Journal articles on the topic 'Eating disorder stereotypes'

Purpose – Previous studies have documented that exposure to stereotypical information about certain social groups leads to unfavorable perceptions and feelings toward that group. Integrating insights from the mental illness stigma and the social identity perspective literatures, the purpose of this paper is to explore the effects of eating disorder public service announcements (ED PSAs) that employ stigma formats through the lenses of the stereotype content model (SCM) and the Behaviors from Intergroup Affect and Stereotypes (BIAS) Map. Design/methodology/approach – The study followed an experimental control group design. Participants were exposed to either a stigmatizing or a non-stigmatizing PSA. Findings – Exposure to the stigmatizing PSA resulted in lower perceptions of warmth and competence being attributed to people who have an ED which further predicted greater feelings of contempt toward these individuals. The stigmatizing PSA also directly predicted greater feelings of contempt. Practical implications – The findings suggest that using stereotypes about EDs in PSAs aimed at preventing such diseases may elicit perceptions of low warmth and competence, further associated with increased feelings of contempt toward people who have an ED in healthy individuals. Social implications – The stereotyping effects of PSAs may reduce the social and emotional support that people with EDs receive and may exacerbate their emotional distress. Originality/value – From a theoretical point of view, these results extend the understanding of mental illness stereotypes from an intergroup, SCM and BIAS Map perspective as it applies to EDs. More importantly, this study draws attention to possible unintended consequences of PSAs, a matter that is rarely researched, but that can have severe implications.

The research examined eating disorders and the risk of their development in students according to the level of personal anxiety from a gender perspective. An analysis showed a connection between the level of personal anxiety and compulsive and external types of eating behavior in female students. The sample group consisted of 70 people, of whom 52,9 % had a high level of personal anxiety (the proportion of girls was 83,8 %). 95,7 % of students had either compulsive (64,2 %) or external (21,4 %) eating disorder. At this age, an eating disorder does not affect body weight. However, if the level of personal anxiety increases, it escalates the risk of developing at least three types of eating disorders by 11,5 times. With an increase in the level of personal anxiety, the risk of developing external overeating increases by 12,5 times and the risk of developing a compulsive type of eating behavior increases by 1,5 times. The research revealed some gender features of eating disorders development: girls with a high level of personal anxiety proved to have a 5,68 times higher risk of developing various eating disorders. However, a study in the ability to cope with stress in students with different levels of personal anxiety with regard to gender did not show any statistically significant differences in the study groups. The research demonstrated that there is a need in psycho-preventive measures that would shape rational nutrition stereotypes in students.

Despite growing recognition of the importance of workforce diversity in health care, limited research has explored diversity among eating disorder (ED) professionals globally. This multi-methods study examined diversity across demographic and professional variables. Participants were recruited from ED and discipline-specific professional organizations. Participants’ (n = 512) mean age was 41.1 years (SD = 12.5); 89.6% (n=459) of participants identified as women, 84.1% (n = 419) as heterosexual/straight, and 73.0% (n = 365) as White. Mean years working in EDs was 10.7 years (SD = 9.2). Qualitative analysis revealed three themes resulting in a theoretical framework to address barriers to increasing diversity. Perceived barriers were the following: “stigma, bias, stereotypes, myths”; “field of eating disorders pipeline”; and “homogeneity of the existing field.” Findings suggest limited workforce diversity within and across nations. The theoretical model suggests a need for focused attention to the educational pipeline, workforce homogeneity, and false assumptions about EDs, and it should be tested to evaluate its utility within the EDs field.

Research about stigmatization in eating disorders (EDs) has highlighted stereotypes, prejudices, and discrimination against people with EDs, as well as their harmful effects on them, including self-stigma and a difficult recovery process. Whereas a recent review focused on the consequences of ED stigma, our work aimed to provide a broader synthesis of ED stigma, including its consequences, but also its content and distribution. More precisely, we focused on three EDs—namely, anorexia nervosa, bulimia nervosa, and binge eating disorder. Based on a systematic search of four major databases in psychology, the present scoping review includes 46 studies published between 2004 and 2021. We did not conduct any quality assessment of the studies included, because our aim was to provide a wide-ranging overview of these topics instead of an appraisal of evidence answering a precise research question. The review confirmed the existence of a common ED stigma: all individuals affected by EDs reviewed here were perceived as responsible for their situation, and elicited negative emotions and social distance. However, our review also depicted a specific stigma content associated with each ED. In addition, the demographic characteristics of the stigmatizing individuals had a notable influence on the extent of ED stigma: men, young adults, and low-income individuals appeared to be the most stigmatizing toward individuals with EDs. It is important to note that ED stigma had a negative effect on individuals’ eating disorders, psychological wellbeing, and treatment-seeking behavior. There is an urgent need for further research on the adverse effects of ED stigma and its prevention.

Abstract. The relevance of the work is caused by the socio-economic consequences of mental illness, the growing psychological distress of the region's population in the situation of the COVID-19 pandemic, and the prevalence of alert sentiments regarding the assistance of specialists. Improving health literacy has a positive effect on behavior related to seeking help for psychiatric symptoms and communication with healthcare practitioners. The purpose of this work is to study public opinion about the problems of mental illness and literacy of the population in the field of mental health. The method is a sociological survey of the population of the Vologda Oblast (quota sample, N = 1500). The study revealed the attitudes of the region's residents in relation to mental illness: lack of interest in the majority of information about mental health; conservatism in the choice of information sources; negative stereotypes in relation to people with mental disorders: the need for their exclusion; stereotypes regarding the lifestyle and treatment of people with mental disorders. The residents of the region have a small potential request for information materials on the forms and manifestations of depressive and anxiety disorders, borderline personality disorder, dementia; information on eating disorders is least in demand. It is concluded that the current situation requires a more attentive attitude to educational programs for the population of the region on the issues of mental health and ill health.

Body image is a dynamic entity that includes three components: perceptive, cognitive-affective and behavioral; It is constructed of characteristics such as age, sex and educational level, as well as the ideas established by the context. The interaction between the psychological and the social can lead to the development of clinically relevant behaviors. Thus, the objective of the present investigation was to know the perceptions on the male body ideal of the college students of nutrition. Through a focus group, since the qualitative-phenomenological approach and based on the participants discourse, four categories of analysis were derived. It was found that media (including social networks), cultures, stereotypes and beliefs are predominant factors in the construction of the male body ideal, which is reflected in self-esteem, health, economic, occupational or professional opportunities, and to achieve it, can be developed eating disorders symptoms or muscular dimorphic disorder symptoms. It is conclude that the focus group allows knowing the perceptions related to male body ideal by college students of nutrition, where it was showed that, also the society pressures to achieve that ideal, for example, participants express body satisfaction, but wish to modify their composition, so their beliefs determine what must be done to reach such ideal. Therefore, it is evident the importance of carrying out intervention programs at the primary level in college students, from health psychology.

Eating disorders are prevalent in college students but college students are not accurate in identifying the presence of eating disorders (ED) especially when race is involved. Much has been researched about diagnostic ability in vignette form, but little outside of this. For example, it is not known how facial features, such as perceived femininity, may affect observers’ beliefs about the likelihood of disordered eating depending on race. In the present study, we examined how biases regarding facial appearance and disordered eating may differ depending on the race of face images. Using a technique called reverse correlation, we estimated the image templates associated with perceived likelihood of disordered eating using both White and Black Faces. Specifically, we recruited 28 college students who categorized White and Black faces according to perceived likelihood of an eating disorder diagnosis in the presence of image noise. Subsequently, we asked Amazon Mechanical Turk participants to categorize the resulting race-specific face templates according to perceived ED likelihood and femininity. The templates corresponding to a high likelihood of an ED diagnosis were distinguished from low-likelihood images by this second independent participant sample at above-chance levels. For Black faces, the templates corresponding to a high likelihood of an ED diagnosis were also selected as more feminine than low-likelihood templates at an above-chance level, whereas there was no such effect found for White faces. These results suggest that stereotyped beliefs about both femininity and the likelihood of disordered eating may interact with perceptual processes.

The article presents data from an anonymous survey conducted among tenth-grade students of schools in Minsk using the Dutch Eating Behavior Questionnaire. On the basis of the results obtained, a qualitative and quantitative assessment of eating disorders associated with overeating, and contributing to the development of overweight in the aftermath, was carried out. The issues of the formation of an incorrect food stereotype in adolescents as a risk factor for the development of obesity are discussed. A general description of the three main types of eating behavior (emotional, external and restrictive), which are a predictor of overweight, is given.

Eating disorders (EDs) are stereotypically associated with thin, White, affluent women and girls. One result of the ED stereotype has been a relative dearth of ED research with marginalized communities. The aim of this study was to replicate recent findings showing an association between the severity of food insecurity (FI) and increased ED pathology. Participants included 891 clients of an urban food bank. Results were consistent with the findings of previous research; participants in the most severe FI group reported significantly higher levels of ED pathology, dietary restraint, anxiety, and depression. Findings provide further evidence that the thin, White, affluent, female ED stereotype offers a flawed portrait and highlight the need for additional psychological research that focuses on marginalized populations to address disparities in access to care. Both scholars and clinicians need to move away from the stereotypical portrait of who is and is not at risk for developing an ED.

Purpose: This research is devoted to the phenomenon of various factors related to the occurrence of eating disorders. The paper focuses on the subject of body image, attitudes towards body and behaviors of young women. Design/methodology/approach: Analyzing the results of the respondents, it was necessary to check whether there are any factors which predict the occurrence of eating disorders, as well as whether the respondents have knowledge of basic eating disorders such as anorexia, bulimia or obesity. Women aged 19-25 years took part in the study, where such variables as attitudes and behaviors towards their bodies, beauty stereotypes, peer criticism, methods of improving appearance, satisfaction with their appearance, physical attractiveness and self-esteem were verified. The following methods were used in this research: Body Image Questionnaire, The Scale for Using Appearance Enhancement Methods, The Scale of Satisfaction with Individual Body Part and Body parameters, Multidimensional Self-Esteem Inventory. Findings: The analysis of the results indicates that there is a significant relation between low self-esteem, peer criticism, the need to be accepted and the occurrence of eating disorders. Practical implications: The research can contribute to the development of new educational programmes in schools to increase young people's knowledge and awareness about eating disorders. Furthermore, the result may also be important in the prevention of possible diseases. Originality/value: This research can contribute to the better understanding of psychological conditions of eating disorders, especially on Polish population of young women.

Various research on sexual harassment and gender harassment confirms the adverse effects on a person's physical and emotional health (Shrier, 1990), but so far, little is known about the impact of sexual harassment and gender harassment on one's body objectification and links to disordered eating behavior. Sexual harassment and gender harassment are not only based on gender stereotypes but also play an essential role in supporting gender norms in society by regulating what is seen as acceptable and unacceptable behavior, and appearance for gender. According to the theory of body objectification (Fredrickson, Roberts, 1997), both forms of gender discrimination can induce attention to one's body and appearance, which ultimately can lead to reduced satisfaction of one's body (Szymanski et al. 2011). Since body dissatisfaction is one of the leading causes of eating disorders (Brechan, Kvalem, 2015; Cruz-Sáez et al. 2018), it is important to have a better understanding of sexual harassment and gender harassment relationship with body objectification and disordered eating behavior. The study aims to assess the relationships between sexual harassment and gender harassment experiences, body-objectification, and disordered eating behavior tendencies. 181 (23 males, 158 females) aged 18-38 (M=24.12) participated in this research. Sexual Harassment Experience Questionnaire (Fitzgerald et al. 1998) was used to measure both Unwanted Sexual Attention (Cronbach α – 0,893) and Quid Pro Quo sexual harassment (Cronbach α – 0,876), and Gender Harassment experience (Cronbach α – 0,868). Objectified Body Consciousness Scale (McKinley et al. 1996) was used to measure body objectification: Body Shame (Cronbach α – 0,825) and Body Surveillance (Cronbach α – 0,804). The Eating Attitudes Test (Garner et al. 1979) was used to evaluate disordered eating behavior tendencies: Dieting (Cronbach α – 0,924), Bulimia and Food Preoccupation (Cronbach α – 0,725) and Oral Control (Cronbach α – 0,714). The results revealed significant sexual harassment and gender harassment experience differences between genders showing that women report significantly higher results of all forms of sexual harassment and gender harassment than men. Data analysis also revealed a statistically significant relationship between higher results of sexual harassment, gender harassment experience, and more pronounced disordered eating tendencies and higher body objectification. Data analysis has shown that gender harassment experience is a significant prognostic factor for higher body surveillance and body shame results, more frequent dieting.

Abstract This study aimed to examine current scientific production regarding sexuality-related issues in the context of eating disorders (ED). Searches were performed on PubMed, LILACS, CINAHL and PsycINFO, including papers published between 2008 and 2018, using the following descriptors: eating disorders, femininity, sexuality and sexual behavior. Nineteen studies were selected. Findings were systematized into two main thematic categories and showed, in general, that femininity can be a risk factor to the development of ED. Studies indicated that endorsing a gender role that is socially considered discrepant from biological sex, despite feminine or masculine, is related to ED symptomatology. Moreover, body dissatisfaction is positively correlated to sexual dysfunction. Interventions targeting prevention of ED should include sexuality-related issues by approaching probable negative consequences of adhering to female gender role social requirements and stereotypes, especially those related to body weight and body shape.

AbstractEating disorders are amongst the most, disabling and lethal of psychiatric conditions. These conditions affect predominantly adolescent and young adult females, but not exclusively so. Whilst stereotypically diagnosed in western, urban societies their emergence in a range of population groups beyond the aforementioned has challenged the stereotype – no more so than in South Africa where eating disorders had not been diagnosed in black, female South Africans until the 1990s. Creating awareness of the changing demographic profile and thus risk was critical in ensuring appropriate diagnosis and management. Whilst this was a key feature of my personal journey there were numerous other aspects of risk explored for the development of eating disorders, as well as management, which will be highlighted and discussed in the paper. This has been especially relevant within the South African context.

Objective To investigate the behavioral characteristics of semantic dementia (SD) using an instrument originally developed for patients with autism spectrum disorder. Methods The behavioral symptoms of 20 patients with SD and 20 patients with Alzheimer’s disease (AD) in both the preclinical state and the dementia state were evaluated using the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS). Results The SD group showed high prevalence in four behaviors related to stereotypy and social impairment: eating very few food items, selfishness, difficulty in recognizing others’ feeling and thoughts, and interpreting language literally. Scores on the PARS short version, which is sensitive for diagnosis of autism spectrum disorder, were significantly higher in the dementia state than in the preclinical state in both the SD (11.5 ± 6.0 and 1.7 ± 2.5, respectively; t (19) = 6.7, p < 0.001) and AD (6.9 ± 4.6 and 1.7 ± 2.0, respectively; t (19) = 5.1, p < 0.001) groups. PARS short version scores after dementia onset increased in both the SD and AD groups, although the increase was significantly larger in the SD group (F = 5.6, p = 0.023). Additionally, a significantly higher rate of patients exceeded the cutoff score for autism diagnosis in the dementia state in the SD group (75%) than in the AD group (40%; χ2 = 5.0, p = 0.025). PARS scores in the dementia state were significantly correlated with illness duration (r = 0.46, p = 0.04) and Mini-Mental State Examination scores (r = −0.75, p < 0.001) in the SD group only. Conclusions Although SD and autism spectrum disorder are etiologically distinct diseases, patients with semantic dementia behave like those with autism spectrum disorder. Our findings suggest the symptomatic similarity of the two disorders.

Background:Modern culture has stereotyped the female body as one that is continually getting thinner. Internalization of the ‘thin’ ideal is partly attributable to the inner ideal to be successful combined with the external pressure imposed by media and others. Many individuals attempt to achieve these ideals by behavior modification that imposes health risks.Purpose:To investigate disordered eating (DE) behavior and energy status in female student dancers.Methods:Volunteer dancers (n = 26) aged 19.0 (18.0; 21.0) years, matched by controls (n = 26) aged 20.0 (19.0; 21.0) years were recruited. Eating Disorder Inventory-3 (EDI-3) subscales, Three-factor Eating Questionnaire (TFEQ) Cognitive Dietary Restraint (CDR) subscale, and EDI-3 Referral Form behavioral questions assessed DE behavior. Energy status was assessed with a food record and Actiheart monitor.Results:Dancers achieved significantly higher scores than controls in all questionnaires, namely: EDI-3 Drive for Thinness [12.0 (3.0; 19.0) vs. 4.5 (2.0; 9.0), p = .023], EDI-3 Body Dissatisfaction [16.0 (10.0; 25.0) vs. 6.5 (3.0; 14.0), p = .004], and TFEQ-CDR [9.0 (2.0; 15.0) vs. 3.0 (3.0; 7.0), p = .032]; dancers used excessive exercise to lose weight (19.2% vs. 0%, c2 = 5.53, p = .019), and had lower energy availability (24% vs. 8%, p < .05) than controls. The average energy balance (EB) was negative for both groups [dancers: EB = -3896 (-5236; -1222) vs. controls: EB = -2639 (-4744; -789) kJ/day].Conclusions:Female dancers are at risk for DE behavior and many have suboptimal energy status which may be related to their quest to achieve a more desirable appearance; education on healthy weight management practices is needed.

The aim of the study was to study the clinical and typological features of eating disorders in patients with schizophrenia spectrum disorders.Materials and methods. We studied 136 patients (84 women and 52 men) with schizophrenia spectrum disorders, aged 19 to 58 years, mean age 37.6±9.8 years; the average duration of the disease was 8.6+7.6 years. Criteria for inclusion in the study: age from 18 to 60 years, the presence of disorders of the schizophrenia spectrum, in accordance with the criteria for ICD-10 (F. 20; F. 25), informed consent for participation in the study. Exclusion criteria: organic diseases of the central nervous system, endocrine pathology, severe somatic and gynecological diseases, pregnancy and lactation. The design of the study was open, comparative, non-randomized. The study of patients was carried out once before the start of therapy. Research methods: anamnestic, clinical-psychopathological, psychometric, anthropometric and clinical-statistical.Results: Clinical and endocrine features of the majority of the studied patients were: appetite deviations, varied in nature, intensity and frequency; an increase in body weight of varying degrees, the predominance of the external type of eating disorders, including as part of a mixed type (more than 60% of cases); a high degree of expressiveness of the emotional and restrictive types; a combination of a significant severity of the emotional type with the apathetic nature of affective disorders occurring within the framework of the underlying disease; single-phase variant of the flow of restrictive type. Clinical features in the studied patients with obesity were the stability of disorders and the combination of increased appetite and daily volume of high-calorie nutrition, incorrect family culinary traditions, the prevalence of mixed or external type.Conclusion. The management of patients with schizophrenia spectrum disorders with eating disorders should be comprehensive, together with endocrinologists, therapists, nutritionists. An integrated approach should include: observation and counseling by narrow specialists, recommendations for the normalization of lifestyle, diet, the formation of a low-calorie diet and nutrition stereotype in the patient’s family.

Existing research investigating gay men’s eating behavior has focused on stereotypes and body image, rather than to understand why disordered eating is prevalent in gay men. The current study adopted a qualitative approach and employed interview methodology to explore gay men’s attitudes, feelings and experiences of their eating behavior, and the potential link to mindfulness and self-compassion. Twenty gay men aged from 21 to 51 years were interviewed using an interview schedule with open-ended questions. Three main themes emerged from the transcript data sets: “Lean to be Seen,” “Sod it ‘I’ll Have a Pizza,” and “You Can’t Sit with Us.” The first theme was developed following responses that participant’s eating behavior and exercise engagement were influenced by their perceived attractiveness by the gay community. All participants spoke of achieving or maintaining a slim or muscular body type and adopted their eating behavior or exercise regime to reach corresponding goals. The second theme relates to the lack of acceptance felt from the gay community upon not conforming to the bodily expectations set out by the community. The third theme relates to the conflicts in participants’ attitudes around how exercising and eating healthily would improve their mental well-being; but that they also would give preference to calorie dense foods to reduce stress. These reflections are observed through a context of self-kindness and self-compassion and are seen to be related to increased feelings of self-criticism and body dissatisfaction. The limitations and implication for this research and suggestions for future research are discussed.

The purpose of this study is to examine the effectiveness of topiramate in promoting weight loss among obese patients. The study was inspired by the fact that men and women, in addition to the stereotyped teenager, are affected by eating disorders. The general scope of this paper will comprise of the evaluation of the effectiveness of topiramate in weight loss amongst obese patients. The research achieves this through a review of past literature. In sum, the reviewed study found that the use of topiramate was associated with an increase in positive outcomes. Most of the positive outcomes were linked with weight reduction among overweight and obese patients. The review also revealed that the administration of the drug reduced the adverse effects of psychotic drugs minimized food cravings, alcohol, and smoking. Moreover, the combination of the drug with other antiepilepsy medications had more positive outcomes than when used as a monotherapy.

This article presents an analytical review of international publications, for the period from 2012 to 2020, that focused on the influence of the digital space as a new social factor that changes the lifestyle of the younger generation and creates new health risks. The literature search was conducted in PubMed using the Cochrane Library, Scopus, and Web of Science. Digital technologies provide positive opportunities of online education of students and schoolchildren, including greater availability of educational and preventive programs. The main health risks associated with the intensive use of digital technologies in education and leisure include manifestations of visual overstrain (computer visual syndrome), disorders of the musculoskeletal system (pain in the neck, back, and hands), and negative lifestyle changes. Adolescents are more susceptible than adults to such negative consequences of intensive use of digital space, which leads to the development of Internet addiction, sleep disorders, eating disorders, psychosocial manifestations, poor academic performance, depressive symptoms, and aggressive behavior. Aggressive behaviors of some young people in the Internet space include harassment (cyber-bullying) and sending sexual messages (sexting) accompanied by cyber-attacks. Against the background of the growing use of digital tools, including the availability of smartphones, parents, teaching, and medical staff of universities and schools should provide early prevention interventions of the above-mentioned negative phenomena. Preventive online programs can be used by college students during the period of adaptation to new learning conditions to reduce alcohol consumption, smoking, and formation of stereotypes of proper nutrition.

Background. Body image concerns (BICs) negatively influence young people’s health as they mutilate psychosocial functioning and lifestyle. The present study aimed to compare BICs, socio-cultural attitudes towards appearance, and disordered eating (DE) in a large sample of student women and men of different body mass (BMI) and physical activity and to evaluate the mediating role of sports participation in the association between BICs and DE. Methods. A total sample of 1850 students (1087 or 58.8% were women, average age 21.6 ± 5.0 years) participated in the study and completed a questionnaire measuring BICs, internalization of the socio-cultural appearance ideals, drive for muscularity, DE, physical activity (PA), and BMI. Two hundred eighty-two men and two hundred eighty-eight women reported leisure-time participation in sports. Two-way ANOVA was conducted to test gender, BMI group, and sports participation effects on study variables. Moderated leisure-time exercise at a sports club effects were tested in the association between body image concerns (BICs) and disordered eating behaviours (DE). Results. Overweight/obese students reported greater BICs, internalization of the stereotyped appearance ideals, and DE compared to students of normal body weight. Participants of sports clubs demonstrated higher appearance evaluation and body areas satisfaction; however, they reported higher overweight preoccupation, internalization of socio-cultural ideals, drive for muscularity (men), and DE. A higher level of BMI, BICs, internalization of socio-cultural body ideals, and drive for muscularity (in men) were associated with greater DE in students. Participation in sports was not a significant moderator between BICs and DE. A significant interaction effect between BMI and exercising at a sports club was observed in women. Conditional effects demonstrated that female students with higher BMI and exercising at a sports club were at higher risk of DE (β = .18, p < .001) than women non-exercising at a sports club (β = .13, p < .001). Conclusions. Overweight students of both genders reported greater BICs and DE. Sports-involved students (men and women) demonstrated more favourable body appearance evaluation. However, sports participants of both genders demonstrated greater BICs and DE compared to non-exercisers. Sports participation had no significant mediating power on the associations between BICs and DE; however, women with higher BMI and participating in leisure-time sports faced a greater risk for DE than women with higher BMI but not participating in sports. The promotion of a positive body image was important to students, especially female students with higher BMI and participating in leisure sports. Keywords: body image concerns, disordered eating, physical activity, sport clubs, emerging adults.

Background Eating disorders (EDs) are complex mental illnesses with debilitating, pervasive psychological and physiological consequences when left untreated. Unfortunately, patients may face barriers to receiving treatment, such as stereotypes surrounding EDs, denial of illness severity, lack of motivation for treatment, and lack of knowledge about treatment resources. Barriers such as these result in a large treatment gap: only 20% of those with EDs will ever receive treatment. Digital tools like chatbots show potential to disseminate mental health–related interventions to large populations while offering a user-friendly, cost-effective, accessible, and anonymous means of tackling patient concerns. Objective This study developed and evaluated the usability of a chatbot designed for pairing with online ED screening. The tool aimed to promote mental health service utilization by improving motivation for treatment and self-efficacy among individuals with EDs. Methods A chatbot prototype, Alex, was designed using decision trees and theoretically informed components: psychoeducation, motivational interviewing, personalized recommendations, and repeated administration. Usability testing was conducted over 4 iterative cycles, with user feedback informing refinements to the next iteration. Postintervention, participants (N=21) completed the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), and a semistructured interview. This process aimed to create an optimized chatbot by the final cycle for use in a randomized trial. Results Interview feedback detailed chatbot aspects participants enjoyed and aspects necessitating improvement. Feedback converged on four themes: user experience, chatbot qualities, chatbot content, and ease of use. Following refinements, users described Alex as humanlike, supportive, and encouraging. Content was perceived as novel and personally relevant. USE scores across domains were generally above average (~5 out of 7), and SUS scores indicated “good” to “excellent” usability across cycles, with the final iteration receiving the highest average SUS score. Conclusions Overall, participants responded well in interactions with Alex, including the initial version. Refinements between cycles further improved user experiences. This study provides preliminary evidence of the feasibility and acceptance of a chatbot designed to promote motivation for and use of services among individuals with EDs. Alex is the first chatbot designed for pairing with an ED or other mental health–related online screen, with the goal of ultimately increasing service utilization. Acknowledgments This research was supported by K08 MH120341 from the National Institute of Mental Health. Availability of Data, Materials, and Code The data will be made available by reasonable request to the corresponding author. Authors’ Contributions EEFC conceptualized and designed the study. OL and BD conducted the investigation process. BD and JS assisted with data curation and conducted formal thematic analyses. JS conducted formal statistical analyses. JS wrote the original manuscript, with contribution from BD. EEFC, CBT, DEW, and SSS designed the data collection instruments, and coordinated and supervised data collection, in addition to reviewing and editing the manuscript with LS, LMF, LAF, and LD. Conflicts of Interest None declared.

The aim. Of the study was to assess the psychophysiological markers of adaptation in men of active working age. Materials and research methods. In two experimental groups, a search for markers of psychophysiological adaptation was carried out: redundant empirical data were collected in 151 patients of the Tyumen clinics; 236 healthy men aged 20 to 35 years were surveyed and the MCTQ chronotype was determined. Results. The article presents the results of a content analysis of the publications of Tyumen scientists who have determined the general trends in the study of adaptation mechanisms in men working and living in the Tyumen region. 4 main approaches to the study of the resource capabilities of the human body are distinguished: anatomical-anthropological, interdisciplinary, chronobiological and integrative. According to the results of the expert mathematical analysis of the data, the leading morphofunctional markers of the human adaptive potential were determined: cholesterol level, body mass index, signs of myocardial hypertrophy, blood pressure level. A model for assessing the adaptive potential of a person under the action of low-intensity background stressors is proposed. Unconscious forms of mental reflection: patriarchal gender stereotype and low level of motivation in choosing a profession, indirectly indicate the low significance of behavioral factors in the development of stress-induced states in men. Conclusion. The significance of subjective methods for assessing the functional state of the human body based on the results of a questionnaire and determining the chronotype of MCTQ is shown. The markers of psychophysiological adaptation in men of active working age were determined: a high level of physical activity, stable hemodynamic parameters against the background of a high level of psychoemotional stress, eating disorders and a lack of night sleep.

Objective to study the adherence to the principles of rational nutrition by representatives of various professional groups living in the Russian Federation and the Republic of Tajikistan. Material and methods.The study was conducted using a questionnaire-survey method among 543 mental workers of the Samara region and 158 students of the Avicenna Tajik State Medical University (Republic of Tajikistan), followed by statistical processing of the data. Results.Violations of the principles of rational nutrition are commonin various professional groups of the working-age population, including among students of a medical university. According to anthropometric studies, 61% of the surveyed workers were overweight and obese; in the group of students this indicator was only 8%, 29% of students were underweight. Violations of nutrition regimen were found among 31.1% of employees and 38% of students. Factor analysis of the actual nutrition of workers revealed 5 types of nutrition models characterized by a stereotype of eating behavior due to the consumption of certain foods and beverage. The regression analysis confirmed the relationship between the risk of obesity and adherence to types 2, 4 and 5 of nutritional models; an individual's adherence to nutritional model type 3 reduced this risk. In the group of the surveyed, the deterioration of the diet quality was revealed due to the excessive consumption of high-calorie foods, "fast food", sweet carbonated drinks, as well as insufficient consumption of vegetables, fruits, fish. The correlation analysis established the relationship between the body mass index and complaints presented by the survey participants concerning the cardiovascular, digestive, endocrine and musculoskeletal systems. The study identified the most common alimentary-dependent pathologies among students such as gastritis, chronic pancreatitis, and chronic cholecystitis. Conclusion.The revealed violations of the principles of rational nutrition, the nutritional status, form the risks of development of the gastrointestinal tract diseases, metabolic disorders and cardiovascular pathology. The results obtained indicate the need of preventive measures in relation to the adherence to the principles of rational nutrition, creating awareness in various professional groups of the population, including students of medical universities in different states.

Abstract Objectives Frequent exposure to negative familial weight talk (NFWT), such as teasing or critical comments about weight from family members, may contribute to weight bias internalization (WBI) in children. WBI entails applying negative weight-based stereotypes to oneself and results in self-devaluation. Higher levels of WBI are linked to adverse outcomes, such as low self-esteem and disordered eating. We examined the association between NFWT exposure and WBI in a diverse sample of children from the Greater Boston Area. Methods Baseline data on 137 parent-child dyads were analyzed. Children, 9–14yo, completed six items measuring NFWT frequency on a 6-point Likert scale (“never” to “almost every day”) from parents, siblings, and other household family members. Responses were converted to times in the past 3 months, summed, and dichotomized as &lt; 9 times vs. ≥9 times. Children completed the WBI Scale–Modified indicating their agreement with applying negative weight-based statements to themselves on a 6-point Likert scale (“strongly disagree” to “strongly agree”). Responses were averaged and the mean WBI score was dichotomized as “low” (&lt;3.0) versus “moderate-high” (≥3.0). Results Over half (52%) of the children were girls and 30% had overweight/obesity (BMI &gt; 85th percentile). Half of the parents were non-Hispanic white. The mean child WBI score was 2.1 (SD = 0.9) and 15% had moderate-high levels of WBI. The median NFWT frequency was 0 (IQR = 6.0) and 25% reported NFWT ≥ 9 times. Children exposed to NFWT ≥ 9 times were 8.2 times more likely to have moderate-high levels of WBI than children exposed to NFWT &lt; 9 times in the past 3 months (prevalence ratio = 8.2, 95%CI = 3.4 to 20.0, P &lt; 0.001, by log binomial regression adjusted for child weight and parent race/ethnicity). Conclusions Family members appear to be a salient source of weight stigma in children. Exposure to NFWT as little as 3 times per month was significantly associated with moderate-high levels of WBI in this diverse sample of children. More research is needed to understand the impact of NFWT on child WBI, such as differences across racial/ethnic groups, by source (i.e., parents versus siblings), and across the lifespan. Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Drug Abuse of the National Institutes of Health.

Interdisciplinary healthcare providers (HCPs) receive only minimal training in identifying, referring for and treating eating disorders and may feel ill-prepared to manage them. There is a need for brief interventions that prepare HCPs for work with people with eating disorders, particularly when they do not fit stereotypes about who might experience an eating disorder. One method for enacting brief interventions that make change in this realm is using digital stories (short videos) to generate awareness and knowledge. In this article, we discuss the results of a pilot study exploring the impact of viewing digital stories created by people in eating disorder recovery and their supporters on an interdisciplinary group of HCPs. We showed five stories to 22 HCPs who filled out qualitative prequestionnaires and postquestionnaires about their experiences of viewing the films and how they conceptualised recovery. Providers found the stories evocative; the stories appear to have complexified their perspectives on recovery. HCPs desired more diverse, detailed and lengthy stories, indicating that pursuing digital storytelling for HCP education and awareness may hold promise. Through centring the voices of people with eating disorders and in recovery, digital stories may also provide new ways of talking about recovery that open up possibilities for embracing difference.

AbstractSubstantial progress has been made in the understanding of anorexia nervosa (AN) and eating disorder (ED) genetics through the efforts of large-scale collaborative consortia, yielding the first genome-wide significant loci, AN-associated genes, and insights into metabo-psychiatric underpinnings of the disorders. However, the translatability, generalizability, and reach of these insights are hampered by an overly narrow focus in our research. In particular, stereotypes, myths, assumptions and misconceptions have resulted in incomplete or incorrect understandings of ED presentations and trajectories, and exclusion of certain patient groups from our studies. In this review, we aim to counteract these historical imbalances. Taking as our starting point the Academy for Eating Disorders (AED) Truth #5 “Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses”, we discuss what we do and do not know about the genetic underpinnings of EDs among people in each of these groups, and suggest strategies to design more inclusive studies. In the second half of our review, we outline broad strategic goals whereby ED researchers can expand the diversity, insights, and clinical translatability of their studies.

Background: Mental health in gyms has not been a topic of study in Colombia. Social stereotypes of beauty and dissatisfaction with body image make women a population prone to excessive exercise. This research analyzes the risk of eating disorder in women who attend gyms (comparing ages), its relationship with the frequency of physical exercise and the use of diet to improve physical appearance. Methods: 519 women with ages between 15 and 50 years participated. The EAT-26 Eating Attitude Test was used, a standardized procedure to estimate the frequency of physical exercise and a brief socio-demographic survey. Results: The percentages of women with risk (46.8%) of TBI and without risk (53.2%) are similar, the factor scores and the total of the EAT-26 only show significant differences in the age range 15 -19 and 20-24, no significant correlations were found between the factors and the total score of the EAT-26 and the measure of the frequency of physical exercise, and there is an association between the risk of eating disorders and diet to improve the physical image. Conclusion: The percentage of women at risk for eating disorders is higher than those reported for high school students, university students, and athletes. A very high percentage of gym users would be compromising their mental health in some way, considering the frequency values of physical exercise.

This study examines media representations of persons with Prader-Willi syndrome (PWS), a rare, complex condition caused by an error on Chromosome 15. Articles appearing in major U.S. and international newspapers from January, 2000 to December, 2005 were included in the study (N = 68). Findings show that while some stories portrayed the syndrome in a more positive light, most reports were overwhelmingly negative or mostly negative, focusing on severe issues related to food-seeking behaviors, obesity, cognition, and behavior. Common stereotypes used to portray persons with PWS aligned with those often used to describe persons with disabilities and obese persons, even in the stories coded as positive or mostly positive. In the more negative portrayals, the obesity or "eating disorder" of the person with PWS was often a focus, illustrating the stereotype of the fat person as deviant. Some overall trends and patterns in U.S. versus international news outlets were also observed.

Abstract Some recent studies have found that food insecurity is one of the factors that can lead to the insurgence of eating disorders, thus challenging the stereotype that associates eating disorders with high-income, Western, white, young women. However, this ground-breaking research and its implications do not seem to have been taken into account by legal scholars. In order to fill this gap, this article explores whether and how the law and policy of food security, and the relevant human rights international monitoring system are dealing with this link between eating disorders and food insecurity. Our analysis shows that these legal and policy frameworks have failed to address this relationship. We argue that the circumstance that marginalised food insecure populations, irrispective of sex, age, and ethinicity, might also suffer from eating disorders should be recognized by policy makers as it could bring to more comprehensive legal and policy responses.

This qualitative study examines how the “Strong Black Woman” (SBW) label can have potentially negative health effects for African American/Black women that contribute to eating disorders. This study addresses the gap in literature on racial disparities that are present in understanding eating disorders that contribute to obesity and obesityrelated issues. Through semi-structured individual interviews conducted with ( N = 11) Black female higher education students, participants were able to discuss how disorganized overeating patterns were associated with the emotional stress of being labeled a Strong Black Woman. Findings provide implications to clinicians, educators, and researchers by identifying stress inducing factors heightened by racist and sexist microaggressions that contribute to the mental and physical health of Black women. This study also adds to the limited literature on the intersection of racism and sexism that contribute to poor health outcomes in Black women.

Eating disorders (EDs) are often stereotyped as affecting the SWAG, that is, as affecting mostly skinny, White, affluent girls. Over the last decade, however, significant progress has been made toward increasing diversity in ED research. There is consensus that EDs affect individuals of all genders, ages, sexual orientations, ethnic, and socio-economic backgrounds, with recent studies exploring social determinants of ED etiology, ED presentation, and developing diversity-affirming ED assessments. This article provides a brief summary of current developments related to diversity as a research theme, and proposes different perspectives toward further improving diversity in ED research. Specifically, we argue for exploring the role of diversity in ED treatment settings and outcomes, for pursuing diversity-oriented research pro-actively rather than as a reaction to issues of under-representation, and for integrating diversity across different areas of medical education and trainings in psychotherapy. Limitations with respect to the paucity of research, and the link between diversity as a research theme and ED-related workforce diversity are discussed.

Abstract Background Previous publications suggested that lockdown is likely to impact daily living issues of individuals with intellectual disabilities. The authors notably suspected an intensification of behavioural, eating and sleep problems. Methods To test these hypotheses, we conducted an international online survey about the impact of COVID-19-associated first lockdown on people with genetic neurodevelopmental disorders. This survey was carried out using GenIDA, an international participatory database collecting medical information on genetic neurodevelopmental disorders. Patients’ relatives took part in this online survey from 30/04/2020 to 09/06/2020. This survey adapted from GenIDA standard questionnaire requested information on diagnosis, lifestyle and was based on yes/no answers to questions regarding behaviour, diet, and sleep, in the 6-months period before lockdown and during lockdown. We also asked relatives to evaluate the intensity of these problems by severity level. Finally, relatives could freely comment in open fields on the medical and/or quality of life problems they had encountered during lockdown. Results In total 199 participants—144 children and 45 adults—with neurodevelopmental disorders (intellectual disability (79.4%) and/or autism spectrum disorder (21.6%)) of various genetic origins, with near-equal male/female (96/103) contribution and originating mainly from Europe and Northern America, were included. The average lockdown duration at time of the survey was 57 days. We did not find differences in the frequency of behavioural, eating and sleep problems before and during lockdown. Moreover, there was no apparent difference in the intensity of eating and sleep disorders between both periods. However, for persons with behavioural problems at both periods, relatives reported an increase in aggressivity, self-aggressivity, depressiveness, stereotypies, and restricted interests during lockdown, all of which might be interpreted as consequences of a lack of stimulation or a reaction to unexpected changes in daily habits. Conclusions Our results support previous studies that suggest that the negative impact of lockdown does not depend on the intellectual disability per se but on the associated comorbidities such as behavioural disorders. This study addresses the need for prevention of behavioural disturbance in the vulnerable population with genetic neurodevelopmental disabilities.

Introduction: Daily diets of contemporary schoolchildren mainly consist of foodstuffs, which are rich in fats and carbohydrates but poor in proteins, vitamins, and trace elements. Food stereotypes associated with consumption of freeze-dried and refined food as well as fast food products have become widespread. Such negative manifestations of the eating behavior of schoolchildren are largely determined by nutritional unawareness and necessitate appropriate measures for enhancing food literacy to preserve and strengthen health of the younger generation. Objectives: To assess nutritional awareness of contemporary schoolchildren in a digital environment using a modified questionnaire. Materials and methods: We modified the questionnaire developed on the basis of ten principles of healthy eating promoted by the World Health Organization to establish healthy diet awareness of 73 Moscow fifth-year schoolchildren. The self-administered questionnaire contained 23 questions. Results: Almost all the respondents lacked the necessary level of knowledge about healthy eating: 93 % and 7 % of the schoolchildren had a moderate and low food literacy level, respectively, and none of the pupils demonstrated a high level of awareness. The diet was perceived as unbalanced or partially balanced by 14 % and 7 %, respectively, and high-calorie – by 70 % of the respondents. Only 10 % of the pupils agreed that the diet influenced their school performance, while 20 % of them were not sure about that and 70 % disagreed. Conclusions: The identified eating disorders were associated with the level of food literacy. Our questionnaire proved to be an effective tool of obtaining detailed information about dietary habits of schoolchildren, and it can therefore be recommended for a larger survey aimed at early detection of eating disorders, improvement of food literacy, and prevention of nutrition-related health problems.

Abstract Background Disordered eating behaviors (DEB) impact on health and wellbeing worldwide. This study aimed to examine sociodemographic trends in the prevalence of DEB over 20 years in the Australian general population. Methods Data were derived from five sequential cross-sectional surveys (1998, 2008, 2009, 2016 and 2017) with population-representative samples of adults and adolescents residing in South Australia (N = 15 075). DEBs investigated were objective binge eating (OBE), strict dieting/fasting, and purging. Sociodemographic data included gender, age, educational level, work and marital status, and residence. Results OBE prevalence increased significantly. Strict dieting/fasting also increased from 1998 to 2008/9 but remained stable between 2008/9 and 2016/7. Purging prevalence did not change significantly over time. All survey years were associated with a significantly higher odds of OBE, and strict diet/fasting compared to 1998. Lower age, a higher Accessibility Remoteness Index of Australia (ARIA) score, higher body mass index (BMI), higher educational attainment, and not being in a married or de facto relationship were independently associated with greater adjusted odds for endorsing OBE. Younger age, female gender, and higher BMI were also independently associated with greater adjusted odds for endorsing strict dieting/fasting. Conclusions The increased prevalence of DEBs in various strata of Australian society has both public health and clinical implications. The results refute the stereotype that eating disorders (EDs) predominantly affect young women. They build impetus for future research on EDs among men and older individuals, with a view to developing tailored public health and clinical interventions for these populations.

LGBTQ+ university students and recent graduates of a large rural Appalachian institution were interviewed for an exploratory thematic analysis on body image and disordered eating behaviors. While participants noted an overall sense of comfortability in the university setting, there were varying obstacles associated with navigating intersecting identities and physical presentation that were noted in the data. Excerpts from participant interviews were coded into five unique themes: (1) feeling “othered”/different from peers as well as fellow LGBTQ+ community members, (2) seeking comfortability with body/self, (3) facing stereotypes and image expectations based on presumed gender identity and/or sexual/affectional orientation, (4) general experiences as an LGBTQ+ community member in a rural university town, and (5) seeking increased support from the university. This study concludes that significant challenges related to body image are exacerbated by common experiences as a person in the LGBTQ+ community.

Introduction: Stigma and discrimination toward obese person are pervasive and have created various consequences for their psychological and physical health. Various studies in American society showed obese person are negatively stereotyped. The aim of the study is to identifying the perceptions of students towards the obesity stigmatisation. Methods: This study used 300 students who will answer a self-administered questionnaire on obese stigmatization. A total of 150 male (50%) and 150 female (50%) are targeted in this research. The study used a convenience sampling method to collect the data using self-administered questionnaires Result: The findings showed that a total of 51% of the students had negative attitude towards obesity. There was a significant correlation between attitude towards obesity stigmatization and eating disorder with (r = 0.201) and between attitude and body image with (r = 0.245) Conclusion: A total of 51% of the students had negative attitude towards obesity. More health promotion and awareness on a balance diet and to understand the perspective view towards obesity stigmatization.

Background: Disturbances in the diet and time of eating meals observed in the population in recent years and characterized by a deficiency of the main nutrients and unhealthy eating habits (e.g., addiction to fatty foods, excessive salt and sugar consumption) dictate the necessity of constant monitoring of school meals in order to develop effective measures for prevention of diet-related disorders in children and adolescents. Objective: Scientific analysis of the results of monitoring qualitative and quantitative indicators of school feeding and the prevalence of nutrition-related diseases in the child population. Materials and methods: We examined reports and statistical data of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing and the Ministry of Health of the Russian Federation, findings of the surveys of school principals, children and parents, and results of analyzing parental control data for the 2020/21 academic year. Results: Incidence rates of child and adolescent obesity, diabetes mellitus, and diseases of the circulatory system demonstrate a positive trend. We established the main reasons for high school students’ refusal of school meals, studied satisfaction of children and parents with school feeding, and assessed the results of parental control over school catering. High prevalence of nutrition-related diseases confirms the importance of monitoring school meals, developing innovative forms and revising their dominating stereotypes. Conclusion: Assessment of diet-related disease rates in schoolchildren updates the significance of their nutrition and health monitoring, the study of nutrition structure, eating behavior, and school catering. The conducted survey of schoolchildren and parents has revealed key problems in school feeding, which require prompt correction. Outcomes of parental control are an additional indicator of nutrition quality at school. The reserve for improving the effectiveness of parental control can become systematization of this work and its evaluation with account for the days of the week and their corresponding menu items, as well as breaks and their corresponding contingents of children eating school meals.

As the rates of Autism Spectrum Disorder (ASD) increase and early screening efforts intensify, more toddlers with high likelihood of ASD are entering the United States' (US') publicly funded early intervention system. Early intervention service delivery for toddlers with ASD varies greatly based on state resources and regulations. Research recommends beginning ASD-specific evidence-based practices (EBP), especially caregiver-implemented intervention, as early as possible to facilitate the development of social-communication skills and general learning. Translating EBP into practice has been challenging, especially in low-resourced areas. The main goal of this study was to obtain a more comprehensive understanding of public early intervention system structure, service delivery practices, and factors influencing EBP use for children with ASD in the US. Participants (N = 133) included 8 early intervention state coordinators in 7 states, 29 agency administrators in those states, 57 early intervention providers from those agencies, and 39 caregivers of children with ASD receiving services from those providers. Online surveys gathered stakeholder and caregiver perspectives on early intervention services as well as organizational factors related to EBP implementation climate and culture. Stakeholders identified key intervention needs for young children with ASD. In general, both agency administrators and direct providers reported feeling somewhat effective or very effective in addressing most needs of children with ASD. They reported the most difficulty addressing eating, sleeping, family stress, and stereotyped behaviors. Data indicate that children from families with higher income received significantly higher service intensity. While administrators and providers reported high rates of high-quality caregiver coaching (&gt;60%), caregivers reported low rates (23%). Direct providers with more favorable attitudes toward EBP had greater EBP use. In turn, provider attitudes toward EBP were significantly associated with implementation leadership and culture at their agency. Results suggest that publicly funded early intervention programs in the US require additional resources and training for providers and leaders to support improved implementation climate and attitudes toward ASD EBPs. Results also suggest that more state system support is needed to increase use of ASD-specific EBP use, including high-quality caregiver coaching, to better serve toddlers with ASD. Recommendations for implementation strategies are addressed.

“I’m fat–and it’s okay! It doesn’t mean I’m stupid, or ugly, or lazy, or selfish. I’m fat!” so proclaims Joy Nash in her YouTube video, A Fat Rant. “Fat! It’s three little letters–what are you afraid of?!” This is the question I pose to my class on day one of Fat Studies. Sadly, many college students do fear fat, and negative attitudes toward fat people are quite prevalent in this population (Ambwani et al. 366). As I teach it, Fat Studies is cross-listed between Psychology and Gender Studies. However, most students who enrol have majors in Psychology or other behavioural health science fields in which weight bias is particularly pronounced (Watkins and Concepcion 159). Upon finding stronger bias among third- versus first-year Physical Education students, O’Brien, Hunter, and Banks (308) speculated that the weight-centric curriculum that typifies this field actively engenders anti-fat attitudes. Based on their exploration of textbook content, McHugh and Kasardo (621) contend that Psychology too is complicit in propagating weight bias by espousing weight-centric messages throughout the curriculum. Such messages include the concepts that higher body weight invariably leads to poor health, weight control is simply a matter of individual choice, and dieting is an effective means of losing weight and improving health (Tylka et al.). These weight-centric tenets are, however, highly contested. For instance, there exists a body of research so vast that it has its own name, the “obesity paradox” literature. This literature (McAuley and Blair 773) entails studies that show that “obese” persons with chronic disease have relatively better survival rates and that a substantial portion of “overweight” and “obese” individuals have levels of metabolic health similar to or better than “normal” weight individuals (e.g., Flegal et al. 71). Finally, the “obesity paradox” literature includes studies showing that cardiovascular fitness is a far better predictor of mortality than weight. In other words, individuals may be both fit and fat, or conversely, unfit and thin (Barry et al. 382). In addition, Tylka et al. review literature attesting to the complex causes of weight status that extend beyond individual behaviour, ranging from genetic predispositions to sociocultural factors beyond personal control. Lastly, reviews of research on dieting interventions show that these are overwhelmingly ineffective in producing lasting weight loss or actual improvements in health and may in fact lead to disordered eating and other unanticipated adverse consequences (e.g., Bacon and Aphramor; Mann et al. 220; Salas e79; Tylka et al.).The newfound, interdisciplinary field of scholarship known as Fat Studies aims to debunk weight-centric misconceptions by elucidating findings that counter these mainstream suppositions. Health At Every Size® (HAES), a weight-neutral approach to holistic well-being, is an important facet of Fat Studies. The HAES paradigm advocates intuitive eating and pleasurable physical activity for health rather than restrictive dieting and regimented exercise for weight loss. HAES further encourages body acceptance of self and others regardless of size. Empirical evidence shows that HAES-based interventions improve physical and psychological health without harmful side-effects or high dropout rates associated with weight loss interventions (Bacon and Aphramor; Clifford et al. “Impact of Non-Diet Approaches” 143). HAES, like the broader field of Fat Studies, seeks to eradicate weight-based discrimination, positioning weight bias as a social justice issue that intersects with oppression based on other areas of difference such as gender, race, and social class. Much like Queer Studies, Fat Studies seeks to reclaim the word, fat, thus stripping it of its pejorative connotations. As Nash asserts in her video, “Fat is a descriptive physical characteristic. It’s not an insult, or an obscenity, or a death sentence!” As an academic discipline, Fat Studies is expanding its visibility and reach. The Fat Studies Reader, the primary source of reading for my course, provides a comprehensive overview of the field (Rothblum and Solovay 1). This interdisciplinary anthology addresses fat history and activism, fat as social inequality, fat in healthcare, and fat in popular culture. Ward (937) reviews this and other recently-released fat-friendly texts. The field features its own journal, Fat Studies: An Interdisciplinary Journal of Body Weight and Society, which publishes original research, overview articles, and reviews of assorted media. Both the Popular Culture Association and National Women’s Studies Association have special interest groups devoted to Fat Studies, and the American Psychological Association’s Division on the Psychology of Women has recently formed a task force on sizism (Bergen and Carrizales 22). Furthermore, Fat Studies conferences have been held in Australia and New Zealand, and the third annual Weight Stigma Conference will occur in Iceland, September 2015. Although the latter conference is not necessarily limited to those who align themselves with Fat Studies, keynote speakers include Ragen Chastain, a well-known member of the fat acceptance movement largely via her blog, Dances with Fat. The theme of this year’s conference, “Institutionalised Weightism: How to Challenge Oppressive Systems,” is consistent with Fat Studies precepts:This year’s theme focuses on the larger social hierarchies that favour thinness and reject fatness within western culture and how these systems have dictated the framing of fatness within the media, medicine, academia and our own identities. What can be done to oppose systemised oppression? What can be learned from the fight for social justice and equality within other arenas? Can research and activism be united to challenge prevailing ideas about fat bodies?Concomitantly, Fat Studies courses have begun to appear on college campuses. Watkins, Farrell, and Doyle-Hugmeyer (180) identified and described four Fat Studies and two HAES courses that were being taught in the U.S. and abroad as of 2012. Since then, a Fat Studies course has been taught online at West Virginia University and another will soon be offered at Washington State University. Additionally, a new HAES class has been taught at Saint Mary’s College of California during the last two academic years. Cameron (“Toward a Fat Pedagogy” 28) describes ways in which nearly 30 instructors from five different countries have incorporated fat studies pedagogy into university courses across an array of academic areas. This growing trend is manifested in The Fat Pedagogy Reader (Russell and Cameron) due out later this year. In this article, I describe content and pedagogical strategies that I use in my Fat Studies course. I then share students’ qualitative reactions, drawing upon excerpts from written assignments. During the term reported here, the class was comprised of 17 undergraduate and 5 graduate students. Undergraduate majors included 47% in Psychology, 24% in Women Studies, 24% in various other College of Liberal Arts fields, and 6% in the College of Public Health. Graduate majors included 40% in the College of Public Health and 60% in the College of Education. Following submission of final grades, students provided consent via email allowing written responses on assignments to be anonymously incorporated into research reports. Assignments drawn upon for this report include weekly reading reactions to specific journal articles in which students were to summarise the main points, identify and discuss a specific quote or passage that stood out to them, and consider and discuss applicability of the information in the article. This report also utilises responses to a final assignment in which students were to articulate take-home lessons from the course.Despite the catalogue description, many students enter Fat Studies with a misunderstanding of what the course entails. Some admitted that they thought the course was about reducing obesity and the presumed health risks associated with this alleged pathological condition (Watkins). Others understood, but were somewhat dubious, at least at the outset, “Before I began this class, I admit that I was skeptical of what Fat Studies meant.” Another student experienced “a severe cognitive dissonance” between the Fat Studies curriculum and that of a previous behavioural health class:My professor spent the entire quarter spouting off statistics, such as the next generation of children will be the first generation to have a lower life expectancy than their parents and the ever increasing obesity rates that are putting such a tax on our health care system, and I took her words to heart. I was scared for myself and for the populations I would soon be working with. I was worried that I was destined to a chronic disease and bothered that my BMI was two points above ‘normal.’ I believed everything my professor alluded to on the danger of obesity because it was things I had heard in the media and was led to believe all my life.Yet another related, “At first, I will be honest, it was hard for me to accept a lot of this information, but throughout the term every class changed my mind about my view of fat people.” A few students have voiced even greater initial resistance. During a past term, one student lamented that the material represented an attack on her intended behavioural health profession. Cameron (“Learning to Teach Everybody”) describes comparable reactions among students in her Critical Obesity course taught within a behavioural health science unit. Ward (937) attests that, even in Gender Studies, fat is the topic that creates the most controversy. Similarly, she describes students’ immense discomfort when asked to entertain perspectives that challenge deeply engrained ideas inculcated by our culture’s “obesity epidemic.” Discomfort, however, is not necessarily antithetical to learning. In prompting students to unlearn “the biomedically-informed truth of obesity, namely that fat people are unfit, unhealthy, and in need of ‘saving’ through expert interventions,” Moola at al. recommend equipping them with an “ethics of discomfort” (217). No easy task, “It requires courage to ask our students to forgo the security of prescriptive health messaging in favour of confusion and uncertainty” (221). I encourage students to entertain conflicting perspectives by assigning empirically-based articles emanating from peer-reviewed journals in their own disciplines that challenge mainstream discourses on obesity (e.g., Aphramor; Bombak e60; Tomiyama, Ahlstrom, and Mann 861). Students whose training is steeped in the scientific method seem to appreciate having quantitative data at their disposal to convince themselves–and their peers and professors–that widely held weight-centric beliefs and practices may not be valid. One student remarked, “Since I have taken this course, I feel like I am prepared to discuss the fallacy of the weight-health relationship,” citing specific articles that would aid in the effort. Likewise, Cameron’s (“Learning to Teach Everybody”) students reported a need to read research reports in order to begin questioning long-held beliefs.In addition, I assign readings that provide students with the opportunity to hear the voices of fat people themselves, a cornerstone of Fat Studies. Besides chapters in The Fat Studies Reader authored by scholars and activists who identify as fat, I assign qualitative articles (e.g., Lewis et al.) and narrative reports (e.g., Pause 42) in which fat people describe their experiences with weight and weight bias. Additionally, I provide positive images of fat people via films and websites (Clifford et al. HAES®; Watkins; Watkins and Doyle-Hugmeyer 177) in order to counteract the preponderance of negative, dehumanising portrayals in popular media (e.g., Ata and Thompson 41). In response, a student stated:One of the biggest things I took away from this term was the confidence I found in fat women through films and stories. They had more confidence than I have seen in any tiny girl and owned the body they were given.I introduce “normal” weight allies as well, most especially Linda Bacon whose treatise on thin privilege tends to set the stage for viewing weight bias as a form of oppression (Bacon). One student observed, “It was a relief to be able to read and talk about weight oppression in a classroom setting for once.” Another appreciated that “The class did a great job at analysing fat as oppression and not like a secondhand oppression as I have seen in my past classes.” Typically, fat students were already aware of weight-based privilege and oppression, often painfully so. Thinner students, however, were often astonished by this concept, several describing Bacon’s article as “eye-opening.” In reaction, many vowed to act as allies:This class has really opened my eyes and prepared me to be an ally to fat people. It will be difficult for some time while I try to get others to understand my point of view on fat people but I believe once there are enough allies, people’s minds will really start changing and it will benefit everyone for the better.Pedagogically, I choose to share my own experiences as they relate to course content and encourage students, at least in their written assignments, to do the same. Other instructors refrain from this practice for fear of reinforcing traditional discourses or eliciting detrimental reactions from students (Watkins, Farrell, and Doyle-Hugmeyer 191). Nevertheless, this tack seems to work well in my course, with many students opting to disclose their relevant circumstances during classroom discussions: Throughout the term I very much valued and appreciated when classmates would share their experiences. I love listening and hearing to others experiences and I think that is a great way to understand the material and learn from one another.It really helped to read different articles and hear classmates discuss and share stories that I was able to relate to. The idea of hearing people talk about issues that I thought I was the only one who dealt with was so refreshing and enlightening.The structure of this class allowed me to learn how this information is applicable to my life and made it deeper than just memorising information.Thus far, across three terms, no student has described iatrogenic effects from this process. In fact, most attribute positive transformations to the class. These include enhanced body acceptance of self and others: This class decreased my fat phobia towards others and gave me a better understanding about the intersectionality of one’s weight. For example, I now feel that I no longer view my family in a fat phobic way and I also feel responsible for educating my brother and helping him develop a strong self-esteem regardless of his size.I never thought this class would change my life, almost save my life. Through studies shown in class and real life people following their dreams, it made my mind completely change about how I view my body and myself.I can only hope that in the future, I will be more forgiving, tolerant, and above all accepting of myself, much less others. Regardless of a person’s shape and size, we are all beautiful, and while I’m just beginning to understand this, it can only get better from here.Students also reported becoming more savvy consumers of weight-centric media messages as well as realigning their eating and exercise behaviour in accordance with HAES: I find myself disgusted at the television now, especially with the amount of diet ads, fitness club ads, and exercise equipment ads all aimed at making a ‘better you.’ I now know that I would never be better off with a SlimFast shake, P90X, or a Total Gym. I would be better off eating when I’m hungry, working out because it is fun, and still eating Thin Mints when I want to. Prior to this class, I would work out rigorously, running seven miles a day. Now I realise why at times I dreaded to work out, it was simply a mathematical system to burn the energy that I had acquired earlier in the day. Instead what I realise I should do is something I enjoy, that way I will never get tired of whatever I am doing. While I do enjoy running, other activities would bring more joy while engaging in a healthy lifestyle like hiking or mountain biking.I will never go on another diet. I will stop choosing exercises I don’t love to do. I will not weigh myself every single day hoping for the number on the scale to change.A reduction in self-weighing was perhaps the most frequent behaviour change that students expressed. This is particularly valuable in that frequent self-weighing is associated with disordered eating and unhealthy weight control behaviours (Neumark-Sztainer et al. 811):I have realised that the number on the scale is simply a number on the scale. That number does not define who you are. I have stopped weighing myself every morning. I put the scale in the storage closet so I don’t have to look at it. I even encouraged my roommate to stop weighing herself too. What has been most beneficial for me to take away from this class is the notion that the number on the scale has so much less to do with fitness levels than most people understand. Coming from a numbers obsessed person like myself, this class has actually gotten me to leave the scales behind. I used to weigh myself every single day and my self-confidence reflected whether I was up or down in weight from the day before. It seems so silly to me now. From this class, I take away a new outlook on body diversity. I will evaluate who I am for what I do and not represent myself with a number. I’m going to have my cake this time, and actually eat it too!Finally, students described ways in which they might carry the concepts from Fat Studies into their future professions: I want to go to law school. This model is something I will work toward in the fight for social justice.As a teacher and teacher of teachers, I plan to incorporate discussions on size diversity and how this should be addressed within the field of adapted physical education.I do not know how I would have gone forward if I had never taken this class. I probably would have continued to use weight loss as an effective measure of success for both nutrition and physical activity interventions. I will never be able to think about the obesity prevention movement in the same way.Since I am working toward being a clinical psychologist, I don’t want to have a client who is pursuing weight loss and then blindly believe that they need to lose weight. I’d rather be of the mindset that every person is unique, and that there are other markers of health at every size.Jones and Hughes-Decatur (59) call for increased scholarship illustrating and evaluating critical body pedagogies so that teachers might provide students with tools to critique dominant discourses, helping them forge healthy relationships with their own bodies in the process. As such, this paper describes elements of a Fat Studies class that other instructors may choose to adopt. It additionally presents qualitative data suggesting that students came to think about fat and fat people in new and divergent ways. Qualitative responses also suggest that students developed better body image and more adaptive eating and exercise behaviours throughout the term. Although no students have yet described lasting adverse effects from the class, one stated that she would have preferred less of a focus on health and more of a focus on issues such as fat fashion. Indeed, some Fat Studies scholars (e.g., Lee) advocate separating discussions of weight bias from discussions of health status to avoid stigmatising fat people who do experience health problems. While concerns about fostering healthism within the fat acceptance movement are valid, as a behavioural health professional with an audience of students training in these fields, I have chosen to devote three weeks of our ten week term to this subject matter. Depending on their academic background, others who teach Fat Studies may choose to emphasise different aspects such as media representations or historical connotations of fat.Nevertheless, the preponderance of positive comments evidenced throughout students’ assignments may certainly be a function of social desirability. Although I explicitly invite critique, and in fact assign readings (e.g., Welsh 33) and present media that question HAES and Fat Studies concepts, students may still feel obliged to articulate acceptance of and transformations consistent with the principles of these movements. As a more objective assessment of student outcomes, I am currently conducting a quantitative evaluation, in which I remain blind to students’ identities, of this year’s Fat Studies course compared to other upper division/graduate Psychology courses, examining potential changes in weight bias, body image and dieting behaviour, adherence to appearance-related media messages, and obligatory exercise behaviour. I postulate results akin to those of Humphrey, Clifford, and Neyman Morris (143) who found reductions in weight bias, improved body image, and improved eating behaviour among college students as a function of their HAES course. As Fat Studies pedagogy proliferates, instructors are called upon to share their teaching strategies, document the effects, and communicate these results within and outside of academic spheres.ReferencesAmbwani, Suman, Katherine M. Thomas, Christopher J. Hopwood, Sara A. Moss, and Carlos M. Grilo. “Obesity Stigmatization as the Status Quo: Structural Considerations and Prevalence among Young Adults in the U.S.” Eating Behaviors 15.3 (2014): 366-370. Aphramor, Lucy. “Validity of Claims Made in Weight Management Research: A Narrative Review of Dietetic Articles.” Nutrition Journal 9 (2010): n. pag. 15 May 2015 ‹http://www.nutritionj.com/content/9/1/30›.Ata, Rheanna M., and J. Kevin Thompson. “Weight Bias in the Media: A Review of Recent Research.” Obesity Facts 3.1 (2010): 41-46.Bacon, Linda. “Reflections on Fat Acceptance: Lessons Learned from Thin Privilege.” 2009. 23 Apr. 2015 ‹http://www.lindabacon.org/Bacon_ThinPrivilege080109.pdf›.Bacon, Linda, and Lucy Aphramor. “Weight Science: Evaluating the Evidence for a Paradigm Shift.” Nutrition Journal 10 (2011). 23 Apr. 2015 ‹http://www.nutritionj.com/content/10/1/9›.Barry, Vaughn W., Meghan Baruth, Michael W. Beets, J. Larry Durstine, Jihong Liu, and Steven N. Blair. “Fitness vs. Fatness on All-Cause Mortality: A Meta-Analysis.” Progress in Cardiovascular Diseases 56.4 (2014): 382-390.Bergen, Martha, and Sonia Carrizales. “New Task Force Focused on Size.” The Feminist Psychologist 42.1 (2015): 22.Bombak, Andrea. “Obesity, Health at Every Size, and Public Health Policy.” American Journal of Public Health 104.2 (2014): e60-e67.Cameron, Erin. “Learning to Teach Everybody: Exploring the Emergence of an ‘Obesity” Pedagogy’.” The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. Eds. Erin Cameron and Connie Russell. New York: Peter Lang Publishing, in press.Cameron, Erin. “Toward a Fat Pedagogy: A Study of Pedagogical Approaches Aimed at Challenging Obesity Discourses in Post-Secondary Education.” Fat Studies 4.1 (2015): 28-45.Chastain, Ragen. Dances with Fat. 15 May 2015 ‹https://danceswithfat.wordpress.com/blog/›.Clifford, Dawn, Amy Ozier, Joanna Bundros, Jeffrey Moore, Anna Kreiser, and Michele Neyman Morris. “Impact of Non-Diet Approaches on Attitudes, Behaviors, and Health Outcomes: A Systematic Review.” Journal of Nutrition Education and Behavior 47.2 (2015): 143-155.Clifford, Dawn, Patti Lou Watkins, and Rebecca Y. Concepcion. “HAES® University: Bringing a Weight Neutral Message to Campus.” Association for Size Diversity and Health, 2015. 23 Apr. 2015 ‹https://www.sizediversityandhealth.org/content.asp?id=258›.Fat Studies: An Interdisciplinary Journal of Body Weight and Society. 23 Apr. 2015 ‹http://www.tandfonline.com/toc/ufts20/current#.VShpqdhFDBC›.Flegal, Katherine M., Brian K. Kit, Heather Orpana, and Barry L. Graubard. “Association of All-Cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-Analysis.” Journal of the American Medical Association 309.1 (2013): 71-82.Humphrey, Lauren, Dawn Clifford, and Michelle Neyman Morris. “Health At Every Size College Course Reduces Dieting Behaviors and Improves Intuitive Eating, Body Esteem, and Anti-Fat Attitudes.” Journal of Nutrition Education and Behavior, in press.Jones, Stephanie, and Hilary Hughes-Decatur. “Speaking of Bodies in Justice-Oriented Feminist Teacher Education.” Journal of Teacher Education 63.1 (2012): 51-61.Lee, Jenny. Embodying Stereotypes: Memoir, Fat and Health. Fat Studies: Reflective Intersections, July 2012, Wellington, NZ. Unpublished conference paper.Lewis, Sophie, Samantha L. Thomas, Jim Hyde, David Castle, R. Warwick Blood, and Paul A. Komesaroff. “’I Don't Eat a Hamburger and Large Chips Every Day!’ A Qualitative Study of the Impact of Public Health Messages about Obesity on Obese Adults.” BMC Public Health 10.309 (2010). 23 Apr 2015 ‹http://www.biomedcentral.com/1471-2458/10/309›.Mann, Traci, A. Janet Tomiyama, Erika Westling, Ann-Marie Lew, Barbara Samuels, and Jason Chatman. “Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer.” American Psychologist 62.3 (2007): 220-233.McAuley, Paul A., and Steven N. Blair. “Obesity Paradoxes.” Journal of Sports Sciences 29.8 (2011): 773-782. McHugh, Maureen C., and Ashley E. Kasardo. “Anti-Fat Prejudice: The Role of Psychology in Explication, Education and Eradication.” Sex Roles 66.9-10 (2012): 617-627.Moola, Fiona J., Moss E. Norman, LeAnne Petherick, and Shaelyn Strachan. “Teaching across the Lines of Fault in Psychology and Sociology: Health, Obesity and Physical Activity in the Canadian Context.” Sociology of Sport Journal 31.2 (2014): 202-227.Nash, Joy. “A Fat Rant.” YouTube, 17 Mar. 2007. 23 Apr. 2015 ‹https://www.youtube.com/watch?v=yUTJQIBI1oA›.Neumark-Sztainer, Dianne, Patricia van den Berg, Peter J. Hannan, and Mary Story. “Self-Weighing in Adolescents: Helpful or Harmful? Longitudinal Associations with Body Weight Changes and Disordered Eating.” Journal of Adolescent Health 39.6 (2006): 811–818.O’Brien, K.S., J.A. Hunter, and M. Banks. “Implicit Anti-Fat Bias in Physical Educators: Physical Attributes, Ideology, and Socialization.” International Journal of Obesity 31.2 (2007): 308-314.Pause, Cat. “Live to Tell: Coming Out as Fat.” Somatechnics 2.1 (2012): 42-56.Rothblum, Esther, and Sondra Solovay, eds. The Fat Studies Reader. New York: New York University Press, 2009.Russell, Connie, and Erin Cameron, eds. The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. New York: Peter Lang Publishing, in press. Salas, Ximena Ramos. “The Ineffectiveness and Unintended Consequences of the Public Health War on Obesity.” Canadian Journal of Public Health 106.2 (2015): e79-e81. Tomiyama, A. Janet, Britt Ahlstrom, and Traci Mann. “Long-Term Effects of Dieting: Is Weight Loss Related to Health?” Social and Personality Psychology Compass 7.12 (2013): 861-877.Tylka, Tracy L., Rachel A. Annunziato, Deb Burgard, Sigrun Daníelsdóttir, Ellen Shuman, Chad Davis, and Rachel M. Calogero. “The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss.” Journal of Obesity (2014). 23 Apr. 2015 ‹http://www.hindawi.com/journals/jobe/2014/983495/›.Ward, Anna E. “The Future of Fat.” American Quarterly 65.4 (2013): 937-947.Watkins, Patti Lou. “Inclusion of Fat Studies in a Difference, Power, and Discrimination Curriculum.” The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. Eds. Erin Cameron and Connie Russell. New York: Peter Lang Publishing, in press. Watkins, Patti Lou, and Rebecca Y. Concepcion. “Teaching HAES to Health Care Students and Professionals.” Wellness Not Weight: Motivational Interviewing and a Non-Diet Approach. Ed. Ellen Glovsky. San Diego: Cognella Academic Publishing, 2014: 159-169. Watkins, Patti Lou, and Andrea Doyle-Hugmeyer. “Teaching about Eating Disorders from a Fat Studies Perspective. Transformations 23.2 (2013): 147-158. Watkins, Patti Lou, Amy E. Farrell, and Andrea Doyle Hugmeyer. “Teaching Fat Studies: From Conception to Reception. Fat Studies 1.2 (2012): 180-194. Welsh, Taila L. “Healthism and the Bodies of Women: Pleasure and Discipline in the War against Obesity.” Journal of Feminist Scholarship 1 (2011): 33-48. Weight Stigma Conference. 23 Apr. 2015 ‹http://stigmaconference.com/›.

Mark Haddon’s The Curious Incident of the Dog in the Night-Time has achieved success as “the new Rain Man” or “the new definitive, popular account of the autistic condition” (Burks-Abbott 294). Integral to its favourable reception is the way it conflates the autistic main character, the fifteen-year-old narrator Christopher Boone, with the savant, or individual who exhibits both neurological problems and giftedness, thereby engaging with the way autism is presented in popular culture. In a variety of contemporary films and television series, autism has been transformed from a disability to a form of giftedness by relating it to abilities associated in contemporary media with a genius, in particular by invoking the metaphor of an autistic mind as a type of computer. As a result, the book engages with the current association of giftedness in mathematics and science with social awkwardness and isolation as constructed in popular culture: in idiomatic terms, the genius “nerd” figure characterised by an uncertain, adolescent approach to social contact (Kendall 353). The disablement of the character is, then, lessened so that the idea of being “special,” continually evoked throughout the text, has a transformative function that is related less to the special needs of those with a disability and more to the common element in adolescent fiction of longing for extraordinary power and control through being a special, gifted individual. The Curious Incident of the Dog in the Night-Time relates the protagonist, Christopher, to Sherlock Holmes and his methods of detection, specifically through the title being taken from a story by Conan Doyle, “Silver Blaze,” in which the “curious incident” referred to is that the dog did nothing in the night. In the original story, that the dog did not bark or react to an intruder was a clue that the person was known to the animal, so allowing Holmes to solve the crime by a process of deduction. Christopher copies these traditional methods of the classical detective to solve his personal mystery, that of who killed a neighbour’s dog, Wellington. The adoption of this title allows a double irony to emerge. Christopher’s attempts to emulate Holmes in his approach to crime are predicated on his assumption of his likeness to the model of the classical detective as he states, “I think that if I were a proper detective he is the kind of detective I would be,” pointing out the similarity of their powers of observation and his ability, like Holmes, to “detach his mind at will” as well as his capacity to find patterns in events (92). Through the novel, these attributes are aligned with his autism, constructing a trope of his disability conferring extraordinary abilities that are predicated on a computer-like detachment and precision in his method of thinking. The accessible narrative of the autistic Christopher gives the reader the impression of being able to understand the perspective of an individual with a spectrum disorder. In this way, the text not only engages with, but contributes to the construction of this disability in current popular culture as merely an extension of giftedness, especially in mathematics, and an associated unwillingness to communicate. Indeed, according to Raoul Eshelman, “one of its most engaging narrative devices is to make us identify with a mentally impaired narrator who is manifestly not interested in identifying either with us or anyone else” (1). The main character’s reference to mathematical and scientific ideas exploits an interest in giftedness already established by popular literature and film, and engages with a transformation effected in popular culture of the genius as autistic, and its corollary of an autistic person as potentially a genius. Such a construction ranges from fictional characters like Sheldon in The Big Bang Theory, Charlie and his physicist colleagues in Numb3rs, and Raymond Babbitt in Rain Man, to real life characters or representative figures in reality series and feature films such as x + y, The Imitation Game, The Big Short, and the television program Beauty and the Geek. While never referring specifically to autism, all the real or fictional representations contribute to the construction of a stereotype in which behaviours on the autistic spectrum are linked to a talent in mathematics and the sciences. In addition to this, detectives in the classical crime fiction alluded to in the novel typically exhibit traits of superhuman powers of deduction, pattern making, and problem solving that engage with the popular notion of genius in general and mathematics in particular by possessing a mind like a computer. Such detectives from current television series as Saga from The Bridge and Spencer Reid from Criminal Minds exhibit distance, coldness, and lack of social awareness or empathy with others, and this is presented as the basis of their extraordinary ability to discern patterns and solve crime. Spencer Reid, for example, has three PhDs in Science disciplines and Mathematics. Charlie in the television series Numb3rs is also a genius who uses his mathematical abilities to not only find the solution to crime but also explain the maths behind it to his FBI colleagues, and, in conjunction, the audience. But the character with the clearest association to Christopher is, naturally, Sherlock Holmes, both as constructed in Conan Doyle’s original text and the current adaptations and transformations of it. The television series Sherlock and Elementary, as well as the films Sherlock Holmes and Sherlock Holmes: A Game of Shadows all invoke a version of Holmes in which his powers of deduction are associated with symptoms to be found in a spectrum disorder.Like Christopher, the classical detective is characterised by being cold, emotionless, distant, socially inept, and isolated, but also keenly observant, analytical, and scientific; one who approaches the crime as a puzzle to be solved (Cawelti 43) with computer-like precision. In what is considered to be the original detective story, The Murders in the Rue Morgue, Poe included a “pseudo-mathematical logic in his literary scenario” (Platten 255). In Conan Doyle’s stories, Holmes, too, adopts a mathematical and scientific approach to construct patterns from clues that he alone can discern, and thereby solve the crime. The depiction of investigators in contemporary media such as Charlie in Numb3rs engages with these origins so that he is objective, dispassionate, and able to relate to real-world problems only through the filter of mathematical formulae. Christopher is presented similarly by engaging with the idea of the detective as implied savant and relying on an ability to discern patterns for successful crime solving.The book links the disabling behaviours of autism with the savant, so that the stereotype of the mystic displaying both disability and giftedness in fiction of earlier ages has been transformed in contemporary literature to a figure with extraordinary powers related both to autism and to the contemporary form of mysticism: innate mathematical ability and computer-style calculation. Allied with what Murray terms the “unknown and ambiguous nature” of autism, it is characterised as “the alien within the human, the mystical within the rational, the ultimate enigma” (25) in a way that is in keeping with the current fascination with the nature of genius and its association with being “special,” a term continually evoked and discussed throughout the book by the main character. The chapters on scientific ideas relate to Christopher’s world view, filtered through a mathematical and analytical approach to life and relationships with other people. Christopher examines beliefs such as the concept of humanity as superior to other animals, and the idea of religion and creationism, that is, the idea of humanity itself as special, with a cold and logical approach. He similarly discusses the idea of the individual person as special, linking this to a metaphor of the human mind being a computer (203, 148). Christopher’s narrow perspective as a result of his autism is not presented as disabling so much as protective, because the metaphorical connection of his viewpoint to a computer provides him with distance. Although initially Christopher fails to realise the significance of events, this allows him to be “switched off” (103) from events that he finds traumatising.The transformative metaphor of an autistic individual thinking like a computer is also invoked through Christopher’s explanation of “why people think that their brains are special, and different from computers” (147). Indeed, both in terms of his tendency to retreat or by “pressing CTRL + ALT + DEL and shutting down programs and turning the computer off and rebooting” (178) in times of stress, Christopher metaphorically views himself as a computer. Such a perspective invokes yet another popular cultural reference through the allusion to the human brain as “Captain Jean-Luc Picard in Star Trek: The Next Generation, sitting in his captain’s seat looking at a big screen” (147). But more importantly, the explanation refers to the basic premise of the book, that the text offers access to a condition that is inherently unknowable, but able to be understood by the reader through metaphor, often based on computers or technology as a result of a popular construction of autism that “the condition is the product of a brain in which the hard drive is incorrectly formatted” (Murray 25).Throughout the novel, the notion of “special” is presented as a trope for those with a disability, but as the protagonist, Christopher, points out, everyone is special in some way, so the whole idea of a disability as disabling is problematised throughout the text, while its associations of giftedness are upheld. Christopher’s disability, never actually designated as Asperger’s Syndrome or any type of spectrum disorder, is transformed into a protective mechanism that shields him from problematic social relationships of which he is unaware, but that the less naïve reader can well discern. In this way, rather than a limitation, the main character’s disorder protects him from a harsh reality. Even Christopher’s choice of Holmes as a role model is indicative of his desire to impose an eccentric order on his world, since this engages with a character in popular fiction who is famous not simply for his abilities, but for his eccentricity bordering on a form of autism. His aloof personality and cold logic not only fail to hamper him in his investigations, but these traits actually form the basis of them. The majority of recent adaptations of Conan Doyle’s stories, especially the BBC series Sherlock, depict Holmes with symptoms associated with spectrum disorder such as lack of empathy, difficulty in communication, and limited social skills, and these are clearly shown as contributing to his problem-solving ability. The trope of Christopher as detective also allows a parodic, postmodern comment on the classical detective form, because typically this fiction has a detective that knows more than the reader, and therefore the goal for the reader is to find the solution to the crime before it is revealed by the investigator in the final stages of the text (Rzepka 14). But the narrative works ironically in the novel since the non-autistic reader knows more than a narrator who is hampered by a limited worldview. From the beginning of the book, the narrative as focalised through Christopher’s narrow perspective allows a more profound view of events to be adopted by the reader, who is able to read clues that elude the protagonist. Christopher is well aware of this as he explains his attraction to the murder mystery novel, even though he has earlier stated he does not like novels since his inability to imagine or empathise means he is unable to relate to their fiction. For him, the genre of murder mystery is more akin to the books on maths and science that he finds comprehensible, because, like the classical detective, he views the crime as primarily a puzzle to be solved: as he states, “In a murder mystery novel someone has to work out who the murderer is and then catch them. It is a puzzle. If it is a good puzzle you can sometimes work out the answer before the end of the book” (5). But unlike Christopher, Holmes invariably knows more about the crime, can interpret the clues, and find the pattern, before other characters such as Watson, and especially the reader. In contrast, in The Curious Incident of the Dog in the Night-Time, the reader has more awareness of the probable context and significance of events than Christopher because, like a computer, he can calculate but not imagine. The reader can interpret clues within the plot of the story, such as the synchronous timing of the “death” of Christopher’s mother with the breakdown of the marriage of a neighbour, Mrs Shears. The astute reader is able to connect these events and realise that his mother has not died, but is living in a relationship with the neighbour’s husband. The construction of this pattern is denied Christopher, since he fails to determine their significance due to his limited imagination. Such a failure is related to Simon Baron-Cohen’s Theory of Mind, in which he proposes that autistic individuals have difficulty with social behaviour because they lack the capacity to comprehend that other people have individual mental states, or as Christopher terms it, “when I was little I didn’t understand about other people having minds” (145). Haddon utilises fictional licence when he allows Christopher to overcome such a limitation by a conscious shift in perspective, despite the specialist teacher within the text claiming that he would “always find this very difficult” (145). Christopher has here altered his view of events through his modelling both on the detective genre and on his affinity with mathematics, since he states, “I don’t find this difficult now. Because I decided that it was a kind of puzzle, and if something is a puzzle there is always a way of solving it” (145). In this way, the main character is shown as transcending symptoms of autism through the power of his giftedness in mathematics to ultimately discern a pattern in human relationships thereby adopting a computational approach to social problems.Haddon similarly explains the perspective of an individual with autism through a metaphor of Christopher’s memory being like a DVD recording. He is able to distance himself from his memories, choosing “Rewind” and then “Fast Forward” (96) to retrieve his recollection of events. This aspect of the precision of his memory relates to his machine-like coldness and lack of empathy for the feelings of others. But it also refers to the stereotype of the nerd figure in popular culture, where the nerd is able to relate more to a computer than to other people, exemplified in Sheldon from the television series The Big Bang Theory. Thus the presentation of Christopher’s autism relates to his giftedness in maths and science more than to areas that relate to his body. In general, descriptions of inappropriate or distressing bodily functions associated with disorders are mainly confined to other students at Christopher’s school. His references to his fellow students, such as Joseph eating his poo and playing in it (129) and his unsympathetic evaluation of Steve as not as clever or interesting as a dog because he “needs help to eat his food and could not even fetch a stick” (6), make a clear distinction between him and the other children, who despite being termed “special needs” are “special” in a different way from Christopher, because, according to him, “All the other children at my school are stupid” (56). While some reference is made to Christopher’s inappropriate behaviour in times of stress, such as punching a fellow student, wetting himself while on the train, and vomiting outside the school, in the main the emphasis is on his giftedness as a result of his autism, as displayed in the many chapters where he explains scientific and mathematical concepts. This is extrapolated into a further mathematical metaphor underlying the book, that he is like one of the prime numbers he finds so fascinating, because prime numbers do not fit neatly into the pattern of the number system, but they are essential and special nevertheless. Moreover, as James Berger suggests, prime numbers can “serve as figures for the autistic subject,” because like autistic individuals “they do not mix; they are singular, indivisible, unfactorable” yet “Mathematics could not exist without these singular entities that [. . .] are only apparent anomalies” (271).Haddon therefore offers a transformation by confounding autism with a computer-like ability to solve mathematical problems, so that the text is, as Haddon concedes, “as much about a gifted boy with behavior problems as it is about anyone on the autism spectrum” (qtd. in Burks-Abbott 291). Indeed, the word “autism” does not even appear in the book, while the terms “genius,” (140) “clever,” (32, 65, 252) and the like are continually being invoked in descriptions of Christopher, even if ironically. More importantly, the reader is constantly being shown his giftedness through the reiteration of his study of A Level Mathematics, and his explanation of scientific concepts. Throughout, Christopher explains aspects of mathematics, astrophysics, and other sciences, referring to such well-known puzzles in popular culture as the Monty Hall problem, as well as more obscure formulae and their proofs. They function to establish Christopher’s intuitive grasp of complex mathematical and scientific principles, as well as providing the reader with insight into both his perspective and the paradoxical nature of an individual who is at once able to solve quadratic equations in his head, yet is incapable of understanding the simple instruction, “Take the tube to Willesden Junction” (211).The presentation of Christopher is that of an individual who displays an extension of the social problems established in popular literature as connected to a talent for mathematics, therefore engaging with a depiction already existing in popular mythology: the isolated and analytical nerd or genius social introvert. Indeed, much of Christopher’s autistic behaviour functions to protect him from unsettling or traumatic information, since he fails to realise the significance of the information he collects or the clues he is given. His disability is therefore presented as not limiting so much as protective, and so the notion of disability is subsumed by the idea of the savant. The book, then, engages with a contemporary representation within popular culture that has transformed spectrum disability into mathematical giftedness, thereby metaphorically associating the autistic mind with the computer. ReferencesBaron-Cohen, Simon. Mindblindness: An Essay on Autism and Theory of Mind. Cambridge MA: MIT Press, 1995. Berger, James. “Alterity and Autism: Mark Haddon’s Curious Incident in the Neurological Spectrum.” Autism and Representation. Ed. Mark Osteen. Hoboken: Routledge, 2007. 271–88. Burks-Abbott, Gyasi. “Mark Haddon’s Popularity and Other Curious Incidents in My Life as an Autistic.” Autism and Representation. Ed. Mark Osteen. Hoboken: Routledge, 2007. 289–96. Cawelti, John G. Adventure, Mystery, and Romance: Formula Stories as Art and Popular Culture. Chicago: U of Chicago P, 1976. Eshelman, Raoul. “Transcendence and the Aesthetics of Disability: The Case of The Curious Incident of the Dog in the Night-Time.” Anthropoetics: The Journal of Generative Anthropology 15.1 (2009). Haddon, Mark. The Curious Incident of the Dog in the Night-Time. London: Random House Children’s Books, 2004. Kendall, Lori. “The Nerd Within: Mass Media and the Negotiation of Identity among Computer-Using Men.” Journal of Men’s Studies 3 (1999): 353–67. Murray, Stuart. “Autism and the Contemporary Sentimental: Fiction and the Narrative Fascination of the Present.” Literature and Medicine 25.1 (2006): 24–46. Platten, David. “Reading Glasses, Guns and Robots: A History of Science in French Crime Fiction.” French Cultural Studies 12 (2001): 253–70. Rzepka, Charles J. Detective Fiction. Cambridge, UK: Polity Press, 2005.