Adults living with obesity have a higher risk of eating disorders and disordered eating behaviours such as binge eating(1,2). However, the prevalence of disordered eating/eating disorders in adults presenting for obesity treatment is unknown and this information is needed to guide service provision. This systematic review aimed to estimate the prevalence of disordered eating/eating disorders in adults presenting for obesity treatment. Embase, MEDLINE and PsycINFO were searched to March 2024. Eligible studies (k) measured disordered eating/eating disorders in adults with overweight/obesity presenting for obesity treatment and included ≥ 325 participants to ensure a representative sample. Prevalence estimates were synthesised using random effect meta-analysis. 81 studies were included (n = 92,002, 75.9% female, median (IQR) age 44 (6) years, BMI 45 (11) kg/m2. Most studies were conducted in the United States (k = 44) and Italy (k = 15). Most prevalence data related to binge eating disorder or binge eating severity. The pooled prevalence of binge eating disorder, assessed by clinical interview, was 17% (95% CI: 12–22, 95% prediction interval (PI): 0–42, k = 19, n = 13447, τ2 = 0.01) using DSM-IV criteria and 12% (95% CI: 5–20, 95% PI: 0–40, k = 9, n = 7680, τ2 = 0.01) using DSM-V criteria. The pooled prevalence for severe binge eating (Binge Eating Scale score > 25) was 12% (95% CI: 8–16, 95% PI: 0–31, k = 18, n = 12136, τ2 = 0.01). For binge eating disorder, measured by clinical interview, the prevalence range for females and males was 14.9 to 27.0% (k = 12), and 4.0 to 24.1% (k = 3) respectively. For moderate to severe binge eating (Binge Eating Scale score ≥ 18) the prevalence for females and males ranged from 20.0 to 32.8%, and 7.1 to 77.5% (k = 2). Three studies reported prevalence by ethnicity. The prevalence of severe binge eating (Binge Eating Scale scores ≥ 27) was 9.5 to 41.7% in white populations (k = 2), 7.5 to 35.8% in black populations (k = 2), and 5.7% in Hispanic populations (k = 1). One study reported binge eating disorder, assessed by clinical interview, for white, black and Hispanic populations and reported prevalence of 15.3%, 11.3% and 11.4% respectively. Overall, there was high variability in the prevalence of binge eating and binge eating disorder in adults presenting for obesity treatment, with available data indicating prevalence can range up to 42%. It is important to identify which population level factors drive this heterogeneity to inform service provision however, the limited data highlights a significant knowledge gap in the reporting of eating disorders in underrepresented populations which needs to be addressed.

Hendra virus (HeV) continues to cause fatal infection in horses and threaten infection in close-contact humans in eastern Australia. Species of Pteropus bats (flying-foxes) are the natural reservoir of the virus. We caught and sampled flying-foxes from a multispecies roost in southeast Queensland, Australia on eight occasions between June 2013 and June 2014. The effects of sample date, species, sex, age class, body condition score (BCS), pregnancy and lactation on HeV antibody prevalence, log-transformed median fluorescent intensity (lnMFI) values and HeV RNA status were assessed using unbalanced generalised linear models. A total of 1968 flying-foxes were sampled, comprising 1012 Pteropus alecto, 742 P. poliocephalus and 214 P. scapulatus. Sample date, species and age class were each statistically associated with HeV RNA status, antibody status and lnMFI values; BCS was statistically associated with HeV RNA status and antibody status. The findings support immunologically naïve sub-adult P. alecto playing an important role in maintaining HeV infection at a population level. The biological significance of the association between BCS and HeV RNA status, and BCS and HeV antibody status, is less clear and warrants further investigation. Contrary to previous studies, we found no direct association between HeV infection and pregnancy or lactation. The findings in P. poliocephalus suggest that HeV exposure in this species may not result in systemic infection and virus excretion, or alternatively, may reflect assay cross-reactivity with another (unidentified) henipavirus.

The wind-driven stably stratified mid-latitude oceanic surface turbulent boundary layer is computationally simulated in the presence of a specified surface gravity-wave field. The gravity waves have broad wavenumber and frequency spectra typical of measured conditions in near-equilibrium with the mean wind speed. The simulation model is based on (i) an asymptotic theory for the conservative dynamical effects of waves on the wave-averaged boundary-layer currents and (ii) a boundary-layer forcing by a stochastic representation of the impulses and energy fluxes in a field of breaking waves. The wave influences are shown to be profound on both the mean current profile and turbulent statistics compared to a simulation without these wave influences and forced by an equivalent mean surface stress. As expected from previous studies with partial combinations of these wave influences, Langmuir circulations due to the wave-averaged vortex force make vertical eddy fluxes of momentum and material concentration much more efficient and non-local (i.e. with negative eddy viscosity near the surface), and they combine with the breakers to increase the turbulent energy and dissipation rate. They also combine in an unexpected positive feedback in which breaker-generated vorticity seeds the creation of a new Langmuir circulation and instigates a deep strong intermittent downwelling jet that penetrates through the boundary layer and increases the material entrainment rate at the base of the layer. These wave effects on the boundary layer are greater for smaller wave ages and higher mean wind speeds.

We devise a stochastic model for the effects of breaking waves and fit its distribution functions to laboratory and field data. This is used to represent the space–time structure of momentum and energy forcing of the oceanic boundary layer in turbulence-resolving simulations. The aptness of this breaker model is evaluated in a direct numerical simulation (DNS) of an otherwise quiescent fluid driven by an isolated breaking wave, and the results are in good agreement with laboratory measurements. The breaker model faithfully reproduces the bulk features of a breaking event: the mean kinetic energy decays at a rate approaching $t^{-1}$, and a long-lived vortex (eddy) is generated close to the water surface. The long lifetime of this vortex (more than 50 wave periods) makes it effective in energizing the surface region of oceanic boundary layers. Next, a comparison of several different DNS of idealized oceanic boundary layers driven by different surface forcing (i.e. constant current (as in Couette flow), constant stress, or a mixture of constant stress plus stochastic breakers) elucidates the importance of intermittent stress transmission to the underlying currents. A small amount of active breaking, about 1.6% of the total water surface area at any instant in time, significantly alters the instantaneous flow patterns as well as the ensemble statistics. Near the water surface a vigorous downwelling–upwelling pattern develops at the head and tail of each three-dimensional breaker. This enhances the vertical velocity variance and generates both negative- and positive-signed vertical momentum flux. Analysis of the mean velocity and scalar profiles shows that breaking effectively increases the surface roughness $z_o$ by more than a factor of 30; for our simulations $z_o/\lambda \,{\approx}\, 0.04$ to 0.06, where $\lambda$ is the wavelength of the breaking wave. Compared to a flow driven by a constant current, the extra mixing from breakers increases the mean eddy viscosity by more than a factor of 10 near the water surface. Breaking waves alter the usual balance of production and dissipation in the turbulent kinetic energy (TKE) budget; turbulent and pressure transports and breaker work are important sources and sinks in the budget. We also show that turbulent boundary layers driven by constant current and constant stress (i.e. with no breaking) differ in fundamental ways. The additional freedom provided by a constant-stress boundary condition permits finite velocity variances at the water surface, so that flows driven by constant stress mimic flows with weakly and statistically homogeneous breaking waves.