Epcot unveiled its latest attraction this month called Habit heroes at Innoventions.  Guests meet superheroes, Will Power and Callie Stenics along with bad guys, Lead Bottom , Glutton and Sweet Tooth.

Ironically, this attraction is not empowering all youth  to feel excited about a vacation filled with momentary wonder and joy-filled activity, but rather reinforcing society’s most hateful negative obesity stereotyping.  If the family vacation is an opportunity for children and youth to feel loved and nurtured, what a potential misstep!  The Habit Heroes attraction may actually reinforce a fragile body image concept, or worse; create a lifelong memory of being compared to Lead Bottom or Glutton after a visit to the theme park. The most impressionable of our youth, may feel that name calling, or shaming is appropriate.

If you would like to express YOUR concern, please call 407-824-2222 to complain about the Habit Heros attraction at Innoventions. Or email TWDC.Corp.Communications@disney.com. Let your voice be heard.  Your advocacy may prevent an eating disorder from emerging or prevent a child from being bullied.

For a parent, seeing your daughter struggle with body image and weight issues can be scary. It’s even scarier to think that she might have an eating disorder. Visions of starving girls dance around in your head. You become afraid that anything you say is going to make it worse. You try to stop the behaviors by trying to reason with her. You say things such as, “You know, Katie, you can get sick doing this.” You try to bargain with her with offers like, “If you eat, you can go shopping/go away for the weekend/get your own phone” etc. You resort to guilt in the form of, “If you really loved me, you would…” When these things don’t work, you become angry and afraid because nothing you do seems to make things better. If you’re a mother, you might blame yourself, even if you know intellectually that it’s not your fault. If you’re a father, you feel powerless. Your job is to take care of and protect your child and to fix things. This is one thing that you cannot fix.

There is no one single factor, experience, or moment in time that causes somebody to develop an eating disorder. They occur because of a complex combination of factors, which include biological predisposition to anxiety or obsessive-compulsive disorder, genetics, stage of development, societal factors, family dynamics, and personality structure. For many girls, food and disordered eating behaviors develop as a coping mechanism that becomes a way for them to deal with painful, scary or “inappropriate” feelings, tension and anxiety, emotional conflict, and unresolved issues. While you can’t change her biology or genetics it helps to understand the impact that societal and personal pressures have on her.

Girls are relational, and their connections with others make up a large part of their sense of well-being and also influence how they navigate in the world. Until girls are between the ages of 8 and 10 they tend to be confident, strong, outspoken, and bold. As they approach puberty, however, they fall prey to the forces of socialization that tell them to be “nice,” and please others at the expense of themselves, and to the media that encourages them to define themselves by how they look. Many girls take their feelings and insights underground—lest they hurt or upset someone else and are then rejected. Girls “lose their voice”—that is, their ability to express their feelings, opinions, and thoughts directly and, instead, express them indirectly though a negative voice. Because fat has become the bogeyman in our society, girls (and especially girls with a tendency toward anxiety) redirect their feelings and concerns into the fear of being fat. Worrying about fat, “feeling fat” and speaking in “fat talk” become a way of turning something real on the inside into something artificial on the outside. In other words, girls deal with the discomfort of their psychological fat by trying to change what they perceive as body fat in the belief that this will change their lives and, thus, how they feel about themselves.

What You Can Do

Work with your family doctor to find out where your daughter is on a continuum that includes girls with disordered eating patterns, girls just beginning to use eating disorder behaviors, girls whose behaviors are more entrenched, and girls whose behaviors are making them sick. Knowing where she is on the continuum will help you assess the kind of intervention she needs.

Remember Golden Rule of Parenting: You didn’t break it. It’s not your fault. You are not a plumber. You can’t fix it.

Understand that eating disorders are coping mechanisms that develop over time. As long as you don’t encourage weight loss or make her feel guilty for not getting better, there is little you can say or do that will make it worse.

Share your concerns about her behaviors. Use “I statements” to describe the specific things that you see. “I see that you are not eating breakfast or lunch. This makes me worried about you.” “I heard you throwing up yesterday, and that worries me.” If she doesn’t want to listen to you or becomes angry with you for calling attention to her behavior, just keep telling her that you are concerned. Remember that this is not about you. She won’t change her behaviors because you tell her you love her or how hard it is on you.

Help her become a detective. Take the focus off the food and the fat talk. Encourage her curiosity about her behaviors, her thoughts, and what she tells herself. Ask her to remember the specific day and time of day when she felt fat or wanted to really exercise or restrict what she was eating. What was she was doing and thinking about? Did she have any “forbidden” thoughts such as being annoyed at someone, or did she feel jealous or insecure? Have her tell her story again focusing on real feelings and issues. Instead of giving her advice, let her know that you understand how and why she feels the way she does in that situation.

Encourage her to be specific. Girls with disordered eating or eating disorders tend to have “black and white” or “all or nothing” thinking. They tend to use global language instead of being specific about right now. Keep asking her to give you a “for instance” and help her focus on just one thing.

Help her expand her range of feelings. Feelings such as anger, disappointment, jealousy, loneliness, and feeling criticized are seldom part of a girl’s emotional vocabulary and are often seen as “bad.” Incorporate descriptions of these emotions into your own language when appropriate so that you can model, diffuse, and normalize them. Let her know that just because she has a feeling doesn’t mean she has to do something about it.

Encourage her to speak in a BIG VOICE. When girls can’t speak out or set boundaries they often feel insignificant and powerless and express themselves in a tiny, soft, little voice. Talk about how the different voices make her feel. Encourage her to stand up and speak in a BIG VOICE when she is telling you how she feels.

Help her accept her body at whatever size it is. Help her counter societal messages around fat by teaching her that beautiful bodies come in all sizes and shapes. Also, educate her that weight does not create health risks; poor nutrition and lack of exercise do.

Examine your own issues around food and weight. If you are dieting, relating to food in terms of calories and fat, and/or making comments about your body or your partner’s body, you are passing your attitudes onto your daughter.

Remember that the greatest gift you can give her is to love and be real with her. Instead of trying to fix her or her disorder, build and nourish a healthy foundation so that no matter what happens you can maintain your connection with her.

By Sandra Friedman, MA
Reprinted from Eating Disorders Recovery Today
Spring 2009 Volume 7, Number 2
©2009 Gürze Books

Chicago, IL – January 12: The National Association of Anorexia Nervosa and Associated Disorders (ANAD) and the Binge Eating Disorder Association (BEDA) appeal to the Children’s Healthcare of Atlanta (CHOA) to discontinue their fear and shame-based advertisements objectifying children. Campaigns that focus on overall wellness, not weight shaming, should be the goal.

The CHOA released a new ad-campaign, known as Stop Sugarcoating, utilizing negative attention and shaming to address childhood obesity. Recently, concern has risen in the state of Georgia, which is ranked the second highest prevalence of childhood obesity in the country, prompting the development of the campaign.

Chevese Turner, Executive Director of BEDA, states, “This ad campaign has the potential to inflict harm through the message it sends. The creators of the campaign quite obviously do not understand the psychological impact this has for individuals of size, including children. CHOA clearly believes this approach will work, despite a growing number of professionals and experts in both the obesity and eating disorders field who disagree because of the growing evidence that shaming and stigmatizing actually lead to weight gain over time. We have received close to 1,000 signatures, within a week’s time, on our petition to end this campaign; the public and many professional physical and mental health providers have joined us to let CHOA know that this approach is dangerous and should be discontinued immediately.”

Laura Discipio, Executive Director of ANAD, says, “Research has shown that children as young as five years old already have been conditioned to fear being fat.  CHOA continues to perpetuate this fear by using shaming and bullying tactics targeted at children who are of larger size. But unfortunately, children who are of normal or low weight can also be negatively affected. This Ad-campaign has the potential of doing more harm than good. Shaming our children should not be tolerated!   Feeling good about yourself increases the likelihood that you will take good care of your body and decreases the likelihood of disordered eating. Instead of shaming our children, let’s help them feel good about themselves and provide all children an opportunity to engage in healthy lifestyles so they can develop healthy attitudes and behaviors and healthy bodies.”

Discipio adds, “Chevese and I, as well as our expert boards and scientific committees, welcome an open conversation with the developers of this ad campaign and future weight-related campaigns to discuss effective and healthy ways to address these important issues. We must be cognizant of the fact that many of the obesity efforts underway in this country are worrisome-at-best and can lead to eating disorders, which have the highest mortality rate of any psychiatric illness and have realized a significant rise in prevalence over recent years.”

To view the Stop Sugarcoating campaign: www.strong4life.com

 ANAD is a non-profit (501 c 3) corporation that seeks to prevent and alleviate the problems of eating disorders, especially including anorexia nervosa, bulimia nervosa and binge eating disorder. ANAD advocates for the development of healthy attitudes, bodies, and behaviors. ANAD promotes eating disorder awareness, prevention and recovery through supporting, educating, and connecting individuals, families and professionals.

BEDA was founded to help those who have binge eating disorder, their friends and family, and those who treat the disorder. BEDA provides individuals who suffer from binge eating disorder with the recognition and resources they deserve to begin a safe journey toward a healthy recovery. BEDA also serves as a resource for treatment providers to prevent, detect, diagnose, and treat the disorder. By establishing strong connections among members and sister organizations, BEDA’s goal is to give everyone access to the tools they need to live with, treat, and, ultimately, prevent the disorder.

Read the full report (PDF)

Blue Shield Must Provide Residential Care Benefits: Mental Health Parity Mandates Coverage for Underlying Depression and Panic Disorders

LOS ANGELES, JANUARY 18, 2012 – Kantor & Kantor, LLP announced today that the U.S. District Court for the Central District of California ruled in favor of the firm’s client Laura Burton, deciding that California’s Mental Health Parity Act mandates that Blue Shield of California must provide benefits for residential treatment of Ms. Burton’s major depressive disorder and panic disorder.

“Mental health parity is firmly established law in California,” said Lisa Kantor, who represents Ms. Burton. “Blue Shield continues to act as if the Act doesn’t exist by denying residential treatment when it is clearly medically necessary. That attitude is offensive to both policyholders and the legal system.”

In Burton v. Blue Shield of California, the court held that under the Act, Blue Shield must cover “medically necessary treatment of severe mental illnesses” under “the same terms and conditions applied to other medical conditions. … The Ninth Circuit interpreted the Act to require that insurance companies provide coverage under the same financial terms and conditions for medically necessary treatment of ‘severe mental illnesses’ and medical conditions.”

The Ninth Circuit case the district court referred to is Harlick v. Blue Shield of California, an August 2011 ruling that determined California’s Mental Health Parity Act requires insurers to pay for eating disorder treatment at residential facilities. That case, in which Ms. Kantor represented a plaintiff denied residential treatment benefits for anorexia, was the first decision to determine that the phrase “same terms and conditions” included financial terms. The court cited in that ruling the nine mental illnesses enumerated in the Act: Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, Major Depression, Obsessive-Compulsive Disorder, Panic Disorder, Eating Disorder (Anorexia Nervosa and Bulimia Nervosa), Autism or Pervasive Developmental Disorder, and Serious Emotional Disturbance in children and adolescents.

The Burton court, dealing with major depression and panic disorders, relied on that language, pointing out the impossibility of separating treatment for severe underlying mental illnesses from treatment for alcohol dependency.

For more information about Lisa Kantor and legal assistance for residential treatment for mental illness, log on to http://www.kantorlaw.net/Areas_of_Practice/Eating_Disorders.

Contact: Laura Discipio or Chevese Turner                                    FOR IMMEDIATE RELEASE

Telephone: 630-577-1330 or 855-855-BEDA

Email: laura.discipio@anad.org or chevese.turner@bedaonline.org

LEADING EATING DISORDERS ORGANIZATIONS AGREE THAT CHILDREN’S HEALTHCARE OF ATLANTA AD-CAMPAIGN IS SHAMING AND DANGEROUS

Chicago, IL – January 12: The National Association of Anorexia Nervosa and Associated Disorders (ANAD) and the Binge Eating Disorder Association (BEDA) appeal to the Children’s Healthcare of Atlanta (CHOA) to discontinue their fear and shame-based advertisements objectifying children. Campaigns that focus on overall wellness, not weight shaming, should be the goal.

The CHOA released a new ad-campaign, known as Stop Sugarcoating, utilizing negative attention and shaming to address childhood obesity. Recently, concern has risen in the state of Georgia, which is ranked the second highest prevalence of childhood obesity in the country, prompting the development of the campaign.

Chevese Turner, Executive Director of BEDA, states, “This ad campaign has the potential to inflict harm through the message it sends. The creators of the campaign quite obviously do not understand the psychological impact this has for individuals of size, including children. CHOA clearly believes this approach will work, despite a growing number of professionals and experts in both the obesity and eating disorders field who disagree because of the growing evidence that shaming and stigmatizing actually lead to weight gain over time. We have received close to 1,000 signatures, within a week’s time, on our petition to end this campaign; the public and many professional physical and mental health providers have joined us to let CHOA know that this approach is dangerous and should be discontinued immediately.”

Laura Discipio, Executive Director of ANAD, says, “Research has shown that children as young as five years old already have been conditioned to fear being fat.  CHOA continues to perpetuate this fear by using shaming and bullying tactics targeted at children who are of larger size. But unfortunately, children who are of normal or low weight can also be negatively affected. This Ad-campaign has the potential of doing more harm than good. Shaming our children should not be tolerated!   Feeling good about yourself increases the likelihood that you will take good care of your body and decreases the likelihood of disordered eating. Instead of shaming our children, let’s help them feel good about themselves and provide all children an opportunity to engage in healthy lifestyles so they can develop healthy attitudes and behaviors and healthy bodies.”

Discipio adds, “Chevese and I, as well as our expert boards and scientific committees, welcome an open conversation with the developers of this ad campaign and future weight-related campaigns to discuss effective and healthy ways to address these important issues. We must be cognizant of the fact that many of the obesity efforts underway in this country are worrisome-at-best and can lead to eating disorders, which have the highest mortality rate of any psychiatric illness and have realized a significant rise in prevalence over recent years.”

To view the Stop Sugarcoating campaign: www.strong4life.com

The National Association of Anorexia Nervosa and Associated Disorders, Inc. (ANAD) is a non-profit (501 c 3) corporation that seeks to prevent and alleviate the problems of eating disorders, especially including anorexia nervosa, bulimia nervosa and binge eating disorder. ANAD advocates for the development of healthy attitudes, bodies, and behaviors. ANAD promotes eating disorder awareness, prevention and recovery through supporting, educating, and connecting individuals, families and professionals.

The Binge Eating Disorder Association (BEDA) was founded to help those who have binge eating disorder, their friends and family, and those who treat the disorder. BEDA provides individuals who suffer from binge eating disorder with the recognition and resources they deserve to begin a safe journey toward a healthy recovery. BEDA also serves as a resource for treatment providers to prevent, detect, diagnose, and treat the disorder. By establishing strong connections among members and sister organizations, BEDA’s goal is to give everyone access to the tools they need to live with, treat, and, ultimately, prevent the disorder.

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For more information regarding ANAD, visit www.anad.org

To connect with help, call 630-577-1330 or email anadhelp@anad.org

For more information regarding BEDA, visit www.bedaonline.org

To connect with help regarding binge eating, call 855-855-BEDA

Available for Interviews:

Laura Discipio, Executive Director of ANAD

Chevese Turner, Executive Director of BEDA

Treatment specialists for the spectrum of all eating disorders

Recent multiple brain imaging studies of patients with restricting-type anorexia nervosa (AN) reveal neurocircuit dysregulation and may help clarify the disorder’s confounding symptoms.

In a review article, Walter Kaye, MD, director of the Eating Disorders Program at the University of California, San Diego (UCSD), and his coauthors¹ said that insights into the ventral (limbic) and dorsal (cognitive) neural circuit dysfunction, perhaps related to altered serotonin and dopamine(Drug information on dopamine) (DA) metabolism, may help explain why individuals with anorexia often report that dieting reduces their anxiety while eating increases it and why they worry about long-term consequences but seem impervious to immediate gratification and unable to live in the moment.

Many women diet in this culture, but relatively few (0.5%) have anorexia, Kaye told Psychiatric Times. “Why is that? Well, you pretty much have to have a certain temperament and personality in childhood to be vulnerable for . . . an eating disorder,” said Kaye. “Not everyone who develops anorexia has all these traits in childhood, but most have one or more of them,” he said. “These traits include harm avoidance, anxiety, behavioral inhibition, difficulty with set shifting [easily moving from one mental set to another], a tendency to focus on details rather than the big picture, and perfectionism.” Even after recovery, these personality and temperament traits persist, pointing to underlying neurobiological factors.

Another clue is the relatively stereotypic course of anorexia. That is, anorexia tends to occur in females with onset during adolescence when some combination of puberty, brain development, stress and/or sociocultural factors comes into play, provoking the onset of anorexic symptoms. Anorexia is marked by body image distortions and the fear of being fat and results in a downward spiral of weight loss that is difficult to reverse.

Once an individual becomes anorexic, starvation and malnutrition affect every system of the body, including the brain. Such changes include neurochemical imbalances, which may, in turn, exaggerate the preexisting traits and accelerate the disease process. Individuals with anorexia, for example, have a reduced brain volume and a regression to prepubertal gonadal function, Kaye said. Yet, these disturbances tend to normalize after weight restoration, which suggests that they are state-related alterations.

In their article, Kaye and colleagues distinguish between state-related and trait-related abnormalities, and then review how new brain imaging technologies are helping identify the brain pathways involved in AN.

Brain imaging

Studies using positron emission tomography (PET) brain imaging and related technologies have assessed serotonin and DA neurotransmitter systems in individuals with anorexia and in those who have recovered, while studies using functional MRI (fMRI) have illuminated altered activity in interconnected brain regions of these individuals.

Imaging studies suggest that individuals with anorexia have an imbalance between circuits in the brain that regulate reward and emotion (ventral) and circuits that are associated with consequences and planning ahead (dorsal).² Brain-imaging studies also show that individuals with anorexia have alterations in those parts of the brain (eg, anterior insula) involved with interoceptive self-awareness that may be implicated in disturbed bodily sensations.³ In addition, altered function of other related regions may contribute to altered sensing of the rewarding aspects of pleasurable foods. Individuals with anorexia may literally not recognize when they are hungry.

The neurotransmitters serotonin and DA are primary targets of study, according to Kaye. “Simply put, the serotonin system tends to be inhibitory while the dopamine system is associated with signals about reward.”

Kaye said that evidence from imaging studies suggests that disturbances in the serotonergic system might contribute to vulnerability for restricted eating and behavioral inhibition as well as a bias toward anxiety, particularly excessive concern with consequences. Meanwhile, DA dysfunction, particularly in striatal circuits, may contribute to altered reward, decision making, stereotypic motor movements, and decreased food ingestion.

Evidence that the dopamine system is involved includes reduced cerebrospinal fluid levels of DA metabolites both in ill individuals and in those who have recovered from anorexia, functional DA _D2 receptor gene (DRD2) polymorphisms in individuals with anorexia, and impaired visual discrimination learning. A PET study found that subjects who recovered from AN had increased D₂/D₃ receptor binding in the ventral striatum, a region that modulates responses to reward stimuli.4 This finding could indicate increased D₂/D₃ receptor densities, decreased extracellular DA, or both in individuals who recovered from anorexia.

With regard to serotonin, brain imaging studies consistently show that when compared with healthy subjects, individuals with or those who have recovered from eating disorders have an imbalance between enhanced 5-hydroxytryptamine (serotonin) receptor 1A (5-HT_1A) and diminished 5-HT_2A receptor binding potential.¹ “Eating carbohydrates is thought to increase extracellular serotonin levels, which, in turn, may drive anxiety and harm avoidance in AN. . . . Because these symptoms are correlated with 5-HT_1A receptor binding in anorexia, stimulation of 5-HT_1A receptors offers a potential explanation for feeding-related dysphoric mood in AN. When individuals with AN starve, extracellular serotonin concentrations might diminish, resulting in a brief respite from dysphoric mood.”

End of Year Package Would Cut Hospital Funding More than $17 billion

“How can someone get that skinny and not realize it?”  It’s a familiar question we receive whenever we visit schools or give presentations in the community.  Many people find it hard to understand how severely an eating disorder can distort someone’s perception (more…)

In the October Archives of Pediatrics and Adolescent Medicine,  results from a Canadian Paediatric Surveillance Program Study of approximately 2453 Canadian pediatricians (a 95% participation rate) was conducted monthly during a 2-year period. This is the first country-wide study in North America to examine the incidence of restrictive eating disorders among children. Results indicated that eating disturbances can result in serious medical consequences, ranging from growth delay to unstable vital signs.  The study found a greater percentage of 5 – 12 year olds with disordered eating than those that were diagnosed with Type II Diabetes.

For greater detail:   Abstract

Source: Archives of Pediatrics and Adolescent Medicine