Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 272: (i) Families; (ii) Pos BI, Part 5 (n = 3); (iii) Restriction/Restraint, Part 3 (n = 2); (iv) Eating Pathol, Part 5 (n = 2); (v) Tech, Part 2 (n = 2); and (vi) Help-Seeking, Part 2 (n = 2)
Colleagues (N now = 1458 in 49 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.
REQUEST FOR RESEARCH PARTICIPATION BY AND/OR ASSISTANCE RECRUITING
Adults (ages 18-65) with Anorexia Nervosa or Atypical Anorexia with Current Suicidal Ideation and/or a Recent History of Suicidal Behavior
from our own Dr. Lauren Harris, Auburn University (USA), in conjunction with her postdoctoral advisors, our own Drs. April Smith (Auburn) and Cheri Levinson (University of Louisville)
for a study (ML, quoting, has) entitled
Better Understanding the Co-Occurrence of Eating Disorders and Suicide and Improving Personalized Treatment for Individuals Struggling with These Conditions
Received 21 May 2026 via an everything-is-advocacy email from our own Dr. Lauren Harris | Postdoctoral Fellow | Department of Psychological Sciences, Auburn University | lmh0159@auburn.edu | redslab.org/. In that email Dr. Harris writes:
I am a postdoctoral fellow at Auburn University working with Dr. April Smith (Auburn) and Dr. Cheri Levinson (University of Louisville). Drs. Smith and Levinson are currently conducting a study funded by the National Institute of Mental Health whose overarching purpose is to improve the prediction and prevention of suicide among individuals with eating disorders. We are hoping to recruit adults (ages 18 and over) with a diagnosis of Anorexia Nervosa or Atypical Anorexia with current suicidal ideation and/or a recent history of suicidal behavior.
ML NOTE 1: Dr. Harris, her colleagues/advisors Dr. April Smith and Dr. Cheri Levinson (both of whom are members of this Newsletter Group), and I would appreciate it if you would (a) participate in this study if eligible; and/or (b) pass this request along to any and all who might be interested in participating in this survey and qualified to do so, or who treat, work with, or otherwise know such people.
[Dr. Harris writes:]
The University of Louisville and Auburn University are conducting an online and telephone-based research study funded by the National Institute of Mental Health (NIMH), aimed at better understanding the co-occurrence of eating disorders and suicide and improving personalized treatment for individuals struggling with these conditions.
We are currently recruiting adults (ages 18-65) with Anorexia Nervosa or Atypical Anorexia with current suicidal ideation and/or a recent history of suicidal behavior. The study involves:
A baseline assessment via Zoom
Completing short surveys via mobile phone for 21 days while wearing a sensor band
Follow-up interviews and questionnaires at 1 month, 6 months, and 1 year
Ability to earn up to $350 for participating
To participate in the study, please use this link to access our screening survey: https://aubie.ie/TRACstudy
For more information, email us at tracstudy@louisville.edu
HONORING A BOLDER MODEL
At its 11 May 2026 Gala in New York
The National Eating Disorders Association
Honors
[our own] Kristina Saffran (USA) for her
Transformative Leadership in Expanding Access to Evidence-Based Care
CONGRATULATIONS to our own Kristina Saffran (USA), honored 11 May 2026 by the National Eating Disorders Association (NEDA) for “her transformative leadership in expanding access to evidence-based care”!
[from the brief bio on the NEDA site; bold-for-emphasis added:]
Since recovering from anorexia as a teenager, Kristina has been on a mission to ensure that all families have access to eating disorder treatment that works. Kristina Saffran is the co-founder and CEO of Equip, a virtual program that delivers modern eating disorder treatment through evidence-based care that promises lasting recovery at home. Prior to Equip, Kristina founded Project HEAL, a leading grassroots eating disorder non-profit dedicated to treatment access. Kristina is an Ashoka Fellow, a Forbes 30 under 30 social entrepreneur, and an honoree on Inc.’s Female Founders 100, Fortune’s 40 under 40, and INSIDER’s 30 under 40 in Healthcare recognition lists. Kristina graduated from Harvard College with a bachelor's degree in psychology.
Research Publication Categories in This Newsletter
(i) Families; (ii) Positive Body Image, Part 5 (n = 3); (iii) Dietary Restriction/Restraint, Part 3 (n = 2); (iv) Eating Pathology, Part 5 (n = 2); (v) Technology, Part 2 (n = 2); and (vi) Help-Seeking, Part 2 (n = 2)
CONGRATULATIONS to our own
Drs. Jekaterina Schneider (England), Nadia Craddock (England), and Nicole Paraskeva (England) for publication of the Positive Body Image research article in #2.
Drs. Eva Kemps (Australia) and Ivanka Prichard (Australia) and colleague for publication of the Positive Body Image research article in #3.
Dr. Joe Doley (Australia) and colleagues for publication of the Positive Body Image research article in #4.
Drs. Amanda Raffoul (Canada) and Allison Kelly (Canada) and colleagues for publication of the Eating Pathology research article in #7.
Drs. Matthew Fuller-Tyszkiewicz (Australia), Mariel Messer (Australia), and Jake Linardon (Australia) and colleague for publication of the Technology research article in #8.
Drs. Cheri Levinson (USA), Leigh Brosof (USA), and Hannah Fitterman-Harris (USA) and colleagues, including distinguished scientist-practitioner-mentor Dr. Michelle Craske (USA), for publication of the Technology research article in #9.
James Downs (England) and colleagues for publication of the Help-Seeking Research article in #11.
Dr. Jason Lavender (USA) and colleagues, including distinguished scientist-practitioner-mentors Dr. Stephanie Manasse (USA), for publication of the Help-Seeking Research article in #12.
FAMILIES
1. Wu, M., Zhang, Y., Liu, R., Wu, D., Zhou, M., Zhang, P., Wang, Z., Ma, K., Li, B., Zhang, L., Guo, Y., Qin, J., Huang, Y., Huang, J., Qu, M., Luo, Y., Chen, J., & Li, K. (2026). Gender differences in relationships among parenting dimensions, disordered eating, and psychological factors in adolescents: A network analysis. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01641-7
Full text available for download at: https://tinyurl.com/48fz98ny
ABSTRACT. Objective: Disordered eating (DE) is prevalent among adolescents and often linked to parenting dimensions. Proximal psychological factors such as self-esteem, depression, anxiety, and sleep quality are associated with DE. However, the interplay between parenting dimensions and these psychological factors remains unclear. This study used a network approach to examine how parenting dimensions are associated with proximal psychological factors in relation to DE in Chinese adolescents, and to explore potential gender differences.
Methods: A total of 5148 adolescents aged 12–20 were included in the analysis. Network analysis was employed to construct basic networks of parenting dimensions and DE, and extended networks incorporating proximal psychological factors. Bridge strength indices were calculated to identify bridge nodes. Network comparison tests were used to explore gender differences in network structure and strength.
Results: In the basic networks, maternal rejection showed the strongest association with DE symptom “self-induced vomiting”. Gender differences were observed in the basic network, with boys’ DE symptoms linked to both maternal and paternal parenting dimensions, while girls’ DE symptoms were more associated with maternal parenting dimensions. When psychological factors were included, self-esteem and sleep quality emerged as key bridge variables connecting parenting dimensions and DE.
Gender-specific patterns were observed: in boys, self-esteem was the primary bridge node, whereas in girls, sleep quality was the strongest bridge node. No significant global differences were found between gender networks, but several edge variations revealed distinct gender-specific associations.
Discussion: Parenting dimensions are closely linked to adolescents’ disordered eating through psychological factors such as self-esteem and sleep quality. Gender-specific associations suggest that prevention efforts should focus on both parental influences and self-esteem for boys, and maternal influences and sleep quality for girls.
POSITIVE BODY IMAGE, Part 5 of 5
2. Schneider, J., Craddock, N., & Paraskeva, N. (2026). Prevalence and correlates of body appreciation in U.S. children aged 9–13 years: A cross-sectional analysis. Body Image, 57, 102102. https://doi.org/10.1016/j.bodyim.2026.102102
Full text available for download at: https://tinyurl.com/bdzebtxv
ABSTRACT. Body appreciation is a central component of positive body image, yet little is known about its prevalence in pre- and early adolescence. This study examined the prevalence and correlates of body appreciation among U.S. children aged 9–13 years. This preregistered secondary cross-sectional analysis used baseline data from a large intervention trial (N = 1359). Children completed self-report measures of body appreciation, internalisation of appearance ideals, and social media literacy. Prevalence of body appreciation was estimated using a midpoint-based classification approach. Gender and age (9–11 vs. 12–13 years) group differences were examined using independent-samples t-tests. Pearson correlations and multiple linear regression were conducted to examine correlates of body appreciation.
Most children reported high body appreciation; however, 18.5% were classified as having low or moderate body appreciation. Older children reported lower body appreciation than younger children. Boys reported lower body appreciation than girls, although the effect size was negligible. Higher body appreciation was independently associated with lower internalisation of appearance ideals, higher social media literacy, younger age, and identifying as a girl, with the overall model explaining 26.5% of the variance. Gender-stratified analyses indicated stronger associations among girls, with age emerging as a significant predictor only for girls, and different domains of social media literacy associated with body appreciation across groups.
The findings of this study show that body appreciation is meaningfully differentiated in pre- and early adolescence, highlighting the importance of early, developmentally appropriate interventions that promote positive body image.
3. Granfield, P., Kemps, E., & Prichard, I. (2026). Psychometric evaluation of Body Appreciation Scale for Children short forms among Australian children. Body Image, 56. Advance online publication. https://doi.org/10.1016/j.bodyim.2025.102023
Full text available for download at: https://tinyurl.com/2t3cbeyy
ABSTRACT. The Body Appreciation Scale-2 for Children (BAS-2C) is a widely used, psychometrically robust measure of body appreciation in children. However, in time-limited or school-based settings, briefer measures may reduce participant burden and improve data quality.
This study examined the psychometric properties of two three-item trait short forms of body appreciation among Australian children aged 10–12 years (N = 303), using data from a larger project evaluating a school-based body image intervention. Confirmatory Factor Analyses (CFA) and multi-group CFA tested whether the short forms replicated the BAS-2C’s unidimensional, gender invariant factor structure. Further assessments of psychometric properties involved composite reliability (McDonald’s ω), four-week test-retest reliability, construct and convergent validity.
For both 3-item forms, findings supported a unidimensional, gender-invariant factor structure. Reliability was acceptable for girls but weaker for boys. Validity evidence was strong, with strong correlations with the 10-item BAS-2C and moderate-to-strong correlations with related constructs of functionality appreciation, self-compassion, and wellbeing.
Overall, findings provide preliminary support for both 3-item short forms for brief, group-level use with children aged 10–12, but caution should be applied given the weaker reliability for boys across both short forms. Future research should refine items with a view to enhancing reliability for boys.
4. Guan, E. Y. H., Williams, A., & Doley, J. R. (2026). Factor analysis and psychometric properties of the Body Appreciation Scale-2 (BAS-2) in transgender and gender diverse people from Western countries. Body Image, 56, 102026. https://doi.org/10.1016/j.bodyim.2025.102026
Full text available for download at: https://tinyurl.com/3wzyptwc
ABSTRACT. The Body Appreciation Scale-2 (BAS-2) is a measure of positive body image that has been validated across diverse demographic groups. Despite increased interest in positive body image among transgender and gender diverse (TGD) people, the scale has not been validated within this group, which includes transgender men, transgender women, and a diverse group of non-binary people.
This study sought to examine the psychometric properties of the BAS-2 in TGD people. A total of 173 transgender men (aged 18–74 years), 106 transgender women (aged 18–73 years), and 163 non-binary and gender diverse people (aged 18–62 years) from Western countries completed an online survey that included the BAS-2 as well as self-reported measures of body dissatisfaction, gender dysphoria, transgender congruence, self-esteem, and impression management.
Confirmatory factor analysis revealed that the BAS-2 generated a unidimensional construct in transgender men, women, and non-binary/gender diverse people. Construct validity was supported in each of the gender groups, and measurement invariance tests suggested the BAS-2 functioned in the same way across transgender men and women. The BAS-2 also demonstrated excellent internal consistency in each of the three groups. This study revealed that the BAS-2 is a reliable and valid measure to evaluate body appreciation among TGD people and provided a nuanced understanding of the measure’s structure in diverse genders.
DIETARY RESTRICTION AND RESTRAINT, Part 3 of 3
5. Harrison, M. E., Vandermorris, A., Vyver, E., Rodrigues, A., Agostino, H., Robinson, A., & Toulany, A. (2026). Position statement: The dangers of dieting in adolescence. Paediatrics & Child Health, 31(3), 258–265. https://doi.org/10.1093/pch/pxaf129
Full text available for download at: https://tinyurl.com/2e5hav5h
ABSTRACT. Dieting is a common occurrence during adolescence. Dieting behaviours and cognitions can have a profound impact during this critical period of development, when youth have a heightened sensitivity to appearance and are actively forming their body image. Adolescents are particularly susceptible to internalizing the myriad and conflicting “health” messages disseminated through mainstream and social media, peer interactions, family dynamics, school systems and health care encounters. These messages can influence their perception of what constitutes a “normal” or “healthy” body, motivating dieting behaviours that are undertaken in an attempt to change their body weight or shape (or both).
ML NOTE 2: In regard to the site of the research described below in #6, according to Wikipedia and a crude Google search, Taif is a Saudia Arabian city of ~600,000 at elevation 6,165 feet (1879 m) on the slopes of Hijaz Mountains, about 93 km (~56 mi) east and slightly south of Mecca (officially Makkah al-Mukarramah). One of the things Taif is known for is “the bloom”: some 900 farms in the area annually produce 300 million damascene roses, which are highly “prized for yielding an extraordinarily rare, intensely rich essential oil valued for its deep, honeyed, and spicy aroma.”
6. Altuwairqi, W. A., & Alrasheedi, A. A. (2026). Associations between job stress, eating behaviors, and body mass index among healthcare professionals at King Faisal Medical Complex, Taif, Saudi Arabia. Eating and Weight Disorders. Advance online publication. https://doi.org/10.1007/s40519-026-01856-2
Full text available for download at: https://tinyurl.com/mr2ntrey
ABSTRACT. Background: Healthcare professionals are frequently exposed to occupational stress due to the demanding nature of their work environment. Such stress may influence eating behaviors and potentially contribute to weight-related health outcomes. This study aimed to examine the association between job stress, eating behaviors, and body mass index (BMI) among healthcare professionals working at King Faisal Medical Complex, Taif, Saudi Arabia.
Methods: A cross-sectional study was conducted among 323 healthcare professionals aged 25–60 years at King Faisal Medical Complex, Taif, Saudi Arabia. Participants completed a self-administered online questionnaire comprising of three sections: sociodemographic and lifestyle characteristics, the Brief Job Stress Questionnaire (BJSQ), and the Dutch Eating Behavior Questionnaire (DEBQ). BMI was calculated based on self-reported height and weight. Descriptive statistics, group comparisons, and correlation analyses were performed.
Results: High job stress was reported by 46.4% of participants. Moderate levels of restrained eating (52.3%) and external eating (65.6%) were common, whereas emotional eating was less prevalent, with 37.5% reporting moderate levels and only 9.0% reporting high levels. Weak but statistically significant correlations were observed between job stressors and emotional eating (r = 0.11, p = 0.049) and stress response and external eating (r = 0.14, p = 0.014). Social support was weakly and inversely correlated with external eating (r = − 0.15, p = 0.006). Restrained and emotional eating behaviors were significantly higher among overweight and obese participants compared with normal-weight individuals (p < 0.05). However, no significant association was observed between overall job stress and BMI.
Conclusions: Job stress is highly prevalent among healthcare professionals and is modestly associated with certain eating behaviors. Although job stress was not directly associated with BMI, maladaptive eating behaviors—particularly restrained and emotional eating––were significantly related to higher BMI. These findings highlight the importance of workplace strategies that address both stress management and healthy eating behaviors to support the well-being of healthcare professionals. Level of Evidence: This study is based on a cross-sectional design and is classified as level of evidence 4.
EATING PATHOLOGY (DISORDERED EATING BEHAVIORS and ED PSYCHOPATHOLOGY), Part 5 of now 8
7. Raffoul, A., Koechl, J., Hammond, D., Dubin, J. A., Kelly, A. C., & Kirkpatrick, S. I. (2026). The impact of calorie menu labeling on disordered eating and related psychosocial outcomes: A longitudinal Study among young adults in Canada. American Journal of Preventive Medicine, 70(6), 108296. https://doi.org/10.1016/j.amepre.2026.108296
Full text available for download at: https://tinyurl.com/449df5fx
ABSTRACT. Introduction: Calorie menu labeling policies are increasingly popular worldwide; however, concerns have been raised about the potential of calorie labels to worsen disordered eating and overall psychosocial wellbeing. This study aimed to investigate the potential unintended consequences of calorie menu labeling interventions on psychosocial wellbeing among young Canadian adults.
Methods: A natural experiment was conducted using longitudinal data from 3 waves of the Canada Food Study (N = 2,327, ages 16-30 years). Multiple imputations were performed to mitigate missing data and attrition across waves. Repeated-measures logistic models with difference-in-difference analysis assessed changes over time for 11 outcomes, including disordered eating, internalized weight bias, experienced weight discrimination, and indicators of psychosocial wellbeing across 4 provinces: Ontario (mandatory calorie labeling) and Alberta, Quebec, and Nova Scotia (no labeling policy).
Results: At baseline, 14% of the sample were at risk of disordered eating. Approximately half reported worrying about becoming fat (48%), and nearly one fifth experienced weight discrimination in the past year (19%). The implementation of a calorie menu labeling policy did not significantly increase the adjusted odds of disordered eating, internalized weight bias, experienced weight discrimination, nor other indicators of mental health.
Conclusions: The findings of this study contribute to the scarce literature assessing trends in disordered eating and psychosocial wellbeing in the ever-changing context of nutrition policy. The implementation of a mandatory calorie menu labeling policy in Ontario did not seem to elicit disordered eating among young adults, although the impact on people with pre-existing disordered eating and eating disorders is unknown.
8. Cheikh Ismail, L., Faris, MA., Abdelrahim, D. N., Zeb, F., Mohamad, M. N., Amer, E., Alali, M., Draghmeh, M., Ben-Mustafa, N., Stojanovska, L., & Al Dhaheri, A. S. (2026). High risk of disordered eating is associated with body composition, behavioural factors, and perceived stress among university students: A cross-sectional study from the UAE. Journal of Nutritional Science, 15, e25. https://doi.org/10.1017/jns.2026.10089
Full text available for download at: https://tinyurl.com/9jtadsvu
ABSTRACT. Disordered eating (DE) significantly affects both physical and mental health, contributing to morbidity, mortality, and considerable global healthcare costs. This cross-sectional study assessed the prevalence of high-risk DE and examined its associations with body composition, behavioural factors, diet quality, and perceived stress among university students in the United Arab Emirates.
A total of 911 students were recruited using non-probability quota sampling (50.49% female). Body composition was measured using a TANITA BC-420MA body composition monitor. Usual dietary intake was assessed via a validated 65-item food frequency questionnaire. DE risk was assessed using the Eating Attitudes Test (EAT-26) and perceived stress using the PSS-10. Analysis included linear regression and independent-samples t-test (p < 0.05).
High-risk DE (EAT-26 ≥ 20) prevalence was 30.3%. High-risk DE was significantly associated with higher body fat percentage (β = 0.121, p < 0.001), fat mass (β = 0.148, p< 0.001), fat-free mass (β = 0.079, p= 0.017), lean mass (β = 0.08, p = 0.016), total body water (β = 0.084, p = 0.011), and lower total body water percentage (β = −0.131, p < 0.001).
High-risk students also reported higher intakes of fibre (β = 0.12, p = 0.018), beta-carotene (β = 0.14, p= 0.025), vitamin A (β = 0.13, p = 0.034), B12 (β= 0.15, p = 0.043), folate (β = 0.16, p = 0.006), and vitamin D (β = 0.16, p = 0.036). Compared with the low-risk group, high-risk DE was associated with higher adiposity markers and slightly higher perceived stress, and differed in selected nutrient intakes; sociodemographic characteristics were largely similar between groups except for smoking status.
These findings support the implementation of targeted prevention strategies, including nutrition education, routine screening, and culturally tailored programmes, for young adults in the UAE.
TECHNOLOGY, Part 2 of now 3
9. McClure, Z, Fuller-Tyszkiewicz, M., Messer, M., & Linardon J. (2026). Personalized treatment selection for digital eating disorder interventions: A proof-of-concept for the Personalized Advantage Index. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.70112.
Full text available for download at: https://tinyurl.com/5ep7uzhb
ABSTRACT. Objective: Although a range of evidence-based treatments for eating disorders exist, treatment response varies substantially. The ability to match individuals to a treatment which they are most likely to benefit from may help improve treatment efficiency and therapeutic outcomes. The present study applies a treatment selection approach called the personalized advantage index (PAI) and evaluates its utility for matching individuals to a broad versus focused digital program for eating disorder symptoms.
Method: Data were used from a randomized non-inferiority trial comparing the two interventions (N = 214). Machine learning models (elastic net and random forest) were trained to predict post-intervention symptom severity for a broad and focused digital intervention using 40 self-reported baseline predictors. The PAI was calculated to identify the predicted optimal treatment for each participant.
Results: Elastic net performed marginally better than the random forest at predicting intervention outcomes (Elastic net R2 = 0.29; Random Forest R2 = 0.26). Independent samples t-tests indicated no significant differences in post-intervention outcomes between participants who received their PAI-indicated treatment and those who did not in both the full sample and a subsample with larger predicted differential responses.
Discussion: PAI-based treatment matching did not improve post-treatment outcomes in this context. Greater utility of the PAI approach may emerge when applied to different treatment orientations or delivery formats, enabling greater opportunity for differential effects to emerge.
ML NOTE 3: In regard to the article described below in #10, see also the following by the same research team, as presented 17 August 2025 in Newsletter NO. 178 (#9).
Levinson, C. A., Fitterman-Harris, H. F., McCarthy, A., Cohen, Z. D., & Craske, M. G. (2025). Adapting digital anxiety treatments to reduce anorexia nervosa relapse. Journal of Affective Disorders, 390, 119842. https://doi.org/10.1016/j.jad.2025.119842 [Email address for correspondence: cheri.levinson@louisville.edu]
10. Levinson, C. A., Brosof, L. C., Stancil, J., Fitterman-Harris, H. F., Tillquist, M., McCarthy, A., Cohen, Z. D., & Craske, M. G. (2026). Digital facing eating disorder fears: An acceptability and feasibility open series trial of a digital relapse prevention program for anorexia nervosa. Behavior Therapy. Advance online publication. https://doi.org/10.1016/j.beth.2026.05.001
Email address for correspondence: cheri.levinson@louisville.edu
ABSTRACT. Anorexia nervosa (AN) is a serious psychiatric illness. Despite its severity, most individuals with AN never achieve full recovery and more than 50% of patients relapse after treatment. One of the primary reasons that many treatments are limited in their effectiveness, is that they do not specifically target cognitive-affective pathology. Furthermore, many treatments are limited by lack of scalability. New treatments that target cognitive-affective pathology (e.g., anxiety, fear) and that are scalable are needed to improve both outcomes and access to evidence-based care.
As such, the current open series trial (N = 10) piloted a new digital, exposure-based modular treatment for AN-related fear and anxiety, called Digital Facing Eating Disorder Fears (FED-F). FED-F consists of five digital modules focused on four common AN fears: weight gain, food, social eating, and physical sensations, and one module of cognitive re-structuring. Modules are complemented by homework assignments and light-touch coaching.
FED-F had high feasibility, acceptability, mixed findings for target engagement (i.e., decreased avoidance behaviors), and good initial clinical efficacy, with pre-post effect sizes ranging from small to large, dependent on the type of fear. Overall, FED-F is a promising new digital treatment that could be used to decrease anxiety-based cognitions and behaviors present in AN. Future work should test FED-F in a randomized controlled trial design especially with populations who may have difficulty accessing evidence-based care.
HELP SEEKING, Part 2 of now 3
11. Mycock, G., Downs, J., Molnár, G., Foye, U., Bartel, H., Griffiths, J. R., & Edwards, C. (2026). “I wanna live in a world where change is possible”: Co-designing guidance for inclusive eating, exercise, and body image psychopathology outreach resources for men. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01562-5
Full text available for download at: https://tinyurl.com/55mcfy5u
ABSTRACT. Background: Men are underserved in research on eating, exercise and body image psychopathology (EEBIP), and remain underrepresented within healthcare settings despite growing clinical need. One barrier to men’s help-seeking for EEBIP-related concerns is that public-facing healthcare information/resources often appear unwelcoming to them, suggesting the need for more inclusive, gender-sensitive resources that engage men and address their specific needs. This study aimed to explore men’s perspectives on the design of inclusive EEBIP resources, to inform the iterative co-design of guidance for future resource development.
Methods: This study employed a lived experience-led approach, integrating a modified nominal group technique with participatory research methods, as part of an iterative co-design of a guidance document. Six men with lived experience of EEBIP ranked their preferred features of male-inclusive resources from a broader list of content and format ideas generated through a survey of 42 men.
Interview and focus group discussions followed, exploring the underlying reasons why the men with EEBIP experience believed these content and format ideas would support men’s help-seeking for EEBIP. Finally, a draft guidance document, underpinned by the results of the discussions, was designed and iteratively edited, following feedback from healthcare organisation representatives, academics, and men with lived experience.
Results: Thematic analysis of the discussions identified five themes to inform the development of future resources. The five themes are titled: (1) Designing accessible resources that navigate men’s readiness; (2) Authentic voices: inclusive, conversation-led outreach; (3) Self-realisation: refraining from labelling men as ‘unhealthy’ or ‘disordered’; (4) Purpose and progress driven resources; (5) Images: the line between helpful and harmful isn’t always clear. These themes are discussed alongside EEBIP and men’s mental health help-seeking literature.
Conclusions: This is the first study to centre men’s experiential knowledge to explore how healthcare organisations can facilitate men’s help-seeking for EEBIP-related concerns via public-facing resources. The themes generated in this study reflect findings of studies exploring the facilitation of men’s general mental health help-seeking, whilst contributing novel EEBIP-specific findings. The results of this study can support EEBIP healthcare organisations to develop public-facing resources that are more inclusive of men.
12. Sonnenblick, R. M., Williams, E. A., Lavender, J. M., & Manasse, S. M. (2026). Good for men, but not for me: A qualitative study of factors preventing men from seeking psychological treatment for their binge-spectrum eating disorders. Psychology of Men & Masculinities, 27(1), 60–68. https://doi.org/10.1037/men0000543
Email address for correspondence: rs3725@drexel.edu
ABSTRACT. Men with binge-spectrum eating disorders (BSEDs) often do not seek psychological treatment. Understanding men’s perceptions of masculinity, eating disorders, and therapy could inform efforts by researchers and clinicians to engage this overlooked and underserved group. Semistructured qualitative interviews were conducted with 15 men (53% White, 80% heterosexual, age range 26–69) who have not sought therapy for their diagnosable BSEDs. The interview guide focused on how men’s perspectives on masculinity, eating disorders, and therapy affect their decisions about seeking therapy for their BSEDs.
Reflexive thematic analysis identified four main themes: (a) Men did not recognize their BSEDs. (b) Men stated that serious eating problems cause physical, not just mental, health consequences. (c) Even though many of these men had been in therapy, and even though they called their eating problems serious, they had often not seriously considered therapy for their BSEDs. (d) The men expressed appreciation and respect for men who sought therapy for their BSEDs. Societal expectations and a lack of information prevented many of these men from seeking treatment.
Many men recognized their eating problems as serious but did not know that binge-eating disorder existed as a diagnosis. Furthermore, they wanted additional clarity about how therapy could effectively address BSEDs. These findings speak to the importance of raising awareness of BSEDs in men.