Severe and Enduring Anorexia Nervosa: Enduring Wrong Assumptions?

Gutiérrez, Emilio; Carrera, Olaia

doi:10.3389/fpsyt.2020.538997

Cited by 13 publications

(11 citation statements)

References 157 publications

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“…From these initial results we can provide some insights to clinical discussion. More and more clinicians (Gutiérrez and Carrera, 2021) ask themselves about the intractability of anorexia nervosa, including the disconcerting aspect of the recovery of a significant number of patients not receiving formal treatment (Keski-Rahkonen, 2014). As Gutiérrez and Carrera (2021) state in a recent review of this issue, Bruch's proposal regarding the charactization of typical anorexia in terms of Body Image Disturbances (BID) (Bruch et al, 1974) and the relevance of this construct in different editions of the Diagnostic and Statistical Manual of Mental Disorders (APA, 2014), may have over-directed clinical practice, rendering other aspects of psychopathology invisible and increasing the numbers of patients diagnosed as atypical cases.…”

Section: Connection To Clinical Researchmentioning

confidence: 99%

Understanding Patterns of Anorexia Manifestations in Social Media Data with Deep Learning

Uban¹,

Chulvi²,

Rosso³

2021

Proceedings of the Seventh Workshop on Computational Linguistics and Clinical Psychology: Improving Access

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Eating disorders are a growing problem especially among young people, yet they have been under-studied in computational research compared to other mental health disorders such as depression. Computational methods have a great potential to aid with the automatic detection of mental health problems, but stateof-the-art machine learning methods based on neural networks are notoriously difficult to interpret, which is a crucial problem for applications in the mental health domain. We propose leveraging the power of deep learning models for automatically detecting signs of anorexia based on social media data, while at the same time focusing on interpreting their behavior. We train a hierarchical attention network to detect people with anorexia, and use its internal encodings to discover different clusters of anorexia symptoms. We interpret the identified patterns from multiple perspectives, including emotion expression, psycho-linguistic features and personality traits, and we offer novel hypotheses to interpret our findings from a psycho-social perspective. Some interesting findings are patterns of word usage in some users with anorexia which show that they feel less as being part of a group compared to control cases, as well as that they have abandoned explanatory activity as a result of a greater feeling of helplessness and fear.

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Section: Connection To Clinical Researchmentioning

confidence: 99%

Understanding Patterns of Anorexia Manifestations in Social Media Data with Deep Learning

Uban¹,

Chulvi²,

Rosso³

2021

Proceedings of the Seventh Workshop on Computational Linguistics and Clinical Psychology: Improving Access

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“…Furthering gaps in AN communication, individuals with AN are not always deemed credible in research studies, such that researchers conclude patients must be in denial when their results are unexpected, (e.g. respondents do not present body image disturbance as anticipated) [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The importance of this study stems from an epistemological view that individuals who experience and narrate AN can be primary “knowers” or experts in this arena [ 7 ]. This research is urgent because conventional treatment practices, which may diminish personal voice in AN healing processes, may cause iatrogenic harm [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Contemporary research into AN is increasingly more interdisciplinary and dynamic in etiological inquiry and epistemological approach, for instance, in considering relationships between the social environment, individual psychology, neuroscience, and epigenetics [ 26 , 27 ]. But even as academic theories have advanced to more complex explanations, AN is still conceptualized in reductionist ways in the cultural imagination, where appearance ideals continue to dominate [ 8 , 28 ]. Legislative initiatives, including body mass index (BMI) minimum mandates for models and advertiser notes on altered images, imply that altering popular media will serve as a protective factor against AN [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Weighing in: qualitative explorations of weight restoration as recovery in anorexia nervosa

Barko

Moorman

2023

J Eat Disord

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Background Anorexia Nervosa (AN) continues to capture the public’s imagination, centered around physical appearance, particularly weight. Clinical conceptions of AN also emphasize weight. The objective of this study was to explore how individuals with lived AN experience thought about the role of weight in illness and recovery. Methods The current study employed a grounded theory approach through qualitative inductive inquiry and analysis of 150 anonymous narratives, exploring firsthand experience of AN and recovery of adult individuals, based in the United States of America. Results Individuals with AN histories contested intersecting popular cultural and medical presumptions of their health and illness positioned in weight. Respondents indicated that while weight does not measure recovery, it matters to recovery in unanticipated ways. Others’ expectations for a low weight served as a gatekeeper to various forms of social and institutional support. Respondents felt that the weight obsessions of other people made it difficult to earn the illness legitimacy to access sufficient care. Conclusions Research findings bear implications for future AN research, advocacy, and clinical practice, as respondents pivot research emphasis from weight as a sociocultural motivation for AN, to weight as a sociocultural obstacle to AN recovery.

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“…Some researchers ( Gutierrez and Carrera, 2020 ) have argued that body image disturbances in AN are merely epiphenomena of the low body weight. This proposition may be correct, but it is difficult to ascertain, considering the absence of such extreme low weights without disease.…”

Section: Diminished Physical Activity and Inertia In Experimental Sta...mentioning

confidence: 99%

Restlessness and an Increased Urge to Move (Drive for Activity) in Anorexia Nervosa May Strengthen Personal Motivation to Maintain Caloric Restriction and May Augment Body Awareness and Proprioception: A Lesson From Leptin Administration in Anorexia Nervosa

Casper

2022

Front. Psychol.

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Anorexia nervosa (AN), a disorder of voluntary food restriction leading to severe weight loss in female adolescents, remains an enigma. In particular, the appropriation of the starved thin body into the self-concept in AN is a process insufficiently researched and still poorly understood. Healthy humans undergoing starvation experience a slowing of movements and avoid voluntary exercise. By contrast, AN tends to be not infrequently associated with voluntary, sometimes excessive and/or compulsive exercise. Such deliberate exercise, not reported in starvation, seems to be facilitated by an increased urge for movement and physical restlessness, particular to AN. The increased urge to move would reflect spontaneous daily activity, the energy expended for everything that is not sleeping, eating, or voluntary exercise. Our hypothesis is that the starvation-induced increased urge to move and restlessness may promote the development of AN. Reversal of the fasting state, by either high caloric food or by leptin administration, would be expected to reduce restlessness and the increased urge to move along with improvement in other symptoms in AN. This review explores the idea that such restless activation in AN, in itself and through accelerating body weight loss, might foster the integration of the starving body into the self-concept by (1) enhancing the person’s sense of self-control and sense of achievement and (2) through invigorating proprioception and through intensifying the perception of the changing body shape. (3) Tentative evidence from studies piloting leptin administration in chronic AN patients which support this hypothesis is reviewed. The findings show that short term administration of high doses of leptin indeed mitigated depressive feelings, inner tension, intrusive thoughts of food, and the increased urge to be physically active, easing the way to recovery, yet had little influence on the patients’ personal commitment to remain at a low weight. Full recovery then requires resolution of the individuals’ personal unresolved psychological conflicts through psychotherapy and frequently needs specialized treatment approaches to address psychiatric co-morbidities. AN might be conceptualized as a hereditary form of starvation resistance, facilitated by the effects of starvation on fitness allowing for an exceptionally intense personal commitment to perpetuate food restriction.

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Severe and Enduring Anorexia Nervosa: Enduring Wrong Assumptions?

Cited by 13 publications

References 157 publications

Understanding Patterns of Anorexia Manifestations in Social Media Data with Deep Learning

Understanding Patterns of Anorexia Manifestations in Social Media Data with Deep Learning

Weighing in: qualitative explorations of weight restoration as recovery in anorexia nervosa

Restlessness and an Increased Urge to Move (Drive for Activity) in Anorexia Nervosa May Strengthen Personal Motivation to Maintain Caloric Restriction and May Augment Body Awareness and Proprioception: A Lesson From Leptin Administration in Anorexia Nervosa

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