Tuesday, March 22, 2016


Poet Fiona Hamilton reminded us in her beautiful performance on the Friday evening that medicine is as much art as science. Where does the mind begin?  No one tried to answer that, but there were a lot of figures and graphs and studies of the brain at EDIC. 

"Science" covers a wide variety of disciplines. RCTs on psychological therapies, MRI scans, mapping the genome, these were all in the programme. They were all mixed and matched with treatment protocols and the economics of funding and personal and family experiences too.

Although Dr Blake Woodside's talk was slap bang in the middle of the "biological factors" plenary he spoke as much about the novel treatments his team are offering as the science behind them. The first talk took us galloping through genetics. The presenter had problems with her slides and there wasn't enough time to cover such a vast topic. The third talk was very technical. Maybe it was because by the Saturday I was tired but I didn't take many notes during that plenary. That didn't stop genetics being a topic of conversation throughout the three days and science being centre stage. The Charlotte's Helix stand did brisk work with their spit for science which caught the imagination of many

The short papers on the Thursday weren't supposed to be about science. I went to the ones specifically labelled as "treatment".  However as a whole they spoke to me of science. One was on training which may be more art, but the three on controlled trials, randomised or otherwise were fascinating to compare. One was a full Randomised Controlled Trial comparing two therapies used on a hard to engage population in the community. The others were therapies given to inpatients that were studied without a control. The presence or otherwise of a control group wasn't the most telling factor. The inpatients (who spent the time of the trial unable to get out of it and being restored to a healthy weight) completed their treatment and seemed to benefit from it. The outpatients mainly failed to stay in the trial. Does that mean that the two IP treatments were effective and the OP not? No way. How on earth can you begin to separate out the effects of refeeding and of all the other therapies given IP from the specific treatments.  Did it mean that the OP treatments held no hope. I don't think so. Surely it meant far more that hard to engage, long term patients need more support in the community to access and continue in treatment (and probably quite a bit of refeeding too).

The last short paper was on the medical complications of severe AN. Patients admitted to an adult ward, often with long histories of the illness, had their medical records scrutinised to see what the physical effects could be. They turned out not to be very well.  While this should be blindingly obvious to anyone who knows anything about the illness this was one of the few studies that has actually studied AN from a medical point of view. Why is that? Why did it seem odd that among the flyers for books and the adverts for private treatment centres in our delegate packs, there was a brochure for medical scales? Therapists may wish to ditch the scales but they are ONE of the important tools in assessing physical health. Why is the data on eating disorders so poor that no one has a clue how many people suffer from them in the UK let alone in the refugee camps?


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