Anorexia Nervosa Research Articles

Application of the integrated data platform combined with dietary management for adults with diabetes: A prospective randomized controlled trial.

To investigate the efficacy of the integrated data platform of cloud hospital combined with dietary management for adults with type 2 diabetes. We conducted a randomized controlled clinical trial. One hundred eighty patients with type 2 diabetes were randomly allocated into a control group (Group A) and an experimental group (Group B). Routine standard diabetes care was applied to the patients in Group A. The integrated data platform with dietary management was applied to Group B. Individualized diabetes education videos were sent to the patients through the platform. The primary endpoint was the change in HbA1c and change in body weight from baseline to Week 12 during the follow-up. At Week 12, HbA1c was 7.4 ± 0.7%, 6.9 ± 0.9% in Groups A and B, P < 0.01. The rate of fasting blood glucose <7 mmol/L, and glycosylated hemoglobin <7% was higher in Group B than in Group A. At Week 12, there was a significant weight loss and body mass index decrease in the overweight or obese patients of the experimental group. Those overweight or obese patients in the experimental group utilizing the appetite suppressant semaglutide achieved the most significant weight loss, with a 13.4% reduction after 12 weeks. The integrated data platform combined with personalized diabetes education video delivery was verified to be a more effective management mode for diabetes. For overweight or obese adults with diabetes, the use of semaglutide in conjunction with dietary management and the integrated data platform led to greater weight loss.

Oculomotor behaviors in youth with an eating disorder: findings from a video-based eye tracking task

BackgroundThe oculomotor circuit spans many cortical and subcortical areas that have been implicated in psychiatric disease. This, combined with previous findings, suggests that eye tracking may be a useful method to investigate eating disorders. Therefore, this study aimed to assess oculomotor behaviors in youth with and without an eating disorder.MethodsFemale youth with and without an eating disorder completed a structured task involving randomly interleaved pro-saccade (toward at a stimulus) and anti-saccade (away from stimulus) trials with video-based eye tracking. Differences in saccades (rapid eye movements between two points), eye blinks and pupil were examined.ResultsYouth with an eating disorder (n = 65, Mage = 17.16 ± 3.5 years) were compared to healthy controls (HC; n = 65, Mage = 17.88 ± 4.3 years). The eating disorder group was composed of individuals with anorexia nervosa (n = 49), bulimia nervosa (n = 7) and other specified feeding or eating disorder (n = 9). The eating disorder group was further divided into two subgroups: individuals with a restrictive spectrum eating disorder (ED-R; n = 43) or a bulimic spectrum eating disorder (ED-BP; n = 22). In pro-saccade trials, the eating disorder group made significantly more fixation breaks than HCs (F(1,128) = 5.33, p = 0.023). The ED-BP group made the most anticipatory pro-saccades, followed by ED-R, then HCs (F(2,127) = 3.38, p = 0.037). Groups did not differ on rate of correct express or regular latency pro-saccades. In anti-saccade trials, groups only significantly differed on percentage of direction errors corrected (F(2, 127) = 4.554, p = 0.012). The eating disorder group had a significantly smaller baseline pupil size (F(2,127) = 3.60, p = 0.030) and slower pro-saccade dilation velocity (F(2,127) = 3.30, p = 0.040) compared to HCs. The ED-R group had the lowest blink probability during the intertrial interval (ITI), followed by ED-BP, with HCs having the highest ITI blink probability (F(2,125) = 3.63, p = 0.029).ConclusionsThese results suggest that youth with an eating disorder may have different oculomotor behaviors during a structured eye tracking task. The oculomotor behavioral differences observed in this study presents an important step towards identifying neurobiological and cognitive contributions towards eating disorders.

Clinicians' confidence in diagnosing atypical anorexia nervosa: An experimental study of the role of patient and clinician characteristics.

This experimental study investigated the weight loss parameters and resulting end weight that influence clinician confidence in diagnosing atypical anorexia nervosa (AAN). Clinicians (N=67) read a series of vignettes where patient weight loss and end weight varied, then rated their confidence in an AAN diagnosis and alternatives. Using repeated measures ANOVAs, we examined patient (weight loss, end weight) and the possible relationship between clinician (e.g., age, profession) characteristics and confidence in diagnosing AAN. Clinicians were most confident in an AAN diagnosis when patients had lost 10% or 15% of their body weight, leaving them at a high or normal weight. Clinicians considered 5% as significant weight loss for AAN, but only when the patient ended at a high or normal weight. However, they did not clearly differentiate AAN from unspecified feeding and eating disorder (UFED) when there was a 5% weight loss resulting in high or normal end weight. Clinician characteristics did not impact on confidence in diagnoses. The DSM's 'significant weight loss' criterion leaves room for clinicians to interpret it idiosyncratically. The lack of a clear pattern of UFED and AAN diagnosis has important clinical implications, as UFED tends to be dismissed as being less serious.

Computational Insight on Potential Activity of Star Apple

Studies reported that Star Apple (C. cainito) has the potential as an anti-obesity agent.

Family therapy for emerging adults with anorexia nervosa: Expert opinion on evidence, practice considerations, and future directions.

Various forms of eating disorder focused family therapy (FT-ED) have been developed and evaluated for adolescents. FT-ED for adolescent anorexia nervosa (AN) focuses on empowering parents/carers with the knowledge and skills required to facilitate recovery for their child. The recent trend and increased awareness of the period between adolescence and adulthood during ages 18-25, known as 'emerging adulthood', has brought into question whether the traditional treatment approach for adults with AN, that is, individual therapies, is the most appropriate approach for this age group. This paper briefly outlines the current forms FT-ED for emerging adults with AN and examines the evidence for each. We then present considerations for tailoring FT-ED for emerging adults with AN across three broad domains: structure and set-up, process, and content. Finally, we present suggestions on how to troubleshoot common pitfalls that may be encountered, such as reluctance to include parents in treatment. Future research should examine which forms of FT-ED are best for which emerging adults and families and under what contexts. There is also a need to explore the incorporation of technology into sessions with families who live apart.

Dynamics of clinical manifestations of social phobia, bulimia nervosa, and anorexia nervosa in medical university students during cognitive behavioral therapy and sertraline pharmacotherapy

In recent years, there has been a significant incidence of psychopathology, leading to a decrease in social adaptation and more serious consequences. In particular, one of these nosologies is social phobia. Social phobia in young people, in particular, in medical students, often leads to the development of eating disorders. A significant part of young people during their studies at the higher educational institution are under constant strain of adaptive resources, sometimes even in a state of decompensation. The purpose of the study was to investigate the dynamics of clinical manifestations of social phobia, bulimia nervosa, and anorexia nervosa in medical students against the background of cognitive behavioral psychotherapy and sertraline pharmacotherapy. The study was conducted in 2020–2021 among students of the Voronezh State Medical University named after N. N. Burdenko. 106 participants were divided into 4 groups. Group I was treated with individual cognitive behavioral therapy (CBT), group II received a combination of psychotherapy and pharmacotherapy with sertraline at a dosage of 100 mg/day, group III — psychopharmacotherapy with sertraline without cognitive psychotherapy, and group IV had cognitive behavioral group psychotherapy. During the two-month study positive dynamics in the frequency of symptoms of social anxiety, anorexia nervosa, and bulimia nervosa were noted among the patients of all groups. The best dynamics of symptoms of social phobia and eating disorders was noted among the participants of the first and second groups. The results in both groups are comparable. The next most effective method of therapy of the combined social phobia and eating disorders according to the two-month study was group cognitive psychotherapy. Sertraline pharmacotherapy without cognitive psychotherapy in the third group of the participants showed the least effectiveness. The results of the study allow recommending the use of individual and group CBT protocols and a combination of individual CBT and sertraline pharmacotherapy in the treatment of comorbid social phobia, anorexia ner vosa, and bulimia ner vosa in students of higher medical institutions.

Development and Evaluation of Reconstructed Nanovesicles from Turmeric for Multifaceted Obesity Intervention.

The escalating prevalence of obesity poses significant health challenges due to its direct association with various diseases. Most existing medications, such as appetite suppressants and fat absorption inhibitors, suffer from limited effectiveness and undesirable side effects. Here, inspired by the versatile metabolic effects of turmeric, we developed a naturally derived nanoformulation of "Reconstructed Turmeric-derived Nanovesicles (Rec-tNVs)" for obesity treatment. Employing quantitative nanoflow cytometry, a four-orders-of-magnitude increase in curcumin content (∼108 molecules per particle) was identified in individual Rec-tNVs compared to their ultracentrifugation-isolated counterparts. Rec-tNVs, featuring highly aggregated curcumin arrangements and other coencapsulated bioactive compounds, demonstrated a dose-dependent lipid-lowering effect in mature 3T3-L1 cells by promoting lipolysis, suppressing lipogenesis, inducing adipocyte browning, and triggering apoptosis after internalization via multiple pathways. In vivo experiments revealed that Rec-tNVs alleviated obesity more effectively than free curcumin and achieved weight reductions of 18.68 and 14.56% through intragastric and subcutaneous delivery, respectively, in high-fat-diet mouse models over a four-week treatment period. These effects were attributed to targeted actions on adipose tissues and systemic impacts on metabolism and gut microbiota composition. Overall, this study underscores the multifaceted antiobesity efficacy of Rec-tNVs, and offers a promising paradigm for developing plant-derived nanovesicle-based therapeutics.

Causal Relationship between Aging and Anorexia Nervosa: A White-Matter-Microstructure-Mediated Mendelian Randomization Analysis.

This study employed a two-step Mendelian randomization analysis to explore the causal relationship between telomere length, as a marker of aging, and anorexia nervosa and to evaluate the mediating role of changes in the white matter microstructure across different brain regions. We selected genetic variants associated with 675 diffusion magnetic resonance imaging phenotypes representing changes in brain white matter. F-statistics confirmed the validity of the instruments, ensuring robust causal inference. Sensitivity analyses, including heterogeneity tests, horizontal pleiotropy tests, and leave-one-out tests, validated the results. The results show that telomere length is significantly negatively correlated with anorexia nervosa in a unidirectional manner (p = 0.017). Additionally, changes in specific white matter structures, such as the internal capsule, corona radiata, posterior thalamic radiation, left cingulate gyrus, left longitudinal fasciculus, and left forceps minor (p < 0.05), were identified as mediators. These findings enhance our understanding of the neural mechanisms, underlying the exacerbation of anorexia nervosa with aging; emphasize the role of brain functional networks in disease progression; and provide potential biological targets for future therapeutic interventions.

Reducing Relapse by Enhancing Reward Responsivity in Anorexia Nervosa: The VIBRANT (Virtual Interventions for Bolstering Recovery following Anorexia Nervosa Treatment) Trial

Reducing Relapse by Enhancing Reward Responsivity in Anorexia Nervosa: The VIBRANT (Virtual Interventions for Bolstering Recovery following Anorexia Nervosa Treatment) Trial

Design, synthesis and structure-activity relationship of novel 2-pyrimidinylindole derivatives as orally available anti-obesity agents

Due to the emerging global epidemic of obesity, developing safe and effective agents for anti-obesity is urgently needed. Our previous study found that 2-pyrimidinylindole derivative Wd3d exhibited potential anti-obesity activity. Herein, to further optimize the potential moiety, structural modifications were proceeded for two rounds in this study. Firstly, we designed, synthesized, and evaluated 36 new derivatives of 2-pyrimidinylindole scaffold with different substituents on the indole ring and pyrimidine ring to investigate their structure-activity relationship (SAR). Then, analogs with potent activity had the aldehyde group replaced with the acylhydrazone group to reduce cytotoxicity and improve metabolic stability. Detailed SAR studies and animal evaluation experiments led to the discovery of the compound 9ga, which significantly reduced TG accumulation with an EC50 value of 0.07 μM and showed relatively low cytotoxicity with an IC50 value of around 24 μM. Oral administration of 9ga effectively prevented the excessive growth of body weight and lessened fat mass as well as liver mass, decreased lipid accumulation in the liver and blood, and improved the heart injury parameter in the diet-induced obesity mouse model significantly better than Wd3d. A mechanism study showed that 9ga regulated the lipid metabolism during early adipogenesis by inhibiting PPARγ pathway. In conclusion, our study further highlights the anti-obesity potential of 2-pyrimidinylindole derivatives in diet-induced obesity.

The potency of &lt;i&gt;Elaeocarpus grandiflorus &lt;/i&gt;Leaf Extract as Anti-obesity: &lt;i&gt;in vivo &lt;/i&gt;and &lt;i&gt;in silico&lt;/i&gt; Study

The research aims to determine the effect of ethanol extract of Elaeocarpus grandiflorus leaves extract as anti-obesity by in vivo and silico computational models. The pre-and -post-tests were carried out on 20 female Wistar rats, divided into 4 groups. The control group (K) received no treatment and the experimental groups were treated with E. grandiflorus extract of 200 mg/kg BW (P1), 400 mg/kg BW (P2), and 800 mg/kg BW (P3) for 14 days. The body weight, abdominal circumference, and abdominal fat mass were measured on Day 1 and Day 15. The results showed differences in body weight (p=0.02), abdominal circumference (p=0.01), and abdominal fat mass (p=0.00). In silico exploration, bioactive compounds of rutin, orientin, luteolin, vitexin, iso orientin, isovitexin, kaempferol, and quercetin were identified, and targeted ELAVL1, IGF1R, CREB1, AKT1, and PIK3R1 of the AMPK signaling pathway that involved in the anti-obesity mechanism. The high binding affinity values was rutin-EVAL1 (-9.3), orientin-ELAVL1 (-8.3), and quercetin- IGFR1 (-8.2). It can be concluded that the ethanol extract of E. grandiflorus leaves has the potential to be developed as an anti-obesity agent.

Incidence of new onset type 2 diabetes in adults living with obesity treated with tirzepatide or semaglutide: real world evidence from an international retrospective cohort study

Tirzepatide, a novel dual agonist of glucagon-like-peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), has demonstrated greater magnitude of weight loss compared to semaglutide in a phase 3 clinical trial. However, the effect of tirzepatide on incidence of type 2 diabetes (T2D) in individuals with overweight and obesity, and the effect on major adverse cardiovascular outcomes in individuals with pre-existing T2D, remains unknown. We performed a retrospective cohort study of anonymised electronic medical records using the TriNetX network (TriNetX LLC, Cambridge, MA, USA) a global federated database. The data used in this study was collected on 5th June 2024. Two cohorts of individuals were generated: 1) without pre-existing T2D and, 2) with T2D. We adopted an active comparator new user design on new initiations of either tirzepatide or semaglutide therapy. Analysis began from the index event which was defined as individuals on respective therapy for 6 months only. Analysis of outcomes was conducted off-drug, in individuals without a pre-existing history of the disease of interest. Individuals were followed up for 12 months post the index event. Primary outcome for cohort 1 was incidence of T2D, and for cohort 2 was composite: all-cause mortality, cerebral infarction, acute coronary syndrome, and heart failure. Secondary outcomes for cohort 1 were change in HbA1c and body weight and for cohort 2: incidence of micro- and macrovascular complications, suicidal ideation and/or attempt, and all-cause mortality. We propensity score matched (1:1) for potential confounders: baseline demographics, socioeconomic circumstances, HbA1c, weight, relevant co-morbidities, and anti-obesity, hypoglycaemic and cardioprotective agents. The study population without T2D consisted of 13,846 individuals, equally split between tirzepatide and semaglutide users. Tirzepatide was associated with both lower risk for incident T2D (HR 0.73, 95% CI 0.58-0.92, p<0.001) and greater weight loss (-7.7kg, [95% CI-6.8,-8.5kg], p<0.001), compared to semaglutide (-4.8kg, [95% CI-3.9,-5.6kg], p<0.001). In individuals with pre-existing T2D (n=8446), tirzepatide was associated with lower risk of the composite outcome (HR 0.54, 95% CI 0.38-0.76, p<0.001), cerebral infarction (HR 0.45, 95% CI 0.24-0.84, p=0.010) and all-cause mortality (HR 0.33, 95% CI 0.15-0.73, p=0.004) compared to semaglutide. Tirzepatide is associated with significantly reduced risk of developing T2D and major adverse cardiovascular events in individuals living with obesity and T2D respectively. Randomised controlled trials investigating the utility of dual incretin agonists in the primary prevention of T2D and cardiovascular disease in higher risk populations are now required. Nil.

Autistic traits and perspective taking in youths with anorexia nervosa: an exploratory clinical and eye tracking study

BackgroundDespite their apparent dissimilarity, Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD) share many features, especially in terms of social and emotional difficulties. In recent years, empathic abilities in AN have been frequently assessed using self-report measures. Otherwise, the director task (DT) has been used to investigate the ability to take the visual perspective of another individual in a communicative context, using eye-tracking technology. The aim of the current study was to test the presence of autism-relevant features in AN, through: (i) comparing self-reported autistic traits and empathic abilities in a group of young inpatients with AN and age/gender matched healthy controls (HC); (ii) comparing performance on the director paradigm.MethodsThe participants were females in the age-range between 11 and 18 years: 24 with AN and 23 HC. Autistic traits, empathic abilities, and severity of the eating disorder were respectively measured using: the Autism Quotient (AQ), the Interpersonal Reactivity Index (IRI), and the Eating Disorder Inventory-3 (EDI-3). Both groups performed a computerized task in which a director instructed them to move objects placed on a set of shelves using a mouse, while their eye gaze was tracked. A total of 36 shelf configurations, divided into three categories (with dimensional distractor – with spatial distractor – control), were created.ResultsSubjects with AN showed higher autistic traits than HC. Eye-tracking data revealed that subjects with AN took longer to decide which object to select and where to move it, both in distractor-trials and in control-trials. In the AN group, we found a significant negative correlation between the total score of the AQ and the number of fixations to the irrelevant object in the dimensional control condition -in which the subjects were asked to focus on dimensional aspects of the object (large-small)-.ConclusionsAutistic traits were over-represented in a group of young inpatients with AN. Through the use of eye-tracking technology, this exploratory study documented some differences between AN inpatients and HC in their online processes during the perspective taking tasks, which could be considered a target of tailored intervention. A larger sample of patients is needed to confirm these preliminary findings.

Anorexia nervosa: Disease process, challenges and hope

Anorexia nervosa, as a psychiatric disorder with a progressively high prevalence, is characterized by the following features: high mortality rate, serious harm, long-lasting effects, difficult to cure and easy to relapse. In recent years, Awareness of anorexia nervosa is different than in the past, going deeper: it is a complex disorder involving multiple systems. Many disciplines are also actively exploring it. However, there are still problems such as Pathologic mechanism unclear, no clear indicators of disease, no targeted drugs, and insufficient public awareness. This article analyses research in the fields of social environment, immunology and brain science in the order of disease onset, evolution and treatment (including difficulties in the treatment process, such as in Refeeding syndrome), and puts forward some recommendations for earlier intervention, comprehensive treatment, and optimization and maintenance of therapeutic efficacy in anorexia nervosa. It is also hoped that public awareness and attention will be raised. There are still many gaps in the road to overcoming anorexia nervosa, which has a large research space and is also not less challenging. Future research could focus on finding objective indicators for diagnosing anorexia nervosa or suggesting recovery, and finding targeted drugs from the perspective of multi-system interactions.

Acyl-CoA binding protein for the experimental treatment of anorexia.

Extracellular acyl-coenzyme A binding protein [ACBP encoded by diazepam binding inhibitor (DBI)] is a phylogenetically ancient appetite stimulator that is secreted in a nonconventional, autophagy-dependent fashion. Here, we show that low ACBP/DBI plasma concentrations are associated with poor prognosis in patients with anorexia nervosa, a frequent and often intractable eating disorder. In mice, anorexia induced by chronic restraint stress (CRS) is accompanied by a reduction in circulating ACBP/DBI concentrations. We engineered a chemical-genetic system for the secretion of ACBP/DBI through a biotin-activatable, autophagy-independent pathway. In transgenic mice expressing this system in hepatocytes, biotin-induced elevations in plasma ACBP/DBI concentrations prevented anorexia induced by CRS or chemotherapeutic agents including cisplatin, doxorubicin, and paclitaxel. ACBP/DBI reversed the CRS or cisplatin-induced increase in plasma lipocalin-2 concentrations and the hypothalamic activation of anorexigenic melanocortin 4 receptors, for which lipocalin-2 is an agonist. Daily intravenous injections of recombinant ACBP/DBI protein or subcutaneous implantation of osmotic pumps releasing recombinant ACBP/DBI mimicked the orexigenic effects of the chemical-genetic system. In conclusion, the supplementation of extracellular and peripheral ACBP/DBI might constitute a viable strategy for treating anorexia.

Anorexia and Bulimia Nervosa in Spanish Middle-Aged Adults: Links to Sociodemographic Factors, Diet, and Lifestyle.

This study examines the prevalence of eating disorders, particularly anorexia and bulimia nervosa, among middle-aged Spaniards, noting their rising incidence in men as well as women. It explores how these disorders relate to sociodemographic factors and lifestyle habits. A cross-sectional survey was conducted from August 2020 to November 2021 via online platforms. Participants were Spanish nationals aged 31-50 years residing in Spain. Out of 9913 respondents, 96.66% reported no diagnosed eating disorders, while 3.34% reported one or more (0.36% anorexia nervosa; 0.53% bulimia nervosa; 1.97% other eating disorders; 0.48% multiple disorders). Concerns about body image and lack of control over food intake were reported by 50% and 28%, respectively, suggesting potential undiagnosed disorders. Significant BMI differences were noted between healthy individuals and those with anorexia or bulimia. Anorexia and bulimia affect both adolescents and middle-aged individuals, challenging existing stereotypes. The high prevalence of undiagnosed eating disorder behaviors highlights the need for early detection. To address these issues in Spain, targeted awareness programs are essential to reduce stigma and improve service access through clinical, social, and political collaboration.

How enduring and multi-faceted self-disgust threatens psychological recovery from anorexia nervosa: a qualitative enquiry

PurposeSelf-disgust appears to be a prominent feature in anorexia nervosa (AN), which might help explain why AN is often such a persistent disorder. Little is known about how this emotion can impact on recovering from this disorder. This study aims to develop our understanding of how people experience the emotion of self-disgust after physical recovery from AN.Design/methodology/approachTwelve female participants who reported previously having had a clinical diagnosis of AN but had physically recovered according to their EDE-Q scores took part in a semi-structured interview to explore their experiences of recovery and the role self-disgust played within this. Interpretative phenomenological analysis was used to explore the data.FindingsThree themes were identified within the data to explain the experiences of self-disgust in those with AN: continued self-disgust following physical “Recovery”, multiple manifestations of self-disgust in recovery and increasing self-disgust in recovery as a driver for relapse.Practical implicationsSelf-disgust was something each participant appeared to experience often, despite being physically recovered from AN. Disgust-based reactions to the self are enduring and highly resistant to change even whilst other aspects of the disorder become less potent. Self-disgust is multi-faceted and may trigger relapse as the signs of improvement and behaviours inherent in recovering were generally viewed as disgusting to the individuals.Originality/valueSelf-disgust is an emotion that continues to affect people with AN despite physical recovery. The recovery process itself is not linear and self-disgust is enduring and may cause those affected to relapse. Considering this emotion within therapeutic intervention may encourage those with AN to accept their recovered self.

Early intervention for adolescents with anorexia nervosa: Pilot evaluation of an outpatient group therapy prior to inpatient treatment.

An increasing demand for inpatient treatment for adolescents with anorexia nervosa (AN) during and after the Covid-19 pandemic contrasts with limited capacity and long waiting times. The current pilot study evaluated an outpatient group therapy (GT) as early intervention for adolescents with AN prior to inpatient treatment. Seventeen female adolescents who participated at the GT (intervention group, INT) were compared to 16 adolescents without GT (treatment-as-usual, TAU). BMI, eating disorder psychopathology and motivation of change (MoC) were assessed at three timepoints. Comparing pre- versus post- group participation, we identified a significant increase of MoC and a trend towards a decreased AN-specific psychopathology. Comparing INT with TAU adolescents, we found a significant lower AN psychopathology at inpatient admission for the INT group and a trend for different BMI courses: While the BMI of the TAU group decreased during waiting time, the INT group did not show a decrease during GT resulting in a higher BMI at admission. Results of the current pilot study suggest positive effects of an early outpatient intervention in a group setting for adolescents with AN prior to inpatient treatment. Further research with larger sample sizes is necessary to validate the current pilot results.

Effectiveness and predictors of psychotherapy in eating disorders: state-of-the-art and future directions.

Psychotherapy is the cornerstone of the multidisciplinary treatment approach for eating disorders. This review examines recent evidence regarding effectiveness, predictors, and mechanisms of change of psychotherapy in eating disorders, providing a road map for clinicians and researchers. Family-based treatments (FBT) are effective in adolescents with anorexia nervosa and bulimia nervosa. Evidence-based psychotherapies for anorexia nervosa have no evidence of superiority compared with treatment as usual (TAU) in adults with anorexia nervosa. Cognitive-behavioural therapy (CBT) is the first-choice psychotherapy recommended for adults with bulimia nervosa and binge-eating disorder (BED). Self-help interventions have some evidence of effectiveness in nonunderweight individuals with eating disorders. Early symptom improvement and adolescent age predict more favourable outcomes. Evidence-based psychotherapies can be suggested for eating disorders, although follow-up data are needed. Beyond anorexia nervosa, bulimia nervosa, and BED, there is no evidence of psychotherapy effectiveness in other eating disorders. The effectiveness of novel (e.g. 'third-wave') psychotherapies, treatment delivery modality (e.g. internet-delivered), and adjunctive interventions (e.g. virtual reality) needs to be further explored. A broader definition of recovery is recommended, including behavioural, physical, and psychological criteria. Predictors and mechanisms of changes have not been studied enough: quantitative and qualitative studies are needed to promote more tailored and individualized psychotherapy interventions.

Effects of Repeated Administration of Rauwolfia Serpentina on Stress-Induced Anorexia and Leptin Levels: Relationship With Adaptation to Stress

Background: Stress is a major contributor to various health issues, including depression, anorexia nervosa, diabetes, and obesity. Rauwolfia serpentina, a traditional medicinal plant, has shown potential in alleviating stress-induced effects due to its influence on serotonin neurotransmission and its anxiolytic properties. Objective: This study aimed to investigate the effects of repeated administration of Rauwolfia serpentina on stress-induced anorexia and leptin levels, and its relationship with adaptation to stress in rats. Methods: Male albino Wistar rats were divided into four groups: DMSO unstressed, DMSO stressed, Rauwolfia serpentina unstressed, and Rauwolfia serpentina stressed. The stressed groups were subjected to two hours of immobilization daily for five days, followed by oral administration of Rauwolfia serpentina at 10 mg/kg. Behavioral assessments included the open field and light-dark transition tests. Body weight, food intake, and plasma levels of glucose, leptin, and corticosterone were measured. Data were analyzed using ANOVA with post-hoc Newman-Keuls test, and significance was set at p&lt;0.05. Results: Rauwolfia serpentina significantly improved body weight maintenance (98.9 ± 1.3% vs. 99.5 ± 1.7%) and increased food intake (16.3 ± 0.6 g vs. 16.5 ± 0.5 g) in stressed rats. It also reduced anxiety-like behaviors and lowered corticosterone levels (15.9 ± 1.6 ng/mL vs. 18.4 ± 1.7 ng/mL) in stressed groups (p&lt;0.05). Conclusion: Rauwolfia serpentina effectively alleviates stress-induced anorexigenic and anxiogenic effects, suggesting its potential as a therapeutic agent for managing stress-related disorders.