Anorexic Patients Research Articles

The creative self in anorexics

The article describes the interaction of anorexic patients, hospitalized in the Regional Pilot Psychiatric Service for the treatment of Anorexia in the Molinette Hospital of Turin, with the reading volunteering group. On the basis of said interaction, the Creative Self is searched for in patients and shows into be present in different ways. It seems anyway enhanced by the presence in the reading group.

Differences between anorexia patients and participants of the Minnesota hunger experiment: Consequences for treatment

Differences between anorexia patients and participants of the Minnesota hunger experiment: Consequences for treatment

The Influence of Body Mass Index in Obese and Morbidly Obese Patients on Complications and 30- and 90-day Readmissions Following Lumbar Spine Fusion.

Retrospective cohort study using the 2013-2017 National Readmission Database. The aim of this study was to quantify the influence of body mass index (BMI) on complication and readmission rates following lumbar spine fusion. Compared to controls, patients with BMI ≥35 had greater odds of readmission, infection, and wound complications following lumbar spine fusion. Patients who underwent elective lumbar spine fusion within the population-based sample were considered for inclusion. Exclusion criteria included nonelective lumbar spine fusions, malnourished, anorexic, or underweight patients, and surgical indications of trauma or neoplasm. Patients were grouped by BMI: 18.5 to 29.9 (controls), 30 to 34.9 (obesity I), 35 to 39.9 (obesity II), and ≥40 (obesity III). Multivariate regression was performed to analyze differences in complications and readmissions between groups. Predictive modeling was conducted to estimate the impact of BMI on 30- and 90-day infection, wound complication, and readmissions rates. A total of 86,697 patients were included for analysis, with an average age of 58.9 years and 58.9% being female. The obesity II group had significantly higher odds of infection (odds ratio [OR]: 1.82, 95% confidence interval [CI]: 1.28-2.62, P = 0.001), wound dehiscence (OR: 3.08, 95% CI: 1.70-6.18, P = 0.0006), and 30-day readmission (OR: 1.32, 95% CI: 1.11-1.58, P = 0.002), whereas the obesity III group had significantly higher odds of acute renal failure (OR: 2.14, 95% CI: 1.20-4.06, P = 0.014), infection (OR: 2.43, 95% CI: 1.72-3.48, P < 0.0001), wound dehiscence (OR: 3.76, 95% CI: 2.08-7.51, P < 0.0001), 30-day readmission (OR: 1.62, 95% CI: 1.36-1.93, P < 0.0001), and 90-day readmission (OR: 1.53, 95% CI: 1.31-1.79, P < 0.0001) compared with controls. Predictive modeling showed cumulative increases of 6.44% in infection, 3.69% in wound dehiscence, and 1.35% in readmission within 90-days for each successive BMI cohort. Progressively higher risks for infection, wound complications, and hospital readmission were found with each progressive BMI level.Level of Evidence: 3.

Microbioma en los trastornos de la conducta alimentaria

Introduction: eating disorders are serious illnesses with genetic and neurobiological bases where the main organs affected are the gastrointestinal tract and the neurologic system making important the role of the microbiome. Objectives: summarize the results of the latest microbiome research that could be future tools in the management of eating disorders. Materials and methods: umbrella review of pubmed publications in humans of the last 10 years regarding microbiome and eating disorders. Results: since the discovery of the microbiome and the function on the cerebral-intestinal axis, through pathways such as vagal nerve, neurotransmitters and immune system, related to symptoms presented on anorexic patients. Conclusions: psychobiotics, live organisms that when ingested in adequate amounts produce health benefits in patients suffering from psychiatric illnesses are the new topic of future research in eating disorders.

Anorexia nervosa: A literature review

Introduction: Anorexia nervosa is a food intake disorder characterized by acute weight loss that it could cause severe psychosomatic problems. Purpose: To present the data and information as well as the treatment related to Anorexia nervosa. Materials and methods: The study material consisted of reviewed articles on the topic found in Greek and globally accepted electronic databases, Pubmed, Scopus, Medline, Google Scholar, regarding the effects of Anorexia nervosa on health and its treatment. Results: Initial symptoms of Anorexia nervosa and Bulimia Nervosa may be characterised by body-related negative interpretation bias, distorted body image and pronounced body dissatisfaction. Anorexic patients refuse to eat with their family or in public places. They lose weight by drastically reducing their total food intake, with a disproportionate reduction in the amount of meals containing carbohydrates and fats. The term Anorexia is unfortunate, because a decrease in appetite does not occur. Patients are constantly hungry and they are constantly thinking about food, but they refuse it. An indication of their way of thinking is that they often collect recipes or prepare complex meals for others. Conclusions: Anorexia nervosa is a disease that connects the physical with the mental dimension of health. A person's disharmonious relationship with oneself, which may have its roots in a dysfunctional family context or in a demanding and competitive social environment, finds the way to be manifested through the individual's reflection on food.

Alexithymia Mediates the Relationship Between Insecure Attachment and Eating Disorder Symptoms

Insecure attachment and alexithymia have traditionally been associated with eating disorders. However, research has recently started to examine the specific mechanisms by which attachment insecurity affect disordered eating. The aim of this study was therefore to investigate the hypothesis that alexithymia mediates the relationships between insecure attachment patterns and eating disorders (EDs) and to test the relative contribution of each component of alexithymia. 323 female university students and 38 anorexic patients completed questionnaires on attachment, alexithymia and ED symptoms within a structural equation modeling approach. Insecure attachment was related to alexithymia, specifically difficulty identifying feelings (DIF) and difficulty describing feelings (DDF) subscales of the Toronto Alexithymia Scale. Furthermore, alexithymia scores were associated with eating disorder symptoms. However, only DIF mediated the relationship between attachment insecurity and ED symptoms. Despite the limitations of the cross-section design, attachment and alexithymia seem to be an important focus when preventing and treating EDs.

Validity of Bioimpedance Equations to Evaluate Fat-Free Mass and Muscle Mass in Severely Malnourished Anorectic Patients.

Background: Bioelectrical impedance analysis (BIA) is a simple and rapid technique to measure body composition (BC). Validity of BIA in patients with low body mass index (BMI) remains controversial. We assessed the validity of several BIA equations to evaluate fat-free mass (FFM), fat mass (FM) and muscle mass in patients with anorexia nervosa (AN) by using dual X ray absorptiometry (DXA) as reference. Methods: Sixteen BIA equations developed for FFM and appendicular lean mass (ALM) were applied on electrical data measured by BIA in AN patients with BMI <16 kg/m². BIA and DXA were done the same day after overnight fasting. Results were compared with the Bland–Altman method, Pearson correlation and a Lin concordance test. Results: Data from 115 female AN patients (14.6 ± 1.2 kg/m²; 32.3 ± 14.5 years) were included. FM and FFM assessed by DXA were, respectively, 4.2 ± 2.4 kg and 35.5 ± 3.8 kg. The best results were obtained with Sun’s equation: respectively for FM and FFM, Bland Altman bias at 0.548 and 0.706 kg, Pearson correlation r at 0.86 and 0.86 and Lin concordance coefficient at 0.81 and 0.84. However, confidence intervals (CI) at 95% were high (−2.73–3.83 kg for FM; −4.55–3.13 kg for FFM). Other equations also showed high 95% CI. Accuracy was acceptable for Sun and Bedogni equations for FFM (approximately 66%) but very low for FM prediction considering all equations (<15%). Concerning ALM evaluated at 14.88 ± 2.04 kg by DXA, only Scafoglieri and Yoshida equations showed acceptable values: bias (−0.2 and 2.8%), Pearson r (0.89 and 0.86), Lin concordance coefficient (0.82 and 0.82) and accuracy (83.5 and 82.6%). Confidence intervals at 95% were high for both equations (−2.1–2.0 for Scafoglieri equation and −1.6–2.4 for Yoshida equation). Conclusion: In AN patients with BMI < 16 kg/m², no BIA equation tested was adapted to evaluate BC at the individual level.

A broader class of modified two-stage minimum risk point estimation procedures for a normal mean

In this paper, we design an innovative and general class of modified two-stage sampling schemes to enhance double sampling and modified double sampling procedures. Under the squared error loss plus linear cost of sampling, we revisit the classic problem of minimum risk point estimation (MRPE) for an unknown normal mean μ () when the population variance () also remains unknown. With stopping variables constructed based on an arbitrary general estimator Wm for σ, which satisfies a set of certain conditions, our procedures are proved to enjoy asymptotic first- and second-order efficiency as well as asymptotic first-order risk efficiency. For illustrative purposes, we further investigate specific modified two-stage MRPE procedures, where we substitute appropriate multiples of sample standard deviation, Gini’s mean difference (GMD), and mean absolute deviation (MAD) in the place of Wm , respectively. Extensive simulation studies are utilized to validate our theoretical findings. A real-life data set of weight change from female anorexic patients is then analyzed to demonstrate the practical applicability of these modified two-stage MRPE procedures. Comparing them in the case where there exist suspect outliers in the pilot sample, we are empirically confident that the GMD- and MAD-based procedures appear more robust than the sample-standard-deviation-based procedures.

Austrian study shows that delays in accessing acute paediatric health care outweighed the risks of COVID-19.

Austrian study shows that delays in accessing acute paediatric health care outweighed the risks of COVID-19.

Abstract 4035: Cannabidiol inhibits the long-term survival of a variety of cancers

Abstract Cannabis has resurfaced as a natural alternative or adjunctive treatment for a variety of chronic conditions, such as anorexia in patients with the AIDS wasting syndrome and chemotherapy-related nausea and vomiting. Exogenous cannabinoids, such as Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are found in the cannabis sativa plant. CBD has been shown to have anti-proliferative and pro-apoptotic effects in addition to preventing invasion and metastasis of various cancer cells. Such effects of CBD have been shown in certain cell lines of breast cancer, leukemia, glioma, small cell lung cancer, and colorectal cancer. Currently, the mechanism by which CBD exerts its effects are not fully understood. Here we have investigated CBD's effects on the long-term viability and mechanisms of cell death in a variety of cancer cell lines. Cancer cell lines of osteosarcoma (U2-OS), adenocarcinoma of the cervix (HeLa 1.2.11), metastatic breast cancer (MDA-MB 231), large cell lung carcinoma (H460) and malignant melanoma (A375) were plated on 12-well plates. 100% pure CBD isolated from cannabis sativa (generously provided by America's Finest CBD) was dissolved in ethanol and added directly to growth medium at various concentrations to determine the optimal dose in which the cells could no longer maintain viability. After 7-10 days, cells were stained with crystal violet. The blue dye was later extracted, quantified with a spectrometer, and dose response curves were plotted. For PARP cleavage analysis, cells were exposed to a certain concertation of CBD concentration and collected over 24-hour intervals. In addition, we have also performed RNA sequencing (RNA Seq) analysis using the melanoma cell line, A375, in an attempt to uncover the molecular mechanism of cell death induced by CBD treatment. Our long-term viability analysis demonstrate that a dose dependent response was present for each cell line exposed to CBD. We showed that CBD allows for a dose dependent killing in a variety of cancer cell lines, including large cell lung carcinoma, metastatic breast cancer, malignant melanoma, cervical carcinoma and osteosarcoma. IC50 of each cell line was determined as follows: A375 - 2.45μM, H460 - 8.47 μM, MDA-MB-231 - 8.35 μM, HeLa1.2.11 - 4.1 μM, and U2OS - 4.63 μM. The more aggressive cancer cell lines H460 and MDA-MB-231 required relatively higher dosages of CBD to kill the cells. A375, a malignant melanoma cell line, is the most sensitive cancer cell line to CBD tested so far. Apoptosis as a mechanism of cell death was confirmed with the presence of PARP cleavage in A375, H460, and MDA-MB-231 cell lines. Preliminary RNA Sequencing results suggest that heightened endoplasmic reticulum (ER) stress response in CBD treated cells is likely the cause of cell death. In summary, CBD demonstrates dose-dependent killing effects on a wide range of cancer cell lines, many of which have demonstrated a mechanism through apoptosis. Intriguingly, one of the melanoma cell lines is the most sensitive cancer cell line tested so far. Our RNA Sequencing analysis showed that CBD treatment induces a drastic increase of ER stress response, suggesting a potential mechanism of CBD induced apoptosis in cancers. In the future, we plan to develop a CBD cream and test its efficacy on preventing and/or treating skin cancers. Citation Format: Emily Seltzer, Andrea Watters, Dong Zhang. Cannabidiol inhibits the long-term survival of a variety of cancers [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4035.

Illness Perception in Adolescent Patients With Anorexia: Does It Play a Role in socio-Emotional and Academic Adjustment?

People’s beliefs about their illness have been shown to affect their adjustment. The aim of this study was to describe illness perception in adolescent patients with anorexia nervosa (AN) and assess its relationship with socio-emotional and academic adjustment following Leventhal’s Self-Regulation Model. Thirty-four female AN patients, with a mean age of 15.76 (SD = 2.00), completed the Revised Illness Perception Questionnaire (IPQ-R), the Psychosocial Adjustment to Illness Scale (PAIS) and the Hospital Anxiety and Depression Scale (HAD). Adolescent anorexia patients perceived that they had control over their illness and treatment would improve their condition. However, they also believed that it was highly distressing, going to last a long time and would have serious consequences. As for the causes of the disorder, they were attributed primarily to a specific eating disorder and psychological factors. The results showed that anorexia patients’ illness perceptions were related to socio-emotional and academic adjustment. In this sense, identity with the illness was associated with a worse academic adjustment, while emotional representation was associated with a worse emotional and social adjustment. These findings highlight how important it is for patients’ beliefs about their disease to be considered in the treatment of anorexia. In this respect, clinicians treating these patients should consider how certain beliefs affect their academic and socio-emotional adjustment. It would be interesting for patients to become aware of how these beliefs influence the strategies they use to cope with their disease as well as their adjustment to it.

Picture Perfect: Anne Sexton’s “The Double Image” Reflects the Poet as Daughter, Mother, and Anorectic

Anne Sexton’s poem “The Double Image” is explored, delving into the complexities of the role of the author as confessional poet, daughter, mother, and anorectic. This piece begins by noting the differences between the final published piece and the earlier drafts of the poem, focusing on the subtle differences and attempting to decipher why these changes were made. The significance of Sexton’s childhood home in the poem is noted, as this is seen to infantilise the author and creates a narcissistic regression often seen in anorectic patients. Sexton’s recurrent mouth imagery is addressed, as it is the gateway for food (or lack thereof) and plays a crucial role in the works of Sexton throughout her work and life. This topic is further developed into using hunger and eating metaphorically by Sexton, noting that as a daughter she engulfed everything in her mother’s world. The placement of the portraits in the poem is another aspect that Sexton changes consistently throughout the drafts and this piece delves into theories of the significance the position of the portraits might have had. This piece ends with the importance the color green has for the author in her work, possibly linking it to the choice of using green for the wicked within the original technicolor version of The Wizard of Oz (LeRoy & Fleming, 1939).

Picture Perfect: Anne Sexton’s "The Double Image" Reflects the Poet as Daughter, Mother, and Anorectic

Anne Sexton’s poem “The Double Image” is explored, delving into the complexities of the role of the author as confessional poet, daughter, mother, and anorectic. This piece begins by noting the differences between the final published piece and the earlier drafts of the poem, focusing on the subtle differences and attempting to decipher why these changes were made. The significance of Sexton’s childhood home in the poem is noted, as this is seen to infantilise the author and creates a narcissistic regression often seen in anorectic patients. Sexton’s recurrent mouth imagery is addressed, as it is the gateway for food (or lack thereof) and plays a crucial role in the works of Sexton throughout her work and life. This topic is further developed into using hunger and eating metaphorically by Sexton, noting that as a daughter she engulfed everything in her mother’s world. The placement of the portraits in the poem is another aspect that Sexton changes consistently throughout the drafts and this piece delves into theories of the significance the position of the portraits might have had. This piece ends with the importance the color green has for the author in her work, possibly linking it to the choice of using green for the wicked within the original technicolor version of The Wizard of Oz (LeRoy &amp; Fleming, 1939).

Effectiveness of Schema Therapy in Psychological Distress, Body Image, and Eating Disorder Beliefs in Patients with Anorexia Nervosa

Background and Objective: Due to the role of recognition in eating disorders, the identification of core beliefs and cognitive schemas becomes debatable. This study aimed to determine the effectiveness of schema therapy in psychological distress, body image, and eating disorder beliefs in anorexic patients. Materials and Methods: This was an applied quasi-experimental study with a pretest and posttest design and control group. The statistical population of the study included patients with an eating disorder, attending the psychological, clinical psychiatric, and obesity treatment centers in Ahvaz, Iran, within the age range of 16-23 years in 2019. The subjects were selected using the purposive sampling method. In this study, the pretest (i.e., filling out the Eating Disorder Beliefs Questionnaire [EDBQ]) was performed before the schema therapy intervention. Then, the intervention was conducted on the experimental group; however, no intervention was carried out for the control group. After the termination of the treatment sessions (12 sessions of 45 min), the posttest was performed. Finally, 3 months following the termination of the treatment, the follow-up test was conducted. The data were obtained using the EDBQ, Psychological Distress Questionnaire, and Body Image Concern Inventory. The data were analyzed using multivariate analysis of covariance and SPSS software (version 22). Results: The results of the present study showed that schema therapy led to a decrease in psychological distress (F=157.36, P&lt;0.0001, Eta=0.89), body image concern (F=8.03, P&lt;0.001, Eta=0.29), and eating disorder beliefs (F=13.85, P&lt;0.0001, Eta=0.91). Conclusion: It can be concluded that schema therapy reduces psychological distress, body image concerns, and eating disorder beliefs

Modified Liujunzi Decoction () Alleviates Chemotherapy-Induced Anorexia in Advanced Non-Small Cell Lung Cancer: A Propensity Score Matched Case-Control Study.

To evaluate the effect of Chinese herbal medicine formula, modified Liujunzi Decoction (, MLJZT), for anorexia, utilized as adjunct therapy during chemotherapy treatment for patients with advanced non-small cell lung cancer (NSCLC). The study adopted a propensity score-matched design based on a prospective database. From February 2016 to September 2017, patients with advanced NSCLC that received both cisplatin-based chemotherapy and MLJZT (IM group) were 1:1 propensity score-matched to patients that received the cisplatin-based chemotherapy alone (control group). Changes in anorexia and weight, as well as side effects were evaluated per week within 4-cycle chemotherapy. Overall, 156 patients with advanced NSCLC that had received chemotherapy from our database were identified and 53 pairs were matched successfully. In total, 48.6% (50/53) of patients in the IM group had anorexia-improvement compared to 28.3% (15/53) of patients in the control group, and a total of 39.6% (21/53) of patients in the control group had a worsening of anorexia compared to only 7.8% (8/53) of patients in the IM group (P<0.01). The weight reduced significantly over time in the control group (-2.36 ± 2.53 kg) as compared to the IM group (-0.62 ± 3.89 kg, P<0.01). CHM didn't reduce the efficacy of chemotherapy in shrinking tumor size, and didn't increase the incidence of side effects such as hematological and hepatorenal toxicity. MLJZT is effective and safe for alleviating anorexia in patients with NSCLC. These findings warrant the conduct of a randomized controlled trial.

Psychic room to breathe. Themes emerging within a staff Balint group on an eating disorder inpatient unit

Anorexia nervosa is the psychiatric disorder with the highest mortality rate. Anorexic patients admitted to inpatient eating disorder units are often critically unwell in both their physical and mental health. Underpinning working with these patients is a real feeling that they are close to death. Staff, and particularly nurses, in eating disorder units may find working with anorexic patients extremely challenging. It has been documented that working with such patients can give rise to strong and difficult to process countertransference feelings and reactions. The authors of this paper introduced a Balint group for the staff on an eating disorder inpatient ward to provide a space for the team to reflect on the work. This paper reports on the experience of running this Balint group and describes the themes that gradually emerged. These are then discussed and related to the nature of the disorder and the particular challenges of working with this inpatient population.

The Effect of Peppermint (Mentha piperita) Extract on the Severity of Nausea, Vomiting and Anorexia in Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Controlled Trial.

Background and Objective: Nausea, vomiting, and anorexia are the most common side effects reported in cancer patients undergoing chemotherapy. The present study aimed to determine the effect of peppermint extract on the severity of nausea, vomiting, and anorexia in patients with breast cancer undergoing chemotherapy. Methods and Materials: In this randomized controlled trial, we selected 84 patients with breast cancer undergoing chemotherapy. They were then assigned to 2 groups of experimental and control (n = 42, each) using block randomization. Patients in the experimental group received 40 drops of peppermint extract mixed in 20 cc of tap water every 8 hours, while patients in the control group received 40 drops of distilled water mixed in 20 cc of tap water every 8 hours. The severity of nausea, vomiting, and anorexia was measured and recorded before the intervention, and immediately, 24 and 48 hours after the chemotherapy using the Visual Analogue Scale. Statistical analysis of the data was conducted using SPSS software version 21. Results: The results of the present study revealed that there was a significant difference between the 2 groups at 24 and 48 hours after the chemotherapy (P < .05), so that the mean score of the severity of nausea, vomiting, and anorexia in the experimental group was lower than in the control group (P < .05). Conclusion: The use of peppermint as a method in complementary medicine may improve nausea, vomiting, and anorexia in patients with breast cancer undergoing chemotherapy. Further studies with greater sample size and longer follow-up period are needed to confirm the current findings.

Physical fitness and nutritional status in female adolescents with anorexia nervosa

ABSTRACT Objective This study aimed to determine whether physical fitness is related to nutritional status in a sample of female adolescents with anorexia nervosa, to contrast the nourished and undernourished patients, and to compare the physical fitness in these patients with normative data of healthy subjects stratified by age and gender. Methods Nutritional status was determined using the body mass index Z-score, fat mass, fat-free mass (bioelectrical impedance analysis), and the Controlling Nutritional Status score in 15 anorexic adolescents with 14.3±1.6 years. Physical fitness was assessed using the ALPHA-Fitness Battery (handgrip strength, standing broad jump, 4x10m shuttle run, and 20m shuttle run tests). Results Handgrip strength was significantly associated with all variables of nutritional status, except with the three blood components of the Controlling Nutritional Status score. The undernourished anorexic patients showed significantly worse physical fitness than the nourished anorexic patients in all tests, except in the standing broad jump and the 4x10m shuttle run tests. The physical fitness tests of the female anorexic adolescents showed scores significantly worse than those of the normative European female adolescent population. Conclusion The observation of female adolescents with anorexia nervosa showed associations between higher physical fitness levels and better nutritional statuses. Handgrip strength and 20m shuttle run tests may be options of additional indicators of undernutrition in anorexic female adolescents. The undernourished anorexic patients showed worse physical fitness than the nourished ones. According to normative data for healthy sex- and agematched adolescents, physical fitness is severely impaired in anorexic female adolescents.

Measuring implicit associations between food categories, moral attributes and bodily representations in anorexic patients

Restrictive dieting is one of the main factors contributing to the persistence of anorexia nervosa (AN). However, food categorization performance and strategy in AN patients remain under-researched. The aim of the present study is twofold: – to investigate food categorization strategies and performance in AN patients; – to capture implicit associations between food, moral attributes (Expe. 1) and bodily representations (Expe. 2). Expe. 1. Two hypotheses have been tested: (H1) food transformation is implicitly associated to “impurity” whereas food naturalness is implicitly associated to “purity” and (H2) the strength of these implicit associations is different in AN patients compared to control subjects. Patients (female, n = 32, mean age = 24.4 y. ± 4.7) and control subjects (female, n = 32, mean age 24,7 y. ± 3.4) were asked to complete a Go/No-go Association Task (GNAT). Reaction times analyses confirmed (H1), both patients and control subjects’ RTs were shorter in the congruent compared to incongruent conditions. Expe. 2. Two hypotheses have been tested: (H1) pictures of energy high foods are implicitly associated with pictures of overweight silhouettes and energy low foods are implicitly associated with underweight silhouettes in both populations (H2) AN patients exhibit specific categorization performance and/or strategies. Thirty female between 18 and 35 years were tested: patients (n = 15, mean BMI = 16.9) and control subjects (n = 15, mean BMI = 22.2) were asked to complete a GNAT. Analyses of errors confirm (H2). Indeed, in congruent conditions patients differ from control subjects with respect to their decision criterion (B″). Indeed, AN patients were very liberal compared to control subjects when detecting energy high foods and overweight silhouettes (i.e. higher proportion of “yes” response even on distractors) and are very conservative when it comes to detect energy low foods and underweight silhouettes. To conclude, results of Expe: – confirmed the existence of implicit associations between food categories and moral attributes in both anorexic patients and control. Results of Expe; – confirmed that patients differ from control subjects with respect to their decision criterion on both food and bodily visual stimuli. To conclude, the GNAT on both bodily and food stimuli represents a promising way of detecting AN and sheds new light on the cognitive mechanisms underlying restrictive dieting and bodily self-knowledge impairments characterizing AN patients.

Early recognition of anorexia through patient-generated assessment predicts survival in patients with oesophagogastric cancer.

Cancer cachexia is common in patients with oesophagogastric cancer (OG) and is linked to overall survival (OS). One of the key components of cachexia is anorexia; it is not known whether anorexia impacts on OS and there is no method of routine screening in current practice. Diagnosis relies on patients describing the symptoms, clinicians diagnosing anorexia and acting upon it. Patients with oesophageal/gastroesophageal junction or gastric cancer were assessed using the Functional Assessment of Anorexia Cachexia Therapy Anorexia/Cachexia Subscale (FAACT A/CS). FAACT A/CS includes 12 questions validated previously to diagnose anorexia in patients with cancer. Of the 182 patients included, 69% scored ≤37/48 and were considered to be anorexic; FAACT A/CS was a better predictor of OS in metastatic patients than body mass index or weight loss in the six months prior to cancer diagnosis. The median OS of patients with FAACT A/CS scores of >37 was longer than patients with scores of ≤37 (19.3 months vs 6.7 months, Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.4–6.0, p<0.0001). Patients with performance status (PS) 0–2 and FAACT A/CS >37 had substantially longer OS than those with PS 0–2 and FAACT A/CS ≤37 (18.7 months vs 7.9 months, HR 2.5 (95% CI 1.2–5.1, P<0.0001). The FAACT A/CS questionnaire allows clinicians to identify patients with anorexia who may benefit from early nutrition interventions. Importantly, this is the first study to show the association between anorexia and survival in patients with metastatic OG cancers. This will form the basis of future interventional studies to improve patient outcomes.