Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 72: (i) RFs; (ii) Comorbidity, Pt 2 (n = 2); (iii) Athletes, Identity, & BI; (iv) Pregnancy, Postpartum, BI, & DE, Pt 1 (n = 2); (v) Food Addiction; & (vi) Aug - Sept Tx Interlude, Pt 1 (n = 4)
Colleagues (N now = 1224 in 48 countries),
Please (a) continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications); and (b) pass along the following to anyone who would like to join this free email list, or who may be interested in joining
POST-DOCTORAL OPPORTUNITIES (Plural) for
Postdoctoral Researchers (one each) at Virginia Commonwealth University (USA)
A. The REPEAT (Research on Persistent, Excessive, and Emotion-Based Actions and Traits) Lab
Headed by our Dr. Ann Haynos (USA) is recruiting a
Postdoctoral Researcher
Application Deadline: Applications considered in an ongoing manner, but preferred by 1 November 2024 for priority review.
Expected start time: Summer or Fall of 2025
A. The Translational Research on Eating and Affect (TREAT) Lab
Headed by our own Dr. Kelsey Hagan (USA), in conjunction with Eating Disorders Outpatient Clinic within the Department of Psychiatry, is recruiting an
Eating Disorders Clinical Research Postdoctoral Scholar
Application Deadline: Applications considered in an ongoing manner, but preferred by 30 October 2024 for priority review
Expected start time: Summer or Fall of 2025
Received 27 September via an everything-is-advocacy email from our own Dr. Annie Haynos (USA) on behalf of her colleague, our own Dr. Kelsey Hagan (USA).
ML NOTE 1: Drs. Haynos and Hagan, their colleagues, and I would appreciate it if you would pass these opportunities along to (a) any and all people who might be qualified and interested, and/or (b) those who mentor, supervise, and otherwise work with such people.
A. The REPEAT (Research on Persistent, Excessive, and Emotion-Based Actions and Traits) Lab headed by Dr. Ann Haynos is hiring a Postdoctoral Researcher to start in the Summer or Fall of 2025.
The specific duties of this position may vary flexibly according to the fellow’s background and training goals, but likely include oversight on ongoing REPEAT Lab NIMH-funded studies (investigating neuroscience-based mechanisms and treatments for eating disorders and other related disorders) and supporting data analysis and manuscript preparation for studies within the lab. Clinical responsibilities, such as conducting or supervising or assessments or therapy for ongoing research studies could be involved in the position as desired by the candidate.
This position will present many opportunities for training in advanced psychological and neuroscience-based methods and analyses, computational modeling, clinical trial administration, as well as for publication, grant-writing, and working towards licensure. A strong emphasis will be placed on the professional development of the fellow. Remote or in-person positions are both possible, though in person is preferred. Here is the link to apply for this postdoctoral position. Applications will be considered in an ongoing manner, but preferred by November 1st for priority review.
B. The Translational Research on Eating and Affect (TREAT) Lab headed by Dr. Kelsey Hagan and the Eating Disorders Outpatient Clinic within the Department of Psychiatry at VCU are recruiting an Eating Disorders Clinical Research Postdoctoral Scholar.
This position involves training and mentorship in eating disorders research as well as supervision and training in evidence-based treatments for adolescent and adult eating disorders. The balance of the research and clinical components of the position will be tailored to the scholar’s individual training goals.
The TREAT Lab is currently conducting studies investigating the neurocomputational and psychosocial mechanisms of binge-purge eating pathology in adolescents and young adults using neurocognitive choice tasks, neuroimaging, ecological momentary assessment, and clinical measures. Day-to-day responsibilities may include mentorship of junior learners, as well as assisting with data management, preparation of project-related abstracts and manuscripts (including analysis and writing), and support of grant applications.
The scholar will be highly encouraged to conduct and launch their own independent line of research and mentorship in grant writing. The clinical component of this position will involve treating adolescent and/or adult patients with eating disorders using evidence-based therapies through the Eating Disorders Outpatient Clinic in VCU Psychiatry. Opportunities will be available for the scholar to provide clinical supervision to learners, such as graduate students, and there will be opportunities for clinical teaching (e.g., of psychiatry residents) and program development and evaluation.
Applications will be considered in an ongoing manner, but preferred by October 30th for priority review. Please see the attached ad with additional details and instructions for applying.
Please feel free to reach out to me or Kelsey (kelsey.hagan@vcuhealth.org) with any further questions about applying for either position!
Annie Haynos, Ph.D. | Assistant Professor of Clinical Psychology
Department of Psychology | Virginia Commonwealth University
Pronouns: She/her/he
ADVOCACY-IN-ACTION FOLLOW-UP
to
Learn About and Join a
a first-of-its-kind International Initiative entitled
Consortium for Research in Eating Disorders (CoRe-ED)
headed by [our own] Dr. Gemma Sharp (Australia)
Open to All AND Membership is Free
Received yesterday (California time), 28 September 2024, via an everything-is-advocacy email (as part of ongoing exchange with me that began in early August 2024) from our own Dr. Gemma Sharp (Australia).
ML NOTE 2: Dr. Sharp, her colleagues in CoRe-ED, and I would appreciate it if you would pass this invitation along to any and all who might be interested
[Dr. Sharp writes; bold-for-emphasis added by ML]:
We thank the many people around the world, across five continents, who joined up for our official launch of the Consortium for Research in Eating Disorders (CoRe-ED) on 25th September 2024.
CoRe-ED membership is free of charge and we welcome anyone interested across the globe to join - researchers, clinicians, people with lived experience, advocates, not-for-profit and industry representatives. As part of the CoRe-ED membership sign up process (which only takes a few minutes to complete), we are asking what experiences/events members would like from the consortium. CoRe-ED is by you and for you.
To sign up for free membership, please go to our consortium website and scroll down to the bottom and click on "Register Now". We look forward to you joining us."
Thanks again.
Kind regards,
Associate Professor Gemma Sharp, , PhD, MAPS, FCCLP, CEDC, on behalf of CoRe-ED | NHMRC Emerging Leadership 2 Investigator Fellow / Senior Clinical Psychologist | Head, Body Image & Eating Disorders Research Program, Monash University | Lead, International Consortium for Research in Eating Disorders (CoRe-ED) | Faculty of Medicine, Nursing and Health Sciences, Monash University| gemma.sharp@monash.edu | https://research.monash.edu/en/persons/gemma-sharp
Research Publication Categories in This Newsletter
(i) Risk Factors and Prevention; (ii) Athletes, Identity, Bodies, and Body Image(s); (iii) Comorbidity, Part 2 (n =2); (iv) Pregnancy, Postpartum, Body Image, and Disordered Eating, Part 1 (n = 2); (v) Food Addiction; and (vi) August - September Treatment Interlude, Part 1 (n = 4)
CONGRATULATIONS to our own
Dr. Timothy Brewerton (USA) and colleagues for publication of the Comorbidity research article #4.
Dr. Ashley Gearhardt (USA) and colleagues, including distinguished research scientist Dr. Nicole Avena (USA), for publication of the Food Addiction review article in #7.
Dr. Ulrike Schmidt (England) and colleagues for publication of the Treatment review articles in #8 and #9.
Ms. Chantal Delaquis (France) and colleagues for publication of the Treatment review article in #12.
Risk Factors and Prevention
1. Keski-Rahkonen, A. (2024). Eating disorders: Etiology, risk factors, and suggestions for prevention. Current Opinion in Psychiatry, 37(6), 381-387. https://doi.org/10.1097/YCO.000000000000096
Email address for correspondence: anna.keski-rahkonen@helsinki.fi
ABSTRACT. Purpose of review: The incidence of eating disorders has increased worldwide. This narrative review gives an overview of research on etiology and risk factors of eating disorders published in 2022–2024.
Recent findings: Eating disorders arise from a complex set of risk factors. The recent increase in incidence of eating disorders can be linked to root causes that include sociocultural pressure to conform to unrealistic and gendered body ideals, rise in obesogenic environments, and the global COVID-19 pandemic.
Recent studies have shown that screen time and social media intensify sociocultural pressure to look a certain way. Individual-specific risk factors also increase the likelihood of onset of eating disorders. These include sports, stressful and traumatic life events, family factors, and psychological factors, including disgust sensitivity, aversive experiences, low self-esteem, perfectionism, neuroticism, obsessive-compulsive and impulsive features, and emotional dysregulation.
Preexisting mental health conditions, particularly anxiety, depression, and posttraumatic stress disorder, and neurodevelopmental conditions, such as autism and attention-deficit hyperactive disorder, are also associated with increased eating disorder risk. Genetic and biological factors contribute both to risk and resiliency.
Summary: The risk factors of eating disorders are well established. Future studies should focus on increasing resilience and preventive interventions.
Athletes, Identity, Bodies, and Body Image(s)
2. Knowlton, M., & Newland, B. L. (2024). Beyond the barbell: Women in strength-based sports and the reshaping of gender norms. Sex Roles. Advance online publication. https://doi.org/10.1007/s11199-024-01521-x
Email address for correspondence: bnewland@uccs.edu
ABSTRACT. Women have made strides in male-dominated sports but still face obstacles from gender biases and lack of diversity. Particularly in strength sports, the underrepresentation of women and lack of research on their lived experiences as athletes and coaches is notable. This study investigated the experiences of 21 women athletes and four coaches aged 18–44 in the strength sports of Olympic weightlifting, powerlifting, CrossFit, and strongman.
Results showed that women athletes struggled with body image, societal expectations, gender bias and diversity, and male interactions, even as they challenged gender norms and established their presence in these male-dominated sports. Athletes’ experiences aligned with past research, but also included powerful expression of what it means to be a strong woman despite societal pressure. Women coaches also report career progression and equal employment challenges and stressed the importance of women’s representation and inclusion at all levels of these sports.
Findings also indicated that while women’s performance demonstrates shifting norms for strength in these sports, more work is needed to overcome continued gender bias and to achieve equal employment opportunities for coaches. National sport governing bodies should review policy to support inclusion at all levels, and provide resources, mentorship, and training opportunities to improve accessibility to women coaches and athletes at all levels.
Comorbidity, Part 2 of now 3
3. Vickers, M. L., Chan, H. Y., Elliott, S., Ketheesan, S., Ramineni, V., Eriksson, L., McMahon, K., Oddy, B., & Scott, J. G. (2024). Stimulant medications in the management of bulimia nervosa and anorexia nervosa in patients with and without comorbid attention deficit hyperactivity disorder: A systematic review. Eating Behaviors, 54. Advance online publication. https://doi.org/10.1016/j.eatbeh.2024.101908
Full text available for download at: https://www.sciencedirect.com/science/article/pii/S1471015324000679
ABSTRACT. Objective: People with attentional problems are at increased risk of eating disorders. This paper aimed to systematically review and synthesize the existing evidence on stimulant medication in the management of patients with bulimia nervosa (BN) or anorexia nervosa (AN) with or without comorbid attention deficit hyperactivity disorder (ADHD).
Method: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A protocol for the review was registered with Open Science Framework (OSF) Registry and critical appraisal of the literature was conducted using Joanna Briggs Institute (JBI) Critical Appraisal Tools.
Results: Thirteen articles met inclusion criteria including two quasi-experimental studies, one randomized controlled trial, four case series, and six case reports. 26 cases were included from studies and 32 from case series/reports. Only two cases from a single case report had a diagnosis of AN, while the remainder had BN. Stimulants included methylamphetamine, lisdexamfetamine, methylphenidate, dextroamphetamine sulphate and mixed amphetamine salt.
In nearly all cases of BN there were reported reductions in eating disorder symptoms. The rates of adverse effects were high and included weight loss, decreased appetite, tachycardia, dry mouth, fatigue, insomnia, restlessness, nausea, bruxism, headache, palpitations, blood pressure changes, irritability, anxiety, depressed mood, and diaphoresis.
Conclusion: There is currently insufficient evidence to support the use of stimulant medications to treat symptoms of BN or AN. The authors recommend considering screening patients with BN for ADHD.
4. Brewerton, T. D., Kopland, M. C. G., Gavidia, I., Suro, G., & Perlman, M. M. (2024). A network analysis of eating disorder, PTSD, major depression, state‐trait anxiety, and quality of life measures in eating disorder patients treated in residential care. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.3136
Full text available for download at: https://onlinelibrary.wiley.com/doi/full/10.1002/erv.3136
ABSTRACT. Background: The network approach in the eating disorder (ED) field has confirmed important links between EDs and posttraumatic stress disorder (PTSD) symptoms. However, studies including comorbid symptoms are scarce, which limits our understanding of potentially important connections. We hypothesised that anxiety, depression and poor quality of life (QOL) would provide a more complete picture of central, maintaining factors.
Methods: Network analysis using R was performed in 2178 adult ED patients (91% female) admitted to residential treatment. Assessments included the ED Examination Questionnaire (EDEQ), the Eating Disorders Inventory (EDI-2), the PTSD Checklist for DSM-5 (PTSD clusters (PCL-5)), the Patient Health Questionnaire (PHQ-9), the Spielberger State-Trait Anxiety Scale (STAI), and the ED QOL Scale (EDQOL), which measure symptoms of EDs, PTSD, major depression, state-trait anxiety, and QOL, respectively.
Results: EDI-2 ineffectiveness showed the highest centrality (expected influence) followed by EDI-2 interoceptive awareness, STAI state anxiety, EDEQ shape concern, EDQOL psychological subscale, and PTSD cluster D (hyperarousal) symptoms. Eating Disorder Quality of Life psychological and physical-cognitive subscales and PHQ-9 major depressive, STAI state anxiety and PCL-5 PTSD cluster E (negative alterations in mood and cognition) symptoms showed the highest bridge expected influence, suggesting their interactive role in maintaining ED-PTSD comorbidity.
Conclusions: This is the first network analysis of the interaction between ED and PTSD symptoms to include the comorbid measures of depression, anxiety, and QOL in a large clinical sample of ED patients. Our results indicate that several symptom clusters are likely to maintain ED-PTSD comorbidity and may be important targets of integrated treatment.
Pregnancy, Postpartum, Body Image, and Disordered Eating, Part 1 of 2
ML NOTE 3: In regard to the article described in #5 and our own Dr. Niva Piran’s (Canada) Developmental Theory of Embodiment, see, the following. The Piran et al. (2023) article was initially presented in the previous version of this Newsletter sent on 18 January 2023 (#4). Dr. Elizabeth Evans (England; b.) is also a member of this Group.
a. Piran, N. (2018). Journeys of embodiment at the intersection of body and culture: The developmental theory of embodiment. Academic Press. https://doi.org/10.1016/C2015-0-04666-4
b. Piran, N., Counsell, A., Teall, T. L., Komes, J., & Evans, E. H. (2023). The developmental theory of embodiment: Quantitative measurement of facilitative and adverse experiences in the social environment. Body Image, 44, 227-245. https://doi.org/10.1016/j.bodyim.2022.12.005 [Full text available for download at: https://tinyurl.com/5nn82ud9]
5. Horton, E., Everett, B., Romito, M. (2024). Inundated with "bounce back" culture: An interpretative phenomenological analysis of postpartum first-time mothers' body image dissatisfaction and mental health implications. The Family Journal. Advance online publication. http://dx.doi.org/10.1177/10664807241269452
Email address for correspondence: horton@uhcl.edu
ABSTRACT. This study explored the lived experiences of and meaning made from postpartum mothers and their journey with their body image following childbirth. Using an Interpretative Phenomenological Analysis design, seven women were interviewed to understand their lived experiences. The Developmental Theory of Embodiment was used to help make sense of the postpartum mothers’ experience and meaning-making processes.
Themes included: (a) transformation of maternal body image, (b) sociocultural pressures of bouncing back, and (c) holding the duality of postpartum body dissatisfaction and body appreciation. Implications are provided for counselors. Recommendations include thoroughly assessing for and treating body image and related mental health needs for postpartum mothers.
6. Nagpal, T. S., Pearce, N., & Adamo, K. B. (2024). Presentation of a weight bias internalization tool for use in pregnancy and a call for future research: A commentary. Obesity Pillars, 10. Advance online publication. https://doi.org/10.1016/j.obpill.2024.100107
Full text available for download at: https://tinyurl.com/3nwtkb2u
ABSTRACT. Background: Emerging evidence has shown that weight stigma is a concern during pregnancy, with several studies documenting common sources including healthcare, the media and interpersonal networks. Experiencing weight stigma may lead to weight bias internalization (WBI), whereby individuals accept and self-direct negative weight-related stereotypes, and limited research has assessed this in the context of pregnancy. Pregnancy is unique in terms of weight changes as many individuals will experience gestatioinal weight gain (GWG). Accordingly, a WBI tool that accounts for GWG may be a more population-specific resource to use.
Methods: This commentary presents a pregnancy-specific WBI tool that accounts for GWG. The validated Adult WBI scale was modified to include ‘pregnancy weight gain’. This commentary also presents a brief summary of research that has assessed WBI in pregnancy and recommendations for future work.
Results: Recommended future work includes validation of the pregnancy-specific WBI tool and prospective examinations of weight stigma and WBI in pregnancy and implications on maternal and newborn outcomes. Conclusion: Ultimately this research may inform development of interventions and resources to mitigate weight stigma and WBI in pregnancy and overall may contribute to improving prenatal outcomes and experiences.
Food Addiction
7. Gearhardt, A. N., Lewandowski, A., & Avena, N. M. (2024). Food addiction. Brain Sciences, 14(10), 952. https://doi.org/10.3390/brainsci14100952
Full text available for download at: https://www.mdpi.com/2076-3425/14/10/952
ABSTRACT. In this review, we aim to draw a connection between drug addiction and overconsumption of highly palatable food (OHPF) by discussing common behaviors and neurochemical pathways shared by these two states. OHPF can stimulate reward pathways in the brain that parallel those triggered by drug use, increasing the risk of dependency.
Behavioral similarities between food and drug addiction can be addressed by tracking their stages: loss of control when eating (bingeing), withdrawal, craving, sensitization, and cross-sensitization. The brain adapts to addiction by way of the mesolimbic dopamine system, endogenous opioids and receptors, acetylcholine and dopamine balance, and adaptations of serotonin in neuroanatomy.
Studies from the current literature are reviewed to determine how various neurological chemicals contribute to the reinforcement of drug addiction and OHPF. Finally, protocols for treating food addiction are discussed, including both clinical and pharmacological modalities. There is consistent evidence that OHPF changes brain chemistry and leads to addiction in similar ways to drugs. However, more long-term research is needed on food addiction, binge eating, and their neurobiological effects.
August-September 2024 Treatment Interlude, Part 1:
8. Webb, H., Griffiths, M. & Schmidt, U. (2024). Experiences of intensive treatment for people with eating disorders: A systematic review and thematic synthesis. Journal of Eating Disorders, 12, 115. https://doi.org/10.1186/s40337-024-01061-5
Full text available for download at: https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-024-01061-5#citeas
ABSTRACT. Background: Eating disorders are complex difficulties that impact the individual, their supporters and society. Increasing numbers are being admitted to intensive treatment settings (e.g., for inpatient treatment, day-patient treatment or acute medical treatment). The lived experience perspectives of what helps and hinders eating disorder recovery during intensive treatment is an emerging area of interest. This review aims to explore patients’ perspectives of what helps and hinders recovery in these contexts.
Methods: A systematic review was conducted to identify studies using qualitative methods to explore patients’ experiences of intensive treatment for an eating disorder. Article quality was assessed using the Critical Appraisal Skill Programme (CASP) checklist and thematic synthesis was used to analyse the primary research and develop overarching analytical themes.
Results: Thirty articles met inclusion criteria and were included in this review. The methodological quality was mostly good. Thematic synthesis generated six main themes; collaborative care supports recovery; a safe and terrifying environment; negotiating identity; supporting mind and body; the need for specialist support; and the value of close others. The included articles focused predominantly on specialist inpatient care and were from eight different countries. One clear limitation was that ethnicity data were not reported in 22 out of the 30 studies. When ethnicity data were reported, participants predominantly identified as white.
Conclusions: This review identifies that a person-centred, biopsychosocial approach is necessary throughout all stages of eating disorder treatment, with support from a sufficiently resourced and adequately trained multidisciplinary team. Improving physical health remains fundamental to eating disorder recovery, though psychological support is also essential to understand what causes and maintains the eating disorder and to facilitate a shift away from an eating disorder dominated identity.
Carers and peers who instill hope and offer empathy and validation are valuable additional sources of support. Future research should explore what works best for whom and why, evaluating patient and carer focused psychological interventions and dietetic support during intensive treatment. Future research should also explore the long-term effects of, at times, coercive and distressing treatment practices and determine how to mitigate against potential iatrogenic harm.
Plain English summary: Some people with eating disorders will need intensive treatment (e.g., inpatient treatment, day-patient treatment or acute medical treatment) during the course of their illness. Understanding what helps and hinders eating disorder recovery during intensive treatment is an important part of developing effective interventions. This review summarises research exploring people with eating disorders’ perspectives of intensive treatment, with the aim of identifying what helps and hinders eating disorder recovery.
We searched in scientific databases for all published qualitative studies that explored people with eating disorders’ perspectives of intensive treatment. Thirty studies meet the inclusion criteria of this literature review. The results sections of these studies were analysed by extracting relevant findings relating to eating disorder recovery.
We found that a person-centred, holistic approach is necessary throughout all stages of eating disorder treatment, with support from healthcare professionals and carers with specialist knowledge of how to support people with eating disorders. Improving physical health is fundamental to eating disorder recovery. However, psychological support is also essential to help people with eating disorders to understand what causes and maintains the eating disorder and support them to move away from an eating disorder dominated identity. Areas for future research are outlined.
ML NOTE 4: The abstract for the article described below in #9 states “This review complements a quantitative scoping review published on ED treatments in EA (Yim & Schmidt, 2023) . . . .” That article, as follows, was initially presented in the previous version of this Newsletter on 25 September 2023 (#10).
Yim, S. H., & Schmidt, U. (2023). The effectiveness and cultural adaptations of psychological interventions for eating disorders in East Asia: A systematic scoping review. International Journal of Eating Disorders, 56(12), 2165-2188. https://doi.org/10.1002/eat.24061 [Full text available for download at: https://onlinelibrary.wiley.com/doi/full/10.1002/eat.24061]
9. Yim, S. H., & Schmidt, U. (2024). Views and experiences of eating disorders treatments in East Asia: A meta-synthesis. Journal of Eating Disorders, 12, 120. https://doi.org/10.1186/s40337-024-01070-4
Full text available for download at: https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-024-01070-4#citeas
ABSTRACT. Introduction: Although there have been qualitative meta-syntheses on experiences of eating disorders treatments, there is a paucity of syntheses specifically examining the perspectives and experiences of eating disorders treatments (ED) in East Asia (EA). Such synthesis could facilitate a better understanding of culture-specific perspectives and experiences.
This review complements a quantitative scoping review published on ED treatments in EA (Yim & Schmidt, 2023), where most interventions reviewed focused on cognitive behavioural therapy (CBT) and internet interventions. The present meta-synthesis summarises stakeholders’ views on treatments and to synthesise clinical and research recommendations. Method: A systematic search of five databases and a citation search were conducted to identify relevant studies and data were analysed using thematic synthesis. Out of the 301 studies found, a total of 12 papers were included in the analysis.
Results: A diverse range of treatments, such as family therapy, paediatric/psychiatric inpatient care, CBT, and counselling, were discussed. Three overarching themes were identified: Delineating Physical and Psychological Recovery; ‘I am not alone in this battle’; and Barriers to Change. The themes further delve into the various obstacles to recovery, including financial concerns and limited access to professionals and services. Culture-specific factors include family obligations and promoting family harmony. Balancing interdependence and independence from one’s family, as well as understanding family body ideals versus broader societal body ideals, are important considerations in ED interventions.
Discussion: Some themes paralleled other qualitative syntheses, highlighting improved family relationships, perceived authoritarianism in treatments, and financial barriers. The review extends beyond the previous findings, revealing nuanced factors like family roles, cultural values, and norms. Clinical recommendations include incorporating family context in treatment and considering cultural influences on body image ideals. Capacity building through telemedicine and increased training is essential for advancing ED treatment in East Asia. Continued research is needed to better understand and treat people affected by ED in EA.
Plain English Summary: Research on eating disorders (EDs) treatment mainly focuses on Western countries, with little exploration of experiences in East Asia. To fill this gap, we reviewed 12 studies on the perspectives of individuals, families and clinicians regarding EDs treatments in East Asia. Our synthesis identified three main themes:
Physical and Psychological Recovery: Effective treatment needs to address both physical and mental aspects of recovery.
Finding Support – ‘I am not alone in this battle’: Many individuals find strength in knowing they are not alone.
Barriers to Change: Obstacles like financial difficulties, limited EDs knowledge from professionals, and cultural factors can hinder recovery.
Cultural-specific factors such as family obligations and maintaining family harmony can impact on treatment motivation and effectiveness. Balancing family’s wishes/ interdependence and personal aspirations/ independence can also be a challenge. Our findings highlight the need for culturally sensitive treatments. Expanding telemedicine and increasing provider training can also help overcome treatment barriers. In conclusion, understanding cultural and contextual factors is essential for developing effective support systems and improving ED treatment outcomes in East Asia.
10. Thorsrud, T., Bang, M. A., Dahlgren, C. L., Nordfjærn, T., & Weider, S. (2024). Cognitive remediation therapy for patients with eating disorders: A qualitative study. Journal of Eating Disorders, 12, 142. https://doi.org/10.1186/s40337-024-01101-0
Full text available for download at: https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-024-01101-0#citeas
ABSTRACT. Background: Transdiagnostic Cognitive Remediation Therapy (TCRT) is a new adaptation of cognitive remediation therapy for eating disorders (EDs) developed to address common cognitive difficulties across ED diagnoses (i.e., cognitive flexibility, central coherence, and impulsivity). This is the first evaluation of this novel treatment. The aim of this study was to explore acceptability and patients’ experience of TCRT.
Methods: Thirteen patients diagnosed with restrictive or binge/purge subtypes of EDs and concurrent cognitive difficulties completed semi-structured qualitative interviews after receiving TCRT. Interview transcripts were analyzed using reflexive thematic analysis.
Results: The analysis resulted in four main themes: (1) Treatment fit (2), Treatment experience (3), Perceived outcomes, and (4) Future recommendations. Eleven of the thirteen patients evaluated the treatment positively, found the focus relevant and expressed how it contributed to new insights related to thinking style. Seven of the patients also described it as a starting point for making changes and using new strategies. Importantly, experiencing some challenges related to the cognitive difficulties addressed in the treatment seemed essential for engagement.
Conclusion: Offering TCRT as an adjunctive treatment for patients with EDs and concurrent cognitive difficulties can be a way to engage patients in treatment, build therapeutic alliances and provide important awareness and strategies to handle challenges related to thinking style. Trial registration: This study is part of a larger randomized controlled trial, ClinicalTrials.gov Id: NCT03808467.
Plain English summary: Cognitive difficulties are thought to be one of several factors contributing to the development and maintenance of eating disorders (ED), but are rarely addressed in ED treatments. Cognitive remediation therapy (CRT) for EDs is a supplementary treatment originally developed for patients with anorexia nervosa (AN) that specifically targets cognitive difficulties. However, cognitive difficulties are found across ED diagnoses and not only in patients with AN.
In this study, we have adapted CRT to address cognitive difficulties across ED diagnoses. The goal of this study was to explore patients’ experiences of this novel transdiagnostic CRT. We interviewed 13 individuals with various eating disorders after they had received the treatment. Eleven of the participants rated the treatment positively, expressed that it was engaging, offered something new and made them more aware of their thought processes. Seven participants also reported using new strategies to handle challenges related to cognitive difficulties. Importantly, one participant expressed that she did not experience cognitive difficulties and chose to drop out of the treatment, highlighting the importance of finding the treatment relevant to foster engagement.
11. Cuerva, K., Spirou, D., Cuerva, A., Delaquis, C. P., & Raman, J. (2024). Perspectives and preliminary experiences of psychedelics for the treatment of eating disorders: A systematic scoping review. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.3101
Full text available for download at: https://onlinelibrary.wiley.com/doi/10.1002/erv.3101
ABSTRACT. Objective: Research regarding the therapeutic application of psychedelics and psychedelic-assisted psychotherapy in the treatment of eating disorders (EDs) has begun to emerge. This systematic scoping review aimed to map and synthesise the existing evidence regarding the participant reported efficacy and perspectives concerning psychedelics in the treatment of EDs, and to identify significant research gaps. Method: A systematic search was undertaken across several databases in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.
Results: 1290 publications were identified, 1135 after duplicates removed, with 17 meeting full-eligibility criteria. Overall, findings suggested that most participants reported experiencing a meaningful reuction in their ED symptoms and having positive experiences or an openness to explore psychedelics as a treatment for ED symptoms, although some noted concerns of adverse effects and the importance of having psychological support to increase safety and efficacy.
Conclusions: While preliminary research suggests psychedelics and psychedelic-assisted psychotherapy may be a viable treatment option for ED symptoms, further research with more robust research designs is required to increase confidence in its efficacy, generalisability, and safety as a therapeutic medium.