Qualitative
This category contains 21 posts

Polar Opposites? The Social Construction of Bulimia and Anorexia Nervosa

Some might argue that bulimia nervosa is more “hidden” than anorexia nervosa — it is not always obvious that someone is suffering from bulimia (though, I would argue, it is not always obvious that someone is suffering from any eating disorder). Even when it is “discovered,” BN is often placed in opposition with AN — as if the two were polar opposites.

Indeed, attempts to define a phenotype (a set of observable traits or characteristics) for AN and BN tend to oppose the two and to suggest that the people who develop AN are inherently different from those who develop BN. While I believe there is some scientific evidence for personality differences between the two, the degree of diagnostic crossover and symptom variability in eating disorders makes me feel like this split is at the very least overly simplistic.

What is interesting is how BN has come to occupy a very different place in our collective social imagination than AN. We know that preconceived notions about what it means to be an individual with an eating disorder in general can …

Good Clinicians, Helpful Comments, & Unpopular Opinions: SEDs Readers’ Responses – Part II

A few weeks ago, I asked SEDs readers a bunch of questions about their experiences with an eating disorder. Then, pretending to be a qualitative researcher, I went through the answers to see if I could find trends. I blogged about people’s responses to the first half of the question here; this post will be about the second half of the questions. (Here’s a ED survey results – Parts I and II to the pdf with all of the raw data).

Please note that this analysis was not rigorous, so in grouping and identifying themes (or how many times a theme/word was mentioned), I will use words like “approximately.”

[The breakdown for the last half of the respondents is:

6. What are characteristics of good eating disorder clinicians?

By far the two most comment themes, mentioned ~13 times each were “understanding” and variations of “willing to challenge,” “confront,” and have a “no bullshit” attitude. Other qualities mentioned were patience, good listening skills, nonjudgemental, empathetic and compassionate, not dismissive, patronizing or condescending, and firm but flexible.

Two individuals mentioned the …

I Asked, “Are You In Recovery? Why or Why Not?” Here’s What You Answered (And More): Exploring SEDs Readers’ Experiences

Are you in recovery right now? Why or why not?” That’s one of the questions I’ve been asking on the SEDs Tumblr every once in a while. It is interesting for me to find out about the people who read the blog/Tumblr. But more importantly, it gives me an opportunity to show diversity of experiences (and feelings).

Last week I decided to formalize this a little bit and to open the floor to non-Tumblr users; I made a survey with over a dozen questions. I received a lot of responses  and I wanted to share them in the hopes that some of you will, perhaps, find them reassuring. I won’t get to cover all the questions I asked, so this will be part I of, well, I don’t know how many posts.

Please note that this survey is not scientific, not comprehensive, and not necessarily representative of the general population of ED sufferers. Here’s a PDF of all the “raw” data for the questions covered in this post: ED survey results – Part I. Some of the …

Matters of Appearance: Eating Disorder Patients’ Interpretations of Therapists’ Bodies

Therapeutic alliance is often highlighted in studies looking at treatment effectiveness, both in and beyond the realm of eating disorder therapy. Evidently, there are a number of factors that can impact how well we get along with our therapists, ranging from disagreements with the course of treatment or type of therapy to a simple, unnamable dislike for the person. But what about their appearance? What kind of impact could a therapist’s body size have on the therapy relationship?

Rance, Clarke & Moller (2014) sought out to investigate this issue, looking specifically at how clients evaluate therapists’ body size and speculate on their relationship with food, with an eye to determine what impact this might have on the therapeutic process.

I was immediately drawn to this study when I was browsing the latest literature; I wondered why this hadn’t been studied before. In some ways it seems obvious; we’re bound to compare ourselves with others, social beings that we are. So when looking at the therapeutic alliance, it would be illogical to assume that physical appearance could be left …

Complex Motherhood: The Perspectives of Mothers with Eating Disorders

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 …

The Impact of an Eating Disorder Prevention Program: The Girls’ Perspective

Over the years, I have read a number of articles describing eating disorder prevention programs. Unfortunately, many reveal limited efficacy, and some even highlight detrimental effects. Primary among concerns of those evaluating prevention programs is that even when effective, we often have limited data about the long-term effects of prevention programs. This lack of follow-up limits the ability to draw conclusions about these initiatives and is cause for pause for those interested in implementing strategies to prevent eating disorders.

Further, there is some debate about whether eating disorders are even really “preventable.” Given our understanding of the complex etiology of these disorders, “prevention” can be a loaded word. The nature of the proposed intervention will undoubtedly be heavily swayed toward whichever factor(s) the program’s designer feels is most important in “causing” or contributing to disordered eating (i.e., Is the program tailored toward media awareness? Nutrition? Body image?)

I approached a recent article by Gonzalez et al. (2012) with these reservations in mind, but optimistic about the authors’ use of a longer-term follow up design. The article details results …

Perspectives of Siblings of Adolescents with Eating Disorders

The experiences of siblings of individuals with eating disorders has received relatively little space in the academic literature to date. Several studies have revealed the disruptions in family life that can occur when a child has an eating disorder (for example, see Hillege, Beale & McMaster, 2005 and Perkins et al., 2004). On the other hand, some studies have shown that siblings of patients with chronic illnesses have both positive (personal growth, responsibility, increased empathy) as well as negative (worry, fear, resentment) experiences.

However, few studies have explored experiences of male siblings, older siblings, or siblings of adolescents with eating disorder not otherwise specified (EDNOS). Consequently, to help fill this gap, Areemit, Katzman, Pinhas & Kaufman (2010) conducted a mixed-methods study looking at experiences and quality of life among siblings of adolescents with eating disorders.

Twenty siblings were recruited from The Hospital for Sick Children in Toronto. All lived with their ill sibling (hereafter AED for “adolescent with an eating disorder”, as they were called in the study), who had been diagnosed at least 3 months prior, …

Hide or Seek? Social Support and Eating Disorders

Social support has been noted as key in helping individuals with any number of health issues to cope with illness and even thrive in adverse situations (Sarason, Sarason & Pierce, 1990). Individuals with eating disorders may be encouraged, as an adjunct to treatment or even in the absence of formal treatment, to seek out social support to help with the day-to-day management of their disorder (Holt & Espelage, 2002). However, not everyone with an eating disorder seeks out social support; in fact, some may actively avoid seeking support during trying times. To find out more, Akey, Rintamaki & Kane (2012) examined social support seeking among men and women with eating disorders.

The authors interviewed 34 men and women, aged 18-53 (mean age 25) diagnosed with eating disorders and used grounded theory methodology (Glaser & Strauss, 1967) to analyze their data. As explained in a prior post, grounded theory is a qualitative methodology that uses participants’ accounts to develop practical theories that apply to particular situations or phenomena.

Analysis was framed in …

Life After Recovery for Men with Eating Disorders

While there is growing recognition that (surprise, surprise!) men are not immune to eating disorders, men are still underrepresented in the literature about eating disorders. We know comparatively little about what it is like to be a man with an eating disorder, and less still about recovery and life after recovery for these individuals. Recently, Björk, Wallin, & Pettersen (2012) conducted a qualitative study that asked men who had been diagnosed with an eating disorder and completed treatment to describe how recovery factors into their present lives. The researchers interviewed 15 men aged 19-52 (mean age 23) in Norway and Sweden, 10 of whom had been diagnosed with AN, 4 with BN, and 1 with EDNOS. The authors did not specify duration of illness.

PHENOMENOGRAPHY

The authors used a phenomenographical approach to study recovery among men. Though I am familiar with qualitative methods, this approach was new to me. From what I gather, phenomenography is an approach that focuses on a particular phenomenon (in this case, recovery from an eating disorder), and the similarities and differences in how …

Interpreting Anti-Obesity Campaigns with a History of Disordered Eating

Advertisements bemoaning the evils of obesity, begging us to eat healthier and to exercise, surround us every day. Big corporations and governments alike have jumped on the anti-obesity bandwagon, crafting public service announcements aimed at correcting what is being framed as an epidemic. For many, these messages are likely generic reminders to strive for health, if they are noticed at all. But what about individuals with eating disorders? A recent (2012) study by Catling & Malson (full text available here) looked into how a group of women with a history of disordered eating interpreted anti-obesity messages.

I was particularly drawn to this article, having personally felt rage at some of the overly simplified messages that circulate around obesity and “health.” Particularly when I was early in recovery, I often felt as though I was swimming against the current in my attempts to do just the opposite to what these advertisements were suggesting. I still often shake my head when I see big companies releasing aesthetically pleasing montages of shiny, happy people drinking diet cola, and talking about “health.”

Something …

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