Marie Reid

Understanding the experience of ambivalence in anorexia nervosa : the maintainer's perspective

People with anorexia often feel ambivalent about whether they wish to maintain it or recover from it. One place where individuals can communicate their experiences of wanting to maintain their anorexia is through pro-anorexia websites. This study investigated the experiences and understandings of those who wish to maintain their anorexia and looked at how these understandings may affect their treatment experiences. Data were collected online and analysed using interpretative phenomenological analysis (IPA). Anorexia denoted meanings of a ‘tool’, an ‘entity’ and a ‘disease’. Participants felt ambivalent about whether their anorexia gave them control or controlled them, whether it played a positive or negative role and whether they wished to maintain their behaviours or recover. Participants also discussed barriers to recovery. Theoretical and treatment implications are discussed.

Effects of sucrose drinks on macronutrient intake, body weight, and mood state in overweight women over 4 weeks

The long-term effects of sucrose on appetite and mood remain unclear. Normal weight subjects compensate for sucrose added blind to the diet (Reid et al., 2007). Overweight subjects, however, may differ. In a single-blind, between-subjects design, soft drinks (4x25cl per day; 1800kJ sucrose sweetened versus 67kJ aspartame sweetened) were added to the diet of overweight women (n=53, BMI 25-30, age 20-55) for 4 weeks. A 7-day food diary gave measures of total energy, carbohydrate, protein, fat, and micronutrients. Mood and hunger were measured by ten single Likert scales rated daily at 11.00, 14.00, 16.00, and 20.00. Activity levels were measured by diary and pedometer. Baseline energy intake did not differ between groups. During the first week of the intervention energy intake increased slightly in the sucrose group, but not in the aspartame group, then decreased again, so by the final week intake again did not differ from the aspartame group. Compensation was not large enough to produce significant changes in the composition of the voluntary diet. There were no effects on hunger or mood. It is concluded that overweight women do not respond adversely to sucrose added blind to the diet, but compensate for it by reducing voluntary energy intake. Alternative explanations for the correlation between sugary soft drink intake and weight gain are discussed.

'It's like there are two people in my head': A phenomenological exploration of anorexia nervosa and its relationship to the self

This study explores the lived experience of anorexia nervosa from the perspective of those who use pro-recovery websites for eating disorders. Fourteen people participated in an online focus group or an e-interview. Data were analysed using interpretative phenomenological analysis. Participants described their disorder as a functional tool for avoiding and coping with negative emotions, changing their identity and obtaining control. A central theme was the experience of an ‘anorexic voice’ with both demonic and friendly qualities. This voice felt like an external entity that criticised individuals and sometimes dominated their sense of self, particularly as anorexia nervosa got worse. Applying dialogical theory suggests a new model of anorexia nervosa, where the anorexic voice is a self-critical position, which disagrees with and attempts to dominate the more rational self. It is suggested that to move on from anorexia nervosa, the individual needs to address his/her anorexic voice and develop a new dominant position that accepts and values his/her sense of self.

A grounded theory approach to the phenomenon of pro-anorexia

This research looked at the thoughts and feelings expressed by visitors to pro-anorexic websites to find out how they felt about anorexia and why they used pro-anorexic sites. Using grounded theory (Strauss A, Corbin J. . Basics of qualitative research: Techniques and procedures for developing grounded theory. 2nd ed. London: Sage), the information expressed by 176 participants on two pro-anorexic message boards and one online journal over eight frequently occurring topics was analysed. People believe in pro-anorexia because they want anorexic behaviours and feel positive towards them, however, anorexia could also be considered a problem at times when for some it was constituted a disorder with negative implications. Depictions of anorexia were very diverse. It is suggested that health professionals need to take into account the anorexic individuals perspectives of their anorexia in order that more successful treatment can be given. Additional research into anorexics perspectives needs to be conducted to further develop understandings of anorexia and the ways it is viewed by those who have it.