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Gorrell, Sasha; Le Grange, Daniel
doi: 10.1002/eat.23992pmid: 37184424
Wilksch (2023) uses survey data to characterize the perspective of caregivers of children who have undergone treatment for an eating disorder. With this framework, the author presents an evocative view of both the challenges these parents experience in acquiring needed specialty treatment, as well as the negative impact that the caregiving role may have on their own well‐being. Altogether, this Forum underscores the unquestionable importance of not overlooking the practical and emotional needs of caregivers of youth with eating disorders, and presents a compelling call to action for our field to better support parents who navigate treatment for these challenging illnesses.
Goldschmidt, Andrea B.; Tortolani, Christina C.
doi: 10.1002/eat.23983pmid: 37144776
Eating disorders (EDs) present high costs to the individual and society, and need for services far surpasses their availability. Caregivers are often on the “front lines” of managing their child's illness yet may have very little support to sustain them in this role. It is well‐established that caregiver burden related to EDs is high, although most research has focused on caregivers of adult patients. Wilksch describes the need for additional attention to caregivers of children and adolescents with EDs, given the elevated psychological, interpersonal, and financial burden incurred on this segment of the population. In this commentary, we describe three major gaps in service delivery and research that may exacerbate caregiver stress: (1) limited exploration of “nontraditional” delivery modalities that could enhance access to care; (2) lack of research into viability of caregiver peer coaching/support models including respite resources; and (3) scarcity of accessible ED training for healthcare providers (particularly physicians) which increases length to receipt of competent care as families search for well‐trained providers and/or languish on waitlists. We propose prioritizing additional research in these areas to help alleviate caregiver burden associated with pediatric EDs, and facilitate delivery of prompt, comprehensive, and competent care to support optimal prognosis.
Tanofsky‐Kraff, Marian; Schvey, Natasha A.
doi: 10.1002/eat.23988pmid: 37159493
In Wilksch (International Journal of Eating Disorders, 2023), survey results from parents of youth with eating disorders (EDs) indicate that parents are often the first to detect their children's ED symptoms, and that they face barriers in accessing appropriate, timely treatment, and experience emotional and financial strain. Wilksch highlights gaps in research and practice, and identifies recommendations to mitigate them. We propose prioritizing similar recommendations for parents of children with higher weight (HW). As EDs and body size are often inextricably entwined, our recommendations involve consideration of both eating‐ and weight‐related impacts. The fields of EDs and HW tend to work independently; as a result, disordered eating, HW, and the convergence of the two, are often overlooked or unaddressed in children. We recommend the prioritization of research, practice, training, and advocacy for youth with HW and their parents. We propose evidence‐based ED screening in youth across the weight spectrum, developing and testing therapies to address both EDs and HW concurrently, training more providers to deliver established interventions, reducing weight‐based stigmatization and parental blame, and advocating for policies that protect children with HW and their families. Finally, we urge policymakers to ensure financial coverage of early intervention to prevent adverse eating and weight‐related outcomes in youth.
Rodgers, Rachel F.; Smith, Kathryn; Murray, Stuart B.
doi: 10.1002/eat.23937pmid: 36987942
Restrictive eating disorders such as anorexia nervosa (AN) are characterized by extremely rigid cognitive and behavioral patterns, understood to underpin the chronic nature of these disorders. Interrogating the mechanisms contributing to and maintaining the rigid cognitive styles and limited behavioral repertoires, particularly in terms of restrictive eating and excessive exercise is of critical importance. Dietary restriction is overall understood to underpin this rigidity to a large extent, however, to date little is understood regarding the relative contributions of different aspects of restriction including low body weight, low fat mass, weight suppression, acute negative energy balance, and chronic restriction. Clarifying the respective roles of these different factors would be useful for both the better targeting intervention efforts in AN. Extending research to other disorders such as muscle dysmorphia, avoidant restrictive food intake disorders, or atypical AN, that may present similar features to AN but differ from it on other critical dimensions, may offer unique opportunities to identify clinical elements specific to these cognitive patterns. Doing so may inform interventions and pave the way towards more effective treatment approaches.
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