All Eating Disorders

Unpacking Recovery Part 4: Are We All on the Same Page?

Andrea 6 Comments

Another issue in defining and understanding recovery is that patients and clinicians may have different opinions about what recovery looks like and how to get there. Certainly, there is a body of literature from the critical feminist tradition in particular that explores how at times, patients can “follow the rules” of treatment systems to achieve a semblance of “recovery,” from a weight restoration and nutrition stabilization perspective, but feels nothing like a full and happy life (see, for example, Gremillion, 2003; Boughtwood & Halse, 2008).

This potential disconnect is one reason for favoring a holistic recovery as articulated by Bardone-Cone et al. and for attending to patients’ subjective experiences of recovery (see part 2 of this series here), as Malson and others have done (see part 3 of this series here). In 2006, Noordenbos & Seubring conducted a study that further unpacked this potential disconnect through … Continue reading →

Unpacking Recovery Part 3: Can Patients Imagine Recovery?

Andrea 5 Comments

Today I have the distinct pleasure of writing about one of my favourite articles about eating disorder recovery by Malson et al. (2011) exploring how inpatients talk about eating disorder recovery. I have personally found this article to be very helpful in understanding some of the difficulties of understanding and achieving recovery in our social context.

As Malson and colleagues explain (and as we’ve established), eating disorder recovery is elusive. Often, poor prognosis is described in relation to individual factors, including:

  • Treatment resistance
  • Hostility
  • Opposition
  • Ambivalence about change
  • Ambivalence about the possibility of change

Problematically, seeing these as the primary reasons for which patients do not recover can make individuals with eating disorders themselves feel as though they are to blame for their “inability to recover,” which help approximately no one. How do patients internalize these kinds of framings, and what impact does it have on how possible … Continue reading →

Using Animal Research to Justify Eating Disorder Treatment Practices: Are We Going Too Far? (On Eating Junk Food in Treatment – Part II)

Liz 10 Comments

As a follow up to Charlene’s  post on eating hyper-palatable foods during eating disorder treatment , I asked Liz–SEDs’ resident expert on animal behaviour, particularly in relation to binge eating and drug addiction–to look at some of the studies that Julie O’Toole mentioned as evidence for Kartini Clinic’s guidelines of avoiding hyper-palatable foods for the first year of eating disorder recovery. If you missed Dr. O’Toole’s post, please do take a look. Here’s the main conversation that led to this post: 

In the comments, I asked Dr. O’Toole, 

I agree that eating cheetos and sugar-y drinks is ubiquitous but not exactly healthy, and I too question many versions of “normal eating” that people promote (and *everyone* has an opinion), but I wonder — if there’s any evidence for not allowing hyper-palatable foods to patients for a year? And what does the Kartini Clinic consider to be hyper-palatable? Why

… Continue reading →

In Defense of Eating Junk Food in Eating Disorder Treatment

Charlene 26 Comments

Should eating disorder patients be introduced to “junk food” or “hyper-palatable” foods during treatment? A few days ago, I stumbled across a blog post where Dr. Julie O’Toole, Founder and Director of the Kartini Clinic for Disordered Eating, argues against introducing “junk food” during ED treatment. The crux of the argument is that “hyperpalatable foods”—e.g., chips and Cheetos—are not real food and should never be forced or encouraged for anyone, regardless of the presence of an eating disorder:

A lot of ink has been spilled on teaching Americans in general and children in particular to make good food choices. Just because you have anorexia nervosa as a child, and desperately need to gain and maintain adequate weight, does not mean that you will be immune from the health effects of bad eating as you get older. This is true whether or not you get fat later on. You can be

… Continue reading →

Unpacking Recovery Part 2: The Multiple Facets of Recovery

Andrea

One of the most common definitions of eating disorder recovery I have seen comes from a 2010 study by Bardone-Cone et al. Before I begin exploring this study I thought I might direct readers to some more resources on recovery: Carrie Arnold over at ED Bites wrote a few posts about recovery on her blog, and the first in the series can be found here. In this post, Carrie looks at the 3 dimensions of recovery that surface in Bardone-Cone’s article, so I thought I might also explore a study Bardone-Cone et al. published in the same year, which specifically touches on self-concept in eating disorder recovery, for variety’s sake.

ASPECTS OF EATING DISORDER RECOVERY

One of the most appealing things about Bardone-Cone and colleagues’ definition of recovery is that it looks at more than just the physical aspects of recovery. The researchers conceptualize recovery instead as … Continue reading →

Attention Deficit Hyperactivity Disorder & Eating Disorders: Is There a Link?

Tetyana 6 Comments

Attention deficit hyperactivity disorder (ADHD), characterized by inattention, hyperactivity, and impulsivity, is a common childhood disorder. ADHD can often persist into adolescence and adulthood. The prevalence of ADHD is thought to be between 6-7% among children and adolescents and ~5% among adults (Willcutt, 2012).

Increasingly, evidence from multiple studies has pointed to comorbidity between ADHD and eating disorders (EDs). For example, one study found that young females with ADHD were 5.6 times more likely to develop clinical (i.e., diagnosable according to DSM-5) or subthreshold (i.e., sub-clinical) bulimia nervosa (BN) (Biederman et al., 2007). Another study found that found that 21% of female inpatients at an ED unit had six or more ADHD symptoms (Yates et al., 2009).

However, most previous studies are limited by the fact that they assessed comorbidity between ADHD and EDs among patients. This limits our ability to generalize these findings to community samples, where many may … Continue reading →

Of Family Dynamics and Eating Disorders: Parents’ Experiences of Skills-Based Training

Andrea 16 Comments

Parents of children with eating disorders face an extraordinarily difficult challenge; the work that they put into caring for their loved ones cannot be discounted. This can be especially challenging in the face of a social environment that tends toward parent-blaming for disorders. Further, the kinds of behaviors caregivers are obliged to encourage in the individual with an eating disorder (for example, eating calorically-dense foods in order to gain weight) are frowned upon, to say the least, in our “anti-obesity” oriented society.

There is a rich body of literature exploring caregiver well-being, including studies suggesting that increasing the availability of support in various forms from social to practical may help caregivers to navigate a complicated path toward supporting a loved one with an eating disorder. Researchers are asking key questions around what we can do to better support parents and other caregivers.

Along these lines, Goodier et al. (2014… Continue reading →

Walking a Mile in Your Shoes: Treating Eating Disorders with a Personal History of Eating Problems

Andrea 9 Comments

A big topic at ICED, and one that seems to continually resurface, is treatment professionals in recovery. One the one hand, many see healthcare professionals with a history of eating disorders as possessing a kind of empathy that may be inaccessible to those who have not “been there.” On the other, some argue that this history complicates the patient-professional relationship in potentially detrimental ways.

You’ll find proponents of both sides of this debate from both professional and patient communities, and there are compelling arguments to be made on both sides of the coin. As an eating disorder researcher with a history of eating disorders, I don’t think you will be surprised that I lean toward the “it’s totally fine” side of the debate.

One thing that stood out to me about the larger discussion on this topic at the conference, however, was how we need to be careful about not … Continue reading →

Political Bodies: What is the Impact of National or Regional-Level Eating Disorder Prevention?

Andrea 1 Comment

When it comes to prevention, I’ve noticed a strong interest in working toward large-scale prevention initiatives. I’ve written about prevention before, noting the potential for unintended effects, as well as schoolgirls’ reactions to and acceptance of prevention interventions (here). But what about the larger scale efforts to prevent body image concerns and eating disorders?

Countries from the US to Australia to Israel have taken strides to implement initiatives aimed at improving national body image (a lofty goal? Perhaps.); you might have heard about bans on thin runway models and airbrushing, among other efforts. We know that eating disorders are not solely caused by thin-ideal internalization or bad body image; in fact, body image might not even be that useful of a concept for everyone, as I wrote about here.

However, improving body satisfaction could be a useful end goal in and of itself. Why not … Continue reading →

Disordered Eating and Athletic Performance: Where’s the Line?

Emma 4 Comments

If a person severely restricts his diet and exercises for hours each day, he has an eating disorder. If another does exactly the same but it is because she wants to make the lightweight rowing team (which has an upper weight limit), she’s a committed athlete. When the two overlap, and an athlete presents with eating disorder symptoms, how do we distinguish between the demands of the sport and the illness?

I’ve been interested in the distinctions we make between disordered and non-disordered eating and exercise behaviours for a while now. Recently, when I was browsing through articles, I came across a literature review by Werner et al. (2013) (open access) of studies examining weight-control and disordered eating behaviours in young athletes.

The authors start by noting the sheer lack of research that has actually been done in this area. This is worrying: typical onset of eating disorders is during … Continue reading →