Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 256: (i) Big Picture; (ii) Methodology: Meta-Analysis; (iii) Risk Factors, Part 1 (n = 2) ; (iv) Eating Pathol, Part 8 (n = 2); (v) Trauma, Part 2 (n = 3); Feb-Mar Tx Interlude, Part 3 (n = 3)
Colleagues (N now = 1453 in 49 countries),
Please continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications, etc.
REQUEST FOR RESEARCH PARTICIPATION BY AND/OR ASSISTANCE RECRUITING
U.S. English-Speaking Adults (≥ 18 years old) Who are the Primary Caregivers of a Child Who is Receiving Treatment for Anorexia Nervosa
from Katherine Raguin, M.A. (USA), Clinical Doctoral Student at Pacific University in Oregon (USA)
for a study (ML, paraphrasing, has) entitled
Understanding Caregiver Burden in Pediatric Anorexia Nervosa
Received this morning (California time) via a post to the Academy for Eating Disorders’ Research Opportunities Digest by by Katherine Raguin, M.A. | Clinical Psychology Doctoral Program | Pacific University (Oregon, USA)
ML NOTE 1: Katherine, her advisor (Dr. Harris). and I would appreciate it if you would participate if eligible and/or pass this request along to any and all who are eligible and/or who provide treatment for or otherwise know people who are eligible. A recruiting flyer is available from Katherine at ragu4869@pacificu.edu.
Understanding Caregiver Burden in Pediatric Anorexia Nervosa
I am seeking clinicians who work with parents of children and adolescents diagnosed with and receiving treatment for anorexia nervosa to help share an IRB-approved study (Pacific University IRB: 005-26; approved February 13, 2026; expires February 13, 2031) with eligible families.
Below is a sample email script that can be provided to caregivers who may be interested in participating:
My name is Katherine Raguin, M.A. and I am a doctoral student in Clinical Psychology at Pacific University. I am soliciting participants for a research study I am conducting.
The purpose of this research is to gain a better understanding of caregiver burden in pediatric anorexia nervosa. It should take about 10 minutes to complete the surveys for my study. You will be asked to answer questions related to the challenges of caregiving for a child with anorexia, anxiety, depression, personality traits, and some demographic or background items.
After completing the online survey of self-report measures, you will be able to be entered in a drawing where six (6) 50$ gift cards will be raffled off after the conclusion of data collection.
To be eligible to participate you must:
1. Be 18 years of age or older
2. Live in the United States
3. Understand English
4. Be the primary caregiver of a child with anorexia nervosa
5. Your child must be receiving treatment for anorexia nervosa
More information about the risks and benefits of participating and how we will protect the privacy and confidentiality of the information you provide is explained in the informed consent. If you meet all eligibility criteria and would like to participate in this study, please click the link below to be taken to the consent form and self-report measures.
Click or open this link to go to the survey on Exploring Caregiver Burden in Pediatric Anorexia: https://pacificu.co1.qualtrics.com/jfe/form/SV_bIN2HyXnUq7TOEm
If you have any questions, please contact either myself or my research advisor:
• Katherine Raguin (she/her); School of Graduate Psychology; ragu4869@pacificu.edu
• Dr. Robert Harris (he/him); School of Graduate Psychology; rharris@pacificu.edu
Note: This study is approved by the Pacific University human subjects research ethics committee
Katherine Raguin | Doctoral Student | Pacific University | Hillsboro OR
EVERYTHING-IS-ADVOCACY
Request for Subject Matter Experts to provide feedback
from Isadora Gallanar, BA | Master’s Student in Clinical Mental Health Counseling | George Washington University (USA)
For a Set of Items Developed for an Instrument Measuring Orthorexic symptomatology
Received this morning (California time) via a post to the Academy for Eating Disorders’ (AED’s) Main Discussion Community by Isadora Gallanar, BA | Master’s Student in Clinical Mental Health Counseling | George Washington University (USA)
ML NOTE 2: Isadora, Peter McCrea, their advisor(s). and I would appreciate it if you would participate if eligible and/or pass this request along to any and all who are eligible and/or who work with or otherwise know people who are eligible.
ML NOTE 3: This post has been approved by AED committee members. This is not a formal research study but rather a request for Subject Matter Experts to review and provide feedback on the proposed scale
Dear colleagues,
I am writing to recruit eating disorder professionals to serve as subject matter experts (SME) for a set of items developed for an instrument measuring orthorexic symptomatology. I would greatly value your perspective in evaluating the conceptual and clinical adequacy of these items.
The purpose of this assessment is to measure clinically significant patterns of orthorexia nervosa (ON) over a three-month period. We have conceptualized ON as an obsessive preoccupation with an overvaluation of food quality, nutrition, and its perceived impact on health, accompanied by affective distress, functional impairment, and cognitive rigidity. A central aim of this instrument is to differentiate pathological orthorexic symptomatology from healthy or adaptive health-oriented eating behaviors (often referred to as healthy orthorexia).
Although ON is not currently recognized as a distinct diagnosis in the DSM-5-TR, the scale adopts a three-month reporting period consistent with DSM-5-TR eating disorder criteria to assess persistence and clinical salience.
Our target population comprises adolescents and young adults, aged 13 to 25. This developmental period may be associated with increased vulnerability to orthorexic
symptomology due to sensitivity to social evaluation, identity formation, and exposure to sociocultural influences such as social media content that moralizes food, glorifies dietary control, and reinforces wellness perfectionism. The instrument is intended to offer a developmentally sensitive operationalization of ON that explicitly incorporates sociocultural and social media–related influences on symptom development and maintenance.
All items have undergone a multi-stage revision process, informed by empirical literature, preliminary diagnostic criteria, and existing ON measures (e.g., ORTO-15, DOS, ONI). Items have been split into four domains: cognitive, affective, behavioral, and sociocultural. Particular care was taken to avoid over-pathologizing normative or medically indicated health behaviors.
As an SME, you will be asked to review each item and provide quantitative ratings and optional qualitative feedback via a secure Google Form. Specifically, we are seeking your input on:
1. Item Relevance: Does each item accurately reflect the construct it is intended to measure?
2. Item Clarity: Is each item clearly worded and easily understood by the target population?
3. Conceptual Necessity: Is each item essential, useful but not essential, or not necessary for defining the construct?
4. Comprehensiveness: Does the overall item set capture the full range of orthorexic symptomatology for adolescents and young adults?
You will also have the opportunity to provide open-ended feedback regarding item wording, redundancy, ambiguity, construct overlap (e.g., with OCD or anorexia nervosa), or missing content areas.
Time Commitment
Participation will involve reviewing and rating approximately 30 items assessing orthorexia-related attitudes and behaviors in adolescents and young adults, along with providing optional qualitative feedback. The review process is expected to take approximately 30–40 minutes to complete. Item-level comments are optional and may be provided only for items that raise concerns.
Thank you for considering this request and for contributing your time and expertise to the development of this assessment tool. Please feel free to contact us with any questions or additional comments.
If you have any questions, please contact izzy.gallanar@gwu.edu or peter.mccrea@gwu.edu
Google Form Link: forms.gle/DZf5pmm7EwuHZWL29
Isadora Gallanar (she/her), BA | Master’s Student in Clinical Mental Health Counseling | George Washington University | izzy.gallanar@gwu.edu
Research Publication Categories in This Newsletter
(i) Big(ger) Picture: Protecting Against Fraud in Research; (ii) Methodology: Meta-Analysis; (iii) Risk Factors, Part 1 (n = 2) ; (iv) Eating Pathology, Part 8 (n = 2); (v) Trauma, Part 2 (n = 3); and (vi) February-March Treatment Interlude, Part 3 (n = 3)
CONGRATULATIONS to our own
Drs. Jamie-Lee Pennesi (Australia), Mia Pellizzer (Australia), and Tracey Wade (Australia) for publication of the Big(ger) Picture article in #1.
Taylor Stanley (USA) and Dr. April Smith (USA) and colleague for publication of the Eating Pathology research article in #6.
Dr. Jennifer Thomas (USA) and colleagues for publication of the Treatment review article in #10.
BIG(GER) PICTURE: Safeguarding Online Research in Eating Disorders Against Fraud
1. Pennesi, J.-L., Pellizzer, M. L., & Wade, T. D. (2026). Safeguarding online research in eating disorders against fraud: Increasing risks and practical recommendations. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.70083
Full text available for download at: https://tinyurl.com/ynkpsvhz
ABSTRACT. Objective: Recent growth of online research has been accompanied by an increase in reports of fraudulent participants, which can significantly comprise research validity. Drawing from our experience using Qualtrics with open recruitment, existing literature, and emerging studies in eating disorders (ED), we outline the risk and provide simple, practical recommendations for preventing, detecting, and managing fraudulent participants in online ED research.
Method: Over the conduct of a three-round Delphi consensus study with 138 English-speaking individuals aged 18 and older, we were inundated with fraudulent sign-ups between July and August 2024, despite implementing multiple fraud prevention strategies. In response, we introduced additional fraud mitigation strategies and established a three-step procedure for identifying and managing fraudulent participants.
Results: The additional fraud mitigation measures, including a second reCAPTCHA, a duplicate question for consistency checks, and modified attention check questions, potentially aided in preventing further fraudulent sign-ups. Our procedure involving manual comprehensive review of all incoming survey data and checks against a fraudulent participants’ profile enabled us to identify and withdraw suspected or likely fraudulent participants.
Discussion: With increasing fraudulent participation rates and rapidly advancing technological advancements such as artificial intelligence, all online studies are at risk and researchers need to be proactive in their use of antifraud practices to safeguard online research. Our practical recommendations can assist future researchers in managing fraudulent participants.
METHODOLOGY: Misconceptions About Meta-Analysis
ML NOTE 4: The article described below in #2 came to my attention via the Obesity and Energetics Offerings (OEO) online newsletter of 3 April 2026. For more information about free participation in the OEO online newsletter series as an ongoing and valuable exercise in education, research methods, and critical thinking, see Obesity and Energetics Offerings.
2. Elmakaty, I., Abdulmajeed, J., Chivese, T., Khan, M. N., Stone, J. C., Doi, S. A. R. (2026). Six entrenched misconceptions about meta-analysis models. Journal of Evidence-Based Medicine. Advance online publication. https://doi.org/10.1111/jebm.70120
Email address for correspondence: sdoi@qu.edu.qa
ABSTRACT. Meta-analysis has become central to evidence-based medicine, yet persistent misconceptions continue to distort how models are selected and interpreted. This paper identifies and clarifies six entrenched misconceptions that have shaped the practice of meta-analysis for decades. It first challenges the belief that the choice of parameter assumption determines whether inference can extend beyond the included studies, emphasizing that conditional or unconditional inference arises from the analyst’s scientific objective—not from the model or its assumptions. Second, it corrects the notion that the fixed-effect (FE) model is the only model under the common parameters assumption (aCP), noting that several modern models within this framework can accommodate heterogeneity.
Third, it dispels the idea that only random-effects (RE) models can address heterogeneity, showing that this property exists under any parameter assumption. Fourth, it refutes the practice of letting observed heterogeneity dictate model choice, arguing that parameter assumptions and inferential purpose must guide decisions instead. Fifth, it challenges the claim that RE estimators best handle overdispersion, demonstrating persistent error-estimation flaws and inflated type I error rates.
Finally, it contests the view that heterogeneity renders aCP-based models unrealistic, highlighting that recent aCP models handle such diversity effectively. By disentangling these misconceptions, the paper proposes a purpose-driven, assumption-aware framework for model selection that prioritizes conceptual clarity, analytical validity, and reproducibility in evidence synthesis.
RISK FACTORS, Part 1 of 2
3. Morales, V., Cardozo, F., Balise, R. R., St. George, S. M., & Feaster, D. J. (2026). The utility of machine learning-enhanced developmental cascade models in prevention science. Prevention Science. Advance online publication. https://doi.org/10.1007/s11121-026-01897-0
Full text available for download at: https://tinyurl.com/4zvt23bt
ABSTRACT. Developmental cascade models provide a valuable framework for understanding how risk and protective factors interact over time to shape health and behavioral outcomes. Traditional statistical methods, such as logistic regression and structural equation modeling, have been instrumental in uncovering developmental pathways within prevention science. However, these methods often impose constraints on model complexity and face limitations in capturing the non-linear and interdependent nature of developmental processes.
Machine learning (ML) offers complementary advantages, such as the ability to incorporate high-dimensional data, detect complex interactions, and enhance predictive accuracy. These capabilities can improve identification of at-risk individuals, support the timing of interventions across developmental stages, and refine theory-driven models. By integrating ML with developmental cascade models, researchers can more effectively identify when and how which risk accumulates and protective factors exert influence, thereby improving the tailoring and efficiency of prevention strategies.
This conceptual paper outlines how ML can extend traditional analytic approaches in developmental cascade research, discusses key practical considerations for researchers including data requirements, software selection, and model validation, and highlights its potential to advance prevention science across the life course.
4. de Rijk, E. S. J., Roula Tsonaka, R., van Furth, E. F., Dingemans, A. E., & Slof-Op ’t Landt, M. C. T. (2026). Long-term eating disorder trajectories and the impact of depression: A naturalistic cohort approach. Eating Behaviors. Advance online publication. https://doi.org/10.1016/j.eatbeh.2026.102087
Email address for correspondence: e.de_rijk@lumc.nl
ABSTRACT. Objective: This study aimed to explore how depressive symptoms were associated with the course of eating disorders (EDs) in a longitudinal naturalistic cohort of individuals with a past or current ED. Method: Data from 1308 participants enrolled in the Netherlands Eating disorder Register was used. Participants completed one to seven waves of assessment, and the mean duration of follow-up was 98 months (range 0–112). At each follow-up, the presence or absence of an ED was assessed at symptomatic (objective presence of ED symptoms and behaviors) and subjective level (individual perception of illness status). Mixed-effects logistic regression analyses were performed to examine whether depressive symptoms were associated with ED outcomes over time, controlling for BMI, age and ED subtype.
Results: Higher levels of depressive symptoms at baseline were associated with increased odds of ED presence at each wave at symptomatic (OR = 2.22 at wave 0 to OR = 1.26 at wave 6) and subjective level (OR = 2.02 at wave 0 to OR = 1.41 at wave 6) with all p’s < 0.001. Over the course of the seven waves, no significant differences were observed between the two levels. Discussion: The results show that higher levels of depressive symptoms at baseline were consistently associated with the presence of EDs at follow-up in a naturalistic transdiagnostic sample. This underscores the importance of systematically assessing and addressing depressive symptoms throughout the entire course of EDs.
EATING PATHOLOGY (DISORDERED EATING BEHAVIOR + ED PSYCHOPATHOLOGY), Part 8 of 10
5. Gemescu, M., Giosan, C., Petre, C. A., Olguța Barizi, A. M., Paraschiv, B. D., Eating styles with some feeling: Latent profiles of appetitive and emotion-related impulsivity traits. Eating Behaviors. Advance online publication. https://doi.org/10.1016/j.eatbeh.2026.102083
Email address for correspondence: maria.gemescu@gmail.com
ABSTRACT. Introduction: Research focused on adult eating styles would benefit from investigating whether latent profiles of appetitive and emotion-related impulsivity traits differ in eating disorder (ED) and general psychopathology. Objective: This study identified and validated latent eating profiles based on appetitive and emotion-related impulsivity traits.
Method: We conducted a cross-sectional study in a non-clinical sample of 232 adults who completed an online battery of questionnaires assessing appetitive traits, emotion-related impulsivity, ED symptomatology, anxiety, depression, stress, and other clinical and background characteristics. We fitted latent profile analysis (LPA) models with 2–8 classes on the dataset without multivariate outliers (N = 223). After retaining the best profile solution, we compared latent classes using ANCOVAs and Tukey post-hoc tests, controlling for age.
Results: The best-fitting model revealed four distinct profiles: Resilient Eaters (23.30%), with the lowest food responsiveness and emotion-related impulsivity; Moderate Eaters (46.27%), showing higher food avoidance and behavioral emotion-related impulsivity; Hedonic Eaters (14.03%), characterized by the highest enjoyment of food and lower emotion-related impulsivity; and Impulsive Eaters (16.40%), with the highest food responsiveness and emotion-related impulsivity.
Resilient Eaters exhibited the most adaptive profile, with higher general and ED-specific flexibility and lower general ED psychopathology, depression, anxiety, and stress, compared to Moderate and Impulsive Eaters. Moderate and Hedonic Eaters showed intermediate levels of ED symptomatology and psychological distress, whereas Impulsive Eaters displayed the most maladaptive profile.
Conclusion: Classifying eating profiles based on appetitive and impulsive traits has the potential to advance screening for complex forms of ED psychopathology.
6. Stanley, T. B., Kearns, N. T., & Smith, A. R. (2026). Latent profiles of cannabis use patterns and associations with eating pathology outcomes. Addictive Behaviors, 174. Advance online publication. 10.1016/j.addbeh.2025.108564
Email address for correspondence: tbs0037@auburn.edu
ABSTRACT. As recreational cannabis increases among United States adults, there is growing interest in understanding potential health co-morbidities. Although past work supports cannabis use and eating disorder comorbidity, and cannabis enhances appetite and reward responses to food, little is known about how specific cannabis use patterns may relate to binge eating and other eating disorder symptoms. The purpose of this study is to identify distinct subgroups of recreational cannabis users based on several use characteristics, including subjective changes to appetite and hedonic properties of food using latent profile analysis, and to examine differences across profiles in binge eating, other eating disorder symptoms, and emotion regulation.
Participants (N = 435, male = 189) were adults recruited through Prolific who endorsed past-month cannabis use and completed a battery of self-report measures assessing cannabis use characteristics, eating changes while using cannabis, eating disorder symptoms, and emotion regulation. Results identified four profiles: “Infrequent Users, Moderate Eating Changes, Low Risk,” “Intense Users, Low Eating Changes, Mild Risk,” “High-Risk Coping Users, Strong Eating Changes,” and “Frequent Users, Slight Eating Changes, Mild Risk.”
All profiles reported more binge eating symptoms while under the influence of cannabis; the “High Risk Coping Users, Strong Eating Changes” profile reported the most severe sober binge eating, eating disorder, and emotion regulation difficulties. Findings highlight the utility of person-centered approaches for capturing co-morbidity risk and may help guide screening and intervention tools for determining eating disorder risk among those using cannabis.
TRAUMA, ABUSE, and MALTREATMENT, Part 2 of 4
7. Jowik-Krzemińska, K., Słopień, A., & Tyszkiewicz-Nwafor, M. (2026). Is it time for a paradigm shift? Trauma in the development of anorexia nervosa in adolescents. Journal of Psychiatric Research, 195, 97-104. https://doi.org/10.1016/j.jpsychires.2026.01.037
Full text available for download at: https://tinyurl.com/yrrhrjs3
ABSTRACT. Context: Anorexia nervosa (AN) in adolescents is a severe disorder with complex aetiology. The role of childhood maltreatment (CM) in the development and course of AN remains unclear. The study aimed to analyse the co-occurrence of CM with the severity of psychopathology in patients with AN and to assess their relationship with the dynamics of clinical improvement.
Methods: The study included only girls under 18 years of age: 39 patients hospitalised for the first time with a diagnosis of AN and 43 healthy participants from the control group (CG). Questionnaires were used to assess trauma (CTQ), symptoms of depression (BDI), anxiety (STAI), eating disorders (EAT), impulsivity (BIS), self-harm (NSSI), and suicidal behaviour (SB).
Results: The analysis did not reveal any statistically significant differences between the AN and control groups in overall frequency or specific CM subtypes. Despite no differences in trauma exposure, the clinical group showed a significant co-occurrence of emotional abuse with higher levels of self-destructive behaviour and anxiety as a trait, while emotional neglect correlated with anxiety as a state. Notably, the presence of reported trauma did not differentiate patients in terms of response to hospital treatment or rate of symptom reduction.
Conclusions: In the sample of adolescent girls studied, the mere occurrence of reported trauma was not a factor differentiating patients with AN from healthy peers, nor was it a negative predictor of early hospital treatment outcomes. These results suggest that although specific forms of emotional abuse may co-occur with a more severe psychopathological picture (anxiety, self-destruction), childhood maltreatment does not necessarily constitute a direct obstacle to symptomatic improvement during the first hospitalisation
8. de Kraker, T., Roedelof, A. J. M., Simons, C. J. P., & Marcelis, M. (2026). Childhood maltreatment in young females with an eating disorder: Associations with self-esteem, body experience, and symptom severity. Journal of Eating Disorders, 15, 6. https://doi.org/10.1186/s40337-025-01442-4
Full text available for download at: https://tinyurl.com/yznnm9e4
ABSTRACT. Background: Childhood maltreatment impacts expressions of mental disbalance, including disturbed eating behavior. Research into relationships between childhood abuse and neglect and other transdiagnostic factors, such as self-esteem and body experiences in eating disorders (EDs) is limited. This study investigates how childhood maltreatment relates to these other transdiagnostic factors and clinical measures in EDs.
Methods: Forty-nine women with an eating disorder (ED) and a control group of 50 women without an ED, aged 15–25 years, participated in an observational study with cross-sectional questionnaires and longitudinal measurements with the Experience Sampling Method (ESM). With ESM, real life, momentary self-esteem, body experience and ED behavior were longitudinally measured 10 times per day over 10 days. The ESM data were modelled at the momentary level using linear mixed-effects regression with random intercepts, to examine the associations between the person-level predictors (childhood maltreatment) and momentary self-esteem, body experience and ED behavior.
Results: The ED group reported more total childhood adversities, abuse, and neglect than the control group did. Childhood maltreatment was not associated with real life, momentary self-esteem, body experience and ED behavior, nor with ED severity. In controls, childhood maltreatment, specifically neglect, was associated with lower momentary self-esteem but not with momentary body experience. Body experience (cross-sectionally measured) was associated with childhood maltreatment in both the ED and control group.
Conclusions: Females with EDs reported more childhood maltreatment than controls did, but associations with body experience appeared more similar across groups. Notably, associations between childhood maltreatment and self-esteem were only found in controls. The findings highlight the relevance of self-esteem and body experience in females with childhood maltreatment, irrespective of psychopathology, and the need for further identification of transdiagnostic factors associated with childhood maltreatment in individuals with ED.
9. Olofsson, M. E., Giltay, E. J., Eielsen, H. P., Vrabel, K., Oddli, H. W., & Kopland, M. C. (in press/2026). From promise to practice: Showcasing the perceived clinical utility of idiographic networks for eating disorders with complex post-traumatic sequelae. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01579-w
Full text available for download at: https://tinyurl.com/57ykuh5p
ABSTRACT. Background: Eating Disorders (EDs) are highly heterogeneous and often comorbid conditions that likely contribute to the suboptimal recovery rates achieved with manualized treatments. EDs with complex Post-Traumatic Stress Disorder (cPTSD) are particularly challenging, as these disorders may reinforce one another. Compassion-Focused Therapy for EDs (CFT-E) recently showed optimistic long-term efficacy in a randomized controlled trial (RCT) for EDs with cPTSD; however, the individual pathways to change vary, even within the ED-cPTSD subgroup. One method for tailoring treatment to the individual is through idiographic symptom networks from longitudinal data. However, it is to date indefinite how personalized networks can be clinically applied to the treatment of ED-cPTSD.
Aim: We aim to discuss the perceived clinical utility and implications of personalized networks in routine clinical care for patients with ED-CPTSD. Methods: This perspective paper presents a case series illustrating the use of personalized network dynamics based on data from five female inpatients receiving CFT-E in an RCT. We examined 13 symptom trajectories, resulting in individual network visualizations that highlight closely aligned symptom trajectories over time.
Results: The five personalized networks showed substantial heterogeneity in symptom dynamics, with each patient displaying a distinct pattern of central symptoms, ranging from tightly interconnected affect-avoidance clusters to more differentiated networks. Discussion: The clinical value of personalized networks lies in their systematic and efficient approach; however, their methodological, translational, and technical challenges, as well as their capacity to capture the complexity of individual therapeutic processes and predictive utility in clinical practice require further investigation in naturalistic settings. Trial registration: Clinical Trials, NCT02649114.
FEBRUARY - MARCH TREATMENT INTERLUDE, Part 3 of 8
10. Winten, C. G., Strodl, E., Kambanis, P. E., Ross, L. J., & Thomas, J. J. (2026). A Systematic review and meta-analysis of psychological therapies for avoidant/restrictive food intake disorder (ARFID) in adolescents and adults. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.70086
Full text available for download at: https://tinyurl.com/3c6bmxzk
ABSTRACT. Objective: The efficacy of psychological therapies for adolescents and adults with avoidant/restrictive food intake disorder (ARFID) has yet to be rigorously analyzed through systematic review or meta-analysis. Method: We identified articles from seven databases that presented psychological therapies for adolescents and adults with ARFID. First, our systematic review explored characteristics of psychological interventions, clinical team composition, changes in dietary intake, and methodological quality. Second, we conducted a meta-analysis to quantify effect sizes for two primary outcomes (ARFID psychopathology and weight gain) and two secondary outcomes (anxiety and depression) from pretreatment to posttreatment.
Results: Forty articles included in the systematic review identified a variety of psychological interventions that led to increased dietary variety. Most studies were of high quality. Of these, 17 articles met the inclusion criteria for the meta-analysis. Across studies, adolescents and adults with ARFID showed significant improvements from pretreatment to posttreatment including medium-size reductions in ARFID psychopathology (g = 0.63, p < 0.001), large increases in weight (g = 1.26, p < 0.001), medium-size reductions in anxiety (g = 0.42, p < 0.001), and small reductions in depression (g = 0.34, p < 0.05).
Discussion: This systematic review and meta-analysis highlights promising preliminary outcomes of psychological therapies for adolescents and adults with ARFID across multiple domains. However, the current evidence base is small and primarily reliant on case studies and case series, with very few quasi- experimental or randomized designs. As such, studies with larger sample sizes utilizing randomized control trial designs are needed to provide a more rigorous evaluation of psychological therapies for ARFID.
11. Minařík, P., Wohlinová, K., Dostálova, V., Bočková, N., Suchý, J., & Papežová, H. (2026). Feasibility and preliminary outcomes of group–based cognitive remediation and emotion skills training (CREST) for adult women with anorexia nervosa and bulimia nervosa: A pilot pre–post study. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70100
Full text available for download at: https://tinyurl.com/u2343vcm
ABSTRACT. Introduction: Cognitive and emotional deficits are common in eating disorders (EDs), especially anorexia nervosa (AN) and bulimia nervosa (BN), and can hinder engagement and recovery. This pilot single–group pre–post study examined the feasibility and preliminary outcomes of group–based Cognitive Remediation and Emotion Skills Training (CREST) for adult women with AN/BN in a day care programme setting.
Methods: Fifty seven women enroled; 32 completed the 5-week, 10–session programme. Completers and non–completers were compared to identify predictors of adherence. Emotional functioning was assessed using symptom and trait self–report measures, including the TAS–20, Zung Self–Rating Anxiety Scale, BDI–II, EDE–Q, TEQ, and the Self–Compassion Scale. Feasibility was evaluated based on enrolment, completion rates, and treatment adherence.
Results: Preliminary analyses indicated decreases in anxiety (SAS, p < 0.001) and depression (BDI–II, p < 0.001), alongside higher self–compassion (SCS, p < 0.001). Results should be interpreted cautiously given the absence of a control group and notable attrition; improvements may reflect combined effects of CREST and standard multidisciplinary care. Higher BMI and shorter illness duration were associated with completion; in regression, only more previous hospitalisations remained significant.
Conclusions: Pilot findings suggest that group–based CREST may represent a feasible adjunctive intervention for patients with AN and BN. Further controlled studies are required to disentangle its specific effects from standard care to confirm its effectiveness.
12. Cruchet, L., Romo, L., Duriez, P., Laszcz, M. A., Poupon, D., & Gorwood, P. (in press/2026). Benefits of a brief, remote psychoeducation intervention in treating eating disorders: A preliminary study in a predominantly AN/BN sample. Eating and Weight Disorders. Advance online publication. https://doi.org/10.1007/s40519-026-01836-6
Full text available for download at: https://tinyurl.com/45brjwwu
ABSTRACT. Purpose: Engagement in care is particularly problematic among patients suffering from eating disorders (ED). We aimed to assess whether a brief, remote, psychoeducation (PE) intervention could facilitate engagement and/or potentiate treatment. We also aimed to study whether the acquisition of knowledge, a key aspect of PE, could relate to its efficacy.
Methods: We designed a brief, remote PE intervention, based on cognitive behavioural therapy (CBT) principles and literature recommendations. Eighteen ED patients receiving the intervention in addition to treatment as usual (TAU) were compared to 17 ED patients receiving TAU only on: self-reported symptomatology and motivation, actual engagement in a treatment, as well as ED-related knowledge. Assessment times were pre-, post-, and 2 months past the intervention.
Results: Within-group improvements in symptomatology (at follow-up) and increases in motivation (post- and follow-up) were observed in the TAU + PE group, but not in TAU. Level of knowledge and changes in motivation were identified as potential mediators of the association between the intervention and ED symptomatology.
Conclusion: These preliminary findings suggest that a simple, easily accessible remote PE intervention may represent a promising adjunct to standard ED treatment. They also highlight the potential role of knowledge acquisition as a component associated with intervention-related change. Level of evidence: IV, Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.