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The main foci have been on the public health effort to contain the spread of the virus, and the care of individuals with acute infection. The continuation of day hospital programmes for eating disorder patients during the pandemic raises many vexed issues including one of viability during this time. Because of physical distancing and the mantra around the globe of “staying at home” the running of face to face programmes becomes at the least challenging. Public Health England, a NHS body, and members of the British royal family released a set of guidelines on ‘mental health and well-being aspects of coronavirus’.

Teachers, politicians, high school students, journalists, caregivers, those with lived experience and clinicians to name but only a few, can at a keystroke view and download all the very latest editorials, research, scholarly reviews, case reports and more. Some of the early and highly cited papers included the “Cognitive -interpersonal maintenance model of anorexia nervosa revisited: a summary of the evidence for cognitive, socio-emotional and interpersonal predisposing and perpetuating factors” [2]. Over the past decade our knowledge base for these disorders has expanded considerably leading to effective interventions for adults, adolescents and children [7, 8]. The Journal will be launching a Collection on this topic in 2026 with the hope of shedding light on how it can best serve eating disorder research and clinical practice. Treasure, J; Schmidt, U. The cognitive-interpersonal maintenance model of anorexia nervosa revisited: a summary of the evidence for cognitive, socio-emotional and interpersonal predisposing and perpetuating factors.

Background There is a dearth of research into mental disorders amongst Aboriginal and Torres Strait Islander peoples (herein First Australians) and especially into eating disorders. In order to understand the healthcare needs of this population, accurate prevalence data is needed. This study aimed to estimate the prevalence of eating disorders amongst First Australians at the diagnostic threshold level and to compare clinical features and health related quality of life (HRQoL) in First and other Australians with and without an eating disorder. Methods Data were sourced from the general population 2015 and 2016 Health Omnibus Surveys in South Australia. Trained interviewers conducted via face to face interviews with 6052 people over 15 years old. Eating disorder questions were based on the Eating Disorder Examination and Health Related Quality of Life (HRQoL) measured with the Short-Form 12 v1. The response and participation rates were over 50% and 68% respectively in both surveys. Body Mass Index (BMI) and First Australian status were derived from interview questions. Data were weighted to population norms and analysed using statistical methods for complex surveys. Results Twenty-five of 92 (27%) First Australian survey respondents had an eating disorder (majority Other or Unspecified Feeding or Eating Disorder characterised by recurrent binge eating). This was significantly more than the prevalence of other Australians with an eating disorder group ( p  = .04). First Australians with an eating disorder had higher levels of weight/shape overvaluation than all other groups. They were also younger and had poorer Mental HRQoL (MHRQoL) than other Australians without an eating disorder. On logistic regression, First Australian status was not independently associated with having an eating disorder, however, age, Body Mass Index (BMI) and MHRQoL emerged as significant independent variables for the increased rate of eating disorders in First Australians. Conclusions Eating disorders were very common in First Australians and were associated with high levels of overvaluation, binge eating frequency and poor MHRQoL. High levels of overvaluation were unexpected. The implications of these findings include an urgent need for further research, and the development of culturally appropriate assessment instruments and treatments for First Australians with eating disorders.

Purpose The association of night eating (NE) and NE syndrome (NES) with dysfunctional eating behaviors, mental health and quality-of-life outcomes has been little explored in the general population. The objective of this study was to explore this for dysfunctional eating behaviors: binge-eating, use of purging, dietary restriction, use of medication to control weight; mental health: anxiety/depression; and quality-of-life outcomes: mental and physical health-related quality of life (M/PHRQoL). NE captured whether in the past 3 months, the respondents had any episodes of waking from sleep and eating, or episodes of eating a very large amount of food after evening meal excluding any such events at social gatherings or travelling overseas on a night flight or because of work shifts. NES was defined by at least weekly episodes of NE with ‘a lot’ of distress. Methods In 2017, 2977 adults from randomly selected households in South Australia were interviewed. Analyses for bivariate association were conducted using weighted tetrachoric and weighted polychoric correlations, and ordinal and binary logistic models, to determine the association between current (3 months) NE or NES as an outcome, and binge-eating, use of purging, dietary restriction, use of medication to control weight, anxiety/depression, mental and physical health-related quality of life (M/PHRQoL) as predictors after controlling for age, sex, and body weight. All analyses adjusted for design effect by stratified cluster sampling. Results Ordinal logistic regression found significantly higher odds of episodes of NE with binge-eating (OR = 1.756, 95% CI 1.527–2.020, p  < 0.001), and significantly lower odds with increased MHRQoL (OR = 0.948, 95% 0.921–0.975, p  < 0.001) and increased PHRQoL (OR = 0.976, 95% CI 0.966–0.986, p  < 0.001). Binary logistic regression found significantly higher odds of NES with binge-eating (OR = 2.62, p  < 0.001), and restrictive dieting (OR = 2.491, 95% CI 1.647–3.769, p  < 0.01), and significantly lower odds with MHRQoL (OR = 0.913, 95% CI 0.879–0.948, p  < 0.001). Conclusions Those with a history of binge-eating have higher likelihood of having both NE and NES which are also increased for the former in those with poorer MHRQoL and PHRQoL, and for the latter in only those with poorer MHRQoL. Revisions of diagnostic schemes may consider these findings in the context of delineation of boundaries between eating disorder syndromes. Levels of evidence Multivariate binary logistic regression analyses found there were significantly higher odds of having night eating syndrome in association with binge eating and restrictive dieting and significantly lower odds of night eating syndrome in association with increases in MHRQoL. These results support the Muscatello et al. (Aust N Z J Psychiatry 56:120–1362022, 2022) review noting associations and overlap between night eating syndrome and other eating disorders characterized by recurrent binge-eating, and the reported associations with disorders of restrictive eating. As both night eating and binge-eating are symptoms of over or excessive eating this was not unexpected. However, the findings at a diagnostic level in this study did also support research that has found overlap between night eating syndrome and disorders characterized by restrictive eating and/or purging behaviors. By “at a diagnostic level” what we meant was when at a level associated with marked distress, as the DSM requires either functional impairment or psychological distress to be present as a defining feature of any mental health disorder and distress is a defining feature of NES (American Psychiatric Association 2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, American Psychiatric Publishing Inc.). MHRQoL rather than PHRQoL was associated with night eating syndrome. More research is required to confirm this result and it does not negate the clinical importance of consideration of physical health status of people with night eating syndrome (Muscatello et al. Aust N Z J Psychiatry 56:120–136, 2022; Sakthivel et al. Eat Weight Disorders-Stud Anorexia Bulimia Obes 28:77, 2023). This study did not find that those who have perceived subjective anxiety/depression have significantly higher odds of NE as well as NES. This may have been because the present study did not have an assessment of depression or anxiety using a validated instrument, but rather a broad self-reported experience of current perceived anxiety and/or depression. Other studies have been also more often conduced in clinical populations which may be expected to have higher rates of mental health comorbidities (Muscatello et al. Aust N Z J Psychiatry 56:120–136, 2022) than this general population sample. Public significance statement To our knowledge this is the first study in a representative adult general population examining the relationships between night eating (NE), NE syndrome (NES) and binge eating, purging, strict dieting and general anxiety or general depression. Those with a history of binge eating and having poorer MHRQoL and PHRQoL have higher likelihoods of experiencing NE. The same associations of these factors except for that of PHRQoL were found with NES. Revisions of diagnostic schemes may consider these findings in the context of delineation of boundaries between eating disorder syndromes. As the nature of overeating is defined more broadly in NES than in other eating disorders it is important to explore all forms of overeating when undertaking estimates of the population prevalence and burden of eating disorder.

Background The adolescent years see significant physical and emotional development that lay foundations for patterns of behaviour that can continue into adult life, including the shaping of eating behaviours. Given parents are key socio-environmental drivers and influencers of adolescent behaviours around physical health and wellbeing, it is critical to consider if specific forms of parental communication are potentially contributing to the associated emotional difficulties experienced in the adolescent years. The aim of this research was to systematically review the myriad of literature pertaining to the prevalence of parental weight or appearance-based teasing and adolescent eating problems to examine how the scientific and clinical community currently understands the relationship between these domains. Methods A systematic search of the literature, using the SCOPUS, APA PsycINFO, Medline, CINAHL databases, reference lists and Google Scholar, was undertaken to identify relevant literature for parental teasing and problem eating in adolescents aged 10–19 years, published between January 1980 to October 2020, in English or French. Results Six studies met criteria for inclusion, all were cross-sectional studies and two included additional prospective data. Although parents were not the most common perpetrators of teasing, often subsidiary to that of peers and siblings, the influence and impact of parental teasing remained significant, and in some cases, appeared to interact with sibling-based teasing. This teasing was associated with problem eating behaviours for adolescents. Conclusions There is evidence in the literature to suggest the existence of an association between ‘eating problems’ amongst adolescents and exposure to parental appearance or weight teasing. Parents are unlikely to be aware of the perception or impact of the words they use or the wider influence these words may have. Future research should employ representative longitudinal designs to develop a greater understanding of the relationships between parental communications around their adolescent’s appearance or weight and how that communication is perceived by adolescents within complex family processes. Trial registration PROSPERO 2018 CRD42018109623 . Prospectively registered 15th October 2018.

Background Little is known about the epidemiology and health related quality of life (HRQoL) of the new DSM-5 diagnoses, Binge Eating Disorder (BED) and Avoidant/Restrictive Food Intake Disorder (ARFID) in the Australian population. We aimed to investigate the prevalance and burden of these disorders. Methods We conducted two sequential population-based surveys including individuals aged over 15 years who were interviewed in 2014 ( n  = 2732) and 2015 ( n =3005). Demographic information and diagnostic features of DSM-5 eating disorders were asked including the occurrence of regular (at least weekly over the past 3 months) objective binge eating with levels of distress, extreme dietary restriction/fasting for weight/shape control, purging behaviors, overvaluation of shape and/or weight, and the presence of an avoidant/restrictive food intake without overvaluation of shape and/or weight. In 2014 functional impact or role performance was measured with the ‘days out of role’ question and in 2015, Health Related Quality of Life (HRQoL) was assessed with the Short Form −12 item questionnaire (SF-12v1). Results The 2014 and 2015 3-month prevalence of eating disorders were: anorexia nervosa-broad 0.4% (95% CI 0.2–0.7) and 0.5% (0.3–0.9); bulimia nervosa 1.1% (0.7–1.5) and 1.2% (0.9–1.7); ARFID 0.3% (0.1–0.5) and 0.3% (0.2–0.6). The 2015 3-month prevalence rates were: BED-broad 1.5% (1.1–2.0); Other Specified Feeding or Eating Disorder (OSFED) 3.2 (2.6–3.9); and Unspecified Feeding or Eating Disorder (UFED) 10.4% (0.9–11.5). Most people with OSFED had atypical anorexia nervosa and majority with UFED were characterised by having recurrent binge eating without marked distress. Eating disorders were represented throughout sociodemographic groups and those with bulimia nervosa and BED-broad had mean weight (BMI, kg/m 2 ) in the obese range. Mental HRQoL was poor in all eating disorder groups but particularly poor for those with BED-broad and ARFID. Individuals with bulimia nervosa, BED-broad and OSFED-Purging Disorder also had poor physical HRQoL. ARFID and bulimia nervosa groups had lower role performance than those without an eating disorder. Conclusions Whilst full spectrum eating disorders, including ARFID, were less common than OSFED or UFED, they were associated with poor mental HRQoL and significant functional impairment. The present study supports the movement of eating disorders in to broader socio demographic groups including men, socio-economic disadvantaged groups and those with obesity.

Objective In recent decades there has been growing interest in the use of neuroimaging techniques to explore the structural and functional brain changes that take place in those with eating disorders. However, to date, the majority of research has focused on patients with anorexia nervosa. This systematic review addresses a gap in the literature by providing an examination of the published literature on the neurobiology of individuals who binge eat; specifically, individuals with bulimia nervosa (BN) and binge eating disorder (BED). Methods A systematic review was conducted in accordance with PRISMA guidelines using PubMed, PsycInfo, Medline and Web of Science, and additional hand searches through reference lists. 1,003 papers were identified in the database search. Published studies were included if they were an original research paper written in English; studied humans only; used samples of participants with a diagnosed eating disorder characterised by recurrent binge eating; included a healthy control sample; and reported group comparisons between clinical groups and healthy control groups. Results Thirty-two papers were included in the systematic review. Significant heterogeneity in the methods used in the included papers coupled with small sample sizes impeded the interpretation of results. Twenty-one papers utilised functional Magnetic Resonance Imaging (fMRI); seven papers utilized Magnetic Resonance Imaging (MRI) with one of these using both MRI and Positron Emission Technology (PET); three studies used Single-Photon Emission Computed Tomography (SPECT) and one study used PET only. A small number of consistent findings emerged in individuals in the acute phase of illness with BN or BED including: volume reduction and increases across a range of areas; hypoactivity in the frontostriatal circuits; and aberrant responses in the insula, amygdala, middle frontal gyrus and occipital cortex to a range of different stimuli or tasks; a link between illness severity in BN and neural changes; diminished attentional capacity and early learning; and in SPECT studies, increased rCBF in relation to disorder-related stimuli. Conclusions Studies included in this review are heterogenous, preventing many robust conclusions from being drawn. The precise neurobiology of BN and BED remains unclear and ongoing, large-scale investigations are required. One clear finding is that illness severity, exclusively defined as the frequency of binge eating or bulimic episodes, is related to greater neural changes. The results of this review indicate additional research is required, particularly extending findings of reduced cortical volumes and diminished activity in regions associated with self-regulation (frontostriatal circuits) and further exploring responses to disorder-related stimuli in people with BN and BED.