The Economic and Social Burden of Eating Disorders

doi:10.1002/0470867183.CH6

Book Chapter•DOI•

The Economic and Social Burden of Eating Disorders

Scott J. Crow¹, Carol B. Peterson¹•Institutions (1)

28 Jul 2003-pp 383-423

About: The article was published on 2003-07-28. It has received 34 citations till now. The article focuses on the topics: Eating disorders.

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Journal Article•DOI•

Predictors of Treatment Acceptance and Completion in Anorexia Nervosa: Implications for Future Study Designs

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Katherine A. Halmi¹, W. Stewart Agras², Scott J. Crow, James E. Mitchell³, G. Terence Wilson, Susan W. Bryson², Helena C. Kraemer² - Show less +3 more•Institutions (3)

Cornell University¹, Stanford University², University of North Dakota³

01 Jul 2005-Archives of General Psychiatry

TL;DR: The only predictor of treatment completion was high self-esteem, which was associated with a 51% rate of treatment acceptance, and pose a major problem for research in the treatment of anorexia nervosa.

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Abstract: Context There have been very few randomized controlled treatment studies of anorexia nervosa. Objective To evaluate factors leading to nonacceptance and noncompletion of treatment for 2 specific therapies and their combination in the treatment of anorexia nervosa. Design Randomized prospective study. Setting Weill-Cornell Medical Center, White Plains, NY; University of Minnesota, Minneapolis; and Stanford University, Stanford, Calif. Patients One hundred twenty-two patients meeting DSM-IV criteria for anorexia nervosa. Interventions Treatment with cognitive-behavioral therapy, fluoxetine hydrochloride, or their combination for 1 year. Main Outcome Measures Dropout rate and acceptance of treatment (defined as staying in treatment at least 5 weeks). Results Of the 122 randomized cases, 21 (17%) were withdrawn; the overall dropout rate was 46% (56/122) in the remaining patients. Treatment acceptance occurred in 89 (73%) of the 122 randomized cases. Of the 41 assigned to medication alone, acceptance occurred in 23 (56%). In the other 2 groups, acceptance rate was differentiated by high and low obsessive preoccupation scores (rates of 91% and 60%, respectively). The only predictor of treatment completion was high self-esteem, which was associated with a 51% rate of treatment acceptance. Conclusion Acceptance of treatment and relatively high dropout rates pose a major problem for research in the treatment of anorexia nervosa. Differing characteristics predict dropout rates and acceptance, which need to be carefully studied before comparative treatment trials are conducted.

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313 citations

Cites background from "The Economic and Social Burden of E..."

...There are few controlled treatment trials for this disorder because (1) the disorder is relatively rare, so that it is difficult to generate an adequate sample size in any one center; (2) patients with anorexia nervosa have a pronounced resistance to treatment and are at best ambivalent toward treatment; and (3) medical complications often require withdrawal from treatment protocols....
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...Among the 101 remaining patients, the dropout rate was substantial: 55% (56/101), or an overall Completers, 43% 18 (6, 7, 5) Completers, 41% 16 (7, 4, 5) Noncompleters, 56% 23 (11, 7, 5) Noncompleters, 40% 17 (5, 5, 7) Noncompleters, 41% 16 (5, 8, 3) Withdrawn, 17% 7 (4, 1, 2) Withdrawn, 17% 7 (3, 3, 1) Withdrawn, 18% 7 (3, 0, 4) Randomized 122 (45, 39, 38) Interviewed 168 (59, 47, 62) Interviewed Out 46 (14, 8, 24) Screened 681 (165, 192, 324) Screened Out 513 (106, 145, 262)...
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Journal Article•DOI•

Parental attitudes, body image disturbance and disordered eating amongst adolescents and young adults: a review.

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Rachel F. Rodgers¹, Henri Chabrol¹•Institutions (1)

University of Toulouse¹

01 Mar 2009-European Eating Disorders Review

TL;DR: Considering the role of parents could help improve public health management and further exploration of the way adolescents and young adults interpret and perceive parental attitudes and of potential protective factors is necessary.

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Abstract: Objective The purpose of this paper was to review the existing literature regarding the contribution of parental influences to the sociocultural pressures on body image disturbance and disordered eating so as to highlight principal findings so that parents can be given practical information and identify areas that require further research. Methods Relevant articles were located through Pubmed, Sciencedirect and PsychInfo, as well as the screening of bibliographies. Results The available data suggest that parents are strong communicators of sociocultural pressures. Parental influences via verbal messages and active encouragement have been shown to have more impact on offspring's body concerns and eating behaviours than modelling effects. Both mothers and fathers are important sources of influence for their offspring. Conclusion Considering the role of parents could help improve public health management. Futher exploration of the way adolescents and young adults interpret and perceive parental attitudes and of potential protective factors is necessary. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association.

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219 citations

Cites background from "The Economic and Social Burden of E..."

...…are strong risk factors for developing eating disorders (Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999), and are costly disturbances in psychological, personal, interpersonal and financial terms (Crow & Peterson, 2003; Hay & Mond, 2005; Paxton, Neumark-Sztainer, Hannan, & Eisenberg, 2006)....
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Journal Article•DOI•

Eating Disorder Symptoms and Obesity at the Intersections of Gender, Ethnicity, and Sexual Orientation in US High School Students

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S. Bryn Austin¹, Lauren A. Nelson², Michelle Birkett, Jerel P. Calzo³, Bethany G. Everett⁴ - Show less +1 more•Institutions (4)

Boston Children's Hospital¹, University of California, San Francisco², Harvard University³, University of Illinois at Chicago⁴

09 Jan 2013-American Journal of Public Health

TL;DR: Interventions to reduce eating disorders and obesity that are appropriate for LGB youths of diverse ethnicities are urgently needed.

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Abstract: Objectives. We examined purging for weight control, diet pill use, and obesity across sexual orientation identity and ethnicity groups.Methods. Anonymous survey data were analyzed from 24 591 high school students of diverse ethnicities in the federal Youth Risk Behavioral Surveillance System Survey in 2005 and 2007. Self-reported data were gathered on gender, ethnicity, sexual orientation identity, height, weight, and purging and diet pill use in the past 30 days. We used multivariable logistic regression to estimate odds of purging, diet pill use, and obesity associated with sexual orientation identity in gender-stratified models and examined for the presence of interactions between ethnicity and sexual orientation.Results. Lesbian, gay, and bisexual (LGB) identity was associated with substantially elevated odds of purging and diet pill use in both girls and boys (odds ratios [OR] range = 1.9–6.8). Bisexual girls and boys were also at elevated odds of obesity compared to same-gender heterosexuals (OR = ...

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186 citations

Journal Article•DOI•

A randomized controlled comparison of integrative cognitive-affective therapy (ICAT) and enhanced cognitive-behavioral therapy (CBT-E) for bulimia nervosa

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S. A. Wonderlich¹, Carol B. Peterson², Ross D. Crosby¹, Tracey L. Smith³, Marjorie H. Klein³, James E. Mitchell¹, Scott J. Crow² - Show less +3 more•Institutions (3)

University of North Dakota¹, University of Minnesota², University of Wisconsin-Madison³

01 Feb 2014-Psychological Medicine

TL;DR: This initial randomized controlled trial of a new individual psychotherapy for BN suggests that targeting emotion and self-oriented cognition in the context of nutritional rehabilitation may be efficacious and worthy of further study.

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Abstract: Background The purpose of this investigation was to compare a new psychotherapy for bulimia nervosa (BN), integrative cognitive-affective therapy (ICAT), with an established treatment, ‘enhanced’ cognitive-behavioral therapy (CBT-E). Method Eighty adults with symptoms of BN were randomized to ICAT or CBT-E for 21 sessions over 19 weeks. Bulimic symptoms, measured by the Eating Disorder Examination (EDE), were assessed at baseline, at the end of treatment (EOT) and at the 4-month follow-up. Treatment outcome, measured by binge eating frequency, purging frequency, global eating disorder severity, emotion regulation, self-oriented cognition, depression, anxiety and self-esteem, was determined using generalized estimating equations (GEEs), logistic regression and a general linear model (intent-to-treat). Results Both treatments were associated with significant improvement in bulimic symptoms and in all measures of outcome, and no statistically significant differences were observed between the two conditions at EOT or follow-up. Intent-to-treat abstinence rates for ICAT (37.5% at EOT, 32.5% at follow-up) and CBT-E (22.5% at both EOT and follow-up) were not significantly different. Conclusions ICAT was associated with significant improvements in bulimic and associated symptoms that did not differ from those obtained with CBT-E. This initial randomized controlled trial of a new individual psychotherapy for BN suggests that targeting emotion and self-oriented cognition in the context of nutritional rehabilitation may be efficacious and worthy of further study.

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185 citations

Cites background from "The Economic and Social Burden of E..."

...…overvaluation of body shape and weight, is associated with high rates of medical complications (Mehler, 2011), psychiatric co-morbidity (Wonderlich & Mitchell, 1997; Fichter et al. 2008) and psychosocial impairment (Crow & Peterson, 2003), along with significant mortality rates (Crow et al. 2009)....
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Journal Article•DOI•

Use of extreme weight control behaviors with and without binge eating in a community sample: implications for the classification of bulimic-type eating disorders.

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Jonathan Mond, Phillipa Hay¹, Bryan Rodgers², Cathy Owen², Ross D. Crosby, James E. Mitchell - Show less +2 more•Institutions (2)

James Cook University¹, Australian National University²

01 May 2006-International Journal of Eating Disorders

TL;DR: The combination of bulimic episodes, objective or subjective, and extreme weight control behaviors, purging or nonpurging, is significant in terms of impairment in psychosocial functioning among individuals affected by eating disorders not meeting formal diagnostic criteria for bulimia nervosa.

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Abstract: Objective and Method: To inform the classification of bulimic-type eating disorders not meeting formal diagnostic criteria for bulimia nervosa (BN), levels of eating disorder psychopathology and functional impairment associated with subjective and objective bulimic episodes (SBEs and OBEs) and purging and nonpurging methods of weight control were examined in a large community-based sample of women (n = 5,232). Results: Participants who reported recurrent bulimic episodes had significantly higher levels of eating disorder psychopathology and functional impairment than those who did not and this was the case whether the episodes were objective or subjective. Similarly, participants who reported the use of extreme weight control behaviors had higher levels of eating disorder psychopathology and functional impairment than those who did not, and this was the case whether purging or nonpurging behaviors were employed. The combination of bulimic episodes and extreme weight control behaviors was associated with particularly high levels of eating disorder psychopathology and functional impairment. Conclusion: The combination of bulimic episodes, objective or subjective, and extreme weight control behaviors, purging or nonpurging, is significant in terms of impairment in psychosocial functioning among individuals affected by eating disorders not meeting formal diagnostic criteria for BN. The combination of SBEs and extreme weight control behaviors, in particular, warrants further investigation.

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128 citations

Cites background from "The Economic and Social Burden of E..."

...Relegation of a large subgroup of individuals with eating disorders to the EDNOS category creates the impression that ‘‘true’’ eating disorders are uncommon and/or that eating disorders not meeting formal diagnostic criteria are associated with minimal impairment.(6) Because funding for mental health services is increasingly dictated by considerations of prevalence and disability,(7) it is important to identify those eating disorders within EDNOS that are most disabling and to consider how classification schemes might be modified to take account of these disorders....
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The Economic and Social Burden of Eating Disorders

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