Although there may be common challenges and opportunities for early career researchers (ECRs), those working in the field of eating disorders may face unique barriers and require tailored support.

The current study sought to explore consensus on career concerns and opportunities in eating disorder ECRs.

A three-stage Delphi model was conducted. Round 1 involved participants rating career concern and opportunity statements, with free-text responses. Researchers then generated a list of Delphi statements, which were shared in round 2, and participants were asked to indicate their level of agreement. A final round was shared, with median ratings from round 2 and the option to change or further expand on responses. Final consensus was calculated as percentage agreement.

Career concerns reaching consensus included timeline pressures, personal sacrifices for roles, unclear career trajectories, job insecurity, funding concerns, fears of being pushed out of the field and pressures to publish. There was no consensus on a range of other concerns (work/life balance, isolation, mental health and well-being and power imbalances), suggestive of context-dependent experiences. Participants agreed that almost all the presented career opportunities were of importance to eating disorder ECRs.

Findings suggest that eating disorder ECRs face significant barriers toward remaining in the field. Although many concerns reflect broader ECR experience (limited research funding, associated job insecurity), some appear to be particularly exacerbated for ECRs working in the eating disorder field. Further research is needed to inform directions for tailored support strategies, such as peer support, mentoring schemes and increased funding from governing bodies.

Eating disorders, particularly anorexia nervosa and bulimia nervosa, are significant global health challenges.

This study analyses historical trends and forecasts future patterns of eating disorders among young adults aged 15–29 years using machine learning techniques.

Global data on anorexia nervosa and bulimia nervosa from the Global Burden of Disease study 2021 spanning 1990 to 2021 were analysed, examining incidence, prevalence and disability-adjusted life years (DALYs) across age groups, sociodemographic index (SDI) levels and regions. Eight machine-learning models were employed to forecast trends from 2022 to 2050.

Bulimia nervosa showed more pronounced increases compared to anorexia nervosa across all metrics. The 15–19 age group had the highest incidence rates, while the 20–24 age group showed the highest prevalence and DALY rates. Low SDI regions experienced substantial increases, with bulimia nervosa prevalence rising by 179.05%. East Asia demonstrated the most significant rise in age-standardised rates. The Prophet model best forecast anorexia nervosa trends, while ARIMA performed best for bulimia nervosa. Projections indicate continued increases through 2050 for both disorders.

The global burden of eating disorders among young adults is projected to increase significantly by 2050, with bulimia nervosa showing more rapid growth than anorexia nervosa. Substantial variations exist across age groups, SDI levels and regions. These findings highlight the urgent need for enhanced prevention programmes targeting high-risk age groups, strengthened healthcare capacity in rapidly developing regions and evidence-based policy interventions to address the growing global burden of eating disorders.

Standard treatments for eating disorders (EDs) typically include nutritional rehabilitation, psychotherapy, and pharmacotherapy, often resulting in modest effectiveness. Neuromodulation has been proposed as a potential add-on strategy. This review aims to critically evaluate its effects on EDs.

The PICO framework was used to conduct a search according to the PRISMA guidelines for systematic reviews (PROSPERO Registration no. CRD42024559700). Descriptive and clinical data for each study, including comorbidity and safety, were tabulated by disorder. Quality assessment was performed using the RoB2 and ROBINS-I tools.

Fifty-eight studies examining rTMS, tDCS, DBS, ECT, iTBS, and dTMS in AN, BN, and BED met inclusion criteria. In AN, the effects of rTMS and tDCS on weight and BMI were modest, with notable benefits for adolescents. Conversely, in refractory AN, DBS produced significant and lasting increases in BMI and reductions in comorbid psychopathology. For BN, single-session rTMS reduced cravings acutely, while multisession results were mixed; tDCS enhanced self-control. In BED, right-DLPFC tDCS decreased cravings, food intake, and binge frequency, showing a dose-dependent effect, whereas early data on NAcc DBS were promising but limited.

Noninvasive stimulation methods effectively reduced cravings and impulsivity, showing more consistent improvements in BN and BED than in weight restoration for AN. Overall, this pattern replicates recent review reports. However, variations in study designs, stimulation protocols, and outcome measures may undermine the reliability of these conclusions and complicate comparisons across studies. Future studies should be adequately powered, multisession, with durability endpoints, and target and dose refinement.

Eating disorders are severe psychiatric conditions associated with high mortality rates, particularly among young people. These disorders often co-occur with self-harm and suicidal ideation, yet the temporal dynamics between these variables remain poorly understood.

This study aims to elucidate the longitudinal associations between symptoms of body dissatisfaction and disordered eating, self-harm and suicidal ideation using structural equation modelling.

Repeated measures of these phenotypes were used to construct a hypothetical model that includes cross-path analyses within and between the variables in two cohorts: the Twins Early Development Study (TEDS; ages 16, 21 and 26 years; N = 5196), representing a general population sample, and the COVID-19 Psychiatry and Neurological Genetics study (COPING; data collected between June 2020 and July 2021; N = 490), which focused on individuals with a history of anxiety or depression. In the TEDS cohort, symptoms of disordered eating, self-harm and suicidal ideation showed limited continuity across adolescence and young adulthood, with peak symptom severity at age 21 years.

Cross-domain associations revealed that both self-harm and suicidal ideation at age 21 years were more strongly associated with disordered eating at 26 years than the reverse. In contrast, the COPING cohort exhibited greater stability in symptoms over time but showed minimal cross-domain effects.

The effects of self-harm and suicidal ideation on disordered eating in early adulthood are stronger than the influence of disordered eating on suicidality.

Stress could increase delay discounting in subjects with bulimia nervosa and alcohol use disorder (AUD), meaning that the short-term benefits of coping through eating or drinking outweigh the long-term negative consequences. Therefore, this study explores differences in delay discounting between patients and healthy controls, the impact of stress on food and alcohol delay discounting and associated changes in brain activity.

A total of 102 female participants (AUD, 27; bulimia nervosa, 25; healthy controls, 50) underwent repeated functional magnetic resonance imaging scanning. Initially, all participants performed a monetary delay discounting task (DDT), followed by a food or alcohol DDT before and after stress induction. Specifically, those with bulimia nervosa completed a food DDT, those with AUD completed an alcohol DDT and healthy controls were randomly allocated to one or either DDT.

Participants with AUD, but not healthy controls, displayed a higher discounting of alcohol after stress. Healthy controls, but not those with bulimia nervosa, had nominally higher discounting rates of food following stress, although not significant following multiple testing correction. Participants with AUD displayed a lower activity of the right supplementary motor area while discounting alcohol after stress. Healthy controls showed a lower activity of the frontal cortex and a higher activity of the motor cortex while discounting food after stress, while those with bulimia nervosa displayed a higher activity of the occipital cortex.

The results suggest that, in subjects with AUD, stress induces neurobiological changes that cause them to prefer more immediately available alcohol. However, the results observed in participants with bulimia nervosa suggest a more complex relation between stress and food.

DSM-5 specifies bulimia nervosa (BN) severity based on specific thresholds of compensatory behavior frequency. There is limited empirical support for such severity groupings. Limited support could be because the DSM-5’s compensatory behavior frequency cutpoints are inaccurate or because compensatory behavior frequency does not capture true underlying differences in severity. In support of the latter possibility, some work has suggested shape/weight overvaluation or use of single versus multiple purging methods may be better severity indicators. We used structural equation modeling (SEM) Trees to empirically determine the ideal variables and cutpoints for differentiating BN severity, and compared the SEM Tree groupings to alternate severity classifiers: the DSM-5 indicators, single versus multiple purging methods, and a binary indicator of shape/weight overvaluation.

Treatment-seeking adolescents and adults with BN (N = 1017) completed self-report measures assessing BN and comorbid symptoms. SEM Trees specified an outcome model of BN severity and recursively partitioned this model into subgroups based on shape/weight overvaluation and compensatory behaviors. We then compared groups on clinical characteristics (eating disorder symptoms, depression, anxiety, and binge eating frequency).

SEM Tree analyses resulted in five severity subgroups, all based on shape/weight overvaluation: overvaluation <1.25; overvaluation 1.25–3.74; overvaluation 3.75–4.74; overvaluation 4.75–5.74; and overvaluation ≥5.75. SEM Tree groups explained 1.63–6.41 times the variance explained by other severity schemes.

Shape/weight overvaluation outperformed the DSM-5 severity scheme and single versus multiple purging methods, suggesting the DSM-5 severity scheme should be reevaluated. Future research should examine the predictive utility of this severity scheme.

Weight suppression represents the difference between highest and current body weight and predicts maintenance of bulimia nervosa and related syndromes (BN-S). This study tested a biobehavioral model of binge-eating severity in which greater weight suppression links to reduced leptin, which links to reduced glucagon-like peptide 1 (GLP-1) release, which links to both decreased reward satiation and increased reward valuation, which link, respectively, to excessive food intake and loss of control while eating – the defining features of DSM-5 binge-eating episodes.

Women (N = 399) who met DSM-5 criteria for bulimia nervosa or another eating disorder with binge eating (n = 321) or had no lifetime eating disorder symptoms (n = 78) participated in a multi-visit protocol, including structured clinical interviews, height, weight, weight history, percent body fat, fasting leptin, post-prandial GLP-1 response to a fixed meal, and self-report and behavioral assessments of food reward satiation (ad lib meal) and food and nonfood reward valuation (progressive ratio tasks).

A structural equation model (SEM) demonstrated excellent fit to data with significant pathways from greater weight suppression to lower leptin, to blunted GLP-1 response, to lower reward satiation, to larger eating/binge-eating episode size, with significant indirect paths through leptin, GLP-1, and reward satiation. SEM with paths via reward valuation to loss of control eating demonstrated inadequate fit.

Findings specifically link reduced GLP-1 response to severity of binge-episode size and support weight history assessment in eating disorders, DSM-5 over ICD-11 criteria for binge eating, and may inform future clinical trials of GLP-1 agonists for BN-S.

This study compared cognitive flexibility (CF) and emotion recognition (ER) in adolescents with eating disorders (ED) to a healthy group.

Forty healthy individuals aged 12–18 years with no psychiatric diagnosis and 46 patients diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) according to DSM-5 criteria participated. CF was assessed using the Cognitive Flexibility Scale (CFS), Stroop Test, and Berg Card Sorting Test (BCST), while ER was evaluated using the test of perception of affect via nonverbal cues.

CFS scores were lower in the ED group compared to the control group. Neuropsychological test results indicated similar BCST perseverative error percentages among ED patients and controls. However, while the BED group demonstrated greater difficulties with inhibitory control, as shown in the Stroop Test, the BN and AN groups performed similarly to the control group. ER performance was similar across groups, although the AN subgroup exhibited heightened recognition of negative emotions, particularly disgust and fear.

This study highlights unique and shared neurocognitive patterns related to CF and ER profiles of ED patients. Despite self-reports of greater cognitive rigidity among ED patients, objective tests did not consistently confirm it. Notably, BED patients exhibited inhibitory control challenges, aligning with impulsive tendencies. ER abilities were similar to controls; however, the AN subgroup showed heightened sensitivity to certain negative emotions, such as disgust. These findings underscore the need for further research with larger, more balanced samples to explore how CF and ER vary across developmental stages and subtypes.

Research suggests that those caring for a loved one with an eating disorder in the UK report unmet needs and highlight areas for improvement. More research is needed to understand these experiences on a wider, national scale.

To disseminate a national survey for adults who had experience caring for a loved one with an eating disorder in the UK, informed by the findings of a smaller scale, qualitative study with parents, siblings and partners in the UK.

A cross-sectional web-based survey was disseminated to adults who had experience caring for a loved one with an eating disorder in the UK.

A total of 360 participants completed the survey. Participants described experiences of care received in both children and young people's, and adult services. Those receiving care from children and young people's services generally reported more timely care, greater involvement in care and more confidence managing their loved one's symptoms post-discharge. In both settings, participants identified a number of areas for improvement, including more timely access to care, improved transition processes and discharge planning, and increased involvement in their loved one's care.

This survey captures the experiences of individuals caring for a loved one with an eating disorder in the UK. There are identified discrepancies between experiences of care in children and young people services compared with adult services. Clinical implications and recommendations for improvement are discussed, including improved transition and discharge processes, increased involvement of and/or support for carers themselves, and more timely access to support services for the unwell individual.