Journal of Eating Disorders最新文献

{"title":"Improvements in sleep, weight, and eating-disorder symptoms following off-label leptin treatment in an adolescent with chronic anorexia nervosa and insomnia: a case report.","authors":"Alexander Dück, Hang Zhu, Judith Melinat, Monika Kruzer, Christoph Berger, Michael Kölch, Martin Reinhardt, Hannes Brehme, Annelie Zimmermann, Linda Frintrop, Olaf Reis","doi":"10.1186/s40337-026-01748-x","DOIUrl":"10.1186/s40337-026-01748-x","url":null,"abstract":"<p><p>We report off-label administration of human recombinant leptin (metreleptin) over a 12-day period in a 17-year-old female adolescent with chronic anorexia nervosa (AN) and clinically significant insomnia. Two observation windows are distinguished throughout: a short-term window between day 1 (pre) and day 12 (post) of dosing, and a longer-term window between day 12 and the two-month follow-up (d + 60), capturing both changes temporally associated with leptin administration and the course of continued weight gain after the end of dosing. Over the short-term window the clinical course comprised a modest weight gain (BMI 15.4 → 16.2 kg/m²), a marked reduction in eating-disorder cognitions and compulsive exercise, attenuation of starvation-associated motor hyperactivity, and changes in objective sleep architecture (more N3 sleep, less wake after sleep onset). In this window, broader cognitive-affective and depressive symptom dimensions remained largely unchanged, and subjective insomnia did not yet improve. Over the longer-term window the course comprised continued substantial weight gain (BMI 18.3 kg/m² at d + 60), a marked drop in subjective insomnia, partial normalisation of circadian rhythm parameters in nonparametric analysis, and a transient increase in broader cognitive-affective symptoms. As a single retrospective case observation, the findings are hypothesis-generating and cannot be disentangled from concurrent weight gain and inpatient treatment.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maladaptive exercise: the hidden role of physical activity and sport professionals in the early detection of eating disorders.","authors":"Valerio Zaccaria, Fabiola Panvino, Roberto Paparella, Maura Ilardi, Dolores Forgione, Ignazio Ardizzone, Francesco Pisani","doi":"10.1186/s40337-026-01742-3","DOIUrl":"10.1186/s40337-026-01742-3","url":null,"abstract":"<p><p>Eating disorders (EDs) are a significant public health concern, particularly among adolescents and young adults. While physical activity (PA) is generally health-promoting, maladaptive exercise, characterized by compulsive and excessive activity linked to weight control, is often a core feature of ED pathology. Despite the high prevalence of these conditions, early identification remains a critical challenge, as most cases are detected only after severe organic or psychiatric complications. PA and sport professionals, such as personal trainers and coaches, are uniquely positioned to observe early warning signs due to their frequent direct contact with at-risk individuals. This Comment, developed within the European ERASMUS+ Sport project \"My Fit Friend\", proposes a practical framework for equipping PA and sport professionals with tools for early detection in youths aged 11-18 years, including a structured observational diary and simulation-based training using avatar interactions. These tools allow those professionals to act as \"informed sentinels\", identifying fractures in global functioning and facilitating timely referrals while maintaining clear professional boundaries. We argued that integrating standardized educational interventions and observational tools into European sport policy is pivotal to bridge the gap between the gym floor and clinical intervention, transforming recreational settings into protective environments for youth mental health.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of universal secondary school-based interventions addressing the psychological risk factors of eating disorders in adolescents: a systematic review.","authors":"Melissa Stock, Robyn Murphy, Joanna Adams","doi":"10.1186/s40337-026-01712-9","DOIUrl":"10.1186/s40337-026-01712-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of universal secondary-school interventions targeting core eating disorder (ED) psychopathology and at least one additional psychological risk factor.</p><p><strong>Method: </strong>A systematic search of databases was conducted, including Scopus, CINAHL, Embase, PsycINFO, MEDLINE and Google Scholar in March 2025. Eligible randomised controlled trials (RCTs) reported quantitative outcomes (e.g., ED psychopathology, body dissatisfaction, dieting behaviors) following universal secondary-school interventions addressing weight, shape, or eating concerns and another psychological risk factor in non-clinical adolescents aged 11-18. Results were synthesized narratively, and study quality was evaluated using the Cochrane Risk of Bias (RoB-2).</p><p><strong>Results: </strong>Seventeen RCTs were included. Eleven studies were conducted in Europe, most participants were female and in middle adolescence. Overall, most universal school-based ED interventions produced some immediate improvement in ED symptoms or well-being but effects were generally small or rarely sustained at follow-up. There were no significant changes in BMI. However, the high risk of bias limits the confidence of findings.</p><p><strong>Discussion: </strong>These improvements were short term, and their effects were mostly small. Future research would benefit from adopting active comparison groups and longer follow-ups. Whilst core ED psychopathology in addition to the risk factors of body image dissatisfaction, dieting, self-esteem, and social media appear consistent factors to include in universal interventions, further understanding of the most effective risk factors to target in this population is needed.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restrictive eating patterns in older adulthood: avoidant/restrictive food intake disorder symptoms and related factors.","authors":"Arda Bağcaz, Beren Özel, Selvi Ceran","doi":"10.1186/s40337-026-01733-4","DOIUrl":"10.1186/s40337-026-01733-4","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to examine the frequency of probable Avoidant/Restrictive Food Intake Disorder (ARFID), restrictive eating patterns, and their associations with mood and anxiety symptoms, chemosensory pleasure, and demographic factors among community-dwelling Turkish older adults.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted with 118 adults aged ≥ 65 years. Participants completed the Nine-Item ARFID Screen (NIAS), the Chemosensory Pleasure Scale (CPS), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Eating Attitudes Test-26 (EAT-26). Probable ARFID was identified using established NIAS subscale cutoffs (picky eating ≥ 10, low interest/appetite ≥ 9, or fear of aversive consequences ≥ 10) after excluding participants with probable weight/shape-related eating disorders based on EAT-26 scores (≥ 20). Comparisons between participants with probable ARFID and the non-ARFID group, as well as correlation analyses between NIAS scores and behavioral, affective, and sensory variables, were performed.</p><p><strong>Results: </strong>Across the whole sample, NIAS scores were negatively correlated with body mass index (BMI) (r = - 0.239, p = 0.011) and pleasure associated with natural odors (r = - 0.353, p < 0.001) but not with mood/anxiety symptoms. Prevalence of probable ARFID was 13.3%. Individuals with probable ARFID had a significantly lower BMI than those in the non-ARFID group (t = 2.750, p = 0.007, Cohen's d = 0.79). The proportion of participants living alone was significantly higher in the probable ARFID group than in the non-ARFID group (χ² = 5.814, p = 0.016, Cramer's V = 0.24).</p><p><strong>Conclusion: </strong>A probable ARFID prevalence of 13.3% suggests that restrictive eating patterns consistent with ARFID are not uncommon among community-dwelling older adults. In addition, NIAS scores were associated with reduced chemosensory pleasure but not with depression or anxiety symptoms. These results may suggest that factors contributing to probable ARFID in older adults differ from those typically reported in younger populations. Overall, the findings highlight the need for improved screening of ARFID symptoms and further investigation of age-specific mechanisms underlying restrictive eating in later life.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of untreated illness in eating disorders: a comprehensive systematic review and meta-regression.","authors":"Gyselle de Geus, Mike Trott, Alessio Maria Monteleone, Joseph Firth, Dan Siskind, Scott Teasdale, Urska Arnautovska, Ravi Iyer, Brendon Stubbs, Natasha Demidenko, David Martin, Ruxandra Antochi, Jess G Fiedorowicz, Amelia Austin, Ulrike Schmidt, Tracey Wade, Fernando Fernandez-Aranda, Beate Herpertz-Dahlmann, Hans W Hoek, Ulrich Voderholzer, David Kolar, Stephan Zipfel, Kathleen M Pike, Andreas Karwautz, Stephen Wonderlich, Lee Smith, Marco Carfagno, Marco Solmi","doi":"10.1186/s40337-026-01731-6","DOIUrl":"https://doi.org/10.1186/s40337-026-01731-6","url":null,"abstract":"<p><strong>Introduction: </strong>Eating disorders (EDs) substantially impair physical health, psychological well-being, and social functioning. Shorter untreated illness duration has been proposed to be associated with better outcomes, though evidence for this relationship remains mixed. Nonetheless, delays in accessing treatment remain common and contribute to prolonged suffering and risk of lasting harm. This study aimed to estimate the duration of untreated eating disorder (DUED) and examine potential moderators.</p><p><strong>Methods: </strong>A PRISMA 2020-compliant systematic review and meta-analysis was conducted. Searches were performed from inception to March 2026 in PubMed, Embase, PsycINFO, and CINAHL. Random-effects models were used to estimate pooled DUED of available studies, with subgroup and meta-regression analyses to explore moderators. Study quality and risk of bias were assessed using National Institutes of Health (NIH) tools.</p><p><strong>Results: </strong>Of 2,776 records identified, 29 studies (n = 17,433) were included. The pooled DUED of available studies was 21.9 months (95% CI 18.0-25.8), with substantial heterogeneity (I² = 99.7%). In subgroup analyses, DUED was longer in bulimia nervosa than anorexia nervosa (41.5 vs. 19.9 months). Meta-regression identified mean age as a significant moderator (β = 1.91, 95% CI 1.1 to 2.7, p < 0.001), indicating longer delays in older individuals. DUED also differed across country, continent, age group, and study design, while decade subgroup estimates were lower in studies from the 2020s than the 2010s.</p><p><strong>Conclusion: </strong>Individuals with EDs experience substantial delays before accessing treatment, with untreated illness exceeding 20 months on average. Older age was associated with longer DUED, suggesting potential gaps in detection and help-seeking among adults. DUED varies across demographic, geographic and methodological factors. While decreasing DUED over time is encouraging, these findings highlight the need for earlier identification and streamlined care pathways to reduce delays and improve outcomes in people with ED.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of blood parameters and body weight during inpatient treatment of anorexia nervosa with extreme underweight.","authors":"Eva P Wuttke, Adrian Meule, Ulrich Cuntz, Ulrich Voderholzer","doi":"10.1186/s40337-026-01734-3","DOIUrl":"10.1186/s40337-026-01734-3","url":null,"abstract":"<p><strong>Background: </strong>Laboratory parameters and body weight are objective markers of physical stability in patients with severe and extreme anorexia nervosa. However, systematic analyses of trajectories during inpatient treatment with high-calorie refeeding and prophylactic phosphate supplementation remain limited in extremely underweight persons. Therefore, it is essential to gain a comprehensive understanding of changes in laboratory parameters, body mass index, and factors influencing these trajectories under this treatment approach in patients with severe and extreme anorexia nervosa, who are at particularly high risk of medical complications.</p><p><strong>Methods: </strong>Retrospective data of a six-week treatment period from 519 female inpatients of a specialized care unit with anorexia nervosa (body mass index at admission: M = 12.6 kg/m², SD = 1.35) were analyzed. Laboratory parameters (hemoglobin, thrombocytes, leukocytes, aspartate aminotransferase, alanine aminotransferase, creatine kinase, sodium, potassium, and phosphate) and body weight were assessed weekly.</p><p><strong>Results: </strong>More than one-third of patients showed leukopenia or hypertransaminasemia at admission. Most laboratory values and body mass index tended to ameliorate during the six-week treatment period. Lower body mass index at admission or longer illness duration was associated with larger changes in body mass index and several laboratory parameters (e.g., hemoglobin or aspartate aminotransferase).</p><p><strong>Conclusions: </strong>These findings provide a detailed characterization of laboratory changes during inpatient refeeding with prophylactic phosphate supplementation. The observed temporal patterns of laboratory stabilization may help inform individualized monitoring strategies and provide a basis for evaluating whether the frequency of routine laboratory testing can be tailored over a longer course of treatment according to clinical status and resolution of previous abnormalities. Furthermore, these findings may support the effectiveness and safety of inpatient refeeding protocols with prophylactic phosphate supplementation in patients with severe and extreme anorexia nervosa and an extremely low body mass index at admission (< 13 kg/m²).</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Turkish parent-reported Diabetes Eating Problem Survey-Revised (DEPS-R) for screening disordered eating behaviors in adolescents with Type 1 diabetes.","authors":"Neslihan Arslan, Feride Ayyıldız, Emine Yassıbaş, Kübra Esin, Elvan Bayramoğlu, Hande Turan, Olcay Evliyaoğlu, Didem Güneş Kaya","doi":"10.1186/s40337-026-01735-2","DOIUrl":"10.1186/s40337-026-01735-2","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with Type 1 diabetes are at increased risk of eating disorders, which have been associated with suboptimal metabolic control and an increased risk of complications. Reliable and culturally adapted screening tools are essential for early identification. However, the parent-reported version of the Diabetes Eating Problem Survey-Revised (DEPS-R) has not yet been validated in Turkish; therefore, this study aimed to evaluate its validity and reliability in adolescents aged 10-17 years years with type 1 diabetes.</p><p><strong>Methods: </strong>This methodological validation study included 96 adolescents (45 boys, 51 girls) aged 10-17 years with Type 1 diabetes and their parents. Linguistic and cultural adaptation procedures were conducted in accordance with standard cross-cultural validation guidelines. Parents completed the parent-reported DEPS-R and the Problem Areas in Diabetes-Parents of Teens (P-PAID-T). Adolescents completed the self-reported DEPS-R. Construct validity was assessed using correlation analyses. Exploratory and confirmatory factor analyses were performed to evaluate structural validity. Internal consistency was assessed using Cronbach's alpha, and test-retest reliability was examined using intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>The parent-reported DEPS-R demonstrated good internal consistency (Cronbach's α = 0.852; McDonald's ω = 0.851) and good test-retest reliability (ICC = 0.83), with a strong correlation between the two administrations (r = 0.89). Exploratory and confirmatory factor analyses supported a single-factor structure and demonstrated with acceptable model fit (χ²/df = 1.629; RMSEA = 0.080; CFI = 0.874; TLI = 0.848). Parent-reported DEPS-R scores were correlated with self-reported DEPS-R scores (r = 0.506, p < 0.001) and P-PAID-T scores (r = 0.458, p < 0.001), supporting construct validity. A positive correlation was also observed between duration of diabetes and DEPS-R scores (r = 0.223, p = 0.029). No significant associations were observed between DEPS-R scores and metabolic indicators, including HbA1c, ketoacidosis episodes, or diabetes-related hospital visits.</p><p><strong>Conclusion: </strong>The Turkish parent-reported DEPS-R is a valid and reliable instrument for screening disordered eating behaviors in adolescents with Type 1 diabetes. Its use in both clinical and research settings may facilitate early detection and improve understanding of the relationship between eating behaviors and metabolic outcomes in this high-risk population.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness without safety: a response to Duggan, Hardy, and Waller (2026).","authors":"Laurence Cobbaert","doi":"10.1186/s40337-026-01732-5","DOIUrl":"10.1186/s40337-026-01732-5","url":null,"abstract":"<p><p>This commentary responds to Duggan, Hardy, and Waller's systematic review and meta-analysis of cognitive-behavioural therapy (CBT) for outpatients with anorexia nervosa (AN). Although the review synthesises evidence of clinical benefit, it does not define, extract, or discuss iatrogenic harm or reasons for dropout. This omission limits what can be inferred from the review's conclusions. Effectiveness and safety are distinct evidentiary domains: improvement in weight or eating disorder (ED) symptoms does not demonstrate absence of iatrogenic harm, especially when clinical trials have not systematically defined, monitored, or reported treatment-related risks. Evidence-based care requires not only evidence of effectiveness, but also evidence about safety. This commentary argues that evidence syntheses may produce an unduly favourable account of treatment impact when they quantify and emphasise benefit without equivalent attention to iatrogenesis, weakening informed consent and obscuring patient-reported experiences that may not be captured by symptom or weight outcomes alone. The paper considers methodological, clinical, ethical, epistemic, and intersectional implications of this asymmetry. It recommends that future ED clinical trials and systematic reviews evaluate benefit and harm together, undertake balanced assessments of benefits versus risks, use clearer harm definitions and patient-reported measures, report reasons for dropout, assess longer-term outcomes, and involve lived experience contributors substantively in study design, interpretation, and translation.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A descriptive study of patients' and families' experience of multifamily therapy for eating disorders in young adults.","authors":"Berit Støre Brinchmann, Anne Kristine Sørstrøm, Lisa Marie Jacobsen, Gro Anita Ytterstad, Laurent Olivier Trichet","doi":"10.1186/s40337-026-01730-7","DOIUrl":"https://doi.org/10.1186/s40337-026-01730-7","url":null,"abstract":"<p><strong>Background: </strong>Eating disorders (EDs) have profound consequences not only for affected individuals but also for their families. While multifamily therapy (MFT) is well established for children and adolescents with an ED, less is known about its relevance and impact for young adults and their families. This study aimed to explore and describe experiences and outcomes of a MFT programme for young adults with a severe ED, and their family members.</p><p><strong>Methods: </strong>A descriptive multi-method design was used, combining qualitative and quantitative data collected at a regional specialist centre in Norway. Qualitative data consisted of group and individual interviews with young women with an ED, and family members who had participated in MFT between 2012 and 2022. Reflexive thematic analysis was applied. Quantitative data were collected from 47 young adult women and 99 family members before and after the MFT programme, using validated measures of ED psychopathology, mental health, quality of life, and family functioning. Descriptive and pre-post analyses were conducted.</p><p><strong>Results: </strong>Qualitative findings generated two overarching themes: \"Knowledge and tools for understanding\" and \"Understand and be understood\". Participants described MFT as providing experiential learning, shared language, and concrete metaphors that enhanced insight into the illness and improved family communication. Quantitatively, patients reported reduced body shape concern, hostility, and trait anxiety, as well as increased satisfaction with their environment. Family members reported significantly reduced perceived burden, guilt, and need for accommodation, alongside lower levels of state anxiety following MFT.</p><p><strong>Conclusions: </strong>Findings suggest that MFT may offer meaningful benefits for both young adults with an ED and their families by strengthening understanding, communication, and emotional coping. The study extends existing evidence by highlighting the relevance of MFT beyond adolescence and underscores the importance of family-oriented interventions for young adults with a severe ED.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of peer and media pressure on muscle dysmorphia for men and women in the general German population is mediated by the internalization of muscularity ideals.","authors":"Marietta Lieb, Christopher Zaiser, Nora M Laskowski, Georg Halbeisen, Georgios Paslakis","doi":"10.1186/s40337-026-01718-3","DOIUrl":"10.1186/s40337-026-01718-3","url":null,"abstract":"<p><strong>Background: </strong>Muscle dysmorphia (MD) is characterized by an excessive concern of not being muscular enough. Sociocultural influences appear to play a central role in the internalization of muscular beauty ideals and the development of MD. No study has examined the potential mediating pathways from sociocultural pressure sources through internalized beauty standards to an algorithm-defined MD diagnosis in the general German population.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among adults (≥ 18 years) in Germany via the Online Platform Prolific^®. Participants completed standardized questionnaires assessing sociocultural influences and internalization of different beauty standards (SATAQ-4R) and a clinically algorithm-defined MD, operationalized using criteria by Pope et al. [4], following the approach described by Mitchison et al. [14]. Data were weighted to approximate representativeness for the German population across the key demographics age and gender.</p><p><strong>Results: </strong>In the total sample, a binary logistic regression indicated that internalization of the beauty standards Thin/Low body fat, Muscularity, and General Attractiveness significantly predicted algorithm-defined MD, whereas sociocultural pressure sources such as Family, Peers, Significant Others, and Media were not significant. In linear regression models, Media pressures predicted all forms of internalization, while Peer pressure predicted only Muscularity internalization. Mediation analyses indicated that internalization, particularly internalization of ideals of Muscularity, significantly mediated the relationship between Media and Peer pressures and algorithm-defined MD. Gender-specific analyses also showed Muscularity internalization as the key mediator for both men and women. In men, internalization of General Attractiveness ideals additionally mediated the relationship between Media pressure and MD. In women, only Family had a significant effect on algorithm-defined MD, mediated via Muscularity Internalization.</p><p><strong>Discussion: </strong>Our findings highlight that internalization, particularly of the Muscularity ideal, appears to be a core mechanism linking sociocultural pressures to algorithm-defined MD. These results provide empirical evidence that interventions for MD need to focus on modifying internalized appearance ideals, especially the Muscularity ideal, to reduce MD symptoms in both men and women, with additional attention to General Attractiveness internalization in men.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"14 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}