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Science of Eating Disorders
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- June 8, 2013
- 07:43 PM
- 88 views
Posttraumatic Stress Disorder in Women with Bulimia Nervosa
by Tetyana Pekar in Science of Eating Disorders
Posttraumatic stress disorder (PTSD) is 3-5 times more prevalent in individuals with bulimia nervosa (BN) than those without (Dansky et al., 1997). However, the relationship between PTSD and BN–in particular, how PTSD might affect or moderate bulimic symptoms–remains largely unexplored. In a recent study, Trisha Karr and colleagues followed 119 women (20 with PTSD and BN, and 99 with BN only) for 2-week period to investigate whether participants with comorbid PTSD + BN dif........ Read more »
Karr, T., Crosby, R., Cao, L., Engel, S., Mitchell, J., Simonich, H., & Wonderlich, S. (2013) Posttraumatic stress disorder as a moderator of the association between negative affect and bulimic symptoms: an ecological momentary assessment study. Comprehensive Psychiatry, 54(1), 61-69. DOI: 10.1016/j.comppsych.2012.05.011
- June 4, 2013
- 10:10 PM
- 50 views
Is Anorexia Nervosa a Subtype of Body Dysmorphic Disorder?
by Tetyana Pekar in Science of Eating Disorders
Is anorexia nervosa a subtype of body dysmorphic disorder (BDD)? Well, probably not, but don’t click the close button just yet. In this post, I’ll explore the relationship between anorexia nervosa and BDD, and discuss how understanding this relationship might help us develop better treatments for both disorders.
Despite the fact that there are obvious similarities between the disorders, studies exploring the relationship between BDD and AN are few and far between. ........ Read more »
Hartmann AS, Greenberg JL, & Wilhelm S. (2013) The relationship between anorexia nervosa and body dysmorphic disorder. Clinical psychology review, 33(5), 675-685. PMID: 23685673
- May 24, 2013
- 01:13 PM
- 30 views
The Genetics of Thin-Ideal Internalization
by Tetyana Pekar in Science of Eating Disorders
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 ac........ Read more »
Suisman, J., O'Connor, S., Sperry, S., Thompson, J., Keel, P., Burt, S., Neale, M., Boker, S., Sisk, C., & Klump, K. (2012) Genetic and environmental influences on thin-ideal internalization. International Journal of Eating Disorders, 45(8), 942-948. DOI: 10.1002/eat.22056
- April 28, 2013
- 11:57 PM
- 78 views
Factors Associated with Recovery from Anorexia Nervosa
by Tetyana Pekar in Science of Eating Disorders
Why do some people recover anorexia nervosa relatively quickly while others seem to struggle for years or decades? Does it depend on the person’s desire to get better? Their willpower? How much they are willing to fight? Is it just that some try harder than others? Some might say yes, but most will correctly realize that the picture is much, much more complex.
We can spend hours talking about barriers to treatment, but in this post I want to talk about something slightly different, somethi........ Read more »
Zerwas, S., Lund, B., Von Holle, A., Thornton, L., Berrettini, W., Brandt, H., Crawford, S., Fichter, M., Halmi, K., Johnson, C.... (2013) Factors associated with recovery from anorexia nervosa. Journal of Psychiatric Research. DOI: 10.1016/j.jpsychires.2013.02.011
- April 22, 2013
- 03:51 PM
- 133 views
Family-Based Treatment for Adolescents with Anorexia Nervosa: Hype or Hope?
by Tetyana Pekar in Science of Eating Disorders
When it comes to eating disorder treatment, few (if any) approaches are as divisive as Family-Based Treatment, also known as the Maudsley Method (I’ll use the terms interchangeably) . When I first heard about Maudsley, sometime during my mid-teens, most likely through an ED recovery community on Livejournal, I thought it was scaaary. But as I’ve learned more about it, my opinion changed (although, it does still seem kind-of scary).
As a side-note: I know many peop........ Read more »
Smith, A., & Cook-Cottone, C. (2011) A Review of Family Therapy as an Effective Intervention for Anorexia Nervosa in Adolescents. Journal of Clinical Psychology in Medical Settings, 18(4), 323-334. DOI: 10.1007/s10880-011-9262-3
- April 18, 2013
- 10:18 AM
- 87 views
Nonpurging Bulimia Nervosa: Where Does It Fit?
by Tetyana Pekar in Science of Eating Disorders
When most people think of bulimia nervosa, they think of binge eating and self-induced vomiting. While that is not incorrect, it is not the full picture either. In the current edition of the Diagnostic and Statistical Manual (DSM-IV), there are two subtypes of bulimia nervosa: purging (BN-P) and nonpurging (BN-NP). The difference lies in the types of compensation methods: patients with BN-P engage in self-induced vomiting, or the misuse of laxatives, diuretics, or enemas whereas patients with BN........ Read more »
van Hoeken, D., Veling, W., Sinke, S., Mitchell, J., & Hoek, H. (2009) The validity and utility of subtyping bulimia nervosa. International Journal of Eating Disorders, 42(7), 595-602. DOI: 10.1002/eat.20724
- April 15, 2013
- 12:27 AM
- 112 views
What’s The Point of Bingeing and Purging? And Why Can’t You Just Stop?
by Tetyana Pekar in Science of Eating Disorders
I defended my MSc degree on Tuesday and I’m not going to lie: I was pretty symptomatic with bulimia in the days prior to my defence. As I was explaining 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-........ Read more »
Smyth, J., Wonderlich, S., Heron, K., Sliwinski, M., Crosby, R., Mitchell, J., & Engel, S. (2007) Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75(4), 629-638. DOI: 10.1037/0022-006X.75.4.629
- March 30, 2013
- 09:38 AM
- 166 views
Eating Disorders in the Elderly
by Tetyana Pekar in Science of Eating Disorders
The first published case of a late-onset eating disorder (at the age of 40) was in 1930 by John M. Berkman. In 1936, John A. Ryle published a case study of an eating disorder in a 59-year-old woman. Just how common are eating disorders in late middle-age or elderly individuals?... Read more »
Lapid, M., Prom, M., Burton, M., McAlpine, D., Sutor, B., & Rummans, T. (2010) Eating disorders in the elderly. International Psychogeriatrics, 22(04), 523-536. DOI: 10.1017/S1041610210000104
- March 25, 2013
- 12:08 AM
- 135 views
Are There Any Meaningful Differences Between Subthreshold and Full Syndrome Anorexia Nervosa?
by Tetyana Pekar in Science of Eating Disorders
I see this on an daily basis: patients with subtreshold eating disorders feeling invalidated and “not sick enough.” They are struggling so much, but maybe they still have their periods, or maybe their weight isn’t quite low enough, and so they often (but not always, thankfully) get dismissed by doctors, other healthcare professionals, and insurance companies. Do you think you really need this treatment, maybe you can just focus on eating healthier? You know you are not fat, you........ Read more »
Le Grange, D., Crosby, R., Engel, S., Cao, L., Ndungu, A., Crow, S., Peterson, C., Mitchell, J., & Wonderlich, S. (2013) DSM-IV-Defined Anorexia Nervosa Versus Subthreshold Anorexia Nervosa (EDNOS-AN). European Eating Disorders Review, 21(1), 1-7. DOI: 10.1002/erv.2192
- March 18, 2013
- 03:30 PM
- 143 views
Demystifying the Genetics of Eating Disorders – Part II
by Tetyana Pekar in Science of Eating Disorders
In my last post I talked about some methods that scientists use to study the genetics of eating disorders. I focused on a subfield of genetics called behavioural genetics (which you can think of as a field that attempts to understand, in part, the interplay of genetics and environment in behaviour). In this post I’ll shift gears and focus on molecular genetics. I’ll be working of the same review paper by Drs. Zerwas and Bulik (2011). Molecular geneticists study the structure and........ Read more »
Zerwas, S., & Bulik, C. (2011) Genetics and Epigenetics of Eating Disorders. Psychiatric Annals, 41(11), 532-538. DOI: 10.3928/00485713-20111017-06
- March 15, 2013
- 09:50 PM
- 186 views
Demystifying the Genetics of Eating Disorders – Part I
by Tetyana Pekar in Science of Eating Disorders
Today I thought I’d take the time to do an overview of what researchers know about the genetics of eating disorders and try to clear up some common misconceptions. The bulk of the content in this blog post comes from a very nice review paper published in 2011 by Drs. Stephanie Zerwas and Cynthia Bulik on the genetics and epigenetics of eating disorders. In an effort to keep blog posts short, this will be a multi-part mini-series.
When it comes to the genetics of eating disorders, there are........ Read more »
Zerwas, S., & Bulik, C. (2011) Genetics and Epigenetics of Eating Disorders. Psychiatric Annals, 41(11), 532-538. DOI: 10.3928/00485713-20111017-06
- March 13, 2013
- 12:04 AM
- 163 views
Avoiding Refeeding Syndrome in Anorexia Nervosa
by Tetyana Pekar in Science of Eating Disorders
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 o........ Read more »
O'Connor G, & Goldin J. (2011) The refeeding syndrome and glucose load. The International journal of eating disorders, 44(2), 182-5. PMID: 20127933
Kohn, M., Madden, S., & Clarke, S. (2011) Refeeding in anorexia nervosa. Current Opinion in Pediatrics, 23(4), 390-394. DOI: 10.1097/MOP.0b013e3283487591
- March 8, 2013
- 11:49 AM
- 204 views
Deep Brain Stimulation for Severe Anorexia Nervosa
by Tetyana Pekar in Science of Eating Disorders
This week, a team of researchers from the University of Toronto published a paper in The Lancet describing the results of a small study using deep brain stimulation (DBS) to treatment severe/chronic anorexia nervosa. Major news outlets, including the BBC, reported on the findings. A few people emailed and messaged me asking me to do a post about it (which is cool! I love it!). So here it is.
DBS is a surgical procedure that involves implanting an electrode that delivers electrical........ Read more »
Lipsman, N., Woodside, D., Giacobbe, P., Hamani, C., Carter, J., Norwood, S., Sutandar, K., Staab, R., Elias, G., Lyman, C.... (2013) Subcallosal cingulate deep brain stimulation for treatment-refractory anorexia nervosa: a phase 1 pilot trial. The Lancet. DOI: 10.1016/S0140-6736(12)62188-6
- March 3, 2013
- 11:24 PM
- 184 views
Is Living in an Urban City a Risk Factor for Bulimia Nervosa?
by Tetyana Pekar in Science of Eating Disorders
The link between urban living and mental disorders such as schizophrenia and depression has been known for quite some time (Sundquist et al., 2004). In one study, Sundquist et al found that individuals living in a densely populated area had a 68-77% higher risk of developing psychosis and 12-22% higher risk of developing depression.
The question then arises, do eating disorders follow a similar pattern? And if yes, what are some possible explanations? Certainly we know that both genetic and envi........ Read more »
VAN SON, G., VAN HOEKEN, D., BARTELDS, A., VAN FURTH, E., & HOEK, H. (2006) Urbanisation and the incidence of eating disorders. The British Journal of Psychiatry, 189(6), 562-563. DOI: 10.1192/bjp.bp.106.021378
- February 28, 2013
- 04:26 PM
- 200 views
Framing Eating Disorders As “Brain Diseases” Might Lead to More Stigma
by Tetyana Pekar in Science of Eating Disorders
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, th........ Read more »
Angermeyer, M., Mnich, E., Daubmann, A., Herich, L., Wegscheider, K., Kofahl, C., & Knesebeck, O. (2013) Biogenetic explanations and public acceptance of people with eating disorders. Social Psychiatry and Psychiatric Epidemiology. DOI: 10.1007/s00127-012-0648-9
- February 25, 2013
- 05:30 PM
- 187 views
Rigid Food Rules in Eating Disorders: Is Perfectionism to Blame?
by Tetyana Pekar in Science of Eating Disorders
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 indivi........ Read more »
Brown, A., Parman, K., Rudat, D., & Craighead, L. (2012) Disordered eating, perfectionism, and food rules. Eating Behaviors, 13(4), 347-353. DOI: 10.1016/j.eatbeh.2012.05.011
- February 20, 2013
- 09:16 PM
- 172 views
Lifetime Prevalence of Eating Disorders Among Eating Disorder Professionals
by Tetyana Pekar in Science of Eating Disorders
How many professionals that treat eating disorders have a personal history of struggling with an eating disorder? It is a crucial question to ask (and answer) because there are important implications for patient treatment and for the health of the afflicted professionals. It is true that many (or most?) individuals who go into mental health do so because of personal experiences–whether due to their own personal history or the experiences of a loved one–so it is useful to ask, just ho........ Read more »
BARBARICH, N. (2002) Lifetime Prevalence of Eating Disorders Among Professionals in the Field. Eating Disorders, 10(4), 305-312. DOI: 10.1080/10640260214505
- February 17, 2013
- 11:45 PM
- 218 views
Shared Genetics Between Disordered Eating and Periods (Menses)
by Tetyana Pekar in Science of Eating Disorders
Puberty at an early age increases the risk for disordered eating behaviours such as bingeing and purging (Jacobi et al., 2004; Kaltiala-Heino et al., 2001). What’s more, the hormone estradiol moderates the risk of disordered eating behaviours. More precisely, in a group of twins with low estradiol levels, differences in disordered eating are likely due to environmental factors (such as family, school, friends), but in a group of twins with high estradiol levels, the differences in dis........ Read more »
Baker JH, Thornton LM, Bulik CM, Kendler KS, & Lichtenstein P. (2012) Shared genetic effects between age at menarche and disordered eating. The Journal of Adolescent Health, 51(5), 491-6. PMID: 23084171
- February 14, 2013
- 11:58 PM
- 257 views
Personality Traits after Recovery from Eating Disorders: Do Anorexia and Bulimia Patients Differ?
by Tetyana Pekar in Science of Eating Disorders
When we think about eating disorders, we tend to think about eating disorder subtypes: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder. A lot of previous work has shown that individuals with AN and BN tend to be anxious, depressed, perfectionistic, and harm-avoidant. Patients with AN also tend to score low on novelty-seeking, impulsivity, and self-directedness, whereas patients with BN score high on novelty-seeking and impulsivity. More recently, however, some researchers ........ Read more »
Wagner, A., Barbarich-Marsteller, N., Frank, G., Bailer, U., Wonderlich, S., Crosby, R., Henry, S., Vogel, V., Plotnicov, K., McConaha, C.... (2006) Personality traits after recovery from eating disorders: Do subtypes differ?. International Journal of Eating Disorders, 39(4), 276-284. DOI: 10.1002/eat.20251
- February 10, 2013
- 02:07 AM
- 249 views
Bingeing and Purging Marathons: Repeated Binge/Purge Cycles in Bulimia Nervosa
by Tetyana Pekar in Science of Eating Disorders
I used to call them bingeing and purging marathons. If I binged and purged in the morning, chances were, I’d binge and purge throughout the day. The next time I’d eat, I was likely to end up–whether I wanted to or not–bingeing and purging. Not all individuals with bulimia nervosa binge and purge every day (or purge everything they eat, for that matter), but many do, and some binge and purge multiple times a day. In recovery, many people start by trying not to binge and purge before a c........ Read more »
Johnson, W., Jarrell, M., Chupurdia, K., & Williamson, D. (2010) Repeated binge/purge cycles in bulimia nervosa: Role of glucose and insulin. International Journal of Eating Disorders, 15(4), 331-341. DOI: 10.1002/eat.2260150404
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