When I am asked about recovery from an eating disorder, I admit that it is often hard to explain.  For everyone, I do think that it can be different. 

1.  Some people may quit their behaviors and never look back.

2.  Others quit their behaviors and live each day longing for them, and in their mind, they struggle with the thought of returning to the old behaviors.

3.  There are still those that take multiple attempts before achieving a life free of their eating disorder.


Recovery is hard work, no matter from which illness one is attempting recovery.

There are no hierarchies.  One cannot say that is it harder to recover from one eating disorder than another.  Certainly if someone has more stressors or has been engaged in disordered behavior longer, it makes it more difficult, but not impossible.

So the real truth about recovery is that is DOES HAPPEN.
You have to want it, and you have to work hard for it.

Go at it with reckless abandon, the same way a toddler attempts to walk.  It falls, cries, mother comforts it, then it gets up and tries again.  A toddler never is afraid to try to walk again.

Having lapses should not make you give up your recovery attempt, just get up again, dust yourself off immediately, give yourself a hug, and try again.  Imagine yourself walking toward a wonderful new life...

Take care,
Leslie

http://www.edrsweb.org

As promised, I said I would write about the recovery experience.  Well today, I had a reminder.

I talked to a friend who really supported me during the rough days of my eating disorder.  She saw me struggle, and it was her who supported me by having meals together, taking my 3am (literally) calls, and even met my shrink! (A hilarious story which even to this day I still cannot believe!)

So today she asked how I was, and initially it was a little annoying because I have been doing well for some time now, but it doesn't stop people from worrying.  But this time it was different. 

When I spoke of my life having a new focus and different interests, it FINALLY gave her a sense that maybe this thing could begin to be behind me.

The thing is, I didn't realize how much I had changed.  Sure, I had been saying to people that I was a changed person, but change does take time, and it is painfully slow. 

In my dreams, Rome can be built in a day...well at least you can fly there in a day...

The challenge will be to steer the course and just take it moment by moment.  Even if we wished, we couldn't go faster than that, and after all the time I've lost, I want to savor every moment from now on.

Best to you always,
Leslie


http://edrsweb.org
http://blog.edrsweb.org

There was a recent study about the use of the diagnosis of ED NOS.

http://psychcentral.com/news/2008/02/07/expand-diagnostic-criteria-for-eating-disorders/1887.html

When the diagnosis was created, it appears that it was envisioned being used for people in recovery from either anorexia or bulimia, not for people whose first presentation didn't meet either criteria.

I'm certain that this has caused frustration for patients and clinicians alike. 

Trying to explain to family that you have an eating disorder, them asking, what you have, you replying, umm "Eating disorder NOS".

For clinicians, the label alone is not descriptive.  They have to have the patient describe which criteria of anorexia or bulimia are not fulfilled. 

People are then creating other terms such as exercise bulimia and orthorexia.  Binge eating disorder does actually appear in the DSM-IV, but as a diagnosis under Eating disorder NOS and research criteria are given for this.

My question to you...

1.  Were you given this diagnosis?
2.  How was it explained to you?
3.  Did you understand it?
4.  How did it make you feel?
5.  Do you feel the name should be changed?
6.  What name would you suggest?

I just read an article about people who are presenting for eating disorder treatment treatment in their 30s (as if that is old), 40s, etc.  Researchers seems surprised to learn that ED's exist beyond the 20s.  Why do you think this is?  I'm sure we all know people who are still active in their eating disorder and are "older."

I think I've actually heard professionals say in the past that they believed that people would "grow" out of their disorder, and imagine the shame when this does not "magically happen!

It is also only recently that there are more treatment is more accessible, with many inpatient and outpatient centers and clinics.  Despite this, cost may still deter some from presenting for care.

I am curious to know what people think on this one.

Leslie

Recently I was in a situation where the for consecutive days the schedule was running behind and I did not get a chance to eat lunch until around 2:30pm.  Of course by this time, I was tired and grumpy and was having fantasies of going home.  But the schedule was overbooked in such a manner in such that as soon as one person was seen and staffed another was ready to be seen.

There is an implicit and some explicit lesson taught that those that can survive on very little are to be treasured.

And we amaze at this segment of the population...

How often have you heard someone brag about how little sleep they need? Or how long they stayed up?
How little food?
How many meals they skip? Or food groups?
How many miles they ran that morning (or total number of marathons)?

But this trend doesn't hold for all things.  Some people brag of their excesses...
How many intimate partners...
How many alcohol shots...
How many pairs of shoes or purses...


I can't pretend to understand rhyme or reason.
I do know that the other day there was actually a lull in the schedule and I thought it would be a great time to sit and enjoy lunch: until someone arrived. 

I was informed of this by a staffer so I said that I wanted to have lunch first.  The staffer responded, "I'LL GIVE YOU 10 MINUTES AND THEN TAKE THEM TO A ROOM."  I didn't even respond, but was livid!  

Our lifestyle is a product of our creation.  If we allow ourselves to becomes slaves to our schedules then we will remain just that.  I decided right then and there that I would take my time and calmly eat my lunch like a normal human being.  All day, we give advice to people that it seems like we don't have a clue of how to follow ourselves.  We tell people to walk during their noon hour, yet we keep staffing our clinic such that noon is always filled and we don't get breaks.  

I say Gimme a Break from the hypocrisy that exists. 

Best to you always
 

I had an experience at work where I was mixed about whether or not the treating physician adequately responded to a patient's concern.

The concern was over the cost of medication.  After the concern was expressed, the physician nodded and left the room.  I was a little stunned but unsure what to do.  I didn't want to step out of place, but I wasn't certain that the concern was addressed fully.  I did later offer some options, but then felt as if I was going behind that physician's back.

My dual role of having been a patient and now a provider of care makes me sensitive to these issues.  There is a wonderful book called "When Doctors Get Sick" and describes the humility that having had an illness will often bring.  Also providers should be required to watch "The Doctor," a 1991 film by William Hurt, which tells the story of an arrogant, cold physician who undergoes an emotional change after being diagnosed with throat cancer.

Can't we just all get along?

Attempting to follow the Golden Rule,
Leslie

http://www.edrsweb.org

Okay, I don't feel like writing a serious blog today.  My day at work was way too stressful...I want to have fun! 

So...I was thinking of amusement parks from when I was younger.  Admittedly, I was a major scaredy cat and didn't ride a roller coaster until my friends made me when I was like 18! 

Okay, so here is my list of favorites in no particular order:

Space Mountain (first roller coaster, I was 12, Disney World)
Loch Ness Monster, Drachen Fire, Big Bad Wolf (Busch Gardens, Virginia)
Wild Thing (Valley Fair, Minnesota)
King Cobra (King's Island, Ohio--no longer functional)
Anaconda, Avalanche (King's Dominion, Virginia)

Now I have "grown up" and amusement parks are merely for the shows, bumper cars, shops, or water rides/slides.  Fun for me would be Epcot Center, MGM or Universal Studios.

Oh who am I kidding...I want to get out of this snowy weather and go to Aruba!

Take care, 
Leslie

http://edrsweb.org

There is an ongoing conversation about the role of triggering material in the form of books, recording artists, magazines, movies and the infamous after school specials (Do they even make those anymore?).  Now this even occurs in the form of websites!

Many people who have had eating disorders can cite which materials they used to help fuel their disorder.  So often, "the media" is blamed for much of this.  I don't doubt for one moment that this contributes, but when taken away from all of these things, I still had moments where the eating disordered thoughts were present.  The thoughts came from within and I looked for anything that I could to validate my negative cognitions.  Despite cutting the tags out of my clothes, staying off of the scale (okay, at least trying not to get on it), I could still be triggered by comparing myself to others (or to my previous measurements) in ways that are likely common to eating disordered individuals.

During the eating disorder, I even sought out triggering material to keep myself in the eating disordered mindset, or to try to tip myself into the disorder when I wasn't totally consumed by it.

I remember talking to a friend about it at the time.  We both agreed that "triggering material" did make us feel bad about ourselves, but being exposed to it alone didn't "drive" the eating disorder unless we were already heading down that all to familiar slippery slope.  


It is time to be honest with ourselves... 

WE SUPPORT THE MEDIA EVERYDAY THROUGH OUR CHOICES!

It is our choice to buy People magazine (Glamour, Vogue, Seventeen, or Marie Claire).  If we stop buying it, they will stop printing it.

Throw away those triggering books and magazines.  (If this is hard for you to do, ask yourself why...)

It is our choice to watch television. 

Admit it, the commercials are horrible. The Kaiser Family Foundation published in March 2007 that kids 8-12 years old averaged 21 food ads every day; 7,600 commercials each year!

http://www.msnbc.msn.com/id/17831211/ (MSNBC coverage of this story)
http://www.kff.org/entmedia/7537.cfm (Kaiser Family Foundation official report)

The FTC (Federal Trade Commission) released a statement in June 2007 taking the position that kids aged 2-11 are not in fact viewing more food ads than in previous years.  As a result Kaiser Family Foundation released the following statement. 
http://www.kff.org/entmedia/upload/7654.pdf

Who right?  Until the studies are completed, the jury is out. 

Eating disorders are not choices, but we can limit our exposure to potentially "triggering messages."  We also have a responsibility to report negative messages.  Participate in the National Eating Disorders Association--Media Watchdog Program.
http://nationaleatingdisorders.org/p.asp?WebPage_ID=300



Take care of yourself,
Leslie

Learn more at http://www.edrsweb.org

In the January issue of Archives of Pediatric & Adolescent Medicine, researchers surveyed 2,516 adolescents at 31 Minnesota schools in 1999 and again in 2004.  They found that teens that ate five or more family meals in 1999 were less likely to report eating disordered behavior five years later.

Fascinating research.  I think that the authors of this study captured a cultural phenomenon that has been going on for some time...the denigration of the family meal.  With today's crazy schedules filled with soccer games, swim practice and piano lessons, meals are often held in the car or with family members missing.

During my own eating disorder, as many have done before me, I attempted to keep family meals to a minimum.  I had some excuse or reason not to be there and it became difficult to keep track of what (and when) I was eating.  Later, I grew to appreciate my family's openness (especially during holidays) to having friends and loved ones gather about the table to tell stories and laugh.  Those times could go on for what seemed like hours.  What I realized was important was NOT the food, but the bond between us.

To parents of children or adolescents I would certainly recommend to them that they make the effort to:
1.  Turn off the TV
2.  Prepare dinner together
3.  Sit down at the table, or floor or backyard (whatever)
4.  Eat dinner together
5.  Talk to one another about the events in your lives.

You know that you don't know anything about someone if it feels hard just to talk.  Ideally, members of a family won't have this struggle.  If it does happen, start slowly.  Admit that the awkwardness is there.  Just say, "I feel that we need to catch up...or tell me what is going on in your life."  This is the time to just be with your family.  This is NOT  the time to mention the dirty clothes under the bed, or the papers on the floor.  This is the time to show your love to your family. 

There will always be time to remind your kids to bring down their dirty clothes, but never enough times to express your love to them.

Best wishes to all,
Leslie

Visit our website at http://edrsweb.org today!

I recently wrote a post about the frustration of people not knowing that one can have an eating disorder and not be emaciated appearing.  (post appears below).  When I re-read the post, I realized that a key part of getting over the eating disorder is no longer identifying with it. 

I wish to make myself clear.  There is a difference between someone admitting that they have a problem with an eating disorder, and being upset that they no longer posess the eating disorder or an eating disordered look.

One of the scary things for me was that point at which I began to give up the disordered behaviors and now was faced with filling my time.  Before the eating disorder, I had a life filled with friends and hobbies.  Those things were lost.  Now I fight to get them back.

So I played online games, (I love scrabble and family feud!), I watched movies, jeopardy, law and order (thank you TNT, USA and BRAVO), read books (john grisham and james patterson) and STILL was left with extra time. 

So...I started my website and made attempts to try to help others.  Even now, I still realize that there are SO many things that I want to do with my life such as practice my french and spanish and now I am playing my flute again (even though I am certain that my neighbors probably are really annoyed when I play into the higher registers!).

I also recently made my first turkey this past thanksgiving (it was great and I have pictures) and my first meatloaf (it sucked and I threw it away!--can't be good at everything!)

The point is, correct people for their ignorance, then move on.  Make certain that your identity is not solely that of a eating disorder sufferer/survivor but of a movie/history buff, bookworm, linguist, flautist, and chef.  Okay, I'm never going to be Emeril LaGasse, but a girl can dream!

Kicking it up a notch,
Leslie

I welcome responses at leslie@edrsweb.org or visit http://edrsweb.org


(Prior Post)

Gosh, you don't look like you have an eating disorder...

Have you heard this before?

I have to admit that I am having difficulty with being patient with people who hold the misconception that someone cannot have an eating disorder unless they are emaciated.  More often in our distorted society, the image of emaciated models is so prevalent, that it becomes difficult to look and someone and know who actually meets weight criteria for anorexia nervosa because of our desensitization to below normal weight models.

Let's keep facts in mind.  There are more people with bulimia and binge eating disorder than with anorexia nervosa.  It is possible to meet criteria for these disorders and exist on multiple places in the weight spectrum from normal weight to severely obese.

Telling someone that they don't look like they have an eating disorder is one of the most damaging things that one can say.  First, it does not validate someone's attempt to be honest about their struggle and what is happening with them, and I had actually known people who upon hearing this makes them want to lose more weight in order to achieve the "proper look" of an eating disordered person.

Similarly, someone recovering from anorexia nervosa may no longer meet weight criteria for their illness, but still struggle with cognitions to the point that if they were told that they didn't look eating disordered, would make attempts to resume their previous state.

In the end, it has to come down to us, those who have suffered, to correct misconceptions, and the sufferers to be prepared for the ignorance of others and not allow this to deter them from their goal of recovery.