International Journal of Eating Disorders最新文献

Objective: There is a great need for the development of scalable augmentations to treatments for anorexia nervosa (AN) and bulimia nervosa (BN), as most individuals with AN/BN are currently not able to access treatment. Mindfulness-based interventions (MBIs) may be promising for AN/BN and lend themselves well to digital delivery, increasing access. We aimed to develop and test the initial acceptability and feasibility of Mindful Courage, a digital MBI for AN/BN and atypical AN/BN.

Method: We evaluated an 8-week version of Mindful Courage including 32 modules (8 core multi-media lessons, 24 brief audio-guided mindfulness practices) in N = 32 participants, who also received weekly phone coaching conducted by psychology students. Ten participants (31.2%) were enrolled in outpatient ED treatment while receiving the intervention. Participants completed assessments at baseline, post-intervention (8 weeks), and 2-month post-intervention follow-up.

Results: Acceptability was demonstrated by relatively high ratings for perceived usability (81.34/100), understandability (4.6/5.0), engageability (4.1/5.0), visual appeal (4.1/5.0), helpfulness (4.2/5.0), skills acquisition (4.3/5.0), and confidence applying skills (4.2/5.0). Feasibility was demonstrated by high module completion (an average of 28/32 modules). There were significant reductions in target outcomes: ED symptoms (d = 1.21), body dissatisfaction (d = 0.73), depression (d = 0.76), anxiety (d = 0.62), and clinical impairment (d = 1.15). In addition, there were significant improvements in target mechanisms: mindfulness (d = 0.79), emotion regulation difficulties (d = 0.65), and savoring beliefs (d = 0.58).

Discussion: Mindful Courage is a viable and potentially effective intervention. A future randomized-controlled trial is warranted.

Objective: We aimed to determine if the high co-occurrence rates between food addiction (FA) and binge-spectrum eating disorders (BSEDs) are partially due to their respective measures assessing similar symptoms. Specifically, we aimed to clarify whether the Yale Food Addiction Scale 2.0 (YFAS 2.0) assesses a distinct symptom profile from common BSED measures (e.g., measures of binge-eating disorder (BED) or bulimia nervosa). Because FA does not include compensatory behaviors, our comparison focused specifically on FA and binge-related features of BSEDs.

Method: We conducted a content analysis on the YFAS 2.0 and five of the most cited BSED measures. Five trained coders inductively assigned symptom codes to every item from each measure. Because FA does not include compensatory behaviors, we removed compensatory-behavior items from the BSED measures prior to coding to focus on binge-related content. We then calculated Jaccard similarity coefficients to quantify symptom overlap between measures.

Results: The YFAS 2.0 showed very low symptom overlap with the BSED measures (Jaccard range = 0.08-0.19). However, nearly half (47%) of its symptoms were captured by at least one BSED measure. The symptoms assessed by the YFAS 2.0 and not the BSED measures tended to focus on the impairment and consequences of eating behavior, whereas the BSED measures focused more on the cognitive features of eating behavior.

Discussion: This comparison revealed both differences and similarities between FA and BSED measures. Although the YFAS 2.0 showed limited overlap with any single BSED measure, about half of its symptoms were represented in at least one BSED measure, indicating partial shared content. The FA and BSED measures also reflect different theoretical emphases, with FA focusing on impairment and BSEDs emphasizing cognitive and behavioral features. Further clarifying how FA and BED relate will require integrating measurement patterns with evidence on mechanisms and clinical course.

Objective: To assess clinical outcomes and parental experiences following an intensive multidisciplinary intervention (IMI) for children with Avoidant Restrictive Food Intake Disorder (ARFID).

Method: A prospective cohort of 28 children (aged 2-8 years) with severe eating difficulties, all meeting ARFID diagnostic criteria at baseline, participated in a 3-day assessment and an 8-day IMI involving guided mealtimes, play-based exposures, nutritional counseling, and caregiver coaching. Clinical outcomes were assessed using the Pica, ARFID, and Rumination Disorder Interview (PARDI) at baseline and at 7-15 months post-intervention. Parental experience was evaluated using the Experience of Service Questionnaire (ESQ) and the study-specific Eating Intervention Experience Questionnaire (EIEQ).

Results: At follow-up, 27 of 28 children continued to meet ARFID criteria; however, overall symptom severity decreased significantly (M = 3.55 → 2.57, d = 0.80, p < 0.001), with reductions in both the sensory (M = 2.77 → 2.21, d = 0.63, p = 0.002) and low-interest profiles (M = 3.48 → 2.50, d = 0.93, p < 0.001), alongside improvements in nutritional status and growth-related criteria. Parents reported high satisfaction with the intervention, valuing the multidisciplinary approach, tailored support, and practical strategies.

Discussion: Findings suggest that intensive, multidisciplinary, nondirective interventions may yield clinically meaningful benefits for young children with severe ARFID, particularly those with combined sensory sensitivity and low interest in eating profiles. Although full remission was uncommon within the follow-up period, the intervention supported symptom reduction and caregiver competence. Larger controlled studies are needed to establish efficacy and guide development of sustainable models of care.

Objective: Anorexia nervosa (AN) is a severe eating disorder associated with extreme weight loss, hyperactivity, and amenorrhea. Neuroimaging studies revealed brain atrophy and disruption of white matter integrity in the corpus callosum (CC) of patients with AN. However, the underlying pathophysiological mechanisms remain unclear. Emerging evidence indicates that starvation induces changes in mitochondrial metabolism and dynamics. We hypothesize that disturbances in white matter integrity arise from modifications in oligodendrocytes, associated with changes in the morphology of myelinated fibers and mitochondrial structure.

Method: The starvation-induced hyperactivity (SIH) model was used, in which mice received a restricted daily amount of food in combination with free access to a running wheel. A body weight loss of 25% was maintained over 2 weeks, followed by a 3-week refeeding phase. Oligodendrocyte density and staining intensity of oligodendrocyte lineage transcription factor 2 (OLIG2) in the CC were analyzed using immunohistochemical staining. Morphometric investigation of myelinated fibers and mitochondria was conducted by transmission electron microscopy (TEM) analysis.

Results: Starvation led to decreased oligodendrocyte density and reduced anti-OLIG2 staining intensity in the CC, which was reversible following refeeding. Additionally, starvation induced a decrease in axonal caliber and an increase in mitochondrial density in the white matter, accompanied by a reduction of mitochondrial area.

Discussion: The findings suggest that oligodendroglial and axonal alterations, alongside disrupted mitochondrial dynamics, impair structural integrity in the white matter and contribute to the pathophysiology of AN.

Objective: This study examined everyday exposure to fitspiration, thinspiration, body positivity, and body neutrality content on image-based social media and its associations with body image, mood, self-esteem, and disordered eating behavior using ecological momentary assessment (EMA) in women with and without eating disorders.

Method: Women with self-reported anorexia nervosa or bulimia nervosa (n = 62) and women without eating disorders (n = 81) reported their social media use, mood, body image, self-esteem, appearance comparisons, and disordered eating behavior via a smartphone app for 7 days.

Results: Viewing fitspiration and thinspiration content was significantly associated with lower happiness, higher body dissatisfaction, and lower body appreciation, but not with daily-reported restrained eating. Only thinspiration content was significantly associated with higher sadness and lower self-esteem. Upward appearance comparisons mediated the associations of exposure to fitspiration and thinspiration content with all outcomes. Except for higher body appreciation after viewing body neutrality content, there were no main effects of body positivity and body neutrality. Compared to women without eating disorders, those with self-reported anorexia nervosa or bulimia nervosa showed a greater reduction in self-esteem after viewing thinspiration.

Discussion: The results highlight the possible detrimental effects of exposure to fitspiration and thinspiration content on mood, body image, and self-esteem in women with and without self-reported anorexia nervosa or bulimia nervosa alike, while only body neutrality content was related to higher body appreciation. Women with and without eating disorders should be educated about the possible negative influences of content purporting to improve one's appearance.

Background: The perinatal period is a critical risk period for changes in eating disorder (ED) symptoms. However, extant research is mixed regarding the direction of these changes, with some studies identifying relief from ED symptoms and others finding evidence of worsening symptoms during this time. To account for heterogeneity in ED symptom change among pregnant and postpartum individuals, the current study aimed to explore ED symptom trajectories and their psychosocial correlates during pregnancy and the first postpartum year using person-centered statistical approaches.

Method: A community sample of pregnant people recruited online (N = 315) completed assessments of ED symptoms and psychosocial factors during pregnancy, 8-weeks postpartum, and 1-year postpartum between October 2020 and January 2023. ED symptom trajectories were identified using group-based multivariate trajectory modeling. Multinomial logistic regression tested if psychosocial factors (anxiety, depression, stress, emotion regulation difficulties, self-compassion, social support, and body mass index) during pregnancy and across postpartum were associated with trajectory groups.

Results: Four distinct groups were identified: decreasing ED cognitions group (34% of the sample), increasing ED symptoms group (29%), early postpartum ED risk group (22%), and early postpartum alleviation group (15%). Postpartum weight retention and increasing depression from pregnancy to 1-year postpartum were associated with higher odds of membership in the increasing ED symptoms group, relative to other groups.

Discussion: Although perinatal ED symptoms were commonly endorsed, symptom changes were heterogeneous. It is important to continue to investigate prospective correlates of perinatal ED symptoms and utilize idiographic modeling to inform prevention and early intervention approaches.

Objective: Pioneer studies suggested the effectiveness of food-specific electroencephalography (EEG) and real-time functional near-infrared spectroscopy (rtfNIRS) neurofeedback (NF) trainings in the treatment of binge-eating disorder (BED). These trainings aim to improve participants' neurophysiological self-regulation. However, pretreatment neurophysiological activity, a supposed key predictor of NF outcomes, remains unexplored.

Method: This preregistered analysis (https://osf.io/xsrj3) used data from a randomized-controlled trial (DRKS00014752) on 47 adults (47 ± 13 years, 81% women) with interview-assessed BED having undergone food-specific EEG- or rtfNIRS-NF (12 sessions, over 8 weeks). Bayesian linear models explored pretreatment fronto-central high beta power (23-28 Hz; indicating increased attention) in EEG, pretreatment prefrontal oxygenation in fNIRS (indicating increased cognitive control), and rapid response (RR; early reductions in binge eating) as predictors of treatment outcomes reflecting mental and physical health at posttreatment and 6-month follow-up.

Results: Higher high beta power during passive viewing of food pictures, lower high beta power, and less oxygenation during regulatory NF tasks, as well as RR predicted more favorable primary outcomes, including reduced objective binge-eating episodes and increased abstinence from binge eating. Overall, neurophysiological predictors-especially EEG activity-showed greater predictive value than RR.

Conclusion: The preliminary findings suggest the relevance of neurophysiological activity in the prediction of NF treatment outcomes in BED. While patients with increased involuntary attention in response to food stimuli profited most from EEG-NF, those with greater difficulties in voluntary recruitment of food-related cognitive control profited most from rtfNIRS-NF. The predictors identified could guide future treatment allocation and represent a first step toward more individualized therapy approaches.

Objective: Studies reporting prevalence estimates of eating disorders in Southern Africa are scarce. To fill this gap, the present Research Forum reviews existing literature on the prevalence of eating disorders, including as assessed by clinical interviews, screeners, and self-reported behaviors, among individuals in Southern Africa. Key recommendations for future research directions are provided.

Method: The present Research Forum was registered in the International Prospective Register of Systematic Reviews (#541032). Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed studies in all languages were searched across multiple databases up to March 2025 using predefined keywords; 209 studies were screened for content.

Results: A total of 16 English studies in six countries were included, all published between 1981 and 2025. Eating disorder point prevalence, defined as the proportion of clinically diagnosed cases, was 0.7%. Named eating disorder prevalences ranged between 0.5% and 4.7%, and high prevalences of pica were found. Prevalence based on screening instruments, indicating increased risk (i.e., proportion scoring above the clinical cutoff) ranged from 3.5% to 37.5%.

Discussion: Studies were few, methodologically diverse, and culturally heterogeneous. Key recommendations for future research include examining factors related to globalization and food insecurity and their potential interplay with the manifestation of eating disorder symptomatology, exploring the roles of ethnicity and sex, evaluating the cultural appropriateness of (Western) standardized assessment tools, and incorporating more diverse samples.

Objectives: LGBTQ+ community involvement is typically considered protective for sexual minoritized men (SMM). However, LGBTQ+ community involvement may expose SMM to body-image specific pressures (i.e., intraminority body stigma) that may reinforce idealized body ideals and disordered eating in SMM. We examined intraminority body stigma and body dissatisfaction as mediators of the longitudinal association between LGBTQ+ community involvement and disordered eating in SMM.

Methods: Two-hundred and twenty-five cisgender SMM between (18 and 30 years) were recruited via Prolific. Participants completed surveys at baseline and 3- and 6-month follow-ups. Prospective serial mediation models examined 3-month intraminority body stigma and body dissatisfaction as mechanisms of the links between baseline LGBTQ+ community involvement and six-month disordered eating.

Results: Greater baseline LGBTQ+ community involvement predicted increased three-month intraminority body stigma, which was associated with greater 3-month thinness-oriented body dissatisfaction, which, in turn, predicted increased 6-month thinness-oriented disordered eating. Simple significant mediation pathways indicated that greater baseline LGBTQ+ community involvement predicted increased three-month intraminority body stigma, which, in turn, predicted increased 6-month thinness-oriented disordered eating in SMM. Prospective models did not describe significant mediation pathways in relation to muscularity-oriented disordered eating. Thinness and muscularity models suggested that, after accounting for covariates and serial mediators, baseline LGBTQ+ community involvement predicted less disordered eating six months later.

Discussion: Intraminority body stigma may be a key mechanism clarifying the link between LGBTQ+ community involvement and thinness-oriented disordered eating in SMM. Future research should further contextualize body image and eating concerns among LGBTQ+ individuals in the service of reducing eating disorder disparities affecting this community.