91 posts · 23,792 views
Ambivalence is a great word to describe how many eating disorder patients feel about recovery. Many people that follow my Science of Eating Disorders tumblr run thinspo blogs. But, they follow me, and many probably follow fyoured, which offers pro-recovery advice. Many people might want to recover someday, but they feel they can’t let go of the behaviours now. They are not denying their illness, or that recovery will happen, or that it really IS a disorder, but, right now, recove........ Read more »
Brotsky SR, & Giles D. (2007) Inside the "pro-ana" community: a covert online participant observation. Eating disorders, 15(2), 93-109. PMID: 17454069
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 this multi-site study, Shro........ Read more »
Shroff, H., Reba, L., Thornton, L., Tozzi, F., Klump, K., Berrettini, W., Brandt, H., Crawford, S., Crow, S., Fichter, M.... (2006) Features associated with excessive exercise in women with eating disorders. International Journal of Eating Disorders, 39(6), 454-461. DOI: 10.1002/eat.20247
Since the late 1990′s, Remuda Ranch Program for Eating Disorders has experienced a 400% increase in patients 40 years of age and older, according to the authors of this paper. However, we don’t really know what the similarities and differences are between women who develop eating disorders in adolescence and those who develop their eating disorders in midlife (40-65 years-of-age).
In this paper, Edward Cumella and Zina Kally present a summary of 50 women who first developed eating di........ Read more »
Cumella, E., & Kally, Z. (2008) Profile of 50 Women with Midlife-Onset Eating Disorders. Eating Disorders, 16(3), 193-203. DOI: 10.1080/10640260802016670
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, but unfortunately, there is a lot of stigma associated with talking about disordered eating behaviours during pregnancy. Openly admitting 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, ........ Read more »
Tierney, S., Fox, J., Butterfield, C., Stringer, E., & Furber, C. (2011) Treading the tightrope between motherhood and an eating disorder: A qualitative study. International Journal of Nursing Studies, 48(10), 1223-1233. DOI: 10.1016/j.ijnurstu.2010.11.007
This is part IV in my mini-series on the role of dopamine in anorexia nervosa. In part I, I did a a little introduction on dopamine and dopamine signalling in the brain. In part II, I discussed preclinical studies using animal models to study the role of dopamine in AN. Finally, in part III, I talked about clinical studies using patients with AN to assess dopamine function. In this final post, I’ll review the evidence for using drugs that modulate the dopamine system in order to treat anor........ Read more »
Cognitive-behavioural therapy (CBT) is one of the most commonly used approaches to treat bulimia nervosa, but even CBT (or any treatment) doesn’t work for everyone. Sometimes, even if CBT is helping, a weekly 50 minute therapy session is just not enough. Moreover, like with many other eating disorder treatments, drop-out and relapse rates are high.
What can be done to help the individuals that don’t benefit (benefit fully) from CBT, or those that relapse after CBT?
Shapiro and c........ Read more »
Shapiro, J., Bauer, S., Andrews, E., Pisetsky, E., Bulik-Sullivan, B., Hamer, R., & Bulik, C. (2010) Mobile therapy: Use of text-messaging in the treatment of bulimia nervosa. International Journal of Eating Disorders, 43(6), 513-519. DOI: 10.1002/eat.20744
This is part III of my series on the role of dopamine in anorexia nervosa. In my first post I did a little introduction on dopamine and dopaminergic signalling. In the second post I talked about preclinical studies that used animal models of anorexia nervosa. In this post I’ll briefly go over some of the research that has used patients with anorexia nervosa to understand the role of dopamine in this disorder.
I’ve got to be honest here: I wish things were simpler. I wish the research........ Read more »
This is part II in my series of posts on the role of dopamine in anorexia nervosa. (You can find the first part, which covers the basics of dopamine signalling, here.) In this post I’m going to discuss the findings from preclinical studies (studies in animal models).
I don’t think I’ve talked about animal models of anorexia nervosa before on the blog, but believe or not, they exist. The most well-known one is called activity-based anorexia (ABA). ABA works like this: ........ Read more »
There is this prevalent myth on tumblr eating disorder blogs that increased dopamine (DA) receptor activity or increased DA signalling causes anorexia nervosa. It has left me quite perplexed, as I have never come across a single paper that has shown increased DA activity causes anorexia nervosa. My research for this post also left me empty-handed. I have no idea where this myth comes from, but I thought I’d blog about what research on DA activity in anorexia has shown.&........ Read more »
Beaulieu, J., & Gainetdinov, R. (2011) The Physiology, Signaling, and Pharmacology of Dopamine Receptors. Pharmacological Reviews, 63(1), 182-217. DOI: 10.1124/pr.110.002642
Self-harm (SH) or non-suicidal self-injury (SI) are common among adolescents, particularly among adolescents with eating disorders. Previous studies have shown that SI seems to be associated with sexual trauma, mood disorders, and substance abuse. The present study aimed to find out whether (1) SI is associated with any specific eating disorder symptoms, such as bingeing, or purging, and (2) how often clinicians screen for SI behaviours (and whether particular patients are more likely to be scre........ Read more »
Peebles, R., Wilson, J., & Lock, J. (2011) Self-Injury in Adolescents With Eating Disorders: Correlates and Provider Bias. Journal of Adolescent Health, 48(3), 310-313. DOI: 10.1016/j.jadohealth.2010.06.017
They are crazy stories, really. It is hard to believe they are true.
A 28-year-old woman with anorexia nervosa complained about weakness and nausea following the insertion of a feeding tube. Her gastroenterologist sent her to the emergency room (ER). The woman was in the emergency room for two days without receiving any food. She was discharged home after she was told her lab tests and X-rays came back normal. Unfortunately, her X-rays weren’t normal. Her gastroen........ Read more »
Powers, P., & Cloak, N. (2013) Failure to Feed Patients With Anorexia Nervosa and Other Perils and Perplexities in the Medical Care of Eating Disorder Patients. Eating Disorders, 21(1), 81-89. DOI: 10.1080/10640266.2013.741994
Eating disorders typically begin in adolescence. One common explanation for this is that during adolescence females are increasingly exposed to the media, thin models, and dieting. While this is probably true to some extent, it doesn’t explain why the rates of eating disorders are quite low despite the high levels of exposure to thin models in the media. Out of 100 girls, only a handful develop eating disorders, yet all of them are exposed to the same magazines and TV shows.
This mean........ Read more »
Klump KL, Keel PK, Sisk C, & Burt SA. (2010) Preliminary evidence that estradiol moderates genetic influences on disordered eating attitudes and behaviors during puberty. Psychological Medicine, 40(10), 1745-53. PMID: 20059800
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 (as opposed to just discu........ Read more »
Orbanic S. (2001) Understanding bulimia. Signs, symptoms and the human experience. The American journal of nursing, 101(3), 35. PMID: 11279994
Pettersen, G., Rosenvinge, J., & Ytterhus, B. (2008) The “Double Life” of Bulimia: Patients’ Experiences in Daily Life Interactions. Eating Disorders, 16(3), 204-211. DOI: 10.1080/10640260802016696
Exercise can be great for your body and for your mental health. It is well accepted that exercise can decrease anxiety, increase concentration, and generally improve mood. But too much exercise can be harmful, especially during recovery from a restrictive eating disorder. So is there a way to reap the benefits of exercise without the risks? And if yes, can this exercise actually help in the recovery process?
One form of exercise that has gained a lot of popularity is yoga. Initial studies o........ Read more »
Carei, T., Fyfe-Johnson, A., Breuner, C., & Brown, M. (2010) Randomized Controlled Clinical Trial of Yoga in the Treatment of Eating Disorders. Journal of Adolescent Health, 46(4), 346-351. DOI: 10.1016/j.jadohealth.2009.08.007
I bet you are thinking parents. Or media. Or thin models.
The SoB I am talking about is the season of birth bias (when the SoB pattern in a specific group differs from that of the general population.)
You might have heard that individuals born between the months of June – August (or sometimes March – August) have a higher chance of developing anorexia nervosa. But is it true? A lot of studies have been done to investigate the question of whether a season of birth........ Read more »
Waller G, Meyer C, & van Hanswijck de Jonge L. (2001) Early environmental influences on restrictive eating pathology among nonclinical females: the role of temperature at birth. The International Journal of Eating Disorders, 30(2), 204-8. PMID: 11449454
van Hanswijck de Jonge, L., Meyer, C., Smith, K., & Waller, G. (2001) Environmental temperature during pregnancy and eating attitudes during teenage years: A replication and extension study. International Journal of Eating Disorders, 30(4), 413-420. DOI: 10.1002/eat.1102
Watkins, B., Willoughby, K., Waller, G., Serpell, L., & Lask, B. (2002) Pattern of birth in anorexia nervosa I: early-onset cases in the United Kingdom. International Journal of Eating Disorders, 32(1), 11-17. DOI: 10.1002/eat.10057
Willoughby, K., Watkins, B., Beumont, P., Maguire, S., Lask, B., & Waller, G. (2002) Pattern of birth in anorexia nervosa II: a comparison of early-onset cases in the southern and northern hemispheres. International Journal of Eating Disorders, 32(1), 18-23. DOI: 10.1002/eat.10058
Peñas-Lledó E, & Waller G. (2002) Pattern of birth and eating attitudes in young adults: failure to replicate in a warmer climate. The International Journal of Eating Disorders, 32(3), 367-71. PMID: 12210652
Munn, M., & Klump, K. (2003) Season of birth and disordered eating in female college students. International Journal of Eating Disorders, 34(3), 343-348. DOI: 10.1002/eat.10195
Peñas-Lledó EM, Rodriguez Santos L, Vaz Leal FJ, & Waller G. (2003) Pattern of birth in restrictive and bulimic eating disorders. Eating behaviors, 3(4), 325-8. PMID: 15000993
Winje, E., Willoughby, K., & Lask, B. (2008) Season of birth bias in eating disorders-Fact or fiction?. International Journal of Eating Disorders, 41(6), 479-490. DOI: 10.1002/eat.20540
Javaras, K., Austin, S., & Field, A. (2011) Season of birth and disordered eating in a population-based sample of young U.S. females. International Journal of Eating Disorders, 44(7), 630-638. DOI: 10.1002/eat.20864
Winje E, Torgalsbøen AK, Brunborg C, & Lask B. (2012) Season of birth bias and anorexia nervosa: Results from an international collaboration. The International Journal of Eating Disorders. PMID: 23070973
Brewerton, T., Dansky, B., O'Neil, P., & Kilpatrick, D. (2012) Seasonal patterns of birth for subjects with bulimia nervosa, binge eating, and purging: Results from the National Women's Study. International Journal of Eating Disorders, 45(1), 131-134. DOI: 10.1002/eat.20898
When my younger sister first told me she wanted to become a vegetarian, I was worried. My biggest fear was that she would, like I did, develop an eating disorder. In high-school, I didn’t eat meat for roughly 14 months, and though I can’t be sure now of what my reasons were at the time, in retrospect, I do think in large part it was just a convenient way to avoid yet another food group. It was a legitimate reason to restrict my intake.
But is there any evidence that this behaviour ........ Read more »
Timko, C.A., Hormes, J,M., & Chubski, J. (2012) Will the real vegetarian please stand up? An investigation of dietary restraint and eating disorder symptoms in vegetarians versus non-vegetarians. Appetite, 58(3), 982-90. PMID: 22343135
If you’ve been reading this blog for a while (or literature on this topic) you know the answer is no. I’ve blogged about this before, but I think it is a topic that needs a lot more coverage because the myths that all anorexia nervosa patients are just afraid of being fat, that they lose weight just to be thin, and that thin models are to blame for AN are still very common.
As you’ll see, I am not claiming that this isn’t true for some patients. Instead, what I am claimi........ Read more »
Ngai ,E.S., Lee, S., & Lee, A.M. (2000) The variability of phenomenology in anorexia nervosa. Acta psychiatrica Scandinavica, 102(4), 314-7. PMID: 11089734
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 othe........ Read more »
Thompson-Brenner, H., & Westen, D. (2005) Personality subtypes in eating disorders: validation of a classification in a naturalistic sample. The British Journal of Psychiatry, 516-524. DOI: 10.1192/bjp.186.6.516
Nurses can play an important role in facilitating recovery from anorexia nervosa, particularly in an inpatient or residential treatment setting. But what makes a good nurse from the patient’s perspective? More specifically, what qualities do adolescents with anorexia nervosa consider important and helpful during recovery?... Read more »
van Ommen, J., Meerwijk, E.L., Kars, M., van Elburg, A., & van Meijel, B. (2009) Effective nursing care of adolescents diagnosed with anorexia nervosa: the patients' perspective. Journal of Clinical Nursing, 18(20), 2801-8. PMID: 19538553
I don’t know how many times I’ve said, “I’ve already eaten, thanks,” “No thanks, I’m going be eating later,” or “I’d love to, but I’ve got a stomach ache,” when I actually hadn’t eaten, wasn’t going to eat later, and didn’t have a stomach ache. Why did I do that? Did I realize I had, or was developing, an eating disorder? How long did it take for that realization to click? And once it did, did I stop lying ........ Read more »
Vandereycken, W., & Van Humbeeck, I. (2008) Denial and concealment of eating disorders: a retrospective survey. European Eating Disorders Review, 16(2), 109-114. DOI: 10.1002/erv.857
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