Explanatory models for eating disorders have changed over time to account for changing clinical presentations. The transdiagnostic model evolved from the maintenance model, which provided the framework for cognitive behavioural therapy for bulimia nervosa. However, for many individuals (especially those at the extreme ends of the weight spectrum), this account does not fully fit. New evidence generated from research framed within the food addiction hypothesis is synthesized here into a model that can explain recurrent binge eating behaviour. New interventions that target core maintenance elements identified within the model may be useful additions to a complex model of treatment for eating disorders.

Oxytocin reduces energy intake when administered as a single dose. Oxytocin can inhibit feeding over two- to three-week periods in rodent models. These effects typically do not persist beyond the third week of treatment. The anorexigenic effect of oxytocin is moderated by pregnant status, dose, method of administration, and diet composition. This article is protected by copyright. All rights reserved.

Objectives The COVID‐19 pandemic is having considerable impact on cancer care, including restricted access to hospital‐based care, treatment and psychosocial support. We investigated the impact on unmet needs and psychosocial well‐being. Methods One hundred and forty four participants (77% female), including people with cancer and their support networks, were recruited. The most prevalent diagnosis was breast cancer. Forty‐one participants recruited pre‐pandemic were compared with 103 participants recruited during the COVID‐19 pandemic. We measured participants' unmet supportive care needs, psychological distress and quality of life. Results Half of our patient respondents reported unexpected changes to treatment following pandemic onset, with widespread confusion about their longer‐term consequences. Although overall need levels have not increased, specific needs have changed in prominence. People with cancer reported significantly reduced anxiety (p = 0.049) and improved quality of life (p = 0.032) following pandemic onset, but support network participants reported reduced quality of life (p = 0.009), and non‐significantly elevated anxiety, stress and depression. Conclusion Psychological well‐being of people with cancer has not been detrimentally affected by pandemic onset. Reliance on home‐based support to compensate for the lost availability of structured healthcare pathways may, however, explain significant and detrimental effects on the well‐being and quality of life of people in their support and informal care networks.

Objective: In the current economic context, it is critical to ensure that eating disorder (ED) treatments are both effective and cost-effective. We describe the impact of a novel clinical pathway developed to better meet the needs of autistic patients with EDs on the length and cost of hospital admissions. Method:The pathway was based on the Institute for Healthcare's Model of Improvement methodology, using an iterative Plan, Do, Study, Act format to introduce change and to co-produce the work with people with lived experience and with healthcare professionals. We explored the change in length and cost of admissions before and after the pathway was introduced.Results: Preliminary results suggest that the treatment innovations associated with this pathway have led to reduced lengths of admission for patients with the comorbidity, which were not seen for patients without the comorbidity.Estimated cost-savings were approximately £22,837 per patient and approximately £275,000 per year for the service as a whole. Conclusion:Going forward, our aim is to continue to evaluate the effectiveness and cost-effectiveness of investment in the pathway to determine whether the pathway improves the quality of care for patients with a comorbid ED and autism and is good value for money.

People with anorexia nervosa (AN) commonly exhibit social difficulties, which may be related to problems with understanding the perspectives of others, commonly known as Theory of Mind (ToM) processing. However, there is a dearth of literature investigating the neural basis of these differences in ToM and at what age they emerge. This study aimed to test for differences in the neural correlates of ToM processes in young women with AN, and young women weight-restored (WR) from AN, as compared to healthy control participants (HC). Based on previous findings in AN, we hypothesized that young women with current or prior AN, as compared to HCs, would exhibit a reduced neural response in the medial prefrontal cortex (mPFC), the inferior frontal gyrus, and the temporo-parietal junction (TPJ) whilst completing a ToM task. We recruited 73 young women with AN, 45 WR young women, and 70 young women without a history of AN to take part in the current study. Whilst undergoing a functional magnetic resonance imaging (fMRI) scan, participants completed the Frith-Happé task, which is a commonly used measure of ToM with demonstrated reliability and validity in adult populations. In this task, participants viewed the movements of triangles, which depicted either action movements, simple interactions, or complex social interactions. Viewing trials with more complex social interactions in the Frith-Happé task was associated with increased brain activation in regions including the right TPJ, the bilateral mPFC, the cerebellum, and the dorsolateral prefrontal cortex. There were no group differences in neural activation in response to the ToM contrast. Overall, these results suggest that the neural basis of spontaneous mentalizing is preserved in most young women with AN.

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Successful telehealth business models are a topic of regular discussion in the healthcare industry, and the financial details of telehealth programs, initiatives, and companies are central to program viability and sustainability. Claims and total payments toward telehealth services are rapidly increasing each year; therefore, it is becoming imperative that organizations carefully navigate the regulatory, financial, operational, and technical aspects impacting, and many times determining, the financial health of telehealth programs. The objective of this article is to define and articulate the financial variables and business models that are the lifeblood of today’s successful telehealth programs, and also to provide insights and information to assist organizations in navigating the nuances of telehealth financial modeling, monitoring, and management. The financial and business models surrounding telehealth are unique for a number of reasons, mainly because the calculations and architecture of such models often contain many continuous variables, such as people (clinical providers and patients), geography (rural or metropolitan areas), telehealth governance structure, the service provided, the reimbursement or coverage eligibility, the technology used, the quality of care rendered, and the outcome of the care rendered. In addition, a clear need for a departure from traditional ways of projecting return on investment (ROI) becomes apparent with the layering of additional complexities of restrictive payer requirements, various business models, and the transition from volume to value.

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