Summary: This systematic review examined change in eating disorder risk during weight management interventions. Four databases and clinical trials registries were searched in March and May 2022, respectively, to identify behavioral weight management intervention trials in adults with overweight/obesity measuring eating disorder symptoms at pre‐ and post‐intervention or follow‐up. Random effects meta‐analyses were conducted examining within group change in risk. Of 12,023 screened, 49 were eligible (n = 6337, mean age range 22.1 to 59.9 years, mean (SD) 81(20.4)% female). Interventions ranged from 4 weeks to 18 months, with follow‐up of 10 weeks to 36 months post‐intervention. There was a within group reduction in global eating disorder scores (20 intervention arms; Hedges' g = −0.27; 95% CI −0.36, −0.17; I² 67.1%) and binge eating (49 intervention arms; −0.66; 95% CI −0.76, −0.56; I² 82.7%) post‐intervention, both maintained at follow‐up. Of 14 studies reporting prevalence or episodes of binge eating, all reported a reduction. Four studies reported eating disorder symptoms, not present at baseline, in a subset of participants (0%–6.5%). Overall, behavioral weight management interventions do not increase eating disorder symptoms for most adults; indeed, a modest reduction is seen post‐intervention and follow‐up. A small subset of participants may experience disordered eating; therefore, monitoring for the emergence of symptoms is important.

Objective: To estimate the prevalence of eating disorders and disordered eating in adults seeking obesity treatment.Method: Databases, MEDLINE, Embase, and PsycINFO, were searched to 20th March 2025. Studies reporting the prevalence of eating disorders or disordered eating at presentation to obesity treatment in adults (≥ 18 years) with overweight (BMI 25 to < 30 kg/m²) or obesity (BMI ≥ 30 kg/m²), with ≥ 325 participants to ensure a representative sample, were included. A random‐effects model was used to pool prevalence estimates of eating disorders and disordered eating.Results: 85 studies were included (n = 94,295, 75.9% female, median (IQR) age 44 (5) years, BMI 46 (10) kg/m²). When assessed by clinical interview, the pooled prevalence of binge‐eating disorder (Diagnostic and Statistical Manual of Mental Disorders‐5) was 14% (95% CI: 7 to 22, prediction interval [PI]%: 0 to 43, k = 10, n = 8534), and bulimia nervosa 1% (95% CI: 0 to 1, PI%: 0 to 2, k = 9, n = 9448, τ² = 0). When assessed using the Binge Eating Scale, the prevalence of self‐reported moderate severity binge eating was 26% (95% CI: 23 to 28, PI%: 18 to 33, k = 12, n = 8113, τ² = 0.001) and severe binge eating was 12% (95% CI: 8 to 16, PI%: 0 to 31, k = 18, n = 12,136, τ² = 0.01).Discussion: Obesity and eating disorders or disordered eating do co‐occur. There was variability between studies and between the prevalence of eating disorders and disordered eating in adults presenting for obesity treatment. It is critical that clinicians are well resourced to effectively identify individuals with eating disorders and disordered eating and provide appropriate treatment pathways.

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.

Aim: To describe popular diet content visible on #intermittentfasting, #keto, and #lowcarb on adolescent social media accounts.Methods: An adolescent Instagram profile captured 200 ‘top’ images from three popular diet hashtags (#intermittentfasting, #keto, and #lowcarb) across two timepoints. Images were coded using a pre‐determined ontology as food (core or discretionary; common foods/food groups), people (group, individual, before/after), or informative. Descriptive statistics were used to summarise these categories across hashtags.Results: At the time of first data collection, there were 3.8 million #intermittentfasting, 19 million #keto, and 22 million #lowcarb posts on Instagram. At the second timepoint there were 4.3 million #intermittentfasting, 21.5 million #keto, and 24.3 million #lowcarb posts. Images tagged #intermittentfasting were categorised as 44% food, 39% people, 10% information; #keto were 64% food, 28% people, 5% information; and #lowcarb were 69% food, 14% people, 16% information. Food images mostly depicted animal proteins (58.6% of #intermittentfasting; 62.9% of #keto; and 40.1% of #lowcarb). Images of people were individual (44%) or before/after (39%); mostly female (77%), of white (53%) ethnicity. Across all posts, 12.5% were linked to a commercial product/program, and 2.3% provided nutrition information.Conclusion: Diet‐related images visible when adolescents search #intermittentfasting, #keto, and #lowcarb on Instagram promote animal‐based foods with or without vegetables. These diet hashtags on Instagram do not provide nutrition information and are not helpful for young people searching for diet information online.

Objective: To understand delivery features and intervention strategies of adolescent weight management interventions which may influence eating disorder risk. Methods: Systematic searches in four databases and two trial registries to identify randomised controlled trials in adolescents with overweight/obesity measuring eating disorder risk pre‐ and post‐intervention. Delivery features and intervention strategies were coded from published descriptions using a project‐specific codebook, validated by trial investigators and narratively synthesised. Results: Of 11 860 records screened, 23 trials, with 54 intervention arms, were included in the analysis. Most interventions focused on weight loss and maintenance (54%) and were informed by a cognitive behavioural framework (43%). Interventions commonly targeted an individual with a support person (70%). Median intervention duration was 26 weeks, with weekly (35%) or staged (e.g., weekly, then monthly) visit (41%) frequency. Interventions had a mean (SD) of 30 (16.1) intervention strategies. Most included healthy eating education (89%), physical activity education (89%) and problem‐solving barriers to dietary change (80%). Few included mental health strategies (17%). Interventions included ‘dietary prescription’ (65%), and 78% promoted ‘healthful/helpful eating behaviours’. Conclusion: Weight management interventions are complex and vary in delivery approach and strategies used to change behaviors. Characterising interventions is a critical first step to understanding how weight management interventions' influence eating disorder risk.