Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter

NO. 271: Positive BI, Part 4 (n = 3); (ii) Dietary Restriction/Restraint, Part 2 (n = 2); (iii) Eating Pathology, Part 4 (n = 3); (iv) Technology, Part 1 (n = 2); and (v) Help-Seeking, Part 1 (n = 2)

May 21, 2026

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 CONSULTATION:

Our own Selen Ozbek, MSc, GMBPsS (England),

as part of her doctoral research in Health Psychology at UWE Bristol

is looking to consult with

ACT practitioners: Psychologists, psychotherapists, intervention facilitators, or trainers who (a) use Acceptance and Commitment Therapy as part of their work and (b) have experience working with clients facing weight stigma or body image concerns

via a

A. Virtual meeting tomorrow, on Friday, May 22, at 5:00 p.m. BST | 9:00 a.m Pacific | 12:00 p.m. Eastern | 4:00 p.m. UTC, OR

B. Virtual meeting at an alternative time, to be arranged, OR

C. Review of materials sent by email

Received 19 May 2026 via an everything-is-advocacy email from our own Selen Ozbek, MSc, GMBPsS (England).

ML NOTE 1: Selen, her graduate advisors, and I would appreciate it if you would pass this along to any and all who are eligible and might be interested, and/or to those who work with, supervise, or otherwise know people who are eligible and might be interested.

[Selen writes:]

I am a doctoral student in Health Psychology at UWE Bristol, and my research is looking into how Acceptance and Commitment Therapy (ACT) is used to address weight stigma. Before finalizing the methodology, I am conducting a brief stakeholder consultation to refine the study materials.

I am looking to consult with:

ACT practitioners: Psychologists, psychotherapists, intervention facilitators, or trainers who use ACT as part of their work.
Have experience working with clients facing weight stigma or body image concerns

What is involved: A brief, informal 20-minute virtual chat (or email review, if preferred) to give your expert feedback on my overarching research question and draft interview guide.

This is an advisory role to shape the methodology, not a formal research participation.

I am holding a meeting at 5pm BST on the 22nd of May and will of course arrange alternative dates that may fit you better.

If you fit the criteria and have a few minutes to help shape this research, I will be very grateful! Please email me at selen2.ozbek@live.uwe.ac.uk

NOTICE OF U.S. FEDERAL GRANT OPPORTUNITY

To develop a

Center of Excellence for Eating Disorders

Anticipated Total Available Funding: $1,873,148

Application Deadline is June 24, 2026

Received yesterday, May 20, 2026, via an Notice of Funding Opportunity email from the Substance Abuse and Mental Health Services Administration (SAMHSA) of the United States government. The text of the email states:

The purpose of this program is to create a Center of Excellence for Eating Disorders. The Center will provide national training and technical assistance (TTA) to healthcare providers on screening, brief intervention, and referral to treatment for eating disorders. The Center will also provide TTA to paraprofessionals and relevant non-clinical community service providers. The TTA is intended to identify and support individuals across the lifespan, including children and youth, with or at risk for eating disorders.

Learn more at: https://tinyurl.com/2z3kdf6u

Short Title: COE-ED | Modified Announcement

Due to Grants.gov maintenance, the application due date has been extended until June 24, 2026.

NOFO Number: SM-26-031

Posted on Grants.gov: Wednesday, May 20, 2026 | Application Due Date: Wednesday, June 24, 2026 | Catalog of Federal Domestic Assistance (CFDA) Number: 93.532

Intergovernmental Review (E.O. 12372): Applicants must comply with E.O. 12372 if their state(s) participates. Review process recommendations from the State Single Point of Contact (SPOC) are due no later than 60 days after application deadline.

Public Health System Impact Statement (PHSIS) / Single State Agency Coordination: Applicants must send the PHSIS to appropriate State and local health agencies by application deadline. Comments from Single State Agency are due no later than 60 days after application deadline.

Eligibility: Eligible applicants are domestic public and private non-profit entities.

AWARD INFORMATION

Funding Mechanism: Cooperative Agreement

Anticipated Total Available Funding: $1,873,148

Anticipated Number of Awards: 1

Anticipated Award Amount: Up to $1,873,148 per year

Length of Project: Up to 5 years

Cost Sharing/Match Required? No

Proposed budgets cannot exceed $1,873,148 per year in total costs (direct and indirect) in any year of the proposed project. Annual continuation awards are contingent on the availability of funds, progress in meeting project goals and objectives, timely submission of required data and reports, compliance with all terms and conditions of award, and alignment with SAMHSA, HHS, and Trump Administration priorities.

CONTACT INFORMATION — Program and Eligibility Questions: Adam Wheeler | Center for Mental Health Services | 240-276-1068 | coe_ed@samhsa.hhs.gov

Financial and Budget Questions: Office of Financial Resources | Division of Grants Management | 240-276-1940 |NOFOBudget.CMHS@samhsa.hhs.gov

Research Publication Categories in This Newsletter

(i) Positive Body Image, Part 4 (n = 3); (ii) Dietary Restriction/Restraint, Part 1 (n = 2); (iii) Eating Pathology, Part 4 (n = 3); (iv) Technology, Part 1 (n = 2); and (v) Help-Seeking, Part 1 (n = 2)

CONGRATULATIONS to our own

Dr. Phaedra Longhurst (England), Dr. Fidan Turk (England), Lindsay Gillikin (USA), and Dr. Viren Swami (England/Malayasia; see also #2) for publication of the Positive Body Image research article in #1.
Drs. Viren Swami (England/Malayasia) and Tracy Tylka (USA) and colleagues for publication of the Positive Body Image research article in #2
Reza Sahlan (USA) and Drs. Wesley Barnhart (USA), Jason Nagata (USA), and Jinbo He (China) and colleagues for publication of the Eating Pathology research article in #6.
Drs Neha Goel (USA), Marisol Perez (USA), and Suzanne Mazzeo USA) and colleagues for publication of the Eating Pathology research article in #8.
Drs. Mariel Messer (Australia) and Jake Linardon (Australia) and colleagues, including Drs. Ata Ghaderi (Sweden, #9) and Hannah Jarman (Australia, #9), for publication of the Technology review article in #9 and the Technology research article in #10.
Drs. Keisha Gobin (Canada) and Kristen Lucibello (Canada) and colleagues for publication of the Help-Seeking Research article in #11.

POSITIVE BODY IMAGE, Part 4 of 5

1. Longhurst, P, Turk, F., Gillikin, L., & Swami, V. (2026). "I'm not concerned with being 'attractive'": A qualitative study of positive body image in asexual adults in an allonormative society. Body Image, 57, 102084. https://doi.org/10.1016/j.bodyim.2026.102084

Full text available for download at: https://tinyurl.com/4c8us3tp

ABSTRACT. Although body image scholars are increasingly centring marginalised communities in their research, individuals who identify as asexual or on the asexual spectrum remain largely invisible in this work. To overturn this, we explored understandings and experiences of positive body image in asexual adults using reflective thematic analysis.

One-to-one semi-structured interviews were conducted with 15 asexual adults (five woman-identifying, six man-identifying, four identifying as gender diverse or non-binary; aged 20-45 years) from the United Kingdom. Our analyses revealed four themes that illustrate the core characteristics of positive body image in our participants: Appreciating and Respecting the Body; Body Authenticity; Body and Self-Acceptance; and Countering Aesthetic Norms.

Our findings suggest that, while some aspects of positive body image in asexual individuals reflect similarities with other communities, the challenges of heteronormativity and allonormativity mean that asexual individuals sometimes rely on unique processes to develop and maintain positive body image. Further research with this marginalised community is necessary to better understand how developing an asexual identity can foster more positive body image, and what this may mean for allonormative societies.

2. Maïano, C., Swami, V., & Tylka, T. L., & Aimé, A. (2026). The Functionality Appreciation Scale: An examination of its psychometric properties in a French-Canadian adult sample. Body Image, 56. Advance online publication. https://doi.org/10.1016/j.bodyim.2026.102044

ML NOTE 2: In regard to the article described below in #3 and to the work of Alleva and Glashouwer and colleagues, see also

a. Glashouwer, K. A., Weiland, S., & Alleva, J. M. (2025). Expand Your Horizon: Testing a brief writing intervention focused on body functionality among adolescent girls with an eating disorder. International Journal of Eating Disorders, 58(7), 1381-1391. https://doi.org/10.1002/eat.24444 [Full text available for download at: https://tinyurl.com/2uwpdf4k]

b. as, presented 3 March 2026, in Newsletter NO. 241 (#9):

Ramesh, S., Glashouwer, K. A., & Alleva, J. M. (2026). Functionality appreciation among adolescents and emerging adults with eating disorders: Associations with body appreciation, self-esteem, and eating disorder symptoms. Body Image, 56. Advance online publication. https://doi.org/10.1016/j.bodyim.2026.102056 [Full text available for download at: https://tinyurl.com/pzu57c4r]

3. Weiland, S., Alleva, J. M., & Glashouwer, K. A. (2025). Expand Your Horizon: A qualitative analysis of how adolescent girls with an eating disorder describe their body functionality. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1111/eat.70006

Full text available for download at: https://tinyurl.com/3cnkw6jd

ABSTRACT. Objective: Negative body image is thought to play an important role in the onset and maintenance of anorexia nervosa and bulimia nervosa. The intervention Expand Your Horizon (EYH), which is focused on increasing functionality appreciation, is being investigated as a potential approach for improving body image. This study investigated the themes that were identified when adolescent girls with an eating disorder are asked to describe their body functionality within the context of EYH.

Method: Fifty-eight girls with an eating disorder received the EYH intervention and wrote about everything their body can do and why these functions are meaningful to them. The qualitative data were analyzed via Thematic Analysis. Results: We identified five themes from the data: body functions as a means to experience and regulate emotions; body functions as a vehicle to form social connections; body functions as a means to experience independence and identity; how body functions are intertwined with the eating disorder; and the aesthetic body.

Discussion: This study highlights the importance of body functionality in the experiences and perceptions of adolescent girls with eating disorders. The findings support the idea that adolescents with eating disorders are able to appreciate their bodies for what they can do rather than focusing solely on their appearance.

DIETARY RESTRICTION AND RESTRAINT, Part 2 of 3

4. Zhao, P., Xu, J., Ma, X., & Wang, H. (2026). Dynamic bidirectional relationships between weight concerns, restrained eating, and psychological distress in Chinese young adults: A daily diary study. Body Image, 57. Advance online publication. https://doi.org/10.1016/j.bodyim.2026.102090

Email address for correspondence: huiwang@bnu.edu.cn

ABSTRACT. Weight concerns, restrained eating, and psychological distress are known to be interconnected, yet their dynamic and bidirectional relationships in daily life remain insufficiently explored. Moreover, little is known about how individual differences—such as body weight contingency of self-worth (CSW)—may moderate these associations. This study examined the bidirectional relationships among these variables in Chinese young adults using a 14-day daily diary design.

Participants were 187 Chinese young adults (M = 18.87 years, SD = 0.85 years; 75.4% females). Employing dynamic structural equation modeling (DSEM), we texted autoregressive, cross-lagged, and feedback effects. Results revealed significant autoregressive effects for all three variables. Weight concerns and restrained eating were bidirectionally linked, and a significant feedback loop between them indicated a self-reinforcing cognitive–behavioral cycle. In contrast, weight concerns predicted subsequent psychological distress, but not vice versa. Notably, among individuals high in body weight CSW, the cross-lagged effects between weight concerns and psychological distress became reciprocal, accompanied by a significant feedback loop, suggesting a tighter coupling between cognitive and emotional facets of body image.

These findings underscore the dynamic and interdependent nature of body image-related functioning, highlighting the need for integrated interventions that address both maladaptive weight-related cognitions and emotional regulation, particularly for individuals whose self-worth is closely tied to body weight.

5. Madan, R., & Martinelli, C. (2026). Food-related attentional biases in restrained eaters: A meta-analysis. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.70090Digital Object Identifier (DOI

Full text available for download at: https://tinyurl.com/47n9zfb4

ABSTRACT. Objective: Dietary restraint may contribute to the development and maintenance of eating disorders (EDs), with food-related attentional biases (ABs) as a key underlying mechanism. We examined associations between dietary restraint and ABs and explored how several methodological factors (i.e., AB mechanism, mode of AB investigation, response task type, stimulus task relevance, and type of food stimulus) might influence these associations.

Method: Database searches followed the guidelines set by the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). We included empirical studies that measured both dietary restraint and ABs, excluding studies involving participants with clinical diagnoses or below 16 years of age. Fifty-one eligible articles were identified, of which 29 unique samples were included in the final analyses. The protocol for this meta-analysis was preregistered at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=532562.

Results: We first examined associations between dietary restraint and attentional maintenance and orienting, separately. This was followed by subgroup analyses to examine whether these associations varied based on the chosen methodological factors. Our findings revealed significant associations between dietary restraint and attentional maintenance in studies that used response tasks (other than the dot probe task), and where the food stimuli were relevant to the task instructions.

Discussion: Collectively, these findings suggest that dietary restrainers activated strategic top-down processing of food cues, rather than the reflexive orienting linked to ED-driven saliency processing. Overall, this may be interpreted as more purposeful monitoring to facilitate restraint when food is relevant to the goals and actions of dietary restrainers.

EATING PATHOLOGY (DISORDERED EATING BEHAVIORS and ED PSYCHOPATHOLOGY), Part 4 of 7

6. Wang, P., Xiao, Y., Cheng, Y., Sahlan, R. N., Barnhart, W. R., Nagata, J. M., & He, J. (2026). Longitudinal associations of body image flexibility with eating disorder psychopathology, eating-related psychosocial impairment, and psychological distress in Chinese cisgender men and women. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70120

Email address for correspondence: Jinbo.He@xjtlu.edu.cn

ABSTRACT. Objective: Body image flexibility is a clinically relevant protective process linked to lower eating disorder psychopathology and better psychological functioning, yet its longitudinal role in shaping psychological risk and resilience remains unclear, particularly across women and men in non-Western contexts. This study examined its bidirectional associations with thinness- and muscularity-oriented disordered eating, eating-related psychosocial impairment, and psychological distress among Chinese adults.

Method: Chinese adults completed baseline (N = 800; 400 women and 400 men) and eight-month follow-up (N = 491; 246 women and 245 men) online surveys. Cross-lagged panel models were used to examine bidirectional associations.

Results: Higher body image flexibility at T1 was related to lower levels of thinness-oriented disordered eating, muscularity-oriented disordered eating, eating-related psychosocial impairment, and psychological distress at T2. Conversely, higher levels of thinness-oriented disordered eating, muscularity-oriented disordered eating, eating-related psychosocial impairment, and psychological distress at T1 were related to lower body image flexibility at T2. These bidirectional associations were consistent across women and men.

Discussion: Body image flexibility can function both as a protective resource and as a process susceptible to psychological strain. Intervention efforts should be gender inclusive and target multidimensional forms of eating disorder psychopathology alongside psychological well-being.

7. Wang, P., Zhang, W., Chen, C., & Yim, I. S. (2026). A mixed-methods study of body esteem, disordered eating behaviors, acculturative stress, and sociocultural correlates among female Chinese international students. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01599-6

Full text available for download at: https://tinyurl.com/2s3epvch

ABSTRACT. Background: Global migration has heightened the need to understand how cultural transitions influence body image and eating behaviors. In the U.S., Chinese international students represent one of the largest migrant student groups, with women showing particular vulnerability to body image concerns and disordered eating. Yet, the ways in which cultural transition and acculturative stress shape these outcomes remain insufficiently studied.

Methods: This study investigated female Chinese international students using online surveys with free-response questions administered during researcher-supervised video sessions prior to their migration to the U.S. for college (N = 127) and again six months after arrival (n = 113; 89% retention).

Results: Across time, participants reported lower body esteem, higher emotional eating, and higher BMI, while perceived sociocultural pressures from different sources and internalization of different body ideals remained stable. Acculturative stress was associated with greater muscular-ideal internalization, lower body esteem, and higher uncontrolled eating at follow-up, even after accounting for pre-migration levels. Qualitative analyses provided additional context, with participants describing shifts toward muscular/fit ideals in the U.S. that shaped body image concerns, dissatisfaction with food environments that fueled eating concerns, and other experiences influencing body image and eating behaviors.

Conclusions: By integrating quantitative and qualitative evidence, this study contributes to the limited research on international migrants and underscores the associations between acculturation experiences, acculturative stress, body image, and eating. Findings highlight food environments and cultural ideals as complex factors within acculturation and tripartite influence models and point to actionable strategies for policies and interventions supporting international students during cultural transition.

8. Goel, N. J., Kaur, B., Sullivan, T., Perez, M., Tummala-Narra, P., & Mazzeo, S. E. (2026). Cultural adaptation of an eating disorders measure for South Asian American women. Asian American Journal of Psychology. Advance online publication. https://doi.org/10.1037/aap0000400

Email address for correspondence: njgoel28@gmail.com

ABSTRACT. Available eating disorder (ED) assessments do not adequately capture cultural nuances in eating psychopathology presentations in South Asians (SAs). The present study describes the cultural adaptation process of the Eating Disorder Examination–Questionnaire for SA American women to enhance its validity, applicability, and cultural relevance for this underserved group.

The research team consulted with participant experts (N = 24) and research experts (n = 4) to create the modified measure. Some items were changed to include SA references; others were added to assess culturally specific body image and eating pressures, such as colorism and religious fasting. Notable feedback from participant and research experts that was incorporated into this measure included: separating weight and shape items, changing the response format of the behavioral frequencies, and incorporating items assessing subjective binge eating episodes. This new measure—the Eating Disorder Examination–Questionnaire-South Asian American women—included 53 items prior to psychometric validation.

To the best of our knowledge, few—if any—previous cultural adaptations of ED measures have added new items to tap into culturally influenced constructs that likely impact ED presentations. Ultimately, this tool can enhance understanding of the nature, presentation, and cultural variation of EDs in SAs. This study is also one of the first to demonstrate how other clinical scientists can culturally adapt measures without translation.

TECHNOLOGY, Part 1 of 2

9. Anderson, C., Soliman, O. M., Moffitt, R. L., Ghaderi, A., Jarman, H. K., Liu, C., McClure, Z., Messer, M., & Linardon, J. (2026). Acute, longer-term, and transdiagnostic outcomes after digital interventions for eating disorders: A meta-analysis. JAMA Psychiatry. Advance online publication. https://doi.org/10.1001/jamapsychiatry.2026.0668

Key Points. Question: What are the acute, longer-term, and transdiagnostic outcomes associated with digital interventions for eating disorders? Findings: This meta-analysis of 36 randomized clinical trials found that digital interventions were associated with moderate effect sizes in core eating disorder symptoms in both the acute and longer-term phases and are associated with transdiagnostic benefits for comorbid mental health symptoms and well-being indicators. Meaning: These findings highlight the clinical utility of digitally delivered interventions for eating disorders, supporting their use as a scalable, flexible, and inexpensive format for narrowing the treatment gap.

ABSTRACT. Importance: Digital interventions are increasingly promoted as scalable options for reducing the treatment gap in eating disorders, with the evidence base expanding in recent years to include new populations, delivery formats, and therapeutic approaches. A comprehensive, up-to-date synthesis is needed to clarify the current evidence for digital treatment delivery formats in eating disorders. Objective: To evaluate the association of digital interventions for eating disorders with core and transdiagnostic symptom outcomes in the acute and longer-term phases.

Data Sources: MEDLINE, PsycINFO, Web of Science, and Scopus were searched (October 2025) using terms related to eating disorder, digital health, and randomized clinical trials. Study Selection: Randomized clinical trials evaluating a digital intervention for threshold or subthreshold eating disorders were eligible. Interventions had to be delivered via digital technologies (eg, websites, applications, chatbots), with or without support, and compared against a control.

Data Extraction and Synthesis: Two reviewers extracted data. Risk of bias was assessed using 4 Cochrane risk of bias criteria. Meta-analyses were conducted using random-effects models, calculating Hedges g for continuous outcomes and odds ratios for symptom abstinence. Main Outcomes and Measures: Primary outcomes included core eating disorder symptoms (global eating disorder psychopathology, binge eating frequency, compensatory behaviors, abstinence, and symptom-specific subscales). Secondary outcomes included comorbid mental health symptoms (depression, anxiety, general distress) and general well-being (quality of life, clinical impairment, self-esteem).

Results A total of 36 trials were included. At posttreatment assessment, digital interventions compared with controls produced significant improvements in primary eating disorder psychopathology (Hedges g = 0.49; 95% CI, 0.38-0.60) and objective binge eating (Hedges g = 0.37; 95% CI, 0.24-0.51) outcomes, as well as other symptom-specific and comorbid mental health outcomes. Effect sizes largely remained significant when adjusting for various sources of biases. Significant benefits were mostly observed across specific clinical populations (eg, bulimia nervosa, binge-eating disorder). Effect sizes were largest for trials that used a waiting list relative to other controls. At follow-up, digital interventions produced weaker but statistically significant sustained improvements for 7 of 9 outcomes.

Conclusions and Relevance In this study, digital interventions were associated with consistent and durable benefits across numerous symptom-specific and transdiagnostic outcomes. These results highlight their potential to expand access to evidence-based support and to inform future clinical implementation efforts.

10. Linardon, J., & Messer, M. (2026). Benchmarking generative artificial intelligence against human judgment in eating disorder case recognition and treatment recommendations. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.70128

Full text available for download at: https://tinyurl.com/yc24s79r

ABSTRACT. Objective: Generative AI is now used to access eating disorder (ED) information, yet the suitability of its outputs remains unclear. Using two vignettes, we evaluated generative AI’s ability to accurately identify ED presentations and recommend appropriate care, while benchmarking its performance against published responses from human samples.

Method: ChatGPT-5.4 was presented with two vignettes and prompted with questions related to problem identification and treatment recommendation. Vignette one depicted a restrictive ED consistent with anorexia nervosa or atypical anorexia nervosa, with body weight varying across low-, average-, and higher-weight conditions. Vignette two depicted a person with binge-eating disorder (BED). Responses across 20 prompt administrations per vignette were compared against benchmark data from clinicians for vignette one and community participants for vignette two.

Results: For vignette one, ChatGPT identified an ED or possible ED in 100% of responses for the low- and average-weight conditions and 90% for the higher-weight condition, compared with 47%, 21%, and 16% among human clinicians, respectively. It recommended specialized ED treatment 100% of the time across all three weight conditions, compared with 35%, 19%, and 17% of clinicians, respectively.

For vignette two, ChatGPT correctly identified BED as the problem in 100% of prompt repetitions (vs. 59% in community participants) and more consistently endorsed evidence-based treatments than community participants (100% vs. 50%). Supplementary analyses confirmed similar results when prompting Gemini-3 and Claude-4.5. Conclusion: Generative AI can accurately identify ED presentations and recommend suitable care in structured scenarios, while showing little evidence of common biases observed in human samples.

HELP SEEKING, Part 1 of 2

11. Laliberte, M. M., Gobin, K. C., Potechin, M. B., Lucibello, K. M., Potter, S., & Grant-Allen, G. (2026). Emerging adults seeking treatment for their eating disorder: An empirical look at young adults relative to adults over 25. European Eating Disorders Review, 34(3), 811-822. https://doi.org/10.1002/erv.70068

Email address for correspondence: kgobin@stjoes.ca

ABSTRACT. Aim: Emerging adults (EAs), aged 18–25, may have distinct characteristics and, therefore, treatment needs compared to adults over 25 (adults > 25) that are poorly understood. Objective: This study compares EAs to adults > 25 entering eating disorder (ED) treatment to better characterise their differences.

Method: Participants were 623 individuals (332 EAs; 291 adults > 25) with anorexia nervosa, bulimia nervosa, or related OSFED, referred to outpatient ED treatment from 2004–2020. Using retrospective demographic data, assessment information, and treatment attendance, EAs were compared to adults > 25 on: demographic characteristics, high-risk behaviours, diagnostic profiles, substance use, and treatment engagement. EAs with and without prior ED treatment were compared.

Results: Over half (55%) of EAs report living with family versus 14% of adults > 25. EAs reported more self-harm, ED-related theft, and greater cannabis use than adults > 25. While there were no differences in rates of comorbidity, EAs were less likely to have received treatment for comorbid illnesses. EAs without previous ED treatment were also more likely to disengage from treatment than those with prior treatment. Conclusions: EAs and adults > 25 demonstrate similar diagnostic profiles and rates of treatment drop-out. However, EAs may need individualised treatment planning for high-risk behaviours and comorbid illnesses. Recommendations for the care of EAs in adult programs are made.

12. Lehe, M. S., Halbeisen, G., Juergensen, V. C., Sabel, L., Steins-Loeber, S., & Paslakis, G. (2025). Boys don’t try? Gendered stigma specifically reduces help-seeking for disordered eating in men, but not women. Journal of Eating Disorders, 13, 204. https://doi.org/10.1186/s40337-025-01407-7

Full text available for download at: https://tinyurl.com/6p27422c

ABSTRACT. Background: Eating disorders (EDs) affect individuals across all genders, but men remain underrepresented in ED treatment settings. Stigma related to EDs in men may impede help-seeking, particularly for symptoms that deviate from traditional masculine ideals. This study investigates whether stigma-related perceptions of EDs in men specifically moderate the association between disordered eating symptoms and help-seeking intentions in men, i.e., whether there is a gender-specific component of ED stigma.

Methods: In a cross-sectional survey, n = 242 men and n = 249 women completed questionnaires on various disordered eating symptoms (“traditional” thinness-oriented, muscularity-oriented, orthorexic, and avoidant/restrictive eating behaviors), stigma-related perceptions of EDs in men, and help-seeking intentions. Moderator analyses were conducted by gender to explore interactions between symptom severity and stigma in predicting help-seeking intentions.

Results: Help-seeking intentions increased with the severity of disordered eating symptoms in both men and women, except for avoidant/restrictive eating behavior in both genders and muscularity-oriented symptoms in men. Stigma-related perceptions of EDs in men moderated the association between symptoms and help-seeking intentions in men, which was exclusively the case for “feminized” ED symptoms (i.e., thinness and weight concerns). No moderation effects were observed for other symptom domains or among women.

Conclusions: Results support the notion of a gender-specific role of stigma in men’s help-seeking behaviors for EDs. Such stigma, which seems to be related to “feminized” ED symptoms, may contribute to men’s reluctance to seek help for EDs. These findings emphasize the need for interventions tailored to reduce stigma, particularly regarding men’s experiences of EDs, to support equal access to healthcare.

Michael’s Substack

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