Eating disorders (EDs) have complex presentations with high rates of comorbidities and low recovery rates. Current treatment options often lack sufficiency in improving ED symptoms. Psychedelic-assisted therapies represent a novel treatment approach for the treatment of EDs, with research documenting preliminary positive evidence. However, psychedelics have their own challenges and risks which need to be considered within an ED population to inform study design and future clinical application. The primary aim of this meta-synthesis was to integrate existing qualitative data on the experience of using psychedelics in ED treatment from the perspectives of both individuals with EDs and providers (e.g. clinicians, ceremony leaders), using meta-ethnography to generate new interpretative insights. The methods followed the seven steps of a meta ethnographic approach. An electronic search of three databases (PubMed, Medline, and PsycINFO) was conducted. Papers were included if they were qualitative studies exploring the use of typical or atypical psychedelics, from the perspective of either a provider or individual experiencing an ED. A total of eight studies were included. From the data we identified five meta-themes that together depict how psychedelic experiences may act as catalysts for transformation. Our interpretive narrative posits that core transformative processes (Mind-Body-Spirit, Emotional Processing), unfold within specific contextual conditions (Navigating Challenges and Risks, Enabling Safe and Supportive Experiences), and lead to meaningful outcomes (Therapeutic Improvements). Meta- and sub-themes reflect ED-specific elements, highlighting that psychedelics may improve emotion processing and enhance perception of and connection with the body and the self, which is pertinent to ED recovery. Themes also indicate the increased risk for adverse side effects with low weight and other physical vulnerabilities associated with EDs. The themes and interpretive narratives identified in this meta-synthesis suggest that to achieve therapeutic outcomes, ED-specific contextual conditions are required to facilitate internal processes during psychedelic therapy for EDs. This includes minimising the uncertainty that typifies EDs through exploration of expectations and autonomy in selection of setting elements (e.g. lighting, music, eye-mask) or collaboratively agreeing strategies for if anxiety spikes. Further, facilitators should require dual competency in psychedelic treatment and ED psychopathology and treatment.

ABSTRACT Residential facilities for eating disorders provide recovery-oriented care in less restrictive home-like treatment environments compared to traditional inpatient hospital treatments. These services also frequently integrate staff members with a lived experience of eating disorder recovery—lived experience practitioners—within their treatment frameworks. However, limited research has examined staff experiences of working in these settings. This study explores employee experiences of an Australian residential eating disorder facility using a fixed mixed-methods approach with an independent convergent parallel design. Sixty-five percent of employees consented to participation, with 50% identifying as lived experience practitioners. Findings highlight employees’ strong sense of purpose and critical role as facilitators of recovery. Participant narratives positioned staff as, in the words of one participant, the “heart and soul” of the facility. While experiences were predominantly positive, employees also identified ideological challenges, including navigating tensions between standardised, phase-based treatment protocols, and person-centered, recovery-oriented care (e.g. adapting structured approaches to meet individual patient needs). Given the centrality of the clinician–patient relationship in treatment outcomes and the interconnection between staff wellbeing, patient safety, and care quality, further research is needed to explore how residential organizations can balance structured protocols with individualized care and employee wellbeing to sustain a skilled and resilient workforce.

TikTok-a highly engaging social media platform with a powerful algorithm that displays short videos-has become massively popular in recent years. As research highlights the concerning relationship between image-based content on social media and disordered eating symptoms, TikTok may serve as an optimal platform to understand eating disorders (EDs) and body image-related concerns. We conducted a rapid review of the research on TikTok, EDs, and body image. From an initial pool of 205 articles, 58 met inclusion criteria for the review. Research included content analyses (n = 19), observational studies (n = 23 studies reported in 22 articles), and experimental studies (n = 22 studies reported in 17 articles). The research identified both potentially harmful content and ED recovery content present on TikTok. There are potentially positive effects of body positivity and body neutrality TikTok content on body image and ED risk. The literature mostly includes non-representative samples of young women. It remains unclear what effects identified in research so far are specific to TikTok, versus generalizable to short-form video content. We conclude by discussing TikTok's potential as a platform for disseminating evidence-based ED information and delivering brief interventions, drawing on harm reduction principles to promote TikTok as a space where providers can meet social media users with EDs where they are. Instead of encouraging users to stop their TikTok usage, we suggest that future research explore how TikTok can be leveraged as a tool for ED treatment, a crucial avenue given the limited accessibility of ED treatment.

Within sport environments, athletes are exposed to norms that circulate narrow meanings about the body and food, contributing to the high prevalence of eating disorders (EDs). While social media can support ED recovery, it can also further constrain food- and body-related messages for athletes. The purpose of this study was to examine the role of social media in athletes' ED and recovery experiences. Data were drawn from a broader study on athletes' support networks during ED recovery, where 29 participants (17 athletes, 12 social agents) completed one-on-one semi-structured interviews. For the present study, all discussion of social media was extracted from the interviews and analyzed using reflexive thematic analysis. We identified four themes. The first theme, Positive Aspects of Social Media Undermined by Harmful ED Content, describes how, despite facilitating connection, social media often exacerbates existing food- and body-related pressures for athletes. The second theme, Establishing a New Relationship With Social Media to Protect ED Recovery, showcases how athletes applied social media literacy skills. The third theme, Using Social Media to Challenge ED Stigma and Diet Culture, describes how some athletes initiated conversations about EDs and countered harmful diet culture messages through their platforms. The fourth theme, Online Visibility as a Recovery Stressor, depicts how increasing pressures for athletes to curate a personal brand on social media may reexpose them to ED-related content. Findings highlight the need for athlete-specific social media literacy within ED prevention and treatment programs, and for sport organizations and media platforms to support safer online environments.

As recovery stories about eating disorders proliferate on social media, many individuals with lived experience are emerging as informal health influencers. While these online spaces can offer community and information, they also shape how individuals understand and perform their identities in recovery. This study examines how young women with clinically diagnosed eating disorders, at different stages of recovery, actively and intentionally document and share their recovery journeys on social media, and how they use these platforms not only to seek support, but also to construct, maintain, and sometimes step away from patient influencer identities. We conducted in-depth, semi-structured interviews with 19 women (mean age = 21.47) in the United States who actively documented their eating disorder recovery journeys on platforms like Instagram, TikTok, and YouTube. Using interpretative phenomenological analysis (IPA), we explored how participants made sense of social media's role across different stages of their recovery. Findings reveal a U-shaped pattern of social media engagement. Participants initially used social media in ways that reinforced disordered behaviors, immersing themselves in content that emphasized dieting, body comparison, and perfectionism. During early recovery, many chose to withdraw from these platforms to protect their mental health and reduce triggers. Later, they re-engaged with social media more intentionally, seeking out pro-recovery communities, reliable health information, and opportunities to tell their stories. Through public storytelling, participants reconstructed their identities, found accountability, and connected deeply with peers. However, some eventually distanced themselves from eating disorder-centered content to grow beyond the patient influencer identity, reflecting the fluid, evolving nature of recovery and online self-presentation. By centering the voices of patient influencers, this study highlights how social media functions both as a risk and a resource in eating disorder recovery, simultaneously shaping psychological well-being, social support, and identity work. These insights underscore the need to view patients as active agents navigating digital spaces and call for treatment approaches that address the online environments where recovery, support, and stigma are continually negotiated.

Defining recovery in eating disorders remains a major challenge due to the absence of standardized, empirically validated criteria. Bardone-Cone etal. (2025) address this gap by testing multidimensional, transdiagnostic recovery criteria spanning physical, behavioral, and cognitive domains. This commentary evaluates the suitability of these criteria for anorexia nervosa (AN). Applying a partial version of the proposed criteria to two independent AN datasets, a high-severity inpatient/day-patient sample and an outpatient sample, revealed very low rates of full recovery and marked instability over time. These findings suggest that, when applied to AN, the criteria may be overly restrictive and insufficiently sensitive to clinically meaningful change, defining recovery as rare and fragile. Three key implications emerge: AN recovery definitions should incorporate broader functional outcomes such as social functioning and quality of life; lived experience perspectives are essential for capturing subjective and identity-related aspects of recovery; and recovery should be conceptualized as a nonlinear, evolving process rather than a binary state. Although Bardone-Cone etal.'s work represents an important step toward standardizing recovery definitions, further refinement is needed to ensure that recovery criteria are clinically meaningful and diagnosis-sensitive for AN.

ABSTRACT Eating disorders (EDs) are considered high-risk health conditions, with one of the highest mortality rates of all psychiatric diagnoses. Despite this risk, recovery and prevention of EDs are difficult to achieve and not widely understood. When analyzing the communicative risk factors that contribute to outcomes related to ED symptomology, messages from parents, peers, and media constitute a tripartite model of influence. However, these communication influences are rarely utilized to create materials to assist in ED recovery. The purpose of this study was to better understand the communication challenges that people with EDs experience and recommend opportunities to develop evidence-based communication interventions. A dataset of 794 posts from five Subreddits related to EDs was scraped to analyze communication challenges. The results illustrate the complex relationship between the ED experience and communication and provide insights into topics of importance to be included in patient education resources.

ABSTRACT Yoga is commonly used as an adjunct to psychological therapy to support ED recovery as it can improve body responsiveness and awareness, interoception, and embodiment, mindfulness, self-compassion, self-efficacy, body satisfaction, body appreciation and body image. Research suggests that using yoga as an adjunct intervention may augment and reinforce psychology therapy, enhancing recovery outcomes. This research aimed to describe and appraise a systematic, sequential approach to integrating scientific evidence, expert knowledge and experience, and community engagement in co-designing and developing a therapeutic yoga group intervention for young people engaged in ED treatment. A four-phase approach to developing this intervention included planning, conducting, evaluating, and reporting phases. This paper reports on the development of the initial YEDRi prototype and co-design workshop conducted with carers (n = 3), consumers (n = 3) and clinicians (n = 3) to test and iterate the intervention. The resulting program is an 8-week therapeutic group yoga program for ED recovery where consumers and their carers attend together. This is the first study to systematically engage consumers and carers with a lived experience of EDs in a co-design process to develop a therapeutic yoga program for ED recovery.

Eating disorders are complex conditions, with aetiological factors and impacts across multiple domains. Religion and spirituality are areas of individual diversity that may represent a source of strength or struggle for those experiencing mental illness. However, there is limited and mixed evidence regarding the influence of religion and spirituality in eating disorders, and this is not well integrated within healthcare. To explore the interplay between Christian religion and spirituality and eating disorder development, experience and recovery, from the perspectives of Australians and New Zealanders with lived experience. Qualitative methodology using reflexive thematic analysis and selected grounded theory techniques. Data is based on semi-structured interviews with 23 participants who had a Christian background and self-identified as having partially or fully recovered from an eating disorder. Trustworthiness was supported by investigator reflexivity and triangulation. Analysis highlighted an overarching experience of eating disorders and Christian spirituality as two non-linear, interwoven journeys. Three themes and seven subthemes elucidated this dynamic. Themes included (1) "Not enough"-A sense of not being "good enough" and/or "safe enough" in an eating disorder could be exacerbated or alleviated by Christian religion and spirituality; (2) "Wrestling"-Eating disorders often triggered religious and spiritual, which could change spiritual trajectories; and (3) "Help to heal"-Some participants found comfort, hope, and a foundation for eating disorder recovery in their Christian religion and spirituality, often experienced as embracing God's grace (that is, God's unmerited love and favour). This study highlights previously under-recognised religious and spiritual influences upon protective and predisposing factors for eating disorders, including perfectionism, attachment and identity formation. Results could inform more personalised approaches to caring for Christians experiencing eating disorders. Findings also suggest a need for similar research with other religious and spiritual traditions.

Nature-based interventions (NBIs) present a promising but underexplored approach in recreational therapy for improving the quality of life in individuals with eating disorders (EDs). Due to limited research, this scoping review focuses on strategies and techniques for implementing NBIs, including wilderness therapy, horticultural therapy, forest bathing, and adventure therapy. Based on theoretical frameworks such as the Biophilia Hypothesis, Attention Restoration Theory, and Stress Reduction Theory, this review suggests ways nature-based experiences may promote emotional regulation, mindfulness, self-efficacy, and social well-being. However, several practical and individual challenges must be addressed, including limited access to natural spaces, financial and logistical constraints, psychological resistance, and the need for culturally sensitive approaches. Additionally, the lack of standardized evaluation methods makes it difficult to measure the effectiveness of NBIs in ED recovery. Given these challenges, this paper offers recommendations for recreational therapists to adapt and integrate NBIs into treatment, emphasizing creative solutions and individualized approaches. By exploring the possibilities of NBI with people who have EDs, this paper contributes to the growing conversation on using nature-based strategies to enhance therapeutic outcomes.

Transgender and gender-diverse (trans) people report disordered eating behaviors at disproportionately high rates compared to their cisgender peers. Although disordered eating can drastically reduce quality of life and lead to early mortality, trans-affirming primary care providers are not typically taught to identify disordered eating behaviors or provide support for eating disorder recovery. A scarcity of trans-competent eating disorder treatment for trans people combined with a lack of training and capacity in trans-affirming primary care leads to substantial barriers to accessing care for disordered eating. Engaging a structural competency approach, we employ two theoretical case vignettes to integrate insights from our clinical experience with existing research and practice. We use these cases to illustrate the application of our recommendations for prevention and early detection of disordered eating in trans-affirming primary care settings, offer suggestions for future research, and explain policy-level implications.

Eating disorder recovery can be complex, with high relapse rates despite various therapeutic approaches. Recent research suggests body compassion may play a protective role in recovery, but studies remain limited. This study aims to explore adults' experiences of body compassion in their eating disorder recovery journey. Ten adults aged between 19 and 49, self-identified as recovered or 'in recovery' from anorexia nervosa, bulimia nervosa, and/or binge eating disorder, and who had received therapeutic support, participated in online semi-structured interviews. Following ethical approval, data were analysed using Reflexive Thematic Analysis (RTA). Participants described body compassion's development as a dynamic process captured through five interrelated themes: Foundation, Confusion, Growth, Reconnection, and Resistance. Foundation highlights body compassion's central role in sustaining recovery. Confusion reflects its initially elusive nature. Growth covers factors and practices supporting its development. Reconnection describes a new relationship with the body through caring actions. Resistance represents a shift toward challenging internalized ideals and societal pressures. These themes inform a tentative model outlining body compassion's role and progression in recovery. This research frames body compassion as a dynamic, reparative force supporting a more holistic, inclusive, and compassionate approach to eating disorder recovery. These findings highlight the need for person-centred treatment models viewing the body as a site of healing, not just symptom management. Clinicians should integrate clear definitions and targeted body compassion practices while addressing broader sociocultural influences, including social media.

ABSTRACT Research into the factors that drive the development, maintenance, and recovery from eating disorders (EDs) has established that social processes play an integral part in helping or hindering one’s recovery from an ED. In a world where social processes have increasingly moved online, this research aimed to better understand themes within ED recovery content on TikTok. A thematic analysis of n = 312 of the most popular TikTok videos about ED recovery was conducted using a snowball sampling method to find common hashtags related to ED recovery and a codebook to compile deductive and inductive codes. Content related to suicide/self-harm or pro-anorexia beliefs was uncommon across the videos, but four themes were generated from the inductive thematic analysis: recovery milestones, the social nature of ED recovery, bodies as evidence of recovery, and the all-powerful ED. The findings from this research contribute to understandings about the shifting online landscape for ED recovery, where platforms like TikTok are increasingly becoming a source of support and community. The findings of this research will assist individuals in ED recovery and those supporting them when deciding whether engaging with recovery content on TikTok is right for their recovery journey.

An exploration of the role of spiritual distress in eating disorder recovery.

Treatment engagement and importance to change remain significant challenges that impact treatment delivery in people with eating disorders. Feelings of shame, stigma, ambivalence and lack of motivation are prominent barriers affecting their engagement with treatment. There is recent evidence that using online recovery communities is beneficial in reaching individuals who do not have access to traditional services. The present study has been designed to investigate the perceived significance and level of confidence regarding change exhibited by users of a recovery Instagram community who suffer from an eating disorder. A mixed methods study surveyed 205 women (mean age = 23.14 years) from an Instragram recovery community. Thematic qualitative analysis was used to evaluate themes reported in response to open-ended questions about participants’ meaning and confidence to change. Participants reported higher scores for importance to change than for ability to change. Seven themes were interpreted from the qualitative data (i.e. Emotional Needs, Management illness factors, External Motivation, Negative Sel-beliefs, Internal and External Resources, and Characteristics of eating disorders). The results of this study highlight that although participants report the importance of change, there are some concerns about their ability to change, related to their negative self-beliefs and ambivalence about change. The findings also suggest that Instragram recovery communities are promising platforms for improving help-seeking among users with eating disorders.

Patients with eating disorders (EDs) often exhibit associated dissociative symptomatology, which could hinder ED treatment and recovery. Similarly, dissociation also appears to be linked to other risk behaviours, such as self-harm and suicide attempts that are commonly present in these patients. This study seeks to investigate the presence of dissociative features in ED and its relationship with the different phenotypical characteristics of these disorders. A systematic review of scientific literature concerning the association of dissociative features and ED was performed. From an initial sample of 651 studies reviewed, 32 articles were included in the analysis after applying the inclusion and exclusion criteria. The review analysis indicates that dissociation is more prevalent in ED patients than in healthy subjects. In addition, ED patients with purgative symptoms exhibit greater dissociation than purely restrictive patients. Finally, three psychological phenotypes were identified in association with dissociative symptoms: emotional-unstable, impulsive-aggressive and cognitive-identity. Results confirm that dissociative symptoms are prevalent in ED, particularly among patients with a purging-impulsive-unstable profile and those with identity-related difficulties.

A standardized definition of recovery would advance treatment outcome research. This study examined combinations of different physical, behavioral, and cognitive recovery criteria to identify the operationalization of eating disorder (ED) recovery with the most empirical support based on concurrent and predictive validity. Participants included 223 females with a history of an ED and 105 age-matched female controls who completed questionnaires, interviews, and weight/height measurements at baseline and ~1-year follow-up. To examine different comprehensive operationalizations of recovery, we considered two approaches to assessing each of the following domains of recovery: physical (BMI ≥ 18.5 kg/m2; BMI ≥ 19 kg/m2), behavioral (no binge eating, purging, or fasting in the past 3 months; none of these ED behaviors in the past 6 months), and cognitive (all four EDE-Q subscale scores within 1 SD of age- and gender-matched norms; Global EDE-Q scores within 1 SD of norms). Allowing for all possible combinations across these domains yielded eight operationalizations of comprehensive ED recovery to test. Results showed that operationalizations were more similar than different, with high rates of stability in recovery (77%-86%) and low relapse rates (7%-15%) over time. Based on the holistic consideration of the patterns of findings, we propose using BMI ≥ 18.5 or 19 kg/m2 (physical recovery), no binge eating, purging, or fasting over the past 3 months (behavioral recovery), and all four EDE-Q subscale scores within 1 SD of age- and gender-matched norms (cognitive recovery) as a standardized operationalization of recovery for research purposes.

Eating disorder (ED) recovery narratives provide valuable insights into the recovery process. While existing research identifies key turning points in ED recovery, most studies focus on majority populations, neglecting the experiences of minoritised individuals. This study aimed to explore the turning points in ED recovery among diverse individuals and examine the role of symbolic objects in understanding recovery processes. English-speaking adults with lived experiences of ED who identify as part of underserved groups were recruited for an adapted photovoice study involving individual interviews (n = 11) and two subsequent focus group discussions (n = 4 per group). Participants shared objects symbolising their recovery journeys. Using reflexive thematic analysis, we generated three themes: (1) Up, Down, and Around: Recovery was described as non-linear, with positive and negative turning points; (2) Growing awareness and readiness of recovery; and (3) From feeling disconnected to belonging. The findings show that recovery was often non-linear for these individuals, with social belonging and identity integration being crucial. The study also illuminates how everyday objects can be used as a research method to encapsulate turning points in recovery by representing progress and offering motivation. The findings are also consistent with minority stress theory which shows how one's mental health intersects with social stressors and marginalisation.

Eating disorders have high relapse and mortality rates, complex treatment needs, and disproportionately affect women. A common characteristic of women with eating disorders is a lack of embodiment and disconnection from the body. Increasing positive embodiment may be a means to help support recovery. This study qualitatively examined the impact of time spent in nature as a potential mechanism for increasing positive embodiment during eating recovery among six women in Canada and the USA using semi-structured interviews and reflexive thematic analysis. Participants shared that spending time in nature helped them appreciate and care for their bodies and slow their eating disorder voice, providing a foundation on which to build and maintain recovery from their eating disorder. Participants also described how being in nature helped them feel connected, leading to feeling a sense of belonging and a part of something bigger than themselves. The findings from this pilot study warrant further investigation, and may have implications for eating disorder treatment for women, as spending time in nature during eating disorder recovery may help counterbalance societal pressures on women and support recovery maintenance.

In this essay we apply the neurodiversity paradigm to the topic of eating disorders. We begin by defining several important concepts, and then we build toward our main argument: because of our anti-fat culture, traits associated with eating disorder recovery, such as unrestricted eating and fat acceptance, are often more pathologized than traits associated with eating disorders; in particular, restrictive eating and anti-fat biases are normalized and even valorized in our society. We argue that eating disorder recovery can therefore be conceptualized as “neurodivergence,” given that unrestricted eating and fat acceptance are pathologized and deemed “abnormal” in our culture. Neurodivergence refers to thoughts, feelings, and behaviors that diverge from what society deems “normal” and are pathologized, and we assert that recovery paradoxically meets this definition. Finally, we end with ideas for mad/neurodiversity-affirming and fat-affirming eating disorder care. Rather than conventional models that aim to restore "normality" and "functioning," we explore a treatment paradigm that celebrates divergence from all oppressive social norms, that creates opportunities for cross-movement solidarity and positive neurodivergent and fat identity, and which supports people on a path of personal and collective healing and liberation from oppression.