E-health strategies, particularly online psychotherapy and tools to document symptoms, are useful and likely effective. Social communication strategies show enormous popularity, but urgently require research evaluation for impact.
There are few well-established treatments for adolescent eating disorders, and for those that do exist, remission rates are reported to be between 30 and 40%. There is a need for the development and implementation of novel treatment approaches. Mindfulness approaches have shown improvements in eating disorder-related psychopathology in adults and have been suggested for adolescents. The present review identifies and summarizes studies that have used mindfulness approaches to modify eating behaviors and to treat eating disorders in adolescents. Focused searches were conducted in Embase, Medline, and PsycINFO, and identified articles were checked for relevance. A small number of studies (n = 15) were designated as appropriate for inclusion in the review. These studies were divided into those that focused on the promotion of healthy eating/the prevention of disordered eating (n = 5), those that concentrated on targeted prevention among high risk adolescents (n = 5), and those that focused on clinical eating disordered adolescents (n = 5). Thirteen of the 15 studies reviewed reported at least one positive association between mindfulness treatment techniques and reduced weight/shape concerns, dietary restraint, decreased body mass index (BMI), eating in the absence of hunger (EAH), binge eating, increased willingness to eat novel healthy foods, and reduced eating disorder psychopathology. In summary, incorporating mindfulness to modify eating behaviors in adolescent non-clinical and clinical samples is still in the early stages, with a lack of data showing clear evidence of acceptability and efficacy. Further studies and preferably controlled conditions are warranted.
To retrospectively assess medical services of a specialist inpatient eating disorders (EDs) unit. Method: We retrospectively evaluated clinical parameters of 288 inpatients classified as 'moderately' or 'significantly' medically compromised between 1 January 2016 and 30 June 2019. Results: We analysed 288 patients (mean age 32.5 [SD ¼ 11.4] years, 96% women, 76% with anorexia nervosa). Average length of stay was 38.4 (SD ¼ 28.4) days. Average admission body mass index (BMI) was 14.8 (SD ¼ 1.8) kg/m 2 , and 16.1 (SD ¼ 1.9) kg/m 2 at 4 weeks. At admission, 82% of patients were considered significantly medically compromised, while 6% were deemed moderately compromised. Only 5% of patients required transfer to intensive care unit. Prevalence of hypophosphatemia was 17.7%; rates did not increase significantly between years despite more assertive re-feeding processes. There was no association between risk classification at admission and change in BMI at 4 weeks (F (2,166) ¼ 0.588, p ¼ 0.557). BMI at admission was found to be significantly associated with clinical outcome (β ¼ 0.92, p < 0.001). Discussion: Hypophosphatemia rates did not increase despite more assertive re-feeding over 3 years. Our results provide support for a model of treatment that simultaneously addresses the medical and psychiatric sequelae of patients with severe EDs. K E Y W O R D S anorexia nervosa, bulimia nervosa, comorbidity, re-feeding, psychotherapy 1 | INTRODUCTION Anorexia nervosa (AN) is a chronic disorder associated with high relapse rates, treatment costs and diminished quality of life (Hay et al., 2017; Khalsa, Portnoff, McCurdy-McKinnon, & Feusner, 2017; Schalla & Stengel, 2019). AN has a 12-fold higher mortality rate than all other causes of death among females between 15 and 24
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