Tetyana

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  • April 19, 2014
  • 12:46 AM
  • 26 views

Energy Expenditure (Calories Burned) in Anorexia Nervosa Patients

by Tetyana in Science of Eating Disorders


How many calories do patients with anorexia nervosa need to eat to gain a kilo (2.2 lbs)? It seems like a simple question and one that we should have figured out a long time ago, given the importance (err, necessity) of refeeding and weight restoration in recovery from anorexia nervosa.
Unfortunately, research in this area has often led to contradictory results (see Salisbury et al., 1995 and de Zwaan et al., 2002 for reviews). Fortunately, a paper by Stephan Zipfel and colleagues (2013,........ Read more »

Zipfel S, Mack I, Baur LA, Hebebrand J, Touyz S, Herzog W, Abraham S, Davies PS, & Russell J. (2013) Impact of exercise on energy metabolism in anorexia nervosa. Journal of Eating Disorders, 1(1), 37. PMID: 24499685  

  • March 5, 2014
  • 11:25 PM
  • 124 views

Eating Disorder Awareness Week: Useful, Useless, or Worse?

by Tetyana in Science of Eating Disorders


National Eating Disorder Awareness Week came and went (in the US, anyway). Posters were shared, liked, and tweeted. Pretty (but often misguided) infographics made the rounds on the internet. Local ED groups visited schools and college campuses to educate students about eating disorders. To, you know, increase awareness. 
The thing is, awareness is not always a good thing. For one, as Carrie over at ED Bites mentioned, there’s a whole lot of misinformation masquerading as fact. An........ Read more »

  • February 19, 2014
  • 10:43 PM
  • 151 views

Eating Disorders and Irritable Bowel Syndrome

by Tetyana in Science of Eating Disorders


Eating disorder patients commonly complain of gastrointestinal (GI) symptoms including bloating, abdominal pain, and constipation. This is, of course, not surprising. After all, disordered eating behaviours such as self-induced vomiting, laxative abuse, and restriction are bound to have negative effects on the digestive system.
But just how common are GI complaints and functional gastrointestinal disorders (FGIDs) like irritable bowel syndrome among ED patients? And is there more to the r........ Read more »

  • February 4, 2014
  • 09:48 PM
  • 137 views

Setting a Target Weight: An Arbitrary Exercise?

by Tetyana in Science of Eating Disorders


Achieving a healthy weight is a major goal of anorexia nervosa treatment. Indeed, a healthy weight is often seen as a prerequisite for psychological recovery. The fact that weight restoration is a crucial component of recovery is uncontroversial, the problem arises when it comes to determining what constitutes a healthy weight. How are ideal, optimal, or goal weights set? And who gets to decide?
Despite its recognized importance, there’s surprisingly little consensus on how target w........ Read more »

  • January 18, 2014
  • 11:04 PM
  • 185 views

Enraged by Sounds: Misophonia in Eating Disorder Patients (Clinicians, Listen Up)

by Tetyana in Science of Eating Disorders


Few people would claim to like the sound of chewing, lip smacking, or pen clicking. But while disliking these noises is commonplace, experiencing anxiety, panic and/or rage in response to them–a condition called misophonia (hatred of sound)–is not.
Well, truth be told, we don’t actually know how common it is: Searching “misophonia” in PubMed returns just 14 results. Seven were published in 2013/2014, and only three were published prior to 2010. (Searching........ Read more »

  • January 13, 2014
  • 10:53 AM
  • 180 views

Examining Mandometer(r) Founders’ 10 “Reasons” Why Eating Disorders Are Not Mental Disorders – Part II

by Tetyana in Science of Eating Disorders


This is the last post in my mini-series on the Mandometer® Treatment. (Links to earlier posts here: Part I, Part II, and Part III). In this post I’m going to continue examining Bergh et al.’s reasons for why eating disorders are not mental disorders (#6-10). In my last post I omitted something important: I didn’t define mental disorders, but to avoid repeating myself, please see my comment on the topic here.
Bergh et al.’s reason #6 why EDs are not mental disorder........ Read more »

Bergh C, Callmar M, Danemar S, Hölcke M, Isberg S, Leon M, Lindgren J, Lundqvist A, Niinimaa M, Olofsson B.... (2013) Effective treatment of eating disorders: Results at multiple sites. Behavioral Neuroscience, 127(6), 878-89. PMID: 24341712  

  • January 8, 2014
  • 10:00 AM
  • 208 views

Examining Mandometer(r) Founders’ 10 “Reasons” Why Eating Disorders Are Not Mental Disorders

by Tetyana in Science of Eating Disorders


This is Part III of my mini-series on the Mandometer® treatment. In my first post, I wrote about the history and rationale of the Mandometer® treatment. In my second post, I evaluated a recent study published by the creators of Mandometer® (Bergh et al., 2013); I wanted to see whether their data supported their claims (spoiler alert: it didn’t). In this post, I’m going to focus on the first five of Bergh et al.’s ten reasons why eating disorders are not mental disorders........ Read more »

Bergh C, Callmar M, Danemar S, Hölcke M, Isberg S, Leon M, Lindgren J, Lundqvist A, Niinimaa M, Olofsson B.... (2013) Effective treatment of eating disorders: Results at multiple sites. Behavioral Neuroscience, 127(6), 878-89. PMID: 24341712  

  • December 30, 2013
  • 11:22 AM
  • 217 views

The Finest Quality Snake Oil: Mandometer(r) Treatment for Eating Disorders – Part II

by Tetyana in Science of Eating Disorders


This is Part II of my mini-series on the Mandometer(r) treatment for eating disorders (link to Part I). In Part I, I provided some background on the Mandometer(r) treatment; in this post, I want to take an in-depth look at the recent Mandometer treatment study. My main goal is to see whether their data live up to their claims. Warning: This post may contain high levels of snark.  
Their main claims? This is from the abstract:
Sounds pretty good, right? (Note the use of the word “........ Read more »

Bergh C, Callmar M, Danemar S, Hölcke M, Isberg S, Leon M, Lindgren J, Lundqvist A, Niinimaa M, Olofsson B.... (2013) Effective treatment of eating disorders: Results at multiple sites. Behavioral neuroscience, 127(6), 878-89. PMID: 24341712  

  • December 24, 2013
  • 08:05 PM
  • 225 views

The Finest Quality Snake Oil: Mandometer(r) Treatment for Eating Disorders – Part I

by Tetyana in Science of Eating Disorders


PROTIP: When selling your snake oil treatment, try NOT to make wildly outrageous efficacy claims. But if you can’t resist that temptation, try to limit your hard-to-believe, eye-roll-inducing claims to your treatment — there’s no need to go further.
In this post, I’m going to give a brief history of the Mandometer® treatment and its apparent rationale. In the next one or two posts, I will do an analysis of the most recently study by the group that claims to show r........ Read more »

Bergh, C., Eklund, S., Eriksson, M., Lindberg, G., & Sodersten, P. (1996) A new treatment of anorexia nervosa. . The Lancet, 611-612. DOI: 10.1016/S0140-6736(05)64824-6  

Bergh C, Callmar M, Danemar S, Hölcke M, Isberg S, Leon M, Lindgren J, Lundqvist A, Niinimaa M, Olofsson B.... (2013) Effective treatment of eating disorders: Results at multiple sites. Behavioral neuroscience, 127(6), 878-89. PMID: 24341712  

  • October 25, 2013
  • 07:10 PM
  • 278 views

The Sobering Reality (and the Silver Lining) of Treating Anorexia Nervosa in Adults: A Randomised Controlled Trial

by Tetyana in Science of Eating Disorders


The challenges of treating anorexia nervosa are plenty; some of these challenges — like low prevalence rate and high treatment dropout rate —  make conducting randomised controlled trials aimed at identifying effective treatment methods really hard as well.
So I was pretty excited about the recently published randomised controlled trial comparing focal psychodynamic therapy (FPT), cognitive behaviour therapy (CBT), and optimised treatment as usual in adult (a harder to treat ........ Read more »

  • October 21, 2013
  • 01:12 PM
  • 244 views

How you doin’? Differences in Psychological Well-being Between Anorexia, Bulimia, and Binge Eating Disorder Patients

by Tetyana in Science of Eating Disorders


Good health is more than just the absence of illness; it is more than just the absence of dysfunction. Good health — that is, mental, social, and physical health — requires the presence of wellness, or the ability to function well.
In this respect, with regard to eating disorders, most research has focused on assessing (health-related) quality of life and subjective well-being of eating disorder patients, often focusing on things like body satisfaction, self-este........ Read more »

Tomba E, Offidani E, Tecuta L, Schumann R, & Ballardini D. (2013) Psychological well-being in out-patients with eating disorders: A controlled study. International Journal of Eating Disorders. PMID: 24123214  

  • September 22, 2013
  • 11:33 PM
  • 198 views

Cognitive-Behavioural Therapy for Bulimia Nervosa in the “Real World”: What’s the Evidence?

by Tetyana in Science of Eating Disorders


Cognitive-behavioural therapy (CBT) is commonly described as the evidence-based treatment for bulimia nervosa. But do the findings from nearly perfectly crafted trials, with stringently followed protocols and “ideal” participants apply to the “real world”? How generalizable are the findings from carefully selected participants to clinical populations where, for one, the prevalence of psychiatric comorbidities is relatively high?
In other words, CBT has been shown to be efficacious ........ Read more »

  • September 18, 2013
  • 11:49 AM
  • 264 views

Demystifying the Genetic and Environmental Influences on Disordered Eating

by Tetyana in Science of Eating Disorders


Genetics play an important role in the development of eating disorders and disordered eating behaviours. To date, many (over 30!) twin studies have been done and all but two found significant genetic effects on the development of eating disorders and disordered eating. However, no methodology is without limitations and tentative conclusions become more convincing when the findings are confirmed using different experimental approaches.
Twin studies, while they offer many advantages, are n........ Read more »

Klump KL, Suisman JL, Burt SA, McGue M, & Iacono WG. (2009) Genetic and environmental influences on disordered eating: An adoption study. Journal of Abnormal Psychology, 118(4), 797-805. PMID: 19899849  

  • September 11, 2013
  • 10:58 AM
  • 291 views

Emotion Fluctuations in Anorexia and Bulimia Nervosa: A Rollercoaster or Not So Much?

by Tetyana in Science of Eating Disorders


Restricting, bingeing, and purging are powerful ways to regulate emotional states. However, these behaviours probably play different roles in emotional regulation. Whereas restriction is hypothesized to pre-empt the onset of highly emotional states, bingeing and purging is thought to act as a coping mechanism to deal with overwhelming emotional states once they’ve already been activated. 
If this is true, we would expect to see more variability (or fluctuation) in the intensity and ........ Read more »

  • September 4, 2013
  • 12:10 AM
  • 257 views

The Benefits of Starving – Part II (Restricting Reduces Anxiety in Anorexia Nervosa)

by Tetyana in Science of Eating Disorders


What is different about anorexia nervosa sufferers that, in contrast to most dieters, enables them to maintain a persistent calorie deficit? Although no one can truthfully claim they know the full answer to that question, we do know that part of the answer most likely lies with serotonin (5-HT), a molecule that neurons use to communicate with each other.
I’ve written about serotonin in the context of anorexia nervosa before, so I’ll just do a brief summary of the impor........ Read more »

Kaye WH, Barbarich NC, Putnam K, Gendall KA, Fernstrom J, Fernstrom M, McConaha CW, & Kishore A. (2003) Anxiolytic effects of acute tryptophan depletion in anorexia nervosa. The International Journal of Eating Disorders, 33(3), 257. PMID: 12655621  

  • August 9, 2013
  • 08:49 AM
  • 317 views

CCK and the “Hunger Trap” in Anorexia Nervosa (Why Gaining Weight is Hard)

by Tetyana in Science of Eating Disorders


Cholecystokinin (CCK) is a digestive hormone that stimulates fat and protein digestion, and promotes the feeling of satiety. CCK is released after food consumption to promote digestion (by releasing digestive enzymes from the pancreas and stimulating bile secretion). In rats and monkeys, injection of CCK induces satiety, though it seems (from what I’ve skimmed), the extent to which CCK regulates food intake in humans is not well-established. Previous research on the role of CCK in a........ Read more »

Cuntz U, Enck P, Frühauf E, Lehnert P, Riepl RL, Fichter MM, & Otto B. (2013) Cholecystokinin revisited: CCK and the hunger trap in anorexia nervosa. PloS ONE, 8(1). PMID: 23349895  

  • July 20, 2013
  • 06:18 PM
  • 369 views

Why Banning Pro-Ana is a Bad Idea

by Tetyana in Science of Eating Disorders


Is banning content that is thought to “promote” eating disorders such as anorexia nervosa (pro-ana) a good idea? I want to put aside the question of whether the goal is even possible (I would argue that it is not) and focus instead on what might happen if pro-ana content is banned or threatened to be banned from mainstream social networks, blogging platforms, and web hosts.
If you only read mainstream news media, you might think that pro-eating disorder websites are evil commun........ Read more »

  • July 7, 2013
  • 09:43 PM
  • 392 views

The Enigmatic Persistence of Anorexia Nervosa

by Tetyana in Science of Eating Disorders


Anorexia nervosa was first described in the medical literature in 1689 by Richard Morton. It has been over 300 years since then and AN continues to be one of the deadliest psychiatric disorders. If not treated early, it runs the risk of becoming deeply entrenched and highly resistant to treatment.
Moreover, established treatments for related disorders like bulimia nervosa and depression, such as cognitive behavioural therapy and antidepressants, are rather ineffective in treating anorexia ........ Read more »

Walsh BT. (2013) The enigmatic persistence of anorexia nervosa. The American Journal of Psychiatry, 170(5), 477-84. PMID: 23429750  

  • June 28, 2013
  • 02:21 PM
  • 317 views

Comorbid PTSD and Eating Disorders: Can Treating One Improve The Other?

by Tetyana in Science of Eating Disorders


Women with bulimia nervosa are three times more likely to struggle with PTSD than women without eating disorders, according to a study by Dansky and colleagues (1997). In that study, 37% of individuals with bulimia nervosa had lifetime PTSD, compared to 12% of women without eating disorders. That’s almost two in five.
Treating eating disorders is hard, but treating eating disorders with comorbid conditions is way harder. There is no consensus, it seems, as to what disorder(s) to tre........ Read more »

Mitchell KS, Wells SY, Mendes A, & Resick PA. (2012) Treatment improves symptoms shared by PTSD and disordered eating. Journal of Traumatic Stress, 25(5), 535-42. PMID: 23073973  

  • June 21, 2013
  • 11:47 AM
  • 367 views

Calorie Restriction, Anorexia Nervosa, and Memory Gaps

by Tetyana in Science of Eating Disorders


I have often heard anorexia nervosa sufferers complain of “memory gaps,” particularly during the times they were really sick. As if they weren’t really there.  It can be scary and unnerving, to say the least. A few months ago, a Tumblr user asked me about this:
I researched the question a bit myself and what was meant to be a short responses turned into a 1,000+ word answer.
In this post I’ll expand on my answer, and so it will be different from what I usually ........ Read more »

Witte AV, Fobker M, Gellner R, Knecht S, & Flöel A. (2009) Caloric restriction improves memory in elderly humans. Proceedings of the National Academy of Sciences of the United States of America, 106(4), 1255-60. PMID: 19171901  

Nikendei C, Funiok C, Pfüller U, Zastrow A, Aschenbrenner S, Weisbrod M, Herzog W, & Friederich HC. (2011) Memory performance in acute and weight-restored anorexia nervosa patients. Psychological medicine, 41(4), 829-38. PMID: 20529417  

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