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• American Academy of Pediatrics. 2023. AAP Publications Reaffirmed. Pediatrics, 151(6), e2023062145.
• Ahrén JC, Chiesa F, Koupil I, Magnusson C, Dalman C, & Goodman A. (2013).
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• Akgul S., Akdemir D., Kara M., Derman O., Cetin F. C, Kanbur N. (2016).
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• American Academy of Pediatrics. (2021). Clinical Report: Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics, 147(1), e2020040279.
• American Academy of Pediatrics. (2016). Clinical Report: Preventing Obesity and Eating Disorders in Adolescents. Pediatrics; 138(3).
• American Psychiatric Association. (2017). What are Eating Disorders?
• Arikawa, A., Ross, J., Wright, L., Elmore, M., Marrero Gonzalez, A., & Wallace, T. C. (2020). Results of an Online Survey about Food Insecurity and Eating Disorder Behaviors Administered to a Volunteer Sample of Self-Described LGBTQ+ Young Adults Aged 18 to 35 Years. Journal of the Academy of Nutrition and Dietetics, S2212-2672(20), 31341-1.
• Attia, E., Blackwood, K. L., Guarda A. S., Marcus, M. D., & Rothman, D. J. (2016). Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency. Psychiatric Services, 67(6), 664-6.
• Bello, N. T., & Yeomans, B. L. (2017). Safety of pharmacotherapy options for bulimia nervosa and binge eating disorder. Expert Opinion on Drug Safety, 17(1), 17-23.
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• Calzo, J. P.,  Blashill, A. J.,  Brown, T. A., & and  Argenal, R. L. (2017). Eating disorders and disordered weight and shape control behaviors in sexual minority populations. Current Psychiatry Reports, 19(8), 49.
• Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. (2021). High School Youth Risk Behavior Survey: Texas 2021 and United States 2021 Results.
• Chapa, D., Kite, B. A., Forbush, K. T., Tregarthen, J. P., & Argue, S. (2020). Eating-disorder psychopathology and driven exercise change models: A latent change score analysis. International Journal of Eating Disorders, Nov 3.
• Ciao, A. C., Lebow, J., VandenLangenberg, E., Ohls, O., & Berg K. C. (2020). A qualitative examination of adolescent and parent perspectives on early identification and early response to eating disorders. Eating Disorders, 1-18.
• Cotton, M., Ball, C., & Robinson, P. (2003). Four Simple Questions Can Help Screen for Eating Disorders. Journal of General Internal Medicine, 18(1), 53–56.
• Crow, S. J., Swanson, S. A., le Grange, D., Feigh, E. H., & Merikangas, K. R. (2014). Suicidal behavior in adolescents and adults with bulimia nervosa. Comprehensive Psychiatry, 55(7), 1534-1539.
• Davis, L. E., & Attia, E. (2019). Recent advances in therapies for eating disorders. F1000Research, 8 (F1000 Faculty Rev), 1693.
• Deloitte Access Economics. (2020). Social and economic cost of eating disorders in the United States of America. Harvard University T.H. Chan School of Public Health’s Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders.
• Deloitte Access Economics. (2020). Overview of Social & economic cost of eating disorders in Texas. Harvard University T.H. Chan School of Public Health’s Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders.
• Desai, N. (2019). The Role of Motivational Interviewing in Children and Adolescents in Pediatric Care. Pediatrics Annals, 48(9), e376-e379.
• Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D. A., & Duncan, A. E. (2015). Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students. Journal of Adolescent Health, 57(2):144-149.
• Ellis, J. M., Essayli, J. H., Zickgraf, H. F., Rossi, J., Hlavka, R., Carels, R. A., & Whited, M. C. (2020). Comparing stigmatizing attitudes toward anorexia nervosa, binge-eating disorder, avoidant-restrictive food intake disorder, and subthreshold eating behaviors in college students. Eating Behaviors, 39, 101443.
• Eskander, N., Chakrapani, S., & Ghani, M.R. (2020). The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus, 12(9): e10309.
• Gao, Y., Bagheri, N., & Furuya‑Kanamori, L. (2022). Has the COVID‑19 pandemic lockdown worsened eating disorders symptoms among patients with eating disorders? A systematic review. Journal of Public Health, 30, 2743–2752.
• Goeree, M. S., Ham, J. C., &  Iorio, D. (2011). Race, Social Class, and Bulimia Nervosa. IZA Discussion Paper No. 5823.
• Goldstein, A., & Gvion, Y. (2019). Socio-demographic and psychological risk factors for suicidal behavior among individuals with anorexia and bulimia nervosa: A systematic review. Journal of Affective Disorders, 245, 1149-1167.
• Goldstein, M. A., Dechant, E. J., & Beresin, E. V. (2011). Eating Disorders. Pediatrics in Review, 32(12), 508-521.
• Gonzales, M., & Blashill, A. (2020). Ethnic/racial and gender differences in body image disorders among a diverse sample of sexual minority U.S. adults. Body Image, 36, 64-73.
• Goodman A., Heshmati A., Koupil I. (2014). Family history of education predicts eating disorders across multiple generations among 2 million Swedish males and females. PLoS ONE, 9(8), e106475.
• Gordon, C. M., & Katzman, D. K. (2020). Lessons learned in caring for adolescents with eating disorders: the Singapore experience. Journal of Adolescent Health, 67, 5–6.
• Gorrell, S., Le Grange, D., Blalock, D. V., Mehler, P. S.,  Johnson, C.,  Manwaring, J., ...  Rienecke, R. D. (2021). Gender identity, race/ethnicity and eating pathology in a treatment-seeking community sample. Journal of Behavioral and Cognitive Therapy, 31(1), 77–89.
• Graell M., Morón-Nozaleda M. G., Camarneiro R., Villaseñor, A., Yáñez, S., Muñoz, R., … Faya, M. (2020). Children and adolescents with eating disorders during COVID-19 confinement: difficulties and future challenges. European Eating Disorders Review, 28(6), 864-870.
• Griffiths, S., Mond, J. M., Murray, S. B., & Touyz, S. (2015). The prevalence and adverse associations of stigmatization in people with eating disorders. International Journal of Eating Disorders, 48(6), 767-74.
• Hackert, A. N., Kniskern, M. A., & Beasley, T. M. (2020). Academy of Nutrition and Dietetics: Revised 2020 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Eating Disorders. Journal of the Academy of Nutrition and Dietetics, 120(11), 1902-1919.
• Haines, J., Gillman, M. W., Rifas-Shiman, S., Field, A. E., & Austin, S.B. (2010). Family dinner and disordered eating behaviors in a large cohort of adolescents. Eating Disorders, 18(1), 10–24.
• Hornberger L. L., & Lane M. A. (2021) AAP THE COMMITTEE ON ADOLESCENCE. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics,
• 147(1), e2020040279.
• Iwajomo, T., Bondy, S., de Oliveira, C., Colton, P., Trottier, K., & Kurdyak, P. (2021). Excess mortality associated with eating disorders: population-based cohort study. The British Journal of Psychiatry, 1-7.
• Khot, S. C., & Monge, M. C. (2022). COVID-19 and Adolescent Eating Disorders. Pediatric Annals, 51(4), e150–e153.
• Klein, D. A., Sylvester, J. E., &  Schvey, N. A. (2021). Eating Disorders in Primary Care: Diagnosis and Management. American Family Physician, 103(1), 22-32.
• Kumar, A., and Nayar, K. R. (2021). COVID 19 and its mental health consequences. Journal of Mental Health, 30, 1-2.
• Kwan M. Y., Gordon K. H., Minnich A. M. (2018). An examination of the relationships between acculturative stress, perceived discrimination, and eating disorder symptoms among ethnic minority college students. Eating Behaviors, 28, 25–31.
• Lavender, J. M., Brown, T. A., & Murray, S. B. (2017). Men, Muscles, and Eating Disorders: An Overview of Traditional and Muscularity-Oriented Disordered Eating. Current Psychiatry Reports, 19(6), 32.
• Lee, E. B., Barney, J. L., Twohig, M. P., Lensegrav-Benson, T., & Quakenbush, B. (2020). Obsessive compulsive disorder and thought action fusion: Relationships with eating disorder outcomes. Eating Behaviors, 37, 101386.
• Le Grange, D. (2005). The Maudsley family-based treatment for adolescent anorexia nervosa. World Psychiatry, 4(3), 142–146.
• López-Gil, J. F., García-Hermoso, A., & Smith, L. (2023). Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatrics, 177(4), 363-372.
• Lydecker J. A., Grilo C. M. (2019). Food insecurity and bulimia nervosa in the United States. International Journal of Eating Disorders, 52(6), 735–9.
• Martinsen M., Bahr R., Børresen R, Holme, I., Pensgaard, A. M., & Sundgot-Borgen, J. (2014). Preventing eating disorders among young elite athletes: a randomized controlled trial. Medicine & Science in Sports & Exercise, 46(3), 435–447.
• Mehanna, H. M., Moledina, J., & Travis, J. (2008). Refeeding syndrome: what it is, and how to prevent and treat it. The BMJ, 336, 1495.
• Meier, M., Kossakowski, Y. K., Jones, P. J., Kay, B., Riemann, B. C., & McNally, R. J. (2020). Obsessive-compulsive symptoms in eating disorders: A network investigation. International Journal of Eating Disorders, 53(3), 362-371.
• Meneguzzo, P., Collantoni, E., Gallicchio, D., Busetto, P., Solmi, M., Santonastaso, P., & Favaro, A. (2018). Eating disorders symptoms in sexual minority women: A systematic review. European Eating Disorders Review, 26(4), 275-292.
• Mulders-Jones B, Mitchison D, Girosi F, Hay P. (2017). Socioeconomic correlates of eating disorder symptoms in an Australian population-based sample. PLoS ONE, 12(1), e0170603.
• Murakami, J. M., Essayli, J. H., & Latner, J. D. (2016). The relative stigmatization of eating disorders and obesity in males and females. Appetite, 102, 77-82.
• Muratore, A. F., & Attia, E. (2022). Psychopharmacologic Management of Eating Disorders. Current Psychiatry Reports, 24(7), 345-351.
• Nagata, J. M., Garber, A. K., Tabler, J. L., Murray, S. B., & Bibbins-Domingo, K. (2018). Prevalence and Correlates of Disordered Eating Behaviors Among Young Adults with Overweight or Obesity. Journal of General and Internal Medicine, 33(8), 1337-1343.
• National Eating Disorders Association. (2024). Anorexia Nervosa.
• National Eating Disorders Association. (2024). Avoidant Restrictive Food Intake Disorder (ARFID).
• National Eating Disorders Association. (2024). Binge Eating Disorder.
• National Eating Disorders Association. (2024). Bulimia Nervosa.
• National Eating Disorders Association. (2024). Pica.
• National Eating Disorders Association. (2024). Rumination Disorder.
• National Institutes of Mental Health (2016). Eating Disorders.
• Neumark-Sztainer, D. (2005). I’m, Like, SO Fat! New York: Guilford Press.
• Peebles R., Wilson J. L., & Lock J. D. (2006). How do children with eating disorders differ from adolescents with eating disorders at initial evaluation? Journal of Adolescent Health, 39(6), 800-805.
• Peebles, R., Lesser, A., Cheek Park, C., Heckert, K., Timko, C. A., Lantzouni, E., Liebman, R., & Weaver, L. (2017). Outcomes of an inpatient medical nutritional rehabilitation protocol in children and adolescents with eating disorders. Journal of Eating Disorders, 5, 7.
• Phillipou, A., Meyer, D., Neill, E., Tan, E. J., Toh, W. L., Van Rheenen, T. E., et al. (2020). Eating and exercise behaviors in eating disorders and the general population during the COVID-19 pandemic in Australia: initial results from the COLLATE project. International Journal of Eating Disorders, 53, 1158-1165.
• Puhl, R., & Suh, Y. (2015). Stigma and eating and weight disorders. Current Psychiatry Reports, 17(3), 552.
• Pulcini, C. D., Zettle, S., & Srinath, A. (2016). Refeeding Syndrome. Pediatrics in Review, 37(12), 516-523.
• Robertson M., Duffy F., Newman E., Prieto Bravo C., Ates H. H., & Sharpe H. (2021). Exploring changes in body image, eating and exercise during the COVID-19 lockdown: a UK survey. Appetite, 159, 105062.
• Rosello, R., Gledhill, J., Yi, I., Watkins, B., Harvey, L., Hosking, A., Viner, R., & Nicholls, D. (2020). Early intervention in child and adolescent eating disorders: The role of a parenting group. European Eating Disorders Review; Oct 21.
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• Schaumberg, K., Welch, E., Breithaupt, L., Hübel, C., Baker, J. H., Munn-Chernoff, M. A., . . . Bulik, C. M. (2017). The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders. European Eating Disorders Review; 25(6), 432-450.
• Schlegl, S., Maier, J., Meule, A., & Voderholzer, U. (2020). Eating disorders in times of the COVID-19 pandemic—Results from an online survey of patients with anorexia nervosa. International Journal of Eating Disorders, 53(11), 1791-1800.
• Seferovic, A., Dianes, G. N., Juan, B., Larsen, D., & Oyler, V. (2019). What is the best screening tool for eating disorders in the primary care setting? Evidence-Based Practice; 22:3-12.
• Sidor A., Baba C. O., Marton-Vasarhelyi E., & Chereches R. M. (2015). Gender differences
• in the magnitude of the associations between eating disorders symptoms and depression and anxiety symptoms: Results from a community sample of adolescents. Journal of Mental Health, 24(5), 294–8.
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Definitions

The medical definitions in this module were obtained or adapted from American Academy of Pediatrics, Britannica, Journal of Substance Abuse Treatment, the Mayo Clinic, National Eating Disorders Association, National Institutes of Health, WebMD and Maria Monge MD.

Continuing Medical Education

The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Nursing Education.

Social Workers

The Texas Department of State Health Services, Continuing Education Service, the continuing education provider, ensures that the education provided is directly related to the practice of social work; and that the individuals presenting the information have the necessary experience and knowledge in the topics presented. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 hours of credit.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.00 hour(s) for attendance.

Certified Community Health Worker

The Texas Department of State Health Services, Promotor(a)/Community Health Worker Training and Certification Program has certified this course for 1.00 contact hour(s) of continuing education for Certified Community Health Workers and Community Health Worker Instructors.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
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   • Complete the evaluation.
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   The THSTEPS Web-based Continuing Education Series has received no commercial support.
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   The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
4. Non-Endorsement Statement.
   Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
5. Off-Label Use.
   Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

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Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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