Friday, June 27, 2008

Why I am a fan of Leora Pinhas

She's a psychiatric director for the eating disorders program at the Hospital for Sick Children in Toronto. At the recent Canadian Pediatric Society Conference, Dr. Pinhas said two things that endeared her to me.

First, she compared childhood eating disorders to cancer:

"We have this thing that [they're] not really serious. But one in 10 will die. We need to act like it's a serious illness."

Thank you, Dr. Pinhas.* And thank you even more for going on to put the question of eating disorders into the context of the ever-more-prevalent obsession with childhood obesity:

Pinhas dismissed the attention being given to childhood obesity rates - which she says have not increased since 2003 and have not increased in any clinically significant way since the late 1990s.

The most disturbing thing about the constant news about obesity rates is it's likely fuelling eating disorders, Pinhas said.

"Dieting is the gateway to eating disorders. If you have people encouraged to diet because being fat is so bad, you're only giving them an intervention that will make them fat, or give them an eating disorder or make them feel bad about themselves."

In the current culture, which supports weight-loss interventions for children as young as 2, Dr. Pinhas' perspective is not just refreshing--it could be a life-saver.

*Though she also went on to say that "most people recover from eating disorders." I'd like to know where that statistic comes from, since the numbers I've seen are far bleaker.

Wednesday, June 25, 2008

The girl at the mall

I noticed her right away, as I always do now: 9 or 10 at first glance, with the thin, prepubescent body of a girl who hasn't begun puberty yet. On second glance I could see she was older--something about the curve of her shoulder, the way she carried her purse, the look on her face, more knowing than a 9-year-old, and more weary, too. I could see the shape of her arm bones under the skin, the sharp edge of her collarbone.

She was shopping with her mother; I was shopping with my 12-year-old. They were discussing a dress, the very dress, it happened, that my daughter had her eye on. The mother hung it back on the rack and my daughter picked it up. "Look, Mom, I love this!" she said. Then she looked at the size--size 7--and regretfully put it back.

I asked the other mother, "How old is your daughter?"

The mom smiled and shook her head. "She's 12, but she thinks she can wear a size 7. She swears it fits and I told her I'm not buying it."

I looked at the girl, her strained smile, her impossibly thin waist. I looked at the mother. I made a decision.

"Could I have a word?" I asked.

I told her my daughter had had anorexia, that I saw some of the same signs in her daughter I'd seen in mine. I told her that her daughter looked worryingly thin, that wanting to wear a size 7 when you're 12 could very well reflect the distorted thinking of an eating disorder. I told her I hoped her daughter wasn't sick but that if I were her, I would take her to the doctor right away.

By the time I was done talking the mother was backing up. "OK, thanks," she said, edging away from me, and they were gone.

I can't get the girl at the mall out of my mind. I wonder what her mother will do. I wonder if I did the right thing to speak to her.

What would you have done?