BackgroundEarly detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals–representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery.MethodsOne-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants’ levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders.ResultsSignificant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about eating disorders.DiscussionThe results of this study demonstrated that the online training program was an effective tool in increasing health professionals’ level of knowledge, skill and confidence to treat people with eating disorders. The results also demonstrated that online training reduced health professionals’ personal bias towards people with eating disorders. Limitations of this study include the use of self-report measures rather than observation of the health professional in clinical practice. As a result, it is not possible to make determinations regarding the translation of these results to clinical settings.ConclusionsThe findings of this study suggest that online training programs may present an innovative solution to the considerable workforce development challenges faced by clinicians needing training in eating disorders.

Anorexia nervosa (AN) is an intractable illness that is difficult to treat. The identification of neural correlates and novel agents to transform treatment has become priority avenues for research. Oxytocin (OT) is a neuropeptide whose emerging sphere of influence on mammalian behaviour and demonstrated impact on psychiatric illness suggest it may have potential in AN. In this paper, we undertake a targeted summary of the existing literature on OT research as it pertains to brain based behaviour and psychiatric dysfunction. Then, we conduct a systematic review of OT in AN. Papers that addressed any aspect of the OT system in AN were examined. The existing literature, although limited and based on small sample sizes, suggests a derangement of the OT system in AN that may normalise upon recovery. Preliminary pilot data from unpublished studies suggest a potential effect of OT administration on eating-related indices.

IntroductionNutritional rehabilitation in anorexia nervosa (AN) is impeded by fear of food, eating and change leading to treatment resistance. Oxytocin exerts prosocial effects on anxiolysis, fear modulation, trust and brain plasticity.ObjectiveA placebo-controlled RCT examined the effects of self-administered intranasal oxytocin (IN-OT) in AN patients.AimTo ascertain whether single and repeated doses of IN-OT enhance treatment in AN.MethodsFemale AN patients self-administered twice daily 18IU IN-OT (n = 21) or placebo (n = 21) for 4–6 weeks during hospital treatment. Weight and BMI were measured at baseline and after treatment. The Eating Disorders Examination (EDE) was the primary outcome measure. Cognitive rigidity was compared between groups after four weeks repeated dosing. The effects of the first and last doses of IN-OT versus placebo, on salivary cortisol before a high-energy afternoon snack, were compared.ResultsWeight gain was similar in IN-OT and placebo groups. Only the EDE eating concern subscale score was significantly lower after 4–6 weeks (mean 35 days) of IN-OT (p = 0.006). Anticipatory levels of salivary cortisol fell from baseline after the initial dose in contrast to the placebo group where levels increased. After four weeks IN-OT, salivary cortisol was significantly lower (p = 0.023) overall with little anticipatory increase compared to placebo. There were no differences in anxiety scores. Cognitive rigidity was significantly lower in the IN-OT group (p= 0.043)ConclusionsSelf-administered IN-OT might enhance nutritional rehabilitation in AN by reducing eating concern and cognitive rigidity. Lower salivary cortisol before a high-energy snack, suggests reduction of fear rather than anxiety.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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