Is Anorexia Nervosa an Eating Disorder? New Insights Into Reward Processing and Eating Behavior.
Walter Kaye, M.D.
Discussion regarding the etiology of anorexia nervosa and evidence regarding disturbed appetite regulation. The background includes a discussion of temperament and anxiety, as well as neural circuity. Finally, this presentation will discuss how new insights in this subject matter are leading to new approaches to treatment.
Starvation and Suicide: The Neglected Tragedy of Death and Dying in Eating Disorders
James Greenblatt, M.D.
Sleep disorders and malnutrition are common among those living with eating disorders. Both issues increase the risk of suicide in this vulnerable population. Recent research shows sleep disturbances in young adults predict suicidal ideation independent of depression and substance use. Early identification of eating disorder signs and prevention strategies are necessary as eating disorders have the highest mortality rate of all psychiatric disorders. This workshop will discuss the high prevalence of sleep disorders and malnutrition among those with eating disorders and their subsequent increase in suicide risk. Research illustrating the benefits of nutritional supplementation to enhance treatment outcomes will also be discussed.
Prevalence and Issues Related to Eating Disorders in Adult Women
Margo Maine, PhD
Increasing numbers of adult women are suffering from both clinical and subclinical eating disorders and are now seeking treatment. The rapid increase in eating disorders, the ongoing gender disparity and the complex realities of female biology suggest the value of a biopsychosocial and developmental perspective. Multiple transitions at midlife and later relational passages all create risk in a globalized consumer culture that promotes weight loss, thinness and a youthful appearance as the ultimate signs of success for women. Across the globe, primary mental health and medical providers must understand the risk factors, signs and symptoms of adult eating disorders, as well as the impact of sociocultural stressors on these risk factors. This patient population requires unique, developmentally appropriate treatment experiences in order to foster recovery while maintaining their roles in their families, workplaces and communities.
Eating Disorders in Males
Roberto Olivardia, PhD
Contrary to popular belief, males of all ages make up approximately 25% of people suffering from eating disorders. Eating disorders and body image issues may present in males differently than females, which may contribute to underreporting and lack of treatment utilization. Research and clinical evidence has demonstrated that boys and men are impacted by media imagery that promotes an ideal, masculine body. Various eating disorders (some which are unrelated to body image) will be discussed as well as gender specific treatment interventions. Specific populations (sexual minorities, athletes, and ethnic minorities) will also be addressed.
Looking Into the Brain: What Can Postmortem Studies Tell Us About Eating Disorders?
Sabina Berretta, M.D.
We will discuss the role of human postmortem research in the context of investigations on brain disorders and different approaches to human brain postmortem studies. Studies from Dr. Berretta’s group and others will be used as examples, drawing from investigations on disorders often co-morbid with eating disorders (e.g. anxiety). The importance of human brain postmortem studies to research on eating disorders will be highlighted. Finally, we will present the FREED brain collection and the Harvard Brain Tissue Resource Center and discuss the process of brain donation and tissue distribution for research.
Emerging and Novel Approaches to Treating / Managing Eating Disorders
Tom Hildebrandt, PsyD
Food avoidance is a core feature of anorexia nervosa (AN) that persists into early recovery. The role of disgust learning in the maintenance of AN suggests using different treatment interventions to target persistent food avoidance, and provides alternative molecular targets for understanding the motivational and aversive learning systems after weight restoration. Specifically, endocannabinoid (eCB) signaling is fundamentally involved in a range of interoceptive (i.e., pain, hunger, etc.…) signals that motivate behavior, which has spurred a whole area of novel therapeutics for pain, sleep and stress disorders that may also be applicable to AN. For individuals with binge eating behavior, shape and weight concerns appear to be the features most resistant to change with existing empirically-supported treatments. Mirror exposure therapy has proven efficacious in improving body image among individuals with shape/weight concerns and eating disorders, and additional data supporting the use of this intervention will be presented.