In this last issue of Volume 4 of Advances, we are pleased to include a range of articles and reports that we hope will engage you and stimulate your thinking.
We start with an interesting paper on the effects of light therapy in bulimia nervosa. Light therapy has been a topic of study for some time, particularly in the field of mood disorders. Its use with people struggling with an eating disorder has been less evident, but more recently, interest seems to have increased. The observation that binge eating is often precipitated by low mood opens the door to arrange of techniques that have been shown to address negative affect. De Young and colleagues report here on results from nine individuals participating in a six-week trial of Bright Light Therapy, specifically investigating the relationship between improved mood and decreases in binge eating.
So-called ‘loss of control eating’ in young people has been shown to be associated with longer-term eating and weight problems as well as broader difficulties with psychological health. The argument is strong therefore for improving understanding of factors underlying the development of this eating style. Ranzenhofer and colleagues explore relationships between attachment style, interpersonal function and mood in a cohort of adolescent girls with loss of control eating and report their findings in our second paper.
Compulsive exercise is a commonly noted behaviour in individuals with eating disorders, particular in those with anorexia nervosa. It can be physically damaging and distressing, yet exercise itself is recognised as having beneficial mental and physical effects. In our third article, Noetal et al. explore the benefits of engaging in exercise for adolescents receiving hospital treatment for anorexia nervosa. In the study, they were particularly interested in mood changes, and offer helpful suggestions for treatment guidelines for exercise programmes on the basis of their findings.
Our next paper also concerns young people receiving in-patient treatment for anorexia nervosa. Kezelman and colleagues report on a qualitative study exploring participants’ experiences of rapid refeeding. This is a much debated issue and the paper provides important insights into the experience of 10 young people. Results highlight the complexity and ambivalence associated with the process of undergoing nutritional rehabilitation, with changes over time in understanding and affective experience demonstrated through the prospective design of the study.
This is followed by a paper on the important topic of eating disorders stigma, in particular with a focus on the internalisation of eating disorders stigma which has been shown to be so damaging. Griffiths and colleagues provide us with a helpful validation paper of the Internalised Stigma of Mental Illness scale, suggesting it can be valid for use with people with eating disorders. This is such a key area for our collective attention and the authors set out some challenges and thoughtful recommendations for our consideration.
Our sixth paper explores two potential cognitive biases in young people with anorexia nervosa, namely perfectionism and ‘inflated responsibility’. Inflated responsibility is a concept that has previously been associated with obsessive compulsive disorders and other anxiety disorders and captures an individual’s belief that they have the power to bring about or prevent negative outcomes, together with a level of responsibility that is pervasive and extreme. The paper by Kerr and colleagues reports on a preliminary study investigating such biases and offers important pointers for next steps in relation to further research.
The final paper in this issue ends on a positive note. Sheens and colleagues write about their exploration of the effect of recovery stories on challenging stigma towards people with anorexia nervosa. The study aimed to investigate the effect of recovery stories on participants’ understanding and beliefs about anorexia nervosa, in the context of expressed difficulties relating to the experience of the disorder, minimisation of its severity, simplistic views of aetiology and superficial understanding of recovery. The authors conclude that their findings support the use of personal stories in changing attitudes towards those with anorexia nervosa, and provide some evidence that they should be included in stigma reduction and prevention programmes.
This issue also includes the third and final part of Mel Hart’s excellent three part series on Nutrition and Eating Disorders. This last paper, entitled Special Considerations, builds on the two previous articles which covered the importance of healthy nutrition, effects of inadequate nutrition, assessment and concepts of refeeding and rehydration in eating disorders. This third and final paper discusses special considerations for nutrition change, including the mode of feeding, children and adolescents, chronic illness, pregnancy, nutrition education, prevention and promotion, and working as a team. The three papers together represent a wonderful resource for clinicians working in our field.
To wind up, we have two book reviews – both of books accompanied by a strong recommendation. Gillian Wright reviews Woodside and colleagues’ book on Eating disorders and marriage – a neglected topic and definitely worth a read, and Philippa Buckley reviews the excellent Wiley handbook of eating disorders, skilfully edited by Linda Smolak and Michael Levine.
On behalf us all at Advances in Eating Disorders, I hope you enjoy this final issue.