Search Results (305)

Background/Objectives: The study aimed to investigate the presence of worry, rumination, and metacognitive beliefs in adolescents with maladaptive eating behaviours. Methods: The study involved 37 adolescents (10 males, 27 females, mean age ± SD: 15.4 ± 1.53 years) with obesity (Body Mass Index, BMI > 97th centile) associated with binge eating disorder (BED) (BES score ≥ 17) and 30 age-matched adolescents (13 males, 17 females, mean age ± SD: 15.2 ± 1.98 years) with essential obesity (i.e., without BED, BES score < 17). Participants completed self-report questionnaires—Penn State Worry Questionnaire (PSWQ), Ruminative Response Scale (RRS), Anger Rumination Scale (ARS), and Metacognitions Questionnaire for Children (MCQ-C)—to assess binge eating, worry, rumination, and metacognitive beliefs, respectively. Results: Patients with obesity and BED showed higher scores on the PSWQ (p = 0.006), RRS (p < 0.001), ARS (p < 0.001), negative Metaworry (p = 0.011), and total MCQ-C (p = 0.027) than those with essential obesity, with a medium-to-large effect size, indicating that the differences between subgroups were meaningful. Conclusions: Our findings highlight that BMI alone is not associated with metacognitive processes and beliefs. The presence of BED in adolescents with obesity is linked to increased levels of worry, rumination, and maladaptive metacognitive beliefs, in comparison with age-matched adolescents with essential obesity. The results of the study underline the need for different psychological approaches in these clinical conditions going forward. Full article

Background: Pride may play a role in eating disorders and related symptomatology. This PRISMA-informed scoping review explores the emotion of pride in eating disorders and in related symptoms. Methods: Four databases (PubMed, PsycINFO, Web of Science, Scopus) were searched (July 2025). This systematic scoping review followed PRISMA guidelines and PICOS procedures. The included reports were written in English language and assessed pride in relation to eating disorder-related symptoms both in diagnosed individuals and in the general population. Results: Twenty-three studies were selected, including sixteen quantitative and seven qualitative studies. Pride was evaluated in various forms, including appearance-related pride, body pride, and LGBT pride. In general population samples, high levels of maladaptive pride and low levels of adaptive pride were associated with greater eating disorder-related symptomatology. In patients, pride was associated with control and illness identification and was found to contribute to illness onset, maintenance, and recovery. Conclusions: Integrating pride experiences in the assessment of eating disorders may be clinically useful and provide guidance for treatment planning. Main gaps consist in the great heterogeneity of the instruments used to assess pride and in the major focus on anorexia nervosa, with only a few studies investigating bulimia nervosa and binge-eating disorder. Full article

Background: Obesity is increasingly recognized as a complex condition characterized by the convergence of metabolic dysregulation and psychological vulnerability. Insulin resistance (IR) has been identified as a biological bridge linking metabolic imbalance with affective symptoms such as anxiety, depression, and disordered eating behaviors. Methods: Fifteen obese adults (mean age = 25 ± 4.3 years) were evaluated through clinical examination, anthropometric assessment (BMI), biochemical assays (fasting insulin, AST, ALT), and standardized psychological assessments (STAI, BDI-II). In parallel, a rapid systematic review (2019–2025) synthesized evidence on the association between IR, affective dysregulation, binge eating disorder (BED), and the clinical role of insulin-sensitizing or incretin-based therapies. Results: Participants exhibited marked hyperinsulinemia (M = 79 μU/mL, SD = 6.61) and elevated anxiety (STAI-Trait = 54.22 ± 22.4) and depression scores (BDI-II = 21.6 ± 7.5). Liver enzymes were within normal limits. Literature synthesis confirmed consistent associations between IR, mood symptoms, and BED, associated with biological processes including inflammation, HPA axis hyperactivity, and dopaminergic imbalance. Integrated treatment approaches combining cognitive-behavioral therapy, medical nutrition therapy, and insulin-sensitizing agents (metformin, GLP-1RA, and GLP-1/GIP RA) were supported as effective and safe options. Conclusions: The coexistence of insulin resistance and emotional dysregulation in obesity is consistent with the hypothesis of a bidirectional metabolic–emotional axis. Early, integrated interventions addressing both metabolic and psychological domains may improve clinical outcomes and reduce progression toward chronic metabolic and psychiatric comorbidity. Full article

Background: Midwives, despite their health-promoting role, face factors that may disrupt eating behaviours and weight regulation. Little is known about their body weight perception or disordered eating attitudes (DEAs). This study assessed body weight perception and eating attitudes across BMI categories among Polish midwives. Methods: A cross-sectional survey of 568 midwives was conducted. BMI was calculated from self-reported measures and classified according to WHO criteria. Body weight perception was assessed using discrepancies between actual and ideal body weight and between self-perceived ideal body weight and ideal body weight. Long-term weight variability was additionally evaluated using the difference between maximum and minimum adult body weight. Eating attitudes were examined using the Polish version of the EAT-26. Group differences were analysed with the Kruskal–Wallis and χ² tests. Results: Among the participants, 62.9% had normal weight, 23.4% were overweight, and 13.7% were obese. Perceived ideal body weight increased with BMI (p < 0.001). Midwives with overweight and obesity demonstrated higher EAT-26 scores than those with normal BMI, with EAT-26 > 20 observed in 8.3% of overweight and 14.1% of obese participants (p = 0.010). Overweight and obese midwives also showed larger discrepancies between actual and ideal body weight and greater lifetime weight variability, and these groups simultaneously presented higher levels of disturbed eating attitudes. Emotional eating, binge-type episodes, and dieting behaviours were more common among overweight and obese participants, while calorie awareness remained consistently high across groups. Conclusions: Midwives with excess body weight often misperceive their body size and show an elevated risk of DEA. Weight perception appears more strongly related to maladaptive eating patterns than BMI alone. These findings highlight the need for targeted, non-stigmatising interventions addressing weight perception, eating attitudes, and occupational stressors, which may support both midwives’ well-being and their professional effectiveness in delivering nutrition and lifestyle counselling. Full article

Background: Eating disorders (EDs) are serious mental health conditions often beginning in adolescence and are associated with significant morbidity and mortality. Although previous research has focused on medical staff, little is known about how EDs are recognised and managed by non-medical mental health professionals within community-based systems. This study examined their awareness, knowledge, and stigmatising beliefs toward EDs in Türkiye, highlighting implications for training and policy development. Methods: A study-specific questionnaire adapted from a validated tool previously used with general practitioners was administered to 42 non-medical professionals (95.2% female; mean age = 33.2 ± 5.6 years) working in community mental health services in Ankara, Türkiye. Participants were randomly assigned to one of six clinical vignettes depicting a young person with anorexia nervosa (AN), bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder (ARFID), depression, or type-1 diabetes. The questionnaire assessed illness perception, causal attributions, emotional reactions, professional knowledge, and stigmatising beliefs. Results: Only 28.6% (n = 12) correctly identified the disorder in their assigned vignette. BED had the highest diagnostic accuracy (50%), while AN and ARFID were most frequently misidentified. Participants commonly believed that EDs mainly affected females, had a short duration, and were less responsive to treatment. Stigmatising beliefs—such as personal blame—were also noted. Conclusions: Findings revealed limited awareness and knowledge of EDs—particularly AN and ARFID—among non-medical mental health professionals. Misconceptions that EDs are self-inflicted may delay recognition and referral. The results underscore the need for targeted education, anti-stigma interventions, and integration of ED content into professional training to improve early detection and community-based support. Full article

Background/Objectives: Obesity results from the complex interplay of biological, psychological, and sociocultural factors. Psychiatric comorbidities and maladaptive eating attitudes are possible contributors to this complexity. Despite accumulating research, current treatment approaches often fail to achieve lasting success, possibly due to the tendency to approach obesity as a uniform condition despite its heterogeneity. This study aimed to identify distinct subgroups of adults with obesity based on their eating behaviors, psychopathology, and food addiction (FA). Methods: The study included 202 adults seeking obesity treatment at Ankara Dışkapı Training and Research Hospital, Turkey. Participants completed the Three Factor Eating Questionnaire-R18, Yale Food Addiction Scale, Night Eating Questionnaire, and Symptom Checklist-90-R (SCL-90-R). Psychiatric diagnoses were confirmed through clinician-administered semi-structured interviews (SCID-5-CV). Two-step cluster analysis was performed using z-standardized variables of eating and psychopathology measures. Subsequent comparisons were conducted between the identified subgroups. Results: Two distinct clusters were identified and described in terms of adaptive and maladaptive eating traits: an Adaptive group (n = 92, 45.5%) and a Maladaptive group (n = 110, 54.5%). The Maladaptive cluster exhibited higher levels of emotional eating, uncontrolled eating, night eating, FA, and general psychopathology (all p < 0.001), along with a greater prevalence of major depressive disorder and binge eating disorder. Conclusions: Our findings indicate that psychopathology and maladaptive eating behaviors meaningfully distinguish two obesity phenotypes. Nearly half of individuals with obesity, characterized by maladaptive eating traits, FA, or elevated psychopathology, may constitute a subgroup that would particularly benefit from psychoeducation or targeted psychiatric intervention. Full article

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed treatment for higher weight and diabetes. Because they also influence appetite and reward processes, these medications may shape eating behaviours, emotions, and body image, raising new challenges for eating disorder (ED) research and clinical care. This narrative review synthesises emerging evidence on the psychological and behavioural effects of GLP-1RA use within a biopsychosocial and equity framework. Method: Using a narrative, non-systematic approach, we conducted targeted searches across major databases (2015–September 2025) with combined GLP-1RA and psychological or ED-related terms, supplemented by cross-referencing. Inclusion criteria focused on empirical, theoretical, and clinically meaningful psychological, behavioural, and sociocultural outcomes, enabling a conceptually driven synthesis of the psychological effects of GLP-1RA use. Results: GLP-1RAs reduce hunger and binge-eating frequency, suggesting possible benefits for binge-type EDs. However, evidence for restrictive EDs remains limited, and appetite suppression may reinforce rigid control or perfectionistic traits. Although short-term reductions in emotional eating have been reported, the long-term psychological safety of GLP-1RAs is unknown. Rapid, medication-driven weight loss may disrupt body perception, while social media discourse glamorises thinness and intensifies stigma. These psychosocial effects intersect with inequities in access, disproportionately affecting adolescents and individuals from culturally diverse or socioeconomically marginalised groups. Conclusions: GLP-1RAs sit at the intersection of medical innovation and psychological risk. To ensure safe and inclusive use, research and clinical practice should integrate developmental, cultural, and lived-experience perspectives. Co-designed research and multidisciplinary monitoring will be essential to reduce stigma, address inequities, and support psychologically informed care. Full article

Background: Autism spectrum disorder (ASD) constitutes a heterogeneous neurodevelopmental condition frequently accompanied by considerable disturbances in feeding behavior and nutritional balance. These difficulties arise from complex and multifactorial mechanisms, exerting a significant impact on physical health, metabolic homeostasis, and psychosocial functioning. The present review aims to provide a critical synthesis of current evidence regarding the underlying biological and behavioral mechanisms of feeding difficulties in ASD and to delineate the spectrum of comorbid eating disorders within this population. Methods: A narrative review of the peer-reviewed scientific literature was undertaken, emphasizing studies investigating the interrelationship between ASD and nutritional functioning in pediatric and adolescent populations. Particular focus was placed on research exploring sensory processing abnormalities, gut microbiota alterations, and the clinical manifestation of eating disorders in individuals with ASD. Results: The analysis revealed that sensory hypersensitivity, behavioral inflexibility, and disturbances within the gut–brain axis constitute principal determinants of atypical eating patterns in ASD. Individuals on the autism spectrum frequently exhibit pronounced food selectivity, neophobia, and symptoms consistent with Avoidant/Restrictive Food Intake Disorder (ARFID). Furthermore, an increased prevalence of anorexia nervosa and orthorexia nervosa has been documented, likely reflecting shared cognitive and behavioral features with ASD. “Emotional eating” tendencies and a marked preference for high-caloric, energy-dense foods—often potentiated by psychopharmacological treatment and reduced physical activity—further contribute to an elevated risk of overweight and obesity. Conclusions: Children and adolescents with ASD display a bimodal distribution of body mass, encompassing both undernutrition and obesity, indicative of a multifaceted interplay among sensory, behavioral, cognitive, and metabolic determinants. A comprehensive understanding of this heterogeneity is crucial for the development of individualized, evidence-based interventions integrating nutritional management with behavioral and psychotherapeutic approaches. Full article

Background/Objectives: Obesity is a multifactorial disease associated with increased consumption of ultraprocessed foods and reduced intake of unprocessed foods. Binge eating, one of the most prevalent eating disorders among adolescents, is closely linked to obesity. Food intake is regulated by both the hedonic system, responsible for reward responses, and the physiological system, which controls hunger and satiety through hormones, such as ghrelin and leptin. The present study aimed to investigate associations between the intake of unprocessed and ultraprocessed foods, neuroendocrine mediators of appetite regulation, and binge eating in adolescents with obesity. Methods: This cross-sectional study included 96 adolescents with obesity who were recruited in São Paulo, Brazil, between 2010 and 2012. Anthropometric and body composition assessments were performed. Binge eating symptoms were evaluated using the binge eating scale (BES), and dietary intake was assessed with a validated Food Frequency Questionnaire, with items classified according to the Nova system. Frequency data were converted into annual consumption scores. Serum levels of ghrelin, leptin, neuropeptide Y (NPY), agouti-related peptide (AgRP), melanin-concentrating hormone (MCH), and alpha-melanocyte-stimulating hormone (α-MSH) were analyzed. Results: Lower consumption of unprocessed foods was associated with higher ghrelin concentrations (p = 0.023), accompanied by a greater percentage of body fat (p = 0.047) and a reduced percentage of lean mass (p = 0.047) compared with adolescents in the second tertile. AgRP was a positive predictor of annual consumption score of ultraprocessed food (β = 0.30; p = 0.04), independent of age, body fat, and binge eating symptoms. Conclusions: In conclusion, lower intake of unprocessed foods was associated with alterations in orexigenic and anorexigenic mediators, suggesting that dietary patterns in adolescents with obesity may influence the neuroendocrine mediators of appetite regulation. Full article

Obesity is a global health problem causing millions of deaths from noncommunicable diseases. Individuals with obesity are also at increased risk for mental disorders, such as depression (DEP) and binge eating (BED). The aim of this study was to evaluate the effectiveness of an inpatient lifestyle-based intervention program for the treatment of obesity in persons with and without DEP and BED. This is a retrospective cohort study involving patients enrolled in a specialized inpatient hospital facility for the treatment of obesity. Participants underwent a long-term program composed of a low-calorie diet and intensive lifestyle changes. Data from 997 adult patients were included. Participants were divided into four groups: a depression group (DG), binge-eating disorder group (BG), depression and binge-eating disorder group (DBG), and a control group (CG). Anthropometric data were obtained at admission and discharge. Most participants were females, were sedentary, and were hospitalized for more than 3 months. No between-group differences were observed among DEP, BED, DEP + BED, and CG. Treatment duration was positively associated with reductions in weight and BMI in all patients. In conclusion, patients with DEP and BED with DEP + BED presented significant reductions in BMI and waist circumference, as well as the CG, and reduction in body weight was directly associated with the length of the intervention. Full article

Binge eating disorder (BED) is a prevalent eating disorder lacking adequate pharmacological interventions. This review examines the therapeutic potential of glucagon-like peptide-1 receptor agonists (GLP-1RAs), medications approved for type 2 diabetes and obesity now being investigated for eating disorders through their modulation of metabolic and reward pathways. A narrative review was conducted using PubMed/MEDLINE, through May 2025, to examine GLP-1RA effects on BED, including preclinical and clinical studies, mechanistic investigations, and relevant reviews. GLP-1 receptors (GLP-1Rs) are expressed in hypothalamic nuclei, regulating energy homeostasis and mesolimbic circuits controlling food reward. Preclinical studies demonstrate that GLP-1RAs reduce food-seeking behavior, suppress dopamine signaling in reward circuits, and modulate neural transmission in key brain regions. These effects extend beyond appetite suppression to directly modify reward processing underlying compulsive eating. Emerging clinical evidence with semaglutide and liraglutide report reductions in binge eating episodes, decreased food cravings, and improved symptom scores. However, current studies remain small-scale with methodological limitations, and translating findings from animal models to human eating disorder complexity presents significant challenges. This review integrates preclinical and clinical evidence demonstrating that GLP-1RAs modulate both metabolic and reward pathways. By elucidating the underlying neurobiological mechanisms, GLP-1RAs may offer advantages over current symptom-focused therapies for BED. Full article

Background: Obesity is a complex health issue influenced by various factors, including behavioral patterns that can be assessed more deeply in real time using Ecological Momentary Assessment (EMA), which can capture the moment in which a person experiences a situation or an emotion that could trigger an eating behavior. Methods: This systematic review synthesizes findings from 89 studies employing EMA to investigate obesity and overweight-related behaviors. The studies were identified through comprehensive searches across multiple databases and included peer-reviewed articles. The primary aim was to analyze how EMA contributes to understanding the temporal dynamics of eating behaviors, physical activity, and psychological factors associated with overweight and obesity. Results: Key findings indicate that EMA provides a nuanced understanding of real-time contexts influencing behaviors contributing to overweight and obesity. Studies consistently report that EMA captures fluctuations in eating habits, exercise routines, stress levels, and emotional states, elucidating the interplay between these factors and weight status. Methodological variations across studies included differences in EMA implementation (e.g., smartphone apps, electronic diaries), assessment frequency, and duration. These variances highlight the flexibility and adaptability of EMA in capturing diverse behavioral aspects relevant to obesity and overweight research. Moreover, the review discusses methodological challenges such as participant compliance, data integration, and real-time data interpretation in longitudinal analyses. Conclusions: In conclusion, EMA emerges as a powerful tool for exploring the complex, dynamic nature of overweight and obesity-related behaviors. Future research should focus on refining EMA methodologies, enhancing data analysis techniques, and integrating findings into personalized interventions aimed at reducing obesity effectively. Full article

Background/Objectives: Eating disorders (EDs) frequently emerge during critical stages of childhood and adolescence, when identity development and emotional regulation are still maturing. Disturbances in self-concept clarity and identity integration may transform the body into a symbolic battlefield for autonomy, belonging, and self-worth. This review synthesizes developmental, psychosocial, neurocognitive, and therapeutic perspectives on the role of identity disturbance in EDs. Methods: A narrative review was conducted (2010–2025) using combinations of terms related to identity, self-concept clarity, self-discrepancy, objectification, interoception, and eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorder). Results: Findings indicate that identity vulnerability (expressed as low self-concept clarity, heightened self-discrepancies, and self-objectification) mediates the association between early adversity, sociocultural pressures, and ED symptoms. Neurocognitive studies reveal altered self-referential processing, default mode network connectivity, and interoceptive signaling. Clinically, comorbid borderline personality features further exacerbate identity disturbance and complicate recovery. Evidence-based treatments such as enhanced cognitive-behavioral therapy (CBT-E) effectively target core maintaining mechanisms, while adjunctive interventions (mentalization-based therapy, schema therapy, narrative approaches, and compassion- or acceptance-based methods) show promise in addressing identity-related processes and improving outcomes. Conclusions: Identity disturbance provides a unifying framework for understanding why ED symptoms become entrenched despite adverse consequences. Integrating identity-focused approaches with nutritional and medical care may enhance recovery and reduce chronicity in youth. Future research should adopt longitudinal and mechanistic designs to clarify pathways linking identity change to clinical improvement and test identity-specific augmentations to standard ED treatments. Full article

The autonomic nervous system (ANS) regulates internal organ function to maintain homeostasis. Dysautonomias are ANS disorders involving reduced or excessive sympathetic or parasympathetic activity and can be associated with metabolic syndrome and eating disorders such as binge eating disorder (BED). The ANS exhibits synaptic plasticity phenomena, including long-term potentiation (LTP) and neurotransmitter expression changes, which may influence autonomic function. BED is defined as recurrent, compulsive intake of large amounts of high-calorie food in a short time. Here, we examined dysautonomia in a rat BED model induced by cycles of food restriction and access to highly caloric food, and assessed whether exercise prevents these alterations. After confirming BED induction, we characterized LTP in the superior cervical ganglion (SCG) and analyzed acetylcholine (ACh) and GABA expression and their co-localization/segregation. BED rats exhibited impaired LTP and increased GABA expression. Voluntary aerobic exercise prevented BED onset and the associated changes in LTP and GABA. We propose that BED-associated dysautonomia proceeds at least in the ganglionic sympathetic cholinergic transmission, with reduced sympathetic activity. These results may contribute to a better understanding of the autonomic disorder associated with BED and support exercise as a protective intervention. Full article

Background: This study examined changes in psychological adjustment among patients with Anorexia Nervosa (AN) and Binge Eating Disorder (BED) following a 3-week inpatient multidisciplinary (disease-tailored) rehabilitation program. Methods: twenty consecutive Italian female adults with a diagnosis of AN (mean age ± SD: 25.9 ± 9.4 years; mean Body Mass Index: BMI: kg/m²: 15.8 ± 1.61) and fifteen consecutive Italian female adults with diagnosis of BED (mean age ± SD: 43.5 ± 15.3 years; mean Body Mass Index: BMI: kg/m²: 41.1 ± 7.82) were admitted to the study. Psychological functioning and well-being were assessed pre- and post-intervention using the Strengths and Difficulties Questionnaire and the Psychological General Well-Being Index. Results: Significant improvements in emotional symptoms [F(1, 31) = 21.1973, p < 0.001, ƞ²p = 0.406] and overall psychological functioning [F(1, 31) = 10.0062, p = 0.373, ƞ²p = 0.026] were observed in both groups, with the most pronounced changes in internalizing symptoms, such as anxiety and depression. Changes in BMI were significantly associated with emotional symptoms, vitality [F(1, 31) = 4.89, p = 0.035, ƞ²p = 0.136], and total well-being scores [F(1, 31) = 6.341, p = 0.017, ƞ²p = 0.170]. By contrast, no significant changes were observed in domains such as behavioral problems, hyperactivity/inattention, and peer relationships, probably indicating the need for more prolonged and targeted, domain-specific interventions. Conclusions: A 3-week inpatient multidisciplinary program was associated with improvements in internalizing symptoms and psychological well-being in women with AN and BED. Domains such as behavioral regulation and social functioning showed limited change, indicating the need for longer and targeted psychosocial components. Full article