Wednesday at 15:30
1: Are we overlooking potential neurocognitive effects from guided physical exercise during therapy of EDs? Experiences from the treatment of AN, BN, BED & elite athletes.
Chaired by Dr Therese Fostervold Mathisen, Associate professor Østfold University College, Faculty of health, welfare and organization, Norway.
In treatment of eating disorders (ED), physical activity is either restricted, used primarily as a socializing arena, or used as a remedy for weight reduction in obese patients. This may not only deprive patients from important physical health effects from exercise, but also from therapeutic cognitive effects from adapted exercise. New scientific findings reveal therapeutic effects from adapted exercise in ED-therapy, and the scientific field of exercise physiology poses promising theories on how exercise may promote favorable neurostructural and -cognitive effects. In this tutorial, we will provide a short introduction to the historical appearance, conceptualization and management of physical activity behavior in patients with ED. We will then highlight how eating disorders and physical activity needs to be understood and managed differently in athletes and in general patients. You will be given insight to the documented clinical effects from using adapted PA in ED-treatment, and be introduced to important future scientific explorations of physical activity in ED-treatment based on the potential neurocognitive and -structural effects from physical activity.
- Dr Therese Fostervold Mathisen, Associate professor Østfold University College, Faculty of health, welfare and organization, Fredrikstad, Norway: The mental and neurocognitive effects from physical exercise
- Prof. Solfrid Bratland-Sanda, University of South-Eastern Norway, Department of Sport, Physical Education and Outdoor Studies, Bø, Norway: Experiences from the “Strong” interventions; guided physical activity during inpatient treatment of eating disorders (AN)
- Dr Therese Fostervold Mathisen, Associate professor Østfold University College, Faculty of health, welfare and organization, Fredrikstad, Norway: Experiences from the physical exercise and dietary outpatient therapy study; from RCT to clinical implementation (BN and BED)
- Prof. Jorunn Sundgot-Borgen, Norwegian School of Sport Sciences, Institute of Sports Medicine, Oslo, Norway: How about the athletes? Frequency of eating disorders and treatment considerations for athletes.
2: Somatic health in anorexia nervosa.
Chaired by Prof. René Klinkby Støving, Professor, consultant physician, MD, Nutrition Clinic, Center for Eating Disorders, Odense University Hospital
Anorexia nervosa is a syndrome defined by core psychopathologic symptoms which inevitably lead to various somatic complications which again affect the mental condition. Thus, there is a complex aggravating interaction between the psychopathology and the somatic consequences. This workshop covers different somatic challenges. Comorbid depression affects the weight gain during re-nutrition which affects cognitive functions. The treatment of anorexia nervosa becomes particularly complicated and multidisciplinary if there is somatic comorbidity such as diabetes or thromboembolism. Finally, the possible influence of the gut microbiota will be discussed.
- Dr. Line Wisting, PhD, Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway: Diabetes Body Project.
- Simone Hemmingsen, Cand. psych., PhD-student at Center for Eating Disorders, Psychiatric Services in the Region of Southern Denmark & Research Unit of Medical Endocrinology, Odense University Hospital, Denmark: The effect of intensive re-nutrition on cognitive functions in patients with severe anorexia nervosa (RESAN).
- Magnus Sjögren, MD, Psychiatric Center Ballerup, Denmark & Institute for Clinical Science, Umeå University, Sweden: Comorbid depression as a negative predictor of weight gain during treatment of anorexia nervosa.
- Jeanie Egedal, M.D., PhD-student at Center for Eating Disorders, Psychiatric Services in the Region of Southern Denmark & Research Unit of Medical Endocrinology, Odense University Hospital, Denmark: Thromboembolism in anorexia nervosa.
- Prof. René K. Støving, M.D., professor, PhD, Center for Eating Disorders, Psychiatric Services in the Region of Southern Denmark & Research Unit of Medical Endocrinology, Odense University Hospital, Denmark: Aberrant microbiome in anorexia nervosa: Cause or effect?
3: How to approach treatment of people with obesity and BED.
Chaired by Mari-Mette Graff, President in The Norwegian Federation for people with obesity
Binge eating disorder (BED) is a common mental health conditions among those who seek weight management. Most obesity interventions are concentrated on weight loss, lacking consideration of possible co-morbid emotional disorders.Hjelmesæth will discuss available evidence and present preliminary clinical experience of treatment of binge eating disorder in patients with severe obesity.Eik-Nes will present how health care professionals can work with psychological constructs that may contribute to development and maintenance of binge eating behavior such as environmental, social, biological, physiological, and familial stressors to improve screening and treatment outcomes in obesity treatment.The workshop covers updated knowledge on BED in weight management including bariatric surgery and challenges and opportunities for treatment of obesity and comorbid BED. Possible challenges and opportunities will be addressed.
- Prof. MD. Jøran Hjelmesæth, Department of Endocrinology, Morbid Obesity and Preventive Medicine, University of Oslo, and Vestfold Hospital Trust, and head of Morbid Obesity Center, Department of Medicine, Vestfold Hospital Trust
- Dr Trine Tetlie Eik-Nes, Associate Professor, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences
Thursday at 13:30
1: Transgender in eating disorders
Chaired by Dr. Gry Kjærsdam Telléus, Senior Researcher, Associate Professor, Clinical Psychologist Unit for Psychiatric Research, Aalborg University Hospital, Denmark.
Research has demonstrated an increased prevalence of eating disorder (ED) among transgender and non-binary individuals, and studies have suggested that transgender individuals are at a higher risk of being diagnosed with an ED or engage in disordered eating than the general population. Findings have suggested that gender-affirming treatment reduces the risk of ED. However, the body of research on the subject is sparse just as clinical knowledge on the subject is extremely limited. Thus, knowledge and increased focus on ED among non-binary and transgender individuals and effect of gender-affirming treatment in relation to ED is important.
- Birte Smidt MD, Head of Clinic, Psychiatric Center Copenhagen, Denmark: Gender identity and eating disorder from a patient perspective.
- Monica Ålgars PhD, Lecturer in clinical psychology, University of Helsinki, Helsinki, Finland: Gender identity, body dissatisfaction, and disordered eating
- Gry Kjærsdam Telléus PhD, Senior Researcher, Associate Professor, Clinical Psychologist Unit for Psychiatric Research, Aalborg University Hospital, Denmark: Prevalence of eating disorder among transgender and non-binary individuals, and the impact of gender-affirming treatment.
2: Mentalization-based therapy
Chaired by Bente Sommerfeldt, Clinical Psychologist, PhD-candidate, Director of Villa Sult, Norway.
This tutorial introduces a new outline for psychotherapy with persons with severe eating disorders. Mentalization-based treatment is evidence-based practice for borderline personality disorder. There is a well-known comorbidity of eating disorders and personality disorders. Severe forms of eating disorders represent their own phenotype of disordered personality development. The aim of the tutorial is to illustrate how mentalization-based treatments for eating disorders (MBT-ED) have been developed and tailored to severe eating disorders. Mentalizing is defined as the ability to understand feelings, cognitions, intentions and meaning in oneself and in others. The capacity to understand oneself and others is a key determinant of self-organisation and affect regulation, and is acquired in early attachment relationships. Eating disorders will be described as examples of different forms of impaired mentalizing, and such impairments are central psychopathological features in eating disorders. Psychotherapeutic enterprise with individuals with compromised mentalizing capacity should be an activity that is specifically focused on the rehabilitation of this function. Mentalization-based psychotherapy for eating disorders should also have a special emphasis on how the body is involved in representing mental states. This tutorial will apply mentalization-based principles to address specific challenges in eating disorders and present an outline for manual. The tutorial will include clinical examples, and will present demonstrations of therapeutic approaches. The tutorial will present basic theory and therapeutic goals, stances and techniques, and a format that combines group treatments, psychoeducation and individual therapy.
3: Binge eating disorder
Chaired by Dr. Sanna Aila Gustafsson, Psychotherapist, Eating disorder specialist, Sweeden.
Despite being the most prevalent eating disorder (ED) studies show that patients with Binge Eating Disorder (BED) are underrepresented in ED treatment. There are several traditional evidence based psychological treatments for BED with Cognitive behaviour Therapy (CBT) and Interpersonal Psychotherapy (IPT) as recommended treatments in several guidelines. There are also promising results from a treatment interventions that combine guided physical exercise and dietary therapy (PED-t). Other promising interventions come from the “third wave CBT” and focus more on acceptance and mindfulness, such as Dialectical behaviour Therapy (DBT) and interventions of Mindful Eating. However, what is largely absent in many BED treatments is an acknowledgement of the profound influence of weight stigma on the health and well-being of people affected by BED. Weight stigma is associated with binge eating, poor body image and overall poor mental and physcial health. This thematic session aims to describe various approaches to psychological treatment of BED and discuss the evidence base and possible shortcomings for these interventions and what might work for whom in a clinical context.
- Lena Meyer, PhD and Clinical Psychologist in Denmark.
- Therese Fostervold Mathisen, PhD, Dietitian and Exercise Physiologist, Associate professor Østfold University College, Faculty of health, welfare and organization, Norway.
- Karianne Vrabel, Specialist in psychology, Associate Professor at the University of Oslo, Head of the Research Institute of Modum Bad, Vikersund, Norway.