Unintentional status quo

My friend, Colleen, shared a great story with me recently by email:
“Why do professionals ignore clear evidence and cling to old ideas that weren't that effective? Because they are people and people resist change, even in the face of clear evidence to the contrary--and especially when they have invested their life's work in doing things this way.

There are parallels to what we are doing in other areas. Our pastor (Paul Freese) opened a recent sermon with a question: "What causes ulcers?" Congregation: "Stress!" Pastor: "And how do you cure ulcers?" Congregation: "Reduce stress!" "Reduce stomach acid!"

He continued: "It's been 27 years--a generation--since two Australian doctors accidentally discovered that it's actually caused by bacteria," and went on to tell the story of Drs. Barry Marshall and Robin Warren, who first isolated H. pylori (great article). For two years, no one took them seriously. In frustration, Dr. Marshall swallowed a petri dish of H. pylori, got sick, took antibiotics, got well. Finally they got published. These drs had a whole new paradigm for ulcer etiology and treatment--and faced a lot of resistance. Even with proof, no one wanted to change. And this is such a clear-cut, replicable scientific phenomenon!!

While the pharmaceutical industry resisted hugely at first (who doesn't love a lifetime prescription for one of their little moneymakers like Tagamet or Zantac?), they also held the key to the cure. And they have armies of drug reps that talk to all the drs, everywhere. Having a profit motive makes it much easier to change the status quo.

Unfortunately for EDs, we don't have a magic pill. Don't have armies of drug reps fanning out, spreading the word, leaving samples, advertising about their great product, posting warning signs.

The point: A generation! 27 years! And the common wisdom has still not caught up with proven science. At least drs are more clued in about prescribing antibiotics--people are being treated.

I don't mean for this to be discouraging. Just to underline human nature. I think the professionals who cling to Old School ideas are well-meaning, caring people, and to ask them to reconsider ED etiology and their treatment model means also asking them to live with the idea that they have actually done evil--that they have harmed their clients and their clients' families. That would be hard to live with, even if it were unintentional.

We need to focus on educating existing professionals, for sure, but I think we especially need to focus on YOUNG professionals--we need to make sure that the doctors and therapists who are being educated now are getting the right information. What can we do to get this information into the hands of the professionals who are educating the professionals?

Way more than two cents...sorry.”


  1. Its hard to say. Id like to think continuing to expose the world to the reality of ED is a good thing because anorexia has been so hidden in secrecy. I think that if every one was talking about it, and worrying about the mis diagnosis,the high rate of death and suicide due to poor or invalid practices then perhaps more people in the world would demand change of the health industry. First the truth needs to be revealed...statistics, facts, then those who will inevitably be inspired by the reality of how poorly eating disorders are handled in many cases, and how many people with ED are given up on purely because so little is understood about ED that doctors and specialists simply in many cases are not equipped or able to handle or help someone with an ED in fact alot of specialists and practitioners end up triggering ED further simply because they do not understand the disorder, let alone how to help effectively treat it.

    This is not to say there aren't many effective doctors and specialist out there helping those with ED however I do feel that the rate of recovery is ridiculously low, and the rate of death and suicide for girls who give up, or die is ridiculously high...and wonder if it isn't so high because the medical world simply doesn't know what to do (sometimes more importantly what NOT to do)...in all actuality.

  2. We also need to keep getting good information quickly into the hands of families with sick children--especially those just starting this journey so they don't waste time, they search out good treatment from the get-go and they know what to avoid.

  3. I think the best way to educate the next generation of professionals would be to ensure that accurate, up-to-date scientific information is taught in graduate schools. The best way to do this might be to lobby the governing bodies of various disciplines.

    As a psychologist, I can only speak for my field. The APA (American Psychological Association) evaluates and accredits doctoral programs in clincal and counseling psychology. Schools need to meet certain standards, teach certain courses, and provide certain training experiences in order to gain and maintain accreditation. If the EDC or FEAST could persuade the APA to require that up-to-date scientific information on EDs be taught to all psychology grad students, this would ensure that the next generation of clinicians goes into practice armed with accurate knowledge. A side benefit would be that the professors would have to learn this information in order to teach it, and many clinical and counseling psychology professors are also practitioners themselvs.

    Information about evidence-based treatments for EDs (especially AN) is sorely lacking even in well-regarded training programs. For example, my graduate program was accredited and well-regarded, heavily emphasized research as well as practice, and taught evidence-based treatment (CBT) for mood and anxiety disorders. However, the faculty member in my department who was considered the eating disorder expert at the university (he taught CBT courses, supervised therapists in training, and had a private practice on the side) new nothing about the Maudsley approach. I educated him about it. I remember doing a presentation on Maudsley in his class, maybe in 2005 or 2006. I specifically remember his response to my paper: "This sounds really controversial." This was a very good professor and a good therapist as well. It would have been great if HE had taught ME and my classmates about Maudsley rather than the other way around. It also would have been great if he could have mentored grad student research on Maudsley.


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