Search Results (424)

Background/Objectives: Binge eating (BE)—eating an objectively large amount of food with a subjective loss of control—occurs broadly beyond formal eating disorder diagnoses. However, its real-time occurrence in the general population remains poorly understood due to reliance on retrospective, clinic-based self-reporting. Ecological momentary assessment (EMA) captures repeated, real-time reports of BE and may overcome these limitations. This scoping review mapped EMA studies of BE in non-clinical, general population samples, paying attention to population characteristics, methodological approaches, and key findings. Methods: This review followed PRISMA-ScR guidelines. PubMed and Scopus were searched for studies published between January 2016 and January 2026, with eligibility independently assessed by two reviewers. Results: Twenty-three studies met the inclusion criteria. Twenty studies (87%) comprised predominantly female samples, and most participants were in their twenties; men, middle-aged adults, and racially diverse populations were underrepresented. Regarding EMA methodology, BE was assessed either by measuring overeating and loss of control of eating separately (15 studies) or through direct, instructed self-report (8 studies); most studies used signal-contingent designs, with response rates generally being between 60% and 85%. Across studies, BE was most consistently linked to negative affect, weight stigma, and body dissatisfaction, while dietary restraint and food insecurity—a more recently emerging focus—were each examined in only one or two studies. Conclusions: This review maps the range of EMA methodologies used to assess BE, offering a methodological reference point for future studies. However, the existing evidence remains concentrated in young, female, and predominantly White samples, and further research in underrepresented populations is needed to clarify the broader determinants of BE in everyday life. Full article

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become first-line pharmacotherapy for eligible patients with type 2 diabetes mellitus and obesity. Soon after their broad uptake, spontaneous reports of suicidal ideation, depression, and anxiety prompted regulatory investigations and a contentious debate about the neuropsychiatric safety of the class. Objective: We aimed to synthesize emerging evidence on psychiatric adverse outcomes associated with GLP-1 RAs by integrating mechanistic, pharmacovigilance, observational, and regulatory data; to trace how the evidence and regulatory assessments evolved chronologically from initial signal detection toward subsequent controlled refutation; and to translate the current balance of evidence into practical clinical guidance. Methods: We conducted a narrative integrative synthesis of peer-reviewed pharmacovigilance studies, cohort and case–control analyses, systematic reviews and meta-analyses, mechanistic literature, and regulatory communications identified through targeted searches of the published record through early 2026. Results: Disproportionality analyses of spontaneous-reporting databases have generated modest, semaglutide-predominant signals for depression and suicidality, whereas liraglutide and tirzepatide have generally not. Anxiety signals parallel those for depression, and emerging data also indicate potential benefits for substance-use, binge-eating, and sleep-disordered breathing. In contrast, large propensity-matched cohort studies, a nationwide case–time–control analysis, an administrative-claims cohort exceeding two million users, and a meta-analysis of 91 placebo-controlled trials enrolling 107,910 participants found no increased risk and, in some analyses, lower risk of suicidal ideation. The principal exception is an amplified reporting signal among patients co-prescribed antidepressants or benzodiazepines, indicating effect modification by psychiatric vulnerability. Conclusions: The preponderance of controlled evidence has not demonstrated a causal relationship between GLP-1 RAs and suicidality or major psychiatric harm, a conclusion reflected in 2024–2026 regulatory determinations. Residual uncertainty persists for psychiatrically vulnerable subgroups, justifying continued individualized monitoring rather than restriction of access. Full article

Background: Subclinical eating-disorder tendencies may reflect early psychological vulnerability before the development of clinically diagnosed eating disorders. Body image concerns, perceived social support, and control-related beliefs are established correlates of eating pathology. However, their joint pattern across several eating-disorder tendency profiles has received less attention in Romanian nonclinical adult samples. Objective: We examined differences in perceived social support, locus of control, and body image concerns among participants with and without subclinical tendencies associated with anorexia, bulimia, and binge eating. We investigated the association between locus of control and body image concerns. Methods: A cross-sectional quantitative design was used. The sample included 108 participants who completed online self-report measures assessing perceived social support, eating-disorder tendencies, body image concerns, and locus of control. Independent-samples t-tests and Welch tests were used for group comparisons. Bonferroni correction was applied within families of comparisons. Effect sizes were reported using Hedges’ g. Pearson correlation and simple linear regression were used to examine the association between locus of control and body image concerns. Results: Body image concerns were significantly higher among participants with anorexic, binge-eating, and bulimic tendencies. Perceived social support was lower among participants with binge-eating and bulimic tendencies, but not among those with anorexic tendencies. Locus of control differed significantly only in the exploratory bulimia comparison after correction. External locus of control was positively associated with body image concerns and explained a small but significant proportion of variance. Conclusions: Body image concerns emerged as the most consistent correlate of subclinical eating-disorder tendencies. The findings support the relevance of body image, interpersonal resources, and control-related beliefs in early eating-disorder vulnerability. Full article

Semaglutide and tirzepatide, glucagon-like peptide-1 (GLP-1) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists, respectively, have revolutionized the management of type 2 diabetes mellitus and obesity. Beyond their established metabolic indications, emerging preclinical and clinical evidence suggests these incretin-based therapies exert pleiotropic effects across multiple organ systems through mechanisms extending beyond glycemic control and weight reduction. This comprehensive review synthesizes current evidence for unconventional applications of semaglutide and tirzepatide across five distinct therapeutic domains: oncology, psychiatry and addiction medicine, orthopedics, aesthetic medicine, and human reproduction. In oncology, both agents demonstrate antitumor activity primarily through immune and metabolic reprogramming rather than direct cytotoxicity, with promising signals in pancreatic, thyroid, breast, and colorectal cancers. In psychiatry, modulation of mesolimbic dopamine reward pathways and GABAergic neurotransmission underlies robust preclinical and observational evidence for reducing alcohol use disorder, substance use, and binge-eating behaviors. Orthopedic applications include clinically meaningful improvements in knee osteoarthritis pain and function, though bone health signals remain mixed. Aesthetic medicine faces the dual challenge of managing GLP-1 receptor agonist-associated facial volume loss while exploring therapeutic potential in inflammatory dermatoses. In reproductive medicine, metabolic improvements translate to benefits in polycystic ovary syndrome and male fertility, though periconception safety concerns persist. Across all domains, evidence derives predominantly from preclinical models, observational cohorts, and pharmacoepidemiologic studies, with randomized controlled trials remaining limited. This review critically evaluates mechanisms, efficacy signals, safety considerations, and research priorities for each application domain, providing a roadmap for translating unconventional uses of semaglutide and tirzepatide into evidence-based clinical practice. Full article

Background: Obesity and Binge Eating Disorder (BED) are common comorbidities in type 2 diabetes mellitus (T2DM), often complicating disease management. Self-efficacy—the belief in one’s ability to manage diabetes—has been shown to influence self-care behaviours and outcomes. This study aimed to assess diabetes management self-efficacy among adults with obesity and T2DM undergoing multidisciplinary rehabilitation, focusing on the impact of BMI, BED, and gender. Methods: A cross-sectional study was conducted with 137 adults (BMI ≥ 30 kg/m²) with T2DM admitted to a residential rehabilitation center. Self-efficacy was measured using the Italian Diabetes Management Self-Efficacy Scale (IT-DMSES), which evaluates confidence in lifestyle and disease management tasks. Data on BMI, BED status, age, and gender were collected. Results: The mean IT-DMSES score was 116.7 ± 23.7, with females scoring slightly higher than males (120.3 ± 24.8 vs. 112.5 ± 22.0, p = 0.057). Higher BMI was significantly associated with lower self-efficacy, particularly in lifestyle (R = 0.282, p = 0.002) and disease management (R = 0.271, p = 0.002) domains. Several individual items, including those related to dietary control and medication adherence, showed strong negative correlations with BMI. BED independently predicted lower self-efficacy on item 13 (emotional eating) (Estimate = −3.18, p = 0.001), even after adjusting for BMI, age, and gender. No significant interactions between gender and BED were observed for overall self-efficacy or domain scores. Conclusions: Although the exploratory nature of the findings requires confirmation, our results underline the independent association of low self-efficacy with BED. Full article

Background/Objectives: The rates of obesity and binge-eating disorder (BED) have increased markedly over the last few decades. The onset of these conditions has been associated in part with the disruption of neural pathways that regulate food reward. Existing literature has implicated the endogenous opioid system as an important mediator of pleasure and reinforcing behaviors associated with food intake. While the relationship between opioids and food intake has been studied extensively, how dysregulated opioid signaling contributes to compulsive eating still remains unclear. Therefore, the aim of this review is to analyze the role of opioid peptides and receptors, and their interactions with dopamine in hedonic feeding. Methods: We conducted a narrative review of preclinical and clinical trials, incorporating studies that were relevant to opioid-mediated feeding and food reward. Results: β-endorphins appear to modulate the hedonic value of food, but their effects appear to be context-dependent. Enkephalins may influence motivational drive toward food, while nociceptin signaling has been linked to the preferential consumption of palatable foods under binge-like conditions. Consistent with these findings, NOP antagonism has been reported to reduce binge-like intake of a high-fat diet (HFD) without affecting homeostatic eating patterns. Lastly, chronic mu-opioid receptor (MOP) activation by palatable foods may induce neuroadaptive changes, including receptor desensitization, dopamine D2 receptor downregulation, and reward hypofunctionality, which overlap with mechanisms associated with substance use disorders. Conclusions: Altered MOP signaling may disrupt the hedonic and behavioral mechanisms that regulate feeding behavior. Pharmacological therapies targeting opioid and opioid-dopamine interactions may show promise for treating obesity and BED. However, additional research is still needed to clarify peptide-specific mechanisms, sex differences, and long-term neurobiological consequences associated with hedonic and compulsive eating. Full article

A dearth of information exists on differences in quality of life across eating disorder diagnoses. The purpose of the current study was to examine quality of life among a large sample of adults with one of six eating disorder diagnoses: anorexia nervosarestricting subtype (AN-R), AN binge/purge subtype (AN-BP), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), and otherwise specified feeding or eating disorder (OSFED). Participants were 1268 adults receiving treatment for an eating disorder across multiple levels of care who completed a measure of quality of life, the WHOQOL-BREF, at admission. Adjusted pairwise comparisons with multiple comparison correction found significant differences among eating disorder groups, even after controlling for age, sex, level of care, body mass index (BMI), and the interaction between BMI and eating disorder diagnosis. Among the five significant findings, four of them involved differences in those with ARFID in comparison to the other eating disorder diagnoses. On the physical health subscale, individuals with BN scored significantly better than did individuals with ARFID. On the psychological subscale, patients with ARFID had significantly better quality of life than those with BN, BED and OSFED. On the social relationships subscale, the BED group scored significantly worse than those with AN-BP. This large study of adults with eating disorders suggests that there are meaningful differences among eating disorder diagnostic groups in quality of life. Full article

Background: Binge eating (BE) is frequently associated with negative emotional states, obesity, and physical inactivity. Although yoga may improve binge eating and emotional symptoms, its effects on physical fitness remain unclear. In contrast, high-intensity interval training (HIIT) has been demonstrated to effectively enhance physical fitness. This study compared the effects of low-volume HIIT (LV-HIIT), high-volume HIIT (HV-HIIT), and yoga on binge eating, negative emotional states, and physical fitness in female college students with binge eating. Methods: Fifty-five physically inactive female college students with binge eating (BES ≥ 18) were randomly assigned to LV-HIIT (n = 19), HV-HIIT (n = 18), or yoga (n = 18) for 8 weeks. The Binge Eating Scale (BES), Depression Anxiety Stress Scale-21 (DASS-21), body fat percentage, waist circumference, and maximal oxygen uptake (VO2max) were assessed before and after the intervention. Data were analyzed using intention-to-treat linear mixed models, with per-protocol repeated-measures ANOVA as a supplementary analysis. Results: After 8 weeks of intervention, significant improvements over time were observed across all groups in binge eating, negative emotional states, and cardiorespiratory fitness (all p < 0.05). Waist circumference and body fat percentage did not change significantly in the ITT analysis. No significant time × group interaction effects were detected for any outcome (all p > 0.05), indicating that the improvements did not differ significantly among the LV-HIIT, HV-HIIT, and yoga groups. Conclusions: An 8-week intervention of LV-HIIT, HV-HIIT, and yoga was associated with improvements in binge eating behaviors, negative emotional states, and VO2max in inactive young women with binge eating, with no evidence of differential efficacy between interventions. LV-HIIT may be promising because of its shorter duration and higher adherence; however, this requires confirmation in larger trials. Full article

Background: Bariatric surgery is the most effective long-term treatment for severe obesity; however, a subset of patients fails to achieve optimal weight loss. This study investigated the role of psychiatric disorders and transdiagnostic psychopathological traits in predicting weight loss outcomes two years after surgery. Methods: This prospective naturalistic study included 125 consecutive bariatric surgery candidates undergoing routine preoperative psychiatric assessment. Psychiatric comorbidities, emotional dysregulation and ADHD-related dimensions were assessed using structured clinical interviews and self-report questionnaires. Weight outcomes were evaluated at 24 months after bariatric surgery, with post-surgical inadequate weight loss defined as percentage of excess weight loss (%EWL) < 50%. Results: Of the 125 patients initially assessed, 89 underwent bariatric surgery and 48 completed the follow-up. At 24 months, 10 patients (20.8%) showed inadequate weight loss. Poorer weight outcomes were associated with older age, sleeve gastrectomy, and lifetime mood disorders, whereas no significant associations emerged with anxiety disorders or binge eating disorder. Patients with inadequate weight loss showed higher levels of emotional dysregulation, while no differences emerged for other ADHD-related dimensions. Emotional dysregulation remained significantly associated with poorer weight outcomes in multivariate analysis. Conclusions: Emotional dysregulation may represent a transdiagnostic factor influencing bariatric surgery outcomes, supporting the importance of integrating emotional and cognitive dimensions into preoperative assessment and postoperative care. Full article

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

Introduction: The widespread use of digital devices has significantly increased screen time among children and adolescents, raising concerns about its effects on dietary behaviors and health outcomes. This narrative review aimed to examine the relationship between screen exposure, unhealthy eating behaviors, and associated physical and mental health risks in pediatric populations. Methods: A narrative review of the literature was conducted using PubMed, Scopus, and Web of Science databases, with the final search updated on 30 April 2026. Studies involving individuals aged 0–18 years were included if they investigated screen time, dietary behaviors, obesity, cardiometabolic risk, sleep, or mental health outcomes. Observational studies, interventional studies, systematic reviews, and meta-analyses were considered. Findings were synthesized qualitatively according to pre-specified thematic domains, with greater interpretive weight given to systematic reviews, meta-analyses, randomized trials, longitudinal cohorts, and large population-based studies. Results: Excessive screen time was consistently associated with unhealthy eating behaviors, including increased snacking, mindless eating, breakfast skipping, and higher consumption of ultra-processed and energy-dense foods. Digital food marketing and exposure to food advertising may influence children’s food preferences and intake. High screen exposure was also associated with sedentary behavior, sleep disturbances, circadian dysregulation, and altered appetite-related hormones such as leptin and ghrelin. These pathways may contribute to, or be consistent with, obesity, insulin resistance, dyslipidemia, hypertension, and metabolic syndrome, although most evidence remains observational. Moreover, excessive screen use was associated with anxiety, depression, emotional eating, binge-eating behaviors, and body image dissatisfaction, particularly among adolescents. Conclusions: Screen time may represent a modifiable behavioral and environmental correlate of dietary habits, metabolic health, and psychological wellbeing in children and adolescents. Prevention strategies should focus not only on reducing screen duration but also on improving the quality and context of media use through family-based interventions, school programs, digital literacy, promotion of physical activity, and regulation of digital food marketing. Further longitudinal and interventional studies are needed to clarify causal relationships and develop effective prevention strategies. Full article

Animals with knockout of the dopamine transporter gene (DAT-KO) display hyperdopaminergic phenotypes, including attention-deficit/hyperactivity-like behaviors. A previous behavioral analysis of heterozygous rats with partial knockout (DAT-HET) suggested increased susceptibility to addictive behaviors. The aim of this study was to investigate elements of addictive behaviors and the mechanisms underlying dopamine release in DAT-HET rats. Offspring derived from DAT-knockout breeding underwent genotyping and behavioral assessment using the marble burying test, a manipulative behavior test using nesting material, and a modified version of the Iowa Gambling Task. Feeding behavior was studied using a binge-eating model. Reinforcing properties were investigated using intracranial self-stimulation under fixed-ratio (FR) and variable-ratio (VR) schedules. Dopamine (DA) release and clearance dynamics were assessed using fast-scan cyclic voltammetry (FSCV). DAT-HET rats exhibited moderate hyperactivity, increased impulsive choice, and compulsive responses. Male DAT-HET rats also showed increased compulsive overeating compared with wild-type (WT) rats of both sexes and female DAT-HET rats. In addition, DAT-HET rats demonstrated a preference for VR self-stimulation, which resembles risk- and thrill-seeking behavior in humans. In DAT-KO rats, impaired DA clearance resulted from complete loss of dopamine transporter function. In DAT-HET rats, increased DA release amplitude was observed, and dopamine persisted longer in the extracellular space than in WT rats. These findings underscore the importance of the DAT-HET model for studying impulsivity, compulsivity, and factors underlying the predisposition to addictive behavior. Full article

Objectives: To examine disordered eating behaviors, orthorexic tendencies, binge-eating episodes, attitudes toward exercise, perceived hormone-related symptoms and body image perception among competitive bodybuilders across different levels of competitive experience. Methods: In this cross-sectional study, 60 competitive bodybuilders (29 men, 31 women) completed an anonymous online questionnaire. The survey evaluated demographic characteristics, coaching and training management, phase-specific symptoms (such as libido, sleep, eating behaviors, and menstrual alterations), orthorexic tendencies, exercise addiction, and body-image perception. Results: Both sexes reported reduced libido, increased hunger, and sleep disturbances, along with frequent weight monitoring and common binge-eating episodes. Moreover, females frequently reported menstrual irregularities. ORTO-15 scores indicated a potential risk of orthorexia nervosa, while EAI-3 scores suggested a risk of exercise addiction in novice females and advanced males, with differences in mood regulation and guilt across sex and experience. Males showed higher perceived and ideal muscle mass, whereas females reported higher perceived body fat and a preference for leaner physiques. Conclusions: Competitive bodybuilders of both sexes exhibit post-competition binge eating, mood- and appearance-driven exercise behaviors, and pronounced body-image concerns. Screening, education on energy availability, structured post-competition support, and health-focused coaching are recommended to prevent the progression from sport-specific practices to clinical pathology. Full article

Objectives: To assess associations between body weight metrics and eating disorder (ED)-psychopathology in adolescents with anorexia nervosa (AN) at baseline and four weeks post-discharge (4-week follow-up) from inpatient psychiatric multimodal treatment (IMT), calculating full and partial body mass index (BMI) percentile/ED-psychopathology remission rates. Methods: Secondary analysis of a prospective observational cohort study in adolescents (12–18 years) with AN-restricting (AN-R)/-binge–purge (AN-BP), and atypical AN (AAN). Body weight metrics and ED-psychopathology (Eating Disorder Examination Questionnaire, EDE-Q) were assessed at baseline and 4-week follow-up. Remission at 4-week follow-up was calculated by applying German-AN-S3-guidelines-based vs. DSM-5 criteria. Results: In 40 adolescents (mean age = 15.6 ± 1.5 years; females = 90%; BMI z-score = −2.59 ± 1.07) receiving IMT (median duration = 118 (IQR = 90–150) days), BMI z-score increased (−2.61 to −1.04, p < 0.001) and EDE-Q global score decreased (3.26 to 1.81, p < 0.001) from baseline to 4-week follow-up. Greater weight gain/week during IMT had a positive impact on ED-psychopathology at 4-week follow-up. In multivariable analyses, greater BMI z-score improvement was independently predicted by lower baseline BMI z-score (p < 0.001) and fewer baseline comorbid psychiatric diagnoses (p = 0.034) (R²_Adjusted = 0.545). Greater EDE-Q global score improvement was independently predicted by typical vs. atypical AN (p = 0.005), higher baseline BMI z-score (p = 0.012), and higher baseline EDE-Q restraint (p = 0.048) (R²_Adjusted = 0.376). By applying stricter S3-guideline-based vs. DSM-5 BMI percentile criteria, full BMI percentile/ED-psychopathology remission was lower (12.5% vs. 50.0%, p = 0.001), while non-remission was higher (25.0% vs. 5.0%, p = 0.001). Conclusions: The complex relationships between body weight metrics, ED-psychopathology, and treatment outcome trajectories in AN, including treatment response and remission criteria, require further investigation. Full article

Background/Objectives: Binge eating behavior has been deemed a significant factor associated with adolescent obesity. Understanding the underlying factors contributing to binge eating is critical, particularly among youth at risk of obesity. Hispanic and African American/Black children and adolescents experience disproportionately higher rates of obesity compared to their White peers. This study investigated the associations among anxiety, sleep quality, and binge eating among 315 Hispanic and African American/Black boys and girls, while controlling for demographic and adiposity covariates. Methods: Participants completed self-report surveys and underwent objective assessments of height, weight, and body fat percentage. Results: Descriptive analyses indicated a mean age of 10.71 years for boys and 10.92 years for girls. Most participants (71.9%) were classified as overweight or obese, and 94.1% were U.S.-born. Hierarchical regression analyses showed that both anxiety (β = 0.24, p < 0.001) and sleep quality (β = 0.23, p < 0.001) were significantly linked with higher levels of reported binge eating, after controlling for age, ethnicity, gender, and body fat percentage. The full model accounted for 15.4% of the variance in binge eating. Conclusions: These findings highlight the importance of targeting anxiety and sleep quality in interventions aimed at reducing binge eating among Hispanic and African American/Black early adolescents. Full article