tag:blogger.com,1999:blog-7728923136858799485.post3870233708363886535..comments2023-10-10T08:13:23.362-07:00Comments on International Eating Disorder Action : Letter to The Butterfly FoundationAnonymoushttp://www.blogger.com/profile/07725569776131176381noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7728923136858799485.post-59152309758750918912015-06-17T10:20:10.457-07:002015-06-17T10:20:10.457-07:00Dear Adam,
Thank your for your input and for your ...Dear Adam,<br />Thank your for your input and for your continuing interest in fighting for access to eating disorders services. Our interest as IEDAction and the five other groups representing over 10,000 affected people and their families is to ensure correct information about eating disorders and increased access to evidence based services. Butterfly Foundation in Australia is a leading eating disorder advocacy and service provider in Australia, receiving federal funds in addition to private funding. According to Butterfly Foundation itself the country has around 1M people with eating disorders (that’s 4.3 percent of the total population) and only 30% have access to services at all. (https://mhaustralia.org/general/investing-need-changing-australias-commitment-investment-eating-disorders). Butterfly is in an EXCELLENT position to influence change and thus we are confused by their investment in things like general population education around body image, which as we noted in our letter can actually undermine efforts to ensure eating disorders receive the attention they need as serious mental illnesses. We are really happy Butterfly has engaged with us on this issue and our expectation is for more collaborative work in future. <br /><br />In terms of your comments on our research review. The Cuijpers article is not a meta-analysis but a review of different levels of prevention (universal, selective and indicated- which are distinctively different types of prevention efforts) from a research and statistical point of view. Cuijpers uses examples of different mental illnesses to help readers understand prevention from a research and statistical point of view. There is an example of anorexia in the FULL text which discusses it from a universal prevention stand point to show how unfeasible this type of effort is with low incident diseases. The point of referencing the citation was to show that a universal prevention effort, which is what Butterfly Foundation and many other groups attempt (preventing ED in the general public via improving body image), is nearly impossible due to not being able to achieve an effect size. A review of the entire article may better help clarify this and help you to understand why effect size is so important; efficacy of universal prevention is next to impossible to prove with a low incident disorder. In short, effect size facilitates the interpretation of the substantive significance of results and without an estimate of the effect size one cannot meaningfully interpret results because you would not know if the variables are actually related, regardless of statistical significance. <br /><br />While you are correct in that lack of research does not equal proof, the studies thus far are mostly conflating disordered eating with eating disorders. There has been no sound research on universal prevention for eating disorders. <br /><br />In terms of reducing mortality – this would be the goal of any prevention efforts for any disease or disorder. Unfortunately we are not aware of any research to date showing a reduction in mortality attributed to prevention efforts. <br />As we noted before our concern is the conflation of body image with eating disorders in the context of lack of access to evidence based services in Australia. Thanks again for your input and comments. <br />Amy Cunningham/Julia Fuentes<br />On behalf of IEDAction<br />Anonymoushttps://www.blogger.com/profile/02438729478902765727noreply@blogger.comtag:blogger.com,1999:blog-7728923136858799485.post-70329760399010444142015-06-14T23:04:36.244-07:002015-06-14T23:04:36.244-07:00To IEDAction,
As a supporter of the Action commun...To IEDAction,<br /><br />As a supporter of the Action community, eating disorder fighter and journalist I am somewhat dismayed to write this; however, there are certain truth that need to be addressed, or, rather factual errors that cannot be overlooked.<br /><br />Firstly, the interpretation of research is incorrect -- at most dangerous. Your statement and citation on the prevention of ED is false. You quote Cuiipers P, 2003 as this source. A review of the abstract suggests eating disorders may not have been involved in the study. It was a meta-analysis of 13 mental illness studies, of which eating disorders were not one of them. The research confirms: "Studies examining universal prevention are hardly feasible, as the number of subjects required amounts to tens of thousands at least. Research examining selective prevention is more feasible, but the number of subjects needed for these studies is still very high. Studies of indicated prevention are possible. Three major studies of indicated prevention examining the effects on the incidence of new cases of mental disorders are described."<br /><br />The National Eating Disorders Collaboration bulletin which was used to support "there have been no studies to prove primary prevention for eating disorders is effective or even possible" is incorrect. Not only does it provide several sources to the contrary, but two provided were researched and published in Australia, one in collaboration with The Butterfly Foundation. Namely, Baily, AP et al. (another meta-analysis) reported information was scant and needed more research. Ergo, lack of research does not equal proof. <br /><br />The NEDC bulletin also cited Chin-A-Loy and Robinson from University of Western Australia who confirm the strong link between eating disorders and body image, a position IEDAction disagrees with.<br /><br />The Nine Truths of Eating Disorders released recently and confirmed by the preeminent advocacy groups (IEDAction included) was used to suggest, or more aptly discourage body image awareness campaigns. In fact, truth seven specifically, and I believe purposefully, places environment and genes together as "important roles in the development of eating disorders."<br /><br />Secondly, I began writing for Proud2Bme.org, the volunteer attache of the National Eating Disorder Association, whose one of several focuses is to promote healthy body image and critique our media environment. As NEDA proxies, surely we can say they have correct interpretations of current research.<br /><br />On a more personal note, we need to respect each other as caring, loving individuals who want fewer people to die each year from eating disorders.<br /><br />Lastly, I was hoping to sit this whole thing out. I thought Butterfly Foundation was doing a good thing for getting the word out and starting conversation and perhaps IEDAction was being a bit overzealous in their mission. Then I read the letter and the cited research (yeah, that part took a while). Finding inaccuracies and misinterpretations of the research author's intent I felt obligated to give my opinion, as well as facts. Be assured, it is with displeasure that I do so.<br /><br />adamAnonymousnoreply@blogger.com