I was reading an article (full text available!) by Walter Vandereycken (which I will post about in greater length soon), and something in his online survey caught my eye:
In the first part of the survey, participants were asked a few general questions, in cluding self-diagnosis of the type of eating disorder they were showing most recently:
- ANR or anorexia nervosa restrictive type (underweight, restricted food intake, no purging);
- ANM or anorexia nervosa mixed type (underweight, purging and/or binge-eating);
- BN or bulimia nervosa (binge eating, more or less normal weight);
- EDNOS or eating disorder not otherwise specified (different from previous ones)
Several things caught me off-guard:
- The use of “ANM” rather than “ANP” — ANM may actually be more accurate, upon second thought, but it’s new terminology to me
- The lack of the mention of purging in bulimia nervosa. Isn’t that a pretty key element of the disorder, and something that separates it from binge eating disorder? Whether it’s purging through vomiting, exercise, or fasting… it’s still purging, and still criteria for bulimia.
- Where’s BED or binge eating disorder? BN sounds more like BED… so in that case, where is BN?
These important points aside, what I really wanted to talk about was the self-diagnosis of eating disorder type. Unfortunately, so much of ED research (and treatment) depends on self-report, so I understand why this was used in the study… but from previous experience, I know that no matter how sick I really was, when I was younger I would have never classified myself as anorexic. Actually, having spent some time on eating disorder boards (back in the day of AOL monitored-forums… does anyone else remember those?), I considered myself to have “pre-anorexia” (aka: anorexia light). I used this terminology because I didn’t feel like a “real” anorexic, despite meeting the criteria. It wasn’t a knowledge issue… I knew about the DSM. It was more of an acceptance thing. To this day, I have a hard time with the anorexia diagnosis because of the “sick enough” factor (I’m sure I’ve mentioned that before).
Personally, I’ve had enough treatment that I probably would have considered myself ANR, but it would be really tempting to choose EDNOS.
I wonder how many (if any) other individuals struggled with their diagnosis when self-reporting in this study. I’m pretty sure I’m not the only one. I would also be interested to see the discrepancy between self-report and official diagnosis, which could be obtained through psychological evaluation. Maybe self-diagnosis is a better indicator… I haven’t read the research on that. Overall the article left me with a lot of questions, that hopefully I’ll address in future posts.
On a final note though, I would like to thank Walter Vandereycken for sending me his article and thinking of me whenever he publishes his new research. If I would have to choose one research subject that I’m most interested in, it would have to be eating disorder subculture. I’m sure you’ll see a trend toward that as Grey Thinking progresses — so you have all been warned