Associations among eating disorder behaviors and eating disorder quality of life in adult women with anorexia nervosa

ObjectiveTreatment options for severe, enduring anorexia nervosa (SE-AN) are limited. Non-invasive neuromodulation is a promising emerging intervention. Our study is a feasibility randomised controlled trial of repetitive transcranial magnetic stimulation (rTMS) in individuals with SE-AN, which aims to inform the design of a future large-scale trial.DesignDouble-blind, parallel group, two-arm, sham-controlled trial.SettingSpecialist eating disorders centre.ParticipantsCommunity-dwelling people with anorexia nervosa, an illness duration of ≥3 years and at least one previous completed treatment.InterventionsParticipants received 20 sessions (administered over 4 weeks) of MRI-guided real or sham high-frequency rTMS to the left dorsolateral prefrontal cortex in addition to treatment-as-usual.OutcomesPrimary outcomes were recruitment, attendance and retention rates. Secondary outcomes included body mass index (BMI), eating disorder symptoms, mood, quality of life and rTMS safety and tolerability. Assessments were conducted at baseline, post-treatment and follow-up (ie, at 0 month, 1 month and 4 months post-randomisation).ResultsThirty-four participants (17 per group) were randomly allocated to real or sham rTMS. One participant per group was withdrawn prior to the intervention due to safety concerns. Two participants (both receiving sham) did not complete the treatment. rTMS was safe and well tolerated. Between-group effect sizes of change scores (baseline to follow-up) were small for BMI (d=0.2, 95% CI −0.49 to 0.90) and eating disorder symptoms (d=0.1, 95% CI −0.60 to 0.79), medium for quality of life and moderate to large (d=0.61 to 1.0) for mood outcomes, all favouring rTMS over sham.ConclusionsThe treatment protocol is feasible and acceptable to participants. Outcomes provide preliminary evidence for the therapeutic potential of rTMS in SE-AN. Largest effects were observed on variables assessing mood. This study supports the need for a larger confirmatory trial to evaluate the effectiveness of multi-session rTMS in SE-AN. Future studies should include a longer follow-up period and an assessment of cost-effectiveness.Trial registration numberISRCTN14329415; Pre-results.

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Eating disorder symptoms and quality of life: Where should clinicians place their focus in severe and enduring anorexia nervosa?

International Journal of Eating Disorders ◽

10.1002/eat.22327 ◽

2014 ◽

Vol 48 (1) ◽

pp. 133-138 ◽

Cited By ~ 30

Author(s):

Bryony Bamford ◽

Christina Barras ◽

Richard Sly ◽

Colleen Stiles-Shields ◽

Stephen Touyz ◽

...

Keyword(s):

Quality Of Life ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Eating Disorder Symptoms

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Factors Associated with Disease-Specific Health Related Quality of Life in Women with Anorexia Nervosa

10.21203/rs.3.rs-132704/v1 ◽

2020 ◽

Author(s):

Laura Al-Dakhiel Winkler ◽

Claire Gudex ◽

Michael Ejnar Röder ◽

Carol E Adair ◽

Jan Magnus Sjögren ◽

...

Keyword(s):

Quality Of Life ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Well Being ◽

Health Related Quality ◽

Psychological Well Being ◽

Related Quality ◽

Health Related ◽

Disease Specific

Abstract Background: Health-related quality of life is severely affected in patients with anorexia nervosa due to both physical and psychological consequences of the disease, but it is still uncertain whether the same factors affect both clinical outcome and quality of life. It is also unknown whether there are differences between patients and controls in terms of self-reported physical, psychological and social well-being. Methods: Women with anorexia nervosa were recruited from specialized eating disorder centers in the five regions of Denmark. Healthy, normal-weight controls were invited via online social media to participate in the study. Six questionnaires including study characteristics, quality of life, eating disorder symptomatology, depression, work and social adjustment and psychological well-being were completed online by all participants. Results: 211 women with anorexia nervosa and 199 controls participated in the study. Women with anorexia nervosa reported significantly lower quality of life, both in terms of disease-specific HRQoL using the Eating Disorders Quality of Life Scale and on measures of general health, psychological well-being, and work functioning. Psychological and cognitive factors were highly associated with poor quality of life (p-value<0.05). Conclusions: Our findings suggest that attention to and management of disordered self-assessment and thought processes may be of special importance to women with anorexia nervosa and their families. It is possible that greater emphasis on such aspects alongside weight gain could enhance patient-clinician alliance and contribute to better treatment outcomes.

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