I recently had a total Aha! moment (or a why-didn’t-I-ever-think-of-it moment) when I had chanced upon a recently published article titled “Eating Expectancies in Relation to Eating Disorder Recovery” by Fitzsimmons-Craft and colleagues. The title caught my attention because I had never come across any research tying eating expectancies to eating disorders, though I was familiar with the concept from the health psychology and obesity literature. Eating, as a behaviour and as a mechanism, is incredibly complex, with many factors contributing to why and how we eat; eating expectancies are one such factor.
Expectancy theory, first proposed by Tolman (1932), suggests that expectancies, or assumptions about the consequences of various behaviours, develop as a result of one’s learning history (Smith et al., 2007). Such expectancies are thought to influence subsequent behavioural choices, with one acting to either increase the likelihood of reward or decrease the likelihood of punishment. Essentially, expectancies are cognitive mechanisms that drive future behaviours.
With respect to eating, expectancies represent the culmination of one’s learning history as related to eating and act
Studying, as I do, in a department of family relations, I have become interested in family relationships and parenting. Accordingly, I have begun to take note of interesting studies that link family dynamics and parenting with eating disorders, including studies that look at the sibling relationship (as I wrote about here), family-based treatment, and motherhood/fatherhood in the context of eating disorders.
The literature appears to have shifted, lately, from a focus on “eating-disorder generating” families toward an acknowledgement of the complex family dynamics that can play into the development and treatment of eating disorders. A move away from mother- or family-blaming discourses is essential, I would argue, to gaining a better understanding of the lived experience of eating disorders for individuals and families alike.
Accordingly, I was pleased to stumble across an article by Tuval-Mashiach et al. (2013) that used a qualitative approach to explore the experiences of mothers with eating disorders. The authors suggest that their study helps to fill a gap in the literature surrounding how mothers experience the intersections between their motherhood roles, their …
Good health is more than just the absence of illness; it is more than just the absence of dysfunction. Good health — that is, mental, social, and physical health — requires the presence of wellness, or the ability to function well.
In this respect, with regard to eating disorders, most research has focused on assessing (health-related) quality of life and subjective well-being of eating disorder patients, often focusing on things like body satisfaction, self-esteem, and positive and negative emotions. There is, however, another way to think about well-being. A model (and assessment scale) developed by Carolyn Ruff, called psychological well-being (also here), aims to assess specific dimensions of functioning that contribute to or make-up well-being. There are six such dimensions.
I found this succinct description of the differences helpful:
Subjective well-being (SWB) is evaluation of life in
In this post I will continue my discussion on weight suppression in bulimia nervosa (click here to read Part I). Just in case you happen to be reading the posts out of sequence, I will summarize the main points of that entry:
THE RELATIONSHIP BETWEEN WEIGHT SUPPRESSION AND WEIGHT GAIN DURING BN TREATMENT
Because most individuals with BN have undergone significant weight loss, this makes them susceptible to weight regain — much like obese individuals usually regain the weight they have lost. Indeed, evidence suggests that weight suppression predicts weight gain in individuals with BN during inpatient (Lowe et al., 2006) and outpatient treatment (Carter et al., 2008).
In contrast, other measures of weight history, such as highest or lowest body mass index (BMI)…
HW. CW. LW. GW1. GW2. GW3. UGW.
If you have (or have had) an eating disorder (or dieted and used online forums), chances are you know what those acronyms mean. And if you have browsed blogs written by eating disorder sufferers, chances are you have come across these acronyms too. After all, they are a prominent feature of many such blogs.
If you are lost, I’ll fill you in: the acronyms stand for Highest Weight, Current Weight, Lowest Weight, Goal Weight 1/2/3, and Ultimate Goal Weight (UGW). Unsurprisingly, most individuals with eating disorders, much like dieters, like to keep track of their weight loss — that is, the difference between the highest weight, HW, and the current weight, CW.
Researchers call this difference weight suppression (WS, more specifically, the highest adult body weight) and one’s current weight). It can be thought of as the extent to which an individual has reduced their weight through dieting. It is usually calculated based on self-reported highest adult body weights. (So those …
This may sound counterintuitive at first, but I’m thankful for two aspects of my eating disorder, which I believe helped me make the choice to aim towards recovery: the development of binge eating after chronic food restriction and the physical inability to purge through self-induced vomiting. Like many individuals diagnosed with anorexia nervosa that go on to develop binge eating, I tended to choose high-fat foods and sweets as my “go-to” food items. I had always enjoyed such foods and was a notorious junk food aficionado as a young girl (way before any eating disorder symptoms developed). Once the bingeing behavior started, I couldn’t stop.
Sitting with the discomfort after a binge made me seriously consider whether this was something I could maintain for any lengthy period of time, and that’s when I started getting help. In a sense, I believe my affection for sweet foods, and propensity to binge on them, was a “life saver” of sorts. I also think these behaviors got me used to eating foods that I had deemed “forbidden” while I was restricting. With this forced confrontation, I …
Restricting, bingeing, and purging are powerful ways to regulate emotional states. However, these behaviours probably play different roles in emotional regulation. Whereas restriction is hypothesized to pre-empt the onset of highly emotional states, bingeing and purging is thought to act as a coping mechanism to deal with overwhelming emotional states once they’ve already been activated.
In BN there is abundant evidence that the binge–purge cycle functions as a means of emotion regulation. Binging [and I would arguing purging too! ] facilitates a temporary suppression of painful self-awareness and helps the self to dissociate from painful emotions or to block negative affect as demonstrated in both laboratory studies and diary studies in daily life.
In AN, restrictive eating patterns have been linked with a narrowing of emotional functioning, flattening of affect and lack of outward display of emotion. As such, Waller, Kennerley, and Ohanian (2007) argue that both binge– vomit-cycle and restriction are emotion suppression strategies which are just utilized at different times.
If this is true, we would expect to see more variability (or fluctuation) in the intensity and types …
I recently attended the International Society of Critical Health Psychology’s 8th Biennial Conference in Bradford, England. At the conference, I had the pleasure of attending many talks that challenged the way we approach health psychology. Luckily for me, there were several sessions that touched on issues of disordered eating and body image.
One such talk, a panel presentation with Hannah Frith, Sarah Riley, Martine Robson and Peter Branney, challenged attendees to re-think the way we approach body image. When I returned home, I immediately downloaded an article by Kate Gleeson and Hannah Frith (2006) that discusses this same idea and essentially begs the question: Is the concept of “body image,” as it is currently articulated, actually useful?
This might come off as a controversial question; after all, body image is central to many studies (and treatment programs) related to eating disorders. We’re told repeatedly that by improving our body image, we can achieve peace with food, with ourselves, with exercise, and with others. Good body image is upheld as …
Anorexia nervosa was first described in the medical literature in 1689 by Richard Morton. It has been over 300 years since then and AN continues to be one of the deadliest psychiatric disorders. If not treated early, it runs the risk of becoming deeply entrenched and highly resistant to treatment.
Moreover, established treatments for related disorders like bulimia nervosa and depression, such as cognitive behavioural therapy and antidepressants, are rather ineffective in treating anorexia nervosa. Finally, even if significant physical and mental improvements are achieved in treatment, relapse rates for older individuals (even those in their 20s) remain high.
What makes anorexia nervosa so persistent and so hard to treat in individuals who develop it, particularly if it is not treated soon after onset? Why is recovery so hard?
In this paper, B. Timothy Walsh outlines a model based on cognitive neuroscience that attempts to answer these questions:
Its central element is that this behavior has become habitual and is grounded in the neural mechanisms that underlie habit formation and persistence. This formulation is based on a substantial body…
I have often heard anorexia nervosa sufferers complain of “memory gaps,” particularly during the times they were really sick. As if they weren’t really there. It can be scary and unnerving, to say the least. A few months ago, a Tumblr user asked me about this:
Hi Tetyana, I’m not sure if this is merely based on my own subjective experience of if there is any grounding at all, but I was wondering if there could perhaps be a link between EDs and a sort of memory loss. It’s hard to describe but I definitely seem to have huge “gaps” in my memory of during that time, as if I selectively block things out. I have limited inaccurate knowledge with regards to memory on a molecular/neurological basis so I do not know if there’s anything there. Perhaps with calorie restriction in anorexia nervosa there is simply not enough “energy” for memory to function adequately? I don’t know whether there is a link here and how far a sort of “memory loss” is experienced by those with anorexia and other EDS