An in-depth look at eating disorders - In Conversation with Janet Treasure
Duration: 26 mins
Publication Date: 10 Jul 2023
Next Review Date: 10 Jul 2026
DOI: 10.13056/acamh.13640
Description
Janet Linda Treasure discusses the transformations in eating disorders over the last 50 years, encompassing changes in their form, epidemiology, and clinical and social features. Genetic research has unveiled the psychosomatic foundations of these disorders, highlighting a profile akin to other psychiatric conditions but with varying aspects of metabolic risk across the eating disorder spectrum. Starvation plays a pivotal role, affecting both the brain and body, perpetuating the illness and contributing to its resistance to treatment. Treasure introduces the cognitive-interpersonal model, which forms the basis of the Maudsley model of anorexia nervosa treatment for adults (MANTRA). She delves into the considerations for inpatient treatment, emphasizing the importance of thoughtful admission, care, and discharge planning. Addressing the legal framework for severely affected patients, Treasure underscores the need for careful management and engagement with both the individual and their support network, especially in cases involving involuntary tube feeding and monitored psychopharmacological treatment. Furthermore, Treasure stresses the significance of post-discharge planning, emphasizing the requirement for a strong and informed support system that can aid individuals in forming an identity beyond anorexia nervosa, facilitating continued recovery. She also touches on the limited pharmacological treatment options available, such as fluoxetine for bulimia nervosa, and explores promising novel ideas, including the use of psychedelic drugs like psilocybin or ketamine and metabolic modulators like metreleptin. Treasure concludes by discussing the potential benefits of digital and technological augmentation in optimizing patients' treatment outcomes and overall well-being.
Learning Objectives
A. To understand the elements that contribute to the cognitive-interpersonal model.
B. To be aware of the various targets for treatment.
C. To be aware of the need to match treatment to medical risk and other prognostic factors.
