Treatment and How You Can Help

While the physical and emotional consequences of anorexia can be devastating, the good news is that it’s a treatable condition. With the right treatment team, people with anorexia can and do get better. They can regain their health, learn to eat normally again, and develop healthier attitudes about food and their bodies.

Since anorexia involves both mind and body, both attitudes and behaviors, a team approach is often best. Those who may be involved in anorexia treatment include medical doctors, mental health professionals, and dieticians. The participation and support of family members also makes a big difference in anorexia treatment success.

There are different types of therapy available for treatment:

Cognitive therapy explores the critical and unhealthy thoughts underlying anorexia. The focus is on increasing self-awareness, challenging distorted beliefs, and improving self-esteem and sense of control. Cognitive therapy also involves education about anorexia.

Behavioral therapy promotes healthy eating behaviors through the use of rewards, reinforcements, self-monitoring, and goal setting. Teaches the patient to recognize anorexia triggers and deal with them using relaxation techniques and coping strategies.

Group therapy allows people with anorexia to talk with each other in a supervised setting. Helps to reduce the isolation many anorexics may feel. Group members can support each other through recovery and share their experiences and advice.

Family therapy examines the family dynamics that may contribute to anorexia or interfere with recovery. Often includes some therapy sessions without the anorexic patient—a particularly important element when the person with anorexia denies having an eating disorder.

Encouraging an anorexic friend or family member to get treatment is the most caring and supportive thing you can do. But because of the defensiveness and denial involved in anorexia, you’ll need to tread lightly. Waving around articles about the dire effects of anorexia or declaring “You’ll die if you don’t eat!” probably won’t work. A better approach is to gently express your concerns and let the person know that you’re available to listen. If your loved one is willing to talk, listen without judgment, no matter how out of touch the person sounds.

You can also seek advice from a health professional, even if your friend or family member won’t. And you can bring others—from peers to parents—into the circle of support. You can also help by being a good role model for healthy eating, exercising, and body image. Don’t make negative comments about your own body or anyone else’s. And whatever you do: don’t turn into the food police. A person with anorexia needs support, not an authority figure standing over the table with a calorie counter.

If your friend or family member won’t listen or doesn’t want to take the steps towards recovery, it may be time to step in and seek professional help. We have an anorexia center in our backyard. Centers For Change, located in Orem, UT. is a leading residential center for eating disorders and is considered to be one of the top eating disorder treatment centers and has even been featured on Dr. Phil.

There are also many other tips available for treatment and therapy centers available on credible sites such as NAMI and ANAD. Online support groups are also available such as this site – The World’s Largest ED Support Group where both anorexics and recovery supporters can voice their thoughts and concerns.

The important concept to remember as a friend or family member is to be supportive, openminded, and loving. Having a compassionate friend or family member is helpful no matter what situation you’re going through, and people in their most vulnerable states need to know that they are surrounded by people who love and do not cast judgement on their situation.

Developing and Sustaining Good Body Image

I briefly discussed how having a good perception of body image can be beneficial to your well-being, but simply stating something is not enough and is so much more helpful when explained.

We’ve all experienced a time or two when we’ve been really down on ourselves. Perhaps a boyfriend/girlfriend broke up with us, we didn’t get asked out on a second date, we had a really bad hair day, or a large pimple appeared on our face at an inopportune time, but whatever the reason, we almost always tell ourselves we aren’t good enough. You may blame your looks – you’re not tall enough, your not thin enough, you’re not muscular enough – whatever it may be, we tear apart our bodies with our minds. We cannot change our looks. Yes, we can change our hair, wear makeup, wear different clothes, but unless expensive surgeries are involved, we cannot change our bodily appearance.

Understanding that we are helpless in changing the way we look is an important aspect to achieving good body image. In order to have good body image, we must see ourselves for who we really are, inside and out. When you look in the mirror, what do you see? Do you only see those “problem” areas and shortcomings? Or do you see your features as unique, beautiful/handsome, and a body created in the image of God? Are you even able to see yourself in a positive light when you see your reflection staring back at you? For every “problem” area you have, try to find one positive characteristic, inside and out, that you and other people love about you. I think you will soon see that you have a lot more positive, beautiful things about you than negative ones. When you look in the mirror, try to remember that you are special, unique, and loved just the way you are. It sounds so cheesy, but it will really help achieve positive body image.

A lot of body image issues can be cured once we understand that we were born with self worth. “The worth of souls is great in the sight of God,” D&C 18:10. God created each of us individually and uniquely. When we understand that we are created in God’s image, that we came to earth for a purpose, it becomes easier to love who we are and who we were made to become.

Often reasons related to poor body image lead to an eating disorder. This is a scary thought considering so many people have distorted ideas about the way they look. Have you ever heard of the term “you are your worst enemy”? You judge yourselves harder than anyone else. The people you surround yourself with should and likely do see you in a better light than you see yourself so surround yourself with uplifting, positive people, don’t compare yourself to others because that will only bring you down. Every one has their strengths and weaknesses and just because yours may not be the same as people you look up to does not mean you are less than they are.

When I think of someone who has a near perfect understanding of her self worth and a great sense of body image I think of Stephanie Nielson. Her story is nothing short of inspiring. In 2008, Stephanie (Nie Nie) and her husband, Christian, were involved in a plane crash leaving them both with serious injuries. Stephanie suffered the worst in terms of physical damage. I’ll let the following pictures do the talking.

Stephanie blogs! She began her blog before the accident, but she has continued her blog with stories of her recovery with humor and some of life’s most precious lessons that she has learned from her experiences. This video will tell her story better than I can in words. Enjoy and have some tissue handy.

Let this be a lesson to us all. Very few of us will ever experience the pain and tragedy Stephanie and her husband have endured these past two years. We can get through our little struggles. We are worth so much more than our appearances. Love yourself and the people you’re surrounded by. Life is too short to spend focused on our shortcomings.

An Anorexic Thanksgiving

It’s that time of year! The holiday that we all recognize is largely centered around gluttony: Thanksgiving! Normally we prepare for the big day(s) by loosening our belt buckles and hiding the scales, but how does this holiday affect anorexics? What to they think? How do they prepare? What do they do? The holidays should be about family and be a fun, happy experience, but it is hard to imagine this being the case for an anorexic or recovering anorexic.

With vast amounts of information at our fingertips, hundreds of sites with tips to surviving Thanksgiving as an anorexic are available. Thanksgiving is the perfect excuse for people to indulge in lots of food and treats, and there are ways for those with eating disorders to enjoy the holiday, too. Thanksgiving can mean guilt, self-loating, fear, anger, and a number of other emotions. However, these steps provided by a “how-to” website, can help guide an anorexic through what could be a very awful experience.

Instructions:

1. Get real with yourself. Don’t delude yourself with unrealistic expectations. Realize that there will probably be several times throughout the day that you will feel out of control. If you go into the day knowing this, you won’t be surprised when it happens — and you will be less likely to act out because of it.
2. Get real with others. You don’t have to begrudgingly pretend to be having a good time or act rudely to get the space that you need during the festivities. Be yourself and do what you enjoy and what makes you feel comfortable. If you don’t want a bite of the fat-laden mashed potatoes that your sister brings every year, don’t have it. It will only make you feel bad about yourself and resentful of everyone that is waiting with baited breath to see if you will eat them.
3. Talk to your therapist before it’s too late. Make sure that you make it to the appointment with your therapist before Thanksgiving. Role play to develop a plan as to how you will handle some of the crazy, awkward scenarios that may play out with the relatives and friends that you will encounter on the big day. Know what you will say when those inconsiderate or “helpful” comments come your way.
4. Put your support team on your speed dial. You can be sure that situations will occur during the day that will be exasperating (you’re dealing with your family, remember?) and it will help to have someone that you trust only a few digits away. Stepping outside or into another room and calling a friend will give you a little break and the opportunity to take a deep breath and regain your composure. Along those lines, consider taking a wingman. It is invaluable to have an ally who understands your situation and recovery plan and with whom you can take a break when things become tough.
5. Set the right goals. Instead of making your goals for the day about food and your weight, set a different type of goal. Have a goal to talk to three different people or to participate in the board games after dinner. Make a goal to interact with the kids at the gathering. Children love unconditionally and tend to be safe people. Taking part in activities can distract you from yourself and food worries.
6. Avoid the “fat talk” ladies. The term “fat talk” was first coined by anthropology professor Mimi Nichter, who wrote a 2007 book on the subject called “Fat Talk: What Girls and Their Parents Say About Dieting”. Simply put, it’s that conversation that tends to play out ad nauseam whenever a group of females get around food.”Oh, I can’t eat that. I’m so fat!””No, you’re not. Look at you in that dress. Now I’m the one who really needs to get to the gym.”

   “You? You’re so skinny! I’d kill to look like you.”

   This kind of conversation can be especially destructive to your recovery. Avoid those ladies and any other toxic people at all costs. Plan your escape route if you see them cloistered around the dessert table.

7. Set boundaries early. Contact the family members that know what is going on with your recovery and insist that they don’t push food on you or comment about your weight, diet, or try and discuss healthy eating choices with you during the holiday. It is not the time or place for such conversations and will not add anything positive to the day.
8. Eat before the feast. If you are a recovering bulimic don’t go to the party hungry. Eat at home first and this will reduce the temptation to overindulge. If you are a recovering anorexic offer to bring a dish to the party. Take something that you will feel comfortable eating. This will be a safety net for you.
9. Stop giving yourself the beat down. Instead, pick yourself up and move on if you slip up. We are all members of the human race and mistakes are part of our humanity. Get back on track by attending a support group meeting, venting in a chat room, or scheduling an appointment with your counselor.
10. Set the clock. Realize that like all other days there are no more than 24 hours in Thanksgiving day. The hours will tick by and you will have survived and for that you can be truly thankful.

You may have resorted to asking a question on yahoo or maybe you were linked to someone else’s yahoo question at some point in your research. I found a girl asking about tips for her Thanksgiving experience as a recovering anorexic. I like this for two reasons: 1) I think it’s great that people are able to ask personal questions like this in an anonymous way, and 2) I’m glad that other people take the time to answer questions and speak of their concerns for a person they do not even know.

If you can’t be content with what you have received, be thankful for what you have escaped.
— Author Unknown

The important thing at any time of year is to be thankful for what blessings we have and the trials that have come along the way, too. Be thankful for all people, no matter what shape or size. We all come in different packaging and it is not acceptable to be too quick to judge. I think this is very important when considering those who suffer with any kind of disease, especially those that deal with eating disorders and other mental illnesses. Be thankful.

“Manorexia”

The past few posts have focused mainly on anorexia in women. Although I did mention that the disease affects men too, even I never thought too far into it. Watch this video.

When we think of the reasons that many people develop anorexia, the media is one of the first sources of influence to blame. Magazines, billboards, TV, celebrities, etc. all portray women as fit, beautiful, and seemingly flawless, and because anorexia is predominant amongst women, we are quick to see how the media causes women to believe that being any other shape or size as unattractive or unacceptable.

Think for a second. In teen magazines young men are posed half-naked with smiling faces, chiseled muscles, and tan bodies with descriptions of their favorite pass-times and other mundane facts. Young women are told by these pictures that boys that look like that are what they want and need in a boyfriend or future spouse. In men’s workout and body building magazines, clothing store ads such as Hollister and Abercrombie & Fitch, and in movies men are typically portrayed with near perfect bodies. Like women, men are susceptible to the message these handsome or beautiful people are sending them.

In the video we just saw, Jeremy was the man we see pictured in media. He had what every man [and woman] envies, but even he wasn’t immune to the grasp of anorexia. This video shows that anorexia is not sexist, racist, or any other form of discrimination. Jeremy was successful and handsome, but he became a victim of a horrible disease that slowly brought him to his death in June 2010 at the age of 38.

There are few large studies of men with anorexia and bulimia. One of them is the one carried out by the department of Psychiatry at the University of Toronto. The study suggests that eating disorders may be higher among men than the current National Association of Anorexia Nervosa and Associated Disorders estimates. They believe that men make up about 1 million of the 8 million Americans with eating disorders.

Due to misconceptions of anorexia, many men do not seek professional help. The symptoms and causes of anorexia are the same in both sexes, but diagnosing and treating anorexia in men is different and often more difficult than with women. In addition to starvation, men also over-exercise in order to lose more weight. For more information on male anorexia, click here.

The Center for Eating Disorders has created a quiz that can help you or someone you know determine whether you (or someone you know) has an eating disorder. Take a peek at the assessment quiz to give you an idea of what to look for or to take the quiz yourself.

If you are interested in learning more about men who have suffered from anorexia, read an article printed by USA Today about a man and his journey with anorexia. At the bottom of the post, there are more references on eating disorders in men that may also be helpful and interesting to you.

Statistics

I know, I know. Statistics are not always very fun to read, but I find it easier to invest in the statistics of issues that I am really passionate about, and as students interested in public health and helping people we should know a little something about the health topics we’re constantly preaching about. Here are some of the most interesting/powerful numbers I found courtesy of The National Association for Anorexia Nervosa and Associated Disorders:

• Without treatment, about 20% of people with serious eating disorders die.
• With treatment, 2-3% of people who had serious eating disorders die.
• With treatment, 60% make full recovery, 20% make partial recovery, and the other 20% stay dangerously underweight
• Almost 50% of people with eating disorders meet the criteria for depression.
• Only 1 in 10 men and women with eating disorders receive treatment. Only 35% of people that receive treatment for eating disorders get treatment at a specialized facility for eating disorders.
• Up to 24 million people of all ages and genders suffer from an eating disorder (anorexia, bulimia and binge eating disorder) in the U.S.
• Eating disorders have the highest mortality rate of any mental illness.
• 95% of all dieters will regain their lost weight within 5 years.
• Anorexia is the third most common chronic illness among adolescents.
• The mortality rate associated with anorexia nervosa is 12 times higher than the death rate associated with all causes of death for females 15-24 years old.

Seeing these numbers and facts helps put the severity of anorexia into perspective and should be a call to action to all. The website also gives reasoning to the symptoms of anorexia such as weight, the fear of gaining weight, body image, and amennorrhea or absence of menstruation. Those who suffer with anorexia are motivated to keep themselves well below the ideal body weight because of their intense fear of gaining weight. This fear causes them to skip meals, even to the point of starvation, count calories and think about their obsession 24/7. Anorexics struggle with their body image because when they look in the mirror, they see themselves as being fat or overweight even when they are dangerously skinny, possibly because they tend to look at their “problem” areas and think that they only way to make them look good is by losing weight. Anorexia, as we know, affects the organ function of the body and one effect of being underweight is women missing at least 3 periods consecutively.

Thomas Insel, MD, Director of NIMH, discusses eating disorder causes and treatment.

NAMI, the National Association of Mental Illness, also discusses anorexia. I think it is important for us to understand that even mental illnesses are serious and life-threatening. New research findings are showing that some of the “traits” in individuals who develop anorexia nervosa are actual “risk factors” that might be treated early on. For example, anxiety, low self esteem, body dissatisfaction, and dieting may be identified and interventions instituted before an eating disorder develops. Advocacy groups have also been effective in reducing dangerous media stories, such as teen magazine articles on “being thin” and pro-anorexia (pro-ana) websites that may glamorize such risk factors as dieting.

Signs of an Eating Disorder

Have you ever wondered if someone you know, someone you love, has an eating disorder? Anorexia is a disease, and with any disease, it is important for us to be proactive in addressing the topic. It is vital for a person’s health that we voice our concerns for their well-being, but how do we know if and when there is a problem and how do we bring it up without sounding harsh?

Here are some signs that could indicate an eating disorder:

• Pretends to eat and eats very little in the presence of others
• Someone who does not like to eat in public
• Use of diet pills
• Sees themselves as fat, but they are actually very thin and underweight
• Wears loose and baggy clothing to hide their weight
• Withdrawal from social situations
• Lethargic, moody, depressed
• Some vomiting or use of laxatives, usually after eating
• Easily tires after simple tasks due to weakness from lack of eating

Addressing someone who may have one or several of these signs is a sensitive task. I think individual consideration and careful planning should be taken into consideration when planning to talk to someone in this situation. Avoiding confrontation with this issue can be fatal for your friend or loved one so it should not be ignored. Sometimes just reaching out to help, showing someone that you care and want to help can influence their recovery.

WebMD has an Anorexia Nervosa Center webpage that outlines key topics of anorexia. It is definitely important for us to be educated on health topics such as anorexia before we try to address it with someone who may be affected by the disease. Visiting sites such as WebMD can help us better understand what our loved one is going through and how to help their individual situation.

Another good approach to educating ourselves is to browse blogs of anorexics and recovering anorexics to see how they were able to deal with their condition and what they did on a daily basis.

However you address the problem, it needs to be addressed whether by you or someone else closer to the anorexic. We all love and care for our friends and no one wants someone they know and love to suffer the ill-effects of anorexia on both the individual and the individuals family and friends.

A Glimpse of Anorexia

“I don’t understand.”

We often think this when we consider the topic of eating disorders. The documentary, THIN, portrays the lives of recovering anorexics in a rehabilitation center, The Renfrew Center, in their quest to overcome their fight with their eating disorder. It is compelling and informative. Their website provides information influential for the patient (present and future) as well as friends family members of those who have a loved one with an eating disorder. Watching this documentary, which is conveniently posted on YouTube, helps us better understand the struggles that an anorexic or bulimic person faces daily. There are several parts to the film, but I will just post the first part for those of you who are interested in seeing a glimpse of the documentary. (And for those of you who wish to see the whole documentary, the rest of the parts are listed to the right of the video).

I thought it was interesting that the two women they introduced admitted themselves to the center rather than having a family member or professional refer them. When I think about rehabilitation centers, I sometimes assume that most the people there are present unwillingly or forcefully rather than by their own strength and determination to get better. The women in this documentary struggle and fight a difficult battle primarily because it is one that they must fight against themselves. I admire their strength and the transformations they are able to make.

As we saw in this first part of the documentary, the women in the facility weighed well below a healthy amount; the two we saw were about 84-86 pounds. Obviously, weight is a big issue involved with anorexia. Towards the end of Part 1, Patty is celebrating her birthday at the Center and is given a cupcake. After blowing out the candle, we see her anxiety begin to set in. Just a few minutes before in the documentary she had told the camera crew that she attempted suicide after eating two slices of pizza so we can only imagine how difficult it was for her to have to eat her birthday cupcake. She says that she only has 10 minutes to eat her cupcake and complains that is is too sweet. Distress begins to set in, but with the encouragement of her friends and her own will-power, she finishes it. It is evident throughout that anorexia is very psychologically based.

After watching THIN, I remembered that I had yet to do one of my favorite things on Sundays: visit PostSecret. PostSecret is actually a website that posts postcards with secrets written on them anonymously sent to a man named Frank. Frank started this project not knowing that it would contribute to suicide prevention and become a realm of comfort and sympathy for people around the world. Anyway, I decided to check the website which Frank updates every Sunday to get my PostSecret fix for the week. To my surprise, there were several postcards sent in this week that fit perfectly with my topic of body image and eating disorders. The following are the postcards that I loved and thought I’d share with all of you. Although my topic is not specifically about suicide, anorexia and distorted body image can influence a person to commit suicide. I love this website and what it stands for. I hope that all of you can read and enjoy some of the world’s deepest thoughts and secrets, too.

 

As we have learned, the media can be used as tools for good. As future health promotion or health care professionals, how can we further use the media to positively influence lives on topics such as negatively portrayed issues such as eating disorders (and even suicide)?

Defining Anorexia and Body Image

Concerns with the problem of anorexia and body image have become prominent issues in the minds of men and women alike in the growing and prominent facet of the media. I am sure that many of us know at least one person who struggles with their personal body image and maybe even an eating disorder such as anorexia. Some of us may not understand why so many people struggle with this issue, while others of us may fight ourselves when we look in the mirror and don’t see what the media has deemed “beautiful”. Due to the media and most people’s shared belief of outward beauty, people have begun to struggle with their body image which can lead to serious disorders like anorexia.

Anorexia is an eating disorder characterized by refusal to maintain a healthy body weight, and an obsessive fear of gaining weight due to a distorted self image which may be maintained by various cognitive biases that alter how the affected individual evaluates and thinks about her or his body, food and eating. It is a serious mental illness with a high incidence of  comorbidity and the highest mortality rate of any psychiatric disorder.

Body image is the personal perception of your body. Ideally, we should view our bodies and accept and love them. I was able to take Women’s Health last semester. One of the first topics we discussed was the issue of body image.

Although the media has done a wonderful job of inadequately and unrealistically portraying what a beautiful woman or handsome man should look like, it has also begun to take strides in the opposite direction. One campaign that I especially love and appreciate is Dove’s Campaign on Beauty. After watching several moving commercials in my Women’s Health class last semester, I had to start showing my support for the cause as well by buying Dove products. Campaigns such as Dove’s is beginning to show women and young girls that beauty runs much deeper than the skin. I have a 10 year old little sister and one of the last things that I want her to struggle with is issues pertaining to her self-worth and body image.

In closing I leave you with one of Dove’s commercials for their campaign on beauty and a quote that was shared with the Relief Society today, “You are not your thoughts” meaning that though our thoughts run through us, they alone do not make us who we are. Although we may often think about the things we want to change in ourselves and how we’d like to look a certain way, those thoughts are not and should not contribute to what makes us who we are.