Sunday, 29 September 2013

SMILE!

Have you ever had one of 'those days' when you REALLY do not feel happy? It is as though everything is going wrong and nothing is going right. You know: you forgot to pay your bills so now you have to pay interest, your child is sick but you need to go to work, you are tired and do not want to get out of bed, and there are a million things that you need to get done but do not have the energy, motivation, or will-power to do any of them.

Well, I had one of those days yesterday. And what really helped me was writing reasons why I should smile instead of frown. Why I should be happy and thankful instead of being down and gloomy. Here are my thoughts - I hope they lighten up your day and fill you with peace and joy!....

Smile today because you are alive. Smile because you can see, hear, and walk. Smile because you woke up in a house and not the street. Smile because you have food to eat and need not starve. Smile because you have clothes and need not be cold.

Smile because although life is hard, these challenges make you stronger. Smile because although you have work, it keeps you busy and teaches you things. Smile because although you may argue with your family, you have one and they love you. Smile because although you struggle, you have the strength to face tribulations. Smile because although you may feel alone, God is always by your side. Smile because although you don't have hope, you know that God can do all things. Smile because although its hard now, you know that it will get better.
Smile because although money is tight, you can still buy your basic needs. Smile because although you have no motivation, you have people who love you. Smile because you have a cover at night to keep you warm. Smile because you have clean water to drink when you are thirsty. Smile because you have a school to go to or a job to work at. Smile because you have people to talk to. Smile because you are able to talk, think, sing, dance, and play. Smile because you are living.
Smile because you are created for a reason. Smile because although you may not yet know what this reason is, there is a bigger Power who DOES know and has a great plan for you. Smile because when you feel alone, God is there. Smile because you are actually never alone. Smile because there are trees and flowers that make the world beautiful. Smile because you are beautiful - simply because you were made by Someone who does not make mistakes. Smile because you are needed. Smile because you are loved and wanted and cherished by God, who loves you the same way no matter what.
Smile because although you feel sad, you know the One who gives eternal joy. Smile because although you are frustrated, you know the Healer who takes away the pain. Smile because although you may not be happy with your life now, you know that God is in control and knows what He is doing. Smile because although you may feel tired, you know that Almighty who gives strength. Smile today because although you have troubles, you know you have more blessings.

Wednesday, 25 September 2013

The Battlefield: Sense of Taste

I have a confession to make: I used to be absolutely terrified of grocery stores and grocery shopping. I hated it. I would walk into the store and see so much food in one place and become anxious. It would also make me frustrated because as much food as there was, I could not eat any. I could not even buy myself a piece of fruit to munch on, a drink to sip, or a meal to prepare.

ED made me feel this way. Why go to a grocery store where there will be food that you don't want and can't have anyways? Look at all those people shopping! Sure, they may look happy during grocery shopping. But what about after they eat? They will GAIN WEIGHT! Do you want that? I don't think so. Avoid grocery stores - they are useless and give you the temptation of wanting to eat! You foolish girl! You are hungry? HA! Have some self-control!

You can imagine that this meant that I did not eat a wide variety of foods during ED. What I are was very limited because I was afraid and reluctant to try new things. Some people with ED even have a list of 'safe foods' that they are comfortable eating. Anything out of that list is a definite 'no'. Others, in complete contrast, may love grocery stores. Some patients with ED find that they become ore obsessed with food as a 'theme' in that they are somewhat obsessed with going to see food and making it (as well as reading recipes), but they don't actually eat any. The biological explanation for this might be that their brains are hungry and trying to motivate them to eat by exposing them to food (ex/ recipes, stores), but that ED is too strong and stops them from eating.

In my case, like many others, the opposite was true. I refused to look at recipes, shows, or stores that involved food. I did not want to go grocery shopping. Even after starting recovery, I was eating, but I still did not eat from a wide variety. It was not until a while ago that I realized that my body needed change. I was eating and that was good. But it would be challenging to try new foods and see what they were like. Part of this stems from the fact that ED actually blunts our sense of taste. Again, think about this: the brain shuts down the taste centre because it realizes that you aren't eating. Thus, in early recovery, I actually had no sense of taste. Everything tasted the same, and I did not enjoy anything at all. However, as time passed by, I realized that I started to get this taste sense back. I could make choices on what I enjoyed eating and what I did not. Of course, ED was far from pleased at the fact that I was starting to gain my taste appreciation back. So, what do you do when ED hates something? You do it again and again to tick him off!

My mom, one of the strongest people I know and my most loving supporter, helped me with this. She took me to grocery stores and helped me choose different foods that I wanted to taste - without any pressure. We went the other day and she told me to look around and put things in the cart. Then, we talked about what I should try, and we bought it. She did not force me to get anything. She just stood there and helped me gather items, and then she listened to my preferences and helped me make a decision. She did not even care how expensive any item was - she bought it for me. Over the next week, I will be trying these new items to see what I like and what I dislike. If I like it, then bonus - it is a keeper! If not, then I have successfully helped myself regain a sense of taste and appreciation for food. With the dedication I have made to recovery, I can now eat a variety of meals and enjoy them too! It must be strange for others without ED to read this and wonder how someone can develop an aversion to food, but you need to understand how important this milestone is. I went from being very ill and not having a sense of taste to being healthy and regaining my appreciation for different flavours and textures. This can take years to happen, especially since I have been suffering with ED for about 7 years. FINALLY! This milestone has given me hope and encouragement. With practice, time, patience, hope, support, love, and motivation, good things happen. ED is on his way out.

Sunday, 22 September 2013

Rant: BMI measures

I'm not a fan of the BMI scale. I just don't think that it is very accurate - and this is supported by facts and research. Now, before I go on, let me put a WARNING. The BMI (body mass index) scale is sometimes needed. For example, we use this all the time to help patients lose weight, to gain weight, and to monitor growth in children and teens. But what I am not fond of is the preoccupation with BMI, when really, we might be losing the bigger picture of things.

First, what is BMI? You can calculate yours by dividing your weight in kg by the square of your height in m. Generally, 18.5-24.9 is normal, less than 18.5 is underweight, and more than 25 is overweight. But what is wrong with this, you might ask? Well, all this measures is your height and weight. It does not take into account other factors, such as muscle mass. If someone with a lot of muscle used BMI, they would likely be in the overweight section. But are they overweight? No. They simply have more muscle, which makes their weight higher. But it is muscle, not fat; thus, they are not overweight. Let's consider another example. What about a child who genetically has bigger or thicker bones than others (yes, this is possible). Their bones will be heavier, but are they fat? No. Their bones just weigh more. But a clinican might not know this, and thus assume that the child is overweight. If we all used BMI in this way, we might mistakenly think that we are overweight and need to lose weight - when really, the measurement is not taking everything into account.

What about when helping ED patients? Many treatment facilities use BMI, as this is their only reliable predictor. Generally, patients are considered 'weight restored' if their BMI is 20+. I'm not arguing with this - I understand that BMI is needed as some way of deciding when patients have gained enough weight. But, really, everyone is different. Maybe I am healthy at a BMI of 22, and not 20. So why should my treatment team decide that I no longer need help for my eating disorder? What if I need to gain more weight than a BMI of 20 in order to be healthy? Or what if someone without ED has beena t a BMI of 18.5 their entire life. Are they sick? Probably not. This may be due to genetics, their way of eating/living, and other factors. Maybe this person does not need to gain more weight, unless other factors necessitate it. Should we force this person to eat more simply to gain more weight? If they are healthy and eating enough, probably not. Do you see why BMI is a 'gray' measurement to use? It is hard to determine when it is useful, and when it is not accurate.

However, I know that BMI provides us with some useful information, and that is why we still use it today. I'm not saying that this is wrong. I am simply giving a warning out there to people who use BMI. For some, this might create an obsession and possibly lead to ED. For others, their BMI may be in the overweight area when really, they are not overweight. For others, their weight may be lower and underweight on the BMI scale, even if they are healthy. For all patients with ED, however, recovering is more than just the BMI scale! I was weight restored quickly, but my thoughts and eating patterns did not improve for a while. So, please do not get stuck with the idea that as soon as your BMI is in the 'healthy' range, you are cured from ED. It is more than just the number. YOU are more than just a number. So, be cautious. Medicine/science/math can come up with theories and equations to help us, but that does not mean that all of these subjects/ideas are flawless.

Wednesday, 18 September 2013

Jeans!

I used to love wearing jeans - they were the most comfy pants ever!

Then...you guessed it, ED came along. I stopped wearing jeans because I couldn't find any that didn't fall off my hips. For around six years, I wore sweat pants all the time. 

Last week I went shopping and decided to buy a pair of jeans - just in case I would need them. Today, I wore them all day. It was weird. I never wanted to wear jeans ever again because that was what I was wearing when my childhood crush called me fat. That teasing has scarred me for so long. And yet, today, I gathered enough courage to wear jeans again. 

It sounds silly, but it was actually hard to do. At first, I felt that they were too tight. But then I realized that they were in fact just the right size - but that voice in my head told me that I looked fat. I ignored it. But I felt restricted. I felt that my stomach would roll over and expand. I felt that my thighs were moving around. It was hard to breathe. Simply put, wearing jeans after six years was challenging. To top that off, I felt insecure about my weight and how high it has gotten since I started recovery. 

But I wore the jeans to school all day. At the end of the day, I really felt as though I had accomplished something important. After six years, I had the strength to put on a pair of jeans. Although I felt heavy and ugly, I still wore them. I have gained more than 50 pounds since I was very ill, but I still wore those jeans. Mission accomplished. 

It's hard to do this all the time. It seeks that everyday, I am fighting for my well-being. I have to resist the feelings that I am fat and ugly. I have to ignore thoughts that I look hideous and am useless. I have to eat despite feeling full. I have to convince myself that I am beautiful simply because I am God's daughter. But it's difficult to be strong all the time. Sometimes I want to take a break and ignore everything around me. Burt at the end of the day, I look back and realize what I have done. I conquered this eating disorder and recovered. I have a blog that is popular, I have done interviews, and I write for NEDIC and other blogs. I eat even though I don't want to. I wear jeans when when I feel fat. Man, I work hard! And it's nice to list these accomplishments - they remind me of why I am fighting each day. They remind me of why life is beautiful. They show me that, with love from others, support, strength, God's guidance, and motivation, I can follow my dreams and live my life to the fullest.
 
Today, I wore jeans for the first time in six years. And I survived. What will tomorrow bring? I don't know. But I know that I'm ready to fight. 

Friday, 13 September 2013

Still Single?

You must be wondering why on Earth I am writing about this topic on my blog. Well, let's start with some facts: I'm a girl. And I'm 20 years old. Oh yes, and I'm Middle Eastern. What does that have to do with anything? Typically, girls in my culture are expected to get married and have a happy marriage. This may seem old-fashioned to some, but it is traditional. My parents (and many other Egyptian parents), do not force their girls to do this, but many do. So, for the sake of some girls out there, this post is for you. I hope it helps you and gives you the peace of mind that I have been blessed with. For the males out there, this is so you can appreciate what some of us go through! It might also apply to those males who have not found a life partner yet. Either way, I think it is worth reading. Just a reminder: most people are too shy to speak about this topic, so please appreciate that I am bringing it out in the open! :)

It is tough being in a society where dating and marriage are fantasized over. This is not wrong - it is a part of life. But it makes it difficult sometimes because there seems to be so much pressure on finding the 'right person'. It is hard when you come to this age and so many people around you are dating or getting married. You start to wonder, 'what is wrong with me? Why am I the only one who has not found someone yet? Why am I different?'. And then you start to criticize yourself, thinking of what is wrong with you.. You might name parts of your body that you hate, what you dislike about your personality, why you are not as good as others, etc. See how destructive this can be? You end up feeling so down because you have not found someone, and now also because you dislike yourself.

This is why it gets frustrating when people ask me if 'anything new is happening' with my love life. They want to know if I am dating, have someone in mind, etc. And I am sure they mean well. But it is tough getting these kinds of questions. To be honest, I do not know what is happening new in my life. I am unsure of whether or not I will be married, have children, etc. I do not even know where I am going in my career right now. I feel annoyed - at myself. I am angry that I do not have a plan for my life like others seem to. I am frustrated that I have not found someone who loves me and wants to spend their life with me. I am sad that I have no idea where my life is going, what my future hols, and who is in it. At the of the day, I feel like I do not know myself at all. and I am hopeless.

 Having an eating disorder made it worse because I often blamed myself for having so many shortcomings. 'No one will ever want to be with me because I had ED. They will be scared of me and not want to spend their life with me. They will think that I am weak and ugly and fat. There is nothing good about me. I am an unsuccessful person. No one wants to be with someone who used to have an eating disorder. That is why I am not dating anyone. That is why I am alone. And my personality? It sucks. I am not fun or exciting. I am not funny, either. I am boring. I am not beautiful or special enough. That is why I will never find anyone for me. That is why I am not dating, engaged, or married'.

So I prayed. I told God how I felt and let Him know how frustrated I was. I complained to Him and told Him that I felt awful about myself and about my future. I asked Him why I was alone and why I was not in a relationship with anyone. And then I reflected on my own. And this is when I started to see that I was wrong to see my life this way. I was missing the bigger picture. Maybe I am not in a relationship with anyone. But does that mean that I am unworthy? No. Maybe it means that God is saving me for the right person. I do not know what God has in store for me, but I DO know that He knows what is best. I know that my idea of a perfect life and future is worldly - it is based on my own thoughts. But God is All-Knowing. He sees my future and is not limited by my human thinking. So, perhaps God is trying to tell me that this is not my time yet. Maybe I will be in a relationship later on in my life. Maybe it will be tomorrow. Or maybe it will never happen. Either way, I am confident that God will do what He knows is best for me. God does not play games.

Perhaps God is trying to tell me that my time has not come yet because there is more that I need to do before I become tied in a relationship. I don't know what that thing is, but it might be something important. Maybe I need to complete my education first so that I can get a stable job and income. Or maybe I need to grow physically, spiritually, mentally, or emotionally. Perhaps my heart is not yet ready to support the love of a partner and children. Maybe I need to first learn HOW to love others with out condition. Maybe I need to learn more life skills, such as empathy, sacrifice, obedience, and kindness. The problem with today's society is that love and relationships are often sought out but not well planned and cherished. Are relationships all about getting gifts from someone and feeling special? Is it only about hugs/kisses and having someone to talk to? Or is there more to it? Relationships are about so much more than those things. In fact, relationships are more about giving than getting. You need to give the other person love, care, and time. You need to be committed. Maybe I am not ready for that yet. Maybe I still need to grow. I have a tough time taking care of myself and being a well-balanced person and leading a healthy and stable life. Am I ready to take on the challenges and responsibilities of another person? Thinking about this changed the way I thought about this topic...

Lastly, we need to remember that in the church community (and many other religions), marriage's purpose is to edify. What this means is that getting married and being in a relationship is supposed to strengthen our faith. It it supposed to bring us closer to God and help us grow in Christ. Do I want marriage for this purpose - to grow spiritually? Or do I seek relationships because of society and because others are getting married? Do I want to be in a relationship because I want to get closer to God? Or do I want it because I just want someone to make me feel loved and special? Do I believe that having a partner will make me a better person, or do I want this because I want to feel that someone loves me and thinks that I am wonderful? Do I want a relationship because it will make me a better Christian, or do I want it because I am sick of feeling like the only one without a 'special someone'? Thinking about this issue from these perspectives really changed my life because it showed me that maybe I am not ready for a relationship. And maybe I do not want it for the right reasons.

With regards to people asking questions - well, they will always ask. They want to know, after all. Perhaps I cannot control what people ask me. Maybe I cannot control their curiosity about why I am still single now. But I can control how I react to this. I can choose to not let it bother me. Instead of focussing on what I do not have, I can focus on what I DO have. I do not have to worry about if anything new is happening now, because I need to focus on what is happening NOW. Tomorrow will come, along with its challenges, experiences, and joys. But right now, I am living in TODAY.

The next time you feel sad or frustrated about this topic, give this some thinking. Or take a look at this blog post and remember what I said. It will not ALWAYS make you feel 100% better, but I guarantee that it will help you reconstruct your view and feelings on relationships. I pray that each and every one of you finds the right person, if this is what God has in store for you. If it is not, I pray that God grants you His peace and comfort and helps you realize that you have other wonderful things planned ahead of you. Remember that what you want may not be what God wants. But in the end of the day, what God wants is bigger, better, and bound to be full of blessings. We all do not have the same lives, and this means that God has different plans for each of us. Instead of being angry about what is NOT happening in you life, thank God for what is. And instead of wondering why you are not in a relationship, think about the other amazing things that God is planning for you. Do not waste your time being sad that you are 'alone' - because in fact, you are NEVER alone as long as you have the love of your friends and family, let alone the love of God the Creator! For those of you in a relationship, I pray that God strengthens it and that it grows in God's love and grace. For those of you not in a relationship, I pray that God continue to fill your life with what HE sees is best.

Monday, 9 September 2013

Hypoglycemia

As promised, here is the post on hypoglycemia.

What is it? Hypoglcyemia means that you have low blood sugar. The body's normal mechanisms regulate blood glucose levels to be about 4.4 - 6.1 mmol/L. This is done through two hormones: insulin and glucagon. This can get confusing, so I'll try to make it as simple as possible.

When we eat, insulin is released from the pancreas. Insulin takes the glucose we eat and stores it as glycogen, thereby reducing glucose levels after a meal. This helps our body to use the glucose we eat. When our glucose levels get too low (as in, between meals), our pancreas releases glucagon. Glucagon breaks down glycogen into glucose, so that our glucose/sugar levels will be normal (increase) again.

So, what happens during hypoglycemia? Let's assume that you have not eaten for a long time, and your blood sugars are too low. This is hypoglycemia. Now, on a regular basis, your body is very good at regulating glucose levels so that this does not happen. But, if there is simply no glucose to use or your body has been deprived for too long (or in diabetes, if you use too much insulin), The body panics. Low glucose means that you have no fuel, since our bodies use gluocse first for enegy. Moreover, the brain can ONLY use gluocse for energy - other organs can use fat and protein, although these are not preferred. So, low glucose = brain has no energy.

The body responds via the sympathetic nervous system - the 'fight or flight' system. Heart rate increases. We sweat. We panic. We are restless. These are some signs of hypoglycemia. Others include shaking, not able to see (ex. everything becomes 'black'), feeling dizzy, etc. At this point, we usually know that there is a BIG problem happening, so we seek out food. And when I say 'seek', I mean we NEED FOOD RIGH NOW. It's like a switch turns on in the brain that says 'I NEED food now or something terrible will happen'.

We need a fast acting source of glucose in these cases. A cup of orange juice is the best source, because our bodies use this gluocse within minutes. A sugar pill is also good. Other good ideas are peanut butter and cheese.

Of course, it would be great if you can avoid hypoglycemia from happening. I have experienced it twice in the past year, and it literally felt like I am going to die. Both times, this happened when I went for a long time without eating anything. When my blood glucose levels got so low, I could not see anything in front of me - everything went 'black' suddenly. I was sweating like crazy, and I was shaking uncontrollably. I called for 'help' because I felt dizzy, my heart was pounding so strongly, and I felt that I would fall down. I could not see myself, but everyone said I went very pale. I told people that I needed to eat something right away. That's right. I asked for food. I did not even think about it - it just came out of my mouth. It is like my body KNEW that it needed food right away. I drank some orange juice (which I HATE by the way. But I had to do it if I wanted to survive), and this helped me recover. After, I ate something else and felt a lot better. Now I have learned my lesson. I cannot go too long without eating or drinking something, or my glucose levels get too low. Hypoglycemia can be life-threatening. It is serious.

What is the lesson to be learned? It can happen to anyone! Do not leave yourself too long without eating or drinking something. And recognize the signs of hypoglycemia - for yourself or for others. And act quickly. In these cases, sugar (glucose) saves lives. Literally. Food is medicine. I never thought I would see the day when I would say that!

Saturday, 7 September 2013

Revisting Serving Sizes in ED patients

Do you remember back when we discussed portion distortion (http://anorexiarecovery1.blogspot.ca/2013/03/portion-distortion.html) and talked about how with ED patients, this tends to get a little funky? ED patients have found to have difficulty estimating how much food is on the plate at any given meal. What does this mean? That ED patients somehow see portions as actually being bigger than they really are. This contributes to how difficult recovery can be, as the patient must rely on his/her judgment in order to eat enough. Clearly, this presents a problem if the patient sees that they are eating more food than what is really on the plate. This is why many patients have a treatment team to help them, or measure their food for accuracy.

Let's consider another study that showed the same results: http://www.ncbi.nlm.nih.gov/pubmed/23276722. This study found that ED patients overestimated how much food was on the plate, and also labelled some meals as being 'large' whereas subjects without ED labelled them as 'small' or 'average/medium'. But WAIT?! What exactly IS a serving size? Not many of us actually measure our our food. This is because we usually have an instinct as to how much is enough for us - in other words, we 'know' how much to eat without meausring. This is not always the case with patients with ED. For the sake of information, let us review what a 'typical' serving size is. One serving of cheese (50g) is about the size of 2 9-volt batteries, while one serving of peanut butter is about the size of a golf ball (30 mL). A piece of meat is about the size of a palm of your habd (75g), and a serving of cooked veggies (125mL) is about the size of an ice-cream scoop or tennis ball. Now, think about your own food. Is this actually the size you eat? Probably not. To be honest, I actually have more than this! But nevertheless, this is what the servings 'look like'. But how many people actually count how many servings of the food groups they eat a day? Not many.

What is the point? Perhaps we are getting too focussed on food group servings that we forget the bigger picture: moderation is essential. If you eat the amount of cheese equal to three batteries instead of two, will you become unhealthy? Likely not. If you have an extra half-cup of vegetables, will you become a superhero? No. It is the LIFESTYLE as a whole that matters. Intake should equal output, and this should be from a variety of foods. This includes desserts as well.

While patients with ED may have a bit of portion distortion, it is not hopeless. I am getting better at realizing how much food I need, although I still have ways to go before I master this. But it is better than a year ago when I first started recovery. My mind is now more open to trying new things as well. In a way, my mind and body have adjusted to my new life without ED, and this is making me a whole lot happier! I still have times when I DO underestimate or even overestimate portions, but that is okay. Recovery is a work in progress. But as I continue, I need to remember one thing: in the long run, portions won't kill me. It is the pattern of over or under eating that will. As long as I eat everything in moderation (meaning, not too much OR too little), I will be healthy. Sure, patients with ED may have trouble getting their serving sizes right. But many other people do. This does not mean that they cannot be healthy. It simply means that maybe they need a little help or direction in realizing how much is enough.

Understanding that 'ENOUGH' means not too much or too little is important. In fact, if you ever come across the correct, medical/scientific definition of malnutrition, it is 'eating more than OR less than what is suitable to meet the demands of one's metabolism and homestasis'. What does this mean? We need to stop worrying so much about the little things that don't matter and start realizing that one's entire lifestyle is more important than a day's meals. For some, this may mean stopping to eat when they are full so that they do not mindlessly graze on food. For others (like some patients with ED), this can mean revisiting their portions and understanding how much food they should be eating. For the rest of us, this can mean eating the way we already eat because we have found a comfortable and healthy balance. To be honest, there is no one powerful almight golden rule of nutrition that states how to have a pefectly healthy life. Except for moderation, laughs, happiness, love, hope, faith, support, knowledge, care, kindness, smiles, perseverance, and good health. A recipe for success.

Tuesday, 3 September 2013

ED is DEADLY

Many parents and patients alike ask me how someone with ED can be so sick, yet they look healthy and their blood tests are normal. Of course, there is not one answer to this question. But, we do know that the body is extremely good at adapting to changes and surviving. The body fights and fights to keep the patient alive, even when severe damage is occuring on the inside. (http://bjp.rcpsych.org/content/194/1/10.short)

What causes death in ED patients? Eventually, the body cannot sustain life anymore and fails to thrive. This can be because it no longer has enough energy to keep the person functioning. A lot of the causes of death can also be related to the effects of ED on the organs. For example, the kidneys cannot function properly and may shut down, which can be deadly. The brain does not have enough glucose and starts turning off. The lungs cannot bring enough oxygen and nutrients to the body, so the organs lose their nutrition. The heart muscle becomes too weak to pump, which in itself is a fatal emergency. The body also becomes too weak to fight off infections, which puts the patient at risk for many illnesses that they could normally fight off. Pneumonia is a big problem in these patients, especially if their breathing is interuppted because of a loss of muscle mass.

(By the way...the picture on the side says 'hope', but when you flip it over, it says 'faith'! COOL!)

Now that we have talked about physical causes of death, we need to consider the other factors that come into play - mental and emotional well-being. Many deaths from ED - like other mental illnesses - can be attributed to suicicde. Why? The patient has lost all hope and feels trapped. They want to get better but are scared to gain weight and to eat, or to seek help. They are tired because they are starving but cannot eat. They are weak but cannot find the power to eat something to sustain them. They are frustrated because no one seems to understand them, and others blame them for their problems. They are angry at themselves because they believe that this is their fault; that they are no good and should be ashamed of themselves. They hope to end their lives because they feel that they are a burden on everyone around them. Sound extreme? I am not exaggerating - this is exactly what patients with ED feel like. Sometimes, these feelings get too strong that the patient believes that the only way to end their misery and pain is to die. It is unforunate, but this happens too frequntly. Can this be prevented? Likely. With encourgament, the patient can see that they have a reason to live, and that ED does not need to control their lives forever. It takes time, but with enough support, the patient can start to see that life is worth living, and that ED is NOT a part of their future.

Whatever the cause of death may be, patients must know that ED is serious and that it can kill them anytime, often without warning. The body can only withstand so much damage until it fails. Likewise, the patient can only take so much pain (physical, mental, and emotional) until they crash and want to end their misery. While I never made attempts to kill myself, I did have days when I was sick when I felt that I just wanted my life to end because it was hopeless. Even in recovery, I still had days when I felt awful and tired and angry. But things got better, and today, I am happy with my life, and I am doing all that I have ever wanted to. Life truly does get better in recovery, but it takes time. Until that time comes, patients need to have support and proper treatment. They need to know that they are ill even if they don't feel 'sick enough'. They need to know that ED should not and WILL not be a part of their lives forever. They need to have hope, faith, and perseverance. Because without hope, you can never see a bright future. Without faith, you will depend on yourself alone for success and never realize that God gives us strength. Without perseverance, you may be discouraged by falls and think that you will never achieve yout dreams. But with the three of them, you will be well on your way towards recovery, healing, and strength.