Why I No Longer Support Genetics Research into Eating Disorders – Part II (Illness and Recovery in a Neoliberal Society)

This is part II of posts on why I am highly skeptical of the argument that we need to understand the genetic basis of eating disorders in order to improve outcomes. If you would like to leave a comment, please read Part I as well.

I worry about the implications of focusing on genetics and neurobiology in identifying causes of and solutions to eating disorders in the context of a neoliberal society.

When I was an adolescent, finding out that eating disorders have a genetic component alleviated my guilt. Coming across Dr. Walter Kaye’s research into the neurobiology of eating disorders — the hypothesis that the drive to restrict may be linked to and reinforced by serotonin systems in the brain (here, here, and here) — provided me with a plausible biological explanation for why restricting made me feel calmer. It meant my eating disorder was … Continue reading →

Why I No Longer Support Studying the Genetics of Eating Disorders – Part I

I no longer support genetics research into eating disorders. Okay, that’s not quite right: I no longer support genetics research into eating disorders under the pretense that it will improve treatment outcomes or prevent eating disorders. I just don’t believe it. Moreover, I think emphasizing the need for a genetic understanding of eating disorders shifts focus away from research and, more importantly, from actions, that can yield much greater benefits much quicker.

It wasn’t always like this. In my third (junior) year of university, I wrote a mini-review on the genetic and neurobiological etiology (cause) of anorexia nervosa. In it, I argued that “in order to improve recovery outcomes, more specific treatments based on genetic and neurobiological evidence need to be developed.” I concluded by writing,

However, with the advent of large-scale genetic databases and worldwide collaboration among researchers resulting in larger sample sizes, the future of AN research

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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:

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Finding What You’re Looking For? Exploring the Eating Disorder Examination Questionnaire

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 →

Eating Disorders: What’s Feminism Got to Do With It?

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 →

Reflections on EDAC-ATAC 2014 Conference

Last week I had the opportunity to attend and present at the Eating Disorders Association of Canada (EDAC-ATAC) Biennial Conference in Vancouver, BC. I was presenting part of my Masters thesis, which felt great. I always love talking to clinicians in the field, and I found that this was a very practical and applied-focused conference.

I sometimes feel like somewhat of an outsider at eating disorders conferences as I am “research only”- I do not have the credentials to counsel or treat individuals with eating disorders. However, I felt quite welcome at this conference. People were quite willing to engage with a relative newbie, in typical Canadian fashion.

If you follow me on Twitter, you’ll have noticed that I was tweeting up a storm. You might also have noticed that I was one of the only people doing so. I learned that this association is relatively new, in its … Continue reading →

Examining Mandometer(r) Founders' 10 "Reasons" Why Eating Disorders Are Not Mental Disorders

This is Part III of my mini-series on the Mandometer® treatment. In my first post, I wrote about the history and rationale of the Mandometer® treatment. In my second post, I evaluated a recent study published by the creators of Mandometer® (Bergh et al., 2013); I wanted to see whether their data supported their claims (spoiler alert: it didn’t). In this post, I’m going to focus on the first five of Bergh et al.’s ten reasons why eating disorders are not mental disorders (or something like it, anyway).

If it seems like I have a personal vendetta against Cecilia Bergh & Co/Mandometer®, rest assured that I most certainly do not. I just don’t like bad science, misleading claims, and snake oil. As I mentioned in my first and second posts, I actually like many of the components of the Mandometer® treatment. (For example, I agree that weigh restoration … Continue reading →

Body Image: Is It a Useful Concept? (Maybe Not So Much)

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 … Continue reading →

Beyond Simple Solutions: The Need for Complex Ideas in Anorexia Nervosa

I often hesitate to make broad, sweeping claims about the nature, cause, and experience of eating disorders and disordered eating. However, if there is one thing I feel absolutely certain saying about these disorders, it is that they are incredibly complex and multifaceted with no “one-size fits all” solution. So, I was quite excited when I came across a recent article by Michael Strober and Craig Johnson (2012) that explores the complexity of eating disorders and their treatment. Both authors have significant clinical experience treating eating disorders.

This article uses cases studies, literature, and the authors’ collective clinical experience to respond to some of the key controversies surrounding anorexia and its treatment. Among the major controversies that have come to light of late, they focus on two:

  1. Genetic/biological causation (Biologically-based mental illness – BBMI)
  2. Family-based treatment (FBT) as the best form of treatment for adolescents

The authors’ exploration of these … Continue reading →

Extreme Medical Negligence: Failure to Feed Patients with Anorexia Nervosa

They are crazy stories, really. It is hard to believe they are true.

A 28-year-old woman with anorexia nervosa complained about weakness and nausea following the insertion of a feeding tube. Her gastroenterologist sent her to the emergency room (ER). The woman was in the emergency room for two days without receiving any food. She was discharged home after she was told her lab tests and X-rays came back normal.  Unfortunately, her X-rays weren’t normal. Her gastroenterologist determined she had a bowel obstruction and sent her back to the hospital. She lost a substantial amount of weight in those 3 days.

A 26-year-old woman with a feeding tube was discharged prematurely from a residential facility. She began to feel dizzy and weak, and was admitted to a hospital. She did not receive any food for the 6 days she was there, despite extremely Continue reading →