Basic HTML Version
Porto, Portugal | September 20-22, 2012
19
17
MENOPAUSE – A WINDOW OF VULNERABILITY FOR
EATING DISORDERS AND NEGATIVE BODY IMAGE
B Mangweth-Matzek
1
, CI Rupp
1
, K Lackner-Seifert
2
, N Frey
1
,
AB Whitworth
3
, J Kinzl
1
1
Department of Psychosomatic Medicine, Innsbruck Medical
University, Innsbruck , Austria,
2
Department of Psychology,
Innsbruck University, Innsbruck, Austria,
3
Paracelsus Medical
University, Salzburg, Austria
Objective: Assessment of eating disorders and body image in
women of different menopausal status. Methods: A randomly
selected non-clinical sample of 1500 women of Innsbruck,
aged 40-60 years, was contacted for a questionnaire survey
covering weight history, eating behavior, body attitude,
menopausal status, current physical and mental illnesses,
and quality of life. Women were classified in 4 groups based
on WHO-criteria: pre-menopause, peri-menopause, natural
menopause, surgical menopause. Results: The four groups
that were similar in all demographic features except age, did
not differ on current, highest and desired BMI, regular weight
controls and diet history after age-adjustment, however
differed significantly regarding eating behavior and EDI-score.
Both peri-menopausal and surgical menopausal women
showed significantly higher numbers of current clinical eating
disorders (anorexia nervosa, bulimia nervosa, EDNOS) (9%
and 9% versus 2%), feeling of fatness, and dislike of the
body as compared to premenopausal women. Both natural-
and surgical menopausal women reported significantly
more psychological, somatic and urogenital symptoms
compared to peri-menopausal women. Conclusions: Our
data suggest that the menopausal transition (especially the
peri-menopause and the surgically induced menopause) is
associated with clinical eating disorders and negative body
image indicating a window of vulnerability due to hormonal
triggered changes of regular menstruation, body composition
and female conception.
18
THE USE OF REAL TIME THERAPY (RTT) TO SUPPORT
EATING IN ANOREXIA NERVOSA
Valentina Cardi, Janet Treasure
King’s College London, Institute of Psychiatry, Psychological
Medicine, Section of Eating Disorders, London, United
Kingdom
1. Purpose of the study: People with Anorexia Nervosa (AN)
have aversive reactions to food cues which may be involved
in the development and maintenance of the illness. Real time
therapy (RTT) approaches have been developed to be used
with mobile technology to support eating. 2. Methods: Self
help and guided interventions targeting food-related anxiety
and avoidance have been developed. The use of short video-
clips (“vodcasts”) played on mobile devices, were tested as
an adjunct to outpatient or inpatient treatment. 3. Results:
The use of a vodcast during a test-meal was associated
with reduced anxiety (
t
(17) = 2.4;
p
<0.05), increased
consumption of a smoothie (
t
(17) = 2.2,
p
<0.05), and a trend
for a decrease of vigilance to food in a group of 18 outpatients
with AN, in comparison to a music (control) condition. The
same protocol was used in a sample of 20 inpatients, but
findings were not replicated. Contrary to the hypotheses, the
use of the music was associated with greater consumption
of the test meal (
t
(17) = -1.9
p
=.06) and lower distress (
t
(18) = -2.7;
p
=.01). The vigilance to food increased after
the test meal, in both conditions, in the inpatient sample. 4.
Conclusions: New theoretically-based interventions targeting
food-related anxiety and avoidance seem promising in
supporting eating in AN. The setting and the overall context of
eating goals and contingencies appear to produce a marked
difference in the response to meal support.
19
EATING DISORDERS AFTER BARIATRIC SURGERY
James E. Mitchell
1
, Joanna Marino
2
, Molly Orcutt
3
, Ross
Crosby
1
, Gavin Meany
3
, Kathy Lancaster
1
1
Neuropsychiatric Research Institute, Fargo, ND, USA,
2
POotomac Behavioral Solutions, Arlington, VA, USA,
3
UND
School of Medicine and Health Sciences, Grand Forks, ND,
USA
Introduction: Bariatric surgery is increasingly being utilized
as a treatment for severe obesity. However, it has become
apparent that a subgroup of individuals who undergo these
procedures subsequently develop eating disorders (EDs).
Methods: 5 sources of information will be briefly examined:
1. A review of the extant literature reports. 2. A description
of a new series of 12 such patients hospitalized with eating
disorders. 3. A discussion of the atypical ED presentations
sometimes seen after bariatric surgery (“grazing”, “loss of
control” eating). 4. A review of the issue of loss of control
eating after surgery. 5. A new analysis examining predictors
of loss of control eating after surgery in a long-term follow-
up study cohort (n=78). Results: These patients may appear
as fairly typical EDs, while others are clearly atypical. The
development of grazing and loss of control eating after
bariatric surgery attenuate long-term weight loss. Pre-
operative binge eating/BED appear to be risk factors for
the development of loss of control eating after surgery.
Discussion: A subgroup of patients who develop eating
disorders after bariatric surgery are atypical in having a much
later age of onset, and may present with malnutrition and
symptoms suggestive of anorexia nervosa at a BMI >17.5.
20
BEHAVING LIKE A FAT PERSON: DISTURBANCES IN
BODY-SCALED ACTION IN ANOREXIA NERVOSA
Anouk Keizer
1
, Monique A.M. Smeets
2
, Chris Dijkerman
1,4
,
Annemarie Van Elburg
3
, Albert Postma
1,4
1
of Experimental Psychology, Helmholtz Research Institute,
Faculty of Social and Behavioural Sciences, Utrecht
University, Utrecht, Netherlands,
2
Department of Clinical
and Health Psychology, Faculty of Social and Behavioural
Sciences, Utrecht University, Utrecht, Netherlands,
3
Rintveld
centre for Eating Disorders, Altrecht Mental Health Institute,
Zeist, Netherlands,
4
Department of Neurology, University
Medical Centre Utrecht, Utrecht, Netherlands
Central to Anorexia Nervosa (AN) is a disturbed experience
of body weight and shape. To date, research mainly focused
on body representation disturbances in AN on a perceptual
level (i.e.
body image
). In the current study we investigated
whether more unconscious, action related, disturbances in
body representation, i.e.
body schema
, could be identified in
AN as well. We compared AN patients (n=13)* and healthy
controls (HC; n=20) on an aperture task. Participants walked
through door-like openings varying in width (36 trials). For
each participant critical
Aperture to Shoulder ratio
(A/S) was
calculated, i.e. the point at which individuals start to rotate
their shoulders in order to fit through the aperture. Results
showed that HC started to rotate their shoulders for aperture
25% wider than their own shoulders (A/S=1.25, SD=0.09),
while AN patients already started rotating for apertures 42%
wider than their shoulders (A/S=1.42, SD=0.17), t(31)=3.85,
p=0.001. These results imply that AN patients have an
unconscious representation of body size, which is used in
body-scaled action, that does not match their actual body
dimensions. As a result, AN patients also rotated their body
when crossing apertures through which they could objectively
(based on actual body dimensions) walk straight through.
Thus, AN patients do not only think they are fat, experience
themselves this way, but also behave in this manner. *Note:
testing is still in progress, we strive to test 20 AN patients.
PLENARY/ORAL ABSTRACTS