Bulimia Nervosa

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 →

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 →

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 →

Bariatric Surgery and Eating Disorders: A Double-Edged Sword

Jacqueline 5 Comments

The high prevalence of eating pathology prior to bariatric surgery reduces the likelihood of what researchers have termed “optimal” weight loss post surgery. However, such weight loss is in part due to post-surgical complications like “dumping” (rapid gastric emptying because digestive systems cannot process the food) or vomiting that can develop into conscious efforts to lose weight. Conceicao et al. (2013a) describe, for example, one patient who deliberately binged and purged on foods that would make her vomit spontaneously.

These kinds of results raise a number of questions:

  • How prevalent are eating disorders (EDs) post-bariatric surgery?
  • What are the risk factors for developing an ED?
  • To what extent is the surgery itself a potential trigger?

PREVALENCE OF DISORDERED EATING AMONG INDIVIDUALS SEEKING BARIATRIC SURVERY

Researchers interested in bariatric surgery have explored how often those seeking bariatric surgery engage in disordered eating or have EDs. Prevalence rates vary between studies depending … Continue reading →

Let’s Talk about Systems Level Change for Eating Disorders

Andrea 7 Comments

This past Wednesday, January 27th, was Bell Let’s Talk day in Canada. In case you’re unfamiliar with the campaign, Bell Canada (a telecom company) donates 5 cents to mental health awareness initiatives for every social media post or text with the hashtag #BellLetsTalk. In general, the campaign has been lauded for its contribution to decreasing shame and stigma around mental illness, which is awesome. There are a number of critics, though, who point out that:

… Continue reading →

Eating Disorders & Socioeconomic Status in the Community

Andrea

The assumption that eating disorders only impact young, white, affluent women seems so out dated as to be laughable – and yet somehow this image persists, one of the most prominent stereotypes about eating disorders. It’s a damaging stereotype on so many levels; as we know, stereotypes about who might suffer from an eating disorder can lead people to feel that they don’t actually have an eating disorder and de-legitimizing their distress. The stigma that stems from having a body not expected to have an eating disorder can lead people to avoid seeking treatment out of fear of being dismissed by doctors, not thinking the type of treatment on offer will be appropriate or helpful, and more. Somehow, in the face of this, the image of the privileged and vain young woman who chooses to not eat marches on. And it is a shame.

Researchers are exploring stereotypes such as … Continue reading →

Incidence of Eating Disorders on the … Decrease?

Tetyana 8 Comments

Reports that eating disorder (ED) rates are rapidly increasing seem nearly ubiquitous, but are rates actually increasing? Are EDs at an “epidemic” level? I came across a recently published study suggesting that this may not be the case; indeed, ED rates might actually be decreasing, at least in the Netherlands.

In the study, Smink and colleagues (2015) followed a group of general practitioners (GPs), servicing roughly 1% of the total population, asking them to record all the newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) between 1985-1989, 1995-1999, and 2005-2009. They were interested in whether incidence rates changed or remained stable over time.

Incidence refers to the number of new cases of a disease or disorder in a population over a certain time period; it is not the same as prevalence, which refers to the total number of individuals suffering from the condition at a given point in time (or … Continue reading →

Eating Disorders are a Political Issue: Bulimia Nervosa and Advanced Capitalism

Andrea 6 Comments

If you know me even a little bit, you can imagine my glee at coming across a paper entitled “The Political Economy of Bulimia Nervosa.” YES! I exclaimed. Let’s explore the ways in which our systems of food production are linked to eating disorders. Let’s complicate the idea of “the social” as it relates to eating disorders and do an analysis of the complex socio-political and economic forces that govern our world.

So, let’s get right into it, shall we?

The Article

Pirie (2011) argues that it is important to understand eating disorders from a political economic perspective so that we can look beyond an equation of the “cultural” and media representations of femininity. The way in, he suggests, is through a look at how food systems have shifted since the time at which bulimia nervosa was introduced as a psychiatric diagnosis, around 1970.

The article is not … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 2

Andrea 25 Comments

In this post I’ll continue on the trend of considering the “culture bound” nature of eating disorders by looking at another commonly-cited article about eating disorders and culture. In this article, Keel and Klump (2003) look at the cultural and historical facets of anorexia and bulimia. They looked at whether eating disorders were present in other sociohistorical and cultural contexts in order to determine whether AN and BN are “culture bound.”

Their research, as I alluded to at the end of the first post in this series, suggests that anorexia is not culture bound (i.e., it can occur in the absence of certain aspects of culture), while bulimia is (i.e., it only/primarily appears in certain cultural contexts). As this finding might actually run counter to what popular press would have us believe, looking at this article provides us some interesting insight into how spin can really be everything. … Continue reading →