All Eating Disorders

Matters of Appearance: Eating Disorder Patients’ Interpretations of Therapists’ Bodies

Andrea 11 Comments

Therapeutic alliance is often highlighted in studies looking at treatment effectiveness, both in and beyond the realm of eating disorder therapy. Evidently, there are a number of factors that can impact how well we get along with our therapists, ranging from disagreements with the course of treatment or type of therapy to a simple, unnamable dislike for the person. But what about their appearance? What kind of impact could a therapist’s body size have on the therapy relationship?

Rance, Clarke & Moller (2014) sought out to investigate this issue, looking specifically at how clients evaluate therapists’ body size and speculate on their relationship with food, with an eye to determine what impact this might have on the therapeutic process.

I was immediately drawn to this study when I was browsing the latest literature; I wondered why this hadn’t been studied before. In some ways it seems obvious; we’re … Continue reading →

Eating Disorder Awareness Week: Useful, Useless, or Worse?

Tetyana

National Eating Disorder Awareness Week came and went (in the US, anyway). Posters were shared, liked, and tweeted. Pretty (but often misguided) infographics made the rounds on the internet. Local ED groups visited schools and college campuses to educate students about eating disorders. To, you know, increase awareness. 

The thing is, awareness is not always a good thing. For one, as Carrie over at ED Bites mentioned, there’s a whole lot of misinformation masquerading as fact. And two, awareness campaigns, even when the information in them is correct, may have unintended consequences, like, for example, increasing stigma or self-stigma.

Moreover, not all approaches to increasing awareness or decreasing stigma are equally effective, and the effectiveness of a particular approach may differ depending on the population studied.

So, what about the effectiveness of EDAW? In 2012, Kathleen Tillman and colleagues published a study looking at … Continue reading →

Impossible Binaries? Eating Disorders Among Trans Individuals

Andrea 14 Comments

Recently I was doing some research for an upcoming (and very exciting)  endeavour that involves exploring eating disorders among LGBTQ individuals. As one does, I set about scouring the research literature in this area in the hopes of stumbling across some prior articles on which to hang my proverbial research hat.

As I sifted through the databases, however, my searches kept coming up short. After sending out a call to a list-serv enquiring about the state of the field in this area, I received many responses highlighting the gap that surrounds trans individuals in particular. While this is good news for arguing for the value in conducting research in this area, it is discouraging news when it comes to understanding and attending to the experiences of trans people with eating disorders.

All this is to say, it seems as though now is as good a time as any to dip … Continue reading →

In a Relationship and It’s Complicated: Eating Disorders in Intimate Relationships

Andrea 4 Comments

What would you do if your partner started restricting caloric intake or bingeing and purging? Would you know how to approach your partner, how to offer support? And what about your own mental health?

Coping with an eating disorder in the context of any relationship can be tricky. There is a growing body of literature that addresses ways to bolster support for caregivers. While this is encouraging, a number of these studies explore the experiences of “caregivers” as a generic category encompassing parents, spouses, and other relatives. Few studies focus on the experiences of spouses and significant others in particular.

Dick, Renes, Morotti & Strange (2013) looked at literature exploring eating disorders in the couple context in an effort to devise recommendations for clinicians working with couples. For their review, the authors honed in on the experiences of heterosexual couples where the female partner was diagnosed with anorexia … Continue reading →

Eating Disorders and Irritable Bowel Syndrome

Tetyana 22 Comments

Eating disorder patients commonly complain of gastrointestinal (GI) symptoms including bloating, abdominal pain, and constipation. This is, of course, not surprising. After all, disordered eating behaviours such as self-induced vomiting, laxative abuse, and restriction are bound to have negative effects on the digestive system.

But just how common are GI complaints and functional gastrointestinal disorders (FGIDs) like irritable bowel syndrome among ED patients? And is there more to the relationship than simply ED behaviours causing GI disturbances? Luckily, a growing number of research studies are beginning to shed some light on these questions.

In a study published in 2010, Catherine Boyd and colleagues examined the prevalence of FGIDs among ED patients admitted to a hospital Eating Disorders Unit. They found that out of the respondents (73 in total), 97% had at least one FGID (as evaluated using the Rome II questionnaire). More specifically, on admission, 73% of the … Continue reading →

Nothing to SCOFF at: Screening for Eating Disorders in the Emergency Room

Andrea

As many who have suffered from eating disorders know, these illnesses can often go unnoticed for years. Family members and friends might not be the only ones who don’t catch the signs and symptoms of EDs; doctors, too, may not identify the presence of an eating disorder. Whether or not sufferers desire to get help, the symptoms associated with eating disorders often lead many to present at doctors’ offices and emergency departments, suffering from “mysterious ailments.”

In a study by Dooley-Hash, Lipson, Walton & Cunningham (2012, 2013), 16% of youth 14-20 presenting to the emergency department screened positive for eating disorders. The researchers describe their study in two articles published in the International Journal of Eating Disorders in 2012 and 2013. For this post, I’ll focus on the 2013 article, which highlights the patterns of emergency department use of those who present with eating disorders.

Tetyana has previously written … Continue reading →

You Sure You Want to Eat That? Perceived Consequences of Eating & Its Relation to Recovery

Jackie 1 Comment

I recently had a total Aha! moment (or a why-didn’t-I-ever-think-of-it moment) when I had chanced upon a recently published article titled “Eating Expectancies in Relation to Eating Disorder Recovery” by Fitzsimmons-Craft and colleagues. The title caught my attention because I had never come across any research tying eating expectancies to eating disorders, though I was familiar with the concept from the health psychology and obesity literature. Eating, as a behaviour and as a mechanism, is incredibly complex, with many factors contributing to why and how we eat; eating expectancies are one such factor.

Expectancy theory, first proposed by Tolman (1932), suggests that expectancies, or assumptions about the consequences of various behaviours, develop as a result of one’s learning history (Smith et al., 2007). Such expectancies are thought to influence subsequent behavioural choices, with one acting to either increase the likelihood of reward … Continue reading →

Narrative Therapy and Eating Disorders: Help or Hype?

Andrea 13 Comments

If you kick around the eating disorder recovery/treatment/research community for a while, you’re bound to come across someone calling their eating disorder “Ed.” In both the popular and scholarly literature around eating disorders, this externalizing and personifying approach has come to be quite popular. At face value, it makes sense to attribute blame for what can be an extremely difficult and painful experience to something other than oneself; it might be easier to “fight for recovery” if you have something to fight against.

But is there any evidence for the helpfulness of externalizing eating disorders? Who is “Ed,” and does “he” (or “she”) hold meaning for most or all sufferers? How might treatment programs make use of this construct in helping to facilitate clients’ recovery?

I will preface this post with a few disclaimers: firstly, I found a lot of solace in personifying my eating disorder early on in treatment … Continue reading →

Enraged by Sounds: Misophonia in Eating Disorder Patients (Clinicians, Listen Up)

Tetyana 19 Comments

Few people would claim to like the sound of chewing, lip smacking, or pen clicking. But while disliking these noises is commonplace, experiencing anxiety, panic and/or rage in response to them–a condition called misophonia (hatred of sound)–is not.

Well, truth be told, we don’t actually know how common it is: Searching “misophonia” in PubMed returns just 14 results. Seven were published in 2013/2014, and only three were published prior to 2010. (Searching “selective sensory sensitivity syndrome,” another name for “misophonia” wasn’t particularly fruitful either.)

Interestingly, the most recent paper on misophonia investigated the phenomenon in eating disorder patients. Timely, I thought, given that a few months ago someone had asked me about this very thing on Tumblr. At the time, I came up with nothing. Now I had something. So I posted it on the SEDs Tumblr. The response was almost immediate (click here to … Continue reading →

Is Eating Disorder Prevention Possible?

Andrea 11 Comments

How did I ever find things to write about before social media? Recently, someone on Tumblr asked whether eating disorder prevention and awareness efforts do more harm than good. In other words, can attempting to prevent eating disorders actually contribute to their development? Good question, I thought. I’ve often wondered about this myself, especially in light of some emerging studies suggesting that “healthy eating” campaigns may actually contribute to unhealthy (restrictive) behaviours around food in school children. So off I went to scour the literature. I came up with a number of hits, but surprisingly few from the past few years. With this recent silence in mind, I will look specifically at a meta-analysis by Stice, Shaw & Marti published in 2007 that highlights some of the characteristics of effective prevention programs and comment on some of the potential pitfalls of prevention.

PREVENTION

As a bit of a primer prevention … Continue reading →