NZ Eating Disorder Specialists

Sitting in my office is a father of an adolescent girl who had severe anorexia. The anorexia had been compounded by the fact that the husband and wife were separated. The marriage fell apart when the husband announced that he had another woman and he was undecided where he wanted to go with his marriage.
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Following from our previous blog, women using their best friends to vent their relationship problems to can be a form of conflict avoidance and can increase problems within the partnership.

Women often tend to spend time with their girlfriends complaining about their partner. (more…)

Describing her self as a “marshmallow,’” Cindy, a mother with a chronic eating disorder came to me with the complaint that she had no control over her four children. The more difficult they became, the more her eating problems worsened.
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“Perfection is the enemy” is an old saying in business that can be both inspirational and a challenge. It is the same in eating disorders.
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Recently a reporter contacted me wanting my opinion regarding the recent weight regulations placed on fashion models in Israel. Read more: New Israeli law seeks to fight spread of eating disorders by banning super-thin models

The new laws aim to prevent inducing eating disorders in young girls who seek to emulate emaciated models.

While there is definitely more to anorexia than food and dieting as has been noted extensively on this website, I nevertheless told the reporter that there was a good rationale to do what whatever is possible to discourage the practice of using emaciated women as role models.

My reasoning has to do with the slippery slope phenomenon of anorexia. While there are a variety of things that lead a person to develop an eating disorder, once the body weight gets low enough, a compulsion takes over. The sufferer no longer has free will, and the eating disorder is fuelled by compulsion driven by the starvation.

It certainly does not help to have endless pictures of emaciated bodies plastered all over the media for young girls to emulate.

I have received a number of emails asking about friends and family who clearly have an eating disorder, even a severe one, but they continue to refuse care. While each case clearly has some different dimensions, in my experience some of the following things can help:

• They need to be evaluated by a GP.
  • This is to ascertain their physical health and is very important. Anorexia is the most fatal per capita of psychiatric disorders. Bulimia nervosa can be extremely dangerous especially to the heart because of low potassium levels.
• Wherever possible, the family needs to be involved.
  • Family are ultimately the most influential people in most people’s lives and therefore have the most influence in changing a person’s mind about seeking and engaging in treatment.
• An intervention can help.
  • Interventions may start by getting all of the people who care about the person with the eating disorder to come together to persuade the person to seek treatment. Try to let them know your fears for their safety, try to reason with them, and try to encourage them in a way that they will respond to best.
  • In cases where there is extreme resistance to treatment, the mental health act can be used. This mandates the person to intensive, inpatient care for their problems.

These are just general guidelines and each case will require something slightly different to get through to your loved one how important it is that they find the treatment that they require.

Please let us know your thoughts and other suggestions for engaging people in much needed treatment.

Fiona is a young woman who had bulimia for over 20 years. She kept it a secret; it was her own private hell.

Let me tell you what I do when people come to see me with problems like this.

I look for areas of conflict. Very frequently people minimize conflicts. I can’t tell you how many times I’ve heard this answer when I query what needs to change: “nothing needs to change”, or: “its me who has to change.”

This of course is how we all live to some extent. We see ourselves of the as the prime movers of our lives.

Nevertheless, I gently ask, might there be some areas of discord?

Fiona mentioned: “well, there’s my aunt… she calls all the time, she’s very critical… but it doesn’t bother me.”

Her husband, incredulous, blurted out “it sure does bother you; you’re just afraid to confront her.”

We then proceeded to find where there were other conflicts. Work had began.

Of course I strongly encouraged her to enlist supporters as she began to address her issues. She chose her husband.

How about conflict in your life?

In your life it may be you have areas of conflict you just pretend would go away.

And as we said many times on this site, to the extent you address these conflicts, the more control you have over your eating disorder.

So so if you haven’t already done it, use the spreadsheet in the tool section.

Let us know how you proceed.

Yours in strength, Charles.

Dear Dr Fishman

Thank you so much for this website. I have a long history of swinging between bulimia and compulsive over-eating. I am currently a compulsive over-eater.

I have been using your scorecard and I have been trying to address the conflicts in my life as you suggest. I have found it very valuable.

However, one issue that I have is that I always feel afraid when I do try to address the conflicts. I always feel that I will hurt somebody, or that, not so much that they will explode, but that I will explode.

What do you suggest?

Mary

A young woman in her early twenties had been living with controlled bulimia for a number of years. All of a sudden it became out of control and she began bingeing and purging multiple times a day.
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General systems theory refers to the inter-connectivity of all things. This theory developed in the middle part of the last century; it states that everything is connected.
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