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Get help. Refer a patient.
Find hope. 888-364-5977

Blog Archives: August 2012

4 Reasons Why You May Not Be Getting Evidenced Based Care

August 31, 2012. Written by Mark Warren, M.D.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    By Dr. Mark Warren

    Every year our understanding of the brain and eating disorders improves. However, there are still a limited number of truly evidence based treatment for our patients. The search for evidence based care may feel overwhelming and sometimes futile. Unfortunately, moving in the direction of care that is not evidence based reduces the likelihood that clients will achieve recovery. There are several reasons why providers may offer care not based on the literature or published data:

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Haiku

August 29, 2012.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    This haiku was written by a client at CCED. He shares it in hopes that it will inspire others.

    A better hope

    gentle wind as a peace

    another sunrise

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What Do We Mean By Causation?

August 22, 2012. Written by Mark Warren, M.D.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    By Dr. Mark Warren

    Often times while in treatment clients wonder how and why their eating disorder developed. The common question "What caused my eating disorder?" is very complicated because it pulls from so many ideas, understandings, conceptions, and misconceptions about the importance of causation, the implication of causation, and the definition of what causation means. Before we deal with the notion of causation itself, it is crucial to point out there is no evidence that knowing causation leads to cure, and no current evidence that knowing cause provides an avenue to change the treatment that we do. Having said that, virtually all clients and families want to know why they have an eating disorder. We believe, and research has indicated, that there are biological factors that predispose an individual to the illness and environmental factors then influence the manifestation of the disorder. This mirrors most psychological illnesses. When you have a treatment that is purely biological for an illness it moves someone towards recovery, but usually they do not feel better until they have re-established the quality of life they had before the illness. This often means a re-establishment of social contacts, work, school, and the ability to experience personal growth, change, pleasure and happiness. So we are careful not to say that the lack of these things are the causes of the illness, even though attaining them may be a core part of the recovery process. The experience of cure does not need to flow directly from the notion of causation. We know that nourishment and cessation of behaviors is a prerequisite to getting better, and we also know that after stabilization of symptoms there is still much work to do. Our current understanding is that the work left to do is not due to underlying things that caused the illness, but rather issues that may persist after refeeding, issues of body image, negative self talk and shame, and the ability to experience oneself as whole and healthy.

    Contributions by Sarah Emerman

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Biology and Eating Disorders

August 01, 2012. Written by Mark Warren, M.D.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    By Mark Warren, MD

    The book Eating Disorders and the Brain edited by Drs Lask and Frampton continues to be an extraordinarily important book to understanding the etiology of eating disorders. Given our current knowledge, we often say that eating disorders are biologically based. Yet, this is somewhat of a two-dimensional statement as eating disorders are experienced as complex and multi factorial. A large number of factors seem to be interacting when someone presents with an eating disorder. These include genes, early attachment, personality issues, cultural issues, cultural norms, peer relationships, sensitivity, and on and on. Current biological work is beginning to show us is that many of these factors may in fact be related to one and other. The complex development of the eating disorder can be understood as the product of a specific genetic profile that develops in a specific individual under specific circumstances. Rigidity, perfectionism, skillfulness, and skill deficits, that are often seen in individuals with the illness are often mislabeled as "causes" when they are in fact part and parcel of the same developmental picture that may ultimately result in an eating disorder. With continued research of the brain, we are closer to understanding this complexity in terms of a specific biology that causes multiple expressions and can ultimately understood and treated through development and improvement of structures within the brain.

    Contributions by Sarah Emerman

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Recovery for life is possible 888-364-5977

Recovery for life is possible

888-364-5977

The Emily Program