When Iris Ruth Pastor was a 19-year-old college student, she thought she found a secret shortcut to maintain her body shape while also developing a social standing within her school and achieving high grades. It all seemed to be working perfectly for her.
Unfortunately, that shortcut was actually a destructive eating disorder that she would be unable to shake for nearly 50 years. It would stick by her side through her career advancements as a successful journalist and author, through her marriage and birth of 5 children, and through every other up and down along the way.
In her recent book, The Secret Life of a Weight-Obsessed Woman: Wisdom to Live the Life You Crave, Pastor looks back on her decades-long experience with eating disorders as an abusive relationship. When she succeeded, it felt like her binging and purging were contributing to this success as a writer, mother, and wife. When she failed, it helped her cope.
“An eating disorder is like an unruly, disparaging lover that wreaks havoc, interlaced with moments of sheer, self-destructive ecstasy,” Pastor writes. “My life, routine, and stress levels were all wrapped around my need for him. He was what kept me coping, but also he was what kept me in a state of perpetual angst and misery.”
Pastor’s story touches on something very rarely addressed in eating disorder communities – the flashes of happiness and confidence as well as the perceived emotional support that can make it hard to “give up” an eating disorder.
“With ED by my side, I believed I could be the best version of me – as a writer wife, mother, daughter, and friend.”
However, as she shows, these short-lived pangs of “ecstasy” are surrounded by a seemingly never-ending anguish.
Even this realization was never enough for her to escape her eating disorder. It wasn’t until she had grandchildren and recognized she was living a risky lifestyle that would likely end in tragedy that she admitted she needed help.
“I had been writing, blogging and motivationally speaking for over thirty years. I had quite a legacy of work I was proud to leave my grandchildren,” she says. Even worse, she knew what alternative was likely awaiting her if she continued down her path.
“I realized that if I died in a pool of my own vomit while purging, that would be my overriding legacy. And that, for me, was intolerable.”
Most importantly, in Pastor’s eyes, was the recognition that she wouldn’t be able to beat bulimia on her own. She needed professional help and support.
“Hope is not a plan, but hope fuels a plan. So first you need hope. You can’t do it alone. So next seek professional help. If the fit is not right, keep searching until you find a professional or an eating disorder treatment centre that intuitively feels like a good fit. When you do, allow yourself to be vulnerable, nurtured, challenged and victorious”
Pastor also notes that recovery is rarely an easy path. There are setbacks and hard moments, but she encourages other sufferers to keep fighting and not give in.
“It’s important to realise that the road to recovery is made up of incremental progress,” she writes. “Small sustainable mouse steps are preferable to kangaroo leaps. Patience and self-compassion are key, but also staying resolute: meaning a dedication to getting healthy and remaining open to new ways of looking at food as fuel for the body not as something to be feared and dangerous.”
Despite living with an eating disorder for 46 years, Pastor has achieved recovery and wants others to know they can too.
“My main message is that recovery is possible at any age and at any stage.”
For people living with or recovering from eating disorders, the grocery store can be an intimidating place. Being surrounded by nothing but food, many proclaiming they are “low-carb” or “low-fat”, can be overwhelming and cause intense anxiety, even years after recovering from a clinical eating disorder.
Thankfully, a new form of telemedicine is aiming to help by providing on-the-go video-chat with nutritional counselors while shopping for food.
The apps provide a form of exposure therapy that allows people to face their triggers or anxieties by gradually introducing them to feared stimuli.
“The eating disorder treatment world has adapted exposure therapy to help people face their food fears. Grocery store therapy can be beneficial by allowing individuals to confront their anxieties with the support of a trusted health-care provider,” Kelsey Latimer told Juli Fraga of the Chicago Tribune.
Latimer is a clinical psychologist at the Center for Discovery, a treatment facility for eating disorders in Palm Beach Gardens, Florida.
In the past, some dieticians and counselors would provide similar forms of exposure therapy by accompanying individuals with eating disorders to the store. However, this type of treatment was relatively rare, and practically impossible to access for individuals living in rural areas.
Anecdotal evidence from patients and medical professionals suggest telemedicine exposure therapy could potentially make a highly-useful but hard to access form of therapy into a widely used treatment for eating disorders. But, there has been relatively little research into the recent practice’s effectiveness.
One of the most notable recent studies on the subject, presented at the International Conference on Eating Disorders in April, included just 34 participants.
In the study, clinical psychologist and eating disorders researcher at Stanford University connected 34 participants with individual and group therapists, as well as nutritionists, using a similar video conference platform.
“Our initial results show a clinically significant reduction in eating disorder symptoms,” Robinson said. She added that future research will examine long-term effectiveness.
Living with an eating disorder is an incredibly complex task, often filled with counting calories and intensely scheduling anything food related to keep their disordered eating behavior a secret. For young women, this is complicated even more with social pressures, responsibilities at work, and stress from family.
Now, imagine dealing with all of that while also celebrating an important religious holiday that includes day-long fasting and a large, community-based meal at the end of the day.
This is what many young Muslim women with eating disorders face every year, as they attempt to navigate staying true to their religious beliefs while facing their own demons of anorexia or bulimia.
Adeline Hocine describes the experience as “something closer to war.” While Ramadan offered the ability to hide her own eating disorder – as everyone around her also abstains from food during the day – the internal pressures of her eating disorder meant she couldn’t even enjoy the end of the day feast. Instead, as she writes for Teen Vogue, she often purged immediately after this meal.
As Adeline notes, she is far from the only Muslim woman who has struggled with balancing her religion and living with her eating disorder. To mark this year’s Ramadan and offer support to others living through similar experiences, Hocine shared her story on Teen Vogue.
Six more U.S. states have announced lawsuits against OxyContin maker Purdue Pharma, bringing the total number of state-level lawsuits to 22. The states are accusing the pharmaceutical company of contributing to the nation-wide opioid epidemic with misleading marketing.
U.S. state attorneys general from Nevada, Florida, Texas, North Carolina, North Dakota, and Tennessee say the company has violated state consumer protection laws by falsely downplaying the addiction risk of opioids while simultaneously overstating the drug’s benefits.
“It’s time the defendants pay for the pain and the destruction they’ve caused,” Florida State Attorney General Pam Bondi told a press conference.
Florida also launched lawsuits against several other pharmaceutical companies, including Johnson & Johnson, Teva Pharmaceutical Industries, and Mallinckrodt, as well as distributors AmerisourceBergen, Cardinal Health, and McKesson.
In response to the announcement, The Healthcare Distribution Alliance, an umbrella group representing drug distributors, released a statement calling the allegations as an attempt to “redirect the blame”. They also said the claims represent a lack of understanding about how the pharmaceutical supply chain functioned.
“Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation,” John Parker, the organization’s senior vice president, said in a statement.
The latest lawsuits join litigation already filed by 16 other U.S. states, as well as Puerto Rico.
Purdue denied the claims in the suits, saying its drugs were approved by the U.S. Food and Drug Administration and only accounted for 2% of all opioid prescriptions.
“We are disappointed that after months of good faith negotiations working toward a meaningful resolution to help these states address the opioid crisis, this group of attorneys general have unilaterally decided to pursue a costly and protracted litigation process,” Purdue said.
In February, Purdue announced it would halt its promotion of opioids to physicians after widespread criticism for the company’s marketing strategies.
According to the U.S. Centers for Disease Control and Prevention, opioids contributed to more than 42,000 overdose deaths in 2016 alone.
In addition to the state-level lawsuits, 433 individual cities and counties have also been filed against pharmaceutical companies including Purdue Pharma, Johnson & Johnson, and Endo International Plc. These lawsuits were recently consolidated in a federal court in Cleveland, Ohio.
Eating disorders have always been notoriously hard to treat, with many people requiring inpatient treatment, long-term counseling, and potentially medication to eventually achieve recovery. However, a new report suggests that eating disorder treatment could one day utilize virtual reality (VR) to more effectively treat individuals in safe, controlled environments.
The report is the result of efforts by Sofian Berrouiguet, MD, from France’s University Hospital of Brest, who analyzed more than 300 studies focusing on the use of VR in treating eating disorders.
According to their findings, VR is already giving doctors unique advantages to traditional eating disorder treatment.
“The virtual environment makes it possible to control the unexpected and to be exposed in a safe environment to certain fears that may be difficult to reproduce in real situations,” study co-author Barbara Peran told Healthcare Analytics News.
Despite this, Peran notes that VR has several hurdles to overcome before being widely accepted and utilized in the medical community. The biggest limitation is simply lack of training among therapists and physicians, but this is compounded by the expensive of the equipment (most VR headsets cost hundreds of dollars alone and require proprietary software to fully utilize). Additionally, some users report “simulation sickness” which can feel similar to motion sickness.
The researchers say they worked with relatively little data because there has been little research directly addressing the use of VR to treat eating disorders. This led the team to use data from several clinical trials including very small subject pools. Some studies included just a single individual.
While it is clear there is significantly more research needed to investigate exactly how effective VR-based treatments for eating disorders may be, the researchers say some studies found significant signs of advancement – especially when combined with cognitive behavioral therapy (CBT).
Using VR, CBT specialists can expose patients to specific stimuli in safe environments, where the therapist can then teach the patient specific strategies to manage the response. There is also evidence that VR can be used to help recontextualize negative body images and body-based anxieties.
Studies into this these types of treatments found that patients experienced less loss to follow-up, indicating they had regressed less in between sessions. The researchers concede part of this may be related to the “attractiveness of new technologies,” but they note patients also exhibited an “increased motivation for change” when using VR-based therapies.
It will likely be at least a few more years before VR technologies are widely used to treat eating disorders, but reports like this latest analysis show virtual reality provides clinicians with unique ways to treat patients in real-world scenarios and experiences while staying within the confines of a safe, controlled environment.
The sting of being insulted for your weight or body shape is strong enough to have lasting effects if a new study is correct. According to a report published in the Journal of Adolescent Health, being called “fat” by friends or family may lead to later development of eating disorders in teen girls. In particular, the harsh criticism from family members seems to carry the strongest impact.
The researchers from the University of California, Los Angeles say the findings show that the negative stigmas and stereotypes surrounding weight are strongly associated in the development of disordered eating.
Past studies have shown that teasing or bullying about weight is linked to binge eating and unhealthy weight control methods in boys, as well as increased dieting in girls. However, this latest study is the first to examine the long-term effects of being called “fat” by close friends and family.
“How we talk about weight – especially with young girls – can have really negative effects on mental and physical health,” said lead author Jeffrey Hunger, a psychologist at UCLA.
“Labeling young girls as ‘too fat’ will never spur positive health behaviors; it is simply going to result in poor body image, unhealthy weight control practices, and disordered eating,” he told Reuters Health.
Hunger felt that too little research followed how weight stigma can affect someone over time.
“With this study, I was hoping to contribute to our understanding of these longitudinal consequences by leveraging data from the NHLBI (National Heart, Lung, and Blood Institute) Growth and Health Study.”
For the study, Hunger and a colleague analyzed data collected from 2,036 girls participating in the NHLBI study.
First, at age 14, the girls were asked to report whether they had been told they were “too fat” by their parents, siblings, best girlfriends, boys they were interested in, any other teens, or their teachers.
Then, at ages 14 and 19, the girls also completed a questionnaire designed to measure unhealthy weight control behaviors, bulimic tendencies, desire for thinness, and body dissatisfaction. During these evaluations, the girls were also asked to report whether they had engaged in unhealthy behaviors such as vomiting or not eating within the last 30 days.
At age 18, the girls were asked whether they used smoking or skipping meals as weight control methods.
According to the findings, girls who had been called “too fat” at age 14 showed much higher scores on the eating disorders assessment at age 19.
This link was consistent even after adjusting for possible outside factors such as body mass index, race, socioeconomic factors, and past disordered eating behaviors at age 14.
The results also indicated that this effect was strongest when the child was labeled “too fat” by family members.
“A somewhat surprising (yet frequently observed) finding is that the effects of weight stigma emerged independent of actual body size,” Hunger noted.
While the effect was similar among heavier and thinner participants, Hunger notes that “heavier girls do disproportionately shoulder the burden of weight stigma, and stigma against heavier bodies is pervasive and systemic.”
“So, we should take care not to equate this to thinner girls’ experiences of weight labeling.”
Based on the findings, Hunger suggests that parents be aware of the risk signs of eating disorders and promote positive body image and healthy eating behaviors at home.
“They can take weight out of the conversation altogether when they are discussing health with their children. Our weight does not dictate our health and most certainly does not dictate our worth.”
“Quit the negative ‘fat talk,’ chronic dieting, and body shame. Recognize and appreciate all that your body can do for you and find eating and exercise habits that are sustainable and enjoyable,” Hunger said.
It should be no secret by now – both men and women of all ages can live with debilitating and potentially deadly eating disorders. The old myth that eating disorders are just a “girl problem” have been effectively proven false and experts believe at least a third of all people with eating disorders are men. However, that doesn’t mean all eating disorders are equal.
In fact, there are numerous differences in both how eating disorders present themselves in the different genders and how boys or men react to eating disorders. Most notably, boys often feel discouraged from talking about issues such as body image or mental health compared to girls.
This can come in the form of outright admonishment by parents or friends for opening up or more subtly in the form of societal pressure. Either way, the effect is the same. Boys, by and large, feel an intense stigma about openly talking about these issues or their own personal struggles.
Because of this stigma, boys and men also feel more isolated. This can be tied to a higher chance of developing an additional mental health problem such as depression or anxiety. Isolation can also increase the risk of suicide.
Boys and men with eating disorders also strive for different ideals of a perfect body. While women with eating disorders typically fetishize a thin body, men will idolize more muscular or perceivably “masculine” body.
This idealization of the muscular male form tends to contribute to extreme exercise or other methods to “bulk up” such as abusing supplements and protein shakes. Compulsive exercise is a common sign of eating disorders, but men are particularly likely to obsess with making sure they hit the gym to achieve their idea of a perfect body.
Thankfully, not everything is different when it comes to eating disorders in both men and women. If you notice your child is showing signs of extreme dieting, body image issues, or purging, there are a few immediate steps you can take to intervene:
Speak frankly – The first step should always be an attempt at honest communication, but it is essential this happens in a calm, safe way. Ask questions and try to get an understanding of how they view their body and what their goals are for their weight.
Consider changes in the home – It may also be helpful to assess how your family has been addressing issues of weight or body image. Does a large part of your daily life or conversation focus on exercise and body weight? It is important to strike a healthy balance that prioritizes health without focusing entirely on scales or muscle size.
Seek help – Some parents struggle with feelings of shame or embarrassment when confronting the possibility of seeking help outside the family for mental health problems. Giving into these feelings and attempting to keep the problem “inside the family” only guarantees it will fester and get worse, leading to potentially deathly consequences. The most important thing you can do if you see red flags of an eating disorder is to seek the help of a professional, whether that be your primary care provider or an eating disorder specialist.
Support your child – Learning how to support your son or daughter through an eating disorder can be a process, but providing support an acceptance are the only way to provide a safe environment for your child to recover. Some parents find it helpful to visit support groups that can help teach productive forms of support and how to approach a life-threatening mental illness in your child.
If your child is living with an eating disorder, give Brookhaven a call at (888) 298-4673. We can answer any questions you have and help you find the best treatment option for your family.
There is no question that the opioid epidemic affecting America is taking a huge toll on the nation’s health and lives, but U.S. Surgeon General Jerome Adams says it is also having a pronounced effect on the economy.
“The facts are that seven out of 10 of our young people between the ages of 18 and 24 are ineligible to serve in the military because of poor health or the inability to pass a physical,” Adams said Wednesday during a forum in Sugar Grove that focused on drug addiction. “Employers continue to tell us they can’t find enough workers to fill their positions because they can’t pass the drug tests, so the problems in this country are not just affecting our health.”
Speaking at Waubonsee Community College, Adams explained that the opioid crisis has had an effect on almost everyone in the country in some way or another. For him, the toll was personal.
“I have a brother who is currently serving 10 years in prison because he stole $200 to support his addiction,” Adams said. “It will cost about $1 million to keep him in prison, but he’ll get no treatment. We have to give law officials more than just the ‘hammer’ because then everything just looks like a nail.”
While there are many factors contributing to the ongoing epidemic, Adams said one of the biggest issues is the stigmatization and unwillingness to face the reality of opioids.
“A stigma exists everywhere among the medical profession, the law, and society in general,” he told the crowd before noting that drug addiction is “a disease, not a moral failing.”
He also pointed to the widespread use of pills as normalizing pills in general, saying, “kids reach for pills in their grandmother’s medicine cabinet today like people did for a beer decades ago.”
“The facts are that four out of five individuals that do injection drugs started with pills,” he said.
Despite the severe tone, Adams indicated that local efforts to decrease overdose deaths related to opioids are working. Particularly, he celebrated the increasing prevalence of naloxone, a fast-acting drug capable of reviving many who have stopped breathing after taking opioids.
Naloxone is obviously more of a band-aid than a long-term strategy for treating the opioid epidemic, but Adams described it as a vital first step that could save millions of lives.
Today, May 1, marks a special day for those who are or have lived with eating disorders. Eating Recovery Day is intended to show people that recovery is always possible and celebrate those who have achieved recovery.
The day was created by the Eating Recovery Center as an effort to encourage more conversation about eating disorders in a way that focuses less on the difficult topic of the actual diseases in favor of the more hopeful topic of living a healthy life in recovery.
“Often, the stories we see and hear about eating disorders feature the depths of someone’s illness,” Dr. Ashley Solomon, Executive Clinical Director of the Eating Recovery Center, told Teen Vogue. “We see pictures of people at very low weights with warnings about not engaging in eating disorder behaviors. I’m not convinced that helps anyone. First, it doesn’t reflect the realities of the people who struggle with eating disorders. Most people with eating disorders are not at low weights, for instance. And focusing on the illness can give it more power.”
This year, the Eating Recovery Center is encouraging survivors to share their stories about recovery and living post-eating disorder with the hashtag #MyRecoveryLetter.
In one recovery letter, award-winning eating disorder blog author Lindsey Hall wrote: “What recovery is at the end of the day is learning how to live in a world where your life is a flexible definition of ‘okay.’ To live presently in the hazy grey of the non-black and white life you’ve chosen through recovery.”
“It’s crucial for people to see recovery reflected in others,” Solomon said. “While recovery will look different for every individual, seeing what it means to be recovered in other people is a starting point for envisioning it for one’s self.”
Solomon is sure to note that recovery can look very different from person to person, but recovery is always possible.
“Most people who recover from eating disorders actually have very similar relationships with their bodies and food as people who never had eating disorders,” Solomon said. “We have lots of reasons, including recent studies, to believe that people can recover at any age and regardless of how long they have had an eating disorder.”
She also explains that seeing others’ stories about recovery can help make living with an eating disorder feel less isolating and the process of recovery seem less intimidating.
“Recovery happens in community,” she said. “Whether that’s an eating disorder treatment community, a family, or another type of community, connection is an important ingredient in creating a life outside of the eating disorder. Eating disorder recovery takes persistence and is not an end state. It requires not just stopping certain patterns, but starting others. That might involve things like changing your sleep, learning to ask for help, slowing down, or practicing mindfulness. Practicing these new behaviors day in and day out is what makes up recovery.”
If you or someone you love are living with an eating disorder, give Brookhaven a call at (888) 298-4673. We can answer any questions you have and help you find the best treatment plan for you.
Despite what most stereotypes would have you believe, eating disorders affect people of all ages, genders, and ethnic or racial groups. This has been backed by numerous past studies, but a new report published in the journal Biological Psychiatry provides the latest look at just how widespread eating disorders are across demographics.
In the latest study from the University at Albany School of Public Health, a team or researchers analyzed data collected from over 35,000 US adults.
Based on their data, white women were still statistically the most likely to develop anorexia. Specifically, women were more likely to be diagnosed compared to men and white people were more at risk than other races or ethnic groups.
However, the risk of bulimia was statistically consistent among all ethnic or racial groups, and fewer non-Hispanic black people had lifetime binge eating disorder (BED) compared to Hispanic and white respondents.
Notably, the report also found that all three “major” eating disorders were linked to significant psychosocial impairment.
“Although eating disorders may not be as prevalent as some other psychiatric disorders, such as depression, anxiety, or alcohol and drug use disorders, they are common and found in men and women across ethnic/racial groups and occur throughout the lifespan,” lead author Tomoko Udo, PhD, assistant professor, Department of Health Policy, Management, and Behavior, University at Albany School of Public Health, New York, told Medscape Medical News.
“Binge eating disorder, a new ‘formal’ diagnosis in the DSM-5, is important to screen for and identify, as it is associated with substantially increased risk of obesity, and all eating disorders are associated with impairments in psychosocial functioning and thus represent an important public health problem,” said Udo, speaking not only for herself but also on behalf of her coauthor, Carlos M. Grilo, Ph.D.
The team recognizes that several past studies have had similar findings, but they say there was little nationally representative population-based data on the prevalence of eating disorders.
In the past, investigators have used DSM-IV criteria to assess the prevalence of eating disorders, and prevalence rates were typically calculated by pooling data from several different samples.
“Data from large-scale nationally-representative samples assessed with diagnostic interview is required to update prevalence estimates of EDs in the US,” they add.
Udo explained that revisions to the widely used DSM-5 made binge eating disorder a formal diagnosis for the first time and lowered the frequency of bingeing necessary for a BED diagnosis.
“We felt it was important to obtain new prevalence estimates in a larger and representative sample, especially because the DSM-5 included several changes to the criteria for EDs from the earlier DSM-IV,” said Udo.
“Many researchers and clinicians expected higher estimates than those found in earlier studies as a result of ‘loosening’ of diagnostic criteria for EDs,” she noted.
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