Quantitative

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, &

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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.

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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

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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 →

How you doin'? Differences in Psychological Well-being Between Anorexia, Bulimia, and Binge Eating Disorder Patients

Tetyana 3 Comments

Good health is more than just the absence of illness; it is more than just the absence of dysfunction. Good health — that is, mental, social, and physical health — requires the presence of wellness, or the ability to function well.

In this respect, with regard to eating disorders, most research has focused on assessing (health-related) quality of life and subjective well-being of eating disorder patients, often focusing on things like body satisfaction, self-esteem, and positive and negative emotions. There is, however, another way to think about well-being. A model (and assessment scale) developed by Carolyn Ruff, called psychological well-being (also here), aims to assess specific dimensions of functioning that contribute to or make-up well-being. There are six such dimensions.

Ryff Scales of Psychological Well-being:

  1. self-acceptance (positive self-evaluation)
  2. a sense of continued growth and development
  3. a sense of purpose and meaning in life
  4. a sense of self-determination and autonomy
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HW vs. CW: Weight Suppression in Bulimia Nervosa – Part I

Jackie 7 Comments

HW. CW. LW. GW1. GW2. GW3. UGW.

If you have (or have had) an eating disorder (or dieted and used online forums), chances are you know what those acronyms mean. And if you have browsed blogs written by eating disorder sufferers, chances are you have come across these acronyms too. After all, they are a prominent feature of many such blogs.

If you are lost, I’ll fill you in: the acronyms stand for Highest Weight, Current Weight, Lowest Weight, Goal Weight 1/2/3, and Ultimate Goal Weight (UGW). Unsurprisingly, most individuals with eating disorders, much like dieters, like to keep track of their weight loss — that is, the difference between the highest weight, HW, and the current weight, CW.

Researchers call this difference weight suppression (WS, more specifically, the highest adult body weight) and one’s current weight). It … Continue reading →

Bingeing Because Food is Yummy: A Stepping Stone Toward Recovery from Anorexia and Bulimia?

Liz 8 Comments

This may sound counterintuitive at first, but I’m thankful for two aspects of my eating disorder, which I believe helped me make the choice to aim towards recovery: the development of binge eating after chronic food restriction and the physical inability to purge through self-induced vomiting. Like many individuals diagnosed with anorexia nervosa that go on to develop binge eating, I tended to choose high-fat foods and sweets as my “go-to” food items. I had always enjoyed such foods and was a notorious junk food aficionado as a young girl (way before any eating disorder symptoms developed). Once the bingeing behavior started, I couldn’t stop.

Sitting with the discomfort after a binge made me seriously consider whether this was something I could maintain for any lengthy period of time, and that’s when I started getting help. In a sense, I believe my affection for sweet foods, and propensity to binge … Continue reading →

Cognitive-Behavioural Therapy for Bulimia Nervosa in the “Real World”: What's the Evidence?

Tetyana

Cognitive-behavioural therapy (CBT) is commonly described as the evidence-based treatment for bulimia nervosa. But do the findings from nearly perfectly crafted trials, with stringently followed protocols and “ideal” participants apply to the “real world”? How generalizable are the findings from carefully selected participants to clinical populations where, for one, the prevalence of psychiatric comorbidities is relatively high?

In other words, CBT has been shown to be efficacious (i.e., it works in a controlled experimental research trial setting) but is it effective (i.e., does it work in a clinical setting where clients might have multiple diagnoses and complex needs)?

This is precisely the question that Glenn Waller and colleagues sought to answer. They wanted to see whether CBT would work in a “routine clinical setting, where none of the exclusion-and protocol-based constraints […] apply.”

PARTICIPANTS

Participants were recruited from a publicly-funded outpatient ED service in the UK. The only exclusion criteria … Continue reading →

Demystifying the Genetic and Environmental Influences on Disordered Eating

Tetyana 8 Comments

Genetics play an important role in the development of eating disorders and disordered eating behaviours. To date, many (over 30!) twin studies have been done and all but two found significant genetic effects on the development of eating disorders and disordered eating. However, no methodology is without limitations and tentative conclusions become more convincing when the findings are confirmed using different experimental approaches.

Twin studies, while they offer many advantages, are not that good when it comes to detecting shared environmental effects on a particular trait (literally, evens that happen to both twins and affect them in the same way). Fortunately, twin studies are just one of several different ways that researchers can use to study heritability. (A quick reminder: Heritability measures the amount of the variability in an observable trait/behaviour that can be attributed to genetic variation. This is NOT the same as stating … Continue reading →