A nutrition and behaviour change group for patients with anorexia nervosa

Dietary intake of adults with eating disorders: A systematic review and meta-analysis

Studies have confirmed the link between altered dietary intake and eating disorders (EDs), although no systematic assessment of this research exists. Rigorous synthesis of dietary intake in anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and similar EDs is needed to explore similarities and differences. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we conducted a systematic review and quantitative synthesis of studies of dietary intake. Searches of three electronic databases resulted in thirty-nine included studies. Meta-analyses of subsets of these studies were undertaken to summarise macronutrient intake across AN, BN, and BED. Study quality was assessed using the American Academy of Nutrition and Dietetics Quality Criteria Checklist, with ratings either Positive (k = 27) or Neutral (k = 12). Adults with AN had low energy intake and those with BED reported elevated macronutrient intake. Individuals with BN reported wide variation in energy intake, including some of the highest estimates. Individuals with AN were likely to under-consume key micronutrients, with sodium potentially over-consumed in BN and BED. Vitamin D was under-consumed across all disorders. This meta-analysis highlights important diagnostic differences and synthesises dietary intake in EDs, with particular relevance to risk assessment and treatment.

Preliminary examination of a mentor-based program for eating disorders

BACKGROUND

There is a current and pressing need for recovery resources for individuals suffering from eating disorders. Mentoring programs have been useful with other psychiatric disorders such as addictions, and may be useful for individuals recovering from an eating disorder. The present study sought to examine a mentoring program for individuals working towards recovery from an eating disorder.

METHODS

The study included mentors (i.e., individuals who have recovered from an eating disorder for an extended period of time), and mentees (i.e., individuals who were in the process of recovering from an eating disorder and wanting additional support aside from their treatment team). Participants included 141 participants, consisting of 34 mentors, 58 mentees who matched with a mentor, and 49 mentees searching for a mentor. Participants completed questions assessing eating disorder symptoms, quality of life, motivation towards recovery, and treatment compliance.

RESULTS

Matched mentees reported higher levels of quality of life on 7 out of 12 domains, and missed fewer appointments with treatment providers when compared to unmatched mentees. There were no differences between matched and unmatched mentees on motivation, energy or confidence towards recovery.

CONCLUSIONS

Findings suggest a mentor model is beneficial for individuals engaged in the process of recovering from an eating disorder in the areas of quality of life and treatment compliance. Specifically, mentees in a mentoring relationship reported better family and close relationships, future outlook, and psychological, emotional, and physical well-being than unmatched mentees. Mentors reported being positively impacted by the mentoring relationship by strengthening the skills they learned while in recovery, and reminding them of how far they had come in their own recovery. The findings in this study suggest that mentor programs warrant further investigation as ancillary support services for individuals recovering from an eating disorder.

Eating Disorder Nutrition Counseling: Strategies and Education Needs of English-Speaking Dietitians in Canada

The purpose of this study was to profile nutrition counseling strategies for eating disorders that English-speaking Canadian registered dietitians (RDs) use and to explore their educational needs in this area. A cross-sectional survey consisting of open- and closed-ended questions on nutrition counseling strategies was developed and administered via mail. Types of strategies included assessment, rapport-building, educational, and behavior-change strategies. Sixty-five of the 116 eligible RDs who were members of the Dietitians of Canada Eating Disorder Network responded to the survey. Descriptive statistics, chi(2), and Spearman correlation statistics were used. P values less than 0.05 were considered significant. Canadian RDs used strategies that were familiar and strategies they considered useful. Content-oriented or "doing" strategies were used more often than strategies that involved some process-oriented or "thinking" strategies. Reading and intuition were the most frequently reported learning routes. Seventy-one percent of respondents were dissatisfied with the educational opportunities available to RDs in this area in Canada. In Canada, both generalist RDs and specialist eating disorders RDs work with clients with eating disorders. In the absence of a formal nutrition counseling education program, there seems to be a reliance on informal learning routes such as reading or intuition, which may be suboptimal. To optimize eating disorders nutrition practice in Canada, formal coordinated programming that accounts for the educational needs of specialist RDs as well as generalist RDs is needed.