It's that time of week again- your Sunday Smorgasbord! As there has been actual research published this week, I am going to focus more on research-y ED stuff.
Nutrition knowledge in young women with eating disorders in Australia and SingaporeThe results of this study were pretty self-explanatory, so I'll let the abstract do the talking.
Women with EDs had greater knowledge than controls, but the magnitude of the difference was small. Greater acculturation to Western culture was associated with greater knowledge. CONCLUSIONS: The difference in nutrition knowledge between women with and without EDs is unlikely to be of clinical importance. The findings may reflect today's ubiquitous availability of nutrition information.In ED treatment, nutrition education is considered an important part of treatment. And the dietician that I saw for years was one of the most helpful people on my team. I adore this woman and keep in contact with her even though I'm no longer formally her patient. So I'll be the first to admit that a dietician can be an important part of a treatment team. But my RD didn't so much provide nutrition education (such as here is what 2 oz. of meat looks like, this is a glass of milk, here are how many calories/fat grams/etc you need) as much as she first designed a meal plan to help me gain back to a healthy weight and worked with me on the best ways to split up meals and snacks, and then she helped me work through my fear of food. This study confirms that it's not that people with EDs are less knowledgeable about food--my mom told me I could write the book on nutrition, but I just need to read the darn thing!--but that their fears get in the way of eating properly. And an RD can be helpful in working with specific food-related fears.
One-third of psychiatric inpatients who self-harm also have eating disorders This study was from the French journal Encephale, and so I once again will have to restrict myself to the abstract. However, the results are interesting. The psychiatrists did a survey of 30 psychiatric inpatients who were hospitalized and had self-harming behaviors, although they didn't mention whether self-harm was the reason they were admitted. Among these 30 inpatients (admittedly, a very small sample), they found that 33% had an eating disorder, and among these 50% had the restrictive subtype of anorexia.
Needless to say, self-harm and EDs seem to co-exist rather strongly, although it still remains unclear why there is an overlap in symptoms, and how related these two illnesses are.
Symptoms of psychosis in anorexia and bulimia nervosaMany of the symptoms of an eating disorder can seem to be almost psychotic in nature. I for once was convinced the entire universe was conspiring to make me fat, and right when I was first diagnosed I refused to take any medication because I thought it was some grand scheme cooked up by my treatment team to get me fat. There were others: at one point, I thought water would make me gain weight, or that I could see my stomach getting larger before my eyes. Clearly, these were not based on reality, and starvation psychosis has been reported over the years in both prisoners of war and in obese patients put on starvation diets. From a study, titled "
Follow-Up of Patients Starved for Obesity":
"[Patient No. 15] developed a paranoid psychosis during starvation, left the hospital against advice and since discharge his only communication has been an indignant, accusatory letter to the chief metabolic investigator."(Can't say I blame Patient No. 15!)
I couldn't find much data on the overlap between schizophrenia and EDs, but it appears that most psychosis seen in people with acute eating disorders is due to malnutrition rather than a separate illness. From the study's abstract:
Compared with controls, the patients with anorexia nervosa were more likely to endorse the item "Never feeling close to another person"; the patients with bulimia nervosa were more likely to endorse the item "Feeling others are to blame for your troubles". Both groups of patients were more likely than controls to endorse the item "Idea that something is wrong with your mind". The students who were identified by the EAT and the BITE as being "at risk" for eating disorders were more likely to assign their body a causative role in their problems. Symptoms of psychosis can be observed in patients with eating disorders, but these could be better explained within the psychopathology of the disorders rather than by assuming a link with schizophrenia.Prevalence and Factors Related to Substance Use among Adolescents with Eating DisordersThis study wasn't particularly fascinating or earth-shattering, but it did make the recommendation that all people with eating disorders should be formally screened for substance abuse problems.
And thus ends your smorgasbord for this week. I'll be back next week with more delightful little morsels for you to sample!
Nutrition knowledge in young women with eating disorders in Australia and Singapore
The results of this study were pretty self-explanatory, so I'll let the abstract do the talking.
Women with EDs had greater knowledge than controls, but the magnitude of the difference was small. Greater acculturation to Western culture was associated with greater knowledge. CONCLUSIONS: The difference in nutrition knowledge between women with and without EDs is unlikely to be of clinical importance. The findings may reflect today's ubiquitous availability of nutrition information.
In ED treatment, nutrition education is considered an important part of treatment. And the dietician that I saw for years was one of the most helpful people on my team. I adore this woman and keep in contact with her even though I'm no longer formally her patient. So I'll be the first to admit that a dietician can be an important part of a treatment team. But my RD didn't so much provide nutrition education (such as here is what 2 oz. of meat looks like, this is a glass of milk, here are how many calories/fat grams/etc you need) as much as she first designed a meal plan to help me gain back to a healthy weight and worked with me on the best ways to split up meals and snacks, and then she helped me work through my fear of food. This study confirms that it's not that people with EDs are less knowledgeable about food--my mom told me I could write the book on nutrition, but I just need to read the darn thing!--but that their fears get in the way of eating properly. And an RD can be helpful in working with specific food-related fears.
One-third of psychiatric inpatients who self-harm also have eating disorders
This study was from the French journal Encephale, and so I once again will have to restrict myself to the abstract. However, the results are interesting. The psychiatrists did a survey of 30 psychiatric inpatients who were hospitalized and had self-harming behaviors, although they didn't mention whether self-harm was the reason they were admitted. Among these 30 inpatients (admittedly, a very small sample), they found that 33% had an eating disorder, and among these 50% had the restrictive subtype of anorexia.
Needless to say, self-harm and EDs seem to co-exist rather strongly, although it still remains unclear why there is an overlap in symptoms, and how related these two illnesses are.
Symptoms of psychosis in anorexia and bulimia nervosa
Many of the symptoms of an eating disorder can seem to be almost psychotic in nature. I for once was convinced the entire universe was conspiring to make me fat, and right when I was first diagnosed I refused to take any medication because I thought it was some grand scheme cooked up by my treatment team to get me fat. There were others: at one point, I thought water would make me gain weight, or that I could see my stomach getting larger before my eyes. Clearly, these were not based on reality, and starvation psychosis has been reported over the years in both prisoners of war and in obese patients put on starvation diets. From a study, titled "Follow-Up of Patients Starved for Obesity":
"[Patient No. 15] developed a paranoid psychosis during starvation, left the hospital against advice and since discharge his only communication has been an indignant, accusatory letter to the chief metabolic investigator."
(Can't say I blame Patient No. 15!)
I couldn't find much data on the overlap between schizophrenia and EDs, but it appears that most psychosis seen in people with acute eating disorders is due to malnutrition rather than a separate illness. From the study's abstract:
Compared with controls, the patients with anorexia nervosa were more likely to endorse the item "Never feeling close to another person"; the patients with bulimia nervosa were more likely to endorse the item "Feeling others are to blame for your troubles". Both groups of patients were more likely than controls to endorse the item "Idea that something is wrong with your mind". The students who were identified by the EAT and the BITE as being "at risk" for eating disorders were more likely to assign their body a causative role in their problems. Symptoms of psychosis can be observed in patients with eating disorders, but these could be better explained within the psychopathology of the disorders rather than by assuming a link with schizophrenia.
Prevalence and Factors Related to Substance Use among Adolescents with Eating Disorders
This study wasn't particularly fascinating or earth-shattering, but it did make the recommendation that all people with eating disorders should be formally screened for substance abuse problems.
And thus ends your smorgasbord for this week. I'll be back next week with more delightful little morsels for you to sample!