Wednesday, February 29, 2012

An Illness, Not an Act: Eating Disorder Sufferers Need Treatment

by Staff of Rogers Memorial Hospital

When Christina Ricci revealed her history of anorexia on a talk show last month, she became the latest public face of a devastating disorder that all too often claims its victims in private. On the Jan. 20 episode of The Talk, the Pan Am actress, now 31, said she suffered from anorexia nervosa for a year and a half when she was a teenager. Like too many other women and girls, as well as men and boys, she had become obsessed with the unrealistic beauty standards of her industry and starved herself in a vain attempt to achieve them.

Thankfully, through therapy, Ricci was able to conquer her eating disorder and resume living a healthy and happy life, as well as continuing the successful career she could have lost. She now cautions others who might be experiencing similar feelings of obsession to seek help before they lose control and succumb to an eating disorder.

Everybody Knows Somebody
Although millions of people know Ricci from her work in television and film, millions more know someone personally with an eating disorder, possibly even themselves. Few of these sufferers admit their disorder as publicly as Ricci – and too many of them fail to admit the problem to anyone until it’s too late – but they all need the same care and compassion in conquering their disorder that Ricci received. No matter who they are, or what age, those suffering from eating disorders such as anorexia, bulimia and binge eating do not need to suffer in silence. 

And they are not alone. In fact, “Everybody Knows Somebody” with an eating disorder, according to the National Eating Disorders Association, which sponsors an annual National Eating Disorders Awareness Week. The goal of Everybody Knows Somebody Week, which runs this year from Feb. 26 through March 3, is to find help for the 10 million women and 1 million men in the United States battling anorexia and bulimia – plus the millions more who suffer from a binge-eating disorder – and also to educate their families and friends.

Although NEDA, doctors, therapists, healthcare professionals, concerned family members and friends work tirelessly all year to inform people about eating disorders and offer support, myths and misinformation persist. Everybody knows somebody with an eating disorder; however, not everybody knows the underlying reasons for these disorders or how best to treat them.

A Mental Illness, Not a Choice
It is important to understand that an eating disorder is not a fad or lifestyle choice, but rather a mental illness with serious, potentially life-threatening consequences. With anorexia, the symptoms include abnormally slow heart rate and low blood pressure; reduction of bone density; muscle loss and weakness; severe dehydration; fainting, fatigue and overall weakness; dry hair and skin, and even hair loss. Bulimia can lead to irregular heartbeats, gastric rupture, tooth decay and staining, chronic irregular bowel movements and constipation, peptic ulcers and pancreatitis. Binge eating can result in high blood pressure, high cholesterol levels, heart disease and gallbladder disease. The common thread in all these disorders is that all require treatment.

Although an eating disorder may involve a preoccupation with food, weight, calories or exercise, it is also about something more deep-seated, from a need for control to a need to be accepted and loved. The underlying biological, psychological and sociological causes of an eating disorder need to be identified and addressed for successful treatment.

Eating disorders are too complex to be generalized or oversimplified, and the causes and symptoms are not always identical from one sufferer to the next. Although it would be easy to blame the entertainment and fashion industries for perpetuating a thin, unrealistic body type as an ideal, aspirational standard, they are not alone in perpetuating the conditions that result in an eating disorder.

Low self-esteem, depression, anxiety, substance abuse, genetics, influences from family and peer groups, and numerous other factors can all contribute to an individual’s obsession with weight or appearance. How a person manifests an eating disorder can also vary widely, including starving, inducing vomiting and exercising beyond the point of exhaustion.

Perhaps the biggest misconception of all is that only women suffer from eating disorders; in actuality, more than 10 percent of all cases are men. Like women, men of all ages are confronted with unattainable body images in the culture, and they, too, can experience any number of physical, emotional and social issues than can manifest in a disorder. 

Help Is Available
As Ricci’s story illustrates, the millions of people suffering from anorexia, bulimia or a binge-eating disorder should seek professional help to conquer their disorders. Fortunately, NEDA and its partner facilities offer a wide array of proven, evidence-based treatment services to sufferers and their families to fight these disorders before it’s too late. These services include inpatient care, therapy sessions, support groups, and nutritional and medical monitoring for women and men.

At a NEDA facility such as Rogers Memorial Hospital in Oconomowoc, Wis. – the first provider in the nation to offer exclusive eating disorders treatment for men and boys – the goal of the treatment is threefold:
1. Nutritional Stability: This is the first priority in treatment. The goal is for patients to achieve abstinence from cycles of binge eating and purging and other eating disordered behaviors, as well as restoring and maintaining a healthy body weight. 
2. Changes in Thinking: Through group therapy sessions, patients identify and correct errors in thinking, such as body image distortions, perfectionism or a drive for thinness. Changes in thinking patterns and habits are necessary to maintain nutritional improvements.
3. Obstacles to Recovery: Patients identify ways to overcome barriers and build confidence using newly acquired coping and self-care skills. Eating disorder symptoms can be more severe for those struggling with a co-occurring anxiety illness like obsessive-compulsive disorder.

From Hollywood to the Heartland, anyone with an eating disorder needs everyone’s help to defeat it. If you think you might have an eating disorder, or if you know someone who does, please contact the Eating Disorder Center at Rogers Memorial Hospital at 800-767-4411, or visit

Last reviewed: By Jacquelyn Ekern, MS, LPC on 8 February, 2012
Published on

Tuesday, February 28, 2012

The Object of Comfort: a Butterflies Process is a Journey

Dr. Deborah A Russo
Clinical Psychologist
Remuda Ranch Treatment Programs

As a mom of toddler twins and a five year old, emotional ups and downs are a daily reality.   When my last minute nerves are just about fried, I take a deep breath and remind myself that I am a mirror for them.  My own emotional regulation affects theirs.  When I talk slowly and calmly, I notice they calm as well.  Sometimes they calm in a moment, other times longer as they work it out within themselves, and we figure out together what they need.  

Each child has his or her their own unique way of dealing with their emotional and relational world.  One recovers quickly from upset; one will discharge into humor, and the other holds on to things like they just stick to him.  Deep thinking and sensitive, he has been this way since I can remember seeing his personality at 4 months old.  My children soothe differently as well.  One reaches for a worn teddy bear, one a sock monkey, and the other a silky blue blanket. One wants a hug to help ground himself, and another needs a few minutes alone. 

My precious children make me think about the precious young people I work with as they make their way to find their needed soothing objects to healthfully cope with aching hearts and souls.  I remember one story in particular of a young woman as she  worked hard in coming to terms with letting go of her eating disorder, grieving,  finding the pieces to the puzzle  of her trauma background and bringing words to the reasons for her pain and anguish.  She also struggled with cutting. Since she was a teenager she recalled being unable to soothe herself, to redirect her mind in another way.  It was her object of comfort. 

In therapy, she worked hard to first reduce self harming, and then succeeded to completely stopping with only few weekly thoughts that she was able to manage with healthy tools.  She opened her world to loving people and to self love.   But, she was still afraid to let go of the self harm object that she had by her side for years.   She said that she kept it in her back pack.  What else do you have in that bag?, I asked.    Anything else that is comforting?  Well not really, books, stuff for school, she said.

We talked about the power she gave to that object- its’ presence was an illusion of safety.
I know now it is not helpful to me, she reflected.   But, there is still somehow comfort.  I understood better than ever before as she spoke.  If I let it go, really let it go, it is like a relationship.  One that seems to help me survive, but actually keeps me from all my possibilities.

We talked about what she could add to her backpack that would be comforting. She needed a replacement to symbolize the true comfort that a consistent, loving and non judgmental relationship could bring.  I thought about the numbers of times per week one of my children cries.. Boo hoo, mommy, Ouchy! – as they run over to show me their wounds.  There is no blood, no visible wound for me to know for sure if they need first aid.  I know that a mommy’s kiss helps mend that moment of anxiety or fear or just that need for touch, love, reassurance, or distraction.  This young woman never had that.  She could not recall one memory, or one moment of being held or protected.  
Band-Aids, how about Band-Aids?, I said.  Would you be willing to add them into your backpack?  Let’s talk about some other things that would help you….,

She began to talk about all the ways she felt like people cared. We reviewed her lifeline of memories of true support.  First was when a friend realized that she was self harming and was concerned, but did not judge her.…. It was when someone noticed what I needed, she said.    I replied, So if someone notices that you carry this harming object, would they see what you needed for yourself through their concern?

Now was the point of contemplation of letting go of that security blanket ….    What would it be like to walk free of the object you depended on for all those years?   All it represented?    Would you have to lose those meaningful things as well?   

We addressed what it is like to see herself letting go of this, putting other things in her back pack to replace it. I have something!   I see it!  I can visualize it! she said.  A friend gave me a Butterfly – I sometimes hold it at night, it is soft and squishy.   The colors always remind me of warmth and hope. 

A butterfly is delicate and powerful at the same time and it must come out of its cocoon when it is time, no sooner.  The butterfly was given by someone who understands her and never judged her...  You are  like the butterfly and it is more then the butterfly, but what it represents to you, the persons who gets you, comforts you and cares for you …     Yes, that is protection to me, she said. I can carry a Band-Aid. I like that, it makes sense to me.   We smiled together.

Many individuals struggle with the battle against an eating disorder, and self harming behaviors.  If you struggle as well, you are not alone and deserve to find the help you need.  Seek counsel and open yourself up to taking the risk of letting others in.   With the support you need, learn about why you self harm and why you suffer.  

Letting go of old things, bad relationships or old behaviors to provide the feeling of security is a multi leveled process.   It isn’t human nature to let go of all our old security blankets at once.  In our humanness we may hold on to things for years…..   Like fingers hanging on to a cliff, holding on for dear life and fear of the fall.   But you must figure, what are all those things you may hold on to that don’t really serve you in the long run….  Will they get you to where you want to be in life?   Will they help you achieve your dreams?

We all want to feel in control, and many people suffer with painful thoughts, memories and emotions.  We all feel vulnerable.  Letting go is a process, grieving is also.  Moving on is a gift and a challenge.   It can be scary… whether it is the silky blue blanket, or another object of comfort, it is a journey.  Have you read the Lessons of a Butterfly?, I asked her.  Read it and think of the metaphors for you.  

No one can make your decision how, when and what to challenge and change but you.  However, you do need others to help you figure out how to fly.  

Please Note:  The information contained in this article is intended to provide readers with helpful information and inspiration.  The story has been adjusted to honor and protect confidential details of all individuals. This article is not to be used to diagnose or treat.  Consult licensed medical, and or mental health professionals for assistance.


Last reviewed: By Jacquelyn Ekern, MS, LPC on 7 Feb, 2012
Published on

Monday, February 27, 2012

We All Know Somebody But Is There More To The Story?

by Staff of Timberline Knolls Residential Treatment Center

You are 17 years old … your best friend is a brilliant student, but due to financial difficulties in the family, must get a full scholarship to a good school or she won’t be able to attend college. You notice she is getting very thin, never eats lunch with you anymore, and always seems distracted and agitated. You ask her if she is okay; she says everything is fine.  She has changed.  

You are a sophomore in college …your roommate has taken health and fitness to a whole new level.  She gets up at 4 a.m. to run for two hours before her first class; she spends afternoons working out in the gym. Although she always wears a knee brace due to pain, she never stops running. You never talk or laugh together anymore. She has changed.

You married into a tight-knit family …you are very fond of your sister-in-law who has a bit of a rocky marriage and very stressful job. At family get-togethers, she always heads for the bathroom immediately after eating. Lately, she spends a lot of time alone; you see her less and less. She has changed. 

Whether it’s a case of disordered eating or full-blown anorexia, bulimia or binge eating, it’s likely that everybody does know somebody with an eating disorder.  But, here is what everybody is less likely to know about their “somebody”: this woman or girl probably has more than one addiction or disorder or is suffering from some type of trauma. The high school senior is taking diet pills to stay thin and help her study; the college student was raped the previous summer; the sister-in-law suffers from such crippling depression she is afraid one day she will not be able to get out of bed, she will lose her job and her husband will leave her.

Those in the behavioral health field know it is rare, indeed, for woman or girl to only struggle with an eating disorder; frequently, she will have a co-occurring disorder such as substance abuse, trauma, or a mood disorder.
What are Co-occurring Disorders?


Unfortunately, trauma and traumatic experiences are nothing new to the human condition.  Whether a child is sexually violated early in life, or an adult experiences a horrific car accident, such trauma can and often does have profound and long-term consequences.  Ever increasingly, research indicates a connection between trauma and eating disorders.  Further, the type of trauma plays a role in whether the individual eventually presents with anorexia or bulimia.  Although variations certainly occur, trauma of a catastrophic nature such as severe physical abuse, rape or extreme injury is more likely to be associated with bulimia. Conversely, lesser trauma such as childhood neglect, being bullied or teased, or experiencing alcoholism in the family is often associated with anorexia.  In each instance, the eating disorder behavior allows the individual to suppress unpleasant emotions related to traumatic experience, to have a sense of control over her emotions and to disassociate from the trauma itself. 
Substance Abuse

Up to 35% of alcohol or illicit drug abusers have eating disorders compared to only 3% of the general population. Similarly, up to 50% of those with eating disorders have a simultaneous problem with drug or alcohol abuse. It is fairly easy to imagine why a woman or girl with an eating disorder would abuse drugs. If the goal is to be skinny, those with anorexia often become dependent on caffeine, nicotine, diet pills and stimulants such as Adderall to suppress  appetite or speed up metabolism. In time, women and girls may graduate to cocaine, meth and even crack. Similarly, those with bulimia often abuse diuretics, stimulants and laxatives for purging purposes.   
Yet, the connection between these two runs deeper.  At the very heart of the disease, eating disorders are about coping with stress, painful emotions or unpleasant thoughts; drugs and alcohol are often utilized to achieve the same effect. When a woman or girl is high or drunk, her emotional pain is numbed and she might not be as sad, lonely, anxious or depressed. In other words, the function of what both the eating disorder and substance abuse can do for these individuals is similar.
Mood Disorders

Mood disorders encompass a wide range of issues including major depression, severe anxiety, post-traumatic stress disorder, bipolar disorder, obsessive compulsive disorder and/or a personality disorder.  It is not uncommon for an individual with anorexia, bulimia or binge eating disorder to also have a mood disorder, particularly depression or anxiety.  In fact, studies indicate a significant connection between mood disorders and eating disorders in families.


Once a diagnosis of an eating disorder is made, it is extremely important to identify additional co-occurring disorders. Knowing all that a woman or girl is struggling with is critical when it comes to treatment. Although outpatient therapy is frequently the first step, if significant strides are not apparent, treatment can progress to residential care.  Many programs focus exclusively on the eating disorder. At Timberline Knolls Residential Treatment Center, all disorders and addictions are addressed simultaneously through an integrated treatment approach. Utilizing dialectical behavior therapy (DBT) in combination with 12-step principles has proven highly effective in treating those with multiple diagnoses.     


The most important thing for everyone to know is that recovery is entirely possible.  Moreover, the earlier treatment is sought for any disorder or addiction, the better the chance for a complete and lasting recovery.

National Center on Addiction and Substance Abuse (CASA) at Columbia University. (2003).Food for Thought: Substance Abuse and Eating Disorders. New York, National Center on Addiction and Substance Abuse.

Last reviewed: By Jacquelyn Ekern, MS, LPC on 8 February, 2012
Published on

Sunday, February 26, 2012

Check out the new Oliver-Pyatt Centers Feature Page in the Eating Disorder Specialist Library

One of the finest treatment centers in the country is featured in our Eating Disorder Specialist Library.  Oliver-Pyatt Centers offers highly customized care in an multidisciplinary team environment.  This beautiful treatment center offers daily individualized therapy, personalized care with low staff to client ratios, and ongoing aftercare to support long term recovery.

Friday, February 24, 2012

Book Drawing in Celebration of NEDAwareness Week!

In celebration of the upcoming NEDAwareness Week, Eating Disorder Hope is offering the chance to win a free book by author Jenni Schaefer (Goodbye Ed, Hello Me) or Cheryl Kerrigan (Telling ED NO!).  


In honor of the theme for NEDAwareness Week, "Everybody knows Someboy", how can YOU do just one thing to promote awareness of Eating Disorders today?

Leave your response in a comment below for an automatic entry in our book drawing for one of these books! 


(McGraw-Hill) by Jenni Schaefer
Don't Battle an Eating Disorder Forever-Recover from It Completely
Jenni Schaefer and Ed (eating disorder) are no longer on speaking terms, not even in her most difficult moments. In her bestseller, Life Without Ed, Jenni learned to treat her eating disorder as a relationship, not a condition - enabling her to break up with Ed.
In Goodbye Ed, Hello Me Jenni shows you that being fully recovered is not just about breaking free from destructive behaviors with food and having a healthy relationship with your body; it also means finding joy and peace in your life.
Combining Jenni's signature personal advice and unfailing encouragement along with valuable exercises you can do as you read, Goodbye Ed, Hello Me will give you the prescriptive tools to take the final steps in divorcing your Ed completely.
Lynn Grefe, CEO of the National Eating Disorders Association, says, "Jenni may someday be named the trend-setter for the miraculous word "recovered.'"

Telling ED NO! and Other Practical Tools to Conquer Your Eating Disorder and Find Freedom

by Cheryl Kerrigan
 With more than 100 practical tools to help you conquer your eating disorder and find freedom, Telling ED NO! is a unique, accessible survivor's guide.
 Held captive by her eating disorder (ED) for more than two decades, Cheryl experienced an entire childhood, adolescence, and much of her adulthood from the perspective of a tortured prisoner until she found the strength and support to break free. Based on the author's own incredible story, Telling ED NO! brings the recovery process to life. Using inspiring real-life stories and candid straight-talk, Cheryl presents over 100 practical recovery tools as well as exercises and questions designed to encourage journaling and discussion that will help you navigate your path to recovery.