To assess associations between multiple dimensions of gender diversity with eating disorder symptoms in a national cohort of U.S. early adolescents.

Fear of Aversive Consequences (FOAC), such as choking or vomiting, is an important associated feature of Avoidant/Restrictive Food Intake Disorder (ARFID). However, the manifestation of FOAC in young children is poorly understood. This study aimed to describe the fears of children with ARFID symptoms and examine the concordance between parent and child ratings of fear.

The present meta-analysis aims to assess whether individuals with anorexia nervosa (AN) demonstrate elevated autistic traits, to explore potential associations between autistic traits and eating disorder symptoms; as well as to estimate the prevalence of a positive screen for autism spectrum disorder (ASD) assessed via Autism Diagnostic Observation Schedule (ADOS), in AN.

This study examined cross-sectional and longitudinal associations of intermittent fasting (IF) engagement with body mass index (BMI), both thinness-oriented and muscularity-oriented eating disorder (ED) psychopathology, eating-related psychosocial impairment, and intuitive eating.

This Virtual Issue of the International Journal of Eating Disorders honors the legacy of the late Dr. Michael Strober in the eating disorders and child psychiatry fields. Having served as Editor-in-Chief of the International Journal of Eating Disorders from 1983 to 2012, Dr. Strober elevated the quality of science conducted in the eating disorders field. His frank feedback and encouraging words inspired many junior researchers to sharpen their work and to think deeply about their results. An incisive thinker, eloquent writer, and gifted clinician, Dr. Strober was a role model for psychologists in clinical leadership positions and demonstrated that it is indeed possible to be a highly effective all-rounder. In this issue, we present an annotated selection of Dr. Strober's publications in the journal over the past decades to illustrate the evolution of his thinking and the seeds of what have become major directions in the field, including fear conditioning and genetics. By presenting this collection of his work, we encourage all investigators to read broadly and deeply and to identify and acknowledge those incisive scholars who have built the foundation upon which our work today stands.

It is often stated that a higher body mass index (BMI) at the beginning of treatment predicts a better weight outcome at the end of treatment in persons with anorexia nervosa (AN). However, this interpretation is based on the between-persons relationship of BMI at the two measurements, which primarily reflects the fact that the rank-ordering of persons according to their BMI is quite stable over time. In contrast, a lower BMI at baseline is related to a larger BMI change, which primarily reflects the fact that the variance of BMI at the end of treatment is larger than that at baseline. This study aimed to demonstrate these relationships empirically and caution against interpreting BMI at baseline as a predictor of BMI at discharge or BMI change.

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by a severely restrictive diet leading to significant physical and/or psychosocial sequelae. Largely owing to the phenotypic heterogeneity, the underlying pathophysiological mechanisms are relatively unknown. Recently, the communication between microorganisms within the gastrointestinal tract and the brain-the so-called microbiota-gut-brain axis-has been implicated in the pathophysiology of eating disorders. This Spotlight review sought to investigate and conceptualize the possible ways that the microbiota-gut-brain axis is involved in ARFID to drive future research in this area.

Eating disorders (EDs) represent a significant public health concern, with a high prevalence among adolescent girls. The COVID-19 pandemic has led to a marked increase in EDs, underlining the need for a brief screening tool in clinical settings. The present study compared ICD-10-based ED-diagnoses with SCOFF-identified at-risk female patients in a clinical setting and assessed the tool's reliability.

This systematic review aims to comprehensively examine up-to-date evidence on the economic burden of eating disorders (EDs), both globally and by region.

This scoping review synthesizes the available evidence on team outpatient eating disorder treatment, focusing on team composition, reported health and service outcomes, and reported principles of Interprofessional Collaborative Practice (IPCP), a synergistic healthcare approach characterized by shared values and ethics, clear roles, communication, and teamwork.

Consistent data support an association between anxiety and eating disorders (EDs), and theoretical models of EDs suggest that anxiety may be involved in the etiology and maintenance of ED symptoms over time. However, the directionality of relations between these variables remains under-characterized, particularly within treatment settings.

Genome-wide association studies implicate metabo-psychiatric origins for anorexia nervosa (AN). There are two case reports totaling six adult females who experienced complete remission of AN following a treatment comprised of ketogenic diet (targeting metabolism) with ketamine infusions (targeting psychiatric origins), but no study has determined the efficacy of ketogenic diet, alone. We addressed this gap in knowledge, with exploration of potential molecular mechanisms, using an animal model.

The Eating Disorder Examination Questionnaire (EDE-Q) is a widely-used measure of eating-disorder symptoms. However, inconsistent replication of the subscale structure raises concern about validity. To provide a rigorous test of the EDE-Q's dimensionality and item-quality, we applied modern and classical test theory approaches to data obtained from a large, transdiagnostic sample of people with clinical eating disorders.

Renourishment and weight restoration are critical first steps in anorexia nervosa (AN) treatment. The ability of the gastrointestinal tract to harvest and utilize energy from food is essential for successful weight restoration, but the functional capacity of the intestine after prolonged caloric restriction remains unknown. In an exploratory study, we quantified the stool energy content of individuals with AN before and after renourishment.

Our understanding of the impact of eating disorders (ED) treatment in Autistic people remains elusive. Research has begun to explore ED treatment outcomes and experiences in this population, however current understandings are poorly integrated. The current review therefore sought to explore the impact of ED treatment on Autistic people and those with higher Autistic traits.

This study describes the current management of patients with eating disorders (EDs) served by publicly-funded Medicaid behavioral health systems.

Individuals with anorexia nervosa persistently restrict their food intake while often severely underweight. This maladaptive food choice behavior and related decision-making processes have mainly been investigated in adults. It is unknown whether the same decision-making processes drive food choices in adolescents, given their more favorable treatment outcomes. This study investigated maladaptive food choice behavior in adolescents with AN and examined whether they display the same decision-making processes as adults.

The relationship between self-reported interpersonal difficulties and eating disorder symptoms is well-established. The Interpersonal Relationships in Eating Disorders (IR-ED) is a new measure of eating-specific interpersonal difficulties (food-related isolation, avoidance of body evaluation, foot-related interpersonal tension). This study aims to (1) explore changes in IR-ED scores, eating disorder symptoms, and psychosocial impairment during ten-session cognitive behavioral therapy for eating disorders (CBT-T), (2) assess whether pre-treatment IR-ED scores moderate the trajectory of change in eating disorder symptoms and psychosocial impairment during CBT-T and (3) investigate the relationship between changes in the IR-ED and changes in eating disorder symptoms and psychosocial impairment.

Although eating disorders (EDs) affect youth from all socioeconomic backgrounds, little is known about the treatment experiences of under-resourced youth with EDs. To address this gap, we examined patterns of outpatient and inpatient service utilization among publicly-insured youth with EDs in California and potential disparities for youth with additional marginalized identities.

Other specified feeding and eating disorders (OSFED) is a diagnostic category in DSM-5 describing individuals with clinically significant eating behavioral disturbances that do not meet criteria for full-threshold eating disorder diagnoses. OSFED includes five example subgroups: atypical anorexia nervosa, sub-threshold bulimia nervosa, sub-threshold binge-eating disorder, purging disorder, and night eating syndrome. A recent review of OSFED by Dang et al. aims to examine differences between OSFED and full-threshold eating disorders as well as between OSFED and healthy populations but is limited by the lack of clear definitions of OSFED subtypes and methodological differences across studies. Clearer diagnostic definitions for OSFED subtypes are needed. Consideration should also be given to indicators of lifetime history of full-threshold conditions, diagnostic drift, and remission criteria as OSFED categories undergo further study.

This Commentary discusses the findings of Dang et al.'s systematic review and metanalysis on the "Other Specified Feeding or Eating Disorder" (OSFED) category in the context of current conceptualizations and main international diagnostic schemes of classification, the DSM-5 and the ICD-11. The aim to reduce less specified eating disorder categories in these classifications has not been completely achieved and OSFED cases remain prevalent. Different definitions of OSFED contribute to difficulties in study selection and limitation of data aggregation in metanalysis, highlighting the need for improving methodologies for studying OSFED subtypes. Although use of either the DSM-5 or ICD-11 scheme concurs with Dang et al.'s main finding that OSFED comprises categories of similar clinical significance to the recognized eating disorders, the ICD-11 includes more people with anorexia nervosa, bulimia nervosa, or binge-eating disorder who would receive a DSM-5 OSFED diagnosis. This may have impacts for epidemiological studies of distribution as well as for identification and treatment of the individual. We support that before creating new eating disorder categories, consideration be given to also broadening current DSM-5 criteria. This approach may result in fewer OSFED subtypes needing elevation to distinct categories, potentially limiting these to just purging disorder and night eating syndrome.

To compare all other specified feeding or eating disorders (OSFED) groups (atypical anorexia nervosa [AN], purging disorder [PD], night eating syndrome [NES], subthreshold bulimia nervosa [sub-BN], and subthreshold binge-eating disorder [sub-BED]) to threshold eating disorders (EDs [AN, BN, and BED]) and control groups (CGs) on measures of eating and general psychopathology.

Dang et al.'s review concludes that atypical anorexia nervosa (atypical AN), purging disorder (PD), and night eating syndrome (NES) are clinically significant and severe eating disorders (EDs). However, findings are unlikely to alter their status in future editions of the DSM due to limitations in the literature to date. Guidelines are offered to promote rigorous and reproducible research on other specified feeding or eating disorder OSFED. First, published research diagnostic criteria for atypical AN, PD, and NES should be consistently used to ensure findings across studies reflect the same conditions. Second, operational definitions are recommended for "recurrent" as at least twice within a 3-month period, minimum duration as at least 1 month, and "significant weight loss" as >5% BMI reduction within 1 month. Third, Thomas's and Gydus's trumping scheme for differential diagnosis of OSFED subcategories is endorsed but should prioritize identifying treatment targets based on medical morbidity over mirroring existing diagnostic algorithms. Fourth, a systematic approach for establishing clinical significance is recommended that explicitly notes medical risk associated with malnutrition, purging and nonpurging behaviors, and relevance of marked distress related to binge eating and body image disturbance. Adoption of these guidelines will facilitate necessary research on clinical utility.

The study by Dang and colleagues in this issue is a timely reminder of the need for careful consideration when it comes to the inclusion of putative new diagnoses in the diagnostic and statistical manual of mental disorders (DSM). The authors conclude that findings from their systematic review and meta-analysis of recent literature bearing on the DSM-5 other specified feeding and eating disorders (OSFED) category "support the conceptualization of atypical AN, PD and NES as clinically significant EDs with similar severity to full-threshold EDs." This commentary attempts to provide some additional context, historical context in particular, that the author believes may be helpful when considering the potential implications of Dang and colleagues' findings. This is achieved through reference to the construct, well-known in the sociology and feminist literature, of medicalization and by highlighting certain issues relevant to the determination of "clinical significance." I hope that readers approaching Dang and colleagues' research from the currently dominant, medical-model perspective might be persuaded of the importance of considering alternative perspectives when interpreting findings from research of this kind.

The results of Dang et al.'s recent systematic review and meta-analysis suggested that individuals diagnosed with other specified feeding or eating disorder (OSFED) and those diagnosed with specified eating disorders (EDs, such as bulimia nervosa) endorse similar, elevated levels of ED-related cognitions (but not behaviors). The DSM has traditionally conceptualized EDs primarily as disturbances in eating behavior, and the diagnostic boundaries for EDs are based on objective markers, such as behavioral frequencies and weight. Although focusing on objective markers for ED diagnoses and severity indices has advantages (e.g., clinical communication, measurement), pitfalls include diagnostic migration and low emphasis on ED cognitions. Dang et al.'s findings provide a basis for rethinking DSM's conceptualization of EDs as primarily behavioral. This commentary discusses the potential merits and challenges of emphasizing subjective cognitions when assigning ED diagnoses. We explore how objective markers (e.g., behavioral frequency, weight) and subjective experience (e.g., fear of weight gain) may be balanced to improve the clinical utility of ED diagnoses. In all, research that more deeply phenotypes the subjective experiences of people with EDs across contexts, identities, and cultures will enrich our understanding of eating pathology and may inform diagnostic revisions.

Because premorbid BMI strongly predicts the amount of weight loss in anorexia nervosa (AN)/atypical AN, we hypothesize that weight loss triggers both disorders by inducing the endocrine adaptation to starvation.

Two recent systematic reviews provide important insights into the current state of the eating disorder literature regarding autistic traits, ASD prevalence, and experience with accessing treatment, with a specific focus on anorexia nervosa (AN). The extant literature provides converging evidence for elevated autistic traits in individuals with AN, while evidence for increased prevalence of ASD in AN is less robust. Presence of autistic traits or a formal ASD diagnosis both appear to elevate the potential for a more complicated experience during eating disorder treatment. Together, this work provides compelling justification to expand the breadth of inquiry regarding eating disorders and ASD, with a specific call for increased methodological rigor when designing and conducting future research. My commentary calls for specific steps to advance our understanding of ASD and eating disorders.

Body checking is considered a behavioral expression of the core psychopathology of eating disorders (EDs), namely, overvaluation of body weight and shape. Compulsive checking is motivated by a desire to increase a sense of certainty regarding feared outcomes. Paradoxically, studies showed that repeated checking acts to reduce certainty, forming a vicious cycle. No previous study examined whether the same principle applies for body checking. This study filled this gap by examining the causal effect of repeated body checking on memory certainty regarding checked body parts.

Studies suggest that adolescents reported more eating problems during the pandemic. Using a population-based sample, we compared eating problems-and how they associate with a range of personal characteristics and genetic factors-among adolescents before (June 2017-April 2020) versus during (April 2020-December 2022) the pandemic.

A minority of individuals with eating disorders seek help from health professionals qualified to provide eating disorder care. This review assessed the proportion of individuals with eating disorders who had sought help or received treatment, as an update to an earlier review conducted more than a decade ago.