To-do list for teens: study for SAT, gain 40 pounds

Of course it annoys me that the headline says "Researcher Says Anorexia May Be Genetic" because it is clear from the article that the message is that Anorexia "is" genetic, but, never mind.

The best part of that AP story is buried toward the end:

Johnson said the research has helped to identify groups most at risk of developing the disease, such as girls ages 11 to 14. ''Girls are expected to gain a third of their adult weight during that time,'' or about 40 pounds, he said.

This is something that comes up poignantly in Doris Smeltzer's book, Andrea's Voice.

Just when our kids start internalizing the messages about "obesity epidemic" and their coaches start telling them to knock off the pizza... they are also programmed to blossom into their adult proportions. Let's not let that be a surprise or a bad thing.

As a society we need to normalize and celebrate the concept that adolescence is a time of rapid change - and weight gain. Yay!

Important Rites of Passage: SAT test, first beard growth, first period, finding out Mom doesn't know her times tables, driving test, first job, bat mitzvah, first pimple, 40 pounds, first date, finding out about Santa...

Ritual to bypass: first diet.

Repeat after me:"I've gained weight, Mom!" "Congratulations!"

Insurance parity on mental illness

Insurance coverage is odd. It seems have trouble locating the brain. They must think brains are inaccessible, mystical creatures located far, far away.... perhaps on Mars?

The brain has actually been located - take notes here - atop the spine, right inside the skull. It is part of the body and deserves medical attention. Just because we aren't very good at it doesn't mean we oughtn't try.

It'd be great if insurance agencies could just get this on their own, but the Mental Health Parity Act of 2007 is a good start. After 15 years of trying, and over the time we actually got spacecraft to Mars, perhaps we're ready to make the leap to the inner reaches of inter-cranial space!

Great blogs

Clear language and unsparing honesty in blog form:

Doris Smeltzer’s blog for parents has the authority and the facts at her Gurze blog www.eatingdisordersblogs.com/parents in which she says such inconvenient truths as this:

"I did not realize that our culture speaks anorexic, nor did I realize that I was fluent in that language as well. After Andrea died, I destroyed our bathroom scale."

I'm also a huge fan of Carrie Arnold's blog, "ED Bites" ed-bites.blogspot.com where she blogs with wit and grim resolve about recovery amidst co-workers on an office-wide "Big Fat Loser" contest.

And another blog with attitude I recommend is "Size Ate" at sizeate.blogspot.com - and don't miss the YouTube introduction for her play. Moving, funny, compelling.

The Lost Boys

For reasons that escape me, at times a story will spread virally throughout the media for a day or two.

This affliction has not yet happened to the Maudsley approach, but my hope springs eternal that it may...

This week the story that I can't stop hearing is headlined "Binge Eating More Common than Other Eating Disorders" in various wordings here and here and here.

But the real story is buried: the number of men who have all eating disorders. We often hear that only 10% of sufferers are men. This Harvard study counts more like 1/3 of the total - that's news.

We tend to refer to boys and men as an afterthought when it comes to EDs. Many treatment centers don't even take you if you have a Y chromosome. As if it wasn't the same illness. As if male sufferers need another barrier to good care.

Eating disorders hurt all sufferers and their loved ones. Let's not mistake being a minority of sufferers for having less severe illness.


Women get MS more often than men, but that doesn't make it a female illness. Heart disease strikes men more often but it isn't a man's illness.

Tell Dennis Quaid anorexia is a girl thing. I dare you.

If food was chemotherapy?

A friend of mine is having her chemotherapy tomorrow morning. She's exhausted, weak, has trouble keeping food down, her hair is gone. It hurts and it sucks.

Maybe I should tell her to go easy on it. If it is hurting her so much, maybe they should stop? She's not leading a normal life, with all these treatments; she's letting it run her life. I wonder if she should just take as much as she feels like, and leave the rest for another time. After all, it's hard.

Of course not. But that's what we do with nutritional rehabilitation of eating disorders. We say "eat as much as you can" or "90 IBW" and "it's not about the weight" and "she's not dangerously thin."

Insurance says discharge when "out of medical danger" and defines that as "not dying today."

We buy into the fear of "fat" and settle for "minimum weights" which leave the body unwell, and the brain unsafe.

My friend with cancer is fighting for her life, and deserves support and comfort while she does it. She takes her medicine - chemo - and everyone around her helps her through it.

Time for caregivers and loved ones - while acknowledging the pain of ED recovery - not to treat full physical rehabilitation as optional. Full doses. Full nutrition. Full support.