Wednesday, April 27, 2011

Family Matters-The Maudsley approach

Living in such an independent society, we assume people's problems are their own. That person needs to deal with the issue and overcome. People dealing with mental disorders are seen in this light as well. That they need to go to therapy to sort out their issues than magically reemerge in society when they are "fixed". and for most disorders, this is not hte case

One of the papers I wrote in college on the topic of eating disorder had broken this commonly held belief. For patients with eating disorders, whether it is anorexia (AN) or bulimia nervosa (BN), there are many different types of therapy one will have. But, in the past 10 years family behavioral therapy (FBT), has gained recognition and has been widely used in the treatment of eating disorders.

With the research I have seen, although they all vary in their percentages, roughly 80% of people with eating disorders report the onset of the disease before the age of 20. A majority of these patients lie between the ages of 11-19. and it is safe to say a majority of the patients in this age range are still living at home. Therefore, their parents are their source of nutrition. They are the providers of the necessities; food and shelter. This is a main reason why FBT is so successful since it is important to educate the parents about their daughters/sons ED because they are essentially in charge of the food supply. This is not a treatment that blames the parents for the ED but rather, therapists will use the family as one of the strongest resources for helping their child to treat their disorder.


FBT, commonly known as the Maudsley Approach, started in London, and recently came to the states. Brought over by Daniel le Grange, it has proved over and over again to be successful, and here is a brief explanation of what this process entails

The Maudsley approact is done in three different steps

Phase I-Weight Restoration-
This phase focuses on the dangers of malnutrition that hte patient with ED is currently suffering from. (hypothermia, growth hormone changes, cardiac dysfunction, and cognitive and emotional changes). Also during this stage, therapist will usually watch the interaction at meal time between the family and child. They learn the interactions to be able to teach them better ways to help their child to eat, normally. The responsibility of mealtime is given more to the parent than to the adolescent. The therapist will teach the parents how to encourage and support their child during mealtime and how to talk them through a meal. During my experience at UMHP, having to talk someone through a meal is the hardest, but most gratifiying experience. But, after 5 hours of trying to get a patient to finish their ensure, it can get frustrating, and for parents who have to do this everyday, 3 or more times a day, learning how to deal with their frustrations is imperative. Therapist will work with parents to make sure that the parent remains focus. Each meal can be a HUGE obstacle for someone with an eating disorder, and it takes lots of energy on both the parents and the childs part to attempt to finish it. "the Maudsley Approach adheres to the tenet that the adolescent is not to blame for the challenging eating disorder behaviors, but rather that these symptoms are mostly outside of the adolescent’s control". Keeping this in mind, it will help the interaction between the child and parent during meal time, to be a lot more successful.

Phase 2- Returning the power to the patient
now that the patient understands the demand for food consumption that was imposed by their parent, they have gained some weight, and a change in the interaction of the family, phase II can start. This phase basically is when the transfer of power is starting to be given back to the patient. During phase 1, the issue of weight gain was brought up, but now other family issues will be discussed during treatment. It is hard to discuss difficult family issues when the patient is going thru the refeeding process since their mental abilities are not normal. Their moods are often erratic due to starvation, as well as being able to properly process what is going on. Now that their are at a healthier weight, their mood and mental processing is being restored to they are able to more successfull handle complex situations. Also during this stage, the patient will attempt to take power and control over their eating abilities, perhaps going out to the movies with friends, even if the parents are afraid they will choose not to eat, or binge while they are away. The patient is learning how to be in control of their meals, sometimes they succeed and sometimes they fail, but overall, they are trying to learn how to be in control of everyday situations that occur in life.

Phase 3- Establishing healthy adolescent identity
Phase III is initiated when the adolescent is able to maintain weight above 95% of ideal weight on her/his own and self-starvation has abated. I have heard a lot of girl say during their treatment, that their only identity is with their eating disorder. "I am anorexic" or "i am bulimic". Their eating disorder was not only a disorder, but is who they were. This phase teaches them that they are so much more. They teach them a healthy adolescent identity that they might have lost or might have never had due to their eating disorder. Therapist will try and support their personal autonomy, teach them and their parents appropriate personal boundaries, and in a whole, teach the family and patient to live a closer to normal life.

This entire process is a lot harder than just a 3 step program. This is process usually will take up to a hear to get through. And although most patients will recover form their disorder, the relapse rate for eating disorders in general is extremely high, over 50%. Although FBT and other treatments are proven successful at restoring weight gain and abstaining from ED tendencies, there had not been enough being done to find permanent or long term recovery methods for people with ED. Most of the memoirs I have read about ED and people I have spoken to say that they will with with ED for their entire life, but being able to maintain and control it is possible. Although they will live healthier lives without ED tendencies, the thoughts are still there and can be extremely stressful. I hope that with further funding and research that eventually there will be a treatment with longstanding result thats will free people with ED from their ED thoughts.

Thursday, April 7, 2011

Bulimia-quick course

Out of the family of eating disorders, Bulimia is not the most commonly discussed in our society. Most people assume that the reason why people purge (throwup) is because they ate too much and are afraid to gain weight. Therefore, they head to the toliet, stick their finger down their throats, and vomit until their bile or marker comes up
*sidenote: a marker can be characterized as a food someone eats at the beginning of hte meal, something distinguishable in color like nacho cheese doritos, so when they see it come up when they purge they know their stomach is almost emptied.
Although this is the case sometimes, it is not the case all the time. People with bulimia do not only purge because they are afraid to gain weight. They also arent necessarily trying to lose weight. They are just trying to maintain. Also Most people don't know, but even by purging, calories are still being absorbed by the body.
Bulimics are usually triggered by emotions. What I mean by this is that they will become so overwhelmed with emotions (depression, anxiety, anger, etc), they will literally purge their emotions. They have said to feel immediate gratification, but shame and guilt settle in shortly after. This loss of control over their emotions is dealt with in therapy by teaching them how to effectively cope with emotions, and not letting them control them. Sometimes they just dont know any other way to deal with lots of emotions but to purge.
Usually people who purge do so in solidarity, because shame, guilt, and embarassment is a common emotion for bulimics, so avoiding other people knowing is important. Purging can occur once a week or several times a day depending on the severity of the disorder
Bulimia is harder to detect than anorexia since most bulimics tend to be of normal or above normal weight. Anorexics are more detectable due to their emaciated looking bodies. Although bulimia is not as detectable does not mean it is not as damaging as anorexia. Some of the consequences of bulimia are erosion of the esophagus, gerd, weak enamel, electrolyte imbalance, low potassium, heart problems, and a lot others.
Bulimia is not only classified by throwing up. But abusing laxatives, dieuretics, enemas, and over excercising are all considered purging.
There is a lot more i could write about but I hope this will give everyone a better understanding of what characterizes a Bulimic and that one doesnt have to weight 70 lbs to have an eating disorder.

Monday, March 21, 2011

Double Standard-Weight

Hello Hello Hello!!!!!
I have returned for my one month lapse of writing in this blog. I had been extremely busy studying for the GRE and that was priority for the month of Feb and March. But it paid off because I did well! :) Just what i had wanted..Anyways..back to business

Topic of today was inspired by something I saw on the Tyra Banks Show. I am not nor have i even been an avid watcher of the Tyra Show but the title has sparked my interest. "Fat Hateration". Poor title but intriguing. The show was basically about a panel of women who were biased or discriminatory towards obese people. At the end of the show, they brought up the point I will be focusing on for this entry….That weight is a double standard. Meaning that our society views obese men and women a lot differently. Men: neutral. Women: Negative....They spoke about how In the corporate world, when one views an obese women they assume she is a secretary, and wouldn't assume that she is in a position of power. They assume she is lazy due to her size. When there is an obese man in power, he is given excuses on why he is fat, such as he works too much.
Even outside the corporate world we can see the double standard taking place. When you see a bigger man with a beautiful petite woman, commonly people will assume that he either must be really nice or has money. Even women said they like when a man is bigger because then they feel more liek a lady and like feeling so much smaller. Obese women on the other hand have said they have felt pressure from their significant other to lose some weight. Especially if there significant other is not over weight. Even through my own experiences, I have noticed there is DEF pressure in a relationship setting for the women to maintain her figure or stay fit. Im sure many of you can think of more instances were the double standard has taken place. Men usually always get the upper hand in these situations. Unfortunately, its not that they are only given the upper hand, but females are so harsh on other females. So it is not only that men get the better light of being bigger, but women beat themselves even further down.

The idea of having womens size being scrutinized while the mans size is not, is unfair. Not saying that we should start scrutinizing the men too, but that we need to stop being so hard on the women. We as women, are the quickest to criticize someones appearance (makeup, hair, size, etc). The only thing that is doing is hurting our own sex by making these criticisms acceptable. If women can do it to women, what makes males think they aren't allowed to do the same. In today's society there is a HUGE pressure for women to look a certain way. Celebrities don't make it easier, our friends don't make it easier, and we def don't make it easier on ourselves. Stop the criticisms. Stop making passing comments to your friends about how big someone is. Im sure they know how big they are without pointing it out. It is not your place to tell someone they are fat or obese. If you want to do something, HELP THEM. Be there to go on a walk with them. Be there to give them motivation on their weightless journey (if they are trying to lose weight). We as a society need to stop being so critical of others because it doesn't help anyone. Calling someone fat does not always motivate someone to lose weight. But I can guarantee it will make someone feel bad about themselves. You never know which comments will stick with someone forever and which wont, so make sure that the ones you are saying to someone are all positive, so those are the ones that stick. It has been studied that the negative things usually stick out more than the positives....

This was more of a rant than an informational post I am aware. But this is something that people need to be reminded of. I am also trying to be more cautious of what I say about people's weight and how I say it. One comment can lead to consequences you never knew were possible. It can trigger someone to want to diet. It can trigger someone to dislike their own body. It can trigger an eating disorder. So next time you are gunna call anyone fat either to their face or behind their back, think about who its helping and who it is making feel better...if you can think of a good answer, it probably shouldnt be said...

with that ...I HOPE EVERYONE WILL SPREAD THIS AROUND TO THE MASSES! :) thanks for reading! i will try to post a more informational one next time...I am thinking of either how Eating Disorders relate to other disorders (borderline personality disorder), or the different types of therapy and what are most effective.. hmmm :)

Saturday, February 12, 2011

NEDA awareness week

NEDA=National Eating Disorders Association

NEDA awareness week: Feb.20-26th

For SEVEN days people around the united states are being asked to help out in spreading EATING DISORDER awareness. Although I have chosen to dedicate my entire year to NEDA awareness, this week is not any less impactful on my journey to spread awareness. But, I have made a goal for this week is to try and reach out to the people reading my blog (yes that is you), to do something during this week as well. What I have learned by writing this entries, that you do not have to do something HUGE to spark change or interest in individuals. ANYTHING that is working towards a goal does help. I feel that with the amount of people that have been reading my blog (786 views people! amazing), that being able to get the word out there and let people know that is NEDA awareness week will be easy and impactful.
so here is my challenge for YOU. For everyone who reads this blog or even just happened to stumble upon this one post of my blog, I would want you to post ONE FACT about eating disorders. It doesnt have to be something that you have read about on this blog, it can be anything you choose. ONE FACT. Post it as a status on your facebook, or a tweet on twitter, or any other social networking thing you use. Ill even post links to facts and stats, to make it even easier for you to spread the word. By taking one minute out of your day from Feb.20th-26th can make huge changes. Something bigger than you ever thought, or may never realize.dont believe me?

For example, people who have been posting my blog on their site may have no idea that out of the 1,000 friends they have on their facebook, That you are bound to have at least 5 friends who suffer from anorexia and 20-30 friends who suffer from bulimia. One in 200 American women suffers from anorexia. Two to three in 100 American women suffers from bulimia.(this is a statistic found on hte neda website).also remember, just because someone has ED does not mean they are getting help for it. There are so many people out there with this disease and are convinved that if they wither away into nothing no one would notice or care. so by posting a fact, is an excellent way to SHOW YOU CARE. By posting one fact, shows you have interest in ED, that you care about this fatal illness. You are now giving someone a potential outlet that they can come to if they need it. and by you reading this blog, you now have the resources to help. The two websites I have on the top left are EXCELLENT resources for finding help and support and information.
There is so much you can do by just becoming aware/educated about this disease, and allowing OTHERS to know of your interest as well. I REALLY HOPE that EVERYONE will take part in NEDA AWARENESS WEEK. and try to get others involved as well. so remember
FEBRUARY 20th-26th. POST YOUR FACT!!

and ill be here to remind you, and as always, please continue to help spread my blog to others. im so thankful for everyone who has retweeted and reposted my blog to others. esp the comments I have received that i have inspired others or just hearing that they read it and like it means SO MUCH TO ME. thanks again for helping to accomplish this task of spreading ED awareness and hopefully we can all work at this together!

here are the links to the facts before i forget!
http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/MediaTip.pdf
http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/RsrchPop.pdf
http://www.nationaleatingdisorders.org/uploads/file/Statistics%20%20Updated%20Feb%2010,%202008%20B.pdf

Tuesday, February 1, 2011

Thinspiration

Warning: This post could be triggering for individuals with ED. I would suggest not reading it if there is a chance you could be sensitive to the material.

Thinspiration: : inspirational material that promotes thinness. See pro-ana
Pro-Ana: anything that involved the promotion of anoretic behaviors.
Example "Nothing tastes as good as skinny feels"

The term “Thinspiration” is not at all to be confused with what could seem like a positive motivating phrase. “Thinspiration” does represent inspirational material to promote thinness, but is used in the eating disordered world as a way to individuals to gain courage, support, and inspiration for maintaining their eating disorder. Try googling “Thinspiration” and you will see exactly what I am referring to. If you go to images, what you will see images of emaciated bodies filling up the screen. There are also Thinspiration websites, full of Pro-Ana proverbs, trying to tell girls that their suffering is worth it and to continue with their eating disorders. This is the sickening world of eating disorders.
The first time I had seen a thinspiration video or even heard about it was last year after reading a book called “Purge” by Nicole Johns. I was curious to see what this motivation for ED entailed. I was sickened by the amount of videos that were available under the title of “Thinspiration”. I literally became sick to my stomach. There are people out there, very sick people, who are creating a photo montague of extremely unhealthy and unidealistic bodies. They use this as motivation for their eating disorder. They use celebrities such as Nicole Ritchie or Victoria Secret models, and use them as motivators of how they BELIEVE their bodies HAVE to look like. They also use self portraits. Anorexic looking bodies are bring used as a model of what they believe they should look like. These emaciated body parts are in NO WAY ideal of how one should look, or how one should strive for.
I have shown these videos to a few of my friends, and they are shocked that this is even real. Who would ever think to promote an eating disorder? What is worse, is that youtube videos arent' even half of the "Thinspiration" material available. There are Pro-Ana websites. Which stands for PRO ANOREXIC. I still can’t believe these websites are allowed on the internet. These websites believe they are a place where individuals with ED can go and feel support. A place where everyone feels the same way they do, and they can go there for words of encouragement to stop eating, and that the hunger is worth the pain. Its basically the same thing as promoting suicide. Eating disorders are a slow sucide. Slowly killing your body from within by starving and/or purging.
I found a video that is a good example of the sickening things that are out there
http://www.youtube.com/watch?v=FqHxlz1kcq8

I have taken the liberty to flag any video on youtube that I find as offensive as this one. Once again, these videos are FUELING eating disorders and should be removed from the internet.
What I want people to take away from this entry is I hope they are shocked and upset from what they have just read about/seen. I hope this entry has let people glimpse into the mind of a person with ED. That there are people out there who are so sick that these phrases, pictures, etc are something they firmly believe it. They believe that if they are fat they are unloveable, or if they aren't skinny enough they arent good enough. I have heard girls say that they are no one without their eating disorder. And none of that is true. Which is why Thinspiration material makes me so upset and scared for the girls that aren't strong enough not to listen to them. I hope that we all can take a stand against "Thinspiration" videos in one way or another. Flag a video on facebook, or write an encouraging comment on a Thinspiration website. Something. Let people out there know that their lives are worth living no matter how big or small they are.

"I finally realized that being grateful to my body was key to giving more love to myself"-Oprah

Monday, January 17, 2011

Look Better Naked

This topic is something that really struck me earlier last week when I signed up for Women's Health Newsletters. I have read Men's Health more than a couple of times, and they seem to have really good tips for nutrition, food, etc. and i figured why not look up the women's version for a change. so i did. and here is what i found

On the opening page right next to the title was "Drop 15 pounds in 6 weeks". I found it unsettling that they would have that RIGHT NEXT TO the title of the page, where everyone who comes across the page is bound to look. So after trying to ignore the sign telling me to drop 15lbs, i kept browsing the page and I see a link called "Look Better Naked". It is a eating/workout plan that is sponsored by Women's Health. Described as a "6-week fat melting breakthrough". It promises to reshape and and lose weight 3xs faster so you can “look better naked”. All of this talk about physically appearing better naked, made me realize, you never see these type of diet plans talk about FEELING better naked.

In our society there are a ridiculous amount of diet plans that sucker us in by trying to convince us that we will have a firm, tightened and toned body in 5 weeks with their special fat busting, high calorie burning, cookie a day diet workout. I myself have been suckered into these fad diets as well. Who doesn't want Kim Kardashian's ass or Pussycat Doll abs? It is a tempting and successful way of making people buy into these diet plans. But, do I ever hear these diet programs promoting mental well being in their infommericials? no. You would never hear, “feel beautiful and more confident about your body in 5 weeks” unless it was followed by “after you drop 20 pounds”. It is always about how you will feel AFTER you lose the weight that you want.

45% of American women are on a diet on any given day (Smolak, 1996). and if diets are being promoted by basically advertising "Lose weight now, feel better about yourself later", how are we gunna feel about ourselves, not just going into starting a diet, but in general? Especially for the younger girls, how are they supposed to feel if what they see on tv are these same people telling them they can be happier if they just lost 5 more pounds? The necessity to promote a health body image in today's society is crucial for not just my generation, but for the ones before me and the ones up and coming. I want to make sure to point out that I am not saying Diets are bad, for some people they can help them to maintain a HEALTHY weight/lifestyle. But, I also feel that with all these major diets becoming apart of our society and way of life, they should be not only responsible for helping people to become more fit, but also try and coach their clients into feeling better about themselves throughout the entire process. No one should have to feel shitty about their own bodies to be forced into dieting. For me, it all comes down to, If you feel better about the body you have, you will take better care of it. If you dislike your body, you will only be satisfied with drastic changes or what shows up on the scale.

to the readers, i hope next time you start a diet plan or if u are on one now, to be conscious of what i just wrote about. Being healthy should not just be defined by your BMI or your heart rate after you run a mile, but its how you feel about yourself mentally. Your body is nothing without confidence. Learn to appreciate your body for what it is, no matter what. Loving your body still does include treating it right by eating right, but also not beating yourself up because you gave into the chocolate treat that was in theh staff lounge today. Do what you can to help nourish your body properly to keep it running smoothly. Hating your body won't make itlook any better, but learning to love your body will make all the difference.


p.s. i ordered the free trial of "look better naked". im going to attempt to see if they do infact try to promote a healthy body image anywhere in their program. im hoping for the best :)

p.s.s. I found out that Weight Watchers has support groups as part of their plan which helps support positive well being

Wednesday, January 5, 2011

so what is an eating disorder EXACTLY?

Eating disorders, such as anorexia and bulimia are categorized in what is called the DSM (Diagnostic and Statistical Manual of Mental Disorders). This book is what therapist and doctors use to diagnose ALL psychiatric disorders. It is basically the bible of mental health. It has the symptoms listed, the amount of symptoms that can be present to diagnose a disorder, and a whole bunch of other guidelines that help mental health professional when diagnosing a disorder.

anyways, onto these definitions...first we have the most commonly known eating disorder in out society..

Anorexia: Characterized by EXTREME weight lost and excessive weight lost
some symptoms include
1. Refusal to maintain body weight at or above a minimally normal weight for age and height.
2. Intense fear of gaining weight or being "fat"
3. Feeling "fat" or overweight despite dramatic weight lose

Anorexia is the most lethal disorder to have out off any psychiatric disorder.
There are also two types of Anorexia.
Restricting type which basically means they severly restrict the amount of caloric intake on a daily basis.
There is also the Binge Eating/Purging Type:During the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior. Purging can include vomiting or the misuse of laxatives and diuretics.

Bulimia Nervosa:
Characterized by a cycle (usually secretive) of binge eating followed by purging(vomiting, misuse of laxatives or diuretics). A binge can differ depending on the size of a person, but some people will consume anywhere from 1000-3000 calories in one sitting. It fluctuates per person and that is just my educated guesstimate lol.

These are the two MAIN eating disorders in today's society, and the two main ones that this blog will cover. But just to have it out there it, there is also an eating disorder known as Binge Eating Disorder. Most commonly known as compulsive overeating. To summarize, Binge Eating is summarized by periods of uncontrollable and compulsive eating that goes WAY beyond the point of fullness. But unlike bulimics, Binge eaters do not purge after eating, which the feeling of fullness they experience after a binge will lead to strong feelings of shame and guilt.

One important thing i have learned from reading about eating disorders, just because you do not have all the symptoms of an eating disorder in the DSM, does not mean you dont have a problem. There is a title for those who fall in this category, which is known as ED-NOS (eating disorder not otherwise specified). This is usually when the patient has symptoms from both anorexia and bulimia but does not necessarily reach the amount of symptoms needed to be diagnosed in either category, but they clearly have a problem. A big downfall of being diagnosed with ED-NOS is that it makes it more difficult for those patients to be covered fully by their health insurance, which willl be a topic i will eventually write about.

The website I got most of this info on is
http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/WhatIsEd.pdf

Remember, all this information is a summarization of what they are. I tried to put it in simple terms, cuz if not I would be writing a book every entry lol
Well I hope this helps whoever is reading this to distinguish a little better what the different types of ED are. If you have any questions, leave a comment :) i would love to get my brain picked about this. If i dont know the answer you can guarantee ill try and look for it. Thanks again for reading!