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/Pg 7 0 R /K [0] >> endobj 33 0 obj << /Type /StructElem /S /H3 /T (Urgent need for surveillance. Comprehensive, up-to-date surveillance data on disordered eating are urgently needed to inform treatment and prevention efforts. To help achieve this goal, this resource has been developed by a multi-state Eating Disorder Public Health Surveillance Working Group and contains evidence-based, best practice recommendations for the selection and prioritization of disordered eating questions in state-specific YRBS surveys. Its aims are to support YRBS Coordinators who are deciding to prioritize the assessment of disordered eating in their survey, while simultaneously navigating decisions about which symptoms and behaviors to assess within the often limited number of available question slots. ) /E (Urgent need for surveillance. Comprehensive, up-to-date surveillance data on disordered eating are urgently needed to inform treatment and prevention efforts. To help achieve this goal, this resource has been developed by a multi-state Eating Disorder Public Health Surveillance Working Group and contains evidence-based, best practice recommendations for the selection and prioritization of disordered eating questions in state-specific YRBS surveys. Its aims are to support YRBS Coordinators who are deciding to prioritize the assessment of disordered eating in their survey, while simultaneously navigating decisions about which symptoms and behaviors to assess within the often limited number of available question slots. ) /Pg 7 0 R /K [1] >> endobj 34 0 obj << /Type /StructElem /S /H2 /T (References) /E (References) /Pg 7 0 R /K [9] >> endobj 35 0 obj << /Type /StructElem /S /P /P 93 0 R /ActualText (Klump, et al. Eating disorders are serious mental illnesses. Int J Eat Disord. 2009.) /Pg 7 0 R /K [10] >> endobj 36 0 obj << /Type /StructElem /S /P /P 94 0 R /ActualText (Swanson, et al. Prevalence and correlates of eating disorders in adolescents. Arch Gen Psychiatry. 2011.) /Pg 7 0 R /K [11] >> endobj 37 0 obj << /Type /StructElem /S /P /P 95 0 R /ActualText (Ward, et al. Estimation of eating disorders prevalence by age and associations with mortality. JAMA Netw Open. 2019.) /Pg 7 0 R /K [12] >> endobj 38 0 obj << /Type /StructElem /S /P /P 96 0 R /ActualText (Peebles, et al. Medical complications of eating disorders in youth. Child Adolesc Psychiatr Clin N Am. 2019.) /Pg 7 0 R /K [13] >> endobj 39 0 obj << /Type /StructElem /S /P /P 97 0 R /ActualText (Hambleton, et al. Psychiatric and medical comorbidities of eating disorders. J Eat Disord. 2022.) /Pg 7 0 R /K [14] >> endobj 40 0 obj << /Type /StructElem /S /P /P 98 0 R /ActualText (van Hoeken, et al. Review of the burden of eating disorders. Curr Opin Psychiatry. 2020.) /Pg 7 0 R /K [15] >> endobj 41 0 obj << /Type /StructElem /S /P /P 99 0 R /ActualText <4BE4726B6BE4696E656E2C20657420616C2E20446F206469736F72646572656420656174696E67206265686176696F7572732068617665206C6F6E672D7465726D206865616C74682D72656C6174656420636F6E73657175656E6365733F2045757220456174204469736F7264205265762E20323031382E> /Pg 7 0 R /K [16] >> endobj 42 0 obj << /Type /StructElem /S /P /P 100 0 R /ActualText (Chin, et al. Trends and correlates of unhealthy dieting behaviours among adolescents. BMC Public Health. 2018.) /Pg 7 0 R /K [17] >> endobj 43 0 obj << /Type /StructElem /S /P /P 101 0 R /ActualText (Devoe, et al. The impact of the COVID-19 pandemic on eating disorders: A systematic review. Int J Eat Disord. 2023. ) /Pg 7 0 R /K [18] >> endobj 44 0 obj << /Type /StructElem /S /P /P 102 0 R /ActualText (Radhakrishnan, et al. Pediatric emergency department visits associated with mental health. MMWR Morb Mortal Wkly Rep. 2022.) /Pg 7 0 R /K [19] >> endobj 45 0 obj << /Type /StructElem /S /P /P 103 0 R /ActualText (Menzel JE, et al. Appearance-related teasing, body dissatisfaction, and disordered eating. Body Image. 2010. ) /Pg 7 0 R /K [20] >> endobj 46 0 obj << /Type /StructElem /S /P /P 104 0 R /ActualText (Streatfeild, et al. Social and economic cost of eating disorders in the United States. Int J Eat Disord. 2021. ) /Pg 7 0 R /K [21] >> endobj 47 0 obj << /Type /StructElem /S /P /P 105 0 R /ActualText (Economic Costs of Eating Disorders by State. https://www.hsph.harvard.edu/striped/economic-costs-of-eating-disorders-by-state/ ) /Pg 7 0 R /K [22] >> endobj 48 0 obj << /Type /StructElem /S /Figure /P 28 0 R /Pg 7 0 R /K [2] >> endobj 49 0 obj << /Type /StructElem /S /Figure /P 28 0 R /Pg 7 0 R /K [3] >> endobj 50 0 obj << /Type /StructElem /S /Figure /P 28 0 R /Pg 7 0 R /K [4] >> endobj 51 0 obj << /Type /StructElem /S /Figure /P 28 0 R /Pg 7 0 R /K [5] >> endobj 52 0 obj << /Type /StructElem /S /Figure /P 28 0 R /Pg 7 0 R /K [6] >> endobj 53 0 obj << /Type /StructElem /S /Figure /P 28 0 R /Pg 7 0 R /K [23] >> endobj 54 0 obj << /Type /StructElem /S /H1 /T (Recommendations for Item Selection) /E (Recommendations for Item Selection) /Pg 8 0 R /K [12] >> endobj 55 0 obj << /Type /StructElem /S /H2 /T (1 question slot available:) /E (1 question slot available:) /Pg 8 0 R /K [0] >> endobj 56 0 obj << /Type /StructElem /S /H3 /T (Binge Eating: During the past 30 days, on how many days did you eat an unusually large amount of food in a short period of time and experience a loss of control over how much you were eating or a feeling that you could not stop eating even when full? A. 0 days; B. 1 or 2 days; C. 3 to 5 days; D. 6 to 9 days; E. 10 to 19 days; F. 20 to 29 days; G. All 30 days.) /E (Binge Eating: During the past 30 days, on how many days did you eat an unusually large amount of food in a short period of time and experience a loss of control over how much you were eating or a feeling that you could not stop eating even when full? A. 0 days; B. 1 or 2 days; C. 3 to 5 days; D. 6 to 9 days; E. 10 to 19 days; F. 20 to 29 days; G. All 30 days.) /Pg 8 0 R /K [1] >> endobj 57 0 obj << /Type /StructElem /S /P /ActualText (Rationale: This question will estimate the prevalence of binge eating, which is the most common form of disordered eating among U.S. youth. Binge eating is a core symptom of bulimia nervosa \(BN\) and binge eating disorder \(BED\) is a high-risk disordered eating behavior in its own right that disproportionately affects racial/ethnic minority youth, LGBTQ+ youth, and youth experiencing food insecurity.) /Pg 8 0 R /K [2] >> endobj 58 0 obj << /Type /StructElem /S /H2 /T (2 question slots available:) /E (2 question slots available:) /Pg 8 0 R /K [3] >> endobj 59 0 obj << /Type /StructElem /S /H3 /T (Add Composite Restrictive Disordered Eating: During the past 30 days, on how many days did you try to control your shape or weight by fasting or skipping meals; taking diet pills or supplements not prescribed by a doctor; or vomiting or taking laxatives? A. 0 days; B. 1 or 2 days; C. 3 to 5 days; D. 6 to 9 days; E. 10 to 19 days; F. 20 to 29 days; G. All 30 days.) /E (Add Composite Restrictive Disordered Eating: During the past 30 days, on how many days did you try to control your shape or weight by fasting or skipping meals; taking diet pills or supplements not prescribed by a doctor; or vomiting or taking laxatives? A. 0 days; B. 1 or 2 days; C. 3 to 5 days; D. 6 to 9 days; E. 10 to 19 days; F. 20 to 29 days; G. All 30 days.) /Pg 8 0 R /K [4] >> endobj 60 0 obj << /Type /StructElem /S /P /ActualText (Rationale: This question will estimate the prevalence of restrictive-type disordered eating behaviors. These behaviors often co-occur and can cause severe and sometimes long-lasting negative health consequences, including cardiovascular complications, bone loss, endocrine abnormalities, and neurological issues. They are also strongly associated with anxiety, depression, suicidality, and substance use and are among the strongest predictors of a future eating disorder diagnosis \(especially anorexia nervosa\) among youth in the U.S. ) /Pg 8 0 R /K [5] >> endobj 61 0 obj << /Type /StructElem /S /H2 /T (3 question slots available:) /E (3 question slots available:) /Pg 8 0 R /K [6] >> endobj 62 0 obj << /Type /StructElem /S /H3 /T (Add Weight Victimization: During the past 12 months, have you ever been the victim of teasing or name calling because of your weight, size, or physical appearance? A. Yes; B. No.) /E (Add Weight Victimization: During the past 12 months, have you ever been the victim of teasing or name calling because of your weight, size, or physical appearance? A. Yes; B. No.) /Pg 8 0 R /K [7] >> endobj 63 0 obj << /Type /StructElem /S /P /ActualText (Rationale: This question will estimate the prevalence of victimization based on weight or shape, which is a robust predictor of disordered eating among youth. Importantly, girls, racial/ethnic minority youth, LGBTQ+ youth, and youth of higher weight status are most likely to be the targets of weight- or shape-related teasing or name calling, making this factor a recognized social determinant of disparities in disordered eating outcomes. ) /Pg 8 0 R /K [8] >> endobj 64 0 obj << /Type /StructElem /S /H2 /T (4 question slots available:) /E (4 question slots available:) /Pg 8 0 R /K [9] >> endobj 65 0 obj << /Type /StructElem /S /H3 /T /E /Pg 8 0 R /K [10] >> endobj 66 0 obj << /Type /StructElem /S /P /ActualText (Rationale: These questions will provide more granular data on the prevalence of a specific restrictive-type disordered eating behavior, which may be relevant in some contexts.) /Pg 8 0 R /K [11] >> endobj 67 0 obj << /ca 1 /BM /Normal >> endobj 68 0 obj << /ca .4 /BM /Normal >> endobj 69 0 obj << /G3 67 0 R >> endobj 70 0 obj << /Type /Group /S /Transparency /I true >> endobj 71 0 obj << /Length 293 /N 3 /Filter /FlateDecode >> stream x}JԂ(28hiRpi"VSAOHStspu+.c(#ARx@?F[V[G@`*dK$O.K o@6`O,f'˘O asx0A6vf 8{c7%opZ:u Q 0Q٣F *Ԑ(SDGACAajgrx]s PxM cvhO> stream xѱ mLOCCf륻svNFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFf98z{L endstream endobj 73 0 obj << /Length 51 /Type /XObject /Subtype /Image /Width 78 /Height 78 /ColorSpace /DeviceGray /BitsPerComponent 8 /Filter /FlateDecode >> stream x1/3Kll6fl6fl6};F| endstream endobj 74 0 obj << /Length 37 /Type /XObject /Subtype /Image /Width 60 /Height 87 /ColorSpace /DeviceGray /BitsPerComponent 8 /Filter /FlateDecode >> stream x!/9!n[%[h)@+ endstream endobj 75 0 obj << /Length 3511 /Type /XObject /Subtype /Image /Width 173 /Height 61 /ColorSpace /DeviceGray /BitsPerComponent 8 /Filter /FlateDecode >> stream xY{\UUK4y"*Ze>58ecZ:fE+RQ˟|9:(Q@&mLC}`½o=$I$!K`e>~z)KRj^{j$74 g8DGdC|*qH;K8pvßS[=3e޲ mgqВm/yh԰⿚wac Э֍˻&BF[7*Ǎpce*++*!!`BV r Z<N$Akj$_-]2N_۪\)}C3N^īfլV,/;H2%TqZ}N:nAxl'MmVh|LV]hKdKt]'F*,ds446aRŧFeŹɒZwn"vaf%V=(2*hv+U$Atrh*TNy=k$ A=~`*UK5ְӭk\S8rimg(@N6:'uf']8FQmؼr de_U4\\詼f9A(W~)il6WNvk(2GFeݭKrғq)HTôӘzO0HfÂT\s ~ufãC WdeIl_H9KkT.KvFd\Fpʂ]}9 .+P㱮YĽFC ѡ%;w1V["[%G1!#Av%m`% iʕ+}x2&$r!GD7*Dxpp$_^]rz[m*M#t-o‚TC>sڈ嶰$"k$lש3$s`#uܾ)kj}{%餹Ÿ́"c-/ߌi)+@|٫UUuJB.gEeZak͇٭O7 ѲjN1#蚻n6a飻[ t `#cc5㸽zS {tAe"e%a*^ tUK'34~|5v6 R _X(B9,@sYfQ;nb(2X[]A0h˜r-fUuMZw&+ 1d +$*2ps`Kh|eԳvʲۼR;HM~xTY}sۚZ N訉kqFlg^^鬙# 9ۑbk"ݎ`:duSv0Q)Hi-*95Q*2,:7qFDx8E|ڃq|@ǽ)IVwZ  hnuZi++KYJ:26V+OQ gTYe$6v2v.zθiMr`{Xwtʝ ;3 4O=|xy8(N`7/~׍W]{߈0eֳg^񱢑^}&cqRWZ4)?E18E|zq>m=kBZK[GsĐ\6]SMwkJ~fG8e׃ -Zk?޺_Fp5j U,-{ ; NAdtO==E0Zwqm[_/A!;a,d \Gg:hLZWǰ"x &^WSYرv-(xV@_ pO&yckwL8[6C46`AtO6`0 < D;. 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