Dancing Your Way to Recovery from Anorexia Nervosa

The idea of including dance and movement in interventions for eating disorders may seem somewhat controversial; generally, exercise and physical activity are discouraged for individuals recovering from eating disorders. Including dance in therapeutic interventions might raise a few eyebrows given the links between appearance-oriented athletic endeavors such as ballet and gymnastics and the development of eating disorders.

However, some therapists and scholars interested in alternative therapies for eating disorders have suggested that certain forms of movement therapy may help individuals with eating disorders connect to their bodies in a different, more positive way.

In 2011, two such scholars from Portugal, Padrão & Coimbra, published a 6-month pilot intervention for individuals hospitalized for anorexia nervosa (AN) based around body movement.

Their aims were twofold:

  1. Find out more about the links between body movement and bodily experience in individuals with AN
  2. Observe the ways in which individuals with AN move
Continue reading →

Mobile Therapy: Using Text-Messaging to Treat Bulimia Nervosa

Cognitive-behavioural therapy (CBT) is one of the most commonly used approaches to treat bulimia nervosa, but even CBT (or any treatment) doesn’t work for everyone. Sometimes, even if CBT is helping, a weekly 50 minute therapy session is just not enough. Moreover, like with many other eating disorder treatments, dropout and relapse rates are high.

Although CBT is effective for 40–67% of patients, efforts are required to augment and improve  treatment to better serve individuals who drop out (0–33%), fail to engage (14%), or relapse (33%). The highest risk period for relapse is in the 6 months after treatment, with risk declining at 4-year follow-up. After 10 years, 11% of individuals originally diagnosed with BN continued to meet full diagnostic criteria for BN and 18.5% met criteria for eating disorder not otherwise specified.

What can be done to help the individuals that don’t benefit (or benefit fully) from CBT, … Continue reading →

The “Double Life” of Bulimia Nervosa: Patients’ Perspectives

My psychiatrist once compared my life to Dexter. He said I was living a double life. It was the summer before my final year in undergrad and I was working in a neuroscience lab. Yet things were so bad that at one point I was very close to quitting and doing Day Program treatment. (I didn’t, and things ended up getting better, thankfully.)

This post is going to be more personal than most. One, I can relate well to the topic. Two, I feel that I can give voice to it under my real name. (As opposed to just discuss it abstractly, or anonymously. There’s nothing wrong with being anonymous, but I feel that, for many reasons I am in a position where I don’t feel I have to be anonymous anymore.)

I think this is important because there are a lot of myths that surround eating disorders and … Continue reading →

Does the Media Cause Eating Disorders? Disordered Eating in Iranian Women: From Tehran to Los Angeles

What is the impact of Western culture on eating disorders? Do images of thin cause eating disorders? I mean, it seems like such a nice and simple hypothesis. It makes intuitive sense: glamorize thin and make thin cool and BAM, everyone wants to be thin. It would be so much easier. Cause? Found. Solution? Easy: ban thin models. Unfortunately (or fortunately for me, since it gives me a lot to blog about) the answer is not that simple.

Just in the last couple of hours, some people who’ve ended up on the SEDs blog have searched:

  • does the media cause eating disorders
  • thin models on tv cause eating disorders to young girls
  • do models influence anorexia
  • ultra thin models causing eating disorders
  • magazine article eating disorders caused by the media
  • and the rare: media doesn’t cause eating disorders

I’m sure most of these search terms lead people to … 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 →

Devil in the Details: Can Poor Cognitive Function be Attributed to Anorexia Nervosa Patients’ Obsession with Detail?

Hi all, Gina here, again. This article is short and sweet, as is my post. I’m becoming increasingly interested in some of the more cognitive aspects of eating disorders and seeing as my background on the subject is pretty limited (re: none, although I’m taking a cognitive science class this term), I was hoping to generate some discussion /or references from readers that I could incorporate into further posts. Cheers!

It has long been suggested that people with eating disorders (in this case, specifically anorexia nervosa) display some core deficits in cognitive ability — namely impairments in executive function (Fassino et al., 2002; Pendleton Jones et al., 1991; Tchanturia et al., 2001, 2002, 2004).

If you’re like me and don’t study cognitive science, executive function basically means that people with AN show abnormal mental rigidity, working memory, capacity to manage impulsive responses (response disinhibition) and abstraction skills (i.e. abstract … Continue reading →

How Do Anorexia Nervosa Patients Define Recovery and Engage in Treatment? The Need for Individualized Treatment

One difficulty in measuring rates of recovery for patients with anorexia nervosa (AN) is coming up with a cohesive definition of “recovery” that most of us can agree on. Similarly, it is hard to identify whether a particular treatment course is working when the patient and the clinician have different goals in mind. A 2010 study by Alison Darcy and colleagues (article is freely available here) – in an attempt to understand the patients’ goals – aims to explore how patients define recovery and engage in treatment. This study differs from a lot of the literature on treatments and recovery in that all the data comes from individuals with a lifetime history of AN. The population sampled includes 20 women with a mean age of just slightly over 29 (range from 19-52). This is a small sample size, which can make it difficult to generalize responses, and the information … Continue reading →

Eating Disorders and Psychiatric Comorbidities in Female Inpatients

Patients with eating disorders commonly exhibit comorbid psychiatric disorders, including anxiety, depression and OCD. The presence of comorbid disorders has been shown to exacerbate the severity and chronicity of the disorder, and unfavourably affect treatment outcome. Moreover, comorbid disorders may necessitate specialized treatment plans that take into account all the co-occuring disorders. Recovery from an eating disorder is hard enough, but when it is complicated by depression and severe anxiety, it can be a lot harder.

Nonetheless, commonly co-occuring psychiatric disorders may also provide researchers and clinicians clues about the etiology of eating disorders, the underlying neuronal processes as well as possible pharmacological interventions.

Researchers have been identifying disorders that commonly co-occur with eating disorders and studying the differences in co-morbidity between disorders. I picked one to write about today, it is a study by Blinder and colleagues that came out in 2007. It is by no means … Continue reading →

More on the Problematic EDNOS Category (and Diagnostic Crossover)

I’ve been thinking a lot lately about the eating disorder not otherwise specified (EDNOS) category. ED-NOS is a diagnostic category for all individuals with subthreshold anorexia or bulimia nervosa or those with a mix of symptoms that don’t fit neatly into AN or BN. ED-NOS is essentially everything else. A mixed bag, if you will. It doesn’t tell the clinician nor the researcher anything useful, outside of what it isn’t. So, is there any use for it? If it doesn’t tell the clinician about patient symptoms or guide choice of treatment, why even bother? Does it help researchers understand EDs or do they just want to avoid this messy and heterogenous group (that by the way makes up most of those with eating disorders)? In this entry (and many more to come), I want to further explore these questions.

There’s been a push by researchers to minimize the … Continue reading →

A Case Against Eating Disorder Not Otherwise Specified (EDNOS)

This study is a follow up on the previous study (last entry) which examined the problems with the EDNOS classification, the frequency of transitions between eating disorders and how the DSM should be changed to reflect the clinical reality of eating disorders (and what is the clinical reality?)

In this study, Eddy and colleagues followed 246 women who were initially diagnosed with either AN or BN, for an average of 9 years. The main goal was to study the growing disparity between (1) the consensus that eating disorders are not stable overtime and how (2) the current diagnostic criteria which do not adequately address this, by following the clinical presentation of EDs overtime and providing suggestions for the upcoming DSM-V.

EDNOS is an often ignored category in research–in main part because it is difficult to study such a heterogeneous group. Nonetheless, Eddy et al. summarize some interesting findings … Continue reading →