The thing about critiquing systemic issues like lacking training environments for medical professionals (and others) is that we have to be cautious to not place undue blame on those who are stuck immobilized between the desire to a) train or b) get training in eating disorders. If the solution to the egregious lack of training was simple, I feel sure that someone would have done it already! What I am gesturing at, here, is that the reasons behind lacking training opportunities are deeply rooted in socio-political, historical, and economic trends and policies. Those providing training and those seeking training do not exist in some glorious black hole devoid of austerity (frugalness, restrainedness) and neoliberalism.
In this post I’ll focus on a few studies that help to illuminate why these gaps in training might exist, including dominant sentiments (in the general public, in government, in training environments themselves) toward eating disorders. I’ll also highlight some promising directions in rectifying the situation. I’ll start with an exploration of the potential ramifications of this lack: burnout amongst those who do decide to treat …
Is there a link between eating disorders and shame? What about pride? Can understanding these emotions help us to understand how eating disorders develop, and how they are maintained? In reviewing literature for my specialization paper, I stumbled upon a qualitative study by Skarderud (2007) about the role of shame in eating disorders. I found the article quite interesting, so I fired up the “where was this cited” tool on my university library database and uncovered a wealth of studies looking at shame, pride, and eating disorders.
For the purposes of this post, I’ll comment on Skarderud’s study, also bringing in a longitudinal study by Troop & Redshaw (2012) that looks at general and bodily shame.
Shame and Pride
Skarderud, who uses a phenomenological approach in his study (meaning that he is trying to unearth the particularities of shame for those who experience it) sees shame as made up of both positive and negative elements. He states that “shame is something we want, and something we do not want” (p. 82), referring to how we (socially) …
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.
Le Grange and colleagues set out to complicate the package picture of the eating disorder/culture-of-thinness relationship by exploring the emergence of eating disorders in groups traditionally presumed to be “immune” to eating disorders …
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 findings, for example, there has been too little attention paid to the other systemic factors that are indeed tied to culture- but not culture as it is generally attended to?…
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 much more complex than a matter of a transporting cultural values (and thus eating disorders) from one society to another.
So let’s go back. Way back to 1994, when Anne …
Is ED recovery easier when your body is “normative or stereotypically desirable”? The anon asking the question implied that recovery could be more difficult because “an obese person … will never stop hearing hearing extremely triggering stuff about their body type.” Anon asked, “Have there been any studies on this?” Andrea tackled this question in her last post (it might be helpful to read it first if you haven’t yet); in this post, I will expand on my original answer.
Assuming anon meant, “Have there been anything studies assessing whether recovery is harder for individuals who do not fit the normative body type (because of fat phobia/fat shaming/diet culture)?” Then, my answer is: Not really, or at least I couldn’t find anything evaluating this question directly.
I was only able to find a few studies commenting on the history of overweight or obesity as a predictor of recovery/treatment outcome (but there are probably more):
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.
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 to identity. This paper considers one part of participants’ broader stories of having eating disorders; specifically, how individuals with eating disorders experienced inpatient hospitalization.
Eli conducted interviews with 13 participants. …
It can be somewhat controversial to suggest that untreated recovery from eating disorders is possible. Certainly, people have varied opinions about whether someone can enact the difficult behavioral and attitudinal changes necessary to recover without the help of (at the very least) a therapist and a dietitian. Nonetheless, we still hear stories about individuals who consider themselves recovered without having sought out external sources of professional support.
When I think about untreated (or “spontaneous”) recovery from eating disorders, two studies in particular come to mind. The first study I am thinking about was written by Vandereycken (2012) and explores self-change, providing an overview of community studies of individuals who have not sought treatment for their eating disorders and implications for treatment and recovery. The second, by Woods (2004) is a qualitative study looking at the experiences of 16 women and 2 men who report recovering from AN and BN without having sought treatment. Vandereycken identifies some difficulties associated with trying to study untreated recovery, and Woods’ study highlights some possible mechanisms through which untreated recovery might …
Today I have the distinct pleasure of writing about one of my favourite articles about eating disorder recovery by Malson et al. (2011) exploring how inpatients talk about eating disorder recovery. I have personally found this article to be very helpful in understanding some of the difficulties of understanding and achieving recovery in our social context.
As Malson and colleagues explain (and as we’ve established), eating disorder recovery is elusive. Often, poor prognosis is described in relation to individual factors, including:
- Treatment resistance
- Ambivalence about change
- Ambivalence about the possibility of change
Problematically, seeing these as the primary reasons for which patients do not recover can make individuals with eating disorders themselves feel as though they are to blame for their “inability to recover,” which help approximately no one. How do patients internalize these kinds of framings, and what impact does it have on how possible they feel recovery is?
Malson et al. used discourse analysis to explore patients’ perspectives, looking at how these participants felt about themselves currently and imagined their future “in recovery.”
What does eating disorder recovery really look like? When you say the word “recovery,” differences of opinion loom large. The lack of definitional clarity around the concept of recovery came up many times at ICED, and continues to surface in discussions among researchers, clinicians, and individuals with eating disorders themselves. We’ve looked at recovery on the blog before (for example, Gina looked at how patients define recovery here; Tetyana surveyed readers about their perspectives on whether or not they thought of themselves as being in recovery and wrote about it here; I wrote about men’s experiences after recovery here). It’s something of a hot topic in the research literature, too.
My Master’s thesis focused primarily on recovery, with one “take home message” being that there can be a disconnect between what recovery means in treatment settings, in popular understanding, and among individuals who have experienced eating disorders. Of course, my study was qualitative and from a critical feminist standpoint, so it is still unclear how well my findings map onto the larger dynamics of recovery. Still, understanding …