All Eating Disorders

What’s Working? Comparing Partial Hospitalization and Residential Treatment for Eating Disorders

Andrea 2 Comments

I can’t help but think I often write more about the issues surrounding the general lack of treatment options for eating disorders that I sometimes neglect to comment on what is available. A part of this is that I would refer to myself as somewhat of a treatment modality atheist – I have the luxury of being someone who does eating disorder research but is not involved in directly treating those with eating disorders, and so I don’t need to specialize in one type of treatment. My bottom line tends to be that no one-size-fits-all, and that the type of treatment that works for someone will depend on so many factors (like their gender, ethnicity, socioeconomic status, body size, ability, even their politics to a certain extent) that I wouldn’t want to proclaim one type of treatment as king.

In spite of this treatment modality atheism (or perhaps because of … Continue reading →

Where’s the Change? Service User Views on Eating Disorder Services

Andrea 1 Comment

I write a lot about systems-level change for eating disorders, and about how the services that we have available for eating disorders are severely lacking. What I tend to struggle with – though it’s something I’m working on – is how to actually MAKE the changes I’m advocating for. I always fear the tendency to get caught up in saying “this is how things should be,” when I know that eating disorders are so complex and multifaceted and that one size does not fit all when it comes to support. I also fear my experience and my story becoming “the” story about eating disorders and recovery; just because something worked for me does not mean it will work for others.

Surprisingly, despite a general discontent in the ED field with the service continuum, there are few studies that explore what kinds of changes might be made to eating disorder services … Continue reading →

Beyond the Muscular Ideal: Talking About Eating Disorders and Masculinity

Andrea

There’s a growing acknowledgment that women/feminine-presenting people are not the only people who get eating disorders. Increasingly, headlines proclaim that “men get eating disorders too!” and note that the stereotype that eating disorders are a “girl thing” is tired and problematic. This is great – anything that breaks down the well-entrenched notion that only young, rich, skinny, white, cis- and hetero girls are the only ones to get eating disorders is a welcome move in my opinion.

However, are we just reinscribing gender norms and the focus on body image and body ideals in the way we talk about eating disorders in boys and men? I just finished reading an article by Wright, Halse & Levy (2015) asking just this question. The article provides a compelling argument for re-visioning how we talk about eating disorders amongst boys and men.

Discourses

Wright, Halse & Levy explore discourses around eating disorders in … Continue reading →

Behind the Journal Article: Thinking Critically about Research Evidence and Eating Disorders

Andrea 2 Comments

There’s been a fair bit of talk lately (ok, always) about evidence in eating disorders. In addition to the evidence for certain types of treatment, there’s talk about evidence for causes of eating disorders, evidence for whether recovery is possible, and more. The framing I generally see advanced is that we need to be using evidence-based practice only; presumably, this evidence comes from scientific research. I don’t disagree, but in this post I’ll be writing about how science is never wholly objective and is situated in social context.

Let the record show that I love science. I love all kinds of science: biological science, genetic science, neuroscience, social science, you name it, I think learning and research and scientific methods are interesting. I can’t do all kinds of science; as Tetyana says, this blog itself has moved away from “science” as she originally intended it as I continue to dominate … Continue reading →

On the Efficacy of Self-Induced Vomiting (Purging)

Saren 9 Comments

A single in-lab assessment of caloric consumption, loss, and retention during binge-purge episodes in individuals with bulimia nervosa (BN) is frequently cited as evidence that purging via self-induced vomiting is an ineffective strategy for calorie disposal and weight control (Kaye, Weltzin, Hsu, McConaha, & Bolton, 1993). These findings have been widely interpreted to mean that, on average, purging  rids the body of only about half of the calories consumed, regardless of total quantity.

However, a closer examination of the study does NOT support the notion that purging is an ineffective compensatory behavior. Indeed, the findings of Kaye et al. (1993) would appear to have been both misunderstood and overgeneralized in the subsequent decades. This has important implications for therapeutic alliance in clinical practice as well as for understanding the nature of symptoms, metabolic processes, and physiological alterations in EDs.

THE STUDY

The study included 17 individuals, all of … Continue reading →

Thinking Critically to Move Forward: Reflections on the International Conference on Eating Disorders 2016

Andrea 9 Comments

For those of you who follow me on Twitter, you may have noticed that I was at the International Conference on Eating Disorders (ICED), the major yearly conference put on by the Academy for Eating Disorders, over the past few days. As I write this post, I am sitting in the San Francisco Airport trying to synthesize my experiences into what may or may not turn into an epic blog post.

Despite my extreme extroversion on the Internet, I actually live in a funny place where I’m continually balancing my innate criticality and training as critical health psychology graduate student with the desire for folks to like me. I see this playing out at conferences like ICED, where people’s opinions of me and my fitness to do this work matter. I am unable to sit in a session and not voice my perspectives on Twitter, but I’m also continually filtering … Continue reading →

Reflections on the Weight Stigma Conference 2016

Andrea 1 Comment

I’ve set myself a bit of an unrealistic conference schedule this year; with that in mind, I thought that if I’m going to write conference recaps at all, I had better do them immediately. Otherwise, I’m likely to forget where I heard a little gem or misattribute some brilliance – can you think of anything worse than misattributed brilliance? (I’m sure you can.)

This week I had the pleasure of attending the 4th annual Weight Stigma Conference in Vancouver, BC. As I write this, I’m still sitting staring at the beautiful mix of mountains and beaches that makes Vancouver a spectacular place to conference. I was also – in the interest of full disclosure around my largely positive views of the conference – on the organizing committee for the conference. I will say, though, that I don’t think my opinion would be different had I not had some say … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 6

Andrea 11 Comments

I thought about writing a post about the factor structure of popular eating disorder scales to celebrate my completion of an advanced statistics course in structural equation modelling. When I sat down to read some articles about that, though, I found myself side-tracked– and thoroughly uninterested in deconstructing scale psychometrics. So with a promise to do that at some point, I return to a favourite topic of mine: culture and eating disorders.

When I was writing about culture and eating disorders for the blog last year, I received quite a few requests for articles about eating disorders in developing countries. I suspect that the desire for this kind of article stems from a need to highlight (for the doubters) that eating disorders are serious mental health issues that can impact anyone who is predisposed, regardless of whether they live in a media-saturated landscape or not. As I noted in the … Continue reading →

Many Types of Expertise: Recovered Therapists Reflecting on Recovery

Andrea 21 Comments

Lately, I’ve been hearing a lot of noise in the social media sphere about whether or not those who have recovered from eating disorders should be treating eating disorders. Some have come out on the side of saying definitely not, listing reasons like the potential for bias, countertransference (the therapist making assumptions about clients’ emotions/experiences) or triggering. Others suggest that therapists who have “been there” can empathize with patients in a way that those who have not struggled with food cannot approximate.

Tetyana blogged about the lifetime prevalence of eating disorder professionals in recovery in 2013; she wrote about a 2002 study that revealed that around 33% of women and 2% of men treating eating disorders had a history of an eating disorder themselves. I have also written on the subject before (here); I focused on a 2013 study looking at experiences that recovered clinicians held in common.… Continue reading →

Whose Weight Are You Watching? Schools, Surveillance, and Eating Disorder Prevention

Andrea 2 Comments

Health class in school is an experience few of us would like to repeat, I’m sure. Though it’s been a good many years since I was subjected to the joys of health education, I continue to think about the types of lessons I had, particularly about eating disorders, and how lacking these were. I can only imagine that things have gotten progressively worse with the focus on the “obesity epidemic” that is so pervasive today.

In one of my favourite articles ever, Pinhas et al. (2013) outline some issues with healthy curricula related to “healthy eating” in schools in the wake of obesity rhetoric. These include:

  • The simplistic “energy in, energy out” message can be highly problematic for some children, who may take this to mean they need to engage in restrictive behaviours
  • Without addressing weight stigmatization in schools, messages about health hold little purchase, and tend to
… Continue reading →