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What Causes an Eating Disorder and How Do You Treat It?

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Shernide Delva

Over the weekend, I watched the movie To the Bone starring Keanu Reeves and Lily Collins. The film took us inside the life of Ellen, a 20-year-old woman who has consistently struggled with an eating disorder.  She enters a residential treatment program with several other women struggling with eating disorders.

The film received a plethora of controversy as many thought it was triggering.  However, after watching the movie, I felt it did an excellent job of allowing the viewer to understand the urgent and severe nature of an eating disorder. Often, films only focus on how little the patient is eating or how much weight they have lost. Yet, this is only a small component of having an eating disorder. Eating disorders go much deeper psychologically, and weight is simply part of the problem.

While the movie does an excellent job explaining what it is like to have an eating disorder, it does not explain what causes eating disorders in the first place. Eating disorders are complex with a broad range of variables.

Treatments for eating disorders vary in efficacy. There is no one size fit all treatment. This is elaborated in the movie as we watch Ellen transfer from one treatment center to another. Finally, she ends up at a treatment center she connects to and has a great therapist played by Keanu Reeves.

Often patients deny the severity of their condition at first. The lack of seriousness only progresses the disorder further. For example, in To the Bone, the women struggle to understand why their eating behaviors are considered abnormal. In fact, they believe that their compulsive eating behaviors are necessary to their survival. The idea of eating any other way is difficult to grasp.

Furthermore, patients lie about the severity of their condition which hampers their treatment options.

Most clinicians agree eating disorders stem from a variety of factors:

These factors range from:

Biological Contributors:

It is possible there is a genetic link that causes eating disorder. Significant studies on depression and anxiety allow reason to be hopeful.  Many people had anxiety and depression prior to the development of their eating disorder. Eating disorders can be a reaction to mental illnesses, in an attempt to manage symptoms of depression and anxiety.

Anxiety can be controlled through food restriction and purging. Symptoms of an eating disorder can elevate the mood as sufferers rely on their weight to fit in with society. Since depression and anxiety have a genetic component, there could also be a clear genetic connection to eating disorders.

Neurobiological Contributors:

Neurobiology is a branch of biology concerned with anatomy and physiology of the nervous system. When it comes to eating disorder, individual ones like anorexia nervosa over activate the inhibition control networks and under activate the reward systems. When looking at bulimia nervosa, there seems to be a dysregulation of both the inhibition control networks and reward pathways. These abnormalities are common among eating disorder patients. However, it is uncertain whether these abnormalities are the result of eating disorder behaviors, or if these abnormalities were present prior to the development of an eating disorder.

The Psychology of Eating Disorders

Needless to say, there is a strong psychological component to eating disorders. Most of what we read regarding eating disorders discusses the psychological component. Psychological elements of an eating disorder range from familial, relational, cultural and social. Most researchers agree that eating disorders and psychological disorders are co-occurring.

Some treatment processes focus on behavior and cognitive changes. These treatments include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT,) Family Based Treatment (FBT,) and others.  However, there is more research needed on how to treat the behaviors rather than solely focusing on the cause. In addition, families need to understand the root of eating disorders in order to understand how to best respond to them.

Overall, the reality is there is so much to be learned when it comes to eating disorders. Eating disorders are a result of a variety of factors. Furthermore, just like addiction, eating disorders are not a choice. People with eating disorders need treatment. If you are struggling with an eating disorder, mental illness or addiction, please call now. You do not have to do this alone. 

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LGBT Community at High Risk of Eating Disorders

LGBT Community at High Risk of Eating Disorders

Author: Justin Mckibben

The lesbian, gay, bisexual, and transgender community is not without its own history of facing conflict and adversity, as the civil rights of these individuals are often debated and questioned, and certain people in the LGBT community have been speculated to have a unique susceptibility to specific health risks. Lesbian women have been said to be more vulnerable to breast cancer, while gay men are suggested to have an increased risk of HIV or other infections.

With the various notions of threats to these individuals health, it may not be too much of a shock that there is some conjecture of another serious health risk for the LGBT community, as recent research proposes these individuals may be at a higher risk of developing an eating disorder than straight and cisgender individuals, with transgender people at the highest risk.

Talking Transgender

Just to clarify some general information:

Cisgender (cissexual) – Related types of gender identity where individuals’ experiences of their own gender match the sex they were assigned at birth

TransgenderWhen gender identity or gender expression does not match one’s assigned sex. Transgender is independent of sexual orientation; transgender people may identify as:

  • Heterosexual
  • Homosexual
  • Bisexual
  • Asexual, etc.

This relates to a report published on April 28th in the Journal of Adolescent Health with data drawn from the first study examining eating disordered behavior among a significant proportion of transgender people compared to cisgender people, with numbers making it sufficient enough to make a meaningful comparison.

Researchers surveyed students from 223 universities across the United States between 2008 and 2011, inquiring about several aspects including:

  • Mental health
  • Substance use
  • Sexual behavior
  • Nutrition history

Out of those included in the study:

  • 200,000 were heterosexuals
  • 5,000 were “unsure” of sexual orientation
  • 15,000 were gay/lesbian/bisexual
  • 479 were transgender

The survey found that cisgender heterosexual men were at the lowest risk of eating disorders, while transgender people were at the highest risk out of those surveyed. This again does not prove to be rule of thumb, but is the idea presented by the research.

Reading Results

According to the study’s lead author, Alexis E. Duncan from Washington University in St. Louis, that in broad terms they determined cisgender heterosexual men had the lowest rates of eating disorders, while cisgender heterosexual women found themselves in the middle, and transgender individuals were found to have the highest risk.

  • Approximately 1.5% of the students reported being diagnosed with an eating disorder during the previous year
  • Nearly 3% had self-induced vomited or used laxatives to control weight
  • More than 3% had used diet pills in the previous month

Out of these overall averages transgender individuals had the highest rates, so from reading these results it seems to support the concept that these issues are more commonly combatted in the LGBT community.

Shifting Stigma

Now this new research may actually provide a shift in stigma that has labeled eating disorders as a ‘women’s issue.’ Past studies of eating disordered behaviors have been generally focused on heterosexual women, who are considered the most at risk, to the extent that so many assume the stigma of disordered eating being a ‘female issue’ and ignoring the growing number of males who suffer from eating disorders as well.

This study could raise a red flag that creates a change, because it revealed that transgender students were actually more than 4 times as likely as cisgender heterosexual women to report an eating disorder diagnosis. Transgender students were also 2 times as likely as cisgender females to have used unsafe methods to control their weight such as:

  • Diet pills
  • Self-induced vomiting
  • Laxatives

These are only part of the data collected that suggests the outdated ideas behind eating disorders being a gender-specific issue are not as founded in facts as many may believe, and more can always be revealed.

Counting Conclusions

Monica Algars of Abo Akademi University in Turku, Finland once conducted a study on eating disorders that determined there is a connection between eating disorders, gender dysphoria and body dissatisfaction among transgender people, which means to infer that transgender people may adopt unhealthy and harmful eating habits to manipulate their bodies to try and fit the gender the identify with, or revolt against one they do not.

Algars explains that these attempts to suppress features of their birth gender may manifest as a desire to control weight, and the added stress created by stigma and discrimination may also contribute to the problem. But all this has the possibility of being alleviated by gender reassignment therapy.

Out of all the conclusions one can come to, one definitively counts: stigma is hurting people, and even killing people who never get the help they need. Be it someone from the LGBT community or a cisgender heterosexual individual, stigma puts us all at a greater risk. It can fuel body dissatisfaction, eating disorders, and even substance abuse. And once someone has fallen prey to these conditions, they can be trapped in a never ending cycle of abuse, stigma and self-mutilation in the form of obsession and deprivation.

Regardless of someone’s sexual orientation, they deserve the same life of love and freedom from stigma as the rest of us. It is up to all of us to make recovery and unity a reality.

Eating disorders and substance abuse are tormenting and fatal symptoms of the disease of addiction, but recovery from that hopelessness is possible for everyone who seeks it. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135

Do Diet Apps Inspire Eating Disorders?

Do Diet Apps Inspire Eating Disorders?

Author: Justin Mckibben

It seems with society moving toward staying in shape, fitness trackers are going mainstream, feeding the growing general concern with body image. It comes as no surprise that America’s obsession with smartphones only added to the popularity of fitness technology, but some recent developments have caused people to notice how harmful these apps can be to a select few. Do these kinds of apps actually promote eating disorders?

The National Eating Disorders Association (NEDA) says that up to 30 million people in the United States have an eating disorder at some point in their life, but considering only 1 in 10 receives proper treatment, is it fair to say they far too many have the potential to be negatively influenced in a world run on iPhones and Androids?

Health App

The Apple iOS 8 update introduced a new Health app designed to combine data from fitness apps like:

  • Runtastic
  • MyFitnessPal
  • Up
  • FitStar

And with new hardware like the Apple Watch to go with this new software, it is sure to get even more popular.

While some critics are more focused on the apps inability to impress with its functionality, Sarah Wanenchak went a step further by turning the focus to a more serious note in her writing in Cyborgology:

“The Health app is literally dangerous, specifically to people dealing with/in recovery from eating disorders and related obsessive-compulsive behaviors.”

She wrote that the app was poorly designed, an enabler of disordered eating behavior, and a temptation to fall back into self-destructive habits. The fact that the Health app was pre-loaded onto devices with the update and couldn’t be deleted only made the situation more vexing, especially for those who do struggle with some form of disordered eating. Michele Kabas is a licensed clinical social worker specializing in eating disorders who says she is troubled that users don’t have a choice about installing the Health app, calling it irresponsible.

Dr. Rene Zweig, therapist at Union Square Cognitive Therapy has said:

“Most people who have healthy relationships with food and their bodies use these fitness trackers and know what the limit is. Someone who has a more obsessive mindset or eating disordered mindset can easily get on that spiral of competing with themselves or other people.”

Almost all of Dr. Zweig’s patients use these kinds of fitness apps. Some in healthy ways, but many use the apps in relentlessly obsessive ways to negatively compare themselves to others and reinforce unhealthy habits.

The Appetite for Apps

The same numbers some people are able to use constructively can also be manipulated to provide inspiration for eating disorders. Or even worse those numbers can exacerbate them. These kinds of apps also allow people to trade and compare numbers with others, which can stimulate an eating disorder out of some sense of competitiveness, or drive unhealthy behaviors when someone negatively compares themselves to another person.

I have written about ‘thinspiration’ and pro-anorexia websites, blogs and chat forums. One of these discusses unhealthy dieting plans including consuming just 750 calories per day and walking a minimum of 14,000 steps, tracking it all with a Fitbit. On MyFitnessPal people with eating disorders even congratulate one another about under-eating or over-exercising to the point that other people using the service have complained.

But wait, there’s more! Those apps all use raw data, but still others are even more malicious and dangerous for those with eating disorders! Some are built around negative motivational tactics that shame the individual into trying to meet unhealthy goals. Some such as:

  • Carrot Fit
  • Nenshou
  • Shock therapy wearable Pavlok

Dr. Zweig says that apps that utilize cruel and negative reinforcement may actually appeal to people who already have disordered eating.

Redirecting the Issue

There is also some effort put forward by some apps to combat the severity or possibility of eating disorders. Some still don’t think that is enough, but it is a start.

MyFitnessPal is one app that offers a page titled “eating disorders resources” and has posted a blog from a licensed clinical social worker about overcoming binge eating. It will even warn users if they appear to not be consuming enough calories.

In similar fashion, social networks Pinterest and Tumblr have programmed their apps to direct users who search hashtags like #proana or #thinspiration to the National Eating Disorders Association. Still some say the apps could also use the available data to provide more contextualized feedback.

On the other end of the spectrum apps do exist to help users overcome their eating disorders. One such app is Recovery Record that allows users to enter their nutrition and fitness information. Users can also make posts about the urge to binge or purge to share with others for support.

Too frequently tech companies will ignore or misunderstand mental illnesses while building apps and services designed for a mass audience, but there is hope in future that people sharing their personal experiences with disordered eating and fitness apps will ultimately inspire designers and developers to think about not just a great undifferentiated mass of users, but also the people they unintentionally marginalize who may use these apps in harmful ways. Health and fitness is not a one-size-fits-all problem, so we need more diverse and specific solutions.

Mental health and eating disorders are another way that we can become addicted, whether to substances, people, compulsions or behaviors. But while the world is not the easiest place for those who struggle, it can be a beautiful place with the right recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135


Is the Food Industry the Next ‘Big Tobacco’?

 Is the Food Industry the Next ‘Big Tobacco’?

By Cheryl Steinberg

Exercising is overrated when it comes to losing weight.

Do I have your attention?

Good, because we’re about to drop a knowledge bomb on your head. For all of you out there struggling to lose weight via hard work at the gym, and who make excuses for a “cheat’ day or that you can eat whatever you want, because, after all, you work out…I have some news for you.

First, let me just say that there are definite health benefits of working out, or even incorporating some kind of physical activity, such as going for walks, especially if done on a daily basis.

However, if you want to lose weight, I’ll tell you the secret: eat healthy.

That’s it. When it comes to shedding weight, exercise alone isn’t enough. Or even all that relevant. It’s about eating the right foods. And to begin learning how to do that, you must first understand that you are facing a battle with a big entity: that of the food industry.

In Britain, a team of cardiologists have decided that it’s high time to “bust the myth” that regular exercise safeguards against obesity.

The physicians submitted a strongly-worded editorial in the British Journal of Sports Medicine, which will appear in the upcoming May edition. In it, they say that the bottom line, when it comes to losing weight, is that you simply can’t out-run a bad diet. They are sure to add that regular exercise reduces the risk of developing a number of health problems, such as heart disease, type 2 diabetes, and even dementia and certain cancers. However, it is not the key ingredient in weight loss.

Is the Food Industry the Next ‘Big Tobacco’?

The authors of the study compare the situation with our food industry with that of the tobacco industry that happened years ago.

They accuse the food industry of misleading the public into believing that obesity is caused entirely by an inactive lifestyle, rather than what’s in their packaged (read: packed with hidden sugars) products. They add that the public is being “drowned by an unhelpful message” and go as far as to describe the tactics being employed by the food industry are “chillingly similar” to those used by big tobacco companies when the science connecting lung cancer and smoking were first becoming known.

“The tobacco industry successfully stalled government intervention for 50 years,” they say. “This sabotage was achieved using a ‘corporate playbook’ of denial, doubt, confusing the public and even buying the loyalty of bent scientists, at the cost of millions of lives.”

If you’ve noticed, the main belief we tend to have when it comes to food consumption is that we just need to count calories. The authors were also critical about this, saying that the food industry is what’s driving this belief. The problem with this is that it’s the source of calories that matters, the editorial asserts, arguing that sugar calories promote the storage of fat and causing you to feel more hungry, while calories that actually come from fat make a person feel full.

The editorial also makes a good point about sports and energy drinks (read: sugary drinks), saying that the relationship between “junk food and sport, must end.” It calls on the British government to put a tax on sugary drinks and ban the advertising of junk food as well as calling for gyms to stop selling these beverages.

In a statement emailed to Mashable, Britain’s Food and Drink Federation strongly rejected comparisons with the tobacco industry, calling them “absurd and offensive.”

So, here it is…the not-so-magical-yet-highly-effective way to weight loss:

Eat a balanced, calorie-controlled diet and get into activities such as fast walking, jogging, swimming, or tennis for up to 300 minutes per week.

And by “calorie-controlled,” the authors, using a study in the academic journal Nutrition, say the single most effective way to fight off obesity is to restrict the intake of carbohydrates.

An unhealthy relationship with food and/or exercise can develop into a full-blown eating disorder. Sometimes, people use drugs as a way of staying thin. This can lead to a situation known as dual diagnosis, where there are 2 or more medical conditions present at the same time and that are most successfully treated when done so at the same time. Eating disorders can be difficult to treat however, there are programs that specialize in treating eating disorders as well as co-occurring substance misuse and abuse. If you or a loved one is struggling in this way, please call toll-free 1-800-951-6135.

10 Charities that Help The Cause

 10 Charities that Help The Cause

By Cheryl Steinberg

Being in recovery is all about giving back. And there are tons of ways to ‘give back.’ Besides time and energy, you can help out by also donating to organizations that do good works. Here are 10 charities that help the cause of addiction.

#1. Amy Winehouse Foundation

Founded by the tragic young singer’s father, Mitch, after her death from alcohol poisoning in July 2011, it focuses on music therapy and education programs, drug prevention programs and rehab services for children. They also offer drug and alcohol education programs in schools across the U.K, launched with the help of Russell Brand.

#2. The Herren Project

Former NBA star Chris Herren, a recovered Oxycontin addict who now has been sober for over six years, initially started the foundation to help pay for other’s drug treatment. It now involves other projects, such as creating sober culture in school for kids and a grant program to fund substance-free after-prom parties and events.

#3. Partnership for Drug-Free Kids

You might remember this one by the name of the Partnership for a Drug-Free America but, this nonprofit has not only changed its name; it’s also changed its focus on preventing teen substance abuse and on families who have been affected by drug and alcohol addiction. It provides parents with children who struggle with addiction with direct support, offers numerous teen-targeted efforts such as Above the Influence, and advocacy for greater access to treatment and support groups for teenagers.

#4. The Brent Shapiro Foundation for Alcohol and Drug Awareness

This L.A. based foundation advocates for a national awareness of drug and alcohol addiction. You may recall hearing about it when Khloe Kardashian endorsed it shortly after her infamous DUI in March of 2007. Among its projects are Brent’s Club, which works with a local Boys and Girls Club to offer sober activities to middle and high-school students. Save A Life cards are another project of this charity and they have been tracked to have reached more than two million people across the country. The foundation is also known for its drug prevention PSAs and two children’s books that were created with the purpose of helping parents introduce their children to the dangers of drugs and alcohol.

#5. Rosecrance Foundation

Rosecrance offers addiction treatment to adolescents and adults, serving more than 14,000 families each year. The foundation raises money specifically for both substance abuse and mental health issues, offering adolescent and adult recovery homes, teen programs and creating endowment funds to help pay for treatment. Their Kinley Charity Care Fund has raised more than $6 million since 1984.

#6. Angels At Risk

This charity was started by actor Ted Danson, and is a Los Angeles-based nonprofit. Its mission is to address the impact of drug and alcohol abuse of teenagers and families and reaches tens of thousands of families annually. They focus on the power of storytelling and communication, hosting teen assemblies and parent education meetings at LA high schools as well as counseling for schools and in family support groups. Some of the Angel’s At Risk funds go to scholarships that pay for teenagers and families to get outside counseling.

#7. To Write Love On Her Arms

This nonprofit addresses the wide range of issues associated with addiction and mental health, including drug and alcohol abuse, depression, self-harm and thoughts of suicide. It was founded in March 2006 and has gone on to raise millions of dollars for organizations across the globe. It partners with universities, social networking sites, even music festivals, such as the Vans Warped Tour, in order to use the exposure to promote other already-existing professional health organizations, as they do not have their own. Donation monies go to programs like Hopeline and, as well as their own programs, such as the high school-focused campaign “The Storytellers.” Celebrities who have endorsed TWLOHA include Miley Cyrus, Joaquin Phoenix, and the band OneRepublic

#8. Eating Disorder Foundation

Toni Saiber created this charity organization after she almost died while battling an eating disorder. This foundation uses an entirely volunteer base to run its programs, which are devoted to the prevention and elimination of eating disorders. Initiatives include presentations at schools and colleges across the country, partnering with local celebrities to raise awareness, and holding conferences during National Eating Disorder Awareness week.

#9. Natural High

Natural High was created in response to the failure of programs such as the “Just Say No” campaign and others with a prevention style found to be largely ineffective. Its goal is to provide programs that allow youth to discover and pursue their own natural high – hence the name – so they don’t feel the need to try or do drugs. Its digital platform allows kids to share their stories and connect with their drug-free peers. Natural High also offers a wide range of curricula and resources on their website for both educators and parents. As well, their project includes video testimonials of more than 40 celebrities who have chosen to say ‘no’ to drugs and their reasons why.  Included are pro surfer Bethany Hamilton, U.S. World Cup goalie Tim Howard and Grammy Award-winning singer Mya.

#10. Mario Do Right Foundation

This one was founded by former R&B chart-topper Mario Barrett back in 2007, and it focuses exclusively on youth development by giving education, awareness and support to children of addicted parents. Mario’s own mother struggled with drug addiction throughout much of his childhood and so he has maintained a highly-involved role within the organization, regularly speaking to ‘troubled youth.’ This evidence-based program was also approved in 2011 by the American Medical Association, White House Office of Drug Policy and U.S. Department of Education, and partners with both local and national organizations. Fundraising is done on behalf of grassroots organizations and the foundation organizes public speaking engagements across the country.

Palm Partners does not endorse or sponsor any charities listed nor is it sponsored by these charities. If you or someone you love is struggling with substance abuse or addiction, please reach out and call us toll-free at 1-800-951-6135. We’ll do the rest. We’re available 24/7.

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