





































       V38 N4 / 2023 

©2023 American Medical Writers Association. All rights reserved.  
ISSN 2163-5315

AMWAJournal.org     10

ABSTRACT 
Eating disorders are a group of severe medical conditions 
that center around energy intake and sometimes body dis-
satisfaction. Despite their severity, eating disorders are 
often viewed negatively by both lay individuals and health 
professionals. This stigmatization is the result of inaccu-
rate and exaggerated information about these illnesses. As 
health educators, medical writers are positioned to chal-
lenge and change these stigmas by creating and distrib-
uting accurate information about eating disorders. This 
article provides medical writers with foundational knowl-
edge about eating disorders and background information 
on their stigmatization and offers suggestions for how to 
write about these conditions to reduce current stigmas and 
improve understanding of eating disorders.

EATING DISORDERS IN HEALTH COMMUNICATION
Health content creators construct health narratives by 
determining what information gets conveyed and omitted 
as well as the style and tone of that information. Medical 
writers, therefore, educate and influence people’s attitudes 
toward medical conditions. These attitudes toward med-
ical conditions can influence a variety of issues, includ-
ing health research funding, health policy decisions and 
insurance coverage, support for individuals during medical 
treatment, and peer acceptance of individuals with certain 
medical conditions.
 Despite the substantial responsibility health communi-
cators have for creating accurate health narratives, online 
health information is often inaccurate and written by non-
experts.1 This lack of credibility and accuracy in health 
content creation is concerning because the lay public and 
health professionals rely on and trust this information to 
educate themselves.2,3 Misleading health information also 
influences how people think and feel about individuals with 
medical conditions.4-6 
 Information about eating disorders has been particu-
larly inaccurate, omissive, and exaggerated in health com-
munication, which has resulted in ongoing stigmatization 

of these illnesses.4-6 Medical writers are well positioned 
to change this narrative by interpreting eating disorders 
research for nonexperts, yet information articles on eating 
disorders have largely been absent in medical communi-
cation. This absence may have contributed to the negative 
attitudes lay individuals and health professionals hold about 
these illnesses.4-6 The pervasiveness of stigmas around eating 
disorders makes now a good time for medical writers to 
more deeply understand these medical conditions in order 
to reframe the narrative and reform attitudes toward them by 
creating informed, nonjudgmental, and accessible content.

EATING BEHAVIOR
Healthy Eating
Eating behavior exists on a spectrum, with healthy eating 
on the far left (Figure 1). The US government defines 
healthy eating as the daily consumption of a variety of nutri-
tious foods and drinks with mindfulness for overeating or 
undereating.7 Fulfilling your body’s homeostatic needs is, 
therefore, one component of healthy eating. A second com-
ponent of healthy eating involves a person’s relationship 
with food.8 Enjoying the foods you eat, avoiding food valua-
tion (eg, labeling foods as forbidden), and having a flexible 
diet are additional aspects of healthy eating. 

Melinda D. Karth, MS, MA  / PhD Candidate in Neuroscience, Purdue University, West Lafayette, IN

Destigmatizing Eating Disorders with Medical Writing

SCIENCE SERIES

Figure 1. The eating behavior spectrum. Healthy eating is typically 
defined as fulfilling the body’s homeostatic needs while maintaining a 
flexible diet. The transition from healthy eating to disordered eating 
is not clearly defined and can occur when a person’s eating behavior 
does not fulfill their body’s homeostatic needs (eg, restrictive or over-
eating); disordered eating also occurs when an individual experiences 
guilt or shame for eating. Eating disorders are extreme versions of 
disordered eating and are identifiable by diagnostic clinical criteria; 
eating disorders have a severe, lasting impact on the body and brain 
(eg, heart and gastrointestinal irregularities).

Healthy Eating Disordered Eating Eating Disorder

http://www.amwajournal.org


AMWAJournal.org     11Destigmatizing Eating Disorders with Medical Writing

Disordered Eating
To the right of healthy eating on the eating behavior spec-
trum is disordered eating. Healthy eating becomes dis-
ordered when a person engages in one or more of the 
following behaviors: restricting food, limiting specific foods, 
eating beyond satiation, experiencing guilt after eating, 
adhering to an inflexible diet, and/or experiencing nervous-
ness when eating in public.9 Under this definition, many 
accepted eating habits (eg, a low-carb diet) can be consid-
ered disordered eating. Disordered eating is not necessarily 
harmful but becomes a cause for concern when it impairs a 
person’s physical health and life quality. Addressing disor-
dered eating is important because if left untreated, it could 
progress into an eating disorder.10

Eating Disorders
Eating disorders are extreme versions of disordered eating 
and are diagnosable by clinical criteria. 

Anorexia nervosa (AN): Individuals must restrict their daily 
energy intake in ways that interfere with their body’s appro-
priate developmental trajectory.11 Additionally, individuals 
must have an intense fear of weight gain, disturbed body 
perception, and denial of the severity of their low weight.

Bulimia nervosa (BN): For at least once a week for 3 
months, individuals must engage in recurrent binge eating 
episodes.11 A food binge is defined as uncontrollably eating 
an atypically large amount of food during a short period of 
time. Body disturbance and compensatory behaviors to pre-
vent weight gain (eg, vomiting) must also occur.

Binge eating disorder (BED): For at least once a week for 3 
months, individuals must engage in recurrent binge eating 
episodes.12 A binge is defined as uncontrollably eating an 
atypically large amount of food during a short period of 
time. Eating until uncomfortably full and distress about 
binge eating behavior might also be present.

Avoidant restrictive food intake disorder (ARFID): Lack  
of interest in food that results in nutritional and energy  
deficits.13 No body image disturbance should be present, 
and restrictive eating cannot be attributed to a separate 
medical condition.
 
Pica: Persistent eating of nonedible substances (eg, soil, 
paper, or chalk) for at least 1 month. These items cannot be 
culturally supported.14

 
Orthorexia: Not officially recognized as an eating disorder 
by the American Psychiatric Association but acknowledged 

as an eating disorder by clinicians and the public.15 Involves 
an obsession with healthy eating that impairs an individu-
al’s well-being.
 
Subclinical: Individuals who do not meet all necessary  
criteria to be diagnosed with an eating disorder yet demon-
strate extreme levels of disordered eating have a subclin-
ical eating disorder. Subclinical eating disorders can be 
damaging to a person’s health and well-being, despite not 
being officially recognized by the American Psychiatric 
Association.

 The point prevalence for eating disorders in men and 
women across eating disorder subtypes has been estimated 
at 8.8% for adults and 5.7% for adolescents, with women 
having a higher lifetime prevalence compared with men 
(8.4% verses 2.2%).16 In children (ie, ages 9 and 10), the 
lifetime prevalence for eating disorders across eating dis-
order subtypes has been estimated at 10%.17 Historically, 
there is the misconception that eating disorders predomi-
nantly occur in White, heterosexual, cisgender individuals.18 
However, emerging research shows that Native American/
Alaska Native women and Black women are as likely as 
White women to meet criteria for an eating disorder across 
subtypes, with these populations more likely to develop 
BED than White women. Similarly, LGBTQIA+ populations 
are at elevated risk for developing eating disorders and 
often have higher rates of eating disorder behaviors across 
subtypes compared with cisgender and/or heterosexual 
individuals.19 These estimates across populations, however, 
could be low and inaccurate, as eating disorders go largely 
undetected by medical professionals for people of all ages 
and groups.16,17 One reason for the underdiagnosis of eating 
disorders across populations could be the normalization of 
disordered eating in diet culture.

EATING BEHAVIOR COMMUNICATION
Diet Culture and Weight Loss
Definitions of eating behavior can be fluid and vague and, 
therefore, are often inconsistent within health communica-
tion. An example of this fluidity is diet culture.20 Within diet 
culture, certain values are attached to different foods and 
lifestyle practices (eg, celery is a good food). These beliefs 
about food values and lifestyle practices are then accepted 
and ritualistically followed by people to achieve thinness, 
which is equated with health, morality, and increased social 
status in diet culture.20 
 Because diet culture limits what a person can eat and 
fixates on weight loss, its practices can be considered dis-
ordered eating. Dieting, however, is rarely considered dis-
ordered eating and has become normalized as a type of 

http://www.amwajournal.org


AMWAJournal.org     12Destigmatizing Eating Disorders with Medical Writing

healthy eating through diet culture communication.20 
Normalizing disordered eating minimizes the seriousness 
of eating disorders—it also influences how people think and 
feel about food, how they eat, and how they relate to their 
bodies.20

Eating Disorder Stigmas
The normalization of eating disorder behavior (eg, food 
restriction) in diet culture has contributed to stigmatiza-
tion about eating disorders.21 The most prevalent stigmas 
about eating disorders include personal responsibility for 
illness (eg, people with eating disorders are vain), atten-
tion-seeking (eg, people with eating disorders are not truly 
sick), and weakness (eg, people with binge-type eating dis-
orders are too lazy and/or weak to lose weight through diet 
and exercise).22 Consequently, people with eating disorders 
are often blamed for their illness and might internalize this 
self-blame.4-6,23 Internalizing this self-blame might lower 
self-esteem, hope, and empowerment during treatment for 
people with eating disorders, which could prolong illness 
and decrease quality of life.24 For example, women diag-
nosed with AN who feel stigmatized for their eating disorder 
(ie, personal responsibility) have a longer duration of illness, 
lower self-esteem, and more severe eating disorder symp-
toms compared with women who feel less stigmatized for 
their eating disorder.20 Stigmatization about eating disorders 
can also foster negative reactions toward these illnesses in 
medical spheres, leading to the underdiagnosis of eating  
disorders.6,23

USING NEUROSCIENCE TO CHALLENGE EATING 
DISORDER STIGMAS
Destigmatizing Eating Disorders with Neuroscience
Eating disorders have a weak presence in medical commu-
nication, despite these illnesses involving and impacting 
nearly every organ in the body.25 One reason for the weak 
presence of eating disorders in medical communication 
could be that these disorders are not considered to be seri-
ous medical conditions.21-24 Unlike other illnesses, few phar-
maceuticals have been effective in reducing symptoms; 
instead, treatments have centered around psychotherapy 
and behavioral therapy.26 Emphasis on therapy in eating dis-
orders treatment might be perpetuating the belief that these 
illnesses are solely psychological in nature. The omission of 
eating disorders from medical communication, however, 
needs to change, because medical communicators have a 
responsibility to accurately inform the public and health 
professionals about the complexities of medical conditions.
 Writing about the brain’s role in eating disorder signs 
and symptoms is one way medical communicators could 
reduce eating disorder stigmas within the public sphere and 

among health professionals. Research has demonstrated 
that people judge arguments supported by neuroscience 
information as more alluring and of higher quality than 
arguments supported by information from other sciences 
(eg, social science).27 For example, when asked to judge the 
quality of several scientific arguments, university students 
rated arguments supported with neuroscience information 
(eg, brain image) as superior to the same arguments with-
out neuroscience information. Research also shows that 
enhancing discussions about eating disorders with biolog-
ical information, rather than strictly sociocultural informa-
tion, improves people’s attitudes toward these illnesses.28,29 
Consequently, including neuroscience information in com-
munication about eating disorders could improve under-
standings of these illnesses and potentially reduce their 
stigmatization.

The Brain’s Role in Eating Disorder Signs and Symptoms
Acknowledging the brain’s role in eating disorder signs and 
symptoms (eg, restrictive eating) in medical communica-
tion could help destigmatize these illnesses by deempha-
sizing personal responsibility for eating disorder behavior. 
For example, research shows that atypically high levels of 
brain serotonin could contribute to AN signs and symp-
toms (eg, restrictive eating, anxiety, and cognitive inflexibil-
ity), whereas atypically low levels of brain serotonin could 
explain BN and BED signs and symptoms (eg, compulsiv-
ity, impulsivity, and binge eating).30 Based on this evidence, 
selective serotonin reuptake inhibitors have been used 
with limited effectiveness in eating disorder treatments 
to rebalance serotonin and reduce symptoms associated 
with eating disorders (eg, depression).26 Whether serotonin 
imbalances are present before eating disorder onset (eg, the 
result of genetic variants) or if serotonin imbalances emerge 
in response to disordered eating behavior (eg, starvation or 
excessive carbohydrate intake), however, is unclear. 
 Acknowledging how the brain constructs body image 
during an active eating disorder might also explain signs 
and symptoms of these illnesses. Body image is a com-
plex concept describing how we perceive and feel about 
our bodies. This construct, which we create using our per-
ceptions of and our feelings toward our bodies, influences 
the third-person image of ourselves we keep for self-refer-
ence in our long-term memory.31 Consequently, our inter-
nal body construct might not accurately represent how we 
appear to others. Nonetheless, our brains work to make this 
construct as accurate as possible by updating it daily with 
current sensory information (eg, seeing our reflection). 
These daily updates to our body construct explain how our 
mental self-representations change as our weight fluctuates. 
The brains of people with AN, however, might not update 

http://www.amwajournal.org


AMWAJournal.org     13Destigmatizing Eating Disorders with Medical Writing

the body construct following weight changes because of dis-
ruptions in short-term memory processing.31 These neuro-
logical disruptions to body construct updates in people with 
AN could explain why severely underweight people with AN 
insist that they are overweight. Potential causes for these 
processing disruptions include, but are not limited to, stress 
and social influence (eg, media images of idealized body 
types).32 It is unclear, though, whether disruptions in body 
construct processing are present before AN onset or if they 
emerge in response to AN illness. Additionally, people with 
AN have reduced communication (ie, connectivity) between 
brain regions responsible for estimating body size and shape 
(eg, extrastriate and fusiform body areas).33 As a result, 
these individuals assess their body dimensions erroneously. 
Body image therapy has shown to increase communication 
between these brain regions, resulting in more accurate esti-
mates of body dimensions in people diagnosed with AN.34

 Dysfunctions in gut-brain interactions might also con-
tribute to eating disorder signs and symptoms.35-37 The gut 
communicates information to the brain that influences not 
only what we eat but also our behavior and how we feel. 
Disorders of gut-brain interactions (DGBIs) (eg, dyspepsia) 
are common among people with ARFID, possibly because 
gastrointestinal discomfort contributes to food avoidance.35 
In these cases, an eating disorder likely develops in response 
to a DGBI, and treating the DGBI could reduce eating dis-
order signs and symptoms. Dysbiosis also plays a role in 
eating disorder signs and symptoms. In AN, certain bacteria 
imbalances in the gut microbiome could contribute to the 
reduced appetite, depression, anxiety, and challenges with 
weight gain associated with this illness.36,37 For example, 
previous research shows that germ-free mice that receive 
fecal microbes from women with AN have reduced food 
intake, difficulties gaining weight, and increased anxiety-like 
and compulsive behavior compared with control mice.38 
How dysbiosis in AN contributes to these outcomes, how-
ever, is unclear. Increased gut permeability during an active 
eating disorder might also alter the immune system in ways 
that contribute to eating disorder pathology (eg, cytokines 
decreasing appetite).37 It is unclear, though, if atypical gut 
composition and/or permeability develops prior to and/or 
during an active eating disorder.

DISCUSSION
The absence of eating disorders coverage in medical  
writing has potentially contributed to ongoing misinforma-
tion about and stigmatization of these conditions in public 
and health professional contexts.4-6 Reducing these  
stigmas and improving eating disorders education in  
medical settings is important because the eating disorder 
recovery process requires a team of health professionals 

(eg, physicians, dieticians, and psychologists). Professionals 
working on an eating disorder treatment team, however, 
often lack specialized knowledge in eating disorders, which 
can slow communication between team members and inter-
fere with treatment decisions.39,40 Medical writers, therefore, 
could play an integral role in facilitating communication 
within eating disorder treatment teams by providing clear 
and accurate educational information about eating dis-
orders. Effective communication among treatment team 
members is crucial for a patient’s recovery; the longer an 
eating disorder persists, the more treatment-resistant it 
becomes, and the more it damages the brain and body  
(eg, heart and gastrointestinal conditions).
 Educational content about eating disorders for health 
professionals could also help prevent these illnesses.41,42 
Physicians often overlook warning signs of an eating disor-
der, particularly in children and athletes, because of mise-
ducation about these disorders and/or not taking these 
illnesses seriously.43,44 Acknowledging signs of an eating 
disorder in children is important because eating disorders 
increase injury susceptibility and impact growth, brain 
development, and immune response. Physicians, therefore, 
need a more comprehensive understanding of eating disor-
ders and disordered eating, specifically early warning signs 
(eg, lanugo body hair growth), common medical complica-
tions with eating disorders (eg, slow heart rate), biochemical 
markers of eating disorders (eg, low potassium levels), how 
to safely stabilize a patient with a chronic eating disorder, 
and how to define eating disorder recovery.
 Finally, medical writers can help destigmatize eating 
disorders in the public sphere by interpreting emerging 
research about these illnesses for lay audiences. Important 
topics to write about include the underlying biology of 
eating disorders, emerging treatments, population-specific 
eating disorders (eg, different genders and ages), health 
consequences of eating disorders, obscure eating disorders 
(eg, ARFID), and recognizing subclinical eating disorder 
behavior (eg, inflexible eating). A challenge for medical  
writers communicating information about eating disorders 
to a nonexpert audience will be to acknowledge the 
limitations of the available information while maintaining 
credibility and authority. To accomplish these tasks, it 
will be essential for medical writers to dispel previous 
misconceptions about eating disorders and embrace the 
complexities of the evolving science.

Author declaration and disclosures: The author notes no  
commercial associations that may pose a conflict of interest in 
relation to this article.

Author contact: melindadkarth@gmail.com

http://www.amwajournal.org


AMWAJournal.org     14Destigmatizing Eating Disorders with Medical Writing

References
1.  Crocco AG, Villasis-Keever M, Jadad AR. Analysis of cases of harm 

associated with use of health information on the internet. JAMA. 
2002;287(21):2869-2871. doi:10.1001/jama.287.21.2869

2.   Bennett NL, Casebeer LL, Kristofco R, Collins BC. Family 
physicians’ information seeking behaviors: a survey comparison 
with other specialties. BMC Med Inform Decis Mak. 2005;5(1):9. 
doi:10.1186/1472-6947-5-9

3.   Cline RJW, Haynes KM. Consumer health information seeking on 
the internet: the state of the art. Health Educ Res. 2001;16(6):671-
692. doi:10.1093/her/16.6.671

4.   O’Connor C, McNamara N, O’Hara L, McNicholas F. Eating 
disorder literacy and stigmatizing attitudes towards anorexia, 
bulimia, and binge eating disorder among adolescents. Advances 
in Eating Disorders: Theory, Research, and Practice. 2016;4(2):125-
140. doi:10.1080/21662630.2015.1129635

5.   Blodgett Salafia EH, Jones ME, Haugen EC, Schaefer MK. 
Perceptions of the causes of eating disorders: a comparison 
of individuals with and without eating disorders. J Eat Disord. 
2015;3(1):32. doi:10.1186/s40337-015-0069-8

6.   Thompson-Brenner H, Satir DA, Franko DL, Herzog DB. Clinician 
reactions to patients with eating disorders: a review of the literature. 
Psychiat Serv. 2012;63(1):73-78. doi:10.1176/appi.ps.201100050

7.   Eat healthy. US Department of Health and Human Services. 
Content updated on July 14, 2022. Accessed February 27, 2023. 
https://health.gov/myhealthfinder/health-conditions/diabetes/
eat-healthy

8.   Falk LW, Sobal J, Bisogni CA, Connors M, Devine CM. 
Managing healthy eating: definitions, classifications, 
and strategies. Health Educ Behav. 2001;28(4):425-429. 
doi:10.1177/109019810102800405 

9.   Dos Santos Alvarenga M, Scagliusi FB, Philippi ST. Development 
and validity of the Disordered Eating Attitude Scale (DEAS). 
Percept Mot Skills. 2010;110(2):379-395. doi:10.2466/
pms.110.2.379-395 

10.  Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg 
M. Obesity, disordered eating, and eating disorders in a 
longitudinal study of adolescents: how do dieters fare 5 years 
later? J Am Diet Assoc. 2006;106(4):559-568. doi:10.1016/j.
jada.2006.01.003

11.  Harrington BC, Jimerson M, Haxton C, Jimerson DC. Initial 
evaluation, diagnosis, and treatment of anorexia nervosa and 
bulimia nervosa. Am Fam Physician. 2015;91(1):46-52. http://
www.aafp.org/afp/2015/0101/p46.html

12.  Giel KE, Bulik CM, Fernandez-Aranda F, et al. Binge eating 
disorder. Nature Reviews Disease Primers. 2022;8(1):16. 
doi:10.1038/s41572-022-00344-y

13.  Eddy KT, Harshman SG, Becker KR, et al. Radcliffe ARFID 
Workgroup: toward operationalization of research diagnostic 
criteria and directions for the field. Int J Eat Disord. 
2019;52(4):361-366. doi:10.1002/eat.23042

14.  Bryant-Waugh R, Micali N, Cooke L, Lawson EA, Eddy KT, Thomas 
JJ. Development of the Pica, ARFID, and Rumination Disorder 
Interview, a multi-informant, semi-structured interview of feeding 
disorders across the lifespan: a pilot study for ages 10-22. Int J Eat 
Disord. 2019;52(4):378-387. doi:10.1002/eat.22958 

15.  Donini LM, Barrada JR, Barthels F, et al. A consensus document on 
definition and diagnostic criteria for orthorexia nervosa. Eat Weight 
Disord. 2022;27:3695-3711. doi:10.1007/s40519-022-01512-5

16.  Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence 
of eating disorders over the 2000–2018 period: a systematic 
literature review. Am J Clin Nutr. 2019;109(5):1402-1413. 
doi:10.1093/ajcn/nqy342

17.  Sanzari CM, Levin RY, Liu RT. Prevalence, predictors, and 
treatment of eating disorders in children: a national study. Psychol 
Med. 2023;53(7):2974-2981. doi:10.1017/S0033291721004992

18.  Mikhail ME, Klump KL. A virtual issue highlighting eating 
disorders in people of Black/African and Indigenous heritage.  
Int J Eat Disord. 2021;54(3):459-467. doi: 10.1002/eat.23402

19.  Parker LL, Harriger JA. Eating disorders and disordered eating 
behaviors in the LGBT population: a review of the literature.  
J Eat Disord. 2020;8(1):51. doi:10.1186/s40337-020-00327-y

20.  Hesse-Biber S, Leavy P, Quinn CE, Zoino J. The mass marketing 
of disordered eating and eating disorders: the social psychology 
of women, thinness, and culture. Women’s Stud Int Forum. 
2006;29(2):208-224. doi:10.1016/j.wsif.2006.03.007

21.  Rose KL, Negrete CE, Sellinger G, Chang T, Sonneville KR. 
Adolescent and emerging adult perceptions of eating disorder 
severity and stigma. Int J Eat Disord. 2022;55(10):1296-1304. 
doi:10.1002/eat.23772

22.  Griffiths S, Mond JM, Murray SB, Touyz S. The prevalence and 
adverse associations of stigmatization in people with eating 
disorders. Int J Eat Disord. 2015;48(6):767-774. doi:10.1002/
eat.22353

23.  Currin L, Waller G, Schmidt U. Primary care physicians’ 
knowledge of and attitudes toward the eating disorders: do 
they affect clinical actions? Int J Eat Disord. 2009;42(5):453-458. 
doi:10.1002/eat.20636

24.  Livingston JD, Boyd JE. Correlates and consequences of 
internalized stigma for people living with mental illness: 
a systematic review and meta-analysis. Soc Sci Med. 
2010;71(12):2150-2161. doi:10.1016/j.socscimed.2010.09.030

25.  Campbell K, Peebles R. Eating disorders in children and 
adolescents: state of the art review. Pediatrics. 2014;134(3):582-
592. doi:10.1542/peds.2014-0194

26.  Aigner M, Treasure J, Kaye W, Kasper S, The WFSBP Task Force 
on Eating Disorders. World Federation of Societies of Biological 
Psychiatry (WFSBP) guidelines for the pharmacological treatment 
of eating disorders. World J Biol Psychiatry. 2011;12(6):400-443. 
doi:10.3109/15622975.2011.602720

27. Fernandez-Duque D, Evans J, Christian C, Hodges SD. Superfluous 
neuroscience information makes explanations of psychological 
phenomena more appealing. J Cogn Neurosci. 2015;27(5):926-944. 
doi:10.1162/jocn_a_00750

28.  Crisafulli MA, Von Holle A, Bulik CM. Attitudes towards anorexia 
nervosa: the impact of framing on blame and stigma. Int J Eat 
Disord. 2008;41(4):333-339. doi:10.1002/eat.20507

29.  Wingfield N, Kelly N, Serdar K, Shivy VA, Mazzeo SE. College 
students’ perceptions of individuals with anorexia and bulimia 
nervosa. Int J Eat Disord. 2011;44(4):369-375. doi:10.1002/
eat.20824

30.  Steiger H. Eating disorders and the serotonin connection: 
state, trait, and developmental effects. J Psychiatry Neurosci. 
2004;29(1):20-29.

31.  Lander R, Heled E, Gur E. Executive functioning and spatial 
processing in anorexia nervosa: an experimental study and its 
significance for the allocentric lock theory. Eat Weight Disord. 
2020;25(4):1039-1047. doi:10.1007/s40519-019-00728-2

32.  Riva G. Neuroscience and eating disorders: the allocentric lock 
hypothesis. Med Hypotheses. 2012;78(2):254-257. doi:10.1016/j.
mehy.2011.10.039

33.  Suchan B, Bauser DS, Busch M, et al. Reduced connectivity 
between the left fusiform body area and the extrastriate body area 
in anorexia nervosa is associated with body image distortion. 
Behavioral Brain Research. 2013;241:80-85. doi:10.1016/j.
bbr.2012.12.002

34.  Vocks S, Busch M, Schulte D, Grönermeyer D, Herpertz S, 
Suchan B. Effects of body image therapy on the activation of 
the extrastriate body area in anorexia nervosa: an fMRI study. 
Psychiatry Res Neuroimaging. 2010;183(2):114-118. doi:10.1016/j.
pscychresns.2010.05.011

35.  Wiklund CA, Rania M, Kuja-Hallkola R, Thornton LM, Bulik CM. 

http://www.amwajournal.org
https://jamanetwork.com/journals/jama/fullarticle/194988
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-5-9
https://pubmed.ncbi.nlm.nih.gov/11780707/
https://health.gov/myhealthfinder/health-conditions/diabetes/eat-healthy
https://health.gov/myhealthfinder/health-conditions/diabetes/eat-healthy
http://www.aafp.org/afp/2015/0101/p46.html
http://www.aafp.org/afp/2015/0101/p46.html
https://doi.org/10.1186/s40337-020-00327-y
https://doi.org/10.1186/s40337-020-00327-y


AMWAJournal.org     15Destigmatizing Eating Disorders with Medical Writing

35.  Wiklund CA, Rania M, Kuja-Hallkola R, Thornton LM, Bulik CM. 
Evaluating disorders of gut-brain interaction in eating disorders. 
Int J Eat Disord. 2021;54(6):925-935. doi:10.1002/eat.23527

36.  Lam YY, Maguire S, Palacios T, Caterson ID. Are the gut bacteria 
telling us to eat or not to eat? Reviewing the role of gut microbiota 
in the etiology, disease progression, and treatment of eating 
disorders. Nutrients. 2017;9(6):602. doi:10.3390/nu9060602

37.  Butler MJ, Perrini AA, Eckel LA. The role of the gut microbiome, 
immunity, and neuroinflammation in the pathophysiology of 
eating disorders. Nutrients. 2021;13(2):500. doi:10.3390/nu13020500

38.  Hata T, Miyata N, Takaura S, et al. The gut microbiome 
derived from anorexia nervosa patients impairs weight gain 
and behavioral performance in female mice. Endocrinology. 
2019;160(10):2441-2452. doi:10.1210/en.2019-00408

39.  Seah XY, Tham XC, Kamaruzaman NR, Yobas PK. Knowledge, 
attitudes, and challenges of healthcare professionals managing 
people with eating disorders: a literature review. Arch Psychiatr 
Nurs. 2017;31(1):125-136. doi:10.1016/j.apnu.2016.09.002

40.  Johns G, Taylor B, John A, Tan J. Current eating disorder 
healthcare services – the perspectives and experiences of 
individuals with eating disorders, their families and health 
professionals: systematic review and thematic synthesis. BJPsych 
Open. 2019;5(4):e59. doi:10.1192/bjo.2019.48

41.  Maguire S, Li A, Cunich M, Maloney D. Evaluating the 
effectiveness of an evidence-based online training program for 
health professionals in eating disorders. J Eat Disord. 2019;7(1):14. 
doi:10.1186/s40337-019-0243-5

42.  Gurney VW, Halmi KA. An eating disorder curriculum for primary 
care providers. Int J Eat Disord. 2001;30(2):209-212. doi:10.1002/
eat.1074

43.  Hornberger LL, Lane MA, The Committee on Adolescence, 
et al. Identification and management of eating disorders in 
children and adolescents. Pediatrics. 2021;147(1):e2020040279. 
doi:10.1542/peds.2020-040279

44.  Greenleaf C, Petrie TA, Carter J, Reel JJ. Female collegiate athletes: 
prevalence of eating disorders and disordered eating behaviors.  
J Am Coll Health. 2009;57(5):489-496. doi:10.3200/JACH.57.5.489-496

A Career in 
Medical Communication:
Steps to Success
Learn about the skills and attributes needed 
to be a successful medical communicator 
and discover opportunities in the field.

www.amwa.org/career_steps

http://www.amwajournal.org



