Dealing with a family member's weight situation

Tomorrow, my mother's husband, M. is having lap band surgery. I've known about it since June, but I was not sure whether he was 100% positive. It turns out he is, because he thinks this is the only way he can lose the weight.

The story of M. is not much different from others who have tried to lose weight. M. has been on several diets. The last one was Atkins a number of years ago. Though he did lose a substantial amount of weight, he was unable to sustain its difficult regimen and deprivation. Like most dieters, when he went off Atkins, his weight returned. That was the last major diet that I can remember him trying. Since then, he hasn't been on any diet to my knowledge. His doctors and family are now concerned since he has developed diabetes, has high blood pressure, and has had a mini stroke.

I tend to sit on the fence with this. Part of me knows from literature research how there is a lack of pre-screen mental evaluation, especially among those with gastric bypass surgery. It's also been suggested how crucial follow-up care is (and not enough get) I also know of several people who have had this same procedure done. They have rapidly lost the weight but eventually regained it later in life.

I know M. is well aware of the side effects, how his eating habits will change, etc., but as my mom says, "he is ready for this." I know his decision is already made, but I can at least voice my concerns here. I worry about whether it will really change his mindset/lifestyle or whether it is only a temporary solution to the problem. I fear this will only cause an elimination of foods rather than learning to take a moderated approach. Like many people, he's always looked at his failures as a lack of willpower, thus, feeling like if he just wasn't tempted, it would all be better. Therefore, if you take away the ability to eat, he will be thin, happy, and all will be well.

I also fear how this will affect my mother and her eating habits. My mother is not a cook, and I can seriously imagine her just eating peanut butter and jelly sandwiches for dinner or just sleeping through dinner (she is the type who could fall asleep right after work).

The other fear I have was from a poster I read on a board discussing whether the side effects were worth it. The poster said, "I can't eat and enjoy foods like I did preband. That is the only side effect I have . Since that was the whole point of having surgery, I can't complain about it, even though a pain free hamburger sounds good every now and then."

M. has always been a person who has seriously enjoyed food. In all honesty, that's always been one thing I admired about him--that he could enjoy food with all its taste and scrumptiousness. Just like as in anorexia and starvation, I worry that that will be gone for the sake of becoming thin.

At this point, I know I don't have much say, but can only hope for the best. I hope he receives adequate follow-up care and can join a support group. In some ways, I'm not sure M. knows what he is in store for despite saying he does. I hope this won't be about restriction but instead incorporating a more healthy lifestyle, e.g. adding in some moderate exercise. Though I sit on the fence with this approach, I hope it works for him, especially from a medical standpoint. Because in reality, I can only imagine what he might feel for himself if it doesn't. A FAIL. And that just continues the cycle all over.

Note--*I hope I do not offend anyone reading this post who may have had lap band or gastric bypass surgery. I know everyone must make their own decision which they feel is best for themselves. I also realize that my perception may be clouded by years of eating disorder abuse. I'm also hoping that I do not come off as judgmental, because I'm truly not trying to be.

Needs in recovery

While I'm on the subject of Dr. Jill Bolte Taylor whom I meant to post about more (I wrote a recovery quote awhile back from her) but never got around to, there is a chapter in her book called "what I needed most" [to recover] I won't write every single one out, but the ones I think most pertinent to eating disorder recovery.

I desperately needed people to treat me as though I would recover completely. This is so true. I think it is important to have people who continually believe in us even when the chips are down, we're in an utterly poor state of malfunctioning, or even when are at a high state of functioning, thinking this may be as good as it gets. I know it has been vital for me to have people like this around me, especially during the times when I think I will never recover.

I needed people to love me--not for the person I had been, but for who I might now become. Even though many eating disorders have a biological basis for development, I think eating disorders will inherently change who you are and how you perceive the world. For some of us, recovery means rediscovering our abilities we may have lost or discontinued. For others it is about discovering new parts of us we never knew we had. Therefore, people need to be patient at the process of recovery. It isn't easy!

I needed those around me to be encouraging. I needed to know that I still had value. I needed to have dreams to work toward. Although it is sometimes hard to look beyond the horizon when depressed, anxious, etc., I do think having motivations to look forward to are important in recovery. It's also important to feel valued, as that can easily become a non-existent feeling when malnourished, depressed, or both.

I had to define my priorities for what I wanted to get back the most and not waste energy on other things. Setting priorities for recovery can be a good thing. Recovery is often frustrating, and sometimes when we put too many things at once on our plate, it gets overwhelming. So I don't look at it as wasting energy on lesser valued priorities, but that they may not be the strongest focus at that point. It doesn't mean to let them go completely, just to set it aside for a moment.

I needed people to celebrate the triumphs I made everyday because my successes, no matter how small, inspired me. Sometimes, this can be difficult for those on the outside of eating disorders. It's like :"so you ate a sandwich." Some may see it as not a big deal, but to others who know how we have struggled, it can be a BIG deal. What's important is to not reach a point of complacency but to further on in your recovery as each thing we conquer can be inspiration for the next goal.

A few things Taylor says were integral to her stroke recovery:

I made the cognitive choice to stay out of my own way during the process of recovery. I found the way she said this interesting. For her it was about trying new things. Some were successful while others were not. Therefore, it was important for her to monitor her self-talk which also meant welcoming support and help from others. In ED recovery, we can easily get discouraged with our hits and misses, so it is vital that we have patience and not denigrate ourselves. I think we can all agree on the aspect of the importance of a support system.

My successful recovery was completely dependent on my ability to break every task down into smaller and simpler steps of action. Most of us have heard this before, but I think it is important to remind ourselves that small and simple is okay. Each success is a building block for a foundation.

And lastly, Taylor says, "I may not be in total control of what happens to my life, but I certainly am in charge of how I choose to perceive my experience."

None of these things she's mentioned are rocket science, but they are good reminders for ourselves and others. What are other things you have needed from other people or from yourself in recovery?

Note: *If you haven't read her book, I recommend it. I especially like how she talks about both hemispheres of the brain and their functions. As many of us have "left-brain" tendencies, recovery becomes about being attuned with the "right-brain" side as well. In the end, it means to strive for a more "balanced" brain.

90 seconds of emotion

Karen Koenig, psychotherapist and author of the Rules of Normal Eating, recently wrote a post about what Dr. Jill Bolte Taylor calls the "90 second emotion rule." The idea is that it takes 90 seconds or less for each emotion to be automatically triggered, surge through the body, and dissipated. Once the emotion (chemical component) is gone physiologically, it then becomes a choice to continue as she puts it the "neurocircuitry" to run or not. In this sense, we become more attuned to the emotion in the current moment versus continuously cruising on autopilot. We become aware to what we are feeling, learning to yes, choose whether to take it, leave it , or change it.

Now, of course, I don't want to go all cognitive-behavioral on everyone as there is sometimes a tendency to feel skeptical (even by me at times), but I think this kind of awareness is important, especially with eating disorders. I think once in a nutritionally stable state, this can be something to work towards. Too often than not, most of us want to shoo away the bad feelings, to pound down whatever it is we are feeling period. I certainly remember those times when I'd tell my therapist, "Why do I have to feel? What's the point? Can't I be a human without emotions?" But that's the thing, the essence of humanity is to have high functioning feelings. It's what distinguishes us from other species, though of course animals do feel and have emotions too.

So do you let yourself sit with an emotion for 90 seconds? If not, maybe it is something to try?

If you're unaware of who Dr. Jill Bolte Taylor is, take a look at her TED presentation about her insights into her own stroke. She wrote a book called My Stroke of Insight about her stroke and her recovery in 2006. It is an amazing book which I found quite relatable to eating disorder recovery.

Honest Scraps--10 more trivial facts about me

Kim so kindly tagged me for the Honest Scrap award. If you have not visited her blog, I suggest you do so. She has lots of great insights about life and recovery. Thanks Kim!

Here's the description: This award is bestowed on a fellow blogger whose blog content or design is, in the giver's opinion, brilliant. This award is about bloggers who post from their heart, who often put their heart on display as they write. There are three rules that need to be followed on accepting this award:

1. Brag about it. 2. Select seven blogs you find brilliant and link to them. 3. List 10 honest things about yourself.

As other bloggers who have received this award, I'm not into bragging about myself, but I will give some other quirks/facts/etc. about me.

*Although I love animals now, when I was younger, I was not always nice to them. I pulled one of our cat's tails once and hugged two of our dogs. I quickly learned hugging was not the way to go with dogs as they both bit the barrettes in my hair which caused my head to bleed everywhere and required stitches.

*My first English word was "kitty."

*One time when I was very young, I refused to come downstairs for dinner. My parents could not figure out why and our communication skills were lacking at that point. Through a picture book, I pointed to black patton leather shoes. My father had to go on a shopping spree on a Sunday night looking for patton leather shoes. Once he did, I put them on, and came downstairs to eat. Apparently, I recognized at an early age that fashion was important. My dress did not go with my little red sneakers, only patton leather ones.

*I continue to be an animal cracker addict and think they should become their own food group. ;-)

*I am a horrible "picker" of sorts as well as a nail biter. I pick scabs, acne, blisters, anything that looks out of place. It's not always the best thing either. I guess that's part of the impatience problem I have with certain things. With nails biting, it's worst when I'm really stressed, sitting in traffic, panicked, or overly worried.

*As many young girls, I used to think I was going to become an Olympic gymnast. That eventually turned into just an elite, and then reality sunk in that that would never happen period.

*I once had a boy not go out with me, because he was afraid I would beat him up if anything went wrong. I really have no clue where he even got this idea.

*In high school and college, I was very big into color coding my notes. I used to use a different color ink for every subject, thinking this would help me remember better.

*For as long as I can remember, I have always been a gum chewer.

*Though my self-esteem is low a lot, I still hold out hope that one day I will find true love, happiness, and finally, feel fulfilled.

Other quirks of me can be found here

Bloggers:

ED Bites
A Heart Tied with a String is a Pretty Thing
More than My Bones
Sunday Confessional
Pratfalls, though I know she is on break right now
Surfacing After Silence
Live your Ideal Life

I of course extend this out to anyone else who wants to participate. I think the majority of people who write blogs write with honesty and share a part of their world with so many others. It's truly amazing at how many wonderful people there are.

Change is in the air

The last few days have truly been a whirlwind. I have so many big decisions to make/do that it is all terrifying to me. I've learned that no matter whether a transition will be positive or negative, I will still feel stressed and overwhelmed. Up until this point, there was still a feeling of "well, you can always change your mind." Now, there is no turning back, this is really real and going to happen. True, I know there is always the possibility to change my mind, but I really have to force myself to think this way. Otherwise, I will only have self doubts and second guess my decisions.

What I have to remember is this: “The only wrong thing is to do nothing.” This was a quote from the "Greater Good" 100th episode of House said by Dana Miller, a patient who had come to the hospital after collapsing. We find out later that Dana was actually a prominent cancer researcher now turned chef.

When Wilson, House's best friend and an oncology doctor, asks her how she could have left her renowned position as a researcher to be a chef, her simple answer was that she wanted to be happy, that she needed a change in her life. This episode revolves around this theme as all the cast members have to re-evaluate what makes them happy.

For Wilson, his happiness had been swept away by the death of his girlfriend, Amber. He remained stuck, not moving on, keeping the apartment just as it had been from the time she had died, including never washing a mug of hers. By the end of the episode, he decides to make a change and wash the mug.

This is just the condensed version, but it's a good episode, looking at this idea of happiness.

In my own life, I think about happiness quite a lot. It's always been a concept that has just felt out of reach due to my own sabotage and self-esteem. I somehow have this fear that my happiness will never be real, that it will be jinxed if I think I am happy. (illogical thinking I know) I wonder if this change will bring about happiness?

Change is so scary. Everything is new, different, the familiarity gone. Sometimes, I think of my life (or I should say others might describe it this way) as the decision-making process to move a piece on a chess board. There I am waiting, waiting, waiting to make a move, the best move, the right time, the move with the maximum security, the maximum chance at winning, thinking, thinking. But no move at all. I remain stuck there--too afraid, too fearful which way is the right way, the best way, the least scary way, the least disappointing way if something should fail. But at some point, I have to move my chess piece. I have to keep making those decisions to get to the other side of the board and reach "check mate." Because otherwise, I will forever just be sitting there like that chess piece.

Note--*At some point, I'd really like to give more background history. I cannot at this time but have thought in the next several months to make the blog private for a few days. I'd switch back to private and delete those posts. Does this make sense or does that seem stupid?

Recap of House episode

Looking at red

I feel like I'm always apologizing for lack of posts. If it seems it is one thing, it turns into another. Right now, my dad is visiting and brought me my new car! Woot! It's a Honda-CRV which will fit all my dogs! It's interesting, because it is a year older than my Malibu but in pristine condition with less mileage. Plus, the tires are new, and it is all-wheel drive which is very nice.

There are definitely things I have to get used to like my gear shifts on a steering column, the window buttons not located on the window, no automatic lights (I really miss that feature), and locking the driver's side door with a key versus automatically locking all the doors. Obviously, these are just nit picky things that I'll get used to over time.

The biggest one, however, is that it is RED. I've never really been a "red" person. If I were to describe anyone who was a "red" person, it would be my dad. He has all those characteristics you normally think of as red--passion, anger, confidence, lust, love, desire, beauty, intensity. Me, nope, not in those sense of blaringly loud. Honestly, I would not have picked red, and my father said he would not have either, but that it looked so good.

If you look at the symbolism of red, it is so varied with both positive and negative connotations. I won't go through all of them, because there are many from historical, religious, mythical, medical, political, cultural, etc. The one that stands out most to me is that RED draws attention. It's one reason why it is used for stop signs.

I have a funny relationship with being visible. There were certainly times in my life when I wanted to be visible but no one saw me, while there were other times when I just wanted to disappear. It's always been a kind of tug of war. Yes, I wanted acknowledgement but shrunk back when I received it. I'd often play my modesty card, always afraid of accepting an award, a trophy, a medal, a line in the paper as unworthy of it. As I got older, I wouldn't say I was content with being in the background, but maybe it felt safer there.

In looking at it from the point of the eating disorder, being thin made me stand out. People asked how I could do this or that and maintain that type of figure. With bulimia, there was less of a disappearance and more of a blending in which made it more difficult to be recognized, though the majority of my ED was as a bulimic.

I'm not sure how this all ties in really, and it's probably just a conceptual idea that I'm over analyzing. I guess I ask myself whether I can turn into a "red" person. I've always considered myself as "blue." Maybe I can just take the good parts of what red means and leave the rest. Certainly, confidence, fully of energy, strength, power, love can all be positive qualities. Maybe, in time and as bizarre as it sounds this car will play a role in learning to be a little more "red."

Give yourself a chance

Several weeks ago, C., my therapist, said to me, "You never give yourself a chance." At the time, this statement was in context to a discussion on my sleeping habits which has been an issue for a long time. We tend to disagree slightly on how and why my sleeping habits are the way they are. C. looks at it as more of a self-care issue, whereas I see it as "I don't need as much sleep" as other people (this study looks at a genetic basis for those who need less sleep than other people) and as a pure habit, like biting my fingernails. (this is despite the evidence which suggests that I probably am sleep deprived) She tells me that whenever I decide to change that behavior, she'll be there with open arms (sleep is one of her specialties)

It's not really that I haven't tried changing my sleeping habits, it's rather that I've tried it, but then come to the conclusion that it doesn't work. This would make complete sense if I actually gave myself the chance to really determine if it would work through a lengthy duration rather than say oh a few days or week. The other scenario is that I've tried it, it works for awhile, and then slowly I fall back into my old ways. I find this type of pattern also intercedes into other areas of my life. Take for example medications. I admit to being incredibly impatient. Like many people, if I take something, I want to see the effects work NOW, not wait and twiddle around, tweaking the dosages ad nauseum. If I actually decide to take a medication, I have been known to take myself off of them. Yes, that was not wise all the time, but I either a) felt it was worthless and made no difference or b) I was actually feeling better (now of course, this couldn't be the medication was my thinking) Failed logic yes.

Besides medications and sleep, there are other issues that come to mind: gaining weight/weight maintenance, recovery, taking risks in life, etc. I think a lot of people may feel similar, so I won't go into elaborate details but the same kind of pattern exists. We have fears and are afraid to deviate from the familiar. We get used to feeling/behaving one way even if we know there is something better beyond the horizon. I know for me, another major issue is fear of disappointment, especially at certain times about recovery (Carrie wrote an excellent post about the meaning of recovery) It's one reason why there are still times when I feel jaded about life and try to keep anything that I really do want in life (relationships, dating, etc) low key with no expectations.

So I pose the question, how many of us really give ourselves a chance? And if you don't, what are your fears? What would giving yourself a chance entail?

Note--* I'm not against medications when you really need them, I just have a difficult time when it comes to me. You can read more about my medication dilemmas here and here
*Sometimes, I find this incredibly ironic, because I have super skills with being patient in other areas of my life, like dog training, people, learning something interesting, etc.

How beliefs are so hard to change

The next few posts will be on thoughts from my therapy appointments. Ahh, C., my therapist, says interesting words which always prove to be food for thought.

I've talked about how one of my goals this year was working on trauma-related issues from the past. It's a cognitive behavioral approach which I do think can be effective at times. We've put aside working on this since there were a lot of other issues which felt more pertinent to me at the time.

Currently, I'm working on the continuance of challenging my belief system through a series of questions/answers, exercises in ways of thinking differently, as well as going through emotional feelings, etc, you know all the CBT stuff. We went over my last assignment which I admit I probably should have worked on more. As I was reading my list of beliefs, saying them aloud, and answering the module questions, I suddenly felt very frustrated. At this point, I just wanted to shut my notebook, throw my hands in the air, and say how this was all stupid. I told C. "you know I know all these beliefs are irrational."

Her reply was, "Okay, this might be true that you know these beliefs are irrational, but how much do you really try to change them?"

Okay, I guess she got me there. That keyword of change. I don't know how much I am trying to do that, honestly. Well, I am, but right now my emotions don't feel as intense, therefore, there is a lackluster approach to feel the need for necessary change. And as horrible as it sounds, sometimes, I feel like putting myself in a situation where that type of trauma occurred, just so I could truly feel those emotions again. However, my logical side kicks in knowing that could be harmful and lead to possible irreparable damage. (this reminds me quite a bit of the parallels ED)

So going back to beliefs and change. How much do we do this with eating disorders? Obviously, that is part of the emotional point of treatment and recovery. I run across so many eating disordered individuals who all know so many things rationally, but I think have such a difficulty in really feeling and changing their beliefs about themselves. Most of them could tell anyone else how whatever feeling, behavior, etc, was irrational, but however, when it is about them, the rules somehow change, they are different (myself included here) A friend of mine often tells me when I am spouting out my justifications for ED this or that, "Do you hear yourself?" It actually does give me pause to think. Still though, why do we have to be our own worst critic?

I guess I'm feeling slightly frustrated with myself for having difficulty with this and not trying as hard as I could be, knowing that if I don't work on it now, it will only continue to bite me in the ass time and time again. :sigh:

Results and relief!

Just to quickly update everyone. I received Baxter's biopsy results today. They came much faster than I expected. Overall, it is GREAT news. He is a Grade 2 with a mitotic index of less than 1. Grade 2 means "intermediately differentiated cells with potential for local invasion and moderate metastatic behavior." (wikipedia)

According to my vet and other canine articles, the mitotic index, "the ratio of the number of cells undergoing mitosis (cell division) to the number of cells not undergoing mitosis (in a population), is actually more important and predictive of survival of mast cell tumors of canines.

Since Baxter's was so low, it is a good prognosis for him. Had the mitotic value been 5 or higher, it would not have mattered what the grade was. So for now, no treatment is warranted since the tumor was fully excised.

This is all a great relief to me, as I was highly concerned Baxter might have a poor prognosis.

Thank you for all your support--those who commented, sent good vibes our way, or just thought of Baxter. It's times like these when you are reminded just how much your pet means, and that things can turn awry quickly.

Variety of photos from the week

More posts to be written soon, but here are some random photos and videos from the past few weeks. Right now, I'm having an insect fetish, so I keep taking close up pictures.

I think this is a great green bush cricket Video of how loud it was

Not sure what kind of bug this is












Grasshopper

Baxter's sutures









Yellow Watermelon



Elvis

Cute video of Bischon Elvis and Tovah playing. Note at the end, when Tovah is running towards the camera, barking, it is because she sees me from the window.

Art and DID

Super tired but read this article on a woman, Kim Noble of London, with DID. She is using art as a way of therapy to help cope with her 12 different personalities. She says that "Painting is a way that some of the personalities can come together so it has really helped me. It is something many of them have in common and a way for them to bond".

Her artwork is incredibly interesting--all very distinct. One personality has anorexia, so a painting of her perceptions of reality and the mirror is shown. Apparently, a documentary is in the work and set to air next year.

Personally, I haven't had that much exposure to art therapy, and honestly, I am a horrible drawer, painter, etc. I know the point is not how good you are at it, but that type of art was never for me. However, art therapy does help many individuals in dealing with pain, grief, and other mental health issues. Just like many of us use metaphors for explaining how we feel, art is similar but on a visual scale.

Do any of you do art (I know several bloggers off the top of my head)? Is it for therapy, personal expression or something different?

Bad day but good karma seems to exist

I hate to sound whiny in this post, but I just need to sort of vent. It was just one of those days where things seemed to go from worse to even worse. First, I woke up to major thunderstorms. The thunder was so loud and the vibration so jarring that it perked up my deaf dog's ears, Daphne. Tovah barked, not sure what the sound was or where it was coming from. To a dog, thunder must be a very puzzling noise from above.

I had my physical therapy appointment for my neck which does seem to be improving, though deep tissue massage is quite painful! Afterwards, I took Baxter to the vet to get some boils/cysts on his stub and new lumps looked at. The boils which turned into cysts looked like they could either be drained or removed. But this other lump was suspicious to me as the size seemed to change, Baxter was licking at it some, and it was not very detached from the skin like a fatty tumor.

The vet did a needle aspiration and looked at it under the microscope. Suspicion confirmed: it is a mast cell tumor. MCTs are common in dogs and very prevalent in Boxers, though they do seem to have a lower grade. Thursday, he will get that removed, a biopsy done, and sent to histology for staging. I am hopeful it will only be a stage 1. Though my demeanor has always been to wait until a firm diagnosis and prognosis is made, it is still hard to think that this could be potentially harmful for my furkid. I already have some thoughts as to course of treatment if it is greater than a stage 1 which includes a more holistic/complimentary approach through supplements and nutrition, as well as necessary short-term medication if needed.

The rain continued all day. In the afternoon, I lost power for a few hours. By the time, I left for work in the afternoon, I had forgotten how high the water could get, especially on country roads where I live. I hit some major water problems and almost panicked at the thought that my car was not going to get through the water. I called my boss and told her I'd try to get to work, but it was no guarantee. Every route I tried was blocked with water. Then, I could not get home and had to sit with several other cars waiting for the water to recede.

One water blockage had receded, and I got the gumption to try it after seeing another car my size go through okay. The second one, however, was deeper, and all I could do was hold my breath that my car would not stall. Weather conditions like this or snow/sleet while driivng just panic me.

I got home, and within a few minutes, the power came back on. So, I guess I had some good karma.

Rundown of crappyness today:
Lots of rain/thunder/lightning
Baxter's MCT
Me not eating breakfast
Weather causing major flood problems, almost not getting home
Power out

Rundown of positives:
We did need the rain, maybe not quite tihs much though.
Baxter didn't shed all over the place at the vet's. It's not his favorite tihng, and he shakes, sheds, and pants
I ate lunch and a snack later, so my day was not ruind by not eating breakfast
My car got through the flood puddle
A neighbor from up the road was courteous enough to follow behind me as I drove through the water to make sure I was okay.
Power came back on

Whew, it's been a long day. Now, I need to go work on therapy stuff, write a blog post for another blog, book tickets for a flight, and call a friend later tonight.

Race, eating disorders, and a new controversial book cover

I think most of us reading this blog or other eating disorder blogs agree that eating disorders do not discriminate. They affect different races, cultures, and ethnicities. This is truly not new news. I remember nearly ten years ago, there were studies looking at ethnic/racial proclivities towards eating disorders. I was even featured in a Washington Post article about it (sorry, can only read the first few paragraphs as it is archived). So to me, it seems a bit crazy that people continue to not "get" it.

Recently, there have been articles and studies about the increasing or rather "out of the closet" phenomena that African-American/black men and women are also affected by eating disorders. For a long time, people just thought this group of people were immune to eating disorders. They believed that African-Americans' definition of beauty was different--that curvaceousness was the more appeasing aesthetic. And that this would somehow protect them from ever developing an eating disorder.

Oh how wrong people can be. In a culture where thinness is prided, there is bound to be a cultural shift. In this 2005 New York Times, it explains how blacks join the eating disorder mainstream. From there, there have been other studies showing the prevalence of eating disorders among this population. Most recently, a study from USC showed that African-American girls were 50% more likely to develop bulimia than their white counterparts, especially those within the lowest income bracket.

Obviously, this is a problem. It is great that research is looking at this population. However, I think there is still a lack of personal story, biography, memoir for this specific group of people. Many times this can be helpful for sufferers to feel less alone.

This is where Stephanie Covington Armstrong comes in. Stephanie, a playwright and screenwriter in CA, has written a new memoir, Not All Black Girls Know How to Eat on her struggle with bulimia. I had not even heard of this book until I read this LA Times Blog asking if this book cover went terribly wrong.

The opinions vary with some feeling it is too graphic, while others feel it it blunt, raw, and to the point. Others say they never would have even guessed the symbolism of the cover had the controversy been stirred. I'm not exactly sure how to feel about the cover. To me, it is on the graphic side, but at the same time, it puts the disorder out there. (or at least one form of bulimia)

I have not read this book, so I cannot say whether it is good, triggering, provocative, etc. But what I am glad about is that there is now a book for this audience. Even though there have been tons of memoirs on eating disorders, people often want to feel a sense of understanding, and sometimes that happens to be because of race or ethnicity. In the end, my hope is that people do not judge the cover of the book, but rather the contents. After all, that is all what we want eating disordered or not.

Note--*Here is a transcript by NPR about African-Americans and eating disorders.