Tuesday, 13 April 2010

At Last Some Common Sense (Courtesy of CNN)

Regular readers of my blog will have noted frequently my frustration and despair and the utterly ridiculous, BMI-based diagnosis criteria for eating disorders in this country. Anorexics who have lost half their body weight in less than six months have been casually dismissed, whilst bulimics who are a ‘normal’ weight (whatever this might turn out to actually mean) are frequently told that they do not ‘qualify’ as having an eating disorder (as if it’s some sort of severity competition. “Congratulations! You’re nearly dead!”).

We’ve created a situation where only those prepared to defy everything their warped mental state is compelling them to do and give a candid account of their most secret behaviour, or, of course, those who reach the ‘magic’ weight of 5 stone are being treated.

At an Amazonian 5 ft 11, my lowest ever weight as an anorexic during my teens was just under 8 stone (that was around the point when my lips and finger tips were constantly white/blue even indoors and my eyes were closing of their own accord) and as a bulimic it was 10 stone (around the point that my uni friends started taking me to one side and asking me if I had a life threatening illness). At neither of these points was I deemed to have an unhealthy BMI. The most perfunctory visual assessment would have concluded without doubt that there was something very wrong and yet my eating disorder continued to ravage my body unchecked, until several years later, when I finally began to get proactive about helping myself.

Official statistics show that around 30% of people will make a full recovery from an ED. The figure could and should be a great deal higher and it’s merely a question of catching them earlier, before the sufferer is so utterly embroiled in their issue they have literally lost the will to be live. What defines an eating disorder is mindset and behaviour and the apparent symptoms on the physical body are almost incidental. We know, for example, that one does not have to physically faint in the street from exhaustion, rupture one’s esophagus or cease menstruating in order to do considerable damage to one’s long term health and put oneself under significant psychological strain.

People with EDs tend to have fleeting pockets of time during their illness when they decide they want help. It doesn’t take much for this brief flash of inspiration to be altogether eclipsed by the omnipresent voice of their condition, which tells them their friends, their family, their doctors don’t understand and are just jealous anyway, at which point they’ll shrink back into their self-carved prison, in preparation for yet more weeks, months and years of torture. If we can grab people when they make their first foray into recovery and find a way to assess their condition with a little bit of common sense, we can save a lot of heartache, both for the sufferer and for their families.

I therefore breathed an audible sigh of relief when I read a paper published yesterday by CNN entitled “Anorexia and Bulimia definitions hinder treatment”. At last some common sense is being applied. Below are the edited highlights:

"Some insurance companies will only cover treatment for eating disorders if the patient meets all of the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, a guidebook for diagnosing mental illnesses, doctors say. Patients who don't match all the symptoms, which include severe weight loss, are labeled "eating disorder not otherwise specified" (EDNOS) and sometimes don't qualify for the level of care they need……..

A new study, published in the journal Pediatrics, found more than 60 percent of patients with EDNOS met medical criteria for hospitalization and were, on average, sicker than patients diagnosed with full-blown bulimia.
EDNOS originally came about as a way of classifying people with dangerous eating behaviors and thoughts who didn't fully meet criteria for anorexia or bulimia, said Peebles.

But that means this single category can apply to an obese person who binges but doesn't purge, a severely underweight person who almost meets anorexia criteria but continues to menstruate, and a normal-weight individual who purges but doesn't binge, Keel said. For example, a person who regularly vomits after eating small amounts of food would fall under EDNOS, not bulimia.

"Some patients who are normal weight or even overweight are still very medically scary," Peebles said. "They are probably, I would expect, the highest risk to get missed in the community by either their physicians or their parents."
"We're seeing patients younger and younger, patients as young as 5," Peebles said. "Certainly 7 to 12 years of age, that's not uncommon to see anymore."

What kind of society believes it is in any way acceptable for EDs to be prevalent amongst 7 to 12 year olds? For the past twenty years, we have buried our heads in the sand, blaming the individual’s circumstances for what was deemed to be their private mental condition. Meanwhile as many as 1.2 million people in the UK continue to suffer (and that is, of course, 1.2 million diagnosed under the current, woefully inadequate diagnostic criteria, the actual figure is likely to be as high as twice that many) whilst we comfort ourselves with the notion that they must all have suffered significant trauma at the hands of someone who wasn’t us.

Is it a coincidence that the steep incline in EDs has mirrored the meteorological rise in celebrity worship culture, in the increasing availability of plastic surgery, the constant nagging temptation towards X factor style overnight fame and fortune which means that every young man or woman is now judged almost solely on aesthetics? We all condemn ourselves and others to suffer and we all have the responsibility for change. Take the first step today and go to www.bodygossip.org.

Thursday, 8 April 2010

Spring is Here (and We've Got it Twisted)

Ah, sunshine. I had almost forgotten what it felt like to have it’s soul-lightening warmth beating down on my (immensely grateful and vampirically pale) skin. I’m also, as I type, being terrorized by my first irritating wasp of the season. Yes, folks, it’s that time of year again. The Easter break, during which it is decreed by God Himself that we should spend, as a nation, a minimum of 48 hours sitting on our collective arses eating snacks shaped like baby wildlife (I can’t find the bit in the Bible where it actually says this but I’m sure it must be in there somewhere) is officially over and it’s time to repent our sugary sins.

The multi-billion pound “health” (please note inverted commas have been used for a reason) and fitness industry has two times of year when it uses all its marketing resources to shock and shame us into investing in their products and services. The first is post-Christmas. Every TV screen, billboard and magazine ad has been screaming at us to consume vast quantities of luxury food for months (the build-up now starts in August) and then, suddenly we are expected to snap into a disciplined and unsustainable routine of detox and cardio the moment the clock strikes midnight on December 31st. By January 5th, naturally, that’s all completely forgotten and we’re gorging on cut-price mince pies to compensate for the trauma of returning to our work routines after 2 weeks of lay-ins and watching re-runs of Only Fools and Horses all day.

Then, of course, come March (usually, although this year is not providing much empirical evidence for my musings) the sun makes it’s appearance and the marketing powers that be leap on the opportunity to exacerbate our natural “impending summer/flesh on show” fears. “Get Your Perfect Bikini Body in Six Weeks!” is actually code for “You Only Have Six Weeks until You’ll be Virtually Naked and Judged by Strangers!”

As I remarked to a Christian friend of mine the other day, I’m not sure that this perpetual and ever-momentum-gaining cycle of bingeing and deprivation in recognition of his birth/death is exactly what Jesus had in mind for the entire Western World. She told me to shut my heathen cake-hole, so probably the less said about that the better.

What is, however, abundantly clear (and considerably less controversial) is that we have our priorities twisted. Mark Newey (you’ll know him as Body Gossip's resident expert, I know his as ‘BossMan’) has helped hundreds of clients shed unwanted pounds over the years, by enabling them to stop focusing on what they eat. It might sound insane to say to someone with an overdeveloped fondness for food “now go away and eat whatever you want” but it works.

Diets are doomed to failure – Our minds naturally draw us towards whatever we think about most and we’re rebellious creatures, who tend to think most about the things we’re not allowed. Don’t think of a pink elephant. Don’t eat cheese. It’s all the same principle. Every time you fail to lose weight, or lose it and then become so crazed with starvation you cave in and gorge on cream cakes, having done irreversible damage to your metabolism, and pile it all back on again, this damages your self esteem. Dieting ultimately makes us feel rubbish about ourselves. And when you don’t value yourself, you could look like Angelina Jolie and still be dissatisfied with what you see in the mirror.

The key to long-term health and real beauty (I’m talking head-turning, birds fly into lampposts as persons of the opposite (or same, depending on preference) sex swoon in your path and make declarations of undying devotion beauty) is High Self Esteem. I know I harp on about it, but self-esteem can never be over valued. When we respect every aspect of ourselves, including our bodies, we naturally want to take care of ourselves.

The prevailing attitudes in our culture have created the illusion of an “all our nothing at all” mentality. We’re either glutinous sloths who eat nothing but KFC and drive ten meters to the corner shop or we’re maniacal health nuts who subside only on items purchased from Holland and Barratt and visit the gym on a daily basis. Of course, this doesn’t reflect reality. Contrary to what we might have been led to believe, (Daily Mail readers of a sensitive disposition might want to look away now) it is possible to be fat and healthy, just as it is possible to be fat and beautiful.

If you chose to lose weight, for acceptable reasons (not so that bloke down the Dog and Duck will fancy you, or because you want to emulate some plastic princess from the pages of Heat Magazine), then the simplest, fastest way to do it, is to love yourself just the way you are. Self esteem comes first and then weight loss, if viable and necessary, will naturally follow. Most of us have it entirely the wrong way round. Women everywhere are procrastinating, refraining from partaking in activities they enjoy, going for that promotion or on that date, for the sake of some (usually imagined) physical imperfection. “When I’m skinny/toned/whatever” they think “then I’ll get on with my life”. It would be funny if it wasn’t so tragic.

That’s why I’m so proud to be an in-house journalist for Evolve Magazine, aimed at women size 14 and over. Evolve are hosting a Full Figured Funk workshop on 22nd May in Central London (because “you’re never too chunky to get funky”), self esteem workshops in association with Winning Minds this summer and are currently recruiting a bevy of plus-size beauties for their modeling agency. Email me at Natasha@evolve-magazine.com if you want further info about any of the above and in the meantime remember the Evolve motto: Be proud, be you!