Friday, March 19, 2021

Eating Disorder Journal Current News May 2020


Current Research and News:

We examine the clinical research and current happenings in the eating disorder field to find the most interesting and useful current information available.

Time Magazine Article: Coronavirus Presents New Challenges For Those With Eating Disorders - Here's How Survivors Are Seeking Out Support Online. Staying home to help prevent the spread of coronavirus has brought major life changes for many. For those who have been diagnosed with an eating disorder, social isolating can pose a serious risk to their recovery. When U.S. health officials began recommending that people stay at home in March, Allison Caswell didn’t expect doing so would trigger old anxieties about food that she struggled with daily in the past. For one thing, Caswell, a 29-year-old in Wilmington, North Carolina, had been in recovery for her eating disorder for 12 years. For another, as a health care worker, she felt that she had a good understanding of the major lifestyle changes that would come with social distancing. However, a trip to pick up supplies at the grocery store ahead of social isolation set off familiar discomforting feelings for her. To continue reading the Time Magazine article click here:



Managing Patients With Severe and Enduring Anorexia Nervosa: When Is Enough, Enough? OBJECTIVE: Approximately 20% of patients with anorexia nervosa develop severe and enduring anorexia nervosa (SE-AN), manifest by decades-long illnesses. At certain points, demoralized and/or based on judicious appraisals of the seeming futility of further professional treatment to radically alter their course, some SE-AN patients decide that "enough is enough" and opt out of intensive treatment. This article considers courses and treatment options available at these stages for patients, families, and clinicians. METHODS: The author uses clinical illustrations, Socratic questioning, and available literature to explore questions of treatment strategies with patients struggling with SE-AN. RESULTS: SE-AN patients have frequently received care in varieties of medical, psychiatric, and specialized eating disorders inpatient, residential, partial hospital, and outpatient treatment settings. Patients may reject further high-intensity treatment for judicious or capricious reasons, but may still accept lower intensity treatments. Some may reject any and all offers of treatment. Clinicians' treatment recommendations, not always coinciding with patients' wishes, are influenced by numbers of clinical, social, and professional pressures, including those from families, treatment settings, regulatory bodies, and payors. CONCLUSIONS: When managing patients with decades-long disease and multiple comorbidities, clinicians must be realistic about the low odds of effecting cure and adjust treatment expectations accordingly. For patients with SE-AN, a variety of low-intensity treatment approaches, at times extending to palliative and hospice care, may be useful. Clinicians should always strive to provide humane comfort and support, as closely aligned to patients' judicious wishes as realistically possible. J Nerv Ment Dis. 2020 Apr;208(4):277-282. doi: 10.1097/NMD.0000000000001124.



Treatment studies with cannabinoids in anorexia nervosa: a systematic review. Anorexia nervosa (AN) is a psychiatric disorder with a high mortality and unknown etiology, and effective treatment is lacking. For decades, cannabis has been known to cause physical effects on the human body, including increasing appetite, which may be beneficial in the treatment of AN. OBJECTIVE: To systematically review the literature for evidence of an effect of cannabinoids on (1) weight gain, and (2) other outcomes, in AN. METHOD: A systematic review was done using three databases Embase, PubMed and Psychinfo. The review was registered in PROSPERO with ID number CRD42019141293 and was done according to PRISMA guidelines. RESULTS: There were 1288 studies identified and after thorough review and exclusion of copies, 4 studies met the inclusion criteria. Three studies used the same AN population and utilized data from one original study, leaving only two original studies. Both of these were Randomized Controlled Trials that explored the effects of delta-9-tetrahydrocannabinol (Δ9-THC) or dronabinol in AN, whereof one study was properly designed and powered and showed a weight increase of an added 1 kg over 4 weeks over placebo. DISCUSSION AND CONCLUSION: There are few studies and the level of evidence is low. The only properly designed, low bias and highly powered study found a weight increasing effect of dronabinol in AN, while the other, using Δ9-THC at a high dose, found no effect and where the dose may have counteracted the weight gaining effects due to adverse events. More research on cannabinoids in anorexia nervosa is warranted, especially its effects on psychopathology. Eat Weight Disord. 2020 Apr 2. doi: 10.1007/s40519-020-00891-x. [Epub ahead of print]



Eating disorder psychopathology in adults and adolescents with anorexia nervosa: A network approach. OBJECTIVE: The aim of this study was to assess and compare eating disorder feature networks in adult and adolescent patients with anorexia nervosa. METHODS: Patients seeking treatment for anorexia nervosa in inpatient and outpatient settings were consecutively recruited from January 2008 to September 2019. Body mass index was measured, and each patient completed the Eating Disorder Examination Questionnaire. RESULTS: The sample comprised 547 adolescent and 724 adult patients with anorexia nervosa. Network analysis showed that in both adults and adolescents, the most central and highly interconnected nodes in the network were related to shape overvaluation and desiring weight loss. The network comparison test identified similar global strength and network invariance, confirming the similarity of the two network structures. DISCUSSION: The network structures in adult and adolescent patients with anorexia nervosa are similar, and lend weight to the cognitive behavioral theory that overvaluation of shape and weight is the core feature of anorexia nervosa psychopathology. Int J Eat Disord. 2020 Apr 21. doi: 10.1002/eat.23270. [Epub ahead of print]

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