Editors Note: 

Welcome to the January issue of the NEDC e-Bulletin. It's the start of another year, and this month we have put together a preview of the events and professional development opportunities available to members of the eating disorders sector in 2013. We are also featuring a professional perspective on hospital emergency rooms and their role in the treatment of eating disorders. 

We hope you enjoy this edition and if you would like to suggest topics or events to be featured in future editions of the e-bulletin, please contact us at info@nedc.com.au

Contents

1. New NEDC resource: 'Eating Disorders in Males'

2. Guest expert article

3. Events in 2013

4. Journal of Eating Disorders update

The NEDC is pleased to announce the release of our new online fact sheet “Eating Disorders in Males”.

Over the last year the NEDC has seen a steep increase in the number of people seeking more specific information on eating disorders in males. This resource has been developed in response to those requests.

The Eating Disorders in Males fact sheet has been created by eating disorders experts incuding members of the NEDC Steering Committee, and as always, it is evidence based. 

To access the fact sheet and download a copy for yourself visit our Eating Disorders in Males page. All of our fact sheets can be downloaded in our Eating Disorders Explained section.

The NEDC will continue to develop new evidence based resources for the website. If you have any suggestions for future content development we would love to hear from you. Please contact us at info@nedc.com.au

Back to top

Some thoughts from an eating disorders specialist who regularly consults to emergency departments

By Warren Ward, Director Eating Disorders Service, Metro North Mental Health Service - RBWH

Eating disorders can be associated with significant medical complications resulting in morbidity and mortality. Anorexia Nervosa, especially, has a high mortality rate, with the risk of death increased by purging behaviours.

For many people with eating disorders and their families, the first step to recovery is often the increased awareness in the patient, or others, of the problems associated with the eating disorder as a result of medical complications such as weakness, fainting or collapse.

It is therefore critical for people suffering from eating disorders, their families, general practitioners and other clinicians involved in their care, that staff working in emergency departments have a good understanding of the medical complications of eating disorders and their management. It is also important that emergency department staff have a good understanding of when admission to hospital is indicated and required for patient safety.

To assist emergency department staff in the above tasks, the Qld Eating Disorders Outreach Service (EDOS) has developed access pathways. These access pathways were developed following a review of the literature including the Royal Australia and New Zealand College of Psychiatry Clinical Practice Guidelines for the management of Anorexia Nervosa. In addition, EDOS consulted with Directors of Medicine, Emergency Departments and Mental Health; as well as drawing on its experience of many years of providing consultation-liaison services to emergency departments and general medical and mental health inpatient units treating patients with eating disorders.

The access pathways provide guidelines to emergency department clinicians as to what should be assessed when patients with eating disorders present, when patients with eating disorders require admission, and whether admission to a medical or mental health setting is indicated. The pathways also provide recommendations as to when patients could safely be transferred from a medical to a mental health setting. A general overriding principle of the pathways is that most patients require close co-operation between medical, mental health and specialist eating disorder clinicians to ensure medical safety as well as help with the cognitive, emotional and behavioural symptoms of eating disorders. Most jurisdictions in Australia unfortunately do not always have access to adequate specialist inpatient eating disorder settings, so the access pathways provide guidance to generalist clinicians including emergency department staff as to the safe medical management of life-threatening complications of eating disorders including malnutrition, effects of purging, and re-feeding syndrome.

Another issue that emergency department clinicians often require assistance with is the use of the mental health act, guardianship or other legislation which may need to be used if the patient’s eating disorder is impairing their decision-making capacity and resulting in great risk to themselves. EDOS has developed a guide to the use of the mental health act in Queensland with patients with eating disorders. Although legislation differs in different jurisdictions, the principles are quite similar in that for the use of such legislation to be considered there must be impaired decision-making capacity due to mental illness, imminent risk to self or others due to the mental illness, and no less restrictive way to help the patient access treatment.

Perhaps the most important thing to consider with respect to emergency department clinicians, is that such clinicians have a very busy, stressful job in which they are expected to assesses and manage a wide range of medical conditions. Therefore specialist eating disorders services and clinicians have an important role in providing guidance, support, advice, consultation and education and training to their emergency department colleagues.

The related guides may assist eating disorders specialists in their efforts to provide education and support to their local emergency department.

To read more about eating disorders in the emergency department check out the following research in our Research and Resources section.

• The prevalence and correlates of eating disorders among emergency department patients aged 14–20 years
• Severe anorexia nervosa: Outcomes from a medical stabilization unit
• What the emergency department needs to know when caring for your patients with eating disorders
• Avoiding deaths in hospital from anorexia nervosa: The MARSIPAN project
• The Same but Different? Treatment of Anorexia Nervosa in Adolescents and Adults

Back to top

2013 is shaping up to be a very busy year for the eating disorders sector. We have put together this preview of local and international events and professional development activities happening in 2013.

March: James Lock, Australia & New Zealand Tour

James Lock is Director of the Child and Adolescent Eating Disorder Program in the Department of Psychiatry at Stanford University, San Francisco and his work has contributed to the development of family based and related treatments particularly for youth.

James is conducting a series of professional development workshops in Australia & New Zealand in March, 2013. The draft schedule and contacts are:

• Mon – Fri March 4th – 8th: Auckland 
  Contact:Dr Roger Mysliwiec - RogerM@adhb.govt.nz
• Fri March 15th: Christchurch
  Contact: Rachel Lawson - Rachel.Lawson@cdhb.health.nz
• Wed March 20 to Friday 22nd: Adelaide
  Contact: Gabbi Heruc - gabriella.heruc@adelaide.edu.au
• Monday 25th March: Melbourne
  Contact: Claire Diffey - Claire.Diffey@mh.org.au
• Tuesday 26th and Wednesday 27th March: Perth
  Contact: Anthea Furthsland - Anthea.Fursland@health.wa.gov.au or Julie McCormack - Julie.McCormack@health.wa.gov.au

March 21-24: iaedp Symposium 2013

What’s New Under the Sun: Innovative Approaches to Treatment

Westin Lake Las Vegas Resort and Spa, Nevada, United States of America

Symposium 2013 is geared to the needs and problems of those who work with patients in a therapeutic environment. Interchange among participants is constant and challenging: workshops and keynote sessions focus on "cutting edge" information and techniques. In this conference, the emphasis is on exchange of information, not just listening.

For more information visit the iaep website.

May 2-4: International Conference on Eating Disorders (ICED)

Join ICED2013 in Montreal, Canada in May for an unparalelled educational programming that includes:

• Clinical Teaching Day and Research Training Day
• Keynote and Plenary Sessions
• Workshops
• SIG Panels
• Research Practice Session

Visit the ICED2013 website for more details.

May 22: Engaging partners as allies: Uniting Couples (in the treatment of) Anorexia Nervosa (UCAN) workshop

Royal Brisbane Women's and Childrens Hospital Education Centre, Queensland

UCAN is a couple-based intervention that emphasizes the power of the partner in treating adult AN. Grounded in a cognitive-behavioral couple therapy framework, UCAN jointly engages patients and partners in the treatment of AN while simultaneously addressing the burden AN imposes on intimate relationships.

This workshop, organized by ANZAED & EDOS will explain how the treatment of adult anorexia nervosa can be optimized by including the couple as a component of treatment. It will demonstrate the various clinical components of UCAN by using videos of couple interactions, rich clinical vignettes, and role plays in order to introduce clinicians to the rewards and challenges of delivering UCAN.

Dr. Cynthia Bulik is the Distinguished Professor of Eating Disorders in the Department of Psychiatry in the School of Medicine at the University of North Carolina at Chapel Hill where she is also Professor of Nutrition in the Gillings School of Global Public Health and the Director of the University of North Carolina Center of Excellence for Eating Disorders.

More details can be found on the ANZAED website.

May 23-25: At Home with Eating Disorders

The 1st Australian eating disorders conference for families and carers

Royal Brisbane Women's and Childrens Hospital Education Centre, Queensland

Best evidence for eating disorders shows that the close involvement of families and carers in the care of their loved ones is key to improving early detection, restoration to a healthy weight and maintaining long term wellbeing. For parents and carers, however, the journey can be confusing, challenging and difficult to navigate.

The primary aim of At Home with Eating Disorders is to provide families and caregivers of people with eating disorders with access to a range of expert information and knowledge so that they can leave the conference feeling empowered, better informed and more able to support, care for and assist in the recovery of the person with the eating disorder.

The secondary aim of the conference is to provide opportunities to network and connect with others who share a similar experience, in a safe and supported environment.

Clinicians and people with eating dsorders wanting to learn more about the role of families and carers in supporting recovery are also welcomed.

More details can be found on the event website.

May 23: Advanced Training Workshop for Family Based Therapy

Presented by Professor Daniel Le Grange.

Daniel Le Grange is Professor of Psychiatry in the Department of Psychiatry and Behavioral Neuroscience, and Director of the Eating Disorders Program at The University of Chicago Medicine. He currently is a principal investigator on several treatment studies in the US and Australia.

This clinical workshop is organised by ANZAED & EDOS as an adjunct to the At Home with Eating Disorders Conference

The workshop will be most suitable for clinicians who are familiar with FBT, and have accrued considerable clinical hours and experience treating adolescent eating disorders within this treatment modality. The primary aims of this one-day workshop are to provide attendees with (1) a forum for discussing challenges to implementation of FBT in various practice settings; (2) in depth case-based consultation on challenging cases; and (3) an opportunity for a discussion of latest research in FBT.

Visit the ANZAED website for more details.

May 23: The Collaborative Care approach to treating and beating an eating disorder

Presented by Professor Janet Treasure

Professor Janet Treasure is currently Director of the Eating Disorders Service in the South London and Maudsley Hospital and Professor of Psychiatry at University College London. Professor Treasure has been active in a number of research projects and has over 150 peer reviewed papers in print. She has also supervised over 20 PhD students in eating disorders research. Much of her research into and development of new treatments has been carried out collaboratively with, and has inspired by, patients and their families.

The workshop, organized by the Butterfly Foundation, is suitable for parents and adult family of a loved one with an eating disorder and clinicians (especially students) who want to gain insight into working effectively with carers. It will cover:

• Factors that can maintain an eating disorder
• How and why the sufferer’s behaviour is difficult to manage
• Caregiver styles – animal metaphors
• How instinctive responses can sometimes hinder rather than help recovery
• What is needed to bring about change in behaviour
• Communication skills
• Motivational interviewing – what it is and how to use it

For more details download the workshop flyer.

May 26-30: Royal Australian and New Zealand College of Psychiatrists 2013 Congress

Achievements and Aspirations

Held at the Sydney Convention and Exhibition Centre and featuring a keynote session by Janet Treasure.

Visit the RANZCP2013 website for more details.

August 22-23: ANZAED Annual Conference

Sebel Albert Park hotel, Melbourne

ANZAED is the peak body representing health professionals and researches working in the eating disorder field in Australia & New Zealand.

The conference of the Australia & New Zealand Academy for Eating Disorders brings clinicians and researchers together to update each other on the latest local and international developments in the field. It includes keynote addresses from Dr Susie Orbach, London psychotherapist and writer and Professor Joe Proietto, University of Melbourne researcher into physiological mechanisms associated with weight & weight loss. The conference will also include presentations by researchers & clinicians, plenary sessions, workshops, poster presentations and opportunities for networking. Susie Orbach will be presenting pre-conference workshop on 22 August. A number of other pre-conference workshops suitable for different disciplines are currently being planned.

For more details visit the ANZAED website.

Late August: Jennifer Gaudiani, Australia/New Zealand Tour

Dr Gaudiani, Assistant Professor of Medicine &, Assistant Medical Director, ACUTE Center for Eating Disorders, Denver, will be touring Australia & New Zealand in late August 2013 to update medical professionals on medical management of eating disorders, including unusual presentations.

Her itinerary is currently being finalised, but is likely to include most capital cities across Australia & New Zealand. Enquiries to anzaed@anzaed.org.au.

October 9-12: The RANZCP Faculty of Child and Adolescent Psychiatry Conference

Melbourne Convention Exhibition Centre, Melbourne

Keynote speaker: Bryan Lask, Emeritus Professor of Child & Adolescent Psychiatry at Great Ormond Street Hospital for Children, at the University of London and is both Visiting Professor and Research Director at the Regional Eating Disorders Service, Oslo University Hospital, Norway.

Visit the conference homepage for more details.

Back to top

The Journal of Eating Disorders, a new Eating Disorder journal has been launched by Open Access publisher BioMed Central. This journal is the first open access journal in the field, meaning that all articles will be freely available over the internet. The Journal of Eating Disorders is co-edited by Prof Phillipa Hay, University of Western Sydney and Prof Stephen Touyz, University of Sydney together with an editorial board of over 50 internationally renowned scientists and clinicians in the field.

Journal of Eating Disorders aims to disseminate research that provides answers to the important issues and key challenges in the field and to facilitate translation of evidence into practice. 

The first papers published reflect the breadth, diversity and scope of this journal. One study examines the relationship between internalized weight bias and quality of life relating to both physical and mental health in 120 overweight or obese participants. Another investigates the role of perfectionism in body dissatisfaction in a large sample of adult women. A systematic review points to the urgent need for more research in eating disorders from other cultures.

The journal is available at the newly launched Journal website where you can subscribe to receive notice of the latest publications or submit manuscripts. Email Enquiries to: editorial@jeatdisord.com.

Back to top

If you enjoyed this e-Bulletin please share!