Eating Disorders Continuum

The only organized base of clinical-research expertise on the eating disorders (EDs) in the Province of Quebec, the Eating Disorders Continuum has been influential locally, regionally and internationally through various arms of its research. Steiger has studied constitution–environment interactions that play in ED development, with a current emphasis on the effects of environmental exposures (developmental traumata, current stressors, nutritional deficits) upon DNA methylation, and the prospective course of changes in DNA methylation coincident with nutritional rehabilitation in Anorexia Nervosa. His more clinically oriented studies have examined effects of motivation for change upon outcome of eating-disorder treatment, effectiveness of virtual delivery of specialized therapy techniques, and also evaluations of variations of treatments applied in inpatient, day treatment and outpatient settings.

Howard Steiger is well-known for clinical, research and advocacy work in the eating disorders. For over 30 years, he directed Quebec’s only large-scale, specialized eating-disorders program—the Douglas Institute Eating Disorders Continuum (EDC). The EDC offers a full range of Inpatient, Day Treatment and Outpatient services for adolescents and adults affected by EDs and their families. He is Professor in Psychiatry and Associate Member in Psychology at McGill University. An active clinician, researcher, and teacher, Steiger has published numerous articles and chapters on the eating disorders. He is Associate Editor of the Journal of EDs, Fellow of the Canadian Academy of Health Sciences, Fellow of the Academy for Eating Disorders, and has been Associate Editor of the International Journal of Eating Disorders, President of the ED Research Society, and Co-President of the Quebec Charter for a Healthy and Diversified Body Image.

• 2019: Fellow of the Canadian Academy of Health Sciences (CAHS)
• 2017: Articles of the Year Award–Eating Disorders: The Journal of Treatment & Prevention
• 2015 : Associate Editor-Journal of Eating Disorders
• 2014 : Prize for Excellence from the Association Québécoise des Établissements de Santé et de Service Sociaux (AQESSS)
• 2014: Eating Disorders Program. Honorable mention, Prize for Excellence, Institut d’Association Publique de Quebec (IAPQ)
• 2012: Innovaction Award for Knowledge transfer. Douglas University Institute.
• 2011: Eating Disorders Program. Eating Disorders Program Knowledge Transfer effort named an “Exemplary Practice” by the Canadian Council on Hospital Accreditation. June 2011.
• 2010 Academy for Eating Disorders (AED) Leadership Award for Clinical, Educational, and Administrative Service
• 2009-2014: Associate Editor, International Journal of Eating Disorders
• 2007-08: President, Eating Disorders Research Society
• 2002: Fellow, Academy for Eating Disorders
• 2002: Heinz Lehmann Award, Canadian College of Neuropsychopharmacology
• 2009-2017: Co-President, Committee to develop a charter to prevent fashion-industry inducements towards extreme thinness and Anorexia Nervosa. (2009 to present)

Selected recent publications

•  Auger, N., Low, N., Chadi, N., Israël, M., Steiger, H., Lewin, A., Ayoub, A., Healy-Profitós, J., Luu, T. M. (in press). Suicide attempts in children 10-14 years of age during the first year of the Covid-19 pandemic. Journal of Adolescent Health.
• Thaler, L., Paquin Hodge, C., Leloup, A-G., Wallace, A., Oliverio, S., Freiwald, S., Israel, M., & Steiger, H. (in press). Barriers and facilitators in the implementation of an eating disorders training program for non-experienced therapists. Journal of Behavioral Health Services & Research.
• Steiger, H., Booij, L., Thaler, L., St-Hilaire, A., Israël, M., Casey, K.F., Oliverio, S., Crescenzi, O., Lee, V., Turecki, G., Joober, R., Szyf, M., & Breton, E. (2022). DNA methylation in people with Anorexia Nervosa: Epigenome-wide patterns in actively ill, long-term remitted, and healthy-eater women. World Journal of Biological Psychiatry,  24:3, 254-259, DOI: 10.1080/15622975.2022.2089731
• Oliverio S, Steiger H, St-Hilaire A, Paquin-Hodge C, Leloup AG, Israel M, Thaler L. Barriers and facilitators to providing autonomy supportive counselling to individuals seeking treatment for an eating disorder. Eat Weight Disord. 2022 Oct;27(7):2919-2929. doi: 10.1007/s40519-022-01395-6. Epub 2022 Apr 2. PMID: 35366169.
• Thaler, L., Booij, L., Burnham, N., Kenny, S., Oliverio, S., Israel, M., & Steiger, H. (2021). Predictors of non‐completion of a day treatment program for adults with eating disorders. European Eating Disorders Review, 1–10. PMID:  34971014.  DOI:  10.1002/erv.2879. https://doi.org/10.1002/ erv.2879.
• Steiger, H., Booij, L., Crescenzi, O., Oliverio, S., Singer, I., Thaler, L., St-Hilaire, A., & Israel, M. (2021). In-person versus virtual therapy in outpatient eating-disorder treatment: A COVID-19 inspired study. International Journal of Eating Disorders, 55:145-150. PMID:  34904742. DOI:  10.1002/eat.23655. https://pubmed.ncbi.nlm.nih.gov/34904742/
• Steiger, H. A Canadian case of ‘lifespan’ programming for people with eating disorders. Australasian Psychiatry. November 2021. doi:10.1177/ 10398562211054658
• Sansfaçon, J.*, Booij, K., Gauvin, L., Fletcher, E., Islam, F., Israël, M., & Steiger, H. (2020). Pretreatment motivation and therapy outcomes in eating disorders: A systematic review and meta-analysis. International Journal of Eating Disorders. 53:1879–1900. https://doi.org/10.1002/eat.23376
• Booij, L. & Steiger, H. (2020). Applying epigenetic science to the understanding of eating disorders: A promising paradigm for research and practice. Review. Curr Opin Psychiatry. 2020 Nov;33(6):515-520. doi: 10.1097/YCO.0000000000000632. PMID: 32576735
• Wonderlich, S.A, Bulik, C.M., Schmidt, U., Steiger, H., & Hoek, H.W.  (2020). Severe and enduring Anorexia Nervosa: Update and observations about the current clinical reality. International Journal of Eating Disorders, 53, 1303–1312. https://doi.org/ 10.1002/eat.23283
• Steiger, H. & Booij, L. (2020). Eating disorders, heredity and environmental activation: Getting epigenetic concepts into practice: Journal of Clinical Medicine. Review. J Clin Med. 3;9(5):E1332. doi: 10.3390/jcm9051332.J Clin Med. 2020. PMID: 32375223
• Burdo, J.*, Booij, L., Kahan, E., Thaler, L., Israel, M., Agellon, L.B., Nitschmann, E., Wykes, L., & Steiger, H. (2020). Plasma levels of one-carbon metabolism nutrients in women with Anorexia Nervosa. International Journal of Eating Disorders; 53: 1534–1538.https://doi.org/10.1002/eat.23292 PMID: 32427359
• Thaler, L., Brassard, S., Booij, L., Kahan, E., McGregor, K., Labbe, A., Israel, M., & Steiger, H. (2019). Methylation of the OXTR gene in women with Anorexia Nervosa: Relationship to social behavior. European Eating Disorders Review, 1–8.
• Paquin Hodge, C., Gauvin, L., St-Hilaire, A., Israel, M., Azzi, M., Kahan, E., Thaler, L., Dansereau, E., & Steiger, H. (2019). A naturalistic comparison of two inpatient treatment protocols for adults with Anorexia Nervosa: Does reducing duration of treatment and external controls compromise outcome? International Journal of Eating Disorders. 2019 Sep;52(9):1015-1023. doi: 10.1002/eat.23150. Epub 2019 Aug 13.PMID: 31408212
• Steiger, H., Booij, L., Kahan, E., McGregor, K., Thaler, L., Fletcher, E., Labbe, A., Joober, R., Israël, M., Szyf, M., Agellon, L.B., Gauvin, L., St-Hilaire, A., & Rossi, E. (2019). A longitudinal, epigenomewide study of DNA methylation in Anorexia Nervosa: Results in actively ill, partially weight restored, long-term remitted, and non-eating-disordered women. Journal of Psychiatry & Neuroscience. 2019 Jan 29;44(2):1-9. PMID: 30693739.