2012

Understanding Disordered Eating in Trans People

Tetyana 17 Comments

Gender nonconformity is the second most popular search term that leads people to Science of Eating Disorders. (After “science of eds” and beating “science of eating disorders”.) Not far behind are variants of “FtM/MtF/transsexual/transgender” combined with “eating disorder/anorexia/bulimia”. That’s telling. It means there is little information on this topic. And it is not just that there’s too little information available to the public – there are only a handful of published studies in the peer-reviewed literature.

One study (which I discussed in my previous post: Gender Nonconformity, Transsexuality and Eating Disorders) published by Vocks et al (2009), compared disordered eating patterns, body image disturbances and self-image scores among trans women and men (131 participants in both groups) and cis female and male controls as well as to females with eating disorders.

Overall, they found disordered eating patterns reported by trans women and trans men were in the middle … Continue reading →

Medical Complications in Patients with Eating Disorders: An ER Perspective

Tetyana 7 Comments

A healthy-looking young woman comes into the emergency room complaining of lightheadedness, dizziness, tiredness, dehydration and constipation. She tells you she doesn’t know what’s wrong, but what she is not telling you is that she has an eating disorder. How do you find out? More importantly, how do you avoid complications that may arise from using conventional treatments for patients without eating disorders?

I often come across questions posted on websites and forums asking if others have experienced a particular symptom, what could be causing it and whether going to the hospital is necessary. I am not a physician, not training to be a physician and not doing research in anything directly relevant to medicine or health. Moreover, I always use caution when answering questions online – the best advice is to go see a doctor (but of course, that’s not always possible, unfortunately).

My goal with this post … Continue reading →

What’s it Like to be a Man with an Eating Disorder?

Tetyana 4 Comments

What is it like for men to live with an eating disorder? What is it like for men to seek and receive treatment for an eating disorder? These are the questions that Kate Robinson and colleagues asked a group of eight men who were receiving treatment (inpatient, day patient or outpatient) at two ED treatment centers in the UK. Their goal was to find out if and how men’s experiences with an eating disorder differ from women with eating disorders.

Men account for roughly 10% of eating disorder patients (when considering anorexia and bulimia, not including binge eating disorder, which is not yet part of the DSM). I suspect this number is actually higher – as less men probably realize they have an ED, admit to having an ED or seek treatment, precisely due to the issues raised in this article (and others). Given that men form a sizeable minority … Continue reading →

The Research-Practice Gap in Eating Disorder Treatment

Tetyana

The approaches used in clinical practice to treat patients often lag behind the most up-to-date developments in research. It can take a long time to integrate scientific findings into clinical practice. This, of course, is not limited to eating disorders or even mental health issues. This so-called “science-practice gap” exists for many reasons, which vary depending on the medical discipline.

This issue, though, seems particularly bad when it comes to eating disorder treatment.

There’s the issue of conducting good studies – how do we determine what is efficacious? That’s a complicated task. What is “recovery” and how long is long-enough for follow-up? Is what we consider to be efficacious really efficacious or just slightly better than the rest?

Then there’s the training: mental health seems to be undervalued in medical school curricula for one, but even more importantly: “Clinicians tend to give more weight to their personal experiences than to … Continue reading →

When Clinicians Do More Harm Than Good (Attitudes Toward Patients with Eating Disorders)

Tetyana 33 Comments

I was going to blog more about mortality rates in eating disorder patients, but recent ED-related deaths have left a bitter taste in my mouth (huge understatement). So, I’ve decided instead to write about a paper requested by the founder of The Joy Project on clinician reactions to patients with eating disorders by Thomspon-Brenner and colleagues that came out this year.

If you have an eating disorder or are close to someone with an eating disorder, you’ve likely heard many stories about dismissive or down-right negative and harmful attitudes that clinicians often have toward patients with EDs.

I’ve experienced it myself: I had to find another doctor to refer me to an outpatient clinic, because the first one didn’t – he didn’t think I needed help (probably because I was very aware that things were not heading in the right direction even before I was at a low weight). Needless … Continue reading →