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Archive for the ‘Research’ Category

From NEDC Newsletter 2016

Eating disorders are complex mental illnesses. To date, no single cause has been identified. Rather, widespread research suggests that the onset of an eating disorder is unique to the individual and often involves the integration of multiple factors (Culbert, Racine, & Klump, 2015; Rikani et al., 2013). Understanding these known risk factors has the potential to improve treatment methods, determine high risk groups for prevention programs and reduce stigma (Striegel-moore & Bulik, 2007). Current literature explores genetic, psychological and socio-cultural influences.

Genetic Vulnerability

The genetic link to eating disorders has been a consistent focus in scientific literature. Previous findings from family and twin studies indicate that eating disorders have a hereditary component (Trace, Baker, Pe, & Bulik, 2013). In particular, one study found that first-degree relatives of individuals with Anorexia Nervosa are 11 times more likely to develop the illness than relatives of individuals without the disorder (Strober, Freeman, Lampert, Diamond, & Kaye, 2000). This suggests that genetics can influence an individual’s vulnerability to eating disorders.

The onset of eating disorders, specifically Anorexia Nervosa and Bulimia Nervosa, typically occurs during adolescence (Hudson, Hiripi, Pope, & Kessler, 2007; Striegel-moore & Bulik, 2007). The complex hormonal, physical and neural changes associated with puberty increase the likelihood of adolescent engagement in disordered eating behaviours (Klump, 2013). Given such, puberty is recognised as a significant risk period.

Although there has been decades of research exploring the genetics of eating disorders, the biological causes are still not well understood. This may be because the majority of studies involve small sample sizes and are often conducted during the acute or recovery phase of an eating disorder (Trace et al., 2013). The QIMR Berghofer Medical Research Institute in Queensland are currently undertaking the largest international investigation into the cause of Anorexia Nervosa. This study, known as the Anorexia Nervosa Genetic Initiative (ANGI), seeks to identify the specific genes associated with Anorexia Nervosa in the hopes of better understanding the causes and finding a potential cure.

Psychological Factors

A connection between certain personality traits and eating disorders has been identified. Research into Anorexia Nervosa and Bulimia Nervosa has shown that obsessive compulsive personality disorder, low self -esteem and perfectionism are considerable risk factors for disordered eating behaviours and attitudes (Culbert et al., 2015; Egan, Wade, & Shafran, 2011). A recent investigation into childhood obsessive compulsive personality traits found that the presence of perfectionism and inflexibility in early life can predict the later development of an eating disorder (Southgate, Tchanturia, Collier & Treasure, 2008). Personality types are also important to consider when treating an eating disorder, as obsessive compulsive tendencies may continue to drive restrictive and rigid behaviours. Given such, Egan et al. (2011) argues that traits such as perfectionism should be treated alongside an eating disorder, in order to effectively reduce disordered eating symptoms.

The cognitive, behavioural and interpersonal changes that accompany eating disorders can make it difficult to discern the psychological causes from the psychological effects. For example, the co-existence of depression and anxiety with eating disorders has raised debate as to whether such conditions precede or are a direct outcome of an eating disorder.

Socio-Cultural Influences

Socio-cultural influences play a considerable role in the development of eating disorders. Mass media, such as television, magazines and advertising, airbrush and alter images to portray unrealistic representations of the male and female body (Perloff, 2014; Striegel-moore & Bulik, 2007). Predominant images suggest that beauty is associated with thinness for females and a lean, muscular body for males. Individuals who internalise this ‘thin’ ideal and strive for the ‘perfect’ body, are at a greater risk of developing body dissatisfaction, which can lead to dieting and other disordered eating behaviours (Culbert et al., 2015). More recent research has explored the impact of social media on body image and eating behaviours. Andsager (2014) argues that the introduction of Facebook and Instagram has increased our exposure to photo-shopped images and thin ideals. Although a direct link to eating behaviours is yet to be established, the appearance-focused nature of social media platforms has been shown to cultivate body image concerns and reduce self-esteem (Perloff, 2014).

Additionally, there is growing evidence that the ways in which weight, shape and size are discussed in the home have a strong impact on self-esteem and dieting behaviours (Loth et al., 2014). Culbert et al. (2015) propose that environmental and psychological factors interact with and influence the expression of genes to cause eating disorders. Further research into this relationship is needed.

Modifiable Risk Factors

Identifying potential risk factors for eating disorders is beneficial in shaping effective prevention and early intervention programs. Research indicates that prevention programs with the most favourable outcomes are those which focus on reducing modifiable risk factors (Jacobi, Hayward, Zwaan, Kraemer, & Agras, 2004). Low self-esteem, body dissatisfaction, dieting behaviours and internalisation of the thin ideal have been acknowledged as variable factors associated with the onset of eating disorders.

The aetiology of eating disorders is becoming a growing field of research. Although limited conclusive evidence has been recorded, understanding possible influences can inform best practice and encourage effective management of eating disorders.

References

Andsager, J. L. (2014). Research Directions in Social Media and Body Image. Sex Roles, 71, 407–413.

Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review : What we have learned about the causes of eating disorders – a synthesis of sociocultural , psychological , and biological research. Journal of Child Psychology and Psychiatry, 11, 1141–1164.

Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process : A clinical review. Clinical Psychology Review, 31(2), 203–212.

Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Journal of Biological Psychiatry, 61, 348–358.

Jacobi, C., Hayward, C., Zwaan, M. De, Kraemer, H. C., & Agras, W. S. (2004). Coming to Terms With Risk Factors for Eating Disorders : Application of Risk Terminology and Suggestions for a General Taxonomy. Psychological Bulletin, 130(1), 19–65.

Klump, K. L. (2013). Puberty as a critical risk period for eating disorders : A review of human and animal studies. Hormones and Behavior, 64(2), 399–410.

Loth, K. A., Ph, D., D, R., Maclehose, R., Ph, D., Bucchianeri, M., … D, R. (2014). Predictors of Dieting and Disordered Eating Behaviors From Adolescence to Young Adulthood. Journal of Adolescent Health, 55(5), 705–712.

Perloff, R. M. (2014). Social Media Effects on Young Women ’ s Body Image Concerns : Theoretical Perspectives and an Agenda for Research, 363–377.

Rikani, A. A., Choudhry, Z., Choudhry, A. M., Ikram, H., Asghar, M. W., Kajal, D., … Mobassarah, N. J. (2013). A critique of the literature on etiology of eating disorders. Annals of Neurosciences, 20(4), 157–161.

Southgate, L., Tchanturia, K., Collier, D., & Treasure, J. (2008). The development of the childhood retrospective perfectionism questionnaire (CHIRP) in an eating disorder sample. European Eating Disorders Review, 16(6), 451-462.

Striegel-moore, R. H., & Bulik, C. M. (2007). Risk Factors for Eating Disorders. American Psychologist, 62(3), 181–198.

Strober, M., Freeman, R., Lampert, C., Diamond, J., & Kaye, W. (2000). Controlled family study of anorexia nervosa and bulimia nervosa: Evidence of shared liability and transmission of partial syndromes. The American Journal of Psychiatry, 157(3), 393–401.

Trace, S. E., Baker, J. H., Pe, E., & Bulik, C. M. (2013). The Genetics of Eating Disorders. Annual Review of Clinical Psychology, 9, 589–620.

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This research sparked a big response on a group I belong to and how so many of our children who have an eating disorder, are also double jointed and flexible.It may be something my readers also relate to and recognise in their children or themselves.

It’s an interesting concept and one that further research would be good to continue. Unfortunately they didn’t link to the actual research papers, but the news post is available on Scientific American.

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Joint flexibility is an oft-coveted trait that provides a special advantage to dancers and athletes, but there can be too much of this good thing. A growing body of research suggests a surprising link between high levels of flexibility and anxiety. A study published last year in the journal Frontiers in Psychology is among the most recent to confirm the association, finding that people with hypermobile joints have heightened brain activity in anxiety regions.

Joint hypermobility, which affects approximately 20 percent of the population, confers an unusually large range of motion. Hypermobile people can often, for instance, touch their thumb to their inner forearm or place their hands flat on the floor without bending their knees. The trait appears to be genetic and is a result of variation in collagen, the main structural protein of connective tissue.

Being double-jointed has long been linked with an increased risk for asthma and irritable bowel syndrome, among other physical disorders. “Joint hypermobility has an impact on the whole body and not just joints,” says Jessica Eccles, a psychiatrist and researcher at the University of Sussex in England. It was only a matter of time before scientists also looked at whether joint hypermobility was linked to mental disorders. The investigation began in 1993 and heated up in 1998 when researcher Rocío Martín-Santos, now at the Hospital Clinic of the University of Barcelona, and her colleagues discovered that patients with anxiety were 16 times more likely to have lax joints. Their findings have since been replicated numerous times in large populations.

A 2012 brain-imaging study conducted by Eccles and her colleagues found that individuals with joint hypermobility had a bigger amygdala, a part of the brain that is essential to processing emotion, especially fear. In the 2014 study, which was conducted by Eccles and her associates in collaboration with researchers from Spain, hypermobile participants displayed heightened neural reactivity to sad and angry scenes in brain regions implicated in anxiety. Researchers have also linked the condition with increased consumption of chocolate, tobacco and alcohol—items that are often used in an attempt to self-medicate anxiety.

Joint hypermobility may also be associated with an exaggerated fight-or-flight reaction. Eccles and her colleagues recently found support for this idea in a study of 400 psychiatric patients. They uncovered a simple yet powerful mechanism behind the link: the collagen abnormalities that make joints especially flexible seem to affect blood vessels, making patients prone to an accumulation of blood in the veins of the legs. This pooling may lead to exaggerated cardiovascular responses to maintain the output of blood from the heart. When the heart has to work extra hard just to circulate blood, it brings the entire body to the verge of a fight-or-flight reaction, requiring very little to set off panic.

Eccles hypothesizes that these patients might benefit in particular from beta blockers, drugs that ease anxiety by reducing symptoms of the body’s fight-or-flight response. She hopes that future studies will investigate such targeted treatments for double-jointed people. In the meantime, the findings are an important reminder for clinicians to consider the possibility that a patient’s mental disorder could have purely physical origins.

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Researchers at the UNC School of Medicine found that people with anorexia nervosa have very different microbial communities residing inside their guts compared to healthy individuals and that this bacterial imbalance is associated with some of the psychological symptoms related to the eating disorder.

The findings, published in the journal Psychosomatic Medicine, provide more evidence that the abundance and diversity of the gut microbiota — the trillions of bacteria that affect digestive health and immunity — could also affect the so-called “gut-brain axis.” This research suggests that gut bacteria could play a prominent role in the debilitating symptoms of anorexia nervosa, a serious eating disorder that affects more than 3 million Americans and has the highest mortality rate of any psychological disorder.

“Other studies have linked gut bacteria to weight regulation and behavior,” said Ian Carroll, PhD, senior author of the paper and assistant professor of medicine in the UNC Center for Gastrointestinal Biology and Disease. “Since people with anorexia nervosa exhibit extreme weight dysregulation, we decided to study this relationship further.”

Read full research article at Science Daily.

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For anyone who saw the ‘DIS’ campaign or participated, this survey is critical. It is not only about the campaign and advertising ‘wins’ or ‘loses’.

It is about getting the correct information about eating disorders out to the public, sufferers, medical professionals and making sure the EDucate is clear and not ambiguous.

Eating disorders are NOT body image developed. 60-80% of all ED’s are genetic/biology based and this is being proven as more research is done, and the percentage pointing to genes rises. The remaining percentage is then a mix of many complex issues of which body image is ONLY ONE of these. 

Most sufferers will say body image is the reason for their ED. In most cases the ED thinking and behaviour is ALREADY in residence in the brain and body image is a symptom not a cause.

The same goes for the ‘diet’ caused my ED. By the time the diet choices start the ED is already in residence in the brain. Again the diet choices are a symptom not the cause.

Please take the time to complete the survey and make a start to build better communication and collaboration with Butterfly so we can better diagnose, intervene, treat and care for sufferers.

https://www.surveymonkey.com/r/dontdismyappearance

 

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This reprinted here in full, making it easier to read. Thank you to Helen Razer for putting it so well and so correctly about eating disorders and the current ‘DIS’ campaign. To read her original please go to: http://www.crikey.com.au/2015/05/07/were-making-ourselves-sick-with-the-publicity-of-eating-disorders/

I will follow in a while with my own post and thoughts on where Butterfly are and aren’t heading and the damage they do because they heavily mix body image campaigns with eating disorder awareness.

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To survive the current calendar, health advocacy groups must claim a month and shake it. January starts with glaucoma and thyroid conditions, and the year ends with Alzheimer’s and AIDS.  This month is given over to a number of health campaigns with notable new May player The Butterfly Foundation currently raising funds and awareness for eating disorders (ED).

Theirs is a well-regarded organisation providing outpatient services to ED sufferers who, in the case of an anorexia nervosa diagnosis, face what is estimated to be the highest standardised mortality figures of any psychiatric disorder. The help they offer is practical and based in firm research. But, like so many other advocacy groups, the public messages broadcast are entirely theoretical and based on flimsy hope.

With the achievable aim of funding itself and the rather more incredible one of stopping ED at its source, the foundation has launched Don’t DIS My Appearance campaign. Let’s set aside the antique hip-hop language that had passed its best before date before Snoop Dogg had packed his first bowl. Let’s also overlook the decision to ask ambassadors to display a middle finger, which I imagine may seem less like a moment of cheeky defiance than a bleak reminder of the toilet bowl to those who suffer from bulimia. Let’s look instead at how this organisation, and others, can so easily extinguish the very awareness they seek to create with crude messaging.

We spend much of the year in a tangle of awareness ribbons and there are those who reasonably argue that we’re bound to stop noticing the meaning of such decoration at all. But even if a public health campaign is good enough to cut through all this shiny bunting, it may achieve the terrible opposite of its intention.

In a study undertaken to assess the effectiveness of the famous breast cancer pink, researchers unexpectedly found that the women have become both more likely to underestimate their risk of the disease and less likely to donate to charities. The marketing professor who undertook the study concluded that in an effort to make the matter of breast cancer seem less taboo, organisers had also drained the matter of its urgency. After all, it’s pink like Barbie.

In a literature review on gender-based violence awareness, authors found that such campaigns can end up describing a standard of behaviour. If audiences believe that violence is very prevalent, as they reasonably might when viewing such ads, the message can license “violent behavior rather than activating behavior to reduce [it]”. In other words, violence is normalised through its depiction.

The Butterfly Foundation runs a similar risk of normalisation with its campaign. It’s a high-profile, celebrity-studded effort that posits EDs as normal and as prevalent enough to ask us all to change our behaviour in order to prevent them.

The thing is, though, this campaign is really not aimed at anorexia patients.”

Of course, all reasonable people would like to see a reduction in the incidence of anorexia nervosa. This disorder, which has a lifetime prevalence of between 0.3% and 1.5% in females and between 0.1% and 0.5% in males, is horrifying. That treatment, if accessible, promises a very high rate of recovery would seem to make the task of “awareness raising” all the more urgent.

If we can save a few lives by making death and extreme disordered eating seem a lot more common than they are — and the campaign absolutely does this by conflating EDs, a diverse group of mental illnesses, many of which have no extreme physical side effects, with anorexia in stating they collectively “kill more Australians than any other psychiatric illness” — then what of it?

The thing is, though, this campaign is really not aimed at anorexia patients. Professor Susan Rossell, a highly regarded expert in EDs with qualifications and associations too several to cite, sees “awareness” of this type aimed chiefly at people with “super anxious body consciousness” rather than an actual illness.

Rossell says that campaigns that demand an end to bullying might have some benefit for some ED patients. But the at-risk anorexia patients whose mortality statistic is used as a call to action are unlikely to be rescued by the injunction not to “dis”.

While there are accounts of anorexia patients who suffered chiding for overweight in early life, this is just one tiny potential element of a complex range of influences, including biological and genetic ones, which can provoke ED. While some patients may report bullying as a factor in their disease, others may report endorsement. Just as the so-called “Pro Ana” and “thinspiration” online community of extreme dieting normalises anorexia, campaigns of the Butterfly type can do exactly the same. To the potentially anorexic mind, the “everybody’s doing it” nature of this campaign is as much of a catalyst as a “dis” or a size 4 pair of skinny jeans.

Scholars in anorexia and all ED commonly use the biopsychosocial model to explain this disorder range. While it might be nice to end the “dis”, it might be also of great benefit to legitimate patients, as opposed to the simply body conscious, to understand that their disease has more of the “bio” and less of the “social” than most of us suspect.

“All eating disorders have a strong biological component,” said Richard Newton, Austin Health’s medical director of mental health and board member of The Butterfly Foundation.  When I suggest that the foundation’s newest campaign continues to situate ED entirely in the realm of the social, he explains that the illness-shaping or “pathoplastic” effects of the culture can switch the disease on. There are, he says, historical accounts that describe anorexia some 3000 years old. The “Holy Anorexia” of ascetic women who sought to become pure through fasting was, says Newton, “apparently epidemic in the Middle Ages”. The culture can turn this genetic predisposition on and off.

But what this awareness campaign does not give us is any indication that the disease may be genetic. Researcher in risk factors for ED at the University of Melbourne Isabel Krug rattles off a list of studies on potential endophenotypes, heritability, genome wide association and other data that we lay people can trust to mean that these disorders, particularly anorexia, involve a genetic predisposition.

There are even emerging biomarkers for anorexia, and Rossell was lately involved in a study on a particular eye movement called the “square wave jerk”. It is my lay understanding that imaging for anorexia shows more evolved promise than for those in the study of all other psychiatric disorders. It’s odd that common wisdom, and a great deal of general medicine, treats a common mental illness like depression as a case of “chemical imbalance” or genes, and anorexia as purely the result of social factors like bullying or super-skinny ladies in magazines.

Depression, despite its lack of biomarkers and clear prevalence among those poor in social capital, is read as biological. Anorexia, despite great evidence of its biological basis, is read as social and The Butterfly Foundation certainly overplays this by recommending being nice to people as a cure for death.

I asked Rossell about our willingness to see anorexia as an entirely manufactured disorder and she said: “It’s because it occurs so often in young girls”. She is unwilling to elaborate much further but when I asked her if it was due to the assumption that young women are empty vessels whose untainted bodies just wait to be filled by the culture she makes an ambivalent noise.

She is not ambivalent, however, on the enduring refusal to study and describe anorexia as having a biological basis. “There are papers I have tried to publish and these have been refused on the grounds that I am trying to overly medicalise anorexia,” she said. “Of course the biopsychosocial model is one that should be observed. But if you continually refuse to acknowledge the ‘bio’ in that complex, then you will end up with no idea of how the different elements interact.”

With medicine so reluctant to commit itself to an explanation for ED, it’s hardly surprising that groups like The Butterfly Foundation would follow suit. But even if we agree that it’s better to take the potential social catalysts for EDs out of the picture, the “dis” campaign fails miserably on that score.

Let’s even allow that the foundation’s normalisation of extreme ED and selective mortality statistic will do no harm and just think about the phrase “don’t DIS my appearance”. Given that the most at-risk ED sufferers are those who are underweight and gain at least as much momentum from the compliments their tiny silhouettes routinely attract as they may have from an early life “DIS”, perhaps “don’t praise my appearance” might be a more effective tactic.

Approbation is, perhaps, even more hazardous to ED patients than condemnation. As Rossell suggests, many public conversations that purport to address ED patients are really just intended for gals who feel like they might be a bit unattractive. And even if making the super body conscious feel a bit better about their flab is considered a good outcome, the “don’t DIS” edict doesn’t even really work here.

If women, both those who suffer an ED and those who just feel a bit shit about their bodies, want to be liberated from the primacy of the image, then surely an obvious solution is to detonate the power of the image.

Here’s my campaign, free of charge, to The Butterfly Foundation next May. How about you try “completely DISregard my appearance”? And instead of using attractive ambassadors and expensive manicures to underscore the lack of importance of the image, try a picture of me after 24 straight hours of researching EDs in my pyjamas. I’ll show you just how visual perfection has very little currency in one adult human woman’s working life.

 

 

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This is worth repeating again, thank you to PEDAW and VanCityBuzz

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Online chatter these days often illustrates there is a long way to go before many people fully realize what an eating disorder truly is: a mental illness, or a disease of the brain.

On February 2, we published an article detailing the struggles of a 21-year-old B.C. woman who has resorted to crowd-funding to treat her severe eating disorder. Some of the publicly posted responses highlight the common misconceptions about eating disorders, so we thought we’d take a look at the kinds of misinformation that gets in the way of the good work being done to help those struggling with eating disorders.

While many of those who responded to our story were supportive of the woman’s endeavors to receive help, another fair share could not understand why her disease warranted help, let alone a news story.

The issue is complex.

But those without the education, life experiences or personal struggles that create compassion for and understanding of eating disorders will continue to criticize the publicity of this disease. They will mumble under their breaths something like “just eat a hamburger” or whisper to their friends “she doesn’t look anorexic.”

And that is where a direct response to these comments is needed. For eating disorders to receive the support they need, the stigmatization needs to be removed and the harsh reality of the disease needs to be learned.

Here are some common misconceptions and comments made about eating disorders, along with responses to the issues from professionals:

1. Just eat if you’re anorexic.

“Having an eating disorder means having neurological or neuroanatomical organization of your brain that creates enormous barriers to eating normally. These barriers include visual and sensory distortions, impacts on reward centers and executive organization of the brain, distortions of senses of fullness and hunger, and over evaluation of body size and shape, in addition to other issues that may be present. The combination of all of these things makes eating incredibly hard to do.”

Dr. Mark Warren, Cleveland Center for Eating Disorders

2. Just smoke weed, then you’ll get the munchies!

“We definitely want individuals to eat and digest food in order to heal their physical bodies. This being said, balance is key, so optimally they will work with supports to find ways of eating without using other substances that further promote numbing out to their present experience.”

Natasha Files, Individual and Family Therapist, Looking Glass Foundation

3. It’s more important to donate money to underprivileged children who can’t afford to eat.

“Suffering takes many forms. I have worked with individuals from all socio-economic realms, with some people having money for food and others not. Please choose to donate money to what moves you, but know that eating disorders are an illness cloaked in shame and secrecy. Many individuals do not get help unless their loved ones encourage them to do so, meaning that asking for support takes significant courage.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

4. #firstworldproblems

“There have been many reports about eating disorders in Western countries in the late 20th century. It has been claimed that those with eating disorders have mostly been white women and that few cases have been seen in non-Western countries other than Japan. Recently, eating disorders have been reported in non-Western countries, such as the Middle East and the People’s Republic of China.These recent studies suggest that the prevalence of eating disorders has been rising among non-Western countries as well. However, eating disorders may present differently in different cultures, and diagnostic criteria based on Western norms may not always be appropriate.”

– Makino, Maria, Koji Tsuboi, and Lorraine Dennerstein. “Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.” Medscape General Medicine 6.3 (2004): 49. Print.

5. There are people fighting cancer who can’t eat, and other people far worse off. Stop being so selfish and just eat.

“These kinds of statements just increase the guilt and shame of a person suffering from an eating disorder- which can lead to an increase in coping behaviours designed to avoid those uncomfortable feelings… cue the binge purge cycle or restriction!”

Trixie Hennessey MSW, RSW, Individual and Family Therapist

6. Anorexia is a serious disorder… but it’s not as bad as cancer or AIDS. We should focus on helping those people.

“Categorizing eating disorders as less deserving of support than other illnesses proves the ongoing struggle with stigmatization in our society. One outcome of struggling with an eating disorder is death. Eating disorders are the third most chronic condition among adolescent females (after asthma and obesity), yet have significantly less funding towards research and treatment.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

“Actually, more people die from eating disorders (350,000) than from breast cancer (approximately 40,000) every year. Females aged 15–24 are 12 times more likely to die of an eating disorder than any other cause of death. More people die of eating disorders than any other mental/behavioral disorder including depression.”

– Atlanta Center for Eating Disorders

7. You don’t look anorexic!

“Being the most lethal of psychiatric illness, eating disorders come with a number of serious health consequences, even if the individual looks “okay”. Low blood sugar, blood abnormalities (electrolyte imbalances), enamel erosion, dizziness/confusion, esophagitis, arrhythmias, acrocyanosis, edema, growth retardation in children and adolescents, and sometimes death. Eating disorders affect every system of the body, meaning that glancing at someone’s body shape does not determine the level of physical impact.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

8. You should be grateful you can afford to feed yourself. If you knew real hardship, you wouldn’t have this problem.

“Individuals who develop eating disorders are usually very sensitive.  They are physiologically more sensitive from birth than the average person. They are very in tune with the feelings of others and have a strong drive to want everyone around them to be happy. This often leads to perfectionism as they try to reduce any negativity that they or others will experience. As the disorder progresses they become caught in a vicious cycle where their attempts at being the best that they can be actually does cause others negative feelings — but at that point they can’t just stop. The attempt to be perfect is primarily a way to ensure that nothing about them will cause anyone else any distress and to ensure that others will not find fault in them, something that they are very sensitive about.”

– Atlanta Center for Eating Disorders

9. Starving yourself to death is a choice, just like taking drugs or drinking too much.

“There is no choice when it comes to an eating disorder. There is a choice to start out with behaviours such as dieting, exercising, fasting, etc… but there are many people that diet, exercise and overeat that do not have an eating disorder. There are many people unhappy with their weight and shape who do not have an eating disorder. Eating disorder treatment is complex and an intense process. I would encourage you to question this assumption, as I feel it perpetuates the stigma and feelings of shame that keep people from reaching our for help if they need it.”

– Trixie Hennessey MSW, RSW, Individual and Family Therapist

“Someone can make the choice to pursue recovery, but the act of recovery itself is a lot of hard work and involves more than simply deciding to not act on symptoms. In most cases, the eating disorder has become a person’s primary way of coping with intense emotions and difficult life events.  In order to heal from the eating disorder, a person needs appropriate treatment and support regarding medical monitoring, nutritional rehabilitation as well as learning and practicing healthier ways to manage stress.”

– The Center for Eating Disorders

 

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Research is only as good as the questions it is asked to frame. If you want a certain position to back or fund, then unfortunately research is often commissioned for a purpose. The questions asked frame the answer that can helpfully back up your stance. There is too much old research for eating disorders still around and sadly, too much new research focussed on the wrong issues. Eating disorders are biological and genetic based. They are not developed from body image, media, diet, trauma or anything else. These issues are the trigger so to speak. Everything that we are exposed to from birth correlate with our genes and personality and create – basically – the perfect storm. It is easy for anyone to blame any of these issues, as they are the visible ones, the easy ones to blame. They provide a nice and easy solution to fund, research and form campaigns on. However the easy way out is not the right way, nor the future of understanding how eating disorders really do begin. Any of us with a son or daughter with an ED will tell you it is far, far more than these touted issues. There really is a genetic switch that flips, that in many cases you can actually see when it flips.

This new research below (from Douglas Mental Health University Institute Eating Disorders Program (EDP), in Montreal,) is the direction we need to start taking. Pulling apart more and more the brain, chemical, and genetic structure. Another good research piece is also the Swinburne finds this year on anorexia: http://www.swinburne.edu.au/media-centre/news/2015/01/anorexia-study-reveals-abnormal-eye-movements.html

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Montreal, February 7, 2015 – A study led by Howard Steiger, PhD, head of the Douglas Mental Health University Institute Eating Disorders Program (EDP), in Montreal, in collaboration with Linda Booij, a researcher with Sainte-Justine Hospital and an assistant professor at Queen’s University, is the first to observe effects suggesting that the longer one suffers from active anorexia nervosa (AN), the more likely they are to show disorder-relevant alterations in DNA methylation.

When methylation is altered, gene expression is also altered, and when gene expression is altered, the expression of traits that are controlled by those genes is also changed. In other words, altered methylation can produce changes in emotional reactions, physiological functions and behaviors. A report to be published in the International Journal of Eating Disorders, entitled “DNA methylation in individuals with Anorexia Nervosa and in matched normal-eater controls: A genome-wide study,” is showing chronicity of illness in women with AN to be associated with more pronounced alteration of methylation levels in genes implicated in anxiety, social behavior, various brain and nervous system functions, immunity, and the functioning of peripheral organs.

“These findings help clarify the point that eating disorders are not about superficial body image concerns or the result of bad parenting. They represent real biological effects of environmental impacts in affected people, which then get locked in by too much dieting,” says Dr. Steiger, Chief of the Eating Disorders Program at the Douglas Institute and a professor of Psychiatry at McGill University.

“We already know that eating disorders, once established, have a tendency to become more and more entrenched over time. These findings point to physical mechanisms acting upon physiological and nervous system functions throughout the body that may underlie many of the effects of chronicity. All in all, they point to the importance of enabling people to get effective treatments as early in the disorder process as possible,” adds Dr. Steiger.

Exploring crucial questions

The results of this work imply that epigenetic mechanisms may underlie some of the consequences of anorexia nervosa that affect nervous system functioning, psychological status and physical health. If so, an intriguing possibility arises: Does remission of anorexic symptoms coincide with normalization (or resetting) of methylation levels (and could such effects provide clues to more effective treatments)? Current work at the Eating Disorders Program at the Douglas Institute is oriented toward exploring exactly this question.

 

http://www.eurekalert.org/pub_releases/2015-02/dmhu-an020615.php

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