"my personal experiences diminished and trivialized"

Of course, it is unfair to expect people who read this blog to be a fair sample - presumably you read here because you like it - but I'm interested to hear reader thoughts on Rachel's response to my blog post yesterday.

Do you find me insensitive? Diminishing? Trivializing?

And if not, why does it seem that way?

Rachel said...
... I really wish you would be more sensitive in this regard, Laura. I realize and understand your position that anorexia is entirely a brain disease, and I concede that that may be true for many people. However, there are people like me for whom our disorders are, in part, a product of emotional instability and therefore are "not really about food."

It really hurts me as a survivor of anorexia and bulimia turned educator and activist to constantly see my personal experiences diminished and trivialized and that is one of the prime reasons I don't read your blog more.

Eating disorders are all about the black/white thinking. Surely, there should also exist shades of gray in the ways we go about combating eating disorders.

Laura Collins said...

I apologize.

I'm surprised and sad you took my post that way. And I think you may have not understood what I was saying - or I inadequately expressed it - because I don't disagree with what you've said.

My point was to say that people are confused about the BED connection because they (incorrectly)think BED *IS* just about food but (incorrectly) think AN and BN are not. Both are wrong.

As you know I believe eating disorders are a brain disorder - brought about by both biological and environmental factors. If you aren't born with the genes for an ED you are not going to develop one. If you are born with those predisposing traits/genes but don't experience those environmental triggers (dieting, overexercise, illness, extreme stress, hormonal problems...etc.) you may never experience one.

My position is that without addressing the food part, the brain can't recover enough to do the thinking part. But I've never believed or said it was "ONLY about the food."

I don't think my daughter, also a survivor, or other survivors I know, think I diminish or trivialize her illness or anyone else's.

Being a brain disorder doesn't minimize the importance of environment or of the WORK of recovery, to my mind - it actually EMPHASIZES the importance of how society and loved ones respond to the person. (Otherwise I'd just be arguing for lifetime feeding tubes.) That's what all my work is about: changing the environment around the patient - beginning with but not exclusively the medical restoration. Getting rid of the blame and the anger and the shame and the wrong answers to the wrong questions. And if there are problems (and most of us have them) fixing them!

I may lean one way in my emphasis, but I'm not black/white in my understanding or my record on this.

I'm also a foster parent, and used to work at a rape/crisis center - I'm not naive or discounting the incidence or significance of bad parents and bad people. I'm simply a believer in getting people help for THEIR lives and unique circumstances - whatever those are. An eating disorder isn't a sign of bad things in that life - and a horrible life doesn't only deserve help when the person develops a mental illness.

I wonder if my emphasis seems black and white to you because that is YOUR frame on me. Because I know it isn't mine of yours. I don't find your work and mine as mutually exclusive, or in conflict - and I'm not sure why you do.

As for hurt, Rachel. Please keep in mind how much it hurts to have my experience as a parent and those of the vast majority of parents of eating disorder patients be treated in the media and in eating disorder literature and in therapist's offices as automatically worthy of blame, shame, and guilt. And that hurt makes helping our loved ones that much harder. That is why I do the work I do.

I apologize for hurting you. I really do. I respect you, and your work.


  1. I actually found the brain disease model the first one that didn't seem to trivialize my experience, one that could allow me to start looking forwards instead of backwards. Yes, I've had some life experiences that no doubt contributed to the eating disorder. But to know that I didn't choose this for me, not even subconsciously, was enormously relieving.

    It's also giving me a launching pad for the rest of the work I have to do in recovery: dealing with my natural brain chemistry and personality traits that make relapse much more likely.

    No disease is ever JUST biology or JUST environment- it's a mix of both. I found the book "The Agile Gene" by Matt Ridley (he wrote "Genome: An Autobiography of the Human Species in 23 chapters," which is one of my all-time faves) to have really good explanations of this, how environment can turn on genes, and vice versa.

  2. This controversy has caused me a lot of personal anguish. Upon admission to inpatient, the director of the unit said to my daughter (in front of me), "We are going to figure out why you stopped eating." This, combined with my not being allowed to see her for 5 weeks said 2 things very clearly about philosophy to me as a parent. 1) This was a 'choice' on my daughter's part and 2) I was somehow involved in her decision not to eat. The director also said, "We find it easier for young people to talk about the reasons when they don't have to look parents in the eye." This was all said to her AFTER we'd flown over 1,000 miles from home to admit her. If I'd felt confident, I'd have turned around (with ill daughter in tow) and re-boarded that plane. But, I didn't feel I had options left--I didn't know of any--and my daughter had lost 30+ lbs., was severely depressed and self harming, all at age 14. I didn't feel I could keep her safe any longer. And, there was a twinge of guilt, based on my sister's AN experience years prior. My sister was AN/BN for 8 years and blamed a good deal of it on my father (I won't go into detail). I and my younger brother lived in the same house and experienced much the same environment. I won't say we had no reaction, but we did not develop ED's. Of course, I self-critiqued every little aspect of our lives together. Interestingly, our daughter, through most of her hospitalization, maintained that she did not know why she had developed an ED, that she felt 'guilty' that she didn't have a good 'reason' (unlike some of the girls on the unit who had more traumatic stories) and that she had a 'good' family. What did happen is that she became very angry at US for leaving her there. And I also think she absorbed some of the attitudes of about choice, control and family dysfunction. It still impacts our relationship--and it never existed previously. That combined with our having to intrude so much into her young life in order to save it. It just seems so unnecessary. If the hospital had taken a stand that "this is an illness, no one is to blame"--how much healthier that would have been for everyone!

  3. I guess my question, a bit like Laura's, is "How does MY experience not get trivialized either?" I was deeply, deeply effected prior to, during and after this whole experience. Traumatized. Some of it is just the nature of an illness in the family. Some of it was the way it was treated. Perhaps you can't do as much about the former but ride the waves. The latter, surely, can be better handled.

  4. Laura, first I want to emphasize that I do respect you and your activism and I wish more parents of people with eating disorders were as empowered, informed and passionate about spreading awareness as you are. If I didn't think that your blog contributed a much-needed voice to the eating disorders awareness movement, I would not have added it to my Eating Disorders Digest feed.

    I may have misunderstood your quote. It is to my understanding that you believe anorexia to be a brain disease and societal factors entirely irrelevant in the development of an eating disorder. If I am wrong in this understanding, I'm not the only one. My friend Dr. Susan Mendelsohn sent you her book "It's Not About the Weight" to be reviewed. She said she received a rather passionate letter from you accusing her and the book of trying to blame eating disorders on parents and culture. If you read her book, as I have, you would know that such a claim is far from the truth. Mendelsohn explores the ways in which her own family dynamics contributed to her own disorder, yes, but she more so offers solutions for readers on how to better manage such family dynamics than she offers blame.

    My comment was made not just in response to the quote I referenced, but in larger response to things I see consistently see echoed on your site. You seem to have special contempt for treatments that examine underlying reasons for one's eating disorder, especially when the focus is on toxic familial relationships. I see you often reduce this kind of therapy goal as that of simply blaming parents. In my case, I believe my relationship with my mother fueled my eating disorder and I don't believe I would have ever developed one had that relationship not existed. In exploring the underlying reasons for my disorder, I wasn't blaming my mother but rather understanding why she acted as she did and why, in turn, I reacted as I did. In fact, I learned to forgive my mother through such therapy and I find it no coincidence that it wasn't until I did so that I was finally able to recover from my eating disorder.

    I agree that the current focus in most treatments is misguided. Getting a patient back to a healthy weight range should be paramount, but family dynamics or other environmental influences should also be explored. Family dynamics don't cause eating disorders, but they can certainly be a prime motivating force in the development of one. I also agree that concentrating on blame won’t do anyone any good, but ignoring environmental influences when such influences exist is like treating a child for lice and then sending them right back into a school infested with it. Sure, not every family is dysfunctional and eating disorders can happen in even the most supportive and loving of homes, but for most of the girls and women with disorders I speak to -- and I've spoken to lots in the course of my research -- there usually exists some kind of harmful environmental influence that must be overcome or managed before recovery is truly successful.

    You also seem to myopically support the Maudsley approach for eating disorder treatment for all people with eating disorders while discrediting other forms of treatment. Yes, Maudsley has been shown to have great promise with adolescents, but I rarely see you acknowledge that it has been shown to be ineffective in adults with eating disorders (like me). With eating disordered adults, more traditional therapy forms have been shown to have greater success rates than the Maudsley approach.

    My recovery gains were the result of self-analysis and from my own graduate research on eating disorders in general. I saw several therapists who helped me in many ways, and I had the benefit of a wonderful friend who I feel to be instrumental in my recovery and growth as a person. The effort, however, was largely self-motivated and self undertaken. so, how can I not feel hurt after putting so much hard work into my recovery and understanding my disorder only to read things from you that seem to dismiss those hard-fought conclusions?

    I think that there are misunderstandings in what I understand you to believe in and promote and I'm glad to see that there are. I do believe there to be a strong genetic component and I don't find it coincidental that my first real dieting attempt quickly escalated into an eating disorder. But even after my health was restored and I began eating healthily again, I still had to learn to overcome those environmental influences that triggered and fueled my disorder before I could truly recover from it. And regardless of any differences that may still exist between us, I think both of us are working towards the same end-goal of reducing eating disorders and seeing those with eating disorders successfully recover from them.

  5. Rachel,

    I am not as black/white as you paint me. Not myopic about Maudsley, don't undervalue environment's role, not dismissive of the work you and my daughter and all ED patients do to get and stay well. I think we all deserve help and therapy and healing from trespasses against us - whether we have eating disorders or not.

    As for the book you mention, I'll just quote you a bit - it is available online at Amazon "online reader:"

    "The thing about ED is that it touches all of us. I can never counsel a single member of the family without affecting the entire family. What's worse is that if I don't counsel anyone else in that family I am basically sending my patient home to the enemy. It sounds harsh, but oftentimes families are not only the root cause of the ED but at times, the codependent enabler of the ED as well."

    That's not even neutral in terms of how it characterizes parents. And as I told the author, the otherwise helpful things in a book that includes that (and other) statements about families are lost.

    As I said, I don't discount environment. But I don't overvalue it, either. I don't know how often I would have to say that, or that FBT/M doesn't work for everyone - if you read what I write you'd see that - it doesn't seem to be heard by some people. Perhaps, again, this is black/white thinking about ME.

    I'm really just a human being, a mom who loves her kid, trying like everyone else to puzzle this stuff out and help others. Being so misunderstood is tough, but I guess it goes with the territory.

    With mutual respect, in time I hope we will find more common ground.

  6. In fact, Rachel, traditional forms of therapy do not show good results with adults with AN. There's not much that seems effective in adult AN, sadly. You seem to throw around "facts" about results (and resources in your comment to yesterday BED post) that are not based in reality.

    Int J Eat Disord. 2007 May;40(4):310-20. Links
    Anorexia nervosa treatment: a systematic review of randomized controlled trials.

    Bulik CM, Berkman ND, Brownley KA, Sedway JA, Lohr KN.
    Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7160, USA. cbulik@med.unc.edu
    OBJECTIVE: The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), harms associated with treatments, factors associated with treatment efficacy, and differential outcome by sociodemographic characteristics. METHOD: We searched six major databases for studies on the treatment of AN from 1980 to September 2005, in all languages against a priori inclusion/exclusion criteria focusing on eating, psychiatric or psychological, or biomarker outcomes. RESULTS: Thirty-two treatment studies involved only medications, only behavioral interventions, and medication plus behavioral interventions for adults or adolescents. The literature on medication treatments and behavioral treatments for adults with AN is sparse and inconclusive. Cognitive behavioral therapy may reduce relapse risk for adults with AN after weight restoration, although its efficacy in the underweight state remains unknown. Variants of family therapy are efficacious in adolescents, but not in adults. CONCLUSION: Evidence for AN treatment is weak; evidence for treatment-related harms and factors associated with efficacy of treatment are weak; and evidence for differential outcome by sociodemographic factors is nonexistent. Attention to sample size and statistical power, standardization of outcome measures, retention of patients in clinical trials, and developmental differences in treatment appropriateness and outcome is required.

    Further, you consistently portray Maudsley as a refeeding-only intervention. If you've done even a minimal amount of reading on the approach, you must know this is not true. Resuming independence and re-engaging in life, getting back on track with individual goals is a huge part of treatment. Kids who recover using FBT do, in fact, undertake helping themselves (as you describe you did) once they are well enough to do so. I give them a lot of credit for that. It's hard. Managing environmental stressors or societal influences may well be part of that for many kids. Environmental or family factors that perpetuate the illness are most certainly not ignored during Maudsley treatment. (Lots of attention is given to helping parents take a positive stance with their kids and avoiding criticism in early recovery for example.) If there are issues--say mom is subsisting on lettuce while trying to get her daughter to down milkshakes--that absolutely would be addressed in FBT. You are just dead wrong that all environmental issues are ignored. I know you've heard this all before, but continue to present FBT as something it's not. Unlike others, I'm not bothered by this on a personal level, but your consistent misrepresentation (I don't think it can be considered a "misunderstanding" since this has come up before) doesn't impress me.

  7. I do believe family matters/relationships need to be dealt with, but as something important in its own right, and not necessarily as a cause of an eating disorder. I think a lot of traditional psychotherapy is very past-oriented, while the therapy I've had the best results with is present- and future-oriented.

    My mom and I have benefited greatly from more traditional family therapy (as opposed to the FBT) to help negotiate a parent/adult child relationship, as opposed to a parent/sick child relationship or a plain old parent/child relationship. There were things my parents did that weren't helpful when I was younger, and they hurt. Addressing them was crucial- but it wasn't a cause of my eating disorder.

    The genetic/environment issue I can summarize like this: genes are a necessary but not sufficient component of an ED. *Something* in the environment had to turn the genes on. But I'm with Laura on this: the importance of the environment is often over-emphasized, perhaps because arising out of the psychotherapeutic tradition, and perhaps because of its tangibility.

  8. Dear laura,
    I think you make it very clear that m/m approach is about restoring nutritional homeostasis as soon as possible so that the sufferer can then move on to step 2That is to recieve proper therapies such as psychological intervention and perhaps chemical intervention. Yes you do have strong opinions but I think it is because of your conviction and follow through attitude that you were able to successfully help your daughter.I guess the proof is in the pudding! There is no time for blame ! For what ever reason our children are afflicted with this horrible disease the goal is to get them better! Yes everybody is different but no one can convince me that anorexia is not biological .There are just too many similarities in these kids for this to be a coincidence .Why do 70 percent of these kids have some previous history of anxiety disorders 50-60% with previous ocd etc.. sending back support to you for all the support you give!!

  9. Never having been subjected to blame and a "traditional approach" until well into my daughter's illness and then from someone so off the wall and obviously dangerous that I could safely ignore him at least once I had rescued my daughter from his "care", sometimes I do find Laura's clarion call to avoid blame a bit surprising. I didn't know I was being blamed until more recently - now I tend to over analyse what professionals say to me in case they are subtly trying to blame me and I never noticed before!

    However Laura is not alone. Many modern thinkers on AN are coming to the conclusion that approaches built too much on analysing the past and researching relationships before addressing the biological factors underpinning the behaviours can be harmful, not because perhaps there is benefit to be had, as Carrie has so eloquently explained, from looking at relationships, but because looking around for environmental triggers that may be long past by now even if they were important at the time (bullying a school for instance, which while cruel and despicable is somewhat difficult to address 10 or so years after the sufferer graduated) while the patient suffers the physical consequences of starvation or the emotional consequences of low self-esteem now, is a waste of valuable time.

    Professionals like Janet Treasure, Ivan Eisler, Thomas Insel, Nancy Zucker, Bryan Lask, Walter Kaye, Daniel LeGrange are all making a similar point. They are in NO WAY trivialising the suffering of the people they are genuinely giving their professional lives to help and neither is Laura.

  10. Rachel,

    I'm a dad with experience in these questions. My daughter is in remission from Anorexia. Here is what I believe....

    The approach to and understanding of ED's that you represent is the institutional one. It's represented by the vast majority of therapists and nearly all of the treatment centers. It's ubiquitous in the lay literature and it's what one hears should one tune in to Oprah or Dr. Phil or Tyra's show.

    Then there is a completely different world of understanding and this is the world represented primarily by university researchers and scientists such as Walter Kaye, Daniel LaGrange, Cynthia Bulik et. al. In this world, relatively new, all the evidence about ED's points to genetic/biological causes. As far as I know, no one in this world takes seriously the notion that ED's are "caused" by toxic families. The reason they don't take it seriously isn't because of ideology, it's because there's simply no evidence for it. None.

    I applaud you and Laura for arguing about this because without the argument taking place, there will be no change. I think of Thomas Kuhn's book, The Structure of Scientific Revolutions, as illustrative in this regard. One of the central points is that every major scientific "discovery" involved the discrediting of the previous set of beliefs.

    We are going through just such a shift in paradigms right now. Freudian beliefs about childhood trauma are being upended by what we've learned from MRI's and genetic sequencing.

    I don't believe we have middle ground here. One of you is right and the other is wrong. Laura believes genetics is at the root of the illness and you don't. You believe that families "can" cause an ED and Laura does not. Good. Argue about it. Present evidence. Get other people involved and let's decide this thing.


  11. My own two cents:

    I am with Carrie on this one, in terms of the nature/nurture debate.

    Most mental illnesses are currently understood as resulting from a COMBINATION of environmental (i.e. familial, school, society) and genetic factors. After the sequencing of the human genome in 2003, we now have the opportunity to understand much more about genetic factors than ever before -- but, as Cynthia Bulik points out, understanding that which can be attributed to genetics allows us to learn more about environmental factors as well. If, as she believes, EDs are 50%-80% attributable to genetic factors, that STILL leaves 20%-50% that are caused by environmental factors or some interaction between genes and the environment.

    More and more, researchers are examining the synergistic relationships between multiple factors; instead of saying "Gene X caused Disorder Y," it might be "Genes V, W, and X create a predisposition towards anxious behaviors, which when combined with an unsupportive environment, may lead to Disorders Y or Z."

    As for scientific revolutions -- genetics have supplemented, not replaced, environmentalist research into mental illness. The more we learn about the genetics, the clearer it is that there are strong environmental factors, as well, that predict onset of particular illnesses.

    This is a great discussion! Thanks to everyone who is weighing in.

    ~Ai Lu

  12. Treading on unchartered territory, I think that it is difficult for such different approaches (social/ psychopathological) to come to any agreement on common ground as both positions have different starting points, assumptions and investments. This by no means disregards the good willed intentions that underpin both approaches. However progress is not going to occur when two equally important research strands are contested. Call me a fence sitter but they both operate within different schools of epistemology.

    Lets face it, eating disorders are complex and sensitive issues. And because of this I think that both approaches have something to offer. The social and environmental approach is not about blaming the parents at all, in fact quite the contrary. There is a complex cocktail of variables in ones environment that can lead to an ED, and often these contributing factors can be quite subtle. The increasing diagnosis of young people with an ED is evidence that the social environment plays a huge role.

    Research in this area could make parents aware of some of the contributing factors that may lead to an ED. This is an important insight because as a parent one can not deny that 'education' and being informed is a good thing.

  13. I'm tired that a midddle ground isn't always found. I actually think it is there if only we look. Rachel, knowing what I now know about biology and genetic predisposition I have even more respect for what you have achieved - not less. My d had 5 years of traditional it's your father type of counselling and her health went from bad to worse. Only when both my adult children started eating was recovery possible. But do I believe that family circumstances were the trigger for my two children - absolutely and no mistake. However, many many of my friends parenting styles are far more critical, demanding, fashion orientated etc etc all those things we look for, but their children did not development an ED. The difference is my children's anxieties, mood, perfectionism made the combination a risky one for them. This is where the predisposition comes in. I do know that counselling was ineffective whilst severly malnourished - goodness much of their day to day discussion was illogical let alone analysing their circumstances.
    If you look carefully at Maudsley - and I didn't do this formally - you will see that whilst refeeding parents are re- evaluating their approach and values and work to model a healthier approach to life. Husbands and wives review the way they work together. All these contribute to recovery.

    I am proud of my children for being weight restored - and they continue to learn about their mental health and wellbeing. I have a HUGE admiration for EVERYONE who has turned around an eating disorder a terrible illness indeed. Surely our goal is not to find one set approach but to take the elements from all approaches being flexible with what works for an individual. What about a world that can use a mandometer computer as a tool to aid early eating, Maudsley knowledge on approaches to encouraging eating and counsellors who can help individuals and families deal with their anxieties and triggers.

    Why is this an either or discussion.

  14. Wow... I'm just marveling at the brilliance and diverse, as well as similar opinions. Wonderful!

    It's a pity I've come so late and basically am only digesting this thread right now...

    Laura and Rachel you BOTH are doing tireless and positive work, educating the broader public as well as increasing awareness; right now I'll just chime in with my gratitude and appreciation for such courageous individuals such as the both of you.

    -shanti *t

  15. I am the mother of a 23 year old who has been battling anorexia for over ten years. She has had five inpatient stays at recognized ED facilities and gone through many hundreds of hours of therapy as an outpatient.

    When she was released this summer from her most recent inpatient stay, still unhealthy, my husband and I came to the realization that if she continued with traditional treatment protocols, she might not survive. Against the advice of her therapists, we began re-nourishment at home. We were initially skeptical about the efficacy of such an approach, but felt that we had run out of other options.

    After a few months, my daughter is healthier now than she has been since her eating disorder began. We are convinced that the changes in her behavior and thinking are the result of her re-nourished brain and are amazed as her improvement continues. NO therapy has worked as well.

    I understand that there are no studies indicating that family based therapy works for adults. It must be remembered, however, that there are few adult eating disordered patients still living with their families. They are likely to have moved through a system that intentionally distanced them from families assumed to be dysfunctional or damaging (as some, no doubt, were). Even healthy families of adult patients are unlikely to have the “currency” required to insist on full nutrition. That doesn’t mean it doesn’t work.

    More on dysfunctional families: they can be found in any population. It seems to me that the stress of such dysfunction to a child who is genetically predisposed to an eating disorder could certainly be enough to tip the scales – literally! Just as over-exercise or dieting might. All could result in weight loss, inadequate nutrition and starved brains.

    I have been busy re-feeding my daughter and have not taken the time to communicate my appreciation, but Laura, your words of wisdom have been of immeasurable value during our efforts and I most humbly offer my thanks. I don’t find you insensitive, diminishing or trivializing. You saved my daughter’s life.

  16. Just thought I'd say that this is very interesting 'debate' that is going on. And despite the differences each 'side' exhibits, I am ecstatic to see people who are so passionate about the recovery of those with eating disorders speaking up and letting their voices be heard.
    I am also an advocate for eating disorder recovery and even did once struggle with an eating disorder myself. Personally, I must say that although my family is what some would call 'dysfunctional', they were NOT the "cause" of my eating disorder in any way, shape or form. I had perfectionistic tendencies, anxiety, and trouble with self esteem, confidence and weight from a young age. I also have a history of mental illnesses and addiction in my family. And as mentioned above there were some ongoing things that needed to be worked through with my immediate family- most of these issues actually rose in intensity with the increase of severity of my eating disorder, which has always had me question which really came first. the chicken or the egg sort of thing. Regardless, weight restoration was critical to my recovery alsong with therapy, working through family isssues, setting boundaries and medication. so all in all, i have to say there was indeed some biological factors that contributed greatly to my development of anorexia, dieting was my coping mechanism for dealing with life issues and in order to recover I had to first of all EAT and secondly learn new, healthy coping mechanisms for anxiety and stress and then also set boundaries with my family etc. I did however need my parents to hold me accountable for eating for quite some time and often have supervision while I ate. So i guess what I'm saying ( does it even make sense?) is that I've been treated and have recovered through a combination of maudsley and traditional techniques, and from what I know, all people are different, and all people who are afflicted withe eating disorders recover in their own way, So what works for one may not work for another, but all in all, there is definitely a large genetic component to these disorders; NO one is to "blame" for the illness; and sufferers cannot do recovery on their own, they need support. and it makes sense that for many children/adolescents that support comes first and foremost from their parents whom they can trust and depend on and as for adults it may often be more through doctors, nutritionists, and support groups. All i know is that recovery is possible for everyone, and that the path isn't so important as long as you get where you're going.

  17. Rachel -- I feel it's a mistake to criticize Laura personally for her blog posts and to imply that what she writes is somehow nothing but her personal opinion. You seem to disagree with two of her views in particular: that eating disorders are a biological disorder of the brain, and that parents and families don't cause eating disorders. These conclusions, however, far from being uniquely held by Laura, represent the new consensus among most experts. For the first, please see a letter from the Director of the National Institute of Mental Health, Dr. Thomas Insel, to the CEO of the National Eating Disorders Association (NEDA), in which Dr. Insel wrote: "Research tells us that anorexia nervosa is a brain disease with severe metabolic effects on the entire body. While the symptoms are behavioral, this illness has a biological core, with genetic components, changes in brain activity, and neural pathways currently under study."
    http://www.myneda.org/nedaDir/files/documents/NimHLetter.pdf For the second, please see a public statement in which NEDA said in no uncertain terms that "families do not cause anorexia." http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=918
    The conclusions of the NIMH and NEDA should not to be dismissed lightly as insensitive, diminishing, or trivializing. The NIMH is the leading agency of the US government dedicated to the scientific study of mental disorders. The NEDA Clinical Scientific Advisory Council consists of more than twenty leading scientists and clinicians, most of whom have spent their entire professional careers studying eating disorders. www.nationaleatingdisorders.org click on Leadership
    On your blog, you say that you are a "proud" member of NEDA. Consequently, I'm confused why you are so critical of Laura for expressing opinions that are so much in harmony with NEDA's in these respects.


Post a Comment

Popular Posts