Some really interesting papers; thanks Carrie :)

I think it has been known for a long time that a significant proportion of runners (and endurance athletes in general) have EDs. That is not to say that training for these sports causes EDs (although inadequate diet during periods of intense training could potentially trigger an ED in vulnerable people through energy deficit). Having done a lot of research work with distance runners in the 1980s and 1990s I would suggest that people with a personality that makes them vulnerable to developing an ED are attracted to endurance sports and the associated training regimes. The life of the endurance athlete is quite rigid and over-controlled.

I must read the entire paper examining relations between autistic spectrum disorder and EDs in children... That particular group (Nicholls, Bryant Waugh et al.) do some excellent research.

The idea of 'spontaneous recovery' in EDs is often dismissed, because it is assumed that the brain of a person stuck in an ED (especially AN) is too 'disordered' to think - at least until eating behaviours are better managed. Yet, I have witnessed a number of people with quite severe AN make spontaneous recoveries when they find something in life that they really enjoy and really want to do, but their ED is stopping them from doing it. They 'see the light' (so to speak) and decide to start eating again. This defies some theories of how EDs operate, but I have seen these spontaneous recoveries in a number of people.

I rarely comment, but I wanted to let you know that I look forward to the Sunday Smorgasbord every week. Thanks!

Thank you for he round-up!

I would like to say a word about the spontaneous recovery article.
Well, I wish every single eating disordered person in the world had a qualified treatment team. But that is not the reality. I am brazilian and I am bulimic and there's no qualified treatment at all. Not even one eating disorder clinic. Nothing.
There are some professionals who work with eating disorders as a side project but I've been to some of them, and listened I should try this diet because it was different from the others, that nobody wants to be fat, that being over the BMI normal range was so dangerous for my health I was going to die.
You know, I'm not going to have a treatment team.
I'm not going to have a therapist. I'm not going to be inpatient, outpatient, whatever. There won't be dietitians.


But I'm recovering. I've been reading lots of information on eating disorders and trying to change my behaviours, normalize my food intake and stop the cognitive distortions. I no longer binge and purge everyday. It has been happening with less and less frequency.

I can't be ok all the time but people with years of professional support can't either.

It is an everyday battle for me too, but I've been way better than before. And my recovery does not comes from formal professional help.

It is possible. And it has to be because not everyone lives in first world full of resources countries. And those people, too, deserve to live. And be happy.

Thanks for doing my work for me, Carrie. I've got some reading to do!

Carrie - I hope you don't mind I posted the L, L, lG, &G paper on ATDT. With a big ole H/T to you of course!

An especially informative roundup this week!

@extralongtail; I hear you on the "spontaneous recovery" thing. I put it in quotes because I doubt that it actually *is* SPONTANEOUS as in at 5:03 I am restricting then *POOF* at 5:04, I can haz pizza with extra-cheese plskthx?!? ;>

But as to people recovering *without treatment* or perhaps despite dubious treatment, I have no doubt of it. For one thing, I too have met a few people who claim this path, and I have no reason to doubt them. But for another, the epidemiology shows that ~50% of people eventually do recover, or at least, become asymptomatic; the disease runs it's course if you will.

This is similar to data I've seen on addictions - about 50% of heroine addicts and alcoholics will recover on their own. Even cancers are known to spontaneously resolve; I remember hearing a talk from a dermatologist suggesting that many spots of melanoma heal without ever progressing & without the person ever realizing they had them.

I do have doubts as to whether finding something they want to do, that ED stops them from is the actual *mechanism* of such recoveries. I'm sure for every spontaneous recovery, we can point to someone else who was not able to recover without treatment despite ED hampering something *they* wanted very badly! I would agree that wanting something *can be* the triggering event towards recovery, in much the way that there is a triggering event of the ED.

It would be VERY interesting to suss out what the difference that makes the difference is between those who do recover without (despite ineffective?) intervention and those who are unable. Or rather what the differenceS ARE, as almost surely there are a variety of factors, traits, and circumstances involved.

Irish and others,

You are very welcome to share any of the articles you read on the smorgasbord or elsewhere on ED Bites.

I was thinking the same thing regarding spontaneous recovery, in that they didn't really define what that meant in the abstract. I think recovering without treatment is generally the rule, not the exception (I believe I read a study or survey that found only 1/4 of people with EDs seek treatment). I don't know that it was some sort of magical moment or what.

I think that EDs (like all diseases) exist on a spectrum of severity and a spectrum of symptoms. It's like pneumonia- some people get better on their own, some people need a week or two of antibiotics, others are hospitalized, and others die. Spontaneous recovery (I'm guessing) probably happens more often in the transient and less severe cases, but no one knows what fraction of eating disorder patients these cases actually make up. I think these are actually very important questions to be asking.

Carrie, thanks as always for a fascinating round-up. I agree very much with your comment above about the ED spectrum with relation to recovery (spontaneous and otherwise).

Also, I'm just curious if you've ever encountered any articles or studies investigating the role of exercise in ED symptom management/recovery--as in, the use of exercise (in moderation, obviously, and for medically stable subjects only) as one part of a treatment approach. I'm taking a course on exercise and health, and working on a paper about the effects of exercise in alleviating depression symptoms, so it's gotten me curious about potential ED benefits. I've not found anything aside from the "oh no, people with eating disorders must never exercise again, for it is a *behavior*!", and of course I can see the conflicts of interest. Still, I can certainly imagine the potential given other psych studies, and was wondering if you'd run across anything of the sort.

My goodness! How have I never seen this blog before? As a psychology/biology major and as someone who has had an eating disorder for 10 years there is so much wonderful information here! Thank you for all the time and effort you have put into these posts.

Much love and support,

Elena

There's a study by Kelly Pedrotty out of Renfrew on using exercise as a treatment for EDs. There are other authors, and I'm not 100% sure of the spelling of her name, but she hasn't published much so tracking the reference down should be easy to find. My tactic from there is to look at which papers have cited that one, and the references in the paper and go from there.

There's been a LOT of work looking at exercise as a treatment/replacement for addictions, which might have some good insights for you as well, if you hypothesize that EDs have an addictive component and dopamine abnormalities.

I LOVE Sapolsky, what a great addition here.
Belated congrats on submitting the manuscript Carrie. Can't wait to read it.