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Anorexia Treatment and Recovery

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They say, as the humans develop in a respective field, more trouble arise for them to counter. So is with the field of medical, with each ephemeral day we hear about some new-fangled yet very atypical medical terms. We are not familiar with those terms, but this does not mean that it is a new illness discovered; in fact it is lack of information and knowledge that we are completely unaware of the disease. One such disease which has emerged as a stern quandary in last two decades is anorexia nervosa. Probably most of the people are not familiar with what does this mean. The main reason due to which we are not eloquent how fatal or somber anorexia nervosa is the fact that it is regarded as a fashion in fact of being considered as a serious disorder.


Anorexia nervosa is fundamentally the disorder whereby an individual resists consuming food, due to the fear of getting fat or gaining extra weight. This might be a bolt from the blue for some people but this is what is happening these days. It is assumed that this disorder started from Europe and has now spread to most parts f the world. A simpler term to define clearly, anorexia nervosa is “Self Starvation”. People suffering from anorexia are more than just “slimness obsessed individuals”. This is because the obscenity turns into a major problem. The word anorexia comes from Greek language which mean “to loose appetite”. However, this is solely not true as the “loosing of appetite” only appears after a long time. In start it is just the urge or obscenity of an individual to remain slim.

In general the physicians and doctors, normally use 4 simple points to discover is an individual is passing through the disorder of anorexia nervosa or not. The four key points are:

• Fear/Obsession: The first point to decide whether an individual is a victim of anorexia nervosa is to see if they have a fear of growing fat, even though they are not maintaining the average weight required for that age and body.
• Meeting Standards: The next point which helps to decide about anorexia nervosa is to determine if the individual is marinating 15% less then average weight required for the respective body, shape and age.
• Vague Intuition: The next point is to see if the individual thinks that his body is not in proper shape, or if they recognize a single or few parts of their body out of shape.
• Menstrual Cycles: Perhaps the easiest or the most vital point which can help a physician to know if a woman is passing through anorexia nervosa is the disturbance in woman’s menstrual cycles. Usually these women miss at least three of their menstrual cycles. They only get the cycles going if they take hormones.


In end, it is clear that anorexia nervosa is more of a “prized disease”. Women, especially in U.S.A and Europe prefer to stay slim as a part of beauty standards. However, one should know that even if you are passing through anorexia nervosa, there still are enormous chances that you can recover 100% and live a normal life again.
 

Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, a lack of menstruation among girls and women, and extremely disturbed eating behavior. Some people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-induced vomiting, or misusing laxatives, diuretics or enemas.

Many people with anorexia see themselves as overweight, even when they are starved or are clearly malnourished. Eating, food and weight control become obsessions. A person with anorexia typically weighs herself or himself repeatedly, portions food carefully, and eats only very small quantities of only certain foods. Some who have anorexia recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic form of anorexia, in which their health deteriorates over many years as they battle the illness.

According to some studies, people with anorexia are up to ten times more likely to die as a result of their illness compared to those without the disorder. The most common complications that lead to death are cardiac arrest, and electrolyte and fluid imbalances. Suicide also can result.

Many people with anorexia also have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular and neurological complications, and impaired physical development.

Other symptoms may develop over time, including:

* thinning of the bones (osteopenia or osteoporosis)
* brittle hair and nails
* dry and yellowish skin
* growth of fine hair over body (e.g., lanugo)
* mild anemia, and muscle weakness and loss
* severe constipation
* low blood pressure, slowed breathing and pulse
* drop in internal body temperature, causing a person to feel cold all the time
* lethargy

TREATING ANOREXIA involves three components:

1. restoring the person to a healthy weight;
2. treating the psychological issues related to the eating disorder; and
3. reducing or eliminating behaviors or thoughts that lead to disordered eating, and preventing relapse.

Some research suggests that the use of medications, such as antidepressants, antipsychotics or mood stabilizers, may be modestly effective in treating patients with anorexia by helping to resolve mood and anxiety symptoms that often co-exist with anorexia. Recent studies, however, have suggested that antidepressants may not be effective in preventing some patients with anorexia from relapsing. In addition, no medication has shown to be effective during the critical first phase of restoring a patient to healthy weight. Overall, it is unclear if and how medications can help patients conquer anorexia, but research is ongoing.

Different forms of psychotherapy, including individual, group and family-based, can help address the psychological reasons for the illness. Some studies suggest that family-based therapies in which parents assume responsibility for feeding their afflicted adolescent are the most effective in helping a person with anorexia gain weight and improve eating habits and moods.

Shown to be effective in case studies and clinical trials, this particular approach is discussed in some guidelines and studies for treating eating disorders in younger, nonchronic patients.

Others have noted that a combined approach of medical attention and supportive psychotherapy designed spe-cifically for anorexia patients is more effective than just psychotherapy. But the effectiveness of a treatment depends on the person involved and his or her situation. Unfortunately, no specific psychotherapy appears to be consistently effective for treating adults with anorexia. However, research into novel treatment and prevention approaches is showing some promise. One study suggests that an online intervention program may prevent some at-risk women from developing an eating disorder.

This publication is in the public domain and may be reproduced or copied without permission from NIMH. We encourage you to reproduce it and use it in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated.

 

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ED Bites

Bad decisions?

Author: Carrie Arnold

This week is, apparently, a good week for infuriating emails and blog posts. I've written about the email that had me scratching my head (or, more accurately, banging it against my desk). Now it's time to write about the blog post that has me doing the same.

Today, I read the latest blog post from fellow Psychology Today blogger Emily Troscianko, aka The Hunger Artist, who is herself in recovery from anorexia. In the title of her post, she posed the following question: Is Anorexia a Disease, a Series of Bad Decisions, or Both?

Writes Toscianko:

A reader recently made a comment which prompted me to write this post. She said that 'anorexia, despite being a "disease", also involves a series of very bad decisions, for which we as the sufferers must bear some responsibility'. This made me reflect on my own experience, and the various 'points of no return' at which the development of full-blown anorexia became significantly more likely...At any of these moments - before leaving the house for school before the non-breakfast, when at the Swiss supermarket or in the kitchen on my boat in Oxford - I could have identified the danger in what I was contemplating doing, and decided otherwise. In the first of these three examples, I had the 'excuse' of really not knowing where this could lead, although I knew that lying to my family about how I was living couldn't be a good thing; but in the second two examples I knew perfectly well what the consequences would be, and went ahead regardless. Yes, numerous physiological, situational, and emotional factors were contributing in each instance to that decision - a decision is not a freely willed thought act detached from its embodied context - but I did nonetheless have the capacity to do otherwise. Whether that doing-otherwise would on its own have significantly slowed or even halted the progression of the anorexia is impossible now to say, but it's clear that all three decisions did have the opposite effect.



...Expressing personal responsibility through action against anorexia is an act of freedom and of self-understanding. The striking simplicity of what is at the heart of any such step towards rejecting anorexia - the simple act of eating - was what made slipping into illness so easy, and is now what makes climbing out of it a process that is constituted primarily of those trivial-seeming daily decisions. Sitting down now with the meal which you have planned to eat, and deciding to take the first bite, may not be an easy decision to make, but the effects both of doing so and of not doing so are very clear, and the moment at which the decision needs to be made - does this fork go into my mouth now, will I swallow now? - equally evident. All the things that have led you to be sitting here at this table contemplating this plate of food are complex and often opaque, but now that you are here, right now, you can make a good decision or a bad one, and however much an inner voice may whisper afterwards to confuse you, you know which is which.


Here's the thing: anorexia isn't a choice. It's not a decision. It's an illness. Which Troscianko admits. The problem is that these types of beliefs about anorexia and recovery--that the sufferer must actively choose and want recovery--don't always lead to the best outcomes.

For years, I felt like a treatment failure because I couldn't simply make the choice to get better. At the beginning, I couldn't see that there was anything to recover from. As the years passed, I started to see that the eating disorder was becoming very problematic, but I couldn't understand why I was still stuck. After all, I didn't want to live this way, I just couldn't figure out how to untangle myself. I couldn't figure out how to choose to get well.

I might not have been able to choose recovery, but I do have to continually choose to stay in recovery. It's a recovery that, now healthy, I am capable of making. It's a choice I have to make many times each day, and will everyday for the rest of my life. I have to take responsibility for my ongoing recovery, and I have.

An eating disorder isn't an illness of bad decisions. Bad decisions are things like buying a pair of Crocs and thinking you'll look stylish. Or buying a house in 2008 thinking it will make a good investment. We all make bad decisions in lif, and most of the time they come to bite us in the ass. This isn't to say that the innocent-seeming decisions we make in the course of everyday life have nothing to do with whether or not we will develop anorexia. The question to ask about some of my seemingly insane ideas and decisions during anorexia is this: was I actually capable of behaving differently? Not in the metaphorical or existential sense; if you look on paper, of course, I could have put food on my plate. But in the thick of the terror and the throes of anorexia, could I have actually done so? Most of the time, I would say no.

Researchers have found that, in the brains of people with active anorexia, reasoning abilities are significantly impaired (McCormick et al., 2008). Which means that the ability of someone with an eating disorder to be able to make rational decisions like eating more, not throwing up, or going into a hospital program pretty limited. It's not impossible--I've known many people who have done the hard and heroic work of having to choose recovery.

Still, current treatment systems for eating disorders (where they exist) are predicated on the patient's ability to choose recovery. "If you don't want to get better," patients are told, "then we can't help you." Of course, everyone's job would be lots easier if eating disorder patients wanted to get better, just as everyone's life would be easier if cancer cells stopped multiplying, psychotic patients stopped hearing voices, and a diabetic's pancreas started producing insulin again. The difference is that we don't view these failures as willful behaviors. We don't sit around and wonder whether it was a bad decision on the part of your lung cell to start dividing and not stop. Or whether someone who is acutely psychotic should try and stop paying attention to those imaginary idiots giving them directions. We understand (okay, at least some of us do) that this is just the limitations of the illness.

If people with anorexia could simply stop making the bad decision of not eating, then it wouldn't be an illness and there wouldn't be a million-dollar treatment industry.

The problem with believing that anorexia is a choice is that we leave sufferers to die alone in their apartments after years of illness. We discharge long-term sufferers to either figure out how to live with their illness or die. We tell them it's their choice whether or not to use behaviors. These are the bad decisions, not the eating disorder itself.

I'm not saying that people have no responsibility for their health, nor that people can't choose to recover. The thing is this: we shouldn't rely on it, nor should we expect it. Someone who is drunk can't drive properly, and we know this. We don't expect someone who is slurring their words after 10 beers to be able to drive a car. They might be able to get home safely. But we still tell them to call a cab. It's like that for eating disorders.

The real bad decisions, in my mind, are in the hands of treatment providers who expect that their eating disorder patients are fully competent and capable of making good decisions. Maybe they are, maybe they're not. But the desire to recover shouldn't be necessary for treatment.

The Renfrew Response

Author: Carrie Arnold

As I mentioned in the Lipstick post, I received an email about a study conducted about women and makeup use by the Renfrew Center Foundation.

I emailed the PR rep, Jennifer, with the following:

I have a question for you, Renfrew, and Dr. Ressler: I'm curious why an eating disorder organization is studying makeup use in women. I don't see the connection, nor do I see what going without makeup has to do with eating disorders awareness week.


I have a blog post here: http://ed-bites.blogspot.com/2012/01/lipstick-connection.html


I really am interested in hearing a response from you guys. Thanks so much.

Jennifer's response:

Thank you for your response, Carrie.  Attached please find a copy of the full press release which further explains the survey that we conducted as well as our campaign, Barefaced & Beautiful, Without & Within. 


Barefaced & Beautiful, Without & Within is a call to action - an opportunity for women to join together and go without makeup in order to celebrate their natural beauty and start a healthy dialogue about body image, self-confidence and self-esteem.  


It is our goal that through this campaign, we will get people talking in broader terms. For many, negative feelings about one's self-image can set the stage for destructive behaviors, such as addictions or disordered eating.  It is our hope that Barefaced & Beautiful - a community of supporters sharing natural photos of themselves - will promote a greater understanding of how beauty and confidence come from within.


Upon your review, please do not hesitate to contact me if you have any further questions or if you would like to schedule a time to speak with our expert.

The press release was a Word document, which I've copied here:



NEWSURVEY RESULTS INDICATE THERE'S MORE TO MAKEUP
USE THANMEETS THE EYE

Inresponse to study, The Renfrew Center Foundation launches nationalcampaign, “Barefaced & Beautiful, Without & Within,” during NationalEating Disorders Awareness Week

PHILADELPHIA,PA (January 23, 2012) — The Renfrew Center Foundation, anon-profit charitable organization dedicated to advancing the education,prevention, research and treatment of eating disorders, today announced surveyresults which revealed that nearly half of all women have negative feelingsabout their image when not wearing makeup and associate a “bare face” withfeeling unattractive and insecure. Additionally, one quarter of the womensurveyed began wearing makeup at age 13 or earlier. 

This survey was conducted online withinthe United States by Harris Interactive on behalf of The RenfrewCenter Foundation, from December 20-22, 2011—among1,292 women 18 years of age and older. Highlights from the survey include: 

·        AlmostHalf of Women Have Negative Feelings When They Don’t Wear Makeup
Forty-fourpercent of women have negative feelings when they are not wearing makeup,reporting feeling unattractive (16%), self-conscious (14%) and naked/as thoughsomething is missing (14%). Only three percent of women said going withoutmakeup made them feel more attractive.

·        WomenWear Makeup for Both Physical and Psychological Reasons
Almosthalf (44%) of women wear makeup to hide flaws in their skin. They also cited emotionalresponses, with 48 percent noting that they wear makeup because they like theway they look with it and 32 percent agreeing that it makes them feel good.Eleven percent said they wear makeup because it is a societal norm.

·        WearingMakeup is Not Just for Adults
Ofwomen who wear makeup, almost half started wearing it between the ages of 14and 16 (51%), yet more than a quarter of women began using it between the agesof 11 and 13 (27%).

“Wearing makeup to enhance one’sappearance is normal in our society and often a right of passage for youngwomen,” said Adrienne Ressler, National Training Director for the RenfrewCenter Foundation and a renowned body image expert. “There is concern, however,when makeup no longer becomes a tool for enhancement but, rather, a securityblanket that conceals negative feelings about one’s self-image and self-esteem.For many individuals, these feelings may set the stage for addictions orpatterns of disordered eating to develop.”

During National Eating Disorders Awareness Week(February 26 – March 3), The Renfrew Center Foundation is sponsoring a nationalcampaign, titled Barefaced & Beautiful, Without & Within (www.renfrew.org). Through the campaign, Renfrew will encourage women nationwide to gowithout makeup for a day in order to start a dialogue about healthy body imageand inner beauty.

“In this age of toddler beauty pageants,digital retouching, celebrity worship, and other unrealistic cultural messagesabout beauty, there are definite challenges to developing a positive bodyimage; challenges that put women at risk for eating disorders and other selfdestructive behaviors,” said Ressler. “Our hope is that through Barefaced & Beautiful, Without & Within, we will promote greater understanding that real beauty andself-esteem truly begins from within.”

To show yoursupport for Barefaced & Beautiful,Without & Within, The Renfrew Center Foundation is asking for women togo without makeup on Monday, February 27th and promote their participationthrough their social media networks by tweeting a photo or changing theirFacebook profile picture to one of their natural self. Tolearn about participating in Barefaced & Beautiful, Without & Within, please go to www.renfrew.org.

TheRenfrew Center Foundation
The RenfrewCenter Foundation, founded in 1990, is a non-profit, charitable organization dedicated to advancing the education,prevention, research and treatment of eating disorders. The Renfrew Center Foundation is supportedfinancially by private donations and funding from The Renfrew Center,the nation’s first and largest network of eating disordertreatment facilities. TheRenfrew Center now operates eleven facilities in nine states.Through its programs, the Foundation aims toincrease awareness of eating disorders as a public health issue and researchthe pathology and recovery patterns of people with eating disorders. TheFoundation also seeks to educate professionals in the assessment, treatment andprevention of behavioral and emotional disorders by sponsoring an annualconference, as well as numerous seminars throughout the country. To date, theFoundation has trained nearly 25,000 professionals. For information about The Renfrew Center Foundation, please calltoll-free 1-877-367-3383 or visit www.renfrew.org.

Survey Methodology                                                                                                         
This surveywas conducted online within the U.S. by Harris Interactive on behalf of TheRenfrew Center Foundation from December 20-22, 2011 among 1,292 women ages 18and older. This online survey is not based on a probability sample and,therefore, no estimate of theoretical sampling error can be calculated. Forcomplete survey methodology, including weighting variables, please contactHolly Dean at 215.875.4365.

About HarrisInteractive                                                                                
Harris Interactive is one of the world’sleading custom market research firms, leveraging research, technology, andbusiness acumen to transform relevant insight into actionable foresight. Knownwidely for the Harris Poll and for pioneering innovative researchmethodologies, Harris offers expertise in a wide range of industries includinghealthcare, technology, public affairs, energy, telecommunications, financialservices, insurance, media, retail, restaurant, and consumer package goods.Serving clients in over 215 countries and territories through our North American,European, and Asian offices and a network of independent market research firms,Harris specializes in delivering research solutions that help us – and ourclients – stay ahead of what’s next.  Formore information, please visit www.harrisinteractive.com.

So, to some extent, Renfrew isn't trying to deliberately link lipstick and eating disorders. They mentioned disordered eating, not eating disorders, which is very good.But it still rubs me the wrong way for some reason. I guess what I really want to know is why the Renfrew Center is studying makeup use. It just doesn't compute.

Jennifer's email ended with an invitation to speak with Dr. Ressler. I would like to ask her directly the question in the above paragraph. And since I'm going to be sending her the question via email, there's plenty of room to add other questions.


What other questions would you like to ask Dr. Ressler? Feel free to suggest away! I may edit your question slightly for clarity, brevity, or to combine several questions into one. I can't promise that I will submit every question asked, either, but I will do my best to make something comprehensive but not overwhelming.

The Fatigue Saga, or where I've been

Author: Carrie Arnold

As I'm sure some of you have guessed, my blogging has tapered off a bit in the last few months. I'm trying to correct that now, but I figured I owed you an explanation.

At the end of September and beginning of October, I got two viral infections pretty much back-to-back. I bounced back...somewhat...but not completely. Then the fatigue set in, big time.

After a few weeks, I went to the doctor and asked her to run some tests to rule out anything obvious (anemia, Vitamin D deficiency, etc). I also asked her to run an Epstein-Barr virus titer to check for mono/glandular fever. The symptoms were eerily similar to what I had about six years ago when I had mono. I'm not sure if the doctor checked for Epstein-Barr specifically, nor did I ask (I call her Dr. Bitchyface, and I try to have as little to do with her as possible). All the other tests, however, came back normal.

Although I have no definitive diagnosis, I'm still leaning towards mono simply because the symptoms have persisted for so long and seem to have limited connection to mood and anxiety.

The fatigue is starting to lift. I'm mostly back to normal. I still have a day or two a week when all I want to do is sleep, and no amount of coffee can convince me otherwise. It's taken a massive toll on my productivity, which is hard for me to deal with. I'm on the home stretch for my book, which means I need every last ounce of energy I can get.

So that's where I've been and where I am. I'm on the upswing now, and I hope to keep it that way.

The Lipstick Connection

Author: Carrie Arnold

As I've mentioned before, I get lots of email from PR people. Mostly, they neither bother me nor really attract much of my attention. One from this morning, however, did.

First, the pitch:

Dear Carrie,


It’s no surprise that most women wear makeup, but what drives the desire to wear bright red lips on a trip to the grocery store or a face full of foundation to the gym, beach or pool? And how does wearing makeup influence a woman’s self image? I thought you might be interested in covering this on your blog.


The Renfrew Center Foundation, a non-profit charitable organization dedicated to advancing the education, prevention, research and treatment of eating disorders, recently conducted a survey which revealed that nearly half of all women have negative feelings about their image when not wearing makeup and equate a “bare face” with feeling unattractive and insecure. Additionally, more than a quarter of the women surveyed began wearing makeup before age 13.


We’d love to work with you on a story revealing the results of this survey and are happy to provide nationally renowned body image expert, Adrienne Ressler of The Renfrew Center Foundation, to discuss the findings.


If interested, I’d be happy to send a full press release on The Renfrew Center Foundation’s survey on women’s attitudes towards makeup. The release also provides information regarding The Renfrew Center Foundation’s Barefaced & Beautiful, Without & Within campaign, a national call to action for women to go without makeup on February 27th in conjunction with National Eating Disorders Awareness Week (February 26- March 3).


Let me know if this is of interest.

The only thing I can think is: what the HELL does makeup have to do with eating disorders?!?


I know that body image obsessions are common in EDs, and I know that makeup can be part of that. But I almost never wear makeup, and I still got an eating disorder. So I'm just wondering how going without makeup is related to Eating Disorders Awareness Week. It's kinda maybe tangentially related, maybe, if you lump body image distress in with eating disorders.

But really? Makeup doesn't cause eating disorders.

Redoing the mental accounting

Author: Carrie Arnold

So I'm trying to finish up my book. The manuscript is due in a little less than a month, and I'm trying to get the last little bits filled in, the references checked, and so on. It's tedious, hard work. I also don't really have much in the way of an advance (basically, the publisher pays the author $X amount in future royalties up front; the first $X of royalties goes to the publisher instead of the author. After that, the royalties goes to the author. It's basically a gamble on the part of the publisher as to how much money they think the book will earn. I'm working with an academic publisher who operates under a royalties only system. No advance, but once the royalties start rolling in, they're all mine.), which means I have to keep up my regular writing stuff, too.

So I devise daily tasks for myself, like finish Chapter 10, email so-and-so, etc. The most common task, however, is "Write XX words." I like numbers. I like tasks that are easily definable and clear-cut. Things like "work on references" are awfully vague, and I never know how much work is required to be able to check that SOB off my list. On the one hand, discrete goals like writing, say, 1500 words are easier to accomplish because they are so concrete.

On the other hand, 1500 words don't always come magically flowing off my fingers. Sometimes I get stuck, sometimes I spend several hours chasing down a single study that I need to make my point (PubMed is a contact sport...really...), sometimes I have other paying writing jobs that act as a giant time suck. My carefully scripted goal of 1500 (or 1000 or 2000 or 500) goes caput.

That happened on Saturday. I did several lengthy interviews during the day, which were all duly checked off. But I still primarily measure my progress in words per day, which was definitely lacking. I really meant to get more done in the evening, but I got in a groove cleaning my place and then some trashy TV came on, which made me keep cleaning so I could justify my occasionally questionable taste in television programs. As it happened, time passed and here I was at bedtime with hardly any progress made on my book.

I was beating myself up in my head for being lazy and not making progress and I was a crap writer so what business did I have trying to finish a book--a book for crap's sake! But then I started thinking. My interviews gave me a LOT of good material, and I can't really write without doing interviews. I got some cleaning out of the way, which was a good thing.

The problem was that my accounting methods weren't actually factoring in the other important work I was doing. It had become just about the numbers, when in fact, the numbers only tell part of the story of book progress.

I suppose this story says a lot about my focus on numbers and on details at the expense of the big picture. No doubt it does. But this focus isn't necessarily written in stone, either. I might gravitate to it rather naturally, but I also need to work on recognizing the problems I encounter when I do this and work on bringing my vision back to be more holistic.

Sunday Smorgasbord

Author: Carrie Arnold

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

Lack Of Sleep Might Make You Feel Hungrier.

Warning: Dieting Increases Your Risk of Gaining MORE Weight, Independent of Genetics.

The first artificial sweetener poisoned lots of Romans. Mmmmm...lead (II) acetate...tasty and calorie free!

A Bridge to Recovery on Campus.

Exercise Can Reduce Anxiety in Women.

Psychological and behavioral traits associated with eating disorders and pregnancy: a pilot study.



Too many US adults with mental illness don't get treatment.

How Frequent Are Eating Disturbances in the Population? Norms of the Eating Disorder Examination-Questionnaire.

The Exhilarating Effects Of Exercise.

Online counselling for eating disorders: Reaching an underserved population.

What To Do the Morning After a Binge.

Made with love, cookies do taste better. The way we read another person's intentions changes our physical experiences.

Age at menarche and digit ratio (2D:4D): Relationships with body dissatisfaction, drive for thinness, and bulimia symptoms in women. Digit ratio is a way to study your androgen exposure in utero.

No Proof Paula Deen’s High-Fat Southern Cooking Caused Her Diabetes.

Adolescents' brains respond differently than adults' when anticipating rewards.

Is There a Perfect Human Diet?

Great article on 'The Age of Anxiety' in this weekend's New York Times.

Anorexia nervosa: patient and family-centered care.

Mindful Eating Restaurant Study-Folks trained in mindful eating ate fewer calories, regardless of portion-size served.

Poor Cognitive Flexibility in Eating Disorders: Examining the Evidence using the Wisconsin Card Sorting Task.

5 Intriguing Facts About Intuitive Eating.

The war on fat backfires. Understanding “Weight” as Social Identity.

Early response to treatment in adolescent bulimia predicts outcome.

The value of solitude and introversion in a world that praises collaborative creativity.

Binge eating, purging and non-purging compensatory behaviours decrease from adolescence to adulthood: A population-based, longitudinal study.

Ecological momentary assessment of bulimia nervosa: does dietary restriction predict binge eating?

The effect of gonadal and adrenal steroid therapy on skeletal health in adolescents and young women with anorexia nervosa.

Talking to reporters

Author: Carrie Arnold

I got this question on my ED Bites Facebook page, and thought it was such a good one that I wanted to share it on my blog and get feedback from all of you. Ideally (when I get the time after my manuscript is due), I would like to compile this into a guide for how to talk with the media about eating disorders.

So here is Lindsee's question:

Ok I might need some help because I think when I polietly spoke up after I thought about this about a question on why our state makes this big deal each October and April with a month spread on Autism and Breast cancer awareness, but never really paid much attention towards eating disorder awareness month, I apparently got a response from one of the editors and reporters. They like to do a story or piece so I guess does any of the members have any suggestions they like me to maybe adress or say.

You can comment either on the blog or on the Facebook page.I think it's a really important topic and I'd love to hear what all of you have to say!

Sometimes...

Author: Carrie Arnold

For everyone out there who is struggling and trying to hang on right now, remember this:

Sometimes things don't go, after all,
from bad to worse. Some years, muscadel
faces down frost; green thrives; the crops don't fail;
sometimes a man aims high, and all goes well.

A people sometimes will step back from war;
elect an honest man; decide they care
enough, that they can't leave some stranger poor.
Some men become what they were born for.

Sometimes our best efforts do not go
amiss; sometimes we do as we meant to.
The sun will sometimes melt a field of sorrow
that seemed hard frozen: may it happen for you.


--"Sometimes" by Sheenagh Pugh

Male eating disorders

Author: Carrie Arnold

Men get eating disorders, too. A British organization by the same name has a website and Twitter account by the same name. Eating disorders information can be found at the website for the National Institute of Mental Health, and also on the website for information on women's health. It implies that eating disorders are just a women's issue.

As the Kartini Clinic blog pointed out last week, one of the very first medical descriptions of anorexia was of an adolescent male. In 1689, believe it or not. So the idea that eating disorders are "just" women's issues is actually quite wrong.

The problem is that after Richard Morton first described anorexia in 1688, later medical doctors lumped anorexia in with "hysteria." Hysteria is derived from the Greek word for the uterus (which is why you get a hysterectomy), which means that men automatically can't be "hysterical" in the nineteenth century, technical usage of the word. Which is where we started to go wrong.

Later conceptualizations of eating disorders continued to exclude men, because eating disorders were seen as a female over-concern with one's looks, or a diet gone wrong. Men, it seemed, didn't face these pressures and/or were too smart to fetishize the size of their asses. Since men didn't face the body image pressures that women did, men couldn't get eating disorders.

It's bollocks, by the way. If you're human, you can get an eating disorder.

I'm blogging about this not just because I've been reading stuff about eating disorders in males, but also because I got a press release emailed to me this morning about a symposium on male eating disorders at the 2012 IAEDP conference this spring.  The tag line was:

Our latest news shares the sad and startling fact that one in three men are willing to shorten their lifespan just for the sake of better meeting society's image of the "ideal" man.

Huh?

I mean, there are just so many things wrong with this. First of all, eating disorders have existed long before current body ideals evolved, so that can't be the cause. Second, an eating disorder isn't being "willing to shorten your lifespan." That's like saying someone is willing to develop cancer so they can lose weight from chemo. Eating disorders aren't choices. They aren't about vanity or looks. They're a real biologically-based illness that kills, not because vain and vapid people of all sexes and genders are too self-absorbed to stop harming themselves, but because they have an illness that we generally suck at treating.

Also, I'm not sure of the scientific validity of a hypothetical "would you rather" question in assessing body image issues or eating disorders in any population. Nor are people with eating disorders actually making these decisions. Like I said, it's an illness, you idiots.

Of course, what I got was a press release and promo information. I don't know exactly what the presentation is going to contain. The email I got did say that they were also premiering a male-specific eating disorders assessment, which could be a very good thing. I haven't seen it, so I can't say for sure.

It's just that perpetuating these myths about what causes eating disorders doesn't do anyone any good in the long run. Yes, issues of eating disorders in males does need more attention, but could we at least get the facts right first?

(Belated) Sunday Smorgasbord

Author: Carrie Arnold

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

Study Finds Problem Drinkers Get Bigger Endorphin Kick.

Is mental illness culturally specific? Fascinating read on the different ways we go mad.

This week in "No shit, Sherlock" science: Watching 'The Biggest Loser' may increase anti-fat attitudes.

And more on Sherlock- how the detective used statistics and the science of personality.

Scales don’t carry that much weight in determining health.

A randomized controlled trial of adjunctive family therapy and treatment as usual following inpatient treatment for anorexia nervosa adolescents.


New guidelines on the care of young people with anorexia nervosa from the Royal College of Psychiatrists.

Clinicians May Have Negative Attitudes Toward Patients With Eating Disorders.

High prevalence of eating disorders not otherwise specified in northwestern Spain: population-based study.


Eating Disorders Recovery Q&A.

“Photo-Therapy:” A Promising Intervention in Anorexia Nervosa?

Anxiety in anorexia nervosa and its management using family-based treatment.


Making the Case for Size Acceptance.

Disordered eating and suicidal intent: The role of thin ideal internalisation, shame and family criticism.


NPR's Science Desk Experiments With Twinkies. It's a tough job, but somebody's got to do it...

Weight is the number one reason kids are bullied.

How pregnancy triggered one woman's long-dormant eating disorder.

How (CBT) Therapy Has Worked For Me.

Exercise Hormone Helps Keep Us Healthy.

Moving from an Eating Disorder's Half-life to Your Full Life.

New blog article about the treatment of orthorexia using CBT and Mindfulness Based CBT.

Emotional Processing Following Recovery from Anorexia Nervosa.

'Tis the Season

Author: Carrie Arnold

...for dieting, that is.

Most of us learned about the four seasons when we were younger, about spring, summer, autumn, and winter. Considering I grew up in Michigan, there were really two seasons: winter and three months of bad sledding. Now that I'm an adult, and living south of the Mason-Dixon line, there are many more seasons than I experienced as a kid in Michigan. To everything, there is a season, and to every season, there is a reason to diet.

Winter: It's your New Year's Resolution to have a Totally New You by developing those Buns of Steel. (I'd settle for buns of cinnamon, but then, that's me.)

Spring: It's going to be Bathing Suit Season soon, and you had better fit in that Itsy Bitsy Teeny Weeny Yellow Polka Dot Bikini you wore when you were three. So it looks like a thong. So what. I hear they're popular these days!

Summer: It's Bathing Suit Season and EVERYONE IS GOING TO SEE YOUR FAT ASS IN THAT BATHING SUIT SO YOU BETTER STOP EATING, YOU FAT PIG.

Autumn: Do NOT gain weight over the holidays, and here's how (you can start by not celebrating the holidays at all).

Ta-da! The year in dieting. Winter season is the worst, and right now about all I seem to hear commercials for are end-of-the-year car sales, cigarette cessation aids, and diet products. It makes me almost pity the poor guy who's trying to hawk replacement windows so that people can get their tax credit.

Almost.

Jeopardy!, the game show for grandmas and geeks like me, Jeopardy! for crap's sake, is now sponsored in part by a colon cleanser (aka, an overpriced laxative that just really dehydrates you and then you take a drink of water and bloat from here to Timbuktu. Trust me, kids, don't try this at home).

The Diet Survivor's Group blog has a list of alternate dieting headlines for magazines to use. Start with these examples and then you might just have a fun game to play in the checkout aisle at the grocery store.

Self Magazine:
The Food Lover's Diet - 31 Tiny Tricks That Peel Off Major Pounds
My Edit:
The Food Lover's Diet - Eat What You Love and Savor Every Bite

Allure:
The Easiest Diet Ever: Drop 600 Calories A Day Without Feeling Hungry
My Edit:
The Easiest Diet Ever: Eat When You Are Hungry And You'll Never Feel Hungry (duh!)

Shape:
How We Lost 477 Pounds Together: 6 Women Share The Diet Secrets That Worked For Them
My Edit:
How We Raised Our Consciousness Together : 6 Women Share Their Wisdom And Empower Each Other

Fitness:
Your Best Body Ever
My Edit:
Your Body Is The Best Body Ever

O Magazine:
How To Get What You Really Want This Year: Weight Loss That Sticks - Dr. Oz's Simple Secrets For Keeping The Pounds Off
My Edit:
Keep Working Toward Getting What You Really Want This Year: Body Satisfaction That Sticks - Dr. Oz's Simple Secret Is That There Is No Secret For Keeping The Pounds Off.

Seventeen
Total Body Confidence - Great Abs, Butt & Legs By New Year's
My Edit: (I got kind of hopeful with the first part...)
Total Body Confidence - Enjoy Your Body In Its Fullness All Year Long

Us:
The Biggest Loser - How I Did It!
My Edit:
The Biggest Winner - How I Did It! Tips To Love, Respect, And Honor Yourself
Woman's World:Break Through Ohio State University BELLY FAT CURE! Discovery - Two Spoonfuls Of This Oil Will Block Fat Storage! Melt 5" Of Belly Fat - No Diet Required!
My Edit:
Woman's World Announces Bankruptcy As Readers Boycott Magazine Due To Outrageous Claims!


I guess this game beats hibernating...

{{brought to you from the archives...}}

Return to the RD

Author: Carrie Arnold

Have any of you guys ever sat down to blog, knowing you had a great idea, but then after staring at the screen for 15 minutes, realized you couldn't remember what the hell it was?

No?

Oh, well then. Me, neither.

Anyway, I finally remembered what I wanted to say at about 2am, which was really too late to be helpful yesterday, but I am finally sitting down to blog this afternoon.

So I've started seeing a dietitian again. I had a few appointments last year, and it's been about two or three years since I really saw an RD with any sort of regularity. In the past, when I'd started back up with a dietitian after a hiatus, it was usually because I was in some sort of crisis mode and was futilely trying to put a Band-Aid on the bullet hole. Occasionally it worked, mostly it didn't.

My therapist has been talking me for a while about returning to a dietitian for a while. Not because I'm doing poorly or having troubles but so I don't in the future. I've been enjoying cycling and such, and I've started doing the occasional longer weekend ride with a group I found. When I've tried to increase my mileage in the past, it's either been an ED-related motivation and/or the exercise has gotten ahead of me and I've ended up in relapse mode.

The general idea, I've been told, is to avoid this in the future. Enter the dietitian.

We had our first session a few days ago, and mostly we discussed how I need to add more protein to fuel my workouts. She also mentioned that I might want to try eating more earlier in the day so I don't get so hungry at night. I, of course, instantly interpreted this as "YOU EAT TOO MUCH YOU FAT, DISGUSTING PIG!" Which isn't at all what she meant, and once I calmed down enough, I was able to make sense of it. My weight is stable, clearly I'm not eating too much.

Clearly, there's plenty of stuff to work on, not to mention things like flexibility, etc.

We meet again in two weeks.

It should be interesting, as I've never really worked with a dietitian while in serious recovery mode. She has been very helpful to getting me to where I am today, but we've never really had a "Carrie is doing well" kind of relationship. So we shall see.

Sunday Smorgasbord

Author: Carrie Arnold

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

Binge-eating and depression go together in teens.

Who pays for treatment of eating disorders?

Theory of mind in bulimia nervosa.

New specialist eating disorders unit in Scotland months behind schedule.

Experts urge BMI method for calculating weight in kids with eating disorders. It's better than throwing darts, but I think clinicians should use information from growth charts whenever available.

Racial/ethnic differences in adults in randomized clinical trials of binge eating disorder.

Great piece on Hope and Full Recovery.

The Starving Brain--FINALLY a magazine article about EDs that actually *gets it*!!!

Everyone has reasons for NOT getting treatment...but that doesn't mean we can't shake it off and move forward.

The usual results: dieting leads to putting on weight later.

Royal Society Christmas brain lectures available worldwide.

Totally unrelated to anything ED, but...what happened to "British accents" in 1776 America.

Tired of all the weight loss ads and diet products being thrown in your face? So is she...

More Examples of Women as Food as Women.

A call for better guidelines in diagnosing and treating childhood eating disorders.

On why guilt and shame don't work in anti-obesity ads.

Article highlights the troubles of EDNOS-- great to see this getting press coverage!

Living a healthy life may or MAY NOT include weight loss, study finds.

The American Dietetic Association gets a new name.

Drawing mental illness – just amazing.

Internet cognitive behavioral therapy for binge eating.

Diagnosis of Borderline Personality Disorder is Often Flawed.

Sad lonely lady rats may really eat their feelings.

Bracing for the Fake Sugar Rush.

Discourage teens to engage in frequent self weighing as per this research.

Why change is so hard and what you can do to make it easier.

Selective Attention of Patients With Anorexia Nervosa While Looking at Pictures of Their Own Body and the Bodies of Others: An Exploratory Study.

Lessons from oversleeping

Author: Carrie Arnold

I overslept today. My sleep schedule hasn't approached anything that could reasonably called a "schedule" for several weeks (night owl + insomnia = chaos!), so it's probably not all that surprising. The problem was that it was late enough to throw off my food schedule for the day. I'm not on some sort of tight schedule where I need to have breakfast at X o'clock and lunch at Y o'clock, and so on. But I do like to have at least some break between meals so I don't get too full.

So I made up my breakfast at some embarrassingly late hour and then sat down to eat. While I was munching on my peanut butter toast, I started to think: okay, so how am I going to get all my food in today?

I was thinking and making adjustments--I have a crochet group in the afternoon that meets at a coffee shop, so adding a latte would be easy to get in some extra energy without feeling overly full, and then get something to eat along with it. Or I could bring some trail mix. And then add something extra in the evening, and all should be good.

Which is when it hit me: instead of planning how to "get away with" eating less, I was planning how to keep in recovery.

I don't think I've ever done that before. I've gotten past the point where I look for opportunities to restrict, but it's been much harder to *not take them* when they arise. And this was a great excuse. After all, I was sleeping, which isn't really known for its calorie-burning potential. Since I didn't wake up until almost essentially lunchtime (I'm, like, seriously moritified over how late I slept, yo), just crossing breakfast off the list would have been super-duper easy.

Except I didn't. I shifted a few things, and added them in here and there and tried to be flexible. It wasn't always ideal, but I was committed to making it work. And that's a really cool place to be.

When bad body image isn't about the body

Author: Carrie Arnold

I remember going to a therapy appointment quite a few years ago, flinging myself into the chair and promptly launching into a ten-minute-long tirade about how fat this complete idiot was making me. Didn't she see how huge I was? And she still wanted me to gain weight?!?

After I came up for air, my therapist looked at me and said with a voice that can only be described as overly saccharine, "Now, Carrie, we know that bad body image really isn't about how we look. Why don't you tell me what's really going on."

The reframe sent me further into a rage. Don't patronize me, I said. I'm feeling fat because I am fat and that's it. There's nothing more to it. Period. End of story. So why don't we talk about what we're going to do about my need to lose weight now that you've porked me up.

And so on. The session would not be classified as "productive."

With time, maturity, and proper nutrition, I've come to realize that my therapist had a point. I remembered her point today, when my work schedule can only be described as a game of Whack-a-Mole on meth. I'd send one email, and other editor would ask for art. I'd send some potential images, do the changes on the previous email. While making those changes, editor #2 would write back and say those images don't work, do you have any more? So I'd search for some, and then editor #1 would write back and...well, you get the idea.

I was stressed and on edge, almost ridiculously so. Perhaps not surprisingly (to my ex-therapist, at least) the feelings of body dysmorphia, body hate, and generally feeling "fat" came back. It got me thinking to something my friend Charlotte said about her daughter. Maybe the "fat" feelings weren't really about fat at all. Maybe it was anxiety that she was trying to translate the best way she knew how. Given our culture's general angst around food and weight, maybe this is how we make sense of anxiety. It's got to be about food and weight, right? What other explanation can there be?

Obviously, this isn't the only explanation, but the more I think, the more I'm beginning to understand the validity of this. My stress today had zero to do with food or weight. Zilch. And yet I immediately started fretting about what I was eating and what I must weigh. Logically, I know my weight is probably the same as it was yesterday, and the day before that, and... I know that emails from editors don't magically make my thighs expand (seeing how many emails I get each day, that's probably a good thing). But that didn't stop my brain from diving into those old, familiar depths.

I don't think that this is the sole explanation for body dysmorphia in eating disorders--one of the emails today was from a piece about body dysmorphia that's will publish shortly--but I do think it explains why stress is such a trigger for so many of us. Our brains are just trying to make sense of something we can't explain, so we do the best we can with the vocabulary we have. My own vocabulary happens to be marinated in the larger culture of diet obsessions. Maybe Catherine of Siena would have worried about her abilities to be holy if she were in my shoes (and they had email and Whack-a-Mole in the Middle Ages). That might have been how she made sense of her compulsion to starve herself. I have the same compulsion, but a very different culture that provides a very different vocabulary.

It would have been nice--and much less patronizing--if instead of just saying "We know bad body image isn't about our bodies..." with an unavoidable patronizing undertone, my ex-therapist had said that sometimes our brains don't translate anxiety properly. That sometimes we get confused and attribute worries about something else to worries about food and weight.