Assessing the reliability and validity of sleep assessments in patients seeking metabolic and bariatric surgery.

Background: More than 80% of patients seeking metabolic and bariatric surgery (MBS) report disturbance in sleep function. No studies have assessed the psychometric properties of sleep measures in MBS samples.

Objectives: This study assessed the reliability and validity of the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) in a large sample of patients seeking MBS.

Impulsivity and reward and punishment sensitivity among patients admitted to a specialized inpatient eating disorder treatment program.

Introduction: Eating disorders (EDs) are conceptualized as disorders of under- and over-control, with impulsivity reflecting under-control. Extant research indicates that impulsivity and related factors such as reward sensitivity and punishment sensitivity may serve as trait-level transdiagnostic risk and/or maintenance factors in EDs. Findings on impulsivity and reward and punishment sensitivity by diagnosis are mixed and research on the relationship between these factors and ED symptoms, hospital course, and treatment outcomes is limited.

Eating disorder symptom non-endorsers in hospitalised patients with anorexia nervosa: Who are they?

Objective: Impaired insight and illness denial are common in anorexia nervosa (AN). Missing an AN diagnosis may delay treatment and negatively impact outcomes.

Method: The current retrospective study examined the prevalence and characteristics of AN symptom non-endorsement (i.

Inpatient hospital course and self-reported symptomatology in underweight adults with ARFID compared to age- and sex-matched controls with anorexia nervosa.

Objective: Avoidant restrictive food intake disorder (ARFID) has similar prevalence to anorexia nervosa (AN) in adults, but research in this population is lacking. Although inpatient or residential treatment involving nutritional rehabilitation is increasingly recommended for malnourished individuals with ARFID, best practices remain poorly defined. Existing studies on self-reported symptomatology and treatment course and outcome are primarily in child and adolescent cohorts and demonstrate inconsistent findings.

Greater dietary variety is associated with lower food anxiety at discharge from intensive eating disorder treatment.

Objective: Food anxiety and limited dietary variety often persist after intensive treatment for eating disorders (EDs) and may contribute to relapse. Prior studies demonstrate decreased meal-related anxiety with residential or inpatient treatment, but less is known about changes in dietary variety and anxiety associated with specific foods. The current study assessed change in food anxiety and dietary variety in inpatients with EDs (anorexia nervosa and bulimia nervosa) in relation to discharge outcomes from meal-based behavioral treatment.

Parental dieting impacts inpatient treatment outcomes for adolescents with restrictive eating disorders.

Objective: Parental feeding practices and disordered eating are potential risk factors for the development of disordered eating in children and adolescents. This study measured the relationship between parental dieting behaviours and inpatient treatment outcomes for adolescents with restrictive eating disorders (EDs).

Method: Parents of adolescents with restrictive EDs (N = 45) admitted to a specialty integrated inpatient-partial hospital meal-based ED treatment programme completed questionnaires assessing parental eating and exercise behaviours.

Evaluating the impact of COVID-19 on severity at admission and response to inpatient treatment for adult and adolescent patients with eating disorders.

Objective: The COVID-19 pandemic has been associated with increased hospitalization rates and worsened symptom severity in patients with eating disorders (ED), but most studies focused exclusively on adolescents. Further, research evaluating the impact of COVID-19 on response to inpatient treatment for ED is limited. This study aimed to compare demographic characteristics, symptom severity at admission, and discharge outcomes for adult and adolescent inpatients with EDs admitted before and after onset of the COVID-19 pandemic.

Psychedelic-Assisted Therapy for People with Eating Disorders.

Purpose Of Review: A growing body of research suggests psychedelic-assisted therapy (PAT) may be safe and effective for a variety of mental health conditions. Among these, eating disorders have been a recent target of interest. This review provides an up-to-date summary of the potential mechanisms and use of PAT in people diagnosed with eating disorders, with a focus on anorexia nervosa.

Evaluating individual- and sample-level response to treatment for inpatients with eating disorders: Is change clinically significant?

Objective: Evaluating treatment efficacy solely on whether sample-level change is statistically significant does not indicate whether clinically significant change (CSC) has occurred at the individual-level. We assessed whether change in measures of eating disorder psychopathology was statistically significant at the sample-level and clinically significant at the individual-level for inpatients treated in a hospital-based eating disorder program.

Method: Participants (N = 143) were consecutive underweight distinct admissions diagnosed with anorexia nervosa or other specified feeding and eating disorder.

Monitoring and treating hypoglycemia during meal-based rapid nutritional rehabilitation in patients with extreme anorexia nervosa.

Purpose: Hypoglycemia, a complication of prolonged starvation, can be life-threatening and is presumed to contribute to the high mortality of anorexia nervosa. Furthermore, early refeeding in severe anorexia nervosa can precipitate paradoxical post-prandial hypoglycemia. Few studies have analyzed the course of hypoglycemia during nutritional rehabilitation in patients with extremely low-weight anorexia nervosa.

Restriction of range effects in post-metabolic and bariatric surgery outcomes research: considerations for clinical decision making.

Background: Preoperative psychopathology does not consistently predict postoperative outcomes in patients who undergo metabolic and bariatric surgery (MBS). Individuals with elevated pre-MBS psychopathology may be less likely to undergo surgery, which may create a floor effect given the limited range of scores on measures of psychopathology included in postoperative analyses, thereby decreasing the power to detect clinically significant differences between groups.

Objectives: Our objective was to compare rates of clinically significant pre-MBS psychopathology across domains of functioning in patients who did and did not undergo MBS: surgical completers (SCs, n = 286) and nonsurgical completers (NSCs, n = 125).

Poor Sleep in Inflammatory Bowel Disease Is Reflective of Distinct Sleep Disorders.

Background: Poor sleep is common in inflammatory bowel disease (IBD), predicting increased risk of flares, surgery, and/or hospitalization and reducing quality of life.

Aims: To profile specific sleep disorder symptoms in IBD, informing intervention efforts.

Methods: 312 adults with Crohn's disease or ulcerative colitis were recruited from an academic medical center in New Hampshire, USA.

Change in normative eating self-efficacy is associated with six-month weight restoration following inpatient treatment for anorexia nervosa.

Anorexia nervosa (AN) is a disorder characterized by rigid and restrictive eating behaviors, resulting in significantly low body weight. While specialized behavioral intensive treatment programs can reliably support individuals with AN to normalize eating and weight control behaviors and achieve weight restoration, prognostic factors predicting relapse following treatment are unclear. We examined whether changes in (i) normative eating self-efficacy, (ii) body image self-efficacy, (iii) drive for thinness, and (iv) body dissatisfaction from inpatient admission to six-month follow-up were associated with weight restoration status at program discharge and at six-month follow-up.

Gastrointestinal symptomatology, diagnosis, and treatment history in patients with underweight avoidant/restrictive food intake disorder and anorexia nervosa: Impact on weight restoration in a meal-based behavioral treatment program.

Objective: Gastrointestinal (GI) concerns are often presumed to complicate nutritional rehabilitation for restrictive eating disorders, yet their relationship to weight restoration outcomes is unclear. This retrospective chart review examined GI history and weight-related discharge outcomes in primarily adult, underweight inpatients with anorexia nervosa (AN, N = 107) or avoidant/restrictive food intake disorder (ARFID, N = 22) treated in a meal-based, behavioral eating disorder program.

Method: Lifetime GI symptomatology, diagnoses, diagnostic tests, and procedures were abstracted from medical records.

Discharge Body Mass Index, Not Illness Chronicity, Predicts 6-Month Weight Outcome in Patients Hospitalized With Anorexia Nervosa.

Proposed treatments for severe and enduring anorexia nervosa (SE-AN) focus on quality of life, and psychological and social functioning. By de-emphasizing weight restoration as a priority, however, premature diagnosis of SE-AN may reduce potential for recovery. The present study assessed the effect of weight restoration, illness duration, and severity on treatment outcome 6 months after discharge from an intensive, meal-based behavioral treatment program.

Acceptability and tolerability of a meal-based, rapid refeeding, behavioral weight restoration protocol for anorexia nervosa.

Objective: Safe, tolerable, effective approaches to weight restoration are needed for adults with anorexia nervosa (AN). We examined weight outcomes and patient satisfaction with an integrated, inpatient-partial hospitalization, meal-based behavioral program that rapidly weight restores a majority of patients.

Method: Consecutively discharged inpatients (N = 149) treated on weight gain protocol completed an anonymous questionnaire assessing treatment satisfaction at inpatient discharge.

Sleep disturbance and insomnia in individuals seeking bariatric surgery.

Background: Sleep disturbance is well established in individuals with obesity, and the relationship between poor sleep and obesity is supported by population, longitudinal, experimental, and intervention studies. However, the prevalence and characteristics of poor sleep in individuals seeking bariatric surgery have thus far been poorly examined.

Objectives: We sought to characterize self-reported sleep parameters in individuals seeking bariatric surgery and to compare these data with controls.

The Effects of a Remote-based Weight Loss Program on Adipocytokines, Metabolic Markers, and Telomere Length in Breast Cancer Survivors: the POWER-Remote Trial.

Purpose: We initiated a clinical trial to determine the proportion of breast cancer survivors achieving ≥5% weight loss using a remotely delivered weight loss intervention (POWER-remote) or a self-directed approach, and to determine the effects of the intervention on biomarkers of cancer risk including metabolism, inflammation, and telomere length.

Experimental Design: Women with stage 0-III breast cancer, who completed local therapy and chemotherapy, with a body mass index ≥25 kg/m were randomized to a 12-month intervention (POWER-remote) versus a self-directed approach. The primary objective was to determine the number of women who achieved at least 5% weight loss at 6 months.

A modified inpatient eating disorders treatment protocol for postbariatric surgery patients: patient characteristics and treatment response.

Background: Bariatric surgery is currently the most effective treatment for obesity. However, outcomes vary and disordered eating may persist or emerge postsurgically. Severe postsurgical eating disorders may require inpatient treatment, and guidelines for the modification of inpatient nutritional treatment protocols for this population are lacking.

Hospital course of underweight youth with ARFID treated with a meal-based behavioral protocol in an inpatient-partial hospitalization program for eating disorders.

Objective: Information on nutritional rehabilitation for underweight patients with avoidant/restrictive food intake disorder (ARFID) is scarce. This study characterized hospitalized youth with ARFID treated in an inpatient (IP)-partial hospitalization behavioral eating disorders (EDs) program employing an exclusively meal-based rapid refeeding protocol and compared weight restoration outcomes to those of patients with anorexia nervosa (AN).

Method: Data from retrospective chart review of consecutive underweight admissions (N = 275; age 11-26 years) with ARFID (n = 27) were compared to those with AN (n = 248) on clinical features, reason for discharge, and weight restoration variables.

Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial.

Objective: This study evaluated the benefits of olanzapine compared with placebo for adult outpatients with anorexia nervosa.

Methods: This randomized double-blind placebo-controlled trial of adult outpatients with anorexia nervosa (N=152, 96% of whom were women; the sample's mean body mass index [BMI] was 16.7) was conducted at five sites in North America.

Self-selection bias in eating disorders outcomes research: Does treatment response of underweight research participants and non-participants differ?

Observational treatment studies provide a valuable alternative to RCTs but are often criticized due to potential self-selection biases. Studies comparing those who do and do not participate in research on eating disorder treatment are scarce, but necessary to evaluate the impact of self-selection bias on outcomes. All consecutive underweight adult first admissions (N = 392) to an integrated inpatient (IP)-partial hospital (PH) behavioral specialty program were invited to participate in a longitudinal study of eating disorder treatment.