Be alert for Eating Disorders this Thanksgiving

[unc70]

As we near Thanksgiving, a holiday focused on families getting together to overeat, come the
predictable TV news reports from packed airports and along crowded highways and various advice
on how to lose those extra pounds you gained or how to avoid gaining them.

This focus on families and food is a good time to remind ourselves that someone at our table
might be gravely ill with an eating disorder while hiding it from everyone else. We mostly hear
about these diseases with the tragic death of another victim, for example an anorexic fashion
model. But these diseases are widespread, afflicting many who are far from the stereotypes, and
EDs have serious complications and can be fatal.

As you join your family and friends, be alert for signs that something isn't right. Maybe someone
gets very small servings or just moves food around on their plates without eating much. Maybe
they have lots of new food rules or have become a vegetarian. Maybe they have become obsessed
with exercise or with sports. Or maybe you notice someone throwing up (purging) or taking laxatives.

Edited to add that obviously none these are enough for a diagnosis, but several of these or other
signs at the link might be reason for concern, but not for confrontation. The linked site has
suggestions for what you should do if you are concerned about someone.

If you or someone you care about has an eating disorder, get help immediately by learning the
real nature of this disease and what treatments actually work. Most everything you read in the
popular press or even in a lot of the medical sites are based on myths and misinformation that
can kill you.

I recommend you start by going to the site for The Eating Disorders Program at the University of
North Carolina Chapel Hill for information on the latest research and most effective, out-come
based treatment programs. Its director, Dr. Cynthia Bulik, who has the only endowed university
professorship in Eating Disorders in the US, leads this multi-discipline treatment center.

http://www.UNCEatingDisorders.org

Get help now. Be skeptical of easy answers, doing it by yourself, using just some internet site,
or checking yourself into some spa-like facility promising results or one modeled on drug or
alcohol treatment. But you can beat this disease, with the help of those who truly understand
what you are going through.

[tridim]

1. Good advice, but I don't eat much at thanksgiving or Xmas..

simply because my Mom is a terrible cook. Sorry Mom.

I try my damnedest to work my way into the kitchen every year, but she kicks me out because of my crazy culinary ideas like USING SEASONING. :)

[LeftyMom]

2. Usually if somebody says they've become a vegetarian, it's because they've become a vegetarian.

I'm sure whoever wrote up that PSA means well, but it's shitty enough dealing with being vegan on Turkey Carcass Day without having some well-meaning aunt get it in their head that I've got an eating disorder because some anonymous person on the internets posted something that scared them.

[LisaM]

3. I agree with you, unless the person is just eating two carrot sticks

and claiming it's because of vegetarianism. I think that just wasn't expressed very well.

[LeftyMom]

7. In my family, that might mean there's nothing else to eat.

As I've posted before, at my mother's on Thanksgiving there's nothing to eat except the veggie tray (if she puts one out) and maybe some chips scrounged out of the cupboard.

You really can't come to any conclusions about somebody's eating habits based on a single meal or day, especially one where they may be stressed by travel or family.

[unc70]

4. But also true of other indicators like exercise

I am sensitive to your situation as a vegan at Thanksgiving and not wanting a misdiagnosis by your aunt. But that does not mean it should be ignored as a possible indicator, particularly when accompanied by other signs.

The person with ED (now recovered) who was the catalyst that lead to the creation of the UNC program was and is a vegetarian.

[Garbo 2004]

10. What's the ratio of vegetarians with ED vs non-vegans with ED? Are people with ED

more likely to be vegetarians or claim they're vegetarians? As a cover for their eating habits?

I just don't see whether or not a person is a vegetarian in itself is an indicator of an eating disorder. (Unless the underlying premise is that being a vegetarian is deviant and therefore suspect.)

I can see other indicators as far more relevant regardless if the person is or is not a vegetarian.

[jesus_of_suburbia]

18. Sorry, this is a serious subject, BUT>>>>>>

I always think of ED as being Erectile Disfunction.


Never heard of it as Eating Disorder.


By the way, I have had body image issues in the past (I'm a gay male).

[MazeRat7]

6. Sounds like you and Ms MZr7 could swap rants and stories.....

See my post below... it should be an interesting holiday....


MZr7

[Clark2008]

12. Try being pregnant.

I know the conventional wisdom is that pregnant women eat more - not I. I'm small and, at 11 weeks, I've already got a sizable little tummy, which means NO ROOM FOR A LOT OF FOOD. And, if I eat too much, well, up it comes - because, again, there is no room.

I'm not nauseated in the least - I just have no room in my tiny body for all this baby, placenta and womb and tons o' food.

[Gormy Cuss]

14. Vegetarianism claims by ED sufferers DO happen.

I worked with a ED afflicted woman who eventually had to be hospitalized because she had been eating one meal a day -- a small salad with diet dressing at lunch. She told everyone that she was on a vegetarian diet.

[Missy Vixen]

16. You know, I've seen this several times now, I have to comment

>shitty enough dealing with being vegan on Turkey Carcass Day<

In other words, unless everyone attending the event decides to follow your eating plan, you will make derogatory comments about their preferences and generally make them uncomfortable? If you expect others to be accepting and supportive of your choices, maybe it starts with being accepting and supportive of theirs. Before warming up your keyboard, you may want to reflect on the following: We've been at more than one social event with what I would consider a militant vegetarian/vegan who did charming things such as obvious and loud gagging when a dish with cheese was served to another person sitting at the table at a Mexican restaurant, dealt with our sister-in-law's various food demands, etcetera.

Any host will go out of their way to do their best to make those attending feel comfortable, at home, and serve something they may enjoy eating. There is a point, however, at which the guest needs to be responsible for themselves and their own preferences. If the vast majority at someone else's table are eating meat and you can't abide the sight or smell, either don't go, or bring your own food. If I was visiting a vegan household, I would politely eat what was served to me. If I didn't like it, I'm free to either bring something else, or eat later. I'd like to think I would be so happy about being invited in the first place I'd want to be a friendly and polite guest.

I don't go to bars because I have a hard time breathing around a large amount of cigarette smoke. If I choose to be there, it's my own damn fault, and up to me to adjust. It's the same thing on holidays. We're not always going to get things exactly the way we think they should be. If it's that objectionable, make other arrangements.

Julie

[LeftyMom]

21. No, actually, that's not what I mean.

What I mean is this: To me Thanksgiving means being invited to family gatherings where there's absolutely nothing to eat unless I bring it and having to deal with questions or debate about how I choose to eat and to feed my child. Thanksgiving is both a food and family centered holiday. The family takes it personally when I don't go, but the nature of a gathering centered on the consumption of animal flesh leaves me unable to feel part of the gathering when I do, as does my mother's resistance to adapting even easily veganized side dishes so I don't have to reinvent the wheel and bring every singe dish for myself. If you want more details, I've posted stories of past Thanksgiving dinners with family as well as this year's current invitation and why I opted to decline.

For the record, I actually do have some manners and don't appreciate your assumption that I don't. While cheese smells like vomit and that ravaged turkey carcass was tortured and murdered before his flesh was desecrated, I actually know better than to say so at dinner. This does not stop people from asking me snotty, annoying or attacking questions, sometimes so rapidly that I can't manage to get a bite of food in my mouth before my plate grows cold.

[Missy Vixen]

26. I read your response and waited overnight before responding

I've read several posts now on the subject over several days. It's just not a post unless there's reference to the "rotting turkey carcass", etcetera. I've read the details of the previous dinners.

Again, my point: I have met very few vegans who offer the same respect to others' eating preferences as they expect for their own. This is more of the same.

>While cheese smells like vomit and that ravaged turkey carcass was tortured and murdered before his flesh was desecrated<

This proves my point, yet again.

Julie

[TroglodyteScholar]

22. Unfortunately...

...sometimes going vegetarian CAN be a sign. I wish it wasn't the case, as being vegetarian is hard enough already. I have a loved one who went vegetarian...and did pretty well with it for several months. But it ended up being the first step towards a full-fledged eating disorder. The person I'm talking about did not even know she had a disorder, because she was not consciously preoccupied with weight or body image. Even after realizing she had a disorder, she had trouble accepting it because she had so much difficulty finding information about cases like hers.

It's not always like that, of course, but it would be a grave mistake to completely write it off.

[MazeRat7]

5. Maybe they "became" vegetarian because they didn't like eating dead animals....

Just a thought...

And BTW... Everyone coming to our house this Thanksgiving will be eating food free from dead animal parts... not their choice... ours. :)
Or they could not eat... in which case...

Maybe "we" should be on the lookout for guests that don't eat much because they only like food with dead animals in it....


MZr7

[unc70]

8. Good luck in Texas

I know you are in Austin, barely in TX. While I live in Chapel Hill, I have many ties to Austin. So does the young women I mentioned; her mother and brother have MBAs from UT-Austin.

Texas makes it tough to be vegan or vegetarian, particularly outside Austin. The same for NC outside Chapel Hill.

I editted the OP to try to clarify and to caution everyone not to confront anyone, but rather to consult the experts on what you should do.

[MazeRat7]

9. Well ok. BTW Welcome to our little corner of the world since we've not met. (n/t)

[Sal Minella]

11. Dietary necrophagia......gack.......

[The Straight Story]

13. Thank you and a kick for you! (nt)

[NC_Nurse]

15. Hey unc70!

I work at UNC and have had several patients from the EDU come to me for procedures/tests. Welcome to DU and thanks for the
post.
Eating disorders are really tricky and people with them come up with all sorts of stories to cover them up - including vegetarianism
or veganism...and a whole lot of others. Any excuse to not eat. I've had patients who had to be watched constantly because they would vomit
any time they were left alone.
It's really sad how thin they are and how they can't stop the compulsion. I'm glad there's a place to help them.

[unc70]

25. They will do almost anything to avoid detection or treatment.

It is nearly impossible to believe all the things an anorexic might do to conceal, justify, and prolong their behavior.

The documentary film "Thin" (currently showing on HBO) gives one a harsh intro to this behavior and the difficulties in getting effective treatment: few centers with effective, comprehensive treatment; limited coverage by insurance companies for this treatment; insufficient educatiion and awareness by providers, educators, coachs, and the general public. EDs are a huge problem, with few resources available for research, treatment, and prevention.

In many ways, the current status with EDs reminds me of autism about 30 years ago, when UNC under Eric Schopler led the efforts to understand and treat autism as a medical problem rather than blaming the patient or parents for their moral failings or bad parenting skills. At the ribbon cuting and dedication of the new ED center, I was proud that the persistent efforts of people close to me could provide hope and help to so many others, and that UNC was again assuming a leading position.

I hope that everyone suffering from this disease finds the help they need to recover and flourish, free of lasting side effects.

[pitohui]

17. this is a good point

but i would also note that if you observe this on turkey day that you meditate on it for a day or two, rather than directly discussing the matter over the big dinner table with the whole family present

as you say, CONCERN not CONFRONTATION

i'm already noticing that i'm for some reason not eating lately, a big scene at the dinner table won't help, quiet support in a private moment is another matter

[grasswire]

19. we discovered an eating "disorder" in our family

A pre-teen who was "addicted" to sugar and sweet things and white things. She was sick a lot, with mood swings and low energy. I noticed that her diet was insufficient, and started reading up on sugar "addiction."

I learned about sugar sensitivity and now know that sugar is like poison to her. This sugar sensitivity occurs in people who do not have sufficient endorphins. Endorphins come from few sources: alcohol, sex, exercise, and sugar. People with endorphin insufficiency crave sugar, which then produces blood sugar swings and poor nutrition.

We have eliminated about 90 percent of the sugar from her diet (she sneaks things when away from home), and we have moved to the recommended diet: move from white to brown food, eliminate sugars, and eat a complex carbohydrate at bedtime.

For the first year, she did not have pneumonia last winter. She is much healthier.

So..........watch for people who only eat white starches and sugary things. Sugar sensitivity may be the hidden ailment.

[TroglodyteScholar]

20. Thank you...

...for your important post. I never thought to look for the signs in my closest of loved ones, and was blindsided well after many other people were noticing the problem. When you live with someone and see them every day, you might miss changes in them that seem obvious and drastic to others. I still get angry with myself when I think back on it -- how could I fail this person so deeply?

Knowing what to do once the problem is in the open...that's an entire battle in itself. When an eating disorder touches your life, it never ever goes away. It is a constant consideration. The sufferer who has acknowledged the problem faces a struggle that can border on multiple personalities. The best thing I think you can do for someone is just listen to them and TRY to understand, even if you know you never will.

Sorry if my post in incoherent, but it's a very emotional topic. I guess I should just say "thank you" again and leave it at that.

[Nikia]

24. I understand where you are coming from as a person recovering from an eating disorder

Everything you say is true.
I hope for continued recovery for your loved one and I wish for better things for both (or all) of you.

[Solon]

23. I'm always the one who eats the least at the dinner table on Thanksgiving and Christmas...

Usually my Thanksgiving dinner consists of 2 slabs of Turkey breast, and some sweet rolls and mashed potatoes. I used to eat corn in addition to that, but haven't been able to digest it in years. The funny thing is that I'm anything but anorexic, in fact I'm quite, uhm...big boned, yeah, big boned. :)

I like simple diets, mostly, I don't like casseroles in general, never have, and there are a LOT of other foods I don't like either. As another example, Subs, I like Chicken Breast with Bacon, Lettuce, Tomato, and Mayo, THAT'S IT.