Monday, 22 February 2010
Eating Disorders research unit lecture
I was intending to go to this lecture in January but was beaten back by snow in London bringing it to a standstill. You can listen to the audio file.
It traces the history of the disease from religious fasting to bulimia identified in the 70's, increasing rapidly in the 90's, and on to the modern disorder of obesity. The second part of the lecture is a personal history.
0.5 - 2 % have AN
2-4% have bullimia
Larger numbers, up to 10% of young women, suffer from EDNOS - eating disorder not otherwise specified (like Waif).
There is a 9:1 ratio of EDs in towns and cities compared with in a rural environment, and also Westernised countries. We are living in London which is not a good start.
There are certain biological factors that are correlated with an increased likelihood of developing an ED:
- stress in pregnancy and/or birth
- having a strong relationship with one's father is very protective
- having a father who approves of thinness and/or who teases about weight is particularly toxic
- the attitude of the mother was commonly thought to be important but the research has in fact indicated that the key relationship is with the father, although insecure attachments of the sufferers and perhaps of their mothers too can be a factor.
- EDs in the family increase risk
There are then triggers:
- the media's obsession with Size Zero and airbrushing images
- the initial praise gained by the sufferer when she loses weight
Other factors tend to sustain the ED after it has commenced, the main one being the effect of starvation on the brain. This means that the sufferer becomes impaired at emotional recognition and regulation - she may have temper tantrums, for instance. I found this interesting as OD gets fed up with Waif's unreasonableness at times and perhaps, after listening to this lecture, she will have more understanding. The upshot of the inability to understand emotions normally is that the sufferer can lose friends and become socially isolated, leaving ED as her "only friend" (snort).
Another cognitive effect of starvation on the brain is that on the ability to think flexibly and to step back and see the bigger picture is inhibited. This too can hinder recovery.
Treatment should focus on these barriers to recovery.
One interesting study showed that rats, when starved and then given unlimited access to palatable food on, say, Mondays and Wednesdays, compulsively over eat. Worryingly, they also show a change in their brains rendering them more "addictive" generally. I worry about Waif drinking/ smoking to excess when she is older as she is immoderate in all she does at the moment. Nothing is half hearted (unlike the rest of us, she never gives up half way through a task).
Gresham College is a wonderful institution.