Eating Disorders

Anorexia nervosa (AN)Less commonAcross all times & cultures Anxious, rigid, perfectionist traitsHigh mortality & burdenNo leading treatment Poor outcomes

Bulimia nervosa (BN)More commonWestern culture-bound Personality traits mixedCBT= leading treatmentMost do not access CBT

Binge Eating Disorder (BED)Very commonRising prevalence

Epidemiology, Risk Factors & Prevention

Neurobiology: Genetics, Neuroimaging, Neuropsychology, rTMS

Psychological TreatmentsBetter treatments for AN

E-health Other Clinical Trials

Brain-Directed Treatment Brain-Directed Treatment rTMS and Eating DisordersrTMS and Eating Disorders

Background• rTMS reduces food craving, bingeing and salivary cortisol

in Bulimia Nervosa & Binge Eating Disorder• Case series of patients with AN, giving one session of

high-frequency rTMS applied to the left DLPF cortex:– Reduction in feeling full/fat & anxiety

Uher et al., 2005; Claudino et al., 2010; Van den Eynde, et al., 2010; 2011a,b,c

E-health Interventions

• Online-CBT for BN in adolescents & adults significantly reduce symptoms

• On-line skills training for carers of people with AN significantly reduce carer distress & unhelpful behaviours (e.g. expressed emotion)

• On-line personality targeted prevention for common mental disorders in students (PLUS-online)– in progress

Schmidt, 2003; Murray et al., 2003; Barra-Carril et al., 2004; Schmidt et al., 2007; 2008; Pretorius et al., 2009; Grover et al., 2010; 2011; Sanchez-Ortiz et al., 2011a,b; Musiat et al., in preparation

Further Questions?

Contact: Ulrike Schmidt

Professor of Eating Disordersulrike.schmidt@kcl.ac.uk