Clinical Research Directory

Cognitive and Behavioral Approaches to Reduce Binge Eating and Excess Weight in Adolescents (Online)

This study will compare a psychological treatment (cognitive-behavioral therapy; CBT-BED) and a lifestyle beahvioral obesity intervention (LBOI) for adolescents who experience binge eating and have overweight or obesity. These treatments will be compared to each other and to a control condition that involves self-monitoring eating and mood using an "app". Participants can be located in most states in the United States. All participation occurs remotely by telehealth. The goal is to learn which approach works best for reducing binge eating and excess weight in this age group.

Young Athlete Body Project - Prevention of Body Dissatisfaction and Eating Disorders Among Adolescent Athletes

Body dissatisfaction is common among adolescents and is a well-established risk factor for the development of eating disorders. Young athletes may be particularly vulnerable because they are exposed to appearance-related pressures from both society and sport environments. Despite the high prevalence of body dissatisfaction and eating disorders among young athletes, there is a lack of evidence-based, large scale prevention programs specifically designed for young athletes. The Young Athlete Body Project is an age- and sport-adapted version of the evidence-based Body Project, a cognitive dissonance-based prevention program that has been shown to reduce body dissatisfaction, internalization of appearance ideals, and eating disorder risk in adolescents and adults from diverse population groups. A pilot study of the Young Athlete Body Project among adolescent athletes demonstrated that the program was acceptable and perceived as beneficial by participants. The findings also indicated promising improvements in the internalization of the thin body ideal and increased awareness of appearance-related pressures, supporting the need for further evaluation in a larger randomized controlled trial. The aim of the present study is to evaluate the effectiveness of the Young Athlete Body Project among adolescent athletes attending sports-specialized lower and upper secondary schools in Norway. The program aims to promote positive body image and body acceptance, reduce the internalization of appearance ideals, strengthen resistance to appearance-related pressures, and prevent body dissatisfaction and eating disorders among adolescent athletes. The intervention program will contribute with new evidence-based knowledge on the effect of a prevention program targeting body dissatisfaction and eating disorders among adolescents athletes.

A Study of the Intestinal Microbiota in Children and Adolescents With Eating Disorders. A Perspective From Psychoneuroimmunology

The goal of this observational study is to learn if behavioral and psychological factors are associated with the intestinal microbiota composition and function in children and adolescents with eating disorders (ED). The main questions it aims to answer are: * Are there any differences between the microbiota composition and function in adolescent patients with eating disorders and healthy adolescents? * Are the dietary pattern and other lifestyle habits associated with the intestinal microbiota composition in patients with a recent onset eating disorder? * Is it possible to predict the treatment response at one year by looking at any of the psychological and biological factors measured in the patients at baseline? * Are there any differences in the intestinal microbiota among patients with different subtypes of anorexia nervosa (restrictive, binge-purging, atypical) or with avoidance/restrictive food intake disorder (ARFID)? Researchers will compare the results with those obtained from a group of healthy children and adolescents matched by sex and age to find out if the associations observed differ between ED and control participants. Participants with ED will fill in different lifestyle questionnaires and psychological tests; they will also undergo anthropometrical measurements and will provide fecal and blood samples at baseline and one year later. Healthy participants will provide the same lifestyle information, anthopometrical measurements and stool and blood samples. They will only undergo the baseline evaluation.

The ITA Model of Integrated Treatment of Eating Disorders

This is a naturalistic study implementing a routine assessment to monitor the evolution of the patients with eating disorders being treated in various centers of "ITA salud mental" in Spain.

Impact of Eating Disorders

Eating disorders (EDs), as classified by the American Psychiatric Association's DSM-5, have an estimated lifetime prevalence of 0.6% in the Caucasian adult population, with a male-to-female ratio of 1:8, and begin in 84% to 87% of cases between the ages of 15 and 25. Anorexia nervosa (AN) is an eating disorder that represents a significant public health concern due to its impact on long-term morbidity and mortality. The incidence of AN is steadily increasing in many countries, particularly in France, with a prevalence of 2-3% among adolescents and young adults. A 10-year mortality rate of 5-10% has been reported, making AN the psychiatric disorder with the highest mortality rate. This predominantly female disorder (female-to-female ratio of 1:9) is defined by the persistent association of disordered eating behavior, distorted body image, and obsessions with weight and food, with detrimental health consequences. Anorexia nervosa (AN) exposes patients to numerous somatic and neuropsychiatric complications, which are poor prognostic factors. Its etiopathogenesis is multifactorial and involves environmental, psychological, genetic, and sociocultural factors. Bulimia nervosa (BN) is also associated with an intense fear of gaining weight. There is a disturbance of body image characterized by profound dissatisfaction with weight and physical appearance. BN is characterized by binge-eating episodes (consuming a large amount of food in a short period of time, associated with a feeling of loss of control) followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or other medications; fasting; and excessive exercise. Individuals with bulimia nervosa generally have a subnormal body mass index (BMI), making diagnosis more difficult. Type 1 diabetes is an autoimmune disease characterized by the destruction of the beta cells of the pancreatic islets of Langerhans, leading to a deficiency in insulin secretion. Generally, the diagnosis is made in childhood or adolescence, but late-diagnosed forms exist, forming an entity called latent autoimmune diabetes in adults (LADA), also known as type 1 diabetes. Diagnosis is made by measuring antibodies specific to type 1 diabetes: anti-GAD and anti-IA2 antibodies as the first-line tests, and anti-ZnT8 antibodies as a second-line test. Drug treatment primarily relies on continuous insulin administration via multiple daily injections or an insulin pump. Nutritional management is a cornerstone of treatment, playing a crucial role in glycemic control and the prevention of metabolic complications. "Diabulimia" is a recent term describing a specific eating disorder in patients with type 1 diabetes. It is characterized by a voluntary restriction of insulin administration for the purpose of weight loss, at the expense of optimal glycemic control. This condition involves several complex factors (such as insulin injection, capillary blood glucose, emotions, and body image) that link diabetes management to the patient's mental health. "Diabulimia" is not yet recognized as a distinct medical entity, lacks precise diagnostic criteria, and is difficult to detect. However, the serious consequences it entails, such as diabetic ketoacidosis in the short term and the chronic complications of hyperglycemia in the long term, make its screening essential.

Feasibility of the TransitionED Framework for Youth and Young Adults With Eating Disorders

Moving from pediatric (children's) health care to adult health care can be challenging for youth and young adults with eating disorders. Many young people and families report feeling unprepared, unsure of what to expect, and worried about losing support during this time. Gaps in care during this transition can increase stress and make recovery more difficult. This study is testing a structured transition support program called the TransitionED framework. The goal is to see whether this program can be successfully used in real hospital settings and whether youth, caregivers, and clinicians find it helpful. The TransitionED framework is designed to help youth and families prepare for the move to adult care. It includes: 1. A transition planning package for youth 2. A separate planning package for caregivers 3. At least two guided transition meetings with a clinician 4. A short "Personal Transition Profile" written by the youth to help new adult providers understand them better 5. Optional virtual peer support sessions for youth and for caregivers 6. Tools to help pediatric and adult providers communicate more clearly Youth who are 16 years or older and currently receiving care in a participating pediatric eating disorder program may be invited to join, along with one caregiver. Clinicians and program leaders will also take part to help deliver and evaluate the program. Participants will complete surveys at the beginning of the study, about two months later, and six months after finishing the program. Some participants will also take part in interviews to share their experiences. This study is focused on feasibility. That means the main goal is to learn whether this transition program is practical, acceptable, and workable in everyday clinical care. What we learn will help improve transition support for youth and young adults with eating disorders in the future.

Evaluation of a Digital School-Based Intervention for the Primary Prevention of Eating Disorders in Pre-Adolescents (PRETA Program)

Background: Eating Disorders (ED) are mental health conditions, characterized by pathological behaviors toward food intake or a persistent obsession with weight control. EDs have a high prevalence among pre-adolescents in developed countries and pose a significant economic burden. Preventive interventions targeting at-risk populations for ED have proven effective. The use of Information and Communication Technologies (ICTs) facilitates access to larger population groups while also reducing costs. Objectives: * Develop and validate a universally applied intervention (PRETA), mediated by ICTs, to reduce eating-disorder risk and modifiable risk factors, through cultural adaptation and adjustment of the POtsdam Prevention at Schools (POPS) Program to preadolescents. * Assess the efficacy of the PRETA Program through a randomized controlled trial (RCT). * Evaluate the efficiency of the PRETA Program from a social perspective. Methodology The PRETA Program uses 9 online sessions with interactive activities for pre- adolescents, plus education for their families and teachers. Its content includes addressing key factors in the development of ED, such as eating habits, beauty standards, and media literacy, as well as activities aimed at strengthening psychological dimensions (self-esteem, emotional regulation, problem-solving, psychological flexibility, and resilience) and social skills, including communication styles and distinguishing between jokes and bullying. The study involves schools being randomly assigned to either the PRETA Program or regular health activities. The effect of the intervention will be evaluated 3 months after its start.

Evaluation of a New Treatment Program for Adolescents With Eating Disorders: MINERVA Program

The aim of this study is to investigate the efficacy, efficiency, and patient experience of a new intervention program on adolescents with high-complexity eating disorders (ED). A prospective group of adolescents with ED (N=60) will follow this treatment program including four different phases: 1) Inpatient treatment; 2) Family Treatment Apartment; 3) Home Treatment; 4) Recovery within the community. The investigators will use a retrospective, control group (N=60) that matched the prospective group in age, sex, ED diagnosis, and severe symptomatology. Primary variables regarding Body Mass Index (BMI), ED symptomatology, functionality, recovery (yes/no), type of outpatient services (low/mid/high intensity), number of readmissions, and patient experience will be assessed at discharge, and after 6 and 12 months. Secondary variables include anxiety, depression, readiness to recover, quality of life symptoms, caregiver skills, and functionality of the family