Minorities and Men

The Magic Diet

This week I've read interesting articles from the lay and scientific literature about weight loss.  I read about how a woman "magically" jump started her body into weight loss after it had stalled.  

I was particularly struck by a story from CNN.  It appeared as part of their Fit Nation series.  What appears to be an inspiring story of the "magic pill" to finally conquer weight backfires.  Does it happen right away?  Of course not.  Later, down the road, just when no one is thinking about it. 

Dangerous dieting can happen to anyone.  Often doctors applaud weight loss and do not ask the proper questions.  We are programmed to think obesity equals cardiovascular risk equals a whole host of problems.  Or to go down another path and include cancer, arthritis, gallbladder problems. 

Physicians walk a fine line between managing their patient's maladies and well, fat-phobia.  In a recent study, it was shown that when health care students were placed on a restrictive diet, they had more empathy for those battling weight problems.

So what was the Magic Diet?  How did Karen start losing weight?  She increased her calories and now eats more on tough workout days. 

You don't sell many books if the title is the "The Moderation Lifestyle" or "There IS no Magic Diet" or my personal favorite, "How to have your cake, eat it and learn to like yourself too lifestyle."

If you are struggling with Binge Eating Disorder or Compulsive Overeating, the Binge Eating Association may be able to help provide you support.  Their website is http://bedaonline.com/

Peace be with you.

In the meantime...

Hi all,

In my time away from the blog, I've been pretty busy!  I've seen been advocating for the Eating Disorders Coalition and even got my Congressman Dave Loebsack to sign on as a co-sponsor of the FREED Act.  It takes a lot of calls and following up but it can be done!  I urge everyone to learn about the Federal Response to Eliminate Eating Disorders H.R. 1193 (Senate version S 3260) today.  The aim of this bill is to provide adequate coverage for eating disorders, improve education about eating disorders, and increase funding for research.

Probably my most exciting news was getting an Op/Ed published in my local newspaper.

http://gazetteonline.com/opinion/guest-columns/2010/06/20/support-bill-to-treat-eating-disorders

I look forward to the next Lobby Day sponsored by the Eating Disorders Coalition on September 29-30, 2010.  I hope that some of you will be consider attending.

Of course I also look forward continue to post regularly.

Peace be with you.

Illnesses, not lifestyle choices.

I came across a website featuring someone deliberately starving themselves to "prove" how dangerous eating disorders are and to put a focus on health and nutrition.  In the process, daily intakes, weights and calorie counts have been published.  This person has even expressed concern that the media is hesitant to cover their quest. My take, this is highly irresponsible behavior and should be shut down. 

We don't need someone to "prove" that eating disorders are dangerous.  We know this from research and the fact that eating disorders carry the highest mortality rate of all mental illnesses.

In our voyeuristic society, perhaps it was only a matter of time before something of this sort unfolded.  From The Biggest Loser to Dance Your "Bottom" Off, there seems to be a fascination with watching people lose weight through extreme means.  This fascination will soon include television programs featuring those with diagnosed eating disorders.  What will be the response?

There are millions who fight a fear of food and weight gain daily. Do not let these serious diseases be distorted into what the uninformed have claimed eating disorders to be:  lifestyle choices.

Peace be with you.

Something good about you...

Tell me something good about yourself.

Seems that that question is often followed by an awkward, even pregnant pause.  

There are the pat answers for job interviews and business, or even things that you tell your friends.  But when alone, what do you tell yourself?  

Can you come up with at least 5 responses?  Are they all related to your body?  When the question was first asked did you think of things that you didn't like?  If you can come up with responses are they based on things that others have told you that were good things about you?  Do you believe it?

In eating disorders, part of recovery is getting comfortable with the idea that you are a worthwhile person and your body deserves many things: love, nourishment, activity, fun, friends (and the list goes on).  

There may be times you will need to ask for your needs to be met from "busy people."  You must know and remember why you are deserving to be heard.  Consider adding to the list the things you look forward to accomplishing in life and why recovery is important to you.

Remember, just start with writing one good thing about yourself everyday.  Just one.  Ask for help if needed.  One good thing already is that you're working on living a life without an eating disorder.

Peace be with you.

British mannequin company produces "skinny" male version

A British company, Rootstein, will unveil its new male mannequin in June 2010.  Part of its Young and Restless line, the company is including a mannequin with a 35in chest and a 27in waist.  Its waistline is reported to be approximately 11in smaller than the average British man. The mannequin was based on the profile of teenage boys up to the age of 20 though the company reports none were known to have eating disorders.  Based on reports in the Guardian and Daily Mail, the "skinny jeans" movement are thought to be based on an celebrity model with a history of an eating disorder himself. 

Will there be a backlash to this pressure or an increase in men and boys attempting to mold themselves to ever changing standards.  This is our decision to make.  

Eating disorders do not discriminate.

To locate treatment for your eating disorder please call the National Eating Disorder Hotline at:

1-800-931-2237

Peace be with you.

After the storm, a rainbow.

Friday was dark and gloomy.  We had a tornado watch, a thunderstorm and lost power.  I found that I was unprepared.  I learned that I didn't have a flashlight or a matches for my candle.  While I gathered the necessary materials, I thought of the storm in terms of recovery.

Recovering will undoubtedly throw you for twists and curves.  Sometimes it is not always about your initial reaction, but the lesson that you learn from it.  If you can learn the lesson and move on, then great.  Sometimes, we make the same mistake over and over before learning that a different result is not going to occur.

Perhaps the best part of having to go through difficulty is that there is greater appreciation of the good times.  

Today, when I walked outside there was a double rainbow.  Interesting, rainbows are only possible because of the sun shining through water droplets.  There must be pain, before you can enjoy the rainbow.

When you go through recovery, unfortunately you don't just get to skip to the rainbow.  There's no magic wand to take away all the storms within.  If there are tears, know that you are just building your rainbow and you will shine brighter than before.  

Peace be with you.

F.R.E.E.D. Forever!

April 27, 2010 was designated as "Lobby Day" for the Eating Disorders Coalition.  On Tuesday, approximately 100 people from 27 states ascended on Washington, D.C. to lobby their Congressmen and Senators to pass H.R. 1193, the F.R.E.E.D. (Federal Response to Eliminate Eating Disorders) Act.  

F.R.E.E.D. was introduced into the House by Rep. Patrick Kennedy of Rhode Island on February 25, 2009.  The Senate version of this bill was introduced on April 26, 2010 by Sen. Tom Harkin of Iowa.  F.R.E.E.D. is a bill long dreamed of, and sought for because of the basic needs that continue to exist.

At this time, we continue to have gaps in coverage, a lack of practitioners trained in the treatment of eating disorders and a need more funding for eating disorders research.  It is also imperative to study the effects of BMI testing in schools and develop methods to prevent eating disorders from occurring.

How you can help:

1.  Visit the Eating Disorders Coalition at www.eatingdisorderscoalition.org and learn more about insurance reform and H.R. 1193, the F.R.E.E.D. Act.

2.  Write a letter or email to your Representative urging them to support and co-sponsor H.R. 1193.  Don't know who this is?  Find out at www.house.gov

3. Contact your Senator urging them to support and co-sponsor S.3260, the F.R.E.E.D. Act.  Don't know who your senators are?  Find out at www.senate.gov.

4.  Join the Family/Friends Action Council of the Eating Disorders Coalition and learn more about efforts going on to support you and make treatment a reality for everyone.  No one should die of an eating disorder.  No one should die due to lack of access to care.

Peace be with you.

The "New Eating Disorder"

Changes are being proposed to the DSM to add Binge Eating Disorder (BED) to DSM-V.  This is a welcomed change for many Americans.  Currently, it is estimated that 3-4% of Americans have BED, making it the most common eating disorder.  It is important to state that sufferers of BED are NOT homogeneous in their appearance, rather they may be of average size or overweight.

Obtaining treatment for BED has been difficult without having recognition in the DSM.  Adding a diagnosis code creates many opportunities in the future that have to this point been nonexistent to many largely because of funding.  

I look forward to seeing more NIH/NIMH funding for BED studies as well as medications being developed. To date, obesity treatment has largely consisted of bariatric surgery, which has helped many but carries medical risks and even risk of development of disordered eating post surgery.

I applaud and thank the DSM-V Eating Disorders Workgroup for their decision to add this diagnosis based on the body of literature and patients who have presented with BED.  

Peace be with you.

Q & A with Dr. Arnold Andersen

Recently, I had the opportunity to discuss topics in eating disorders with Dr. Arnold Andersen, not only a world renowed eating disorders specialist, author of several books including Making Weight: A Men's Guide to Problems with Food, Weight and Shape; Eating Disorders: Guide to Medical Care and Complications and Males with Eating Disorders, but a fellow University of Iowa colleague and mentor. 

 

LM:  In the past few years, there have been more men coming forward to discuss their battles with eating disorders.  Do you feel that stigma among men has decreased?

AA:  Unfortunately, not.  Stigma is still high at this time.

LM:  Can you estimate the prevalence of eating disorders in boys and men?

AA:  At this time, the community based estimate is three female sufferers for every male sufferer.  Clinical studies also underestimate males.

LM: How do you explain the lack of self care in men?

AA:  This is an assumption, probably founded, based on the lower percentage of males who go to doctor for any reason.  The answer is probably sociological and perhaps neurobiological.

LM:  I have noticed that eating disorders, mainly anorexia in young boys generally develops for different reasons and is treated differently than older boys.  Can you speak about treatment prognosis for different disorders at various ages?

AA:  Prognosis is as good or better for males.  I conducted a study a Johns Hopkins and others have conducted studies with similar results.  Old ideas about being sicker or harder to treat or worse prognosis are out of date.

LM:  What can parents do to bolster the self-esteem of their sons to help prevent eating disorders?

AA:  Individualize parent-child interaction so each has a sense of competence within their biological endowment—the skinny, slow to development boy needs more patient encouragement than the early mesomorph with natural athletic skills.  Talk over issues of body image at home.  Learn media skepticism.

LM:  How should a parent address an overweight child?

AA:  Complex issue—the key is to nip it in the bud by understanding family history creates a vulnerability to genetic obesity where present.  No tv/video games until an hour of daily physical activity and serve healthy balanced meals without concentrated sweets or fats at homes.

LM:  Would it be your recommendation that the entire family change their eating habits to incorporate more healthy choices, not just the identified patient?

AA:  The whole family of an obese child, unless the obesity is driven by medication, will benefit from a life-long approach to high volume, low-density meals, with fast food once a week maximum, lots of fruits and vegetables done in tasty manner.   It’s not that hard to make the changes gradually.  Families need to know that it takes about 6 weeks for a change to taste good, for example, decreasing salt.  What is not recommended is different meals for different family members, or any focus on weight or calories.  Eating as a family is a nurturing experience.  There is a good study that showed that there is a direct inverse correlation between the number of meals a family eats together and the probability of developing an eating disorder or drug abuse. 

LM:  What do you recommend to parents of boys who aren't naturally athletically inclined, yet strive to do well in sports?

AA:  The U.S. needs to stop the divide that occurs around 7^th grade into elite athletes and bench warmers. It is a major mistake to stop taking P.E. seriously.  Studies have shown that aerobic activity improved academics, especially ADHD.   By having all children involved in sports at their peer level at every grade, as is done in Scandinavia, each kid can develop enjoyment and competence about their bodies.  The key is to emphasize enjoyment and lifetime carry through skills.  The kiss of death is when one sibling is compared to another negatively or parents are critical of the boy’s best efforts (like the out of control dads and moms you see at some soccer games).  In Norway, each town has sports clubs for people of every ability.  Each poor child in Oslo who receives state support must receive a pair of cross country skis—it’s considered basic, not an extra for elites.  Also, tailoring the boy’s body type, stage of development, height, weight, fast-twitch vs. slow-twitch muscle balance to different types of sports is important.  Not everyone needs to be a quarterback. 

LM:  Thank you, Dr. Andersen

AA: Best Wishes.

 

Dr. Andersen is especially interested in the integration of biomedical and psychosocial therapies, the gender factor in behavioral disorders, the neurobiology of eating disorders, medical complications of eating disorders, and cross-cultural studies. He and colleagues have published numerous peer-reviewed research studies, clinical teaching chapters in books, and presented outcome and other research studies at local, national, and international meetings. His background includes Cornell Medical College, a medical internship, board certification in psychiatry, 15 years on the faculty of Johns Hopkins Medical Institutions, and participation in numerous scientific groups.

What is NOR•MAL?

Many people ask this question daily; with my usual answer is "who knows?"

My favorite answer comes from the musical NOR•MAL, "A city in Illinois." Ah, if everything could be so easy.

NOR•MAL is the gut wrenching story of a family's struggle to cope with their daughter's eating disorder.  Told through the beauty of song, it is at times humorous, poetic and heartbreaking.  For anyone who wishes to understand eating disorders, has had an eating disorder or wants to open a dialogue about eating disorders, NOR•MAL is a must see.  Based on a true story, NOR•MAL has an authenticity that only real life experience with an eating disorder can bring.

Under the helm of Robyn Hussa and Eric Christiansen, the NOR•MAL vision expanded into Normal in Schools (NIS).  Greendale High School students in Wisconsin proved that theatre could be used to educate and prevent eating disorders.  At each showing of NOR•MAL, there is an eating disorders specialist present for an audience "talkback" session and questions can be answered.  Myths about eating disorders come to light and people have sought treatment after seeing NOR•MAL.

Listen to excerpts of songs here.

To license the play in your community, contact Robyn Hussa at rhussa@normalinschools.org.  Keep an eye for shows near you!

Recently, NIS held an inaugural event called INSIDE OUT -- Celebrating Inner Beauty Through Theatre, Music and Art at Milwaukee's Turner Hall Ballroom, which was hosted by Kirsten Haglund, Miss America 2008 and President of the Kirsten Haglund Foundation for Eating Disorders. The evening featured a silent auction and art gallery with some pieces donated by members of the community whose lives had been personally touched by eating disorders.  

 
 

Upcoming NIS events include:

1. Ongoing Tour of NOR•MAL into schools, universities, conferences and communities to educate audiences. Always present are mental health professionals specializing in the treatment of eating disorders and people in recovery.

2. SELF ESTEEM STOMP – in October 2010, NIS is launching one of its most exciting programs to date: a family wellness “fair” and interactive “playground.” On Saturday, October 15, 2010, families will meet to do a short “walk” together. At the finish line, we will have an interactive fair of experiential therapy booths so families can learn about mental health, treatment and wellness in a fun, non-stigmatized environment. Fun for the entire family!

3. INSIDE OUT Gala – an elegant, exclusive event at Turner Hall Ballroom each year to Celebrate Inner Beauty Through Theatre Music and Art. Participants walk through an art gallery – with work created by patients in recovery for eating disorders and other mental health illnesses, they experience live theatre and music and end the night dancing to swing music. Next event: February 26, 2011.

4. Team NOR•MAL is an ongoing program where we educate athletes about the issues of eating disorders and body image among runners and athletes. We also have athletes who run on TEAM NORMAL to fundraise for our organization. Our next TEAM NORMAL event is August 1, 2010 in Chicago, IL for the Rock ‘n’ Roll Chicago Half Marathon.

5. NIS is currently working to create the online version of our award-winning program and curriculum. Students will be able to log in to an internet portal to access the program. Stay tuned!

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NOR•MAL is an original musical with book by Yvonne Adrian, lyrics by Cheryl Stern, music by Tom Kochan and developed with Jack Cummings III.  Scott Rink served as choreographer and Associate Director and John DiPinto served as Musical Director and was adapted for Normal in Schools by Robyn Hussa and Eric Christiansen.

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Peace be with you.