Eating Disorders

Treating Severe Anorexia Nervosa in the Community

Tetyana 19 Comments

Can treatment for severe anorexia nervosa be delivered safely in a community setting? According to a recent paper by Calum Munro and colleagues (2014, open access), the answer is yes.

In 2001, a systematic review by Meads, Gold, and Burls found that inpatient treatment is not more or less effective than outpatient treatment for individuals with AN. Of course there will always be patients who will require inpatient care, but given the high cost, lack of clear efficacy, and known risks, it is important to ask if there are better options, particularly for a subgroup of individuals who may not need or may not benefit from inpatient care.

In their paper, Munro et al. describe a program that they’ve developed for treating individuals with severe AN in the community. The program is called the Anorexia Nervosa Intensive Treatment Team (ANITT) service. It is one … Continue reading →

Fat Talk Free Zone: What is the Impact of Fat Talk on Body Dissatisfaction?

Andrea 7 Comments

There has been a veritable explosion of “anti-fat talk” movements in the body image and eating disorder prevention realms over the past few years. Indeed, campaigns like the Tri-Delta Sorority Fat Talk Free week have become relatively well known. Events like the “Southern Smash,” where participants literally smash scales are other iterations of this social phenomenon encouraging a more positive conversation around bodies.

I am, of course, a fan of the idea that we shouldn’t put our bodies down; I’m a huge proponent of the need to avoid putting our own and others’ bodies down. I think that initiatives like Fat Talk Free week are good practice as they help move conversations in more productive directions and help to redirect our focus from bodies as our only source of value.

One of my concerns about these initiatives is that in signing up to do a Fat Talk Free … Continue reading →

Recovering from an Eating Disorder in a Society that Loves Fat Shaming (and Dieting)

Tetyana 3 Comments

Is ED recovery easier when your body is “normative or stereotypically desirable”? The anon asking the question implied that recovery could be more difficult because “an obese person … will never stop hearing hearing extremely triggering stuff about their body type.” Anon asked, “Have there been any studies on this?” Andrea tackled this question in her last post (it might be helpful to read it first if you haven’t yet); in this post, I will expand on my original answer.

Assuming anon meant, “Have there been anything studies assessing whether recovery is harder for individuals who do not fit the normative body type (because of fat phobia/fat shaming/diet culture)?” Then, my answer is: Not really, or at least I couldn’t find anything evaluating this question directly.

I was only able to find a few studies commenting on the history of overweight or obesity as a predictor of recovery/treatment … Continue reading →

Eating Disorder Recovery In a Non-Normative Body

Andrea 11 Comments

Do you think it is easier for someone to recover from an ED when they have a more normative or stereotypically desirable body? Versus, say, an obese person who will never stop hearing extremely triggering stuff about their body type everywhere they turn? . . .

This post was originally written in response to the above question that was posed to Tetyana on the SEDs Tumblr (you can see the full question and Tetyana’s response here).

This is an interesting and timely question, and one that drives much of my research: I’m interested in knowing which bodies are easily accepted as “recovered,” and how body privilege (i.e., unasked for benefits associated with having a body that is perceived as “normal” in sociocultural context, to oversimplify) might play into the experience of recovery.

Tied into the question, I’ve been wondering, lately: Can one only hold themselves up as a beacon … Continue reading →

I Need How Many Calories? Caloric Needs in Bulimia Nervosa Patients

Tetyana 2 Comments

In the 1980s, a few studies came out suggesting that patients with bulimia nervosa (BN) require fewer calories for weight maintenance than anorexia nervosa patients (e.g., Newman, Halmi, & Marchi, 1987) and healthy female controls (e.g., Gwirtsman et al., 1989).

Gwirtsman et al. (1989), after finding that patients with bulimia nervosa required few calories for weight maintenance than healthy volunteers, had these suggestions for clinicians:

When bulimic patients are induced to cease their binging and vomiting behavior, we suggest that physicians and dietitians prescribe a diet in which the caloric level is lower than might be expected. Our experience suggests that some patients will tend to gain weight if this is not done, especially when hospitalized. Because patients are often averse to any gain in body weight, this may lead to grave mistrust between patient and physician or dietitian.

Among many things, this ignores the fact … Continue reading →

Reflections on EDAC-ATAC 2014 Conference

Andrea

Last week I had the opportunity to attend and present at the Eating Disorders Association of Canada (EDAC-ATAC) Biennial Conference in Vancouver, BC. I was presenting part of my Masters thesis, which felt great. I always love talking to clinicians in the field, and I found that this was a very practical and applied-focused conference.

I sometimes feel like somewhat of an outsider at eating disorders conferences as I am “research only”- I do not have the credentials to counsel or treat individuals with eating disorders. However, I felt quite welcome at this conference. People were quite willing to engage with a relative newbie, in typical Canadian fashion.

If you follow me on Twitter, you’ll have noticed that I was tweeting up a storm. You might also have noticed that I was one of the only people doing so. I learned that this association is relatively new, in its … Continue reading →

Ambivalence and Eating Disorders: Inpatient Treatment, Belonging, and Identity

Andrea 1 Comment

When Tetyana Tweeted and “Tumblr-ed” (is there a better name for putting something on Tumblr?) a quote from a qualitative research article about ambivalence and eating disorders, I knew I would want to write a blog post about it. Of course, life happened, and so this post is coming a little later than I had intended. Nonetheless, I am happy to be sharing a post about a fresh article by Karin Eli (2014) about eating disorders and ambivalence in the inpatient hospital setting. The article itself is published through PLOS One and so is also open access, in case you are interested in reading the original.

THE STUDY

This article is about one aspect of a larger longitudinal study Eli conducted in Israel between 2005 and 2011. The broader study explores the “sensory experiences” (embodied feelings, sensations, and perceptions) of individuals with eating disorders and how these relate … Continue reading →

Living in Our Bodies: Embodiment, Eating Disorders and the IDEA Scale

Andrea 8 Comments

A good deal of my time is devoted to reading articles about eating disorders, feminism, qualitative research, and embodiment. I don’t know if this makes me a very interesting person or a very boring one, but it certainly makes me a very opinionated one, especially about these topics. Lately, I’ve been exploring the literature around eating disorders and embodiment in particular, trying to get a sense of how researchers attend to “embodiment” in the development, course, and outcomes of eating disorders and recovery. Predictably, I have my own opinions about this relationship, but am of course interested in how other researchers have explored embodiment in the context of eating disorders.

In my research spiral to find relevant articles, I came across an article by Stanghellini et al. (2012), in which the authors look at how individuals with eating disorders experience their bodies. In the article, the authors discuss … Continue reading →

Unpacking Recovery Part 5: Clinical Recovery Without a Clinic?

Andrea 24 Comments

It can be somewhat controversial to suggest that untreated recovery from eating disorders is possible. Certainly, people have varied opinions about whether someone can enact the difficult behavioral and attitudinal changes necessary to recover without the help of (at the very least) a therapist and a dietitian. Nonetheless, we still hear stories about individuals who consider themselves recovered without having sought out external sources of professional support.

When I think about untreated (or “spontaneous”) recovery from eating disorders, two studies in particular come to mind. The first study I am thinking about was written by Vandereycken (2012) and explores self-change, providing an overview of community studies of individuals who have not sought treatment for their eating disorders and implications for treatment and recovery. The second, by Woods (2004) is a qualitative study looking at the experiences of 16 women and 2 men who report recovering from … Continue reading →

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 →