A systematic review of the ‘eating disorder voice’ experience

Aya, Viviana; Ulusoy, Kubra; Cardi, Valentina

doi:10.1080/09540261.2019.1593112

Cited by 27 publications

(22 citation statements)

References 44 publications

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“…Isolation and unstructured time affected participants in many ways, and resulted in the ED voice becoming more prominent and harder to resist. Experience of the ED voice has been shown to influence ED pathology [e.g., (26)], such that a stronger ED voice has been associated with more severe ED psychopathology (27). This was reflected in the worsening of ED symptoms reported by the majority of participants, which is consistent with research showing that social support is an important factor in managing ED recovery (28,29).…”

Section: Discussionsupporting

confidence: 79%

“Now It's Just Old Habits and Misery”–Understanding the Impact of the Covid-19 Pandemic on People With Current or Life-Time Eating Disorders: A Qualitative Study

et al. 2020

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Background: Many aspects of the Covid-19 pandemic may make living with or recovery from an eating disorder (ED) particularly challenging. Understanding the processes which underlie the psychological and behavioral responses of people with EDs during this time are key to ensure tailored support in these unprecedented circumstances. Methods: People with lifetime EDs (n = 32) were recruited through social media from May to June 2020 during a period of strict infection control measures in the United Kingdom (i.e., "lockdown," "social distancing"). They completed open-ended questions in an online anonymous questionnaire that invited them to reflect on how various aspects of their lives have been affected by the Covid-19 pandemic, including ED symptoms and coping strategies. Responses were analyzed using thematic analysis. Results: Most respondents reported that their ED worsened or resurfaced. Isolation, low mood, anxiety, lack of structure, disruption to routines, and media/social media messages around weight and exercise seemed to contribute to this. There was a clear sense that individuals struggled with which aspects of psychological distress to prioritize, i.e., mood vs. ED cognitions and behaviors, particularly as attempts to cope with one often exacerbated the other. Nonetheless, some participants reported "silver linings" of the pandemic. Conclusions: In this self-selected sample, deterioration or recurrence of ED symptoms were the norm. This has implications for the provision of treatment and care for people with EDs both in the immediate short-term and in potential future waves of the pandemic, with a significant surge of new and re-referrals expected.

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Section: Discussionsupporting

confidence: 79%

“Now It's Just Old Habits and Misery”–Understanding the Impact of the Covid-19 Pandemic on People With Current or Life-Time Eating Disorders: A Qualitative Study

et al. 2020

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“…In the context of the goal conflict model of eating (Stroebe et al, 2013 ), dietary self-talk might provide a mechanism for switching from the weight control goal to the food enjoyment goal. Despite the prominence of the self-talk concept in domains such as sports performance (Tod, Hardy, & Oliver, 2011 ) and disordered eating (Aya, Ulusoy, & Cardi, 2019 ), limited research to date has explicitly focused on the self-talk around everyday food choices including the context of discretionary snacking. As snacking is a complex behaviour, understanding the content of dietary self-talk before consuming discretionary snacks may provide a target for health-focused eating interventions.…”

Section: Introductionmentioning

confidence: 99%

Examining dietary self-talk content and context for discretionary snacking behaviour: a qualitative interview study

Rose

Pedrazzi

Dombrowski

2022

Health Psychology and Behavioral Medicine

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Background: Consuming discretionary snack foods high in calories, salt, sugar or fat in between regular meals can have a negative impact on weight management and health. Despite the intention to refrain from discretionary snacking, individuals often report feeling tempted by snack foods. A cognitive process to resolve food choice related tension may be dietary self-talk which is one’s inner speech around dietary choice. This study aimed to understand the content and context of dietary self-talk before consuming discretionary snack foods. Methods: Qualitative semi-structured interviews based on Think-Aloud methods were conducted remotely. Participants answered open-ended questions and were presented with a list of 37 dietary self-talk items. Interview transcripts were analyzed thematically. Results: Interviews ( n = 18, age: 19–54 years, 9 men, 9 women) confirmed the frequent use of dietary self-talk with all 37 content items endorsed. Reported use was highest for the self-talk items: ‘It is a special occasion’; ‘I did physical activity/exercise today’; and ‘I am hungry’. Three new items were developed, eight items were refined. Identified key contextual themes were: ‘reward’, ‘social’, ‘convenience’, ‘automaticity’, and ‘hunger’. Conclusions: This study lists 40 reasons people use to allow themselves to consume discretionary snack foods and identifies contextual factors of dietary-self talk. All participants reported using dietary self-talk, with variation in content, frequency and degree of automaticity. Recognising and changing dietary self-talk may be a promising intervention target for changing discretionary snacking behaviour.

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“…18 19 Patients who develop AN can experience an 'anorexic voice' which can be powerful, negative and omnipotent. 20 The strength of this 'voice' has been positively associated with childhood emotional abuse. 21 This voice may also complicate the assessment process, as it may leave patients feeling anxious about being in healthcare settings and the intention of the healthcare staff they encounter.…”

Section: Underlying Psychology and Neurophysiologymentioning

confidence: 99%

“…21 This voice may also complicate the assessment process, as it may leave patients feeling anxious about being in healthcare settings and the intention of the healthcare staff they encounter. 20 Externalising conversations about AN, which locate the condition and its voice outside of the person, rather than as being a part of them, shifts the locus of volition.…”

Section: Underlying Psychology and Neurophysiologymentioning

confidence: 99%

Recognising and managing eating disorders in the emergency department

Jafar

Everitt

et al. 2021

Postgraduate Medical Journal

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Compared with other mental health conditions or psychiatric presentations, such as self-harm, which may be seen in emergency departments, eating disorders can seem relatively rare. However, they have the highest mortality across the spectrum of mental health, with high rates of medical complications and risk, ranging from hypoglycaemia and electrolyte disturbances to cardiac abnormalities. People with eating disorders may not disclose their diagnosis when they see healthcare professionals. This can be due to denial of the condition itself, a wish to avoid treatment for a condition which may be valued, or because of the stigma attached to mental health. As a result their diagnosis can be easily missed by healthcare professionals and thus the prevalence is underappreciated. This article presents eating disorders to emergency and acute medicine practitioners from a new perspective using the combined emergency, psychiatric, nutrition and psychology lens. It focuses on the most serious acute pathology which can develop from the more common presentations; highlights indicators of hidden disease; discusses screening; suggests key acute management considerations and explores the challenge of mental capacity in a group of high-risk patients who, with the right treatment, can make a good recovery.

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A systematic review of the ‘eating disorder voice’ experience

Cited by 27 publications

References 44 publications

“Now It's Just Old Habits and Misery”–Understanding the Impact of the Covid-19 Pandemic on People With Current or Life-Time Eating Disorders: A Qualitative Study

“Now It's Just Old Habits and Misery”–Understanding the Impact of the Covid-19 Pandemic on People With Current or Life-Time Eating Disorders: A Qualitative Study

Examining dietary self-talk content and context for discretionary snacking behaviour: a qualitative interview study

Recognising and managing eating disorders in the emergency department

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