Integrative Management of Disordered Eating

Fahs, Deborah B.; Krause, Robert; Tusaie, Kathleen R.

doi:10.1891/9780826132529.0012

Cited by 1 publication

(1 citation statement)

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“…*Treat comorbid psychiatric disorders (Aziz, 2017) Review [ 49 ] GQ 67 (F) AN (AT) *BMI 14 *Restriction of food intake *Other symptoms: felt full, not hungry, affect indifferent and lacked drive *Psychotherapy *Support from local eating disorders services *BMI reached 16.5 As above (Aziz, 2017) Review [ 49 ] GQ 89 (F) AN *BMI 14 *Restriction of food intake *ADT antidepressant medication *Responded to this as above (Zayed, 2017) Report PQ [ 11 ] 66(F) AN *BMI 17.5 *Fear of gaining weight *Body image disturbance *Restriction of food intake *Denial of seriousness of current low body weight *Physical complications: oedema, ECG changes, pathology changes (low haematocrits, glucose, calcium, protein, albumin) *Enteral feeding *Developed refeeding syndrome, with multi-organ failure resulting in death *Combination of both behavioural and pharmacological treatment found to be most successful. (Hasan, 2017) Case report [ 50 ] PQ 76 (F) AN *Restriction of food intake *Fear of gaining weight *Body image disturbance *CBT (with exposure and response modification): 8 weeks *Group programming (experiential therapy, nutrition, nursing) *Psychoeducation (body image & nutrition education) *Dietitian and meal plan *Managing physical complications *Venlafaxine 187.5 mg daily *Gained 17 lbs *Increased caloric intake *Home health nurse to help with managing medications *Support for the use of exposure-based CBT, coupled with behavioural activation, medical consultation (Fahs, 2013) Book Chapter [ 51 ] General comments made by author “An older adult generally presents with a greater severity of disordered eating but has fewer body image difficulties. Tend to deny symptoms.…”

Section: Methodsmentioning

confidence: 99%

Treatment of eating disorders in older people: a systematic review

et al. 2021

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Background Historically, eating disorders were not identified in older populations and it is only in more recent times that there is greater recognition of the existence of eating disorders among the elderly. This is despite the high level of morbidity and mortality associated with these disorders. Current guidelines focus on treatment of eating disorders within the adolescent and general adult age groups, without apparent concessions made for the older age group. The aim of this study was to review existing literature on the demographics and treatment of eating disorders in older people. Methods/design A systematic review of the literature was conducted using CINAHL, MEDLINE, EMBASE, PsycInfo, Scopus, and Web of Science to identify publications focusing on treatment of eating disorders in people over the age of 65 years, age of diagnosis, gender distribution, treatment setting, and treatment outcomes. Results A total of 35 articles (reporting on 39 cases) were relevant to our study, with 33 of the 35 articles being either case studies or case series. The mean age of participants was 73.2 years (range 66–94 years) with the majority (84.6%) being female. Most cases (84.6%) were diagnosed with anorexia nervosa, and 56.4% of all cases were reported as late onset (i.e., after age 40 years). The vast majority (94.8%) received treatment, of which 51.5% was hospital-based treatment. In case descriptions where improvement was reported, the majority described a multidimensional approach that included a combination of hospital admission, therapy and pharmacotherapy. Overall, 79.5% of cases who underwent treatment for an eating disorder improved, while 20.5% relapsed or died as a result of the complications from their eating disorder. There were significant inconsistencies and omissions in the way cases were described, thereby impacting on the interpretation of the results and potential conclusions. Conclusions The information available on the treatment of eating disorders in people over the age of 65 years is limited. The quality of case reports to date makes it difficult to suggest specific assessment or treatment guidelines for this population.

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