Eating Disorders
Fingers crossed!
could be the official motto of the eating disorder clinical profession.
Content warning:This story discusses eating disorders and body image.
Shes white (the majority ofresearch around eating disorders has centered on white women).
She could afford to seek professional help.
And perhaps most interestingly, her father was the president of the American Psychological Association.
Surely, if anyone were able to access high-quality care, it wouldve been her.
Therelapse rateis anywhere from 40 to 70 percent to who knows?
Kazdin writes (citing a 2020 study published inCurrent Opinion in Psychiatry).
Its a serious epidemic, but its not often treated that way.
If you break your leg, a doctor knows to put you in a cast and give you crutches.
As Kazdin writes, Recoverydoesnt just feel elusive; it is.
Whats Eating Us?is a fascinating and frustrating read.
In this excerpt, Kazdin explores the obstacles facing those who attempt to seek treatment.
could be the official motto ofthe eating disorder clinical profession.
Theres a lot of great research and researchers out there.
But eating disorders are less understood than many other mental illnesses.
Which is not to say there cant be positive results with particular therapies.
There absolutely can be.
And once you do, you may not be able to find a qualified practitioner.
Theres a lot of mediocre treatment for eating disorders, said NEDA co-founder Ilene Fishman.
Anyone can say they specialize in treating eating disorders.
Its very hard to find.
Back in 2008, when I sought care, treatment wasnt regulated in any way and it still isnt.
Family therapy, for children suffering from eating disorders and their families.
Acceptance and Commitment Therapy, focusing on sitting with unpleasant thoughts and emotions.
FBT is the only evidence-based treatment for children and teens.
Often, therapists combine modalities for a multidisciplinary approach, for example: DBT and art therapy.
The very best ones kind of work.
But hospitals and residential facilities employ all kinds of methods that have never been researched thoroughly with eating disorders.
A lot of therapists are winging it.
Cutting out paper dolls.
There is no standard of care.
Its depressing to hear it from him.
Kaye is a leading researcher in the field and has worked for decades to improve this state of affairs.
His UCSD facility is widely recognized as one of the best treatment and research centers in the country.
Many untested but superficially appealing treatments are marketed direct to consumer and direct to clinician.
Outcome data are rarely published, he co-wrote recently in the journalJAMA Psychiatry.
When I ask her views on equine therapy?
Dont get me started, she glared.
Really good when your bones are brittle to be bouncing around on a horse just saying.
And when treatment doesnt work?
Youre always going to have people who need treatment.
Sell a product that doesnt work, keep people coming back for more.
Thats not to say things arent moving in a positive direction, albeit at a glacial pace.
It actually used to be a lot worse.
If you look at the big picture, things are getting better, Kaye told me.
When I went into this field, nobody had any clues about anorexia.
There were all kinds of crazy ideas about cause and its really gotten better than that.
Since then, there have been significant improvements in understanding the illnesses and developing treatments.
It doesnt happen in months or years, he said.
It sometimes takes decades and unfortunately, thats the pace of science.
She was 15, and entered a residential hospital where she stayed for three months.
In the hospital, she roomed with another bulimic.
I was a rebel, she said.
I was like, F*ck you, Im going to do what I want.
It was terrifying, she shuddered in the retelling.
Was it the right thing to do?
But it did wake me up.
After that, she stopped throwing up.
In the hospital, at least.
She started again once she was home.
It didnt cure me, she said of her time in the hospital.
About a year or so after she was out, she was back in the same hospital.
I had a hard time finding help, she said.
Its relevant here to point out that Deanna is white and I am too.
If theres no standard of care for white girls, theres even less of one for everyone else.
But is it made for people like me?
People like me, meaning BIPOC.
Most researchers are white; most clinicians are, too.
Most studies are conducted with white subjects.
Perhaps no one set out to create treatment For Whites Only but its kind of whats happened.
Glorias parents are Mexican, and she grew up all around Southern California.
Around age 10 she started binge eating, which developed into bulimia in her late teens.
(Who the f*ck can afford treatment?
And even though she wanted help, the finite course of treatment only added more pressure.
Theres no room given for people who arent ready to give up their eating disorder, she told me.
I want to be met where Im at.
Its unfair to put this expectation on people, wanting them to seek recovery.
You dont know my life, you dont know how my eating disorder has helped me survive till now.
And now youre telling me I have to stop?
This article was originally published onMarch 6, 2023
