Sunday, September 7, 2014

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! 


  1. From one of your normal weight patients who often subsists on 400 calories...I appreciate this post. Being 'anorexic' and not underweight (frankly I am completely average weight) is very difficult. From one perspective it keeps the suffering invisible (pros and cons), from another perspective I feel like a fraud. My eating disorder tells me that I am not working hard enough and not doing my best at being 'disordered' - such greatness to aspire to! Sometimes, because eating 400 calories somehow does not result in weight loss (I will never understand this), I decide I might as well eat. But then, the thoughts creep in that tell me that if I do so I will only get fatter and fatter. Then I am back at the start. Thanks for this post. Ps. Love the arm art!

  2. To Anonymous above-- what you wrote is exactly what I was thinking and feeling as I read this post. I'm stuck in the same cycle that seems to swap every few days. For a few days I feel like I might as well eat...then I panic and go back to my super low calorie amount. I'm thin, but "normal" looking to everyone else. My family and closest friends compliment me all the time which makes me feel even worse.
    The misbeliefs even extend even as far as treatment goes. I spent months with a therapist who minimized my ED and tried to get me to stop going to the RD and weekly doctor's appointments. Once I fired that therapist and found a new one, she convinced me to do a treatment program. Unfortunately (or really, fortunately!) my bmi is not low enough for an anorexia diagnosis and I don't purge, so no bulimia diagnosis either. Insurance won't pay for treatment for EDNOS (or whatever it's called now). Blergh. So many misbeliefs still exist! It's refreshing to read this blog and get a blast of sanity once a week!