Stress significantly influences eating behavior, yet individual responses vary. Binge eating - a core feature of Binge Eating Disorder and Bulimia Nervosa - is frequently triggered by acute stress. One proposed mechanism is that stress increases the motivational salience of food cues, which could promote craving and food intake. To test this idea experimentally, this study examined how stress affects attentional bias toward food, and how such changes relate to food craving and food intake in individuals with binge eating behaviors compared with individuals without binge eating. Using a mixed experimental design, 130 participants (68 with binge eating, 62 without binge eating) completed sessions with and without stress induction via a video-conference Trier Social Stress Test. Attentional bias was assessed via the Dot Probe Paradigm and eye tracking, food craving was measured via self-reports, and food intake was measured behaviorally. Stress did not significantly change attentional bias toward food, nor did it affect food intake. Stress did increase craving in the group with binge eating, indicating that stress enhanced the motivational value of food. The absence of corresponding changes in attentional bias suggests that heightened craving under stress does not necessarily translate into measurable shifts in attentional allocation toward food cues, or that stress may influence motivational processes without altering overt attentional patterns. Another possibility is that methodological restraints specific to our study design limited the detection of stress-related changes in attentional processes. Further research is needed to clarify the role of attentional processes in stress-related eating, especially regarding binge eating.

Maintenance factors for eating disorder symptoms based on ecological momentary assessment studies: A systematic review.

Neurodegenerative diseases and disordered eating have become rapidly expanding areas of research. However, research addressing the relationship between the two is lacking. A scoping review guided by the Joanna Briggs Institute methodological framework was completed to synthesise the evidence related to disordered eating behaviours among individuals living with neurodegenerative disease. A systematic search strategy was applied across four scientific databases. A narrative descriptive analysis was conducted to identify key patterns in the studies categorised by the type of eating behaviour. The types of tools used within studies were explored. Thirty-six evidence sources were included in this review. Overeating-related issues such as hyperphagia were identified (n = 5, 25%) for dementia and Alzheimer's disease-related studies. Appetite-related changes were prevalent across amyotrophic lateral sclerosis (n = 1, 100%) and dementia and Alzheimer's disease-related studies (n = 6, 30%). Food addiction and binge eating were reported in all Parkinson's disease studies (n = 9, 100%), and in one case report for dementia. Eating disorders such as anorexia, bulimia and binge eating disorder were identified in all multiple sclerosis-related studies (n = 6, 100%). Validated and unvalidated tools (53%, n = 19) were used to identify eating behaviours. This review revealed reports of disordered eating behaviours among various neurodegenerative disease types. Additional research is required to understand the aetiology and mechanisms behind disordered eating behaviours in these populations. Standardised tools to assess eating behaviours for people living with a neurodegenerative disease are needed. Eating behaviours should be screened upon neurodegenerative disease diagnosis and monitored as part of routine care.

Bariatric surgery effectively treats severe obesity. However, long-term data on weight maintenance and patient well-being remain scarce. This study assessed patients' perspectives on their bariatric trajectory and outcomes of their historical and current status across multiple domains, irrespective of surgical procedure. A retrospective cohort study was conducted among patients who were referred to the Department of Medical Psychology for bariatric screening between 1998 and 2004. Of the 547 referred patients, eligible participants received a survey after informed consent addressing weight outcomes, current eating patterns, dietary guidelines adherence, expectation fulfillment, satisfaction, and peer advice. Sixty-two participants completed survey. Mean postoperative time since the initial surgery was 19 years (range 6-27). Mean preoperative weight decreased 33%, from 144.2 to 97.5kg. Preoperative Body Mass Index decreased from 50.3 to 34.0kg/m2. Healthy postoperative behaviors included regular meals, portion control and control regarding snacking between meals. Unhealthy behaviors included evening snacking, alcohol consumption and binge eating. One third reported using vitamins never or sometimes. Participants reported diverse encountered barriers regarding eating, drinking, physical and psychological health and social functioning. Most would choose surgery again except those with expectation-outcome discrepancies or ongoing weight instability. Peer advice emphasized comprehensive preoperative education on all potential postoperative consequences from multiple sources. After 19 years, weight loss, healthy eating and adherence to advice varied, yet most participants were satisfied regardless of weight loss or reoperation. We plea for lifelong follow-up care to optimize bariatric results regardless type of surgery.

Does food insecurity elucidate the relationship between food addiction and binge eating among bariatric surgery candidates?

Binge eating (BE) and addictive-like eating behaviors, as assessed by the Yale Food Addiction Scale (YFAS) may change following metabolic bariatric surgery (MBS), yet their long-term trajectories and relationship with weight recurrence remain unclear. We examined their prevalence, longitudinal course, and associations with weight outcomes seven years following sleeve gastrectomy (SG). Women who underwent primary SG (n = 62) were evaluated prospectively at baseline and at 3, 6, 12, and 24 months, and 7 years post-surgery. Addictive-like eating behaviors and BE were assessed using the YFAS and Binge Eating Scale (BES), respectively. Longitudinal changes and associations with 7-year weight recurrence from nadir were examined. Thirty women completed the 7-year follow-up. At baseline, addictive-like eating behaviors and BE were identified in 40.0% and 46.0% of participants, respectively. Prevalence declined at 6 months (addictive-like eating behaviors: 8.7%, BE: 10.6%), followed by a gradual increase by 7 years (addictive-like eating behaviors: 21.4%, BE: 26.9%). Baseline behaviors were not associated with weight recurrence at 7 years. In contrast, BE at 7 years was associated with greater weight recurrence from nadir (P = 0.015), whereas addictive-like eating behaviors were not. Although BE and addictive-like eating behaviors decline substantially during the early postoperative period following SG, both may gradually re-emerge over long-term follow-up. BE present at 7 years, but not addictive-like eating behaviors, was associated with significantly greater weight recurrence from nadir, underscoring the importance of sustained behavioral and psychological monitoring during long-term postoperative care.

Disordered eating (DE) is common among children living with overweight and obesity, and individual appetitive traits may contribute to the persistence of both DE and excess weight. This study examined whether pre-intervention appetitive traits in 7- to 14-year-olds with overweight/obesity attending a 10-week lifestyle camp were associated with DE at a 3-year follow-up. Second, correlations between pre-intervention appetitive traits and Body Mass Index-Standard Deviation Score (BMI-SDS) 3years later were explored. Children with overweight/obesity were recruited from two Danish lifestyle camps. Self-reported questionnaires were completed to collect data on appetitive traits and DE, assessed as overeating (OE) and loss-of-control (LOC) eating. Five categories (No DE, occasional/regular OE and occasional/regular binge eating (BE)) were generated based on OE frequency (1-3 vs. ≥4 episodes) and the presence or absence of LOC eating. Measured weight and height were used to calculate BMI-SDS. 190 children were included, and 102 reassessed at 3years. Higher pre-intervention Food Responsiveness was associated with a twofold increased risk of Regular BE (vs. no DE) at follow-up (RRR = 2.05 95% CI: 1.03;4.09, p = 0.04). Higher scores of Slowness in Eating and Emotional Undereating were associated with Occasional OE 3years later (RRR = 2.22 95% CI: 1.05;4.68, p = 0.04) and (RRR = 5.16 95% CI:1.80;14.79, p = 0.002), respectively. Pre-intervention Food Responsiveness correlated positively with BMI-SDS at 3years, whereas Emotional Undereating correlated negatively (both p < 0.05). Identification of high-risk appetitive traits could offer a unique opportunity for early intervention to prevent later DE and weight gain in children with overweight/obesity. Level of evidence Level II: evidence obtained from well-designed controlled trials without randomization. Trial registration The study was preregistered at clinicaltrials.gov (ID: NCT04522921). The longitudinal part of this study was preregistered at OSF Registries (www.osf.io), https://doi.org/10.17605/OSF.IO/MPE4Z.

BackgroundImpulse control disorders (ICDs) are potentially serious complications of Parkinson's disease (PD). Treatment, particularly the use of dopamine agonists (DAs), is associated with the development of ICDs and related behaviors. However, susceptibility to these disorders appears to be linked to specific risk factors.ObjectiveTo assess the frequency, clinical presentation, and factors associated with the development of ICDs in a population of patients with PD.MethodsPatients with PD were screened for ICD-related symptoms using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson''s Disease -Current Short (QUIP-CS) questionnaire. Additionally, they underwent cognitive evaluation and were assessed using the Movement Disorder Society–Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Sociodemographic data and disease progression information were collected. Levodopa equivalent daily dose (LEDD) was calculated for each patient.ResultsOf the 90 patients evaluated, 42 (46.6%) exhibited symptoms of ICDs. The most frequent subtype was binge eating (50%), followed by compulsive buying (33.3%) and hypersexuality (21.4%). A significant association was found between DA use and the development of ICDs (p = 0.041). Patients with ICDs using DAs had a higher mean LEDD (p < 0.001) and a higher frequency of motor complications (MDS-UPDRS Part IV,p = 0.028) compared to those not using DAs.ConclusionIn the current study, the use of DAs was the main risk factor associated with the development of impulse control disorders. No other significant associated factors could be identified.

From urge to behavior: An investigation of the temporal relationship between eating disorder urges and engagement in eating disorder behaviors.

Sleep, mood, and binge eating: Evidence from a student sample.

BackgroundObesity increases chronic disease risk and is related to psychological implications like depression and anxiety. However, research has predominantly focused on overweight or class I obesity, leaving a gap concerning severe (class II/III) obesity. The objective of this study was to evaluate the prevalence of anxiety and depression and associated factors in adults with class II/III obesity.MethodsThis cross-sectional study used baseline data from the DieTBra Clinical Trial. A total of 150 adults (mean age 39.6 ± 8.8 years; 85.3% female) with class II/III obesity were evaluated. Sociodemographic, lifestyle, biochemical variables (iron, 25-hydroxyvitamin D, vitamin B12, homocysteine, C-reactive protein), multimorbidity, and binge eating disorder (BED) were assessed. The hospital anxiety and depression scale and binge eating scale were used. The outcomes analyzed were anxiety symptoms, depression, and their co-occurrence, using multiple Poisson regression with a significance level of 5%.ResultsThe prevalence of depression was 63.3%, anxiety 72.7%, and their co-occurrence was 56.7%. After multivariate analysis, factors associated with anxiety were female sex (p = 0.048), age over 50 (p = 0.029), lower educational level (p = 0.002), and BED (p = 0.003). Factors associated with depression included: female sex (p = 0.006), age over 50 (p = 0.029), age 18-29 (p = 0.043), multimorbidity (p = 0.027), and BED (p = 0.026).ConclusionsWe observed high prevalences of anxiety, depression, and their co-occurrence in adults with class II/III obesity. Independent risk factors included female sex, specific age groups, lower educational level, multimorbidity, and BED. Future longitudinal studies are needed to establish causality, and interventional research should focus on these high-risk subgroups.

Digital interventions are increasingly promoted as scalable options for reducing the treatment gap in eating disorders, with the evidence base expanding in recent years to include new populations, delivery formats, and therapeutic approaches. A comprehensive, up-to-date synthesis is needed to clarify the current evidence for digital treatment delivery formats in eating disorders. To evaluate the association of digital interventions for eating disorders with core and transdiagnostic symptom outcomes in the acute and longer-term phases. MEDLINE, PsycINFO, Web of Science, and Scopus were searched (October 2025) using terms related to eating disorder, digital health, and randomized clinical trials. Randomized clinical trials evaluating a digital intervention for threshold or subthreshold eating disorders were eligible. Interventions had to be delivered via digital technologies (eg, websites, applications, chatbots), with or without support, and compared against a control. Two reviewers extracted data. Risk of bias was assessed using 4 Cochrane risk of bias criteria. Meta-analyses were conducted using random-effects models, calculating Hedges g for continuous outcomes and odds ratios for symptom abstinence. Primary outcomes included core eating disorder symptoms (global eating disorder psychopathology, binge eating frequency, compensatory behaviors, abstinence, and symptom-specific subscales). Secondary outcomes included comorbid mental health symptoms (depression, anxiety, general distress) and general well-being (quality of life, clinical impairment, self-esteem). A total of 36 trials were included. At posttreatment assessment, digital interventions compared with controls produced significant improvements in primary eating disorder psychopathology (Hedges g = 0.49; 95% CI, 0.38-0.60) and objective binge eating (Hedges g = 0.37; 95% CI, 0.24-0.51) outcomes, as well as other symptom-specific and comorbid mental health outcomes. Effect sizes largely remained significant when adjusting for various sources of biases. Significant benefits were mostly observed across specific clinical populations (eg, bulimia nervosa, binge-eating disorder). Effect sizes were largest for trials that used a waiting list relative to other controls. At follow-up, digital interventions produced weaker but statistically significant sustained improvements for 7 of 9 outcomes. In this study, digital interventions were associated with consistent and durable benefits across numerous symptom-specific and transdiagnostic outcomes. These results highlight their potential to expand access to evidence-based support and to inform future clinical implementation efforts.

Disordered eating behaviors pose significant health risks, yet evidence among young adult (YA) cancer survivors is limited. We examined the prevalence and associated factors of disordered eating attitudes and binge eating symptoms in YA survivors (18-39 years). Participants (n = 173) completed surveys assessing eating attitudes and behaviors, food security, and demographics. Briefly, 21.5% reported high concern for disordered eating attitudes, and 26.6% had moderate-severe binge eating risk. Both outcomes were significantly associated with weight-related concerns (β = 0.45 and β = 0.46) and socioeconomic advantage (β = 0.31 and β = 0.22). Food insecurity predicted higher binge eating (β = 0.22). Screening, education, and resource provision in survivorship care are needed.

Weight suppression (WS), or the difference between one's highest past and current weights, may help maintain bulimia nervosa (BN) by altering reward response to food cues. This pilot study tested associations among WS, brain reward activation to food cues, and BN behaviours. Twenty women with BN were shown images of milkshake or tasteless control solution, followed by receipt of the corresponding beverage during fMRI. Regressions examined associations between brain activation in a priori regions of interest and WS and BN behaviours (i.e., objective binge-eating episodes, self-induced vomiting episodes, dietary restraint), corrected at k=333, p<0.010. Correlations examined the association between WS and BN behaviours. Upon consumption of milkshake versus control solution, WS positively associated with activation in the left caudate (k=361, p=0.001). WS also positively associated with binge eating (r=0.52, p=0.019), purging (r=0.48, p=0.032), and restraint (r=0.53, p=0.017). No BN behaviours associated with brain activation upon anticipation or consumption of milkshake (all ps>0.010). Given the caudate's role in hedonic eating, the WS-caudate association may help maintain BN behaviours, such as binge eating. Although we failed to find an association between BN behaviours and caudate activation, our sample size was small. Therefore, we encourage replication in larger samples.

To compare preoperative metabolic parameters and body composition in individuals with obesity with and without binge-eating disorder (BED), and to evaluate postoperative short-term weight-loss outcomes in these two groups in the absence of structured preoperative cognitive-behavioral therapy (CBT). This retrospective analysis included 302 participants with obesity from the Western China Bariatric Surgery Cohort. Participants were classified into the BED group and the group without BED based on the Binge Eating Scale (BES) questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria. Basal metabolic parameters were assessed via an InBody 770 body composition analyzer, and rigorous follow-up tracking of postoperative weight variations was performed. A total of 302 individuals with obesity were included, with 151 participants in the BED group and 151 in the group without BED. The proportion of females was significantly higher in the BED group than in the group without BED (p = 0.023). After adjustment for sex, there were no significant between-group differences in preoperative glucose, triglyceride, or total cholesterol levels. Sex hormone levels were comparable between groups in both males and females. Analysis of body composition showed no group differences in overall body weight, BMI, visceral fat area, or basal metabolic rate; however, females with BED exhibited greater leg fat mass (p = 0.037), while a trend toward a larger thigh circumference was observed among males (p = 0.050). In the linear mixed-effects model adjusted for sex and baseline weight, neither the main effect of group nor the group × time interaction was statistically significant, indicating comparable postoperative weight trajectories between the BED and NBED groups from baseline to 2 years after surgery. Individuals with obesity with and without BED showed largely comparable body-composition and metabolic characteristics. Bariatric surgery was associated with similar short-term weight-loss outcomes in individuals with obesity with and without BED, even in the absence of structured preoperative cognitive-behavioral therapy. These findings suggest that bariatric surgery may be an effective short-term weight-loss intervention for individuals with obesity and binge-eating disorder.

This study aimed to develop and test the feasibility and acceptability of a telehealth treatment for adolescent loss-of-control (LOC) eating, including the feasibility of attaining clinically meaningful outcomes. LOC-eating episodes occur when experiencing a sense of LOC while eating a subjectively or objectively large amount of food. Participants were 55 adolescents (aged 12-17) with recurrent LOC-eating episodes and elevated weight (based on age and sex-normed percentiles) who enrolled in a feasibility trial of cognitive behavioral therapy (CBT). Five participants enrolled in the treatment development "open series" and provided feedback. Fifty participants were randomized to the subsequent randomized controlled trial and received either CBT-LOC or nutrition education. Treatment fidelity was checked. CBT-LOC for adolescents with LOC eating demonstrated treatment feasibility and acceptability. Retention (M = 15.3 of 16 sessions), treatment credibility (M = 5.26 of 6), and treatment fidelity (92%-100% of broad topics covered) were high. Treatment satisfaction was higher in CBT-LOC than nutrition education (ps < .001). Time × Intervention effects revealed greater improvements for CBT-LOC than nutrition education for binge eating, LOC eating, secretive eating, and global eating-disorder psychopathology. Weight change was minimal for both interventions. Among adolescents with weekly or greater baseline LOC-eating episodes, overvaluation of weight/shape and depression also improved. Overall, this feasibility randomized controlled trial testing CBT-LOC for adolescents experiencing LOC eating and elevated weight demonstrated feasibility and acceptability. Initial evidence demonstrated that it was feasible to produce clinically significant improvements in LOC-eating episodes, eating behaviors, and eating-disorder psychopathology. Few participants attained decreased weight, which may limit motivation to seek treatment from parents and adolescents. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Glucagon-like peptide1 receptor agonists (GLP1RAs) effectively reduce body weight and improve metabolic outcomes; however, established peptide-based therapies require injections and are complex to manufacture1-3. Small-molecule GLP1RAs promise oral bioavailability and scalable manufacturing, but their selective binding to human versus rodent receptors has limited mechanistic studies4-9. Here we developed humanized GLP1R mouse models to investigate how small-molecule GLP1RAs influence feeding behaviour. We found that these compounds regulate both homeostatic and hedonic feeding through parallel neural circuits. Beyond engaging canonical hypothalamic and hindbrain networks that control metabolic homeostasis, GLP1RAs recruit a discrete population of Glp1r-expressing neurons in the central amygdala, which selectively suppress the consumption of palatable foods by reducing dopamine release in the nucleus accumbens. Stimulating these central amygdalar neurons curtails hedonic feeding, whereas targeted deletion of the receptor in this cell population specifically diminishes the anorectic efficacy of GLP1RAs for reward-driven intake. These findings identify a neural circuit through which small-molecule GLP1RAs modulate reward processing, with implications for the treatment of substance-use disorder and binge eating.

Depressive symptoms during pregnancy and the postpartum period have been extensively studied; however, evidence regarding mental health in the preconception period remains limited. Women preparing for pregnancy undergo physiological changes, lifestyle adjustments, and psychosocial transitions, and emotional vulnerability may be heightened by reproductive stressors, including infertility. Nevertheless, population-based studies examining depressive symptoms and their associated lifestyle and reproductive factors during the preconception period remain scarce. This cross-sectional study included 14,004 women aged 20-45 years who participated in the Seoul Metropolitan Preconception Health Management Program between 2019 and 2021. Depressive symptoms were assessed using the Korean-validated Hospital Anxiety and Depression Scale-Depression subscale (HADS-D), with scores ≥ 11 indicating elevated risk. Sociodemographic, lifestyle, nutritional, menstrual, and reproductive factors were assessed. A multivariable logistic regression model was used to identify factors independently associated with depressive symptoms. Among the participants, 1,102 women (8.5%) exhibited elevated depressive symptoms. In a multivariable logistic regression model, depressive symptoms were independently associated with current smoking, passive smoking exposure, insomnia, binge eating, irregular menstruation, severe dysmenorrhea, infertility history, and previous pregnancy. Insomnia, binge eating, current smoking, and severe dysmenorrhea were each associated with more than twofold higher odds of depressive symptoms. In contrast, regular physical activity showed a clear dose-response association, with increasing physical activity level associated with progressively lower odds of depressive symptoms, whereas greater dysmenorrhea severity was associated with progressively higher proportions screening positive for depressive symptoms. Folic acid supplementation was also independently associated with reduced odds of depressive symptoms. Depressive symptoms were relatively common among women preparing for pregnancy and were closely associated with modifiable lifestyle factors, including smoking, sleep problems, and eating behaviors, as well as reproductive-related factors such as dysmenorrhea and infertility. These findings underscore the need to integrate systematic mental health screening and targeted lifestyle and reproductive health interventions into routine preconception and infertility care to improve women's psychological well-being and support healthier future pregnancies.

Efficacy of Dialectical Behavior Therapy (DBT) and DBT-Informed Interventions for Binge Eating in Adolescents: A Systematic Review

Binge-like eating in early adolescence induces glial changes and dopaminergic dysregulation linked to risk-taking behaviors in rats.