3-Dimensional Optical Scanning to Assess and Monitor Malnutrition in Eating Disorders (3D-ED) Study

Conditions: Anorexia in Adolescence; Anorexia Nervosa; Anorexia Nervosa, Atypical; Anorexia Nervosa, Binge Eating/Purging Type; Anorexia Nervosa Restricting Type; Anorexia Nervosa With Significantly Low Body Weight; Body Composition Changes; Growth & Development; Malnutrition Severe; Malnutrition, Calorie

Sponsors: University of California, San Francisco; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); Denver Health and Hospital Authority; University of Hawaii

Not yet recruiting

The association between worry, rumination, and metacognitive beliefs in female adolescents with Anorexia Nervosa

BackgroundA growing body of literature has emphasized the role of worry and rumination in eating disorders (EDs). According to the metacognitive model, worry and rumination are maintained by dysfunctional metacognitive beliefs. Although metacognitive beliefs have been investigated in adults with EDs, their role in adolescents with EDs remains underexplored. The present exploratory study aimed to examine the specific association among worry, rumination, and metacognitive beliefs and eating disorder symptomatology in adolescents with AN.MethodsThirty Italian female adolescents (mean age ± SD: 15.387 ± 1.35 years, mean Body Mass Index (BMI): 16.34 ± 2.5 kg/m2) completed a self-report survey composed of the Penn State Worry Questionnaire (PSWQ), the Ruminative Response Scale (RRS), the Metacognitions Questionnaire – 30 (MCQ-30), and the Eating Disorder Inventory – 3 (EDI-3).ResultsThus, Model 1, including RRS and PSWQ, was significant (F = 17.5, p<0.001) and explained 57% of the variance (R² = 0.574). Within this model, RRS was the only significant predictor (p = 0.019) of the Eating Disorder Risk Composite (EDRC) of EDI-3, indicating that higher rumination scores were associated with greater eating disorder symptomatology. Once MCQ was entered as a predictor of EDRC, there was no significant incremental variance compared with Model 2 (ΔR² = 0.0034, p = 0.658), even though the model remained significant overall (F = 11.4, p < 0.001). The final model explained 58% of variance (R² = 0.578; Cohen’s f2 = 1.37).ConclusionRumination was significantly associated with eating disorder symptomatology. Although worry showed strong positive associations with eating disorder symptomatology at the correlational level, it did not maintain an independent role once rumination was included in the regression model. The final model showed a very large effect size (Cohen’s f² = 1.37), suggesting strong associations between predictors and eating disorder symptoms in the present sample. However, this estimate should be interpreted cautiously, given the limited sample size and the exploratory nature of the analysis. Contrary to our expectations, metacognitive beliefs did not significantly explain the variance of eating disorder symptomatology. This finding may reflect the more proximal role of RNT in explaining the variance in eating disorder symptomatology, or alternatively, the possibility that only specific metacognitive domains—rather than overall metacognitive functioning—are relevant in this population.

E-diary vs Paper Diary in Binge Eating Disorder

Conditions: Binge Eating Disorder

Interventions: Other: The subject will complete e-diary for 2 weeks; Other: complete paper diary for 2 weeks

Sponsors: Lindner Center of HOPE; SignanthHealth; The Lindner Center of HOPE

Recruiting

Perspectives on Remote Monitoring via Smartphones and Wearables Among Individuals With Lived Experience or at Risk of Eating Disorders (“This Could Go Very, Very Wrong”): Qualitative Interview Study

Background: Remote measurement technology (RMT) is increasingly used in health research to collect real-world data relevant to clinical states (eg, sleep, activity, and stress). Concerns exist about the impact of remote tracking via personal devices and wearables on individuals with or at risk of eating disorders (EDs) by promoting a focus on exercise, diet, and appearance. There is a lack of research applying RMT to EDs. Objective: This study aimed to explore how smartphone- and wearable-based RMTs influence eating-, exercise-, and weight-related experiences among individuals with a history of or at risk of EDs and to identify perceived benefits, harms, and recommendations for their use in this population. Methods: In total, 14 semistructured interviews were conducted with former participants of Remote Assessment of Disease and Relapse: Major Depressive Disorder, a 2-year digital health study tracking depression outcomes via RMTs. Participants were included in this follow-up if they had disclosed a history of a comorbid ED or were within the at-risk age range (18-30 years) for EDs during Remote Assessment of Disease and Relapse: Major Depressive Disorder and displayed subclinical ED symptoms (Eating Disorder Diagnostic Scale). Interviews explored the impact of app engagement and wearables (Fitbits) on food, activity, and weight-related behaviors and attitudes. Template analysis was adopted to capture themes guided by the focus on ED-relevant domains. Results: In total, 6 themes captured participants’ experiences with RMTs across clinical status and presentation. Participants broadly appreciated the convenience and reflective potential, while some described emotional strain linked to constant self-tracking. Health data impacted participants’ eating and exercise habits through a dynamic process from awareness to cognition to action, fostering healthy routines or obsessive patterns, depending on emotional state, ED presentation, and recovery stage. Self-tracking appeared to mirror illness stage, supporting ED recovery among those with greater distance from illness, but risking reinforcement of compulsive patterns among those with residual or emerging symptoms. Participants’ recommendations for future studies in EDs stressed balancing autonomy with safeguards for vulnerable individuals. Conclusions: These exploratory findings, drawn from individuals with lived ED experience and young people at subclinical risk, suggest that RMT use was shaped by recovery stage and contextual factors, rather than being inherently beneficial or harmful. While findings should not be interpreted as evidence of RMT safety or acceptability in ED cohorts broadly, they raise important questions about ethical RMT design, including the selection of wearables, access to data, and researcher communication with participants.
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HALO-TRIAL: High, Medium And LOw Intensity Psychotherapy for Binge Eating Disorder

Conditions: Binge Eating Disorder; Binge Eating Episodes; Binge Eating/Loss of Control Eating; Binge Eating Disorders; Binge Eating; Binge Eating Behaviour; Binge Eating Disorder Associated With Obesity; Eating Disorder Binge; Eating Disorders

Interventions: Behavioral: Cognitive Behavioral Therapy Enhanced – Individual; Behavioral: Cognitive Behavioral Therapy Enhanced – Group; Behavioral: Cognitive Behavioral Therapy – Guided Self Help; Behavioral: Systemic Narrative Therapy – Group

Sponsors: Herlev and Gentofte Hospital; Jascha Fonden; BETA-HEALTH Foundation; Mental Health Centre Ballerup; Region Capital Denmark; University of Copenhagen

Recruiting

StockWatch: Insilico Projects Profit, Revenue Leaps as AI-Developed Lead Candidate Moves to Phase III

Insilico Medicine (Hong Kong Exchange: 3696), an AI-based drug developer whose profile within biopharma has risen with its recent collaborations with industry giants, has offered investors an upbeat revenue and profit forecast for the first half of 2026, driven by its series of partnerships and a wide-ranging pipeline whose first program has reached late-stage development this past week.

Insilico said it expects to finish the first half of 2026 in the black, with “net profit” or net income ranging from approximately $33.5 million to $39.5 million, compared with its $19.2 million net loss in January–June 2025. Insilico also released adjusted non-International Financial Reporting Standards (IFRS) net profit forecasts in the range of approximately $45.5 million to $51.5 million for H1 2026. Non-IFRS metrics exclude one-time costs, such as restructuring charges and asset sales.

The company is additionally forecasting record first-half revenue ranging from approximately $102.5 million to $106.5 million, up approximately 272.7% to 287.3% from a year ago.

By contrast, Insilico finished all of 2025 with $56.239 million in revenue, down 34% from $85.834 million a year earlier, as a 69% slide in pipeline development revenue (to $23.885 million) outpaced the company’s nearly eight-fold increase in drug discovery revenue, to $24.952 million.

Notably, Insilico last year incurred a $352.5 million net loss, more than 20 times the company’s $17.1 million net loss in 2024, a jump the company attributed to the revenue drop as well as a $296.7 million loss from changes in the fair value of financial liabilities at fair value through profit or loss. That loss stemmed from Insilico converting the preferred shares issued in previous financings into ordinary shares when the company went public in December, raising HKD 2.277 billion (about $292.3 million at the time; now worth $283.9 million) on the Hong Kong Exchange.

Yet just as notably, Insilico’s cash and cash equivalents more than tripled last year, to $393.338 million.

“We look forward to achieving sustained profitability,” Alex Zhavoronkov, PhD, Insilico’s founder and CEO, said in a statement.

The forecasts continued the small but noticeable rise in Insilico’s stock price since Wednesday when the company announced that its lead candidate rentosertib, a drug designed to treat idiopathic pulmonary fibrosis (IPF), has advanced to a Phase III trial, the first drug within the company’s expansive 40+ program pipeline to reach that clinical milestone.

“Full arc of our mission”

“Rentosertib is a very important program for Insilico because it represents the full arc of our mission: using AI not only to move faster, but to originate new biology, new chemistry, and new therapeutic opportunities in aging and disease,” Zhavoronkov stated.

That news sparked a mini surge that sent Insilico’s shares climbing 19% over three days. Shares rose 2.7% from HKD$36.02 ($4.49) Tuesday to HKD$37 ($4.61) Wednesday, followed by a 7.7% gain Thursday as the stock rose to HKD$39.84 ($4.97)—then a 7.5% jump Friday, with Insilico closing the week at HKD42.82 ($5.34).

At least one investment firm started coverage of Insilico’s Hong Kong-traded stock with positive commentary: Cui Cui, an equity analyst with Jefferies, initiated the firm’s coverage with a “Buy” rating and 12-month price target of HK$100 ($12.47).

Jefferies’ endorsement capped a year in which Insilico escalated its partnership activity with pharma giants and smaller biotechs, adding roughly up to $7 billion to a potential haul that could exceed $10 billion.

The largest of these collaborations is its up-to-$2.75 billion collaboration ($115 million upfront) with Eli Lilly (NYSE: LLY), under which Insilico granted Lilly an exclusive global license to develop, manufacture, and commercialize “potentially best-in-class, novel oral therapeutics in preclinical development for certain indications,” according to an announcement that didn’t specify the therapeutic areas where the companies plan to partner. The alliance expanded from an “over $100 million” R&D partnership inked last November, which in turn grew from a 2023 licensing agreement allowing Lilly to access Insilico’s Pharma.AI software suite.

“Combining first-mover advantage, wet-lab validation, deep medical science, and in-house clinical expertise to train and refine AI, plus LLY’s endorsement, Insilico looks well positioned for scalable BD [business development] and LT [long-term] monetization,” Cui wrote in a research note.

“As AI-driven productivity cont[inues] to scale PCC [preclinical candidate] output, Insilico is positioned to expand its pool of proprietary assets, enhancing the likelihood of future out-licensing opp[ortunity] and strengthening LT monetization potential,” Cui added.

Zhavoronkov highlighted the research note on his LinkedIn feed, adding: “I think that in many ways the analysts know the industry and the company even better than some of the insiders. Definitely worth a read.”

Phase III plans

Cui’s comments followed Insilico announcing its Phase III plans for rentosertib (formerly ISM001-055), which is designed to treat IPF by targeting Traf2- and NCK-interacting kinase (TNIK), a serine/threonine kinase whose activation plays a crucial role in cellular processes that include signal transduction pathways essential for fibrosis development.

Insilico said its planned Phase III trial (NCT07687459) will be a randomized, double-blind, placebo-controlled, parallel-group study that is expected to enroll 320 participants across 47 centers in China. The trial’s primary endpoint will be the annual rate of decline in forced vital capacity (FVC) over 52 weeks, with a key secondary endpoint of time to first occurrence of any disease progression event.

The Phase III trial aims to assess whether rentosertib can provide clinically meaningful benefit in a larger patient population and over a longer treatment period than its two 12-week Phase IIa studies.

Rentosertib has completed a Phase IIa trial (NCT05938920) in China, published in Nature Medicine last year, and is in a separate Phase II trial (NCT05975983) in the United States. In the Chinese trial, rentosertib met its primary endpoint of safety and tolerability across all dose levels, as well as positive secondary endpoint data, namely dose-dependent FVC improvement with a mean FVC change of +98.4 mL at 12 weeks in patients dosed at 60 mg once daily, vs. -20.3 mL for placebo.

During the BIO International Convention in San Diego, Zhavoronkov hinted at the Phase III, highlighting a planned “next step” for the program “in the second half, but maybe closer to the earlier second half,” he told GEN.

At the convention, Zhavoronkov led Insilico in celebrating its latest big-money collaboration, an up-to-$2.5 billion partnership with SK Biopharmaceuticals to discover new AI-based drug candidates for disorders affecting the neuroimmune area of the central nervous system (CNS). Insilico agreed to apply its Pharma.AI platform, which addresses target validation, generative chemistry, and molecule optimization, along with its preclinical drug discovery expertise, to discover, design, and optimize candidates for neuroimmune indications against targets that will originate with SK.

SK is part of a privately held, family-owned chaebol or conglomerate whose parent holding company is public, SK Inc. (Korea Exchange: 034730). Another SK-owned company—SK Hynix (Nasdaq: SKHY), a supplier of high-bandwidth memory chips that power the AI processors of Nvidia and AMD—went public Friday, raising a staggering $26.5 billion by pricing its U.S. American depositary shares (ADS) at $149 each.

Potentially lucrative partnerships

In addition to SK and Lilly, Insilico also has potentially lucrative partnerships with Sanofi (Euronext Paris: SAN), with which Insilico plans to advance up to six targets (up to $1.2 billion); privately held Menarini Group, to which it has outlicensed Phase I cancer treatments targeting KAT6 and KIF18A (up to $1.05 billion in collaborations launched 2024 and 2025); privately held, French-based Servier, also cancer focused (up to $888 million); and Takeda Pharmaceutical (Tokyo Stock Exchange: 4502), drug discovery across its therapeutic areas (up to $600 million).

Also among Insilico’s collaboration partners: Exelixis (Nasdaq: EXEL), to which Insilico outlicensed in 2023 a Phase I BRCA-mutated cancer drug targeting USP1 (“close to” $1 billion plus royalties), Fosun Pharma (Shanghai Stock Exchange: 600196; Hong Kong Exchange: 02196), which is joining Insilico on R&D for four biological targets plus co-development of Insilico’s QPCTL program (up to $82 million, including $13 million upfront and a $15 million equity investment); Fosun-backed but privately held Hygtia Therapeutics, which is co-developing with Insilico ISM8969, a Phase I oral brain penetrant NLRP3 inhibitor, in CNS disorders (up to $66 million, including $10 million upfront and milestones); and Taipei-based TaiGen Biotechnology (Taipei Exchange: TWD), which holds Greater China rights to an oral PHD1/2 inhibitor in anemia of chronic kidney disease (milestones and royalties totaling “two-digit million dollars”).

Rounding out the list of Insilico’s disclosed collaboration partners are Chinese-based Qilu Pharmaceutical Group, which is partnering to jointly develop small molecule inhibitors for specific targets in cardiometabolic disease management (up to “near” $120 million, including milestones and single-digit royalties); China Medical System Holdings (CMS; Hong Kong Exchange: 867 and Singapore Exchange: 8A8), which is teaming up with Insilico on discovering drugs for central nervous system and autoimmune diseases (up to “tens of millions in Hong Kong dollars per project in R&D support”); and Tenacia Biotechnology, a Bain Capital-backed, privately held Sanghai-based drug developer which in March joined Insilico to expand a year-old R&D collaboration aimed at developing therapies for “underserved” neurological disorders (up to $94.75 million in near-term and milestone payments).

Insilico has out-licensed to undisclosed partners rights to a GLP-1R-targeting program designed to treat obesity and metabolic diseases; and Greater China rights to a Nav1.8-targeting program designed to treat pain.

Vaxart takes a double dose of good news

Settlement ends threat of proxy war; COVID-19 pill aces Phase IIb trial

This week’s annual shareholder meeting had threatened to be anything but routine for Vaxart (Nasdaq: VXRT) after its current executive team and three of its six nominees for board seats had been challenged by an activist shareholder through a proxy campaign.

Since last fall, shareholder Daniel P. Houle and allies have offered persistent criticism of Vaxart’s management—led by CEO Steven Lo and Sean Tucker, PhD, senior vice president and CSO—and the company’s board, whose operations and independent oversight are led by a lead independent director, W. Mark Watson, rather than a traditional chair.

But earlier this month, the threat of a proxy war over Vaxart’s direction ended when Houle and five allies signed a cooperation agreement with the company. Vaxart agreed to begin a search for an additional independent director to be conducted within 90 days of the conclusion of the 2026 annual meeting. Vaxart also agreed to work with Houle and allies to identify a “mutually agreeable” candidate for appointment to the board.

In return, the stockholder group consisting of Houle and his allies—Mark Silverberg, MD; Matthew M. Wallace, MD; Patrice Raffy; Marc Eustace Pereira; and Q3 Nominees Pty Ltd.—agreed to withdraw their board nominations for Houle, Silverberg, and Wallace.

The cooperation agreement also calls for:

  • Creation of a Stockholder Engagement Committee and a Clinical and Regulatory Affairs Committee
  • A revamp or “refreshment” of board committee chairs, including the selection of new chairs for the Nominating and Governance and Compensation Committees
  • Adoption of director stock ownership and resignation policies
  • Customary standstill, voting, engagement, and other provisions

“Vaxart is approaching a series of important value-inflection milestones, and these actions enable the company to move forward with a unified focus on executing its strategy,” Watson said in a statement. “We appreciate the constructive dialogue with the stockholder group toward our shared goal of creating value and are pleased to resolve our proxy contest so we can dedicate our full resources and attention to advancing our pipeline with stockholder interests in mind.”

Houle and allies insisted they believe “deeply” in the promise of Vaxart’s oral vaccine platform and resulting commercial opportunities—but took issue with the company’s declining stock price, capital raises that they said diluted the value of existing shareholders’ stock, and with what they termed insufficient oversight by the board.

In February, Houle launched his campaign to persuade shareholders to elect himself, Silverberg, and Wallace to Vaxart’s board. Silverberg is founder and CIO of Heatjac, a manufacturer of heated medical garments. Wallace is a double board-certified dermatologist and Mohs micrographic surgeon, and managing partner of a medical specialty practice focused on dermatology, dermatologic surgery, and oncology.

“We believe Vaxart possesses a unique technology platform with the potential to reshape vaccine delivery and transform global public health. Yet despite this promise, stockholder value has remained significantly compromised,” Houle and allies, calling themselves the Concerned Vaxart Shareholders, wrote in a June 9 letter to shareholders. “Despite these strengths, stockholders have endured years of disappointing performance, declining market value, and insufficient engagement from those entrusted to represent our interests.”

They also took issue with Vaxart’s two workforce reductions last year. The first was a 10% cut after Advanced Technology International, a nonprofit R&D collaboration manager acting on behalf of the U.S. Biomedical Advanced Research and Development Authority (BARDA), issued the first of two stop-work orders on the company’s Phase IIb trial assessing its government-funded COVID-19 oral pill vaccine. The second was a 21% cut in May–June 2025 intended to lower operating costs and better align Vaxart’s resources with higher-priority clinical programs.

“This election is not about creating conflict. It is about restoring confidence,” the Concerned Vaxart Shareholders added. “It is about restoring accountability, increasing transparency, and ensuring that stockholder interests are once again placed at the center of the company’s decision-making process.

Concerned Shareholders owned 1,515,343 shares of Vaxart stock—including 15,622 owned by Houle himself—as of a May 6 regulatory filing.

In an interview at the recent Biotechnology Innovation Organization (BIO) International Convention in San Diego, Lo and Tucker defended the company-endorsed board nominees as possessing greater biotech-related experience.

Lo defended the workforce cuts: “You want to be at the right size. You want to extend your runway. And we’re very careful with shareholder money. We don’t want to exhaust our funds. The reduction in the workforce was not only to extend our cash runway, but also make sure that this company had the right people to fulfill its mission.”

“Our case is, we have a very experienced management team. We have to stay the course,” Lo added. “We are in a great situation where we have good relationships with the U.S. government, as evidenced by being one of the only companies that has survived stop-work orders. We also have good relationships with pharma, as evidenced by our deal with Dynavax.”

Following a second stop-work order issued in August 2025, Vaxart and BARDA agreed to reduce funding for the Phase IIb trial to about $345 million from up to $453 million, but maintain the study at the estimated 5,485 patients recruited by Vaxart. In November 2025, Vaxart signed an up-to-$700 million global exclusive license for the oral COVID-19 vaccine with Dynavax Technologies, with Vaxart allowed to run the trial. Dynavax was acquired by Sanofi (Euronext Paris: SAN) for $2.2 billion, in a deal completed in February.

The cooperation agreement was one of two positive announcements Vaxart shared on July 6. The other was good clinical news: positive topline data from the approximately 400-participant sentinel safety cohort of its Phase IIb trial (NCT06672055) assessing the company’s oral pill COVID-19 vaccine candidate against an undisclosed approved mRNA vaccine comparator. Among key findings:

  • No vaccine-related serious adverse events (SAEs) or sustained Grade 3 or higher AEs were reported in either the oral pill vaccine or mRNA arms of the trial.
  • The most common AEs for oral vaccine patients were malaise/fatigue (20.9%), headache (18.9%), and anorexia (10.0%). Fewer than 10% of participants experienced any other AE.
  • By contrast, the most common AEs in participants receiving the mRNA vaccine were injection site pain (60.3%), injection site tenderness (40.2%), malaise/fatigue (35.2%), myalgia/muscle pain (33.2%), and headache (28.6%). Arthralgia, chills, anorexia, nausea, diarrhea, and induration/swelling at the injection site were experienced by between 10–15% of participants. Fewer than 10% of participants experienced any other AE.
  • Thirty-three participants in Vaxart’s oral pill vaccine arm and 30 in the mRNA vaccine arm had symptomatic COVID-19. Asymptomatic COVID-19 cases were reported in 12 participants in each of the trial arms.

“These topline safety data are encouraging and are consistent with the safety profile observed to date in other studies of our oral pill vaccine constructs,” stated James Cummings, MD, Vaxart’s chief medical officer.

Vaxart shares, which trade under $1, rose 16% from 55 cents on June 25 to 64 cents on July 2, the day of the filing disclosing the cooperation agreement. Since then, shares have given back the entire gain, sliding back to 55 cents at Friday’s close.

Leaders and laggards

  • Chemomab Therapeutics (Nasdaq: CMMB) shares tumbled 29% from $2.77 to $1.97 Wednesday after the developer of therapeutics for immune-fibrotic diseases with high unmet need said it agreed to merge with precision medicine developer Scipher Medicine through an all-stock merger. The combined company plans to operate under the Scipher Medicine name and trade on Nasdaq under the ticker symbol SCIP. Upon completion of the merger, the combined company plans to focus initially on advancing nebokitug, a first-in-class clinical-stage anti-CCL24 antibody, into a Phase II trial for the treatment of rheumatoid arthritis, Chemomab said. The combined company is valued at $150 million before a concurrent $30 million private placement from a syndicate of current Scipher investors led by Northpond Ventures, with participation from Khosla Ventures, Blue Owl Healthcare Opportunities, funds managed by Neuberger, and other leading investors, and is expected to have cash runway into the second half of 2028.
  • Forte Biosciences (Nasdaq: FBRX) shares rocketed 78% from $20.38 to $36.70 Thursday after the developer of treatments for autoimmune and autoimmune-related diseases announced positive results from the FB102 double-blind placebo-controlled Phase Ib study in vitiligo. FB102 achieved a 29.6% mean Facial Vitiligo Area Scoring Index (FVASI) improvement from baseline at week 24 (p-value = 0.020). Response to FB102 was seen early, Forte said, with statistically significant improvements observed by the day 64 visit (p=0.023), continuing through week 24, after completion of the 12-week treatment period. FB102 achieved 43.2% mean FVASI improvement from baseline at week 24 (p-value = 0.006) in subjects with greater disease involvement having baseline FVASI ≥0.75 (approximately one-quarter of face depigmented), including FVASI50 (58.8%) and FVASI75 (23.5%). Forte shares continued climbing Friday, rising another 20% to $43.92.

The post StockWatch: Insilico Projects Profit, Revenue Leaps as AI-Developed Lead Candidate Moves to Phase III appeared first on GEN – Genetic Engineering and Biotechnology News.

Biasing Food Value Construction

Conditions: Anorexia Nervosa

Interventions: Behavioral: Training food attributes

Sponsors: University of Chicago; National Institute of Mental Health (NIMH)

Not yet recruiting

Lung Tumors Hijack Nerve Signals to Drive Cachexia, Opening New Therapeutic Target

Cancer cachexia has long been viewed as a systemic inflammatory syndrome driven primarily by tumor-secreted molecules circulating through the bloodstream. Now, a study published in Science suggests that at least one subset of lung cancers may instead exploit the nervous system to trigger appetite loss and rapid weight loss, revealing a potential new avenue for therapeutic intervention.

Using mouse models and supporting clinical observations, researchers found that certain lung tumors produce prostaglandin E2 (PGE2), a lipid signaling molecule that activates sensory neurons in the lung. Those neurons transmit signals through the vagus nerve to appetite-regulating centers in the brainstem, ultimately driving anorexia and cachexia.

The findings challenge the prevailing view that circulating inflammatory cytokines are the primary drivers of cancer-associated wasting and instead point to direct neural communication between tumors and the brain.

“We found that there’s some subsets of lung cancer that are at high risk of developing cachexia,” said senior author Thales Papagiannakopoulos, PhD, from the Salk Institute. “We wanted to understand how the cachexia is actually mediated, and in particular the neurological symptoms related to anorexia—the lack of appetite.”

Cachexia affects up to 80% of patients with advanced cancer and contributes substantially to treatment intolerance, reduced quality of life, and mortality. Despite decades of research, effective therapies remain limited because the biological mechanisms underlying the syndrome have been incompletely understood.

One of the study’s most unexpected findings involved diet.

Clinicians have often recommended calorie-dense, high-fat foods to help patients maintain weight during cancer treatment. Instead, the investigators found that high-fat diets—particularly those rich in animal fats—accelerated cachexia in their lung cancer models.

“We found that high-energy, high-calorie, high-fat diets, particularly animal-containing fat, instead of delaying the weight loss and the cachexia, made it worse,” Papagiannakopoulos said. “That’s quite surprising, but important to know.”

The researchers traced this effect to prostaglandin E2, a bioactive lipid involved in inflammation and known to be regulated by drugs such as aspirin and ibuprofen. Tumors produced higher levels of PGE2 when animals consumed diets rich in animal fat, intensifying appetite loss.

Importantly, the investigators found little evidence that well-known cachexia-associated cytokines, including IL-6 and GDF15, were responsible for the anorexia observed in this model. Instead, the biology appeared to mirror mechanisms previously described during respiratory infections.

Studies of influenza and bacterial lung infections have shown that sensory neurons detect inflammatory signals in the lung and relay information directly to the brainstem, producing sickness behaviors such as reduced appetite, decreased activity, and diminished water intake.

Papagiannakopoulos and colleagues suspected lung tumors were co-opting this same pathway. “The tumors are sort of co-opting these infection-like scenarios,” he said. “They’re signaling to the neurons and, by doing so, directly connecting to the brain and not requiring factors in circulation.”

To test that hypothesis, the researchers disrupted communication between the lung and the brain in two different ways.

In one experiment, they surgically severed one branch of the vagus nerve, reducing neural signaling from the lung by approximately half. The intervention significantly improved anorexia. The team then used chemogenetics—a neuroscience technique that selectively turns specific neurons on or off—to inhibit only lung sensory neurons projecting to the brain. “When we did that, we could rescue the mice,” Papagiannakopoulos said. “They were able to eat and drink and move as if they didn’t have cachexia.”

While surgically interrupting the vagus nerve is unlikely to become a treatment for cancer cachexia, the experiments identified an actionable biological pathway that could be targeted pharmacologically.

One possibility is developing therapies that block the specific prostaglandin receptors on sensory neurons rather than broadly suppressing prostaglandin production with nonsteroidal anti-inflammatory drugs.

“We want to identify what receptors on the neurons prostaglandin E2 is signaling through,” Papagiannakopoulos said. “Then we could potentially use inhibitors against the specific receptors, which would be much more focused than using ibuprofen or aspirin.”

Another approach could involve neuromodulation. Devices that electrically stimulate the vagus nerve are already FDA-approved for certain inflammatory diseases, and early studies are exploring similar technologies in cancer patients.

The researchers ultimately hope to identify the precise population of vagal sensory neurons responsible for transmitting cachexia signals and determine where those neurons communicate within the brain.

Beyond cachexia, the work raises broader questions about how tumors communicate with the nervous system. Rather than acting solely through hormones and inflammatory proteins circulating in blood, cancers may directly manipulate neural circuits to produce many of the systemic symptoms experienced by patients.

“The brain acts as a central integrator of all these signals coming from the body,” Papagiannakopoulos said. “We actually think that a lot of the effects seen in cancer patients—some of them grouped under cachexia or other paraneoplastic syndromes—are mediated through the brain through these neural networks.”

If confirmed in patients, those neural pathways could represent an entirely new class of precision medicine targets aimed not at shrinking tumors themselves, but at preventing one of cancer’s most devastating complications.

The post Lung Tumors Hijack Nerve Signals to Drive Cachexia, Opening New Therapeutic Target appeared first on Inside Precision Medicine.

“Mirror, mirror, on the wall, without you, I will fall”: investigation into body dysmorphic disorder from an attachment perspective

ObjectiveBody dysmorphic disorder (BDD) is a prevalent concern among young adults. However, the underlying mechanisms of BDD development remain elusive. This study aims to investigate the intricate relationship between attachment styles and BDD symptoms, with appearance-based rejection sensitivity (ARS) as a mediating factor and gender as a moderator.MethodsA total of 815 young adults participated, completing a battery of questionnaires including the Revised Adult Attachment Scale (RAAS), Appearance-Based Rejection Sensitivity Scale (ARSS), and Scale of Body Image (SBI).ResultsData indicated a positive association between attachment anxiety and BDD symptoms, with ARS found to mediate this link. Furthermore, gender differences were observed to moderate the relationship between ARS and BDD symptoms.ConclusionThis study sheds light on the foundational mechanisms of BDD, tracing its origins to early caregiver-infant bonds and highlighting the enduring impact of ambivalent care on body image perceptions. Additionally, the identification of ARS as a specific contributing factor to BDD onset underscores its significance in understanding and addressing this disorder. By considering the influence of social norms and cultural context, gender differences in the association between ARS and BDD symptoms are elucidated.

Boys, Masculinity, and the Looksmaxxing Trend  

By now, you’ve probably heard of the term looksmaxxing. Think pieces about the trend have popped up all over the internet. And in a recent episode of Saturday Night Live, comedians poked fun at lookmaxxing influencers obsessed with having the perfect male physique.

While this new social media craze may seem silly, it’s impacting more boys than you might think. In a study conducted last year that surveyed over 3,000 young men (ages 16–25) from the United States, United Kingdom, and Australia, nearly two-thirds of participants were regularly engaging with masculinity influencers.

Teen boys are being encouraged to change the way they look in order to fit a certain standard of attraction. The growing amount of looksmaxxing content they see online can have real effects on their self-esteem and mental health.   

What is looksmaxxing?  

Looksmaxxing originated nearly a decade ago in incel forums where men blamed their lack of romantic partners on the belief that female sexual selection is primarily based on physical qualities. So men who aren’t born with traits desirable to women are doomed to fail romantically. While traditional incels wallow in this fate, looksmaxxers seek to enhance their appearance to become more attractive. Their community claims that there is a universal standard for what the ideal man (and woman) should look like.

This is determined by a rating system called the PSL scale — the name being an amalgamation of three prominent misogynistic incel forums of the 2010s. There are many factors that go into the scaling, such as eye shape, jaw size, nose angle, and body fat percentage. Along this scale, you can land in four categories: subhuman, normie, Chadlite, and Chad (the ultimate catch).

During the pandemic, looksmaxxing went mainstream, merging with “manosphere” content on social media platforms like TikTok and Instagram. The trend became less about the ability to attract women and more of a competition among boys and men as they engaged in mog-offs — online contests where people have their faces analyzed and compared by facial recognition software to determine who’s better looking.

Self-improvement practices have gained popularity among boys. Some are considered to be softmaxxing, like developing skincare routines or eating high-protein diets, and others to be hardmaxxing, like using growth hormones or getting cosmetic surgery.

Prominent young influencers like Clavicular represent the extreme side of looksmaxxing. He practices bonesmashing (using a hammer on facial bones to try to form more angular features), injects himself with testosterone, and takes meth to maintain a low body fat percentage while still having a muscular physique.

Looksmaxxing and new beauty standards

The rise of looksmaxxing seems to have a caused a ripple effect among teen boys. While the ideal look has centered on big muscles and washboard abs for decades, there’s now an added pressure on facial beauty that’s typically been reserved for girls.

“With some of the teen boys I work with, most of whom already have self-esteem issues, I think there is a lot more concern about how they look,” observes Alnardo Martinez, LMHC, director of the Pediatric OCD Intensive Program and a mental health counselor at the Child Mind Institute. “They want to have the strong jaw, really big muscles, clear skin, and a perfect haircut.”

However, Martinez notes that it sometimes take a while for boys  to admit that they feel this pressure. They may insist that they don’t really care about that stuff. “But then, maybe a few months later, it comes out that there is a lot of comparison. They’re spending a lot of time in front of the mirror or in the bathroom trying to create this perfect image,” he observes.

What teen boys think about looksmaxxing and self-improvement

We talked to young men who were critical of Clavicular and the impact looksmaxxing can have on teens but were positive about engaging in some form of physical self-improvement.

Wyatt, now 19, remembers comparing his jawline to his peers’ when he was in 7th grade. “I just felt like they had really sharp jawlines. And I was just like, ‘Oh, I want to get closer to that.’” He would also come across TikToks advertising rubber chewing blocks and chin exercises meant to strengthen the jawline.

And so, Wyatt began to do jaw exercises he’d found online, reciting the alphabet while stretching out the muscles. “I would go through my Zoom classes throughout the day and then after that was done, I’d just go into the bathroom and go through the whole exercise. It would take like an hour sometimes,” he recalls. “It turned into more like a self-care, self-improvement session. I would do that every day after my classes. I didn’t feel like I was done with school until I finished my jawline routine.” He took photos to document his progress.  

Wyatt feels like the routine had a positive effect, because he was able to see an improvement. “I felt more satisfied with myself, a little more confident.”

Lev, now 19, remembers wanting to have some control over his body when going through puberty in high school. “Puberty is not a straightforward process. It’s not all peaches and cream. Your body changes, and it can be uncomfortable,” he explains. “But with lifting and strength training, it was very exciting to see this, you know, man energy that came out of it. I wanted to harness that and really take it by the reins. Have some agency as a man.”

And while he rejects the extreme parts of looksmaxxing, Lev does regularly practice self-improvement through weight lifting, skin care routines, and taking GLP-1 weight loss medication.

How looksmaxxing can impact boys’ mental health

Since looksmaxxing places such a strong emphasis on achieving a very specific look, clinicians are concerned about its influence on teens. “Self-esteem is pretty fragile during puberty,” Martinez says. “There’s already a ton of comparison and perceived flaws that teens don’t love about themselves.”

These insecurities can be exacerbated by the type of content teens engage with online, Martinez explains. Along with ChatGPT bots specifically designed to judge aesthetics, Reddit threads such as r/Mewing and websites like Looksmaxxing Forum encourage boys to post pictures of their faces and bodies to get rated by their peers. Boys as young as 13 visit these forums, posting pictures and asking for tips on how to improve their looks.

“These are generally places where people are already pretty harsh and critical. These boys are receiving a lot more ‘confirmation’ around the perceived things that are wrong with them or that they need to change,” Martinez says. “And it just feeds into the already present negative self-image and self-talk.”

He explains that this type of social media engagement can also compound underlying mental health issues like depression and social anxiety. “They might be less likely to go out and talk to people because they’re thinking, ‘Everyone is going to see this one thing that everyone else has told me is wrong with me. So now I can’t go out,’”he says.

Martinez is also concerned that online content can negatively affect teens with body dysmorphic disorder (BDD). “If they think they have a big nose, for example, they might go on these Reddits and ask, ‘What does my nose look like? Is it too big?’ There are trolls out there. Someone is going to say yes and then that’s going to make the BDD symptoms even worse.”

When behaviors might be concerning

In some ways, teen boys taking part in more self-improvement practices could be seen as a good thing. They’re exercising, taking care of their skin, and eating more balanced diets. The issues begin when these types of practices turn into obsession. And given the underlying ideology of looksmaxxing and the nature of social media, things can become unhealthy.

According to Martinez, there are some changes in behavior to look out for that indicate you might want to step in.

One clear change, he says, is a noticeable shift in the amount of time they’re spending on grooming themselves. “Maybe they were someone who would typically just get up and run out the door without washing their face,” he says. “But now they’re spending a lot more time in the bathroom and asking a lot of questions about how they look.”

Another warning sign can be a big change in personality. “Irritability is a big one that we’ll see a lot,” he says. “They’re unhappy with how they look, so this increases a general level of irritation.”

These behaviors paired with an unusual uptick in time spent on social media, Martinez explains, can be a sign that something’s wrong and support is needed.

How to support your child

If you’re worried that your child might be engaging in looksmaxxing-related behaviors to an unhealthy degree, says Martinez, there are a few things you can do:

  • Open communication. Martinez suggests approaching your child with curiosity. “You could start the conversation by saying something like, ‘So have you heard about this? What do you think about it? Have you ever had any thoughts yourself about how you look or desires to change your body or face?’ And then give them some space to be open and vulnerable about it. Validate their experience.” 
  • Find out where your child is getting their information. “Read it together, talk about it, and see what your child thinks about it,” Martinez advises. “And if it’s promoting something dangerous, then you can talk to them about how those practices can be harmful and what could actually happen if they do some of those things.”
  • Encourage male role models. “There’s a patient I work with now who doesn’t have a present dad,” Martinez explains. “His mom tries to talk to him about things like body image, but he feels like she doesn’t understand and can’t relate. So having someone that he can talk to and be open about this stuff with, especially someone who can also share their own struggles, can be really helpful.”
  • Seek help from a mental health professional. This is especially important if you find out that your child has been engaging in extreme forms of looksmaxxing such as bonesmashing or starvemaxxing. Martinez recommends looking for a clinician who specializes in body image or body dysmorphic disorder.

A lot of parenting comes down to open communication around what your kids are seeing and what they’re feeling. We all have things about our bodies that we might not like and wish we could change, says Martinez, and it can help to normalize those feelings. “And then you can discuss how they can make changes in healthy ways,” he suggests. “Go over what’s a realistic change and what’s a dangerous change.”

The post Boys, Masculinity, and the Looksmaxxing Trend   appeared first on Child Mind Institute.