Journal of Eating Disorders最新文献

Introduction: Eating disorders (EDs) are serious mental disorders that often remain untreated for many years. Digital mental health interventions could provide low-threshold support especially in underserved areas. However, the knowledge of mental health professionals (MHPs), who could integrate such interventions into routine care, is still limited.

Objective: This study aimed at the development and evaluation of a web-based toolkit to provide evidence-based knowledge about digital interventions for EDs for MHPs.

Methods: A mixed methods design was chosen to iteratively evaluate the toolkit. First, three focus groups with 16 MHPs were conducted, who tested the toolkit and gave feedback. Then, N = 66 MHPs completed an online survey with self-developed questionnaires on the perceived quality of the toolkit and its modules. Further, several scales were used to measure website clarity (Web-CLIC), visual aesthetics (VisAWI-S), system usability (SUS), e-therapy attitudes (ETAM) and elements of the Unified Theory of Acceptance and Use of Technology (UTAUT).

Results: The focus groups resulted in a number of suggestions that were used to improve the toolkit. The results of the quantitative study showed that the toolkit reached high ratings in website clarity, visual aesthetics and system usability. E-therapy attitudes were positive in 51 (77.3%) cases. While perceived usefulness was M = 2.75 (SD = 0.62, range = 1-3.86), relative advantage remained lower with M = 1.08 (SD = 0.54, range = 0-2.5). Results following the concept of UTAUT, showed a medium Behavioural Intention to use digital interventions for their patients with M = 3.60 (SD = 1.01) and a medium Performance Expectancy of M = 3.50 (SD = 0.93) with lower values for anorexia nervosa than for other kinds of EDs.

Conclusions: In general, MHPs show positive attitudes towards the use of digital interventions for patients with EDs to complement conventional psychotherapy. However, there is also a clear need for more knowledge in the field. The web-based toolkit may serve as a promising educational resource to meet the needs of MHPs. The effectiveness of the toolkit regarding learning success can be tested in future studies.

Background: Eating disorders affect millions worldwide and are associated with serious medical complications, functional impairment, and increased risk of mortality. Yet current treatments are only effective for 40-55% of people, underscoring a dire need for improved and novel interventions. Limited treatment response may be due to (a) the high heterogeneity of eating disorder symptoms and (b) high rates of co-occurrence with other transdiagnostic symptoms, which are not currently addressed in standard treatments.

Main body: To address this gap, recent work has adopted a symptom-focused perspective to clarify how transdiagnostic symptoms interact and maintain pathology. This approach aims to guide more personalized treatment by identifying symptoms most relevant for each individual. However, this requires a clearer understanding of how eating disorder symptoms and co-occurring symptoms relate to one another. The present review synthesizes 30 common eating disorder and co-occurring symptoms and outlines the associated evidence-based treatments. These symptom-treatment connections are derived from prior empirical symptom network analysis and organized to help clinicians and researchers better understand the functional role of each symptom and the interventions used to address them.

Conclusion: By linking symptoms with their corresponding treatment approaches, this review offers a comprehensive and practical reference to support refinement of existing treatment and development of personalized, symptom-level interventions. This framework may assist clinicians and researchers in selecting targeted strategies for individuals.

Background: Anorexia nervosa (AN) often requires nutritional rehabilitation including nasogastric feeding. However, achieving shared treatment goals between clinicians, patients, and families can be challenging. Weight prediction can be a valuable tool in this process; however, conventional approaches rely largely on clinical experience and lack precision. We therefore developed a simplified calorie-based weight prediction model grounded in the revised Harris-Benedict equation.

Case presentation: This case report describes the clinical application of this model in a woman in her twenties with AN. By visualizing predicted weight trajectories under different caloric intake strategies, the model facilitated consensus building between the patient, her family, and the treatment team, leading to the acceptance of nasogastric feeding and structured behavioral therapy.

Conclusions: The present case may suggest the potential utility of a calorie-based weight prediction model as a dynamic, noninvasive, and quantitative tool for inpatient management of AN. While the approach could facilitate understanding and agreement regarding treatment for AN, further evaluation in larger cohorts is required to assess accuracy and clinical impact.

Menstrual disturbances are a common yet often overlooked feature of eating disorders, impacting individuals across diagnostic categories and age groups. This Matters Arising piece responds to Porter (2025), a survivor-led qualitative study highlighting that menstruation is often treated as a simple health indicator, with little attention to emotional or psychosocial aspects. Specifically, I discuss broader intersections between eating disorder pathology and menstrual health, including functional hypothalamic amenorrhea, oligomenorrhea and menopause-related changes, illustrating how menstrual irregularities reflect disruptions in hormonal and metabolic regulation and carry psychological and identity-related implications. Current clinical approaches frequently overlook these dimensions, focusing narrowly on the presence or absence of menstruation rather than holistic well-being. Drawing on research evidence and clinical experience, I recommend a patient-centred approach that includes routine assessment of menstrual history and symptoms, integration of menstrual considerations into nutritional, medical and psychological treatment plans and sensitive communication regarding emotional and identity-related experiences. Interdisciplinary collaboration and further research are essential to better understand menstrual experiences across the lifespan. Recognising menstrual health as a meaningful component of overall treatment can enhance recovery and provide more comprehensive, empathetic care.

Background: Research has suggested that consuming appearance-related content on social media is associated with eating disordered thoughts, but social media also contains content that supports recovery. There is some evidence that TikTok algorithm fed more appearance-related content for people with eating disorders (EDs). However, there are no studies on how people with EDs experience and negotiate the way in which algorithms steer them towards specific social media spaces, which is the original aim of our research.

Methods: Semi-structured interviews were conducted with 31 UK people, 28 women and 3 men, aged 18-49 years, and self-identified as having past or present experience of EDs, most of whom defined themselves as in recovery. The interviews were analysed using reflexive thematic analysis.

Results: In analysing the material we developed a novel spatial approach to algorithms, analysing how they shaped participants' movement across social media and identified three key themes: (i) negative and positive repetitive refrains, (ii) wayfaring between helpful and unhelpful spaces and (iii) being enveloped in a gendered body and wellness landscape. First, algorithms encouraged repetitive viewing or refrain, which made participants to veer into or, when unwell, to steer themselves into social media and psychological spaces characterised by constant thoughts and practices of restricting eating; yet, participants could also repetitively view self-compassion messages on social media to move to a space of self-affirmation. Second, participants wandered into and between helpful mental health and body positive spaces and unhelpful diet and beauty spaces, being mostly casually informed by algorithms and their own interests but also critically reflecting on the steer. Third, wandering between seemingly antithetical diet and recovery spaces still enveloped participants in stereotypically gendered landscape focusing on bodies and wellness and did not cultivate other interests.

Conclusion: The findings suggest that participants recovering from EDs often sought to steer themselves towards social media spaces that enhanced their well-being, but algorithms frequently complicated these journeys, which merits further attention in research, practice and policy.

Background: Eating disorders (EDs) are complex mental health conditions influenced by genetic, psychological, and sociocultural factors. In Saudi Arabia, rising ED prevalence among youth underscores the need for early diagnosis, increased awareness, and targeted intervention. This study examined the relationship between Mental Health Literacy (MHL) and EDs stigma within the Saudi population.

Methods: Utilizing a cross-sectional design, data were collected from 370 participants across all Saudi provinces through a convenience sampling method. Data analysis was conducted by the R software version 4.2.2.

Results: Findings from this study showed generally high MHL and low to moderate stigma. There was a significant inverse relationship between MHL and stigma. Unadjusted linear regression indicated that higher MHL was associated with lower ED stigma. Other predictors of greater stigma included male gender, older age, being married, employment in the private sector, and higher income. Exposure to EDs, such as knowing someone with an ED or having self-diagnosed, was associated with reduced stigma.

Conclusions: The findings of this study underscore the central role of MHL in mitigating stigma toward EDs. Enhancing public education about EDs and promoting accurate understanding may reduce stigmatizing attitudes, improve early intervention, and support better health outcomes in Saudi Arabia.

Background: Compulsive exercise (CE) is commonly observed in eating disorders (ED) and is associated with a more severe clinical picture. Including 3105 participants from the Eating Disorders Genetics Initiative-Sweden, the aim of this cross-sectional study was to expand the knowledge of how CE relates to ED symptoms and other core psychological features.

Methods: Through multiple linear regression analyses, we investigated simple and unique associations between CE, measured with the Compulsive Exercise Test (CET) including its subscales and ED symptoms, obsessive compulsive disorder (OCD) symptoms, anxiety, perfectionism, depression, and health-related quality of life.

Results: Results suggested that ED symptoms, OCD symptoms, and perfectionism all have unique positive associations with CE, and depressive symptoms a negative association when controlling for the other constructs. Each CET subscale showed its own specific pattern of associations with the examined constructs.

Conclusions: Overall, results were consistent with previous research and the proposed cognitive-behavioral model of CE. Implications support the idea that CE may not be clinically relevant in the absence of ED symptoms, but an important symptom domain when they are present. Future research should focus on the directionality of associations between OCD symptoms, perfectionism, and CE, including samples without ED experience.

Background: Individuals with type 1 diabetes (T1D) are at increased risk of developing disordered eating (DE) and eating disorders (ED). Diabetes self-management focuses on food and insulin administration, which may contribute to development of EDs. The dual diagnosis may contribute to suboptimal glycemia, early diabetes-related complications and mortality. Evidence for ED prevention programs for this high-risk population remains limited. This systematic review aims to evaluate the feasibility and efficacy of available interventions to prevent EDs and improve glycemia in people with T1D.

Methods: A literature search of PubMed, Embase, PsycINFO, CINAHL and Web of Science was conducted on 25 January 2025. Studies using randomized controlled, quasi-experimental or cohort design that targeted ED prevention in T1D population were included.

Results: Nine studies met the inclusion criteria, featuring interventions such as cognitive dissonance based programs, psychoeducation and self-compassion programs. Cognitive dissonance based programs demonstrated the most consistent reduction in ED risks and symptoms. However, most studies showed negligible improvement in glycemia. Common limitations were small sample sizes, high drop-out rates and short follow-ups.

Conclusion: Future research should focus on well-powered RCTs to evaluate interventions over longer timeframes, younger age groups, both genders, carer involvement and additional modifications to improve glycemia concurrently.

Binge Eating Disorder (BED) is the most prevalent eating disorder and is associated with psychiatric comorbidities, health impairments, and decreased quality of life. Emerging evidence suggests that psilocybin-assisted therapy may promote cognitive and emotional flexibility and disrupt maladaptive behavioral patterns, making it a promising candidate for BED treatment. This open-label pilot study evaluated the feasibility, safety, and preliminary therapeutic effects of a single 25 mg dose of psilocybin administered in the context of Acceptance and Commitment Therapy (ACT)-based psychotherapy in adults with BED (N = 5). Primary outcomes included safety measures, and exploratory outcomes included self-reported binge eating frequency, depression, anxiety, psychological flexibility, anthropometric indices, and neuroimaging biomarkers assessed over a 14-week follow-up. Psilocybin was well tolerated, with no serious adverse events. Reductions in self-reported binge eating frequency were observed across all participants and sustained through week 14. Improvements were also noted in depression, anxiety, and psychological inflexibility. Three participants showed reductions in body mass index and waist circumference. Given the open label design and small sample size, causality cannot be inferred. fMRI analyses generated preliminary signals of change-such as increased functional activation from pre- to post-intervention in the middle frontal gyrus, angular gyrus, and supramarginal gyrus in response to processed versus unprocessed food cues. Psilocybin-assisted therapy was feasible and well-tolerated in individuals with BED. The clinical and neurobiological observations provide directions for future adequately powered trials.

Background: Online training programs offer accessible, cost-effective solutions to disseminate evidence-based interventions. Yet, online training is typically insufficient without additional clinical case consultation (CCC). This is particularly salient in adolescent eating disorders treatment, where clinical demand far outstrips capacities of providers trained in evidence-based treatment approaches. This study seeks to better understand attitudes and barriers to receiving CCC among private practice clinicians treating adolescent eating disorders.

Methods: Licensed private practice clinicians (n = 47; 100% female, average age 36 y old; 75% master's degree; average of 4y experience) across the United States enrolled in a randomized trial offering online training (webinar or e-learning) in family-based treatment (FBT) for anorexia nervosa. Post online training, participants were asked before and after 12 sessions of expert CCC to self-report attitudes and barriers to obtaining CCC.

Results: Prior to CCC, participants rated expert CCC in learning FBT as important/very important (100%). The majority participated in CCC since licensure (82%) and in the last year (68%), rating it valuable or very valuable (77%). Participants predicted that CCC would be valuable (96%) and an important motivation in completing the training study (96%). After CCC, participants viewed CCC as important/very important in learning FBT (94%). Common obstacles included finding a study-eligible patient (44%), scheduling constraints (19%), lost wages (16%), mismatch with consultant (3%), and hesitation to discuss cases (3%).

Conclusions: Clinicians reported favorable perspectives on CCC in complimenting learning FBT via online training. Future studies are needed to determine methods to deliver, assess, and scale CCC to enhance treatment fidelity.