“I am the embodiment of an anorexic patient's worst fear”: Severe obesity and binge eating disorder on a restrictive eating disorder ward

Matthews, Kaitlyn N.; Psihogios, Maria; Dettmer, Elizabeth; Steinegger, Cathleen; Toulany, Alène

doi:10.1111/cob.12398

Cited by 6 publications

(4 citation statements)

References 12 publications

(19 reference statements)

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“…Considering binge eating is part of BN’s diagnostic criteria, 6 it is particularly surprising to see the lack of binge eating discussion among the #miarecovery videos. This likely aligns with how treatment centers tend to emphasize disrupting restrictive behaviors and place a smaller focus on disrupting binge eating behaviors outside of BED specific treatment [ 64 ]. Furthermore, it may align with an avoidance of discussing binge eating due to the shame associated with it [ 65 ].…”

Section: Discussionmentioning

confidence: 69%

Visions of recovery: a cross-diagnostic examination of eating disorder pro-recovery communities on TikTok

et al. 2023

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Individuals seeking support or inspiration for eating disorder recovery may turn to pro-recovery content on social media sites such as TikTok. While research has thus far treated pro-recovery social media as a fairly homogeneous space, many pro-recovery hashtags single out particular eating disorder diagnoses. This exploratory study used codebook thematic analysis of 241 popular pro-recovery videos on TikTok to compare the presentation of eating disorders and eating disorder recovery across five different diagnosis-specific hashtags: #anarecovery, #arfidrecovery, #bedrecovery, #miarecovery, and #orthorexiarecovery. These hashtags refer to the following eating disorder diagnoses respectively: anorexia nervosa, avoidant restrictive food intake disorder, binge eating disorder, bulimia nervosa, and orthorexia nervosa. Our analysis generated the following qualitative themes across the entire dataset: (1) centrality of food to eating disorders and recovery, (2) what eating disorders look and feel like, (3) recovery as a process, (4) getting and giving help, and (5) negotiating diet culture in recovery. To supplement our qualitative findings and facilitate cross-diagnostic comparisons, we also conducted one-way ANOVAs and chi-square tests to probe for statistically significant differences in audience engagement and code prevalence across the different hashtags. Our results indicate that there are clear differences in how recovery is envisioned on TikTok based on which diagnostic hashtags are employed. Such variations in how different eating disorders are imagined on popular social media demand further investigation and clinical consideration.

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Section: Discussionmentioning

confidence: 69%

Visions of recovery: a cross-diagnostic examination of eating disorder pro-recovery communities on TikTok

et al. 2023

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“…However, there is a lack of appropriate care options for youth with disordered eating disorder and/or severe obesity, which highlights possible inequities in care. 35 Given the increasing prevalence of obesity and mental illness in adolescents, it is critical to create the evidence needed to support these treatment models of care for youth.…”

Section: Discussionmentioning

confidence: 99%

Development and Implementation of a Pilot Integrative Day Hospital Program for Youth with Severe Obesity and Mental Health Issues

et al. 2021

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Background: Adolescents with severe obesity and comorbid mental health issues are the most resistant to traditional weight management approaches and have poor treatment outcomes. Our objective was to implement and evaluate a pilot day hospital treatment program for adolescents with severe obesity, or risk for severe obesity, and significant mental health comorbidities.Methods: This was a prospective cohort study of adolescents 12-18 years of age with severe obesity (BMI >99th percentile), or at risk for severe obesity, and comorbid mental health issues. The intervention, focused on healthy lifestyle and mental health support, was implemented within an existing psychiatric day hospital at a pediatric quaternary care hospital. Anthropometric and mental health measures were analyzed pre-and postintervention.Results: Thirty-two adolescents with a mean age of 14.9 years [standard deviation (SD) 1.6] participated in the pilot integrative day hospital program for a mean duration of 5.2 months (SD 2.3). Eleven participants had primary severe obesity and comorbid mental health conditions (obesity subgroup) and 21 participants had primary mental illness and were at risk for obesity (psychiatry subgroup). We did not observe a significant difference between BMI pre-and postprogram among adolescents in both subgroups. In other words, adolescents in both subgroups achieved weight maintenance. Fear in losing control of overeating and/or being seen by others when eating decreased significantly in the obesity subgroup [mean difference (MD) 0.99; 95% confidence interval (CI): 0.27 to 1.71]. There was a significant decrease in participant-reported depression symptom severity, both overall and within program subgroups. Quality-of-life scores of study participants improved significantly within the obesity subgroup (MD -12.31; 95% CI: -21.69 to -2.93), but not within the psychiatry subgroup (MD -6.35; 95% CI: -13.37 to 0.67).Conclusions and Implications: A day hospital model of care may result in weight maintenance, decreased eating concerns, and improved mental health in adolescents with severe obesity or risk for severe obesity, and significant mental health comorbidities.

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“…The BETR program is designed to specifically serve the needs of patients struggling with BESD. A case report suggested that having patients with BESD participate in treatment programs designed primarily for restrictive eating disorders may be problematic due to differing foci of weight restoration versus normalizing eating patterns, as well as patients’ comparisons to other patients, which can be detrimental to recovery [ 24 , 25 ]. Although there is little empirical evidence to support this, a study of intensive treatment specifically for patients reporting episodes of overeating (patients with BN, BED, or obesity without binge eating) found improvements in eating disorder psychopathology after 5 weeks, suggesting that targeted specialty care may be more effective and more efficient than general eating disorder treatment programs that address a wide range of symptomatology [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

Treatment Outcome for Adults in a Residential Program for Binge Eating Spectrum Disorders: Protocol for a Prospective Pragmatic Single-Arm Trial

Rienecke¹,

Blalock²,

Mills³

et al. 2022

JMIR Res Protoc

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Background Most studies reporting treatment outcomes for eating disorders at higher levels of care focus on anorexia nervosa and bulimia nervosa. No studies have been published with a singular focus on examining treatment outcomes for adults receiving residential programming specifically designed for the treatment of binge eating spectrum disorders (BESD), including binge eating disorder and bulimia nervosa. Objective The purpose of this paper is to outline the protocol of a prospective study examining treatment outcomes at discharge and 3-month, 6-month, and 12-month postdischarge follow-up, for a sample of consecutive admissions to a residential program specifically for patients with BESD. Methods One hundred consecutive admissions to a binge eating treatment program were enrolled in the prospective single-arm trial between January 2019 and February 2020. Data were collected at admission, discharge, and 3, 6, and 12 months postdischarge, with admission, discharge, and 12-month follow-up as the major timepoints of interest. Results across the major timepoints will be analyzed with mixed effects general linear models. Results The primary aim is to assess the impact of the program on eating disordered behaviors at discharge and 12-month follow-up, which are hypothesized to improve as a result of treatment. Secondary hypotheses include improvements on comorbid symptoms, including trauma, depression, and obsessive-compulsive symptoms, as well as improvements on medical indicators of health, including cholesterol and triglycerides, at discharge and 12-month follow-up. Conclusions This study may aid in the development of treatment guidelines for patients with BESD at higher levels of care and lend support to having specialty treatment programs for patients with BESD. International Registered Report Identifier (IRRID) DERR1-10.2196/32270

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“I am the embodiment of an anorexic patient's worst fear”: Severe obesity and binge eating disorder on a restrictive eating disorder ward

Cited by 6 publications

References 12 publications

Visions of recovery: a cross-diagnostic examination of eating disorder pro-recovery communities on TikTok

Visions of recovery: a cross-diagnostic examination of eating disorder pro-recovery communities on TikTok

Development and Implementation of a Pilot Integrative Day Hospital Program for Youth with Severe Obesity and Mental Health Issues

Treatment Outcome for Adults in a Residential Program for Binge Eating Spectrum Disorders: Protocol for a Prospective Pragmatic Single-Arm Trial

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