‘Blindness to the obvious’?: Treatment experiences and feminist approaches to eating disorders

Eating disorders (EDs) are now often approached as biopsychosocial problems, but the social or cultural aspects of the equation are often marginalised in treatment - relegated to mere contributory or facilitating factors. In contrast, feminist and socio-cultural approaches are primarily concerned with the relationship between EDs and the social/ cultural construction of gender. Yet although such approaches emerged directly from the work of feminist therapists, the feminist scholarship has increasingly observed, critiqued and challenged the biomedical model from a scholarly distance. As such, this article draws upon data from 15 semi-structured interviews with women in the UK context who have experience of anorexia and/or bulimia in order to explore a series of interlocking themes concerning the relationship between gender identity and treatment. In engaging the women in debate about the feminist approaches (something which has been absent from previous feminist work), the article explores how gender featured in their own understandings of their problem, and the ways in which it was - or rather wasn’t - addressed in treatment. The article also explores the women’s evaluations of the feminist discourse, and their discussions of how it might be implemented within therapeutic and clinical contexts

The role of sociocultural perspectives in eating disorder treatment: A study of health professionals

Eating disorders are now often approached as biopsychosocial problems, because they are widely recognised as multifactorial in origin. However, it has been suggested that there is a substantial and unwarranted imbalance within this biopsychosocial framework, with the ‘social’ aspects of the equation relegated to secondary or facilitating factors within treatment contexts. Drawing on data from 12 qualitative interviews with health professionals in a UK region, this article examines the extent to which sociocultural perspectives on eating disorders are valued and explored in eating disorder treatment, with a particular focus on the relationship between eating disorders and gender. As girls/women are widely acknowledged to be disproportionately affected by eating problems, the article draws on feminist perspectives on eating disorders to explore whether the relationships between cultural constructions of femininity and experiences of body/eating distress are actively addressed within treatment. The study reveals high levels of inconsistency in this regard, as while some participants see such issues as central to treatment, others have ‘never really considered’ them before. In addition, the study examines the potential limitations of how such sociocultural issues are conceptualised and addressed, as well as why they might be marginalised in the current climate of evidence-based eating disorder treatment. The article then considers the implications of the findings for thinking about feminist perspectives on eating disorders – and the significance of gender in treatment – at the level of both research and practice

Deconstructing “real” women: Young women's readings of advertising images of “plus-size” models in the UK

© 2016, © The Author(s) 2016. Critical feminist researchers and others have amply elucidated the perniciousness of contemporary Western beauty ideals and, particularly, the near-ubiquitous idealisations of slenderness. In this context, the advent of media images featuring “plus-size” models has been rightly heralded as a welcome challenge to this hegemony. Yet, little attention has been given to women's interpretations of these images. In this brief report, we outline a preliminary exploration of young women's views about advertising images featuring “plus-size” models in the UK. We used a discourse analytic method to analyse 35 young women's responses to a qualitative questionnaire asking for their views and feelings about three adverts featuring “plus-size” models. Our analysis suggests that, while the models were positively construed, participants also drew on distinctly conservative notions of femininity such that romanticised constructions of a “plus-sized”, traditional and domestic femininity were contrasted with a highly pejorative framing of “stick thin” women as vain, vindictive and self-obsessed. Our analysis thus indicates how representations of women focusing on body weight and shape can, even when reclaiming “fat” or “plus-size” bodies, mobilise derogatory and constricting rather than empowering constructions of femininity

Making sense of being at 'high risk' of coronary heart disease within primary prevention

types: Journal ArticleCurrent National Health Service policy advocates screening to identify individuals at 'high risk' of cardio-vascular disease (CHD) in primary care. This article utilizes the work of Radley to explore how 'high risk' of CHD patients make sense of their new risk status. Results are presented here from a nested qualitative study within a quantitative randomized trial of a CHD risk intervention in primary care. 'Discovery' interviews were conducted with 'high risk' participants (n = 38, mean age = 55) two weeks after intervention and thematically analysed. In response to perceived threat, many participants sought to both 'minimize' and 'normalize' their risk status. They also reported intentions to act, particularly concerning dietary change and exercise, although less so for smoking amongst the lower socio-economic status participants. Such perceptions and intentions were contextualized within the life-course of later middle-age, so that both being at risk, and being treated for risk, were normalized as part of growing older. Social position, such as gender and SES, was also implicated. CHD risk interventions should be context-sensitive to the life-course and social position of those who find themselves at 'high risk' of CHD in later middle-age

Nonfatal Strangulation in a Sample of Domestically Violent Stalkers: The Importance of Recognizing Coercively Controlling Behaviors

© 2019 International Association for Correctional and Forensic Psychology. Strangulation is different to other types of physical violence as it often leaves no visible injuries and is frequently motivated by coercive control. Few studies have explored nonfatal strangulation and coercive control, and no studies have explored these factors within a sample of stalkers. Given that stalking perpetrators exhibit many of the coercively controlling behaviors related to nonfatal strangulation, the current study explored nonfatal strangulation and other coercively controlling behaviors in a stalking sample. A police dataset of 9,884 cases of domestic violence that involved stalking was analyzed. Results revealed that coercive control and related behaviors of excessive jealousy, victim isolation, victim fear, and victim’s belief that the perpetrator will kill them were associated with higher likelihood of having experienced nonfatal strangulation. These results may help first responders to identify victims at risk of nonfatal strangulation and suggest a need for nonfatal strangulation to be a criminal offense

Between feminism and anorexia: An autoethnography

Critical feminist work on eating disorders has grown substantially since its establishment in the 1980s, and has increasingly incorporated the use of anorexic stories, voices and experiences. Yet rarely do such accounts offer the anorexic a space to respond to the now established feminist conceptions of the problem which structure the books or articles in which they appear. Anorexic, or recovered anorexic, voices are used by the researcher to interpret the role played by gender, even whilst the subjects are invited to respond to and critique, medical and popular discourses on the disorder. This lack of dialogue is all the more striking in the context of the feminist aim to fight ‘back against the tendency to silence anorexic women’s’ own interpretations of their starving, treatment and construction (Saukko, 2008: 34). As someone who suffered from anorexia for 20 years, this article offers an autoethnographic account of my experience of encountering the feminist literature on anorexia in a bid to speak back, or enter into a dialogue between feminist politics and eating disorder experience

Membrane-Dependent Binding and Entry Mechanism of Dopamine into Its Receptor

Synaptic neurotransmission has recently been proposed to function via either a membrane-independent or a membrane-dependent mechanism, depending on the neurotransmitter type. In the membrane-dependent mechanism, amphipathic neurotransmitters first partition to the lipid headgroup region and then diffuse along the membrane plane to their membrane-buried receptors. However, to date, this mechanism has not been demonstrated for any neurotransmitter-receptor complex. Here, we combined isothermal calorimetry measurements with a diverse set of molecular dynamics simulation methods to investigate the partitioning of an amphipathic neurotransmitter (dopamine) and the mechanism of its entry into the ligand-binding site. Our results show that the binding of dopamine to its receptor is consistent with the membrane-dependent binding and entry mechanism. Both experimental and simulation results showed that dopamine favors binding to lipid membranes especially in the headgroup region. Moreover, our simulations revealed a ligand-entry pathway from the membrane to the binding site. This pathway passes through a lateral gate between transmembrane alpha-helices 5 and 6 on the membrane-facing side of the protein. All in all, our results demonstrate that dopamine binds to its receptor by a membrane-dependent mechanism, and this is complemented by the more traditional binding mechanism directly through the aqueous phase. The results suggest that the membrane-dependent mechanism is common in other synaptic receptors, too

(Un)twisted: talking back to media representations of eating disorders

In 2014-15, there were several news reports about a rise in the diagnoses and treatment of eating disorders (EDs), as attributed to the use of image-driven social media. Such coverage can be situated within a long history of concern in which those diagnosed with an ED are constructed as ‘especially vulnerable’ to the power of media images – a subjectivity which is pathologised and devalued precisely through its association with femininity. The most incisive objections to EDs being presented as a response to the ‘weight’ of media representation have come from Abigail Bray (2005) in her work on how anorexia is constructed as a reading as well as an eating disorder. Indeed, there is a whole history of empirical work in Feminist Media Studies and Girlhood Studies which has challenged the pernicious construction of female subjectivity as ‘excessively’ invested in, and ‘damaged’ by, the consumption of mass mediated forms. Yet the media consumption practices of those with experience of an ED have not been subject to similar feminist re-evaluation – an omission which this research seeks to address. In exploring the results of 17 semi-structured interviews with people who have experience of an ED discussing their encounters with media representations of EDs (material that is often co-opted into debates about the ‘toxic’ nature of media culture in this regard), this article seeks to intervene in how such imagined media consumption practices are often defined. In seeking to speak back to historically pathologising constructions, the article seeks to explore the qualitative responses in the context of more ‘every day’ understandings of media engagement, thus working against the gendered othering which has persistently occurred

Type 2 diabetes enhances arterial uptake of choline in atherosclerotic mice: an imaging study with positron emission tomography tracer F-18-fluoromethylcholine

Background: Diabetes is a risk factor for atherosclerosis associated with oxidative stress, inflammation and cell proliferation. The purpose of this study was to evaluate arterial choline uptake and its relationship to atherosclerotic inflammation in diabetic and non-diabetic hypercholesterolemic mice.Methods: Low-density lipoprotein-receptor deficient mice expressing only apolipoprotein B100, with or without type 2 diabetes caused by pancreatic overexpression of insulin-like growth factor II (IGF-II/LDLR−/−ApoB100/100 and LDLR−/−ApoB100/100) were studied. Distribution kinetics of choline analogue 18F-fluoromethylcholine (18F-FMCH) was assessed in vivo by positron emission tomography (PET) imaging. Then, aortic uptakes of 18F-FMCH and glucose analogue 18F-fluorodeoxyglucose (18F-FDG), were assessed ex vivo by gamma counting and autoradiography of tissue sections. The 18F-FMCH uptake in atherosclerotic plaques was further compared with macrophage infiltration and the plasma levels of cytokines and metabolic markers. Results: The aortas of all hypercholesterolemic mice showed large, macrophage-rich atherosclerotic plaques. The plaque burden and densities of macrophage subtypes were similar in diabetic and non-diabetic animals. The blood clearance of 18F-FMCH was rapid. Both the absolute 18F-FMCH uptake in the aorta and the aorta-to-blood uptake ratio were higher in diabetic than in non-diabetic mice. In autoradiography, the highest 18F-FMCH uptake co-localized with macrophage-rich atherosclerotic plaques. 18F-FMCH uptake in plaques correlated with levels of total cholesterol, insulin, C-peptide and leptin. In comparison with 18F-FDG, 18F-FMCH provided similar or higher plaque-to-background ratios in diabetic mice. Conclusions: Type 2 diabetes enhances the uptake of choline that reflects inflammation in atherosclerotic plaques in mice. PET tracer 18F-FMCH is a potential tool to study vascular inflammation associated with diabetes.</p

Leukocyte trafficking-associated vascular adhesion protein 1 is expressed and functionally active in atherosclerotic plaques

Given the important role of inflammation and the potential association of the leukocyte trafficking-associated adhesion molecule vascular adhesion protein 1 (VAP-1) with atherosclerosis, this study examined whether functional VAP-1 is expressed in atherosclerotic lesions and, if so, whether it could be targeted by positron emission tomography (PET). First, immunohistochemistry revealed that VAP-1 localized to endothelial cells of intra-plaque neovessels in human carotid endarterectomy samples from patients with recent ischemic symptoms. In low-density lipoprotein receptor-deficient mice expressing only apolipoprotein B100 (LDLR-/- ApoB(100/100)), VAP-1 was expressed on endothelial cells lining inflamed atherosclerotic lesions; normal vessel walls in aortas of C57BL/6N control mice were VAP-1-negative. Second, we discovered that the focal uptake of VAP-1 targeting sialic acid-binding immunoglobulin-like lectin 9 based PET tracer [Ga-68]DOTA-Siglec-9 in atherosclerotic plaques was associated with the density of activated macrophages (r = 0.58, P = 0.022). As a final point, we found that the inhibition of VAP-1 activity with small molecule LJP1586 decreased the density of macrophages in inflamed atherosclerotic plaques in mice. Our results suggest for the first time VAP-1 as a potential imaging target for inflamed atherosclerotic plaques, and corroborate VAP-1 inhibition as a therapeutic approach in the treatment of atherosclerosis