A few days ago, I read this article on the Huffington Post by Kimberly Dennis, MD, entitled Eating Disorders: Be the First Line of Defense. I wanted to re-post it here because it includes a lot of educational and statistical information that serves to re-iterate what eating disorders are. It also helps to dispel myths about eating disorders. It seems to me that the goal of this article is to provide a little bit of education to readers to help us become more aware, and possibly apprehend when a friend, loved one, or acquaintance may be exhibiting concerning behaviors related to food. This article is certainly not exhaustive, but I think it provides some basic info that everyone should know! I have copied and pasted the article below.

Eating Disorders: Be The First Line Of Defense

While the majority of us may not work in the emergency room, or even work in the healthcare industry, we can still save lives.

In the United States, as many as 10 million women and one million men are fighting a life-and-death battle with anorexia or bulimia, according to the National Eating Disorders Association. More often than not, dentists can provide the gateway to critical medical treatment for these individuals.

By becoming aware of certain signs and symptoms, you can uncover illness that may otherwise go unnoticed - and untreated. With the right knowledge, you can save a life.

A deadly disease spreads - faster

Eating disorders are potentially deadly, biologically-based psychiatric illnesses. Anorexia nervosa has the highest mortality rate of any psychiatric illness, nearly 12 times greater than any other cause of death among women between the ages of 15 and 24.

What's more, eating disorders among young women are increasing at an alarming rate. Nationally, the incidence of bulimia in women ages 10 to 39 tripled between 1988 and 1993, and continues to grow.

Anorexia typically begins at the start of puberty and is more common among adolescent girls and young adult women. It affects one to two percent of the female population, and 0.1 to 0.2 percent of men. Because more than 90 percent of all those who are affected are adolescents and young women, the disorder has been characterized as primarily a young woman's illness. But it should also be noted that males and children as young as seven years old have been diagnosed with this illness, as well as middle-aged and elderly women.

Patients are diagnosed with anorexia when their body weight falls to 85 percent or less of their normal, healthy weight. Typically, these patients have an obsessive preoccupation with body weight and calories, as well as an intense fear of gaining weight or becoming fat. Their body image is grossly distorted, resulting in an unwarranted psychological impact on how they see and value themselves.

There are two types of anorexia nervosa: the restrictive eating type and the binge-eating/purging type. Binge eaters rapidly consume a large amount of high-calorie food in a very short time - perhaps 1,500 to 3,000 calories or more. Those who purge may do so with self-induced vomiting, excessive exercise or the misuse of laxatives, diuretics or enemas. Approximately 70 to 80 percent of people with bulimia purge by means of self-induced vomiting, while 30 percent use laxatives. Some who purge, however, do so without actually binge-eating first.

Recognizing the danger signs

The physical complications associated with anorexia are potentially life-threatening, since dehydration and malnutrition can damage vital organs. This can result in:

- low blood pressure

- electrolyte imbalance

- cardiac arrhythmias

- thyroid gland deficiencies, which can lead to cold intolerance and constipation

- appearance of fine, baby-like body hair

- bloating or edema

- decrease in white blood cells, leading to increased susceptibility to infection

- osteoporosis

- seizures related to fluid shifts due to excessive diarrhea or vomiting

- kidney damage or failure from chronic use of diuretics

Signs of an eating disorder are:

• Exhibits concern about her weight and attempts to control weight by diet, refusal of food, vomiting or laxative abuse.

• Prolonged exercising despite fatigue and weakness.

• Peculiar patterns regarding handling food.

• Exhibits abnormally fast weight loss, without any other known medical condition.

• Experiences depressive moods and self-deprecating behavior.

If you recognize these signs, fight the urge to remain silent. Remember, denial is a big part of eating disorders - another reason they can become fatal and a major obstacle to recovery. Act in a caring and non-judgmental way, simply stating what you see, and asking how you can help.

Also, you can go to the Web site of the National Eating Disorders Association (www.myneda.org) or call Timberline Knolls at 877-257-9611, and we would be happy to help find a professional in your area. That referral just might save a life.

Kimberly Dennis, M.D., is the medical director at Timberline Knolls (www.timberlineknolls.com). Located in Lemont, Ill., this innovative residential treatment center is designed exclusively for women with emotional disorders, including eating disorders, addiction and self-injury behavior. Dr. Dennis is a member of the American Medical Association, the Academy of Eating Disorders, the American Academy of Addiction Psychiatry and the American Society of Addiction Medicine.

Michelle Obama's Campaign to Fight Childhood Obesity

I have seen a lot in the news this past week about Michelle Obama's campaign to fight childhood obesity. And I have really been wanting to write something about this because I have had some thoughts that I want to share-- but I think I have been slow to do so because I never want my blog to sound like a diatribe against society or pop culture or the media or different individuals or (fill-in-the-blank). Yes, I like to think critically; and yes, there are things from time to time that need to be called out. But the purpose of my blog is not to point these things out that I observe or read from day to day for the sake of being critical. I am MUCH more interested in raising peoples awareness and encouraging others to think about the ways that we view ourselves, our bodies, beauty and eating disorders- and that is why I blog! When I read statistics about women, young girls and even men- really everyone!- I am always surprised to find out just how far people will go to lose weight or to look 'good'. While I get that we all want to look and feel good, it just seems so unreal and sad that things have been taken to such extremes. The fact that more than 2/3 of women ages 18-25 would rather be labeled mean or stupid instead of fat, and over 50% would rather be hit by a truck than be labeled fat is pretty outrageous (Martin, 2007). I also want to be clear (again) about the fact that when it comes to eating disorders, they are a serious mental illness- not simply a lifestyle choice, like many people believe.

So, with that being said, I am going to go back to the First Lady's new pet project- childhood obesity. I think it is wonderful that she is targeting children's health, but when I read on CNN.com that President Obama was calling his daughter Sasha "chubby" and that Michelle had mentioned things were "off balance" with her daughters weight wise, it made me cringe on the inside. While I loudly applaud her efforts to approach this issue nationally (because it is an issue), using her daughters as an example draws unnecessary attention to their weight at an age when they are vulnerable and sensitive to developing body image issues, not to mention eating disorders. While she has been significantly criticized in the wake of her comments, I think the focus, rather than chastising her for making the comments, should be on approaching this issue from a supportive and healthy standpoint for the sake of the children involved. Dr. Albers who has written books about mindful eating, wrote a great article for the Huffington Post that you may want to check out. Her point is that weight is not always the best indicator of health, and that we need to focus on the big picture rather than on dieting (which we know does not work!). Follow this link to read her article. And follow this link to read another great article called Dads, Daughters and Diets: Obama's Mistake.

In light of this recent controversy, CNN.com has listed some helpful suggestions for parents about talking to their children/teens about being healthy. Some of the suggestions that they encourage parents to consider include focusing on health and not pounds (or a number on the scale), being open to discuss any issues related to health or otherwise with their children, ending fat talk, and avoiding diet mentalities with 'good' foods and 'bad' foods. For more, follow this link. Whether you are a child or not, these tips are helpful for people of all ages to help maintain a healthy approach and attitude towards health, food and our bodies.

Operation Beautiful

A lot of girls play dress-up when they're little. It's fun to dress up and pretend to be glamourous. I know when I was little, getting the chance to play around with make-up, high heels and princess dresses was definitely a special thing. However, I don't really remember looking up to anyone in the media and idolizing them. I know that I watched TV, and I wasn't a completely sheltered kid. But I don't remember having the kinds of 'role models' today that many young girls do (like Hannah Montana, etc). For example, I was at Target the other day, checking out, and there were two five year old looking girls with one of their mothers. They were looking at all of the magazines on display and kept screaming, "Ooohh Taylor Swift, I love her, she is so pretty. She is so lucky that she is dating [so-and-so]." All I kept thinking was- how do they know this stuff? Haha. I mean, I watch TV and read up on celebrity gossip from time to time but it just seemed weird to me that they knew so much about Taylor Swift. It just dawned on me how different things are for children who are growing up now, and how much more intense, accessible and available media is for people of all ages.

I guess the concerning thing to me is that when girls this young are exposed to an ideal standard of beauty as dictated by Hollywood, they are shaped from this young age to view beauty as what they see on the covers of magazines. The issue is not that young girls should not think Taylor Swift is beautiful, or that magazines are horrible. I actually love Taylor Swift and think she is a good role model for young girls- she appears to be gracious, hard working, and humble- all things that make one beautiful. The issue to me is that if young girls (as well as women of all ages) are not seeing people of all shapes, sizes and colors, etc, in the media that are regarded as beautiful, then it is likely they will view beauty very narrowly. And, beauty is not just about looks! How many times have you met someone that is physically attractive or beautiful, and then they spoke or acted in such a way that made them unattractive to you? As much as it is a cliche, beauty (in Hollywood) is only skin deep! In a world where already 'beautiful' people are getting plastic surgery to enhance their image, the messages that are sent to women about beauty are not necessarily healthy or positive.

Someone recently shared with me about a really amazing movement going on that is called Operation Beautiful, which aims to help people embrace their beauty. The mission of Operation Beautiful is to end fat talk, which involves talking about weight, lamenting over the width of our thighs (or any other body parts), and comparing ourselves to others! The tag-line on their website is "Ending Fat Talk One Anonymous Post-It At A Time." They encourage people to leave positive, encouraging, anonymous notes in random places- public restroom mirrors in schools, restaurants, etc- to be seen by random people. (An example from their site: When the world says 'give in', stay strong! You are a fighter. You are beautiful. Have a great day!) They encourage people to leave the website address on the note so people can go to the site and find out more about Operation Beautiful. The site is awesome in that people share personal stories about how they have been impacted by an anonymous note, as well as the impact that leaving notes around for people has on them. This is such a great pro-active way to encourage people and to end fat talk. The person who told me about Operation Beautiful leaves anonymous post-it notes in the diet/health section at Barnes and Noble. What a great idea!! The reason I love this so much is that so often it is difficult to know how to do little things that positively impact people in a significant way- and this is an example of something that is super easy to do but that makes a big difference.

For more information on Operation Beautiful, follow this link. And view this video below for more information and to be inspired by what they are doing!

A Wake-Up Call

One of my all-time favorite movies is Clueless. Say what you want about it, but everything about it makes me laugh. My best friend gave me that movie for my birthday shortly after it came out years ago, and I probably know all of the words by heart. When I heard Sunday that Brittany Murphy, the actress who played Tai in this movie, was found unconscious and died of cardiac arrest, I could not believe it. She was only 32 years old- so tragic.

There is a lot of speculation surrounding her death- she has been plagued with rumors of drug use, as well as an eating disorder. At this point, it is all speculation, but what is clear is that the most recent pictures published of her show her looking extremely emaciated. I was not planning on blogging about her, but I have had quite a few conversations about her death in the last two days with my clients that have really been making me think. A lot of the girls and women that I work with have eating disorders, and Brittany Murphy's death has possibly serious implications for those with anorexia, and eating disorders. As I mentioned before, no one really knows what caused her death. But what statistics tell us is that anorexia nervosa has the highest mortality rate of any mental illness. In fact, according to the National Eating Disorders Association (NEDA), females between the ages of 15 and 24 who suffer from anorexia nervosa experience a death rate that is 12 times higher than the death rate of all other causes of death. Just to be clear, this statistic only applies to those suffering with anorexia-- this does not mean that the leading cause of death among females who are between 15 and 24 is anorexia.

This week as I have heard clients question and ponder what ultimately killed Brittany Murphy (investigators said it was 'natural causes' but what is natural about dying at 32?), I have been struck by something else. Regardless of which self-destructive behavior (eating disorder, drugs, etc) may have contributed to her death, I think there is an important lesson that can be learned from this whole situation. It appears that Brittany's friends and fellow actors were not as shocked to hear about her death as the rest of us- apparently, she had been exhibiting erratic behavior as of late, and they were all very concerned about her shrinking frame. I think her death is a wake-up call. No matter what ultimately caused her death, her tragic exit from this world demonstrates that we are fragile. So many people with eating disorders think that they are immune from the dire health consequences that result from eating disorders, especially death; likewise, often those with drug dependencies and addictions often think that nothing bad will happen to them as a result of their drug use, including death. But death can happen and it does happen. And it is so important to take mental illness and self-destructive behaviors seriously! If you know someone who is practicing self-destructive habits, or is engaging in harmful behaviors, or you yourself are engaging in these behaviors, please seek help. This is such a serious issue. Hopefully Brittany Murphy's death will not be in vain- and will serve as a warning for others who are walking this fine line of danger.

If you or someone that you know is interested in finding out about receiving help to deal with an eating disorder, follow this link. To find out more about receiving help for a drug related issue, click here.

Kids, Mental Health and Hope

I like to think that I am a 'glass half full' kind of person. Generally, I try to see the good in people and situations, and am hopeful about change- if I weren't, I'm not so sure that counseling would be the best field for me! All that to say... I noticed the other day that while I was reading an article about young people and mental health, I found myself taking a 'glass half empty' mentality. Why??

Well, according to a survey funded by the National Institute of Mental Health (NIMH) which will soon be published in the journal Pediatrics, 13 percent of all children and young teens have at least one 'mental health disorder.' And of that 13 percent, only half have been evaluated and treated by a mental health professional. These facts indicate that while one half of young people are being treated, one half are not. This is a staggering number when considering that half of all youth with mental illness are receiving no treatment or help at all.

This survey sampled 3, 042 children between the ages of 8 and 15, and the findings were based on assessments of these children for six common mental disorders--anxiety disorder, panic disorder, eating disorders (anorexia and bulimia), depression, ADHD (attention-deficit/hyperactivity disorder) and conduct disorder. For a bit of perspective, imagine if half of young people who deal with diabetes or asthma were living without medical treatment. To think about the number of children and teens who are suffering from untreated mental health issues is alarming. And sad! Research indicates that when mental health issues are not treated, they typically persist and become more severe with age. (I wrote a blog awhile back on teens and depression that addressed this issue- follow this link to read it and to learn some of the symptoms of childhood/teenage depression.) This is concerning because young children and teens who suffer from eating disorders, for example, and are not being treated are at serious risk for many physical and psychological problems. This is a serious issue!

The article suggested that part of this problem is due to the fact that there is a shortage of mental health workers that specialize in treating children, specifically psychiatrists. So what is a parent to do?? Perhaps we need to focus on educating more parents and teachers about the symptoms of anxiety, depression, eating disorders, ADHD, etc.. in children and teens so that they are able to notice the warning signs and advocate for their treatment. While mental health professionals have the tools and knowledge to diagnose and treat, parents and teachers are able to notice patterns of behavior in children over time that a professional is not necessarily capable of seeing when sitting with them for 30 minutes. To read this article in its entirety, follow this link, as well as this one for more info!