Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 282: (i) Wt Stigma, Part 2 (n = 3); (ii) Athletes, Sports, & Dance, Part 3 (n = 3); (iii) Binge Eating, Part 1 (n =2); Nature of EDs, Part 9 (n = 2); and (v) Apr-May Tx Interlude, Part 10 (n = 3)
Colleagues (N now = 1460 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.
CALL FOR MANUSCRIPTS
from Discover Mental Health for a forthcoming Special Issue on
Biological Treatments in Eating Disorders
Co-Edited by our own Drs. Andrea Phillipou, Stephanie Miles, and Erica Neill (all in Australia)
Submission Deadline is the 31st of July (but a small extension may be granted).
Received 14 June 2026 via an everything-is-advocacy email from our own Dr. Andrea Phillipou (Australia).
Submissions are currently being accepted to a forthcoming Special Issue of Discover Mental Health on biological treatments in eating disorders: https://link.springer.com/collections/adccdffjcc. The aim of the Special Issue is to bring together contemporary work examining biological approaches to the understanding and treatment of eating disorders, and to highlight emerging directions in this space.
We are accepting original research articles, reviews, case reports, as well as perspective pieces that provide conceptual, clinical, or translational insights into this important area.
Article processing charges (APC) can be waived in most instances if the authors email us (eatingdisorders@orygen.org.au) with their proposed manuscript prior to submission. The submission deadline is the 31st of July (but a small extension may be granted).
Andrea Phillipou, BSc, BSc (Hons), PhD | Associate Professor | Principal Research Fellow in Eating Disorders | Head, Eating Disorders | Scientific Work in Anorexia Nervosa & Other Eating Disorders (SWAN) Research Group | Orygen | Centre for Youth Mental Health, the University of Melbourne
REGISTRATION IS OPEN/SCHOLARSHIPS ARE AVAILABLE for
The 36th Annual Renfrew Center Foundation Virtual Conference for Professionals
Feminist Relational Perspectives and Beyond: Centering Connection and Cultural Healing in Eating Disorders Treatment
November 6 through December 31, 2026
Live & On-Demand Workshops: Earn Up to 49.5 Credits
Received yesterday, 15 June 2026 (California time), via an email from the Renfrew Center Foundation:
We invite you to the 36th Annual Renfrew Center Foundation Conference, Feminist Perspectives and Beyond: Centering Connection and Cultural Healing in Eating Disorder Treatment.
REGISTRATION at: https://tinyurl.com/2uu5ve88
This immersive, VIRTUAL event unites providers in the eating disorder treatment community. Whether you’re a clinician, dietitian, psychiatrist, or advocate, this year’s Conference offers the insights, connections, and continuing education to support your professional journey.
Keynotes — Relational-Cultural Theory in 2026: Evolving Applicability to Therapy and Life, presented by Amy Banks, MD, and Maureen Walker, PhD | Polarization in Civic and Intimate Life: How Therapists Can Help, presented by William J. Doherty, PhD | Cutting Through the Noise: Helping Clients Navigate Nutrition Misinformation in a Social Media Age, presented by Jessica Knurick, PhD, RDN
In addition to three inspiring Keynote presentations, live and on-demand workshops will be offered on a variety of topics, including: Adolescents & Family | Culturally Adapted Care | Digital Impact on Clinical Work | Ethics of Treating Eating Disorders | Lesser‑Known Eating Disorders & Comorbidities | Medical & Psychiatric Advancements | Navigating Misinformation | The Power of Community | Trauma & Systemic Oppression
SCHOLARSHIP OPPORTUNITIES — Complimentary Registration: We’re proud to support early-career professionals and first-time attendees through a limited number of scholarships that include a full conference registration.
Eligibility (meet one or more): A first-time attendee to The Renfrew Center Foundation Conference | A credentialed researcher, clinician or advocate with five years or less experience in the eating disorders field | Demonstrates a strong commitment to education, prevention, research, advocacy, and/or treatment of eating disorders.
To Apply: Submit your completed online registration form and resume/CV to conference@renfrewcenter.com (Use subject line: Scholarship Application) by Friday, July 10, 2026.
CONGRATULATIONS (!) are in order for our own advocate-educator and force-to-be-reckoned with Leah Stiles (USA), Founder and CEO of SEA WAVES, who recently posted the following (abridged by ML) on LinkedIn:
I am so incredibly honored and excited to share that I’ve been selected as an Ambassador with the Institute for Veterans and Military Families - IVMF at Syracuse University. As a Syracuse University alum and proud Newhouse graduate, IVMF has always held a special place in my heart. In fact, when I was first starting 🌊Sea Waves Inc🌊, I reached out to IVMF and they were instrumental in connecting me with the resources, education, mentors, and community I needed to move forward. Since then, I’ve had the privilege of participating in several incredible IVMF programs, including V-WISE, Breaking Barriers in Entrepreneurship, EBV, and now Founder’s Lab. Each experience has helped shape both my leadership journey and the growth of SEA WAVES.
In this role, I’m excited to help strengthen the veteran-serving and veteran-owned nonprofit ecosystem by creating more connection, collaboration, and shared impact. There are so many people doing important work in this space, and I firmly believe that when we share ideas, resources, and relationships, everyone benefits, especially the communities we serve. Learn more about IVMF and their incredible programs: https://lnkd.in/enxTcDN4
Research Publication Categories in This Newsletter
(i) Weight Stigma, Part 2 (n = 3); (ii) Athletes, Sports, and Dance, Part 3 (n = 3); (iii) Binge Eating, Part 1 (n =2); (iv) Nature/Correlates of EDs, Part 9 (n = 2); and (v) April-May Treatment Interlude, Part 10 (n = 3)
CONGRATULATIONS to our own
Dr. Deborah Mitchison (Australia) and colleagues for publication of the Athletes research article in #4.
Dr. Catherine Sabiston (Canada) and colleagues for publication of the Athletes research article in #6.
Dr. Janet Treasure (England) and colleagues for publication of the Treatment review/commentary article in #12.
WEIGHT STIGMA, Part 2 of Many
ML NOTE: The article described below in #1 came to my attention via the Obesity and Energetics Offerings (OEO) online newsletter of 24 April 2026 (see Obesity and Energetics Offerings).
1. Rodríguez-González, M. d. M., Vargas-Veleda, Y., & Maurari-Castillo, I. (2026). Weight stigma in the news: Fatphobia on the media agenda of Spanish-language newspapers. Journalism and Media, 7(2), 88. https://doi.org/10.3390/journalmedia7020088
Full text available for download at: https://tinyurl.com/5yxd37vw
ABSTRACT. Fatphobia, or the stigmatization of fat bodies, is increasingly prevalent in our society and is manifested in many ways, leading to serious consequences for those who suffer its effects. This study aims to enhance the understanding of the extent of media coverage regarding this issue, as well as the approach taken in its coverage.
To this end, all the information containing the term fatphobia, which was published in six leading Spanish-language newspapers, (n = 309) was analyzed to pinpoint the moment when fatphobia appeared on the media agenda, as well as the specific features of its coverage. Using a multidisciplinary methodology including content analysis, framing theory, and a gender perspective, the following digital media outlets were analyzed: eluniversal.com.mx (Mexico), eltiempo.com (Colombia), clarin.com.ar (Argentina), elcomercio.com.pe (Peru), elmercurio.com (Chile), and elpaís.com (Spain).
The findings reflect an inconsistent media portrayal, and the coverage was generally found to be superficial, which indicates the need for a more committed approach to the social acceptance of all bodies and to the struggle against aesthetic discrimination suffered by women with non-normative bodies.
2. Rosenthal, M. H., & Himmelstein, M. S. (2026). Social stigma and health care utilization among gender diverse adults. Health Psychology. Advance online publication. https://doi.org/10.1037/hea0001606
Email address for correspondence: mhimmels@kent.edu
ABSTRACT. Objective: The present study examines the relationships between different forms of stigma related to one’s weight and gender identity on health care utilization within a gender diverse sample. Method: Gender diverse individuals across the weight spectrum were recruited from an online panel via Prolific. Participants completed questionnaires regarding health care experiences, health behaviors, health beliefs, and gender identity. Data were collected between September and November 2023.
Results: The final sample was 343 transgender and nonbinary participants. Adding weight stigma (enacted, internalized), transgender stigma, and intersectional stigma to the models accounted for 49.8% of the variance in weight-based health care avoidance, ΔR² = .217, ΔF(4, 331) = 35.80, p < .001, and 13.1% of the variance in general avoidance of health care, ΔR² = .071, ΔF(4, 331) = 6.72, p < .001. Adding the stigma variables to the model predicting health care delay accounted for 13% of the variance, ΔR² = .08, ΔF(4, 331) = 7.60, p < .001.
However, adding stigma did not uniquely contribute to the variance in hormonal gender affirming care interest, ΔR² = .014, ΔF(4, 331) = 1.68, p = .155, gender affirming care typical for those assigned male at birth, ΔR² = .050, ΔF(4, 76) = 1.18, p = .325, and gender affirming care typical for those assigned female at birth, ΔR² = .029, ΔF(4, 197) = 1.80, p = .131.
Conclusions: Results partially supported our hypotheses, suggesting both enacted weight/transgender stigma and internalized weight stigma are significantly associated with utilization of health care services in a gender diverse sample. Future research is needed to understand the relationships between coping strategies and health care utilization.
3. Viola, L. F., Valerio, C. M., Muniz, R. B. G., Moreira Allgayer, R. M. C., Trujilho, T. D. G., Hohl, A., Lamounier, R. N., Bernardini, M. A., Brito, R., Halpern, B., & Trujilho, F. R. (2026). Obesity-related beliefs, concerns, and stigmatizing perceptions among adults living with obesity. Obesity Science and Practice. Advance online publication. https://doi.org/10.1002/osp4.70133
Full text available for download at: https://tinyurl.com/ypjr2f2a
ABSTRACT. Background: Weight stigma represents a barrier to effective obesity management and to achieving health equity. Although most research has focused on high-income countries, data from Latin America remain scarce. This study aimed to examine perceptions, beliefs, and concerns about obesity among adults living with obesity in a middle-income country. Methods: This subanalysis used data from a nationally representative survey investigating perceptions of obesity among 2560 adults residing in Brazil. Responses from 653 people living with obesity (body mass index ≥ 30 kg/m2) were included in the present analysis. Analyses were stratified by gender and obesity class.
Findings: Stigmatizing beliefs were prevalent: 27.5% of participants agreed that people living with obesity are personally responsible for their weight, with a significantly higher prevalence among men (35.5%, p < 0.001). Among those with Class II obesity, 42.8% of men and 15.0% of women endorsed this belief (p < 0.001). Leisure environments (48.2%) were the most frequently reported settings of discrimination, followed by workplaces (33.4%) and public transportation (33.1%). Healthcare settings were also cited by 11.6% of the responses. The most commonly reported sources of obesity-related information were healthcare professionals (50.3%) and those professionals active on social media (39.3%).
Interpretation: Stigmatizing attitudes and the attribution of personal blame toward people living with obesity are widespread in Brazil. These findings underscore the need to integrate stigma awareness into medical education, public health communication, and clinical practice. Leveraging trusted sources, including healthcare professionals and influential social media communicators, may help mitigate weight stigma.
ATHLETES, ATHLETICS, SPORT, AND DANCE, Part 3 of 3
4. Parker, E., Mitchison, D., & Hronis, A. (2026). Intrinsic and extrinsic risk factors for mental health difficulties in dancers: A systematic review. Journal of Dance Medicine & Science. Advance online publication. https://doi.org/10.1177/1089313X261456446
Email address for correspondence: ellen.m.parker@student.uts.edu.au
ABSTRACT. Introduction: Dancers are a vulnerable population for a range of mental health difficulties, including eating disorders, depression, and anxiety. In order to understand the mental health landscape in this population, we conducted a systematic review of the risk factors for mental health difficulties in pre-professional and professional dancers.
Methods: The search was conducted using PsycINFO, Scopus, Embase, and Medline databases. Peer-reviewed studies that examine possible risk factors for mental health difficulties were included in this systematic review. Studies were included if they analysed mental health as an outcome (either symptoms or diagnoses), studied a dancer-only sample, and were published in English. There were no restrictions on dance style, although studies with samples of recreational dancers were excluded. Quality appraisal was completed using Joanna Briggs Institute (JBI) Checklists.
Results: Full texts of 180 studies were screened, resulting in 37 papers for the final sample. A range of risk factors for mental health difficulties were identified. Risk factors were categorised as either intrinsic, characters that exist within an individual, or extrinsic, those that exist in the broader environment or cultures. Perfectionism, self-esteem, and body-dissatisfaction were amongst the most consistent intrinsic risk factors identified. Findings about other intrinsic risk factors, including age and gender, were inconsistent. Although less frequently examined, extrinsic risk factors were also identified, including teacher behaviour and experiences of trauma.
Conclusion: Certain factors within dancers as individuals and within dance environments may make dancers vulnerable to mental health difficulties. The results of this systematic review highlight a range of risk factors for mental health in dancers that may be targeted in psychological intervention.
5. Jung, J., Lilly, F., Owens, J., & Vidal, C. (2026). Disordered eating and vaping in athlete and non-athlete college students: Does sex matter? Journal of American College Health. Advance online publication. https://doi.org/10.1080/07448481.2026.2674301
Email address for correspondence: yjung@jh.edu
ABSTRACT. Objective: Vaping prevalence is rising among young adults, with linked evidence to disordered eating. Given the unique pressures of performance and body image in athletics, this study examines vaping-eating disorder (ED) risk associations comparing college athletes and non-athletes. Participants: Data was gathered from U.S. college students in the 2021–2022 Healthy Minds Study. Methods: Students reported past-30-day vaping and completed the SCOFF (Sick, Control, One, Fat, Food) questionnaire. Logistic regressions tested vaping-ED risk associations with athlete status as a covariate, adjusting for confounders.
Results: Overall, 18.1% of respondents reported vaping and 32.8% screened positive for ED risk. Vaping was associated with higher ED risk (adjusted OR = 1.45, p < .001). Athlete status did not independently predict ED risk or moderate the vaping-ED risk associations, while sex did moderate this association. Conclusions: Findings highlight the need for integrated mental health campus initiatives addressing substance use and disordered eating behaviors among athletes and non-athletes.
6. Ricketts, C., Malete, L., Myers, N. D., & Sabiston, C. M. (2026). Body acceptance by others in sport: Psychometric evaluation of a teammate-adapted version of the Body Acceptance by Others Scale-2 in Botswana athletes. Journal of Sport and Exercise Psychology, 48(3), 150-159. https://doi.org/10.1123/jsep.2025-0290
Full text available for download at: https://tinyurl.com/ymwj9rkp
ABSTRACT. In this study, the dimensionality of scores from a teammate-adapted version of the Body Acceptance by Others Scale-2, measurement invariance by sex, and theoretically convergent correlations with positive body image constructs were examined in Botswana athletes. Cross-sectional data from 508 athletes who completed the modified Body Acceptance by Others Scale-2, and measures of body and functionality appreciation were analyzed.
Exploratory structural equation modeling supported a three-factor solution representing perceived unconditional body acceptance by teammates, perceived positive body regard by teammates, and perceived teammate support for body acceptance, which was invariant by sex. The three latent factors exhibited significant, positive correlations with body and functionality appreciation. These findings challenge the unidimensional assumption of Body Acceptance by Others Scale-2 scores, providing evidence for a multidimensional structure in sport. In Botswana’s collectivistic context, athletes may gauge body acceptance from teammates through feeling accepted, supported, and noticing behaviors that signal acceptance, presenting noteworthy implications for supporting positive body image in sport.
BINGE EATING, Part 1 of 3
7. Escrivá-Martínez, T., Zarco-Alpuente, A., Ciudad-Fernández, V., Rodríguez-Arias, M., & Baños, R. (2026). From impulsivity to binge eating: The mediating influence of emotional, external, and restrictive eating styles. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01642-6
Full text available for download at: https://tinyurl.com/4zz4smjm
ABSTRACT. Background: This study aimed to examine the associations between impulsivity, dysfunctional eating styles (emotional, external, and restrictive eating), and binge eating in a nonclinical sample of young adults, as well as to test the mediating role of dysfunctional eating styles in the relationship between impulsivity and binge eating. Methods: A total of 390 young adults (Mage = 22.36, 59% women) self-reported impulsivity (UPPS-P scale), dysfunctional eating styles (Dutch Eating Behavior Questionnaire), binge eating (Binge Eating Scale), weight and height.
Results: Negative urgency was significantly associated with emotional (β = 0.353, p < 0.001), external (β = 0.379, p < 0.001), and restrictive eating (β = 0.266, p < 0.001). Additionally, lack of perseverance was positively associated with external eating (β = 0.105, p = 0.050). All dysfunctional eating styles were positively linked to binge eating: emotional eating (β = 0.306, p < 0.001), external eating (β = 0.183, p < 0.001), and restrictive eating (β = 0.461, p < 0.001). Indirect effects revealed that only negative urgency was connected to binge eating through emotional eating (β = 0.106, p < 0.001), external eating (β = 0.068, p = 0.003), and restrictive eating (β = 0.120, p = 0.001).
Conclusions: The findings highlight the central role of negative urgency in the emergence of dysfunctional eating styles and binge eating, underscoring the importance of addressing negative urgency and dysfunctional eating styles in prevention programs and interventions to reduce the risk of binge eating.
8. Erdogan Akturk, B., Erdogan Kaya, A. & Tamam, L. (2026). From mental fatigue to binge eating: Emotion dysregulation as a transdiagnostic bridge. Cognitive Therapy and Research. Advance online publication. https://doi.org/10.1007/s10608-026-10753-y
Full text available for download at: https://tinyurl.com/bdfcs4v8
ABSTRACT. Background: Binge eating and binge-eating disorder (BED) have been closely linked to emotion dysregulation and ADHD symptoms, whereas mental fatigue has received comparatively limited direct attention. The relative importance and interplay of these self-regulatory processes remain poorly understood. Network analysis offers a framework for identifying central and bridging processes within complex symptom systems.
Methods: In a psychiatric outpatient sample (N = 279), binge-eating severity, mental fatigue, emotion regulation difficulties, and ADHD symptoms were examined using a regularized partial correlation network. Binge-eating severity was modeled as a continuous variable for network and mediation analyses; established cutoff scores were additionally used for descriptive group comparisons. Centrality and bridge metrics were estimated, network stability was evaluated, and a theory-informed exploratory mediation analysis was conducted.
Results: Binge-eating severity was not among the most central nodes in the network but occupied a bridging position between emotional and cognitive symptom domains. Mental fatigue showed the strongest associations with binge-eating severity and occupied a prominent bridging position across symptom communities. Descriptive group comparisons indicated moderate-to-large effect sizes (η²H = 0.152–0.359), with mental fatigue showing the largest between-group differences.
Within emotion regulation, strategy deficits, difficulties in goal-directed behavior, and impulse control problems were most central, whereas non-acceptance and emotional clarity were more peripheral. Mediation analyses suggested that the association between mental fatigue and binge-eating severity was partially accounted for by emotion regulation difficulties, but not by ADHD symptoms.
Conclusions: These findings suggest that binge-eating severity may be linked to co-occurring difficulties in mental fatigue and behaviorally proximal dimensions of emotion regulation. Mental fatigue may represent a clinically relevant and underexamined correlate warranting further investigation in assessment and intervention research targeting binge eating.
NATURE, CORRELATES, AND COURSE OF EDs, Part 9 of 9
9. Carbone, E. A., Dani, C., Geraci, M., Romeo, A., Jiménez-Peinado, A., Rania, M., Lodovici, E., Cordasco, V. Z., Cassioli, E., Rossi, E., Tarchi, L., Ricca, V., Castellini, G., & Segura-Garcia, C. (2026). Impact of COVID-19 lockdown on psychopathology at the onset of eating disorders. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70123
Full text available for download at: https://tinyurl.com/4w7wy6c7
ABSTRACT. Objective: Previous research has shown that the COVID-19 pandemic worsened eating-disorder (ED) symptoms, but most studies have focused on inpatients and compared only two periods: pre-COVID and the period following the pandemic’s onset. Outpatient populations, particularly those with binge eating disorder (BED) and other specified feeding or eating disorders (OSFED), have been underrepresented. It remains unclear whether the pandemic influenced the clinical presentation at ED onset. This study aimed to examine differences in general and eating-disorder-related psychopathology at first presentation among outpatients with all ED diagnoses before, during, and after the COVID-19 lockdown in Italy.
Methods: We retrospectively reviewed clinical records and assessment data from 400 patients seeking treatment for the first time at a specialised outpatient ED service. Patients were grouped into three periods: pre-lockdown (01.01.2019-10.06.2020), lockdown (11.06.2020-30.09.2021), and post-lockdown (01.10.2021-31.12.2022). These periods were defined to capture the effects of the lockdown while considering the DSM-5 requirement that symptoms persist for at least 3 months to establish a diagnosis. Multivariate analyzes of variance were used to evaluate the effects of period, diagnosis, and their interaction on sociodemographic characteristics, eating-disorder specific symptoms, and general psychopathology.
Results: Significant differences were observed across diagnoses, including BED and OSFED. During the lockdown, patients exhibited greater concerns regarding dietary restriction, binge eating, and body, weight and shape across diagnostic groups compared with pre-lockdown. The post-lockdown period was associated with a younger age at ED onset and earlier initiation of dieting behaviours.
Conclusions: By distinguishing pre-lockdown, lockdown, and post-lockdown phases and accounting for the DSM-5 diagnostic timeline, this study extends prior research beyond the conventional pre/post pandemic comparison. The COVID-19 lockdown was linked to more severe eating-disorder specific and anxiety-related symptoms at illness onset in outpatients across diagnoses, while the post-lockdown period was marked by earlier onset and increased disorder-specific concerns.
10. Vaccaro, D. H., Zhang, Z., Wang, Y., Han, X., Walsh, B. T., Posner, J., & Steinglass, J. E. (2026). COVID-19-related stress and adolescent anorexia nervosa: Early detection, similar illness course. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.70134
Email address for correspondence: js1124@cumc.columbia.edu
ABSTRACT. Objective: The COVID-19 pandemic was associated with a worldwide increase in hospitalizations among adolescents with anorexia nervosa (AN). The factors contributing to this remain unclear and may include alterations in healthcare systems and/or clinical factors. This study examined the possibility that pandemic-related stress led to more severe illness in adolescents with AN.
Methods: Participants included adolescents with AN and healthy controls (HC) enrolled in a longitudinal study between 2017 and 2022. Illness severity and response to treatment were compared between individuals enrolled pre-COVID-19 and mid-COVID-19, with HC providing an additional reference for community levels of mood, anxiety, and eating symptoms. Exposure to COVID-19-related stress was assessed systematically, and the effect on illness severity was evaluated.
Results: There were no significant differences in age, body mass index (BMI), or eating disorder/depression/anxiety severity between individuals who presented for evaluation of AN pre-COVID-19 (n = 60) versus mid-COVID-19 (n = 31). Illness duration was shorter in the mid-COVID-19 group (Mmid-COVID = 0.30 ± 0.35 vs. Mpre-COVID = 0.83 ± 1.07 years, t88 = 2.62, p = 0.01). Duration of restrictive eating was also shorter in the mid-COVID-19 group (Mmid-COVID = 1.4 ± 1.1 years vs. Mpre-COVID = 2.4 ± 2.1 years, t88 = 2.36, p = 0.02). Individuals with AN and HC showed similar levels of COVID-related stress, and there was little association between COVID-19-related stress and symptom severity or response to treatment.
Discussion: This study suggests that while the pandemic led to increased incidence and hospitalizations for AN, there may have been less impact on overall illness severity and treatment response. For some, pandemic-related circumstances might have influenced hospitalization rates more than the level of pandemic-related stress.
APRIL - MAY TREATMENT INTERLUDE, Part 10 of now 11
11. Toda, K., Takakura, S., Gondo, M., Suematsu, T., Yokoyama, H., Asou, C. S., Hata, T., & Sudo, N. (2026). Clinical outcomes of restricting-type anorexia nervosa onset in female adolescents and young adults aged 12–24 years during Japan’s first COVID-19 state of emergency. Journal of Eating Disorders, 14, 130. https://doi.org/10.1186/s40337-026-01619-5
Full text available for download at: https://tinyurl.com/mr2fe9bv
ABSTRACT. Background: Our previous research indicated that patients with self-reported onset of eating disorders (EDs) during Japan’s first state of emergency (declared April 7, 2020) for COVID-19 were significantly Eyounger at presentation and had a shorter illness duration, which potentially facilitated earlier clinical intervention. Since early consultation is often associated with better prognosis in anorexia nervosa (AN), we hypothesized that patients with AN development during the first state of emergency would exhibit more favorable outcomes.
Methods: This age-adjusted comparative study included 36 female adolescent and young adult patients (aged 12–24 years) with restricting-type AN (AN-R) diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria. Both inpatients and outpatients were included and categorized into three groups: those who visited the hospital before (Before group, n = 12) and after (After group, n = 12) the emergency declaration and those with self-reported symptom onset during the first state of emergency (During group, n = 12).
Patients were evaluated at their initial visit (T0) and 3 (T1), 6 (T2), and 12 months (T3) thereafter using the Global Clinical Score (GCS) and percent standard weight as outcome measures. Psychological characteristics at T0 were assessed using the Parental Bonding Instrument (PBI) and Eating Disorder Inventory (EDI).
Results: The During group demonstrated significantly earlier improvement compared to the other two groups. Specifically, GCS scores at T1 were significantly lower in the During group (Before vs. During: 11 vs. 9, p = 0.006; After vs. During: 11 vs. 9, p = 0.0030), indicating a large effect. Percent standard body weight at T2 was significantly higher in the During group than in the After group (After vs. During: 73 vs. 83.5, p = 0.01), exhibiting a large effect. EDI and PBI scores were comparable among groups.
Conclusion: Patients whose patient-reported AN-R symptom onset occurred during the first state of emergency showed a faster recovery trajectory than did those who presented before or after the emergency, consistent with our hypothesis. Increased time spent at home with family during the “stay-at-home” period may have contributed to earlier medical consultation and subsequent recovery, although this interpretation remains speculative. These findings highlight the importance of early intervention in AN treatment.
12. Morris, R., Gundogan, A., Lawrence, V., Himmerich, H., Treasure, J., & Keeler, J. L. (2026). Understanding experiences of psychedelic treatments for eating disorders: A meta-synthesis of qualitative studies. BMC Medicine. Advance online publication. https://doi.org/10.1186/s12916-026-04929-2
Full text available for download at: https://tinyurl.com/5dcrvuyj
ABSTRACT. Background: Eating disorders (EDs) have complex presentations with high rates of comorbidities and low recovery rates. Current treatment options often lack sufficiency in improving ED symptoms. Psychedelic-assisted therapies represent a novel treatment approach for the treatment of EDs, with research documenting preliminary positive evidence.
However, psychedelics have their own challenges and risks which need to be considered within an ED population to inform study design and future clinical application. The primary aim of this meta-synthesis was to integrate existing qualitative data on the experience of using psychedelics in ED treatment from the perspectives of both individuals with EDs and providers (e.g. clinicians, ceremony leaders), using meta-ethnography to generate new interpretative insights.
Methods: The methods followed the seven steps of a meta ethnographic approach. An electronic search of three databases (PubMed, Medline, and PsycINFO) was conducted. Papers were included if they were qualitative studies exploring the use of typical or atypical psychedelics, from the perspective of either a provider or individual experiencing an ED.
Results: A total of eight studies were included. From the data we identified five meta-themes that together depict how psychedelic experiences may act as catalysts for transformation. Our interpretive narrative posits that core transformative processes (Mind-Body-Spirit, Emotional Processing), unfold within specific contextual conditions (Navigating Challenges and Risks, Enabling Safe and Supportive Experiences), and lead to meaningful outcomes (Therapeutic Improvements). Meta- and sub-themes reflect ED-specific elements, highlighting that psychedelics may improve emotion processing and enhance perception of and connection with the body and the self, which is pertinent to ED recovery. Themes also indicate the increased risk for adverse side effects with low weight and other physical vulnerabilities associated with EDs.
Conclusions: The themes and interpretive narratives identified in this meta-synthesis suggest that to achieve therapeutic outcomes, ED-specific contextual conditions are required to facilitate internal processes during psychedelic therapy for EDs. This includes minimising the uncertainty that typifies EDs through exploration of expectations and autonomy in selection of setting elements (e.g. lighting, music, eye-mask) or collaboratively agreeing strategies for if anxiety spikes. Further, facilitators should require dual competency in psychedelic treatment and ED psychopathology and treatment.
13. Heiderscheit, A. (2026). The Bonny Method of Guided Imagery and Music as a trauma-informed approach in eating disorder treatment: Theoretical framework and case illustrations. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01625-7
Full text available for download at: https://tinyurl.com/t9m4f2x5
ABSTRACT. Background: Eating disorders (EDs) are severe and complex mental health conditions with high mortality, significant psychiatric comorbidity, and increasing global prevalence. ED behaviours (e.g., restriction, bingeing, purging) may function as adaptive strategies for affect regulation, management of trauma-related distress, and avoidance of embodied experience. While trauma-informed care emphasises safety, empowerment, and relational attunement, trauma in EDs is often held somatically and may remain inaccessible through verbal therapies alone.
The Bonny Method of Guided Imagery and Music (GIM), an experiential depth-oriented music psychotherapy, uses therapist-selected programmed music to evoke imagery, emotion, memory, and embodied processes within a supportive therapeutic relationship. This paper explores GIM as a trauma-informed approach targeting psychological and embodied mechanisms underlying ED symptoms. A theoretical framework is outlined in which music-evoked imagery and neuroaesthetics engagement facilitate symbolic emotional exploration, embodied integration, interoceptive reconnection, affect regulation within safety, and meaning-making and identity repair.
Case presentation: The framework is illustrated through four case examples from a qualitative feasibility study of GIM in ED treatment. Participants were four adult women (aged 26–57) engaged across levels of care, each receiving 12–16 individual GIM sessions over 12-months. The cases include selected session excerpts highlighting music and imagery processes that explore the functional role of ED symptoms.
Conclusions: Across cases, GIM enabled access to unresolved emotions, trauma-related somatic distress, attachment dynamics, and identity disturbances, while supporting emotion regulation, agency, and transformation of symptom-related coping. These findings position GIM as a promising multimodal, embodied intervention for trauma-informed ED treatment, particularly for individuals with complex trauma and difficulties engaging in verbal interventions. Further research is needed to clarify mechanisms of change, clinical indications, and integration within multidisciplinary ED care.