Reflections on BEDA Conference 2016

I spent the last weekend of October attending the Binge Eating Disorder Association Conference in San Francisco and it was awesome. I have attended several conferences over the past several years and each and every one fails to be inclusive. The discussion is always centred on the cisgender white straight middle to upper-middle class thin woman who suffers from anorexia. Every research presentation, every session, the same discussion just new material every conference.

Those involved in putting together BEDA this year decided to change the conversation and focus instead on diversity and including all the people that every other conference seems to leave out – and it was wonderful. Obviously I could not attend all of the sessions, so if you want more information check out the #BEDA2016 hashtag on Twitter.

It was clear from the opening session that this conference was going to be a completely different mood. This … Continue reading →

Reflections on the Weight Stigma Conference 2015

This past week I had the opportunity to attend the third annual Weight Stigma Conference (WSC) in Reykjavik, Iceland. I lived Tweeted throughout, as did some others, so if you’re interested in seeing the social media from the conference I recommend checking out the #StigmaConf2015 hashtag on Twitter. A few people asked if I would blog about the conference, and I’m more than happy to do so! If you’re not a fan of conference recap blogs, stay tuned for our regular Science of EDs programming soon.

Overall, I thought this conference was fantastic. Though it was not a conference strictly geared toward eating disorders, weight stigma is not helpful for anyone in any kind of body and engaging in any kind of behaviours around food and exercise. It oversimplifies complex issues, makes body management a personal issue with strong political stakes, and reduces eating disorders and obesity to a binary … Continue reading →

Eating Disorders are a Political Issue: Bulimia Nervosa and Advanced Capitalism

If you know me even a little bit, you can imagine my glee at coming across a paper entitled “The Political Economy of Bulimia Nervosa.” YES! I exclaimed. Let’s explore the ways in which our systems of food production are linked to eating disorders. Let’s complicate the idea of “the social” as it relates to eating disorders and do an analysis of the complex socio-political and economic forces that govern our world.

So, let’s get right into it, shall we?

The Article

Pirie (2011) argues that it is important to understand eating disorders from a political economic perspective so that we can look beyond an equation of the “cultural” and media representations of femininity. The way in, he suggests, is through a look at how food systems have shifted since the time at which bulimia nervosa was introduced as a psychiatric diagnosis, around 1970.

The article is not … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 2

In this post I’ll continue on the trend of considering the “culture bound” nature of eating disorders by looking at another commonly-cited article about eating disorders and culture. In this article, Keel and Klump (2003) look at the cultural and historical facets of anorexia and bulimia. They looked at whether eating disorders were present in other sociohistorical and cultural contexts in order to determine whether AN and BN are “culture bound.”

Their research, as I alluded to at the end of the first post in this series, suggests that anorexia is not culture bound (i.e., it can occur in the absence of certain aspects of culture), while bulimia is (i.e., it only/primarily appears in certain cultural contexts). As this finding might actually run counter to what popular press would have us believe, looking at this article provides us some interesting insight into how spin can really be everything. … Continue reading →

Temperament in Eating Disorders

Much research has been done on personality traits associated with eating disorders, and, as I’ve blogged about here and here, on personality subtypes among patients with EDs. For example, researchers have found that individuals with AN tend to have higher levels of neuroticism and perfectionism than healthy controls (Bulik et al., 2006; Strober, 1981). Moreover, some traits, such as anxiety, have been associated with a lower likelihood of recovery, whereas others, such as impulsivity, with a higher likelihood of recovery from AN (see my post here).

Personality refers to “a set of psychological qualities that contribute to an individual’s enduring and distinctive patterns of feeling, thinking and behaviour” (Pervin & Cervone, 2010, as cited in Atiye et al., 2014). Temperament is considered to be a component of personality and refers to, according to one definition,”the automatic emotional responses to experience and is moderately heritable (i.e. genetic, biological) and … Continue reading →

Resistance is (not so) Futile? Exploring Treatment Resistance in Eating Disorders

To me, the idea of “treatment resistance” in eating disorders sparks some ill feelings. While many have suggested that treatment resistance is common among those with eating disorders, others have noted how receiving the label of “treatment resistant” can make it more difficult to receive needed support or impact how one is perceived in treatment settings and how one’s behaviours are interpreted (e.g., Gremillion, 2003).

Of course, this is a tricky ground to tread, primarily because sometimes people do resist treatment. Regardless, I think it is important to think about what lies behind the resistance to treatment. Is it the type of treatment? The people doing the treating? The compelling nature of the behaviours (e.g., restricting, binging and purging) at least in the short term?

In any case, to say that treatment resistance occupies a contested place in the eating disorder literature would likely be an understatement. Perhaps for this … Continue reading →

Smartphone Apps for the Treatment of Eating Disorders

As of January 2014, over 50% of adults in the United States own a smartphone; unsurprisingly, there has been a growth in the number of mobile applications (apps) aimed at providing health care services for various mental (and physical) health problems, including eating disorders. The purpose of mobile health technologies is to utilize the functionality of smartphones to deliver a wide range of health services, including providing psychoeducation, treatment services and/or recovery support.

POTENTIAL BENEFITS OF SMARTPHONE APPS FOR ED TREATMENT

When it comes to the treatment of EDs, there are many potential benefits of smartphone apps. Smartphone apps can potentially help increase access to treatment (if, for example, they link users to ED services), enhance treatment compliance and/or engagement, and support treatment “outside of the therapy office.” Apps may also be able to improve motivation by connecting individuals to others who are recovering from EDs.

Smartphone apps can increase access to … Continue reading →

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

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 →

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

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 →

Unpacking Eating Disorder Recovery Part 1: The Recovery Model

What does eating disorder recovery really look like? When you say the word “recovery,” differences of opinion loom large. The lack of definitional clarity around the concept of recovery came up many times at ICED, and continues to surface in discussions among researchers, clinicians, and individuals with eating disorders themselves. We’ve looked at recovery on the blog before (for example, Gina looked at how patients define recovery here; Tetyana surveyed readers about their perspectives on whether or not they thought of themselves as being in recovery and wrote about it here; I wrote about men’s experiences after recovery here). It’s something of a hot topic in the research literature, too.

My Master’s thesis focused primarily on recovery, with one “take home message” being that there can be a disconnect between what recovery means in treatment settings, in popular understanding, and among individuals who have experienced eating disorders. … Continue reading →