Tuesday, September 04, 2007

A basic misunderstanding of anorexia

has got to be part of where nutrition "expert" Dr. Elliott Berry is coming from when he offered the latest in potential anorexia treatment: cannabis.

You can't blame Dr. Berry; anyone who reads DSM-IV gets the same wrong-headed criteria for anorexia front and center: Anorexia is a "refusal t maintain body weight at or above a minimally normal weight for age and height."

It's the word refusal that is so misleading. Those of us with personal knowledge understand that it should read inability to maintain body weight. Someone with anorexia isn't "refusing" to eat, because s/he's not really capable of making a choice on the subject of food and eating.

I'd love to see this definition change, and with it our notions of good treatment. I'd love to see a time when starvation would not be an option, when we didn't confuse appetite with illness. And I don't think cannabis has any place in the treatment of anorexia.

2 comments:

Rachel said...

I'd like to hear more on this brain receptor that he claims has been shown to be turned off in malnourished peoples.

Because at first reading, what he's purporting cannabis does is boost the appetite of an eating disordered person. But in the case of anorexia, it's not appetite that's the problem.

carrie said...

Rachel,

Exactly. It's not that people with anorexia aren't hungry, it's that food gives them so much anxiety that they are unable to eat.

Harriet,

Refusal always bothered me, too, especially as I entered recovery. It's so misleading because AN is very ego-syntonic and it does actually seem as if the sufferer is refusing. I'm not saying that I didn't take the opportunity to torture some well-meaning but ill-informed treatment providers with the fact that I wasn't gonna gain weight, but this was also after years of the disease, endless treatment, and a certain amount of cynicism. I was pissed. Fix me, already, dammit!

And the last thing with the 'refusal' word, besides implying choice: I never thought I was underweight. So how could I refuse to maintain a normal weight if I already was? Yes, I saw the number on the scale and such, but I couldn't believe- I couldn't see- that I was underweight.

Just my two cents.

Carrie