Tuesday, March 31, 2009

Restorative teeth

Ever wonder what your teeth could look like from bulimia? Here's an example:

Here's a result after major teeth restoration:

This specific case of a young woman who had recovered from bulimia was featured in the Journal of Cosmetic Dentistry Spring 2008 and is retold here by a Virginia dentist. The press release goes into much detail on the treatment plan and how her teeth were restored.

Besides these interesting details, the conclusion was the best part. This dentist said, "This patient's case involved many of the challenges we face daily in our practice. Just a few years ago, however, I would not have known in which direction to take her treatment. Perhaps I simple would have provided her with a bruxism appliance, while "patching up" some of her fractured restorations and attempting to improve her smile be restoring some of her anterior teeth with direct resins. these would have failed repeatedly, causing us both much frustration."

Though I certainly see this as a wonderful step in cosmetic dentistry, I hope that other dentists will follow in suit. I often wonder how many of us stop smiling or become more self-conscious due to our poor teeth conditions. It's kind of a sad predicament. I hope one day we will all be able to have our smiles back whether it is through cosmetic dentistry or not.

Note--*all images from Full Mouth Rehabilitation and Bite Management of Severely Worn Dentition

*Though the article doesn't talk about it, since this is cosmetic dentistry, the monetary costs for these procedures is quite substantial.

Sunday, March 29, 2009

Can anorexia be predicted?

I think we've all asked this question before: can anorexia be predicted?

Several researchers are beginning to look into this more thoroughly. This week, new research on the predictability of anorexia through subtle differences in brain development in children will be revealed at the Institute of London, according to UK paper, The Guardian.

Researchers tested more than 200 people in the UK, US, and Norway who had anorexia. The majority were girls between the ages of 12 and 25, currently receiving treatment.

Through in-depth neuropsychological testing, " they found that about 70% of the patients had suffered damage to their neurotransmitters, which help brain cells communicate with each other, had undergone subtle changes in the structure of their brains, or both."

The researchers go on to say that these results are random and not based on other factors such as the environmental chemicals or poor maternal diet. They also believe that "
Imperfect wiring in the brain's insular cortex that may lead to dyslexia, ADHD or depression in other children produces what he calls "an underlying vulnerability" among some young people that makes them more likely to develop anorexia."

The significance of this study is that it can give better understanding to eating disorders as well as to possibly pave a new path for drug treatment, an area of research which has currently been unsuccessful for treating eating disorders. This also takes some of the blame off of parents for causing their child's eating disorder.

Another interesting point made in this study is the implications of the insular cortex. Research has already shown that the insular cortex is involved in a variety of neuropsychiatric illnesses. The insular cortex was also implicated in a study looking at a sense of taste among women with anorexia. There, researchers found that the women who had recovered from anorexia showed differences in processing taste, especially in the feeling of pleasantness/reward of foods, compared to normal controls who never had anorexia.

Stay tuned as this is some interesting research.

Note--I'm hoping the researchers will go more into detail about their "neuropsychological" testing. If more information is presented, I'll update the post as needed.

Saturday, March 28, 2009

Procrastinating...and a favorite movie

What should I be doing? Working on my two weeks worth of therapy assignments. Yeah, just a little procrastination. :sigh: Not sure why, it's really not that tough: write at least one page on how your trauma has affected your beliefs. I've actually thought about it in my head, but that doesn't really count. Perhaps, putting it on paper, just makes it more real, similar to saying actual words. The second exercise is rather easy and based on thoughts and actions/consequences. I guess I should be good for that one after last weekend.

I know it'll get done before my appointment on Monday, I'm just upset with myself for procrastinating it and now feeling stressed. It's like school when you've procrastinated a much needed class project, except this time, there isn't a grade, no right or wrong answer, no judgment, no reading it aloud to class. Therefore, there shouldn't be this perceived sense of pressure. Come to think of it, I've procrastinated a lot of things I had planned to get done this week--working on my taxes, doing that edriving course a la speed ticket (registered for it and went through the introduction which I might add is incredibly cheesy--talking bobbledheads, hula girls, and tree shaped air refreshener), going to the bank, making eggrolls, and probably more. I guess my plan is to lump it all into Monday and Tuesday when I don't feel so time constrained. But then, it just becomes a vicious cycle. You plan to accomplish all these things, yet feel stressed. However, you know if you don't get all this done, you'll just feel unsuccessful for the day. Yes, this is how I make things difficult for myself.

Moving on.


I happened to catch one of my favorite movies last night: American Beauty (1999) For some reason, as dark of a comedy (if you can call it that) it was, I found it to be such a moving piece of work. Not only did it portray so many overlying themes, but each character had so much depth that it made it easy for me to identify with their various issues--feeling unsuccessful, wanting to be successful, trying to be perfect, fear of being ordinary, feeling different, feeling like a loser, trying to find yourself,, holding onto secrets, feeling powerless, wanting to change, trying to find happiness, seeing beauty, etc. I think one of the best themes it showcased was that you can never assume anything, you never know what goes on behind closed doors. During the time this movie came out, I felt like everything was for show, so this theme resonates with me closely. I know I've talked about facades before, but it makes me really think about the people I've encountered in my life, both past and present. How many others held a facade? Would knowing their back story cause me to be different towards them? Or if they knew my background, would they have felt differently towards me? I could probably talk more about this film, but I do want to mention a few other scenes I really like. The paper bag video is beautiful, and the last scene in the movie is quite moving, especially of Annette Bening grabbing Lester's clothes. I think that particular moment touches me so much, because it's a scene I can imagine so many others doing when there is profound loss. To end on a positive, random note, 8/9 books I ordered have come in this week.

Thursday, March 26, 2009

EDs and salvation

This morning, as I was just leaving for work, I happened to notice one of my amazon shipments arrived. I ordered 9 or 10 books which will be trickling in all throughout the week. Some were eating disorder-related books, including Harriet Brown's, Feed Me! one lengthy running book--over 900 pages, looking at ALL aspects of running, a Korean survival book for the future, and a few Suze Orman books. I've been a fan of her for a few years but hadn't read one of her books yet.

The first book that arrived was Kathryn Zerbe's Integrated Treatment of Eating Disorders: Beyond the Body Betrayed. I read her previous book The Body Betrayed a number of years ago and felt that was a good comprehensive book on eating disorders, so I was interested in what this book had to offer as well.

This book is geared more towards the practitioner/therapist, but I think it is likely useful for the client, especially in giving a perspective of what therapists may feel like/struggle with in treating the eating disorder population. The book is broken down into three sections: phases of treatment, treatment through life cycles, and special issues such as sexuality, transference, counter transference, and assessing outcomes and resiliency. I'm quite curious about the last section as those issues aren't necessarily talked about much in eating disorder books. In just a skim of the book, like her previous book, she devotes sections to biology too.

I'm only on the first chapter, but this quote struck me. I believe the quote was also used in her other book where she went more into detail. The context of the quote is in talking about how therapists have a difficult time in retrieving information from eating disorder persons due to the aspect of "identity" as the ED which the client encompasses.

H.N. Boris, a psychoanalyst said, "What we call their symptoms, they call their salvation."

In certain ways, I agree with this. For a long time, the ED was like a "salvation" to me, a way of survival. It was the tool I knew how to use. Later, as I developed other tools, the ED was no longer completely like a "salvation" but something else. I never quite figured out what the purpose was after my die-hard years of ED Hell, but there must have been one. Otherwise, I would have recovered a long time ago.

What are your thoughts? Are ED symptoms like salvation?

Tuesday, March 24, 2009

Smell evoked memories

Yesterday, I was listening to the here on earth podcast on the "scent of desire." If you've never listened to this podcast, there are some interesting topics--everything from food to books to Islam to research, etc. This one talked about the evolution of scent with Rachel Herz, an expert on the smell of psychology. Rachel believes that smell is the sense most closely tied to mental health and happiness.

If you think about this, smell certainly plays a significant role in our lives. We use smell to distinguish various objects in everyday life--simple things like food and flowers to more complex odors like our spouses/significant others, etc. In research, smell has often been linked with taste. Those who have anosmia often report a loss of taste which also influences their dietary behaviors, as seen in this recent study. Studies have also looked at depressed individuals and shown that they have a loss of smell. Then with eating disorders, studies have shown that there are olfactory deficits, as well as taste differentiations.

But besides this, smell can also evoke strong memories. This reminded me of a piece I wrote on a smell-memory association in an honors/writing course in college. In this specific exercise, we were in pairs. One partner was blindfolded and and had to choose an item out of a bag and write what memory evoked from the smell. The object I obtained was garlic salt. I wrote a piece on it for both this assignment and as an introduction to another body awareness paper.

The distinct smell of garlic salt reminded me f the times when I was young and cooked spaghetti with my father. The spaghetti part was always easy--boil the water, put the noodles into the pot. However, making the sauce was the tricky part. Since my father was an expert cook, he didn't believe in store bought sauces. Rather, he opted to make his own sauce from scratch. Although my father was never a "methodical" man, he did make his sauces that way. First, he minced the elephant garlic clove and chopped the onions and carrots. He used to tell me that you could never use too much garlic in anything. After the olive oil was heated, he'd add the carrots, onions, celery, and garlic last, not wanting them to burn. Once the onions were clear, as he would tell me, then you could add the the crushed tomatoes. the next part was his "secret," as he used to say. Spices such as basil, oregano,. salt, black and white pepper, and red flakes were
sprinkled into the sauce. The last part was to add some mushrooms and tomato paste to thicken it.

As my father made his special sauce, I watched intently. One of the things that amazed me about my father was that he never measured anything, yet the sauce always turned out perfect. "Years and years of practice," he'd tell me. I sure believed it, as his sauce smelled so good. When he wasn't looking, I just couldn't resist and would taste it--just to make sure it was exactly right. He'd question who tried the sauce, knowing it was me, but of course, playing to my innocence. I can
still remember the smell of the sauce. The pleasant aroma filled the house and would last for hours. I used to tell myself that one day I would be able to cook like him and create my own things.

This smell-memory association evokes both happiness and sadness in some aspects. I know I adored my father and enjoyed the equality time with him. After all, not too many daughters at my age (five or six) and fathers have similar interests of cooking. However, the sad aspect of
this certain smell and memory is when I think about it now. Smelling that aroma takes me back to the days when food was not such a big issue. It reminds me that then I didn't worry so much about what I looked like or what foods I ate. Instead, it was only food--nourishment for your body, but with no meaning attached.

Nowadays, I look at that food and think, "do I really have to eat this, how many calories are in this, how long would it take me to burn off?" Although I try not to attach a meaning to it, it's not always easy. These certain smells like the garlic salt remind me of my
childhood days--when it seemed everything was so easy, when I was a different person--a happy child with no real worries. There are days that I yearn to reach that spot in my life again. Yet, at the same time, it's a paradox in a way, because I can't seem to remember it that well. I know I did not have an unhappy childhood in the classical sense of any kind of abuse or neglect, but the memories that stand out most to me are still the ones more in the realm of sadness. Maybe one only remembers what is exception as Virginia Woolf said; or as Iris Origo believed, that "memory has a filter of its own, sometimes suppressing or retaining but always significant--some that stand out in disproportionate clarity to the res." And in my case, the most vivid memories were ones that did not envelope my daily life of what seemed happy.

To this day, spaghetti.is still a difficult food for me, though it is better than it used to be. It's not due to the taste but rather the memories behind it. I think it also hits me hard, because I still remember that certain smell when spaghetti was purged. Like my aversion with cheese which I've talked about before, it's pretty interesting just how much smell is laden with memories.

So how does smell affect memory for you? Is there a connection with your eating disorder past of present? Has your sense of smell been affected due to a mental illness?

EDIT: I should also note that parts of my childhood are now viewed differently and there was trauma. At the time when I wrote this piece, I never looked at it that way.

Monday, March 23, 2009

Misjudging consequences

In my last post, I talked about how we don't always think about the consequences of our actions. Case in point: SPEEDING!

Scenario: I was driving tonight, going to get gas and stop by the store. It was 11:00 PM at night, and I really wasn't paying attention to the speed limits, not that I was recklessly driving but faster than the posted sign. The speed limit goes from 55 to 45 in like 0.2 mile, and normally, yes, I slow down. I just wasn't thinking about it despite seeing another car pulled over. I kind of thought, "oh, that car got pulled over." By the way, in this intersection everyone speeds. Not that it is justified, it's just what happens.

The cop guy pulled me over, asked for license, registration, insurance card. I had all the above but realized I had not put my new registration in the glove compartment. I had the old one and hoped he might glance over the expiration of almost two months. He didn't. Then, he asked about my plates. They are out of state plates which I've had since I have lived here. He said they needed to be transferred over to the actual state I live in, even though I pay taxes here. I was surprised by this, because no one has ever told me this, not even the other dog trainer who is a sergeant!

I waited for him to get all the info which felt like an eternity, just sitting there. He finally got back to me, said he'd cite me for speeding, not the license plate transfer, and ended with, "drive safely, have a nice night." Yeah, buddy, okay, whatever.

After that, I got gas and drove home. The funny thing is that another car was pulled over right after me! Obviously, this cop was hell bent on citing everyone for speeding. I keep wondering where is the cop who should be pulling over people for going through red lights in broad daylight which I've seen happen too many times.

This is just one of those moments where you accept the consequences and move on. Though of course if I'd been thinking about the consequences, then I wouldn't have been speeding or gotten a ticket. Or if I had just gone home and decided not to get gas, I wouldn't have been in this predicament. All those what ifs. Sometimes life just sucks that way. I'll pay the fine, do some online driving course, and be done with it. It's all I can really do. That and not beat myself up over it like I have in the past. There's no changing the past here.

What a lovely way to end the week/begin the new one.

Saturday, March 21, 2009

Foot woes

I don't think I've mentioned on here my latest foot woes. If you've followed me on twitter or facebook, I have discussed it there in my one liner comments.

This is not my foot but an image from Brittanica

Symptoms: metatarsal pain in left foot, mostly over the second digit and pain in the ball of my foot upon running and/or walking
Duration: longer than a month
X-ray: no stress fracture but only 50% show up anyway
MRI: no stress fracture but arthritis over first metatarsal and bunion (already knew)
Dr.'s advice: DON'T increase your mileage, take an OTC anti-inflammatory consistently, follow-up in a month

When I received the results on Friday about the MRI, a part of me was glad it was not a stress fracture as that would have meant I would have had to completely stop running for probably a month or more. However, another part almost wished it had shown that too. It's not for my usual validation reasons either. But rather, the thought about consequences.

See, if it had been a stress fracture, as much as I would have groaned about not being able to run (both for physical and mental reasons), I would have likely laid off my foot at least for a little while. Now, that it is only arthritis and inflammation, it doesn't seem as crippling. The consequences don't seem as severe.

Athletes and eating disorder individuals alike have a tendency to push our bodies to the limit. How fast and far can we run/exercise? How fast and far can we run/exercise on such little food? How many days can we go without nourishing ourselves? How many times can we purge and still conceivably stand upright? How many things can we pack into one day to consider ourselves successful?

We do this with no real forethought, or I should say the forethought may be there but it gets pushed aside for the ED's wants, needs, and gratifications. I'm sure many can relate. It's a hard boat to row ashore. If we ever want to get better, we have to start thinking about the consequences. The sad thing is that even when we think about the consequences, it doesn't really hit us how badly it can get until we've already reached that point and beyond.

With thinking about the ED and my foot, I had to remind myself of the possible outcomes if I continued to push to reach my optimum level of running. Basically, if I planned on running any marathon this year, that chance could be ruined. So for the next month, as hard as it is for me, I'm going to heed my Dr.'s advice and keep the running to low level mileage.

Note--I was originally hoping to upload the MRI images of my foot, however, it looks like the software is only for hospitals and physicians. I'm hoping to see them on Monday when I visit S., my physical therapist friend, who works at the hospital.

Thursday, March 19, 2009

Today's breakfast

EDIT: Okay, I feel majorly stupid, because I read this label wrong. I'll keep it up, so this can be your laugh for the day.

Breakfast has always been a non-existent "meal" for me. For many years, I subsisted on 4-5 cups of coffee as my breakfast. The last few years, I added energy bars with my daily coffee as the morning "meal." However, I've been consistently trying to make an effort of eating something more
substantial for breakfast. The last several weeks I've been on an oatmeal kick, adding in fruits, raisins, and occasionally peanut butter to make it a bit more palatable.

This morning I was in a rush and running late. I had not made oatmeal the night before, so I just picked up an oatmeal raisin Luna bar. After doing the morning chores at the kennel, I went to sit and eat my energy bar. I noticed it tasted different, kind of stale which was odd. After eating about half of it, I looked at the wrapper and saw this:

If you can't read the date, it says: 07 JAN10

I was naturally kind of shocked. I know expiration deals aren't that big of a deal with energy bars and most do last longer than the best sell by date (one reason why many people sell them on ebay), however, over two years is a little old in my opinion. And on top of that, this was in a grocery store. How could an energy bar over two years old even be on the shelf? This makes me slightly paranoid that I'm going to need to check all my expiration dates now. (I do with refrigerated and bread items which spoil faster)

So you may wonder what I did with the energy bar. Yes, I confess, I ate it. It was the only thing I had, and I was hungry. I figured that if I didn't have any unusual symptoms within a few hours, I was probably okay. You also may being wonder what does an expired energy bar taste like? It's quite dry and stale and not worth eating.

EDIT: So basically, this energy stale bar tasted like crap and was not expired! I guess I thought since it tasted so awful, it must have been expired and read the label incorrectly. See this is what happens when you don't eat a good breakfast. ;-)

Obesity "epidemic" may be overstated

It's nice to read every once in awhile that people need to rethink the obesity epidemic as so many of us have already stated. In this article, sociologist Samantha Kwan of the University of Houston says the obesity epidemic may be overstated and is more of a moral panic. Kwan says:

"This epidemic has been constructed to the benefit of the medical industry that has in part medicalized the treatment of obesity over the years. While there may be a rise in 'obesity,' the BMI is not always accurate. Some scholars describe this epidemic more as a moral panic. While there may be some truths to rising rates, they have been overstated."

Unfortunately, you don't hear this much but rather just how significant the obesity rate is. I still often wonder if this obesity hysteria would not have been so dramatic had the BMI cut offs for branding someone "overweight" been lowered. To me, there was a correlation between that and the mass thinking of the obesity epidemic.

Tuesday, March 17, 2009


Yesterday 's therapy session was tough, and I have a feeling it's not going to get easier. After I revealed my secret to C., I agreed to try to work on this issue, hoping maybe this time with concerted effort, I might be able to get past it. During the last few weeks, we've been working on trauma-related exercises.

The first exercise was to write rules prior to the trauma-related event and then see whether those beliefs were reinforced or different after the trauma. For me, since this trauma was over ten years ago, I had to think really hard about what I felt then versus now. It was much more difficult than I thought. C. could see how hard it was for me and pointed out how I was able to place the feelings but not the thoughts. This was an interesting observation, because with eating disorder issues, I'm Miss Rationalization and the feelings part become non-existent.

This is not to say that I don't rationalize with trauma-related issues either, it's just different. Often, it's with me wanting to continuously blame myself for everything. C. said something helpful which I thought might be helpful to some other bloggers who I know are having difficulties right now in dealing with both past and
present issues.

She said it wasn't so much a matter whether you were right or wrong or that you had choice in the matter. What matters is how it affected your beliefs--the way you see people, the world, yourself.

This helped me to take less blame for the situation and reminded me that it certainly did change the way I view some things. Beliefs are an interesting thing. From childhood, we are taught certain beliefs. As we grow and have both positive and negative experiences, we decide to either change our belief system or hold onto it. The thing that is hard is when a belief you had is shattered. You don't know whether you'll ever able to see it the same way even though that way was healthy.

Monday, March 16, 2009

Group photos

Okay, so these were my first attempt at getting a group shot today. The dogs were somewhat cooperative, but it certainly wasn't easy. I'm going to have to start to pull out the big guns as rewards! The pair photos came out a lot better. It's still early in the year, so I'm sure I'm bound to get one really good shot.

Note--It's kind of funny, but Baxter and Tovah have the same expression in every photo. No one seems to look very thrilled in the photos.

Saturday, March 14, 2009

Schools and calorie boards

Within the last few years, there has been a big push to put calories on menus to fight the "obesity" epidemic. I'm sure most of us have heard about it. In mid-February, a Federal Appeals court in New York upheld the ruling of posting calories on menus. Though some chain restaurants have already been doing this, it is now required if there are 15 or more outlets. California and Philadelphia have taken similar regulations with effects occurring next year. Even the UK has gotten in on this bandwagon.

With large states taking this action, it seems like it is happening everywhere. Posted calorie menus have been seen on college campuses (though Harvard removed theirs) and now even in school districts. Case in point, in North Carolina, some districts are going high tech in presenting nutrition information, including some with calorie and fat numbers. Amy Harkey of the CMS Child Nutrition Services says, "
Food can be fun for kids, and I think that message needs to come across. We don't want to burden them with too much."

While it's true that food can be fun and should be, how would presenting a blaring neon-type board with calorie counts not be burdening to children? This only emphasizes dieting, a pre-cursor to eating disorders and unhealthy body image. Though I think it is is important to have some general information, like ingredients of wheat, soy, seafood, peanut for those with allergies, I think listing calories is unwise. Schools need to figure out an alternative way of passing along nutrition information. I can guarantee that this will only cause more harm than good on an already vulnerable population.


As I was reading through google reader, trying to catch up on articles, I came across this one about the HappyHR. After I read this, alarm bells went on in my head how this could be very abused, especially for those with eating disorders and chronic dieters. Basically, the HappyHR is a device which counts calories 24/7, including in your sleep! It is touted as "a fitness monitoring and management" device which the creators hope to extend to health applications for glucose and respiratory monitoring.

I think this is kind of scary. It doesn't say its accuracy, but how much concern is that really? It's just the point that there are people out there creating tools to determine how many calories you expend each and every minute of the day. It's not like we need another tool to add to society's obsession with numbers or as a way of measuring up, determining our worth. Seriously, what are people thinking?

I know I'm ranting here, but do other people see the pitfalls of this technology?

Thursday, March 12, 2009

Cracked plates

I finished Handle with Care the other day. I didn't expect the book to end quite the way it did but my assumptions were correct in how the book was written. Overall, it was a good read and raised interesting points in a variety of issues. It really gives me more respect with those with OI and what their families have to go through both emotionally and financially.

There were two quotes which stuck out for me the most in the book. I'm only going to discuss one here and post the other one at a later time.

At the end of the book, Charlotte says: "Things that break--be they bones, hearts, promises--can be put back together but will never really be whole."

This reminds me a lot about the cracked plate analogy someone once told me. Actually, I've been wanting to post this for awhile but I could not find a cracked plate image, and I wasn't about to break a plate to just photograph. However, ironically, a few weeks ago, my favorite bowl broke. So that image will have to suffice, and then you can be at your own devices to think about a cracked plate if you want. ;-)

At the time I heard the cracked plate analogy, it was in reference to a dog. She had had trauma in her life which was irreparable. Though the owner did her best to help the dog overcome her trauma, and had successful management, it became too much for the dog. The dog continually tried to hold it together, but in the end, the pressure of the crack was too much to bear.

I think about this with myself and so many others. We all have cracks no doubt which leave indelible scars. We all try hard to put on a facade that everything is okay, that our cracked plates are really together. When in fact, they could break at any moment. Then, we are left with the shattered pieces, repairing ourselves which will never truly be the same.

I think about this type of thing a lot, because I think about "wholeness"--how I want to desperately be whole. Maybe I'm just chasing an illusion that will never be there. Maybe I'm tired of just repairing my cracked plate, just lying to myself that it can be the same, different, be something other than what it is.

Related post: succession of a nut

Tuesday, March 10, 2009

Healthy food: choice versus instinct

Carrie's post and commentary of her encounter at Whole Foods reminded me or I should say made me think about my food beliefs a bit.

Back in October, I went to a large dog conference. Though I tend to do horribly eating at conferences, I did manage to socialize and eat dinner every night. I remember on the night before the conference ended, a big group of us--10 or 11 people went to the Old Spaghetti Factory. I'd never been here, but everyone said how good it was.

I remember ordering some angel hair pasta with mushrooms over a marinara sauce. L., a woman who I had dinner with almost every night and who I knew from past conferences, sat beside me. After the orders were taken, I remember leaning over toward her and saying something to the effects of, "I'm surprised they don't have whole wheat pasta. Normally, that's what I would have eaten."

Her reply to me was "that's because you are a health nut."

Maybe I am. Maybe I'm not. Maybe it's just a convenient way to mask the eating disorder. I'm sure many of us are used to that. The thing is, however, I question how much my thinking has come to the point of becoming ingrained. How much is changeable?

Example: if I'm choosing between a white baguette and a multigrain one, I always choose the latter. I tell my self it is healthier, has more nutrients than the white, therefore, I should only eat that one. This is true, but it's the point that I really don't allow myself to eat the one that is less nutritionally valued.

I do this with other items too--white potato versus sweet potato, lowfat yogurt versus nonfat Greek yogurt, iceberg lettuce versus romaine lettuce, green pepper versus red pepper, white flour versus wheat flour (in the dogs' case, it would be wheat flour versus oat or white/brown rice flour), whole wheat pasta versus regular pasta, and you see the drift here. My choices wind up becoming based on what is nutritionally "better, more dense" than for purely what I may want or what has more taste.

This is what we are all told, right? We should choose foods that are nutritionally dense, balanced, just simply healthier for you. So when you're in recovery, trying to unhinge that mindset a bit, how much can you change really? How much becomes almost instinctual by now?

This is not to say that I don't eat some foods that have the item I would normally not choose (example I'm an animal cracker addict), it's just when push comes to shove, I'll go with the item with more nutrients. I'm certainly not trying to knock people who choose healthier options for health reasons, but when does it become about choice versus instinct? Right now, I'm grappling with that question and trying to figure out a balance somewhere.

Monday, March 9, 2009

Future dietitians and weight bias

I came across this disturbing article the other day about weight bias among future dietitians. A new study in the Journal of the American Dietetic Association showed only two percent of future dietitians have positive or neutral attitudes towards obese individuals with the rest moderately biased.

Dietetic students were asked questions about both a normal weight male and female as well as an obese male and female with the same health characteristics other than weight. The results indicated that
the majority of the 182 students who participated viewed obese patients' self control, attractiveness, eating habits, compliance to treatment, self-esteem, and insecurity negatively.

Although this may show that dietitians are not immune to weight bias, this can impact treatment negatively. What patient wants insensitivity by a professional? How can a patient learn to trust her/his dietitian and get though the treatment plan?

This makes me wonder what dietitians think of eating disorder patients as first impressions. Do they think we are all stubborn, non-compliant? Do they feel some of us are too thin or too fat to be there? Whatever stereotype a dietitian or any other professional may hold affects both the patient relationship and treatment in the long run. No one needs stigma held over them. Perhaps, stigma reduction classes, similar to medical students compassion training classes, should be implemented into in the class curriculum, as well as positive role models and mentors who do not reflect weight bias.

Note--this is only a small study with a mostly Caucasian group, so there might be differences in ethnicity attitudes. This also can obviously not be a clear generalization, as with any profession, there are always the good apples and the bad.

Sunday, March 8, 2009

International Women's day

Associated content

Today marks International Women's Day, a day to celebrate the economic, social, and political achievements of women around the world. In more than 30 countries, it is an official holiday. According to the International Women's Day website, 956 events will be held in 62 countries, highlighting this special day. Some countries continue to emphasize the political and social importance of this day while in other countries, it's become a day for men to express their love and appreciation for the women in their lives, similar to a Mother's Day.

It doesn't really matter how you celebrate this particular day, but I do think its acknowledgment is important. If you are not familiar with the history of IWD, it is interesting. Imagine yourself in that era--fighting for better working conditions and pay. It is those generations that have paved the way for where women are today, though I'd still say globally, women have a long way to go too. Like anything, one small step at a time.

Saturday, March 7, 2009

Handle with Care

Handle With Care


Currently, I'm reading Jodi Picoult's new novel, Handle with Care. Coincidentally, I was able to actually place the book on "hold" while it was "in processing" at my local library. Thus, I'm the first to get my hands on it before so many other place holds on them. I'm almost halfway through the book, and as is Picoult's style, it is a very engaging read.

From Jodi Picoult's website, a brief synopsis of the book:

When Charlotte and Sean O’Keefe’s daughter, Willow, is born with severe Osteogenesis Imperfecta, they are devastated – she will suffer hundreds of broken bones as she grows, a lifetime of pain. As the family struggles to make ends meet to cover Willow’s medical expenses, Charlotte thinks she has found an answer. If she files a wrongful birth lawsuit against her ob/gyn for not telling her in advance that her child would be born severely disabled, the monetary payouts might ensure a lifetime of care for Willow. But it means that Charlotte has to get up in a court of law and say in public that she would have terminated the pregnancy if she’d known about the disability in advance – words that her husband can’t abide, that Willow will hear, and that Charlotte cannot reconcile. And the ob/gyn she’s suing isn’t just her physician – it’s her best friend.

Besides the story of their child with OI, another story is weaved with their other, adolescent daughter who struggles with not only her sister's illness but also issues of perfectionism, feeling of want by her mother, and simple attention as well. This time, this character turns to bulimia as well as cutting. I thought this was an interesting (though of course realistic too) decision to use the eating disorder as this character's way of coping. In other books, Picoult has used other destructive means like cutting, drugs, etc. But to my knowledge, this was the first she actually used an eating disorder. (I could be wrong on this since I have not read all of her books)

I was able to ask this question to her today in a live Q&A from the Washington Post Book World discussion. Kind of exciting! After her answer, it made more sense to me why she chose this means per se. I think a lot had to do with the fact that eating disorders are so secretive and because her mother was wrapped up taking care of the other daughter with OI, her other daughter's emotions, struggles, lack of coping well, flew under the radar.

I also asked if in the future she was going to use an eating disorder individual as a main plot line. I was holding out hope that maybe she would consider this as I'd be very interested to see how she developed the character. Sadly, she thought she probably would not any time soon. Oh well. However, if you're interested in autism, her next book's main character revolved around this diagnosis as well as being accused of murder.

Anyway, I'll give an opinion of the book once I'm finished if anyone is interested. If you haven't read her novels, I highly recommend them. She does a great job with in-depth characters, weaving different plot lines, discussing many issues revolved around families, and she always has a moral question in her books, often with a twist at the end. Some people find her books a bit predictable, and in a way they are once you know her style. Still, however, they make you think twice about how you would handle a certain situation. And any book that leaves me thinking more is a great read in my opinion.

Thursday, March 5, 2009

Ranting on food safety

In a recent post, Cammy discussed the awful oversight of dietary drugs. This reminded me again about the peanut product recall which is still ongoing--now with 677 people sickened in 45 states (I guess if you were one of the five states not affected, hurrah to you?), 9 deaths, and more than 2,833 products pulled. To show how faulty the system is, FDA inspectors recently found dead mice and rodent droppings in the Texas plant run by Peanut Corporation of America, the source of the peanut product recall. This was the first time the inspectors had ever been there!

Then, in the past week, sprouts in Nebraska and Iowa, Safeway instant non-fat dry milk, Goya brand dried yellow potato have all been recalled. Only two were due to possible contamination, the other for possible allergic reactions of those with asthma. These are all on a small scale and seem to have been promptly found, however, it's another example of the overhaul this system needs.

According to this Scientific American article, a Senate bill was introduced recently to enhance the FDA regulatory measures for our national food supply. A few of these new implementations would be higher scrutiny of inspections, more inspections, expands access to tests/results and company records, verify/deny importers of food, and a substantial increase in funds.

Perhaps, this will help with the broken system. Personally, I think the biggest thing is funding for more workers as it does seem the FDA is stretched quite thin and cannot do an adequate job of food safety. Whatever happens with this bill or any other which may be introduced, the take home message is that something needs to be done.


The University of North Carolina at Chapel Hill is conducting a trial focusing on UCAN--Uniting Couples in the Treatment of Anorexia Nervosa. More information can be found at the link. I think this could be very beneficial as many times spouses, partners, significant others, etc. do not know how to help their loved one with an eating disorder. I think this could especially be helpful for the older eating disorder individual.

The one thing that boggles me about this is why this hasn't really been implemented sooner, or maybe it has just through family therapy? In any case, I hope it will just be another tool in the process of recovery.

The study is still open, so go to the link if you're interested.

Tuesday, March 3, 2009

Asian food labels, Calories, and their significance?

Last week, I headed to the Asian supermarket. I go once about every 3-4 months, all depending on when I run out of this: Yes, kimchi! It's probably one of my favorite foods. I'm not the typical Korean, eating it for every meal, just dinner, along with my other veggies, rice/noodles, and protein.

While I was there, I picked up other items, like noodles, sweet wild
rice, crackers, sauces, frozen potstickers, bean paste products, and even some whole sardines! (for the dogs not me) Who knew sardines came in other sizes than just those ones you see canned? :grin:

The majority of items there have labels both in Asian and English languages. However, I was thinking about this very thing. I used to love to try all the different Asian ramen noodles there. They are much tastier than the standard supermarket kind. I used to buy 5 or 6 different types--everything from kimchi flavor to sesame to even green tea! That was until I read the actual food label. As I've mentioned before, my ED descent led me to a life of being fat-phobic. So I w
as naturally appalled at how many fat grams this 4-5 oz package of noodles had. Well, that was the end of that, and I never touched those specific noodles again, rather opting for something like soba noodles which were less calorific.

Then, I was thinking, what if all my food items were only with Asian food labels, like this one below.

I say this, because I cannot read Asian characters. Would this make a difference, or would it backfire and just cause me more anxiety not knowing how much a certain food item was? I mean, what if I were stuck on some island like all those people in Lost and had to forage for myself? (The Lost people did find normal, packaged foods which they lived off of for awhile) Would I be thinking about calories then?

This led me to think about the actual history of the "Calorie." (kcal) How did it become to play such a significant role in how we eat, diet, and exercise?

According to this brief article in the Journal of Nutrition, it really wasn't until 1887 when chemist Wilbur Atwater published a paper about the "Calorie" relating to food energy that the concept even arose. Atwater used the calorimeter as away to measure the energy in food. In this case, the Calorie is the amount of heat produced when a food is burned to dry powder or ash.

It wasn't until about two decades later that the idea behind calories with dieting hit mainstream. Prior to this, we could say "modern" dieting began with the likes of William Banting in England, forerunner of the Atkins plan, Sylvester Graham, inventor of the Graham cracker who believed in strict vegetarianism, and Horace Fletcher, aka the "Great Masticator" who felt everyone must chew their food something like 32 times before swallowing. None of these men said people should eat X amount of calories.

That is until Dr. Lulu Hunt Peters published her book, Diet and Health, the key to the Calories in 1918. This is considered the first modern diet book where counting calories became the key to weight reduction. The book gives a formula to find ideal body weight, sort of a forerunner to the BMI configuration. She also includes advice on how many calories one should eat based on their ideal body weight with an analysis of macronutrient information. Dr. Hunt, surprisingly, did not promote diet aids nor saccharine.

However, she was apparently not shy to tell readers that dieting was hard work, a life-long commitment, where vigilance was required--that dieting was based on self-discipline. Some have credited her with starting the idea that being overweight is a moral sign of weakness. Despite this, the book proved to be successful, selling somwhere between 800,000 and 2 million copies.

After this book, there came others who emphasized food combinations and when to eat certain foods. Some even mentioned "magic pairs" of foods to eat. During this time (1920s and beyond), there were also many substances touted as the miracle cure for obesity (hmm, that one hasn't changed a bit, has it?), as well as an array of diet plans.

So ladies and gentlemen, that's a brief overview of how the Calorie came about in the role of dieting. It's quite amazing when you think about how much "clout" we give to a simple word, a simple measurement of heat in science, isn't it?

Other Sources:
The history of diets
The history of dieting
When did dieting begin?
Lulu Hunt Peters and the birth of the modern diet book

*Note--I'm still working up to eating those Korean ramen noodles with much more than my usual alloted fat grams.

Monday, March 2, 2009

"Beyond eating disorders..."

Sorry for my lack of posting this week. It wasn't due to being really busy, but rather being exhausted. I'd come home from work, do my usual stuff of feeding dogs, a few chores here and there, and then would find myself drifting off to sleep around 9:30/10 PM which is quite early for me. Sometimes, I get really concerned about this since it deviates from my norm, but more than likely it is due to some combination of eating, sleeping, mood, and/or exercising. :sigh:

Now that you have that preface, onto the actual blog post. A few of you were interested in hearing about
Bordo's presentation I attended last week: "Beyond eating disorders: why we must rethink everything we thought we knew." The presentation itself was good but it only touched the broad surface, but I guess that's all that can be done in an hour's time. Much of the presentation focused on consumerism--the ideology to get us to "see it, love it/want it, buy it/here's how to get it." From there, Bordo used a step by step approach to show the progression of how this type of thinking/advertisements have lead to the problems we are currently seeing in impulse disorders which includes eating disorders.

A few interesting key words in her presentation were the "
pedagogy of the binge" and "deregulation." She uses "pedagogy of the binge, " because consumer society has trained individuals to be without limits. Looking at a variety of current advertisements, frequent words like "voraciousness," "indulgence," and "craving" have appeared more often. This type of idea is not strictly related to food ads but also ads about perfect bodies, overexercising, shopping, etc. In essence, this continues the cycle, leading to an increase in what is deemed as impulse disorders, like binge eating, kleptomania, shopaholism, etc.

In relating this all to eating disorders, the term "
deregulation" comes up. Often times, deregulation is seen more in terms of the government reducing, restricting, or simplifying in order to raise productivity. With anorexia, what is looked at as deregulation, i.e. food and other pleasurable activities, Bordo sees it as a "failure of self-regulation." Consumption is not seen as just guilt-ridden but rather dangerous. She didn't go into much detail here, but I think she talks about it more in depth in her book, Unbearable Weight.

There were several other interesting points she made. For example, much of society is about "craving," and how with anorexia, it is about being in a state of "beyond craving." This isn't exclusive to food either but many other areas of life. I thought that was a different way of looking at it or at least a choice of words.

I should also mention that
Bordo is skeptical of the medical model pertaining to eating disorders but does feel that eating disorders are multi-dimensional. She doesn't discount the medical model, but she feels it leaves out important other criteria. Her thoughts are that some individuals are vulnerable to eating disorders (or whatever disorder), but culture brings out those vulnerabilities. In essence, culture is like a "smoking gun." She makes a much better argument than I can here in her book. There is one line that I think really stands out to me in her book about this issue. It's that as she sees we are not all exposed to the same cultural environment, but rather "what we are all exposed to, rather are homogenizing and normalizing images and ideologies concerning 'femininity' and female beauty."


After the presentation, I decided to go say hi to Dr. Bordo. What I did not mention in my last post was that I in fact know Dr. Bordo. I took an english/women's studies class she taught on "Lolita" as an undergrad, so I do have a relationship with her, though this was about seven years ago. This was another reason why I felt nervous about going.

I waited my turn, and then said "Hi, it's Tiptoe." She kind of looked at me puzzled, but then P. (this is the former professor/client who boards her dog at the kennel) who was there, yelled out, "It's Tiptoe," like shouting it out would jostle her memory better. I guess it worked, because then she remembered me. However, she also said, "
Omg, I didn't recognize you. You look so much thinner." Argh! Those of you who have read this blog know how I feel about this sort of comment --drives me insanely mad and paranoid. But I will let go of this statement and move on.

I gave her a brief thing about how I was blogging these days and keeping current with eating disorder/body image stuff. I should also note that I had shared a body awareness piece with her that I wrote in college which recounted how the ED evolved, so she was one of the few who ever knew. Why, I shared it with her, I'm not sure but there seemed to be some comfort, or maybe just because I knew she was familiar and wrote about these types of topics.

Anyway, Dr.
Bordo ended our conversation with "We should get together and catch up." I'm super stoked that she offered this even with her very busy schedule. I can just think now all the questions I have for her.

In the end, I left feeling like I rekindled an old connection, one that I hope to keep in touch with better.

Note--for the record, I didn't sit in the back--in the middle