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Of all the quibbles that may carry on in these modern days of Thanks&Giving surely we can find the time to reflect a bit deeper and capture renewed meaning this Thanksgiving Day.
-Wishing all a Very Blessed and Happy Thanksgiving!
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For, after all,
put it as we may to ourselves,
we are all of us from birth to death guests at a table which we did not spread.
The sun, the earth, love, friends,
our very breath are parts of the banquet….
Shall we think of the day as a chance to come nearer to our Host,
and to find out something of Him who has fed us so long?
-Rebecca Harding Davis
… where are we?
Objective: The present review addresses the outcome of bulimia nervosa, effect variables, and prognostic factors. Method: A total of 79 study series covering 5,653 patients suffering from bulimia nervosa were analyzed with regard to recovery, improvement, chronicity, crossover to another eating disorder, mortality, and comorbid psychiatric disorders at outcome. Forty-nine studies dealt with prognosis only. Final analyses on prognostic factors were based on 4,639 patients. Results: Joint analyses of data were hampered by a lack of standardized outcome criteria. There were large variations in the outcome parameters across studies. Based on 27 studies with three outcome criteria (recovery, improvement, chronicity), close to 45% of the patients on average showed full recovery of bulimia nervosa, whereas 27% on average improved considerably and nearly 23% on average had a chronic protracted course. Crossover to another eating disorder at the follow-up evaluation in 23 studies amounted to a mean of 22.5%. The crude mortality rate was 0.32%, and other psychiatric disorders at outcome were very common. Among various variables of effect, duration of follow-up had the largest effect size. The data suggest a curvilinear course, with highest recovery rates between 4 and 9 years of follow-up evaluation and reverse peaks for both improvement and chronicity, including rates of crossover to another eating disorder, before 4 years and after 10 years of follow-up evaluation. For most prognostic factors, there was only conflicting evidence. Conclusions: One-quarter of a century of specific research in bulimia nervosa shows that the disorder still has an unsatisfactory outcome in many patients. More refined interventions may contribute to more favorable outcomes in the future.
http://ajp.psychiatryonline.org/cgi/content/short/appi.ajp.2009.09040582v1?rss=1
… it’s not “just a phase”.
Potentially life threatening medical complications are ‘common’ in children affected by early onset eating disorders (EOEDs), a study reported in the Medical Journal of Australia has found.
The first prospective national study of EOEDs also revealed major limitations in current diagnostic criteria, possible missed diagnoses and a need for better education of health professionals. The study examined data from 101 cases of EOEDs in children aged five to 13 years, and found that 78% were hospitalised with an average length of stay of almost 25 days.
Study co-author and leading child psychologist Dr Sloane Madden, from Westmead Children’s Hospital, said the results show younger children with EOEDs are presenting with severe disease. “Only 37% of inpatients in the study met the current diagnostic criteria for anorexia nervosa, yet 61% had potentially life threatening complications of malnutrition and only 51 % met the weight criteria,” Dr Madden said. “This suggests the current criteria for diagnosing anorexia nervosa in young children are limited.”
An editorial on the study in the same edition of the MJA highlighted that about a quarter of cases in the study were boys. Editorial author, Foundation Chair of Mental Health at the University of Western Sydney’s School of Medicine, Professor Phillipa Hay, said “The relatively high proportion of younger boys with EOEDs contrasts with men accounting for about one in ten adult cases of anorexia nervosa and bulimia nervosa,” Professor Hay said. “More research is needed, but the work by Madden and colleagues supports the hypothesis that EOEDs may differ in important ways, including sex distribution and course, from eating disorders with onset in adolescence and adulthood. “It is imperative that research attention is now directed towards understanding why such young children are developing severe eating disorders and how effective identification and treatment can be targeted earlier.”
-SourceMedical Journal of Australia
Grateful to be part of this year’s gathering…
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‘When the sun has set, and the moon has set, and the fire has gone out, and speech has stopped, what light does a person here have?’
‘The soul, indeed, is his light,’ said he, ‘for with the soul, indeed, as the light, one sits, moves about, does one’s work, and returns.’
BRHADARANYAKA UPANISAD, IV. 3.6.
If you haven’t read Hinshaw’s The Triple Bind you need to…
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“Impossible expectations — Blue jeans and “blue” genes *(love this analogy)* : depression and the triple bind — Life in the pressure cooker : impossible expectations and the culture of busy-ness — No place to run, no place to hide : the popular culture of “self-erasing identities” — When virtue is its own punishment : how empathy and verbal skills may put our girls at higher risk — Bratz dolls and pussycat dolls : teaching our girls to become sexual objects — The wired child : how cyberculture interferes with girls’ identities — See Jane hit : the new culture of violence among teenage girls — Is there a triple bind solution? — Conclusion: coming to terms with the triple bind.”
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Love’s Philosophy
The fountains mingle with the river
And the rivers with the ocean,
The winds of Heaven mix forever
With a sweet emotion;
Nothing in the world is single;
All things by a law divine.
-Percy Bysshe Shelley
-Melissa Punch
Blogger and writer Celina Ottaway (her blog-life is a wonderful and conscious journey!) wrote a nice piece for November’s issue of body+soul regarding an important component that is essential to all of our lives, eating disordered or not: FOOD – and how mindful eating (I’m partial to the term “conscious eating”) can help reconnect and form a healthier relationship to that which sustains us.
I don’t have an eating disorder. But like many women I know, somewhere along the way, eating — what, when, how much, in front of whom, how fast — got complicated. The sensation of hunger went from a physical signal with a simple response (“eat”) to a mixed emotion that has no clear solution. Should I, shouldn’t I? I’m being bad, I’m being good. I deserve this. I will hate myself in the morning. And on and on
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How did our appetites — for nourishment and pleasure — become suspect? Is it possible to listen to our bodies the way we did when we were children? The answers lie somewhere in the tangle of emotional, cultural, and neurological reactions that shapes our desire to eat. “Hunger is complicated,” says Jean Kristeller, Ph.D., professor of psychology at Indiana State University and president of The Center for Mindful Eating. Besides the actual physical sensation, “it has to do with a complexity of psychological cravings that may have very little to do with your physical need for food.”
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I love Celina’s parting thoughts:
Whether we move toward our deepest hungers or simply recognize them, we begin inhabiting ourselves more fully. And this moves us closer to feeling ourselves from the inside out, like we did once upon a time.
“Fire” T-Mere
… what’s it worth?
“Art is the most passionate orgy within man’s grasp.”
-John Donne
Journalist and author Trisha Gura will be hosting an online chat this evening at 8PM on The Center for Eating Disorder Sheppard Pratt forum and will be speaking at CED’s afternoon conference on October 5th in Baltimore, Maryland. Attendance is free and Ms Gura will have signed copies of her book Lying in Weight available as well.
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