ChickSpeak

According to the Academy of Eating Disorders,  eating disorders have been on the rise over the past 30 years and “at any given time 10 percent or more of late adolescent and adult women report symptoms of eating disorders. Although these symptoms may not satisfy full diagnostic criteria, they do often cause distress and impairment. Interventions with these individuals may be helpful and may prevent the development of more serious disorders.”

 What this means is that at some point in your life, odds are that you have personally battled unhealthy issues with food and your body, and/or you have a friend who has experienced disordered eating.

Because we hear from you, our ChickSpeak community, often about topics ranging from a basic lack of self-confidence to full-blown anorexia and bulimia, we decided to enlist the help and support of an expert. Aimee Liu is the author of GAINING: The Truth About Life After Eating Disorders, just published by Warner Books. GAINING is, in part, a sequel to Liu’s very first book, SOLITAIRE (1979), which was also America’s first anorexia memoir. In her latest book, Aimee Liu revisits the questions of what really causes eating disorders and what it takes to fully recover. Aimee interviewed leading researchers and more than 40 other women and men with histories of eating disorders, then found the common threads of behaviors and traits that linked each story together. The end result is moving, strengthening and- beyond anything profoundly encouraging for anyone suffering and for loved ones trying to best be of support.

After reading GAINING and being deeply impressed with Aimee’s honest and thoughtful examination of her own journey of recovery and her findings from in-depth research, we knew we had to share her book and break-through strategies with all of the women we care about, especially YOU.

What came of our Q&A with Aimee was extraordinary, not only because she graciously answered questions from our ChickSpeak members, but because she also brought in the ideas and incites of Judith Banker, President Elect of the Academy of Eating Disorders. ChickSpeak will run the full interview as a special four part series over the next month. A big thanks to both Aimee Liu and Judith Banker for your time, support and enthusiasm in this!

These were challenging questions!  Some of them pressed for insight that goes beyond my expertise.  Rather than attempting to answer them “perfectly” on my own, I decided to admit my limitations and call for professional advice. (In other words, I used this occasion to practice what I preach in Gaining: when you need help, don’t be ashamed to seek it!)  I turned to Judith Banker, president-elect of the Academy for Eating Disorders, who generously gave these questions her full attention. (For information about the AED, go to http://www.aedweb.org/.) Because Judith’s responses are so full of important information, I don’t want to paraphrase her, but am including her answers uncut (marked by JB) alongside my own (marked AL).  Bear in mind that Judith is the professional - she founded and directs the Center for Eating Disorders in Ann Arbor, Michigan (http://www.center4ed.org/ ).  My own answers will reflect only what I have learned as a survivor and student of eating disorders, and from the feedback I’ve received from readers of Gaining. –Aimee

CS:  Based on your knowledge, what does the medical community know now about the effective treatment of eating disorders that they didn’t know at the time of your turning point?

AL:The entire scientific profile of eating disorders has been transformed by the research findings of the past twenty years.  When I was in the grip of anorexia in the 1960s and early ‘70s, treatment was reserved for those who were in imminent mortal danger, and that treatment consisted almost exclusively of hospitalization and forced refeeding.  Bulimia wasn’t even named yet!  Doctors, families, and counselors alike mostly assumed that people with eating disorders were just very stubborn, and that if they chose to cooperate and stopped being “difficult” they could get well on their own.  Recovery was defined almost exclusively in terms of weight gain and nutrition. Unfortunately, most of the general public still maintains these outdated notions.  They do not understand that eating disorders represent serious psychological illnesses and that fasting, binging, and purging behavior are expressions of some combination of depression, anxiety, trauma, genetics, and biochemistry.  The medical community is beginning to understand this, however, and changes in treatment have resulted as Judith details below.

JB:There is a greater appreciation now for the physiological influences and the psychological traits that serve as risk factors for the development of eating disorders. New areas of eating disorder research, such as genetics and neurobiology, have led to breakthroughs in our understanding of these illnesses. Genetic research shows that personality traits, such as the tendency to be anxious and depressed, predispose an individual to developing anorexia and that the role of heritability is quite strong (at least 50%) in anorexia nervosa. Neuroimaging research provides a window in to the brain processes involved in body image disorders.

Advances in psychopharmacological research have given the medical community a better understanding of how to use antidepressants and other medications in  treating people with eating disorders. And the evolution of an integrated team treatment approach in the acute care of anorexia has helped to significantly reduce the mortality rate. Psychotherapy research has shown Cognitive Behavioral Therapy is effective in the treatment of bulimia and that manual-based family therapy (the Maudsley Method)  is a promising new treatment for children and adolescents with eating disorders.

Research on all these fronts has provided important new information that has improved eating disorder treatment and prevention over the last 20 years.. But there is much more we need to learn about the causes and treatments of eating disorders. Unfortunately, the funding for eating disorder research is inadequate.

Advocacy groups throughout the U.S. are working hard to educate legislators and funding agencies about the seriousness of eating disorders so funding dollars can be directed to support further eating disorder research.

CS: At the beginning of Gaining, you encourage anyone suffering from an ED to seek professional help. What would you suggest that someone do if he or she can’t afford treatment? Even with health insurance, programs I’ve found still cost more than what I can possibly pay. I want help, but don’t think I can get it.

AL:  This is a difficult question, as many treatment programs are intimidatingly expensive.  But I have found professionals in this field to be generous and caring, and I would urge you to contact those that seem right for you, regardless of cost, and see what provisions they have for aid or referral.  You can begin your research on the web at The Eating Disorder Referral and Information Center (http://www.edreferral.com/).  I have listed additional sites and resources on my new website http://www.gainingthetruth.com/.  Below, Judith offers more extensive and specific advice.

JB: Inadequate health insurance coverage for the treatment of eating disorders is frequently an obstacle for many individuals and their families to getting the help they need. There is an active health care advocacy movement within the eating disorder community that seeks to bring eating disorders the same health care coverage as other major medical illnesses.

Many individual practitioners and outpatient programs will offer sliding fee scales. Some university settings offer affordable treatment with graduate student interns or through student health services. Some university-based programs conduct research trials which provide free treatment in exchange for participation in a research project.  The best advice I can offer is not to give up. The resource network for eating disorder treatment is vast. Keep searching and making contacts. Ask friends and family to search too. Affordable treatment is often available-but it can take an extensive hunt to find it.

Please watch for the next installment in our four part series with Aimee Liu and Judith Banker- Next Friday, August 31st.