Mental health literacy for bulimic-type eating disorders : the role of self-recognition

Abstract

Despite the availability of effective treatments for bulimic-type eating disorders, especially when help is sought early on, individuals with these disorders often delay seeking treatment. Amongst other barriers that account for poor treatment seeking, one hypothesis is that individuals experiencing bulimic-type eating disorders may be poor at recognising that their eating behaviours are problematic. To determine whether and to what extent poor self-recognition of bulimic-type symptoms occurs, and the possible factors associated with poor self-recognition, two studies were conducted in sub-groups of individuals with bulimic-type eating disorders recruited from population-based samples. The first study explored self-recognition amongst female university students (n=756), who completed self-report measures of eating disorder and comorbid pathology, as well as help-seeking. A sub-group of participants with bulimic eating disorders (n=94) were identified, and self-recognition was assessed through the use of a vignette that featured a fictional character with symptoms of bulimia nervosa. The main findings were that (i) self-recognition was poor, with just over half (52.1%) of the participants reporting that they currently had a problem with their eating; (ii) self-induced vomiting was the only variable independently associated with self-recognition; and (iii) participants who recognised a problem with their eating were more likely to have sought treatment for an eating or weight problem. These findings suggested that young women with eating disorder symptoms who are not engaging in self-induced vomiting may be particularly unlikely to recognise a problem with their eating and that this may reduce the likelihood of early, appropriate treatment being received. The second study investigated self-recognition of disordered eating amongst female adolescents with bulimic-type eating disorders (n=139) using the same methodology. In this study, as in the first study: (i) self-recognition was poor, with more than half of participants (58%) reporting that they did not currently have a problem with their eating; (ii) self-induced vomiting was strongly and independently associated with self-recognition; and (iii) participants who recognised a problem with their eating were more likely to have sought treatment for an eating or weight problem. Impairment in emotional wellbeing was also strongly associated with self-recognition in this study. Again, these findings suggested that self-recognition of disordered eating may be poor among young women with bulimic-type eating disorders, particularly those who do not engage in self-induced vomiting, and that that this may be a barrier to help-seeking. Taken together, the outcomes of these two studies indicated that improving self-recognition of bulimic-type eating disorders amongst adolescent and young adult women may strengthen early intervention and relevant health promotion programs. There may be a need to improve self-recognition and other aspects of eating disorders mental health literacy relating to bulimic-type eating disorders, not only amongst individuals with symptoms but also with whom they interact and the community as a whole. Show more