The research combines event-related potentials, or ERPs, with a behavioral attentional-blink measure in a rapid serial visual presentation task. This approach allowed the investigators to distinguish different temporal stages involved in food-related attentional bias. The participants were female adolescents, a population in which anorexia nervosa typically emerges and in which the disorder can carry substantial psychological and physical consequences. The study therefore focused not merely on whether food attracted attention, but on how that attention unfolded during and after food images appeared.

At the behavioral level, the results showed increased attentional engagement with food among adolescents with anorexia nervosa. That finding is important because cognitive models of eating disorders have emphasized the role of attentional biases in processing food stimuli, although relatively few studies have examined their temporal dynamics in adolescents with the disorder. At the same time, the lack of an observed impairment in attentional disengagement means the findings do not indicate a uniform deficit in shifting attention away from food. Instead, the group difference was selective, appearing in the engagement and temporal-processing measures rather than across every aspect of attention.

The ERP results added a finer temporal picture. When high-calorie food images served as distractors, participants with anorexia nervosa displayed reduced early electrocortical processing followed by enhanced later processing. In other words, the measured response to these images was not consistently heightened at every stage. The initial response was weaker than that of controls, while later processing was stronger. This pattern suggests that food-related attentional bias in adolescent anorexia nervosa is temporally dynamic rather than a single, fixed mechanism operating identically from first exposure onward.

The attentional-blink results further indicated that the bias was not entirely autonomous. When the task became more demanding and required greater concentration, the anorexia nervosa–specific differences in food attention were no longer evident. The authors interpret this as evidence that allocation of attention to food depends on the attentional resources available at a given moment. Under greater cognitive demand, the observed group differences disappeared, suggesting that they arise under particular conditions of attention rather than independently of the person’s current mental capacity.

Overall, the study points to a more nuanced account of how adolescents with anorexia nervosa process food-related visual information. It does not show that altered attention to food causes the disorder, and it does not establish that the measured pattern is specific to anorexia nervosa beyond the population studied. As an ERP comparison with a limited sample of female adolescents, it identifies measurable differences in temporal attention allocation rather than demonstrating a treatment effect or clinical outcome. Nevertheless, its findings offer a mechanism-level account of how food stimuli can be attended to differently across time and across levels of task demand, with implications for future research into processes that may help maintain the disorder.

Subject of Research: Temporal food-related attentional bias in female adolescents with anorexia nervosa

Article Title: Temporal attentional bias to food stimuli in adolescent anorexia nervosa – an ERP study

Article References: Nannt, J., Wolz, I., Vagedes, J., & Svaldi, J. (2026). Temporal attentional bias to food stimuli in adolescent anorexia nervosa – an ERP study. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01800-w

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01800-w

Keywords: anorexia nervosa, adolescent health, food attention, event-related potentials, attentional blink, electroencephalography, eating disorders, cognitive processing, Temporal, attentional, bias, food

The review examined original studies assessing the relationship between social media use and orthorexia nervosa, including symptoms and diagnostic measures. The search covered PubMed, Web of Science, Embase, Scopus and PsycINFO through January 2026. The researchers pooled zero-order correlations using Fisher’s z transformation and a random-effects model estimated with restricted maximum likelihood.

Statistical heterogeneity was high, with I² = 84.3% in the main correlation analysis. The authors also conducted subgroup and meta-regression analyses, sensitivity tests, leave-one-out analyses and assessments of publication bias. Estimates remained within a narrow range of r = 0.18 to r = 0.20 across the leave-one-out, subgroup and sensitivity analyses, while a bias-adjusted estimate was r = 0.17.

The narrative synthesis suggested that the type of content consumed was more consistently associated with orthorexic tendencies than the platform used or the duration of social media use alone. The supplied findings do not identify particular content categories, platforms or mechanisms, however, so they cannot show that a specific type of social media content causes orthorexic symptoms. Reported prevalence varied sharply with the diagnostic threshold used.

The pooled prevalence was 39.9% when studies applied an ORTO-15 cutoff below 35 and 65.5% with a cutoff below 40. Heterogeneity exceeded 90% in these prevalence comparisons, showing that estimates differed substantially across studies and making the pooled percentages difficult to interpret as a single uniform prevalence. A secondary analysis of two studies with reconstructable 2 × 2 data suggested greater odds of orthorexia among heavier social media users.

The estimated odds ratio was 1.57, with a 95% confidence interval of 1.25 to 1.97. This finding rests on only two studies and therefore offers narrower support than the broader meta-analysis of correlations. All of the included studies used cross-sectional designs.

These studies measure social media use and orthorexic symptoms at the same point in time, so they cannot determine which came first. Reverse causality remains plausible: social media use may be associated with orthorexic tendencies, but people with those tendencies may also engage differently with social media. The evidence therefore supports a cautious conclusion of association rather than a causal effect.

The authors said longitudinal and experimental research is needed to clarify the direction of the relationship.

Subject of Research: Association between social media use and orthorexic symptoms in adolescents and adults

Article Title: The association between orthorexia nervosa and social media use: A systematic review and meta-analysis

Article References: Nakhl, A.-M., Barakat, M. A., Kotaich, J., Elleik, E., Afyouni, A., & Abou Abbas, L. (2026). The association between orthorexia nervosa and social media use: A systematic review and meta-analysis. PLOS Mental Health, 3(10), e0000758. https://doi.org/10.1371/journal.pmen.0000758

Image Credits: AI Generated

DOI: 10.1371/journal.pmen.0000758

Keywords: orthorexia nervosa, social media, systematic review, meta-analysis, orthorexic symptoms, adolescents, adults, cross-sectional studies, evidence certainty, eating disorders, association, between

The study, led by Timothy D. Brewerton of the Medical University of South Carolina together with colleagues at SunCloud Health and the University of Illinois Chicago College of Medicine, focused on patients admitted to residential treatment, partial hospital programs, or intensive outpatient programs for eating disorders, substance use disorders, PTSD, and mood disorders. Within 72 hours of admission, each patient completed a battery of standardized self-report assessments. These included the modified Yale Food Addiction Scale 2.0, which screens for addiction-like eating patterns consistent with DSM-5 substance use criteria applied to food; the Eating Disorder Examination Questionnaire; the Life Events Checklist for DSM-5; the PTSD Checklist for DSM-5; the International Trauma Questionnaire, which captures the ICD-11 construct of complex PTSD; and the Dissociative Subtype of PTSD Scale, among other measures of depression, anxiety, substance use, and quality of life.

Of the 722 patients, 151 met criteria for ultra-processed food addiction on the modified Yale Food Addiction Scale, while 571 did not. The research team compared the two groups using multivariate analyses of variance, statistically adjusting for age, admission body mass index, sex at birth, gender, and eating disorder diagnosis. This design allowed the investigators to isolate differences in trauma exposure and trauma-related symptoms that could not be explained by these baseline characteristics alone. The results were consistent and, in several cases, dramatic.

Patients with ultra-processed food addiction reported significantly higher rates of traumatic event types across the board. Provisional DSM-5-defined PTSD was present in 72 percent of the food addiction group compared with 51 percent of those without it. Using the ICD-11 framework, 40 percent of the food addiction group met criteria for PTSD versus 25 percent of the comparison group, and 37 percent met criteria for complex PTSD compared with 20 percent. The dissociative subtype of PTSD, characterized by symptoms such as depersonalization and derealization, was identified in 53 percent of patients with ultra-processed food addiction, against 32 percent of those without. All of these differences were statistically significant at p less than 0.001.

The comorbidity picture extended well beyond trauma diagnoses. Major depression affected 86 percent of patients with ultra-processed food addiction compared with 68 percent of those without. Eating disorders were dramatically overrepresented, present in 78 percent of the food addiction group versus just 24 percent of the others. Nearly half of the food addiction group, 46 percent, had a body mass index above 30, compared with 30 percent of the non-addiction group. Taken together, the data depict ultra-processed food addiction as a marker of a substantially more complicated clinical presentation, one in which trauma, mood pathology, disordered eating, and elevated body weight converge.

Complex PTSD, formally recognized in the ICD-11, differs from standard PTSD in that it arises typically after prolonged or repeated trauma and includes what clinicians call disturbances of self-organization: difficulties with emotion regulation, a persistently negative self-concept, and problems in relationships. The dissociative subtype of PTSD, recognized in the DSM-5 system, adds a further layer in which individuals experience depersonalization, a sense of being detached from their own body or self, and derealization, a feeling that the surrounding world is unreal. Both conditions were markedly enriched in the food addiction group, and the study found considerable overlap between them.

Within the ultra-processed food addiction group, patients who met criteria for the dissociative subtype and/or complex PTSD scored significantly higher on measures of PTSD symptoms, depersonalization and derealization, loss of awareness, psychogenic amnesia, and disturbances of self-organization. They were also more likely to have a diagnosed eating disorder. Notably, 26 percent of patients with ultra-processed food addiction met criteria for both complex PTSD and the dissociative subtype of PTSD simultaneously, a level of diagnostic overlap that underscores how severe and multi-layered the trauma symptomatology can be in this population. For these patients, the trauma-related illness is not confined to intrusive memories and hyperarousal but extends into memory gaps, diminished awareness, emotional dysregulation, and destabilized self-perception.

The findings carry significant implications for how clinicians assess and treat food addiction. Screening tools used in eating disorder and addiction treatment settings rarely probe systematically for complex PTSD or dissociative symptoms, and the study suggests that this gap may leave some of the most clinically distressed patients without targeted care. The authors emphasize that thorough assessment of the full spectrum of trauma-related symptoms is essential, and that treatment for patients with ultra-processed food addiction should be integrated and individualized, directly addressing trauma sequelae rather than focusing narrowly on eating behavior alone. This is particularly urgent, they argue, for patients who meet criteria for both complex PTSD and the dissociative subtype, whose symptom profiles indicate the greatest psychiatric complexity.

The study also situates ultra-processed food addiction within a broader scientific conversation about the overlapping neurobiology of addiction and trauma. Like substance use disorders, ultra-processed food addiction involves compulsive consumption patterns that persist despite adverse consequences, and the high comorbidity observed here echoes long-standing findings that trauma and PTSD elevate risk for substance-related and behavioral addictions. Dissociative symptoms, by numbing emotional experience and fragmenting awareness, may function for some patients as a coping mechanism in which ultra-processed foods, engineered for intense palatability, provide a rapidly accessible form of affect regulation. The cross-sectional design of the study cannot establish causal direction, and the authors rely on self-report measures, with diagnoses described as provisional; nevertheless, the consistency and magnitude of the associations strengthen the case that trauma is a central clinical consideration in this population.

Published open access in the Journal of Eating Disorders, the study draws on data from patients whose anonymized information was used with written informed consent under approval from the Brany Institutional Review Board. As rates of ultra-processed food consumption continue to climb worldwide, and as health systems grapple with rising obesity and eating disorder prevalence, the research adds a vital dimension to the public understanding of food addiction: for a substantial share of affected patients, the drive toward ultra-processed food may be inseparable from unresolved trauma, dissociation, and the deep psychological wounds of complex PTSD. Recognizing and treating that reality, the authors conclude, is not optional but fundamental to effective care.

Subject of Research: The association of PTSD, complex PTSD, and the dissociative subtype of PTSD with ultra-processed food addiction in psychiatric patients

Article Title: PTSD, complex PTSD and the dissociative subtype of PTSD in patients with ultraprocessed food addiction

Article References: Brewerton, T. D., Nguyen, C., Bilenker, D., & Dennis, K. (2026). PTSD, complex PTSD and the dissociative subtype of PTSD in patients with ultraprocessed food addiction. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01780-x

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01780-x

Keywords: ultra-processed food addiction, PTSD, complex PTSD, dissociative subtype, eating disorders, trauma, depression, obesity, substance use disorder, modified Yale Food Addiction Scale, psychiatric comorbidity, ICD-11

The study was motivated by a persistent gap in the scientific literature. Previous research had suggested that girls who enter puberty earlier than their peers face a higher risk of eating disorders, but evidence in boys remained scarce, and the role of pubertal tempo — the speed at which the body progresses through pubertal stages — had never been clearly established in either sex. Eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder often have their onset during or shortly after puberty, making this developmental window a critical period for understanding how vulnerability emerges. Muscle dysmorphia, a condition characterized by a pathological preoccupation with perceived insufficient muscularity, has received even less attention in longitudinal designs, particularly in relation to pubertal development.

Methodologically, the study stands out for the density and quality of its pubertal data. Rather than relying on a single retrospective question about when puberty occurred, the researchers asked participants to self-assess Tanner stages — the standardized clinical classification of breast, genital, and pubic hair development — as well as age at menarche in girls, first ejaculation in boys, and voice break in boys. These assessments were repeated half-yearly throughout puberty, allowing the investigators to construct detailed individual trajectories of development. From these repeated measurements, pubertal timing and tempo were derived using a non-linear mixed effect growth model, a statistical framework capable of capturing the non-linear, S-shaped character of pubertal progression. Each participant was then categorized as having early or slow, average, or late or fast development for each milestone separately.

The outcomes were assessed at the 18-year follow-up of the Danish National Birth Cohort, combining two complementary data sources. Self-reported diagnoses of anorexia nervosa, bulimia nervosa, and binge eating disorder were collected by questionnaire, while clinically diagnosed anorexia nervosa and bulimia nervosa were identified through the Danish National Patient Register, a national database that captures diagnoses assigned in the Danish healthcare system. Muscle dysmorphia symptoms in boys were measured through self-report at the same follow-up. Associations were quantified as adjusted odds ratios with 95 percent confidence intervals estimated from logistic regression models, controlling for a range of potential confounding factors.

For girls, the pattern of results was strikingly bidirectional. Both early timing of pubic hair development, with an odds ratio of 3.06, and late timing, with an odds ratio of 2.43, were associated with significantly higher odds of clinically diagnosed anorexia nervosa compared with average timing. In other words, deviating in either direction from the population norm for pubic hair development roughly doubled or tripled the odds of receiving a clinical anorexia diagnosis. This U-shaped pattern challenges the simplistic assumption that only early developers are at risk, and it suggests that being out of synchrony with one’s peers — whether ahead of them or behind them — may itself be a source of psychological vulnerability.

The self-reported outcomes in girls painted a more differentiated picture. Late timing of breast development, pubic hair development, and menarche were each associated with markedly higher odds of self-reported anorexia nervosa, with late breast development showing the strongest association at an odds ratio of 3.86 and late menarche at 3.10. In contrast, early timing of these same milestones appeared to be associated with higher odds of binge eating disorder. This divergence hints at distinct psychological pathways: delayed puberty in girls may intersect with body dissatisfaction and restrictive eating as adolescents compare themselves to more physically mature peers, while earlier development, which brings rapid increases in body fat, may be channeled toward loss-of-control eating patterns characteristic of binge eating disorder.

The tempo analysis in girls revealed equally intriguing complexity. Fast tempo of pubic hair development was associated with higher odds of clinically diagnosed anorexia nervosa and self-reported binge eating disorder, but lower odds of self-reported anorexia nervosa, compared with average tempo. That a single characteristic of pubertal progression can point in opposite directions across related outcomes underscores how heterogeneous eating disorders are, and why no single developmental marker should be interpreted in isolation. For boys, the tempo findings were inconsistent overall, offering no clear evidence that the pace of puberty independently shapes muscle dysmorphia risk.

In boys, however, the timing findings were coherent and clinically meaningful. Early timing of first ejaculation was associated with higher odds of muscle dysmorphia symptoms, with an odds ratio of 1.96, and late timing of genital development was similarly associated, at an odds ratio of 1.88. This is among the strongest population-based evidence to date linking pubertal timing to muscle dysmorphia, a condition that has grown more visible with the rise of appearance-focused social media, supplement culture, and male body image concerns. The bidirectional pattern seen in girls was mirrored here: boys whose sexual development departed from the typical schedule, whether precocious or delayed, showed elevated odds of symptoms. Early-maturing boys may have experienced rapid muscular growth that drew attention and shaped expectations, while late developers may have felt their bodies lagged behind an idealized masculine physique.

Taken together, the study’s central conclusion is that pubertal timing, rather than tempo, showed the most consistent associations across clinically diagnosed and self-reported outcomes. The authors suggest that earlier and later pubertal timing may help identify adolescents who could benefit from closer monitoring for early signs of eating disorders and muscle dysmorphia symptoms. Because the Puberty Cohort assessed development half-yearly with a validated growth-modeling approach, and because clinical diagnoses were drawn from a national patient register rather than self-report alone, the study offers unusually robust triangulation of exposure and outcome. The availability of register-based diagnoses is a particular strength, since anorexia nervosa in clinical settings is far less susceptible to reporting bias than questionnaire-based assessment.

Nevertheless, some limitations warrant cautious interpretation. Pubertal milestones were self-assessed rather than rated by clinicians, and self-report of Tanner stages, while widely validated, carries some measurement imprecision. The outcomes were captured at age 18, and residual confounding by factors such as pre-pubertal body mass index, family environment, or genetic predisposition cannot be excluded. The modest number of clinically diagnosed cases, reflected in wide confidence intervals for some estimates, means the precise magnitudes of the associations should be treated as approximate. Even so, the scale of the cohort, the granularity of the pubertal assessments, and the convergence of self-reported and register-based outcomes make this one of the most comprehensive investigations of puberty and body image pathology conducted to date. The message for clinicians, parents, and educators is deceptively simple: adolescents whose puberty does not arrive on the typical schedule — in either direction — deserve particular attention in the years that follow, when disordered eating and distorted body image are most likely to take root.

Subject of Research: Pubertal timing and tempo in relation to eating disorders and muscle dysmorphia symptoms in Danish adolescents

Article Title: Pubertal development and eating disorders and muscle dysmorphia symptoms in adolescents: a Danish population-based follow-up study

Article References: Thomsen, A. M. L., Ernst, A., Strandberg-Larsen, K., Rask, C. U., Gaml-Sørensen, A., Benson, T. E., Arah, O. A., & Ramlau-Hansen, C. H. (2026). Pubertal development and eating disorders and muscle dysmorphia symptoms in adolescents: a Danish population-based follow-up study. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01799-0

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01799-0

Keywords: pubertal timing, pubertal tempo, eating disorders, anorexia nervosa, bulimia nervosa, binge eating disorder, muscle dysmorphia, Tanner stages, adolescents, Danish National Birth Cohort, body image, epidemiology

A research team led by Clara Sophie Beer of LWL University Hospital Hamm for Child and Adolescent Psychiatry at Ruhr University Bochum, working with colleagues from the University of Hildesheim and Charité Universitätsmedizin Berlin, has now taken a step toward closing that gap. In a study published in BMC Psychology, the team evaluated whether the Body Checking and Avoidance Questionnaire, known as the BCAQ, can be used reliably and validly in female adolescents diagnosed with anorexia nervosa or atypical anorexia nervosa. The instrument is the only questionnaire designed to capture both checking and avoidance behaviors in a single measure, which makes it uniquely suited to assessing the full behavioral spectrum of body image distortion.

The conceptual logic behind the BCAQ is straightforward. Body image is conventionally divided into components: an affective component covering feelings about the body, a cognitive component covering beliefs and attitudes, a perceptual component covering how accurately people judge their size and shape, and a behavioral component covering what people actually do. Established instruments such as the Body Checking Questionnaire and the Body Image Avoidance Questionnaire each target one side of the behavioral picture, but the BCAQ, originally developed for adults, combines both. Its 27 items ask respondents how frequently they engage in specific actions, from scrutinizing particular body parts to wearing baggy clothing to sidestep attention. Whether those items make psychological sense to a 14-year-old, and whether they hang together as coherent scales in younger respondents, was precisely what the German team set out to test.

The study drew on anonymized routine clinical data from female adolescents treated for anorexia nervosa or atypical anorexia nervosa, the latter diagnosis applied when all criteria of anorexia are met except significant weight loss. The research was approved by the Ethics Committee of the Medical Faculty at Ruhr University Bochum, and because the analyses used anonymized clinical data, informed consent was not required under German data protection regulations, though patients and their legal guardians were informed that anonymized data might be used for research. This clinical sampling strategy matters because validation studies conducted only in healthy or community samples can say little about how a measure performs where it is needed most, among patients whose symptoms are severe enough to require treatment.

The psychometric work began with a confirmatory factor analysis, the standard technique for testing whether a questionnaire’s predefined structure fits new data. Here the news was initially sobering: the original 27-item BCAQ showed poor model fit in the adolescent sample. Fit indices, which include the comparative fit index, the Tucker-Lewis index, the root mean square error of approximation, and the standardized root mean square residual, all indicated that the adult-derived factor structure did not translate cleanly to this younger clinical group. Rather than abandoning the measure, the researchers turned to exploratory factor analysis, a more open-ended statistical approach that lets the data reveal their own underlying structure. This analysis flagged four items with low or inconsistent loadings, meaning those items did not correlate strongly or consistently with any coherent behavioral dimension in adolescents.

Removing those four items produced an adapted 23-item version, and the revised measure performed considerably better. The analyses yielded a preliminary three-factor structure, suggesting that checking and avoidance behaviors in adolescents organize into three distinguishable behavioral clusters rather than the two broad categories the original instrument assumed. Reliability, assessed with Cronbach’s alpha, ranged from 0.78 to 0.94 across the scales, values that sit within the range conventionally regarded as good for psychological instruments. Convergent validity, the degree to which the BCAQ scores correlate with related constructs measured by other questionnaires such as the Eating Disorder Examination Questionnaire and body shape concern measures, was satisfactory, indicating that the adapted measure taps the same underlying clinical reality as established adult instruments.

The known-groups comparisons, which test whether a measure distinguishes groups expected to differ, provided more limited and exploratory evidence. A small group difference emerged only for avoidance behavior, while checking scores did not separate the groups as clearly. The authors are careful to frame these findings as preliminary rather than definitive. Validation is never a single verdict but an accumulating body of evidence, and this study represents one early data point in what will need to be a longer process before the adapted BCAQ can be recommended for broad clinical use.

Why does a questionnaire validation study deserve attention beyond the psychometrics community? Because measurement is the foundation on which everything else in clinical science rests. Eating disorders carry among the highest mortality rates of any psychiatric condition, and they typically begin during adolescence, a developmental window when body image concerns intensify and early intervention can alter the trajectory of illness. If clinicians and researchers cannot accurately measure the behavioral symptoms of body image distortion in teenagers, they cannot track treatment progress, compare interventions, or identify which patients are at greatest risk. Instruments developed and tested exclusively in adults leave clinicians guessing about whether the questions even make sense to younger patients, whose bodies, social environments, and daily routines differ substantially from those of the grown-ups the items were written for.

The German team is explicit about the limits of the current evidence. The study examined temporal stability only indirectly, and the authors call for longitudinal research to evaluate how stable the measure’s scores are over time, an essential property for any instrument intended to monitor change during treatment. They also note that further work is needed in other groups of adolescents before the questionnaire can be recommended more broadly, since the current evidence comes from female patients with anorexia or atypical anorexia nervosa and may not generalize to boys, to adolescents with other eating disorder diagnoses such as bulimia nervosa or binge-eating disorder, or to community samples.

Even so, the study offers clinicians and researchers a promising tool at a moment when the need is acute. The adapted 23-item BCAQ provides preliminary evidence of good reliability and satisfactory convergent validity for assessing behavioral body image distortion in female adolescents with anorexia nervosa, filling a genuine gap in the assessment literature. For a field in which the behavioral symptoms of illness are often the most observable and the most treatable targets, having a validated way to measure them in the patients who need it most is a meaningful advance. The full open-access article, including supplementary materials detailing the factor analyses, is available from BMC Psychology for researchers who wish to build on this work.

Subject of Research: Validation of the Body Checking and Avoidance Questionnaire in adolescents with anorexia nervosa

Article Title: Measuring body checking and avoidance in adolescents: validation of a behavioral questionnaire

Article References: Beer, C. S., Zillmer, S., Drießnack, N., Jaite, C., & Legenbauer, T. (2026). Measuring body checking and avoidance in adolescents: validation of a behavioral questionnaire. BMC Psychology, 14(1), Article 1359. https://doi.org/10.1186/s40359-026-05614-y

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05614-y

Keywords: eating disorders, body image, body checking, body avoidance, adolescence, psychological assessment, psychometrics, anorexia nervosa, BMC Psychology, Measuring, body, checking

The review team, led by Becky Watts of the University of Sheffield alongside Samuel Chawner, Gareth Burchell and John Fox, searched four major databases, PsycINFO, MEDLINE, Scopus and CINAHL, for peer-reviewed qualitative studies of autistic adults with lived experience of eating disorders or disordered eating. From 424 initial records, thirteen studies survived full-text screening. Each was appraised with the Critical Appraisal Skills Programme qualitative checklist, and the findings were combined using thematic synthesis, a three-stage method that codes participant quotations and author interpretations line by line, groups the codes into descriptive themes, and then distils higher-order analytical themes that cut across individual studies. Eleven of the thirteen studies were rated high quality, and the review was registered prospectively on PROSPERO.

Three analytical themes emerged, and together they amount to a quiet revolution in how the intersection of autism and eating disorders might be understood. The first is that eating disorder experiences cannot be understood independently of autistic ways of processing the world. The second is that recovery is enabled through developing self-understanding and integrating autism into personal identity. The third is that recovery is facilitated when support aligns with autistic needs rather than neurotypical assumptions. Each theme is anchored in vivid first-person testimony, and each carries direct implications for how clinicians assess, formulate and treat eating disorders in this population.

The sensory thread runs through nearly every account. Participants described food choices driven by texture, smell and temperature rather than calories or body shape. One person explained that a salad was terrifying because its components were mixed together. Another described restricting food after weight gain not because of how their stomach looked but because they disliked the sensation of how it felt. A third traced the onset of restriction to the school canteen, a space of overwhelming noise, crowds and social demands. For some, the sensory experience of clothing or of their own skin was itself aversive, one participant describing her body as a cage she decorated with tattoos. These are not the classic mechanisms of anorexia nervosa as taught in textbooks, and the review argues that sensory-driven restriction was frequently experienced entirely independently of body image concerns.

Interoception, the brain’s perception of internal bodily states, emerged as a second crucial mechanism. Many participants reported profound difficulty recognising hunger, fullness, thirst and satiety. One described being able to identify dizziness, stomach pain or a dry mouth without ever connecting those signals to hunger. Another said they could binge or miss meals very easily because they did not fully understand their thirst and hunger responses. In the context of binge eating disorder, neurodivergent participants described eating as a form of sensory seeking or emotional regulation, with one noting that recognising they wanted sensory input rather than food helped them choose vegetables instead. These accounts suggest that both restriction and bingeing can arise from the same underlying difference: an unreliable channel of information between body and brain.

The third mechanism is cognitive. A preference for routine, predictability and rule-based thinking appeared repeatedly, both as a driver of rigid eating patterns and, paradoxically, as a resource for recovery. Participants described self-imposed food rules that felt impossible to break, and eating routines so entrenched that travel or social occasions became untenable. Yet the same preference for structure meant that predictable, planned approaches to eating, such as meal plans agreed in advance, reduced anxiety and supported engagement with treatment. One participant noted that the containment and structure of an inpatient ward was genuinely helpful, precisely because it removed the burden of self-organisation.

Perhaps the most striking finding concerns identity. Many participants received an autism diagnosis only in adulthood, often after years of eating disorder treatment that never addressed what they felt was the real cause. One woman summarised the experience bluntly: for her, the anorexia was just a symptom, and the cause was the autism. Receiving a diagnosis frequently acted as a turning point, allowing people to reinterpret decades of struggle not as personal failure but as the predictable consequence of navigating a neurotypical world with a differently wired nervous system. Participants described greater self-compassion, a re-storying of their lives, and connection with others who shared the dual experience. The review notes, however, that this process could also carry grief, as people mourned the years in which their needs went unrecognised.

Against this backdrop, conventional treatment often fell short. Participants reported being told off in hospital for autistic behaviours such as walking on tiptoes, which staff interpreted as calorie-burning. Others described clinicians who insisted on body image work even when patients said their difficulties had nothing to do with weight or shape, an approach one person found humiliating and condescending. Some were discharged from services because their cases were deemed too complex. In contrast, support that worked was individualised and collaborative: therapists who provided written summaries and goal setting, services that gave advance notice of changes and allowed comforting sensory items, families who respected a person’s refusal of intolerable foods without pressure. The behaviours of autism and the behaviours of an eating disorder can look identical, participants stressed, but their causes, and therefore their treatments, can be entirely different.

These findings have conceptual consequences that reach beyond the clinic. The review highlights a potential overlap with avoidant/restrictive food intake disorder, or ARFID, a diagnosis characterised by sensory-based food avoidance without body image concern. Because the evidence base is dominated by anorexia nervosa, the authors caution that some autistic people with primarily sensory-driven restriction may historically have been misclassified, and they argue that whether such presentations constitute ARFID, or simply eating behaviours embedded within autistic experience, remains an open question. They suggest the field may need a paradigm shift, from treating autism and eating disorders as co-occurring conditions toward a model rooted in lived phenomenological experience, in which autistic characteristics such as sensory processing, interoceptive differences and a preference for predictability are understood as mechanisms that shape how eating disorders develop, persist and resolve.

The authors are careful about limitations. Only thirteen studies met the criteria, most focused on anorexia nervosa, most participants were women, and all included research was published in English, leaving bulimia nervosa, binge eating disorder, ARFID, men and non-English-speaking populations underrepresented. Reflexivity was the most common methodological weakness in the primary studies. The review itself was conducted by a non-autistic researcher without lived experience of an eating disorder, a position the authors acknowledge and address through explicit reflexive consideration. Even so, the synthesis represents the most comprehensive attempt yet to centre autistic voices in this literature, and its message is unambiguous. When autistic adults say their eating difficulties are about the way food feels rather than the way their body looks, clinicians should listen, because recovery, the evidence suggests, begins when treatment is built around autistic needs rather than neurotypical assumptions.

Subject of Research: Lived experiences of eating disorders in autistic adults

Article Title: A systematic review of qualitative research of eating disorders in autistic adults: convergent and divergent experiences

Article References: Watts, B., Chawner, S. J. R. A., Burchell, G., & Fox, J. R. E. (2026). A systematic review of qualitative research of eating disorders in autistic adults: convergent and divergent experiences. Frontiers in Psychiatry, 17, Article 1953234. https://doi.org/10.3389/fpsyt.2026.1953234

Image Credits: AI Generated

DOI: 10.3389/fpsyt.2026.1953234

Keywords: autism, eating disorders, anorexia nervosa, ARFID, sensory sensitivities, interoception, qualitative research, systematic review, thematic synthesis, neurodiversity, mental health, recovery

The study population consisted of 146 girls and 163 boys with an average age of 16.0 years, recruited from two randomly selected high schools in Istanbul. The researchers calculated their minimum sample size using G*Power software, adopting a small-to-medium effect size consistent with Cohen’s criteria for the social and behavioral sciences, and determined that at least 285 students would be needed to detect significant relationships in correlation and regression analyses. Participants were physically and mentally healthy volunteers drawn from a total school population of 1,457 students. Height and body weight were measured directly, and body mass index-for-age percentiles were calculated according to standard pediatric classifications, with 78.3 percent of participants falling within the healthy weight range.

The methodological design relied on three validated psychometric instruments administered face-to-face. The social media use scale, developed by Deniz and Tutgun-Ünal, contains eight items divided into two subscales: continuity of social media use and social media use competence. The continuity subscale captures not merely the duration of daily use but the habitual, psychologically embedded nature of access, reflected in items such as checking accounts immediately before sleeping and right after waking. The social appearance anxiety scale, developed by Hart and colleagues and adapted into Turkish by Doğan, comprises 16 items assessing the anxiety and stress experienced when one’s physical appearance is evaluated by others. The Eating Disorder Examination Questionnaire-Short Form, or EDE-Q-13, evaluates eating behaviors over the preceding 28 days across five subdimensions: eating restraint, shape and weight over-evaluation, body dissatisfaction, binging, and purging. Internal consistency coefficients for the three scales were 0.824, 0.930, and 0.890 respectively, indicating strong reliability.

The descriptive findings reveal the sheer ubiquity of social media in adolescent life. WhatsApp was the most widely used application at 83.2 percent, followed closely by Instagram at 81.2 percent. A substantial majority of participants, 73.8 percent, reported engaging with social media for one to five hours daily, a pattern consistent with previously reported global trends and reinforcing the view that digital platforms have become a primary environment for adolescent socialization. Gender differences emerged in platform preferences and behaviors: girls were significantly more likely to use Snapchat, to apply social media effects to their photos, and to care about friends’ opinions regarding shared photos. While 72.6 percent of adolescent girls indicated that peer feedback on their visual content mattered to them, only 38.0 percent of boys said the same.

The central statistical finding concerns social appearance anxiety, defined as the anxiety and stress experienced during the evaluation of one’s appearance by others. The mean social appearance anxiety score for girls was 38.1, significantly higher than the boys’ mean of 30.8. In the multiple linear regression model examining predictors of social appearance anxiety, the model was statistically significant and accounted for 26.4 percent of the variance. Three independent variables emerged as significant: being male was associated with lower anxiety, increasing age was associated with decreasing anxiety, and continuity of social media use was associated with increasing anxiety, with a coefficient of 0.963 and a 95 percent confidence interval of 0.520 to 1.406. This finding suggests that the habitual, always-on nature of social media access, rather than mere technical proficiency with digital devices, is what drives the psychological burden.

Correlation analysis further illuminated the web of relationships among the study variables. Social appearance anxiety was positively correlated with social media use continuity, eating restraint, shape and weight over-evaluation, body dissatisfaction, binging, purging, and overall eating disorder risk. The strongest correlations were with shape and weight over-evaluation and body dissatisfaction, both exceeding 0.43. Social media continuity itself was positively correlated with shape and weight over-evaluation, body dissatisfaction, and eating disorder risk. These bivariate associations paint a coherent picture: adolescents who remain continuously connected to social media report greater dissatisfaction with their bodies and more disordered eating attitudes.

However, the multivariate regression analysis for eating disorder risk revealed a more nuanced mechanism. The model accounted for 29.6 percent of the variance in eating disorder risk, but the direct effect of social media continuity dropped below statistical significance once social appearance anxiety was included. Instead, two independent variables remained significant: social appearance anxiety, with a coefficient of 0.068 and a 95 percent confidence interval of 0.053 to 0.083, and body mass index-for-age percentile, with a coefficient of 0.019. This pattern suggests that the observed risk is primarily driven by underlying psychological constructs rather than by social media use itself. The researchers interpret this as evidence that social appearance anxiety functions as the proximal psychological pathway through which continuous digital exposure translates into disordered eating attitudes.

The theoretical framework underlying these findings draws on body image theories, which hold that the media transmits social appearance ideals through which pressures regarding appearance are placed on individuals and comparisons are made. Social media users compare their own appearance with that of others and may edit their photos, generating negative thoughts about body image and body dissatisfaction. Body dissatisfaction, in turn, forms a basis for the development of eating disorders. The relationship may also be bidirectional: adolescents heavily exposed to idealized visual content may develop body image anxiety, while those with high body image anxiety may use social media as a tool to seek approval and attention regarding their appearance. The cross-sectional design prevents the establishment of causality, but the findings suggest that continuity of social media use and concerns about social appearance are mutually reinforcing factors that may trigger eating disorder risk through this process.

The broader epidemiological context amplifies the urgency of these results. Eating disorders are chronic and treatment-resistant physical and mental illnesses with high mortality rates, affecting all age groups, ethnicities, body sizes, socioeconomic statuses, and religions regardless of sex. Between 1999 and 2022, 22.36 percent of children and adolescents were reported to have disordered eating, and the incidence of eating disorders has increased over the last 40 years in parallel with the rise of social media use among adolescents. The present study also found that increasing body mass index-for-age percentile was associated with increased eating disorder risk, consistent with previous research by Flament and colleagues linking weight status to eating disorder diagnoses in community adolescents.

The authors acknowledge several limitations that temper generalization. The study was conducted in only one city and two high schools, potential confounding factors such as depression, anxiety disorders, self-esteem, and socioeconomic status were not examined, and the explanatory power of the regression models remained relatively limited. Pubertal development stages were not objectively determined, and body dissatisfaction was not directly assessed. Nevertheless, the conclusions carry practical weight. The researchers recommend designing social media literacy education programs for adolescents, organizing school activities to raise awareness, creating environments for face-to-face communication, and developing national policies aimed at conscious social media use. Educating adolescents about social media use and monitoring their usage, they argue, may be associated with a potential reduction in eating disorder risk and related health problems in the long term.

Subject of Research: Health

Article Title: Association between social media use, social appearance anxiety, and eating disorder risk in adolescents

Article References: Özkan, G. Ö., Yüce, M. N., & Karagöl, B. (2026). Association between social media use, social appearance anxiety, and eating disorder risk in adolescents. Frontiers in Nutrition, 13, Article 1812469. https://doi.org/10.3389/fnut.2026.1812469

Image Credits: AI Generated

DOI: 10.3389/fnut.2026.1812469

Keywords: adolescents, eating disorders, social media, social appearance anxiety, body image, mental health, nutrition, Association, between, social, media, appearance

The technical design of the study is what gives its results their punch. Rather than measuring eating behavior and heart risk at the same moment, the investigators used a prospective cohort framework: binge eating symptoms were assessed first, at ages 11 to 12, and cardiovascular outcomes were assessed two years later, at ages 13 to 14. This temporal separation matters because it reduces the chance that the results simply reflect cross-sectional associations, where it is impossible to tell whether poor metabolic health drives disordered eating or the other way around. Here, the eating symptoms came first, and the risk factors followed.

Binge eating symptoms were identified through parent report using the Kiddie Schedule for Affective Disorders and Schizophrenia, a structured diagnostic interview aligned with the DSM-5, the current edition of the Diagnostic and Statistical Manual of Mental Disorders. Roughly 6.01 percent of the adolescents in the sample showed binge eating symptoms at the first assessment. That figure may sound modest, but applied to the scale of the adolescent population it represents a substantial number of children whose eating patterns may be quietly shaping their metabolic futures. Binge eating involves episodes of consuming large amounts of food while experiencing a sense of loss of control, and it is distinct from other eating disorders in that it does not necessarily involve compensatory behaviors such as purging.

When the researchers ran the numbers, the associations were consistent and statistically robust. Adolescents with binge eating symptoms at baseline had, two years later, a BMI percentile that was 2.33 points higher on average than their peers, with a 95 percent confidence interval of 0.60 to 4.06 and a p-value of 0.008. Their waist circumference percentile was 5.06 points higher, a stronger effect with a confidence interval of 2.68 to 7.44 and a p-value below 0.001. Waist circumference is a particularly meaningful metric because it captures central adiposity, the accumulation of fat around the abdomen, which is more closely tied to insulin resistance and cardiovascular risk than fat deposited elsewhere in the body.

The metabolic signals extended beyond body size. Diastolic blood pressure percentile, which reflects the pressure in the arteries between heartbeats, was 1.20 points higher among adolescents with prior binge eating symptoms. Hemoglobin A1c, a laboratory measure of average blood sugar over the preceding two to three months, was 0.12 percentage points higher, with a confidence interval of 0.03 to 0.20 and a p-value of 0.008. Even a small elevation in A1c during adolescence can be an early warning of declining glucose regulation, the pathway that leads from normal metabolism toward prediabetes and type 2 diabetes. The lipid profile told a complementary story: HDL cholesterol was 6.02 units lower in the binge eating group, a highly significant difference with a confidence interval spanning -9.15 to -2.89. Low HDL is a classic component of metabolic syndrome, the constellation of abnormalities that multiplies long-term heart disease risk.

The statistical machinery behind these estimates was carefully chosen. For continuous outcomes such as BMI percentile, waist circumference percentile, blood pressure percentile, A1c, and lipid measures, the team used linear regression, which estimates how much the average outcome shifts for adolescents with versus without binge eating symptoms. For binary outcomes, they applied modified Poisson regression, a technique that directly estimates risk ratios and is better suited than logistic regression when outcomes are not rare. Crucially, all models adjusted for a battery of sociodemographic and clinical covariates, meaning the associations were not simply artifacts of differences in household income, race and ethnicity, baseline body size, or other confounding factors that could masquerade as an eating-behavior effect.

One of the more striking aspects of the results is what the researchers did not find: significant sex differences. The team tested whether the associations between binge eating and cardiovascular risk factors differed between boys and girls, and after applying the Benjamini-Hochberg correction for multiple comparisons, no significant differences survived. This correction is a standard safeguard against false positives when many statistical tests are run simultaneously, and its application here suggests the relationship between binge eating symptoms and metabolic risk operates similarly across sexes in early adolescence. That universality has practical implications, because it means pediatric clinicians may need to watch for cardiovascular warning signs in all adolescents with binge eating symptoms, not just one group.

The ABCD Study itself deserves attention as the engine of this discovery. With data collected at ages 11 to 12 between 2018 and 2020 and follow-up at ages 13 to 14 between 2020 and 2022, the cohort spans a developmental window when pubertal changes, shifting peer dynamics, and emerging mental health conditions converge. The study obtained written informed consent from parents and guardians and assent from the adolescents themselves, with centralized institutional review board approval from the University of California, San Diego, and local approval at each participating site. The scale and rigor of the cohort allow researchers to detect associations that smaller studies would miss, and its ongoing design means these adolescents can be followed deeper into adolescence and adulthood.

Why would binge eating symptoms in early adolescence translate into cardiovascular risk factors two years later? The most direct mechanism is energy balance: recurrent episodes of consuming large quantities of food, particularly energy-dense foods, promote fat accumulation, especially central fat, which in turn drives insulin resistance, raises blood pressure, and alters lipid metabolism. But the story may not be purely mechanical. Stress and emotional dysregulation, which often accompany binge eating, activate the hypothalamic-pituitary-adrenal axis and sympathetic nervous system, and chronic activation of these systems is independently associated with hypertension and metabolic dysfunction. Sleep disruption, inflammation, and altered gut hormone signaling are additional plausible pathways that researchers are only beginning to untangle. The present study cannot definitively isolate which mechanism dominates, but the consistency of the associations across five separate risk factors suggests multiple converging processes.

The authors are careful about what their findings do and do not prove. A prospective cohort study, however well designed, cannot establish causation with the certainty of a randomized trial, and unmeasured confounders could still contribute to the observed associations. Yet the convergence of evidence, temporal ordering, statistical adjustment, and effect sizes that are modest but reliable, makes a compelling case that binge eating symptoms deserve a place in conversations about cardiovascular prevention during adolescence. The researchers conclude that their findings highlight the potential relevance of binge eating symptoms to cardiovascular health during adolescence and warrant further research into how these symptoms relate to cardiovascular disease risk over time. For parents, pediatricians, and public health officials, the message is that disordered eating in the tween years is not only a mental health concern but potentially an early metabolic one, and that identifying and supporting adolescents with binge eating symptoms may pay dividends for heart health decades before the first heart attack.

Subject of Research: Prospective cohort study linking binge eating symptoms in early adolescence to later cardiovascular disease risk factors

Article Title: Prospective associations between binge eating symptoms and cardiovascular disease risk factors in early adolescence: a cohort study

Article References: Nagata, J. M., Nguyen, N. D., Frimpong, I., Heuer, A., Helmer, C. K., Wong, J. H., Ganson, K. T., Testa, A., Gooding, H. C., Baker, F. C., & Lavender, J. M. (2026). Prospective associations between binge eating symptoms and cardiovascular disease risk factors in early adolescence: a cohort study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07858-4

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07858-4

Keywords: binge eating, adolescence, cardiovascular disease, ABCD Study, obesity, blood pressure, HbA1c, cholesterol, cohort study, pediatrics, eating disorders, metabolic health

Food addiction is a contested but increasingly studied construct. It describes a cluster of experiences that mirror substance addiction in an eating context: powerful cravings for certain foods, consumption in larger amounts than intended, repeated failed attempts to cut down, continued overeating despite negative consequences, and withdrawal-like states or distress when consumption is curtailed. Researchers typically measure it with symptom counts rather than a simple yes-or-no diagnosis, which allows the severity of the pattern to be graded across a population. The condition has been linked to pathological eating behaviour, obesity and a range of adverse mental health outcomes, yet the emotional underpinnings of the syndrome remain incompletely mapped. Depression and anxiety have received considerable attention; anger, by contrast, has been largely unexplored in this context.

The research team, led by Felix S. Hussenoeder of Leipzig University’s Institute of Social Medicine, Occupational Health and Public Health, set out to close that gap with an unusually rigorous design. Rather than simply asking whether angry people eat more compulsively, they asked whether trait anger, the stable disposition to experience angry feelings across situations, predicts food addiction symptoms independently of the Big Five personality traits: openness, conscientiousness, extraversion, agreeableness and neuroticism. This distinction matters because trait anger is conceptually entangled with neuroticism and low agreeableness, and a naive analysis could mistake a general personality vulnerability for a specific emotional signal.

The data came from 1,138 adults aged 20 to 79 who participated in the LIFE-Adult Study, a cohort drawn from the general population of Leipzig between 2011 and 2014. Participants completed established questionnaires assessing trait anger along with three dimensions of how anger is handled: anger expression-in, which reflects suppressing angry feelings and directing them inward; anger expression-out, which reflects directing anger toward other people or objects in the environment; and anger control, which reflects attempts to restrain angry feelings before they are expressed. Food addiction symptoms were quantified as symptom counts, and the team used sequential Poisson regression, a statistical approach suited to count outcomes, to build models of increasing complexity.

The analytical strategy was deliberately layered. The researchers first examined the association between trait anger and food addiction symptoms on its own, then progressively adjusted for sociodemographic characteristics such as age and sex, for social support, for alcohol use, for the anger expression and regulation dimensions, and finally for the Big Five personality traits. This stepwise approach allowed them to see which associations survived as the statistical company grew more crowded, a technique that helps separate genuine independent signals from correlations that merely ride on other variables.

The results were striking in their selectivity. Higher trait anger was associated with higher food addiction symptom counts, and the association remained statistically significant even after adjustment for the anger expression and regulation dimensions and for sociodemographic characteristics. In the fully adjusted model, four factors emerged as independently associated with higher symptom counts: trait anger, lower social support, higher neuroticism and lower conscientiousness. Notably, the specific dimensions of anger expression and regulation, the inward suppression, the outward venting and the deliberate control of anger, were no longer significant once trait anger and personality were taken into account.

That pattern carries a theoretical implication. It suggests that what matters for food addiction is not so much how a person manages or expresses their anger, but rather the underlying propensity to feel angry in the first place. In other words, the emotional disposition itself, rather than its behavioural outlets, appears to be the relevant correlate of difficult-to-control eating. This framing aligns with broader models of addiction in which negative affect serves as a trigger for compulsive consumption: anger, like other aversive emotional states, may prompt eating as a form of self-regulation or escape, and a person who experiences anger frequently and intensely may accumulate more such triggers over time.

The independent contributions of social support and personality fit coherently into this picture. Lower social support has long been associated with poorer self-regulation and with using food as a coping resource in the absence of interpersonal ones. Higher neuroticism, the tendency toward negative emotionality and emotional instability, is a well-replicated correlate of addictive and compulsive behaviours, and lower conscientiousness, which reflects reduced impulse control and planning, plausibly weakens the behavioural brakes on overconsumption. That trait anger retains its association alongside these established markers suggests it captures something they do not, a specific hot emotional propensity rather than a general tendency toward distress or poor self-discipline.

The authors are careful about what the study cannot show. Because anger and food addiction symptoms were measured at a single point in time, the cross-sectional design cannot establish whether trait anger causes food addiction, whether compulsive eating amplifies angry feelings, or whether both arise from a shared underlying vulnerability. Temporal ordering and causality remain open questions, and longitudinal follow-up would be needed to disentangle them. The study also relies on self-report questionnaires, which are subject to recall and reporting biases, and the sample, while population-based, comes from a single German city.

Even with those caveats, the findings carry practical weight. If trait anger is confirmed as a relevant emotional correlate of food addiction, it could inform screening and intervention: clinicians working with disordered eating might consider assessing anger proneness alongside depression and anxiety, and emotion-focused treatments that address anger specifically might complement existing approaches. For the public, the study adds nuance to a familiar narrative. Food addiction is not simply a matter of willpower or the seductive engineering of ultra-processed foods; it is entangled with temperament, emotional life and social circumstances. A stable tendency to feel angry, the research suggests, may be one thread in that web, quietly shaping why some people find eating far harder to control than others.

Subject of Research: The association between trait anger, anger expression and regulation, and food addiction symptoms in adults

Article Title: Associations of trait anger and the anger expression and regulation dimensions with food addiction in the LIFE-adult study

Article References: Hussenoeder, F. S., Conrad, I., Luppa, M., Löbner, M., Pabst, A., Engel, C., Reyes, N., Yahiaoui-Doktor, M., Glaesmer, H., Hinz, A., Witte, V., Schroeter, M. L., Medawar, E., Kirsten, T., Loeffler, M., Villringer, A., & Riedel-Heller, S. G. (2026). Associations of trait anger and the anger expression and regulation dimensions with food addiction in the LIFE-adult study. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01802-8

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01802-8

Keywords: food addiction, trait anger, anger expression, anger control, emotion regulation, personality, neuroticism, conscientiousness, social support, eating disorders, LIFE-Adult Study, mental health

The process Mond is describing has a name with a long pedigree in sociology. Medicalisation, a term coined in the early 1970s, refers to the way previously nonmedical aspects of appearance or behaviour become defined and treated as medical problems. The classic examples are familiar: disruptive behaviour in children became attention-deficit/hyperactivity disorder, and combat stress among soldiers became post-traumatic stress disorder. In each case, the relabelling brought real benefits in legitimacy, research funding and access to care, but it also carried costs that took decades to appreciate, from overdiagnosis to the quiet expansion of pharmaceutical markets.

In the eating disorders field, Mond contends, medicalisation has accelerated to a remarkable degree. The number and diversity of conditions recognised as eating disorders in classification schemes, most notably the Diagnostic and Statistical Manual of Mental Disorders, has proliferated dramatically in recent years. Behaviours that once attracted little clinical attention, such as binge eating or what clinicians describe as excessive exercise for weight control, are now increasingly viewed as disorders, diseases or illnesses demanding clinical or public health intervention.

The push has not come from clinicians alone. Mond points to concerted efforts by influential organisations, including the United States National Institute of Mental Health, to portray these conditions as brain-based mental illnesses for which certain forms of intervention, so-called evidence-based treatments, are demanded. This framing, he notes, now predominates not only in academic and public policy literature but also in the popular media, where eating and weight-control behaviours are routinely presented through the language of disease.

What makes this development striking, Mond argues, is how little critical scrutiny it has received. In contrast to the medicalisation of other mental health problems, which has been the subject of sustained sociological analysis for half a century, analysis of the medicalisation of eating and weight-control behaviours has been sporadic and piecemeal. The goal of his commentary is to expose this process to critical examination and to lay out the questions that future research needs to answer.

The technical stakes are considerable. Diagnostic expansion changes who counts as ill, and therefore who receives treatment, who is enrolled in research studies and whose experiences are captured in epidemiological surveys. When the boundaries of a diagnostic category widen, prevalence estimates rise, sometimes steeply, and the population deemed to have or be at risk of having an eating disorder grows larger and more diverse. Mond emphasises that this increasingly large and diverse subgroup is precisely the population whose wellbeing medicalisation is supposed to serve, yet whether it actually does remains an open question.

That question, whether and to what extent medicalisation has been beneficial for people deemed to have or be at risk of having an eating disorder, is the first of the key issues Mond believes future research should address. The benefits of diagnosis are not trivial: a recognised disorder can reduce stigma by reframing behaviour as illness rather than failure of willpower, can open doors to treatment and insurance coverage, and can justify research funding. But the costs are equally real. Wider diagnostic nets can pathologise behaviours that fall within the normal range, can create illness identities where none existed before, and can channel attention and resources toward clinical treatment while neglecting the social and environmental drivers of disordered eating.

The second key question concerns intervention and policy. Mond asks what the implications of increasing medicalisation are for different possible approaches to intervention and for public health policy more generally. The technical distinction here matters. A medicalised framing tends to favour individual clinical treatment, delivered by trained professionals to diagnosed patients, whereas a public health framing might target the population-level factors, from weight stigma to social media environments, that shape eating and weight-control behaviours in the first place. How a problem is defined determines which solutions appear rational, and Mond suggests that the current dominance of the medical model has narrowed the field of what is even considered.

None of this amounts to a rejection of eating disorders as real and serious conditions. Mond’s argument is methodological rather than dismissive: a process as consequential as the medicalisation of eating and weight-control behaviours should be examined with the same rigour that sociologists have applied to ADHD, PTSD and other relabelled conditions. The parallels he draws are instructive. Just as the expansion of ADHD diagnosis prompted decades of debate about where disorder ends and normal variation begins, the proliferation of eating disorder categories invites the same scrutiny of boundaries, benefits and unintended consequences.

The timing of the commentary could hardly be more pointed. As diagnostic categories continue to expand and as brain-based framings gain traction in policy and popular culture, the population deemed ill grows with each revision. Mond’s call is for the field to take stock before the process becomes irreversible, to ask whether the medicalisation of eating and weight-control behaviours has served the people it claims to help, and to consider whether other framings, clinical, sociological or public health, might better capture the complexity of human eating. The answers, he suggests, will shape not just the future of eating disorders research but the broader question of how societies decide which behaviours count as disease.

Subject of Research: Medicalisation of eating and weight-control behaviours

Article Title: Medicalisation of eating and weight-control behaviours: time to take stock?

Article References: Mond, J. M. (2026). Medicalisation of eating and weight-control behaviours: time to take stock?. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01785-6

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01785-6

Keywords: eating disorders, medicalisation, DSM, mental health, public health, sociology of medicine, diagnosis, weight-control behaviours, eating, weight-control, behaviours, time