Social Impairment High In People with Eating and Food Issues

Eating issues (ED) such as anorexia (AN), bulimia, and binging/purging can lead to many physical and psychological problems. Long term ED can cause damage to the heart and other organs, and can even lead to death. Psychologically, people with ED often experience anxiety, depression, low self-esteem, isolation, guilt, shame, and even suicidal ideation. The introduction of the Work and Social Adjustment Scale (WSAS) brought to light certain domains of functioning that are directly impacted by psychological issues such as obsessions and compulsions, psychosis, and schizophrenia. But in the study on ED, there is little research demonstrating the efficacy of the WSAS. Because work and social realms are considered ripe areas in which to measure functionality and impairment, Kate Tchanturia of the Division of Psychological Medicine and the Institute of Psychiatry at King’s College in London, decided to test the validity of the WSAS in assessing the consequences of ED and also the severity of symptoms in a sample of 160 adult women with and without ED. Her sample was comprised of 83 women without AN who represented control subjects (HC), and 77 women with AN. Tchanturia evaluated the women with the WSAS for levels of ED severity, depression, and anxiety.

She found that the women with anorexia had significant impairment across all measures on the WSAS. In particular, work and social functioning was drastically impaired when compared to the HC participants. Tchanturia also discovered that there was a direct relationship between impairment and severity of ED symptoms, as indicated by the WSAS. But, she added, “The greatest impairment in the AN group was reported in the realm of social leisure.” Based on these results, Tchanturia believes that the WSAS is a highly effective tool for assessing impairment in individuals with ED. Not only can this clinical tool identify certain areas of life that are impacted by ED, but the WSAS can also help clinicians ascertain symptom severity by way of domain impairment. Tchanturia hopes that these findings will provide support for the continued use of the WSAS in the diagnosis and treatment of ED.

Tchanturia, Kate, et al. (2013). Work and social adjustment in patients with anorexia nervosa. Comprehensive Psychiatry 54.1 (2013): 41-5. ProQuest. Web.

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Kris S

    Kris S

    April 6th, 2013 at 5:16 AM

    This article and study makes a lot of sense. This is the first time I’ve heard about the WSAS scale, looks like a good way to measure and uncover correlations. If I may add my 2 cents… ED can be a result of deeper emotional issues, and that also impairs our social skills.

  • Mika


    April 6th, 2013 at 7:07 AM

    This is spot on, because there are times when I will turn down invites to go out all because I am worried about what I will have to eat and how much I would have to eat for my friends to get off my back about my eating issues.

    This is something that is very personal for me, so much so that I am afraid to talk to anyone else about it. I don’t necessarily feel like it is affecting my health yet, which is good, but I am so afraid to put on any weight that it almost paralyzes me with fear.

    So most of the time I stay home alone and out of situations thta would force me into a food situation that I would be very uncomfortable with.

  • Jordyn


    April 6th, 2013 at 1:08 PM

    Things like this can go both ways too, because I am overweight and I am embarassed about what other people think about me when I go out. Like they will be thinking that no wonder I am fat because look at how much I am eating. Why do they want to judge me? Or at least that’s what I feel like it is anyway/

  • P.L


    April 6th, 2013 at 11:18 PM

    Social events are ripe with food. It may not be obvious but think about it- most social events are focused around food. And even just going out with friends involves eating. That can put people with eating issues under so much stress! Makes it worse for them because if they are looking for support from friends and others they have to participate in events that are directly related to their problem area!

  • raina


    April 7th, 2013 at 6:08 AM

    I think that many times we pay a lot of attention to the physical damage that an eating disorder can leave but we tend to forget that there are a whole host of mental and emotional issues that those faced with eating disorders have to deal with as well.

    This is just one of them, that whole thing of having to muddle through social situations and figuring out how to make it through them when for most of us they are terribly hard. You never feel good enough or thin enough or whatever to be okay in these situations and that turns some into recluses for that very reason. It is easier to hide from others than it is to let them see your weaknesses.

  • Noelle


    April 8th, 2013 at 3:49 AM

    I am not being insensitive when I state the obvious fact that weight issues, these can be easily controlled. You just watch what you eat and how much exercise you do, and that most of the time will solve the problem. That AND the social issues that may go along with that. This is one of those things that I have a hard time wrapping my head around because it is so easily preventable when many of the other things that we deal with, we don’t have control over in this way.

  • Treavor


    April 8th, 2013 at 9:13 AM

    I had a sister-in-law with real bad anorexia like she almost died a couple of time. she had to go to get help at one of those places where you stay two or three weeks anyways it didn’t really help. She didn’t die or nothing but she was crazy as all get out and she and my brother ended up splitting up. she ended up moving back to where she was from and took both her kids and won’t let them see my brother no more even tho he was like there dad for so many years while she was so sick all the time.

  • R.Y.G.


    April 8th, 2013 at 9:15 AM

    Definitely makes sense that work and social functions would be impaired. In addition to the physical stress of not having enough energy to function properly, you have the emotional stress that comes with lack of self-esteem, etc.

  • Kylie


    April 8th, 2013 at 9:18 AM

    Man, anorexia is a tricky thing. My dad of all people had it and it was so hard on him and the whole family. He ended up losing his job.

    So, then my mom had to get two jobs to support us. In the end, his body couldn’t handle it and he ended up dying.

    Growing up with a dad who was sick was real tough. When people asked me why he died, I was always so embarrassed to say exactly why he died.

    But, I’ve gotten past that now and realize there were a lot of things my dad did that I can be proud of. I just wish my kids had gotten to meet him.

  • Jax


    April 8th, 2013 at 9:19 AM

    So, are there any plans to expand the study to include eating disorders other than anorexia? I think it would make for an interesting read…

  • Patty


    April 8th, 2013 at 9:21 AM

    WSAS is a very helpful tool for me in my practice. I am thrilled to hear of it being used with this particular population of patients. I am excited to see how these results influence therapy.

  • colton y

    colton y

    April 8th, 2013 at 10:56 AM

    And the thing that we have to remember is that so many of these people suffer from low self esteem to begin with, making new friends and feeling entirely comfortable in social settings is not going to be a strength of theirs anyway. When you add that on top of the disordered eating patterns, then that makes it quite difficult for them to cope where most of us could shrug it all off and be fine.

  • Teddy


    April 9th, 2013 at 3:59 AM

    Eating disorders in men are so ofetn overlooked that it is even harder when we have to go through this because it does not feel like there is any help out there that is geared toward us. And to admit this to people that we may not even know that well would be beyond difficult.

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