Plenaries ICED 2024

Biology Plenary: Facing the Challenges and Unknowns Posed by GLP-1 Receptor Agonist Medications

Co-Chairs: Dr. Trevor Steward, PhD & Dr. Claudia Pieper, PhD

Abstract: Glucagon-like peptide-1 (GLP-1) is a hormone that plays important roles in regulating appetite and blood sugar levels. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a new group of drugs that were originally developed to treat type 2 diabetes and that are increasingly prescribed to manage weight. GLP-1 RAs have been shown to be very effective at lowering blood sugar levels and weight, as well as demonstrating benefits for heart health and kidney function. However, there is a lack of evidence to inform whether GLP-1 RAs could be administered in populations with eating disorders. This plenary will provide an overview of how GLP-1 RAs work to modify reward-related circuitry and to improve metabolic health, factors clinicians should take into account when patients with an eating disorder seek guidance on GLP-1 RAs. Discussions will cover what future research is needed to determine what role GLP-1 RAs could have, if any, in the treatment of EDs and how to manage patients with an ED who are taking GLP-1 RAs.

Learning Objectives

1. Learn more about how GLP-1influences physiological functioning and how GLP-1 Ras work to improve metabolic health and modulate eating behaviors.
2. Provide a balanced view on the possible benefits and risks of taking GLP-1 RAs for patients with an eating disorder and to help audience members discern meaningful developments in GLP-1 RA treatment from hype. 
3. Detail what steps need to first be taken in order to effectively and safely introduce GLP-1 RAs as a potential adjunct treatment for EDs and how to manage patients with an ED who are taking GLP-1 RAs.

Presenters & Talk Titles

GLP-1 receptor agonists medications: What are they? How do they work?
Dr. Milan Piya, PhD, FRACP
Clinical Academic Endocrinologist, Western Sydney University AND Camden and Campbelltown Hospitals, NSW, Australia

An introduction into the role of GLP-1 in influencing stress-related eating, emotion, and mood
Dr. Robyn Brown
University of Melbourne

Clinical implications of GLP-1 RA use in patients with eating disorders
Dr. Kim Dennis, MD, CEDS
Chief Medical Officer & CEO, SunCloud Health

Discussant: Facing the challenges and unknowns posed by GLP-1 receptor agonist medications
Kelly C. Allison, PhD, FAED, FTOS
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania

Sociocultural Plenary: Beyond the West: Cultural adaptations to target sociocultural risk factors for eating disorders

Co-Chairs: Dr. Helena Lewis-Smith, Dr. Caitlin Martin-Wagar & Dr. María Luz Scappatura

Abstract: Sociocultural risk and maintenance factors for eating disorders are not necessarily universal or primary eating disorder contributors across cultures. Recognized sociocultural determinants for eating disorders in the West (e.g., appearance-based teasing, thin-ideal internalization) vary by culture and geography. Most evidence-based practices for eating disorders have been developed in Western regions. However, assessment tools, prevention efforts, and treatment approaches are impacted by culture. In a globalized world, providing culturally sensitive practices is essential for ethical and effective research and patient care. Furthermore, culturally sensitive intervention models are necessary for reducing health disparities. This plenary panel focuses on the sociocultural considerations in the assessment, measurement, prevention, and treatment of eating disorders in underrepresented regions. Panelists will review the current research base of the evidence-based assessment, measurement, prevention, and treatment approaches in non-Western cultures. Knowledge gained from the plenary will address how to balance maintaining fidelity with making appropriate cultural adaptations. Based on up-to-date regional and cross-cultural research, recommendations for how clinicians and researchers across the globe can best incorporate cultural considerations into eating disorder research and practice will be provided. 

Learning Objectives

1. Identify cultural elements from underrepresented regions and populations that should be considered when delivering interventions and conducting research with underrepresented populations. 
2. Describe potential cultural adaptations of evidence-based measures and interventions for assessment, prevention, and treatment in underrepresented cultures and populations.
3. Incorporate culturally-sensitive practices into your own eating disorder research or practice.

Presenters & Talk Titles

How do we account for diverse cultures and groups in interventions of disordered eating and mental health?
Anne E. Becker, MD, PhD, SM
Presley Professor of Global Health and Social Medicine, Harvard Medical School

Speaking the language of culture: How do we ensure a responsive prevention model for diverse cultures and groups?
Dr. Sook Ning Chua
Harvard T.H. Chan School of Public Health

Integrating culture in our current evidence-based treatments
Yael Latzer, DSc
University of Haifa, Israel

Discussant: Embracing cultural sensitivity in our practice: Where are we as a field?
Debra Franko, PhD
Senior Vice Provost for Academic Affairs and Professor, Applied Psychology, Northeastern University

Treatment Plenary: Anorexia Nervosa, Later Illness Staging and Palliative Care – Considerations from Clinical, Research and Lived Experience Perspectives

Co-Chairs: Sandra Schlegl, PhD., Joanna Mercuri & Caitlin McMaster, PhD

Abstract: Many academic papers about anorexia nervosa (AN) begin by citing its very high mortality rate, yet the field both clinically and academically has been cautious about proposing staging criteria or even identifying groups of patients who might qualify for other than the classic treatment protocols that focus on recovery as the only acceptable outcome. Recently, more consideration has been given, for carefully identified patient populations, to harm reduction treatment approaches, palliative care as a novel, non-pre-terminal multidisciplinary support system, and hospice care and other compassionate measures for those who may die from their illness. There is a risk these care options may be misused by health insurance companies or professionals. This plenary aims to facilitate a discussion on how to apply appropriate, responsive care modalities to adults with severe and persistent AN from the perspective of clinicians, ethicists, researchers, and individuals with lived experience, and it will explore the implications of this for individuals with AN and their families.

Learning Objectives

1. Understand the current evidence-base for the management of severe and enduring AN.
2. Present the proposed staging criteria of AN and consider the pros and cons of identifying groups of patients who might qualify for care protocols that do not endeavor for recovery.
3. Describe the proposed clinical approaches for the management of patients in later stages of AN, including care practices such as harm reduction, palliative and hospice care, and medical aid in dying (MAID).
4. Discuss the ethical considerations and potential consequences for the eating disorder field of staging AN and utilizing care practices reserved for patients with identified terminal illnesses (e.g., hospice and MAID, where legal).

Presenters & Talk Titles

Care in the latest stages of AN: Honoring the complexity, the stakes, and the patient 

Jennifer Gaudiani, M.D., C.E.D.S.-S., F.A.E.D. 
Founder & Medical Director, The Gaudiani Clinic

Terminal anorexia nervosa cannot and should not be defined
Patricia Westmoreland, MD
Consultant Psychiatrist, ACUTE Center for Eating disorders and Severe Malnutrition

Palliative care for severe and persistent mental illness: bioethical considerations
Dr. Manuel Trachsel, MD, PhD
University of Basel, Switzerland

A Lived Experience Response to the Consideration of a Terminal AN Diagnosis
James Downs,  MEd, MBPsyS
Royal College of Psychiatrists, London; Faculty of Wellbeing, Education & Language Studies, Open University, Milton Keyes, UK

Discussant: Should the diagnosis of terminal AN and the integration of palliative care or hospice into the treatment of some individuals with SE-AN be considered?
Eric van Furth, Ph.D., FAED
Rivierduinen Eating Disorders Ursula / Leiden University

Wildcard Plenary: Cultivating early intervention for eating disorders: Opportunities for building research-supported pathways for access and inclusion

Co-Chairs: Erin Harrop, PhD, LICSW & Dr. Andrea LaMarre

Abstract: Cost-effective and innovative approaches to early intervention for eating disorders are urgently needed. Unfortunately, eating disorders often go unrecognized--particularly amongst people in larger bodies, as well as BIPOC, LGBTQ+, and lower SES populations. This results in missed opportunities for early intervention. Promising research-supported models for early intervention are emerging, and researchers and practitioners are exploring ways to tailor these interventions to meet the needs of diverse groups. In this plenary, presenters will share emerging approaches and next steps for early intervention for eating disorders. This panel integrates researcher-clinician-lived experience co-design in service development, delivery, and research. Panelists will consider training in eating disorder recognition and referral across the healthcare and community support continuum. Presenters will offer insights into practices to address eating disorders early and engage people who may otherwise fall through the cracks of eating disorders treatment.

Learning Objectives

1. Critically evaluate different avenues for early intervention for eating disorders.
2. Identify the strengths and challenges of various models for early intervention.
3. Understand the ways in which early intervention can be supported by enhanced training and support in eating disorder recognition, particularly in diverse populations, across the care continuum.

Presenters & Talk Titles

Adapting early intervention models for integrated community settings
Dr. Nicole Obeid
Scientist, Children's Hospital of Eastern Ontario Research Institute

A health equity lens on early intervention for eating disorders
Scout Silverstein, MPH
Clinical Curriculum Development Specialist, Project HEAL

Improving recognition of eating disorders across the weight spectrum to facilitate early intervention 
Lesley Williams, MD, CEDS
Senior Associate Consultant & Eating Disorder Specialist, Mayo Clinic

Discussant: The future of early intervention for eating disorders: Building interventions for sustainability, impact, and inclusion
Dr. S. Bryn Austin
Professor of Pediatrics, Boston Children's Hospital Harvard Medical School