“Our Results Are Unexpected, So The Participants Must Have Been in Denial”: Exploring a Worrying Trend in Eating Disorders Research

Something I have come across several times when reading ED research studies is a disclaimer that research has been dutifully carried out, but the findings have to be viewed with some scepticism because the participants (and – more specifically – the participants with AN-R) were in denial when completing the self-report questionnaires.

In this post, I will to look at a couple of recent studies that flag-up this issue, to examine what is behind this disclaimer.

The first paper I will explore was published very recently by Gailledrat et al. and touches on body shape concerns in women with eating disorders. Participants were women with a diagnosis of AN or BN selected from a clinic in France. The researchers inform us that, “patients with an ED are much more concerned with their body image and weight than the rest of the population”. The authors do not provide any support for … Continue reading →

Poverty and Eating Disorders in Hong Kong

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 →

Not So Fast: Is There a Connection Between Religious Fasting and Eating Disorders?

I’ve always wondered about how being encouraged to fast for religious reasons might impact those who are vulnerable to eating disorders and those who already have eating disorders. I can’t imagine it would be easy to be around others who were fasting in the name of religion while struggling with an eating disorder. Equally, I can certainly see the dangers of participating in fasting for those who are predisposed to eating disorders.

Despite not being religious myself, however, I understand that fasting is important to some people who subscribe to religions that encourage the practice. So, how might we balance the potential dangers of fasting with the freedom of religious observance? And, what is the impact of religious fasting on individuals with eating disorders, or those developing eating disorders?

In this post, I’ll highlight some of the main findings from 2 studies about religious fasting and eating disorders: one quantitative … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 5

We’ve begun to scratch the surface of the vast and growing literature on cultural context and eating disorders in the previous 4 posts in this series. Of course, as I reflected the other day, there could (maybe should?) be a blog solely devoted to this topic- each time I read another study in this area, it pulls me down the rabbit hole into another related area.

In what will be the last part of this series for now, I’ll review a study by Bennett, Sharpe, Freeman, and Carson (2004) on the request of Lisa LaBorde (via Twitter). The authors wanted to learn more about the presence (or lack thereof) of eating disorders in Sub-Saharan Africa, a context that they describe as less driven by the thin-ideal. This was, they suggest, the first thorough exploration of anorexia in sub-Saharan Africa, and so might reveal more about whether and how … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 4

The more I write about culture and eating disorders, the more I want to know. I keep finding more articles to add to the mix; I know I’m far from the first to be interested in how culture and eating disorders intersect, and for that matter, what counts as “culture.” Still, this has been a fascinating exploration so far! In case you’re curious, this is to be the second last post in the series, for now at least. There will be one more after this, about eating disorders in Ghana (from a Twitter request). In this post, I will continue to explore the “culture boundness” of eating disorders by looking at a study relating to eating disorders in Africa. In this study, Le Grange, Louw, Breen & Katzman (2004) illustrate how eating disorders have emerged in Caucasian and non-Caucasian adolescents in South Africa.

THE STUDY

Le Grange and … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 3

The articles I’ve looked at so far in this series (Becker, in part 1, and Keel and Klump in part 2) give us some insight into the idea that the link between “Western” societies and eating disorders is more complex than a simple matter of media exposure. But, having read these studies, I was still left a bit wanting in terms of unpacking that black box of “culture” that gets tossed around in scholarly and popular literature. What, exactly, are we talking about when we talk culture in eating disorders?

Rebecca Lester, who is quite a prolific social anthropologist and who has written about eating disorder treatment systems in the USA and Mexico, makes the argument that “culture” is too often used as an umbrella term for semi-related but not-entirely-synonymous factors. This makes me wonder: is it possible that in latching on to the media side of Becker’s … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 2

In this post I’ll continue on the trend of considering the “culture bound” nature of eating disorders by looking at another commonly-cited article about eating disorders and culture. In this article, Keel and Klump (2003) look at the cultural and historical facets of anorexia and bulimia. They looked at whether eating disorders were present in other sociohistorical and cultural contexts in order to determine whether AN and BN are “culture bound.”

Their research, as I alluded to at the end of the first post in this series, suggests that anorexia is not culture bound (i.e., it can occur in the absence of certain aspects of culture), while bulimia is (i.e., it only/primarily appears in certain cultural contexts). As this finding might actually run counter to what popular press would have us believe, looking at this article provides us some interesting insight into how spin can really be everything. … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 1

Often, in writing about eating disorders, you will come across references to how some consider these disorders to be “culture bound.” If you start to unpack what researchers and clinicians are referring to, you might come to the conclusion that “culture bound” means specific to one particular culture or society, for example, modern Western society.

By extension, you might then think that the more “Western” a culture is, the more likely that there will be eating disorders present. You might have seen this logic reproduced in such works as: “Western Media is the Root of all Evil” (note: title does not refer to an actual study/article… I hope).

The way the popular press has taken up the culture boundedness of eating disorders does not always represent the way that it is described in research articles (I know, you’re shocked–not). Generally, and quite predictably, the “culture bound” nature of eating disorders is … Continue reading →

Are All Anorexia Nervosa Patients Just Afraid of Being Fat? – Part 2

If you’ve been reading this blog for a while (or literature on this topic) you know the answer is no. I’ve blogged about this before, but I think it is a topic that needs a lot more coverage because the myths that all anorexia nervosa patients are just afraid of being fat, that they lose weight just to be thin, and that thin models are to blame for AN are still very common.

As you’ll see, I am not claiming that this isn’t true for some patients. Instead, what I am claiming is that it is not true for all patients.

And a big personal goal of mine with this blog is to broad the conversation about eating disorders. Let’s get away from stereotypes and painting all anorexia nervosa or bulimia nervosa patients in the same light. Let’s instead have meaningful discussions about research on eating disorders, about … Continue reading →

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

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 →