How to discuss the impact of genetics and environment in therapy for eating disorders

Dietary intake requires attention in the treatment of both eating disorders and type 1 diabetes (T1D) to achieve optimal outcomes. Nutritional management of both conditions involves encouraging a wide variety of healthful foods in the context of usual cultural and family traditions. In recent times, low carbohydrate diets have seen a rise in popularity, both in T1D and in the general population. Low carbohydrate diets involve dietary restriction, although the extent depends on the level of carbohydrate prescription. Although dietary restriction is a known risk factor for eating disorders, there is limited literature on the impact of following a low carbohydrate diet on the development and maintenance of eating disorders in T1D. The aim of this review is to discuss the impact of dietary restriction on the development and treatment of eating disorders and propose considerations to enable optimum health outcomes in individuals with T1D, an at risk group. In order to achieve this, clarity regarding strategies that allow both flexibility in dietary intake and facilitate healthy eating behaviours, whilst achieving glycaemic targets, are required.

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17.1 Examining the Impact of COVID-19 on Adolescents With Eating Disorders

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2021.09.182 ◽

2021 ◽

Vol 60 (10) ◽

pp. S192

Author(s):

Wendy Spettigue ◽

Nicole Obeid ◽

Natalie Finner ◽

Megan Harrison ◽

Leanna Isserlin ◽

...

Keyword(s):

Eating Disorders ◽

The Impact

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Cognitive Mapping: Its Use as an Assessment Tool for Disordered Eating

Women in Sport and Physical Activity Journal ◽

10.1123/wspaj.8.2.63 ◽

1999 ◽

Vol 8 (2) ◽

pp. 63-72

Author(s):

Kristin L. Wiginton ◽

Deborah Rhea

Keyword(s):

Eating Disorders ◽

Disordered Eating ◽

Eating Behaviors ◽

Cognitive Mapping ◽

Female Athletes ◽

Assessment Tool ◽

Mental Representations ◽

Disordered Eating Behaviors ◽

Preventive Practices ◽

The Impact

The incidence of eating disorders among female athletes continues to increase, presenting intervention challenges to athletic trainers. Additionally, a number of female athletes have disordered eating behaviors that do not yet constitute an eating disorder diagnosis, but have similar characteristics to those athletes diagonised with eating disorders. However, each athlete exhibits individual mental representations of disordered eating and the impact of those representations on important aspects of her life. The athletic trainer has the potential to offer comprehensive preventive education when all aspects of the athlete’s own understanding of disordered eating are assessed. Cognitive mapping is an assessment technique that can be used in addition to other preventive practices and can be useful in determining an athlete’s current mental representations of disordered eating.

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Impact of eating disorders on paid or unpaid work participation and performance: a systematic review and meta-analysis protocol

Journal of Eating Disorders ◽

10.1186/s40337-021-00525-2 ◽

2022 ◽

Vol 10 (1) ◽

Author(s):

Fatima Safi ◽

Anna M. Aniserowicz ◽

Heather Colquhoun ◽

Jill Stier ◽

Behdin Nowrouzi-Kia

Keyword(s):

Systematic Review ◽

Eating Disorders ◽

Meta Analysis ◽

Experimental Studies ◽

Work Participation ◽

Unpaid Work ◽

Cochrane Library ◽

And Performance ◽

The Impact

Abstract Background Eating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED. Methods Medline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed. Discussion This synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies. Trial registration The registration number for this systematic review on PROSPERO is CRD42021255055.

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Improving knowledge and confidence in the acute management of eating disorders and resulting complications

BJPsych Open ◽

10.1192/bjo.2021.503 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S186-S186

Author(s):

Sarah Fynes-Clinton ◽

Clare Price ◽

Louisa Beckford ◽

Maisha Shahjahan ◽

Brendan McKeown

Keyword(s):

Eating Disorders ◽

Clinical Information ◽

Easy Access ◽

Average Score ◽

Junior Doctors ◽

Refeeding Syndrome ◽

Improvement Project ◽

Positive Effects ◽

The Creation ◽

The Impact

AimsThis project aimed to improve the knowledge and confidence of doctors at all levels when managing patients with eating disorders while on call.BackgroundA recent survey found just 1% of doctors have the opportunity for clinical experience on eating disorders. Anecdotally, a number of junior doctors within our trust had mentioned that they felt unsure when asked to manage patients with eating disorders during their out of hours shifts.MethodThis project aimed to ascertain levels of confidence with managing patients with eating disorders, and to collect suggestions to improve this. This was achieved using a survey sent out to 97 doctors working in a Mental Health Trust.We then utilised two of the suggestions to improve the identified areas of concern. The first method involved direct lectures. This was followed up with the creation of a poster highlighting the pertinent information which was displayed in key clinical areas. The second avenue was the creation of an information booklet covering key clinical information that is available to all on call doctors.ResultThe response rate for the survey was 37.11%. The survey found that doctors lacked confidence in the management of common conditions that arise in patients admitted with eating disorders. Refeeding syndrome was identified as the greatest area of concern by responding doctors.To assess the impact of the lectures, MCQs were given out before and after the presentation. The results were compared, and showed a clear improvement in overall knowledge, with results going from an average score of 56.6% to 80%.ConclusionBy using multiple methods to improve doctors confidence, (lectures, written information and visual posters), this quality improvement project achieved its aims in improving doctors knowledge, and through having easy access to important information, will have long term positive effects on patient care.

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Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

10.1101/2021.03.29.21254526 ◽

2021 ◽

Author(s):

Andreas Birgegård ◽

Afrouz Abbaspour ◽

Stina Borg ◽

David Clinton ◽

Emma Forsén Mantilla ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Data Availability ◽

Evidence Based ◽

List Type ◽

Convenience Sample ◽

Eating Disorder Symptom ◽

Disorder Symptom ◽

Evidence Based Care ◽

The Impact

AbstractObjectiveTo document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.MethodWe re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).ResultsThree important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.ConclusionsThe COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.Significant Outcomes and LimitationsIndividuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental healthEven individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptomsA large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across SwedenLimitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.Data Availability StatementFully anonymized data are available from the corresponding author upon request.

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