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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. [ABSTRACT FROM AUTHOR]

Objective: Previous research demonstrates that sociocultural appearance pressures and internalization of appearance ideals lead to disordered eating (DE); however, only a subset of individuals exposed to these influences develop clinically significant DE. Identifying moderators of these associations may increase efficacy of targeted preventions for eating disorders. This study investigated whether the fear of negative evaluation (FNE) moderates these associations. Participants: 567 university students participated between November 2019 and 2020. Methods: Participants completed self-report questionnaires assessing appearance pressures, internalization of appearance ideals, FNE, and DE. Results: There was a significant interaction between appearance pressures and FNE in relation to DE. Individuals with high appearance pressures and high FNE had the highest levels of DE. The interaction between internalization of appearance ideals and FNE did not significantly contribute to DE. Conclusions: Eating disorder prevention programs that address FNE and appearance pressures may have beneficial effects, particularly for university students with heightened FNE. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including integration of a sociocultural and developmental framework for disordered eating risk in LGBTQ+ adolescents, factors contributing to increased risk for body image and eating disorders in LGBTQ+ individuals, and protective factors for body image and eating disorders in LGBTQ+ individuals.

This theoretical review paper offers a sociocultural–developmental framework for understanding LGBTQ+ adolescents' body image concerns and disordered eating risk. The Pride Framework integrates well-established sociocultural theories and extant empirical research, drawing from objectification theory, the tripartite influence model, minority stress theory, and intersectionality theory. The Pride Framework situates sociocultural appearance pressures within the adolescent developmental context, wherein biological, cognitive, and social transitions exacerbate the likelihood of body image disturbances and eating pathology. Various processes are then posited to link these sociocultural–developmental pressures to body image concerns and disordered eating. Crucially, this framework underscores that LGBTQ+ status itself does not pose a risk for body dissatisfaction and eating disorders. Instead, it is the experience of residing in a society that stigmatizes LGBTQ+ identities that increases youth's vulnerabilities. LGBTQ+ health researchers and practitioners are encouraged to engage in collaborative efforts with the aim of fostering acceptance for LGBTQ+ youth. This, in turn, could support normative adolescent identity exploration processes within sociocultural settings that are both affirming and inclusive, potentially mitigating adverse health consequences associated with body image disturbances. [ABSTRACT FROM AUTHOR]

Eating disorders (ED) usually involve hospital admission and a high relapse rate, with the return home being a critical moment for patients and their families. After their return home, they often have trouble incorporating the guidelines they have learned into their daily context. ECHOMANTRA intervention program aims to facilitate this transition by offering psychological strategies that involve both patients and their families and carers. Specifically, the ECHO program is aimed at the relatives of these patients. The present study aimed to analyze the efficacy of adding the ECHO program to the usual treatment (TAU) of relatives through a novel format based on individual intervention and with an online format and to examine the acceptability and feasibility of this new format. The study design was multi‐center, randomized, controlled, with a longitudinal design and comparing two parallel groups. A total of 108 family members participated. Results indicated that relatives from both groups, TAU and ECHO + TAU, showed improvements in expressed emotion, accommodation, impact of the ED, emotional well‐being, and caregiver skills. However, effect sizes in the ECHO + TAU group were slightly larger than the TAU group. In addition, the changes were greater in depression and caregiver skills when the ECHO component was added. Most caregivers (81.48%) completed the ECHO and indicated a high level of satisfaction with the program. These results suggest the efficacy and the feasibility of adding the ECHO intervention program to the usual treatment in an individual online format. [ABSTRACT FROM AUTHOR]

Objective: Although social media use, such as Instagram, has been associated with ED pathology, mechanisms connecting social media use to disordered eating behaviors (DEBs) remain largely unevaluated. Based on Dual Process, Tripartite, and Affect Regulation models of ED pathology, we proposed a moderated mediation model evaluating impacts of exposure to fitspiration/thinspiration on Instagram. Method: We evaluated a hypothesized pathway from exposure to fitspiration/thinspiration (i.e., ED‐salient content) on Instagram to disordered eating mediated by negative affect and tested individual differences in weight bias internalization, trait self‐esteem, and trait self‐comparison as moderators. We recruited 173 undergraduate women who reported engaging in DEBs on average at least once per week over the past 3 months. Participants completed a seven‐day ecological momentary assessment protocol, during which they reported their ED‐salient content exposure on Instagram, affect, and engagement in DEBs. Results: Multilevel modeling was used to assess moderated mediation. Negative affect partially mediated associations between viewing ED‐salient content and subsequent engagement in objective binge eating and restricting but did not mediate the pathway to purging or excessive exercise. Higher weight bias internalization intensified the association between viewing ED‐salient content and negative affect. Discussion: The association between viewing ED‐salient content and engaging in objective binge eating and restricting may be a partial consequence of elevated negative affect; however, effects were small. Individuals with higher weight bias internalization may be more vulnerable to negative consequences from viewing ED‐salient content. Findings suggested that reducing negative affect responses (e.g., via emotion regulation) could reduce negative consequences of viewing ED‐salient content. [ABSTRACT FROM AUTHOR]

Background: Disordered eating among athletes and physical activity practitioners is a growing concern that can negatively impact health and performance. Understanding the prevalence and predictors of disordered eating in these populations is essential for developing effective interventions. Objective: To investigate disordered eating tendencies among athletes and physical activity practitioners in Riyadh, Saudi Arabia. Methods: Participants from five athletic clubs and six fitness centers were surveyed. Data were collected using an interviewer-administered questionnaire that included the Eating Attitudes Test (EAT-26), the Abridged Nutrition for Sport Knowledge Questionnaire (ANSKQ), and the Global Physical Activity Questionnaire (GPAQ). Anthropometric data were also collected. The study comprised a sample of 263 individuals, who were divided into two groups: athletes (n = 121) and physical activity practitioners (n = 142). Results: The average age of the participants was 26.41 years with a standard deviation of 8.1 years. Females comprised nearly two thirds of the sample, representing 60.8% of the participants. Physical activity practitioners exhibited higher disordered eating scores compared to athletes. The total EAT-26 scores were significantly higher in practitioners (15.63 ± 4.12) than in athletes (13.21 ± 3.89; p < 0.001). Subscale scores for Dieting (8.95 ± 2.73 vs. 7.49 ± 2.58; p = 0.001) and Bulimia (3.32 ± 1.15 vs. 2.20 ± 1.03; p < 0.001) were also higher in practitioners. BMI was a significant predictor of higher total EAT-26 scores and its subsets, indicating a greater risk of disordered eating behaviors in individuals with higher BMI. Participants with lower levels of sports nutritional knowledge and those engaging in low-intensity physical activities were more likely to exhibit disordered eating tendencies. Conclusions: The findings highlight that physical activity practitioners are at a higher risk of disordered eating compared to athletes. Addressing BMI and improving nutritional knowledge are key strategies for preventing and managing disordered eating behaviors in physically active populations. Interventions targeting these areas may enhance health outcomes and performance among athletes and practitioners. [ABSTRACT FROM AUTHOR]

Background/Objectives: Individuals with eating disorders frequently describe encountering a highly critical internal voice that fixates on their eating habits, body shape, and weight. While existing literature acknowledges the significant impact of this eating disorder voice on affected individuals and its influence on treatment trajectories, research in this area remains limited. This study aimed to comprehensively examine and synthesize qualitative data concerning the experience of the eating disorder voice, with the goal of deepening our understanding of its fundamental characteristics and informing more effective approaches to assessment, treatment, and support in clinical settings. Methods: A systematic search was conducted across six databases for studies presenting qualitative findings relevant to the eating disorder voice. Fifteen studies were included, and their findings were reviewed and synthesized. Results: Results revealed that the eating disorder voice is often perceived by individuals as both protective and comforting, yet also controlling and intrusive, often seen as a force more powerful than themselves. Participants described a constant struggle to manage this internal criticism by differentiating themselves from the voice, with the fear of separation from the voice posing a significant challenge. Conclusions: This study underscores the complex nature of the EDV and its profound impact on individuals with eating disorders. [ABSTRACT FROM AUTHOR]

Objective: Accessible treatment options for avoidant/restrictive food intake disorder (ARFID) in children are limited. The current study sought to assess acceptability, feasibility, and preliminary efficacy of a brief, virtual intervention for ARFID in children ("ARFID‐PTP"). Method: Families of children ages 5–12 with ARFID (n = 30) were randomized to immediate or waitlist treatment groups, with both groups ultimately receiving ARFID‐PTP. ARFID‐PTP consists of two, 2‐h individual treatment sessions with an optional booster session at 4‐week follow‐up. Families completed acceptability and feasibility measures at end‐of‐treatment, as well as preliminary efficacy measures at 4‐week, 3‐month, and 6‐month follow‐up. Results: Of 30 families who completed an intake session, 27 (90%) completed treatment. Families rated acceptability as high (MCEQ‐C = 7.75). Treatment was feasible by participant retention. Exposure adherence was lower than expected, and booster session requests were higher than expected, indicating that achieving feasibility across measures may require treatment modifications. Regarding preliminary efficacy, children in the immediate treatment group had a decrease in ARFID symptoms compared to those on the waitlist. Overall, at 6‐month follow‐up linear mixed models showed participants had significantly reduced ARFID symptoms by presentation (p < 0.05) and in follow‐up completers, children incorporated eight new foods on average. Discussion: ARFID‐PTP is acceptable and preliminarily efficacious. The protocol may benefit from modifications to increase feasibility; however, booster session content and treatment outcomes suggest a priori feasibility markers may not accurately capture the utility of ARFID‐PTP. Further work should continue to examine the efficacy ARFID‐PTP, particularly in diverse samples where treatment accessibility is urgently needed. Trial Registration: ClinicalTrials.gov identifier: NCT04913194 [ABSTRACT FROM AUTHOR]

Aims: To co‐create strategies and identify opportunities to integrate eating disorder content within dietetics curricula at one Australian university with stakeholders using a design thinking approach. Methods: A pragmatic mixed‐methods, participatory design approach was used. An online survey explored the learning needs of dietetic students and recent graduates regarding eating disorders. Following the survey, a one‐day design thinking retreat was held with stakeholders who were identified from the research team's professional networks. Eating disorder dietitians, learning experts, dietetic students, graduates, and those with lived experience were asked to identify strategies to enhance students' confidence and competence to provide care for people living with eating disorders. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using inductive coding and reflexive thematic analysis. Results: Sixty‐four students (n = 55, 86%) and recent graduates (n = 9, 14%) completed the online survey (26% response). Seventeen stakeholders attended the retreat. Four themes were identified: (1) changing perceptions of eating disorder care from specialist to 'core business'; (2) desiring and advocating for a national change to dietetics curricula; (3) importance of lived experience at the centre of curriculum design and delivery; and (4) collaborating to co‐design and deliver eating disorder content at university. Conclusion: Raising awareness, upskilling students and educators, enhanced collaboration between universities and stakeholders, and the inclusion of lived experience were key to preparing students to provide care to people seeking support for eating disorders. Further research is needed to assess the impact these strategies have on dietetic students' confidence and competence. [ABSTRACT FROM AUTHOR]

Research has revealed an important role for appearance-focused, and in particular photo-based, social media in the development of body image and eating pathology. Social media literacy is a multifaceted construct involving purposeful selection and exposure to social media content and use of protective filtering (deliberately screening and interpreting information in a protective manner), as well as implementing critical skills related to understanding the unrealistic nature of social media content, limiting appearance comparisons with images, and contributing to social media (comments and images) in ways that limit the pursuit of appearance ideals. Previous work has provided partial support for these facets as related to lower levels of body image and eating concerns. However, additional conceptual and measurement work is needed to advance understanding of this protective role and how to foster social media literacy. Although data are scarce, targeting social media literacy in prevention and intervention programs may also be valuable. In this perspective piece, key features that we identify as priorities for future prevention and intervention efforts include developing interventions that target the implementation of social media skills beyond their acquisition. In addition, leveraging social media user generated content for prevention purposes would likely be useful, as would embedding micro-skill delivery within platforms. [ABSTRACT FROM AUTHOR]

Epidemiologic research has identified numerous interpersonal and individual risk factors for and warning signs of emerging eating disorders in adolescents. These findings have informed public health prevention and treatment strategies, including translation of findings to clinical recommendations for primary care providers (PCPs). A next step in this translational work could include a comprehensive approach where PCPs are seen as partners in efforts to improve population health outcomes. PCPs have great potential to implement high-yield interventions that prevent or attenuate the course of adolescent eating disorders. To illustrate this potential, we present a case that highlights missed opportunities for a PCP to prevent, detect, and intervene during a patient's developing eating disorder. We then relate the case to two emerging research programs that utilize PCP partnerships: one trains PCPs in Strengths-Based Adolescent Healthcare to improve eating disorder prevention; the other adapts Family-Based Treatment for primary care to improve early access to evidence-based treatment. In addition to these promising areas of research, efforts are needed to widen requirements for eating disorder curricula in medical training programs and to address weight stigma in primary care. Together these efforts will help PCPs become effective partners in the prevention and treatment of eating disorders. [ABSTRACT FROM AUTHOR]

This article concludes the special issue, Identifying and Closing the Gaps in the Prevention of Disordered Eating and Eating Disorders, by reflecting on some of the shared themes as the bases for guiding improvements, if not innovations, in future research. Overall, the articles in this collection highlight the progress achieved within eating disorders prevention in recent years, while addressing many of the existing—and sometimes glaring—gaps within the field. While these manuscripts represent important steps forward, they also offer conceptual frameworks and methodological roadmaps for future developments in the field. Based on prominent themes across those 12 articles, in this conclusion we recommend that future research within eating disorders prevention prioritize equity within research teams, participants, and research approaches. We encourage partnerships with non-academic teams and communities, as well as with multidisciplinary academic colleagues, to ensure that foundational research is directly translatable into program development and implementation, that our prevention efforts are sustainable over time, and that our research development and participating "audiences" include perspectives currently underrepresented in the literature. We also encourage action-based research in which research teams and other stakeholders consider ways to address policy and other systemic factors that lead to body- and appearance-based oppression and inequality. [ABSTRACT FROM AUTHOR]

The Body Project (BP) intervention for body image issues is supported by extensive efficacy and effectiveness research, most of which has been conducted in the United States. The BP uses cognitive dissonance to help participants critique the ideal appearance through written, verbal, and behavioral exercises. This reduces the internalization of the appearance ideal, which in turn decreases body dissatisfaction symptoms and, in some individuals, the onset of eating disorders. To broadly implement this program in Mexico and Latin America, Comenzar de Nuevo (CdN), a non-profit organization for eating disorder treatment, partnered with the Body Project Collaborative in 2014. Together, they created a training and implementation infrastructure. This paper explores the adaptation of BP and its implementation in Mexico and Latin America. We used sustainable business, marketing, and educational models to fulfill CdN's mission to reduce eating disorder risk factors, including weight stigma, in the Latin American region. By integrating strategies to combat weight stigma within our program delivery, we strive to contribute to a more inclusive and supportive environment. We trained master trainers, regular trainers, and/or group facilitators from Argentina, Bolivia, Colombia, Costa Rica, Chile, Dominican Republic, El Salvador, Guatemala, Mexico, Panama, and Spain; and implemented the BP in 15 public schools supported by sponsorship programs. This paper provides crucial lessons learned, future directions, and implications for dissemination and implementation efforts in this region of the world. [ABSTRACT FROM AUTHOR]

Adolescent ballet dancers are commonly recognized as aesthetic athletes who are at higher risk for body dissatisfaction, disordered eating, and eating disorders. Although athletic participation can generally protect against negative mental and physical health outcomes, idealization of a body ideal specific to ballet can confer unique vulnerability for eating pathology. Despite this known vulnerability, rigorous efforts to prevent eating pathology among young dancers are lacking. Previously, we reported on a trial of the Female Athlete Body Project adapted for professional female ballet dancers. The current study tested a subsequent adaptation, the Athlete Body Project (ABP), tailored for younger dancers, including a version for boys. This non-randomized, uncontrolled pilot trial tested ABP among boys and girls in two elite ballet schools (N = 23), formatted in-person and via video-conferencing. Program delivery met benchmarks for feasibility and acceptability across gender and delivery formats, and dancers provided positive qualitative feedback. Overall results suggest the potential of ABP in intervening on pre-post eating pathology and body appreciation, and significantly decreasing drive for muscularity among young ballet dancers. Taken together, this pilot work addresses a gap in the field and advances the needed development of eating disorder prevention programming for young, high-risk aesthetic athletes. [ABSTRACT FROM AUTHOR]

Early adolescence (ages 11–14 years) is a key period for the emergence of body image and eating concerns, and early identification and access to treatment are imperative for positive outcomes. Despite research identifying this critical developmental period, few prevention resources are available for early adolescents. Parents are key players for this age group and important socializing agents. As such, they are well positioned to help youth access resources or support where needed. However, programs to position and involve parents as interventionists are lacking. Our aims are two-fold. First, we review the evidence for the effectiveness of parents as body image interventionists and the existing data regarding parental needs. Second, we provide directions for future research and outline a framework for empowering parents as interventionists, identifying key domains in which parents may play a role in addressing body image and eating concerns among early adolescents. Based on the extent literature, these domains include facilitating engagement with or co-utilizing intervention content to decrease body image and eating concerns in at-risk children, which may also help to increase parents' effectiveness in their efforts to support youth. In addition, parents may deliver content to decrease or reverse risk-factors and early symptoms, or disrupt the early disorder phase of illness. To date, parents constitute an underutilized resource in eating disorder and disordered eating prevention, and efforts should be made to increase the evidence-based strategies to leverage their relationship with at-risk children. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including the creation and pilot evaluation of a dissonance-based intervention (DBI) designed to change variables that previously have not been the focus of DBI research and prevention programming, adaptation and implementation of the Body Project, and ecological perspective in designing policies and programs.

The Body Advocacy Movement (BAM) is a novel, cognitive-dissonance-based intervention designed to target fatphobia and anti-fat bias as mechanisms to drive reductions in eating disorder (ED) risk. Previous dissonance-based programs (i.e. the Body Project; BP) have successfully targeted thin-ideal internalization as an intervention mechanism. As burgeoning research indicates that fatphobia and anti-fat bias may play a central role in the maintenance of ED pathology, a focused intervention designed to target these constructs could bolster prevention efforts. The aims of this pilot study include confirming acceptability and feasibility of BAM and developing preliminary estimates of its effects on intervention targets, along with benchmarking these effects against the BP intervention. BAM was found to be accepted by participants and feasible to facilitate in a peer-led model. Preliminary results from 50 participants (BAM: N = 26; BP: N = 24) reveal small-to-moderate pre-to-post intervention effects on fatphobia, anti-fat bias, thin-ideal internalization, and eating pathology, which dissipated at 8-week follow-up. The BAM intervention has the potential to supplement the existing suite of ED prevention programs by specifically targeting anti-fat bias, though additional testing in larger and more diverse samples is necessary to clarify its impact on both hypothesized risk mechanisms and ED outcomes. [ABSTRACT FROM AUTHOR]

Introduction: In an uncontrolled study, we previously demonstrated the feasibility and preliminary efficacy of our virtual diabetes-specific version (Diabetes Body Project) of the eating disorder (ED) prevention program the Body Project. The aim of the current study was to evaluate further this program for women with type 1 diabetes (T1D) by assessing within-subject changes in outcomes from pretest over 6-month follow-up. Methods: Young women with T1D aged 16–35 years were invited to participate in Diabetes Body Project groups. A total of 35 participants were allocated to five Diabetes Body Project groups (six meetings over 6 weeks). Primary outcome measures included ED risk factors and symptoms, and secondary outcomes included three T1D-specific constructs previously found to be associated with ED pathology: glycemic control as measured by HbA1c level, diabetes distress, and illness perceptions. Results: Within-subject reductions, with medium-to-large effect sizes, were observed for the primary (ED pathology, body dissatisfaction, thin-ideal internalization, and appearance ideals and pressures) and secondary outcomes (within-condition Cohen's ds ranged from.34 to 1.70). Conclusion: The virtual Diabetes Body Project appears to be a promising intervention worthy of more rigorous evaluation. A randomized controlled trial with at least a 1-year follow-up is warranted to determine its efficacy compared to a control condition. [ABSTRACT FROM AUTHOR]

Eating disorder (ED) research and practice have been shaped by prevailing stereotypes about who EDs are most likely to affect. Subsequently, the field has prioritized the needs and concerns of affluent, cisgender, heterosexual, white girls and women to the exclusion of others, especially people marginalized based on their race, ethnicity, sexual orientation, and/or gender identity. However, EDs exist across diverse groups and actually occur with elevated prevalence in several marginalized groups. Growing research points to differences in the drivers of EDs in such groups (e.g. desire to attain the curvy rather than thin ideal; dietary restraint due to food insecurity rather than weight/shape concerns), yet tools typically used for screening and intervention evaluation do not capture eating pathology driven by such factors. In this commentary, we describe gaps in existing ED assessment tools and argue these gaps likely underestimate EDs among marginalized groups, bias who is invited, participates in, and benefits from ED prevention programs, and obscure potential group differences in the efficacy of such programs. We also discuss the potential of these ramifications to exacerbate inequities in EDs. Finally, we outline recommendations to overcome existing gaps in measurement and, consequently, advance equity in the realm of ED prevention. [ABSTRACT FROM AUTHOR]

We describe a community-engaged research process to co-create and implement an evidence-informed, diversity-focused body image program for early adolescents. Our team included middle school staff, students, and teachers, and university faculty and students. Team members had a diverse range of intersecting cis- and transgender, racial, sexuality, and disability identities. Specific steps to the research process included: (1) establishing team leads at each site to maintain a collaborative and non-hierarchical team structure; (2) bi-weekly advisory team meetings to establish program needs and discuss curriculum and implementation options; (3) a year-long youth co-design process to generate content ideas, pilot pieces of programming, and incorporate youth leadership through an equity lens; (4) inclusive program writing from members of socially marginalized groups; (5) program piloting to solicit feedback from teachers, facilitators, and students; and (6) collaboratively incorporating feedback. The resulting 8-session (6 hours total) Body Justice Project has both dissonance-based and media literacy foundations, with topics related to cultural appearance ideals, diet culture and non-diet nutrition, media and appearance pressure, and body autonomy. It is designed for in-class delivery to middle school students by trained college and youth co-facilitator teams. We emphasize guiding principles and lessons learned, along with next steps in implementation. [ABSTRACT FROM AUTHOR]

Prior research has been conflicted on whether gay community involvement serves as a risk or protective factor for body image and eating disorders (EDs) in sexual minority men (SMM), perhaps given that prior research has examined community involvement unidimensionally. The present study examined whether non-appearance-based ("social activism") and appearance-based ("going out/nightlife") community involvement differentially predicted ED prevention outcomes in SMM. SMM (N = 73) enrolled in a randomized controlled trial of an ED prevention program completed measures of community involvement, drive for muscularity, body dissatisfaction, and bulimic symptoms at pre-intervention, post-intervention, and 1-month follow-up. "Social activism" community involvement moderated intervention effects for drive for muscularity and body dissatisfaction scores, but not bulimic symptoms, such that those who placed higher importance on social activism demonstrated expected improvements, while those who placed lower importance on social activism did not exhibit expected improvements. "Going out/nightlife" community involvement did not moderate intervention outcomes; however, greater importance of going out/nightlife was associated with increased body dissatisfaction. Findings support that the impact of community involvement on body image and ED risk for SMM may be nuanced. Encouraging community involvement through activism could help enhance ED prevention efforts for SMM. [ABSTRACT FROM AUTHOR]

Objective: People with Type 1 diabetes (T1D) face an increased risk of eating disorders/disordered eating (ED/DE), with adolescents being particularly vulnerable. Empirical knowledge on the mechanisms underlying development of ED/DE in T1D is crucial for evolving prevention strategies. Research Design and Methods: Fourteen semi‐structured interviews with adolescent females with T1D and ED/DE between 14 and 18 years were conducted and analyzed using reflexive thematic analysis. Results: Analyses identified four main themes; 'Interconnected afflictions', 'Judgment', 'Feeling Different', and 'Chaos & Control', These themes explore the interconnectedness of T1D and ED/DE, with shame and guilt emerging as common underlying mechanism. The development of a biopsychosocial model was based on the integration of these data with existing models. Conclusions: The study extends previous developmental pathways of ED/DE in adolescents with T1D. We propose a biopsychosocial model that incorporates various factors: predisposing factors such as parental management of T1D and weight gain during adolescence; precipitating factors including comments on weight, frequency of weighing, perceptions of surveillance; the perpetuating bilateral influence of ED/DE and T1D and finally highlighting the protective mechanisms of disease acceptance encompassing parental handling of diagnosis and the contribution of healthcare professionals (HCP's) role in psychoeducation. The present study highlight the vulnerability of adolescence in the presence of T1D, particularly concerning issues related to eating, weight, and body. It offers clinically relevant insights, with the aim to improve communication and management strategies for this very specific group. [ABSTRACT FROM AUTHOR]

Background: Maudsley Model of Anorexia nervosa (AN) Treatment for Adults (MANTRA) is recommended by NICE for the treatment of adults with AN. However, despite this fact, the approach remains relatively understudied. The aim of this study was to systematically update the research evidence regarding the use of the MANTRA in the treatment of Eating Disorders (ED). Method: The databases used were Web of Science, Scopus, and PsycInfo, including studies up to 31 May 2023. PRISMA guidelines were followed, and Cochrane tools were used to assess the risk of bias. The search focused on identifying published articles that discussed the usefulness of MANTRA as a component of treatment for ED, following PICO criteria. Results: Nine studies spanning the period from 2011 to 2023 were included. Findings suggested that MANTRA was effective in improving body mass index (BMI), eating symptomatology and emotional state. There were generally no significant differences compared to other treatment conditions. Limitations to interpreting this systematic review include the methodological quality of included studies and the elevated risk of bias. Conclusions: This review was the first to examine the effectiveness of MANTRA. The results indicate that MANTRA has shown effectiveness similar to other treatments for adults AN patients in addressing key clinical variables. It has been used in different populations (adolescents, males, inpatients) and formats (group, online) However, more research is needed to determine its effectiveness. Highlights: This systematic review is based on a rigorous methodology, following the recommendations of the PRISMA and PICOS guide to guarantee its rigour. It adopts a critical and up‐to‐date perspective to analyse the extensive number of studies that provide evidence on this programme.MANTRA appears to be as effective as CBT and SSCM for anorexia nervosa, showing favourable results in body mass index (BMI), eating disorder symptomatology and emotional state. More research is needed to establish its effectiveness in addressing the interpersonal and cognitive factors for which it was also designed.The adaptability of MANTRA is highlighted. It has been used in adolescent population, in group and online format, with inpatients and in males. However, more research is needed to determine its effectiveness. [ABSTRACT FROM AUTHOR]

The incidence of eating disorders in children, mainly of anorexia nervosa, is dramatically increased in the last years. A timely identification of the disease is associated with higher rates of recovery. Aim of the work is to underline signs and symptoms that can be used to an early detection of anorexia nervosa in the pediatric age. A scoping review has been conducted by The Italian Pediatric Society Adolescent Study Group according to the PRISMA Extension guidelines for Scoping Reviews, using the search term "anorexia nervosa" and the following filters "review", "systematic review", "age 0–18", "last 4 years". The strategy search produced 657 studies, of which 52 were included in this revision. Screening and red flags were discussed in 23 reports, genetics in 12, neurological pathways in 11, environmental factors in 10, and gut microbiota in 7. An accurate physiological and pathological anamnesis, physical and psychological examination, including the body perception, should be taken in account as well as the presence of co-morbidities, including chronic functional abdominal pain and autoimmune/autoinflammatory diseases. Evidence suggests the role of familiar predisposition as well as of neurological morphology and pathway in anorexia nervosa development. Gut microbiota has also been included among possible risk factor for developing anorexia nervosa due to a complex direct and indirect interactions between gut and brain. The Italian Pediatric Society Adolescent Study Group suggests performing an accurate familial and personal anamnesis, including psychological evaluation as well as a physical exam including auxological parameters as a screening tool during pediatric checks to better explore the risk of developing anorexia nervosa. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have indicated that virtual treatments for eating disorders (EDs) are roughly as effective as are in‐person treatments; the present nonrandomized study aimed to expand on the current body of evidence by comparing outcomes from a virtual day treatment program with those of an in‐person program in an adult ED sample. Method: Participants were 109 patients who completed at least 60% of day treatment sessions (n = 55 in‐person and n = 54 virtual). Outcome measures included ED and comorbid symptoms, and motivation. Results: Linear mixed models showed that global EDE‐Q scores decreased during treatment (AIC = 376.396, F = 10.94, p = 0.002), irrespective of treatment modality (p = 0.186). BMI significantly increased over time (AIC = 389.029, F = 27.97, p < 0.001), with no effect of treatment modality (p = 0.779). Discussion: Our findings suggest that the virtual delivery of day treatments produces comparable outcomes to those obtained using in‐person formats, and that virtual formats may represent a pragmatic treatment option, especially in situations in which access to in‐person care is limited. [ABSTRACT FROM AUTHOR]

Objective: Prevention programs for eating disorders (EDs) and high body index mass (BMI) have the potential to reduce the onset of these interconnected public health concerns. However, it remains unclear whether routine implementation of such programs would be cost‐effective. This study aims to determine the cost‐effectiveness of an intervention that aims to prevent both ED and high BMI. Method: A Markov model was developed to evaluate the incremental cost‐effectiveness of a targeted school‐based program, Healthy Weight, that aims to prevent both EDs and high BMI among Australian adolescents with body image concerns (aged 15–18 years), versus a "no intervention" comparator. A cost‐utility analysis was conducted from a "healthcare and education" sector perspective with costs (measured in 2019 Australian dollars) and health impacts modeled over the lifetime of the target population. An incremental cost‐effectiveness ratio (ICER), expressed as cost per health‐adjusted life year (HALY) gained, was calculated. Sensitivity analyses were done to test model assumptions. Results: The mean intervention cost and HALYs gained were AUD$2.13 million (95% CI, AUD$1.83–2.43 million) and 146 (95% CI, 90–209), respectively. With healthcare cost‐savings (AUD$3.97 million) included, the intervention was predicted to be cost‐saving (AUD$1.83 million; 95% CI, AUD$0.51–3.21 million). Primary findings were robust to extensive sensitivity analyses. Discussion: The Healthy Weight intervention is likely to represent good value‐for‐money. To ensure the successful implementation of this program at the population level, further research on its feasibility and acceptability among schools and the wider community is required. [ABSTRACT FROM AUTHOR]

Objective: Gay and bisexual men are at an increased risk for eating disorders (EDs) and muscle dysmorphia (MD) compared with their heterosexual counterparts. Existing dissonance‐based (DB) EDs prevention programs for this population have been evaluated in the United States; however, these programs have not been evaluated in the Brazilian context. Thus, we investigated the feasibility, acceptability, and efficacy of a DB ED prevention program (i.e., the PRIDE Body Project) among Brazilian cisgender gay and bisexual men. Method: Eligible men were randomly assigned to either a DB intervention (n = 74) condition or an assessment‐only control (AOC) condition (n = 75). Participants completed measures assessing ED and MD risk and protective factors at baseline, post‐intervention, 1‐month, 6‐month, and 1‐year follow‐up. Those in the intervention condition also completed acceptability measures. Results: Feasibility and acceptability ratings were highly favorable. Regarding efficacy, post‐intervention results were not significant, except for self‐objectification, which showed a significantly greater decrease in the DB condition compared with the AOC condition at all time‐points of follow‐ups (Cohen's d = −0.31 to −0.76). At follow‐up, the DB condition showed significantly greater decreases in appearance‐ideal internalization, drive for muscularity, self‐objectification, ED and MD symptoms at 1‐month, 6‐month, and 1‐year follow‐ups (d = −0.33 to −0.92) compared with the AOC condition. Significant increases were observed in the DB compared with the AOC condition for body appreciation at 1‐month, 6‐month, and 1‐year follow‐ups (d = 0.31–0.81). Discussion: Results support the feasibility, acceptability, and efficacy of the PRIDE Body Project up to 1‐year in Brazilian cisgender gay and bisexual men. Trial Registration: Brazilian Registry of Clinical Trials (ReBEC; available at http://www.ensaiosclinicos.gov.br/) number of registration: RBR‐62fctqz. [ABSTRACT FROM AUTHOR]

Body image disturbance (BID) is central to eating disorders (EDs), yet the role of self‐face perception has received limited empirical attention despite rising sociocultural pressures emphasizing facial appearance through technologies such as social media. Emerging evidence suggests impairments in self‐face recognition accuracy and distorted perceptions of facial appearance among individuals with EDs. Enfacement illusions, involving the experimental induction of perceived ownership over another's face, offer a novel paradigm to comprehensively investigate the perceptual multisensory integration processes underlying self‐face perception disturbances in ED populations. Such an approach may hold promise for elucidating core pathological mechanisms contributing to BID and ED psychopathology. We discuss how rigorous investigation of self‐face perception through the enfacement illusion paradigm represents an innovative direction of research and/or clinical application that may advance etiological models of EDs and possibly inform interventions targeting the potentially multidimensional nature of body and facial image disturbances characterizing EDs. Public Significance Statement: Body image disturbance is central to eating disorders (EDs), yet, the role of face‐related disturbances remains critically under‐investigated. After summarizing findings on face‐related disturbances in EDs we propose how enfacement illusions (i.e., the experimental induction of ownership over another's face) may elucidate self‐face perception disturbances in EDs, and their underlying mechanisms. Enfacement illusions may also offer an intervention to potentially address multifaceted face and body image disturbances characterizing EDs. [ABSTRACT FROM AUTHOR]

Objective: To compare attitudes and behaviors of American adults who have experienced food shaming versus those who have not. Design: This was an online survey of 2003 US adults, followed by an additional 5 one-on-one in-depth interviews, for a total of 2008. Data were collected between September and November 2022. Participants: US adults (n = 2008) recruited via commercial research panels. Main Outcome Measures: Prevalence of food shaming, and attitudes and behaviors among adults who have experienced food shaming versus those who have not. Analysis: χ2 and analysis of covariance investigating associations between experience with food shaming and foodrelated attitudes and behaviors, controlling for body mass index where possible. Results: Nearly 3 in 10 American adults report that they have experienced food shame. Experiencing food shame correlates with higher guilt and shame, greater likelihood to engage in regimented eating, and more prevalent, as well as negative, emotions around food and imagined interactions with food and nutrition professionals. Conclusions and Implications: Food shaming is a phenomenon with wide-reaching impacts on attitudes and behaviors. We expect that this innovative study will inform registered dietitian nutritionists and other health professionals to help people develop healthy, sustainable relationships with food. [ABSTRACT FROM AUTHOR]

Aim: Young women with type 1 diabetes are a high‐risk population for eating disorders (ED). Prevention programs are lacking. In young women without diabetes, the Body Project has produced reductions in ED risk factors, ED symptoms and future ED onset. Therefore, the Body Project was adapted to type 1 diabetes, the Diabetes Body Project (DBP). In this protocol, we describe the multi‐site randomized controlled trial (RCT) to evaluate efficacy of the DBP. Methods: This is an ongoing RCT with four sites (Europe and US). In total 280, 14–35 year‐old, women with type 1 diabetes ≥1 year and some level of body image concerns will be recruited in 2023. Participants are randomized to either virtual DBP groups or an educational control. The study constitutes 5 measurement points distributed over 2 years. The primary aim is to test if DBP will produce significantly greater reductions in ED behaviours, ED symptoms and future ED onset. The secondary aim is to test if DBP has significantly greater improvements in diabetes distress, quality of life and glycaemic outcomes. Results: We expect that DBP will be more efficacious in reducing ED behaviours, ED symptoms and ED onset compared to the control condition. Additionally, we hope to gain new knowledge on how DBP may affect diabetes‐related outcomes. Conclusions: If DBP proves efficacious, it has potential for immediate, clinical implementation at low‐cost and may contribute to broad prevention of future ED onset among young women with type 1 diabetes. ClinicalTrials.gov Identifier: NCT05399446. [ABSTRACT FROM AUTHOR]

Aim: In Taiwan, over 90% of dementia patients received home care. Severe dementia‐linked food refusal significantly affects nutrition, thereby straining caregivers. Family caregivers can reduce their burden by learning feeding and dementia nutrition online, thus preserving patient oral feeding. The study aim for family caregivers learn online Hand‐Under‐Hand (UH) techniques to ease feeding in severe dementia, enhancing nutrition and reducing their burden. Methods: In this quasi‐experimental study, participants in the experimental group received 2‐h UH courses online, while the control group received their usual care. The primary outcome indicators were abnormal eating behavior, nutritional status, and caregiver burden, with outcomes tracked at 0, 1, and 3 months. At the neurology outpatient clinic of a medical center in Taipei, 65 dyads—comprising patients with severe dementia and their caregivers—were randomly assigned to groups. Results: The study participants comprised 36 female and 29 male caregivers, with an average age of 58.09 years. The patient group included 43 females and 22 males, with a mean age of 83.32 years. Patients in the experimental group exhibited reduced abnormal eating behavior, and caregiver burden was reduced at 1 and 3 months, patients demonstrated improved nutritional status by month 3. Conclusions: The accessibility and convenience of online courses enabled family caregivers to use UH feeding techniques to effectively improve the nutritional status and correct the abnormal eating behavior of patients with dementia, while also decreasing caregiver burden. Geriatr Gerontol Int 2024; 24: 867–873. [ABSTRACT FROM AUTHOR]

Objective: Research regarding the therapeutic application of psychedelics and psychedelic‐assisted psychotherapy in the treatment of eating disorders (EDs) has begun to emerge. This systematic scoping review aimed to map and synthesise the existing evidence regarding the participant reported efficacy and perspectives concerning psychedelics in the treatment of EDs, and to identify significant research gaps. Method: A systematic search was undertaken across several databases in accordance with Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews guidelines. Results: 1290 publications were identified, 1135 after duplicates removed, with 17 meeting full‐eligibility criteria. Overall, findings suggested that most participants reported experiencing a meaningful reduction in their ED symptoms and having positive experiences or an openness to explore psychedelics as a treatment for ED symptoms, although some noted concerns of adverse effects and the importance of having psychological support to increase safety and efficacy. Conclusions: While preliminary research suggests psychedelics and psychedelic‐assisted psychotherapy may be a viable treatment option for ED symptoms, further research with more robust research designs is required to increase confidence in its efficacy, generalisability, and safety as a therapeutic medium. Highlights: While research regarding the efficacy of psychedelics in the treatment of eating disorders (EDs) is still in its infancy, preliminary findings have been promising.Participants across the included studies reported largely positive experiences and an openness to explore the use of psychedelics and psychedelic‐assisted psychotherapy as a treatment modality for EDs. However, some participants noted concerns about potential adverse effects (AEs) and the importance of ensuring psychological support was provided before, during, and/or after a psychedelic treatment experience.There is currently not enough evidence to determine which psychedelic substances are most efficacious for therapeutic intervention for EDs. Further research is therefore needed, with more robust research methodologies. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to compare treatment trajectories in anorexia nervosa (AN) and atypical AN. Method: Adolescents and adults with AN (n = 319) or atypical AN (n = 67) in a partial hospitalization program (PHP) completed diagnostic interviews and self‐report questionnaires measuring eating disorder (ED), depression, and anxiety symptoms throughout treatment. Results: Premorbid weight loss did not differ between diagnoses. Individuals with atypical AN had more comorbid diagnoses, but groups did not differ on specific diagnoses. ED psychopathology and comorbid symptoms of depression/anxiety did not differ at admission between groups nor did rate of change in ED psychopathology and comorbid symptoms of depression/anxiety from admission to 1‐month. From admission to discharge, individuals with atypical AN had a faster reduction in ED psychopathology and comorbid symptoms of depression and anxiety (ps < 0.05; rs = 0.01–0.32); however, there were no group differences in ED psychopathology or depression symptoms at discharge (ps>.50; ds =.01–.30). Individuals with atypical AN had lower anxiety at discharge compared to individuals with AN (p = 0.05; d =.4). Length of stay did not differ between groups (p = 0.11; d =.21). Discussion: Groups had similar ED treatment trajectories, suggesting more similarities than differences. PHP may also be effective for AAN. Public Significance: This study supports previous research that individuals with AN and atypical AN have more similarities than differences. Results from this study indicate that individuals with AN and atypical AN have similar treatment outcomes for both ED psychopathology and depressive symptoms; however, individuals with atypical AN have lower anxiety symptoms at discharge compared to individuals with AN. AN and atypical AN also have more symptom similarity at admission and throughout treatment, which challenges their current designation as distinct disorders. [ABSTRACT FROM AUTHOR]

Varying patterns in eating disorder (ED) classification are evident and may impact ED treatment and prevention. However, investigations of patterns of heterogeneity in ED presentations have been limited to civilian samples, despite the high prevalence of EDs in military personnel and veterans. The present study aimed to explore ED-related symptom patterns, including emotional overeating, in women veterans. Participants were 407 women veterans using health care services at a large Veterans Affairs health care system who completed mental health measures via surveys. Latent profile analyses were used to explore distinct ED symptom patterns (binge eating, purging, heavy exercise, positive and negative emotional overeating, dietary restraint, and shape/weight concerns). Subsequent auxiliary models explored associations with mental health concerns (depressive symptoms, posttraumatic stress disorder, anxiety, alcohol misuse, substance misuse), adjusting for age, race and ethnicity, and service branch. A four-class solution demonstrated the best model fit, characterized as follows: 1) Low ED Concerns, 2) Moderate Dietary Restraint/Negative Emotional Eating, 3) High Binge/Emotional Eating, and 4) High ED Concerns. Although all profiles had moderate or higher levels of negative emotional overeating, the High Binge/Emotional Eating and High ED Concerns profiles were distinct in levels of dietary restraint and had the highest probabilities of positive emotional overeating. The High ED Concerns profile also had the most severe mental health concerns relative to the other profiles. The identification of unique ED symptom patterns in women veterans can inform prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

This study evaluated the acceptability and effectiveness of the Eat Breathe Thrive (EBT) program as an eating disorder prevention intervention among women collegiate athletes. Change over time in eating disorder risk and competencies of positive embodiment were examined in 94 women (n = 48 EBT participants and n = 46 matched-controls) from one National Collegiate Athletic Association (NCAA) Division I-classified university in the United States. Eating disorder risk factors were measured using the Eating Disorder Examination Questionnaire (EDE-Q) and State Trait Anxiety Inventory (STAI). Aspects of positive embodiment were measured using the Multidimensional Assessment of Interoceptive Awareness (MAIA) and The Mindful Self-Care Scale (MSCS). Data were collected through participants' completion of online surveys across three time-points. Repeated measures ANOVAS revealed EBT participants reported experiencing significantly less state anxiety and greater interoceptive body trusting over time relative to matched-controls. No other significant interactions were found. Respondents found the EBT program acceptable. Acceptability and partial support for integrative, yoga-based, interventions targeting Division I student-athletes is indicated. [ABSTRACT FROM AUTHOR]

A growing body of evidence suggests that yoga-based interventions might aid in the prevention and treatment of eating disorders. The current qualitative study used Interpretative Phenomenological Analysis (IPA) to analyze the nature and degree of impact of a yoga and mindfulness-based eating disorder prevention intervention Eat Breath Thrive (EBT). Data was collected via semi-structured interviews with 16 participants over the age of 18 who took part in the EBT program between 2018 and 2022. Using IPA methodology, and after several rounds of coding, emergent themes were interpreted and organized to develop a theoretical model explaining the mechanism of change experienced and described by EBT participants. The resulting model outlines an experiential progression from psychoeducation and skill development/practice to increased mindful awareness, and empowered state experiences which led to the following outcomes: independent positive action, self-initiated positive state experiences, and increased embodied well-being. Participants reported increased self-compassion and self-acceptance, with decreased emphasis on disordered eating behaviors. Qualitative data is necessary for understanding why yoga works, from an experiential perspective. This study adds to the new, and rapidly expanding body of research supporting the positive effects of yoga and mindfulness on the prevention and treatment of eating disorders. [ABSTRACT FROM AUTHOR]

Objective: Disordered eating is common in pregnancy and associated with adverse health outcomes. Weight suppression (WS), the discrepancy between highest lifetime and current weight, is a robust predictor of loss of control (LOC) and binge eating and weight gain trajectories in clinical populations. This study explored the role of preconception WS as a predictor of disordered eating and weight gain in pregnancy. Method: Pregnant individuals (n = 137) reported their highest, preconception, and current weights to calculate preconception WS, actual gestational weight gain (GWG), and deviations from recommended weight gain trajectories in pregnancy. Participants also completed the Prenatal Eating Behaviours Screening (PEBS) tool, a validated measure of disordered eating specifically in pregnancy. Results: Preconception WS was a significant predictor of PEBS total scores [F(5, 122) = 2.70, p = 0.02, R2 = 0.10] and significantly and positively correlated with individual item scores quantifying restrictive eating behaviours. Preconception WS was not predictive of deviations from recommended GWG trajectories or LOC or binge eating frequency and did not interact with pre‐pregnancy body mass index or GWG to predict eating disorder symptom severity. Conclusions: Preconception WS was predictive of disordered eating, and specifically restrictive eating behaviours in pregnancy, and should be assessed as part of screening for eating disorder risk in pregnant individuals. Highlights: Disordered eating is common in pregnancy and associated with adverse health outcomes.Weight suppression (WS) is predictive of loss of control and binge eating in clinical populations.Preconception WS was found to be predictive of restrictive eating behaviours in pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents and young adults place significant value to appearance. Medical students are likely to be vulnerable to dissatisfaction with appearance and maladaptive eating attitudes. Aims and Objectives: This study was designed to study the eating attitudes, body image perception, and self-esteem in MBBS students and their correlations with each other and with body mass index (BMI), to identify students at risk and possibly plan measures for intervention. Methodology: A study was conducted on 700 medical students (including interns), with electronic questionnaires assessing sociodemographic data, eating attitudes, body image perception, and self-esteem. Using the Chi-square tests and t -tests, the parameters were studied and correlations using Spearman's rank correlation were established. Results: Students with a higher BMI were at a greater risk of eating disorder (ED), higher concerns with body perception, and lowered self-esteem. Those with a higher risk of ED were associated with body dissatisfaction and lower self-esteem. Body image distortions were associated with low self-esteem. Conclusions: ED risk is associated with body dissatisfaction and lower self-esteem in medical students. Future studies are required to establish this relation. [ABSTRACT FROM AUTHOR]

Objective: Inefficiencies in executive functioning (EF), more specifically cognitive flexibility and an overly detailed processing style, are frequently observed in individuals with Anorexia Nervosa (AN) and have been identified as potential targets in treatment. Cognitive Remediation Therapy (CRT) is an adjunctive treatment approach specifically designed to have a positive impact on EF. Mainly evaluated in adults, CRT has been criticized for its perceived ineffectiveness in promoting weight restoration or directly reducing eating disorder symptoms. Method: We argue that we need to refocus our conceptual framework for using CRT as an adjunctive treatment and specifically explore its potential benefit in adolescents. Results: Adolescence is a critical window for EF development during which CRT has the potential to have the most impact. While it may not specifically ameliorate eating disorder symptoms and directly improve weight gain, CRT may mitigate the impact of malnutrition on adolescent brain development, reduce attrition rates in treatment, and improve cognitive flexibility and (indirectly) other maintaining factors, thereby improving global functioning. Discussion: More research needs to be done to understand the development of EF in adolescents with AN and how best to employ CRT as an adjunctive treatment to support development and target maintaining factors. The current article broadly reviews findings on executive functioning inefficiencies in adolescents with AN and discusses the purpose and role of CRT in treating AN. Finally, we highlight key critiques of using CRT and pose questions for future research. Public Significance: Treatments targeting executive functioning in adolescents with AN are limited. We need to better understand how CRT can benefit adolescents in treatment. Increasing treatment options, including adjunctive treatments, is necessary to reduce the long‐term impact of AN. [ABSTRACT FROM AUTHOR]

Objective: Digital interventions show promise as an effective prevention or self‐management option for eating disorders (EDs). However, it remains unclear how, for whom, and through what mechanisms they work in this population, as a synthesis of outcome predictors, moderators, and mediators is lacking. This systematic review synthesized empirical research investigating predictors, mediators, and moderators of response to digital interventions for EDs. Method: Six databases were searched (PROSPERO CRD42022295565) for studies that assessed predictors, moderators, or mediators of response (i.e., uptake, drop‐out, engagement, and symptom level change) to a digital prevention or treatment program for EDs. Variables were grouped into several overarching categories (demographic, symptom severity, psychological, etc.) and were synthesized qualitatively across samples without a formally diagnosed ED (typically prevention‐focused) and samples with a formally diagnosed ED (typically treatment‐focused). Results: Eighty‐six studies were included. For studies recruiting samples without a formal diagnosis (n = 70 studies), most predictors explored were statistically unrelated to outcome, although participant age, baseline symptom severity, confidence to change, motivation, and program engagement showed preliminary evidence of prognostic potential. No robust moderators or mediators were identified. Few studies recruiting samples with a formal diagnosis emerged (n = 16), of which no reliable predictors, moderators, or mediators were identified. Discussion: It remains unclear how, for whom, and under what circumstances digital programs targeting EDs work. We offer several recommendations for future research with the aim of advancing understanding of client characteristics and intervention elements that signal success from this intervention modality. Public Significance: Digital interventions have shown potential as an effective, scalable, and accessible intervention option for EDs. However, responsiveness varies, so advancing understanding of predictors, mediators, and moderators of outcome to digital interventions for EDs is needed. Such knowledge is important for enabling safe and efficient treatment matching, and for informing future development of effective digital interventions. [ABSTRACT FROM AUTHOR]

The article reviews the journal's publications and accomplishments in 2023. It discusses the importance of contributions on the concept of lived experience workforce. It highlights the progress on journal mission and goals focused on bridging the research-practice gap on the treatment approaches in the eating disorders arena. A list of the 2023 Articles of the Year is presented, including Informing treatment article of the Year and Informing prevention article of the Year.

This review of 16 prevention-related publications in Eating Disorders during 2022 is framed by three models: (1) Mental Health Intervention Spectrum: health promotion → types of prevention → case identification/referral → treatment; (2) the prevention cycle: rationale and theory, shaped by critical reviews → clarifying risk and protective factors → program innovation and feasibility studies → efficacy and effectiveness research → program dissemination; and (3) definitions of and links between disordered eating (DE) and eating disorders (EDs). Seven articles fell into the category of prevention rationale (including screening studies) and relevant reviews, while nine articles addressed correlates of/risk factors (RFs) for various aspects of DE and EDs. One implication of the 16 articles reviewed is that RF research toward construction of selective and indicated prevention programs for an expanding array of diverse at-risk groups needs to address, from a nuanced, intersectional framework, a broad range of factors beyond negative body image and internalization of beauty ideals. Another implication is that, to expand and improve current and forthcoming prevention programs, and to shape effective advocacy for prevention-oriented social policy, the field in general and Eating Disorders in particular need more scholarship in the form of critical reviews and meta-analyses; protective factor research; prevention program development and multi-stage evaluation; and case studies of multi-step activism at the local, state (province, region), and national levels. [ABSTRACT FROM AUTHOR]

This study presents an initial effort to develop disordered eating pathology (DEP) prevention program with an emphasis on maternal involvement. Disordered eating pathology representing a range of behaviors and attitudes, from negative body image to full-blown eating disorder. It appears mainly in adolescent females and related to psychological and familial factors, including maternal modeling of thinness. A sample of 118 Israeli girls (11–12) was divided into three groups: participants in the program in parallel with their mothers, participants without their mothers, and control. Participants completed self-report questionnaires. Groups were tested three times: pre-intervention, post-intervention, and follow-up. For those girls who participated in parallel with their mothers, higher self-esteem was associated with fewer pathological diet behaviors. Findings deepen understanding of the risk factors involved in the development of DEP. The main study contribution is the important role mothers play in preventing DEP among their daughters. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the frequency of sleep and eating problems in children with autism spectrum disorder (ASD), the factors associated with these problems, and the relationship with the risk of developing depression and anxiety in their parents. In the study, 156 children with ASD and their parents were included. The Brief Autism Mealtime Behavior Inventory (BAMBI), the Children's Sleep Habits Questionnaire (CSHQ), the Hospital Anxiety Depression Scale (HADS) were completed by the parents. The Childhood Autism Rating Scale (CARS) was administered by the researchers to evaluate the severity of ASD in children. The mean age of children was 8.08 ± 2.84, and 87.2% of the children were male. The mean score of CARS was 41.25 ± 6.16, the mean score of BAMBI was 45.67 ± 11.87, and the mean score of CSHQ was 51.67 ± 10.17. According to the CSHQ, 83.3% of the children had sleep problems. The response rate above the cut-off point in the HAD-A subscale was 59.6%, whereas it was 67.3% in the HAD-D subscale. There was a positive correlation between CARS and BAMBI, CSHQ, HAD-A, and HAD-D subscales. There was a positive correlation between BAMBI and CHSQ, HAD-A, and HAD-D subscales. There was a positive correlation between the CSHQ, HAD-A, and HAD-D subscales. There was a negative correlation between the age of the child with ASD, food refusal, and resistance to bedtime. As sleeping and eating problems affect a large portion of children diagnosed with ASD and their caregivers, large population-based studies evaluating both these problems must be designed and carried out to understand factors affecting the prevalence, development, and persistence of sleeping and eating problems and to determine interventions to reduce these issues. [ABSTRACT FROM AUTHOR]

Dietary habits established in childhood, often persist into adulthood highlighting the importance of early intervention. However, limited interventions exist promoting "how" to establish healthful eating behaviors in children. To create impactful interventions, it is important they are based on evidence and co-designed with end-users. Fifteen child health nurses participated in this co-design study, underpinned by the Knowledge to Action Framework. Child health nurses reviewed evidence-based statements and then workshopped practical strategies. Findings from the co-design sessions were used to inform the development of a preventive intervention. The study has important health marketing implications for conducting co-design with child health nurses. [ABSTRACT FROM AUTHOR]

Aims: Children and young people (CYP) with type 1 diabetes (T1D) are at increased risk of disordered eating. This study aimed to determine the feasibility and acceptability of a novel, theoretically informed, two‐session psychoeducational intervention for parents to prevent disordered eating in CYP with T1D. Methods: Parents of CYP aged 11–14 years with T1D were randomly allocated to the intervention or wait‐list control group. Self‐reported measures including the Diabetes Eating Problem Survey—Revised (DEPS‐R), Problem Areas in Diabetes Parent Revised (PAID‐PR), Child Eating Behaviour Questionnaire subscales (CEBQ), Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), clinical outcomes (e.g. HbA1c, BMI, medication and healthcare utilisation) and process variables, were collected at baseline, 1‐and 3‐month assessments. Acceptability data were collected from intervention participants via questionnaire. Results: Eighty‐nine parents were recruited, which exceeded recruitment targets, with high intervention engagement and acceptability (<80% across domains). A signal of efficacy was observed across outcome measures with moderate improvements in the CEBQ subscale satiety responsiveness (d = 0.55, 95% CI 0.01, 1.08) and child's BMI (d = −0.56, 95% CI −1.09, 0.00) at 3 months compared with controls. Trends in the anticipated direction were also observed with reductions in disordered eating (DEPS‐R) and diabetes distress (PAID‐PR) and improvements in wellbeing (WEMWBS). Conclusions: This is the first study to have co‐designed and evaluated a novel parenting intervention to prevent disordered eating in CYP with T1D. The intervention proved feasible and acceptable with encouraging effects. Preparatory work is required prior to definitive trial to ensure the most relevant primary outcome measure and ensure strategies for optimum outcome completion. [ABSTRACT FROM AUTHOR]

There is growing evidence of prior experiences of trauma and trauma-related symptoms among people with eating disorders; however, there is little understanding as to how post-traumatic stress disorder (PTSD) and exposure to traumatic events affect treatment outcomes. Without this knowledge, eating disorder clinicians are unable to tailor treatment to ensure good outcomes for the large percentage of this population that is affected by PTSD and trauma. This systematic review aimed to identify how PTSD and trauma exposure influence outcomes in eating disorder treatment. Systematic searches of PsycINFO, MEDLINE, PubMed, and Scopus databases identified 16 articles that met the inclusion criteria. The results indicated a negative effect on rates of eating disorder treatment completion and eating disorder psychopathology posttreatment. These findings were evident across studies that investigated the impact of a history of traumatic events as well as studies that investigated the impact of the presence of trauma-related symptoms seen in PTSD. Several methodological limitations were identified in the literature. These include: heterogeneous and unstandardized measures of PTSD and trauma, high attrition rates with follow-up, and insufficient data to enable comparisons by treatment setting, diagnostic presentation, and type of trauma exposure. The findings of this review have implications for future research and clinical care, including the importance of considering PTSD and trauma in assessment, treatment planning, and provision of both trauma-informed care and trauma-focused treatments for individuals with eating disorders. [ABSTRACT FROM AUTHOR]