2014

Reflections on EDAC-ATAC 2014 Conference

Andrea

Last week I had the opportunity to attend and present at the Eating Disorders Association of Canada (EDAC-ATAC) Biennial Conference in Vancouver, BC. I was presenting part of my Masters thesis, which felt great. I always love talking to clinicians in the field, and I found that this was a very practical and applied-focused conference.

I sometimes feel like somewhat of an outsider at eating disorders conferences as I am “research only”- I do not have the credentials to counsel or treat individuals with eating disorders. However, I felt quite welcome at this conference. People were quite willing to engage with a relative newbie, in typical Canadian fashion.

If you follow me on Twitter, you’ll have noticed that I was tweeting up a storm. You might also have noticed that I was one of the only people doing so. I learned that this association is relatively new, in its … Continue reading →

Ambivalence and Eating Disorders: Inpatient Treatment, Belonging, and Identity

Andrea 1 Comment

When Tetyana Tweeted and “Tumblr-ed” (is there a better name for putting something on Tumblr?) a quote from a qualitative research article about ambivalence and eating disorders, I knew I would want to write a blog post about it. Of course, life happened, and so this post is coming a little later than I had intended. Nonetheless, I am happy to be sharing a post about a fresh article by Karin Eli (2014) about eating disorders and ambivalence in the inpatient hospital setting. The article itself is published through PLOS One and so is also open access, in case you are interested in reading the original.

THE STUDY

This article is about one aspect of a larger longitudinal study Eli conducted in Israel between 2005 and 2011. The broader study explores the “sensory experiences” (embodied feelings, sensations, and perceptions) of individuals with eating disorders and how these relate … Continue reading →

In Defense of Eating Junk Food in Eating Disorder Treatment

Charlene 26 Comments

Should eating disorder patients be introduced to “junk food” or “hyper-palatable” foods during treatment? A few days ago, I stumbled across a blog post where Dr. Julie O’Toole, Founder and Director of the Kartini Clinic for Disordered Eating, argues against introducing “junk food” during ED treatment. The crux of the argument is that “hyperpalatable foods”—e.g., chips and Cheetos—are not real food and should never be forced or encouraged for anyone, regardless of the presence of an eating disorder:

A lot of ink has been spilled on teaching Americans in general and children in particular to make good food choices. Just because you have anorexia nervosa as a child, and desperately need to gain and maintain adequate weight, does not mean that you will be immune from the health effects of bad eating as you get older. This is true whether or not you get fat later on. You can be

… Continue reading →

Unpacking Eating Disorder Recovery Part 1: The Recovery Model

Andrea 5 Comments

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 →

Serious Restrictive Eating Disorders Occur at Any Weight

Tetyana 8 Comments

Although the words “anorexia nervosa” typically conjure up images of emaciated bodies, eating disorders characterized by dietary restriction or weight loss can — and do — occur at any weight. However, precisely because anorexia nervosa is associated with underweight, doctors are less likely to identify eating disorders among individuals who are in the so-called “normal” or above normal weight range, even if they have all the other symptoms of anorexia nervosa.

Clearly, this is a problem.

For one, there is no evidence that eating disorder not otherwise specified (EDNOS) — a diagnosis given to individuals who do not fulfill all of the criteria for anorexia nervosa or bulimia nervosa — is less severe or less dangerous than full syndrome anorexia nervosa. As I’ve blogged about, individuals with EDNOS have comparable mortality rates (see: EDNOS, Bulimia Nervosa, as Deadly as Anorexia Nervosa in Outpatients) and similar (sometimes even more severe) … Continue reading →

Attention Deficit Hyperactivity Disorder & Eating Disorders: Is There a Link?

Tetyana 6 Comments

Attention deficit hyperactivity disorder (ADHD), characterized by inattention, hyperactivity, and impulsivity, is a common childhood disorder. ADHD can often persist into adolescence and adulthood. The prevalence of ADHD is thought to be between 6-7% among children and adolescents and ~5% among adults (Willcutt, 2012).

Increasingly, evidence from multiple studies has pointed to comorbidity between ADHD and eating disorders (EDs). For example, one study found that young females with ADHD were 5.6 times more likely to develop clinical (i.e., diagnosable according to DSM-5) or subthreshold (i.e., sub-clinical) bulimia nervosa (BN) (Biederman et al., 2007). Another study found that found that 21% of female inpatients at an ED unit had six or more ADHD symptoms (Yates et al., 2009).

However, most previous studies are limited by the fact that they assessed comorbidity between ADHD and EDs among patients. This limits our ability to generalize these findings to community samples, where many may … Continue reading →

The Dollars and Cents of Eating Disorders

Andrea 11 Comments

I must admit that I cringe slightly every time I try to think about healthcare from an economics perspective. To me, this comes a little close to putting a dollar value on human beings, which feels uncomfortably post-humanistic to me. Nonetheless, there is no ignoring the ways in which economic concerns factor into policy decisions that drive our human services, including health care.

There are also a number of pragmatic reasons for thinking about the costs associated with illnesses; talking in dollars and cents can make for a convincing argument when seeking funding to do research on a particular illness, for example. The ability to reduce healthcare costs is incredibly compelling in a time of fiscal restraint.

Crow (2014) published a short article about the economic costs of eating disorder treatment. In this article, he highlights some recent studies that have examined factors related to “the economics of … Continue reading →

Of Family Dynamics and Eating Disorders: Parents’ Experiences of Skills-Based Training

Andrea 16 Comments

Parents of children with eating disorders face an extraordinarily difficult challenge; the work that they put into caring for their loved ones cannot be discounted. This can be especially challenging in the face of a social environment that tends toward parent-blaming for disorders. Further, the kinds of behaviors caregivers are obliged to encourage in the individual with an eating disorder (for example, eating calorically-dense foods in order to gain weight) are frowned upon, to say the least, in our “anti-obesity” oriented society.

There is a rich body of literature exploring caregiver well-being, including studies suggesting that increasing the availability of support in various forms from social to practical may help caregivers to navigate a complicated path toward supporting a loved one with an eating disorder. Researchers are asking key questions around what we can do to better support parents and other caregivers.

Along these lines, Goodier et al. (2014… Continue reading →

Gendering the Pro-Anorexia Paradox: Men in Pro-Ana Spaces

Andrea 12 Comments

When someone says “pro-ana,” what comes to mind? Likely, given the strong reactions pro-anorexia websites provoke, you may be able to conjure up an image of what would take place in such a forum. Thoughts of “thinspiration,” emaciated and waif-like images, and starving tips likely spring to mind, alongside considerations of the dangers of a community that would encourage behaviors that can be very harmful to health.

I’d venture to say that it is unlikely that you have pictured a man participating in these sites. Given that we know that men get eating disorders too, and that they may feel alienated in their struggles, is it surprising that some might seek out online communities, including pro-ana?

As Tetyana noted in previous posts on pro-ana (here and here), these sites can serve a harm reduction purpose and/or provide a space for sufferers to openly and honestly share their struggles … Continue reading →

For the Health of It: Disentangling “Healthy Eating” and “Orthorexia”

Andrea 14 Comments

When is “healthy eating” not so healthy? The line between “normal” and “pathological” eating behaviours is blurry, to say the least. For some time, researchers have been attempting to define a “new” category of eating disorders: orthorexia. This category would capture “obsessions” with “healthy eating” that are (presumably) not already captured in current diagnostic criteria for eating disorders.

If you’ve been reading my posts for a while, you might already know how I feel about the liberal sprinkling of the suffix “orexia” onto behaviours related to food, exercise and body image (see, for example, my post on “drunkorexia”). The problematics of language use and eating disorders are numerous; we tend to use diagnoses as currency in discussing eating disorders, often glossing over the intricacies of behaviours with food and exercise by lumping them into (continually shifting) diagnostic criteria.

Of course, labeling is necessary to a certain extent. Diagnoses can help … Continue reading →