Outcomes and moderators of shame in residential treatment for eating disorders in females

Eat Disord. 2025 Apr 30:1-19. doi: 10.1080/10640266.2025.2498249. Online ahead of print.

ABSTRACT

Shame is a painful, self-conscious emotion that is implicated in the onset and maintenance of eating disorders. However, there is a dearth of research examining shame outcomes in clinically acute eating disorder samples. The primary purpose of this study is to evaluate the outcomes and moderators of internal shame in female (adolescent and adult) residential patients diagnosed with a range of eating disorders. Participants (N = 176) were attending residential eating disorder treatment for eating disorders and were assessed for internal shame, self-esteem, eating disorder diagnosis, duration of eating disorder, body mass index, depression, and anxiety. Multilevel models were use to explore outcomes and moderators of shame from intake to discharge. Shame (g = 1.21) and self-esteem (g = -0.86) significantly improved from intake to discharge. Changes in shame were moderated by eating disorder diagnosis, BMI, depression, and anxiety, but not duration of eating disorder. These findings suggest that shame and self-esteem significantly improve during eating disorder residential treatment, with specific eating disorder diagnoses and baseline psychological characteristics moderating these changes. Future research is needed to replicate these findings in larger samples to further explore the mechanisms underlying changes in shame in eating disorder residential treatment.

PMID:40305560 | DOI:10.1080/10640266.2025.2498249