2011

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 →

What You Should Know About Anorexia Nervosa and Bone Health

Tetyana 7 Comments

Recovery from an eating disorder is really hard. Unfortunately, the negative effects of that occur as a result of the eating disorder often persist long after recovery. It is hard to undo the mental and psychological aspects of anorexia or bulimia nervosa, but it may be just as hard, if not impossible, to undo the damage done to body.

What are some of the long-term health effects of eating disorders? What do patients with eating disorders – recovered or not – have to live with, for years, often decades, after recovery?

A really common consequence of anorexia nervosa is osteoporosis: thinning of bone tissue and loss of bone density. Unlike delayed gastric emptying – another consequence of EDs – which can make every meal a nightmare (particularly for someone recovering from an eating disorder): acid reflux, stomach pain and abdominal bloating are just some of the symptoms, bone density … Continue reading →

When Clinicians Do More Harm Than Good – Part 2 (Risks Associated with Treatment)

Tetyana 6 Comments

My previous post on the effectiveness of residential treatment centers (RTCs) generated a lot of discussion. A point that was raised several times, on the blog, on Facebook and other forums was the fact that there are risks in choosing an RTC for treatment.

Laura Collins did a great job of articulating some of the risks in her comment:

Among the risks: delaying necessary changes at home, disempowering or alienating relationships at home that are necessary for longterm health, exposure to behaviors and habits that had not been an issue previously, exposure to unhealthy relationships with other clients, an artificial environment that can’t translate to life after RTC, and therapeutic methods or beliefs that are false or don’t apply.

There risks are not specific to RTCs. They hold true for inpatient treatment, partial hospitalization and to a lesser extent, outpatient treatment. I thought it would be nice to explore in … Continue reading →

The Anorexia Nervosa Brain: A Summary of Neuroimaging Studies – Part 1

Tetyana 1 Comment

Journalists like to report on novel and exciting findings regardless of how likely they are to be replicated or how well they fit with everything else known about the topic. It is an all too common occurrence that a small pilot study which has favourable results, creates a buzz and gets into our heads, only to produce negative results once the sample size is increased. But the latter, negative finding, rarely makes it to the printing press. So, we are left thinking the results of the pilot study are correct, when they might be an outlier or a false positive.

Given this, I wanted to summarize an article that provides a critical overview of the current neuroimaging studies in anorexia nervosa. We can use this as an introduction to neuroimaging in AN: to get a sense of the scientific consensus, the trends that emerge and what can be learned from … Continue reading →

A Meta-Analysis of Mortality in Eating Disorders

Tetyana

You often hear that anorexia nervosa has the highest mortality rate of any psychiatric illness, but you might struggle to find the rates for bulimia nervosa or EDNOS. Even for AN, the most common cause of death is rarely reported and the reported rates often vary a lot (depending on the study (and the media outlet).

I wanted to find out what are: (1) the mortality rates in BN and EDNOS and (2) the common causes of death in these disorders.  A relatively recent meta-analysis (click here for some background, pros and cons of meta-analyses) of 36 studies, which addressed some of my questions, was published by Arcelus and colleagues.

They excluded studies that had less than 15 patients and/or <1-year follow-up.

SO, WHAT DID THEY FIND?

Mortality in Anorexia Nervosa:

  • 35 studies, mean follow-up time: 12.8 years (maximum 36.2), mean sample size was 361 (maximum 6009).
  • Total
… Continue reading →