— Lebow, J., SIm, L. A., & Kransdorf, L. N. (2014) Prevalence of a History of Overweight and Obesity in Adolescents with Restrictive Eating Disorders.
Of 179 adolescents, 36.7% were found to have a body mass index (BMI) history above the 85th percentile.
Patients with a BMI history above the 85th percentile had a larger BMI decrease at presentation (p < .0001) and a longer duration of illness before presentation (p < .0001). There were no differences in the number of physical symptoms or eating disorder severity.Findings suggest that adolescents with a history of overweight or obesity represent a substantial portion of treatment-seeking adolescents with restrictive eating disorders, underscoring that extreme weight loss in adolescents is not healthy, regardless of whether the end weight is theoretically within a healthy range.
Because eating disorders in adolescents who have history of overweight take longer to be identified, they consequently may have a poorer prognosis.
I blogged about this paper here.
My goal was, for the most part, to illustrate that group data sometimes masks really, really important stuff: While overall group effects might be positive, the effects for a crucial subgroup (i.e., those who are predisposed to eating disorders and/or have eating disorder history) might be negative.
This is why it is important to evaluate program and campaign effectiveness, particularly given that the last thing we want to do during EDAW is harm those who are most at risk.
Old post but semi-relevant (semi because not about suicide) because of the current discussion on my dash.
Unbelievable anon message in so many ways that it is just mindboggling. So fucking ironic. Ugh. Sorry you have to deal with that BS kyssandrith.
Thank you for your kind words. It was definitely a load of BS, but I do feel like the conversation psychhealth and I had was worth the trouble. I hope that whoever sent the anon message thinks on what motivated them to do that- and if they advocate for mental health issues, I hope they come to understand everything that is wrong with what they did.
Exactly. Having an honest discussion is SO important. That’s the point, isn’t it? We trying something out, and we get responses and evaluate if the initial goals were met. That’s what we should always be doing. We all know that goals people have when they do these things are good. It is not coming from a bad place. No one wants to harm or trigger anyone. But we should still always have honest discussions about the effects because some things cannot be predicted when people sit in a boardroom or some university/college classroom brainstorming these campaign ideas.
It is SO fucking ironic that the anon who sent the message was attempting to silence YOUR honest opinion! The campaign is about ending silence — ending people’s silence about their experiences, thoughts, and feelings, especially negative ones — and let’s see, that’s EXACTLY what anon was attempting to do in his/her message: silence you. It is bizarre that he/she missed the irony of the message. So fucking ironic.
The message that it overwhelmingly does more good than harm (someone else said it in another message that I just reblogged) is also misleading. There’s is literature (albeit in the ED field, because that’s mostly what I read about) that ED awareness weeks/campus events sometime do harm. (I blogged about it here: Eating Disorder Awareness Week: Useful, Useless, or Worse?)
Yes, it is minimal. Yes, few people say they were negatively affected by the imagery, for example. But guess what: Those who were negatively affected were overwhelmingly those who had (had) eating disorders:
Mann et al. (1997) found that when women who had recovered from eating disorders presented a primary prevention session, symptoms of eating disorders actually increased among participants presumably because the presenters may have unintentionally normalized the disorders.
Of the three participants who reported that the session was a negative experience, one was a woman with a history of an eating disorder who experienced negative memories while listening to the information.
Oh hey, it’s the first anon hate I’ve ever gotten.
ANON HATE BINGO TIME.
1) Gendered slur.
2) “just get over yourself”
3) Pretty much laughing at my past mental health history and reducing my actual, real triggers at this sort of thing to dismissive quotation marks.
This is exactly why I have a problem with these kinds of displays. In an effort to shock people into caring about the problem, the actual needs of the people it’s purporting to help are being trampled over.
I’m being told here that because the event is extremely evocative, I need to tuck my mental health history away and simply grit my teeth and bear the fact that were I still who I was in college, and if I had to navigate this display on the way to class, I would have had a full-on breakdown that might have taken me weeks to recover from.
psychhealth I’m still mulling over my response to your reply, but my feelings here are a hint to what I’m thinking about.
I figured that you should see some of the things that were said here.
This was one of the PSA ads they used in the study (the others were similar but were endorsed by “Tropicana” or “Tropicana + NEDA”):
“The theme of genetic diversity was emphasized in the headline of the PSA: Women come in many different shapes. A photo of a university women’s swim team was chosen as the visual element because it illustrated the theme clearly by featuring a number of female bodies varying in shape, size, and height, in spite of same diet and exercise regimen. Right below the photo, a text encouraging self-esteemand self-acceptance was placed. The text read,
‘Although these women go through the same training and diet regimen, they look all different from one another. But, they share one thing—they are great athletes. Whatever you look like outside, it is what’s inside that matters. Be happy about your body. You are one of a kind!’
The source of the message was identified on the bottom of the ad with a brief description:
‘A message sponsored by the NEDA. The NEDA is dedicated to eliminate eating disorders and body dissatisfaction through education and support services.’”
As expected,overall, the ads (there were a few) had a positive effect on body satisfaction, but that’s not the whole story…
BUT HOLD ON, WHAT’S THIS?
"At the same time, these positive main effects were mostly due to the gains in body satisfaction and the size of the ideal female-body norm by women whose body satisfaction was relatively undamaged to begin with. For women who were already suffering from low body satisfaction, the experimental treatments interacted with the predisposition to the effect that they further deteriorated body satisfaction and the norm of the ideal female body.
This decline in body satisfaction of women with low initial body satisfaction is particularly problematic for many reasons. Foremost, body satisfaction is the ultimate outcome that we want to see improved. Also, the women who were negatively affected are the ones who urgently need an intervention. The harm, no matter how smaller than the benefit, should be taken seriously and ways to amend the problem have to be identified.”
So, it is not just a numbers game. (Yes the above is about EDs and not suicide, but c’mon does anyone think it cannot possibly be true for suicide prevention/awareness campaigns either?)
While they may be a minority, and the campaign may overwhelmingly do more good than harm, we really do have to ask ourselves if we want to trigger or adversely affect the very people who at high risk and/or suffering from the issues we are trying to raise awareness about.
If we silence these dissenting/critical voices, we are stigmatizing and we are doing the very thing our campaigns try to fight.