Month: November 2012

What Makes a Good Nurse? Perspectives of Anorexia Nervosa Patients

Tetyana

Nurses can play an important role in facilitating recovery from anorexia nervosa, particularly in an inpatient or residential treatment setting. But what makes a good nurse from the patient’s perspective? More specifically, what qualities do adolescents with anorexia nervosa consider important and helpful during recovery?

The answer may seem obvious: understanding, empathetic, supportive, non-judgemental, and the like. But those are sort of general characteristics that apply to good friends, family members, partners, doctors, other healthcare professionals, and even teachers.

Joyce von Ommen and colleagues wanted to dig a little deeper than that. They wanted to find out what components of nursing care helped patients restore normal eating and exercise patterns.

In order to find out, they collected interviews from 12 female adolescent patients (mean age of 15, range from 13-17), who were discharged from a specialized eating disorder treatment centre within three months of the interview. The patients were diagnosed … Continue reading →

Self-Denial, Secrecy and Deliberate Lying in Eating Disorders

Tetyana

I don’t know how many times I’ve said, “I’ve already eaten, thanks,” “No thanks, I’m going be eating later,” or “I’d love to, but I’ve got a stomach ache,” when I actually hadn’t eaten, wasn’t going to eat later, and didn’t have a stomach ache. Why did I do that? Did I realize I had, or was developing, an eating disorder? How long did it take for that realization to click? And once it did, did I stop lying to avoid eating with others or did I do it more?

A lot of questions spring up when you start thinking about secrecy, denial, and lying as it related to eating disorders. And answering these questions by having to remember what you thought when you first began to show signs of your eating disorder is hard. It is hard for many reasons, but one reason is that the we feel about … Continue reading →

Weight Restored, Eating Well, But No Menses in Sight? Huh?

Tetyana 5 Comments

It is to be expected that the Diagnostic and Statistical Manual of Mental Disorders, at least when it comes to anorexia nervosa, relies heavily on measures that are hard to quantify and measure objectively. The big exception is amenorrhea: the absence of menses (commonly known as “periods”) for three consecutive months. As I’ve mentioned before, this criterion will be removed from the next edition of the DSM, thankfully. But for now, it is still there.

Perhaps because it is easy to measure objectively, the resumption of menses is often taken to be a marker of “health” and “recovery.”  It is a common goal in treatment for patients to reach a “menstruating weight.”

[Conversely, not losing one’s menstrual cycle is often perceived by the patient that they are not “sick enough.” Their eating disorder is not legitimate because clearly they are eating enough for their menstrual cycle to continue, and thus … Continue reading →

Should Anorexia Nervosa Patients Get the Flu Shot?

Tetyana 2 Comments

Is getting the flu shot a good idea if you have anorexia nervosa? Is it safe?

To be honest, I’ve never asked myself that question before. Last year, when I was underweight, I got a flu shot mainly because the laboratory where I am doing my graduate degree is in a hospital–the same hospital that was at the centre of the SARS epidemic in Toronto–and I didn’t want to put patients at risk. Sure, I spent most of my time staring at worms through a microscope (true story) but in the rare event I ventured outside for a coffee, I didn’t want to cough on newborn.

So I was kind of excited to find out the answer when someone asked me this question earlier today on tumblr. As expected, I didn’t find much information, but I did find one relevant paper published online in 2011 by Arne Zastrow and … Continue reading →

Think You Are Not “Sick Enough” Because You Didn’t Lose Your Period? Read This.

Tetyana 1 Comment

Anonymous asked, “I’ve never lost my period. Weight restored I am naturally thin, but even at a BMI of 15 or so I always got my period (although it wasn’t always regularly). This makes me feel like I’m not actually sick because I hear about everyone losing their period.”

eatruncats replied: “To the anon who asked about losing periods: For all the times she worries about not being sick enough because she never lost her period, there are people who lost their periods at BMIs of 18, 19, and 20 who worry about not being sick enough because they never got to a BMI of 15. If you have an eating disorder, you are “sick enough.” Period.“

As it stands now, amenorrhea–or the loss of three consecutive menstrual cycles–is a diagnostic criterion for anorexia nervosa. Individuals who have not lost their periods are diagnosed with eating disorder not … Continue reading →

Does the Media Cause Eating Disorders? Disordered Eating in Iranian Women: From Tehran to Los Angeles

Tetyana

What is the impact of Western culture on eating disorders? Do images of thin cause eating disorders? I mean, it seems like such a nice and simple hypothesis. It makes intuitive sense: glamorize thin and make thin cool and BAM, everyone wants to be thin. It would be so much easier. Cause? Found. Solution? Easy: ban thin models. Unfortunately (or fortunately for me, since it gives me a lot to blog about) the answer is not that simple.

Just in the last couple of hours, some people who’ve ended up on the SEDs blog have searched:

  • does the media cause eating disorders
  • thin models on tv cause eating disorders to young girls
  • do models influence anorexia
  • ultra thin models causing eating disorders
  • magazine article eating disorders caused by the media
  • and the rare: media doesn’t cause eating disorders

I’m sure most of these search terms lead people to the … Continue reading →

A Study Without a Control Group? Evidence for Enhanced Cognitive Behavioural Therapy for Adults with Anorexia Nervosa

Tetyana 7 Comments

Here’s a quick tip: when a study that purports to find evidence of treatment effectiveness–preliminary or not–doesn’t have a control group (a group that doesn’t undergo treatment but is otherwise similar to the group that does), you should raise your eyebrows. Or shake your head. Or roll your eyes. Whichever you prefer.

Why do we need a control group? If the treatment works, we will see improvement in the patients, so isn’t that evidence enough? Well, no.

[T]he whole idea of an experiment is to identify two identical groups of people and then to manipulate something. One group gets an experimental treatment, and one does not. If the group that gets the treatment (e.g., a drug, exposure to a violent video game) behaves differently than the control group that did not get the treatment, we can attribute the difference to the treatment – but only if we can rest assured

… Continue reading →