{image credit: Jamie Young}

“Anorexia is quite possibly the most misunderstood illness in America today. It’s the punch line of a mean joke, a throwaway plot device in TV shows and movies about spoiled rich girls. Or else it’s a fantasy weight-loss strategy; how many times have you heard (or said yourself) ‘Gee, I wouldn’t mind a little anorexia’?”

I couldn’t agree more with this excerpt from the memoir Brave Girl Eating: A Family’s Struggle With Anorexia by the amazing Harriet Brown, co-chair of Maudsley Parents, a website for parents struggling with eating disorders, and an assistant professor of magazine journalism at the S.I. Newhouse School of Public Communications.

In reality, anorexia, like other eating disorders, is a serious and debilitating illness.

In Brave Girl Eating, Harriet recounts how she and her family helped her then 14-year-old daughter Kitty recover from anorexia, using family-based treatment (FBT), also known as the Maudsley approach.

Brave Girl Eating is a powerful book that debunks the deeply entrenched myths about anorexia and eating disorders, and educates readers on the key research. Of course, it’s also deeply personal, and at many times, heart-wrenching.

But it’s also hopeful, and in my opinion, an absolute must-read. It’s beautifully written and provides a truly valuable – and much-needed! – contribution to the field.

I’m honored to present my interview with Harriet Brown below. In part one of our interview, Harriet talks about dieting, the early warning signs, what parents can do and so much more.

Stay tuned for part two tomorrow!

Q: With the widespread hysteria over the obesity epidemic, our society as a whole and schools in particular have started instituting potentially detrimental practices (like measuring fat with calipers; weighing kids) and lessons on “healthy” eating. In Brave Girl Eating, you talk about the time that Kitty came home after health class and announced that she was cutting out dessert because it’s unhealthy, a decision that first made sense to you (as it does to so many people). What can parents do in such situations?

A: Great question. Parents are vulnerable to the subtle and not-so-subtle pressures about their kids’ weight. I’d like to remind them that teens grow at different rates, and that they’re supposed to continue to gain weight even after they stop growing height-wise.

Dieting is the biggest risk factor for both obesity and eating disorders, so I hope parents would discourage dieting for their children and teens. When a child does decide to cut out an entire food group—whether it’s sugar, fat, meat, or whatever—parents should not encourage it and should keep an eye on their child’s eating habits.

Q: In the beginning of the book, you talk about the various eating disorder signs you and your husband initially missed with Kitty: calling you to ask what’s for dinner, sobbing without any reason, inconsistent moods, an out-of-the-blue passion for cooking (while not eating). All of these are still fairly subtle, especially when you consider that Kitty was going through adolescence at the time. What signs should parents watch out for, however subtle?

A: One of the biggest things I feel I missed early on was Kitty’s failure to gain weight when she should have. In my mind, anorexia equaled weight loss, and when she didn’t lose weight, I thought it couldn’t be anorexia.

Other early warning signs include cutting out whole food groups, like sugar, fats, carbs, or meat (vegetarianism often represents the early stage of an eating disorder, though obviously it can also not be related to an eating disorder); a sudden new interest in cooking for other people; an uptick in general anxiety and/or OCD-ish kinds of anxieties, especially (but not exclusively) around food and body image; and a new pattern of avoiding family meals.

I would also encourage parents to trust their instincts. Looking back, I realize I was worried about Kitty six months before she was diagnosed. I had some sense that something wasn’t quite right, but I let myself be reassured by our pediatrician.

Q: Throughout the book, you talk about the impact of Kitty’s illness on your younger daughter, Emma. How do you suggest parents deal with the impact of an eating disorder on the other children?

A: I think first parents have to accept that an eating disorder will affect everyone in the family. There’s no getting around that. And I think you have to at some point go through a grieving process about that.

Beyond that, it helps to talk openly with other children about what’s going on, keeping it simple and matter-of-fact: “Your sister has an illness right now that makes it very scary for her to eat. We’re helping her through it, and sometimes she’s going to feel very upset.”

I’d also try to have a safe place for other kids to get away from the inevitable conflicts, whether it’s family, friends, or just a room somewhere in the house that becomes an ED-free zone.

If they seem to be very upset, counseling could be a good idea—letting them talk to someone other than parents about what’s going on. They’re going to feel angry at parents at some point, for “letting” the illness happen, and that’s natural.

I do think in the long run it can also be empowering for siblings to see that their parents can take care of a sick child, especially of course if the outcome is positive.

Q: One of the symptoms of an eating disorder is the deep denial. Sufferers genuinely think that they don’t have a problem, and this becomes a particularly big issue when kids are 18 and considered to be adults. You write that you’ll do whatever it takes to make sure that Kitty is well whether she’s 18 or 38. What can parents do if their adult child refuses to get treatment?

A: I’m not an expert on the legal aspects of such situations, so I’ll stick to what I know: That parents often have more leverage than they think with adult children, especially young adults. If they’re supporting their children—financially, emotionally, in any way—that gives them a way to connect and potentially support that child into treatment.

If their relationship with their child has been good, they likely have influence with that child. I would unhesitatingly use that influence to make sure my adult child was moving toward recovery as much as possible.

Q: When Kitty was first diagnosed, you saw various practitioners who were clueless about eating disorders and their treatment (I found myself gritting my teeth in frustration during these parts!). One therapist informed you that anorexia had nothing to do with food and that the illness was usually caused by mom’s unresolved conflicts. What first steps do you suggest parents take if they think their child may have an eating disorder?

A: First, take your child for a full physical workup by the pediatrician, including an EKG, vitals, and of course height and weight.

Second, educate yourself about eating disorders, especially evidence-based treatment. The best evidence-based treatment we have for children and teens with anorexia right now is family-based treatment, or FBT.

Educate yourself about that as well as other treatments. Knowledge is power.

Again, I greatly appreciate Harriet speaking with me! Stay tuned tomorrow for part two, when Harriet talks more about FBT and eating disorder myths.

What are your thoughts on the interview? Have you read Brave Girl Eating? If so, what did you think?

 


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    Last reviewed: 9 Nov 2010

APA Reference
Tartakovsky, M. (2010). Brave Girl Eating: Interview with Author Harriet Brown, Part 1. Psych Central. Retrieved on July 29, 2014, from http://blogs.psychcentral.com/weightless/2010/11/brave-girl-eating-interview-with-author-harriet-brown-part-1/

 

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