The group will be discussing an article by Melissa Whitelaw, B.App.Sc. (Phys.Ed.), B.App.Sc. (Hlth.Sc.), B.Nutr.Diet., A.P.D, Heather Gilbertson, Adv.A.P.D., Ph.D. Pei-Yoong Lam, M.B.B.S. and Susan M. Sawyer, M.D.

Does Aggressive Refeeding in Hospitalized Adolescents With Anorexia Nervosa Result in Increased Hypophosphatemia? Journal of Adolescent Health 46 (2010) 577–582

Concerns about refeeding syndrome have led to relatively conservative nutritional rehabilitation in malnourished inpatients with anorexia nervosa (AN), which delays weight gain. Compared to other programs, we aggressively refed hospitalized adolescents. We sought to determine the incidence of hypophosphatemia (HP) in 12-18-year-old inpatients in order to inform nutritional guidelines in this group.

A light breakfast will be provided. Please confirm your attendance  so Children’s Hospital can plan accordingly for breakfast. RSVP to Leah Schwechel by Friday, June 18. A copy of the article is available by request.

Journal Club provides an opportunity for members of the greater Milwaukee area’s professional eating disorders treatment community to discuss recent developments or trends in the field and to provide an opportunity for informal networking.

“Mindful eating is about listening to hunger, fullness, and tastesatiety cues,”echoes Jean L. Kristeller, PhD,  professor of psychology at Indiana State University and co-founder of The Center for Mindful Eating with fellow co-founder Jennifer Fletcher, MEd, RD. Kristeller is currently in the data analysis process of a study on mindful eating funded by the National Institutes of Health and conducted in partnership with Duke University researcher Ruth Wolever, PhD.

A light breakfast will be provided. Please confirm your attendance. RSVP to Leah via lschwechel@rogershospital.org.
Journal Club provides an opportunity for members of the greater Milwaukee area’s professional eating disorders treatment community to discuss recent developments or trends in the field and to provide an opportunity for informal networking.

 Thought challenging is a supplemental technique used at Rogers Memorial Hospital in the treatment of residents who have co-occurring anxiety and eating disorders in the special dual diagnosis unit. This technique is used to lower the anxiety-producing thoughts which accompany their eating disordered behaviors. Generally, errors in thinking fall into two categories, overestimation and catastrophizing.

A probability overestimation error is when someone overestimates the likelihood of a bad event happening. A catastrophizing error is when someone blows out of proportion, magnifies, or catastrophizes how bad fairly likely events really are. Thought challenging addresses these errors.

Thought challenging has three steps:

• Identifying fears which keep them from engaging in anxiety provoking situations
• Identifying factual evidence which they believe supports the likelihood of their fears occurring, and
• Systematically examining the evidence identified to determine whether it truly supports the occurrence of feared consequences.

Learning to lower anxiety levels

Throughout their stay, residents cite their individual experiences with anxiety and construct their own arguments against feared consequences. The result is individualized and personally believable arguments they can use against their internal anxiety.

Members of Rogers Memorial Hospital’s eating disorders treatment team use thought challenging to target feared foods, binge foods, compulsive exercise, body checking behaviors, body avoidant behaviors, body image dissatisfaction and mealtime ritual behaviors, among other eating disorder symptoms.

Building upon successful experiences

Self-efficacy, or the ability of a person to feel competent and masterful in his or her journey toward the goal of recovery, is an important aspect of relapse prevention. Often this mastery is built upon previous experiences and examples of skillful responses to triggers and anxiety.

As a result of thought challenging, patients are able to feel more confident in their ability to encounter stressful situations and manage their thoughts and urges in a skillful and effective manner.

This month’s meeting will feature an article by Rachel Bryant-Waugh, DPhil; Laura Markham, BSc; Richard E. Kreipe, MD; and B. Timothy Walsh, MD: Feeding and Eating Disorders in Childhood (Int J Eat Disord 2010; 43:98-111)

The club will also  review the literature related to the current DSM-IV-TR diagnostic criteria for feeding disorder of infancy or early childhood; pica; rumination disorder; and other childhood presentations that are characterized by avoidance of food or restricted food intake, with the purpose of informing options for the DSM-V.

A light breakfast will be provided.

New location
This month’s meeting is being held at Children’s Hospital of Wisconsin located at 9000 W. Wisconsin Avenue, Children’s Hospital Clinics Building, Adolescent Medicine, Suite 165 (enter on 2nd floor).

This month we will discuss typical and atypical restrictive anorexia nervosa (AN) as described by authors Paolo Santonastaso, MD; Romina Bosello, MD; Paolo Schiavone, MSc; Elena Tenconi, PhD; Daniela Degortes, MSc; and Angela Favaro, MD, PhD.

Typical and Atypical Restrictive Anorexia Nervosa: Weight History, Body Image, Psychiatric Symptoms, and Response to Outpatient Treatment. (Int J Eat Disord 2009; 42:464-470)

Few studies have examined the characteristics of atypical restrictive anorexia nervosa (AN) with a well-powered design.  The study aims to explore this issue, with particular attention paid to psychopathology and response to outpatient treatment.

A light breakfast will be provided. Please confirm your attendance by Friday, February 19, so Children’s Hospital can plan accordingly for breakfast. RSVP to Leah via lschwechel@rogershospital.org. A copy of the article is available by request.

Journal club provides an opportunity for members of the greater Milwaukee area’s professional eating disorders treatment community to discuss recent developments or trends in the field and to provide an opportunity for informal networking.

This year’s schedule has been sent to current journal club participants. To receive future invitations or schedules, contact Leah Schwechel at lschwechel@rogershospital.org to be added to our list.