Perspectives

Finding What You’re Looking For? Exploring the Eating Disorder Examination Questionnaire

Shiran 8 Comments

If you’ve ever been assessed for an eating disorder in a clinical setting, there is a good chance you’ve completed the Eating Disorder Examination Questionnaire (EDE-Q). The EDE–Q is a self-report questionnaire widely used in ED assessment and research. Clinicians and researchers calculate several different scores from patient or participant responses to the questionnaire:

  • A score on the global scale, which provides a measure of the severity of ED psychopathology
  • 4 sub-scales: eating restraint, eating concern, weight concern and shape concern

There are a number of cut-off scores that can be used to distinguish between clinically significant and non-significant cases. In this post, I will look at a few papers critiquing the use of the EDE-Q in clinical and research settings.

BACKGROUND

The EDE-Q was originally developed as an assessment tool for bulimia nervosa and binge eating and contains few, if any, questions that specifically assess anorexia nervosa symptomology. … Continue reading →

Eating Disorders: What’s Feminism Got to Do With It?

Andrea 17 Comments

There has been a lot of talk in the Twittersphere lately about feminism and eating disorders. Because I live and breathe my feminism and my eating disorder research and activism, I’ve been struggling to reconcile my commitment to making sure people feel heard and my commitment to clarifying what I feel are misconceptions about the links between feminism and eating disorders.

Certainly, it can’t be denied that some have adopted the name “feminism” and supported some decidedly shady claims or research. Then again, people of all stripes have done shady research with questionable motives and outcomes. Science and research are never neutral. Everything from what is seen as being “important enough” to study to how results are interpreted and used takes place in a socio-political context. Try as we might, we can’t fully remove ourselves from our research, whether we research micro-RNA or eating disorders (or both? It’s probably possible … Continue reading →

Culture and Eating Disorders: The Thin Ideal in Singapore

Jacqueline

The paper I’m writing about in this post is a master’s thesis published elsewhere in adapted form as a book chapter – not the usual subject here, admittedly. However, for lack of more detailed qualitative research, it’s quite useful in fleshing out some of the observations in more descriptive studies on Singaporean eating disorder patients. This origin is one among a few other caveats to bear in mind; among them, Isono Maho’s ethnography does not aim to be a representative study of ED patients in Singapore, but rather a reflection on the aspects of Singapore culture that related to her interviewees’ particular experiences. Some of the themes Isono Maho found in this data set, nevertheless, help to supplement other studies’ findings, including those indicating that patients with eating disorders in Singapore tend to:

  • Present with body image concerns
  • Attribute comments and judgments from others as factors in their eating disorders.
… 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 →

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 →

Unpacking Recovery Part 3: Can Patients Imagine Recovery?

Andrea 5 Comments

Today I have the distinct pleasure of writing about one of my favourite articles about eating disorder recovery by Malson et al. (2011) exploring how inpatients talk about eating disorder recovery. I have personally found this article to be very helpful in understanding some of the difficulties of understanding and achieving recovery in our social context.

As Malson and colleagues explain (and as we’ve established), eating disorder recovery is elusive. Often, poor prognosis is described in relation to individual factors, including:

  • Treatment resistance
  • Hostility
  • Opposition
  • Ambivalence about change
  • Ambivalence about the possibility of change

Problematically, seeing these as the primary reasons for which patients do not recover can make individuals with eating disorders themselves feel as though they are to blame for their “inability to recover,” which help approximately no one. How do patients internalize these kinds of framings, and what impact does it have on how possible … Continue reading →

Polar Opposites? The Social Construction of Bulimia and Anorexia Nervosa

Andrea 10 Comments

Some might argue that bulimia nervosa is more “hidden” than anorexia nervosa — it is not always obvious that someone is suffering from bulimia (though, I would argue, it is not always obvious that someone is suffering from any eating disorder). Even when it is “discovered,” BN is often placed in opposition with AN — as if the two were polar opposites.

Indeed, attempts to define a phenotype (a set of observable traits or characteristics) for AN and BN tend to oppose the two and to suggest that the people who develop AN are inherently different from those who develop BN. While I believe there is some scientific evidence for personality differences between the two, the degree of diagnostic crossover and symptom variability in eating disorders makes me feel like this split is at the very least overly simplistic.

What is interesting is how BN has come to occupy a … Continue reading →

Good Clinicians, Helpful Comments, & Unpopular Opinions: SEDs Readers' Responses – Part II

Tetyana 5 Comments

A few weeks ago, I asked SEDs readers a bunch of questions about their experiences with an eating disorder. Then, pretending to be a qualitative researcher, I went through the answers to see if I could find trends. I blogged about people’s responses to the first half of the question here; this post will be about the second half of the questions. (Here’s a ED survey results – Parts I and II to the pdf with all of the raw data).

Please note that this analysis was not rigorous, so in grouping and identifying themes (or how many times a theme/word was mentioned), I will use words like “approximately.”

[The breakdown for the last half of the respondents is:

6. What are characteristics of good eating disorder clinicians?

By far the two most comment themes, mentioned ~13 times each were “understanding” and variations of “willing to challenge,” “confront,” and … Continue reading →

I Asked, "Are You In Recovery? Why or Why Not?" Here's What You Answered (And More): Exploring SEDs Readers' Experiences

Tetyana 8 Comments

“Are you in recovery right now? Why or why not?” That’s one of the questions I’ve been asking on the SEDs Tumblr every once in a while. It is interesting for me to find out about the people who read the blog/Tumblr. But more importantly, it gives me an opportunity to show diversity of experiences (and feelings).

Last week I decided to formalize this a little bit and to open the floor to non-Tumblr users; I made a survey with over a dozen questions. I received a lot of responses  and I wanted to share them in the hopes that some of you will, perhaps, find them reassuring. I won’t get to cover all the questions I asked, so this will be part I of, well, I don’t know how many posts.

Please note that this survey is not scientific, not comprehensive, and not necessarily representative of the … 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 →