Anorexia and Bulimia in Our Culture: Unspoken Questions

It wasn't until after i started writing a completely different post that i realized what i wanted to write about today. It's a topic that affects me personally and deeply, but also something that is very rarely talked about in the eating disorder community (both on blogs & in treatment or with mental health professionals, and even with friends). 

There isn't exactly a "name" for this topic so, here, i'll try to spell it out for you.

Is Anorexia Nervosa a more serious, deadly, scary, real, or traumatic illness than Bulimia Nervosa or ED-NOS?

(source: thedownsidesofbeingawallflower)

I'd be interested in what people's gut-reactions are to this question. 

I don't mean the well-formulated answers that people think of, I mean the feeling that comes, the spark of thought that enters the brain or heart when this question is posed. (or when it is presented to your face- is there an image that comes to mind when this question is asked?.

I honestly am afraid of asking this question on my blog. I'm afraid of starting this conversation. Its one that I've never seen or heard out in the open, and I think it's time that it's brought to the table.

I, personally, as someone who has always had a "primary diagnosis" of bulimia, have always felt as though i need to "justify" to people that it is an actual illness, with physical consequences and harsh emotional ramifications, like anorexia, despite the fact that it often does not leave it's sufferers looking deathly ill. 

My first-ever example of this was the very day that my mother confronted me about my "vomiting" when she said

"Well, I'm just glad you're not anorexic, I mean, those girls are really crazy."

At the time, I had wanted to jump out of my skin when I heard this and scream at her and lecture her on all the awful things running through my head, and how much I was tormented by this disease every day and every second, and could she please (f!#@ing) realize that this was serious, but of course I shushed myself and threw up to "swallow" my need to speak up.

I understand completely that part of this whole "complex" I have about bulimia not being considered as "serious" as anorexia has to do with my own eating disordered-mindset, and how I personally always feared that I was "not sick enough" as many sufferers do.

I would really like to emphasize however, that this dilemma, I think, reaches beyond that personal "fear" and, I think, is actually a really serious problem that still exists (albeit 'underground') in the eating disorder "sphere".

I honestly am astounded and appalled at the number of top New York City- area Eating disorder 'specialists' (usually with big titles & rather fat pay-checks to show for it)  who have, in one way or another, implied to me (or to other patients or professionals) that weight & how someone looks and whether or not they have lost their menses is the most important factor in determining how "ill" someone really is. There was a psychiatrist at the first treatment center I was at who was almost notorious for telling bulimics that they didn't really have a problem, that being bulimic was just what someone did if they "couldn't be anorexic". (This is a man who did his residency at Stanford University Hospital under world-renowned eating disorder researchers). 

I'd like to look at the researchers, and ask why there is always much, much more research done on Anorexia than Bulimia? Why when I type either one in on PubMed do I get over 22,000 results for anorexia and a less than 7,000 results for bulimia? 

Why, when I visit a website that advocates for Maudsley (or Family-based treatment) , is there a video on the front page about how to treat Anorexia whereas I have to search for information about treating Bulimia? (I say this not to be a nit-picky complainer, but because these subtleties are important. this is how we are taught, in school, to read between the lines and to pick up on the editors' (or writers' or poets' or artists') message, to understand what is really being fed to us and to be conscious, educated consumers of information.

Why do I always find more blogs that are written by women/men recovering from Anorexia (or some {often restricting} form of ED-NOS) than Bulimia? 

Is it shame? 

Is it more shameful to say "I was bulimic" than to say "I was anorexic" ? Do you want my honest answer?

Honestly,

I think it IS slightly more shameful. 

I hate saying that i was bulimic. 

It seems like it's the difference between saying: Hello, yes, I used to stick my fingers down my throat all the time and I wasn't even skinny! or Yes, I starved myself, and my sick body looked similar to that of one of the highly paid fashion models who represent a sick & twisted beauty standard that is idealized in a very confused culture.

opposites?
(source: sagaseahorse)

What would you rather say?

I'd like to clarify a few things, so that I am not hated by all the wonderful people who decided to read this blogpost. 

I am not trying to say that being bulimic is harder than being anorexic, or anything RIDICULOUS like that. I am talking about the way in which culture (and yes, even our insulated culture in the eating disorder world- meaning those who are even EDUCATED & EXPERIENCED in the eating disorder field) tends to still idolize, or idealize, or freak out about Anorexia more often and more strongly than it does Bulimia. 
This is separate from a persons personal experience of either illness, and is about how they are talked about & treated.

Also, that being said, many (and I mean MANY) of my best friends (from treatment) suffered from Anorexia. I relate to and respect them, their struggles and their strengths, and talk to them about everything & anything under the sun and I love them to pieces. Many of the ED related blogs that I read are written by people who are recovering/recovered from Anorexia. This opinion that I am sharing has nothing (and i mean NOTHING) to do with how I relate to other ED sufferers in the world, it is simply a cultural nuance that disturbs and perplexes me.

I'm not trying to blame anyone. I wanted to bring this up because it affects me personally, and I feel very strongly about it and have never really had a platform on which to speak about it. I want us to move forward in the ED world, and learn how to move past "undercurrent" issues like this, so that there are no latent stigmatizations or unspoken judgements that are not out in the open, so that EATING DISORDERS are the only battle that we have to fight. 

On an only slightly related note, here's a video for you, that made me feel better after a rough body-image day (it's a good video for multiple reasons, but i won't ramble more right now!)

xo,
Rose

Autumn: Neda Walk, Hot Cocoa & Comfy Sweaters

Hi Lovelies!

I hope everyone is having a good weekend.

Yesterday morning I decided to see what all the fuss was about and make myself some Oatmeal! Everyone in the blogosphere seems to be obsessed with oats, so i decided to jump on the breakfast bandwagon ;). I decided to make my own recipe which I will call Hot Chocolate Oats.

Doesn't it just LOOK delicious? It's amazing. I finally decided to try a more
natural (&more expensive! Eek!) alternative to my trademark Nutella. 

I also just wanted to share this loveliness. I had never seen a container of Fage
this big before! It's a heaven send. I mean, I literally go through the medium container in three days- so
clearly this was made just for me!

I wanted some chocolate in mine, b/c i love chocolate in EVERYTHING,
but i didn't have any plain cocoa powder, so I just used a swiss miss packet.

At one point i got worried that it was never going to cook...jeez  it is a long process! 

But no worries, eventually it worked!

And the finished product...

added some walnuts, Fage, dried blueberries & Justin's Chocolate Hazelnut Butter. YUM!

Was craving some brussel sprouts around lunchtime today...

Steamed and then grilled with some olive oil, balsamic & honey. Delicious.

Homemade turkey burger w/ chipotle sauce, fresh mozzarella
& tomato on a whole wheat sandwich thin.




One of my favorite things about autumn? The clothing! I love scarves and big comfy sweaters. I went shopping with my dad yesterday (it was supposed to be for him but he's picky and didn't get anything) I got two sweaters and a pair of shoes...

Cashmere & Cotton. The camel is from Calypso & the Grey is H& M. The grey
one was originally my dad's but I pretty much inherited it when we walked out of the store and I told him I was cold...

shoes! Note: Yes, the bottom is already filthy...I might have (shamelessly) worn them out of the store..

In Eating Disorder news...

I went to the 2nd annual NYC Neda walk today

This is when the walk finally started. It was freezing out, so I was relieved!

It was a really great event, I'm so glad I went! A lot of the speakers were really touching. Lynn Grefe, the head of NEDA spoke really well. Judy Arvin, of Someday Melissa, spoke, as she did last year only five months after her daughter died from a hard struggle with bulimia. Jenni Schaefer spoke and sang a song for us "It's okay to be happy". A few other people spoke, and I have to admit, I cried at a couple  of the stories

I caught up with some of my friends from  treatment (not the last place I was at), which was nice. I don't feel all that connected to a lot of the girls, like i was last year. Its nice to see people, but its also really great to know that I've come a long way since  I last was with them, I feel like a different person now than the person that they knew (in a very good way)  :)

Me (on the right)and my friend Sammy -who  i still see /talk to pretty often, mostly b/c
i see her in the waiting room at my dietitian's office pretty frequently ;) 

I was had a really hard day yesterday. It was so good to get out, enjoy the new October chill ( I LOVE Autumn weather- couldn't you tell?) I almost didn't go, but I'm so glad I got my butt out of bed and made myself go. I am so glad that NEDA exists and is growing and working hard to help all of us fighting this awful disease. We all deserve recovery. I need to remember that on days like yesterday, I need to fight for myself ,because there are men & women who can't any longer.

Finally, Willy wants to say hi & congratulations for getting through this monster of a post!

Excitedly licking peanut butter off of a spoon, of course!

xo,

Rose

Rambling Tuesday

I just registered for the NYC NEDA walk!
Thought i'd just share that little tidbit of information.
Not that i'm super excited about it or anything, but I do think it's a good thing to do to show my support, and it's not like I have any other pressing plans at ten am on a saturday morning (besides sleeping, which, trust me- i do enough of!) so I figured  i'd fork out twenty bucks and say Hi to some old friends.

I was talking with my dietitian today (well, mostly, she was talking...) about how i should really find something I'm interested in and get into it, so i have something aside from school to keep me interested. I really would love to be more directly involved in advocacy work, but I'm not sure exactly how to go about it. Any brilliant ideas? I mean I know for sure that I'm going to go into the Psych field, and i'll most likely do some work in eating disorders, consider that I AM passionate about the subject- however, I'm not sure that anybody is really interested in what a seventeen year old former bulimic high school junior has to say about anything....so it's a little discouraging.
Anyway- Day # 2 was a huge improvement. This is good news because I think it would be pretty hard NOT to be better than day number one (unless, ya know...someone maybe put a "Kick Me" sign on my back or maybe I accidentally forgot to wear pants- but no worries ,that didn't happen- yet)
Maybe tomorrow will be a little bit better? I hope so. I just want friends! Is that so much for a girl to ask for? :)
Love you all, and hope everyone had a lovely day! (P.S. if you're in the NYC area you should totally come to the walk in October- I'd love to meet other bloggers!)
xoxo
Rose

View from the Outside

I saw this picture tonight.
And it perfectly describes a lot of things that went on for me today.

image from 'weheartit'
A lot of times, I feel like I'm just holding my life together at the seams, and that everything could fall apart at the drop off a hat.
I had a family session this morning, and it was really hard and brought up a lot of stuff (fear, sadness) for me. Basically, I'm really worried about this upcoming school year (or 2 school years, but I'm trying to take it one year @ a time right now). I am really nervous and not sure how I'm going to hold everything together. My eating disorder was my coping mechanism for a life that I felt was unbearable. But now I'm back in what sometimes seems like an unbearable life again but without that mechanism. So yeah, sometimes I do feel like the sky could fall in at any moment.
Today, I also spent a lot of time thinking about  a friend of mine who is having a really rough time right now (not with ED stuff, only but with a lot of other things). Then I talked with her on the phone and felt like I needed to keep reminding her that life is not always going to be this hard. She's just going through a rough patch, and can't see a way out right now, but I really believe that things are going to work out for her. I need to have hope for her right now, when she can't have it for herself. I just kept telling her "things are going to be okay" over and over and over again.* I knew that she needed to hear that, she needs someone to believe in her right now. I'm not her right now, I'm not going through the emotional roller-coaster she must be on, so it's easier for me to see the situation with more clarity. 
It really is like when someone is on an actual roller-coaster. When you're strapped into that seat and going a zillion miles an hour, you have no idea where it's going to turn next or when you'll be flipped upside down. But when someone is down below, watching their friend on the coaster- waving (and thanking god that they just stick to the teacups), they can see where the roller-coaster ends, where it curves and turns, because they aren't stuck in a fast-moving whirlwind. 
After getting off the phone with L, I realized that I just need to keep telling myself the same things I was telling her- that things are going to be okay. And just because you can't see that in the moment, doesn't mean it's not true. Just because a solution isn't in your immediate view, doesn't mean it doesn't exist. Sometimes it just takes time to get there. Moral of my long-winded story? I need to calm the F*&^$ down and just trust that I'm going to be okay this year, and the sky isn't gonna fall in.
Its funny how it is so much easier to think and see clearly when you are on the outside, when it's not your own problem. I guess this is why people can't do this (and by this i mean everything- recovery, life) on their own, they need the clarity that comes from the outside.

*I really do believe that we can change the way we respond to situations if we change the way we think about them first. I asked her to try writing that statement ^^^above multiple times, even if she doesn't believe it. It's like how in order to change your body image, you need to just keep telling yourself that you think you are beautiful, until you actually believe it. In order to affect change, we need to change from the inside out- not the other way around. There must be studies done on how thought + brain patterns change based on simple repetition - right? I know that the whole 'body image' thing must work because I remember a point when I was younger when I specifically taught myself to keep thinking I was fat. Clearly- it worked. 

really, NEDA?

I normally have no problem with NEDA or the National Eating Disorders Association, (hey, i even went to their NYC walk last year!) and I respect their work as a central kind of force in the ED world. But the email I got today was just ridiculous.

Rachel Roy Personal Appearance & Fashion Presentation at Neiman Marcus Short Hills Neiman Marcus, Short Hills, NJ Bunny Johnson Vice President and General Manager, Neiman Marcus,Short Hills and Deborah Q. Belfatto Board of Directors, National Eating Disorders Association Invite you to join us for cocktails and a benefit fashion presentation, as designer RACHEL ROY presents herRachel Roy New York and Rachel Roy Signature Collections for Fall 2010. Wednesday, August 18 6:00 pm Fine Apparel, Level Three, Neiman Marcus 1200 Morris Turnpike Short Hills, NJ 07078 Tickets are $75.00. All proceeds benefit NEDA. Purchase Tickets Online Rachel Roy’s collections will be available for viewing following the event and on Thursday, August 19 until 4 pm.

i mean, really now?
And I went to the designers website and the page that comes up is just pictures of catwalk models looking sick and angry, as per usu.


i don't even think I have to write much more to explain why I think this is ridiculous and ironic, but holding a fashion show to benefit an organization that is supposed to be fighting eating disorders?
REALLY, NOW?
I'm really not going to get into my two cents (or twenty-two) on what effect the media/society has on eating disorders. The media/fashion industry are not to blame for  the existence of eating disorders. Eating disorders aren't caused by any one thing. Yada yada yada. They are highly genetic but also environmental, and while our society's obsession with thinness as a virtue does play a large role in the high incidence of eating disorders (and disordered eating), it is not the "cause". This is a discussion that I could spend months writing a blog post on, but it's not the time for that now.
I just wanted to share how ludicrous I think that email I got today was.
I think it takes some serious nerve for NEDA to hold a charity fashion show. That seems to me like raising money for diabetes research/awareness by having a donut eating contest, it just doesn't make sense.

smart people, un-smart posts

Something that gets to me a lot is the way in which Maudsley advocates boast about the approach.
I understand the Maudsley treatment method. I understand how it is implemented and why it seems to work. I also understand is that, to date, it is really the only treatment method that has been well-researched in the ED science field and actually has been proven to be effective. What i do not understand is why people who advocate for the Maudsley approach seem to become so attached to the idea that Maudsley is like a freaking miracle, god-sent treatment and speak (or write) about it as though there is nothing else that could possibly be effective.


This pisses me off.


I really do respect a lot of the people (bloggers, mostly) who advocate day-in, day-out for the Maudsley method and I think they are smart individuals with valid points and good intentions. What I would like to pose to them, however, is a reminder, that "The aim of an argument ... should not be victory, but progress."(Joseph Joubert) 
Recently, whenever i read a post by someone who is advocating for Maudsley, they always seem to be trying to win some argument against the world. They always seem to somehow frustrate other readers by implying that Maudsley is the ONLY approach that works, just because it is, so far, the only approach that has actually been well-researched. Effective and researched are not synonymous. 
I also, personally, get frustrated because there really are so many pitfalls in the Maudsley approach that just seem to be ignored. First of all, I would like to see any individual with a diagnosis of BN rather than AN actually successfully be treated by Maudsley. I honestly think that this would be a freaking miracle because all of the studies on Maudsley have been done on AN, and the two are very different disorders (especially in terms of how the individual relates to their family, which is a key component of Maudsley) and, knowing the way in which those with BN tend to act with their families, I would be astounded to see anyone with that diagnosis have a successful Maudsley treatment.
Let's be clear here. I know professionals who like to say that for adolescents with bulimia, purging is like puking up the family. Purging is like a f***-you to the rest of your family who you are angry, resentful at. Often, with AN, this is not the case. Most adolescents with AN tend to not have the same experience of rage and resentment to their families. Most girls i know with anorexia suffer the sweet, well-behaved, "good-girl syndrome". They often seen as the "golden child", and while this is not to say that they are not angry with their families, or tyring to convey something with their ed behaviors, it is often quite a different experience than that of someone with BN. 
And secondly, aside from diagnosis, lets just take a look at the multitude of families who CAN'T for either personal, emotional, physical or financial reasons, in any way,shape or for, ever conceive of using Maudsley. Some parents  are clueless, and couldn't give a shit about their child's eating disorder/ recovery for that matter. Some don't have the financial resources or the time to invest so much energy in feeding their child. Some are just emotionally unavailable or unable to be a support to their children in this way (if a parent rarely sets any kind of boundaries for their child (homework, curfew, friends, etc) there is no way that they are going to either A. Be interested in bothering to set boundaries around food + eating or B. be able to have any kind of authority over their sick adolescent). 
I guess one of the reasons I am so touchy on this entire subject (and hence am writing this massive, bitchy post) is because it really just frustrates me that my family couldn't (+ most definitely wouldn't) ever do Maudsley. The idea of my family trying to implement the maudsley method is a joke. Sometimes I laugh when people suggest that it's a good treatment for the majority because, um, I think i know about four people in the entire world who have families that would be suitable/able/available/willing to do Maudsley(if it was ever needed). I imagine my mother and father cooking me some "nutritious" meal, telling me to sit down and eat, and then offering to have some sort of "family activity" afterwards to keep me from purging (as is suggested by Locke + LeGrange) and i have to roll my eyes at the absurdity of that image. 
Basically, I often find that people can be a little freaking self-righeteous when it comes to Maudsley and it bugs the hell out of me (for both personal and general reasons).
I really do think that for the most part, yeah, it's great and i love when people advocate for well-researched, fast, safe, effective care for eating disorders as others would for any other possibly-fatal illness, but i really do wish that people could be a little more understanding and far- sighted, and just freaking get it through their brains that it can't work for all of us, and that maybe, just maybe, it's okay to try something else!


Sorry if this post is ranty. Just needed to get that off my chest. 
Phew.

Buhhhhhh-rain chemistry

Had an interesting conversation with L today about brain chemistry.
(That is, if you can even call it a conversation, it was more like one of our little episodes where i'm just napping chilling on her couch while she rambles on about life)  I swear to god i love that woman and listening to her craziness just about always makes my day...
Anyway, she started talking about how we are all wired really really differently, and we are all meant to function differently in the world, and yet people try to fit themselves into these little boxes (which I like to call "societal norms") even when that just isn't right for them- and i think that is just SO TRUE.
I've been really frustrated with myself recently because i've been feeling so lethargic, and i've been feeling like something is "wrong" with me. I get home from work these days, and I'm just exhausted. And i feel awful for feeling that way, because in my head, and in this society, it's as if i should still be a ball of energy and now i should want to go do 6489229404050 more things! I know so many people (particularly lots of ED people) who are exactly the opposite and are super hyperactive and can't ever sit still and are bouncing off the walls. *
Anyway, the thing L said to me which simultaneously cracked me up and got me thinking was "Well, I think you just need to become a Buddhist".
Seriously though. I really am just a very chill, relaxed person. Apparently, as i have been told by many people, I have a very calm demeanor. I move slowly, I think fast, but I act on things carefully (except for when i'm crazy and impulsive, but that's a different story) I think that he way that I am is just not the desirable by societal standards, and I think that's where I run into troubule.
I have all these things I feel like i should be doing, but really, I don't want to, and maybe I need to learn to just be okay with that? Maybe it's just the way i'm hard-wired?


Anyway, it's super duper gross out today, I dont understand July city weather! I hate it so much! One day (aka yesterday when  I had to run/walk 60 blocks to do an errand for my boss!) it's like 100 degrees and disgustingly sunny out and then today its like torrential rain. WHAT THE HELL?! The rain also totally adds to my lethargy, which is very frustrating, and not at ALL good for my overall productivity at work (which was, today, about zilch)


Right now I'm reading the book Born Round by Frank Bruni. It's a memoir that i picked up because I remember reading a piece of his "I Was a Baby Bulimic" in the New York Times Magazine.Click here to read it. (it's not nearly as weird as it sounds, btw) One of the lines that I picked out from the book though, seems to fit well with this post...


"Born round, you don't die square"


Ok, that was my random thought for the day, on to research how to convert to buddhism...
Peace.
R


* I think it would be interesting to look at brain images and see where people with different diagnoses of eating disorders fit on the spectrum of slow-brain - fast brain lol i'm so technical!!! put it this way: RoseBrain-BouncingOffTheWalls/SuperProductive/Energetic Brain
I have a hunch that those on the bulimia side of the spectrum would be on the Rose camp, while those with tending towards AN would be more likely on the other side. I'm guessing this also could be correlated with the hyperactivity that often occurs with starvation induced in AN? Hmph. 

Thinking it All Out

I get really stuck in my head sometimes.
I can spend entire years in my head.
That pretty much is what happened to me when i was in my eating disorder.
I would wake up with numbers. My first thoughts of the morning were how many calories did i yesterday (already stuck in my mental calculator from the night before, just a lovely reminder) and did i binge/purge? Then I would jump out of bed, weigh myself. Based on what the weight was, i would have an ongoing dialogue in my head about what kind of person I was (good/bad/dumb/idiot/okay/successful/whale etc) and what I was going to do with my food based on my weight that day. Then I would go about my day, going through the motions of going to school, greeting friends mindlessly (I was basically chronically depressed but tended to wear a smile), running to classes, trying to be engaged (but really I'm not thinking about physics - how the HELL is everyone else here really thinking about Physics? I'm too busy figuring out how i'm going to get away with not eating lunch and trying to figure out what to buy at the supermarket when i leave school). I'd finally escape the walls of school and then run home to binge and purge, the time of day when  i could finally escape from the hell that was my life (and basically, the hell that was my head, my thoughts).
Recently though, I'm still in my head a little bit. I am beginning to think that this tendency to be overly cerebral might just be a personality trait, or the way i'm wired. I used to always blame it on the eating disorder, but I'm beginning to wonder if part (or most, even) of the eating disorder was a way to make my tendency to "be in my head" more bearable. The eating disorder behaviors, at least, (the high of starvation & restriction, the high from bingeing and purging) gave my mind a temporary break from itself. *
These days, I've been in my head a lot. It has not necessarily been a bad thing, I have just had a lot to think about in terms of my summer, my goals, my intentions, my relationships and so on.
Writing this out, however, I am realizing that maybe all of this time spent in my head isn't a good thing. Maybe I need to stop worrying so much about the future and be more in the present moment. As if that were easy. I do definitely need to pick up my yoga again, because I love and miss it and just kind of forgot about it this month. It definitely keeps me grounded and in the moment. I also have just felt very preoccupied recently with some kind of dissatisfaction in my life that i have been trying to "figure out" in my head. Maybe I need to just give life a chance and see what comes. I wish i were more "go with the flow". Ha!


Okay well, it's getting late and I'm going to go grab a snack.
Time to be grateful ;)
1. My new paint markers and canvases! I can't wait to finish my new painting and start more!
2. My running shorts - in the past week or so, its basically all ive been wearing, it (along with my favorite grey t-shirt) is my go to outfit for these awful body image days and I don't know what I'd do without it.
3. Iced Coffee - looking forward to my Starbucks tomorrow morning when I am at work.


*I know a couple friends of mine from treatment who also are just very cerebral people. One in particular comes to mind who always used to say "I need to figure this out in my head, first", and then proceed to spend hours just thinking.  I wonder what this is about and I'd be interested if there were any research on the topic of the correlation of people with eating disorders and a tendency to be overly cerebral.