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Can Eating Disorders Be Contagious?

Tetyana 15 Comments

Treating a patient with an eating disorder can often feel like walking on eggshells; it is easy to say or do the wrong thing. I’ve covered this topic in my previous posts. In my first post, I wrote about negative attitudes that health care providers often have with regard to eating disorder patients and in my second post, I covered some ways in which caring clinicians that do work with ED patients may – usually inadvertently – negatively impact treatment, often by impairing the physician-patient/caregiver relationship.

But let’s forget about clinicians for a second, what if the treatment environment itself is damaging? Could treatment itself do more harm than good?

That’s the question that Walter Vandereycken explored in this commentary article. (This interesting paper was brought to my attention by a reader – you know who you are, so thanks!)

And just to be really clear Vandereycken doesn’t … Continue reading →

How Do Anorexia Nervosa Patients Define Recovery and Engage in Treatment? The Need for Individualized Treatment

Gina

One difficulty in measuring rates of recovery for patients with anorexia nervosa (AN) is coming up with a cohesive definition of “recovery” that most of us can agree on. Similarly, it is hard to identify whether a particular treatment course is working when the patient and the clinician have different goals in mind. A 2010 study by Alison Darcy and colleagues (article is freely available here) – in an attempt to understand the patients’ goals – aims to explore how patients define recovery and engage in treatment. This study differs from a lot of the literature on treatments and recovery in that all the data comes from individuals with a lifetime history of AN. The population sampled includes 20 women with a mean age of just slightly over 29 (range from 19-52). This is a small sample size, which can make it difficult to generalize responses, and the information gathered … Continue reading →

Serotonin Function in Bulimia Nervosa – Brain Circuits & Behaviour

Tetyana 15 Comments

Serotonin (5-hydroxytryptamine, 5-HT) is a neurotransmitter that is involved in just about everything. It helps ensure proper cell growth, maturation and migration during development. Serotonin is also important in regulating emotions, cognitive functions, appetite, pain, circadian rhythms, and our endocrine system in adulthood. It is hardly a surprise then, that the serotonergic system seems to be important in bulimia nervosa (BN).

I’ve written previously about serotonin in restricting-type anorexia nervosa, so for this post I’m going to be shifting focus and talk about bulimia and binge-purge type anorexia nervosa (AN-BP).

The information in this post isn’t coming from a review paper. Instead, I’m going to be summarizing and explaining information from a chapter in a book titled Behavioural Neurobiology of Eating Disorders. In the chapter on serotonin and bulimia, Howard Steiger and colleagues propose a model for serotonin action in bulimia nervosa which takes into account “diverse … Continue reading →

Financial Burden of Bulimia Nervosa: Cost of Food, Laxatives, Diuretics, and Diet Pills Adds Up

Tetyana 12 Comments

The financial burden of bulimia nervosa can be substantial, and yet little is known about the monetary costs associated with bulimic symptoms. At least little is known in academic circles – there is definitely a lot of anecdotal evidence floating around the internet. I found just one paper from 2009 by Scott J. Crow and colleagues. I stumbled upon it accidentally, actually. I was searching for articles on the economic burden of eating disorders (treatment cost, productivity loss, etc..) for a post I’m planning, but I thought I’d write about this in the mean time.

It is a short paper but I think it is important because it highlights an often overlooked issue.

The method Crow et al used to evaluate how much money individuals with bulimia nervosa spend on food, laxatives, diuretics and diet pills is simple (keep in mind, this hasn’t really been done before). Essentially, they asked … Continue reading →

How Can We Treat Chronic and Severe Anorexia Nervosa? (On the Need for New Approaches)

Tetyana 27 Comments

Treating anorexia nervosa is hard. Treating chronic and severe anorexia nervosa is a lot harder. Although the situation seems to be improving, there are really no evidence-based treatments for anorexia nervosa – particularly for those who have been sick for a long time.

Patients with severe and enduring anorexia nervosa have one of the most challenging disorders in mental health care  (Strober, 2010).They have the highest mortality rate of any mental illness with markedly reduced life expectancy (Harbottle et al., 2008). At 20 years the mortality rate is 20%, and given the young age of onset this results in many young adults dying in their 30s, and a further 5–10% every decade thereafter (Steinhausen, 2002)… Patients are often under- or unemployed, on sickness benefits, suffer multiple medical complications… have repeated admissions to general and specialist medical facilities, and are frequent users of primary care services (Birmingham and Treasure, 2010;

… Continue reading →

Understanding Disordered Eating in Trans People

Tetyana 17 Comments

Gender nonconformity is the second most popular search term that leads people to Science of Eating Disorders. (After “science of eds” and beating “science of eating disorders”.) Not far behind are variants of “FtM/MtF/transsexual/transgender” combined with “eating disorder/anorexia/bulimia”. That’s telling. It means there is little information on this topic. And it is not just that there’s too little information available to the public – there are only a handful of published studies in the peer-reviewed literature.

One study (which I discussed in my previous post: Gender Nonconformity, Transsexuality and Eating Disorders) published by Vocks et al (2009), compared disordered eating patterns, body image disturbances and self-image scores among trans women and men (131 participants in both groups) and cis female and male controls as well as to females with eating disorders.

Overall, they found disordered eating patterns reported by trans women and trans men were in the middle … Continue reading →

Medical Complications in Patients with Eating Disorders: An ER Perspective

Tetyana 7 Comments

A healthy-looking young woman comes into the emergency room complaining of lightheadedness, dizziness, tiredness, dehydration and constipation. She tells you she doesn’t know what’s wrong, but what she is not telling you is that she has an eating disorder. How do you find out? More importantly, how do you avoid complications that may arise from using conventional treatments for patients without eating disorders?

I often come across questions posted on websites and forums asking if others have experienced a particular symptom, what could be causing it and whether going to the hospital is necessary. I am not a physician, not training to be a physician and not doing research in anything directly relevant to medicine or health. Moreover, I always use caution when answering questions online – the best advice is to go see a doctor (but of course, that’s not always possible, unfortunately).

My goal with this post … Continue reading →

What You Should Know About Anorexia Nervosa and Bone Health

Tetyana 7 Comments

Recovery from an eating disorder is really hard. Unfortunately, the negative effects of that occur as a result of the eating disorder often persist long after recovery. It is hard to undo the mental and psychological aspects of anorexia or bulimia nervosa, but it may be just as hard, if not impossible, to undo the damage done to body.

What are some of the long-term health effects of eating disorders? What do patients with eating disorders – recovered or not – have to live with, for years, often decades, after recovery?

A really common consequence of anorexia nervosa is osteoporosis: thinning of bone tissue and loss of bone density. Unlike delayed gastric emptying – another consequence of EDs – which can make every meal a nightmare (particularly for someone recovering from an eating disorder): acid reflux, stomach pain and abdominal bloating are just some of the symptoms, bone density … Continue reading →

Are All Anorexia Nervosa Patients Just Afraid Of Being Fat and Can We Blame The Western Media?

Tetyana 42 Comments

A really fun aspect of blogging is seeing what search terms lead people to my blog; a frustrating side-effect is not being able to interact with those people directly. This entry is, in part, an attempt to answer a common question that leads individuals to my blog. Common question or search queries are variants of the following (these are actual search terms that led to this blog, I corrected spelling mistakes): “do models cause eating disorders in women?”, “pictures of skinny models linked to eating disorders”, “do the images of models in magazines cause eating disorders?”, “eating disorders relating to thin models”, “psychiatrists thought on how skinny models are causing eating disorders”, “thin models are to blame for eating disorder.”

Well, you get the point.

I briefly started tackling the notions that the “thin ideal” promoted by Western media is to blame for the prevalence of eating disorders and a … Continue reading →

When Clinicians Do More Harm Than Good – Part 2 (Risks Associated with Treatment)

Tetyana 6 Comments

My previous post on the effectiveness of residential treatment centers (RTCs) generated a lot of discussion. A point that was raised several times, on the blog, on Facebook and other forums was the fact that there are risks in choosing an RTC for treatment.

Laura Collins did a great job of articulating some of the risks in her comment:

Among the risks: delaying necessary changes at home, disempowering or alienating relationships at home that are necessary for longterm health, exposure to behaviors and habits that had not been an issue previously, exposure to unhealthy relationships with other clients, an artificial environment that can’t translate to life after RTC, and therapeutic methods or beliefs that are false or don’t apply.

There risks are not specific to RTCs. They hold true for inpatient treatment, partial hospitalization and to a lesser extent, outpatient treatment. I thought it would be nice to explore in … Continue reading →