I find the idea of treatment retention for eating disorders to be quite interesting. Mostly, I find it intriguing to dissect the way that authors write about treatment retention – that is, how they tend to look at factors within people that make them more or less able to complete treatment, rather than things about the treatment that serve or don’t serve people’s needs. I’ve been reading a lot more about adolescent eating disorder treatment these days, given that I’m doing a practicum at an adolescent treatment centre that does things a bit differently. Resultantly, I’ve become more interested than ever in how we can better meet people’s different treatment needs and provide a more comprehensive treatment continuum.
The stark reality of treatment is that people don’t always finish it. That statement sounds fairly banal, but it’s a loaded one. Too often, I see this framed as people failing … Continue reading →
I no longer support genetics research into eating disorders. Okay, that’s not quite right: I no longer support genetics research into eating disorders under the pretense that it will improve treatment outcomes or prevent eating disorders. I just don’t believe it. Moreover, I think emphasizing the need for a genetic understanding of eating disorders shifts focus away from research and, more importantly, from actions, that can yield much greater benefits much quicker.
It wasn’t always like this. In my third (junior) year of university, I wrote a mini-review on the genetic and neurobiological etiology (cause) of anorexia nervosa. In it, I argued that “in order to improve recovery outcomes, more specific treatments based on genetic and neurobiological evidence need to be developed.” I concluded by writing,
However, with the advent of large-scale genetic databases and worldwide collaboration among researchers resulting in larger sample sizes, the future of AN research
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I can’t help but think I often write more about the issues surrounding the general lack of treatment options for eating disorders that I sometimes neglect to comment on what is available. A part of this is that I would refer to myself as somewhat of a treatment modality atheist – I have the luxury of being someone who does eating disorder research but is not involved in directly treating those with eating disorders, and so I don’t need to specialize in one type of treatment. My bottom line tends to be that no one-size-fits-all, and that the type of treatment that works for someone will depend on so many factors (like their gender, ethnicity, socioeconomic status, body size, ability, even their politics to a certain extent) that I wouldn’t want to proclaim one type of treatment as king.
In spite of this treatment modality atheism (or perhaps because of … Continue reading →
This past Wednesday, January 27th, was Bell Let’s Talk day in Canada. In case you’re unfamiliar with the campaign, Bell Canada (a telecom company) donates 5 cents to mental health awareness initiatives for every social media post or text with the hashtag #BellLetsTalk. In general, the campaign has been lauded for its contribution to decreasing shame and stigma around mental illness, which is awesome. There are a number of critics, though, who point out that:
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This week I had the pleasure of attending a workshop with Janet Treasure on collaborative care in eating disorders. Treasure focused her workshop on supporting caregivers of people with eating disorders, offering practical skills for carers and clinicians alike to improve interactions with those with eating disorders. Though I am neither a carer nor a clinicians, I got a lot out of the workshop, and it reminded me of a few of Treasure’s articles I’ve read over the years, and how much I appreciate her strong focus on working collaboratively with patients and families to facilitate recovery.
I especially appreciated how she aims to integrate those with lived experience (of either having an eating disorder or caring for someone with an eating disorder) in research and treatment design. Some of her journal articles, including this article on the potential for harm in existing treatment models, even include former patients as … Continue reading →
In this last post about eating disorders in Singapore, I’ll write about the one Singapore-based retrospective outcome study in relation to a similar retrospective study conducted in Hong Kong.
In the Singapore study, researchers reviewed the charts of 94 patients diagnosed with anorexia nervosa from 1992 to 2004 at the National University Hospital, looking back from the time of the study. They didn’t contact any of the subjects for follow-up. 49 were first seen as inpatients, 34 as outpatients, and 11 were seen as outpatients but later admitted. The hospital doesn’t have a specialized ED service, so the authors relied on dietetic notes that unfortunately don’t provide a full picture of the patients’ eating disordered behaviors and cognitions.
The authors wrote about patient ‘improvement’ (not recovery!) as making a weight gain of at least 0.5 kg, or about 1 pound. 83% of their patients attended follow up appointments, which lasted … Continue reading →