This paper is a call for health providers to become more aware of their own biases and reflect on the impact of current models of care and communication about the mental health of patients across the weight spectrum. A continuation of the current model of caring for patients who do not fit the emaciated archetype of ED will only perpetuate the difficulties of affected individuals and contribute to increasing health disparities based on weight.
Open access. Maudsley Family Therapy (MFT), and its manualised version, Family-Based Therapy (FBT), are the only well-established treatment interventions for adolescent anorexia nervosa (AN), with treatment efficacy primarily measured by improvements in eating behaviours and weight restoration. A crucial component of this therapy is an intensive home-based refeeding intervention that requires a substantial commitment from parents for up to one year. While this treatment works to restore weight in a proportion of adolescents, very little is known about its impacts on family distress, relationships and identity, including in the 40% of families where the adolescent experiences ongoing eating disorder (ED) symptomatology and/or psychological distress during and post-treatment.
Open access. Maudsley Family Therapy and its manualised version Family-Based Therapy for Anorexia Nervosa (FBT-AN) have accrued the most significant research evidence-base for the treatment of adolescent Anorexia Nervosa (AN). A tradition of seeking augmentations for this treatment has also been established to enhance efficacy. There exists, however, a gap in the uptake of this form of manualised treatment into the “real world” of clinicians who work with adolescent AN.
In the wake of a damning ombudsman report, nurse leaders have vowed to tackle problems in England
The parliamentary and health service ombudsman has criticised a lack of funding, training and eating disorder specialists, as well as inadequate care planning, assessment and coordination for people with eating disorders.
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In this paper, the feelings, thoughts and experiences of an individual with bulimia nervosa are explained, and the positive and negative effects of their experiences during the treatment process are emphasized. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
We’ve just heard that SSOTP will not be renewing their agreement with SSSFT LKS for library services for this financial year. Because of this we will be reviewing our Be Aware bulletins. Sadly we won’t be accepting any new sign-ups from SSOTP staff and will be withdrawing some of the physical healthcare bulletins that we…
Avoidant/restrictive food intake disorder (ARFID) was a new diagnosis in DSM-5 and is due to be included in ICD-11. However, confidence in making the diagnosis seems to be low among clinicians. Furthermore, there is no national consensus on care pathways for ARFID and therefore patients tend to be managed across core child and adolescent mental health services, specialist eating disorder services and paediatric services. If not adequately treated, ARFID can result in stunted growth, nutritional deficiency and impaired psychosocial functioning. Research and guidelines for managing this disorder are scarce, owing to low rates of diagnosis. This article aims to improve clinician confidence in the use of ARFID as a diagnosis and explores current consensus on treatment approaches, in order to progress future service planning for this complex and diverse patient group.. To read the full article, log in using your MPFT NHS OpenAthens details.
Francesca Solmi appraises a recent population-based cohort study that explores links between eating disorders and autoimmune and autoinflammatory diseases.
Open access. Avoidant/Restrictive Food Intake Disorder (ARFID) is a comparatively new DSM-5 diagnosis. In an effort to better understand this heterogeneous patient group, this study aimed to describe the physical and psychological attributes of children and adolescents with ARFID, and to compare them to patients with full-threshold or atypical anorexia nervosa (AN).
Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement48.3 (Jul 2016): 232-237.
The current study assessed attitudes of youth toward anthropometric measurements—specifically, weight and mid-upper arm circumference (MUAC) measurements. We hypothesized that nonclinical youth would report fewer intrusive thoughts about MUAC than about weight measurements, and that higher eating pathology would be associated with more intrusive thoughts. We further hypothesized that youth with an eating disorder would have more negative comments about anthropometric measurements than would nonclinical youth. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
The researchers found the probability of a girl having an eating disorder at a school where 75% of the pupils were female and 75% of the pupils had parents with a "higher education" was 3.3%.
This is more than double that of a girl attending a school where 25% of the pupils were female and 25% had parents with a higher education.
The researchers were careful not to state that they had uncovered reasons for this trend, unlike the media.
There is a direct association between patients with insecure attachment style (IAS), behavioural inhibition (BIS) as well as behavioural activation (BAS) motivational systems and anorexia nervosa (AN). However, the possible direct relationships between these three variables have not been studied. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Open access. Physical activity is an important factor related to eating disorders, but the relationship between symptoms of eating disorders and physical activity is multifaceted. The aims of this study were to investigate how symptoms of eating disturbance (ED) were associated with physical activity, and to explore potential sex differences and the potential moderating effects from body mass index (BMI) scores.
Anorexia nervosa is a psychiatric disorder of unknown etiology. Understanding associations between behavior and neurobiology is important in treatment development. Using a novel monetary reward task during functional magnetic resonance brain imaging, the authors tested how brain reward learning in adolescent anorexia nervosa changes with weight restoration. : Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Findings In this cross-sectional multimodal brain imaging study of 56 female adolescents and young adults with AN and 52 matched controls, the AN group showed hyperactivation in the caudate head, nucleus accumbens, and insula compared with controls during a classical conditioning paradigm that has been associated with dopamine function. Orbitofrontal brain response in the AN group was positively associated with harm avoidance and striatal-hypothalamic connectivity but negatively associated with change in body mass index during treatment.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
What you need to know:
When a child or young person presents alone, it is important to be honest with them from the start about the limits of confidentiality
Parents can become used to the “new normal” of disordered eating; it is important to explain the risks
Focus ideas about treatment on helping the young person feel better about themselves rather than particularly on their weight
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Feeding and eating disorders (FEDs) are serious mental health disorders that cause impairments in physical health, development, cognition and psychosocial function and can go undetected for months or years. They are characterised by disturbed eating behaviour associated with concerns about weight and shape or by disinterest in food, phobic avoidance or avoidance due to sensory aspects of food. Restrictive forms of FEDs lead to significant weight loss requiring intervention. Without specific knowledge of these conditions, they can evade detection, delaying time to diagnosis and treatment and potentially influencing outcome. This review article focuses on the key factors involved in the psychiatric assessment and treatment of four feeding or eating disorders (EDs): anorexia nervosa, avoidant-restrictive food intake disorder, bulimia nervosa and binge eating disorder. To read the full article, log in using your NHS OpenAthens details.
Feeding and eating disorders (FEDs) are serious mental health disorders that cause impairments in physical health, development, cognition and psychosocial function and can go undetected for months or years. They are characterised by disturbed eating behaviour associated with concerns about weight and shape or by disinterest in food, phobic avoidance or avoidance due to sensory aspects of food. Restrictive forms of FEDs lead to significant weight loss requiring intervention. Without specific knowledge of these conditions, they can evade detection, delaying time to diagnosis and treatment and potentially influencing outcome. This review article focuses on the key factors involved in the psychiatric assessment and treatment of four feeding or eating disorders (EDs): anorexia nervosa, avoidant-restrictive food intake disorder, bulimia nervosa and binge eating disorder. To read the full article, log in using your NHS OpenAthens details
Feeding and eating disorders (FEDs) are serious mental health disorders that cause impairments in physical health, development, cognition and psychosocial function and can go undetected for months or years. They are characterised by disturbed eating behaviour associated with concerns about weight and shape or by disinterest in food, phobic avoidance or avoidance due to sensory aspects of food. Restrictive forms of FEDs lead to significant weight loss requiring intervention. Without specific knowledge of these conditions, they can evade detection, delaying time to diagnosis and treatment and potentially influencing outcome. This review article focuses on the key factors involved in the psychiatric assessment and treatment of four feeding or eating disorders (EDs): anorexia nervosa, avoidant-restrictive food intake disorder, bulimia nervosa and binge eating disorder. To read the full article, log in using your NHS OpenAthens details
To review current medical literature regarding the causes and clinical management options for low bone mineral density (BMD) in adult patients with eating disorders.
The objective of the study was to determine the factorial structure and test the measurement invariance of the EAT-26 in a large probability sample of young female university students in Qatar (n = 2692), a Muslim country in the Middle East.
Binge Eating Disorder (BED) is currently recognized as a severe disorder associated with relevant psychiatric and physical comorbidity, and marked emotional distress. Shame is a specific negative emotion that has been highlighted as central in eating disorders. However, the effect of shame and underlying mechanisms on binge eating symptomatology severity remained unclear. This study examines the role of shame, depressive symptoms, weight and shape concerns and eating concerns, and body image-related cognitive fusion, on binge eating symptomatology severity. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
In this commentary, some aspects of the context of this diagnosis are considered. It is suggested that avoidant/restrictive food intake disorder (ARFID) is principally a reconfiguration of existing problems. However, it is also stressed that we still need to develop treatments that help patients and their families, given the expectation that has been fuelled by the promotion of the new diagnostic scheme. In developing those therapies, we should not forget that we previously had a number of psychosocial treatment approaches that were helpful for such children when their problems were labelled differently.. To read the full article, log in using your MPFT NHS OpenAthens details.
Anecdotally it is well known that eating disorder memoirs are popular with people with anorexia nervosa and recovery stories are readily available online. However, no research to date has empirically explored whether such stories are helpful for current sufferers. The aim of the current pilot study was to explore the efficacy of recovery narratives as a means of improving motivation and self-efficacy and to qualitatively explore patient perspectives of such stories.
The study aims to explore the connection between the family interactive patterns, investigated with a standardized observational tool based on a recorded play session, the Lausanne Trilogue Play, and the outcome of adolescent patients with anorexia nervosa after a 6 months treatment, based on the Morgan–Russel Outcome Assessment Schedule. Seventy‐two parents and adolescent daughters with anorexia nervosa, consecutively referred to an adolescent neuropsychiatric service, participated in the study and underwent an integrated model of treatment, based on constant neuropsychiatric and dietary monitoring, weekly individual psychotherapy for the daughter, and parental counselling and support. A better adolescents' functioning in family relationships, in particular in the triadic ones, at first assessment, was associated with a better outcome. Data on family interactions may help predict the most appropriate intervention for the patient and his family.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Anorexia nervosa is a severe, biologically based brain disorder with significant medical complications. It is critical that new, effective treatments are developed to interrupt the persistent course of the illness due to the medical and psychological sequelae. Several psychosocial, behavioral and pharmacologic interventions have been investigated in adult anorexia nervosa; however, evidence shows that their impact is weak and treatment effects are generally small.
This paper considers how the three principles of evidence based practice (clinical expertise, scientific evidence, and patient preference) can be applied to the complexity of treatment for anorexia nervosa AN. To read the full article, log in using your NHS OpenAthens details.
This paper considers how the three principles of evidence based practice (clinical expertise, scientific evidence, and patient preference) can be applied to the complexity of treatment for anorexia nervosa AN. To read the full article, log in using your NHS OpenAthens details
Psychological Assessment (Jan 21, 2019). DOI:10.1037/pas0000697
Despite revisions to the DSM–5, current diagnostic criteria poorly capture the phenomena of eating disorders. The construct of food craving may help to explain the range of disordered eating and compensatory behaviors, but current measures do not fully capture the construct. Borrowing from the substance use literature and emphasizing both approach and avoidance craving inclinations, the ambivalence model of craving (AMC) provides a useful framework for predicting broad patterns of disordered eating behaviors. This study sought to develop and preliminarily validate a multidimensional AMC-based measure of food craving.. To read the full article, log in using your NHS OpenAthens details.
Letter. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
We usually think of anorexia nervosa (AN) and other eating disorders (ED) as primarily psychological conditions. However there is a surprising amount of evidence suggesting that autoimmunity has something to do with it. Some autoantibodies can have a direct effect on brain neurons causing obvious behavioural disorders, as a seen in PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections): indeed some PANDAS-type cases have been reported to have acute-onset anorexia...... To read the full article, log in using your NHS OpenAthens details.
The festival featured two dramas about the eating disorder – one depicting its emotional aftermath and the other its deceptive nature. Two outstanding shows about people with eating disorders featured at this year’s Edinburgh Fringe Festival in August. To read the full article, log in using your MPFT NHS OpenAthens details.
The article discusses the application of psychotheraphy in helping adolescent patients with anorexia nervosa. Topics covered include the need to help patients connect with their innate life force or self-actualizing tendency, ways to deal with patient's ambivalence, strategies for helping patients development a more accepting attitude toward themselves and the psychological processes that anorexia patients appear to go through during recovery. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Excessive exercise is recognized as a predictor of poor outcome in eating disorders. However, little is known about how excessive exercise might affect the treatment process. The aim of this study was to describe process of weekly changes in eating disorder psychopathology, general psychopathology and exercise, and the possible interactive effects of excessive exercise on these changes during inpatient treatment of longstanding eating disorders.
The need for novel approaches to understanding and treating anorexia nervosa (AN) is well recognized. The aim of this paper is to describe an integrative bio-psycho-social theory of maintaining factors in AN. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Open access. Although family-based treatment (FBT) is accepted as the first-line treatment for adolescent anorexia nervosa, studies show that it is infrequently used by clinicians in community settings. To elucidate some of the barriers to implementing this evidence-based treatment, mixed (quantitative and qualitative) methods were used in this exploratory study to examine therapist experiences with FBT.
Spirituality in Clinical Practice (May 21, 2018): No Pagination Specified.
This article reports two qualitative studies that explored how religion and spirituality (R/S) influenced the treatment and recovery process of patients with eating disorder.. To read the full article, log in using your NHS OpenAthens details.
Open access. Eating disorders (EDs) and their subclinical variants are important health concerns for adolescent girls, and body dissatisfaction is a more common yet often debilitating experience that typically precedes the development of an ED. Despite this fact, little is known about what makes girls who are dissatisfied with their bodies more likely to engage in pathological eating behaviors. The present study explored eating pathology among a sample of adolescent girls from New Zealand and examined a variety of established risk factors that may moderate the relationship between body dissatisfaction (BD) and eating pathology.
The Transtheoretical Model (TTM) which focuses on stage of change has been the main conceptual model used in understanding the lack of motivation to change in patients with Anorexia Nervosa (AN). Whilst there is evidence to support the prognostic value of the TTM in AN, this evidence base sufferers from limitations including limited studies in adults and none in outpatient populations. The primary aim of this study was to clarify whether readiness to change, as measured by the University Rhode Island Change Assessment Scale (URICA) and the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) could predict weight gain in adults with AN following treatment in an outpatient setting.
Overweight and obese individuals show increased psychological and physiological reactivity to food cues and many of them have difficulties in achieving long-term weight loss. The current study tests whether abnormalities in the learning and extinction of appetitive responses to food cues might be responsible for this. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
A 34-year-old woman with a history of anorexia nervosa and severe malnutrition (body mass index of 6, weight of 31.7 lbs) was hospitalised for multidisciplinary management. Three weeks after progressive enteral nutrition via nasogastric tube, the patient developed acute intense abdominal pain. CT angiography revealed gastric pneumatosis with submucosal thickening associated with significant intrahepatic portal venous gas, and no evidence of mesenteric ischaemia (figure 1). Endoscopic evaluation showed areas of patchy mucosal necrosis ….... To read the full article, log in using your NHS OpenAthens details.
Letter. A wealth of studies has investigated the neurobiological underpinnings of anorexia nervosa. In our letter to the editor, we point to a number of ways in which the advances in our understanding of the neurobiology of anorexia nervosa - focusing on neuroimaging studies of brain structure and function - can be translated into treatment. We point to how such advances can: inform psychological treatment, be implemented in psychoeducation, point to novel therapeutic targets, lead to the identification of biomarkers, and expand our vocabulary for how we think and talk about anorexia nervosa.
One presentation of Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by picky eating, i.e., selective eating based on the sensory properties of food. The present study has two aims. The first is to describe distress and impairment in individuals with ARFID secondary to picky eating. The second is to determine whether eating behaviors hypothesized to be specific to picky eating can differentiate picky eaters with and without ARFID from typical eaters (e.g., individuals not reporting picky or disordered eating) and individuals who strongly endorse attitudes associated with anorexia and bulimia (eating disordered attitudes).
Anorexia Nervosa (AN) destroys developmentally important early years of many young people and knowledge is insufficient regarding course, treatment outcome and prognosis. Only a few naturalistic studies have been conducted within the field of eating disorder (ED) research. In this naturalistic study we included adolescents with AN or subthreshold AN treated in outpatient care, and the overall aim was to examine sample characteristics and treatment outcome. Additional aims were to examine potential factors associated with remission as an outcome variable, and possible differences between three time periods for treatment onset. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Practice Pointer. What you need to know
Addiction to exercise might form part of a broader eating disorder or may occur in isolation
Inability to stop or reduce exercising, for example in response to an injury, may indicate addiction
Treatment broadly follows the principles of treating other addictions, for example cognitive behavioural therapy and exercise reprogramming
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The use of dialectical behaviour therapy for patients with binge eating disorder has developed recently and, as part of the Eating Disorder Service in Forth Valley, an adapted dialectical behaviour therapy treatment programme has been piloted prior to patients progressing on to the weight management service, to find out if an adapted dialectical behaviour therapy group can help patients with binge eating disorder reduce bingeing behaviour and improve quality of life. To read the full article, log in using your NHS OpenAthens details.
Anorexia nervosa (AN) continues to remain poorly understood within eating disorders. Recent research and theory have moved away from understanding its aetiological causes, addressing instead potential maintaining factors. This study is focused on interpersonal maintenance factors: the response of close others. Relatives of those with AN typically carry the main burden of care, and research has found high levels of carer distress and unmet needs. Recent theories have proposed this emotional impact to contribute to expressed emotion and other unhelpful caregiver interactions which inadvertently maintain AN. One such understudied response is accommodation, described as a ‘process’ whereby caregivers ‘assist or participate’ in symptomatic behaviours of the cared for individual. There is a dearth of research relating to accommodation within eating disorders, particularly qualitative accounts. This study utilized a grounded theory methodology to explore caregivers' responses to managing AN, focusing particularly on carers' experience of accommodation. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Establishing the sequence in which risk factors for eating disorders (ED) emerge would enable more effective ED prevention. Thus, in our study we investigated reciprocal and indirect associations between three cognitive and behavioral ED determinants (appearance orientation, appearance worries, and dieting) emphasized in the transdiagnostic model of ED.
Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions.
Open access. Avoidant/restrictive food intake disorder (ARFID) was added to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition in 2013. ARFID can result in impaired growth and significant nutritional deficiency; individuals with ARFID may be so nutritionally compromised that they require medical stabilization in a hospital. Prior to the new diagnostic criteria, it is unclear how patients now diagnosed with ARFID may have been medically stabilized when hospitalized. Our study aim was to assess the inpatient medical management of adolescents with ARFID.
Despite the theoretical links between eating disorders and perfectionism, the definition of perfectionism in practice is complicated. The present study explored descriptions and experiences of perfectionism described by a transdiagnostic sample of patients.
Journal of Abnormal Psychology126.5 (Jul 2017): 565-592.
Although a growing body of research has examined Purging Disorder (PD), there remains a lack of conclusive evidence regarding the diagnostic validity of PD. This meta-analysis compared PD to DSM–5 eating disorders (i.e., Anorexia Nervosa [AN], Bulimia Nervosa [BN], and Binge Eating Disorder [BED]) and controls. A comprehensive literature search identified 38 eligible studies. Group differences on indicators of course of illness and both general and eating psychopathology were assessed using standardized effect sizes. Results supported the conceptualization of PD as a clinically significant eating disorder, but findings were less clear regarding its distinctiveness from other eating disorder diagnoses. To read the full article, log in using your NHS OpenAthens details.
The objective of the study was to determine whether levels of biochemical and haematological parameters in patients with eating disorders (EDs) varied from the general population. Whilst dietary restrictions can lead to nutritional deficiencies, specific abnormalities may be relevant to the diagnosis, pathogenesis and treatment of EDs.
No specific psychotherapy for adult anorexia nervosa (AN) has shown superior effect. Maintenance factors in AN (over-evaluation of control over eating, weight and shape) were addressed via Acceptance and Commitment Therapy (ACT). The study aimed to compare 19 sessions of ACT with treatment as usual (TAU), after 9 to 12 weeks of daycare, regarding recovery and risk of relapse up to five years.
Negative body image is a risk factor for development and relapse in eating disorders (ED). Many patients continue to be dissatisfied with their body shape or weight after treatment. This study presents a qualitative analysis of written reflections on body image from patients with an ED and a negative body image before and after an Acceptance and Commitment Therapy group treatment at a specialized ED-unit.
Journal of Abnormal Psychology (Dec 20, 2018). DOI:10.1037/abn0000400
Prospective studies have identified risk factors that predict future onset of eating disorders, but none has provided a test of the temporal sequencing of the emergence of risk factors hypothesized in a multivariate etiologic model of eating disorder development. . To read the full article, log in using your NHS OpenAthens details.
Considerable progress has been made in recent years in developing effective treatments for child and adolescent anorexia nervosa, with a general consensus in the field that eating disorders focussed family therapy (often referred to as Maudsley Family Therapy or Family Based Treatment) currently offers the most promising outcomes. Nevertheless, a significant number do not respond well and additional treatment developments are needed to improve outcomes. Multifamily therapy is a promising treatment that has attracted considerable interest and we report the results of the first randomised controlled trial of multifamily therapy for adolescent anorexia nervosa.
A 12-month, open-label extension study assessed the long-term safety and tolerability of lisdexamfetamine dimesylate (LDX) in adults with binge eating disorder (BED). SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
I’ve said it before and no doubt I will have to say it again at some point: we’re not very good at treating anorexia nervosa. We don’t have many evidence-based treatments, and those we have are not great in terms of outcome and rates of drop out. Yet anorexia nervosa is a horrible illness to live with, exhausting for those suffering from it and those caring for them; we should be doing better than we are at treating it.
But there is hope. It has been recognised that things need to change, and that new, theory-based treatments should be developed, and here is one: “MANTRA – Maudsley Model of Anorexia Nervosa Treatment for Adults” being rigorously tested against a manualised treatment as usual, “SSCM – Specialist Supportive Clinical Management”.
Network analysis has recently been introduced as a clinically relevant methodology for understanding the structure of mental disorders and for evaluating cognitive behavioral models of psychopathology. The current study uses network analysis to validate the transdiagnostic model of eating disorders by examining the association between overvaluation of shape and weight and eating disorder symptoms......Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Refeeding is the first step in long-term nutritional rehabilitation of patients with anorexia nervosa (AN). It may begin in the outpatient setting or in the hospital, if close medical and/or psychiatric monitoring is needed. In either case, early weight gain appears to be crucial for recovery. In hospital, faster weight gain [1] and higher weight upon discharge [2, 3] predict weight recovery at 1 year. In outpatient psychotherapy, substantial early gain (at least 0.43–0.86 kg/week during the first 4 weeks) predicts both weight and cognitive recovery at 12 months [4]. The importance of weight gain, however, must be balanced with the need for safety......
Open access. Anorexia Nervosa (AN) is a debilitating, sometimes fatal eating disorder (ED) whereby restraint of appetite and emotion is concomitant with an inflexible, attention-to-detail perfectionist cognitive style and obsessive-compulsive behaviour. Intriguingly, people with AN are less likely to engage in substance use, whereas those who suffer from an ED with a bingeing component are more vulnerable to substance use disorder (SUD).
Open access. Eating disorders are serious conditions which are increasing in prevalence internationally. The causes of these conditions are complex and incompletely understood, and clinical presentations can vary over time. The complexity of these conditions can also complicate treatment. Therefore, stepped care treatment comprising a hierarchy of interventions, including access to day treatment programs (DTPs), is recommended. While studies have examined patient outcomes and provided narrative accounts of these programs, no published studies describe DTP development. This study aims to address this gap by examining development and implementation of a DTP from service providers and patients’ perspectives.
On social media, images such as thinspiration, fitspiration, and bonespiration, are shared to inspire certain body ideals. Previous research has demonstrated that exposure to these groups of content is associated with increased body dissatisfaction and decreased self-esteem. It is therefore important that the bodies featured within these groups of content are more fully understood so that effective interventions and preventative measures can be informed, developed, and implemented.
Carers of individuals with eating disorders (EDs) report high levels of burden and distress and describe a number of unmet needs. As a result, a number of interventions have been designed to support carers, including the “Maudsley eating disorder collaborative care skills workshops,” which comprise six 2-hr workshops delivered over 3 months for parents and carers of people with EDs. The current study aimed to test a proof-of-concept that this workshop could be effectively delivered in 1 day. An additional aim was to assess whether the workshop had direct effects on carer skills. A nonexperimental repeated measures research design was employed, giving measures before and after a 1-day workshop. Results suggested significant increases in carer self-efficacy and carer skills, with moderate to large effect sizes. Qualitative analyses supported these results whilst also generating ideas to improve the 1-day workshop. To read the full article, log in using your SSSFT NHS OpenAthens details.
Cognitive-behavioral therapy (CBT) has been recommended for the treatment of eating disorders, and group therapy is known to have certain advantages over individual therapy. The aim of the current study was to compare the 10-year prognosis of patients who completed integrated group CBT with those who dropped out and to examine the effect of completion of group CBT on the prognosis.
Eating disorders, such as anorexia nervosa and bulimia nervosa, can have devastating effects on both the health and performance of athletes. Compared to non-athletes, both female and male athletes are at higher risk of developing an eating disorder. This is especially true for athletes participating in sports where low body weight or leanness confers a competitive advantage. Screening for disordered eating behaviours, eating disorders and for related health consequences should be a standard component of preparticipation examinations, and team physicians should be knowledgeable of the updated diagnostic criteria for eating disorders in the Diagnostic and Statistical Manual-V. Athletes with eating disorders should undergo thorough evaluation and treatment by an experienced multidisciplinary team. Team physicians play a critical role in decision-making on clearance for participation and return to play. Using evidence-based guidelines for clearance and return to play encourages transparency and accountability between the sports medicine care team and the athlete. Efforts to prevent eating disorders should be aimed at athletes, coaches, parents and athletic administrators, and focused on expanding knowledge of healthy nutrition in support of sport performance and health. To read the full article, log in using your NHS Athens