Three lessons to know:
- Eating disorders are like a cancer in that they grow insidiously and slowly. They grow from temperament. An easy kid, perfectionist, self disciplined, modest; wonderful traits to have but also grounds for developing these disorders. It is helpful to understand and recognize the disorder at a much earlier stage. Behavior is the last thing to change when the illness develops. The brain is wired in ways to compensate for amazing changes. It is an amazing computer, and this also presents an opportunity to identify the illness early, before behaviors start to appear. This is true now in heart disease and diabetes so the aim is for pre-emption rather than prevention. This can make a huge difference (in the prognosis).
- Eating disorders are family disorders. They are not necessarily a family system problem but the family provides the context in which the eating disorder develops and exists, and this is the context in which the illness will ultimately be resolved. The culture counts too, and family is the prime culture. The focus needs to be on learning to express emotion, to ‘out’ any secrecy. It is tough going. Family-focused treatment in recent years has a clear track ride. This treatment may not be the right answer for everyone but for everyone, unless family is involved in some way, there will still be problems that won’t be resolved in that family culture.
- Most people with an eating disorder are doing great. Although there are scars and fatalities; the story, however, is mostly a hopeful story. Most people who develop such an illness go on to do spectacular things as adults, using the very traits that may have taken them into the addiction of an eating disorder. It may be assumed that we know how people get sick or better but with this problem there is no single path either way.
The soil for anorexia – low self-esteem, perfectionism, obsessiveness – grows an awful tree of chaos, guilt, and helplessness.
Families and support organizations are passionate about advocacy for getting access to insurance coverage and quality care. We have to be humble because we also need better science, more information, and understanding. For instance, with diabetes and cystic fibrosis, the focus is where they already know a lot: they are deeply and continually focused on science. This provides an important lesson. We need to be thinking how to advocate for better treatments that will be cures rather than slow, rehabilitative interventions.
PRESIDENT KENNEDY – MESSAGE HALF A CENTURY AGO
President John Kennedy, 50 years ago, stated:
“Yet mental illness and mental retardation are among our most critical health problems. They occur more frequently, affect more people, require more prolonged treatment, cause more suffering by the families of the afflicted, waste more of our human resources, and constitute more financial drain upon both the public treasury and the personal finances of the individual families than any other single condition.”
President Kennedy focused the country for first time on these issues. That was 1963. How do we make sure that 15 or 16 years from now, we are not having the same conversation? It is great to be aware and measuring things, but we cannot accept a significant increase in prevalence of these diseases. We need to be mindful, and identify much early through biomarkers, screenings, or whatever we need to focus on family and culture and define the paths to recovery. Most of all, we need to build a community of addressing these biological illnesses.
At the end of the day it is up to each of us, and this is ok because we CAN make a difference by working in communities and supporting others.