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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 ].

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A wonderful non-profit organization created by Gail Schoenbach For Recovery and Elimination of Eating Disorders – F.R.E.E.D. will be holding a Mother-Daughter Workshop in conjunction with the Eating Disorders Association of New Jersey Saturday, October 18th from 9:30AM-2:30PM at Summit Medical Group.

The workshop’s aim is to “engage women and girls as they explore and challenge their beliefs about themselves, their bodies, and body image”. Freelance journalist, blogger and author, Courtney E. Martin who wrote Perfect Girls, Starving Daughters will be the keynote presenter along with therapist, Suzanne Rubinetti.

F.R.E.E.D.’s mission is to:

  • Provide financial support for treating eating disorder (a major hindrance for sufferers and their families in obtaining treatment/recovery resources as well as follow-up care — F.R.E.E.D.’s priority and focus on this issue is to be commended).
  • Increase public awareness and provide educational resources.
  • Advocate for the acknowledgement and acceptance of Eating Disorders as a serious and urgent disease.

Ms Schoenbach’s own battle with ED and body image issues took place in silence for years until she began the slow process of recovery, and it was during this healing time that she found a passion and drive to create F.R.E.E.D. and her additional adjunct G.R.Schoenbach Foundation which holds annual fund-raising events and campaigns to continue her committed work.

Organizations like these are inspiring, so if you live in the New Jersey area, are a mother with a daughter with/without an eating disorder, go partake in “day of empowerment”, sharing, support and learning– it will do the body&mind good!

shanti

 

Some of the most common events become quite significant when your child has an eating disorder, and at times worry seems to be a constant irritating leach sucking your Mom-force astray even when the coast is clear.

For the past two years our daughter has missed out on class trips due to the pernicious nature of the eating disorder. And as if heading back to school doesn’t already bring with it some added stress and anxiety for a developing young middle-schooler, these trips always take place at the beginning of the year– great idea for setting the tone and building relationships for the school term, not so great idea if your child is trying to gauge the semester and transition in the first couple of weeks tacked on with the complexity of managing an eating disorder.

For the first year of middle school this trip was a no-go. Last year also didn’t happen since she was not yet able to make food-meal choices on her own, as well as eating without some additional support, and being comfortable enough to ask for help if encountering some difficulty and parents and family were not around.

Initial diagnosis of the eating disorder, immediate hospitalization, the following year inpatient and residential treatment, along with intensive outpatient treatment; days-months of missed school, family and social life seem strangely long ago, healing does take time.

This school year is markedly different though, our daughter is actually getting a bit pissy about missing out on certain aspects of teen social life and events her friends and peers seem to do “so easily”. These are things she also did easily, without second thought, prior to the eating disorder and another positive sign that she is remembering and awakening to her former Self.

This year’s “Leadership Trip” my baby is on the road for three days of fun and camaraderie. First to camp, canoeing, rope climbing and mingling while looking at the constellations, second to the State Capital, then finishing off sliding down the plastic tubes of a favored water park, who would want to miss this?

She left this morning her bags packed with extra snacks and necessities, pre-ordered her meals (all by herself- yeah!) and wasn’t embarrassed to give an extra hug.

But my ultimate moment came seeing her classic dimpled smile!

 

The road ahead is like the road behind.
The dreams achieved revise the dreams to come.
Mind shapes world, and new-shaped world shapes mind,
As what you are steps back from what you’ve done.
The deeper you resides in its own space,
Sheltered like a yolk from wind and tide,
Filled with unimaginable grace
To wander through the paradise inside.
Ambitious girl!
Become what dream you will,
And sail across each dark, forbidding sea.
Within, the fawn will graze sweet meadows still,
Untouched by all the phantoms you will be.
-Nicolas Gordon
 

 

By now everyone has read and seen the devastation caused by the earthquake measuring a magnitude of 7.9 in the Sichuan province of China.  We have been holding our breath these past couple of days since dear friends of ours were living and working in China but were extremely fortunate and arrived saftely back home in India. 

Many, many  others are yet to be accounted for, and have not been left untouched by this horrific natural disaster– something of this extent not witnessed in over thirty years.

There are several relief organizations  scrambling to help those who have been affected by this catastrophe, though what’s growing increasingly frustrating is how the local government is really making things difficult for aid-workers to get through and deliver assistance ASAP.

We continue to send our deepest sympathies and heartfelt condolences to all those affected by this tragic event.

-shanti

                                                 “This day is a special day, it is yours

                           Yesterday slipped away, it cannot be filled anymore with meaning

                                                   About tomorrow nothing is known.

                                           But this day, today, is yours, make use of it.

                                                Today you can make someone happy.

                                                      Today you can help another,

                                                This day is a special day, it is yours.

                                                              -INDIAN POEM-

 

Most of us realize that we need “fat” not only in our diet, but within our bodies– I say most since when you have an eating disorder, know someone with an ED, or care for someone suffering with this illness, specifically anorexia nervosa, which is hallmarked by the intense fear of gaining weight, this is a very difficult truth to swallow as well as visually accept within ones’ physical body.  

There are also some studies that suggest for some this “fear” can be a precusor to eating disorders  among the array of environmental, behavioral influences as well as genetic and/or biochemical predeterminers that scientists are still compiling and discovering that can leave some individuals much more susceptible than others to either severe eating disordered behavior, EDNOS, or a severe diagnosed eating disorder that requires serious and comprehensive treatment. 

What’s also intriguing is the work by researchers continuing to unfold in evolutionary biology, genetic imprinting, and epigenetic inheritance which I’m certain there are correlations within these findings and eating disorders that have yet to be fully available and utilized, but may be able to provide us with a much more inclusive picture behind the illness and how to improve prevention and treatment.

There was a recent study highlighting the benefits (mostly catching everyone’s eye with the glorification of our ever evolving rump, or as writer Debra Dikerson slammed in Salon.com last year about mainstreaming “Gi-normous butts”) of subcutaneous fat, which produces hormones known as adipokines found to boost metabolism (of course, I’m assuming this study will also fuel the weight-loss industry and war-on-obesity too) found in the booty area as well as belly and showing to be protective against type2 diabetes, but also reaffirming the adage that “diets don’t work” and briefly explains why this is part of the reason it’s difficult to keep that weight off once lost; and that our fat cells are set during adolescence and don’t decrease, but do actually expand in size.   

And while I don’t embrace the the good/bad dichotomous thinking and categorization of really anything when it comes to our daily living and Life– you tend to find things more in shades of gray or muted with other colors vs just a pigment of one– the study is looking at two types of fat: subcutaneous and visceral , and where they are found within the body.  Subcutaneous tends to be in the booty and stomach area, and has more benefits vs visceral, which tends to be the gunk blocking arteries, causing damage to organs– sorry to say you’re bad visceral, or maybe scientists just haven’t fully found out what you’re doing and why you are getting such a bad wrap. 

Another study that continues in similar dialogue and highlights the complications of metabolic syndrome and that this can be triggered by overeating, which is correlated with weight gain, especially if done consecutively over a sustained period of time, and makes me wonder about endocannabinoids and their role cause/effect in obesity  and how this, if at all correlates.  The study also points to our fat cells being set during adolescence,  but Dr Stephen O’Rahilly of Cambridge remains unconvinced, and isn’t prescribing to this determination just yet.

Maybe another more basic message to keep at forefront is that it’s not nice to fool with Mother Nature– she rises up with a vengeance.  Our bodies have evolved over time and there is inherit wisdom to what we carry around with us everyday.

-Love Thyself

 

While I’m playing with WP Themes -my creative side itches- I’ve been curious what other parents and those who have found their path towards healing, recovery and well being from their eating disorder find gives them greatest support and sustains them throughout? At your most difficult times, what has buoyed and held you steady, lifted you up and got you through (like my friend Ganesha up there)? 

Do you wish some things could have been done better in hindsight, wished clinicians, treatment providers, community resources, insurance, etc. could have known perhaps more than you, practicing with up-to-date, evidenced-based research and data vs rehashing false and painful stereotypes that can keep a family from getting the best care possible? And that  everyone worked more as a cohesive whole vs fragmented, inconsistent, and leaving too many gaps for uncertainty and misunderstanding– or worse barely any informative communication or basic follow up to keep focus on the best methods towards recovery and support?

And if you were/are a parent(s), caregivers, extended-family, siblings do you wish there would have been services that encompassed and included the entire family, and not just for weekly family therapy sessions, the once a month “Family & Friends” events held at treatment centers.  But further additional healing and supportive measures like what is comprised in most respite centers/facilities and typically standard for family members when a child has cancer, or any other major life-threatening illness. 

All of us know that ED’s are potentially life-threatening if proper treatment and nutritional support are not addressed, and the sooner diagnosis is made and intelligent, comprehensive action taken, the better the chances recovery can be, and less relapsing and monumental expenses for the revolving door of IP, OP, residential, IOP, etc. care.

Being a parent of an adolescent with an ED, there are unique aspects to what parents and family members need, your life and “time” seem to come to complete stops and starts depending on where the progression of the illness may be, how many extra hands there are to pitch in when you need time to take care of yourself, take care of other siblings, reconnect with spouses, get some perspective, and to keep centered and strong. 

If I were to draw a graph of how our family has progressed through our daughter’s illness, it would have some deep dips and high escalations, and many dotted straight lines– but not always clearly defined and consistent (thinking about this makes me want to create just such a map/graph!)  Sometimes things seem to just “click” and things move forward without much ado; but there are other times when it seems the cyclone of ED can just demolish the very health and Life of an entire household, leaving pulverized rubble and ruin that needs the utmost and gentlest of care and compassion– those are the moments when all your resources get pulled together and you roll up your sleeves and get down to business– you take action and you may find setbacks galore, but you also find incredible inner resilience, Hope, courage and more Love than you ever realized was always there. 

Moments like these can also be some of the most magnificent and humbling of points within our human experience …

 I feel a deep human need to collectively share these experiences, swap stories- like sharing a recipe!- connect with others who “get it” and aren’t going to be dismissive, discourteous, judgmental or even worse, think I’m a bit over-the-top… off my rocker… box ‘o crack ‘o jack, etc. 

And I think if it weren’t for the Internet of collective voices, fellow parental-comraderie and individuals such as an incredible Mom who hosts a forum for parents to find one another, along with so many of you whom I’ve met virtual-via email, your websites/blogs, etc. and found such amazing insight and resolve into this illness– I do feel I would have felt much more isolated and possibly a bit more despairing (I say a bit since my Finnish ancestry is laced with “SISU” = strength… so this would not have lasted long) but it also points to the reality of the importance to support and encourage one another through the recovery and healing process within eating disorders.  To make certain adequate treatment is delivered, proper support and resources are available in all demographics. 

Change is still quite snail-paced within ED’s, so I think our collective voices and efforts however big or small DO matter and make a difference.

Now if only I could get some of the ladoos (Indian sweet) that Ganesha is holding… my rant would be complete.

-shanti

 

 

 

I love how the birth of International No Diet Day began “from a picnic in Mary’s living room” in the early ’90’s and fertilized it’s magnitude world-wide.  Ms Evans-Young is herself a recovered anorexic and wrote the book Diet Breaking: Having it all Without Having to Diet and it couldn’t be a better time than now to let the message sink in– deep and with reflection.

Largesse gives the background on the term: size esteem  which was initially coined by Richard Stimson, husband to a contributing director/writer at the site, Karen Stimson who explains it perfectly:

– Feeling acceptance of, respect for, and pride in one’s body, whatever its size or shape

But I like this analogy even more highlighted by Cheri Erdman EdD who wrote the book Live Large! and thought about it as a simple yet poignant equation:  Size Acceptance + Self Esteem = SIZE ESTEEM

Either way you think about it, the insanity of dieting, wanting to force our bodies to be a size/shape it was not genetically determined to be– and thankfully so for the beautiful variety of shapes, sizes, colors, we all add to the collage of life, is quite dubious. 

It’s even further magnified when you or a loved one suffer from an eating disorder and are trying to regain your health and follow through with recovery and maintaining wellness in a seemingly endless fat-phobic, diet-crazed, fashion-consumed environment.  Our daughter at times can take on this incessant self-doubt and accusational inquiries about why she has to eat what she has to when others, her classmates, etc. eat less than she does and are constantly discussing “fat” laden topics— it’s enough to make anyone go a little bonkers.  Advertisers, marketing, the health ins field, even health care (hey, let’s face it– those mega-million dollar hospitals that now look more like shopping malls want  to treat the ill business) and the all time winner: the diet industry.

Stuffed and Starved is a title from researcher Raj Patel more about food prices, the global-glut, etc. but I had to think about this a little bit more this morning how it really ties into so many other layers of Life– and will be worth dissecting and playing off the similar as well as dissimilar dualities we can only pretend don’t exist, or just think is someone else’s “problem” to fix, get over, medicate– like the cliched remark I’ve heard countless times since our daughter was diagnosed with anorexia- “why doesn’t she just eat?!”, then the instant turn against parents when our children don’t eat = it’s your fault, you did something “wrong”, etc.

Yes, INDD is a day we find relative and meaningful in our family.  And with the weather reaching low 70’s, sun shining– I think a picnic is just what we’ll do to celebrate this day!

-shanti

  T. Mere-

 

 

I awoke early before the rest of the family this morning to have some quiet time- make some chai, sit out on the deck in the bitter chill, layered in winter-wear.  May 1st it is… our daughter will be turning a year older this month and is fully discharged from the eating disorder program she has had several months of treatment in, both inpatient, residential and finishing with their intensive outpatient program. 

Thinking back to her initial admission in November seems eons away from where she is now.  She’s come full-circle, rather similar to the cycle of the year and anticipated, sometimes even prominent, seasonal changes (this winter was one of the heaviest in terms of snowfall and duration!) that mark distinct, at times mundane or significantly important passages of time. For our family it was one of change, acceptance and movement forward- leaving what does not nurture or support us happily behind.  And with great hope, looking towards the future, but staying as grounded and balanced as possible in the present.

I remember when our daughter’s were much younger and attended a Waldorf school where seasonal change, holidays and traditions were both honored and incorporated directly within the curriculum (such idealism we as parents carried– but so much fun!) and one of the highlights of the school’s year end was the annual May Faire that had Maypole dancing, farmer’s market, crafts… just all around energy, wonderful food, children running, giggling, singing with weaved flower-crowns or greenery in their hair (parents too!) and just an all-around connected sense of community, diversity and optimism– SPRING had sprung! It was a celebration to honor the changing of the seasons, from darkness into light.  Back then our daughter was completely free from fears of food and worries of weight-gain, she couldn’t have been farther from such an ugly menace as ED.

Much time has passed since those pre-K days, and our children grow to find their own unique challenges and strengths– sometimes we are faced with circumstances in our lives that can send one afloat upon unchartered territory, navigating can be difficult, but you find a way back to dry land, solid ground and the comfort of those that love and welcome you; and are there for you “have your back” when you need them most. 

Yesterday after our daughter had a brownie with “sprinkles” I realized she is really making huge steps towards facing the ED demon head-on, and while she won’t admit at this point “Wow! I just loved that brownie– Yum, yum!” she is taking what is presented to her each day, much more consciously than five months ago.  Perhaps not always with her trademark dimpled smile and sparkly eyes, but she’s doing it, and we’re cheering her on!

As I see the small buds on the apple and cherry trees grow in size each day, and the striking presence of the yellow daffodils dot the yard along with the tulips beginning to take on their dark hues; I feel on this first day of May that we’re finally able to see some Light shine back into our own families’ healing and daily rhythm more akin to life before ED– and that feels so wonderful!

 

                    An optimist is the human personification of spring

                                       –  Susan J. Bissonette

Howard S. Hoffman

 

                    We tend to see only what we are prepared to comprehend.

                                         Howard S. Hoffman …On Life

 

Tula Karras

 

When your child is diagnosed with an eating disorder your life changes- permanently.  There is no looking back (though you do, and weep and grieve for the child you once knew and still know lies underneath the ED just waiting to find his/her way back– and they do!) there is no denying the obvious even when this illness can completely blindside and throw you off your center until you fully understand and grapple with its complexity– and even then you can still be utterly perplexed. 

But you take action, keep your son/daughter safe, provide nutritional sustenance, comfort and support.  You find the appropriate medical care, treatment facilities and resources that will help him/her, as well as yourself,  find their way back to health, well being and continuing to work towards their full recovery– however that needs to happen- you just do it.  We’re parents, Moms&Dads, families, grandparents, cousins, all taking those measures and lending a hand because we love each other and want to see those suffering find their way back to their true selves, living their dreams, passions and finding happiness- not perfection- in what gift of our Lives we have been given.  Life is certainly not an easy journey, and growing up, becoming an adult, raising a family, fumbling through difficulties– these are all illuminating lessons to help bring us back to grace and compassion, wisdom and understanding.

Something within my own inner perspective and thinking is having a bit of a snag though.  Maybe because I know how damn hard it is to wrestle with an illness our daughter was diagnosed with over a year ago.  Knowing how hard she has worked to get to where she is now, how much more persistence and vigilance she will continue to have, especially now that she is fully discharged from the eating disorder program she has been intensely involved with for several months, and facing a culture and society that seems to be ironically having increased insecurities, issues and numbers of individuals (especially within older adult populations) with “disordered eating” patterns and behaviors, which to me on the outside look and behave just like our daughter did prior to her being diagnosed with Anorexia Nervosa. 

There is this surreal sensation that comes over me when I briefly skim over an article in SELF Magazine that highlights a partnered survey studythat was done in collaboration with Dr Cynthia Bulik and the University of North Carolina that states that “3 out of 4 American Women have disordered eating” and the magazine survey whose participants numbered over 4000, and probably still counting on both the survey, forum and follow up, continue to show an increase in disordered eating patterns and ranges of destructive habits that clearly as Dr Margo Paine boldly states exemplifies, “Dieting is a national pastime for women” and “as a society, we don’t see the problem“.

The survey also goes further into describing additional categories that 6 out of 10 (1 out of 10 have eating disorders) women who are categorized as “disordered eaters” describe themselves into specific subsets:

 

* Calorie Prisoners

* Secret Eaters

* Career Dieters

* Purgers

* Food Addicts

* Extreme Exercisers

 

Of course, none of these descriptors are new.  But while some studies and stats have been pointing towards an increase of younger individuals being diagnosed with eating disorders, which may indeed be on the rise, though it’s always difficult to know whether we are only getting better at earlier diagnosing and intervention; and if some of the outcry and attention to the issue is creating the continued awareness, discussion, research and treatment standards.  But this survey, as some previous others, is showing the age range to be in the adult category of a 25-45 year old female base, and from what I’ve read in some previous studies, this seems to be more consistent and increasing if you are to follow the conclusions.

Yes, I’m perplexed and even angry.  I don’t want to see anyone needlessly suffering with any disordered eating behavior(s) that can have even the subtlest of impact upon ones’ health- period.  But I also have another irritating irk in thinking about the continued impact these findings, if they are showing continued rises in eating-disordered behavior have upon our youth and young adults who are watching, reading, and taking in this information too.  What, if anything does this ultimately translate to and what can be done to counteract this deranged preoccupation with dieting, body-dissatisfaction, and just overkill of the human body? When will the craziness stop just long enough to take a step back, breathe, and find acceptance and compassion for who you are as you are being enough, being worthy– because we all are.

And our kids need us to model and reinforce these strong capabilities and common-sense practicalities.  When I see a book titled: My Beautiful Mommy I think this is a joke, right? But I find that it’s written by a plastic surgeon, and really set on promoting this “upkeep” ideal while cunningly proclaiming under a guise of “help”.  Are we so far gone into our self-absorbed psyches that we are so easily swayed and coerced into finding this worthy of publication to begin with? Apparently so, as the book is being sold and bought, joke or not– some are taking the bait and seem to be biting hard, though not into much that will keep one nutritionally and mentally stable.

Our daughter has to not only find safety, stability and assurance within her home environment, but the world outside as well.  And this rant of a thread I’ve lowered myself to in this post just proves what an apparently obnoxious mother on a mission I am (imperfections and all- silicon free and able to eat minus fear thankfully) to keep my daughter moving towards a healthy, happy and internally sustained recovery and passionately what that means to me.

Ladies and Gentlemen, can this insanity please begin to find it’s way back in the hole from where it came?  Like a fire out of control, can we begin to find some means of putting this insatiable flame to some simmering rational end? Will these studies and polls just continue to bloom, boggle and frustrate so many of us, while invoking the opposite within others to think less of themselves, and to possibly court a potential ED, especially for those who are either biologically, physiologically and/or genetically predisposed and vulnerable?

To continued Health, Strength & Insight for us all.

End Health Discrimination
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