Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 6

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 … Continue reading →

Many Types of Expertise: Recovered Therapists Reflecting on Recovery

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 … Continue reading →

Bariatric Surgery and Eating Disorders: A Double-Edged Sword

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 →

Let’s Talk about Systems Level Change for Eating Disorders

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 →

Eating Disorders & Socioeconomic Status in the Community

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 →

Incidence of Eating Disorders on the … Decrease?

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 … Continue reading →

Eating Disorders are a Political Issue: Bulimia Nervosa and Advanced Capitalism

If you know me even a little bit, you can imagine my glee at coming across a paper entitled “The Political Economy of Bulimia Nervosa.” YES! I exclaimed. Let’s explore the ways in which our systems of food production are linked to eating disorders. Let’s complicate the idea of “the social” as it relates to eating disorders and do an analysis of the complex socio-political and economic forces that govern our world.

So, let’s get right into it, shall we?

The Article

Pirie (2011) argues that it is important to understand eating disorders from a political economic perspective so that we can look beyond an equation of the “cultural” and media representations of femininity. The way in, he suggests, is through a look at how food systems have shifted since the time at which bulimia nervosa was introduced as a psychiatric diagnosis, around 1970.

The article is not … 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 →

I Need How Many Calories? Caloric Needs in Bulimia Nervosa Patients

In the 1980s, a few studies came out suggesting that patients with bulimia nervosa (BN) require fewer calories for weight maintenance than anorexia nervosa patients (e.g., Newman, Halmi, & Marchi, 1987) and healthy female controls (e.g., Gwirtsman et al., 1989).

Gwirtsman et al. (1989), after finding that patients with bulimia nervosa required few calories for weight maintenance than healthy volunteers, had these suggestions for clinicians:

When bulimic patients are induced to cease their binging and vomiting behavior, we suggest that physicians and dietitians prescribe a diet in which the caloric level is lower than might be expected. Our experience suggests that some patients will tend to gain weight if this is not done, especially when hospitalized. Because patients are often averse to any gain in body weight, this may lead to grave mistrust between patient and physician or dietitian.

Among many things, this ignores the fact … Continue reading →

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

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 →