Response to Yesterday

I got some interesting comments about my post yesterday, and instead of posting a reply in the comments (which would be far too long for a comment, unless of course you're Mary. /********) I'm doing it here.

I know that my ideas on eating disorders are somewhat outside the mainstream- if indeed there is a mainstream about views on eating disorders. I am a scientist both by training and orientation. I read studies, I read news reports, occasionally I read People magazine if left in a doctor's waiting room for too long. And while I mostly set my views with the science if there is a dispute or lack of other evidence, I think there is still an element of truth in all areas.

A sufferer's experience is important. Screw the fact that it might not be scientific. What a person sees and thinks and feels is crucial to understanding what this disorder really is.

Do I think a bad home life causes an eating disorder? No. Could it contribute? Yep. Maybe it is what pushes some people who have the genetic background into an eating disorder. Maybe parents who are critical of their children's weight have their own body image issues. Maybe they're just shitty parents.

But it's not a cause.

Both my parents probably came from what most people would call an unsupportive home environment. Some of it, I would call abusive. If that caused eating disorders, more people would have them. A totally effective home environment is a rare thing. My parents were far from perfect. Very few people are encouraged to emote freely.

Environment is still important. Eating disorders are not single gene disorders. For some diseases (a very select few), a single mutation in a single gene is enough for you to become ill. Diseases like cystic fibrosis, sickle cell anemia- these are single gene disorders. Most other diseases- diabetes, depression, asthma- are controlled by multiple genes AND need significant environmental influence. You need some sort of environmental trigger in order to get anorexia or bulimia. That trigger could be teasing. It could be abuse. It could be starting a diet. Any number of things. Emotions and brain chemistry are intimately related. Stress changes neurochemistry. So does dieting.

I don't want to say completely, utterly that insight is not important. Because it is. Just not at first (or at least that it's minimally important). Therapy isn't very useful for a starving brain. Therapy can facilitate the cessation of behaviors, it can help you learn how to ride out the distress and emotional waves that come with eating. My friend in treatment called it "urge surfing." Therapy can help reassure you that you're not the first person to have felt these things and that it WILL get better.

And like you said, A, insight has a place in learning when to use your skills. I know final exam time is a major trigger for me. I know I need to make sure to take time for myself and destress during that time. That's insight. But for me, insight as to why I developed anorexia hasn't proven useful. I don't know why, I don't need to know why.

I just need to know how NOT to fall back down the rabbit hole.

"For you have suffered enough
And warred with yourself,
It's time that you won..."

posted under , |


A :) said...

Thanks for replying Carrie,

I hope you didn't take any offense to what I said -- that was not my intention at all!

A :)

carrie said...

No, no offense taken. None at all. This kind of discussion is good- for everyone. :)

another anon said...

I'm actually a scientist as well. Which is why I find this topic so fascinating. I did try to make it clear in my comment that of course I know that an unstable household never causes an e/d. Heck, my sister was in the same house and didn't get an e/d. My brother became an alcoholic. My point was that sometimes therapy does lead the path to recovery. It did work for me before refeeding despite what most of the research and theory says. For me personally, I had to have some therapy and insight before I allowed myself to refeed. I didn't recover until I was an adult. There was no one who could legally force me to eat. Yes, this frustrated therapists and doctors immensely! But somehow therapy got me to trust the risk of eating. They all said therapy wouldn't be helpful in the starving brain, but it was. A light bulb went on when I realized that I didn't have to starve any more. That's I'd be okay if I allowed myself to eat. I could let go of that need to be small. Would therapy alone have saved my life? No, of course not. Refeeding was essential in saving my life and I was able to have *more* clarity. Could I have died waiting for therapy to work? Absolutely. It was a risk, for everyone. But again, no one could make me eat. It took a therapeutic intervention to lead me there.

If I had a child with anorexia,of course I'd want refeeding to come first. To put it bluntly, I did things ass backward when it comes to e/d recovery. It's not ideal - I get that. My point was it *can* work. It is risky and may not have worked. But it did. I think therapy is better then nothing if that is all a person is willing to do. In my case it cleared the path to refeeding.

I don't argue your points under the ideal circumstance. I only argued the idea that therapy can't work in a starving brain because I know it actually did. I agree that insight normally doesn't mean much if someone is starving to death. But if it opens that door - it's at least worth a shot when we are dealing with a person that fights refeeding and there is no legal leg to stand on to make a person eat.

I wish you well on your trip. It sounds amazing. You really lead a full and inspiring life. Your willingness to dive into new things makes me want to take chance on things that scare me.

Have a great trip.

Harriet said...

another anon,
i'm glad for you that things have worked out ok.

but as a parent of a child who has recovered from anorexia, i can say categorically that my daughter would have died before therapy had a chance to work. she very nearly did. you may have been the exception.

and as far as saying "there was no one legally who could make me eat"--parents do not need the sanction of the legal system to create an environment in which their children must eat. i don't care how old my daughter is--she could be 14 or 24 or 54, if i see her starving i'm going to do something about it.


mary said...

"(which would be far too long for a comment, unless of course you're Mary. /********)"

hey! ; )


anon again (last time, I promise!) said...

harriet -

That's just it. There was no one who could even take legal steps to have me forced fed. The one person that cared enough to look into and call the proper resources found that they had no leg to stand on, I was still deemed "too healthy" to take legal action on (adults often have far better labs and vitals then teens and the body seems to often "adjust" better.)

My parents always knew I had an e/d. They never sought treatment for me. They had their own issues. I was told just not to embarrass my mother by it and that was the only discussion. It wasn't until much later in life that I finally "got" that it was really a problem, that I couldn't live like that forever. And I'm lucky that way. I'm an adult and they (parents) still don't understand why I couldn't just get over this if it was such a problem. That happens sometimes in families. Some parents just can't offer the needed support.

I won't post again as this is not my place to do so, but no one has yet heard my point. All my point was is that therapy can help. That's all.

This is what I consider to be a big problem with e/d. The people who have them are rarely heard and differences are not understood. Recovery does not look the same for everyone. There may be certain paths that are certainly ideal. Some people may for the most part just need refeeding and strong family support. Other people (including independents and those with no family support) may need a different path. I said several times that refeeding first is optimal. It's unfortunate that not all of us have/had family support. But that doesn't mean therapy doesn't have its place.

That's all all say on the topic (sorry Carrie for robbing your blog for a debate that was never intended to be a debate!) but please just be open minded that paths sometimes are different. What works for one (even when ideal) does not always work for another and there are those that don't have equal support and care in recovery. Reading the different view points has been very interesting and as I've said, I've read all the studies too. I put a great deal of time as well into reading and studying this topic - from *all* angles.

In a perfect world we'd all have caring families to help them refeed before the e/d became ingrained so deeply it became chronic. Unfortunately, it's not a perfect world.

I still have to hold on to the good fortune I had in recovering without the path that seems to be the consensus here. I don't want to feel that I did something wrong by recovering the "wrong way." I feel kind of bad for mentioning what helped me.

my apologies.

A :) said...

anon ~

I don't think you need to feel bad about what you posted. I know, on occasion I have certainly had contrary opinions to Carrie, Laura or Harriet. I think everyone is tolerant of different opinions.

I think its hard for a starving brain to respond to therapy as a healthy brain would. I had therapy all during my ED but never used it effectively until I became weight restored.

But that does not mean recovery doesn't work the opposite way. I don't think the debate here is the effectiveness of therapy, but its time and place in recovery.

I know most inpatients in the program I was in (I was a day patient -- we were mixed) were mainly unresponsive to therapy until they reached a semi-healthy BMI (16+), as they were just too out of it to see past behaviours or weight (though therapy did give them a great outlet to vent their fears/be undestood.) In this phase, CBT and DBT strategies seemed to help them the most.

When they reached a healthier weight, they were able to make sense of what was happening and deal with underlying issues. When they reached their target weights (a BMI of 20+) they had an even easier time sorting through issues -- though of course this phase is NOT easy.

I guess I just like to emphasis the need for full nutrition because I think too many individuals with EDs tend to say they are "recovered" at unhealthy BMI's or still have an ED mindset.

However, this may just be my jealousy having to attain a BMI of 20+ when others don't necessarily need to do this.

Never feel bad about expressing your opinion!

A :)

Post a Comment

Newer Post Older Post Home

ED Bites on Facebook!

ED Bites is on Twitter!

Search ED Bites

About Me

My photo
I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

Drop me a line!

Have any questions or comments about this blog? Feel free to email me at

nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


Popular Posts


Recent Comments