Ronda Rousey’s Fight with an Eating Disorder

rousey

I recently read Ronda Rousey’s book My Fight/Your Fight. In case you’re not familiar with her, I will list a few of her accomplishments: she is a former UFC champion, an Olympic bronze medalist in judo, and an ESPY Award recipient of both the Fighter of the Year and Best Woman Athlete awards. A few of the personal reasons that I connect with Rousey’s story are that I also started judo as a young girl and am a black belt in it (unlike her, I am not currently in my prime fighting condition); I, too, moved from a warm-weathered coastal city to a smaller town in North Dakota; and, like her, I really value authenticity both for myself and in other people. I admire Rousey for the numerous difficulties she has overcome, her position as one of the most dominant athletes of all time, and the barriers that she broke through by not letting people stop her from pursuing her dreams in a male-dominated field.

The two aspects of Rousey’s book that are most relevant to our lab’s research are related to her father’s tragic death by suicide and her past with an eating disorder (she reportedly had bulimia nervosa that began when she was an adolescent). Rousey speaks openly and compassionately about her father and how his death by suicide impacted her. I recommend reading about it in her own words in detail in her book or briefly in a piece she wrote at this link. Here, I will focus on three points about eating disorders from her book:

  1. There is a common misperception that people with bulimia nervosa are fragile.  I can’t imagine that anyone would describe Rousey as anything other than exceptionally mentally and physically tough. You can see it in her judo matches and UFC fights. She is remarkably resilient despite the numerous hardships she has experienced (born with her umbilical cord around her neck, overcame a significant speech problem, lost her dad, and much more). Despite her obvious and immense strength, she suffered from bulimia nervosa for years before recovering. Her openness about her past helps to decrease public perception that eating disorders result from weakness.
  2. Rousey offers insight into the factors that she believes contributed to her eating disorder, and they are consistent with what we know from scientific research. Being an athleteholding perfectionistic standards, feeling dissatisfied with her body, having low social support (which she experienced when her bulimia nervosa started), and fasting (which Rousey did to make weight for competitions) all elevate the risk for developing and continuing to have an eating disorder.
  3. In her book, Rousey states that she no longer binges or purges, no longer fasts to cut weight, that she typically maintains a healthy weight (rather than striving for an unhealthy low competition weight, as she did in the past), and that she now has a positive view and appreciation for her body. Like Serena Williams and other female athletes, people have attempted to criticize Rousey’s body by saying that she looks masculine. She responded to this by saying that her body was “badass” and “there’s not a single muscle on my body that isn’t for a purpose…” She raised money for a charity that focuses on mental health issues including body image, and her positive message about body image is spreading. Beyonce played the speech where Rousey said these things during a performance, and Demi Lovato (who also recovered from an eating disorder) has also expressed admiration for Rousey. There is hope for recovery and thriving after an eating disorder. If you or a loved one needs treatment for an eating disorder, there is help available: 12, 3, and 4.

I will conclude with a fun fact for us folks who live in North Dakota. Ronda Rousey’s first full sentence was, “I like North Dakota more than California.” (p.18 of her book)

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Exciting Week for the Lab

The past 7 days have been very exciting for the Disordered Eating & Suicidal Behavior Lab!

1) ICED – Saturday Recap

On the last day of the International Conference on Eating Disorders, we saw:

  • Dr. Christopher Fairburn present on Minimising* the Risk of Relapse. This presentation focused on helping clients stay well after treatment termination. Through data presentation, clinical examples, and a video, Dr. Fairburn outlined specific approaches for empowering clients with relapse prevention tools. The key idea is that clients can learn to recognize and effectively manage the inevitable setbacks that come with recovery from an eating disorder.

*Fairburn is British.

A blurry picture of Fairburn:

fairburn

  • Dr. Jo Ellison from the Neuropsychiatric Research Institute presented on Meal Patterning in the Treatment of Bulimia Nervosa. She described interesting data on how changes in meal patterns from the beginning of treatment to the end of treatment impact disordered eating behavior. There was a lot of useful information, and one main take-home message was that eating breakfast and especially dinner regularly was associated with less bulimic behavior. It can be a struggle for people with eating disorders to stick to eating regular, calorie-sufficient meals because of their concerns about weight gain. However, these data, along with other studies, suggest that a daily routine of consistently eating meals and snacks is really helpful for preventing binge eating and purging.

A slightly less blurry picture of Jo:

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2) NDSU College of Science and Mathematics Community Lecture

My graduate mentor, Dr. Thomas Joiner, gave this year’s community lecture on Wednesday. There was a wonderful turnout at the Fargo Theatre for his talk on Why People Die By Suicide. I heard from several students, faculty, and community members that his talk was informative and inspiring. It was also great to have time to catch up with him. You can listen to the interview he did with Prairie Public here.

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Dr. Joiner describing his theory:

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Our lab group with Dr. Joiner & Dr. Steve Wonderlich:

lab group

3) Area Paper Defense

In our graduate program, students advance to doctoral candidacy by completing a comprehensive, critical analysis and review of a research area of their choice. They write a manuscript and then present their findings to their dissertation committee. Today, Allison Minnich presented on The Relationship Between Appearance-Related Comparisons and Disordered Eating Behaviors. She delved into this literature and emerged with exciting ideas for future research. Her committee was impressed, and she passed with flying colors. Congratulations, Ally!

ally

ICED 2015 – Friday Recap (with more pictures!)

I originally intended to post this on Friday night, but I was working on a grant application on nonsuicidal self-injury and didn’t have time to post it.  Better late than never, I hope!

Plenary Session II – Dissemination and Development of Psychological Treatments in Eating Disorders: Evidence-Based or How to Sell Snake Oil? Dr. James Coyne started the session by countering the commonly held belief that all types of therapy are equally effective (referred to as the Dodo Bird Verdict).

dodo

He then went on to make several additional interesting points, some of which I’ve highlighted below:

1) Cognitive-behavioral therapy clearly has the strongest evidence base in terms of treatment for bulimia nervosa.

2) Evidence suggests that treatments that have a clear rationale, are goal-oriented, time-limited, and include regularly monitoring progress tend to outperform treatments without those components.

3) Similar to rules about medication, our field would benefit from predetermined rules about when to switch therapy modalities, when to stop a type of treatment (e.g., due to client deterioration or lack of progress), and when to refer a client to another treatment provider. All of these rules should be based on decisions made from frequent assessment of client progress.

4) Part of the work of treatment dissemination includes researchers findings ways to help clinicians and physicians feel comfortable with utilizing manualized treatments.

5) Keep in mind that behaviors that look like sabotage or nonadherence from eating disorder clients could be biological reactions related to their disorder. I interpreted this as a reminder to have compassion for our clients when they exhibit behaviors that look like resistance.

Among Dr. Coyne’s many contributions is his interactional description of depression. This paper has inspired studies in our lab about interpersonal processes related to eating disorders. I was fortunate to have an opportunity to talk with Dr. Coyne after the plenary session. I quoted something to him from one of his papers, and he replied, “well said.” I said, “I got that from you.” He said, “You know the funny thing is that I never said that. Someone just said I did, and I liked it, so I went with it.” (Disclaimer: this conversation is how I remember it and may not be exact).  Fellow Coyne fans might find it amusing to know that I was talking about the statement that, “Depression isn’t just what’s in your head, it’s what your head is in.” (Also paraphrased).

coyne

Dr. Carolyn Becker focused on treatments that people widely adopt ahead of data proving their effectiveness and presented a list of hypothesized factors for this phenomenon. Her idea is that the identification of these factors could lead to better strategies for evidence-based treatment dissemination in the future. Some commonalities that she suggested were treatments that:

1) have big promises for success

2) are flexible (and often blended) approaches

3) are validating and supportive of therapist frustrations (e.g., coping with comorbidity, difficult-to-treat conditions)

4) have accessible, well-packaged trainings

5) are associated with charismatic leaders/presenters who are good storytellers and marketers

As a final highlight of this session, Dr. Kelly Vitousek said (with regards to treatment promotion), “It’s naive to assume researchers can be corrupted only by money.” She proposed a more comprehensive, accurate list of disclosures that researchers should declare:

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This plenary panel critically examined our field and generated specific suggestions for improving practice and treatment dissemination. Overall, it was an excellent, thought-provoking session!

Oral Scientific Paper Session I – Binge Eating Disorder & Obesity

Some highlights:

1) The negative impact of weight bias on self-esteem and emotions appears to be magnified when a person internalizes the bias (e.g., blames themselves for being the target of weight-based discrimination).

2) Preliminary evidence suggests that first-year college weight gain may be prevented by making healthy food the optimal default (i.e., creating cafeteria menus with healthy foods featured as the default and making unhealthy food less convenient to eat).

3) A specific type of impulsivity (negative urgency; the tendency to act rashly when distressed) predicts food consumption in the lab for individuals experiencing high levels of arousal during emotional states. This presentation was especially fun to see because the presenter, Joe Wonderlich, worked in our lab before he started graduate school. He is currently in a doctoral program for clinical psychology and doing very interesting work with Dr. Sarah Fischer.  Here is a blurry picture of him:

Joe

Poster Presentations Session II – I enjoyed meeting many of the current students from my alma mater, Florida State University. Most importantly, Mun Yee Kwan represented our lab very well with her poster on Social Support, Perceived Stress, and Bulimic Behaviors. Her poster displayed findings from her dissertation, which demonstrated that higher levels of social support are related to lower levels of bulimic behaviors, because of its impact on stress perception. Specifically, it seems that individuals who have people that they can count on for support tend to feel less stressed about life’s challenges, and therefore, are less prone to engaging in bulimic behaviors.

Mun Yee

Fun This was a particularly busy day, but we did find time to take the T to Chinatown for lunch and eat some delicious Malaysian food at a restaurant Mun Yee discovered when she lived in Boston.  I had the tofu curry pot and roti canai (Indian pancake).  All of it was so good!

currypotindian pancake

ICED 2015 – Thursday Recap (With Pictures!)

Hello everyone!  We are at the International Conference on Eating Disorders (ICED), and I thought it would be fun to write about a few of the highlights from today.

Keynote AddressThe keynote speaker was Dr. Cindy Bulik. Her talk focused on strategies for practicing engaged science. She emphasized the importance of getting outside of your lab and connecting with the community, people suffering from eating disorders, their families, and people with areas of expertise outside of psychology. Her inspiring message was that engaged science builds strong teams that are capable of greater advancement in the prevention and treatment of eating disorders.

Examining Food & Mood: Affect, Eating Behavior and Implications for Treatment in Anorexia Nervosa: This was an excellent workshop session examining the roles of mood and habit in eating disorders. Fargo was well-represented by Drs. Jason Lavender and Steve Wonderlich. They introduced novel research-based ideas about maintenance factors in eating disorders. They identified negative mood reduction, emotion regulation skill acquisition, and interventions that disrupt automatic responses to cues as promising areas for intervention.

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Commonalities and Differences in the Treatment of Eating Disorders across Diverse Populations: Considering Transcultural Issues: A major priority in the United States is to reduce health disparities, including those related to mental health. This session examined research and case examples for methods of reducing barriers to treatment access, treatment retention, and treatment effectiveness. Several useful suggestions included targeting acculturative stress, recruiting a more diverse population of clinicians into the field, and culturally-tailoring treatment. It was also wonderful to reconnect with Dr. Marisol Perez, who supervised my undergraduate honors thesis, which was relevant to this very topic!

marisol

A Test of an Interactive Model of Binge Eating among Undergraduate Men: Our very own Allison Minnich presented her research from her Master’s thesis during the poster session. She found that college men with high levels of perfectionism, high levels of body dissatisfaction, and low levels of self-esteem were most likely to engage in binge eating in a longitudinal study. She did an outstanding job representing the lab and explaining the research!

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Fun

In between sessions, we had an opportunity to check out Cheers for lunch (Frasier is one of my all-time favorite TV characters) and see the bench that Robin Williams and Matt Damon sat on in Good Will Hunting (which is one of my favorite movies).

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