Is the Doctor In? Eating Disorders Training Amongst Medical Professionals — Part 2

It is challenging for me to rein myself in when I start ranting about the poor state of affairs of eating disorder training for medical professionals. However, I reconcile my critical ranting with a paradoxical penchant for optimism. I figured, in my searching, that there must be something out there that gives us more to work with. Is there a functional model of providing training for medical professionals? At the very least, are the opportunities that do exist doing a good job at equipping healthcare providers with the skills they need to begin to navigate the complexity of eating disorders?

Building on part one, in which I highlighted 2 studies offering some challenging knowledge around how little is on offer within medical training environments, I will focus here on 2 studies about the outcomes of training. The first, a UK study, explores whether medical professionals are trained in eating … Continue reading →

Teacher, Learn Thyself: Critical Issues in School-Based Eating Disorder Prevention

Prevention programs for eating disorders abound, though many people I’ve talked to (mostly on Twitter, because that’s where I have a lot of discussions of this type) have expressed the sentiment that limited resources might be better spent on early intervention or treatment in general. Still, it isn’t hard to understand why we still optimistically aim for eating disorder prevention; of course we would rather stop eating disorders in their tracks, before they wreak havoc on the lives of people and their loved ones. I’ve written about my own take on the “is prevention possible” debate elsewhere, highlighting some of my concerns, as well as some more optimistic sentiments about truly systemic prevention efforts.

One of the things I am most concerned about is the fact that prevention tends to take place in the school context, delivered by teachers who may or may not know much about eating disorders … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 5

We’ve begun to scratch the surface of the vast and growing literature on cultural context and eating disorders in the previous 4 posts in this series. Of course, as I reflected the other day, there could (maybe should?) be a blog solely devoted to this topic- each time I read another study in this area, it pulls me down the rabbit hole into another related area.

In what will be the last part of this series for now, I’ll review a study by Bennett, Sharpe, Freeman, and Carson (2004) on the request of Lisa LaBorde (via Twitter). The authors wanted to learn more about the presence (or lack thereof) of eating disorders in Sub-Saharan Africa, a context that they describe as less driven by the thin-ideal. This was, they suggest, the first thorough exploration of anorexia in sub-Saharan Africa, and so might reveal more about whether and how … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 4

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 … Continue reading →

Whose Culture is it Anyway? Disentangling Culture and Eating Disorders – Part 1

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 … Continue reading →

Unpacking Recovery Part 5: Clinical Recovery Without a Clinic?

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 … Continue reading →

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 … Continue reading →

Chewing and Spitting: A Neglected Symptom in Eating Disorders?

Eating disorders come in all shapes and sizes, but all of them are characterized by the same goal: to avoid weight gain or induce weight loss. While behaviours such as food restriction, purging, and laxative abuse are relatively well studied, chewing and spitting (CHSP) is not. A simple Google search, however, reveals over 1.5 million results for the term “chewing and spitting.” Results often links to blog posts or Tumblr pages where CHSP sufferers confess their guilt, disgust and obsession with the behaviour.

What is chewing and spitting? How does it relate to other disordered eating behaviours  such as restrictive eating or binge eating?

Chewing and spitting describes the pathological eating behaviour where the individual chews a variety of enjoyable foods, and spits it out to avoid undesirable consequences of weight gain (Mitchell et al, 1988). This seemingly “smart” workaround allows them to enjoy the taste of foods … Continue reading →

Maintaining Change Following Intensive Eating Disorder Treatment

It is a relatively well known fact that eating disorders have a high relapse rate and many people, myself included, find themselves in multiple intensive – residential, inpatient, even partial hospitalization – treatments. One may ask if such intensive treatments really work or if long term intensive care is just a band-aid of sorts. I know I’ve had to ask myself, “why is this going to work this time when it hasn’t worked in the long run before.”

There is even debate in the field on whether residential treatment actually has evidence supporting its effectiveness (see Tetyana’s post here). I can speak from experience that the various intensive treatments I’ve personally done have saved my life and given me more perspective, skills training, and support than I could have had otherwise. However, despite having made significant changes, I’ve had more than my share of slips and relapses.

I … Continue reading →

Naomi Wolf Got Her Facts Wrong. Really, Really, Really Wrong.

I’m working on a post about the role of serotonin in the development and maintenance of anorexia, but it is taking me some time as I want to include a sufficient amount of background information. So, in the meantime, I’m going to blog about a short paper that was brought to my attention by Sarah. As you might have guessed by the title, the paper’s author, Casper Schoemaker, wanted to do some fact-checking on Naomi Wolf’s first book, titled The Beauty Myth. A quick glance at the Amazon ratings reveals that a lot of people like it, and many find it shocking and “eye-opening”. Now, I’ll admit: I haven’t read it, and I don’t plan to. (I don’t read books like this.) But I have come across blatantly wrong statistics on eating disorders from people citing her work.

(Books are not peer-reviewed. The main thing you need to … Continue reading →