Hollow An Unpolished Tale
EATING DISORDERS OVERVIEW <ul><li>PART ONE </li></ul>
This is not a “new” problem.  <ul><ul><li>The term ‘’Anorexia Nervosa’’ was established in 1873 by Queen Victoria’s person...
Eating Disorder Statistics <ul><li>It is estimated that 8 million Americans have an eating disorder – seven million women ...
ED Statistics, cont.  <ul><li>An estimated 10 – 15% of people with anorexia or bulimia are males  </li></ul><ul><li>Eating...
Types of Eating Disorders <ul><li>Anorexia Nervosa </li></ul><ul><li>Bulimia Nervosa </li></ul><ul><li>Compulsive Overeati...
Anorexia Nervosa Criteria <ul><li>Low Weight : At least 15% below normal </li></ul><ul><li>Weight Phobia : Intense fear of...
Anorexia Warning Signs <ul><li>Loss of period </li></ul><ul><li>Dieting obsessively; denial of hunger </li></ul><ul><li>Cl...
Bulimia Nervosa Criteria <ul><li>Binge-Eating on a regular basis </li></ul><ul><li>Purging: self-induced vomiting, laxativ...
Bulimia Warning Signs <ul><li>Excessive thoughts about weight </li></ul><ul><li>Strict dieting followed by binge eating </...
EATING DISORDERS AND YOU,  THE SUFFERER <ul><li>PART TWO </li></ul>
A Brief Eating Disorder Screen <ul><li>Do you make yourself sick because you feel uncomfortably full? </li></ul><ul><li>Do...
How Anorexia Affects Your Body
How Bulimia Affects Your Body
Okay, so what next?  <ul><li>If you have an eating disorder, you will need help to overcome it. This is not something you ...
WHEN SOMEONE YOU LOVE HAS AN EATING DISORDER  <ul><li>PART THREE </li></ul>
What Should I Do? <ul><li>Learn all you can </li></ul><ul><li>Understand the complexity </li></ul><ul><li>Discuss the prob...
What SHOULDN’T I Do? <ul><li>Agree to keep secrets </li></ul><ul><li>Get over-involved </li></ul><ul><li>Oversimplify </li...
Resources for YOU <ul><li>FINDINGbalance </li></ul><ul><li>www.findingbalance.com </li></ul><ul><li>National Eating Disord...
HOPE FOR THE HOLLOW <ul><li>PART FOUR </li></ul>
There Could Never Be a More Beautiful You . . .  Click image to play music video From YouTube
Choose to Listen and Believe  the Voice of Truth! Click image to play music video From YouTube
There is HOPE . . .  <ul><li>“ For I know the plans I have for you,” declares the LORD. “Plans to prosper you and NOT to h...
Father in Heaven, we love You. You are mighty and we are weak, You are big and we are so small. We make messes so easily, ...
More Resources <ul><li>Join a community of caring people at the  book’s social network . </li></ul><ul><li>Follow  Hollow ...
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Hollow - Recovering from Eating Disorders

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Teach the dangers of eating disorders by sharing this presentation with young girls at local churches and schools. Based on the book Hollow: An Unpolished Tale by Jena Morrow, it includes slides and a complete presentation script. www.hollowthebook.ning.com

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  • The history of eating disorders is actually quite interesting, and it makes us realize that we are not – perhaps never have been – alone in our struggles with food, weight, and our emotions. For further reading on the history of eating disorders, check out “Fasting Girls” by Joan Jacobs Brumberg and Dr. Hilde Bruch’s classic book on the subject, “The Golden Cage.” NOTE: For some, this sort of reading can be triggering. I suggest these books mostly for parents, spouses, and other support people, or to those firmly grounded in their own recovery. The goal is to gain a greater understanding of the illness – not to worship it, which is a danger to some.
  • Additional statistics to note: Anorexia is the 3rd most common chronic illness among adolescents 95% of those who have eating disorders are between the ages of 12 and 25 50% of girls between the ages of 11 and 13 see themselves as overweight 80% of 13-year-olds have attempted to lose weight
  • These are the “four biggies” – but there are other, less common types of eating disorders as well. These include Anorexia Athletica (Anorexia athletica is when a person no longer enjoys exercise, but feels obligated to do so to an obsessive and excessive degree as a means of purging); Over Exercise (Over exercise, or compulsive exercising, is a problem when the person is scheduling life around exercise just like people with eating disorders schedule their lives around eating or not eating); Over Eating (Compulsive over eating is the excessive consumption of food (bingeing), often thousands of calories at a time); Night Eating (Night eating syndrome is characterized by a lack of appetite in the morning and overeating at night with agitation and insomnia); Anorexia Athletica Anorexia athletica is when a person no longer enjoys exercise, but feels obligated to do so... Over Exercise Over exercise, or compulsive exercising is a problem when the person is scheduling life around exercise just like people with eating disorders schedule their lives around eating or not eating... Over Eating Compulsive over eating is the excessive consumption of food (bingeing), often thousands of calories at a time... Night Eating Night eating syndrome is characterized by a lack of appetite in the morning and overeating at night with agitation and insomnia... Orthorexia (Orthorexia nervosa is one of a little-known group of eating disorders. Orthorexia nervosa refers to a fixation on eating proper food, only organic food to the absolute exclusion to any inorganic food, or food that is believed to be “pure”); Chewing-and-Spitting (a sub-classification of EDNOS, wherein the sufferer chews and spits large quantities of foods, but does not swallow or digest any of it). EDNOS is the MOST COMMONLY DIAGNOSED eating disorder – and yes, it can be every bit as dangerous and life-threatening as the other clinical eating disorders!
  • Anorexia is self-starvation. There is nothing good about eating disorders , especially anorexia. When a woman has this disease, it affects her entire life, health, home and often, her work. Since the risk factors are the same, the situation is similar for adolescents and children. Once a young girl starts with the behavior, often there is no end in sight. Weight loss becomes her top priority. She will spend all her time in search of the perfect diet -- the best way to stay thin. People with anorexia starve themselves to dangerously thin levels, at least 15% below their appropriate weight. Activists have been lobbying to get that last criterion removed; the next edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) may likely not include any diagnositic criteria involving the cessation of a woman’s menstrual period. Not all women who become severely malnourished lose their periods; this has caused many women to be inaccurately diagnosed.
  • Whereas individuals with anorexia starve themselves to dangerously thin levels, those with bulimia eat large amounts of food—sometimes thousands of calories at a time—and then purge the calories out of their bodies through vomiting, excessive exercise, fasting, laxatives, and other methods. Unlike with anorexia, it is not immediately obvious when a person is struggling with bulimia. Their weight is usually not low and they often seem healthy. Usually, the only overt physical signs are swollen cheeks or scrapes on their fingers, the result of induced vomiting. Dentists are often the only ones to recognize the problem, due to damage to the teeth from repeated exposure to stomach acid. It is not unusual for a person with bulimia to want to stop. They experience a large amount of guilt and a great deal of shame regarding their behaviors. Their sense is that they have a total loss of control in their lives. They feel a high level of stress, yet they cannot change. If bulimia is severe and prolonged, the medical consequences are extremely serious, especially if laxatives are abused. These include injury to the stomach, intestines and esophagus and damage to the heart and kidneys. Fortunately, many of these medical complications can improve once a person recovers from the disorder.
  • Any person answering &amp;quot;yes&amp;quot; to two or more of these five questions is quite likely to have an eating disorder. The screening test above, called the SCOFF, picks up nearly 100 percent of anorexia and bulimia cases. It has a small false positive rate. It is therefore an excellent, rapid, and cost-effective screening tool for identifying eating disorders. LISTEN UP: If you answered “yes” to two or more of these questions, you need to take this very seriously. If you didn’t but someone came to your mind who you believe would answer yes to two or more of these questions, you need to pray about how to approach that person in love and confront them about this. You could be the one to save their life – seriously.
  • Yikes . . . This is serious stuff, people. (Ask the group to identify which of these affects could potentially be permanent – even if the person recovers.) Ask them which they think could be fatal. If no one identifies the potentially fatal symptom, educate the group about the danger of low potassium: Potassium is a mineral ( electrolyte ) in the body. Almost 98% of potassium is found inside the cells. Small changes in the level of potassium that is present outside the cells can have severe effects on the heart, nerves, and muscles. Potassium is important to maintain several bodily functions: Muscles need potassium to contract. The heart muscle needs potassium to beat properly and regulate blood pressure . The kidney is the main organ that controls the balance of potassium. It removes excess potassium into the urine . When potassium levels are low (hypokalemia), you can become weak as cellular processes are impaired. Extremely low serum potassium is associated with CARDIAC ARREST. The young woman to whom “Hollow” is dedicated – Jena’s friend Cindy – DIED from cardic arrest brought about by LOW POTASSIUM. Her heart stopped and her life was cut short at age 29. Anorexia is serious!
  • How many of these effects are potentially permanent? How about fatal? A common misconception is that, because a bulimic person may not be underweight, that her illness is not as dangerous as anorexia. What do you think – true or false? FALSE. The possible rupture of the esophagus and stomach can both be fatal. Electrolyte imbalance – those fluids we just learned about (sodium and potassium) – is a HUGE danger for a person suffering from bulimia. A couple things this chart doesn’t mention – bulimia not only erodes your tooth enamel, it can completely ruin your smile. I’ve known women who have had a full set or veneers – or even dentures – in their twenties! Also, regular vomiting can cause broken blood vessels in and around the eyes. I know a girl who works at a Starbucks, and she’s clearly bulimic – she has scars on the knuckles of her right hand from scraping against her teeth, and she always looks like she has two black eyes – broken blood vessels. Not the best beauty regimen, is it?
  • NOTE: At this point in your presentation, if you have handouts or referral lists of counselors, other groups, treatment programs, hotlines, or online resources, you might mention these to the group and tell them that they will be made available to them at the end.
  • Learn what community and healthcare resources are available. Understand that eating disorders are complex. Recovery is not just a matter of will power. Discuss your concerns with the individual. Be compassionate; listen. Try to understand things from the person&apos;s perspective. Understand that persons with eating disorders often make decisions based on their feelings rather than on facts and logic. State what you have observed -- list evidence of the problem. Express your concerns about the person&apos;s health and functioning, not just their weight. Indicate your conviction that the situation should at least be evaluated by a professional. Explain how you can help-with a referral, information, emotional or financial support. End the conversation if going nowhere or if the person becomes upset. But if possible, leave the door open for further conversations. Have patience: If rejected, try again later, explaining that you are coming back because you think the situation is serious. Respond during emergencies: If the person is throwing up several times per day, passing out, complaining of chest pain, or talking about suicide, get help immediately. Find support for yourself. Talk to a counselor or healthcare professional; attend a support group for family and friends of those with eating disorders.
  • Don&apos;t make promises you can&apos;t keep; don&apos;t promise to keep the person&apos;s behavior a secret. Don&apos;t get over-involved. Know your limits. You are not a substitute for professional care. Don&apos;t oversimplify. Avoid platitudes like, &amp;quot;Eating disorders are an addiction like alcoholism,&amp;quot; or &amp;quot;All you have to do is accept yourself as you are.&amp;quot; Don&apos;t nag about eating or not eating, or spend time talking about food and weight. Don&apos;t be judgmental; don&apos;t say that what the person is doing is &amp;quot;sick&amp;quot;, &amp;quot;stupid&amp;quot;, or &amp;quot;self-destructive.&amp;quot; Don&apos;t give advice about weight loss, exercise, or appearance. Don&apos;t say, &amp;quot;I know how you feel.&amp;quot; You can demonstrate that you understand by paraphrasing what the person has said. Don&apos;t feel obliged to agree with the person&apos;s perspective or beliefs, even though you are making an effort to understand them. Don&apos;t bring a group of people to confront the person.
  • FINDINGbalance www.findingbalance.com is an excellent resource for parents, spouses, and friends of those with eating disorders. (It is also a good resource for sufferers, as well). You must create a login and password, but it is worth it for the searchable database of informative videos (about one to four minutes each) on various issues associated with eating disorders. Many of the counselors and doctors featured in the videos are from Remuda Ranch (the treatment center featured in “Hollow.”) National Eating Disorders Association http://www.nationaleatingdisorders.org The NEDA is a nonprofit association dedicated to the prevention and treatment of eating disorders. Contact them at: National Eating Disorders Association 603 Stewart St. Suite 803 Seattle, WA 98101 (206) 382-3587 National Association of Anorexia Nervosa and Associated Disorders (ANAD) http://www.anad.org ANAD is a national nonprofit organization for people with eating disorders and their families. In addition to its hotline counseling, ANAD operates an international network of support groups and offers referrals to health care professionals who treat eating disorders. Contact them at: ANAD Box 7 Highland Park, IL 60035 (847) 831-3438 National Institute of Mental Health (NIMH) http://www.nimh.nih.gov NIMH offers information about the symptoms, diagnosis, and treatment of mental illnesses, and supports research to help those with mental illness.
  • Hollow - Recovering from Eating Disorders

    1. 1. Hollow An Unpolished Tale
    2. 2. EATING DISORDERS OVERVIEW <ul><li>PART ONE </li></ul>
    3. 3. This is not a “new” problem. <ul><ul><li>The term ‘’Anorexia Nervosa’’ was established in 1873 by Queen Victoria’s personal physician, Sir William Gull. </li></ul></ul><ul><ul><li>There are documented cases of “wasting disease” in medical history, believed by some to have been anorexia – among them, Mary Stewart (known as Mary, Queen of Scots) in 1556. </li></ul></ul>
    4. 4. Eating Disorder Statistics <ul><li>It is estimated that 8 million Americans have an eating disorder – seven million women and one million men </li></ul><ul><li>One in 200 American women suffers from anorexia </li></ul><ul><li>Two to three in 100 American women suffers from bulimia </li></ul>
    5. 5. ED Statistics, cont. <ul><li>An estimated 10 – 15% of people with anorexia or bulimia are males </li></ul><ul><li>Eating disorders have the highest mortality rate of any mental illness </li></ul><ul><li>Only 1 in 10 people with eating disorders receive treatment </li></ul>
    6. 6. Types of Eating Disorders <ul><li>Anorexia Nervosa </li></ul><ul><li>Bulimia Nervosa </li></ul><ul><li>Compulsive Overeating (COE) or Binge Eating Disorder (BED) </li></ul><ul><li>Eating Disorder Not Otherwise Specified </li></ul>
    7. 7. Anorexia Nervosa Criteria <ul><li>Low Weight : At least 15% below normal </li></ul><ul><li>Weight Phobia : Intense fear of gaining weight or becoming fat, even though underweight. </li></ul><ul><li>Body Image Issues : Believing you are fat when you are not, denying the medical seriousness of your low weight. </li></ul><ul><li>Loss of menstrual period : Missing at least three menstrual cycles in a row. </li></ul>
    8. 8. Anorexia Warning Signs <ul><li>Loss of period </li></ul><ul><li>Dieting obsessively; denial of hunger </li></ul><ul><li>Claiming to feel &quot;fat&quot; when overweight is not a reality </li></ul><ul><li>Preoccupation with food, calories, nutrition </li></ul><ul><li>Hair loss </li></ul><ul><li>Excessive exercising </li></ul><ul><li>Frequent weighing </li></ul><ul><li>Strange food-related behaviors </li></ul><ul><li>Episodes of binge-eating </li></ul><ul><li>Depression </li></ul><ul><li>Slowness of thought/memory </li></ul>
    9. 9. Bulimia Nervosa Criteria <ul><li>Binge-Eating on a regular basis </li></ul><ul><li>Purging: self-induced vomiting, laxative abuse, diuretics, enemas, other medications, fasting, or excessive exercise. </li></ul><ul><li>Frequency: episodes of binge eating and purging both occur, on average, at least twice a week for three months. </li></ul><ul><li>Body Image Issues </li></ul>
    10. 10. Bulimia Warning Signs <ul><li>Excessive thoughts about weight </li></ul><ul><li>Strict dieting followed by binge eating </li></ul><ul><li>Frequent overeating, especially when distressed </li></ul><ul><li>Bingeing on high calorie, sweet foods </li></ul><ul><li>Abuse of laxatives, diuretics, exercise, and/or vomiting </li></ul><ul><li>Leaving for the bathroom after meals </li></ul><ul><li>Being secretive about binges or vomiting </li></ul><ul><li>Feeling out of control </li></ul><ul><li>Depression </li></ul>
    11. 11. EATING DISORDERS AND YOU, THE SUFFERER <ul><li>PART TWO </li></ul>
    12. 12. A Brief Eating Disorder Screen <ul><li>Do you make yourself sick because you feel uncomfortably full? </li></ul><ul><li>Do you worry you have lost control over how much you eat? </li></ul><ul><li>Have you recently lost more than 15 pounds in a three-month period? </li></ul><ul><li>Do you believe yourself to be fat when others say you are too thin? </li></ul><ul><li>Does food dominate your life? </li></ul><ul><li>Take the “Are You Hollow Quiz” online at http://quizilla.teennick.com/tests/16114830/are-you-hollow </li></ul>
    13. 13. How Anorexia Affects Your Body
    14. 14. How Bulimia Affects Your Body
    15. 15. Okay, so what next? <ul><li>If you have an eating disorder, you will need help to overcome it. This is not something you can expect yourself to face and conquer alone. You have several options, and combining two or more of these will serve you best: </li></ul><ul><li>PROFESSIONAL COUNSELING </li></ul><ul><li>PASTORAL COUNSELING </li></ul><ul><li>OUTPATIENT / PARTIAL DAY PROGRAM </li></ul><ul><li>SUPPORT GROUPS </li></ul><ul><li>WOMENS MINISTRY GROUPS </li></ul><ul><li>INPATIENT TREATMENT </li></ul>
    16. 16. WHEN SOMEONE YOU LOVE HAS AN EATING DISORDER <ul><li>PART THREE </li></ul>
    17. 17. What Should I Do? <ul><li>Learn all you can </li></ul><ul><li>Understand the complexity </li></ul><ul><li>Discuss the problem </li></ul><ul><li>Listen patiently </li></ul><ul><li>Be compassionate </li></ul><ul><li>Express yourself </li></ul><ul><li>Respond in emergencies </li></ul><ul><li>Find support for yourself </li></ul>
    18. 18. What SHOULDN’T I Do? <ul><li>Agree to keep secrets </li></ul><ul><li>Get over-involved </li></ul><ul><li>Oversimplify </li></ul><ul><li>Nag about food or weight </li></ul><ul><li>Judge </li></ul><ul><li>Give inappropriate advice </li></ul><ul><li>Claim to know how they feel </li></ul><ul><li>“ Gang up on” the person </li></ul>
    19. 19. Resources for YOU <ul><li>FINDINGbalance </li></ul><ul><li>www.findingbalance.com </li></ul><ul><li>National Eating Disorders Assn. </li></ul><ul><li>www.nationaleatingdisorders.org </li></ul><ul><li>ANAD </li></ul><ul><li>www.anad.org </li></ul><ul><li>NIMH </li></ul><ul><li>www.nimh.nih.gov </li></ul>
    20. 20. HOPE FOR THE HOLLOW <ul><li>PART FOUR </li></ul>
    21. 21. There Could Never Be a More Beautiful You . . . Click image to play music video From YouTube
    22. 22. Choose to Listen and Believe the Voice of Truth! Click image to play music video From YouTube
    23. 23. There is HOPE . . . <ul><li>“ For I know the plans I have for you,” declares the LORD. “Plans to prosper you and NOT to harm you. Plans to give you HOPE and a FUTURE.” </li></ul><ul><li>(Jeremiah 29:11 NIV) </li></ul>
    24. 24. Father in Heaven, we love You. You are mighty and we are weak, You are big and we are so small. We make messes so easily, God – and yet You love us, even in the midst of them. Thank You for being willing to meet us where we are – to reach down into the dirt and show us the way, by Your Spirit. As we read this book, we pray that You would speak to us through its pages; through one woman’s story, would You please help us to see our own stories and to recognize the part You need to play in them. We invite You in, humbly and gratefully . . . We need You, Lord. We pray this in the name of Your Son, Jesus. Amen.
    25. 25. More Resources <ul><li>Join a community of caring people at the book’s social network . </li></ul><ul><li>Follow Hollow on Twitter </li></ul><ul><li>Become a fan of Hollow the Book on Facebook </li></ul>

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