Eating Disorders

Is Anorexia Nervosa a Version of Autism Spectrum Disorders?

Tetyana 9 Comments

Patients with anorexia nervosa often have difficulties recognizing and regulating emotions. This  conclusion that is largely based on data from  common tests such as Reading the Mind in the Eyes assessing  emotion recognition, and questionnaires like Difficulties in Emotion Regulation Scale (DERS) assessing emotion regulation (see my post here).  Although that study compared currently ill patients with healthy controls (thus raising the possibility that the resulting data was due to the effects of starvation or due to the chronic nature of the ED  in the sample, ~7.5 year on average), there is some evidence that some of these difficulties persist post-recovery.

Individuals with autism (ASD, or autism spectrum disorders) also have difficulties with emotion recognition and regulation, leading some investigators to hypothesize that AN and ASD may share common etiology. Providing further support for this hypothesis are studies suggesting that AN might be overrepresented in ASD and … Continue reading →

Diabulimia: Disordered Eating in Type 1 Diabetic Patients

Tetyana 15 Comments

Type 1 diabetes mellitus (DMT1) is a lifelong chronic disorder that occurs when the body is unable to produce enough insulin – a hormone that is required for carbohydrate metabolism. Patients must learn to manage their disorder by monitoring their blood sugar levels on a regular basis, carefully selecting the foods they eat and how much exercise they do. Before insulin was extracted and purified (at University of Toronto!), type 1 diabetes, which usually occurs in children and adolescents, would very quickly lead to death – the body, unable to take in the very thing it needs to survive.

Unfortunately,  patients with type 1 diabetes are at increased risk of developing eating disorders or disordered eating behaviours. Diabulimia refers to an eating disorder in patients with DMT1 who reduce or skip insulin doses to reduce their weight.

The exact prevalence rates vary study by study, depending on the population sample, … Continue reading →

Emotion Recognition and Regulation in Anorexia Nervosa

Tetyana 1 Comment

Should anorexia nervosa (AN) – or subtypes of AN – be classified as part of the autism spectrum disorders (ASD)? That’s a question that has been receiving some attention in the literature in the last few years, although there are only a handful of studies, most of which are small and limited in scope (thus limiting interpretation of the results).

In the Time Magazine article  “A Genetic Link Between Anorexia and Autism?” the author mentions a study – which I decided to cover today – on emotion regulation and recognition in patients with AN. It is not directly evaluating the link between AN and ASD, but it is related and a good starting point. I was originally going to write about two papers, but I will save the other one  (Is anorexia nervosa a version of autism spectrum disorders?) for another time.

The study design in this paper … Continue reading →

The Ethics of Force Feeding in Anorexia Nervosa

Tetyana 8 Comments

I’m cheating. This is not a real blog post.
I’m going to plug a piece I just wrote for another publication/blog (see below) called:

Anorexia Nervosa: The Ethical Dilemma of Force Feeding. Check it out, leave a comment.

I’m “cheating” in part because I’ve been busy  (mostly writing my thesis, but also writing and editing other articles, editing essays, tutoring, and all sorts of fun things that leave me with less time for the blog), and in part because it is relevant and I think it will be of interest to SEDs readers.

Here is the story:
A friend of mine asked me to write an article for Inquire UofT. Inquire is an interuniversity publication and the University of Toronto chapter is at its infancy–as is their blog. My friend told me I could write about anything I wanted but the topic had to be current and controversial. … Continue reading →

Genetics: Friend or Foe in Ending Eating Disorder Stigma?

Tetyana 10 Comments

Refrigerator mothers or the idealization of thin models? Toxic families or toxins in our diets? Oh, if only determining the cause (because it has to be just one, right?) of eating disorders was that simple. All behaviour has a biological basis, a neurobiological correlate. The way our brains function—and the resulting behaviours — is due to complex interactions between our genome, epigenome, and the environment. Eating disorders do not have a single cause; we cannot put the blame solely on families, or thin models, vanity or genetics.

As a science grad student, I am interested in how non-scientists interpret scientific findings on mental disorders, particularly eating disorders. With respect to eating disorders, I am interested in how patients’ understanding of the science shapes the way they view themselves and their eating disorders, as well as how it shapes their treatment and recovery.

In a recent paper, Michele Easter wanted to find out … Continue reading →

Doing It Together: Uniting Couples in the Treatment of Eating Disorders

Tetyana

Eating disorders don’t discriminate against gender, age, sexual orientation or race. Veteran men in their 50’s can struggle with eating disorders, as can trans men and women of all ages and backgrounds, and so can congenitally blind (and deaf) individuals.

Besides the barriers that many of these patients face in simply getting diagnosed with an eating disorder, yes, even if they’ve passed that hurdle, many face an even bigger problem: getting appropriate treatment.

Naturally, no one treatment method will work for everyone, especially when the patient population is so diverse. What works for a 13-year-old female may not work for a man in his 40’s or 50’s.  Unfortunately, treatment options (at least those that have some empirical evidence) are limited. As I’ve recently blogged, new treatments are being developed and utilized in treating adults and/or patients with with long-standing eating disorders – sub-populations that have largely been … Continue reading →

Devil in the Details: Can Poor Cognitive Function be Attributed to Anorexia Nervosa Patients’ Obsession with Detail?

Gina 9 Comments

Hi all, Gina here, again. This article is short and sweet, as is my post. I’m becoming increasingly interested in some of the more cognitive aspects of eating disorders and seeing as my background on the subject is pretty limited (re: none, although I’m taking a cognitive science class this term), I was hoping to generate some discussion /or references from readers that I could incorporate into further posts. Cheers!

It has long been suggested that people with eating disorders (in this case, specifically anorexia nervosa) display some core deficits in cognitive ability — namely impairments in executive function (Fassino et al., 2002; Pendleton Jones et al., 1991; Tchanturia et al., 2001, 2002, 2004).

If you’re like me and don’t study cognitive science, executive function basically means that people with AN show abnormal mental rigidity, working memory, capacity to manage impulsive responses (response disinhibition) and abstraction skills (i.e. abstract thinking, … Continue reading →

Can Eating Disorders Be Contagious?

Tetyana 15 Comments

Treating a patient with an eating disorder can often feel like walking on eggshells; it is easy to say or do the wrong thing. I’ve covered this topic in my previous posts. In my first post, I wrote about negative attitudes that health care providers often have with regard to eating disorder patients and in my second post, I covered some ways in which caring clinicians that do work with ED patients may – usually inadvertently – negatively impact treatment, often by impairing the physician-patient/caregiver relationship.

But let’s forget about clinicians for a second, what if the treatment environment itself is damaging? Could treatment itself do more harm than good?

That’s the question that Walter Vandereycken explored in this commentary article. (This interesting paper was brought to my attention by a reader – you know who you are, so thanks!)

And just to be really clear Vandereycken doesn’t … Continue reading →

How Do Anorexia Nervosa Patients Define Recovery and Engage in Treatment? The Need for Individualized Treatment

Gina

One difficulty in measuring rates of recovery for patients with anorexia nervosa (AN) is coming up with a cohesive definition of “recovery” that most of us can agree on. Similarly, it is hard to identify whether a particular treatment course is working when the patient and the clinician have different goals in mind. A 2010 study by Alison Darcy and colleagues (article is freely available here) – in an attempt to understand the patients’ goals – aims to explore how patients define recovery and engage in treatment. This study differs from a lot of the literature on treatments and recovery in that all the data comes from individuals with a lifetime history of AN. The population sampled includes 20 women with a mean age of just slightly over 29 (range from 19-52). This is a small sample size, which can make it difficult to generalize responses, and the information gathered … Continue reading →

Serotonin Function in Bulimia Nervosa – Brain Circuits & Behaviour

Tetyana 15 Comments

Serotonin (5-hydroxytryptamine, 5-HT) is a neurotransmitter that is involved in just about everything. It helps ensure proper cell growth, maturation and migration during development. Serotonin is also important in regulating emotions, cognitive functions, appetite, pain, circadian rhythms, and our endocrine system in adulthood. It is hardly a surprise then, that the serotonergic system seems to be important in bulimia nervosa (BN).

I’ve written previously about serotonin in restricting-type anorexia nervosa, so for this post I’m going to be shifting focus and talk about bulimia and binge-purge type anorexia nervosa (AN-BP).

The information in this post isn’t coming from a review paper. Instead, I’m going to be summarizing and explaining information from a chapter in a book titled Behavioural Neurobiology of Eating Disorders. In the chapter on serotonin and bulimia, Howard Steiger and colleagues propose a model for serotonin action in bulimia nervosa which takes into account “diverse … Continue reading →