ChickSpeak

 Continued from last week, our second installment of our Q&A with Eating Disorder Experts, Aimee Liu, accomplished author, and Judith Banker, President-Elect of the Academy for Eating Disorders.

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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

1. My roommate has an eating disorder. I think she’s bulimic, but I’m not sure. She also makes negative comments about herself and her body constantly, to the point that I just want to stay away from her sometimes because I can feel it wearing me down. I don’t know what to do to help her and don’t want to make my living situation any more uncomfortable. What should I do?

AL: I’m asked similar questions all the time by concerned friends and family members.  A close friend of mine recently arranged an intervention by the dean of students when her friend - a male - developed exercise anorexia.  Another teamed up with her father to get her sister out of school and into treatment.  I mention these examples in order to persuade you that you should not shoulder this problem alone.  Do confront your roommate, but make sure you express your concerns for her rather than accusing her.  Encourage her to consult your campus counselor, student health services, or dean’s office.  If she denies the problem, consult them yourself.  Enlist other mutual friends who care for her to show that they do care, not about how she looks but about how she feels and about the distress that underlies her self-punishment.  Isolation fuels eating disorders, and social support is vital in fighting them.  But make sure you have plenty of support for yourself, too.  It won’t help you or her to “go it alone.”   Read on for Judith’s astute advice…

JB: This is a difficult situation but, unfortunately, not uncommon. Negative body image  and disordered eating behaviors and attitudes can be contagious, particularly in schools, sororities, dormitories, and other environments where girls and women spend extended periods of time in close contact.  These environments literally become toxic. Your roommate’s negative comments about herself and her body are damaging to both of you so I understand and support your desire to do something about the situation.

It is important that you talk with your roommate about your concern for her and about how her comments and behavior are affecting you. There are some steps to take before you have this conversation however. First, decide what it is you hope to accomplish by talking with your roommate. For example:  Do you want her to seek treatment? Do you want her to stop the self-critical remarks? Do you want her to agree to talk with a resident director with you to resolve the issues you are having? Next, be honest with her about your concern for her and about how you are affected by her actions. Be compassionate but clear about what you feel and what you would like to have happen.

This conversation may simply be a first step. Confronting a friend about such a serious subject can be difficult.  Just remember a satisfactory resolution can take time. Don’t hesitate to seek support for yourself. Talk to your parents, or consult a counselor at your school or an eating disorder treatment specialist to help you navigate this situation. 

2. You say that the first step to recovery is to admit that you have a problem. This is in line with recovery programs such as Alcoholics Anonymous and Over eaters Anonymous. I’ve read recently that people with bulimia can benefit from following the OA program. Do you think there is any merit to this?

AL:  Twelve-step programs can provide positive support and do encourage self-transcendence, an important element of recovery.  I’ve met many people who have benefited from OA while battling compulsive or binge eating or bulimia. However, many others have told me that these programs can do more harm than good, depending on the composition of the group and one’s own specific circumstances.  If you are underweight, for instance, it can be extremely triggering to enter a group that is mostly overweight.  Even when the group is all struggling with the same problem, such as bingeing and purging, the exchange of experiences and “methods” can be triggering.  Some people report that they actually learn how to binge and purge “better” in 12-step groups! Except for those held within hospitals or organized treatment programs, these groups generally are unsupervised and so are only as helpful as the individuals who attend.

JB: Substance use disorders (SUD) are more strongly associated with bulimia nervosa than anorexia nervosa but the complex nature of the neurobiological factors underlying bulimia nervosa and substance use is not known. Therefore, the question as to whether or not bulimia is an addiction process has not been answered. That being said, programs that treat eating disorders and accompanying SUDs commonly incorporate Alcoholics Anonymous meetings. For someone in recovery from bulimia who has an accompanying SUD, the familiarity of the 12-step model and the ready availability of OA groups in most communities can provide an important source of ongoing support.

Stay tuned for the next installment in one week.