I really wanted to like Take Charge of Your Child’s Eating Disorder, co-written by Pamela Carlton, M.D., who directs Stanford University’s Adolescent Eating Disorder Parent Education and Support Program. I’m a huge fan of the work being done at Stanford by James Lock and nearby at UC San Diego by Walt Kaye. But after reading this, I want to ask them both, “How could you have let this happen?”
Families with anorexic or bulimic children need all the information and help they can get. But for the most part, they’re not going to get it here.
If I’d read Carlton’s book when my daughter was newly diagnosed with anorexia, I would have wanted to shoot myself, mostly because of statements like this: “Full recovery from anorexia is not easy, and many people struggle with ongoing body image disturbances and disordered eating behaviors throughout their lives. Fortunately, with early treatment, your child’s chance for full recovery is likely to be increased.” (p. 9) This leads parents to believe that their child will be dealing with an eating disorder for the rest of her life—which in many cases is simply not true.
In reality, there’s lots of hope for full recovery, especially among adolescents who are treated early with family-based treatment, also known as Maudsley treatment. Nowhere does Carlton mention this as one of the treatment modalities for eating disorders. Instead, she recommends that parents put together a treatment team—a good idea, in and of itself—and says, “The most important thing to remember is you cannot do this alone.”
Actually, you can do this alone, and sometimes you should. A treatment team is great, so long as everyone is on the same page. My husband and I assembled a terrific treatment team, but there were times, inevitably, when they contradicted one another or said just the wrong thing to our daughter. It’s certainly better to have no therapist than a bad one—and the vast majority of eating disorders specialists out there are bad, make no mistake about it. A third of them have or had eating disorders themselves, which tells you something right there.
Throughout the book, Carlton pays lip service to the idea that parents should be involved in their child’s treatment. But she doesn’t actually seem to believe it. Take this example she offers about a 15-year-old, Jinny, in treatment for anorexia. She writes that because Jinny was fixated on her weight, she did not give the girl her weekly weight updates. Fair enough. Then she writes, “But after each appointment, her mother would follow me out of the room with her notebook, ready to write down a weight, promising, ‘It’s okay, I won’t tell Jinny.’ I finally told her this was not healthy for Jinny and her actions were undermining my efforts to help her stop focusing on her weight. We came up with a solution: since she really needed to know her weight progress, I would meet with her once a month to review her progress. Yes, I would share her weight with her, but she had to accept that it would only happen once a month and not at her daughter’s appointment.” (pp. 84-85)
Of course any parent who has watched their child starve themselves nearly to death is going to be fixated on weight. Each pound gained represents another step away from the awful abyss their child has fallen into. The notion that such interest is unhealthy or somehow undermining treatment is both wrong-headed and deeply offensive. I hope this mom fired Carlton and found a smarter, more compassionate therapist who would actually empower the family to help Jinny recover.
Carlton insists that families need to find experienced eating disorders therapists and specialists to make up the treatment team for their child. In my family's experience, the “specialists” were frequently so heavily invested in their own particular take on eating disorders—-and often this was an outmoded and ineffective one—-that they were not able to give my daughter what she needed. A good therapist can be helpful. A bad therapist can do a lot of damage. And you don’t need collateral damage when you’re dealing with an eating disorder.
Finally, Carlton seems to subscribe to the notion that eating disorders are caused at least in part by psychology: “Without appropriate psychiatric help and treatment, eating disorders can become lifelong illnesses. To regain a healthy relationship with her body and with food, your daughter may require long-term treatment, which may continue long after her body is considered medically healed. The average length of psychological treatment is two to three years.” (p. 88)
Actually studies on family-based treatment (the Maudsley approach) show that teens often recover without this kind of intensive psychological or psychiatric treatment, and the recovery "takes": 90 percent are still recovered five years later. Carlton’s perspective gives families the wrong message: that only the doctor can “take charge” of their child’s eating disorder and bring about recovery.
In my experience, and in the experiences of many families I know, the reverse is true: recovery happened when parents were empowered to "take charge" of their child's recovery, often with backing from a truly supportive team.
The best part of this book is the insurance section. Too bad Carlton didn't publish just that. Except for that one chapter, you’re better off reading Help Your Teenager Beat an Eating Disorder by James Lock and Daniel Le Grange or Eating With Your Anorexic by Laura Collins.
Friday, March 16, 2007
Sunday, March 11, 2007
Is anorexia like alcoholism?
The first question people ask after they read our family's story of helping our daughter Kitty recovery from anorexia: Is this like alcoholism, where she'll be dealing with it for the rest of her life?
It's a fair question, given the fact that traditional rates of relapse in anorexia are extraordinarily high--up to 50% of anorexia sufferers relapse within a year of treatment, according to one 2001 study. I know of several girls my daughter's age who are in the midst of relapses right now. My heart goes out to them.
The first few times people asked this question, it made me cry. The thought that my daughter might have to deal with anorexic thoughts, feelings, and behaviors for the rest of her life is awful and scary and beyond demoralizing.
But there's good reason to hope that for girls like Kitty, whose anorexia is treated relatively quickly (within 3 years of onset) and who become fully weight restored (not to 90 percent of their ideal body weight, as many clinicians are willing to settle for, but to 100 or 110 percent), relapse is far less likely. Preliminary studies of long-term outcomes for teens treated with the Maudsley approach, or family-based therapy, are very promising.
So now when people ask the question, I answer this way: We don't know what will happen for Kitty in the future. But we're hopeful that 10 years from now she will look back on anorexia as one of the trials of adolescence, not as a defining moment in her life. She'll remember it (actually I hope she doesn't remember many of the really bad moments) rather than still be experiencing it.
Our job will be to watch and protect her for the rest of her adolescence, especially when she goes to college, which is often a vulnerable time. Which, when you think of it, is what a parent's job is all about, anyway--to protect and take care of a child.
It's a fair question, given the fact that traditional rates of relapse in anorexia are extraordinarily high--up to 50% of anorexia sufferers relapse within a year of treatment, according to one 2001 study. I know of several girls my daughter's age who are in the midst of relapses right now. My heart goes out to them.
The first few times people asked this question, it made me cry. The thought that my daughter might have to deal with anorexic thoughts, feelings, and behaviors for the rest of her life is awful and scary and beyond demoralizing.
But there's good reason to hope that for girls like Kitty, whose anorexia is treated relatively quickly (within 3 years of onset) and who become fully weight restored (not to 90 percent of their ideal body weight, as many clinicians are willing to settle for, but to 100 or 110 percent), relapse is far less likely. Preliminary studies of long-term outcomes for teens treated with the Maudsley approach, or family-based therapy, are very promising.
So now when people ask the question, I answer this way: We don't know what will happen for Kitty in the future. But we're hopeful that 10 years from now she will look back on anorexia as one of the trials of adolescence, not as a defining moment in her life. She'll remember it (actually I hope she doesn't remember many of the really bad moments) rather than still be experiencing it.
Our job will be to watch and protect her for the rest of her adolescence, especially when she goes to college, which is often a vulnerable time. Which, when you think of it, is what a parent's job is all about, anyway--to protect and take care of a child.
Wednesday, March 07, 2007
The rest of the family
An incident that happened at my sixth-grader's school last fall prompted me to write a piece about the effects of eating disorders on the rest of the family, which appeared in yesterday's New York Times. (Sorry, I can't do links when I'm blogging remotely, and right now I'm sitting at the airport waiting for a flight that's been delayed 6 hours.) The URL is http://www.nytimes.com/2007/03/06/health/06case.html?em&ex=1173416400&en=774d3d641fa1234b&ei=5087%0A.
But truly, this kind of fallout is true whenever one child in a family is desperately ill, particularly if the illness has a chronic or potentially lethal component. Having a sibling with cancer, diabetes, autism, developmental delays, and other conditions always creates a difficult situation for the other sibling.
I was an other sibling when I was growing up. Today, no doubt, our family would have wound up in family therapy, but back then my sister was the one who got the diagnosis "emotionally troubled," whatever that was supposed to mean. I now understand that she was most visibly acting out many of the feelings swirling around our little family. Even so, her behaviors and condition dominated the household.
I remember what it was like to have to stuff my feelings so as not to upset the teetering balance of our family dynamic; to resent the attention she got even though it was mostly negative attention, and clearly she was miserable; to wish that her problems, whatever they were, would just go away. This perspective was much on my mind last year and now as I watch my younger daughter struggle with the fallout from her sister's illness.
I have enormous respect for both my daughters, for the pain and difficulties they have both suffered, as well as for all children living with chronic illnesses, whatever they are. And I'm grateful that we now understand a lot more about how illnesses like these change the family, and what to do about it: Get the best medical care possible and then love the heck out of our children, and ourselves.
Maybe that's not so different from what our parents did.
But truly, this kind of fallout is true whenever one child in a family is desperately ill, particularly if the illness has a chronic or potentially lethal component. Having a sibling with cancer, diabetes, autism, developmental delays, and other conditions always creates a difficult situation for the other sibling.
I was an other sibling when I was growing up. Today, no doubt, our family would have wound up in family therapy, but back then my sister was the one who got the diagnosis "emotionally troubled," whatever that was supposed to mean. I now understand that she was most visibly acting out many of the feelings swirling around our little family. Even so, her behaviors and condition dominated the household.
I remember what it was like to have to stuff my feelings so as not to upset the teetering balance of our family dynamic; to resent the attention she got even though it was mostly negative attention, and clearly she was miserable; to wish that her problems, whatever they were, would just go away. This perspective was much on my mind last year and now as I watch my younger daughter struggle with the fallout from her sister's illness.
I have enormous respect for both my daughters, for the pain and difficulties they have both suffered, as well as for all children living with chronic illnesses, whatever they are. And I'm grateful that we now understand a lot more about how illnesses like these change the family, and what to do about it: Get the best medical care possible and then love the heck out of our children, and ourselves.
Maybe that's not so different from what our parents did.
Thursday, March 01, 2007
Another Lead Fork award goes to . . .
the well-meaning but clueless youth director who recently sent home a flyer to parents in her church describing an upcoming activity for middle-schoolers titled "Hunger Feast!" This activity, which was described as "strongly encouraged," involves middle schoolers going without food for 30 hours in a lock-in at the church to "raise our awareness of hunger in the world and in our midst." The flyer goes on:
"Many of the activities we do during the lock-in focus on food (preparing food for and sharing it with others, doing volunteer tasks in the pantry, etc.); so we feel the ache of knowing that food is available to some, but—for this brief period of time—not to us. Experiences like this deepen our understanding of and increase empathy for the real human suffering that underlies the statistics.
There is, however, another aspect to this time of fasting. Fasting is a spiritual discipline, defined as “the voluntary abstention from an otherwise normal function—most often eating—for the sake of intense spiritual activity”. In addition to our hunger awareness activities, we also experience worship and prayer. It is always touching to observe the tender reactions of youth when they experience worship after having gone without food for a whole day. It is a powerful experience."
My recommendation: If you want your middle schoolers to develop empathy for those who are hungry, educate them--and yourself--about eating disorders. Celebrate food as part of life--a holy part of life, if you will--and have your kids volunteer at a food bank or soup kitchen. But for god's sake--and theirs--don't make self-starving holy or exalted.
"Many of the activities we do during the lock-in focus on food (preparing food for and sharing it with others, doing volunteer tasks in the pantry, etc.); so we feel the ache of knowing that food is available to some, but—for this brief period of time—not to us. Experiences like this deepen our understanding of and increase empathy for the real human suffering that underlies the statistics.
There is, however, another aspect to this time of fasting. Fasting is a spiritual discipline, defined as “the voluntary abstention from an otherwise normal function—most often eating—for the sake of intense spiritual activity”. In addition to our hunger awareness activities, we also experience worship and prayer. It is always touching to observe the tender reactions of youth when they experience worship after having gone without food for a whole day. It is a powerful experience."
My recommendation: If you want your middle schoolers to develop empathy for those who are hungry, educate them--and yourself--about eating disorders. Celebrate food as part of life--a holy part of life, if you will--and have your kids volunteer at a food bank or soup kitchen. But for god's sake--and theirs--don't make self-starving holy or exalted.
Sunday, February 25, 2007
National Eating Disorders Awareness Week
Today marks the start of National Eating Disorders Awareness Week, and our family marked the day by taking part in the Virtual Family Dinner sponsored by Maudsley Parents. We sat down to dinner at a friend's house and ate chicken curry, salad, and homemade pumpkin chocolate chip muffins.
The food was delicious. Even more delicious was the fact that we all ate, together, and ED was not at our table. Not tonight, anyway, and hardly at all for the last nine months.
Two years ago we were still ignorant about our daughter's anorexia. A year ago we were in the midst of Maudsley treatment. Tonight we ate with the memories of anorexia fresh but beginning to fade, and the hope that next year we will be that much further away from the nightmare.
My deepest wish for all of you, all of us, is that in the years to come we banish ED from all of our dinner tables. That we learn to feed ourselves and one another with joy and love and appreciation for what tastes good as well as for our selves, body and soul and mind and heart.
The food was delicious. Even more delicious was the fact that we all ate, together, and ED was not at our table. Not tonight, anyway, and hardly at all for the last nine months.
Two years ago we were still ignorant about our daughter's anorexia. A year ago we were in the midst of Maudsley treatment. Tonight we ate with the memories of anorexia fresh but beginning to fade, and the hope that next year we will be that much further away from the nightmare.
My deepest wish for all of you, all of us, is that in the years to come we banish ED from all of our dinner tables. That we learn to feed ourselves and one another with joy and love and appreciation for what tastes good as well as for our selves, body and soul and mind and heart.
Wednesday, February 21, 2007
Jane Brody on binge eating disorder
Jane Brody wrote a personal and very powerful column in yesterday's New York Times about her own experience with binge eating disorder. It's worth reading, whether you've had experience with BED or another eating disorder or not, for its description of the slow, inexorable descent into hell that eating disorders entail.
Defintely worth a read.
Defintely worth a read.
Sunday, February 18, 2007
Anorexia as metaphor
Recently I've read seveal memoirs about being anorexic, or books by doctors about eating disorders, that emphasize the metaphoric context of anorexia and bulimia. They talk about anorexics craving emptiness and hunger, the politics of appetite, the power trip of self-starvation.
I can see that for those who suffer from anorexia for a long time--more than a year? more than two?--the natural human tendency to assign meaning and metaphor to biological reality kicks in. When you live with something for a long time, it becomes part of your self-image, a key element in how you see yourself.
Such writers tend to make an important and to my mind unsupported leap, though. They generalize backward from their own situation, years down the line with anorexia, and conclude that the metaphor is what causes girls and boys to become anorexicv. This is the classic pitfall in anorexia treatment, the conventional wisdom espoused by doctors and therapists. And it's wrong.
It's important for parents and therapists and doctors to not get sucked in to the persuasive world of the anorexia metaphor. To remember that the vast majority of anorecxics become sick accidentally, from a diet that takes on a life of its own, an illness, a natural propensity for losing weight that gets pushed too far in some way and takes over a child's physial and psychological life.
To buy in to the notion of anorexia as metaphor is, frankly, to fall under its sway. I think this is one reason why, as Daniel Le Grange told me, even doctors and therapists sometimes make bad decisions about anorexia. "It's as if the anorexia affects the thinking processes of those around the sufferer," he told me.
I think the mechanism he was talking about is metaphor. And that's why I think it's absolutely vital that we de-metaphorize anorexia. We can best help our children--and other people's children--by taking anorexia's power away, both literally and metaphorically. By remembering that anorexia is a biological disease and that its symptoms and consequences are larely the result of starvation. And that the first line of treatment for it is not psychological but physiological: food.
There is time later, after a child is weight restored and mentally restored, to discuss the metaphors of eating disorders, if they apply. But it's a dangerous trap to fall into that conversation right away.
I can see that for those who suffer from anorexia for a long time--more than a year? more than two?--the natural human tendency to assign meaning and metaphor to biological reality kicks in. When you live with something for a long time, it becomes part of your self-image, a key element in how you see yourself.
Such writers tend to make an important and to my mind unsupported leap, though. They generalize backward from their own situation, years down the line with anorexia, and conclude that the metaphor is what causes girls and boys to become anorexicv. This is the classic pitfall in anorexia treatment, the conventional wisdom espoused by doctors and therapists. And it's wrong.
It's important for parents and therapists and doctors to not get sucked in to the persuasive world of the anorexia metaphor. To remember that the vast majority of anorecxics become sick accidentally, from a diet that takes on a life of its own, an illness, a natural propensity for losing weight that gets pushed too far in some way and takes over a child's physial and psychological life.
To buy in to the notion of anorexia as metaphor is, frankly, to fall under its sway. I think this is one reason why, as Daniel Le Grange told me, even doctors and therapists sometimes make bad decisions about anorexia. "It's as if the anorexia affects the thinking processes of those around the sufferer," he told me.
I think the mechanism he was talking about is metaphor. And that's why I think it's absolutely vital that we de-metaphorize anorexia. We can best help our children--and other people's children--by taking anorexia's power away, both literally and metaphorically. By remembering that anorexia is a biological disease and that its symptoms and consequences are larely the result of starvation. And that the first line of treatment for it is not psychological but physiological: food.
There is time later, after a child is weight restored and mentally restored, to discuss the metaphors of eating disorders, if they apply. But it's a dangerous trap to fall into that conversation right away.
Monday, February 12, 2007
Why do we settle for treatment that doesn't work?
This morning I'm feeling so grateful for the Maudsley approach of treating anorexia, which I am sure saved my daughter's life. While there may be a better treatment out there yet to be discovered someday, for now Maudsley is so much better for teens than traditional treatment that it's hard for me to understand how and why professionals could recommend anything else.
Especially pediatricians. They're the ones on the front lines. They're the ones who presumably know a child, watch his or her growth from infancy on. Who have a chance to see the growth curve and know when a child is "just thin" or "too thin." When thinness becomes pathological.
Often pediatricians wait far too long to flag a problem--very likely because they're watching for the opposite problem, overweight in teens. Our society has such a strong fat phobia that all of us, myself included, have to struggle to take off our "thin-is-always-good" glasses and see reality sometimes.
Some pediatricians will notice a drop in weight or off the child's growth curve, but then stall when it comes to treatment, letting months or even years go by while a child starves and anorexia becomes more entrenched. Why? Could it be that many pediatricians--especially women--have eating or body or weight issues themselves?
If your intuition tells you that your child might have a problem, get another opinion. Follow your gut. The treatment you pursue might save your child's life. And you don't have to settle for treatment that doesn't work. There is hope for anorexia. The vast majority of teens treated with the Maudsley approach are weight restored, fully recovered, and back to normal life--and stay that way five years down the line.
Don't settle for anything less than your child's best life.
Especially pediatricians. They're the ones on the front lines. They're the ones who presumably know a child, watch his or her growth from infancy on. Who have a chance to see the growth curve and know when a child is "just thin" or "too thin." When thinness becomes pathological.
Often pediatricians wait far too long to flag a problem--very likely because they're watching for the opposite problem, overweight in teens. Our society has such a strong fat phobia that all of us, myself included, have to struggle to take off our "thin-is-always-good" glasses and see reality sometimes.
Some pediatricians will notice a drop in weight or off the child's growth curve, but then stall when it comes to treatment, letting months or even years go by while a child starves and anorexia becomes more entrenched. Why? Could it be that many pediatricians--especially women--have eating or body or weight issues themselves?
If your intuition tells you that your child might have a problem, get another opinion. Follow your gut. The treatment you pursue might save your child's life. And you don't have to settle for treatment that doesn't work. There is hope for anorexia. The vast majority of teens treated with the Maudsley approach are weight restored, fully recovered, and back to normal life--and stay that way five years down the line.
Don't settle for anything less than your child's best life.
Monday, February 05, 2007
If you've ever loved a Mr. Wrong . . .
I'm looking for a few brave readers to read MR. WRONG: REAL-LIFE STORIES ABOUT THE MEN WE USED TO LOVE and write a review for amazon.com. I'm going to NY this week (tomorrow, actually) to promote the book and a couple of reviews on amazon would help. And of course, I hope you like it and write a good review, but hey, you should tell the truth.
If you're up for a little book reviewing, click here.
Happy reading!
If you're up for a little book reviewing, click here.
Happy reading!
Sunday, February 04, 2007
Ranking eating disorders
Last week a study published in the journal Biological Psychiatry (love the name! um, what other kind of psychiatry is there?) made the headlines by proclaiming that the most prevalent eating disorder in the U.S. is binge eating disorder. It said that 3.5% of women have episodes of "uncontrollable eating" at least twice a week for at least three months at a time. In classic sensationalist style, BED is now bring described as the "biggest" eating disorder in the U.S.
I had binge eating disorder for much of my teens, 20s, and 30s. It didn't have a name then, or at least I was unaware of it. It didn't seem unusual to me; other women in my familiy clearly had it too. It wasn't a good thing, and I wanted to change my eating patterns. I saw various therapists and finally landed with a good one in my late 30s. I signed up for 10 weeks of eating sessions and wound up with 8 years of intensive, fantastic therapy. Somewhere along the way I stopped eating compulsively, and while I still overeat on occasion, I have a healthier relationship with food now.
I hardly noticed when I "recovered" from compulsive eating. My weight dropped a whopping pounds. That's about it.
Why am I telling you all this? Because I'm worried that the hoo-ha over binge eating disorder will add fat (excuse the pun) to the anti-obesity fire. And that's bad news for all of us, whether we're fat, "normal," or suffer from anorexia or bulimia.
I don't want to play the "which is worse?" game. But as someone with personal experience of both B.E.D. and anorexia, I have to say there's no comparison. B.E.D. isn't a good thing, but it doesn't disrupt your life. Anorexia, the most deadly psychiatric disorder, kills. And while some people maintain a facsimile of ordinary life while they're anorexic, most do not.
I'm not saying it's OK to have an eating disorder. But I worry when I see all e.d.s lumped into the same category and discussed in the same terms. It simply isn't true. Anorexia is a life-and-death diagnosis. B.E.D. is not.
More anti-obesity rhetoric won't cause the prevalence of anorexia to rise, but it might trigger more people who are susceptible into active restricting and anorexia. And it certainly contributes to the culture of thinness that reflects our overall disordered relationship with food and eating.
It can and does affect treatment protocols, too. In my experiences (and the experiences of many families I've talked to), I've seen how the culture and bias toward thinness extends into the medical profession--sometimes quite deeply. One of the dirty little secrets well known among families with anorexic children is that doctors consistently set target weights that are far too low for true recovery. Not surprising, when you consider that a third of all eating disorders specialists have suffered (or still suffer) from an eating disorder themselves.
So my fear is that all this uproar over B.E.D., and how it's the "biggest" e.d., will cause more grief for families who are struggling with the ravages of anorexia.
I had binge eating disorder for much of my teens, 20s, and 30s. It didn't have a name then, or at least I was unaware of it. It didn't seem unusual to me; other women in my familiy clearly had it too. It wasn't a good thing, and I wanted to change my eating patterns. I saw various therapists and finally landed with a good one in my late 30s. I signed up for 10 weeks of eating sessions and wound up with 8 years of intensive, fantastic therapy. Somewhere along the way I stopped eating compulsively, and while I still overeat on occasion, I have a healthier relationship with food now.
I hardly noticed when I "recovered" from compulsive eating. My weight dropped a whopping pounds. That's about it.
Why am I telling you all this? Because I'm worried that the hoo-ha over binge eating disorder will add fat (excuse the pun) to the anti-obesity fire. And that's bad news for all of us, whether we're fat, "normal," or suffer from anorexia or bulimia.
I don't want to play the "which is worse?" game. But as someone with personal experience of both B.E.D. and anorexia, I have to say there's no comparison. B.E.D. isn't a good thing, but it doesn't disrupt your life. Anorexia, the most deadly psychiatric disorder, kills. And while some people maintain a facsimile of ordinary life while they're anorexic, most do not.
I'm not saying it's OK to have an eating disorder. But I worry when I see all e.d.s lumped into the same category and discussed in the same terms. It simply isn't true. Anorexia is a life-and-death diagnosis. B.E.D. is not.
More anti-obesity rhetoric won't cause the prevalence of anorexia to rise, but it might trigger more people who are susceptible into active restricting and anorexia. And it certainly contributes to the culture of thinness that reflects our overall disordered relationship with food and eating.
It can and does affect treatment protocols, too. In my experiences (and the experiences of many families I've talked to), I've seen how the culture and bias toward thinness extends into the medical profession--sometimes quite deeply. One of the dirty little secrets well known among families with anorexic children is that doctors consistently set target weights that are far too low for true recovery. Not surprising, when you consider that a third of all eating disorders specialists have suffered (or still suffer) from an eating disorder themselves.
So my fear is that all this uproar over B.E.D., and how it's the "biggest" e.d., will cause more grief for families who are struggling with the ravages of anorexia.
Wednesday, January 31, 2007
New York City, here we come!
I'm always excited to be heading back to New York City. I lived there for 14 years, most recently here. Next Tuesday my friend Gale and I will be heading east for 4 days in the city I love most of all.
Tuesday night I go right from the airport to a midtown radio studio, where I'm a guest on the "Busted Halo Show" with Father Dave Dwyer. That should be interesting! Then it's uptown to 190th Street to stay with dear old friend (and ex-Mr. Wrong) and his really great wife. (It really is true--one woman's Mr. Wrong is another woman's dream come true!)
Wednesday night is The New York Reading. Come on out and have a good time! I'm bringing some of these with me, unless airplane security takes them away before we board. Some of my favorite writers are reading, too--Roxana Robinson, Catherine Texier, Dana Kinstler, Raphael Kadushin, and me. 7 o'clock, Barnes & Noble, 82nd & Broadway. I'm bringing my Mr. Wrong T-shirts, too--maybe you'll win one at the reading.
Oh, and along the way I plan to eat a lot of Japanese food. Yum. At my favorite restaurant, Natori, if it's still around.
Tuesday night I go right from the airport to a midtown radio studio, where I'm a guest on the "Busted Halo Show" with Father Dave Dwyer. That should be interesting! Then it's uptown to 190th Street to stay with dear old friend (and ex-Mr. Wrong) and his really great wife. (It really is true--one woman's Mr. Wrong is another woman's dream come true!)
Wednesday night is The New York Reading. Come on out and have a good time! I'm bringing some of these with me, unless airplane security takes them away before we board. Some of my favorite writers are reading, too--Roxana Robinson, Catherine Texier, Dana Kinstler, Raphael Kadushin, and me. 7 o'clock, Barnes & Noble, 82nd & Broadway. I'm bringing my Mr. Wrong T-shirts, too--maybe you'll win one at the reading.
Oh, and along the way I plan to eat a lot of Japanese food. Yum. At my favorite restaurant, Natori, if it's still around.
Sunday, January 28, 2007
Valentine's string cheese?
In today's Wisconsin State Journal, columnist Susan Lampert Smith wrote about how parents at one school in southern Wisconsin have been asked not to send in the traditional Valentine's treats--cookies, cakes, and especially those little conversation hearts. Only slightly tongue in cheek, Smith suggests that parents send in string cheese for Valentine's Day treats, and writes, "This, sadly, is what Valentine's Day has become in schools where the federal wellness policy is being interpreted with revolutionary zeal."
You go, Susan. The zealots at this and other school districts obviously haven't read the studies on the effects of deprivation on eating habits. Restrained eating--in this case, telling kids they mustn't eat sweets for Valentine's Day--usually winds up making them eat more sweets, later on. If you've ever been on a diet, you're familiar with this paradigm. We're hard-wired to eat, and deprivation only triggers that urge, often leading to binging--often on the very thing you'd been deprived (or deprived yourself) of.
I saw this in my own children when they were young. Anxious to save them from the conflicted relationship I had with food, I enforced a stringent low- or no-sweets policy at home. The result? They became dessert hounds on playdates at other kids' houses.
A more sensible approach--and one I've applied to my own eating--would center around moderation rather than deprivation or binging, with plenty of opportunities for physical activity.
Of course, anyone who expects the school system to be sensible about anything is in for disappointment. But I hate the thought of all those federal dollars going toward food policies that actually cause some of the problems they're designed to help solve. I'll be sending a treat in my younger daughter's lunch bag on Valentine's Day. And I'll be glad to explain why to anyone who asks.
You go, Susan. The zealots at this and other school districts obviously haven't read the studies on the effects of deprivation on eating habits. Restrained eating--in this case, telling kids they mustn't eat sweets for Valentine's Day--usually winds up making them eat more sweets, later on. If you've ever been on a diet, you're familiar with this paradigm. We're hard-wired to eat, and deprivation only triggers that urge, often leading to binging--often on the very thing you'd been deprived (or deprived yourself) of.
I saw this in my own children when they were young. Anxious to save them from the conflicted relationship I had with food, I enforced a stringent low- or no-sweets policy at home. The result? They became dessert hounds on playdates at other kids' houses.
A more sensible approach--and one I've applied to my own eating--would center around moderation rather than deprivation or binging, with plenty of opportunities for physical activity.
Of course, anyone who expects the school system to be sensible about anything is in for disappointment. But I hate the thought of all those federal dollars going toward food policies that actually cause some of the problems they're designed to help solve. I'll be sending a treat in my younger daughter's lunch bag on Valentine's Day. And I'll be glad to explain why to anyone who asks.
Thursday, January 25, 2007
Girlpower--or why I wish I lived in Sweden
A while back someone e-mailed me about a health campaign out of Sweden called Girlpower. Tonight I was looking for the link, and came across a program by the same name, but out of the U.S. Department of Health and Human Services.
Eventually I found the one I was looking for. It's worth looking at, especially if you've ever had any body image issues (which unfortunately covers the vast majority of westernized women).
Not that I think stuff like this causes eating disorders. But it sure can trigger them among kids who are susceptible. And I know for myself that if you look at enough of this kind of image, the face and body you see in the mirror are always going to look inferior.
That's why I'd rather live in Sweden. It's no perfect society, but at least they're doing something right.
Eventually I found the one I was looking for. It's worth looking at, especially if you've ever had any body image issues (which unfortunately covers the vast majority of westernized women).
Not that I think stuff like this causes eating disorders. But it sure can trigger them among kids who are susceptible. And I know for myself that if you look at enough of this kind of image, the face and body you see in the mirror are always going to look inferior.
That's why I'd rather live in Sweden. It's no perfect society, but at least they're doing something right.
Wednesday, January 24, 2007
Post-traumatic anorexia stress syndrome
I haven't posted in a few days, mostly because I'm feeling sad.
Sad about my daughter Kitty's illness, even though she is doing quite well now. Because she is doing well now, probably.
Last year at this time it wasn't safe to feel sad, or mad, or anxious. It really wasn't safe to feel much of anything. Last year at this time her father and I were relentless cheerleaders in the land of anorexia recovery.
This year, we are back to what passes in our house for normal life. Kitty is off to the state Latin convention tomorrow, where she will stay in a hotel with lots of other teenagers (and teachers), play Latin games, and generally have a swell time. Last night she came in 6th in a XC ski race. Go, Kitty!
You've heard of the 5 stages of grief--how about the 5 stages of anorexia: 1. Formless worry. 2. Emergency/crisis. 3. Battle with the demon. 4. Jubilation at recovery. 5. Post-traumatic anxiety.
I think I'll call this Post-Traumatic Anorexia Stress Syndrome. PTASS. It's a good thing, basically, because it means things are good.
I wonder how we'll all feel a year from now?
Sad about my daughter Kitty's illness, even though she is doing quite well now. Because she is doing well now, probably.
Last year at this time it wasn't safe to feel sad, or mad, or anxious. It really wasn't safe to feel much of anything. Last year at this time her father and I were relentless cheerleaders in the land of anorexia recovery.
This year, we are back to what passes in our house for normal life. Kitty is off to the state Latin convention tomorrow, where she will stay in a hotel with lots of other teenagers (and teachers), play Latin games, and generally have a swell time. Last night she came in 6th in a XC ski race. Go, Kitty!
You've heard of the 5 stages of grief--how about the 5 stages of anorexia: 1. Formless worry. 2. Emergency/crisis. 3. Battle with the demon. 4. Jubilation at recovery. 5. Post-traumatic anxiety.
I think I'll call this Post-Traumatic Anorexia Stress Syndrome. PTASS. It's a good thing, basically, because it means things are good.
I wonder how we'll all feel a year from now?
Saturday, January 20, 2007
Gisele Bundchen, educate yourself!
Supermodel Gisele Bundchen thinks she knows what causes anorexia: weak families.
Because she's not anorexic, and she comes from a strong family, she's deduced that anorexics must come from weak families.
This is what's known in philosophy as a tautology. Or something like that. It's faulty reasoning, circular logic, and a bunch of hooey.
It's also unfortunate that someone with as much power to draw media attention is saying things like this, because many families and professionals will listen to her uninformed words.
Gisele, I'm glad you're able to be a supermodel without falling prey to the awful disease of anorexia. But frankly, you don't know what you're talking about here.
Take a look at some of the very latest research on anorexia and genetics. Then how about coming out with a more useful pronouncement on the topic?
I dare you.
Because she's not anorexic, and she comes from a strong family, she's deduced that anorexics must come from weak families.
This is what's known in philosophy as a tautology. Or something like that. It's faulty reasoning, circular logic, and a bunch of hooey.
It's also unfortunate that someone with as much power to draw media attention is saying things like this, because many families and professionals will listen to her uninformed words.
Gisele, I'm glad you're able to be a supermodel without falling prey to the awful disease of anorexia. But frankly, you don't know what you're talking about here.
Take a look at some of the very latest research on anorexia and genetics. Then how about coming out with a more useful pronouncement on the topic?
I dare you.
Thursday, January 18, 2007
Have dinner with your family on Feb. 25!
Just in case you needed a reason to make family dinners more of a priority, here are some fascinating statistics:
* Kids whose families eat dinner together more often eat better and show less eating-disordered behavior than kids whose families eat together less often
* Kids whose families eat dinner together three times a week or less are twice as likely to try marijuana and cigarettes and 1-1/2 times likelier to try alcohol than those whose families eat together 5-7 times a week
* A 2001 University of Michigan study found that family meals trumped most other predictive factors in kids’ lives, including amount of time spent in school, studying, church, playing sports, and in art activities. When the results were statistically controlled for gender, race, family structure and employment, income, social class, parents’ education and age, and family size, family meals were still the single strongest predictor of better achievement scores and fewer behavioral problems
http://www2.blogger.com/img/gl.link.gif
And what better way to honor National Eating Disorders Week this February than to schedule a family dinner?
To celebrate the role of family support in recovery from eating disorders, the Maudsley Parents group (of which I am proud to be a founding member) will sponsor a worldwide Family Dinner on February 25. Sign up to share a meal with your family that day, and you'll receive a Gold Fork pin and NEDAW materials on request.
My family's in--how about yours?
* Kids whose families eat dinner together more often eat better and show less eating-disordered behavior than kids whose families eat together less often
* Kids whose families eat dinner together three times a week or less are twice as likely to try marijuana and cigarettes and 1-1/2 times likelier to try alcohol than those whose families eat together 5-7 times a week
* A 2001 University of Michigan study found that family meals trumped most other predictive factors in kids’ lives, including amount of time spent in school, studying, church, playing sports, and in art activities. When the results were statistically controlled for gender, race, family structure and employment, income, social class, parents’ education and age, and family size, family meals were still the single strongest predictor of better achievement scores and fewer behavioral problems
http://www2.blogger.com/img/gl.link.gif
And what better way to honor National Eating Disorders Week this February than to schedule a family dinner?
To celebrate the role of family support in recovery from eating disorders, the Maudsley Parents group (of which I am proud to be a founding member) will sponsor a worldwide Family Dinner on February 25. Sign up to share a meal with your family that day, and you'll receive a Gold Fork pin and NEDAW materials on request.
My family's in--how about yours?
Monday, January 15, 2007
Support group forming
I'm thinking of starting a weekly support group for parents using the Maudsley approach to refeed their anorexic children. I've had a couple of parents say they would love such a group. If you're interested (I'm in Madison, Wisconsin), send an e-mail to hnbrown@tds.net.
Anorxia, culture, and a Golden Fork award
JG's thoughtful responses to my previous post included a link to an interesting article on eating disorders and culture. It's a good overview of the conventional wisdom on the role of culture in eating disorders, and I'm putting the link up here in case anyone wants to read it.
JG writes, "I'd give anything to spare a young woman today from going through what I did." That's how I feel--I'd give anything to spare a young woman from going through what my daughter did.
I think if we keep talking about this, keep questioning, raising the issues, that's a good thing. I wrote here months ago about the posters at my younger daughter's middle school--there were bulletin boards in the hallways promoting "healthy eating," exercise, and, yes, unbelievably, weight loss. I went in and talked with the assistant principal about it. The posters went away for a while, and have no, my daughter says, been replaced with posters saying something like "Losing weight is not healthy for children and adolescents."
Yay! Hamilton Middle School got it! I hereby award them a Golden Fork award for being responsive to the issue. One small step at the table, one giant step (I hope) for our understanding and treatment of eating disorders.
JG writes, "I'd give anything to spare a young woman today from going through what I did." That's how I feel--I'd give anything to spare a young woman from going through what my daughter did.
I think if we keep talking about this, keep questioning, raising the issues, that's a good thing. I wrote here months ago about the posters at my younger daughter's middle school--there were bulletin boards in the hallways promoting "healthy eating," exercise, and, yes, unbelievably, weight loss. I went in and talked with the assistant principal about it. The posters went away for a while, and have no, my daughter says, been replaced with posters saying something like "Losing weight is not healthy for children and adolescents."
Yay! Hamilton Middle School got it! I hereby award them a Golden Fork award for being responsive to the issue. One small step at the table, one giant step (I hope) for our understanding and treatment of eating disorders.
Saturday, January 13, 2007
Fear of food
I was in the food co-op this afternoon, picking up a bunch of spinach, when another shopper spoke to me. She was a young mother, shopping with her preschooler, and she watched me put the spinach in my cart with frank shock. Then she shook her head. "Boy, you're brave," she said.
It took me a minute to understand what she was referring to. Once I got it, I couldn't stop thinking about it. Here was fear of food in a different context from the one I'm used to seeing--the kind of fear of food anorexics feel--and it made me think. Our relationship to food is so primal, so necessary for survival, that to be afraid of it seems not just counterintuitive but, also, awful.
If I'm honest, I must admit that I have fears around food, too. I'm guessing many of us do. I spent years being afraid of fat because of the cultural hysteria around overweight. I grew up in the 1960s, eating a lot of packaged, chemically preserved food--Snowballs and Tastykakes, anyone?--and now try to eat organic when I can, partly from fear of what's in our food supply, partly because organic food tastes better, and partly because organic practices are better for the earth and animals.
And I got to wondering just how pathological my food fears are. I'm not afraid of spinach--in fact I cooked it up and ate it for dinner, and it was delicious--but I wouldn't willingly eat a hot dog (red meat, nitrates).
How sad to have fear enter into the essentially joyful relationship we should have with food. I don't make New Year's resolutions, but I think I'll make that a priority on my list this year: to vanquish my own food fears and reestablish a healthier and happier relationship with food in 2007.
It took me a minute to understand what she was referring to. Once I got it, I couldn't stop thinking about it. Here was fear of food in a different context from the one I'm used to seeing--the kind of fear of food anorexics feel--and it made me think. Our relationship to food is so primal, so necessary for survival, that to be afraid of it seems not just counterintuitive but, also, awful.
If I'm honest, I must admit that I have fears around food, too. I'm guessing many of us do. I spent years being afraid of fat because of the cultural hysteria around overweight. I grew up in the 1960s, eating a lot of packaged, chemically preserved food--Snowballs and Tastykakes, anyone?--and now try to eat organic when I can, partly from fear of what's in our food supply, partly because organic food tastes better, and partly because organic practices are better for the earth and animals.
And I got to wondering just how pathological my food fears are. I'm not afraid of spinach--in fact I cooked it up and ate it for dinner, and it was delicious--but I wouldn't willingly eat a hot dog (red meat, nitrates).
How sad to have fear enter into the essentially joyful relationship we should have with food. I don't make New Year's resolutions, but I think I'll make that a priority on my list this year: to vanquish my own food fears and reestablish a healthier and happier relationship with food in 2007.
Friday, January 12, 2007
Mr. Wrong goes to New York!
The publication date for MR. WRONG: REAL-LIFE STORIES ABOUT THE MEN WE USED TO LOVE is getting close, and I'm thrilled to be traveling to New York City for a reading. Even better, I won't be standing up there alone, but will be in the company of some of the highly entertaining writers with essays in the collection--Roxana Robinson, Catherine Texier, Caroline Leavitt, Raphael Kadushin, and Dana Kinstler. The reading is at the Barnes & Noble at 82nd & Broadway, Feb. 7 at 7 p.m. It's going to be a lot of fun.
For those of you closer to (my) home, I'll be reading on Feb. 14 at Borders West in Madison, along with Jackie Mitchard and Raphael Kadushin.
Watch this space for news of the MR. WRONG contest--and to find out how you can win a chance to tell your story to the world, plus a signed copy of the book and a MR. WRONG T-shirt. Yes, I'm having T-shirts made up, and they're a hoot.
For those of you closer to (my) home, I'll be reading on Feb. 14 at Borders West in Madison, along with Jackie Mitchard and Raphael Kadushin.
Watch this space for news of the MR. WRONG contest--and to find out how you can win a chance to tell your story to the world, plus a signed copy of the book and a MR. WRONG T-shirt. Yes, I'm having T-shirts made up, and they're a hoot.
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