The coronavirus disease 2019 pandemic was as tressful time for adolescents, with increased isolation, loss of routines, and changes in access to medical care. In this setting, the medical system saw a significant rise in the number of adolescents seeking care for eating disorders, as well as increased severity of patient presentation. Telehealth treatment for eating disorders was a unique shift during the pandemic, with some benefits but not universally positive experiences among patients, families and providers.

The pathogenesis of anorexia nervosa (AN) has been hypothesized to involve several biological systems. However, reliable biomarkers for AN have yet to be established. This study was aimed to identify statistically significant and clinically meaningful peripheral biomarkers associated with AN. A systematic literature search was conducted to identify studies published in English from inception until 30 June 2022. We conducted two-level random-effects meta-analyses to examine the difference between AN and comparison groups across 52 distinct biomarkers and found that acylated ghrelin, adrenocorticotropic hormone (ACTH), carboxy-terminal collagen crosslinks (CTX), cholesterol, cortisol, des-acyl ghrelin, ghrelin, growth hormone (GH), obestatin, and soluble leptin receptor levels were significantly higher in cases of AN compared with those in non-AN controls. Conversely, C-reactive protein (CRP), CD3 positive, CD8, creatinine, estradiol, follicle-stimulating hormone (FSH), free thyroxine, free triiodothyronine, glucose, insulin, insulin-like growth factor 1 (IGF-1), leptin, luteinizing hormone, lymphocyte, and prolactin levels were significantly lower in AN compared with those in non-AN controls. Our findings indicate that peripheral biomarkers may be linked to the pathophysiology of AN, such as processes of adaptation to starvation. Scientific investigation into peripheral biomarkers may ultimately yield breakthroughs in personalized clinical care for AN.

OBJECTIVE: Social challenges are common in patients with eating disorders (ED). The presence of autistic characteristics often exacerbates social difficulties within this group, potentially affecting treatment outcomes. This study investigates the communication preferences, challenges, dislikes, and support needs of patients with ED, both with and without autistic traits, using a communication passport in a national inpatient ED service.
METHODS: An explorative qualitative analysis of 38 completed communication passports was conducted to investigate patients\' communication preferences, sensory needs, struggles and dislikes, and areas of support required, paying particular attention to the distinct needs of patients with high levels of autistic traits.
RESULTS: The communication passport provided valuable insights into patients\' communication preferences, sensory sensitivities, challenges, and support needed. Patients also used the passports to share information about their strengths, personal identity, and life beyond the hospital.
CONCLUSIONS: The communication passport fosters a deeper understanding of patients\' needs and may support clinicians in care planning and communication strategies tailored to each patient\'s needs. Regular evaluation and updates are warranted to ensure its usability and accessibility by the wider care team.
UNASSIGNED: ZIEL: Bei Patienten mit Essstörungen sind soziale Herausforderungen häufig. Das Vorliegen autistischer Merkmale verstärkt oft soziale Schwierigkeiten innerhalb dieser Gruppe, was sich möglicherweise auf die Therapieergebnisse auswirkt. In der vorliegenden Studie wurden die Kommunikationsvorlieben, Probleme, Abneigungen und der Unterstützungsbedarf von Patienten mit Essstörungen, sowohl mit als auch ohne autistische Züge, anhand eines Kommunikationspasses in einer nationalen stationären Einrichtung für Patienten mit Essstörungen untersucht.
METHODS: Es wurde eine explorative qualitative Analyse von 38 ausgefüllten Kommunikationspässen durchgeführt, um die Kommunikationsvorlieben, sensorischen Bedürfnisse, Probleme und Abneigungen sowie Bereiche mit Unterstützungsbedarf der Patienten zu untersuchen, wobei insbesondere Aufmerksamkeit auf die speziellen Bedürfnisse von Patienten mit stark ausgeprägten autistischen Zügen gelegt wurde.
UNASSIGNED: Durch den Kommunikationspass boten sich wertvolle Einblicke in die Kommunikationsvorlieben, sensorischen Empfindlichkeiten, Probleme und den Unterstützungsbedarf der Patienten. Dabei nutzten die Patienten die Pässe auch, um Informationen über ihre Stärken, persönliche Identität und das Leben außerhalb des Krankenhauses mitzuteilen.
UNASSIGNED: Der Kommunikationspass fördert ein tieferes Verständnis der Bedürfnisse von Patienten und hilft den klinisch Tätigen möglicherweise bei der individuell auf die Bedürfnisse des einzelnen Patienten abgestimmten Behandlungsplanung und Kommunikationsstrategie. Um seine Verwendbarkeit und Zugänglichkeit durch das erweiterte Behandlungsteam zu sichern, müssen regelmäßig Evaluationen und Aktualisierungen durchgeführt werden.

OBJECTIVE: We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA).
METHODS: Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA\'s effort to address them.
RESULTS: Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible.
CONCLUSIONS: For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.

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UNASSIGNED: Anorexia nervosa (AN) is a complex neuropsychiatric disorder. This systematic review synthesizes evidence from diverse studies to assess and investigate the association between gene polymorphisms and psychological and neurobiological factors in patients with AN.
UNASSIGNED: A systematic search across PubMed, PsycINFO, Scopus, and Web of Science databases, along with manual searching, was conducted. The review protocol was approved by PROSPERO (CRD42023452548). Out of 1,250 articles, 11 met the inclusion criteria. The quality of eligible articles was assessed using the Newcastle-Ottawa Scale (NOS) tool. The systematic review followed the PRISMA guidelines.
UNASSIGNED: The serotoninergic system, particularly the 5-HTTLPR polymorphism, is consistently linked to altered connectivity in the ventral attention network, impaired inhibitory control, and increased susceptibility to AN. The 5-HTTLPR polymorphism affects reward processing, motivation, reasoning, working memory, inhibition, and outcome prediction in patients with AN. The dopaminergic system, involving genes like COMT, DRD2, DRD3, and DAT1, regulates reward, motivation, and decision-making. Genetic variations in these dopaminergic genes are associated with psychological manifestations and clinical severity in patients with AN. Across populations, the Val66Met polymorphism in the BDNF gene influences personality traits, eating behaviors, and emotional responses. Genes like OXTR, TFAP2B, and KCTD15 are linked to social cognition, emotional processing, body image concerns, and personality dimensions in patients with AN.
UNASSIGNED: There was an association linking multiple genes to the susceptibly and/or severity of AN. This genetic factor contributes to the complexity of AN and leads to higher diversity of its clinical presentation. Therefore, conducting more extensive research to elucidate the underlying mechanisms of anorexia nervosa pathology is imperative for advancing our understanding and potentially developing targeted therapeutic interventions for the disorder.Systematic review registration: [https://clinicaltrials.gov/], identifier [CRD42023452548].

Objective: To investigate the effects of eating and emotions on reproductive axis function in patients with functional hypothalamic amenorrhea (FHA).
Methods: A retrospective cohort study was conducted to summarize the clinical and endocrine characteristics of 58 patients with FHA at initial diagnosis and to follow up the recovery of ovulation and spontaneous menstruation in the patients to investigate these biochemical indicators and their effects on recovery outcomes.
Results: Among patients with FHA, 13.8% (8/58) and 15.5% (9/58) had above moderately severe depressive and severe anxiety symptoms respectively, and 25.9% (15/58) were at high risk for eating disorders. 34.5% (20/58) were included assessed as having recovered. The non-recovered group had higher scores on the Patient Health Questionnaire (PHQ-9) (p = .022) and higher scores on the Eating Attitude Test-26 (EAT-26) (p = .03) as well as bulimia and food preoccupation (p = .041). Follicle diameter >5 mm at initial diagnosis was an independent factor influencing recovery of reproductive axis function (odds ratio = 7.532; 95% confidence interval, 1.321-42.930; p = .023).
Conculsions: Mood disorders and a certain risk of eating disorders were present in FHA.These, together with weight loss, endocrine and follicle size, could influence the outcome.

Avoidant restrictive food intake disorder (ARFID) is newly established as a category of eating disorder (ED). Acupuncture is one treatment option for ED. However, no cases of acupuncture treatment of ARFID have been reported. A 28-year-old female presented with reduced food intake and weight, abdominal bloating, abnormal sense of taste, and tongue pain. Her body weight (BW) had been around 50 kg until four years previously. Three years before, her symptoms occurred, and her BW decreased to 36.5 kg after experiencing excessive mental stress at her workplace. She was diagnosed with ARFID by a psychosomatic physician and tended to refuse her prescribed antipsychotic drugs. She was treated weekly with the Hokushin-kai style, a traditional Japanese acupuncture, and the moxibustion method. After one month, the patient felt somewhat better and returned to work once a week for the first time in two years. Four months later, her BW started to increase. After 10 months, her BW had increased to 48 kg. Her acupuncture treatment continues. This case suggests acupuncture as an optional treatment for ARFID. Further studies, such as a combination of medications and acupuncture, would be desirable.

BACKGROUND: Remote research methods and interventions for mental health disorders have become increasingly important, particularly for conditions like eating disorders (EDs). Embodiment illusions, which induce feelings of ownership over another person?s body or body parts, offer valuable insights into the mechanisms underlying self-perception issues in EDs and potential interventions. However, existing research using these illusions has been limited to face-to-face settings. We illustrate a novel online protocol to induce the enfacement illusion (embodiment illusion principles applied to one\'s face) in an ED-based sample.
METHODS: Participants complete a 2-hr virtual session with a researcher. First, baseline trait/state ED psychopathology measures and a self-face recognition task occur. Second, participants experience two testing blocks of the enfacement illusion involving synchronously and asynchronously mimicking a pre-recorded actor\'s facial expressions. After each block, subjective and objective enfacement illusion measures occur alongside state ED psychopathology reassessment.
CONCLUSIONS: Successfully inducing enfacement illusions online could provide an affordable, accessible virtual approach to further elucidate the mechanistic role of self-perception disturbances across psychopathologies such as EDs. Moreover, this protocol may represent an innovative, remotely-delivered intervention strategy, as \'enfacement\' over another face could update negative self-representations in a cost-effective, scalable manner.

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