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Posts

May 13, 2013

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1:43 PM | Bingeing and Purging: Keeping the “Positives” and Eliminating The Negatives?
I have been fascinated and perplexed by reports of the seemingly invigorating and anxiety reducing effects of bingeing and purging (purging by self-induced vomiting). Personally, I cringe at the idea of self-induced vomiting and have always wanted to avoid vomiting at all costs, including during food poisoning. The insight from recent blog entries and the subsequent comments has made an impact on me. I see that the motivation to engage in bingeing/purging (b/p-ing) behavior can […]
Science of Eating Disorders
Neuroscience | Psychiatry

April 18, 2013

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2:18 PM | Nonpurging Bulimia Nervosa: Where Does It Fit?
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 […]
Science of Eating Disorders
Neuroscience | Psychiatry

April 15, 2013

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4:27 AM | What’s The Point of Bingeing and Purging? And Why Can’t You Just Stop?
I defended my MSc 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 […]
Science of Eating Disorders
Neuroscience | Psychiatry

March 04, 2013

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4:24 AM | Is Living in an Urban City a Risk Factor for Bulimia Nervosa?
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 […]

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:

Science of Eating Disorders
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4:24 AM | Living in a Large City: A Risk Factor for Bulimia Nervosa?
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 […]

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:

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3:24 AM | Living in a Large City: A Risk Factor for Bulimia Nervosa?
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 […]
Science of Eating Disorders
Neuroscience | Psychiatry

February 28, 2013

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9:26 PM | 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, […]

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:

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February 23, 2013

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2:28 AM | Chewing and Spitting: A Neglected Symptom in Eating Disorders?
Dear Science of Eating Disorders readers, please welcome Shelly, our newest contributor! Shelly is a PhD Candidate in Neuroscience at the University of British Columbia. You can find out more about Shelly on the ‘About Shelly‘ page. Check out her neuro(science) blog, Neurorexia and follow her on Twitter. Email shelly@scienceofeds.org to get in touch.  Just a note, do keep in mind that I (Tetyana) try to give as much freedom as possible to guest writers and contributors to write […]

Guarda, A., Coughlin, J., Cummings, M., Marinilli, A., Haug, N., Boucher, M. & Heinberg, L. (2004). Chewing and spitting in eating disorders and its relationship to binge eating, Eating Behaviors, 5 (3) 231-239. DOI:

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February 21, 2013

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2:16 AM | Lifetime Prevalence of Eating Disorders Among Eating Disorder Professionals
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 […]

BARBARICH, N. (2002). Lifetime Prevalence of Eating Disorders Among Professionals in the Field, Eating Disorders, 10 (4) 305-312. DOI:

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February 10, 2013

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7:07 AM | Bingeing and Purging Marathons: Repeated Binge/Purge Cycles in Bulimia Nervosa
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 […]

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:

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Neuroscience | Psychiatry
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7:07 AM | Bingeing and Purging Marathons: Repeated Binge/Purge Cycles in Bulimia Nervosa
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 […]

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:

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Neuroscience | Psychiatry
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February 08, 2013

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4:59 AM | Medical Complications of Purging in Bulimia Nervosa
Eating disorders are mental disorders with physical complications. Sometimes lots of them. I’ve blogged before about medical complications that are likely to come up in an emergency room setting, but that was a while ago. So I thought today I’ll focus specifically on medical complications  that occur in bulimia nervosa (BN) as a result of purging (self-induced vomiting, laxative abuse, and diuretic abuse). These complications are particularly important because patients with BN […]

Mehler, P. (2010). Medical complications of bulimia nervosa and their treatments, International Journal of Eating Disorders, DOI:

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4:59 AM | Medical Complications of Purging in Bulimia Nervosa
Eating disorders are mental disorders with physical complications. Sometimes lots of them. I’ve blogged before about medical complications that are likely to come up in an emergency room setting, but that was a while ago. So I thought today I’ll focus specifically on medical complications  that occur in bulimia nervosa (BN) as a result of purging (self-induced vomiting, laxative abuse, and diuretic abuse). These complications are particularly important because patients with BN […]

Mehler, P. (2010). Medical complications of bulimia nervosa and their treatments, International Journal of Eating Disorders, DOI:

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February 03, 2013

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4:11 AM | Over-Exercise is Associated With Suicidality in Individuals with Disordered Eating
Last week, I blogged about a study that examined personality traits and clinical variables associated with excessive exercise in eating disorder patients. In that study, 2 out of 5 participants engaged in excessive exercise. Today, I’m going to discuss a study that suggests over-exercise in disordered eating patients is associated with suicide behaviour. Suicide rates in eating disorder patients are high. One meta-analysis suggested that out of all eating disorder related deaths, 1 in 5 […]

Smith, A., Fink, E., Anestis, M., Ribeiro, J., Gordon, K., Davis, H., Keel, P., Bardone-Cone, A., Peterson, C., Klein, M. & Crow, S. (2012). Exercise caution: Over-exercise is associated with suicidality among individuals with disordered eating, Psychiatry Research, DOI:

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Neuroscience | Psychiatry
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January 27, 2013

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4:35 AM | 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 this multi-site study, […]

Shroff, H., Reba, L., Thornton, L., Tozzi, F., Klump, K., Berrettini, W., Brandt, H., Crawford, S., Crow, S., Fichter, M. & Goldman, D. (2006). Features associated with excessive exercise in women with eating disorders, International Journal of Eating Disorders, 39 (6) 454-461. DOI:

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Neuroscience | Psychiatry
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January 26, 2013

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4:58 AM | Characteristics of Women with Midlife-Onset Eating Disorders
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 […]

Cumella, E. & Kally, Z. (2008). Profile of 50 Women with Midlife-Onset Eating Disorders, Eating Disorders, 16 (3) 193-203. DOI:

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Neuroscience | Psychiatry
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January 12, 2013

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2:02 PM | Mobile Therapy: Using Text-Messaging to Treat Bulimia Nervosa
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 (or benefit fully) from CBT, or those that relapse after CBT? Shapiro […]

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:

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Neuroscience | Psychiatry
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January 03, 2013

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3:44 AM | Self-Harm is Common Among Adolescents With Eating Disorders
Self-harm 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 screened […]

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:

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Neuroscience | Psychiatry
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December 24, 2012

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5:59 PM | 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 […]

Orbanic S (2001). Understanding bulimia. Signs, symptoms and the human experience., The American journal of nursing, 101 (3) 35. PMID:

Broussard, B. (2005). Women's experiences of bulimia nervosa, Journal of Advanced Nursing, 49 (1) 43-50. DOI:

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:

Science of Eating Disorders
Neuroscience | Psychiatry
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December 20, 2012

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4:52 AM | Yoga in the Treatment of Eating Disorders: A Randomized Controlled Trial
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 on […]

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:

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Neuroscience | Psychiatry
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December 16, 2012

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8:03 AM | Anorexia Nervosa: Can We Blame The SoB? (It’s Not What You Think.)
I bet you are thinking parents. Or media. Or thin models. Nope. 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.) That SoB.  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 […]

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:

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:

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:

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:

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:

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:

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:

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:

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:

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:

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:

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December 03, 2012

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4:59 AM | 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 […]

Thompson-Brenner, H. & Westen, D. (2005). Personality subtypes in eating disorders: validation of a classification in a naturalistic sample., The British Journal of Psychiatry, 186 516-524. DOI:

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November 23, 2012

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8:57 PM | Self-Denial, Secrecy and Deliberate Lying in Eating Disorders
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 […]

Vandereycken, W. & Van Humbeeck, I. (2008). Denial and concealment of eating disorders: a retrospective survey, European Eating Disorders Review, 16 (2) 109-114. DOI:

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November 11, 2012

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4:51 AM | Think You Are Not “Sick Enough” Because You Didn’t Lose Your Period? Read This.
Anonymous asked, “I’ve never lost my period. Weight restored I am naturally thin, but even at a BMI of 15 or so I always got my period (although it wasn’t always regularly). This makes me feel like I’m not actually sick because I hear about everyone losing their period.” eatruncats replied: “To the anon who asked about losing periods: For all the times she worries about not being sick enough because she never lost her period, there are people who lost their […]

Poyastro Pinheiro A, Thornton LM, Plotonicov KH, Tozzi F, Klump KL, Berrettini WH, Brandt H, Crawford S, Crow S, Fichter MM & Goldman D (2007). Patterns of menstrual disturbance in eating disorders., The International Journal of Eating Disorders, 40 (5) 424-34. PMID:

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Neuroscience | Psychiatry
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October 30, 2012

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8:57 PM | History of Anorexia or Bulimia Nervosa? Are You Putting Your Unborn Child At Risk?
You know how you are not supposed to get on the topic of kids on your first date? Well, I did. Clearly I wasn’t good at following social rules (in my defense, this was many years ago). “It would be cool to be surrogate mother,” I said. And then I thought about it. “But that would probably be difficult, who would want me to carry their child?” Needless to say, my date was confused. I thought, surely having had an eating disorder and a long history of amenorrhea […]

Micali, N., De Stavola, B., Dos-Santos-Silva, I., Steenweg-de Graaff, J., Jansen, P., Jaddoe V, Hofman A, Verhulst F, Steegers E & Tiemeier H (2012). Perinatal outcomes and gestational weight gain in women with eating disorders: a population-based cohort study., BJOG: An International Journal of Obstetrics and Gynaecology, 119 (12) 1493-1502. PMID:

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October 25, 2012

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2:38 PM | Eating Disorders Among Lesbian and Bisexual Women
The hardest part of science blogging is picking an article to blog about. In times when I’m indecisive–when I spend hours sifting through the literature, inevitably creating several draft posts before deciding each article isn’t interesting enough–I turn to the list of topics that have been suggested by readers. The last suggestion I received was “eating disorders in the lesbian community.” It is a great suggestion, but I thought my search wouldn’t […]

Koh, A.S. & Ross, L.K. (2006). Mental health issues: a comparison of lesbian, bisexual and heterosexual women., Journal of Homosexuality, 51 (1) 33-57. PMID:

Share, T.L. & Mintz, L.B. (2002). Differences between lesbians and heterosexual women in disordered eating and related attitudes., Journal of Homosexuality, 42 (4) 89-106. PMID:

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October 14, 2012

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4:29 AM | Chronicity in Eating Disorders: How Do We Define It and What Do We Do About It?
It comes as no surprise that the earlier eating disordered individuals receive treatment, the higher the likelihood that they will make a full recovery. In other words, the duration of the illness is inversely proportional with the likelihood of full recovery. The problem is that a lot of eating disorders are not caught early. That a lot of people don’t have access to the treatment they need. Insurance will not cover it, their doctors don’t think it is a problem or won’t […]

Wonderlich S, Mitchell JE, Crosby RD, Myers TC, Kadlec K, Lahaise K, Swan-Kremeier L, Dokken J, Lange M, Dinkel J & Jorgensen M (2012). Minimizing and treating chronicity in the eating disorders: a clinical overview., The International Journal of Eating Disorders, 45 (4) 467-75. PMID:

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October 10, 2012

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3:21 PM | How Common Are Eating Disorders? Incidence, Prevalence and Mortality Rates
Six month of blogging and I have yet to do a proper post on the prevalence of eating disorders. I think it is about time. I see all sorts of numbers thrown around, often depending on the purpose of the article and the author’s bias. Is it 1 in 1000, 1 in 100, 1 in 20 or maybe even 1 in 2? Who is right? Well, it is a tricky question to answer. The number depends on how the particular study was conducted. Here are some factors that may influence the final rates: the population being […]

Smink, F.R., van Hoeken, D. & Hoek, H.W. (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates., Current Psychiatry Reports, 14 (4) 406-14. PMID:

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September 30, 2012

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7:52 PM | Endophenotypes and Biomarkers in Eating Disorders: Genetic Underpinnings, Personality Traits, Vulnerabilities – Part 2
This post continues the discussion of the chapter on eating disorders by Carolina Lopez, Marion Roberts, and Janet Treasure from The Handbook of Neuropsychiatric Biomarkers, Endophenotypes and Genes (2009). Part 1 focused on neurotransmitter biomarkers, and this second part will focus on the neuropsychological biomarkers. Neuropsychological biomarkers Attentional bias is the tendency for individuals to attend to or be distracted by emotionally relevant stimuli over neutral […]

Carolina Lopez, Marion Roberts & Janet Treasure (2009). Biomarkers and Endophenotypes in Eating Disorders, The Handbook of Neuropsychiatric Biomarkers, Endophenotypes and Genes, 227-237. DOI:

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3:30 PM | Endophenotypes and Biomarkers in Eating Disorders: Genetic Underpinnings, Personality Traits, Vulnerabilities – Part 1
There have been some interesting discussions on the F.E.A.S.T. Facebook group over the past month regarding the role of genetics, personality traits, environmental factors and their role (or lack thereof) in the development of eating disorders and their prognosis. A parent group may seem like an unlikely forum for several hundred-odd comment threads on etiology; however, what we (caregivers, patients or clinicians) believe to underlie these disorders naturally informs our attitudes, decisions […]

Carolina Lopez, Marion Roberts & Janet Treasure (2009). Biomarkers and Endophenotypes in Eating Disorders, The Handbook of Neuropsychiatric Biomarkers, Endophenotypes and Genes, 227-237. DOI:

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