“To the Bone” – Professional Review of the Netflix Movie

All in all, To the Bone focused on recovery, while it has initiated the needed conversation around eating disorders and its addictive nature. If we continue to shove this topic under the rug – this disease that affects millions of individuals – then we perpetuate its “disorder,” and it becomes as secretive as the sickness itself.

We glorify movies that highlight shootings, killings and violence. Shows featuring those addicted to drugs and alcohol are now mainstream. When it comes to documentaries about individuals struggling with eating disorders, these features become the white elephant in the room.

In the eating disorder community, there has been much drama around the recently released, To the Bone, featuring Lily Collins and Keanu Reeves. The greatest concern has been the potential of the film to “trigger” those who are currently struggling with an eating disorder.

As a certified eating disorder specialist, who previously owned and operated an eating disorder treatment center prior to its acquisition, our former treatment team would not walk on eggshells to prevent our clients from being “triggered.” Triggers are a part of everyday life, and it is the job of a competent professional working in an eating disorder treatment setting to acclimate clients to triggers. Triggers are not bad, they exist to push our clients to become aware, along with grow and transform.

If you feel your clients will be triggered by watching this and similar documentaries, ask yourself:

“What makes you uncomfortable as a treatment professional, and why?”, “What do you identify personally with in the respective triggers?”, and “Are you invested in the recovery process of your clients?”

When informational programs regarding diabetes and/or heart disease are featured on television, do medical professionals become concerned that these programs could trigger those individuals who are afflicted with these conditions? I think not.  Our clients with eating disorders don’t walk around with blinders. We are not shielding them from anything they don’t already know.

Our clients want to be pushed. They don’t want to be handled with kid-gloves. It is our job to continue push their buttons. An astute eating disorder practitioner is not one that receives rave reviews because they were good listeners and colluded with their patients. A skilled eating disorder professional receives reviews that exude, “My therapist/doctor challenged me and pushed me out of my comfort zone. I often left our session in tears…and gained insight.”

The film did not clarify for the audience what was unconventional about Dr. Beckham’s treatment approach. In addition, although diversity of individuals with eating disorders were portrayed – vs the stereotype – along with eating disorders across the spectrum, Anorexia Nervosa was still highlighted as the top of the food chain per usual.

All in all, To the Bone focused on recovery, while it has initiated the needed conversation around eating disorders and its addictive nature. If we continue to shove this topic under the rug – this disease that affects millions of individuals – then we perpetuate its “disorder,” and it becomes as secretive as the sickness itself.

Diabetes and Eating Disorders: Yoga as an Adjunct

For someone struggling with diabetes and an eating disorder, Yoga can be a powerful adjunct to treatment. Read my article here-re posted from We are Diabetes:

http://www.wearediabetes.org/articles/166/diabetes-and-eating-disorders-yoga-as-an-adjunct

The Concurrent Nature of Eating Disorders and Substance Abuse: Yoga as an Adjunct to Treatment

Mindful Yoga and meditation can affect the cerebral cortex, improving focus and awareness. The cerebral cortex is the center of the brain that is responsible for impulses, irrational thoughts and behaviors. Activating the cerebral cortex can diminish the impulsivity along with irrational thoughts and behaviors involved in eating disorders, substance abuse and related addictions.

The National Center on Addiction and Substance Abuse at Columbia University has concluded that at least one half of women who suffer from an eating disorder also suffer from a substance use disorder (SUD). While eating disorders, and substance use disorders are linked to higher risk for mortality than all other psychological disorders, the two are present together result in a much more damaging outcome.

The rate of comorbidity varies among eating disorder classifications with the prevalence of SUD in individuals with Bulimia Nervosa or Anorexia Nervosa purging type much greater than individuals with Anorexia Nervosa, restricting type. Researchers have reported a higher use of stimulants, sedatives, and cocaine in individuals with Bulimia Nervosa, with marijuana and hallucinogen use in those with Anorexia Nervosa.  It is speculated that the heighted impulsivity of those with Bulimia may reflect their more frequent use of these drugs along with the appetite suppressing nature of the drugs in individuals with Bulimia and those with Anorexia. It is also speculated that the escape offered by the drugs maybe appealing to those who suffer from anxiety associated with eating disorders.

Researchers at the University of Washington concluded that the onset of an SUD could be predicted in individuals with Anorexia Nervosa and Bulimia Nervosa if the individual had attempted suicide, or had been hospitalized. Furthermore, the severity of the bulimic symptoms could also be used to predict a future SUD.

For professionals working with eating disorder patients, a thorough knowledge of and specialized training in substance abuse is warranted, along with understanding the research regarding eating disorders and co-occurring substance use disorder. In a therapeutic setting, a thorough history needs to be completed in order to assess an individual’s comorbidity. It’s not acceptable for the clinician to omit an SUD diagnosis because the individual did not report substance use to that respective clinician – especially when the SUD is clearly documented in the individual’s history. If it is not documented, digging deep is a must for the clinician, given the concurrent nature of eating disorders and SUD. A thorough history can determine the degree of co morbidity in eating disorder patients and may also be used in determining treatment options that suit the patient’s unique coexisting disorders.

Behavioral therapies alone, or along with medications can be a highly effective for of treatment that can lead to more positive outcomes. Another treatment option for co-morbidities is Yoga therapy. Yoga therapy is the process of empowering individuals to progress toward improved health and well-being through the application of the philosophy and practice of Yoga. Yoga therapy incorporates a number of positive mind and body practices such as deep breathing, relaxation, deep meditation, and postural exercises. It adapts the practice of Yoga to an individual’s specific condition, and in the treatment of co-occurring eating disorders and substance abuse disorders, can be adapted to enforce a positive mental outlook, improved self-awareness and acceptance, and can relax and ground a patient.

Gamma-Amino Butyric acid (GABA) is an amino acid which acts as a neurotransmitter in the central nervous system. It inhibits nerve transmission in the brain, calming nervous activity. In recent studies, Yoga has been shown to increase the levels of GABA in the brain by more than 20 percent. This is important because people dealing with substance abuse usually exhibit low levels of GABA.

Mindful Yoga and meditation can affect the cerebral cortex, improving focus and awareness. The cerebral cortex is the center of the brain that is responsible for impulses, irrational thoughts and behaviors. Activating the cerebral cortex can diminish the impulsivity along with irrational thoughts and behaviors involved in eating disorders, substance abuse and related addictions.

The Concurrent Nature of Eating Disorders and Substance Use Disorders – Yoga as an Adjunct to Treatment Two (1) contact hours Tuesday June 20, 2017 11:45 am – 1:00 pm at Henry Ford Maplegrove, West Bloomfield, MI – Speaker BEVERLY PRICE, RD, MA, E-RYT 200, C-IAYT, CEDRD-S, IAEDP For more information or to register: Jessica Jacobs LMSW, MSW, CAADC (248)788-3011.

A special thank you to Bridgette Grabowski, NDTR, who researched the original content for this article.

Where is Beverly?

It is said that Yogini’s don’t grow old, but grow wiser. I hope that you will find wisdom in my writings and look forward to keeping in touch through my blog…

Hello and welcome to my blog!

I wanted to update you as to the acquisition of my business, the Inner Door Center, Eating Disorder Treatment Center this past September 2016. Recently, I have left the center, yet still plan to remain active in the national and local Eating Disorder professionals community through consulting, lecturing, board positions, supervising and mentoring, along with taking time for myself.

Through my certification as a Yoga Therapist (C-IAYT) through the International Association of Yoga Therapists, I will be offering Yoga therapy specialty training programs in eating disorders, as affiliated with Phoenix Rising Yoga Therapy. I hope you will join me on my next retreat in Nicaragua, February 2018.

In addition, through my credentialing as an International Association of Eating Disorders Professionals (iaedp) Certified Eating Disorder Registered Dietitian Supervisor (CEDRD-S), I am available to provide supervision to registered dietitians on the traditional path to becoming a CEDRD.

It is said that Yogini’s don’t grow old, but grow wiser. I hope that you will find wisdom in my writings and look forward to keeping in touch through my blog, along with website and other social media outlets.

Sincerely,

Beverly