New treatment approaches for severe and enduring eating disorders

Treasure, Janet; Cardi, Valentina; Leppänen, Jenni; Turton, Robert

doi:10.1016/j.physbeh.2015.06.007

Cited by 74 publications

(57 citation statements)

References 165 publications

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“…In addition, research using different statistical methods (e.g., SDT analyses) and alternative indicators and validators is needed to elucidate whether thresholds for defining an ‘enduring’ class of AN can be identified. For example, a staging model of eating disorders has been described in which severe and enduring presentations are characterized by neuro-progressive changes that were not evaluated in the current study (42). If the inclusion of different indicators helped to distinguish SE-AN from more acute presentations, this might suggest criteria for an evidence-based definition.…”

Section: Discussionmentioning

confidence: 99%

Characterizing severe and enduring anorexia nervosa: An empirical approach

Wildes

Forbush

Hagan

et al. 2016

Intl J Eating Disorders

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Objective Targeted approaches for the treatment of severe and enduring anorexia nervosa (SE-AN) have been recommended, but there is no consensus definition of SE-AN to inform research and clinical practice. This study aimed to take initial steps toward developing an empirically based definition of SE-AN by characterizing associations among putative indicators of severity and chronicity in eating disorders. Methods Patients with AN (N=355) completed interviews and questionnaires at treatment admission and discharge; height and weight were assessed to calculate body mass index (BMI). Structural equation mixture modeling was used to test whether associations among potential indicators of SE-AN (illness duration, treatment history, BMI, binge eating, purging, quality-of-life) formed distinct subgroups, a single group with one or more dimensions, or a combination of subgroups and dimensions. Results A three-factor (dimensional), two-profile (categorical) mixture model provided the best fit to the data. Factor 1 included eating disorder behaviors; Factor 2 comprised quality-of-life domains; Factor 3 was characterized by illness duration, number of hospitalizations, and admission BMI. Profiles differed on eating disorder behaviors and quality-of-life, but not on indicators of chronicity or BMI. Factor scores, but not profile membership, predicted outcome at discharge from treatment. Discussion Data suggest that patients with AN can be classified on the basis of eating disorder behaviors and quality-of-life, but there was no evidence for a chronic subgroup of AN. Rather, indices of chronicity varied dimensionally within each class. Given that current definitions of SE-AN rely on illness duration, these findings have implications for research and clinical practice.

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Section: Discussionmentioning

confidence: 99%

Characterizing severe and enduring anorexia nervosa: An empirical approach

Wildes

Forbush

Hagan

et al. 2016

Intl J Eating Disorders

View full text Add to dashboard Cite

show abstract

“…Consequently, difficulties in inhibitory control may be one mechanism that helps to explain why people with obesity and binge eating develop eating behaviours that can become highly persistent and difficult to change. This predisposition to compulsively overeat may underpin obesity and eating disorders and is a possible target for treatment [138].…”

Section: Control Over Eating Behaviour: Impulsive and Compulsive Traitsmentioning

confidence: 99%

Emotional Eating, Binge Eating and Animal Models of Binge-Type Eating Disorders

2017

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Evidence has been found to suggest that for some high-risk individuals, obesity/binge eating may develop as an impulsive reaction to negative emotions that over time becomes a compulsive habit. Animal models highlight the neural mechanisms that might underlie this process and suggest similarities with substance use disorders. Emotional difficulties and neurobiological factors have a role in the aetiology of eating and weight disorders. Precise treatments targeted at these mechanisms may be of help for people who have difficulties with compulsive overeating.

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“…Providing families with information and skills has potential as an early intervention 75. Approaches which focus on remediating the physical (such as osteoporosis76), cognitive, emotional and social consequences69 of enduring illness are in the process of development.

Main messages

Awareness of the early signs of eating disorder behaviour by parents and schools can lead to early diagnosis and treatment and a better prognosis.

Engagement of the individual in treatment can be difficult.

…”

Section: Resultsmentioning

confidence: 99%

“…In addition to treatments designed to broadly address eating disorders, new treatments have been developed that target specific symptoms 69. For example, cognitive remediation targets rigidity and weak central coherence and produces improvement in these domains 70.…”

Section: The Scientific Evidencementioning

confidence: 99%