It’s not all about control: Challenging mainstream framing of eating disorders

Background: The concept of control has long been suggested as a central factor in eating disorder ( aetiology. The concept is now so mainstream that it risks being used in a potentially reductionist, stigmatising or otherwise harmful manner. In this we explore and discuss our positions on the use of control related terminologyfor EDs. Methods: The authors of this auto ethnographic position paper include academic researchers, individuals with lived experience and clinicians not mutually exclusive) In sharing our experiences and observations, we aim to raise awareness of the wider impacts that control framing can have on ED perceptions, treatment, recovery and individuals’ lived experience. Results We argue that although control can play a role in some ED experiences, an overemphasis upon this factor to the exclusion of other conceptualisations is not beneficial. Conclusions: To mitigate against pathologisation of an individual, it is important to challenge a discourse that can lead to EDs being perceived as something ‘ with the individual, rather than a consequence of life events or other environmental influences We identify priorities for the future for researchers, clinicians, policy makers and the wider public

Conceptualizing eating disorder recovery research: Current perspectives and future research directions

BackgroundHow we research eating disorder (ED) recovery impacts what we know (perceive as fact) about it. Traditionally, research has focused more on the "what" of recovery (e.g., establishing criteria for recovery, reaching consensus definitions) than the "how" of recovery research (e.g., type of methodologies, triangulation of perspectives). In this paper we aim to provide an overview of the ED field's current perspectives on recovery, discuss how our methodologies shape what is known about recovery, and suggest a broadening of our methodological "toolkits" in order to form a more complete picture of recovery. BODY: This paper examines commonly used methodologies in research, and explores how incorporating different perspectives can add to our understanding of the recovery process. To do this, we (1) provide an overview of commonly used methodologies (quantitative, qualitative), (2) consider their benefits and limitations, (3) explore newer approaches, including mixed-methods, creative methods (e.g., Photovoice, digital storytelling), and multi-methods (e.g., quantitative, qualitative, creative methods, psycho/physiological, behavioral, laboratory, online observations), and (4) suggest that broadening our methodological "toolkits" could spur more nuanced and specific insights about ED recoveries. We propose a potential future research model that would ideally have a multi-methods design, incorporate different perspectives (e.g., expanding recruitment of diverse participants, including supportive others, in study co-creation), and a longitudinal course (e.g., capturing cognitive and emotional recovery, which often comes after physical). In this way, we hope to move the field towards different, more comprehensive, perspectives on ED recovery.ConclusionOur current perspectives on studying ED recovery leave critical gaps in our knowledge about the process. The traditional research methodologies impact our conceptualization of recovery definitions, and in turn limit our understanding of the phenomenon. We suggest that we expand our range of methodologies, perspectives, and timeframes in research, in order to form a more complete picture of what is possible in recovery; the multiple aspects of an individual's life that can improve, the greater number of people who can recover than previously believed, and the reaffirmation of hope that, even after decades, individuals can begin, and successfully continue, their ED recovery process

It’s not all about control: Challenging mainstream framing of eating disorders

Background: The concept of control has long been suggested as a central factor in eating disorder (ED) aetiology. The concept is now so mainstream that it risks being used in a potentially reductionist, stigmatising or otherwise harmful manner. In this paper, we explore and discuss our positions on the use of control-related terminology for EDs. Methods: The authors of this auto-ethnographic position paper include academic researchers, individuals with lived experience and clinicians (not mutually exclusive). In sharing our experiences and observations, we aim to raise awareness of the wider impacts that control framing can have on ED perceptions, treatment, recovery and individuals’ lived experience. Results: We argue that although control can play a role in some ED experiences, an overemphasis upon this factor to the exclusion of other conceptualisations is not beneficial. Conclusions: To mitigate against pathologisation of an individual, it is important to challenge a discourse that can lead to EDs being perceived as something ‘wrong’ with the individual, rather than a consequence of life events or other environmental influences. We identify priorities for the future for researchers, clinicians, policy makers and the wider public

Attitudes towards eating disorders clinicians with personal experience of an eating disorder

Purpose: This study explores the perspectives and opinions towards ED clinicians with lived experience of ED. Methods: Three hundred and eighty-five ED clinicians and 124 non-clinicians from 13 countries, between 18 and 76 years of age completed an online survey about attitudes towards ED clinicians with a personal ED history. Almost half the respondents (n = 242, 47.5%) reported a lifetime ED diagnosis. Survey items included ten multiple-choice and three open questions about clinician disclosure, employer hiring practices, and perceived advantages and disadvantages of clinicians with a personal ED history practicing in the ED field. Multiple-choice responses from clinicians with and without a personal ED history were compared with responses from non-clinicians with and without a personal ED history. Open questions were examined using thematic analysis. Results: Clinicians with no ED history, whose responses often differed from both ED-history groups (clinicians and non-clinicians), were more likely to indicate that clinicians with an ED should not generally treat ED patients, and that clinicians should self-disclose their ED history to employers but not to their patients. Thematic analysis of the open-ended questions revealed that advantages of having clinicians with an ED history include a deep experiential understanding and the ability to be empathic and non-judgmental, whereas disadvantages include the lack of objectivity and the risk of clinicians being triggered. Conclusion: Further research informing guidelines for ED clinicians with a personal ED history, their colleagues and employers are needed to protect and empower the significant minority of ED professionals with “lived experience” of EDs. Level of evidence: Level III, case-control analytic study