Posts

May 24, 2013

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5:13 PM | The Genetics of Thin-Ideal Internalization

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 achieve […]

May 17, 2013

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4:13 PM | Transitioning from Adolescent to Adult Eating Disorder Treatment Programs: What Are The Challenges?

Navigating health service systems can seem daunting, to say the least. Making phone calls, getting doctor appointments and referrals, attending intake appointments, and preparing oneself for treatment can be both mentally and physically draining. When children and adolescents develop eating disorders, their parents become the main navigators in this scenario, making decisions and arrangements for their under-18-year-olds. But what happens when these adolescents reach the age of 18, and still […]

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 […]

May 09, 2013

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6:24 PM | Dancing Your Way to Recovery from Anorexia Nervosa

The idea of including dance and movement in interventions for eating disorders may seem somewhat controversial; generally, exercise and physical activity are discouraged for individuals recovering from eating disorders. Including dance in therapeutic interventions might raise a few eyebrows given the links between appearance-oriented athletic endeavors such as ballet and gymnastics and the development of eating disorders. However, some therapists and scholars interested in alternative therapies […]

April 29, 2013

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3:57 AM | Factors Associated with Recovery from Anorexia Nervosa

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, […]

April 26, 2013

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3:18 PM | Patient Perspectives on Anorexia, Treatment, and Therapeutic Alliance

Dear Science of Eating Disorders readers, please welcome Andrea, our newest contributor! Below is her introduction and first post. Hello SEDs readers, my name is Andrea and I’m excited to be contributing to the blog. I have an undergraduate degree in sociology and I am currently a Masters student studying family relations and human development. My research is looking at the experiences of young women in recovery from eating disorders, and uses qualitative methods including narrative […]

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 […]

April 10, 2013

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3:37 AM | Diabulimia: A Dangerous Duet

Type 1 diabetes (DMT1, or T1DM) is a lifelong disease often diagnosed in children or adolescents. Though causes of DMT1 are complex and not fully understood, it results from the body’s immune system destroying its own insulin-producing cells. This drastically lowers insulin levels and leads to high blood sugar (insulin is crucial for regulating blood sugar). If not managed properly, DMt1 can wreck havoc on the nerves, heart, and retina. The onset of DMT1 often results in dramatic weight […]

March 25, 2013

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4:08 AM | Are There Any Meaningful Differences Between Subthreshold and Full Syndrome Anorexia Nervosa?

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, […]

March 21, 2013

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8:36 PM | Your Body’s Response to Chewing and Spitting: The Role of Insulin

In my previous post, I looked at two hormones released during the cephalic phase (gastric secretion that occurs before food is eaten), ghrelin and obestatin, and how they may contribute to runaway eating behavior. Today I’m going to be looking at insulin release during chew and spit (CHSP), a fairly common symptom in eating disorders where the food is tasted, chewed and spit out. Insulin is a small peptide hormone that acts as a key regulator of metabolism; deregulation of […]

March 08, 2013

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4:49 PM | Deep Brain Stimulation for Severe Anorexia Nervosa

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 […]

Lipsman, N., Woodside, D., Giacobbe, P., Hamani, C., Carter, J., Norwood, S., Sutandar, K., Staab, R., Elias, G., Lyman, C. & Smith, G. (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

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March 06, 2013

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6:20 PM | Your Body’s Response to Chewing & Spitting: The Role of Ghrelin and Obestatin

Shelly’s follow-up post on chewing and spitting, an often overlooked symptom in eating disorders. In her first post, Shelly discussed the prevalence of chewing and spitting among eating disorder patients. In this post, Shelly discusses some of the physiological effects of chewing and spitting. Enjoy! – Tetyana Your body responds to food long before it reaches your stomach. The taste, smell, even the mere sight of food all act to trigger a physiological response, “priming” the […]

Monteleone, P., Serritella, C., Martiadis, V. & Maj, M. (2008). Deranged Secretion of Ghrelin and Obestatin in the Cephalic Phase of Vagal Stimulation in Women with Anorexia Nervosa, Biological Psychiatry, 64 (11) 1005-1008. DOI: 10.1016/j.biopsych.2008.04.006

Méquinion, M., Langlet, F., Zgheib, S., Dickson, S., Dehouck, B., Chauveau, C. & Viltart, O. (2013). Ghrelin: Central and Peripheral Implications in Anorexia Nervosa, Frontiers in Endocrinology, 4 DOI: 10.3389/fendo.2013.00015

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5:20 PM | Your Body’s Response to Chewing & Spitting: The Role of Ghrelin and Obestatin

Shelly’s follow-up post on chewing and spitting, an often overlooked symptom in eating disorders. In her first post, Shelly discussed the prevalence of chewing and spitting among eating disorder patients. In this post, Shelly discusses some of the physiological effects of chewing and spitting. Enjoy! – Tetyana Your body responds to food long before it reaches your stomach. The taste, smell, even the mere sight of food all act to trigger a physiological response, “priming” the […]

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: 10.1192/bjp.bp.106.021378

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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: 10.1192/bjp.bp.106.021378

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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 […]

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: 10.1007/s00127-012-0648-9

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February 25, 2013

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10:30 PM | Rigid Food Rules in Eating Disorders: Is Perfectionism to Blame?

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 […]

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

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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: 10.1016/j.eatbeh.2004.01.001

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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: 10.1080/10640260214505

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February 18, 2013

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4:45 AM | Shared Genetics Between Disordered Eating and Periods (Menses)

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 […]

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

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February 15, 2013

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4:58 AM | Personality Traits after Recovery from Eating Disorders: Do Anorexia and Bulimia Patients Differ?

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 […]

Wagner, A., Barbarich-Marsteller, N., Frank, G., Bailer, U., Wonderlich, S., Crosby, R., Henry, S., Vogel, V., Plotnicov, K., McConaha, C. & Kaye, W. (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

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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: 10.1002/eat.2260150404

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February 05, 2013

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4:56 AM | Is Anorexia Nervosa An Anxiety Disorder?

Anxiety disorders (ADs) are common among patients with eating disorders. In one study of female inpatients, around 50-65% had a comorbid anxiety disorder (see my post here). Anxiety disorders in patients with anorexia nervosa (AN) typically begin before the eating disorder and often persist after weight restoration and recovery (Bulik et al., 1997; Casper, 1990). Moreover, previous twin studies have suggested that there’s a “correlation between eating disorders and certain anxiety […]

Strober, M., Freeman, R., Lampert, C. & Diamond, J. (2007). The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: Evidence from a family study with discussion of nosological and neurodevelopmental implications, International Journal of Eating Disorders, 40 (S3) DOI: 10.1002/eat.20429

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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: 10.1080/10640260802016670

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January 11, 2013

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4:58 AM | Dopamine and Anorexia Nervosa: Tackling the Myths – Part III (Clinical Studies)

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 […]

Kontis, D. & Theochari, E. (2012). Dopamine in anorexia nervosa, Behavioural Pharmacology, 23 (5 and 6) 496-515. DOI: 10.1097/FBP.0b013e328357e115

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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: 10.1016/j.jadohealth.2010.06.017

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December 29, 2012

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4:54 AM | Can Puberty Affect the Development of Eating Disorders?

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 […]

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

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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: 10.1016/j.jadohealth.2009.08.007

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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: 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

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