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Vitamin D deficiency and depressive disorders are both common in patients with eating disorders (EDs). However, the association between vitamin D status and current depressive disorder (CDD) in EDs populations remains insufficiently explored. We conducted a cross-sectional study including 481 outpatients with EDs assessed at a specialized eating-disorders unit in Montpellier, France. Psychiatric diagnoses were established using the Mini-International Neuropsychiatric Interview (M.I.N.I.). Eating-disorder severity was assessed with the Eating Disorder Examination Questionnaire (EDE-Q). Serum 25-hydroxyvitamin D levels were measured as part of routine clinical assessment, and vitamin D deficiency was defined as <&#x2009;20 ng/mL. Odds ratios (ORs) were estimated using logistic regression. Vitamin D deficiency was significantly associated with higher odds of CDD (OR 1.98, 95% CI 1.20-3.28; p&#x2009;=&#x2009;0.008). This association persisted after adjustment for EDs severity, psychiatric comorbidities, and season of assessment. No significant interactions were found between vitamin D deficiency and eating-disorder subtype, EDE-Q score, or season. Vitamin D deficiency was associated with the presence of a current depressive disorder in patients with eating disorders, independently of EDs subtype, severity, and seasonality. These findings support the clinical relevance of assessing vitamin D status in patients with EDs presenting with depressive symptoms. Longitudinal studies are needed to clarify the direction and clinical implications of this association. People with eating disorders often have low vitamin D levels, and depression is also common in this group. We studied 481 outpatients seen in a specialist eating disorder service in Montpellier, France, to find out whether vitamin D deficiency was more frequent in those who also had a current depressive disorder. Vitamin D deficiency was defined as a blood level below 20 ng/mL. We found that patients with vitamin D deficiency were almost twice as likely to have a current depressive disorder as those without deficiency. This relationship remained after taking into account eating disorder severity, other psychiatric conditions, and the season of assessment. It was also similar across different eating disorder subtypes. Because this was a cross-sectional study, we cannot determine whether low vitamin D contributes to depression, whether depression contributes to low vitamin D, or whether other factors influence both. Still, our findings support checking vitamin D status in patients with eating disorders who present with depressive symptoms.

Eating disorders are serious, multi-systemic and chronic disturbances in eating behavior among young people. Body image dissatisfaction is a known risk for developing eating disorders; therefore, this study aims to explore the proportion of participants screening-positive for elevated eating disorder risk among medical students in Jordan and their relationship with associated factors including body shape concerns. A cross-sectional study that used an online survey to collect the data for 402 undergraduate medical students (117 males; 285 females) from six public universities in Jordan. The surveying tool included a sociodemographic section, Eating Attitudes Test (EAT-26), and Body Shape Questionnaire (BSQ-16B). IBM SPSS Statistics (version 27) was used for descriptive statistics, multivariate analysis and logistic regression to identify the factors associated with the increased risk of eating disorders. Female students had higher mean EAT-26 scores compared to males (p&#x202f;=&#x202f;0.03), while BSQ-16B scores did not differ by gender. BMI was significantly associated with both eating attitudes and body shape concerns, with obese participants demonstrating higher EAT-26 scores than those with normal BMI (p&#x202f;=&#x202f;0.029) and a graded increase in BSQ-16B scores across the BMI categories (all p&#x202f;<&#x202f;0.001). Students living alone reported higher BSQ-16B scores compared to those living with their families (p&#x202f;=&#x202f;0.029). Participants with a history of psychiatric illness, use of diet pills or laxatives, or recent weight loss greater than 10&#x202f;kg had significantly higher EAT-26 and BSQ-16B scores (all p&#x202f;&#x2264;&#x202f;0.047). Females were more likely to fall into the high-risk group compared to males (36.1% vs. 29.9%, p&#x202f;=&#x202f;0.03). This study revealed that a considerable proportion of medical students in Jordan were screening-positive for elevated eating disorder risk. The strongest associated factors were female gender, higher BMI, rapid weight loss, use of diet pills or laxatives, and a history of psychiatric illness, with a strong correlation observed between eating-disorder risk and body shape concerns. These findings highlight the need for further research and targeted preventive strategies to support the mental and physical wellness of medical students.

GLP-1 receptor and GIP agonists are widely used for weight loss in obesity, with strong evidence supporting their efficacy, and their potential positive impact on binge eating disorders. However, little is known about their use in individuals with eating disorders. Despite growing concerns, research exploring this intersection is limited, and clinical guidance is lacking. This scoping review explores existing literature on weight loss injections in the context of eating disorder development and treatment to identify gaps and inform future practice. The scoping review searched six electronic databases (Embase, MEDLINE, PsycINFO, AMED, HMIC, and Emcare) in April 2025. Studies were eligible if they focused on the use of weight loss injections (GLP-1 receptor agonists), in individuals with current or past eating disorders, including all diagnoses. Both clinical and non-clinical settings were included, with no age or geographical restrictions. A total of 80 records were identified through database searches. After title and abstract screening, 11 full-text articles were assessed for eligibility. Two papers were excluded due to the absence of empirical data, resulting in 9 studies being included in the final review. Overall, there is very limited evidence exploring the psychological impact of GLP-1 receptor agonists on individuals with eating disorders. While some findings suggest potential benefits for managing binge eating symptoms in populations with comorbid type 2 diabetes, there is a significant gap in our understanding of how these medications may influence disordered eating behaviours and body image concerns, particularly when used outside of weight-based indicators. Further research is essential to inform clinical guidelines.

Recovery in eating disorders (EDs) is often defined in terms of symptom remission, potentially overlooking the broader meanings individuals attribute to illness and recovery. Qualitative research has highlighted the multidimensional nature of recovery, yet less is known about how therapeutic contexts may shape how individuals make sense of illness, change, and recovery. This study aimed to explore how individuals with EDs conceptualize illness and recovery, and how these meanings may be shaped through participation in group psychotherapy. A qualitative study was conducted within an interpretivist framework using reflexive thematic analysis. Ten adult outpatients with EDs participated in semi-structured interviews at the end of a group psychotherapy program integrated within a multidisciplinary treatment setting. Participants described a shift from understanding the ED mainly through food, weight, body image, and symptom control toward a more emotionally and relationally informed understanding of distress. Recovery was increasingly constructed as a multidimensional and non-linear process involving emotional awareness, self-acceptance, agency, identity renegotiation, and connection with others. The group was experienced as a space that fostered recognition, belonging, and reflection, while also exposing participants to shame, fear of judgment, and emotional vulnerability. Findings suggest that group psychotherapy may support a reconfiguration of how individuals with EDs understand illness and recovery, moving from a primarily symptom-centred perspective toward a more holistic, relational, and personally meaningful framework. Rather than operating mainly through direct behavioural change, the group appeared to function as a space for meaning-making, emotional reflection, and relational experimentation. This study highlights emotional awareness, identity renegotiation, self-acceptance, and interpersonal connection as potential targets for fostering recovery in EDs. Trial registration The study protocol (n. 0034565/i) was approved by the local Institutional Review Board. Eating disorders are often understood mainly in terms of eating behaviours, weight, and body image. However, people with eating disorders may experience illness and recovery in broader and more personal ways, involving emotions, relationships, identity, shame, and self-acceptance. This study explored how adults with eating disorders understood their illness and recovery after taking part in group therapy within a multidisciplinary treatment setting. Ten adults were interviewed after completing a group therapy program. Before the group experience, participants often described their eating disorder mainly through symptoms such as food restriction, bingeing, purging, body dissatisfaction, and weight control. After the group, many described their difficulties in a broader way, linking the eating disorder to emotions, relationships, and personal experiences. Recovery was seen not only as reducing symptoms, but also as becoming more aware of emotions, accepting oneself, developing personal agency, and connecting with others. The group helped some participants feel understood and less alone, but it could also involve shame, fear of judgment, and emotional vulnerability. Overall, group therapy appeared to support broader and more personally meaningful understandings of recovery.

Coparenting, defined as the ability of mothers and fathers to coordinate and provide mutual support in parenting, plays a key role in children's social, emotional, and behavioral adjustment. While previous research has highlighted its influence on internalizing and externalizing problems, comparatively less is known about how children contribute to and respond to coparenting at a relational level. This study investigates coparenting behaviors in families of adolescents with restrictive eating disorders and examines their association with the patients' interactive styles during the Lausanne Trilogue Play. We also explore potential correlations of coalition patterns with age, BMI, and clinical diagnosis. Seventy-seven adolescents with restrictive Eating Disorders (DSM-5) and their parents participated. Most families (81%) were intact. Coparenting coordination was assessed using the Coparenting and Family Rating System, while children's interactive styles were coded using the Lausanne Trilogue Play reading grid adapted for preadolescents and adolescents. Distinct coalition patterns emerged linking coparenting behaviors and adolescent interactive styles. Functional coparenting was associated with engaged child responses, whereas dysfunctional patterns corresponded to overinvolved responses. No significant correlations were found between coalition patterns and Body Mass Index, age, or specific Eating Disorders diagnosis, suggesting that these relational dynamics do not reflect current clinical status and needed more investigations. Identifying coalition patterns between coparenting and adolescent interactive styles provides valuable insights for family-based interventions in restrictive Eating Disorders. Such patterns allow clinicians to recognize both challenges and resources within the family system, informing psychoeducational and therapeutic strategies that integrate parental support with clinical and nutritional care.

ObjectiveThe development, implementation, and study of virtual day treatment programs for adolescents with eating disorders (EDs) was accelerated by the onset of the COVID-19 pandemic. As we transition into a post-pandemic period, it is necessary to analyze how adolescents, parents, and healthcare professionals experience such programs in a context where pandemic-related challenges are less relevant.MethodSemi-structured interviews were conducted with 25 individuals including eight adolescents with EDs, nine parents, and eight healthcare professionals who participated in the Intensive Ambulatory Care Program (IACP). The IACP is a 6 to 8-week virtual day treatment program for EDs, offered alongside usual in-person care. Phenomenology was adopted as the guiding qualitative theory, and interviews were analyzed using a six-step thematic analysis.ResultsThree themes emerged across all groups: (1) the positive impact on adolescents' well-being; (2) improved access to care through the virtual format; and (3) challenges encountered due to the program's virtual and intensive format. An additional theme, the positive impact on parents' well-being, was identified among parents and healthcare professionals only. Participants also shared their suggestions for improvement for future virtual day treatment programs.ConclusionOverall, participants reported a positive experience during the virtual day treatment program, noting improvements in well-being and valuing its accessibility. Taken together with the reported challenges and suggestions for improvement, our findings can guide clinicians and researchers implementing virtual day treatment programs for adolescents with EDs to ensure they fit the needs of this population. Treatments for teenagers with eating disorders moved online during the COVID-19 pandemic. As we enter the post-pandemic period, we need to understand how families and professionals feel during these virtual treatments. We interviewed 8 teenagers with eating disorders, 9 parents, and 8 professionals who participated in a virtual intensive program for 6 to 8 weeks. Most families and professionals enjoyed the program and saw that it improved teens&#x2019; and parents&#x2019; well-being. They also described challenges related to the virtual format, and suggested improvements. This suggests that virtual intensive programs could be helpful for teens and parents who can&#x2019;t access in-person care.

Family-Based Treatment (FBT) is evidence based for patients younger than 18 with anorexia nervosa; however, continued refinement of FBT is needed to increase response and remission rates. This study aimed to compare traditional FBT with an interoceptive exposure (IE) intervention that targets visceral sensitivity and autonomous eating in a family context. We hypothesized that IE would reduce food avoidance to a greater degree than FBT, as measured by laboratory feeding independent of weight gain. Adolescents diagnosed with a low-weight eating disorder (LWED) were randomized to six sessions of FBT or IE. Before and after the intervention, patients completed interviews and self-report questionnaires, laboratory test meals (single and multi-item), and functional magnetic resonance imaging. Healthy controls provided a comparison group for these assessments. The study was registered as follows: clinicaltrials.gov NCT02795455 (https://clinicaltrials.gov/study/NCT02795455?term=NCT02795455&rank=1), GCO 15-0939 Reward Systems and Food Avoidance in Eating Disorders. Adolescents receiving IE (n&#x2009;=&#x2009;30) consumed significantly more energy (kcal) during the post-treatment single item (Mdiff&#x2009;=&#x2009;98.12&#x2009;kcal, SDpooled&#x2009;=&#x2009;119.84, d&#x2009;=&#x2009;0.82) and multi-item meals (Mdiff&#x2009;=&#x2009;137.11&#x2009;kcal, SDpooled&#x2009;=&#x2009;301.85, d&#x2009;=&#x2009;0.45) than the FBT group (n&#x2009;=&#x2009;30). No significant differences were found for age and sex adjusted % expected body weight between groups. Adolescents with LWED reported significantly more symptoms on all clinical measures than controls (n&#x2009;=&#x2009;27). Six sessions of a novel form of IE yielded significant changes in eating behavior, namely an approximately two-fold increase in energy consumed in both multi-item and single-item meals among those randomized to IE. Additional research using a fully expanded version of these treatments is needed.

This cross-sectional study examined the relationships among nutritional knowledge, eating disorder symptoms, orthorexia-related scores, and body satisfaction among Turkish adults. A total of 1,457 adults aged 19-64 years completed an online questionnaire including the Nutrition Knowledge Scale, Eating Attitudes Test-40, ORTO-11 Orthorexia Scale, and Body Satisfaction Scale. Descriptive statistics, Pearson correlation analyses, and hierarchical multiple regression analyses were conducted. The mean Nutrition Knowledge Scale score was 81.42&#x2009;&#xb1;&#x2009;17.61, and 46.3% of participants were classified as having low nutritional knowledge. After adjustment for demographic, health, and lifestyle covariates, higher nutritional knowledge was significantly associated with lower Eating Attitudes Test-40 scores (&#x3b2; = -0.151, p&#x2009;<&#x2009;0.001), higher ORTO-11 scores (&#x3b2;&#x2009;=&#x2009;0.126, p&#x2009;<&#x2009;0.001), and higher Body Satisfaction Scale scores (&#x3b2;&#x2009;=&#x2009;0.133, p&#x2009;<&#x2009;0.001). These findings suggest that nutritional knowledge may be linked to fewer disordered eating symptoms and greater body satisfaction. However, interpretation of the ORTO-11 findings requires caution because lower ORTO-11 scores indicate greater orthorexia risk in the original scoring direction. Nutrition education programs should therefore promote accurate knowledge while also supporting flexible eating attitudes, positive body image, and psychological well-being. Future longitudinal studies using updated orthorexia assessment tools are needed to clarify causal pathways and the role of cultural and psychosocial mediators.

Family-based therapy is the main evidence-based outpatient treatment for children and adolescents with eating disorders. In this context, nutritional education and family guidance can be carried out using different strategies, including calorie counting, exchange lists, and visual models and resources such as the Plate-by-Plate Approach&#xae;. The objectives of this study were to develop a visual resource adapted to the Mediterranean diet pattern and the eating and gastronomic habits of Spain, and to evaluate the energy and macro- and micronutrient contribution, as well as the methodology's nutritional quality, using models such as the Plate-by-Plate Approach&#xae; as a reference. The MedPlate Method&#x2122; was designed as a graphical tool that accounts for meals being distributed on a single plate or two plates. Different recipes and menus were developed according to cultural preferences, and their composition and nutritional quality were analyzed using specialized software. The results show that the MedPlate Method&#x2122; allows for meeting energy intake requirements and the recommended intakes for most nutrients. Further studies are needed to evaluate and validate the usefulness of the MedPlate Method&#x2122;, a new nutritional education tool designed to help professionals and serve as a guide for family members and caregivers of eating disorder patients who are metabolically stable and not at risk of refeeding syndrome.

As an emergent secondary analysis of a wider qualitative study, we aimed to understand how paediatricians apply the Medical Emergencies in Eating Disorders (MEED) guidelines in relation to recommending nasogastric tube feeding under physical restraint. Paediatric wards in England. We recruited clinicians working in acute paediatric settings in England via adverts using three professional networks. Participants were from a variety of professions within the multidisciplinary team involved with caring for those with an eating disorder. Individual interviews using semistructured interviews were conducted. The interviews were recorded and transcribed by Microsoft Teams and checked for accuracy. This secondary analysis applied Braun and Clarke's approach to thematic analysis. 20 participants (five males and 15 females) were recruited across 15 National Health Service Trusts. Overlapping themes between participants identified three main themes of 'positives of MEED', 'negatives of MEED' and 'learning how to use MEED well'. Subthemes of 'tolerating risk', 'individualised meal plans', 'second opinion', 'more time' and 'teamworking' were identified. This research identifies that paediatric clinicians find the MEED guidelines helpful in understanding who needs to be admitted. Additionally, participants reported their learning on how to make these admissions more successful through personalisation of treatment planning.

Eating disorders (EDs) and disordered eating behaviours (DEBs) are major global health concerns that remain under-recognized and under-treated. In addition to structural barriers, individuals encounter symbolic and epistemic obstacles, including failures of recognition, diagnostic exclusion, and medical silencing. These processes shape who is legitimized as having EDs/DEBs within biomedical systems and society. To examine how such gaps are produced and navigated, we employ a narrative intersectional methodology. Although analysis was grounded in inductive coding, interpretations were informed by lived-experience alongside narrative and intersectional commitments. We present the overarching theme Who Gets Seen: Recognition and Visibility in EDs/DEBs. Three subthemes emerged: Struggles for Legitimacy, Being Seen, Misread, or Overlooked, and Navigating Self-Recognition. Across themes, participants described barriers to care, recognition, and healing, illustrating how individuals negotiate norms of being seen by family, friends, healthcare providers, and themselves. Findings highlight persistent inequities in recognition and visibility that leave many individuals unnoticed and undertreated. These dynamics reflect epistemic injustice, where credibility and lived realities are undermined within medical systems. Advancing epistemic justice requires reimagining what EDs/DEBs look like and who is considered deserving of recognition and care.

Suicidal behaviour is a major public health issue, particularly among individuals with eating disorders (EDs), who exhibit elevated risks of suicidal ideation and attempts. EDs, including anorexia nervosa and bulimia nervosa, are associated with significant psychological distress and psychiatric comorbidities, contributing to higher suicide rates. This study aimed to explore the clinical characteristics and suicidal behaviour in patients with EDs following a suicide attempt. Specifically, we sought to analyse the influence of sociodemographic factors, psychiatric comorbidities, impulsivity, and childhood trauma on suicide-related outcomes. A total of 1,441 adults were included, of whom 131 (9.1%) had an ED diagnosis. Participants were categorized into ED and no-ED groups. Group comparisons were conducted using &#x3c7;&#xb2; and ANOVA tests. Linear and logistic regression models explored the influence of sociodemographic and clinical variables (e.g., comorbidities, impulsivity, trauma) on suicidal ideation intensity, number of suicide behaviours, and medical damage from the index attempt. The ED group was younger, predominantly female, and had higher educational attainment. Clinically, they showed greater psychopathology, higher rates of non-suicidal self-injury (NSSI), emotional and sexual abuse, and more previous suicide attempts. They also exhibited a higher number of suicidal behaviours (d = 0.70), but only slightly greater ideation intensity (d = 0.28). Regression models identified psychiatric comorbidities, depression, acquired capability, and past attempts as key predictors of ideation; suicide behaviours were associated with ED (binging-purging subtype), comorbidities, psychotic symptoms, NSSI, and prior attempts. EDs, particularly those with binging-purging patterns, are linked to repeated suicidal behaviour. Suicide risk assessments in ED patients should consider comorbidities, trauma, NSSI, and impulsivity to guide targeted interventions.

Eating disorder (ED) and obsessive-compulsive disorder (OCD) exhibit clinical and genetic overlap, yet whether they converge at the molecular level in the human brain is unknown. We perform large-scale transcriptomic profiling of the dorsolateral prefrontal cortex (DLPFC) and caudate in postmortem tissue from 86 controls, 57 individuals with ED, and 27 with OCD. ED shows robust, region-specific transcriptional dysregulation (102 differentially expressed genes [DEGs] in DLPFC and 222 in caudate at FDR <1%) that replicates in an independent cohort. OCD shows no single-cohort DEGs, but meta-analysis across three datasets identifies 57 caudate-associated genes. Despite these differences, transcriptome-wide effects strongly correlate between ED and OCD (DLPFC r = 0.67; caudate r = 0.75), indicating shared molecular pathology. Joint ED + OCD analysis identifies 233 DEGs in DLPFC and 815 in caudate, implicating GABAergic signaling, neuroendocrine regulation, mitochondrial metabolism, and CHD8-associated networks. Genetically regulated expression analyses identifies five genes (WDR6, NCKIPSD, P4HTM, DALRD3, and SHISA5) with convergent risk associations across disorders and brain regions, all mapping to a gene-dense region on chromosome 3. These findings define a shared cortico-striatal transcriptional architecture and identify candidate genes for transdiagnostic intervention.

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