Insight in eating disorders: terminology, methodologies, and assessment tools. A scoping review protocol.

ABSTRACT Introduction: Awareness of illness, or insight, plays a critical role in treatment for EDs, with low awareness often leading to higher dropout rates and resistance to therapy. The use of terms such as "denial of illness," "lack of insight," and "unawareness" have been frequently used interchangeably leading to confusion and limiting comparability across studies. To advance our understanding, it is essential to first identify the various conceptualizations and definitions used, along with the measurements employed to investigate it. Objective: The aim of this scoping review is to investigate how insight is defined and measured in individuals with an eating disorder (ED). Inclusion criteria: This review will include any existing literature on insight or awareness of illness in EDs. Peer-reviewed sources such as academic books, book chapters, theses and dissertations, clinical guidelines, letters to the editor and papers using quantitative or qualitative designs will be included. Informal or non-academic sources such as blogs, popular media, or non-peer-reviewed websites will be excluded. Methods: A comprehensive search will be conducted in academic databases, including PubMed, PsycINFO, MEDLINE, Web of Science, Scopus and ProQuest Dissertations & Theses Global. Additionally, grey literature sources such as OpenGrey and Google Scholar will be consulted to minimize publication bias and ensure a thorough coverage of unpublished literature. Eligible records will be de-duplicated, and two independent reviewers will carry out title, abstract, and full-text screening. Findings will be presented in tables supported by a narrative summary.