April 28, 2007

It does gets worse

I don't know why this isn't explained to parents, and sufferers: before it gets better, it gets much worse.

For biological reasons that are well known but not often enough discussed with patients, the worst parts of recovery are not when you are most medically compromised.

And it isn't because "now I'm fat."

The worst is when the mind and body fight back.
Like a diver with the bends.
Like an alcoholic during detox.

Caregivers need to be prepared. It does get worse before it gets better - but what's the alternative?

It is worth it, but not at first. Pace ourselves.

April 24, 2007

Feeding the enemy

And you thought family dinner was already scary enough?

If you've run out of things to blame, try this: eating disorder caused by siblings.

Oh, Mr. Freud, what's it like to live forever?

(I'm joking, by the way. Of course siblings don't cause eating disorders. In fact, in the Maudsley approach the siblings are an active and important part of recovery and as a result are themselves able to stay engaged and included and well. I just could not resist sharing the tortured and circular thinking in the "research" cited above.)

April 18, 2007

"naturally thin" vs. "anorexic"

"He's always been slender."
"That kid looks anorexic."
"Our whole family is naturally small-boned."
"I'm just built this way."

How DO you know when it is an eating disorder?

Is it appearance, BMI, behavior? Is it what they tell us?

Wouldn't it be lovely to have a way to tell the difference between "naturally thin" metabolism and life-threatening restriction:

"... hormones appear to be valuable biomarkers for distinguishing these 2 categories of severely underweight subjects."

BMI is a population screening tool, not a diagnosis. It gives an idea, at higher and lower ranges, of who might need a closer look at behaviors and other markers of illness. It should not ever be seen as an indicator of any individual's health.

April 15, 2007

even-handed eating disorder treatment

Until recently, I could think of no reason why "eye movement desensitization and reprocessing" deserved attention.

I'm not a fan of seeing mental illness as a wound or a protest, and not a believer in therapies oriented in the past.

EMDR as an ED therapy had an air of witchcraft to me and not until a clinician I deeply respect mentioned she used it did I give it a second thought.

"I can't tell you why it works, but it does seem to for some people."

Here's a possible clue: "right-handedness linked to poor body image" in a Reuters Health article describing a possible connection between distorted body image and strong dependence on one hand. This could indicate an organic problem behind both features. The writer brings up the idea that EMDR may also be acting on the communication between the right and left hemispheres.

All day I've been picturing Tevye, the Fiddler on the Roof: "On the other hand..."

April 12, 2007

Living Life Without "ED"

Last night I attended a talk by Jenni Schaefer, the author of "Life Without ED."

I'm honored to call Jenni a friend, and always tear up when I see her connect with a room of people. She's honest, funny, and smart. Driving home in the dark from the talk - which I attended with my daughter and my son - I had time to really ponder what it is about Jenni's message that sets it apart.

Jenni is all about recovery. Of course she talks about illness - boldly, unsparingly, and bravely - but it is really about recovery: getting there, and staying there.

Hers is the only book by an ED patient I've ever given my daughter. Too much of the ED literature and media is about scaring, titillating, gloating, and justifying illness. Jenni is about engaging, working, bravery, and getting better.

Thank you, Jenni, for all the good you are doing and for living the example.

April 6, 2007

House calls from Jennifer Lopez

Big news: Jennifer Lopez Wants Models to Eat

Thank you, Ms. Lopez! Why, let them eat cake!

But, um, I'm guessing that all the parents out there with eating disordered kids could really use your help at the dinner table as well? Why not throw them a donut, too?