International Conference on Eating Disorders

Student and early-career ICED attendees are invited to attend the Annual Mentor-Mentee Breakfast, hosted by the AED Membership Recruitment and Retention Committee. The event, which is scheduled for Thursday, March 14th from 07:30 – 08:30, pairs student and early-career attendees with seasoned AED members to talk about issues relevant to those new to the field of eating disorders. Topics for 2019 include:

1. Advocacy/Policy
2. Athletics/Sports
3. Binge Eating Disorder
4. Body Image/Body Dysmorphia
5. Therapeutic Modalities – CBT, DBT, ACT, FBT
6. Medical Management
7. Neuroscience
8. Nutrition
9. Obesity/Healthy at Any Size
10. Experts by Experience (formerly Patient-Carer)
11. Pediatrics/Adolescence
12. Prevention
13. Research-Practice Integration

This is a TICKETED event, requiring pre-registration. If you wish to attend, please be sure to choose this event as an option during your ICED registration process.

Why People Die by Suicide

In his new theory of suicidal behaviour, Thomas Joiner, PhD proposes three factors that mark those most at risk for suicide: the feeling of being a burden on loved ones; the sense of isolation; and, perhaps chillingly, the learned ability to hurt oneself. He tests the theory against diverse facts taken from clinical anecdotes, history, literature, popular culture, anthropology, epidemiology, genetics, and neurobiology - - facts about suicide rates among men and women; white and African-American men; individuals with anorexia, athletes, sex workers, and physicians; members of cults, sports fans, and citizens of nations in crisis.

Learning Objectives:

• To review basic facts about the epidemiology and risk factors for death by suicide
• To learn about a new theory of suicidal behavior
• To learn about anecdotal, clinical, and scientific evidence that evaluates this new theory
• To learn about approaches to suicide risk assessment
• To learn about developments in the treatment of suicidal behavior
• To  learn about developments in suicide prevention
• To understand the experience of people who are bereaved by suicide

Treatment Quicker and Better: What is the Evidence for Short-Term Treatments in Eating Disorders?
Co- Chairs: Karina Allen, PhD, MPsych¹ and Judy Krasna, BA^2
1South London and Maudsley NHS Foundation Trust, London, UK; ²Bet Shemesh, Jerusalem District, Israel

There is a growing body of research to show that short-term treatments may achieve similar therapeutic outcomes to longer term interventions (e.g., Ost & Ollendick, 2017; Waller et al., 2018). This reflects, in part, a non-linear dose-response relationship between treatment duration and treatment outcomes, with benefits dropping off rapidly after an initial optimum ‘dose’. In addition, early symptom change is one of the most potent predictors of longer-term outcomes in cognitive behavioral therapy and family-based therapy, and if early reductions in symptoms do not occur, additional treatment may offer relatively little benefit (Le Grange et al., 2014; Rose & Waller, 2017; Turner et al., 2015). This plenary seeks to examine evidence around the optimum dose-response relationship in the treatment of psychological disorders generally and eating disorders more specifically. In addition, it aims to describe and evaluate some of the available short-term interventions for eating disorders.

Learning Objectives:

1. To explore the relationship between treatment duration and treatment outcomes in eating disorders.
2. To explore the evidence base for short-term interventions for eating disorders.

Balancing Input with Output: How Treatment Duration Relates to Symptom Improvement
Michael Barkham, BEd, MA, MSc, PhD
University of Sheffield, Sheffield, UK

This presentation introduces and summarises various models and key issues in relation to treatment duration and symptom improvement within the broader field of research in the psychological therapies. Evidence on the relationship between treatment duration and outcome is drawn from randomised controlled trials and large practice-based (i.e., naturalistic) studies, including the UK government’s Improving Access to Psychological Therapies (IAPT) initiative. The clinical merits and challenges of shorter treatment durations are considered along with a number of caveats in relation to carrying out research in this area.

Doing Less to Achieve More: The Case of CBT-T for Eating Disorders
Glenn Waller, BA, MClinPsychol, DPhil
University of Sheffield, Sheffield, UK

While we routinely assume that ‘more therapy = better outcomes’ in working with eating disorders, the evidence for that assumption is poor. Indeed, offering more treatment can have negative outcomes for all concerned. This presentation will explain the development of a brief, ten-session therapy for non-underweight eating disorders (CBT-T) and will present evidence that doing less can indeed be better than doing more. Therapy can be cheaper, faster, and easier to access, without losing any effectiveness, and with very positive acceptability to the patients who undertake it. However, while patients are positive about shorter therapies, clinicians are often more resistant, and we need to understand why that is the case. Otherwise, we will continue to waste time when we could be helping more people to recover and reducing waiting times substantially.

Brief Single and Multifamily Interventions for Child, Adolescent and Young Adult Anorexia Nervosa: When, Why and in What Context

Ivan Eisler, OBE, PhD, FAED
Kings College, London, UK

Most treatment research in eating disorders tends to focus on trying to identify the best evidence-based treatments i.e. it centres on questions such as is treatment A better than treatment B or is one variant of treatment A better than another variant of treatment A.  This presentation will take a broader look, that will include factors (individual, family as well as the service context) that may need to be included when considering using brief family treatments and the different aims that such brief treatments might have. For instance, recent major investment by the National Health Service in England to establish a network of specialist community-based services for young people with an eating disorder has resulted in a growing number of very early referrals at a point in time when the family is concerned but as yet has not been much affected by the emerging eating disorder and where a very brief intervention of 2-4 sessions may be all that is needed. A very different type of brief family intervention is a 5-day intensive multi-family therapy for young adults that we are currently developing at UCSD. The aim of this intensive intervention is primarily to address motivation to change and the ambivalence of the young person about accepting help and support from their families. For some, the brief intervention may itself lead to significant symptom change but for others the key aim is to target possible individual or family “roadblocks” and thereby facilitate other, longer individual or family treatments. The talk, while drawing on existing (though very limited) empirical evidence, will be more clinically oriented and will aim to raise new questions rather than provide answers.

Discussant

Tracey Wade, BSc, MClinPsych, PhD
Flinders University of South Australia, Adelaide, SA, Australia

The goal of this presentation is to summarize and synthesize key points from other presentations. The discussant will express their viewpoints on the optimal ‘dose’ of eating disorder treatment and short-term interventions in the field, drawing on the previous presentations, their own work, and the general literature on these issues. The Discussant will talk about her opinion regarding the optimal dose of treatment, based on a synthesis of information presented by speakers.

Lunch is NOT provided. Meetings start 45 minutes after the lunch period begins in order to allow attendees to eat before, or bring their lunch to, the meeting.

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Session Topics

• Bariatric
• Body Image & Prevention
• Family-Based Treatment
• Genes & Environment
• Medical Care
• Neuroimaging
• Somatic & Somatically-Oriented Therapies
• Sports & Exercise
• Substance-Related & Addictive Disorders
• Technology & Innovation
• Transcultural
• Trauma
• Universities

View all Abstracts
Session Topics

• Top Abstracts I
• Treatment: Adult I
• Treatment: Child and Adolescent I
• Risk Factors I
• Body Image
• BED/Obesity
• Comorbidity
• Diagnosis, Classification, and Measurement
• Epidemiology
• Prevention
• Personality & Cognition
• Atypical Eating Disorders

Let’s Get Things Straight, I’m Not: Eating Disorders in the LGBTQ+ Community
Co-Chairs: Kelly Bhatnagar, PhD¹ and Erin C. Accurso, PhD^2
1Center for Evidence-Based Treatment, Moreland Hills, OH, USA; ²University of California San Francisco, San Francisco, CA, USA

Despite greater awareness that eating disorders affect a diverse group of individuals and research suggesting that certain LGBTQ+ subgroups are disproportionately vulnerable to body dissatisfaction and eating disorder psychopathology, relatively little research has focused on eating disorders in LGBTQ+ individuals. The links between sexuality, gender identity, body image, and eating disorders are still under investigation, but stressors specific to LGBTQ+ individuals may increase risk for developing an eating disorder. Further, this group may experience additional barriers to seeking treatment. This plenary strives to explore the unique factors in understanding disordered eating behaviours, body image, and eating disorders in LGBTQ+ individuals and discuss best practice clinical guidelines.

Learning Objectives:

1. Describe the context of social stigma for individuals who identify as LGBTQ+.
2. Summarize emerging research about associations between sexuality, gender identity, body image, and eating disorders.
3. Identify barriers to seeking care and best practice clinical guidelines.

Stigma and LGBT Health Inequalities
Mark Hatzenbuehler, PhD
Columbia University, New York, NY, USA 

Epidemiologic studies have consistently documented that LGBT populations are at heightened risk for a range of adverse health outcomes relative to cisgender heterosexuals, including eating and weight disorders. Having documented this increased risk, researchers have turned their attention to understanding causes of these disparities. Stressors related to stigma are one of the most frequently studied mechanisms contributing to LGBT health disparities. In this talk, I will review illustrative evidence documenting the health consequences of stigma for LGBT populations, with a particular focus on structural forms of stigma, which are defined as societal-level conditions, cultural norms, and institutional policies and practices. I will end the talk with a brief discussion of the implications of this research for the eating disorders field, and for the development of preventive interventions aimed at reducing the negative health sequelae of stigma for LGBT populations.  

Learning Objectives:

1. Briefly review the evidence for LGBT health disparities.
2. Discuss stigma as a mechanism contributing to LGBT health disparities.
3. Summarize and evaluate research about the health consequences of stigma for LGBTQ+ populations, with a particular focus on structural forms of stigma.
4. Discuss implications of this research for the eating disorders field and for preventive interventions with LGBTQ+ populations.

Understanding the Relationship Between Sexual Orientation and Eating Disorder Psychopathology in Youth
Jerel P. Calzo, PhD, MPH
University of California San Diego, San Diego, CA, USA 

A tendency in research and clinical practice is to treat sexual and gender minority populations as a monolithic group (e.g., grouped as LGBTQ+); rather, sexual and gender minority populations are diverse. Although early epidemiologic research indicated overall greater risk for disordered eating among sexual and gender minorities relative to heterosexual and cisgender populations, emerging research indicates greater complexity with regards to the direction and magnitude of health inequities in eating disorder risk (e.g., across age, across and within gender subgroups, by race/ethnicity). These emerging insights introduce new lines of inquiry regarding the development of sexual orientation disparities in eating disorder risk. This presentation will discuss body image and disordered eating in the context of sexual orientation identity development in adolescence and young adulthood. Using gender-based analysis as a framework, the talk will explore cross-sectional and longitudinal data that explicate how age and developmental factors, race/ethnicity, minority stress, and socialization processes shape eating disorder risk among heterosexual and sexual minority adolescents and young adults of diverse gender groups. Gaps in research, and their implications for prevention and clinical practice will also be explored.

Learning Objectives:

1. Recognize differences and similarities in gender minority identity development and sexual minority identity development.
2. Utilize examples from various research designs and gender-based analysis to understand how gender and sexual orientation identity development processes are connected to adolescent and young adult body image and eating disorder risk.
3. Summarize relevant gaps in research and practice in addressing eating disorder psychopathology among youth of diverse sexual orientations.

Body Image and Trans People
Jon Arcelus, MD, PhD
University of Nottingham, Institute of Mental Health, Jubilee Campus, Nottingham, UK

As transgender people have become more visible in our society, the number of people who identify as transgender and gender diverse attending health services has increased dramatically over the last few years. In view of this, health professionals need to have a good understanding of the needs of this population, including knowledge of the correct terminology when addressing transgender people.  There has been a rapid development and change in the use of language in transgender healthcare. Recent research has started to identify some of the difficulties with regards to mental health and body image that some of transgender people experience. The role of gender affirming medical interventions, such as hormone treatment and surgery to improve body image and mental health difficulties has also started to emerge. This presentation will firstly describe the current terminology to be used when working with the transgender population. It will follow with a description of the body image difficulties that this population present with and the risk of developing eating disorders. The role of gender affirming medical treatment in reducing body dissatisfaction will also be discussed. The presentation will use research and clinical experience to discuss why this population may be at an increased risk of developing eating disorders.

Learning Objectives:

1. To describe current terminology in transgender health.
2. To discuss, using clinical and research evidence, body image difficulties of transgender people attending transgender health services.
3. To present the most recent evidence describing eating disorders psychopathology among the transgender population.
4. To discuss the role of gender affirming medical interventions regarding the body satisfaction of transgender people.

Discussant
Rachel Levine, MD
Commonwealth of Pennsylvania and the Pennsylvania College of Medicine, Middletown, PA, USA

The goal of this presentation is to summarize and synthesize key points from other presentations.  The discussant will express viewpoints on future directions for research on eating disorders in the LGBTQ+ community and how the treatment community can ensure the unique needs of this population are being met.

Do you have specific questions that you would like to ask of established experts in your field? Are you looking for consultation on clinical cases, practice issues or ethical dilemmas? Are you interested in developing or evaluating an intervention to treat or prevent eating disorders? Do you want advice on writing a grant application or publishing your work?

If you answer to any of these questions is YES, then the Meet the Experts session is just for you!

The Meet the Experts session is scheduled for Friday, March 15th from 13:30 – 14:30, and provides you with an opportunity to talk with AED Fellows about the following topics:

1. ARFID – Rachel Bryant-Waugh, Ovidio Bermudez
2. Psychotherapy/Treatment Research – Carol Peterson, Evelyn Attia, Howard Steiger
3. Obesity, Bariatric Surgery – Marsha Marcus, James Mitchell
4. Treatment of EDs - FBT Multifamily Therapy – Ivan Eisler, Eric van Furth
5. Research and Publishing/Career Development – Tracey Wade, Jenny Lundgren, Marian Tanofsky
6. Medical Complications – Neville Golden, Laurel Mayer
7. Public Health, Prevention, Risk Factors, Body Image – Dianne Neumark-Sztainer
8. ED Midlife and Beyond- Margo Maine
9. Outpatient Treatment of EDs – Jennifer Wildes, Wayne Bowers, Charles Portney
10. Weight Stigma, Health at Every Size – Deb Burgard, Rachel Calogero
11. Treatment Approaches – Drew Anderson (CBT), Lucene Wisniewski (DBT)
12. Medical Care, Psychopharmacological Treatment - Wayne Bowers, Arnold Andersen, Susan McElroy
13. Nutrition and EDs – Leah Graves, Marcia Herrin
14. Binge Eating Disorder – Kelly Allison, Fernando Fernandez-Aranda, Wendy Oliver-Pyatt
15. EBT in Eating Disorders and Treatment Dissemination – Pat Fallon, Kristen von Ranson
16. Brain-Based Approach to ED Treatment – Laura Hill

This is a TICKETED event, requiring pre-registration and space is limited, so be sure to choose this option and your topic of interest when you register for ICED 2019.

• Top Abstracts II
• Treatment: Adult II
• Biology
• Neuroscience
• Gender & Ethnicity
• Sexual Identity
• Risk Factors II
• Treatment: Child & Adolescent II
• Males
• Emotion
• Technology
• Potpourii