A poster shows a beautiful mountain scene with a young girl bending down to pick a wild flower. The caption reads:

“I bend down to pick a flower and realise that it is attached to the universe”.
(Sierra Club)

I received an email over the holidays from a woman who said that she had battled bulimia for many years, and wanted to meet to deal with her difficulties. As many of you will know, just sitting and talking about the difficulties does not help.

What helps is addressing the problems, dealing with the relationships; it is focusing on people people people. And it is how you address these problems. To do this you need support. And you need to realise that it isn’t just you that needs to change.

So join our website, give us your feedback, your queries, your suggestions, and help us to help you and make this website as valuable as possible to our community.

In the world of eating disorders, there are similar challenges. Over the years, healthcare providers have underestimated the public’s ability to adapt to healthier lifestyles. For example, people have begun exercising as a way of overcoming health complaints as well as preventing future complaints. Similarly there can be earlier intervention with eating disorders.

Here are some suggestions:

1. For families of young children, especially young daughters, the focus should not be on physical beauty. It should be on the value of the child as a loving, caring, intelligent person. Likewise, females should be valued for their humanness, intelligence and values.
2. Children, especially girls, should be encouraged to speak their minds, albeit in a respectful way, and not to avoid situations that they feel are unjust to themselves or other people. Ideally they should be made aware of the sexist messages that pervade western society.
3. Parents should be good roles models. It is invaluable for a girl to see their mother as a person who speaks up when necessary, and is in control of herself and her life.
4. Do not leave healthcare just to the professionals, and be proactive in addressing issues that you know that make your eating disorder compulsions worse. That is conflict avoidance and isolation.
5. Finally, it is important when seeking treatment, that there should be clear evidence of progress. The only good thing about eating disorders is that you have immediate symptoms that give you feedback about whether the treatment is being effective or not.

Prior to starting The Challenge, make a list of what some of the issues may be, so that you can start working on these conflicts immediately. Your list may include certain people who are bothering you; or a ‘friend’ who is always saying things to insult you. Maybe it is that you are always spending time alone. Perhaps your symptoms are aggravated by finding yourself filling the role of “domestic help” while your partner enjoys only the good part of domestic life? Or maybe your eating urges arise due to a whole lot of little things that you have been putting off, that you never seem to have time for, but are constantly on your mind.

Don’t forget to get a text buddy to help you through this challenge. This person could be a friend or a relative, or anyone else you trust. A text buddy is someone who makes you feel safe, who won’t criticise you, who understands you, and will support you through this challenge.

So do a two week trial, see what difference it makes.
Give it a go!

This is the inauguration of a weekly blog in which we will deal with topical issues, messages, feedback and questions that we receive through this website.

One email that I received recently from a young woman asked whether she should seek treatment for her bulimia as she was now at a regular weight. I responded that it was very important for her to seek treatment as it is not the weight that is the problem, but the compulsion related to food intake. Weight is a side effect of the compulsion/eating disorder, and it is the compulsion that must be treated.

As readers and followers of this website know, eating disorders are not voluntary. Nobody would choose to have an eating disorder.

Disney recently pulled the plug on a show after it made fun of eating disorders: Disney Channel Pulls Eating Disorder Jokes After Demi Lovato Blasts Network.

Demi Lavoto blasts Disney for eating disorder jokes - Foxnews

This highlights the insensitivity and lack of knowledge about eating disorders and the devastating effects that they can have on one’s life. It is unbelievable that one would think that an eating disorder is something to be laughed at.

We support you in your struggle with your eating disorder. You may want to make a New Years resolution to use the worksheet to help you address the stressful conflicts in your lives. You will see that by addressing these issues the eating disorder is more controllable. In addition to the worksheet, do whatever you can to diminish social isolation. Please get supports and have the courage to seek treatment that involves addressing the issues with the people closest to you, especially your family.

A woman was recently referred to me who had struggled with her eating for over 15 years and was extremely debilitated by it. I met with her and her husband. During the session I said that it was important for me to meet with her family, with whom she still lived. I emphasised that family can be an invaluable source of support through therapy, but it may also be some of the cause of the eating disorder, especially in terms of intrusiveness and patterns of conflict avoidance.

Two days later I received an email from the woman informing me that she and her family had decided that there were no issues within their family to discuss and she did not want to continue with therapy. I was saddened by this outcome and I saw this as an unfortunate lost opportunity for this woman and her family.

Caroline and I wish you a happy and productive new year. Remember eating disorders are readily treatable.

Again, as a regular reminder, I reiterate that this website is not in place of seeking professional treatment.

We call this the rubber band effect. People tend to accommodate or ignore the minor infractions in their relationships until one day they can’t take anymore and the rubber band snaps. As a result, as a result of the stress, the eating disorder symptoms emerge. The small infractions come in many forms from hostile comments which are delivered in the form of bad jokes; or built up anger at being the one who does all of the house work.

Betsy was sexually harassed in her relationship. The comments started early on in the relationship, and Betsy never responded, and her eating disorder became worse as the comments built up. It is about opening up the communication and making your partners or family understand what your boundaries are. The earlier you address these issues the better for the relationship, and you are better able to control the eating disorder.

Jane was furious at the avalanche of unsolicited “good advice”. In the session we discussed why she didn’t respond to her Aunt. Jane said that she did not want to her hurt her. We discussed that if Jane said to her Aunt, “I care about you very much and do not want to hurt you; if I want your advice I will ask you for it”, would this hurt her Aunt? Not only is this the honest thing to do, it also guarantees that there not be a build up of hostilities between Jane and her Aunt. Furthermore Jane will not lose control with her eating.

These seemingly minor insults make eating disoders flare. Is best to use your power as a person, supported by your “text buddy” to educate the these helpful people.

We invite you to join our community, and again we encourage you to get a text buddy to support you control your eating disorder.

Thank you again for becoming a member on our website. As a member, we would like your input and feedback about what is, and what is not, working for you. If you have any questions about eating disorders or treatments, or more general queries please feel free to ask. Also, please feel free to comment on the tools found on this website such as the compulsive overeating/bulimia nervosa worksheet. Your feedback is helpful for us to improve this service for yourself and for other members.

In clinical practice, the eating worksheet is extremely valuable. It helps to identify what is making the eating problem better and worse. Although eating disorders are chronic, , there are times when they are better and worse. By identifying, and then addressing, the factors that make the eating problem worse, these difficulties will lessen. Likewise, by increasing those elements in your life which have a positive influence on your eating habits, the eating obsessions will decrease.

It is not always easy to identify and change stressors, and it is made more difficult if you try to do it alone. The help of a support will make it easier for you. We on the website are here to support you, but a social friend who you can meet up with is also important.

As we have said many times, this website is not in place of getting professional help for your problems. It is instead aimed at supporting you through your difficulties and giving you new ideas to tackle this problem.

Please feel free to contact us with any questions you have, and also let us know if this approach is working for you. Feedback can be invaluable at improving our service as well as helping other members of this website community.

Kind regards,

Charles Fishman

Caroline Judson

She told me, “I see this as a problem stemming from my father. He is completely focused on my weight and talks to be about it all the time. While he does not appear to have weight struggles himself, he is still concerned about it, and relates frequently that he married my mother because he knew that she would not gain weight”.

We later discussed these issues and she disclosed how she has had difficulties in her intimate relationships. She is currently in her third marriage and says that the only time when she is able to control her eating is when she is not married. She said that when she is not married she does not have to be a “domestic slave”.

For our work on this website, there are two issues that I believe are very important for sufferers of eating disorders.

The first is the intrusiveness of Mercedes’ father. Even now, as a grown woman and far along in her career, she still has not created boundaries with her father and made it clear to him that while she loves him very much, her weight is her own issue and is not his concern.

The second issue is Mercedes’ relationships. In intimate relationships, she still does not assert her power as a woman. She does not feel able to tell her various spouses that she is not their slave, and that they must meet her half way with the household chores. It is very telling that the only time that she is in control of her eating is when she is living alone.

Again, I see this as lessons to everyone suffering with eating disorders. Conflict avoidance is a crucial issue, and Mercedes must address this if she wants to get over her eating disturbances. To give her strength and support, Mercedes found what we call a “text buddy”, someone to support her as she addresses these conflicts.

* Not her real name

Most importantly, we hope that the idea of being the master or mistress of your own life, and addressing issues as they emerge, strikes you, and grabs you. It can be difficult to have a clear perspective on our own lives at times, and it can be difficult to make a stand when things are not the way we wish them to be.

At times, we can almost be hypnotised into accepting the status quo even if it is unsatisfactory, or even detrimental to us. Furthermore, it is hard to make the mental jump between an unhappy situation and an eating disorder raising its ugly head. But there is a link between these two things.

The other issue that we hope you take notice is how important addressing maladaptive or unsatisfactory relationships is for your own self healing. Understanding the link between particular relationships and disordered eating patterns is important. However, seeing this link is not enough, you need to do something about it.

To do this, it is crucial that you have support. We call them a “text buddy”, but it can be anyone who is there for you, and can encourage you to make positive changes in your life.

It is essential to not be isolated. Some ways of avoid this isolation is to become active. If you don’t have a job, you may look into volunteering, or alternatively, if you can, get a job. If you are lonely, use the different avenues available to you to connect with others. This might be social networking sites, internet dating, or community groups that are offered in your area.

What we encourage you to try these ideas and see if they work for you. You can use the spreadsheet that is on this website entitled “Bulimia Nervosa & compulsive over-eating worksheet” to track your progress.

Please let us know how you are doing, and what is working for you. Send us your scores after one month. We are here to support you.

Charles Fishman.

No one can deny the cultural “value” in Western culture for women to be thin and have the “perfect body”. As I have said many times on this website, there is more to the development of eating disorders than just cultural values.

Anorexia is the most serious eating disorder and is very rare with a prevalence rate of approximately 1% of females. However, millions of young women read magazines that promoting the idea of the “perfect body”.

Eating disorders occur when there is a “perfect storm” of factors that include cultural biases – towards the “perfect body”, conflict avoidance, and social isolation. Together, these factors increase the likelihood of an individual developing anorexia, bulimia and/or compulsive overeating.

Please join our community and commit yourself to finding a texting partner who will support you while you ascertain which relationships you need to revise in your life so that you feel less stressed and more empowered.