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You’ve found the best eating disorder treatment center, packed your suitcase to point where you are still shocked you got it to close, and now you are off – off to spend the next couple of weeks or months literally fighting for your life.

Currently the relapse rate for anorexic patients ranges from 9% to 65%, with the highest rate of relapse occurring during the first four to twelve months after treatment. For bulimia sufferers, the numbers are just as frightening.  Within six months of receiving treatment, 30% to 50% of bulimics will relapse.  Now we all know that relapses occur for many different reasons, but I would argue that one reason a person falls back into their disease is that they didn’t taken advantage of everything their treatment center had to offer.  So in this post, I am going to tell you the three things  I wish I had been told on how you can get the most out of eating disorder treatment.

1. Remission Never Occurs through Osmosis

If you want to get into remission, you must take some accountability and play an active role in your treatment.   Would you expect to get rid of an ear infection by just standing by a bottle of antibiotics? NOPE! Then please tell me why you would expect to get your eating disorder into remission by just passively sitting through groups, hiding things from your treatment team, and not completing CBT and DBT homework?   You have a disease that can and will kill you if you don’t step up. Now is the time to harness every ounce of strength and courage you have and fight for your life.

2. Sickness is NOT a Competition

The one thing I remember the most about my stints in residential and inpatient was the constant competition between the patients to be the sickest.  If one person said they didn’t eat for two days straight, another patient would chime in and proclaim that they didn’t eat for three.  When you go to eating disorder treatment, never enter this toxic tournament.  You are in treatment to get well and regain all that your eating disorder has stolen from you, not to brag about your life-threatening fasts and the amount of time you spent nearly killing yourself on the treadmill.

3. Don’t Play a Role in the Soap Opera

When you’re a patient at a treatment facility, you are living in close quarters for quite a bit of time with a bunch of other pretty sick people.   You don’t need to be a rocket scientist to understand that this is the perfect recipe for drama so intense that it would make even the Kardashians look relatively normal.   It is incredibly easy to be consumed by it, but remember, every single moment you spend playing a role in treatment center drama, is a moment you lost working towards getting well.  Don’t let drama derail your path to remission! Focus on yourself and yourself only!


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After months, years, or maybe even decades of swallowing laxatives instead of food, torturing your weary body with endless exercise,  mindlessly devouring the contents of your refrigerator, and spending hours vomiting in your porcelain commode – you’ve made a decision.

A decision that may not just change the course of your life, but also save it.

You’ve made the decision that you are ready to salvage your moribund corpse and admit yourself into an eating disorder treatment center.

Today, there is certainly no shortage of  dedicated eating disorder treatment facilities here in the United States. Don’t believe me? Just ask your good ol’ friend Google where some facilities are located and you’ll find treatment centers stretching from east to west.  The problem is though that far too many treatment centers are doling out treatment regimens that are not just astronomical in price, but also almost completely ineffective.

So how do you, someone desperate to get your eating disorder in remission, find that hidden gem of a treatment center in a vast ocean of facilities willing to take your money, but leave you sicker than ever?

Well my friend, you’re in the right place because this post right here will give you ALL THE INFORMATION you need to find an eating disorder treatment facility that is BEST FOR YOU!

So without further adieu, let’s get started!

1. THIS IS A LIFE-OR-DEATH SITUATION, NOT A TIME FOR A VACATION.

Horseback riding, massages, yoga, scenic hikes – believe it or not, I am not describing some five-star retreat center, I am describing just some of the services that you are likely to find at a treatment facility for the deadliest psychiatric illness – eating disorders. Although this menu of luxurious so-called “treatments” may make you want to fill out the admission paperwork right then and there,  you need to remember that you are currently suffering from a serious brain disorder that has no problem with leading you to your grave.  What you need right now isn’t a spa, it’s a credible facility that focuses all of its resources on providing you with evidence-based therapies such as CBT, DBT, and Maudsley.

Still need a little more convincing that you should not be considering spa-like eating disorder programs? Well let me provide you with an little analogy. Let’s say you just got diagnosed with cancer, a merciless disease, and you now need to find a place to receive treatment.  I can guarantee you that your search would not include looking for places that offer equine or art therapy, you would be looking for top-notch hospitals that know the ins-and-outs of your cancer and offer treatments that have been shown to provide the best outcomes. Why should it be any different when looking for a place to treat your eating disorder?

2. KNOW WHAT WORKS.

Before you start searching for an eating disorder treatment center, it is CRUCIAL that you are aware of the therapies that have been shown to be the most effective at treating eating disorders. What are these treatments you ask? Don’t worry, I’ve got you covered.

3. DON’T JUST GOOGLE IT.

Never just rely on Google to help you find eating disorder treatment centers.  Here is a list of my FAVORITE online resources that will help you locate a treatment center that fits your needs.

  • EDreferral.com – If you are looking for an incredibly comprehensive directory of eating disorder treatment centers in the USA, Canada, or Australia, this site is a gold mine.
  • US Eating Disorders Treatment Referral Guide: This guide contains a bounty of information on eating disorder treatment centers across the United States. Each entry on a treatment center tells you exactly the conditions the center treats, what demographic of patients it treats, the levels of care that are offered, the types of treatments it uses (WHICH YOU SHOULD KNOW BY NOW IS SUPER DUPER IMPORTANT INFORMATION TO HAVE), whether or not it takes insurance, and if it accepts Medicaid or Medicare.
4. DON’T BE AFRAID TO ASK QUESTIONS.

Once you find a treatment center that you think is potential candidate, CALL THEM UP AND ASK QUESTIONS!  Don’t know what to ask? Here’s a list!

  • How long has your center been treating eating disorders and are you familiar with the 2013 Clinical Practice Recommendations for Residential and Inpatient Eating Disorder Programs published by the American Academy for Eating Disorders?  (Make sure to check out the guidelines before you call the center . . .obviously).
  • What is your belief on the etiology of eating disorders? (make sure they recognize that eating disorders are biologically-based brain disorders that are NOT choices and that they are not the fault of the patient or patient’s family)
  • What is your treatment philosophy? What treatments do you offer? How much time is spent on each of those treatments? (make sure the MAJORITY IF NOT ALL OF THE TIME IS SPENT ON EVIDENCE-BASED TREATMENTS!!!!).  Can you explain the science behind each of your therapies?
  • Is your program hospital-based or allied with a hospital-program sponsor? (if you want good treatment, THEY SHOULD BE!)
  • Are all you clinical staff members trained in evidence-based therapies? What are their credentials?
  • What is the training and background of the therapists you have on staff? How long have they been treating eating disorder patients? What kind of credentials do these therapists have?
  • Who is apart of my treatment team (centers should provide the four major components of eating disorder treatment which include medical/nursing, nutrition, psychological care, and psychiatric care)? How often do I meet with each member of my treatment team?  How does my treatment team coordinate my care? Do they work together?
  • Does your center provide education for family members and family therapies? How does your center keep my family involved in my care?
  • Does your center engage in quality improvements efforts? If so, how? Do you evaluate your outcomes and if so, how? Can you provide me with data on these outcomes? (they should evaluate their outcomes and be transparent about them).

For more information on how you can evaluate a treatment center, click here!

5. RECOGNIZE RED FLAGS

As you question and investigate an eating disorder treatment center, you MUST be aware of red flags.

Here is a link to an wonderful article by Dr. Sarah Ravin, a psychologist who specializes in evidence-based treatments for eating disorders, on eating disorder treatment red flags.

Now that your armed with these helpful guidelines, BEGIN YOUR SEARCH!
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Let me tell you the story on why I have decided to write this series on eating disorder treatment.

As most of you know, I spent the early years of my eating disorder in hospitals and treatment facilities.  Since I was so young at the time,  making my own medical decisions was off the table, and so my parents were the ones who searched for facilities and signed all the admission papers.  The first time I arrived at a facility after a hospitalization, I was just thirteen. I had no understanding of how serious my illness actually was and how medically unstable I had become.   I also had absolutely no desire to get well. Sure, I chugged my Ensures and stuffed my face with bowls upon bowls of lukewarm mac-n-cheese, but I did not actively participate in groups, I kept myself guarded in individual therapy sessions, and I blatantly refused to complete my CBT packet.

Now here I am – an eighteen year old who dreams of being able to speak French fluently, of traveling the world to visit every religion’s most sacred sites, and of becoming a health care professional who helps those who suffer from eating disorders. And I am also an eighteen year old who still can’t eat at restaurant, who still counts calories religiously, and who still is incredibly frightened of gaining even one measly ounce!

My friends, I am still very ill. Sure, I’ve made progress over the years but my eating disorder has yet to go into remission. Now I live with the regret of not taking advantage of the intensive treatment I was offered.

And that’s exactly why I am writing this new series on eating disorder treatment. I do not want anyone making the same mistakes I made. I want to help you, my fellow eating disorder sufferer, find and get the best treatment you can possibly receive and to take advantage of everything treatment has to offer.

So you may be wondering what exactly I am going to cover in this series. Lucky for you, I’m a meticulous planner and I made a list of the every single one of the topics you’ll see here on Forever Going Forward.

  1. How to Find the Best (for you) Eating Disorder Treatment Center – March 7th, 2016
  2. Packing for Eating Disorder Treatment? The Ten Things You Must Bring!  – March 14th, 2016
  3. How to Get the Most Out of Eating Disorder Treatment -March 21st, 2016

Alright you guys, I hope that sounds like a good plan!

Now before you head on off to work or school or whatever you do at this time of day, I want to remind you guys to check out my new Q&A YouTube video and after watching it, please leave a comment in the comment box below about your experiences (good or bad) with family or friends who don’t know anything about eating disorders. I’d love to feature some of them in my next YouTube video, “How to Deal with People Who Don’t Know Anything about Eating Disorders.

Have a wonderful day and you’ll hear from me soon!


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Well, it’s been quite a while since I have posted. University had me drowning in more tedious essays, meticulous lab reports, and mundane reading assignments than anyone could have ever imagined.  Once summer break started in June, you’d think I would have felt relieved and would have started blogging again .  . . .well folks, that’s not how it happened.   Just two weeks after I was freed from the obligations of the world of academia, my family and I moved.  Now that my boxes are unpacked, I am FINALLY ready to reenter the blogosphere and what better way then to write a post about Netflix’s newest eating disorder film staring Lily Collins – “To the Bone”. 

I have seen multiple films attempting to depict the horrific, merciless nature of eating disorders – For the Love of Nancy, Dying to Dance, Kate’s Secret. To my disappointment, all of these paint a very stereotypical picture of anorexia – a young female who is being suffocated by the drama of a dysfunctional family and decides to turn to self-starvation in order to escape the hurricane of problems in her life.  Since most of these films are the product of the late 80’s and early 90s, I have reconciled the films shortcomings with the time they were created – a time when the understanding of neurobiology of eating disorder was almost completely nonexistent.

So, when I saw that Netflix released To the Bone, I had high expectations. I thought that this film would present the world with a true image of an anorexic patient – an individual suffering from a vicious disease caused genetics and abnormal brain biology, not by trauma or family turmoil.

But as I watched the story of “Ellen” (Lily Collins), To the Bone‘s  anorexic protagonist, unfold, I was disgusted to find that the film’s writer and director, Marti Noxon, not only decided to paint an especially outdated picture of anorexia, but also failed to portray an accurate image of evidence-based treatment for patients struggling with eating disorders.  In this blog post, I hope to shed some light on the gross misconceptions that tainted Netflix’s To the Bone.

Misconception #1: Family Problems Cause Eating Disorders

Right in the beginning of the film, it was clear Ellen was drowning in a sea of intense family drama. Her father was a obvious workaholic who put his paycheck first before his family.  In fact, Ellen’s father was so disengaged,  he never even appeared in any of the film’s scenes – he was only mentioned briefly in conversations.  Ellen’s biological mother  , Judy, was portrayed as a mentally unstable individual whose psychiatric ailments rendered her incapable of caring for Ellen as she grabbled with anorexia. Judy had also separated from Ellen’s father after she apparently came out as a lesbian. Due to Judy’s incompetence, Ellen lived with her step-mother, Susan – a grossly charismatic egomaniac.

This depiction of an overtly dysfunctional family supports the widely-held, but outrageously archaic, belief that the etiologic agent of eating disorders is an “anorexigenic” family system.

Nowadays, it is understood that merciless diseases such as anorexia nervosa and bulimia nervosa are biologically-based brain disorders. Neuroimaging has shown us that anorexic patients have significant brain abnormalities that likely contribute to the pathological behaviors that are exhibited. In the book, “Give Food a Chance: A New View on Childhood Eating Disorders” by the acclaimed Dr. Julie O’Toole, O’Toole also establishes that bulimic patients demonstrate severe neurological abnormalities as well.

The film’s writer and director, Marti Noxon, said in a statement that that she wanted to help the world “achieve a greater understanding” of eating disorders through the film. Well if Ms. Noxon desired to do so, why didn’t she show that eating disorders don’t just affect individuals trapped in broken homes? Myself and a myriad of other ED sufferers who I know grew up in families so incredibly normal that you’d think their family was the modern version of the Cleavers from Leave it to Beaver! 

Do Parents Cause Eating Disorders in Teens and Children? - YouTube
Misconception #2: Pretty Much All Anorexics are Sexually Abused

While Ellen was staying at a highly-unorthodox and absurdly incompetent (more on that later) “inpatient facility”, Ellen meant Luke – a fellow patient who seemed to want to get into Ellen’s pants a little bit too much. While the two patients were sitting outside together, Luke asked Ellen if she had ever been “touched bad” as a child since “that was common among Rexies”.

I was disgusted when I heard this line in the film. By Luke saying this, it was clearly suggested that individuals suffering from anorexia nervosa were most likely to be survivors of some form of sexual abuse. Believe it or not folks, but this is far from truth. In actuality, it has been shown that there is NO statistically significant difference in the incidence of sexual abuse between eating disorder patients and healthy individuals.  Therefore, this particular scene in the movie propagates the myth that anorexics have all been “touched bad” as children.

Misconception #3: Treatment is Basically a Hotel for ED Patients

One of the most digusting things I witnessed while watching To the Bone was how Ms. Noxon depicted inpatient eating disorder treatment. In the film, Ellen was sent to a so-called “inpatient” facility managed by Dr. William Beckham – an apparent eating disorder specialist.  This “inpatient” facility only had one supervisor to care for several  very ill patients, patients were not supervised during meals nor were they given a meal plan to follow, the facility was not locked allowing patients to come and go as they pleased, and no effort was made to prevent patients from engaging in eating disorder behaviors (one patient purged in her room, another patient with BED could eat a full jar of peanut butter at every meal, the list goes on and on . . .). For anyone who has experienced inpatient treatment, they know Dr. Beckham’s facility isn’t anywhere close to what true inpatient treatment is like.

Inpatient treatment is the highest level of care for eating disorder patients and is for patients who are both mentally and psychiatrically unstable (read more about levels of care here).  This level of care provides patients with STRICT 24/7 monitoring in a LOCKED unit, supervised meals & snacks, nutritional rehabilitation, medical interventions such as feeding tubes and IV hydration, and evidence-based individual and family therapies.  The Joint Commission, a nonprofit organization that accredits and certifies thousands of US-based healthcare facilities, has also established a slew of guidelines that must be followed by facilities that care for patients suffering from eating disorders.

Some of these guidelines include . . .

  • “For organizations that provide 24-hour eating disorders care, treatment, or services: The organization supervises the daily activities of individuals served as needed to prevent them from engaging in behavior that could be detrimental to their health, such as excessive or inappropriate exercise, inappropriate use of laxatives, or self-induced vomiting.”
  • “For organizations that provide eating disorders care, treatment, or services: The plan of care, treatment, or services provides for sufficient nutritional rehabilitation to support regular and consistent weight when indicated (including expected rates of controlled weight gain of at least one pound per week) and/or measurable improve- ment in eating disorders behavior (for example, restricting, binge eating, purging).“

Clearly, the so-called “inpatient facility” in To the Bone fails to meet the definition of inpatient care as described by the National Eating Disorder Association  and also neglects to follow some of the most basic guidelines published by the Joint Commission.  If Ms. Noxon longed to produce a film that raised awareness about eating disorders, why did she decide to paint a highly inaccurate picture of eating disorder treatment?

All in all . . .

To the Bone is no different than any other eating disorder film produced.  It continues to spread the idea that anorexics and bulimics are the product of family dysfunction, that anorexia nervosa is simply a physical manifestation of the trauma of past sexual abuse, and finally that eating disorder treatment is a free-for-all.  In my opinion, Netflix should be ashamed of this film and Ms. Noxon should also apologize for her obvious lack of research in the subject of eating disorders.


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February Q&A: Anorexia, Advocacy, and Autoimmune Disease - YouTube

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EATING DISORDER RECOVERY // The BEST Meals! - YouTube

Have an eating disorder? In need of some NUTRITIOUS and QUICK entree ideas? Look no further because in this video I will share with you my TOP THREE pro-recovery entrees that are so easy to prepare, all you need is a microwave!  I also calculated the exchange values for each nutritious pro-recovery entree so you can easily fit it into your eating disorder recovery meal plan!

To learn more about the food exchange system and how you can make your own exchange-based meal plan, check out this one of my blog posts http://wp.me/p3LqYN-tZ

Wondering where you can find some of these amazing pro-recovery entrees?  Check out these sites!

Quorn Naked Chicken Cutlets: http://www.quorn.us/store-locator/

GardenLites Souffles: http://www.gardenlites.com/stores/

Amy’s Quinoa and Black Bean Frozen Meal: http://www.amys.com/buy/store-locator


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