Beating Eating Disorders

Dr. Aaron Keshen, Thomas Helson, Sarrah Ali & Laura Dixon
The growing eating disorders team at NSHA, left to right: Dr. Aaron Keshen, Thomas Helson, Sarrah Ali & Laura Dixon

As many as 30,000 Nova Scotians suffer from bingeeating disorder (BED), the most common eating disorder in adults. BED sufferers feel a loss of control and consume much larger quantities of food than is healthy for them. This can lead to such problems as obesity and diabetes, as well as social and emotional issues that can wreak havoc with work, relationships and overall quality of life.

“There are few accessible evidence-based treatments for BED,” says Laura Dixon, an NSHA research assistant and Dalhousie graduate student with the Department of Psychiatry. “We want to build evidence for an approach that combines group therapy with self-help to empower people to overcome urges to binge.”

The NSHA Research Fund has awarded Dixon and her team a grant to test their approach. It is based on a self-help program called Brain Over Binge that teaches the importance of non-restrictive eating and four key steps to changing binge-eating behavior: view the urge as “neurological junk”; separate the urge from your authentic self; do not react to the urge; and, detach from the urge.

“We’ve added group therapy to provide support and accountability,” says Dixon. “Participants will take part in three group sessions over eight weeks; we’ll follow up halfway through, at the end, and one year later to see how people are doing.”

Another study is addressing bulimia nervosa (BN), an eating disorder in which sufferers cannot bear to keep food energy in their bodies so they induce vomiting, use laxatives or over-exercise to rid themselves of it.

Psychiatrist Dr. Aaron Keshen has designed a clinical trial to see if Vyvanse, a stimulant used to treat attention-deficit disorders, can reduce the urge to binge and purge in BN.

Dr. Keshen decided to test the concept in a larger clinical study, which first required Health Canada approval for the off-label use, as well as approval from the NSHA Research Ethics Board. This was granted, as was funding from the NSHA Research Fund, to proceed with a pilot involving 30 BN patients.

“We will not enroll patients who have a history of anorexia or low body mass index, cardiac risks or electrolyte imbalances,” says Dr. Keshen, noting that Vyvanse can suppress appetite in some. “But for those patients who can safely take it, a short course of the medication may help break the habitual patterns and give us an opportunity to help them be more successful in talk therapy.”