L6 - Eating disorders and Obesity 2 4/11 Flashcards
What did Scott Lilienfeld et al 2014 identify?
Concerns about treatment of eating disorders
He identified over 600 therapies, with quite a few being seen as ‘wacky’. Very few were evidence-based.
He found that most clinicians in the field do not deliver evidence-based treatments.
What are some statistics from Lilienfeld’s review of studies of clinical practice?
Only 38% reported using the strongest therapy, and if they do use this they take out the key elements
Only 6% report using evidence-based treatment manuals
Many are untrained in the therapy they are using
What do different therapies focus on?
Different elements in the aetiology and maintenance of eating disorders
such as Biology, family interaction, sociocultural influences, trauma, bullying
What makes interventions effective?
Focusing on maintenance factors, such as
- safety behaviours
- cognitive patterns
- emotional patterns
- social maintenance
- family accommodation of symptoms
- nutrition
When is the prevention of eating disorders ideal - time wise?
Ideal for implementation in late childhood/early adolescence
Inoculates the individual against the development of eating pathology
What are the two potential targets of prevention of eating disorders?
A lowering of eating and other concerns in the present
A lower level of future development of eating disorders
Is prevention risk free?
Not always
Carter et al 1997 and Baronowski + Heatherington both tried psychoeducation about dieting and eating disorders (targeted on school children aged 11-14) - in both cases the level of pathology got worse (Carter - long term, Baronowski - short term). Carter reported this as a problem whilst the others reported it as a success when it wasn’t.
Media literacy approach as a prevention approach:
Media literacy approaches reduce shape and weight concerns for everyone in the whole young population
Cognitive dissonance approaches as a prevention approach:
Cognitive dissonance approaches reduce eating behaviours and attitudes in high risk groups
CBT interventions as a prevention approach:
Reduce risk of dieting
Weight management intervention as a prevention approach:
Reduces some risk factors
What does NICE recommend to prevent obesity?
NICE 2015 - recommends interventions involving schools, local government, families, policies such as taxation rather than specific psychological interventions
What are the obesity rates in England?
Almost three quarters of people aged 45-74 in England are overweight or obese. Since 1993 the proportion of individuals who are obese has risen from 14.9% to 28% (Health survey for England, 2021)
Where can you find the strongest evidence for most effective eating disorder treatments?
The NICE guideline
What are the primary differences between effective eating disorder treatments?
Adults vs children/adolescents
Underweight vs non-underweight patients
