You Sure You Want to Eat That? Perceived Consequences of Eating & Its Relation to Recovery

I recently had a total Aha! moment (or a why-didn’t-I-ever-think-of-it moment) when I had chanced upon a recently published article titled “Eating Expectancies in Relation to Eating Disorder Recovery” by Fitzsimmons-Craft and colleagues. The title caught my attention because I had never come across any research tying eating expectancies to eating disorders, though I was familiar with the concept from the health psychology and obesity literature. Eating, as a behaviour and as a mechanism, is incredibly complex, with many factors contributing to why and how we eat; eating expectancies are one such factor.

Expectancy theory, first proposed by Tolman (1932), suggests that expectancies, or assumptions about the consequences of various behaviours, develop as a result of one’s learning history (Smith et al., 2007). Such expectancies are thought to influence subsequent behavioural choices, with one acting to either increase the likelihood of reward … Continue reading →

The Enigmatic Persistence of Anorexia Nervosa

Anorexia nervosa was first described in the medical literature in 1689 by Richard Morton. It has been over 300 years since then and AN continues to be one of the deadliest psychiatric disorders. If not treated early, it runs the risk of becoming deeply entrenched and highly resistant to treatment.

Moreover, established treatments for related disorders like bulimia nervosa and depression, such as cognitive behavioural therapy and antidepressants, are rather ineffective in treating anorexia nervosa. Finally, even if significant physical and mental improvements are achieved in treatment, relapse rates for older individuals (even those in their 20s) remain high.

What makes anorexia nervosa so persistent and so hard to treat in individuals who develop it, particularly if it is not treated soon after onset? Why is recovery so hard?

In this paper, B. Timothy Walsh outlines a model based on cognitive neuroscience that attempts to answer these questions:

Its

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Bingeing and Purging: Keeping the “Positives” and Eliminating The Negatives?

I have been fascinated and perplexed by reports of the seemingly invigorating and anxiety reducing effects of bingeing and purging (purging by self-induced vomiting). Personally, I cringe at the idea of self-induced vomiting and have always wanted to avoid vomiting at all costs, including during food poisoning. The insight from recent blog entries and the subsequent comments has made an impact on me. I see that the motivation to engage in bingeing/purging behavior can be intense and can provide an effective way increase positive affect and reduce stress. The ameliorating effects of bingeing/purging remind me of drug addiction, with bingeing/purging behavior as the “drug.”  This made me wonder, what happens in the brain to impart such “addiction-like” reinforcement?

I know there are reports of opiate and endorphin release following purging, but to me, this seemed like an effect meant to counter the intense aversion (and discomfort?) of the … Continue reading →

What's The Point of Bingeing and Purging? And Why Can't You Just Stop?

I defended my MSc on Tuesday and I’m not going to lie: I was pretty symptomatic with bulimia in the days prior to my defence. As I explained to my boyfriend: the anxiety-reducing effects of purging are so powerful, and the compulsion to binge and purge (when I’m stressed/anxious/”not okay”) is so strong that it is much easier to do it, get it over with, and continue working (in a much calmer state).

I’ve mentioned before, for me, purging is very anxiety-reducing and in some ways, almost a positive experience. It is so tightly coupled with bingeing that it is hard to separate the two, but the anxiety-reducing effects are strongest when I binge and purge, non-existent when I binge, and weak when I purge a normal meal (which is exceptionally rare/almost never.)

It turns out, of course, that I’m not alone.

Negative emotional states and stressors have long been … Continue reading →