Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 164: (i) Binge Eating, Part 1 (n = 2); (ii) Pregnancy, Part 2 (n = 3); (iii) Disordered Eating/Eating Pathology, Part 3 (n = 3); and (iv) Nature, Course, and Correlates of EDs, Part 6 (n = 3)
Colleagues (N now = 1387 in 50 countries),
Please (a) continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications); and (b) pass along the following to anyone who would like to join this free email list.
TIME URGENT MATTER: JOB OPENING for
Full-Time Clinical Research Coordinator
at the
Research on Excessive Persistent and Emotion-based Actions and Traits (REPEAT) Lab in the Department of Psychology at Virginia Commonwealth University
under the direction of our own Dr. Annie Haynos (USA)
If possible, APPLY BEFORE 22 July 2025
Received yesterday (California time) via an everything-is-advocacy email from our own Dr. Annie Haynos (USA; see #11 below).
ML NOTE 1: Dr. Haynos and I would appreciate it if you would share this opportunity with any and all who are eligible and might be interested, and/or with those who teach, supervise, and otherwise know anyone who is eligible and might be interested. Note that, as Dr. Haynos states, “"This is an excellent opportunity for obtaining research and clinical experience prior to applying for graduate or medical school.”
[Dr. Haynos writes:]
I wanted to share that I have a sudden opening for a fulltime clinical research coordinator to start in my lab this fall. I recognize that this is a bit late in the hiring cycle for individuals who graduated this spring, so please spread the word to anyone who you think might be interested! Here is a brief description of the position:
The Research on Excessive Persistent and Emotion-based Actions and Traits (REPEAT) Lab in the Department of Psychology at Virginia Commonwealth University is recruiting to fill a Clinical Research Coordinator position. This position will provide support for various research projects conducted by the Principal Investigator, Dr. Ann Haynos, most of which investigate the neurobiology and treatment of eating disorders and other problems of rigidity (e.g., obsessive-compulsive spectrum disorders, suicidal and self-harming behaviors). Current projects include using a range of methods (fMRI, neurocognitive measures, computational modeling, ambulatory assessment, clinical interviews) to investigate how people develop and maintain eating disorders and related disorders, and how to target these processes in treatment.
The Clinical Research Coordinator will be responsible for coordinating clinical research studies that involve individuals with eating disorders, obsessive-compulsive disorder, obsessive-compulsive personality disorder, and other psychological concerns. This position will allow knowledge and skill development related to conducting neuroimaging procedures and complex statistical and computational analysis, interfacing with clinical populations, and working within a multidisciplinary, collaborative environment. This is an excellent opportunity for obtaining research and clinical experience prior to applying for graduate or medical school, and will involve professional development, including the ability to work on publications, conference talks, and grants.
And here is the link for the full description and job application! I am on a tight timeline to fill this position, so I only plan to leave the position open for one week. Please encourage anyone who may be interested to submit an application ASAP to be held under consideration.
Please feel free to reach out if you or any applicant has questions about the positions.
Annie Haynos, Ph.D. | Assistant Professor of Clinical Psychology, Department of Psychology | Virginia Commonwealth University | email: haynosa@vcu.edu
EVERYTHING IS ADVOCACY
New Social Media Initiative:
Making Evidence-Based Information—Particularly in the Areas of Body Image and Eating Disorders—More Accessible to the Public
Curated by our own Dr. Hannah Jarman (Australia) and her Ph.D. student Claudia Liu
Received yesterday morning (California time), via an everything-is-advocacy email from our own Dr. Hannah Jarman (Australia; h.jarman@deakin.edu.au).
ML NOTE 2: Dr. Jarman and I would appreciate it if you would pass this along to any and all who might be interested.
[Dr. Jarman writes; bold-for-emphasis added by ML:]
I wanted to share a social media initiative that my PhD student Claudia Liu and I have set up on Instagram — https://www.instagram.com/the.wellbeing.doctors/ — and TikTok https://www.tiktok.com/@the.wellbeing.doctors
Our goal is to make evidence-based information—particularly in the areas of body image and eating disorders—more accessible to the public. We focus on creating content that is clear, relatable, and actionable. We’d love for you to pass it on in your newsletter—your subscribers might find it interesting or useful to share with students etc.
Best wishes,
Hannah Jarman, PhD | Research Fellow | School of Psychology, Faculty of Health |Deakin University, Melbourne Burwood Campus
RECOVERY/ADVOCACY ESSAY
The Addiction of Weight Loss: Weight loss drugs are being touted as life-changing in the “war” on obesity
by Nancy Manther
Received via the 13 July 2025 Life Stories Diary online Newsletter (https://lifestoriesdiary.com) published/curated by our own Recovery Advocate Par Excellence, Author, Bolder Model, Force to Be Reckoned With, and my close friend Dr. June Alexander (Australia). Below, after Ms. Manther's self-introduction/bio, is the first half of this essay. The entire essay is available at https://lifestoriesdiary.com/2025/07/14/the-addiction-of-weight-loss/.
About Nancy Manther [from All [Life Stories Diary] articles by Nancy Manther]*
I am an author who writes fiction as a way to make sense of things for myself and hopefully, my readers. Exploring complex, often painful issues to find meaning and hope is central to my motivation as a writer.
I live in Minnesota with my husband, where the long, cold winters provide ample time to write. My novels include A Charmed Life, Ahead of Time and most recently, A Battle for Hope, a novel about eating disorders. These books are available through Amazon and Barnes and Noble in both digital and print form.
*ML NOTE 3: See the other 25(!) recovery-focused essays by Ms. Manther, written for Dr. Alexander’s website, that are available at: https://lifestoriesdiary.com/contributors/nancy-manther/
The Addiction of Weight Loss: New types of weight loss drugs are being touted as life-changing in the “war” on obesity. Television commercials run consecutively, claiming easy access and low prices. And it scares the daylights out of me. | Nancy Manther
I’ve hesitated to write about this thorny subject. At the end of one commercial, the actor says something to the effect of, “And I also lost some weight!” As a person in recovery from an eating disorder (ED), that statement grabbed my attention. I feared that the word “weight” would be the one thing people would focus on, and they have.
Almost overnight, many people began using the drug, originally intended to assist people with Type 2 diabetes, solely to lose weight. Concerns arose that there would be a shortage of the drug for people with Type 2 diabetes. Increasingly, variations of the drug have become available, primarily for weight loss, and the trend continues to explode.
A downside to taking this drug is that once a person stops taking it, they regain the weight they lost.
The drug can also be expensive if not covered by insurance. Intentional weight loss of any kind is not sustainable in most cases, and this weight loss method concerns me.
I am neither a physician nor a pharmacist, and I am not an expert in this field. From what I understand, the drugs are beneficial for patients with Type 2 diabetes. Besides helping to manage weight, they can lower high blood pressure and the risk of heart attack and stroke. According to the Mayo Clinic, the adverse side effects of such drugs are the same if taken for diabetes or weight loss, but for weight loss, the drug is usually taken at a higher dose.
While these drugs raise red flags in my mind, I’m not judging people who take them when responsibly prescribed by their doctor. That is not my place. What disturbs me the most, however, is society’s obsession with weight loss, which is actually an obsession with weight gain.
I’m concerned that these drugs may put pressure on “overweight” people to take them, because after all, doesn’t everyone want to lose weight? (No, they do not.) The people in the commercials appear so happy, as though their lives are infinitely better now that they are thinner. The commercials promote a belief that one cannot be satisfied unless they are thinner than one is right now.
The human body is a complex and miraculous entity. It also remains a mystery, despite the available scientific knowledge. While a correlation exists between health and weight, the causation is less clear.
Everybody is different in how they metabolise energy (calories).
To generalise that everyone is the same, so any weight loss method, whether it be medication or behavioural, is effective, is not true. There are many factors at work: genetics, trauma, and socioeconomic circumstances. Intentional weight loss often leads to weight cycling and additional weight gain. Nobody can predict if that will happen to them.
Research Publication Categories in This Newsletter
(i) Binge Eating, Part 1 (n = 2); (ii) Pregnancy, Part 2 (n = 3); (iii) Disordered Eating/Eating Pathology, Part 3 (n = 3); and (iv) Nature, Course, and Correlates of EDs, Part 6 (n = 3)
CONGRATULATIONS to our own
Dr. Petra Warschburger (Germany) and colleagues for publication of the Binge Eating research article in #1.
Dr. Tyler B. Mason (USA) and colleagues for publication of the Binge Eating research article in #2.
Dr. Steven Eggermont (Belgium) and colleagues, including distinguished scientist-practitioner-mentor Dr. Laurence Claes (Belgium), for publication of the Disordered Eating/Eating Pathology research article in #6.
Dr. Marios Argyrides (Cypress) and colleagues for publication of the Disordered Eating/Eating Pathology research article in #7.
Dr. Cheri Levinson (USA) and colleagues for publication of the Eating Disorders research article in #10.
Dr. Annie Haynos (USA) and colleagues, including distinguished scientist-practitioner-mentor Dr. Scott Crow (USA), for publication of the Eating Disorders research article in #11.
BINGE EATING, Part 1 of 4
1. Westermann, N., Klein, A.M., Busching, R., & Warschburger, P. (2025). From childhood to adolescence: Development of binge eating and the prospective role of self-regulation. Journal of Eating Disorders, 13, 129. https://doi.org/10.1186/s40337-025-01330-x
Full text available for download at: https://tinyurl.com/4cnvscnn
ABSTRACT. Background: Research shows that binge eating often starts in childhood or adolescence, but its development remains largely unexplored. Additionally, while cross-sectional studies link self-regulation to binge eating, longitudinal research is lacking. Therefore, this study examined the development of binge eating and self-regulation as a potential predictor for this development in a community sample.
Methods: A total of N = 1660 children were assessed at four time points spanning ages 6–11, 7–11, 9–13, and 16–21. The assessment of self-regulation encompassed emotional reactivity, working memory updating, cognitive flexibility, inhibition, inhibitory control, planning behavior, affective decision-making, anger regulation, and as appetite self-regulation, satiety responsiveness, emotional overeating, food responsiveness, and external eating, using computerized tasks, teacher- and parent-reports.
Binge eating was modeled by child-reported loss of control eating, overeating, and eating in the absence of hunger. A latent change score model was used to evaluate intra- and interindividual differences in binge eating across middle childhood and adolescence. Self-regulation facets were regressed on changes in binge eating.
Results: Results indicated a decrease in binge eating at the beginning of middle childhood, followed by a stagnation and then an increase during adolescence, with significant interindividual differences in these changes. Higher planning behavior, inhibitory control, and cognitive flexibility predicted decreases in binge eating during middle childhood, while higher satiety responsiveness unexpectedly predicted an increase in binge eating during adolescence. Results remained the same after controlling for body weight
Conclusions: Our findings highlight adolescence as a critical period for binge eating prevention, with planning behavior, inhibitory control, and cognitive flexibility acting as protective factors in middle childhood. The longitudinal data underscore the importance of self-regulation in the development of binge eating.
2. Luo, Y., Morales, J. C., Dunton, G. F., & Mason, T. B. (2025). Assessment of EMA binge-eating symptoms in adolescents: Factor analysis and associations with social context and food types. Appetite, 214. Advance online publication. https://doi.org/10.1016/j.appet.2025.108212
Email address for correspondence: yluo5848@usc.edu
ABSTRACT. Objective: This study examined the factor structure of five binge-eating symptom items and identified the social contexts and food types associated with these symptoms in adolescents using ecological momentary assessment (EMA).
Methods: Seventy-four adolescents aged 13–17 completed ten days of EMA, including signal-contingent prompts and event-contingent eating episode prompts. When recording eating episodes, adolescents completed measures on their current social context, food and drinks consumed, and binge-eating symptoms during the episode. Primary analyses included multilevel exploratory factor analysis of five binge-eating symptom items and generalized linear models of associations between social contexts and food types with binge-eating symptoms.
Results: A two within-subject (i.e., overeating and loss of control eating [LOCE] subscales) and one between-subject factor solution fit the data. Within-subjects alone versus not alone was associated with lower overeating (p = .010) and within-subjects family versus not with family was associated with higher overeating (p = .033). Between-subjects family context was associated with lower LOCE (p = .008), while between-subjects peers/friends context was related to higher LOCE (p = .002) and overeating (p = .003).
Both within- and between-subjects consumption of sweet food was associated with increased LOCE (p = .03 and p < .001, respectively) and overeating (p = .02 and p = .003, respectively). Within-subjects consumption of salty/fried food and pizza/fast food was both significantly associated with higher LOCE (p < .001 and p=.021, respectively) and overeating (p=.041 and p < .001, respectively). Within-subjects consumption of sweetened beverages was linked to higher overeating (p < .001), while water consumption was associated with lower overeating (p = .002).
Conclusions: Implications include the use of context-specific nutrition and social interventions in reducing adolescent binge eating.
PREGNANCY, CHILDBIRTH, AND THE POSTPARTUM PERIOD, Part 2 of 2
3. Stein, S. F., Miller, A. L., Nuttall, A. K., Bogat, G. A., Lonstein, J. S., Muzik, M., & Levendosky, A. A. (2025). Emotion regulation difficulties during pregnancy mediate the relationship between childhood maltreatment and emotional, external, and restraint eating. Appetite. Advance online publication. https://doi.org/10.1016/j.appet.2025.107984
Email address for correspondence: steinsf@umich.edu
ABSTRACT. Purpose: Childhood maltreatment is a common and severe form of stress associated with compromised functioning in women including emotion regulation difficulties and eating behaviors associated with negative health outcomes. Although pregnancy is a sensitive period for women’s health, mechanisms by which childhood maltreatment may drive eating behaviors during pregnancy remain unknown. The aim of this study was to determine if emotion regulation difficulty was a mechanism by which women’s childhood maltreatment leads to emotional, external, and restraint eating during pregnancy and which types of maltreatment drive these associations.
Methods. Women (N = 446) were recruited during pregnancy based on experiences of pregnancy stress, including intimate partner violence. They reported on history of childhood maltreatment and emotion regulation difficulties and eating behaviors in pregnancy. We tested if emotion regulation difficulties mediated associations between childhood maltreatment and emotional, external, and restraint eating in pregnancy.
Results. Maternal childhood maltreatment was associated with greater emotion regulation difficulties and, in turn, greater severity of emotional, external, and restraint eating during pregnancy. Emotional abuse and neglect were each positively associated with emotion regulation difficulties and, in turn, all three eating behaviors.
Conclusions. Emotion regulation difficulties may be a mechanism by which childhood maltreatment leads to emotional, external, and restraint eating during pregnancy. Interventions should address emotion regulation difficulties in women with histories of childhood emotional maltreatment and neglect as a way to mitigate these eating behaviors in pregnancy.
4. Dığrak, E., Akkoç, İ., & Calpbinici, P. (2025). The role of social media usage in the impact of body image on disordered eating attitudes during the third trimester of pregnancy. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70001
Full text available for download at: https://tinyurl.com/2bxzpc54
ABSTRACT. Objective: Social media use can negatively impact both physical and mental well-being by influencing aspects like body image and potentially leading to eating disorders. This issue is particularly significant during pregnancy, a time when maternal and foetal health are heavily influenced by nutrition. This study aims to examine how social media use affects the relationship between body image and disordered eating attitudes in the third trimester of pregnant women.
Method: A cross-sectional survey was conducted with a convenience sample of 368 pregnant women during their routine prenatal visits. Data collection occurred between May 2023 to May 2024, utilising the Social Media Use Integration Scale, the Disordered Eating Attitudes in Pregnancy Scale and the Body Image in Pregnancy Scale. The study's hypotheses were analysed using structural equation modelling.
Results: The study demonstrated significant positive correlations among body image perception, disordered eating attitudes, and social media use during the third trimester of pregnancy. Particularly, higher levels of social media use exacerbated the negative effects of body image perception on disordered eating attitudes. The overall model explained 29.21% of the variance in disordered eating attitudes, with social media use playing a significant moderating role.
Conclusion: These findings suggest that negative body image perceptions and social media use affect disordered eating attitudes in the third trimester of pregnant women. Furthermore, social media use serves as a significant moderator, increasing the negative effects of body image concerns. Healthcare providers should take into account the influence of social media on pregnant women’s body image and eating behaviours when developing intervention strategies. Implementing educational programs that promote a positive body image perception and enhance media literacy could be beneficial.
5. Bień, A., Grzesik-Gąsior, J., Ćwiek, D., Pięta, B., Kulesza-Brończyk, B., & Bączek, G. (2025). Self-efficacy as a moderator in the relationship between body image and health behaviors in pregnant women. Scientific Reports, 15, 18064. https://doi.org/10.1038/s41598-025-01784-8
Full text available for download at: https://tinyurl.com/2y5r7f7s
ABSTRACT. During pregnancy, women often experience shifts in their body image perspective. Active engagement in positive health behaviors is crucial for achieving optimal pregnancy outcomes and promoting healthy fetal development. In this context, self-efficacy may influence how body image perception translates into such behaviors.
This study aimed to determine whether self-efficacy among pregnant women moderates the relationship between body image and their health behaviors. The study was conducted from December 2023 to July 2024, involving 921 pregnant women in Poland. A diagnostic survey method using a questionnaire technique was applied. The research instruments included the generalized self-efficacy scale, body esteem scale, positive health behavior scale, and a standardized interview questionnaire.
Pregnant women with a more positive attitude toward their bodies demonstrated a greater tendency to engage in positive health behaviors during pregnancy (p < 0.001). For sexual attractiveness, a positive association with positive health behaviors was maintained across all levels of self-efficacy (p < 0.001). A significant positive association with positive health behaviors was found for weight concerns (p < 0.001) and physical condition (p = 0.013), but only at moderate and high levels of self-efficacy. The impact of body image on positive health behaviors is more pronounced in women with higher levels of self-efficacy, although this relationship varies across different aspects of body image.
DISORDERED EATING/EATING PATHOLOGY, Part 2 of now 3
6. Vankerckhoven, L., Claes, L., Van Laere, E., Eggermont, S., & Luyckx, K. (2025). From disordered eating to eating competence: Exploring transitions in adolescent eating profiles and the role of identity, embodiment, and critical eating messages from parents and peers. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70004
Email address for correspondence: lore.vankerckhoven@kuleuven.be
ABSTRACT. Objective: Adolescence is a key period for the development of eating behaviours. To date, little attention has been paid to the development of positive eating behaviours during adolescence, and longitudinal research with such a holistic focus is lacking. To provide a better understanding of adolescent eating behaviours, this study examined patterns of stability and change in eating profiles among community youth. In addition, this study examined how these profiles and patterns were related to background, psychological, and contextual variables.
Method and results: This longitudinal study with two timepoints included 608 adolescents and emerging adults at the first timepoint for the current analyses (T1: 64.3% female; Mage = 16.99; SD = 1.24; range = 14-21 years). Using latent transition analysis (LTA), three eating behaviour profiles emerged: a competent eating profile, a subclinical profile, and a clinical profile. Although most individuals in the competent eating and clinical profiles remained within their profile over time, individuals in the subclinical profile were more likely to progress toward greater eating competence or more severe eating disorder symptoms. Using multinomial logistic regression models; sex, adjusted BMI, identity, embodiment, and critical parent and peer eating messages appeared to be related to profile membership, whereas only age, sex, and adjusted BMI were related to transition patterns.
Conclusion: The present study informs theory and practice by identifying subgroups of adolescents who differ in their eating behaviours. In addition, these findings provide insight into which aspects are meaningfully related to stability and variability in eating behaviours, supporting the development of targeted interventions.
7. Argyrides, M., Efthyvoulou, L., Zamba, K., Anastasiades, E., & Charalambous, Z. (2025). Influences of sex and BMI on body image, weight bias, disordered eating, and psychological well-being: A multivariate analysis. Obesities, 5(3), 54. https://doi.org/10.3390/obesities5030054
Full text available for download at: https://tinyurl.com/mjdmj2ae
ABSTRACT. Body image and mental health outcomes are influenced by both sex and body weight. This study investigated how sex and BMI category (participants classified with healthy weight, overweight, or with obesity) relate to body image, disordered eating, weight bias, global self-esteem and depression. Participants (N = 642; 278 (43.3%) males; 364 females (56,7%)) provided self-report measures of appearance satisfaction, body appreciation, overweight preoccupation, disordered eating scores, weight bias, depression, and self-esteem.
The results indicated that women and participants classified with overweight and obesity based on BMI categories reported lower appearance satisfaction and body appreciation and a higher preoccupation with overweight and depression. Interaction effects showed that women participants with overweight and obesity reported particularly low appearance satisfaction and body appreciation. Individuals classified with healthy BMI category reported higher disordered eating scores than those classified with overweight. No significant effects were found for global self-esteem.
These findings suggest that sex and BMI contribute to the study’s variables of interest, with some effects more pronounced in women with a higher BMI. The results align with sociocultural theories of appearance pressure but indicate complexity in disordered eating patterns. The findings underscore the importance of adopting intersectional, weight-inclusive, and sex-responsive approaches in both research and clinical practice.
8. Mighani, S., Shivyari, F. T., Razzaghi, A., Amerzadeh, M., & Javadi, M. (2025). Relationship between dietary intake, eating attitudes, and premenstrual syndrome severity among Iranian women: Insights from a cross-sectional study. Journal of Eating Disorders, 13(1), 131. https://doi.org/10.1186/s40337-025-01326-7
Full text available for download at: https://tinyurl.com/ytertk57
ABSTRACT. Background: Premenstrual syndrome (PMS) is a common issue that impacts many women, and a well-balanced diet can help alleviate PMS symptoms. Evidence suggests that dietary factors and eating disorders may influence PMS severity, yet the specific relationships remain unclear. This study aimed to evaluate the association of specific dietary components and eating behaviors with PMS symptoms.
Methods: This cross-sectional study was conducted on 252 women with PMS who were referred to healthcare centers in Qazvin province. Data concerning PMS, dietary factors, and eating disorders were collected using online questionnaires, including the premenstrual symptoms screening tool (PSST), 3-day dietary recall, and Eating Attitudes Test-26 (EAT-26) questionnaires. Statistical analysis utilized ANOVA and chi-square tests. The adequacy of the sample was evaluated using the Kaiser-Meyer-Olkin (KMO) test. To examine the relationship between eating disorders, dietary factors, and PMS symptoms, multivariable linear regression analysis was conducted. Statistical significance was set at p < 0.05.
Results: According to the PSST, 28.7% of individuals reported mild severity, 21.9% reported moderate severity, and 49.4% reported severe severity. The study revealed that higher sodium (p = 0.003, OR = 1.000, 95% CI = [1.000, 1.001]), vitamin D (p = 0.044, OR = 1.298, 95% CI = [1.007, 1.674]), and vitamin C intake were positively linked to increased psychological PMS symptoms, (p = 0.036, OR = 1.006, 95% CI = [1.000, 1.012]) while magnesium showed a negative association with these symptoms. Also, sodium and vitamin D intake were significantly associated with increased physical symptoms (p < 0.05). Individuals with eating disorders showed higher rates of severe PMS symptoms, though differences were not statistically significant (p > 0.05).
Conclusion: These findings highlight the potential influence of specific nutrients on PMS severity. This insight could inform dietary recommendations for managing PMS symptoms, providing young women with potential non-pharmacological options to relieve discomfort.
NATURE, COURSE, AND CORRELATES OF EDs, Part 6 of 7
9. Kakar, S, Foye, U., Davies, H. L., Palaiologou, E., Malouf, C. M., Meldrum, L., Smith, I., Kalsi, G., Allen, K. L., Breen, G., Herle, M., & Hübel, C. (2025). Beyond the diagnostic checklist: A large-scale analysis of under-recognized weight loss behaviors in individuals with eating disorders. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.24477
Full text available for download at: https://tinyurl.com/mr3utxm6
ABSTRACT. Objective: This study aimed to explore the diverse range of weight loss behaviors that extend beyond traditional diagnostic criteria, highlighting the variability in symptom presentation. Method: We text mined free-text responses from 1675 participants with anorexia nervosa, bulimia nervosa, or binge-eating disorder in the Genetic Links to Anxiety and Depression (GLAD) Study and the Eating Disorders Genetics Initiative UK (EDGI UK). In secondary analyses, we investigated differences by eating disorder and gender.
Results: Frequently endorsed behaviors included structured diets (619 endorsements) and calorie counting (422 endorsements), but also less commonly considered behaviors like compression garments (147 endorsements) and self-harm (88 endorsements). We identified four overarching themes: restriction-based approaches, medical intervention, body manipulation, and food avoidance. The most frequently reported weight loss behaviors and resultant themes did not differ among eating disorders or genders, closely resembling those in the broader sample. Notably, 81 participants with binge-eating disorder, which typically lacks the endorsement of recurrent compensatory behaviors, reported weight loss and compensatory behaviors.
Discussion: Our findings identify a crucial gap in current diagnostic assessments, which may hamper recognition and lead to underdiagnosis of eating disorders. By incorporating our insights into an inclusive assessment process that expects and accommodates novel behaviors, clinicians could capture a broader spectrum of behaviors, thus improving diagnostic accuracy. However, our sample homogeneity implies the need for more diverse samples. Our study contributes essential insights for enhancing diagnostic criteria.
10. Kapadia, A., Machry, K., & Levinson, C. A. (2025). Disgust, shame, and guilt: Examining unique relationships with eating disorder, obsessive-compulsive disorder, and post-traumatic stress disorder symptoms. Eating Behaviors. Advance online publication. https://doi.org/10.1016/j.eatbeh.2025.102012
Email address for correspondence: avantika.kapadia@louisville.edu
ABSTRACT. Objective: Obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders (EDs) are frequently comorbid, but mechanisms shared between their comorbidity remain understudied. Interconnected moral emotions, such as disgust, shame, and guilt, show associations with these disorders, yet, no research has tested if these emotions are unique or overlapping factors contributing to symptoms of OCD, PTSD, and EDs.
Method: The present cross-sectional study (N = 3513) investigated the potential overlap of disgust sensitivity, state shame, and state guilt in a large sample of undergraduate students. A path analysis was utilized to examine the unique and shared associations between these emotions and OCD, PTSD, and ED symptoms.
Results: The path model indicated that state shame was significantly associated with OCD, PTSD, and ED symptoms, while state guilt was associated with OCD and PTSD symptoms, but not ED symptoms. Disgust sensitivity showed no significant associations with OCD, PTSD, and ED symptoms.
Conclusion: Shame may be an important shared emotional correlate for symptoms of OCD, PTSD, and EDs, whereas guilt may be less impactful in relation to ED symptoms. These findings underscore a need for further research exploring the role of moral emotions in psychopathology, especially guilt and disgust, and suggest that integrated treatments focused on shame could alleviate co-occurring OCD, PTSD, and ED simultaneously.
11. Lee, S. E., Crow, S. J., & Haynos, A. F. (2025). Investigating associations between general and disorder-specific reward and suicidality in anorexia nervosa. European Eating Disorder Review. Advance online publication. https://doi.org/10.1002/erv.70002
Full ext available for download at: https://tinyurl.com/jpnmk7ae
ABSTRACT. Objective: Altered reward processing is proposed to be central to the pathology of anorexia nervosa (AN). This study aimed to investigate how aspects of reward dysfunction relate to suicidal thoughts and behaviours (STBs) in AN.
Method: We compared responses on self-report measures of general (i.e., anticipatory, consummatory, and social reward) and disorder-specific (i.e., self-starvation reward) reward between individuals with AN with (AN + STBs; n = 28) or without (AN; n = 31) lifetime active STBs and healthy controls (HC; n = 32). Further, we examined whether interactions between general and disorder-specific reward dysfunction were associated with lifetime active STBs in AN.
Results: Compared to AN and HC groups, the AN + STBs group reported significantly lower anticipatory and social reward; both AN + STBs and AN groups reported higher self-starvation reward than HCs. When accounting for the effects of depression, group differences became non-significant for general rewards but remained significant for disorder-specific reward processing. The interaction between anticipatory and self-starvation reward was significantly associated with STB risk beyond the effects of depression: AN participants reporting high self-starvation reward were at elevated STB risk regardless of anticipatory reward levels, whereas those with low self-starvation reward showed increased STBs only when anticipatory reward was also low.
Conclusion: Our results suggest that the combination of general and disorder-specific reward processes may shape distinct suicidality risk profiles in AN.