Living With Food: The Science Supporting Eating Disorder Treatment

Please take a look at the recently published ebook, Multi-diagnositc Eating Disordered Patients, by Drs Lucene Wisniewski and Anita Federici.

The book discusses challenges and complexities in treating clients with comorbid eating disorders and borderline personality disorder, and offers Dialectical Behavioral Therapy tactics and principles as clinical solutions.

For more information, please click on the link below:

Multi-diagnositc Eating Disordered Patients

With the upcoming Thanksgiving holiday upon us, we would like to re-post our article for family members on suggestions of what to say and what not to say to loved ones in eating disorder treatment during the holidays.

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

By Dr. Mark Warren

Given that there are eleven million people in America who struggle with anorexia or bulimia, why is it so unusual for people to talk about these issues in public (or even with loved ones) with honesty and clairty? We have recently seen Portia de Rossi on Oprah and the cover of People magazine speaking about her eating disorder. While we are profoundly impacted and praise her for her willingness to share her story in its complexity, one also asks what makes this so hard and why does this happen to rarely? It seems the answers to this are complex and multi-layered. For many, one of the issues is shame. The illness itself speaks with a loud, negative voice and almost always tells you there is something wrong with you, that you’re not perfect, and that you’re not achieving your goals. For many, this persistent negative self-talk reiterates that others will see you in the same negative light in which you see yourself and often produces much shame and guilt.

Layered into this is that society at large may also hold a stigma of people with eating disorders. Society often minimizes the pain of those with eating disorders, telling people just to snap out of it, eat, and stop having behaviors, as if it were an easy thing to do. The stigma exists that those with these illnesses are weak and are choosing to have an eating disorder. Additionally, for many people, particularly women who have eating disorders, by letting their truth be revealed they are opening themselves up to a lifetime of others doubting that they are in recovery. This belief may also lead to doubt that they are able to be healthy and to lead full and happy lives. We do not yet have the structures in place to provide the support, validation, and praise for people who have made the journey from illness to recovery. Until we do it will continue to be difficult for people to be open about their illness and get the help they need. As a society we must examine the stigma that exists and recognize that these are highly misunderstood, biologically based illnesses, which require evidence-based treatment and ongoing care.

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

Contributions by Sarah Emerman

Do families cause eating disorders?

Nope.

Really, we don’t need to write a post longer than that one word. In fact, there is no evidence that families cause eating disorders, and there has never been any evidence that families cause eating disorders. There has been a significant amount of unfounded and unjustified suspicion over the years about families and causation, which is not unique to eating disorders. Families have been speculated to be the cause of every psychiatric disorder from schizophrenia to bipolar disorder to autism for as long as these disorders have existed.

On the other hand, families can cure eating disorders. We recently discussed this fact in reference to the new data on family based therapy. Some people might ask: “If families can cure eating disorders, doesn’t this imply that they were part of the problem at some point in the past?” Again, the answer to this is no. The fact that families have a role in the treatment and in fact are the most powerful catalysts in helping their children does not in any way imply that they had anything to do with causation. It would be no more true to link these two things than it would be to say that doctors who prescribe chemotherapy cause cancer.

So no, families do not cause eating disorders. But they can cure them.
 
For more information on the effectiveness of Family Based Therapy, please visit the following links:

F.E.A.S.T.

Maudsley Parents

New Research on the Maudsley Method for the Treatment of Anorexia

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

Contributions by Sarah Emerman

By Sarah Emerman and our adult day treatment clients

1. Don’t expect your loved one to eat normally right away. For many clients, treatment will be the first time in a long while that they will eat normally. They will be trying foods that terrify them, which they will need to work up to in a manner that is appropriate for them. While you should encourage variety in your loved one’s diet, realize that they may not be ready to try all foods right away.
2. Don’t set a time line on when you expect your loved one to be fully recovered. Eating disorder treatment can take a long time. The time it takes to be recovered will depend on their level of motivation, commitment, and the severity of their behaviors. Know that it is normal for motivation to increase and decrease throughout the recovery process. It does not mean that your loved one isn’t trying or doesn’t care about getting better. Check in with your loved one on how they feel they’re doing, and don’t expect their recovery to take a specific amount of time.
3. Be careful with commenting on your loved one’s food and/or meal plan. Your loved one will be working with a dietitian who is trained to support them in following their meal plan and making balanced choices. If you do have a question about your loved one’s food, ask them outside of mealtime. If you have questions about their meal plan ask your loved one if he or she would sign a release and talk to the dietitian directly.
4. Watch your own judgments about food choices. For example, be careful not to label food as “good” or “bad”. Judging something as “bad for you” or “junk food” can reinforce to the client that they shouldn't be eating that type of food and will most likely be contrary to what their treatment team is telling them.
5. Watch the diet talk and use of diet products. Your loved one’s treatment center will be encouraging the use of non-diet products and trends to foster an environment of normalized thoughts towards food and body shape.
6. Do research. Get education about eating disorders, their causes, their symptoms and evidence based care. The more you know about what your loved one is experiencing and why, the easier it will be to understand and support them in their recovery. If your loved one is in one of our higher levels of care please know that we offer a family support group on Thursdays from 5:30 - 6:30, which is included in the cost of our day treatment and intensive outpatient programs.
7. Be willing to practice normalized eating. Many people without eating disorders struggle with making balanced food choices. Be aware of unbalanced eating and strive to make good choices for yourself. Eating in a normalized way will model for your loved one what balanced eating is and will make it easier for them to practice it themselves.
8. Get involved with your loved one’s treatment team.While their treatment team will not tell you specifics about their care without a signed release, the team can provide you with education about eating disorders and give you ideas on how to support your loved one.
9. Don’t blame yourself. What we know about eating disorders is that they are highly biologically and genetically based. You did not cause your loved one’s eating disorder and you did not make them sick.
10. Get support for yourself. The effect of an eating disorder extends far beyond the person experiencing it. Make sure you are getting care for yourself during a challenging and difficult time. CCED offers a free community support group the second Tuesday of every month from 6:30 -7:30 pm, which is open to anyone who has a loved one suffering from an eating disorder. The next community support group will be Tuesday November 9th.

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