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Eating Disorder vs. Disordered Eating: Patterns Noted Across the Autism Spectrum

Presenter: Janice Goldschmidt, MPH, MS, RD, LDN, Director of Nutrition Services at Community Support Services, Inc. (Gaithersburg, MD)

Thursday 21 October (1 hour duration)
Time: 12pm New Zealand; 10am NSW, ACT, VIC, TAS; 9am QLD; 9.30am SA & NT; 7am WA

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Janice Goldschmidt, MPH, MS, RD, LDN received her Master’s Degree in Nutrition and Food Science as well as a Master’s in Public Health from the University of Maryland-College Park. She is actively involved as both a researcher and practitioner in the nutritional status of individuals with autism and other developmental disabilities and has published and presented on this topic in numerous professional publications and conferences. Other research interests include assessment and treatment of disordered eating on the autism spectrum and development of cooking skills for this same population as a form of nutritional intervention. In 2018, the American Association on Intellectual and Developmental Disabilities (AAIDD) published her first book entitled Teaching Authentic Cooking Skills to Adults With Intellectual and Developmental Disabilities: Active Engagement. Based on this work, in October 2018, Janice received the “Excellence in Written Communication” Award presented by the Behavioral Health Nutrition Dietetics Practice Group (BHNDPG) at the 2018 national conference of the Academy of Nutrition and Dietetics.

Janice is currently serving as the Director of Nutrition Services at Community Support Services, Inc. (Gaithersburg, MD) where she is responsible for development of programs intended to support the health and wellness of adults with autism through nutrition related programming.

Webinar Overview: Disordered eating is noted as widespread on the autism spectrum and, despite this, there are relatively few resources to address it. The reasons for this are complex but likely due to a widespread pattern of diagnostic overshadowing on the spectrum, a form of underdiagnosis in which any cooccurring conditions are attributed to the underlying autism. The consequences of this practice are profound, particularly in regard to studying eating disorders within this population. In this presentation, Janice Goldschmidt, researcher and practitioner in disability studies, will outline four broad patterns of disordered eating for those with Autism Spectrum Disorder: food rigidity, sensory-based preferences, high risk behaviors, and binge eating. The presenter will describe the features of each, as well as outline the relevant research and treatment options.

Enhanced Cognitive Behaviour Therapy (CBT-E) with Younger Patients

Presenter: Riccardo Dalle Grave, MD, FAEDDirector of the Department of Eating and Weight Disorders at Villa Garda Hospital (Garda, VR, Italy)

Thursday 18 November (1 hour duration)
Time: 8pm New Zealand; 6pm NSW, ACT, VIC, TAS; 5pm QLD; 5.30pm SA & NT; 3pm WA

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Riccardo Dalle Grave, MD, FAED is the Director of the Department of Eating and Weight Disorders at Villa Garda Hospital (Garda, VR, Italy). In this department, he developed an original treatment for the eating disorder based entirely on the enhanced cognitive behavior therapy (CBT-E), the adaptation of outpatient CBT-E for adolescents with eating disorders, and the personalized cognitive behavior therapy for obesity (CBT-OB). Currently, the main focus of his research is evaluating CBT-E and CBT-OB in the treatment of adult and adolescent patients with eating disorders and obesity, respectively, both in outpatient and in inpatient settings. He is the director of the master course for health professionals ‘1° Certificate in Eating Disorder and Obesity’. He also teaches CBT-E and CBT-OB at several Italian psychotherapy schools and supervises teams in Europe, the US, Australia, and Middles West. He is a member of the editorial board of several scientific journals and fellow of the Academy for Eating Disorders. He is the author of 160 peer review articles, several book chapters, and books, including the recent “Cognitive Behavior Therapy for Adolescents with Eating Disorders”.

Webinar Overview: Enhanced Cognitive Behaviour Therapy (CBT-E) has demonstrated efficacy in adult with anorexia nervosa (AN) and bulimia nervosa (BN) and has recently been adapted for use with adolescents with eating disorders. CBT-E for younger patients has been evaluated in three cohort studies of patients aged between 13 and 19 years. Two studies included adolescents with severe AN and one was of adolescents who were not underweight with other eating disorders. The promising results obtained by these studies led the National Institute for Health and Clinical Excellence to recommend CBT-E for adolescence as an alternative to Family Based Treatment (FBT) both for AN and BN. CBT-E has a number of advantages. It is acceptable to young people, and its collaborative nature is well suited to ambivalent young patients who may be particularly concerned about issues of control. The transdiagnostic scope of the treatment is an advantage as it is able to treat the full range of disorders that occur in adolescent patients. It therefore provides a good alternative to FBT. In this workshop the CBT-E for adolescents will be described in detail, together with data on its effectiveness, and the webinar will be illustrated with numerous clinical vignettes.

At the completion of this webinar:
1. Participants will gain knowledge on how to adapt the CBT-E for adolescents
2. Participants will gain knowledge on the use of a “manualized” treatment in a real world clinical setting
3. Participants will gain knowledge on how CBT-E differs from FBT

Eating Disorders in People with Type 1 Diabetes: Considerations for Psychological Treatment

Presenter: Emma Reid, Psychologist & Health Psychology Registrar, Centre for Integrative Health

Thursday 9 December (1 hour duration)
Time: 12pm New Zealand; 10am NSW, ACT, VIC, TAS; 9am QLD; 9.30am SA & NT; 7am WA. SEE YOUR LOCAL TIME HERE

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Emma Reid is a Psychologist and Health Psychology Registrar from the Centre for Integrative Health. Emma has undergone extensive training in evidence-based eating disorder treatment modalities including Cognitive Behaviour Therapy for eating disorders (CBT-E), Family Based Therapy (FBT), Dialectical Behaviour Therapy and Specialist Supportive Clinical Management. She currently facilitates Centre for Integrative Health’s CBT-E masterclass sessions, which are aimed at supporting the ongoing development of clinicians’ skills and expertise in this treatment model. Emma has a particular interest in the mind-body connection, and the interaction between eating disorders and chronic health conditions such as diabetes. Emma has worked with individuals living with a number of health conditions including diabetes mellitus, functional gastrointestinal disorders, respiratory disease, cardiac conditions, chronic pain, and fatty liver disease. Emma is passionate about working with clients to achieve their treatment goals, overcome concerns they may have with eating and/or body-image, and improve both their physical and emotional health, practicing from a weight-neutral, Health At Every Size (HAES) framework.

Webinar Overview: Eating disorders are wide-spread in individuals living with Type 1 Diabetes Mellitus (T1DM), with prevalence rates up to 2.4 times greater than that of the general population. Often referred to as “diabulimia”, the co-occurrence of these two conditions poses severe and devastating risks. These include increased risk of diabetes related complications (e.g. cardiovascular disease, kidney disease, vision problems, peripheral nerve damage) and mortality rates 5 times greater than that of Anorexia Nervosa alone. While this remains an under-researched area, etiological models suggest the demanding self-management requirements and physiological impacts of T1DM may predispose and exacerbate the eating disorder cycle. The over-evaluation of weight and shape may be triggered by weight changes at the time of diabetes diagnosis; dietary restriction may be exacerbated by the stringent food monitoring and carbohydrate counting requirements; binge eating may develop in response to hypoglycaemia; and insulin misuse poses a dangerous form of purging. This webinar will present an overview of current research and considerations for adapting psychological assessment, formulation and treatment of eating disorders in persons with T1DM.

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