Coping strategies and binge eating

Researchers from the University of Oviedo in Spain have been looking into the prevalence and causes of binge eating and in particular how people's coping styles affect how likely they are to binge eat. They studied 1,913 children between 12 and 18 who filled out a questionnaire about their eating habits and how they coped with the problems in their life. The study found that 6.94% of the children reported bingeing in the last six months. The adolescents who binged were more likely to blame themselves for their problems and were more introverted while those who used more positive-effortful coping were less likely to binge. The authors of the study concluded that helping teenagers deal with problems more constructively could be a good way of cutting down the rates of bingeing.

Sierra-Baigrie, Susana ... [et al] - Exploring the relationship between coping strategies and binge eating in nonclinical adolescents European Eating Disorders Review DOI: 10.1002/erv.1103

Tackling weight and eating problems in Spanish schools

More and more teenagers have problems with eating and weight, either because they are too fat or because they show signs of developing an eating disorder. Universal prevention programmes are ones which involve boys and girls and are given to everyone in a particular school or year. They aim to improve pupil's body image, their knowledge of eating disorders and reduce shape and weight concern. Researchers from the Universitat Autonoma de Barcelona studied 443 children. 201 formed a control group while 143 took part in a media-literacy programme and 99 in the media-literacy and a nutrition-awareness one as well. The children's attitudes to eating, body weight and nutrition were assessed a month, seven months and 30 months after the programmes. The children who had taken part in both programmes had 'healthier' scores on the assessments than those who hadn't.

Gonzalez, Marcela ... [et al] - Disordered eating prevention programme in schools: a 30-month follow up European Eating Disorders Review DOI: 10.1002/erv.1102

Child abuse and eating disorders

A team of researchers from the Universitat Autonoma de Barcelona have been looking into the links between disordered eating and childhood physical and sexual abuse. They studied 708 female undergraduates aged between 18 and 30 asking them about traumatic events in their past and about their current attitudes to food and their weight. The study found that 14.3% of the sample had suffered childhood sexual abuse and 3.8% childhood physical abuse. The women who had been sexually abused as children were more concerned about weight, however, once depression, anxiety, self-esteem, body-mass index, age and socioeconomic status were taken into account there was no link between sexual abuse and disordered eating behaviours. Childhood physical abuse was associated with a decreased risk of disordered eating and the researchers thought that this was because women who had been physically abused were more concerned with just having a safe, healthy body rather than their weight or physical appearance.

Villarroel, Ana M. ... [et al] - Childhood physical and sexual abuse in Spanish female undergraduates: does it affect eating disturbances? European Eating Disorders Review DOI: 10.1002/erv.1086

Study finds more eating disorders in Muslim girls

Researchers from the University of Granada in Spain have been looking into the prevalence of eating disorders in different cultures. They studied 494 students aged between 12 and 20 from the town of Cueta where 30% of the population is Muslim. They found that the incidence of eating disorders was 2.3x higher among the Muslim youngsters and body dissatisfaction was 80% greater. Overall the study found that one in four of the youngsters had some kind of eating problem and that 15% of them suffered from body dissatisfaction.

Weighing in in anorexia treatment

Weighing people is of crucial importance in anorexia. For something that sounds quite simple there are a number of issues to think about including the privacy and dignity of patients, what they wear while they are being weighed and whether they are able to falsify their weights or not. A team of researchers from the Phoenix Centre in Fulbourn, Cambridgeshire looked into this in a survey of 20 former patients and 98 health professionals. The majority of professionals in outpatient settings said that they weighed patients in normal or light clothing, while in inpatient units the majority said that they weighed patients in underwear. The percentage of patients weighed in underwear who were comfortable with this was double that of those weighed in normal clothing and patients overwhelmingly recommended that weighing should be in underwear; the patients were more concerned with the accuracy of their weight measurement than issues of privacy and dignity. More than half of the ex patients reported having falsified their weights in the outpatient setting and the patients who got weighed in their underwear were just as likely to falsify their weights. The patients who got weighed in clothes falsified their weights by carrying heavy items in their pockets while those who got weighed in their underwear falsified their weights by drinking lots of water before they got weighed.

Jaffa, Tony,  Davies, Sarah and Sardesai, Anagha - What patients with anorexia nervosa should wear when they are being weighed: report of two pilot surveys European Eating Disorders Review
DOI: 10.1002/erv.1093

Lifting the lid on the pro-ana websites

Researchers from the University of Cincinnati have been looking into pro-anorexia social networks and web sites in a piece of qualitative research that found four main themes:

• Staying "true" to the anorexia movement - in which members of social networks or forums "confess" their guilt at eating too much and not exercising enough
• Promoting self-loathing strategies - when web sites encourage postings that involve people's loathing of their bodies and their mental worthlessness and weakness. In pro-anorexia sites these feelings are accepted and not contradicted as they are in other social networks
• Pro-anorexia advising - such as tips on dieting and how to deal with family members who are advising healthy eating
• Pro-anorexia encouragement - affectionate messages that bind the group together and tips and techniques to encourage anorexic behaviour

The researchers carried out their study between October 2006 and May 2007 and most of the members of the sites were thought to be White women or girls between the ages of 13 and 26.

Self portraits and eating disorders

Women who suffer from anorexia and bulimia draw themselves differently from other women. Researchers from the University of Haifa in Israel studied 76 women. 36 had been diagnosed with anorexia or bulimia, 20 had no eating disorders but were overweight and 20 were normal weight. The women with eating disorders drew themselves either with a lager neck, a disconnected neck or no neck at all, they emphasized the mouth more and drew themselves with wider thighs. They also drew themselves either without feet or with disconnected feet. Compared to the women with bulimia the women with anorexia tended to omit breasts from their drawings, draw less defined body lines and draw smaller figures relative to the size of the page.

Theory of Mind and eating disorders

Theory of Mind - how we interpret our own and other people's thoughts and emotions - has become one of the most influential ideas in psychology. It is thought to be deficient in people with autism and some psychologists think that people with eating disorders could also have problems in telling what other people are thinking. Researchers from Oxford University looked into this a bit more in a study of 145 women recruited from among university students and local workplaces. The women were asked aobut four different situations: having an argument with a family member, being on one's own at the end of the day, coming back from a date which didn't go well and moving to a new area. As well as writing about their own reactions to these situations the participants were also asked how an attachment figure (usually their mother) and an acquaintance would have reacted. Those women who had a higher number of eating-disorder symptoms had a 'concretised' understanding of their own emotions, i.e. they were more likely to mention food in their responses even though there was no mention of food in the original vignettes, although they did have a sophisticated understanding of a same-sex acquaintance's emotions. Eating-disorder symptoms were also associated with fewer positive thoughts about oneself but also fewer negative emotions about one's own behaviour. People with eating-disorder symptoms were also more likely to mention food when discussing how a same-sex acquaintance would react.

Warren, Louis and Cooper, Myra J. - Understanding Your Own and Other’s Minds: The Relationship to Eating Disorder Related Symptoms European Eating Disorders Review DOI: 10.1002/erv.1079

Even second-hand TV can increase the risk of eating disorders

The mixed blessings of broadcast television only arrived in Fiji in 1995 which makes it an ideal place to research its effects. Researchers from Harvard Medical School have been looking into the effects of media consumption on eating disorders in adolescent girls there and found that the girls participating in the study did not even need to have a TV at home themselves in order to see a raised risk of eating-disorder symptoms. In fact, by far the biggest factor for eating disorders was how many of a subject's friends and schoolmates had access to TV. By contrast, researchers found that direct forms of exposure, like personal or parental viewing, did not have an independent impact, when factors like urban location, body shape and other influences were taken into account. Higher exposure to TV among a girl's peer group was linked to a 60% increase in the odds of having a high level of eating-disorder symptoms. The study is particularly interesting as Fijian culture traditionally prizes a fuller-figure among women.

Eating disorders and mindfulness

Mindfulness - being aware of the present moment in an open and non-judgmental fashion - has become something incorporated into the treatment of more and more mental-health problems. People with eating disorders often have trouble regulating their emotional, cognitive and physical experiences and an inability to recognise when they feel hungry or full. Natasha Hepworth, who works in a private clinic in Melbourne, Australia, studied the effectiveness of a Mindful Eating Group in a study of 33 patients being treated there. The group was designed to increase the participants' awareness of hunger and satiety cues. After taking part in the group for 10 weeks the participants showed significant improvements in their scores on the Eating Attitudes Test-26 (EAT-26) assessment tool.

Hepworth, Natasha S. - A Mindful Eating Group as an Adjunct to Individual Treatment for Eating Disorders: a Pilot Study Eating Disorders, 19:6–16, 2011

Spending cuts lead to revolving door for eating disorder patients

Spending cuts meant that many people with eating disorders are not admitted to an inpatient treatment programme until their weight has fallen to dangerously low levels. However, there has been little research into whether waiting this long to admit patients can affect their chances of recovering in the long run. Researchers from St George's Hospital in South London studied 82 people with anorexia being admitted to an eating-disorder ward. They found that people's weight when they were admitted to hospital didn't affect how much weight they put on during treatment. However, people who weighed less when they were admitted were kept in hospital no longer than those who were heavier meaning that, although they put on weight at the same rate, they were still lighter when they were discharged and were more at risk of having to go back to hospital within a year.

Sly, Richard and Bamford, Bryony - Why Are We Waiting? The Relationship Between Low Admission Weight and End of Treatment Weight Outcomes European Eating Disorders Review doi: 10.1002/erv.1061

Genes and anorexia

A team of researchers from the Center for Applied Genomics at The Children's Hospital of Philadelphia has been looking into the genetics of anorexia nervosa. They studied 4,736 people, 1,003 of whom had anorexia and compared their genes. The study found that variations in two genes - OPRD1 and HTR1D - increased the risk of developing the condition. However, most scientists think that although genes might increase the risk of developing mental-health problems the true causes of these conditions lie in a combination of genetics and people's upbringing and experiences.

Mothers' mental health and children's feeding problems

Mothers' eating disorders, depression and anxiety are all known to cause feeding difficulties in their children, however, there have been few studies investigating how eating disorders interact with mothers' other mental-health problems to create feeding difficulties in children. A team of researchers from the Institute of Psychiatry, King's College London studied 10,902 women taking part in the long-term Avon Longitudinal Study of Parenting and Children. They found that mothers having an eating disorder had a direct effect on children's feeding problems and also had an indirect effect by making women more depressed and anxious. Having a child with feeding difficulties also increased the mothers' distress over time.

Micali, Nadia ... [et al] - Maternal eating disorders and infant feeding difficulties: maternal and child mediators in a longitudinal general population study Journal of Child Psychology and Psychiatry DOI: 10.1111/j.1469-7610.2010.02341.x

Problem-solving and binge eating

Previous studies have shown that people with eating disorders often have poor interpersonal problem-solving skills and a lot of therapy for these problems aims to improve these skills. However, there has been little research into problem-solving skills in people with binge-eating disorder. Researchers from the University of Freiburg in Germany compared 25 women with binge-eating disorder to 30 women who were overweight but who did not have a problem with binge-eating. The women were tested using a series of scenarios which were designed to measure their problem-solving abilities. These started with a problem and ended up with a solution but the women had to come up with the intervening steps themselves. The scenarios were: an argument with a partner; making friends in a new neighbourhood; being avoided by friends or difficulties with one's boss. The women with binge-eating disorder produced less effective and less specific solutions than the group without them and the worse their solutions were the more likely they were to binge.

Svaldi, J., Dorn, C. and Trentowska, M. - Effectiveness for interpersonal problem-solving is reduced in women with binge eating disorder European Eating Disorders Review doi: 10.1002/erv.1050








Publication History

Article first published online: 19 OCT 2010

Boosting self-esteem in patients with eating disorders

People with eating disorders can often have low self-esteem, difficulties in relating to others and feelings of dissatisfaction about their relationships. A team of researchers from Barcelona looked into the effectiveness of a group-therapy programme, aimed at boosting self-esteem and social skills, in a study of 160 patients attending a day-hospital treatment programme. At the start of the study the patients with bulimia had lower self-esteem and less confidence in their social skills. After eight sessions of therapy both those with bulimia and those with anorexia showed significant improvements in their perceptions of their physical appearance, their self-esteem, their happiness and their sociability with the patients with bulimia showing a greater improvement.

Lazaro, L. ... [et al] - Effectiveness of Self-esteem and Social Skills Group Therapy in Adolescent Eating
Disorder Patients Attending a Day Hospital Treatment Programme European Eating Disorders Review DOI: 10.1002/erv.1054

Anorexia and abortion

Women with anorexia are more likely to have unplanned pregnancies and abortions. Researchers from the University of North Carolina at Chapel Hill, and from Norway, studied 62,060 women as part of the Norwegian Mother and Child Cohort Study. They found that 50% of the women with anorexia reported having an unplanned pregnancy, compared to 18.9% of the women without the eating disorder; for abortions the figures were 24.2% and 14.6% respectively. The researchers thought the difference could be due to the fact that the women with anorexia thought that their condition had rendered them - at least temporarily - infertile.

New helpline for parents of children with eating disorders

U.K. charity Care for the Family has launched the U.K.'s first telephone befriending service for parents of children with an eating disorder. It offers parents one-to-one ongoing support from trained befrienders whose own child has had an eating disorder. You can find out more about the befriending service by telephoning 029 2081 0800 or by emailing them at mail@cff.org.uk

Anorexia and eyesight

Poor eyesight is a well-known side effect of anorexia and new research from Athens University Medical School had given an indication as to why this might happen. In a detailed study of 33 women, 13 of whom had suffered from anorexia for at least 10 years, they found that the macula - a structure behind the retina, which is responsible for detailed vision - was thinner in the women with anorexia and even thinner in women with bulimia. Neurotransmitters which pass signals from the eyes to the brain were also significantly less active in the women with anorexia.

Missing self-harm in girls with eating disorders

Teenagers with eating disorders could also be cutting themselves. Researchers from Stanford University School of Medicine studied 1,432 eating-disorder patients, aged between 10 and 21, who were admitted to the hospital's eating-disorder programme between 1997 and 2008. They found that 40.8% of them were physically harming themselves. The average age of those who engaged in self-harm was 16, many of them had a history of bingeing and purging and 85.2% of them cut themselves. However, less than half of the girls' medical records showed that they had been asked about self-harm indicating that elsewhere a number of patients with eating disorders could go without this aspect of their behaviour being picked up.

Family therapy does the trick for anorexia

Psychologists have sometimes seen parents as part of the problem rather than as part of the solution when it comes to dealing with their children's eating disorders. However, a new study led by Dr James Lock from Stanford University School of Medicine suggests that family therapy - which involves parents in their children's treatment - might be more effective than individual therapy. The study involved 121 teenagers, mostly girls, who received 24 hours' worth of either family therapy or individual therapy over the course of a year. At the end of their treatment both those receiving family and individual therapy had similar remission rates. However, six months after treatment the family-therapy group had a better remission rate (40% vs 18%) and the difference remained after a year (49% vs 23%).