Numbers – a Catch 22

I read this post on Dads and Daughters With Eating Disorders: Eating Disorders – Weights & Scales

To summarize:

Because her health is directly related to her weight.  Measured by scales.
Her recovery is directly related to her weight.  Measured by scales.
Her life is directly related to her weight.  Measured by scales.
Weight matters.
And scales matter because they measure weight.

I posted a comment on this post, which hasn’t been approved yet, but I decided that I wanted to discuss the issue on Grey Thinking anyway.

Yes, weight is inexorably tied to health and to recovery.  Weight restoration is vitally important to recovery.  You can’t be recovered and still be below the healthy weight range.  Professionals need to monitor weight.  Some treatment decisions need to be made based on weight.  In short, I am not at all arguing that weight is unimpotant for recovery.

With all of that said… I find a lot of diagnostic criteria and treatment approaches to be contradicting and frustrating.  In therapy, you’re told that you are not a number.  That you are lovable regardless of what the number on the scale says.  That coping with food / weight is not okay.  That eating should be mindful and emotional eating is unhealthy.  You don’t have to be sick to deserve care.

But think — how is your health measured?

• weight, BMI, % of IBW
• calories, exchanges, % of meal plan completed
• heart rate, blood pressure, potassium, electrolytes
• # of binges / purges, # of laxatives, # of diet pills
• hours exercised

… see my point?  Everything is measured in numbers.

I have an issue with your mental health being measured in numbers.  From this point of view, gaining weight = a good week and losing weight = a bad week.  That has just never been a linear relationship for me.  I have bad weeks and gain weight, and vice versa.  Sometimes I follow my meal plan and lose weight, and other times I restrict and gain weight.  The system reinforces the necessity of communicating through your eating disorder.  If you’re feeling crappy but follow your meal plan, then obviously you weren’t really feeling bad — if you were, you would have restricted.  Plus, when you are at a healthy weight — ta da, end of treatment!  You’re all better!  Even if you feel as crappy as ever, you’re not sick anymore, so…..

Thankfully not all professionals practice this way, but measuring your progress in recovery by numbers is not unusual.  I feel strongly that weight is just a piece of the puzzle… and while weight and eating are core components to eating disorders, by basing treatment on just these factors you are really limiting treatment.  There are people who will stay sick because the system inforces that they need to be to get help.  And that’s unfair…

Why blog about eating disorders?

What’s the value of mental health blogging? I stumbled upon this post on The Secret Life of a Manic Depressive, where Seaneen discusses the role that blogging has played in her struggle with bipolar disorder. At the end of the post she poses a question:

What are your views on mental health blogging? If you have a blog, why did you start writing it?

I wrote this in her comments (in case it sounds familiar), but I think that mental health blogging is valuable for several reasons:

1. It can provide a healthy outlet for dealing with feelings surrounding your own struggles with mental illness.
2. It’s comforting to know that “you’re not alone”–there are other people out there struggling with the same things as you. Often another person can articulate something that you’ve been trying to explain/identify/put your finger on for a long time.
3. Community support and wisdom. There is a lot of collective and experience within the mental health blogging community.
4. It provides a unique inside look at otherwise poorly understood mental illnesses. How many people really understand how you view/experience the world with a disorder? How does the media affect you? What do you think about current research? What has/hasn’t been helpful for you treatment-wise? There is so much information that only someone who has struggled with mental illness can provide.
5. You can challenge others… challenge them in their recovery, or to look at something from another perspective, or to break through their denial about a problem. Mental health blogs make you think and examine your own reactions

Why did I start Grey Thinking? Well, for all of the reasons above–plus a couple more:

1. I have a lot of opinions on new research, eating disorders in the media, approaches to treatment, etc. My friends were getting tired of listening to my philosophical views of “what is wrong with the DSM-IV,” etc.
2. I have a psychology degree, an eating disorder history, an endless interest in mental health, and web design experience. I felt that this was a good way to combine my personal struggles, knowledge, and interests.
3. Not that I am objective, but I think that having dealt with an eating disorder I have a different perspective of eating disorders in the media, treatment approaches, popular theory, etc.
4. There are not enough mental health blogs out there

Tis the Season for Comparing

“Holiday” and “reflection” go hand-in-hand for me. Actually, I think the equation is more like this:

holidays + remembering to be thankful + being at home + the annual family Christmas card photo = reflection.

Reflection might not be such a bad thing… but reflection leads to comparing. There is still the day-to-day comparing myself to others in my surrounding (although I think I’m getting better about this), but this time of year leads me to compare myself to former versions of myself.

I blame a lot of this on the family Christmas card (a convenient scapegoat). There’s nothing like being able to physically line up images of myself over the years and make harsh judgments. I treat my picture each year almost as if I were a different person. Somehow I am not the same person as I was before… maybe before I was happier, or thinner, or smarter, or more considerate–who knows what it could be. I’m looking for an indication that I am a worse person now.

I know how disordered this all sounds, but there is something about self vs. self comparison that is much more significant than comparing myself to the person standing in front of me in the check-out line. Somehow these images say something about me as a person.

I know that comparing is a big problem for most people with eating disorders, but I wonder how many people beat themselves up over not measuring up to their former selves? I may possibly be my biggest trigger.

Telemental Health

Wall Street Journal: Text Messaging for Health

I guess it’s about time that someone came up with a big word for “texting your therapist / nutritionist / doctor.” Honestly, my healthcare providers are just starting to utilize email in their practices. I have no doubt that they check their email in their personal lives (or at least I hope they do), but their work email? I would never email my doctor or therapist if I needed something urgent. Or by the end of the week.

In fact, the only professional I see who IS on top of technology is my dentist… which is unfortunate, because I hate “you are due for your 6 month teeth cleaning!” reminders.

After reading this:

“… young diabetics could send a text message to their doctor to check how to modify their insulin treatment after eating certain foods, or drinking alcohol at a party,”

all I could think about is all the anorexics frantically texting their nutritionists about whatever unsafe food they just ate.

I’ll be the first to admit that I’ve sent “I feel so crappy for eating this, this, and this” emails to an old (and more technologically savvy) nutritionist of mine.

You have to wonder… at what point does the convenience of instant communication lose it’s helpfulness? And what professional wants all of his/her patients texting on a regular basis?

…. but, the fish thing? now THAT is something I would use.

Tags: eating disorder, health, telemental health, technology and therapy, text messaging for health, health technology