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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

The Feed

Every year around this time, the back-to-school bonanza begins. Stationery stores are stock-piled with school supplies. Bedding and home stores are advertising all the latest dorm room designs. And clothing stores are clamoring about ways to refresh a fall wardrobe.

Photo Credit: Creative Commons by emerille

However, if your summer involved intensive eating disorder treatment, you may have some other important back-to-school concerns. Here are a few of the worries commonly voiced by people with eating disorders as they approach the start of a new school year:

Will people notice changes in my eating or my appearance?

The simple, yet perhaps unsatisfying, answer is, “it depends.” Many people are consumed with their own worries, and therefore may not be as acutely aware of the changes that you’ve made as you are.

That said, the friends (or teammates) who know you well – those with whom you were eating regularly

View original post 909 more words

negative thoughts and behavioursOften we post lots of information about ‘positive’ signs and skills. After all part of recovery is learning to focus on the positive. But what about the negative, how do you recognise negative coping skills. How do you know that the behaviours you are doing are actually harming you or not promoting recovery. We live inside our heads so much that often negative process are so natural as breathing we think this is normal. Continuing negative behaviours can act as triggers for relapse or harming ourselves even more.

As part of a bigger post, I found a great list of negative behaviours and recognising them as such. Put together by Blake Flannery it is an excellent starting point. You can add your own unique negative behaviours to the list. The full article by Blake ‘List of Coping Skills for Anger, Anxiety and Depression’, also gives a lot of positive skills and how they actually help us by adopting them.

Being aware is the starting point for changing any behaviour.

Negative Coping Skills

Here’s a list of things that will cost you in the long run as coping strategies. These do more harm than good in most cases and can make life more stressful.

Diversions

  1. Procrastination
  2. Abusing drugs or alcohol
  3. Wasting time on unimportant tasks
  4. Shopping (online or malls)

Interpersonal (With Others)

  1. Blaming
  2. Isolating/withdrawing
  3. Mean or hostile joking
  4. Gossiping
  5. Criticizing others
  6. Manipulating others
  7. Refusing help from others
  8. Lying to others
  9. Sabotaging plans
  10. Being late to appointments
  11. Provoking violence from others
  12. Enabling others to take advantage of you

Cognitive (of the Mind)

  1. Denying any problem
  2. Stubbornness/inflexibility
  3. All or nothing/black or white thinking
  4. Catastrophizing
  5. Overgeneralizing

Tension Releasers

  1. Tantrums
  2. Throwing things at people
  3. Hitting people
  4. Yelling at others
  5. Destroying property
  6. Speeding or driving recklessly

Physical

  1. Suicide
  2. Self harm
  3. Developing illnesses

Intrapersonal

  1. Making fun of yourself
  2. Self-sabotaging behaviors
  3. Blaming yourself

Indulging

  1. Spending too much
  2. Gambling
  3. Eating/drinking too much
  4. Setting dangerous fires
  5. Continually crying

Sophie has been home and gone back to uni. Wow 6 weeks at home just flew. It was wonderful having her for so long. She had the usual depression/anxiety drop down during the peak assignment time, but this time didn’t ring me as much. With her new psychologist she handled it herself. Doesn’t mean it was any easier or less deep, but she made her own decisions and didn’t need to vent to me. I see this as a step forward and wait to see how this semester goes.

This post though is about getting sick. It’s winter here, Melbourne has it’s own strong flu variety this year and lots of other nasty bugs. When http://scu.edu.au/staffdirectory/person_detail.php?person=20601you get sick, it’s normal to cut back on eating. You really don’t feel like food, nor sometimes can you keep it down. If you get the viruses with the killer sore throats or Tonsillitis then you have an extra level added to the pain of eating. You might not eat anything decent apart from some light liquids for anything up to 14 days. It’s the nature of being sick that we all follow.

For those recovered or in recovery getting sick needs extra care. If you are at home or still not fully independent, you then have a team or family support to encourage you to eat. The bottom line for those with anorexia, is you DON’T lose weight. But it’s hard to remember that when you really sick, living independently away from home and figure that you can easily gain any weight loss back or it won’t matter, or being so sick it doesn’t even cross your mind you might be losing weight. Or that it might be an issue if you do lose weight.

After all – if you are fully recovered – you won’t have had any Ana behaviour to stop you eating. You won’t have had any Ana thoughts or heard Ana’s voice either. Your well past that. You may even still see a psychologist, take good care of yourself, see a doctor regularly, have medication for anxiety or other mental health issues. So when you get really sick, you tend to do what we all do – eat when or how much as you are able to.

Sophie learnt her next step in self care and staying recovered. She got the flu and Tonsillitis together – one very sick girl. And she did try to eat and drink. However being unable to eat her normal amount for over 2 weeks, her weight dropped. What it brought home to her, was how quickly during sickness the body can drop in weight. And in the case of a recovered anorexic, weight loss to a certain point can start to bring thinking changes.

As she said, she felt physically ok, and wasn’t anywhere in the realm of Ana thoughts, but her mind ‘darkened’, it was easy to slip back into the habit of not eating a meal or eating enough when getting over the sickness. She found herself a bit defensive about food. Thankfully she was home by this stage, so mother got involved (despite the fact she is now 20 and really beyond me dictating food routines). Yep, I can still be the Food Police. But because she doesn’t want to go back down the Ana path, she drank the sustagen, ate pies, bread, raisin toast, pasta, pizza etc etc. She snacked in-between meals and she brought her weight back up. Not quite as high as I’d like to go back to Melbourne, but still in her good weight range.

It’s a confronting lesson when just being sick can result in weight loss you didn’t plan or want, and the extra strength needed to continue to eat. Whilst recovery teams will tell you that this might happen, until it actually does you don’t plan or really know how you will actually react or be when very sick. Sometimes you learn as situations become a reality for you – rather than a textbook experience. Now she knows.

Third week back in Melbourne she has come down with a similar bug and another round of damned Tonsillitis (sensitive little things once they get sick). This time Soph is more knowledgeable and is eating more and drinking sustagen etc. She also is seeing her psychologist and doctor as well. We are also heading down (we couldn’t do it last semester) for a parent check in of how she is going.

The learning curve can be tricky, sneaky and sometimes ‘left of field’ in recovery, but as long as you take note of the lesson and build toward being strong if sickness happens again, then you have learned another step in the reality of self-care. Getting flu vaccine might also be part of the lesson!

 

 

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

 

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/

All of these are early signs, none of them alone mean much, you may see any combination of them. Most of these comments and behaviours can seem innocent, teenage behaviour. Mostly though they are out of character for your child. They will be a departure from their normal personality and family routines. Watch, ask, challenge. Don’t let any of these go unnoticed or uncommented about. Keep watching, keep asking, keep challenging.

If you do, if you have any suspicion at all, bring your child to the doctor and insist, insist and keep insisting.

early signs of an eating disorderThings they say

I just want to eat healthier
I want to be a vegetarian
My stomach hurts
I am not hungry
I already ate
I think I am allergic to….
(foods they never had an issue before or diagnosed allergy)
I don’t eat this
This is not organic or gmo
I just don’t like this any more
I am so sick
What’s in this food (nutrients)

Things they do

Disappearing after meals
Checking out the nutrition labels
Increased exercise
Pushing food around plate
Cutting food in tiny pieces
Chewing food forever
Stop making plans with friends
Taking forever to make it to the table for meals
Frequent showers (especially after meals)
Spending forever in the bathroom after shower – body checking
Sleeping at meals time
Watching cooking shows, reading cook books none stop
Cooking/baking obsessively without eating it
Going to the grocery store and reading all labels
Buying expensive foods that go uneaten
Frequent body stretching and movement
Wearing baggy clothing (despite temperature)
Refusing to go out with friends if meals are involved
Writing calorie/meal/fitness journals
Taking a lot of body checking selfies
Picking fights at meals so they can be sent to room, or storm out
Eating only low calorie foods
Spitting food into napkins
Having to exercise even when injured or sick
Spitting food into napkins
Having to exercise even when injured or sick
Notice the calories in everything
Dissect the ingredients of a meal
Interested in high metabolism foods
Lots of gum chewing
Taking ice baths
Very emotional response if any of the above is mentioned
Skin picking

Things you can observe

Over dressed in summer, under dressed in winter
Blood shot eyes after meals
Social withdrawal
Unnatural seating positions
Constant foul mood especially at meal times
Weight decrease – A child should never ever lose weight
Anxious, distracted, avoidant behaviour at school
If pets, notice if the dog/cat is seating closer to your child
Cats will gravitate to someone with an illness
Dogs will gravitate for food being dropped
Increased perfectionism, rigidity, ritualistic behaviour
Increase in anxiety, depression, OCD if these are already part of your child’s character
Cold hands and feet
Bad breath or personal smell
Small sores on body which take a long time to heal and can bruise easy
Blue finger nails
Obsessive body checking
Thinning and failing hair
Soft down on skin particularly chest, neck and upper back
Loss of menstruation
Panic attacks out of nowhere
Weight gain despite exercise due to B/P or binging
House plumbing issues from: purged food, hair lumps.

With thanks to The Dirty Laundry Project with additions from me.