The-F-Word.org

Jennifer Barnes, a doctoral student in clinical psychology at Teeside University, is looking for men and women between the ages of 18-65 who speak fluent English to participate in an online eating disorder survey.  Jennifer explains:

This study is looking for any relationship between symptoms of eating disorders, beliefs people hold about themselves, and the ways in which people protect themselves against stress. Therefore, the study will involve asking questions about people’s thoughts and feelings about eating and about the relationships in their lives, as well as questions about people’s attitudes. It is hoped that this study will further understanding of the characteristics of individuals with symptoms of an eating disorder, and this information would be useful in order to inform therapeutic practice. In addition, this study will hopefully contribute to the body of research involving men with symptoms of eating disorders. However, please note that people of any gender can take part in this study.

You do not need to have an official eating disorder diagnosis to participate.  The survey should take about 30 minutes to complete.  Participants will be entered into a drawing to win a prize of £50.  h/t Men Get Eating Disorders Too.

Plus-size model and body image darling Crystal Renn and blogger Leslie Goldman appeared on the Today show to discuss the recent airbrushing scandal of Crystal by photographer Nicholas Routzen. I found her to be extremely smart and eloquent in her response to the situation, as well as to the pervasive issues plaguing plus-size models.

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Renn also earlier spoke with Glamour about her reaction to the photos, explaining:

Well, I was shocked. When I saw the pictures, I think I was silent for a good five minutes, staring with my mouth open. I don’t know what was done to those photos or who did it, but they look retouched to me. And listen, everybody retouches, but don’t make me into something I’m not.

I look like me; I look strong. But in the new pictures…well, that body doesn’t look like my body. It doesn’t. Having had an eating disorder, I know what that very thin body looks like on me, and it’s not something I find attractive. It’s not something I aspire to.

I feel completely confident in my own health because I know I don’t look like that, but even to see it in an image was really disturbing to me.

Airbrushing a model beyond recognition is unethical in more ways than one, but given Crystal’s hard-fought battle against anorexia and her public campaign to raise awareness of the disorder, this act of virtually whittling her back to those dark days is especially heinous. Even more ironically, photographer Nicholas Routzen shot and altered these images to promote his nonprofit charity Fashion for Passion, which supports arts and music programs for children. Ehem, Nicholas? It may be a little difficult to inspire a passion for the arts in children who are too obsessed with looking like the unrealistic and unattainable airbrushed images they see in magazines and the media.

Your thoughts on the whole debacle?

I have a feeling I’m not the only writer for the-f-word.org that is insanely busy right now since no one has posted in over a week. On behalf of the three of us, you have our apologies. We hate it when life gets in the way of blogging just as much as you do.

With that in mind, here comes another roundup of links instead of a fully thought-out post, but at least it’s something new…right? Right!

MSNBC profiles three women who gained weight as a result of illness, not overeating. One struggles with a hormonal imbalance and has noticed how people treat her differently because of her weight. Another gained weight as a result of taking steroids for migraines. The third woman developed insulin resistance, and prior to developing her condition, believed that obesity was a “couch potato disease.” Not any longer — she says she is ashamed for being so judgmental in the past.

In case you haven’t already heard about this, former Biggest Loser contestant Kai Hibbard is speaking about her experience on the show, saying she left the show with a distorted body image and developed an eating disorder. She is going public with her story because she feels that some elements of the show are misleading and hurtful to viewers.

Haaretz.com in Israel has a fantastic story about what life is like at the eating disorders unit at Sheba Medical Center.

And finally, the Los Angeles Times published an article a couple of days ago about the Maudsley Approach. Success stories as well as skepticism about the method are discussed.

For the sake of discussion, what has everybody been doing while we’ve been absent? Share your latest by making a comment!

Margarita Tartakovsky of the blog Weightless interviews Cheryl Kerrigan, author of the new book Telling ED NO! and Other Practical Tools to Conquer Your Eating Disorder and Find Freedom.

Fat Lot of Good blogger Bri weighs in on a recent study that found that children whose mothers were chronically abused by their partners were more likely to be fat by age 5.  Because being fat is so much more pressing of an issue than being victimized by domestic violence.

Urban Outfitters removes what many are calling a pro-ana t-shirt from its website, but the “Eat Less” shirt remains available in stores.   Outraged?  Join the Girlcott Urban Outfitters group on Facebook.

Should appearance-based discrimination be treated with the same weight as we give to other -isms like racism and sexism?  That’s the question Deborah Rhodes tackles in her new book, The Beauty Bias: The Injustice of Appearance in Life and Law. Read Dahlia Lithwick’s review of the book on Slate.

Just when you thought the insanity would never end…  It’s not enough that some parents lose custody of their obese children because of their weight.  Now a British animal welfare council has seized custody of an obese dog.  The pudgy pup Gucci is said to now be on a strict diet and exercise regime at a special canine fat club.

FEAST has launched its Around the Dinner Table Plate Drive through June.  The fundraising initiative supports the group’s mission, which is to empower families and support parents and caregivers in helping loved ones recover from eating disorders.

The British Mail’s Lucy Taylor ruminates on on how she gave up running and learned to simply enjoy the journey.

Oprah.com contributor Karen Salmansohn looks at the Fox and ABC refusal to air the sexy new Lane Bryant lingerie commercials in a different light: “The fact that a TV network would find this Lane Bryant spot far more sexually enticing than Victoria’s Secret spots — which air all the time — simply shows they’re acknowledging the extreme sexiness of voluptuous women!”

Comments?  Any links to share?  Add your two cents in the comments below.

Speaking of women, food and god… Reader Jocelyn (who comments here by the name J.S.) contacted me a few weeks ago proposing a guest blog entry on the convergence of fasting for religious purposes and eating disorders among women of faith — and we’re not just talking here about pursuit of the Gospel of Thinness. As someone who subscribes to spiritual beliefs (Buddhism) in which followers promote many dictates around food (no meat or alcohol, eat only until you’re 80 percent full, etc…), I was intrigued to learn more about the fasting traditions held in other religions.* Many religions, such as Buddhism, Hinduism, Islam and Judaism, incorporate fasting into spiritual beliefs, believing it to give followers a heightened sense of self-awareness and more intimate connection with god or nature. Yet I was still a bit shocked to read in Jocelyn’s guest post of the extreme fasting lengths to which some people of faith will go — and how quickly those religious motivations can morph into something entirely more dangerous and insidious.

“You have to watch it with those religious girls,” my sister murmured to me under cover of the blender noise.

I looked away from my room-mate, who was shoving a concoction of blueberries, soy milk, and bananas into the blender’s pitcher across the kitchen. “What do you mean?”

“That’s going to be her only meal today? She’s ‘fasting’?” At my nod, she added, “Didn’t you tell me she’s anorexic?”

I shifted, uncomfortable. “Well, she was. I mean, obviously she’s not starving herself now, she looks healthy…”

“Maybe she’s still trying to starve herself,” my sister said softly, just before the motor cut out.

At the time I had recently moved to the area in order to become part of a large group of Christian people who believe in something called the “fasted lifestyle.” As preached, the fasted lifestyle means voluntary restraint, from spending to housing to food—in other words, one lives in a simple fashion in order to have greater resources to devote to the Kingdom of God. As practiced by many of the early twenty-something women who devoted themselves to the cause, it became practical, religious-sanctioned anorexia.

I didn’t know this when I moved there. I had friends from a previous year spent in the city; we had all belonged to a church that was now defunct. Many of them had joined the group before I returned. I liked their message of whole-hearted devotion. I still do, which is why I’m not naming it; the leaders practice what they preach. But. When I would hang out, outside the building, I would overhear snatches of conversation that should have given me pause.

“She’s only eating one meal a day for… forever. She’s, like, totally devoted.” (This was about a church leader who was in her early twenties at the time.)

“What are you fasting from this time?” “He said we’re not supposed to talk about it so we don’t compare… Okay. I’m doing liquids only.” “Oh man. Maybe I should make mine tougher. I was just going to go no meats, no sweets.”

“It was supposed to be a 21-day fast, but I lost ten pounds so I thought maybe I should go to forty days?”

I wasn’t self-aware enough to realize it, but this was a toxic scene for me. I had recently lost quite a bit of weight through extremely regimented means, although it was all physician-approved, and I lived with the daily fear that I would gain it all back. Every time I stepped on the scale, and it was often, I would suffer a shaft of icy panic if I had even gained one pound. When my room-mate moved into my apartment, we fed each others’ obsessions. We would go and eat monster servings of frozen custard, and then declare we were fasting for the next two weeks—or at least until we could fit into our skinny jeans again. But of course, the fasting was all for God, not for us… right?

Eventually I moved back to my home state. Once there, I found a church that I felt comfortable with. They were loosely connected with my previous spiritual leaders, and preached a similar message. I slowly regained some stability in my eating habits. I stopped obsessing over weight gain. All was well for a couple of years… And then I noticed that fasting was becoming more and more commonly preached from the pulpit as a means to connect with God. Church-wide fasts were declared. The teenaged and slightly older girls grew gaunt, or gained weight—almost none stayed the same. I lost a bunch of weight, and then yo-yoed back up again. I have to admit, though, that I didn’t comprehend how dire the situation had become until my best friend, who had started attending about six months after me, came to me with the news that she and her husband were strongly considering leaving.

“Do you realize, Chris (her husband) and I added up all the days we were supposed to be fasting—I mean, church-wide fasts that were called from the pulpit? And it added up to one hundred and fifty days,” she told me. “That’s ridiculous.”

I had by no means participated whole-heartedly in that many days of fasting, though I had tried, but—150? Faced with that number, I retreated to my computer. I looked up fasting to see if I could find anybody else who had experienced something similar. The first blog I read opened with an introduction in which the author pleaded for support and understanding for her lifestyle of fasting. I thought I must have found someone from the same church… And then, as I continued scrolling, I discovered that it was a pro-ana blog. Her fasted lifestyle was one of stylized starvation. A light bulb went off in my head—not the ultimate light bulb that I was eating disordered, that came later, but I did realize, “this is not healthy. And if I’m not caring for my body, which is a temple, then it can’t be holy either.”

It took another year, but I left that church. There were other reasons, of course, but the emphasis on fasting over practical expressions of love was the main factor. I had come to realize that my relationship with food simply wasn’t healthy enough for me to deny myself all of it for a period of time without serious consequences. Nor was I ready to hear it preached as a shortcut to God’s action without experiencing crippling guilt about my inability to participate.

I have friends who are Muslim who have told me about their conflicted relationship with faith-mandated fasting. I know (partly from Rachel) that other religions recommend denying oneself food as a gateway to accessing the divine. Have you ever experienced this sort of thing, or am I the only one? I’d love to hear from The F-Word’s readership, because I’ve felt like an oddity.

* For more on fasting and Buddhism, read the last half of the post here.

I’d heard of Angie Jackson, the Florida mother who’s been making the news rounds since she live-tweeted her abortion last month, but it wasn’t until I saw this Slate story on Jackson’s bizarre, evangelical fundamentalist upbringing that I took the time to read further into it all.  Religious cults?  End-of-days extremists? Demonic energy purging and faith-healing?   Even the National Enquirer couldn’t make up stuff this juicy.

Aside from the obvious connection between abortion and this blog’s focus on feminism, it seems that Jackson also has some experiences with the other two F-words discussed here.  First some background:   Jackson was raised  in a conservative, evangelical household that would make Rick Warren look like a lefty liberal by comparison.  Her grandmother, a fringe Christian leader and author of Christian apocalyptic thrillers, acted as a “spiritual midwife” in “Zion home births” conducted without medicine or medical intervention (which she considered to be “pagan religion”).  In her mid-20s, Jackson googled her grandmother’s name and discovered a trail of deaths and tragedies that occurred as result of her grandmother’s extremist teachings and shortly after began an antithetical blog, Angie the Antitheist, where she writes frequently about atheism and the abuses of faith healing.  It was on her blog that Jackson, the mother of a four-year-old special-needs son, announced her decision to terminate her second pregnancy after her birth control (she was on three different forms) failed.  Read more of Jackson’s background in her own words here.

In an interview with The Frisky, Jackson said that she initially thought that people might be more accepting of her decision to have a non-surgical abortion in her first trimester because of the serious health risks a full-term pregnancy would hold for her (it still didn’t stop the death threats lobbed at her and her family by good “Christian” folk).  She suffered from such severe sexual abuse as a child that she was told beginning at the age of 8 that she would never be able to have children, but got pregnant at 22 and went on to deliver her son after a grueling 98-hour delivery.  Yes, you read that right — a 98-hour delivery.  Yikes!  On her blog, Jackson details some of the serious health problems she suffered from at the time of her first pregnancy, including anorexia, bulimia, body dysmorphia and self-harm (cutting) — all of which she says is closely linked to her cult upbringing.  She writes:

I was told, over and over and over, in the repetative indoctrination style of a cult, that I was a burden, that I had too many needs, and that I was no good. I tried to cut away my flesh (my “Adam nature” or sinfulness) with a razor blade. I tried to make my physical body as small as possible, thinking maybe then I wouldn’t take up too much space or be so in the way. I starved and I ran. When my hip went out, I couldn’t run anymore so I went back to throwing up. I once carved the word “FAT” into my left thigh, and the scars are still there.

And from an excerpt in her forthcoming book (trigger warning for glamorizations of eating disorders):

My grandmother taught that there were worlds or realms – the spirit realm and the flesh realm. Flesh was always bad. I can’t help feeling like that has to mean something in the origin of my eating disorder. Starving was a way of making myself less about my body – that evil, human, sinful natured, Adam and Eve descended, recently molested and victimized body – and more about my thoughts, and the voices in my head. After all, that’s what I was taught to do.

So, given her history, Jackson just assumed her missed periods to be amenorrhea caused by a “particularly bad bout of anorexia.”  In fact, she only found out that she was pregnant because her weight loss had plateaued and she had trouble reaching her goal of getting below 100 pounds.  Anorexia wasn’t Jackson’s only problem; she was in an abusive relationship, had struggled to get off drugs and was struggling financially.  She describes that first visit with her doctor and her consequent efforts to get healthy:

“You need to gain weight,” he told me, looking at my 5’3″ 104 lbs frame. “You need to gain 50 pounds, and you need to do it yesterday.” That was my battle for the next four months, trying to put on and keep on enough weight to make sure the fetus’ brain developed properly.

I quit smoking pot, and mostly quit smoking cigarettes. (Yeah, I snuck a few here and there, most memorably on my wedding day, early in my third trimester.) I laid off the diet sodas, energy drinks, and diet pills I’d relied on to get me through school, and dropped out of college. I changed everything about my body, from what I put into my body, to how long I kept it there (no bulimia for me, as the electrolyte imbalance that would cause could be extremely damaging to the fetus), to what size I tried to be. I dropped bad habits, bad friends, but regretfully, picked up again the bad relationship I had with my ex-boyfriend…

I struggled to stay healthy, while planning a wedding (on an extremely lean budget), fighting with my fiancee, fighting with my mother, and moving three times. I didn’t always win that fight, and I spent days and days in the maternity wardmergency room, on IV drips and supplements. My iron levels were low, but the prenatal vitamins with iron in them made me throw up. I was living off pizza, ice cream, and Subway sandwiches, but I couldn’t keep weight on to save my life (or my fetus’). A week after my honeymoon, I went into the ER with a fever and a stomach flu, and over the course of that week I lost 10 pounds through vomit and diarrhea. I wondered if either one of us would make it out alive.

Miraculously, Jackson and her son did make it out alive, but with her doctor’s warnings that a second pregnancy could be seriously risky for her health.  And from some of her recent blog posts, it appears as if Jackson is still struggling with body image and disordered behaviors, thus complicating her preexisting health risks all that much more.Jackson’s case is a biographer’s dream not only for her bizarro religious upbringing and decision to live-Tweet her abortion., but what I find most interesting is how the issue of personhood (generally defined as personal integrity and autonomy) plays out here in relation to abortion and eating disorders.  Indeed, it’s an issue that lies at the very heart of the heated abortion debates.  Anti-choice zealots argue that personhood begins at conception, with some going so far as to claim that even sperm or ovum possess all the rights of personhood, while pro-choice activists maintain that to affirm the personhood of the fetus is to, in effect, deny personhood to the woman bearing it — and by proxy, to all women.

I’m sure you can guess which side of the abortion fence I straddle. As a Buddhist, I would have a difficult time reconciling a decision to have an abortion for myself, but as a feminist, I absolutely believe in a woman’s right to make medical decisions for her own body. Abortion is about so much more than women’s reproductive rights; a woman’s right to decide on abortion when her health and life are at stake is synonymous with her very right to be.  Uh huh, I see you nodding, but how exactly does the issue of eating disorders come into play?

It may be a leap here on my end, but I see the denial of bodily integrity to women when it comes to their reproductive choices as representative of a much larger and historical devaluation of the bodies of women in general. And I’m not alone. In the anthology Unbearable Weight, Susan Bordo includes an essay titled “Are Mothers Persons?” in which she examines women and reproductive rights that, at first blush, appears incongruous in a book about women, body image and eating disorders. Bordo’s motives become increasingly clearer, however, as she examines court cases and legal decisions in which pregnant women have been systematically denied agency over their own bodies and in making medical decisions for themselves and their unborn babies. The American legal tradition has traditionally upheld cases involving bodily integrity or “the right to one’s own person” — that is, in cases brought before the court by male plaintiffs. Cases involving pregnant women and mothers, however, evoke a legal double standard.

Social control of women is predicated on bodily control of women — throughout the centuries, women’s bodies have been subject to assault, rape and other forms of violence, their movements restricted both literally and figuratively, their sexual expression and self-determinations denied, their bodies sexualized and commodified, their health issues dismissed and undertreated, access to food restricted and regulated, ad nauseum.  Is it any wonder then that 90 percent of eating disorder cases are seen in girls and women? Women seek to control their bodies precisely because they continue to lack control over their bodies.

And that’s what I find most interesting about the case of Angie Jackson, a woman with a history of abuse, both externally and self-inflicted. Sure, Jackson has serious medical problems that could complicate a full-term pregnancy, but as she very plainly stated on her blog, she also just didn’t want to be pregnant. For Jackson, terminating her pregnancy represented the best possible choice she could make for her physical and emotional health, and by live-Tweeting it, she declared her rejection of some of the same fetters that helped make her a victim of sexual abuse and eating disorders.  If that’s not good enough of a reason to trust women, what is?

This month is Black History Month and this week is National Eating Disorders Awareness Week, and Stephanie Armstrong addresses both in an interview on “Saturday Mornings with Joy Keys,” an interactive, live Internet talk-radio show that focuses on “providing people with tools to enrich and advance their lives mentally, physically, monetarily and emotionally.”  Stephanie  is the author of the new memoir Not All Black Girls Know How to Eat: A Story of Bulimia, in which the now 40-something, recovered, married mother of one daughter and two stepdaughters documents her descent into bulimia in her early 20s and describes her struggles as a black woman with a disorder consistently portrayed as a white woman’s disease.  The Brooklyn native also examines the “bootylicous” black woman stereotype and why the black community’s “code of silence” often leaves black women with eating disorders suffering in silence.  The work is being hailed as the first book by and among black women about eating disorders.  You may remember that Stephanie also answered the-F-word’s questions a few months ago.

Guests included Stephanie and Laurie Vanderboom, program director for the National Eating Disorders Association, which sponsors and coordinates National Eating Disorders Awareness Week.  A few interview highlights

Joy: What do you (NEDA) see when you have these programs?  Do you see a lot of African American women coming to the programs?

Laurie: We’re just beginning to and we’re just beginning to reach out.  There’s so much shame involved in an eating disorder that people hesitate to step up.  Stephanie, wouldn’t you agree that no matter what your racial make-up…

Stephanie: Absolutely, but especially coming from a culture that doesn’t support therapy, that doesn’t support getting outside help, and risking falling outside of the strong black woman archetype that we’re raised believing and have to become.  It’s hard to disassociate yourself with that image to get the help you need.

———————————-

Stephanie: One of the things I always talk about, especially in the black community, is that we don’t have an awareness of what exactly bulimia is.  It’s like you go to someone’s house and they’re drinking that dieter’s tea.  That’s bulimia.  Laxative abuse is bulimia.  Diuretic abuse is bulimia.  Compulsive exercising is bulimia.  It’s like we think it’s just throwing up, but it’s not just throwing up.

———————————-

Joy: I was talking with a professor of mine and he mentioned that psychologists don’t diagnose African American women properly with eating disorders, because they’re not used to seeing a African American woman coming to their office with this issue. Stephanie, do you feel that that’s the case?

Stephanie: Absolutely. Absolutely. I am constantly talking to women — some who are therapists, some who are young — who are constantly misdiagnosed. I’ve had doctors say, ‘Oh, you don’t have an eating disorder. African Americans don’t have eating disorders.’ I had a young woman call me yesterday – she goes to Clark Atlanta College and she’s at the American University in DC working on an exchange and she’s doing a paper in journalism and decided to do a paper on blacks and eating disorders because her aunt was bulimic and died from it. She calls me up and she said her teacher said, ‘Well, the problem is that there aren’t really that many black women with eating disorders, so that’s going to be a hard paper to do.’ It’s that overall belief that we don’t exist. (she briefly cites a rundown of research showing the prevalence of eating disorders among black women and girls, including this study) …the research is seeping in, but it’s still not getting the attention.

And it’s not just black women with eating disorders who are thought to be virtually non-existent.  Running Tiptoe recently posted a review of a recent “Intervention” episode featuring an Hispanic woman with an exercise addiction and a history of bulimia.  In her review, she offered this link to this 2006 study of “eating disturbances among Hispanic and native American youth,” in which it was found a much more significant pattern of disordered eating behaviors than previously thought.  There are more stats and studies on Hispanic women and eating disorders listed in this 2003 news report.*

Despite all the evidence to the contrary, eating disorders continue to persist in public opinion as a disease young, white girls from middle-class and wealthy backgrounds develop.  But eating disorders are the great equalizers: food is one of the few legal “drugs” out there; everyone needs it to survive;  and in industrialized nations, at least, is widely available and relatively cheap.  That, combined with the constant affirmations of weight loss as morally good and idolization of thinness saturating virtually every facet of our lives, and it’s no wonder that  those with emotional issues and unfulfilled needs might turn to food and the body to express a pain they cannot put into words.

Black girls and women with eating disorders.  Hispanic girls and women with eating disorders.  Adult women with eating disorders.  Boys and men with eating disorders.  Orthodox Jewish girls and women with eating disorders.  Poor girls and women with eating disorders.  We. All. Exist.

* For more information on eating disorders amongst non-white populations, see here.

This week marks National Eating Disorders Awareness Week (NEDAW), and so we will be posting tools/resources/tips/personal stories and more this week in support of eating disorder recovery.  To kick the week off, how about checking out and joining these supportive Facebook groups (because isn’t everyone and your grandma on Facebook?).

• Letters to My Body: Fostering body kindness and promoting stronger self-esteem; One letter at a time (check out the project’s website to read letters from others).

• 5 Resolutions to Transform the Fashion and Beauty Industries: Founded by model Magali Amadei and writer Claire Mysko, 5 Resolutions (http://5resolutions.blogspot.com) is a network for anyone who believes in promoting healthy beauty and fashion.

• Eating Disorders Coalition for Research, Policy & Action: The Eating Disorders Coalition for Research, Policy & Action promotes the recognition of eating disorders as a policy concern. This Facebook group was created so that people will know that there is hope. It is for everyone who is alarmed by the prominence and danger of eating disorders, but is unaware of what can be done to change it. We can ask our government to help create actual policies that will translate into advancing the goal of eating disorder prevention and recovery…

• Blogging for [ED] Awareness & Recovery: A group of bloggers that write specifically about eating disorders, whether a loved one has been diagnosed or you have been yourself.  This group is *NOT* for pro-ed blogs! These are strictly recovery and awareness-minded bloggers!

• I’m making fat socially acceptable and I’m not sorry:  This is a fat acceptance group. This group is for people who one day stumbled upon the truth that fat is not as bad as it is made out to be. In fact, most of the time fat isn’t bad at all – and even in the cases where it is (where is causes mobility or other issues) it isn’t being treated properly, and fat hatred is only hurting the issue…

• Dear Eating Disorder,: This is a group for those of us who suffer from an eating disorder can come and write a letter to let ED know exactly what we think of it. Whether you are recovering or recovered. Whether you are struggeling or in a good place. Whether the Eating Disorder is runining your life or the life of a friends or family members its time it should know. Tell your Eating Disorder your thoughts and feelings about it. Breakup with the Eating Disorder if you want!!!

• Start a Revolution.  Stop hating your body.: is an attempt to raise awareness about the vast array of problems that stem from body consciousness and lack of esteem including, but not limited to: anorexia nervosa, bulimia nervosa, body dysmorphic disorder, binge eating disorder, depression, and general dissatisfaction. Furthermore we acknowledge that society today has constructed a multi-billion dollar industry designed to perpetuate the desire for unattainable beauty while capitalizing on products for self-improvement. Our mission is to end corporate dominance over body esteem.

• Men Get Eating Disorders, Too: is a web and publicity campaign that aims to raise awareness of male eating disorders to enable men to get support. The site provides essential information and advice, links to support and a message board.

• Academy for Eating Disorders: The AED is a leading global professional association committed to promoting innovative eating disorders research,education, treatment and prevention.

• Eating Disorders Anonymous: For those with eating disorders looking for support OR someone with a loved one suffering and needing advice as to what to do OR supporting friends with eating disorders OR wanting to know more about eating disorders and their danger [this group’s content is public, so be forewarned that it’s not exactly “anonymous,” per se).

And, of course, be sure to join The-F-Word’s Facebook page, as well as friends of the blog: Big Fat Deal and Feed Me!. Know of any other great Facebook or MySpace groups? Give them a shout out in the comments below!

Given the blog’s focus, it’s not often that I have good news to report, so I tend to get a little giddy when the cosmos align in our collective favor. I blogged back in December, 2008 about proposed changes under consideration by the American Psychiatric Association to the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM).  Considered the psychiatric bible of the field, the DSM is used by doctors to make a diagnosis and provides insurance companies with diagnostic codes without which the insurers will not reimburse patients’ claims for treatment. Among the conditions up for debate included making binge eating disorder (BED) an independent diagnosis (BED is currently lumped into the vague catch-all category of ED-NOS, which encompasses those who don’t meet one or more of the criteria for anorexia or bulimia).

You’d think that a condition estimated to eclipse both anorexia and bulimia combined would be a no-brainer for inclusion, right?  You’d think wrong.  Some mental health professionals actually protested classifying BED as a disorder, suggesting it to be a “normal behavior.”  Luckily for those who suffer from decidedly abnormal binge eating behaviors, the duh truck must have finally arrived at the APA, because when they released a draft of its recommendations today, it included recognizing BED as an official independent diagnosis — read the recommended criteria for diagnosis here.  This is awesome news, for in addition to psychotherapy, there are medications that have been shown to help people with binge eating disorder (Topamax and Wellbutrin, for example). If binge eating disorder were included in the manual as a legitimate eating disorder, those people who struggle with it might have an easier time getting insurers to cover the treatment and medication they so desperately need.

The recommendation of BED as an independent diagnosis is certainly the biggest change for eating disorders in the DSM, but there are other proposals under consideration that I think are pretty fabulous, too.

Purging Disorder

The work group is considering whether it may be useful and appropriate to describe other eating problems (such as purging disorder–recurrent purging in the absence of binge eating, and night eating syndrome) as conditions that may be the focus of clinical attention. Measures of severity would be required, and these conditions might be listed in an Appendix of DSM-5. If these recommendations are accepted, the examples in Eating Disorder Not Otherwise Specified will be changed accordingly.

As someone who suffered from what would be considered purging disorder with anorexic tendencies and was misdiagnosed with bulimia, I’m excited to see this relatively newly-popularized condition being entertained by the panel.  Pamela Keel, an associate professor of psychology in the UI College of Liberal Arts and Sciences, has made great inroads in research indicating purging disorder to be a significant problem in women that is distinct from bulimia.

Anorexia

Many eating disorder activists are critical of the phrasing in the criteria for anorexia of a “refusal to maintain body weight at or above a minimally normal weight for age and height.”  Refusal here, being the key word as myself and others argue that it’s not so much a refusal as it is an inability.  For more on this, read Harriet Brown’s critique of the semantics.  In its draft, the APA recommended clarifying the criterion to focus instead on behaviors, acknowledging that the word “refusal” implies intention and is “possibly pejorative and difficult to assess.”  The panel also recommended deleting the criterion of amenorrhea, thus opening up the diagnosis to a broader range of sufferers, including a growing number of men reporting anorexic behaviors.

In DSM-IV, amenorrhea is required. However, individuals have been clearly described who exhibit all other symptoms and signs of Anorexia Nervosa but who report at least some menstrual activity. In addition, this criterion cannot be applied to pre-menarchal females, to females taking oral contraceptives, to post-menopausal females, or to males. However, there are some data that women who endorse amenorrhea have poorer bone health than do women who fail to meet this criterion.  Deletion of this criterion is recommended.

Bulimia

The current DSM-IV requires episodes of binge eating and inappropriate compensatory behaviors both occur on average twice a week for three months.  The panel cited a literature review that found that the clinical characteristics of individuals reporting a lower frequency of once/week were similar to those meeting the current criterion, so they recommended that the required minimum frequency be reduced to once/week over the last three months.  The bulimia diagnosis also currently includes two subtypes: purging and non-purging.  People with non-purging bulimia often try to purge calories via exercise or fasting, but do not use enemas, self-induced vomiting, laxatives, etc..  The panel found that non-purgers more  closely resembled people with BED, and so they recommended deleting this subtype altogether.

Obesity

Despite reports from the Boston Globe that the APA was considering classifying obesity a mental illness, I see nothing in the draft indicating that it would be included.  The sheer ridiculousness of such a proposal simply blows my mind and at first I thought the Globe perhaps erroneously conflated obesity with binge eating disorder, since those with BED tend to be overwhelmingly overweight or obese, but it appears as if the idea was at least introduced.  A study released last summer examined the evidence for making obesity a mental disorder and found it significantly lacking, acknowledging only “evidence that obesity is related to mental disorder and many of the medications used to treat psychiatric illness.”  Considering that the latter evidence has been around since the 1990s, the study basically only confirmed the obvious.

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Before we pop the cork on the champagne, keep in mind that this is only a draft, and is subject to change and that’s where you come in.  In a new twist for the APA, the organization has posted the draft online and is seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them.  The draft manual, posted at www.DSM5.org, is up for public debate through April.  The final version is expected to be released in 2013.

A new study of 1,000 American girls between the ages of 13-17 by the Girl Scouts finds that 9 out of 10 girls say they feel pressure from the media and/or fashion industry to be skinny.  More than 80 percent of the girls polled said they’d rather see natural photos of models than digitally enhanced or altered photos.

Specialists calculate life expectancy for people with anorexia to be 25 years shorter than average.  Patients who recover however, may expect full lifespans.

A Chicago mom and grandmother shares her story of finally overcoming anorexia after 25 years of battling the disorder.

Remember the mental health parity law that passed in 2008? The The U.S. Departments of Health and Human Services, Labor and the Treasury jointly issued new rules this week governing the law.

The Website Realself.com tracked cosmetic surgery trends by region and even city with some surprising results.

New “groundbreaking” study shows abnormal brain function in people with body dysmorphic disorder.

Eve Ensler: Girl power can save the world.

The New York Times reviews Michael Pollan’s new book, “Food Rules: An Eater’s Manual.”