Beating eating disorders, even without a "cure"
I couldn't help but think about eating disorder recovery when I read this article: Diabetes? Some beat it, but are they cured?
Some people with Type 2 Diabetes are able to control their blood sugar through the euphemistic "lifestyle changes," namely eating "healthier,"* losing weight, and exercising, to the point that they no longer need medication.
"For right now, we're not saying they're cured, but the bottom line is ... good glucose control, less infections," said Sue McLaughlin, president of health care and education for the American Diabetes Association. The organization has no estimate of how many people fall into that category...
Doctors caution that, for some diabetics, lowering blood sugar may be only temporary. Stress, weight gain and other factors can push it back to unhealthy levels.
"Blood sugars can come down to normal. Then the issue is how long does that last?" said Dr. Sue Kirkman, vice president of clinical affairs for the diabetes association. "Sometimes people start putting weight back on and their blood sugars come back up."
In other cases, patients are diagnosed so late that blood sugar levels can't be brought back to normal, even with weight loss, she said. As the disease progresses, even those who made diet and lifestyle changes might eventually have to go on medications.
That's one reason Wagner and some other diabetics who've managed their disease through diet and exercise are also reluctant to consider themselves "cured."
"American culture, our environment, is not conducive to having good health," said Wagner. She believes diabetes will always be lurking in the background, waiting for her to slip.
And, though it sounds a little ominous, I think an eating disorder will always be waiting for me to slip. I don't believe recovery is all doom and gloom, but I'd be really stupid to forget that I am and will always be vulnerable to an eating disorder. American culture isn't conducive to eating disorder recovery, either, which only adds to the need to remain vigilant.
Here's the thing: we don't know how many people recover from an eating disorder only to fall back down the rabbit hole decades later. We know relapse is common and recovery can be a long and difficult road. We know that malnutrition is almost always the first step both in the initial descent into an ED and into relapse. We know that normalizing eating habits goes a long way in treating ED thinking. But we don't know about "cures," if there is one, if there will ever be one.
For me to stay healthy, I can't brag about how little sleep I'm getting or how stressed I am. These things make me nutty, which tends to lead to food restriction. Food restriction leads to overexercise and overexercise leads to stress fractures and The Boot. I can't go on a diet and expect a positive outcome. I can't be carefree about food and eating- I need to make sure I'm eating enough of EVERY different food group and that I'm getting enough fats and proteins.
In spite of this, I do believe that it's possible to go on and life a happy and fulfilling life. I don't think I will be dealing with food phobias and urges to exercise myself half to death forever. I tell myself it could be worse. I have people to support me on this journey, to get my back when Ed starts calling again.
*A "healthy diet" isn't one specific thing, hence the quotation marks.
10 comments:
I've spent a lot of time thinking about "recovery" versus "remission." There probably are some people who really do recover. Whether that means they are just in remission and have all the pieces fall into place to keep them healthy when stressors occur later in their life, I'm not sure. I don't like the word "cure," either. I'm still not positive on where I stand on all of this, but I think that you can be in 100% remission -- if that makes sense. You can live a normal day-to-day life without food/weight issues. However, I think you will always be at risk for relapse... which prevents you from being "cured."
I saw this diabetes article this morning -- very interesting!
I love that phrase "100% remission"- how hopeful! It's a hard balance, and I think retaining a healthy fear of ED is good.
I, too, am hesitant to think in terms of a 'cure' for an eating disorder, partly because that sounds so one-dimensional, and I've really tried to view my recovery in stages and as something that has required an entire life-style change. And as for vigilance (I've said this before, but I always think of Mad-Eye Moody in the Harry Potter series), I do think it keeps us from going to that dark place. It's not about being paranoid, but rather about being aware and cognizant of ourselves. Which, again, I see as part of recovery.
I was told in the ED program I attended that recovery was possible, but I would likely have to be viligant my whole life. You are right Carrie, I can't be on the run all day with only a bagel in my stomach as some of my friends do or skip a meal and promise to eat it later because of lack of time. . . I also have to be viligant about exercise. . .
Before labelling recovery and remission, the ED professionals need to DEFINE it. In some studies remission is considered achieved over 85% of target weight or a good outcome is considered weight restored with symptoms. . . To me (and I think to many ED sufferers) this is not the definition of recovery, but this is how the statistics are laid out. . .
We need consistency in diagnosis, recovery and remission -- in addition to what constitutues a relapse. Is there any other field where the prognosis is so uncertain and varies depending upon what study is used?
A little off topic, but still grrr... I don't even know what recovery is and I am trying to get there. Funny, most of the professionals I'm working with don't know what it is either.
A
Kristina,
Love the Mad Eye Moody quote.
A- You're right. 86% IBW doesn't equal wellness, not by a long shot. For that matter, nor does 200% IBW.
I've seen a recent study where the researchers were trying to define recovery and their conclusion was essentially, "Well, it's kinda subjective." Just run me over with the duh truck, why don't you?
I hear (and echo!) your frustration with the what-the-hell-is-recovery-anyway? question. I mean, if we're supposed to be working towards it, it would be nice to know what exactly it was.
Carrie...I like your post - thought provoking. As a Dad with a daughter with an Eating Disorder, I would love to believe there is a once and for all cure. When my mom, after much treatment, was diagnosed as "cancer free," her Oncologist confided to me that it didn't mean she was really "cancer free." Only that there weren't enough cancer cells to detect with their testing capabilities. But the doc said once those cells are there, they are never 100% gone. I suspect that the reality of EDs is similar to that and also similar to any other addiction. Even when you're ED Free, or cured, or in 100% remission, or recovered, you aren't really any of those things. Even though I'm positive ED sufferers can lead a healthy, productive, happy life, the ED danger always lurks. Whoever said constant vigilance is needed, I agree. It's too easy for the alcoholic to have "just one glass of champaign" at someone's wedding, or for the drug addict to get "just one little fix" to help through a tough day. And for the ED sufferer to resort to one ED behavior under stress to undo months or years of recovery efforts and start down a slippery slope of relapse. I caution my daughter to think through every decision and choice she makes and ask, "Is this good for my health and recovery, or not." And, if not, to make a different choice. Easier said than done, I know, but I think necessary. And necessary for life.
Dexter - DAD-EDs.com/blog
I pray there's going to be a "cure." For now,though, I'm just happy I can eat normally on most days.
How can we sit here and let this disease kill our friends and family? I have already lost someone to this mess and I pray that people become more aware of this disorder.
http://www.eatingdisorder.com/anorexia-nervosa.html?utm_source=blog&utm_medium=pv&utm_content=zs&utm_campaign=anorexia
Michael,
What friends and family need to do is stop sitting there. May types of treatment tacitly or explicitly encourage this, saying the sufferer has to choose to get better, that it's detrimental to take away "control." Obviously, if the sufferer is an adult, it's much harder to do that legally.
However, we can stop pretending that everything is okay. Stop attending lunches where the person never eats. Stop discussing exercise and food. Stop letting life go on as usual.
I'm confused, however, about the link you posted and if you're trying to "advertise" your site. I hope that's not the case.
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