Search Results (1,918)

Background: Tirzepatide is a novel therapeutic option for the management of metabolic disorders which has started to be implemented in routine practice. The study aimed to analyze the effectiveness of tirzepatide use and patient education in the field of healthy eating and weight loss, based on real-life data from the practice of a primary care physician, in metabolic syndrome (MetSyn) patients during a one-year follow-up period. Methods: This is a retrospective study based on real-life data of 118 MetSyn patients who were under the supervision of a general practitioner (GP). Analysis was conducted on 62 patients supported by trizepatide (2.5 mg for 4 weeks, then 5 mg for 4 weeks and 7 mg for 46 weeks) with dietary education and 56 patients that underwent dietary education with motivation only. Lipid profile, glucose level and blood pressure were assessed. Body Mass Index (BMI), waist-to-height ratio (WHtR), A Body Shape Index (ABSI), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI) and Body Roundness Index (BRI) were calculated. The KomPAN^® questionnaire was used for dietary assessment and WHO Quality of Life-BREF for the quality of life assessment at 52 weeks. Results: Patients from both groups significantly reduced their body weight and WC and the values of the following indices: BMI, WHtR, ABSI, LAP and BRI. A significant increase in LDL cholesterol and triglyceride values was observed in both groups and a significant decrease in glucose level only in the group with tirzepatide combined with dietary modification. Energy value, energy density of food and nutrient intake did not differ between groups, while the intensity of beneficial nutritional features (pHDI-10) was low. Significant differences in patients’ QoL were observed, especially in the domain related to mental health (higher in trizepatide + diet group). Conclusions: Support in primary care by a physician was successful from a long-term perspective in the group using tirzepatide in combination with diet modification as well as in the group based on dietary modification only. The data do not indicate a significant advantage of any one approach for patients, prioritizing an individualized approach to treatment. Full article

Anorexia nervosa is a clinically complex and ethically challenging psychiatric disorder. Clinicians are frequently confronted with ethical dilemmas arising from conflicts between core ethical principles in everyday clinical practice. Professional codes of ethics and legal frameworks often fail to provide a stable basis for resolving these dilemmas due to the fluctuating medical risk and the ego-syntonic nature of anorexia nervosa. Under conditions of heightened responsibility and medical risk, clinicians’ cognitive and emotional responses may be activated and may mediate ethical decision-making. Although such internal processes have been described in the literature, limited attention has been paid to their role in shaping ethical judgment in routine clinical care. The aim of this article is to conceptualize the decision-making processes that unfold in response to ethical dilemmas in the clinical context of anorexia nervosa and propose a sequential multi-level framework. A focused conceptual literature review was conducted to develop a reflective framework for clinical practice, drawing on selected studies in clinical ethics, healthcare law, anorexia nervosa care, and cognitive theory. Clinicians’ internal cognitive and emotional processes play a significant role in ethical decision-making in complex clinical contexts such as anorexia nervosa and should be explicitly recognized and brought into reflective awareness through supervision and reflective practice. Ethical decision-making is therefore conceptualized as a dynamic process linking clinical events, clinicians’ internal responses, ethical and legal considerations, and reflective clinical judgment. Incorporating structured reflection into clinical, educational, and supervisory settings may support more ethically informed and context-sensitive clinical judgment within multidisciplinary eating disorder services. Full article

We examined how sociodemographic, parental, and temporal factors are associated with parent-reported reasons for seeking consultation in a child and adolescent psychotherapeutic clinic. Data were derived from a large retrospective sample of more than 3000 cases collected between 2011 and 2023. Multivariable binary logistic regression analyses assessed the independent effects of age, gender, living arrangements, migration background, parental education, parental age at childbirth, parental separation or bereavement, and pandemic-related periods. School-aged children and adolescents were more likely than younger children to present with learning difficulties, depression, anxiety, mobbing and media addiction. Female patients showed lower odds of consultations related to learning difficulties, aggression, behavioral addiction, attention deficit/hyperactivity, but higher odds of depression, psychosomatic symptoms, anxiety, eating disorders and sleeping disorders. Parental separation increased the likelihood of consultations related to problematic social behavior within the family, delinquency and trauma and grief. Consultations for attention deficit/hyperactivity concerns were more frequent in the post-pandemic period compared to pre-pandemic. The findings highlight that sociodemographic, familial, and temporal factors are systematically associated with distinct patterns of parent-reported help-seeking patterns in child and adolescent psychotherapeutic care. Full article

Orthorexia nervosa (ON) is a clinical condition characterized by rigid and inflexible rules about consuming healthy food, potentially leading to harmful consequences for physical and mental health and significant impairment in major life domains. Overlap or independence between ON and other clinical entities, like other eating disorders (EDs) or obsessive compulsive disorder (OCD), still needs clarification. Objectives: This study aims to examine the overlap versus independence of core symptoms of ON from these two classes of disorders using a network approach. Methods: A group of 422 university students (71.8% females), with a mean age of 20.70 years (SD = 3.44), completed questionnaires assessing those symptoms. Results: Results revealed that no ON symptoms were nested within the OCD and ED clusters, and vice versa, thereby supporting their empirical distinctiveness. Although the symptoms were organised into distinct communities, ON symptoms were more strongly linked to EDs than to OCD. Bridge symptom analyses revealed that the nodes “Emotional consequences due to healthy eating”, “Worry about healthy food”, and “Obsessing” exhibited the highest bridge strength connecting clusters of ON, EDs, and OCD symptoms. Conversely, the nodes “Food safety” and “Ordering” showed the lowest bridge strength, suggesting that these nodes played only a marginal role in linking ON, EDs, and OCD. Conclusions: From a nosological perspective, the findings provide empirical support for conceptualizing ON as a distinct yet symptomatically related condition within the broader spectrum of eating-related psychopathology, while acknowledging that definitive nosological classification requires further longitudinal and clinical research. Full article

Background: Recent research has highlighted the potential of postbiotics for addressing obesity and associated metabolic disorders. In this randomized, double-blind clinical trial, the efficacy of a postbiotic product in managing overweight and associated parameters was assessed. Methods: Sixty individuals were randomized into two groups: one group (n = 30) received the Postbiotic (heat-killed L. fermentum strain K8-Lb1) and the other (n = 30) a Placebo control. Body weight, waist circumference, body composition, vital signs, blood biomarkers and questionnaires for quality of life, eating behavior, eating control and gastrointestinal symptoms were assessed. Results: After a 12-week intervention, body fat mass (primary parameter) was significantly (p = 0.016) reduced in the Postbiotic group (98.15 ± 3.32% of baseline) compared to the Placebo group (100.41 ± 3.39%). In line with this, body weight (p = 0.047) and waist circumference (p = 0.034) were significantly reduced and visceral fat tended to be reduced (p = 0.053). Accordingly, the Postbiotic group tended (p = 0.066) to feel more in control of their body weight. Despite weight loss, muscle mass tended (p = 0.062) to increase. ALT, AST and GGT tended to be reduced, which may indicate an improvement in liver steatosis. Estimated average glucose (eAG) differed significantly between the groups in individuals with normal fasting glucose levels. The ability to concentrate significantly (p = 0.014) improved. Conclusions: Under an ad libitum diet, the postbiotic L. fermentum strain K8-Lb1 reduced body fat mass, body weight, and waist circumference, improved the ability to concentrate, and showed a trend towards an increase in muscle mass. The results of this pilot trial need confirmation by a pivotal trial. Full article

Background: This study investigated the relationship between weekly structured physical exercise (PE) volume and type and the risk of eating disorders (EDs), with particular attention to age and sex differences. Methods: A total of 417 healthy adults (mean weekly PE: 256.19 ± 133.03 min) completed a self-report questionnaire covering personal information, weekly PE characteristics, and the Eating Attitudes Test-26 (EAT-26). Binary logistic regression was performed with the EAT-26 score as the dependent variable and PE volume, exercise type, age, and sex set as predictors. Results: The results of the binary logistic regression model were statistically significant (χ² = 16.784, p = 0.003). Sex emerged as the strongest independent predictor of ED risk (p = 0.003). Cross-tabulation confirmed a significant sex disparity, with females showing a threefold higher prevalence of at-risk EAT-26 scores (17.6%) compared to males (5.2%). No significant correlation was found between EAT-26 score and PE volume, nor were significant differences in ED risk observed across different types of structured exercise. Conclusions: When controlling for age, neither exercise volume nor type serves as a direct linear predictor of ED risk. Sex remains the strongest demographic predictor. Full article

African migrants living in High-Income Countries are more vulnerable to socio-economic insecurity, as well as higher morbidity and mortality. In their cultural background, these populations, especially the Bamiléké ethnic group from Cameroon, tend to socially value stoutness as a symbol of health and prosperity, potentially obesogenic in urban areas. However, recent studies showed that urbanisation has led to an acculturation process toward the promotion of thinness in young African adults, exposing them to emerging eating disorders. From this perspective, we conducted an original mixed-methods anthropological study, through a repeated qualitative cross-sectional study (two time points in 2011 and 2021) and a quantitative survey (in 2012), in young Cameroonian Bamiléké [18–39 y] migrating to urban Cameroon and France to innovatively explore obesity- and eating disorder-related body weight perceptions. We observed that the qualitative rural–urban tendencies were similar between 2011 and 2021. While rural people tended to value stoutness as a symbol of prosperity, wellbeing and peacefulness, urban people, especially in Paris, tended to value thinness, even extreme thinness, as a symbol of beauty and health and reported a pronounced weight stigma. Quantitatively, we found that Parisian Bamiléké had a desired and ideal body size (DBS and IBS) in the normal-weight category with standard deviations reaching or close to the underweight category, whereas the rural and urban ones had DBS and IBS means between normal-weight and overweight categories. Moreover, we observed a high prevalence of overweight and obesity in both urban groups while the Parisian one tended to underestimate one’s weight and expected to lose it. Public health policies should consider body image as a persisting risk factor for obesity and also a risk factor for emerging eating disorders in young Cameroonian migrants experiencing this dual burden within the urban transition. Full article

Background/Objectives: This study was conducted to determine the validity and reliability of the Eating-Related Eco-Concern (EREC) in young Turkish adults and to evaluate the effect of ecological concerns on disordered eating characteristics, with a view to comparing these effects with the risk of eating disorders. Methods: The study included 600 young adults (138 males and 462 females) aged 18 to 35. Using face-to-face administration, the Eating Disorder Examination Questionnaire (EDE-Q-13) Short Form to assess eating disorder-related psychopathology and the EREC Scale to assess eating behaviors related to eco-concern were administered, and Turkish validity and reliability were examined. Results: The Kaiser–Meyer–Olkin (KMO) was 0.801, signifying acceptable sample adequacy, while Bartlett’s test of sphericity was significant (χ² = 636.159, p < 0.001). All item factor loadings ranged from 0.582 to 0.767 and were statistically significant (p < 0.001). The scale’s Cronbach’s alpha was 0.854. Test–retest reliability was good, with an infraclass correlation coefficient (ICC) of 0.811 95% CI. The analysis revealed that the single-factor model demonstrated an acceptable fit to the data (χ²/df = 2.84, CFI = 0.976). There was no statistically significant correlation between EREC and the total EDE-Q-13 score (p = 0.064). On the other hand, the total EDE-Q-13 score was identified as a significant negative predictor of EREC scores (β = −2.648, p = 0.028). Conclusions: All item factors of the Turkish adaptation of the scale exhibit a structure that is quite consistent with the original scale. The 10-question version of EREC can be used with young adults in Türkiye. In this study, although ecological anxiety was associated with eating restraint or purging, it was not found to be generally associated with eating disorders. Full article

Background: The widespread use of Social Networks (SNS), particularly among youths, could promote Feeding and Eating Disorders (FEDs), but could also be a tool for implementing FED prevention strategies. This study aimed to identify which SNS could be most effective for implementing primary and secondary FED prevention. Methodology: A cross-sectional study was conducted via an Italian population-based survey, distributed using a snowball sampling strategy. The survey included 283 participants aged 18–35 by using the Bergen Social Media Addiction Scale (BSMAS), the SCOFF screening tool for FEDs, items from the Body Uneasiness Test (BUT), and the Mukbang Addiction Scale (MAS). Results: The sample was predominantly female (69.3%). Participants screening positive on the SCOFF were more frequently TikTok users. Stepwise logistic regression analysis showed that TikTok use was associated with SCOFF positivity (OR = 1.9) and body image concerns (e.g., spending a lot of time in front of the mirror; OR = 1.9). Instagram use was associated with body image dissatisfaction (OR = 3.9). In the overall sample, the likelihood of screening positive on the SCOFF was associated with TikTok use (OR = 1.7), higher BSMAS scores (OR = 1.1), exposure to body positivity/neutrality content (OR = 1.9), and watching Mukbang videos (OR = 1.8). Conclusions: TikTok and, to a lesser extent, Instagram appear to be widely used by young individuals vulnerable to FEDs and body image dissatisfaction. These platforms may therefore represent strategic channels for delivering educational and preventive interventions targeting eating behaviors and body image among young people. Further longitudinal research is needed to clarify causal relationships and evaluate the effectiveness of SNS-based prevention strategies. Full article

Eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED), are complex psychiatric conditions characterized by high morbidity and mortality. Increasing evidence suggests that beyond disorder-specific symptomatology, shared transdiagnostic mechanisms contribute to their onset and persistence. This narrative review synthesizes current data on neurobiological and nutritional factors implicated in EDs, with particular emphasis on trait–state interactions and starvation-induced neuroadaptations. Predisposing vulnerabilities such as heightened anxiety, cognitive rigidity, and perfectionism appear to interact with state-dependent biological alterations induced by malnutrition. Chronic dietary restriction is associated with measurable alterations in serotonergic and dopaminergic systems, altered reward processing, and persistent activation of the hypothalamic–pituitary–adrenal (HPA) axis. Experimental studies suggest that acute tryptophan depletion may transiently reduce anxiety in individuals with anorexia nervosa, suggesting that, in some individuals, food restriction may function as a biologically reinforced strategy of affect regulation. Furthermore, disturbances in leptin and ghrelin signaling, along with widespread micronutrient deficiencies—including zinc, iron, selenium, and B vitamins—may exacerbate cognitive inflexibility, mood instability, and impaired decision-making. These metabolic and endocrine adaptations may contribute to a self-perpetuating cycle in which starvation-induced neurochemical changes reinforce restrictive or dysregulated eating behaviors. Importantly, several of these mechanisms extend beyond anorexia nervosa and may represent common transdiagnostic processes across eating disorders and related mental health conditions, including anxiety, depression, and addictive behaviors. Recognition of these biological and nutritional factors has significant implications for treatment. Nutritional rehabilitation should be conceptualized not solely as weight restoration, but as a neurobiological recalibration of stress regulation, reward sensitivity, and affective processing systems. An integrative treatment approach that combines behavioral stabilization with attention to underlying neurobiological and relational mechanisms may offer a more comprehensive framework for long-term recovery. Full article

Background/Objectives: Sensory processing disorders (SID) are common in children with autism spectrum disorder (ASD) and can influence children’s eating behaviors. Evaluating the nutritional status of children with ASD is crucial for families or caregivers to manage their feeding. Therefore, this study aimed to compare the eating behaviors and dietary intake between children with ASD and children with ASD + SID. Methods: This cross-sectional study included 72 children with ASD aged 6–15 years, of whom 36 also had SID. Sociodemographic information and dietary habits of children were collected. The children’s body weight and height were measured. Children’s eating behaviors were assessed using the Children’s Eating Behavior Scale. Dietary intake was obtained using 3-day food consumption records. Results: The rate of overweight was higher in children with ASD compared to children with ASD + SID, but there was no statistically significant difference between the groups (p > 0.05). Children with ASD + SID were more likely to skip main meals than children with ASD (p < 0.05). Children with ASD + SID had significantly lower dietary reference intake levels of energy, macronutrients, fiber, PUFAs, vitamin E, B1, B6, folate, potassium, calcium, magnesium, phosphorus, and iron compared to children with ASD (p < 0.05). Increased scores on the drinking passion subscale were identified as a risk factor for SID (OR = 2.15, 95% CI [1.30, 4.30], p = 0.005). Conclusions: The higher frequency of skipping main meals, significantly lower energy and nutrient intake in the ASD + SID group indicates that these children are at higher nutritional risk. Incorporating sensory-based assessments and interventions into nutritional management may be crucial. Full article

Type 1 diabetes is the most common autoimmune endocrine disorder in children and adolescents, with incidence rising worldwide. Its management demands comprehensive care encompassing glucose monitoring, insulin therapy, and individualized nutritional education to support glycemic control and overall health. Establishing normal eating patterns is pivotal not only for prandial euglycemia but also for reducing the risk of disordered eating behaviors and eating disorders that are more frequently observed in youth with diabetes. Because eating patterns and self-management capabilities vary by developmental stage, interventions must be tailored to the physical, psychological, and social context of each age group. Screening tools such as the Diabetes Eating Problem Survey—Revised (DEPS-R) enable timely identification of at-risk individuals. In this scoping review we present the data from the literature regarding the eating patterns and deviations from infancy to adolescence, report the complications and discuss the challenges and insights for their management. Full article

Background/Objectives: Adolescents and university students appear to be at increased risk for internet addiction (IA), while disordered eating behavior (DEB) is common in these age groups. At the same time, adherence to the Mediterranean diet (MD) has declined in many countries. This study aimed to explore the potential association between IA, DEB and MD compliance among high school and university students. Methods: A total of 212 students aged 15–24 years participated in this cross-sectional study conducted in Greece. Data were collected via an online questionnaire including the Internet Addiction Test (IAT), KIDMED, and EAT-26 scales. Descriptive statistics, chi-square tests, and univariate and multivariate logistic regression analyses were performed. Results: Most participants demonstrated normal internet use (69.8%), while 23.1% showed mild IA and 7.1% moderate IA. Regarding dietary habits, 9.4% had low MD adherence, 52.8% moderate and 37.7% high adherence. A total of 15.6% scored above the EAT-26 cut-off, indicating risk for disordered eating behavior. IA was only significantly associated with urbanization (p = 0.014). MD adherence was not associated with gender, urbanization, financial or education status. Multivariate logistic regression showed that female gender (OR = 9.28, 95% CI: 2.10–40.91, p = 0.003) and moderate IA (OR = 6.70, 95% CI: 1.71–26.35, p = 0.006) were significant predictors of disordered eating, while educational status and MD adherence were not significant predictors. Conclusions: Moderate IA and female gender were strongly associated with an increased risk for disordered eating. Further qualitative and clinical studies are needed to better understand the interaction between IA, eating behaviors, and dietary patterns in young people. Full article

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