Disordered Eating and Athletic Performance: Where’s the Line?

If a person severely restricts his diet and exercises for hours each day, he has an eating disorder. If another does exactly the same but it is because she wants to make the lightweight rowing team (which has an upper weight limit), she’s a committed athlete. When the two overlap, and an athlete presents with eating disorder symptoms, how do we distinguish between the demands of the sport and the illness?

I’ve been interested in the distinctions we make between disordered and non-disordered eating and exercise behaviours for a while now. Recently, when I was browsing through articles, I came across a literature review by Werner et al. (2013) (open access) of studies examining weight-control and disordered eating behaviours in young athletes.

The authors start by noting the sheer lack of research that has actually been done in this area. This is worrying: typical onset of eating disorders is during … Continue reading →

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 →

Rigid Food Rules in Eating Disorders: Is Perfectionism to Blame?

I remember cutting baby carrots into 6 pieces. Rushing home to eat because I wasn’t “allowed” to eat after 7 pm. Eating the exact portion size–no more, no less. (Oh the rules. I don’t miss them.) Rigid food rules are very common among eating disorder sufferers. These rules can be about anything: the foods you are allowed to eat, how you are allowed to eat them, the time you are allowed to eat them, and so on.

But where do they come from? Why do some individuals have more rules and more ritualistic behaviours than others?

It is a complex question, but a recent study suggests that perfectionism might play a role. Specifically, the authors explored the idea that perfectionism mediates adherence to food rules in disordered eating behaviours. In order words, food rules might be a way in which perfectionism “expresses itself” in eating disorders.

Why perfectionismContinue 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

Continue reading →

3 Personality Subtypes in Eating Disorder Patients: Which One Fits You?

Scientists love classifying and categorizing things they study. But it can be a double-edged sword. Classification can lead to new insights about etiology or new treatment methods. But classification can also hamper our understanding. For example, researchers like to classify and study anorexia nervosa and bulimia nervosa as if they are two wholly separate disorders, but clinicians know that most patients fluctuate between diagnoses, and as a result often fall into the eating disorder not otherwise specified (EDNOS) category.

Nonetheless, if we keep in mind that the way in which we classify things can be very artificial and may not necessarily reflect some fundamental truths about the subject matter, we can focus on extracting the insights gained from the classifications.

In the case of eating disorders, classifying patients into subtypes may be useful for developing successful treatment approaches suited for particular patient subgroups.

Previous research on this topic has identified … 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 →