Treating Eating: A Dynamical Systems Model of Eating Disorders

Ethics-testing an eating disorder recovery memoir: a pre-publication experiment

BACKGROUND

Narratives (including memoirs and novels) about eating disorders (EDs) are typically published with the intention to benefit readers, but survey evidence suggests that reading such narratives with an active ED may more often be harmful than helpful. To reduce the probability of inadvertent harm and learn more about how narrative reading and EDs interact, a pre-publication study was designed to determine whether or not a recovery memoir should be published.

METHODS

64 participants with a self-reported ED read either the experimental text (The Hungry Anorexic [HA]) or a control text (Ten Zen Questions [TZ]) over a roughly two-week period. All participants completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) one week before and two weeks after reading, and answered three recurring open-ended questions at regular timepoints during and after the reading. Computational analysis of the free-text responses assessed text/response similarity and response characteristics on emotional, sensory, and action-effector dimensions. Both rating-scale and free-text data were analysed using mixed ANOVAs to test for effects of time and condition, and the university ethics board was notified in advance of the quantitative threshold for harmful effects that would prohibit the ED memoir from being published.

RESULTS

On the two quantitative measures, there was an effect of time but not of condition: Significant improvement was found in both groups on the EDE-Q (with a medium-to-large effect size) and the ANSOCQ (with a very large effect size). In an ANCOVA analysis, no significant mediating effects were found for age, education, duration of professional support for the ED, or pre/post-reading BMI change. For the free-text responses, linguistic similarity measures indicated that HA responses most closely matched the text of HA, with the same being true for TZ. In a word-norm analysis, text condition significantly affected six emotional, sensory, and action-effector variables (interoception, olfaction, gustatory, mouth, torso, and hand/arm), mean scores for all of which were higher in HA responses than TZ responses. Close reading of readers' responses explored two potential mechanisms for the positive effects of time but not condition: engagement with the during-reading prompts as part of the experimental setup and engagement with the texts' dialogical form.

CONCLUSIONS

The ED memoir was found not to yield measurably harmful effects for readers with an ED, and will therefore be published. The finding that significant improvement on both quantitative measures was observed irrespective of text condition suggests that positive effects may be attributable to linguistic characteristics shared by the two texts or to elements of the reading and/or reflective processes scaffolded by both. The quantitative results and the free-text testimony have implications for our understanding of bibliotherapy, "triggering", and the practicalities of responsible publishing.

Systematic Review of Binge Eating Rodent Models for Developing Novel or Repurposing Existing Pharmacotherapies

Recent advances in developing and screening candidate pharmacotherapies for psychiatric disorders have depended on rodent models. Eating disorders are a set of psychiatric disorders that have traditionally relied on behavioral therapies for effective long-term treatment. However, the clinical use of Lisdexamfatamine for binge eating disorder (BED) has furthered the notion of using pharmacotherapies for treating binge eating pathologies. While there are several binge eating rodent models, there is not a consensus on how to define pharmacological effectiveness within these models. Our purpose is to provide an overview of the potential pharmacotherapies or compounds tested in established rodent models of binge eating behavior. These findings will help provide guidance for determining pharmacological effectiveness for potential novel or repurposed pharmacotherapies.

Risk Factors for Eating Disorders and Perception of Body in Young Adults Associated with Sex

(1) Background: The integrated approach to the prevention and treatment of eating disorders (EDs) requires knowledge and can be used only when specific risk factors are known. The aim of this study was to examine the differences in food choices and eating behavior between males and females; (2) Methods: This study comprised 148 females and 27 males aged from 18 to 26-years-old (MEAN ± SD = 21.4 ± 1.86 years old). Information about EDs was obtained from four different measures: the body mass index (BMI), the eating disorder screen for primary care (ESP), a standardized and validated questionnaire called “My Eating Habits” and the food frequency questionnaire with 10 answers (FFQ-10); (3) Results: The risk for developing eating disorders was detected in nearly 67% of respondents. It was also shown that EDs were more common in females and how body weight affected the way individuals feel about themselves. Females showed more unhealthy eating habits, which contributed to dietary restrictions and emotional overeating, as they were also afraid of gaining weight. The frequency of eating meat and drinking alcohol was higher in males, whereas eating legume seeds was less frequent in females. (4) Conclusions: This study opens a new field, which will help health care professionals recognize the problems with eating disorders and treat them based on different sex characteristics.