Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 237: (i) Prevention, Part 1 (n = 2); (ii) Positive Body Image, Part 3 (n = 2); (iii) BDD/MDD, Part 1 (n = 2); and (iv) December 2025 - January 2026 Treatment Interlude, Part 6 (n = 3)
Colleagues (N now = 1447 in 49 countries),
Please continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications, etc.
NATIONAL EATING DISORDERS AWARENESS WEEK Events
National Eating Disorders Association (NEDA) presents
4 Free Events
Received yesterday (California time), 23 February 2026, via an email from the National Eating Disorders Association (NEDA). Shivani Dutt (Manager, Mission Initiatives; see Wednesday event) and Mollie Schlapp-Gilgoff, LMSW (Manager, Mission Initiatives) are members of this Newsletter Group.
ML NOTE 1: REGISTER at the link (title) for each event.
TUESDAY, Feb 24 - 2 pm ET | 11 am PT | 7 pm UTC — Community Conversation: Athletes’ Lived Experience Panel with Athlete Edge at EDCare featuring Amanda Sobhy, Danny O’Connor, and Alice Merryweather.
WEDNESDAY, Feb 25 - 2 pm ET | 11 am PT | 7 pm UTC — Learning Session: Beyond Willpower: Understanding the Psychology of Emotional Eating hosted by our own Shivani Dutt & our own Sondra Kronberg, MS, RD, CEDRD-S
THURSDAY, Feb 26 - 12 pm ET | 9 am PT | 5 pm UTC — Webinar: Trauma, Culture, & Emotional Avoidance in collaboration with ADAA, presented by Paula Edwards-Gayfield, LCMHCS, LPC, CEDS-C
THURSDAY, Feb 26 - 1 pm ET | 10 am PT | 6 pm UTC — CE Event: Eating Disorders & Co-Occurring Complex PTSD in collaboration with The Dorm, presented by Kim Dennis, MD, CEDS & Amanda Fialk, PhD, LCSW, LCISW
The Body Positive team presents
A free Community of Care Circle Event
Returning to the Body: Self Love as Practice, Not Perfection
Wednesday, February 26, 2026, 6:30 pm - 7:30 pm Pacific | 9:30 pm - 10:30 pm Eastern | February 27, 2026, 2:30 am - 3:30 am UTC
Received 12 February 2026 via an email from The Body Positive team.
ML NOTE 2: Our own Bolder Models Ms. Elizabeth Scott (USA) and Ms. Connie Sobczak (USA) are the co-founders of The Body Positive (“Teaching People How to Overcome Conflicts with Their Bodies to Lead Happier, More Productive Lives”). Our own Dr. Wintor McNeel (USA) is the Executive Director.
💗 Community of Care Circle — Returning to the Body: Self Love as Practice, Not Perfection
Wednesday, February 26, 2026: 6:30 PM - 7:30 PM Pacific | 9:30 PM - 10:30 PM Eastern | February 27, 2026 2:30 AM - 3:30 AM UTC
This February, we are gathering in a sacred act of coming home to ourselves.
Join The Body Positive for our first Community of Care Circle, an affirming and restorative space where we will explore what it means to practice self love beyond perfection, performance, or appearance.
Register here to join the Self-Love Community of Care Circle. Once registered you will receive a calendar invite with the Zoom link.
Together, we will:
• Reflect on our relationship with our bodies
• Unlearn harmful narratives rooted in shame
• Reclaim self love as a daily practice
• Build connection in a supportive, inclusive community
This is not about fixing your body. This is about honoring it.
Whether you are early in your journey or have been doing this work for years, there is space for you here. Every body belongs. Every story matters.
Come as you are. Leave more rooted in your worth. We cannot wait to gather with you.
With love,
The Body Positive 💞
REQUEST FOR RESEARCH PARTICIPATION BY AND/OR ASSISTANCE RECRUITING
Men ages 40–60 residing in the United States of America
from our own Tanvi Pawar, M.A. (Hofstra University), under the supervision of our own Dr. Mun Yee Kwan, at the Lab CARES (Hofstra)
for a study [ML, paraphrasing] has entitled: Risk Factors for Disordered eating in Men Ages 40-60
Received 12 February 2026 via an everything-is-advocacy email from our own Tanvi Pawar (USA), who writes “I am a second year PhD student from Hofstra University, working under [our own] Dr. Mun Yee Kwan, at the Lab CARES. recruiting for my Research 223 thesis, which is IRB approved.”
ML NOTE 3: Tanvi, Dr. Kwan, and I would appreciate it if you would (a) participate if eligible, and/or (b) pass this request along to any and all men you know who are eligible, and to anyone you know who works with men who are eligible.
Middle Aged Men’s Health Research Needs Your Voice
We are looking for men aged 40–60 residing in the United States of America to help us identify risk factors for disordered eating.
How it works: Two short surveys, spaced 4–6 weeks apart.
Reward: Enter a raffle for one of 12 Amazon gift cards ($20 each). Take the Survey: https://touropsych.az1.qualtrics.com/jfe/form/SV_3qpeibzbV6Cllr0
Your participation can help change how we understand men’s mental health.
For questions email: tpawar1@pride.hofstra.edu
Lab CARES (Cultural And Risk factors of Eating disorders and Suicidality), Hofstra University.
Tanvi Pawar, M.A. | Clinical Psychology Trainee, Hofstra University
FREE PROFESSIONAL/PERSONAL OPPORTUNITY FOR CLINICIANS
Webinar entitled
Restoring the Roots of Care: From Awareness to Adaptation
with Shayla Dube, RSW (Canada) and our own Dr. Adele Lafrance, C.Psych (Canada)
Friday, February 27, 2026, 9:00 a.m. - 10:00 a.m. Pacific | 12:00 p.m. - 1:00 p.m. | 5:00 p.m. - 6:00 p.m. UTC
Received 12 February 2026 via our own Dr. Adèle Lafrance’s (Canada) February EFFT Newsletter.
ML NOTE 4: In my experience time spent with Dr. Lafrance will be time well spent, no matter how old you are or how much clinical/treatment experience you have. Just sayin’ . . . .
Join Shayla and Adele for a grounding dialogue inspired by Marcus Garvey’s reminder that “A people without the knowledge of their past history, origin and culture is like a tree without roots.” Paired with the wisdom that “when the roots are strong, the tree doesn’t fear the wind,” this dialogue explores what happens when our roots are disrupted and what becomes possible when we reclaim them. A glimpse of deeper work to come soon.
Webinar: Restoring the Roots of Care: From Awareness to Adaptation
Presenters: Shayla Dube, RSW (Canada) and our own Dr. Adele Lafrance, C.Psych (Canada)
Date and Time: Friday, February 27, 2026, 9:00 a.m. - 10:00 a.m. Pacific | 12:00 p.m. - 1:00 p.m. | 5:00 p.m. - 6:00 p.m. UTC
FREE — REGISTER at https://dradelelafrance.com/roots-of-care
REQUEST FOR RESEARCH PARTICIPATION BY AND/OR ASSISTANCE RECRUITING
Women Ages 18 and Over Who Have Been Treated for Bulimia Nervosa AND Have Been Mostly Symptom-Free for At Least 1 Year
from Samantha Abouzeeni (Michigan School of Psychology)
for a study she has entitled: Exploring Women’s Experiences of Bulimia Nervosa Recovery
Received 12 February 2026 via an everything-is-advocacy email from our own Dr. Anita Frederici (Canada), who is a member of Samantha Abouzeeni’s doctoral dissertation committee.
ML NOTE 5: Samantha, Dr. Frederici, and I would appreciate it if (a) you would participate, if eligible; and/or (b) pass this request along to any and all people who might be eligible and interested, and/or who know them. A flyer is available from Samantha at sabouzeeni@msp.edu.
This research is exploring women’s experiences of bulimia nervosa recovery
ELIGIBILITY: 18 years or older | Identify as female | Have been diagnosed with bulimia nervosa | Have undergone therapy for treatment of bulimia nervosa | Have been mostly symptom- free for at least one year | Fluent in English
CONTACT: If interested in participation contact Samantha Abouzeeni: sabouzeeni@msp.edu
Participation is voluntary & confidential
60-90 minute interviews will be done via zoom
PROFESSIONAL DEVELOPMENT/EATING DISORDERS LITERACY
In conjunction with/support of the USA’s Eating Disorders Awareness Week
The RENFREW CENTER FOUNDATION presents 4 Free On Demand Events
Received yesterday (California time), 23 February 2026, via an email from the Renfrew Center Foundation. All on-demand events became available that day.
EVENT 1: Nutrition Myths That Harm: Beyond Calories and Clean Eating, with Sam Wint, MPH, RDN, LDN | Register at: https://tinyurl.com/av4e433h
EVENT 2: The Myth of Perfectionism as Protection, with Mehak Merchant, MS, LPC, NCC | Register at: https://tinyurl.com/3m7mb7wp
EVENT 3: The Dos and Don’ts: Supporting the [Recovery] Journey, with Samantha DeCaro, PsyD | Register at: https://tinyurl.com/3vvc3kdy
EVENT 4: Values Based Recovery- Reconnecting with Who You, with Ashley Moser, LMFT, CED| Register at: https://tinyurl.com/2xucekzr
Research Publication Categories in This Newsletter
(i) Prevention, Part 1 (n = 2); (ii) Positive Body Image, Part 3 (n = 2); (iii) BDD/MDD, Part 1 (n = 2); and (iv) December 2025 - January 2026 Treatment Interlude, Part 6 (n = 3)
CONGRATULATIONS to our own
Dr. Nadia Craddock (England), Harriet Smith (England), and Drs. Jake Linardon (Australia), Tracy Tylka (USA), and Phillippa Diedrichs (England) for publication of the Prevention article in #2.
Katrina Holmes à Court (Australia) and colleagues, including our own Dr. Amy Malcolm (Australia; #5), for publication of the Body Dysmorphic Disorder articles in #5 and #6.
Mr. Alan Duffy (USA) and Dr. Renee Rienecke (USA) and colleagues, including distinguished scientist-practitioner-mentor Dr. Philip S. Mehler (USA), for publication of the Eating Disorders Treatment article in #9.
PREVENTION, Part 1 of 3
1. Levine, M. P. (2026). Prevention of eating disorders: 2025 in review. Eating Disorders: The Journal of Treatment & Prevention. Advance online publication. https://doi.org/10.1080/10640266.2026.2622418
Full text available for download at: https://tinyurl.com/bccxanwf OR email address for correspondence: levine@kenyon.edu
ABSTRACT. This review of 15 prevention-related publications in Eating Disorders during 2025 is framed by three models: (1) Mental Health Intervention Spectrum: health promotion → types of prevention → case identification/referral for treatment; (2) the prevention cycle: rationale and theory, shaped by critical reviews → clarifying risk and protective factors → program innovation and feasibility studies → efficacy and effectiveness research → program dissemination; and (3) definitions of and links between eating disorder psychopathology, disordered eating behavior, and eating disorders.
Four articles were categorized as prevention theory, methodology, or ethics; three articles were categorized as prevention rationale (including screening studies); six articles addressed correlates and putative risk factors for eating disorders or eating pathology; and one article each addressed protective factors and the upscaling/adaptation of the Body Project prevention program, respectively.
Seven implications for prevention improvement are presented. For example, we must do more than acknowledge a spectrum of disordered eating. In many countries, eating pathology in girls and boys is a pressing public health problem that is almost certainly in place before age 13. Consequently, the developmental trajectories of eating pathology in children and adolescence, and the creation of effective school-based prevention programs for youth ages 10 through 15, are two under-studied areas that deserve research priority.
2. Craddock, N., Smith, H. G., Linardon, J., Tylka, T. L., & Diedrichs, P. C. (2026). Existing and future use cases, and safety and ethical considerations for AI in body image, and eating disorder prevention. Body Image, 56. Advance online publication. https://doi.org/10.1016/j.bodyim.2026.102042
Full text available for download at: https://tinyurl.com/bdzmjkpb
ABSTRACT. Artificial intelligence (AI) is rapidly transforming digital, clinical, and cultural landscapes in ways that hold significant implications for body image and eating disorder (ED) prevention. This article outlines how traditional and generative AI technologies influence societal appearance ideals as well as digital environments, including online mental health tools. While AI offers opportunities for early detection, personalized and scalable prevention, and the promotion of more inclusive representation, it also poses ethical and psychological risks, including amplification of harmful appearance ideals, algorithmic bias, and overreliance on technology.
This article identifies key research priorities relevant to body image spanning macro-level impacts, emerging use cases, ethics and safety, equity and representation in datasets, public perceptions, and the need for interdisciplinary and participatory governance. As AI becomes embedded in everyday life, its responsible and safe use will be critical to ensuring it does not exacerbate body image concerns or increase ED risk.
POSITIVE BODY IMAGE, Part 3 of 3
3. Carels, R. A., DeRouen, K., Metzler, A. L., Woodall, P., Byrd, R., Jansen, E., & Mansour, L. (2026). The association between stigma consciousness and weight stigma, psychological well-being, positive body image, and eating behaviors. Body Image, 56. Advance online publication. https://doi.org/10.1016/j.bodyim.2026.102038
Full text available for download at: https://tinyurl.com/5hd49wwu
ABSTRACT. Stigma consciousness refers to an individual difference in the extent to which members of stereotyped groups believe that their stereotyped status permeates interactions with out-group members. This investigation examined whether stigma consciousness contributed unique variance in predicting mental well-being, and eating and positive body image outcomes (i.e., depression, self-esteem, body appreciation, intuitive eating, emotional eating) after controlling for experienced weight stigma (EWS), including fat microaggressions (FM), and internalized weight bias (IWB).
Study participants (N = 288) were recruited through a Qualtrics research panel, all of whom were required to be at least 18 years old with a BMI > 25. In hierarchical regressions predicting self-esteem, depression, body appreciation, and intuitive eating, stigma consciousness significantly accounted for 3.7–20.0 % of unique variance beyond EWS, FM, and IWB. Stigma consciousness was not associated with emotional eating and did not predict depressive symptoms after accounting for weight stigma. The belief that one is being judged according to stereotypes may not be sufficient to induce occurrences of emotional eating, nor contribute uniquely to depression symptoms above and beyond weight stigma.
These findings indicate that stigma consciousness is not redundant with existing weight-related constructs such as FM, IWB, and EWS in predicting self-esteem, body appreciation, and intuitive eating. These findings further indicate that the expectation that an individual is being judged based on stereotypes related to their identity is associated with negative psychological outcomes. Developing interventions to empower individuals and buffer against the harmful effects of stigma consciousness is imperative.
4. Sire, T., Jany St-Cyr, J., Carbonneau, É., & Carbonneau, N. (2026). Latent profile analyses of intuitive eating and motivation to regulate eating behaviors: Associations with diet quality, eating behaviors, and body image. Appetite. Advance online publication. https://doi.org/10.1016/j.appet.2026.108485
Full text available for download at: https://tinyurl.com/3dmmkjvv
ABSTRACT. Unhealthy eating behaviors and body dissatisfaction are prevalent in Western societies, underscoring the importance of identifying adaptive eating patterns that support diet quality and well-being. This study examined how intuitive eating and motivation to regulate eating behaviors combine into distinct profiles, and how these profiles relate to diet quality, eating behaviors, and body image.
A sample of 408 French-speaking adults from Québec, Canada (65.20% women; Mage = 46.93 years) completed an online questionnaire. Using the four dimensions of intuitive eating (i.e., unconditional permission to eat, eating for physical rather than emotional reasons, reliance on hunger and satiety cues, body—food choice congruence) and amotivation, controlled, and autonomous motivations to regulate eating behaviors as indicators, four profiles emerged from latent profile analysis: Autonomous Intuitive Eaters (15% of the sample), Moderately Intuitive Eaters (31%), Mixed-Motivation Unattuned Eaters (11%), and Disengaged Eaters (44%). Men, individuals with lower education, lower income, and higher body mass index were more likely to be Disengaged Eaters.
Comparisons across profiles showed that Autonomous Intuitive Eaters reported the most favorable pattern (greater diet quality and body esteem, fewer problematic eating behaviors), while Moderately Intuitive Eaters reported similar but less pronounced outcomes. Mixed-Motivation Unattuned Eaters achieved high diet quality but reported poorer body esteem and more problematic eating behaviors, whereas Disengaged Eaters showed the lowest diet quality and least favorable psychological outcomes. Findings highlight the interplay between intuitive eating and motivation, suggesting that fostering adaptive combinations of both may promote healthier dietary patterns and positive relationships with food.
BODY DYSMORPHIC DISORDER/MUSCLE DYSMORPHIA, Part 1 of 3
5. Holmes à Court, K., Malcolm, A., Toh, W. L., & Rossell, S. L. (2025). A systematic review of neurocognition and social cognition in body dysmorphic disorder. Australian & New Zealand Journal of Psychiatry, 59(3), 224-247. https://doi.org/10.1177/00048674241309747
Full text available for download at: https://tinyurl.com/bddj7hjz
ABSTRACT. Objective: Neurocognitive underpinnings are implicated in the aetiology and maintenance of body dysmorphic disorder (BDD); however, inconsistent findings across a range of neurocognitive domains suggest that a comprehensive synthesis of the literature using a hierarchical framework of neurocognition is needed.
Methods: A final search across OVID Medline, PsycNET, Scopus and Web of Science databases was conducted on 20 June 2024 to identify research that examined performance on behavioural tasks of objective neurocognition in BDD. Risk of bias was assessed using the Newcastle-Ottawa Scale. Fifty-four studies aligned with the following inclusion criteria: (1) full-text; (2) peer-reviewed; (3) published in English; (4) employed a neurocognitive task with an objective outcome and (5) involved a case-controlled paradigm consisting of BDD and healthy control samples. Findings were synthesised according to neurocognitive sub-domains viewed as a hierarchy from basic to higher-level domains.
Results: Neurocognitive differences in BDD relative to controls were identified at almost all levels of the hierarchy, most consistently in the upper domains of executive function and social cognition. Vulnerabilities were also demonstrated in the sub-domains of visual perception of faces, Gestalt processing, selective attention to faces and verbal memory. Methodological limitations or the influence of neurocognitive sub-groups may contribute to inconsistencies across the literature.
Conclusions: Although neurocognitive differences appear central to BDD, a picture of neurocognitive heterogeneity emerged with the salience of stimuli important and a likely bias to local-over-global processing demonstrated across the domains.
6. Holmes à Court, K., Van Rheenan, T. E., & Rossell, S. L. (2025). How do individuals with body dysmorphic disorder (BDD) perceive their own cognition? A qualitative investigation into subjective cognition in BDD. BMC Psychiatry, 25, 1083. https://doi.org/10.1186/s12888-025-07482-z
Full text available for download at: https://tinyurl.com/4rj5tnpf
ABSTRACT. Background: Cognition is implicated in the aetiology and maintenance of body dysmorphic disorder (BDD); however, there is almost no research concerning individuals’ perception of their cognition. Understanding real-world, subjective cognitive experiences will improve understanding of the functional impacts of BDD and could alter treatment approaches. This study aimed to examine the subjective impressions of the prominence, type and impact of cognitive impairments experienced by adults with BDD.
Methods: Participants responded to a global, online self-report survey asking qualitative questions regarding cognitive experiences in BDD (N = 316). Data was analysed using Interpretative Phenomenological Analysis (IPA). Five superordinate themes were identified: (1) the cognitive experiences of BDD, (2) functional impairment, (3) relationship between cognitive impairment and BDD, (4) social and emotional impacts, and (5) strategies.
Results: Individuals recognise impaired cognition as relating to their experience of illness. Many individuals report impairments across multiple specific cognitive domains (attention, memory, executive function, social cognition and processing speed) and some perceive themselves as generally ‘cognitively flawed’. Conclusions: The self-reported social and emotional consequences of cognitive impairments in BDD are significant and many individuals report functional impairment. Being aware of patients’ perceptions of their cognitive impairments may help clinicians tailor or modify their strategies. Questioning of cognitive experiences should form part of patient assessments.
DECEMBER 2025 - JANUARY 2026 TREATMENT INTERLUDE, Part 6 of now 6
7. Prätzel Ellwanger, M., Westphalen Pomianoski, B., Lopes Vieira, D., Pozza Ellwanger, M., Astori, V., & Frizzo Messinger, M. (2025). Efficacy, safety and tolerability of lisdexamfetamine dimesylate treatment compared to placebo in adults with binge-eating disorder: A systematic review and meta-analysis of randomized controlled trials. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70070
Email address for correspondence: ellwangermp@gmail.com
ABSTRACT. Introduction: Binge-Eating Disorder (BED) causes significant psychosocial impairment and comorbidities like obesity, depression, and anxiety. Given the limited effectiveness of current treatments, Lisdexamfetamine dimesylate (LDX), approved for Attention-Deficit/Hyperactivity Disorder- ADHD and BED in the U.S., may provide a promising alternative by enhancing impulse control and targeting reward pathways. Objective: This study aims to assess the efficacy, safety, and tolerability of LDX compared with placebo in adults with BED.
Methods: We systematically searched PubMed, Embase and Cochrane databates for randomised controlled trials (RCTs). We used a random-effects model with a 95% confidence interval (CI) to pool the data. Outcomes analysed included binge-eating frequency, Yale-Brown Obsessive-Compulsive Scale for Binge-Eating (Y-BOCS-BE), weight change, treatment-emergent adverse events (TEAEs), and discontinuation rates. Sensitivity analyses were performed to assess heterogeneity. This systematic review and meta-analysis was prospectively registered in PROSPERO (CRD42024619617).
Results: Five RCTs were included in this meta-analysis, encompassing a total of 988 participants. LDX significantly reduced binge-eating days per week by an average of 1.29 days and decreased obsessive-compulsive behaviours by 6.16 points on the Y-BOCS-BE scale, compared with placebo. Additionally, LDX led to a significant weight reduction with an average decrease of 1.31 standardised mean differences (SMD). Diarrhoea was identified as a significant side effect not previously acknowledged in guidelines (RR = 4.06). Discontinuation rates were comparable between LDX and placebo.
Conclusion: LDX demonstrates significant efficacy in reducing binge-eating behaviours and associated obsessive-compulsive symptoms in patients with BED, with a tolerable safety profile. These findings support the clinical use of LDX for managing BED.
8. Harkhoe, M., Offringa, T., & Vermetten, E. (2025). Exploring MDMA assisted therapy in eating disorders: Mechanisms, clinical evidence, and future directions. Journal of Eating Disorders, 13, 293. https://doi.org/10.1186/s40337-025-01409-5
Full text available for download at: https://tinyurl.com/4d8rajr4
ABSTRACT. Background: Patients with eating disorders (EDs), particularly anorexia nervosa (AN), experience a complex psychiatric condition often characterized by extreme food restriction, intense fear of weight gain, elevated levels of emotional dysregulation, body image disturbance, and comorbid trauma. Several of these factors can undermine the therapeutic alliance and reduce engagement with treatment, contributing to poorer outcomes.
MDMA, a non-classical psychedelic, is being explored as a novel PTSD treatment adjuvans due to its ability to rapidly reduce trauma symptoms and enhance therapeutic alliance. Recent clinical trials and regulatory considerations, as highlighted in emerging research, are shaping its potential therapeutic role, and MDMA may offer a unique mechanism to disrupt maladaptive neural circuits, enhance cognitive flexibility, and facilitate emotional processing in EDs.
Objective: To comprehensively evaluate the potential of MDMA-assisted therapy for EDs with a particular focus on the distinct neurobiological and psychological profiles of AN and comorbid PTSD. Methods: This paper synthesizes current research literature on MDMA, PTSD, and EDs, with an emphasis on clinical trial outcomes, neurobiological mechanisms, and therapeutic frameworks. Both pharmacological and psychotherapeutic components of MDMA-AT are reviewed.
Results: No clinical trials of MDMA-AT have been conducted in ED populations to date. Findings from clinical trials in patients with PTSD suggest that MDMA’s pro-social and fear-reducing and neuroplastic properties may enhance emotional processing, therapeutic alliance, and cognitive flexibility - key factors that often hinder eating disorder treatment. The ability of MDMA to increase emotional openness, reduce fear responses, and promote cognitive flexibility could support deeper engagement with the therapeutic process and improve treatment outcomes in EDs with comorbid trauma.
Conclusions: The current evidence base suggests that MDMA-AT may hold promise as an adjunctive treatment for EDs echoing its demonstrated therapeutic potential in PTSD. By facilitating deeper emotional processing, enhancing patient-therapist attunement, and fostering openness to change, MDMA may help overcome avoidance, cognitive rigidity, and therapeutic impasses that often hinder progress in EDs. Its integration into clinical practice will require rigorous validation through well powered trials, alongside careful ethical and regulatory oversight, and integration into multidisciplinary treatment frameworks. Tailored dosing, patient selection, and therapist training will be essential for safe and effective implementation. Further research is warranted to fully explore this potential application.
9. Wassenaar, E., Blalock, D. V., Duffy, A., Riddle, M., O’Melia, A. M., Weeks, H., Mehler, P. S., & Rienecke, R. D. (2025). Ketamine for treatment resistant depression in individuals with eating disorders: A comparison study. Journal of Eating Disorders, 13, 280. https://doi.org/10.1186/s40337-025-01448-y
Full text available for download at: https://tinyurl.com/4b9vyb5h
ABSTRACT. Background: Individuals with eating disorders (EDs) have an increased risk of treatment resistant depression (TRD) and treatment resistant bipolar disorder (TRBD) and a higher rate of suicidal ideation and death by suicide than individuals without EDs. Individuals with EDs are less responsive to conventional treatments for mood disorders than individuals without EDs. Ketamine has evidence for treatment of TRD and TRBD and for the treatment of acute suicidality. Ketamine has also been shown to be safe in individuals with EDs who are malnourished. This study is among the first to examine the efficacy of ketamine in TRD and TRBD in patients with co-occurring EDs at higher levels of care.
Methods: Participants were 85 adults admitted to an ED treatment facility who received subanesthetic intranasal generic ketamine compared to a sample of 85 adults matched for age, sex, gender, race, diagnosis, and level of care at admission admitted to the same facilities who did not receive ketamine. Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), suicidal ideation (PHQ-9 Item 9) and Generalized Anxiety Disorder-7 (GAD-7) at admission and discharge.
Results: Patients receiving ketamine and matched controls were not significantly different on age, sex, gender, race, diagnosis, or level of care at admission. There were no significant differences between groups on admission for all EDE-Q subscales, PHQ-9, suicidal ideation, or GAD. All patients, irrespective of use of ketamine, improved significantly from admission to discharge on all outcomes. There were no significant differences between groups for change in all EDE-Q subscales, change in PHQ-9, change in suicidal ideation, or change in GAD-7. Patients receiving ketamine had significantly longer lengths of stay than controls (b = 0.39, p = .01). The lack of significant differences was maintained irrespective of predicting raw change, controlling for admission scores, or additionally controlling for length of stay.
Conclusions: In a population of individuals seeking higher level of care for an ED and controls matched for age, gender, sex, diagnosis, level of care, and race, treatment with ketamine was associated with significant reductions in depression and ED severity, but not more so than individuals not treated with ketamine. Findings from the study suggest that ketamine may be a viable treatment option for individuals with EDs, however, further research is needed to determine ketamine’s efficacy in treating EDs with comorbid depression.