Background/Objectives: The primary aim of this study was to characterize athletes approaching an outpatient interdisciplinary and multidisciplinary consultation structure for athletes with a suspected relative energy deficiency in sport (REDs) cross-sectionally and longitudinally to prove treatment efficacy. Methods: Data of 58 athletes suspected of REDs were collected at the onset (t₀) and completion (t₁) of interdisciplinary and multidisciplinary REDs treatment (clinical practice) between January 2019 and December 2022. The data included extracted information from medical records, anthropometric characteristics, physical performance diagnostics, laboratory values, dietary records, and partially gynecological and psychosomatic diagnostics. Results: The sample primarily consisted of female athletes (97%) under 18 years of age (66%) who were underweight with a body mass index (BMI) < 18.5 kg/m² and BMI percentile below the 10th percentile for their age and gender-specific norms (59%), and experienced menstrual disorders (93%). The dietary behavior is characterized by plant-based and low-energy-dense foods. Eating disorders (anorexia nervosa and bulimia nervosa) were diagnosed in 40% of the athletes according to the International Statistical Classification of Diseases and Related Health Problems 11th revision criteria. During the program, 64% of the athletes exhibited a mean weight gain of 7 (±6) kg (p < 0.001), excluding those still undergoing treatment (36%). Conclusions: The proposed interdisciplinary and multidisciplinary treatment approach proved effective and holds promise for future evidence-based developments in REDs treatment.

Background: Various mental health and eating behavior variables have been independently associated with predicting weight loss in individuals with obesity. This study aims to investigate a mediation model that assesses the distinct contributions of these variables in predicting weight changes in patients with obesity following an outpatient behavioral weight loss intervention (BWLI). Methods: General mental health (depression, anxiety, stress, impulsivity), eating behavior (cognitive restraint, disinhibition, hunger), eating disorder pathology, and body mass index (BMI) were assessed in a group of 297 patients with obesity at the admission of a BWLI program. BMI was re-evaluated during the final treatment session. A mediation model was employed to examine whether mental health and eating behavior variables predicted BMI changes, with eating disorder pathology serving as a mediator. The model was tested both overall and within two patient subgroups: those with regular binge eating (≥four episodes/month) and those without. Results: In the overall sample (n = 238), the relationships between depression, impulsivity, and cognitive restraint with BMI change were mediated by eating disorder pathology. In the subgroup with regular binge eating (n = 99, 41.6%), the associations between stress and disinhibition with BMI change were additionally mediated by eating disorder pathology. In the subgroup without regular binge eating, eating disorder pathology showed no mediating effect. Discussion: Multiple mental health and eating behavior variables assessed at admission predicted BMI changes, particularly when mediated by eating disorder pathology in patients with regular binge eating. A comprehensive psychopathological assessment prior to starting BWLI may help identify multiple factors affecting prognosis and treatment outcomes. Long-term follow-up studies in this field are required.

Background: Obesity is a major global public health burden, yet the mechanisms underlying interindividual variability in treatment response remain poorly understood. Olfactory function influences eating behavior and may differ in individuals with obesity. However, evidence in pediatric populations is limited, and their responsiveness to weight loss remains unclear. This study aimed to assess olfactory function in children and adolescents with obesity before and after an inpatient weight loss intervention. Specifically, we examined whether olfactory performance is within normative values and whether it changes in response to weight reduction. Methods: Sixty children and adolescents with overweight or obesity (13.0 ± 1.9 years, BMI z-score: 2.5 ± 0.5) underwent a structured inpatient rehabilitation program (mean duration: 38 ± 10 days) integrating nutrition therapy, physical activity, stress management, and behavioral modification. Olfactory function was assessed at baseline (T1, ~ 7 days after admission) and after the intervention (T2, ~ 27 days after T1) using the Sniffin’ Sticks Test©, comprising odor threshold, discrimination, and identification. At both time points, participants self-reported their perceived olfactory ability. Results: At T1, data were available for 59 participants; 50 completed the follow-up assessment at T2. Completers showed significant reductions in body weight and BMI z-score ( p < .001). Olfactory function at T1 was largely within the normative range when compared with age-matched reference data. During weight loss, olfactory function remained largely stable: odor identification improved modestly ( p = .003), whereas odor threshold and discrimination showed no significant changes and were not associated with weight loss. Self-reported olfactory ability showed weak correspondence with objective measures and remained unchanged. Conclusions: Olfactory function in children and adolescents with obesity was largely within the normative range and showed limited change during short-term inpatient weight loss. These findings suggest that olfactory alterations may not be a primary determinant of short-term treatment response. However, age- and domain-specific variability may still be relevant for how individuals perceive and respond to food-related cues, with potential implications for dietary adherence and long-term weight management. Future studies with normal-weight control groups should examine whether such variability contributes to differences in eating behavior and long-term outcomes. Trial registration: DRKS00005122.

Maintaining adequate nutritional intake and body mass is critical in spaceflight and its terrestrial analogs; however, comprehensive evidence on dietary intake patterns and nutritional adaptations during long-term isolation and confinement remains limited. Following PRISMA guidelines, this systematic review synthesizes evidence on dietary intake and nutrition-related adaptations in isolated and confined environments. Across 184 studies, dietary structure ranged from highly standardized to highly variable. Energy intake differed substantially across habitats, whereas macronutrient distributions remained within recommended ranges, characterized by stable protein intake across habitats and more variable carbohydrate and fat contributions. Body mass generally decreased, with the greatest heterogeneity observed in terrestrial isolated, confined, and extreme environments. Vitamin D insufficiency was consistently reported but could be effectively prevented through supplementation. Overall, isolated and confined environments challenge nutritionally adequate food systems, and current evidence is insufficient to draw firm conclusions on optimal strategies, particularly for longer-duration space missions.