The 13th General Meeting of the European Council on Eating Disorders (ECED) Oslo, Norway; September 2013 – A Report
Colleagues – what makes the European Council on Eating Disorders (ECED) general meetings so special? In many ways, one could argue it’s just another in a long list of conferences related to the understanding and treatment of eating disorders that take place all across the world. The conferences are always organised to a very high level with much thought given to both the academic and social content of the meetings. Yet somehow, in the midst of each gathering of this unique ‘family’, something different emerges. Often, this appears to happen over coffee during a break in proceedings, or in the evenings at a social gathering or in a local hostelry. A casual observer, eavesdropping on a conversation, might be surprised to hear passionate debate taking place about an aspect of treatment or diagnosis or core understandings around epidemiology or causative factors in the world of eating disorders. And so, important relationships are both formed and maintained, and colleagues from all over the world (yes, ECED meetings are often peopled by those from other hemispheres!) get to enjoy the unique atmosphere of an ECED meeting.
This year, in the splendid setting of the Bristol Hotel in central Oslo, it was no exception. Finn Skårderud and his team accomplished the wonderful task of pulling together disparate groups from across Europe to share their knowledge and, most importantly, allow us to debate with those who work at ‘the cutting edge’ of research and treatment in order to enable us to bring that vital new information back to our various individual workplaces. The weather in Oslo was warmer that weekend than the south of France, so we had plenty of opportunity also to enjoy the delights of Norway’s capital city and environs. The stunning National Norwegian Opera House, where we gathered for the first evening was a delight, and many took the opportunity to walk on the roof (!) of the building upon the kind invitation of Tom Revlov, the director of the Den Norske Opera & Ballet, who gave a warm speech welcoming us to Oslo.
Then, on Friday and Saturday - we got down to the real business. The official opening was kindly delivered by Roy Andersen, CEO Division of Mental Health and Addiction Marit Bjartveit at Oslo University Hospital. There followed some wonderful plenary discussions on New Technology, New Challenges, and New Possibilities with Fernando Fernandez-Aranda (Spain) presenting on Modern Technology for Affect Regulation followed by Maria Munkesjo (Sweden) presenting on Virtual Relationships: chat at a voluntary service for eating disorders and finally, David Clinton (Sweden) on An Interpersonal Perspective on New Technologies.
Then, after refreshments, we were treated to a sizzling debate entitled “Eating Disorders are Brain Disorders” between Bryan Lask (UK) and Finn Skårderud (NO), and it was truly riveting. These two research giants gave it their all and in my mind, it was like watching a (academic) clash of the Titans. Wonderful stuff, and it was so elegantly moderated by Rachel Bryant-Waugh (UK). Judging by the debate among participants that followed, I somehow believe we will be returning to this topic again, and again.
Four quite diverse concurrent sessions took up most of the afternoon before we were treated to a splendid ‘State of the Art’ presentation from Hubert Lacey (UK). The topic - “The problems of failure. The potential for success in the treatment of Eating Disorders”, was delivered in a serious and engaging manner by Hubert, who expertly brought us through the challenges many clinicians face when dealing with those who fail to recover from what might be termed ‘standard’ approaches to treatment, especially in Anorexia Nervosa. Taking us through his own team’s most recent research into this area, we were challenged to consider not simply consigning ‘treatment failures’ to standard outpatient ‘treatment-as-usual’, but instead to take on the challenge of actively engaging these patients toward recovery. Hubert showed how this could be achieved by aiming toward firstly, retaining the patient in treatment by deliberately putting weight gain, as a specific goal, to one side. Thereafter direct attention is given to working at improvement of quality of life, harm minimisation, and avoidance of a sense of failure. This is no easy task, but it was clearly demonstrated this could be achieved with some effort. An interesting ‘side-effect’ for many of those in the study was that, they actually gained weight.
There followed a truly splendid banquet that Friday evening at Gamle Logen, where we all ate and drank to our hearts’ content and were wonderfully entertained by some of Norway’s finest classical music talent.
Day two opened with a plenary session and we heard excellent presentations on Recent Clinical Studies from Ivan Eisler (UK) speaking on Multi-family therapy for adolescent anorexia nervosa: results of a multi-centre treatment trial; Stig B. Poulsen and Susanne Lunn (DK) speaking on The Copenhagen bulimia trial and finally, Stephan Zipfel (DE) speaking on The ANTOP study - outpatient treatment of anorexia nervosa.
On Saturday, the second debate explored the thorny subject of “One disorder, one treatment?” with Riccardo Dalle Grave (IT) proposing the motion and David Clinton (SE) opposing. Ably chaired by Hubert Lacey (UK), both presented strong and compelling arguments and much debate followed among the participants. The result, when it came to a vote though, was overwhelmingly against the motion.
The afternoon was firstly covered by another round of diverse concurrent sessions followed by the final plenary session on Comorbidity and Therapeutic Implications. Øyvind Rø (NO) presented on Treatment of eating disorder patients with personality disorders followed by Angela Favaro (IT) presenting on Anxiety, cognition and resistance to treatments in eating disorders and finally, Johan Vanderlinden (B) delivered a very moving presentation on The psychotherapeutic treatment of eating disorders with a history of psychotrauma.
Our appetites truly sated, we moved on to the final business of ECED 2013 and that was to confirm Heidelberg, Germany as our host for ECED 2015 where the organiser will be Dr. Stefanie Bauer. The final date is to be confirmed, but as usual will take place in the autumn. Bryan Lask (UK) made a special plea for the future ECED meetings NOT to be held in the same week as the EDRS meetings. We also had requests to have 3 debates at future ECED meetings; have poster presentations, as this allows many to attend who cannot otherwise get funding; case presentations; more presentations on how to treat EDNOS and a consideration for future meetings to be budgeted at a cheaper cost to all.
Presentations were made too for hosting ECED 2017 and votes were taken for three candidate cities – Paris, Lund, and Vilnius. In the end it was decided that Vilnius, capital city of Lithuania would be the host city for ECED 2017 and the organiser will be Dr. Brigita Baks. We are very much looking forward to ECED coming to Germany for the first time in 2015 and also to the exciting prospect of meeting new colleagues from other areas when we meet in Vilnius in 2017.
We said our ‘goodbyes’ and fond farewells. Our thanks go out once again to Finn Skårderud and his team for a wonderful and successful meeting in Oslo. Once again, the bar has been set quite high but there is little doubt that there will be a lot of competition for attendance at ECED 2105 in Heidelberg.
Gerry Butcher (Ireland)