scholarly journals Current eating disorder healthcare services – the perspectives and experiences of individuals with eating disorders, their families and health professionals: systematic review and thematic synthesis

BJPsych Open ◽  
2019 ◽  
Vol 5 (4) ◽  
Author(s):  
Gemma Johns ◽  
Bridget Taylor ◽  
Ann John ◽  
Jacinta Tan
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Health Professionals ◽  
Help Seeking ◽  
Healthcare Services ◽  
Future Research ◽  
Inclusion Criteria ◽  
Specialist Care ◽  
Internet Resources ◽  
Quantitative Studies

Background Eating disorders have the highest mortality rate of mental disorders and a high incidence of morbidity, but if diagnosed and treated promptly individuals can benefit from full recovery. However, there are numerous problems at the healthcare interface (i.e. primary and secondary care) for eating disorders. It is important to examine these to facilitate appropriate, seamless treatment and improve access to specialist care. Aims To examine the current literature on the experiences and perspectives of those across healthcare interfaces for eating disorders, to include individuals with eating disorders, people close to or caring for those with eating disorders such as family and friends, and health professionals. Method To identify relevant papers, a systematic search of electronic databases was conducted. Other methods, including hand-searching, scanning reference lists and internet resources were also used. Papers that met inclusion criteria were analysed using a systematic methodology and synthesised using an interpretative thematic approach. Results Sixty-three papers met the inclusion criteria. The methodological quality was relatively good. The included papers were of both qualitative (n = 44) and quantitative studies (n = 24) and were from ten different countries. By synthesising the literature of these papers, three dominant themes were identified, with additional subthemes. These included: ‘the help-seeking process at primary care’; ‘expectations of care and appropriate referrals’ and ‘opposition and collaboration in the treatment of and recovery from eating disorders’. Conclusions This review identifies both facilitators and barriers in eating disorder healthcare, from the perspectives of those experiencing the interface first hand. The review provides recommendations for future research and practice. Declaration of interest None.

Re-ordering Desires: A Trinitarian Lens on Eating Disorders

2017 ◽  
Vol 99 (2) ◽  
pp. 255-274
Author(s):  
Jillian Jackson
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Holy Spirit ◽  
Healthcare Services ◽  
Unique Role ◽  
Thought Patterns ◽  
Doctrine Of The Trinity ◽  
The Mind ◽  
The Trinity

This paper uses the doctrine of the Trinity to demonstrate the unique role God as Father, Son, and Holy Spirit can play in the healing of eating disorders and explores how a trinitarian framework may be brought alongside healthcare services to aid in recovery. Drawing on the theological work of Sarah Coakley, the paper considers various trinitarian models and practices that can redirect our minds, hearts, and imaginations to a new participation in the trinitarian God. This essay seeks to show that it is also possible to challenge the idolatrous thought patterns of an eating disorder by redirecting the mind to participation in life through the lens of the life-giving Trinity.

Body Dysmorphic Disorder and Eating Disorders

2017 ◽  
pp. 112-125
Author(s):  
Danyale McCurdy-McKinnon ◽  
Jamie D. Feusner
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Eating Disorder ◽  
Disordered Eating ◽  
Body Dysmorphic Disorder ◽  
Future Research ◽  
Body Image Concern ◽  
Core Feature ◽  
Visuospatial Processing

This chapter addresses the comorbid presentation of body dysmorphic disorder (BDD) and disordered eating. BDD affects approximately 2% of the population and involves perceived defects of appearance along with obsessive preoccupation and repetitive, compulsive-like behaviors. The prevalence of comorbid BDD and eating disorders is high: Approximately one–third of those with BDD will have a comorbid eating disorder, and almost half of those with an eating disorder will have comorbid BDD. There are complicating diagnostic and treatment factors that arise when an individual experiences both. A core feature of these disorders is body image concern, which may be explained by both shared and unique aberrancies in visual and visuospatial processing that have neurobiological underpinnings. Understanding shared and unique pathophysiology may help inform and guide treatment, as well as open up lines of future research into their etiology.

Feminist-Informed Protective Factors for Subthreshold Eating Disorders

2020 ◽  
Vol 30 (10) ◽  
pp. 1546-1560
Author(s):  
Emily C. Wacker ◽  
Megan L. Dolbin-MacNab
Keyword(s):  
Eating Disorders ◽  
Grounded Theory ◽  
Eating Disorder ◽  
Protective Factors ◽  
Theory Model ◽  
Constructivist Grounded Theory ◽  
Future Research ◽  
Sociocultural Context ◽  
Research And Practice ◽  
Tangible Support

Despite knowledge that the larger sociocultural context contributes to the development of eating disorders, few studies have examined protective factors for women with subthreshold eating disorders. Using feminist-informed constructivist grounded theory methodology, 15 women (ages 18–25 years) with subthreshold eating disorders were interviewed. Results suggest that participants spoke of their subthreshold eating disorders in an externalized way and used protective factors to guide decision making toward their preferred values. A grounded theory model was developed to illustrate this process. Protective factors included (a) people who provide emotional and tangible support, (b) support people who challenge the eating disorder, (c) personal sense of agency, and (d) community activism and involvement. Participants experiencing subthreshold eating disorders demonstrated a capacity to distinguish their own thoughts and values from those of the “eating disorder voice,” and protective factors facilitated this process. Implications for future research and practice are discussed.

Eating Disorders

2014 ◽  
pp. 391-409
Author(s):  
Robyn Sysko ◽  
G. Terence Wilson
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
American Psychiatric Association ◽  
Behavioral Therapy ◽  
Future Research ◽  
Pharmacological Treatments ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Not Otherwise Specified ◽  
Dsm Iv

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) describes two eating disorder diagnoses, anorexia nervosa (AN) and bulimia nervosa (BN). Provisional criteria are also provided in DSM-IV for binge eating disorder (BED), which is an example of an eating disorder not otherwise specified. This chapter presents a summary and synthesis of research related to the clinical features and treatment of AN, BN, and BED, including studies of prevalence, common comorbidities, and treatment efficacy. Both psychological and pharmacological treatments are reviewed, including cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and the use of antidepressant medications. Recommendations are made for future research across the eating disorders.

scholarly journals Uncovering ED: A Qualitative Analysis of Personal Blogs Managed by Individuals with Eating Disorders

2014 ◽  
Author(s):  
Jacqueline Gies ◽  
Sara Martino
Keyword(s):  
Eating Disorders ◽  
Grounded Theory ◽  
Eating Disorder ◽  
Qualitative Analysis ◽  
Future Research ◽  
Study Results ◽  
Mind And Body ◽  
Self Worth ◽  
Harmful Effects

Previous studies have investigated the potential harmful effects of pro-eating disorder (ED) websites. Websites, such as personal blogs, may contain eating disorder content that may hold important information as well and must be considered. Fifteen blogs hosted by the site “Tumblr” were qualitatively analyzed. Each blog owner was anonymous and all were female. Ten main themes were extracted using grounded theory: interaction, negative self-worth, mind and body disturbances, pictures, eating disorders, suicide, diet, exercise, stats, and recovery. Additional themes also appeared in the study. Results indicate that although each individual blog is unique to its owner, common concepts existed among the majority. The implications for the information in the ED blogs and directions for future research are discussed.

scholarly journals Exploring the impact of the COVID-19 pandemic and UK lockdown on individuals with experience of eating disorders

2020 ◽  
Author(s):  
Dawn Branley-Bell ◽  
Catherine V. Talbot
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Social Isolation ◽  
Technology Use ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Psychological Wellbeing ◽  
Living Situation ◽  
Negative Impacts ◽  
The Impact

Background: The coronavirus disease 2019 (COVID-19) pandemic may raise unique challenges for individuals with experience of eating disorders. Many factors have potential for detrimental impacts on psychological wellbeing and eating disorder recovery, including: Disruption to living situations, ‘social distancing’ restrictions, difficult access to healthcare, and societal changes to food behaviours and technology usage. To date, little is known on the impact of the pandemic on this population particularly within the UK.Method: A mixed-methods online survey was developed for the purpose of this study. Data was collected from 129 individuals currently experiencing, or in recovery from, an eating disorder during the early stages of the UK pandemic lockdown. Participants were aged between 16-65 years, with 121 participants identifying as female, 7 male and 1 participant preferring not to disclose their gender.Results: Findings suggest that the pandemic is having a profound, negative impact upon individuals with experience of eating disorders. 8 key themes are generated: Disruption to living situation, increased social isolation and reduced access to usual support networks, changes to physical activity rates, reduced access to healthcare services, disruption to routine and perceived control, changes to relationship with food, increased exposure to triggering messages, and positive outcomes. The results suggest detrimental impacts on psychological wellbeing including decreased feelings of control, increased feelings of social isolation, increased rumination about disordered eating, and low feelings of social support.Conclusions: Individuals with eating disorders are at significant risk of negative impacts of the pandemic. There is a vital need for interventions to support this population. Inequalities in healthcare provision were identified, emphasising a need for a more cohesive approach to remote treatment across UK healthcare services. Positive aspects of technology use were identified but the results suggest a need to address and/or limit the potential for negative impacts of public messages around food and exercise behaviours, and to co-design technologies with end-users to facilitate effective treatment.

Eating Disorder Comorbidity with OCD

2017 ◽  
Author(s):  
Marina Gershkovich ◽  
Olivia Pascucci ◽  
Joanna Steinglass
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Empirical Support ◽  
Future Research ◽  
Weight History ◽  
Eating Disorder Treatment ◽  
Weight Restoration ◽  
Disorder Treatment ◽  
Support Treatment ◽  
Shed Light

This chapter discusses the comorbidity of eating disorders with OCD, including epidemiology, neurobiology, clinical features, and treatment. These disorders frequently cooccur. There are hints that eating disorders and OCD may share underlying neural mechanisms of illness, but these neurobiological models are preliminary. Cooccurrence of eating disorders and OCD is more common in clinical populations than community samples, highlighting the importance of assessing eating and weight history among patients with OCD. Treatment for bulimia nervosa includes psychotherapy and medication options, all with good empirical support. Treatment for anorexia nervosa emphasizes behaviorally based approaches to weight restoration treatment, with no clear evidence for medication treatments. When these illnesses occur together, treatment focused on the eating disorder yields improvement in OCD symptoms. Integrating exposure and response prevention techniques into eating disorder treatment may yield synergistic improvement in both illnesses. Future research may shed light on shared and distinct neurobiological mechanisms of these illnesses.

Controversies and Questions in Current Evaluation, Treatment, and Research Related to Child and Adolescent Eating Disorders

2010 ◽  
pp. 50-72
Author(s):  
James Lock
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Emotional Disorders ◽  
Child And Adolescent ◽  
Outpatient Setting ◽  
Future Research ◽  
Research Issues ◽  
Not Otherwise Specified ◽  
Disorder Symptom ◽  
Adolescent Eating Disorders

This chapter addresses specific diagnostic, treatment, and research issues related to child and adolescent eating disorders. Current diagnostic formulations are inadequate for diagnosing eating disorders such as selective eating, food avoidance emotional disorders, and food phobias in children. Classification schemes for anorexia and bulimia nervosa are not developmentally sensitive, leading to overuse of “eating disorder not otherwise specified” as a diagnosis. Treatment studies in children and adolescents are few; however, those available suggest that certain guidelines are generally applicable. Adolescents with eating disorders should be treated as early as possible in an outpatient setting utilizing parents as resources. Medications, if used, should address comorbid conditions. Data hopefully forthcoming in the next 5 to 10 years will shed light on how best to classify and treat these disorders. Future research should integrate neuropsychological and neurofunctional findings related to brain development, cognitive functioning, and eating disorder symptom development in this age group.

scholarly journals Help-Seeking Behavior in Victims of Elder Abuse: A Systematic Review

2019 ◽  
pp. 152483801986061 ◽  
Author(s):  
Silvia Fraga Dominguez ◽  
Jennifer E. Storey ◽  
Emily Glorney
Keyword(s):  
Help Seeking ◽  
Elder Abuse ◽  
Future Research ◽  
Narrative Synthesis ◽  
Help Seeking Behavior ◽  
Inclusion Criteria ◽  
Research Gaps ◽  
Service Engagement ◽  
Seeking Behavior ◽  
Comprehensive Search

Elder abuse has become increasingly relevant for intervention and study in the context of an aging population. One of the major barriers to progress in the field is underreporting of elder abuse by victims. This systematic literature review aimed to synthesize the available findings regarding victims’ help-seeking behavior to inform practice, understand the limits of the evidence, and identify research gaps. A comprehensive search of published and unpublished literature was undertaken, and studies were included if they addressed help-seeking behavior from the perspective of elder abuse victims aged 60 and older. A total of 19 studies met inclusion criteria for review. Findings are presented as a narrative synthesis organized according to help-seeking barriers, facilitators, sources of help, the responses of others, and the characteristics of victims more likely to seek help. Although barriers and sources of help received detailed attention across all studies, findings regarding victim characteristics and facilitators for and responses to help-seeking were limited. The results suggest that there are many barriers to help-seeking and that some victims only seek help when the abuse is perceived as unbearable or they fear for their safety. Results are discussed in relation to implications for intervention, including suggestions to enhance help-seeking behavior. Future research should identify facilitators of help-seeking among victims of elder abuse and victim characteristics associated with early disclosure. Research efforts should frame help-seeking as a continuing process and study ways in which the responses of others may impact future help-seeking or service engagement.

scholarly journals Stigmatising views towards individuals with eating disorders: trends and associations from 1998 to 2008 using a repeated cross-sectional design

2021 ◽  
pp. 1-7
Author(s):  
Jennifer Guy ◽  
Helen Bould ◽  
Glyn Lewis ◽  
Francesca Solmi
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Alcohol Dependence ◽  
Help Seeking ◽  
Formal Education ◽  
Mental Illnesses ◽  
Sociodemographic Characteristics ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Over Time

Background Eating disorders are stigmatised. Little is known about whether stigma has decreased over time and which groups hold more stigmatising beliefs. Aims To explore whether stigma towards eating disorders has changed between 1998 and 2008 and whether it varies by sociodemographic characteristics. Method We used the Office for National Statistics Omnibus surveys 1998 and 2008. As outcomes, we selected four questions eliciting participants’ views on issues of blame and ability to recover, and compared their mean scores across eating disorders, depression and alcohol dependence in both years. We used multivariable linear regressions to investigate associations between sociodemographic characteristics and each stigma domain. Results In total, 2720 participants had data on all variables of interest. Compared with 1998, in 2008 stigmatising views towards eating disorders improved. In both years, participants believed it was easier to recover from eating disorders than depression or alcohol dependence. Respondents believed people with eating disorders were more to blame for their condition than those with depression, but less than those with alcohol dependence. Men, those with less formal education, and those from ethnic minority backgrounds were more likely to place greater blame on individuals for their mental illness. Men were more likely than women to think it was possible to recover from an eating disorder. Conclusions Stigmatising attitudes towards people with eating disorders have improved over time, but are still greater than those observed for other mental illnesses. Improving eating disorder mental health literacy could help to reduce these negative views and lead to improved quality of life, greater help-seeking and better prognosis.

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