All Eating Disorders

We’re In This Together: Collaborative Care for Eating Disorders

Andrea 2 Comments

This week I had the pleasure of attending a workshop with Janet Treasure on collaborative care in eating disorders. Treasure focused her workshop on supporting caregivers of people with eating disorders, offering practical skills for carers and clinicians alike to improve interactions with those with eating disorders. Though I am neither a carer nor a clinicians, I got a lot out of the workshop, and it reminded me of a few of Treasure’s articles I’ve read over the years, and how much I appreciate her strong focus on working collaboratively with patients and families to facilitate recovery.

I especially appreciated how she aims to integrate those with lived experience (of either having an eating disorder or caring for someone with an eating disorder) in research and treatment design. Some of her journal articles, including this article on the potential for harm in existing treatment models, even include former patients as … Continue reading →

Poverty and Eating Disorders in Hong Kong

Jacqueline

Eating disorders are typically seen as an illness of the middle class, with most patients coming from that socioeconomic group. However, the invisibility of poorer patients within eating disorder research in part reflects the barriers to treatment that they face, including both cost and lower levels of awareness. This paper, written by a Hong Kong social work professor, Joyce Ma, focuses less on the process of eating disorder recovery, highlighting instead the context of treatment. She discusses how family dynamics and socioeconomic status come into play in her encounters with 7 Hong Kong teenagers from low-income families.

While her sample size is very small, it reveals a more diverse — and less body image-focused –disease pathway than most American studies, with Ma breaking down the precipitating factors as follows (patient numbers in brackets):

  • Constipation (1)
  • Desire to be thin (3, 7)
  • Relationship issues (6)
  • Parental conflicts (5)
  • Poverty (2, 4)
… Continue reading →

Not Horsing Around: Using Equine Therapy For Eating Disorders

Andrea 5 Comments

It’s possible that some of you are already rolling your eyes: I know my audience. In the calls for evidence-based treatment, alternative therapies are often sidelined, deemed less important or less effective. While I certainly see that side of the argument, and would advocate for a continued search for treatment efficacy, I’m not ready to abandon the search for alternative approaches. Especially when used in concert with other treatments, I find alternative therapies very intriguing, partially for what they tell us about the complexity of treating eating disorders.

In a recent study, Lac, Marble & Boie (2013) explored the use of equine-assisted psychotherapy (EAP) for eating disorders. Keep in mind that as is the case with many alternative therapies, the article is based on a case study, rather than a large-scale clinical trial. To me, the point of these types of articles is to get us thinking differently … Continue reading →

Reflections on the Weight Stigma Conference 2015

Andrea 6 Comments

This past week I had the opportunity to attend the third annual Weight Stigma Conference (WSC) in Reykjavik, Iceland. I lived Tweeted throughout, as did some others, so if you’re interested in seeing the social media from the conference I recommend checking out the #StigmaConf2015 hashtag on Twitter. A few people asked if I would blog about the conference, and I’m more than happy to do so! If you’re not a fan of conference recap blogs, stay tuned for our regular Science of EDs programming soon.

Overall, I thought this conference was fantastic. Though it was not a conference strictly geared toward eating disorders, weight stigma is not helpful for anyone in any kind of body and engaging in any kind of behaviours around food and exercise. It oversimplifies complex issues, makes body management a personal issue with strong political stakes, and reduces eating disorders and obesity to a binary … Continue reading →

Culture and Eating Disorders: Treatment Outcomes in Singapore and Hong Kong

Jacqueline

In this last post about eating disorders in Singapore, I’ll write about the one Singapore-based retrospective outcome study in relation to a similar retrospective study conducted in Hong Kong.

In the Singapore study, researchers reviewed the charts of 94 patients diagnosed with anorexia nervosa from 1992 to 2004 at the National University Hospital, looking back from the time of the study. They didn’t contact any of the subjects for follow-up. 49 were first seen as inpatients, 34 as outpatients, and 11 were seen as outpatients but later admitted. The hospital doesn’t have a specialized ED service, so the authors relied on dietetic notes that unfortunately don’t provide a full picture of the patients’ eating disordered behaviors and cognitions.

The authors wrote about patient ‘improvement’ (not recovery!) as making a weight gain of at least 0.5 kg, or about 1 pound. 83% of their patients attended follow up appointments, which lasted … Continue reading →

Sensing the Body: Bodily Experience in Anorexia Nervosa

Andrea 1 Comment

I’ve been reading a lot of literature on bodies and eating disorders lately as I gear up to write the theoretical paper that becomes the basis of my PhD qualifying exam. Perhaps unsurprisingly, I’ve become a little preoccupied with teasing out my understanding of the relationship between body image and eating disorders in an era in which even saying those words in the same sentence sparks visceral reactions among listeners.

This post is not about whether body image causes eating disorders or not (sorry to disappoint). It is, however, about one of the best articles I’ve stumbled across thus far that seeks to shed some light on the ways in which those with eating disorders (specifically anorexia nervosa, in this case) might experience bodily sensations, which in my view is much more interesting than quibbling about whether body image is the primary causal factor for eating disorders.

In the article, … Continue reading →

Culture and Eating Disorders: The Thin Ideal in Singapore

Jacqueline

The paper I’m writing about in this post is a master’s thesis published elsewhere in adapted form as a book chapter – not the usual subject here, admittedly. However, for lack of more detailed qualitative research, it’s quite useful in fleshing out some of the observations in more descriptive studies on Singaporean eating disorder patients. This origin is one among a few other caveats to bear in mind; among them, Isono Maho’s ethnography does not aim to be a representative study of ED patients in Singapore, but rather a reflection on the aspects of Singapore culture that related to her interviewees’ particular experiences. Some of the themes Isono Maho found in this data set, nevertheless, help to supplement other studies’ findings, including those indicating that patients with eating disorders in Singapore tend to:

  • Present with body image concerns
  • Attribute comments and judgments from others as factors in their eating disorders.
… Continue reading →

Culture and Eating Disorders: A Singaporean Perspective — Part 2

Jacqueline

I previously looked at two retrospective studies of anorexia patients in Singapore, which primarily concerned female patients. In this study, Tan et al (2014) looked at 72 male-identified patients diagnosed with all forms of eating disorders.

  • 1% had anorexia nervosa (15.3% binge-purge subtype, 20.8% restrictive subtype)
  • 3% had bulimia nervosa (27.8% purge subtype, 5.6% non-purge subtype)
  • 5% had EDNOS
  • 9% had BED

The mean age at intake was 19.9 years old; patients were mainly students (41.7%) and national servicemen (41.7%). Compulsory army service (National Service) usually takes place in the two years after high school graduation, though some may defer until completing further studies. The typical age range for those in National Service is 19-24.

Of the patients in the study, 88.9% identified a precipitating factor for their eating disorder, including being overweight (59.7% reported pre-morbid obesity) and having people make comments about their body. 68.1% of patients … Continue reading →

Is The Doctor In? Eating Disorders Training Amongst Medical Professionals — Part 3

Andrea

The thing about critiquing systemic issues like lacking training environments for medical professionals (and others) is that we have to be cautious to not place undue blame on those who are stuck immobilized between the desire to a) train or b) get training in eating disorders. If the solution to the egregious lack of training was simple, I feel sure that someone would have done it already! What I am gesturing at, here, is that the reasons behind lacking training opportunities are deeply rooted in socio-political, historical, and economic trends and policies. Those providing training and those seeking training do not exist in some glorious black hole devoid of austerity (frugalness, restrainedness) and neoliberalism.

In this post I’ll focus on a few studies that help to illuminate why these gaps in training might exist, including dominant sentiments (in the general public, in government, in training environments themselves) toward eating disorders. … Continue reading →

Is the Doctor In? Eating Disorders Training Amongst Medical Professionals — Part 2

Andrea

It is challenging for me to rein myself in when I start ranting about the poor state of affairs of eating disorder training for medical professionals. However, I reconcile my critical ranting with a paradoxical penchant for optimism. I figured, in my searching, that there must be something out there that gives us more to work with. Is there a functional model of providing training for medical professionals? At the very least, are the opportunities that do exist doing a good job at equipping healthcare providers with the skills they need to begin to navigate the complexity of eating disorders?

Building on part one, in which I highlighted 2 studies offering some challenging knowledge around how little is on offer within medical training environments, I will focus here on 2 studies about the outcomes of training. The first, a UK study, explores whether medical professionals are trained in eating … Continue reading →