Journal of Obesity & Eating Disorders

Description

Eating disorders (ED) present a significant challenge in clinical practice due to their low remission rates, treatment drop-out, and persistence of residual symptoms. In response to this challenge, the staging approach has emerged as a promising framework to improve the assessment and treatment of ED. This systematic scoping review aimed to map the existing staging models that explicitly propose stages of the progression of ED. From the extensive search results, eleven studies met the inclusion criteria, presenting a total of nine ED staging models, with a predominant focus on anorexia nervosa. Among the identified staging models, three were empirically tested, with one utilizing an objective measure specifically developed to differentiate between stages of ED progression.

Physical features

The majority of the staging models delineated early stages characterized by the exacerbation of ED symptoms, followed by acute phases and transitioning into chronic stages. Intermediate stages encompassed a spectrum of states, including residual phases, remission, relapse, and recovery. The criteria for differentiating between stages varied across the identified models and included behavioral, psychological, cognitive, and physical features, such as body mass index and illness duration. Additionally, one study recommended stage-oriented interventions tailored to the specific needs of individuals at different stages of ED. However, despite the advancements in staging models, the review underscores the importance of empirically testing these frameworks and developing new proposals tailored to diverse ED populations. Moreover, there is a need to incorporate criteria based on medical features and biomarkers to enhance the accuracy and reliability of staging models. Ultimately, staging models have the potential to inform assessment and interventions in daily clinical settings, guiding healthcare professionals in identifying individuals at different stages of ED progression and tailoring treatment approaches accordingly. By adopting a staged approach, clinicians can better understand the trajectory of ED and provide timely and targeted interventions to improve patient outcomes. In conclusion, while the staging approach shows promise in enhancing the assessment and treatment of ED, further research is needed to refine and validate existing models and develop comprehensive staging frameworks applicable to diverse ED populations. Embracing the staging approach has the potential to revolutionize the management of ED and improve long-term outcomes for individuals affected by these complex disorders.

Bulimia nervosa

Furthermore, the inclusion of criteria based on medical features and biomarkers could enhance the accuracy and predictive validity of staging models. Medical features such as hormonal imbalances, electrolyte disturbances, and cardiovascular complications are commonly associated with severe ED presentations and could serve as objective markers for staging. Biomarkers related to neuroendocrine dysregulation, inflammation, and genetic predisposition may also provide valuable insights into the underlying pathophysiology of ED and inform staging criteria. In addition to refining existing staging models, there is a need for the development and validation of staging frameworks tailored to other ED populations beyond anorexia nervosa. Bulimia nervosa, binge-eating disorder, and other specified feeding or eating disorders present unique clinical profiles and trajectories that warrant specialized staging approaches. By incorporating diverse perspectives and leveraging advances in technology and data analytics, future research can advance our understanding of ED progression and inform the development of more personalized and effective interventions. Ultimately, staging models have the potential to revolutionize the way EDs are assessed, monitored, and treated, offering hope for improved outcomes and quality of life for individuals affected by these debilitating conditions.