Long-term Eating Disorder Research Articles

Examining negative urgency as a predictor of eating disorder maintenance in purging syndromes.

Negative urgency is associated with short-term maintenance of binge eating and purging in unselected samples. The current study used an eating disorder sample to test the hypothesis that negative urgency maintains bulimia nervosa (BN) and purging disorder (PD) at long-term follow-up. It was also hypothesized that baseline differences in negative urgency between BN and PD would remain at follow-up. Secondary analyses were conducted on a sample of women who engaged in recurrent self-induced vomiting (n = 68; 52.9% BN; 47.1% PD). Women completed diagnostic interviews and questionnaires at baseline and at a mean (SD) of 5.95 (1.58) years follow-up (range = 2.51-9.62; retention rate = 75%). Negative urgency did not predict eating disorder diagnostic status, recovery status, or global eating pathology at follow-up (p's = .06-.83). There were no significant differences in negative urgency across women with BN and PD at follow-up (p = .16). However, post hoc analyses indicated that negative urgency was not stable across time (ICC = .102). Increases in negative urgency from baseline to follow-up were associated with greater global eating pathology at follow-up (p = .002). Results suggest negative urgency does not predict long-term eating disorder maintenance. Negative urgency may not be a stable personality trait but rather an indicator of overall poor emotion regulation. Future research should confirm that changes in negative urgency predict chronic eating pathology over long durations of follow-up in women who have increasing negative urgency across time.

Розлади харчової поведінки дітей внаслідок стресу, спричиненого війною: загальні результати дослідження

The purpose of the study is to determine eating disorders based on the results of a survey of parents and an analysis of the perception of the behavior of children aged 5-17 in conditions of stress caused by war. Research materials and methods. A large-scale cross-sectional survey of parents of school-age children who were in Ukraine at the time of the start of the war (February 24, 2022) was conducted. A total of 5,165 parents took part in the survey. The survey concerned eating disorders and included information about the gender, age, place and conditions of the child's stay, financial support and the family's access to food, general mental manifestations of stress, eating disorders that arose as a result of military operations, changes in the child's physique, etc. The work uses a specially developed questionnaire based on standardized questionnaires about children's stress and eating disorders. This stage of the work determines the peculiarities of the child's whereabouts in relation to military events (staying in occupied territories, in close proximity to hostilities, in peaceful territory, moving within Ukraine or going abroad) and their impact on the eating behavior of school-aged children. The processing of the results included descriptive statistics, as well as the analysis of the relationships of the variables using conjugation tables by calculating the Spearman's rank coefficient and Pearson's chi-square for qualitative variables. The results. It was established that the absence or decrease of appetite, rapid satiety, change in attitude to food are general stress disorders inherent in the entire studied cohort of children. Statistical analysis revealed that the frequency and duration of eating disorders, appetite, delayed satiety, capriciousness or lack of understanding, somato-vegetative manifestations, the formation of disgust or passion for certain food products in school-age children are related to the intensity and nature of the experienced military stress. Being in occupied territories or near hostilities and subsequent displacement has the greatest impact on the frequency and duration of eating disorders. The formation of long-term eating disorders in all groups is actually a deepening of unhealthy eating habits of schoolchildren, which were demonstrated in previous studies. It is expected that these violations will lead to an increase in the frequency of chronic non-communicable diseases in later life. Conclusions. The obtained results are important for the further interpretation of the results in the framework of the study of children's eating disorders under the conditions of stress caused by the war in Ukraine and providing recommendations for the correction of the detected violations. The research has an important social significance for Ukraine, as it is aimed at solving the psychological and medical consequences of the war.

The Association Between Body Mass Index, Emotional Eating and Perceived Stress during COVID-19 Partial Quarantine in Healthy Adults.

We investigated emotional eating behaviours and perceived stress during COVID-19 partial quarantine according to BMI levels in healthy adults. Cross-sectional study. An online survey including demographic variables, eating attitude-related questions, Emotional Eater Questionnaire (EEQ) and Perceived Stress Scale-14 (PSS-14) was sent via online data collection platform. Self-reported weight, height and weight changes during the quarantine were also collected. A total of 506 people aged between 20-65 years who were partially quarantined due to COVID-19 participated in this study. BMI was positively correlated with EEQ (r 0 ·205, P = 0·001). However, BMI was negatively linked with PSS-14 during COVID-19 (r -0·125, P = 0·001), indicating that participants with lower BMI had higher perceived stress during COVID-19. Participants gained weight during the lockdown situation (+1·20 ± 1·70 kg in men; +0·91 ± 1·40 kg in women). EEQ and PSS-14 scores of women found to be significantly higher than men (9·39 ± 5·37 in men v. 11·17 ± 5·85 in women for EEQ; 24·67 ± 8·32 in men v. 27·99 ± 7·34 in women for PSS-14). Obese participants consumed sweetened and carbonated drinks two-fold more in those compared with other participants. These findings suggest that partial quarantine may be closely related to emotional eating and weight gain, and participants with higher BMI showed more emotional eating behaviours. Therefore, certain precautions should be considered beforehand in order not to cause long-term eating disorder problems.

Cognitive impairment in eating disorder patients of short and long-term duration: a case-control study.

Introduction: Several studies have noted the potentially negative effect of eating disorders (ED) on cognitive performance.Objective: To compare the impact of the duration of abnormal eating behaviors on cognitive performance in a sample of people with short- and long-term eating disorders and in two control groups matched for age.Method: The neuropsychological performance of 82 women diagnosed with an eating disorder were compared with two control groups from the community of 66 healthy women. Time of duration of the disorder was less than two years in half of the clinical sample, and more than 10 years in the other half. The following instruments were used to measure neuropsychological performance: the Matrix Test, the Stroop task, the Trail-Making Test, the Tower of London Test, the Posner Spatial Task, the Rey’s Complex Figure, the Wechsler Vocabulary Test, and the Hayling Completion Test.Results: It showed that persons with long-term ED presented more impaired neuropsychological profiles, but not in all areas. In contrast, the short-term ED group presented similar profiles to the control groups.Discussion: This study highlights the positive association between cognitive impairment and time of evolution of ED, above all in perceptual measures and non-verbal memory. Considering the effect of the evolution of ED cognitive performance (especially in long-term patients) may further our understanding of the development of the disorder and the factors that may favor its persistence.

‘The body remembers’: narrating embodied reconciliations of eating disorder and recovery

ABSTRACTAfter severe illness, there are stories: narrative strands to suture discontinuities of identities, practices, and lives. But within these narratives of illness and recovery, the body's discontinuities stand apart, striking in the materiality of change, in the tangible multiplicity of bodies – healthy, ill, recovering, recovered – that a person can call one's own. Based on longitudinal research interviews with Israeli women who identified as recovered from long-term eating disorders (fieldwork conducted in 2005–2006 and in 2011), this paper explores how these bodily discontinuities are expressed, drawing particular attention to the narrative role of embodied memory in linking past and present-tense bodies and selves. Embodied memory, as narrated by the participants, is deeply, sometimes surprisingly, embedded in lived experience, imbuing recovered bodies with moments of sensory continuity, the past coming into presence through forms of sensation and perception learned at the height of disorder. Examining narrative moments of sensory remembrance, this paper analyses how participants narrate embodied memory as a mode of reflection, self-protection, and dynamic integration, wherein the experience of disorder informs practices of recovery, and the body becomes a site for the reconciliation of past and present.

Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa.

Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders.

Severe and enduring anorexia nervosa (SEED-AN): a qualitative study of patients with 20+ years of anorexia nervosa.

Little is known about how patients with long-term eating disorders manage their clinical problems. We carried out a preliminary qualitative study (using Thematic Analysis) of patients with severe and enduring anorexia nervosa (SEED-AN) in which we undertook recorded interviews in eight participants whose conditions had lasted 20-40 years. We found 15 principle features in physical, psychological, social, family, occupational and treatment realms. Psychological and social realms were most affected. Severe physical problems were reported. They described feelings of unworthiness, frugality regarding money and obsessive time-keeping. Persisting with negligible social networks, participants described depression and hopelessness, while somehow achieving a sense of pride at their endurance and survival in spite of the eating disorder. They emphasized the importance of professional help in managing their care. The severe and enduring description, often reserved for people with psychotic illness, is appropriately applied to SEED-AN, which has major impacts in all realms.

Rhythm and Semiotic Structures of Long-Term Ambivalence in the Dialogical Self: Eating Disorder and Recovery Voices

Ambivalence in the dialogical self is conceptualized as resistance to change. The cyclic processes that characterize ambivalence are seen to maintain a balance between opposing voices, producing dynamic stability in the self-system. What has not been incorporated in the study of ambivalence so far is consideration of structural levels from which the opposing voices are speaking. This prompted the present case study of long-term eating disorder ambivalence, which joins a consideration of semiotic system structure with process. In interviews with a young woman conducted over a three-year period, cyclic processes of eating disorder and recovery voices were pervasive, yet structural analysis of the subsystems and their transactions suggested that change was actually occurring in this presumably change-resistant system, pointing to a need for reconceptualizing ambivalent systems in relation to development.

A system of evidenced‐based techniques and collaborative clinical interventions with a chronically ill patient

Although evidence-based treatments (EBTs) exist for both bulimia nervosa and binge eating disorder, there is far less evidence underpinning the treatment of anorexia nervosa (AN). Furthermore, there is no clearly defined standardized approach to patients who have not responded to treatment over an extended period of time. Chronic eating disorder patients in particular might need long-term engagement with treatment providers offering a wide range of interventions. This case study highlights how an experienced private practitioner systematically employed a variety of EBT techniques for a patient with a severe, long-term eating disorder and its comorbidities, within a model of attachment and collaboration. The practice of utilizing a wide variety of EBT techniques in a systematic manner guided by clinical expertise and supported by a therapy relationship of collaboration and attachment may prove to be a fruitful avenue for future research.

Sudden death in eating disorders

Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds) must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.

Orthodontic / Prosthetic Treatment of Enamel Erosion Resulting from Bulimia: A Case Report

Orthodontic treatment was necessary before maxillary incisors, eroded as a result of a long-term eating disorder, could be restored. A removable maxillary bite plane appliance was developed to open the bite, while cosmetically covering the facial surfaces of the incisors.