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:
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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 →
Reports that eating disorder (ED) rates are rapidly increasing seem nearly ubiquitous, but are rates actually increasing? Are EDs at an “epidemic” level? I came across a recently published study suggesting that this may not be the case; indeed, ED rates might actually be decreasing, at least in the Netherlands.
In the study, Smink and colleagues (2015) followed a group of general practitioners (GPs), servicing roughly 1% of the total population, asking them to record all the newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) between 1985-1989, 1995-1999, and 2005-2009. They were interested in whether incidence rates changed or remained stable over time.
Incidence refers to the number of new cases of a disease or disorder in a population over a certain time period; it is not the same as prevalence, which refers to the total number of individuals suffering from the condition at a given point in time (or … Continue reading →
Not much is known about eating disorders in China, especially compared to its East Asian counterparts of Hong Kong and Japan. It would appear that researcher-practitioners in China are not publishing much data about eating disorders in the country; in fact, the author of the study I’ll be looking at in this post, Joyce Ma, practices primarily in Hong Kong. In this study, Ma explores China-specific patterns of ED presentation and how they relate to the social context. As she notes, treatment models have been slow to develop from the mother-blaming paradigm proposed by Chen (1990), which recommended that eating disorder patients be isolated from their parents. No other study appears to have been done (at least that she cites) using evidence-based modalities.
In her study, she reports on the results of treatment with 10 families in a Shenzhen clinic, with patients of a relatively wide age range – … Continue reading →
There has been a lot of talk in the Twittersphere lately about feminism and eating disorders. Because I live and breathe my feminism and my eating disorder research and activism, I’ve been struggling to reconcile my commitment to making sure people feel heard and my commitment to clarifying what I feel are misconceptions about the links between feminism and eating disorders.
Certainly, it can’t be denied that some have adopted the name “feminism” and supported some decidedly shady claims or research. Then again, people of all stripes have done shady research with questionable motives and outcomes. Science and research are never neutral. Everything from what is seen as being “important enough” to study to how results are interpreted and used takes place in a socio-political context. Try as we might, we can’t fully remove ourselves from our research, whether we research micro-RNA or eating disorders (or both? It’s probably possible … Continue reading →
This week I had the pleasure of attending a workshop with Janet Treasure on collaborative care in eating disorders. Treasure focused her workshop on supporting caregivers of people with eating disorders, offering practical skills for carers and clinicians alike to improve interactions with those with eating disorders. Though I am neither a carer nor a clinicians, I got a lot out of the workshop, and it reminded me of a few of Treasure’s articles I’ve read over the years, and how much I appreciate her strong focus on working collaboratively with patients and families to facilitate recovery.
I especially appreciated how she aims to integrate those with lived experience (of either having an eating disorder or caring for someone with an eating disorder) in research and treatment design. Some of her journal articles, including this article on the potential for harm in existing treatment models, even include former patients as … Continue reading →
Eating disorders are typically seen as an illness of the middle class, with most patients coming from that socioeconomic group. However, the invisibility of poorer patients within eating disorder research in part reflects the barriers to treatment that they face, including both cost and lower levels of awareness. This paper, written by a Hong Kong social work professor, Joyce Ma, focuses less on the process of eating disorder recovery, highlighting instead the context of treatment. She discusses how family dynamics and socioeconomic status come into play in her encounters with 7 Hong Kong teenagers from low-income families.
While her sample size is very small, it reveals a more diverse — and less body image-focused –disease pathway than most American studies, with Ma breaking down the precipitating factors as follows (patient numbers in brackets):
- Constipation (1)
- Desire to be thin (3, 7)
- Relationship issues (6)
- Parental conflicts (5)
- Poverty (2, 4)
… Continue reading →