Dr Karin Eli: List of publications

<p><strong>Background:</strong><br /> As measured through body mass index (BMI), obesity is more prevalent among upwardly mobile adults than among adults born into middle-class families. Although BMI reflects general adiposity, health risks are more strongly associated with abdominal adiposity. It is therefore important to investigate associations between upward mobility and fat distribution.</p><br /> <p><strong>Methods:</strong><br /> A socioepidemiological questionnaire was developed, qualitatively validated and piloted with Oxford BioBank participants. Sex-specific analyses of variance (ANOVA) investigated associations between participant occupational class and adiposity, paternal occupational class and adiposity, and upward occupational mobility and adiposity. The main aim was to observe whether the expected directional effect of adiposity in relation to paternal occupational class would emerge.</p><br /> <p><strong>Results:</strong><br /> 280 participants (166 women, 114 men; age 32–67 years) completed the questionnaire. Men with fathers of occupational class 2 or 3 had higher mean BMI, total body fat percentage, android fat mass and android-to-gynoid fat mass ratio than men with fathers of occupational class 1. Women with fathers of occupational class 2 or 3 had higher mean BMI, total body fat percentage, android fat mass and gynoid fat mass than women with fathers of occupational class 1. Among men, upward mobility was not associated with adiposity. Among women, upward mobility was associated with higher total body fat percentage, android fat mass and gynoid fat mass.</p><br /> <p><strong>Conclusion:</strong><br /> The expected directional effect was found, thereby supporting the questionnaire’s use. Upward mobility did not appear to change associations between paternal occupational class and participant adiposity. Future research using the socioepidemiological questionnaire should investigate associations between gender, educational mobility, adiposity and health.</p>

OBJECTIVE:Although eating disorders occur worldwide, prevalence data beyond Euro-American contexts are sparse, and eating disorders largely remain outside global mental health agendas. This study aims to address this gap in the epidemiological literature through a global infodemiological comparison of Google search volumes for the topics "Anorexia nervosa" and "Bulimia nervosa." METHOD:Data were generated through Google Trends, a tool that assesses the relative search volumes of keywords and topics. Google Trends data, collected from January 1, 2004 to December 31, 2016, were obtained for the relative search volumes of the topics "Anorexia nervosa" and "Bulimia nervosa" worldwide. RESULTS:The findings revealed that Latin American countries accounted for the top 10 in search volume for both topics, with Mexico ranked first until 2016, when Bolivia rose to the top of the list. DISCUSSION:The results suggest that eating disorders are of considerable and consistent salience across Latin America, and that population-based, nationally representative studies to assess the prevalence of eating disorders in Latin American countries should be prioritized within global mental health research agendas.

In the last three decades, anthropological analyses of eating disorders have peeled away layers of 'common sense' to reveal tacit and often contradictory forces that inhere in people's bodies, practices, and lives. From investigations of institutional practices to analyses of embodied experiences, anthropologists have developed insightful accounts of how local, shared worlds shape disordered eating, and of the grounding of disorder in social structures and relationships that tend to be obscured in clinical and popular interpretations. In this introductory essay, we offer a brief review of anthropological work on eating disorders, with particular emphasis on studies published in the last decade. Attending to person, structure, and bodily being-in-the-world, these anthropological studies reveal multiple cultural logics within which disordered eating practices are embedded. The deciphering of cultural logics forms the basis for this special issue, whose constituent papers interrogate recurring and ongoing eating disorders, with analyses that focus on relapse, ambivalence toward treatment, and the persistence of disordered eating practices. In their shared focus on long-term eating disorders, the papers offer anthropological responses to clinical questions about the low rates of treatment success. As such, the special issue conveys the potential for new productive collaborations between anthropology, policy, and clinical research and practice for the prevention of and effective intervention in eating disorders.

The Child Eating Behaviour Questionnaire (CEBQ) is a well-established instrument in the study of obesity-related eating behaviours among children. However, research using the CEBQ in multicultural samples is limited. This study aims to identify and examine differences in child eating behaviours as reported by Swedish-born and non-Swedish-born mothers living in Sweden. Mothers (n = 1310, 74 countries of origin, mean age 36.5 years, 63.6% with higher education, 29.2% with overweight or obesity) of children aged 3–8 years (mean age 4.8 years, 18.1% with overweight or obesity) completed the CEBQ. Responses were analysed using CEBQ subscales Food Responsiveness, Emotional Overeating, Enjoyment of Food, and Desire to Drink, clustering into Food Approach, and subscales Satiety Responsiveness, Slowness in Eating, Emotional Undereating, and Food Fussiness, clustering into Food Avoidance. Data were compared across seven regional groups, divided by maternal place of birth: (1) Sweden (n = 941), (2) Nordic and Western Europe (n = 68), (3) Eastern and Southern Europe (n = 97), (4) the Middle East and North Africa (n = 110), (5) East, South and Southeast Asia (n = 52), (6) Sub-Saharan Africa (n = 16), and (7) Central and South America (n = 26). Crude, partly and fully adjusted linear regression models controlled for child's age, gender and weight status, and mother's education, weight status and concern about child weight. The moderation effect of maternal concern about child weight was examined through interaction analyses. Results showed that while Food Approach and Food Avoidance behaviours were associated with maternal migrant background, associations for Food Fussiness were limited. Notably, mothers born in the Middle East and North Africa reported higher frequencies of both Food Approach (except for Enjoyment of Food) and Food Avoidance. The study highlights the importance of examining how regionally-specific maternal migrant background affects mothers' perceptions of child eating behaviours.

This paper considers food as a site of public engagement with science and technology. Specifically, we focus on how public engagement with food is envisioned and operationalised by one non-profit organisation, foodwatch. Founded in Germany in 2002, foodwatch extensively uses new information and communication technologies to inform consumers about problematic food industry practices. In this paper, we present our analysis of 50 foodwatch e-newsletters published over a period of one year (2013). We define foodwatch’s approach as ‘governance by campaign’ – an approach marked by simultaneously constituting: (a) key food governance issues, (b) affective publics that address these topics of governance through ICT-enabled media and (c) independent food and food-related expertise. We conclude our paper with a discussion of foodwatch’s mode of ‘governance by campaign’ and the democratic limits and potentials of a governance mode that is based on invited participation.

In this article, I argue that eating disorders constitute a form of social suffering, in which sufferers embody liminality as a response to, and a reflection of, oppressive sociality, structural violence, and institutional constraints. Based on the illness narratives of people with anorexia nervosa, bulimia nervosa, and their subclinical variants in Israel, the analysis draws the experiential, the social, and the structural into critical focus. These narratives, which delineate lived experiences of self-starving, bingeing, and purging, and the attendant viscerality of hunger, fullness, and emptiness, reveal how participants developed an embodied drawing inward and away, being at once within and without society for extended periods of time, through eating disordered practices. This liminal positioning, I argue, was a mode through which participants cultivated alternative (if temporary) personal spaces, negotiated identities, and anesthetized pain: processes many deemed essential to survival. Embedding the participants’ narratives of eating disordered experiences within familial, societal, and political-economic forces that shaped their individual lives, I examine the participants’ striving for liminality as at once intimately embodied and structurally mapped. The analysis suggests that policy initiatives for eating disorder prevention must address the social suffering that eating disorders manifest: suffering caused by structures and institutions that reinforce social inequality, violence, and injustice.

In this chapter, we turn to the three case studies we explored in our 2013–2016 research project on how new information and communication technologies (ICTs) mediate novel forms of consumer activism and food governance. Each case study represents a different type of digital platform used in food activism: a mobile app, a wiki platform, and an online-centric activist organization. Case studies, by definition, do not provide an exhaustive review; for example, the case studies we selected do not address more diffuse activism through social media. Our aim, however, is not to review all types of digital food activism, but rather to capture diverse forms and potentials of digital food activism, and develop an analytic framework that can be applied to other cases in the field.

OBJECTIVE: Parental feeding practices shape children's relationships with food and eating. Feeding is embedded socioculturally in values and attitudes related to food and parenting. However, few studies have examined associations between parental feeding practices and migrant background. DESIGN: Cross-sectional study. Parental feeding practices (restriction, pressure to eat, monitoring) were assessed using the Child Feeding Questionnaire. Differences were explored in four sub-samples grouped by maternal place of birth: Sweden, Nordic/Western Europe, Eastern/Southern Europe and countries outside Europe. Crude, partly and fully adjusted linear regression models were created. Potential confounding variables included child's age, gender and weight status, and mother's age, weight status, education and concern about child weight. SETTING: Malmö and Stockholm, Sweden. SUBJECTS: Mothers (n 1325, representing seventy-three countries; mean age 36·5 years; 28·1 % of non-Swedish background; 30·7 % with overweight/obesity; 62·8 % with university education) of pre-school children (mean age 4·8 years; 50·8 % boys; 18·6 % with overweight/obesity). RESULTS: Non-Swedish-born mothers, whether European-born or non-European-born, were more likely to use restriction. Swedish-born mothers and Nordic/Western European-born mothers reported lower levels of pressure to eat compared with mothers born in Eastern/Southern Europe and mothers born outside Europe. Differences in monitoring were small. Among the potential confounding variables, child weight status and concern about child weight were highly influential. Concern about child weight accounted for some of the effect of maternal origin on restriction. CONCLUSIONS: Non-European-born mothers were more concerned about children being overweight and more likely to report controlling feeding practices. Future research should examine acculturative and structural factors underlying differences in feeding.

© 2016.In this article, we explore the discursive constructions of Buycott, a free mobile app that provides a platform for user-generated ethical consumption campaigns. Unlike other ethical consumption apps, Buycott's mode of knowledge production positions the app itself as neutral, with app users generating activist campaigns and providing both data and judgment. Although Buycott is not a dedicated food activism app, food features centrally in its campaigns, and the app seems to provide a mobile means of extending, and perhaps expanding, alternative food network (AFN) action across geographies and constituencies. Thus, as a case study, Buycott unveils contemporary possibilities for citizen participation and the formation of activist consumer communities, both local and transnational, through mobile technologies. Our analysis shows, however, that despite the app's user-generated format, the forms of activism it enables are constrained by the app's binary construction of action as consumption or non-consumption and its ethos of 'voting with your wallet'. Grounded in texts concerning Buycott's two largest campaigns (Demand GMO Labeling and Long live Palestine boycott Israel), our analysis delineates how Buycott, its campaigns, and its modes of action take shape in user, media, and app developer discourses. We find that, as discursively framed, Buycott campaigns are commodity-centric, invoking an 'ethics of care' to be enacted by atomized consumers, in corporate spaces and through mainstream, barcode-bearing, retail products. In user discourses, this corporate spatiality translates into the imagined materializing of issues in products, investing commodities with the substance of an otherwise ethereal cause. This individualized, commodity-centric activism reinforces tenets of the neoliberal market, ultimately turning individual users into consumers not only of products, but also of the app itself. Thus, we suggest, the activist habitus constructed through Buycott is a neoliberal, consumer habitus.

From briefcases to drugs, and from boxing rings to tower blocks, this issue of M/C Journal turns its attention to the diverse materialities that make up our social worlds. Across a variety of empirical contexts, the collected papers employ objects, structures, and spaces as lenses onto corporeality, extending and unsettling habitual understandings of what a body is and does. By exploring everyday encounters among bodies and other materialities, the contributors elucidate the material processes through which human corporeality is enacted and imagined, produced and unmade. <br/>That materialities “tell stories” of bodies is an implicit tenet of embodied existence. In biomedical practice, for example, the thermometer assigns a value to a disease process which might already be felt, whereas the blood pressure cuff sets in motion a story of illness that is otherwise hidden or existentially absent. In so doing, such objects recast corporeality, shaping not only experiences of embodied life, but also the very matter of embodiment. <br/>Whilst recognising that objects are “companion[s] in life experience” (Turkle 5), this issue seeks to go beyond a sole focus on embodied experience, and explore the co-constitutive entanglements of embodiment and materiality. The collected papers examine how bodies and the material worlds around them are dialectically forged and shaped. By engaging with a specific object, structure, or space, each paper reflects on embodiment in ways that take account of its myriad material dynamics.

IntroductionInsight into parents' perceptions of their children's eating behaviors is crucial for the development of successful childhood obesity programs. However, links between children's eating behaviors and parental feeding practices and concerns have yet to be established. This study aims to examine associations between parental perceptions of preschoolers' eating behaviors and parental feeding practices. First, it tests the original 8-factor structure of the Child Eating Behavior Questionnaire (CEBQ). Second, it examines the associations with parental feeding practices, measured with the Child Feeding Questionnaire (CFQ).Materials and methodsQuestionnaires were sent to parents from 25 schools/preschools in Stockholm, Sweden and to parents starting a childhood obesity intervention. The CEBQ factor structure was tested with confirmatory factor analysis (CFA). Associations between CEBQ subscales Food approach and Food avoidance and CFQ factors Restriction, Pressure to eat and Monitoring were examined with structural equation modelling (SEM), adjusting for child and parental characteristics, and parental confidence, measured with the Lifestyle Behavior Checklist (LBC). CFQ Concern for child weight and Perceived responsibility for child eating were used as mediators.Results478 parents completed the questionnaires (children: 52% girls, mean age 5.5 years, 20% overweight/obese). A modified 8-factor structure showed an acceptable fit (TLI = 0.91, CFI = 0.92, RMSEA = 0.05 and SRMR = 0.06) after dropping one item and allowing three pairs of error terms to correlate. The SEM model demonstrated that Food approach had a weak direct effect on Restriction, but a moderate (β = 0.30) indirect effect via Concern, resulting in a substantial total effect (β = 0.37). Food avoidance had a strong positive effect on Pressure to eat (β = 0.71).DiscussionThe CEBQ is a valid instrument for assessing parental perceptions of preschoolers' eating behaviors. Parental pressure to eat was strongly associated with children's food avoidance. Parental restriction, however, was more strongly associated with parents' concerns about their children's weights than with children's food approach. This suggests that childhood obesity interventions should address parents' perceptions of healthy weight alongside perceptions of healthy eating.

BackgroundClinical studies describe binge eating as a reaction to hunger, negative affect, or the need to dissociate. However, little is known about the meanings that women with bulimia nervosa and anorexia nervosa associate with binge eating.AimsTo examine how women with anorexia nervosa and bulimia nervosa interpret their experiences of binge eating.MethodsSixteen women who engaged in binge eating and had been diagnosed with anorexia nervosa, bulimia nervosa, or their subclinical variants were interviewed about their experiences of eating disorder. Interview data were analyzed using phenomenologically-informed thematic analysis.ResultsParticipants described binge eating as a practice through which the self experiences a sense of release, and existential emptiness is replaced by overwhelming fullness.ConclusionMeaningful experiences of release and fullness are central to binge eating in bulimia nervosa and anorexia nervosa, and may contribute to the long-term maintenance of this practice.

Although narrative-based research has been central to studies of illness experience, the inarticulate, sensory experiences of illness often remain obscured by exclusively verbal or textual inquiry. To foreground the body in our investigation of subjective and intersubjective aspects of eating disorders, we-a medical anthropologist and a contemporary dance choreographer-designed a collaborative project, in which we studied the experiences of women who had eating disorders, through eight weeks of integrating dance practice-based, discussion-based and interview-based research. Grounded in the participants' own reflections on choreographing, dancing and watching others perform solos about their eating disordered experiences, our analysis examines the types of knowledge the participants used in choreographing their dance works, and the knowledge that they felt the dance enabled them to convey. We find that the participants consistently spoke of feeling as guiding their choreographic processes; they also said the experiences they conveyed through their dance works were centred in feelings, rather than in practices or events. Through dance, the participants said they could communicate experiences that would have remained unspoken otherwise. Yet, notably, dance practice also enabled participants to begin defining and describing their experiences verbally. We suggest, therefore, that through engaging participants in contemporary dance practice, we can begin to identify and address embodied experiences of illness and recovery that may be silenced in speech or writing alone.

Dedicated inpatient care for eating disorders has profound impact on patients' embodied practices and lived realities. Analyses of inpatients' accounts have shown that participants endorse complex and conflicting attitudes toward their experiences in eating disorders wards, yet the apparent ambivalence that characterizes inpatient experiences has not been subject to critical examination. This paper examines the narrated experiences of 13 participants (12 women and one man; age 18-38 years at first interview) with past or present anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified, who had been hospitalized in an inpatient eating disorders ward for adults in central Israel. The interviews, which took place in 2005-2006, and again in 2011, were part of a larger longitudinal study exploring the subjective experiences of eating disorders and recovery among Israeli adults. Employing qualitative analysis, this study finds that the participants' accounts were concerned with dynamics of difference and belonging, as they played out in various aspects of inpatient care, including diagnosis, treatment, relationships with fellow patients and staff, and everyday life in hospital. Notably, participants simultaneously defined themselves as connected to, but also distinct from, the eating disordered others who formed their reference group at the ward. Through negotiating a protectively ambivalent positioning, participants recognized their eating disordered identities and connected with others on the ward, while also asserting their non-disordered individuality and distancing themselves from the potential dangers posed by 'excessive' belonging. The paper suggests that this ambivalent positioning can usefully be understood through the anthropological concept of liminality: being both a part of and apart from one's community.

With its multidimensional etiology, rich history, and increasingly complex epidemiology, anorexia nervosa has emerged as a biocultural disorder of significance for medical anthropology. Anthropological work on anorexia was first published in the 1980s, with these initial engagements examining the Western cultural context wherein anorexia was (predominantly) expressed. Over the decades, paradigm shifts in medical anthropology—from culture-bound syndromes and explanatory models of disease, to analyses of globalization and ethnographies of the body and self—transitioned the anthropological discussion of anorexia away from “culture” and toward the critical analysis of practice, experience, and subjectivity. But the anthropological narrative of anorexia is even richer, having been informed by more than a century of multidisciplinary work: a vast corpus that constitutes an unlikely gathering of disciplines, all searching for the key to anorexia’s causation and course. Since its clinical definition in the 1870s, anorexia—a disorder of ambiguous and complex causation, with striking psychological, social, physiological, and behavioral manifestations—has been subject to myriad interpretations. In fields ranging from biomedical (including genetic and neuro-) science, to the many schools of psychology, history, and feminist social theory, scholars have offered interpretations of and hypotheses about anorexia, each addressing a facet of the disorder. With historical analyses tracing anorexia through the Victorian era and toward medieval times, feminist analyses positioning anorexia as the embodiment of sociopolitical thought, and evolutionary and genetic analyses suggesting anorexia is the possible expression of adaptive traits, multidisciplinary work on anorexia has captured a complexity that is yet to be fully understood. It is this complexity, blurring the boundaries of body, society, history, and self, that makes anorexia so relevant for medical anthropology, its enduring ambiguities evoking the wholeness of the human experience that anthropological research seeks to explain. Given the nature of the anorexia literature on which anthropological research draws, this article does not highlight genres of publication: journals and textbooks dedicated to eating disorders tend to be exclusively clinical, emphasizing biomedical research and quantitative data analyses (rather than clinical case reports), such that they would not provide the most-salient references for anthropologists. The works featured in this article are divided, therefore, according to the analytic perspectives they express. Emphasis is placed on the history of thought on anorexia, while drawing out the salience of specific works for contemporary anthropological research.