Daniel Wilson, Govind Krishnamorthy, Renata A. Mendes, Tania Withington, Melanie Dalton, Natalie J. Loxton
Objective
Psychiatric comorbid conditions are common among individuals with Eating Disorders (EDs), and these symptoms may exacerbate and/or interact with ED symptoms and impact treatment effectiveness. Whilst comorbid symptomology in Anorexia Nervosa (AN) has been well described, less is known about how the ‘newer’ ED diagnoses of Atypical Anorexia Nervosa (AAN) and Avoidant/Restrictive Food Intake Disorder (ARFID) differ relative to AN. The current study aimed to extend the literature by examining similarities and differences in comorbid symptomology AN, AAN, and ARFID groups.
Method
In this cross-sectional study, young people (n = 311, female = 87.8%, mean age = 14.32: SD = 2.05, range 5–17) with AN, AAN, and ARFID completed self-report measures capturing comorbid symptomology prior to engaging in treatment at a specialist ED outpatient clinic.
Results
There was no difference between AN and AAN on any measure of comorbid symptoms. Both showed severe levels of comorbidity with over half exceeding the cut-point for four or more comorbid diagnoses, with Obsessive Compulsive Disorder, depression and Social Anxiety particularly common. ARFID, on the other hand, had comparatively less severe comorbid symptoms compared to AN and AAN.
Conclusions
Findings provide a better understanding of the nature of comorbid symptomology among these disorders and encourages future research to investigate the role that they play in the treatment outcome.
{"title":"A Comparison of Psychiatric Comorbid Symptomology Between Adolescents With Restrictive/Avoidant Food Intake Disorder, Anorexia Nervosa and Atypical Anorexia Nervosa","authors":"Daniel Wilson, Govind Krishnamorthy, Renata A. Mendes, Tania Withington, Melanie Dalton, Natalie J. Loxton","doi":"10.1002/erv.70014","DOIUrl":"10.1002/erv.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Psychiatric comorbid conditions are common among individuals with Eating Disorders (EDs), and these symptoms may exacerbate and/or interact with ED symptoms and impact treatment effectiveness. Whilst comorbid symptomology in Anorexia Nervosa (AN) has been well described, less is known about how the ‘newer’ ED diagnoses of Atypical Anorexia Nervosa (AAN) and Avoidant/Restrictive Food Intake Disorder (ARFID) differ relative to AN. The current study aimed to extend the literature by examining similarities and differences in comorbid symptomology AN, AAN, and ARFID groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In this cross-sectional study, young people (<i>n</i> = 311, female = 87.8%, mean age = 14.32: SD = 2.05, range 5–17) with AN, AAN, and ARFID completed self-report measures capturing comorbid symptomology prior to engaging in treatment at a specialist ED outpatient clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no difference between AN and AAN on any measure of comorbid symptoms. Both showed severe levels of comorbidity with over half exceeding the cut-point for four or more comorbid diagnoses, with Obsessive Compulsive Disorder, depression and Social Anxiety particularly common. ARFID, on the other hand, had comparatively less severe comorbid symptoms compared to AN and AAN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings provide a better understanding of the nature of comorbid symptomology among these disorders and encourages future research to investigate the role that they play in the treatment outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 1","pages":"113-124"},"PeriodicalIF":3.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vittoria Trolio, Ege Biçaker, Alexia E. Miller, Sarah E. Racine
Objective
Research on avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) has emphasised differences between these disorders, but similarities maintaining dietary restriction may be overlooked. ARFID-related eating disturbances may also occur and facilitate egosyntonic restriction in AN.
Method
Using the Nine Item ARFID Screen (NIAS; N = 141) and ecological momentary assessment (N = 76), we examined endorsement of ARFID-related and traditional eating disorder (ED) reasons for restrictive eating in women with ARFID, AN-restrictive subtype (AN-R), AN binge eating/purging subtype (AN-BP), and controls.
Results
Clinical groups scored higher on NIAS subscales than controls. ARFID participants scored higher on NIAS-Picky than AN groups, and higher on NIAS-Fears and NIAS-Appetite than AN-BP, while AN-R did not differ from either. For skipped meals, ARFID and AN-R did not differ on ratings of avoidant/restrictive motivations, while AN-BP did not differ from either on fears of aversive consequences. For restriction at meal/snack, ARFID did not differ from AN-R on endorsement of picky eating nor AN-BP on lack of interest but endorsed stronger fears of aversive consequences.
Conclusions
While sensory sensitivity/picky eating appears unique to primarily-restrictive EDs, lack of interest was common across clinical groups. Results highlight differences and potential transdiagnostic treatment targets.
{"title":"Endorsement of Avoidant/Restrictive Eating Motivations Across Restrictive Eating Disorders: A Trait- and State-Level Examination","authors":"Vittoria Trolio, Ege Biçaker, Alexia E. Miller, Sarah E. Racine","doi":"10.1002/erv.70016","DOIUrl":"10.1002/erv.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Research on avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) has emphasised differences between these disorders, but similarities maintaining dietary restriction may be overlooked. ARFID-related eating disturbances may also occur and facilitate egosyntonic restriction in AN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Using the Nine Item ARFID Screen (NIAS; <i>N</i> = 141) and ecological momentary assessment (<i>N</i> = 76), we examined endorsement of ARFID-related and traditional eating disorder (ED) reasons for restrictive eating in women with ARFID, AN-restrictive subtype (AN-R), AN binge eating/purging subtype (AN-BP), and controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinical groups scored higher on NIAS subscales than controls. ARFID participants scored higher on NIAS-Picky than AN groups, and higher on NIAS-Fears and NIAS-Appetite than AN-BP, while AN-R did not differ from either. For skipped meals, ARFID and AN-R did not differ on ratings of avoidant/restrictive motivations, while AN-BP did not differ from either on fears of aversive consequences. For restriction at meal/snack, ARFID did not differ from AN-R on endorsement of picky eating nor AN-BP on lack of interest but endorsed stronger fears of aversive consequences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While sensory sensitivity/picky eating appears unique to primarily-restrictive EDs, lack of interest was common across clinical groups. Results highlight differences and potential transdiagnostic treatment targets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 1","pages":"101-112"},"PeriodicalIF":3.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Negative emotional states have been found to predict food cravings and consumption in the general population. People with a persistent tendency to restrict food intake, however, might be eating less when sad, angry, or stressed. In this study, the impact of inducing a negative emotional state through social exclusion on wanting and liking of food pictures was explored in patients with anorexia nervosa.
Method
43 patients with anorexia nervosa and 22 healthy controls completed a computerised social rejection and food appraisal task. Participants viewed short videos in which a stranger made either a negative comment directed toward them or a neutral comment. After each video, participants rated their affective state, as well as their wanting and liking for pictures of high-calorie foods.
Results
Participants in both groups experienced greater negative affect after viewing the negative videos compared to the neutral ones. They also reported lower wanting for high-calorie foods following negative videos, while no significant effects were observed for liking scores. Interestingly, patients with higher body mass index exhibited a greater reduction in both food wanting and liking following negative videos.
Conclusions
These results suggest that negative social interactions can exacerbate restrictive behaviours, especially in patients who are recovering weight during treatment.
{"title":"The Impact of Negative Social Feedback on Wanting and Liking of Food Pictures in Anorexia Nervosa","authors":"Ludovica Natali, Valentina Cardi, Chiara Tosi, Enrico Collantoni, Chiara Caulo, Francesca Fontana, Alessandra Sala, Enrico Ceccato, Palmiero Monteleone, Angela Favaro, Valentina Meregalli","doi":"10.1002/erv.70012","DOIUrl":"10.1002/erv.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Negative emotional states have been found to predict food cravings and consumption in the general population. People with a persistent tendency to restrict food intake, however, might be eating less when sad, angry, or stressed. In this study, the impact of inducing a negative emotional state through social exclusion on wanting and liking of food pictures was explored in patients with anorexia nervosa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>43 patients with anorexia nervosa and 22 healthy controls completed a computerised social rejection and food appraisal task. Participants viewed short videos in which a stranger made either a negative comment directed toward them or a neutral comment. After each video, participants rated their affective state, as well as their wanting and liking for pictures of high-calorie foods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants in both groups experienced greater negative affect after viewing the negative videos compared to the neutral ones. They also reported lower wanting for high-calorie foods following negative videos, while no significant effects were observed for liking scores. Interestingly, patients with higher body mass index exhibited a greater reduction in both food wanting and liking following negative videos.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results suggest that negative social interactions can exacerbate restrictive behaviours, especially in patients who are recovering weight during treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 1","pages":"92-100"},"PeriodicalIF":3.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina Horsager, Emil Færk, Jens Meldgaard Bruun, Marlene B. Lauritsen, Søren Dinesen Østergaard
Background and Aims
Food addiction has been linked to psychopathology and reduced psychological well-being. Here, we investigated whether these associations are mainly driven by food addiction itself or mediated via an increase in BMI.
Methods
Data stem from a nationwide survey from Denmark (n = 1474 participants). The survey questionnaire included the Yale Food Addiction Scale 2.0 (YFAS 2.0) measuring food addiction, questions on height and weight (to compute BMI), and a range of self-reported measures of psychopathology and psychological well-being. The association between food addiction and psychopathology/psychological well-being, stratified by weight category (normal weight (BMI 18.5-24.9), overweight (BMI 25–29.9) and obesity (BMI ≥ 30)), was assessed via multivariable regression analyses, adjusted for sex, age, socioeconomic status and BMI.
Results
Across all BMI categories, having food addiction was strongly positively associated with psychopathology (depression, anxiety, and interpersonal sensitivity) and strongly negatively associated with psychological well-being (all p-values < 0.001), despite adjustment for BMI. These associations remained following exclusion of participants either having received a diagnosis of mental disorder or having redeemed a prescription for psychopharmacological treatment.
Conclusion
The findings from this study are compatible with food addiction itself, and not increased BMI likely arising from it, being associated with psychopathology and reduced psychological well-being.
{"title":"Food Addiction Is Strongly Associated With Psychopathology and Reduced Psychological Well-Being Among Adults Irrespective of BMI","authors":"Christina Horsager, Emil Færk, Jens Meldgaard Bruun, Marlene B. Lauritsen, Søren Dinesen Østergaard","doi":"10.1002/erv.70011","DOIUrl":"10.1002/erv.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Food addiction has been linked to psychopathology and reduced psychological well-being. Here, we investigated whether these associations are mainly driven by food addiction itself or mediated via an increase in BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data stem from a nationwide survey from Denmark (<i>n</i> = 1474 participants). The survey questionnaire included the Yale Food Addiction Scale 2.0 (YFAS 2.0) measuring food addiction, questions on height and weight (to compute BMI), and a range of self-reported measures of psychopathology and psychological well-being. The association between food addiction and psychopathology/psychological well-being, stratified by weight category (normal weight (BMI 18.5-24.9), overweight (BMI 25–29.9) and obesity (BMI ≥ 30)), was assessed via multivariable regression analyses, adjusted for sex, age, socioeconomic status and BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across all BMI categories, having food addiction was strongly positively associated with psychopathology (depression, anxiety, and interpersonal sensitivity) and strongly negatively associated with psychological well-being (all <i>p</i>-values < 0.001), despite adjustment for BMI. These associations remained following exclusion of participants either having received a diagnosis of mental disorder or having redeemed a prescription for psychopharmacological treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings from this study are compatible with food addiction itself, and not increased BMI likely arising from it, being associated with psychopathology and reduced psychological well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 1","pages":"79-91"},"PeriodicalIF":3.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tyler B. Mason, Diego Hernandez, Jeremy C. Morales, Genevieve F. Dunton
Objectives
Impulsivity has been linked to overeating and loss of control eating (LOCE), yet most adolescent research has focused on between-subjects (i.e., trait) impulsivity; thus, less is known about how within-subjects (i.e., state) impulsivity predicts overeating and LOCE. Given this gap, this study used ecological momentary assessment (EMA) to examine the construct validity of the four-item Momentary Impulsiveness Scale (MIS) in adolescents and the relationship between within- and between-subjects impulsivity and overeating and LOCE.
Methods
Seventy-four adolescents (Mage = 15.68) completed a 10-day EMA protocol, reporting impulsivity (measured with the MIS) and eating behaviours multiple times daily. Generalised linear mixed models were run examining associations between baseline impulsivity measures and EMA impulsivity and impulsivity, disaggregated into within- and between-subjects effects, as a prospective predictor of overeating and LOCE.
Results
Generally, baseline impulsivity measures predicted elevated EMA impulsivity. Also, higher within-subject impulsivity significantly predicted greater LOCE and higher between-subject impulsivity was significantly associated with greater overeating and LOCE.
Discussion
Analyses demonstrated concordance between baseline and EMA impulsivity measures in adolescents and suggested that state impulsivity impacts the perceived control over eating. Adolescent preventions/interventions that provide strategies to reduce or mitigate state impulsivity warrant further investigation (e.g., providing in-the-moment self-regulatory strategies when feeling impulsive).
{"title":"Ecological Momentary Assessment of Impulsivity and Overeating and Loss of Control Eating in Adolescents","authors":"Tyler B. Mason, Diego Hernandez, Jeremy C. Morales, Genevieve F. Dunton","doi":"10.1002/erv.70010","DOIUrl":"10.1002/erv.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Impulsivity has been linked to overeating and loss of control eating (LOCE), yet most adolescent research has focused on between-subjects (i.e., trait) impulsivity; thus, less is known about how within-subjects (i.e., state) impulsivity predicts overeating and LOCE. Given this gap, this study used ecological momentary assessment (EMA) to examine the construct validity of the four-item Momentary Impulsiveness Scale (MIS) in adolescents and the relationship between within- and between-subjects impulsivity and overeating and LOCE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-four adolescents (M<sub>age</sub> = 15.68) completed a 10-day EMA protocol, reporting impulsivity (measured with the MIS) and eating behaviours multiple times daily. Generalised linear mixed models were run examining associations between baseline impulsivity measures and EMA impulsivity and impulsivity, disaggregated into within- and between-subjects effects, as a prospective predictor of overeating and LOCE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Generally, baseline impulsivity measures predicted elevated EMA impulsivity. Also, higher within-subject impulsivity significantly predicted greater LOCE and higher between-subject impulsivity was significantly associated with greater overeating and LOCE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Analyses demonstrated concordance between baseline and EMA impulsivity measures in adolescents and suggested that state impulsivity impacts the perceived control over eating. Adolescent preventions/interventions that provide strategies to reduce or mitigate state impulsivity warrant further investigation (e.g., providing in-the-moment self-regulatory strategies when feeling impulsive).</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 1","pages":"71-78"},"PeriodicalIF":3.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. J. Besjes, S. H. W. Mares, A. A. van Elburg, J. Spijker
Objective
Major depressive disorder (MDD) is a frequent comorbidity in anorexia nervosa (AN). This review aimed to evaluate evidence on the effectiveness of pharmacological treatments for MDD in underweight individuals.
Method
A systematic review was conducted using PubMed, Medline, PsycINFO, and Web of Science through March 2025. Nineteen studies with 477 underweight patients were included, involving pharmacological treatment of depressed underweight young adults. Study designs ranged from randomised controlled trials (RCTs) to open-label trials and case reports, with quality assessments performed. Most studies focused on patients with AN; a few included underweight individuals without eating disorders.
Results
No RCTs specifically examined antidepressant treatment for MDD in AN. Most studies prioritised weight restoration and eating disorder symptoms over depressive outcomes. Some case reports indicated potential benefits of medications such as mirtazapine and ketamine. However, evidence was mixed and generally low in quality. Overall, it shows insufficient evidence for the effectiveness of pharmacological treatments in underweight individuals. There is insufficient data to determine whether being underweight affects antidepressant efficacy.
Conclusions
Evidence on pharmacological treatment of MDD in underweight individuals, particularly those with AN, is scarce and inconclusive. Well-designed RCTs are needed to assess the efficacy and safety of antidepressants in this population.
目的：重度抑郁障碍（MDD）是神经性厌食症（AN）的常见合并症。本综述旨在评价体重过轻个体的重度抑郁症药物治疗有效性的证据。方法：通过PubMed， Medline， PsycINFO和Web of Science进行系统综述，截止到2025年3月。19项研究纳入了477名体重过轻的患者，包括对体重过轻的抑郁年轻人的药物治疗。研究设计范围从随机对照试验（rct）到开放标签试验和病例报告，并进行了质量评估。大多数研究集中在AN患者身上；少数包括体重过轻但没有饮食失调的人。结果：没有随机对照试验专门检查了AN患者的MDD的抗抑郁治疗。大多数研究优先考虑体重恢复和饮食失调症状，而不是抑郁结果。一些病例报告指出了米氮平和氯胺酮等药物的潜在益处。然而，证据参差不齐，质量普遍较低。总的来说，它没有充分的证据表明药物治疗对体重过轻的个体有效。没有足够的数据来确定体重过轻是否会影响抗抑郁药的疗效。结论：关于体重过轻个体，特别是AN患者的重度抑郁症的药物治疗的证据很少且不确定。需要设计良好的随机对照试验来评估抗抑郁药在这一人群中的有效性和安全性。
{"title":"The Efficacy of Pharmacological Treatment of Depression in Anorexia Nervosa and Underweight Patients: A Systematic Review","authors":"M. J. Besjes, S. H. W. Mares, A. A. van Elburg, J. Spijker","doi":"10.1002/erv.70008","DOIUrl":"10.1002/erv.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Major depressive disorder (MDD) is a frequent comorbidity in anorexia nervosa (AN). This review aimed to evaluate evidence on the effectiveness of pharmacological treatments for MDD in underweight individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic review was conducted using PubMed, Medline, PsycINFO, and Web of Science through March 2025. Nineteen studies with 477 underweight patients were included, involving pharmacological treatment of depressed underweight young adults. Study designs ranged from randomised controlled trials (RCTs) to open-label trials and case reports, with quality assessments performed. Most studies focused on patients with AN; a few included underweight individuals without eating disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No RCTs specifically examined antidepressant treatment for MDD in AN. Most studies prioritised weight restoration and eating disorder symptoms over depressive outcomes. Some case reports indicated potential benefits of medications such as mirtazapine and ketamine. However, evidence was mixed and generally low in quality. Overall, it shows insufficient evidence for the effectiveness of pharmacological treatments in underweight individuals. There is insufficient data to determine whether being underweight affects antidepressant efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Evidence on pharmacological treatment of MDD in underweight individuals, particularly those with AN, is scarce and inconclusive. Well-designed RCTs are needed to assess the efficacy and safety of antidepressants in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 1","pages":"55-70"},"PeriodicalIF":3.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Moody, Lindsay Ross, Marie-Christine Opitz, Amelia Hemmings, Başak İnce, Callum Bryson, Carina Kuehne, Daire Douglas, Matthew Phillips, Vivienne Langhorne, Ulrike Schmidt, Helen Sharpe
Background
The fitness and wellbeing technology industry is growing rapidly. Concerns are emerging regarding whether these may increase disordered eating behaviours. This review is the first to systematically examine the relationship between fitness and diet tracker use and disordered eating in general and clinical populations.
Methods
The following databases were searched: EMBASE, Medline/PubMed, PsychInfo, CINAHL Plus, ERIC, SportDiscus, ASSIA, Social Science Premium, Sociological Abstracts, Sports Medicine and Educational Health, SCOPUS, Cochrane Library, and ProQuest Dissertation and Theses Global. Studies were selected using predetermined inclusion and exclusion criteria. A narrative synthesis was used, and results were reported by disordered eating outcome.
Results
Twenty-seven studies were included in the final review. Cross-sectional studies revealed reasonably consistent evidence of an association between disordered eating and fitness and diet tracker use, specifically regarding global disordered eating, dietary restraint, excessive exercise, and disordered muscle-orientated behaviour. However, this association was not replicated in experimental research.
Conclusion
While fitness and diet tracker use is a correlate of disordered eating, it is currently not possible to conclude if they increase disordered eating, or the direction of this relationship. Future research should determine the nature of this relationship and possible mechanisms to ensure their safe use in vulnerable populations.
背景：健身和健康技术行业正在迅速发展。越来越多的人担心这些药物是否会增加饮食失调的行为。这篇综述首次系统地研究了普通人群和临床人群中健康和饮食追踪器使用与饮食失调之间的关系。方法：检索EMBASE、Medline/PubMed、PsychInfo、CINAHL Plus、ERIC、SportDiscus、ASSIA、Social Science Premium、Sociological Abstracts、Sports Medicine and Educational Health、SCOPUS、Cochrane Library、ProQuest Dissertation and Theses Global等数据库。采用预先确定的纳入和排除标准选择研究。采用叙事综合法，结果以进食障碍结果报告。结果：最终综述纳入了27项研究。横断面研究显示，饮食失调与健康和饮食追踪器使用之间存在相当一致的关联，特别是在全球饮食失调、饮食限制、过度运动和肌肉导向行为紊乱方面。然而，这种关联并没有在实验研究中得到证实。结论：虽然健身和饮食追踪器的使用与饮食失调相关，但目前还无法得出它们是否会增加饮食失调，或者这种关系的方向。未来的研究应确定这种关系的性质和可能的机制，以确保它们在弱势群体中安全使用。
{"title":"Associations Between the Use of Fitness and Diet Tracking Technology and Disordered Eating Behaviour: A Systematic Review","authors":"Sarah Moody, Lindsay Ross, Marie-Christine Opitz, Amelia Hemmings, Başak İnce, Callum Bryson, Carina Kuehne, Daire Douglas, Matthew Phillips, Vivienne Langhorne, Ulrike Schmidt, Helen Sharpe","doi":"10.1002/erv.70006","DOIUrl":"10.1002/erv.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The fitness and wellbeing technology industry is growing rapidly. Concerns are emerging regarding whether these may increase disordered eating behaviours. This review is the first to systematically examine the relationship between fitness and diet tracker use and disordered eating in general and clinical populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The following databases were searched: EMBASE, Medline/PubMed, PsychInfo, CINAHL Plus, ERIC, SportDiscus, ASSIA, Social Science Premium, Sociological Abstracts, Sports Medicine and Educational Health, SCOPUS, Cochrane Library, and ProQuest Dissertation and Theses Global. Studies were selected using predetermined inclusion and exclusion criteria. A narrative synthesis was used, and results were reported by disordered eating outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies were included in the final review. Cross-sectional studies revealed reasonably consistent evidence of an association between disordered eating and fitness and diet tracker use, specifically regarding global disordered eating, dietary restraint, excessive exercise, and disordered muscle-orientated behaviour. However, this association was not replicated in experimental research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While fitness and diet tracker use is a correlate of disordered eating, it is currently not possible to conclude if they increase disordered eating, or the direction of this relationship. Future research should determine the nature of this relationship and possible mechanisms to ensure their safe use in vulnerable populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 6","pages":"1288-1313"},"PeriodicalIF":3.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helene Krauss, Michael Zeiler, Dunja Mairhofer, Julia Klang, Julia Schwarzenberg, Michaela Mitterer, Gudrun Wagner, Maria Glüder, Karin Egberts, Manfred Gerlach, Andreas Karwautz
Background
Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality, requiring innovative treatment strategies. Olanzapine (OLZ), an atypical antipsychotic, has demonstrated efficacy in promoting weight gain and reducing psychopathological symptoms in adults with AN. However, its efficacy and safety in adolescents remain insufficiently explored.
Objective
This study assessed the impact of adjunctive OLZ in adolescents with AN during inpatient care, focussing on weight gain, eating disorder pathology, and metabolic safety.
Methods
A naturalistic, prospective study compared two groups of adolescent inpatients with AN (n = 47 each), one receiving standard multidisciplinary care plus OLZ and one receiving standard care alone (Non-OLZ). Weekly weight gain as well as admission-to-discharge changes in body-mass-index, eating disorder symptoms, and metabolic markers were compared between the two cohorts.
Results
The OLZ group (∅ 9 mg/day) achieved greater weekly weight gain (0.898 vs. 0.677 kg, p = 0.004) compared to the Non-OLZ group. Both groups showed similar reductions in eating disorder pathology; however, improvements in body dissatisfaction were larger in the Non-OLZ group. Administration of OLZ was associated with significant prolactin level increases.
Conclusions
OLZ is a promising adjunctive treatment for adolescents in terms of supporting weight gain during inpatient care. However, psychological effects and possible metabolic risks warrant further study.
背景：神经性厌食症（AN）是一种严重的高死亡率精神疾病，需要创新的治疗策略。奥氮平（OLZ）是一种非典型抗精神病药，已被证明对an成人患者促进体重增加和减轻精神病理症状有效。然而，其在青少年中的有效性和安全性仍未得到充分探讨。目的：本研究评估了住院治疗期间辅助OLZ对AN青少年的影响，重点关注体重增加、饮食失调病理和代谢安全性。方法：一项自然的前瞻性研究比较了两组青少年AN住院患者（n = 47），一组接受标准的多学科治疗加OLZ，一组接受标准治疗（非OLZ）。比较两组患者每周体重增加以及入院至出院时体重指数、饮食失调症状和代谢指标的变化。结果：与非OLZ组相比，OLZ组（∅9 mg/day）周增重较大（0.898 vs 0.677 kg, p = 0.004）。两组的饮食失调病理都有相似的减少；然而，非olz组对身体不满的改善更大。服用OLZ与泌乳素水平显著升高相关。结论：OLZ在支持青少年住院期间体重增加方面是一种很有前景的辅助治疗方法。然而，心理影响和可能的代谢风险需要进一步研究。
{"title":"Efficacy of Adjunct Olanzapine Treatment in Adolescents With Anorexia Nervosa: A Comparison of Two Patient Cohorts","authors":"Helene Krauss, Michael Zeiler, Dunja Mairhofer, Julia Klang, Julia Schwarzenberg, Michaela Mitterer, Gudrun Wagner, Maria Glüder, Karin Egberts, Manfred Gerlach, Andreas Karwautz","doi":"10.1002/erv.70009","DOIUrl":"10.1002/erv.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality, requiring innovative treatment strategies. Olanzapine (OLZ), an atypical antipsychotic, has demonstrated efficacy in promoting weight gain and reducing psychopathological symptoms in adults with AN. However, its efficacy and safety in adolescents remain insufficiently explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study assessed the impact of adjunctive OLZ in adolescents with AN during inpatient care, focussing on weight gain, eating disorder pathology, and metabolic safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A naturalistic, prospective study compared two groups of adolescent inpatients with AN (<i>n</i> = 47 each), one receiving standard multidisciplinary care plus OLZ and one receiving standard care alone (Non-OLZ). Weekly weight gain as well as admission-to-discharge changes in body-mass-index, eating disorder symptoms, and metabolic markers were compared between the two cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The OLZ group (∅ 9 mg/day) achieved greater weekly weight gain (0.898 vs. 0.677 kg, <i>p</i> = 0.004) compared to the Non-OLZ group. Both groups showed similar reductions in eating disorder pathology; however, improvements in body dissatisfaction were larger in the Non-OLZ group. Administration of OLZ was associated with significant prolactin level increases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>OLZ is a promising adjunctive treatment for adolescents in terms of supporting weight gain during inpatient care. However, psychological effects and possible metabolic risks warrant further study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 6","pages":"1314-1320"},"PeriodicalIF":3.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paolo Meneguzzo, Alberto De Mico, Enrico Collantoni, Valentina Meregalli, Elena Tenconi, Angela Favaro
Objective
Eating disorders (ED), including bulimia nervosa (BN) and binge eating disorder (BED), are characterised by dysfunctional eating behaviours and maladaptive emotional regulation tied to concerns about body image. This study investigates the emotional and cognitive impacts of social exclusion and overinclusion on individuals with ED using the Cyberball task, a computerised simulation of social interaction, to examine the role of early maladaptive schemas (EMS) in these responses.
Method
The sample included 124 women: 34 with BN, 26 with BED, and 64 controls, assigned to either an ostracism or overinclusion condition. Emotional responses were measured using PANAS before and after the Cyberball task, and EMS were assessed via the Young Schema Questionnaire. Mediation models were applied to explore EMS effects on emotional responses.
Results
Participants with ED showed unique emotional patterns compared to controls across both Cyberball conditions. In the overinclusion condition, controls experienced increased positive affect, whereas individuals with ED showed no significant change. During ostracism, ED participants reported reduced negative affect, suggesting complex reactions to social exclusion. EMS were found to mediate emotional responses, particularly in the overinclusion condition.
Discussion
The findings underscore the distinct social-cognitive and emotional effects of interpersonal interactions on individuals with BN and BED, emphasising the importance of addressing EMS and social cognition in treatment. Future research should focus on refining our understanding of social perception and emotional skills in ED populations, particularly within the bulimic spectrum.
{"title":"Examining the Effects of Ostracism and Overinclusion in the Eating Disorder Binge Spectrum: Evidence From a Controlled Cyberball Task","authors":"Paolo Meneguzzo, Alberto De Mico, Enrico Collantoni, Valentina Meregalli, Elena Tenconi, Angela Favaro","doi":"10.1002/erv.70007","DOIUrl":"10.1002/erv.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Eating disorders (ED), including bulimia nervosa (BN) and binge eating disorder (BED), are characterised by dysfunctional eating behaviours and maladaptive emotional regulation tied to concerns about body image. This study investigates the emotional and cognitive impacts of social exclusion and overinclusion on individuals with ED using the Cyberball task, a computerised simulation of social interaction, to examine the role of early maladaptive schemas (EMS) in these responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The sample included 124 women: 34 with BN, 26 with BED, and 64 controls, assigned to either an ostracism or overinclusion condition. Emotional responses were measured using PANAS before and after the Cyberball task, and EMS were assessed via the Young Schema Questionnaire. Mediation models were applied to explore EMS effects on emotional responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants with ED showed unique emotional patterns compared to controls across both Cyberball conditions. In the overinclusion condition, controls experienced increased positive affect, whereas individuals with ED showed no significant change. During ostracism, ED participants reported reduced negative affect, suggesting complex reactions to social exclusion. EMS were found to mediate emotional responses, particularly in the overinclusion condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings underscore the distinct social-cognitive and emotional effects of interpersonal interactions on individuals with BN and BED, emphasising the importance of addressing EMS and social cognition in treatment. Future research should focus on refining our understanding of social perception and emotional skills in ED populations, particularly within the bulimic spectrum.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 6","pages":"1276-1287"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Zeiler, Tanja Wittek, Stefanie Truttmann, Julia Klang, Konstantin Kopp, Helene Krauss, Ellen Auer-Welsbach, Susanne Ohmann, Petra Sackl-Pammer, Sonja Werneck-Rohrer, Ulrike Schmidt, Andreas Karwautz, Gudrun Wagner
Objective
To investigate longitudinal changes in alexithymia and emotion recognition among adolescents and emerging adults with anorexia nervosa (AN) and whether these domains can independently predict the long-term eating disorder (ED) outcome.
Method
Ninety-one female patients with AN (mean age: 16.2; 87.6% restrictive type) were included. Forty-five patients received the Maudsley Model Anorexia Nervosa Treatment (MANTRa) and 46 patients received psychotherapeutic treatment-as-usual (TAU). Alexithymia and facial emotion recognition were assessed at baseline and after 1 year. ED pathology was assessed at four time points (until 18-months follow-up).
Results
Alexithymia significantly improved until follow-up when controlled for weight change, with no significant difference between the MANTRa and TAU groups. There was no change in emotion recognition accuracy while we observed significant reductions in emotion recognition response times. Neither baseline alexithymia nor emotion recognition accuracy significantly predicted ED outcome when adjusted for illness severity psychiatric comorbidity. The effects of improvements in alexithymia on improvements in ED pathology were partly mediated by change in depression.
Conclusions
We recommend to routinely assess alexithymia in young people with AN. Therapeutic interventions helping patients to identify, differentiate, and describe their emotions should be intensified. Psychoeducational elements, expressive writing and group intervention components may be supportive.
目的：探讨青少年和初成人神经性厌食症（AN）患者述情障碍和情绪识别的纵向变化，以及这些领域是否能独立预测长期进食障碍（ED）的预后。方法：91例女性AN患者(平均年龄16.2岁；87.6%为限制性型)。45例患者采用莫兹利神经性厌食症治疗（Maudsley Model Anorexia Nervosa Treatment, MANTRa）， 46例患者采用常规心理治疗（TAU）。在基线和1年后评估述情障碍和面部情绪识别。ED病理在四个时间点进行评估（直到随访18个月）。结果：在控制体重变化后，述情障碍在随访前有明显改善，MANTRa组与TAU组之间无显著差异。情绪识别的准确性没有变化，但我们观察到情绪识别的反应时间显著减少。当调整疾病严重程度和精神合并症时，基线述情障碍和情绪识别准确性都不能显著预测ED的结果。述情障碍的改善对ED病理改善的影响部分是由抑郁症的改变介导的。结论：我们建议对AN患者的述情障碍进行常规评估。应加强帮助患者识别、区分和描述其情绪的治疗干预措施。心理教育因素、表达性写作和团体干预因素可能是支持性的。
{"title":"Alexithymia and Emotion Recognition Over the Treatment Course in Adolescents and Emerging Adults With Anorexia Nervosa","authors":"Michael Zeiler, Tanja Wittek, Stefanie Truttmann, Julia Klang, Konstantin Kopp, Helene Krauss, Ellen Auer-Welsbach, Susanne Ohmann, Petra Sackl-Pammer, Sonja Werneck-Rohrer, Ulrike Schmidt, Andreas Karwautz, Gudrun Wagner","doi":"10.1002/erv.70005","DOIUrl":"10.1002/erv.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate longitudinal changes in alexithymia and emotion recognition among adolescents and emerging adults with anorexia nervosa (AN) and whether these domains can independently predict the long-term eating disorder (ED) outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Ninety-one female patients with AN (mean age: 16.2; 87.6% restrictive type) were included. Forty-five patients received the Maudsley Model Anorexia Nervosa Treatment (MANTRa) and 46 patients received psychotherapeutic treatment-as-usual (TAU). Alexithymia and facial emotion recognition were assessed at baseline and after 1 year. ED pathology was assessed at four time points (until 18-months follow-up).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Alexithymia significantly improved until follow-up when controlled for weight change, with no significant difference between the MANTRa and TAU groups. There was no change in emotion recognition accuracy while we observed significant reductions in emotion recognition response times. Neither baseline alexithymia nor emotion recognition accuracy significantly predicted ED outcome when adjusted for illness severity psychiatric comorbidity. The effects of improvements in alexithymia on improvements in ED pathology were partly mediated by change in depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We recommend to routinely assess alexithymia in young people with AN. Therapeutic interventions helping patients to identify, differentiate, and describe their emotions should be intensified. Psychoeducational elements, expressive writing and group intervention components may be supportive.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 6","pages":"1265-1275"},"PeriodicalIF":3.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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