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Eating Disorders

Signs of Anorexia to Watch for in Teens

Anorexia nervosa is one of the most common eating disorders in teens, and a condition that has risen in prevalence over the last few decades. It’s largely characterized by unhealthy and unsustainable weight loss, a consistently below-average body mass index (BMI), and a very low body weight in the absence of any contributing diseases or conditions.

Anorexia is commonly mentioned in contrast to bulimia. Where bulimia is characterized by binge eating and purging behavior (i.e. laxative use, induced vomiting, etc.), anorexia is characterized by controlling and reducing body weight largely via exercise and self-induced starvation. Women are more often affected by anorexia nervosa, but men can also struggle with eating disorders and associated body image issues.

While eating disorders are most often diagnosed among teens and young adults, they can occur (or persist) later in life too. Because teens are learning to take care of themselves and taking concepts such as nutrition and healthy living into their own hands, it’s important for parents and educators to differentiate between healthy lifestyle changes and potential symptoms of an eating disorder.

A Key Characteristic of Anorexia Nervosa

There are several signs and symptoms for anorexia nervosa, the most important being self-induced starvation, physical symptoms of extreme malnutrition, and a fear of gaining weight, particularly fat. However, it often comes back to a central point: The need to always lose more weight.

Teens who struggle with anorexia nervosa constantly perceive themselves as fat in some way, and often suffer from symptoms of body dysmorphia, a compulsive mental health issue wherein someone constantly perceives flaws within themselves even when these flaws aren’t present. More than any other symptom, teens with anorexia nervosa will insist that they need to lose more weight even while they’re unhealthily underweight.

Other Warning Signs of Anorexia

Teens with anorexia nervosa will go through extreme lengths to avoid eating food or making up for meals with excessive and intense exercise. While there is certainly a benefit to intense exercise, the level of exercise that is characteristic for someone with anorexia is destructive and harmful, particularly in the absence of much needed nutrition and critical recovery.

At the very least, a growing teen body needs plenty of sleep and plenty of food. This is doubly important when undergoing training. If your teen is obsessed with sports alongside unrealistic calorie restrictions, they may be struggling with anorexia. Other important signs and symptoms include:

    • Denying hunger
    • Eating in secret to avoid being judged
    • Developing certain rituals during meals (centered around reducing intake, such as excessive chewing)
    • Extreme dietary rulesets (completely avoiding one type of food or nutrient)

Aside from behavioral symptoms, anorexia can lead to the development of serious physical symptoms because of malnutrition and intense physical stress. These symptoms include:

    • Amenorrhea, or the absence of menstruation
    • Signs of osteoporosis, or brittle bones
    • Abnormally dry and flaking skin
    • Acne
    • Hair loss
    • The development of very fine facial and body hair, known as lanugo
    • Frequent fainting spells
    • Low blood pressure

These are not surefire signs of anorexia, and any one of these symptoms should prompt a visit to a doctor. But in the absence of a different medical condition, they may be caused by malnutrition and stress because of an eating disorder – especially in combination with the aforementioned behavioral signs.

What Causes Anorexia?

The causes of anorexia are complex, consisting of both environmental triggers and potential heritable traits that overlap with symptoms of obsessive-compulsive disorder (eating disorders and OCD can cooccur), anxiety, and depression. Psychiatric causes, including abuse and exposure to certain media, also play a large role. Other identified causes range from genetics to bacterial infection.

Given that eating disorders are more common in developed or Western countries, and are rising in prevalence in developing or non-Western countries, one theory is that the growing rate of eating disorders among teens is at least partially a result of Western beauty standards, media, and advertising (from TV to Instagram).

In the age of fitness models and influencer culture, teens are more inundated with unrealistic bodies and beauty standards than ever and may adopt unhealthy diets or exercise regimens not understanding what goes on behind the scenes. They may not be aware of how dangerous it is to remain at a certain low bodyfat outside of competition or aren’t aware of the use of things like fake weights, imperceptible image manipulation, and performance-enhancing drugs.

However, whether these environmental factors simply trigger an innate potential for anorexia or contribute to its development is still unclear. Research into eating disorders has shed a lot of light on just how complex they are, as well as revealing the many internal and external factors that play a role in their origin.

Signs of Anorexia in Boys

When eating disorders are brought up in the context of boys and men, other body image issues – such as muscle dysmorphia – are more commonly talked about. Indeed, “bigorexia” is a more common issue among boys than girls. However, that doesn’t mean anorexia nervosa does not exist in men. An estimated 20 percent of anorexics are male, presenting with all the same symptoms – starvation, a heavily distorted body image, and extremely restrictive dietary habits.

Again, symptoms of anorexia in boys overlap with symptoms of anxiety, depression, and obsessive-compulsive behavior. It’s a disorder that claims lives across gender lines, and while women are more heavily affected than men, the cases of boys with anorexia are rising, or at least becoming more known to clinicians and researchers.

How Anorexia Is Treated?

Some cases are far more severe than others. Because anorexia nervosa can sometimes go untreated until hospitalization occurs (because many teens refuse treatment), one of the most important steps to treating anorexia is first ensuring an anorexic teen’s survival. Teens with anorexia are carefully monitored to ensure that their hydration and electrolyte levels are improved, that their heart health hasn’t deteriorated too much, and they may require a feeding tube if they can’t keep down solid food. In extreme cases, hospitalization plays a vital role in the long road towards recovery and improvement.

Because the causes for anorexia may be neurological as well, treatment differs from individual to individual depending on how effective certain approaches are deemed to be. Teens with anorexia will usually work with a therapist to overcome and deny delusions of fatness and accept that they need help to work towards a healthier bodyweight. Different types of behavioral therapy such as CBT may help teens with anorexia confront their own thought patterns and avoid re-engaging in self-induced starvation.

Sadly, anorexia has the highest mortality rate of any mental disorder, in large part because of the risk of cardiovascular failure and the effects of starvation. Treating this disorder can be difficult, and requires a holistic approach addressing a teen’s psychological and physical symptoms. Family members often work with specialists to provide critical support, and a registered dietitian will help a teen learn to rethink their eating habits and slowly return to a healthier weight.

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Eating Disorders

What Are Symptoms of an Eating Disorders?

One of the most common eating disorders we’ve all come to know is anorexia. Most of those accounts portraying anorexia are focused on women and young girls. There are also other eating disorders we may not be aware of looking at someone directly. Other eating disorders are harder to see on the surface, whereas anorexia is characterized by deficient weight that causes the person affected to waste away before our very eyes.

Conditions like these hurt families, and they often feel confused and helpless because they are unaware there’s an issue half of the time. At Visions, our parents and loved ones must learn a little something about every mental health and emotional condition so they can be ready, with eyes wide open, to see the signs. We hope to prepare families everywhere to care for each other, even when the person hurting can’t express themselves in words at that moment.

Most people don’t realize that eating disorders don’t just affect women and girls, unlike what the media continues to show us. Eating disorders affect everyone, no matter their gender. It’s known that over 10 million men in the United States are affected by eating disorders; this number is half of women and girls affected, but the point is that women are not the only people that struggle with weight and body image.

Most Common Eating Disorders

Anorexia Nervosa

As one of the leading, most common eating disorders, anorexia nervosa is a condition that begins with the complete cessation of eating or gaining any nutrition into the body at all. Adolescents affected by anorexia often lose weight rapidly to the point that it can cause serious health issues, possibly even death.

Symptoms of Anorexia

  • Depression
  • Thinning hair
  • Suicidal thoughts
  • Social withdrawal
  • Trouble with digestion
  • Wearing baggy clothes
  • Reduced periods in women
  • Acute fatigue and insomnia
  • Anxiety concerning weight gain
  • Dehydration Jaundice (yellowed skin)
  • Won’t eat in a group setting and often makeup excuses

Bulimia Nervosa

Those affected by bulimia eat, but they won’t allow the food to digest in their system. You’ll notice them take frequent bathroom breaks to vomit up their food to avoid absorption of nutrients so they can avoid gaining any weight. Bulimia is a serious condition that could cause deterioration of the esophagus and other tissues in the body. Those with bulimia could suffer from seizures and irregular heart rhythm.

Symptoms of Bulimia

  • Frequent mood changes
  • Depression and anxiety
  • Their breath will often have an obscure odor
  • Dental deterioration
  • Constipation or inflammation of the intestinal tract
  • Dry skin
  • Devour lots of food and excuse themselves
  • Critical of body weight and shape
  • Muscle cramping
  • Tremors
  • Social withdrawal
  • Fainting

Binge Eating Disorder

People eat with binge eating disorders, and they will eat regularly, but these abnormal eating behaviors occur when they’re alone. Bulimics have periods where they won’t eat, fast, then eat a high amount of food in one sitting. Those with bulimia will often eat fast food alone and hop from one restaurant to another to eat in isolation.

Symptoms of Binge Disorder

    • Lack of self-control
    • Eating significant amounts of food and hiding food away
    • Continually eating until it becomes uncomfortable
    • Social withdrawal
    • Weight gain
    • Feeling guilty eating
    • Excessive exercising
    • Can binge eat and then vomit their foods

Body Image Disorder or Body Dysmorphic Disorder (BDD)

A mental health condition that often comes from anorexia, bulimia, and binge eating disorder often comes from these disorders. It might be the case that your loved one started with a form of extreme dieting or became addicted to exercise, and this body dysmorphic disorder (BDD) manifested, or the other way around. These conditions work off one another.

At Visions, we work with our teens to help them realize the beauty within every one of them. If we’re aware of how our children feel about themselves and how we talk to them as a family or supportive unit, we might notice these changes in eating behaviors and their adverse effects. As always, pay attention and be attentive to your children. If your child or loved one develops an eating disorder, contact us today.

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Body Image Eating Disorders Mental Health Recovery

Eating Disorders: Recovery and Service

Eating disorders can breed contempt or denial in those that don’t understand them while feeding the silent devastation and fear in those who have them. This is an inherently challenging situation. Types of eating disorders vary but we are most familiar with Anorexia and Bulimia or a variation of the two. Still, there are some who suffer from disordered eating. I’ve heard it said that disordered eating is not an “actual eating disorder,” but rather a “phase” of bad eating behaviors.  However, the DSM and professionals in the field of addiction and mental illness have proven that not to be the case. For example, disordered eating has now earned the diagnostic term Eating Disorder Not Otherwise Specified or EDNOS.

For real clarification, the DSM descriptions of the various criteria for Anorexia, Bulimia, and EDNOS can be found below:

Eating disorder not otherwise specified includes disorders of eating that do not meet the criteria for any specific eating disorder.

  1. For female patients, all of the criteria for anorexia nervosa are met except that the patient has regular menses.
  2. All of the criteria for anorexia nervosa are met except that, despite significant weight loss, the patient’s current weight is in the normal range.
  3. All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than twice a week or for less than 3 months.
  4. The patient has normal body weight and regularly uses inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies).
  5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.

The criteria for Anorexia Nervosa is:

  • Refusal to maintain body weight at or above a minimally normal weight for age and height: Weight loss leading to maintenance of body weight <85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.
  • Intense fear of gaining weight or becoming fat, even though under weight.
  • Disturbance in the way one’s body weight or shape are experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
  • Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women. Amenorrhea is defined as periods occurring only following hormone (e.g., estrogen) administration.

And the criteria for Bulimia Nervosa:

  • Recurrent episodes of binge eating characterized by both:
  1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
  2. A sense of lack of control over eating during the episode, defined by a feeling that one cannot stop eating or control what or how much one is eating
  3. Self-induced vomiting
  4. Misuse of laxatives, diuretics, enemas, or other medications
  5. Fasting
  6. Excessive exercise
  • Recurrent inappropriate compensatory behavior to prevent weight gain
  • The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • The disturbance does not occur exclusively during episodes of anorexia nervosa

Recovering from any of these eating disorders is hard work. We have to learn to navigate the food playing field with healthy awareness. One of the interesting things I’ve learned about recovering from my own eating disorder is that food is merely a symptomatic component of the greater problem: low self-esteem, an out of control environment, poor body image, fear, control. Not eating was always a way to control the chaos around me. What I was clueless about was the fact that I was created chaos within. The more out of control the outside environment is, the more control someone struggling with an eating disorder requires to simply survive. Yes, there’s deep irony in the use of “survive” here, because the end result of some severe eating disorders is ultimately death.

Chelsea Roff, a recovering anorexic, yoga teacher, speaker, and author, has come out publically with her story of recovery. Chelsea suffered from a stroke when she was 15 and ended up in a hospital for 18 months under constant care. Her essay, bravely discussing her story first appeared in the book 21st Century Yoga: Culture, Politics, & Practice. From there, she was swept into the fray of instant publicity and exposure, ranging from the Huffington Post to Dr. Sanjay Gupta on CNN. While being in recovery isn’t about celebrity, there’s something to be said for a young girl who is taking this exposure and using it for good. There’s something deeply inspiring about someone who came from near death and is now thriving and being of service. In the end, being of service is what it’s about.

Eating disorders have their way of creeping back in when we least expect it. When we are of service and helping others, our own transparency is paramount to that process. In other words, being of service helps keep us honest. We have to eat. We have to learn to develop healthy relationships with our bodies and with food. Here, instead of vigilantly controlling our intake of calories, we can direct our vigilance to being of service. I look to Voice in Recovery and Chelsea Roff as young women who give back what was so freely given to them. I look to Melanie Klein (also a contributor in 21st Century Yoga) and Claire Mysko to provide the education and passion for body image advocacy in order to help young people gain a better understanding of the deeply rooted, media-infused sources of poor body image and eating disorders.

Kindness starts from within. We can and will recover.

RESOURCES:

NEDA

NIMH

Proud2BMe

Voice in Recovery (ViR)

 

Categories
Body Image Eating Disorders Mental Health

Adios, Chubby Chatter!

Image by Brent Weichsel via Flickr

“Do I these pants make me look fat?”

“OMG, I feel so fat today!”

“I can’t believe she’s wearing THAT!”

I honestly wish this commentary occurred less than it actually does, but the reality is, it doesn’t. It occurs on a daily basis in the lives of girls (and boys) from elementary school age to women in their older years. It’s the baseline for many conversations and it’s more often than not done without concern for those around them. Think about this: when someone who’s a size 2 says to a friend who’s a size 10 that she feels “fat,” there is an  implication of body-image judgment, regardless of intent or level of self-esteem of the person hearing the comment. As soon as we start adding to the ever-present dialogue that one body type is somehow better than another, we inadvertently fuel the fire of low self-esteem and negative body image. In fact, when asked about the consequences of fat talk, Elizabeth Easton, PsyD and clinical director of child and adolescent services at the Eating Recovery Center says, “Negative body image is an easy hook for individuals who struggle with self-esteem or identity to latch onto as a way to feel more confident and even accepted by others.” Fat talk is damaging, no matter how you look at it.

Parents play a huge part in this as both contributors and as allies in our efforts to combat this type of language. We need to be mindful of what we say about ourselves, letting go of the delusion that we are “just talking about ourselves,” because in the eyes of an impressionable young girl or boy, the negative impact is very real. We are our kids’ first teachers, and if we teach them to hate themselves because of our own perceived weight problem, we potentially create a lifetime of body-image issues that can translate into disordered eating and/or eating disorders. I’ll never forget the kindergartener at my son’s school who burst into tears during a dress rehearsal because her costume made her look fat  (she was playing Toto!); or the 8-year-old who won’t eat because she’s afraid she might get fat. Neither of these kids have a weight problem: rather, they have a perception problem brought on by the fear-inducing commentary from their parents, peers, and media. Fat talk is a real issue and one we need to ardently address. There are some very real consequences to this constant barrage of body bashing, and it shows in these eating-disorder statistics from NEDA:

  • In the US, as many as 10 million females and 1 million males are struggling with an eating disorder such as anorexia or bulimia;
  • 80% of American women are dissatisfied with their appearance;
  • The mortality rate for 15- 20-year-old  females who suffer from anorexia is 12 times the death rate of all other causes of death;
  • Anorexia has the highest premature fatality rate of any mental illness;
  • 40% of newly identified cases of anorexia are girls 15-19;
  • 54%  of women would rather be hit by a truck than be fat;
  • 81% of 10 year olds are afraid of being fat (Mellin et al., 1991).
  • 42% of 1st-3rd grade girls want to be thinner (Collins, 1991).
  • 67% of women 15-64 withdraw from life-engaging activities like giving an opinion, going to school, and going to the doctor because they feel badly about their looks;
  • Most fashion models are thinner than 98% of most American women (Smolak, 1996);
  • Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives (Neumark-Sztainer, 2005);
  • 46% of 9-11 year-olds are “sometimes” or “very often” on diets, and 82% of their families are “sometimes” or “very often” on diets (Gustafson-Larson & Terry, 1992);
  • 91% of women recently surveyed on a college campus had attempted to control their weight through dieting, 22% dieted “often” or “always” (Kurth et al., 1995);
  • 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full syndrome eating disorders (Shisslak & Crago, 1995);
  • 25% of American men and 45% of American women are on a diet on any given day (Smolak, 1996).

Next time you wonder if you look fat in your outfit, or feel compelled to use body bashing as a conversation starter, name 3 things that are positive about yourself. Challenge yourself to be kinder to YOU so you can affect positive change on those around you. You’re worth it.

For more information on eating disorders:

National Eating Disorders Association’s Information and Referral Helpline: 1-800-931-2237  | www.NationalEatingDisorders.org

References for aforementioned Statistics as documented at NEDA:

Collins, M.E. (1991). Body figure perceptions and preferences among pre-adolescent children. International Journal of Eating Disorders, 199-208.

Crowther, J.H., Wolf, E.M., & Sherwood, N. (1992). Epidemiology of bulimia nervosa. In M. Crowther, D.L. Tennenbaum. S.E. Hobfoll, & M.A.P. Stephens (Eds.). The Etiology of Bulimia Nervosa: The Individual and Familial Context (pp. 1-26) Washington, D.C.: Taylor & Francis.

Fairburn, C.G., Hay, P.J., & Welch, S.L. (1993). Binge eating and bulimia nervosa: Distribution and determinants.

In C.G. Fairburn & G.T. Wilson, (Eds.), Binge Eating: Nature, Assessment, and Treatment (pp. 123-143). New York: Guilford.

Gordon, R.A. (1990). Anorexia and Bulimia: Anatomy of a Social Epidemic. New York: Blackwell.

Grodstein, F., Levine, R., Spencer, T., Colditz, G.A., Stampfer, M. J. (1996). Three-year follow-up of participants in a commercial weight loss program: can you keep it off? Archives of Internal Medicine. 156 (12), 1302.

Gustafson-Larson, A.M., & Terry, R.D. (1992). Weight-related behaviors and concerns of fourth-grade children. Journal of American Dietetic Association, 818-822.

Hoek, H.W. (1995). The distribution of eating disorders. In K.D. Brownell & C.G. Fairburn (Eds.) Eating Disorders and Obesity: A Comprehensive Handbook (pp. 207-211). New York: Guilford.

Hoek, H.W., & van Hoeken, D. (2003). Review of the prevalence and incidence of eating  disorders. International Journal of Eating Disorders, 383-396.

Mellin, L., McNutt, S., Hu, Y., Schreiber, G.B., Crawford, P., & Obarzanek, E. (1991). A     longitudinal study of the dietary practices of black and white girls 9 and 10 years old at enrollment: The NHLBI growth and health study. Journal of Adolescent Health, 27-37.

National Institutes of Health. (2005). Retrieved November 7, 2005, from
https://www.nih.gov/news/fundingresearchareas.htm

Neumark-Sztainer, D. (2005). I’m, Like, SO Fat!. New York: The Guilford Press. pp. 5.

Shisslak, C.M., Crago, M., & Estes, L.S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18 (3), 209-219.

Smolak, L. (1996). National Eating Disorders Association/Next Door Neighbors Puppet Guide Book.

Sullivan, P. (1995). American Journal of Psychiatry, 152 (7), 1073-1074.

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Eating Disorders

Anorexia Doesn’t Have to be a Death Sentence

     If this isn’t a reminder of of the deadliness of anorexia, I don’t know what is: Isabelle Caro, a French model and actress well-known for bringing mass attention to the issue of anorexia in the world of fashion died last week. She was a mere 28 years old. It’s not just her youth that saddens me, but the overwhelming destructive nature of eating disorders in general. They wreak havoc in the most pervasive way: infecting family meals, creating shame-based thinking over the mere act of fueling our bodies, shattering any sense of self-esteem, and creating the sensation of falling down the rabbit hole whenever we venture into the realm of nourishment. The truth is, they negatively impact those suffering in more ways than the few I’ve mentioned. 
    Circumstances maintaining the virulence of eating disorders are in abundance: fashion magazines tout the ultra-thin, we’ve got a myriad of celebrity diets and pop-up ads declaring easy weight-loss without exercise, but the piece du resistance — pro-ana (pro-anorexia) sites celebrating and encouraging emaciation. In fact, when Caro died, it was a pro-ana site that posted her images with the tag line “die young, stay pretty.” On sites like this, recovery is the anti-goal.
    Recovering from an eating disorder takes time, support, and patience.  It takes acceptance of the fact that there will be good days, bad days, and days that fall in between. For me, it also takes the willingness to be transparent when transparency is usually not an option–this means I let someone know the tricks of the trade, so to speak, by sharing my “tells.” I have gleaned new ways and means of dealing with the lies my head tells me by being mindful about what I am feeling and thinking in relation to food. I engage in a loving-kindness practice when I eat, particularly when the day is rough. I regularly practice yoga, which directly brings my attention to my breath and body in a positive way. I share my experience, strength and hope whenever I can.
    I’m deeply saddened by the death of Isabelle Caro. It reminds me of how precious our lives are and how invaluable it is to be healthy. Taking a step towards recovery has positive, life-changing consequences. Why enter another decade suffering needlessly? I encourage you to reach out, ask for help, and begin talking about what’s going on. I’d like to be able to look at Isabelle Caro as a beacon of change, not just a victim of this disease, her voice becoming a vehicle for awareness, encouraging us to get to a place of healing and recovery. Nothing is impossible!

Categories
Body Image Eating Disorders Mental Health Recovery

Help With My Eating Disorder

I began to address my eating disorder when I was in adolescent treatment in Malibu. It has been a very difficult journey and sometimes it has been very hard not to lapse into old behaviors. In the last year, I have really dedicated myself to staying committed to recovery and have recently seen a big change- I’ve gained weight! In the past, this would have destroyed me, but since I have been working so hard to get healthy, I feel pretty good about it. Mostly. Honestly, this week I had a bit of an emotional meltdown when I went to try on a bathing suit I hadn’t worn for three years. It didn’t fit. Later that night I went to put on a favorite summer dress. It didn’t fit. My jeans didn’t fit. Like, overnight my clothes stopped fitting. It’s one thing to talk about the work, to write about the work, to intellectualize the work- and an entirely different thing to actually have it happen. In my brain, I am very pleased to have some success in this very difficult area of my life. In my eating disorder’s brain, I am losing my mind. It’s horrifying. I feel like I shouldn’t be so upset, but of course I am. This old way of thinking has dominated my life for years and years. Of course I will grieve.
My sponsor and my best friend both suggested that I get rid of my old clothes. They will never fit me again as long as I am healthy. I took their advice and began to bag up my eating disorder clothes and cried the whole time. It was intensely symbolic for me to say goodbye to them, and to my eating disorder– to acknowledge that I’m not going to be that underweight again. That I’m going to stay healthy. I felt like I could almost hear my eating disorder yelling “Noooooo!” as if it was a villain being shoved off of a cliff in a movie. Sometimes those ceremonial gestures are important, like I’m showing myself what is really happening.
This week has been kind of heavy for me, but now that it’s over I feel a certain levity. I know that there is still a lot of work to do so that I don’t lapse in behavior. I have to power through this challenging time. It was hard to say goodbye, and I know that this is part of my grieving process. It may sound weird to grieve something that hurt me so much, but it was my greatest comfort for many years, and it’s scary to let go of it. I know that I have a lot of love and support around me, and that I don’t have to go through this alone. And hey, I get to go shopping.

Adolescent Eating Disorder Treatment In Malibu