that tend to start in childhood and adolescence. Around to 6% of women and 2% of men experience anorexia nervosa, bulimia nervosa, binge eating disorder, or other specified feeding and eating disorders. Up to one in five young people have some of their symptoms. It is not clear how many people have avoidant/restrictive food intake disorder (ARFID), Pica, and rumination disorder, which have been more recently included as feeding and eating disorder diagnoses. Overall, we still know little about who has eating disorders in the population and what causes these conditions. Work package 1. Research on eating disorders is limited. Few large studies have collected eating disorders data. In some cases, this is because we do not have adequate measures. Our first goal is to improve availability of eating disorder data to facilitate future research. We will:1. include a short eating disorder questionnaire in the Age of Wonder Cohort, a large general population study of 30,000 adolescents. 2. Create a short questionnaire for ARFID, Pica, and rumination disorder.3. Link population studies to clinical data in order to better understand who is or is not diagnosed with an eating disorder and what are long-term health outcomes of people who are not diagnosed. Work package 2. More young people experience eating disorders now than 20 years ago. Societal changes that have happened during this period could have led to this increase. There is evidence that aspects of urban environments - such as lack of parks, higher pollution, deprivation, fast-food availability - are associated with worse mental and physical health in young people. This might be because of increased problems with sleep, fewer opportunities for socialisation and physical activity, and weight gain. Sleep disturbances, loneliness, and weight gain are also seen in people with eating disorders, but there is no robust evidence on whether they are a cause of eating disorders which, if addressed, could help prevent them. Similarly, social media are thought to have led to an increase in eating disorders in young people, but there is no strong evidence of this. Understanding if and which content and type of social media engagement might cause eating disorder symptoms could help identify adolescents at risk and put in place measures to reduce this risk. Our second goal is to develop new approaches to study these societal risk factors. We will create a network of young people and researchers with different backgrounds to develop research hypotheses and pilot new ways of collecting data that will help researchers study these questions in the future. We will: 4. Collect information on location, sleep, physical activity, stress, mood, appetite on 250 adolescents in the Age of Wonder cohort using smartwatches. 5. Explore different ways to collect social media data from these adolescents6. Understand how we can identify adolescents at risk of eating disorders using data from a large social media platform, TalkLife. Work package 3. Young people spend much of their day in schools, making them important environments to study in relation to eating disorders. We know that some schools have higher rates of eating disorders, so a better understanding of which aspects of school culture might cause eating disorders could help developing preventative interventions. Our third goal is to create a network of researchers with expertise in different aspects of young people's mental health and school environments to work alongside young people, parents, and teachers to: 7. Generate a list of potential school-level risk factors for eating disorders and identify measures and datasets that allow investigating these questions. This information will help future researchers testing hypotheses and conduct new research in this important area.