Project BodyTalk goes live!

After nearly a year of development and work, I'm pleased to announce that thanks to my fabulous graduate assistant, Megan Swann, we've got a website up and running for Project BodyTalk. I've been writing about eating disorders for a while now, and at some point I began thinking that it would be really fabulous to be able to hear the actual voices of people who struggle with EDs. I'm also a radio devotee and big fan of shows like This American Life and the StoryCorps project.

From these sources, Project BodyTalk was born. It's an audio project that collects commentaries on the subjects of food, eating, body image, and eating disorders. Here on the Syracuse University campus, we opened a recording booth for a couple weeks last fall and collected a number of commentaries from students, faculty, and community members who came up to campus to record. Since then I've had people send me mp4 and mp3 files. A couple of teachers at a high school in Baldwinsville had students record commentaries.

The first commentators were told to record a commentary anywhere from 1 to 10 minutes, on any related subject. Some people told stories about friends and family members struggling with body-related issues. Some talked about foods they love. Some talked about what it's like to be fat, or thin, to have anorexia or binge eating disorder, to feel pressured to look a certain way. It's turning into a wonderfully eclectic, diverse, and moving project.

So . . . the website is up and running with the first half dozen commentaries. Over the next few months I'll be editing and uploading more commentaries, and, I hope, collecting them too.

We've also got a page labeled ACT, where I'm posting links and descriptions of other body-positive projects. If you've got one to share, send me info, and I'll happily add yours to the page.

I'd love your feedback--and your commentaries.

*Image by Megan Swann.

New research study

If you struggle with binge eating disorder and live in the Boston area, this study might be of interest. You've got to be between 18 and 50 years old and a non-smoker, at least for the last six months. For more details, see the study posting.

I'm a fan of taking part in research studies-IF they offer you something useful.

For information contact Miguel Alonso-Alonso, malonso@bidmc.harvard.edu.

Overheard at the lunch table

Recently I had occasion to take my kids on an all-day excursion, to which they were allowed to each invite a friend. As we cruised the lunch joint we'd chosen, the 12-year-old friend seemed, well, anxious about what to choose. She wanted nachos, she said, but that wasn't healthy. (Sound familiar, anyone?) Her parents, she explained, have a rule about eating fruits and vegetables at every meal. She finally settled on nachos and a container of cut-up fruit. "My father says I don't eat enough for a girl my age," she commented. Gee, I wonder why; could she be learning from them to be afraid of food? If she has the genetic loading for an eating disorder, she's in big trouble.

As we ate, the conversation turned to a new movie, Ratatouille. This girl had seen it. "I really liked it," she reported, "except for all those rats who were so fat!" Then she went on: "It's so disgusting! They had all these bulges of so much fat!"

I was fairly stunned, but only because she was articulating what I know so many people think. I didn't know what to say, honestly, and what came to mind wasn't great: "In our family we don't feel fat is bad. People come in all shapes and sizes."

"But all they have to do is eat less and eat healthy and they wouldn't be fat!" she cried. Out of the mouths of babes, huh? "That's not actually true," I said, and then changed the subject, feeling like a coward. But I really didn't feel like taking it on, especially since I could see she was just parroting what she'd heard at home.

Later in the day, everyone else got ice cream, and so, I was happy to see, did she. The fruit went home unopened. For what it's worth.

Fat--it's all in your head

At least according to this editorial in the American Journal of Psychiatry, exploring the question of whether to make obesity a brain disorder in DSM-V.

Of course, it's not really clear what exactly they mean by brain disorder. Anorexia and bulimia are listed in DSM-IV as brain disorders, sorta, and I have to say, I'm not sure what that means, either. Insurers still treat them as mental health issues rather than biologically based illnesses, and use that as a way to skive off covering them (at least in beknighted states like Wisconsin, which have no mental healthy parity laws).

It depends what the rationale is here, really. What we now know about eating disorders like anorexia is that some people are genetically and biologically predisposed to them, and that environment seems to play some kind of role in triggering those who are susceptible. Maybe that's true for obesity. That makes more sense to me than suggesting that all so-called obese people are compulsive eaters, which we know ain't true. Yo-yo dieting might be the environmental trigger, resetting the metabolism over time in ways that result in obesity.

But if an entry in DSM-V is going to result in more stigma attached to being obesity, I think we should say no thanks.

What do you think?

Anorexia and control

How many times have you read it or heard it: Anorexia is all about control. And its corollaries: People with anorexia have to choose to eat. Parents who try to make them eat have control issues.

Those of us who have used the Maudsley approach to help our children heal from eating disorders don't buy this. But the rest of the world still does.

I know a family that's had both kinds of treatment for their anorexic child. The mom put her finger on how each felt to her: "Anything less than Maudsley gets into really icky murky games. Maudsley is brutally hard but man it is all above board: parents want kids to eat. Period. What we've been doing instead is no less psychologically tense or painful."

That's exactly what I appreciate about the Maudsley approach: It's all right there out in the open. No hidden agendas, no submerged power struggles. Parents want their child to eat. They require it. They support it. Not out of a need to control, or boundary-crossing, or a wish to keep their child small, or any of the other accusations leveled at parents of anorexics.

We require our children to eat because we love them and want them to get better.

What could be wrong with that?

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.

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.