Why a hidden epidemic?

I ran across an article on The Center for Eating Disorders at Sheppard Pratt’s blog, about “Eating Disorders in Adult Women.”  This topic is becoming increasingly popular in ED news… probably because more and more adult women are reaching out and asking for help.  In fact, Renfrew says that a quarter of their patients are over 35.  Anyway, the article interviews Dr. Trisha Gura, medical journalist and author of Lying in Weight: The Hidden Epidemic of Eating Disorders in Adult Women.

According to the article, adult women don’t seek treatment because:

1. They feel like a loser for having an eating disorder
2. They think that they should know better due to age
3. Until recently, they were so embarrassed and/or didn’t realize they could have an eating disorder in the 40s, 50s, 60s, and 70s.
4. Society portrays the illness as a teenage vanity issue.

I’d like to add a couple of my own to this list….

1. Their parents are not seeking treatment for them
2. They are busy taking care of others (like children)… and spending that much time focusing on yourself seems selfish (or impossible).
3. It’s much harder to take time out of life for treatment.  Leaving work and a family that relies on you is much different than missing some classes in high school.
4. If they have had these disordered habits for so many years, then their lifestyle seems “normal” to them… and less disturbing than had the ED began six months ago.

It’s not just genetics

One of these days, I will start a “Grey’s take on the Maudsley Method” series. Not because I think that it’s wrong or right, but just because I think it’s really interesting and have a lot to say about it.

In the meantime though, I want to highlight a quote from Laura Collins’ article, “The size of the trigger or the speed of the bullet?”

An eating disorder is not a sign of deep wounds, but some people do have deep wounds, and it makes recovery harder.

I’m curious — this this a “duh” statement for everyone treated with the Maudsley Method? Because it basically goes against all of my inpatient and outpatient treatment, formal education, and research. Just to quote a few of the institutions, professionals, and resources I’ve had experience with:

“Eating disorders are serious health- and life-threatening physical disorders that usually stem from some underlying emotional cause.” – The Renfrew Center

“Genetics make the gun, environment loads it, and that an experience of unbearable trauma is what actually pulls the trigger.” – Lui, Aimee. Gaining: The Truth About Life After Eating Disorders.

“Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes.” – National Institute of Mental Health

If you don’t see my point by now… it’s that I have always been told, eating disorders are not about the food. They’re a symptom, coping mechanism, etc. of something else.

That said, I don’t think that everyone has trauma… I’m not a fan of repressed memory therapy, because I think a lot of it is made up (or generated in the process).  Ruminating on traumatic events prolongs mental illness.  You can’t change what happened to you when you were three.  This is all true… but I also think that some people are using food to subconsciously avoid feelings/situations related to previous trauma, and in those cases, they need to be resolved in therapy.

I like Aimee Lui’s perspective on the matter.  You NEED the genetic component to develop and eating disorder.  They don’t really just happen to people.  Even if you have the genetic component, though, growing up in a wonderful environment can be protective.  I refuse to believe that you just inherit the anorexia gene and you’re doomed for a life haunted by an eating disorder (and if that’s the case, then I should never have children given my family history).  There IS a strong genetic component… but in all these genetic studies, you also have to consider environment!  Chances are, these kids are growing up with semi-similar relationships as their parents did.  There are just too many variables.

Anyway, I think that given genetics, environment CAN be enough… but for many people, it’s the unbearable stressing event that pushes them over the edge.  Those are the people with the trauma history.  So, regardless of whether or not you have a history of trauma, you at least have underlying relationship/environment issues to address

It's not just genetics

One of these days, I will start a “Grey’s take on the Maudsley Method” series. Not because I think that it’s wrong or right, but just because I think it’s really interesting and have a lot to say about it.

In the meantime though, I want to highlight a quote from Laura Collins’ article, “The size of the trigger or the speed of the bullet?”

An eating disorder is not a sign of deep wounds, but some people do have deep wounds, and it makes recovery harder.

I’m curious — this this a “duh” statement for everyone treated with the Maudsley Method? Because it basically goes against all of my inpatient and outpatient treatment, formal education, and research. Just to quote a few of the institutions, professionals, and resources I’ve had experience with:

“Eating disorders are serious health- and life-threatening physical disorders that usually stem from some underlying emotional cause.” – The Renfrew Center

“Genetics make the gun, environment loads it, and that an experience of unbearable trauma is what actually pulls the trigger.” – Lui, Aimee. Gaining: The Truth About Life After Eating Disorders.

“Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes.” – National Institute of Mental Health

If you don’t see my point by now… it’s that I have always been told, eating disorders are not about the food. They’re a symptom, coping mechanism, etc. of something else.

That said, I don’t think that everyone has trauma… I’m not a fan of repressed memory therapy, because I think a lot of it is made up (or generated in the process).  Ruminating on traumatic events prolongs mental illness.  You can’t change what happened to you when you were three.  This is all true… but I also think that some people are using food to subconsciously avoid feelings/situations related to previous trauma, and in those cases, they need to be resolved in therapy.

I like Aimee Lui’s perspective on the matter.  You NEED the genetic component to develop and eating disorder.  They don’t really just happen to people.  Even if you have the genetic component, though, growing up in a wonderful environment can be protective.  I refuse to believe that you just inherit the anorexia gene and you’re doomed for a life haunted by an eating disorder (and if that’s the case, then I should never have children given my family history).  There IS a strong genetic component… but in all these genetic studies, you also have to consider environment!  Chances are, these kids are growing up with semi-similar relationships as their parents did.  There are just too many variables.

Anyway, I think that given genetics, environment CAN be enough… but for many people, it’s the unbearable stressing event that pushes them over the edge.  Those are the people with the trauma history.  So, regardless of whether or not you have a history of trauma, you at least have underlying relationship/environment issues to address