Staging models in eating disorders: A systematic scoping review of the literature
Open accessAbstract
Eating Disorders (ED) are characterized by low remission rates, treatment drop-out, and residual symptoms. To improve assessment and treatment of ED, the staging approach has been proposed. This systematic scoping review is aimed at mapping the existing staging models that explicitly propose stages of the progression of ED. A systematic search of PubMed, PsycINFO, Scopus was conducted with the terms staging, anorexia nervosa, bulimia nervosa, binge-eating disorders, eating disorders. Eleven studies met inclusion criteria presenting nine ED staging models, mostly for anorexia nervosa. Three were empirically tested, one of which was through an objective measure specifically developed to differentiate between stages. Most staging models featured early stages in which the exacerbation of EDs unfolds and acute phases are followed by chronic stages. Intermediate stages were not limited to acute stages, but also residual phases, remission, relapse, and recovery. The criteria for stage differentiation encompassed behavioral, psychological, cognitive, and physical features including body mass index and illness duration. One study recommended stage-oriented interventions. The current review underscores the need to empirically test the available staging models and to develop and test new proposals of staging models for other ED populations. The inclusion of criteria based on medical features and biomarkers is recommended. Staging models can potentially guide assessment and interventions in daily clinical settings.
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Prioritization of Psychopathological Symptoms and Clinical Characterization in Psychiatric Diagnoses
Leucht, S., van Os, J., Jäger, M., & Davis, J. M. (2024) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2024.2652 · Cited by 48 · see citing works
Early intervention for eating disorders
Mills, R., Hyam, L., & Schmidt, U. H. (2024) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000963 · Cited by 18 · see citing works
Assisted death in eating disorders: a systematic review of cases and clinical rationales
Roff, C., & Cook-Cottone, C. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1431771 · Cited by 16 · see citing works
The pharmacological treatment of anxiety in people with eating disorders: A systematic review
Morris, R. C., Keeler, J. L., Treasure, J. L., & Himmerich, H. (2025) · Pharmacological Research · doi:10.1016/j.phrs.2025.107782 · Cited by 7 · see citing works
Robinson, P. H., Guidetti, G., Kasriel, J., Khawandanah, J., Hughes, M., & Hachem, Z. A. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01161-2 · Cited by 7 · see citing works
Longstanding eating disorders: insights and innovations in severe and enduring illness
Hay, P., Dann, K. M., & Touyz, S. W. (2025) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000001036 · Cited by 5 · see citing works
Clinical staging across eating disorders: a scoping review protocol
Hyam, L., Phillips, M. D., Gracie, L., Allen, K. L., & Schmidt, U. H. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-077377 · Cited by 5 · see citing works
Häfeli, X. A., Morosan, L., Hirsig, A., & Schmidt, S. J. (2026) · JCPP Advances · doi:10.1002/jcv2.70118 · Cited by 3 · see citing works
Validated eating disorder screening tools for paediatric populations: A systematic review
Jabs, M., Pennesi, J., Baillie, S. E., Hay, P., Mitchison, D., Norton, L., Prnjak, K., Wade, T. D., & Hart, L. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116631 · Cited by 3 · see citing works
Early intervention in eating disorders: introducing the chronopathogram
Preti, A., Bevione, F., Lacidogna, M. C., Raballo, A., Poletti, M., & Daga, G. A. (2025) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-025-01715-6 · Cited by 3 · see citing works
Anorexia nervosa: 150 years of critical theory
Bryant, E., Touyz, S. W., Oldershaw, A., Treasure, J. L., & Maguire, S. (2026) · Journal of Eating Disorders · doi:10.1186/s40337-026-01528-7 · Cited by 2 · see citing works
Chiesa, A., Giuseppe, R. D., Motta, G., Sottotetti, F., Scribante, A., Cena, H., & Butera, A. (2025) · British Journal Of Nutrition · doi:10.1017/s000711452510500x · Cited by 1 · see citing works
IGF-1 and recovery in anorexia nervosa: evidence from population-based and clinical cohorts
Dani, C., Tarchi, L., Bonacchi, L., Haydar, S., Cassioli, E., Rossi, E., Fanelli, A., Logu, F. D., Nassini, R., Micali, N., et al. (2026) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgag211 · Cited by 1 · see citing works
Schmidt, U. H., Hyam, L., Gallagher, L. B., & Allen, K. L. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01297-9
Innovations in Models of Staged Care for Youth Mental Health
Blonner, M., Simcock, G. P., Storch, E. A., & Farrell, L. J. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.06.001
Defining Recovery and Relapse in Bulimia Nervosa: A Systematic Review of the Literature
Gardini, V., Pagli, F., & Tomba, E. (2025) · European Eating Disorders Review · doi:10.1002/erv.70033
Tomei, G., & Tomba, E. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01491-9 · Cited by 1 · see citing works
Morales‐Puerto, N., Fayt, C., du Montcel, C. T., & Everard, A. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01503-8
Morris, R. C., Gundogan, A., Lawrence, V. C., Himmerich, H., Treasure, J. L., & Keeler, J. L. (2026) · BMC Medicine · doi:10.1186/s12916-026-04929-2
Alckmin-Carvalho, F., Wendt, G. W., Teixeira, I. D. N., Teixeira, M. C. T. V., & Melo, M. H. D. S. (2026) · Psychiatry International · doi:10.3390/psychiatryint7040152
de Geus, G., Trott, M., Monteleone, A. M., Firth, J., Siskind, D., Teasdale, S., Arnautovska, U., Iyer, R., Stubbs, B., Demidenko, N., et al. (2026) · Journal of Eating Disorders · doi:10.1186/s40337-026-01731-6
Aurup, A. V., Joensen, A., Olsen, E. M., Mikkelsen, N. M., Danielsen, S., Larsen, P. S., & Strandberg‐Larsen, K. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70204
Cassioli, E., Maiolini, G., D’Areglia, E., Tarchi, L., Rossi, E., Ceccarelli, V., Dani, C., Zompa, L., Ranieri, C., Lodovici, E., et al. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70224
- Authors
- Tomba, E., Tecuta, L., Gardini, V., Tomei, G., & Lo Dato, E.
- Affiliations
- University of Bologna (IT)
- Corresponding author
- Tomba, E.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2024-05
- Volume
- 131
- Pages
- 152468
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W4392381253
- Cited by
- 24
- References
- 106
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 4 · 2023: 1
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Comprehensive Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- eating disorders, staging model, anorexia nervosa, bulimia nervosa, binge eating disorder, disease progression, remission, relapse, recovery, biomarkers, disease duration, body mass index
- MeSH terms
- Anorexia Nervosa, Feeding and Eating Disorders, Humans, Body Mass Index, Disease Progression, Bulimia Nervosa, Binge-Eating Disorder
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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