ABSTRACT: There are no established treatment programs for shoplifting in eating disorder patients. Our objective was to observe the effect of an established behavioural treatment program in a series of eating disorder patients.
Patients with eating disorders who shoplift voluntarily took part in an 8-week behavioral treatment program at the Elizabeth Fry Society of Greater Vancouver, British Columbia. They completed assessments at the first session, last session, and at 1 and 6 months post intervention.
Six patients enrolled in the study and three patients completed the treatment program. Only one patient reported a decrease in shoplifting frequency. All subjects reported an increase in self-esteem and ability to control shoplifting impulses.
Our findings suggest that behavioral therapy may be effective in treating shoplifting in eating disorders, but that longer sessions and follow-up may be necessary to show benefit. A randomized control trial with longer-term follow-up is needed to determine whether there is a benefit.
Eating and weight disorders: EWD 01/2006; 10(4):e105-8. · 0.63 Impact Factor
ABSTRACT: Measurement of the basal metabolic rate (BMR) can be used to estimate the calories required for weight gain during refeeding in anorexia nervosa (AN). The reference method for measuring the BMR is indirect calorimetry. MedGem has developed a new indirect calorimeter that calculates the metabolic rate much more quickly than standard indirect calorimeters. This study compared the BMR measured by the MedGem and standard indirect calorimetry in an AN population.
We measured the BMR using the Deltatrac metabolic cart followed immediately by the MedGem indirect calorimeter in 27 subjects (12 patients and 15 controls).
Bland-Altman plots show that there is poor agreement between the BMR reported by the MedGem compared to the Deltatrac.
Until better agreement with standard indirect calorimetry can be shown the MedGem should not be used for calorimetry in AN. Possible factors that may limit the MedGem's reliability include patient discomfort with the mouthpiece, use of a fixed RQ, and the short sampling period.
Eating and weight disorders: EWD 01/2006; 10(4):e83-7. · 0.63 Impact Factor
ABSTRACT: There is currently no convenient method for measuring parotid gland hypertrophy, a common condition among patients with bulimia nervosa (BN) and anorexia nervosa (AN).
To develop a technique for reliably estimating change in parotid gland size.
A method for measuring facial width as a surrogate marker of parotid gland size was developed using calipers to measure between defined reference points located on the parotid gland region. The method was tested for reliability when performed by a single operator and used to determine face width measurements of 15 control subjects.
Face width measurements were reliable when performed by a single operator. Face width measurements of control subjects ranged from 9.1 cm to 15.3 cm.
The caliper method of measuring changes in parotid size is a novel method of measurement of parotid hypertrophy. It is quick, non-invasive and inexpensive and is highly reliable in the hands of a single operator.
Eating and weight disorders: EWD 10/2005; 10(3):e61-5. · 0.63 Impact Factor
ABSTRACT: Zinc deficiency is a putative risk factor for anorexia nervosa (AN). Detecting zinc deficiency may therefore be important in treatment. However, serum zinc is not a good measure of total body zinc. An alternative test for zinc deficiency is taste testing because zinc deficiency is known to impair taste (dysgeusia). To determine whether taste testing could be used in this way, we measured the reliability of the only commercially available taste test in 16 patients with eating disorders. The results were analyzed graphically and with the kappa statistic (K). The taste test was found to be unreliable and should not be used to determine zinc status.
Eating and weight disorders: EWD 07/2005; 10(2):e45-8. · 0.63 Impact Factor
ABSTRACT: Refeeding inpatients with anorexia nervosa (AN) is costly, stressful, and can precipitate the refeeding syndrome. Caloric intake is usually increased gradually from a low starting point until a steady weight gain is achieved. There is no reliable equation that predicts the number of calories required for a weight gain. It was our clinical suspicion that anxiety, exercise, and cigarette smoking might increase the caloric need for refeeding.
We conducted an observational cohort study of 17 females with AN admitted to an inpatient eating disorder unit for refeeding. We estimated the energy intake by observation, the caloric expenditure due to exercise with a triaxial accelerometer, the number of cigarettes smoked by history, and the anxiety by the Beck Anxiety Inventory (BAI).
Neither anxiety, exercise, or cigarette smoking predicted the caloric requirement for refeeding, individually or in combination.
Our data suggest that the caloric requirement for weight gain during refeeding is not predicted by the patient's anxiety, exercise or smoking habits. The standard methods of estimating caloric requirements for refeeding remain indirect calorimetry and previous history.
Eating and weight disorders: EWD 04/2005; 10(1):e6-9. · 0.63 Impact Factor
ABSTRACT: Magnesium deficiency can cause weakness, constipation, seizures and arrhythmias. We frequently observe hypomagnesemia during refeeding in AN.
To determine the incidence and time of onset of hypomagnesemia during refeeding in anorexia nervosa (AN).
Observational cohort study.
University teaching hospital in Vancouver, Canada.
Patients with AN (DSM-IV criteria) admitted for refeeding.
All patients were admitted for supervised refeeding by meal support, in conjunction with our standard medical and psychological treatment.
Serum magnesium was measured daily for 5 days and then 3 times a week.
Fifty patients were admitted for an average of 24 days. Sixty percent (30/50) had low serum magnesium during their admission. Hypomagnesemia was present on admission in 16% but as late as the third week of refeeding in others.
Serum magnesium should be measured on admission and rechecked weekly for the first 3 weeks of refeeding as a minimum.
Eating and weight disorders: EWD 10/2004; 9(3):236-7. · 0.63 Impact Factor