Month: June 2012

What’s it Like to be a Man with an Eating Disorder?

Tetyana 4 Comments

What is it like for men to live with an eating disorder? What is it like for men to seek and receive treatment for an eating disorder? These are the questions that Kate Robinson and colleagues asked a group of eight men who were receiving treatment (inpatient, day patient or outpatient) at two ED treatment centers in the UK. Their goal was to find out if and how men’s experiences with an eating disorder differ from women with eating disorders.

Men account for roughly 10% of eating disorder patients (when considering anorexia and bulimia, not including binge eating disorder, which is not yet part of the DSM). I suspect this number is actually higher – as less men probably realize they have an ED, admit to having an ED or seek treatment, precisely due to the issues raised in this article (and others). Given that men form a sizeable minority … Continue reading →

Impulsivity in Eating Disorders is Associated with Bingeing/Purging

Tetyana 4 Comments

There is a marshmallow in front of you. Can you wait for twenty minutes, starring intently at the white, soft, cylindrical shaped sweet, to get another marshmallow? Or do you devour it right away, forgoing the opportunity to have two sweets?

I’d probably wait. But that’s only because I don’t like marshmallows, and would be in no rush to consume either one or two of them. What about you?

That’s the famous experiment that’s shown to many first year psychology undergrads (I, too, watched videos of little kids anxious waiting for 20 minutes, or not, in my first year psych class). It was designed to measure delayed gratification, in other words, are you able to wait, to get a reward, to delay gratification?

Leah recently asked whether studies have looked at delayed gratification in eating disorder patients. What I loved about her comment is that she included a hypothesis: “I … Continue reading →

The Research-Practice Gap in Eating Disorder Treatment

Tetyana

The approaches used in clinical practice to treat patients often lag behind the most up-to-date developments in research. It can take a long time to integrate scientific findings into clinical practice. This, of course, is not limited to eating disorders or even mental health issues. This so-called “science-practice gap” exists for many reasons, which vary depending on the medical discipline.

This issue, though, seems particularly bad when it comes to eating disorder treatment.

There’s the issue of conducting good studies – how do we determine what is efficacious? That’s a complicated task. What is “recovery” and how long is long-enough for follow-up? Is what we consider to be efficacious really efficacious or just slightly better than the rest?

Then there’s the training: mental health seems to be undervalued in medical school curricula for one, but even more importantly: “Clinicians tend to give more weight to their personal experiences than to … Continue reading →

Your Time in the Womb Matters: Risk Factors for Anorexia Nervosa

Tetyana 4 Comments

A not-so-recent, but interesting paper by Cynthia Bulik and colleagues outlines an interesting model for perinatal risk factors in the development of anorexia nervosa. The model “focuses on adverse perinatal events and prematurity as risk factors for AN and encompasses the potential role of passive gene-environment correlation in perpetuating AN risk.”

Importantly, this model “provides intriguing data on a potential cycle of risk for at least a subset of individuals with AN.” The word subset is important: this model, if true – and we don’t know yet, undoubtedly applies only to a proportion of individuals that develop anorexia nervosa, so keep that in mind.

(In case you are wondering, because I was, perinatal period  starts at 140 days of gestation and ends 28 days post birth, prenatal period is any time before birth.)

Trying to figure out the risk factors for anorexia, a rare disorder (<1% of the population), is … Continue reading →

Benefits of Starving and Why You Don’t Have a “Chemical Imbalance”

Tetyana 9 Comments

Most people hate starving, hate prolonged hunger and suck at dieting. Patients with anorexia nervosa (AN), on the other hand, excel in these areas. How can someone like being hungry? How are they able to exert such “self-control”  (as many non-ED people often say) over their food intake? Part of the answer might lie with serotonin. But don’t worry, there’s no “chemical imbalance” – it is much more complex than that.

In this post, I’m going to continue discussing the review article in Nature Neuroscience (2009) by Kaye et al., focusing on what is currently known or hypothesized about the role of serotonin in anorexia (reminder, findings Kaye et al focuses are specific to restricting-type AN and may not apply to AN-BP or BN).

BUT FIRST, A LITTLE NEUROSCIENCE

Serotonin (aka 5-hydroxytryptamine or 5-HT) is a neurotransmitter, meaning that it is a chemical messenger that cells in … Continue reading →

Naomi Wolf Got Her Facts Wrong. Really, Really, Really Wrong.

Tetyana 18 Comments

I’m working on a post about the role of serotonin in the development and maintenance of anorexia, but it is taking me some time as I want to include a sufficient amount of background information. So, in the meantime, I’m going to blog about a short paper that was brought to my attention by Sarah. As you might have guessed by the title, the paper’s author, Casper Schoemaker, wanted to do some fact-checking on Naomi Wolf’s first book, titled The Beauty Myth. A quick glance at the Amazon ratings reveals that a lot of people like it, and many find it shocking and “eye-opening”. Now, I’ll admit: I haven’t read it, and I don’t plan to. (I don’t read books like this.) But I have come across blatantly wrong statistics on eating disorders from people citing her work.

(Books are not peer-reviewed. The main thing you need to … Continue reading →

Symptoms in Anorexia: Cause or Consequence?

Tetyana 4 Comments

In 2009, Dr. Walter Kaye and colleagues published an article in the prestigious journal, Nature Neuroscience Reviews, titled “New insights into symptoms and neurocircuit function of anorexia nervosa”. [By anorexia nervosa, Kaye et al. limited themselves to restricting-type anorexics (AN-R), so some but not all findings may extend to bingeing-purging anorexics and bulimics] This review, which is lengthy and will take me a few posts to cover thoroughly, focuses on the “findings from pharmacological, behavioural and neuroimaging studies that contribute to the understanding of appetite regulation, reward, neurotransmitters and neurocircuits that are associated with AN.”

A striking feature of anorexia nervosa is the incredibly uniformity of traits and symptoms that patients experience, as well as the narrow range of onset. While the course of the illness varies from person to person, during the AN-R state, individuals exhibit very stereotypic presentation (and that, of course, may be due to malnutrition … Continue reading →

Who Gets Treatment? Your Ethnicity Matters

Saren 9 Comments

In 2010, I wrote a literature review on eating disorders in women of color in North America. I expected to find only a few articles on this subject – every lecture in my undergrad psychology classes, every piece of information targeted to the public, every discussion I had, it seemed, either omitted the existence of EDs in non-stereotypical (white, female, heterosexual, adolescent, upper/middle-class) populations altogether – or glossed over it with a footnote on “acculturation” that reductively attributed the disorder to a misguided desire to fit into the dominant culture, much as other women might aspire to look like the images of female bodies in mass media. (Acculturative stress is actually far more complex than this, and furthermore is not necessarily the sole or even the primary cause of EDs for all people of color.)

[Some people] think that I hate being Asian and want to look white, which

… Continue reading →