Psychology

Body Image: Is It a Useful Concept? (Maybe Not So Much)

Andrea 6 Comments

I recently attended the International Society of Critical Health Psychology’s 8th Biennial Conference in Bradford, England. At the conference, I had the pleasure of attending many talks that challenged the way we approach health psychology. Luckily for me, there were several sessions that touched on issues of disordered eating and body image.

One such talk, a panel presentation with Hannah Frith, Sarah Riley, Martine Robson and Peter Branney, challenged attendees to re-think the way we approach body image. When I returned home, I immediately downloaded an article by Kate Gleeson and Hannah Frith (2006) that discusses this same idea and essentially begs the question: Is the concept of “body image,” as it is currently articulated, actually useful?

This might come off as a controversial question; after all, body image is central to many studies (and treatment programs) related to eating disorders. We’re told repeatedly … Continue reading →

The Enigmatic Persistence of Anorexia Nervosa

Tetyana 17 Comments

Anorexia nervosa was first described in the medical literature in 1689 by Richard Morton. It has been over 300 years since then and AN continues to be one of the deadliest psychiatric disorders. If not treated early, it runs the risk of becoming deeply entrenched and highly resistant to treatment.

Moreover, established treatments for related disorders like bulimia nervosa and depression, such as cognitive behavioural therapy and antidepressants, are rather ineffective in treating anorexia nervosa. Finally, even if significant physical and mental improvements are achieved in treatment, relapse rates for older individuals (even those in their 20s) remain high.

What makes anorexia nervosa so persistent and so hard to treat in individuals who develop it, particularly if it is not treated soon after onset? Why is recovery so hard?

In this paper, B. Timothy Walsh outlines a model based on cognitive neuroscience that attempts to answer these questions:

Its

… Continue reading →

Calorie Restriction, Anorexia Nervosa, and Memory Gaps

Tetyana 48 Comments

This post has been translated into Russian by Polina here.

I have often heard anorexia nervosa sufferers complain of “memory gaps,” particularly during the times they were really sick. As if they weren’t really there.  It can be scary and unnerving, to say the least. A few months ago, a Tumblr user asked me about this:

Hi Tetyana, I’m not sure if this is merely based on my own subjective experience of if there is any grounding at all, but I was wondering if there could perhaps be a link between EDs and a sort of memory loss. It’s hard to describe but I definitely seem to have huge “gaps” in my memory of during that time, as if I selectively block things out. I have limited inaccurate knowledge with regards to memory on a molecular/neurological basis so I do not know if there’s anything there. Perhaps with calorie

… Continue reading →

What's The Point of Bingeing and Purging? And Why Can't You Just Stop?

Tetyana 24 Comments

I defended my MSc on Tuesday and I’m not going to lie: I was pretty symptomatic with bulimia in the days prior to my defence. As I explained to my boyfriend: the anxiety-reducing effects of purging are so powerful, and the compulsion to binge and purge (when I’m stressed/anxious/”not okay”) is so strong that it is much easier to do it, get it over with, and continue working (in a much calmer state).

I’ve mentioned before, for me, purging is very anxiety-reducing and in some ways, almost a positive experience. It is so tightly coupled with bingeing that it is hard to separate the two, but the anxiety-reducing effects are strongest when I binge and purge, non-existent when I binge, and weak when I purge a normal meal (which is exceptionally rare/almost never.)

It turns out, of course, that I’m not alone.

Negative emotional states and stressors have long been … Continue reading →

Rigid Food Rules in Eating Disorders: Is Perfectionism to Blame?

Tetyana 12 Comments

I remember cutting baby carrots into 6 pieces. Rushing home to eat because I wasn’t “allowed” to eat after 7 pm. Eating the exact portion size–no more, no less. (Oh the rules. I don’t miss them.) Rigid food rules are very common among eating disorder sufferers. These rules can be about anything: the foods you are allowed to eat, how you are allowed to eat them, the time you are allowed to eat them, and so on.

But where do they come from? Why do some individuals have more rules and more ritualistic behaviours than others?

It is a complex question, but a recent study suggests that perfectionism might play a role. Specifically, the authors explored the idea that perfectionism mediates adherence to food rules in disordered eating behaviours. In order words, food rules might be a way in which perfectionism “expresses itself” in eating disorders.

Why perfectionism… Continue reading →

Personality Traits after Recovery from Eating Disorders: Do Anorexia and Bulimia Patients Differ?

Tetyana 4 Comments

When we think about eating disorders, we tend to think about eating disorder subtypes: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder. A lot of previous work has shown that individuals with AN and BN tend to be anxious, depressed, perfectionistic, and harm-avoidant. Patients with AN also tend to score low on novelty-seeking, impulsivity, and self-directedness, whereas patients with BN score high on novelty-seeking and impulsivity. More recently, however, some researchers began to wonder if there was another way to categorize patients–not according to symptoms, but according to personality traits?

They identified three clusters of personality subtypes that seemed to “cut across” eating disorder diagnoses, outlined below (taken from a previous post):

Three Personality Subtypes in Eating Disorder Patients:

  1. “dysregulated/undercontrolled pattern: characterized by emotional dysregulation and impulsivity”
  2. “constricted/overcontrolled pattern: characterized by emotional inhibition, cognitively sparse representations of self and others, and interpersonal avoidance”
  3. “high-functioning/perfectionist pattern: characterized
… Continue reading →

Over-Exercise is Associated With Suicidality in Individuals with Disordered Eating

Tetyana 6 Comments

Last week, I blogged about a study that examined personality traits and clinical variables associated with excessive exercise in eating disorder patients. In that study, 2 out of 5 participants engaged in excessive exercise. Today, I’m going to discuss a study that suggests over-exercise in disordered eating patients is associated with suicide behaviour.

Suicide rates in eating disorder patients are high. One meta-analysis suggested that out of all eating disorder related deaths, 1 in 5 are suicides. (Keep in mind, these numbers are really hard to pin down as they depend a lot on the sample population, sample size, and how the authors did their statistics, among other things.)

Another analysis found that the standardized mortality ratio (ratio of observed deaths in the study sample/expected deaths in the population of the same age but without the disease/disorder you are studying) for suicide in eating disorders was 31 for patients with … Continue reading →

Pregnancy, Motherhood, and Eating Disorders: Women's Experiences

Tetyana 7 Comments

There is a common misconception that eating disorders somehow disappear during pregnancy; that becoming a mother stops all those silly worries about being slim and attractive. This is not necessarily the case, and unfortunately, there is a lot of stigma associated with talking about disordered eating behaviours during pregnancy. Openly admitting to it is an invitation, it seems, to being called selfish and vain. The implication is that eating disorders are something only young girls struggle with, and that pregnancy and motherhood are such big and important things that they should be enough to overcome an eating disorder.

Over recent decades, eating disorders have entered the public’s consciousness. They are regularly discussed, and often trivialized, in the popular media, depicted as no more than dieting gone wrong or overzealous weight loss. Yet these conditions warrant serious consideration because they are potentially life-threatening and can persist for years, ruining individuals’ long-term

… Continue reading →

Will The Real Vegetarian Please Stand Up? – Part 1

Tetyana 12 Comments

When my younger sister first told me she wanted to become a vegetarian, I was worried. My biggest fear was that she would, like I did, develop an eating disorder. In high-school, I didn’t eat meat for roughly 14 months, and though I can’t be sure now of what my reasons were at the time, in retrospect, I do think in large part it was just a convenient way to avoid yet another food group. It was a legitimate reason to restrict my intake.

But is there any evidence that this behaviour (becoming vegetarian as a convenient way to restrict intake) is common among individuals with eating disorders? What is the relationship between dietary restraint, eating disorder symptoms, and vegetarianism? Is vegetarianism a risk factor for developing an eating disorder or do eating disorders lead many to adopt a vegetarian diet as a socially acceptable excuse to avoid eating specific … Continue reading →

3 Personality Subtypes in Eating Disorder Patients: Which One Fits You?

Tetyana 10 Comments

Scientists love classifying and categorizing things they study. But it can be a double-edged sword. Classification can lead to new insights about etiology or new treatment methods. But classification can also hamper our understanding. For example, researchers like to classify and study anorexia nervosa and bulimia nervosa as if they are two wholly separate disorders, but clinicians know that most patients fluctuate between diagnoses, and as a result often fall into the eating disorder not otherwise specified (EDNOS) category.

Nonetheless, if we keep in mind that the way in which we classify things can be very artificial and may not necessarily reflect some fundamental truths about the subject matter, we can focus on extracting the insights gained from the classifications.

In the case of eating disorders, classifying patients into subtypes may be useful for developing successful treatment approaches suited for particular patient subgroups.

Previous research on this topic has identified … Continue reading →