More Bad Advice

I don't know why I'm still astounded at all of the mis-information on eating disorders out there, but I am.

This fascinating tidbit comes from an advice column in the New York Daily News:

Recovering from eating disorders a lifelong challenge.

At first I cringed a bit because this seemed like just another you-will-always-be-sick sturm und drang article. To some extent, it is true: for chronic, adult sufferers, the stats aren't necessarily something to put a spring in your step.

On the other hand, stats aren't everything.

The two guys writing this column (one of them with a "Dr." before his name, which means precisely what, I don't know) were discussing the causes of anorexia and how hard it was to recover. Only they managed to perpetuate almost every myth about eating disorders out there.

Like the following:

Dr. Dave: Anorexia is also often accompanied by loss of menstruation and shrinking of breasts. This makes girls feel "small" and "young" again --
Bill: -- and allows them to put off dealing with the excitement and fear of their emergent sexuality a bit longer?
Dr. Dave: It is also a way they can control something in a world they see as beyond their control.


I have always felt my world was out of control, that I was out of control. And once the anorexia began, I thought my food and eating was out of control. I was eating too much, or the wrong things, or not exercising enough. The eating disorder was a desperate attempt to control them, and control the anxiety that they caused. The perfectionism was a desperate attempt to control everything else.

I was trying to control fear, not food.

And fear of emergent sexuality? Why, hello, Dr. Freud, nice to meet you.

Secondly, and the irony in this is just beyond classic, they quote a doctor with a weight loss guide for girls about the necessity of gaining weight during puberty. Like she should talk!

Bill: With National Eating Disorders Awareness Week upon us (Feb. 21-March 1), I’ve been wondering why anorexia and bulimia occur so much more often among women -- especially young girls. So I called a friend of mine, Dr. Susan Bartell, author of "Dr. Susan's Girls-Only Weight Loss Guide," who said that one reason is that women's bodies change so much during puberty. Many fashion-conscious girls reject the changes as "fat."...
Dr. Dave: ...But I have many adult female patients, too, who crave the emotions and physiology of starvation. Did Dr. Bartell go into how the brain reacts to self-starvation by releasing a compensatory chemical called opiods?
Bill: They’re the cause of the high, she says, to which people with eating disorders become addicted. My answer to that was, yes but with the great emphasis we put on feminine beauty, how can her patients become addicted to looking three days dead?
You know, Dave, in my experience, women are much more sensible than men when it comes to good looks. Sure they like a handsome man, but that’s where the female calculus merely begins. They also ask themselves if he is grown-up, reliable and true, manly without being a jerk about it, generous-natured and capable of love.
Dr. Dave: You were asking her, since women are so sensible about the value of good looks in men, why couldn’t they be just as sensible about their own?
Bill: Dr. Bartell said the very mark of eating disorders is the distortion that occurs when the addict looks in the mirror. "They TRULY see themselves as fat," she says, "even when they're skin and bones."


I know there are 12-step groups for eating disorders, like EDA (Eating Disorders Anonymous) and OA (Overeaters Anonymous), but TDDA (Three Days Dead Anonymous)? That sounds more for people with necrophilia than anorexia.

I'm just glad that before the article was over, Dr. Dave went to such heroic efforts to distinguish between anorexia and bulimia.

Dr. Dave: We usually lump both anorexia and bulimia under the one catchall title -- eating disorders. But anorexics go for stimulants which cause weight loss: cocaine, black market Ritalin, etc. Bulimics tend to abuse alcohol, street drugs and laxatives.

That sure clears things up, Dr. Dave. I'm sure they'll add that to the DSM.

So I just have one request for journalists and other well-meaning people who intend to write about eating disorders: learn about them first. Because inaccuracy is the last thing we need.

Now I'm, uh, going to go find a TDDA meeting.

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8 comments:

Harriet said...

I'm not sure whether to laugh or cry. Ritalin? Cocaine? Maybe these guys were on some of that.

Joanna Poppink, MFT said...

Dear Carrie,

I like your passion.

It seems that some material written about eating disorders gets sent out through electronic, air and print media as if people with eating disorders wouldn't be able to see it.

When reading the bits of the article you share on your blog I experienced the same feeling I get when people are talking about someone and acting as if she or he were not in the same room quite capable of hearing every word.

The exchange might have been okay if the men were asking questions or wondering if their perspective had any merit. But they come down hard with so called "facts" that don't fit with an eating disorder person's lived experience.

I agree completely with you when you said the control is about controlling fear. When that point is acknowledged the discussion goes away from food, fashion, weight, appearance, and even sexuality.

The discussion becomes based around the question, Why are growing numbers of women at increasingly younger ages afraid? What are they afraid of? Why do they feel that their fears are justified and that they have no way of protecting themselves except through eating disorders?

Addressing those questions takes courage and honesty. In my experiences as a psychotherapist, the attempt at reaching answers to those questions is the beginning of genuine eating disorder recovery.

Thank you, Carrie, for bringing up this issue and for letting your honest and true sense of indignation come through to all of us.


Joanna Poppink, MFT, psychotherapist, eating disorder specialist, Los Angeles, CA
http://www.eatingdisorderstoday.typepad.com

carrie said...

Harriet,

I think I combined the laugh/cry with a snort of my tea. As if that is the difference between anorexia and bulimia...

Joanna,

I'm honored that you found and commented on my blog.

I agree that there can be many things underlying the fears, but sometimes you forget why they existed in the first place. My eating disorder is (as far as I can tell) rooted in my bipolar disorder, OCD, and perfectionism. And the fears had a LOT to do with wanting to be perfect- which meant I had to eat and exercise perfectly.

Correcting those inaccurate thoughts is the work I'm still doing in therapy, as well as accepting my body at a healthy weight and eating properly. After 10 years, it's hard to remember what it's like to eat three meals and 2-3 snacks per day.

I'm lucky to have had several wonderful therapists along the way, both of whom have used DBT.

Thank you again for commenting.

Carrie

Anonymous said...

Quite the "expert" they called in. Interesting that there was no mention at all about the genetic (and brain chemistry) components to the causes of eating disorders. But isn't it more simplistic and easy to just make it seem like those skinny girls are all just afraid of having boobs?

Charlynn said...

Laugh or cry? I think I'll do both. What a pathetic, misguided attempt at explaining eating disorders. As you said, the last thing we need out there is misinformation, and this is a prime example of what NOT to read out there.

carrie said...

Anon-

It's easier for them to talk about fear of boobs and it's more catchy. Making serotonin and leptin and ghrelin is a lot harder- worth it, IMHO, but being a science writer, I would think that.

Char-

This kind of misinformation is insulting to sufferers. Oh the poor dears- they just don't want to grow up. When it's *so much more* than that. And we're wondering why we can't get insurance coverage...

Laura Collins said...

That's just what it is: insulting to sufferers.

I'm not an expert, but I can diagnose this stuff as hogwash!

luccy said...

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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.

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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



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