Stop being tall, left-handed, and reading books

The term 'risk factors' causes a great deal of unnecessary mischief. If two things appear together, we assume one causes the other. If two things happen in sequence, the first one causes the second one. I can only imagine the leap in collective intelligence if we invested the same brain time we do to figuring out the plot line of Lost, or Brickbreaker, on repeating: "correlation is not the same as cause."

We get it when we hear: Mixed-handed children more likely to have mental health, language and scholastic problems, though it may be surprising. We don't try to cure mixed-handedness so kids will be mentally healthy. Redheads need stronger anesthesia but we don't dye people's hair to reduce pain. Higher bipolar risk for straight-A students shouldn't lead us to tell kids to stop studying** because we can easily understand that some of the same traits that cause great highs and lows can bring about higher grades (though it would probably explain more low grades). Did you know that being taller puts you at risk of some cancers? Off with their heads!

But we don't get it when we hear that eating disorder patients report families with higher incomes, parents who diet, and moms and dads with anxiety problems. This is licence to ascribe EDs to an overemphasis on achievement, parental vanity, and stressed out families - and say that the solution is for parents to chill, get over themselves, and be humble.

We understand "risk factors" doesn't mean "cause" when it suits us.

The difference? We WANT to ascribe cause to eating disorders. We WANT to blame someone and we WANT to see in eating disorders an object lesson in greater issues. We want villains, and we want heroes. We don't like smug, driven, self-conscious parents and instead of seeing them as trapped in some of the same patterns as their kids we think they have a choice and we don't like it.

**though you will note that some people immediately jumped on parental pressure to achieve.

Comments

  1. The first thing I thought when I read your post was this comic:

    http://xkcd.com/552/

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  2. xkcd always gets it right. Well, at least whenever I understand it!!

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  3. Risk factors, even the least well researched such as parental income, do indeed lead directly to more DIAGNOSIS, but I doubt very much whether that proves any causation except that the assumptions of the clinicians doing the diagnosis CAUSE them to look for the illness in cases where they think they will find it - and conversely to ignore it when it is staring them in the face if the patient is male, black, poor etc.

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  4. I guess my son is ambidextrous..small skills like writing and eating he uses lt. Throwing, kicking he uses rt.
    He is a very good student and has no language problems. Opposite of ADHD..very very laid back.

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  5. Coming from a family that comprises of +/-50%: left/mixed handed, tall, redhead readers - I obviously don't have a hope!
    LOL...just put me down now!

    Oh and sorry, about working hard, having a good income and being anxious about my very sick child.
    Perhaps those should be seen as reasons why my sick child is able to be in care filling out surveys, not causes.
    M

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  6. Phew, lucky me being right-handed! I promise to remember about correlation/causation, though I can't promise to spend less time thinking about BrickBreaker.

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  7. as someone who is tall, (5'11") left-handed, and a devourer of books...well shit. no wonder i have an eating disorder!

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  8. Oh, wow...all these new things for me to develop.

    And yet, you know what, Laura? I agree with you 100%. But I can already hear Those Who Don't Understand & Refuse To come back with the infuriating line, "But it's not their choice to be taller, to be ambidextrous, to have red hair. It's not their choice to be smart and driven. But with eating disorders, it IS their choice. And because it is the patient's choice, then it's obviously someone's fault that the patient makes such choices."

    I wish there was a simple villain in EDs sometimes, simply because if there was a simple villain, there would--perhaps--be a simple panacea.

    I've also really come to terms with the sad fact that many people are terrified of mental illness in any and all forms. And instead of learning about what they fear, they cower and cover their ears and say "LA-la-LA" as loud as possible.

    :(

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  9. Oh, wow...all these new things for me to develop.

    And yet, you know what, Laura? I agree with you 100%. But I can already hear Those Who Don't Understand & Refuse To come back with the infuriating line, "But it's not their choice to be taller, to be ambidextrous, to have red hair. It's not their choice to be smart and driven. But with eating disorders, it IS their choice. And because it is the patient's choice, then it's obviously someone's fault that the patient makes such choices."

    I wish there was a simple villain in EDs sometimes, simply because if there was a simple villain, there would--perhaps--be a simple panacea.

    I've also really come to terms with the sad fact that many people are terrified of mental illness in any and all forms. And instead of learning about what they fear, they cower and cover their ears and say "LA-la-LA" as loud as possible.

    :(

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  10. Not only is correlation not causation, but in much of the commentary on eating disorders, correlations are assumed to exist that actually don't. Example: it is widely believed that exposure to Western television causes an increase in eating disorders. People routinely cite a study in Fiji for that conclusion. Becker, et al, "Eating Behaviours and Attitudes Following Prolonged Exposure to Television Among Ethnic Fijian Adolescent Girls," British Journal of Psychiatry
    (2002), 509-514 However, the study in Fiji looked at whether attitudes and certain limited behaviors concerning food and eating changed after TV was introduced. There was no analysis of whether actual cases of clinical eating disorders changed. There was no evidence that the incidence or prevalence of anorexia or bulimia changed. Further, it turns out that after TV was introduced in Fiji, some types of disordered eating behaviors increased, while other types decreased. So, the widely held view that exposure to Western TV is associated with eating disorders, and contributes as a causal factor, isn't supported by the study most widely cited for that proposition. Throwing away the TV may be a good thing, but not because it is correlated with or causes clinical eating disorders.

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  11. It's not just that we want to blame someone and we want to see an object lesson in EDs. It's that we as human beings don't want our bubble of safety punctured. There's a certain smug self-congratulation in seeing other people's suffering as somehow deserved. "Sure, her d developed anorexia...she MADE that girl practice the piano! I would never do that!" As if by being superior parents they are immune from these disasters. It's a very scary world to think otherwise....that bad things can actually happen to good people (even me). It's a kind of magical thinking. And since EDs have such a long history of blaming parents, it's a very scary magic feather for the rest of the world to let go of.

    M, I'm as doomed as you are.

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  12. A lot of eating disorders have to do with the media. The media tells you that you need to look a certain way when in fact you don’t. If you are comfortable with the way you look don’t change it just because the media says too. Once you start an eating disorder it becomes a mental illness and it is very difficult to stop. Some of the influences in media are magazine articles, models, and advertising. Today alone I saw ads on TV for 12 different weight loss pills and the media still says that eating disorders are bad for you when they are the ones causing most of them. If someone you know has an eating disorder the media might be the one to blame not peer pressure as the media leads us to believe. Look for your self count in 30 minutes of commercials and see how many weight lost pill ads there are. Look in magazines see how many advertisements there are. And look at the women in fashion shows, no one can look like that not even them, so why are they even trying, its not healthy and its not attractive to look like that, look for your self and you will be surprised.

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