Perelman School of Medicine at the University of Pennsylvania

Timko Research Group

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Research Foci

Sex Differences

Historically, males have been grossly understudied in the area of disordered eating. We know there are sex differences in normal brain development, but it is unclear how restrictive eating affects this process and whether or not restrictive eating affects brain development differently in males compared to females. Our research regularly includes males with eating disorders. In addition to potential differences in brain structure and function, we focus on how sex hormones impact the risk and/or onset of AN-R, and sex differences in executive functioning in adolescents with eating disorders.

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Understanding Neurobiology in Anorexia Nervosa

Anorexia nervosa is characterized as a biologically based disorder, but research on the neurobiology of the illness remains in its infancy. Because the onset of AN (~12 years old) is during a period of significant brain development, it is important that we focus our understanding of the neurobiology of anorexia in adolescents. Work in this area also focuses on sex differences in adolescents with eating disorders. Ideally, we will be able to identify markers or risk factors for a longer course of illness.

 

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Understanding Executive Functioning in Eating Disorders

Executive functioning is an umbrella term that describes a set of skills related to controlling ones actions, emotions, and thoughts in order to plan and achieve goals. Of recent, research on psychiatric illnesses has focused to measuring executive functioning through neuropsychological domains. We are specifically interested in endophenotypes such as set-shifting and central coherence, both of which have been reported to be impaired in those with anorexia.

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Treatment and Health Coaching

Treating anorexia nervosa involves a multidisciplinary approach. The current gold standard is Family Based Treatment; yet, treatment is effective for half of adolescents. We need to develop new treatments, and/or augment current treatments. Ideally, research into the neurobiology of eating disorders will help us identify those at risk of having a more chronic course of illness – allowing us to develop treatments specifically for this population. The end goal would be have precision treatments for adolescents with eating disorders and prevent these illness from lasting into adulthood.  In addition to Family Based Treatment and Cognitive Remediation Therapy, TRG examines the use of Acceptance and Commitment Therapy (ACT) for the treatment of eating disorders.

In addition to treatment for eating disorders, TRG collaborates with Dr. Aletha Akers at Children’s Hospital and Dr. Julia Hormes at SUNY Albany on the use of health coaching to increase health related behavioral change. The health coaching programs developed by Dr. Timko involve the use of Acceptance and Commitment Therapy and Motivational Interviewing. TRG continues to explore ways in which ACT-informed health coaching can be used to increase access to health care and improve outcomes.

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