{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:52:46Z","timestamp":1790689966384,"version":"4.1.0"},"reference-count":197,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T00:00:00Z","timestamp":1576540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Over the last 50\u2009years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.<\/jats:p>","DOI":"10.1093\/nutrit\/nuz089","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T19:46:33Z","timestamp":1570736793000},"page":"579-596","source":"Crossref","is-referenced-by-count":48,"title":["The Western diet: a blind spot of eating disorder research?\u2014a narrative review and recommendations for treatment and research"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3722-0854","authenticated-orcid":false,"given":"Agnes","family":"Ayton","sequence":"first","affiliation":[{"name":"University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Foundation Trust, Snowsfields Adolescent Unit, Mapother House, Maudsley Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,17]]},"reference":[{"key":"2020112113262474600_nuz089-B1","first-page":"1","article-title":"Anorexia nervosa in males: excess mortality and psychiatric co-morbidity in 609 Swedish in-patients","author":"Kask","year":"2017","journal-title":"Psychol Med"},{"key":"2020112113262474600_nuz089-B2","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/eat.22624","article-title":"Binge-eating disorder in the Swedish national registers: somatic comorbidity","volume":"50","author":"Thornton","year":"2017","journal-title":"Int J Eat Disord."},{"key":"2020112113262474600_nuz089-B3","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1017\/thg.2017.27","article-title":"A comparison of personality, life events, comorbidity, and health in monozygotic twins discordant for anorexia nervosa","volume":"20","author":"Thornton","year":"2017","journal-title":"Twin Res Hum Genet."},{"key":"2020112113262474600_nuz089-B4","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1001\/archgenpsychiatry.2011.74","article-title":"Mortality rates in patients with anorexia nervosa and other eating disorders. 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