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Integration of Nutritional and Psychological Interventions in the Management of Anorexia Nervosa, Bulimia Nervosa and Other Eating Disorders

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition Methodology & Assessment".

Deadline for manuscript submissions: 5 October 2026 | Viewed by 7434

Special Issue Editor


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Guest Editor
Department of Eating and Weight Disorders, Villa Garda Hospital, Via Monte Baldo 89, 37016 Verona, Italy
Interests: eating disorders; obesity; eating disorder psychopathology; anorexia nervosa
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Special Issue Information

Dear Colleagues,

The integration of nutritional and psychological interventions is crucial for effectively managing anorexia nervosa, bulimia nervosa, and other eating disorders. This Special Issue explores multidisciplinary approaches that combine nutritional interventions with psychological therapies to improve treatment outcomes.

Nutritional interventions address undereating, extreme and rigid dietary rules, and malnutrition while promoting healthy weight restoration and eating behaviors. They also aim to correct dysfunctional cognitions related to food and eating. Meanwhile, evidence-based psychological therapies, such as cognitive-behavioral therapy, family therapy, and others, target the mechanisms and features that maintain eating disorder psychopathology. Integrating these approaches creates a comprehensive treatment model addressing physiological and psychological factors.

This Special Issue will feature research on novel treatment models, personalized nutrition plans and management, and the effectiveness of integrated programs. It will also examine challenges in multidisciplinary care, patient adherence, and long-term recovery strategies across different levels of treatment. Contributions from clinicians, dietitians, psychologists, and researchers will provide critical insights into optimizing interventions.

This Special Issue will advance scientific understanding, enhance clinical practice, and improve patient outcomes and quality of life by fostering interdisciplinary collaboration.

Dr. Riccardo Dalle Grave
Guest Editor

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Keywords

  • anorexia nervosa
  • bulimia nervosa
  • binge-eating disorder
  • eating disorder
  • treatment
  • nutritional intervention
  • diet
  • psychotherapy
  • cognitive behavior therapy
  • family therapy

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Published Papers (3 papers)

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Research

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18 pages, 736 KB  
Article
Changes in Difficulties in Emotion Regulation Following Eating Disorders Treatment: Relevant Prospective Implications for Treatment Outcome
by Tânia F. Rodrigues, Lucero Munguía, Roser Granero, Isabel Sánchez, Jessica Sánchez-González, Jessica Jimenez-de Toro, Laura Galvez, Cristina Artero, Susana Jiménez-Murcia, Paulo P. P. Machado and Fernando Fernández-Aranda
Nutrients 2025, 17(21), 3470; https://doi.org/10.3390/nu17213470 - 3 Nov 2025
Viewed by 1595
Abstract
Background: Difficulties in emotion regulation (ER) are commonly described in eating disorders (ED), but few studies report its impact on ED treatment outcome. The main goal of this study was to investigate the patterns of change in difficulties in ER among ED-diagnosed [...] Read more.
Background: Difficulties in emotion regulation (ER) are commonly described in eating disorders (ED), but few studies report its impact on ED treatment outcome. The main goal of this study was to investigate the patterns of change in difficulties in ER among ED-diagnosed female patients who received a Cognitive Behavioral Therapy (CBT) treatment. Methods: Participants (N = 74; Mage = 29.2; SD = 11.5) completed pre- and post-treatment questionnaires to assess difficulties in ER, disordered eating symptoms, general psychopathology, and personality traits. Results: Considering ED treatment outcome status, 24.3% of patients displayed a poor outcome, while 28.4% achieved partial remission, and 47.3% achieved full remission. Most of the patients who achieved full remission (80%) reported decreases in difficulties in ER, while only 55.6% of the participants displaying poor outcomes reported improvements in ER. The results from the structural equation modeling (SEM) suggest that the risk of poor outcome was directly related to increased post-treatment difficulties in ER, while improvements in the severity index of global psychopathology was related to increased pre-treatment difficulties in ER. Conclusions: Better ED treatment outcomes are associated with higher levels of ER improvements. Future prospective studies are warranted to establish which ER components may positively influence the recovery of ED-diagnosed patients. Full article
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16 pages, 259 KB  
Article
Enhanced Cognitive Behavioral Therapy for Young Adolescents with Anorexia Nervosa: Identifying Predictors of Treatment Response
by Simona Calugi, Mirko Chimini, Anna Dalle Grave, Gianmatteo Cattaneo, Maddalena Conti and Riccardo Dalle Grave
Nutrients 2025, 17(17), 2731; https://doi.org/10.3390/nu17172731 - 23 Aug 2025
Cited by 2 | Viewed by 3968
Abstract
(1) Background: This study aimed to identify baseline demographic, clinical, and psychosocial predictors of treatment response in adolescents with anorexia nervosa (AN) undergoing an intensive 20-week enhanced cognitive behavioral therapy (CBT-E) program, which included inpatient and day patient phases. Treatment outcomes were assessed [...] Read more.
(1) Background: This study aimed to identify baseline demographic, clinical, and psychosocial predictors of treatment response in adolescents with anorexia nervosa (AN) undergoing an intensive 20-week enhanced cognitive behavioral therapy (CBT-E) program, which included inpatient and day patient phases. Treatment outcomes were assessed at the end of intensive treatment (EOIT) and at a 20-week follow-up. (2) Methods: A prospective cohort of 68 adolescents under the age of 16 consecutively admitted to intensive CBT-E was evaluated. Baseline measures included body mass index (BMI)-for-age percentiles, percentage of expected body weight (%EBW), eating disorder psychopathology (EDE-Q), general psychopathology, and functional impairment. (3) Results: Of those who began treatment, 83.4% completed the program and 70.2% were available for follow-up assessment. Based on intent-to-treat analysis, 94.1% achieved a “good BMI outcome” and 73.5% met criteria for “full response” at EOIT. At follow-up, 64.7% maintained a good BMI and 55.9% sustained a full response. Completers’ analysis indicated that baseline body weight, clinical impairment, general psychopathology, and weight regain influenced treatment outcomes. However, no baseline demographic or clinical variables predicted treatment completion or outcome at either time point at intention-to-treat analysis, except that younger age at admission was linked to higher eating disorder psychopathology at follow-up. (4) Conclusions: In treatment completers, certain baseline clinical factors and weight regain influenced outcomes, while in the full sample, younger age predicted greater residual psychopathology at follow-up. These findings, if confirmed, emphasize the need for early intervention, focused support for weight regain, and potential adaptations of CBT-E for early adolescents. Full article

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11 pages, 714 KB  
Brief Report
Dietary Fat and Carbohydrate Exposure During a Group-Based Nutritional Psychoeducational Program in Anorexia Nervosa
by Paolo Meneguzzo, Alessandra Zattarin, Arianna Carpin, Anna Svaizer, Beatrice Varotto, Zaira Salvador, Anna Marchetto, Angela Veronese and Angela Favaro
Nutrients 2026, 18(6), 902; https://doi.org/10.3390/nu18060902 - 12 Mar 2026
Viewed by 373
Abstract
Background: Nutritional psychoeducation is a core component of multidisciplinary treatment for anorexia nervosa, yet evidence on its association with changes in eating behavior beyond weight outcomes remains limited. Methods: This pre–post observational study included 45 patients with anorexia nervosa attending a Day Hospital [...] Read more.
Background: Nutritional psychoeducation is a core component of multidisciplinary treatment for anorexia nervosa, yet evidence on its association with changes in eating behavior beyond weight outcomes remains limited. Methods: This pre–post observational study included 45 patients with anorexia nervosa attending a Day Hospital program who participated in a structured, group-based nutritional psychoeducational intervention as part of standard multidisciplinary care. Nutritional knowledge, dietary rules, eating behaviors, food group exposure assessed by a Food Frequency Questionnaire (FFQ), and body mass index (BMI) were evaluated before and after the intervention. Pre–post changes were examined using paired statistical tests with Holm correction. Associations between changes in cognitive–nutritional variables and eating behavior were explored using correlations and multiple linear regression models. Results: Significant pre–post improvements were observed in nutritional knowledge and reductions in rigid dietary rules. Eating behavior showed specific changes, with increased exposure to carbohydrate- and fat-containing foods, as well as improved meal adequacy. BMI increased during the observation period, consistent with expected outcomes of Day Hospital treatment. Changes in nutrient-related knowledge were positively associated with changes in dietary fat exposure, independent of baseline BMI and changes in dietary rules, whereas no comparable association was observed for carbohydrate exposure. Conclusions: In this Day Hospital sample, participation in a group-based nutritional psychoeducational program within a multidisciplinary treatment context was associated with specific changes in eating behavior alongside cognitive–nutritional changes and weight gain. The observed association between nutrient-related knowledge and dietary fat exposure may suggest the relevance of assessing food-specific behaviors and cognitive–nutritional processes as complementary outcomes during treatment for anorexia nervosa. Full article
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