Friday, September 11, 2009

Day Twenty-Five, and I'm stunned.

Hey everyone.  Things are going pretty well here at my casa, except Andrew is a bit sicky with some weird tepid stomach bug, but that's ok, as long as I don't catch it!  God forbid the Mommy gets sick, then all hell will break loose!

So I did some researching today on Wikipedia, the most trusted name in research (um, no).  I started out with a fun list of phobias, just to warm up the old brain.  I got a whole list of 'em!  Good luck on pronounciation, because some of this is going to take me six weeks just to type up the word, let alone say it!

Aichmophobia:  Fear of sharp or pointed objects (needle, knife, a pointing finger)
Catoptrophobia:  fear of mirrors or of one's own reflection (bummer)
Algophobia:  fear of pain (seems like a smart one to have)
Gelotophobia:  fear of being laughed at (glad I don't have that one)

I loved this one....

Coulrophobia:  fear of clowns (not restricted to evil clowns) --->totally quoting straight from the page.  Not restricted to evil clowns!  ha ha ha ha!

Emetophobia:  fear of vomiting (I got that one!)

ok...let me try this one on for size:

hexakosioihexekontahexaphobia:  fear of the number 666.   Sheesh.

nomophobia:  fear of being out of mobile phone contact (*smirk*...shouldn't it be nomophonophobia?)
selachophobia:  fear of sharks

The list has lots of other phobias on there, and I looked it over and saw this one:

Cibophobia, Sitophobia:  aversion to food, synonomous to Anorexia Nervosa.

I decided to go and follow the path, so to speak.  I looked up Anorexia Nervosa.  Where this took me is really amazing, depressing, stunning, and on and on.  Before I write another word, though, I am going to preface the rest by saying this.  I am just a goofbutt with a laptop, writing a blog about health and fitness.  I wanted to learn a little bit more about this area of living and self-care, since I am not very good at it yet.  I am not a learned professional in this topic, I will try very hard to not cast an insensitive view on what I write, and I will try very hard not to offend.  However, I am human, and may very well do just what I try not to do.  I write this in advance so that you might remember this as you read someting that makes your blood pressure rise and the condemnations fly.  I'm just a regular Joe...Anne.  Also, I want to say that if you, for any reason, feel that you are having trouble with eating disorders, I hope you know that there are many places you can turn to for help and a someone to listen.  I will try to include a couple of options as I go.  Ok, ready? 

Anorexia Nervosa is from the Greek words for A- or An- (meaning a lack of) and orexis, meaning appetite.  This is literally "a lack of desire to eat."

It is a psychiatric illness that has social, economic, psychological, neurochemical, and other layers, levels, intersections, you name it.  It is an eating disorder with hallmarks of low body weight, body image distortion, obsessive fear of gaining weight, and an inability to recognize the gravity of the situation when continued behaviors of Anorexia Nervosa can lead to death.  People with Anorexia Nervosa are known to control their body weight through various means.  Starvation, excess exercise, diuretics, diet pills.  The disorder primarily affects adolescent women ages 15-19, but up to 10% of the sufferers are men.  It can affect any age group, and the onset has been documented as late in life as the early 90s. 

People suffering with Anorexia Nervosa refuse to maintain a healthy body weight, such as beneath a BMI (Body Mass Index) of 17.5 or 85% of body weight expected for an age group.  There is also intense fear of being overweight or gaining weight, even when the person is underweight.  Also, there is a change in the way the person assesses their own body shape or weight, and a denial of the seriousness of the disorder.  Interestingly, people with Anorexia Nervosa have a very clear-sighted view of their own bodies in relation to other, healthy people.  From what I've read, healthy people have a tendency towards overconfidence in regards to their looks and body shapes (explains why I'm always a little disappointed when I look in a full-length mirror!).  The person suffering from AN sees more clearly what they look like, and then proceeds to reinforce their belief that their looks or what-have-you would improve with the loss of more weight.

There are two sub-types of AN:
1)Restricting Type:  the person doesn't regularly engage in binge eating or purging behavior.  Weight loss for the current episode is accomplished mostly through dieting, fasting, or execessive exercise.
2)Binge-Eating Type or Purging Type:  the person has regularly performed binge-eating or purging behavior (laxatives, enemas, diuretics). 

What is interesting to me as well about AN is that individuals can move from one sub-type to another, and from Anorexia Nervosa to Bulimia Nervosa, over time, as their thinking patterns and behaviors change over time. 

There have been observable changes in the brain in people suffering from AN, but it is difficult to tell the relationship between the damage to the brain and the eating disorder (chicken or egg kind of a thing).  This damage can be partially reversed when normal weight is regained. 

There is a whole laundry list of symptoms of AN.  Some (and really just a few, compared to the list) are extreme weight loss, stunted growth, decreased libido, impotence in males, thinning of hair, constantly feeling cold, zinc deficiency, creaking joints and bones, dry skin, chapped lips, extreme fatigue, difficulty concentrating, memory deficits.  The person suffering with AN has a distorted body image, their self-evaluation is solely in terms of their weight and shape.  Can you imagine being able to only relate to life via your size?  I try to sit back and imagine relating everything from how I feel to whether or not that boy I liked back in fifth grade like me back...and feeding it through that mental state, putting it all in terms of my size and shape, my weight.  Perfectionism also tends to be evident here, as well as clinical depression and obsessive-compulsive disorder.

There has also been strenuous debate over whether or not Anorexia Nervosa is considered an illness or a choice.  One person, Dr. Thomas Insel, director of the US National Institue of Mental Health (http://www.nimh.nih.gov/health/publications/eating-disorders/anorexia-nervosa.shtml) wrote a letter to the National Eating Disorder Association (www.nationaleatingdisorders.org/) stating that "eating disorders are brain disorders."

I got a bit sidetracked at this point.  It goes on and on.  Medication may help, but studies are dubious.  Family therapy may help, but rehabilitation of people with AN has a low success rate.  But the topic of whether or not AN was a choice really got my attention.  "Why, isn't it obviously a disorder?" I thought to myself.  Aside from the person involved, who may be so far advanced they can't see the damage done to themselves (how like an active alcoholic or drug addict!), wouldn't it be obvious the person needs help? 

As I read along, I came to the part describing societal and environmental factors.  Here is where everything seemed to go all pear-shaped.  I read that the internet has enabled anorexics and bulimics to communicate with one another outside of treatment.  That some of these sites are pro-anorexia (pro-ana) and pro-bulimic (pro-mia).

I admit, the first thing I thought was....WTF?!

I then went to look further into this.  Pro-ana's reject the medical viewpoint that Anorexia Nervosa is a disorder, and argue it is a lifestyle choice.  There are websites similar in scope to MySpace or Facebook, where they get together and support one another's eating (or non-eating, really) choices, swap ideas for losing weight, compete with one another regarding weight, and advise each other on subjects like subduing hunger pangs.  Some people even come to personify "Ana" as a helper to the person with AN.  There is a sense of feeling "clean, pure, spiritual" to be abstaining or fasting from food, whereas sin can be denoted with eating imagery. 

There is "Ana's Creed":

I believe in control, the only force mighty enough to bring order in the chaos that is my world.


I believe that I am the most vile, worthless and useless person ever have to existed on this planet, and that I am totally unworthy of anyone's time and attention.


I believe in oughts, musts and shoulds, as unbreakable laws to determine my daily behaviour.


I believe in perfection and strive to attain it.


I believe in salvation through starvation.


I believe in calorie counters as the inspired word of God, and memorize them accordingly.


I believe in bathroom scales as an indicator of my daily succeses and failures.


I believe in hell, cause sometimes I think I live in it.


I believe in a wholly black and white world, the losing of weight, recrimination for sins, the alonegation of the body and a life ever fasting.


 and "Ana's Commandments":

1. If you aren't thin you aren't attractive.

2. Being thin is more important than being healthy.
3. You must buy small clothes, cut your hair, take diet pills, starve yourself, do anything to make yourself look thinner.
4. Thou shall not eat without feeling guilty.
5. Thou shall not eat fattening food without punishing oneself afterwards.
6. Thou shall count calories and restrict intake accordingly.
7. What the scale says is the most important thing.
8. Losing weight is good / gaining weight is bad.
9. You can never be too thin.
10. Being thin and not eating are signs of true will power and success.


To be fair, not every single Pro-Ana site has the same aims.  Many claim to be a place where anorexics can be to discuss their illness, and discuss recovery.  It has been noted that anorexics can "pool" together at websites like these to normalize their condition, and to have a sense of identity amongst others.  Some of these sites (and again, not necessarily all of them) offer tips on crash dieting, advise on how to purge, how to hide weight loss from parents and doctors, how to appease the side effects of Anorexia Nervosa.  On and on.

Then another word came up I was unfamiliar with.  Thinspiration.  These are images or montages of slim women, even emaciated women, to offer encouragement (?) to others.  Also, there is reverse thinspiration, where there are images of fatty foods, overweight or obese people, designed to inspire disgust and fear of weight gain. 

And there are red and blue and purple beaded bracelets that are worn by supporters of this lifestyle. 

I went and Googled Pro-Ana, and Ana's Creed, and Ana's Commandments.  I ended up finding imagery for Ana-lifestyle people.  One image was of a cadaverous, green angel leaning out of a computer screen, hugging a woman sitting in front of it.  A plate with what appeared to be two rice cakes on it sat next to the computer.  I saw imagery of thin women, emaciated women, and I stumbled onto one or two blogs of active Anorexics who were attempting to get even thinner, and were blogging their lives and their self-control.  I didn't notice any recent entries for one of them (I do not recall the address), and I had to wonder if she was still alive. 

There is no happy ending for this report, guys.  AN is thought to have the highest mortality rate of any psychiatric disorder.  Up to 20% eventually die from related causes to AN.  The suicide rate for people with AN is higher than the general population, and is thought to be the major cause of death for people with AN.

It has a tendency to be more prevalent in Western societies, among the more wealthy as well, but this is spreading across the planet as Western media reaches further across the globe.  Yet there is no clear causality between the imagery of thin women in the media and Anorexia Nervosa. 

All I can do is to say this.  If you or someone you love might be suffering from this disorder, there are options.  You can call your local hospital, your physician.  You can visit the National Association of Anorexia Nervosa and Associated Eating Disorders (http://www.anad.org/).  You can visit http://www.nationaleatingdisorders.org/ as well.  There are places to go for help. 

With the exception of the Ana material (creed, commandments), almost everything I found was through wikipedia.  I simply typed in Anorexia Nervosa and took it from there, so you can read more about this disorder if you choose to. 

As for me, I am very grateful to not be affected by AN.  I know there are times when I have joked that I wish I had the discipline to be an anorexic, but I take it back 100%.  Never would I want to know the fearful discipline and measuring rod of the anorexic.  For what I have, I am truly grateful, and I hope you are, too.   

2 comments:

  1. thank you Erin. Thank you thank you thank you. The "pro-ana" info really helped me better understand the perspective of others, and gave me good links to find out more. Maybe now I can be of better help at the next opportunity. I know this is vague, but you get my drift.

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  2. Definitely was an eye opening experience for me. I had no idea about some of this stuff.

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