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Eating Disorders and Disordered Eating Behaviors: Prevention, Mechanisms, Treatments, and Outcomes

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A Special Issue of Nutrients (ISSN 2072-6643) belonging to the section "Nutrition and Public Health".

Deadline for manuscript submissions: 5 December 2026 | Viewed by 3689

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Editors

Dr. Laura Dalla Ragione

E-Mail Website
Guest Editor

Food Science and Human Nutrition Unit, University Campus Biomedico of Rome, 00128 Rome, Italy
Interests: eating disorders; eating behaviors; disordered eating behaviors; anorexia nervosa; bulimia nervosa; binge eating disorder

Dr. Alessandro Alberto Rossi

E-Mail Website
Guest Editor

Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35121 Padova, Italy
Interests: eating disorders; eating behaviors; disordered eating behaviors; food addiction; orthorexia nervosa; drunkorexia
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Special Issue Information

Dear Colleagues,

Eating disorders (e.g., Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder) and disordered eating behaviors (e.g., food addiction, orthorexia nervosa, and drunkorexia) represent a significant and growing public health concern worldwide. These conditions are associated with severe psychological, medical, and social consequences, often leading to chronic impairment and reduced quality of life.

Despite considerable advances in our understanding of these phenomena, several questions remain unanswered regarding their underlying mechanisms, risk and protective factors, and optimal treatment approaches. Moreover, the boundaries between clinical eating disorders and subclinical disordered eating behaviors are often unclear, highlighting the need for research that addresses the full spectrum of eating pathology.

This Special Issue aims to advance our understanding of eating disorders and disordered eating behaviors by bringing together empirical research, theoretical contributions, and clinical perspectives. We welcome original research articles, reviews, meta-analyses, and study protocols.

Topics of interest include (but are not limited to) the following:

Risk factors, protective factors, and underlying mechanisms of eating disorders and disordered eating behaviors;
Prevention programs and early intervention strategies;
Psychological, pharmacological, nutritional, and multidisciplinary treatment approaches; Long-term outcomes, recovery processes, and sequelae;
Assessment and psychometric evaluation of eating pathology;
Cross-cultural perspectives on eating disorders and disordered eating behaviors.

Dr. Laura Dalla Ragione
Dr. Alessandro Alberto Rossi
Guest Editors

Andrea Tagliagambe E-Mail Website
Guest Editor Assistant
Affiliation: Residence Cabrini DCA, Pontremoli, Italy
Interests: eating disorders; eating behaviors; disordered eating behaviors; anorexia nervosa; bulimia nervosa; binge eating disorder

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

eating disorders
disordered eating behaviors
anorexia nervosa
bulimia nervosa
binge eating disorder
prevention and treatment
risk factors
psychological mechanisms
treatment oucomes

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Published Papers (5 papers)

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Research

17 pages, 1042 KB

Open AccessArticle

Nutritional Rehabilitation and Medical Stabilization of Adolescents with Anorexia Nervosa: Length-of-Stay Predictors, Cardiovascular Recovery, Refeeding Safety, and Psychiatric Comorbidity Burden

by Saba F. Elhag, Abdulla Fahmi, Abdulrahman Alansari, Sara Al-Kuwari, Amal Saleh Al-Kuwari, Amna Ahmed, Shahd Hani Jaouni, Amine Zaidi, Tasnim L. Milhem, Reem Bachir, Moayad H. Ali, Asma Ahmed, Qusi Shaban, Sheema Hashem and Madeeha Kamal

Nutrients 2026, 18(17), 2789; https://doi.org/10.3390/nu18172789 - 26 Aug 2026

Viewed by 262

Abstract

Background/Objectives: Adolescents with anorexia nervosa (AN) face substantial medical and psychiatric risk during hospitalization. We examined predictors of length of stay (LOS), cardiovascular recovery, refeeding safety, and psychiatric comorbidity in a consecutive pediatric cohort at a national tertiary center. Methods: Retrospective cohort of 68 consecutively admitted adolescents (91.2% female; mean age 14.2 ± 1.8 years, range 8–17; 85.3% restricting type) admitted between January 2017 and May 2025. A structured nutritional rehabilitation protocol (1000–1200 kcal/day, escalating by 200 kcal/day every 48 h to 2500–3000 kcal/day) was implemented with daily serum electrolyte monitoring. Statistical analyses included paired tests, Spearman correlations, multivariable regression of log-transformed LOS, and partial correlations controlling for the admission BMI z-score. Results: Nutritional and cardiovascular parameters improved from admission to discharge. Mean supine heart rate (HR) increased by 28.4 bpm (95% CI 25.0–31.8; p < 0.001), and bradycardia prevalence (HR < 50 bpm) improved from 39.7% to 1.5%. Lower admission BMI z-score was associated with longer LOS; each 1-unit higher BMI z-score was associated with an 18.9% shorter LOS in adjusted log-LOS regression (p = 0.003). Exploratory analyses of HR recovery suggested that the magnitude of HR improvement was more closely associated with baseline BMI z-score and baseline supine HR than with caloric escalation. Systematic electrolyte monitoring documented no hypophosphatemia requiring intervention and no refeeding syndrome. Documented mental health comorbidities or clinically significant symptom clusters were present in 82.4% of patients. Conclusions: In this adolescent anorexia nervosa cohort, structured inpatient nutritional rehabilitation was associated with substantial cardiovascular and nutritional improvement. Baseline nutritional status was associated with hospital course and cardiovascular response, while LOS should be interpreted as a composite outcome influenced by nutritional severity, discharge criteria, mental health needs, and family readiness. The absence of refeeding complications is reassuring and suggests that the protocol was metabolically safe under systematic electrolyte monitoring in this specialized tertiary setting. Full article

(This article belongs to the Special Issue Eating Disorders and Disordered Eating Behaviors: Prevention, Mechanisms, Treatments, and Outcomes)

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21 pages, 738 KB

Open AccessArticle

Long-Term Recovery Following Adolescent Anorexia Nervosa: A Mixed-Methods Follow-Up Study

by Izabela Łucka, Maciej Łucki, Patrycja Leśnicka and Marta Kopańska

Nutrients 2026, 18(16), 2606; https://doi.org/10.3390/nu18162606 - 10 Aug 2026

Viewed by 383

Abstract

Background/Objectives: Long-term recovery following adolescent anorexia nervosa (AN) remains incompletely understood because restoration of nutritional status does not necessarily coincide with psychological remission. Comprehensive evaluation of recovery requires consideration of psychological, behavioural, and patient-reported outcomes in addition to anthropometric measures. To evaluate long-term recovery following adolescent anorexia nervosa by integrating clinical outcomes, patient- and caregiver-reported experiences, orthorexic tendencies, and eating-disorder psychopathology, and to identify factors associated with persistent psychological impairment. Methods: This retrospective follow-up study employed a cross-sectional survey design. Families of 100 former patients previously hospitalized for adolescent anorexia nervosa in a child and adolescent psychiatric inpatient unit were invited to participate 5–10 years after discharge. Follow-up questionnaires were returned by 23 former patients and 17 caregivers. Former patients completed the SCOFF questionnaire and questions assessing orthorexic tendencies, whereas caregivers and the patients as well provided information regarding their child’s long-term recovery, treatment experiences, current functioning, and selected demographic characteristics. Responses from former patients and caregivers were analysed according to respondent group and the variables available for each group, while information from both groups was used to obtain a comprehensive assessment of long-term recovery. Descriptive and inferential statistical analyses were performed. Results: Mean BMI increased from 13.4 kg/m² during the acute phase of illness to 18.8 kg/m² at follow-up, indicating substantial nutritional improvement. Nevertheless, approximately 60% of former patients screened positive on the SCOFF questionnaire, suggesting persistent eating-disorder symptoms despite nutritional rehabilitation. Orthorexic tendencies were strongly associated with positive SCOFF screening results (Cramér’s V = 0.828; p < 0.001). Psychiatric comorbidity and poorer subjective health perception were also associated with less favourable long-term outcomes. Qualitative findings further demonstrated that recovery was perceived as extending beyond symptom reduction to include psychological wellbeing, restoration of autonomy, interpersonal functioning, and social reintegration. Full article

(This article belongs to the Special Issue Eating Disorders and Disordered Eating Behaviors: Prevention, Mechanisms, Treatments, and Outcomes)

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13 pages, 925 KB

Open AccessArticle

Validation of the Turkish Version of the Eating Attitudes Test-7

by Gamze Ayakdaş, Meryem Kahrıman, Ladan Hajhamidiasl, Yaşar Alp Erol, Selen Köksal, Perim Fatma Türker and Murat Baş

Nutrients 2026, 18(14), 2344; https://doi.org/10.3390/nu18142344 - 17 Jul 2026

Viewed by 469

Abstract

Background: Disordered eating attitudes are major public health concerns associated with adverse physical, psychological, and social outcomes. Therefore, brief, psychometrically sound screening tools are needed to identify individuals at risk early. The Eating Attitudes Test-7 (EAT-7) is a shortened screening tool developed to assess disordered eating attitudes. However, its Turkish validity and reliability have not been previously examined. Therefore, this study aimed to assess the validity and reliability of the Turkish version of the EAT-7 among Turkish-speaking adults. Methods: This methodological validation study was conducted between November 2025 and January 2026. Data were collected online using a snowball sampling technique. After a pilot study with 210 participants, the main study included 1635 adults aged ≥18 years. Exploratory factor analysis was performed with 500 participants, and confirmatory factor analysis was performed with an independent sample of 1135 participants. Internal consistency and construct validity were assessed. Convergent validity was evaluated through correlations with the EAT-26, Eating Disorder Examination Questionnaire-13 (EDE-Q-13), and Depression Anxiety Stress Scale Short Form (DASS-8). Results: The Turkish version of the EAT-7 demonstrated excellent internal consistency, with a Cronbach’s alpha coefficient of 0.925. The Kaiser–Meyer–Olkin value was 0.909, and Bartlett’s test results were significant. Exploratory factor analysis supported a single-factor structure explaining 70.133% of the total variance. Confirmatory factor analysis confirmed a good model fit. The total EAT-7 score was positively correlated with the EAT-26, EDE-Q-13, and DASS-8 scores. Conclusions: The Turkish version of the EAT-7 is a valid, reliable, brief, and practical screening tool for assessing disordered eating attitudes among Turkish-speaking adults. Full article

(This article belongs to the Special Issue Eating Disorders and Disordered Eating Behaviors: Prevention, Mechanisms, Treatments, and Outcomes)

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11 pages, 422 KB

Open AccessArticle

Food Insecurity and Binge Eating: Exploring Reward-Based Eating, Psychological Distress, and Diet Quality as Underlying Mechanisms

by Chelsea Arnold, Courtney P. McLean, Luiza Bonfim Pacheco and Antonio Verdejo-Garcia

Nutrients 2026, 18(13), 2126; https://doi.org/10.3390/nu18132126 - 1 Jul 2026

Viewed by 545

Abstract

Background: Food insecurity is a risk factor for binge eating behaviours and related disorders; however, the mechanisms underlying this association remain unclear. This study examined reward-based eating, psychological distress, and diet quality as potential mechanisms underscoring this association. Methods: Participants (N = 176) completed self-reports measuring reward-based eating (Reward-Based Eating Drive scale), distress (Depression, Anxiety and Stress scale), and diet (Australian Eating Survey), alongside a well-validated food insecurity survey, as part of a broader biopsychosocial assessment study. Parallel mediation analysis was utilised to explore the candidate variables as potential mediators between food insecurity and binge eating indicated by the Binge Eating Scale. Results: Food insecurity independently predicted binge eating behaviours, in association with the mediating variables. Reward-based eating and psychological distress were statistically significant mediators, but diet quality was not. Conclusions: Food insecurity is associated with binge eating through both reward drive and distress. Future research should investigate how both social and psychological interventions may leverage these mechanisms to overcoming binge eating. Full article

(This article belongs to the Special Issue Eating Disorders and Disordered Eating Behaviors: Prevention, Mechanisms, Treatments, and Outcomes)

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18 pages, 444 KB

Open AccessArticle

Compulsive Skin Picking in Anorexia Nervosa: A Qualitative Study of Emotional and Interoceptive Dysregulation

by Jaworski Mariusz and Giersz Urszula

Nutrients 2026, 18(7), 1070; https://doi.org/10.3390/nu18071070 - 27 Mar 2026

Viewed by 1084

Abstract

Background: Body-focused repetitive behaviors (BFRB), including compulsive skin picking, are observed in patients with anorexia nervosa (AN). However, their functional significance remains unclear. AN is characterized by chronic energy restriction and altered interoceptive processing, which may contribute to persistent internal tension beyond overt eating symptoms. This study aimed to explore the functional meaning of compulsive skin picking as a potential behavioral marker of emotional and interoceptive dysregulation relevant to clinical assessment and treatment planning. Methods: A qualitative descriptive study was conducted among 33 hospitalized patients with AN who reported recurrent skin picking leading to tissue damage. Patients were undergoing structured nutritional rehabilitation. Individual semi-structured interviews were performed. Results: Patients with AN described a consistent emotional and physiological sequence preceding skin picking: increased internal tension followed by short-term relief and subsequent self-directed negative emotions. Episodes occurred in contexts of emotional overload, understimulation, reduced emotional awareness, and, in some cases, hunger- or meal-related stress. Participants described the behavior as partly intentional, serving to reduce tension, but at times occurring almost automatically. It was closely connected with eating-related anxiety and dissatisfaction with the body. Conclusions: The findings indicate that compulsive skin picking in AN may reflect underlying emotional and interoceptive instability, instead of being an unrelated co-occurring symptom. In the broader context of chronic energy restriction, such behaviors may reflect attempts to modulate internally generated physiological arousal. Incorporating routine assessment of BFRB into clinical practice could improve the identification of ongoing emotional instability and support more coordinated multidisciplinary care. Future studies combining qualitative insights with physiological measures would help clarify the mechanisms underlying this association. Full article

(This article belongs to the Special Issue Eating Disorders and Disordered Eating Behaviors: Prevention, Mechanisms, Treatments, and Outcomes)

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