Eating Disorders

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 →

Examining Mandometer(r) Founders' 10 "Reasons" Why Eating Disorders Are Not Mental Disorders – Part II

Tetyana 8 Comments

This is the last post in my mini-series on the Mandometer® Treatment. (Links to earlier posts here: Part I, Part II, and Part III). In this post I’m going to continue examining Bergh et al.’s reasons for why eating disorders are not mental disorders (#6-10). In my last post I omitted something important: I didn’t define mental disorders, but to avoid repeating myself, please see my comment on the topic here.

Bergh et al.’s reason #6 why EDs are not mental disorders:

Reason #6. Gender differences argue against an underlying mental health disorder. Women constitute more than 90% of eating disorder patients (Hoek & van Hoeken, 2003), but teenage males are more likely to have OCD than teenage females (Fireman, Koran, Leventhal, & Jacobson, 2001), and there are no differences in the prevalence of anxiety and anxiety-related disorders in male and female teens (Beesdo, Knappe, &

… Continue reading →

Examining Mandometer(r) Founders' 10 "Reasons" Why Eating Disorders Are Not Mental Disorders

Tetyana 9 Comments

This is Part III of my mini-series on the Mandometer® treatment. In my first post, I wrote about the history and rationale of the Mandometer® treatment. In my second post, I evaluated a recent study published by the creators of Mandometer® (Bergh et al., 2013); I wanted to see whether their data supported their claims (spoiler alert: it didn’t). In this post, I’m going to focus on the first five of Bergh et al.’s ten reasons why eating disorders are not mental disorders (or something like it, anyway).

If it seems like I have a personal vendetta against Cecilia Bergh & Co/Mandometer®, rest assured that I most certainly do not. I just don’t like bad science, misleading claims, and snake oil. As I mentioned in my first and second posts, I actually like many of the components of the Mandometer® treatment. (For example, I agree that weigh restoration … Continue reading →

The Finest Quality Snake Oil: Mandometer(r) Treatment for Eating Disorders – Part II

Tetyana 16 Comments

This is Part II of my mini-series on the Mandometer(r) treatment for eating disorders (link to Part I). In Part I, I provided some background on the Mandometer(r) treatment; in this post, I want to take an in-depth look at the recent Mandometer treatment study. My main goal is to see whether their data live up to their claims. Warning: This post may contain high levels of snark.  

Their main claims? This is from the abstract:

The estimated rate of remission for this therapy was 75% after a median of 12.5 months of treatment. A competing event such as the termination of insurance coverage, or failure of the treatment, interfered with outcomes in 16% of the patients, and the other patients remained in treatment. Of those who went in remission, the estimated rate of relapse was 10% over 5 years of follow-up and there was no mortality.

… Continue reading →

The Finest Quality Snake Oil: Mandometer(r) Treatment for Eating Disorders – Part I

Tetyana 6 Comments

PROTIP: When selling your snake oil treatment, try NOT to make wildly outrageous efficacy claims. But if you can’t resist that temptation, try to limit your hard-to-believe, eye-roll-inducing claims to your treatment — there’s no need to go further.

In this post, I’m going to give a brief history of the Mandometer® treatment and its apparent rationale. In the next one or two posts, I will do an analysis of the most recently study by the group that claims to show remission rates of 75% and relapse rates of only 10%. Sounds great, right? Well… we’ll see.

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We suggest that the reason self-starving patients do not fit the DSM-IV criteria of anorexia nervosa is because there is in fact no psychopathological basis of the disorder … The DSM-IV offers no definition [of psychopathology], but it is reasonable to assume that a psychopathological basis of anorexia nervosa would be reflected

… Continue reading →

Complex Motherhood: The Perspectives of Mothers with Eating Disorders

Andrea 10 Comments

Studying, as I do, in a department of family relations, I have become interested in family relationships and parenting. Accordingly, I have begun to take note of interesting studies that link family dynamics and parenting with eating disorders, including studies that look at the sibling relationship (as I wrote about here), family-based treatment, and motherhood/fatherhood in the context of eating disorders.

The literature appears to have shifted, lately, from a focus on “eating-disorder generating” families toward an acknowledgement of the complex family dynamics that can play into the development and treatment of eating disorders. A move away from mother- or family-blaming discourses is essential, I would argue, to gaining a better understanding of the lived experience of eating disorders for individuals and families alike.

Accordingly, I was pleased to stumble across an article by Tuval-Mashiach et al. (2013) that used a qualitative approach to explore the experiences … Continue reading →

Dialectical Behavioural Therapy for the “Difficult to Treat” Eating Disorder Patients

Andrea

If there is anything we’ve learned over the  many years of eating disorder research, it is that eating disorders are extremely complex. Often, this complexity is intensified by comorbidities, including post-traumatic stress disorder, depression, and “personality disorders.” Unfortunately, individuals whose disorders are labeled persistent, chronic, or “difficult to treat” may be even less likely to receive the treatment and support they require, deserve, and desire.

“Standard” approaches to eating disorder treatment, such as cognitive behaviour therapy (CBT), may prove ineffectual for these individuals. In a recent article, Federici & Wisniewski (2013) reflected on the difficulty of treating patients whose eating disorders are accompanied by other mental health issues. They noted that focusing on ED symptoms alone generally fails to achieve treatment goals, as behaviours associated with other disorders often decrease ED treatment effectiveness. This situation may leave both patients and clinicians feeling burnt out and unsatisfied (to say … Continue reading →

Problematic Labelling: The Case of “Drunkorexia”

Andrea 9 Comments

Recently, I was browsing the Twittersphere and came across (yet another) tweet about so-called “drunkorexia,” or the phenomenon of drinking to excess coupled with restrictive behaviours around food. After firing off a mildly miffed tweet bemoaning our societal tendency to add the suffix “orexia” to all “new” potentially problematic behaviours around food, I took to Scholar’s Portal to see if academics, too, were using this term. I wondered if “drunkorexia” was piquing scholarly interest, or just circulating in media headlines.

Beyond its problematic moniker, coupling problem drinking and restrictive eating is a phenomenon that might be worth delving into in greater detail, particularly if, as the reports claim, its incidence is rising. Barry & Piazza-Gardner (2012) explored the co-occurrence of weight maintenance behaviours and alcohol consumption, and their article clarifies what people mean when they say “drunkorexia.” I’ll get more into my issues with this terminology following a … Continue reading →

The Sobering Reality (and the Silver Lining) of Treating Anorexia Nervosa in Adults: A Randomised Controlled Trial

Tetyana 5 Comments

The challenges of treating anorexia nervosa are plenty; some of these challenges — like low prevalence rate and high treatment dropout rate —  make conducting randomised controlled trials aimed at identifying effective treatment methods really hard as well.

So I was pretty excited about the recently published randomised controlled trial comparing focal psychodynamic therapy (FPT), cognitive behaviour therapy (CBT), and optimised treatment as usual in adult (a harder to treat demographic than adolescents) anorexia nervosa patients.

Reading the paper, I was pretty impressed with how good the study design was; I’m not going to go into all the nitty-gritty details, but if you have access to and the chance to read the paper, do it. You’ll appreciate, I think, the amount of effort that went into this.

THE STUDY

Patients were recruited from ten universities across Germany. They had to be adult females with a BMI between 15-18 and with … Continue reading →