It's once again time for your weekly Sunday Smorgasbord (delayed by only 24 hours), where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

Join me at FEAST's first-ever conference in Washington, DC this November.

Will Students Take a Mental Health Test?

Aetiology of anorexia nervosa: from a "psychosomatic family model" to a neuropsychiatric disorder?

Live in Australia and want to participate in a clinical trial of outpatient treatment for anorexia? Here's your chance.

Relevance of Social and Self-standards in Eating Disorders.

Eating disorder side effects in men.

Illness perception in bulimia nervosa.

Distinguishing between introversion, shyness, and social anxiety.

Characteristics of suicide attempts in anorexia and bulimia nervosa: a case-control study.

Dieting women may lose bone mass that doesn't return.

Knowledge of eating disorders among collegiate administrators, coaches, and auxiliary dancers.

Who Says You’re Fat?

Ghrelin and anorexia nervosa: A psychosomatic perspective.

Guide Dogs for the Mind Gain Popularity.

Study finds fat acceptance blogs can improve health outcomes.

How psychotherapy changes the brain.

Well, I have survived this week's natural disasters: an earthquake and a hurricane. If there were locusts, I would have thought the horsemen of the apocalypse were galloping by.

Power came back on at my place this morning, it was back at my parents' yesterday.  My freezer didn't thaw too much, so I hope everything will be okay.

Your smorgasbord will appear tonight.

Glad to be back!

So. If you're in the US, you've probably heard about the massive hurricane that's hitting the East Coast. And I'm in its path. That means I've stocked up on bottled water (I think I found the last pack in my town earlier today), peanut butter, protein bars, baked beans, and tuna--for me AND Aria.

I'm guessing we're going to lose power and that cooking is going to be a bit creative the next day or two. I'm staying with my parents since they have a generator and I don't, so I'll at least have a bit of juice. It also likely means NO INTERNET and limited phone, since I don't want the battery running dead.  In the mornings, we're going to fill all the bathtubs in case we lose water so we can flush toilets, etc.  Basically, when you combine the brains of three obsessive and perfectionistic people, you can ensure that all your bases are going to be covered.

So here I am, trying to fit both my job and my recovery into this madness.  Yes, I know, I should be worrying primarily about my recovery, but I also have bills to pay.  Trying to get copy in on Monday could be an interesting adventure. I suppose that this could be an optimal time to drop the ball on recovery.  Stress? Check. Legitimate disruption of food schedule? Check. Lapse? Let's not tick that box.

But I've taken every precaution and have no reason not to stay compliant with my meal plan.  There will definitely be extra stress.  I try to stay practical: not eating won't help anything. 

I may or may not be able to blog again for several days. So for all of you East Coasters, batten down the hatches and hole up with your can openers. For everyone else, enjoy a meal that doesn't come from a can and think of me. :)

This is actually a post I've been meaning to write for a while: the curious upside to relapse.

Before I go any further, let me say that I don't advocate relapse, I'm not saying you should try to relapse just to "see what it's like" or to stare the demon in the face and see who blinks first.  I'm also not saying relapse is inevitable.

It is, however, exceedingly common.  So common that I don't know anyone who has recovered without at least a minor relapse.

But here's the thing: although a relapse isn't good, it's also not 100% bad, either. Your first task when you find yourself slipping is to pull yourself out of the hole. Then, I've found it helpful to identify triggers and potential turning points where I could have done something differently.  From a number of these dissections, I've learned some things that have ultimately helped my recovery.

1. Relapse can show you where your recovery is weak. For some people, it's PMS. For others, it's work stress. Or kids. Or breakfast. Or whatever. These things can be easy to overlook or shrug off.  But a relapse can give you a chance to address these, head-on.
2. Relapse can force you to re-evaluate your goals. Maybe you love your job but it's stressful as hell, and a relapse is showing you that all that stress isn't healthy. Or that your college major isn't what it's cracked up to be. Relapse can be an opportunity to rethink things with a fresh set of eyes. If high stress and low sleep are demanded by your job or major, it might be time to rethink just how much you want to be on that path.
3. Relapse can remind you just how bad the illness is. We forget, sometimes, just how crappy we feel when entrenched in the eating disorder.  But a period of wellness followed by a return of symptoms helps drive home the difference that recovery can make.
4. Relapse can be humbling. Humbling in a good sense. It's easy to think that we'll be fine, that there won't be any problems, that we don't need extra help. And then comes a little friendly reminder that we do, in fact, need support and lots of it.
5. Relapse can let you refine your treatment. It's easy to coast through and think that everything is fine. And it's hard to see the need for change when things are going well.  Obviously--if things are going well, you don't want to change that. But a relapse can be the extra nudge you need to switch medications or therapists, try a new treatment approach, or otherwise shake things up.

The idea isn't to just let relapse happen. If it does, however, you can use the experience to build up your recovery, rather than using it as an excuse to let everything decay.

What are some of the things you have learned from relapse? Share in the comments!

Some days, I think recovery can go shove it. The process sucks. It's expensive, time-consuming, and it makes me really, really cranky. Like, you know, it's doing right now.

On other days--days when I feel more positive, well-rested, and can take the long view--I can see that recovery, naturally, doesn't totally suck.  Especially on days like today when I'm crotchety and short-tempered, I need to read things like what my friend says about how recovery is a gift:

1. When we stop letting our eating disorders determine our self worth and begin to focus on health, it’s easier to make time for ourselves – no longer over-committing to others or trying to find meaning simply in what we mean to others.
2. Recovery allows us to re-set our priorities. Rather than believing that the only thing that matters is losing x pounds, or running some arbitrary distance, or. . . recovery allows us to see that there are friends who love us, healthy goals to achieve, and life that needs to be lived.
3. Recovery gives us the opportunity to talk out long-buried issues and to grow from our past rather than always living in it.
4. Recovery can teach us life skills. Whether it’s saying no to that one last thing, speaking up when we need support, using yoga/meditation/journaling to gain perspective, or something else altogether, identifying the simple steps needed to get through an anxiety attack, an evening with a large group of people, a moment, an hour, a week, or a year, the process of recovery enables us to draw on a variety of techniques and skills that – sometimes, at least – it seems like others don’t draw on.
5. Recovery allows us the opportunity to construct life on our terms, and to see that there are times when we’re not going to have control – and that those things are okay.
6. Recovery lets us learn more about the parts of ourselves that we’ve buried – and often, while this can be related to pain, it’s the strengths that we’ve given over that we’re able to reclaim.

I don't think my eating disorder is a gift, mind you, but I also think that recovery can force us to reconsider some fundamentals about who we thought we were. I'm still a workaholic and overachiever (I'm writing this after a 12+ hour day, and I'd have kept working except I'm working on that sleep thing), but I'm also much more willing to take a break.  I also have an identity outside of my occupation.  Before the ED struck, all I cared about was schoolwork. I wrecked friendships and had a bloody miserable time in high school and college because of it.

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

Young vegetarians prone to binge eating, says new study.

Back to school fuel: how restrictive diets can compromise student performace.

Thoughts on recovery from a recovering mother.

The brains of people with BN process emotional information differently.

Psychophysiological responses to idiosyncratic stress in bulimia nervosa and binge eating disorder.

Male Athletes Struggle With Eating Disorders.

Binge eating in binge eating disorder: A break-down of emotion regulatory process?

{{Sorry- it was a really slow news week.}}

Every day, we make tens of thousands of decisions, most of which we're not aware of. Shoes or sandals? What pair of socks? Paper or plastic? The list is endless. Not all of these decisions are obviously decisions--our brain likes to take shortcuts. If there's snow on the ground, I'm obviously going to choose shoes over sandals. That one's a no brainer. These shortcuts are essentially an energy saver- our brain is a limited resource. It can only do so much thinking. To save time (and energy), we have habits or patterns. We drive the same route to work. We flip through the channels in the same order. We eat the same flavor of ice cream out of the same bowl with the same spoon. Okay, maybe that last one is just me. Decisions are hard to make.

It's why, ultimately, we're creatures of habit. Simply, it's easier.

Scientists have come up with a name for why we get so tired after we have to decide something: decision fatigue. It's the subject of a recent New York Times article:

Decision fatigue helps explain why ordinarily sensible people get angry at colleagues and families, splurge on clothes, buy junk food at the supermarket and can’t resist the dealer’s offer to rustproof their new car. No matter how rational and high-minded you try to be, you can’t make decision after decision without paying a biological price. It’s different from ordinary physical fatigue — you’re not consciously aware of being tired — but you’re low on mental energy. The more choices you make throughout the day, the harder each one becomes for your brain, and eventually it looks for shortcuts, usually in either of two very different ways. One shortcut is to become reckless: to act impulsively instead of expending the energy to first think through the consequences. (Sure, tweet that photo! What could go wrong?) The other shortcut is the ultimate energy saver: do nothing. Instead of agonizing over decisions, avoid any choice. Ducking a decision often creates bigger problems in the long run, but for the moment, it eases the mental strain. You start to resist any change, any potentially risky move — like releasing a prisoner who might commit a crime. So the fatigued judge on a parole board takes the easy way out, and the prisoner keeps doing time.

The highlights are mine.

That's my default mechanism: when I'm stressed, when my brainpower is at an ebb, I default into anxious rituals of indecision. ED behaviors are a way to avoid any choice. They're ritualized, prescribe. Once they start, they continue of their own accord. They let the world pass me by without ruffling my feathers.

It also seems to me that the ED is a way to avoid decision fatigue. When I'm in AN mode, my decisions are much more limited. Eat only the lowest calorie options. Say no. Weigh myself again. And again. Get back on the treadmill. There's no decisions involved*, just commandments. That life is on autopilot, and it's uniquely positioned to limit decision fatigue.

I don't have to face the anxiety over deciding what to eat and when, and even with what utensils, because I eat the same thing, every day, on the same plate with the same cutlery. I don't have to decide where I want to go out to eat because I'm not going out to eat. If I do have to go out, I order the house salad, dressing on the side, and a Diet Coke. No menu (or decision) required. My life becomes prescribed and circumscribed by the anorexia. It's a hellish existence, a very limited one, but then there's this: it's easier.

Author Barry Schwartz calls it The Paradox of Choice. If you haven't read his book, definitely go do so. I think it goes a long way to explain some facets of ED thinking.

Besides being fatiguing, decisions are usually anxiety provoking. Most decisions actually result in minimal anxiety. After all, wearing the wrong pair of socks can make your feet sweat or make your shoes look funny, but this rarely results in lasting harm. The problem with decisions--the reason I think they provoke anxiety--is that they're a turning point. Once you've chosen a car, it's hard to un-choose that. Ditto for the socks, once you've left the house if you're not carrying a spare pair.

An eating disorder is the ultimate un-decision. You avoid everything. Sure, it saves you the anxiety over actually making a decision, but it also costs you a lot, too. Recovery means learning to face the decision anxiety and accepting it as part of normal life. I'm guessing lots of us retain our mental shortcuts and rituals that help us avoid anxiety (and decision making), but our brains take on lots more.

Have you developed strategies to deal with decision fatigue? Do you find yourself falling into similar traps?  Share in the comments!

*At least, no real conscious decisions.

One of my good friends was recently diagnosed with breast cancer and is now undergoing chemo.  I'm not exactly sure how the whole "shoe" theme got started (I think she and another one of her friends had an identical pair of loafers that they both wore the first day of chemo), but it's taken off.  We all wear our loafers on her chemo day to show our solidarity.

I don't know if ballet flats count as a proper pair of loafers, but they're the closest thing I've got.  I also don't think this is an actual chemo day, but I didn't get around to taking the damn picture until now.

With that said:

I love you, Charlotte.

When I went on vacation last week, I knew there was a lot of activities I would want to do.  I spoke with my therapist about being more active than usual, which she said was fine, as long as I ate more to compensate.  So I ate a bit off the meal plan, and all worked out well.

We've discussed this in the past, the idea of eating "extra."  That is, eating outside of scheduled snacks and meals, or eating more food than "required" at those times.  Not surprisingly, this freaks me out.  I've never been a rule-breaker.  The very idea terrifies me.  Part of it is the sense that the rules are the rules, and you don't break the rules.  If I do think a rule is silly, I often am too anxious to go outside the prescribed letter of the law anyway.  I rely on rules (many of them self-imposed, but rules nonetheless) to help me cope with anxiety. Breaking a rule is anxiety-provoking in and of itself.  Breaking an ED rule is even more so.

But my therapist raised a really good point.

It's not "extra" if you're hungry or you've been more active.  That food is necessary.

I've often complained to her about how horrible I feel when I eat food that isn't on my meal plan*.  And almost every time, my therapist said that my weight stayed the same and so my body needed every calorie.  This meant that those "extras" weren't extra at all--they were more like little "necessaries."

Oh.

An extra is eating some dessert because it looks good, even though you've just had dinner and aren't all that hungry.  It's finishing all of your favorite entree at your favorite restaurant because you love it, even though you started feeling full near the end.  That sort of thing.  Eating in response to hunger is never "extra," even though the food may not appear on any piece of paper.

The obvious solution would be a new rule to "eat when hungry."  Except implementing this rule means changing the old rule of "eat what's on the plan," which means facing the anxiety of rule-breaking AND change, neither of which I do well at.  I also mistrust hunger signals and never quite know (unless I'm ready to gnaw on my neighbor's arm) if I'm really hungry or just think I am or if what I think might be hunger means I should eat something or get something to drink or just suck it up.

Quite a quandry.

*I'm guessing right now that I'm going to get comments saying I should ditch the meal plan.  The problem is that I would likely undereat without the guidelines. My instincts on what I "need" to eat aren't the greatest. A meal plan can be a double-edged sword, but I think the positives outweigh the negatives at this point.

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web looking for the latest in ED-related news, research, and more, so you don't have to.

{{It's a little shorter than usual this week--a combination of not as much news/research published and the fact that I was on vacation. My apologies.}}

NIMH defines mental illness as a "disruption in neural circuits." I doubt this definition will be the be all, end all of what we know of mental illness, but it's a start.

Overvaluation of shape and weight among overweight children and adolescents with loss of control eating.

Getting Back On The Wagon: Success, Failure And The Cycle Of Change. I'm not a huge fan of the "stages of change" model for EDs, but I do think it's important to remember that relapse doesn't mean starting over.

An Investigation of Goodman's Addictive Disorder Criteria in Eating Disorders.

Listen again to BBC Cornwall's recent phone-in on eating disorders, with expert input from a local psychiatrist. BBC Audio is limited to folks in the UK, however.

The new link between gut-brain axis and neuropsychiatric disorders.

Confusing Medical Ailments With Mental Illness.

Retrospective Maternal Report of Early Eating Behaviours in Anorexia Nervosa.

Is obesity really contagious?

Poor Decision Making in Male Patients with Anorexia Nervosa.

Internalizing and Externalizing Behaviour Problems in Childhood Contribute to the Development of Anorexia and Bulimia Nervosa-A Study Comparing Sister Pairs.

American Indian/Native American women have higher levels of disordered eating than white women, according to a new survey.

Jess Weiner (a nationally known body image advocate) does a 180 and writes a piece called "How Loving My Body Almost Killed Me". It should also be noted that she's launching a Conscious Weight Wellness^TM (yep, already trademarked) speaking gig, announced the day after the article, only reinforcing the idea that weight loss sells (honestly, I do believe the marketing idea came after her desire to lose weight BUT still). Also, pre-pre-diabetes didn't "almost kill you." Just sayin'. Sorry- I'm a cynic.

This past week, I was on a short vacation.  It was nice to have a break from the daily grind, and it also explains why posting was so light recently. 

Overall, the trip went really well, I think.  I was probably more active than usual, and I tried to respond by being more flexible about what I ate and not freaking out at ordering higher-calorie items in restaurants.  No, it wasn't perfect, but I was much more relaxed on this trip than previous ones.

It's late and I'm tired, so I'll provide a more detailed feedback later.

I was talking with my therapist the other day about the difference between "average" and "normal." On a mathematical level, the two words are intimiately linked.  On an etymological level--or at least the way many people with EDs think of or use the words--they have slightly different implications.  I want to become more "normal" with respect to eating and exercise habits,* but I was also afraid that lessening my perfectionism would make me merely "average."

I'll be honest: I don't like being called "average." It makes me squirm a bit. Much of it is my own rather demanding personality--if I'm average at something that means people are doing better than me. I took plenty of statistics classes in grad school. I know that the very way "average" is defined mathematically means that most of us are average at most things. In some areas, it doesn't bother me to think of myself as average.  I know I'm an average driver. I would be flattered to be thought of as average as drawing (I have a problem with depth perception that makes things look wonky) or, for that matter, most sports.

I don't hate to be called average because of some deep-seated need to be special. It's that my deepest fear is that I will be a failure.  I'm also a perfectionist.  That means I have always equated average with failure.  To be average means I have failed.  If I don't have a large piece of who I am staked on that factor, like driving or drawing, I can dismiss it without much of a twinge.  But in those areas in which I've invested a lot of time, effort, and money, it becomes a lot harder to just accept average.

It's a perfectionism and self-esteem thing, I think.  I need outside feedback because it's hard for me to judge if I've done a good job or if I'm good enough unless someone specifically tells me.  It's never happened internally.  If I'm average, I don't really get meaningful feedback, so I seek to excel.  It does away with the anxiety of not being able to judge myself and my performance.

For some reason, normal doesn't have the same connotation. It means (to me, anyway) sort of a shortcut for as expected.  My bloodwork is normal.  My weight is normal.  That sort of thing. It has more of a positive spin than average, which in the US is code for "meh" at best.

The moral of the story really isn't to delve into my strange, dark fears (though I'm aware that fear of failure is very common. Shall we say "normal"?) and admittedly rather messed up way of thinking, just that switching words around can make a daunting task (ie, recovery) seem a little easier to tolerate.

*Yes, most people in our culture are pretty messed up around food. I guess I mean normalized eating rather than "normal" in the sense of that's-what-everyone-else-is-doing normal.

**I know, I know. Normal is just a setting on a washing machine. There is no one "normal" weight or way of eating or whatever.  I guess normal is another way of saying "within reason" or "in a way that isn't harmful to your health."

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

UCLA Study Seeking Individuals with Anorexia.

Evidence suggests that body satisfaction is inversely related to BMI increase.

Fertility and prenatal attitudes towards pregnancy in women with eating disorders.

Disordered Weight Control Behaviors in Teens: An Under-Recognized Factor in Child Obesity Epidemic.

An investigation into the relationship between eating disorder psychopathology and autistic symptomatology in a non-clinical sample.

Dieting starves your brain cells, turning neurons into self-cannibals, which cranks up hunger signals.

Emotional expression, self-silencing, and distress tolerance in anorexia nervosa and chronic fatigue syndrome.

Top 10 Cracks That Crack (and Other) Addicts Fall Through on Their Way to Recovery. I think a lot of these suggestions are useful for ED recovery, too.

Women with bulimia show difficulties with impulse control and emotion processing in fMRI scans when faced with food.

Gross AND hazardous: Why do a colon cleanse?

Another article proving that weight loss surgery is not for everyone.

Psychosocial determinants and family background in anorexia nervosa-results from the Stockholm birth cohort study.

Position of the american dietetic association: nutrition intervention in the treatment of eating disorders.

Leptin Levels Are Associated With Decreased Depressive Symptoms in Women Across the Weight Spectrum, Independent of Body Fat.

How I got an eating disorder at 62. A wonderful, balanced, accurate article on EDs in older women from a woman who is living it.

I've never been a good sleeper.  Even when I was younger, it always took me well over an hour to fall asleep--pretty unusual for an 8-year-old.  But my brain just doesn't shut off.  Even if I'm not worrying per se, I can't stop thinking.

As I've gotten older, my circadian clock has shifted to be ever later.  I can fall asleep fairly easily as long as I don't head to bed until at least 2am.  A lot of times, later.  I've tried forcing myself to wake up early in the morning in the hopes that then I'll want to fall asleep earlier.

Nope.  Didn't work.

Just as I haven't yet mastered the art of intuitive eating, I apparently having mastered intuitive sleeping.  It seems obvious that you would fall asleep more easily if you're really tired.  You would think, right?  Not always, though. 

I don't think that being an extreme night owl is wrong or bad, but it's not always convenient when you're trying to keep regular work hours.  I had hoped by having a little less sleep for a few days that I would get tired earlier.  Except I didn't.  If I just stayed up until I really felt like going to sleep, I'd be up until the middle of the night.

Which has ultimately led me to the conclusion that I need more structure to my sleep schedule.  On the one hand, going to bed earlier means that I will probably be tossing and turning for many hours.  On the other hand, if I don't start going to bed earlier, then I'm never going to actually start getting to sleep earlier. I just get so insanely frustrated when I'm utterly exhausted, but my eyes won't stay shut.* Sleep meds just don't work for me, either.  If they do help me sleep, they turn me into a total zombie the entire next day, which sort of defeats the point of taking them.

Right now, I'm just hoping that more concerted efforts to sleep right will help.  Otherwise, I'm getting seriously frustrated.

*Sometimes, I have difficulty sleeping because I'm still hungry, but even when I get something extra, I still can't sleep.

I don't know if you've seen the headlines (the story has been making the rounds in the psychology circles for the past day or two), but a study just came out that looked at the relationship between body dysmorphic disorder and nose jobs. The study found that one-third of people who wanted a nose job for cosmetic reasons had moderate to severe symptoms of BDD. Of those who wanted a nose job for medical reasons (to improve breathing, etc), 2% had been diagnosed with BDD.

Except that's not how the study was reported. Instead, headlines like "Nose job patients often mentally ill, study says." An excerpt from this piece below:

Of patients who were seeking the procedure to correct a breathing problem, only about 2 percent showed symptoms of BDD. But of those who wanted a nose job for cosmetic reasons, 43 percent showed symtoms of the disorder.


BDD was especially common among people with a history of mental illness, as well as those who had already had a nose job and were seeking “revision” surgery.

The problem, as John Grohol pointed out on the World of Psychology blog, is that "symptoms of BDD" aren't the same as being diagnosed with BDD. It's a subtle difference in words, yes. But it's a major difference in what we're actually talking about.

I had symptoms of the flu several winters ago. High fever, muscle aches, chills, feeling utterly crap, all with a sudden onset. Classic flu symptoms. Except a flu test revealed that whatever I had wasn't the flu. It looked a lot like the flu, it had the same symptoms as the flu, but it wasn't caused by the influenza virus.

Someone can have symptoms of depression (low mood, feeling hopeless), but not actually have clinical depression. Same with BDD. Same with EDs, too. The scales and questionnaires used in research aren't diagnostic tools. They can give you an idea whether you should see an actual living, breathing professional for evaluation and a potential diagnosis, but they don't say whether you actually have the condition.

It's not the public's job to know this. I'm not saying scientists shouldn't use these measures simply because they are so frequently misinterpreted by laypeople and journalists alike. But I am saying that journalists and editors need to know the difference. It's responsible reporting.

It happens with eating disorder stories all the time. Most commonly, it happens when people conflate disordered eating with eating disorders, or the scores on a survey with an actual diagnosis. The problem is that most people don't know there's a difference between these two things, or that the difference really matters.

Of course we would expect that people seeking nose jobs have higher concern and focus on their appearance. They are, after all, dropping thousands of dollars in an attempt to, you know, look better. But focus on your appearance isn't the same as BDD, and it's offensive to those who are suffering to make the two things equivocal. It's like saying someone who is obsessed with their weight has an eating disorder. They're not the same. At all.

We need to start distinguishing between these two things so that we stop trivializing deadly mental illnesses as little more than cultural fads.

In the book I was reading the other day (that I blogged about here), there was another quote from a cancer patient about how she coped with all of her treatments.

She said that cancer had become "her new normal."

I related a lot to that.  Recovery has to become my new normal.  For so long, the eating disorder was "normal."  Even if I could see that my behaviors were bizarre (eating cottage cheese, curd by curd, with a fork), they were normal to me.  The hours of exercise? They were just what I did. And it's hard to know exactly how crappy you feel when you don't have anything to compare it to--at least, not that you remember.  The eating disorder is crazy-making, it's bizarre, but it was also completely and utterly normal.

Much of the work I'm doing now is making recovery my new normal.  Breaking those old ED habits and making recovery stuff seem the normal, natural thing to do.

It's hard, when you look at recovery every from a practical standpoint.  The endless appointments: signing in, sitting in offices, reading ancient issues of Time Magazine.  Then there are the other food issues, like eating five or six times a day, grocery shopping, meal planning, cooking.  There's also finding ways to fill your time that you used to spend exercising (or binge eating and purging).

You start to look normal, and maybe even start to act somewhat normal.  Not that this is bad, but it doesn't mean that your ED is gone.  It doesn't mean that the ED is gone or even feels like a piece of history.  The ED feels normal and "standard" for a long time, even after the behaviors are long gone. It's much easier for the brain to "learn" ED behaviors than unlearn them. Fear is a strong learning mechanism, and it helps the ED stuff become engrained in our brains. Recovery behaviors don't have that strong fear driving them, and so it takes much, much longer for them to become as solid as the ED was.

Over time, recovery is starting to become my new normal. Not that I don't reserve the right to piss and moan about cooking and food prep, or about the anxiety about not having my food rituals. Part of what makes recovery get easier is that you simply get used to it.  The hard part is getting used to it, but the good thing about the brain is that it can get used to anything.  It adjusted to ED and it will adjust to recovery.

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

My dear friend Charlotte and her daughter Georgie are featured in this Telegraph (UK) article (it's the only part of it worth reading, between the photos and the comments, yikes).

Genetics Complicate Recovery from Eating Disorders.

Should I Ask About Eating? Patients' Disclosure of Eating Disorder Symptoms and Help-seeking Behaviour.

Leaving the sport, gaining an eating disorder.

Components of Shame and Eating Disturbance Among Clinical and Non-clinical Populations.

Two Friends Help Others With Eating Disorders.

Differential Neural Responses to Food Images in Women with Bulimia versus Anorexia Nervosa.

Woman's death a wake-up call for Nevadans. It would be nice if media stories could get beyond the idea that eating disorders are more than a way to manipulate body weight, though. They're not really helping the major argument of the piece that EDs are real illnesses whose treatment needs to be covered by insurance. Sigh.

Factors Associated with Emotional Well-being in Primary and Secondary Caregivers of Patients with Eating Disorders.

Genes play key role in making people susceptible to eating disorders.

Physical appearance as a measure of social ranking: The role of a new scale to understand the relationship between weight and dieting.

Why Comfort Foods Are So Comforting.

Motivation-focused Treatment for Eating Disorders: A Sequential Trial of Enhanced Cognitive Behaviour Therapy with and without Preceding Motivation-Focused Therapy.

Is The Idea Of Health At Every Size Just Permission To Be Fat?

Disgust Sensitivity and Anorexia Nervosa.

Does Rehab Work as a Treatment for Alcoholism and Other Addictions? You could write similar things about ED treatment, too.

Serum amylase in bulimia nervosa and purging disorder: Differentiating the association with binge eating versus purging behavior.

Social Programs to Reduce Stress May Also Lower Obesity.