anorexia

Round Up of ICED 2016

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It’s been more than a week since I’ve returned from the International Academy of Eating Disorders annual conference (though returned is really a silly word as it was only 12 miles from my house this year), and I’m finally able to sit down and gather my thoughts about it. If you’ve never been, even if you’re not a clinician, I highly recommend. There is a lot of advocacy and research there and many things to learn.  Next year it’s going to be in Prague! I certainly won’t be able to go, but I was psyched to have an opportunity to go this year as it was in San Francisco. With two littles at home, big travel is hard.

There were  a few main themes ICED 2016 (International Conference of Eating Disorders) that were floating around:

Eating disorder research and treatment vs. obesity research and treatment.  Wow. There was serious, serious controversy there. This is because obesity researchers as well as state funded grants (think NIH) are still using ideas such as food restriction, caloric restriction and BMI to measure recovery. All eating disorder clinicians and researchers have evidence that all of this, dietary restriction, BMI, “weight management” and dieting all lead to disordered eating patterns. Obesity researchers believe that obesity has to be treated because it leads to heart disease, Type II diabetes, etc. But Eating Disorder researchers and clinicians (and me too!) believe that when you focus on the obesity as the health problem, you are doing a disservice to the patient – you should be focusing on health and treating the specific disease. “Treating Obesity” continually leads to failure. Obesity isn’t a disease, but heart disease is.

Next off we discussed ADVOCACY a whole lot. People often think of eating disorders as a white woman’s disease, but the truth is that EDs hit not just white women, but women AND MEN across all races. In fact, Latina women have a higher incidence of eating disorders than white women. But most people of color or folks who aren’t cisgender tend to shy away from treatment – for many reasons. It’s not accessible (affordable), it’s not relatable- treatment is geared toward one gender and one race, and it’s stigmatized and unsupported by family and community. For instance, many years ago I had a client who, despite the fact that she had a horrific case of bulimia, her family would not support her treatment because they said it was a “white women’s disease.” She did come in for treatment and got great support from our treatment center and the treatment community but not from her family or her own community. This is not an uncommon situation. The fact that she came in for treatment is really fantastic, but most people don’t.  The conference spoke a lot about getting it out there that EDs strike everyone everywhere and nobody should be ashamed to try and get help. And, as a community of ED professionals- we have to provide more help in different and more accessible ways. So lots to do there. And a note, if you are a human being who is not a white woman and you are suffering from an ED- please do reach out (you can even reply to this post) and I’ll point you in the right direction for treatment- thanks to this conference I have some really great resources now.

I met some of my heros of Eating Disorders, like Deb Burgard – and I was really seriously starstruck and took a selfie with her- it was more exciting to me than meeting say Johnny Depp (but honestly that would excite me too).  If you don’t know about Deb, please click her name above and check out her work. She is a brilliant Psychologist, speaker and advocate for size diversity and Health at Every Size.  I also got to meet Lizabeth Wesely-Casella from Bingebehavior.com – (have you read that blog? It’s awesome). And that was really exciting as well. Such amazing people do this work – it’s good work, and it’s hard work. 

Body Positivity – A lot of people ask me why as a a clinician treating Eating Disorders I advocate for Health at Every Size and why it’s important. The answer is easy- almost every eating disorder started with a diet. If we can eradicate people being told that they are not good enough and they need to diet, we can deeply change the internalized messages that dieting is the only way out – we then allow people to live in bodies that were meant for them. Those bodies might be big or they might be small- but what we want them to focus on is their true health. True health isn’t about getting on a scale to measure your health. It’s about giving your body what it needs- good healthy food and good healthy movement (where you can), but of course movement and exercise can be difficult for those in larger bodies because of the social stigma. So it’s all very challenging and there needs to be a lot more kindness and acceptance out there.  And the obesity paradox actually says that people in the “overweight” BMI category live longer and are healthier. So there you go. There’s no good science around these debates yet.

Body Image – The body image part was interesting. I talked to a lot of different experts on it. The consensus is really that body image is deeply ingrained and that we should be working on prevention more than anything else. The body project is a good example of that kind of early intervention.

I went to a ton of neuropsych panels that were fascinating, but I’ll metabolize them into a different and accessible post soon enough.

Eating disorders are notoriously difficult to both treat and understand, but people are working really hard to make it happen and to find help for those suffering. Fortunately many people have gotten to the other side of their EDs and recovery is possible. If you need help, please reach out, you can reply to this post, email me directly or go directly to NEDA or call 800-931-2237.

Only Rich White Girls Get Eating Disorders

The road to recovery leads to beautyI tend to shy away from talking about what I do for a living when meeting someone in social situations like at parties or on an airplane. The phrase “I am a psychotherapist specializing in the treatment of eating disorders,” is met with either awkward silence, or uncomfortable reactions such as, “I wish I had an eating disorder, but I could never stop eating…” or someone telling me in detail about their friend/college roommate/friend’s daughter’s eating disorder… or other conversations that are potentially difficult to get into at a party. But this week, at a Holiday Party, when I told someone what I did, he responded, “Oh so you talk to selfish snotty rich white girls all day long…”  Ugh. I sat for a moment to think about whether or not I would be willing to continue my conversation and decided against it. I said to him, “that’s actually really not accurate…”  and excused myself.

But I began to think about that stereotype, that eating disorders only touched a certain demographic. And the truth is that eating disorders transcend race, age and gender.  Unfortunately though, the stereotype remains for a variety of reasons. First off, because of the stereotype, men and women who do have eating disorders who don’t fall into the category or white, young, female, or rich might have trouble identifying that they have an eating disorder. They might also feel that it’s not okay for them to go to treatment because they won’t fit in or because they are not the typical patients.

But lots and lots of people suffer with eating disorders. Because we believe that our bodies are our external manifestation of what is going on inside, that our bodies tell the world who we are. And for some dumb reason, society has decided that what makes us good is being skinny. And so when someone feels bad or insecure about him or herself, he or she tries to change their body, and usually to make it smaller, because they believe that they will then be worthy or be treated better or be allowed to go out into the world. And often this plan backfires. They diet and diet and diet and disordered eating ensues. And then they cease to be out in the world. They stop doing what they were meant to be doing. They don’t dance or sing or preach or write poetry or teach aerobics or teach literature or go to Africa or go to medical school because they feel that they are not good enough. They feel that they don’t belong. They feel that they can only participate in the world once they lose the weight that they need to lose. And then the world misses out on them. The world misses out on all those amazing men and women out there because they don’t think they are good enough. They become embroiled in a power struggle with their jeans, with their diet plan, their treadmill and with food and don’t leave that cage.  And we miss out on them. We miss all the joy and learning they could have brought. We miss the gifts that they were meant to share. We miss the fun we could have had with them. We miss the smiles on our children’s faces for being around them. We miss out on all that.

And that is why I treat eating disorders. Because the world should be a better place and you should be in the world. I want to help you get out of the cage of despair and into the world of joy, life, expansion and happiness. Who knows, you could cure cancer! You could make peace in the Middle East. You could save a child from a burning building. Or you could simply go swimming with the dolphins in Hawaii and have fun because it’s okay for you to be in a bathing suit. It’s okay for you to be out in the world.

Happy Holidays to you.

Have a Safe and Wonderful Holiday.

I’m Really Impressed by The Blond Vegan

Courtesy of www.theblondevegan.com

Courtesy of www.theblondevegan.com

If you’ve been following eating disorder news or blogosphere foodies at all, you know the story about the blond vegan. If you don’t, I’ll give you a quick recap. A young woman, Jordan Younger, who has been a prolific instagrammer and blogger had spent a year photographing her beautiful vegan meals, her exercise feats, and her shopping trips.  Her photographs and eating became an obsession. Not just for her, but for her 70,000 instagram followers. Ms. Younger then began to get ill. She lost her period, became fatigued and her skin dried up. She then came to the conclusion that she had an eating disorder and despite the fact that she had close to 100k followers, decided to work on letting go on her obsessions and let go of Veganism. Holy fuck that’s brave.

 

The symptoms that are described are very typical of of anorexia.  Ms. Younger discusses having orthorexia, which is basically the obsession with healthy eating.

Her story is very close to my heart. As I describe in my book, I too was a vegan– for many, many years. My mother and I were both vegetarian from the time that I was 10 years old and then we became vegan when I was 20. My mom remained mostly vegan until she passed away when I was 28. It was then that I chose to begin  integrating new foods.  Were we orthorexic?  Mom was, I was more about trying to reject a whole bunch of foods in order to control my eating. I mean, I was smoking and drinking diet coke like it was going out of style. So, I probably wasn’t vegan for health or environmentally responsible reasons. But, having been a vegetarian/vegan for almost my whole life, 18 years, it was very difficult for me to change. It was my identity- both to myself and to others. I was pained about what I believed was contributing to the suffering of animals, I was depressed about wondering who I was.  But you know what, I wasn’t what my eating dictated I was. That wasn’t my identity. And that’s the problem with eating disorders, isn’t it? They become your identity to you. If you are anorexic this is who you believe you are. And everyone knows you as “tiny,” and you want to be that. You don’t want to change who you are to people. If you are bulimic- you have this secret identity, this huge secret that is so hard to let go of because what would you have when you were alone without your binges/purges?    It’s interesting how we allow the way we eat to give us identity and shape the way people see us. I mean, look at Gwenyth Paltrow and her whole Goop cult.  People become obsessed with the way they eat and then other people become obsessed with the way they eat.

Your identity isn’t what you eat or how you eat and it’s none of anyone else’s business.  Which is why I’m so impressed by Ms. Younger’s bravery.  She not only had to make a decision to change her eating to save her health (which is rough) she had to do it to a hundred thousand followers- people watching her and looking to her for guidance on how to be healthy. She did a great thing by admitting to all those people that she was not balanced. I think she will help many, many people who think that they have to be perfect. She made it alright to let go of an eating disorder.

Jordan, if you read this, I want you to know that I think you are so awesome. You have totally gotten the word out there that recovery is okay and possible. You sent an amazing message. You have done a great thing for the eating disorder recovery community. I’m so impressed! And I know that recovery is difficult, and changing and letting go of obsessions is extremely difficult. I hope that you have a great supportive community to support you through this transition.

How to Support National Eating Disorder Awareness Week

 

large_The War On Women's BodiesIt’s that time again! National Eating Disorder Awareness Week. 

What is NEDAwareness Week and why is it important you ask?

I’m glad you asked.  Bringing focus to eating disorders is more than just showing support for those who are struggling with anorexia, bulimia and binge eating disorder.  The intention here is to show just how pervasive eating disorders are and how much support there is for eating disorders in our culture. Yes, eating disorders are supported, not recovery.   You can see it everywhere. You can see it when you turn on reality television, you can see it in a yogurt commercials or cereal commercials when you are encouraged to give up a meal and replace it with this artificially flavored yogurt or processed cereal to lose weight. You are supporting eating disorders when you sit around with people and talk about how fat you are and what your next diet is or when you start to discuss someone else’s weight gain or weight loss.  All of this behavior supports eating disorders by reinforcing the idea that you are not okay as you are, that you have to do something dramatic to change yourself.

How can you support National Eating Disorder Awareness?

1. Choose not to engage in Fat Chat– that means, don’t base a friendly conversation around how much weight you need to lose or how much weight others need to lose or who looks like what right now. You have better things to do with your time and more important things to discuss. If someone tries to engage you in their own conversation about their body or someone else’s body, be kind and explain to them what you’re trying to do, “I’m trying this new thing where I don’t speak disparagingly about my own body or anyone else’s. And I don’t want to engage in any negative conversation about your body. My hope is to change the conversation and society’s focus on women’s bodies. Are you onboard?”

2. Don’t buy women’s magazines, especially diet magazines that are disguised as health magazines.

3. Check out NEDA’s How to page– to help you support eating disorder recovery

 

Power to the What?

Before I had my son last fall I was petite but also strong  and healthy. I ate my three healthy meals a day, I ran  3-4 miles 3-4 times a week, I meditated daily, had a pretty good Vinyasa Yoga practice going, I ate ice cream, drank wine, and ate chocolate in moderate amounts.  I had a solid psychotherapy practice, a solid marriage and was enjoying a pleasant rhythm of life. I liked my body, I liked my routine and things felt relatively comfortable and easy. And then, after a few years of false starts, I finally got pregnant. and we were happy, my husband and I.

But pregnancy is not easy on a woman’s body. I developed a condition very early in my pregnancy called a subchorionic hematoma, which put me on moderate bedrest for the first half of my pregnancy. Which meant no running, no yoga (not even gentle restorative yoga), and pretty much doing nothing when I wasn’t at work other than laying in my bed. And I was hungry. I mean, I was really, really, really hungry. I was so hungry that I would be hungry while I was eating, I would be hungry after I finished a meal. The portions that I was used to eating were no match for my intense hunger. And forget eating fish, turkey, lean meats and vegetables. All I could stomach was fruit, pasta, grains, bread, juice and more fruit. I would sit down and ravage two whole mangoes in a few minutes. I would chug down watermelon juice. My body was totally rejecting protein and just begging for intensely sweet fruit. The only protein that I could manage to choke down was tofu. I would wake up in the middle of the night in agony because I was so hungry. The only way I’d fall back to sleep was by drinking milk and eating peanut butter. I was so hungry that I would sometimes cry because I just couldn’t quell this hunger. As he got bigger, there was less and less room. So I’d be ravenously hungry and uncomfortably full all at the same time.  I felt so different than I ever had in my body. It wasn’t like I was binge eating or restricting, it was like I was no longer driving the car. I just was not in charge. And, I gained weight. Because that is what happens when you get pregnant. You gain weight. And sometimes, a lot of weight.

My baby was born via C-Section at a whopping 8 pounds 8 oz and 21 inches long. And everything was great. But we were tired. Really, really, really tired. And the only thing I could get myself to eat was pasta and chocolate. It was easy, it was quick energy and it was all that I was craving. Really? Me, after years of eating a very balanced diet of mostly high quality proteins and unprocessed carbohydrates, I was all about spaghetti and chocolate.  I just couldn’t help it. I couldn’t be mindful about my eating, I was trying to keep this very demanding creature alive by using nothing more than my body. I fed him with my body all day long. And if he didn’t eat every two hours for an hour at a time, day or night, he would scream. I had no time to cut vegetables. I had no time to cook meat. I had no time to go to the farmer’s market and pour over beautiful organic produce. All I could do was breastfeed my baby, eat chocolate, eat spaghetti, change diapers, and if I was lucky, every once in a while, I’d get an hour of sleep. But that was rare.

So, let’s get back to my body. My stomach, which was once  tight and taught was  now completely stretched out. There was lots of loose skin, And, because I am a small woman who had a large baby,   my stomach muscles had split in half and my intestines were hanging out and pushing through the flesh of my stomach. And let’s not even mention the gigantic incision from my C-Section.  I also wound up having to have surgery to fix two hernias and now have three scars between my belly-button and pelvis. All just from becoming a Mom. Gross, right? Totally gross.

But not really.

To tell you the truth, I have never loved and been as proud of my body as I am today. I’m kind of in awe of it actually. It’s a workhorse. I can’t believe that my body managed to not only create a whole human being, but I’ve been able to make food for this baby in my body and keep building him for the past 11 months. I can’t believe that my body can create and grow and sustain a whole person! It’s amazing to me. To that end, I can’t believe that women’s bodies are exploited the way they are. Mens’ bodies should really be the display pieces, I mean, their nipples are vestigial.

So, do I still run several days a week and do yoga and have a great deal of consciousness about everything I eat? No. No. and No. But I’m not concerned. I imagine that when my baby isn’t a baby and longer, I’ll have time to do those things. Right now he is bringing me pleasure. He is my workout. He is my downtime and my fulltime job. My meditation and mindfulness practice still exists, though, not to the extent that it did. My baby is what I’m mindful of. I’ve definitely had to cut down my Psychotherapy practice a great deal, as I run home to nurse my baby between patients, and have to be home in the evenings to feed, bathe, and nurse him to sleep. And I’m happy. And very, very, very tired. But happy.

So what spurred me to write all this? It was this ad that I came across the other day: If you can’t read it, it says: Kick-start your day. Focus. Hit your stride. Breath. Change your pace. Change the oil. Make a difference. Make a home. Be courageous. Encourage others. Stay fit. Fit it all in. Breathe. Hug a kid. Kid around. Run your life. Run your heart out. Power to the She.

I know it’s supposed to be inspiring, but this ad made me really, really angry. It’s not new news that the media is detrimental to women, but this particular ad really rubbed me the wrong way. More than the ancient herion chic Calvin Klein ads with waifish Kate Moss, more than the diet pill ads, more than the Chanel ads of tiny women weighed down by big jewelry– I’ve become immune to all those ads and the messages they send. This one however, it really got to me, because it sends the message to women that not only do we have to be skinny, not only to we have to be perfect, but we have to be everything to everyone and nothing less is acceptable. We have to be to be Real Women.

What happened to us as women that we are expected to do all this? I mean, that is a lot to do in a day. When do I get to take a bath? When do I get to sit and eat a meal? When do I get to go to the bathroom? When do I get to check my email? Talk on the phone to my girlfriends? When do I get to relax with a glass of wine and watch reruns of Sex & the City on E!?   Obviously I don’t, because I’m busy running, doing laundry, cooking dinner for my husband, taking care of my kid, making sure that I don’t “lose my figure,” taking care of people around me, doing volunteer work, and being in complete control of everything around me– Running my life. But rejecting myself.

It’s just not okay. We as women have always been the ones who take care of everything. And we are expected to. This ad sends a message not  that we can have it all, but that we should be everyone to everything and still manage to workout all the time.  It sends a message to women that they have to be on top of things all the time, they can’t stop for themselves, it’s not okay to be tired, to be run down, to relax, to lose their shit, to freak out, to be sad, angry, lazy, or to be messy. This ad tells me that the “Power to the She”– Being a woman, is about being totally perfect, being in control all the time, and sacrificing my needs so that I can spend my days being everything to everyone. And skinny.

I call bullshit. I don’t think that these are feminist beliefs. I don’t think that men are held to these standards. My husband goes to work everyday, he’s a wonderful man and he’s a great Dad, but he’s not up three times each night breast feeding our son. He doesn’t run home several times during the day to nurse him and play with him and to make sure that he’s feeling safe and secure. Yet, because I’m the woman, I’m still expected to keep our house clean and cared for,  maintain my career and still go out for a run? No not in our house. Not ever.  I think that women are held to much, much higher standards, nearly impossible standards, lest they be judged. Women who stay home are lazy, women who work are neglectful, women who don’t exercise are lazy, woman should bear children, then still stay in shape to be sex symbols for their husbands, go to work, and still do the laundry.

No. That is not power to the she. Power to the she is responsibility to self first.  And that means not beating yourself up if you can’t be everything to everyone and still have a hot bod. It means splitting up your responsibility with your husband or partner.   It means taking care of your kids if you have them, taking care of your needs and asking for help if you need it. It’s not about being an island. It’s not about being perfect. That’s just a dangerous message. That’s just a woman trying to control herself and her environment to such an extreme extent that she’s not left anymore. She becomes what she does rather than who she is.

My feelings? As a woman, power to the she is taking care of what you need to and taking care of yourself first. Eating real food and honoring your hunger and your nutritional needs when you are pregnant and breastfeeding. Having integrity, being kind, and saying no to things that are too much. Knowing what is too much and being able to create boundaries. You don’t have to do it all. You don’t have to beat yourself up if you can’t.

A lot of my clients feel so driven to be everything, that they wind up having these secret binge or binge and purge episodes or starving themselves, or exercising themselves into the ground. This isn’t okay. Women are being given the message that they have to be everything and they are hurting themselves to be so.

Power to the She? I’m rewriting this ad.

Be powerful, be strong, be good to yourself,  be everything that you can be, be proud of yourself, be encouraging to yourself and others, be loving to yourself, be loving to people around you, be kind to yourself, be compassionate to yourself, be calm, be bitchy, be happy, be sad, surrender control, honor your appetite, be in the moment, laugh, cry, let go, smell the roses, eat ice cream, drink wine, exercise when you can and try to relax and be you. 

 

 

 

A recovery story- Finally choosing to let go of Ed

This amazing and intense recovery story was submitted by April via email.

My name is April and when I was 8 I started having serious body issues. I started my period and didn’t really know why or what it was. My mother was not a very nurturing mother always competing with me about weight and clothes and she would take over my friends so they liked her better. I hated my body. I remember praying to die at 8. I always felt awkward in my skin never comfortable.  I got the message early on that being fat like my aunt Kathy was unacceptable.  I was told fat people were not worthy of love and were failures in not so many words.  I started my first diet at 8 eating just an apple and orange every day for a week and lost weight. I saw the pride in my parents faces when I dropped weight.  The next few years were a blur until I hit junior high. I had friends and I felt like I belonged but my body was an issue.  I hated my body. I hated being in it. I would throw up but it was getting out of hand. Just when I felt stressed. I just sort of hated my body and then it was time for high school.  All my friends went to one school I went to another. I was shell shocked. I had no idea how to make new friends. I hated my body and myself and was in awe of all the pretty girls.  I turned inward. I was sad my old friends left no room for me in their life.  My home life was a little scary as my dad and brother constantly fought.  I would live in my room never coming out unless I had to. I also ate the same thing every day for over a year.  Then that summer I turned 15 and the binging and purging took over. I became a full-fledged bulimic. I lost weight I was like 95lbs and I loved being thin and I was 5’2” and usually 113 to 110. My parents put me in a hospital for kids with behavior issues. This only pissed me off because all they said was get to 100 and you can go home. I got to 100 in two weeks they never put me in with the eating disorder unit they just stuck me with gang members and drug addicts. I was so angry at my parents. I had no control and I felt so alone.  When I got out of high school I started exercising and running. I think started on anorexia. I would eat very little like an apple and glass of milk and then throw it up.  From the age of 19 to 33 I was severely anorexic and bulimic and exercise crazed. I had no life, no friends, and just was waiting to die. My life was sad and lonely.  I did manage to get a college degree, a paralegal certificate cause my dad wanted me to and then a master’s in business management. I quit any job if my weight came in question. I floated between 69lbs and 84lbs for that period of time.  I thought I would die and I wanted to. I somehow married and had two kids.  My kids are healthy but I was starving and binging and purging all through my pregnancies. I lost one but I blame myself cause I purged and was exercising two hours a day. Therapy after therapy couldn’t help me. I was married to a man that ignored me and treated me like servant. I realize now I picked that man because I could continue practicing my behavior because it went unnoticed. I started for some reason reaching out to people through FB. I don’t know why I did it but something in me changed. I saw my daughter being left out by my parents who treated my son like the number one grandchild and I just snapped. I thought I had to get better. I read the book by Portia De Rossi and one night I believe I heard the voice of God tell me to stop. I stopped. I stopped the crazy behavior and I stopped allowing a man to dominate and ignore me. I have had to cut out my parents because they are very sick and controlling and will never get help. I have had to get better for myself for my kids. The sad part is I had to recover alone with the help of God and the support of some friends.  I am getting divorced but it is the right thing to do.  Even if I end up alone forever, I have my health and my mind back. I am sad I wasted all those years and all that time stuck in an eating disorder without knowing how to lift the fog. I have no idea what the future holds for me but I know I am a good mother and I love my children and nurture them and will see they group up with love and self-esteem.  I had to come to terms too with the fact just cause I got sober doesn’t mean I can get everything I ever wanted. It doesn’t mean I can turn back the clock and recover lost time with people. That is probably the hardest part. Letting go of the pain and the hurt that I caused myself is really hard to do but I am trying to and it feels so good not being consumed with starving and exercising or purging. Life is hard enough and surviving an eating disorder for 22 years was hard but I did it, so I think I can pretty much do anything.  I lost so much time.  22 years wasted, and I don’t want to waste another minute, another day, another hour.

If you have a recovery story that you would like to be published, please send it to bingeeatingtherapy (at) gmail.com

How to Talk to a Loved One with an Eating Disorder

how to talk to a friend with an eating disorder

 

Watching someone that you love being active in their eating disorder is devastating.  It’s so painful to watch your mother, sister, wife or girlfriend (or husband, father, brother or son) either restrict their food, or binge on foods that are unhealthy for them, or to know that they’re purging in the bathroom after they’ve eaten. It’s painful and upsetting and scary.

You might find yourself becoming very angry at the person whom you love when you see them taking such poor care of themselves. It’s important to find compassion for the person who has the eating disorder when you choose to talk to them about it.

1.)Although you might feel angry, please try to understand that this is a serious problem that she/he has. They would certainly stop if they could.

2.)When you talk to them, don’t be attacking. If you come at the person and say things like, “you really need to be eating more,” or  “you have to take better care of yourself,” or “I want you to stop purging now,” you’re going to create a face off and a defensive stance. The person is going to be forced to defend themselves against this attack. Instead, talk to them using I statements. For example:

“I have noticed lately that you look very, very thin, and I’m worried. I haven’t seen you eat at all in several weeks. It’s really hard for me to watch this because I love you so much and I’m terrified that I’m going to lose you. I just don’t know what I would do without you. Is there anything I can do to support you? Would you be willing to do some family counseling with me with an eating disorder specialist? Or can we go see a nutritionist together and perhaps I can help you go shopping? I just really love you and want you to be healthy.”

Really contact your own feelings of fear rather than anger in order to get a conversation going.

3.)Don’t try to fix the person. Don’t try to take food away from them or force food on them. Don’t refuse to eat if they’re not eating. Don’t make comments about what they are or are not eating.

4.)Don’t be afraid to talk openly and honestly about how their eating is affecting you.

5.)Remember that this is a very hard topic and the person who you confront will most likely feel embarrassed and ashamed. You don’t want to shame them into recovery. In fact, this can often backfire. Let them know how much you love them and want to be there for them and you’re not going to let them go through this alone.

6.)Understand that recovery takes time, don’t expect them to see a therapist once and then all of a sudden to be cured. Be patient and if you can, try to be an active participant in their recovery.

7.)If this person is completely unreceptive to you, don’t push or get angry. Get help for yourself. You need support when you love someone with an active eating disorder. You might want to check out Al-anon or Codependents Anonymous or seek therapy or a support group for family members of people with EDs.

8.)Even though you might feel angry and frustrated (that’s so normal) don’t give up on someone you love. Let them know that you love them and you will be there for them when they are ready.

Recovery from eating disorders is hard. But watching someone struggle is downright painful. You feel helpless and scared and depressed. Please try to get love and support for yourself as well.

Some further reading and resources:

http://www.pbs.org/perfectillusions/help/friends.html

http://www.nationaleatingdisorders.org/information-resources/family-and-friends.php

https://bingeeatingtherapy.com/?p=277

https://bingeeatingtherapy.com/?p=283

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Friday Q & A– I can’t stop dieting– I just want to be a normal teenager

 

Question:

Hi, I’m a 16-year-old Asian who’s had an eating disorder for almost one year. When I was as young as 13 I was already at a weight of 60kg/132lbs. I began feeling more insecure about my body after that so I went on a diet and lost 10kg/22lbs. But as days go by there’s always a voice in my mind that says I don’t look good enough and there’s always that big stomach of mine underneath my clothes. As of now I’m at a height of 161cm/5ft 3in and a weight of 45kg/99lbs.

No one knows about my diet and everything I did to lose weight although my friends and family have been saying “Since when did you get so thin?” these kind of things to me for the past year. I made my decision to recover in April 2011. But it’s just so, SO hard to completely recover and I really don’t want to see a doctor, I just don’t. I count calories every day and I try to keep them no more than 1500 but sometimes I’m just so upset that I haven’t lost my tummy weight I start binge eating and reach 2000 calories in a day!

I’m so tired of counting calories, weighing myself every day, exercising (running, jogging, dancing, sit-ups) in my room.. But I just can’t help it. Last night my parents brought me to a restaurant for dinner and as soon as I came home I saw my bloated, really huge stomach in the mirror and only went to sleep after I jogged in my room for about 20 minutes.

Please help me. I want to live a normal teenager life with no worries about weight at all, and I’m now worried of the fact that I haven’t had my period for 3 months and a half. I want to be able to live like my friends who can eat whatever they want and will never be weight-conscious, and I’m really, really afraid of weight gain. I’ll just start exercising again. I want a real meaningful life at a young age of 16…

And one more thing. I’m a huge fan of Korean music industry and the female celebrities (who have such great bodies and long legs) often remind myself how imperfect I am..

Sincerely, Kim

Answer:

Kim, thank you so very much for writing. I’m so sorry for what you’re going through. It sounds really, really difficult.  I know that you don’t want to go to a doctor– that’s not unusual, but I’m very concerned about your health. Your weight puts you at underweight and the fact that you’re in amenorrhea (no period) shows that there is something very serious going on with your health. I do think that you need to tell your parents what’s going on and have them take you to a doctor and a therapist who specialize in treating EDs.

What seems to be happening is that you’re beginning to listen to the voice of ED. That’s the voice of your eating disorder that tells you wrong information, such as “you’re too fat,” or “your belly is big, you can’t eat anymore, you have to stay up and exercise before you’re allowed to go to sleep because you’ve eaten too much.”    ED is what drives you to see yourself in a distorted way. ED is what tells you that you’re not good enough. ED is what provokes you to look at pictures of pop-stars and tell yourself that you’re not good enough because you don’t look like them.

Your belief that you haven’t “lost your tummy weight,” sounds like a cognitive distortion to me. Something that appears true in your mind, but isn’t reality. Lots of women have distorted body images where they see their bodies very differently than the way most others see them.   Unfortunately, when you get stuck in that loop, it’s hard to get out of.  You keep hearing in your head that you’re not good enough and you spend all your time trying to make yourself good enough and you miss out on your life. Not to mention that restricting your calories so low can lead to cardiac arrest, and your other organs shutting down, and eventual death.

So, this kind of eating disorder is not just dangerous emotionally, but dangerous physically.

1.)Please tell your parents immediately and tell them that you absolutely need treatment. Treatment should be a therapist, a group, a doctor or outpatient or residential treatment.

2.)If your parents are not receptive, tell someone at school, a teacher, school nurse, guidance counselor, etc.

3.)Try not to let yourself focus on pictures of other women and tell yourself that they are better than you. Begin to think about what is wonderful about you and how you can continue down that path to create the life that you want for yourself.  Often we get into the compare and destroy mode. We compare ourselves to someone, decide that we are not good enough, then decide that we might as well not exist because we are not “as good” as that other person. It gives us very little room for being who we are.

4.)Remember that your beliefs about your weight and your size and the way you look and your fears about getting fat are nothing more than fears and beliefs. They are not factual or based in truth. This is the kind of messages that your eating disorder sends to you. As you work to recover, you can change these beliefs.

 

I hope that you’ve found something here helpful and I hope that you get the help that you need. Please email me if you need further help or have more questions.