Search Results (121)

Background and Objective: Obesity is currently one of the major challenges in medicine. Research indicates that assessing eating habits can contribute significantly to the development of more effective treatment. This study aims to validate the Eating Behaviors Assessment for Obesity (EBA-O) in a sample of Spanish adults with overweight or obesity. Methods: This cross-sectional study included 384 participants. To evaluate the structure, reliability, and measurement invariance of the Spanish EBA-O, we conducted a confirmatory factor analysis (CFA), calculated McDonald’s omega for reliability, and carried out a hierarchical sequence of multigroup CFAs. Two-way MANOVA was used to assess the effects of sex and body mass index (BMI) categories on EBA-O scores. Results: CFA supported a second-order five-factor structure for the EBA-O, demonstrating excellent fit indices. It respected the configural, metric, and scalar invariance. The Spanish version of the EBA-O exhibited significant correlations with measures of binge eating, food addiction, and eating disorder psychopathology. Internal consistency was high (ω = 0.80). Significant effects of sex and BMI were observed across EBA-O subscales. Conclusions: The EBA-O appears to be a valid, reliable, and easy-to-use instrument for assessing eating behaviors among Spanish-speaking individuals with overweight or obesity. Its strong psychometric properties support its use in both clinical settings and research, enhancing the development of tailored interventions for this population. Full article

Aims. In the present study, we investigated the associations between the three identity dimensions of Kaufman (Consolidated Identity, Disturbed Identity, Lack of Identity) and symptoms of personality disorders (PDs) in 176 female inpatients with an eating disorder (ED). We examined five aspects: the prevalence of categorical PD diagnoses in patients with EDs; the relationship between dimensional PD scores and identity dimensions as well as their relationships with age and ED subtype; and the unique variance in dimensional PD scores explained by identity dimensions, while controlling for age and ED subtype. Methods. To assess identity functioning, we made use of the Self-Concept and Identity Measure, and to assess PDs, we used the categorical and dimensional scores of the Assessment of DSM-IV Personality Disorders. Results. The findings showed that the avoidant, obsessive–compulsive, and borderline categorical PDs were the most frequently reported PDs. Age was negatively related to all Cluster B PDs and Disturbed Identity, and binge-eating/purging ED patients reported significantly more Cluster B PD features compared to restrictive ED patients. ED subtype and identity dimensions were unrelated. Correlational analysis showed that all dimensional PD scores were positively related to Disturbed Identity and Lack of Identity and negatively related to Consolidated Identity. The results of the hierarchical regression analyses showed that Cluster A PDs were significantly predicted by Lack of Identity, controlled for age and ED subtype. Additionally, Cluster B PDs were significantly predicted by Disturbed Identity. Finally, two of the three cluster C PDs were predicted by Lack of Identity (avoidant and obsessive–compulsive PD), whereas the dependent PD was explained by Disturbed Identity. Conclusions. The co-occurrence of identity issues in both PDs and EDs underscores the role of identity as a transdiagnostic feature. Accordingly, using identity-based interventions in treatment may have broad therapeutic benefits across these disorders. Full article

Emerging evidence highlights the critical role of the gut microbiota in the development and progression of eating disorders (EDs), particularly in women, who are more frequently affected by these conditions. Women with anorexia nervosa, bulimia nervosa, and binge eating disorder exhibit distinct alterations in gut microbiota composition compared to healthy controls. These alterations, collectively termed dysbiosis, involve reduced microbial diversity and shifts in key bacterial populations responsible for regulating metabolism, inflammation, and gut–brain signaling. The gut microbiota is known to influence appetite regulation, mood, and stress responses—factors closely implicated in the pathogenesis of EDs. In women, hormonal fluctuations related to menstruation, pregnancy, and menopause may further modulate gut microbial profiles, potentially compounding vulnerabilities to disordered eating. Moreover, the restrictive eating patterns, purging behaviors, and altered dietary intake often observed in women with EDs exacerbate microbial imbalances, contributing to intestinal permeability, low-grade inflammation, and disturbances in neurotransmitter production. This evolving understanding suggests that microbiota-targeted therapies, such as probiotics, prebiotics, dietary modulation, and fecal microbiota transplantation (FMT), could complement conventional psychological and pharmacological treatments in women with EDs. Furthermore, precision nutrition and personalized microbiome-based interventions tailored to an individual’s microbial and metabolic profile offer promising avenues for improving treatment efficacy, even though these approaches remain exploratory and their clinical applicability has yet to be fully validated. Future research should focus on sex-specific microbial signatures, causal mechanisms, and microbiota-based interventions to enhance personalized treatment for women struggling with eating disorders. Full article

Background: Binge eating is a disordered eating behavior implicated in eating disorders such as binge eating disorder (BED) and bulimia nervosa; it significantly affects an individual’s physical and mental health. Recent studies suggest shared neurobiological mechanisms between binge eating and addictive behaviors. Comorbid addiction (e.g., substance use disorders and behavioral addictions) is also frequently reported in binge-eating patients. However, it is still unclear whether binge-eating individuals with comorbid addictions differ in their cognitive and mental health characteristics from those without comorbid addictions. Objectives: The present study aimed to examine the cognitive and mental health profiles of binge-eating individuals with and without co-occurring addictions. We hypothesized that binge-eating individuals with comorbid addictions would show greater impairments in impulsivity and self-control, as well as elevated depression and emotion dysregulation. Methods: In the present study, we assessed psychometric scales on various cognitive and mental health domains (e.g., impulsivity, behavioral inhibition, self-control, emotion regulation, mood, and anxiety) across 30 binge-eating individuals with co-occurring addictive behaviors (i.e., alcohol, nicotine, gambling, and video games), 32 binge-eating individuals without addiction, and 180 healthy control subjects with neither binge-eating tendencies nor addiction. Results: Both binge-eating groups showed a significant increase in punishment sensitivity, perceived stress, and state/trait anxiety compared to healthy controls, but there was no difference between the two binge-eating groups. Higher impulsivity and lower self-control were observed in both binge-eating groups to a significantly greater degree in the group with comorbid addiction. Notably, significantly increased depression and impaired emotion regulation (reduced use of cognitive reappraisal) were observed only in the binge-eating group with comorbid addiction when compared to the healthy controls. Conclusions: Our findings demonstrated the commonalities and differences in binge-eating populations with and without comorbid addiction. It will help to elucidate cognitive and mental health aspects of comorbid addiction in the binge-eating population and to develop more tailored diagnoses and treatments. Full article

Background/Objectives: Dialectical Behaviour Therapy (DBT) has emerged as a promising intervention for Eating Disorders (Eds), especially Binge Eating Disorder (BED), which is often characterized by severe emotion dysregulation. The aims of this study were to evaluate the longitudinal course of BED symptomatology following a group-based DBT intervention focused on two specific modules, Emotion Regulation and Distress Tolerance, and to examine the mediating role of emotion dysregulation and alexithymia in symptom improvement. Methods: This non-randomized longitudinal clinical study involved 170 patients with BED who received a 16-week DBT group treatment including modules targeting emotion regulation and distress tolerance. Self-report questionnaires were administered at baseline (T0) and at the end of treatment (T1). Linear mixed models were used to analyze the longitudinal trend, and a mediation analysis was conducted to examine whether changes in emotion dysregulation and alexithymia mediated symptom improvement. Results: Longitudinal analyses showed a significant reduction in BED symptoms at the end of treatment as well as in the levels of emotion dysregulation and alexithymia. Mediation analyses revealed that both emotion dysregulation (indirect effect: −0.68 [−1.20; −0.31]) and alexithymia (indirect effect: −0.59 [−1.33; −0.20]) significantly mediated the improvement in BED symptoms over time. Conclusions: These findings support the application of focused DBT group interventions targeting emotion regulation and distress tolerance in reducing BED symptomatology. Emotion dysregulation and alexithymia were identified as mediators of longitudinal clinical improvement, highlighting the importance of modular and precision-based approaches in the treatment of BED. Full article

Background/Objectives: There is scientific evidence showing that body- and/or body weight-related blaming, guilting, and shaming continue to be both promoted and tolerated in many societal contexts, including schools and healthcare settings. A deeply ingrained belief still prevails among many individuals that inducing these negative emotions can serve as a motivator for children and adolescents to engage in obesity treatment. Therefore, the aim of this systematic review is to examine these emotions (blame, guilt, shame) in relation to body weight and their impact on psychological functioning within the pediatric population affected by overweight and obesity. Methods: Articles were searched up using PubMed and Web of Science in June 2023 and March 2025. The search was conducted without limiting the years of publication. The inclusion criteria included the following: (1) pediatric samples, (2) full text available, and (3) original research articles. Articles were excluded if they were editorials, letters, replies from authors, review articles, and articles without a full text. Results: The initial search returned 199 results. A total of 16 articles were included in the study. Analysis of the collected records revealed associations between body- or weight-related blame, guilt, and shame and various aspects of psychological functioning in the pediatric population such as (a) interpersonal context (e.g., social stigma, bullying, teasing history, social connectedness, weight-related language used by parents in conversations with children and adolescents; (b) intrapsychic context—relationship with eating and food (e.g., binge eating, dietary restraint, emotional eating, and the risk of developing eating disorders); (c) intrapsychic context—self-perception (e.g., self-esteem, feelings of worthlessness, self-compassion, self-efficacy, perceived control); (d) intrapsychic context—emotional functioning (e.g., emotional distress, anxiety, depression, emotion regulation strategies); and (e) intrapsychic context—additional psychological factors (e.g., mindfulness, quality of life, willingness to seek help, and motivation for both help-seeking and sustaining successful lifestyle changes). Conclusions: Understanding the dynamics of body- and/or weight-related blame, guilt, and shame among children and adolescents with overweight and obesity is essential for developing effective support systems that enhance their well-being and psychological resilience in both the prevention and treatment of obesity. Further research is needed to explore the relationships between body- and weight-related blame, guilt, and shame and psychological functioning in pediatric populations with overweight and obesity, including the dynamics of child–parent–healthcare provider interactions, the context of parenting skills and attitudes that support the child during obesity treatment, the long-term consequences of body- and weight-related blame, guilt, and shame, the relationship between healthcare providers’ tendencies to engage in body- and weight-related shaming or blaming and their communication skills and mental well-being (e.g., levels of professional burnout, emotion regulation skills, and personality traits), as well as the influence of social media on body- and weight-related shame, guilt, and blame. Full article

Objectives: Feeding and eating disorders (FED) represent a major public health issue and are the second leading cause of death among psychiatric conditions in children and adolescents. Psychopathological comorbidities play a significant role in the onset and persistence of FED, yet research on their underlying structure remains limited. This study explores the psychiatric comorbidities associated with FED, focusing on common etiopathogenetic factors and their clinical implications. Methods: Data were retrospectively collected from the Italian Regional Center for FED in the Emilia-Romagna Region between June 2023 and April 2024. Diagnoses were assigned following DSM-5 criteria using the Italian version of the semi-structured K-SADS-PL diagnostic interview. Principal component analysis (PCA) was performed to identify latent psychological dimensions underlying FED psychopathology, retaining five components based on the scree plot. Additionally, an analysis of covariance (ANCOVA) was conducted to examine differences in factor scores across FED subtypes, while adjusting for potential confounders. Results: Seventy-two participants were included (mean age: 14.6 years; mean BMI: 18.3 kg/m²; male-to-female ratio: 1:8). Diagnoses were distributed as follows: 63.9% anorexia nervosa (AN), 13.9% other specified feeding and eating disorder (OSFED), 6.9% avoidant restrictive food intake disorder (ARFID), 4.2% binge eating disorder (BED), 4.2% unspecified feeding and eating disorder (UFED), and 2.7% bulimia nervosa (BN). All participants met the criteria for at least one psychiatric comorbidity. Identified psychopathological clusters include the following: (1) mood disorders (66.5%); (2) anxiety disorders (87.5%); (3) obsessive–compulsive and related disorders (47.2%); (4) neurodevelopmental disorders, i.e., attention-deficit/hyperactivity disorder (ADHD) (30.5%); (5) disruptive and impulse-control disorders (13.9%); and (6) psychotic symptoms (40.3%). No instances of tic or elimination disorders were detected. Conduct disorder was more prevalent among UFED, BED, and BN patients compared to other FED (p = 0.005), and moderate/severe ADHD was associated with higher body mass index (BMI) (p = 0.035). PCA revealed distinct psychological dimensions underlying FED, while ANCOVA indicated significant differences in factor scores across FED subtypes, supporting the presence of shared transdiagnostic mechanisms. Conclusions: This study highlights the complex interplay between FED and psychiatric comorbidities, emphasizing the need for early intervention and personalized treatment approaches. The dimensional structure identified through PCA suggests that common psychopathological factors may drive FED development, and ANCOVA findings support their differential expression across FED types. Future research should further investigate these transdiagnostic mechanisms to optimize clinical care. Full article

Background/Objectives: Psoriasis is a chronic inflammatory skin disease increasingly linked to psychiatric and behavioral comorbidities, including depression, anxiety, and substance use disorders. Shared inflammatory pathways, including elevated IL-6, TNF-α, and IL-17, may link psoriasis with psychiatric disorders such as depression and anxiety. The bidirectional interaction between systemic inflammation and mental health may exacerbate the disease burden and affect treatment outcomes. The objective of this study was to determine the prevalence of psychiatric and behavioral comorbidities in patients with psoriasis and to explore potential demographic and clinical correlations. Assessing these correlations contributes to a better understanding of the mental health status of psoriasis patients, potentially influencing both therapeutic efficacy and quality of life. Methods: We conducted a cross-sectional observational study on 316 patients with clinically and histopathologically confirmed psoriasis, evaluated between January 2021 and March 2025 at the Clinical Railway Hospital in Iași, Romania. Psychiatric and behavioral comorbidities were assessed through clinical interviews, medical record reviews, and standardized tools including AUDIT-C, Fagerström Test for Nicotine Dependence, and the Binge Eating Scale. Psoriasis severity was evaluated using the Psoriasis Area and Severity Index (PASI). Results: Of 316 participants, 88 (27.8%) had psychiatric/behavioral comorbidities. The most frequent conditions were tobacco use disorder (11.1% overall; 39.8% among comorbid patients), alcohol use disorder (9.2%; 32.9%), binge eating (7.9%; 28.4%), anxiety (6.3%; 22.7%), and depression (4.1%; 14.8%). Additional diagnoses included personality disorders, dementia, PTSD, and sleep disorders. Conclusions: Psychiatric and behavioral comorbidities, particularly substance use disorders, are relatively common in patients with psoriasis. These findings support the need for regular mental health screening and integrated care approaches in psoriasis management. Full article

Binge eating disorder (BED) has long been an overlooked mental health condition, making its recognition and treatment more challenging. This study examines the impacts of social stigma and fatphobia on individuals with BED, exploring how these factors influence their well-being and perpetuate cycles of exclusion and discrimination. Using a psychosocial approach, this research analyzes how societal misperceptions about BED foster harmful stereotypes, such as the belief that being overweight results from a lack of willpower or personal negligence. This study is based on a qualitative discourse analysis of 12 participants diagnosed with BED. The findings highlight the presence of compensatory behaviors, including fasting, excessive exercise, and laxative use, which challenge the conventional understanding of BED. The results reveal that BED affects not only individuals at a personal level, but also deeply impacts their social and family lives, reinforcing shame, guilt, and self-hatred. Diet culture and weight stigma contribute to social exclusion, further hindering access to proper treatment. This study provides a critical perspective on the need for a cultural shift in how society perceives weight and eating behaviors, advocating for a more inclusive health model that prioritizes mental well-being and body diversity over arbitrary aesthetic standards. These findings underscore the need for greater societal understanding, inclusive health narratives, and further qualitative research into the lived experiences of individuals with BED. Full article

Background/Objectives: To inform person-centred clinical practice, it is important to know what features may predict or moderate treatment outcomes. Thus, we investigated pre-treatment clinical features and mid-therapy reduction in loss of control over eating (MTLOCE), including impacts on treatment outcomes of a new manualised psychotherapy, a healthy approach to weight management and food in eating disorders (HAPIFED). HAPIFED was developed as an integrated psychological and behavioural treatment for individuals with bulimia nervosa or binge eating disorder, which are co-morbid with a high body mass index (BMI). Methods: In total, 50 participants were randomised to HAPIFED and 48 were randomised to the control cognitive behaviour therapy-enhanced group. Assessments included mental health-related quality of life (MHRQoL), eating disorder symptom severity, binge-eating frequency, BMI, and loss of control over eating (LOCE) at baseline, mid-treatment, end-treatment, and 6 and 12 months end of follow-up (EndFU). These were measured with the SF-12, the EDE-Q, and the LOCES, respectively. Linear and negative binomial mixed models were used. Missing data were imputed multiple times, assuming intention of treatment for the analysis. Results: Pre-treatment eating disorder symptom severity, MHRQoL, and BMI positively predicted eating disorder symptom severity, MHRQoL, and BMI up to 6 and 12 months end of follow-up. Mid-treatment LOCE MTLOCE predicted improved MHRQoL (coefficient = 0.387, 95% CI 0.0824–0.6921, p = 0.004), reduced binge-eating frequency (IRR = 0.5637, 95% CI 0.3539–0.8977, p = 0.0191), and eating disorder symptom severity (coefficient= −0.65, 95% CI −1.0792–−0.2217, p = 0.0139). Neither purging nor illness duration were a significant predictor of any of the outcomes. The effect of HAPIFED was not moderated by baseline weight/BMI but was moderated negatively by MTLOCE for binge-eating frequency (coefficient = −0.636, SE = 0.28, p < 0.05, IRR = 0.529) and eating disorder symptom severity (coefficient = −0.268, SE = 0.13, p < 0.05, Cohen’s d = −0.102). Conclusions: Greater control over eating improved MHRQoL and decreased the frequency of binge-eating episodes and eating disorder symptom severity. These positive effects were moderated by being in the HAPIFED group, supporting previous findings of benefits to people’s mental health through participation in the HAPIFED trial. Full article

Background/Objectives: Over the past decade, numerous studies have explored the bidirectional relationship between obesity and mental health, mainly eating disorders (EDs). This study aimed to assess the prevalence and characteristics of altered eating behaviors (AEBs) in a cohort of people with obesity (PwO) using the validated Eating Behaviors Assessment for Obesity (EBA-O). Methods: We conducted a cross-sectional study from May 2023 to April 2024, recruiting consecutive PwO seeking weight loss. Participants completed the 18-item EBA-O questionnaire, which focuses on five primary eating behaviors: night eating, food addiction, sweet eating, hyperphagia, and binge eating. Unlike other validated tools, the EBA-O is specifically designed to capture these behaviors in PwO and is easy for patients to self-administer. We also collected sociodemographic and clinical data. Results: A total of 127 participants were included (76 women, median age 52 years, median BMI 42.9 kg/m²). We found a significant prevalence of AEBs: 33.1% for sweet eating, 23.6% for hyperphagia, 15.7% for food addiction, 14.2% for binge eating, and 7.1% for night eating. The EBA-O scores correlated positively with BMI (r = 0.201, p = 0.024) and increased across BMI categories (p = 0.001). Males had higher scores for night eating and hyperphagia (p = 0.01), and active smokers had higher hyperphagia scores (p = 0.043) than ex-smokers and non-smokers. The night eating scores were inversely correlated with sleep hours (r = −0.197, p = 0.026), and food addiction was positively correlated with age (r = 0.261, p = 0.003); conversely, hyperphagia (r = −0.198, p = 0.025) and binge eating (r = −0.229, p = 0.010) were inversely correlated with age. PwO without diabetes had higher scores for food addiction (p = 0.01) and binge eating (p = 0.004) compared to those with diabetes. Conclusions: These results highlight the potential to characterize PwO based on their AEBs, offering new opportunities to tailor treatment strategies for PwO by targeting specific eating behaviors. Full article

Disordered eating, such as binge-eating and loss of control eating (LOCE), contribute to suboptimal weight loss and weight regain in some patients who undergo weight loss surgery (WLS). Despite robust evidence linking disordered eating and poor WLS outcomes, there is no consensus on standardized screening and treatment practices for this population. To address this gap, our team conducted a literature review using Ovid MEDLINE, Scopus, CINAHL, EMBASE, and Cochrane CENTRAL, focusing on studies examining screening and treatment of disordered eating in WLS populations. Our review identified key findings related to (a) screening and diagnostic tools, including semi-structured interviews and self-report measures, and (b) psychotherapeutic interventions, including cognitive behavioral therapy (CBT) and other modalities. Findings are inconclusive but suggest avenues for future research examining the routine implementation of post-WLS screening and treatment protocols (including adjunctive pharmacotherapy) for disordered eating. Full article

This systematic review investigates the effectiveness of virtual reality as a tool in the treatment of eating disorders, either alone or in combination with other therapies. The limitations of traditional therapies, along with the high prevalence of eating disorders, have driven research into the use of virtual reality techniques as a new approach to treatment. The review includes studies published between November 2021 and February 2025, focusing on virtual reality-based interventions for anorexia nervosa, bulimia nervosa, binge eating disorder, and body image disturbances. A total of 228 articles were screened, with eight meeting the inclusion criteria. The studies show that virtual reality interventions, particularly when combined with other therapeutic techniques, can significantly improve psychological and behavioral factors related to eating disorders. Virtual reality exposure and inhibitory control training were the main interventions. The results indicate that virtual reality exposure is effective in reducing body concerns, food anxiety, and attentional bias, while inhibitory control training shows mixed results in binge eating disorder treatment. Despite the promising findings, limitations such as small sample sizes and lack of follow-up highlight the need for further research. Future studies should aim to include larger, more diverse samples and explore the long-term effectiveness of the interventions. Full article

Background/Objectives: Eating disorders (EDs) are complex psychopathological conditions involving dysfunctional eating behaviors, excessive body image concerns, and impaired emotional regulation. Among moral emotions, guilt plays a significant role in ED dynamics, influencing both symptomatology and interpersonal relationships. This study examines specific guilt subtypes (normative and altruistic guilt) using a specific psychometric tool. Methods: Forty-three adults with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) were recruited from the Eating Disorder Center of the University of Campania “Luigi Vanvitelli” or referred by psychotherapists. Diagnoses followed DSM-5 criteria. Participants completed the Moral Orientation Guilt Scale (MOGS), assessing guilt subtypes, and the Eating Disorder Inventory-2 (EDI-2), measuring ED symptomatology. Spearman’s rank correlation and stepwise multiple regression analyses were used to identify relationships between guilt dimensions and ED-related symptoms. Results: MOGS subscales were positively correlated with ED symptomatology. Normative guilt was significantly associated with binging and purging (ρ = 0.26, p < 0.05), while altruistic guilt predicted higher interpersonal distrust (t = 3.4, p < 0.01). Regression analysis revealed that age negatively influenced interpersonal distrust (t = −2.9, p < 0.01). Conclusions: In the population examined, guilt significantly influences ED symptomatology and interpersonal functioning, with specific dimensions linked to distinct behaviors and traits. Therapeutic interventions targeting guilt may enhance treatment outcomes by addressing ED emotional underpinnings. However, the results should be interpreted with caution due to the small sample size and lack of longitudinal data to establish causality. Further research with larger samples and longitudinal designs is necessary to validate these findings. Full article

Background/Objectives: Binge Eating Disorders are severe mental and physical health conditions, closely linked to lifestyle habits. The aims are to describe the prevalence of Binge Eating Disorders and their correlation with nutritional habits and lifestyle factors within the Spanish population. Methods: A descriptive, cross-sectional design was employed. Using non-probabilistic snowball sampling, an electronic survey was released. A total of 22,181 Spanish adults were evaluated, excluding those with any pathology or limitation at the time of survey response that could potentially affect their diet, such as hospitalization or confinement. The validated Nutritional and Social Healthy Habits (NutSo-HH) scale was used to collect data on nutrition, lifestyle, health habits, and socio-demographic variables. Descriptive and inferential statistics were used. Non-parametric tests were applied due to non-normal distribution. Results: Of the 22,181 sample subject (80.8% female), a total number of 260 individuals reported Binge Eating Disorder. The prevalence of Binge Eating Disorder was higher in women than in men (239 vs. 21 respectfully; 91.9%). Individuals with Binge Eating Disorder exhibited poorer nutritional indices (p < 0.001), higher consumption of ultra-processed and fast food (p < 0.001), sugary soft drinks (p = 0.01), and worse sleep quality (p < 0.001). Although time dedicated to physical activity was not different, individuals with Binge Eating Disorder were more sedentary and had lower health status (p = 0.11 for sport practice). Behavioral regulation plays a key role in managing BED, highlighting the need for personalized intervention strategies. Conclusions: Binge Eating Disorders are associated with lifestyle and health habits and worse quality of life. These data can help design public health programs for early detection and effective treatment. Full article