The Genetics of Thin-Ideal Internalization

The Tripartite Model of body image dissatisfaction postulates that three factors (peers, parents, and media) affect body image dissatisfaction and disordered eating through thin-ideal internalization and appearance comparison.

Thin-ideal internalization is the extent to which one accepts or “buys into” socioculturally defined beauty standards of thinness. The idea is that the more someone internalizes these standards, the more likely they are to engage in behaviours to achieve their “ideal”, and the more likely they are to develop an eating disorder.

A growing number of of studies have been done evaluating the validity of this model. Although I’m not well-read on the subject, it does seem like there is a growing number of studies showing an association between thin-ideal internalization and disordered eating practices.

But is the picture complete? Are peers, parents, and media the only or even the main factors that influence the extent of … Continue reading →

Avoiding Refeeding Syndrome in Anorexia Nervosa

Refeeding syndrome (RS) is a rare but potentially fatal condition that can occur during refeeding of severely malnourished individuals (such as anorexia nervosa patients). After prolonged starvation, the body begins to use  fat and protein to produce energy because there are not enough carbohydrates. Upon refeeding, there’s a surge of insulin (because of the ingested carbohydrates) and a sudden shift from fat to carbohydrate metabolism. This sudden shift can lead to a whole set of problems that characterize the refeeding syndrome.

For example, one of the key features of RS is hypophosphotemia: abnormally low levels of phosphate in the blood. This occurs primarily because the insulin surge during food ingestion leads to a cellular uptake of phosphate. Phosphate is a very important molecule and its dysregulation affects almost every system in the body and can lead to “rhabdomyolysis, leucocyte dysfunction, respiratory failure, cardiac failure, hypotension, arrhythmias, seizures, coma, and … Continue reading →

A Study Without a Control Group? Evidence for Enhanced Cognitive Behavioural Therapy for Adults with Anorexia Nervosa

Here’s a quick tip: when a study that purports to find evidence of treatment effectiveness–preliminary or not–doesn’t have a control group (a group that doesn’t undergo treatment but is otherwise similar to the group that does), you should raise your eyebrows. Or shake your head. Or roll your eyes. Whichever you prefer.

Why do we need a control group? If the treatment works, we will see improvement in the patients, so isn’t that evidence enough? Well, no.

[T]he whole idea of an experiment is to identify two identical groups of people and then to manipulate something. One group gets an experimental treatment, and one does not. If the group that gets the treatment (e.g., a drug, exposure to a violent video game) behaves differently than the control group that did not get the treatment, we can attribute the difference to the treatment – but only if we can rest

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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 →