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.


Angela said...

I think it is rare to achieve total recovery from an eating disorder. I've been trying to recover for over 20 years. Most of my friends from treatment have relapsed one or more times. Hopefully I won't ever have a full blown relapse again, but I don't believe those thoughts ever totally go away, as much as I wish that they would.

Harriet said...

Angel, I think it depends when you got sick and how long you were sick for. For adolescents who are sick less than 3 years and who reach *full* weight restoration (not just a medically safe lowball weight), full recovery is not unusual. But I agree that if you put all the figures together, the total recovery numbers are something less than "most."

I'm sorry you have been struggling for so long. You sound like a very strong person.

Anonymous said...

Amazing woman. . .

Was my psychiatrist for about 3 years -- she really is big for nutrition and weight restoration -- and she DOES NOT go by BMI in terms of level of progress. She did threaten to hospitalize me at a BMI of 18.5 when I was losing weight.

She is an action taker and extremely blunt. Many did not like her, but we got along fine.


Ara said...

Hi Angel,
I agree with Harriet that age and the length of illness are important factors for recovery but -and this is a BIG but- in my opinion based on statistics from the largest south-american non-profit clinic for eating disorders in Argentina. The modality of treatment is fundamental in order to achieve full recovery. Children undergoing day hospital at ALUBA will recover fully in one or two years and teenagers and adults take no less than 4 years of continuous treatment.
Of course I don't know if costs would make it possible to implement such a complex/complete treatment here in North America. Anyway I just wanted to point out that no matter the length of your illness and your age if you have the right treatment you would probably achieve full recovery.

(former E.D. client) started treatment for Bulimia after 7 years of illness at 23. Underwent treatment for 6 years at Aluba and I have been 10+ years in full remission. Zero symptoms.

By the way, psychiatrist Dr. Mabel Bello (Aluba’s founder) has Dr. Phinas same style. I guess it takes strong women to battle bulimia and anorexia ;o)
Cheers! There is hope out there :^)