Friday, August 21, 2009

Ask the Expert - Week 4

Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, recently took readers’ questions on anorexia, bulimia, binge eating and other problems. Here, she responds to one reader’s question about growing up in a household where eating disorders were common.

My mother-in-law is in her 60s and has struggled with bulimia since her early 20s. Both my husband and his sister struggle with food but in different ways. She is very thin, is addicted to exercise and is obsessed with her body image. My husband overeats and is overweight. This is impacting his health. I know that there are many books and resources for adult children of alcoholics. Are there any resources for adults raised by a mother with an eating disorder?


Dr. Zerbe responds:

There is only one book that I know of that addresses your question specifically, but I bet there will be more in the future. Take a look at Daniel Becker’s “This Mean Disease: Growing Up in the Shadow of My Mother’s Anorexia.” Mr. Becker describes his mother’s 30 year battle with anorexia in a way that is not only touching and thought provoking but shows how each family member must make changes in his or her life to really deal with the effects of such a severe problem on the life of the family.

Your problem is coming to the attention of more and more therapists because we are seeing eating disorders in older women and men. There are a number of good books and resources out there for loved ones who have a family member with an eating disorder, but nothing takes the place of having those with food issues talk with someone knowledgeable and understanding.

For example, I am thinking of one of my patients, I’ll call him Jeff, whose mother and father both had significant issues with their depression, body image and low weight. Jeff is now in recovery, but we discovered in his therapy that an obsession with thinness went back at least to both of his grandmothers, who could never be too thin and always seemed to be angry and demanding.

As Jeff’s psychiatrist, I could not give a formal diagnosis, such as depression, dysthymia (low mood) or an eating disorder, to any of his family members, since I wasn’t treating them. In fact, they refused all interventions that Jeff asked them to get. But I offered him therapy and medications, and a book I suggested he read, Judith Viorst’s classic 1986 work on adult life transitions called “Necessary Losses: The Loves, Illusions, Dependencies, and Impossible Expectations That All of Us Have to Give Up in Order to Grow,” helped him come to accept what he could and could not do for his mother and father, as much as he wanted to help them.

Jeff gradually embraced more of his own life and faced down his eating problem. He is now married and raising a couple of children, and has become aware through his reading how common eating concerns are becoming in younger and younger children. And though he struggles from time to time with his body image, he is a lot better than when he started his therapy work over six years ago.

As Jeff put it, “I don’t want my parents’ problem to become the problem of my own kids. We will have a ‘no teasing’ policy at the dinner table when it comes to body image, and my wife and I plan to start media awareness of the slender body ideal even when they are in grade school.”

Another resource I recommend for those who grew up or live in a household with eating disorders is the Web site from Gurze books, which publishes a catalog of excellent books on the subject. (They can also be reached at (800) 756-7533.) You will likely find something that helps you and perhaps raises the awareness of your loved ones.

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