Posts Tagged ‘Research’

One of the tricky things about mental health problems is that the outside world only sees the tip of the iceberg. The observable behaviors and symptoms are apparent for all to see, but underneath the visible exterior is a complex set of thoughts, emotions, beliefs, and experiences. These are the mechanisms which truly power things like eating disorders and OCD, but for better or worse, they tend to go unnoticed. It makes sense, then, that someone might believe that treating these problems is as simple as telling someone to “just eat” or to “just stop eating.” After all, we have the ability to make choices about our behavior, so shouldn’t we be able to wrangle these symptoms into our control? When a therapist says to resist a compulsion or to follow a meal plan, aren’t they saying that it’s just a matter of pushing through the discomfort?

As you probably know, it’s not quite that simple. Sure, determination and willingness will come in handy, but we have to be careful not to reduce this process to something so simple. The oversimplified American mentality of “picking yourself up by your bootstraps” doesn’t always fit with the complexities of mental health. Tempting as it might be to double down on willpower, it’s actually not a particularly effective way to get things done. Willpower is a finite resource. We inevitably lose steam and end up depleted. 

“Eating disorders.” Reading those two words, most of us just visualized a teenage or college-aged girl. And let’s be honest—she’s probably white as well.

Not so long ago, age seemed to immunize adult women from the body image concerns, weight issues, and eating disorders that plague the younger years. Although most cases still appear in adolescent girls and young women, an alarming shift has occurred. Eating disorders have been on the rise among middle-aged and older women. Between 1999 and 2009, inpatient admissions showed the greatest increase in this group, with women over age 45 accounting for a full 25% of those admissions in the United States. Despite this, these women are invisible in our healthcare system. This must change.

The cultural pressures to be perfect—including having a flawless, slim body—have no expiration dates and no boundaries. This pressure is now occurring across age, gender, sexual orientation, race, ethnicity, ability, class, culture, and place. Our fast-moving consumer culture has created unprecedented opportunities and stress for women. Despite growing economic strength, political influence, and educational and career opportunities, a Gallup Well-Being Index indicates that women aged 45 to 64 have the lowest well-being and highest stress of any age group or gender in the United States.

Eating disorders have stereotypically been associated with slim, white, young, heterosexual, cisgender women. In reality, eating disorders can affect anyone, regardless of how they look or identify. Eating disorders are brain-based biological illnesses that have complex causes and require specialized care. However, the stereotypical idea of someone with an eating disorder has serious ramifications on who is diagnosed and who then receives proper treatment.

Consequences of the Thin, White Woman Stereotype

Historically, there has been a misconception that eating disorders affect only thin, young, white females. Early research was conducted on only white women, which led people to believe eating disorders were only a white woman’s disease. Despite most providers now knowing that this is false, the initial belief had serious implications for eating disorder treatment today.

This initial stereotype became ingrained in the larger society, with both patients and healthcare providers working under the assumption that eating disorders only happened in certain individuals. Not only did this lead to providers missing eating disorder diagnoses in people of color, but it also caused people of color to question if they really had disordered eating that was worthy of treatment.

Episode description:

Dr. Laura Hill is an international eating disorder consultant focusing on brain-based eating disorder treatment approaches. She is an Adjunct Associate Professor of Psychiatry and Behavioral Health at The Ohio State University and Assistant Clinical Professor in the Department of Psychiatry at The University of California, San Diego. She is one of the original founders of the Academy for Eating Disorders and the Director of the organization now known as NEDA from 1990 to 1994. In addition, Dr. Hill is the founder and former President and Chief Executive Officer of The Center for Balanced Living.

In this episode of Peace Meal, Dr. Hill introduces an emerging brain-based treatment called Temperament-Based Therapy with Supports (TBT-S). TBT-S helps people with eating disorders understand their unique temperament so that they can use it as a tool for recovery. Distinguishing between traits and symptoms, Dr. Hill explains that temperament includes traits like impulsivity, introversion, and determination, while symptoms include eating disorder behaviors, thoughts, and emotions. She emphasizes that temperament traits are neither good nor bad; what’s important is how they are applied. TBT-S helps people with eating disorders and their support people use their traits more productively to aid in recovery. Dr. Hill also talks about the importance of support in treatment and recovery. In the end, she addresses how providers can use TBT-S to complement other treatment approaches. 

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The 10th Annual Veritas Collaborative Symposium on Eating Disorders, co-hosted by The Emily Program, will unite healthcare professionals and eating disorder experts around this year’s theme, “Engaging Science, Unifying Voices, and Transforming Access.” In this article, Mae Lynn Reyes-Rodríguez, PhD, FAED, a speaker at this year’s Symposium, discusses the prevalence of eating disorders in the Latino population and underscores the need for culturally competent care.

Eating disorders do not discriminate based on race or ethnicity. Actually, data from different national studies have shown that eating disorders in the Latino population are at similar or higher prevalence when compared with non-Latino Whites (Alegria et al., 2007; Marques et al., 2011; Udo & Grilo, 2018). However, due to the historical emphasis around European White females in the eating disorder field, most of the assessments and treatments have been developed and tested with and for this population. This is problematic because it has contributed to clinician bias and stigma, which are some of the barriers preventing Latinas to seek treatment for eating disorders (Reyes-Rodríguez et al., 2013). Moreover, the research about service utilization among individuals with a history of eating disorders reveals that Latinxs with bulimia nervosa (BN) and binge eating disorder (BED) are less likely to seek treatment when compared with non-Latino Whites (Coffino, Udo, & Grilo, 2019; Marques et al., 2011). This health disparity is concerning because BN and BED are the most prevalent eating disorders in this population (Perez, Ohrt, & Hoek, 2016). Other factors such as lack of health insurance, lack of bilingual services, and lack of information about services can be associated with this underutilization of services (Ali et al., 2017; Reyes-Rodríguez, 2013). The long history of misconception and negligence has negatively affected the early detection, prevention, and treatment for eating disorders in the Latino population.

The 10th Annual Veritas Collaborative Symposium on Eating Disorders, co-hosted by The Emily Program, will unite healthcare professionals and eating disorders experts around this year’s theme, “Engaging Science, Unifying Voices, and Transforming Access.” In this article, Ben Eckstein, a speaker at this year’s Symposium, explores the connection between OCD and eating disorders.

Rigid routines. Experiential avoidance. Feeling out of control. Ruminative thoughts. Are we talking about OCD or eating disorders? Maybe both. Are we talking about OCD or eating disorders? Maybe both. If you’ve spent any time treating eating disorders, chances are good that you’ve come across an individual with comorbid Obsessive-Compulsive Disorder (OCD). While rates vary across different types of eating disorders, studies generally show comorbidity rates ranging from 10–44%. This frequent overlap can create diagnostic confusion even for seasoned clinicians. It’s easy to see why: though there are some clear distinctions, the phenomenological similarities can muddy the water and complicate diagnosis and treatment planning.