Frequently Asked Questions

1) To let others know that they are not alone, reduce the isolation, expose the reality of eating disorders, and reduce the stigma. This is now a resource for the medical and treatment community to fill the gaps in their training, so they are able to recognize red flags and be able to diagnose and refer people for treatment–in other words, open up pathways to proper treatment.

2) I interviewed parents who currently have, or had a child with an eating disorder, as well as people in recovery, and those who are fully recovered.

Information from National Eating Disorders Association (NEDA) website, except for EDNOS, which is from Wikipedia:

• Eating Disorder Not Otherwise Specified (EDNOS) - This category is frequently used for people who meet some, but not all, of the diagnostic criteria for anorexia nervosa or bulimia nervosa.
• Binge Eating Disorder (BED) - This is a type of eating disorder not otherwise specified and is characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.
• Bulimia Nervosa (BN) - This is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.
• Anorexia Nervosa (AN) - This is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.

No one really knows the percentage of teens with eating disorders

The numbers are staggering–about 10 million in the U.S. alone, and when we include disordered eating, the number of people in the U.S. has been estimated to be about 24 million. Worldwide the numbers are about 70 million. These illnesses affect people of ALL ages.  The age of onset used to be 13-24, but now has been lowered to age 8, and children as young as 5 years old are being diagnosed with eating disorders and the elderly are also affected in record numbers. More statistics at http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

Eating Disorders are the deadliest of all mental illnesses.

According to The Renfrew Center Foundation for Eating Disorders, “Eating Disorders 101 Guide: A Summary of Issues, Statistics and Resources,” published September 2002, revised October 2003, http://www.renfrew.org, 20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, which includes suicide and heart problems. Even with the standard number of people with diagnosed eating disorders—that is 2 million people who may die from an eating disorder.

Just as is the case with many illnesses, we still don’t have the answers as to why some people are predisposed and develop eating disorders—and others do not.

No definitive answers are known yet.

The prevailing research is clearly indicating that these are bio-psycho social illnesses that have a genetic component.

Learn as much as possible about eating disorders so you understand what you are dealing with.

Educating yourself will help you know what questions to ask to choose the appropriate solution-oriented treatment for your loved one. If you are wondering what questions would help in your particular situation, our group coaching classes or a complimentary 1-to-1 coaching session are both good places to start.

What doesn't work: Ignoring the situation, isolating yourself, getting angry, hoping they will just stop, blaming yourself, and working with treatment providers who blame the family rather than helping the healthy part of the sufferer to grow.

Absolutely. People can be any size and have eating disorders.

He or she may sit at the table with you and say he/she ate at a friend's house or tha the will take his dinner to his room.

Any food phobias and restricting foods can quickly develop into a life-threatening situation in a genetically pre-disposed person. These are all big red flags that need to be taken seriously. A great resource for these red flags is: http:// www.familyfeedingdynamics.com/

The signs to look for in both of these areas would be that other parts of your loved one'slife are changing—such as: friendships, personality, clothing choices, grades,as well as the number of hours she is exercising and how she is using exercise.

If the regular routine suddenly changes, you need to start asking, "What's up?" Also, if your instinct is telling you something is a miss, listen to it and learn as much as you can. You are in the right place.

Though thinness is highly praised in many societies, and we may see weight loss as a positive, many with anorexia nervosa actually become malnourished, which is extremely dangerous for our organs. Organ failure, including heart failure, is quite often the cause of death.

Very often these issues occur at the same time.

Definitely. The list can include but is not limited to: Esophageal and stomach cancers, reflux, Irritable Bowel Syndrome (IBS), osteopenia (a precursor to osteoporosis), infertility, decreased lifespan, lowered immune function, tooth enamel erosion, and kidney failure.

Much disagreement exists in the eating disorders world on this topic. Many papers have been written on this. One of the best I have seen so far is "Understanding The Complex Relationship between Eating Disorders and Substance Use Disorders written by Bethany Helfman, PsyD and Amy Dennis, PhD published in the Winter 2010 Renfrew Perspectives Newsletter.

If we need to put our child into a treatment center for this disorder, how do we decide which one is right for him/her? How do I know if the treatment center near us has had good results? Do we use in-patient that is usually 30-day program? Will a local outpatient program be as effective?

As you are researching treatment options, it may help to talk with other families to learn what their experiences have been,and what questions to ask for your particular situation. A great place to connect with other families is an online forum hosted by the F.E.A.S.T. organization at www.aroundthedinnertable.org

Though one thing most agree on is that this tears families apart, there are no statistics on divorce rates in families impacted by eating disorders.

Setting clear boundaries is essential, even when your child is very ill. Choosing to remain calm will help, as it may be a very long time before you have "normal" family meals again.

It is not necessary to be wiped out financially, although it happens with alarming frequency. Excellent resources on the National Eating Disorders Association website at http://www.nationaleatingdisorders.org can help you learn about how to make sure your insurance company pays what they are obligated to pay, as well as lists scholarships for certain centers. In addition, an approach called Maudsley Family-Based Therapy, is an option for some people, is much more affordable than traditional treatment centers.

The laws differ, depending on what country you are in. Your country's eating disorders association will have information on what your rights are. In the U.S., with our health system changing, be aware of what the current regulations are for dependents over age 18. As of 2010, private insurance is still trying to avoid paying, but if you are persistent, you will increase your ability to get them to pay. Keep detailed notes in designated notebook with the date, time, and name of the  representative that you speak to, along with notes about the conversation. The next time you speak with someone, let her know that you are keeping this notebook. Detailed records will pay off, and insurance will be less likely to deny your claims. Know that if they do, you can go higher up in the organization. A  great resource for writing a letter to the CEO of your insurance company is: http://www.annawestinfoundation.org/

That is a personal choice. If you want to help yourself and your love done with the eating disorder, getting support from those around you (who are able to help without being judgmental), is going to reduce the isolation that gives eating disorders power.

Make a conscious choice that the eating disorder will not be in control of the household. Choose to make time for the other children, even if it means finding others to be with your ill child.

Being aware that relapse is very common will help you remain calm, as will making sure you have a great support system in place. As I mentioned in a previous question, a great way to connect with world wide support of other families is an online forum hosted by the F.E.A.S.T. organization at www.AroundTheDinnerTable.org. When you are seeing more secretive behaviors, and some of the signs that initially got your attention, it is time to trust your instincts and ask for help from your support team.

Many great books and websites are available. Visit links page on http://www.hopenetwork.info, and you may order my book here which shares other families' stories you may identify with. The book also includes many references to organizations, websites, books, and resources.

Learn how to have healthy boundaries, learn as much as possible about eating disorders, and find a qualified treatment team to support you. Remember, you must "put your own oxygen mask on first" before helping your child. This is essential—not optional.