Eating Disorder-Diabetes Mellitus Type 1 (ED-DMT1) refers to individuals who have type 1 diabetes and a co-occurring eating disorder. The aim of this study was to identify current treatment practices for individuals with ED-DMT1 in a residential eating disorder treatment setting. Clinical nutrition managers (CNMs) at 18 residential eating disorder treatment facilities were interviewed about treatment practices for patients with type 1 diabetes. Four themes were identified through qualitative case study analysis: 1) nutrition interventions for patients with diabetes, 2) medical diabetes management, 3) interdisciplinary diabetes team, and 4) CNM's assessment of diabetes care. The majority of CNMs interviewed reported utilizing an exchange- based meal plan, which is well suited for patients with type 1 diabetes. Dietitians described the use of diabetes technology (e.g., insulin pumps and continuous glucose monitors) and described a gradual advancement of responsibility and autonomy with portioning food at meals and snacks and managing diabetes care. The dietitian is heavily involved in providing diabetes education along with the medical and/or nursing team. The majority of CNMs interviewed demonstrated knowledge deficits related to diabetes management and expressed the need and desire for increased education for themselves and other staff members in order to provide the highest quality of care.

"In this study we sought to compare eating disorder attitudes and behaviors, and proneness to an eating disorder ("ED proneness"), between gay men, lesbian women, and transgender and gender non-conforming (TGNC) adults. A further aim was to identify and compare risk and protective factors, and examine a mediational model based on the interpersonal theory of eating disorders (IPT-ED), whereby the association between interpersonal factors and ED proneness would be mediated by psychological constructs pertaining to the self and negative affect. Data was obtained from a larger national study of health risk and protective factors among sexual minority and gender diverse populations. The sample included 97 gay men, 82 lesbian women, and 138 TGNC adults. Participants completed the National College Health Assessment, Eating Disorders Screen for Primary Care, Patient Health Questionnaire Depression scale, Generalized Anxiety Disorder 7 scale, Self-Compassion Scale-Short Form, Negative Social Exchange subscale of the Multidimensional Health Profile, Interpersonal Needs Questionnaire, and Perceived Stigma Scale. There was a significant difference between groups in ED proneness, with lesbian women (66.7%) having a significantly higher percentage than gay men (47.6%). There was also a significant difference between groups in weight-based self-worth, with the lowest percentage in gay men (63%) and the highest percentage in lesbian women (82%), as well as dissatisfaction with eating patterns, with the highest percentage in TGNC adults (69.8%) and the lowest percentage in gay men (47.7%). There was a low percentage of inappropriate compensatory behaviors, with no significant difference between groups. Logistic regression analyses showed that the predictor variables of ED proneness were depression, perceived stigma, and self-compassion in gay men; depression in lesbian women; and self-compassion in the TGNC adults. Mediation analyses showed that thwarted belongingness (i.e., an unmet to belong) and perceived stigma had an indirect association with ED proneness that was mediated by self-compassion and depression (for perceived stigma alone) in gay men, depression in lesbian women, and self-compassion in TGNC adults. The interpersonal theory of eating disorders therefore extends to sexual minority and gender diverse populations; however, the results suggest a broadening of theoretical models and intervention programs to include the role of stigma and self-compassion."

El estudio tuvo como propósito realizar un análisis bibliométrico de las publicaciones científicas de la base de datos Psicodoc, esto para establecer y organizar la información actual sobre los artículos científicos latinoamericanos sobre sobre el Funcionamiento Familiar en personas diagnosticadas con algún Trastorno de conducta alimentaria, recogidos de la base de datos Psicodoc entre los años 2010-2019. Primero, se realizó una búsqueda de la variable funcionamiento familiar, se encontró un total de 77 investigaciones en español, en la base de datos de Psicodoc entre los años 2010 y 2019, de estos quedaron 2 artículos que eran de revista sobre el funcionamiento familiar de personas que tengan trastornos de conducta alimentaria en Latinoamérica. Posteriormente, se realizaron los análisis de los datos y las metodologías que se utilizaron, y a partir de ello se realizó una breve discusión. Se destaca que ambos artículos son de corte cuantitativo y todos poseen resumen, abstract, palabras clave, introducción y objetivos, mientras que solo uno contaba con hipótesis. Se concluye que el bajo número de investigaciones encontradas demuestran la poca relevancia que se le ha dado a un tema de gran importancia. / The purpose of the study was to carry out a bibliometric analysis of the scientific publications of the Psicodoc database, to establish and organize the current information of Latin American scientific articles on Family Functioning in people diagnosed with an Eating Disorder, collected from the Psicodoc database between the years 2010-2019. First, a search was made for the variable family functioning, and a total of 77 investigations in Spanish, were found in the Psicodoc database between the years 2010 and 2019, of which 2 were magazine articles on the family functioning of people with eating disorders. Subsequently, an analysus of the data and the methodologies used was carried out and then discussed briefly. It is highlighted that both articles are of a quantitative nature and all of them have abstract summaries, keywords, introduction and objectives, while only one had hypotheses. It is concluded that the low number of investigations found demonstrate the little relevance that has been given to such an important topic. / Trabajo de investigación

Background: Motivation to change is a core variable in understanding and treating women with both anorexia and bulimia nervosa. The transtheoretical model (TTM) has been put forward as a framework for the assessment and treatment of motivation to change for a variety of disorders, including eating disorders. Even though motivation and ambivalence should be assessed with regard to specific symptoms in eating disorders, there is a lack of validated measures in the German language. Due to the importance of motivation to change in women with eating disorders, several studies have used the TTM to develop, and test the effectiveness of face-to-face motivational programs for this clientele. However, no randomized controlled trial for an internet-based program enhancing motivation to change has been conducted. The present thesis aimed to establish symptom-specific measures of motivation to change and ambivalence, and to develop and evaluate an internet-based therapy program for women with eating disorders. Methods: Two observational studies and one randomized controlled trial including a total of N=460 women with eating disorders were performed. The first study tested the psychometric properties (reliability and validity) of a questionnaire assessing motivation to change in a sample of N= 63 inpatients. In the second study, the psychometric properties of a questionnaire assessing ambivalence in a sample of N =195 women with eating disorders were investigated. The third study comprised a randomized controlled trial with N =202 women assessing the effectiveness of an internet-based motivational program for women with eating disorders. The fourth study systematically investigated the dropout from this program using survival analysis. Results: In the observational studies, the questionnaires showed satisfactory psychometric properties, with good reliabilities and validities. The randomized controlled trial showed significant time x group interactions, demonstrating that the internet-based program was effective in enhancing motivation to change, and in reducing some eating disorder symptoms. However, the dropout from the program was 51 %, with participants with more severe eating disorder pathology and depressive mood being more likely to terminate the program prematurely. Discussion: The results demonstrate the feasibility of both symptom-specific assessment of motivation to change and measurements of ambivalence across eating disorder diagnoses, enabling novel research questions and supporting clinical work. Evidence for the efficacy of the internet-based program in enhancing participants’ motivation to change and reducing eating disorder symptoms support the wider adoption of such programs. The results from the dropout analysis offer new perspectives for future research on additional treatment modulesm for women at risk of terminating treatment prematurely.

Contexte : Les personnes atteintes de troubles des conduites alimentaires (TCA) auraient un meilleur pronostic s’ils étaient pris en charge précocement pour cette maladie. Le médecin généraliste (MG) est souvent cité dans les recommandations internationales comme un acteur principal de dépistage et de prise en charge précoce des patients atteints de TCA. Les études de prévalence effectuées dans un contexte de soins primaires (SP) ne retrouvent pourtant que peu de patients atteints de TCA, voire aucun. Aucune étude de prévalence en MG en France n’a encore été effectuée. La dépression est souvent étudiée comme une comorbidité fréquente des TCA.Objectif : Etudier la place du MG dans la prise en charge des patients atteints de TCA1)Evaluer l’efficacité d’un dépistage systématique des patients atteints de TCA par des MG sur leur pronostic et leur taux de guérison.2)Décrire les caractéristiques des patients atteints de TCA et suivi en MG et d’étudier la temporalité entre la survenue d’une prise en charge pour dépression et prise en charge pour TCA3)Décrire les perceptions des MG et des patients de la place du MG dans la prise en charge de ces patientsMéthodes1)Revue systématique de la littérature selon les critères PRISMA2)Etude de cohorte à partir de la prise en charge en médecine générale de patients atteints de TCA avec analyse de différents groupes de suivi comparant les patients TCA pris en charge pour dépression et ceux non pris en charge pour dépression.3)Etude qualitative en miroir de patients atteints de TCA et de MG sélectionnés dans la cohorte disponible des MG, avec analyse par théorisation ancrée et phénoménologique en miroir, avec double codage d’entretiens semi directifsRésultats : La revue systématique de la littérature n’a pas permis de conclure à l’efficacité d’un dépistage systématique des TCA par les MG, du fait d’une littérature hétérogène, composée en grande majorité d’articles d’opinion dans un contexte de SP.1310 patients (sur 350 000 patients suivis) ont eu au moins une prise en charge pour TCA par des MG de l’OMG entre 1994 et 2007. 80 % étaient des femmes, âgées de 35,19 ans en moyenne. Seuls 39 % avaient une amorce de suivi pour TCA. 67,1 % avaient une première prise en charge pour TCA. 32,3 % d’entre eux avaient eu au moins une fois une prise en charge pour dépression, dont 62,41 % pour la première fois. Les patients ayant une dépression étaient plus âgés, plus suivis pour TCA que les autres. Un cinquième des patients TCA ont eu au moins une fois une prescription d’antidépresseurs dans leur suivi, un peu moins de la moitié des anxiolytiques. La prise en charge pour DEP ne précédait pas la prise en charge du TCA.Dans l’étude qualitative, les 24 MG et les 8 patientes décrivaient la prise en charge comme difficile et longue. L’enjeu d’une bonne prise en charge dépendait d’une relation de confiance des deux acteurs, d’un côté une patiente prête à se livrer en dépassant le déni et le sentiment de honte, de l’autre côté, un médecin prêt à écouter, en dépassant son sentiment d’impuissance.Discussion : Il s’agit de la première étude en France s’intéressant à la prise en charge des patients en SP, utilisant des méthodes complémentaires. Les enjeux de prise en charge des TCA en SP restent à définir. La dépression et les TCA étaient concomitants et semblent devoir être pris en charge dans une approche globale. Cette approche devra tenir compte de situations retrouvées dans les deux syndromes : la mauvaise estime de soi, une image négative de son corps, des antécédents de maltraitance, des antécédents familiaux psychiatriques de dépression ou de TCA au premier degré. / Background : People suffering from eating disorders (ED) may have a better prognosis if they benefit from early management for their disease. GPs are often quoted in international guidelines as the main actors of screening and early management of ED patients. Prevalence studies in a primary care setting however find few ED patients and sometimes none. No study in GP has been done in France. Depressive disorders are often related as a comorbidity of ED. Aim: to study the GP role of ED patients management. 1) To evaluate the efficacy of systematic screening of ED patients conducted by GPs on prognosis and recovery. 2) To describe the characteristics of ED patients followed by their GPs and study the temporality between depression management and ED management. 3) To describe GPs and patients' views of the role of GPs management of ED patients. Methods 1)Systematic review according to PRISMA statement 2)Cohort study in a French GP setting of ED patients with analysis of different follow up groups comparing ED patients with depression to ED patients without depression. 3)Qualitative study of ED patients comparing GPs and patients' views selected in the cohort study, with a grounded theory approach and a phenomenological approach, double coding of semi directive interviews. Results : the systematic review found no evidence of efficacy of systematic screening of ED patients by GPs. The literature is too heterogeneous and contains mainly opinion papers in primary care. 1310 patients (out of 350,000) had at least one consultation for ED by GPs in the French database between 1994 and 2007. 80 % were women, mean age of 35.19 years. Only 39 % benefited from a follow up for ED. 67.1 % were taken in charge for the first time. 32.3 % of ED patients had at least one consultation for depression, 62.41 % for the first time. ED patients with depression were older, followed longer for ED then the others. One fifth of patients had at least one prescription of antidepressants during their follow up period, half of them had anxiolytics. Depression management did not precede ED management. In the qualitative study, 24 GPs and 8 patients described the management as difficult and long. The key to a good management depended on trust, with a patient willing to talk about her disease; overcoming shame and denial, and a GP ready to listen, overcoming his helplessness feeling.Discussion : it was the first study about this subject in France, using complementary methods. Management points are to be defined in primary care. Depression and ED are cofactors and should be managed in a global approach. This approach will have to take into account signs found in those two syndroms: low self esteem, negative body image, abuse background, pscyhiatric diseases in family (depression and ED) in first degree relatives.

Eating disorders are associated with high mortality rates. Most eating disorder prevention research is conducted within the fields of psychology and psychiatry, not in public health. This gap in public health research can lead to insufficient attention to the root causes of eating disorders and minimal upstream prevention efforts. The purpose of this phenomenological study was to identify public health leaders' perceptions of and attitudes concerning eating disorders as a public health issue. Objectification theory was used to describe how societal expectations have created an environment in which people's self-worth is based on their outward physical appearance. Ecological theory was used to identify environmental factors that influence the development of eating disorders. Public health leaders at local public health departments throughout California were invited to participate in the study, as they hold significant public health positions in the state. Data were collected using open-ended questions. Results were coded and analyzed via thematic analysis. NVivo 11 software was used for data management. Theoretical saturation was reached after 6 interviews when the information was redundant and no new themes were revealed. Emerged themes included observations from the participants that eating disorders are not considered a public health issue. The participants did not view eating disorders as a significant problem and they noted that they do not monitor the rates of these illnesses. They expressed interest in exploring the public health role in eating disorder prevention. Public health educators, researchers, and leaders can use these results to assess the burden of eating disorders and recognize ways to address this health threat at the macro level. In doing so, they will affect positive social change.

Eating disorders (ED) are maladaptive eating patterns that can have social, biological, health, and occupational consequences. The purpose of this study was to explore and compare binge eating episodes, locus of control, and body dissatisfaction between African-American men (n = 66; 53.70%) and Caucasian-American men (n = 57; 46.30%). There is a current gap in the existing literature regarding the study of men who BE and a sampling bias with regard to ethnic minorities. Based on Bandura's social learning theory model and Rotter's locus of control, the purpose of this research was to determine and compare the relationship between BE, locus of control, and body dissatisfaction among African-American and Caucasian-American men. The participants answered a demographic questionnaire, Eating Attitudes Test (EAT-26), Internality, Powerful Others and Chance Scale (IPC), and Body Satisfaction Questionnaire (BSQ). A quantitative research design was used and the chi-square was performed to evaluate the variables of the research questions. The sample population came from the Walden University participants pool and men who are self-described binge eaters from the African-American and Caucasian-American ethnicity in the community. Key results showed that African- American men believed they had less power in their lives, lower levels of body dissatisfaction, and increased feelings of chance in their lives. Recommendations for further research can be to replicate this study using other ethnicities. Implications for social change can include increased knowledge of men that BE which can improve their overall health and quality of life while reducing medical costs.

Eating disorder clients show low motivation, poor follow-through, and inordinate premature dropout rates in treatment. Earlier studies support the use of pretherapy training to help clients understand the tasks and challenges of therapy. However, a pretherapy intervention, such as showing prospective clients a video that outlines recovery issues and themes, had not yet been developed specifically for the prevalent, recalcitrant problem of eating disorders. Thus, of particular interest to clinicians who treat eating disorders may be the development of a theoretically sound, pretherapy videotape that outlines recovery issues. One of the purposes of this study was to review prior investigations of the 111 effects of pretherapy films/videos on therapy outcomes. However, the central focus of this dissertation was to develop a pretherapy video for use with eating disorder clients, and using quantitative methods, assess the quality and likely therapeutic utility of the pretherapy video. The video was developed to be theoretically consistent with Bandura' s modeling paradigm, social learning theory. Eating disorder clients, a comparison group of college women, and professional clinicians who are experienced at treating women with eating disorders were asked to view and evaluate the video (developed to orient prospective clients to recovery issues during treatment for eating disorders). All three groups reportedly found the recovering women portrayed in the video credible, believable, and persuasive. All groups of observers indicated that the video presented an understandable and hopeful message possessing emotional impact, and they avowed that the video created expectations for improvement. Also, the viewers believed the pretherapy video would likely increase knowledge of eating disorder recovery, and that future eating disorder clients viewing the video would likely learn new information that would facilitate their recovery. Additionally, the three groups indicated the video seemed to be of general relevance and therapeutic utility to women with eating disorders.

Bakgrund: Ätstörningar är ett samlingsnamn för flera diagnoser som orsakar lidande både fysiskt och psykiskt för de personer som lever med dem. Det är många som drabbas och därav kan vårdpersonal möta dessa personer var hen än jobbar. Det är en svår diagnos att tillfriskna från och det är därför av stor vikt att veta hur omvårdnaden bör se ut.  Syfte: Syftet var att beskriva vårdpersonals erfarenheter av omvårdnad till personer som drabbats av ätstörning.  Metod: En kvalitativ litteraturstudie som grundat sig på 9 empiriska artiklar gällande ämnet. De har granskats och analyserats av författarna för att besvara studiens syfte.  Resultat: Resultatet delades in i fyra kategorier: strategier för omvårdnad, vägen till tillfrisknande, vikten av utbildning och vikten av samarbete.  Konklusion: Studien visar att en god relation är en av grundstenarna för omvårdnaden av denna patientgrupp. Andra viktiga faktorer i omvårdnaden är att involvera patientens familj, att ha ett fungerande vårdteam och att erbjuda fortlöpande utbildning till sjuksköterskan. / Background: Eating disorders is an umbrella term for a several diagnoses causing both physical and mental suffering for those who fall ill. The diagnoses are wide-spread which means that healthcare staff meet such patients regardless of work place. Recovery is often long-drawn which highlights the need to understand the care practices needed.  Aim: The purpose was to describe healthcare staff’s experiences of caring for people diagnosed with an eating disorder. Methods: This qualitative literature based review is composed of 9 empirical articles focusing on eating disorders and nursing care. The articles have been reviewed and analysed by the authors to answer the aim of the study. Results: The results are divided into four categories: strategies for nursing care, the road to recovery, the importance of education and the importance of cooperation. Conclusion: The study shows that a good nurse-patient relation is one of the founding stones of nursing care to this patient group. Other factors are to involve the patient’s family, to have functioning team collaboration and continuously provide education to the nursing staff.

Eating disorders are prevalent among female athletes, particularly those involved in lean sports, which put greater emphasis on a slim physique. Because of the negative --- physical and emotional consequences associated with disordered eating, it is essential that such behavior be detected and treated early. However, it may be difficult to identify symptoms of disordered eating among female athletes, perhaps due to perfectionism. Individuals scoring high in perfectionism may be more self-critical of mistakes and thus more likely to conceal such behavior. The present study combined the Frost Multidimensional Perfectionism Scale (FMPS) with the Athletic Mileu Direct Questionnaire (AMDQ), in an effort to determine whether the combined use of a perfectionism and disordered eating inventory would better identify those at risk for disordered eating. Both questionnaires were compared to the Eating Disorder Examination (EDE) and results indicated that both AMDQ and FMPS scores correlated positively with EDE global scores. Type of sport did not result in a significant correlation with disordered eating scores, although potential explanations are discussed.