Anorexia nervosa (AN) is a complex and serious mental disorder, which may affect individuals of all ages and sex, but primarily affecting young women. The disease is characterized by a disturbed body image, restrictive eating behavior, and a lack of acknowledgment of low body weight. The underlying causes of AN remain largely unknown, and current treatment options are limited to psychotherapy and nutritional support. This paper investigates the impact of Fecal Microbiota Transplants (FMT) from patients with AN on food intake, body weight, behavior, and gut microbiota into antibiotic-treated mice. Two rounds of FMT were performed using AN and control (CO) donors. During the second round of FMT, a subset of mice received gut microbiota (GM) from a different donor type. This split-group cross-over design was chosen to demonstrate any recovery effect of FMT from a non-eating disorder state donor. The first FMT, from donors with AN, resulted in lower food intake in mice without affecting body weight. Analysis of GM showed significant differences between AN and CO mice after FMT1, before cross-over. Specific bacterial genera and families Ruminococcaceae, Lachnospiraceae, and Faecalibacterium showed different abundances in AN and CO receiving mice. Behavioral tests showed decreased locomotor activity in AN mice after FMT1. After FMT2, serum analysis revealed higher levels of appetite-influencing hormones (PYY and leptin) in mice receiving AN-GM. Overall, the results suggest that AN-GM may contribute to altered food intake and appetite regulation, which can be ameliorated with FMT from a non-eating disorder state donor potentially offering FMT as a supportive treatment for AN.

Eating disorders significantly impact physical health and have negative psychosocial consequences. The global burden of anorexia nervosa and bulimia nervosa among young females is estimated to account for 1.9 million disability-adjusted life years. Early identification of disordered eating attitudes is critical for preventing the progression to more severe forms of eating disorders; however, there is limited evidence on this issue among university students in Ethiopia. Therefore, this study aimed to assess disordered eating attitudes and their associated factors among female students at Arba Minch University, Arba Minch, Southern Ethiopia, in 2023.

An institution-based cross-sectional study was conducted at Arba Minch University from January 1, 2023, to April 1, 2023. A total of 600 female students participated in the study, selected through simple random sampling. Data were collected using a self-administered questionnaire, entered into Epi-Info version 7, and exported to SPSS version 20 for analysis. Multivariable binary logistic regression was used to identify factors associated with disordered eating attitudes, with variables having p-values <0.05 considered statistically significant. The strength and presence of associations between the outcome variable and independent variables were measured using adjusted odds ratios with 95% confidence intervals. Model fitness was assessed using the Hosmer and Lemeshow goodness-of-fit test.

The study found that the prevalence of disordered eating attitudes among female students at Arba Minch University was 11.5% (95% CI: 9.0-14.3). Factors significantly associated with disordered eating attitudes included academic department (AOR=2.27, 95% CI: 1.06-4.86) and body mass index (AOR=5.83, 95% CI: 2.34-14.52).

The study indicated a notable prevalence of disordered eating attitudes among female students at Arba Minch University. Body mass index and academic department were found to be significantly associated with these attitudes. The link between disordered eating and body image concerns underscores the need for policies promoting self-confidence and positive body image. More specifically, university health services should implement routine screening using EAT-26, combined with psychological counseling services to support at-risk students.

Internet-related disorders for example, internet addiction (IA) seem to be frequent among adolescents all over the world. However, there could be a possible link between body mass index (BMI) and the risk of eating disorders (EDs) in connection with IA. This study aimed to determine the relationship between risk of EDs, BMI, and IA among Bangladeshi adolescents, as well as factors associated with IA.

A cross-sectional study was carried out among 2147 individuals, using a stratified random sampling method, aged 13-19, from various selected schools and colleges spread across Bangladesh using a Google form questionnaire consisting of sections on socio-demographic factors, body mass index (BMI), eating attitude test scale, and internet addiction test scale. Descriptive analysis, Pearson Chi-square test, logistic regression model, and a bivariate correlation analysis were fit to determine the relationship and factors.

We found that 24.1% of students had IA, 23.2% were at risk of EDs, 6.6% were underweight, 1.9% were overweight, 24% were obese and the remainder were normal. The relationship between IA, BMI, and risk of EDs was significant and positively co-related. Moreover, we found gender, the purpose of internet use, daily internet usage, physical exercise, literature reading habits, and victims of bullying were significantly associated with IA.

The findings highlight the need for further research and strategies to diagnose and treat EDs and IA, among adolescents. Promoting physical activity, healthy habits, and awareness at the institutional and parental levels is crucial for mitigating these risks and addressing sociodemographic, internet usage, and emotional health factors.

Suicidal behaviour is a growing problem in child and adolescents, and the Emergency Department (ED) is often where the first contact with Mental Health occurs. Here we factors associated with suicidal behaviour in this children and adolescents attended at the ED.

Our sample consisted of children and adolescents who attended the ED of Hospital 12 de Octubre for psychiatric reasons between January 1st and December 31st, 2022. Inclusion criteria were age under 18 years. No restrictions by diagnosis, ethnicity, nationality, gender or any other variables. We conducted an initial interview with patients in the ED and reviewed patients' digital patient records for the six months following their first visit during 2022.

We found that the variables that were independently associated with a repeated visits for suicidal behaviour were eating problems, transgender identity, emotional dysregulation and previous mental health follow-up.

In our study, we found that ED revisits were concentrated in the first month after the first visit. Just as associated factors and approaches have historically been studied in the adult population, the child and adolescent population needs an even more in-depth study of this alarming situation.

Problematic or addictive use of social media has been associated with psychological and health issues. The main objective of this study was to explore the relationship between Facebook addiction and eating disorders (EDs) among young adults in Bangladesh.

We conducted an online-based cross-sectional study among 550 young adults aged 18 to 27 in Bangladesh. A structured questionnaire was used to obtain the survey data. The survey tool consisted of three sections: (i) socio-demographic, behavioral, and social media use-related characteristics, (ii) assessment of Facebook addiction using Bergen Facebook Addiction Scale, and (iii) assessment of EDs risk using Eating Attitudes Test-26 (EAT-26, outcome variable). Scoring at or above 20 on the EAT-26 scale (total score ranges from 0 to 78) indicated an ED risk. Unadjusted and adjusted binary logistic regression analyses were performed to investigate the relationship outcome and explanatory variables.

Approximately 38% of the study participants showed addiction to Facebook, whereas 23.6% were at risk of developing an ED. Multiple adjusted logistic regression models demonstrated that Facebook addiction was significantly associated with an increased risk of EDs (OR  =  1.784; 95% confidence interval [CI]: 1.154-2.760). Moreover, smoking habits, self-rated body mass index (BMI), and physical activity level showed a significant association with the risk of EDs.

These findings may help public health professionals and policymakers to take the initiative and develop strategies to overcome these addictive behaviors and promote healthy eating habits across the country.

Severe burns place patients in a compromised state, especially those with pre-existing chronic diseases such as malignancy. Due to improvements in detection and treatment, cancer mortality has declined significantly, leaving a growing population of cancer survivors. Therefore, we wondered whether pre-existing cancer diagnoses influence patient outcomes following burn injury.

46,275 patients with a neoplasm diagnosis prior to experiencing a burn injury were identified using the TriNetX research network. Two control groups were organized: 1) cancer patients without burns and 2) burn patients with no history of cancer. The test group included patients with a pre-existing cancer diagnosis who received a subsequent burn injury. Outcomes included death, sepsis, nutritional deficiency, eating disorder, immunodeficiency, and depression. Odds ratios were calculated with 95 % confidence intervals.

Of the nearly 10 million cancer patients, 0.45 % experienced a burn injury after diagnosis. Compared to propensity-matched burned patients without cancer, burned patients with a previous cancer diagnosis had increased odds of developing sepsis (2.013, 1.895-2.138), nutritional deficiency (1.874, 1.58-2.221), immunodeficiency (5.584, 4.85-7.06), eating disorder (2.384, 1.947-2.918), and depression (1.772, 1.695-1.853). The odds ratios of sepsis (1.718, 1.612-1.83), nutritional deficiency (1.963, 1.593-2.418), immunodeficiency (1.265, 1.098-1.459), eating disorder (2.569, 2.077-3.177), and depression (1.538, 1.468-1.611) were increased when compared to cancer patients without burn injury. Burned patients with a previous neoplasm of hematologic origin fared worse in the odds of developing the mentioned outcomes compared to those with solid neoplasms. Lastly, burned patients with any previous neoplasm who later received chemotherapy and/or radiation suffered worse outcomes than those who never received such treatment.

Patients who developed neoplasms before receiving a burn injury demonstrated considerable increases in odds of poor outcomes. Increased odds of developing poor outcomes were greater in those with hematologic neoplasms and those who received chemotherapy or radiation treatment.

Following the COVID-19 pandemic, internet-based computer self-help platforms for eating disorders (EDs) became increasingly prevalent as a tool to effectively prevent and treat ED symptoms and related behaviours. This systematic review explored the effectiveness of unguided internet-based computer self-help platforms for EDs.

From inception to the 31st of May 2024, a systematic search of Ovid MEDLINE, Embase, Global Health, and APA PsycInfo was conducted. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Outcome quality assessments were conducted according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

12 RCTs, with a total of 3400 participants, were included. 2 studies explored the effectiveness as primary prevention, 7 as secondary prevention, and 3 as tertiary intervention. The gathered literature demonstrated unguided internet-based computer self-help platforms as effective in reducing ED core symptoms and related behaviours, with psychoeducation, cognitive behavioural, and dissonance-based approaches being the most prevalent approaches.

Unguided internet-based computer self-help platforms are effective in the short-term reduction of ED symptoms and associated behaviours and should be implemented in the early stages of a tiered healthcare system for ED treatments.

Prospero (CRD42024520866).

Eating disorders are serious conditions that affect how people think and behave around food, and their body image. This study investigated how common eating disorders are among medical students in Uganda, and the factors linked to their occurance. The findings revealed that 16.6% of medical students showed signs of possible eating disorders based on the SCOFF screening tool. Those at high risk included female sex, individuals with multiple sexual partners, and those experiencing suicidal thoughts. These results highlight the importance of raising awareness about eating disorders in academic settings, particularly in medical institutions, and underscore the need for early identification and targeted interventions. Further research is necessary to explore sociocultural influences on eating disorders in Uganda and other low-resource settings to inform culturally appropriate prevention and treatment strategies.

This study explored eating disorders (ED) prevalences, comorbidity of ED with other mental disorders, and risk factors for ED among university students. ED included binge eating disorder (BED), bulimia nervosa (BN), or other specified feeding and eating disorders (OSFED).

A total of 3425 first-year university students in Sweden completed an online survey covering a range of criteria for psychiatric diagnoses, within the World Mental Health International College Student (WMH-ICS) initiative. Pearson's χ2 -tests were used to compare algorithm-based diagnostic prevalences for eating disorders and other comorbid psychiatric disorders between three groups: students with ED with or without other comorbid psychiatric disorders (A), students with psychiatric disorders but no ED comorbidity (B), and students with no psychiatric disorders (C). Multinomial logistic regression was used to calculate between-group comparisons of odds ratios for independent risk factors, where group B served as the reference group for comparisons with groups A and C.

Of the total sample, 75% had at least one psychiatric disorder and 28% had at least one lifetime ED diagnosis. Students with ED (group A) reported higher prevalences for comorbid anxiety disorders, depression, suicidal behavior, and non-suicidal self-injury compared to students with psychiatric disorders but no ED (group B). Group A participants exhibited a higher risk of hazardous drinking, were more likely to have received medical treatment, and to identify as bisexual. Compared to group B, students with no psychiatric disorders (group C) were more likely to report better mental and physical health, but less likely to engage in hazardous drinking, and to have sought mental health treatment.

A large proportion of students with ED had additional psychiatric disorders, indicating that individuals with ED suffer from multiple mental health problems. It is crucial that student health services acquire competency to offer effective ED assessment and treatment.

To review and explore the eating disorder admissions to an in-patient child and adolescent mental health hospital which had restarted taking such presentations. This was done by conducting three audits using RiO (an electronic patient records system) and including all young people with eating disorders or related difficulties admitted between 1 February 2019 and 30 June 2023. As part of this, relevant practice standards were identified using the baseline assessment tool in UK national guidelines.

The audits identified 46 completed admissions, detailing demographic information, nasogastric and restraint feeding, therapeutic interventions and medication, admission and discharge routes, length of admission and more.

The review highlighted the apparent overall success of a general admission unit in treating eating disorders and related difficulties and identified key areas of importance and development in terms of clinical practice.

Eating disorders (EDs) are prevalent psychopathological conditions with significant psycho-physical consequences. Despite advances in diagnostic tools and treatment approaches, many patients experience barriers to accessing specialized ED care (SEDC). This study aimed to (1) examine the timeline of the care pathway from symptom onset to referral to a regional SEDC; (2) assess the association between referral to SEDC and factors such as the initial healthcare provider and clinical symptoms; and (3) investigate the relationship between the care pathway and clinical severity at the time of referral.

This study analyzed data from 174 patients accessing the SEDC in Bologna, Italy, between 2022 and 2024. Chi-square tests and Kendall Tau correlations were used to assess the associations between referral patterns, healthcare professionals, symptom severity, and healthcare contacts prior to referral.

On average, participants took 26.3 months from symptom onset to seek help and 53.7 months before reaching the SEDC. General practitioners and psychiatric services had higher referral rates to SEDC. Weight loss and amenorrhea were positively associated with referrals, while depressed mood and fear of weight gain showed negative associations. No significant link was found between the care pathway and clinical severity at the time of referral.

Referral to SEDC is associated with the type of healthcare provider initially consulted and the presence of specific symptoms, particularly weight loss and amenorrhea. These findings highlight the importance of enhancing awareness among frontline healthcare providers to promote earlier recognition and referral of ED cases.

To describe clinical characteristics among adolescents and young adults with isolated low body mass index (BMI) and identify socioeconomic indicators in the lived environment associated with this outcome.

Using our electronic health record, we conducted a retrospective case-control study that included 135 adolescents and young adults ages 13 to 21 from an under-resourced neighborhood of Massachusetts with isolated diagnoses of failure to thrive or underweight status. We used the Centers for Disease Control and Prevention weight classification to allocate patients into low and normal BMI categories. We used chi-square and Fisher exact tests to compare differences in clinical characteristics and neighborhood socioeconomic indicators by BMI outcome and a 2-sample test of proportions or logistic regression to calculate the effect estimate and 95% confidence interval.

Forty percent of the participants with low BMI were diagnosed with malnutrition and required nutritional supplements. Low BMI finding was positively associated with depression, anxiety, and unmet social drivers of health-primarily driven by housing insecurity.

Our findings indicate that a significant proportion of adolescents and young adults with low BMI experience housing insecurity and unmet social needs in their lived environment and suffer from malnutrition at a critical time of their growth and development. Further research is needed to understand the role of the lived environment and outcome of low BMI, the underlying mechanisms at play, and its impact on adolescents' and young adults' growth and development.

Higher levels of body image dissatisfaction play a crucial role in the development and maintenance of eating disorders. Among different age groups, adolescents tend to focus more on their body image. However, there is limited data available on body image satisfaction in transfeminine youth. This study aimed to investigate body image satisfaction among transfeminine youth compared to cisgender female youth and to identify factors associated with body image satisfaction in transfeminine youth. Factors such as exercise and hormone intake were examined for their potential influence on body image satisfaction.

We developed a self-administered questionnaire to survey a sample of 600 youth (212 transfeminine and 388 cisgender female), aged 12-25 years, between 2021 and 2022. Body image satisfaction was assessed using the Body Image Concern Inventory Score (BICI), with a higher BICI score indicating greater body image dissatisfaction.

A total of 209 transfeminine youth and 378 cisgender female youth participated in the study. The results showed that transfeminine youth reported higher levels of body image dissatisfaction than cisgender female youth, with mean ± SD scores of 59.3 ± 15.8 and 50.2 ± 15.9, respectively. Notably, regular exercise was associated with greater body image satisfaction (adjusted b = -7.53 [95% CI -14.78 to -0.27]; p-value = 0.04), while gender-affirming hormone intake did not show a significant association with body image satisfaction.

These findings emphasize the importance of evaluating body image among transfeminine youth and suggest that promoting regular exercise may be an effective strategy to reduce body image dissatisfaction in this population.

Stigma significantly hinders treatment seeking, adherence to treatment, referrals, and can prolong recovery, while increasing the risk of relapse due to social exclusion and stress. Stigmatizing attitudes towards anorexia nervosa are widespread, and not only held by the general public, but also by professionals.

As stigmatizing attitudes towards mental disorders often develop early during education and training, the study's objective was to investigate stigmatizing attitudes towards anorexia nervosa among Dutch psychiatry residents, as well as their mental health literacy.

In this pilot study, Dutch psychiatry residents (N = 61) were surveyed, with a 49% response rate, using a comprehensive questionnaire that included nine parts, covering multiple stigma domains, disease prestige, knowledge, and professional training.

Anorexia nervosa was ranked 18th in disease prestige with a mean score of 6.23. Although most stigmatizing attitudes were not widely endorsed by psychiatry residents, there were a few notable exceptions, especially attitudes related to blame, fragility and social distance. They characterized patients as insecure, controlling, sad, and defensive, and reported feeling worried, incompetent, pessimistic and anxious when dealing with patients with anorexia nervosa. Only 37% felt confident in diagnosing anorexia nervosa.

There is a critical need for further research on the social value ranking of psychiatric disorders and the development of a comprehensive stigma scale, as well as targeted educational interventions. Addressing stigma through focused training programs could lead to better patient outcomes, improved treatment satisfaction, and reduced barriers to care for individuals with anorexia nervosa.

Anorexia nervosa (AN) is a mental and behavioral health condition characterized by an intense fear of body weight or fat gain, restriction of food intake resulting in low body weight, and distorted body image. Substantial research has focused on general anxiety in AN, but less is known about eating-related anxiety and its underlying neurobiological mechanisms. We sought to characterize anxiety-to-eat in AN and to examine neurometabolite levels in the dorsal anterior cingulate cortex (dACC), a brain region putatively involved in modulating anxiety-related responses, using edited magnetic resonance spectroscopy. Sixteen women hospitalized with AN and 16 women of healthy weight without a lifetime history of an eating disorder (healthy controls; HC) completed a computer-based behavioral task assessing anxiety-to-eat in response to images of higher (HED) and lower energy density (LED) foods. The AN group reported greater anxiety to eat HED and LED foods relative to the HC group. Both groups reported greater anxiety to eat HED foods relative to LED foods. The neurometabolite myo-inositol (myo-I) was lower in the dACC in AN relative to HC. In the AN group only, myo-I levels negatively predicted anxiety to eat HED but not LED foods and was independent of body mass index, duration of illness, and general anxiety. These findings provide new insight into the clinically challenging feature of eating-related anxiety in AN, and indicate potential for myo-I levels in the dACC to serve as a novel biomarker of illness severity or therapeutic target in individuals vulnerable to AN.

Family therapy for eating disorders (ED) is well-established and represents the treatment choice for ED in children and adolescents according to guidelines, with cognitive behavior therapy (CBT) as a second line treatment. There is limited knowledge about how these treatments work in routine clinical care. The goal of the present meta-analysis is to investigate the effectiveness of family therapy and CBT for various EDs in children and adolescents when carried out in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were searched for articles published until December 2023. The outcome of family therapy and CBT, methodological quality, risk of bias, and moderators of treatment outcome were examined and benchmarked by meta-analytically comparing with ED efficacy studies. Forty-four effectiveness studies comprising 3251 family therapy or CBT patients were included. Large to very large within-group effect sizes (ES) were found for ED-psychopathology (0.80) and weight measures for AN (1.64) at post treatment. The attrition rate was 15%. Risk of bias was considerable. Moderate to large ES were found for family therapy and CBT, respectively. The benchmarking analysis showed that effectiveness studies had comparable ESs to efficacy studies (0.80 and 0.84 for the ED-psychopathology at post treatment). The findings support family therapy and CBT for ED in children and adolescents as effective treatments when delivered in routine clinical care, with effects comparable with those found in efficacy studies. The evidence needs to be interpreted with caution because of the risk of bias in a high proportion of studies.PROSPERO [CRD42023441794].

Both obesity and underweight are matters of global concern. Weight-related content frequently shared on social media can reflect public recognition and affect users' behaviors and perceptions. Although X (Twitter) is a popular social media platform, few studies have revealed the content of weight-related posts or details of dietary behaviors for weight loss shared on X.

This study aims to describe body weight-related content frequently reposted on X, with a particular focus on dietary behaviors for weight loss, in English and Japanese.

We collected English and Japanese X posts related to human body weight having over 100 reposts in July 2023 using an application programming interface tool. Two independent researchers categorized the contents of the posts into 7 main categories and then summarized recommended weight loss strategies.

We analyzed 815 English and 1213 Japanese posts. The most popular main category of the content was "how to change weight" in both languages. The Japanese posts were more likely to mention "how to change weight" (n=571, 47.1%) and "recipes to change weight" (n=114, 9.4%) than the English posts (n=195, 23.9% and n=10, 1.2%, respectively), whereas the English posts were more likely to mention "will or experience to change weight" (n=167, 20.5%), "attitudes toward weight status" (n=78, 9.6%), and "public health situation" (n=44, 5.4%) than Japanese posts. Among 146 English and 541 Japanese posts about weight loss strategies, the predominant strategies were diet (n=76, 52.1% in English and n=170, 31.4% in Japanese) and physical activities (n=56, 38.4% and n=295, 54.5%, respectively). The proportion of posts mentioning both diet and physical activity was smaller in Japanese (n=62, 11.5%) than in English (n=31, 21.2%). Among 76 English and 170 Japanese posts about dietary behaviors for weight loss, more than 60% of posts recommended increasing intakes of specific nutrients or food groups in both languages. The most popular dietary component recommended to increase was vegetables in both English (n=31, 40.8%) and Japanese (n=48, 28.2%), followed by protein and fruits in English and grains or potatoes and legumes in Japanese. Japanese posts were less likely to mention reducing energy intake; meal timing or eating frequency; or reducing intakes of specific nutrients or food groups than the English posts. The most popular dietary component recommended to decrease was alcohol in English and confectioneries in Japanese.

This study characterized user interest in weight management and suggested the potential of X as an information source for weight management. Although weight loss strategies related to diet and physical activity were popular in both English and Japanese, some differences in the details of the strategies were present, indicating that X users are exposed to different information in English and Japanese.

Eating ability is central to human existence and survival, societal acceptance, life satisfaction, and social participation. Although eating difficulties (EDs) are common after stroke, few studies are reporting their impact on the quality of life (QoL) of stroke survivors. This study aimed to assess the prevalence, correlates, and association of EDs with QoL among stroke survivors.

A cross-sectional study on 233 (Mean age: 59.6 ± 10.9 years; 52.8% female) Nigerian community-dwelling stroke survivors attending rehabilitation at three public hospitals was conducted. The Minimal Eating Observation Form- version II and WHOQOL-BREF were used to collect data on EDs and QoL respectively. Socio-demographic, stroke-related, and clinical characteristics of patients were assessed using structured questionnaires. The association of EDs with each domain of WHOQOL-BREF (physical health, psychological health, social relationships, environmental health, perceived health status, and overall QoL) was assessed with hierarchical regression analyses.

The majority (60.9%) of stroke survivors had at least one form of ED. Among the three types of EDs assessed, difficulty with energy/appetite (45.1%) was the most prevalent, followed by difficulty with ingestion (43.8%) and deglutition (40.8%). The results showed that EDs were associated with haemorrhagic stroke (r = 0.158; p = 0.016), right-sided hemiplegia (r = 0.172; p = 0.008), increasing stroke severity (r = 0.466; p < 0.001), increasing co-morbidity (r = 0.384; p < 0.001), poor oral health (r = 0.511; p < 0.001), poor mental health (r = 0.260; p < 0.001), poor affected grip strength (r= -0.157; p = 0.016), poor nutritional status (r= -0.362; p < 0.001), low functional ability (r= -0.415; p < 0.001), and low social support (r= -0.257; p < 0.001). After adjustments, EDs independently explained 10.7% of the variance in psychological health (β= -0.467; p < 0.001), 4.7% in social relationships (β= -0.308; p < 0.001), 2.4% in perceived health status (β= -0.221; p = 0.002), and 7.4% in overall QoL (β= -0.383; p < 0.001). However, the variance accounted for by EDs in physical and environmental health domains was insignificant.

The prevalence of EDs among Nigerian community-dwelling stroke survivors is high, which is associated with many stroke-related and clinical factors. Meanwhile, increasing in EDs is independently associated with reduced QoL among stroke survivors using WHOQOL-BREF. Emphasis on screening and management of EDs in stroke rehabilitation protocols may assist in improving survivors' QoL.

Eating disorders (EDs) are among the most serious forms of psychiatric illness, potentially leading to multi-systemic complications. Owing to their high stress levels, medical students are more likely to experience mental health difficulties that predispose them to developing EDs. Societal stigmatization and misinformation, especially in a middle eastern context, contribute to the underreporting and challenges in seeking the appropriate treatment at an early stage, increasing the risk of complications and mortality. EDs remain an under-studied phenomena in the middle east, limiting understanding and treatment options.

The objectives of the current study were to assess the prevalence of EDs, potential contributing factors, and the impact of the COVID-19 pandemic as an independent global stressor among medical students at the Arabian Gulf University.

This cross-sectional study consisted of a three-part self-administered questionnaire comprising of demographic data, the Eating Attitudes-26 (EAT-26) test, and COVID-19 associated stressors. The study was conducted on medical students at the AGU in the preparatory year up to Year 6. Data was collected from September 2022 to February 2023.

Three hundred and ninety-seven students were recruited in the present study. 32.1% of the tested students demonstrated an elevated risk for developing EDs. Living situation, earlier years of study, and mental health status were significantly associated with increased risk. Response to global stressors such as COVID-19 pandemic was significantly correlated to worsening EDs status in high-risk individuals.

Eating disorders have been discovered to be highly prevalent among medical students, which brings to light an undervalued health concern. This warrants both awareness programs on campus, and the development of individual-tailored eating disorder treatment programs to halt progression and increase overall quality of life and education.

Disordered eating includes both behaviors and cognitions and can cause many of the same negative health outcomes as clinically diagnosed eating disorders (e.g., growth retardation, nutritional deficiencies, and psychosocial disturbances). Compared to the general population, disordered eating is more common in college-age women. An experiment was conducted to test 8 expressive writing interventions in the context of disordered eating. Interventions were drawn from theory-based prevention programs, which included cognitive behavioral therapy, peer and media risk reduction, and cognitive dissonance theory. Dependent variables included emotions (e.g., sadness and hope), evaluation of the expressive writing interventions (e.g., engagement, clarity, ease, and interest), and re-evaluation of disordered eating behaviors and cognitions. Results show that 62.90% of participants had observed disordered eating in their peers. Sadness, with an action tendency related to increased inward evaluation, was the most typical emotional response upon completion of the expressive writing tasks. Interventions that were based on the principles of cognitive behavioral therapy led to the most positive outcomes including engagement and re-evaluation of current disordered eating behaviors and cognitions. Overall, it was concluded that expressive writing interventions are effective in eliciting emotions and causing a re-evaluation of harmful behaviors and cognitions in the context of disordered eating.

Anorexia nervosa is an eating disorder characterized by severely low body weight due to psychological reasons. Its presentation and ideal management may differ depending on the cultural background of the patient. We present a 52-year-old female of East Asian descent with a unique presentation of anorexia nervosa and takotsubo cardiomyopathy. An extensive medical workup revealed no medical abnormalities, she reported negative answers to most questions posed in eating disorder screening surveys, and she wished to be discharged against medical advice despite having a BMI of 10 kg/mg2. Her desire to leave as well as her perception of her eating disorder were likely influenced by her collectivist culture mentality, and factoring in her cultural background was vital in managing her care. Patient autonomy vs. beneficence was considered throughout her stay, and she was determined to have the capacity to leave against medical advice two weeks after presenting. This case aims to demonstrate that providers should consider cultural components when caring for patients with eating disorders to better understand causes, treatment preferences, and guide care.

This study, which is a longitudinal extension of previous cross-sectional studies in Chinese and American college students and general adults (Dixit, He, Whited, Ellis, & Zickgraf, 2023; He, Chen, Wu, Niu, & Fan, 2020; Xu et al., 2024), used latent profile and latent transition analyses to investigate negative emotional eating patterns and the stability of these patterns in 1462 Chinese adolescents (41% boys, aged 11-17 years) at baseline and 18 months later. We also explored baseline demographic predictors of negative emotional eating patterns and the associations between these patterns and outcome variables measured 18 months later. Negative emotional eating was measured with the Adult Eating Behavior Questionnaire (emotional undereating and emotional overeating subscales). Latent profile analysis (LPA) replicated the four patterns of negative emotional eating in each wave of assessment: low emotional eating (Low-EE), emotional overeating (EOE), emotional undereating (EUE), and emotional over- and under-eating (EOE-EUE). Latent transition analysis (LTA) showed that the EE patterns had transition probabilities of <55% remaining in the same class across 18 months. Furthermore, relative to adolescents in the stable Low-EE group, adolescents in all other stable or unstable emotional eating groups in LTA were linked to higher eating disorder psychopathology and psychological distress measured 18 months later. Thus, emotional eating, regardless of type (i.e., EOE, EUE, and EOE-EUE) and stability (i.e., stable or unstable), may be a viable research and treatment target in improving adolescents' eating behaviors and mental health.

Explore associations between eating disorders (EDs) and sleep duration and the impact of depression symptoms (DSs) in American college students.

College students from 2018 to 2019 Healthy Minds Study.

Multivariate logistic regression evaluated associations between EDs (bulimia, anorexia, binge eating [BED]) and sleep duration. Stratified analyses assessed effect modification by DSs and gender.

Students reporting any eating disorder had no greater risk of not recommended sleep duration during weekdays compared to those with no eating disorder history (Adjusted OR = 0.99, 95% CI: 0.89-1.13). However, subjects reporting BED were at greater risk of deficient sleep during weekends compared to those with no EDs (Adjusted OR = 1.26, 95% CI: 1.01-1.58). This association was not impacted by DSs. However, all EDs were associated with not-recommended sleep duration among those who identified as other gender identity in comparison to those with no EDs.

Health educators should monitor academic performance in students with EDs for adequate sleep duration.

Improving care for SEED-AN patients is urgently needed. Current specialist eating disorder (SEDU) programs have minimal impact, resulting in poor quality of life. Flexible assertive community treatment (FACT) focuses on improving the quality of life of people with severe mental illness.

This study systematically examined professionals' and patients' experiences with existing care for SEED AN in two settings in two health districts in the Netherlands. Specifically, the specialised Eating Disorder Unit and FACT.

A qualitative approach was used: Twelve professionals participated in focus groups, and four professionals and six patients were interviewed individually. Reflective thematic analysis was used to analyse the data.

Four themes were constructed: "We feel ignorant in the treatment of SEED-AN patients"; "There is a disability to act"; "We are more than executive practitioners alone"; and "The professionals at FACT have given me back my confidence in treatment". The findings reflect how support for SEED-AN patients is provided by both FACT and SEDU professionals and how SEED-AN patients experience the FACT approach.

A resource group model promotes collaboration among professionals, patients and the patient's support system. The model is expected to increase knowledge about SEED-AN among stakeholders who support the quality of life of SEED-AN patients.

Eating disorders (EDs) have increasingly become a public health problem globally, especially among children and adolescents.

To estimate the burden of EDs in children and adolescents (ages 5-19 years) at the global, regional, and national levels.

Retrieved from Global Burden of Disease Study 2019 for EDs, including anorexia nervosa and bulimia nervosa, we extracted the disability-adjusted life years (DALYs) and prevalence rates with 95% uncertainty intervals between 1990-2019. The temporal trends of the DALYs and prevalence rates of EDs were assessed according to the estimated annual percentage changes.

In our study, we found that the burden of EDs continuously increased globally from 1990 to 2019. Although females accounted for more EDs cases, the burden of EDs in males had a greater increment. Meanwhile, the burden of EDs was associated with the high sociodemographic index (SDI) over the past 30 years and the human development indexes in 2019.

EDs, predominantly in high-income countries, are rising globally, especially in Asia, highlighting the need for resource planning and medical policy prioritization across all SDI quintiles.

Eating disorders comprise an array of mental disturbance with profound implications for individuals' psychophysical and societal well-being. Extensive research has elucidated the role of the Big Five personality traits in explaining individual differences in the risk of eating disorders, overshadowing alternative personality taxonomies, such as the Dark Triad - DT (i.e., Machiavellianism, psychopathy, and narcissism). Accordingly, the current study aimed to address the association between DT and the risk of eating disorders, also exploring the potential involvement of body uneasiness as captured in terms of weight phobia (fear of being or becoming fat), body image concerns (worries related to physical appearance), avoidance (body image related avoidance behaviors), compulsive self-monitoring (compulsive checking of physical appearance), and depersonalization (detachment and estrangement feelings towards one's own body). By using an online cross-sectional design, data were gathered from 419 participants. Results indicated that among the three dimensions of DT, only narcissism exhibited a positive correlation with the risk of eating disorders, while only weight phobia mediated this association. These findings yield theoretical implications extending the knowledge about the role of DT and body uneasiness in the risk of eating disorders. These results also have implications for tailoring prevention or treatment strategies to reduce the risk of eating disorders. Limitations and avenues for future research directions are discussed.

The prevalence and impact of obesity and overweight is one of the main concerns among researchers worldwide. There are several consequences of overweight and obesity among students in developing countries like Bangladesh. Therefore, this study aims to explore the prevalence and impact of overweight or obesity on individuals' self-esteem and academic performance among university students in Bangladesh.

This study is based on primary data that was collected from 600 students of Jahangirnagar University using a well-structured questionnaire. The questionnaire included demographic information, the Rosenberg Self-Esteem Scale (RSES), and the International Physical Activity Questionnaire (IPAQ-7). The summary statistics, the Fisher exact test, the Chi-square test, and the Pearson correlation matrix were computed. A logistic regression model assessed the relationship between low self-esteem and other variables such as demographic characteristics, BMI status, and physical activities.

The findings indicate that 38.2% of the students are overweight or obese, and the prevalence rate is high among males. The lowest academic performance across all disciplines is observed among obese students. A negative correlation is observed between BMI and self-esteem (r = -0.41) and academic performance is negatively linked with overweight or obese (r = -0.26) Results depict that overweight/obese students are 7.11 times more likely to have low self-esteem (AOR: 7.11, 95% CI: 4.59-11.02) compared to normal students.

Overweight and obese students are more prone to lower academic performance and low self-esteem, considering physical inactivity and irregular dietary patterns. Therefore, university authorities ought to encourage students to engage in physical activities and should create awareness among students about the beneficial effects of nutritious foods and the importance of physical exercise.

Eating disorders (EDs) are complex and often linked to traumatic childhood experiences. While childhood trauma is known to increase the risk of EDs, the role of loneliness remains underexplored. This study investigates whether loneliness mediates the relationship between childhood trauma and ED symptoms.

A total of 230 individuals with EDs completed the Childhood Trauma Questionnaire, the UCLA Loneliness Scale, and the Eating Disorders Examination Questionnaire. Mediation analysis was conducted to assess if loneliness mediates the relationship between childhood trauma and ED severity.

Childhood trauma significantly predicted higher levels of loneliness (p < 0.001), which was associated with more severe ED symptoms (p = 0.001), with age and BMI as covariates. Mediation analysis showed loneliness partially mediated the relationship between childhood trauma and ED severity (indirect effect b = 0.003, 95%CI [0.001, 0.006]).

Loneliness partially mediates childhood trauma and ED symptoms, highlighting the need to address loneliness in treatment to mitigate the impact of childhood trauma on ED severity. These findings suggest the possible role of social connection-focused interventions in ED care and contribute to understanding the mechanisms underlying the development of EDs. Future research should explore additional mediators and moderators to provide a more comprehensive perspective.

Sexual and gender minority (SGM) individuals show disproportionately high rates of mental distress relative to their cisgender, heterosexual peers resulting from minority stress, or unique identity-related stressors. The majority of research on minority stress and mental health in SGM individuals has focused on adults, a notable gap given that SGM youth face unique developmental factors that intersect with identity development and availability of support resources. SGM youth therefore represent a critical population for the mental health workforce to serve competently. Mental health providers risk significant harm to their SGM youth clients if they do not understand the mechanisms underlying mental health disparities in this population. This article will review treatment practices that carry the potential for harm with SGM youth, including harms that are more overt and attempt to change SGM identities (i.e., so-called "conversion therapies"), and others that are more covert, such as neglecting to consider SGM identity in conceptualization and treatment (e.g., eating disorders), pathologizing SGM identity and behaviors (e.g., personality disorders, social anxiety), and reinforcing stigma related to SGM identities (e.g., obsessive-compulsive disorder). Accordingly, this article reviews each of these potential harms in detail and provides alternative recommendations for affirming and justice-based treatment for SGM youth.

Eating disorders (EDs) have traditionally been studied among heterosexual cisgender women, but recent research highlights a higher prevalence in LGBTQIA+ individuals.

This study aims (1) to investigate the association between different groups based on gender identity and sexual orientation (GISO) and experiencing eating symptoms, and (2) to explore the extent to which self-perceived discrimination and adverse conditions explain this association.

We administered an online survey to assess eating symptoms using the Eating Disorder Examination Questionnaire (EDE-Q 6.0) and measures of self-perceived discrimination and adverse conditions. Multistep logistic regressions were employed to analyze the associations between GISO and eating symptoms, initially unadjusted, then adjusted for sociodemographic variables, and finally adjusted for self-perceived discrimination and/or adverse conditions.

A total of 560 adults aged 30 ± 10.9 years old were included. After adjusting for socio-demographics all groups were more likely to experience eating symptoms compared to heterosexual men, with odds ratios (ORs) of 5.7 [95% CI: 1.3, 24.3] for cisgender heterosexual women, 6.7 [95% CI: 1.5, 29.8] for cisgender non-heterosexual women, and 9.3 [95% CI: 1.8, 47.5] for non-cisgender individuals. After adjusting for self-perceived discrimination and adverse conditions, the associations for women were attenuated, while the associations for non-cisgender individuals were no longer significant.

This study (1) confirms that sexual and gender minorities may be at higher risk for EDs, and (2) suggests that discrimination and adverse conditions may contribute to the higher prevalence of eating symptoms in this population. Additional research is needed to investigate these minority stressors as they may represent targets for effective interventions to prevent eating symptoms in the LGBTQIA+ community.

Even though robust evidence suggests the high prevalence of eating disorders (EDs) in China, EDs in China are characterized by low diagnosis rates, delayed treatment-seeking, and ineffective treatments. Given that listening to patients' perspectives and lived experiences is crucial to improving our understanding of EDs in the Chinese context, an investigation of the perceived causes of EDs in Chinese individuals with EDs represents a key step in improving the prevention and treatment of EDs in China.

To explore the perceived causes of EDs based on data from a sample of Chinese social media users with self-reported EDs, with a particular focus on the Zhihu platform.

We extracted and analyzed data through content analysis. Eight specific causes that could be classified into two groups were coded, including individual factors (e.g., "body image and eating") and sociocultural factors (e.g., "media and cultural ideals").

A total of 2079 entries regarding self-reported EDs were retained for content analysis (14.7% were anorexia nervosa, 37.6% were bulimia nervosa, and 47.7% were binge-eating disorder). More than 90% of users with self-reported EDs claimed causes belonging to individual factors, while 35-51% of users claimed sociocultural factors. "Body image and eating" (68-87%) and "psychological and emotional problems" (65-67%) were the most commonly claimed specific causes, while "traumatic life events" (13-14%), "genetics and biology" (7-13%), and "sports and health" (9-12%) were the least claimed. Chi-square independent tests showed that users with different self-reported EDs disproportionately claimed certain causes.

Using large-scale social media data, findings provide a deeper understanding of the perceived causes of EDs in the Chinese context from individuals with self-reported EDs and highlight the variations in perceived causes across different self-reported ED types.

Affect regulation models posit that aversive affective states drive binge-eating behavior, which then regulates negative emotions. However, recent findings among individuals with binge-eating disorder (BED) suggest that food-related anticipatory processes may precede and potentially explain the negative affect thought to drive binge eating. Specifically, studies using ecological momentary assessment (EMA) demonstrate that the negative affective state of "Guilt" (from the Positive and Negative Affect Schedule) most strongly predicts later binge eating in the natural environment, and it has been hypothesized that planning a binge or feeling that a binge-eating episode is inventible may account for the increases in Guilt observed prior to binge episodes. In the present study, we tested the hypothesis that binge planning or inevitability may contribute to feelings of shame (a key facet of the broader Guilt construct), which then predict binge-eating episodes, using EMA in 43 individuals with BED. Consistent with hypotheses, feelings of binge inevitability and planning prospectively predicted binge-eating episodes. Further, binge planning predicted subsequent increases in shame. However, shame did not predict subsequent increases in binge planning. Finally, a mediation model revealed that binge planning (Time 1) predicted future binge eating (Time 3) directly and indirectly through increases in shame (Time 2). The results provide novel evidence that individuals with BED anticipate and actively plan for binge-eating episodes, and that binge planning may explain the increased shame/guilt typically observed before binge eating. Overall, accruing evidence suggests that negative affect, although predictive of binge eating, may be better conceptualized as a consequence of the anticipatory processes that lead to binge eating, rather than the starting point, at least among some individuals with BED. Future experimental research is needed to more conclusively test this hypothesis.

Students pursuing food-related academic fields such as dietetics have higher orthorexia nervosa (ON) tendencies and are at a greater risk of developing eating disorders (EDs). However, there is limited research available on ON tendencies and on the risk of EDs in the culinary arts field, which also revolves around food. The present study explored ON tendencies and the risk of EDs among culinary arts students and compared them with those of dietetics students.

A cross-sectional study was conducted in France, using the eating habits questionnaire (EHQ) to measure ON tendencies, and the SCOFF as well as the eating disorders examination questionnaire (EDEQ) to evaluate the risk of EDs and ED symptoms. The study also included questions about sports practice. In total, 267 students participated in the study, including 144 culinary arts students (51 women, 92 men and one other) and 123 dietetics ones (106 women, 15 men and two others).

Culinary arts students exhibited similar means of EHQ scores as dietetics ones (32.99 vs. 33.34) but higher SCOFF scores (52.8% vs. 39.8%). In addition, a gender difference was evidenced: women in culinary arts showed higher EHQ, SCOFF and EDEQ scores than men in culinary arts. Linear regression models showed no effect of the type of academic field (culinary arts vs. dietetics) on the EDEQ score but revealed effects of gender, body mass index and hours of sports practice.

The study emphasises the need to monitor culinary students and implement interventions to prevent EDs. It also suggests a correlation between food-related education and the risk of EDs, which requires further research.

Eating disorder treatment should be underpinned by a recovery-oriented approach, be therapeutic, personalised and trauma informed. Within such models of care, social support is an important factor to explore in terms of its influence in supporting hope for recovery, reducing stigma, and mitigating life stressors. Limited research has been conducted to understand the types of social support that are available to young people formally diagnosed with an eating disorder, their feasibility and acceptability and the positive outcomes. This integrative review sought to explore the positive outcomes of social support or social support programs for young people with eating disorders. An integrative review was conducted based on a search of five electronic databases from inception to 31 March 2023. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools and findings have been narratively synthesised and presented in accordance with the review's aims and questions. Seven studies (total 429 individuals, range 3-160) published between 2001 and 2023 were included in the final synthesis. Overall social support interventions showed promising preliminary evidence as a feasible and acceptable adjunct to treatment for young people with an eating disorder motivated to change, with some clinical improvements in psychopathology. Social support augmented existing relationships, providing a human element of open dialogue, friendship and a sense of hope for recovery. Despite the small number and heterogeneity of the studies, this review has highlighted some promising preliminary benefits. Future treatment for eating disorders should embrace adjunct modalities that enhance psychosocial recovery for young people with eating disorders.

Corticosteroids are extensively used in medicine for their powerful anti-inflammatory and immunosuppressive effects. However, their psychiatric side effects-such as mood disturbances, anxiety, and psychosis-are significant yet often underappreciated. This review provides a comprehensive exploration of corticosteroid-induced psychiatric disorders, with a focus on their underlying mechanisms and clinical implications. We examine how corticosteroids influence the hypothalamic-pituitary-adrenal (HPA) axis, leading to the dysregulation of stress responses and alterations in neurotransmitter levels, particularly dopamine, serotonin, and glutamate. These changes are linked to structural abnormalities in key brain areas such as the hippocampus and amygdala, which are implicated in mood and anxiety disorders, psychosis, and conditions like post-traumatic stress disorder (PTSD) and eating disorders. This review highlights the need for healthcare providers to be vigilant in recognizing and managing corticosteroid-induced psychiatric symptoms, especially in vulnerable populations with pre-existing mental health conditions. The complex relationship between corticosteroid type, dose, duration, and mental health outcomes is explored, emphasizing the importance of personalized treatment approaches to mitigate psychiatric risks. Given the widespread use of corticosteroids, there is an urgent need for more focused research on their psychiatric side effects. This review underscores the importance of patient education and careful monitoring to ensure optimal therapeutic outcomes while minimizing mental health risks associated with corticosteroid therapy.

Disordered eating behaviors (DEBs) and nonsuicidal self-injury (NSSI) frequently co-occur in university students, yet what underlies this co-occurrence remains unknown. Network analysis was used to identify psychosocial correlates that may link DEBs and NSSI in university students and test whether networks were similar across gender.

Four hundred and seventy college women and 473 college men (aged 18-25 years).

Participants completed online questionnaires. Networks were estimated for men, women, and a combined sample.

The networks for men and women were invariant. The most central nodes in the combined network were difficulties in emotion regulation and body dissatisfaction. Interoception and difficulties in emotion regulation were directly associated with past-month NSSI and strongly associated with body dissatisfaction, linking DEBs and NSSI in the network.

Difficulties in emotion regulation, interoception, and body dissatisfaction may play critical roles in the comorbidity of DEBs and NSSI in university students.

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.

Feasibility was assessed using numbers participating, questionnaire completion in patients and parent/carers completing and declining participation, a researcher implementation record and clinical measures. Subjects included adolescents aged 12-17 years with AN. The study was conducted over a 12-week period, with the intervention group receiving 5 mg of L-tyrosine supplement and the control group receiving a placebo.

Recruitment targets were not met and recruitment to a full RCT based on the current study protocol and recruitment sites did not prove feasible. Of the 39 approached for RCT participation, seven were recruited to the RCT (18% response rate) despite extending recruitment periods, with 100% retained and analysed. Patients or parents/carers identified barriers to study participation including burden, the need to consume tyrosine as tablets, and the use of blood, urine and psychological testing. Blood tyrosine rose markedly for subjects in the intervention group. No side effects were reported or measured.

This study offers a unique exploration of the feasibility of a tyrosine trial in anorexia nervosa and is of relevance to assist the success of future nutrition trials. Exploring the suitability of future study designs for nutrition intervention research is warranted.

Gender is a socially constructed concept influenced by social practices, norms, and expectations. The impact of gender differences on mental health has been long recognized, with consequences such as over-diagnosis and pathologization or under-diagnosis of some disorders depending on gender. This also has implications for the treatments that each gender receives. In this narrative review, we will analyze (a) the gender differences in the prevalence of mental disorders, (b) the explanations for gender differences in mental health, including biological, social constructionist, and sociocultural risk factors, and (c) the gender differences in the treatment of mental disorders, including differences in health-seeking behavior and treatment outcomes. Overall, there is a consistent pattern of differences in prevalence, with women more likely to have internalizing disorders (e.g., anxiety or depression) and men more likely to have externalizing disorders (e.g., antisocial personality or substance use). The explanations aimed at disentangling the reasons for these gender differences are complex, and several approaches should be considered to achieve a comprehensive explanation. In addition to biological factors (e.g., hormonal changes), social constructionist factors (e.g., biased diagnostic criteria and clinicians' gender bias) and sociocultural factors (e.g., feminization of poverty, gender discrimination, violence against women, and prescriptive beauty standards) should be considered. Future studies in the field of mental health should consider gender differences and explore the bio-psycho-socio-cultural factors that may underlie these differences.

Objective: The present experimental study assessed college students' ability to recognize an eating disorder across various body weights. Participants: Undergraduate students (N = 428) from a midsized public university. Methods: Participants completed an online questionnaire and were randomized to read one of four vignettes describing a woman with anorexia nervosa symptoms who was underweight, average weight, overweight, or obese. Participants completed a survey to assess body image, eating concerns, and ability to recognize an eating disorder. Results: Results showed participants in the underweight condition were significantly more likely to correctly identify an eating disorder (adjusted residual = 2.5) and showed fewer incorrect identifications than would be expected (adjusted residual = -2.5). In the underweight condition, 83.78% correctly recognized an eating disorder, followed by average weight (76.84%), obesity (69.16%), and overweight (68.89%). Conclusions: College students may have a harder time recognizing an eating disorder in someone with a higher body weight.

Access to psychological health care is extremely difficult, especially for individuals with severely stigmatized disorders such as eating disorders (EDs). There has been an increase in children, adolescents, and adults with ED symptoms and ED, especially following the COVID-19 pandemic. Computer-based self-help platforms (± associated apps) allow people to bridge the treatment gap and receive support when in-person treatment is unavailable or not preferred.

The aim of this systematic review is to evaluate the effectiveness of computer-based self-help platforms for EDs, some of which may have associated apps.

The proposed systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. This review will report and evaluate the literature concerning the efficacy of self-help platforms for EDs. Articles were obtained from the Ovid MEDLINE, Embase, Global Health, and APA PsycInfo. The inclusion criteria included research with original data and gray literature; research evaluating the efficacy of web-based psychoeducational self-help platforms for EDs; people with an ED diagnosis, ED symptoms, at risk of developing EDs, or from the general population without ED-related behaviors; pre- and post-computer-based ± associated apps intervention clinical outcome of ED symptoms; pre- and post-computer-based ± associated apps intervention associated mental health difficulties; and literature in English. The exclusion criteria were solely guided self-help platforms, only in-person interventions with no computer-based ± associated apps comparison group, only in-person-delivered CBT, self-help platforms for conditions other than eating disorders, systematic reviews, meta-analyses, posters, leaflets, books, reviews, and research that only reported physical outcomes. Two independent authors used the search terms to conduct the initial search. The collated articles then were screened by their titles and abstracts, and finally, full-text screenings were conducted. The Cochrane Risk of Bias 2 tool will be used to assess the risks of bias in the included studies. Data extraction will be conducted, included studies will undergo narrative synthesis, and results will be presented in tables. The systematic review will be submitted to a peer-reviewed journal.

The authors conducted a database search for articles published by May 31, 2024. In total, 14 studies were included in the systematic review. Data charting, synthesis, and analysis were completed in Microsoft Excel by the end of July 2024. Results will be grouped based on the intervention stages. The results are expected to be published by the end of 2024. Overall, the systematic review found that computer-based self-help platforms are effective in reducing global ED psychopathology and ED-related behaviors.

Self-help platforms are helpful first-stage resource in a tiered health care system.

PROSPERO CRD42024520866; https://tinyurl.com/5ys2unsw.

DERR1-10.2196/60165.

Current treatments for adolescents with eating disorders (ED) show limited effectiveness, emphasizing the need for enhanced therapeutic approaches. Cognitive behavioral therapy (CBT) has emerged as a potential alternative. A derivative of this approach, group cognitive behavioral therapy (G-CBT), has been shown to reduce treatment costs and increase treatment accessibility when compared to CBT. This program evaluation aimed to assess the effectiveness of G-CBT in adolescents and young adults diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and experiencing comorbid anxiety and depression within a Canadian mental health facility. The specific objectives were to determine if participants increased their knowledge about eating normalization and coping strategies after participating in the eating disorder (ED) treatment program and examine if participants experienced changes in eating-disordered behavior, anxiety, and mental health.

We conducted a program evaluation using secondary data collected at admission and discharge from 44 adolescents and young adults (16-39 years) with AN or BN participating in the ED program at a Canadian health center. Outcome measures were eating psychopathology, depression, anxiety, and illness cognitions assessed using validated tools: Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Illness Cognition Scale (ICS).

The mean age of participants was 24.1 years (standard deviation (SD) = 5.8). All outcome measures showed statistically significant improvement from admission to discharge (p < 0.001). Specifically, subscales of the EDE-Q (eating concern, weight concern, shape concern, and restraint) and the global score indicated a significant reduction in ED behaviors (p < 0.001).

Findings suggest that G-CBT is effective in reducing eating-disordered behavior, depression, anxiety, and maladaptive illness cognitions in adolescents and young adults with EDs. These results underscore the potential of G-CBT to address both behavioral and psychological aspects of ED recovery, although further studies with control groups are warranted to confirm these findings.

Eating disorders (ED) are characterized by serious and persistent disturbances with eating, weightcontrol, and body image. Symptoms impact physical health, psychosocial functioning, and can be life-threatening. Individuals diagnosed with an ED experience numerous medical and psychiatric comorbidities due to issues caused by or underlying the ED. Therefore, it is vital to address the complex nature of an ED, as well as the comorbid and underlying issues. This necessitates a psychotherapeutic approach that can help to uncover, explore, and support working through unresolved emotions and experiences. Guided Imagery and Music (GIM) is an in-depth music psychotherapy approach utilizing therapist-programmed music to support the client in uncovering and examining underlying and unresolved issues. The literature surrounding the use of GIM with clients in ED treatment is anecdotal and comprised primarily of clinical case studies.

This secondary analysis, based on a descriptive feasibility study that integrated GIM sessions into the client's regular ED treatment and examined 116 transcripts from a series of sessions of eight clients.

Thematic analysis of the transcripts identified nine subthemes and three themes that emerged. These themes include emotional landscape (feeling stuck, acknowledging emotions, and working through unresolved emotions), relationships (self, others, and eating disorders), and transformation and growth (finding strength, change, and empowerment). A short series of GIM sessions helped ED clients identify and address issues underlying the ED and to gain or reclaim a sense of self that enabled them to make choices for their life that support their recovery and sense of empowerment. Intertextual analysis revealed imagery indicative of the Hero's Journey.

Further, how engagement in this embodied aesthetic experience stimulates perceptual, cognitive, and affective brain functions which are key in fostering behavioural and psychological change is explicated as it relates to ED treatment and recovery.

Anorexia nervosa is a complex mental disorder that has severe physical and psychological consequences, often requiring hospitalisation, and in the most severe cases, patients receive coercive treatment. Among the various nursing tasks associated with encountering these patients, the administration of nasogastric tube feeding under restraint stands out. It is crucial to recognise and address the unique practical and ethical challenges nurses face when caring for adults struggling with severe anorexia nervosa. The aim of the study was to gain a deeper understanding of registered nurses' experience of nasogastric tube feeding under restraint in hospitalised patients with severe anorexia nervosa.

A naturalistic design guided this study. Narrative interview data were analysed using reflexive thematic analysis. The participants were twelve registered nurses recruited from an inpatient ward for adult patients with an eating disorder in a Norwegian psychiatric hospital.

Three main themes were developed: providing good nursing care during coercive treatment; having ethical concerns about nasogastric tube feeding under restraint when the patient reaches a body mass index that is not immediately life-threatening; and having concerns about involving personnel from another ward in the nasogastric tube feeding under restraint procedure.

Nurses find nasogastric tube feeding under restraint to be part of life-saving nursing for patients with severe anorexia nervosa. It raises ethical concerns, especially with patients with a body mass index that is no longer life-threatening. Our results demonstrate the vulnerability of nurses as well as the difficulties and ethical dilemmas of nursing during nasogastric tube feeding under restraint.

Evidence on how persons with and in remission from an eating disorder experience their oral health is limited. Dental treatment in Sweden today is often postponed until medical rehabilitation has been completed, but this carries risks. For the patient, the risk is severely impaired oral health and additional suffering, and for both society and the patient, higher costs than might have been necessary.

Ten female informants aged 21-51 years (mean age = 36.7, standard deviation 12.7) in remission from an eating disorder with a median duration of 12.5 (range 4-25) years of illness, were questioned in semi-structured interviews about their perceptions of oral health. All participants had been referred to a specialist dental clinic and needed oral rehabilitation. 10% of the patients had been diagnosed with anorexia nervosa and 90% with bulimia nervosa. All had been in remission from the eating disorder for at least one year. Transcripts of the interviews were analyzed with thematic analysis using an inductive approach.

One overarching theme emerged from the analysis: dental damage persisted as a visible, lingering scar during remission of the eating disorder, reminiscent of the disease and its consequences. The three major themes identified were (1) Physical impact, (2) Psychological impact, and (3) Impact on daily living. The first major theme included erosive tooth wear and impaired oral function and aesthetics. Interviewees described the second as feelings of stigma, guilt, shame, anxiety, and worry, in particular concerning self-inflicted dental damage through self-induced vomiting. The last major theme covered avoidance strategies such as limiting smiling and laughing and minimizing social situations such as eating with others, pursuing a wanted career, and meeting a partner.

The participants in this study expressed a profound negative impact on daily life and a two-fold burden of stigma of having suffered from both an eating disorder and poor oral health.

Only one in four individuals with eating disorders (EDs) seek help, with many barriers to treatment-seeking present. Placing an early intervention model in primary mental health care settings is one approach to reducing these barriers. To date, only one model (emerge-ED) has been evaluated in the literature.

We aimed to replicate findings from the initial emerge-ED evaluation. We report on treatment outcomes in a new cohort and their views on barriers to treatment-seeking. We then examine how this early intervention model in primary health care has evolved to overcome the barriers to treatment delivery cited by health professionals in the initial evaluation.

Eighty participants commenced treatment between July 2020 and March 2022 and completed a mean of 8.98 sessions, 70 (87.5%) completed >1 sessional measure on ED cognitions and behaviours, but only 31% (n = 24) completed lengthier assessments. Findings replicated initial emerge-ED outcomes, with small to moderate effect size decreases in the ED sessional measure at 70 days since treatment commencement for cognitions (d = .63) and ED behaviours (d = .09., .69). The most cited barrier by participants was "belief that my problem is not bad enough", reflective of denial of illness. Lastly, to overcome barriers to treatment delivery clinicians had to deviate from treatment protocols and work collaboratively with other healthcare providers.

Our findings replicated the initial emerge-ED evaluation and highlight the importance of considering primary health care settings as an essential site in delivering early intervention services for EDs.