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and I mean, ALWAYS. Never give up.

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Researchers at the UNC School of Medicine found that people with anorexia nervosa have very different microbial communities residing inside their guts compared to healthy individuals and that this bacterial imbalance is associated with some of the psychological symptoms related to the eating disorder.

The findings, published in the journal Psychosomatic Medicine, provide more evidence that the abundance and diversity of the gut microbiota — the trillions of bacteria that affect digestive health and immunity — could also affect the so-called “gut-brain axis.” This research suggests that gut bacteria could play a prominent role in the debilitating symptoms of anorexia nervosa, a serious eating disorder that affects more than 3 million Americans and has the highest mortality rate of any psychological disorder.

“Other studies have linked gut bacteria to weight regulation and behavior,” said Ian Carroll, PhD, senior author of the paper and assistant professor of medicine in the UNC Center for Gastrointestinal Biology and Disease. “Since people with anorexia nervosa exhibit extreme weight dysregulation, we decided to study this relationship further.”

Read full research article at Science Daily.

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With thanks to FEAST for this post. They have spelt it out perfectly. Why add to it!?

Defining Recovery

defining recovery from an eating disorderThe goal of eating disorder treatment is full recovery: living life free of eating disorder thoughts and behaviours. There is always hope, even for patients with chronic illness, but the best path to recovery is early intervention and firm and unyielding progress toward full medical, emotional, and cognitive health. Although they are extremely serious brain illnesses, anorexia and bulimia can be successfully and fully treated.

No patient or patient’s family need ever settle for treatment that isn’t working, is stalled, settles for less than 100% recovery, or stops before the patient is fully self-sufficient.

It is important for parents to know that full physical, emotional, and cognitive recovery is not unattainable or rare. In fact, if properly treated an eating disorder can be short in duration and without long-term medical consequences.

And although it has become common to say that it takes 5-7 years to recover, this is a statistic based on older treatment approaches and drawn from the most severe cases. Recovery is rarely achieved in less than several months, but treatment that languishes or settles for low weight goals should be reexamined.

It is also common to say that one never completely recovers from an eating disorder. This is a disabling and self-perpetuating myth.

FEAST was founded by families who have supported or are currently supporting loved ones through the recovery process. Many of us have seen children and young adults go from gravely ill to full remission of symptoms, living healthy normal lives.

FEAST believes in full recovery.


SIGNS OF RECOVERY
published by Cris Haltom in the EATING DISORDER SURVIVAL GUIDE, May 25, 2006
(adapted from sources below)

1. Eating occurs at regular intervals and is guided primarily by physical rather than emotional hunger.
2. Metabolic rate, if measured, is restored and maintained at a healthful level.
3. The ability to recognize and respond to hunger as a guide for eating appropriately has returned.
4. Weight for height based on age and gender is restored to a healthful range.
5. For females, menstruation is achieved or restored and maintained without oral contraceptives.
6. Skin health, dental health,thermo-regulation, hair growth, and digestion/ absorption functions are restored to normal.
7. Healthy body composition (lean body mass and body fat) is restored and maintained.
8. Caloric and nutrient intake is appropriate for maintaining a healthy weight and body composition.
9. Purging behaviour, e.g., self-induced vomiting and laxative or enema use, is absent.
10. Use of diet pills or appetite suppressants is absent.
11. Excessive exercise is absent.
12. Binge eating behaviour is absent or rare.
13. The ability to tolerate a wide variety of foods so that a good balance of high- quality protein, carbohydrates, fatty acids, minerals, and vitamins is maintained.
14. The ability to tolerate natural shifts in weight (one to several pounds) related to such factors such as hydration changes, illness, and season of the year.
15. The ability to tolerate ‘spontaneous’ natural eating – especially out in public.
16. Weight gain does not deter from eating well.
17. Acceptance of genetically-determined body type, size and shape.
18. The percentage of waking hours spent obsessing about weight, food, and/or body image is reduced to 15% or less.
19. The ability to effectively cope with problems in ways other than through disordered eating behaviors.
20. After physical health is restored, the ability to understand and resolve, other than through disordered eating, the issues underlying and driving disordered eating.
21. The ability to recognize signs of relapse and to seek appropriate help if relapse occurs.
22. Triggers for relapse thinking or behaviours can be identified.
23. The family as a whole has moved beyond food and weight preoccupation.
24. The family as a whole is able to identify, explore, and cope with normal adolescent issues.
25. The family as a whole has created a healthy culture around food and regular meals.

SUMMARY: Understanding what to look for in recovery helps parents recognize signs of improving health. Parents need to be encouraged to hope for recovery, even though statistics about recovery can be discouraging. Recovery may take many routes and may include setbacks and unexpected turns. However, all the evidence suggests that recovery should remain the desired destination and the hope for the future.

REFERENCES Coutier, J. and Lock, J. What is remission adolescent anorexia? The International Journal of Eating Disorders. 2006, 39:3, 175-183.    Hudson, J. I. et al as reported in Eating Disorders Review, “BED: A chronic or temporary condition?” 2005, 16:6, 7.     Peterson, C. and Mitchell, J.E. Self-report measures. In Mitchell, J. and Peterson, C. Assessment of Eating Disorders. 2005, 98-119. New York: The Guilford Press

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C0uldn’t word it better. Most sufferers of an eating disorder self-harm at some stage. Some just flirt with the behaviour, others become entrenched. The self-harm can start before the ED develops, it can start during or be part of the recovery process.

Thank you to PsychCentral: http://psychcentral.com/blog/archives/2015/06/12/11-helpful-tips-from-the-parent-of-a-self-harmer/

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Caring for self-harmersHere are 11 tips that I discovered along the way to help any parent going through a similar situation.

  1. Do not ask why. When someone self-harms, they don’t have words to describe their pain. The self-harm is an outward display of their inner emotions. Asking why will not give you the explanation you are looking for. Your child doesn’t have the answer, and this line of questioning will only make him or her feel uncomfortable and ashamed. Instead, ask if there is anything you can do to help him or her feel better.
  2. Talk to your child about first aid. By inquiring if bandages, antibiotic ointment, or any other type of first aid is needed you are starting a dialogue. This may open up an opportunity for your child to show you more of their injuries or tell you something about their pain. It is important that your child knows that they should wash their wounds with soap and water and continue to keep them clean to avoid an infection. Explain the signs of an infection and the importance of seeking medical attention if needed.
  3. Ask if he or she is safe or can keep him- or herself safe. If your child has hurt him- or herself, then they are in emotional as well as physical pain. Self-harm usually isn’t a suicide attempt, but suicidal thoughts can accompany the self-harm. There is a strong link between previous self-harm and suicide. Do not ignore it. Speak to a professional if suicidal thoughts are involved.
  4. Validate your child’s feelings. Validation is one of the most important elements to learn before parenting any child. You are acknowledging your child’s emotions, not diminishing them. You don’t have to agree with his or her feelings, you just have to be supportive. Everyone deserves to be accepted without judgment. Validation helps your child feel heard, acknowledged, and understood.
  5. Find a counselor, therapist, or psychiatrist. Your child needs to talk to an experienced and competent professional. Do not be afraid to interview them and make sure they are the right fit. Obtain referrals from physicians, friends, or family members.As the caregiver, you need to talk to someone just as much as your child does. Take time to nurture yourself.
  6. Do not punish your child for self-injurious behavior. Self-harm is not an act of rebellion or attention-seeking behavior. Your child is hurting him- or herself because he or she is in a great deal of emotional pain. Don’t make their pain worse. Love them, nurture them, and listen to them.
  7. Remove obvious items that can be used for self-injury. If your child has to go to the effort of finding something to self-harm, rather than grabbing a knife from the kitchen drawer, it may give him or her time to think about what he or she is doing and change his or her mind. Lock sharp items away, take them with you or hide them, but don’t leave them out for easy access.
  8. Research self-harm and healthy coping skills. This is a time when you have a lot of questions. There are many helpful sites about self-injury on the Internet.Learn about Dialectical Behavioral Therapy (DBT). This type of therapy combines standard psychotherapy with skills training. The patients learn healthy coping skills to combat self-harm triggers. DBT works best if the parent also learns about the therapeutic method, so he or she can be supportive and encouraging.
  9. Do not minimize self-harm. When a child self-harms on a regular basis, a parent can get into the habit of thinking that this behavior is “not so bad.” This is dangerous; every incident of self-harm is significant and should not be minimized. Remember there are links between self-injury and suicide.
  10. Be honest, not disappointed. Your child doesn’t want to be in emotional pain or self-harm. Part of the healing process will involve setbacks. Be prepared for these. Never tell your child that you are disappointed in him or her for self-harming. This will only create a barrier in your relationship. Remember to validate. You don’t have to agree, you just have to listen.Honesty can create a bond between you and your child. If you don’t know what to say or do, be truthful and tell your child that you don’t know how to help him or her. They are likely to accept this, because he or she doesn’t know what to do, either.
  11. Don’t say “but.” But is an invalidating word. For example, if you say “I’m proud of you for telling me that you cut yourself, but next time talk to me before this happens,” the only thing your child will hear is that they weren’t good enough. Instead say, “I’m proud of you for telling me that you cut yourself. How do you feel now?” Have a dialogue and then later ask, “What can we do to help you talk to me if you are having these feelings or urges again?” Your child doesn’t listen to everything you say; make sure everything you say is worth hearing.

Overcoming the addictive hold self-harm has on your child will take time, patience, and effort. Offer your help and guidance. Be the parent your child needs during this difficult time in his or her life.

 

APA Reference
Larsen, T. (2015). 11 Helpful Tips from the Parent of a Self-Harmer. Psych Central. Retrieved on June 14, 2015, from http://psychcentral.com/blog/archives/2015/06/12/11-helpful-tips-from-the-parent-of-a-self-harmer/

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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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Many therapists use the term ‘Distraction Toolbox’ for recovery strategies. I have written before out this too and what Sophie used as her distraction toolbox. Basically the idea is to use healthy and positive means of taking the attention from eating, or ED thoughts, negativity etc that drag you down into ED behaviour or worse, relapse. Learning to block ED thoughts and behaviours, automatic thoughts, anxieties, fears, black/white thinking is critical to recovery and moving forward.

The below is a visual idea that makes it clear and easy to imprint your mind. Sophie’s biggest problem was trying to remember her tools to use when the ED voice was really loud. She would get distressed and her mind would go blank. So visual for her worked in clearing some of the ‘noise’ and helped her focus.

Thanks to Buzznet and ‘Forbidden’ Blog.

Let's make a Coping Skills Toolbox photo 1
Let's make a Coping Skills Toolbox photo 2
Let's make a Coping Skills Toolbox photo 3
Let's make a Coping Skills Toolbox photo 4
Let's make a Coping Skills Toolbox photo 5
Let's make a Coping Skills Toolbox photo 6
Let's make a Coping Skills Toolbox photo 7
Let's make a Coping Skills Toolbox photo 8
Let's make a Coping Skills Toolbox photo 9

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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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