jews in the d continued from page 12 “I have to tell myself to eat. I’ve gotten so used to being hungry. But, at this point, food is not always on my mind. Today, I see food as something that will fuel me and will keep me healthy.” — NATALIE Some signs and symptoms of a possible eating disorder • Changes in the food choices a child/young adult makes • Comments about their relationship with food • Loss of period if a young woman has begun menstruation • Body changes • Changes in apparel, where the individual wears clothing that conceals their body • Young children who express a desire to go on a diet • Kids who play with their food • Kids who sleep a lot and show low energy 14 December 27 • 2018 jn intention of eating more healthfully but then becomes very rigid in what they will and will not eat. The National Eating Disorders Association (NEDA) reports that between 0.3-0.4 percent of young women and 0.1 percent of young men will suffer from anorexia nervosa at any given time. For bulimia nervosa, 1.0 percent of young women and 0.1 percent of young men will meet diagnostic criteria for bulimia nervosa at any given point in time. Although eating disorders in gen- eral affect more females, NEDA cites research that showed from 1999 to 2009, the number of men hospitalized for an eating disorder-related cause increased by 53 percent. ARFID also tends to affect more males. ADDRESSING EMOTIONAL ISSUES Today, Natalie says she still battles her eating disorder but that working with her medical team, and especially her therapist Tammy Dines, LMSW, ACSW, she has been able to manage her depres- sion and anxiety, and control that voice in her head that “tells” her to skip meals. “At this moment, it’s just more frustrating deal- ing with the eating disor- der,” Natalie said. “I have to tell myself to eat. I’ve gotten so used to being hungry. But, at this point, Tammy Dines food is not always on my mind. Today, I see food as something that will fuel me and will keep me healthy.” Natalie said she’s looking to the future, which includes going to college. She also has found greater purpose and meaning in helping to prepare students for their bat or bar mitzvahs. Dines, who runs a private practice in Farmington Hills, said that treating an eating disorder is frustrating for the individual because progress can be slow. But she recommends a holistic approach in that the person with the disorder work with a team, such as a therapist, a psychiatrist, a nutritionist and a medical doctor. “We have to address emotional, nutri- tional and physical aspects of the disor- der,” she said, adding that her role is to address the emotions that come about with eating disorders. “I think for some eating disorders, it’s societal pressure to look a certain way and to be thin,” Dines said. “There’s a lot of family dynamics and eating dis- orders occur more in chaotic families or families with eating disorders. We’re seeing with anorexics [a desire for] per- fection and wanting that control. Eating becomes a way to be in control. “With some bulimics, there’s a lot of anger and rage and this is one way of externalizing it, by vomiting. With exer- cise bulimia, it’s calories in, take it off. A lot of these people are rigid.” A MOTHER’S TAKE Natalie’s mother, who also asked to be anonymous, said she began noticing emotional changes in her daughter, that she always seemed angry and sad, as her eating disorder developed. “Puberty hit Natalie really hard, physically and mentally,” she said. “For Natalie, finding happiness is difficult.” Natalie’s mom, who also dealt with anorexia as a young person, said that helping Natalie has taken an emotional and financial toll on the family, but that she has been proactive in her daughter’s ongoing recovery. “With Natalie’s eating disorder, it’s not just about being skinny,” she said. “You have to focus on their mental health. Don’t be afraid to snoop. I snooped. I’m a concerned mother. Ask questions of your child and keep questioning them. Don’t just let it go. Seek medical help sooner rather than later.” GETTING HELP One center in Bloomfield Hills is addressing the unique issues surround- ing eating disorders. The Center for Eating Disorder Assessment, Recovery & Support (CEDARS) is run by Kristine Vazzano, Ph.D., and registered dietitian Patrizia Jesue. The center provides outpatient ser- vices, including a therapeutic meal support program, which helps indi- viduals successfully manage, confront and overcome difficulties and anxieties of meal time. It also helps individuals manage their disordered thoughts about and behaviors around eating and food. Additionally, CEDARS offers different types of behavioral therapy and various support groups, as well as therapeutic yoga, meditation, culinary art therapy and creative art therapy. Taylor Beardsall is an art therapist at CEDARS and says those who are more creative have a higher risk of developing an eating disorder. “There tends to be a lot of anxiety and perfection- ism” in these individuals, she said. “Having an eat- Taylor ing disorder can lead to Beardsall feelings of depression and really high anxiety.” Beardsall said that using the creative process can help individuals cope with the feelings of having an eating disorder. “The art process can be a source of grounding,” she said, adding that when individuals see their own artwork, it often gives them a sense of strength and shows them positive aspects of them- selves. LONG ROAD TO RECOVERY As therapist Dines mentioned, the recov- ery process from an eating disorder is slow and challenging. Laurie Jablonski, a mother of two grown daughters who lives in Warren, knows this is true. Jablonski, who was raised Jewish and attends Temple Israel in West Bloomfield, has dealt with anorexia and, to a lesser extent, binge-eating for decades, dating back to her high school years. She’s worked with various therapists over the years Laurie but has found greater Jablonski success working with Dr. Vazzano and Jesue. She also has utilized CEDARS services, including art therapy and mindfulness practices. “I’ve learned how to look at things differently, how not to blame myself over everything,” she said. “There’s still a lot of work to do, but I feel so much better. My relationship with food is I can eat any- thing I want, in proportion. There’s no such thing as a good or bad food.” She also has advice for younger people coping with an eating disorder. “If the young person is ready for recovery, I would tell them to listen to their therapist and to work harder than their therapist,” she said. “If you want recovery, you have to work at it every day.” ■ For details, go to www.nationaleatingdisorders. org.