Mind Body Well Director Janet Lowndes recently attended the Academy for Eating Disorders international conference in Chicago USA, along with almost 1400 delegates from around the world, and she shares this summary.
The International Conference on Eating Disorders (ICED), held in Chicago in April 2018, was a convergence of scientists, academics, clinicians, carers, and people with a lived experience of an Eating Disorder. When you get such a diverse group of stakeholders in the one place it can be quite a melting-pot of conversation and ideas, demonstrating both the commonalities in the field and also the diversity of priorities and paradigms for treatment and prevention.
The biggest highlights for me were meeting and spending time with colleagues who are doing such important work to assist people to develop healthy relationships with their bodies, liberating themselves from body shame and destructive behaviours. It is difficult to pick just a few highlights from such varied conversations, but here are some of the standout messages:
The Need for Common Ground
There was discussion in a conference workshop about the need for those involved in the Eating Disorders field to establish common ground on some of the shared understandings in our field, in order for us to establish priority areas in which to move forward. During a very lively group workshop the following consensus statements were agreed upon, with the Academy for Eating Disorders (AED) aiming to continue to explore further areas of consensus at future meetings. The group present at the workshop found agreement with the following important statements:
- Addressing weight stigma in the Eating Disorders field is a key to moving forward
- It is possible to be at a higher weight and healthy
- Parents should not be blamed for causing Eating Disorders
- Standards of care for eating disorder treatment are necessary
It will be interesting to see how the AED continues to move forward guided by these statements.
‘Atypical’ Anorexia Nervosa
There was extensive conversation at the conference about the recognition of the high incidence of ‘Atypical Anorexia Nervosa’ – that is people who meet all of the criteria for a diagnosis of Anorexia Nervosa, with the exception of a very low Body Mass Index (BMI). Recent research suggests that rates of ‘Atypical’ Anorexia Nervosa in adolescents may be as much as 2-3 times those of ‘typical’ anorexia, and that the condition is often unrecognised by medical practitioners, health professionals and the general community, due to the assumption only people with a very low weight can have anorexia. Those with a diagnosis of ‘Atypical’ Anorexia are often people who had a higher weight prior to the significant restriction and weight loss, and are often congratulated for weight loss – despite experiencing many of the serious complications of starvation caused by restrictive dieting.
Recent research also suggests that those with ‘Atypical’ Anorexia have similar medical risk factors as those with the more ‘typical’ version of the illness, but due to the lack of low weight status, their health risks may be going unrecognised, placing them at risk of further medical and psychological complications. This workshop was a powerful reminder of the importance of weight neutral approaches to Eating Disorder treatment which focus on behaviours, cognitions and emotions, rather than emphasising weight.
A group of researchers and clinicians aligned with the Health at Every Size movement presented a wonderful workshop on weight stigma amongst health professionals, demonstrating that people with a higher BMI often delay seeking medical treatment due to a number of factors including:
- Having previously received disrespectful treatment
- Negative attitudes of healthcare providers
- Unsolicited advice about weight loss
Recent research by Janell Mensinger from Drexel University highlights that women with higher BMI are less likely than thinner women to seek healthcare, often due to their attempts to avoid exposure to weight stigma and judgements from healthcare providers. (Mensinger, J.L. et al (2018) ‘Mechanisms underlying weight status and healthcare avoidance in women: A study of weight stigma, body related shame and guilt, and healthcare stress’. Body Image, (25), p.139-147.) This workshop highlighted the importance of weight neutral, Health at Every Size approaches to health care.
Access to Quality Care
There was an important conversation at the conference about the need to prioritise ‘reach’ in Eating Disorder treatment, improving access to quality treatment for a more diverse range of people experiencing Eating Disorders. Many people with Eating Disorders do not have access to quality treatment, due to a number of barriers which the AED are aiming to continue to address, and which organisations like The Butterfly Foundation are addressing here in Australia.
The international Conference on Eating Disorders will be coming to Australia (Sydney) in 2020, being co-hosted by the Australia and New Zealand Academy of Eating Disorders Conference.
Janet Lowndes, Director, Mind Body Well