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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

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Fat Talk Free Week 2009

Outside of the word ‘Ma’am’ there is another word — the ‘F-A-T’ word that I despise quite vehemently… it’s been refreshing to be rid of at least one of those words this week!

*Diwali 2009*

 

Tu jagmagaaye teraa deep jagamagaaye
Saare jahaan ki khushiya tere bhee ghar ko aaye
Ganga aur Yamuna sa nirmal ho tera man
Ambar our dhara sa swachh ho tera tan
Is nagar me teri jyoti chamchamaaaye
Tu jagmagaaye teraa deep jagamagaaye

Achchhe karmo se jag me naam hogaa tera
Teri aahat se buraiya lengi nahi basera
Tere marane ke baad bhee log tera naam gaaye
Tu jagmagaaye teraa deep jagamagaaye

Mit jaaye andhera jo teri dagar me aaye
Aaye kabhi na gam jo deti chintaaye
Naam amar ho tera ek taaraa timtimaaye
Tu jagmagaaye teraa deep jagamagaaye

Door karna chhuachoot mandir masjid ka jhagara
Koi mare na bhookha koi rahe na kangala
Aane waalaa kal tera naam gungunaaye
Tu jagmagaaye teraa deep jagamagaaye
    –Shambhu Nath

*Wishing You a Very Happy Diwali!*

OM

 

Men say the world is full of fear and hate,

 And all life’s ripening harvest-fields await

 The restless sickle of relentless fate.

 

But I, sweet Soul, rejoice that I was born,

When from the climbing terraces of corn

I watch the golden orioles of Thy morn.

 

What care I for the world’s desire and pride,

Who know the silver wings that gleam and glide,

The homing pigeons of Thine eventide?

 

What care I for the world’s loud weariness,

Who dream in twilight granaries

Thou dost bless

With delicate sheaves of mellow silences?

 

Say, shall I heed dull presages of doom,

Or dread the rumoured loneliness and gloom,

The mute and mythic terror of the tomb?

 

For my glad heart is drunk and drenched with Thee,

O inmost wind of living ecstasy!

O intimate essence of eternity!

-Sarojini Naidu
 

~~ Summer is in full-swing and we are finally escaping for a long overdue respite. Destined long nights, mythical and ancient sites… meditating on cliffs, dusting off the lens and capturing images that provoke and provide aesthetic sustenance. Lingering and contemplative hikes up temple steps that have been etched by devotees feet countless times before– who are we but humble and gracious guests- not the arrogant and time-constrained forceful tourist.

Foraging in sacred forests with gamelons playing in the distance, and dancing deities battling the age-old epic between black&white-good&evil ending with the balance of Life, once again, restored. Then taking what was digested of the day to a lamp lit night to write, write, write. Littering my splattered journal with poetic meanderings that have waited, sometimes it seems far too long, for a time such as this.

Life has certainly been blessed and full of positive changes lately! Our daughter has courageously turned the tables on Anorexia within the past couple of months, and is enjoying a summer filled without fear, vibrant, healthy and triumphant in this very moment– we are so extremely proud of her!

Thank you so very much to all of you who are a constant source of human wisdom, compassion and many who have also lent a comforting shoulder to lean on. Along with the ever gracious comrades who work with me tirelessly towards creating our monthly “healing&creative space”– which will return once again late this fall; I really don’t have enough words to do justice in this meager post to give adequate appreciation.

I am deeply grateful for the small patch of ground we continually attempt to uncover to help support those with eating disorders and their families, partners and loved ones. I hope to continue to dig a deeper and wider-reaching network that will eventually have an even greater substantial and purposeful base of resources, along with caring, intelligent and genuine individuals to be of greater service for those who continue to suffer. Patience, time and perserverance– many of us know all too well the meaning of those words, but they truly do remain at the forefront of what long-term recovery entails well after weight-nutritional restoration has been established.

As always, many additional thanks to those who continue to be of support, who listen, read the blog and email, and have allowed me this welcoming space to share our family’s Journey to Recovery– much deep love.

 Wishing everyone a relaxing, peaceful and enjoyable summer! See all of you when the leaves begin to crinkle and the crispness of fall begins to fill the air.~~

Assalamu Alaikom

Each star a rung,night comes down the spiralstaircase of the evening.
The breeze passes by so very close
 as if someone just happened to speak of love.

 

In the courtyard,the trees are absorbed
 refugees embroidering maps of return on the sky.

 

 On the roof,the moon – lovingly, generously -is turning the stars into a dust of sheen.
 From every corner, dark-green shadows,in ripples, come towards me.
At any moment they may break over me,
like the waves of pain each time I remember this separation from my lover.

 

 This thought keeps consoling me:
though tyrants may command that lamps be smashed
in rooms where lovers are destined to meet,
they cannot snuff out the moon,
so today,nor tomorrow, no tyranny will succeed,
no poison of torture make me bitter,
if just one evening in prison
can be so strangely sweet,
if just one moment anywhere on this earth.
-Faiz Ahmed Faiz

*Happy Birthday A!*

We know you always deal with your illness with such courage,
but we still wanted to send you a few hugs,
along with rays of sunshine, big smiles,
and a whole roomful of good thoughts!
So think of these words as a beautiful sunset all your own
and the sound of the ocean gently washing the shore…
Let our thoughts wrap you up in warmth and peace
and sit at your side.
So as you imagine yourself in the midst of these things,
remember how many people care about you and are
wishing you comfort and Love.
-Mary Miro

 *Lots&Lots of LOVE to You Today and Everyday! — Mom*Dad*Sis*

 

 

UCAN

 

I often, as many other parents of children suffering from an eating disorder, find myself envisioning what the future may hold for our daughter when she is older, well beyond the preparatory stages of ED recovery-maintenance, living a full, healthy and ED-free adult life will be like; especially when there may come a time when she decides upon a life-long partnership, marriage and/or family of her own.

Wouldn’t it be comforting and assuring to know that the care your son or daughter is receiving now will also be available for him/her and their partner-spouse when and if the time comes?

Thankfully some forward-thinking clinicians from the UNC Eating Disorders Program are working to provide just such a program, which is at this time addressing Anorexia Nervosa, and can continue to implement these necessary and supportive elements towards long-term health and maintenance for those who have loved ones suffering.

The UCAN Program

UCAN is a research program funded by the National Institute of Mental Health and is part of the UNC Eating Disorders Program. UCAN aims to help couples work together in the treatment of anorexia nervosa. Couples participate in UCAN over a period of six months and return for follow-up treatment three months after the end of the original six-month period. Your participation in UCAN can help you gain new confidence in facing anorexia as a team and can help us understand how best to involve partners in the treatment of eating disorders.
What Couples Can Expect
Treatment Team
Couples can expect that their treatment will be conducted by trained, licensed professionals from the UNC Eating Disorders Program who are experienced in the treatment of eating disorders.
Comprehensive Assessment
All participating couples have four assessments during which they complete questionnaires and interviews with a clinician, and are videotaped having a discussion with their partner about an anorexia nervosa-related topic.
Comprehensive Treatment
During their participation in UCAN, couples will be randomly assigned (like a coin flip) to receive 20 sessions of either:
• Couples Therapy
• Family Supportive Therapy
In addition, the patient also receives comprehensive treatment for anorexia nervosa from the UNC Eating Disorders Program at no additional cost, including:
• Individual Psychotherapy
• Psychiatry Consultations
• Nutritional Counseling

 

*For further information about registering for the program contact at: UCAN@unc.edu or phone: (919)966.3065

Eostre

 

The air is like a butterfly
With frail blue wings.
The happy earth looks at the sky
And sings.
Joyce Kilmer

Niyama...

 

Grateful to be part of this year’s gathering
____________________
‘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.

I LOVE Chicago!

 

… but we’ll happily settle.

 

When he speaks,

The air, a chartered libertine, is still.

Henry V, 1.1

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