Evidence map›Paper›PMID 40527344›Full record

ArticleThe International journal of eating disorders2025

Beyond the Diagnostic Checklist: A Large-Scale Analysis of Under-Recognized Weight Loss Behaviors in Individuals With Eating Disorders.

Saakshi Kakar, Una Foye, Helena L Davies, Elisavet Palaiologou, Chelsea M Malouf, Laura Meldrum, Iona Smith, Gursharan Kalsi, Karina L Allen, Gerome Breen and 2 more

Abstract read
In one paragraph

Article in The International journal of eating disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Saakshi KakarSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0003-1677-1857
Una FoyeSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0002-3414-2854
Helena L DaviesSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0002-9419-1009
Elisavet PalaiologouSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0003-4707-3349
Chelsea M MaloufSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0002-5564-7464
Laura MeldrumSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0009-0005-0936-5932
Iona SmithSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0009-0001-7135-1743
Gursharan KalsiSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0002-5156-7176
Karina L AllenEating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.ORCID 0000-0003-2896-6459
Gerome BreenSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0003-2053-1792
Moritz HerleSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0003-3220-5070
Christopher HübelSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0002-1267-8287

Funding

Medical Research Council MR/W002418/1Medical Research Council MR/X030539/1National Institute for Health and Care Research RG85445National Institute for Health and Care Research RG94028NIHR Maudsley Biomedical Research Centre IS-BRC-1215-20018
6 · The paper itself

Abstract

objectiveThis study aimed to explore the diverse range of weight loss behaviors that extend beyond traditional diagnostic criteria, highlighting the variability in symptom presentation.

methodWe text mined free-text responses from 1675 participants with anorexia nervosa, bulimia nervosa, or binge-eating disorder in the Genetic Links to Anxiety and Depression (GLAD) Study and the Eating Disorders Genetics Initiative UK (EDGI UK). In secondary analyses, we investigated differences by eating disorder and gender.

resultsFrequently endorsed behaviors included structured diets (619 endorsements) and calorie counting (422 endorsements), but also less commonly considered behaviors like compression garments (147 endorsements) and self-harm (88 endorsements). We identified four overarching themes: restriction-based approaches, medical intervention, body manipulation, and food avoidance. The most frequently reported weight loss behaviors and resultant themes did not differ among eating disorders or genders, closely resembling those in the broader sample. Notably, 81 participants with binge-eating disorder, which typically lacks the endorsement of recurrent compensatory behaviors, reported weight loss and compensatory behaviors. DISCUSSION: Our findings identify a crucial gap in current diagnostic assessments, which may hamper recognition and lead to underdiagnosis of eating disorders. By incorporating our insights into an inclusive assessment process that expects and accommodates novel behaviors, clinicians could capture a broader spectrum of behaviors, thus improving diagnostic accuracy. However, our sample homogeneity implies the need for more diverse samples. Our study contributes essential insights for enhancing diagnostic criteria.

Indexed as

Feeding and Eating DisordersWeight LossAdolescentAdultChecklistFemaleHumansMaleMiddle AgedYoung Adultanorexia nervosabinge‐eating disorderbulimia nervosadiagnosisonline studyqualitative analysistext miningweight loss behavior

Identifiers

PMID40527344
PMCPMC12423573

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.