The Eating Disorders Review recently send out this review of ICED in Montreal. A very insightful look at how necessary it is to consider all variebles leading up to and including the treatment of a patient struggling with an eating disorder.
A few key topics highlighted below:
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A Transdisgnostic Approach
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Emotions Role in Eating Disorders
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Men with Eating Disorders
Reprinted from Eating Disorders Review
July/August Volume 24, Number 4
©2013 Gürze Books
Taking a New Look at Old Boundaries in Eating Disorders
The International Conference on Eating Disorders (ICED) in May offered a program filled with practical and research-oriented presentations. Following this year’s theme, “Crossing Disciplinary Boundaries in Eating Disorders,” sessions included a keynote address reminding the audience about the challenges of overlap and similarities among eating disorders, a look at how emotions can drive eating disorders, and an analysis of why male patients are so infrequently involved in eating disorders treatment.
Developing a Transdiagnostic Approach
In his keynote address, David Barlow, PhD, ABPP, professor of psychology and psychiatry, and founder and director emeritus of the Center for Anxiety and Related Disorders at Boston University, told audience members that a transdiagnostic approach to psychiatric and psychologic disorders is slowly but surely developing.
“We have thousands of protocols,” Dr. Barlow noted, adding that the “time has passed for one protocol after another with only a slight twist.” There is no way that such an approach can ultimately be useful, he said. At the present time there may be effective treatment but there is plenty of room for improvement, he said, adding that there are still too many protocols and manuals, and these protocols are still relatively complex, which interferes with effective dissemination.
He also pointed to work by Dr. Chris Fairburn and colleagues a decade ago, which marked the beginnings of taking a transdiagnostic approach to eating disorders. By honing in on overvaluation of shape and weight and control, the researchers hypothesized that the remaining disorders follow this same pattern. Research on the comorbidity of anxiety with bulimia nervosa is another example. Various researchers showed a high comorbidity rate of anxiety with bulimia nervosa.
Intolerance of uncertainty (IU) is a characteristic predominantly associated with generalized anxiety disorder (GAD); however, emerging evidence indicates that IU may be a shared element of emotional disorders, Dr. Barlow said. He explained that a synergy of several types of vulnerabilities leads to stress, and in turn to generalized anxiety, and depression. It is thought that the vulnerabilities come together, perhaps triggered by stress, to find their phenotypical outlet as anxiety and/or depression, the flip side of generalized anxiety, he said. Dr. Barlow said that emotions are not meant to be suppressed; instead, they are present to motivate us to engage in certain behaviors. If the vulnerability is not present, mood recovers naturally and more quickly in response to stress, he said.
Dr. Barlow also shared a unified protocol approach illustrating the principal of transdiagnostic unified treatment for anxiety. This approach features eight treatment modules, including: motivation enhancement for treatment engagement; psychoeducation and treatment rationale; emotional awareness training; cognitive appraisal and reappraisal; interoceptive awareness and tolerance; situational exposures; and relapse prevention.
Dr. Barlow also addressed a question about the interdependence between biological vulnerability and psychological vulnerability. Splitting apart biological and psychological vulnerability does have empirical support, he said because there are recognizable differences in the brain. The fact that specific brain circuits are activated is an argument for keeping disorders separate, as in the case of obsessive-compulsive disorders. However, he added, his group wonders if these vulnerabilities are continually influencing each other.
Emotion’s Role in Eating Disorders
In a plenary session, Steve Wonderlich, PhD, Director of Clinical Research at the Neuropsychiatric Institute, Fargo, ND, said that the study of emotion may be very important to the diagnosis and treatment of persons with eating disorders. The role of emotion in eating disorders is still being debated, and “emotion” is a slippery term, Dr. Wonderlich said. Very significant questions have to do with the possible functional relationship between emotion and eating disorder behaviors. Do emotions precipitate or modulate disordered eating behaviors?
Dr. Wonderlich, a Past President of the Academy for Eating Disorders and a member of the EDR Editorial Advisory Board, described a technique, ecological momentary assessment (EMA), that his group and others have used to collect data about patients in a real-world environment. Patients use a handheld computer or a cell phone to record current states, events, and emotions and thus are able to record events as they occur.
To gain a richer view of a patient’s life, the device signals the patient to record their behavior and emotions 6 to 10 times a day. Thus binges, components of meals, and emotions can be recorded at or near the time they occur. According to Dr. Wonderlich, the real beauty of such devices is that the connection between emotion and behavior can be studied at a very precise point in time, which will help establish whether emotions are driving the behavior, or vice versa. This method also establishes a record of emotions and behaviors for longitudinal study. In a 2007 study of 131 adult female volunteers diagnosed with DSM-IV criteria for BN, 90% of the time patients responded within 45 minutes or less. Other researchers who examined the trajectories of emotion before and following the bulimic behavior found that during the 6 hours before a binge episode, a steady increase in negative affect occurred, and culminated in a binge.
Do different emotions have specific relationships to bulimic behavior? Dr. Wonderlich also briefly described the work of Dr. Kelly C. Berg et al., who explored the connection between four negative emotions--guilt, fear, sadness, and hostility-- and bulimic behavior. Guilt was linked to the highest degree of negative affect, and was significantly associated with binge eating; this was not the case with the other emotions. Another question concerned individual differences, and whether certain characteristics of people with specific forms of disordered eating made them more vulnerable to behaviors triggered by negative affect. Increasing evidence suggests that negative emotional states may play a role in precipitating eating disorders behavior across diagnoses, he said.
What are the implications for treatment? Some implications for treatment include:
- Consider treatments that directly reduce the intensity of emotion (example, psychotropic drugs).
- Promote more adaptive regulation of high-risk emotion moments. This may be accomplished by targeting events that increase negative affect in persons with eating disorders and\or to enhance their ability to clarify, accept, and tolerate negative affect states (distress tolerance), and...
- Promote inhibition of impulsive behavior, especially in times of heightened negative affect.
Does it matter if the eating disorder behavior reduces the negative affect or produces negative reinforcement? Dr. Wonderlich quoted B. F. Skinner, who said, “Although antecedent conditions help to establish a behavior, consequences maintain it.” However, Dr. Wonderlich asked, if this is true, why does a person who pursues low weight engage in behaviors such as binge-eating, which directly interfere with attaining the goal of low weight? Biologically induced binge eating counteracts a physiological state connected with starving, as Ancel Keys noted.
Binge eating and other disordered eating behaviors are maintained because they help the person escape from or avoid the precipitating negative emotional states. If eating disorder behaviors actually function to reduce/avoid a negative emotional state, clinicians have two treatment options, he said. The first would be to identify and help patients develop alternative behaviors that promote the same emotional reward; the second option would be extinction of the behavior.
He described a 2008 study evaluating extinction as a functional treatment for binge eating (Behavior Modification 2008; 32:556). Dr. Ray Miltenberger and colleagues at the University of South Florida trained bulimic patients first in the lab and then at home. Patients listened to a tape recording they had made after a previous binge, one that made them feel badly about the binge. As a result, some of the trainees became abstinent and remained so, Dr. Wonderlich said. He also cited a very recent paper by Dr. Tim Walsh and colleagues that described AN as a well-entrenched habit and reported that with habit acquisition, rather than reward, the brain shifts. Thus, habit formation appears to be critical to the persistence of the dieting behavior. (Am J Psychiatry. 2013; 170:477-484. doi:10.1176/appi.ajp.2012.12081074 ).
Finally, Dr. Wonderlich offered several conclusions about emotion and eating disorders. First, emotion variables and eating disorder behaviors co-vary at a momentary level. Next, antecedent emotional states may be meaningful clinical targets for eating disorders treatment, but the impact of eating disorder behaviors on emotional states still needs much study. Finally, he noted that eating disorder treatment interventions may benefit from a greater focus on specific situations, affects and actions that occur in a momentary timeframe and promote conditioning or reinforcement that perpetuates eating disorder behaviors.
Where Are All the Men?
Men face a number of barriers to obtaining treatment, according to two clinicians who specialize in treating men with eating disorders. In a special plenary session on eating disorders in men, Roberto Olivardia, PhD, and Mark Warren, MD, PhD, FAED, explored some of the reasons that men with eating disorders are often overlooked or never seek treatment.
First, there is a misperception that only women have eating disorders. According to Dr. Olivardia, clinical instructor of psychology at Harvard Medical School and co-author of one of the first books to deal with eating disorders in men, The Adonis Complex, there is a wide misperception that eating disorders only affect women; another misperception is that eating disorders affect only gay men. Sexual orientation can be a huge issue, he said, noting that shame and secrecy also keep many young men from seeking help for an eating disorder. Gay men are more likely to discuss their disorders with peers, while heterosexual men are far more secretive, and even their spouses are often unaware of the problem.
When men do seek help, they may find themselves in treatment centers that cater to women, and they may have problems dealing with a female physician as well. And, since so many treatment centers cater primarily to women, treatment may not be available for men, even if they do want help.
Dr. Olivardia noted that eating disorders can appear in boys as young as 9 or 10, and disorders very often focus on muscle mass rather than with weight alone. They may see themselves as too thin and scrawny, and seek anabolic steroids to “bulk up.” Just as with women, cultural influences are powerful-- muscularity is seen as a core element of masculinity, dominance, and attractiveness. For example, in the 1980s, a shift in the movies occurred at which time bigger bodies became important commodities and important currency; this was accompanied by an explosion of “muscle magazines,” men’s fitness magazines, and even video games stressing male bulk. He pointed to an extreme example of newer action figures, wherein even Star Wars action figures were re-mastered to be much more muscular. It is estimated that from 4 to 6 million males are affected, and the onset of these disorders is around the time of puberty. He added that much more data are needed about incidence, race, and socioeconomic status.
Men are less likely to seek treatment because of shame about having what is “a female disorder,” according to Dr. Olivardia. Males with eating disorders are often self-conscious and find themselves in settings with few other male patients. The good news is that once these men get into treatment, they do as well if not better than do women, he said.
Men need to be included in the conversation about eating disorders. Dr. Warren, Medical Director of the Cleveland Center for Eating Disorders, traced the history of eating disorders in men, noting that the first two reported cases of anorexia nervosa involved one female and one male. Our culture focuses on gender, food, and bodies, he said. For example, even the story of Adam and Even featured nakedness and food and how genders are affected. He added that men have been excluded from the current narrative of eating disorders because the criteria, screening tools, and treatment have all been based upon the histories of women patients. He added, “For men to be included in the conversation, we have made many attempts to distinguish how eating disorders are different in men. We need to accept that men have eating disorders and then to find how biology and genetics exist to present a different clinical picture in men.”
Dr. Warren also said that there are compelling reasons to improve studies of eating disorders in men; these problems are serious, potentially life-threatening conditions that are extremely challenging to diagnose and treat and they are increasing. He praised Dr. Arnold Andersen, a longtime member of EDR’s Editorial Board, for his pioneering work in the treatment of men with eating disorders. Dr Warren also shared with the audience that he himself had anorexia nervosa in his teens and knew nothing about the disease at the time. He said that his recovery was a matter of luck and that even now most men recover as a matter of luck rather than as a result of clear diagnosis and treatment. Men started “disappearing from the equation when the focus turned to amenorrhea and “hysteria,” neither of which applied to men. In the late 1970s, Dr. Gerald Russell’s work on bulimia brought men back into the eating disorders world, Dr. Warren said. However, even today most research articles are written exclusively about women, he said, showing that we have not progressed in the way we might want to.
What else can be done? Dr. Warren told the audience that one positive step in the future would be to always include men in every eating disorders study. Clinicians can also ask themselves what it is like to be a man with an eating disorder. In most treatment centers, male patients only see women patients, and a woman clinician typically asks a male patient to discuss his body, feeding, and intake. He added that most males are asked if they are gay before they are asked if they are afraid their illness will kill them.
Shame is such a powerful emotion, he said, which keeps men with eating disorders from seeking help. Health care providers can be more mindful and sensitive to eating disorders in males. They can remember to ask male patients more about their body goals and use gender-neutral language. Treatment centers can be more welcoming, for example, by including men in their ads. Men also need to know about the history and sociocultural beliefs that underlie eating disorders and how culture affects us all, he said. Having a male clinician to talk with and to be validated by is also a powerful way to help a man with eating disorder feel more comfortable about seeking treatment and sticking with it. The chemistry of the treatment team is extremely important, Dr. Warren said.
Full article here...
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The following story recently ran in the L.A. Times covering the growing number of males struggling with anorexia and the added challenges they face in seeking treatment.
Excerpt...
A survey shows that L.A. male high school students are about as likely as females to use diet aids or laxatives or vomiting to lose weight. The numbers challenge old assumptions.
Bryan Piperno was just 9 years old when he began keeping his secret.
The Simi Valley youngster tossed out lunches or claimed he ate elsewhere. As he grew older, he started purging after eating. Even after his vomiting landed him in the emergency room during college, he lied to hide the truth.
Piperno, now 25, slowly fended off his eating disorder with time and care, including a stay in a residential treatment facility. But surveys show a rising number of teenage boys in Los Angeles now struggle with similar problems.
High school boys in Los Angeles are twice as likely to induce vomiting or use laxatives to control their weight as the national average, with 5.2% of those surveyed saying they had recently done so, according to the most recent survey data gathered by the Centers for Disease Control and Prevention and the Los Angeles Unified School District. They are also more likely to have used diet pills, powders or liquids than boys nationwide.
The numbers challenge old assumptions that boys are immune to a problem better known to afflict teenage girls. Girls still exceed boys in fasting to lose weight, but the latest data, from 2011, showed that Los Angeles boys were nearly as likely as girls to purge through vomiting or laxatives. They were also as likely as girls to use diet pills, powders or liquids without the advice of a doctor — 6.2% said they recently used such substances, compared with 6.1% of girls.
Some experts say boys are starting to face the pressures long placed on girls, as buff, bare men proliferate in pop culture. Boys today watch Channing Tatum strip as "Magic Mike" or weigh themselves against the muscular Dwayne Johnson. The nonstop chatter of Twitter and Facebook has amplified those messages, therapists say.
"Boys are growing up now with the billboard of the guy with perfect pecs and biceps," said Roberto Olivardia, a clinical instructor in the Harvard Medical School psychiatry department. "You just didn't see that years ago."
Teenage boys say abs are prized and ogled. Andrew Shrout, a 19-year-old junior at UC Berkeley, said boys felt they needed to be very lean at his former high school in Long Beach. "Men are pressured to have as little fat as possible — but you've got to pretend like you don't watch what you eat," Shrout said.
He decided to lose weight for his health but also because another guy on the water polo team used to grab his stomach and jiggle it. "I can see why a lot of younger kids get sucked into a vortex and end up doing bad things," Shrout said.
Steroid use is also on the rise among Los Angeles teen boys, the survey found, with roughly one out of 20 saying they have used steroids — only a slightly smaller percentage than those who had recently turned to diet pills, powders or liquids.
Sports can pile on more pressure. Wrestlers, for instance, often aim to lose enough weight to grapple with lighter opponents. For some competitors, throwing up or downing laxatives can be a gateway to a disorder that lasts beyond the sporting event, said Dawn Theodore, clinical director of the Eating Disorder Center of California in Brentwood.
Los Angeles isn't the only city where boys have been increasingly likely to purge or turn to diet substances, with higher-than-average rates also seen in Chicago, Houston, Charlotte, N.C., and elsewhere. Government estimates show that the number of males hospitalized for eating disorders rose 53% between 1999 and 2009. Some experts say they are unsure whether more boys and men are in fact suffering such disorders or whether more are now willing to seek help.
Females remain much more likely to be hospitalized for eating disorders than boys and men, who made up 12% of such hospital stays as of four years ago, the government estimates show. However, researchers say that because men fear coming forward, the rates among males might be higher than the numbers suggest.
When they finally get help, the boys' cases "tend to be especially severe," said clinical psychologist Jennifer Henretty, who directs intensive outpatient programs at the Center for Discovery, a national system of eating disorder programs headquartered in Orange County. "People don't look until it's really out of hand."
Experts say part of the problem is that traditional methods of detecting disorders were made with girls and women in mind.
Benjamin O'Keefe, 18, remembers Googling the word "anorexia" and finding a website that said it halts menstruation. "There was nothing targeted at me," said O'Keefe, who struggled with the disorder in high school in Florida.
He exercised constantly and sometimes ate only a cheese sandwich for days at a time. He suffered massive headaches, slept incessantly and fainted onstage while rehearsing for a play.
While he weakened, "people were saying, 'Wow, you look great,' " O'Keefe remembered.
He began talking about his past struggle with anorexia upon launching a petition earlier this yearurging Abercrombie & Fitch — known for its shirtless models — to carry larger sizes.
Men who battled anorexia or bulimia as teens told The Times that other problems often drove their disorders. Piperno, the Simi Valley man, said it began as a way of exerting control over his body after suffering sexual abuse.
Matthew, a 20-year-old who faced anorexia as a teen in the Pasadena area, first avoided eating to "numb out" the alcoholism of his father and stepmother.
Read full article here...
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Fairwinds Treatment Center is a dual-diagnosis eating disorder facility. We offer personalized treatment for men and adolescent males who are struggling with anorexia nervosa. For more information or to discuss your situation, contact our admissions team at 727-447-0300 or through our website here.
Huffington Post UK blogger and student Rhiannon Morgan just posted the following article explaining the confussion and often misrepresentation surrounding anorexia nervosa.
Below is an exerpt from the article:
Last month we witnessed Mental Health Awareness Week - a week dedicated to mental health campaigning. Like many of you, I followed all the campaigns almost religiously. However, now that it's all blown over - are things any different?
It is taking a long time, but mental health is gradually on its way to becoming less of a 'taboo topic'. This is due to the amount of effort put in by campaigners and activists. Last month it was a delight to see news reports on mental health issues, and my Twitter feed was flooded with blog posts and articles. It was fantastic seeing stigmas broke down by this new social movement. But the hard work isn't over yet.
One mental health issue facing misrepresentation and discrimination is anorexia nervosa. When portrayed in the media, anorexia sufferers are often depicted as obsessive teenage girls who made the choice themselves to stop eating, or celebrities driven to starvation through their strive for perfection. The reality is far more complex, yet the same media image continues to appear - day after day.
Myth busting
I made the mistake this week of typing in the search-term "anorexia" into an online Q&A discussion site. This particular site was based on the concept of females asking males questions, and vice versa.
Sufferers of anorexia were asking the community what they thought about the illness. Common responses? "Men like meat - not bones!", "Why do you intentionally starve yourself?", "Why do girls feel like they have to be perfect?", "Why don't you just eat?"
In about five minutes, my blood was boiling to the brim and I closed the tab. It's 2013. Why is there still a common belief that anorexia is intentional? Why do people still think that it's a choice or a decision that can be solved by choosing to eat? If it was that simple, experts wouldn't dedicate years to research, people wouldn't be dying, and sufferers would be cured by a couple of words and a pat on the back.
It is an issue close to heart, having suffered the mental torment myself. A couple of months ago, I discharged myself from a mental health ward. In hospital, I didn't have the option to starve myself, so I "just ate". But did the anorexia go away? Do I feel cured? No. It isn't a "phase", isn't a simple "hiccup", or a seasonal cold. And it is definitely not a choice.
I see the disease as a thief, robbing people of their lives - metaphysical and physical. People don't ask to be robbed.
If anorexia was a choice, like many sufferers, I would have chosen against it. I would have chosen friends, college and freedom over social isolation, growth over a weak body, and living life over facing death.
Anorexia has the highest mortality rate out of all mental illnesses. Various studies have been conducted, and most statistics show that between five and 20% of sufferers die.
The most agonizing part of recovery is weight restoration. At this point, many sufferers are unable to cope with their feelings around reaching a healthy weight, and some even try to take their own lives.
This leads to another misconception - the misconception that people have to be severely underweight to be diagnosed with an eating disorder.
Anorexia is a mental illness which is experienced, on a personal level, through intrusive thoughts and obsessive cognitions.
Personally, my mental state was at its worse at the beginning, when my BMI was in the normal range and my mind was in agony, engulfed by possessive thoughts. It felt like the GP shook everything off as a phase, and this pushed me to further restriction, and eventually physical damage.
This is why there needs to be more early intervention, and experts need to keep a look out for not just the physical symptoms, but the painful psychological ones too.
Where do we go from here?
It's about time that we stop discriminating against an illness just because it is an illness of the mind. We're currently moving forward on all forms of discrimination - women rights, racial issues, LGBT and physical disabilities. Society needs to continuing progressing; so we should add "mental illness" on to that list as well.
One thing I would like to see (and I hope you all agree) is more politicians supporting our campaigns.
Read full article here...
Fairwinds Treatment Center specializes in helping people overcome dangerous and deadly disorders such as anorexia, bulimia, alcoholism and drug addiction. Being a dually licensed psychiatric facility, Fairwinds physicians and therapists engage an integrated treatment plan, incorporating several treatment models combined with psychiatric methods to identify the root of the disorder in order for specialized treatment to begin and to ensure a lasting recovery.
For more information or to discuss your situation with an admissions counselor, contact Fairwinds Treatment Center at 727-449-0300 / 800-226-0301 or through our website here.
Fairwinds Treatment Center Offers Both DAY and EVENING
Intensive Outpatient Programs for Eating Disorders
Day IOP at Clearwater location
Monday, Wednesday 9:30am - 4pm and Friday 8am -2pm
Family Nights: Thursday 4:30pm – 7:30pm
Patients will eat meals prepared and planned with our Dietician.
Evening IOP at Tampa Location
Monday, Tuesday, Thursday 5pm - 8pm
Family Nights in Clearwater: Thursday 4:30pm – 7:30pm
Patients will bring their own food to this program, meals are planned with our Dietician.
IOP programs include one-one one sessions with our Psychiatrist, Dr. Pauline Powers
The program is designed for 6 weeks, but the length is based on what the individual’s needs are for treatment. Further time may be requested.
Some groups topics include:
CBT/DBT, Art Therapy, Life Skills, Medical Issues, Process Groups, Experiential Activities, Mindfulness, Family, Meal Support
Fairwinds is proud to be a Bronze Sponsor with the National Eating Disorders Association
The National Eating Disorders Association (NEDA) is the leading non-profit organization in the United States advocating on behalf of and supporting individuals and families affected by eating disorders. Reaching millions every year, we campaign for prevention, improved access to quality treatment, and increased research funding to better understand and treat eating disorders. We work with partners and volunteers to develop programs and tools to help everyone who seeks assistance.
NEDA was formed in 2001, when Eating Disorders Awareness & Prevention (EDAP) joined forces with the American Anorexia Bulimia Association (AABA) – merging the largest and longest standing eating disorders prevention and advocacy organizations in the world. The merger was the most recent in a series of alliances that has also included the National Eating Disorder Organization (NEDO) and the Anorexia Nervosa & Related Disorders (ANRED).
This article written by Sharon Stephenson for the New Zealand website Stuff.co.nz explains the work of eating disorder therapist Victoria Marsden and how eating disorders and body image issues can affect people of all ages and status.
"Marsden, who has worked with patients from age nine to their late 60s, says older women suffering from eating disorders generally fall into three categories: those whose illness has gone untreated since adolescence; those whose disorder may have gone into remission, only to resurface later in life; and those who may have developed an eating disorder in their 30s, 40s, 50s, even 60s."
Excerpt:
It was the lemon slice that did it. Biscuity layers of butter and condensed milk, swaddled in icing so sweet it could crack your teeth.
While the rest of us gobbled them down as though in the shadow of a famine, it was too much for Andrea, a former colleague. "Please stop bringing fattening food to work," she shouted, slicing through the calorific coma that made Monday mornings bearable.
"You should be ashamed of yourselves for eating such bad food." And so ended Baking Mondays.
What makes Andrea's behaviour unusual is that she isn't a 20-year-old desperate for thin thighs and a pert bottom, or an unfortunate 14-year-old trapped on the ferris wheelof anorexia. She is a 46-year-old, university educated, high-achieving, property-owning consultant.
Attractive and successful, she's the kind of woman whose good-luck thermostat has never been out of whack. Hardly the poster girl for eating disorders? You'd be surprised, says Auckland body image and eating-issue therapist Victoria Marsden.
"Most attention is given to adolescent eating issues, but they by no means discriminate by age. Eating disorders can happen to anyone at any stage of their lives," she says. Due to a lack of age-related research data on disordered eating in New Zealand, it's difficult to say if older women are the new face of eating disorders, but statistics from the United States indicate a 42 percent spike in the past five years of older women seeking treatment.
These include patients suffering from anorexia, where excessive or compulsive dieting, starvation and over-exercising can result in dramatic weight loss, as well as bulimia, which is characterised by excessive binge eating followed by purging with vomiting or laxatives.
Marsden, who has worked with patients from age nine to their late 60s, says older women suffering from eating disorders generally fall into three categories: those whose illness has gone untreated since adolescence; those whose disorder may have gone into remission, only to resurface later in life; and those who may have developed an eating disorder in their 30s, 40s, 50s, even 60s.
Blame life's major and often unexpected events - divorce, redundancy, illness, retirement and empty nest syndrome, among others - for propping open the door for middle-age eating disorders. "As women get older, they tend to be loaded with responsibilities - raising children, paying off a mortgage, caring for ageing parents - as well as having to navigate some of life's big career and relationship changes. Society assumes that by 40, a woman should have her life sorted, she should be so busy caring for family, working and running a home that she shouldn't have the time or energy to worry about how much she's eating or how slim she looks," says Marsden.
But while women may not be able to control what's going on around them, they can control what goes into their mouths. Wellington-based Andrea has spent more than 30 years doing this. "I've struggled with weight and food issues since I was 13. I believe that if I can control my eating, then I can control my life. The minute stress hits me, my first thought is, how can I restrict my food intake?"
At her worst, Andrea survived on less than 500 calories a day. "Some days I would eat only 30 grapes. A blow-out day would be a cup of plain pasta or a Diet Coke." If she tried to eat more, Andrea's stomach would clench until she vomited. Her periods stopped and she couldn't brush her hair without losing clumps of it. At one stage Andrea's elderly labrador weighed almost as much as she did.
However, turning 40 proved somewhat of a lifeline: Andrea paid off her mortgage, landed her dream job and let go of some of what she calls her "craziness about kai". "For the first time in my life I was able to go to restaurants and eat, rather than just pushing the food around my plate. I felt normal."
But six months ago, the trifecta of a high-pressure career, unrelenting perfectionist tendencies and the death of her father pushed Andrea "back down the road of previous coping strategies".
"At a certain point, you cross that line and can't stop what you're doing. Sometimes it feels as though this illness owns me.''
One of the biggest culprits of disordered eating for women - and men - of all ages is society's obsession with body image. On any given day, around 60 percent of women are on a diet.The weight-worry gun is loaded early: in New Zealand, it's estimated as many as 10 percent of adolescent girls go through a mild phase of anorexia. And it would appear that there is no age at which we learn to love our bodies: an Austrian study of 475 women aged 60 to 70 years revealed that 60 percent were dissatisfied with their bodies, while four percent were diagnosed with an eating disorder.
Here in New Zealand, Weight Watchers reports 13,000 members over 40, with their oldest member being 79 years old. Marsden says that the necessity to maintain a certainweight is particularly critical if a woman's identity and self-esteem is wrapped up in her appearance.
"This may lead her to seek a thin, youthful body through unhealthy behaviours, such as food restriction, diet pills, extreme exercise, drugs, laxatives or purging." Throw in the weight gain caused by hormonal fluctuations in menopause and the stage is set for eating disorders.
Jenna was 38 when she first stuck a finger down her throat. "The feeling of wanting to be slim doesn't go away just because you get older," she says. When her husband of 10 years announced he was leaving her for a younger woman, his parting words included an insult about her weight.
Read full article here...
Eating disorders affect people of all ages and gender. If you feel you have an unhealthy body image that controls your life and eating habits, contact Fairwinds Treatment Center to discuss your situation with one of our admissions counselors - 800-226-0301 or through our website here. You can get better. We can help.
It is widely know children can develop Anorexia Nervosa at a very early age. It is important for parents to be aware of the behavours associated with this disease and know the treatment options available to eliminate it before it is too late.
During National Eating Disorder Awareness Week,
SUSAN DONALDSON JAMES of ABC News recently a story about children as young as 6 developing anorexia nervosa.
(Sophie, shown here at 6, was just starting to restrict her eating. She was diagnosed with anorexia nervosa the following year.)
Sophie started starving herself in kindergarten, giving up sweets at first, then taking smaller and smaller portions of food. She exercised compulsively on the monkey bars.
But her parents had no idea she was developing anorexia nervosa because the active girl's height and weight looked normal on the pediatrician's growth chart.
"She was slim, but not skeletal," said her mother Anne, a college professor from Washington State, who did not want to use real names to protect their privacy.
Sophie complained of being dizzy, having "itchy skin" and constipation, all symptoms of malnutrition. She later confessed that she had been throwing out her school snacks and lunches.
And one night when her mother was tucking her into bed, she blurted out, "Mommy, I have a problem … I am hungry all the time and I can't eat," remembers Anne. "A voice in my head is telling me not to eat."
When Sophie was finally diagnosed in first grade, she hadn't gained a pound for 10 months and had dropped from the 60th to the 19th percentile on the weight charts.
More than 10 million Americans have eating disorders, which have a 10 percent mortality rate, the highest of any psychiatric illness, according to the National Institute of Mental Health. Look for these upcoming reports throughout Eating Disorders Awareness Week: ABC News will examine why men have a harder time getting an anorexia diagnosis, and we'll give a revealing report on the rise of thinspo (short for thinspiration), a growing web-based movement that promotes anorexia as a lifestyle choice rather than an illness.
Anorexia nervosa is a chronic brain disorder with no known causes. It is rare among young children -- but the number of hospitalizations is on the rise. According to the Agency for Healthcare Research and Quality, the rate jumped 72 percent between 1999 and 2009, the last year for which there are statistics.
Highly inheritable, it is estimated that 56 to 70 percent of those who are anorexic have a family member with an eating disorder or a co-morbidity like anxiety....
Read full article here
Located in Clearwater, Florida Fairwinds Treatment Center specializes in the treatment of eating disorders such as anorexia nervosa and bulimia nervosa. Fairwinds Treatment Center's eating disorder program is lean by Pauline Powers, M.D..Dr. Powers is nationally and internationally recognized as a leading researcher, educator and trainer in the ongoing battle to end eating disorders.
If you or someone close to you is in need of help, contact Fairwinds Treatment Center at 727-449-0300 or by email here. Our admissions counselors are here to help guide you through the process of determining the best course of action to meet your needs.
As a follow up to our recent announcement regarding the opening of our IOP opening in Tampa, we would also like to announce Dr. Pauline Powers has re-assumed her role as Medical Director of the Fairwinds Treatment Center Eating Disorder Program. "We are excited to have Dr. Powers back on staff, her background and experience makes Fairwinds the most qualified and effective eating disorder program not only in the 67 counties in Florida, but one of the best recovery centers in America." said Mazhar Al-Abed, CEO Fairwinds Treatment Center.
Pauline Powers, M.D. is nationally and internationally recognized as a leading researcher, educator and trainer in the ongoing battle to end eating disorders. With over 40 years of experience in the field of eating disorder treatment, Dr. Powers was the founding President of the Academy for Eating Disorders (AED), past President of the National Eating Disorders Association (NEDA), a founding member of the Eating Disorders Research Society, is on the Editorial Board of the Eating Disorders Review, and is apublished author on the subject of eating disorders.
Dr. Powers is on the Scientific Board of Directors of the National Eating Disorders Screening Program. As an active board member for NEDA , she recently served as the President in 2005 and was awarded the Life Time achievement award in 2006. She is a member of the American Psychiatric Association Committee preparing Guidelines of the Treatment of Eating Disorders. Dr. Powers was recognized as the Outstanding Clinician in 2000, by the Academy for Eating Disorders. She is the immediate past president for the National Eating Disorders Association.
Fairwinds Treatment Center Intensive Outpatient Program Opens Monday, March 4th 2013
Lead by Dr. Pauline Powers, the Fairwinds Treatment Center intensive outpatient program (IOP) is held 3 nights per week, 2-3 hours per night, for a duration of 6 weeks.
Treatment at this level allows for individuals to continue with work and or schooling, and also continues the healing process.
PLEASE CALL 727-449-0300 FOR ASSESSMENTS
Hours of Operation:
MONDAY, TUESDAY AND THURSDAY EVENINGS
4:30PM-7:30PM
For questions contact Kristin Reagan at kreagan@fairwindstreatment.com or call 727-449-0300.
There are an estimated 20 million women and 10 million men in the United States who are struggling with an eating disorder. Please get involved and help call attention to these diseases. Fairwinds Treatment Center is proud to be a part of National Eating Disorders Awareness Week. Here are some events that will be happening and ways that you can get involved in your area.
Fairwinds is a proud sponsor of the 3rd Annual Tampa Bay NEDA Walk on Saturday, February 16th at 9am. Come on out to Al Lopez Park and join the fight against eating disorders.
Join Tampa Bay iaedp Chapter for a free screening of "SOMEDAY MELISSA: The Story of an eating disorder, loss and hope"
Someday Melissa Trailer from Judith Avrin on Vimeo.
The film will be shown Wednesday, February 27th at 7pm at the Upper Tampa Bay Regional Public Library (11211 Countryway Blvd. Tampa, 33626-2624)
For more information or to become involved, please contact Kristin Reagan, kreagan@fairwindstreatment.com/727-449-0300.
Fairwinds Treatment Center specializes in treating anorexia and bulimia for both adolescent and adult females and males with individualized treatment plans for each patient. Our Eating Disorders program is extremely focused on each specific patient. We use different types of treatment and therapy to help facilitate each patient's recovery process. Each patient follows a treatment schedule and has a specific therapist assigned to their treatment plan and is able to visit with the psychiatrist on a daily basis. For more information please contact our Admissions Department at (727) 449-0300.
An excellent article by Roger Collier on canadian site cmaj.ca overviewing the struggles that men with eating disorders face and why many wait until it is too late before seeking treatment.
Treatment Challenges for Men with Eating Disorders
Men with eating disorders have far more treatment options than a decade ago but their needs still go largely unaddressed in what remains a female-centric realm. That’s cause for concern, warn experts on eating disorders, especially considering the difficulty of getting men into treatment in the first place.
"There is already enormous stigma for having something that is considered a ‘female problem,’" says Tom Wooldridge, assistant professor of psychology at Golden Gate University in San Francisco, California.
Though research over the past decade indicates men account for a quarter of cases of eating disorders such as anorexia nervosa and bulimia — far more than previously believed — treatment is still largely geared toward women. In fact, it even exists at the diagnosis stage. Among the factors identified as possible indicators of an eating disorder, for example, is irregular menstruation.
The traditional format of treatment programs may also be ill suited for men. Therapy often takes place in a group setting, in which women typically outnumber men by a wide margin. It’s no stretch to propose that an 18-year-old male with anorexia would be reluctant to share his fears and insecurities in such an environment. After all, it’s not as though boys are frequently encouraged to reflect upon their emotional well-being.
"Males are taught to repress their feelings to the point where they have difficulty even identifying what they are feeling," says Merryl Bear, director of the National Eating Disorder Information Centre, a nonprofit organization based in Toronto, Ontario. "So much of it has to do with how we manage our emotions and how we solve our problems. If we displace our emotions and problems onto our bodies, we are more likely to be at risk of harmful behaviours."
Discussions in group sessions dominated by women can also veer into territory foreign to men, focusing on subjects such as missed menstrual periods and distorted body images attributed to waif-like models in fashion magazines. The clinicians in charge likely have little experience working with male patients. Some men in treatment have even suggested there was a feminist bent to the group sessions they attended, making them feel more like intruders than confidants.
"It is really common for men to feel very alienated," says Wooldridge, who writes about male eating problems on his blog The Forgotten Gender (www.psychologytoday.com/blog/the-forgotten-gender). "If it involves groups, they are likely to be the only male."
The majority of the physical and psychological problems associated with eating disorders, however, are similar for both genders. So the solution to ineffective engagement of men probably lies in modifying existing programs, rather than coming up with something brand new, suggests Wooldridge. "I’m not convinced we need entirely different treatment models, but we could develop a way of speaking to men that acknowledges the differences — to help in understanding the experience of what it’s like to be a man with this disorder."
Indeed, this appears to be one of the guiding tenets at Rogers Memorial Hospital in Oconomowoc, Wisconsin, which offers an eating disorder program exclusively for men. "You have to facilitate a level of comfort for men. That seems to be an important thing," says Dr. Ted Weltzin, medical director of eating disorder services.
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At Fairwinds Treatment Center, we treat both adolescent and adult male clients to recover from eating disorders such as anorexia, bulimia and compulsive overeating.
For more information on the treatment options for males at Fairwinds Treatment Center, please call 727-449-0300 or email here.
Saturday, February 16, 2026
Join Tampa Bay in the fight against eating disorders! With your help we can make a difference and change lives! Join us for fun and friendship and a beautiful stroll in the park! Don't forget to register your dog!
Event Details
Walk Venue: Al Lopez Park, Shelter 315
Walk Location: 4810 North Himes Avenue, Tampa, FL
Walk Date: Saturday, February 16, 2026
Check In Time: 9AM
Program Start Time: 9:30 AM
Walk Start Time: 10AM
For information or sponsorships contact: Cherie & Bailey Monarch 727-422-3668
Email: fighteatingdisorders@tampabay.rr.com
Follow us on Facebook and spread the word!
And don't forget, you can register your pets!
More questions about the walk? Read Walk FAQ or contact NEDA at 212-575-6200 or credfern@nationaleatingdisorders.org
Fairwinds Treatment Center is a proud sponsor of the Annual NEDA Walk. For more information about Fairwinds Treatment Center and the treatment of eating disorders such as anorexia and bulimia, click here or call 727-449-0300.