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Mills R, Hyam L, Schmidt U. Early intervention for eating disorders. Curr Opin Psychiatry 2024:00001504-990000000-00136. [PMID: 39146555 DOI: 10.1097/yco.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
PURPOSE OF REVIEW Research on early intervention for eating disorders has started to gain traction and examples of this in practice are increasing. This review summarizes findings over the past 3 years, focusing on the clinical effectiveness of early intervention in practice and the barriers and facilitators to its implementation. RECENT FINDINGS Recent developments in early intervention for eating disorders can be divided into three broad themes: research that has examined the efficacy of early intervention pathways in practice, research that has informed understanding of the target patient groups of early intervention (via clinical staging models, e.g.), and research that has suggested new ways to progress early intervention, towards becoming a standard part of best practice care. SUMMARY Early intervention pathways have shown promising clinical outcomes and are viewed positively by patients, clinicians and other stakeholders. However, more robust trials of their efficacy, effectiveness and cost-effectiveness are needed. Additionally, barriers to early intervention have been identified (e.g. delayed help-seeking); research must now develop and evaluate strategies to address these. Finally, the early intervention models in practice are underpinned partly by clinical staging models for eating disorders, which require further development, especially for eating disorders other than anorexia nervosa.
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Affiliation(s)
- Regan Mills
- Department of Clinical, Education and Health Psychology, University College London
- Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience
| | - Lucy Hyam
- Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience
| | - Ulrike Schmidt
- Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience
- Eating Disorders Outpatient Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Conboy L, Mingoia J, Hutchinson AD, Reisinger BAA, Gleaves DH. Digital body image interventions for adult women: A meta-analytic review. Body Image 2024; 51:101776. [PMID: 39094422 DOI: 10.1016/j.bodyim.2024.101776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 07/15/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024]
Abstract
Although many women experience body dissatisfaction, treatment options that prevent the onset of more serious conditions are limited in accessibility. As such, digital interventions may be an appropriate alternative resource to address restricted treatment options. This study provides statistical syntheses of the evidence for digital body image interventions for non-clinical adult women. A systematic literature search identified 19 studies (N = 2424) that tested the effect of a digital body image intervention compared to a control condition. Study results were synthesised using random effects models, and small to medium statistically significant effect sizes indicated that digital interventions were beneficial in increasing overall global satisfaction (g = 0.43) and reducing cognitive body dissatisfaction (g = 0.36). These meta-analytic findings provide evidence for the efficacy of digital body image interventions for non-clinical adult women. Intervention type was not found to be a statistically significant moderator, which may suggest that a range of intervention types can produce similar reductions in body dissatisfaction. Overall, digital body image interventions may be a feasible option to alleviate body dissatisfaction, particularly for women who may be unable to access conventional treatment.
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Affiliation(s)
- Lauren Conboy
- The University of South Australia: Justice and Society, GPO Box 2471, Adelaide, South Australia 5001, Australia.
| | - John Mingoia
- The University of South Australia: Justice and Society, GPO Box 2471, Adelaide, South Australia 5001, Australia
| | - Amanda D Hutchinson
- The University of South Australia: Justice and Society, GPO Box 2471, Adelaide, South Australia 5001, Australia
| | - Bennett A A Reisinger
- The University of South Australia: Justice and Society, GPO Box 2471, Adelaide, South Australia 5001, Australia
| | - David H Gleaves
- The University of South Australia: Justice and Society, GPO Box 2471, Adelaide, South Australia 5001, Australia
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Kasson E, Szlyk HS, Li X, Constantino-Pettit A, Smith AC, Vázquez MM, Wilfley DE, Taylor CB, Fitzsimmons-Craft EE, Cavazos-Rehg P. Eating disorder symptoms and comorbid mental health risk among teens recruited to a digital intervention research study via two online approaches. Int J Eat Disord 2024; 57:1518-1531. [PMID: 38445416 PMCID: PMC11262972 DOI: 10.1002/eat.24186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION It is crucial to identify and evaluate feasible, proactive ways to reach teens with eating disorders (EDs) who may not otherwise have access to screening or treatment. This study aimed to explore the feasibility of recruiting teens with EDs to a digital intervention study via social media and a publicly available online ED screen, and to compare the characteristics of teens recruited by each approach in an exploratory fashion. METHOD Teens aged 14-17 years old who screened positive for a clinical/subclinical ED or at risk for an ED and who were not currently in ED treatment completed a baseline survey to assess current ED symptoms, mental health comorbidities, and barriers to treatment. Bivariate analyses were conducted to examine differences between participants recruited via social media and those recruited after completion of a widely available online EDs screen (i.e., National Eating Disorders Association [NEDA] screen). RESULTS Recruitment of teens with EDs using the two online approaches was found to be feasible, with 934 screens completed and a total of 134 teens enrolled over 6 months: 77% (n = 103) via social media 23% (n = 31) via the NEDA screen. Mean age of participants (N = 134) was 16 years old, with 49% (n = 66) identifying as non-White, and 70% (n = 94) identifying as a gender and/or sexual minority. Teens from NEDA reported higher ED psychopathology scores (medium effect size) and more frequent self-induced vomiting and driven exercise (small effect sizes). Teens from NEDA also endorsed more barriers to treatment, including not feeling ready for treatment and not knowing where to find a counselor or other resources (small effect sizes). DISCUSSION Online recruitment approaches in this study reached a large number of teens with an interest in a digital intervention to support ED recovery, demonstrating the feasibility of these outreach methods. Both approaches reached teens with similar demographic characteristics; however, teens recruited from NEDA reported higher ED symptom severity and barriers to treatment. Findings suggest that proactive assessment and intervention methods should be developed and tailored to meet the needs of each of these groups. PUBLIC SIGNIFICANCE This study examined the feasibility of recruiting teens with EDs to a digital intervention research study via social media and NEDA's online screen, and demonstrated differences in ED symptoms among participants by recruitment approach.
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Affiliation(s)
- Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Xiao Li
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Anna Constantino-Pettit
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Arielle C Smith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Melissa M Vázquez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Denise E Wilfley
- Department of Psychology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
| | | | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Lindgreen P, Willaing I, Clausen L, Ismail K, Grønbæk HN, Andersen CH, Persson F, Cleal B. "I Haven't Told Anyone but You": Experiences and Biopsychosocial Support Needs of People With Type 2 Diabetes and Binge Eating. QUALITATIVE HEALTH RESEARCH 2024; 34:621-634. [PMID: 38183221 PMCID: PMC11103901 DOI: 10.1177/10497323231223367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
Up to 25% of people with type 2 diabetes (T2D) may binge eat which is almost 10 times as many as in the general population. Binge eating is associated with depression, anxiety, and social isolation. Moreover, binge eating may increase the risk of obesity and high blood glucose levels, both of which can accelerate the onset of complications to diabetes and death in people with T2D. Still, little is known about the experiences, needs, and preferences of people with T2D and binge eating that can inform and develop current and future treatment efforts. The aim of the study was therefore to gain in-depth insights into the experiences and biopsychosocial support needs of women and men with T2D and binge eating. Twenty semi-structured individual interviews (65% with females) were conducted and analyzed according to the methodology of Interpretive Description. Four themes were identified: (a) T2D and binge eating: Feeling trapped in a vicious circle; (b) Unwanted outcasts: Responding to continuous criticism; (c) Biomedical relief: Blaming and adjusting the body; and, (d) Silent struggles: Wanting to cease the secrecy. Pertinent to all themes were the guilt, shame, and worries about developing complications that the participants experienced when binge eating despite having T2D. Although binge eating triggered emotional distress, binge eating was at the same time a way of coping with such distress. Implications for treatment and future research are discussed, including the need to systematically assess and address binge eating in routine T2D care.
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Affiliation(s)
| | - Ingrid Willaing
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Loa Clausen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Khalida Ismail
- Department of Psychological Medicine, King’s College London, London, UK
| | | | | | | | - Bryan Cleal
- Steno Diabetes Center Copenhagen, Herlev, Denmark
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Levine MP. Prevention of eating disorders: 2023 in review. Eat Disord 2024; 32:223-246. [PMID: 38721678 DOI: 10.1080/10640266.2024.2345995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
This review of 16 prevention-related publications in Eating Disorders during 2022 is framed by three models: (1) Mental Health Intervention Spectrum: health promotion → types of prevention → case identification/referral → treatment; (2) the prevention cycle: rationale and theory, shaped by critical reviews → clarifying risk and protective factors → program innovation and feasibility studies → efficacy and effectiveness research → program dissemination; and (3) definitions of and links between disordered eating (DE) and eating disorders (EDs). Seven articles fell into the category of prevention rationale (including screening studies) and relevant reviews, while nine articles addressed correlates of/risk factors (RFs) for various aspects of DE and EDs. One implication of the 16 articles reviewed is that RF research toward construction of selective and indicated prevention programs for an expanding array of diverse at-risk groups needs to address, from a nuanced, intersectional framework, a broad range of factors beyond negative body image and internalization of beauty ideals. Another implication is that, to expand and improve current and forthcoming prevention programs, and to shape effective advocacy for prevention-oriented social policy, the field in general and Eating Disorders in particular need more scholarship in the form of critical reviews and meta-analyses; protective factor research; prevention program development and multi-stage evaluation; and case studies of multi-step activism at the local, state (province, region), and national levels.
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Affiliation(s)
- Michael P Levine
- Department of Psychology (emeritus), Kenyon College, Gambier, Ohio, USA
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Liao Z, Scaltritti M, Xu Z, Dinh TNX, Chen J, Ghaderi A. A Bibliometric Analysis of Scientific Publications on Eating Disorder Prevention in the Past Three Decades. Nutrients 2024; 16:1111. [PMID: 38674800 PMCID: PMC11054308 DOI: 10.3390/nu16081111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Eating disorders (EDs) present a growing concern due to their widespread occurrence and chronic course, the low access to evidence-based treatment, and the significant burden they place on the patients and society. This picture justifies intensive focus on the prevention of EDs. The current study provides the first bibliometric analysis of research on the prevention of EDs, focusing on trends and contributions, to prompt further prevention research. METHODS We conducted a bibliometric analysis of publications on the prevention of EDs using the Web of Science database, from 1993 to 2023. Focusing on universal and selective prevention strategies, our study involved a rigorous selection process, narrowing down from 10,546 to 383 relevant papers through manual screening. The analysis utilized the "bibliometrix" R package (version 4.2.2) and Python (version 3.9.6) for data processing, with VOSviewer employed for mapping collaboration networks. RESULTS Our analysis revealed a consistent annual growth rate of 10.85% in ED prevention research publications, with significant contributions from the "International Journal of Eating Disorders" and some notable authors. The United States emerged as the dominant contributor. The analysis also highlighted key trends, including a surge in publications between 2010 and 2017, and the role of major institutions in advancing research in this field. DISCUSSION The increasing rate of publications on the prevention of EDs is encouraging. However, the actual number of studies on the prevention of EDs are limited, and the majority of this work is performed by a few research groups. Given the high concentration of publications within a few countries and research groups, increased funding, facilitation of prevention research on a wider scale, and engagement of more researchers and further collaboration are called for.
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Affiliation(s)
- Zhenxin Liao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels vag 12A, 17177 Stockholm, Sweden;
| | - Martina Scaltritti
- Department of General Psychology, University of Padua, Via Venezia, 12, 35131 Padua, Italy;
| | - Zhihan Xu
- Division of Network and Systems Engineering (NSE), KTH School of Electrical Engineering and Computer Science, Teknikringen 33, 10044 Stockholm, Sweden;
| | - Thu Ngoc Xuan Dinh
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Nobels vag 6, 17177 Stockholm, Sweden; (T.N.X.D.); (J.C.)
| | - Jiahe Chen
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Nobels vag 6, 17177 Stockholm, Sweden; (T.N.X.D.); (J.C.)
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels vag 9, 17177 Stockholm, Sweden
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Fritzson AE, Schrag BHC, Park B, Strife S, Peña Teeters LA, Lischwe EH, Bell GBM, Herron WB, Dimidjian S. Enhancing body image satisfaction and well-being among early adolescents: Feasibility and preliminary outcomes of the mind. body. voice. program. Eat Behav 2024; 53:101875. [PMID: 38574495 DOI: 10.1016/j.eatbeh.2024.101875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
Although most research has emphasized high-school and college-aged women, body dissatisfaction and eating disorder behavior are also a concern for middle-school girls. We partnered with Girls Inc., a community-based organization to explore feasibility and preliminary outcomes of the mind. body. voice. (m.b.v.) program with a middle-school-aged cohort. The program was collaboratively designed with youth, focusing on body image satisfaction, disordered eating risk factors, and mental health and well-being. The work occurred during the COVID-19 pandemic, offering a unique opportunity to assess the promise of the program under difficult extenuating circumstances. In an open-trial design, we assessed change from pre- to post-program administered with two cohorts, one delivered remotely in 2020 (n = 17) and one in-person in 2021 (n = 13). Findings indicated that participation in the m.b.v. program was associated among both cohorts with significant decreases in negative body judgment and adherence to cultural appearance biases, and significant increases in body awareness, agency, and positive self-regard, as well as significant reductions in negative affect. Results support the feasibility and promise of both remote and in-person administration of the program targeting young adolescents, and in partnership with a well-established community-based organization.
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Affiliation(s)
- Anne E Fritzson
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA; Psychology & Neuroscience Department, University of Colorado Boulder, 345 UCB, Boulder, CO 80309, USA
| | | | - Bernadette Park
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA; Psychology & Neuroscience Department, University of Colorado Boulder, 345 UCB, Boulder, CO 80309, USA
| | - Samantha Strife
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA; Psychology & Neuroscience Department, University of Colorado Boulder, 345 UCB, Boulder, CO 80309, USA
| | - Leah A Peña Teeters
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA
| | - Emma H Lischwe
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA
| | - Gav B M Bell
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA
| | - Wendy B Herron
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA; Boulder Valley School District, 6500 Arapahoe Rd., Boulder, CO 80303, USA
| | - Sona Dimidjian
- Renée Crown Wellness Institute, University of Colorado Boulder, 1135 Broadway, Boulder, CO 80302, USA; Psychology & Neuroscience Department, University of Colorado Boulder, 345 UCB, Boulder, CO 80309, USA.
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Smith LL. Similarities and differences regarding acute anorexia nervosa and semi-starvation: does behavioral thermoregulation play a central role? Front Behav Neurosci 2023; 17:1243572. [PMID: 37953827 PMCID: PMC10634530 DOI: 10.3389/fnbeh.2023.1243572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/22/2023] [Indexed: 11/14/2023] Open
Abstract
Objective To clarify the association between acute anorexia nervosa (AN) and semi-starvation (SS) by focusing on similarities and differences in physiology, mood, and behavior. Method A comparison of published literature between these two groups. Results Both groups show similar hormonal and metabolic changes in response to caloric restriction and extreme weight loss (~25%). Associated changes result in a reduced body temperature (Tcore-low). Maintenance of body temperature within a specific range is crucial to survival. However, both groups cannot activate autonomic strategies to maintain their Tcore-low, such as increasing metabolic rate, constricting skin blood vessels, or shivering. Furthermore, Tcore-low increases the individuals' "coldness sensations" throughout the body, hence the frequent reports from ANs and SSs of "feeling cold." To eliminate these uncomfortable "coldness sensations" and, importantly, to maintain Tcore-low, ANs, and SSs "select" different thermoregulatory behavioral strategies. It is proposed that the primary differences between AN and SS, based on genetics, now manifest due to the "selection" of different thermo-regulatory behaviors. AN patients (ANs) "select" hyperactive behavior (HyAc), which increases internal metabolic heat and thus assists with maintaining Tcore-low; in harmony with hyperactive behavior is a lively mood. Also related to this elevated arousal pattern, ANs experience disrupted sleep. In contrast, SS individuals "select" a passive thermo-behavioral strategy, "shallow torpor," which includes reduced activity, resulting in energy conservation. In addition, this inactivity aids in the retention of generated metabolic heat. Corresponding to this lethargic behavior, SS individuals display a listless mood and increased sleep. Conclusion Initial similarities between the two are attributable to physiological changes related to extreme weight loss. Differences are most likely attributable to genetically programmed "selection" of alternate thermoregulatory strategies, primarily to maintain Tcore-low. However, if acute AN is prolonged and evolves into a chronic condition, AN will more closely align with starvation and more precisely reflect SS symptomology.
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Affiliation(s)
- Lucille Lakier Smith
- Human Performance Laboratory, Department of Kinesiology, School of Health Sciences, East Carolina University, Greenville, NC, United States
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Lacalaprice D, Mocini E, Frigerio F, Minnetti M, Piciocchi C, Donini LM, Poggiogalle E. Effects of mealtime assistance in the nutritional rehabilitation of eating disorders. Eat Weight Disord 2023; 28:73. [PMID: 37688675 PMCID: PMC10492868 DOI: 10.1007/s40519-023-01605-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023] Open
Abstract
PURPOSE The aim of the study was to examine the effects of meal supervision, provided by health professionals, volunteers or family members, on anthropometric, nutritional, psychological, and behavioural outcomes in patients with eating disorders (EDs). METHODS The present systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The last search was conducted in three databases (PubMed, Scopus, and the Cochrane library). Inclusion criteria considered paediatric and adult patients suffering from EDs, regardless of ethnicity, and treated in different therapeutic settings. The quality of the studies was evaluated using the Newcastle Ottawa Scale (NOS) adapted for cross-sectional studies and Version 2 of the Cochrane risk-of-bias assessment tool for randomised trials. RESULTS 3282 articles were retrieved, out of which only 6 met the eligibility criteria. A marked heterogeneity in definitions and approaches to supervised mealtime was observed. This variability emerged in the methodologies used in the supervised meal, and in the reference values for the outcome measures that were used, such as the analysis of different parameters. Based on these observations, mealtime assistance provided to patients with EDs shows an overall positive effect on eating behaviour and dysfunctional attitudes. Future research should be prompted to provide a thorough definition of a structured procedure for meal assistance to be potentially and systematically included in the nutritional rehabilitation protocols for patients with EDs. LEVEL OF EVIDENCE Level IV systematic reviews of uncontrolled trials.
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Affiliation(s)
- Doriana Lacalaprice
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - Francesco Frigerio
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Marianna Minnetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Claudia Piciocchi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Bryant E, Koemel N, Martenstyn J, Marks P, Hickie I, Maguire S. Mortality and mental health funding-do the dollars add up? Eating disorder research funding in Australia from 2009 to 2021: a portfolio analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 37:100786. [PMID: 37693868 PMCID: PMC10485676 DOI: 10.1016/j.lanwpc.2023.100786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/01/2023] [Accepted: 04/25/2023] [Indexed: 09/12/2023]
Abstract
Background Eating Disorders (EDs) are among the deadliest of the mental disorders and carry a sizeable public health burden, however their research and treatment is consistently underfunded, contributing to protracted illness and ongoing paucity of treatment innovation. Methods We compare absolute levels and growth rates of Australian mental health research funding by illness group for the years 2009-2021, with a specific focus on eating disorders analysed at the portfolio level. Findings Actual and adjusted data obtained from Australia's three national medical research funding bodies (NHMRC, ARC and MRFF) shows eating disorders receive a disproportionately low allocation of mental health research funding despite having amongst the highest mortality rates. Forty-one category one research grants totalling $AUD28.1 million were funded for eating disorders over the period. When adjusted for inflation, this equates to $2.05 per affected individual, compared with $19.56 for depression, $32.11 for autism, and $176.19 for schizophrenia. Half of all research funded for eating disorders was 'basic' research (e.g., illness underpinning), with little investment in the development of innovative treatment models, novel therapeutics or translation, well reflected by recovery rates of less than 50% in individuals with Anorexia Nervosa. Interpretation Significant discrepancy remains between research funding dollars and disease burden associated with the mental health disorders. The extent to which eating disorders are underfunded may in part be attributable to inaccuracies in epidemiological and burden of disease data. Funding This work was in-part funded by the Australian Government Department of Health and the National Eating Disorder Research & Translation Strategy. The funder was not directly involved in informing the development of the current study.
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Affiliation(s)
- E. Bryant
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
| | - N. Koemel
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - J.A. Martenstyn
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
- School of Psychology, Faculty of Science, University of Sydney, Australia
| | - P. Marks
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
| | - I. Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - S. Maguire
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
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