“Our Results Are Unexpected, So The Participants Must Have Been in Denial”: Exploring a Worrying Trend in Eating Disorders Research

Something I have come across several times when reading ED research studies is a disclaimer that research has been dutifully carried out, but the findings have to be viewed with some scepticism because the participants (and – more specifically – the participants with AN-R) were in denial when completing the self-report questionnaires.

In this post, I will to look at a couple of recent studies that flag-up this issue, to examine what is behind this disclaimer.

The first paper I will explore was published very recently by Gailledrat et al. and touches on body shape concerns in women with eating disorders. Participants were women with a diagnosis of AN or BN selected from a clinic in France. The researchers inform us that, “patients with an ED are much more concerned with their body image and weight than the rest of the population”. The authors do not provide any support for … Continue reading →

Does Body Dissatisfaction in Children Predict Eating Disorder Symptoms?

Identifying risk factors for eating disorder symptoms may help us develop more evidence-based prevention mentions. Personally not convinced that prevention is really possible with the types of individual-focused programs we have today, I would argue that identifying risk factors may at least help us determine which individuals should be screened in subsequent years. If they do develop eating disorders, they will hopefully be more likely to receive early intervention and treatment.

To identify predictors of eating disorder symptoms, Elizabeth Evans and colleagues (2016) conducted a longitudinal study that measured various putative risk factors at ages 7, 9, and 12 in a group of boys and girls. The authors also wanted to identify correlates of eating disorder symptoms at 12 years of age. They measured eating attitudes and dietary restraint, BMI, body dissatisfaction, and depressive symptoms.

THE STUDY

  • 516 participants; 262 girls and 254 boys
  • all individuals were residents of Gateshead, located
Continue reading →

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.

BACKGROUND

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 →

Plenty of Reasons to Sit Still: The Problem(s) with Fitspiration

I can’t quite believe that I have yet to write a post here about fitspiration, given the ire that it provokes in me. And there you have it, right off the bat, my bias: I find fitspiration to be incredibly problematic – this will be controversial, but I often wonder if it could be more dangerous than thinspiration, in its subtleness. Fitspiration posts closely resemble what we are asked to do with our bodies every single day: eat “clean,” work out in a gym, put mind over matter, be productive, and succeed. Unlike thinspiration, these messages target a wide demographic of people with and without eating disorders; they carry neoliberal undertones (ok, probably overtones).

I’m not the only one interested in unpacking the issues with fitspiration. Indeed, I’m far from the first to call out these problematic messages (I especially like this article!). Researchers, too, have become interested … Continue reading →

Sensing the Body: Bodily Experience in Anorexia Nervosa

I’ve been reading a lot of literature on bodies and eating disorders lately as I gear up to write the theoretical paper that becomes the basis of my PhD qualifying exam. Perhaps unsurprisingly, I’ve become a little preoccupied with teasing out my understanding of the relationship between body image and eating disorders in an era in which even saying those words in the same sentence sparks visceral reactions among listeners.

This post is not about whether body image causes eating disorders or not (sorry to disappoint). It is, however, about one of the best articles I’ve stumbled across thus far that seeks to shed some light on the ways in which those with eating disorders (specifically anorexia nervosa, in this case) might experience bodily sensations, which in my view is much more interesting than quibbling about whether body image is the primary causal factor for eating disorders.

In the article, … Continue reading →

Not So Fast: Is There a Connection Between Religious Fasting and Eating Disorders?

I’ve always wondered about how being encouraged to fast for religious reasons might impact those who are vulnerable to eating disorders and those who already have eating disorders. I can’t imagine it would be easy to be around others who were fasting in the name of religion while struggling with an eating disorder. Equally, I can certainly see the dangers of participating in fasting for those who are predisposed to eating disorders.

Despite not being religious myself, however, I understand that fasting is important to some people who subscribe to religions that encourage the practice. So, how might we balance the potential dangers of fasting with the freedom of religious observance? And, what is the impact of religious fasting on individuals with eating disorders, or those developing eating disorders?

In this post, I’ll highlight some of the main findings from 2 studies about religious fasting and eating disorders: one quantitative … Continue reading →

Political Bodies: What is the Impact of National or Regional-Level Eating Disorder Prevention?

When it comes to prevention, I’ve noticed a strong interest in working toward large-scale prevention initiatives. I’ve written about prevention before, noting the potential for unintended effects, as well as schoolgirls’ reactions to and acceptance of prevention interventions (here). But what about the larger scale efforts to prevent body image concerns and eating disorders?

Countries from the US to Australia to Israel have taken strides to implement initiatives aimed at improving national body image (a lofty goal? Perhaps.); you might have heard about bans on thin runway models and airbrushing, among other efforts. We know that eating disorders are not solely caused by thin-ideal internalization or bad body image; in fact, body image might not even be that useful of a concept for everyone, as I wrote about here.

However, improving body satisfaction could be a useful end goal in and of itself. Why not … Continue reading →

Disordered Eating and Athletic Performance: Where’s the Line?

If a person severely restricts his diet and exercises for hours each day, he has an eating disorder. If another does exactly the same but it is because she wants to make the lightweight rowing team (which has an upper weight limit), she’s a committed athlete. When the two overlap, and an athlete presents with eating disorder symptoms, how do we distinguish between the demands of the sport and the illness?

I’ve been interested in the distinctions we make between disordered and non-disordered eating and exercise behaviours for a while now. Recently, when I was browsing through articles, I came across a literature review by Werner et al. (2013) (open access) of studies examining weight-control and disordered eating behaviours in young athletes.

The authors start by noting the sheer lack of research that has actually been done in this area. This is worrying: typical onset of eating disorders is during … Continue reading →

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; … Continue reading →

Eating Disorder Awareness Week: Useful, Useless, or Worse?

National Eating Disorder Awareness Week came and went (in the US, anyway). Posters were shared, liked, and tweeted. Pretty (but often misguided) infographics made the rounds on the internet. Local ED groups visited schools and college campuses to educate students about eating disorders. To, you know, increase awareness. 

The thing is, awareness is not always a good thing. For one, as Carrie over at ED Bites mentioned, there’s a whole lot of misinformation masquerading as fact. And two, awareness campaigns, even when the information in them is correct, may have unintended consequences, like, for example, increasing stigma or self-stigma.

Moreover, not all approaches to increasing awareness or decreasing stigma are equally effective, and the effectiveness of a particular approach may differ depending on the population studied.

So, what about the effectiveness of EDAW? In 2012, Kathleen Tillman and colleagues published a study looking at … Continue reading →