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Stanford program takes aim at eating disorders
Original post made
on Jun 24, 2011
Eating disorders are serious mental illnesses involving abnormal, unhealthy eating behaviors, including anorexia nervosa (self-starvation), bulimia nervosa (binging and purging) and other, non-specified conditions. Though eating disorders affect relatively few people, the impact on those suffering from them is severe.
Read the full story here Web Link
posted Friday, June 24, 2011, 8:43 AM
Posted by Alice
a resident of Los Altos
on Jul 14, 2014 at 3:58 am
Thank you for this locally oriented article on EDs and the Stanford ED program. I'm glad to read others locals' experiences with EDs. I now live north of the Bay Area, and am stunned to come back to this area and see how almost universally slim people are around here. There is much greater size diversity where I live, and it makes me wonder how extreme the pressures are today in Silicon Valley to be thin. It reminds me of how much pressure I felt back in high school, and I wonder if it has intensified since then, given the even higher achievement pressures that go along with the higher cost of real estate.
I grew up in Los Altos, graduating high school in 1980. I was put on my first diet by my pediatrician, Dr. Richards, whose office was at Loyola Corners, in 1976. I write the doctor's name here because I would like to connect with other women who were patients of his who may have developed EDs as a result of his care, to compare notes. I wonder how many other teen girls were put on diets by him.
He told me, when I was a slim 14 year old (in the middle of the "normal" BMI range used today), that I had gained 10 lbs. but no height since my last check-up, and that if I kept "gaining weight this way," I would "be a blimp" by the time I was 30. He apparently didn't know (and nor did I, until recently), that it is normal for girls to gain around 10 lbs. at puberty, but no height.) He didn't even first ask how much I was exercising (4 hours/day: 2 sports teams), and put me on a 1000 kcal/day diet. (I have since been told by a college nurse that female college athletes at his school are told to eat at least 3000 kcals/day: I was being starved by my pediatrician.) Dr. Richards told me to return weekly for a weigh-in to confirm I was losing a pound a week. He said after I lost 10 lbs., he'd put me on a "maintenance diet."
As you might imagine, on the first day of 1000 kcal eating, I was "bingeing" by nighttime (1500 kcals eaten for the day total): "bingeing" for the first time in my life, because I'd never been restricted before. The next morning, I woke feeling stuffed and ashamed that I couldn't last even one day on a diet. I feared I should only eat 500 kcals on day 2, to make up for "overeating" by 500 kcals on day 1, to make sure I could show a 1-lb. weight loss by the end of the week. Again, I "binged," eating 1500 kcals on day 2. So on day 3, I thought I'd have to eat 0 kcals to make up for "overeating" the previous 2 days.
I spent the rest of the week trying to eat as close to zero kcals as possible. The last day of the week, I fasted, and showed a 1-lb. weight loss the next day at the doctor's office.
After a second week like that, I could no longer keep showing a weekly 1-lb weight loss, so I never went to my pediatrician again, throughout high school. I initially starved and exercised my way down by more than the 10 lbs, then quickly gained it all back, and have been stuck in the starve/binge pattern ever since.
The restricting/bingeing pattern had taken hold, starting from that first day on Dr. Richard's diet. I'm now 51, have gained over 200 lbs. (yes, you read that right), from the increasingly chaotic eating from numerous diets ever since, and am still struggling to stop that pattern of early-day restricting and late-day bingeing.
Being started on dieting and hatred of my then-thin size has been one of the worst things a doctor could do to a client. Dieting has been the most frustrating and painful experience, because the long-term effect of dieting for most people is *weight gain.* The research now shows that the more a person diets, and the more severely, the more they will likely gain weight over time. Unfortunately, I'm so tuned out to my hunger signals that for the past 26 years, I have not been able to *stop* dieting for part of the day (not even realizing I haven't eaten, or not being able to make myself eat), and then bingeing later.
My ED started the first morning of Dr. Richard's diet, because it is on the first day of a diet that a person learns she has to override her hunger in order to stick to the diet. That first day, when I was hungry by mid-morning, for the first time in my life, I had to go against what I had always done: eat when hungry. To stick to the diet (or risk being reviled and rejected by others), when hungry, I had to consciously *not eat* and get hungrier. The doctor-prescribed/doctor-approved diet taught me to ignore and go against my hunger signals and what my body was telling me to do: the hunger signals that are a product of evolution to perfectly guide us to eat as we need to. I learned to fear eating, fear hunger, and to fear even being aware of hunger. It is the perfect set-up for undereating and then overeating. All from the first day of being on a diet. And the irony is, the more weight I gain, the more I fear being aware of my hunger. It's a vicious cycle. The problem is one of *primary* restricting leading to *secondary* overeating (or more accurately, make-up eating.) The solution is to stop the restricting. But of course, going to most doctors exacerbates this, because most still advise weight loss and some form of restricting: even if I warn them I have an ED and to not go there, because I'm so sensitized, particularly to doctors criticizing my weight. (Fortunately, I have found some wonderful PCPs who understand. When I see them now, my eating does not get worse after the appointment, which is a huge relief.)
In addition to Dr. Richard's terrible advice, I, too, along with another commenter above, felt enormous criticism and judgment from males: my father, brother, and boys at my high school, all of which contributed to the eating disorder.
So if you can imagine, I am very frustrated when I read articles discussing the *media* role in the development of EDs, but not that of those who I believe are the biggest culprits: DOCTORS who advocate weight loss; and second in line, males judging and criticizing girls' and women's bodies, and our weight and size.
Parents need to raise boys from a very early age to reject the peer pressure and cultural nonsense and to not judge females (or males) by our bodies, and to not critize or reject females based on weight or size, or judge/criticize how we eat. It just makes it harder to listen to one's own body. (And the same should go for girls' parents, regarding boys or other girls.)
Any doctor telling patients to lose weight (by whatever method) is interfering with body image/esteem and one's ability to listen to hunger signals, and is contributing to disordered eating and eating disorders. They are inadvertently and inevitably *causing* the very weight gain they are trying to prevent.
Instead, doctors should be identifying clients who are caught in the dieting trap, help them to stop dieting and recover normal (3+ meals, hunger-based) eating (some may need to follow meal plans to recover, or for the rest of their lives), help them to focus on healthy lifestyle, and to love and accept themselves at whatever size they are (known as Health At Every Size-HAES(TM)) for best self-care and health outcomes.
My thanks to those doctors helping those of us with EDs and who teach their clients about HAES. And kudos to the men and women who accept and love people of all sizes.
Posted by Whatamess
a resident of Another Palo Alto neighborhood
on Jul 14, 2014 at 9:43 am
My mother had been a model in her day, and was terrified of body fat. As a result, she had some strange notions about nutrition, and thought that dietary fats of any kind, as well as dairy products, were bad for children.
Basically, I was.starved throughout childhood. Once I was on my own, I began to eat more, but did not make good choices. Pathetically skinny as a child, I was now of normal weight, but thought I was fat. Having no knowledge of good nutrition, I began to cut out entire meals, eating one hot dog a day and nothing else.
A very disciplined person, having been an "A" student all through school, including college, I became pathetically thin again. To make a long story short, I ended up in the Woodside Women's Hospital ( no longer exists, thank God), after over dieting to the point of emaciation after the birth of my son.
Woodside Women's Hospital hired chefs from the Culinary Institute to entice women to eat, and to make another long story short, their methods turned anorexics into bulimics.
Eventually I was sent to Stanford, where I was drugged heavily against my will, and nurses would check my mouth to make sure I had swallowed the pills they gave me. My doctor, an Iranian woman named Mali Mann, threatened to take my son away from me and put him in foster care ( although I found out later that she never mentioned this to my husband). This woman never even saw me before committing me to Stanford, and made a diagnosis of major depression, sight unseen, to get me admitted.
When my husband realized that Dr Mann was doing things that were not entirely legal, and wanted to keep me in Stanford for months ( our insurance paid only 25%), he found he could not get me released. Finally, he told her we would not be able to pay her, and realizing this would not be profitable for her ( she had very few clients), she had me released.
I switched to a psychiatrist who saw me once per week, whose rates we could afford, and who practiced out of El Camino Hospital. It also came to light that I was not the first person with complaints about Dr Mann, which is why she had so few clients. Anyway, this new doctor helped me work through childhood issues and see that I was not mentally ill, but my mother was, and because of her influence I was clearly misguided. I was put on Zoloft temporarily, til my thinking cleared and the mental fog lifted, and have had no ED issues since. Eventually I needed no psychiatric help at all.
I wanted to mention Dr Mann's name, because I understand that she is still practicing in Palo Alto, and still doing illegal things to her patients. This woman is dangerous, and to be avoided at all costs!
I also want to say that the fashion industry is responsible for a lot of EDs, as evidenced by my mother and her passing this onto me. This industry, along with dance and gymnastics, encourages unhealthy food limitations that are especially dangerous for growing girls. They also pass onto society an unhealthy icon of what a woman should look like, an icon that is largely unattainable to most women, and is NOT NORMAL! For this reason, they are no better than the porn industry!