Researchers recruited athletes through non-probability convenience sampling and used the Low Energy Availability in Females Questionnaire (LEAF-Q) to assess LEA risk and the Eating Attitudes Test-26 (EAT-26) to assess DE risk. The proportion classified as being at risk of LEA did not differ significantly across competition levels (p = 0.825). By contrast, DE risk varied by level, with the highest proportion recorded among athletes in the Turkish Women’s Volleyball Second League (p = 0.034).

Disordered-eating risk was associated with substantially higher odds of low-energy-availability risk: the unadjusted odds ratio was 3.80, with a 95% confidence interval of 1.82–7.92. The overlap was therefore substantial but incomplete, showing why screening results for one risk should not be treated as proof of the other. EAT-26 total scores were positively correlated with LEAF-Q total scores and gastrointestinal-function scores (both p < 0.001), as well as injury-history scores (p = 0.004). There was no statistically significant correlation with menstrual-function scores (p = 0.133).

The findings identify LEA risk as the more common classification in this sample, with disordered-eating risk occurring less often. They also support assessing both risks rather than assuming that one implies the other. However, the online survey, convenience sample, and cross-sectional design restrict conclusions about prevalence and relationships in the wider female-athlete population. Because the data were not collected prospectively, the study cannot establish whether the observed associations reflect an underlying relationship, shared influences, or another pattern. The results instead provide a snapshot of screening outcomes and their co-occurrence among the participating volleyball players.

Subject of Research: Co-occurrence of screening-based low energy availability and disordered eating risks among female volleyball players in Türkiye

Article Title: Screening-based low energy availability risk, disordered eating risk, and their co-occurrence among female volleyball players: a cross-sectional study

Article References: André, H., Sarışık, D. Ç., & Özçelik, A. (2026). Screening-based low energy availability risk, disordered eating risk, and their co-occurrence among female volleyball players: a cross-sectional study. PLOS One, 21(10), e0360395. https://doi.org/10.1371/journal.pone.0360395

Image Credits: AI Generated

DOI: 10.1371/journal.pone.0360395

Keywords: female athletes, volleyball, low energy availability, disordered eating, athlete screening, nutrition, cross-sectional survey, Türkiye, Screening-based, energy, availability, risk

Rejection sensitivity, a construct first formalized by Geraldine Downey and Scott Feldman in 1996, describes a disposition to anxiously expect, readily perceive, and intensely react to social rejection. People high in rejection sensitivity scan their social world for cues of impending dismissal, interpret ambiguous signals as threatening, and respond with disproportionate emotional force. Decades of research have linked this trait to a strikingly wide range of outcomes, from jealousy and conflict in intimate relationships to aggression, withdrawal, and, increasingly, disordered eating attitudes and behaviors. The breadth of that list is precisely what created the conceptual puzzle the new study set out to solve.

The puzzle can be stated in the language of clinical theory. Psychopathology is often organized along two broad axes: internalizing disorders, in which distress is turned inward, producing anxiety, depression, and conditions such as eating disorders; and externalizing disorders, in which distress is directed outward, producing aggression, impulsivity, and conduct problems. Rejection sensitivity has been implicated in both domains. That raises a structural question about the architecture of risk. Is the pathway sequential, with rejection sensitivity first producing aggression, which then somehow manifests as disordered eating? Or are aggression and disordered eating parallel outputs, two independent translations of the same underlying social threat system into different behavioral currencies?

To answer it, Kuzgun recruited 344 university students, roughly 61 percent of them female, with a mean age of about 20 years. Emerging adulthood is a strategically chosen window for this kind of work: it is a period of intense social reorganization, identity formation, and heightened concern with peer evaluation, and it is also a period in which disordered eating attitudes frequently emerge or intensify. Participants completed validated self-report instruments measuring rejection sensitivity, aggression, and eating attitudes, including Turkish adaptations of established scales such as the Buss-Perry Aggression Questionnaire and the Eating Attitudes Test short form. The study received ethical approval from Istanbul Arel University in March 2025, and informed consent was obtained from all participants.

The analytical engine of the study was structural equation modeling, a statistical framework that allows researchers to test whether a network of hypothesized relationships is consistent with the observed patterns of covariance among measured variables. Crucially, this approach makes it possible to evaluate mediation: whether the effect of one variable on another travels through a third variable, or whether a direct pathway remains once the indirect route is accounted for. In this case, the model tested whether aggression carried the influence of rejection sensitivity onto disordered eating attitudes, or whether rejection sensitivity reached disordered eating on its own.

The descriptive findings were consistent with a large body of prior work. Rejection sensitivity was positively associated with both aggression and disordered eating attitudes, meaning that students who anxiously expected rejection also reported more hostile tendencies and more problematic attitudes toward food and eating. Up to that point, the data told a familiar story. The decisive test came next, when the model separated the direct pathway from the indirect one.

The result was unambiguous in one direction and null in the other. Rejection sensitivity significantly predicted aggression, replicating its well-established role as an externalizing risk factor. But aggression, once its own relationship with rejection sensitivity was modeled, was not associated with disordered eating attitudes. The indirect effect, the hypothesized chain running from rejection sensitivity through aggression to disordered eating, was not statistically significant. Instead, rejection sensitivity retained a significant direct association with disordered eating attitudes. In other words, the link between expecting rejection and eating pathologically did not depend on hostility toward others; it operated along its own channel.

The theoretical implication is that aggression and disordered eating are best understood as parallel rather than sequential responses to rejection sensitivity. One response externalizes, converting anticipated social pain into anger and aggression toward others. The other internalizes, converting the same anticipated pain into disturbed attitudes toward eating, a domain of behavior that is, notably, directed at the self. This framing refines current models of interpersonal vulnerability by suggesting that a single social-cognitive trait can be transduced into qualitatively different forms of psychopathology, and that clinicians and researchers should not assume that treating one manifestation will automatically defuse the other.

The study also reinforces a growing movement to treat rejection sensitivity as a transdiagnostic vulnerability, a risk factor that cuts across diagnostic categories rather than belonging to any single disorder. Recent work cited in the article points in the same direction: longitudinal research has linked rejection sensitivity and related justice sensitivity to eating disorder pathology over five-year spans, systematic reviews have documented the role of social rejection sensitivity in anorexia nervosa, and experimental and longitudinal studies have connected appearance-based and interpersonal rejection sensitivity to loss-of-control eating in youth. Some researchers have argued that sensitivity to rejection may matter even more than actual experiences of peer stress for the development of eating pathology, a claim that fits neatly with the new finding that the pathway is direct rather than mediated by outward hostility.

As with any single study, important caveats apply. The design is cross-sectional, capturing associations at one point in time rather than tracking how risk unfolds across development, so causal direction cannot be established from these data alone. The sample consists of university students rather than clinical patients, and eating attitudes were measured by self-report, which may not fully capture diagnosed eating disorders. The data are also not publicly available, though the author notes they can be requested. Even so, the study’s central contribution stands: by statistically disentangling two candidate pathways, it provides evidence that the road from rejection sensitivity to disordered eating does not run through aggression. For a field increasingly interested in identifying shared mechanisms of vulnerability, that is a meaningful piece of the map, suggesting that the anxious anticipation of rejection may be a common root from which both outward anger and inward struggles with food can grow, each on its own branch.

Subject of Research: Rejection sensitivity as a transdiagnostic risk factor linking aggression and disordered eating attitudes in young adults

Article Title: Rejection sensitivity and disordered eating: evidence for distinct internalizing and externalizing pathways

Article References: Kuzgun, T. B. (2026). Rejection sensitivity and disordered eating: evidence for distinct internalizing and externalizing pathways. Current Psychology, 45(20), Article 1611. https://doi.org/10.1007/s12144-026-10171-z

Image Credits: AI Generated

DOI: 10.1007/s12144-026-10171-z

Keywords: rejection sensitivity, disordered eating, aggression, internalizing, externalizing, structural equation modeling, transdiagnostic, eating attitudes, emerging adulthood, psychology, social cognition, emotion regulation

The study, published in Discover Psychology, was led by Leo C. M. Cheung of the Sports Nutrition & Monitoring Centre at the Hong Kong Sports Institute, working alongside colleagues from the institute and the Department of Sports Science and Physical Education at The Chinese University of Hong Kong. The team administered the Eating Attitudes Test-26, or EAT-26, a twenty-six item self-report instrument that has served as the workhorse of eating-attitude screening since the 1980s. Respondents rate statements about food preoccupation, dieting behavior, and eating-related guilt on a six-point scale, and a total score of twenty or above conventionally flags a need for clinical follow-up. The instrument does not diagnose anorexia nervosa or bulimia, but it reliably identifies individuals whose attitudes toward food have drifted into territory associated with those conditions.

Statistically, the headline number is the overall at-risk proportion of 4.0 percent. Beneath that aggregate, however, the researchers uncovered a series of gradients that tell a more interesting story than any single prevalence figure could. Female athletes registered a risk proportion of 7.1 percent, roughly four times the 1.7 percent observed in male athletes, a sex difference consistent with the broader epidemiological literature in which women carry a substantially higher burden of eating pathology. Yet even the female figure remained modest, suggesting that the structured environment of Hong Kong’s elite sport system, with its professional nutrition support, may buffer some of the pressures that push other populations toward restriction.

The more striking patterns emerged when the researchers stratified their sample by dieting history, age, and self-perceived body image. Athletes who reported previous dieting experience scored significantly higher on the EAT-26 than those who had never dieted, with mean scores of 8.08 plus or minus 9.03 compared with 4.92 plus or minus 5.73, a difference that reached statistical significance at the five percent level. This finding matters because dieting attempts are widely understood as a gateway behavior; in athletes, a single episode of deliberate caloric restriction can spiral into chronic under-fueling, and under-fueling in turn drives the syndrome known as Relative Energy Deficiency in Sport, which degrades bone density, endocrine function, and performance itself.

Age produced an equally compelling signal. Athletes under nineteen years old scored significantly higher than their older counterparts, with mean EAT-26 values of 9.24 plus or minus 11.21 versus 5.33 plus or minus 5.71. Pearson correlation analysis confirmed a weak but significant negative association between age and EAT-26 score, with a correlation coefficient of -0.234 and a p-value below 0.05. In plain terms, the younger the athlete, the more disordered the eating attitudes tended to be. The authors point to this developmental window as a critical target for intervention, and the logic is sound: adolescence is precisely the period when body image consolidates, when sport-specific pressures about weight class and aesthetics intensify, and when nutritional habits harden into lifelong patterns.

Body image proved to be the strongest single correlate in the dataset. Participants rated their self-perceived body image on a nine-point scale, and those scoring below the midpoint of five showed markedly elevated EAT-26 scores, averaging 11.08 plus or minus 7.88, compared with 5.41 plus or minus 6.99 among athletes who rated their body image at five or above. The difference was significant at the one percent level, and Pearson analysis revealed a moderate negative correlation of -0.344 between body image and EAT-26 score with a p-value below 0.001. Athletes who felt worse about their bodies, in other words, consistently harbored more disturbed attitudes toward eating, independent of the sport they played.

To disentangle the overlapping effects of age and body image, the team ran a multiple linear regression, and both variables survived as independent negative predictors of EAT-26 scores. Age carried a standardized coefficient of -0.228 with a p-value below 0.05, while self-perceived body image carried a standardized coefficient of -0.344 with a p-value below 0.001. Because both predictors point in the same direction, the regression supports a coherent risk profile: the athlete most likely to exhibit problematic eating attitudes in this sample is young, has experimented with dieting, and holds a negative view of her own body. That profile gives sports medicine staff something actionable, because every one of those characteristics can be screened for during routine athlete monitoring.

Methodologically, the study is a descriptive, cross-sectional survey, and the authors classify it as Level V evidence, the lowest rung on the clinical evidence ladder. Cross-sectional designs capture a single moment in time, which means they can identify associations but cannot establish whether poor body image causes disordered eating or vice versa, nor can they track how risk evolves across an athlete’s career. The sample size of 100, while respectable for a single-institute study, is small enough that subgroup estimates, particularly the 1.7 percent figure for male athletes, rest on a handful of individuals. The researchers themselves frame the work as a foundation for tailored health education programs and differentiated screening rather than as a definitive prevalence estimate.

Even with those caveats, the study adds a valuable data point to a literature that the authors describe as frequently contradictory. Prevalence estimates for disordered eating among athletes vary wildly across studies, driven by differences in sport type, assessment tools, cultural context, and how risk is defined. High-risk sports such as gymnastics, distance running, and weight-class combat disciplines consistently show elevated rates, but pooled figures are notoriously unstable. By anchoring the Hong Kong data to a standardized instrument and a defined at-risk threshold, the study gives regional sport bodies a benchmark against which future surveillance can be measured, and it suggests that the often-cited narrative of an eating-pathology epidemic in elite sport may require regional calibration rather than blanket assumptions.

The practical implications ripple outward from the institute itself. Screening programs that incorporate the EAT-26, a simple body-image rating, and a question about dieting history could be embedded into existing athlete health checks at negligible cost, flagging young athletes with poor body image for early nutrition counseling before attitudes calcify into behavior. The research, which received no external funding and was approved by the Research Ethics Committee of the University of Hong Kong School of Professional and Continuing Education, emerged from an MSc project in Sport and Exercise Nutrition, a reminder that some of the most immediately useful findings in sports science come from practitioners working directly with athletes rather than from large-scale trials. For coaches and parents watching a teenage athlete quietly shrink portions or fixate on body shape, the study’s message is direct: age, dieting history, and body dissatisfaction together form the earliest warning system, and acting on that warning early is far easier than treating an eating disorder once it takes hold.

Subject of Research: Disordered eating risk factors among Hong Kong Chinese athletes

Article Title: A cross-sectional study of eating attitudes in Hong Kong athletes

Article References: Cheung, L. C. M., Sze, J. W. H., Siu, F. P. L., Li, S. L., Pun, G. T. K., Lau, J. T. Y., O’Reilly, J., & Kuo, M. J. (2026). A cross-sectional study of eating attitudes in Hong Kong athletes. Discover Psychology. https://doi.org/10.1007/s44202-026-00848-8

Image Credits: AI Generated

DOI: 10.1007/s44202-026-00848-8

Keywords: disordered eating, EAT-26, Hong Kong athletes, body image, sports nutrition, eating disorder risk, cross-sectional study, adolescent athletes, dieting behavior, sport psychology, Relative Energy Deficiency in Sport, athlete screening

The scale of the evidence base is what gives the finding its force. The researchers pooled observational studies from Western countries, examining not only diagnosed conditions such as anorexia nervosa, bulimia nervosa and binge eating disorder, but also the early warning symptoms that precede formal diagnosis. These included restricting food intake, fasting, poor body image, and feeling a persistent pressure to become thinner. Capturing this broader spectrum matters because eating disorders often begin quietly, with behaviours and attitudes that never reach a clinic until the illness is entrenched. By including subclinical symptoms, the review could detect patterns that diagnosis-based datasets alone would miss, particularly in populations where access to specialist care is already limited.

Among the various measures of socioeconomic background, family income emerged as the strongest and most consistent correlate. Roughly two-thirds of the reviewed studies found that teenagers from lower-income families were more likely to exhibit eating disorder symptoms, and, strikingly, no studies found the opposite association. In epidemiology, where individual studies frequently disagree and effect directions flip between cohorts, such one-sided consistency is unusual. It suggests that the relationship between economic disadvantage and disordered eating is not a statistical artefact of one dataset but a pattern replicated across dozens of independent samples, methods and national contexts.

Parental education told a similar story. Teenagers whose parents had more education were less likely to show symptoms of an eating disorder. In one illustrative comparison, adolescents whose parents had not attended university were around 25 per cent more likely to report eating disorder symptoms than those whose parents had gone to university. The authors caution that education was measured in different ways across the included studies, but that the measures broadly map onto whether parents held a university-level qualification. Even with that imprecision, the direction of the effect aligns with the income findings: advantage, in this domain, appears protective rather than risk-elevating.

Not every socioeconomic indicator behaved so cleanly. Measures such as neighbourhood deprivation, parental occupation, financial difficulties within the household, and receipt of government benefits produced far more mixed and inconsistent results across the literature. That heterogeneity is itself informative. Income and education are relatively stable, well-recorded characteristics of a household, whereas benefits receipt or neighbourhood-level deprivation may capture different things in different countries and welfare systems. The inconsistency may also reflect how thinly these variables have been studied compared with income and education. For researchers, the message is that the choice of socioeconomic measure is not neutral, and future work should be explicit about which dimension of disadvantage it is testing.

Senior author Dr Nora Trompeter, of UCL Great Ormond Street Institute of Child Health, said the stereotype of eating disorders as a problem of affluence is not the full picture. She noted that the review found teenagers from lower-income, lower-education households are actually more likely to show signs of disordered eating, and argued that prevention and treatment efforts therefore need to reach families facing financial and social disadvantage who may currently be overlooked. In a further statement, she was blunt about the stakes: eating disorders do not discriminate by income or education, and if anything the evidence points the other way, so treating them as a privileged condition risks leaving the adolescents most in need of support undiagnosed and untreated.

The clinical consequences of that stereotype are easy to trace. If parents, teachers and general practitioners assume that eating disorders concentrate among wealthy families, then a teenager from a low-income household who is skipping meals, fasting or expressing intense body dissatisfaction may not trigger the same alarm. Screening tools may be applied less readily, referrals may be delayed, and the young person themselves may not recognise their experience as an illness worth reporting. The researchers are now calling on clinicians, healthcare professionals and school counsellors to broaden their assumptions about who is at risk, in order to improve early identification. Challenging outdated stereotypes, they argue, could directly reduce missed diagnoses and get timely treatment to the young people who need it most.

The review also raises broader questions about why disadvantage might amplify eating disorder risk, and the authors are careful not to overclaim mechanisms from observational data. Plausible pathways discussed in the wider literature include chronic stress associated with financial hardship, food insecurity that can disrupt regular eating patterns and later contribute to binge-type behaviours, limited access to mental health services, and social pressures around body image that cut across class lines. None of these mechanisms is confirmed by the review itself, which is designed to establish the association rather than explain it. But the consistency of the income and education findings gives researchers a clear target for the next generation of studies, which should follow adolescents over time to test whether disadvantage precedes and contributes to disordered eating rather than merely co-occurring with it.

The study has limitations that the authors acknowledge openly. Most of the included research involved mainly white adolescents from Western countries, meaning the findings may not generalise to other ethnic groups or to low- and middle-income countries, where the relationship between socioeconomic status and eating behaviour could differ substantially. The reviewed studies also used different ways of measuring family socioeconomic status, which makes it difficult to draw firm, quantified conclusions about effect sizes across the whole body of evidence. The 25 per cent figure associated with parental education should be read in that light, as an illustration of the direction of the association rather than a precise universal estimate. These caveats temper but do not undermine the central result, which rests on the sheer consistency of the income findings across dozens of studies.

What the review ultimately delivers is a course correction. Eating disorders are among the most lethal psychiatric conditions, and early treatment markedly improves outcomes, which makes systematic under-recognition in any population a serious public health failure. If the prevailing stereotype has steered clinical attention toward affluent, well-educated families while the epidemiological evidence points the other way, then thousands of adolescents from disadvantaged backgrounds may be slipping through unexamined. The research team, whose work was supported by grants from UK Research and Innovation and the Novo Nordisk Foundation, hopes the findings will prompt a practical shift: wider screening assumptions in primary care and schools, greater awareness among families facing financial and social disadvantage, and research funding directed at understanding and interrupting the pathways that link hardship to disordered eating. For a field that has spent decades fighting one stereotype about who gets eating disorders, the data now demand that it fight another.

Subject of Research: The association between adolescent eating disorder symptoms and family socioeconomic status

Article Title: Eating disorders more common in teens from low socioeconomic backgrounds

Article References: Eating disorders more common in teens from low socioeconomic backgrounds. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: eating disorders, adolescents, socioeconomic status, family income, parental education, systematic review, UCL, disordered eating, mental health, health inequalities, early identification, International Journal of Eating Disorders

The study’s participants completed a battery of self-report questionnaires, including validated measures of body dissatisfaction, disordered eating, and the internalization of sociocultural appearance ideals, alongside a purpose-built questionnaire assessing how they actually used Instagram. The researchers deliberately went beyond the crude metric of minutes per day. They asked about the content participants consumed, the activities they engaged in, and the social feedback they received, on the premise that an hour spent scrolling fitspiration accounts is not psychologically equivalent to an hour spent watching cooking videos or messaging friends.

What they found paints a vivid statistical portrait of a generation living inside an appearance-saturated visual economy. One in four participants reported spending three or more hours per day on Instagram. More than half — 55.1 percent — admitted to editing their photos before posting them, digitally reshaping their faces and bodies to fit an idealized template. Nearly 40 percent reported that receiving many likes on a post made them feel better about their appearance, a striking illustration of how quantified social approval has become entangled with self-worth. And 53.8 percent said they followed fitspiration content, the genre of fitness-themed imagery that research has repeatedly shown promotes a ‘strong is the new skinny’ ideal while functioning much like thin-ideal media in its effects on viewers.

These specific behaviors mattered. The researchers found that photo editing, sensitivity to likes, and following fitspiration accounts were each associated with some or all of the body-image variables they measured, including greater appearance-ideal internalization, more frequent appearance comparisons, higher body dissatisfaction, and more disordered eating symptoms. In other words, it is not simply being on Instagram that correlates with body image concerns; it is what users do there and what they expose themselves to. A user who edits her selfies, tracks her likes, and fills her feed with sculpted fitness bodies is participating in a feedback loop in which she both consumes and produces idealized imagery, continuously reinforcing the standards she is measured against.

The most consequential finding, however, concerned perceived appearance pressure. The majority of participants reported feeling pressure from Instagram to conform to appearance standards — a subjective sense that the platform demands a certain kind of body, face, and presentation. This perceived pressure was significantly related to higher levels of appearance-ideal internalization, meaning participants had absorbed those standards as their own personal ideals; to more frequent appearance comparisons, the mental habit of measuring one’s own body against the bodies on screen; to greater body dissatisfaction; and to more disordered eating. The researchers’ theoretical model, the Tripartite Influence Model, originally developed to explain how peers, family, and traditional media shape body image, proved remarkably adaptable to the social media era.

Crucially, the statistical analysis showed that both appearance-ideal internalization and appearance comparison significantly mediated the relationship between perceived appearance pressure on Instagram and body dissatisfaction. In plain terms, the pressure itself does not act directly; it works through two intermediate psychological steps. First, women internalize the ideals they perceive — the thin, toned, edited aesthetic becomes their personal benchmark. Second, they engage in habitual comparison, holding their real bodies up against that benchmark and, inevitably, finding themselves wanting. This dual-pathway structure is scientifically important because it identifies specific, testable targets for intervention. If internalization and comparison are the conduits of harm, then programs that disrupt those conduits — media literacy training, for example, which has a documented evidence base in reducing body dissatisfaction — could plausibly blunt Instagram’s impact even in a world where the platform remains ubiquitous.

The findings arrive amid a growing international body of research linking image-based social media to body image disturbance and disordered eating. Systematic reviews and meta-analyses have consistently reported positive associations between social networking site use and body image concerns in young women, and experimental work has shown that brief exposure to idealized Instagram imagery can measurably worsen women’s mood and body satisfaction compared with control images. Studies have also documented that photo-based activities — posting selfies, investing in feedback on those selfies, editing images — are more strongly tied to body surveillance and dissatisfaction than passive text-based use. The Portuguese study adds granularity to this literature by dissecting the platform’s effects into content, activity, and perceived pressure, rather than treating Instagram as a monolithic exposure.

The study also carries implications for how the fitspiration phenomenon should be understood. Marketed as health motivation, fitspiration content has been shown in content analyses to objectify and sexualize women’s bodies, present narrowly defined and largely unattainable physiques, and frequently pair imagery with diet and exercise messaging that shades into disordered eating territory. That more than half of the surveyed students followed such accounts suggests how thoroughly this genre has been normalized. The fact that following fitspiration content was associated with body-image variables in this sample reinforces the argument, advanced by several research groups, that ‘wellness’ aesthetics can function as thin-ideal media in a new visual dialect — one that borrows the language of health to legitimize appearance scrutiny.

There are, of course, limits to what a cross-sectional, self-report study can establish. The design cannot prove that Instagram pressure causes body dissatisfaction; it is possible that women who already feel worse about their bodies seek out more appearance-focused content and perceive more pressure. Self-report measures are also vulnerable to recall and social desirability biases, and the sample — female college students at a Portuguese university — may not generalize to men, to adolescents, or to users in other cultural contexts. The researchers note that the data cannot be shared publicly for privacy and ethical reasons, and that participants consented to their data being used only for this study. Still, the consistency of the present findings with experimental and longitudinal work elsewhere strengthens the case that the observed pathways reflect a genuine risk mechanism rather than a statistical artifact.

The authors argue that their results carry weight for research, intervention, educational programs, and policy alike. For clinicians, the identification of internalization and comparison as mediators supports assessment and treatment approaches that directly target these processes, which are already central to cognitive-behavioral and media-literacy-based prevention programs. For educators, the high prevalence of photo editing and like-sensitivity among young women suggests that digital literacy curricula should address not just what students see online but how they curate and perform their own images. And for policymakers, the study adds to the accumulating evidence base behind regulatory efforts to scrutinize how platform design — infinite appearance-focused feeds, quantified approval metrics, and algorithmic amplification of idealized bodies — may contribute to harm among young users. As Instagram and its visual kin become ever more deeply woven into daily life, the study’s central message is difficult to ignore: the danger lies not in the app itself, but in the pressure it transmits and the psychological machinery through which that pressure becomes self-criticism.

Subject of Research: The relationship between Instagram use, perceived appearance pressure, and body image outcomes in female college students

Article Title: Instagram Use and Body Image Variables in Female College Students

Article References: Coelho, C., Fontes, C., Ramos, R., Rodrigues, T., Machado, P. P., & Gonçalves, S. (2025). Instagram Use and Body Image Variables in Female College Students. Trends in Psychology. https://doi.org/10.1007/s43076-025-00501-8

Image Credits: AI Generated

DOI: 10.1007/s43076-025-00501-8

Keywords: Instagram, body image, body dissatisfaction, disordered eating, appearance pressure, appearance comparison, appearance-ideal internalization, fitspiration, photo editing, social media, female college students, Tripartite Influence Model

The review, led by Anna Preece and colleagues at Bournemouth University with collaborators at the University of Southampton, the University of Exeter and a primary care practice in Poole, systematically searched five major research databases: EBSCO, PubMed, Scopus, Cochrane and Web of Science. Two reviewers independently screened the results, resolving disagreements through discussion, and the team included all published, peer-reviewed studies that examined clinical populations with alcohol use disorder, regardless of study design or country of origin. That broad net captured forty-four studies, spanning observational research and intervention trials, from which four key themes emerged: the prevalence of eating disorder symptomology, the psychological mechanisms underpinning both conditions, treatment engagement and outcomes, and differences across cultural, ethnic and gender lines.

The headline finding is one of sheer frequency. Disordered eating symptomology proved highly prevalent among people in alcohol treatment services, with bulimia nervosa the most frequently reported diagnosis. This is a striking pattern because much of the existing literature on eating and drinking comorbidity has focused on college students or on populations recruited from eating disorder clinics, groups whose experiences differ substantially from those of people actively receiving treatment for alcohol dependence. By concentrating specifically on clinical AUD populations, the review fills a gap that has left clinicians without a clear picture of who in their caseloads may also be struggling with binge eating, restrictive eating or compensatory behaviours.

Why should these two conditions be so intertwined? The review points to a set of shared psychological mechanisms that function as common engines for both behaviours. High levels of negative urgency, the tendency to act impulsively when experiencing intense negative emotions, were identified across studies, alongside emotional dysregulation and low self-esteem. In practical terms, this means that for many individuals, alcohol and food serve parallel functions: both can become tools for numbing, soothing or escaping difficult feelings. A person who drinks to blunt distress may also binge eat for the same reason, or swing between restriction and binging as another way of exerting control or coping with shame. The behaviours look different on the surface, but they may be two expressions of the same underlying vulnerability.

The consequences of this comorbidity are not merely additive; they compound. The review found that individuals with comorbid eating disorders were more likely to leave treatment services early or against medical advice, and that the presence of disordered eating was associated with increases in illness severity, mortality risk and recovery time. Demographic patterns also emerged: people with comorbid eating disorders were more likely to be Caucasian and less likely to be employed, findings that may reflect both differential risk and differential access to care. For treatment services, the message is sobering. A patient who abandons an alcohol programme prematurely may not simply be resisting abstinence; they may be struggling with an unrecognised eating problem that no one has asked about.

That last point leads to one of the review’s most provocative clinical implications: the possibility that abstinence-focused treatment models may inadvertently reinforce restrictive eating. Alcohol treatment is, by design, built around stopping a behaviour entirely. But if food is serving a similar emotional function for a patient, a treatment culture that frames all coping-through-substance as failure could push individuals toward restricting food instead, simply swapping one form of dysregulated consumption for another. The authors argue that this underscores the need for research into holistic, integrated approaches that address the shared mechanisms rather than treating each behaviour as an isolated target. A transdiagnostic model of diagnosis and intervention, one that cuts across diagnostic categories to target emotional dysregulation, impulsivity and self-esteem directly, may offer a more coherent framework than parallel but separate treatment pathways.

The review also raises a significant equity concern regarding gender. Although the evidence showed that disordered eating symptomology and its functional role were broadly similar in men and women, most research to date has focused on women, and gender-specific screening tools remain underdeveloped. Given that men make up the majority of people in alcohol treatment services in many countries, this gap means that men’s disordered eating may be going systematically unrecognised. A man in an alcohol programme who binges or restricts may never be asked about his relationship with food, because both the screening instruments and the research base were built primarily around female presentations of eating disorders. The authors call for research that recruits men and women equitably, so that the evidence base reflects the actual population of people seeking help.

Methodologically, the review is candid about the limitations of what it synthesised. The forty-four included studies varied widely in design, measurement instruments and populations, as reflected in the long list of questionnaires catalogued in the paper, from the Eating Disorder Examination Questionnaire and the Binge Eating Scale to the Difficulties in Emotion Regulation Scale and the Barratt Impulsiveness Scale. This heterogeneity makes it difficult to pool findings or draw precise prevalence estimates, and the field relies heavily on cross-sectional data that cannot establish whether disordered eating precedes alcohol problems, follows them, or emerges from the same vulnerabilities. The authors are explicit that there is a clear research need for adequately powered, longitudinal studies that follow people over time and include both men and women, which would allow researchers to untangle the direction of the relationship and identify when intervention would be most effective.

For clinicians working in alcohol services, the practical recommendation is comparatively simple: consider routinely asking about eating behaviours. Screening for disordered eating at intake, and monitoring it throughout treatment, could identify patients at elevated risk of dropout and relapse before those risks materialise. Because the two conditions share psychological underpinnings, interventions that build emotion regulation skills, address impulsivity and support self-esteem could plausibly benefit both problems simultaneously, though the review stops short of claiming that existing integrated treatments have been proven effective, since that evidence does not yet exist at scale. What the review does establish is that the status quo, in which eating behaviours go unassessed in AUD clinical settings, leaves a measurable and consequential blind spot.

The broader significance of this work lies in how it reframes addiction and eating disorders not as separate silos of psychiatry but as neighbouring expressions of shared vulnerability. As research on transdiagnostic mechanisms matures, the boundaries between diagnostic categories may become less clinically meaningful than the underlying processes that generate them. For the millions of people worldwide receiving treatment for alcohol use disorder, the review’s message is that recovery may depend on asking a question that services have rarely thought to ask: not just how much are you drinking, but how are you eating, and why?

Subject of Research: Comorbidity of disordered eating behaviour and alcohol use disorder in clinical populations

Article Title: Understanding the comorbidity of disordered eating behaviour and alcohol use disorder: a scoping review

Article References: Preece, A., Casey, C., Foote, G., Greville-Harris, M., McDermott, L., Murphy, J., & Sinclair, J. M. A. (2026). Understanding the comorbidity of disordered eating behaviour and alcohol use disorder: a scoping review. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01788-3

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01788-3

Keywords: alcohol use disorder, disordered eating, comorbidity, binge eating, bulimia nervosa, emotional dysregulation, impulsivity, scoping review, treatment dropout, transdiagnostic model, gender differences, screening

The research, published in the Journal of Eating Disorders by Chenfan Yang and Nurul Fazzuan Khalid of Universiti Sains Malaysia, took what statisticians call a person-centered approach. Instead of asking how a single parenting dimension correlates with eating outcomes across a whole sample, the researchers asked a more realistic question: how do paternal and maternal rejection and overprotection actually combine within individual families? Guided by the Developmental Psychopathology framework, which emphasizes that risk emerges from configurations of factors rather than isolated variables, they used latent profile analysis, a technique that sorts people into unobserved groups based on patterns in their responses.

The sample comprised 1,198 Chinese college students, 45.3 percent of them female, with an average age of 19.14 years, recruited from five colleges through stratified cluster sampling. Each participant completed the short form of the Egna Minnen av Barndoms Uppfostran, a Chinese-language questionnaire known as the s-EMBU-C that measures remembered parenting along the dimensions of rejection and overprotection separately for fathers and mothers. Disordered eating was assessed with the EAT-19, a brief screening instrument capturing attitudes and behaviors characteristic of eating pathology. Crucially, the researchers did not simply run the analysis once and accept the result. They employed a split-half cross-validation procedure, dividing the sample and testing whether the same profiles emerged independently in each half, a safeguard against statistical artifacts that many similar studies skip.

Four distinct and replicable parenting profiles emerged from the data, and their composition tells a story about contemporary Chinese family life. The smallest group, accounting for 5.8 percent of students, was labeled Dual-Risk: these were families in which both rejection and overprotection were extremely high, a combination of emotional coldness and intrusive control. The Moderate group, 30.5 percent of the sample, showed high rejection paired with moderate overprotection. The Healthy group, 29.5 percent, reported low levels of both dimensions. But the most common profile, encompassing 34.2 percent of participants, was the one the researchers called Helicopter: low rejection combined with elevated overprotection. More than a third of the students in the study described parents who were deeply involved and protective but not hostile or dismissive.

When the researchers compared disordered eating scores across these four profiles, the differences were statistically robust, with an analysis of variance yielding F(3, 1194) = 14.46 and p < .001. The severity ranking was unambiguous: students from Dual-Risk families reported the highest levels of disordered eating, followed by those from Moderate families. Students from Helicopter and Healthy families, however, showed similarly low levels. In other words, overprotection on its own, even at intense levels, was not associated with elevated eating-related risk. What mattered was rejection. Families defined by emotional rejection, whether or not they were also overprotective, were the ones linked to disordered eating vulnerability.

This finding cuts against a popular narrative. Helicopter parenting has become a catch-all villain in discussions of young adult wellbeing, blamed for everything from anxiety to fragile self-esteem. The new results suggest that in the Chinese context, at least where disordered eating is concerned, the alarm about intensive parental involvement may be misplaced. A parent who monitors closely, restricts autonomy, and involves themselves heavily in their child’s life does not, on this evidence, raise the risk of disordered eating so long as the emotional climate remains warm and accepting. The toxic ingredient is the experience of feeling rejected, unloved, or dismissed, and the study suggests that interventions should prioritize addressing rejection-centric family climates over merely curbing intensive involvement.

The study also examined whether sociodemographic characteristics predicted which parenting profile a student belonged to, using multinomial logistic regression. Only one factor emerged as significant: only-child status. Students without siblings were substantially more likely to belong to the Helicopter profile than students with siblings, with odds ratios of 0.60 to 0.61, meaning non-only children had roughly 40 percent lower odds of membership in that group. This makes intuitive sense in the context of China, where the legacy of the one-child policy means that an enormous generation of parents concentrated their attention, resources, and anxieties on a single offspring. Intensive, protective parenting may be less a pathology than a structural consequence of family composition.

The methodological rigor of the study deserves attention, because person-centered research is vulnerable to overfitting. Latent profile analysis can sometimes produce groups that look meaningful in one sample but dissolve in another, reflecting sampling noise rather than genuine family types. By requiring the same four profiles to replicate across randomly split halves of the sample, Yang and Khalid strengthened the case that these configurations represent something real about how parenting dimensions cluster in Chinese families. The disaggregation of parenting into four separate dimensions, paternal rejection, maternal rejection, paternal overprotection, and maternal overprotection, also allowed the analysis to capture asymmetries between mothers and fathers that composite scores would have erased.

There are, of course, limits to what a cross-sectional survey can establish. The study measured students’ recollections of parenting and their current disordered eating at the same point in time, so it cannot prove that rejection causes eating problems; it is possible that young people who struggle with food and body image retrospectively perceive their parents as more rejecting. Self-report questionnaires are also subject to memory biases and cultural norms about what one admits on a survey. The sample, while large and drawn from five colleges, consists of university students, and findings may not generalize to adolescents or to young people outside higher education. The authors published their work as an open-access article, and the version released in September 2026 is an early citable edition subject to final editorial updates.

Even with those caveats, the practical implications are considerable. Disordered eating is increasingly prevalent among Chinese college students, and prevention programs often target parenting, advising parents to loosen their grip. This study suggests that message may need recalibrating. If overprotection alone carries little risk, then resources aimed at reducing parental involvement could be redirected toward the emotional quality of the parent-child relationship, specifically toward reducing rejection, hostility, and emotional dismissal. For clinicians screening students, the profiles offer a shorthand: the students most at risk are not those with the most intrusive parents, but those who grew up feeling unwanted. In a country where helicopter parenting is increasingly the norm rather than the exception, that distinction could shape how a generation of families understands what children actually need to grow up with a healthy relationship to food.

Subject of Research: Associations between parenting profiles and disordered eating among Chinese college students

Article Title: Four parenting profiles and disordered eating: A latent profile analysis with cross-validation in Chinese college students

Article References: Yang, C., & Khalid, N. F. (2026). Four parenting profiles and disordered eating: A latent profile analysis with cross-validation in Chinese college students. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01778-5

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01778-5

Keywords: disordered eating, parenting profiles, latent profile analysis, parental rejection, overprotection, helicopter parenting, Chinese college students, only children, developmental psychopathology, s-EMBU-C, EAT-19, Journal of Eating Disorders

Weight bias internalization, often abbreviated as WBI, describes the process by which individuals absorb the negative stereotypes, prejudice, and discrimination that circulate around body weight and then direct those beliefs inward. Rather than simply holding stigmatizing views about others, a person who has internalized weight bias engages in self-blame and self-devaluation, judging their own body through the lens of cultural assumptions that equate higher weight with laziness, poor discipline, or moral failing. In adolescence, a developmental window in which body image is consolidating and identity is still forming, psychologists consider this self-directed stigma particularly corrosive.

Most of what scientists knew about the link between internalized weight stigma and disordered eating came from cross-sectional studies, snapshots taken at a single point in time. Those designs can show that WBI and disordered eating co-occur, but they cannot establish which comes first. The new study was designed to break that ambiguity by measuring weight bias internalization at a baseline assessment and then tracking the same adolescents over two years to see whether their earlier levels of internalized stigma forecast later eating problems, even after accounting for how they were doing at the start.

The researchers drew a representative sample of adolescents from Terrassa, a city in the Barcelona metropolitan area, using random multistage cluster sampling to select participants across schools. At baseline in 2022, 1,016 adolescents completed assessments, and 551 of them returned for follow-up in 2024, an overall retention of 54.2 percent. Retention was substantially higher among participants who remained in compulsory secondary education, reaching 81.3 percent, which the authors note strengthens confidence in the representativeness of the longitudinal subsample for that group. The study received ethics approval from the Universitat Autònoma de Barcelona and followed the Declaration of Helsinki, with active parental consent and adolescent assent at baseline and participant consent at follow-up.

Weight bias internalization was measured with the WBIS-M scale, a widely used instrument that asks respondents to rate their agreement with statements reflecting self-directed weight stigma. Two years later, the team assessed a battery of outcomes: drive for thinness, body dissatisfaction, bulimic symptoms, binge eating severity, and engagement in unhealthy weight control behaviors, the latter covering strategies such as skipping meals, fasting, or other potentially harmful attempts to manage weight. The statistical models were deliberately conservative. Linear regression, multinomial logistic regression, and modified Poisson regression were all adjusted for baseline levels of the outcome being predicted, for measured weight status, and for sociodemographic variables, meaning the analyses tested whether WBI added predictive value beyond what was already known about each adolescent.

The results were consistent across outcomes. Higher weight bias internalization at baseline prospectively predicted greater disordered eating attitudes and higher overall eating disorder risk two years later, with regression coefficients ranging from 0.7 to 3.28 and p-values between 0.029 and below 0.001. The effects were especially pronounced in girls, a pattern the authors emphasize as clinically important given that girls already carry the heaviest burden of eating pathology during adolescence. The finding suggests that internalized stigma functions as a specific amplifier of risk in the group most vulnerable to it.

Two findings stand out for their magnitude and prevalence. Among girls, baseline WBI was associated with a more than twofold increase in the relative risk of severe binge eating at follow-up, with a relative risk ratio of 2.45 and a p-value of 0.001. Girls with higher internalized weight stigma were also significantly more likely to report unhealthy weight control behaviors, with a relative risk of 1.04 at p equal to 0.017. That modest relative risk translates into substantial absolute impact because the behaviors themselves are so common: 42.1 percent of the entire sample reported engaging in unhealthy weight control behaviors, rising to 55.4 percent among girls. More than half of the adolescent girls in this representative sample were, in effect, using potentially harmful methods to control their weight.

The technical strength of the design lies in its temporal separation and adjustment strategy. Because WBI was measured before the outcomes, and because the models controlled for baseline outcome levels, the associations cannot be explained by reverse causation in the simple sense, that is, by eating problems already present driving higher internalized stigma. The adjustment for measured weight status also matters, since it rules out the possibility that the association merely reflects the well-documented link between higher body weight and both stigma and eating concerns. What remains is a pathway in which the psychological experience of self-directed stigma contributes to the development of eating pathology in its own right, independent of body size.

The Mediterranean context of the sample adds weight to the findings. Research on weight stigma has been concentrated in North America and northern Europe, and there has been a genuine gap in prospective data from Mediterranean populations, where dietary culture and body image norms may differ. The Terrassa sample, representative of a mid-sized Spanish city, indicates that the mechanisms linking internalized stigma to disordered eating are not confined to Anglophone settings. The authors also point out that adolescence is a critical period for both body image development and the emergence of eating disorders, which makes longitudinal evidence from this age group especially valuable for prevention planning.

The implications reach beyond the clinic. If internalized weight stigma is a modifiable risk factor, then interventions that reduce stigma before it takes root in self-evaluation could help prevent disordered eating before it begins, rather than treating it after the fact. The authors argue that promoting supportive and inclusive attitudes toward body diversity, and moving away from framing weight as a matter of individual blame, may protect young people’s health and well-being. In practical terms, that points toward school-based programs that address stigma directly, media literacy education that counters narrow body ideals, and public health messaging that avoids the moralizing tone long shown to backfire. With more than half of adolescent girls in this sample already engaging in unhealthy weight control, the case for acting early on the stigma that feeds those behaviors is difficult to ignore.

Subject of Research: Weight bias internalization as a prospective predictor of disordered eating and unhealthy weight control behaviors in adolescents

Article Title: Weight bias internalization and risk of disordered eating and unhealthy weight control behaviors in Spanish adolescents: a two-year longitudinal study

Article References: Almazán, C., Tárrega, S., Fornieles-Deu, A., & Sánchez-Carracedo, D. (2026). Weight bias internalization and risk of disordered eating and unhealthy weight control behaviors in Spanish adolescents: a two-year longitudinal study. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01782-9

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01782-9

Keywords: weight bias internalization, weight stigma, disordered eating, unhealthy weight control behaviors, adolescents, binge eating, body dissatisfaction, longitudinal study, eating disorders, Spain, body image, prevention

The research team recruited 373 women aged between 18 and 58, each of whom reported having experienced at least one traumatic event. The majority of participants reported trauma related to natural disasters or the loss of close loved ones, a profile that reflects the real-world burden carried by many trauma-exposed populations. Data were collected online using a battery of validated instruments: the Posttraumatic Diagnostic Scale for DSM-5 to measure post-traumatic stress symptoms, the Difficulties in Emotion Regulation Scale, the Acceptance and Action Scale-2 to capture experiential avoidance, and the Munich Eating and Feeding Disorder Questionnaire alongside the Eating Attitude Test-26 to assess a spectrum of disordered eating behaviors.

Rather than asking whether post-traumatic stress symptoms simply predict disordered eating, the researchers built a cross-sectional path analysis, conducted in the AMOS statistical software, to test whether specific psychological constructs carry the association indirectly. Path analysis is a structural equation modeling technique that allows researchers to estimate several hypothesized causal-looking pathways simultaneously within correlational data. In this case, the model positioned experiential avoidance, emotion regulation difficulties, and preoccupation with figure and weight as potential mediators standing between trauma symptoms and eating pathology.

The results were striking in their nuance. When the model included only the pathway through preoccupation with figure and weight, that indirect route was not significant. In other words, body image concerns alone could not explain why trauma-exposed women develop disordered eating. But when experiential avoidance and emotion regulation difficulties were added to the model, the indirect pathways became significant both with and without the body preoccupation route. This finding suggests that the emotional machinery of trauma, the tendency to flee painful inner experiences and the struggle to manage overwhelming feelings, is central to the trauma-eating connection, while body dissatisfaction operates as a secondary or downstream factor rather than the primary engine.

Experiential avoidance, a concept rooted in acceptance and commitment therapy research, refers to the unwillingness to remain in contact with distressing internal experiences such as thoughts, memories, and emotions. For a trauma survivor, intrusive memories and hyperarousal can make avoidance feel like survival. Yet avoidance is a blunt instrument: it suppresses not only pain but also the ability to respond flexibly to life. The study found that higher levels of experiential avoidance were linked to more binge eating, more vomiting, and more inappropriate compensatory behaviors, patterns consistent with the idea that food-related behaviors can become a powerful, if destructive, form of emotional escape.

Emotion regulation difficulties told a similarly complex story. Women who reported greater problems managing their emotions showed elevated binge eating, vomiting, compensatory behaviors, and stronger preoccupation with figure and weight. But in a twist that the authors highlight as clinically important, higher emotion regulation difficulties were associated with lower levels of restrictive eating behaviors. This asymmetry challenges the assumption that all disordered eating stems uniformly from poor emotional coping. Restriction, it appears, may follow a different psychological logic than bingeing and purging, one that is less tightly bound to acute emotional dysregulation in this sample.

The distinction matters because it implies that different disordered eating presentations may require different therapeutic targets. A woman whose trauma symptoms drive her toward binge eating as a way of numbing unbearable states may benefit from interventions that build emotion regulation skills and reduce experiential avoidance, such as acceptance-based or dialectical behavior therapy approaches. Someone whose eating pathology centers on restriction may not show the same emotional profile, and treatment that assumes emotion-driven overeating could miss the mark. The authors conclude that the association between post-traumatic stress and disordered eating is unlikely to be accounted for by a single emotional or cognitive construct, but rather involves multiple indirect pathways that manifest differently across symptom presentations.

The study’s cross-sectional design imposes important limits on interpretation. Because all data were collected at a single point in time, the analysis cannot establish that trauma symptoms precede the mediating constructs or the eating behaviors, even though theory and prior longitudinal work make that direction plausible. The sample consisted exclusively of women, which means the findings cannot be generalized to men or to gender-diverse populations, who also experience trauma and eating disorders. Self-report measures introduce the possibility of recall bias and social desirability effects, particularly around stigmatized behaviors such as vomiting and compensatory behaviors. The authors also note that the majority of traumas reported were natural disasters and bereavement, and pathways may differ for survivors of interpersonal violence, which is strongly represented in clinical eating disorder populations.

Even with those caveats, the research carries significant public health weight. Eating disorders are among the most lethal psychiatric conditions, and trauma exposure is extraordinarily common, particularly among women. If even a fraction of trauma-related eating pathology flows through modifiable mechanisms like experiential avoidance and emotion regulation difficulties, then screening trauma-exposed women for these specific vulnerabilities could enable earlier, more targeted intervention. The findings also bolster a growing movement in clinical psychology away from diagnosis-specific silos and toward transdiagnostic models that treat avoidance and emotional dysregulation as shared engines of multiple forms of suffering.

The study, which received no specific funding from any public, commercial, or non-profit agency, was approved by the Ethics Committee of Hacettepe University and is published open access under a Creative Commons Attribution 4.0 license. As the authors and the broader field look ahead, the challenge will be to test these pathways prospectively and across more diverse trauma populations. For now, the message for clinicians and researchers alike is clear: the road from trauma to disordered eating is not a single highway but a network of routes, and understanding which route a patient is traveling may be the key to guiding her back.

Subject of Research: Psychological pathways linking post-traumatic stress symptoms and disordered eating in trauma-exposed women

Article Title: Investigating the roles of experiential avoidance, emotion regulation difficulties and preoccupation with figure and weight in the relationship between post-traumatic stress and disordered eating in a sample of trauma-exposed women

Article References: Ayanlar, K., & Çakır, Z. (2026). Investigating the roles of experiential avoidance, emotion regulation difficulties and preoccupation with figure and weight in the relationship between post-traumatic stress and disordered eating in a sample of trauma-exposed women. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01781-w

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01781-w

Keywords: disordered eating, post-traumatic stress, experiential avoidance, emotion regulation, binge eating, body image, trauma psychology, eating disorders, path analysis, women's mental health, Investigating, roles

The study, conducted at the University Medical Center Ho Chi Minh City and published in Discover Mental Health, followed patients who were either initiating or continuing antidepressant therapy. Participants were assessed at four time points: baseline, one month, three months, and six months. Depressive symptoms were measured with the Quick Inventory of Depressive Symptomatology–Self-Report, a sixteen-item instrument widely used in clinical research, while eating attitudes and behaviors were tracked using the Eating Attitudes Test-26, a validated screening tool that captures dieting behavior, food preoccupation, and oral control.

At the start of the study, the clinical picture was severe. More than 32 percent of participants scored above 15 on the QIDS-SR16, indicating severe or very severe depression. This is consistent with the reality that many patients reach psychiatric care only after symptoms have become disabling. Major depressive disorder has long been linked to disturbances in appetite and weight, with some patients losing interest in food entirely and others turning to eating as a coping mechanism. What has remained underexplored, the authors note, is how these psychological attitudes toward eating evolve once treatment begins and mood begins to stabilize.

The trajectory of depression over the six months was, by every standard metric, a success story. By the end of follow-up, 45.2 percent of participants had achieved remission, meaning their depressive symptoms had receded to clinically insignificant levels. For a condition that resists treatment in a large fraction of patients, this remission rate represents meaningful therapeutic progress and underscores the effectiveness of pharmacological care delivered in a structured outpatient setting.

The eating data told a strikingly different story. The mean EAT-26 total score rose from 4.7 at baseline to 17.0 at six months, a mean increase of 12.3 points that was highly statistically significant. All three subscales of the instrument—Dieting, Bulimia and Food Preoccupation, and Oral Control—showed significant progressive increases over the same period. Perhaps most alarming from a screening standpoint, the proportion of patients crossing the conventional clinical threshold of an EAT-26 score of 20 or higher grew from just 1.6 percent at baseline to 39.6 percent at six months. In other words, roughly two in five patients who began treatment with unremarkable eating attitudes ended the study period scoring in a range typically associated with elevated risk of disordered eating.

To understand what was driving this shift, the researchers turned to generalized structural equation modeling, a statistical framework capable of handling multivariate longitudinal associations while accounting for the complexity of repeated measurements. Two factors emerged with particular force. Patients who reported increased appetite or weight gain during treatment scored substantially higher on the EAT-26, with a beta coefficient of 3.2, while those who achieved clinical remission of their depression scored significantly lower, with a beta of minus 6.1. Both associations were highly significant, and together they sketch a nuanced picture: recovery itself appears protective, but the metabolic and appetite side effects that often accompany antidepressant medications may push patients toward dieting behaviors, food preoccupation, and restrictive attitudes even as their mood improves.

This finding carries particular weight given the pharmacology of modern antidepressants. Selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressants all interact with neural circuits that regulate both mood and appetite. Some agents are well known to stimulate appetite and promote weight gain, effects that patients frequently report as distressing. The new study suggests these physical changes are not merely cosmetic concerns but may translate into measurable psychological distress centered on food, body, and control, even in patients whose depression is otherwise responding well to treatment.

The authors argue that the divergence between mood improvement and worsening eating attitudes exposes a blind spot in routine psychiatric monitoring. Clinical follow-up for depression typically focuses on mood, sleep, energy, and suicidal ideation, while eating attitudes are rarely assessed unless a patient volunteers concerns. Because the conventional EAT-26 cutoff of 20 would have flagged only the extreme end of the distribution, the researchers emphasize that continuous measures, rather than binary clinical thresholds, are essential for detecting the gradual erosion of healthy eating attitudes that their data reveal. A patient scoring 17 would escape screening under current practice, yet sits within a population whose mean scores more than tripled over six months.

The study’s setting adds an important dimension to its significance. Research on eating psychopathology in depression has been concentrated in high-income Western countries, and data from Southeast Asian populations remain scarce. Cultural factors shape both the expression of depression and attitudes toward food, body size, and dieting, and treatment guidelines imported from other contexts may not transfer cleanly. By demonstrating that the mood-eating divergence emerges in a Vietnamese outpatient cohort, the study suggests the phenomenon is not an artifact of Western clinical populations but a potentially general feature of antidepressant treatment that deserves attention across diverse health systems.

For clinicians, the practical message is straightforward: recovery from depression should be monitored with a wider lens. Patients whose mood is improving but who report new appetite changes, weight gain, or growing preoccupation with food and dieting may be developing disordered eating attitudes that warrant intervention before they harden into clinical eating disorders. For researchers, the findings open a clear agenda for future work, including studies that disentangle the effects of specific antidepressant classes, examine whether the trajectory reverses with longer follow-up, and test whether structured nutritional and psychological support during treatment can prevent the rise in disordered eating attitudes. What this study makes unmistakably clear is that healing the mind and healing the relationship with food are not always the same journey, and that treating depression successfully means watching both.

Subject of Research: Longitudinal changes in disordered eating attitudes and behaviors during antidepressant treatment for major depressive disorder

Article Title: Changes in depressive symptoms and disordered eating attitudes and behaviors during antidepressant treatment among Vietnamese patients with major depressive disorder

Article References: Bui, M. X., Ngo, L. T., Huynh, N., Le, P. T. V., Vuu, L. T. M., Nguyen, N. T. Y., & Nguyen, P. D. (2026). Changes in depressive symptoms and disordered eating attitudes and behaviors during antidepressant treatment among Vietnamese patients with major depressive disorder. Discover Mental Health. https://doi.org/10.1007/s44192-026-00598-y

Image Credits: AI Generated

DOI: 10.1007/s44192-026-00598-y

Keywords: major depressive disorder, antidepressants, disordered eating, EAT-26, QIDS-SR16, appetite changes, weight gain, Vietnam, longitudinal study, psychiatry, mental health, remission