Journal of Eating Disorders最新文献

Background: Social media use is a risk factor for eating and body image disturbances. The overlap between social media and eating and body image disturbances is particularly concerning in the Chinese context given an estimated billion active social media users in China, especially among females. This highlights the need for scalable, culturally adapted prevention and intervention strategies. This study developed and evaluated two online, self-guided, single-session interventions (SSIs), including a Media Literacy Intervention (MLI) and a Body Functionality-focused expressive writing Intervention (BFI), alongside waitlist controls, and examined their ability to improve body image among adult female Chinese social media users with eating disorder (ED) symptoms.

Methods: A total of 204 female social media users with ED symptoms were recruited via Xiaohongshu (Little Red Note) and randomized to the MLI (n = 68), BFI (n = 68), or waitlist control group (n = 68). Primary outcomes included measures of negative and positive body image. Secondary outcomes included a range of measures including ED psychopathology and psychological distress. Assessments were conducted at baseline, 1-week post-intervention, and 4 weeks after baseline.

Results: Both MLI and BFI interventions significantly outperformed the waitlist control on primary and secondary outcomes. The two interventions demonstrated comparable efficacy across most domains, except for eating flexibility, where BFI yielded greater improvements. Intervention uptake was high (93%), and most participants (95%) reported they would recommend the intervention to others.

Conclusions: SSIs show promise as accessible, acceptable, and effective tools for improving body image and reducing ED symptoms among Chinese female social media users with ED symptoms. Future research should conduct larger-scale studies to examine their effectiveness and long-term impact.

Background: Bodily illusion research has demonstrated that altered bodily-self-perception in eating disorders (EDs) may be linked to abnormalities in the integration of sensory bodily signals. Experiencing bodily illusions can also temporarily reduce body image disturbance. Whether similar alterations in multisensory integration processes extend to self-face representation and whether face-based multisensory illusions can reduce face or body image disturbance remains unclear. This study investigated whether susceptibility to the enfacement illusion differs based on ED risk status and whether experiencing the illusion reduces face and body image disturbance.

Methods: The sample included 226 women classified as high (n = 102) or low (n = 124) ED risk, who underwent an enfacement illusion induction procedure involving synchronous (ilillusion-inducing) versus asynchronous (control) visuo-motor stimulation (via facial mimicry) between their own face and an unfamiliar person's face. Illusion strength was assessed subjectively (via self-report) and objectively (via a self-face recognition task), alongside pre- and post-illusion face and body image outcomes.

Results: Synchronous interpersonal visuo-motor stimulation led to modest changes in self-face recognition (i.e., the other person's face came to be perceived as more similar to one's own); however, these changes were not modulated by ED risk status (high versus low). Cognitive-affective responses to the illusion diverged in unexpected ways. Low ED-risk participants reported reduced body dissatisfaction and dysmorphic concern following synchronous interpersonal visuo-motor stimulation, whilst high ED-risk participants reported increased head and body dissatisfaction following both synchronous and asynchronous stimulation.

Conclusion: These findings suggest that the multisensory processes underlying self-face representation, and ultimately supporting self-recognition and the integrity of self-other boundaries, may not be disrupted in individuals with elevated ED symptomatology. This observation may challenge the notion of a globally disrupted sense of bodily self in EDs, at least with respect to self-face processing. Instead, current results suggest that ED-related body image disturbance may reflect altered higher-order evaluative or affective processing of self-related social information rather than a fundamental deficit in multisensory integration.

Introduction: Childhood traumatic experiences (CTEs) represent a significant vulnerability factor for addiction-like eating behaviors, yet the underlying developmental pathways remain poorly understood. According to infancy research and attachment theory, this study tested a comprehensive mediation model examining how CTEs contribute to addiction-like eating patterns (i.e., appetite drive and low diet control) through attachment insecurity, impaired reflective functioning, and emotional eating.

Method: A cross-sectional study was conducted on a conventional non-clinical sample 1,014 Italian adults. Participants completed a set of validated and standardized scales. Structural equation modeling with latent variables and bootstrap resampling (10,000 iterations) was employed to test the hypothesized model.

Results: The model demonstrated adequate fit and supported all hypotheses. CTEs significantly predicted both attachment anxiety, attachment avoidance, and impaired reflective functioning. Attachment anxiety, but not avoidance, mediated the relationship between CTEs and impaired reflective functioning. Also, impaired reflective functioning significantly predicted emotional eating, which in turn predicted both appetite drive and low dietary control. The complete mediation pathway was statistically significant, explaining 53.5% of variance in appetite drive and 20.6% in dietary control.

Discussion: These findings provide the first empirical support for a trauma-based developmental model of addiction-like eating behaviors. The results highlight the central role of attachment anxiety and impaired reflective functioning in linking early relational trauma to emotional eating and food addiction-like patterns. Clinical implications suggest that mentalization-based interventions targeting attachment insecurity and emotion regulation may be particularly beneficial for individuals with trauma histories and problematic eating behaviors.

Background: Several animal protocols have been designed to model binge eating disorder (BED) and elucidate its neurological basis. A wide variety of factors, including the frequency of access to palatable food and a previous history of caloric restriction, have been modulated to induce binge eating intake. The aims of this work were to compare the effects of these two factors on the development of binge eating behaviour and to analyse possible alterations in neurotransmitter markers in the striatum.

Methods: We performed a binge eating test in male and female C57BL/6J mice, which consisted of 2 h of limited access to a high-fat high-sucrose (HFHS) diet in a sated state with ad libitum access to a control diet and water. Mice were subjected to either daily or intermittent (every other day) 2-h limited access to the HFHS, with or without previous episodes of caloric restriction. Dopaminergic, glutamatergic and GABAergic markers were analysed in the striatum by RT-qPCR. Behavioural and biomolecular differences between groups were analysed by one-way ANOVA for multiple comparisons.

Results: Both male and female mice developed binge eating behaviour following a 2-h HFHS access paradigm, while the frequency of exposure and history of caloric restriction did not affect the BE response. However, the combination of caloric restriction and intermittent access to HFHS induced an early BE response in females, with no compensatory decrease in chow intake and no weight changes in either sex. Moreover, we observed differences in the modulation of Drd2 expression between animals subjected to binge eating and those with ad libitum access to HFHS, independent of sex.

Conclusions: This work is the first to compare the effects of the frequency of exposure to HFHS and a history of caloric restriction on binge eating behaviour in both male and female mice within a single experimental setting. The results do not reveal any major effects on binge eating behaviour but highlight the combination of both conditions for translational applications since any compensatory process is observed. Moreover, the results underscore a role of striatal Drd2 expression as a key factor involved in the course of BED.

Gidlund and colleagues' recent study highlights the profound unmet dental care needs of people with eating disorders, extending earlier work that showed oral health can remain a visible scar long after illness. Their findings reveal how shame, stigma, and systemic barriers prevent timely care, while oral rehabilitation can play a vital role in restoring dignity, hope, and identity. The study strengthens the case for viewing dental complications not as secondary impacts of eating disorders, but as core symptoms that demand timely, evidence-based, and compassionate care. Meeting this challenge requires a shift from recognition to response. This includes changes to clinical practice, where harm-reduction approaches and sensitive communication are essential; to health systems and policy, where equitable access and interdisciplinary pathways must be established; and within research, where coproduced interventions and longitudinal studies can provide the evidence base that is currently lacking. Oral health should no longer be treated as an afterthought in eating disorder care but recognised as an integral part of recovery.

Background: TikTok's algorithm is at the centre of its user experience. The platform, which allows users to create and consume short-form content, can enable young people (YP) to feel less alone when experiencing illnesses such as eating disorders (EDs) by encouraging them to build communities around mental health-related content. However, emerging research suggests TikTok's algorithm might exacerbate ED symptoms by leading YP into spirals of ED content. This paper provides a lived experience perspective on what experiencing high volumes of ED content on TikTok's For You Page (FYP) can be like for YP.

Methods: We conducted 17 semi-structured interviews in which participants (UK-based, aged 18-25, with experience of disordered eating or an ED) described their experiences of using TikTok. We identified three themes that express how participants interact with ED content on TikTok: (1) View One, See More, (2) Morbid Curiosity, and (3) From Helpful to Unhelpful. Theme 1 describes viewing one unhelpful video and then being exposed to more of this content on the FYP. Theme 2 refers to YPs descriptions of a strong impulse to view ED content when it surfaces on their FYP even if it is felt to be unhelpful. Theme 3 recounts YPs experiences of viewing potentially helpful content (e.g., pro-recovery videos) and then being presented with pro-ED content on the FYP. Through a close linguistic analysis, we examine how participants talk about how they feel when viewing ED content on TikTok.

Findings: Participants reported engaging regularly with ED content on TikTok. Their interactions with ED content show that the personalised nature of TikTok's algorithm (which is sensitised to how long a user watches a video) can interact with and exacerbate some ED behaviours and psychologies, leading some YP into what they describe as negative echo-chambers of ED content.

Conclusion: Platforms should assume greater responsibility for their algorithms' roles in intensifying ED symptoms and improve the efficacy of functions that help users control the content they see. A greater awareness of the role of TikTok in exacerbating ED thoughts and behaviours among mental health professionals is also necessary.

Background: Eating disorders (EDs) are associated with high heterogeneity of sexual dysfunction, but the underlying psychological mechanisms contributing to these difficulties have been poorly investigated. This study aimed to explore whether body trusting and need for approval, two core dimensions of ED psychopathology, are associated with differences in sexual desire across subgroups of women with EDs.

Methods: A cross-sectional study was conducted with 348 women diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED). Participants completed the Female Sexual Function Index, the Multidimensional Assessment of Interoceptive Awareness, and the Attachment Style Questionnaire. Mixture regression modeling was used to identify clusters based on the prediction of body trusting and need for approval on sexual desire. Multigroup structural equation modeling (SEM) was used to confirm the identified clusters.

Results: Two clusters emerged. Cluster 1 showed a negative association of both need for approval and body trusting with sexual desire. Cluster 2 showed the opposite pattern, with both predictors positively associated with sexual desire. SEM confirmed the differential predictive pathways for these psychological traits across clusters membership in predicting desire.

Conclusions: Women with EDs show opposite patterns of association between need for approval and body trusting with sexual desire. These findings suggest the utility of interventions targeting interoception and attachment-related features and highlight the importance of individualized approaches to promote sexual well-being in the treatment of EDs.

This case report presents the comprehensive, multidisciplinary treatment of a 17-year-old male adolescent diagnosed with avoidant/restrictive food intake disorder (ARFID) in Turkiye. The patient developed severe food avoidance, vomiting, and significant weight loss after experiencing traumatic medical interventions, including nasogastric tube placement. His clinical course was further complicated by medical comorbidities such as achalasia, superior mesenteric artery syndrome, and gallstones, which contributed to persistent gastrointestinal discomfort and reinforced his restrictive eating behaviors. Treatment combined with outpatient Cognitive Behavioral Therapy for ARFID (CBT-AR), psychopharmacological support, family-based interventions, and ongoing medical management. CBT-AR was flexibly adapted to address the patient's fear of negative eating consequences, sensory sensitivities, and low appetite, while considering family dynamics and culturally relevant eating practices. Over a 12-month period, the patient's weight increased from 42.6 kg to 55 kg, his dietary variety expanded with the addition of 38 new foods, and his ARFID symptoms showed significant clinical improvement. This is the first documented case of CBT-AR applied in Turkiye, highlighting the feasibility and effectiveness of a combined medical-psychological approach for complex ARFID presentations. The case underscores the necessity of individualized, culturally sensitive treatment strategies and multidisciplinary collaboration in addressing ARFID, particularly in medically compromised patients.