Agnes Ayton 💙

Consultant psychiatrist - Chair 2019-23 @RCPsychEDFac, re-elected as vice chair 2023-2027, #EPSIG, Proud IMG. All views are my own. @agnesayton.bsky.social

[Agnes Ayton 💙 @AgnesAyton]

Integrated CBTE improves outcomes for anorexia nervosa - YouTube

Thinking about this presentation we did with ⁦@sensinglorna⁩. It’s hard for people to share their experiences publicly, but it’s important to give hope to others who may feel hopeless https://t.co/y9TDSwBp6C

[Agnes Ayton 💙 @AgnesAyton]

This was entirely predictable.

[Sherrill Stroschein 💙 @sstroschein2]

The British university is dying.
https://t.co/aSOtERPCYU

[Nicole Laurent, LMHC @KetoCounselor]

After just 14 weeks. Results like this are unheard of for #anorexia with standard of care treatments. Bring on the #RCT and so appreciate @GuidoFrank's ground breaking study accumulating evidence to support his existing theory.

"By the end of the study, 72% of the participants had EDE-Q and depression scores within the normal range, indicating significant improvements in eating disorder symptoms, including reduced dietary restraint, less concern about food and body shape, and improved mood."

https://t.co/7oz4WsiNpZ

[🌙biomimic🐾🍉 @iseeuliars]

My father was hospitalized when he fell down the stairs, got Covid in hospital, and his then-mild dementia accelerated with extreme rapidity, and he died within the year.

My story is not unique. How many millions of people is this happening to?

[Chris Stringer @ChrisStringer65]

Mammalian Brains Seen through the Lens of Evolution | Journal of Neuroscience https://t.co/ytXegPKFeW

[Dr Evonne T Curran NursD 💙🇺🇦 @EvonneTCurran]

A post-cvd report masterpiece. Let me give you some highlights
🧵🧵

[Harry Spoelstra @HarrySpoelstra]

Retinal microvascular alterations consistent with endothelial dysregulation in paediatric post-COVID-19 syndrome: A prospective matched-cohort study

🚨More “hidden” post-COVID damage in children!

Kids with long COVID show blood-vessel damage in their eyes, persistent, with partial & slow reversibility in some, still clearly abnormal months after one infection (retinal scans prove it)!

➡️German study design:
- Prospective matched-cohort; 58 children (7–17 yrs) with paediatric post-COVID-19 syndrome (chronic phase) vs. 58 healthy controls (matched age/sex/BMI),
- Retinal vessel analysis (static: CRAE/CRVE/AVR + dynamic flicker vasoreactivity) at baseline, and ~14-week follow-up,
- Single-infection chronic PCS kids,

➡️Main findings:
- Markedly wider central retinal arterioles (+28.1 μm, p<0.001) and venules (+21.7 μm, p<0.001) + higher AVR (+0.038, p=0.005), independent of BP or confounders,
- Pattern = endothelial dysregulation,

➡️Longitudinal changes:
- No overall group improvement at follow-up,
- Kids with largest baseline venular dilation & reduced flicker response showed greatest recovery,
- Longer follow-up + reduced symptoms → venular narrowing & AVR improvement,

➡️Implication:
- First in-vivo evidence of persistent microvascular alterations in paediatric PCS, detectable non-invasively,

➡️Conclusion (paper):
- “This study provides the first in-vivo evidence of altered retinal microvascular parameters in children and adolescents with PCS… persistent alterations in microvascular regulation several months after SARS-CoV-2 infection… heterogeneous, time-dependent changes… some patterns consistent with partial normalisation.”

‼️So paediatric post-COVID-19 syndrome causes long-lasting endothelial dysfunction in the microvasculature, visible months after infection, confirming a biological, vascular basis for kids’ persistent symptoms (not psychosomatic or transient).

This isn’t “mild” anymore. It never was!

This is measurable microvascular damage and remember: a second COVID infection DOUBLES their risk of Long COVID (Lancet Infect Dis 2026, RR 2.08).
#AvoidSars2 #AvoidReinfections #ChildrenCovid19
https://t.co/ggQ3taMKnf
https://t.co/rR6KTdiHif

[Vinnie Tortorich @VinnieTortorich]

For fifty years the world's obesity advice has come down to one phrase. Eat less. Move more.

A Harvard pediatric endocrinologist named David Ludwig spent twenty years showing it was the wrong answer.

Ludwig directs the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital. He is a professor at both Harvard Medical School and the Harvard T.H. Chan School of Public Health. He has spent his career treating the most obese children in New England.

The standard playbook was not working. The kids cut calories. They tried harder. They came back heavier.

So Ludwig started asking a different question. What if the calorie was not the lever.

He built what he calls the carbohydrate-insulin model.

Refined carbs spike your insulin. Insulin tells your body to store fat. After the spike your blood sugar crashes. Your body interprets the crash as starvation. You get hungry again. You eat. You store more fat. You crash again.

It is a feedback loop. And the loop runs on the carbohydrate, not the calorie.

In November 2018 his team published the result in the British Medical Journal.

164 adults. 12 percent body-weight loss on a run-in diet. Then randomly assigned to high-carb, moderate-carb, or low-carb at calorie levels designed to maintain their new weight.

For twenty weeks straight.

The low-carb group burned over 200 extra calories per day at the same body weight as the high-carb group. The effect was larger in participants with the highest insulin secretion.

Read that again.

Same body weight. Same maintenance calories. The low-carb body was running 200 calories per day hotter.

That number ends every "a calorie is a calorie" debate the moment you read it.

Ludwig is not a fringe figure. He is the most credentialed voice in nutrition science quietly dismantling the orthodoxy from the inside.

His 2016 book Always Hungry has been on the New York Times bestseller list. His 2021 paper in the American Journal of Clinical Nutrition formalized the model into a unified theory of obesity.

The standard advice is not just wrong. It is the wrong question.

Eat less and move more is what you say when you do not understand the disease.

#NSNG #DavidLudwig #CarbInsulinModel #AlwaysHungry #LowCarb #Insulin #Obesity #HarvardMedicine

[Nuwan Dissanayaka @nuwandiss]

Apart from when treated in hospital VC was v paranoid, v avoidant of services &amp; posed significant violent risks to others

He was never going to feel “at home” in a Neighbourhood Mental Health Centre

The way this offer is being presented isn’t realistic

#NottinghamInquiry

[Ihtesham Ali @ihtesham2005]

A team at Oxford built a search engine for every drug the NHS prescribes, and it has quietly saved the health service millions.

It's called OpenPrescribing.

The NHS publishes its full prescribing dataset every month. It's 700 million rows of raw numbers nobody could actually read. So Oxford built a tool that turns it into live charts in seconds.

You type a drug name. It shows you which practices over-prescribe it, which regions are slow to follow new guidelines, and where the money is being wasted.

→ Search any drug across any GP practice in England
→ Find safety and cost outliers instantly
→ 70+ ready-made quality measures
→ Updates monthly, automatically
→ Free, open source, MIT licensed

20,000 people use it every month. Doctors. Researchers. Journalists.

Public data that sat unreadable for years is now one search away.

https://t.co/U9KI0mUCAp

[Integrative Ketogenic Research & Therapies (IKRT) @ikrt_org]

Groundbreaking New Research: Ketogenic Therapy in Treating Weight Normalised Anorexia Nervosa
#MentalHealth
#KetogenicTherapy
#KetogenicDiet
#AnorexiaNervosa
https://t.co/RXrt8CtPry

[Kevin Yuill @historykev]

This is the way some #assisteddying/#assistedsuicide campaigners operate. They pretend its a great democratic project with minimal impact on society. Then they slip major changes past an unaware public.

[Liz Webster @LizWebsterSBF]

Former MI6 chief Sir Alex Younger on Brexit: “Putin would have been absolutely delighted by our decision.”

“So would Xi. France has effectively eclipsed us. Brexit has marginalised us.” Most striking of all: “Just nobody mentions the UK.”

Very sad that Sir Alex Younger, chief of the Secret Intelligence Service, born on July 4, 1963, died of pancreatic cancer on June 2, 2026, aged 62

[Martin Picard @MitoPsychoBio]

What if anorexia and anxiety around food could be improved with the ketogenic diet—by changing the source of energy we feed our mitochondria?

This is the first clinical trial of ketogenic therapy in anorexia nervosa.

This encouraging research shows that 1) many young women who struggle with anorexia can go on and sustain a ketogenic diet, and 2) many experience an improvement in their symptoms.

https://t.co/jWVldybuML

[AsifAMHP @asifamhp]

30 years later &amp; I suspect the #NottinghamInquiry will make many of the same recommendations✔️

Even the ASW (now #AMHP) gets a mention✔️

Lessons learned?

[Dr David Unwin @lowcarbGP]

Looking at abstinence in ultra processed food addiction Will this worsen binge eating symptoms as so many think? Not necessarily as this new paper shows binge eating symptoms improve after reducing carbs https://t.co/Tb5yryMg48… @subodhdave1 @AgnesAyton

[Agnes Ayton 💙 @AgnesAyton]

We need marketing regulations. As long as UPF is advertised as “fun” “choice” “convenient” - it’ll remain widespread, in households, schools and everywhere.

[Dr Jen Unwin @drjenunwin]

Something we can all agree on
UPF is addictive
Just eat real food
Just feed your kids real foods

[Dr Jen Unwin @drjenunwin]

Something we can all agree on
UPF is addictive
Just eat real food
Just feed your kids real foods

[Nuwan Dissanayaka @nuwandiss]

Is it truthfully not for the lack of effort? In communication with ICBs too?

NHSE should have been much clearer about need for high fidelity Assertive Outreach Teams

The term “Intensive &amp; Assertive Community Mental Health Care” is a meaningless made up phrase in their guidance

[Agnes Ayton 💙 @AgnesAyton]

@ProfLAppleby Please include eating disorders

[Dr David Unwin @lowcarbGP]

This is the third study showing a ketogenic or low carb diet may help with eating disorders. Previously some worried that restricting a food group (carbs) would make eating disorders worse I have not found this in clinical practice @BDA_Dietitians @BrownAdey