Emma Austen, Jocelyn R Clarke, Isabel Chua, Sarah Giles, Patrick Haylock, Imran M Keshani, Po-Han Kung, Elyse O'Loghlen, Scott Griffiths
{"title":"Reflections on Using the Eating Disorders Examination to Assess Eating Disorder Pathology in Queer Men.","authors":"Emma Austen, Jocelyn R Clarke, Isabel Chua, Sarah Giles, Patrick Haylock, Imran M Keshani, Po-Han Kung, Elyse O'Loghlen, Scott Griffiths","doi":"10.1002/eat.24526","DOIUrl":"https://doi.org/10.1002/eat.24526","url":null,"abstract":"<p><strong>Objective: </strong>Queer men face potent appearance-related pressures that exacerbate their eating disorder risk. While the Eating Disorder Examination (EDE) is a widely used eating disorder assessment, queer men may experience unique motivations for disordered eating that may impact its administration in this population. To generate practical guidance for clinicians and researchers using the EDE, we qualitatively examined reflections from interviewers who administered the EDE to queer men.</p><p><strong>Method: </strong>Thirteen provisionally or generally registered psychologists administered the EDE to 179 queer men (M<sub>age</sub> = 39.52, 84.36% with an eating disorder diagnosis, 87.15% identifying as gay) to assess their eligibility for a clinical trial of an eating disorder's intervention in Australia. Interviewers provided written reflections on their experience administering the EDE, which were analyzed with reflexive thematic analysis.</p><p><strong>Results: </strong>Interviewers noted that stringent norms around appearance, dieting, and exercise among queer men impaired men's insight into the harm caused by disordered behaviors, despite marked distress, and/or impairment. Usefully, interviewers noted the EDE helped men to gain insight into their disordered behaviors. Interviewers noticed that norms around dieting skewed what some participants perceived to be a \"large\" amount of food-this was useful context for interviewers to consider when distinguishing subjective from objective bulimic episodes.</p><p><strong>Discussion: </strong>Interviewers administering the EDE to queer men should be cognizant of subcultural appearance-related pressures that may lead queer men to underreport impairment or to misjudge instances of their own overeating. Having this knowledge ahead of administering the EDE can equip interviewers to deliver this assessment accurately.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838505","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}
Johanna Stadler, Markus Moessner, Katja Becker, Alisa Hiery, Silke Diestelkamp, Heike Eschenbeck, Vera Gillé, Michael Kaess, Julian Koenig, Christine Rummel-Kluge, Elisabeth Kohls, Rainer Thomasius, Stephanie Bauer
{"title":"Why Young People With Eating Disorder Symptoms Do Not Seek Help-Exploring Barriers to Help-Seeking.","authors":"Johanna Stadler, Markus Moessner, Katja Becker, Alisa Hiery, Silke Diestelkamp, Heike Eschenbeck, Vera Gillé, Michael Kaess, Julian Koenig, Christine Rummel-Kluge, Elisabeth Kohls, Rainer Thomasius, Stephanie Bauer","doi":"10.1002/eat.24515","DOIUrl":"https://doi.org/10.1002/eat.24515","url":null,"abstract":"<p><strong>Objective: </strong>Rates of help-seeking and treatment uptake are low in eating disorders. Delayed initiation of treatment has a negative impact on prognosis and treatment outcome and leads to a higher burden on the healthcare system. The aim of this study was to explore factors associated with help-seeking and their interactions in a large sample of adolescents and young adults with current symptoms of an eating disorder.</p><p><strong>Methods: </strong>Based on the Classification and Regression Trees (CART) algorithm, the data collected within the German school-based project ProHEAD (N = 9796; age: 12-25 years) were used to estimate a decision tree to classify students into help-seekers and non-help-seekers for a mental health issue.</p><p><strong>Results: </strong>Of those screened, 13% reported substantial current eating disorder symptoms (N = 1273). Out of those, 77.3% reported that they did not seek formal help (i.e., from a mental health professional). The absence of suicidal ideation and emotional problems, as well as a low level of education and openness to mental health issues, was characteristic of those who did not seek help for a mental health problem. Emotional problems, suicidality, and depressive symptoms were identified as the most important factors associated with general help-seeking.</p><p><strong>Discussion: </strong>In line with previous research, our findings indicate that individuals with eating disorder symptoms are more likely to seek help when other mental health issues are present. Public health efforts should aim to promote awareness and increase knowledge of eating disorders.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823174","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":"Predictors and Mediators of Outcome of a Focussed, Programme Led Intervention for Young People With Eating Disorders.","authors":"Daniel Wilson, Renata A Mendes, Natalie J Loxton","doi":"10.1002/eat.24516","DOIUrl":"https://doi.org/10.1002/eat.24516","url":null,"abstract":"<p><strong>Background: </strong>Focussed and programme-led interventions have been of increased interest in the eating disorders (EDs) field as a potential solution to barriers in accessing timely, effective treatments. Little is known about the mechanisms through which these treatments work or for whom they are most suitable.</p><p><strong>Objective: </strong>To identify mediators and predictors of outcome in a focused, program-led intervention for young people with EDs.</p><p><strong>Method: </strong>Participants included young people with an ED (n = 169, female = 92.9%, M<sub>age</sub> = 14.46 years) and their parents/caregivers (female = 147, male = 92), who undertook a 6-week parent-focused, psychoeducation-based treatment program and completed measures pre and post treatment. Young person measures included BMI centile, self-report measures of dietary restraint, ED-related obsessions and rituals, and expressed emotion (perceived criticism), and parents completed measures of self-efficacy.</p><p><strong>Results: </strong>Overall, the models explained modest variance in outcomes. Results showed that increased parental self-efficacy mediated the effect of the treatment on reductions to dietary restraint, but not for BMI centile. Perceived criticism predicted the effect of the treatment on BMI centile, such that higher levels of perceived criticism were associated with less weight gain. ED-related obsessions and rituals predicted the effect of the treatment on dietary restraint, although the high correlation between these measures may limit the meaningfulness of this result.</p><p><strong>Discussion: </strong>The findings support existing research in traditional treatments highlighting the benefits of empowering parental self-efficacy to progress ED recovery; it highlights the need for supporting families with high expressed emotion.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823173","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}
Ariel L Beccia, Jenny Poon, Karol Fink, Jenny Loudon, S Bryn Austin
{"title":"Prevalence and Correlates of Disordered Eating Among Alaska Youth: Results From the 2023 Alaska Youth Risk Behavior Survey.","authors":"Ariel L Beccia, Jenny Poon, Karol Fink, Jenny Loudon, S Bryn Austin","doi":"10.1002/eat.24518","DOIUrl":"https://doi.org/10.1002/eat.24518","url":null,"abstract":"<p><strong>Objective: </strong>Despite the ongoing youth mental health crisis and reports of spiking eating disorder rates, especially in rural and underserved areas, epidemiologic data on these patterns remain scarce. To help address this gap, the objectives of our study were to document the prevalence of key disordered eating behaviors in a representative sample of youth from Alaska (a state with a vast geographic area and significant rural and remote populations), examine differences across sociodemographic subgroups, and identify mental health correlates.</p><p><strong>Method: </strong>Participants were those from the 2023 Alaska Youth Risk Behavior Survey, a cross-section of traditional (n = 1129) and alternative (n = 418) high school students in grades 9-12. We estimated weighted proportions of youth reporting past-month binge eating or unhealthy weight control behaviors (UWCBs), overall and by grade, sex/gender, race/ethnicity, and weight status; we then fit a series of logistic models to quantify associations between each outcome and indicators of mental distress and substance use.</p><p><strong>Results: </strong>Approximately one-half of Alaska youth engaged in disordered eating in 2023, with female youth, racial/ethnic minority youth, and youth of higher weight status having inequitably higher prevalence. Youth who reported depression, anxiety, suicide ideation or attempts, alcohol use, e-cigarette use, or other substance misuse had significantly higher odds of both binge eating and UWCBs; conversely, cigarette use was not associated with either outcome.</p><p><strong>Discussion: </strong>These findings collectively underscore the urgent need to include eating disorders within broader conversations regarding the ongoing youth mental health crisis, especially as it pertains to impacts on rural areas of the US. Ongoing surveillance at the state and federal levels, enhanced screening, and large-scale prevention efforts are warranted to address this growing public health threat.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977506","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}
Johanna Xemaire, Ines Wolz, Dustin Werle, Carolin Dudschig, Jennifer Svaldi
{"title":"Measuring Implicit Approach-Avoidance Tendencies Using Self-Depicting Body Pictures in Female Adults With Bulimia Nervosa, High Body Dissatisfaction and Healthy Controls.","authors":"Johanna Xemaire, Ines Wolz, Dustin Werle, Carolin Dudschig, Jennifer Svaldi","doi":"10.1002/eat.24523","DOIUrl":"https://doi.org/10.1002/eat.24523","url":null,"abstract":"<p><strong>Objective: </strong>Body dissatisfaction is an important factor for the etiology and maintenance of eating disorders such as bulimia nervosa (BN). At the behavioral level, body dissatisfaction often manifests itself in excessive body-related avoidance, thought to act as a negative reinforcer. The Approach-Avoidance Task (AAT) is an implicit measure of avoidance behavior, but the literature on body-related avoidance measured by the AAT is inconclusive. In the present study, we considered self-reference and cognitive load as important dimensions to better understand AAT-evoked biases.</p><p><strong>Method: </strong>Adult female participants with BN (n = 21), high body dissatisfaction (n = 20), and healthy controls (n = 20) completed a novel, slider-based AAT with task-irrelevant self-depicting body pictures and scrambled versions of these pictures as control stimuli. We further induced cognitive load through a flanker task to assess possible moderating effects.</p><p><strong>Results: </strong>There was no significant Group × Picture Type × Motion Direction interaction for either motion onset or motion duration. The results further revealed a standard flanker effect in that participants reacted faster to compatible trials; but this was independent of Group membership, Picture Type, and Motion Direction.</p><p><strong>Discussion: </strong>In sum, the AAT did not yield evidence of body-related avoidance behavior. Future studies should control for the occurrence of body checking (i.e., increased focus on disliked body parts which could activate approach-biases) during AAT, manipulate the strength of self-reference, e.g., by presenting/omitting facial cues in self-depicting body pictures, and consider the task relevance of (and thus overt attention to) the body pictures.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805261","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":"The Meta-Analytic Evidence Is In-Time to Get on and Improve Our Treatments.","authors":"Tracey D Wade","doi":"10.1002/eat.24520","DOIUrl":"https://doi.org/10.1002/eat.24520","url":null,"abstract":"<p><p>The good news is that Bruns and colleagues' robust meta-analysis of randomized controlled trials (RCTs) of individual Cognitive-Behavioral Therapy (CBT) for eating disorders has provided us with evidence congruent with other recent meta-analyses in this area. The emerging message, however, holds up an unflattering mirror reflecting the following regarding the use of CBT with eating disorders; we do not know whether to use CBT with adults who have anorexia nervosa; CBT is better than doing nothing with the other eating disorder diagnostic groups; any form of therapist input will suffice as the length and intensity of the CBT make no difference to outcomes; all evidence-based therapeutic approaches seem to perform just as well as CBT. The field needs to rise to the challenge to offer something more informative for clinicians and consumers alike, and three research strategies to achieve this are described. Evidence-based approaches to improving overall outcomes of all our therapies for eating disorders are also described. The use of these approaches in our existing therapies can be evaluated to examine whether these achieve improved remission rates. The challenge for our research community is not in producing further meta-analyses but in improving CBT for people with eating disorders.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800804","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":"Commentary on: The Prevalence of Eating Disorders and Disordered Eating in Adults Seeking Obesity Treatment: A Systematic Review With Meta-Analyses by Melville et al.","authors":"Natasha A Schvey, Marian Tanofsky-Kraff","doi":"10.1002/eat.24522","DOIUrl":"https://doi.org/10.1002/eat.24522","url":null,"abstract":"<p><p>Melville et al.'s 2025 systematic review and meta-analysis highlight the prevalence of eating disorders and disordered eating among adults seeking obesity treatment. Findings showed that the prevalence of binge-eating disorder in obesity treatment-seeking samples exceeds community norms. Results corroborate prior research suggesting that high body weight and eating pathology frequently co-occur and that individuals seeking weight management may be a high-risk population for both sub- and full-threshold eating disorders. Although concerns persist that weight loss efforts may promote or worsen eating disorder symptoms, research indicates that structured, evidence-based interventions typically have neutral or positive effects on disordered eating outcomes. However, rigorous and consistent screening for eating disorders among individuals with high weight is lacking. Importantly, obesity and eating disorders share many common etiological factors, suggesting that integrated intervention is both feasible and highly beneficial. Despite this, the fields of obesity and eating disorders remain siloed. This bifurcation disproportionately impacts youth and adolescents who are at high risk for the onset of both conditions. Currently, standards of care fail to include screening for eating disorders, particularly in youth with high weight, who may be overlooked or misdiagnosed due, in part, to weight-based stigma. Universal, developmentally sensitive screening tools and comprehensive assessment of eating disorder risk factors are urgently needed in pediatric primary care settings. As evidence mounts for concurrent treatment models of high weight and eating disorders, integration across science and clinical care is vital to improve outcomes for youth affected by both conditions.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800803","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 Pilot Evaluation of a Focused Acceptance and Commitment Therapy Program for Individuals With an Eating Disorder Waitlisted for Treatment.","authors":"Jessica Tone, Belinda Chelius, Yvette D Miller","doi":"10.1002/eat.24517","DOIUrl":"https://doi.org/10.1002/eat.24517","url":null,"abstract":"<p><strong>Objective: </strong>Increasing demand for eating disorder treatment services has placed pressure on service capacity and extended wait times. Although wait times have been associated with treatment disengagement, there is limited evidence for interventions to mitigate their impact for adults with eating disorders. The aim of this study was to evaluate the implementation and impact of a pilot Brief Intervention/Therapy for Eating Disorders (bITE) for adults waiting for outpatient eating disorder treatment.</p><p><strong>Method: </strong>The bITE pilot program provided six sessions of Focused Acceptance and Commitment Therapy for participants in Brisbane South, Australia, who were on the treatment waitlist at an outpatient specialist eating disorder service for adults. Implementation was evaluated using routinely collected participant record data and self-reported participant feedback. Impact on participants' eating disorder symptomology and psychological distress was evaluated using repeated (pre- and post-participation) self-reported measures.</p><p><strong>Results: </strong>From 90 waitlist individuals referred to the bITE pilot, 47.7% commenced and 65.1% of those completed all six sessions. Mean wait times for referral to bITE were significantly shorter (18.6 days) for those joining the waitlist after bITE implementation compared to those who joined the waitlist prior to bITE commencement (149.4 days). Participants reported significantly reduced severity of eating disorder symptomology, frequency of overeating episodes, and psychological distress after participating.</p><p><strong>Discussion: </strong>Providing bITE reduced wait time for a face-to-face intervention by approximately 18 weeks on average. These findings suggest that a brief therapeutic intervention may reduce wait time for an intermediate intervention and facilitate early improvements in symptomology. Longitudinal follow-up and comparison to alternative interventions are required.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796054","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}
Clare Levenspiel, Lisa Dawson, Julian Baudinet, Deborah Mitchison, Andrew Wallis
{"title":"Exploring Interactive Change Processes in Multifamily Therapy for Adolescents With Anorexia Nervosa.","authors":"Clare Levenspiel, Lisa Dawson, Julian Baudinet, Deborah Mitchison, Andrew Wallis","doi":"10.1002/eat.24505","DOIUrl":"https://doi.org/10.1002/eat.24505","url":null,"abstract":"<p><strong>Objective: </strong>Multifamily therapy (MFT) is a unique treatment approach that is growing in popularity for adolescents with anorexia nervosa (AN) and their families. MFT aims to create change through experiential and activity-based content and purposeful use of group processes. Despite growing evidence supporting MFT's efficacy, there is limited understanding of possible mechanisms of change. This study explored interactive group processes associated with MFT for adolescent AN and how these processes may influence change in MFT.</p><p><strong>Methods: </strong>A short-term ethnographic field approach was taken with observational data collected across two MFT groups. Qualitative interviews and focus groups were also conducted with young people, parents, and facilitators following each group. The data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Five themes and seven subthemes were generated, and a hypothesized model based on these themes was developed. Relational processes (Theme 1) and learning processes (Theme 2) occurred within individual families and between families in the group. These processes were understood to contribute to whole group dynamics (Theme 3) where emotional safety and momentum built across the week. Facilitator responsiveness (Theme 4) was crucial in navigating uncertainty and supporting these processes. These themes were understood to be interconnected and contributed to a way forward toward recovery (Theme 5) for individual families and for the group as a whole.</p><p><strong>Discussion: </strong>These findings suggest that several unique group processes play an important role in promoting change within MFT. Consequently, MFT may offer a valuable alternative for families for whom traditional single-family therapy has not been effective.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755067","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}