Having And Eating Your Cake

Posted on by ncfed

The desire for two mutually exclusive events bedevils eating disorder treatment. You see it in someone with anorexia who wants to get rid of the effects of starving but remain very thin. You see it in someone who wants to get rid of bulimia but eat very little to become their perfect weight.

Eating disorder symptoms are cravings, binge eating, purging, tiredness, panic, depression, fainting, getting the shakes, anxiety, obsessions and crazy destructive moods. Many of these symptoms are the result of dietary chaos and its effects on the brain and the nervous system.

There is no way out of an eating disorder unless someone is willing to eat a balanced highly nutritional diet for a while even if they are still purging. This will include carbs and it will include some fat.  This must be done with guidance and support because it is NOT just healthy eating. Then, surprisingly, many of these symptoms will calm down, allowing the real emotional strengthening to take place where it is needed.

But eating is often the thing most feared. They say to me, I want you to stop me bingeing, perhaps with hypnosis or discussing my unhappy childhood. I don’t want to eat, because I want to lose some weight (or stay at the weight I am now).

In my very long experience, people with compulsive eating problems and bulimia often lose weight after treatment. But there is no way around it for the anorexia sufferer. Remaining thin will feel safe, but  will keep you demented. If someone doesn’t get what they really want, it is because they are bargaining with the price.

For some people with eating disorders, the price of recovery is too high. Eating is worse than murder. We have to be so patient, and so able to help someone to see that we cannot have our cake, and eat it too.

 

 

 

 

Does Anorexia Ever Really Go?

Posted on by ncfed

In the Times way back in August 2013 Lizzie Porter wrote movingly about the after-effects of the illness, which are still with her.

In her book about Anorexia, Emma Woolf also writes movingly about her struggle to get well. Despite being able to move away from the cachexia of severe anorexia, she documents in her column An Apple A Day how residual anorexic thinking prevents her from being able to eat cheese. Her recovery  is conditional upon maintaining an orthorexic relationship with food.

I was, oh so briefly anorexic  years ago, and now I eat a very broad diet. Only yesterday  I dug happily into  a meringue made by one of my friends. I stir fry quite a lot of food. I have butter on my jackets.  But I do eat more healthfully and in smaller quantities than most of my friends.  Even now, after all these years,  you won’t see me tucking into the canapes at parties. I drink very little alcohol and rarely want  dessert, only ice cream, perhaps one boule.  I eat cheese although dainty little chunks. I’m not very interested in food.  Am I just looking after my health, or, does anorexia ever really go?

Lizzie Porter’s account of her 10 year struggle with anorexia needs to be read by all eating disorder professionals who feel stuck after working with a young patient for 2 or 3 or even 10 years.  While it is clearly a mental disorder, the manipulation of food has very physical effects. Perhaps the physical effects of eating trump the emotional ones and make it easier for someone to become or stay anorexic rather than  depressed or psychotic. Lizzie writes about all the medicines she has to take to manage indigestion, cramping,  bloating and nausea. Is this an effect of the anorexia or did it make the anorexia happen?

In my case for example, from as early as I can remember, I couldn’t eat large platefuls of food. The usual party food loved by kids made me queasy when I was very young.  I was only interested to eat fish and chips when I went out.  I only wanted to drink milk or bitter lemon. I couldn’t stomach biscuits or coloured ice creams. Unlike other kids, I was not interested in food. My tummy is very unhappy if I eat a lot of fat or drink more than half a glass of wine. That was there before I had any concerns about weight.

Lizzie says that the anorexia is still with her long after therapists think her treatment is done. Until recently she says, the idea of sex was repulsive but she seems to have dragged herself out of that. What an effort everything is for her, although outwardly she seems to be successful, she is still secretly weighing food and scheduling her day around mealtimes.  She wishes to be free of the fears  of food and its effects  like occasional dizzy spells while and enjoys being thin.

I would say to Lizzie that anorexia never really goes, but as one gets older, one becomes more forgiving.  We learn to be “anorexic” and also well. We can learn to live without thinking about food at all. We can have fat moments and fat days and give them no attention at all.

So to therapists who agonise about the extent to which someone is stuck with their anorexia I would say this. If the patient is bulimic, they need constant care since they are those most likely to be very, very sick.  But if  your patient is safe and functioning reasonably well, endless therapy probably isn’t going to do much at all other than provide the illusion that something is being done.  Anorexia isn’t a quick fix, a life sentence or something that has to be chewed on by well meaning therapists until someone is maintaining a totally normal weight .

Many therapists might disagree with me and argue in favour of treatments that represent a complete cure. This is ideal, but is it possible if anorexia doesn’t really ever go?  I’ve met some eating disorder experts running well known treatment services who are still extremely thin.  YES,  YOU KNOW WHO YOU ARE…. They argue in favour of health. But has their anorexia ever really gone?

Obesity Experts For Sale To VLCD?

Posted on by ncfed

Today I found myself arguing with the NICE co-ordination team who are on the verge of recommending VLCD liquid diets for Obese Type 2 diabetics.

VLCD diets are associated with addictive behaviours, long term weight loss failure and severe binge eating, which can make people even more  unhealthy. Of course they “work” in the short run, as does anything.  Is it any surprise that some of the expert obesity specialists who endorse diet systems and who “do the research” are in the pay of these commercial operations?

In 2010 it was reported that Susan Jebb, obesity expert, is being paid by Rosemary Conley and Weight Watchers presumably to lobby on their behalf. Or something else. Just about all commercial weight loss enterprises have their expert obesity academic on their letterhead.to confer “authority” on their products. Do you think that such organisations should be compelled to disclose what they pay and to whom? Shame on the academics for taking the “kings silver” and for not having the courage to say that everything works for someone, that long term outcomes are pretty much the same for everything, and for not being able to admit which enterprises are causing harm.

I should know about harm – I pick up the pieces. On behalf of the overweight and ill, it is naughty.

Business Women Needed For Body Image Project

Posted on by ncfed

Successful women wanted with disordered eating and body image concerns

 Are you a successful business woman who has/or had issues with disordered eating and body image? Would you be prepared to speak confidentially for 15 minutes about your experiences? If the answer is YES, then please read on.

 Harriet (Specialist Therapist in Disordered Eating and Body Image Issues) is currently expanding her Service to support women like you. She is keen to hear your views and experiences and how (if at all) you cope and if you have accessed support.

 If you would like to help with this research, please get in touch with Harriet on 07779 940326 or harriet.frew@gmail.com. Please be assured that all contact will be confidential. If you would prefer, you do not need to use your real name.

Thanks in advance for your support of this project.

An Open Letter To Rebecca Adlington About Appearance Bullies

Posted on by ncfed

 

Dear Rebecca,

I note that you have been very insecure about showing your body in the presence of some beauty queen called Wilmington. I also note that you have been abused by people who have made comments about your body.

I’ve been working with eating disorders and body image issues for many years; over  these years I have seen a horrific rise in bullying  generally. Bullies tend to do their thing in secret but social media like Facebook or Twitter have made it easy for people to be poisonous and obscene without having to bear the consequences. It would seem like there is a sea of sad, pathetic people out there who are nobodies in their own lives and who get pleasure in ruining the lives of people who are better than them. They tried to pull down the young diver Tom Daley and they are trying to pull you down as well. They don’t do it because there is anything wrong with your body, they do it because they haven’t got what you have and they hate you for it.

In the range of people I respect and admire, beauty queens come way down the pecking order, in fact I don’t rate them at all. Not Beckham nor Moss nor whoever Delevinge.  Even so, even after all these years  of wisdom, I don’t think I could cope with reading evil things about myself.

You are a champion and a star.  Please don’t cry about your body.  It did what you wanted it to do, which was to swim like a dolphin and make your country proud of you. Can some wise person  please help you to  stop using Twitter and needing to reply to the idiots who are writing about you?  Why are you giving them this power?

Daniel Radcliffe isn’t on Facebook or on Twitter. You needn’t be either. You will miss out on absolutely NOTHING worth knowing and you will start to take back your power bit by bit.  There is life without Twitter; some of us have realised that it is just a massive waste of time.

No one smiles when they look at a skinny body (do they really?)  We can never have a perfect body  and we can never have a body like someone else’s. But some of us die trying. Rebecca, dry your tears and if you have body image issues because of your spell in the limelight get some help and learn how to celebrate the skin you are in. Because I love the way you look, I rate what you have done, and so do many, many people who don’t waste their time being an Appearance Bully.

Anorexia In Children NOT Increasing?

Posted on by ncfed

Some people who have an interest in shock horror headlines (why?) have made a big deal about a so-called increase in eating disorders in young children.

I’ve always  hesitated to agree with all the hype and panic.

Lets look at the evidence. On 31st July the Sunday Telegraph ran the headline “Hundreds of preteen children treated for eating disorders….. including 197 children between the ages of five and nine, with cases within this age group almost doubling over the period.”

How do journalists get this information? Its easy and cheap. and often relies on reporting cards filled in by consultants to monitor rare conditions (2011;198:295-301). So is health information like this, obtained by freedom of information requests, accurate and useful?

Rachel Bryant-Waugh (consultant clinical psychologist /joint head of the feeding and eating disorders service at Great Ormond Street Hospital in London) said, “I think that there is a fundamental difficulty in confusing terms: it’s easy to see how these things get a bit muddled, and it then comes across in a way that is slightly misleading. It is very unlikely indeed that 5-7 year olds present with anorexia nervosa. … But they may have low weight and significant eating difficulties for many other reasons – for example, illness, gastrointestinal problems …..or a range of psychological factors. Such children might present with eating difficulties as the main problem, but they do not have anorexia or bulimia “.

So, when journalists use the Freedom of Information Act to ask for the numbers of children with “eating disorders”, they are not being specific enough to enable concrete conclusions. Waugh says…”Eating is a very complex behaviour in terms of all the processes required: many specialities care for children with eating problems. Formal eating disorders – that is, anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS) – are relatively rare in young children. However, they may be increasing in middle childhood. But the lack of consistent terminology means that there is a large difficulty in drawing conclusions here.” 

Mark Berelowitz, consultant child and adolescent psychiatrist at the Royal Free in London agrees. “The DSM puts eating disorders into two categories, one is eating disorders-anorexia, bulimia, EDNOS.  The other is feeding and eating disorders of infancy and early childhood. Its not clear that information given to journalists related to anorexia nervosa or the vast number of other conditions much more common in young children, like failure to thrive and other problems. 

The other thing is that with the best will in the world its hard to produce good data quickly during the summer holidays and in a short time scale: and ordinarily need to be scrutinised carefully before they’re submitted, and I would have been astonished if any trust would have high quality data at its fingertips”.

Of the apparent rise in anorexia diagnoses in the very young he said, “When you come across this seeming threefold rise you have to ask yourself how good are the data: if you project the rate forward you would get an absurd number”. 

It seems that journalists aren’t asking the right questions and the NHS Trusts are not giving accurate answers. “The data they got was from ALL FEEDING DISORDERS, and then in the press this was expressed effectively as anorexia nervosa. I suspect that if the Sunday Telegraph had asked the Royal College of Paediatrics and Child Health or any specific clinical service how many patients had these disorders in these young age groups we’d have very different numbers.”

So lets not alarm parents and doctors and lets not tar all children with funny eating issues with the same brush. It makes Good Press but it is…. LIES

Alcohol And Diets

Posted on by ncfed

Alcohol Ruins Dieting Efforts for 1 in 4 persons according to research into the dieting efforts of 1000 people by Forza Supplements in 2013 .

We already knew this, but the research makes worrying reading. Alcohol shows effects on willpower, wishes to indulge and impulsivity. It’s calorific too, and very few calorie conscious people calculate how much energy is in a tipple. A moderate drinker can ingest up to nearly 1000 calories in a gentle night out.

Alcohol is known to increase appetite due to its effects on leptin (which is suppressed) leaving the brain ignorant of whether a person has eaten enough or not. As few as two standard drinks can slow down the ability to burn fatty acids by up to 73%.

Alcohol compromises the liver which recognises alcohol as a toxin. As the liver works to get rid of the toxins in alcohol,  it favours the burning of empty calories in the sugar. When those calories are used up, more may not be needed; leaving the calories from more nutritious food to be laid down as fat.
A drink, anyone?

We Need You For Research Please: Eating Problems & / Or Self Harm

Posted on by ncfed

Are you 18 years old or over, with an eating disorder and with or without self harm?  We need your help.

I am looking at the reasons why some people have difficulties with impulsive behaviours, such as self-harm and what their feelings are around food. This study  aims to look at how people pick up on what others are thinking and feeling, as well as how people think about their own thoughts and feelings. Greater knowledge in  this area will help in designing better psychological therapies for people who have impulsive behaviours or strong feelings they find it difficult to deal with.

Eating disorders and impulsive behaviours represent two very common, but under-researched areas. I want to focus especially on people who present with difficulties
around food, as well as difficulties around self-harm so I can see how things like
understanding other’s feelings impact on their capacity to engage in
therapy.

I am attaching the link for the survey. The participants information is all in the link and
comes up by clicking on the relevant words.

https://cityunilondon.eu.qualtrics.com/jfe/form/SV_9sOL7WgeajExeGF?Q_JFE=qdg

We would love to hear from you. You will be helping us to help other people. Thank you.

I Would Not Eat With You

Posted on by ncfed

Someone said that they would not (be able to) eat with me, when I wrote a blog on behalf of carers. So I have written a reply because it has been on my mind. Yes YOU I do take notice of what you write to me!

http://deannetalks.blogspot.co.uk/2013/10/i-wouldnt-eat-with-you.html?spref=tw

Have a look and feel free to let me know what you think. When you become a carer you learn what loneliness means. When you are the one with the eating disorder you discover a new and very lonely world. The eating disorder won’t go away by itself. It takes a lot of courage to fight it. It isn’t good company for anyone.

I really hope that we can help you, even if it is just one baby step at a time.

Eat Butter Eat Butter Eat Butter – Yay!

Posted on by ncfed

There’s growing evidence that our favourite fat can not only be good for us, it also wont make us fat in moderation says one of my favourite nutrition experts, Dr John Briffa.

For years and years we have had the illusion that all foods can be measured in calories and all calories are the same. We have bought the story that all fat is dangerous and rush like lemmings to buy skimmed or semi skimmed milk, fat reduced sludge that we call margarine,  and low fat everything.

I’m not going to replicate all the physiological arguments here, but the body doesn’t work like that. We have been sold many pups by people who are interested in making money out of our fears. We buy strange yoghurts with plant stanols in our fear to reduce cholesterol and we buy fat-reduced chocolate biscuits and low-fat crisps that taste like cardboard. Fat-reduced biscuits? Who are these people really kidding!

In addition to being made fearful of fats, we are also fearful of particular kinds of fat. Saturated types of fat like butter is supposed to be bad for our waistline and our hearts.  We don’t even know that the second most plentiful fat in butter is unsaturated, which is supposed to be good for us like nuts and seeds and cold pressed olive oil.

But does butter make us fat? Strangely there isn’t much good evidence. Taking fat out of food and milk can make it higher in sugars, which is associated with weight gain. Adding butter to your diet might be good for your brain, make you happier and reduce your cravings for sugar.

So next time your hand hovers over the full cream milk and your eyes wander over the butter in Tesco, let yourself buy it. Full cream milk is a low fat food which will keep your blood sugar stable and light your inner fire. Butter tastes nice, won’t make you fat and is good for your heart.

People with eating disorders and weight problems have become terrified of fat. It’s often the first thing that gets ditched with the dieting.  We need to eat fats and we needn’t be scared of butter. Follow the informed arguments, not the advice of people who want to make money out of your fears. I’ve started eating toast with butter and drinking full fat milk again, and it makes me very, very happy that I can, without fear.