psychology research questions about eating disorders

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The association between eating disorders and mental health: an umbrella review

Eng joo tan.

1 School of Public Health and Preventive Medicine, Monash University Health Economics Group (MUHEG), Monash University, Melbourne, VIC 3004 Australia

Tejeesha Raut

2 Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC 3125 Australia

Long Khanh-Dao Le

Phillipa hay.

3 Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia

4 Camden and Campbelltown Hospital, SWSLHD, Campbelltown, NSW 2560 Australia

Jaithri Ananthapavan

5 Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC 3125 Australia

Yong Yi Lee

6 School of Public Health, The University of Queensland, QLD 4006 Herston, Australia

7 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, QLD 4076 Wacol, Australia

Cathrine Mihalopoulos

Associated data.

All relevant data are within the manuscript and supplementary materials.

There have been an increasing number of systematic reviews indicating the association between eating disorders (ED), including its risk factors, with mental health problems such as depression, suicide and anxiety. The objective of this study was to conduct an umbrella review of these reviews and provide a top-level synthesis of the current evidence in this area.

A systematic search was performed using four databases (MEDLINE Complete, APA PyscInfo, CINAHL Complete and EMBASE). The inclusion criteria were systematic reviews (with or without meta-analysis), published in the English language between January 2015 and November 2022. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for use of JBI Systematic reviews.

A total of 6,537 reviews were identified, of which 18 reviews met the inclusion criteria, including 10 reviews with meta-analysis. The average quality assessment score for the included reviews was moderate. Six reviews investigated the association between ED and three specific mental health problems: (a) depression and anxiety, (b) obsessive-compulsive symptoms and (c) social anxiety. A further 3 reviews focused on the relationship between ED and attention deficit hyperactivity disorder (ADHD) while 2 reviews focused on ED and suicidal-related outcomes. The remaining 7 reviews explored the association between ED and bipolar disorders, personality disorders, and non-suicidal self-injury. Depression, social anxiety and ADHD are likely to have a stronger strength of association with ED relative to other mental health problems.

Mental health problems such as depression, social anxiety and ADHD were found to be more prevalent among people suffering from eating disorders. Further research is necessary to understand the mechanism and health impacts of potential comorbidities of ED.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40337-022-00725-4.

This review aimed to investigate the association between eating disorders (ED) and mental health problems. A review of existing systematic reviews was conducted to provide a top-level synthesis of the current evidence in this area. Our review found a total of 18 systematic reviews, which investigated the association between ED and a wide range of mental health problems. These conditions include depression and anxiety, obsessive-compulsive symptoms, attention deficit hyperactivity disorder (ADHD), social anxiety, personality disorders, suicidal-related outcomes, bipolar disorders and non-suicidal self-injury. Depression, social anxiety and ADHD are likely to have a stronger strength of association with ED relative to other mental health problems.

Introduction

Eating disorders (ED) such as anorexia nervosa, bulimia nervosa and binge eating disorders lead to higher physical and psychological morbidity, disabilities, and mortality rates [ 1 ]. The prevalence of eating disorder is increasing, with the lifetime prevalence between 3.3 and 18.6% among women and between 0.8 and 6.5% among men [ 2 ]. Risk factors such as dieting and body dissatisfaction have been considered predictors of ED onset for many years [ 3 ]. Other predisposing factors of ED also include family history of EDs, having close relatives with a mental health problem, personal history of anxiety disorder, and behavioural inflexibility and sociocultural issues such as weight stigma, bullying or teasing and limited social networks [ 4 ].

Many studies have linked EDs to various mental health problems. For example, personality disorders can be found in a portion of patients with anorexia nervosa (AN) and bulimia nervosa (BN), and were encountered in the treatment of EDs [ 5 ]. Binge eating disorder (BED) has been found to impact mental health problems such as anxiety and depression which worsens health-related quality of life (HRQL) of an individual [ 6 ]. In a study of a nationally representative sample of 36,309 adults, all three EDs were associated with more than one comorbid somatic condition, which can range from lifetime mood disorders, anxiety disorders, major depressive disorder and alcohol and drug use disorders [ 7 ]. It has been widely recognized that individuals with EDs show higher rates of suicidality, which includes complete suicide, suicidal attempt, and suicidal ideation [ 8 ]. The negative perception of body image, a risk factor for ED, has also been linked to depression and obesity [ 9 ]. Individuals suffering from anorexia nervosa or bulimia nervosa also exhibit social anxiety disorders, have low self-esteem and more likely to feel nervous about their appearances in public places [ 10 – 12 ].

The significant burden of mental health problems necessitates a more comprehensive understanding of the relationship between mental health and ED. Recent evidence suggested that the burden of mental health problems has increased, with suicide as the second leading cause of death among 15–29 years and the annual global cost of depression and anxiety was estimated to be USD 1 trillion [ 13 ]. While previous studies and reviews have investigated the association between EDs and specific mental health problems such as anxiety, depression and substance use disorder, there is no existing review that provides a top-level summary of these associations by using a broader definition of mental health. Consequently, there is a lack of comparative analyses of the various mental health problems and their associations with ED. Addressing this gap in current research can assist researchers and clinicians to develop a suite of interventions that has the most impact on reducing the ED-mental health co-morbidity. In this context, an umbrella review is useful because it allows the findings of existing reviews to be compared and contrasted. Therefore, this umbrella review aims to synthesize contemporary evidence in order to better understand the relationship between eating disorders and various mental health problems across demographic and clinical factors.

This review adhered to the Joanna Brigg Institute (JBI) guidelines for umbrella reviews [ 14 ] and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards [ 15 ]. An ethics exemption for this research was approved by the Deakin University Human Research Ethics Committee (DUHREC) (ref. 202–1030). The protocol was registered with PROSPERO: International Prospective Register of Systematic Reviews (ref. CRD42021232372).

Search strategies and databases

In consultation with an experienced librarian, a literature search to identify potentially eligible publications was performed by the second author (TR) on 16 November 2020. A second literature search was performed by the first author (EJT) on 8 November 2022 to include potential studies published from 16 November 2020 onwards. Both searches were conducted via the EBSCOhost platform on four databases: MEDLINE Complete, APA PyscInfo, CINAHL Complete and EMBASE. The International Classification of Diseases version 10 (ICD-10) was used to define the mental health problems relevant to this review. For the purpose of this review, the disease category of disorders of psychological development, which included disorders related to speech, language, scholastic skills, motor function and autism were not considered. The search terms used in the study were various combinations of eating disorder keywords (e.g., “anorexi*”) and mental health keywords (e.g., “addiction”) using Boolean operators (or/and). Further details of the search terms can be found in Table S1 in the supplementary information file.

Inclusion and exclusion criteria

The aim of this umbrella review was to identify reviews of studies that investigated the association between eating disorders and mental health problems. Therefore, reviews that reported the association or consequences of EDs or ED risk factors and mental health problems such as depression, anxiety, substance use disorders were included. The inclusion criteria required studies to be systematic reviews with or without meta-analyses while scoping reviews, narrative reviews, or literatures reviews without quality assessment were excluded. For the purpose of this umbrella review, a study is considered a systematic review if it had a clearly formulated research question, reported systematic and reproducible methods to identify, select and critically appraise relevant research studies. The studies were limited to the general population although there were no age or gender restrictions on the participants. All the articles included in the study were human studies, published in the English language published in peer-reviewed journals within the last seven years i.e. from January 2015 to November 2022. Non-review studies such as cohort, prevalence, case-control or cross-sectional studies were excluded from this review. Reviews with the wrong setting, study design, outcomes or the patient population were excluded. Further details of the inclusion and exclusion criteria can be found in Table S2 in the supplementary information file.

Identification of relevant studies and data extraction

All studies from the database search results were imported into Endnote and duplicates were removed. The remaining studies were then uploaded to Covidence, an online systematic review management tool, for screening [ 16 ]. A two-stage screening process applying the inclusion and exclusion criteria was conducted: (a) title and abstract screening and (b) full-text screening. Both screening processes were done independently by two reviewers (TR, EJT) and any discrepancies were discussed and resolved by the third reviewer (LL). The following data were extracted from reviews that fulfilled the inclusion criteria: year of publication, number of included studies, type of eating disorders or risk factors of eating disorders, mental health problem, presence of meta-analysis component, study design, population description, country and effect size (if available). Data extraction was performed by TR and independently checked by EJT and LL.

Quality assessment

The bias and quality of the included reviews were assessed using the Joanna Briggs Institute Critical Appraisal tools for systematic reviews (The Joanna Briggs Institute, 2017). The purpose of this appraisal tool is to assess the methodological quality of the included studies and to determine the extent of the possibility of bias in design, conduct and analysis. The tool consists of 11 items (further details are available Table S2 in the supplementary information file) include three choices - “Yes”, “No” and “Unclear”. The total score on the scale is 11.

A total of 7,275 potentially relevant studies were identified from the database search. After duplicates were removed, 6,537 studies were available for screening. After title and abstract screening, 94 studies were progressed to full-text screening. Full-text screening resulted in 18 studies meeting the inclusion criteria and being included in the umbrella review. The PRISMA diagram shown in Fig.  1 reports the reason for exclusion for the remaining 76 studies with full-text review.

PRISMA flow diagram of included studies

Characteristics of included studies

Out of the 18 systematic reviews, ten included a meta-analysis component. There were six reviews investigating the association between ED or ED risk factors (e.g. body dissatisfaction) and three specific mental health problems: (a) depression and anxiety, (b) obsessive-compulsive symptoms and (c) social anxiety. Another three reviews focused on the relationship between ED and attention deficit hyperactivity disorder (ADHD) while two reviews focused on ED and suicidal-related outcomes. The remaining seven reviews explored the association between ED and bipolar disorders, personality disorders, and non-suicidal self-injury. Further details of the included studies are presented in Table  1 . The number of individual studies included within the reviews ranged from five to 122 studies with the majority of included studies being conducted using a cross-sectional study design. All but one review investigated the general population, including males and females, and the sample size ranged from 1,792 to 2,321,441 participants.

Summary of included reviews

SMD = standardized mean difference; OR = odds ratio

*The quality score was calculated from the total score out of 11 based on the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews questionnaire

ED, depression and anxiety, obsessive compulsive symptoms and social anxiety

The evidence from two reviews [ 17 – 19 ] suggest that individuals afflicted with BED or disordered eating have a higher risk of experiencing negative mood, tension, sadness and emotional instability [ 19 ], which can further develop into depressive and anxiety symptoms [ 17 ]. However, limited evidence was found to support any link between disordered eating and obsessive-compulsive symptoms [ 17 ]. There is evidence to suggest that the relationship between anxiety and AN can be bi-directional. For example, the review by Lloyd et al. [ 18 ] demonstrated that the risk of anorexia is predicted to increase in adolescents and young adults diagnosed with an anxiety disorder. Meanwhile, Kerr-Gaffney et al. [ 11 ] conducted a systematic review and meta-analysis and found that both BN and AN were associated with social anxiety with a medium effect size of 0.71 [95% CI 0.47, 0.95; p  < 0.001] and a large effect size of 1.65 [95% CI 1.03, 2.27; p  < 0.001], respectively as estimated using the Cohen’s d statistic. The authors concluded that individuals with AN or BN have high levels of social anxiety compared to healthy controls.

Several reviews have indicated that certain ED risk factors can potentially contribute to depression. The systematic review and meta-analysis conducted by Puccio et al. [ 20 ] suggested that eating pathology is one of the risk factors for depression and vice-versa. The effect of eating pathology on depression among 18,641 females aged 6–50 years was shown to be significant with an effect size of 0.13 (95% CI: 0.09 to 0.17, p  < 0.001), which was conducted on r values [ 19 ]. A systematic review of body image dissatisfaction and depression found that in men the perception of being underweight or dissatisfaction due to low weight was observed by idealizing a larger body, whereas women perceived their body larger than it was by idealizing a lean body [ 21 ]. Both of these conditions were associated with the presence of depression or depressive symptoms although the review was unable to conclude whether more severe body image dissatisfaction increased chances of also having depressive symptoms or both conditions co-exist.

ED and attention deficit hyperactivity disorder

A systematic review conducted by Kaisari et al. [ 22 ] on disordered eating behaviour and (ADHD) among 115,418 participants (including both male and female populations) suggested that the impulsivity symptoms of ADHD were positively associated with overeating in AN and BN. Similarly, Levin & Rawana [ 23 ] explored the association between AN, BN and BED and ADHD among 74,852 participants and showed that childhood ADHD increases the risk of disordered eating or developing ED in later life. The systematic and meta-analysis of ED on ADHD by Nazar et al. [ 24 ] showed that the pooled odds ratio of diagnosing any ED in ADHD populations was 3.82 (95% CI 2.34–6.24). BN has the highest odds ratio (5.71, 95% CI 3.56–9.16) followed by AN (4.28, 95% CI 2.24–8.16) and BED (4.13, 95% CI 3.00–5.67). On the other hand, the pooled odds ratio of diagnosing ADHD in people with eating disorders was 2.57 (95% CI 1.30–5.11) [ 24 ].

ED and bipolar disorder

The systematic review by Álvarez Ruiz & Gutiérrez-Rojas [ 25 ] found that the severity of BN and BED in women was higher among patients with bipolar disorder. The evidence from their review suggested that there is a comorbidity between ED and bipolar disorder, with prevalence rate of EDs in bipolar disorder patients ranging from 5.3 to 31%. In addition, a more recent meta-analytic review of 47 studies reported the lifetime prevalence of AN, BN and BED as 3.8% (95% CI 2–6%), 7.4% (95% CI 6–10%) and 12.5% (95% CI 9.40–16.6%) among individuals with bipolar disorder, respectively [ 26 ].

ED and suicidal factors

A systematic review of 12 cross-sectional and 5 longitudinal studies on BED and suicidal factors among adolescents and adults found that BED is associated with a higher risk of suicide, including suicidal behaviours and ideation [ 8 ]. Similarly, the systematic review by Goldstein & Gvion [ 27 ], which included 36 cross-sectional studies and 2 longitudinal studies, suggested that eating disorders with purging behaviour, impulsivity and specific interpersonal features were associated with greater risk of suicidal behaviours.

ED and non-suicidal self-injury

A systematic review and meta-analysis by Cucchi et al. [ 28 ] reported that, among patients with various EDs, the prevalence of a lifetime history of non-suicidal self-injury (NSSI) was 27.3% (95% CI 23.8–31.0%) for ED, 21.8% (95% CI 18.5–25.6%) for AN, and 32.7% (95% CI 26.9–39.1%) for BN. Based on 29 studies and 6,575 participants, the review concluded that NSSI is a significant correlate of ED and prevalent among adolescents and young adults with ED.

ED and personality disorders

The systematic review and meta-analysis conducted by Farstad et al. [ 29 ] on ED and personality disorders (PD) included 14 studies and showed that pooled prevalence rates of PD ranged from 0% (95% CI: 0–4%) (for schizoid) to 30% (95% CI 0–56%) (for obsessive-compulsive) in individuals with ED. The authors concluded that increases in perfectionism, neuroticism, low extraversion, sensitivity to social rewards, avoidance motivation, negative urgency and high-self-directedness was found in the people presenting with EDs. This finding is consistent with another review that investigated the association between EDs and symptoms of borderline personality disorder [ 30 ]. The authors found that nine symptoms of borderline personality disorder were significantly elevated in patients with EDs compared to controls.

In a meta-analytic review of 59 studies, the lifetime and current prevalence of obsessive-compulsive disorder was reported to be 13.9% [95% CI 10.4–18.1%] and 8.7% [95% CI 5.8–11.8%] respectively across EDs, which included all ED subtypes [ 31 ]. Another meta-analysis review reported lifetime comorbidity rates for obsessive-compulsive disorder of 19% in AN patients and 14% in BN patients based on cross-sectional studies [ 32 ]. These rates increased to 44% in AN patients and 18.5% in BN patients when longitudinal studies were considered.

Quality of included systematic reviews

The scores achieved by the included reviews ranged from 45% (i.e. 5 out of 11 questions) to 100% (i.e. 11 out of 11 questions). On average, the reviews met 72% of the JBI criteria. The details of the score are presented in Table S3 in the supplementary information file. Overall quality was acceptable and most reviews performed well in the design of review question, inclusion criteria, search strategy and criteria used for study appraisal. The main loss of scores were from the criteria of methods to minimize errors in data extraction and assessment of publication bias.

To the best of our knowledge, this is the first umbrella review to examine the overall evidence of the association between eating disorders and mental health across the age spectrum. While previous reviews were focused on investigating the relationship between eating disorders and specific mental health problems, our review captured all relevant mental health problems, including mental disorders, personality disorders and suicide-related outcomes. The findings of this review were synthesized from contemporaneous systematic reviews (i.e. in the last 7 years) and highlighted the growing body of evidence in this area, particularly the frequency of comorbidity of ED and mental health problems. In addition, our review provides a top-level summary of the strength of the association between the various mental health problems and eating disorders, and the direction of effect where possible.

A total of 643 individual studies were reviewed by the 18 systematic reviews included in this umbrella review. The synthesis of evidence revealed that there is a significant association between ED and mental health problems in general. However, among the various mental health problems investigated, only reviews focusing on depression, social anxiety and ADHD reported an effect size or odds ratio from their respective meta-analysis. Therefore, based on quantitative evidence, the association between these three mental health problems and ED is more prominent compared to other mental health problems. There is also evidence to suggest that depression and anxiety are significantly associated with different types of EDs and their risk factors. For example, symptoms of depression and anxiety were often observed in individuals suffering from AN, BN and BED or those with ED risk factors such as body dissatisfaction [ 16 , 21 ]. Interestingly, existing research shows that childhood ADHD increased the risk of disordered eating or developing ED in later life and vice versa while the risk of ADHD in individuals with ED is increased three-fold, compared to control groups [ 24 ]. This phenomenon is particularly relevant for prevention efforts given that diagnosis of ADHD in young girls or women can be delayed or missed [ 33 ]. As such, there are potential shared benefits to be gained when addressing both conditions. Further research is required to explore the underlying mechanisms and comorbidity between EDs and mental disorders. The prevention or treatment of this comorbidity also needs to be addressed by future intervention studies.

While females continue to be disproportionately affected by ED, including through its association with other mental health problems, there is also growing evidence to indicate the adverse impacts of the ED-mental disorder comorbidity on the male population. For example, the correlation between the risk of developing eating pathology due to childhood ADHD was observed to be stronger in males compared to females [ 23 ]. Furthermore, restrictive eating behaviour has been linked to ADHD-related hyperactivity symptoms in boys although the causal pathway is still not fully understood [ 34 , 35 ] As the population group investigated by the reviews included in this study was predominantly females, the association between ED and mental health may be underestimated in males. A balanced representation of the two sexes should be considered in future studies and will lead to an improved understanding of the function of gender in this emerging comorbidity.

Our umbrella review also reported that most of the research were undertaken in high-income countries, whereas limited studies have been conducted in low- and middle-income countries. This is not surprising given that previous evidence have indicated a severe scarcity of mental health research resources in low- and middle-income countries, especially in Asian and African countries [ 36 ]. Furthermore, ED-related epidemiology research in low- and middle-income countries often focused on prevalence studies and less on comorbidity between ED and mental health problems [ 37 ]. Therefore, there is a need to address this gap in the literature and investigate the generalizability of present evidence across different regions.

One of the limitations of our umbrella review is that it did not include reviews published in languages other than English. In addition, our literature search was limited to the last 7 years, therefore, reviews published before 2015 were not considered. However, it is likely that the more recent reviews in our study have included previous evidence. Another limitation is that no recent individual studies were included. Although this omission may have an impact on the findings of our study, it is unlikely to change the overall conclusion.

Overall, there may be several clinical implications from our findings. First, there is a need to increase awareness and screening for ED in general mental health settings and broader demographics. Compared to general mental health, ED is often underdiagnosed in primary care and therefore the health burden of ED is largely hidden even though it is substantial [ 38 , 39 ]. Second, it is necessary to address the unmet need for treatment of ED. Evidence has shown that although a majority of community cases with a diagnosable ED who seek treatment received treatment for weight loss, only a small proportion received appropriate mental health care [ 40 ]. There is a need to promote supported integrated treatments such as the introduction of mood intolerance module in temperament based therapy with supports [ 41 ].

The outcome of the umbrella review suggests that eating disorders and mental health problems are significantly associated with each other. Mental health problems such as depression, anxiety, suicidal attempts are found to be more prevalent among people suffering from eating disorders. EDs also arise from impulsive behaviours, poor emotion regulation, history of childhood physical and emotional abuse, pain tolerance and interpersonal fears such as perceived burdensomeness [ 16 , 27 ]. Our findings suggest that there is a need for further research to understand the health impacts of eating disorder and mental disorder comorbidities. For instance, there is a limited assessment of risk factors of suicide in people with ED and, therefore, historical and contemporary data need to be collected in order to better understand the risk of suicide in ED. Further efforts should also be made to identify effective and cost-effective interventions for the prevention or treatment of ED and its comorbidities.

Acknowledgements

Not applicable.

Author contributions

EJT and LKDL conceptualized and designed the study. TR, EJT, LKDL contributed to the acquisition, analysis, and interpretation of data for the work, drafted the initial manuscript, and reviewed and revised the manuscript. PH, JA, YYL and CM contributed to the conception and design of the work and the acquisition, analysis, and interpretation of data for the work and critically revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

This study was funded by the National Health and Medical Research Council Ideas Grant (APP1183225). LKDL is funded by the Alfred Deakin Postdoctoral Research Fellow. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Availability of data and materials

Declarations.

An ethics exemption for this research was approved by the Deakin University Human Research Ethics Committee (DUHREC) (ref. 2021-030).

Dr Long Le is a Guest Editor for the collection of “Environmental Influences on Eating disorders, Disordered eating and Body Image” in Journal of Eating Disorders. All other authors do have any competing interest to declare.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Eng Joo Tan, Email: [email protected] .

Long Khanh-Dao Le, Email: [email protected] .

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Eating Disorders: Current Knowledge and Treatment Update

• B. Timothy Walsh , M.D.

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Although relatively uncommon, eating disorders remain an important concern for clinicians and researchers as well as the general public, as highlighted by the recent depiction of Princess Diana’s struggles with bulimia in “The Crown.” This brief review will examine recent findings regarding the diagnosis, epidemiology, neurobiology, and treatment of eating disorders.

Eight years ago, DSM-5 made major changes to the diagnostic criteria for eating disorders. A major problem in DSM-IV ’s criteria was that only two eating disorders, anorexia nervosa and bulimia nervosa, were officially recognized. Therefore, many patients presenting for treatment received the nonspecific diagnostic label of eating disorder not otherwise specified (EDNOS), which provided little information about the nature of the patient’s difficulties. This problem was addressed in several ways in DSM-5 (see DSM-5 Feeding and Eating Disorder list). The diagnostic criteria for anorexia nervosa and bulimia nervosa were slightly expanded to capture a few more patients in each category. But two other changes had a greater impact in reducing the use of nonspecific diagnoses.

The first of these was the addition of binge eating disorder (BED), which had previously been described in an appendix of DSM-IV . BED is the most common eating disorder in the United States, so its official recognition in DSM-5 led to a substantial reduction in the need for nonspecific diagnoses.

DSM-5 Feeding and Eating Disorder

Rumination Disorder

Avoidant/restrictive food intake disorder

Anorexia nervosa

Bulimia nervosa

Binge-eating disorder

Other specified feeding or eating disorder

Unspecified feeding or eating disorder

The second important change was the combination of the DSM-IV section titled “Feeding and Eating Disorders of Infancy or Early Childhood” with “Eating Disorders” to form an expanded section, “Feeding and Eating Disorders.” This change thereby included three diagnostic categories: pica, rumination disorder, and feeding disorder of infancy or early childhood. Pica and rumination disorder are infrequently diagnosed.

The other category, feeding disorder of infancy or early childhood, was rarely used and had been the subject of virtually no research since its inclusion in DSM-IV . The Eating Disorders Work Group responsible for reviewing the criteria for eating disorders for DSM-5 realized that there was a substantial number of individuals, many of them children, who severely restricted their food intake but did not have anorexia nervosa. For example, after a severe bout of vomiting after eating, some individuals attempt to prevent a recurrence by no longer eating at all, leading to potentially serious nutritional disturbances. No diagnostic category in DSM-IV existed for such individuals. Therefore, the DSM-IV category, feeding disorder of infancy or early childhood, was expanded and retitled “avoidant/restrictive food intake disorder” (ARFID). Combined, these changes led to a substantial reduction in the need for nonspecific diagnostic categories for eating disorders.

In the course of assessing the impact of the recommended changes in the diagnostic criteria for eating disorders, the Eating Disorders Work Group became aware of another group of individuals presenting for clinical care whose symptoms did not quite fit any of the existing or proposed categories. These were individuals, many of them previously overweight or obese, who had lost a substantial amount of weight and developed many of the signs and symptoms characteristic of anorexia nervosa. However, at the time of presentation, their weights remained within or above the normal range, therefore not satisfying the first diagnostic criterion for anorexia nervosa. The work group recommended that a brief description of such individuals be included in the DSM-5 diagnostic category that replaced DSM-IV ’s EDNOS: “other specified feeding and eating disorders” (OSFED); this description was labeled atypical anorexia nervosa. The degree to which the symptoms, complications, and course of individuals with atypical anorexia nervosa resemble and differ from those of individuals with typical anorexia nervosa remains an important focus of current research.

Epidemiology

Although eating disorders contribute significantly to the global burden of disease, they remain relatively uncommon. A study published in September 2018 by Tomoko Udo, Ph.D., and Carlos M. Grilo, Ph.D., in Biological Psychiatry examined data from a large, nationally representative sample of over 36,000 U.S. adults 18 years of age and older surveyed using a lay-administered diagnostic interview in 2012-2013. The 12-month prevalence estimates for anorexia nervosa, bulimia nervosa, and BED were 0.05%, 0.14%, and 0.44%, respectively. Although the relative frequencies of these disorders were similar to those described in prior studies, the absolute estimates were somewhat lower for unclear reasons. Consistent with clinical experience and prior reports, the eating disorders, especially anorexia nervosa and bulimia nervosa, were more prevalent among women (though men are also affected). Although eating disorders occurred across all ethnic and racial groups, there were fewer cases of anorexia nervosa among non-Hispanic and Hispanic Black respondents than among non-Hispanic White respondents. Consistent with long-standing clinical impression, individuals with lifetime anorexia nervosa reported higher incomes.

Finally, when BED was under consideration for official recognition in DSM-5 , some critics suggested that, since virtually everyone occasionally overeats, BED was an example of the misguided tendency of DSM to pathologize normal behavior. The low prevalence of BED reported in the study by Udo and Grilo documents that, when carefully assessed, BED affects only a minority of individuals and is therefore distinct from normality.

A subject of some debate and substantial uncertainty is whether the incidence of eating disorders (the number of new cases a year) is increasing. Some studies, such as that of Udo and Grilo, have found that the lifetime rates of eating disorders among older individuals are lower than those among younger individuals, suggesting that the frequency of eating disorders may be increasing. However, this might also reflect more recent awareness and knowledge of eating disorders. Other studies that conducted multiple examinations of the frequency of eating disorders in the same settings over time appear to suggest that, in the last several decades, the incidence of anorexia nervosa has remained roughly stable, whereas the incidence of bulimia nervosa has decreased. Presumably, this reflects changes in the sociocultural environment such as an increased acceptance of being overweight and reduced pressure to engage in inappropriate compensatory measures such as self-induced vomiting after binge eating.

The COVID-19 pandemic has impacted virtually every facet of life across the world and has produced severe financial, medical, and psychological stresses. Preliminary research suggests that such stresses have exacerbated the symptoms of individuals with preexisting eating disorders and have led to increased binge eating in the general population. Hopefully, these trends will improve with successful control of the pandemic.

Neurobiology

Much recent research on the mechanisms underlying the development and persistence of eating disorders has focused on the processing of rewarding and nonrewarding/punishing stimuli. Several studies have suggested that individuals with anorexia nervosa are less able to distinguish among stimuli with varying probabilities of obtaining a reward. Other studies suggest that, when viewing images of food during MRI scanning, individuals with anorexia nervosa tend to show less activation of brain reward areas than do controls. Such deficits may be related to disturbances in dopamine function in areas of the brain known to be involved in reward processing. Research based on emerging methods in computational psychiatry suggests that individuals with anorexia nervosa may be particularly sensitive to learning from punishment; for example, they may be very quick to learn what stimuli lead to a decrease in the amount of a reward. Conceivably, they may learn that eating high-fat foods prevents weight loss and produces undesirable weight gain, and they begin to avoid such foods. These studies, and a range of others, focus on probing basic brain mechanisms and how they may be disrupted in anorexia nervosa. A challenge for this “bottom-up” approach is to determine how exactly disturbances in such mechanisms are related to the eating disturbances characteristic of anorexia nervosa.

Other recent studies take a “top-down” approach, focusing on the neural circuitry underlying the persistent maladaptive choices made by individuals with anorexia nervosa when they decide what foods to eat. Such research successfully captures the well-established avoidance of high-fat foods by individuals with anorexia nervosa and has documented that such individuals utilize different neural circuits in making decisions about what to eat than do healthy individuals. These results are consistent with suggestions that the impressive persistence of anorexia nervosa in many individuals may be due to the establishment of automatic, stereotyped, and habitual behavior surrounding food choice. A challenge for such top-down research strategies is to determine how these maladaptive patterns develop so rapidly and become so ingrained.

Research on the neurobiology underlying bulimia nervosa is broadly similar. Although the results are complex, individuals with bulimia nervosa appear to find food stimuli more rewarding, and there are indications of disturbances in reward responsiveness to sweet tastes. Several studies have documented impairments in impulse control assessed using behavioral paradigms such as the Stroop Task. In this task, individuals are presented with a word naming a color (for example, “red”) but asked to name the color of the letters spelling the word (for example, the letters r, e, and d are green). Increased difficulties in performing such tasks have been described in individuals with bulimia nervosa and linked to reduced prefrontal cortical thickness.

It has long been known that eating disorders tend to run in families, and there has been strong evidence that this in part reflects the genes that individuals inherit from their parents. In recent decades, it has become clear that the risk of developing most complex human diseases, including obesity, hypertension, and eating disorders is related to many genes, each one of which contributes a small amount to the risk. Because the contribution of a single gene is so small, the DNA from a very large number of individuals with and without the disorder needs to be examined. For instance, genomewide association studies (GWAS) in schizophrenia have examined tens of thousands of individuals with schizophrenia and over 100,000 controls and identified well over 100 genetic loci that contribute to the risk of developing schizophrenia.

GWAS examining the genetic risk for eating disorders are under way but to date have focused primarily on anorexia nervosa. The Psychiatric Genetics Consortium has collected information from 10,000 to 20,000 individuals with anorexia nervosa and over 50,000 controls and has, so far, identified eight loci that contribute to the genetic risk for this disorder. In addition, this work has identified genetic correlations between anorexia nervosa and a range of other disorders known to be comorbid with anorexia nervosa such as anxiety disorders as well as a negative genetic correlation with obesity. These data suggest that the genetic risk for anorexia nervosa is based on a complex interplay between loci associated with a range of psychological and metabolic/anthropometric traits.

Although there have been no dramatic developments in our knowledge of how best to treat individuals with eating disorders, there have been some significant and useful advances in recent years.

For anorexia nervosa, arguably the most significant advance in treatment in the last quarter century has been family-based treatment for adolescents. In this approach, sometimes referred to as the “Maudsley method,” the family, guided by the therapist, becomes the primary agent of change and responsible for ensuring that eating behavior normalizes and weight increases. This approach differs markedly from prior treatment strategies that assumed parental involvement was not helpful or even detrimental. Family-based treatment is now widely viewed as a treatment of first choice for adolescents with anorexia nervosa and has also been adapted to treat bulimia nervosa.

Family-based treatment can be quite challenging for parents. The entire family is asked to attend treatment sessions, and one session early in treatment includes a family meal during which the parents are charged with the difficult task of persuading the adolescent to consume more food than he/she had intended. An alternative but related model, termed “parent-focused treatment,” has recently been explored in a few studies. In this approach, parents meet with a therapist without the affected adolescent or other members of the family and receive guidance regarding how to help the adolescent to alter his or her behavior following techniques virtually identical to those provided in traditional family-based treatment. Several small studies have examined this approach, and results suggest similar effectiveness. Although more research is needed, these findings suggest that parent-focused treatment may be an attractive alternative to family-based treatment for many parents and practitioners.

The COVID-19 pandemic has led to a dramatic acceleration in the provision of psychiatric care remotely, including family-based treatment. Work on providing family-based treatment via videoconference had begun prior to the arrival of COVID-19, as this specialized form of care is not widely available, and its provision via HIPAA-compliant video links would offer a substantial increase in accessibility. Several small studies suggested that remote provision of family-based treatment is feasible and likely to be efficacious. The restrictions imposed by COVID-19 on face-to-face contact have accelerated the remote delivery of family-based treatment; hopefully, new research will document its effectiveness. It should be noted, however, that, in most cases, local contact with a medical professional who can directly measure weight and oversee the patient’s physical state is required.

The treatment of adults with anorexia nervosa, who typically developed the disorder as teenagers and have been ill for five or more years, remains challenging. Structured behavioral interventions, such as those available in specialized inpatient, day program, or residential centers, typically lead to significant weight restoration and psychological and physiological improvement. However, the rate of relapse following acute care remains substantial. Furthermore, most adult patients with anorexia nervosa are very reluctant to accept treatment in such structured programs. A recent helpful development is evidence that olanzapine, at a dose of 5 mg/day to 10 mg/day, assists modestly with weight gain in adult outpatients with anorexia nervosa and is associated with few significant side effects. Unfortunately, it does not address core psychological symptoms and must be viewed as adjunctive to standard care.

There have been fewer recent developments in the treatment of patients with bulimia nervosa and of BED. For bulimia nervosa, cognitive-behavioral therapy remains the mainstay psychological treatment, and SSRIs continue to be the first-choice class of medication. For BED, multiple forms of psychological treatment are associated with substantial improvement in binge eating, and, in 2015, the FDA approved the use of the stimulant lisdexamfetamine (Vyvanse) for individuals with BED. Unlike most psychological treatments, lisdexamfetamine is associated with modest weight loss but has effects on pulse and blood pressure that may be of concern, especially for older individuals.

Also noteworthy are the development and application of new forms of psychological treatment for individuals with eating disorders. These include dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), and integrative cognitive-affective therapy (ICAT). Although only a few controlled studies have examined the effectiveness of these treatments, anecdotal information and the results of these studies suggest that such methods may be useful alternatives to more established interventions.

Conclusions

Eating disorders remain uncommon but clinically important problems characterized by persistent disturbances in eating or eating-related behavior. Cutting-edge research focuses on neurobiology and genetics, utilizing novel and rapidly evolving methodology. There have been modest advances in treatment approaches, including the COVID-19 pandemic’s acceleration of treatment delivery via video-link. Future studies will hopefully clarify the nature of ARFID and of atypical anorexia nervosa and lead to the development of more effective interventions, especially for individuals with long-standing eating disorders. ■

Additional Resources

Walsh BT. Diagnostic Categories for Eating Disorders: Current Status and What Lies Ahead. Psychiatr Clin North Am . 2019; 42(1):1-10.

Udo T, Grilo CM. Prevalence and Correlates of DSM-5 -Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults. Biol Psychiatry . 2018; 84(5):345-354.

Van Hoeken D, Hoek HW. Review of the Burden of Eating Disorders: Mortality, Disability, Costs, Quality of Life, and Family Burden. Curr Opin Psychiatry . 2020; 33(6):521-527.

Bernardoni F, Geisler D, King JA, et al. Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa. Biol Psychiatry . 2018; 83(3):235-243.

Frank GKW, Shott ME, DeGuzman MC. The Neurobiology of Eating Disorders. Child Adolesc Psychiatr Clin N Am . 2019; 28(4):629-640.

Steinglass JE, Berner LA, Attia E. Cognitive Neuroscience of Eating Disorders. Psychiatr Clin North Am . 2019; 42(1):75-91.

Bulik CM, Blake L, Austin J. Genetics of Eating Disorders: What the Clinician Needs to Know. Psychiatr Clin North Am . 2019; 42(1):59-73.

Attia E, Steinglass JE, Walsh BT, et al. Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial. Am J Psychiatry . 2019; 176(6):449-456.

Le Grange D, Hughes EK, Court A, et al. Randomized Clinical Trial of Parent-Focused Treatment and Family-Based Treatment for Adolescent Anorexia Nervosa. J Am Acad Child Adolesc Psychiatry . 2016; 55(8):683-92.

Pisetsky EM, Schaefer LM, Wonderlich SA, et al. Emerging Psychological Treatments in Eating Disorders. Psychiatr Clin North Am . 2019; 42:219-229.

B. Timothy Walsh, M.D., is a professor of psychiatry at the Columbia University Irving Medical Center and the founding director of the Columbia Center for Eating Disorders at the New York State Psychiatric Institute. He is the co-editor of the Handbook of Assessment and Treatment of Eating Disorders from APA Publishing.

Dr. Walsh reports receiving royalties or honoraria from UpToDate, McGraw-Hill, the Oxford University Press, the British Medical Journal, the Johns Hopkins Press, and Guidepoint Global

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40 years of research on eating disorders in domain-specific journals: Bibliometrics, network analysis, and topic modeling

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation School of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Perú

• Carlos A. Almenara

• Published: December 15, 2022
• https://doi.org/10.1371/journal.pone.0278981
• Peer Review
• Reader Comments

Previous studies have used a query-based approach to search and gather scientific literature. Instead, the current study focused on domain-specific journals in the field of eating disorders. A total of 8651 documents (since 1981 to 2020), from which 7899 had an abstract, were retrieved from: International Journal of Eating Disorders (n = 4185, 48.38%), Eating and Weight Disorders (n = 1540, 17.80%), European Eating Disorders Review (n = 1461, 16.88%), Eating Disorders (n = 1072, 12.39%), and Journal of Eating Disorders (n = 393, 4.54%). To analyze these data, diverse methodologies were employed: bibliometrics (to identify top cited documents), network analysis (to identify the most representative scholars and collaboration networks), and topic modeling (to retrieve major topics using text mining, natural language processing, and machine learning algorithms). The results showed that the most cited documents were related to instruments used for the screening and evaluation of eating disorders, followed by review articles related to the epidemiology, course and outcome of eating disorders. Network analysis identified well-known scholars in the field, as well as their collaboration networks. Finally, topic modeling identified 10 major topics whereas a time series analysis of these topics identified relevant historical shifts. This study discusses the results in terms of future opportunities in the field of eating disorders.

Citation: Almenara CA (2022) 40 years of research on eating disorders in domain-specific journals: Bibliometrics, network analysis, and topic modeling. PLoS ONE 17(12): e0278981. https://doi.org/10.1371/journal.pone.0278981

Editor: Alberto Baccini, University of Siena, Italy, ITALY

Received: February 5, 2021; Accepted: November 27, 2022; Published: December 15, 2022

Copyright: © 2022 Carlos A. Almenara. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data that support the findings of this study are publicly available from the OSF repository: https://osf.io/5yzvd/ (DOI: 10.17605/OSF.IO/5YZVD ).

Funding: Funding for this study was obtained from Universidad Peruana de Ciencias Aplicadas (A-006-2021).

Competing interests: The author has no competing interest to declare.

Introduction

There are a large and growing number of scientific publications on eating disorders (ED) [ 1 – 3 ]. ED are mental disorders characterized by a continuous disturbance in eating behavior, such as Anorexia Nervosa [ 4 ]. ED are usually defined according to manuals like the Diagnostic and Statistical Manual of Mental Disorders (DSM) [ 4 ]. The spectrum of ED can share some symptoms (e.g., fear of fatness ), and these symptoms negatively impact psychosocial functioning and physical health. Due to the complexity of ED like Anorexia Nervosa, scholar literature about them covers different disciplines, such as ED related to: visual arts (e.g., art history) [ 5 ], sociology (e.g., social history) [ 6 ] and even dentistry (e.g., oral health) [ 7 ]. Thus, ED literature has a broad diversity.

Previous bibliometric studies about ED have focused on: identifying the distribution by language, region and country, as well as topics and their trends [ 1 ], productivity trends and collaboration patterns [ 2 ], most cited works in Anorexia Nervosa research [ 8 ], cross-cultural aspects of ED [ 3 ], comparison of citations between types of journals [ 9 ], female authorship [ 10 ], secular trends in the scientific terminology [ 11 , 12 ], the gap between scientific research and clinical practice [ 13 ], the use of keywords [ 14 ], and network analyses of common terms used in the field [ 15 ]. In particular, the current study complements the work by He et al. [ 1 ].

A standard practice of these studies is to retrieve the literature by performing a systematic search in databases like Web of Science or Scopus (i.e., employing a query-based approach), although there are some caveats worth mentioning. As noted elsewhere [ 16 , 17 ], those two databases differ in journal coverage and their use can introduce bias favoring science publications (e.g., biomedicine) in detriment of arts and humanities, other than overrepresenting English-language journals. Second, databases in general (including others like PubMed, Dimensions, JSTOR), differ in their search engine functionality and information retrieval capabilities.

For example, some databases offer a controlled vocabulary like a thesaurus or taxonomy from which to choose the search terms (e.g., the Medical Subject Headings [MeSH] in PubMed), whereas others offer a full text search. Regarding the latter, indexing scanned documents to offer a full text search, requires pre-processing methods like optical character recognition (OCR), known to include typos, and post-OCR processing, both affecting information retrieval accuracy [ 18 – 23 ].

In other words, a query-based approach, although widely used, can be affected by several factors, including: domain expertise to design the most appropriate search strategy, the characteristics of the selected database(s), including indexation accuracy (e.g., due to OCR typos). The former is particularly important because scholars are not always consistent in using the terminology [ 24 ]. In fact, their selection of keywords is not systematic, but rather influenced by factors like their background knowledge and previous experience [ 25 ]. In this regard, within the field of ED, scholars are encouraged to use appropriate terminology [ 26 , 27 ], usually a controlled vocabulary such as the Thesaurus of Psychological Index Terms. This helps to optimize the Knowledge Organization Systems (KOS) of journals and databases, such as a controlled vocabulary for information retrieval [ 14 , 28 ].

In sum, most previous studies have employed a query-based search, being compelled to choose among different databases, search terms, and search strategies [ 29 ]. Nevertheless, this approach not necessarily recognizes the boundaries and limitations of both databases and we as humans interacting with machines, using diverse information retrieval strategies, and dealing with information overload [ 30 , 31 ].

An alternative to the query-based approach is the one proposed in this study: to select a set of specialty journals exclusively devoted to the study of ED. Although this sampling could seem arbitrary, it was adopted: (1) to complement the findings of previous studies [ 1 , 2 ] and (2) because it has in fact a sound base: the intellectual and social structure of knowledge [ 32 – 36 ]. We must recognize that documents need to be understood with regard to "the broader contexts in which they are produced, used, and cited" [ 37 , p. 42]. Thus, the following sections will explain how domain-specific journals are tightly tied to an organized social and disciplinary structure. Moreover, I will explain how this approach does not necessarily exclude all ED literature from non-domain-specific journals, but rather incorporates part of it into their citations. Finally, from a complex systems perspective, I will show how domain-specific journals can be conceived as a specialized subset from the larger and more complex network comprising all ED literature.

Domain-specific journals and its social structure

From a scientometric perspective, science, metaphorically conceived as a knowledge space or knowledge landscapes , can be defined in terms of a network of scholars that produce a network of knowledge [ 35 ]. In the former case, the social function of science has long been recognized (e.g., by Thomas Kuhn): scholars produce and communicate scientific knowledge and this organized activity has the characteristics of a social process [ 36 , 38 ]. More importantly, the patterns of interactions and communication within this social organization are tightly tied, rather than isolated, to the knowledge they produce [ 36 ].

An exemplary case is the role of journal editors as gatekeepers, with studies identifying editorial gatekeeping patterns [ 39 , 40 ]. According with the Network Gatekeeping Theory, inspired by the work of Kurt Lewin, gatekeeping refers to the control in the flow of information [ 41 , 42 ]. In the field of ED, this intellectual and social organization of knowledge can be seen in professional societies like the Academy of Eating Disorder, which since 1981 publishes the most renowned scientific journal: The International Journal of Eating Disorders. Within its editorial board, there are distinguished scholars that can act as gatekeepers to ensure quality control and that manuscripts published by the journal are in line with the aims and scope of it.

In sum, domain-specific journals have the goal of publishing information within the boundaries of their aims and scope, allowing the diffusion of specialized knowledge.

Domain-specific journals and its disciplinary organization

From a network perspective, specialty journals are also indicators of disciplinary organization [ 43 ], which exerts a non-trivial influence at both the global and local level of the network. To be more precise, if we visualize a network [e.g., 2 , 44 , 45 ], the local density of specialty journals evidence emerging patterns such as citation patterns by articles from the same journal or group of journals [ 43 ]. At the author level, these patterns reflect the local influence of specialty journals on scholars who adhere to their research tradition and their contributions help to advance a research agenda [ 46 ].

For example, domain-specific journals on ED often publish curated information from conferences [e.g., 47 ] or special issues about a specialized topic [e.g., 48 ], which commonly include a research agenda [ 48 ], setting the stage for future research. As we mentioned above, similar literature, such as special issues about ED published in other journals [e.g., 49 ], is not necessarily excluded in the analysis of domain-specific journals. Rather, such literature is commonly cited in documents from domain-specific journals and can be included in a citation analysis. Importantly, these citation patterns suggest that the former intellectual and social structure of knowledge constrains what is being studied in the future [ 46 ]. Thus, in the upcoming years, most of this specialized literature is expected to become an active research front [ 32 ], as evidenced by its high number of citations.

Finally, it is worth mentioning that the analysis of these patterns can reveal latent hierarchies and topological properties of journal networks. In fact, domain-specific journals can be identified through the study of the hierarchical organization of journal networks. When hierarchical network analysis is used to identify the capability of journals to spread scientific ideas, multidisciplinary journals are found at the top of the hierarchy, whereas more specialized journals are found at the bottom [ 50 , 51 ]. Similarly, significant articles from a specific domain have unique topological properties that can affect the dynamic evolution of the network [ 52 ]. In sum, it is important to recognize the topological properties of networks and their latent hierarchies, both at the journal level and document level. In our case, focusing on domain-specific journals, it would be like zooming into the most central part (core) of the network topology to analyze its organization and distinctive features. Indeed, this approach is commonly employed, for example, when studying network subsets such as niches or communities in complex systems.

Domain-specific journals and complex adaptive systems

Domain-specific journals can also be comprehended from a complex systems standpoint, as the aggregation of the intellectual, social, and citation patterns outlined above. According to the Structural Variation Theory [ 53 ], the body of scientific knowledge can be conceived as a complex adaptive system (CAS). As such, it can be described and studied as a complex network with a series of characteristics like non-linearity, emergence, and self-organization; and a series of social, conceptual, and material elements that evolve over time [ 46 ]. Ideally, we must study CAS holistically to understand the properties of the system at the macrolevel [ 54 ]. In our case, this would require including all scholar literature on ED, which could be attempted using a query-based approach and employing ad hoc methodologies (e.g., iterative citation expansion) [ 45 ]. However, complex systems emerge from rules and behavior of lower-level components, and there is growing interest in understanding complexity from its simplest and fundamental elements and patterns [ 55 , 56 ]. In our case, this can be accomplished by zooming into domain-specific patterns that emerge from the relational structure and organization of journals and papers [ 46 ], rather than focusing on the whole system which comprises all the scientific literature on ED.

This approach can be described in terms of modularity , a structural property of systems: the local density of specialty journals is indicative of a structural module or subsystem [ 57 ]. This property of complex systems is important because it recognizes, as we did above, the existence of subsets within networks. Indeed, scientometric studies usually attempt to detect communities based on the principle of modularity by grouping similar literature (i.e., clustering) [ 44 , 58 ]. However, in the approach used in this study, rather than using bibliographic connections (e.g., through co-citation analysis) to detect domain-specific literature, we can use logical connections [ 59 ], to identify modules that operate as domain-specific representations [ 60 ]. In other words, domain-specific journals can be seen as clusters of articles that are logically linked because they all pertain to a given domain, which is explicitly stated in the aims and scope of the journals.

This modular organization has some advantages over others such as a hierarchy (e.g., Scimago categorization of journals) or a cluster obtained by literature partitioning algorithms. First, it has the advantage of reducing both complexity bias and hierarchical bias . The former is the tendency to assume and adopt a more complex system (the opposite to Occam’s Razor: prefer the simplest explanation), which means to analyze all ED literature. The latter assumes that behavior is directed in a hierarchical fashion, where a central authority passes instructions to all agents in the system [ 54 ]. Second, although it still recognizes a hierarchical structure composed by diverse classes of subsystems, it assumes heterarchy [ 43 , 61 ], which means that both hierarchical and nonhierarchical elements can be present in a system; holarchy , which means that systems are composed of components that can be recognized as subsystems [ 62 ]; and glocal control , which means that local and global phenomena in a system are achieved by local actions [ 63 ]. In simple words, sampling a set of domain-specific journals reduces complexity without affecting assumptions such as a categorical hierarchy of journals.

The current study

To expand on previous studies [ 1 , 2 ], the current study aims to answer the following research questions:

Which are the most cited documents in this domain-specific corpus of articles?

Which are the most important authors and their collaboration networks?

Which are the most relevant topics in this domain-specific corpus of articles?

How have the identified topics evolved over time (since 1981 to 2020)?

To answer these questions, this study employs a hybrid methodology. First, basic bibliometrics will be performed to identify the most cited documents. Second, network analysis will be employed to identify the most important authors and their networks of collaboration. Third, text mining, natural language processing, and machine learning algorithms will be used to identify the most relevant topics (i.e., topic modeling). Finally, a simple time series analysis will be performed to examine the evolution of these topics over time. The procedure employed for the analyses is detailed in the methods section below (and S5 File ), whereas the dataset and the code to perform the analyses are shared in a public repository ( https://doi.org/10.17605/OSF.IO/5YZVD ), allowing the reproducibility of results [ 64 ].

Data collection

The methodology workflow is presented in Fig 1 .

• PPT PowerPoint slide
• PNG larger image
• TIFF original image

https://doi.org/10.1371/journal.pone.0278981.g001

First, in May 2020, a search of journals was performed in Scimago Journal Reports (SJR, https://www.scimagojr.com/ ), using the term “eating disorders”. In this step, the following five journals were identified: International Journal of Eating Disorders (ISSNs: 0276–3478, 1098-108X), European Eating Disorders Review (ISSNs: 1072–4133, 1099–0968), Eating Disorders (ISSNs: 1064–0266, 1532-530X), Eating and Weight Disorders (ISSNs: 1124–4909, 1590–1262), and Journal of Eating Disorders (ISSN: 2050-2974). The official website of each journal was then visited to confirm that the scope of the journal specifically includes the publication of research articles on eating disorders. It should be noted that the journal Advances in Eating Disorders (ISSNs: 2166–2630, 2166–2649) was not included because it was not found in SJR, it was published only between 2013 and 2016, it was incorporated into the journal Eating Disorders , and by the time of writing this article, it was not indexed neither in Scopus ( https://www.scopus.com ) nor in Web of Science ( https://www.webofknowledge.com ).

Next, also in May 2020, the Scopus database was chosen to retrieve the document records from the aforementioned journals. The election was made for no other reason than the capability of Scopus to retrieve several structured information (metadata, such as the abstract), and the file types for download are easy to manage, such as comma-separated values (CSV). Therefore, all document records published by these journals were searched in Scopus using the ISSN as the search term (e.g., ISSN (0276–3478) OR ISSN (02763478) OR ISSN (1098-108X) OR ISSN (1098108X) ). A total of 8651 documents between 1981 and 2020 were retrieved (of which 7899 had an abstract): 4185 (48.38%) from the International Journal of Eating Disorders, 1540 (17.80%) from Eating and Weight Disorders, 1461 (16.88%) from the European Eating Disorders Review, 1072 (12.39%) from Eating Disorders, and 393 (4.54%) from the Journal of Eating Disorders. These 8651 documents included a total of 213,744 references. It should be noted that the International Journal of Eating Disorders is the oldest of these journals, established in 1981. The S7 and S8 Files provide the number of documents per year and per journal. The document records were downloaded from Scopus both as comma separated values (CSV) and as BibTex ( http://www.bibtex.org/ ), and selecting all fields available (i.e., title, author, abstract, etc.). Due to copyright, the full text of all documents was not retrieved but rather their metadata (i.e, title, author, date, abstract), whilst the dataset shared online ( https://doi.org/10.17605/OSF.IO/5YZVD ) is the one obtained after the preprocessing procedures detailed below.

Analyses were performed using open software: R Statistical Software 4.0.3 (Bunny-Wunnies Freak Out) [ 65 ], and Python programming language version 3.9.1 ( https://www.python.org/ ).

Bibliometric analysis and network analysis in R

The biblioshiny application from the R package bibliometrix [ 66 ] was used to preprocess the CSV file. Next, it was used to identify the most cited documents. Local citations (i.e., citations only from documents whithin the dataset), and global citations (i.e., citations made by any document from the whole Scopus database), were computed. Biblioshiny was also used for network analysis as described by Batagelj & Cerinšek [ 67 ], and Aria & Cuccurullo [ 66 ]. Regarding the network, it is defined as a pair of sets: a set of nodes or vertices and a set of edges (link between nodes) [ 68 ]. In this study, when authors were treated as nodes, a link would represent co-authorship or collaboration [see 69 ]. More precisely, the Louvain algorithm for community detection [ 70 ] was used to identify communities within the collaboration network. This algorithm identifies densely connected nodes within the network (i.e., communities) [e.g., 71 ]. It works unconstrained to automatically extract a number of clusters although it requires basic network parameters as input. These network parameters were: up to 100 nodes, a minimum of two edges by node, and the removal of isolated nodes. For network layout visualization, the Fruchterman & Reingold [ 72 ] algorithm was chosen. Finally, common centrality measures were calculated: betweenness, closeness, and PageRank. Betweenness centrality refers to “the frequency that a node is located in the shortest path between other nodes” [ 73 , p. 772]. Closeness centrality refers to nodes that can easily reach others in the network, whilst PageRank , originally created to rank websites [ 74 ], has been used to rank authors because it takes into account the weight of influential nodes [ 75 ].

Topic modeling: Dimensionality reduction and matrix factorization

As can be seen in the workflow ( Fig 1 ), once network analysis was finished, a series of steps (detailed in S5 File ) were necessary to preprocess the dataset prior to topic modeling. Topic modeling refers to applying machine learning techniques to find topics by extracting semantic information from unstructured text in a corpus [ 76 ]. As we explain in S5 File , to this point we end up with a high-dimensional and sparse document-term matrix. In other words, we have many features (columns) each corresponding to a term in our corpus, and for a given document (rows) we have many columns with zero values meaning the term of that column is not in the given document. To deal with sparsity, we can perform dimensionality reduction to obtain a representation that effectively captures the variability in the data. In summary, dimensionality reduction can be categorized in feature extraction and feature selection ; the former combines the original feature space into a new one, whereas the latter selects a subset of features [ 77 ].

As explained in S5 File , the term frequency (TF) and the term frequency-inverse document frequency (TF-IDF) were used as feature extraction for vectorization. Then, the following machine learning algorithms were applied for topic modeling: Latent Dirichlet Allocation (LDA) [ 78 ], Latent Semantic Analysis (LSA or Latent Semantic Indexing) [ 79 ], Hierarchical Dirichlet Process (HDP) [ 80 ], and Non-negative Matrix Factorization (NMF) [ 81 ]. LDA is a generative probabilistic model that decomposes the document-term matrix into a topic-term matrix and a document-topic matrix, and it is commonly used for topic discovering from a corpus [e.g., 82 ]. LSA utilizes a truncated Singular Value Decomposition for decomposition and can work efficiently on TF or TF-IDF sparse matrices. In a fully unsupervised framework, the HDP model is characterized by inferring the number of topics on its own. Finally, NMF is an alternative approach that implements the Nonnegative Double Singular Value Decomposition, an algorithm suitable for sparse factorization [ 83 ].

First, the GENSIM library [ 84 ] was used for topic modeling because it provides a way to calculate topic coherence , an index to compare models based on measures of segmentation, probability estimation, confirmation measure, and aggregation [see 85 ]. Therefore, based on a TF matrix, HDP, LSA, NMF, and LDA were performed in GENSIM and compared in topic coherence. Once identified the topic modeling algorithms with the highest topic coherence, scikit-learn [ 86 ] was used because it provides an Exhaustive Grid Search option for ensemble learning the models (i.e., automatically fine-tuning the parameters to find the most optimal). Finally, once the topics were extracted, a simple time series analysis was performed to visualize the changes over time in the topics found. This analysis consisted of simply plotting the number of documents for each topic across years, from 1981 to 2020.

First, bibliometric analyses were performed to identify the most cited documents. Local citations are presented in Table 1 (and the S1 File ), whereas global citations are in Table 2 (and the S2 File ).

https://doi.org/10.1371/journal.pone.0278981.t001

https://doi.org/10.1371/journal.pone.0278981.t002

Next, a network analysis was performed to identify the most important authors ( Table 3 ) and their collaboration networks ( Fig 2 , see also S3 File , a dataset, and S4 File , an interactive visualization in HTML and JavaScript, also available online: https://osf.io/5yzvd/ ). This collaboration network analysis identified eight clusters with 96 authors: (1) red color, 4 authors; (2) blue, 15 authors; (3) green, 17 authors; (4) purple 21 authors; (5) orange, 2 authors; (6) brown, 18 authors; (7) pink, 2 authors; (8) grey, 17 authors.

https://doi.org/10.1371/journal.pone.0278981.g002

https://doi.org/10.1371/journal.pone.0278981.t003

Regarding the most relevant topics, LDA and NMF were superior to HDP and LSA in topic coherence. Then, when ensemble learning was used for LDA (based on TF) and NMF (based on TF-IDF), NMF provided the most meaningful results, and 10 topics were identified ( Table 4 ).

https://doi.org/10.1371/journal.pone.0278981.t004

The labels for the topics were manually added based on the top 10 keywords and their respective weights. Thus, each topic was manually labeled as follows: (1) risk factors for eating disorders, (2) body image dissatisfaction, (3) Binge Eating Disorder diagnosis, (4) weight loss, weight control, and diet, (5) clinical groups, (6) treatment outcome, (7) family and parent-child, (8) binge and purge episodes, (9) gender and subgroups, (10) EDNOS.

To examine how these topics have evolved over time, a simple time series analysis plot was created ( Fig 3 and S6 File ).

Note . Values in the y-axis are the sum of the weight values from the NMF analysis for topic dominance, per year and per topic. Values go from minimum 0 to maximum 11.2 (see S6 File ).

https://doi.org/10.1371/journal.pone.0278981.g003

This study analyzed 8651 documents between 1981 and 2020 from domain-specific journals in the field of eating disorders. The aims were: to identify the most cited documents, the most important authors and their collaboration networks, and the most relevant topics and their evolution over time. The results expand previous findings of studies that employed a query-based approach and included articles dating back as far as 1900 [ 13 ]. In particular the results expand the studies by Jinbo He et al. (2022) and Juan-Carlos Valderrama-Zurián, et al. (2017), which employed a similar methodology [ 1 , 2 ]. For example, He et al. (2022) created a collaboration network, although it was based on countries rather than authors [ 1 ]. Therefore, the results obtained here (e.g., author centrality measures, author clusters) provide a more fine grained understanding of the relevance and contribution of individual authors and their collaboration networks. Furthermore, He et al. (2022) [ 1 ] identified top authors based on traditional performance metrics (e.g., h-index), and it should be noted that there is some criticism towards their use and a claim to shift towards more responsible metrics of research excellence [ 87 ]. Then, He et al. (2022) [ 1 ] employed LDA for topic modeling, whilst this study employed NMF. Although LDA is largely used, in this study NMF outperformed LDA in interpretability, reproducibility, and as we said above, it suits better for short texts, as is the case of article abstracts used here. Finally, the top journals identified by He et al. (2022) confirmed that the five journals selected for this study are in fact among the most important in the field of eating disorders [ 1 ]. In the case of Valderrama-Zurián, et al. (2017) [ 2 ], they also focused on authors’ productivity trends whereas their social network analysis was focused on network metrics such as the number of nodes and edges over time, which precludes to inspect the social network at the author level. Therefore, this study also expands on the findings of Valderrama-Zurián, et al. (2017) [ 2 ].

Below, we discuss in more detail the results of the analysis employed to answer the four research questions outlined in the introduction.

Bibliometric analysis

The top cited documents were all from the International Journal of Eating Disorders. As noted above, this journal is the oldest one (it started in 1981), and it has the largest number of articles per year, with the exception of the year 2019 when it was outperformed by the Eating and Weight Disorders journal (see S7 and S8 Files). The majority of top cited documents were related to the development of instruments for the assessment of eating disorders or the course and outcome of eating disorders. For example, we can see in the results the most common instruments used for the screening of eating disorders, as well as the evaluation of its core symptoms: Eating Disorder Inventory (EDI), Body Shape Questionnaire (BSQ), Dutch Eating Behavior Questionnaire (DEBQ), and Eating Disorder Examination Questionnaire (EDE-Q). These instruments are widely used to screen the general population, as well as in clinical settings, together with more recent instruments [ 88 ]. It should be noted, however, that in clinical practice settings the use of instruments for the diagnosis and the different phases of the treatment process is not necessarily widespread [ 89 , 90 ]. To reduce this gap, some authors suggest to provide assessment training and/or assessment guidelines for mental health professionals and general practitioners in primary health care [ 91 , 92 ]. This can help obtain a comprehensive clinical assessment, particularly of individuals with higher risk such as young adolescents with restrictive Anorexia Nervosa [ 93 ]. The instruments mentioned above are reliable measures, and they could be used online for a quick screening or session by session for ongoing monitoring, although further research is necessary [e.g., 94 – 96 ].

The rest of most cited documents include important review articles on epidemiology (Hoek & van Hoeken, 2003, in Table 1 ); the course and outcome of eating disorders (Berkman, Lohr & Bulik, 2007; Strober, Freeman & Morrell, 1997; in Table 1 ); and the diagnosis of Binge Eating Disorder (Spitzer et al., 1992, 1993, in Table 1 ). These results are similar to previous studies in which measurement methods (including instrument development), epidemiology, and review articles were the most common type of document [ 8 , 9 ].

Finally, the large number of articles on the diagnosis of Binge Eating Disorder, which was not fully recognized as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) until its fifth edition [ 4 ], reveal that the recognition of Binge Eating Disorder as an own disorder took several years. To reach expert consensus in a shorter time, eating disorder professionals should pay special attention to emerging eating problems, such as Orthorexia Nervosa [ 97 ].

Network analysis

The network analysis identified eight clusters with 96 authors. Previous studies have examined the network of authors in the field in terms of network statistics such as number of edges or network density [ 2 ]. By contrast, this study provides a more fine-grained network analysis, identifying experts and group of experts in the field of eating disorders. As seen in the results section, the majority are distinguished authors with contributions dating back to the early 1980s.

The author with the largest betweenness centrality was Ross D Crosby (Sanford Center for Biobehavioral Research, United States), followed by James E Mitchell (University of North Dakota, United States) which has the largest value in PageRank. Authors with high betweenness centrality can act as both enablers and gatekeepers of information flow between communities [ 75 ]. Moreover, it has been found that authors with high betweenness centrality establish more collaborations than those high in closeness centrality [ 75 ]. In summary, the results of centrality measures can help to identify experts in the field of eating disorders, particularly authors that can quickly reach other authors in the network (high in closeness), act as gatekeepers (high in betweenness), or relate to influential others (high in PageRank).

Regarding the clusters identified by the network analysis, in the same cluster of Ross D Crosby and James E Mitchell are found other renowned authors like Daniel Le Grange (University of California, San Francisco, United States), Stephen A Wonderlich (Sanford Center for Biobehavioral Research, United States), and Carol B Peterson (University of Minnesota, United States). Among the most relevant results of collaboration of this cluster we can find studies on the ecological momentary assessment of eating disorders [ 98 ], the psychometric properties of the EDE-Q [ 99 ], and the diagnosis of Binge Eating Disorder [ 100 ].

The second largest cluster includes authors like Cynthia M Bulik (University of North Carolina at Chapel Hill, United States), Walter H Kaye (University of California, San Diego, United States), and Katherine A Halmi (Weill Cornell Medical College, United States). The results of their collaboration include studies related to the phenotypic characterization of eating disorders, such as the International Price Foundation Genetic Study, a multisite study that included a large sample of patients with eating disorders and their families [e.g., 101 ].

Finally, the third largest cluster includes authors like Janet Treasure (King’s College London, England), Ulrike Schmidt (King’s College London, England), and Tracey D Wade (Flinders University, Australia), which are widely recognized by the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) [ 102 , 103 ]. Interestingly, this is the only cluster that includes collaborations with authors from non-English speaking countries, more specifically from Spain. Examples of these collaborations include studies resulting from the Wellcome Trust Case Control Consortium 3 (WTCCC3) and the Genetic Consortium for AN (GCAN) [ 104 ], and other studies with clinical samples in Spain [e.g., 105 ].

On the other hand, the results reveal the importance of multisite studies that strengthen collaboration and originate in relevant outcomes for the prevention and treatment of eating disorders. Research groups could look for opportunities to collaborate in multisite studies and strengthen both their interdisciplinary and transdisciplinary collaboration, and their collaboration with less common partners such as stakeholders and policy makers [ 106 , 107 ]. By establishing these integrative and strategic collaborations we can promote translational research, and thus helping to reach broader public health goals [ 108 ].

Topic modeling

The combination of TF-IDF and NMF provided meaningful results, identifying 10 topics. After labeling these topics based on the first 10 keywords and their respective weights, we can see that most of the research on eating disorders done in the past 40 years has focused on their prevention and treatment. Interestingly, the time trend analysis of these topics revealed a noticeable change in the first lustrum of the 1990s. Whereas during the early 1980s the study of clinical groups (topic 5) was the most dominant topic, from the mid-1990s, this topic was surpassed by the study of risk factors of eating disorders (topic 1). This indicates an increasing interest for the prevention rather than solely the treatment of eating disorders. This result is consistent with the historical shift that occurred in the United States when in 1992 the Institute of Medicine (IOM) Committee on Prevention of Mental Disorders was created [ 109 ]. Then two years later, a report on reducing risk factors for mental disorders and promoting a preventive approach in research was published [ 110 ]. As expected, this shift had echo in several scholars at the time, became a research front, and relevant publications started to include more information on the prevention of eating disorders, including a special issue [ 111 ], book chapters [ 112 ], and progressively entire books [ 113 ]. It is important to note that this historical shift, as well as later others like in 2017 [ 114 ], were favorable, because in other cases like obesity, it took more time to focus on its prevention due to different issues, including the pressure of the weight loss industry and its commercial interest [ 115 ].

Another interesting finding was that the outcome of the treatment of eating disorders (topic 6), is the second most important topic of 2013, and this finding has important aspects to discuss. First, the surge of state-of-the-art machine learning algorithms provide several opportunities to build intelligent systems for precision medicine. Thus, the treatment course and outcome of eating disorders can be more personalized, guided, and enhanced with the help of predictive technologies and intelligent systems [e.g., 116 ]. Second, as suggested elsewhere [ 117 ], the advantages of technology can be particularly relevant for certain age groups like adolescents, and when a digital intervention is employed [ 118 ]. In summary, treatment outcome is currently an important topic, and future studies can deploy digital interventions and machine learning algorithms for a more precise treatment planning.

Limitations and conclusions

Although this study has strengths, such as using data and code that allows the reproducibility of the results, readers should consider some limitations. First, the analysis of most cited documents is for all the time span, and more recent highly cited documents are underrepresented. Moreover, the journal Advances in Eating Disorders was not included due to indexing issues. Nevertheless, this study provides the code and a detailed procedure to allow researcher to perform further analyses, such as document co-citation analysis. Future studies can also evaluate the Mexican Journal of Eating Disorders ( Revista Mexicana de Trastornos Alimentarios , ISSN 2007-1523), which has published articles primarily in Spanish [ 119 ]. Second, the network analysis included close to 100 scholars mostly with a long trajectory in the field, and this can be a limitation in representing more younger scientists or newcomers [ 2 ]. Future studies can focus on a larger number of scholars and apply different techniques in network analysis, such as other community detection techniques [e.g., 120 ]. Finally, the results of topic modeling suggested a solution of 10 topics out of up to 30 topics solution models tested. Although there is not a universally accepted approach to establish the number of topics, this study relied on several strategies, including ensemble learning, to automatically fine-tune the parameters of the machine learning algorithms, stability, and heuristic approaches [ 121 ]. Future studies can try other machine learning algorithms and techniques to retrieve topics [ 121 ].

In conclusion, this study analyzed 40 years of research on eating disorders, identified the most cited articles, networks of collaboration, experts in the field, and the 10 major topics in the field.

Supporting information

S1 file. most local cited documents..

https://doi.org/10.1371/journal.pone.0278981.s001

S2 File. Most global cited documents.

https://doi.org/10.1371/journal.pone.0278981.s002

S3 File. Network statistics.

https://doi.org/10.1371/journal.pone.0278981.s003

S4 File. Network of collaboration including close to one hundred authors.

https://doi.org/10.1371/journal.pone.0278981.s004

S5 File. Data preprocessing and text representation in Python.

https://doi.org/10.1371/journal.pone.0278981.s005

S6 File. Sum of NMF results for topic dominance per year and per topic.

https://doi.org/10.1371/journal.pone.0278981.s006

S7 File. Number of documents per year and per journal.

https://doi.org/10.1371/journal.pone.0278981.s007

S8 File. Trends over time in number of documents per journal.

https://doi.org/10.1371/journal.pone.0278981.s008

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• Letter to the Editor
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• Published: 16 June 2021

Transformative eating disorder research: qualitative research considerations

• Margaret G. Janse van Rensburg   ORCID: orcid.org/0000-0002-0780-7945 1  

Journal of Eating Disorders volume  9 , Article number:  72 ( 2021 ) Cite this article

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This letter identifies the potential of qualitative eating disorder research to work within a transformative paradigm that naturalizes the state of living with an eating disorder. The number of qualitative research publications with persons living with eating disorders have increased, however, a substantive proportion of this qualitative research follows traditional research paradigms that are built upon the assumption that eating disorders signify a personal deficit. Transformative qualitative eating disorder research has potential to include those living with eating disorders in all stages of the research process to ensure that research leads to the de-stigmatization of eating disorders promoting health, wellbeing, and quality of life for persons living with eating disorders.

In recent years there has been an increase in qualitative eating disorder research [ 1 ] which explores the experiences of persons living with eating disorders. However, a number of these studies struggle to grasp the importance of conducting qualitative research in natural settings [ 2 , 3 ]. Much of this qualitative research has also been grounded in traditional research paradigms, and therefore lack critical and emancipatory strategies, including discourse and discursive analyses, which may have transformative implications for bettering the lives of persons living with eating disorders. Qualitative research, as research in natural settings, should also seek to naturalize the state of living with an eating disorder, rather than using research to legitimize disparate treatment. This recognizes eating disorders as a natural phenomenon, a valid state of being, and promotes autonomy and self-determination surrounding treatment and recovery.

Historically, eating disorders have been positioned as individualised, being caused by personal deficits [ 1 , 2 , 4 ]. I, while taking part in eating disorder hospital programs and as a participant in an, an rTMS randomized control trial on bulimia, had my own data collected. These research opportunities were hopeful for myself, as they held potential for me to get better. However, they also personalized my issue, rather than acknowledged the structural and societal contributors to my eating disorder development and maintenance [ 5 ].

In my work with disabled and autistic Footnote 1 advocates, I have learned approaches to naturalize diversity, promoting inclusivity and acceptance in our society. However, the societal de-stigmatization efforts I encourage for those whom I work with have never extended to me, a woman living with an eating disorder. I am a member of a minority group, an over-researched population, a divergent body and mind. My differences, however, are a cause for concern, something to treat, cure, and eliminate. Yes, the health risks of eating disorders are real, however, I believe that traditional research which promotes the idea of individual deficit does not lead to transformative personal and societal outcomes bettering the lives of persons living with eating disorders.

Inspired by academics in the field of Critical Autism Studies [ 6 ], where autistic authors have begun to question the role of research in perpetuating stigma and power imbalances between autistic persons and a perceived normal [ 7 ]. I have begun to question the role of the dominant eating disorder research in stigmatizing my state of being. Informed by principles of community based participatory research [ 9 ], action research [ 10 ], and post-colonial theory [ 8 ], could qualitative eating disorder research occurring with, rather than on, persons living with eating disorders, lead to transformative outcomes?

I encourage future eating disorder researchers to involve stakeholders in their research [ 9 , 10 ], to recognize those who are researched as experts on their own lived experience [ 7 ] and to critically reflect on how research decisions may have the potential to perpetuate the stigmatization of the persons they aim to assist. Ways to address this are outlined in Table  1 .

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Walter Kaye and the UCSD Eating Disorders Research team have published over 250 papers on the neurobiology of eating disorders. These publications include behavioral, treatment, and cognitive neuroscience studies that have improved understanding of the clinical presentation, genetics, neurotransmitter systems, and neural substrates involved in appetite dysregulation and disordered eating. These studies are guiding the development of more effective, neurobiologically informed interventions.

• Change in motivational bias during treatment predicts outcome in anorexia nervosa
• Sophie R. Abber MS, Susan M. Murray PhD, Carina S. Brown MS, Christina E. Wierenga PhD
• doi: 10.1002/eat.24156. Epub 2024 February 01.
• Wiley Online Library
• The acceptability, feasibility, and possible benefits of a neurobiologically-informed 5-day multifamily treatment for adults with anorexia nervosa
• Christina E. Wierenga, Laura Hill, Stephanie Knatz Peck, Jason McCray, Laura Greathouse, Danika Peterson, Amber Scott, Ivan Eisler, Walter H. Kaye
• oi: 10.1002/eat.22876. Epub 2018 May 2.
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What Are Eating Disorders?

Reviewed by Psychology Today Staff

Eating disorders are psychological conditions characterized by unhealthy, obsessive, or disordered eating habits. Eating disorders come with both emotional and physical symptoms and include anorexia nervosa (voluntary starvation), bulimia nervosa (binge-eating followed by purging), binge-eating disorder (binge-eating without purging), and other or unspecified eating disorders (disordered eating patterns that do not fit into another category).

Eating disorders occur more frequently in affluent cultures than in non-affluent ones, but they are not exclusive to the well-off. A disproportionate number of those diagnosed are young women in their teens and 20s, but anyone—including young men and older adults of any gender —can develop an eating disorder. Eating disorders often become all-consuming, forcing the afflicted to focus on eating (or not eating) to the exclusion of much else in their life.

Biological factors, social and interpersonal pressures, and family history are some of the factors associated with eating disorders. Culturally mediated body-image concerns and personality traits like perfectionism and obsessiveness also play a large role in the disorders, which are often accompanied by depression or anxiety .

Treatment is rarely simple. Eating disorders may create additional medical problems and can even be acutely life-threatening, requiring hospitalization and forced nourishment. It often takes multidisciplinary teams of health professionals—including psychotherapists, medical doctors, and specialized dietitians or nutritionists—to bring about full recovery.

For more on eating disorders, see the Diagnosis Dictionary or find a treatment center near you.

Anorexia nervosa is an eating disorder marked by an extreme obsession with weight loss or exercise. It is especially prevalent among young to middle-aged women, and increasingly among young men, but it can affect anyone at any age.

Characterized by a distorted sense of body image and extreme voluntary starvation or overexercising—and closely associated with perfectionism and depression —it is the most deadly psychiatric disorder. The most common behavioral signs of anorexia include extreme dieting, obsessive food rituals, and secretive and antisocial behavior.

Anorexia is highly resistant to treatment and is often accompanied by anxiety and depression. Treatment may include cognitive behavioral therapy, medication , nutrition education and management , and family-based therapies, all of which may take place at specialized eating-disorder centers.

If the condition becomes life-threatening, the only recourse may be hospitalization with forced feeding, which may create ethical and legal dilemmas for all caregivers involved.

For more, see Anorexia Nervosa.

Bulimia nervosa is an eating disorder marked by frequent cycles of binge-eating excessive amounts of food, followed by purging. Purging is usually done by self-induced vomiting but may sometimes include the use of laxatives, diuretics, or non-purging compensatory behaviors, such as fasting or overexercising.

The disorder typically begins during adolescence , but it can also develop earlier or later. Regardless of age, it can be difficult to identify because those with bulimia are often secretive about their eating and purging habits. Although many people with bulimia are overweight, they generally have an intense fear of weight gain and often suffer anxiety, depression, and poor self-esteem .

Signs of bulimia include unusual eating behaviors, constant weight fluctuation, frequent use of the bathroom, and avoidance of social events. Treatment usually includes cognitive-behavioral or other forms of psychotherapy , antidepressant medication, and nutrition counseling.

For more, see Bulimia Nervosa.

Binge-eating disorder is marked by recurrent episodes of extreme overeating not accompanied by compensatory behavior; as a result, those with the disorder are often overweight or obese.

People with this disorder tend to eat much more rapidly than normal and don't stop until feeling uncomfortably full. They may consume large amounts of food even when they're not hungry. They often eat alone because of shame or embarrassment about their eating behaviors.

Many people experience occasional instances of overeating and may even "binge" from time to time. To be considered a disorder, then, these behaviors must occur at least two days a week for six months or more.

For more, see Binge-Eating Disorder.

Avoidant/restrictive food intake disorder is characterized by the avoidance or restriction of food. People with the condition may be uninterested in food—perhaps trying to avoid a negative experience they had in the past, or because they are unsettled by particular sensory characteristics of food, such as its smell or texture.

As a result, people with ARFID do not consume enough food or receive adequate nutrition. In contrast to anorexia, ARFID food constraints are not due to fears related to weight or body image.

For more, see ARFID (Avoidant Restrictive Food Intake Disorder).

Orthorexia is an eating disorder characterized by an obsession with healthy eating. People with orthorexia fixate on the purity of food and the ingredients within the food they prepare and consume, perhaps cutting out certain food groups or adhering to a strict diet. Orthorexia often involves rigid routines and the removal of pleasure and fulfillment from the experience of eating.

Orthorexia is not an official psychiatric diagnosis in the DSM-5 , but it is increasingly recognized and studied as a form of disordered eating.

For more, see Orthorexia.

Though anorexia, bulimia, and binge-eating disorder are the most well known, eating disorders encompass a number of other conditions, too. These include rumination disorder, pica, and others.

Rumination disorder is characterized by repeated regurgitation of food after eating, bringing previously swallowed food up into the mouth without displaying nausea, involuntary retching, or disgust. The food is typically then re-chewed and spit out or swallowed again.

Pica is a condition characterized by the eating of one or more nonnutritive, nonfood substances on a regular basis, such as paper, soap, or hair. Those with the disorder typically do not have an aversion to food in general.

Other eating disorders, such as night eating syndrome or atypical anorexia, may be classified under "other specified feeding and eating disorders" in the DSM-5.

For more, see Types of Eating Disorders.

Eating disorders involve disturbances in how individuals eat and perceive their body and weight. But those disturbances can manifest in very different ways. In some cases they can be obvious, such as dramatic weight loss or refusing to eat. In other cases they can be subtle, such as developing rigid routines around meals—only eating specific foods or at specific times—or beginning to exercise obsessively. Still in others, signs of the disorder can be hidden, such as going to the restroom after meals in the case of bulimia or eating in private in the case of binge-eating disorder.

Mental health symptoms can also emerge from or be exacerbated by the condition. People with eating disorders may become more withdrawn, avoiding people or activities they previously enjoyed, or they may struggle with mood swings and anxiety. Although it can be difficult to discuss, recognizing an eating disorder early on can help the person seek the help they need to recover.

For more, see Signs and Symptoms of Eating Disorders .

There is no single cause of any eating disorder. It's not yet understood why ostensibly voluntary behaviors associated with eating turn into disorders for some people but not for others.

A disturbed relationship with food and a sense of emotional fragility are hallmarks of all eating disorders. Eating disorders typically start out unnoticed––a person eats a little more or a little less food than usual. The urge to eat more or to eat less becomes increasingly compelling until it can become the focus of a person's existence.

Biology also plays a role. Appetite control and the regulation of food intake is highly complex, with many hormones in the brain and the body signaling hunger and satiety. Evidence also suggests that eating disorders have genetic roots.

Culture is thought to also play a significant role, as people—women especially—are pressured to fit an ideal of beauty that is largely defined by weight.

Other circumstances factor in, too; the conditions can be triggered by stress , social difficulty, loneliness , depression, trauma , or by dieting itself.

For more, see What Causes Eating Disorders?

It can take a long time—sometimes years or decades—for people with an eating disorder to decide to seek help. When they do, there are numerous treatment options that can help them recover.

People with eating disorders often receive outpatient treatment, but severe cases may require hospitalization or treatment at an inpatient facility. Treatment involves a physician, a psychologist, and a nutritionist to address the different elements of the illness. Therapies for eating disorders of any type include cognitive behavioral therapy, and a version tailored to eating disorders called enhanced cognitive behavioral therapy, as well as family-based treatment.

For more, see How Are Eating Disorders Treated?

Recovering from an eating disorder can be a long and winding road. And once in recovery, people must continue to observe and adapt to prevent setbacks and relapses . Treatment can provide the necessary skills to do that.

In concrete terms, recovery means that a person no longer meets the diagnostic criteria for an eating disorder, that they have healed both physically and emotionally. That experience will be different for everyone, as they develop a personalized approach to treatment, eating habits, social support, and coping skills.

For more, see The Recovery Process.

Watching a child suffer through an eating disorder can be deeply upsetting. Parents shouldn’t blame themselves for the development of the disorder, but they can take steps to provide support and help their child heal.

Different stages of the process require different actions. Those steps might include recognizing the signs of a disorder, learning about the illness, discussing it with the child, and encouraging them to seek treatment.

For more, see Parenting a Child with an Eating Disorder.

Research shows that what you eat can improve your well-being. But that doesn’t mean a new fad diet is the way to get those benefits. 

Calorie counting and negativity around numbers can spiral into disordered eating; considering a “New Math” approach can shift your perspective in a mindful, meaningful way.

Shifting our often unspoken scripts during or before recovery from anorexia can help dissolve the fear of “she let herself go” and lean into the subversion of letting go.

How easily do images of “letting go” come to mind for you? What does it mean to let your life be changed by them rather than by the “letting yourself go” alternatives?

How viewing oneself can improve self-image.

What does the phrase “she really let herself go” conjure up for you? What might it be preventing you from doing in your life right now?

How and why obesity and being overweight may be caused by addiction-like behavior with food.

Do you ever eat too much or wonder if you are "addicted" to food? This is how and why this happens, and how you can overcome cravings.

While chatbots offer potential benefits like affordability and increased access to therapy, there are significant challenges.

Teenagers and young adults offer clarity on the issues that cause depression and anxiety in their agemates, and the strategies that can help them cope most effectively. Social media plays a unique role in these strategies.

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Understanding what emotional intelligence looks like and the steps needed to improve it could light a path to a more emotionally adept world.

• Coronavirus Disease 2019
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• Neuroscience

Thesis Helpers

Find the best tips and advice to improve your writing. Or, have a top expert write your paper.

154 In Depth Eating Disorder Research Topics For Your Dissertation

Before you get started on potential eating disorder thesis or dissertation ideas, you should first know what eating disorder means. Eating disorder is a behavioral condition that patterns consistent uneasiness when it comes to eating.

It is associated with uncomfortable thoughts and emotions and it could affect the physiological, psychological, and social function of the body. Eating disorders cut across bulimia, avoidant restrictive food intake disorder, binge eating disorder, anorexia nervosa, and many other areas. Writing a comprehensive eating disorder thesis or dissertation requires dissecting any of these types of eating disorders.

Characteristics Of A Good Thesis Research Paper

Before your eating disorder thesis paper can be termed perfect for your essay or research study, these are the necessary things that must be present in the paper.

• Top-Notch Research: Your work will cover real-life data and examples which must be true. Researching is a rigorous effort that could get you discouraged. However, you must focus on providing a comprehensive and reliable paper for future references. You must also be knowledgeable to embody basic features which you’ll need to show that you’re a skilled researcher.
• Accurate Analysis: When you analyze an existing literature, ensure to achieve accuracy. You will need to establish hypotheses but you must reference authority literature to back them up. When your facts are wrong, they could disapprove of everything you’ve written in your paper. Thus, you must review all you write to ensure that you’re still on the right path.
• Clear and Precise: You want to communicate with people, not flex your vocabulary prowess. If you want to achieve clarity, write in simple language. You should also consider adding only relevant details to your paper. This will help you avoid unnecessary detailing and explanation of scientific terms.
• Original and Coherent: While your paper can contain studies from other authors, you must ensure that you credit them. You must also ensure that you input your thoughts into what you write. Doing this makes you possess the good qualities of a trustworthy and reliable researcher. You must not compromise on originality, and you must also be coherent with your writing.

All these will help you create a detailed and well-constructed research paper on eating disorders.

Research Questions About Eating Disorders

As you already know, eating disorders are behavioral challenges when it comes to feeding. It manifests in different ways and it affects people.

To create interesting research on eating disorders, you may need research questions about eating disorders. Questions to consider include:

• What does eating disorder mean professionally?
• What is the rate at which eating disorders occur to people?
• What are the main factors leading to eating disorders?
• Does an individual personality trait has any influence on the person’s eating disorder?
• How does individual personality trait affect eating disorders?
• Examining anorexia nervosa and bulimia: what are the basic differences?
• What is the treatment for people suffering from eating disorders?
• How do eating disorders manifest amongst people?
• What is the leading treatment to solve the challenge of eating disorders?
• What is the most effective potentiality of recovery?
• Are there any factors that determine recovery potentiality and rate?
• Would it be better to address the symptoms over the problems of eating disorders?
• Would it be effective to offer treatments rather than provide advice to manage them?
• Does treatment for eating disorders mean therapy?
• What are the risks patients might face?
• What are the guidelines for health officials on eating disorders?

Eating Disorders Research Paper

As a student of research, exercising your writing abilities is one of the requirements for graduate certification. Your professors and teachers at university and college want to know what you can produce.

These are significant current eating disorder research topics that can aid in identifying the issues to target in today’s world:

• Evaluate the factors leading to bulimia amongst teenagers
• Examine the means to prevent and correct anorexia nervosa amongst teenagers
• Discuss why the diagnosis of anorexia is significant amongst youngsters
• Evaluate the mental consequence of bulimia amongst kids
• Examine the physical Influence of bulimia amongst kids
• Observe bulimia from the position of a psychologist
• Examine the significance of parents in helping prevent eating disorders
• Examine the category of children who are susceptible to anorexia nervosa and bulimia
• Examine the long-term consequence of anorexia and bulimia on kids
• Examine the Influence of society and family with kids overwhelmed by eating disorders
• Discuss how anorexia and bulimia will affect the social lifestyle of kids
• Examine how anorexia nervosa and bulimia will influence the emotions and attitudes of kids towards others
• Examine how TV shows and other public communication networks can help change children’s disorders
• Examine the fundamental basis of eating disorders amongst people
• Discuss the possibilities of eating disorders amongst private school students that public schools
• Examine the events of self-injurious in the lens of eating disorders
• Discuss the major things that help in curbing eating disorders
• Examine any five pieces of literature related to the eating disorder and their relevance to current discussions
• Examine various standpoints of different scholars on their subject as well their significance
• Discuss the role of intimidation in worsening eating disorder conditions
• Examine a calorie program to know the effect of eating disorders on children’s weight
• Research to know the statistics of those affected by stunted eating culture
• Discuss how sleeping disorder connects with eating disorders
• Examine the core biological features of a sleeping disorder and compare it with an eating disorder
• Critically discuss Night Eating Syndrome (NES)
• Does eating disorder less to substance abuse? Discuss
• Discuss whether stopping addictive habits will help with eating disorders
• Examine is vegetarianism has a role to play in eating disorder
• Examine how the tension in sport could lead to eating disorders
• Would you say that hereditary factors are considerations for eating disorders?
• Discuss the importance of body fat to eating disorder
• Examine the effects of eating contemplation on eating disorders
• Discuss how sex abuse connects with eating disorders
• Examine the major hunger drive leading to eating disorders
• Does the lack of required food lead to eating disorders: discuss
• Examine the influence of obesity patterning o eating disorder
• Listen to the story of any victim and analyze what caused their eating disorder
• Discuss the way experiences and thought can shape eating desires.

Research Topics On Eating Disorders

For your undergraduate or college research, you can pursue in-depth research into eating disorders. Eating disorders could be considered biological and psychological issues.

You can consider the following research topics in eating disorders:

• Examine how the symptoms of anorexia and bulimia overlap
• Discuss the basic psychological makeup of eating disorder
• Discuss the pursuit of perfectionism and how it enhances a behavior of the eating disorder
• Examine the need for psychotherapy to help eating disorder patients
• Discuss the eating disorder by assessing the intellectual impairment of the patients
• Discuss the complex nature of eating disorders leading to suicide amongst kids
• Examine the high risk of suicide rate amongst those with bulimia and anorexia and why
• Discuss the variations interconnected with anorexia therapy
• Would you say unhappiness and physical shame about the body worsens bulimia and anorexia?
• Would you say their disappointment and discontent about other things lead to anorexia and bulimia?
• Critically examine Nasser, Katzman, and Gordon’s ‘Eating Disorders: People in Transition’
• Discuss Janet’s book titled ‘Skills-Based Learning with regard to Caring for a family member with an Eating Disorder: The New Maudsley Method’ and its significance
• Examine the paths to healing as established by Alexander Lucas in ‘Demystifying Boeing underweight Nervosa: An Optimistic Guide to Knowledge and Healing’
• Observe the perspectives of Sharlene and how thinness affects eating disorders in ‘Am I Thin A Sufficient Amount of Yet? The very cult associated with thinness and also the Commercialization for Identity’
• Discuss Carrie Arnold’s ‘Decoding Anorexia’
• Critically discuss A.M. Logue’s ‘The Mindset of Taking and Drinking’
• Examine how obesity contributes to eating disorders as noted in Linda Smolak et al’s ‘Body Photo, Eating Disorders, in addition to Obesity around Youth: Analysis, Prevention, and also Treatment’
• Discuss the importance of diagnosis to the condition through the lens of Kevin Thompson et al’s ‘Exacting Splendor: Theory, Diagnosis, and Treatment of Body Image Disturbance’
• Evaluate how subconscious features of bulimia and anorexia develop amongst girls
• Discuss the main features of anorexia amongst female athletes
• Examine the factors that could hinder recovery
• Discuss why women of any age are more prone to eating disorders than men
• Discuss the odds of eating disorder through the epidermis
• Examine the symptoms of bulimia and anorexia amongst men
• Evaluate the symptoms of anorexia and bulimia amongst women
• Do you think diagnosis for anorexia are often underrated?
• Discuss the factors that shape the future of a patient’s eating disorder
• After identifying the disorder, what do most patients do?
• Examine the connection of disinterest in sex to eating disorders
• Does eating disorder affect any group of people more?
• Examine the consequences of eating disorders on the LGBTQ community
• Examine the major differences in eating disorders amongst male and female military personnel
• How do anorexia and bulimia affect women libido?
• Examine the design models and risks of eating disorders
• Discuss the process of medical diagnosis
• Examine possible solutions to eating disorders
• Discuss the risks of eating disorders
• Choose any three lifestyles and examine how eating disorders would affect patients with such lifestyle
• Examine the tactics patients use to evade therapy
• Do you think the work on decoding eating disorders is done?

Thesis About Eating Disorders

Systems of treating eating disorders could be considered controversial but interesting submissions from doctors and officials about eating disorders could be helpful in your research. Consider the following custom ideas and expand them in your thesis statement or research:

• Discuss with three doctors within your institution and know their take on eating disorder
• Speak with three doctors outside your Institution and know their take on eating disorders
• Identify the influence on dieting on eating disorder
• Identify the influence of weight loss on eating disorders
• Discuss the influence of eating disorders on academics
• Discuss the treatments of Ayahuasca
• What are eating disorder treatment techniques based on?
• What are the institutional positions on eating disorders?
• Discuss the role of the family in treating eating disorders
• Examine the role of friends in treating eating disorders
• Discuss the significance of health insurance in eating disorder
• Evaluate the issues that complicate bulimia and anorexia
• Examine the factors that ruin chances of hastening to heal
• Go through the medical report of any patient with bulimia and analyze it
• Go through the medical report of a patient with anorexia and analyze it
• Get a chance to sit in therapy with a patient with anorexia and examine their response habits
• Examine the response habit of a patient with bulimia in therapy
• Discuss how productive therapy sessions could be
• Identify the importance of support groups for eating disorder patients
• Discuss the purpose of support groups for eating disorder patients using any two examples
• Does the loss of appetite connect with eating disorders?
• Will eating Disorder be managed, not cured?
• What are the latest scientific breakthroughs on eating disorders?
• What is Virtual Reality Graded Exposure Therapy (VRGET) all about?
• Examine the Influence of culture on eating disorders
• Examine the influence of bullying on eating disorders
• Discuss the Influence of internet threats on eating disorders
• Examine how western culture react to bulimia
• Discuss how western communities react to anorexia
• Examine the trends of eating disorders from over 50 years
• How do major ethnic groups react to eating disorders?
• Discuss how publicity of eating disorder help people open up about it.

Review the following books:

• Lauren Greenfield’s ‘Thin’
• Jenni Schaefer’s ‘Life Without Impotence: How An individual Woman Stated Independence Right from Her Eating Disorder and How It is possible to Too’.
• Marya Hornbacher’s ‘Wasted: A Memoir of Anorexia nervosa and Bulimia’
• Sarah Dessen’s ‘Just Listen’
• Herriet Brown’s ‘Brave Girl Eating: A new Family’s Tom Anorexia’
• Ellen Hopkins’ ‘Identical’
• Bev Mattocks’ ‘Please Eat…: A Single Parent’s Struggle to 100 % free Her Teenage Son Through Anorexia’
• Nancy Tucker’s ‘The Amount of Time in Between: A good Memoir connected with Hunger in addition to Hope’.

Eating Disorder Body Image Research Topics

Body image disorder or body dysmorphic disorder is the consistent worry over appearance. This could be obsessing over weight gain or weight loss which lead to greater health challenges.

To discuss this, you can consider these topics:

• Evaluate the examples of body image challenges
• Discuss the connection between body image issues and depression
• Discuss the connection between anorexia and body image issues
• How do body image disturbances emerge?
• Examine the effects of eating habits on body image
• Discuss how the concern of others affect obese people
• Examine how the worry and anxiety of relatives affect thin people
• Examine three records of those with body image disorder and understand the motivating factors
• Discuss the motivating factors behind poor dieting
• Examine the negative outcome of diets
• Examine how staying hungry affect patients with eating disorders
• What are the cons of disordered eating
• Discuss the relationship of love in reducing negative image perception
• Examine how unhealthy eating habit affects mental health
• Discuss how unhealthy eating habits influence decision-making processes
• How does negative body image affect teenagers?
• How does negative body image affect adults?
• How do parents impose negative body image on kids?
• Examine the consequence of bad comments on kids with obesity
• Examine the nexus between bullying and unhealthy eating habits.

Don’t Want To Do Research?

To earn top marks, you can create a high-quality paper with these eating disorder research topics. However, you can still earn your top marks by applying for thesis help from knowledgeable writers.

We are a reliable team of thesis writers with professors, teachers, and skilled researchers based online. You can hire us for your graduate, undergraduate, or college assignments and papers. Any specifications are doable for us, including a medical thesis writing service .

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List of 122 Eating Disorder Research Topics

Are you looking for some eating disorder research topics that you can use as your own? Of course, you are! Otherwise, why would you be reading this blog post? Well, the good news is that we have just what you are looking for right here on this page.

No, you don’t have to download anything. You don’t have to pay anything either. All our 122 eating disorder research topics are free to use as you see fit. We have just finished updating the list, so you can find unique topics that are entirely original. Nobody in your class has probably found them, so you’re safe.

Best Eating Disorder Research Topics on the Internet

Every student should focus on studying or learning for his terms or exams. However, hunting for eating disorder research topics can take hours – if not days. You probably don’t have so much free time on your hands. This is why, if you need to write an eating disorders research paper, you should first visit our blog. You will find that our topics are the best on the Internet. Also, here is what you get if you visit our page periodically:

Our list of topics is updated relatively frequently, so you will probably be able to get an original topic right here in just a couple of minutes. All our topics are relatively easy to write about. You can find plenty of information online about 99% of these topics. You will never have to pay anything to get topics. They are all free. You are also free to reword them to suit your needs. You can get a list of new topics from our expert writers if you can’t find what you are looking for on this page.

So, let’s take a look at our list of the latest and most interesting eating disorder research topics.

Anorexia Research Paper Ideas

Talking about anorexia may not be the easiest thing in the world, but we have some anorexia research paper ideas that are not that complicated right here:

• What causes anorexia in children?
• The 3 most effective anorexia nervosa treatments
• How do affected people perceive their anorexia?
• Physical effects of anorexia nervosa
• Psychological effects of anorexia
• The ethics behind the nasogastric tube treatment
• The link between anorexia and infertility
• The link between osteoporosis
• The link between anorexia and heart damage
• Cultural factors that influence the occurrence of anorexia
• Does anorexia cause depression?
• Anorexia nervosa in evolutionary psychiatry

Eating Disorders Research Paper Topics

Have you been asked by your professor to write a research paper on an eating disorder or related subject? Check out these unique eating disorders research paper topics:

• Best screening tools for eating disorders
• Compare and contrast 2 eating disorders
• Discuss eating disorders to social media
• A short history of eating disorders
• How can one achieve body positivity?
• Most interesting myths about eating disorders
• Differences between bulimia and anorexia
• What causes the relapse of eating disorders?
• The epidemic of anorexia in the United States
• Mass media’s effect on body image in the UK
• Gender role in eating disorders

Children Eating Disorders

We can guarantee that if you write about children eating disorders, you will capture the attention of your professor from the first two sentences. Give these topics a try:

• Self-injury in children with anorexia
• Occurrence of bulimia nervosa in adolescents
• Treating autistic children with anorexia
• What causes eating disorders among children in the US?
• Correcting children’s eating disorders in the United Kingdom
• Preventing relapses in young children
• The developmental psychology behind eating disorders
• Mental development problems in children with anorexia
• Successful parenting to prevent the occurrence of anorexia
• Television and its effects on self-esteem
• The link between fat-shaming and anorexia

Top Questions About Eating Disorders

Wondering what are the top questions about eating disorders today? Our experts have compiled them in an original list of questions below:

• What factors influence complete recovery for eating disorders?
• Can we develop personalized treatments for each patient?
• Should the symptoms be treated first?
• What chances does a person with co-morbidities have to survive an episode of anorexia?
• Which type of treatment offers the best chances of complete recovery?
• What can parents do to help children with anorexia?
• What are the risk factors that lead to bulimia nervosa?
• What causes self-harm in patients with anorexia?
• Why are eating disorders on the rise in developed countries?

Binge Eating Disorder Topics

Yes, binge eating is a very serious eating disorder. So why now write an essay about it? Check out these interesting binge eating disorder topics and pick the one you like:

• The social problems associated with binge eating
• The psychological problems caused by binge eating
• Physical issues caused by the binge eating disorder
• Differences between binge eating and bulimia
• Differences between binge eating and anorexia nervosa
• Prevalence of binge eating in healthy adults in the US
• Underreporting problems in the male population
• Benefits of counseling
• Surgery affects on binge eating
• Best lifestyle interventions in cases of binge eating
• Effective medication against binge eating disorders

Eating Disorder Topics for College

If you are a college student, you need a more complex topic to win a top grade. Take a look at these great eating disorder topics for college and take your pick:

• Household income effects on bulimia incidence
• The accuracy of the Eating Disorder Examination
• Effects of anorexia on the reproductive system
• An in-depth analysis of the refeeding syndrome
• Using hypnotherapy to treat bulimia nervosa
• The effect of selective serotonin reuptake inhibitor on binge eating
• Using olanzapine in anorexia nervosa cases
• Cognitive-behavioral therapy for binge eating
• The mortality rate of anorexia nervosa patients
• The effects of fluoxetine on bulimia nervosa patients
• The role of antidepressants in treating bulimia

Complex Eating Disorder Research Topics

If you want to impress your professor and awe your classmates, you may need to consider picking a topic from our list of complex eating disorder research topics below:

• Discuss physical morbidity caused by eating disorders
• The first documented case of anorexia nervosa
• An in-depth look at eating disorder psychosocial morbidity
• Binge eating in the Roman society
• Effective methods for eating recovery
• Sports effects on the occurrence of bulimia nervosa
• Bulimia nervosa in the 18th century
• Analyze the accuracy of the Anorectic Behavior Observation Scale
• An in-depth look at evolutionary psychiatry
• Topiramate and zonisamide for treating binge eating
• Using anti-obesity medications for bulimia and binge eating

Bulimia Nervosa Essay Topics

Of course, you can write an essay about bulimia nervosa or something related to it. Let’s help you with some bulimia nervosa essay topics:

• 5 lesser-known facts about bulimia
• Famous people who had bulimia
• The psychological consequences of bulimia
• Physical effects of bulimia nervosa
• Gender’s role in the bulimia nervosa disorder
• Effective methods to diagnose bulimia
• Effective treatments against bulimia nervosa
• First symptoms of bulimia
• Incidence of bulimia cases among children in the US
• Can willpower alone treat bulimia nervosa?

Eating Disorder Research Topics in Nursing

If you are a nursing student (or are attending a nursing class), you may find these eating disorder research topics in nursing highly interesting:

• Nursing’s role in eating disorder recovery
• Discuss nursing best practices when dealing with anorexia
• Nursing techniques for patients with bulimia
• Treating the symptoms of anorexia nervosa effectively

Treatments for Eating Disorders

Your professor will surely appreciate you taking the time to research various treatments for eating disorders. You may get some bonus points if you use one of these topics:

• The best treatment for bulimia nervosa
• A universal treatment for all eating disorders
• Medications that are effective against the binge eating disorder
• Talk about the use of hypnosis to treat eating disorders
• Discuss the cure rate for anorexia nervosa

Anorexia Nervosa Research Paper Topics

Did you run out of ideas for your eating disorder research paper? No problem, just check out the following anorexia nervosa research paper topics and pick the one you like:

• First symptoms and manifestations of anorexia nervosa
• Is anorexia nervosa contagious?
• Genetic transmission of the anorexia nervosa disorder
• Risk factors that influence anorexia nervosa in the United States
• Effective medication for the anorexia nervosa disorder

Gender Issues and Eating Disorders

Yes, there are many gender issues that you can talk about when it comes to eating disorders. We have an entire list of gender issues and eating disorders ideas right here for you:

• The gender with the highest rates of eating disorders
• Men and their struggle with anorexia nervosa
• Gender issues that make diagnosis difficult
• Mortality rates of eating disorders by gender
• Stereotypes related to eating disorders

Easy Eating Disorder Research Topics

These easy eating disorder research topics are for students who don’t want to spend days doing the research and writing the essay:

• What causes bulimia?
• Psychiatric help for eating disorder patients
• Effective medications that prevent anorexia episodes
• What causes anorexia nervosa?
• How can the binge eating disorder be treated effectively?
• Psychological problems caused by eating disorders

Controversial Eating Disorder Research Topics

Take a look at some controversial eating disorder research topics and pick one. Probably nobody in your school has even thought about writing a paper on any of these ideas:

• Anorexia Nervosa portrayal in the media in the United States
• Forced therapy in eating disorders in Eastern Europe
• Negative social media effects on the treatment of eating disorders
• False positives when diagnosing people with eating disorders
• Palliative care for people with anorexia and co-morbidities

Eating Disorder Topics for High School

If you are a high school student, you will be thrilled to learn that we have some very simple topics about eating disorders. Check out our list of eating disorder topics for high school students:

• An in-depth analysis of anorexia nervosa
• The history of binge eating in the United States
• Effective treatment options for bulimia nervosa
• The best way to diagnose an eating disorder
• The role of the family in treating eating disorders
• Dangerous medications used to treat eating disorders

Need Writing Help for a Top Grade?

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80 fascinating psychology research questions for your next project

Last updated

15 February 2024

Reviewed by

Brittany Ferri, PhD, OTR/L

Psychology research is essential for furthering our understanding of human behavior and improving the diagnosis and treatment of psychological conditions.

When psychologists know more about how different social and cultural factors influence how humans act, think, and feel, they can recommend improvements to practices in areas such as education, sport, healthcare, and law enforcement.

Below, you will find 80 research question examples across 16 branches of psychology. First, though, let’s look at some tips to help you select a suitable research topic.

• How to choose a good psychology research topic

Psychology has many branches that break down further into topics. Choosing a topic for your psychology research paper can be daunting because there are so many to choose from. It’s an important choice, as the topic you select will open up a range of questions to explore.

The tips below can help you find a psychology research topic that suits your skills and interests.

Tip #1: Select a topic that interests you

Passion and interest should fuel every research project. A topic that fascinates you will most likely interest others as well. Think about the questions you and others might have and decide on the issues that matter most. Draw on your own interests, but also keep your research topical and relevant to others.

Don’t limit yourself to a topic that you already know about. Instead, choose one that will make you want to know more and dig deeper. This will keep you motivated and excited about your research.

Tip #2: Choose a topic with a manageable scope

If your topic is too broad, you can get overwhelmed by the amount of information available and have trouble maintaining focus. On the other hand, you may find it difficult to find enough information if you choose a topic that is too narrow.

To determine if the topic is too broad or too narrow, start researching as early as possible. If you find there’s an overwhelming amount of research material, you’ll probably need to narrow the topic down. For example, instead of researching the general population, it might be easier to focus on a specific age group. Ask yourself what area of the general topic interests you most and focus on that.

If your scope is too narrow, try to generalize or focus on a larger related topic. Expand your search criteria or select additional databases for information. Consider if the topic is too new to have much information published on it as well.

Tip #3: Select a topic that will produce useful and relevant insights

Doing some preliminary research will reveal any existing research on the topic. If there is existing research, will you be able to produce new insights? You might need to focus on a different area or see if the existing research has limitations that you can overcome.

Bear in mind that finding new information from which to draw fresh insights may be impossible if your topic has been over-researched.

You’ll also need to consider whether your topic is relevant to current trends and needs. For example, researching psychology topics related to social media use may be highly relevant today.

• 80 psychology research topics and questions

Psychology is a broad subject with many branches and potential areas of study. Here are some of them:

Developmental

Personality

Experimental

Organizational

Educational

Neuropsychology

Controversial topics

Below we offer some suggestions on research topics and questions that can get you started. Keep in mind that these are not all-inclusive but should be personalized to fit the theme of your paper.

Social psychology research topics and questions

Social psychology has roots as far back as the 18th century. In simple terms, it’s the study of how behavior is influenced by the presence and behavior of others. It is the science of finding out who we are, who we think we are, and how our perceptions affect ourselves and others. It looks at personalities, relationships, and group behavior.

Here are some potential research questions and paper titles for this topic:

How does social media use impact perceptions of body image in male adolescents?

2. Is childhood bullying a risk factor for social anxiety in adults?

Is homophobia in individuals caused by genetic or environmental factors?

What is the most important psychological predictor of a person’s willingness to donate to charity?

Does a person’s height impact how other people perceive them? If so, how?

Cognitive psychology research questions

Cognitive psychology is the branch that focuses on the interactions of thinking, emotion, creativity, and problem-solving. It also explores the reasons humans think the way they do.

This topic involves exploring how people think by measuring intelligence, thoughts, and cognition. 

Here are some research question ideas:

6. Is there a link between chronic stress and memory function?

7. Can certain kinds of music trigger memories in people with memory loss?

8. Do remote meetings impact the efficacy of team decision-making?

9. Do word games and puzzles slow cognitive decline in adults over the age of 80?

10. Does watching television impact a child’s reading ability?

Developmental psychology research questions

Developmental psychology is the study of how humans grow and change over their lifespan. It usually focuses on the social, emotional, and physical development of babies and children, though it can apply to people of all ages. Developmental psychology is important for understanding how we learn, mature, and adapt to changes.

Here are some questions that might inspire your research:

11. Does grief accelerate the aging process?

12. How do parent–child attachment patterns influence the development of emotion regulation in teenagers?

13. Does bilingualism affect cognitive decline in adults over the age of 70?

14. How does the transition to adulthood impact decision-making abilities

15. How does early exposure to music impact mental health and well-being in school-aged children?

Personality psychology research questions

Personality psychology studies personalities, how they develop, their structures, and the processes that define them. It looks at intelligence, disposition, moral beliefs, thoughts, and reactions.

The goal of this branch of psychology is to scientifically interpret the way personality patterns manifest into an individual’s behaviors. Here are some example research questions:

16. Nature vs. nurture: Which impacts personality development the most?

17. The role of genetics on personality: Does an adopted child take on their biological parents’ personality traits?

18. How do personality traits influence leadership styles and effectiveness in organizational settings?

19. Is there a relationship between an individual’s personality and mental health?

20. Can a chronic illness affect your personality?

Abnormal psychology research questions

As the name suggests, abnormal psychology is a branch that focuses on abnormal behavior and psychopathology (the scientific study of mental illness or disorders).

Abnormal behavior can be challenging to define. Who decides what is “normal”? As such, psychologists in this area focus on the level of distress that certain behaviors may cause, although this typically involves studying mental health conditions such as depression, obsessive-compulsive disorder (OCD), and phobias.

Here are some questions to consider:

21. How does technology impact the development of social anxiety disorder?

22. What are the factors behind the rising incidence of eating disorders in adolescents?

23. Are mindfulness-based interventions effective in the treatment of PTSD?

24. Is there a connection between depression and gambling addiction?

25. Can physical trauma cause psychopathy?

Clinical psychology research questions

Clinical psychology deals with assessing and treating mental illness or abnormal or psychiatric behaviors. It differs from abnormal psychology in that it focuses more on treatments and clinical aspects, while abnormal psychology is more behavioral focused.

This is a specialty area that provides care and treatment for complex mental health conditions. This can include treatment, not only for individuals but for couples, families, and other groups. Clinical psychology also supports communities, conducts research, and offers training to promote mental health. This category is very broad, so there are lots of topics to explore.

Below are some example research questions to consider:

26. Do criminals require more specific therapies or interventions?

27. How effective are selective serotonin reuptake inhibitors in treating mental health disorders?

28. Are there any disadvantages to humanistic therapy?

29. Can group therapy be more beneficial than one-on-one therapy sessions?

30. What are the factors to consider when selecting the right treatment plan for patients with anxiety?

Experimental psychology research questions

Experimental psychology deals with studies that can prove or disprove a hypothesis. Psychologists in this field use scientific methods to collect data on basic psychological processes such as memory, cognition, and learning. They use this data to test the whys and hows of behavior and how outside factors influence its creation.

Areas of interest in this branch relate to perception, memory, emotion, and sensation. The below are example questions that could inspire your own research:

31. Do male or female parents/carers have a more calming influence on children?

32. Will your preference for a genre of music increase the more you listen to it?

33. What are the psychological effects of posting on social media vs. not posting?

34. How is productivity affected by social connection?

35. Is cheating contagious?

Organizational psychology research questions

Organizational psychology studies human behavior in the workplace. It is most frequently used to evaluate an employee, group, or a company’s organizational dynamics. Researchers aim to isolate issues and identify solutions.

This area of study can be beneficial to both employees and employers since the goal is to improve the overall work environment and experience. Researchers apply psychological principles and findings to recommend improvements in performance, communication, job satisfaction, and safety. 

Some potential research questions include the following:

36. How do different leadership styles affect employee morale?

37. Do longer lunch breaks boost employee productivity?

38. Is gender an antecedent to workplace stress?

39. What is the most effective way to promote work–life balance among employees?

40. How do different organizational structures impact the effectiveness of communication, decision-making, and productivity?

Forensic psychology research questions

Some questions to consider exploring in this branch of psychology are:

41. How does incarceration affect mental health?

42. Is childhood trauma a driver for criminal behavior during adulthood?

43. Are people with mental health conditions more likely to be victims of crimes?

44. What are the drivers of false memories, and how do they impact the justice system?

45. Is the media responsible for copycat crimes?

Educational psychology research questions

Educational psychology studies children in an educational setting. It covers topics like teaching methods, aptitude assessment, self-motivation, technology, and parental involvement.

Research in this field of psychology is vital for understanding and optimizing learning processes. It informs educators about cognitive development, learning styles, and effective teaching strategies.

Here are some example research questions:

46. Are different teaching styles more beneficial for children at different times of the day?

47. Can listening to classical music regularly increase a student’s test scores?

48. Is there a connection between sugar consumption and knowledge retention in students?

49. Does sleep duration and quality impact academic performance?

50. Does daily meditation at school influence students’ academic performance and mental health?

Sports psychology research question examples

Sport psychology aims to optimize physical performance and well-being in athletes by using cognitive and behavioral practices and interventions. Some methods include counseling, training, and clinical interventions.

Research in this area is important because it can improve team and individual performance, resilience, motivation, confidence, and overall well-being

Here are some research question ideas for you to consider:

51. How can a famous coach affect a team’s performance?

52. How can athletes control negative emotions in violent or high-contact sports?

53. How does using social media impact an athlete’s performance and well-being?

54. Can psychological interventions help with injury rehabilitation?

55. How can mindfulness practices boost sports performance?

Cultural psychology research question examples

The premise of this branch of psychology is that mind and culture are inseparable. In other words, people are shaped by their cultures, and their cultures are shaped by them. This can be a complex interaction.

Cultural psychology is vital as it explores how cultural context shapes individuals’ thoughts, behaviors, and perceptions. It provides insights into diverse perspectives, promoting cross-cultural understanding and reducing biases.

Here are some ideas that you might consider researching:

56. Are there cultural differences in how people perceive and deal with pain?

57. Are different cultures at increased risk of developing mental health conditions?

58. Are there cultural differences in coping strategies for stress?

59. Do our different cultures shape our personalities?

60. How does multi-generational culture influence family values and structure?

Health psychology research question examples

Health psychology is a crucial field of study. Understanding how psychological factors influence health behaviors, adherence to medical treatments, and overall wellness enables health experts to develop effective interventions and preventive measures, ultimately improving health outcomes.

Health psychology also aids in managing stress, promoting healthy behaviors, and optimizing mental health, fostering a holistic approach to well-being.

Here are five ideas to inspire research in this field:

61. How can health psychology interventions improve lifestyle behaviors to prevent cardiovascular diseases?

62. What role do social norms play in vaping among adolescents?

63. What role do personality traits play in the development and management of chronic pain conditions?

64. How do cultural beliefs and attitudes influence health-seeking behaviors in diverse populations?

65. What are the psychological factors influencing the adherence to preventive health behaviors, such as vaccination and regular screenings?

Neuropsychology research paper question examples

Neuropsychology research explores how a person’s cognition and behavior are related to their brain and nervous system. Researchers aim to advance the diagnosis and treatment of behavioral and cognitive effects of neurological disorders.

Researchers may work with children facing learning or developmental challenges, or with adults with declining cognitive abilities. They may also focus on injuries or illnesses of the brain, such as traumatic brain injuries, to determine the effect on cognitive and behavioral functions.

Neuropsychology informs diagnosis and treatment strategies for conditions such as dementia, traumatic brain injuries, and psychiatric disorders. Understanding the neural basis of behavior enhances our ability to optimize cognitive functioning, rehabilitate people with brain injuries, and improve patient care.

Here are some example research questions to consider:

66. How do neurotransmitter imbalances in specific brain regions contribute to mood disorders such as depression?

67. How can a traumatic brain injury affect memory?

68. What neural processes underlie attention deficits in people with ADHD?

69. Do medications affect the brain differently after a traumatic brain injury?

70. What are the behavioral effects of prolonged brain swelling?

Psychology of religion research question examples

The psychology of religion is a field that studies the interplay between belief systems, spirituality, and mental well-being. It explores the application of the psychological methods and interpretive frameworks of religious traditions and how they relate to both religious and non-religious people.

Psychology of religion research contributes to a holistic understanding of human experiences. It fosters cultural competence and guides therapeutic approaches that respect diverse spiritual beliefs.

Here are some example research questions in this field:

71. What impact does a religious upbringing have on a child’s self-esteem?

72. How do religious beliefs shape decision-making and perceptions of morality?

73. What is the impact of religious indoctrination?

74. Is there correlation between religious and mindfulness practices?

75. How does religious affiliation impact attitudes towards mental health treatment and help-seeking behaviors?

Controversial topics in psychology research question examples

Some psychology topics don’t fit into any of the subcategories above, but they may still be worthwhile topics to consider. These topics are the ones that spark interest, conversation, debate, and disagreement. They are often inspired by current issues and assess the validity of older research.

Consider some of these research question examples:

76. How does the rise in on-screen violence impact behavior in adolescents.

77. Should access to social media platforms be restricted in children under the age of 12 to improve mental health?

78. Are prescription mental health medications over-prescribed in older adults? If so, what are the effects of this?

79. Cognitive biases in AI: what are the implications for decision-making?

80. What are the psychological and ethical implications of using virtual reality in exposure therapy for treating trauma-related conditions?

• Inspiration for your next psychology research project

You can choose from a diverse range of research questions that intersect and overlap across various specialties.

From cognitive psychology to clinical studies, each inquiry contributes to a deeper understanding of the human mind and behavior. Importantly, the relevance of these questions transcends individual disciplines, as many findings offer insights applicable across multiple areas of study.

As health trends evolve and societal needs shift, new topics emerge, fueling continual exploration and discovery. Diving into this ever-changing and expanding area of study enables you to navigate the complexities of the human experience and pave the way for innovative solutions to the challenges of tomorrow.

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'All we hear about are the diets.' Starving, gorging, fighting to heal amid eating disorders

More than 10,000 people die every year from eating disorders. these 11 people are determined not to be among them. by telling their stories, they hope to save others..

A first-time mother tries to conceal her new curves .

A teenage boy endlessly compares himself to the bulked-up bodies he sees online.

An elderly woman, in an attempt to avoid the ailments that took her mother, grows fragile instead. 

They all struggle with disordered eating. 

The Detroit Free Press , part of USA TODAY Network, spoke with 11 people from Michigan about their struggles, triumphs and paths toward understanding their condition ― and, finally, healing. 

While each story is unique, many share common experiences. Some developed unhealthy habits, such as restriction ― limiting what kind of food they eat, how much, or going for long periods without eating. Many acted on societal cues that correlate thinness with health. Others felt pressure to look like the idealized images they flip through in magazines or scroll past on TikTok.

Those who sought help said the health care system routinely overlooked their struggles and used an industry standard of health, the Body Mass Index (a measure of body fat based on a person’s height and weight), that failed to signal their eating disorders. It’s a number that does a disservice to patients, said Judith Banker, founder and president of the Center for Eating Disorders in Ann Arbor, Michigan.

“People abuse themselves with that number. The medical system abuses people with that number,” Banker said. “We should be looking at blood pressure and heart rate and how the internal systems are working because weight is just a very, very poor proxy for body health.”

In Michigan, some 900,000 people, or about 10% of the state's population, will develop an eating disorder, according to the Harvard T.H. Chan School of Public Health . The percentage is about the same across the country, where more than 10,000 people die from an eating disorder every year.

People who struggle with disordered eating say helping people relearn what it means to be healthy, and making treatment more accessible are crucial steps to saving lives. So is understanding that recovery is a process with successes and setbacks.

At a time when millions of Americans clamor for appetite-suppressing drugs, when the negative effects of social media on body image cycle through headlines and congressional hearings, and when studies show that pandemic-induced isolation has worsened eating disorders, the people who spoke to the Free Press say they want to share their stories to help others who may struggle to find hope. They also shared, in handwriting on some of their photos, what they wish they knew at the start of their recovery journeys.

Samantha Barash: What healthy really looks like

Crisp, tender falafel, aromatic mejadra, delicate dolmas and warm pockets of wood-fired pita. This is the food that brings Samantha Barash home.

But that's not how Barash has always felt.

“Food was a big way that I didn’t fit in with others growing up,” said Barash, 31, who grew up in a Middle Eastern household. The food at Barash’s home didn’t look like what her classmates ate. It also clashed with the messages she heard about eating healthy.

"I remember being at my grandmother's house after I read in one of those silly 'health' magazines about damned rice and I didn't want to eat white rice," Barash recalled. "I remember not eating the grape leaves that my grandmother made.”

Barash developed a fixation on food, starting her first diet in the eighth grade, and deciding to become a dietitian. But it was in college while studying to be a dietitian that her eating disorder worsened.

"You come into this with a fascination with food and then you start to truly think food is the most important thing in the world. It can spiral very, very quickly,” Barash said.

Barash's journey to recovery began when she started working as a dietitian after college.

"I had the realization that no matter how much weight I lost, it would never be enough,” she said.

Barash now helps others mend their relationships with food and body image at her own practice, Tap Into Nutrition.

Barash tells her clients that “true health is way more than a body size.”

“Some foods have more nutrition than others, but all foods are healthy,” Barash said. “If you go to your grandma's house, and it's her birthday and she’s 90 years old, and you guys are eating a birthday cake, eating that cake with your family at that moment is healthy.”

Racheal Rickabaugh: Rewriting her story

Racheal Rickabaugh was the face of successful weight loss — literally.

In 2018, Rickabaugh, 36, of Grand Haven, sought help from an obesity specialist through a local hospital group. Two years later, the hospital published an article marveling over her weight-loss journey.

But Rickabaugh quickly realized that she had taken the weight-loss strategies she learned to an extreme and was, in fact, suffering from unhealthy eating habits.

“I ate mostly vegetables almost to the extent that it was almost my entire diet, and my body wasn’t happy with that.”

Rickabaugh grew up as one of the only girls of color in predominantly white Spring Lake, Michigan, where trying to fit in meant trying not to look like herself.

“I think it made me ashamed, I just wanted to act like I look like them,” said Rickabaugh.

In adulthood, Rickabaugh’s regimented diet developed into severely restrictive eating habits, and eventually, she fell into a dangerous cycle of binging and restriction. She exhibited symptoms of malnourishment, losing her period and frequently feeling freezing cold, she said.

And yet, according to body mass index (BMI) calculations, she was healthy.

“I thought, ‘I’m not underweight, so there's just no way there could be anything wrong,’ ” said Rickabaugh , who didn’t hear others talk openly about these issues.

In 2021, Rickabaugh pursued therapy and said that the experience has been “life-changing.”

“Before therapy, it was really isolating,” she said. “On my own, I felt like I was crazy. I didn't understand all the things that were happening to me.”

Rickabaugh is an elementary school teacher, and says she has seen kids fixate on weight loss and food as early as second grade.

“I wish they knew everybody is different and self worth isn’t attached to the shape or size of their body,” she said.

Fran Betz: Realization, recovery later in life

When Frances Betz was 25, her 52-year-old mother, who was diabetic, died from a heart attack. Betz vowed to avoid the same fate.

“I did not want to die when I was 50,” Betz said. “I wasn't going to go through life like that.”

Betz dieted throughout adulthood. The fear of suffering the fate as her mother followed Betz into her 70s, when she decided to cut processed sugar out of her diet.

She began to rapidly lose weight. Betz's daughter became increasingly worried about how frail her mother was and pushed her to see a specialist.

In doing so, Betz discovered a different danger: eating disorders.

“I never thought there was any danger in being too thin. We don’t hear that anywhere. All we hear about are the diets. I had no idea that people my age had eating disorders,” Betz said.

Research support’s Betz’s assessment. Treatment guidelines tend to be based on case studies of adolescents and middle-age adults.

By the time Betz sought help, she was tired frequently and moving slower ― signs of malnutrition.

“I felt my brain slowing down,” Betz said. “It just took me longer to do things. That’s when I realized the absolute danger.”

Starving the body of nutrition can cause parts of the brain to thin, suggesting that people who are heavily restricting are destroying their brain cells and breaking connections between brain cells, according to a 2022 study by the Keck School of Medicine at the University of Southern California .

The study also found that malnutrition can also cause heart damage: the very thing Betz was trying to avoid.

Betz blames her doctors for not realizing how her weight loss could impact her health.

“They didn’t do a damn thing,” Betz said. “That’s a remiss on their part, I thought I was doing OK.”

Betz is working to rebuild the way she thinks about eating, but trying to unwind a lifetime of bad habits can feel overwhelming, she said.

Betz, however, said she is working hard toward recovery and that her goal has always been to be with family for as long as possible.

Jacy Kirby: A healthy relationship with exercise

Jacy Kirby was 14 years old when he first sought help for binge eating. His primary care physician simply told him to “just stop eating.”

At the time, Kirby was bullied about his weight and appearance and he spiraled into a deep depression.

“I’ve always used food to cope,” said Kirby, now 25, of Clinton Township. “The binge eating aspect, the full blown disorder, was when I was struggling with depression and I pushed into it further.”

For Kirby, cycles of severe restriction and binge-eating started in 2017. The slightest frustration, like hitting a couple of red lights in a row, might trigger a bingeing episode, Kirby recalled.

During a binge, Kirby went to multiple fast-food restaurants and gas stations and ordered food from each location. He returned home to sit in his room for days at a time, “gorging on all that food,” he said.

Afterward, Kirby called off work, exercised excessively and starved himself for days, trying to rapidly purge the calories he had consumed.

“You enter a sort of euphoric bubble where the world could literally be ending outside and it wouldn’t matter,” Kirby said. “But as soon as you take that last bite, it’s immediate self-loathing”

Though Kirby tried to change his behavior, he didn’t know how.

“Behind the closed doors of my room, I would try to sort things out and deal with it on my own. But I literally had no sense of coping mechanisms whatsoever,” Kirby said.

Kirby forged a new path after he began kickboxing, started therapy and met his fiancee, Chloe.

Before, Kirby saw exercise exclusively as a way of purging from binges.

“Exercise was about doing something to my body, instead of for it,” he said.

Now, Kirby is a fitness trainer at Planet Fitness in Clinton Township, Michigan, where he teaches his clients how to build healthy relationships with food and exercise.

Kirby has also found an outlet through writing. In January, he published a collection of poems titled “ To My E a ting Disorder ," in which he details his struggles and seeks the strength to heal.

“I have a lifetime to go dealing with this eating disorder,” he said. “One of the biggest points I’ve learned is, you slip up, it doesn't mean you relapse. I’m just taking it moment by moment.”

Dana Demeter: Beauty in a new body

Dana Demeter was 5 years old when a doctor told her mother that Demeter was overweight.

After that, sweets were off limits. She hadn’t thought much about her appearance before, but it wasn’t long until she started to compare her body to those around her.

By the time she turned 12, Demeter had developed bulimia.

“I learned about purging in health class and I thought, ‘That could be a good way to lose weight,’ ” said Demeter, remembering that it became a pattern for her when a friend did it, too.

Demeter started to cycle through restriction and binge-eating, which got worse in college. Hoping to start a new chapter after graduating, Demeter managed to quit purging on her own and thought she was cured. About a decade later, Demeter became a mother, which brought another set of pressures.

“It’s normal to talk about weight gain during pregnancy,” said Demeter, now 39 and a mother of three. “Then after you have the baby there's very little talk about healthy weight loss, or just being OK with (your) new body.”

When her mother passed away in 2020, Demeter's disorder worsened and she turned to food to cope with her grief.

Demeter sought therapy in 2022, after realizing that the way she talked and thought about food could hurt her first-born daughter, Frankie, then 6 years old.

“I would catch myself saying things that were said to me and having to stop myself,” she said. “It wasn’t just about me anymore.”

With therapy, Demeter has relearned how to think and talk about food.

“I’ve realized weight loss isn’t always healthy,” Demeter said. “I have always been told that I would be beautiful if I was thin. I'm not. But I am beautiful.”

NaJaRee Nixon: Grounding in self-realization

NaJaRee Nixon spent much of her life fixated on losing weight.

Nixon, 32, of Southfield, faced relentless bullying over her weight and battled depression and anxiety during childhood and adolescence.

Nixon spent years bingeing, overexercising and then undereating just “trying to feel comfortable” in her own skin.

When Nixon would lose weight at an alarming rate, she remembers hearing praise.

“No one even gave a second thought that I was sick,” Nixon said. “No one thought that maybe I was doing dangerous things. Because I was small, I was prettier.”

Nixon said the search for external acceptance caused her to lose sight of herself. When Nixon was 28, she was sexually abused twice by separate people in the same year.

“Self-sacrificing for the sake of others became a part of who I was,“ Nixon said. “I sacrificed so much of myself that I couldn’t even recognize when I was being harmed.”

Nixon started therapy in 2021 and found support for her depression and anxiety, as well as her eating disorder. Along the way, Nixon was diagnosed with autism and dyslexia, two diagnoses that she said helped her on her healing journey.

“I’ve been living with these things my entire life and didn't know,” said Nixon. “Learning about my needs helped me deal with my eating disorder, depression, anxiety ― everything.”

Nixon is now a certified reiki practitioner and an advocate for people with disabilities as a community organizer at Detroit Disability Power.

Nixon said she is proud of how far she has come and her ability to stay grounded.

“I’m not trying to force my body into society’s standards anymore.”

Katie Whitney: Listening to cues

As her mother took part in Weight Watchers, 10-year-old Katie Whitney was there, tracking points alongside her.

From fourth grade on, every summer Whitney, 41, of Ann Arbor, said to herself, “I’m going to get thin.”

Whitney found it hard to fit in at home. “Petite and slender,” is how Whitney described her mother and sisters. She was the youngest in a family with four much older siblings who all seemed to have it together.

“I felt like a different species,” Whitney said.

She remembers feeling like she was floundering.

“I didn't have a lot of skills for managing everyday stressors and anxiety,” Whitney said. “I thought being sad or being angry was wrong, that there was something wrong with me if I felt those things, so I needed to get rid of those feelings.”

Whitney coped with binge eating through her teens. Tired of the self-loathing, restriction and bingeing, Whitney sought therapy at 22 years old, when transitioning out of college, and was prescribed an appetite suppressant.

But it didn't work.

“It didn't stop me feeling like I couldn't get enough,” she recalls. “And that there was something wrong with me.”

Whitney's therapist directed her to a dietitian, who taught her about intuitive eating, which relies on trust internal hunger and satiety cues to help decide what and how much to eat.

"I didn't even recognize those cues anymore," Whitney said.

Working with a dietitian helped Whitney, but she still faces challenges.

“Other people are seeing you first as fat and then as whatever else,” Whitney said, noting that she constantly thinking, “there’s going to be some place where I am not allowed, where I don’t belong.”

Whitney sees a therapist and a dietitian once a month. She has learned to put her struggles into perspective.

“Like, OK, I’m fat, but I’m here, living my life and it’s pretty great.”

Raya Lasiewski: Forging a career to help others

For the first seven years of Raya Lasiewski’s life, she starved in a Russian orphanage.

After being adopted and moving to America, Lasiewski’s childhood trauma continued to affect her relationship with food. As a child, Lasiewski, 30, of Northville, hoarded food at home, hiding it under her bed because she was worried about returning to the orphanage.

In high school, Lasiewski lost a close friend to suicide and fell into a deep depression. To cope, she wanted to control something in her life, Lasiewski remembers. She restricted how much food she ate and rapidly lost weight.

Despite her dangerous eating habits, however, Lasiewski found that doctors and peers praised her weight loss instead.

“Why is it that all of a sudden when I’m losing weight, I’m attractive?” she asked.

What is generational trauma? An expert gets into how families inherit trauma, how to cope

Lasiewski began to seek treatment after fainting at work. She had always dreamed of becoming a social worker, but realized her eating disorder was keeping her from reaching her goals.

Doctors, she recalls, told Lasiewski she “wasn’t skinny enough” to be diagnosed with an eating disorder. After that Lasiewski sought out treatment.

Lasiewski said she finally found the help she needed at Timberline Knolls Residential Treatment Center in Illinois.

“I probably wouldn’t be here today without them,” Lasiewski said. “They actually believed me. They made me feel safe.”

Lasiewski said she is working to help those around her understand that overcoming an eating disorder can take years of consistent work.

“Once you go into treatment, people think of you as a car going into the (repair) shop and coming out fixed,” Lasiewski said. “But it’s a lifelong journey. That’s the hardest part.”

Lasiewski is the coordinator for the annual Ann Arbor National Eating Disorders Association Walk , which is scheduled for April 13, helping to raise awareness for eating disorders. She also is studying to earn her master's degree at Eastern Michigan University to become a therapist, specializing in eating disorders.

“My eating disorder was taking away my goals of becoming a social worker,” said Lasiewski, who is slated to graduate in April. “But I want to be an example of the light at the end of the tunnel for those struggling like I was.”

Alisha Washington: Reconnecting with beloved foods 

Growing up in Louisville, Kentucky, Alisha Washington remembers being one of a few Black kids in her community. 

“Nobody is saying anything to me, but I just felt like I'm not supposed to be here,” Washington said. “You just feel like you're very different from the people around you and you're just trying to do everything possible to assimilate.”

For Washington, 30, assimilating meant changing her body.

“Fitting in meant literally shrinking myself down to fit down to what everyone else around me is,” said Washington, who now lives in Detroit.

That included rejecting the food her family loved: Fried chicken, bread, collard greens, ham.  

“It felt like my food didn't have value to the health-conscious people and I was ashamed,” said Washington. “The food that I loved, the food that my mom made for me, the food that was at my family celebrations wasn’t good.”

Washington struggled the most when she was at college. She frequently skipped meals and once fainted in the cafeteria. 

“Perversely, the worse I was taking care of my body, the more positive feedback I got, which feeds into the cycle of ‘I should keep doing it, because everyone’s giving me compliments,’ ” said Washington. “I don't blame anyone for doing it, it’s just our social conditioning.”

Washington sought help in her mid-20s. The COVID-19 pandemic had set in and she had recently gotten married and bought a house with her husband. She thought about their future together and the family they want to build. 

Washington’s therapist suggested she start working with a nutritionist. Washington agreed, but previous experiences with healthcare professionals made her cautious. 

“Doctors tend to start conversations about weight loss before they know anything else about me,” said Washington. 

In 2022, Washington began working with a dietitian who steered her away from focusing on weight loss and toward mending her relationships with food and eating.  

Now, Washington is reconnecting with the foods that her family loves, even as she fights an inner voice telling her she’s not good enough, that she needs to change.  

“It’s one of those things where you want to buck the system and be like ‘screw this,’ but at the same time you know that you're a person and exist in a world in which certain bodies are praised and other bodies are punished."

Tommy Hojnicki: Beating the algorithm

For Tommy Hojnicki, lifting weights is as routine as brushing his teeth.

The habit for Hojnicki, 23, was triggered after his father’s stroke, which put his dad in a coma for a month. Hojnicki's dad recovered and needed years of rehab and therapy. The stroke, doctors said, could have been mitigated through diet and exercise.

The next year, Hojnicki, 12 at the time, joined his local gym.

“Something just clicked that was like, ‘Hey, I don't want this to be my future,’ ” he said.

At 13, Hojnicki started lifting. Throughout high school he viewed exercise as a stress release and a path toward health. In college at Michigan State University, however, he turned his focus to size.

"It's college when you just start seeing more people bigger and stronger than you," said Hojnicki, who earned a master’s degree in computer science at MSU, and recently moved to Colorado. "It became normal for me to be in (the gym) for three hours a day."

Hojnicki said he experienced muscle dysmorphia, a preoccupation with the idea that one's body isn't muscular or lean enough, sometimes causing compulsive behaviors aimed at achieving an unrealistic physique.

Approximately 25% of adolescent males are worried about not appearing muscular enough, according to a 2021 study published in the Journal of Adolescent Health.

“We don’t really talk about it, because if you do, you’re seen as weak,” he said.

Social media makes it worse.

“Every other video, you’re seeing shirtless guys with washboard abs, huge arms and you don't know if they’re natural or on steroids,” Hojnicki said about TikTok. “The algorithm identified that weightlifting and exercise is something I’m into, so that’s all the content I’m seeing.”

In real life, Hojnicki realizes that body dysmorphia isn't something he can solve completely on his own. He said he hopes, however, to change his inner and outer dialogue.

“I just want to strive to be healthy,” Hojnicki said. “I just want to work on not being as hard on myself.”

Makenna Silverman: Always reaching for recovery

Green light. Yellow light. Red light. 

Makenna Silverman, 22, of Bloomfield Hills, imagines a stoplight when she thinks of where she’s at in terms of her eating disorder. At a green light, Silverman glides, free from the weight of her illness. When she hits yellow, she struggles with negative thoughts but can move forward. At red, Silverman’s eating disorder brings her life to a halt. 

Silverman was in the red in the fall of 2022 when she lost the ability to walk and fainted in front of her young cousins.

“I was bedridden,” Silverman said. “I had to sit down to brush my teeth.”

During Silverman’s childhood and teenage years, she often saw her mom receive compliments about her body. Silverman wanted the same, she said.

“If I had that much self control, then people would be saying that to me, too,” Silverman recalled thinking at the time. 

Silverman carried her search for validation to Michigan State University.

“I noticed the type of girls that made it farther socially,” Silverman said. To fit that mold, Silverman dyed her hair blonde, and started to pair restriction with intense exercise to lose weight.

After a year, Silverman had isolated herself from friends and family to avoid their concern, was dizzy and aching from undereating.

In October of 2022, Silverman’s friends held an intervention ― gentle but insistent that she get help. They convinced her to seek treatment. 

“I realized I was sacrificing my friends and my family,” Silverman said. “I didn’t want that for myself anymore.” 

But the intensive in-patient program Silverman sought was hard to find.

C.S. Mott Children’s Hospital had a seven-month waiting list. Silverman researched several other in-patient treatment facilities, trying to find one her family’s insurance would cover.  

In December of 2022, Silverman found Focus Integrative Centers in Tennessee, and spent two months receiving in-patient treatment there.

Silverman credits Focus with saving her life.

Silverman continues therapy with a care team and says she lately finds herself somewhere between yellow and green lights.

Last year, she reached one of her biggest goals, attending one of the Taylor Swift concerts in Detroit with a group of friends, the same ones who intervened to stop Silverman’s spiral seven months prior.

“I stood and screamed for three hours straight,” said Silverman. “I thought, 'this is what recovery feels like.' ”

Green light.

How to find help

Here are some resources for people seeking help with an eating disorder:

• Eating disorder information, screening tools and support can be found at National Eating Disorders Association (nationaleatingdisorders.org/screening-tool)
• National Alliance for Eating Disorders (allianceforeatingdisorders.com) offers a list of treatment providers in each state, free therapist-led virtual support groups and additional resources.
• To learn more about recently published research on eating disorders, you can go to the Academy for Eating Disorders website (aedweb.org).

Two key brain systems are central to psychosis

Inside the brains of people with psychosis, two key systems are malfunctioning: a "filter" that directs attention toward important external events and internal thoughts, and a "predictor" composed of pathways that anticipate rewards.

Dysfunction of these systems makes it difficult to know what's real, manifesting as hallucinations and delusions.

The findings come from a Stanford Medicine-led study, publishing April 11 in Molecular Psychiatry , that used brain scan data from children, teens and young adults with psychosis. The results confirm an existing theory of how breaks with reality occur.

"This work provides a good model for understanding the development and progression of schizophrenia, which is a challenging problem," said lead author Kaustubh Supekar, PhD, clinical associate professor of psychiatry and behavioral sciences.

The findings, observed in individuals with a rare genetic disease called 22q11.2 deletion syndrome who experience psychosis as well as in those with psychosis of unknown origin, advance scientists' understanding of the underlying brain mechanisms and theoretical frameworks related to psychosis.

During psychosis, patients experience hallucinations, such as hearing voices, and hold delusional beliefs, such as thinking that people who are not real exist. Psychosis can occur on its own and is a hallmark of certain serious mental illnesses, including bipolar disorder and schizophrenia. Schizophrenia is also characterized by social withdrawal, disorganized thinking and speech, and a reduction in energy and motivation.

It is challenging to study how schizophrenia begins in the brain. The condition usually emerges in teens or young adults, most of whom soon begin taking antipsychotic medications to ease their symptoms. When researchers analyze brain scans from people with established schizophrenia, they cannot distinguish the effects of the disease from the effects of the medications. They also do not know how schizophrenia changes the brain as the disease progresses.

To get an early view of the disease process, the Stanford Medicine team studied young people aged 6 to 39 with 22q11.2 deletion syndrome, a genetic condition with a 30% risk for psychosis, schizophrenia or both.

Brain function in 22q11.2 patients who have psychosis is similar to that in people with psychosis of unknown origin, they found. And these brain patterns matched what the researchers had previously theorized was generating psychosis symptoms.

"The brain patterns we identified support our theoretical models of how cognitive control systems malfunction in psychosis," said senior study author Vinod Menon, PhD, the Rachael L. and Walter F. Nichols, MD, Professor; a professor of psychiatry and behavioral sciences; and director of the Stanford Cognitive and Systems Neuroscience Laboratory.

Thoughts that are not linked to reality can capture the brain's cognitive control networks, he said. "This process derails the normal functioning of cognitive control, allowing intrusive thoughts to dominate, culminating in symptoms we recognize as psychosis."

Cerebral sorting

Normally, the brain's cognitive filtering system -- aka the salience network -- works behind the scenes to selectively direct our attention to important internal thoughts and external events. With its help, we can dismiss irrational thoughts and unimportant events and focus on what's real and meaningful to us, such as paying attention to traffic so we avoid a collision.

The ventral striatum, a small brain region, and associated brain pathways driven by dopamine, play an important role in predicting what will be rewarding or important.

For the study, the researchers assembled as much functional MRI brain-scan data as possible from young people with 22q11.2 deletion syndrome, totaling 101 individuals scanned at three different universities. (The study also included brain scans from several comparison groups without 22q11.2 deletion syndrome: 120 people with early idiopathic psychosis, 101 people with autism, 123 with attention deficit/hyperactivity disorder and 411 healthy controls.)

The genetic condition, characterized by deletion of part of the 22nd chromosome, affects 1 in every 2,000 to 4,000 people. In addition to the 30% risk of schizophrenia or psychosis, people with the syndrome can also have autism or attention deficit hyperactivity disorder, which is why these conditions were included in the comparison groups.

The researchers used a type of machine learning algorithm called a spatiotemporal deep neural network to characterize patterns of brain function in all patients with 22q11.2 deletion syndrome compared with healthy subjects. With a cohort of patients whose brains were scanned at the University of California, Los Angeles, they developed an algorithmic model that distinguished brain scans from people with 22q11.2 deletion syndrome versus those without it. The model predicted the syndrome with greater than 94% accuracy. They validated the model in additional groups of people with or without the genetic syndrome who had received brain scans at UC Davis and Pontificia Universidad Católica de Chile, showing that in these independent groups, the model sorted brain scans with 84% to 90% accuracy.

The researchers then used the model to investigate which brain features play the biggest role in psychosis. Prior studies of psychosis had not given consistent results, likely because their sample sizes were too small.

Comparing brain scans from 22q11.2 deletion syndrome patients who had and did not have psychosis, the researchers showed that the brain areas contributing most to psychosis are the anterior insula (a key part of the salience network or "filter") and the ventral striatum (the "reward predictor"); this was true for different cohorts of patients.

In comparing the brain features of people with 22q11.2 deletion syndrome and psychosis against people with psychosis of unknown origin, the model found significant overlap, indicating that these brain features are characteristic of psychosis in general.

A second mathematical model, trained to distinguish all subjects with 22q11.2 deletion syndrome and psychosis from those who have the genetic syndrome but without psychosis, selected brain scans from people with idiopathic psychosis with 77.5% accuracy, again supporting the idea that the brain's filtering and predicting centers are key to psychosis.

Furthermore, this model was specific to psychosis: It could not classify people with idiopathic autism or ADHD.

"It was quite exciting to trace our steps back to our initial question -- 'What are the dysfunctional brain systems in schizophrenia?' -- and to discover similar patterns in this context," Menon said. "At the neural level, the characteristics differentiating individuals with psychosis in 22q11.2 deletion syndrome are mirroring the pathways we've pinpointed in schizophrenia. This parallel reinforces our understanding of psychosis as a condition with identifiable and consistent brain signatures." However, these brain signatures were not seen in people with the genetic syndrome but no psychosis, holding clues to future directions for research, he added.

Applications for treatment or prevention

In addition to supporting the scientists' theory about how psychosis occurs, the findings have implications for understanding the condition -- and possibly preventing it.

"One of my goals is to prevent or delay development of schizophrenia," Supekar said. The fact that the new findings are consistent with the team's prior research on which brain centers contribute most to schizophrenia in adults suggests there may be a way to prevent it, he said. "In schizophrenia, by the time of diagnosis, a lot of damage has already occurred in the brain, and it can be very difficult to change the course of the disease."

"What we saw is that, early on, functional interactions among brain regions within the same brain systems are abnormal," he added. "The abnormalities do not start when you are in your 20s; they are evident even when you are 7 or 8."

The researchers plan to use existing treatments, such as transcranial magnetic stimulation or focused ultrasound, targeted at these brain centers in young people at risk of psychosis, such as those with 22q11.2 deletion syndrome or with two parents who have schizophrenia, to see if they prevent or delay the onset of the condition or lessen symptoms once they appear.

The results also suggest that using functional MRI to monitor brain activity at the key centers could help scientists investigate how existing antipsychotic medications are working.

Although it's still puzzling why someone becomes untethered from reality -- given how risky it seems for one's well-being -- the "how" is now understandable, Supekar said. "From a mechanistic point of view, it makes sense," he said.

"Our discoveries underscore the importance of approaching people with psychosis with compassion," Menon said, adding that his team hopes their work not only advances scientific understanding but also inspires a cultural shift toward empathy and support for those experiencing psychosis.

"I recently had the privilege of engaging with individuals from our department's early psychosis treatment group," he said. "Their message was a clear and powerful: 'We share more similarities than differences. Like anyone, we experience our own highs and lows.' Their words were a heartfelt appeal for greater empathy and understanding toward those living with this condition. It was a call to view psychosis through a lens of empathy and solidarity."

Researchers contributed to the study from UCLA, Clinica Alemana Universidad del Desarrollo, Pontificia Universidad Católica de Chile, the University of Oxford and UC Davis.

The study was funded by the Stanford Maternal and Child Health Research Institute's Uytengsu-Hamilton 22q11 Neuropsychiatry Research Program, FONDEYCT (the National Fund for Scientific and Technological Development of the government of Chile), ANID-Chile (the Chilean National Agency for Research and Development) and the U.S. National Institutes of Health (grants AG072114, MH121069, MH085953 and MH101779).

• Birth Defects
• Brain Tumor
• Nervous System
• Psychology Research
• Schizophrenia
• Disorders and Syndromes
• Brain-Computer Interfaces
• Brain Injury
• Dopamine hypothesis of schizophrenia
• Cognitive dissonance
• Electroconvulsive therapy
• Brain damage
• Psycholinguistics
• Memory-prediction framework

Story Source:

Materials provided by Stanford Medicine . Original written by Erin Digitale. Note: Content may be edited for style and length.

Journal Reference :

• Kaustubh Supekar, Carlo de los Angeles, Srikanth Ryali, Leila Kushan, Charlie Schleifer, Gabriela Repetto, Nicolas A. Crossley, Tony Simon, Carrie E. Bearden, Vinod Menon. Robust and replicable functional brain signatures of 22q11.2 deletion syndrome and associated psychosis: a deep neural network-based multi-cohort study . Molecular Psychiatry , 2024; DOI: 10.1038/s41380-024-02495-8

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