A PhD Student’s Quest to Better Treat Food-Related Disorders

When Helen Murray was a clinical research assistant at Children’s National Medical Center in Washington, D.C., shortly after she finished her undergraduate education in 2011, she saw something that helped chart her career path. She was working on a study of children with bipolar disorder and saw how it affected their food intake.

“One of the things we assessed was their eating symptoms, and that changed drastically depending on what kind of mood cycle they were in,” said Murray, a third-year doctoral candidate in clinical psychology in Drexel University’s College of Arts and Sciences. “So that got me more and more interested in figuring out how eating symptoms change over time.”

Eventually, after two years as a clinical research coordinator in an eating disorders program at Massachusetts General Hospital, Murray’s interest led her to Drexel. Over time she’s narrowed her focus — she’s now working on a treatment manual for rumination disorder, in which a person repeatedly regurgitates, then re-chews or spits out food — but maintained her broad desire to help the medical community better detect and treat food-related disorders.

Murray’s research looks at three categories of disorders, all of which can present similarly, complicating detection and treatment: eating disorders, such as binge eating, anorexia nervosa or bulimia nervosa; feeding disorders, in which an individual struggles with food intake but is not motivated by body image; and functional gastrointestinal conditions that present challenges for eating and digestion. A patient could be dealing with a disorder in any of the three categories if they are experiencing vomiting or restricting their food intake, for example, and it is often difficult to determine the root causes and the appropriate treatment.

Diagnosis is sometimes complicated by a patient’s lack of motivation to seek treatment, which is common among those with restrictive eating disorders, Murray said. In some cases, the issue is with the type of providers patients present to — psychologists and physicians are specialized, and not all are trained to assess for and differentiate gastrointestinal symptoms and eating or feeding disorder symptoms.

The result is patients who can go years without an accurate diagnosis, which can lead to extraordinary costs — all those doctor visits and new medications add up quickly. Murray’s work under the mentorship of Adrienne Juarascio, PhD, director of practicum training and assistant professor in the Department of Psychology and a faculty member in the WELL Center, aims to address that issue, among others, by improving detection methods.

“We hope it will reduce burdens on patients, so they’re able to get better by getting into treatment, and also reduce burdens on the medical system,” said Murray.

With rumination, in particular, the complications are heightened. Because the disorder is understudied, Murray said, its prevalence is unclear. The circumstances make it less likely for an individual in need of treatment to seek out care, or for that individual’s disorder to be detected.

Murray is currently taking the lead on developing a treatment manual — the first of its kind — to help medical professionals whose patients have rumination disorder. Along with Jennifer Thomas, PhD, a former mentor at Mass General, she has published a case report detailing the treatment given to a woman who went 15 years without a diagnosis, bouncing among doctors and medications and going through invasive diagnostic testing along the way. Murray’s work could help prevent similar cases in the future.  

That’s not all Murray has going on as she enters the third year of her doctoral program at Drexel. Her master’s thesis project is aimed at determining why nearly two-thirds of patients with binge-eating disorder don’t get better from currently available treatments — and she’s using a uniquely Drexel method. Using functional near-infrared spectroscopy technology developed at Drexel, she’s studying patients who are receiving a gold-standard treatment for the disorder, which involves cognitive behavioral therapy. At the end of treatment, she’ll look at differences in brain activation between the patients who improved and those who didn’t, in an attempt to decipher any potential clues.

It’s all part of Murray’s efforts to bring awareness to the breadth of challenges people face — as she said, “People think an eating disorder means you’re either really, really thin or you throw up” — and help people with a wide range of eating and feeding challenges find solutions.

“A number of people who are struggling with concerns related to eating in some way don’t get the treatment they need, and my goal is to fix that,” said Murray. “That, simply, is the reason why I’m doing this.”

Anyone looking for support with a food-related disorder can contact the WELL Center.