Wednesday, June 24, 2009

New Anorexia Research

I find it encouraging to see new research coming out about eating disorders. It gives me hope that there will someday be a cure. For the meantime, it gives me hope because I know that there is actually some money being spent on research on eating disorders. That is so important, given the high mortality rate with eating disorders and the lives that are destroyed even when people are able to stay alive.

Check out the press release on the latest research on Anorexia:

Marking anorexia with a brain protein

A biomarker for anorexia?

Eating disorders are frequently seen as psychological or societal diseases, but do they have an underlying biological cause? A new study shows that the levels of a brain protein differ between healthy and anorexic women.

Anorexia is a serious and occasionally fatal eating disorder most commonly affecting women. Scientists do not yet understand the physical causes of anorexia, though some studies suggest a link to low levels of a brain protein called BDNF. Now, a study recommended by Cynthia Bulik, a member of Faculty of 1000 Medicine and leading expert in the field of psychiatry and eating disorders, shows that BDNF levels are higher in women who have recovered from anorexia. This suggests that low BDNF levels may be reversible.

Researchers at Chiba University in Japan found that anorexic women had lower levels of BDNF in their blood than healthy women or those who had recovered from anorexia. Women with low BDNF also had the lowest self-image, suffered from anxiety and depression, and performed poorly on certain tests of cognitive ability.

Further study is needed to determine what role BDNF plays in anorexia, and if it can be used to predict the risk of developing it, but Bulik forecasts that "...BDNF may emerge as a useful biomarker of [anorexia] and of recovery from [anorexia]."


Tuesday, June 16, 2009

What to say to someone with an eating disorder

Where do I begin? There is so much I could say about our culture, how we find it perfectly okay to make comments about another's appearance when we greet them. I really want to get to the point today and give you some really concrete language to remind yourself and your friends and family to use when talking with a loved one in eating disorder recovery.

You may have been told by care providers: Don't mention his/her appearance. WAAAYYY easier said than done, I know. But it is essential. Why, you ask? Well, basically if you say something like, "You look so healthy." The eating disorder that is the powerful force that has inhabited your loved one is going to hear: "You are fat, you have gained so much weight, you fat pig." I know, this sounds incredible, but it is true.

So, again, the skills build on one another. If we can stick with keeping our loved one and the eating disorder separate, then we can know that it will be the eating disorder, not our loved one who hears something negative and destructive.

In interviewing Kitty Westin yesterday to write her story for my upcoming book for families, by families: Just Tell Her To Stop: Families Surviving the Crisis of an Eating Disorder–Moving From Fear To Hope (new working title), she shared a story with me that she heard from another family. Kitty hears from families all over the country about their challenges with eating disorders and she had such wisdom to share with me and this person about what to say when a well meaning friend or family member makes a comment about the appearance of our loved one in eating disorder recovery. This woman, I'll call her Jane, shared with Kitty that her close friend was so happy to see that Jane's daughter had gained some weight during her treatments for anorexia. She came into their home and saw Jane's daughter and proclaimed, "Oh, wow, you're getting a girlish figure again!" Now this friend, really was happy and so glad to see this progress towards reclaimed health, she meant no harm. But, it was very damaging to Jane's daughter.

Kitty's words of wisdom were for Jane to go to her daughter in private and ask her, "What did your eating disorder hear when my friend said that?" Then listen to the horrific lies the eating disorder told her. Ask what else was heard. Then ask, "What do you know that she meant?" LISTEN AGAIN. Then ask what she needs to do to take care of herself. Remind her that the stronger voice needs to be heard. Also remind her that the comment gave the eating disorder more ammunition.

Looks easy on paper, but it is harder to do in the moment. Especially when your heart stops and your mind races to thoughts of years of more therapy to cancel out that one comment.

We'll never be able to train all of our family, friends and neighbors about what to say. So it is about empowering the person in recovery to take back her power from the eating disorder.

I'd love to hear how you have found effective ways of coping with unintentionally destructive comments.

Friday, June 12, 2009

What does "Using Symptoms" mean?

One of my editors for my book for families: Just Tell Her To Stop; Stories of Families Moving From Fear and Panic to Peace and Hope (working title), questioned my use of the phrase "Using Symptoms" yesterday. I have become so accustomed to the phrase that I didn't realize that not all readers might know what it means.

It is important for family members of people with eating disorders and also health care providers who treat people with eating disorders to understand how their language may impact the use of symptoms.

My understanding of using symptoms is an unhealthy way of coping with stress for people in eating disorder recovery. What this means very simply is: when a person with the eating disorder is feeling stressed, overwhelmed, lame, worthless, guilty, basically feeling badly about themselves or something they did or didn't do; they may fall into their pattern of utilizing ineffective behaviors to cope.

What can this look like? I don't want to get into too much detail here because some people who are still struggling may see these things I say as a "trigger" (which is another term to learn about another day), so I don't want to be the cause of more destructive behavior, therefore will keep this simple, general and brief. If you want to know more we can talk about it but I don't want to put triggering information out here in this cache to be here forever. For those supporting people in recovery, it will be helpful to know that "using symptoms" for the person in recovery can mean that they will skip eating, purge, eat or do whatever it is that they do to utilize their destructive behaviors to calm themselves.

An example of how language of a care provider or family or friend might trigger the "use of symptoms" could be saying simply: "You look so healthy, it looks like you are getting better." It sounds so positive and encouraging doesn't it? Well, to a person in recovery this is what they might hear when you say that: "You are so big." "You are fat." "You need to cut back on calories so you can get back to being thinner." "You've failed at even your eating disorder and now you are too big." Sounds irrational. Well, that's one irrational way that eating disorders impact people. Staying away from comments about appearance and food are essential. AND, I know that it is extremely hard to do. And, there is not much you can do as a family when loved ones come over who haven't seen your person in recovery for a long time and they burst forth with what they think is a compliment: "Oh, you look so great!" AAAarrrrggg, you think, all that therapy, undone in one fell swoop. Hopefully not, but if you can educate your doctors, nurses, social workers, teachers, family, friends...send them to this article so that they can understand the gravity and impact of their words. This is a concept that can be challenging for people to grasp and they might think that they are having to tiptoe around the person in recovery. Well, it might feel like tiptoeing but, it's better than attending a funeral. Once people understand how great the negative impact can be, then they will be more likely to heed your advice.

For health care providers this can be a huge challenge as weighing is such a major part of our typical medical checkups. There are ways to weigh people without informing them of their weight, this is essential for people who are in recovery and often it would be useful for teens and pre-teens who are very sensitive about their size.