It's your mom's fault? Words and genes: what we can do about eating disorders

It's all your mother's fault.

Really, it's about lack of approval from your dad.

If you're a boy or a man, it must mean you're gay.

If you aren't underweight you certainly don't have anorexia.

As long as you're eating healthy foods, you're okay.

It's simply a choice.

Once you've had it, you'll never truly recover.
It's all about appearance and weight.
You have to be ready to recover.

True statements? Not at all. These commonly held misbeliefs about eating disorders do only harm. They minimize the complexity of eating disorders and the struggle of those suffering with anorexia, bulimia, and binge eating disorder. 

They prejudice everyone from those living with an eating disorder, to providers treating those they may or may not know have eating disorders. 

They lay guilt on parents who may be among the best supports for their kids in recovery, as evidenced by the FBT model. 

They stereotype people based on weight--as if BMI alone determines severity of eating disorders! My normal weight patients who subsist on 400 calories surely know better. As do those of my disordered obese patients who have struggled with size discrimination for most of their lives and are no less free of obsessive thoughts, patterns of severe food restriction and symptoms of starvation. Yes, weight, size and appearance mislead.

And if we wait until someone is "ready" to recover, it just might be too late. Yet just these past weeks I've heard that this was the guidance conveyed by a therapist 'treating' a patient with an eating disorder--"you've got to wait until you're ready" they were foolishly advised; no, undernourished people don't tend to make the wisest and healthiest decisions. That's right up there with the wisdom of the cardiologists who recently minimized the very serious risk of severely restricting intake; suggesting no need for worry because Sara was not actively purging (simply overexercising and restricting) or that Dan's low heart rate must just be a result of being an athlete (a starved one, that is, with a low metabolic rate).

Yes, there is work to be done.

Eating disorders need science, not stigma

Here's yet another brilliant idea from Cate Sangster (the first I'm familiar with is her suggestion for an eating disorder recovery cookbook, which we created to great acclaim--food to eat). This time, in recovery, Cate puts her social media savvy and creative thinking to great use with this ice bucket alternative to help us get answers about eating disorders. Like Cate, I support Dr. Cynthia Bulik's move to create a genetic database to better understand eating disorders, and the organization, Charlotte's Helix which was created to help make it happen. In the US, check out this link to ANGI to donate. Please check out the resources on this site as well, to arm you with correct information about eating disorders.

"Learn From Genes, Not Jeans, About Eating Disorders."

I have followed Cate's lead with my educating arm (pic on right), and encourage you all to do the same--and to donate $20 to Charlotte's Helix or ANGI or other worthy eating disorder organizations. Share your pics  on Twitter, Pinterest and Facebook, too! 

Declare Your Freedom: Gaining independence from diets and disorders.

This stormy day, oppressed by the weather and the limits on my freedom to enjoy the outside, I find myself home, contemplating your freedom. It’s July 4, a national holiday in these united states.  Fortunate to have been born in the US, never oppressed by my government, I take for granted the freedoms that some yearn for. Yet through my day to day interaction with patients, I’m painfully aware of how enslaved many are by their own thoughts and actions—though admittedly not by their choosing. Most wish not to suffer, but feel entrapped; they are overwhelmed by the rules which dictate what’s acceptable to eat and the intrusive thoughts and judgments about their eating and activity. They irrationally fear anything from white flour and sugar to fats. Sometimes the type of foods is not the issue, but the portions are. At first glance, a food record may look impressively normal—until I probe about quantities consumed—the limited bites here and pieces there that are actually consumed.

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness…”

While this preamble to the Declaration paves the way to addressing national independence, it’s predicated on individual rights.  Yet how many of you acknowledge these basic entitlements?

Equality. Do you feel that your needs should be considered equally with those around you? Do you consider your needs—for time for yourself, for eating when you need to and what you feel like? Do you feel deserving of pleasurable dining experiences? Or is such pleasure only for other people to experience?

Life. A full and satisfying life. Yes, you are deserving of this too. A healthy life, allowing you to engage in whatever you enjoy. A life not eaten up by self criticism.

Liberty. Freedom from food rules (barring medically critical ones, like avoidance of an allergen that causes a reaction). And liberation from mental hoops you jump through whenever you consider food and eating. Must you feel guilty if something tastes ‘too good’?

The pursuit of happiness. Can you even imagine what this is? Do you remember what you were passionate about before food and diets snatched it all away? What do you dream about when you free yourself from the bitterness of your diets, of your restrictions, of your unrealistic expectations for size?

Freedom can be scary. But independence from both diets and disorders is the sure way to support life, liberty and the pursuit of happiness. I don’t think it’s simple. But taking a stand for change is a valuable first step.Seek out supports--an experienced therapist, dietitian and medical provider can help. But also use your close connections--don't be afraid to ask loved ones for help. Become informed--there's a wealth of posts on this blog on nutrition realities and great links to other reputable bloggers and websites, as well as my books, drop the diet and food to eat, coauthored with ASPIRE's founder, Cate Sangster.

What steps will you take to declare your independence?

More on this topic:

• http://dropitandeat.blogspot.com/2011/04/slave-to-diet-deprivation.html
• http://dropitandeat.blogspot.com/2011/04/over-30-or-40-and-struggling-youre-not.html
• http://dropitandeat.blogspot.com/2012/04/0-false-18-pt-18-pt-0-0-false-false.html
• http://dropitandeat.blogspot.com/2012/03/youre-invited-to-celebrate.html

Do you ASPIRE to recover from your eating disorder?

Is your eating disorder your own little secret? Do you hesitate to confide in others, fearing they just wouldn't get it? Do you wish you had support from someone knowledgable about the struggle to recover, yet safe to share with?

Introducing the desperately needed ASPIRE, created by Cate Sangster, who knows a lot about these struggles, as you'll read. We connected through this blog as she embarked on her journey to recover, created a book together and are now dear friends. So read on and then visit ASPIRE!

"Ask someone off the street about eating disorders and they’ll probably tell you about skinny young girls with too much vanity and not enough substance to their lives. But those of us in the know, understand that the true landscape of eating disorders looks very different to this. 

Firstly we understand that eating disorders are not a lifestyle choice. They are not about vanity or attention seeking, but rather they are a severe mental illness that cannot be cured by guilt and ridicule. 

Secondly eating disorders are not just about anorexia. Bulimia and BED are far more prevalent and equally as devastating to the sufferer, both in terms of mental and physical health. 

And thirdly, we also recognise that this is not an illness that strikes only young girls. Increasingly it is being seen in older women as well as men. However little exists in the way of exclusive treatment centres or support networks for older adults.

ASPIRE, or Adults Supporting Peers In Recovery from Eating Disorders is group I started recently to fill the gap I felt existed for adults with an eating disorder. During my own recovery from anorexia I found that one of the places I felt most at home was on the FEAST facebook page, and Laura’s Soap Box (the FEAST founder’s personal blog) as the people on these sites were not only adults, but also parents like me. However these sites were set up to support carers – the parents of young ED sufferers – so was not really my place. As much as I enjoy Laura’s perspective on things, as well as the information shared by the parents, it is not set up to support sufferers.

This is where ASPIRE fits. Adults need information and support – we are often in the treacherous position of being in charge of our own recovery, as well as, in some cases, needing to raise a family at the same time. We have unique problems, but also unique skills and insights that we can use to help each other through the minefield of recovery. Being in charge of our own recovery means we have to make the decision to attend appointments, make and eat appropriate meals, take medication, hold down jobs, pay bills etc, all while our eating disorder is in control of our minds. Not impossible, but very difficult, especially when you are not accountable to anyone but yourself (and your eating disorder).

So where can you find ASPIRE?

-        blog – adult recovery tips and answers to questions from readers

-        facebookgroup - *new* a space for members to ask questions, reach out for support and provide advice to other adults sufferers

-        twitter – random thoughts on recovery, RTs from other ED tweeters and respected researchers, as well as inspirational quotes to get you through the week

-        pinterest – boards for recovery motivation

How can ASPIRE help me?

•        providing you with information about recent ED research
•        providing you with motivational advice and information
•       providing you with support  - talk to other adults in recovery, ask questions about the things that are on your mind
•        and you can provide others with support when you are in a good place – helping others gives great purpose to our lives. We have a wealth of experience we can use to help others just starting out on the recovery journey.

-          

The value of ASPIRE will increase with every member that joins. The more members we have to support each other and provide advice on the myriad of complicated situations that arise during recovery, the better!! Start by visiting the blog to find out more.

Look forward to meeting you soon."

Cate

http://aspire-network.blogspot.com.au/2014/02/welcome-to-aspire.html

I Had No Idea! Secrets About Eating Disorders

We can't always tell just by looking at someone 
that something isn't right.

There are no excuses for perpetuating misinformation about eating disorders. No justification exists for minimizing eating disorders based on BMI, for generalizing them by age or gender, or for continuing to blame parents for causing them. While the news media may sensationalize and sometimes distort research, social media can fight back to correct misinformation. So read on, and please share!

Today starts a week devoted to spreading the word about eating disorders with the theme “I had no idea!” Thank you NEDA, the National Eating Disorder Association and promoter of Eating Disorder Awareness Week, for inspiring this post.

Random thoughts come to mind when I consider what this theme means to me—and what it might mean to you.  My beliefs and knowledge about eating disorders have evolved over many years, to which I credit the Academy for Eating Disorder listserve, the FBT researchers and Laura Collins and FEAST, blogs like Carrie Arnold’s  and my many, many awesome patients and colleagues. 

What I’ve learned over the decades

Got your period? This doesn’t minimize your diagnosis of anorexia, if you meet the other criteria. And resuming menses after being without a period does not mean you have fully recovered. No, the work is not yet done.

Obese and anorexic? How can that be? You do not need to be below the BMI chart to meet criteria for anorexia. Really. Unfortunately, you are the ones who most often fall through the cracks. And you are continually subjected to messages that your weight is the issue. I am truly sorry for this. Health care professionals need to be educated! 

Eating disorders are quite common in males, straight and gay. Males get anorexia, and struggle with bulimia and binge eating. Their focus on bulking up their muscle mass may seem like a cultural norm, but may be the sign of an underlying disorder. Check out Roberto Olivardia’s work on men and eating disorders.

Time to look at eating disorders a bit differently.

Over 30 or 40 and struggling with an eating disorder? You are not alone! Eating disorders are not just a teen thing. You can be living with an eating disorder at any age—an eating disorder that never resolved, one that reared it’s head again after previously recovering, or one that developed later in adulthood. Check out Dr. Cynthia Bulik’s work on this population. 

Parents don’t cause eating disorders. And parents shouldn’t be sidelined in the treatment of kids with eating disorders. They play an integral part in recovery, particularly when your poorly nourished brain fights you on eating. Learn more about how families can help from FEAST, from scholarly articles and other from resources.

Barbie didn’t cause your eating disorder. Sure, the media may impact how we see ourselves but eating disorders are much more complicated, involving genetic predisposition, environmental triggers and support for maintaining the disorder. We don’t know exactly what causes eating disorders, but it won’t be long before we understand the genetics. See what research is underway and how you can help the study of eating disorders and genetics.  

People don’t plan to have an eating disorder. It’s not a decision sufferers made. Individuals with anorexia, bulimia and Binge Eating Disorder aren’t simply refusing to change when they maintain their behaviors. Change is complicated—by fear, anxiety, and hard wiring of behaviors. My patient shares some wisdom we can all learn from here. 

It’s not so easy to just do it as this post describes. In spite of my many years of working with clients with eating disorders, I don’t think I fully grasped how many obstacles to change there can be—that is until Cate. Writing Food to Eat and feeling I was living her struggle with her was beyond enlightening; it heightened my sensitivity to things I had taken for granted—the planning to eat, shopping, cooking, and ultimately eating. 

Let's work to not live by diet rules and restriction, 
but to trust what our bodies both need and enjoy.

Recovery is possible, even for those who have lived with an eating disorder for many decades. But it has to start with the belief that change is possible. Connect with a treatment team-a therapist, an eating disorder dietitian and an MD, and reach out to friends and family for support. I now know that it is not too late to.

Want to help others recover? Share this post to increase awareness of eating disorders, and check out this awesome new eating disorder support by Cate. 

Oh, and please tell me what you think! Thanks for reading.