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Archive for the ‘Bulimia’ Category

This reprinted here in full, making it easier to read. Thank you to Helen Razer for putting it so well and so correctly about eating disorders and the current ‘DIS’ campaign. To read her original please go to: http://www.crikey.com.au/2015/05/07/were-making-ourselves-sick-with-the-publicity-of-eating-disorders/

I will follow in a while with my own post and thoughts on where Butterfly are and aren’t heading and the damage they do because they heavily mix body image campaigns with eating disorder awareness.

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To survive the current calendar, health advocacy groups must claim a month and shake it. January starts with glaucoma and thyroid conditions, and the year ends with Alzheimer’s and AIDS.  This month is given over to a number of health campaigns with notable new May player The Butterfly Foundation currently raising funds and awareness for eating disorders (ED).

Theirs is a well-regarded organisation providing outpatient services to ED sufferers who, in the case of an anorexia nervosa diagnosis, face what is estimated to be the highest standardised mortality figures of any psychiatric disorder. The help they offer is practical and based in firm research. But, like so many other advocacy groups, the public messages broadcast are entirely theoretical and based on flimsy hope.

With the achievable aim of funding itself and the rather more incredible one of stopping ED at its source, the foundation has launched Don’t DIS My Appearance campaign. Let’s set aside the antique hip-hop language that had passed its best before date before Snoop Dogg had packed his first bowl. Let’s also overlook the decision to ask ambassadors to display a middle finger, which I imagine may seem less like a moment of cheeky defiance than a bleak reminder of the toilet bowl to those who suffer from bulimia. Let’s look instead at how this organisation, and others, can so easily extinguish the very awareness they seek to create with crude messaging.

We spend much of the year in a tangle of awareness ribbons and there are those who reasonably argue that we’re bound to stop noticing the meaning of such decoration at all. But even if a public health campaign is good enough to cut through all this shiny bunting, it may achieve the terrible opposite of its intention.

In a study undertaken to assess the effectiveness of the famous breast cancer pink, researchers unexpectedly found that the women have become both more likely to underestimate their risk of the disease and less likely to donate to charities. The marketing professor who undertook the study concluded that in an effort to make the matter of breast cancer seem less taboo, organisers had also drained the matter of its urgency. After all, it’s pink like Barbie.

In a literature review on gender-based violence awareness, authors found that such campaigns can end up describing a standard of behaviour. If audiences believe that violence is very prevalent, as they reasonably might when viewing such ads, the message can license “violent behavior rather than activating behavior to reduce [it]”. In other words, violence is normalised through its depiction.

The Butterfly Foundation runs a similar risk of normalisation with its campaign. It’s a high-profile, celebrity-studded effort that posits EDs as normal and as prevalent enough to ask us all to change our behaviour in order to prevent them.

The thing is, though, this campaign is really not aimed at anorexia patients.”

Of course, all reasonable people would like to see a reduction in the incidence of anorexia nervosa. This disorder, which has a lifetime prevalence of between 0.3% and 1.5% in females and between 0.1% and 0.5% in males, is horrifying. That treatment, if accessible, promises a very high rate of recovery would seem to make the task of “awareness raising” all the more urgent.

If we can save a few lives by making death and extreme disordered eating seem a lot more common than they are — and the campaign absolutely does this by conflating EDs, a diverse group of mental illnesses, many of which have no extreme physical side effects, with anorexia in stating they collectively “kill more Australians than any other psychiatric illness” — then what of it?

The thing is, though, this campaign is really not aimed at anorexia patients. Professor Susan Rossell, a highly regarded expert in EDs with qualifications and associations too several to cite, sees “awareness” of this type aimed chiefly at people with “super anxious body consciousness” rather than an actual illness.

Rossell says that campaigns that demand an end to bullying might have some benefit for some ED patients. But the at-risk anorexia patients whose mortality statistic is used as a call to action are unlikely to be rescued by the injunction not to “dis”.

While there are accounts of anorexia patients who suffered chiding for overweight in early life, this is just one tiny potential element of a complex range of influences, including biological and genetic ones, which can provoke ED. While some patients may report bullying as a factor in their disease, others may report endorsement. Just as the so-called “Pro Ana” and “thinspiration” online community of extreme dieting normalises anorexia, campaigns of the Butterfly type can do exactly the same. To the potentially anorexic mind, the “everybody’s doing it” nature of this campaign is as much of a catalyst as a “dis” or a size 4 pair of skinny jeans.

Scholars in anorexia and all ED commonly use the biopsychosocial model to explain this disorder range. While it might be nice to end the “dis”, it might be also of great benefit to legitimate patients, as opposed to the simply body conscious, to understand that their disease has more of the “bio” and less of the “social” than most of us suspect.

“All eating disorders have a strong biological component,” said Richard Newton, Austin Health’s medical director of mental health and board member of The Butterfly Foundation.  When I suggest that the foundation’s newest campaign continues to situate ED entirely in the realm of the social, he explains that the illness-shaping or “pathoplastic” effects of the culture can switch the disease on. There are, he says, historical accounts that describe anorexia some 3000 years old. The “Holy Anorexia” of ascetic women who sought to become pure through fasting was, says Newton, “apparently epidemic in the Middle Ages”. The culture can turn this genetic predisposition on and off.

But what this awareness campaign does not give us is any indication that the disease may be genetic. Researcher in risk factors for ED at the University of Melbourne Isabel Krug rattles off a list of studies on potential endophenotypes, heritability, genome wide association and other data that we lay people can trust to mean that these disorders, particularly anorexia, involve a genetic predisposition.

There are even emerging biomarkers for anorexia, and Rossell was lately involved in a study on a particular eye movement called the “square wave jerk”. It is my lay understanding that imaging for anorexia shows more evolved promise than for those in the study of all other psychiatric disorders. It’s odd that common wisdom, and a great deal of general medicine, treats a common mental illness like depression as a case of “chemical imbalance” or genes, and anorexia as purely the result of social factors like bullying or super-skinny ladies in magazines.

Depression, despite its lack of biomarkers and clear prevalence among those poor in social capital, is read as biological. Anorexia, despite great evidence of its biological basis, is read as social and The Butterfly Foundation certainly overplays this by recommending being nice to people as a cure for death.

I asked Rossell about our willingness to see anorexia as an entirely manufactured disorder and she said: “It’s because it occurs so often in young girls”. She is unwilling to elaborate much further but when I asked her if it was due to the assumption that young women are empty vessels whose untainted bodies just wait to be filled by the culture she makes an ambivalent noise.

She is not ambivalent, however, on the enduring refusal to study and describe anorexia as having a biological basis. “There are papers I have tried to publish and these have been refused on the grounds that I am trying to overly medicalise anorexia,” she said. “Of course the biopsychosocial model is one that should be observed. But if you continually refuse to acknowledge the ‘bio’ in that complex, then you will end up with no idea of how the different elements interact.”

With medicine so reluctant to commit itself to an explanation for ED, it’s hardly surprising that groups like The Butterfly Foundation would follow suit. But even if we agree that it’s better to take the potential social catalysts for EDs out of the picture, the “dis” campaign fails miserably on that score.

Let’s even allow that the foundation’s normalisation of extreme ED and selective mortality statistic will do no harm and just think about the phrase “don’t DIS my appearance”. Given that the most at-risk ED sufferers are those who are underweight and gain at least as much momentum from the compliments their tiny silhouettes routinely attract as they may have from an early life “DIS”, perhaps “don’t praise my appearance” might be a more effective tactic.

Approbation is, perhaps, even more hazardous to ED patients than condemnation. As Rossell suggests, many public conversations that purport to address ED patients are really just intended for gals who feel like they might be a bit unattractive. And even if making the super body conscious feel a bit better about their flab is considered a good outcome, the “don’t DIS” edict doesn’t even really work here.

If women, both those who suffer an ED and those who just feel a bit shit about their bodies, want to be liberated from the primacy of the image, then surely an obvious solution is to detonate the power of the image.

Here’s my campaign, free of charge, to The Butterfly Foundation next May. How about you try “completely DISregard my appearance”? And instead of using attractive ambassadors and expensive manicures to underscore the lack of importance of the image, try a picture of me after 24 straight hours of researching EDs in my pyjamas. I’ll show you just how visual perfection has very little currency in one adult human woman’s working life.

 

 

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What they don't tell you about eating disordersWelcome to all my new followers. Thank you for joining me. Whilst it’s lovely to have you hear, it means though, there are more and more searching the internet to find support, resources and answers when facing an eating disorder.

Thinking back on our experience and what we have travelled through plus what others have shared, there is a list of things that aren’t told to you when you start this journey. You find them out yourself the hard way and often alone. Some come as a surprise, others you realise are normal but you didn’t think about it. So I thought I would list them, just so it’s out there and because medical support teams don’t tell you.

  • You (the carer) are often the front-line and sometimes only line of care. Funding and resources can make it very difficult to get what you may need.
  • This is going to be a long journey. You won’t just get well after the first ’round’. It will take years in some cases.
  • You need to treat yourself for self-care just as much as you care for your loved one. It’s essential to survival.
  • Your marriage or significant relationship will be tested to the max. Take care of it.
  • This is NOT your fault. It’s not your parenting or your family. It is a genetic pre-disposition.
  • How exhausted and OVER it you will be. How refeeding is draining. That you will have a list of appointments on a weekly, fortnightly, monthly basis that you might have to drive miles to.
  • You will find yourself up against schools, doctors, clinics, friends, family. Most have a ‘warped’ idea of eating disorders. You have to explain and educate just to get the care your loved one needs.
  • You will need to swat up on symptoms, treatment, research. No one else will teach this. As you are the front line you need to know this stuff.
  • There are not enough resources or funds in place to provide what your loved one or you will need. That includes treatment centres and hospital beds. And a lot of written resources are often out of date (badly).
  • You are not alone – even if it feels like it. There are many of us on the internet, facebook and other medias who are travelling this journey and can support you.
  • Your child will become a totally different person – loud, rude, violent, abusive, manipulative and lies. This is the illness not your child.
  • Logical, clear, rational thinking will not be part of your loved ones thinking. The illness is in full residence and they are not able to eat, care, stop or save themselves when they are very ill.
  • When really sick, they smell. This really threw me. My beautiful daughter smelt like death – sour, old and decaying. The body is breaking down and the smell starts from a relatively higher weight than you think.
  • Watching the lanugo (fine hair) grow on your child body. Also quite freakish for a parent. It’s the body’s way of keeping warm when there is no fuel to feed it or enough fat to warm it.
  • Night-time heart rates go much lower than day time. Whilst doctors do the medical observations they only ever do day-time, standing and sitting ones. At very low weights the night-time heart rate is actually very scary and can be dropping into intensive care levels without you knowing it.
  • Medical professional won’t know it all. Medications are one big area they are in the dark about. It’s trial and error, of sometimes many medications tried or grouped to find something that might work.
  • That relapse is every parents nightmare, when in actual fact it can be monitored and cared for quite closely by an aware and caring team.
  • There will be a before ED and an after ED state for your family. It will affect everything and the way you live and think for years to come – even when your loved one is fully recovered.
  • Eating disorders are a family illness. It will affect all the members and relationships within.
  • How quickly your loved one can develop an eating disorder and become critical.
  • The blood results will stay ‘normal’ for ages then suddenly drop at the last possible minute. Make sure you have medical support around you.
  • Hope is real and full recovery possible. Even good levels of recovery are better than the original illness.
  • Associated and long term digestive problems, bowel problems, bladder problems, over health problems, teeth, bones, Vit D, Vit B, calcium levels.
  • Despite all the pain, fear and the enormity of it all, you will be given strength to do this.

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“Learn to separate yourself from the eating disorder”

Heard that yet from your therapist? If you are in very early recovery you are not going to understand what they mean. You and the eating disorder are still very much one unit. Are psychiatrist used this image to help Sophie understand.

  • Cover one hand with the other: that’s you and the eating disorder at the beginning. The ED is totally controlling you.
  • Then slowly, gradually start to move the hands apart: As you recover and learn more, you can start to see two separate entities, yourself and the ED.
  • Finally, your two hands are far apart: you are no longer controlled by the ED, you are your own person.

Both carers and sufferers must learn this separation technique. It is critical for recovery. It removes the blame and the idea the person is the problem. It shows that the eating disorder is a separate voice and thinking pattern to you. The eating disorder is the problem, never ever the person.

One of the best ways of becoming aware of the ED and how it is separate to you, is to learn to externalise the eating disorder. Like it is a separate being. It also empowers you to be able to make positive changes and think encouraging thoughts. It disempowers the eating disorder and the control is has on your life.

1. Give it a name

This may sound weird, but it does work. Give the ED a name. Ana, Mia, Ed, anything. This makes the illness separate to you. You address the illness. You see it as a separate entity to yourself. This gives some distance and makes the illness objective rather than personal.

2. You are not a label (or a victim)

Don’t call yourself or others the ‘anorexic’ or  the ‘bulimic’. Doing this ignores the sufferer as a person. They become a label or statistic. You are a person with a mental health illness called anorexia. All the things that made you unique as a person before this illness are still there and still real. The idea that you are a victim, also removes your power as a person. The word makes you feel you are unable to take control of your own life.

3. You still have a voice

It’s just silenced. That’s what the ED does. Learning to exercise your voice and make it strong again, gives you back the control. Just because all you hear at the moment is the loud, negative and destructive ED voice, that that is all there is. Your voice is still there, underneath, and can be developed to be stronger than the ED voice.

4. Make third party statements

When you don’t eat your scheduled meals, or you choose ED behaviour ask questions that don’t point the finger at you.

  • How did the eating disorder make you skip lunch?
  • What did Ana tell you today about yourself?
  • That’s the eating disorder voice I hear, what does (your name) think or feel?
  • Who made that statement, you or Ana?

5. Notice your vulnerable triggers and times

Eating disorders use certain ‘weak’ points, situations, times of the day, certain people to trip you up. ED behaviour and slip-ups are always stronger at these times. Being aware and forewarned can help you beat the ED at it’s own game.

6. Don’t beat yourself up

When you find it too exhausting or too hard to separate from the ED and you just let the ED do it’s thing, be gentle on yourself. It takes a lot of time and learning to get the separation/externalisation happening. You have lived for so long with the ED being often the only voice in your head. Your own voice is rusty from dis-use and like any unused item, takes a while to work.

7. Believe

Yes, externalising the ED is possible. It is a real thing and can happen for anyone and everyone. But it’s not a magic pill or wand. It needs commitment and skills but achieving this is a major step forward in recovery. It opens your eyes to the real character of the eating disorder and it shows you the beauty of your own voice. Therapy with a skilled professional really helps with learning this process.

 

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I wanted to share this lovely post from one of my readers. As a mum with two children struggling with an eating disorder she gives some great advice, hope and strength to those of use following a similar path. The reality of living with an eating disorder in the house is different for everyone. It is tough, frightening, painful and like living in some private, hellish parallel universe. What is also frightening is how strong a link there is from eating disorders developing and fathers who are absent, abusive and neglectful.

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Hello everyone,

A swift update. My son Jordan [who likes to be called just J] ended up being sectioned and spending nearly two and a half months in the Huntercombe hospital, Stafford, UK. It was a nightmare trying to get him in the ambulance to take him on the 3 hour journey – his resistance and strength was superhuman – quite surprising for someone so weak with starvation. The dents in my freezer where he punched it is testament. I’d even struggled to disarm him when he’d grabbed a couple of bread knives and tried to stab the social workers. Once inside the hospital, he protested violently, kicked the furniture and finally fell to his knees, sobbing and breaking down totally. It was heartbreaking, but necessary. I was relived that he was finally where he needed to be. He was admitted weighing 8 1/2 stone after losing around 1/3 of his body weight. After admission his blood pressure dropped dangerously low. Thankfully the hospital staff saved his life and put him on the road to recovery. He hated it there, but was determined to do whatever it took to get himself out and he quickly and steadily gained weight. He was discharged weighing 10 stone, which is still very low for his height, but he is terrified of getting any heavier.

He is still firmly in the grip of anorexia and doesn’t really want to recover [although he tries to convince us that he has recovered.] Just like Sophie, for the first month he seemed to be doing well; he was perky and chatty, controlling his own food intake and maintaining his discharge weight. However he is now slowly losing weight again, even though he eats somewhere between 1700 and 2000 cals per day. He goes through periods of food obsession. At first he would only eat a variety of just a handful of ‘healthy’ foods; that changed and his calorie intake came largely from ‘healthy’ fluids, including lots of milk; now he’s gone to the extreme of eating mainly unhealthy food and drink, such as energy drinks, kitkats, fish and chips from the chippy and black coffee. He sees the CAMHS team regularly, but under duress. He refuses to co-operate and will only agree to being weighed and having a very brief consultation. He began haphazardly taking his anti depressants, just before stopping them completely, insisting he doesn’t need them. He refuses to see the medics and have tests re his curved spine and sleep paralysis, saying that he can’t stand being touched during examinations. Despite all of this, the old happy ‘normal’ J that we used to know – the one that used to joke around and the one who you could have an intelligent conversation with – does still exist and emerges fairly frequently. He is very changeable though, one minute he’s laughing and feeling optimistic about the future and making plans/setting goals and the next he’s angry and depressed and saying he didn’t ask to be born. He is frequently argumentative, aggressive, verbally abusive, selfish … it’s as if he’s possessed by the devil. I’ve learnt to keep my composure and walk away from him when he’s being nasty, telling him I refuse to talk to that other voice/creature. After a short time he will calm down and be nice and reasonable again and all the harsh words will have been forgotten. He never apologises though and has a complete lack of empathy for anyone else. The good thing is, he is truthful and admits his dieting had got out of hand, that it was all about control, that he does hear the ‘anorexic voice’ [saying, for example, that he used to grab a handful of cereal, put it in his mouth, but was then compelled to spit it out], that we had all been right, but that he had refused to listen, believing that we were all lying to him… He says he forces himself to ignore the Ana voice as he has no intention of ever getting sectioned again. He jokes that he’ll be visiting his younger sister Melissa in hospital when she gets sectioned. He tells me to stop worrying and that although he hates food, he knows he has to eat. He is aware that there is a strong chance of relapse and says he’s not going to let that happen. How can any parent not worry? Due to being malnourished for so long he now has low bone density and a curved spine and he has weakened his heart. He also has very poor short-term memory and constantly repeats himself. The hope is that he will settle at college next year, build up his confidence and find some happiness [he did try a college course this September but it was all too soon – all the anxieties and doubts flooded back and overwhelmed him and he had to drop out]. Thankfully he has a lovely supportive friend.

Melissa [now 15] is sliding down the same slope as J. After battling with her E.D and, for months being able to maintain her weight of around 8 1/2 stone [which is very low for her height of 5ft 8″], she is now losing weight again and struggles to tip the scales at 8 stone, fully clothed. She used to be a healthy 10 stone and a perfect size 10, but thought she was fat. She is very rigid in the handful of different foods that she allows herself and in her calorie intake, which is now only a few hundred per day. She still thinks she’s fat even though she is very thin. Thankfully she has a lovely CAMHS counsellor, who sees her weekly and her teachers/mentors at Bryn Elian school in North Wales are bending over backwards to support her – she is allowed to leave early and go in late on some days, has been able to drop unnecessary subjects and is allowed to learn maths at home. So the reduced school stress has resulted in an improvement in her confidence and mood. She is motivated to complete year 11 and pass her GCSEs and go to college next year. Hopefully she can stay healthy enough. Frequently though she gets so depressed, tearful, argumentative, nasty and even violent. Her eyes glare and something ugly speaks. It really isn’t her as the real Melly is gentle, loving, caring, helpful, beautiful and a joy to have around. Ana-Melissa sometimes threatens to self-harm. We have spent endless hours just talking and cuddling and crying together. [She’s so different to J who doesn’t do hugs]. Despite the fact she has many lovely supportive friends and lots of male admirers, she struggles to be happy. She feels constantly cold and her hair is falling out.

Their older brother and sister Andy and Shelly seem to have given up and feel that Mel is just an attention seeking difficult teen. It is difficult trying to convince them that neither J or M want to be this way, that they cannot help it, nor can they fight it alone. At least Mel had the strength to ask her school teachers and everyone else for help. I try to stay calm and understanding and supportive and positive thinking, however I’m not supermum and I sometimes can’t help raging and effing and blinding back at them. And yes, I’ve told them both to just grow up. I do get over my angry outbursts and frustration quickly though and both J & M know that I’m just releasing tension and that I’ll always be there for them, will always love them and will do whatever it takes to help them both back to health and happiness. My GP and the CAMHS team have told me to expect to be the punching bag and that this will be an up/down struggle for years, maybe a lifetime. There was only one time when I totally lost control, and that was when after the millionth time of going round and round in circles with Melissa I finally blew my top and yelled that I couldn’t take it any more. She had been my rock during our worst times with J and now she was sapping all my energy. Rather than hurt her or smash up the house as I so deeply desired at that moment, I stomped my way upstairs to my room, sat on my bed, gripped the quilt and, from the pit of my stomach, just screamed and sobbed and rocked backwards and forwards, yelling “why, why why”. This went on for a good 10 minutes until I had burst blood vessels in my face and I had nothing left inside of me. Shelly came up with a cup of sweet tea, spoke soothing words to me, told me everything’s going to be ok and helped me pull myself together. Meanwhile Melly ran outside and we found her sitting and just staring into space. Anorexia is an ugly powerful destructive demon. Daily I pray that J & M find the strength to overcome it.

If I could offer any parent advice I would say get your GP [pressure him/her if need be] to refer your child into the psychiatric services as soon as you know he/she is showing signs of a worrying eating pattern, and once there, if things don’t improve, push for admittance into an inpatient eating disorder unit/hospital. Remember, our kids will not/cannot just ‘snap out of it’. I was so angry with the old GP [we’re with a much more sympathetic and helpful one now] because he just dismissed us, saying nothing could be done unless J wanted help. He had a mocking, couldn’t-care-less attitude and told me I had no choice but to just wait until J got so ill that he’d be rushed into hospital, but by then it might be too late. I just sat there, stared at him with a look of shock horror and told him he has to get us some help. I didn’t move from my seat and just kept repeating that he has to help us. Eventually he said he would have a word with his colleagues at the local hospital and see what could be done. A few days later he phoned me to say that he had put a referral through to the Child and Adolescent services, but warned me that the waiting list was long and that we could be waiting weeks. Thankfully it only took 2 weeks.

My love and prayers go out to all who struggle with an eating disorder and all the families involved. It really is tough on everyone with all the stress and worry and constant walking on egg shells, not to mention the endless meetings with all sorts of professionals – psychiatric nurses, psychiatrists, doctors, family therapists, dieticians, school teachers/mentors/educational welfare officers… all this on top of having to earn a living.

Sorry I’ve gone on a bit! It helps to get the thoughts down. Mel also finds it therapeutic to diarise stuff that has happened in her life in relation to her father and what led to her eating disorder. She says that when she is older she will publish it on my website http://www.sharonkilby.co.uk/site/ The site exposes corruption in North Wales and the people responsible for forcing my children to live with their abusive father almost half their lives.

I have been shocked to learn that eating disorders are not so uncommon anymore. It seems that everyone knows someone who is suffering with one. Melissa knows 4 people in her school year who are sufferers. My boss knows 2 people who are anorexic, a friend of mine knows 2 anorexics [one of them fully recovered and went on to be happily married with child, the other person didn’t recover], my solicitor has an anorexic in her family… My God what is happening to our youngsters? Maybe EDs are symptomatic of the sick insane, evil society that we are forced to live in [more on that in my site.]

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the front line:

  •  the GP, general medical doctor
  • school/uni nurse or counsellor
  • parents

what are they missing:

  • the truth/facts about eating disorders
  • how serious they are
  • they are not a passing phase or something else
  • you NEED to act immediately, REGARDLESS!

This month we have 5 new inpatients to our children’s ward, one of which is in the intensive care unit. Why, because local doctors don’t react quickly enough, don’t believe, don’t refer onto appropriate care. The young men and women, then end up so ill that they need hospital care.

Worse parents and sufferers have to find through other means, word of mouth, who to see, what to do to find the appropriate medical assistance.

What does it take to get the message through??? Seriously, do local GP’s just bury their heads in the sand or pretend they know everything!!!!!

Someone asked this week on Tumblr, what happened in the years previous before this enlightened age of eating disorder care. I told her the enlightened age has still not come. Too many are still heading for inpatient treatment because no one will act early enough to help them. Too many are still dying.

 

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This post is to all those who are still struggling to weight gain but are compelled to exercise. Exercise is a form of purging, is unhealthy, and has a negative effect on the body’s ability to recover. Basically all the food you are eating to weight gain is being used to fuel the exercise regime and your body is still self-destructing.

 

From Libero Network, Jodie Mechielsen

“Exercise is good for you. You’re not doing anything wrong, keep exercising. It will make you fit and strong and lean. You’re not exercising too much, those other people are just jealous. You’re only feeling tired because you’re so unfit, exercise more. You have to work hard if you want results.”

That was what my ED said to me day in and day out to keep me trapped and compulsively exercising. I know now that voice was lying. I work as an exercise scientist, personal trainer and group fitness instructor and study exercise physiology at university so a very large portion of my life revolves around exercise.

When I first started exercising, I genuinely loved and enjoyed it, but as my ED developed it began to use this to its advantage. I began exercising excessively and obsessively, yet despite all my own knowledge about exercise I still wasn’t open to the thought that I was doing anything unhealthy and denied it when anyone asked.

Exercise, as a general rule, is good for you. However, there are two factors which shift exercise from the ‘good for your health’ to the ‘bad for your health’ basket: exercising to the detriment of your body and exercising to the detriment of your mind.

1. Exercising to the detriment of your body is the result of the amount of exercise you’re doing and the lack of recovery your body is receiving.

At this point, you might even still be enjoying exercising (as I was at the beginning) however your body will eventually begin to feel tired, sore and weak. You may experience dizzy spells, fainting, irregular or absent menstrual cycles, difficulty sleeping, increased injuries or illness. The amount of exercise that is healthy will vary from person to person – what is healthy for an iron man isn’t healthy for me. My ED told me that the amount of exercise I was doing was perfectly healthy, because athletes do it and they’re healthy. Athletes also gradually build up to that level over many years, they fuel their bodies appropriately, they have regular recovery sessions and they stop or reduce exercise when injured/sick.

2. Exercising to the detriment of your mind develops because of reasons why you are exercising and the thoughts behind it.

You may be engaging in a healthy amount of exercise (or you might be over- exercising as well), but the thought processes behind it are still damaging. Being motivated to exercise purely as a means to burn calories, as opposed to improving the health of your body is a red flag. If you are consistently prioritizing exercise over social situations/study/work, feeling anxious or guilty at the thought of missing an exercise session, exercising because you ‘have to’ rather than because you ‘want to’ and/or spending a large amount of time thinking about or planning exercise, it is likely that you’ve developed an unhealthy obsession with exercise that leaves little room in your thoughts and life for other things.

Signs that you may be compulsively exercising or over-training:

  • Irregular or absent menstrual cycles
  • Depression
  • Difficulty sleeping
  • Muscle soreness, aches and injuries
  • Prioritizing exercise over social events/work/study
  • Exercising despite being sick or injured
  • Inability to miss an exercise session or feeling guilty for missing an exercise session
  • Exercising because you ‘have to’ rather than because you ‘want to’
  • Exercising purely to burn calories
  • Consistently thinking about exercise
  • Exercising at inappropriate times (eg middle of the night)

So, what is healthy exercise?

Healthy exercise occurs when we exercise because it makes us feel good, physically, emotionally and mentally. As mentioned earlier, it’s difficult to set general guidelines on what constitutes the right amount of exercise for everyone; for most people 2-5 hours per week is an appropriate range. However, with some thought and listening to your body (and maybe some professional advice) you can determine the healthiest amount of exercise for you.

Signs of healthy exercise

  • Exercise makes you feel good – physically, mentally and emotionally
  • You can take a day/week/month off of exercise without feeling anxious or guilty
  • You rest and recover if you are sore, injured, tired or sick
  • You engage in physical activity that you enjoy (walking, dancing, kayaking, cycling etc), rather than the type you think you should do/burns the most calories
  • You allocate no more time to thinking about exercise than you would to household chores or what’s on television
  • You are comfortable with missing an exercise session to attend a social event/work/study
  • You think about exercise as a way to keep your mind and body fit, strong and healthy; as opposed to simply a way to burn calories or change your body shape

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To all the doctors, dietitians, medical professionals, and parents

Imagine you are in a dark, scary place. Your mind is playing tricks on you so you don’t know what is real and what is not. You have lost what truth means or write your own truth. You are terribly insecure, sad, and have no hope. You know you are sliding into a deep hole but are powerless to stop it. You hate yourself and feel so weird around others you isolate yourself. Your emotions and life are just numb and you prefer to just ‘disappear’. It would be better to hide. You have obsessions that you can’t control, that just take over your body and mind. It is like being on a treadmill that you can’t stop, but gets faster and faster. Until you are out of control and desperately want help, but are terrified to ask for it. Giving up on life completely seems a better option.

Would you like to live like this everyday for months or years?

This is the basis of what it is to live with an eating disorder. It is a mental health illness that needs treatment not ignorance.

How much educational awareness, media coverage, research etc will it take for you to realise eating disorders are serious. Or worse, they actually exist and will not go away just because you don’t want to understand or treat the disorder.

How many sufferers are condemned to getting sicker because you don’t believe they have an eating disorder or are not critical enough? Your brush off and lack of care or support silences the voice of the sufferer. Imagine having finally reached out to someone because you are desperate for help only to be told you don’t rate enough to get help.

Where do you get the idea that ‘just eat’ will work or ‘I know you can eat so get over this’. Why would you use medication to increase the appetite when you aren’t treating the mind or emotions? Who decides who is critical enough to warrant the attention of a psychologist or psychiatrist? Who decides that an eating disorder has ‘levels’ of diagnosis? Cancer is cancer not almost cancer. An eating disorder is the same and demands the same instant attention and treatment.

EATING DISORDERS ARE NOT ATTENTION SEEKING BEHAVIOUR

EATING DISORDERS ARE NOT A MINOR ILLNESS THAT YOU GIVE A BANDAID FOR

EATING DISORDERS ARE NOT A FOOD OR WEIGHT PROBLEM

EATING DISORDERS ARE NOT THE LATEST SOCIAL CRAZE AND MUST HAVE

There is no excuse apart from ignorance to treat people with an eating disorder as unimportant or stupid. Information is widely available including research. No one wants their loved one to have an eating disorder, but to bury your head in the sand and pretend it doesn’t exist will only make the eating disorder worse. It will get a stronger grip and you will end up with someone who is very sick. Early intervention and treatment is the key and so much research and statistics prove this point. And follow up support after treatment is also essential. You just don’t drop and run.

When you are an adult sufferer you can at least keep pursuing the challenge to find appropriate support/medical professionals to help you recover. It is a challenge that should NOT be there. Public health systems, medical insurers make the task of finding appropriate help a nightmare. Any other illness is a straight forward approach, but eating disorders still have not made even made it to basic level.

For those under adult age and are reliant on a parent getting them help they need it is heartbreaking. Not having a parent who understands or wants to take the time to learn what an eating disorder is only adds to the strength of the illness and the entrenchment of the illness. It won’t go away conveniently for you and yes it will cost money and time. Ignoring the illness and your child adds guilt, shame and denial of self to your child. They don’t need that – it just feeds the illness. I will be the first to put my hand up and say the journey over the last 4 years has been hell at times. But it has been worth it to see my daughter now.

I know I have vented before, and have said a lot of this before too. But I get sooooooo frustrated and angry when I get emails with desperate cries of help because families and the medical establishment remain blissfully ignorant.

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