Search Results (2,055)

Background/Objectives: Patients with cystic fibrosis (CF) have been reported to have eating disorders. This can contribute to poor weight gain, which can result in increased morbidity and mortality. The aim of this review is to understand the prevalence and impact of eating disorders (ED) and body image disturbance in the CF population. Methods: A review of the current literature on eating disorders in CF. Results: Disordered eating behaviors appear common in CF. However, it is unclear if the prevalence is greater or similar to that of the general population. Conclusions: Routine screening for eating disorders is important in the care of CF patients to help prolong survival and quality of life in this patient population. Full article

Background and objectives: Intolerance of uncertainty (IU) is a well-established transdiagnostic process in anxiety (ANX) and major depressive disorder (MDD), and has been increasingly implicated in anorexia nervosa (AN). However, most previous research including patients with AN has relied on total or subscale scores from eating disorder measures, which obscures how specific eating attitudes and body dissatisfaction symptoms relate to distinct facets of IU. The primary objective of the present study was to characterize item-level networks linking eating attitudes, body dissatisfaction, and IU in a pooled clinical mental health sample, alongside a control group (CG). Methods: Data were drawn from a sample including individuals with symptoms related to AN (N = 105), MDD (N = 97), and ANX (N = 240), a comorbid group (N = 84) with symptoms of two or more of these conditions, and a CG (N = 842). Separate item-level networks were estimated for clinical and control groups, and network structure and centrality indices were compared. Results: Network analyses revealed distinct organizational patterns between the clinical and control subsamples. Although both networks showed identical diameters, the clinical network exhibited a shorter average path length and higher clustering, indicating stronger local connectivity, whereas the control network showed higher modularity. In the clinical subsample, nodes related to binge eating, post-eating guilt, and IU emerged as the most central and acted as key connectors between clusters. In contrast, the control network displayed a more distributed centrality pattern, suggesting a more integrated and homogeneous network organization. Conclusions: This study provides new evidence to refine our understanding of how IU relates to eating attitudes and body dissatisfaction across diagnostic mental health boundaries. Identifying highly influential psychopathological symptoms across eating, mood, and anxiety disorders, as well as bridge nodes linking these mental health domains, is important for understanding transdiagnostic symptom dynamics. These insights may inform the development of more sensitive screening and diagnostic tools, as well as targeted intervention points to support more personalized and mechanism-focused treatments. Full article

Background/Objectives: Psychological variables such as body image, self-esteem, and life satisfaction have become important research topics in recent years, particularly in their relationships with individuals’ eating attitudes. The purpose of this study is to examine the predictive effect of body image and self-esteem on eating attitudes in emerging adults and to evaluate the mediating role of life satisfaction in this relationship. Method: The study included 402 participants aged 18–30. Data were collected using the Eating Attitudes Test (EAT-26), the Rosenberg Self-Esteem Scale (RSS), the Body Image Scale (BIS), and the Life Satisfaction Scale (LSS). The analyses included correlational analyses to examine relationships among eating attitudes, body image, self-esteem, and life satisfaction; multivariate regression to test the predictive roles of body image, self-esteem, and life satisfaction on eating attitudes; and structural equation modeling to evaluate the mediating role of life satisfaction in the relationships between body image, self-esteem, and eating attitudes. Result: The correlational analysis revealed that eating attitudes are associated with body image, life satisfaction, and self-esteem. Body image was identified as the most influential predictor of eating attitudes. Structural equation modeling indicated that life satisfaction mediates the relationship between self-esteem and eating attitudes. Conclusions: Body image, self-esteem, and life satisfaction play a crucial role in shaping eating attitudes among emerging adults. The mediating effect of life satisfaction underscores psychological well-being as a key regulatory factor rather than solely an outcome. Promoting positive body image, strengthening self-esteem, and enhancing life satisfaction through preventive and psychoeducational programs may help protect against disordered eating attitudes in this population. Full article

Emotion dysregulation and altered interoceptive processing are increasingly recognized as core processes in eating disorder (ED) psychopathology. Difficulties in identifying, tolerating, and regulating negative emotional states may interact with reduced trust in bodily signals and distorted interpretation of hunger and satiety cues, contributing to maladaptive eating behaviors. The aim of this PRISMA-guided qualitative systematic review was to synthesize original empirical evidence on the interaction between emotion dysregulation and interoceptive processing in EDs, with particular attention to how emotional distress may be misinterpreted as physical hunger or food-related urges. A systematic search of PubMed and Scopus identified 78 records; after removal of duplicates and screening procedures, 24 original empirical studies were included in the qualitative synthesis. Across ED presentations, emotion dysregulation consistently emerged as a central transdiagnostic process associated with symptom severity, impulsivity, maladaptive eating behaviors, and related risk outcomes. Interoceptive alterations were widely reported, particularly involving reduced body trust and distorted interpretation of internal sensations rather than a uniform deficit in interoceptive sensitivity. The reviewed studies also showed that emotional states and cognitive expectations may shape the appraisal of hunger and satiety cues, contributing to the misinterpretation of emotional distress as physiological need across restrictive, binge-purge, and binge-eating presentations. The findings support a close interplay between emotion dysregulation and altered interoceptive processing in EDs and highlight the clinical relevance of interventions that integrate emotion regulation and interoceptive awareness to promote more adaptive eating behaviors. Full article

Background: Overweight and obesity remain major public health challenges in Puerto Rico, affecting over 70% of adults and contributing to cardiovascular, metabolic, and mental health disorders. This study explores the psychosocial and behavioral factors influencing obesity within low-income Puerto Rican communities, emphasizing both biological sex differences and socially defined sex-role influences, along with their respective mental health dimensions. Method: Using a qualitative approach, Community-Based Participatory Research (CBPR), ten focus groups were conducted with 71 participants (37 women and 34 men) from two municipalities in southern Puerto Rico. Discussions were analyzed thematically with the Socioecological and Health Belief Models to identify key determinants. Results: The data collected revealed that women expressed greater emotional vulnerability, frequently citing anxiety, depression, body image concerns, and stress-related eating as contributors to obesity. Men, meanwhile, reported frustration with diet adherence, economic limitations, and healthcare inaccessibility. Across participants, economic hardship, cultural norms, and limited health education emerged as major obstacles. Conclusions: Findings underscore the need for holistic, sex-informed and socially responsive interventions that integrate mental health support with nutritional and physical health strategies. Addressing self-esteem, emotional regulation, and stress management alongside behavioral modification can promote sustainable, culturally tailored obesity prevention in Puerto Rico. Full article

The endocannabinoid system (ECS) is a fundamental regulator of brain and body homeostasis, integrating neural, immune, and stress-related signaling pathways. Dysregulation of ECS components, including cannabinoid receptors (CB1 and CB2), endocannabinoids such as anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and their metabolic enzymes (FAAH and MAGL), has been increasingly implicated in the pathophysiology of neuropsychiatric disorders, including mood, anxiety, psychotic, stress-related, and eating disorders. Altered endocannabinoid signaling contributes to maladaptive stress responses, emotional dysregulation, and impaired synaptic plasticity, highlighting the role of the ECS as a core integrative mechanism. Therapeutic strategies targeting ECS, particularly through FAAH inhibition and the use of plant-derived cannabinoids, such as cannabidiol (CBD), show promise in restoring endogenous homeostasis while minimizing the adverse cognitive and affective effects associated with direct CB1 activation. ECS function and treatment response are further influenced by genetic polymorphisms in CNR1, CNR2, FAAH, and MGLL, as well as epigenetic mechanisms, including DNA methylation, histone modifications, and microRNA regulation. Despite these advances, clinical translation remains limited by interindividual variability, the complexity of ECS interactions, and the relatively small size of existing clinical studies. Future research integrating longitudinal clinical trials with multi-omics approaches is essential to support the development of evidence-based, personalized interventions. Overall, understanding ECS mechanisms and dysregulation provides a valuable framework for the development of targeted therapies in neuropsychiatric disorders. Full article

Background/Objectives: Functional dyspepsia (FD) is relatively common among young adults and is increasingly understood within the framework of brain–gut interactions. Eating behaviors and psychological distress may be related to FD, but evidence in young adults remains limited. This study examined the associations between FD and eating behaviors and depressive symptoms among university students. Methods: A cross-sectional study was conducted during health checkups. A total of 4328 students (2232 males and 2096 females) completed questionnaires assessing FD symptoms based on Rome IV, eating behaviors (EAT-26 and BITE), depressive symptoms (BDI-II), and coping styles (CISS). We compared scores between students with and without FD and performed multivariable logistic regression including gender, BMI, sleep, eating behaviors, and depressive symptoms. Results: The prevalence of questionnaire-based FD was 6.1% in males and 7.2% in females. Students with FD had higher EAT-26, BITE, BDI-II, and emotion-oriented coping scores. In multivariable logistic regression, EAT-26 ≥ 10 (OR: 1.92, 95% CI: 1.26–2.91, p = 0.002), BITE ≥ 10 (OR: 1.45, 95% CI: 1.01–2.08, p = 0.04), BDI-II ≥ 10 (OR: 3.83, 95% CI: 2.97–4.95, p < 0.001), and BMI < 18.5 kg/m² (OR: 1.74, 95% CI: 1.31–2.31, p < 0.001) were significantly associated with FD; gender and sleep were not. Conclusions: FD was associated with disordered eating behaviors, depressive symptoms, and low BMI. Differences in emotion-oriented coping were observed between groups. These findings suggest that integrating assessments of gastrointestinal symptoms, eating behaviors, and psychological factors may inform early detection and support at university. Full article

Background: Gastroesophageal reflux disease (GERD) is a common digestive disorder with a substantial impact on quality of life. Emerging evidence suggests that dietary patterns and lifestyle behaviors are associated with the occurrence and severity of GERD symptoms; however, integrated data from Romania remain limited. Objective: The aim of this study was to evaluate associations between pro- and anti-inflammatory dietary patterns, lifestyle-related behavioral factors, and the presence and severity of gastroesophageal reflux symptoms in an adult Romanian population. Methods: A national cross-sectional observational study was conducted using a self-administered online questionnaire. All participants included in the study reported a prior diagnosis of gastroesophageal reflux disease (GERD), and participant classification was based exclusively on current symptomatology assessed using the GERD-Q score. Therefore, comparisons were not performed between patients and a healthy population, but rather between individuals at different stages of clinical expression of the same condition, characterized by a fluctuating course. The instrument included standardized GERD-Q items for symptom assessment, together with questions regarding dietary intake and lifestyle behaviors. Pro-inflammatory (PRO), anti-inflammatory (ANTI), and combined (PRO–ANTI) dietary scores were established. Statistical analyses included comparative and correlational tests as well as multivariable logistic regression models. Results: Among the 340 participants included in the study, 72.4% reported symptoms consistent with GERD according to the GERD-Q score. A higher pro-inflammatory dietary score was significantly associated with GERD, with participants in the highest PRO category showing more than a fourfold higher likelihood of GERD in multivariable analyses. Consumption of spicy foods and carbonated beverages was associated with an increased risk of GERD in univariate analyses; however, these associations did not remain significant in multivariable models. Late meals (defined as consumption of one’s last meal of the day less than two hours before bedtime) were independently associated with GERD. Combined analyses indicated a higher risk among participants who reported eating late meals, particularly when combined with large evening meals. Most foods considered protective, along with classical lifestyle factors (smoking, alcohol consumption, and sleeping position), were not independently associated with GERD. Conclusions: These findings suggest that overall dietary patterns with pro-inflammatory potential and meal timing in relation to the sleep–wake cycle may be more consistently associated with GERD symptoms in this sample than isolated food items or traditional lifestyle risk factors. Nutritional and behavioral interventions focused on improving overall dietary patterns and avoiding late meals may represent potential strategies for GERD management. Full article

Background: Eating disorders are among serious psychiatric conditions and are associated with an increased risk of mortality and significant psychological distress. Mind–body therapies are attracting increasing attention as complementary interventions aimed at improving psychological well-being. The aim of this meta-analysis is to examine the effects of mind–body therapies on psychological outcomes in adults diagnosed with an eating disorder or exhibiting clinically significant symptoms associated with it. Methods: Randomized controlled trials published between 2003 and 2026 were identified through a systematic search of the PubMed, CINAHL, Web of Science, Cochrane, and Scopus databases. Studies were included that involved participants aged 18 years and over who had received a diagnosis of an eating disorder according to standard diagnostic criteria (e.g., DSM-IV, DSM-IV-TR, DSM-5) or who exhibited clinically significant symptoms associated with an eating disorder. Mind–body interventions were compared with control conditions. Methodological quality was assessed using the Joanna Briggs Institute assessment tool. Statistical analyses were performed using Stata 16.0 software. Results: Nine randomized controlled trials involving a total of 688 participants were included in the meta-analysis. It was found that mind–body interventions significantly reduced levels of depression (Hedges’ g = −0.44, 95% CI: −0.67 to −0.20). Similarly, significant reductions were observed in levels of inadequate self (g = −0.51, 95% CI: −0.84 to −0.18) and self-hated (g = −0.56, 95% CI: −0.89 to −0.23). Although an effect in the direction of an increase was observed for self-compassion (g = 0.31, 95% CI: 0.07–0.54), this effect was not found to be statistically significant following the correction applied for multiple comparisons. In contrast, anxiety (g = −0.19, 95% CI: −0.39 to 0.02), stress (g = −0.48, 95% CI: −1.05 to 0.09), and self-esteem (g = 0.29, 95% CI: −0.16 to 0.73). Conclusions: Mind–body therapies are associated with improvements in certain psychological outcomes among adults with a diagnosis of an eating disorder or those exhibiting clinically significant symptoms. However, the current findings should be interpreted with caution, as the included studies largely relied on waiting-list or usual-care control groups. Full article

Food noise refers to persistent and intrusive thoughts about food that may interfere with daily functioning, emotional well-being, and eating behaviors. Although the construct has gained increasing attention in clinical and research contexts, no psychometrically sound tools are currently available in Italian to assess food noise. Therefore, the present study aimed to translate, adapt, and evaluate the psychometric properties of the Italian version of the Food Noise Questionnaire (FNQ). A total of 1087 participants (mean age 37.45 ± 10.35 years; 50.6% female) were enrolled in the investigation. Participants completed the Italian version of the FNQ, along with a convergent measure of food-related preoccupation and self-report measures of depressive symptoms, anxiety symptoms, and perceived stress. Confirmatory factor analysis supported a unidimensional factor structure for the FNQ, with salient standardized factor loadings (range = 0.803–0.919) and strong internal-consistency reliability (categorical ω = 0.917). Evidence of convergent validity was provided by strong associations with food-related preoccupation (r = 0.831, p < 0.001), whereas discriminant validity was supported by smaller, yet significant, correlations with anxiety, depression, and perceived stress (r range = 0.350 to 0.417, p < 0.001). In addition, configural, metric, and scalar invariance across gender was established within a multi-group framework. These findings provide evidence for the FNQ as a reliable and valid measure of food noise in the Italian adult population, demonstrating robust psychometric properties and gender-invariant measurement. Full article

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