Music-based interventions (MBIs) include a broad range of practices that utilise music to support health and wellbeing. These can integrate the use of music in various ways, including listening to, singing, playing, composing, and improvising music (39). MBIs can be distinguished by the way one engages with the music (for example, listening to songs and discussing them, listening to instrumental music for relaxation, actively playing instruments or singing songs, improvising instrumentally or vocally, composing a song or instrumental music) and by who facilitates the MBI. MBIs may be facilitated by qualified music therapists (music therapy) or other healthcare professionals (non-music therapists) as well as musical experiences led by community musicians or the use of self-selected music implemented by the client themselves (39). The accessible nature and myriad ways of engaging with music allows for the use of MBIs in various contexts and for a range of client needs, across therapeutic and community-based settings (27). While music therapy is encompassed in this broad category, it is a specialist-delivered intervention differentiated by formal training and qualification. Music therapists are allied health professionals trained in a wide range of music therapy theories, approaches and methods to address therapeutic goals across clinical populations. Music therapists use both active and receptive methods, adapting sessions reflexively to meet emerging and changing needs of the individual or group throughout the therapeutic process (40–42). MBIs therefore can encompass a continuum of music use for wellbeing, from personal use to specialist music therapy sessions (43).

There has been a recent increase in reviews evaluating the use and potential outcomes of music in people with or at risk of EDs (44–47). Testa et al. completed a systematic review that included 16 studies examining the effects of music in people with EDs or at risk of EDs. Studies were limited to experimental or observational designs which reported measurable outcomes, and thus only one qualitative study was included (44). Results indicated that listening to music improved nutritional intake, group singing reduced anxiety after meals, while songwriting assisted in processing various therapeutic issues. A recent systematic review of controlled studies utilizing music therapy in ED treatment found no randomised studies and only two relevant publications from one treatment-as-usual (TAU) controlled study (45). Pre-post results (quantitative and qualitative) indicated a decrease in post-meal stress and anxiety following 1-hour music therapy group sessions twice per week, which was greater for the music therapy intervention than TAU (48, 49). The group sessions integrated various music therapy methods such as singing, listening to music, and songwriting. Chang et al. conducted a narrative systematic review that evaluated therapeutic outcomes in individuals with EDs, where music was a component of the intervention (46). Results from 16 quantitative, qualitative and mixed methods studies indicated that the intervention improved mood regulation, helped manage distress associated with mealtimes, and improved emotional wellbeing. The authors indicate generalisability of the results is limited due to small sample sizes (16 studies ranged from 3 to 20 participants) and the lack of detailed information about the MBIs. While in a recent systematic review exploring the extent to which music therapy and systemic or family-based therapy is integrated into ED treatment, the examination of 26 studies revealed common parallels across where both facilitated embodiment and interconnectedness, served as a gateway of deeper engagement with self and illness, fostered and self-expression, and supported emotion regulation (47).

Each of these systematic reviews have captured a corpus of the literature, helping to explicate the use of music in the context of EDs or subclinical disorder. However, there has been a lack of singular focus on studies where music is a key component to the intervention, which is instrumental to a clearer understanding of the impact of MBIs. For example, all the above reviews except one (45) included studies where background music was played in a video, but music was not a focus of the intervention. Further, systematic reviews can limit the type of research literature included, resulting in rich therapeutic descriptions from clinical case studies being excluded. A recent study revealed widespread adaptation of music therapy methods to meet the needs of patients in ED treatment (50). Case studies illustrating these varied and nuanced ways of delivering and engaging with MBIs would further inform literature reviews and support clinicians employing MBIs in building an evidence-based practice.

Therefore, the aim of this scoping review was to encompass studies where music comprised an essential component of the intervention in a therapeutic ED setting, including case studies to contextualise and more comprehensively understand the use of MBIs in the context of ED treatment. A challenge in reviewing and evaluating MBIs in research is that there is often a lack of clarity in the literature due to inconsistent terminology and quality of reporting (51, 52). As a result, MBI reporting guidelines were introduced in an effort to improve the transparency and specificity of MBIs as well as to evaluate the quality of the research and ensure that it can be replicated (51). The present scoping review therefore also expands on prior systematic reviews by examining the clarity of reporting based on these MBI reporting guidelines.

Eight electronic databases were queried for relevant articles from inception to May 2025, including MEDLINE (National Library of Medicine), Embase (Elsevier), Scopus (Elsevier), APA PsycArticles (American Psychological Association), APA PsycINFO (American Psychological Association), Psychology and Behavioural Sciences Collection (EBSCO), Web of Science (Clarivate), and Cochrane Library (The Cochrane Collaboration). The following search terms were applied: (music therapy OR music-based intervention OR guided imagery and music OR songwriting OR song composition OR drumming OR music listening OR music improvisation OR song discussion OR active music making) AND (eating disorders OR anorexia nervosa OR bulimia nervosa OR binge eating disorder OR pica OR rumination disorder OR avoidant restrictive food intake disorder OR unspecified feeding OR eating disorder). There were no restrictions on publication date or status; however, articles were filtered by subject (humans only), study type (peer-reviewed), and language (English). In addition to database searches, reference lists and relevant conference abstracts were hand-searched to identify supplementary eligible studies.

The following inclusion criteria were applied to evaluate eligibility in the qualitative synthesis: (1) patients of any age and sex with a primary ED diagnosis; (2) MBIs (i.e. any intervention utilising music as a core component, including music therapy and other non-music therapist delivered music experiences used in the treatment or management of EDs across any clinical or community setting; (3) qualitative, quantitative, and mixed methods studies, whether prospective or retrospective, including case reports; and (4) peer-reviewed articles and published in the English language. To ensure breadth and relevance, inclusion was not limited by study design, publication status, or geographical location. Primary outcomes of interest encompassed physical and mental health following the implementation of MBIs. We included all study designs, excluding review articles, book chapters, nonhuman studies, conference abstracts, and articles in a language other than English. Studies were excluded if ED was not the primary diagnosis, if the MBI was not a key component of the intervention, or the paper was not available in English. Screening of the articles was independently performed by four reviewers (AH, AR, JB, JG). Any disagreements were resolved during discussions between the reviewers.

Data from eligible studies were charted by five independent reviewers (AH, AR, JB, JG, TM), including two (JG, TM) with no prior content knowledge of the topic. This approach allowed for both subject-matter expertise and naïve interpretation, helping to minimize potential bias while enhancing objectivity and transparency. Using a standardised charting form created in Microsoft Excel, the following variables were extracted: author, publication year, country, study design, and outcome measures; sample size, participant age, and ED diagnosis; intervention type, duration, and setting; and primary outcomes and any other pertinent findings. Details were recorded when studies indicated the facilitator’s theoretical approach and methods or techniques used. A sixth reviewer (SASN) examined all extracted data to ensure alignment with inclusion criteria and internal consistency. Discrepancies were resolved through team consensus. The charting form was updated iteratively to accommodate emerging themes and variations in data reporting across studies.

Qualitative and quantitative studies were summarised in a narrative format. Qualitative data were then analysed thematically. Additionally, evaluation of MBI reporting for each study was also conducted following established MBI reporting guidelines (51, 54).

Qualitative data was integral to 17 of the studies and was initially reviewed by one research team member (AH) to begin the reflexive thematic analysis. This process entailed reviewing and coding the data following the six-step process (55, 56). Emergent themes were identified based on integrating the outcome data from these studies. This iterative process included grouping themes into categories of similar orientation. The next step involved examining these categories to identify points of connection and patterns. This led to developing subordinate themes which were then reviewed by all members of the research team and integrated into a comprehensive framework. When discrepancies emerged, the reviewers returned to the data to inform their discussion and understanding of the themes. This iterative process continued until reviewers (AH, SN) reached a mutually agreeable decision. Following this, other research team members were asked to complete a final review of the themes to ensure full team consensus.

Study characteristics and participant demographics are reported in Table 1 (qualitative studies) and Table 2 (quantitative studies) including country of publication, study design, sample size, participants’ age, gender, participant diagnostic information, type of music intervention, source of outcome assessment used, setting, and assessment based on reporting guidelines. This included identifying how many of the 11 recommended and relevant components from the 7 criteria were included in the MBI reporting of the study (50, 53). The component of treatment fidelity was not included in evaluating case reports as it is not relevant to this type of research.

The majority of included studies were carried out in Europe (n=10) followed by North America (n=6), Australia (n=4), Asia (n=1), for studies with available data. Overall, 254 participants (range:1-66) were included from ages 11 to 62 for studies with available data. The research methods used were primarily qualitative (n=16), with the remainder quantitative (n=4) or mixed methods (n=1). Most studies reported on anorexia nervosa (n=19), followed by bulimia nervosa (n=7), binge eating disorder (n=4), other specified feeding or eating disorder (n=4), emotional eating (n=1), chronic dieter (n=1), and eating disorder not otherwise specified (n=4). Evaluation of reporting guidelines differed across studies, with a range of 45-100% and a mean of 76%, equivalent to reporting on nearly 8 of the 11 components.

MBIs were identified when details regarding the music experience were provided. MBIs are reported as music therapy when facilitated by a qualified music therapist and other MBIs (non-music therapist delivered) are reported by the type of intervention only. Within the included studies, the majority investigated music therapy (n=18). Music therapy sessions included individual (n=12), group (n=4), and both individual and group sessions (n=1). One study did not specify whether the sessions were in a group or individual format. Music therapy sessions utilized receptive music experiences (n=10) (song discussion, music listening for relaxation, or music directed imaging), instrumental improvisation (n=8), songwriting or song/music collage (n=7), singing or chanting/toning (n=5), drumming (n=2) or movement to music (n=1). One music therapy intervention combined music listening with cognitive behavioural therapy. MBIs led by non-music therapists (n=3), two qualitative and one quantitative) included vibroacoustic stimulation, a singing workshop, and music listening during mealtimes. Details of the music therapy theoretical approaches, when indicated, are further outlined in subsequent sections.

Qualitative studies included a total of 106 participants, which were comprised predominantly of case reports/studies (n=10), and qualitative designs (n=6), followed by mixed methods pre-post design (n=1). Nine were conducted in an inpatient setting, six in outpatient settings, and two studies across both inpatient and outpatient settings. Gender of study participants was between 95-100% female; one case report did not report gender. Nine of the studies reported comorbid mental health diagnoses that included bipolar disorder, dissociative identity disorder, generalized anxiety disorder, major depressive disorder, obsessive compulsive disorder, post-traumatic stress disorder, and substance use disorder. Study outcomes were based on therapist observations (n=9), self-report (n=3), analysis of content from sessions (song lyrics, musical improvisation, imagery) (n=5), and semi-structured interviews (n=2). Evaluation of the reporting of the qualitative studies represents a range of 45-100% with a mean of 84%, reflecting reporting of approximately 9 of the 11 components.

Table 3 highlights study duration within the context of design, detailing information on the MBI, theoretical approaches, and any other intervention components. Finally, the main results from the studies are indicated. We note that length of intervention varied widely across these studies, from two weeks to 2.5 years. Main results were further explored through the thematic analysis. This analysis resulted in seven emergent outcome themes being identified including: building interpersonal capacity, managing the emotional landscape, developing capacity in self, embracing novelty and growth, mental processes, experience and relationship with body, and fostering engagement in ED treatment. Table 4 presents the 7 themes with the 13 emergent subthemes, along with related outcomes and quotes. Quotes from the studies included in the analysis provide examples of content that informed the themes. We note that negative outcomes were only reported in one study and consisted of experiencing the body more consciously and a negative evaluation of new experiences.

Organization of these themes reflects various stages of the treatment and recovery process. Figure 2 illustrates how these themes follow differing levels of treatment, beginning with symptom management that focuses on fostering emotional expression, stress management and developing coping skills which leads to improved attention and cognitive restructuring, leading to improved body awareness and body image. This therapeutic work supports transitioning to self-development that highlights improved self-awareness and self-esteem, developing a growth mindset through engaging in new and novel experiences, and supporting the development of interpersonal skills through social engagement. The therapeutic work in these areas fosters engagement in treatment through increased motivation and responsiveness by addressing contributing or underlying issues that have not been addressed by conventional treatment. Figure 2 illustrates that these processes are not linear but rather circuitous, meaning an individual may move back and forth through these at different levels of ED treatment.

Overview of quantitative study characteristics (SN) included only five studies which met inclusion criteria (see Table 2 , with one study included in Tables 1 , 3 and 5 as a mixed methods study (71)). Three studies focused on patients with anorexia and two studies also included other EDs. Comorbid mental health diagnoses were reported in two studies. Subjects were 92-100% female (seven males out 169 total participants across studies), all but one study was conducted in adults, and all studies used a pre-post design. Table 5 outlines the results of the quantitative studies, explicating study duration, design, music intervention and main outcomes. A Canadian study of group music therapy (MT, e.g. improvising and drumming) showed a significant decrease in negative affect and emotional suppression following MT; however, the MT also included mindfulness and was accompanied by treatment as usual (TAU) such as CBT and DBT (71). With this multifaceted intervention and no control group, one cannot discern whether the MT or other intervention components were instrumental in driving this observed improvement. Two Australian studies involved interventions comprised solely of group MT (e.g. singing and discussing songs), based on a humanistic therapeutic approach (48, 49). While neither study had random assignment, both interventions showed a significant decline in anxiety and distress immediately post intervention and one study showed a steeper decline in the intervention versus inpatient TAU control (48). A crossover study (where participants receive all conditions and so are their own control) of an MBI in Italian inpatients showed that compared with no music being played at supervised mealtimes, when patients listened to either classical or pop music during mealtimes, they consumed more food and had greater positive emotions following the meal (74). However, there was no waiting period between the interventions to ensure the effects of the first treatment wore off before delivering the next treatment (75).

Finally, a Chinese study on adolescents involved a receptive (music listening) MT intervention plus CBT and TAU compared with inpatient TAU only as the control group (76). While these groups were randomly assigned, the study conducted per-protocol analyses without dropouts, and there was a significantly greater dropout in the control vs intervention group (22.5% vs 5.4%). The study reported a greater increase in post-treatment weight, BMI, and abdominal subcutaneous fat in the MT + CBT arm compared with the control group. However, it is impossible to determine whether this was due to MT, CBT, or both. MBI reporting of the quantitative studies ranged from 55-82% with a mean of 67%, reflecting reporting on about 7 of the 11 components. While no negative outcomes were reported in any of the quantitative studies, null findings were reported in two of the studies (e.g. positive affect and impulse control (71); negative affect, stress, satiety (74)). In sum, coupled with small sample sizes, none of the quantitative studies implemented best practice of randomly assigning individuals to clear MBI and control groups, precluding firm conclusions about the efficacy of MBIs in people with EDs.

The studies implemented a wide array of MBIs, including music listening (listening to classical or popular music and song discussion, music-based relaxation, music-directed imaging, movement to music, and vibroacoustic stimulation), song writing, instrumental and vocal improvisation and active music making experiences (singing, group singing and drumming), while several studies integrated multiple types of MBIs. Although not reported in many of the included studies, theoretical approaches reported within the music therapy interventions included psychotherapeutic, cognitive-behavioural and trauma-informed music therapy. The large number of interventions utilised illustrates the diversity and depth of MBI options available to meet the emerging and changing needs of a patient at various levels of care and across the treatment process (63). These findings are consistent with a recent mixed methods study that surveyed and interviewed music therapists working with patients in ED treatment, which indicated clinicians utilize a wide array of methods in their regular clinical practice to address diverse therapeutic needs across levels of treatment and adapt these to meet the needs of individual patients and groups (50). This aligns with the focus on personalized ED care with tailored interventions based on individual psychological, biological, environmental, and genetic profiles (86).

While it is evident that the current body of research does not fully represent the diversity of interventions utilized by qualified music therapists and non-music therapists in the context of clinical practice in ED treatment, the inclusion of case reports (half of the studies in our review) gives breadth and depth of understanding and further highlights other methods including song discussion, music listening, group drumming, guided imagery and music, and music and movement. Additionally, it is worth noting that all but two of the studies in the scoping review (18/20) integrated music therapy facilitated by a qualified music therapist, highlighting a need for professional training required to implement MBIs within the treatment of these complex disorders.

Overall, the qualitative studies provided detailed information when reporting the MBI, meeting an average of 84% of MBI reporting guidelines (51, 53), compared to the quantitative studies that reported an average of 67% of the guidelines (note six qualitative studies were published before the MBI guidelines and all quantitative studies were published four or more years after publication of the MBI guidelines). Given that 10 of the 17 qualitative studies include case reports which typically provide rich and thorough descriptions of the therapeutic process, this difference in reporting is not surprising. Information consistently missing from the quantitative studies included details regarding the music intervention and materials utilized in the sessions. Clear and detailed reporting of MBIs is key to transparent reporting of the intervention and for replicating a study. Nonetheless, studies within this review demonstrate an improvement in the overall quality of reporting compared to a previous evaluation of music intervention studies, where reporting was poor (52). This may be due to the fact that more of the present studies were, which typically include detailed information about the music-intervention within the therapeutic process.

In a majority of the studies in this review the MBIs were facilitated by a qualified music therapist. The other three studies included group singing workshops led by music teachers (68), vibroacoustic stimulation led by a therapist (no specific therapeutic training specified) (58) and music listening during mealtime delivered by dieticians and nurses (75). In the three studies facilitated by non-music therapists, participants reported numerous positive outcomes, with some negative outcomes related to the vibroacoustic body music. These studies illustrate how researchers are flexibly utilizing different ways of engaging with music to address the needs of patients in ED treatment. The reporting of the MBI in these three studies varied significantly, from 5 of the 11 aspects of the intervention (58) to 9 of the 11 (68). Ensuring that all MBI research adheres to the MBI quality reporting guidelines (51, 54) is instrumental, so the intervention is described in detail and there is clarity, and transparency in research methodology. The complex nature of music stimuli requires detailed and careful description to ensure a study can be replicated and necessitates music-based knowledge and expertise to describe it effectively. Since MBIs include music experiences that may be facilitated by music therapists, administered by staff, community musicians, other providers, or self-administered by the patient/patient, clarity in intervention descriptions is vital (50, 54). Dedication and advocacy to improve the quality of reporting of MBIs will help improve the rigor and reproducibility of these interventions (51, 52, 54, 85).

It is evident from our review that group and individual sessions offer unique affordances and may help to address different therapeutic needs. Across our reviewed studies (excluding case studies, which by necessity were individual MBIs), individual and group MBIs were used comparably (n=5 and n=4, respectively), with one study not reporting which method was used. Group based music interventions provide opportunities that capitalise on meeting new people, fostering a social connection (71), engaging in healthy social interactions, and feeling a sense of belonging (68), as well as feeling motivated to engage in treatment (64).

Group sessions can be economical and providing opportunities for social engagement in a shared or collaborative experience is particularly important if an individual feels isolated due to their ED (76). There is also a means of support that can be embedded or experienced in group MBIs that is valuable when engaging in a new or novel experience such as improvisation or songwriting (66, 73). Conversely, individual sessions can provide therapeutic space needed to address complex or deeply personal issues, which may include ED symptoms (restricting or purging) or trauma that are not appropriate for group based work (61, 86, 87). A trauma-informed approach to MBI practice is recommended to inform clinical decision-making and avoid causing harm (42, 50, 61). From synthesising information regarding patient presentation across the studies, we are encouraged that choice of group versus individual MBIs appear to have been selected to best meet patient needs.

EDs are complex in nature due to the multiple underlying factors that contribute to their development, the symptoms that negatively impact physical health and psychological wellbeing, a myriad of comorbid diagnoses, and a high incidence of trauma (15, 86, 87). While only half of the studies in our scoping review reported on comorbid mental health conditions, seven comorbid conditions (including trauma-related conditions) were reported across these studies. This indicates that many MBI studies include complex cases but also highlights that presence (or absence) of comorbid conditions needs more consistent reporting in future studies. This complex clinical matrix necessitates treatment across various levels of care that addresses the diverse and underlying issues needed to support an individual’s ED treatment process (36, 37, 62). The studies in this scoping review included individuals engaged in various levels of treatment including inpatient, residential, and outpatient. This is consistent with survey data indicating the clinical settings in which music therapists work with patients with EDs (50). While ED treatment may occur at specialty ED treatment programs, music therapists also provide services to patients in private practice, mental health units, medical units, long term psychiatric settings, and community mental health settings (46, 50). Providing treatment across various levels of care indicates that music therapy and MBIs are utilized to address a variety of therapeutic needs.

The present review’s qualitative and quantitative results indicate MBIs focus on a wide array of therapeutic issues and needs. The qualitative themes emerging from these interventions operate across various levels of ED treatment and recovery - that of symptom management, self-development, and treatment engagement as indicated by our model in Figure 1 . The organization of these themes aligns with various levels of therapeutic work consistent with previous literature that highlights, “the flexibility of music as a therapeutic agent allows the therapist to individualize the process and meet a wide array of needs simultaneously, especially when feelings and emotions may be fragmented, elusive and inaccessible to language” (77) (p.128). Addressing core emotional processes is key, as impaired affective processes are often implicated in the maintenance of disordered eating behaviours (87). Recent research including a comprehensive synthesis of 30 years of clinical and empirical evidence underscores the importance of affective temperament, emotion regulation, and personality vulnerabilities related to symptom management (emotions, cognition, and body image) as a prerequisite to self-development (89–92). Thus, our model begins with symptom management by fostering emotional expression and learning coping skills to manage stress. This supports changes in cognition such as improved attention, and cognitive restructuring, which helps to decrease distortions. This supports shifting the relationship with one’s body by improved body awareness and image and increasing the level of comfort in one’s body through experiencing new ways of engaging the body.

In our model, symptom management then supports engaging in the next level of self-development which includes improved self-awareness, understanding, and self-esteem, which is substantiated by research indicating that addressing these emotional underpinning of the ED enhances treatment outcomes (88). Prior MBI literature highlights how songwriting links self-expression to the development of autonomy and exploring or developing one’s identity (66, 69). Building this self-capacity is key to a growth mindset which is necessary to support embracing challenges by facing fears and engaging in new experiences, which can foster hope and optimism (62, 63). These experiences are instrumental in having the capacity to develop interpersonal skills through increased social engagement, which helps to foster a sense of belonging and engagement in meaningful relationships (61, 65). This work can then lead to increased motivation to engage in treatment, fostering responsiveness to address and target contributing issues that have not been addressed in conventional ED treatment (44, 46, 62). However, we note that our model follows an iterative feedback loop, with treatment engagement facilitating further symptom management and self-development, which promotes continued healing and recovery. We further acknowledge that effective initial symptom management must be catalysed by an initial willingness to engage in treatment.

The capacity of MBIs to address diverse therapeutic needs across various levels of treatment is also highlighted in Dvorak’s survey of music therapists working in ED treatment (50). These therapists reported addressing 90 different treatment areas, with the five most common including self-expression, development of coping skills, managing mood and depression, and identifying and expressing feelings. While these only encompass the first component of the “symptom management” level in our model, cognition and body image/awareness (other components of the “symptom management” level) were treatment areas identified by more than half of therapists in that study. Further, self-esteem and self-awareness (operating on the “self-development” level of our model) were identified by therapists as comparably frequent treatment areas to identifying and expressing feelings (50). However, interpersonal/social aspects and optimism (other components of the “self-development” level) were less frequently cited as treatment areas by therapists in the study, and growth mindset components of embracing challenge and novelty-seeking were not included as a response in this survey. This highlights the importance of qualitative research which can bring out important factors which have been previously unidentified. Our review reveals growth mindset as a potentially important outcome which should be assessed in future MBIs for people with EDs. Indeed, previous research has explicated the unique capacity of creative and aesthetic experiences to afford opportunities to externalize and explore their thoughts and feelings in new and different ways, which helps an individual to develop new understandings and attach new meaning to them (63, 93, 94). This is further evidenced by quotes from Table 4 which indicate that making music (nonverbal) serves as a referent to project, explore or recast one’s inner experiences (65) and that this process of externalizing inner experiences helps to make meaning and comprehend their experiences (62). Engagement in a supported creative aesthetic therapeutic experience can help individuals in ED treatment access affective, cognitive and perceptual brain functions which are key to their treatment and recovery process (92) and are instrumental in developing insight, fostering growth, and a sense of mastery and self-efficacy (62, 63, 66, 72, 73).

Although findings generally support positive outcomes for individuals ED treatment following a MBI, our conclusions are impeded by the heterogeneity of interventions and outcomes, and inadequately controlled methods to ascertain effectiveness. Synthesizing this body of literature is also impacted by the complex nature of EDs, including the physical and psychological aspects of the disorder, as well multiple comorbid diagnoses and trauma history. While some research methodologies may not be able to robustly capture the nuanced and complex phenomenon of MBIs, ensuring clear and transparent reporting is necessary to provide a clear understanding of the therapeutic intervention. Further, these shortcomings will be addressed with more rigorous quantitative studies which capture the range of patients treated in practice and appropriately assess treatment effects. To that end, there is a particular need for well-powered randomised controlled trials with distinct and clearly defined comparison groups, implementing intention-to-treat analyses and assessment of and controlling for diverse clinical and background factors (96). This will necessitate researchers addressing the challenges and barriers in conducting RCTs with MBIs in ED treatment, particularly balancing the personalisation of therapy with the required standardisation (97).

Future reviews should aim to understand and explicate the efficacy, benefits, and risks of MBIs in ED treatment, and the role of MBIs in addressing the complex and myriad needs of individuals in the treatment process. Given the established link between emotional rigidity, emotion regulation, and ED symptoms, there is need for specific exploration of MBIs that support the development of temperament-linked coping styles (50, 78, 89). Further, all future studies should provide detailed information on case presentation (including comorbidities), comprehensive descriptions of the MBIs utilized, as well as the experience, qualifications, and theoretical orientation of the professionals facilitating the MBI. Future reviews should assess each study’s adherence to MBI quality reporting guidelines (51, 54). Due to the unique nature, variety, and complexity of MBIs, adhering to these reporting guidelines to explicate the different components of the intervention is crucial in supporting replicability and identifying key and active elements in the intervention (44, 51, 52, 54).