Anorexia & Bulimia

MDNG PsychiatryDecember 2010
Volume 12
Issue 4

Online CMEA Neural Signature of Anorexia Nervosa in the Ventral Striatal Reward System

Credits: 1.00

Fee: $150/year (American Journal of Psychiatry subscribers), $300/year (non-subscribers)

Expires: January 30, 2012

Multimedia: None

Based on the article of the same name printed in the American Journal of Psychiatry, this course will enable participants to better demonstrate an increase in their knowledge of clinical medicine. “Participants should be able to understand the contents of a selected research or review article and to apply the new findings to their clinical practice.”

The Spectrum of Eating Disorders

Credits: 0.50

Fee: None

Expires: August 10, 2011

Multimedia: None

The various types of eating disorders, the need for clinically evaluating patients for eating disorders, and available treatments for managing eating disorders form the focus of this activity.


An Off-line Pilot Evaluation of a Web-based Systemic Cognitive-behavioral Intervention for Carers of People with Anorexia Nervosa

Journal: International Journal of Eating Disorders (November 15, 2010; online ahead of print)

Authors: Grover M, Dip P, Williams C, et al.

Purpose: To “evaluate the feasibility and acceptability of a novel systemic cognitive behavior therapy-based intervention for carers of people with anorexia nervosa (AN),” with the intervention providing information and promoting “skills development in managing the illness” and offering caregivers professional support.

Results: Following intervention, the researchers saw significant decreases in anxiety, depression, negative experiences of caregiving, and expressed emotion, as well as significant increases in positive experiences in caregiving, with most improvements maintained at follow-up. The intervention was well-received by participants.

Demographic and Clinical Characteristics of Individuals Utilizing an Internet-based Digital Coaching Program for Recovering from Binge Eating

Journal: International Journal of Eating Disorder (October 26, 2010; online ahead of print)

Authors: Bedtrosian, R, Moore R, Wang C

Purpose: To examine “demographic and clinical characteristics of adults who accessed a self-help program for binge eaters made available to them via their employers or health plans,” as few studies have examined who uses the digital coaching self-help interventions that are offered increasingly on the Internet for facilitation behavioral change.

Results: With more women (3,053) than men (998), mostly those who report binge eating below levels of frequency required for a clinical diagnosis, few people who had received prior treatment for an eating disorder, and many reporting high levels of motivation to overcome their eating disorders taking advantage of the intervention, the researchers concluded that “digital coaching programs may be a viable treatment option, particularly for individuals with infrequent binge eating who otherwise might not seek or receive treatment.”

Evaluation of a Guided Internet Self-treatment Programme for Bulimia Nervosa in Several European Countries

Journal: European Eating Disorders Review (September 21, 2010; online ahead of print)

Authors: Carrard I, Fernandez-Aranda F, Lam T, et al.

Purpose: To “evaluate the use of an online guided self-treatment programme for bulimia nervosa (BN) and to determine predictors of outcome” using data “collected in four European countries where the programme was simultaneously used.”

Results: Following a four-month intervention using a cognitive behavioral therapy-based, online-guided, self-help program, significant improvements were seen in severity of eating disorder symptoms and general psychopathology. At the end of treatment, one-third of patients were symptom free. The dropout rate was roughly 25%.

Clinical Trials

Motivation to Exercise in People with Anorexia Nervosa

Study Type: Observational

Age/Gender Requirement: 18-45 years (female)

Sponsor: National Institute of Mental Health

Purpose: To “determine the importance and level of physical activity in people with anorexia nervosa.”

Neurocognitive Model of Anorexia Nervosa

Study Type: Observational

Age/Gender Requirement: 16-45 years (male/female)

Sponsor: New York State Psychiatric Institute

Purpose: To “investigate thought processes and neural mechanisms that may contribute to the development of habitual behaviors,” based on the hypothesis that patients with anorexia nervosa “will perform differently than people without eating disorders on a series of neuropsychological tasks and will show different neural activation patterns in functional neuroimaging scans.”

Online Cognitive Behavioral Therapy for Bulimia Nervosa

Study Type: Interventional

Age/Gender Requirement: 18 years (male/female)

Sponsor: University of North Carolina (UNC), Chapel Hill

Purpose: To compare cognitive behavioral therapy delivered via face-to-face group therapy to online group therapy delivered through Cognitive Behavioral Therapy for Bulimia Nervosa, a research program funded by the National Institute of Mental Health and conducted by the UNC Eating Disorders Program and the University of Pittsburgh Medical Center.

The Educated PatientTM

Eating Disorders: Mirror Mirror

Mirror Mirror is a site developed by an eating disorder survivor to share experiences with other affected patients; the emphasis here is on providing support, not medical advice. The site does offer brief overviews of eating disorders, an exploration of the recovery process from the perspective of the survivor, and a “Myths vs. Realities” section. Visitors can also view (or add their name to) the Survivor’s Wall, an online display comprising the names and comments of people dealing with eating disorders.

National Eating Disorders Association: Information for Family and Friends

This section of the NEDA website states, “Parents, siblings and close friends play a significant role in guiding and supporting others. In many cases, individuals with eating disorders cannot recognize a need for help in themselves, and it takes a strong, caring individual to reach out.” To that end, the resource offers general information on eating disorders, an FAQ section where site visitors can also ask their own question of an expert, stories of hope, and the NEDA Parent Toolkit. The latter, updated by two physicians in March 2009, was developed for parents “in response to requests for a simple, easy-to-use way to get answers to questions and concerns” and covers common myths, treatment, getting help, insurance issues, and more.

SAMHSA’s National Mental Health Information Center — Center for Mental Health Services: Eating Disorders

This website’s fact sheet covers the three most common eating disorders: anorexia nervosa, bulimia nervosa, and binge-eating disorder. Descriptions the eating disorders, who sufferers from them, and what symptoms include are all covered. Factors considered in the formal labeling of eating disorders are described, which may enable unknowing patients to better identify that they have an illness. National resources will help patients find help closer to their home.

Medical Websites

Eating Disorders Coalition for Research, Policy, and Action

Among the resources available at the online home of the EDC—which include legislative updates, congressional briefings, and event information—are reports and disorder information, where physicians can read the American Public Opinion on Eating Disorders, 2005, which shows Americans agree that eating disorders are illnesses, not choices. Statistics here also display the seriousness of eating disorders.

Pharma Focus

Seroquel (quetiapine)

Clinical Trials

Quetiapine in Anorexia Nervosa

Study Type:Interventional

Age/Gender Requirement:18-65 years (male/female)

Sponsor:University of South Florida

Purpose:To determine the efficacy of quetiapine in anorexia nervosa, by titrating the dosage to subject tolerance, beginning at 50mg every 24 hours and going up to 400mg every 24 hours.

Trial of Quetiapine in Anorexia Nervosa

Study Type: Interventional

Age/Gender Requirement: 18-65 years (male/female)

Sponsor: University of California, San Diego

Purpose: To determine if quetiapine is effective in reducing core eating disorder symptoms in patients suffering from anorexia nervosa, as well as symptoms of anxiety, depression, obsession. The ability of quetiapine to increase body mass index will also be examined.

From the HCPLive Network

Anorexia Is Not a Good Contraceptive

Anorexic women, given a false sense of security by irregular or a lack of menstruation, are far more likely to have unplanned pregnancies and induced abortions.

How Does Undernutrition Contribute to Reproductive Dysfunction?

Karen Klahr Miller, MD of Massachusetts General Hospital presented at Endo 2010, the Endocrine Society’s Annual Meeting, held in June, on the effects of anorexia and female reproductive dysfunction.

Start of College Can Mean Start of Eating Disorders

For many teenagers, the start of college is an event that can push them into a dangerous battle with eating disorders, according to an expert from the University of Alabama at Birmingham.

Anorexia in Cancer Patients: A Syndrome

Multi-drug therapy appears to be better than a standard single drug in treating anorexia, says Mellar P. Davis, MD, FCCP, of the Cleveland Clinic.

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