2012

What Are You Re-covering? Critical Conversations About Eating Disorder Recovery

Andrea 54 Comments

As usually happens, when I spill my brain out onto Twitter I end up having some minor (or, let’s face it, major) discussions and disagreements with other Twitterites. It’s both a wonderful and a stressful experience, in part because one of the hazards of the medium is its rapid-fire and protracted style. Inevitably, discussions lose their nuance and some of what I am advocating for gets lost in the ether.

The latest discussion centered around recovery and how it is portrayed in the literature. I’ve been working on a meta-analysis of recovery studies, and commented that I was tired of the way that researchers tend to write about recovery as “becoming whole” or finding oneself. Because I am a critical researcher and a generally squeaky wheel, and based on some research I’ve done, I question whether this framing is helpful for all of those who have recovered/are in recovery/want to … Continue reading →

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 →

Is The Doctor In? Eating Disorders Training Amongst Medical Professionals — Part 3

Andrea

The thing about critiquing systemic issues like lacking training environments for medical professionals (and others) is that we have to be cautious to not place undue blame on those who are stuck immobilized between the desire to a) train or b) get training in eating disorders. If the solution to the egregious lack of training was simple, I feel sure that someone would have done it already! What I am gesturing at, here, is that the reasons behind lacking training opportunities are deeply rooted in socio-political, historical, and economic trends and policies. Those providing training and those seeking training do not exist in some glorious black hole devoid of austerity (frugalness, restrainedness) and neoliberalism.

In this post I’ll focus on a few studies that help to illuminate why these gaps in training might exist, including dominant sentiments (in the general public, in government, in training environments themselves) toward eating disorders. … Continue reading →

Disclosure and Pathways to Treatment in Eating Disorders

Andrea 7 Comments

We hear a fair bit about the length of time it can take to access eating disorder treatment. Delays are particularly distressing as the evidence points to better outcomes for those who receive timely care for their eating disorders (e.g. Treasure & Russell, 2011). We know about some of the potential barriers to care for eating disorders, including the lack of specialized services, the stereotypes and stigma that can impede formal and informal help-seeking, and the financial costs of seeking care not always covered by insurance. However, we know less about when people with eating disorders disclose their struggles, who they disclose to, and how this impacts their path to care.

When I was searching for articles related to treatment access for eating disorders, I came across a preliminary study published in 2012 by Gilbert and colleagues investigating disclosure of eating disorders and subsequent pathways to care. Because … Continue reading →

Pride Before a Fall: The Intertwining of Pride and Shame in Eating Disorders

Andrea 2 Comments

Is there a link between eating disorders and shame? What about pride? Can understanding these emotions help us to understand how eating disorders develop, and how they are maintained? In reviewing literature for my specialization paper, I stumbled upon a qualitative study by Skarderud (2007) about the role of shame in eating disorders. I found the article quite interesting, so I fired up the “where was this cited” tool on my university library database and uncovered a wealth of studies looking at shame, pride, and eating disorders.

For the purposes of this post, I’ll comment on Skarderud’s study, also bringing in a longitudinal study by Troop & Redshaw (2012) that looks at general and bodily shame.

Shame and Pride

Skarderud, who uses a phenomenological approach in his study (meaning that he is trying to unearth the particularities of shame for those who experience it) sees shame … Continue reading →

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

Tetyana 3 Comments

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 →

Living in Our Bodies: Embodiment, Eating Disorders and the IDEA Scale

Andrea 8 Comments

A good deal of my time is devoted to reading articles about eating disorders, feminism, qualitative research, and embodiment. I don’t know if this makes me a very interesting person or a very boring one, but it certainly makes me a very opinionated one, especially about these topics. Lately, I’ve been exploring the literature around eating disorders and embodiment in particular, trying to get a sense of how researchers attend to “embodiment” in the development, course, and outcomes of eating disorders and recovery. Predictably, I have my own opinions about this relationship, but am of course interested in how other researchers have explored embodiment in the context of eating disorders.

In my research spiral to find relevant articles, I came across an article by Stanghellini et al. (2012), in which the authors look at how individuals with eating disorders experience their bodies. In the article, the authors discuss … Continue reading →

Unpacking Recovery Part 5: Clinical Recovery Without a Clinic?

Andrea 24 Comments

It can be somewhat controversial to suggest that untreated recovery from eating disorders is possible. Certainly, people have varied opinions about whether someone can enact the difficult behavioral and attitudinal changes necessary to recover without the help of (at the very least) a therapist and a dietitian. Nonetheless, we still hear stories about individuals who consider themselves recovered without having sought out external sources of professional support.

When I think about untreated (or “spontaneous”) recovery from eating disorders, two studies in particular come to mind. The first study I am thinking about was written by Vandereycken (2012) and explores self-change, providing an overview of community studies of individuals who have not sought treatment for their eating disorders and implications for treatment and recovery. The second, by Woods (2004) is a qualitative study looking at the experiences of 16 women and 2 men who report recovering from … Continue reading →

Political Bodies: What is the Impact of National or Regional-Level Eating Disorder Prevention?

Andrea 1 Comment

When it comes to prevention, I’ve noticed a strong interest in working toward large-scale prevention initiatives. I’ve written about prevention before, noting the potential for unintended effects, as well as schoolgirls’ reactions to and acceptance of prevention interventions (here). But what about the larger scale efforts to prevent body image concerns and eating disorders?

Countries from the US to Australia to Israel have taken strides to implement initiatives aimed at improving national body image (a lofty goal? Perhaps.); you might have heard about bans on thin runway models and airbrushing, among other efforts. We know that eating disorders are not solely caused by thin-ideal internalization or bad body image; in fact, body image might not even be that useful of a concept for everyone, as I wrote about here.

However, improving body satisfaction could be a useful end goal in and of itself. Why not … Continue reading →

Eating Disorder Awareness Week: Useful, Useless, or Worse?

Tetyana

National Eating Disorder Awareness Week came and went (in the US, anyway). Posters were shared, liked, and tweeted. Pretty (but often misguided) infographics made the rounds on the internet. Local ED groups visited schools and college campuses to educate students about eating disorders. To, you know, increase awareness. 

The thing is, awareness is not always a good thing. For one, as Carrie over at ED Bites mentioned, there’s a whole lot of misinformation masquerading as fact. And two, awareness campaigns, even when the information in them is correct, may have unintended consequences, like, for example, increasing stigma or self-stigma.

Moreover, not all approaches to increasing awareness or decreasing stigma are equally effective, and the effectiveness of a particular approach may differ depending on the population studied.

So, what about the effectiveness of EDAW? In 2012, Kathleen Tillman and colleagues published a study looking at … Continue reading →