stigma

stigma

This tag is associated with 11 posts

Eating Disorder Awareness Week: Useful, Useless, or Worse?

National Eating Disorder Awareness Week came and went (in the US, anyway). Posters were shared, liked, and tweeted. Pretty (but often misguided) infographics made the rounds on the internet. Local ED groups visited schools and college campuses to educate students about eating disorders. To, you know, increase awareness. 

The thing is, awareness is not always a good thing. For one, as Carrie over at ED Bites mentioned, there’s a whole lot of misinformation masquerading as fact. And two, awareness campaigns, even when the information in them is correct, may have unintended consequences, like, for example, increasing stigma or self-stigma.

Moreover, not all approaches to increasing awareness or decreasing stigma are equally effective, and the effectiveness of a particular approach may differ depending on the population studied.

So, what about the effectiveness of EDAW? In 2012, Kathleen Tillman and colleagues published a study looking at the impact of a “campus-wide, week-long series of psycho-educational and awareness program designed for National Eating Disorders Awareness Week.”

In particular, they assessed individuals’ willingness to seek help, their levels …

Hide or Seek? Social Support and Eating Disorders

Social support has been noted as key in helping individuals with any number of health issues to cope with illness and even thrive in adverse situations (Sarason, Sarason & Pierce, 1990). Individuals with eating disorders may be encouraged, as an adjunct to treatment or even in the absence of formal treatment, to seek out social support to help with the day-to-day management of their disorder (Holt & Espelage, 2002). However, not everyone with an eating disorder seeks out social support; in fact, some may actively avoid seeking support during trying times. To find out more, Akey, Rintamaki & Kane (2012) examined social support seeking among men and women with eating disorders.

The authors interviewed 34 men and women, aged 18-53 (mean age 25) diagnosed with eating disorders and used grounded theory methodology (Glaser & Strauss, 1967) to analyze their data. As explained in a prior post, grounded theory is a qualitative methodology that uses participants’ accounts to develop practical theories that apply to particular situations or phenomena.

Analysis was framed in …

Framing Eating Disorders As “Brain Diseases” Might Lead to More Stigma

Many–myself included–assume that emphasizing the biological basis of mental disorders will reduce mental health stigma. The idea is that it will place less blame and personal responsibility on the affected individual.

Still, when it comes to raising awareness and reducing stigma, we need to make sure that our assumptions hold up to the evidence, otherwise we run the risk of playing a game of broken telephone. Given that this is Eating Disorder Awareness Week in the United States, the topic is particularly timely. Those of us involved in some aspect of mental health awareness don’t want to be saying “x” only to have be interpreted as “y.”

So, the question is–does a biological or genetic framing of eating  disorders lead individuals to hold more positive views of eating disorder sufferers and place less blame on “weak will”?

This is precisely what Matthias Angermeyer and colleagues asked almost 1,350 individuals from two German cities. Angermeyer had them read two vignettes about a woman with either anorexia nervosa or bulimia nervosa (see below) and answer a series of questions aimed at …

Pregnancy, Motherhood, and Eating Disorders: Women’s Experiences

There is a common misconception that eating disorders somehow disappear during pregnancy; that becoming a mother stops all those silly worries about being slim and attractive. This is not necessarily the case, and unfortunately, there is a lot of stigma associated with talking about disordered eating behaviours during pregnancy. Openly admitting to it is an invitation, it seems, to being called selfish and vain. The implication is that eating disorders are something only young girls struggle with, and that pregnancy and motherhood are such big and important things that they should be enough to overcome an eating disorder.

In a large population-based study of 12,254 pregnant women in the UK, over 4% of women experienced past or present eating disorders (Micali et al., 2007). In this study, Tierney and colleagues wanted to find out how those women with present or past eating disorders experienced pregnancy and early motherhood.

They interviewed eight women between the ages of 17 to 37 about their experiences during pregnancy and (if applicable) motherhood. Some women were expecting their first child while others already had three. Five out …

What’s Wrong with How We Talk About Eating Disorders in the Media and in ED Communities – Part 2

This is a follow-up to my last post on what I think can be improved in how we talk about eating disorders in the media and in ED communities. If you haven’t read my last post, I strongly recommend doing so before reading this one. My focus in this post will be on what individuals with a history of EDs and ED organizations can do to improve how eating disorders are perceived by the general public.

(Sidenote on my last post: I feel I didn’t emphasize enough that I used Emma Woolf’s quote as an example and a starting point. I’m confident I’ve made the same blunders that I am now speaking about. It is okay. I think the important thing is to think about our future actions, as opposed to dwelling on the past. My goal isn’t to single anyone out. Woolf is not the first, the last, or the only person to have said things of that nature–her quote was just on my mind since I saw it just a few days ago on tumblr.)

FIRST, FOR THOSE

What’s Wrong with How We Talk About Eating Disorders in the Media and in ED Communities – Part 1

I’m going to do something different today. I’m going to talk about some of the problems I see in how eating disorders are discussed by some media organizations, ED awareness groups, and ED advocates.

This isn’t meant to be an exhaustive list of everything that’s wrong (and there will be a follow-up). It is my personal opinion and I strongly encourage readers to leave comments if you disagree with me or feel that I’m missing something important.

I saw this quote on tumblr two days ago:

Anorexia is a young person’s game and I don’t have the time or energy to play any more.

This quote is amazing for all the wrong reasons. It is so wrong, so harmful, and embodies so much of what’s wrong with mainstream ED discourse. It was written by Emma Woolf. I traced the quote back to this document put out by the UK organization ED awareness organization b-eat.

Let me be clear: I do not care who said this quote, or what was meant by it, or what context it was said in. …

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 any more.)

I think this is important because there are a lot of myths that surround eating disorders and those who suffer from them, and I want to do my part in crushing those myths. Moreover, while restrictive anorexia nervosa is often, at least partly, associated with positive traits …

Genetics: Friend or Foe in Ending Eating Disorder Stigma?

Refrigerator mothers or the idealization of thin models? Toxic families or toxins in our diets? Oh, if only determining the cause (because it has to be just one, right?) of eating disorders was that simple. All behaviour has a biological basis, a neurobiological correlate. The way our brains function—and the resulting behaviours— is due to complex interactions between our genome, epigenome, and the environment. Eating disorders do not have a single cause; we cannot put the blame solely on families, or thin models, vanity or genetics.

As a science grad student, I am interested in how non-scientists interpret scientific findings on mental disorders, particularly eating disorders. With respect to eating disorders, I am interested in how patients’ understanding of the science shapes the way they view themselves and their eating disorders, as well as how it shapes their treatment and recovery.

In a recent paper, Michele Easter wanted to find out just that; she wanted to know how patients with eating disorders view the increasing focus of genetics in eating disorders on ED stigma. She interviewed 50 women with …

UK vs. US in Media Reporting on Eating Disorders: Who Does it Better?

Given the popularity of my post on how the media portrays eating disorders, I thought I’d do a follow-up entry by looking at more recent and comprehensive study on the topic. Specifically, I am going to review Shepherd & Seale’s 2010 paper, which built on the findings of O’Hara & Clegg-Smith, with a UK-focus. In particular, they: (1) compared UK and US media reporting of EDs, (2) tracked changes of in ED coverage over a 17-year period, and (3) studied the differences between newspapers with different target audiences.

Shepherd & Seale reiterate much of what O’Hara & Clegg-Smith wrote: ED specialists and researchers understand that EDs are complex, multi-factorial diseases with complex genetic and environmental underpinnings, that they are often associated with many medical complications and that they are hard to treat. The public, however, largely puts the blame on the patient and/or their parents, viewing it as a “moral failing… underestimating the severity and ease of recovery”, and viewing it as a largely young white female disease. (Unfortunately, some clinicians have this view of EDs as well

Chances Are, What You Know About Eating Disorders is Wrong

Although clinicians (and medical professionals not specializing in eating disorders) often carry a lot of false beliefs about EDs, the public is even worse. Way worse. The portrayal of eating disorders in the news contributes to the myriad of myths and misconceptions that surround EDs. O’Hara and Clegg-Smith wanted to find out how exactly newspapers “contribute to shaping public perception of EDs.” 

It is awful when doctors are dismissive and ignorant, but it is even worse when you encounter these attitudes from your friends and family. When they not only don’t get it, they don’t want to get it. As O’Hara & Clegg-Smith point out, this ignorance and “disconnect potentially prevents timely ED diagnosis and reinforces a stigma that limits treatment availability.”

While researchers and ED specialists increasingly understand that eating disorders are “caused by a combination of genetic and environmental factors” (for example, evidence from twin studies suggests that genetic factors account for >50% of the risk for developing an ED), the public does not. 

Surveys of what the public thinks about eating disorders and those struggling …

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