Eating Disorders Research Articles

The prevalence of disordered eating habits in female collegiate athletes.

The prevalence of disordered eating habits in college-aged females is at an all-time high. This population is more likely to experience issues with body image and poor eating behaviors due to the pressure of being a collegiate athlete. The objective of this qualitative study aimed to determine the prevalence of disordered eating habits in female collegiate athletes and determine if playing a sport puts them at risk of harmful behaviors. An anonymous survey was sent out to participants of various sports, asking them to answer a 10-question survey about eating habits and compensatory behaviors such as excessive exercise and caloric restriction. Results indicated that 75% of those surveyed said playing a collegiate sport negatively impacts their relationship with food, and 71% said playing a sport negatively impacts their body image. While some female athletes do not meet the clinical diagnostic criteria for an eating disorder, a large portion still displays disordered eating behaviors, which can be detrimental to their overall well-being. It is essential for the safety of these athletes that staff members, health professionals, and the athletes themselves are aware of these circumstances and can prevent them from progressing into fully diagnosed eating disorders.

The Relationships Between Body-Related Emotion Intolerance and Restrictive Eating as a Function of Multidimensional Perfectionism.

Emotion intolerance and perfectionism are two maintaining mechanisms to eating disorder symptomology. However, it is unclear how these mechanisms relate to one another. This study explored whether perfectionism is a vulnerability factor for facets of restrictive eating in the context of body-related emotions. Female undergraduate students (N = 148) completed questionnaires assessing baseline levels of self-critical perfectionism and personal standards perfectionism. Participants then engaged in an ecological momentary assessment protocol where body-related emotion intolerance and restrictive eating facets (cognitive restraint and behavioral restriction) were assessed over 10 consecutive days. Multilevel modeling and simple slopes analysis were used to explore these moderated relationships. Within-person (Level 1 body-related emotion intolerance) and between-person (Level 2 perfectionism dimensions) relationships were examined. Based on the analyses, both self-critical and personal standards perfectionism dimensions interacted with body-related emotion intolerance to predict increases in restrictive eating facets. These findings indicate that personal standards perfectionism, though conceptualized as the less maladaptive dimension of perfectionism, should not be ignored when conceptualizing and intervening with restrictive eating. Recommendations are provided on how to refine treatment targets to be more attuned with situations that elicit body-related emotion intolerance.

Assessment of diabetes-specific eating disorder risk in adult patients with diabetes

PurposeAdults with type 1 diabetes (T1D) are reported to be at higher risk for clinical eating disorders (ED) and other disordered eating behaviors (DEB) than their peers without diabetes. On the other hand, there is insufficient data on DEB in adults with type 2 diabetes (T2D). Our study aimed to investigate the prevalence of DEB in patients with T1D and T2D on intensive insulin therapy followed in our outpatient clinic.MethodsDiabetes Eating Problem Survey-Revised (DEPS-R), electronically delivered to the patients with T1D and T2D who were on an intensive insulin regimen followed up in the diabetes outpatient clinic in our center for the evaluation of DEB. A total of 120 participants, 80 patients with T1D and 40 patients with T2D, were included in the study. DEB was defined as a DEPS-R score ≥ 20 according to the answers given to the questionnaire.ResultsRisk of DEB was observed in 35% of all individuals with diabetes and was higher in T2D (55% (n = 22)) than in T1D (25% (n = 20)) (p < 0.001). In patients with T1D, BMI was similar between the risk and normal groups in terms of DEB (p = 0.15), whereas in patients with T2D, BMI was significantly higher in the risk group in terms of DEB compared to the non-risk group (p < 0.001). There was a positive correlation between the risk of DEB and HbA1c and a negative correlation with the duration of diabetes in the T1D group (p < 0.05). Weight loss was an important goal for more than 50% of individuals with diabetes in both groups, more than 60% said they skipped a main meal or snack. 13.8% of those with T1D and 27.5% of those with T2D preferred being thin to having their diabetes better controlled.ConclusionIn our study, 35% of patients with diabetes were found to have a risk of DEB, with the risk being higher in the T2D group. Our results emphasize the importance of increasing awareness among physicians and patients about DEB, which is prevalent among patients with diabetes. Early detection of individuals at risk for DEB should be considered a crucial aspect of treatment.

Dopamine Drives Feedforward Inhibition to Orexin Feeding System, Mediating Weight Loss Induced by Morphine Addiction.

Feeding behavior changes induced by opioid addiction significantly contribute to the worsening opioid crisis. Activation of the reward system has shown to provoke binge eating disorder in individuals with opioid use disorder, whereas prolonged opioid exposure leads to weight loss. Understanding the mechanisms underlying these phenomena is essential for addressing this pressing societal issue. This study demonstrates that weight loss resulting from feeding behavior changes during morphine addiction requires the activation of the ventral tegmental area dopamine (DA) system, which suppresses the orexin feeding center. Specifically, DA exerts an inhibitory effect on orexin neurons in the lateral hypothalamus area (LHA) through a feedforward inhibition mediated by GABA neurons in the LHA, involving D1 receptors (D1R) and T-type Ca2+ channels. Moreover, the morphine addiction-induced reduction in body weight and food intake can be reversed by the D1R antagonist SCH23390 and chemogenetic silencing of GABA neurons in the LHA. These findings delineate a neuromodulatory mechanism underlying morphine addiction-associated feeding behavior changes and weight loss.

Changes in Circadian Rhythm in Chronically-Starved Mice Are Associated With Glial Cell Density Reduction in the Suprachiasmatic Nucleus.

Anorexia nervosa (AN) is an eating disorder characterized by severe weight loss and associated with hyperactivity and circadian rhythm disruption. However, the cellular basis of circadian rhythm disruption is poorly understood. Glial cells in the suprachiasmatic nucleus (SCN), the principal circadian pacemaker, are involved in regulating circadian rhythms. We hypothesize that the circadian rhythm disruption in AN patients is associated with glial cell changes in the SCN. In the starvation-induced hyperactivity mouse model, mice had free access to a running wheel and received a restricted amount of food once a day, until a 25% body weight loss was reached and maintained their weight loss for two weeks. This was followed by a refeeding phase. Different daily periods of running wheel activity were defined, such as food anticipatory activity up to 4 h before feeding. Circadian rhythmicity was analyzed using the cosinor method. Gene expression was evaluated using real-time polymerase chain reaction. Immunohistochemistry was used to quantify astrocytes, microglia, and oligodendrocytes. Starvation induced changes in circadian rhythm, as indicated by changes in cosinor-based characteristics. Refeeding reversed these effects. Additionally, there was an increase in cryptochrome circadian regulator 1 expression and a decrease in the density of astrocytes and oligodendrocytes in the SCN after chronic starvation. Starvation-induced alterations in circadian rhythms are associated with molecular, and cellular changes in the hypothalamus. Reduced astrocytes and oligodendrocytes in the SCN in a mouse model of AN suggest that glial pathophysiology may play a role in circadian rhythm disruption.

‘Captivating voices’: evaluation of a patient-centred animated video on excessive physical exercise and eating disorders

This project aimed to evaluate the acceptance of a short, animated video addressing excessive exercise within the context of eating disorder (ED) behaviours among diverse target groups, assess its impact...

Clinicians' Experiences of Eating Disorder Focused Family Therapy With Autistic Young People.

Eating disorder focused family therapy (FT-ED) is the leading outpatient intervention for adolescents with Anorexia Nervosa. Autistic people report poorer eating disorder treatment experiences and may be at increased risk of inpatient admissions. There is a need to consider adaptions to eating disorder treatment for this population. The aim of this study is to explore the experiences of clinicians in the delivery of FT-ED for Autistic young people with Anorexia Nervosa and any adaptations currently being implemented. FT-ED trained clinicians who had experience of delivering this modality with young Autistic people and their families, were invited to take part in interviews. Transcripts were analysed using Reflexive Thematic Analysis. Eleven clinicians completed interviews and analysis generated four themes and eight subthemes: (1) Systemic context, (2) Raising potential autism, (3) Autism eating disorders crossover, (4) Manual versus adaptations. This paper is the first exploration of clinician's experience delivering FT-ED to Autistic young people and their families and highlighted unique considerations with this population. It is an initial step to consider adaptations to the FT-ED model, with the aim of making eating disorder treatments more effective, accessible and acceptable for Autistic young people and their families.

Clinical Experiences Using Family Based Treatment forEating Disorders.

Despite the availability of several evidence-based treatments for eating disorders (EDs), including Family-Based Treatment (FBT), therapist drift from evidence-based treatments in real-life clinical settings is common. This study explores clinicians' use of FBT techniques and identifies clinician-reported barriers to their use in real-world settings. Clinicians (N = 54) who self-identified as using FBT for EDs were recruited through social media, professional listservs, and mental health provider databases. Participants completed an online survey comprised of questions developed alongside ED researchers (n = 5). Questions included quantitative self-rating of frequency of FBT technique use and usefulness, limitations of the treatment, and barriers to effective implementation of FBT. Descriptive statistics indicated frequent use of most FBT techniques (i.e., Ms > 75 on scales ranging from 0 [never use] to 100 [always use]). On a scale from 0 (not at all a barrier) to 100 (a major barrier), ratings of FBT barriers ranged from 25.07 (i.e., caregiver motivation decreases when learning reasons for ED) to 80.70 (i.e., low time resources). Regarding limitations of FBT, between 37% and 42.6% of participants indicated challenges in establishing an alliance with youth and validating their experiences as barriers to treatment success. Overall, clinicians reported frequent use of FBT techniques. Barriers that received higher mean ratings included items related to emotional processes experienced by caregivers, caregiver/patient beliefs related to weight stigma/diet culture, resource and time-related constraints, and challenges with caregiver buy-in/beliefs about treatment. Future research should explore ways to adapt FBT to address these barriers within naturalistic settings.

Latent Trajectories of Change in Dietary Restriction During Treatment in Avoidant/Restrictive Food Intake Disorder and Anorexia Nervosa.

Outcomes for low-weight restrictive eating disorders, including anorexia nervosa, restricting type (AN-R) and avoidant/restrictive food intake disorder (ARFID), are sub-optimal. Reducing dietary restriction is a key treatment target. Understanding heterogeneity in patterns of change in dietary restriction may aid in improving outcomes. We examined latent trajectories of change in dietary restriction during treatment and follow-up in AN-R and ARFID. Adolescents and adults with R-EDs (N = 276, 18% ARFID, 90% female, Mage = 18) receiving intensive ED treatment completed assessments at five timepoints. Latent growth mixture modeling examined trajectories of change in dietary restriction, measured using the Eating Pathology Symptoms Inventory Restricting subscale. Classes were compared on clinical features at admission to determine characteristics prospectively associated with trajectory. A 3-class solution emerged: Class 1 comprising individuals with "good response" (n = 138; 33% of those with ARFID in the sample); Class 2 with "good response, rebounding" (n = 81; 41% of ARFID); and Class 3 with "gradual response, low symptoms" (n = 57; 26% of ARFID). Class 3 had lower anxiety and R-ED symptoms than Classes 1 and 2. Class 2 presented with older age than Class 1. No ARFID-specific classes emerged, underscoring similarities in response to intensive treatment between AN-R and ARFID.

Examining eating pathology and psychosocial functioning across subjective eating disorder recovery stages in sexual and gender minority individuals

ABSTRACT Subjective eating disorder (ED) recovery has important clinical relevance. However, studies have focused on the perspectives of cisgender heterosexual individuals, which is notable given that sexual and gender minority (SGM) people often describe feelings misrepresented by prevailing ED conceptualizations. We examined eating pathology and psychosocial functioning across subjective recovery stages in SGM individuals (N = 196). Analyses of variance tested differences between active ED (n = 106, 54.1%), partial recovery (n = 82, 41.8%), and full recovery (n = 8, 4.1%) groups. Groups differed in body dissatisfaction, binge eating, restricting, clinical impairment, autonomy, environmental mastery, and self-acceptance. Most differences were observed between the full recovery and active ED groups and the full recovery and partial recovery groups, such that subjectively higher levels of ED recovery were generally associated with lower transdiagnostic ED symptoms and better psychosocial functioning. Clinical profiles appear similar between SGM and cisgender heterosexual individuals across subjective ED recovery stages.

The Treatment Experiences of Vegetarians and Vegans with an Eating Disorder: A Qualitative Study.

Vegetarianism and veganism have long been tied to disordered eating and are frequently considered to be methods of limiting available food choices. Health professionals specializing in eating disorder treatment may modify their treatment practices to support their vegetarian or vegan clients. However, there are no formally recognized clinical guidelines for the treatment of eating disorders in these groups. Moreover, no studies have yet explored the experiences of seeking and receiving eating disorder treatment while adhering to vegetarianism or veganism, which are needed to inform the development of guidelines. The present study aims to explore the lived experiences of vegetarians and vegans on eating disorder treatment through semi-structured interviews and reflexive thematic analysis. Seventeen participants (aged 19-48, 76% female, 41% vegan) with a history of receiving eating disorder treatment were recruited. We identified five themes that participants described as important experiences for the treatment of their eating disorder when sought as a vegetarian or vegan: (1) Health professional perspectives, (2) The interaction of dietary status with treatment quality, (3) The give and take of treatment, (4) Lack of flexibility in treatment services, and (5) Current treatment approaches not well equipped to support dietary variations. This paper identifies the complex relationship between eating disorders, veganism, and vegetarianism and the perceptions of treatment from the perspectives of those who have received treatment. Our findings suggest that acknowledgement and the flexibility to work with an individual's vegan and vegetarian values within treatment may contribute to enhanced outcomes and treatment experiences. Limitations include potential participation and response biases and a predominantly female-identifying sample. This study will contribute to the development of clinical guidelines when working with vegan and vegetarian clients.

Unattractive, corrupted, and culpable feared self-themes: Expanding our understanding of self-concept in relation to eating pathology

ABSTRACT There is growing support for fear of self as a transdiagnostic construct implicated in obsessive-compulsive disorder (OCD) and eating disorders. However, few studies have examined how perceived proximity to a feared self may be associated with the relationship between fear of self and eating pathology. A community sample of women (N = 290) completed an online questionnaire battery. Eating pathology was positively associated with the feared unattractive self and, to a lesser extent, with feared corrupted and culpable selves, suggesting the relevance of a range of feared selves in eating pathology. There was a significant interaction between fear of the unattractive self and perceived proximity to this feared self (operationalized as “feeling fat”) in relation to eating pathology.

The risk of believing that emotions are bad and uncontrollable: association with orthorexia nervosa

PurposeThis study aimed to explore emotional functioning in individuals with varying levels of orthorexia nervosa (ON) symptoms. Given the established links between emotion dysregulation and other eating disorders (EDs), and the conceptualization of ON within the ED spectrum, this research sought to examine the relationships between ON symptomatology and emotion regulation strategies, alexithymia, and beliefs about emotions.MethodsA large sample (N = 562) completed self-report measures with high psychometric properties, assessing ON traits (E-DOS), emotion regulation strategies (DERS-SF and ERQ), alexithymia (TAS-20), and beliefs about emotions (ERQ). The study used well-validated measures to address limitations of previous research.ResultsIndividuals with high ON traits demonstrated difficulties in most aspects of emotional functioning compared to those with low ON traits. Suppression, but not reappraisal, partially mediated the relationship between beliefs about emotions and ON symptoms. Believing emotions are bad or useless, difficulty controlling impulses, and relying on suppression to regulate emotions were most strongly associated with ON symptoms.ConclusionThis study provides evidence that emotion dysregulation plays an important role in ON symptomatology. The findings suggest that when emotions feel unhelpful or uncontrollable, and maladaptive strategies like suppression are employed, individuals may seek perceived control through pathologically 'healthy' eating. There is currently no diagnosis criteria for ON, and consequently no clear treatment pathway. Our research suggests that specific aspects of emotional functioning such as beliefs about the usefulness of emotions or difficulties with feeling out of control when upset may be a useful treatment target to help individuals with ON develop healthier coping mechanisms and reduce reliance on rigid dietary rules as a means of emotional regulation.Level of evidence.Level III: Evidence obtained from well-designed cohort or case–control analytic studies.

Role of neuropeptide Y in development of valproate-induced eating behaviour disorder

Background. Eating behaviour disorder (EBD) induced by valproic acid (VPA) is one of the components of the pathogenesis of a serious complication of therapy with VPA and its salts such as VPA-induced metabolic syndrome (MetS). About 20% of patients receiving VPA have weight gain, which is also a consequence of altered eating behaviour in such patients. Substances such as neuropeptide Y (NPY), leptin, orexin and ghrelin are involved in the regulation of eating behaviour. NPY has received special attention in recent years because it is one of the most potent brain orexigenic peptides and its expression level directly affects the quantity and quality of food intake. NPY overexpression is associated with EBD, food preferences, obesity, and MetS.Objective: to review preclinical and clinical studies of NPY role as a potential sensitive and specific serum biomarker of VPA-EBD, secondary weight gain and VPA-MetS development in children and adults with epilepsy.Material and methods. We analyzed Russian and foreign publications submitted to eLibrary, PubMed/MEDLINE, Scopus, and Google Scholar databases between 2014 and 2024. The full-text articles in Russian and English (original studies, systematic reviews, meta-analyses, Cochrane reviews, and clinical cases) were analyzed. After the selection procedure, 53 out of 1105 publications retrieved by query keywords were included in the analysis.Results. VPA-EDB refers to multifactorial diseases, requiring to take into account the additive contribution of external (food education, eating habits of the patient and family members) and internal (key hormones and neuropeptides regulating appetite and food preferences, the dose and duration of VPA intake, the metabolic rate of VPA) factors while assessing a risk of its development. NPY-associated VPA-EDB affects dietary preferences in favor of high-calorie food and beverages, increases the frequency of meals, the risks of insulin resistance, hyperglycemia as one of the major domains in MetS pathogenesis.Conclusion. VPA-EBD requires timely diagnosis, as it can cause VPA-MetS. NPY is an important biomarker of VPA-EBD, because recent studies have convincingly demonstrated that this neuropeptide is involved in the regulation of eating behavior in patients with epilepsy.

Experiences of eating disorder services for people caring for a loved one with an eating disorder in the UK: national survey.

Research suggests that those caring for a loved one with an eating disorder in the UK report unmet needs and highlight areas for improvement. More research is needed to understand these experiences on a wider, national scale. To disseminate a national survey for adults who had experience caring for a loved one with an eating disorder in the UK, informed by the findings of a smaller scale, qualitative study with parents, siblings and partners in the UK. A cross-sectional web-based survey was disseminated to adults who had experience caring for a loved one with an eating disorder in the UK. A total of 360 participants completed the survey. Participants described experiences of care received in both children and young people's, and adult services. Those receiving care from children and young people's services generally reported more timely care, greater involvement in care and more confidence managing their loved one's symptoms post-discharge. In both settings, participants identified a number of areas for improvement, including more timely access to care, improved transition processes and discharge planning, and increased involvement in their loved one's care. This survey captures the experiences of individuals caring for a loved one with an eating disorder in the UK. There are identified discrepancies between experiences of care in children and young people services compared with adult services. Clinical implications and recommendations for improvement are discussed, including improved transition and discharge processes, increased involvement of and/or support for carers themselves, and more timely access to support services for the unwell individual.

Descriptives and genetic correlates of eating disorder diagnostic transitions and presumed remission in the Danish registry.

Eating disorders (EDs) are serious psychiatric disorders with an estimated 3.3 million healthy life-years lost worldwide yearly. Understanding the course of illness, diagnostic transitions and remission, and their associated genetic correlates could inform both ED etiology and treatment. The authors investigated occurrences of ED transitions and presumed remission and their genetic correlates as captured by polygenic scores (PGSs) in a large Danish register-based cohort. The sample was compromised of 10,565 individuals with a diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS) with at least two registered hospital contacts between 1995 and 2018. Based on medical records, occurrence of diagnostic transitions and periods of presumed remission were identified. Associations between 422 PGS and diagnostic transitions and presumed remission were evaluated using Cox proportional hazard models. A minority of ED cases (14.1%-23.1%) experienced a diagnostic transition. Presumed remission ranged between 86.9%-89.8%. Higher (one SD increase) PGS for major depressive disorder and multisite chronic pain were positively associated with transitioning from AN to either BN or EDNOS. Higher PGS on a measure of body fat percentage and financial difficulties were positively associated with presumed remission from AN. Higher PGS for mood swings was positively associated with presumed remission from EDNOS whereas higher PGS for health rating showed the opposite. The authors found that most ED patients did not experience diagnostic transitions but were more likely to experience a period of presumed remission. Both diagnostic transitions and presumed remission have significant polygenic component.

The Role of Body Image Perception on a Continuum from Dysfunctional to Healthy Eating Attitudes and Behaviors Among People Seeking Treatment.

Background: Body image disturbance has been associated with various health conditions and has the potential to trigger the development of unhealthy behaviors, including dysfunctional attitudes and eating behaviors, which may evolve into eating disorders. This study explores the relationship between body image variables-such as global self-worth, physical self-worth, and physical attractiveness-and the continuum of eating attitudes and behaviors. Methods: A canonical correlation analysis was performed to assess the multivariate relationship between attitudinal and perceptual variables and the continuum of eating behaviors, with a total of 113 cases analyzed. Results: The findings indicate that intuitive eating and a positive body image (including global self-worth and physical attractiveness) are most strongly associated with the functional end of the continuum, while disordered eating behaviors and body dissatisfaction are linked to the dysfunctional end. Conclusions: These results suggest that interventions targeting the emotional and attitudinal dimensions of body dissatisfaction, whether delivered in vivo or via virtual reality (e.g., weight exposure), may facilitate a shift toward healthier, more functional eating behaviors along the continuum.

Early menarche is associated with disordered eating-results from a National Youth Survey.

Disordered eating (DE) is highly prevalent among adolescents, though its definition varies. The association between DE and early pubertal maturation (EPM) remains underexplored in Israel, and has not been sufficiently examined using the widely-used SCOFF questionnaire. This study examines these associations in adolescents. Participants (n = 2415 girls, 2095 boys; ages 12-18 years) in a nationally-representative, cross-sectional Youth Health and Nutrition Survey (2015-2016) completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. EPM was determined by menarcheal age <11.5 years in girls, and facial hair appearance <12.5 years in boys. Respondents affirming ≥2 SCOFF items were classified as DE cases. Multivariable logistic regression analyses examined the associations between EPM and DE. Among the participants, 12.7% of the girls and 20.4% of the boys met EPM criteria; 55.5% and 33.7%, respectively, were categorized as having DE. Following adjustment for age, socioeconomic status, ethnic background, and weight status, EPM was significantly associated with DE in girls (OR 1.47, 95%CI: 1.12-1.93) and with 3/5 SCOFF items. No such association was found in boys (OR 1.00, 95%CI: 0.77-1.28). EPM in girls was associated with DE. Identifying high risk groups for DE in adolescents is crucial for early intervention and prevention. This study included a large, nationally representative sample of Israeli adolescents and utilized the SCOFF questionnaire, a widely used screening measure for disordered eating (DE). Following comprehensive analyses, a significant association between early pubertal maturation (EPM), defined as early menarche, and DE was documented in Israeli adolescent girls. Identifying girls with EPM and screening for disordered eating will allow for early interventions, potentially improving physical and mental health, and preventing progression to eating disorders.

Elevating the Discourse on the Comorbidity and Treatment of Eating Disorders and Autism Spectrum Disorder: Commentary on Inal-Kaleli etal. and Nimbley etal.

Two recent review papers published in the International Journal of Eating Disorders have considerably elevated the rigor of scholarship on the comorbidity between autism spectrum disorder (ASD) and eating disorders. One paper reported that more than one-quarter of individuals with acute anorexia nervosa also have ASD, and that autistic traits are positively correlated with eating disorder psychopathology. The other paper reported that, compared to individuals with low autistic traits, those with high autistic traits report poorer experiences of eating disorder treatment, despite similar treatment outcomes. While both papers make excellent points, in this commentary we highlight important challenges in the assessment of ASD that may artificially inflate its prevalence in the context of disordered eating. We then caution the field against completely discarding evidence-based eating disorder treatments in the setting of comorbid ASD. Finally, we offer recommendations for future research to determine when and how eating disorder treatments should be modified to accommodate neurodiversity.

“Snatch, Eat, Erase”: The Demonization of Women’s (Sexual) Appetite Through Eating Disorders in the CW TV Series the Vampire Diaries (2009–2017)

ABSTRACT Ever since the Victorian period, eating disorders have been influenced by patriarchal discourses that monitor women’s bodies. Female vampires in Victorian Gothic narratives—e.g., Dracula (1897) and Carmilla (1872)—transitioned from a restrained, anorexic body to an insatiable, voluptuous one. Contemporary vampire teen dramas—including the Twilight saga (2005–2008), or the TV series The Vampire Diaries (2009–2017) and Vampire Academy (2022)—are also a reflection of their socio-cultural time of production, thus featuring dubious and postfeminist representations of female hunger and eating disorders that mirror our post-postmodern gender and identity politics. In this article, I examine how the transformation of the female protagonists in The Vampire Diaries from slender, proper girls to voracious vampires could be understood as a patriarchal demonisation of women’s (sexual) appetite, particularly in the case of Vicki Donovan and Elena Gilbert, but also as a source of empowerment for Caroline Forbes.