Feeding and eating disorders (FED) are increasingly common among university students, particularly in healthcare settings characterized by high stress and performance demands. However, data on Southern Italian student populations remain limited. This study aimed to assess the prevalence of disordered eating behaviors, associated psychological factors, and preferred support strategies among Sicilian healthcare students. A cross-sectional web-based survey was conducted between 2022 and 2024 across multiple Sicilian universities. The questionnaire included sociodemographic data, the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS-21), and behavioral items assessing overeating, purging behaviors, and suicidal ideation. Multivariable linear regression analyses were performed to identify factors associated with EAT-26 scores. A total of 3,278 students participated. Although most had a normal BMI, substantial body dissatisfaction and unhealthy weight-control behaviors were reported. Overall, 14.2
Family-Based Treatment (FBT) is a first-line treatment for anorexia nervosa in childhood and adolescence, however, remission rates following treatment remain modest. This systematic review aimed to examine definitions of, and identify factors that may influence, non-completion or non-response to FBT in children and adolescents with anorexia nervosa or atypical anorexia nervosa (AN/AAN). A systematic review was conducted according to PRISMA guidelines. Three databases (APA PsycINFO, Embase, and Web of Knowledge) were searched from 2005 to 4th August 2025, supplemented by citation searching. Inclusion criteria were studies in any language examining FBT for AN/AAN, in participants aged 18 years or under, in outpatient settings. Quality assessment was completed using the Joanna Briggs Institute critical appraisal tools. The review was prospectively registered (PROSPERO CRD420251114023). Searches identified 1794 articles, 988 following removal of duplicates. Fifty-five papers examined treatment non-completion and/or non-response (25 primary studies; 30 secondary analytic studies; N = 2,820). Definitions of treatment non-completion and non-response varied significantly. Non-completion rates ranged from 2
Eating disorder (ED) rates are rising in Australia, yet many individuals are not accessing timely or appropriate treatment. A key barrier is the availability of clinicians with the clinical knowledge and training to assess, diagnose, and provide timely, safe, and effective eating disorder treatment. The Australia New Zealand Academy for Eating Disorders (ANZAED) introduced the ANZAED Eating Disorder Credential (the Credential) to address this challenge and ease the burden on individuals living with an eating disorder, their carers’, and other supporting health professionals. The current study aims to explore parents’ and carers’ experience of eating disorder treatment in Australia provided by Credentialed Eating Disorder Clinicians (credentialed clinicians) and non-credentialed clinicians. An exploratory mixed-methods cross-sectional study was conducted involving 51 participants who had cared for a young person, family member, or loved one with an ED who received treatment by a credentialed clinician or a non-credentialed clinician. Participants were recruited via Australian eating disorder services and organisations, with recruitment information distributed through their email and social media platforms. Participants completed a survey with open- and closed-ended questions on their attitudes towards the Credential and their experiences of treatment by a credentialed clinician or non-credentialed clinician. Descriptive statistics and Mann–Whitney U tests were used to examine differences in treatment experiences and perceptions of treatment between participants who had experience with credentialed and non-credentialed clinicians, alongside content analysis of open-ended survey responses. The Credential was valued among parents and carers, irrespective of whether they had experience with a credentialed clinician. Parents and carers also expressed an overall preference for treatment from a credentialed clinician. However, when considering perceived therapeutic success, credentialing status was considered less important than other factors such as access, collaborative care, therapeutic rapport, and individualised treatment. Further, despite the introduction of the Credential, several barriers to safe and effective ED treatment remain. The Credential is an important step towards improving the standards of care and treatment experiences for individuals with eating disorders and their families. However, addressing ongoing barriers to access and delivery of care will be critical to realising its full potential. Eating disorders are becoming more common in Australia, but many people are not accessing the treatment they need. One reason is that it can be difficult to find clinicians with the appropriate training, knowledge, and experience to provide suitable treatment for eating disorders. The Australia New Zealand Academy for Eating Disorders (ANZAED) introduced the ANZAED Eating Disorder Credential (the Credential) to address this and ease the burden on individuals living with an eating disorder, their carers, and other supporting health professionals. This study explored how parents and carers experience treatment from clinicians who have the Credential compared with those who do not. Parents and carers valued the Credential, regardless of whether they had experience with a credentialed clinician. They also expressed an overall preference for treatment from a credentialed clinician. However, when it came to the perceptions of factors that matter for successful treatment, parents and carers highlighted the importance of other factors. These included treatment access, collaborative care, therapeutic rapport, and individualised treatment. While the Credential is an important step towards improving the standards of care and treatment experiences for individuals with eating disorders and their families, there are still barriers which need to be addressed so that the Credential can reach its full potential.
Cumulative exposure to adverse life events during childhood and adolescence is associated with of binge eating symptomology in adulthood. However, the mechanisms that underpin this relationship are uncertain. Emerging research suggests that early life stress increases the risk of future mental health problems by accelerating the maturation of functional connectivity between limbic regions (i.e., amygdala, hippocampus) and the cingulo-opercular network (CON) during adolescence. Correspondingly, the CON has been implicated in binge eating behaviour. Therefore, the current study leveraged longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study to ascertain whether stress exposure and binge eating symptoms are mediated by changes in amygdala-CON and hippocampus-CON functional connectivity. Longitudinal mediation models were used to examine the indirect effect of self-reported negative life events at baseline on binge eating symptoms at two-year follow-up via changes in amygdala-CON and hippocampus-CON resting-state functional connectivity among a sample of eligible adolescents (n = 94). We found a significant direct effect, with greater exposure to negative life events at baseline predicting a higher number of binge eating symptoms two years later. However, indirect effects via both amygdala-CON and hippocampus-CON connectivity were not significant. These findings support evidence linking chronic stress exposure with binge eating symptoms in youth, but not a mediating role of cingulo-opercular – limbic functional connectivity. Experiencing stress as a child or adolescent can increase the risk of binge eating, but it’s unclear why. This study explored whether stress exposure in young people aged 9–10 years old predicted binge eating symptoms 2-years later, and if this was related to networks in the brain that are related to the regulation of emotions. Youth who experienced greater lifetime stress exposure at age 9–10 years had more binge eating symptoms 2-years later, but this was unrelated to changes in emotional regulation brain networks. More research is needed to understand the relationship between stress exposure during childhood and adolescents and future binge eating behaviours.
The DSM-5 severity specifier for anorexia nervosa (AN), which relies primarily on body mass index (BMI) thresholds, has shown limited prognostic utility for predicting treatment outcomes. The present study aimed to develop a multivariable prognostic severity model for AN based on the risk of achieving full remission following treatment. A clinical sample of N = 398 patients with AN treated in a day patient program was used to develop a prognostic severity algorithm (366 women and 32 men, with age between 16 and 68 years). Candidate predictors included BMI-related indicators, illness duration, eating disorder (ED) symptom severity, previous treatment history, non-suicidal self-injury (NSSI) and lifetime substance use. An elastic-net logistic regression (ENLR) model was fitted and internally validated using nested cross-validation. Its performance was subsequently compared with that of a multilayer perceptron (MLP) neural network. The ENLR model identified current BMI (at pre-treatment) as the strongest predictor, followed by treatment history and NSSI. Compared with the DSM-5 BMI-based severity classification (AUC = 0.56), the ENLR model showed substantially superior prognostic discriminative performance (AUC = 0.68), and adequate calibration (Brier score = 0.21), with no evidence of systematic over- or underestimation of risk. Results were largely replicated by the MLP model, which yielded comparable discrimination and only marginally improved probabilistic accuracy. The ENLR-derived severity groups exhibited a markedly steeper gradient in remission rates (43.4
