The Finest Quality Snake Oil: Mandometer(r) Treatment for Eating Disorders – Part I

PROTIP: When selling your snake oil treatment, try NOT to make wildly outrageous efficacy claims. But if you can’t resist that temptation, try to limit your hard-to-believe, eye-roll-inducing claims to your treatment — there’s no need to go further.

In this post, I’m going to give a brief history of the Mandometer® treatment and its apparent rationale. In the next one or two posts, I will do an analysis of the most recently study by the group that claims to show remission rates of 75% and relapse rates of only 10%. Sounds great, right? Well… we’ll see.

We suggest that the reason self-starving patients do not fit the DSM-IV criteria of anorexia nervosa is because there is in fact no psychopathological basis of the disorder … The DSM-IV offers no definition [of psychopathology], but it is reasonable to assume that a psychopathological basis of anorexia nervosa would be

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Excessive, Obsessive, Compulsive? The Links Between OCD, OCPD and Excessive Exercise in Anorexia Nervosa

Excessive exercise played a big role in my eating disorder and, predictably, I am drawn to studies that look at the role excessive exercise plays in eating disorder symptomatology, course and outcome. This topic has captured the interest of many eating disorder researchers, with studies revealing that up to 80% of individuals with anorexia nervosa may exercise excessively (Davis et al., 1997), though others suggest more modest statistics, around 39% (Shroff et al., 2006; Tetyana wrote a post about this article here).

Scholars have also noted the potentially obsessive and compulsive nature of exercise among some individuals with eating disorders and have made the natural transition toward examining whether links exist between excessive exercise and obsessive-compulsive disorder (OCD) and/or obsessive-compulsive personality disorder (OCPD) traits (If you are confused about the difference between OCD and OCPD, click here). Young, Rhode, Touyz & Hay (… Continue reading →

Over-Exercise is Associated With Suicidality in Individuals with Disordered Eating

Last week, I blogged about a study that examined personality traits and clinical variables associated with excessive exercise in eating disorder patients. In that study, 2 out of 5 participants engaged in excessive exercise. Today, I’m going to discuss a study that suggests over-exercise in disordered eating patients is associated with suicide behaviour.

Suicide rates in eating disorder patients are high. One meta-analysis suggested that out of all eating disorder related deaths, 1 in 5 are suicides. (Keep in mind, these numbers are really hard to pin down as they depend a lot on the sample population, sample size, and how the authors did their statistics, among other things.)

Another analysis found that the standardized mortality ratio (ratio of observed deaths in the study sample/expected deaths in the population of the same age but without the disease/disorder you are studying) for suicide in eating disorders was 31 for patients … Continue reading →

Excessive Exercise in Eating Disorders

Excessive exercise (EE) is common among eating disorder patients. Indeed, in the study I’ll write about today, 39% of patients engaged in EE. Previous studies have tried to find psychopathological and personality correlates of EE but the results have been inconsistent. Some studies have suggested that impulsivity and addictiveness are highly correlated with EE whereas others found that anxious and depressive traits were more closely associated.

In a retrospective case series study involving outpatients with AN and BN, Penas-Lledo et al. found higher levels of anxiety and depression… among those who were identified as exercising excessively. The authors claimed that exercise might serve to reduce anxiety and stress in individuals with AN. In a similar study with adolescent inpatients with AN, Holtkamp et al. found that anxiety significantly predicted variance in exercise levels. These investigators proposed that anxiety symptoms in combination with food restriction contributed to increased levels

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