Cognitive behavioral therapy-enhanced through videoconferencing for night eating syndrome, binge-eating disorder and comorbid insomnia: a Case Report
Both night-eating syndrome and binge-eating disorder are characterized by episodes of excessive food consumption, significant distress, and functional impairment related to maladaptive eating behaviors. Both types of eating disorders are associated with poorer sleep quality. Cognitive behavioral therapy has demonstrated good outcomes for binge-eating disorder; however, it is unknown if it is effective for night-eating syndrome and comorbid insomnia.
Exploring eating disorder risk among Thai transfeminine youth: a comparative study with cisgender females
Adolescents, particularly vulnerable during puberty, often face heightened concerns about dieting and body image. Transfeminine youth, especially in Asian cultures, are understudied in this context. This study investigates eating disorder risks among Thai transfeminine youth and compares to cisgender females, focusing on the association with body dissatisfaction. This study aims to explore 3 objectives: (1) to assess and compare the prevalence of eating disorder risks between Thai transfeminine youth and cisgender females; (2) to examine the link between body dissatisfaction and eating disorder risks; (3) to identify risk factors associated with abnormal eating disorder screening outcomes.
Assessing orthorexic behaviors in a clinical sample: validity and reliability study of the Turkish version of the Düsseldorf orthorexia scale
Orthorexia nervosa (ON) is defined as a pathological fixation on eating healthy and pure food. In this study, it was aimed to evaluate the psychometric properties of the Turkish version of the Düsseldorf orthorexia scale (DOS) in a clinical sample.
An in-depth understanding of stakeholders' experiences about their participation in the co-production of 'Maze Out': a serious game for the treatment of eating disorders
Co-production is increasingly used in mental health research and clinical settings. Maze Out is a digital game co-produced by clinicians, patients with eating disorders (EDs), an art director with lived experience in EDs, and a game-developing company. Maze Out is based on everyday challenges when suffering from EDs and is currently being evaluated as a supplement tool in EDs treatment. Several studies on co-producing mental health interventions focus on design and effectiveness, but the experiences of those involved in the co-production process remain unexplored. An in-depth exploration of stakeholders' experiences offers valuable insights into the impact of co-production on different groups and generates crucial knowledge for successful implementation.
Developing an educational resource for people experiencing eating disorders during the menopause transition: A qualitative co-design study
The pronounced changes in reproductive hormones, such as oestradiol and progesterone, that occur during the menopause transition can contribute to increased risk of eating disorder onset or exacerbate a pre-existing eating disorder. Despite this heightened risk, there is a lack of available education and support that takes into consideration the unique challenges of experiencing an eating disorder during the menopause transition. This research aimed to qualitatively explore the perspectives of people with a lived experience of an eating disorder during the menopause transition, and to co-design a support option that addressed their unmet needs.
How feasible is nutrition intervention research in eating disorders? Lessons learnt from a pilot parallel randomised controlled trial of tyrosine supplementation in adolescents with anorexia nervosa
Eating disorders are complex illnesses with high morbidity and mortality. Yet, there is promising evidence to support the effects of nutrition on the brain and behaviour. One proposed example is the use of tyrosine as an adjunct treatment in anorexia nervosa (AN). However, recruitment and retention in eating disorder clinical trials has posed difficulties for researchers. The aim of this study was to pilot test a parallel randomised controlled trial (RCT) of tyrosine supplementation to explore the feasibility of recruitment and retention, intervention adherence and data collection methods from the perspective of participants and researchers.
Correction: The role of impulsivity and binge eating in outpatients with overweight or obesity: an EEG temporal discounting study
Early-onset anorexia nervosa: a scoping review and management guidelines
Anorexia nervosa (AN) is a serious multifactorial eating disorder characterized by insufficient nutritional intake to maintain a minimum normal weight for one's age and height, a fear of gaining weight and a distorted body image. It affects mainly adolescents, but a decreased age at diagnosis has been reported, leading to the definition of a rare form of AN called early-onset or prepubertal anorexia nervosa (EOAN; ORPHA 525738), with reported epidemiological and clinical specificity. Current knowledge and specific treatments for this particular condition remain scarce. We aim to summarize the literature review and synthesize actual knowledge on EOAN for preliminary guidelines to harmonize the diagnosis, treatment and follow-up.
Does 24/7 care result in better outcomes for adults with eating disorders? A comparison of inpatient/residential care to partial hospitalization/intensive outpatient care for patients at low BMIs
Higher level of care (HLOC) treatment for eating disorders (EDs) is sometimes necessary, but research is lacking on whether HLOCs are actually more effective than less structured, lower levels of care. The purpose of the current study was to compare outcomes for patients with EDs at low weights who entered 24/7 care (inpatient and residential) to those entering non-24/7 care (partial hospitalization programming and intensive outpatient programming).
Assessing disordered eating behaviours and attitudes: Factor structure and measurement invariance of the Arabic version of the eating attitudes test (EAT-26) in Saudi Arabia
The factorial structure of the Eating Attitudes Test (EAT-26) has been found to be inconsistent across studies and samples. This study aimed to resolve inconsistencies in the factorial structure of the Arabic version of the EAT-26 by identifying the best-fitting model and test its measurement invariance across sexes and BMI categories in a large non-clinical Saudi sample.
Development and validation of the Lebanese Orthorexia Nervosa Inventory (LONI)
Unlike eating disorders (ED) that are officially recognized and focusing on the quantity of food, Orthorexia Nervosa (ON) revolves around an unhealthy fixation on the quality of food eaten. Existing ON scales differ in how these conceptualize and define ON, ensuing inconsistency in assessments that not only affects the validity and reliability of ON related research, but also impacts the ability of healthcare professionals to identify and provide support for individuals struggling with ON.
"I mean, it kind of saved my life, to be honest": a qualitative study of participants' views of a dialectical behaviour therapy for multidiagnostic eating disorders programme
Despite the increasing use of dialectical behaviour therapy (DBT) as a treatment for eating disorders (EDs), there is little published evidence of its effectiveness for treating restrictive eating disorders. DBT for EDs may be particularly helpful for those who live with severe and enduring eating disorders (SE-EDs) given that it targets those for whom first-line treatments have not been effective, its focus on factors thought to maintain symptoms and its focus on improving quality of life. This study sought to evaluate the experiences of participants in a comprehensive DBT programme for people with SE-EDs.
Participatory development of evidence-based patient narrative videos for patients with eating disorders: a methodological approach and pilot data
Patient narratives can best be defined as personal stories of persons previously or currently affected by a physical or mental health disorder. The collaborative development and implementation of such narratives reflects a participatory approach between researchers, patients, and members of the public towards the development of new interventions. Patient narratives can foster feelings of support and belonging, as well as increase hope and motivation towards recovery. Aims of this pilot study were (a) the collaborative development of a series of evidence-based patient narrative videos about eating disorders, (b) their initial evaluation with a group of participants without (current) eating disorders, and (c) to provide a reproducible documentation of this methodological approach.
Neurodivergence, intersectionality, and eating disorders: a lived experience-led narrative review
Autistic people and those with attention deficit hyperactivity disorder are at a high risk of developing an eating disorder. While there is limited evidence on the relationship between other forms of neurodivergence and eating disorders, research suggests associations between giftedness, intellectual disability, obsessive-compulsive disorder, psychosis, Tourette's syndrome, and disordered eating. Factors underlying disordered eating and/or eating disorder risk for neurodivergent people are multifaceted and complex, encompassing a wide range of intertwined psychosocial, environmental, and biological processes. Moreover, research shows that neurodivergent individuals experience poorer treatment outcomes compared to neurotypical individuals. However, there is a paucity of research in this area overall. More specifically, lived experience-led research remains rare, despite its critical role for improving individualised eating disorder care, as well as mental healthcare more broadly. Indeed, the importance of eating disorder care individuation is increasingly being recognised, particularly within the context of neurodivergence, given the heterogeneous experiences and support needs of neurodivergent people affected by disordered eating and/or eating disorders. Furthermore, despite documented overlaps between various forms of neurodivergence (e.g., co-occurring autism and attention deficit hyperactivity disorder), research looking at eating disorders in the context of neurodivergence through a transdiagnostic perspective is scarce. This lived experience-led narrative review aims to shed light on the intersectional factors underlying elevated disordered eating and/or eating disorder risk for neurodivergent individuals. First, an overview of prevalence data is provided, followed by a thematic framework identifying factors underlying disordered eating and/or eating disorder risk in relation to neurodivergence. A critical appraisal of current eating disorder research and care is then offered before suggestions for neurodiversity-affirming eating disorder care are made. In this view, this paper offers a foundation for future empirical work in this nascent field of inquiry by providing a lived experience-led, transdiagnostic, and intersectional account of eating disorders in the context of neurodivergence.
Intolerance of uncertainty and repetitive negative thinking: transdiagnostic moderators of perfectionism in eating disorders
Perfectionism has been identified as a vulnerability and maintenance factor across eating disorders (EDs). Additionally, research has found that intolerance of uncertainty (IU) and repetitive negative thinking (RNT) moderate the relationship between perfectionism and psychopathology. Despite this evidence, few studies have examined if these factors specifically moderate ED severity. This study aimed to fill this gap by investigating the moderating effect of IU and RNT on the relationship between perfectionism and ED symptoms, as well as the predictive power of these factors on identifying participants with clinically significant ED symptoms. 331 treatment-seeking adults from a university-affiliated community clinic and 264 undergraduate students completed measures to assess ED symptoms, RNT, perfectionism and IU. 147 participants (24.7% of the total sample) had clinically significant levels of ED symptoms as determined by the Eating Disorder Questionnaire Short-Form (EDE-QS). Multiple linear regressions found significant associations between ED symptoms and both the IU*perfectionism interaction (p < .001) and the RNT*perfectionism interaction (p < .001). A binary logistic regression identified that both the IU*perfectionism interaction (p = .03) and the RNT*perfectionism interaction (p = .001) predicted clinically significant EDE-QS scores. The findings indicate that both IU and RNT moderate the relationship between perfectionism and ED symptoms and build on previous literature recognising transdiagnostic contributors to ED symptomatology.
Correction: Interdisciplinary perspectives on accessing specialty evidence-based treatment for Medicaid-insured adolescents with eating disorders
Muscularity-oriented disordered eating: investigating body image concerns and the moderating role of emotion dysregulation in cyclists
A lean muscular body of low weight is often associated with performance for cyclists and can be difficult to achieve. Disordered eating for some cyclists may develop in the pursuit of lean muscularity which is perceived to be beneficial to performance. Further, emotion dysregulation may exacerbate negative feelings about body image, increasing the risk of developing disordered eating as a means of controlling weight and shape. While research in athlete populations has been substantial, disordered eating in cyclists is relatively under-explored. The current study examined whether shape and weight concern and drive for leanness were associated with muscularity-oriented disordered eating and whether these relationships were moderated by emotion dysregulation. Interactions between these factors were also investigated. Participants were 139 Australian competitive cyclists (112 males, 27 females, aged 18-68 years) who completed a self-report questionnaire comprised of measures of shape and weight concern, drive for leanness, muscularity-oriented eating and emotion dysregulation variables. Both shape and weight concern and drive for leanness had a unique association with muscularity-oriented disordered eating. Emotion dysregulation was found to have a unique association with muscularity-oriented disordered eating when controlling for drive for leanness, but not when shape and weight concern was controlled. Additionally, emotion dysregulation moderated the association between shape and weight concern and muscularity-oriented disordered eating, whereby the relationship was intensified at higher levels of emotion dysregulation. Our study has extended the literature by indicating that cyclists' desire to attain a lean body is associated with muscularity-oriented disordered eating. Further, emotion dysregulation moderated this link, suggesting it could be a maintaining factor worth addressing.
Addressing weight bias among pediatric healthcare clinical staff
Children with obesity may experience weight-based discrimination as a result of weight bias and stigma, which can have deleterious effects on their health and wellbeing, including increased risk of dysregulated, maladaptive, and disordered eating such as restriction, purging, and binging. Prior work has shown that weight bias occurs from healthcare workers caring for adults, but less is known about the prevalence of weight bias in the pediatric healthcare setting.
Discovering a "sense of community": patient experiences of connection in intentionally remote eating disorder care
While some findings indicate high levels of patient satisfaction with remote eating disorder treatment, others reflect feelings of disconnection due to unique telehealth treatment challenges. The COVID-19 pandemic presented circumstances that likely impacted the findings established thus far. As such, the present study sought to understand patient experiences of connection in an intentionally remote eating disorder treatment program, specifically in a context outside of pandemic transition.
On the Journey: a qualitative study of a community-based, client-centred eating disorder recovery group
Community-based eating disorder (ED) treatment frequently includes manualized group-based psychoeducation facilitated by a mental health clinician. Body Brave, a non-profit ED organization, developed a novel, participant-guided, community-based virtual healthcare provider (HCP)-facilitated support program called On the Journey (OtJ). The program was designed for people with longstanding EDs who had previously participated in group or individual ED programs but require continued support in their recovery. The purpose of the study was to describe the development and components of OtJ and to understand participant perceptions of the program and its effect on their recovery.
Applying integrated enhanced cognitive behaviour therapy (I-CBTE) to severe and longstanding eating disorders (SEED) Paper 2: An in-depth case study for clinicians
This case study examines the application of Integrated Enhanced Cognitive Behavioural Therapy (I-CBTE) for a patient with severe, longstanding anorexia nervosa and multiple comorbidities, including organic hallucinosis, complex post-traumatic stress disorder (CPTSD), and severe self-harm. Such complex presentations often result in patients falling between services, which can lead to high chronicity and increased mortality risk. Commentaries from two additional patients who have recovered from severe and longstanding anorexia nervosa are included.