Enter With Compassion: What You Should Say
Demi Lovato Shares Insight Into Her Eating Disorder
Demi Lovato is a veteran in a culture where many celebrities have just begun to use their star power to speak out on mental health issues.;As an actress and singer since childhood, Lovato has always been very upfront about her struggles with depression, substance use, self-harming behaviors, bullying, and an eating disorder.
Her courage in speaking openly about these issues has paved the way for other celebrities to be transparent about their own struggles in a way that helps the millions out of the spotlight feel comforted and understood.;Lovatos influence has become stronger since 2018 when she relapsed after six years of sobriety and experienced a life-threatening drug overdose.
Lovato took a step back at that time, assuring fans that she would tell her story one day but that, for the time being, she was focusing on herself and her recovery.;In a 2019 interview on the Ellen Degeneres Show, she shared that, 3 months previous to her overdose, she had also relapsed back into her bulimia symptoms .
The fact that so much can be written about the rollercoaster experience Lovato has had with mental health is a testament to her character. Especially since there is very little, she has not openly spoken about as an advocate for eating disorders, substance use, mental health, and many other causes.
About the Author:
May 29, 2020, on EatingDisorderHope.comReviewed & Approved on May 29, 2020, by Jacquelyn Ekern MS, LPC
Digital Ethnography And Used Data
People with an eating disorder mainly interact with others who have an ED online. They do this because online communication holds a sense of anonymity. Therefore in order to study this social group, digital ethnography is a useful approach.;Digital ethnography is research on online practices and communication, and on offline practices shaped by;digitalization .
People with an ED can be influenced and thus shaped by digitalization: they may gather tips or inspire others to worsen their behaviors.;
My field of research will focus on;the eating disorder community on Twitter. Data was collected through participant observation of 200 Twitter accounts for;three weeks. The users;selected all had public profiles and were identifiable as;people who explicitly stated that they have an;eating disorder.
Many users use this platform as a sort of diary, to vent about their struggles. Even though these profiles are publicly tweeting, I will always anonymize the data.;Many users see it as a sort of diary, and thus do not necessarily see their tweets as public. The screenshots of tweets will have no username or date in it.;It is also important to remember that we indeed only see what is on the screen. what is observable on the screen can be misleading, or at least only provide a partial image. .;
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Elimination Of The Multi
The MAS has been eliminated in DSM-5. The non-axial listing was previously an option in DSM-IV, but now this will become the norm. The clinician simply lists diagnoses, starting with the primary diagnosis , followed by other relevant psychiatric and medical conditions .
Diagnoses are not designated by axis, and there is no listing of formerly Axis IV and V characteristics.
Just Eat Implies That Eating Is A Simple Uncomplicated Thing But For Someone With An Eating Disorder It Isnt
Theres a reason why acceptance is the first step and not the last of any recovery journey.
Simply accepting that something is a problem doesnt magically resolve all the trauma that led you to that point, nor does it address the damage that was done both psychologically and physiologically by an eating disorder.
I hope one day that food is as simple as just eating, but I also know that its going to take a lot of time, support, and work to get there. Its difficult and brave work that Im willing to do; I just hope other people can begin to see it that way.
So the next time you see someone struggling with food? Remember the solution isnt so obvious. Instead of giving advice, try validating our feelings, offering an encouraging word, or simply asking, How can I support you?
Because chances are, what we need most in those moments isnt just food we need to know that someone cares, especially when were struggling to care for ourselves.
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Proposed Scheme Of Three Broad Eating Disorder Categories: Bcd
In brief, the BCD-ED scheme consists of three broad categories for individuals with an eating disorder , in a hierarchical relationship, consisting of:
Anorexia Nervosa and Behaviorally Similar Disorders . An eating disorder category characterized by the restriction of food intake relative to caloric requirements resulting in the maintenance of an inappropriately low weight, not better explained by a general medical condition or another psychiatric disorder. The prototype for this category is an individual meeting DSM-IV criteria for AN.
Bulimia Nervosa and Behaviorally Similar Disorders . An eating disorder category characterized by recurrent out of control eating and the recurrent use of inappropriate purging methods to control eating or weight. The prototype for this category is an individual meeting DSM-IV criteria for BN.
Binge Eating Disorder and Behaviorally Similar Disorders; . An eating disorder characterized by recurrent episodes of out of control eating. The prototype for this category is an individual meeting DSM-IV criteria for BED.
Eating Disorder Not Otherwise Specified . A residual diagnostic category for all other individuals with a clinically significant eating disorder.
When You Want To Quit Eating Disorder Recovery
Are you in a season right now where you want;to quit eating disorder recovery? I hope you feel encouraged by this open letter. Could;someone else in your life;use a reminder to stay the course or re-commit to their healing;journey? Share this letter with them. Eating disorder recovery is an uncomfortable;process, but I am grateful that I chose not to quit.
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Is There Support For The Hierarchy
A number of clinical features and behaviors are shared across the eating disorders . In DSM-IV, an individual experiencing frequent binge eating and purging behaviors could be given a diagnosis of either BN or of AN, binge-purge subtype . Although there are other small differences in the required diagnostic characteristics, the salient distinguishing feature between these categories in DSM-IV is weight. If the individuals weight was below 85% of expected, the AN-B/P diagnosis would likely be appropriate; this hierarchy in DSM-IV, which is implemented via Criterion E for BN, reflects the major impact of low weight on a range of important clinical phenomena and complications. Similarly, in the BCD-ED scheme, individuals would not be assigned to multiple categories, but rather, be assigned to a single category on the basis of a hierarchical progression.
Only limited data are available about the clinical characteristics or treatment response of individuals with a clinically significant eating disorder who do not meet the existing criteria for AN, BN, or BED . Therefore, we reviewed data evaluating whether these three DSM-IV categories, which are the prototypes for the three broad categories in BCD-ED, can reasonably be hierarchically arranged. We extrapolated these results to the BCD-ED proposal, assuming that other individuals in the broad categories would exhibit symptoms and complications that bear some similarity to those of the prototypes.
Think Your Friend May Have An Eating Disorder Heres What You Can Do
Some situations in life are just hard. Theres no prettying them up, no filter to cover the pain and no looking without seeing. When you suspect a friend may be struggling with an eating disorder, well, youve found yourself in a really tough spot.
It can be tricky to balance the tender nature of talking about the problem with your passion for helping the person. Pair that with the emotions of your friend and the physical destruction happening to her body, and you might be tempted to phone this whole thing in.
Can we encourage you, instead, to pick up the phone? Of course, youll want to learn a little more about eating disorders first, determine the best time and place to talk, and make a plan for what youll say and how youll be there for her when she needs you. Dont worry! Well walk you through the process below.
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Nnn1 Anorexia Nervosa And Behaviorally Similar Disorders
Diagnostic Criteria for AN-BSD
Severe restriction of food intake relative to caloric requirements leading to the maintenance of an inappropriately low body weight for the individual taking into account their age and height.
Clinically significant distress or functional impairment related to the eating disturbance.
Not better accounted for by another Axis I disorder or a general medical condition.
nnn.11, Typical Anorexia Nervosa, with or without amenorrhea
nnn.12, Anorexia Nervosa, without evidence of distortions related to body shape and weight
nnn.13, AN-BSD with significant weight loss at or above a minimally acceptable body weight
Diagnosis And Comorbidity: Food For Thought
With DSM-5, mental health clinicians in general and eating disorders clinicians in particular, have at their disposal the most researched and deliberated diagnostic manual in Psychiatrys history. Why do we need such a manual? By learning the diagnostic nomenclature, it helps clinicians speak a common language and communicate with each other about our patients. Thinking diagnostically about patients encourages us to generally organize our thinking about their illness, allows us to make some hopefully valid assumptions about associated features , which usually accompany a diagnosis. But perhaps most importantly, making a diagnostic formulation helps to inform treatment, increasingly so as evidenced based treatments become the norm.
Once diagnostic formulations are made, they should be regularly reviewed, by those who made them as well as clinicians who inherit a patient with a particular diagnosis. They should be assessed both for accuracy and agreement amongst clinicians as well as being up to date. Accurate diagnosing of FED utilizing DSM-5 criteria should not pose major challenges for the average clinician. Well-honed interviewing skills and an ability to match historical data to the criteria obtained from a thorough interview and appropriate physical assessment will usually produce accurate diagnoses.
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What Does Bed Stand For
What does BED mean? This page is about the various possible meanings of the acronym, abbreviation, shorthand or slang term: BED.
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Recovering;from and learning to live in my recovery process from an Eating Disorder and Bipolar Disorder has been really challenging at times. There is no sugar coating it. My brain at times operates against me; and I have had to develop skills and tools to combat that. Thankfully Ive had a lot of really great treatment providers patiently teaching me and coaching me though fighting my own brain.
One of the things that my brain does is all or nothing thinking. Naturally I want to be the best or I dont want to do it at all. I want to be best friends with someone or not friends. I want to write a book or write nothing. I want to run a marathon or run nothing. You get the idea. This way of thinking is harmful in many ways. First, it set myself up for failure and disappointment. My expectations for everything I did or wanted was so high that my ability to achieve it was actually very small. It also put really high and challenging expectations on relationships. I had all of these ideas of what the relationship should be; I never actually got to enjoy any of the people around me.
The things that I was ALL about and the things that I was NOTHING about fluctuated given the time. Living this way added to the chaos of my life. I never felt satisfied, and always felt not good enough.
So how do you recognize and begin to change this way of thinking?
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Check Your Judgment At The Door: What You Should Not Say
Eating disorders may seem to be all about outward appearances, but theyre actually a result of whats going on inside. People who deal with anorexia, bulimia and binge-eating hope to gain some measure of control over their feelings of sadness, loneliness or self-hate.2
And the brain itself plays a role too. Researchers found that people with eating disorders show an abnormal response to dopamine the chemical that tells our brain when something feels good causing some patients to experience extra doses of dopamine when they eat and others to actually endure anxiety when they eat.4
With these facts in mind, do not say:2
Appendix Ii: Proposed Diagnostic Criteria For The Broad Categories For The Diagnosis Of Eating Disorders
All individuals classified in the BCD-ED scheme meet the fundamental conceptual definition of an eating disorder, i.e., a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical or psychosocial functioning. The disturbance is not secondary to any recognized general medical disorder or any other psychiatric disorder .
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Nos Diagnoses In Dsm And Eating Disorder Nos
Eating disorder NOS is an example of the Not OtherwiseSpecified category in DSM-IV . Since the publication of DSM-III , the AmericanPsychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders hasincluded either atypical or not otherwise specified categories and DSM-IV), respectively in each broad diagnostic class in view ofthe difficulty covering every presentation encountered in clinical practice. Thesediagnoses are intended to indicate a category within a class of disorders that isresidual to the specific categories in that class .
Eating disorder NOS is the category in DSM-IV reservedfor eating disorders of clinical severity that do not meet diagnostic criteria for eitherone of the two eating disorders recognised in DSM-IV, anorexia nervosa and bulimianervosa. In common with other NOS diagnoses, it is a residual category. Thus, there aretwo steps in making a diagnosis of eating disorder NOS: first, it must be determined thatthere is an eating disorder of clinical severity; and then, it must be established thatthe diagnostic criteria of anorexia nervosa and bulimia nervosa are not met. This secondstep therefore involves diagnosis by exclusion: no positive diagnostic criteria for eatingdisorder NOS need to be fulfilled.
Other Specified Feeding And Eating Disorders
Any person, at any stage of their life, can experience an eating;disorder. More than one million Australians are currently living;with an eating disorder .
Of people with eating disorders, 3% have anorexia nervosa,;12% bulimia nervosa, 47% binge eating disorder and 38% with;other eating disorders .
Eating disorders are not a choice but are serious mental;illnesses. Eating disorders can have significant impacts on;all aspects of a persons life physical, emotional and social.;The earlier an eating disorder is identified, and a person can;access treatment, the greater the opportunity for recovery orimproved quality of life.
Figure 1. Prevalence of eating disorders by diagnosis
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How Are Eating Disorders Diagnosed
Doctors use guidelines for diagnosing different mental health conditions, such as eating disorders. When deciding on a diagnosis doctors will look at these guidelines. They will look at what symptoms you have had. And how long you have had these for. The main guidelines are:
- International Classification of Diseases , produced by the World Health Organisation , and
- Diagnostic and Statistical Manual , produced by the American Psychiatric Association.
A health professional will assess you to work out if they think you have an eating disorder. As part of the assessment they will:
- ask about your feelings, thoughts and behaviours,
- see if there has been any rapid weight loss,
- check if your body mass index is too high or too low,
- ask you about any diets that you are on,
- listen to the concerns that your family or carers have about your eating behaviour, and
- think about different reasons for your symptoms.
My Eating Disorder Is How Ive Learned To Survive
Once upon a time, my eating disorder was an important coping tool.
It gave me a sense of mastery when my life was out of control. It numbed me emotionally was I was enduring abuse. It gave me something to obsess about, like a mental fidget spinner, so that I didnt have to face a troubling reality.
It helped me feel smaller when I was ashamed of the space I took up in the world. It even gave me a sense of accomplishment when my self-esteem was at its lowest.
In order to just eat, youre asking me to give up a coping tool that helped me to survive for most of my life.
Thats an enormous thing to ask of anyone. Eating disorders arent just diets you can pick up and stop at any time theyre deeply ingrained coping mechanisms that have turned against us.
The brain circuits that are in charge of hunger and fullness become less and less activated, which erodes our ability to interpret, understand, and even experience normal hunger cues.
Just eat is a pretty simple directive to someone with normal hunger cues if youre hungry, you eat! If youre full, you dont.
But how do you decide to eat when you dont feel hungry , you dont feel full , and on top of that, youre terrified of food?
Without those regular and consistent cues, and all the fear that can interfere with them, youre left completely in the dark. Just eat is not helpful advice when youre neurologically impaired.
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