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Friday 30 March 2012

Modelling Effective Parenting

Impulsive Focus

No one said that parenting would be this much fun.  I am going to give you a little insight into two very different people, with the same genetic codes.

The scenario: a warm, sunny day near the end of term at school.  A group of teenagers are hanging around in the corridor waiting for lessons to start.  They are bored, restless and acting in a pack.  One girl is hovering with her hand over the Fire Alarm button, saying "Dare me?"

Person 1: Should I push the button?  Should I?  What would happen if I did?  The alarm would go off and school would be disrupted, the staff would get angry and try to find out who did it.  What if someone told it was me?  What if people hate me enough to get me into trouble?  The staff would be really cross.  I would get a lecture.  They might even suspend me, or phone my parents, or put me in detention or something.  Then, I would be in real trouble and everyone would think I am an idiot.  What if I got suspended?  I would miss my lessons and get behind.  This might mean I wouldn't get the grades I want because the questions in the exams are bound to be about the stuff I missed.  So, no, I'll just walk away.

Person 2: "I'll just press the button. LOL"

Wednesday 28 March 2012

Dieting for children a la Vogue

This blog post inspired me.

Vogue Magazine’s Irresponisble Story on a Child’s Weight Loss Diet (7 years old)

     By Evelyn Tribole, MS, RD
Unbelievable. Disturbing. The April issue of Vogue magazine prominently features a cover story about a mother who puts her 7-year old child on a weight loss diet, triggered by the pediatrician classifying her as obese.
The mother acknowledges her own disordered eating issues, with 30 years of dieting, with self-described “dabbling with the occasional laxative or emetic”. She even admits, “I like that the word [obesity], carries a scary diagnostic tone.” And to fight this scary battle, the mother rigidly policed every morsel of food that enters her daughter’s mouth. For example:
  • When discovering that her daughter ate a high calorie lunch at school, the mother “reproachfully denies her dinner”.
  •  In the case of social settings, “I often derided her for not refusing an inappropriate snack”
  • “I dressed down the Starbucks barista when he professed ignorance…” (of the caloric content of a kids hot chocolate).
      Let me be clear, my criticism is aimed at Vogue magazine’s irresponsibility of publishing such an article. (This is also why I am not using the names of the mother and daughter provided in the story). Not a single expert or health authority was quoted as cautionary source, even though the mother expresses her doubt, worrying at one point, that she might be stunting her daughter’s growth or metabolism. The research is quite clear on this matter:
  • A large 3-year study on nearly 2,000 adolescents found that dieting is the most important predictor of new eating disorders (Patton et al 1999).
  • Eating disorders are deadly.
      Furthermore, dieting appears to be causally linked to both obesity and eating disorders (Haines & Neumark-Sztainer 2006). Dieting is associated with increased food preoccupation, binge eating, and eating in the absence of hunger. A recent study on 2,000 sets of twins ages 16-25, found that dieting itself, independent of genetics, is significantly associated with accelerated weight gain. Furthermore, the risk of becoming overweight increased with each dieting episode (Pietilaineet al, 2011). Similar results were found in a study on nearly 17,000 kids school-age kids, which found that dieting, itself, was a significant predictor of weight gain (Field et al 2003). The risk of binge eating increased 7-12-fold in these young dieters.

      It’s beyond ironic that a fashion magazine would publish a child’s weight loss story in the name of health, when in actuality, they describe how to increase the risk of getting an eating disorder—for which there is no doubt a direct cause of death. Vogue’s ‘war on obesity’ as described by a mother-in-the-trenches, has created a dieting causality for a child, whose photo and story is on public display. The concluding paragraph, the mother reports, “When I ask her if she likes how she looks now, if she’s proud of what she’s accomplished, she says yes.”

      With the ancient practice of Chinese foot binding, women really believed that if they didn't raise daughters with tiny feet, they wouldn't marry into the right family and they would have less status. Many of those girls were in extreme pain from the binding process, and 10% of them died. Today, we have modern day version—pursuit of weight loss, no matter the age, no matter the futility, no matter the danger.
Outraged? Want to take action?  Let Vogue magazine know how you feel about this article:

Another petition

Why This Is Important
For the state of NSW there are currently 2 acute inpatient beds. This has been reduced from the initial & inadequate 4 beds in 2010. With the creation of the National Eating Disorders Coalition in early 2009, the profile of eating disorders was supposed to be raised, yet in this time we have seen a decrease in the number of acute beds available to eating disorders patients in the state of NSW.
Eating disorders have the highest mortality rate of any mental illness; according to The Butterfly Foundation, the mortality rate of anorexia nervosa is 15-20%, with those with anorexia 32 times more likely to suicide than their healthy peers. Statistics for other eating disorders (bulimia nervosa & EDNOS) are poorly researched but outcomes are estimated to be on par with that of anorexia nervosa. The average duration of treatment is 7 years. Eating disorders come in all shapes & sizes. The biomedical approach to care means that patients in the public system are treated when most physically unwell (usually in a state of anorexia nervosa), leaving the illness to most often be treated as a physical illness & not a mental illness. "The health and socio-economic costs are also high with bulimia and anorexia being the 8th and 10th leading causes respectively of burden of disease and injury in young women (18 -24 years) in Australia, measured by disability-adjusted life years (10) and the percentage of disability-adjusted life years associated with eating disorders being comparable to schizophrenia." (The Butterfly Foundation, Eating Disorders Statistics).
The reality is that eating disorders are a mental illness with dire physical consequences. With adequate early intervention, there needn't be a high mortality rate, nor should there be physical complication associated with a mental disorder.

Idiots of the Week

Idiots of the week - it's only Wednesday:

1. Jenny Craig for their "Healthy Management Tips for 13-17 year olds".

Wake up people, diets don't work.  This kind of guilty-inducing, self-esteem wrecking peddling of an unobtainable "ideal" for money is just plain wrong.  To my mind, Jenny Craig (and by default Nestle, who own them) are peddling self-harm and self-hate, all wrapped up in a smug package of self-righteousness.

2. Alliance of Girls' Schools, Australia

Perhaps if Jan Butler, Executive Officer of the AGSA had bothered to reply to some of the emails that were sent expressing concern about the CEO of Jenny Craig speaking at their annual conference, then this could have been resolved, without the intervention of media (brilliant cartoon, Sydney Morning Herald!) and a petition.  A little honey catches more flies than vinegar.

3. Everyone who has been so useless here.  A litany of disasters for Batty Matty and her son.

4. My eldest daughter.

Nominations welcome.

Tuesday 27 March 2012

Standing up to the diet industry or David vs Goliath

Taking on big corporations (emphasising our issue is with the corporation Jenny Craig, and not the CEO, Amy Smith) takes courage. Charlotte Bevan, UK, writes from her heart in explaining why:

They never like anything that upsets the status quo or threatens their income stream. 

I think we have to remember that we live in a world where fat – all fat – is bad and we are about to all die of obesity.  No one in the real world seems to get that Jenny Craig (owned by Nestle) is in the business of making money – a lot of money – not in the business of making us happy, healthy bunnies.  Repeat business is what they need to sustain their profit levels and repeat business is what they get from hundreds of thousands of (mainly) women, with their self esteem in shreds, because of a number on a scale.

It is nothing but a number, people.  It is not a measure of physical or mental health.  Whether people are eating disordered or not, this constant bullying by the diet industry, which has no evidence base to support its more preposterous claims of becoming happier by losing half a stone (7 lbs or 3.2 kg), is putting people’s mental health at severe risk and ruining lives.

Jeez, they have more power than the tobacco industry had in the 1960s and PEOPLE BELIEVE THEM.

Some day my prince will come.....

 Do you want to know how to waste your money, shred your self-esteem and make big business more profitable?

The answer?  Go on a weight loss regime - or diet as it is more commonly called.  Firstly, spend a fortune on products from the likes of  Jenny Craig.  These companies are, in turn, owned by huge food conglomerates.  These big businesses make money out of repeat business.  You get the logic.  Psychologically you are setting yourself an impossible task and are doomed to failure - that should help your stress levels.  Oh yes, the big business stuff - why don't you try again and again and again for the whole of your life, buying in to the latest fad of weight loss and spending thousands of pounds over a lifetime, buying in to an impossible dream.

Or you could read carry on watching Cinderella and believe that she and Prince Charming lived happily ever after and never got cross about dirty socks being left on the floor, or the loo seat being left up or his snoring, or her snoring or any of those other minor irritations that ruin the fairytale.

Here's why you shouldn't bother with dieting.  I love this post and have to reblog most of it - my comments are in red.

1. As weight loss programs, diets don't work! Yes, you lose weight, but about 95% of people who lose weight by dieting will regain it in 1-5 years. Since dieting, by definition, is a temporary food plan, it won't work in the long run. Moreover, the deprivation of restrictive diets may lead to a diet-overeat or diet-binge cycle. And since your body doesn't want you to starve, it responds to overly-restrictive diets by slowing your metabolism which of course makes it harder to lose weight. 

Is there no solution then to obesity and eating disorders? Actually there is. We should eat in a way to convince our bodies that they no longer, and will never again, live with famine. That means never go on a reduced calorie diet. Most people should eat more frequent, smaller meals beginning with breakfast. We should eat a diet closer to the one humans evolved with. There are no naturally occurring sweet fats or processed carbohydrates and our bodies don’t regulate as well with them. Follow Michelle Obama’s advice to substitute water for soft drinks, and increase fruits and vegetables. It is easier to do if you stop dieting. Find some physical activities you enjoy and make time for them. And then pray for the grace to accept the body you have. (Shan Guisinger)

2. Fad diets can be harmful. They may lack essential nutrients, for example. Moreover, they teach you nothing about healthy eating. Thus, when you've "completed" your fad diet, you simply boomerang back to the unhealthy eating patterns that caused your weight gain in the first place! This is the beginning of "yo-yo dieting," which can bring its own health problems in its wake.

Last month, The Journal of Adolescent Health reported results from a 10-year study that indicates teenagers who engage in extended cycles of yo-yo dieting end up increasing their body mass index years later: “Specific weight control behaviors used during adolescence that predicted large increases in BMI at 10-year follow-up included skipping meals and reporting eating very little (females and males), use of food substitutes (males), and use of diet pills (females).”

3. Overly restrictive diets can take all the pleasure out of eating! There's no reason to be a sacrificial lamb, so to speak, to lose weight.

 A report in the August issue of the Cell Press journal Cell Metabolism might help to explain why it's so frustratingly difficult to stick to a diet. When we don't eat, hunger-inducing neurons in the brain start eating bits of themselves. That act of self-cannibalism turns up a hunger signal to prompt eating.

4. Dieting, along with the frequent and compulsive weighing that accompanies it, can lead to eating disorders. According to one source, people who diet are 8 times as likely to develop an eating disorder as people who don't.

I think the odds of 8 times more like to develop the most lethal psychiatric disorder there is should give some pause for thought.....

5. Unscrupulous people can peddle "magic weight-loss potions," such as "special" powders and pills, to desperate people, costing them their money and time at best, and fatal health consequences at worse (think "fen-phen," the diet drug that caused often fatal heart valve problems). And have you ever noticed that every diet product claims it will be wondrously effective "if used simultaneously with a healthy diet and regular exercise program?" Skip the magic potions--it's the healthy eating and exercise that are actually the effective ingredients.

As fat blockers like orlistat (Xenical) remove excess fats via the intestines, they may cause uncomfortable cramping, gas and diarrhea. Because these drugs also reduce the body's absorption of essential vitaminsand nutrients, people who take Xenical are advised to take a daily multivitamin supplement.
Sibutramine (Meridia) and other similar appetite suppressants stimulate the sympathetic nervous system, which can raise blood pressure and heart rate. This increases the risk of heart attack and cardiac arrest, especially among people who already suffer from high blood pressure, irregular heartbeat or heart disease. In fact, between February 1998 and March 2003, the FDA received reports of 49 deaths related to sibutramine. Other, more minor side effects include constipation, headache, dry mouth and insomnia (because the chemicals in these drugs also influence sleep patterns).
Herbal diet pills, even though they're "all natural," can have potentially dangerous side effects depending upon their ingredients. "Herbal" doesn't necessarily mean "safe." Also, because they are considered part of the food industry and are therefore regulated differently by the FDA, there is no guarantee that they can live up to their manufacturers' claims.

Monday 26 March 2012

Carers Workshop - Friday 18th May

Friday 18th MAY 2012
Time9.30am - 4.30pm
Venue: The Fitzrovia Room, Park Crescent Conference Centre, International Students House,
229 Great Portland Street London, W1W 5PN
(Opp. Great Portland Street tube station and near Regents Park tube station)
Cost: £80.00 per person.
Earlybird bookings made before Friday 4th May £60.00 per person

Overall aim

Ø  To help carers identify what they can do to help their Loved One and assess whether they achieve their desired outcome.
Ø  To propose and practice communication skills.
Ø  To facilitate the development of an ongoing self-care plan for carers.

The workshop will be interactive and based around Motivational Interviewing Principles. This will give you the chance to practice some of the skills required when looking after someone with an eating disorder. There will be a strong emphasis on:

Robustness and Resilience


09.30-10.00              Arrival

10.00-10.05              Welcome & Housekeeping

10.05-10.15              Introductions & Ground Rules

Ø  Mind Shower - "What I want from the Workshop"

Ø  Brief PowerPoint presentation "Maintaining Factors in Eating Disorders"

Ø  Group Work - What is good about having an Eating Disorder from the sufferers perspective?

Ø  What robust personality characteristics do the sufferers have?

Ø  Eating Disorders an exploration from the Group's Perspective

Ø  Feedback & Discussion

11.45-12.00              Break


Ø  Veronica's story - the importance of change

Ø  Discussion about what hampers change - animal models

Ø  Skills needed to facilitate the change process

Ø  Understanding the psychology of change


13.00- 13.45             Lunch



Ø  Skills practice - OARS exercises

Ø  Group Work: Identifying the problem areas and stumbling blocks versus what works well - Making a plan of what to try next

Ø  How to assess Difficult Behaviours using the ABC analysis

15.15 -15.30                         Break


Ø  Question & Answer

Ø  Feedback

Ø  Close
Veronica Kamerling

Shan Guisinger - Dangers of Dieting

Is there no solution then to obesity and eating disorders? Actually there is. We should eat in a way to convince our bodies that they no longer, and will never again, live with famine. That means never go on a reduced calorie diet. Most people should eat more frequent, smaller meals beginning with breakfast. We should eat a diet closer to the one humans evolved with. There are no naturally occurring sweet fats or processed carbohydrates and our bodies don’t regulate as well with them. Follow Michelle Obama’s advice to substitute water for soft drinks, and increase fruits and vegetables. It is easier to do if you stop dieting. Find some physical activities you enjoy and make time for them. And then pray for the grace to accept the body you have.

To read the full paper, please look here.  Now why can't Shan be presenting at the Girls' School Conference in Melbourne, rather than the CEO of Jenny Craig.

The Good, the Bad and the Ugly

The good was having a giggly conversation with the House of Mutt this morning.  There is something life affirming about someone who reads my blog and agrees with me.  We also agree about teenage daughters and their experimentation with clothes and make up being an important step in growing up and a chance to marvel at their beauty.  (Also, the chance to get to post a picture of Clint....)

The bad is that I have so much to do and only four days to do it in, before the aforementioned teenage daughters finish school and become instantly "bored" and need entertainment/money/lifts/attention.

The ugly was getting involved in a particularly vicious internet debate about Harriet Brown's Brave Girl Eating.  On a personal note, the name calling and the slightly hysterical ranting does not bother me but I know it bothers many who are new to this.  To those who are upset/angry/bothered, I need to quote LPA and post the Fairy Blogmother's favourite cartoon

"I mean seriously, you've got yourself worked up over an internet thread. Calm down." 

Someone Is WRONG On The Internet

Saturday 24 March 2012

Strep and Pandas Part 2

Possible causes of sudden onset OCD in kids broadened

NIH immune-based treatment study underway

 IMAGE: Children with PANS and PANDAS sometimes experience sudden loss of fine motor skills.

Click here for more information.
Criteria for a broadened syndrome of acute onset obsessive compulsive disorder (OCD) have been proposed by a National Institutes of Health scientist and her colleagues. The syndrome, Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), includes children and teens that suddenly develop on-again/off-again OCD symptoms or abnormal eating behaviors, along with other psychiatric symptoms – without any known cause.
PANS expands on Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS), which is limited to a subset of cases traceable to an autoimmune process triggered by a strep infection. A clinical trial testing an immune-based treatment for PANDAS is currently underway at NIH and Yale University (see below).
"Parents will describe children with PANS as overcome by a 'ferocious' onset of obsessive thoughts, compulsive rituals and overwhelming fears ," said Susan Swedo, M.D., of the NIH's National Institute of Mental Health (NIMH), who first characterized PANDAS two decades ago. "Clinicians should consider PANS when children or adolescents present with such acute-onset of OCD or eating restrictions in the absence of a clear link to strep."
Swedo, James Leckman, M.D., of Yale University, and Noel Rose, M.D., Ph.D. of Johns Hopkins University, propose working criteria for PANS in February 2012 in the open source journal Pediatrics & Therapeutics.
"As the field moves toward agreement on this broadened syndrome, affected youth will be more likely to receive appropriate care, regardless of whether they are seen by a neurologist, pediatrician or child psychiatrist," said NIMH Director Thomas R. Insel, M.D.

Differing causes sharing a "common presentation"
The PANS criteria grew out of a PANDAS workshop convened at NIH in July 2010, by the NIMH Pediatric and Developmental Neuroscience Branch, which Swedo heads. It brought together a broad range of researchers, clinicians and advocates. The participants considered all cases of acute-onset OCD, regardless of potential cause.
Clinicians reported that evaluations of more than 400 youth diagnosed with PANDAS confirmed that affected boys outnumbered girls 2:1, with psychiatric symptoms, always including OCD, usually beginning before 8 years.
Although debate continues about the fine points, the field is now of one mind on the core concept of "acute and dramatic" onset of a constellation of psychiatric symptoms. There is also broad agreement on the need for a "centralized registry" that will enable the research community to analyze evidence from studies that will eventually pinpoint causes and treatments. Such a registry is currently under development by members of the International Obsessive Compulsive Foundation (IOCDF).
Since a diagnosis of PANS implies no specific cause, clinicians will have to evaluate and treat each affected youth on a case-by-case basis.
"PANS will likely turn out to include a number of related disorders with different causes that share a common presentation," explained Swedo.
The authors propose that a patient must meet 3 diagnostic criteria for a diagnosis of PANS:
  1. Abrupt, dramatic onset of OCD or anorexia.
  2. Concurrent presence of at least two additional neuropsychiatric symptoms with similarly severe and acute onset. These include: anxiety; mood swings and depression; aggression, irritability and oppositional behaviors; developmental regression; sudden deterioration in school performance or learning abilities; sensory and motor abnormalities; somatic signs and symptoms.
  3. Symptoms are unexplainable by a known neurologic or medical disorder.

  • Among the wide range of accompanying symptoms, children may appear terror stricken or suffer extreme separation anxiety, shift from laughter to tears for no apparent reason, or regress to temper tantrums, "baby talk" or bedwetting. In some cases, their handwriting and other fine motor skills worsen dramatically. Leckman's team at the Yale Child Study Center is in the process of developing assessment tools for diagnosing the syndrome.
    PANDAS treatment study targets errant antibodies
    Meanwhile, Swedo, Leckman, and Madeleine Cunningham of the University of Oklahoma, and colleagues, are collaborating on a new, multi-site placebo-controlled study, testing the effectiveness of intravenous immunoglobulin (IVIG) for reducing OCD symptoms in children with PANDAS.
    Previous human and animal research suggested mechanisms by which strep-triggered antibodies mistakenly attack specific brain circuitry, resulting in obsessional thoughts and compulsive behaviors.
    "Strep bacteria has evolved a kind of camouflage to evade detection by the immune system," Swedo explained. "It does this by displaying molecules on its cell wall that look nearly identical to molecules found in different tissues of the body, including the brain. Eventually, the immune system gets wise to this 'molecular mimicry,' recognizes strep as foreign, and produces antibodies against it; but because of the similarities, the antibodies sometimes react not only with the strep, but also with the mimicked molecules in the human host. Such cross-reactive 'anti-brain' antibodies can cause OCD, tics, and the other neuropsychiatric symptoms of PANDAS."
    IVIG, a medication derived from normal antibodies, neutralizes such harmful antibodies, restoring normal immune function. It is used to treat other autoimmune illnesses and showed promise in a pilot study with PANDAS patients.
    "We predict that IVIG will have striking benefits for OCD and other psychiatric symptoms, and will prove most effective for children who show high levels of anti-brain antibodies when they enter the study," said Swedo.
    Prospective study participants are first screened by phone by investigators at the NIH or the Yale Child Study Center. Those who meet eligibility requirements are then randomized to receive either active IVIG or a placebo procedure during a brief inpatient stay at the NIH Clinical Center. The researchers remain blind to which children received the active medication; after 6 weeks of placebo control, they give any children whose symptoms fail to improve the option to receive open-label active treatment.
    In addition to assaying for antibodies that attack brain cells, the researchers use magnetic resonance imaging to see if the treatment reduces inflammation in an area of the brain known as the basal ganglia, which is thought to be the target of the errant antibodies. They also analyze levels of immune system chemical messengers (cytokines) in cerebrospinal fluid and blood – with an eye to identifying biomarkers of disease activity and potential predictors of treatment response.
    The study was launched with support from the NIH Clinical Center's Bench to Bedside program, which encourages such intramural-extramural collaborations in translational science.
    Swedo, SE, Leckman JF, Rose, NR. From Research Subgroup to Clinical Syndrome: Modifying the PANDAS criteria to describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Feb 2012, Pediatrics & Therapeutics.
    The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit the NIMH website.
    About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit
  • Please sign the petition

    Thank you to Body Matters Australasia for setting this up

    Friday 23 March 2012

    For parents of teenagers....

    Responsible Parenting

    Having a breast cancer diagnosis changed my parenting almost overnight.  I decided that my children needed more freedom and responsibility and to learn about things that, had I not been diagnosed with cancer, I probably would have protected them for a few years more.

    I know some of my peer group with the same age children (nearly 15 and 16) still buy their teenager's clothes for them.  You can spot them a mile off.  They are the ones wearing the Fat Face fleece at pony club camp - the mothers that is.  They also buy their teenagers underwear and talk disparagingly about other other teenagers wearing "unsuitable" clothes and "too much makeup".  We took the view that experimentation now, whilst still secure in the bosom of their family, was the way forward.  After all, teenage years are all about finding your own way in the world, discovering your limitations, pushing your boundaries and falling flat on your face.  It is made much easier if you have a loving, supportive family to pick you up afterwards.

    We got told off loudly and aggressively a few weeks ago for not being good parents when making a decision about schooling.  It was implied that my children should have no input into their schooling and that HWISO and I were being "bad parents" for consulting the girls and listening to their wishes.  I have mulled this over for a while, especially as we are still looking at schooling options and I have decided that my daughters should have the final say.  After all, I am not the one going to school.  They are.

    It is a bit like their clothes really.  I wouldn't choose to wear what they do.  For a start, I'd look like mutton dressed as lamb.  Also, I think mothers wearing the same clothes as their daughters looks sad, desperate and ridiculous and it is just so embarrassing for the teenagers.

    Letting my children learn to stand on their own two feet, make their own decisions and face up to the consequences of those decisions, with a loving, supportive set of parents to catch them when they fall makes sense to me.

    Perhaps I am not a bad parent, merely parenting from a different perspective.

    Friday Video - J K Rowling

    I love Harry Potter.  This talk was witty, funny and deeply moving, all at once.

    Thursday 22 March 2012

    Sons and heirs

    With the new Julian (Downton Abbey) Fellowes' TV show, Titanic, launching on Sunday, I was remusing on Cora Crawley's anger at the unfairness of primogeniture.

    Being farmers - and we are certainly not talking Downton and its rolling acres here - merely what is a medium sized arable farm, when both my brother in law's larger holding is joined with HWISO's farm, there is always a certain pressure to keep things intact to pass on to the next generation.  Having two daughters, we are not in the unenviable position of other members of the family and friends to have to make the decision to pass on the farm to their eldest (or only) son.  The girls, in time, will have to decide what to do about passing it on to the next generation but that is not our concern.

    I have seen some estates passed on to eldest sons and they have made a very fine job of it.  I have seen some divided between all the children, which seems fair to me, but this only works if the person who takes charge of the farming operations is a committed farmer.  I have seen some estates pass to sons and seen some families have many many children in order to beget a son - one famous aristocratic family had 7 daughters before a son was born.

    In many ways, this primogeniture has kept great estates intact.  However, I have seen families torn apart with jealousy.  I have watched parents go to court to get Trusts broken and children disinherited, when they prove feckless or incapable.  I have watched perfectly capable women, who have their heart and soul in farming, bypassed for a son who would rather be in London, Singapore, New York or anywhere but rural Herefordshire.  I have seen sons get the land and the monolithic house, whilst all the cash so desperately needed to keep it going is divided among the siblings.  I have dined in cold, draughty dining rooms with peeling wallpaper and mould growing up the walls, in houses built for an army of servants, set centrally in an estate that cannot sustain it, all tied up in an unbreakable Trust by dear Grandpapa in 1920.

    I know my US readers don't get primogeniture and in France, everyone gets an equal share, which often means 10 great grandchildren each owning one 1 acre field.

    I am so glad we didn't have a son.  I would hate either of my beloved children to be denied an equal part of our livelihood, based on their choromosones.

    Just sayin.....

    The sins of the fathers shall be visited on the sons

    Or rather the sins of the parents shall be visited on young women.....

    WE ALL KNOW ABOUT HEALTHY EATING.  It is rammed down our throats every day.  Genetically vulnerable children are forced to watch propaganda films about healthy eating and exercise at the age of 10.  The multimillion pound diet industry continues to scare - or should that be fund? - governments and scientists into issuing wildly inaccurate statements about obesity.

    According to the latest figures, some 15% of Australians are morbidly obese.  The number of men is more than women, which means that around 7 out of a hundred women in Australia are morbidly obese.

    The latest research to come out of Australia suggests that 8 women in 100 have suffered from a serious eating disorder in their life time.  Whilst I am aware that there be some cross over between eating disorders and obesity, it should be noted that most bulimia and BED patients are of a normal weight.

    Why, oh why, are we persisting in promoting the diet industry to adolescent girls, the most vulnerable group?  Diets don't work.  The vast majority of people lose and gain the same 15lbs over and over again during their lifetime.  There are the 1-2% who develop anorexia, the psychiatric disorder with the highest mortality rate but, hey, unless you understand that an eating disorder is a brain disorder, you just disregard them as stupid willful teenagers, right?  We must all persecute the overweight and force them to go on a diet, adding millions more to the coffers of the diet industry.  Talk about hamsters on a wheel.

    I am more than aware that eating disorders in young men are rising, horrifically.  However, no one has brought to my attention a conference for boys' schools which features a representative of Jenny Craig diet bollox......

    So Ms Catherine Misson of Melbourne Girls Grammar School, why don't you line up a hundred of your girls in front of you and decide which 8 are going to be the ones who are going to suffer (and maybe die) from an eating disorder and which 8 are likely to be morbidly obese?  Once you have looked at those 15 faces, perhaps you will look at the other 85 pupils who will probably spend the rest of their lives feeling inadequate and overweight, whilst writing a cheque to Jenny Craig's representative for all she is doing for their self-esteem?

    Wednesday 21 March 2012

    For my Australian friends

    Australian parents, just in from my friend, Deb:

    Hi, All,

    We have an activism opportunity - our colleagues at BodyMatters Australia have let us know that the CEO of Jenny Craig Australasia, Amy Smith, will be speaking at an upcoming conference for the Alliance of Girls' Schools in Melbourne later this year. Lydia Jade Turner, head of BodyMatters, writes, "When a colleague wrote an email expressing her concerns, she was told by the Principal of Melbourne Girls' Grammar Catherine Misson that Smith is 'transforming the organisation into a champion of women's health.'"

    We have good research documenting the hazards of dieting for youth. The marketing departments of these companies are appropriating concerns about weight and health to insert themselves into workplaces, schools, and healthcare settings.

    Lydia asks that we  email both Ms Catherine Mission (school principal of Melbourne Girls' Grammar School and the organisers of the conference to voice your concerns.

    Thank you for any help you can offer!

    Best wishes,
    Deb Burgard, PhD

    Monday 19 March 2012

    What not to say

    Things doctors should not say when confronted with an Eating Disordered patient:

    "He/she's not that thin"
    "I've seen worse"
    "It's just a phase"
    "Only 35% of patients recover, you know.  You may be lucky"
    "Anorexia Nervosa is very rare."
    "Try and get her/him to eat a sandwich"
    "He/She'll grow out of it"
    "He/She is too young to have an eating disorder"
    "Just tell her to stop"
    "He/She's just doing it for attention.  Ignore it."
    "If you back off about eating, it will probably resolve itself"
    "Oh Teenagers - it is a difficult time."
    "Do YOU think you are ill or is it just Mummy fussing?"

    Sunday 18 March 2012

    The Khan Academy

    I have just been put on to this You Tube channel by my darling brother, Professore Wills (1) (or Tuppence, as he commonly known within the family.  What an amazing find for brilliant sciencey mathsy videos.  Thanks, darling!

  • Visiting English Professor - Beni Culturale (Art History) Faculty at Università di Macerata
  • Visiting English Professor - Science Faculty at Università degli Studi di Urbino 'Carlo Bo'
  • Visiting English Professor - Economics Faculty at Università di Macerata
  • The Sky's falling in......

    Having been assessed by a psychiatrist this week, I now officially have a "get on with life" attitude - I prefer the term optimistic.

    When my daughter was very ill with anorexia nervosa, I was urged by the wonderful people on the Around the Dinner Table forum to "have a plan".  Here is the best example of a plan for refeeding that I have come across (with thanks to MWM):

    Rule : Life stops until you eat.
    Details: 3 meals and 3 snacks a day. Magic Plate. No leaving food on the plate.  Meals are 45 minutes. Snacks are 30 minutes. No more than 4 hours between meals. No going to the bathroom immediately after a meal, unless supervised.
    Meals should be supervised in a calm, loving manner with no engaging ED.  If that means no conversation, or removing other children from the room, then that is what needs to happen.  You shouldn’t have to say much more than “food is your medicine” or “yes,  you need to eat everything on your plate” or just ”hmmm” or “uh-huh.”
    Consequences: If food is left over the time limit, a liquid supplement is offered.  Simply take the plate and ask “what flavor supplement drink would you like vanilla or chocolate?” (Give choices as you would to a toddler, not too many options, and choose for them if no preference is given. )  If not consumed in 15 minutes, the calories are added to the next meal.   If the next meal is not eaten entirely and in time, repeat the above steps.  If at the end of the day, all the required food is not eaten, the patient is “On Alert” for the next day.
    On Alert:  No school, or other planned activities are allowed.  The treatment team is notified that patient is on alert and a plan should be worked out with them as to what to do if food is again not eaten. Our plan was a visit to the ER, where the Dr. would have called ahead with instructions to provide supplemental calorie drinks and/or feeding tube.  The message to the patient is that not eating is an emergency situation for an underweight anorexic, even if they are not in physical distress.  The message to the ER staff should be to trust the patient’s doctor and parents who are simply following the patient’s treatment plan – you could even have it typed up and bring it with you.
    Incentives:  If eating goes well, and no consequences are invoked, then  life goes on until the next meal time with no one bugging the patient about food.  We found that rewards didn’t work, and that the biggest reward for my d was just to be able to not have to think about food for a while.  Find activities to do that engage her mentally like games, books, music, etc.  Limits should be imposed on activities only if they interfere with weight gain (i.e. exercise, outings that delay meals, skip meals, or require the patient to eat in a stressful or not fully supervised manner like school lunches) or cause stress (clothes shopping, for our daughter – unstructured social events, for some kids – going to school, etc.) Eventually my d got to a better state of mind where she could look ahead to an enjoyable event or activity, but she knew that if she didn’t eat, we would pull her out. Those were the rules.

    This may sound to parents who have not been in the hell of refeeding, like some militaristic, control freak, slightly psychotic parenting.  However, if you reframe the food as medicine and reframe the anorexic as diabetic, you can begin to see how life saving this plan is.

    We did not have the luxury of a visit to ER or even a clinician who understood what we were doing, let alone a therapist.  There was just me, HWISO and elder daughter.  Having this sort of plan was not an option.  Besides, I hate plans.  I find that if I plan something too much, it all goes awry and I am left with having to deal with two members of the family who have difficult set shifting, have depressive personalities and lean towards catastrophising over every detail.

    Luckily, the "get on with life" leaves me a position to tease the two Henny Pennys out of their misery.  If teasing is ineffective, a stern reminder that if the world is ending, we might as well enjoy the last few hours, seems to work.