There’s been a fair bit of talk lately (ok, always) about evidence in eating disorders. In addition to the evidence for certain types of treatment, there’s talk about evidence for causes of eating disorders, evidence for whether recovery is possible, and more. The framing I generally see advanced is that we need to be using evidence-based practice only; presumably, this evidence comes from scientific research. I don’t disagree, but in this post I’ll be writing about how science is never wholly objective and is situated in social context.
Let the record show that I love science. I love all kinds of science: biological science, genetic science, neuroscience, social science, you name it, I think learning and research and scientific methods are interesting. I can’t do all kinds of science; as Tetyana says, this blog itself has moved away from “science” as she originally intended it as I continue to dominate … Continue reading →
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 →
Eating disorders are rarely static. Symptoms fluctuate, waxing and waning as circumstances change. Often, these fluctuations lead to diagnostic crossover–between subtypes of one disorder or to a different eating disorder altogether. The heterogeneity of symptom severity and frequency led to the establishment of the “eating disorder not otherwise specified” diagnosis in the Diagnostic and Statistical Manual. Essentially, it is everything that doesn’t quite fit into the “anorexia nervosa” or “bulimia nervosa” categories. (For example, I would guess that it is a common diagnosis for patients who fail to meet the “amenorrhea” criterion for the AN diagnosis.)
ED-NOS is a category for everything that doesn’t conform to some rather arbitrary criteria required for bulimia nervosa and anorexia nervosa, meaning: it is the diagnosis for a lot of people. Okay, that’s not very scientific, I know, but I wouldn’t trust these numbers anyway–usually people who fall into this category don’t … Continue reading →