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Thursday 6 September 2012

Nothing to be guilty of.....

Guilty Puppy

See more funny pictures and videos at Fugly.

So today I am musing on anorexia at two ends of the spectrum.  I had a long conversation with some parents in Europe.  They have discovered that their daughter, at university the other side of the world, has anorexia.  In a desperate panic, prepared to fly to the other side of the world on the first flight out, with no clear plan, but determined to DO SOMETHING, they came across as good, loving parents who would do anything to help their daughter now.

So I asked them to tell me a little bit about themselves and their daughter.  I stopped the conversation on more than one occasion to tell them that this was not their fault.  It didn't matter that one of them had to lose weight for a medical condition 8 years ago.  That did not cause their daughter's eating disorder.  How were they to know that the desire to go vegetarian was linked in to her anorexia?  A lot of people, especially young people, go vegetarian for any number of reasons - usually ethical.  The fact that it is a well-known sign of an eating disorder is totally irrelevant to 99 of 100 parents.  It is not their fault that they both have jobs and are at work every day.  Nor is it their fault that they live in a country very hostile to people who are not stick thin.  Environment impacts in different ways on different people.

At the other end of the spectrum I am dealing with a lovely lady in her '80s, who has developed anorexic symptoms (no diagnosis yet) after diverticulitis (or however it's spelt!) and various medical procedures (too squeamish to talk about) to investigate anemia.

When I presented this lady with the Maudsley Eating Plan, after a lunch where she ordered a beef sandwich "with no bread" (HUH?), she looked terrified and declared it was at least double what she was eating now.  (That was kind of obvious after lunch.....).   She has begun to understand that she is malnourished, very malnourished, but has reached that manic stage of carrying on as normal, or even doing more than before, to prove that she is "fine".  She also is quite positive in her mind that all the stuff about starvation, eating disorders and health risks don't apply to her.

I know for a fact that her family didn't cause this eating disorder.  I know that runs in her family and that, for 80 odd years, the environmental hasn't had all its cards in the right place, at the right time, to pull the gun.  Until now.

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