MSGID: 1:317/3 642e4ae9   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Exposure therapy to feared foods may help kids with eating disorders   
      
      
     Date:   
         April 5, 2023   
     Source:   
         Penn State   
     Summary:   
         Whether you're afraid of dogs, needles or enclosed spaces, one   
         of the most effective interventions for this type of anxiety   
         disorder is exposure therapy in which you confront your fear in a   
         safe environment. A new study finds that exposure therapy is also   
         a promising treatment for adolescents with eating disorders. They   
         found that exposure to feared foods -- such as candy bars and pizza   
         -- helped kids who were in a partial hospitalization program for   
         eating disorders experience decreased anxiety toward food.   
      
      
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   FULL STORY   
   ==========================================================================   
   Whether you're afraid of dogs, needles or enclosed spaces, one of the most   
   effective interventions for this type of anxiety disorder is exposure   
   therapy in which you confront your fear in a safe environment. A new   
   study led by researchers at Penn State College of Medicine finds that   
   exposure therapy is also a promising treatment for adolescents with   
   eating disorders. They found that exposure to feared foods -- such as   
   candy bars and pizza -- helped kids who were in a partial hospitalization   
   program for eating disorders experience decreased anxiety toward food.   
      
      
   ==========================================================================   
   "As a society that is so heavily influenced by diet culture, our   
   relationships with our bodies can be dysfunctional," said Jamal Essayli,   
   assistant professor of pediatrics and of psychiatry and behavioral   
   health. "I came out as gay in high school, and by the time I got   
   to college, I noticed an increased emphasis on body image among gay   
   men. That's partly what inspired my interest in researching and working   
   with patients with eating disorders."  According to the National Eating   
   Disorders Association, approximately 30 million Americans will struggle   
   with eating disorders, including anorexia nervosa, bulimia nervosa,   
   binge-eating disorder and others, at some point in their lives. In   
   addition to the LGBTQ+ community, adolescents and young adults are   
   particularly vulnerable, and the COVID-19 pandemic didn't help. Recent   
   research by co-author Jennifer Shook, assistant professor of pediatrics at   
   the Penn State College of Medicine, and others demonstrated a significant   
   increase in eating disorder-associated inpatient and outpatient visits   
   to emergency departments among adolescents and young adults during   
   the pandemic.   
      
   "While this is an active area of research, the causes of eating disorders   
   are typically thought to be a combination of biological predisposition   
   and environment," said Essayli. "For example, having an anxious or   
   perfectionistic predisposition and being teased about your body size   
   or weight can both increase a person's risk for developing an eating   
   disorder."  In the current study, which was published in theInternational   
   Journal of Eating Disorders, Essayli and his colleagues recruited 54   
   adolescents with a median age of 14 years who were participating in a   
   partial hospitalization program for eating disorders. The program ran   
   five days a week for an average of eight weeks per individual. Each day,   
   the clinical team exposed the patients to a feared food. For example,   
   participants were given a full-sized candy bar on Mondays, a baked good   
   such as a cookie on Tuesdays, pizza on Wednesdays, a dessert on Thursdays   
   and a breakfast item such as pancakes on Fridays.   
      
   "Many of these patients were underweight or weight suppressed, and had   
   intense anxiety about these foods," said Essayli. "It was important   
   for them to learn that there's nothing horrible about having pizza   
   and ice cream at a party, for example, that it's actually part of a   
   fulfilling life."  Patients provided subjective units of distress (SUDS)   
   ratings on a scale from 0 (no distress) to 10 (extremely high distress)   
   immediately before and after each food exposure. In addition, patients   
   were periodically given the Children's Eating Attitudes Test and Fear   
   of Food Measure, which are aimed at determining levels of anxiety about   
   eating and food avoidance behaviors. Finally, the adolescents were   
   encouraged to discuss their feelings about the exposure challenges in   
   weekly therapy sessions.   
      
   "One of the things we wanted to test was whether within-session and   
   between- session habituation were important for weight gain," said   
   Essayli. "Say, you're afraid of dogs. If you're doing exposure therapy   
   by spending time around a dog, within-session habituation is when your   
   anxiety decreases while you're with the dog. Between-session habituation   
   is when your anxiety decreases from session to session across days."   
   This distinction is important, Essayli said, because the extent to which   
   clinicians should emphasize or disregard fear-reduction during exposure   
   therapy sessions for eating disorders was previously unknown.   
      
   Overall, the team found that SUDS decreased significantly over time prior   
   to exposure to feared foods, providing some evidence that between-session   
   habituation occurred. However, the difference between pre-exposure   
   and post- exposure SUDS did not decrease over time, indicating that   
   within-session habituation did not occur. Therefore, the team concluded   
   that between-session habituation, but not within-session habituation,   
   predicted favorable treatment outcomes, including weight gain and   
   improvements on the Children's Eating Attitudes Test and Fear of Food   
   Measure.   
      
   "Our findings provide support for integrating food exposure into partial   
   hospitalization programs for adolescents with eating disorders who are   
   undergoing weight restoration," said Essayli. "And while more research   
   is needed, our results may begin to help clinicians determine how much   
   emphasis to place on within-session habituation and between-session   
   habituation."  Other Penn State authors on the paper include Lauren   
   Forrest, assistant professor of psychiatry and behavioral health;   
   Kathleen Keller, professor of nutritional sciences and food science;   
   and Susan Lane-Loney, associate professor of pediatrics and of psychiatry   
   and behavioral health. Hana Zickgraf, assistant professor of pediatrics,   
   Emory University, and Emily Stefano, assistant professor, Bariatric and   
   Weight Management Center, Wake Forest University, also are authors.   
      
   The National Institutes of Health supported this research.   
      
       * RELATED_TOPICS   
             o Health_&_Medicine   
                   # Eating_Disorder_Research # Diet_and_Weight_Loss #   
                   Obesity # Nutrition   
             o Mind_&_Brain   
                   # Eating_Disorders # Nutrition_Research # Psychiatry #   
                   Dieting_and_Weight_Control   
       * RELATED_TERMS   
             o Panic_attack o Mental_illness o Eating_disorder o   
             Therapy_dog o General_anxiety_disorder o Sleep_disorder o   
             Chinese_food_therapy o Anxiety   
      
   ==========================================================================   
   Story Source: Materials provided by Penn_State. Original written by Sara   
   LaJeunesse. Note: Content may be edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Jamal H. Essayli, Lauren N. Forrest, Hana F. Zickgraf, Emily   
      C. Stefano,   
         Kathleen L. Keller, Susan E. Lane‐Loney. The impact of   
         between‐session habituation, within‐session habituation,   
         and weight gain on response to food exposure for adolescents with   
         eating disorders. International Journal of Eating Disorders, 2023;   
         56 (3): 637 DOI: 10.1002/eat.23894   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2023/04/230405161354.htm   
      
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