faulker053

1) Recovery is about weight gain. Period. The simple answer?  It just might not be going the way you planned.  False.  Now don't let your eating disorder get all excited, saying "See! I told you so!" Weight restoration is surely a must for those who have fallen from their usual weight or in the case of kids, their weight for age and BMI curves. That is, their expected pattern of gain based on their age and their weight history. For kids, falling off their usual growth curve suggests a problem. It shouldn't be praised or rewarded, but evaluated. (Pediatricians, did you read that?!) But if someone's weight was high due to unhealthy behaviors such as binging, emotional overeating, or general disregard for satiety, and weight dropped with improved eating and coping, weight gain is likely unnecessary. Simply reaching a healthy range based on the charts also isn't enough. Perhaps your restrictive eating and suppressed weight began as a young teen, and you've liv...

I want your input. I need to hear your voices. For EDAW 2015, I have volunteered to present to two medical residency programs—one in Boston, MA and one in Providence, RI on what doctors need to know about eating disorders.  I've incorporated recommendations from twitter responders and from Aspire , but I welcome more input. Here's what I have to share with new doctors so far: Avoid the ‘Don’t ask, don’t tell’ approach .   Patients rarely volunteer behaviors they feel ashamed of—bingeing, purging, diet pill and laxative abuse.   So providers need to ask. Nicely. Casually. Non-judgmentally. Include basic ED screening questions at routine visits. Early action is not just for college admissions . Eating disorders are best identified early and treated promptly. We wouldn’t simply wait it out to see if blood sugars simply turn around in a patient with type 1 diabetes. Take eating disorders as seriously as you would cancer, or The time is now for improving medical management of...

Since I’ve last posted, I’ve had a troubling, food related conflict. Can I dump on you, dear readers? Can I model what I suggest you should do—to express yourselves and reach out for support? Colleague conflict I love good chocolate. So it follows that at holiday time I’d want to share the joy as holiday gifts to some providers that refer to my practice. (Remember, this dietitian has a cupcake as the mainpage image on her website. What harm in that, I thought? Yet in sharing my intentions with a nutritionist colleague, I heard a very different perspective. Namely, that many office employees are trying to lose weight—so chocolates are the last thing they need. Those who are obese hardly need the box of chocolate sitting around the office. And since many are so anti-sugar these days, giving chocolates is simply a bad idea. Once I moved from my totally speechless state (a rarity with me), I tried to be open-minded. Is it diet sabotage to give a box of chocolates to be eaten in an office ...

Rapid weight loss is incompatible with mental and physical health. Period. I beg to differ with Daily Beast columnist Tricia Romano , who believes Rachel Frederickson’s extreme weight loss on the Biggest Loser is none of our business. And I disagree that her weight is just a tad lower than a healthy BMI. And Rachel’s BL trainer Bob Harper is simply wrong when he assumes that “…when contestants leave home ... they are in charge of themselves.”  Admittedly, I’ve never watched more than a few minutes of TBL—I found it intolerable. Yet the show is unfortunately quite popular. Many of my plus size patients report being inspired, identifying with the desperate contestants, tolerant of the verbal abuse and crazy diet and activity demands. They're smitten by the fairy tale that rapid weight loss through extreme measures works. And that extreme weight loss equals extreme happiness. Let me inform you otherwise; I yearn to protect you from the damage, both visible and hidden, from this diet ...

I’ve done it. In just a few sessions I made my mark on a future generation of nutrition providers—an intern interested in eating disorder treatment, no less. She was, like most, biased by the sensationalized images and the media’s descriptions of emaciated anorexics; of teenage girls who ‘just wanted to be thin’; and of visibly unhealthy looking bulimics. Those were people with eating disorders, she believed. Yet in the few days she has spent with me, she’s seen anorexic men, normal weight binge eaters, and women in their 40s, 50s and 60s struggling with eating disorders. Some developed their disorder recently, some only recently presented for treatment, having struggled with their relationship with food for decades. All are pained by their condition—no one chose to live with a disorder. Really, there are places they’d much rather be than in a medical office on a nice summer day. Yet what they all have in common is that their appearance is not a give away. Most look just fine, I must ...