I’ve set myself a bit of an unrealistic conference schedule this year; with that in mind, I thought that if I’m going to write conference recaps at all, I had better do them immediately. Otherwise, I’m likely to forget where I heard a little gem or misattribute some brilliance – can you think of anything worse than misattributed brilliance? (I’m sure you can.)
This week I had the pleasure of attending the 4th annual Weight Stigma Conference in Vancouver, BC. As I write this, I’m still sitting staring at the beautiful mix of mountains and beaches that makes Vancouver a spectacular place to conference. I was also – in the interest of full disclosure around my largely positive views of the conference – on the organizing committee for the conference. I will say, though, that I don’t think my opinion would be different had I not had some say … Continue reading →
I thought about writing a post about the factor structure of popular eating disorder scales to celebrate my completion of an advanced statistics course in structural equation modelling. When I sat down to read some articles about that, though, I found myself side-tracked– and thoroughly uninterested in deconstructing scale psychometrics. So with a promise to do that at some point, I return to a favourite topic of mine: culture and eating disorders.
When I was writing about culture and eating disorders for the blog last year, I received quite a few requests for articles about eating disorders in developing countries. I suspect that the desire for this kind of article stems from a need to highlight (for the doubters) that eating disorders are serious mental health issues that can impact anyone who is predisposed, regardless of whether they live in a media-saturated landscape or not. As I noted in the … Continue reading →
Lately, I’ve been hearing a lot of noise in the social media sphere about whether or not those who have recovered from eating disorders should be treating eating disorders. Some have come out on the side of saying definitely not, listing reasons like the potential for bias, countertransference (the therapist making assumptions about clients’ emotions/experiences) or triggering. Others suggest that therapists who have “been there” can empathize with patients in a way that those who have not struggled with food cannot approximate.
Tetyana blogged about the lifetime prevalence of eating disorder professionals in recovery in 2013; she wrote about a 2002 study that revealed that around 33% of women and 2% of men treating eating disorders had a history of an eating disorder themselves. I have also written on the subject before (here); I focused on a 2013 study looking at experiences that recovered clinicians held in common.… Continue reading →
Health class in school is an experience few of us would like to repeat, I’m sure. Though it’s been a good many years since I was subjected to the joys of health education, I continue to think about the types of lessons I had, particularly about eating disorders, and how lacking these were. I can only imagine that things have gotten progressively worse with the focus on the “obesity epidemic” that is so pervasive today.
In one of my favourite articles ever, Pinhas et al. (2013) outline some issues with healthy curricula related to “healthy eating” in schools in the wake of obesity rhetoric. These include:
- The simplistic “energy in, energy out” message can be highly problematic for some children, who may take this to mean they need to engage in restrictive behaviours
- Without addressing weight stigmatization in schools, messages about health hold little purchase, and tend to
… Continue reading →
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 →
The high prevalence of eating pathology prior to bariatric surgery reduces the likelihood of what researchers have termed “optimal” weight loss post surgery. However, such weight loss is in part due to post-surgical complications like “dumping” (rapid gastric emptying because digestive systems cannot process the food) or vomiting that can develop into conscious efforts to lose weight. Conceicao et al. (2013a) describe, for example, one patient who deliberately binged and purged on foods that would make her vomit spontaneously.
These kinds of results raise a number of questions:
- How prevalent are eating disorders (EDs) post-bariatric surgery?
- What are the risk factors for developing an ED?
- To what extent is the surgery itself a potential trigger?
PREVALENCE OF DISORDERED EATING AMONG INDIVIDUALS SEEKING BARIATRIC SURVERY
Researchers interested in bariatric surgery have explored how often those seeking bariatric surgery engage in disordered eating or have EDs. Prevalence rates vary between studies depending … Continue reading →
This past Wednesday, January 27th, was Bell Let’s Talk day in Canada. In case you’re unfamiliar with the campaign, Bell Canada (a telecom company) donates 5 cents to mental health awareness initiatives for every social media post or text with the hashtag #BellLetsTalk. In general, the campaign has been lauded for its contribution to decreasing shame and stigma around mental illness, which is awesome. There are a number of critics, though, who point out that:
… Continue reading →
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.
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 →
Stigma is a real thing. There you go, the most profound statement I’ve ever written. In all seriousness though, there’s a big stigma problem around eating disorders, and not all of it is imposed from the outside. Many people with eating disorders also self-stigmatize, feeling responsible for their disorder (Holliday, Wall, Treasure & Weinman, 2005 wrote more about this). Other stigma is externally imposed; for instance, the widely held (and erroneous) belief that eating disorders are only something vain young girls get or that they are a choice.
Stigma around eating disorders sometimes differs betweens diagnoses, and especially between eating disorders and other mental illnesses – for instance, Roehrig and McLean (2010) found that eating disorders (both anorexia nervosa and bulimia nervosa) were more stigmatized than depression, and that eating disorder stigma uniquely (and horribly) included a certain degree of envy. The stigma associated with AN is … Continue reading →
The assumption that eating disorders only impact young, white, affluent women seems so out dated as to be laughable – and yet somehow this image persists, one of the most prominent stereotypes about eating disorders. It’s a damaging stereotype on so many levels; as we know, stereotypes about who might suffer from an eating disorder can lead people to feel that they don’t actually have an eating disorder and de-legitimizing their distress. The stigma that stems from having a body not expected to have an eating disorder can lead people to avoid seeking treatment out of fear of being dismissed by doctors, not thinking the type of treatment on offer will be appropriate or helpful, and more. Somehow, in the face of this, the image of the privileged and vain young woman who chooses to not eat marches on. And it is a shame.
Researchers are exploring stereotypes such as … Continue reading →