Living With Food: The Science Supporting Eating Disorder Treatment

By Dr. Mark Warren

Next week F.E.A.S.T. will be having its 2011 conference in Arlington, VA. This important event will allow families and professionals to gather to discuss Family Based Treatment (FBT), current practice, clinical and biological research, and new directions for the field. The keynote speaker will be Thomas Insel, MD, the director of the National Institute of Health. His presence will not only be extraordinary opportunity to hear a true leader in the field but also represents the important shift towards treating eating disorders with evidence based therapy.

CCED is proud to be presenting two posters at the conference. The first involves working with multi-diagnostic clients using FBT combined with other therapies. The other poster presents the feasibility of utilizing FBT with children over age 18. We are proud to be represented by Dr. Jorey Beegun, our director of FBT, and Abby Scalise, a graduate student we have the pleasure of working with. If you’re going to be at the conference, please stop by and see our posters. If you’re not attending the conference, F.E.A.S.T. will be blogging the conference live on their website, please check it out and get involved.

Should you have any questions or comments regarding this post, please email blog@eatingdisorderscleveland.org.

Contributions by Sarah Emerman

By Dr. Mark Warren and Sarah Emerman, PC

Chances are, if you have an eating disorder, you also experience shame associated with your illness. You may have shame about your body size and shape, the eating disorder itself, how you perceive that others view you, or many other issues that are reinforced by the eating disorder voice. Along with this shame you also may experience social stigma. The way people talk about their bodies, your body, the things you read in magazines or see on television, the lack of accurate information on the development of an eating disorder, and messages you might hear from family and friend may all contribute to feeling stigmatized for having an eating disorder. By the time someone presents for eating disorder treatment their thoughts are often tangled in the multiple ways stigma and shame affect their relationship between themselves and the world at large. As a result, many people delay entering into treatment, may try to convince themselves that the disorder does not exist, or have a difficult time accepting the severity of the disorder. To some degree, entering into treatment means confronting the stigma and shame that go along with the illness. The solution to this problem only comes from connecting with others in a supportive environment that will allow secrets and shame to be slowly understood and to understand that the stigma of these illnesses is unjustified, unfair and unnecessary.

De-stigmatization goes hand in hand with awareness, education, and honesty. Become a Media Watchdog through NEDA, participate in Fat Talk Free week, or get involved with an organization that works towards increasing awareness of eating disorders, their causes, and effective treatment. A critical eye and ear, along with a supportive community that lends its way to recovery can help to reduce the shame and stigma associated with suffering from these biologically based illnesses.

Should you have any questions or comments regarding this post, please email blog@eatingdisorderscleveland.org

By Dr. Mark Warren

I’ll be speaking at the Renfrew conference in November with Jenni Schaefer on the topic of Professionals in Recovery: Then and Now – Stigma and Secrets, Science and Support. The issue of professionals who are in recovery, and how they discuss history of their disorder with their clients is a topic that has been discussed quietly for many years and recently has been more openly considered. The literature describing the impact on clients who are working with individuals in recovery has also begun to emerge. A landmark study by Nichole Barbarich in 2002 surveyed professionals in the Academy for Eating Disorders, finding that approximately 1/3 of female respondents (most of the respondents were females) had a history of an eating disorder or eating disorder treatment. The percentage for men was much lower. Given this level of prevalence of professionals with an eating disorder history, the time is clearly right for an open discussion on eating disorder professionals and recovery.

Recent surveys have suggested that virtually all treatment centers are open to the idea that people with a history of an eating disorder who are recovered are good candidates for employment. This represents a significant change from 15 years ago, when people who had recovered from an eating disorder were often fearful of discussing it within the field and tended to keep their histories a secret. I believe there are multiple reasons for this change: One is that we are more hopeful about recovery so that for a professional to say they are recovered is more accepted as the truth. The second is that clients have expressed and continue to express that it is helpful to them to know professionals who are recovered and who can provide an example of a life in recovery. Third, we are more aware of the impact of shame on those who suffer from these disorders. The ability to join with others in a conversation about their experience helps to diminish that shame.

There are of course many complications for professionals and their relationship with their clients when it comes to discussing their mental health histories. It is crucial that a provider be fully recovered if they are to practice, has adequate supervision, and is associated with a treatment center that provides a supportive atmosphere to encourage them in their recovery. When the proper pieces are in place, the presence of recovered professionals can be an important and positive part of eating disorder treatment for clients.

Should you have any questions regarding this post please email blog@eatingdisorderscleveland.org 

Contributions by Sarah Emerman

By, Dr. Mark Warren 

A recent study by Dr. Janet Treasure, one of the world’s most prominent eating disorder researchers, has demonstrated the significant importance of early and aggressive treatment for anorexia nervosa. In her study, regardless of the treatment mechanism, patients who had been ill for longer than three years had significantly worse outcomes after treatment then those who had been ill for less time. Give the lack of evidence based treatment available until ten years ago, we do not know if current treatment mechanism may be more effective for those who have been ill longer. However, we can certainly say that based on this study, the faster someone gets into treatment and the more aggressive the treatment, clients are faster into recovery and less likely to relapse.

This study supports previous data from Drs Lock and LeGrange, showing the effectiveness of family based treatment for those under age 18 who had been ill for less than three years. The accumulation of data over time continues to support the necessity of not ignoring, downplaying or minimizing eating disorder behaviors, or hoping that patients will get better on their own without aggressive behaviorally based treatment.

We do not want to discourage hope in those who have been ill longer than three years or those who have started treatment later. Treatment continues to get better as providers and agencies are utilizing evidence based treatment models to treat their clients. Nonetheless, a reading of the current data strongly suggests that no matter where you are, where your loved one is in their eating disorder, the faster they get into aggressive treatment for weight restoration and behavioral cessation the greater their lifelong chance of recovery.

Should you have any questions or concerns regarding the post please email blog@eatingdisorderscleveland.org

Contributions by Sarah Emerman

The Eating Disorder Network is proud to host the first of a free speaker series at the Bertram Woods Library in Shaker Heights. Join us for "Nutrition: what every parent needs to know", presented by Dr. William Dietz, on November 7th at 7 p.m.

William H. Dietz, MD, PhD, is the Director of the Division of Nutrition, Physical Activity, and
Obesity at the Center for Disease Control. Prior to his appointment to the CDC, he was a Professor of Pediatrics at the Tuft′s University School of Medicine, and Director of Clinical Nutrition at the Floating Hospital of New England Medical Center Hospitals.

Following the presentation, Dr. Dietz will be available to sign copies of "Nutrition - What Every Parent Needs to Know", co-edited by William H. Dietz, MD, PhD, and Loraine Stern, MD

Questions, concerns or interested in attending, please contact Sarah Dietrich, LISW, at sarah.dietrich7@gmail.com