Beyond the Muscular Ideal: Talking About Eating Disorders and Masculinity

There’s a growing acknowledgment that women/feminine-presenting people are not the only people who get eating disorders. Increasingly, headlines proclaim that “men get eating disorders too!” and note that the stereotype that eating disorders are a “girl thing” is tired and problematic. This is great – anything that breaks down the well-entrenched notion that only young, rich, skinny, white, cis- and hetero girls are the only ones to get eating disorders is a welcome move in my opinion.

However, are we just reinscribing gender norms and the focus on body image and body ideals in the way we talk about eating disorders in boys and men? I just finished reading an article by Wright, Halse & Levy (2015) asking just this question. The article provides a compelling argument for re-visioning how we talk about eating disorders amongst boys and men.

Discourses

Wright, Halse & Levy explore discourses around eating disorders … Continue reading →

Poverty and Eating Disorders in Hong Kong

Eating disorders are typically seen as an illness of the middle class, with most patients coming from that socioeconomic group. However, the invisibility of poorer patients within eating disorder research in part reflects the barriers to treatment that they face, including both cost and lower levels of awareness. This paper, written by a Hong Kong social work professor, Joyce Ma, focuses less on the process of eating disorder recovery, highlighting instead the context of treatment. She discusses how family dynamics and socioeconomic status come into play in her encounters with 7 Hong Kong teenagers from low-income families.

While her sample size is very small, it reveals a more diverse — and less body image-focused –disease pathway than most American studies, with Ma breaking down the precipitating factors as follows (patient numbers in brackets):

  • Constipation (1)
  • Desire to be thin (3, 7)
  • Relationship issues (6)
  • Parental conflicts (5)
  • Poverty (2,
Continue reading →

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 … Continue reading →

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. … Continue reading →

Is Anorexia Nervosa an Anxiety Disorder?

Anxiety disorders (ADs) are common among patients with eating disorders. In one study of female inpatients, around 50-65% had a comorbid anxiety disorder (see my post here). Anxiety disorders in patients with anorexia nervosa (AN) typically begin before the eating disorder and often persist after weight restoration and recovery (Bulik et al., 1997; Casper, 1990). Moreover, previous twin studies have suggested that there’s a “correlation between eating disorders and certain anxiety and depressive disorders, suggesting they comprise a spectrum of inherited phenotypes” (Hudson et al., 2003; Mangweth et al., 2003).

In this paper, Michael Strober and colleagues hypothesized that anxiety disorders and anorexia nervosa share common genetic, neural, and/or behavioural mechanisms. As such, they sought to investigate the association of AN with ADs by studying the prevalence of ADs in first-degree relatives of AN patients and comparing it to the prevalence of ADs in first-degree relatives of Continue reading →

Pregnancy, Motherhood, and Eating Disorders: Women's Experiences

There is a common misconception that eating disorders somehow disappear during pregnancy; that becoming a mother stops all those silly worries about being slim and attractive. This is not necessarily the case, and unfortunately, there is a lot of stigma associated with talking about disordered eating behaviours during pregnancy. Openly admitting to it is an invitation, it seems, to being called selfish and vain. The implication is that eating disorders are something only young girls struggle with, and that pregnancy and motherhood are such big and important things that they should be enough to overcome an eating disorder.

Over recent decades, eating disorders have entered the public’s consciousness. They are regularly discussed, and often trivialized, in the popular media, depicted as no more than dieting gone wrong or overzealous weight loss. Yet these conditions warrant serious consideration because they are potentially life-threatening and can persist for years, ruining individuals’ long-term

Continue reading →

Predictors of Diagnostic Crossover and Symptom Fluctuation in Eating Disorders

Symptom fluctuation and diagnostic crossover are common in eating disorder patients. A study by Eddy et al. (2008) – who followed patients over an average of 7 years – showed that crossover between subtypes and full-syndrome diagnoses is very common : of those initially diagnosed with anorexia nervosa, almost 73% crossed over to another diagnosis (between symptoms and to bulimia nervosa). More specifically, roughly 50% experienced fluctuation between subtypes (restricting, AN-R, and binge/purge type, AN-BP) and roughly 35% crossed over to bulimia nervosa (a subset experienced both). Of those initially diagnosed with bulimia, roughly 14% crossed over to AN-BP and of those, 3.91% crossed over to AN-R.

This finding (though, well-known to ED specialists and even more well-known to patients) has important implications for treatment. For example, CBT and anti-depressants seem to have positive results in bulimic patients, but not so much in anorexics. What then, about those that crossover … Continue reading →