Sarah Fogarty

A systematic review and meta-synthesis of the effects and experience of mentoring in eating disorders and disordered eating.

In this review, we aimed to explore the benefits, effects and experiences of mentoring on those with an eating disorder or disordered eating. After a systematic search of the literature, four papers were included in the review. A qualitative analysis of the papers identified three key themes. The themes were (1) diverse benefits (mentees), (2) finding comfort in belonging (mentees), and (3) affirmation of the transformation they have made (mentors). The experience of mentoring was shown to have value for both mentors and mentees. Mentorship should be further utilized in the areas of eating disorders and disordered eating, as it shows promising reciprocal benefits for both mentor and mentee.

Participatory action research for women with anorexia nervosa.

AIM To discuss the application of the principles of participatory action research (PAR) in a project that developed and evaluated a mentor-mentee support programme for women with anorexia nervosa. BACKGROUND A programme was developed and implemented in which mentors and mentees participated in workshops, social activities and focus groups that sought to support and develop resilience for those experiencing anorexia nervosa. DISCUSSION PAR principles were mirrored in the programme, paying respect to the views and needs of each participant, an open trajectory to possible conclusions and a continuous feedback cycle. Mentees had a sense of empowerment, ownership of the programme and hope that recovery was possible. It allowed their voices to be heard and provided them with belief they could begin new relationships and friendships. CONCLUSION The principles of PAR suited a project aimed at developing self-determination and resilience in women with anorexia nervosa. IMPLICATIONS FOR RESEARCH/PRACTICE PAR would be readily transferable to a number of mental health settings where empowerment is of paramount concern.

The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review

This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only.

A randomised cross-over pilot study investigating the use of acupuncture to promote weight loss and mental health in overweight and obese individuals participating in a weight loss program.

BackgroundAcupuncture is widely used as an alternative modality for weight loss. Despite its increasing use, few acupuncture studies have evaluated the effect of a weight loss program on the mental health of obese/overweight participants and none have looked at the effect on those with eating, weight and shape concerns.ObjectivesTo investigate the feasibility of conducting an acupuncture study involving overweight or obese individuals undertaking a weight loss program with particular reference to those with eating concerns.MethodsThirty-five overweight/obese males and females participated in a single-blinded randomised cross-over study. The two intervention phases were: (1) nutritional counselling plus Traditional Chinese Medicine (TCM) acupuncture and (2) nutritional counselling plus sham acupuncture.Outcome measuresThis study evaluates the feasibility and practicalities of the study including recruitment, retention, adverse events, effectiveness for defining eating and weight concerns, study design and statistics for power calculations.ConclusionThe outcome measures, the recruitment of those with eating and weight concerns and the acceptability of the intervention demonstrate a larger trial investigating the use of acupuncture for weight loss in those who have elevated eating and weight concerns is feasible.

Practice guidelines for acupuncturists using acupuncture as an adjunctive treatment for anorexia nervosa

Anorexia nervosa is a potentially life-threatening eating disorder where people intentionally refuse to eat sufficient amounts to maintain a healthy body-weight for fear of becoming fat. The intense preoccupation with restriction of food and control of body weight makes this one of the most complex and confusing conditions for practitioners to treat. While no single treatment has been found to be superior to another in the treatment of anorexia nervosa, general practice guidelines are available to guide mainstream treatment, however there are no guidelines for practitioners of complementary therapies. Complementary therapies such as acupuncture show promise as an adjunctive therapy in improving co-morbidities such as depression and anxiety levels among people with anorexia nervosa, by strengthening mind, body and overall well-being. The aim of this guideline is to assist and support acupuncture practitioners to deliver effective and safe adjunctive acupuncture treatments to people with anorexia nervosa, by providing a practice guideline that is underpinned by an ethical and evidence-based framework. The use of complementary therapies and specifically acupuncture in the treatment of anorexia nervosa may provide important adjunctive care to allow a comprehensive treatment approach that potentially improves quality of life, reduces anxiety and instils hope for recovery. It is hoped that acupuncture practitioners treating patients with anorexia nervosa will refer to these guidelines and apply the guidance (as deemed appropriate).

Alternative and Complementary Therapies in the Treatment of Eating Disorders, Addictions, and Substance Use Disorders

Research over the past decade into eating disorders and substance use disorders has been considerable. Despite this, response to treatment for many remains poor. New adjunctive therapies that improve the effectiveness of existing treatments and lead to improved mental health outcomes for these patient groups are highly desirable. Recent research into the role of complementary and alternative medicine in eating disorders and substance use disorders has responded not only to the need to improve treatment outcomes but also to the common usage of complimentary therapies by individuals with these disorders. While still in its early stages, research into different types of complimentary therapies including yoga, acupuncture, therapeutic massage, hypnosis, herbal medicine, light therapy, spiritual healing, and art therapy has shown promise both in addressing not only comorbid anxiety and depression but also core disorder symptoms. It is therefore critical that these therapies are rigorously evaluated so we utilize any potential benefits from these treatments and respond to our patients’ considerable interest in and desire to utilize complementary and alternative medicine in their recovery.

Development of a Chinese Medicine Pattern Severity Index for Understanding Eating Disorders

INTRODUCTION Eating disorders commonly affect young girls and women. Four eating disorders are analyzed in this study: anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and binge eating disorder (BED). Eating disorders are a modern concept and as such there is no critically appraised research on how Traditional Chinese Medicine (TCM) conceptualizes of or treats eating disorders. The purpose of this study is to identify and quantify the TCM patterns relevant to eating disorders based on a systematic evaluation of the results of a self-reported questionnaire. METHODS One hundred and ninety-six (196) female participants (142 with a self-reported eating disorder and 54 with no eating disorder) completed an online survey, designed to collect data on their current general health and, where relevant, their eating disorder. The Berle methodology was used to identify TCM patterns involved in eating disorders to tabulate and score the number of signs and symptoms experienced by the participants. RESULTS For many of the TCM patterns, statistically significant differences were found between presentation severity across the four eating disorders. CONCLUSIONS For the first time, there is evidence-based research to classify the TCM patterns involved in AN, BN, EDNOS, and BED. Evidence is given to support the anecdotal theories of TCM patterns involved in eating disorder presentation. These results have relevance on how eating disorders are treated and viewed by TCM practitioners.

The experience of women with an eating disorder in the perinatal period: a meta-ethnographic study

BackgroundPregnancy is a time of enormous body transformation. For those with an eating disorder during pregnancy this time of transformation can be distressing and damaging to both the mother and the child. In this meta-ethnographic study, we aimed to examine the experiences of women with an Eating Disorder in the perinatal period; that is during pregnancy and two years following birth.MethodA meta-ethnographic framework was used in this review. After a systematic online search of the literature using the keywords such as pregnancy, eating disorders, anorexia, bulimia, binge eating disorder, perinatal, postnatal and post-partum, 11 papers, involving 94 women, were included in the review.ResultsA qualitative synthesis of the papers identified 2 key themes. The key theme that emerged during pregnancy was: navigating a ‘new’ eating disorder. The key that emerged in the perinatal period was return to the ‘old’ eating disorder.ConclusionFollowing a tumultuous pregnancy experience, many described returning to their pre-pregnancy eating behaviors and thoughts. These experiences highlight the emotional difficulty experienced having an eating disorder whilst pregnant but they also point to opportunities for intervention and a continued acceptance of body image changes. More research is needed on the experiences of targeted treatment interventions specific for pregnant and postpartum women with an eating disorder and the effectiveness of putative treatment interventions during this period.

The tipping point of change in Anorexia Nervosa (AN): Qualitative findings from an online study

ABSTRACT The aim of this study was to understand factors related to treatment and/or recovery from self-reported Anorexia Nervosa (AN), including ‘the tipping point of change’. An online questionnaire was developed and administered from December 2014 to December 2015 to individuals ≥18 years of age with AN in the past or currently who were recruited through eating disorder organizations in Australia and the United Kingdom. Responses to a specific qualitative question on ‘the tipping point of change’ were analyzed using conventional content analysis (CCA). One hundred sixty-one participants completed some or all of the questionnaire; only 67 women (41.61%) answered Question six on ‘the tipping point of change’, and analyses were restricted to data from these women. The themes identified were: 1) realizing the loss of something valuable, 2) the risk of losing something valuable, and 3) something to live for/stay well for. These results are important for health-care providers as they work with patients to identify life experiences, including ‘loss/potential loss’ and ‘the need for preservation’, that have personal significance. Some patients may realize that ‘enough is enough’; something needs to change. These intrinsic motivating factors may also be the impetus for eventual recovery for some individuals.

A mentor-mentee support program for people with anorexia nervosa

Results During workshop discussions, participants (4 mentors and 5 mentees) defined the program, examined roles and responsibilities, partnerships, interaction, use of funds, conflict resolution and risk management. The workshop, conducted informally in a setting that simulated a home environment, reduced anxiety levels. Uncertainty evolved into an appreciation for the program, development of new relationships, learning that everyone had similar reservations yet reassurance that people were there to support and encourage recovery. Participants were positive and optimistic for the program’s trial. Conclusion PAR is an apt research method for actively engaging stakeholders in the development of a tailored program to support recovery.