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 →

Unpacking Recovery Part 3: Can Patients Imagine Recovery?

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 →

Eating Disorders and Irritable Bowel Syndrome

Eating disorder patients commonly complain of gastrointestinal (GI) symptoms including bloating, abdominal pain, and constipation. This is, of course, not surprising. After all, disordered eating behaviours such as self-induced vomiting, laxative abuse, and restriction are bound to have negative effects on the digestive system.

But just how common are GI complaints and functional gastrointestinal disorders (FGIDs) like irritable bowel syndrome among ED patients? And is there more to the relationship than simply ED behaviours causing GI disturbances? Luckily, a growing number of research studies are beginning to shed some light on these questions.

In a study published in 2010, Catherine Boyd and colleagues examined the prevalence of FGIDs among ED patients admitted to a hospital Eating Disorders Unit. They found that out of the respondents (73 in total), 97% had at least one FGID (as evaluated using the Rome II questionnaire). More specifically, on admission, 73% of the … Continue reading →

Clinical Utility of Weight Suppression in Bulimia Nervosa Treatment – Part II

In this post I will continue my discussion on weight suppression in bulimia nervosa (click here to read Part I). Just in case you happen to be reading the posts out of sequence, I will summarize the main points of that entry:

  1. Weight suppression is the difference between one’s current body weight and highest adult body weight.
  2. It has been found that individuals with BN are on average well below their highest historical weights (i.e. they are weight suppressed).
  3. Many studies have consistently found positive associations between WS and the onset and maintenance of BN symptoms.

THE RELATIONSHIP BETWEEN WEIGHT SUPPRESSION AND WEIGHT GAIN DURING BN TREATMENT

Because most individuals with BN have undergone significant weight loss, this makes them susceptible to weight regain — much like obese individuals usually regain the weight they have lost. Indeed, evidence suggests that weight suppression predicts weight gain in individuals with … Continue reading →

HW vs. CW: Weight Suppression in Bulimia Nervosa – Part I

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 (WSmore specifically, the highest adult body weight) and one’s current weight). It … Continue reading →

Calorie Restriction, Anorexia Nervosa, and Memory Gaps

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 →

Dancing Your Way to Recovery from Anorexia Nervosa

The idea of including dance and movement in interventions for eating disorders may seem somewhat controversial; generally, exercise and physical activity are discouraged for individuals recovering from eating disorders. Including dance in therapeutic interventions might raise a few eyebrows given the links between appearance-oriented athletic endeavors such as ballet and gymnastics and the development of eating disorders.

However, some therapists and scholars interested in alternative therapies for eating disorders have suggested that certain forms of movement therapy may help individuals with eating disorders connect to their bodies in a different, more positive way.

In 2011, two such scholars from Portugal, Padrão & Coimbra, published a 6-month pilot intervention for individuals hospitalized for anorexia nervosa (AN) based around body movement.

Their aims were twofold:

  1. Find out more about the links between body movement and bodily experience in individuals with AN
  2. Observe the ways in which individuals with AN move
Continue reading →

Family-Based Treatment for Adolescents with Anorexia Nervosa: Hype or Hope?

When it comes to eating disorder treatment, few (if any) approaches are as divisive as Family-Based Treatment, also known as the Maudsley Method (I’ll use the terms interchangeably) . When I first heard about Maudsley, sometime during my mid-teens, I thought it was scaaary. But, as I’ve learned more about it, I began to realize it is not as scary as I originally thought.

As a side-note: I know many people reading this post know more about Maudsley than I ever will, so your feedback will be very much appreciated, especially if I get something wrong. I should also mention that I never did FBT or any kind-of family treatment/therapy as part of my ED recovery. (I have done family therapy, but it was unrelated to my ED; it was a component of a family member’s treatment for an unrelated mental health issue.)

In this post, I want to … Continue reading →

Diabulimia: A Dangerous Duet

EDIT: I want to apologize for an oversight in this blog entry. Shelly and I forgot to mention Diabulimia Helpline in our list of organizations that help raise awareness and support sufferers with type 1 diabetes and eating disorders. Diabulimia Helpline is the only non-profit in the US dedicated to “education, support, and advocacy for diabetics with eating disorders, and their families.” I also want to highlight some services that Diabulimia Helpline offers: “a 24 hour helpline available via (425) 985-3635, an insurance specialist to walk clients and/or their parents through the complicated world of getting insurance to cover eating disorders, and a referral service to help people find the treatment centers, doctors, therapists, and counselors that would be a good fit for them on their road to recovery.” – Sincerely, Tetyana

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Type 1 diabetes (DMT1, or T1DM) is a lifelong disease often diagnosed in children or adolescents. … Continue reading →

Binge Eating: When Should We Call It An “Addiction”?

The recent New York City soda ban controversy has contributed to increased discussion about the “addictive” properties of sugar and its contribution to the obesity epidemic. While I do not deny that there is an overabundance of high-sugar/high-fat foods in the societal milieu, and that the rewarding properties of these foods encourages their overconsumption; I think it is a mischaracterization to refer to the typical overeating associated with the “obesity epidemic” as reflective of a widespread “sugar addiction” that millions have fallen prey to.

Stice, Figlewicz, Gosnell, Levine, and Pratt (2012) have recently released a review in Neuroscience and Biobehavioral Reviews entitled “The contribution of brain reward circuits to the obesity epidemic.” In the paper, the authors elegantly describe the overlap between food and drug rewards while also highlighting major differences.

BRIEF INTRO TO DOPAMINE SIGNALLING

Before discussing the parallels between food and drug rewards, we should first introduce some … Continue reading →