scholarly journals Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Deborah R. Glasofer ◽  
Alexandra F. Muratore ◽  
Evelyn Attia ◽  
Peng Wu ◽  
Yuanjia Wang ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Inpatient Treatment ◽  
Weight Status ◽  
Self Report ◽  
Healthy Weight ◽  
Health Maintenance ◽  
Duration Of Illness ◽  
Clinical Impairment

Abstract Background Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. Methods Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains. Results One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. Conclusions Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes.

scholarly journals Knowledge and Practice of Eating Disorders among a Group of Adolescent Dental Patients

2013 ◽  
Vol 38 (1) ◽  
pp. 39-43 ◽  
Author(s):  
TM Hicks ◽  
JY Lee ◽  
T Nguyen ◽  
M La Via ◽  
MW Roberts
Keyword(s):  
At Risk ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Weight Status ◽  
Educational Interventions ◽  
Healthy Weight ◽  
Research Subjects ◽  
Dental Patients ◽  
Question Survey

Objectives: The objectives are to ascertain how much is known about the eating disorders of bulimia and anorexia nervosa in a group of female adolescents, to determine if they had practiced behaviors consistent with these eating disorders, and to determine if there was a disconnect with actual and perceived healthy weight status. Study Design: 126 research subjects completed a survey instrument. Embedded in the eighteen question survey were the five “SCOFF” questions, to determine if an eating disorder may exist. The BMI percentile was obtained for all participants. Results: 18.3% of the research sample may have an eating disorder as predicted by the SCOFF questions. Of those with a suspected eating disorder, only 38% could correctly identify the best description of bulimia nervosa and 50% for anorexia nervosa. The BMI percentiles were higher in the group suspected of having an eating disorder. Conclusions: Young adolescent females are at risk for eating disorders. Educational interventions should be directed at this young age group. If the at-risk individuals knew more about the consequences of these disorders, they may be less likely to practice the behaviors.

scholarly journals A randomised controlled trial of three psychological treatments for anorexia nervosa

2017 ◽  
Vol 47 (16) ◽  
pp. 2823-2833 ◽  
Author(s):  
S. Byrne ◽  
T. Wade ◽  
P. Hay ◽  
S. Touyz ◽  
C. G. Fairburn ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Healthy Weight ◽  
Psychological Treatments ◽  
Psychosocial Impairment ◽  
Eating Disorder Psychopathology ◽  
Randomised Controlled

BackgroundThere is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.MethodA multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.ResultsTreatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.ConclusionThe findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/

scholarly journals Temperament-Based Treatment for Young Adults with Eating Disorders: Acceptability and Initial Efficacy of an Intensive, Multi-Family, Parent-Involved Treatment.

2021 ◽  
Author(s):  
Stephanie Knatz Peck ◽  
Terra Towne ◽  
Christina Wierenga ◽  
Laura Hill ◽  
Ivan Eisler ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young Adults ◽  
Eating Disorder ◽  
Self Report ◽  
Program Satisfaction ◽  
Full Remission ◽  
Eating Disorder Psychopathology ◽  
Clinical Impairment ◽  
Spectrum Disorders

Abstract Background: Adult eating disorder treatments are hampered by lack of access and limited efficacy. This open-trial study evaluated the acceptability and preliminary efficacy of a novel intervention for adults with eating disorders delivered to young adults and parent-supports in an intensive, multi-family format (Young Adult Temperament-Based Treatment with Supports; YA-TBT-S). Methods: 38 YA-TBT-S participants (m age = 19.58; SD 2.13) with anorexia nervosa (AN)-spectrum disorders, bulimia nervosa (BN)-spectrum disorders, and avoidant/restrictive food intake disorder (ARFID) completed self-report assessments at admission, discharge, and 12-month follow-up. Assessments measured program satisfaction, eating disorder psychopathology and impairment, body mass index (BMI), and trait anxiety. Outcomes were analyzed using linear mixed effects models to examine changes in outcome variables across diagnoses over time. Results: Treatment was rated as highly satisfactory. 53.33% were in partial or full remission at 12-month follow-up. Participants reported reductions in ED symptomatology (AN and BN), increases in BMI (AN and ARFID), and reductions in clinical impairment (AN and ARFID) at 12-month follow-up. Conclusions: YA-TBT-S is a feasible and acceptable treatment that may improve ED outcomes in young adults with a broad range of diagnoses. Further evaluation of efficacy is needed in larger samples, and to compare YA-TBT-S to other ED treatment approaches.

scholarly journals The Influence of Food Reinforcement and Eating Disorder Pathology on Weight Change in Adolescents (P21-057-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Katherine Balantekin ◽  
Amanda Crandall ◽  
Amanda Ziegler ◽  
Jennifer Temple
Keyword(s):  
Eating Disorder ◽  
Weight Gain ◽  
Weight Change ◽  
Weight Status ◽  
Food Reinforcement ◽  
Self Report ◽  
Schedules Of Reinforcement ◽  
Eating Disorder Examination ◽  
Funding Sources ◽  
Median Split

Abstract Objectives Both the relative reinforcing value (RRV) of food, or the motivation to obtain food, and eating disorder (ED) pathology have been shown to independently predict weight gain. However, less is known about how the interaction between the RRV of food and ED pathology predicts weight gain over time. Therefore, the purpose of this study was to examine the combined effects of the RRV of food and ED pathology on weight change over 6 months in a sample of adolescents. Methods Participants included 77 12–14 year old adolescents participating in a longitudinal study examining factors that predict changes in weight status. Data presented are from baseline and 6 months. The RRV of food was assessed using a computer task. Participants earned points for energy dense food by pressing a mouse button on a computer across escalating schedules of reinforcement. Participants were classified as “low” or “high” in RRV based on a median split of their total responses. Global ED pathology was assessed at baseline using adolescent self-report on the Eating Disorder Examination Questionnaire. Participants were classified as “low” or “high” in ED pathology based on a median split of their global ED pathology. Four groups were created: low ED pathology/low RRV (n = 20), high ED pathology/low RRV (n = 23), low ED pathology/high RRV (n = 15), and high ED pathology/high RRV (n = 19). Height and weight were measured at both baseline and 6 months and used to calculate zBMI. ANOVA was used to examine differences in zBMI change over 6 months by RRV/ED pathology group. Results zBMI change from baseline to 6 months differed by RRV/ED pathology group (P < .05). Changes in zBMI over 6 months were as follows: - 0.025 ± 0.298 for low ED pathology/low RRV; 0.010 ± 0.322 for high ED pathology/low RRV; - 0.095 ± 0.181 for low ED pathology/high RRV; and 0.186 ± 0.268 for high ED pathology/high RRV. Follow-up contrasts revealed that the high ED pathology/high RRV group experienced greater zBMI changes than the other groups (ps < 0.05). Conclusions While the RRV of food and ED pathology are both independently associated with weight gain, the current study indicates that there may be something unique about the combination of high RRV of food and high ED pathology related to risk of weight gain. Future work is needed to identify strategies to limit weight gain in this vulnerable population. Funding Sources National Institutes of Health.

Mixture Modeling to Characterize Anorexia Nervosa: Integrating Personality and Eating Disorder Psychopathology

2019 ◽  
pp. 107839031986202
Author(s):  
Karen M. Jennings ◽  
Lindsay P. Bodell ◽  
Ross D. Crosby ◽  
Ann F. Haynos ◽  
Jennifer E. Wildes
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Latent Class ◽  
Clinical Presentation ◽  
Mixture Modeling ◽  
Eating Disorder Psychopathology ◽  
Personality Psychopathology ◽  
Latent Dimension ◽  
Eating Disorder Behaviors

BACKGROUND: Efforts to examine alternative classifications (e.g., personality) of anorexia nervosa (AN) using empirical techniques are crucial to elucidate diverse symptom presentations, personality traits, and psychiatric comorbidities. AIM: The purpose of this study was to use an empirical approach (mixture modeling) to test an alternative classification of AN as categorical, dimensional, or hybrid categorical–dimensional construct based on the co-occurrence of personality psychopathology and eating disorder clinical presentation. METHOD: Patients with AN ( N = 194) completed interviews and questionnaires at treatment admission and 3-month follow-up. Mixture modeling was used to test whether indicators best classified AN as categorical, dimensional, or hybrid. RESULTS: A four-latent class, one-latent dimension mixture model that was variant across groups provided the best fit to the data. Results suggest that all classes were characterized by low self-esteem and self-harming and suicidality tendencies. Individuals assigned to Latent Class 2 (LC2; n = 21) had a greater tendency toward being impulsive and easily angered and having difficulties controlling anger compared with those in LC1 ( n = 84) and LC3 ( n = 66). Moreover, individuals assigned to LC1 and LC3 were more likely to have a poor outcome from intensive treatment compared with those in LC4 ( n = 21). Findings indicate that the dimensional aspect within each class measured frequency of specific eating disorder behaviors but did not predict treatment outcomes. CONCLUSION: These results emphasize the complexity of AN and the importance of considering how facets of clinical presentation beyond eating disorder behaviors may have different treatment and prognostic implications.

Activity and Obesity of Colombian Immigrants in Canada Who Use a Food Bank

2007 ◽  
Vol 105 (2) ◽  
pp. 681-687 ◽  
Author(s):  
Victor Ng ◽  
Timothy J. Rush ◽  
Meizi He ◽  
Jennifer D. Irwin
Keyword(s):  
Physical Activity ◽  
Weight Status ◽  
University Education ◽  
Self Report ◽  
Healthy Weight ◽  
Food Bank ◽  
Convenience Sample ◽  
Face To Face ◽  
Received Social Support ◽  
Canadian Immigrants

The purpose of this study was to provide some preliminary description of the Latin-Canadian community by reporting the socioeconomic status, physical activity, and weight status (i.e., healthy weight, overweight, or obese status) of Colombians newly immigrated to London, Ontario Canada. Face-to-face interviews were conducted on a convenience sample of 77 adult Colombian immigrant food bank users (46.8% men; mean age 39.9 yr., SD = 11.8). Physical activity was gauged using the International Physical Activity Questionnaire and self-report Body Mass Index, and sociodemographic data were collected. Of respondents, 47% had a university education, and 97% received social support. 61% met recommended levels of physical activity. Men were more active, being involved in about 130 min. more of exercise per week, and more men were overweight than women (63.9% versus 39.0%, respectively). Of respondents, 73% reported being less active than before coming to Canada. This pilot study indicates that Latin-Canadian immigrants are a vulnerable group in need of acculturational support. Further study is warranted.

Outcome of severe anorexia nervosa patients receiving inpatient treatment in Japan: An 8-year follow-up study

2001 ◽  
Vol 55 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Hideki Tanaka ◽  
Nobuo Kiriike ◽  
Toshihiko Nagata ◽  
Keisen Riku
Keyword(s):  
Anorexia Nervosa ◽  
Inpatient Treatment ◽  
Follow Up Study

scholarly journals Randomised controlled feasibility trial of real versus sham repetitive transcranial magnetic stimulation treatment in adults with severe and enduring anorexia nervosa: the TIARA study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021531 ◽  
Author(s):  
Bethan Dalton ◽  
Savani Bartholdy ◽  
Jessica McClelland ◽  
Maria Kekic ◽  
Samantha J Rennalls ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Eating Disorder Symptoms ◽  
Randomised Controlled

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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