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Eating disorders affect individuals of all ages, ethnicities, and genders

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Dr. Josie Geller

February 1–7 is Eating Disorders Awareness Week. We sat down with CHÉOS Scientist Dr. Josie Geller to discuss history, future, misconceptions and research into eating disorders.

Dr. Geller is a CHÉOS Scientist, Associate Professor of the University of British Columbia (UBC) Department of Psychiatry, and the Director of Research of the St. Paul’s Hospital Eating Disorders Program.

CHÉOS: What are some of the different types of eating disorders?
Josie Geller: The eating disorders include bulimia nervosa, anorexia nervosa, binge eating disorder, and other specified feeding and eating disorders. Bulimia nervosa is characterized by a cyclical pattern of bingeing and use of compensatory strategies such as vomiting as well as the experience of shape and weight as core determinants of self-esteem. Anorexia nervosa is characterized by significant weight loss due to restriction of food intake, an extreme fear of gaining weight or becoming fat, feelings of ‘fatness’, and experiencing body shape and weight as a core determinant of self-esteem. Binge eating disorder is characterized by recurrent binge eating in the absence of compensatory behaviours.

C: What are some of the biggest misconceptions about eating disorders?
JG: One misconception is that eating disorders are about vanity. Research has shown that a combination of factors, including biological, psychological, and environmental, contribute to the development and maintenance of an eating disorder. Another misconception is that eating disorders affect only white, middle-class females. In fact, eating disorders affect individuals of all ages, ethnicities, and genders.

C: With increasing globalization, are eating disorders still mostly a “Western phenomenon”?
JG: Eating disorders affect individuals of all race and cultures. Research has shown that while the prevalence of eating disorders is lower in non-Western countries, globalization may be a factor that is contributing to increased prevalence.

C: What have we learned about eating disorders that we didn’t know 20 years ago?

JG: Recent research has focused on patient and family readiness in recovery. Developing a collaborative relationship and maximizing patient and family autonomy are key to the recovery process. With the introduction of new brain imaging technology, structural and functional differences have been found in individuals with eating disorders. Research on how these findings can be applied to treatment is ongoing.

C: What research are you currently conducting on treatment and trajectory of eating disorders?
JG: Our program of research at St. Paul’s, funded by the Canadian Institutes of Health Research, Social Sciences and Humanities Research Council, and Michael Smith Foundation for Health Research, has focused on understanding and enhancing readiness and motivation for change in the assessment and treatment of adults with eating disorders. Our current focus is on the provision of a menu of treatment options tailored to patient readiness status, determinants of a patient-centered collaborative support stance in clinicians and carers, and the role of self-compassion and mindfulness in recovery.

C: What are some of the resources available at the Eating Disorders Clinic at St. Paul’s?
JG: The Provincial Adult Tertiary Specialized Eating Disorders Program at St. Paul’s Hospital provides inpatient care, intensive residential treatment, and outpatient transitional services for adults 17 years of age and older.