Date post: | 09-Feb-2017 |
Category: |
Education |
Upload: | andrea-lamarre |
View: | 73 times |
Download: | 0 times |
Reproductive Health Embodied
A Social Science Perspective on Eating Disorders, Obesity, and
PregnancyAndrea LaMarre, MSc.PhD CandidateVanier Scholar (CIHR)Department of Family Relations and Applied NutritionUniversity of Guelph
Agenda• Introduction• Taking a Social Science Perspective• Eating Disorders: Key Features• Eating Disorders in Pregnancy• Obesity – Biomedical and Critical Perspectives• Weight Stigma• Obesity & Weight Stigma in Pregnancy
Introduction: about me• PhD candidate• Primary research on
eating disorder recovery• Project manager for
“Reproducing Stigma” (U Manitoba)
• Daughter of a biomedical science prof
• Feminist• Wanderlust
Taking a social Science Perspective• Why should you care?– Medical school– Human impact– Critical thinking– Challenging objectivity
About Eating Disorders• Anorexia Nervosa (AN) – Restricting subtype– Binge-purge subtype– Atypical
• Bulimia Nervosa (BN)• Binge Eating Disorder (BED)• Other Specified Feeding and Eating Disorder
(OSFED)
About eating disorders• Eating disorders in popular
culture– Assumptions & stereotypes– Barriers to diagnosis,
treatment– Important of honouring lived
experience
About Eating Disorders• Low recovery rates• Difficult to treat• Social sanctioning of many eating-disorder-related
behaviours
About Eating Disorders• Medical complications– Cardiac– Metabolic– Endocrine– Gastrointestinal– Neurological– Dental
Eating disorders in Pregnancy
• Women with eating disorders can & do get pregnant– Absent menses ≠ uniformly
anovulatory• Eating disorders may
_____ pregnancy– Pre-exist– Be precipitated by– Follow
Eating disorders in pregnancyRecognition• Little/no weight gain or weight loss• Restriction, skipping/avoiding meals• Fear of weight gain• Engaging in extreme exercise • Chronic fatigue• Dizziness, headaches, blacking out• Difficulty concentrating• Social isolation/avoidance• Increased depression/anxiety
Eating disorders in pregnancy
Complications• Pre-eclampsia• Preterm labour• Low birth weight in baby• Cardiac irregularities• Stillbirth/fetal death• Gestational diabetes• Miscarriage• Respiratory difficulties• Abnormal fetal growth• Cesearean birth• Difficulture breastfeeding
Eating disorders in pregnancy
• Monitoring of bodies: increased scrutiny• Triggering long-dormant eating disorders• Post-partum depression– 1/3 – 2/3 of cases
• Genetic links + hormonal changes
Eating disorders in pregnancyManagement• Multi-disciplinary care (doctors, psychologists,
dietitians, etc.)• Recommending delaying pregnancy until significant
recovery is achieved • Acute or long-term hospitalization may be required
in some situations
Eating disorders and fertility• People seeking fertility care may also have eating
disorders• Higher prevalence of ovulatory disorder in women
with severe eating disorders– May be less likely to present for assistive reproductive
technology; fear dismissal/stigma
Reproducing Stigma?• 2011: fertility specialists debate whether to deny
services to women classified as obese• May present these women as unfit potential
mothers• Stigma itself may exacerbate health issues (Budd et al.,
2009; Erdman Farrell, 2011; Wray & Dreery, 2008)
Reproducing stigma?• Complex links between obesity & health: focus on
health (e.g. physical fitness, etc.), not size• Obesity stigma– Harrassment– Denial of healthcare services– Questioning of parenting abilities– Exacerbated amongst otherwise marginalized people
Reproducing stigma?• Barriers to women in larger bodies seeking
reproductive health care:– Being told to lose weight prior to full health screening
• Cited risks for maternal & infant health:– Gestational diabetes– Pre-eclampsia– Child health outcomes including future obesity, heart
disease, and diabetes
Reproducing stigma?“A lot of people who look like you have treated me like crap”– Participant in Reproducing Stigma study
1. Dignity and respect2. Collective, compassionate care3. Recognizing the body size ≠ health