All Eating Disorders

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 →

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 →

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 →

Does Too Much Exposure to Thin Models Cause Eating Disorders? Anorexia, Bulimia in Blind Women

Tetyana 42 Comments

As many of you already know, Vogue has recently banned models that are “too-thin” (and “too young”). It is a big step in the right direction, no, a huge step, and one deserving an applause, that’s according to an article on allvoices.com. Cue a drop in the prevalence of eating disorders, right? The logic in most articles, whether implicit or explicit, seems to be: no more skinny models = no more girls aspiring to be like skinny models = no more eating disorders.

Health of models belonging to both genders has been a growing issue in the past, especially after the death of two models in 2006-2007 from what the doctors blame to their acute eating disorders. This important step by Vogue targets not just skinny models, but also the impact they have on the young minds of girls and boys by presenting an image of perfection that

… Continue reading →

UK vs. US in Media Reporting on Eating Disorders: Who Does it Better?

Tetyana

Given the popularity of my post on how the media portrays eating disorders, I thought I’d do a follow-up entry by looking at more recent and comprehensive study on the topic. Specifically, I am going to review Shepherd & Seale’s 2010 paper, which built on the findings of O’Hara & Clegg-Smith, with a UK-focus. In particular, they: (1) compared UK and US media reporting of EDs, (2) tracked changes of in ED coverage over a 17-year period, and (3) studied the differences between newspapers with different target audiences.

Shepherd & Seale reiterate much of what O’Hara & Clegg-Smith wrote: ED specialists and researchers understand that EDs are complex, multi-factorial diseases with complex genetic and environmental underpinnings, that they are often associated with many medical complications and that they are hard to treat. The public, however, largely puts the blame on the patient and/or their parents, viewing it as … Continue reading →

Gender Nonconformity, Transsexuality and Eating Disorders

Tetyana 9 Comments

Too many people still mistakenly believe that eating disorders are for the Mary-Kates, Nicole Richies and Lara-Flynn Boyles, or vain adolescent and teenage girls aspiring to be just like them. Actually, as I’ve blogged earlier, even male veterans in late middle age are not immune to struggling with anorexia and bulimia nervosa. All in all, males make up ~ 5-10% of all eating disorder sufferers.

But what about those that dread having to check off “male” or “female” on a data form? What about individuals who feel their gender identity is not the same as their assigned birth sex. Perhaps they were born in a female body, with two XX chromosomes, but they feel and prefer to think of themselves as males, or the reverse? There’s some research (albeit limited, due to the rarity of both gender dysphoria and eating disorders) that suggests these individuals face an increased risk … Continue reading →

When Clinicians Do More Harm Than Good (Attitudes Toward Patients with Eating Disorders)

Tetyana 33 Comments

I was going to blog more about mortality rates in eating disorder patients, but recent ED-related deaths have left a bitter taste in my mouth (huge understatement). So, I’ve decided instead to write about a paper requested by the founder of The Joy Project on clinician reactions to patients with eating disorders by Thomspon-Brenner and colleagues that came out this year.

If you have an eating disorder or are close to someone with an eating disorder, you’ve likely heard many stories about dismissive or down-right negative and harmful attitudes that clinicians often have toward patients with EDs.

I’ve experienced it myself: I had to find another doctor to refer me to an outpatient clinic, because the first one didn’t – he didn’t think I needed help (probably because I was very aware that things were not heading in the right direction even before I was at a low weight). Needless … Continue reading →

EDNOS, Bulimia Nervosa: As Deadly as Anorexia in Outpatients

Tetyana

Eating disorder not otherwise specified (EDNOS), the catch-all diagnosis for eating disorder patients that don’t neatly fit into the DSM-IV anorexia nervosa (AN) or bulimia nervosa (BN) categories, is often thought to be less severe. Patients with sub-threshold AN or BN (missing one or two criteria) fall into the EDNOS (a large proportion, perhaps the majority, of patients). The inherent assumption in the word sub-threshold is that the patient is not as sick. Symptom frequency and behaviours are not that bad.

Increasingly, research is showing otherwise (which comes as no surprise for those of us who have struggled with eating disorders).

One study that has illustrated this quite nicely was published in 2009 by Dr. Scott Crow and colleagues in the American Journal of Psychiatry. Given that most ED mortality research has focused on anorexia nervosa, Crow et al wanted to compare mortality (from all-causes and suicide specifically) in patients … Continue reading →