Pro-Ana and Pro-Mia Websites

I enjoy reading blogs.  I read blogs on cooking, healthy living, do-it-yourself, decorating,gardening, and a lot of other things.  I am on Pinterest.  I have 18 different boards on Pinterest and nearly 200 pins covering several broad topics.  Never have I come across a Pro-Ana or Pro-Mia website.  Until this past week… 

I have done a fair amount of research on the web regarding eating disorders and ethics.  I have read discussions about sites that promote the anorexic and bulimic lifestyles.  This week I decided to d a search and looked them up.  I was shocked by the ease of finding the sites.  Just typing pro-ana came up with hundreds of websites. 

When I first started viewing some of these sites, I was horrified and disgusted.  I found them everywhere.  Blogs, Youtube, Pinterest, Facebook, Instagram, everywhere.  There seemed to be more fro the UK, than other countries.  The websites themselves gave warnings about the dangers and that they could not be held responsible for other’s actions.  Clearly the authors of these blogs knew the dangers of promoting the lifestyle.  These websites contain helpful hints on staying true to the lifestyle, how to hide your weight loss or how to hide your lack of eating.  There are list of low/no calorie foods.  There are forums that people can post questions and victories.  Pictures of super-thin models and quotes about being thin abound on these sites.  “Thinspiration” is what these pictures are called.

Dig a little deeper, though, and you find people.  Real people.  These girls(I did not find any posts by boys or men), were true to themselves and each other.  They had found a place where they were accepted.  Their thinking is clearly flawed, but they felt safe to talk about their struggles.  There was a lot of poetry. Many dreamed about recovery.  

I began to think of the good that might come from these sites.  Asking a client to “friend” them on their social media, could give a therapist a wealth of information.  Family and friends of people with eating disorders would benefit going onto these websites and getting to know about how eating disorders affects one’s thinking. Psychologist can use these websites for research. We can reach out to them, lovingly and encourage recovery.  Rather than condemn one of the few outlets that these girls have, let’s use it to our advantage and learn all we can from them.  

References

Davis, J. (2008). Pro-anorexia sites--A patient's perspective. Child And Adolescent Mental Health, 13(2), 97. doi:10.1111/j.1475-3588.2008.00489_3.x

Fox, N., Ward, K., & O'Rourke, A. (2005). Pro-anorexia, weight-loss drugs and the internet: an ‘anti-recovery’ explanatory model of anorexia. Sociology Of Health & Illness, 27(7), 944-971. doi:10.1111/j.1467-9566.2005.00465.x 

I met a girl named Ana,

I heard she ruins lives.

Won't let me have a banana,

a peach or pumpkin pie.

No chicken, no meat, no pasta.

Just water and some air.

I know this girl named Ana,

She's making my life a nightmare.

                                                                   -author unknown

Force feeding-Why or Why Not?

As I consider the ethical issues of eating disorders, the issue of force-feeding a patient is a valid question.  Is saving the patient a greater goal than informed consent?  What if the person with anorexia does not want to eat?  There are life threatening dangers in force-feeding, but the alternative may lead to death also.  Since most people with an eating disorder have a duel diagnosis of another psychological disorder, can we ignore the patients desire not to eat?  

There is value in every life.  I  believe the answer is that we must do what we can to save the life of the individual.  Force-feeding individuals who are malnourished have the risk of “re-feeding syndrome,”  where the individual’s cells cannot support the sudden influx of fluid and electrolytes.  Extreme care and attention to the type of medical intervention used must be taken.  Medical practitioners must carefully consider if the use of IV fluids or a feeding tube is more appropriate.  IV  fluids may be necessary if the digestive system is not functioning properly.

Studies show that most individuals with eating disorders, such as anorexia nervosa, do not want to die and do not have suicidal tendencies.  If force-feeding severely malnourished individuals with eating disorders saves lives and leads to getting the psychological help needed, I believe it is the ethical thing to do

.

References

Persaud, R. (n.d.). Should Anorexics be force fed?. The Huffington Post UK. Retrieved September 21, 2014, from http://www.huffingtonpost.co.uk/dr-raj-persaud/should-anorexics-be-force_b_1608531.html

Bowcott, O. (n.d.). Anorexic woman should be fed against her wishes, judge rules. The Guardian. Retrieved September 18, 2014, from http://www.theguardian.com/society/2012/jun/15/anorexic-woman-fed-judge

Bodily Autonomy

In every person’s life, there comes a time when you are autonomous, able to make your decisions on your own.  We have all made both good and bad choices in our lives and have faced the consequences, good and bad.  One of the biggest questions in my mind is at what age does that happen?  As a mother of four(yes, four) teenagers ranging from 14-18 in age, I have often wondered when do you allow them to start making decisions that may effect their lives for a long time?  

I remember the first time I let my sons go into a men’s restroom for the first time without their father.  I stood outside the door, counting the minutes and scrutinizing any man that entered or exited the restroom.  I remember making the three boys go into together, and making them promise not to leave each other alone.  This is a normal scenario.  It is a step every boys mother must eventually make. 

As parents, we have always been the ones to make all decisions in the home.  Those choices included entertainment, healthcare, schooling, clothing, food and many others. Letting some of those decisions be made by the teens is sometimes hard, but I believe are necessary to raising healthy, confident young adults. 

When do your teens become mature enough to visit the doctor’s office by themselves?  My 17 year old son recently had strep throat and I accompanied him into the doctor’s office.  When a child has a serious illness, such as an eating disorder, is it ok for the doctor to refuse to allow parents in or to give information to the parents?  If so, at what age?   Eating disorders are often duel-diagnosed with another mental disorder, such as depression, anxiety, or OCD.

Success in treating eating disorders vary greatly.  Factors include needs of the individual, severity of other diagnosed illnesses, type of treatment, willingness of the individual to embrace treatment and the family or social support network. (Eating Disorders, n.d.)  People with eating disorders need nutrition education, and medical and psychological care.  

In my research I found that those with a strong support system tended to have more long term success.(The Family-Based, or Maudsley Treatment Approach. n.d.)  I believe that a strong family/social support system a key in recovery from eating disorders.  If the teen with an eating disorder has a supportive family,  doctors and psychologist will benefit having everyone involved in the care of the patient.  Parents need to be involved in the health of their children.  

References

Eating Disorders. (n.d.). Retrieved August 18, 2014, from http://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml#part5

The Family-Based, or Maudsley Treatment Approach. (n.d.). Retrieved from http://www.feast-ed.org/TheFacts/MaudsleyApproach.aspx

Eating Disorders and Teens

There are several reasons to start a blog on eating disorders and teens.  When I was a teen I knew a few girls who struggled with eating disorders, and the sister of a good college friend has struggled with anorexia nervosa for over 2 decades.  And now as a parent with teens, I realize that the body image issues are greater now than ever.  My goal as I write this little blog is to work through my thoughts on the topic, bring in some relevant research on treatments and ethical issues, and hopefully bring some hope and direction to parents and/or teens struggling with these issues.

In my research, I came across an very sobering fact:  Eating disorders have the highest mortality rate of any other mental illness.  This fact alone brings many ethical issues to my mind.  How much intervention is enough?  Can we force feed individuals against their will?  How much information should psychologist share or withhold from parents?  At what age can a teen display autonomy and not have to share private medical info with their parents?  Should pro-ana websites and blogs be banned?  These are just a few of the topics that I would like to explore.  I would love your comments and feedback

-Sherrill