Experimenting again! The one from last week didn’t seem to light anyone’s fire (going to www.womenssurvivalguide.com under Blog Photos to see the extra photos with comments). That’s not to say I won’t do a photo essay again. I enjoyed putting it together. But, maybe doing a “thread” for this edition to answer questions and hear comments would be helpful and interesting. So, I will start a thread for my first time ever for you, dear reader.
I sat on my door step in Boston today and a group of tourists walked by. This happens a lot as we live in a historic area and it’s Summer. I like to sit on the steps and let our dog, Gidget, wander around, sniffing all her “wee-mail.” Gidget is a 20 pound Havanese and she is pretty adorable. The tourists always want to pet her and sometimes Gidget lets them and sometimes she growls. That always surprises people. She’s so cute and then she snarls.
Anyway, the tourists usually say how much they miss their dog back home when they see her, as this woman did today. They need a dog snuggle. I had the same experience recently in Greece where I was the tourist but there wasn’t an abundance of dogs. When I did see a pet-able dog, I went for it. I needed to feel the soft fur and sweet eyes of an unbiased, people pleasing pet. But why? I know I am not alone in wanting to pet a random animal. I guess people can be like that with little kids, too. The whole head patting thing. Anyone ever have a total stranger pat their super pregnant belly? How weird was that?! So, patting a strange dog isn’t really so bad, at least in comparison.
Thinking about pets for a moment. People have had pets for thousands of years. It’s fun to think about pets and their level of importance in our lives. In Ancient Greece, 7000 BC and on, they were very big on pet ownership, as were the Romans. The Dark ages were rough on pets. Cats had a hit out on them from Pope Gregory (1227-1241) who thought they embodied Satan. Imagine what happened to the rodent population after he killed all the cats.
There were wealthy Roman businessmen and politicians who had eels they were smitten with. The eels would come to the side of their tank when they heard their owner. They decorated their favorite eels with gold jewelry (weird). They publicly mourned when the eel died and were occasionally mocked for it. The Egyptians loved animals, especially cats. Looking into it a bit, these long ago people had pets for the same reasons we do, save for the dark ages when pets were utilitarian, apparently. But, I’m sure they loved their Fido’s and Snowball’s just as much as we do now.
In modern times, we have almost a hysterical need for pet ownership. Here is what the CDC has to say about pets from their website:
“There are many health benefits of owning a pet. They can increase opportunities to exercise, get outside, and socialize. Regular walking or playing with pets can decrease blood pressure, cholesterol levels, and triglyceride levels. Pets can help manage loneliness and depression by giving us companionship. Most households in the United States have at least one pet.
Studies have shown that the bond between people and their pets can increase fitness, lower stress, and bring happiness to their owners.” It goes on and on for a page.
I agree! Dog Snuggle!!
FYI: Popular names for dogs in antiquity, translated from Greek, include Lurcher, Whitey, Blackie, Tawny, Blue, Blossom, Keeper, Fencer, Butcher, Spoiler, Hasty, Hurry, Stubborn, Yelp, Tracker, Dash, Happy, Jolly, Trooper, Rockdove, Growler, Fury, Riot, Lance, Pell-Mell, Plucky, Killer, Crafty, Swift, and Dagger (from the Smithsonian Magazine).
Onward.
This week, I am delving into the eating disorder world with Michelle Felton. It’s an intense place. Often misunderstood and definitely underestimated in its serious physical health effects.
One of the big take-aways I got from interviewing Michelle and reading the articles I have attached is that the eating disorder is not a choice for most. Researchers can see from brain scans the physical differences in how a healthy brain responds to reward stimulants and how a brain Prone to eating disorders responds. Here is a quote from one article on malnourishment and the brain:
“The brains of those with and recovered from anorexia have subtle but impactful differences from those who have never struggled with the disorder. The brains of people with anorexia have a different reward response, react differently to feedback, and have altered serotonin pathways.
These differences are found not just in people who are actively anorexic but also in people long recovered from the disease. So nobody is certain if these neurobiological differences are present before someone becomes anorexic and are physical predictors of the illness or if these neurobiological differences are “scars” from prolonged starvation.” “How Malnourishment Affects the Brain: Research on Anorexia and Neurobiology” Eating Disorder Hope.com
So when people tell someone with this disease to just eat, it isn’t the answer. Though, food is the pathway and the “medicine” to recovery, it’s true. It sounds like the best hope is to treat the underlying anxiety or trauma through therapy and medication. However, it also sounds like the current treatments really aren’t the ultimate answer if the disease is hardwired in the brain. This interview leaves more questions than answers in many ways.
Maven of the Week! Michelle Felton
Michelle is a licensed mental health care counsellor specializing in eating disorders and a consultant for the day program at Monte Nido in Boston, MA. Until recently Michelle was the clinical director at Monte Nido and for several years she had a private practice, as well. She left to commit herself to Monte Nido full time, but quickly realized she wanted something different as higher up the job ladder at Monte Nido meant more management focus which meant being farther away from patient contact, which is why she does what she does. Now she is in full time private practice and a consultant supervising licensure at Monte Nido. (LMHC (licensed mental health care) counsellors in MA you have to be three years post licensure to supervise even if you’ve been licensed in another state).
How did you become interested in eating disorders?
In college I was an athlete, a mid-distance runner and high jumper and was exposed to eating disorders for the first time. Some teammates were restricting meals and purging with the belief that lighter was better/faster. Inevitably, what really happened was fatigue and injury. As a high school student her team looked at food as a positive, unifying culture. The pre-meet pasta meals were an important team bonding event.
What changed between high school sports and college?
More pressure, more running. Two times a day practice, increase in exercise and at 18 kids didn’t know how to properly fuel their bodies. There would be an unintentional loss of weight and it would affect their brains and how they viewed food/performance. They would make a correlation that lighter meant better performance, even though ultimately, it wouldn’t. The initial success fueled the weight loss process until there was a tipping point. The athlete, under fueled and their brain malfunctioning due to lack of food, needs rest and food. The athlete crashes and underperforms at best, at worst has a heart attack and and ends up in the hospital or up dead. (Heart disorders are a common side effect of eating disorders and how they become deadly).
How would you explain what an eating disorder is to someone who doesn’t understand them?
There is a huge mental component (physically the brain) and it is not about the food or the weight. It is a voice for an internal struggle, like serious anxiety, depression or trauma. Once the eating disorder has been adopted as a coping mechanism for the internal struggle, not binging, purging or restricting creates extreme anxiety. The eating disorder makes them feel they are in control. There is a drive for perfectionism. Many of the typical eating disorder patients are extremely bright and high functioning. Unfortunately, for recovery, it isn’t as simple as just eating. If it were that simple I wouldn’t have a job.
Is there a difference in telehealth versus in person?
Yes, but not necessarily a negative one. It’s different. You have to know how to engage someone. Adolescents need to be engaged anyway. It can be like the adage of kids telling you more in the car not looking at you than sitting face to face.
Does telehealth affect the quality of the therapy?
It is a different skill set, I think it is an advantage and that people will learn to do both, in person and online. One advantage of telehealth is access to care. It can be easier for clients to get to appointments and for people to have access to specialists who might not have had that before.
Eating disorder and the effect on the brain
Please see this article: “Eating disorder behaviors alter reward response in the brain,” NIH.com
Shift in mood, decrease concentration, sleep disturbances, preoccupation with food, preoccupation with exercise, increase rigidity around food.
Eating disorder and the effect on the body
Please see this article: “Health Consequences,” Eating Disorder Foundation .org
There are many different effects an eating disorder can have on the body but typically what doctors and specialist look for are orthostatic vitals, mood swings, dizziness when going from sitting to standing, lower heart rate, abnormal labs (typically, electrolytes), loss of bone density, loss of menstruation in women and decreased testosterone in men and decreased muscle strength.
What sorts of things do ED people do as far as food goes ?
They abuse caffeine, make smoothies because they are full of bubbles that make them feel full. Only eating dinners, restricting what they eat (no carbs, sugars, meat). Suddenly developing a cooking hobby, eating “healthy food” like salmon and sweet potato but without any additional sauces and that is the only real food they have actually had all day. Going to the bathroom right after meals or snacks, eating in secret, hiding food, moving food around the plate but not actually eating it. New food allergies that don’t actually have medical support. Laxatives, even though they don’t actually do anything but dehydrate you.
Are there more people with eating disorders now?
I think there is more awareness, though yes, I also think they are more prevalent. To blame is the usual culprit, the Internet. Social Media and searches online for how to lose weight, or how to purge. If someone is genetically predisposed to eating disorders, trying to restrict or purge can become a real problem. And, Yes, they are genetic. If you have a family member with anorexia you are 11 times more likely to develop an eating disorder. For kids who try them and are not predisposed, it may not stick as a coping mechanism.
What does recovery look like?
The eating disorder takes on a personality of its own with power over the person hosting them. Recovery is perceived by their eating disorder as failure. It is extremely difficult to recover the brain, feed the brain, enough to combat the power of the eating disorder. It’s a circular argument, the brain isn’t thinking reasonably and needs food, but the brain isn’t thinking reasonably because it needs food and so on. The eating disorder might as well have a name because it acts as though it is in control of the patient and keeps them under it’s thumb by convincing them they are nothing without the eating disorder, or they are weak and unworthy. See this article: The Brain and Anorexia
Someone who has recovered is free to eat and has no shame about what they are eating or how much. They do not think about calories and fat. Someone who has not recovered is thinking when can I binge. When should I restrict if I eat what is in front of me now to look normal in front of people. How much more will I need to exercise if I eat what is in front of me?
To recover, a person needs to challenge the eating disorder voice inside of them. When the ED voice says shameful things, they need to be countered by the healthy brain that says “I need those carbs so my brain can combat the eating disorder.” The ED voice gets stronger and meaner as the brain recovers. This is normal.
Have eating disorders always been with us?
Eating disorders have been around through history, but now there is a voice for recovery and an awareness that didn’t exist until recently. We as adults have to be aware of the messages we are delivering to our kids. The thin body and the idea of success and a good life, as an ideal. Healthy is not necessarily thin. Nor is success connected to weight. Or happiness. Kids pick up on our biases. How do we prioritize our time? Do we exercise all the time, obsessively? How do we speak about food? Using the terms “good” and “bad” connected with food stigmatizes them with behavioral qualities. Just say “let’s have more or this and less of that” as far as food parenting goes.
Is an Eating Disorder contagious?
It depends. An ED is a behavior that doesn’t necessarily stick. Trying it out can come from suggestion (a friend), but a true disorder is genetic. If the person doesn't have a genetic predisposition or an underlying issue the eating disorder behaviors may not be something they adapt into their lives. It’s something parents need to look out for and not be afraid to discuss the way they might with sex, drugs etc.
Are eating disorders mainly a female affliction?
No. The male ED looks different, but it behaves the same. Men aim for different physical goals. But the way they get there is identical to the female ED.
We are focussing on teenage eating disorders, but about middle age and senior eating disorders?
Eating disorders do impact males and females of all ages. For some women they actually develop eating disorders later in life after they have kids. Or have had eating disorders their whole life that have gone not noticed. Unfortunately in treatment you do not see all ages always represented since many people feel a stigma going to treatment once they are older. They also maybe have full time jobs and families that are harder to take time off.
What did you want to be when you grew up?
A nurse or a teacher. I knew I wanted to work with people I just needed to figure out in what capacity. I was a very social kid and could never see myself in a typical office job.
When I first became interested in my profession athletes with eating disorders were not a population taken very seriously. I grew up playing sports and was a high school and college athlete so I felt connected to the population.
What are you excited about now?
I am passionate about working with athletes with eating disorders
What books are on your bedside table?
I am currently reading Malibu Rising. While this is not my typical type of book I read I highly recommend it. The last book I read was The Therapist by B.A. Paris. It was more of a murder/suspense book which I typically read more of.
What do you do to relax?
I love going to the beach! Reading and running.
Thank you.Michelle!
Eating Disorder Resource List
Article you should read: Malnourishment and the Brain:
Another Article about eating disorders and malfunctioning brain circuitry:
Treatment Centers in Massachusetts: Monte Nido, Walden, Renfrew, Klarman at McLean Hospital in Belmont, MA
MEDA, Mass Eating Disorder Association
NEDA, National Eating Disorder Association
IAEDP, International Assoc of ED Professionals
A RECIPE YOU WON’T HATE: Ceviche!
Ceviche!!! I love Ceviche. I’ll find a proper recipe for you detail sticklers out there, but, in general: raw white fish or scallops or shrimp, a lot of lime juice, red onion sliced thin, some jalapeño (optional), cilantro, salt. put in a glass container all together for a few hours in the fridge. The lime juice “cooks” the fish. It is so refreshing. Serve with guac and chips, and drink of choice!!
From Martha Stewart, Why not?
Ingredients
Ingredient Checklist1 1/2 cups fresh lime juice (from 10 limes) 1/2 cup fresh orange juice (from 1 orange) 1 1/4 pounds red snapper fillet, skin removed, flesh cut into 1/4-inch slices 1 avocado, cut into 1/2-inch pieces 1 cup grape tomatoes, halved 1/4 cup thinly sliced red onion 1 small jalapeno, seeded and finely chopped 2 tablespoons roughly chopped fresh cilantro leaves 2 tablespoons extra-virgin olive oil Coarse salt and ground pepper Lime wedges, for serving.
Directions
Step 1
Pour lime juice and orange juice through a sieve set over an 8-inch square glass baking dish. Arrange red snapper fillet in a single layer in dish (fish should be completely covered by juice). Cover with plastic wrap and refrigerate until fish is opaque throughout, about 4 hours. Drain fish well; discard marinade.
Step 2
Divide fish among four plates. In a large bowl, combine avocado, tomatoes, jalapeno, cilantro, and olive oil. Season with salt and pepper. Serve fish topped with avocado salad and lime wedges alongside.
This concludes another fine edition of Women's Survival Guide. I hope you’ve enjoyed it and if you did, I hope you’ll put it on your social media. That would be great.
your friend,
kim