Month: August 2012

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 →

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 →

Understanding Disordered Eating in Trans People

Tetyana 17 Comments

Gender nonconformity is the second most popular search term that leads people to Science of Eating Disorders. (After “science of eds” and beating “science of eating disorders”.) Not far behind are variants of “FtM/MtF/transsexual/transgender” combined with “eating disorder/anorexia/bulimia”. That’s telling. It means there is little information on this topic. And it is not just that there’s too little information available to the public – there are only a handful of published studies in the peer-reviewed literature.

One study (which I discussed in my previous post: Gender Nonconformity, Transsexuality and Eating Disorders) published by Vocks et al (2009), compared disordered eating patterns, body image disturbances and self-image scores among trans women and men (131 participants in both groups) and cis female and male controls as well as to females with eating disorders.

Overall, they found disordered eating patterns reported by trans women and trans men were in the middle … Continue reading →