adults

Maintaining Change Following Intensive Eating Disorder Treatment

Gina 9 Comments

It is a relatively well known fact that eating disorders have a high relapse rate and many people, myself included, find themselves in multiple intensive – residential, inpatient, even partial hospitalization – treatments. One may ask if such intensive treatments really work or if long term intensive care is just a band-aid of sorts. I know I’ve had to ask myself, “why is this going to work this time when it hasn’t worked in the long run before.”

There is even debate in the field on whether residential treatment actually has evidence supporting its effectiveness (see Tetyana’s post here). I can speak from experience that the various intensive treatments I’ve personally done have saved my life and given me more perspective, skills training, and support than I could have had otherwise. However, despite having made significant changes, I’ve had more than my share of slips and relapses.

I … Continue reading →

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 →

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 →

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 →

Financial Burden of Bulimia Nervosa: Cost of Food, Laxatives, Diuretics, and Diet Pills Adds Up

Tetyana 12 Comments

The financial burden of bulimia nervosa can be substantial, and yet little is known about the monetary costs associated with bulimic symptoms. At least little is known in academic circles – there is definitely a lot of anecdotal evidence floating around the internet. I found just one paper from 2009 by Scott J. Crow and colleagues. I stumbled upon it accidentally, actually. I was searching for articles on the economic burden of eating disorders (treatment cost, productivity loss, etc..) for a post I’m planning, but I thought I’d write about this in the mean time.

It is a short paper but I think it is important because it highlights an often overlooked issue.

The method Crow et al used to evaluate how much money individuals with bulimia nervosa spend on food, laxatives, diuretics and diet pills is simple (keep in mind, this hasn’t really been done before). Essentially, they asked … Continue reading →

How Can We Treat Chronic and Severe Anorexia Nervosa? (On the Need for New Approaches)

Tetyana 27 Comments

Treating anorexia nervosa is hard. Treating chronic and severe anorexia nervosa is a lot harder. Although the situation seems to be improving, there are really no evidence-based treatments for anorexia nervosa – particularly for those who have been sick for a long time.

Patients with severe and enduring anorexia nervosa have one of the most challenging disorders in mental health care  (Strober, 2010).They have the highest mortality rate of any mental illness with markedly reduced life expectancy (Harbottle et al., 2008). At 20 years the mortality rate is 20%, and given the young age of onset this results in many young adults dying in their 30s, and a further 5–10% every decade thereafter (Steinhausen, 2002)… Patients are often under- or unemployed, on sickness benefits, suffer multiple medical complications… have repeated admissions to general and specialist medical facilities, and are frequent users of primary care services (Birmingham and Treasure, 2010;

… Continue reading →