Jennifer Couturier

Objective: Eating disorders (EDs) are complex conditions with medical and psychosocial implications. Social media (SM) exposure has been associated with increased body image concerns and maladaptive eating behaviors. Pro‐eating disorder (pro‐ED) communities exist across SM platforms and often perpetuate ED‐related identities and behaviors. As Ozempic gains prominence as a weight‐loss medication, online discourse surrounding its use has grown considerably. This study aims to characterize attitudes and perspectives toward Ozempic within the pro‐ED community on X. Method: Using netnography, publicly available tweets containing the terms “Ozempic” and “edtwt” posted between August 2024 and July 2025 were retrieved. Content analysis was conducted by two independent reviewers using an iterative, consensus‐based approach to analyze naturally occurring online discourse without direct user engagement. Results: The initial search yielded 451 tweets; after applying exclusion criteria, 255 were included in the analysis. Three main categories were identified: personal narrative, information sharing and risk warning, and attitudes and perceptions. Personal narratives reflected curiosity and information seeking (19.2%), desire or intent to use (11.8%), access (9.0%), and active use or experimentation (11.4%). Information sharing and risk warnings accounted for 3.5% of posts. Attitudes and perceptions included ethical and moral judgments (8.2%), normalization and cultural saturation (28.6%), and rejection and critique (8.2%). Discussion: The findings demonstrate that Ozempic is actively integrated within pro‐ED discourse on X, where discussions often normalize its use for weight loss and express sustained interest in its use. This highlights the need for greater awareness of how these medications are circulated within vulnerable online communities.

Objective: This qualitative study aimed to explore paediatric providers' perspectives on the acceptability, feasibility, and appropriateness of the Transition Intervention for Eating Disorders (TIDE) within existing specialised paediatric eating disorder (ED) programs to inform its refinement and implementation in real‐world clinical settings. Method: A Qualitative Description study was conducted in Ontario paediatric ED programs; clinicians and administrative staff participated in virtual focus groups and transcripts were analysed inductively using conventional content analysis. Results: Twenty‐four staff from five Ontario paediatric ED programs participated. TIDE was viewed as valuable and addressing unmet transition needs. Providers endorsed its components but emphasised tailoring to developmental readiness, family structures, and local service contexts. Peer support, structured transition meetings, navigation resources, and primary care involvement were seen as beneficial. Feasibility concerns centred on limited staffing, time, and coordination infrastructure, with many indicating willingness to implement selected components rather than the full model. Conclusions: TIDE was considered a promising framework, but successful implementation depends on contextual adaptation and organisational support. Flexible delivery that preserves core functions of TIDE may enhance its scalability and improve continuity of care for youth transitioning to adult ED services.

Background: Some young people with eating disorders (EDs) require transfer from paediatric to adult services, which can be difficult and distressing. While most research on this topic is qualitative, no qualitative focused synthesis yet exists. Methods: Systematic review identified 21 qualitative studies, which were analysed using meta‐aggregation. Results: Findings included: (1) Age‐related transfers deserve specific attention; (2) The distress of the young person, families, and clinicians must be considered; (3) Clear communication between all parties is essential; (4) Paediatric supports should include early conversations and build health management skills; (5) Timing should align with developmental readiness; (6) Plans should be personalised and account for concurrent life transitions; (7) Referrals should be straightforward; GPs need more training to young people during referral gaps; (8) Joint supports include overlapping care, transition coordinators, transition passports, and peer support; (9) Paediatric and adult services should develop a shared philosophy/culture for emerging adults; (10) Parent/carer involvement should be balanced with building the young person's independence; (11) ED‐specific guidelines or interventions may be beneficial; (12) Adult supports include emerging adult programming, increased resources, and ED training for generalist services. Discussion: While consistent with existing expertise based guidance, this synthesis provides a qualitative evidence base to inform intervention development and co‐production.

In Canada, access to timely, evidence-based care for eating disorders is limited, with long wait times and fragmented services. Clinical practice guidelines can improve consistency and quality of care, but successful implementation remains limited. Canadian practice guidelines and a virtual care addendum have been developed for the treatment of youth with eating disorders (EDs). This study aims to qualitatively seek perspectives on the barriers, facilitating factors and implementation strategies from various interested parties. One semi-structured qualitative focus group was conducted in each of nine Canadian provinces. Focus groups consisted of a combination of clinicians, administrators, and individuals with lived experience who elaborated upon barriers and facilitating factors to guideline uptake as well as possible strategies to enhance implementation. Focus group transcripts were analyzed using conventional content analysis. Findings suggested that participants found it difficult to implement guideline recommendations due to a myriad of factors such as a lack of external resources and minimal training in guideline recommended therapies. Facilitating factors of uptake included support from leadership and explicit training on guideline therapies. Potential implementation strategies included the creation of adapted versions for families and healthcare professionals, as well as enhanced education materials. The findings of this study indicate areas within healthcare provision that can be enhanced and expanded upon to further enhance the uptake of the Canadian practice guidelines for children and adolescents with eating disorders.

Introduction: Despite its serious impact, anorexia nervosa (AN) remains one of the least understood mental illnesses, with significant gaps in effective treatment options. No medications have been deemed effective and only 50% of individuals respond to conventional psychotherapies. Gastrointestinal (GI) bacteria have been found to be altered in individuals with AN. While, Fecal microbiota transplantation (FMT) has shown potential for alleviating anxiety and depression, its effects remain understudied for individuals with AN. This study aims to determine whether oral capsular FMT is acceptable to adolescents with AN and results in clinical improvement in weight and/or psychological symptoms. Methods: This study will randomise 20 adolescents with AN, ages 12–17 years, to receive either FMT or placebo capsules. These 20 youth, as well as an additional 10 youth who decline trial enrolment, will participate in qualitative interviews. We will track recruitment rates and collect psychological and biological measures (blood, stool, urine and saliva) at multiple timepoints to assess how gut microbiota and their metabolites may influence the symptoms of AN. Interviews with participants and caregivers will explore their experiences and views on FMT as a treatment approach. Ethics and dissemination: This study has received ethics approval by the Hamilton Integrated Research Ethics Board (#17493) and investigational drug approval by Health Canada (Dossier ID: c292423). Informed consent will be obtained by research staff from all participants. Findings will be disseminated through academic conferences, clinical forums and partnerships with advocacy organisations to reach clinicians, researchers and individuals with lived experience. Trial registration number: NCT06593366 .

Parenting a child with an eating disorder (ED) while also navigating the healthcare system can be complex and overwhelming. Preliminary research indicates

Background: Early intervention for eating disorders (EDs) models and services is not formalized in Canada, despite increasing demand for care and well-established clinical, social, and economic benefits of intervening early. Purpose: FREEDcan (First Episode Rapid Early Intervention for Eating Disorders–Canada) introduces a community-based model to improve early identification, initial response, and access to evidence-based interventions for young people aged 8–25 years with early-stage EDs. Methods: FREEDcan was co-adapted from the United Kingdom’s evidence-based FREED model for the Canadian context with a multi-partner advisory group of clinicians, community organizations, youth and family advisors, researchers, and an implementation science team. It has three pillars: early identification, initial response, and evidence-based interventions for early-stage EDs. Implementation is supported by intersectoral partnerships, community-driven adaptation, and integrated workforce expansion to build capacity and facilitate sustainable, integrated early intervention. Anticipated outcomes: From a service perspective, FREEDcan aims to improve early detection of EDs, reduce duration of untreated illness through rapid, low-barrier responses, and increase access to stage-appropriate interventions. Additional implementation-based outcomes are anticipated, including evidence for core components, costs, and adaptations relevant to scaling this model in diverse regions across Canada. Conclusions: FREEDcan has the potential to provide an accessible, youth-centered, developmentally appropriate approach to early ED care within a collaborative, community-driven, integrated care framework. Using a learning health systems approach, it strives for continuous evaluation to support real-time learning, opportunities for model improvement, and evidence-generation for a new integrated model of care for early-stage ED care for young people in Canada.

Guided self-help family-based treatment (GSH-FBT) is emerging as a promising, more efficient alternative to traditional family-based treatment (FBT). The present study is designed to examine the real-world implementation of GSH-FBT at pediatric treatment sites across nine provinces in Canada. Implementation teams at each site consisting of a GSH-FBT coach, a medical provider, and a program administrator will be formed. Clinician coaches will be trained in this new modality and supported with weekly GSH-FBT consultation. Each site will recruit ten families with an adolescent with anorexia nervosa and the parents will undergo ten virtual GSH-FBT sessions. The implementation approach will be evaluated using qualitative and quantitative methods. Outcomes of interest include (1) treatment fidelity, (2) treatment wait times, (3) change in adolescent symptoms and parent/caregiver self-efficacy, (4) change in provider readiness, attitudes, and confidence towards the intervention, and (5) the overall experience of the implementation of the intervention from the perspective of the provider teams, and participant families. The findings of this study will help to identify factors important to the acceptability and implementation of GSH-FBT in real-world clinical settings. This study was first registered with clinicaltrials.gov (registration # NCT06851273) on February 12, 2025 (url: https://clinicaltrials.gov/study/NCT06851273?id=NCT06851273&rank=1 ).

There is increasing interest and exploration in tailoring eating disorder (ED) treatment for emerging adults/transition-age youth. This review provides a narrative update on research findings from 2021 to 2025. There has been continued development of ED-focused family therapy approaches for emerging adults, and we have also started to see the tailoring of existing individual treatments (e.g., Cognitive Behavioural Therapy (CBT), Maudsley Model of Anorexia Nervosa Treatment) for this age group. A notable development is the implementation and evaluation of treatments or service pathways aiming to deliver timely and accessible intervention to emerging adults: the First Episode Rapid Early Intervention for ED (FREED) service model and care pathway continues its scale and spread, and shorter forms of treatment, such as CBT-Ten, have been successfully delivered via both FREED and general mental health early intervention pathways. There has been a marked increase in ED treatment innovation and evaluation for emerging adults over the last few years. As of yet, it remains unclear if there is a single 'best' treatment approach for this age group. Anecdotally, there appears to be a shift away from exclusively family or individual oriented treatments. Future research should advance inclusive, developmentally aligned treatments for emerging adults by addressing peer support, youth engagement, and gaps in care models. Interventions must be adaptable across formats and populations while integrating seamlessly within existing systems through personalized, context-responsive strategies.