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Eating Disorders: A “Deadly Passion”, Neglected and Misunderstood

March 8th, 2015

scaleAndre Picard’s article (Globe and Mail, December 2, 2014), A Scourge in Need of a Strategy, highlighted, in his words, “…shocking findings about how Canada treats anorexia and bulimia”.

Picard is right when he points out that eating disorders can be the, “…most deadly” affliction and he goes on to state that, “…between 10% and 15% of young women hospitalized for treatment of anorexia and bulimia will be dead within 10 years”. While the numbers quoted vary, there are estimates that between half a million and a million Canadians are struggling with an eating disorder of some kind.

Picard notes that this is the most neglected and misunderstood condition and he also emphasizes that the problem is made worse by protracted wait times for treatment due to the fact that few hospitals have the resources to offer care. As well, he points out that psychological treatment offered in the private domain typically represents the only option but can be too costly for a lot of people.

Adriana Barton’s article published earlier in the year, What if Anorexia wasn’t a Disorder but a Passion? (Globe and Mail, Life Section, September 15th, 2014) features Dr Louis Charland, who argues intriguingly that eating disordered patients are actually caught up in what she describes as the grip of  a, “…dark passion”. Charland explains that patients somehow become fixated on an ‘idea’, such as ‘I am too fat’, and that idea becomes the organizational focus of the passion, which in turn prompts broader patterns of thoughts and behaviour to support the now ‘fixed idea’. Soon the passion becomes integrated within rational thought and a belief system whereby the person becomes a, “…slave to passion”. Dr Russell Marx, cited in the same article, supports Picard’s contention with the sombre assertion that if Charland is right, it is indeed the most deadly of passions. Although more common in young girls and women, we know now that eating disorders affect all ages and, as Picard asserts, an estimated 10% of patients are male. I would suspect these numbers are higher because we traditionally see less boys and men presenting for treatment.

In another article in the same newspaper (What its like to live with an Eating Disorder), Kyla Fox (Globe and Mail, Life and Arts Section, September 15th, 2014) makes a very important point, asserting that manipulating food and the body serves as a necessary distraction from deep rooted, seemingly out of control emotions and life circumstances. It is the ‘distraction’ that offers the sadly perverse ‘reprieve’ from the real turmoil with which sufferers are struggling. Similarly, in my experience working with these particular patients, many of them, and young people in particular, express conflict through the manipulation of the body. Expanding on Kyla Fox’s observations, I have found that there has usually been a loss of faith somehow for the patient in the reliability of human relationships. Although I find in the course of therapy, that the need for a relationship is still evident, it remains sequestered or hidden. The world of the eating disordered patient is a closely guarded, sealed-off area and very difficult to access without necessary longer-term therapeutic work. In this regard, I agree with Dr Charland in that this sealed-off world can become an exclusive and much idealized passion.

Finally, Picard is rightfully critical of the government in their failure to address the issue of eating disorders as a serious mental health concern. Disconcertingly, he cites the typical case or scenario when it comes to addressing the need for action, commenting that, “…committee recommendations” often represent little more than, “…indifference and platitudes”.

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