Sunday, February 03, 2013

Eating Disorder Awareness

Today, February 3,  2013 is the start of Eating Disorder Awareness Week here in Canada. The US version of this annual event begins February 24. So this seems like a good time to delve into the topic on my blog.

For the past three years my primary occupation has been counselling and group facilitation  in a community based ED treatment program with adult women and men. With the support of an amazing agency and management team and together with passionate and brilliant colleagues,  I've had the unique opportunity of helping to imagine and create this program from scratch.   Prior to that, I spent 17 years working with teen girls, mostly as a counsellor and sometimes in other roles.  It was inevitable that I worked with body image issues, weight preoccupation and disordered eating throughout my career... these issues are far too common among adolescent girls. I also spent five years coordinating a prevention program that involved training volunteers to do body image workshops in schools.

With this history, some might see me as an expert in this field. While I learn new things every day,  I agree that I am more aware than the average person when it comes to eating disorders. I am aware of the symptoms and the potential outcomes. I know first hand the distress and despair that eating disorders cause an individual and his or her family. I teach others what may be most and least helpful when they want to help.  I read the research and consult with colleagues.  I've worked with people of all ages and in all stages of recovery or resistance to recovery.  I've spoken with their families.  I've heard their stories. I've worked closely with a woman who lost her daughter to an eating disorder and who herself has continued to fight tirelessly for services and awareness, in memory of her beautiful girl.

And then one day not so long ago, a serious and devastating eating disorder swept through my world in a deeply personal way.  A young woman whom I have loved since birth became ill.   I'll call her B. I saw the signs for a while... but was I right? B seemed thinner. She was clearly unhappy.  She was skipping out on the activities that she had been passionate about and no longer bringing her friends home.  Yet the rocky world of an adolescent has so many potential pitfalls... was I seeing something that wasn't there because I was hyper aware?  

B's family is nourishing, supportive, and very conscious of and attentive to adolescent development and challenges. Yet, early in B's adolescence, she had already suffered  serious consequences of alcohol use, had experienced dramatic conflicts with her parents and seemed to have lost the confidence that the younger B had displayed. I think we were all waiting for her to grow out of it. I stepped up ... bringing my skills to the relationship ...  talking to her whenever possible about her relationships, sexual decision making and being safe, how to access local teen clinics or counselling, and why it might be a bad idea to engage in some of the activities that her peers were engaging in. I talked with her about body image and included her in every self-esteem building opportunity I could.

Her parents noticed the body and eating changes too, yet there were so many issues, it was difficult to know what to prioritize.  B was in counselling for a long time but a developing eating disorder was not flagged as a critical issue. By the time that they, and I, were fully aware that a serious  eating disorder had taken over B's body and psyche, she met clinical criteria for anorexia nervosa with purging behaviours. She was admitted to a hospital day treatment program very quickly after her initial medical assessment. In other words, with all my awareness and knowledge, I missed this one and no amount of experience could halt the devastation in this family that I love. 

We now know that B's eating disorder was developing slowly over several years, taking over her body and brain.    It has been fourteen months since that diagnosis and B struggles. She has been in and out of treatment.  Unhealthy, too thin, depressed and often withdrawn, she nevertheless is functioning in the world... making plans for after high school graduation, partying with her friends and maintaining a part time job.  Still,  I often look at her and think of the title of a 1999 film, Girl, Interrupted.  In personality and physicality,  B is a shadow of her former self. We all miss the vibrant, creative, curious, outgoing girl. The girl who was deeply connected to her family and loved family vacations more than anything. There are glimpses of the real girl from time to time but she is often hard to spot amid the endless circular drama of eating disorder, depression and a series of poor choices and painful consequences.

Statistics indicate that one in ten girls with anorexia will die within ten years of onset. Sometimes death is a result of malnutrition or heart failure. More often it is the result of suicide. While B's family does everything they can to help her get well, there is only so much control a family has and any family's ability to intervene diminishes significantly when young women reach their later adolescence or move into adult hood. Prevention and early intervention are the best defences against the ugliness of disordered eating. Some parents aren't aware of the the early signs, or choose to ignore them or don't realize it is important enough to take seriously. After all, isn't body despair an expected rite of passage for girls in this body-hating culture? Isn't it normal and even healthy to be concerned about your weight and to always be on a diet?

There are no easy explanations here. Eating disorders are not just a result of cultural pressures, advertising and the diet industry although I've never met someone with an eating disorder who didn't start out dieting.  These illnesses are more complex than that.  Some people are just more vulnerable than others. Personality traits such as perfectionism, all-or-nothing thinking, compulsive tendencies or poor impulse control are factors. Family environments that are chaotic or over controlling, a traumatic experience or even a death in the family can be a trigger for an eating disorder to take hold.

The theme for this year's Eating Disorder Awareness Week  in Canada is Talking Saves Lives.   

Would we have caught B's eating disorder earlier  if we had talked with her more about our concerns? Maybe... but then again B created a lot of chaos and distraction... giving her parents and other loved ones many other important issues to address.  What if her friends had been more aware and less entrenched in their own body dramas... would they have been able to help?  What if her therapist or her family doctor had known what to ask and what the red flags were?  

If you suspect disordered eating behaviours or thoughts are taking up residence in your home... start talking and listen hard.  Seek out medical help and counselling. If your child's doctor doesn't know about eating disorders or doesn't take your concerns seriously... find someone who will.  

For support, advice and referral information, use these toll free helplines:

Want to read more?

My latest magazine article was just published in alive magazine in the February 2013 issue. In Eating Disorders: Increasing Awareness, I explores signs and symptoms as well as causes and underlying issues.  I also explain some of the latest buzzwords in the media:  drunkorexia, pregorexia and orthorexia.  The current issue is available on line through this cool new interactive program or you can pick up alive at your local natural health store.

You can link here to an article I previously wrote for alive called Not Just About Food: Recovering from Eating Disorders that offers hope through one woman's story of recovery.

For further information on signs, symptoms and how to help, check out  Eating Disorder Information For Families from the Manitoba Healthy Living website.


  1. Thank you Lisa for making your thoughts and resources available. I am an educator and the mother of a young daughter. I appreciate your insights and admire your work. Thank you.
    ~ Tamara R.

  2. Thank you for posting this- I agree there is still a huge amount of stigma surrounding eating disorders.Really it is a very nice post thanks for sharing it.


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