Eating disorders are serious, treatable, and finally getting the science they deserve. ED Currents gathers that momentum into one bright, open place — the research library, the guidelines, the care map, free education, and the interventional frontier — for clinicians, researchers, and families alike.
An interactive, free learning experience built around the AED's medical care standards — red flags, labs, refeeding, and specialty pearls.
ScreeningValidated self-report measures for eating disorders — take the SCOFF here, and find the EDE-Q, EAT-26, NIAS, and more.
NourishThe evidence-based framework by Evelyn Tribole & Elyse Resch — the ten principles, the science, and the Intuitive Eating Scale.
New · Living Evidence SummaryOzempic-era medicines are colliding with eating disorders — helping some, endangering others. What the evidence actually shows, honestly graded.
Walk through timeAn animated journey through the changing meaning of self-starvation — from medieval "holy anorexia" to the science of today.
StandardsEvery major treatment guideline, tagged for clinicians and for families — from the APA to MEED.
NavigationPrograms across every level of care, with a plain-language guide to what the levels mean and what to ask.
EcosystemThe societies, family organizations, advocacy groups, and conferences that hold this field together.
NewsletterWhat's moving in the science, advocacy, and care — plus a mailing list that sends signal, not noise.
FoundationsPlain-language foundations, the interventional frontier, and safety standards for ketamine & psychedelics in EDs.
Two separate collections, for two separate needs: published evidence you can read and cite, and trials in progress you can follow or refer to — from the first ketamine infusions in 19981 to studies now enrolling.2
New: Living Evidence Summary №1 — GLP-1 medications & eating disorders →
The published literature on ketamine, psilocybin, MDMA, and ayahuasca in eating disorders — feasibility trials, case series, secondary analyses, qualitative work, and the reviews that synthesize them. Every paper carries an evidence grade (L1–L5, by study design) — and the honest headline is that no completed RCT yet exists in this field, which is exactly why seeing all of it, graded, in one place matters. Each entry links to its primary source; this is what you cite, not treatment advice, and inclusion is not endorsement of efficacy.
Every published paper carries a grade for study design — its position on the evidence pyramid. A grade reflects design, not quality of execution: a small pilot can be superb science and still sit low on the pyramid.
Recruiting, active, and planned studies — research that hasn't reported results yet. For patients and families, these may be avenues to care; for clinicians and researchers, a map of where the field is heading. Verify current enrollment status directly, since it changes often.
The studies that anchor this library. Every card above also links directly to its own primary source.
The major clinical practice guidelines for eating disorder care, tagged by audience. Clinicians: these define the standard of care. Families: knowing they exist is power — a program should be able to tell you how its care maps to them.
A directory of established eating disorder treatment programs across levels of care. Listings are informational — not endorsements, referrals, or guarantees. Always verify licensure, accreditation, insurance, and current availability directly.
Hospital-based care for when the body is in danger — severe malnutrition, unstable vitals, electrolyte disturbance. Medicine first; everything else follows.
24-hour therapeutic care in a non-hospital setting, for those who are medically stable but need round-the-clock support with meals, urges, and structure.
Partial hospitalization (typically full weekdays) and intensive outpatient (several sessions weekly) — structured treatment while living at home.
A therapist, dietitian, and medical provider working as a team — increasingly available virtually, including family-based treatment (FBT) delivered at home.
No one recovers alone, and no one researches alone. These are the professional societies, family organizations, and gatherings that make up the eating disorder community.
What's moving in the field — trial results, policy, and milestones — curated with a clinician's eye for what actually matters.
A concise digest of eating disorder science, advocacy, and care — for clinicians, researchers, and families. Signal, not noise. Unsubscribe anytime.
Plain-language foundations, the honest state of the interventional frontier, and the safety standards this new era requires.
Eating disorders — anorexia nervosa, bulimia nervosa, binge eating disorder, ARFID, and others — are serious, biologically-influenced illnesses, not choices, phases, or vanity. They affect people of every gender, age, body size, race, and income. They are also treatable, and outcomes improve dramatically with early, evidence-based care. Person-first language matters: people live with eating disorders; they are never defined by them.
Anorexia nervosa still has no FDA-approved medication, and relapse after standard treatment remains common. Interventional psychiatry — ketamine, psilocybin, and related medicines paired with structured therapy — targets the cognitive rigidity, depression, and suicidality that keep severe illness entrenched. The early evidence is promising and honest: small studies, encouraging signals, much still to prove. That is exactly why rigorous science, not hype, must lead.
People with eating disorders can carry physiological vulnerabilities that most psychedelic and ketamine research populations do not. Any clinician, researcher, or program working at this intersection should address, at minimum:
Grounded in the peer-reviewed safety literature (see Downey et al., Journal of Eating Disorders, 2024, in the Research Index). Educational only — not medical advice. A full published safety standard is in development with clinical reviewers.
An interactive learning experience in the medical care of eating disorders — built for clinicians of every specialty, trainees, and the families who so often see it first. Free, forever. This is our way of giving back.
The majority of people living with one are not underweight. Serious medical danger occurs at every body size — and the exam and labs can look completely normal. Learning to see past the stereotype is the single most life-saving skill in this whole course.
Explore the warning signs ↓A life-threatening eating disorder can be present with no obvious physical signs and completely normal laboratory results. Suspicion, history, and behavior outrank any single test. When in doubt, screen and refer — never wait for the labs to declare an emergency.
You'll see both claims, often stated with equal confidence. Here's the scientifically defensible version. The landmark meta-analysis by Arcelus and colleagues (2011) found anorexia nervosa carries an all-cause standardized mortality ratio of about 5.86 — patients are nearly six times as likely to die as age-matched peers — and it is frequently described as having the highest mortality rate among the classic psychiatric diagnostic categories.2
However, the most comprehensive meta-review to date (Chesney, Goodwin & Fazel, 2014; over 1.7 million patients) estimated that several substance use disorders — opioid, cocaine, and amphetamine use — carry mortality risks higher than anorexia nervosa.5 This is why careful clinical sources describe anorexia as the second-most-lethal psychiatric disorder, surpassed only by substance use disorders.6
The defensible bottom line: anorexia nervosa has one of the highest mortality rates of any psychiatric illness — commonly ranked second only to substance use disorders. The exact rank depends on how substance use disorders are grouped and measured. What is not in dispute: eating disorders are among the deadliest mental illnesses, and roughly half of those deaths trace to medical complications and half to suicide.3
You've seen the shape of it above. Now lock it in: myth or fact? (Answer, then reveal the reasoning.)
Physical signs cluster by body system — but remember the golden rule: a life-threatening eating disorder can be present with no obvious physical signs and completely normal labs. Tap a system to review its warning signs:
History highlights: the rate and amount of weight change matters as much as absolute weight — rapid loss at any starting weight can produce the same complications as severe underweight. Ask about weight suppression (highest recent weight minus current; even ~5% can be medically significant), compensatory behaviors, exercise rigidity, menstrual changes, and psychiatric history including suicidality.
Baseline testing for every suspected ED: CBC, comprehensive metabolic panel, and ECG. Patterns worth knowing: low potassium and chloride with raised bicarbonate suggest vomiting; low phosphate flags early refeeding risk; mildly elevated transaminases occur in starvation; ECG may show bradycardia or QTc prolongation above 450 ms. And again — normal results never rule out a dangerous eating disorder.
Interactive: hospitalization triggers. Check any that apply to a (hypothetical) patient — adapted from published admission criteria for medical and psychiatric stabilization:
Refeeding syndrome — the metabolic derangement that can follow renourishment of a malnourished patient — can cause edema, cardiac and respiratory failure, delirium, and death. Its laboratory hallmark is hypophosphatemia, with hypoglycemia, hypokalemia, and hypomagnesemia close behind. Electrolytes typically reach their lowest point 3–7 days after feeding begins, so check before starting and monitor daily early on. Give a multivitamin, consider thiamine in severe malnutrition, replete electrolytes without delaying feeding, and rehydrate gently — low-rate continuous fluids, not boluses.
The old reflex of "start low, go slow" has been overturned: underfeeding is its own danger, prolonging illness and worsening prognosis. Current evidence supports higher-calorie starts (roughly 1600–2400 kcal/day) with stepwise increases every 1–3 days under close lab monitoring — and many patients ultimately need 3500–4000 kcal/day or more for consistent restoration. Oral nutrition is always preferred.
Interactive: refeeding risk screen. Any single factor argues for inpatient initiation with specialist support:
People with eating disorders arrive everywhere before they arrive at an ED program — the dentist's chair, the ER, the cardiology clinic. One pearl can change a trajectory:
1 — Expect ambivalence; it's a symptom. Minimizing and hiding are part of the illness, and articulate competence elsewhere can mask severity. 2 — Trust the family's worry. Parents and partners are the frontline help-seekers; even a single consultation about eating or weight concerns strongly predicts a real problem. 3 — Diffuse blame. Families didn't cause it; patients didn't choose it — saying so out loud opens the door to treatment. 4 — Monitor the body. Regular vitals and labs, interpreted in the context of starvation physiology, remembering everything can look normal. 5 — Assess psychiatric risk, always. Up to half of eating disorder deaths are by suicide.
Assessment aids for clinicians and caregivers. These contextualize risk — they are never targets, and never a diagnosis.
Two or more positive answers indicates a possible eating disorder and should prompt referral for full evaluation. Take it interactively on our Scales page.
Go to the SCOFF →This is a science site; our numbers should be checkable. Key statistics on this page trace to the peer-reviewed sources below. Where the literature is genuinely mixed, we say so rather than pick the more dramatic number.
Self-report measures used in eating disorder research and care. A screen is a doorway, never a diagnosis — a positive result means "worth a real conversation with a professional," and a negative result never overrules concern.
Choose a validated self-report screen to complete right here. Everything runs privately in your browser — nothing is saved or sent. A screen is a doorway, never a diagnosis.
Widely used, validated instruments — what each measures and where to find the official copyrighted version when it isn't ours to reproduce.
Intuitive Eating is the evidence-based framework created by dietitians Evelyn Tribole and Elyse Resch in 1995 — a compassionate alternative to diet culture, now supported by hundreds of studies linking it to lower disordered eating and better wellbeing.
Intuitive Eating teaches people to rebuild trust with their body — using internal cues of hunger, fullness, and satisfaction, rather than external rules, to guide when, what, and how much to eat. It explicitly rejects the diet mentality and weight stigma, and it has a serious research base: prospective studies find that people who eat more intuitively show lower odds of developing disordered eating, better body image, and greater psychological wellbeing over time. Explore the official home of the framework — including books, research, and a directory of certified counselors — at intuitiveeating.org.
Let go of the promise that the next diet will finally work — the evidence says it won't, and the chase causes harm.
Feed your body adequately and on time; biological deprivation is the fuel of loss-of-control eating.
Unconditional permission to eat ends the deprivation-rebellion cycle that forbidden foods create.
Notice and answer the inner rules that score foods as "good" and "bad" and you as good or bad for eating them.
Pleasure belongs in eating; satisfying meals quiet the search for "more."
Listen for the body's signals of comfortable fullness — trust builds with practice.
Food can comfort, but it can't resolve feelings; build a wider toolbox for hard moments.
Accept your genetic blueprint and treat your body with dignity at every size.
Shift exercise from punishment and calorie math to energy, strength, and how it feels.
Food choices that honor health and taste, without perfection; patterns matter, not single meals.
The Intuitive Eating Scale-3 (Tylka et al., 2024, Appetite) is a 12-item measure of intuitive eating across four domains: Unconditional Permission to Eat, Reliance on Hunger and Satiety Cues, Eating for Physical Rather than Emotional Reasons, and Body-Food Choice Congruence. It's psychometrically strong, invariant across gender, unbiased across age and BMI — and free to use in any setting.
Read the development paper (PubMed) →The IES line began with Tylka's original 2006 scale and the widely used 23-item IES-2 (2013); an early-adolescent adaptation (IES-2-EA) also exists. Researchers and clinicians use these to measure adaptive eating — a reminder that recovery science can measure what's going right, not only what's wrong.
Official Intuitive Eating resources →Self-starvation is not a modern invention. Across two thousand years, the behavior recurs — while the meaning a culture assigns to it keeps changing: holiness, hysteria, vanity, illness. Walk the river of that story, and watch the meaning shift beneath your feet.
Deliberate self-starvation appears in the Hellenistic world and beyond — ascetics, philosophers, and the practice the Romans knew as inedia. Fasting is woven into ritual and self-mastery long before any physician thinks to call refusal of food a disease. The behavior is old; the diagnosis is young.
In the Middle Ages, a refusing body could be read as a holy one. Historian Rudolph Bell, studying 170 Italian holy women in Holy Anorexia (1985), found that roughly half showed patterns of extreme self-starvation.1 Catherine of Siena — who by her twenties reportedly lived on almost nothing — became its most famous figure. The Church called it anorexia mirabilis: miraculous loss of appetite.
Bell's controversial thesis: for women stripped of agency, the mastery of appetite was one of the few forms of autonomy a suffocating society left available. Caroline Walker Bynum's Holy Feast and Holy Fast (1987) offered a richer, competing reading — that food, for these women, was above all about union with a suffering Christ.2
The English physician Richard Morton published the first medical description of what we would now recognize as anorexia nervosa — in his treatise on "consumptions," he called it a nervous atrophy, a wasting born of "sadness and anxious cares" rather than any disease of the lungs. Of one young patient he wrote that he beheld "a skeleton only clad with skin."3 The meaning had begun to shift: from miracle toward malady.
In the same year, independently, two physicians described the illness in clinical detail. In Paris, Charles Lasègue wrote of l'anorexie hystérique. In London, Sir William Gull — a physician to Queen Victoria — gave the condition the name we still use: anorexia nervosa. Gull was among the first to insist its roots were of the mind, not the stomach.4 The refusing body was now, officially, a patient.
The Victorian label hysterica — later dropped — reveals the era's lens: this was read as an affliction of young women's nerves and will.
As the cultural ideal of the female body thinned — the "Twiggy" era — recognition surged. In 1979, British psychiatrist Gerald Russell named bulimia nervosa, "an ominous variant of anorexia nervosa."5 In 1980, the DSM-III created a dedicated Eating Disorders section;6 by 1987 bulimia gained its "nervosa." 1983: the death of Karen Carpenter brought anorexia into millions of living rooms. By 1994, binge eating disorder entered the manual's appendix as a condition for further study.
The DSM-5 (2013) recognized binge eating disorder as its own diagnosis and added ARFID, decoupling some eating disorders from body image entirely. The science moved toward genetics, neurobiology, and the understanding that these are serious brain-based illnesses affecting every body, gender, and culture — not choices, not vanity. And a new frontier of interventional treatment began to open. The meaning shifts again: from moral failing toward treatable illness — and toward hope.
Seeing that self-starvation has worn so many masks — saint, hysteric, fashion victim, patient — is itself a form of treatment. It loosens shame ("this is not your moral failing"), it humbles certainty ("today's explanation is also of its moment"), and it points forward: if the meaning has always been changing, then a kinder, truer understanding is still ours to build.
Continue to the Medical Care Academy →
Semaglutide, tirzepatide, and their siblings are reshaping how the world eats — and colliding with eating disorders in both directions at once. Here is what the evidence actually shows, at every depth, with every claim graded and sourced.
Last reviewed August 23, 2026 · Reviewed monthly · A living document
The same appetite-suppressing power that can quiet binge eating in one person can arm restriction in another. Early evidence suggests GLP-1s may reduce binge episodes in binge eating disorder — and case reports show them reactivating anorexia in people with restrictive histories. Roughly a third of surveyed eating-disorder patients have already used one.2 No national guideline yet requires eating-disorder screening before prescribing.3 Screening first is the whole ballgame.
This is not a future problem. In early 2026 the New England Journal of Medicine published a perspective titled "GLP-1 Receptor Agonists and Eating Disorders — Cause for Concern," flagging worrisome signals around disordered eating.1 And in June 2026, JAMA Psychiatry published the numbers: among 436 U.S. adults with eating disorders, 32.1% had used a GLP-1 and 22% were using one currently — with 10.1% reporting misuse (altered doses, extended courses, shared medications) and nearly 10% using compounded products obtained outside normal channels. Use was most common in binge eating disorder and least common in anorexia — but anorexia was the largest diagnosis in the sample, and fewer than one in five participants overall were in remission.2 These medicines are already inside the eating-disorder population, mostly without eating-disorder oversight.
The evidence, in both directionsMultiple syntheses now point the same direction: a 2025 meta-analysis (five studies, 182 patients) found meaningful improvement in Binge Eating Scale scores4; a 25-study rapid review found binge episodes and prevalence reduced with liraglutide and semaglutide, with cravings improving in six of seven semaglutide studies5; and a retrospective cohort found semaglutide outperforming lisdexamfetamine — the only FDA-approved BED medication — on binge scores.6 Mechanistically plausible too: GLP-1 receptors act on reward circuitry, not just appetite.7 The honest caveats: studies are small, short, mostly in obesity populations, and randomized data are thin — and fewer binges is not the same thing as recovery.8
For someone with anorexia, atypical anorexia, or a restrictive history, a medication that silences hunger — and is culturally celebrated for weight loss — can function as medically sanctioned starvation. Clinicians have documented GLP-1s appearing to reactivate anorexia dormant for years, including relapse after a decade of recovery9, and a 2026 case of atypical anorexia emerging after sleeve gastrectomy followed by semaglutide and tirzepatide.10 This is L4 evidence — selected cases, not rates — but the mechanism requires no imagination, and the population survey above shows exactly who is obtaining these drugs.2
The person asking for a GLP-1 "for binge eating" may actually have atypical anorexia or non-purging bulimia — disorders that can present in larger bodies and get misread as BED, especially where clinicians have little eating-disorder training.11 Prescribing appetite suppression into misdiagnosed restriction is the single most dangerous error this collision makes possible. People of color are less likely to be correctly diagnosed or referred to specialty care, compounding the risk.12
For binge eating disorder — the most common eating disorder, with exactly one approved medication — a drug class that quiets food noise, reduces binges across every synthesis to date, and acts on reward circuitry itself could be the biggest pharmacological advance in the field's history. Dismissing it to protect a narrative would abandon the patients it might help.
Screen before prescribing, every time. A five-question SCOFF takes sixty seconds — run it on this site. Ask why the patient wants the medication; "to stop binges" and "to lose weight" are different answers with different risks.2 Take a lifetime history — remission decades ago still matters.9 Weigh atypical anorexia and non-purging bulimia before accepting a BED label.11 If prescribing with an ED history: co-manage with an eating-disorder specialist, monitor for accelerating restriction, over-exercise, and secret continuation, and predefine stop criteria. And document that lisdexamfetamine and CBT remain the evidence-based standards for BED8 — a GLP-1 is an adjunct under study, not a substitute.
If you or someone you love has any eating-disorder history and a GLP-1 is on the table: tell the prescriber the full history, even if it feels long past. Ask: What are we treating — a disorder, or a weight? Who is monitoring my eating, not just my dose? What's our plan if old thoughts come back? Appetite silence can feel like peace at first; if food shrinks to almost nothing, that is a medical signal, not a success. An eating-disorder specialist should be part of the team — our directory can help you find one.
Long-term outcomes beyond a few months. What happens to binge behavior — and weight cycling — after discontinuation. True incidence of restriction-activation, versus the case reports we happen to see. Safety in adolescents, where both prescribing and eating disorders are rising. Whether "food noise" reduction translates into psychological recovery or merely silences a symptom while the disorder waits. Randomized trials of GLP-1s in diagnosed eating-disorder populations are only beginning — until they report, everything above is early.
ED Currents interprets science in public, for people making real decisions. That obligates us to show our work: who curates, what gets included, how it's graded, how we disclose our conflicts, and what happens when we're wrong.
ED Currents is a project of Farther Shore Institute, curated by its founders — a psychiatrist and clinical trial investigator, and an eating-disorder researcher — with clinical review of health content. That closeness to the field is our qualification and our conflict, so we manage it in the open: our founders author papers in this exact literature, and are affiliated with organizations that conduct clinical trials in it. Insider-authored entries appear under the same rules as every other paper — full author-visible citations, the same design-based grade, no preferential placement. Farther Shore's governance requires that funding decisions touching insider-affiliated entities be approved by disinterested directors only; the same wall applies here editorially.
What gets includedThe Research Library aims to include every peer-reviewed publication and registered clinical trial at the intersection of ketamine/psychedelic medicine and eating disorders — comprehensiveness is the standard, not selection by conclusion. Every published entry must link to its primary source; every trial to its registry record. Inclusion is never endorsement of efficacy. Guideline and directory listings follow the same rule that governs everything here: no one pays to appear on this site, and payment can never influence inclusion, order, or grading.
How we gradeEvery published paper carries an L1–L5 evidence grade determined by study design — systematic review, RCT, open-label trial, case-level evidence, perspective — not by whether we like its findings. Design-based grading is deliberately mechanical: it leaves no room for a curator's enthusiasm (or an author's self-interest) to promote a paper. The full rubric lives in the Research Library legend, including the honest empty shelf: no completed RCT yet exists in this field.
Corrections & retraction watchErrors are corrected in place with a dated note; substantive corrections are announced in Currents. We monitor the retraction status of cited work, because published is not the same as permanent: in February 2026, a systematic review comparing eating-disorder guidelines was retracted by Frontiers — a paper that summary-aggregation sites would have kept citing indefinitely. Human curation exists precisely for that failure mode. Spot anything wrong, missing, or out of date? hello@edcurrents.org — corrections make this resource better, and we credit them.
A living resource, on a stated cadenceThe Research Library is maintained as a single versioned catalog by the editorial team and updated within days of new publications — every update ships with a visible library date. Living Evidence Summaries carry a visible last-reviewed date and are re-reviewed monthly. The Guidelines shelf is re-swept quarterly. If a date on this site looks stale, treat that as a finding — and tell us.
On AIWe use AI tools to help draft, structure, and maintain this site — and every health claim is grounded in the cited primary sources under human editorial review. What we will not do: deploy chatbots that give individualized eating-disorder advice. The field already ran that experiment — a national helpline's chatbot began dispensing diet advice to people seeking eating-disorder help and had to be shut down. Our line is bright: this site informs; it does not advise. Decisions belong with you and your clinical team.
ED Currents is a project of Farther Shore Institute, an independent nonprofit forming in Utah that funds mental health research and access to care.
The eating disorder field is entering its most scientifically interesting decade — real momentum in interventional treatments, real datasets waking up, real policy movement. But the knowledge is scattered across journals, registries, and organizational silos. Families can't find it; clinicians can't track it. This site gathers it into one open harbor, free, for everyone.
No program, company, or sponsor pays for placement, and none ever will. We describe evidence at its actual strength — case series are called case series. Listings are informational, not endorsements. Content is clinician-curated and correctable: if we've erred, tell us and we'll fix it, visibly.
A generation of large real-world clinical datasets in eating disorders is ready to be studied. Farther Shore Institute funds postdoctoral fellowships and data-driven eating disorder research — and welcomes collaboration inquiries from investigators and institutions. Start a conversation.
A verified directory submission process, a published safety standard for interventional ED care, a screening-tools library, an annual State of the Science review, and vetted event and retreat listings. Want to help shape it? Join Currents — that's where we'll ask.