AMELIA COFFMAN
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Quality of life for those in recovery "deteriorates steadily, despite remittance"?

7/10/2017

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I was glad to see an article in the Chicago Tribune about Netflix’s upcoming, and very controversial, movie “To the Bone” written by someone who had actually lived through anorexia, but I was stunned to see this quote:
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“The quality of life for those who have recovered from an eating disorder, namely anorexia nervosa, deteriorates steadily, despite ‘remittance from the disorder'....”
Come again? I downloaded the article cited for this single sentence (Mitchison, Hay, Mond, & Slewa-Younan, 2013), and my hands made tighter and tighter fists as I read it.

Nowhere in this study do I see the authors conclude that the quality of life “deteriorates” over time, much less “steadily,” or “despite remittance from the disorder.” (They don't even measure time.)
The authors ​do explain why they went out of their way to use a real-world sample: they wanted to find people “who [had] not sought treatment” for their eating disorder.
I research the process of recovery from eating disorders, but I also lived it. ​In early recovery, I would have written all of the things scattered throughout this article—maybe even the quote I’m in such an outrage over today.

​I still had calories counts bouncing around my head. I held onto my skinny jeans. I turned down food I really wanted. I thought full recovery was for “other people.”

I no longer do any of those things. The skinny jeans are long gone, along with the treatment center mementos and all their friends. I honestly don’t remember most calorie counts, because I eventually had to make room in my brain for important things, like the names of people.

I passionately enjoy food and life, without any of anorexia’s whispers (really...that’s possible). I hope the journalist who was courageous enough to bare her soul in this article keeps fighting until anorexia seems like it was an entirely different lifetime.

It takes time. It’s definitely a fight. But, with treatment, patience, and some gumption, full recovery can absolutely be the reality. And it’s fabulous.

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Interested in the run-down of Mitchison, Hay, Mond, & Slewa-Younan's (2013) methods? Here are my main prickle points:
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  • This study was very purposefully community based in order to capture the roughly 9 out of 10 people who do not get treatment for their eating disorders.
 
  • The authors asked no questions about how long ago the self-reported “history” of anorexia had been. One year ago was counted the same as twenty. There was no assessment at all (self-report or otherwise) for where in recovery any participant was.
 
  • Despite having responses from an assessment of eating disorder symptoms, the only metric the authors used to decide that “at least 95% of participants” with a history of anorexia did not have a current diagnosis of anorexia nervosa was a (quite low) BMI cutoff. My hypothesis is that the recovery rate was much lower in this sample, given the overall rates of recovery (around 60%) and the aforementioned community sample.
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  • The difference the study authors found in quality of life was just that: a difference. There was no measure in the study of “over time” (deterioration or otherwise). That also means there was no “steadily.”
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