Dads And Daughters With Eating Disorders

I am proud and delighted to offer up another post by guest blogger, Dan D - a friend and a Dad whose daughter suffers from Bulimia.  Perfectionism is a common characteristic of people with Eating Disorders.  I’m sure you’ll agree that Dan puts it in perspective and illustrates again how complex and confounding Eating Disorders are. 

Thanks, Dan, for you insight and your willingness to share your experiences with our readers.  It’s a great help to me, for one.

Dexter

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Our daughter is a magical girl.  As parents, we love her deeply and want only good things to happen to her.  She’s one of four children that we have and our desire for each of them is to succeed beyond their dreams.  And we want them to dream big.

 

We’ve all learned a tremendous amount while going through her struggle with Bulimia and the co-addictions that accompanied the eating disorder (ED).  My wife and I were dumbfounded to find out that a very high percentage of girls with ED’s are perfectionists. 

 

What we thought was procrastination, or no commitment, was actually the result of a mistake made along the way.  For example, my daughter was given a take-home art project that was due in 2 weeks.  We saw her start on it and watched as it progressed.  Each day something new was added.  With three days remaining to complete it, her work stopped.  The project, by all appearances was not complete.  The due date came and we saw the project still settled in her room. She didn’t turn it in.  Her grade was a zero.  I interpreted her behavior as apathy and laziness and reprimanded her accordingly.  Wow.  I could not have been more wrong.

 

My daughter is a perfectionist.  Whether athletics or academics, if it wasn’t the “best” it was completely unacceptable in her mind.  Mistakes were not permissible in her world.  They were synonymous with “Failure” with a capital F.  In fact, she would get a 0 or F, rather than turn-in a project that was not perfect.  As a dad, that’s a paradox that I just can’t get my arms around.  It makes no sense at all.  She personified the “all-or-nothing” approach.  To me, there’s a lot of space between F and A+.  But she couldn’t see the many degrees, only the extremes.

 

She came home from treatment on a Wednesday.  She had been away for 60 days – 45 in a very controlled environment and 15 more in a transitional, but monitored setting.  She felt strong and confident about her recovery and was excited to come back.  She was justifiably anxious about re-entry, and so were we.  One of my primary concerns was her group of “friends.”  But we discussed it with her and her therapists and we had some semblance of peace.  My wife and I had spoken with a few of her friends individually before our daughter came home.  She also realized that some relationships needed to be severed.  We prepared for her homecoming the best we could.  Our plan was to be very low-key and slowly introduce activities, friends, and commitments.  It was our objective to “plan her life around her recovery, and NOT, her recovery around her life”.  That’s a subtle, but extremely important difference.

 

On Friday, my daughter had appointments with 3 members of her local support team.  She met with the first 2 and the 3^rd cancelled due to illness.  We did several “feelings checks” throughout the day and all was going well.  She made plans to attend an annual, school function that night and we decided to allow it. 

 

The school event was scheduled to end by 10:00 PM and we expected our daughter and her friend to be back by 11 or 11:15.  At 11:15 we started calling her cell phone and she didn’t answer.  Our antennae started twitching.  Shortly after, the mother of the girl our daughter was with, called us asking if we knew where they were?  We assumed they were on their way home.  We continued to try reaching our daughter on her cell phone.  She didn’t answer.  By midnight, we were very anxious and concerned.  At 12:15 she texted my wife’s cell phone and told her she was on the way.  At 12:30 she pulled up.  My wife and I had used the 15-minute gap to discuss how we would respond to what we might see.  We were ready.  When our daughter walked in the door, she was noticeably under the influence of something.  We saw her dilated pupils and heard her slow, deliberate speech.  Our fears were confirmed.  Our daughter had officially “slipped” just two days after getting back. 

 

My wife and I realized that the next several hours were going to be extremely critical in the recovery process of our daughter.  How we responded to her and this incident could affect her entire life.  It is that critical.  Through the training we received at Family Week, we knew to look for specific signs in her expressions and countenance.  We recognized the presence of “shame” and “regret”.  So, instead of anger and disappointment, we felt compassion and concern.  We were all being tested.

 

Having been prepared for the worst, my wife and I escorted our daughter to the kitchen table and calmly began the process of determining what happened.  About 5 minutes into the discussion, she revealed that her friend, who was too afraid to go home and face her own parents, was still out in the car.  I took a break to drive her home and deliver a much-loved daughter to two very concerned parents.  (My daughter’s friend is also going through recovery of substance abuse.  We thought that would cause them to support each other if anything did happen.)  During the short drive to her house, I asked the friend what had happened and who they were with?  This turned out to be very helpful so we could compare stories.

 

As we listened to our daughter and the events of the evening unfolded, my wife and I noticed she was not being totally forthcoming with us.  So we probed.  I asked who she was with.  Her answer was elusive.  There was a particular young man who we did not want our daughter to see, at least not yet.  This guy was the common denominator in my daughter’s co-addiction episodes.  She believes he is a “good guy”, “like a brother” to her.  She couldn’t see the damage he had done in her life.   I asked if she had been with him.  She had.  Even sitting at the table, in her altered state, she defended him.  Anger and sadness began to overtake my emotions.  Then I saw my daughter begin to lose her esteem before my very eyes.   The hope that was in her was seeping away.

 

Her “perfectionist” nature was quickly becoming an entity that demanded all of our attention.  Her alter-ego, ED, was beginning to tell her she wasn’t perfect.  That she was a failure.  My mind’s eye flashed an image of the unfinished art project sitting on a desk.  This same girl had abandoned it and took a zero grade because of a slight mistake.  My very perceptive wife recognized the change in our daughter as well, and we immediately addressed it.  We remained calm and assured her that we loved her no matter what happened.  We reminded her of her therapy and that what happened was a “slip”, not a relapse.  Mistakes are okay.  We all make them.  We helped her to talk through the process of picking-up from here and to keep moving forward.  We did a lot of listening and comforting.  30 minutes later, we all went to bed.  My daughter’s last words, and I’ll never forget them, were, “I can’t wait to get-up tomorrow and put this behind me.”  And that’s what happened.  She got out of bed on Saturday and continued to take steps forward.

 

While recovering, when discussing the possibility of a “slip”, it’s not “if” it’s “when.”  My daughter’s took place just two days after she was home.  I don’t know if that’s good or not.  I do know that it served as a very real reminder to us all that this is not easy.  ED is a big, ugly monster that doesn’t like his possessions taken away. Our daughter’s image used to sit on his trophy shelf.  He’s not giving her up without a fight.  Our job is to stay well armed and prepared for confrontation.  My daughter tried to move too fast into her next phase of life.  She didn’t realize the power of ED and how aggressive and controlling he and his co-addiction comrades can be.  My daughter has a renewed respect for the magnitude of the problem she’s trying to overcome.  And so do we.

 

Dan D

 

Our daughters are growing up in a world where they are being taught that thin is “good” and fat is “bad.”

 

 A Little Historical Perspective

 

The look that society calls beautiful changes with the times.  And, as Bob Dylan said, “The Times They Are A Changin’.”

According to the Miss America – American Experience Website, the only 2 time Miss America, Mary Catherine Campbell, who was Miss America in 1922 and 1923, was 5’ 7” tall and weighed 140 lbs.  This is in the “Normal” BMI (Body Mass Index) range. 

The first runway models were in the 150 lb. to 160 lb. range.

 

Marilyn Monroe was one of the best known beauties of the 50’s and into the early 60’s.  She is reported to have been 5’ 5” and 135.  Although that’s also a “Normal” BMI, today she would be seen as plus sized (a politically correct way of saying kind of fat) for a star and her agent would be all over her to lose 20 lbs…or more.

 

Now fast forward to “Twiggy,” who was also a world renowned popular beauty.  The time is about 50 years later.  The weight is about 50 pounds lighter.  Twiggy was 5’ 6” and 91 lbs.

 

Today, most models more than meet the clinical criteria for Anorexia Nervosa.  The criteria is less than 85% of normal body weight for your height and age.  Twiggy was 70% of the mid-range of “Normal.”   She would easily qualify for forced tube feeding.

 

Today’s average fashion model is 5’ 11” and weighs in at an average of about 117 lbs.  That’s about 78% of the mid-range “Normal” body weight for that height – clinically Anorexic.  And also subject to forced tube feeding.

 

Do you find it strange that we call them “models.”   Models of what, I ask?  Models of severe malnutrition and how to mistreat your body and abuse your health?

 

In spite of the fact that the average American woman is 5’ 4” tall and weighs about 140 lbs., the models, the stars, those in the spotlight, on the magazine covers, in movies, and in all manner of advertising are sickly, and I mean literally sickly, thin.

 

The stars who seem to have it all and who appear in movies and advertisements demonstrate that thin, beautiful women get everything they want – handsome men, money, nice cars, watches, clothes, and, above all happiness. 

 

So is it any wonder that our daughters equate thin with “good?”

 

The Disconnect

 

Can you see the disconnect here? 

 

“Normal” women are 140 lbs., and successful superstars are 117 lbs. (and a whole lot taller, to boot).

 

It’s obvious to anyone with a brain who stops to think about it that this is ridiculous.  What appears in the media to be “good” is completely disconnected from reality. 

 

But, our daughters see the supermodel images everywhere they turn.  You can’t get away from them even if you try.   

 

We are inundated with images and messages that tell us that in order to be successful and happy we need to be thin.  Thin, in other words, is good. 

 

And all you have to do is watch TV for an hour or two and you’ll be assaulted with diet program and exercise equipment ads carrying the message that fat is bad.

 

With all the media messages imbedded in her brain, suppose your daughter then faces some sort of real or imagined trauma.  A boyfriend dumps her.  She runs into a teacher that she doesn’t get along with.  She struggles with grades.  A friend betrays her.  She finds a job but hates it – it’s not working out.  We put pressure on her to excel at school or work, at some sport, at dancing, in the drama club, or at her job. 

 

And, because she’s human and struggles with some of those things, she begins to lose a little self confidence and a little self esteem.  She questions herself…her worth.  She may come to believe that her failures are all her fault.  And failure, of course, is bad.

 

And what do we dads do so often?  Cajole.  Push.  Pressure.  Lecture.  Dictate.  Ask for more.  Demand more.  Sometimes overtly and obnoxiously.  Sometimes kindly and subtlety.

 

But nevertheless, we do it, don’t we?  After all, we want the best for our daughters and we know if they just try harder and put their minds to it more and practice more and keep their noses to the grindstone more they CAN do it…whatever it is.

 

We’re talking to them about doing THINGS that they should or shouldn’t or can or cannot do.

 

But they are experiencing the can and cannot do’s EMOTIONALLY.  And, most likely, we dads are not talking to them about how they feel about it at all.  After all, it really doesn’t matter how they feel about it.  They have to do it and accomplish it anyway, don’t they?  Just like we would.   

 

And as they continue to not quite live up to our expectations, they lose a little more self confidence and a little more self esteem.    

 

And, perhaps, they come to a point where it is very difficult for them to deal with their experiences and what they perceive as failures emotionally.  They have no emotional refuge.  No emotional recourse.  If we haven’t given them a good way to do that (like talking to us without fear of judgment), their self esteem and self confidence can take a major nose dive.

 

Meaning, they feel “bad.” 

 

And that leads to the connection.

 

The Connection

 

If you are a daughter with a dad who doesn’t listen to you and doesn’t understand you and doesn’t get you and who you don’t feel like you can talk to and you (the daughter) feel “bad,” what might you do to feel “good?”

 

We’ve already seen that in our society it is impossible to not relate being thin to “good.”  All good things happen to the ridiculously thin models, advertisers, and stars.  The emaciated people who we are bombarded with daily have it all.  And having it all is good.  So, thin must be good.

 

When your daughter feels bad about herself and has lost confidence and self esteem, it becomes simple to relate good and bad to thin and fat.  There is an obvious connection.

 

So if she sees herself (rightly or wrongly – if SHE sees herself as fat, even if her perception is completely distorted) and if she’s having trouble controlling other areas of her life and feels out of control and emotionally vulnerable, for her, there may be a pretty simple solution.

 

Get thin because thin is good.  Get really thin because really thin must be better than just thin.  And, besides, no matter how bad my grades are or even if I can’t keep my boyfriend, or if I hate my job, or I can’t talk to my dad, there is one thing I can absolutely control.  How much I eat.  Or how much I vomit after I eat. 

 

The allure is strong.  Thin is good.  I’m bad (meaning unworthy), so if I get thin I’ll be good (meaning worthy).  And, getting thin by restricting what or how much I eat or by vomiting or abusing laxatives or even over exercising is the one thing – maybe the only thing – in my life that I can actually control.  Doing so gives me power and my self esteem can now be based on having that power.  At least, if nothing else, I have that.

 

It’s a prescription for an Eating Disorder. 

 

And once the Eating Disorder gets hold of your daughter, it takes over everything else and becomes a self fulfilling prophesy of sadness, loneliness despair, bad health, and even death.

 

Conclusion

 

Obviously this is a very simplistic and one dimensional look at some of the factors that can lead to an Eating Disorder based on my perspective and on a little of what I’ve learned and seen while experiencing my daughter’s ED. 

 

Although it is never simple, I that by putting it into these simple terms you see how it can happen.  And it can happen to any of our daughters (and sons) at any time and at any age.  Do not for a minute think that your loved one is immune.  She isn’t.

 

Please be alert and use our Dad-EDs website, blog, and forum resources to help you learn all you can about EDs and about communicating with your daughters and all of your loved ones. 

 

It may save their lives.

 

 

I had a huge revelation the other day.

We need to talk about our Daughters’ Eating Disorders.

Seems simple, huh?

Why was it such a huge revelation to me?

The Background

I was talking to a friend who has a daughter suffering with Bulimia. (Actually, we were emailing back and forth, but in the 21st Century electronic communication is so akin to talking, I just lump it all together now.)

Here’s part of what he said: “What an incredibly small world. A friend of ours was at the mall over the weekend. While her daughter was trying on clothes, our friend struck up a conversation with another woman in the fitting room. It turns out that woman was there with her daughter who was going through treatment for an Eating Disorder. Can you believe it? Stuff like this is too strange to be coincidence.”

I was just starting to reply that I, too, seemed to be “coincidentally” running into more and more people with EDs impacting their families.

My Light Came On

That’s when the light went on.

Duh.

Of course I was running into more people affected by EDs. It is simply because I was talking about it, thus opening the door for others to talk to me about it.

Dumb me.  I could have gotten a lot of insight from other dads (and moms and whole bunches of other people, too) if I would have started talking about my daughter’s ED long, long ago.  If only I would have opened up before. 

Before what, you ask?

Before my daughter came close to death because of it.

Before that, I never mentioned her ED to a single soul….not even my own dad.

It’s not that I was embarrassed or humiliated or anything like that. I just thought of it as our family’s personal business and no one else’s. I’m very private by nature and certainly didn’t want to burden others with my problems or seem to be complaining about things going on in my life.

Also, I was so ignorant, I’m not even sure what I might have said to anyone.

Plus, I don’t think I realized just how serious, dangerous, and difficult Eating Disorders are to overcome.  

Think about this. There are 11 or 12 million cases right now in the US. If we are open and honest, we’re bound to bump into some of them.

Let’s Not Not Talk About It

I suspect there is a lot of that “not talking about it” going on. Maybe it’s a form of denial. Maybe a symptom of our own ignorance, fear, and insecurity. Maybe we dads, in particular, don’t want to admit how useless we are in these matters…that we cannot just fix it. And, although I have no evidence, I’m pretty sure the “not talking about it” problem is more prevalent with us dads than moms.

I’ve changed in a big, big way.

Now, I talk to every single person I meet about it. I want everyone to know that we’ve created our website, blog, and forum as a Dads And Daughters With Eating Disorders Support Group and Resource Center. I want people to know they can talk to me and that, although I am not and don’t claim to be any sort of expert, I have some experience now and am willing to share that experience and learn from theirs.

And, I hope that if we can all start opening up more and sharing together, we’ll make some headway both in prevention and in our loved ones’ recovery efforts.

In fact, I feel duty bound to talk about EDs with everyone I can. A born introvert, I’ve become an extrovert on the EDs subject.

If I would have been more open about my daughter’s Anorexia earlier, I have no doubt I would have “coincidentally” found some good prevention or early intervention advice and resources early on. And if that would have happened, who knows what difference it might have made in my daughter’s life.

It’s a huge mistake I made.  I hope I can some how, some way help other dads (and moms, sisters, brothers, aunts, uncles, granparents, friends, co-workers…everyone) avoid the same mistake. 

Right here, with complete anonymity if you want it, is a friendly place to start.

I hope you, too, will open up and start talking. Eating Disorders are nothing to hide. In fact, the opposite is true.  We need to expose them.  The sooner the better. 

The more we talk, share, and learn from each other, the better off all of our daughters will be.

Introduction

 

We took a look at the signs and symptoms of Anorexia the other day.

 

Now let’s do the same for Bulimia.

 

Anorexia and Bulimia are the most common Eating Disorders we dads have to face. 

 

They have some similarities. 

 

First, they are both attached to food issues – dieting and weight.

 

More importantly, the underlying or “real” issues are about negative feelings and emotional issues.  Your daughter is likely to want to stop her ED, intellectually, but she is helpless to stop simply by force of will or logic.  She will invariably feel guilty and a high level of shame about her behavior, but she may also experience a complete loss of control.  It’s a vicious circle which causes more and more stress and the stress reinforces the un-normal eating behaviors leading to more guilt, more stress, and the cycle builds and builds and builds.

 

Anorexia and Bulimia are completely opposite in that Anorexics starve themselves (sometimes to death) while Bulimics often eat copious amounts of food (sometimes binging on thousands of calories of food at a time) and then purge or get rid of those calories in one or more of a variety of ways:  vomiting, excessive exercise, fasting, and use of laxatives are the most common. 

 

Unfortunately, the behavior becomes addictive.  All addictive behaviors have a tendency to take over the addict’s life, and Bulimia does that.  It has dire effects on the Bulimic’s health, family relationships, relationships with friends, school work, professional life…everything.

 

Signs & Symptoms

 

We dads can have a very hard time recognizing the signs and symptoms of Anorexia, but one good clue we can usually observe is rapid weight loss.  It’s way trickier with Bulimia. 

 

Your bulimic daughter may not have low weight at all and may look perfectly healthy.  (When I first visited my daughter while she was undergoing intensive inpatient treatment at Remuda Ranch, I’d notice a girl or she’d introduce me to a friend of hers there and I’d might say something like, “She must have been here a while because she looks really healthy.”  Invariable my daughter would say, “No.  She’s Bulimic.”  It took me a while to get this in my brain.  The girls who looked emaciated or overly thin suffered from Anorexia.  The girls who looked healthy and of a healthy weight were Bulimic.  But both were suffering mightily and desperately needed the treatment they were receiving.)

 

So dads, unless you find your daughter binging and purging, how can you tell she may have Bulimic symptoms?

 

Be alert to swollen cheeks and scrapes on your daughter’s fingers.  These are often the first observable signs we can see.  They are typical results of lots of self induced vomiting. 

 

By the way, make sure your daughters get regular dental check ups.  Sometimes dentists are first to recognize the Bulimic behaviors because of visible damage to the teeth and gums from exposure to too much stomach acid.

 

Long term Bulimia can result in damage to the stomach and stomach lining, damage to the intestines, damage to the esophagus, kidney damage, and damage to the heart.  Depending on the length of the damaging behavior and other factors, fortunately, many, if not most or all, of the damage can improve with proper treatment and recovery.  The human body is pretty miraculous at healing itself when it has the proper nutrients.

 

Here are some other signs you can watch out for that can indicate that your daughter may be Bulimic.

 

She may be thinking and/or talking about her weight a lot.  A whole lot.

 

She may start a diet and then become very strict, perhaps compulsive, about it, but then she may get so “sick of dieting” you’ll notice her binge eating, too. 

 

You may notice her deal with stress (school, work, relationships, etc.) with frequent overeating.

 

If she is doing a lot of binging on sweets, it can be a sign your daughter is suffering from Bulimia.

 

Watch out if you notice your daughter using laxatives, diuretics, excessive vigorous exercise, and/or vomiting to help her control her weight.  Occasional use is one thing, but be alert to over-use or excessive use on any of the above.

 

This is a big one and you have to be on the look out for you daughter going to the bathroom – regardless of her excuse – immediately after her meals. 

 

Your daughter, if she has Bulimia, will invariably become secretive and deceptive.  Remember, she feels shame and guilt, and wants to hide the behavior as well as the shame and guilt she is experiencing from you.  She’ll go to extremes to do that and will certainly be secretive about her binging and purging.  You have to be vigilant and notice these things.  (I recently met a woman who had been binging and purging at least once a day for 20 years.  She was married with three kids, had dated her husband for 3 years before they were married and had been married to him for 7 years.  She was so accomplished at lying and hiding the truth that her husband had no idea she was Bulmic until she told him she was and that she wanted to get professional help.  Imagine the level of deception and the amount of lies that would take.  Ten years with the man she loves, raising children together, and he never knew.  So dads (and anyone else reading this) – be alert.  People with EDs are very, very accomplished at hiding their truths from you.  Very accomplished.)  

 

You may also notice that your daughter is depressed or feeling sad or morose more than usual.  Sometimes this is a bit difficult for us hard charging dads to pick up on.  Good communications and developing sensitivity about your daughter’s perceptions and feelings is key if you truly want to help your daughter avoid or recovery from Bulimia or any ED. 

 

(Again, thanks to an article on the Remuda Ranch website for the substance of the above with my personal observations and comments thrown in.)  

 

This sensitivity factor was definitely not my strong suit.  And most of the dads I’ve been involved with who have daughters with Eating Disorders were not very good at sensitive, heartfelt, open, honest listening to their daughters either.  It’s mostly about listening.  We dads tend to “lecture” and tell our kids what to do and how to behave.  We expect them to experience the world and deal with it from our perspective.  We want them to “be tough” (yes, even our girls).   We want them to be like us and do what we say rather than getting in their hearts and souls and brains and seeing and experiencing their world from their perspective. 

 

What Can You Do?

 

As I said in the Anorexia Signs & Symptoms post, the most important thing you can do is to be alert to the signs and symptoms.  Be aware.  Be sensitive.

 

You can give support and love.  Care and concern.  Do your best to communicate with your daughter openly and honestly. 

 

Beyond that, there isn’t much you can do that will be productive.

 

Give her support and understanding and get her professional help…immediately.

 

See our Dad-EDs Resource Page for some further information, resources, referrals, and guidance.   

 

You cannot rely on your daughter to walk up to you one day and say, “Dad, I have Bulimia and I want help.”  It will not happen. 

 

You will want to be alert and proactive.  Earlier rather than later.

 

 

 

 

 

 

 

 

The following post was submitted by a friend of mine, Dan D.  I met Dan and his family while at Family Week (a very exciting, intense, emotionally charged, and highly productive week of family group counselling and related activities at Remuda Ranch where both of our daughters were undergoing intense ED inpatient treatment.  This post is very insightful and should help to show us dads why this ED business is so difficult for us to do anything effective about and even to comprehend.  It is a complex subject to say the least.

Thank you, Dan, for your contribution.  Keep it up, please.   Give us more!

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According to Barbara Cole, MFT, Psy.D., clinical director at The Victorian of Newport Beach, a world-renowned facility for the treatment of women with eating disorders and co-occurring substance abuse issues in Southern California, as many as 80 to 85 percent of eating disorder sufferers display co-occurring addictive behaviors of some type.

While attending treatment with our Bulimic daughter, the counselors we spoke to stated that 100% of the women who entered their facility had a co-addiction.  The co-addiction can be anything from alcohol, drugs, laxatives, smoking, sex, workaholic, shopping, gambling, or some other destructive behavior.  So not only are you trying to understand the irrational behavior of an ED, you are also seeing your daughter struggle under the strain of at least one other addiction.  If you think, “My daughter is just not herself” you’re absolutely right.  The addictions are controlling her.   

Here’s another eye-popping statistic, almost 35% of drug-abusers have eating disorders, compared with only 3% of the general public. 

These co-addictions can cause quite a dilemma when trying to treat the problem.  Drug abuse is corrected with high resistance, discipline, and rigidity.  Rigid behavior and resistance are the building blocks for an eating disorder and need to be removed.  So it is a Catch-22. 

And, to compound the problem, not all chemical dependency is treated the same way.  It takes a professional to determine the co-addiction and the proper direction to overcome it while not reinforcing the ED. 

So how can we expect our daughters to know this when they’re incapable of being rational while under these influences?

Do you see why it’s so hard for them to overcome this alone?  An Eating Disorder by itself, or a drug addiction by itself, can be overwhelming for the strongest among us.  But together, who can bear the burden and overcome it?   

_________________________________ 

How to Cope With Bulimia

Coping with bulimia can be a very difficult endeavor, especially if you attempt to overcome it on your own. Eating disorder treatment is often recommended for those with bulimia as these programs focus on both the physical and psychological aspects of your eating disorder. 15 steps which may help you cope with bulimia include:

Recognize that you have bulimia. Be willing to seek out help.

Determine reasons why you have an eating disorder. Is it because of past experiences? Do you hope to accomplish something through this disorder?

Set goals to change negative behavior. Rather than viewing your worth through how you look, view it through your personality and by what you accomplish.

Recognize that your perception of yourself may not be what everyone else sees.

Set up a healthy meal plan. Allow room for flexibility. Do not stress yourself out by attempting to perfectly maintain your meal plan.

Love yourself and your body. Understand that some things can not change and the parts that do don’t change over night.

Share your problems with others. Keeping your disorder a secret makes it that much harder overcome.

Acknowledge the serious consequences of bulimia.

Write in a notebook. This method of release may help greatly when you feel the urge to throw-up or have no one to talk to.

Before you binge or purge, consider how it may affect your life. Will anything good come from these actions?

Set aside time to relax.

Talk with a professional.  This person may be a nutritionist, a therapist, or your doctor. Professionals working at eating disorder treatment centers are also very helpful in dealing with bulimia.

Chew food without swallowing it. This method may help in overcoming the urge to binge. However, be sure to also eat enough food on a daily basis.

Read a self-help book or a book addressing those with bulimia.

Don’t criticize yourself. Realize that everyone makes mistakes sometimes.

___________________________

Thanks, again, to guest Blogger, Dan D.  We appreciate your contribution and hope to get more of your thoughts and insights in the future.  

 

 

What are the Signs & Symptoms of Anorexia?  (We’ll look at Bulimia next time.)

 

Introduction

 

For every dad with a daughter with Anorexia that I’ve ever met or even heard of, this disease is almost impossible for us to understand.  A complete mystery.

It isn’t just a diet gone wrong.  It’s not a game that our daughters play for attention. 

Anorexia is a psychiatric disorder, not unlike clinical depression or anxiety.  

To make this really simple for us feeble minded dads, let’s just say it is self starvation.

 

Our daughters literally starve themselves to a state of severe emaciation or even death.  As I mentioned in previous posts and on our website, my daughter was literally on the brink of death a couple of months ago as a result of her Anorexia.  Death, dads. 

 

I’m talking about actual death here.

 

So please take this very seriously.  I certainly did not.  At least not soon enough.  That’s why I’m talking to you now…in the hope you’ll avoid some of the mistakes I made.

 

Here’s the biggest problem.  Once our daughters start or get caught on this course of self-starvation, it is very difficult, and, for some, impossible, to end their irrational eating behaviors and go back to normal eating. They can’t just will themselves to do it and you certainly are not going to be able to force them to.  Don’t try.  You’ll do more harm than good.

 

If your daughter is Anorexic or becomes Anorexic, it impacts everything in her life: work, home, health, friendships, and everything else.  Families are particularly impacted, and not in a good way.

 

The Symptoms…

 

There are an array of Anorexia symptoms.  They are not the same for everyone.  They may be more or less severe or obvious from one of our daughters to another.  They are typically a combination of physical, biological, and behavioral things.  You need to be alert to all of them and, if you notice them, become proactive quickly.  

 

Because dieting turned to starvation plays a huge role for most Anorexics, many of the most common symptoms that we dads can actually see and evaluate surround food, eating habits, and dieting.

 

If your daughter has Anorexia, she will be dieting obsessively (or “restricting” her food intake severely even if she doesn’t call it or even think of it as “dieting”) even when she clearly doesn’t need to or shouldn’t be dieting.  But you may not know she’s doing it because she will be likely hiding the fact and denying the fact that she is dieting.  At first she may tell you she is on a diet, but as the disease takes over, she’ll hide it from you.  You may even see her eating normally in front of you, but the next day, to make up for the “normal” meal, she may completely starve herself.

 

What you will be able to see and what you need to be alert to is a rapid weight loss.  The experts say 15% of more below her normal body weight, but I doubt you’ll be able to figure that out.  Just be alert to rapid weight loss.  Enough so that it is easily visible to you.

 

At the same time, if she talks to you about it at all (please see previous posts about communication skills and techniques) you may hear her complain that she’s fat when she obviously isn’t.

 

You may see her jumping on the scale often - maybe several times a day.  That’s pretty common Anorexic behavior, especially at first. 

 

Even as our Anorexic daughters are starving themselves, you’re likely to notice that, at the same time, they are preoccupied with food, calories, nutrition, and cooking.  And, they may also talk about food a lot.  A lot more than they usually do.  Be alert to these signs.

 

Remember, your Anorexic daughter is starving herself.  So does that mean she’s hungry?  Of course.  For gosh sakes she’s starving.  But, she’ll deny it.  She’ll almost never admit that she’s hungry.

 

Also be alert to what they call “food rituals.”  When your daughter eats with you, she may start some strange food related behaviors.  For example, watch out if you notice her cutting her food into little tiny pieces, eating only one food at a time, or placing unusual condiments on her food.

 

This next one should be obvious, I guess, although it wasn’t to me.  Since your daughter is starving and therefore hungry even though she’ll deny it, at some point her body will simply rebel against her will and she will engage in periodic binge eating when she just can’t control that overwhelming, ever present hunger any more.  Watch for it.  Be alert.  

 

Sounds like all of that nutritional depravation and abuse would be pretty hard and a body, doesn’t it? 

 

It is.  But that’s not all.  Many of our Anorexic daughters compound the whole problem by compulsive exercising to an extreme.  We dads know that horrible nutrition plus massive exercise don’t mix. 

 

Our Anorexic daughters can lose their menstrual periods and their hair (on their heads) may start to fall out.  But, since they have essentially no body fat, the hair on their arms and legs may grow more than usual — this is the body trying to find ways to keep itself warm.

 

Finally, in spite of putting on a cheerful demeanor and asserting everything is tip top - what the experts call “wearing a mask” - some other common Anorexic symptoms include depression, slowness of thought, and memory loss.  Why?  Because our human brains don’t function very well without proper nutrition.

 

(The basis for the above is from an Article on the Remuda Ranch Website with many of my own observations and ideas thrown in.  If you have a daughter (or son) with any Eating Disorder, I recommend you visit that site immediately.)

 

Truth or Deception?

 

Notice from the above sort of “official” signs and symptoms of Anorexia, that there are several mentions about our daughters denying this or falsely claiming that and wearing their masks or disguises.  They hide the truth.

To put it bluntly, they will lie to you.  A lot.  Deception, both self-deception and deceiving others, is, in my experience, a huge part of this disease. 

Experts say that much of that is not “really” your daughter lying, it is the Eating Disorder which takes over her life that does the lying.  Either way, whatever it is, be alert to the fact that if your daughter, who maybe never lied to you before in her life, develops an eating disorder, she will deny it, hide it, and lie about it and many things related to it incessantly and right to your face.  

 

What To Do?

You need to be alert to the signs and symptoms.  Be aware.  Be sensitive.

And, also, be advised that there is probably nothing you can do about it.  Except give her support and get her professional help.  This is beyond our magical dad “fix-it” abilities.  Get professional help immediately.

See our Dad-EDs Resource Page for some resources, referrals, and guidance.   

As I post this, our resource list  is in the very beginning stages of development.   But keep checking back.  We’ll be adding resources on an on-going basis.

You need to be alert to the signs and symptoms and you need to be proactive.

The point of all this is that you can’t rely on your daughter to walk up to you one day and say, “Dad, I have Anorexia and I want help.”  It will not happen. 

 

 

 

Here’s a communications tip for you Dads. 

When you feel absolutely compelled to give your daughter some criticism (I actually prefer the word “feedback,” but usually it really is criticism, isn’t it…or maybe we could call it “critical feedback”) about anything at all, always, and I mean always use the Criticism Sandwich. 

 

I learned this from the Positive Coaching Alliance.  It is an organization that teaches youth coaches how to coach youth sports so that the athletes learn positive life lessons from their experiences.  I am a Certified Trainer for them.  We encourage all youth coaches, when they have to provide any of their athletes with critical feedback, to use the Criticism Sandwich to do so.

It is simple. 

 

The “Criticism” is the meat in the sandwich.  Both of the pieces of bread of the sandwich are praise.  So you sandwich the critical feedback between 2 pieces of positive praise.

 

1. Start with praise or some positive feedback about something your daughter has done recently.

 

1. Then deliver the meat – the criticism, feedback, or critical feedback.  Be specific and deal with her actions/behaviors – not her personally.  Don’t label her as lazy or stupid or anything like that.
   
   
2. Then sandwich that bit of criticism in with another piece of praise bread – another positive statement.
   
   

Here’s an example, that also uses a Feelings Check (see Post dated 03.03.09) to start the conversation.

 

Assume you’re suspicious that your 15 year old daughter is losing too much weight and you’re becoming concerned that she may have or be developing an Eating Disorder. 

Dad:  Hey, Julie, can we talk for a couple of minutes.

Julie: OK, Dad, but I’m in a kind of rush.  What’s up?

Dad:  Let’s start with a quick feelings check, OK?  How are you feeling right now?

 

Julie:  Pressured.  Anxious.

 

Dad:  I thought so.  Why?

 

Julie:  Because I have a History test tomorrow and I want to study more for it.  Plus I have an English paper due tomorrow, too, that I still need to edit one more time.  Plus Janet is picking me up for tennis in about 5 minutes.  I just have a lot to do.

 

Dad:  I know you’re always really busy, but if it makes you feel pressured and anxious, have you thought about cutting something out?  Obviously not schoolwork, so maybe tennis?

 

Julie:  I’ve thought about it before, but it’s OK.  I really like the tennis and most of the time things aren’t this bad.  It’s just that a lot sort of piled up this week.

 

Dad:  Do you feel like maybe skipping tennis today so you can get your school work done without so much stress?

 

Julie:  No…I’ll manage it.  I’m OK….just feeling a little pressed for time.  But I’m OK.

 

Dad:  What can I do to help you?

 

Julie:  Nothing, really.  I’ve got it…next week will be easier.

 

Dad:  OK.  Actually, I just wanted to tell you I’m really proud of you for moving up the tennis ladder like you have.  I know you’ve been working hard at it and it’s paying off, isn’t it?  It’s awesome.

 

Julie:  Thanks, Dad.

 

Dad:  Also, I want you to know I feel a little scared sometimes like last night when you barely ate any of your dinner and this morning when you were rushing out for class and skipped breakfast.  The reason I feel scared about it is because I worry about your health.  With all you’re doing and with your growing body and sports and everything, you put a lot of stress and strain on yourself so really good, consistent nourishment is very important.  Is there anything I can do to help you make sure your nutritional needs are met?

 

Julie:  No, Dad.  I know sometimes I get going so fast on so many things I just forget to eat or don’t realize I’m hungry. 

 

Dad:  On a 10 scale, how important is your health to you?

 

Julie:  10.

 

Dad:  So if it is truly the highest priority, do you think you can make it that way in practice and protect it by getting the nutrition you really need?

 

Julie:  Yeah.  You’re right.  I’ll watch it better.

 

Dad:  Other than just being rushed and pressured, is there anything else making you feel like not eating or getting good nourishment?

 

Julie:  Nope.

 

Dad:  OK.  Oh, also, I know I told you this before, but I wanted to tell you again that I think that was really great work you did on your science project.  I couldn’t have done anything that good in science. 

 

Julie:  Thanks, Dad.  It was pretty good, wasn’t it?

 

Dad:  Yeah.  Now get going our you’ll be late for tennis.  Glad we could talk. 

 

Notice the 2 to 1 ratio of compliments to criticisms…the whole point of the Criticism Sandwich. 

 

Notice the non-confrontational way Dad told Julie he’s worried about her and that she needs to eat to keep her health up.  Notice that she self-rated her health as a high priority.  And, also notice Julie’s agreement to make her health a high priority not just in theory, but in practice.

 

Also notice that Dad asked Julie several times, “What can I do to help?”  We dads, although sometimes we want to believe we are omniscient, are not mind readers.  So please get in the habit of asking what you can do to help your daughters.  You might be surprised by their answers.

 

This is a very positive conversation all done in a pleasant, non-threatening, and non-argumentative way.  

 

It may not be the last conversation on this subject, but it’s a start.

 

Start practicing this with your daughters – whether they have EDs or not.  Make it a habit. 

 

And, by the way, the Criticism Sandwich does wonders for other relationships, too, with spouses, friends, family members, employees, co-workers…you name it.

 

 

 

I’m a linear thinker.  It’s my nature and I admit it.

Eating Disorders are NOT linear problems.

In other words, in Eating Disorders A does NOT lead to B in a straight line.

I suspect many, if not most, of us dads tend to be linear thinkers. 

That’s one of the reasons it is so difficult  for us to grasp that Eating Disorder problems (Anorexia, Bulimia, chronic dieting, compulsive exercising, compulsive overeating, weight preoccupation, body image compulsions, and you name it) have virtually nothing to do with weight, food, and eating. 

What? 

Eating Disorders have nothing to do with weight, food, and eating.

The problem is that weight, food, and eating are only symptoms. 

The real problems - the underlying problmes - seem to almost always revolve around confusion, pain, lack of self esteem and self worth, and loss of identity.   Compounding the problems are issues of depression, anxiety, and disappointment.  We dads tend to try to just ignore or deny the latter if we can.

Compounding it all further is our media and constant bombardment by and access to the media.  I defy you to watch TV for very long and not see a diet commercial or a commercial for a gym or some exercise device overtly saying you’ll be popular, rich, famous, accepted, happy, etc. if you’re thinner.  Or you’ll at least see a bunch of impossibly thin models selling something while implicitly saying you’ll be popular, rich, famous, accepted, happy, etc. if you’re thinner…like they are. 

Same with other media….most TV shows,  billboards, and magazines.  With the massive problem of Eating Disorders in mind, take a fresh look look at the tabloids and the “Hollywood” magazines at the check out stand at your market.  They’re pretty disgusting from an Eating Disorder perspective. 

Thin is in.  No doubt about that. 

And, notice that the commercials and all the media, explicit and implicit, are linear.  Their message is “Get thinner and you’ll be happier.”  A leads to B. 

We dads tend to think the opposite when we see our daughters struggling with Eating Disorders.  We get caught in the simplistic, linear solution.  “If only she’d eat more, she’d be fine.”  Or “If only she’d feel better about herself, she’d eat more, and be fine.”  Linear thinking.

But we all know that’s a lie.  It doesn’t work that way at all.  The solutions to being happier are complex.  They involve an array of issues - family relationships and dynamics, family communication and conflict resolution, peer group pressures and influences, how and how often a person receives feedback (positive and negative), innate physical structure and characteristics, heredity, genes, biochemical functions, psychological makeup, and hundreds if not thousands of other factors.  It’s how all these array of factors interact and interconnect with each individual that is the key to success or failure….happiness or despair….health or Eating Disorders.

What can we dads do about all this?

Be aware.  Be sensitive to everything going on in your daughter’s world.  Learn to see the world from her perspective.  If she gets teased at school about her new hair style, just saying the typical dad thing, “Who cares what those losers think,” may not be enough.  Find out how she feels, why she feels that way, validate her feelings, and see if you can, together, discover solutions that will make her feel better.  The bottom line is to take it seriously.

If she breaks up with a boyfriend and is distressed about it, simply saying, “I never liked that jerk anyway….good riddance,” is probably not the best approach.  You have to take it seriously.  If she’s afraid to talk to you about her feelings because she knows from experience that you’ll give her some glib, insensitive dad response, she may stuff those feelings down in her tender psyche for years before they surface as a part of the complexity underlying her Eating Disorder.

As a caring dad, please do whatever you possibly can to look at the world from your daughter’s perspective and to take that world very, very seriously.  It is her world.  You may not see it easily and you may not like it.  But is is where she lives.  It may be quite different from your world.  Foreign territory.  

But it is the world where she will grow and develop her self esteem or her lack of self esteem.  You can’t control it all.  In fact you may not be able to control any of it.  But you can add to her comfort, her self image, and her self worth if you will at least acknowledge that you understand and are willing to validate her world.  Her point of view.  Her perspective.

It doesn’t matter if she is 3 or 30.  It is her world and you owe it to her to become acquainted with it and accept it. 

And then gently, kindly, and with much love help her deal with that world, always remembering that it is NOT linear.

I was recently with my Anorexic daughter, my older daughter, my ex, and about  10 or 12 other families at “Family Week” at Remuda Ranch in Wickenburg, AZ.  My daugher went into their in-patient, residential 60-day intense treatment program - literally to save her life.  (More on Remuda in subsequent posts.)

Before tackling anything at all in our family/group sessions, we’d go around the room for a “feelings check.”  At first this made me quite anxious and unfomfortable because I am a self proclaimed “non-feelings guy.”

I wish I would have done this small, simple, yet profound exercise with my family my whole life. 

I highly recommend you start having feelings checks with your daughters (those with EDs and those without EDs) immediately and often.

At least before or during every family meal and before any serious discussion or conversation about anything at all.

Here’s how it works - using a family meal as an example.

When you start the meal, just go around the table  and each family member does a feelings check and tells the rest of the family how they are feeling at that moment.  One rule:  There can be no judgment and no criticism. 

Not, “…how was your math test today?”  Not “…how was cheerleading practice?”  Not “…what are you doing this weekend?”

Just ask, “…Sally, how are you feeling right now?” 

Then shut up and listen.  (I know this may be really difficult, but do it.)

And don’t let Sally say “fine” or “good” or, more typically, “OK.”

Those are NOT feelings.

Since, if you’re like me, you may not be familiar with these, here is an example of some feeling words to help get you started: 

In the ANGRY category:  Outraged, Wounded, Fed-up, Humiliated, Mad, Critisized, Offended, Used, Infuriated, etc.

In the FEARFUL category:  Anxious, Worried, Nervous, Afraid, Tense, Mixed Up, Jumpy, Overwhelmed, etc.

In the SHAMEFUL category:  Unloved, Worthless, Embarrassed, Exposed, Humiliated, Disgraceful, Regretful, etc.

In the GUILTY category:  Wrong, Self Blame, Miserable, At Fault, Ashamed, etc.

In the LONELY category:  Unloved, Left Out, Alone, Isolated, Abandoned, Ignored, Excluded, Withdrawn, etc.

In the JOYFUL category:  Cheerful, Content, Delighted, Excited, Loved, Happy, Glad, Satisfied, Eager, etc.

In the PAIN category:  Sad, Hurt, Angry, Alienated, Cushed, Defeated, Hopeless, Insecure, Unhappy, etc.

Pull out of your daughter her FEELINGS at that moment.  Do any pulling out gently and with love and without criticism.  She feels how she feels. 

Then you can ask, “On a 10 scale, where would you put that feeling?”  Find out if it is strong or weak.

Then see if you can dig to the bottom of it and gently, with love and understanding, ask “…why are you feeling that way?”  You might have to ask the “why” questions a number of times to get to the heart of the matter, but it is worth it.

Finally, if it’s a positive feeling, ask “…what can you do to make it even better and keep it going?  Is there anything I or we (the family) can do to make it better and keep it going?  What do you need from me (us)?”

If it is a negative feeling ask “…what can you do do to help yourself get rid of that feeling?  Is there anything I or we (the family) can do to make it better for you?  What do you need from me?”

Do this feelings check exercise at least once a day with your daughter.  I suggest you do it with every member of your family, but without fail do it with your daughter. 

And don’t forget, you have to reciprocate.  You have to share your feelings at that moment, too. 

That was the hardest part for me.  For me to express my feeling, I have to stop to think about them.  Notice what I said.  I have to think about my feelings.  When I think about that sentence it’s odd, isn’t it?

That, I believe, is one of the frequent disconnects between us dads and our daughters.  Our daughters feel their feelings and if we encourage them to express those feelings, without judgment or criticism or a lecture, they can and will.  We dads, on the other hand, are more likely to have to stop to think about our feelings and are more likely to filter our responses.   Our brains filter our hearts.

In any case, do this regularly.  You will find it to be a powerful tool in developing a strong bond with your daughter. 

And encouraging her to freely express her feelings and emotions without criticism or judgment should help her to avoid “bottling” or “stuffing” those feelings down.

And that bottling or stuffing of feelings and emotions is one of the big contributing causes for Eating Disorders and getting them out is one of the major steps to recovery.