Elusive Etiology of Anorexia Nervosa: Finding Answers in an Integrative Biopsychosocial Approach

An exploratory study of experiences with conventional eating disorder treatment and ceremonial ayahuasca for the healing of eating disorders

PURPOSE

Ayahuasca is a traditional Amazonian medicine that is currently being researched for its potential in treating a variety of mental disorders. This article reports on exploratory qualitative research relating to participant experiences with ceremonial ayahuasca drinking and conventional treatment for eating disorders (EDs). It also explores the potential for ayahuasca as an adjunctive ED treatment.

METHODS

Thirteen individuals previously diagnosed with an ED participated in a semi-structured interview contrasting their experiences with conventional ED treatment with experiences from ceremonial ayahuasca. The interviews were analyzed using thematic analysis.

RESULTS

Participant reports were organized with key themes including that ayahuasca: led to rapid reductions in ED thoughts and symptoms; allowed for the healing of the perceived root of the ED; helped to process painful feelings and memories; supported the internalization of greater self-love and self-acceptance; and catalyzed spiritual elements of healing.

CONCLUSIONS

The results suggest that ayahuasca may have potential as a valuable therapeutic tool, and further research-including carefully controlled clinical trials-is warranted.

LEVEL OF EVIDENCE

Level V, qualitative descriptive study.

The impact of urbanization on risk for eating disorders

PURPOSE OF REVIEW

Urbanization has broadly been implicated in negatively impacting mental health, including risk for disordered eating and eating disorders. Understanding the specific mechanisms that contribute to risk for maladaptive eating behavior in the context of urbanization is essential to improving public health policy and guiding future clinical, research, and prevention efforts.

RECENT FINDINGS

This review of recent investigation related to the impact of urbanization on eating disease highlights specific risk factors for eating disorders, including acculturation to Western standards of beauty and food resources with associated body weight and body image concern.

SUMMARY

Recommendations for clinical and research endeavors include improved specificity in defining urbanization, as well as increased sensitivity within community-based assessment of cultural and demographic variables that may impact eating behavior and risk for eating disorders.

Family-based treatment: Where are we and where should we be going to improve recovery in child and adolescent eating disorders

OBJECTIVE

Family therapy has long been advocated as an effective intervention for eating disorders. A specific form of family therapy, one that utilizes family resources, has proven especially effective for adolescents with anorexia or bulimia nervosa (AN and BN). First developed in London, a behaviorally focused adaptation, called family-based treatment (FBT), has been manualized and systematically studied in six randomized clinical trials for adolescent AN and two for adolescent BN.

METHOD

This Commentary focuses on manualized FBT; what we know, what we do not know (yet), and what we hope for.

RESULTS

We do know that efficacy data for FBT, especially adolescent AN, are quite robust, even though remission rates remain elusive for more than half of all cases. While preliminary, moderators of FBT for adolescent AN have been identified and could aid us in determining the most (or least) responsive patient groups. And weight gain (∼2.5kg) by week four has been confirmed as an early predictor of remission at end-of-treatment. What we do not know, yet, is whether specific adaptations to manualized FBT will confer improved remission rates.

DISCUSSION

Finally, and in terms of what is hoped for, we highlight the promise of improved access, dissemination, and implementation of FBT.

Attention-deficit/hyperactivity disorder and eating disorders across the lifespan: A systematic review of the literature

Attention-deficit/hyperactivity disorder (ADHD) and eating disorders are common and concerning mental health disorders. There is both empirical and theoretical support for an association between ADHD and eating disorders or disordered eating. This systematic review aims to summarize the extant literature on the comorbidity of ADHD and eating disorders across the lifespan, including the influences of sex, age, eating disorder diagnosis, and potential mediators. A total of 37 peer-reviewed studies on diagnosed ADHD and eating disturbances were identified through key research databases. Twenty-six studies supported a strong empirical association between ADHD and eating disorders or disordered eating. The systematic review findings suggest that children with ADHD are at risk for disordered eating, while adolescents, emerging adults, and adults are at risk for both eating disorders and disordered eating. Methodological considerations, future research, and clinical implications are discussed.