International Journal of Eating Disorders最新文献

{"title":"Weight Trajectories During Inpatient Treatment for Anorexia Nervosa: A Dynamic Time Warp Analysis.","authors":"Marianne Tokic, Georg Halbeisen, Karsten Braks, Thomas J Huber, Nina Timmesfeld, Georgios Paslakis","doi":"10.1002/eat.24573","DOIUrl":"https://doi.org/10.1002/eat.24573","url":null,"abstract":"<p><strong>Background: </strong>Restoring weight is a primary goal during anorexia nervosa (AN) treatment. Previous studies linked different weight gain profiles to treatment outcomes, but there is currently no consensus on profile shapes and numbers. We argue that heterogeneity stems from temporal distortions (\"warping\") in weight gain, and that similar weight improvements can stretch over different time periods. We thus favor a novel non-parametric solution that accounts for warping to identify weight trajectories.</p><p><strong>Method: </strong>Time series clustering with dynamic time warping (DTW) was used to identify weight change trajectories among N = 518 patients with AN during inpatient treatment. Within-person body-mass-index gain (∆ BMI) served as our primary dependent variable to identify clusters. We characterized clusters based on admission psychopathology scores, and analyzed associations of cluster affiliation with changes in clinical outcomes between admission and discharge using linear and logistic models.</p><p><strong>Results: </strong>We identified four distinct clusters, with n = 76 patients showing initial weight gain (Cluster 1), n = 329 showing continuous weight gain (Cluster 2), n = 70 showing initial weight loss and recovery (Cluster 3), and n = 43 showing weight loss (Cluster 4). The four clusters differed in terms of admission BMI, psychopathology scores, and days spent in treatment, and cluster assignment predicted treatment outcomes.</p><p><strong>Conclusion: </strong>Using one of the largest hitherto examined samples for weight gain profile analysis, the novel DTW-based approach provided an overall more elaborated set of outcome-predictive profiles compared to previous studies, which could help inform individualized treatment strategies and allocate therapeutic resources efficiently.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Non-Randomized Comparison of the Addition of New Maudsley Model Workshops for Parents of Adult Women Receiving Multidisciplinary Care for Anorexia Nervosa.","authors":"Cristiano Dani, Eleonora Rossi, Emanuele Cassioli, Valentina Zofia Cordasco, Alice Roscioli, Giulia Selvi, Livio Tarchi, Luca Zompa, Sandra Moretti, Maria Rita Troiani, Stefano Lucarelli, Valentina Cardi, Valdo Ricca, Giovanni Castellini","doi":"10.1002/eat.24577","DOIUrl":"https://doi.org/10.1002/eat.24577","url":null,"abstract":"<p><strong>Objective: </strong>The impact of the add-on of New Maudsley Model (NMM) training workshops for carers of individuals with eating disorders (EDs) on clinical outcomes in adults with anorexia nervosa (AN) undergoing enhanced cognitive behavior therapy (CBT-E) remains unexplored. The outcomes of females with AN aged 18 and 35 years, treated with CBT-E, were compared between those whose parents agreed to attend NMM workshops and those whose parents declined participation.</p><p><strong>Method: </strong>Psychopathology was assessed up to 1-year follow-up. Baseline differences were analyzed using analysis of covariance (ANCOVA), while longitudinal changes were evaluated with generalized additive mixed models (GAMMs).</p><p><strong>Results: </strong>At admission, individuals in the NMM group had higher levels of ED psychopathology, body uneasiness, and alexithymia. At 1-year follow-up, both groups improved significantly, and between-group comparisons revealed significant effect sizes in favor of the NMM group.</p><p><strong>Discussion: </strong>Parental participation in NMM workshops was associated with more favorable treatment outcomes in adults with AN undergoing CBT-E. These findings suggest the potential relevance of integrating family participation into adult AN treatment.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and Management of Binge-Eating Disorder and Bulimia Nervosa in Primary Care Settings: A Qualitative Systematic Review of Healthcare Professionals' and Patients' Perceptions.","authors":"Stella Kozmér, Christopher O'Rouke, Natalia S Lawrence, Jane R Smith, Samantha B van Beurden","doi":"10.1002/eat.24568","DOIUrl":"https://doi.org/10.1002/eat.24568","url":null,"abstract":"<p><strong>Objective: </strong>To understand how the identification and management of binge-eating disorder (BED) and bulimia nervosa (BN) in primary care settings are perceived by both patients and healthcare professionals, and how rates of identification and referral for support may be improved.</p><p><strong>Methods: </strong>A systematic review of qualitative studies was conducted. Eight databases were searched in August 2025. Studies were excluded if they focused on secondary or tertiary care, patients under the age of 16, or anorexia nervosa. Data on sample, type of eating disorder, year of publication, and country were extracted, and thematic synthesis was used to synthesize the data. The quality of studies was assessed using the Critical Appraisal Skills Programme checklist for qualitative research.</p><p><strong>Results: </strong>Twenty-five studies were included. Four articles were of high quality; the rest (N = 21) were medium with a moderate risk of bias. Most of the studies were from the United Kingdom (N = 9), with 14 focusing on healthcare professionals' and 13 on patients' perspectives. The main factors influencing the identification and management of BED/BN were identified to be knowledge and understanding of the conditions, healthcare professional-patient interactions, attitudes and emotions toward BED/BN and the healthcare system, and the existence and accessibility of treatment and referral pathways.</p><p><strong>Discussion: </strong>The interaction of these factors is discussed in relation to the literature, and gaps in research and clinical practice are identified, such as a limited separation of eating disorder categories, which could help inform the development of strategies to improve the identification and management of BED and BN.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myo-Inositol Levels in the Dorsal Anterior Cingulate Cortex Are Associated With Anxiety-to-Eat in Anorexia Nervosa.","authors":"Yulu Song, Sarah H Guo, Christopher W Davies-Jenkins, Angela S Guarda, Richard A E Edden, Kimberly R Smith","doi":"10.1002/eat.24549","DOIUrl":"https://doi.org/10.1002/eat.24549","url":null,"abstract":"<p><p>While substantial research has focused on general anxiety in anorexia nervosa (AN), eating-related anxiety is insufficiently understood and less is known about its underlying neurobiological mechanisms. We integrated behavioral and magnetic resonance spectroscopy (MRS) methods to characterize anxiety-to-eat and to identify its neurometabolic correlates in females with AN (n = 16) and in healthy weight females without a lifetime history of an eating disorder (healthy controls; HC; n = 16). Anxiety-to-eat was assessed via a computer-based task in which participants rated their level of anxiety-to-eat on a visual analogue scale in response to images of a standard serving of higher (HED) and lower energy density (LED) foods. Levels of nine neurometabolites in the dorsal anterior cingulate cortex (dACC), a brain region putatively involved in modulating anxiety-related responses, were assessed using edited MRS. The AN group reported greater anxiety-to-eat in response to HED and LED foods relative to the HC group. Both groups reported greater anxiety-to-eat in response to HED relative to LED foods. The neurometabolite myo-inositol (myo-I), a carbocyclic sugar and precursor molecule to phosphatidyl-inositol species in second-messenger systems shown to be dysregulated in AN (e.g., adrenergic, serotonergic, glutamatergic), was lower in the dACC in AN relative to HC. Additionally, in the AN group only, myo-I levels negatively predicted anxiety-to-eat in response to HED but not LED foods independent of body mass index, duration of illness, and general anxiety. These findings raise the possibility that lower myo-I in the dACC and its relationship with anxiety-to-eat responses in AN reflect a distinct biological and behavioral phenotype of AN pathology. To understand the clinical implications of these findings, future studies should investigate the effect of treatment on myo-I levels or directly manipulate myo-I levels in the diet and assess resulting changes in anxiety-to-eat.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Group Cognitive-Behavioral Therapy for Non-Underweight Eating Disorders: Feasibility and Preliminary Effectiveness.","authors":"Jill L L Bluff, Ellie K Daly, Isabelle R Bird, Hazel Bryce, Sally Brook, Jessica Beard","doi":"10.1002/eat.24572","DOIUrl":"https://doi.org/10.1002/eat.24572","url":null,"abstract":"<p><strong>Objective: </strong>Individually delivered 10-session cognitive-behavioral therapy for nonunderweight eating disorders (CBT-T) has demonstrated comparable levels of effectiveness to longer CBT-ED. Group CBT-T has demonstrated feasibility and potential effectiveness in a pilot study. This study assessed the effectiveness and feasibility of group CBT-T in a larger sample of adults, and evaluated the predictive value of early change on treatment outcomes.</p><p><strong>Method: </strong>The data analysis was pre-registered and received ethical clearance, and sample size analysis requirements were met. Using intention to treat analyses (ITT), generalized linear mixed models were used to examine change in eating disorder psychopathology, depression, anxiety, and objective binge eating. Recovery, reliable improvement, and clinically significant change were also examined. Early response as a predictor of treatment outcome was assessed with a paired samples t-test and Pearson's product-moment correlation.</p><p><strong>Results: </strong>Fifty-nine patients started group CBT-T and were entered into the ITT analyses. Twenty-two (37.3%) patients did not complete therapy. Eating disorder psychopathology, depression, anxiety, and objective binge eating significantly reduced from pre- to post-therapy (sustained at 3-month follow-up) with medium to very large effect sizes. Of the treatment completers (n = 37, 62.7%), over 70% recovered on the EDE-Q, and over half showed reliable improvement and clinically significant change. Patients who showed early change in EDE-Q scores by session 4 had significantly greater mean changes in EDE-Q scores from session 1 to session 10.</p><p><strong>Discussion: </strong>The present study shows that group CBT-T can be effective in reducing eating disorder psychopathology and objective binge eating frequency, and improves mood in a transdiagnostic sample of patients with non-underweight eating disorders. Group CBT-T has the potential to increase accessibility to evidence-based treatment for nonunderweight eating disorders.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Machine Learning to Predict Complex Clinical Course in Youth With Eating Disorders.","authors":"Stephanie Ryall, Abigail Bradley, Khaled El Emam, Nicole Obeid","doi":"10.1002/eat.24570","DOIUrl":"https://doi.org/10.1002/eat.24570","url":null,"abstract":"<p><strong>Objective: </strong>To compare the predictive performance of supervised machine learning models to logistic regression in identifying youth with eating disorders at risk of a complex clinical course based on clinical characteristics from the first treatment episode.</p><p><strong>Methods: </strong>Clinical data from 327 youth treated at any level of care at the Children's Hospital of Eastern Ontario Eating Disorders Program (2018-2024) were extracted. Complex clinical course outcome was defined as either readmission after discharge or a treatment trajectory deviating from the expected step-down in intensity, including return to the same or escalation to a higher level of care. Thirty-four intake and discharge variables from the first treatment episode were used to train seven machine learning models and logistic regression using repeated nested cross-validation. Performance was assessed by AUC and brier scores. Models using intake-only versus intake plus discharge data were compared. A parsimonious model using the top 10 predictors was also evaluated.</p><p><strong>Results: </strong>Random forest model with intake and discharge data achieved the best performance (AUC = 0.723; Brier = 0.176) that was significantly superior to logistic regression. Models trained on intake-only data showed poor discrimination (AUCs < 0.6). Including discharge data improved model performance across all algorithms. The most important predictor was weight change throughout treatment. Random forest performance declined when restricted to the top 10 predictors.</p><p><strong>Discussion: </strong>Supervised machine learning demonstrates improved predictive performance for eating disorder disease course outcomes compared to traditional statistical methods, especially in higher-dimensionality settings. These findings support future application of machine learning to complex biopsychosocial datasets to advance precision medicine initiatives in the eating disorder field and better understand the etiology of disease trajectory.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Timely Update: An Umbrella Review and Meta-Meta-Analysis of Psychotherapy for Non-Underweight Eating Disorders.","authors":"Mia L Pellizzer, Yuan Zhou, Madelaine K de Valle, Jake Linardon, Tracey D Wade","doi":"10.1002/eat.24567","DOIUrl":"https://doi.org/10.1002/eat.24567","url":null,"abstract":"<p><strong>Objective: </strong>This umbrella review and meta-analysis synthesized recent evidence on the efficacy of psychotherapy for adults with non-underweight eating disorders (EDs).</p><p><strong>Method: </strong>PsycINFO, Scopus, PubMed, and ProQuest Dissertations and Theses Global were searched for meta-analyses of randomized controlled trials comparing psychotherapy to treatment as usual (TAU) or control conditions in non-underweight adults with EDs (published January 2020-September 2025). Standardized mean differences (SMDs) for ED psychopathology and objective binge episode (OBE) frequency were pooled using second-order random-effects models. Subgroup analyses examined specific diagnoses and delivery format. Quality was assessed with the A MeaSurement Tool to Assess systematic Review (AMSTAR 2). Data were synthesized with Covidence and analyzed using R.</p><p><strong>Results: </strong>Ten meta-analyses (71 RCTs) were included. Most participants were female, White, and diagnosed with bulimia nervosa or binge eating disorder. Psychotherapy yielded significant medium-to-large improvements in ED psychopathology (SMD = 0.74, 95% CI: 0.67-0.82, Q_p = 0.79, I² = 0.0% [95% CI: 0.0%- 56.6%]) and OBE frequency (SMD = 0.64, 95% CI: 0.52-0.77, Q_p = 0.40, I² = 4.5% [95% CI: 0.0%- 66.4%]) relative to TAU/control, with low heterogeneity. Effects were comparable across sub-group analyses. Nine of 10 meta-analyses were rated as critically low regarding confidence in results, as per the AMSTAR 2.</p><p><strong>Discussion: </strong>Psychotherapy is efficacious for non-underweight adults with eating disorders, including when delivered using program-led focused interventions. The use of the AMSTAR-2 tool is encouraged to guide high-quality, transparent reporting of future meta-analyses in our field.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Information: Editorial Board & Table of Contents","authors":"","doi":"10.1002/eat.24564","DOIUrl":"https://doi.org/10.1002/eat.24564","url":null,"abstract":"","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":"58 10","pages":"1831-1832"},"PeriodicalIF":4.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eat.24564","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145230801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported Physical Activity Energy Expenditure in Patients With Anorexia Nervosa: A Cross-Sectional Analysis at Hospital Admission From the Study of Refeeding to Optimize iNpatient Gains.","authors":"Siena S Vendlinski, Sasha Gorrell, Amanda E Downey, Arjun S Mehta, Daniel Le Grange, Vanessa I Machen, Erin C Accurso, Sara M Buckelew, Cynthia J Kapphahn, Barbara A Moscicki, Neville H Golden, Andrea K Garber","doi":"10.1002/eat.24569","DOIUrl":"https://doi.org/10.1002/eat.24569","url":null,"abstract":"<p><strong>Objective: </strong>Elevated physical activity is a feature of anorexia nervosa (AN), often associated with poorer clinical outcomes. Less is known about how physical activity energy expenditure (PAEE) prior to hospital admission relates to illness severity at presentation.</p><p><strong>Method: </strong>Secondary data analysis of the Study of Refeeding to Optimize Inpatient Gains, a randomized controlled trial comparing inpatient refeeding approaches in AN and atypical AN. Upon admission, patients self-reported: physical activity (past 7 days), Eating Disorder Examination-Questionnaire (EDE-Q), anxiety (GAD-7), depression (PHQ-A), distress tolerance (DTS), and menstrual status. Medical instability (heart rate and systolic blood pressure, orthostasis, electrolyte abnormalities) was assessed. PAEE was calculated by multiplying the activity-specific Metabolic Equivalent of Task (MET, kcal/kg/h) by the number of hours per activity; weekly METs for all activities were summed and averaged to obtain mean METs/day, then multiplied by admission body weight (kg) to obtain PAEE (kcal/d). Regressions assessed the association of PAEE and admission variables.</p><p><strong>Results: </strong>Physical activity data were available for 91 of 116 patients (56% with AN, 95% female), with M (SD) age = 16.6 (2.5) years and %median Body Mass Index = 84.6 (11.4). Across 37 recorded activities, PAEE was 354 (319) kcal/day. Higher PAEE was associated with older age, longer duration of weight loss, higher eating restraint (EDE-Q; β = 0.17, p = 0.04), and anxiety (GAD-7; β = 0.57, p = 0.04), but not with markers of medical instability.</p><p><strong>Discussion: </strong>Patients with high PAEE may need additional psychological support for anxiety and eating disorder cognitions during hospital admission. Further research is needed to understand how pre-admission PAEE relates to long-term recovery.</p><p><strong>Public significance statement: </strong>Patients with anorexia nervosa (AN) and atypical AN often report increased physical activity (PA). The extent to which energy expended in PA impacts indices of illness severity in the acute phase of illness is less well understood, especially among those who are subsequently hospitalized. Findings suggest patients expending greater energy in PA prior to admission may benefit from additional support to manage higher anxiety and eating restraint while in hospital.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT02488109.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Individuals on Eating Disorder Waitlists Through App-Based Motivational Interviewing: A Qualitative Evaluation of a Program-Led Pilot Intervention.","authors":"Amané Halicki-Asakawa, Jill Gerlof, Emily Mayzes-Kotulla, Maya Libben","doi":"10.1002/eat.24561","DOIUrl":"https://doi.org/10.1002/eat.24561","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with eating disorders (EDs) often face long wait times before receiving formal treatment, which can exacerbate distress and undermine motivation for recovery. Despite this risk, few structured interventions are available to support individuals during the pretreatment period. This qualitative study examined the feasibility, acceptability, and perceived utility of motivational interviewing (MI)-Coach: ED, a structured and focused program-led mobile app intervention grounded in MI, designed to support individuals with EDs while waitlisted for treatment.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with two interest-holder groups: individuals with lived ED experience (n = 14) who completed a 4-week pilot study and clinicians (n = 5) in ED treatment settings. Data were analyzed using framework analysis to integrate themes across groups.</p><p><strong>Results: </strong>Both groups described MI-Coach: ED as accessible, flexible, and relevant to recovery. Preliminary indications of clinical benefit in the lived-experience group were observed, including clarity surrounding reasons for change, more manageable near-term goals, and renewed motivation. Clinicians described similar motivational benefits for clients facing lengthy treatment delays. Both groups emphasized the importance of a supportive digital relationship and suggested accessibility improvements.</p><p><strong>Discussion: </strong>Findings support the feasibility and acceptability of MI-Coach: ED as a program-led digital tool for individuals awaiting ED treatment. The framework approach integrated cross-group themes and informed ongoing refinements to strengthen emotional safety, accessibility, and equitable use and will guide a future randomized controlled trial evaluating clinical impact and implementation.</p><p><strong>Public significance statement: </strong>People with eating disorders often wait a long time for treatment, leaving them feeling isolated and unmotivated. This study conducted interviews with people with eating disorders and clinicians to explore the value of MI-Coach: ED, a guided mobile app designed to support people during this waiting period. Feedback from both groups showed that the app was helpful, and suggestions are now shaping future improvements and research.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}