You are currently browsing the category archive for the ‘Empowered Families’ category.

The Am Journal of Psych

… 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

Advertisements

An interesting study… 

This study shows that serum brain-derived neurotophic factor (BDNF) is significantly lower in women with anorexia nervosa (AN) compared with women without an eating disorder and women recovered from AN. While recovery from AN is difficult to define, BDNF may emerge as a useful biomarker of AN and of recovery from AN.

Finding biomarkers for AN and recovery from AN can help improve diagnostic accuracy and help better identify individuals who have recovered from AN. BDNF polymorphisms have not only previously been associated with AN {1}, but the BDNF-specific receptor neurotrophic tyrosine kinase receptor type 2 has also been associated with temperament characteristics and low BMI in individuals with eating disorders {2}. The current study evaluated serum BDNF levels in women with AN (n=29), women without an eating disorder (n=28) and women recovered from AN for 1 or more years (n=18). In addition, set-shifting ability was also evaluated in all 3 groups using the Wisconsin Card Sorting Task (WCST). Age was similar among all three groups, and women with AN and recovered women did not differ in lowest lifetime BMI. Women with AN had lower serum BDNF than controls and recovered women. Overall, there was a positive association between BDNF and BMI. BDNF was inversely correlated with the eating concerns, shape concerns, weight concerns, and global scale on the Eating Disorder Examination Questionnaire and on the depression and anxiety sections of the Hospital Anxiety and Depression Scale. Women with AN made more mistakes on the WCST than control women, but BDNF level was not associated with performance on the WCST. Set-shifting was not impaired in individuals recovered from AN. The current study excluded healthy control women with a BMI below 19 or over 26 thereby excluding constitutionally thin and obese women. It is plausible that BDNF is related more to BMI or the starvation state than to AN per se. However, the relationship between BDNF and BMI is unclear as the results from one study indicate lower levels of BDNF in morbidly obese individuals compared with obese individuals {3}. Including constitutionally lean and obese women in future studies may help clarify the relationship among BDNF, BMI, and AN. BDNF may be a useful biomarker in the underweight AN state and in indexing recovery from AN. However, it is important to first ensure that BDNF is in fact associated with AN and not strictly BMI or other indices of starvation.

References: {1} Ribases et al. Mol Psychiatry 2003, 8:745-51 ]. {2} Ribases et al. Mol Psychiatry 2005, 10:851-60 ]. {3} Bullo et al. Eur J Endocrinol 2007, 157:303-10 ].

Turkey

 

Yes, it’s already December and I’m still concocting a various array of T-Day leftover meals. The latest- and hopefully the last turkey creation!- curried turkey potpie was a hit, but with one plate empty at the table.

Life for our family, once again, is on temporary halt to regroup, realign, and reaffirm former, as well as new recovery priorities-goals; and up the ante a bit to get beyond the bump-in-the-road our daughter is experiencing wrestling free (though as of late, resembling more acquiescence) from the dangerous clutches of anorexia.

Leftovers…

Ironically we were in this familiar territory the same time last year. And as a parent, when you’ve seen how far your child has come through his/her ED recovery, how hard the fight gets fought, seeing and knowing they can do it; it feels like suddenly your footing on that long arduous climb is becoming loose and weak. You’ve been tossed back down, the wind has been knocked clean out — “GASP!” Some confusion sets in, frustration, even some anger– “Damn you friggin’ (I use a word with a bit more gusto and power) ED!” It’s time to take action, as most of us know, eating disorders love the waiting-game, the delay, the postponing… we’ve already been there too.

Adolescence is a time of rapid growth and development, and a body taxed with an eating disorder at this time cannot do fully what it was meant to do normally unhindered. The reports regarding bone density and calcium loss within eating disorder sufferers are not new but it is a necessary reminder of the severity of this illness and why treatment should not be delayed, since significant changes do take place before decreases in bone structure become evident, and some of these changes can be permanent after a certain age.

Leftovers in this scenario can also be remembered as requiring 100% full nutritional support and adherence- without question, without exception. This time of year brings forth both a welcoming joy towards celebration with family and friends, but as well an unwelcome increase of stressors and worries that pose some unique challenges for those with eating disorders.

There has been a wide variety of posts and informational resources in this regard which is fantastic. One incredibly busy and committed individual interviewing as of late is Dr Cynthia Bulik, who is the director of the UNC Eating Disorder Program prompting:



Keep your support team on speed dial and call them at any time during or after a party. Talking relieves the pressure. You’re not overburdening them. They will undoubtedly have stories to share, too.– Potlucks are your friends. Don’t hesitate to take a food you prepared that feels safe enough to you so that you will have at least one manageable entrée.– Lavish holiday spreads don’t have to be the enemy. If faced with one, channel your inner Boy Scout or Girl Scout skills and be prepared! Before stepping in line, and before getting a plate, evaluate the options. Mindfully consider which foods you’ll sample, portion sizes and whether you feel comfortable trying a “feared food.” Make a decision and stick with it!– If your treatment team has given you a meal plan stay on track so you aren’t starving when you get there.– Listen with your heart, not your head. Hear the happiness and caring in a person’s tone when they tell you that you look “so much better.” They are saying they care about you. Don’t let the eating disorder lead you to misinterpret those words in a way that deprives you of hearing that people really care about you.— Get Real! People too often have a fantasy about how “perfect” the holidays are going to be. When family members fail to live up to unrealistic expectations, it might be tempting to restrict or overeat in an effort to feel better temporarily. Try to anticipate some of the possible emotional traps in advance so you can cope (and maybe even laugh) when you encounter them.– The well-known HALT slogan works for any type of recovery. Don’t let yourself get too hungry, angry, lonely or tired. This is especially important over the holidays.– ‘Tis the Season to Forgive, so forgive yourself if you have an eating slip.– Try your best not to skip appointments with your treatment team. It’s an important time to stay in touch with people who can help.

 

Dr Bulik also continued with an “Eating Pressure” interview recently conducted by CNN worth viewing.

And there is an equally interesting qualitative study: “Total Control? Eating Disorders and Emotional Responses to Food” conducted by the University of Adelaide in Australia with the result podcast and interview available from CQ University’s International Program of Psych-Social Health Research Dept that looks at emotional responses to images of food presented to adults with eating disorders, and using the qualitative methodology to further measure and explore issues of self-control, food fears/responses, CBT-cognitive behavior therapy as a means to help adjust maladaptive ways of thinking and behaving. I think this could also be extremely beneficial to younger ED sufferers as well, and crucial for helping them deal more cohesively with their “fear” foods that many times get downplayed or ignored within many treatment programs by only having the patients eat the foods, or avoid them altogether in their meal plans.

And yet more leftovers, as lastly I found BBC’s-Radio4 All In The Mind Segment by Claudia Hammond insightful in regards to the variations in some residential programs and getting additional perspectives from patients who are going through the program, their personal thoughts and views. The “partnership” message from the Phoenix ED program in the UK director, Dr Thompson was also welcoming to hear in having patients play a significant role in their treatment and recovery process along with more collaborative and balanced strategies. The numbered tables that residents eat at are something quite interesting as well, with Table 1 being a level requiring most support and moving towards Table 3 with more independence, and thusly Table 2 being 50/50. I think to me what stands out is the ability to remain open to making changes and being creative in strategies, and not simply applying practices to ED care and treatment that simply don’t always work for the individual patient.

So while I’m still musing over Thanksgiving tidbits and at the same time putting up the Christmas lights and bringing out the boxes of holiday decorations, we’ll keep fighting and rallying behind our daughter to continue to move forward within her next level of recovery. Regaining some ground lost with deeper learning and strength gained (we all make mistakes and have setbacks- with or without an eating disorder!) We know we’ll get through this together and once again her place at the table will be filled when she is ready… until then leftovers may be on the menu for awhile.

Melissa Punch- Whole Living

-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

____________________

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.”

___________________

 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

 

With the passing of Mental Health Parity many who suffer from eating disorders will finally (albeit slowly-see how your state ranks) be able to begin receiving adequate insurance coverage and necessary treatment needed for long term recovery goals. Great progress without a doubt.

But there is a Judge by the honorable name Faith Hochberg who is rockin‘ the houses of Aetna, Horizon- Blue Cross/Blue Shield who has recently ruled:

                           __________________________________________________

– approval Tuesday to a class action settlement that requires Aetna Insurance Co. to provide about $300,000 in back payments to 119 insureds whose benefits for eating disorders were limited.

The company also promised to treat future claims more liberally and make internal reforms to resolve disputes over benefits for eating disorders.

U.S. District Judge Faith Hochberg also approved a $350,000 payment to the plaintiffs’ class counsel,
Nagel Rice in Roseland, N.J. All of the fee comes from Aetna, not out of a percentage of the class members’ recovery.

“It makes perfect sense to me,” Hochberg said after ruling that
the settlement in De Vito v. Aetna, 07-418, was fair, reasonable and adequate.

The settlement requires the company to treat some claims for anorexia and bulimia as it does claims for biologically based mental illnesses, such as schizophrenia. That makes a class of eating-disorder patients eligible for eight months of treatment, compared with 20 outpatient visits per calendar year and 30 days of inpatient benefits.

The 119 insureds who will receive checks were those who had at least one claim limited by Aetna’s practices during the past seven years. And in the future, Aetna will treat anorexia and bulimia the same way it does BBMIs.

In addition, anyone Aetna determines to have no medical necessity for enhanced eating-disorder treatment during the next four years would have the right to elect binding review by an independent eating-disorder specialist selected with input from the plaintiffs’ lawyers.

At the same time, though, the settlement affects only patients in “fully insured” plans — those funded by employers. Enrollees in self-funded plans, such as employee welfare and state worker health benefits programs, are not covered by the settlement and would not automatically benefit from the more liberal process.

Nagel estimates that about 530,000 of Aetna’s 1.2 million insureds are eligible for the new claims procedures and that the process could be worth up to $2 million in recoveries by the insureds.

Law.com

 

As many of us already know recovering from an eating disorder takes time, patience, perseverance and an added sense of humor never hurts either. This journey of Hope, Change and Healing can be a long road, but well worth every step! And when a sufferer is not able to obtain the adequate and experienced care that is required for ED treatment this journey can seem like climbing the Himalayas.

Families and sufferers can have a voice and advocate for the care and support they deserve, but it takes some persistence and not taking “no” for an answer but digging deeper and rooting out the resources and connections one needs to help along this road.

One courageous and honorable teen diagnosed with anorexia has taken such a step in Northern Ireland, and is demanding change all the way to the courts to get the care she needs- bravo!

With fire-in-the-heart like that, the sky is the limit to what can be possible so that everyone suffering from this illness will eventually have access and covered care that they need to fight the battle and win their full and healthy lives back.

-shanti

       … and how I feel about eating disorders, about the current state of our economy, the political scrapping and other such quibbles. Maybe it’s the post Harvest Moon which resembled the bounty and beauty of a big, bright pumpkin in all it’s glory bringing Ursa Major back down for Autumn hibernation and seasonal change. My ancestral forefather’s and mother’s deeply rooted with Finnic-myths describing the endeared Kontio – “dweller of the land”; such ancient stories recalling and reconnecting with one another.

 

*

*

Right now,

what she said,

what

I

said

is the size of a grizzly,

nine feet

tall

with stiletto claws swiping

at

my innards.

*

But

if

I

can

just inhale

and

back

slowly away,

time,

like a sailboat,

is waiting for tomorrow’s

wind

to sweep me

safely from this shore,

where

I

can stand on the deck,

day by day,

watching that grizzly shrink

smaller

and

smaller until it’s only

a

mouse,

easily

chased away.

 

*

*

Jacqueline Jules – The Argument

 

Juoksahkka, Maadteraahka I think of you!

-NY Times

… and putting real faces and voices to the lives of those with Eating Disorders. The NYtimes Health Guide along with Well column/blog by Tara Parker has a wonderful piece documenting a variety of brave and courageous individuals who share their journey of Hope and Healing.

shanti

 

: Sarva mangala mangalye shive sarvartha sadhike

Sharanye trayambake gauri, Narayani namostute :

_______________________________


: O Mother ! You are the personification of all that is auspicious,

You are the benevolent form of Lord Shiva,

You bestow Divine energy and help people achieve Righteousness, wealth, fulfill desires and Liberation,

You are worthy of being surrendered to.

Three eyes adorn You.

O Narayani Devi, I pay obeisance to You

End Health Discrimination
Vote

RSS EDDigest

  • An error has occurred; the feed is probably down. Try again later.

Access to Mental Health Care/Eating Disorders Adolescent Anorexia Nervosa Adolescent Anorexia Nervosa and Family-Based Therapy Adolescent Eating Disorders and Recovery Stories anorexia Anorexia Nervosa Behavioral Health blog Body Acceptance body image Books Bulima Nervosa Bulimia Bulimia Nervosa Carer Support Carer Support and Eating Disorders COE (Compulsive Over-Eating) cognitive processing and Eating Disorders Community Health Education Culture Disordered Eating Behaviors Dr Cynthia Bulik Eating Disorder Advocacy eating disordered Eating Disorder Hope & Recovery Eating Disorder News Eating Disorder Recovery Eating Disorder Recovery/Support Eating Disorder Research Eating Disorders Eating Disorder Treatment ED-NOS ED advocacy EDNOS ED recovery Empowered Families Empowered Parents Empowered Parents/Families Engaged Families and Eating Disorder Treatment/Recovery environmental factors influencing ED's Evidence Based Treatment for Eating Disorders family Family & Culture Family Based Therapy Family Life & ED Recovery Family Meals Family Supported ED Recovery Family supported ED treatment Family Supported ED Treatment/Recovery Health Health & Wellbeing Health Care Life Love Love Your Body Mental Health Mental Health Parity/Policies musings news Parent Activism and Eating Disorders Parent Support and Eating Disorders Parent Support and ED's Personal Personal Empowerment Personal Narratives Personal Stories Poetry Psychology Public Health and Nutrition Recovery Science self-help Society Sociocultural Factors in Eating Disorders Thoughts
Blog Awards Winner
Page copy protected against web site content infringement by Copyscape

Blog Stats

  • 65,310 hits
Advertisements