Resources

The NEDIC Conference Journal collects papers which were presented in sessions, workshops, or keynotes at the NEDIC biennial conference. Edited by Lorayne Robertson and Joli-Scheidler-Benns Contents: Margo Maine: Nine Truths about Eating Disorders at Midlife and Beyond Niva Piran: Privilege and the Body: The Role of Critical Awareness to Enhancing Positive Embodiment Angela Grace: Booty Shorts and Sexting: A Social Justice Approach to Body Image and Self-Esteem Andrea LaMarre and Kaley Roosen: Navigating Differences Within Eating Disorders and “The Other”: What the Professional Brings and What They Leave Behind Ann McConkey and Lisa Naylor: A Weight Neutral Approach to Health and Wellness Lorayne Robertson and Joli-Scheidler-Benns: A Weight Neutral Approach to Health and Wellness Lorayne Robertson: Learning about Real: Critical Media Literacy and Body Equity

A NEDIC Bulletin discussing the inclusion of exercise in eating disorders treatment, guidelines, and risks of doing so.

A Bulletin by Margaret Notar, MSW, RSW, describing the use of Acceptance and Commitment Therapy, an approach that uses acceptance and mindfulness processes, and commitment and behaviour change processes, to produce greater psychological flexibility.

This article by Madalyn Marcus, PhD, CPsych will explore what eating disorders are, how they may present in the workplace, and how workplaces may trigger eating-related concerns, and will offer tips for supporting those suffering from these concerns. Ultimately, the hope is that this article will help people create a safe space at work for preventing and addressing eating-related concerns.

A NEDIC Bulletin discussing autonomy and beneficence in an eating disorder context. In general terms, the principle of autonomy recognizes that an individual who is competent has the right to make an informed choice about medical treatment. This choice must be made without coercion or undue influences from others. The principle of beneficence requires that health care providers do that which is considered “good”, or in the best interests of the person for whom they are providing care.

A NEDIC Bulletin discussing eating disorders from an addictions perspective.

A NEDIC Bulletin discussing what bariatric surgery is and its relationship with eating disorders.

A NEDIC bulletin discussing critical media literacy and the importance of research.

Given stressors like stigma, discrimination, internalized homophobia/transphobia, and concealment of sexual/gender identity, eating disorder preventive strategies must be grounded in an intersectional framework, attending to gender identity, body-based bullying and weight stigma, and self-esteem. In this Bulletin, Emily Donahue, Emily Huynh, and Janani Suthan discuss the collaborative effort between NEDIC and Canadian Centre for Gender and Sexual Diversity to develop Building Body Binaries, a workshop for students in grades 7 to 10 that builds their knowledge around the social factors that influence health and body image, employs an intersectional analysis of beauty standards and a hierarchy of bodies, and strengthens their media literacy skills when it comes to fatphobia and other forms of discrimination.

A NEDIC Bulletin discussing body image and self-perception of women who have disabiliities.

A NEDIC Bulletin discussing body dissatisfaction and eating disorders in transgender individuals.

A NEDIC Bulletin examining body equity, particularly in an educational context. Body-equitable curriculums and their implementation are discussed.

In this issue, Anita Khakh, BEd, MEd, discusses issues within the school context that can negatively influence students' body image, and proposes ways of creating positive institutional change.

It is increasingly understood that there are individuals of diverse body size, gender identity, race, ability, sexuality, and socioeconomic status who struggle with an ED. This Bulletin explores the strengths and the gaps of the existing ED literature as it relates those living in poverty and food insecurity.

People with polycystic ovarian syndrome (PCOS) are at an increased risk of struggling with binge eating disorder, bulimia nervosa, night eating syndrome, and subclinical disordered eating. However, there is limited information available about how to offer individualized care for people with PCOS and eating disorders. Traditional PCOS treatment recommendations tend to focus on weight management, which can be particularly damaging to individuals with an active eating disorder or eating disorder history. In this Bulletin, Kimmie Singh, MS, RD, CDN explains the complexity of balancing PCOS management and eating disorder recovery and offers recommendations for clinicians caring for people living with PCOS and eating disorders.

A NEDIC Bulletin discussing coping strategies for the families, partners, and caregivers of individuals living with an eating disorder.

A NEDIC Bulletin discussing coping strategies for individuals living with eating disorders and food/weight preoccupation, especially surrounding the holiday season.

This article by Yurico Shu Ping Li aims to provide insights into the cultural and familial influences that play a role in the development of eating disorders and eating disturbances among East Asian and Southeast Asian populations in Asia and North America. It will also discuss considerations for psychotherapy for East and Southeast Asians living with eating disorders.

A NEDIC Bulletin exploring the strengths and gaps of the existing body image literature as it relates to cultural sensitivity and body image programs for young Aboriginal women. Considerations for future directions in this area for research and clinical settings are also provided.

A NEDIC Bulletin discussing dental issues that may arise as a result of eating disorders.

A NEDIC Bulletin discussing strategies for developing public awareness campaigns.

A NEDIC Bulletin discussing strategies for developing and implementing support programming in rural and under-served areas.

In this NEDIC Bulletin article that has been translated into Chinese (Simplified), Anita Federici, PhD, CPsych, FAED explains how DBT blends cognitive behavioural approaches with meditative practices and acceptance-based strategies, why it is a treatment modality that can be helpful for people with eating disorders, and which type of DBT to apply based on the nature of an individual's eating disorder.

In this NEDIC Bulletin article that has been translated into French, Anita Federici, PhD, CPsych, FAED explains how DBT blends cognitive behavioural approaches with meditative practices and acceptance-based strategies, why it is a treatment modality that can be helpful for people with eating disorders, and which type of DBT to apply based on the nature of an individual's eating disorder.

In this NEDIC Bulletin article that has been translated into Persian, Anita Federici, PhD, CPsych, FAED explains how DBT blends cognitive behavioural approaches with meditative practices and acceptance-based strategies, why it is a treatment modality that can be helpful for people with eating disorders, and which type of DBT to apply based on the nature of an individual's eating disorder.

In this NEDIC Bulletin article that has been translated into Punjabi, Anita Federici, PhD, CPsych, FAED explains how DBT blends cognitive behavioural approaches with meditative practices and acceptance-based strategies, why it is a treatment modality that can be helpful for people with eating disorders, and which type of DBT to apply based on the nature of an individual's eating disorder.

In this NEDIC Bulletin article that has been translated into Spanish, Anita Federici, PhD, CPsych, FAED explains how DBT blends cognitive behavioural approaches with meditative practices and acceptance-based strategies, why it is a treatment modality that can be helpful for people with eating disorders, and which type of DBT to apply based on the nature of an individual's eating disorder.

In this NEDIC Bulletin article, Anita Federici, PhD, CPsych, FAED explains how DBT blends cognitive behavioural approaches with meditative practices and acceptance-based strategies, why it is a treatment modality that can be helpful for people with eating disorders, and which type of DBT to apply based on the nature of an individual's eating disorder.

A NEDIC Bulletin discussing the intersections of body image and self-esteem in women.

What is eating disorder recovery coaching? How is it helpful for individuals with eating disorders? Written by Sarah Rzemeniak, certified recovery coach, with Carolyn Costin, founder of the Carolyn Costin Institute™ Coach Training Program, this Bulletin article explains how recovery coaches support affected individuals in overcoming the day-to-day challenges of recovery. This article also sheds light on how one can become a recovery coach and suggests what to consider in choosing a recovery coach.

A NEDICBulletin considering the Standing Committee on the Status of Women's report entitled "Eating Disorders Among Girls and Women in Canada" one year following the report's issue.

Social media platforms provide a unique opportunity for the public to be both consumers and creators, interacting with what is posted and posting content themselves with 24/7 access. With the popularity and accessibility of these platforms, experts in various domains, including eating disorders, have discussed the potential harms that social media use may pose. This Bulletin authored by Casidhe Gardiner, RD, explores what is known so far, what still needs to be studied, and potential prevention strategies.

A resource prepared by NIED for Eating Disorders Awareness Week 2017, containing an overview of Canadian-centric facts and statistics about eating disorders.

A NEDIC Bulletin discussing the "burden of disease" cost of eating disorders in Australia.

The complex and enduring nature of eating disorders and the associated experiences of shame and guilt are often seen as hurdles to treatment success. While psychological interventions are the first-line approach to treating eating disorders, their effectiveness is considered modest. In this issue of the NEDIC Bulletin, Rachel Hoi Laam Leung explores the potential power of using creative arts as an adjunct or alternative to traditional therapies for individuals impacted by eating disorders.

In this NEDIC Bulletin, Adele Lafrance, PhD and Joanne Dolhanty, PhD, discuss the potential of Emotion-Focused Family Therapy, which is rooted in a deep and unwavering belief in the healing power of families, to benefit people with eating disorders and their parents/carers.

A NEDIC Bulletin discussing the role of physical activity in health as well as the connections between activity, appearance, and self-esteem

In this issue, Carolyn Minnick, MSc, explores the intersection of food insecurity and eating disorders. She shares findings from research that she carried out with the objective of elucidating the relationship between food insecurity, eating disorder risk, and disordered eating symptoms, and discusses their implications.

Research has shown that some children experience loss-of-control (LOC) eating patterns that resemble but do not meet full criteria for binge eating disorder (BED). It is important to delineate the differences between pediatric BED (P-BE) and BED, because in youth, the size of the binge episode matters less than LOC and other behavioural and psychological symptoms. LOC eating in childhood predicts the development of P-BE, disordered eating attitudes, and depressive symptoms. Early identification and treatment of P-BE can prevent or mitigate negative outcomes and correlates. In this issue of the NEDIC Bulletin, Dr. Gina Dimitropoulos and Dr. Katharine L. Loeb discuss binge eating behaviour in young people, and highlight how parents/caregivers can foster a neutral to positive relationship with food and body for their children, thereby reducing triggers for binge eating.

A NEDIC Bulletin examining the Maudsley family-based outpatient treatment for anorexia in adolescents.

A NEDIC Bulletin exploring the experience of fat women in therapy from a variety of perspectives. Cultural and psychotherapeutic prejudices against fat women are explored

A NEDIC Bulletin discussing "fat talk", or negative body-related conversations. The Bulletin discusses motivations and consequences of this type of talk as well as strategies to stop it.

A NEDIC Bulletin discussing eating disorders and body image for women in midlife.

A NEDIC Bulletin exploring getting help, including how to select a therapist and what to expect from therapy as well as common obstacles.

A NEDIC Bulletin exploring the recovery process, focusing on the period after the initial tasks of recovery have begun and potential issues or roadblocks that may arise.

Research has found that 23.7% of individuals with digestive conditions display disordered eating. Therefore, prior to making recommendations for nutrition therapy, it is important for health care providers working with individuals with digestive conditions to screen for a history of disordered eating. It is risky for individuals affected with irritable bowel syndrome (IBS) who have a history of disordered eating to attempt a restrictive therapeutic diet, such as the low-FODMAP diet. This Bulletin by Dr. Megan Riehl explains the role of psychological therapies in treating digestive conditions and highlights gut-directed hypnotherapy as an effective option for individuals with IBS.

A NEDIC Bulletin offering coping strategies for individuals who are living with eating disorders and their partners, families, and loved ones.

The significant social, emotional, and physical health consequences of pica for individuals have been long-recognized, however, the impact on caregivers is underemphasized in research and treatment approaches. This article by Rachel L. Moline, PhD, RPsych sheds light on the underrecognized needs of caregivers of youth with pica and outlines practical ways in which they can supportively intervene when a youth is experiencing pica symptoms.

A NEDIC Bulletin discussing the value of self-compassion and the burdens of self-consciousness and associated emotions.

A NEDIC Bulletin considering the value of eating disorders prevention work and body image improvement work, and whether the two are linked.

Eating disorders are a culmination of genetic, epigenetic, biological, psychological, sociocultural, and individual factors. Volumes have been written and said about the contribution of some of these factors, such as cultural messages about appearance ideals. In comparison, some factors have not been examined to a great extent. For example, what if an underlying physical dysfunction in a body – insulin resistance – significantly increases the risk of the onset of disordered eating behaviour? It’s similar to the age-old question, “which came first – the chicken or the egg?” Which came first the eating disorder or the insulin resistance? Regardless of the answer, these two diagnoses have the possibility of occurring hand in hand. This bulletin is written by Amy Enright, RD.

There is a deep and troubling silence that cloaks boys’ bodies in schools. This absence of discussion has left the ways in which boys’ bodies are perceived, embodied, and lived in schools largely misunderstood. In this issue of the Bulletin, Chris Borduas, MPE and Michael Kehler, PhD examine adolescent boys' body image in Canadian health and physical education.

A NEDIC Bulletin discussing the impact of eating disorders on the family, including siblings. As the family organizes around the affected individual, the entire family can be impacted. This family discusses the role of and impact on siblings.

A NEDIC Bulletin discussing the experience of males affected by eating disorders, including barriers to care, myths, and symptoms.

A NEDIC Bulletin discussing triggers in the context of eating disorder recovery, and offering strategies to predict and manage possible triggers.

A NEDIC Bulletin discussing the impact of eating disorders on the affected individual's partner, putting the stages of change into context along with roadblocks and experiences the partner may encounter.

A NEDIC Bulletin discussing the therapeutic interactions that accompany nutrition intake, including traditional approaches to meal support and principles developed by clinicians at Ontario Shores Centre for Mental Health Sciences.

A Bulletin discussing the experience of men with eating disorders, including body dissatisfaction, symptoms, sexuality, and treatment.

Mirror exposure therapy is a form of exposure therapy designed to specifically target body image disturbances. It can be considered a first-line treatment for body image dissatisfaction and has also been studied as an adjunctive treatment for individuals with eating disorders. In this Bulletin article, Trevor C. Griffen, MD, PhD, describes mirror exposure therapy and provides recommendations for clinicians to consider.

A NEDIC Bulletin discussing motivational considerations in the treatment of eating disorders, including motivational interviewing, ambivalence, and preparing for change.

A NEDIC Bulletin explains why individuals self-harm and how, using techniques from dialectical behaviour therapy, they may shift from self-harm to self-care.

A NEDIC Bulletin explaining the Health at Every Size model of care, as well as dissecting myths about what HAES is or isn't.

A NEDIC Bulletin exploring the role of stigma , either internalized or from health care providers, in the experience of bariatric patients.

The aim of this article is to provide an overview of the emergence of orthorexia as a public health concern, with particular attention on its link to social media usage.

Eating disorders are traditionally treated with nutritional rehabilitation and behavioural management/psychotherapy within a multimodal context (psychiatrists, psychologists, dietitians, social workers, etc.). However, patients often wonder: can medication help? In general, eating disorders have not been found to be as responsive to medication as other mental health disorders. There is limited evidence for the efficacy of medication in the treatment of eating disorders; however, it may be useful for the management of comorbid conditions, e.g., depression and anxiety. Written by Georgios Paslakis, MD, this Bulletin highlights current evidence for pharmacological options for the treatment of anorexia nervosa, bulimia nervosa, and binge eating disorder.

Eating disorders (EDs) in women often manifest at an age that may coincide with the desire to have children. The presence of an ED, especially an active case, may be associated with unfavourable health outcomes for both mother/birthing parent and child. ED-associated behaviours may also be considered relevant to the development of EDs in children of mothers/birthing parents with EDs. It therefore appears important for healthcare providers to be able to create the space in which women wishing to become mothers/parents will feel comfortable to openly bring up their thoughts and feelings and receive adequate support. In this article, Dr. George Paslakis discusses considerations for caring for women/birthing parents experiencing binge-eating disorder in the perinatal period.

A NEDIC Bulletin considering eating disorders prevention. This Bulletin considers both primary (eliminating factors causing eating disorders) and secondary (reducing the causes and perpetuating factors of eating disorders) prevention.

The COVID-19 pandemic created insurmountable obstacles to organizing and holding a NEDIC conference in 2021. However, with this special issue of the NEDIC Bulletin, we can revisit Radical Unlearning, celebrate the sharing of knowledge and ideas that occurred, and extend the discussions that were sparked. NEDIC is grateful to the conference participants who contributed to this Bulletin. In their article, Kelsey Sick, Catherine M. Sabiston, and Eva Pila discuss the development of an evidence-based and stakeholder-informed program for sport contexts that aims to prevent body image concerns and disordered eating, and to address gender inequity in sport participation. Justine Van Herk, Sara Santarossa, Jory Fulcher, and Sarah J. Woodruff report on their evaluation of a community-based workshop and toolkit designed to educate mothers about how to effectively help their adolescent daughters navigate the online world. In her contribution, Annina Schmid provides an overview of solution-focused approaches to counselling and explains how to use solution-focused dialogue to help clients who are engaging in disordered eating as a means to lose weight envision and pursue a more positive relationship with food and their body.

Radically Open Dialectical Behaviour Therapy (RO DBT) posits that Anorexia Nervosa can sometimes be a symptom of an overcontrolled personality trait that may have preceded the onset of an eating disorder. In this Bulletin, Amanda Buckingham, MSW, RSW explains how RO DBT can help, not by focusing primarily on the restrictive eating and other eating disorder behaviours, but on the maladaptive overcontrol traits that contribute to emotional loneliness and social disconnectedness.

A NEDIC Bulletin considering the importance of hope in the recovery process.

A NEDIC Bulletin explaining secretive eating and its relevance in working with individuals with binge-eating disorder.

In this Bulletin, Danielle Keenan-Miller, PhD, provides an overview of evidence-based treatment options for binge eating disorder and highlights that many affected individuals benefit from self-help approaches. Dr. Keenan-Miller also includes five tips for breaking the binge eating cycle.

A NEDIC Bulletin exploring the self-monitoring of weight from an eating disorders perspective, considering potential benefits and risks.

A NEDIC Bulletin considering smartphone "apps" for eating disorder treatment and monitoring.

A NEDIC Bulletin exploring stigma regarding eating disorders, including what it means for individuals, how it is perpetuated, and misconceptions about eating disorders.

A NEDIC Bulletin exploring the transition to post-secondary education, including leaving home, facing changes, and tips for the student.

In this issue of the NEDIC Bulletin, Emily Donahue, BA, reviews research examining suicidality among people with eating disorders; outlines best practices in treating co-occurring suicidality and eating disorders; and provides coping strategies that can be helpful for people who struggle with both an suicidality and an eating disorder.

Authored by Leslie Schilling, MA, RDN, CEDRD, this Bulletin explains how a responsive feeding style fosters self-regulation and and intuitive eating skills. In a culture in which a conversation about a cloudy day comes up as often as a new keto recipe, how do we protect the innate wisdom of our little ones? It is possible – professionals, parents, friends, and family members, can help support a child to develop a healthy relationship with food from their first bite. After all, we are all born to eat.

A NEDIC Bulletin discussing two treatment options, Emotion-Focused Family Therapy and the New Maudsley Model.

Given the prevalence of binge eating both in community and clinical populations, a sound understanding of the underlying mechanisms that maintain binge eating behaviour is crucial for developing effective models and treatments. In this Bulletin, Amy Burton, PhD and Maree Abbott, PhD, present a new model for understanding binge eating that builds upon the existing literature, integrating the variables of core low self-esteem, difficulty with emotional regulation, negative affect, dietary restraint, and eating beliefs.

Consider recovery from anorexia nervosa (AN), and eating disorders in general, like traversing down a road – one that is unpaved, full of potholes, and for which there is no (Google) map. Common pitfalls encountered during recovery could then be considered normal “roadblocks” – the egosyntonic nature of the illness being among them. In order not to stumble, it is important that patient, carer, and therapist alike fully understand what aspects of their illness AN patients may value, as well as get familiar with methods to bypassing pitfalls linked with egosyntonicity.

A NEDIC Bulletin examining the experience of Black women with eating disorders and offering an overview of research and gaps in research

How was your sleep last night? Did you fall asleep easily? Did you sleep through the night? Did you feel alert when your alarm went off? Take another moment to reflect on what you ate yesterday. Did you eat regularly? Were you satisfied? Did you nourish your body? How do you feel after a poor night’s sleep? What about after eating too little or too much? In this issue of the Bulletin, Abigail R. Cooper, MA, Eleanor McGlinchey, PhD, and Katharine L. Loeb, PhD, provide an overview of the research examining the relationship between sleep difficulties and eating disorders, as well as practical tips for improving sleep.

A NEDIC Bulletin exploring the New Maudsley Model. In this model, clinicians work collaboratively with the famiilies and carers of the affected individual, who may be an adult or adolescent.

A NEDIC Bulletin exploring the adolescent experience of eating disorders through the lens of the stages of change.

A NEDIC Bulletin written by a dietitian considering her experience working as a dietitian in eating disorder contexts.

A NEDIC Bulletin exploring the transition from the youth to adult health care systems, including differences in treatment and potential stumbling blocks for the caregiver and the youth. Suggestions to manage the transition are offered for all parties.

The current DSM-5 diagnoses of “Feeding and Eating Disorders” reflect a broad range of eating disturbances across the developmental spectrum with a lifespan approach. In particular, Avoidant/Restrictive Food Intake Disorder (ARFID) is a new diagnosis, more commonly seen in childhood, acknowledging significant eating disturbances not characterized by concerns about body weight or size.

Avoidant/Restrictive Food Intake Disorder (ARFID) captures individuals of all ages with limited food intake and/or range of foods; their eating behaviours, often accompanied by fear and revulsion of novel foods, result in impaired psychosocial function or development. Considering the range of ARFID presentations, it is unlikely that one standardized intervention or protocol will emerge. This article discusses “responsive” approaches in ARFID treatment and the supporting rationale.

The diary is considered a deeply personal and private document in which one keeps a record of meaningful events and experiences. For centuries it has been widely relied upon as a safe place in which to sort and refine one’s thoughts. It may be seen as a friend, a tool with which to cultivate and strengthen connection between mind and body, and a means for continual striving to improve one’s overall sense of self. The diary can be and do all of these things. However, when a person develops an eating disorder, the diary can become an unwitting accomplice of the illness, aligning with and intensifying its traits, and exacerbating separation of mind from body.

A NEDIC Bulletin exploring the benefits of vegetarianism as well as potential problems for the individual experiencing an eating disorder.

Existing documents have identified areas for improvement in the Canadian context, but the perspectives of adults with lived inpatient treatment experience are often missing at the forefront. In this NEDIC Bulletin, Catherine Q. Armour reports on findings from a study she carried out to explore how can adult inpatient eating treatment be improved from the perspectives of Canadians with lived experience.

A NEDIC Bulletin exploring the concept of Health at Every Size. The connections between weight and health are considered, and tips for focusing on behaviour rather than weight are offered.

Clinical interviews with young people recovering from an eating disorder suggest that the "stages of change" model provides youth and their helpers with a framework for understanding the course of the disorder. When asked what helped them to move forward or to get ready for change, they indicated that their helpers (including parents, friends, teachers, and health professionals) played a key role in recognizing their need for treatment, and providing them with the structure and tools for recovery. In this article, Joanne Gusella, PhD highlights some helping tools and suggest the stage at which they may be particularly important.

A NEDIC Bulletin exploring primary prevention in schools, in the family, and beyond, with a focus on the experience of adolescents..