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Archive for the ‘Education and awareness’ Category

From NEDC Newsletter 2016

Eating disorders are complex mental illnesses. To date, no single cause has been identified. Rather, widespread research suggests that the onset of an eating disorder is unique to the individual and often involves the integration of multiple factors (Culbert, Racine, & Klump, 2015; Rikani et al., 2013). Understanding these known risk factors has the potential to improve treatment methods, determine high risk groups for prevention programs and reduce stigma (Striegel-moore & Bulik, 2007). Current literature explores genetic, psychological and socio-cultural influences.

Genetic Vulnerability

The genetic link to eating disorders has been a consistent focus in scientific literature. Previous findings from family and twin studies indicate that eating disorders have a hereditary component (Trace, Baker, Pe, & Bulik, 2013). In particular, one study found that first-degree relatives of individuals with Anorexia Nervosa are 11 times more likely to develop the illness than relatives of individuals without the disorder (Strober, Freeman, Lampert, Diamond, & Kaye, 2000). This suggests that genetics can influence an individual’s vulnerability to eating disorders.

The onset of eating disorders, specifically Anorexia Nervosa and Bulimia Nervosa, typically occurs during adolescence (Hudson, Hiripi, Pope, & Kessler, 2007; Striegel-moore & Bulik, 2007). The complex hormonal, physical and neural changes associated with puberty increase the likelihood of adolescent engagement in disordered eating behaviours (Klump, 2013). Given such, puberty is recognised as a significant risk period.

Although there has been decades of research exploring the genetics of eating disorders, the biological causes are still not well understood. This may be because the majority of studies involve small sample sizes and are often conducted during the acute or recovery phase of an eating disorder (Trace et al., 2013). The QIMR Berghofer Medical Research Institute in Queensland are currently undertaking the largest international investigation into the cause of Anorexia Nervosa. This study, known as the Anorexia Nervosa Genetic Initiative (ANGI), seeks to identify the specific genes associated with Anorexia Nervosa in the hopes of better understanding the causes and finding a potential cure.

Psychological Factors

A connection between certain personality traits and eating disorders has been identified. Research into Anorexia Nervosa and Bulimia Nervosa has shown that obsessive compulsive personality disorder, low self -esteem and perfectionism are considerable risk factors for disordered eating behaviours and attitudes (Culbert et al., 2015; Egan, Wade, & Shafran, 2011). A recent investigation into childhood obsessive compulsive personality traits found that the presence of perfectionism and inflexibility in early life can predict the later development of an eating disorder (Southgate, Tchanturia, Collier & Treasure, 2008). Personality types are also important to consider when treating an eating disorder, as obsessive compulsive tendencies may continue to drive restrictive and rigid behaviours. Given such, Egan et al. (2011) argues that traits such as perfectionism should be treated alongside an eating disorder, in order to effectively reduce disordered eating symptoms.

The cognitive, behavioural and interpersonal changes that accompany eating disorders can make it difficult to discern the psychological causes from the psychological effects. For example, the co-existence of depression and anxiety with eating disorders has raised debate as to whether such conditions precede or are a direct outcome of an eating disorder.

Socio-Cultural Influences

Socio-cultural influences play a considerable role in the development of eating disorders. Mass media, such as television, magazines and advertising, airbrush and alter images to portray unrealistic representations of the male and female body (Perloff, 2014; Striegel-moore & Bulik, 2007). Predominant images suggest that beauty is associated with thinness for females and a lean, muscular body for males. Individuals who internalise this ‘thin’ ideal and strive for the ‘perfect’ body, are at a greater risk of developing body dissatisfaction, which can lead to dieting and other disordered eating behaviours (Culbert et al., 2015). More recent research has explored the impact of social media on body image and eating behaviours. Andsager (2014) argues that the introduction of Facebook and Instagram has increased our exposure to photo-shopped images and thin ideals. Although a direct link to eating behaviours is yet to be established, the appearance-focused nature of social media platforms has been shown to cultivate body image concerns and reduce self-esteem (Perloff, 2014).

Additionally, there is growing evidence that the ways in which weight, shape and size are discussed in the home have a strong impact on self-esteem and dieting behaviours (Loth et al., 2014). Culbert et al. (2015) propose that environmental and psychological factors interact with and influence the expression of genes to cause eating disorders. Further research into this relationship is needed.

Modifiable Risk Factors

Identifying potential risk factors for eating disorders is beneficial in shaping effective prevention and early intervention programs. Research indicates that prevention programs with the most favourable outcomes are those which focus on reducing modifiable risk factors (Jacobi, Hayward, Zwaan, Kraemer, & Agras, 2004). Low self-esteem, body dissatisfaction, dieting behaviours and internalisation of the thin ideal have been acknowledged as variable factors associated with the onset of eating disorders.

The aetiology of eating disorders is becoming a growing field of research. Although limited conclusive evidence has been recorded, understanding possible influences can inform best practice and encourage effective management of eating disorders.

References

Andsager, J. L. (2014). Research Directions in Social Media and Body Image. Sex Roles, 71, 407–413.

Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review : What we have learned about the causes of eating disorders – a synthesis of sociocultural , psychological , and biological research. Journal of Child Psychology and Psychiatry, 11, 1141–1164.

Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process : A clinical review. Clinical Psychology Review, 31(2), 203–212.

Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Journal of Biological Psychiatry, 61, 348–358.

Jacobi, C., Hayward, C., Zwaan, M. De, Kraemer, H. C., & Agras, W. S. (2004). Coming to Terms With Risk Factors for Eating Disorders : Application of Risk Terminology and Suggestions for a General Taxonomy. Psychological Bulletin, 130(1), 19–65.

Klump, K. L. (2013). Puberty as a critical risk period for eating disorders : A review of human and animal studies. Hormones and Behavior, 64(2), 399–410.

Loth, K. A., Ph, D., D, R., Maclehose, R., Ph, D., Bucchianeri, M., … D, R. (2014). Predictors of Dieting and Disordered Eating Behaviors From Adolescence to Young Adulthood. Journal of Adolescent Health, 55(5), 705–712.

Perloff, R. M. (2014). Social Media Effects on Young Women ’ s Body Image Concerns : Theoretical Perspectives and an Agenda for Research, 363–377.

Rikani, A. A., Choudhry, Z., Choudhry, A. M., Ikram, H., Asghar, M. W., Kajal, D., … Mobassarah, N. J. (2013). A critique of the literature on etiology of eating disorders. Annals of Neurosciences, 20(4), 157–161.

Southgate, L., Tchanturia, K., Collier, D., & Treasure, J. (2008). The development of the childhood retrospective perfectionism questionnaire (CHIRP) in an eating disorder sample. European Eating Disorders Review, 16(6), 451-462.

Striegel-moore, R. H., & Bulik, C. M. (2007). Risk Factors for Eating Disorders. American Psychologist, 62(3), 181–198.

Strober, M., Freeman, R., Lampert, C., Diamond, J., & Kaye, W. (2000). Controlled family study of anorexia nervosa and bulimia nervosa: Evidence of shared liability and transmission of partial syndromes. The American Journal of Psychiatry, 157(3), 393–401.

Trace, S. E., Baker, J. H., Pe, E., & Bulik, C. M. (2013). The Genetics of Eating Disorders. Annual Review of Clinical Psychology, 9, 589–620.

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For anyone who saw the ‘DIS’ campaign or participated, this survey is critical. It is not only about the campaign and advertising ‘wins’ or ‘loses’.

It is about getting the correct information about eating disorders out to the public, sufferers, medical professionals and making sure the EDucate is clear and not ambiguous.

Eating disorders are NOT body image developed. 60-80% of all ED’s are genetic/biology based and this is being proven as more research is done, and the percentage pointing to genes rises. The remaining percentage is then a mix of many complex issues of which body image is ONLY ONE of these. 

Most sufferers will say body image is the reason for their ED. In most cases the ED thinking and behaviour is ALREADY in residence in the brain and body image is a symptom not a cause.

The same goes for the ‘diet’ caused my ED. By the time the diet choices start the ED is already in residence in the brain. Again the diet choices are a symptom not the cause.

Please take the time to complete the survey and make a start to build better communication and collaboration with Butterfly so we can better diagnose, intervene, treat and care for sufferers.

https://www.surveymonkey.com/r/dontdismyappearance

 

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The Dirty Laundry Project (DLP)

Dirty Laundry ProjectAt the DLP we celebrate, recognize & honor those whose actions are breaking the eating disorders & mental health “Stigma wall.”

Beating Eating Disorders (BED)

There is so much more to eating disorders than the way someone looks.
Eating disorders are a seBeating Eating Disordersrious mental illness. This disease affects millions of people all over, and has the highest mortality rate of mental illness. Often times, people with eating disorders are afraid of being judged due to the stigmatism and for that reason keep it a secret. Would you keep the diagnosis of cancer a secret? NO!!! This mental illness deserves the same kind of attention and respect as every other medical/mental diagnosis.

Eating Disorder Parent Support (EDPS)

Eating Disorder Parent SupportEating Disorder Parent Support (EDPS) is specifically and only for adults who care, or have cared for a loved one with an eating disorder. We are here for peer-to-peer sharing, support, education, guidance, encouragement, and to offer HOPE as we support our loved ones toward recovery. We welcome parents, spouses, and adult siblings, who are involved in the care; however, we are not a site or a support network for sufferers themselves.

Website: http://eatingdisorderparentsupport.weebly.com/
Facebook: https://www.facebook.com/groups/EatingDisorderParentSupport.E/

International Eating Disorder Action (IEDAction)

International Eating Disorder ActionInternational Eating Disorder Action is a coalition of parents, carers, survivors, sufferers and others, established so that members can take ACTION on issues relating to Eating Disorders (EDs).   We have members in over 15 countries and address issues globally.

Our goals:  1) to increase awareness and knowledge of EDs as treatable, biological, brain-based illnesses that that are neither the fault of, or chosen by sufferers, nor caused by parents; 2) to advocate for national Eating Disorder strategies and treatment systems that use evidence-based services; 3) to demand legislation and funding parity; and 4) to address groups/companies overtly or inadvertently fuelling Eating Disorders by glamorizing them or profiting from them.

Website: http://iedaction.weebly.com/
Blog: http://internationaleatingdisorderadvocacy.blogspot.com.au/
Facebook: https://www.facebook.com/groups/IEDAction/

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Butterfly, with respect your constant body image campaigns and it’s all about looks ideology heavily promote to the general public, medical people, parents and kids of all ages that eating disorders come from body image, dieting or models. You do not separate the issues enough nor do you promote campaigns that clearly state what an eating disorder is – they are genetic/biology based with a very complex mix that trigger the development. Just because you struggle with your body image or you diet does NOT mean you are seriously opening yourself to an ED. Otherwise there would be millions with an ED. Those who develop an ED do so because of a genetic/biological predisposition. Your campaigns do not indicate this and in their simple, trivial body image design muddy what is the truth. You also confuse disordered eating with eating disorders. The two are VERY different and are not the same. Disordered eating can sometimes lead to an ED but again ONLY if your predisposed that way.

If you are the most public spokes group for EDs in Australia then do so without the body image stuff being too closely associated with EDs. We desperately need early intervention, and diagnosis and treatment centres. Yet you spend grant money on silly, superficial campaigns. There is no research at all that says these type of campaigns work in preventing EDs and these have been done world wide. In fact research show they don’t help. Research does however show that early diagnosis, intervention and full on treatment does work. Yet Australia DOES NOT invest in this. Instead we do best practice which in the end ends up worst for the patient. We still cannot even get GPs, psychologists, psychiatrists to even be trained correctly to clearly diagnose an ED or provide correct treatment and therapy. What the medical profession here tells sufferers is appallingly wrong and old school.

Your ‘dis’ campaign makes a joke of my daughters serious (almost deadly) illness and long recovery, as it was never ever about body image nor dieting nor media related. She herself will tell you your campaigns miss the mark. Many others will tell you that. And because people keep pushing the body image barrow, of course sufferers think they can blame their poor body image. They aren’t told of the truth of how an ED develops so of course they blame body image or diets. It is so much more complex and deeper and your campaign does not go that deep. It remains shallow, superficial and unlinked to the reality of an ED. Thankfully my daughter had a decent, highly ED educated medical team who explained what EDs really are and worked far beyond the silly body image idea. Her recovery is a testament to the fact they totally understood EDs, early diagnosed, heavily intervened, used high level therapy and long term treatment.

The campaigning for better body image alludes that this is the key to prevention. This naturally then follows the idea that you can then choose to get an ED or not. By choosing better body image then you can prevent an ED occuring. This is a very wrong concept and not achievable and in the end this type of thinking lays blame at the doorstep of sufferers. They could have ‘chosen’ better, ‘done’ better. You cannot choose to give yourself an ED, you cannot do superficial body image external caring that will prevent an ED developing. By pushing the external body image line, you also make is sound so simplistic and easy to either get the ED and worse, to remove the ED in your life.

You CANNOT prevent an ED. It is wishful thinking and taking the easy/wrong road out to say that good body image will prevent an ED. Complete crap. As parents of sufferers we are so over the body image linkage, the half naked women, and all that goes with this. It does nothing more than send the wrong message, not provide what is needed nor address the gaps in care. We see our children develop EDs, we see the generic and biological trigger set off and we can tell you very very very clearly that if our children had been exposed to your campaigns it would NOT have made any difference. There are and have been for years many such school based programs and self esteem stuff – it made and makes no difference. US research are proving this, they have been at this body image campaign longer than Australia has. It isn’t working for the prevention of EDs.

Research in this country is either suppressed or not valued for the medical side, and obviously not funded. The push is for quick research, popular topics and public opinion. Research is only ever as good as the questions it fields and the frame it has surrounding it. The research touted often aligns to a purpose or campaign and the real research with the truth and guts of eating disorder development is ignored or not done. The strong alignment with genetics, biology, neurology, personality etc are not marketed. In doing so we hide for longer the real truth and we hamper any decent forward progress we can make toward this illness.

Many clinicians in this country do not understand EDs fully nor do they keep up to date with latest findings. They are many of them, still in old school format. Thousands of parents can testify to this hard cold fact when we seek treatment for our children. Our country is very out of date and has a severe limitation on diagnosis and treatment. The parent body is a critical aspect you have ignored and forgotten. We are the frontline of care, we seek, fight and get so frustrated with the lack of knowledge, treatment and care. We are ignored but have far more ability than your experts. In most cases it is us who sees the the real ED, it is us who save our kids by doing refeeding and fighting for correct care because our health system fails us. We can tell doctors far more about this illness, it’s reality and development and yet we are classed as sub-people. Other countries have realised the value of the parent body and utilise them. Australia and its ED areas still ignore our input or only ever include us after all the ‘experts’ have decided what is best. Time to change and start to listen to what is needed and what could be better approaches.

Don't 'DIS' our eating disorder recognition and recovery

Further information:

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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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Truth #1: You can’t tell by looking at someone whether they have an eating disorder. Many people with eating disorders look healthy, yet may be extremely ill.

Truth #2: Families are not to blame.

Truth #3: Families can be the patients’ best allies in treatment.

Truth #4: An eating disorder diagnosis is a health crisis that disrupts personal and family functioning

Truth #5: Eating disorders are not choices, but serious biologically-influenced mental illnesses.

Truth #6: Eating disorders affect people of all genders, ages, races, ethnicities, sexual orientations, and socio-economic statuses.

Truth #7: Eating disorders carry an increased risk for both suicide and physical/medical complications.

Truth #8: Genes play a role in eating disorders, but environment also influences their development. Genes AND environment both play important roles.

Truth #9: Genes are not destiny when it comes to eating disorders. Genes alone do not predict who will develop eating disorders.

Truth #10: Full recovery from an eating disorder is possible. Early detection and intervention are important.

Republished from: http://www.nationaleatingdisorders.org/blog/9-truths-about-eating-disorders#sthash.IcK01qQE.dpuf

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This is worth repeating again, thank you to PEDAW and VanCityBuzz

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Online chatter these days often illustrates there is a long way to go before many people fully realize what an eating disorder truly is: a mental illness, or a disease of the brain.

On February 2, we published an article detailing the struggles of a 21-year-old B.C. woman who has resorted to crowd-funding to treat her severe eating disorder. Some of the publicly posted responses highlight the common misconceptions about eating disorders, so we thought we’d take a look at the kinds of misinformation that gets in the way of the good work being done to help those struggling with eating disorders.

While many of those who responded to our story were supportive of the woman’s endeavors to receive help, another fair share could not understand why her disease warranted help, let alone a news story.

The issue is complex.

But those without the education, life experiences or personal struggles that create compassion for and understanding of eating disorders will continue to criticize the publicity of this disease. They will mumble under their breaths something like “just eat a hamburger” or whisper to their friends “she doesn’t look anorexic.”

And that is where a direct response to these comments is needed. For eating disorders to receive the support they need, the stigmatization needs to be removed and the harsh reality of the disease needs to be learned.

Here are some common misconceptions and comments made about eating disorders, along with responses to the issues from professionals:

1. Just eat if you’re anorexic.

“Having an eating disorder means having neurological or neuroanatomical organization of your brain that creates enormous barriers to eating normally. These barriers include visual and sensory distortions, impacts on reward centers and executive organization of the brain, distortions of senses of fullness and hunger, and over evaluation of body size and shape, in addition to other issues that may be present. The combination of all of these things makes eating incredibly hard to do.”

Dr. Mark Warren, Cleveland Center for Eating Disorders

2. Just smoke weed, then you’ll get the munchies!

“We definitely want individuals to eat and digest food in order to heal their physical bodies. This being said, balance is key, so optimally they will work with supports to find ways of eating without using other substances that further promote numbing out to their present experience.”

Natasha Files, Individual and Family Therapist, Looking Glass Foundation

3. It’s more important to donate money to underprivileged children who can’t afford to eat.

“Suffering takes many forms. I have worked with individuals from all socio-economic realms, with some people having money for food and others not. Please choose to donate money to what moves you, but know that eating disorders are an illness cloaked in shame and secrecy. Many individuals do not get help unless their loved ones encourage them to do so, meaning that asking for support takes significant courage.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

4. #firstworldproblems

“There have been many reports about eating disorders in Western countries in the late 20th century. It has been claimed that those with eating disorders have mostly been white women and that few cases have been seen in non-Western countries other than Japan. Recently, eating disorders have been reported in non-Western countries, such as the Middle East and the People’s Republic of China.These recent studies suggest that the prevalence of eating disorders has been rising among non-Western countries as well. However, eating disorders may present differently in different cultures, and diagnostic criteria based on Western norms may not always be appropriate.”

– Makino, Maria, Koji Tsuboi, and Lorraine Dennerstein. “Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.” Medscape General Medicine 6.3 (2004): 49. Print.

5. There are people fighting cancer who can’t eat, and other people far worse off. Stop being so selfish and just eat.

“These kinds of statements just increase the guilt and shame of a person suffering from an eating disorder- which can lead to an increase in coping behaviours designed to avoid those uncomfortable feelings… cue the binge purge cycle or restriction!”

Trixie Hennessey MSW, RSW, Individual and Family Therapist

6. Anorexia is a serious disorder… but it’s not as bad as cancer or AIDS. We should focus on helping those people.

“Categorizing eating disorders as less deserving of support than other illnesses proves the ongoing struggle with stigmatization in our society. One outcome of struggling with an eating disorder is death. Eating disorders are the third most chronic condition among adolescent females (after asthma and obesity), yet have significantly less funding towards research and treatment.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

“Actually, more people die from eating disorders (350,000) than from breast cancer (approximately 40,000) every year. Females aged 15–24 are 12 times more likely to die of an eating disorder than any other cause of death. More people die of eating disorders than any other mental/behavioral disorder including depression.”

– Atlanta Center for Eating Disorders

7. You don’t look anorexic!

“Being the most lethal of psychiatric illness, eating disorders come with a number of serious health consequences, even if the individual looks “okay”. Low blood sugar, blood abnormalities (electrolyte imbalances), enamel erosion, dizziness/confusion, esophagitis, arrhythmias, acrocyanosis, edema, growth retardation in children and adolescents, and sometimes death. Eating disorders affect every system of the body, meaning that glancing at someone’s body shape does not determine the level of physical impact.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

8. You should be grateful you can afford to feed yourself. If you knew real hardship, you wouldn’t have this problem.

“Individuals who develop eating disorders are usually very sensitive.  They are physiologically more sensitive from birth than the average person. They are very in tune with the feelings of others and have a strong drive to want everyone around them to be happy. This often leads to perfectionism as they try to reduce any negativity that they or others will experience. As the disorder progresses they become caught in a vicious cycle where their attempts at being the best that they can be actually does cause others negative feelings — but at that point they can’t just stop. The attempt to be perfect is primarily a way to ensure that nothing about them will cause anyone else any distress and to ensure that others will not find fault in them, something that they are very sensitive about.”

– Atlanta Center for Eating Disorders

9. Starving yourself to death is a choice, just like taking drugs or drinking too much.

“There is no choice when it comes to an eating disorder. There is a choice to start out with behaviours such as dieting, exercising, fasting, etc… but there are many people that diet, exercise and overeat that do not have an eating disorder. There are many people unhappy with their weight and shape who do not have an eating disorder. Eating disorder treatment is complex and an intense process. I would encourage you to question this assumption, as I feel it perpetuates the stigma and feelings of shame that keep people from reaching our for help if they need it.”

– Trixie Hennessey MSW, RSW, Individual and Family Therapist

“Someone can make the choice to pursue recovery, but the act of recovery itself is a lot of hard work and involves more than simply deciding to not act on symptoms. In most cases, the eating disorder has become a person’s primary way of coping with intense emotions and difficult life events.  In order to heal from the eating disorder, a person needs appropriate treatment and support regarding medical monitoring, nutritional rehabilitation as well as learning and practicing healthier ways to manage stress.”

– The Center for Eating Disorders

 

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