A UK-wide survey of healthcare professionals' awareness, knowledge and skills of the impact of food insecurity on eating disorder treatment.

OBJECTIVE: Food insecurity (FI) is associated with significant adverse effects on health and well-being and increasingly recognised as a global problem. The current study explored the impact of FI on eating disorder (ED) clinical practice in the UK, aiming to assess healthcare professionals' (HCPs) knowledge, skills and views on the topic of FI in their patients. DESIGN: This study was an exploratory, mixed-methods, descriptive analysis of online survey data collected from ED HCPs in the UK between September and October 2022. MEASURES: A 15-item survey with rating and open-ended questions was circulated to ED professional organisations in the UK. Descriptive statistics were used to summarise quantitative data, including perceived prevalence of FI in ED clinical practice and confidence in knowledge on the topic. Descriptive content analyses provided insight into perspectives on FI screening and aspects to be included in guidance and resources. RESULTS: 93 ED HCPs completed the survey (40.9 % psychologists). Findings demonstrated healthcare providers' limited knowledge on FI and its relation to EDs, while they increasingly perceive it in their patients, as well as a general lack of available resources on how to address FI in ED treatment. HCPs stressed the need for practical guidance and formal training for dealing with FI in their patients, as well as implementing routine screening. CONCLUSION: These findings provide both important directions for future research and clinical applications related to screening, assessment, treatment and support of food-insecure patients with EDs.

Pragmatic Sensory Screening in Anorexia Nervosa and Associations with Autistic Traits.

BACKGROUND: Research suggests that people with anorexia nervosa (AN) experience subjective hypersensitivity to external sensations that may require consideration in treatment. These difficulties may be particularly pronounced in people with AN and high autistic traits. The purpose of this pilot study was to explore the use of a brief screening tool to assess sensory sensitivity in individuals receiving treatment for AN, and to assess if self-rated sensitivity in AN is related to autistic traits. METHODS: 47 individuals receiving treatment for AN completed a brief sensory screening tool and self-rated their autistic traits. Individuals were also asked to give qualitative feedback on the screening tool. RESULTS: People with AN and high autistic traits rated themselves as more hypersensitive compared to people with AN and low autistic traits. Feedback surrounding the use of the screener was positive. CONCLUSIONS: The results of this study suggest that the use of this screener may be beneficial in eating disorder settings to help adjust and calibrate treatment to personal needs, although further research and psychometric evaluation around the clinical use of the screener is required. The finding that people with AN and high autistic traits may experience elevated hypersensitivity also warrants further exploration in future research.

"There's nothing there for guys". Do men with eating disorders want treatment adaptations? A qualitative study.

PURPOSE: Men with eating disorders may experience unique issues compared to their female counterparts, and there is a growing interest in how these differences should be addressed in clinical practice. However, the views of male patients on potential treatment adaptations remain under-explored. The purpose of this study was to explore the experiences of men who have experienced treatment for eating disorders. METHODS: Men who had experienced eating disorder treatment were recruited through UK National Health Service eating disorder services and online advertising. 14 participants took part in semi-structured interviews discussing their experiences of treatment, and their views on the need for adaptations. Interviews were analysed using thematic analysis. RESULTS: Three main themes were identified from the analysis: a preference for person-centred, rather than gender-centred treatment, a feeling of being "the odd one out" as men in current treatment environments, and recommendations for treatment adaptations. CONCLUSIONS: Participants described wanting to be treated as individuals and not defined by their gender. Whilst existing treatment approaches were mostly felt to achieve this individual focus, the actual treatment setting may inadvertently reinforce a perception of atypicality due to being men in a female-dominated environment. Adaptations may therefore be required to make the treatment environment more male friendly. Clinical recommendations are outlined. LEVEL OF EVIDENCE: V. Qualitative study.

Eating as an autistic adult: An exploratory qualitative study.

BACKGROUND: Although eating difficulties are known to be common in children on the autism spectrum, there is a lack of research on whether these behaviours persist or change into adulthood. Emerging evidence suggests that autistic adults may experience higher levels of disordered eating than the general population, indicating the impact of autism on eating in this adult population warrants further exploration. METHOD: This study interviewed 12 autistic adults about their eating habits, with a focus on the continuing or changing presence of behaviours often seen in autistic children such as sensory sensitivity or a preference for routines. Interviews were transcribed and analysed using thematic analysis. RESULTS: Overall, participants suggested that autism did continue to impact their eating into adulthood, particularly in the areas of sensory sensitivity, medical difficulties, executive functioning difficulties, and rigidity, but that they had learned to adapt so that these issues no longer represented a problem. However, a minority of participants did feel that their autism had a negative effect on their eating, particularly those diagnosed with eating disorders. Additionally, eating behaviours associated with autism were identified as potentially contributing to having an unhealthy body weight. CONCLUSIONS: Certain traits associated with autism, such as cognitive rigidity and sensory sensitivity, could potentially continue to influence the eating behaviours of autistic adults. These traits are typically experienced as differences which can be adapted around and managed, rather than specific problems. However, these traits can potentially contribute to difficulties such as disordered eating and weight gain, and the implications of these should be explored by future research.