Eating Disorders

Think You Are Not “Sick Enough” Because You Didn’t Lose Your Period? Read This.

Tetyana 1 Comment

Anonymous asked, “I’ve never lost my period. Weight restored I am naturally thin, but even at a BMI of 15 or so I always got my period (although it wasn’t always regularly). This makes me feel like I’m not actually sick because I hear about everyone losing their period.”

eatruncats replied: “To the anon who asked about losing periods: For all the times she worries about not being sick enough because she never lost her period, there are people who lost their periods at BMIs of 18, 19, and 20 who worry about not being sick enough because they never got to a BMI of 15. If you have an eating disorder, you are “sick enough.” Period.“

As it stands now, amenorrhea–or the loss of three consecutive menstrual cycles–is a diagnostic criterion for anorexia nervosa. Individuals who have not lost their periods are diagnosed with eating disorder not … Continue reading →

Does the Media Cause Eating Disorders? Disordered Eating in Iranian Women: From Tehran to Los Angeles

Tetyana

What is the impact of Western culture on eating disorders? Do images of thin cause eating disorders? I mean, it seems like such a nice and simple hypothesis. It makes intuitive sense: glamorize thin and make thin cool and BAM, everyone wants to be thin. It would be so much easier. Cause? Found. Solution? Easy: ban thin models. Unfortunately (or fortunately for me, since it gives me a lot to blog about) the answer is not that simple.

Just in the last couple of hours, some people who’ve ended up on the SEDs blog have searched:

  • does the media cause eating disorders
  • thin models on tv cause eating disorders to young girls
  • do models influence anorexia
  • ultra thin models causing eating disorders
  • magazine article eating disorders caused by the media
  • and the rare: media doesn’t cause eating disorders

I’m sure most of these search terms lead people to the … Continue reading →

A Study Without a Control Group? Evidence for Enhanced Cognitive Behavioural Therapy for Adults with Anorexia Nervosa

Tetyana 7 Comments

Here’s a quick tip: when a study that purports to find evidence of treatment effectiveness–preliminary or not–doesn’t have a control group (a group that doesn’t undergo treatment but is otherwise similar to the group that does), you should raise your eyebrows. Or shake your head. Or roll your eyes. Whichever you prefer.

Why do we need a control group? If the treatment works, we will see improvement in the patients, so isn’t that evidence enough? Well, no.

[T]he whole idea of an experiment is to identify two identical groups of people and then to manipulate something. One group gets an experimental treatment, and one does not. If the group that gets the treatment (e.g., a drug, exposure to a violent video game) behaves differently than the control group that did not get the treatment, we can attribute the difference to the treatment – but only if we can rest assured

… Continue reading →

Eating Disorders Among Lesbian and Bisexual Women

Tetyana 9 Comments

The hardest part of science blogging is picking an article to blog about. In times when I’m indecisive–when I spend hours sifting through the literature, inevitably creating several draft posts before deciding each article isn’t interesting enough–I turn to the list of topics that have been suggested by readers. The last suggestion I received was “eating disorders in the lesbian community.” It is a great suggestion, but I thought my search wouldn’t turn up much. But, to my surprise, it did turn up some studies.

But please, don’t expect too much: it is not a well-studied area, and most of the data comes from self-reported questionnaires, which are not particularly reliable:

  • First, there’s selection bias: the 50% or so of people who return the surveys could be different in significant ways from the 50% that don’t. For example, in a survey about mental health, perhaps individuals that have
… Continue reading →

Can Socioeconomic Status Predict Mental Health Literacy?

Tetyana 3 Comments

Is there an association between socioeconomic status (SES) and mental health literacy? Can we predict the extent of an individual’s knowledge about mental disorders based on how much money they make, how much education they’ve received, or how far up the career ladder they’ve climbed?

That is the question that Olaf von dem Knesebeck and colleagues attempted to answer in a paper published recently in the journal Social Psychiatry and Psychiatric Epidemiology. 

The authors interviewed 2,014 men and women, residents of two German cities Hamburg and Munich, using a telephone survey. The split is roughly 50/50 between men and women respondents and the mean age was 47.5. The authors presented each interviewee with two vignettes out of three (one on depression, one on schizophrenia, and one on eating disorders).

The gender in the depression and schizophrenia vignettes was varied 50/50 between male and female patients, but all vignettes about eating … Continue reading →

Chronicity in Eating Disorders: How Do We Define It and What Do We Do About It?

Tetyana 5 Comments

It comes as no surprise that the earlier eating disordered individuals receive treatment, the higher the likelihood that they will make a full recovery. In other words, the duration of the illness is inversely proportional with the likelihood of full recovery.

The problem is that a lot of eating disorders are not caught early. That a lot of people don’t have access to the treatment they need. Insurance will not cover it, their doctors don’t think it is a problem or won’t treat it, or there is simply no space. And even if there is space, and insurance will  cover it, dropout rates are incredibly high and treatment success is meager. The end result? Sometimes it is a success story – a full or partial recovery. But other times, the stories make headlines across the world, and not for good reason.

So then, what can we do about … Continue reading →

How Common Are Eating Disorders? Incidence, Prevalence and Mortality Rates

Tetyana 1 Comment

Six month of blogging and I have yet to do a proper post on the prevalence of eating disorders. I think it is about time. I see all sorts of numbers thrown around, often depending on the purpose of the article and the author’s bias. Is it 1 in 1000, 1 in 100, 1 in 20 or maybe even 1 in 2? Who is right?

Well, it is a tricky question to answer.

The number depends on how the particular study was conducted. Here are some factors that may influence the final rates: the population being studied, the sample size, the definition of eating disorder, the methods used by researchers to identify and screen for individuals with eating disorders, the number of years over which data is collected, and so on. In other words, a lot! That’s why in order to get a better sense of the true numbers, I … Continue reading →

Endophenotypes and Biomarkers in Eating Disorders: Genetic Underpinnings, Personality Traits, Vulnerabilities – Part 2

Saren 4 Comments

This post continues the discussion of the chapter on eating disorders by Carolina Lopez, Marion Roberts, and Janet Treasure from The Handbook of Neuropsychiatric Biomarkers, Endophenotypes and Genes (2009). Part 1 focused on neurotransmitter biomarkers, and this second part will focus on the neuropsychological biomarkers.

NEUROPSYCHOLOGICAL BIOMARKERS

Attentional biases

Attentional bias is the tendency for individuals to attend to or be distracted by emotionally relevant stimuli over neutral stimuli. Attentional biases have been observed in several studies:

  • Current AN and BN individuals showed bias towards food, body-related stimuli.
  • Past AN but not past BN showed bias towards body shape concerns.
  • Both current and “long-term recovered” AN showed “abnormally higher activation in the medial prefrontal and anterior cingulate cortices in response to food stimuli using fMRI [brain imaging]” (232)

These biases can be minimal but annoying: waiting in line at the pharmacy, staring into space and finding your focus … Continue reading →

Endophenotypes and Biomarkers in Eating Disorders: Genetic Underpinnings, Personality Traits, Vulnerabilities – Part 1

Saren

There have been some interesting discussions on the F.E.A.S.T. Facebook group over the past month regarding the role of genetics, personality traits, environmental factors and their role (or lack thereof) in the development of eating disorders and their prognosis. A parent group may seem like an unlikely forum for several hundred-odd comment threads on etiology; however, what we (caregivers, patients or clinicians) believe to underlie these disorders naturally informs our attitudes, decisions and choices with regards to treatment and our relationship to the disorders themselves:

Is this something they will have to manage their entire life?
Does anyone ever fully recover?
I had bulimia as a young adult and now my son has an eating disorder, too – did I pass on “bad genes”, bad habits, or is it a coincidence?
Is her rigidity and anxiety merely a side affect of starvation, or should we treat those as an underlying … Continue reading →

Maintaining Change Following Intensive Eating Disorder Treatment

Gina 9 Comments

It is a relatively well known fact that eating disorders have a high relapse rate and many people, myself included, find themselves in multiple intensive – residential, inpatient, even partial hospitalization – treatments. One may ask if such intensive treatments really work or if long term intensive care is just a band-aid of sorts. I know I’ve had to ask myself, “why is this going to work this time when it hasn’t worked in the long run before.”

There is even debate in the field on whether residential treatment actually has evidence supporting its effectiveness (see Tetyana’s post here). I can speak from experience that the various intensive treatments I’ve personally done have saved my life and given me more perspective, skills training, and support than I could have had otherwise. However, despite having made significant changes, I’ve had more than my share of slips and relapses.

I … Continue reading →