搜索结果：The International journal of eating disorders

There is an increasing trend towards embedding consumer and community involvement in all health and medical research. The Executive Committee of the International Journal of Eating Disorders (IJED) disseminated a survey for eating disorder researchers investigating their practices and perspectives regarding Patient and Public Involvement (PPI) in research, with the goal of informing our procedures in future. A survey was distributed globally via eating disorder organizations, professional networks, and individual researchers. Researchers (N = 119) of various career stages completed the survey. Three quarters of the researchers had consulted people with lived experience to inform their research; 45% said that they employed lived experience and/or peer researchers across all stages of their research, and 75% viewed PPI as improving the quality, relevance, feasibility, adoption, or implementation of research. Concerns were expressed about the challenges associated with PPI, including cost, time, expertise, disclosure of lived experience status, the need to maintain robust scientific principles, concern about the validity of results, and potential harm to the person with lived experience. Most did not want disclosure of PPI to be mandatory or to impact the review process. These insights informed the development of an approach to recognizing the involvement of PPI in our publishing. Rather than an obligatory statement, IJED encourages use of PPI and disclosures, with inclusion of a description and implications for the interpretation of the research detailed in manuscripts.

The Body Project is a dissonance-based body image intervention that was originally developed to prevent the onset of eating disorders. The aim of this review is to provide an overview of the key scientific Body Project findings along with a discussion of implementation successes and approaches as well as ongoing questions. This is an invited narrative review. The Body Project is backed by significant efficacy and effectiveness research and has been found to reduce internalization of the appearance-ideal, body dissatisfaction, negative mood, dieting, and continuous measures of eating disorder pathology. Some variants have also been found to reduce onset of eating disorders, thus making the Body Project a true eating disorders prevention program. Despite this, many communities choose to implement the Body Project primarily for its effectiveness at improving body image under a wide range of circumstances. Although the mental health field broadly has struggled to translate efficacy and effectiveness research into widespread adoption of evidence-based programs, an informal global village comprised of researchers, community partners, and clinicians has collectively worked together to successfully implement the Body Project on a very large scale. It offers numerous lessons about the importance of theory and research in intervention development as well as the potential of community participatory research. Future directions include novel and cultural adaptations to allow flexible Body Project implementation in new contexts.

To update the evidence regarding the diagnostic accuracy of eating disorder (ED) questionnaires in adolescents and adults with higher weight. Five databases were systematically searched from 2020 to November 2025 (CRD420251186115). Included studies reported on the diagnostic accuracy of self-report questionnaires against a clinical interview to identify EDs and disordered eating behaviors (DEBs) in adolescents and adults with higher weight. Narrative synthesis was conducted, and findings from new studies were synthesized alongside previously identified studies. Thirty-two studies (5 new) were included, reporting on the diagnostic accuracy of 13 questionnaires in adults and 5 in adolescents. The diagnostic accuracy of questionnaires was examined to identify any ED (5 questionnaires in adults, 0 adolescents), binge-eating disorder (8 adult, 2 adolescent), DEBs (e.g., binge eating, purging) (4 adult, 1 adolescent), loss-of-control eating (1 adult, 2 adolescent), bulimia nervosa, atypical anorexia nervosa, purging disorder, and night eating syndrome (each n = 1 adult, 0 adolescent). The Eating Disorder Examination Questionnaire (7 studies; sensitivity 0.16-0.88; specificity 0.54-1.0), Binge Eating Scale (6 studies; sensitivity 0.37-0.98; specificity 0.48-0.96), and Questionnaire on Eating and Weight Patterns (6 studies; sensitivity 0.07-1.0; specificity 0.0-1.0) were most used. Progress in evaluation of the diagnostic accuracy of ED questionnaires in people with higher weight has been limited. There remains a lack of evidence regarding the diagnostic accuracy of questionnaires in adolescents and a lack of sufficiently sensitive questionnaires to identify EDs other than binge-eating disorder. Assessing the diagnostic accuracy of questionnaires in people with higher weight remains a research priority.

This study aimed to assess the structural validity and readability of a brief 7-item version of the Eating Disorder Examination Questionnaire (the EDE-Q7) among adolescents. Latent variable analysis was used in a sample of 263 adolescents (age range = 13-17.99y) diagnosed with an eating disorder and recruited from treatment centres in the United States of America and Australia. Several indices were used to provide different estimates of overall model fit. The EDE-Q7 showed good fit to the data, although absolute fit indices suggested some evidence of imperfect fit. Several other models (both brief and full-item versions) failed to meet most criteria indicating good fit. The subscales of the EDE-Q7 showed significant correlations with several disordered eating behaviors, suggesting convergent validity. Review of the EDE-Q7 suggests ease of readability for adolescents from at least 11 years of age. This is one of the first clinical studies to support the EDE-Q7 as a brief, valid assessment of eating psychopathology that can be used with adolescents as well as adults. The results indicate that the EDE-Q7 might be appropriate for assessing eating pathology among adolescents from the age of 13 years.

Early adolescence is characterized by the onset of mental health problems, including eating pathology (e.g., body image concerns, restrictive eating). Inhibitory control (IC) and reward sensitivity (RS) are two key traits that have been implicated in the development of eating problems. IC is defined as the ability to suppress a prepotent response to facilitate goal-directed behavior; RS refers to individuals' responsivity to reward-related stimuli (e.g., food). Despite growing research on IC and RS, little work has examined their joint contribution in predicting emerging eating problems in early adolescents. Further, no work has examined how neurophysiological correlates of IC, like the P3 component, interact with RS to predict subsequent eating pathology. We analyzed two waves of data from 63 healthy early adolescents (39 girls; Mean age/SD at T1 = 11.01/1.18 years), collected approximately 1 year apart. Youths completed an EEG Go/No-Go task and reported on their eating problems at T1 and T2; they also reported on their RS at T1. We found a moderating effect of RS on the association between the No-Go P3 and disordered eating symptoms: controlling for T1 disordered eating symptoms, a smaller No-Go P3 at T1 predicted greater disordered eating symptoms at T2, specifically for those with higher RS at T1. Contrary to our expectations, higher, but not lower, commission errors at T1 predicted lower disordered eating symptoms at T2. We contribute novel evidence on the moderating effect of RS on the prospective association between IC and eating pathology in early adolescence. Future studies can leverage these findings to inform IC-related preventions for youths at risk for eating problems, particularly those with heightened RS.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and related incretin-based medications are rapidly changing the treatment landscape for type 2 diabetes, obesity, cardiovascular risk reduction, and weight management. Their effects on appetite, satiety, gastrointestinal function, reward-related eating, and weight loss place them in direct contact with core psychological and behavioral domains of eating disorders. This Spotlight article argues that the eating disorders field urgently needs a coordinated clinical and research agenda for the GLP-1 era. We synthesize emerging clinical concerns and early evidence regarding GLP-1 RA use in populations with binge eating, bulimic symptoms, restrictive eating, body image disturbance, weight stigma exposure, and histories of eating disorders. We focus on unresolved questions rather than providing a systematic review. GLP-1 RAs may hold therapeutic promise for some individuals with binge eating disorder or loss-of-control eating, but the same mechanisms that reduce appetite and food preoccupation may also reinforce restriction, avoidance of regular eating, compulsive weight control, and relapse in vulnerable individuals. Current prescribing pathways often lack systematic eating disorder screening, multidisciplinary monitoring, and guidance on how to distinguish medically appropriate appetite modulation from emerging or worsening eating disorder psychopathology. We propose six priorities: routine eating disorder screening before and during GLP-1 RA treatment; risk stratification; development of validated monitoring tools for GLP-1-related eating disorder risk; discontinuation planning; integration of lived experience in guideline development; and communication strategies that reduce weight stigma while supporting metabolic health.

Imaginal exposure therapy facilitates the approach of feared stimuli (e.g., fear of weight gain) not accessible in everyday life (e.g., rapidly gaining weight) and has initial promising data for the treatment of eating disorders (EDs). In the current randomized controlled trial (RCT) participants (N = 130) were randomly assigned to a five-session digital imaginal exposure condition or a control online journaling condition within 4 months of discharge from intensive (e.g., inpatient) treatment. We examined the feasibility and acceptability of the treatment conditions, target engagement, and initial clinical efficacy. This study was pre-registered. Imaginal exposure therapy significantly outperformed the control condition on our primary outcome and target mechanism: fear of weight gain. Imaginal exposure therapy also outperformed the control condition on overall ED symptoms, fear of food, food avoidance, clinical impairment, and PTSD symptoms, suggesting initial clinical efficacy. This RCT suggests that the active ingredient (i.e., exposure to feared stimuli) in imaginal exposure leads to significant decreases in fear of weight gain and associated clinical outcomes. This work supports imaginal exposure therapy as an effective intervention for fear of weight gain, a primary maintenance factor of EDs. NCT04862247.

The Eating Disorder-15 (ED-15) questionnaire measures core symptoms of eating disorders (EDs) and is used to track session-by-session symptom change during treatment. The ED-15 was found to have good validity and reliability with a two-factor structure in the original English version, as well as in the Portuguese, Spanish, and Turkish versions. The aim of the current study was to examine the psychometric qualities and factor structure of the Dutch version of the ED-15 (ED-15-NL). Fifty-nine patients with an ED (currently receiving CBT-T treatment) and 513 non-clinical controls completed a set of questionnaires, including measures pertaining to ED-pathology (ED-15-NL, and Eating Disorder Examination Questionnaire; EDE-Q), anxiety (Generalized Anxiety Disorder-7; GAD-7), and depressive symptoms (Patient Health Questionnaire-9; PHQ-9). The ED-15-NL provided evidence supporting the originally two-factor structure, good concurrent validity (i.e., strong correlations with the EDE-Q) and good divergent validity (i.e., differentiated well between EDs, and between symptoms of depression and anxiety). The ED-15-NL also provided evidence supporting excellent reliability (i.e., internal consistency, test-retest reliability) and high sensitivity to change. The findings show preliminary support for the reliability and validity of ED-15-NL scores for session-by-session assessment of changes in ED-symptoms, despite the relatively small clinical sample. The ED-15-NL therefore represents not only a valuable tool for clinical practice, but also a useful instrument for scientific research.

Eating disorder recovery content is widely circulated on TikTok. We thematically analyzed recovery content on TikTok, examined its associations with symptom severity among individuals with eating disorders, and assessed its co-occurrence with pro-eating disorder material within their TikTok feeds. Study 1 was a qualitative reflexive thematic analysis of 250 TikTok posts containing eating disorder recovery hashtags. Study 2 was a quantitative examination of TikTok usage data and symptom severity collected from 42 individuals with eating disorders over a one-month period. Fifty percent of "recovery" posts contained pro-eating disorder elements, including imagery or messaging consistent with disordered eating norms, weight comparisons, and thin-ideal reinforcement. Quantitative analyses provided no evidence that greater exposure to recovery content was associated with lower or higher eating disorder symptom severity, although the study was underpowered to detect small-to-moderate effects. Recovery and pro-eating disorder content were strongly correlated within participants' TikTok feeds in terms of the volume of videos delivered (Spearman's ρ = 0.91) and their proportional representation (ρ = 0.77), with the former association remaining high even after controlling for overall TikTok exposure (ρ = 0.81). Our findings raise concerns about the safety of TikTok recovery spaces. TikTok content pitched as "eating disorder recovery" frequently contains pro-eating disorder features, shows no strong protective association with symptom severity, and is regularly encountered alongside pro-eating disorder content within users' feeds. We conclude that overlap between recovery content and pro-eating disorder content operates at two levels: within individual videos and across the broader feed context.

Fear of fat may reflect concern regarding rejection one may experience at a higher weight. Peers play a major role in socialization and support during adolescence and young adulthood. While studies have highlighted peers as an important source of influence underlying disordered eating, it is unclear whether one's own fear of fat or peers' fear of fat is associated with concerns about weight, shape, eating, and eating behaviors. The present study used data from 94 female friend pairs (mean age = 20.18, SD = 1.77). Actor-partner interdependence models were conducted to explore the extent to which one's own fear of fat predicted their own dietary restraint, weight concerns, shape concerns, eating concerns, and thin-ideal internalization (actor effects), as well as the extent to which the individual's friend's fear of fat predicted the individual's dietary restraint, weight concerns, shape concerns, eating concerns, and thin-ideal internalization (partner effects). The Antifat Attitudes Questionnaire was used to assess fear of fat. The Eating Disorder Examination Questionnaire was used to assess dietary restraint and weight/shape/eating concerns. The Sociocultural Attitudes Toward Appearance Questionnaire-4 was used to assess thin-ideal internalization. BMI was included as a covariate. Findings demonstrated robust actor effects, whereas partner effects were small and/or non-significant. Results highlight that one's own attitudes about weight are stronger predictors of their dietary restraint, weight/shape/eating concerns, and thin-ideal internalization. These results might further suggest that an individual's perception of their peers may be a stronger predictor of their disordered eating than their peers' objective attitudes.

Neurodevelopmental conditions frequently co-occur with eating disorders (EDs). This study aimed to investigate the occurrence of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), tic disorder (TD), and obsessive-compulsive disorder (OCD) in individuals with EDs and their full and half siblings. Study population comprised all individuals born in Finland between 1991 and 2001 with a recorded diagnosis of the following ICD-10 EDs (N = 4240): anorexia nervosa (AN; F50.0/F50.1), bulimia nervosa (BN; F50.2/F50.3), and other/unspecified EDs (F50.8/F50.9). Population controls without ED (N = 16,494) and full and half siblings of participants with ED and controls (N = 36,301) were included. Conditional logistic regression was applied in analysis. Individuals with AN had increased occurrence of ASD, ADHD, and OCD compared to population controls (Odds ratios [ORs]: 6.62 [95% CI 4.21-10.39]; 3.30 [95% CI 2.33-4.69]; 10.67 [95% CI 7.07-16.10], respectively). Individuals with other/unspecified EDs had increased occurrence of ASD, ADHD, TD, and OCD (ORs: 9.06 [95% CI 5.5-14.77]; 2.78 [95% CI 1.92-4.01]; 4.68 [95% CI 1.94-11.32]; 7.64 [95% CI 4.92-11.87], respectively). The occurrence for ASD was particularly pronounced in males with other/unspecified EDs (OR 32.40 [95% CI 9.78-107.39]). Compared to full siblings of population controls, full siblings of individuals with AN had two-fold odds for ASD and three-fold odds for OCD; full siblings of individuals with other/unspecified EDs had 2-3-fold odds for ASD, ADHD, TD, and OCD. Individuals with EDs have a high occurrence of neurodevelopmental conditions, also extending to their full siblings. These findings provide detailed characterization of comorbidity and the familial aggregation of these conditions.

Loss of control (LOC) eating is common among adolescents and is linked to adverse physical and psychosocial outcomes. Black youth report equal or higher rates of LOC than white youth, yet little research has examined culturally specific factors underlying these experiences. Prior findings on emotional precursors to LOC in Black adolescents are mixed, highlighting the need for foundational qualitative work. This study explored how Black teens understand, experience, and interpret LOC eating. Twenty-one Black adolescent girls participated in six virtual focus groups (n = 3-4 participants each), and seven Black adolescent boys completed individual Zoom interviews. All were ages 14-17, had overweight or obesity, and reported LOC eating within the past 3 months. Sessions explored the emotional and contextual factors surrounding LOC episodes. Using applied thematic analysis, transcripts were double coded with a collaboratively developed codebook, and data collection continued until thematic saturation was achieved. Girls described three emotional pathways to LOC: (1) eating in response to a high-arousal, negatively-valenced state (e.g., anxiety), (2) eating in response to a low-arousal, negatively-valenced state (e.g., boredom), and (3) eating in response to a high-arousal, positively-valenced state (e.g., joy) that devolves into LOC. Boys endorsed Pathways 1 and 2 but less often Pathway 3, instead describing difficulty identifying and articulating the emotional antecedents of LOC, as well as experiences of teasing or critical family comments as key triggers for these episodes. Participants often recognized upon reflection that LOC episodes were emotionally driven and later experienced regret. Findings highlight multiple emotional and contextual pathways to LOC and underscore the role of regret, family expectations, and cultural norms, emphasizing the importance of culturally and developmentally appropriate intervention approaches.

The US federal government has enacted sweeping policy changes since January 2025 that imperil public health, with important implications for the eating disorders field-a field that is already disproportionately under-resourced. This paper examines the pathways through which these recent policy changes threaten progress in eating disorder research, treatment, and prevention, and calls for a coordinated response. We identify three interconnected areas of concern: (1) the threats to the scientific enterprise, including terminated eating disorder grants, the purging of public health data, and disruptions to the research training pipeline; (2) the erosion of healthcare access, including bans on gender-affirming care and slashed funding for government programs such as Medicaid; and (3) the dismantling of structural protections and equity infrastructure, including reducing the Supplemental Nutrition Assistance Program budget and the systematic dismantling of diversity, equity, and inclusion initiatives. These domestic crises are further compounded by global consequences resulting from the US retreat from international research and health investments, with direct implications for eating disorder science and care worldwide. We call on the eating disorders field to respond with coordinated advocacy, cross-national collaboration, and sustained commitment to protecting the infrastructures on which equitable progress depends.

We need to understand therapists' experiences of delivering manual-based psychotherapies to identify possible dissemination barriers and opportunities. This study explored therapists' experiences of delivering CBT-AN-20, a new 20-session cognitive-behavioral intervention for outpatients with anorexia nervosa. Ten therapists who had delivered CBT-AN-20 to at least one patient participated in an online survey. We used descriptive statistics (Likert-scale questions; demographics) and thematic analysis (open-ended text) to analyze responses. Pre-registration: https://doi.org/10.17605/OSF.IO/R2U8P. Therapists' mixed experiences of CBT-AN-20 were evident across quantitative and qualitative responses. Thematic analysis generated three main themes: Feelings about therapy over time; beliefs about for whom therapy might work; and perceptions of the characteristics of therapy. Despite some initial uncertainty, therapists reported both positive and negative experiences of delivering CBT-AN-20. They felt it worked well for some patients (highly motivated/less complex eating disorder presentations) but not for others (less motivated/more complex presentations). They experienced CBT-AN-20 as fast-paced and action-packed, yet with a clear, supportive structure. Therapists found encouraging rapid, early changes to patients' eating and weight difficult but worthwhile. CBT-AN-20 is feasible and broadly acceptable for therapists to deliver. Therapists' mixed feelings were like those reported in qualitative studies of other psychotherapies for anorexia nervosa. While the manual addresses many identified challenges, training and supervision should focus on bolstering therapists' confidence in delivering CBT-AN-20 with fidelity. Future research should explore whether therapists' perceptions of CBT-AN-20 change with experience and if their expectations about whom CBT-AN-20 might work for are accurate.

Anxiety and depression are highly prevalent among adolescents and young adults with eating disorders. A comorbid mental health condition is associated with worsened long-term eating disorder outcomes. While individual risk factors for comorbid anxiety or depression and eating disorders have been elucidated, the impact of external factors, such as neighborhood disadvantage, remains understudied. The purpose of this study was to examine the associations between levels of neighborhood disadvantage and comorbid anxiety and depression. This was a retrospective study utilizing data available from Epic Cosmos, an electronic health record data platform. Individuals aged 9-25 years with an eating disorder diagnosis and a healthcare encounter within the last year were included. The exposure variable of neighborhood disadvantage was measured by the Area Deprivation Index percentile ranks. Outcomes included ICD-10 diagnoses of anxiety or depression. Logistic regression models were used to assess associations between area deprivation and mental health conditions. Inclusion criteria were met in 100,924 individuals. The median age was 17 years, and the majority were female, White, and non-Hispanic. Anxiety was present in 71.2% of the cohort and depression was present in 52.5%. Higher levels of neighborhood disadvantage were associated with increased odds of anxiety and depression. Disparities based on sociodemographic characteristics were also observed. More neighborhood disadvantage is associated with increased odds of anxiety and depression among adolescents and young adults with eating disorders. These findings highlight the importance of understanding neighborhood context in eating disorder presentations.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are linked to disordered eating in youths. Although ADHD and ASD often occur together, little is known about disordered eating among children and adolescents with both conditions. This study explored the relationships between ADHD, ASD, and co-occurring ADHD-ASD with maladaptive eating behaviors in U.S. children and adolescents, including whether these associations differed by age, sex, and race/ethnicity. Children and adolescents (N = 64,691) from the 2022-23 U.S. National Survey of Children's Health were divided into subgroups based on parent-reported ADHD and ASD: ADHD only, ASD only, comorbid ADHD-ASD, and neither condition. Multiple logistic regression models examined associations between diagnostic group status and eight binary maladaptive eating behaviors, adjusting for age, sex, race/ethnicity, household income, adult education, and weight status. Interaction terms evaluated moderation effects, with stratified analyses performed for significant interactions. The false discovery rate was controlled using the Benjamini-Hochberg procedure. Compared to youth with neither condition, both ADHD and ASD were independently linked to higher odds of various maladaptive eating behaviors, including food avoidance (e.g., restrictive eating) and food approach (e.g., emotional overeating) behaviors (AORs = 1.70-4.50). Children and adolescents with both ADHD and ASD showed the most significant and consistent increases across behaviors (AORs = 3.18-5.85). These associations differed by age and race/ethnicity but not by sex, generally with stronger associations observed among children and White participants. These findings support early detection, thorough assessment of both restrictive and binge-type behaviors, and targeted prevention efforts for neurodivergent youth.

The Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used measures of eating disorder psychopathology; however, its original four-factor structure is not supported in data-driven investigations. This study examined the latent structure of the EDE-Q in a large sample of inpatients with anorexia nervosa (AN) at the beginning and end of hospitalization. Inpatients with AN (ages 13-64 years) were included. Exploratory factor analysis (EFA) was conducted using EDE-Q data collected at admission (n = 320). Confirmatory factor analysis (CFA) was conducted using data collected just prior to discharge (n = 301). Reliability was assessed using internal consistency indices and construct validity of the proposed EDE-Q subscales was explored using correlational analyses with the eating disorder inventory (EDI) and the eating pathology symptoms inventory (EPSI). The original four-factor structure was not supported. A three-factor model (Body Image Dissatisfaction, Discomfort with Body Exposure, and Restrictive Eating Concerns) emerged from the EFA and was supported in CFA with improved model fit (CFI = 0.928, TLI = 0.915, RMSEA = 0.087, SRMR = 0.055). The model showed acceptable internal consistency and convergent validity. The EDE-Q was found to have a three-factor structure, comprising two body image-related domains and one domain assessing restriction and concern about eating. Findings support the emergence of a distinct factor capturing discomfort with body exposure, independent of body dissatisfaction. This highlights the need for empirically derived subscales that better disentangle overlapping eating disorder constructs.

Anorexia nervosa (AN) is a serious illness in which more than half of all deaths are due to malnutrition. Critically low energy and protein intake are known causes of massive weight loss, whereas micronutrient deficiencies due to a low-calorie food pattern remain poorly characterized in children with AN. Micronutrient deficiencies in AN, such as selenium deficiency, are known to increase anxiety and the risk of suicide. Two large studies in adults highlighted frequent selenium and copper deficiencies; this information is lacking in children. The present study aimed to provide a comprehensive description of the micronutrient status in pediatric AN and evaluate whether deficiencies differ according to AN subtype (restricting, R, binge-eating/purging, BP). A retrospective, single-center, descriptive study was conducted in a cohort of children with AN who were evaluated at a specialist eating disorders center from 2016 to 2022. The sample comprised 349 patients (mean age 14.7 ± 1.8 years); 91.4% had AN-R, 8.6% BP. Mean weight loss was 18.2% ± 10.7%, and initial BMI was 16.7 ± 1.1 kg/m2 according to the International Obesity Task Force. At least one micronutrient deficiency was found in 90% of patients; 51.3% experienced multiple deficiencies. The most common were selenium (23.5%), copper (18.4%), and vitamin A (29.1%). The prevalence of deficiencies was similar between AN-R and AN-BP, except for potassium and calcium which were significantly lower in AN-BP. Micronutrients deficiencies are frequent in pediatric AN with no difference according to subtype. The functional impact and the benefit of supplementation remain to be studied.

Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR) is an emerging treatment for ARFID, but to date, it has only been delivered by mental health clinicians. Given the relevance of nutrition to treatment goals, we adapted the treatment to be dietetic-led (D-CBT-AR). We conducted a pilot trial of D-CBT-AR. Participants self-referred to a multidisciplinary eating-disorder clinic in Brisbane, Australia, and attended in person or virtually. Participants rated D-CBT-AR on acceptability and feasibility. We also measured changes in ARFID psychopathology, Body Mass Index, and co-morbid psychopathology. Of the 12 participants offered D-CBT-AR, 92% (n = 11) took up the treatment, and 72% (n = 8) completed, with a median treatment length of 33 weeks. The majority of completers rated D-CBT-AR above benchmarks on feasibility (89%) and acceptability (78%). Using intent-to-treat analyses, participants reported large and significant improvements in ARFID psychopathology on all subscales of the Pica, ARFID and Rumination Disorder Interview. They incorporated a median of 26 new foods. For those who were weight-suppressed, Body Mass Index increased by 1.5 bands from pre- to post-treatment, though effects were non-significant. Participants also reported large and significant reductions in clinical impairment, depression, and stress. Additionally, at 6-months post-treatment, five participants met remission criteria. The trial shows proof-of-concept for the feasibility and acceptability of D-CBT-AR. Although requiring replication in larger and randomized controlled trials, our findings highlight the potential of D-CBT-AR to expand the types of professionals who could effectively deliver CBT-AR, thereby increasing access to care for individuals living with ARFID.