You're invited

to the next--and probably last one for a while--Maudsley Parents conference. This one is very exciting, because it's covering not just Family-Based Treatment but a broader spectrum of issues in child and adolescent eating disorders.

The one-day conference will bring together families, clinicians, and experts to talk about the current state of treatment in child and adolescent eating disorders and new directions for the future. It's being held in an absolutely gorgeous hotel, the Pearl River Hilton, in Pearl River, NY, about an hour outside of New York City.

Featured speakers include Debra Katzman, MD, on the current state of treatment for kids and teens with eating disorders; Rebecka Peebles, MD, on the medical side of treating kids and teens; Katharine Loeb, PhD, on the need for early intervention (and how best to achieve it); Evelyn Attia, MD, on the role of medication in treating eating disorders in kids and teens; and Daniel LeGrange, PhD, on working with families from both a therapist's and parent's point of view. Oh, and I'll be talking about the parents' perspective as well.

We've worked hard to keep the price reasonable, so families who are already financially stressed can attend. If you register before 12/31, the cost is $60; after 1/1 it's $75. We've reserved a block of rooms. For more information and to register, click here.

So please join us for what promises to be an educational and entertaining day! See you there.

What do you expect from the research journal Obesity?

This is what you get, at least on the cover of the journal's November issue:



I don't know about you, but I think Santa looks kind of grim. Ill, even. Someone should tell him that physical activity and fitness are a lot more important than weight. He might want to read up on the fact that being heavier later in life isn't such a bad thing, that in fact weight loss later in life isn't a good idea. So long as he stays active, making and delivering all those gifts, he'll likely live to a ripe old age whatever his weight.

Someone should give that guy a cupcake.

Looking for . . .

Greetings everyone!

I'm working on a story for the New York Times, and am looking to interview any of the following:

--> eating disorders therapists or clinicians with a history of eating disorders themselves
--> eating disorders patients who have been treated by therapists, nutritionists, etc. who have had a history of ED themselves

I'm looking to explore the pros and cons, so any and all feedback is welcome.

Please email me at hnbrown at syr dot edu if you'd like to chat or email. And please pass along the word.

Thanks!

Another entry in the annals of Bad Ideas in Eating Disorders

is a soon-to-be-aired reality show called, I kid you not, "Starving Secrets with Tracey Gold.

The idea is that child actress-grown-up Tracey Gold, who nearly died from anorexia in her early 20s but is now married and recovered, will meet one-on-one with women suffering from eating disorders. As the show's early PR puts it, Gold will "work with women in the grips of anorexia or bulimia as she uses her own experience to reach them in ways no one else can."

Really? No one else but this particular former actress can help these women? I knew the state of treatment was bad, but not this bad.

And who the hell gave the show this title? It doesn't sound like it's designed to help. It sounds like viewers will be treated to pro-ana tips from Gold.

I'm sure that's not her intention . . . right? Someone reassure me? Because so far I'm unconvinced.

I'm not a fan of reality shows in general, especially when they purport to stage interventions or reveal long-held secrets in a very public forum designed to entertain other people. They can't help but be exploitative-that's their whole raison d'etre. But this one sounds particularly egregious.

Ugh.

Britney Spears, before and after Photoshopping

If you're reading this blog, you probably know what I'd like to say about this. But I think I'll let the image speak for itself.

Come talk to me!

Thanks to Maudsley Parents and the University of Chicago for hosting an evening with Dr. Daniel le Grange and myself at University of Chicago on October 20th. This is your chance to meet up with other families who may have dealt with eating disorders, to learn from them, and, most important, to not feel isolated or alone.

This event is free, thanks to the generous sponsorship of Maudsley Parents, but you must RSVP to reserve a place: RSVP@maudsleyparents.org.

I hope to see you there!

Upcoming events

In honor of the paperback version of Brave Girl Eating, which was just released, I'm doing some events this fall, and I'd love to see you at any of them. Here's what's coming up:

Thursday, October 6: I'll be reading at Syracuse University's Nonfiction Reading Series. This should be an informal chance to hear excerpts of the book and talk. 3:30-5 p.m., 500 Hall of Languages, on the Syracuse University campus. Free!

Thursday, October 13th: I'll be reading from the book, along with Randy Cohen, who write "The Ethicist" column for the NY Times magazine for many years; poet Charles Martin; and others. 6 p.m. At Lubin House, 11 E. 61st St., NYC. Free!

Thursday, October 20: I'll be reading from the book, and facilitating a conversation with Dr. Daniel le Grange and families who have struggled with eating disorders. This will be an informal evening, with chances to connect and talk and ask questions. Sponsored by Maudsley Parents. 7 p.m. At the University of Chicago's Quad Club, 1155 E. 57th Street, Chicago, IL. FREE, but please RSVP to RSVP@maudsleyparents.org or or call Leah Boepple at 773-702-0789.

Hope to see you in Syracuse, New York or Chicago!

New Zealand Radio

ran a nice interview about Brave Girl Eating. You can find it here. The lovely New Zealand accents don't hurt either! :)

Just in case you were confused about the nature of eating disorders . . .

read this, which is circulating on Tumblr. My younger daughter sent it to me. Wise girl.

OT: Veterans and mental health

Indulge me in a slight change of subject this morning, to the very real problem of health care for veterans. Specifically, mental health care.

It's well known that veterans who return from war struggle with a slew of mental health issues. And it's very well known that suicide is a major problem among active-duty personnel and vets, as this editorial in the New York Times points out. There were more than 295 suicides last year among active-duty soldiers. Kudos to President Obama for at least starting the process of, as he put it, "destigmatizing the mental health costs of war."

But we need to ramp up the conversation. We need to keep talking about the issue of war and mental health. We need to acknowledge that war damages people, that veterans struggle, and we need to do more to help them once they've done the dirty work of fighting for us. This blog explores some of the issues. Please take a minute to visit and leave a comment, and tweet the link to the blog. It's time we talked about it.

Book giveaway: We have a winner!

Actually, we have two winners, because I couldn't bear to choose just one.

Madz and Psychocat, you have each won a copy of the UK edition of Brave Girl Eating. Congratulations! Please email me your snail mail addresses to harriet at harrietbrown dot com.

Thanks to everyone who left a comment. I'm sorry I don't have enough books to give away more.

Book giveaway!

To celebrate the U.K./Australia/New Zealand publication of Brave Girl Eating, I'm giving away a copy of the book.

To enter, leave a comment on this post and tell me why you'd like to read the book. (Or, if you've read it already, what you liked about it.) I'll choose a winner at random this Wednesday, June 29.

Good luck!

NAMI in NYC, July 14

Just a quick note to let you know I'll be speaking at a NAMI event about eating disorders on July 14 in New York City, along with filmmaker Jesse Epstein. The NAMI page has a link to the event flyer, but warning: it contains potentially triggering images. So I've put the details below. I hope to see you there!


Where: NYU Langone Medical Center, 550 First Avenue (between 32nd and 33rd Streets, Smilow Seminar Room
When: July 14, 6 p.m.
RSVP: 212.684.3264 (but I think you can show up without RSVPing in advance)

I need your advice and wisdom

As you no doubt know if you're reading this, I've let this blog languish for a long time now. Too long. I won't go into the reasons for that lapse here, but I do beg your forgiveness. And so it's fitting that for my comeback post, I'm asking you for advice.

The advice isn't for me but rather is for a woman I'll call Mary, who's in her mid-30s and has been ill with anorexia since she was a teenager. She's been through in-patient, residential, intensive outpatient, outpatient treatment--you name it, she's been through it. And she is still sick.

Mary is smart and motivated. She understands what she has to do to recover: she has to eat. As for everyone with anorexia, eating is terrifying for her. Those of us who have re-fed a child or teen or young adult with anorexia know how very hard it is for someone with the illness to eat, and how much they need someone to stand with them and stand up to the eating disorder. Mary wants that very badly. She doesn't want to die. She wants to recover and knows, at this point, that she can't do it eating on her own.

Mary's dilemma has made me think long and hard about the need for a different level of care. I think one of the reasons FBT (the Maudsley approach) is successful most of the time is because parents care about their children in a different way than, say, administrators or caregivers at a residential facility care about their patients. I've come to believe that that love is part of the cure, maybe because it motivates parents to hang on through the toughest moments, or maybe because it's part of what breaks through the cognitive distortions of the illness. It doesn't matter why, really.

So I wonder: What if we created something like halfway houses for refeeding people with anorexia? Not residential facilities, with their (perhaps necessary) rules and restrictions and inevitably institutional feeling. More like a small house, with 3 or 4 people living there and round-the-clock nurses who developed real relationships with their patients. Who really cared about them. Who were capable of empathy and affection and, yes, maybe even love sometimes. There wouldn't be hours of group and individual therapy, because those things really don't help people until they're more or less weight-restored, so the cost could be much lower than the one to two thousand dollars a day cost of residential care.

What I'm really talking about is a kind of foster re-feeding home. I've given a lot of thought to inviting Mary to my home and re-feeding her, but there are some logistical challenges involved that I'm not sure are solvable.

So I put it to you: Do any of you know of resources for someone like Mary? Resources I'm perhaps not aware of? And what do you think of the idea of creating refeeding homes for people with anorexia?

I'm eager to hear from you. So is Mary.

Honor National Eating Disorders Awareness Week with Project BodyTalk

The last week of February is National Eating Disorders Awareness Week, a week-long way to raise awareness of eating disorders, the devastation they cause, and hope for the future.

This year's theme is "It's Time to Talk About It," a notion I love because I'm all about talking about it, whatever "it" may be. Secrecy perpetuates bad feelings--let's get all the "its" out in the open. So I'm excited to be partnering with the National Eating Disorders Association to use that week to raise awareness and get people thinking in new ways--not just about eating disorders but about all of the crazy, disordered attitudes toward food and our bodies we hold in this country. This year I'm doing my part through Project BodyTalk, a web-based audio project I started two years ago to give people a place to talk about their relationships with food, eating, and their bodies.


If you're anywhere near the Syracuse, New York, area the last week of February, you can come to one of our open recording sessions. We'll put you in a private studio and let you record a commentary. You can choose to be anonymous, use a first name, or use your whole name. You can talk about something you love about your body, something you've struggled with, something you want other people to know about eating disorders--it's up to you. I'll be posting details on the sessions soon, but I expect they'll be held on campus at the Newhouse School, 3-8 p.m. every day that week. (Contact me for more info as the time gets closer.)

If, like most people, you don't live anywhere near Syracuse, or you can't make it to one of our sessions, you can still do your part by recording a commentary and sending it my way. Listen to some of the incredibly powerful and moving commentaries on the site for inspiration, and then make your own MP3 or MP4 file, or use a CD, and send it in through this handy web submission form. You can also hear an NPR program on Project BodyTalk here.

I hope you'll join me and Project BodyTalk this week for National Eating Disorders Awareness Week. Because you know what? It's really freaking time to talk about it.

San Diego Conference

I'm sitting in the San Diego Airport, having gotten here at an ungodly hour for my flight back to NY. But I don't mind, because yesterday's Maudsley Parents conference was a great success.

The conference sold out, and our room was packed with a dynamic mix of clinicians and families.
The always cerebral Dr. Walter Kaye opened the conference with a friendlier-than-usual exploration of the neurobiology of eating disorders. Next up was Dr. Daniel leGrange of the University of Chicago, who took us through the history of research on eating disorders (distressingly meager) and explained in great detail the history of family-based treatment.

After lunch, we heard from Dr. le Grange and Dr. Renee Hoste, also of the University of Chicago, on clinical applications of the research. Last but not least, Roxie Rockwell of University of California-San Diego explained UCSD's wonderful week-long multi-family intensive program. (All PowerPoint slides are up on the Maudsley Parents website.)

Kudos to the main conference organizer, my partner-in-crime at Maudsley Parents, Jane Cawley, who by now really knows how to put on a great day.


And thanks to everyone who participated and attended. We're thinking New York City for our next conference. Stay tuned!

Dr. Sharma, I love you

I love you for acknowledging what many of us know to be true: that people metabolize calories differently, that yo-yo dieting screws up people's metabolisms and causes weight gain in some people, and, most important, that shaming people inspires not healthy behaviors but self-destructive ones.

But don't take my word for it. Read this interview with the University of Alberta's Dr. Arya Sharma yourself.

I love the fact that, as this story from the CBC news points out, Sharma is the chair of obesity research and management at the University of Alberta and is still "no fan of most diets." And I love this quote from Sharma:

We keep hammering home the stereotype of the fat, lazy slobs who are eating fast food all the time who are not moving, not exercising or not taking care of themselves, making poor choices, when there's very little science that actually backs this up.

Thank you, Dr. Sharma, for saying it so plainly, so matter-of-factly, so clearly. I hope someone's listening.


*Photo © CBC.

Obesity and eating disorders: they're connected

When I talk with doctors about eating disorders, I often end my presentation with a caveat to them, to be aware of how the current
"war on childhood obesity" can trigger eating disorders in those who are vulnerable. That's the point in the program where I often see one or two audience members sit back and cross their arms in a way that telegraphs plainly their disbelief and even disgust. (I've had people walk out at that point, too.)

If you think that's pushing things a bit too far, I'd like to call your attention to just one of the many "anti-childhood-obesity" websites I've run across lately. This one is particularly egregious, as it offers up cartoon characters that are both offensive and poorly illustrated (not to mention an obnoxious soundtrack, which you can turn off at the lower lefthand corner of the screen). The "cast" of characters here includes O-Bee-Sity, described herein as "s "the supreme fat lord of the universe" who can "turn kids into globs of fat with one slimy touch"; Phat Cells, which "have the ability to multiply and wreak havoc on the human body"; and--rather unbelievably--Anna-Rexia, who apparently hails from the planet Bulimia (don't these folks get the difference?) and both "infects little girls with eating disorders" and "despises" the rest of the cast (shown above).

Aside from the bad art and wild overuse of copyright symbols, there's some just plain bad information here. The site claims that childhood obesity causes not just diabetes, high blood pressure, and heart disease (all of which is still up for discussion, especially given the fact that we don't know whether obesity causes these ailments or whether the ailments themselves contribute to obesity), but also cancer, liver disease, asthma, and eating disorders.

Hello? Considering the fact that one of the "characters" here is "Dr. Smart," billed as the "secretary of health and fitness at the Pentagon," I'd like to think that someone was actually doing some research and not just spewing ill-founded and unsupported opinions as facts. Sadly, this is not the case. And I'd have to say that this is the norm for sites like this, which remind me of other zealous-but-ignorant campaigns.

In fact, as readers of this blog probably know, it's not obesity that causes eating disorders, but rather a combination of factors, mainly genetics and dieting. It's the war on childhood obesity--and on adult obesity--that's responsible for triggering anorexia, bulimia, and other eating disorders, not the condition of obesity itself. And the prejudice and stigma directed against the obese is likely responsible for many of the negative health outcomes we associate with weight.

Any way you look at it, websites like this one are not just ignorant or misguided; they're dangerous. And that's why I'll keep sounding the alarm when I talk to doctors. They need to know the consequences of their crusades.

Project BodyTalk on 51% this Thursday

I'm delighted that the talented Susan Barnett, host of the nationally syndicated NPR show 51%, will be airing a segment this Thursday, January 6, on Project BodyTalk. This audio and web-based project collects commentaries (a la StoryCorps) on issues relating to food, eating, and bodies. This show includes a lively conversation between Barnett and myself, as well as clips from several audio commentaries made last year by faculty and students at the S.I. Newhouse School of Public Communications. You can hear the full commentaries on the Project BodyTalk website.

Here's a list of NPR stations that carry the show. I hope you'll tune in, and then visit the website to listen to more commentaries and upload your own.

Thanks to my amazing grad student from last year, Megan Swann, who took the photo above and created the website.