Brian Cuban and I co-wrote this piece; his is a strong voice for speaking out about eating disorders affecting not just men, but women. I very much appreciate his willingness to engage in dialogue about causation of eating disorders and am pleased to do advocacy work with him.
In her July 12, 2014 column, syndicated advice columnist “Ask Amy”, Amy gave advice to a teen who was worried both about her father having anorexia and her own increasing unhealthy thoughts about her weight. (Ask Amy: Daughter worries about dad’s unhealthy eating), Frequently, when a young person “Asks Amy”, or another columnist, for advice on a complicated medical topic, he/she is encouraged to seek further counsel and disclose the concern to a trusted adult. Instead, the response to this letter left the teen with no more information than when she wrote in (other than advice to protect the family’s pets from the food restriction which is a symptom of the father’s illness) and a directive to share her concerns with her parents then move on.
It is appropriate for any advice columnist to consult an expert when faced with a question that is outside his/her scope of knowledge, as this question seems to have been for Amy. Most people, not just advice columnists, assume they know what causes eating disorders. The research in the field of eating disorders is ever changing and has exploded in the past decade with the advent of new technologies such as functional MRIs and conventional wisdom has been turned on its head. It is unlikely that any layperson would be able to offer solid advice in this situation. This is not the first time an eating disorder related question has been posed to Amy. In a June 18th column, “Parents Undermine Eating Disorder Recovery” Amy did in fact reach out to someone with specialized knowledge in in the Eating Disorder field as part of her answer. Why not this time before giving dismissive, and frankly ridiculous input about the effect on the pets.
If this daughter is correct, her father has anorexia, a biological, brain-based mental illness with a mortality rate in the neighborhood of 20%. Eating disorders in themselves, have the highest mortality rate of any psychological illness. Not something in which advice should be given dismissively or without a specialized background. Sadly, eating disorders are often accompanied by anosonogsia, a medical term which means the sufferer doesn’t recognize that he/she is ill. Additionally, these illnesses have a strong genetic and psychosocial interface, so both her genetics and a childhood spent in an environment of disordered eating and other symptoms of anorexia increase her risk of developing an eating disorder exponentially.
In order to prevent giving out medical advice which is off the mark or potentially damaging to the point of terminal, standard practice for any advice columnist should be to consult an expert and disclose who they contacted. If no expert is available, they should just shut up.
Eating Disorder Activist and survivor
Author: Shattered Image: My Triumph Over Body Dysmorphic Disorder
Jennifer Denise Ouellette
Mothers Against Eating Disorders
UCSD Eating Disorder Treatment Program Parent Advisory Committee