Perioperative dexmedetomidine is associated with improved respiratory outcomes in patients undergoing cardiac surgery: a systematic review and meta-analysis of randomized controlled trials.

Muscularity-oriented disordered eating (MODE) refers to abnormal eating behaviors and attitudes specifically aimed at increasing muscle mass and achieving a more muscular, lean physique []. Unlike thinness-oriented eating disorders, which typically focus on weight loss [], MODE is characterized by excessive concerns about protein intake, strict control of dietary practices, and the use of supplements or intentional overeating to increase muscle growth. MODE may be accompanied or driven by muscle dysmorphia (MD), a subtype of body dysmorphic disorder [, ]. MD is primarily characterized by a chronic preoccupation with being insufficiently muscular and was first described by Pope, who referred to it as “reverse anorexia” []. While Pope et al. noted similarities between MD and eating disorders (EDs), they highlighted that individuals with MD primarily pursue muscularity through exercise rather than diet, distinguishing it from EDs. However, this classification has faced criticism, as disordered eating behaviors are often associated with MD and may reflect a male perspective within ED pathology []. From a transdiagnostic perspective, exercise and eating behaviors can be seen as two sides of the same coin, varying according to the desired aesthetic ideal. In the context of a muscular ideal, exercise is used to build muscle, while eating behaviors are modified to either promote muscle gain or reduce fat and achieve leanness. Both behaviors reflect body-modifying practices aimed at achieving the muscular aesthetic ideal, complementing each other in their effects. MODE is not adequately assessed by tools designed for traditional, thinness-oriented eating behaviors []. To address this limitation, the Muscularity-Oriented Eating Test (MOET) was developed in 2019 []. Comprising 15 items, the MOET specifically evaluates muscularity-oriented eating behaviors, capturing attitudinal, affective, and behavioral aspects related to increasing muscle mass or reducing body fat. The original study, conducted with 519 male students from two U.S. universities, demonstrated good psychometric properties, including a one-factor structure and significant correlations with related constructs such as the Muscle Dysmorphic Disorder Inventory (MDDI), the Drive for Muscularity Scale (DMS), and the Eating Disorder Examination Questionnaire (EDE-Q).