Why is eating disorder treatment so dysfunctional? Part one

[@ababy6074]

Inpatient treatment: triggering, traumatising, humiliating, degrading, condescending, minimising, one-size-fits-all.

[@rebeccarose4448]

I was refused treatment at all because my BMI was underweight but not underweight enough. They called me up and literally said “we cannot offer you help because you aren’t underweight enough, but please do call us back if you keep losing weight again”...if they’d had an ED themselves they would’ve known how much that comments fuels an ED, especially because they’re competitive etc 🙃

[@emmalouge123]

I will say, the biggest problem I encountered in eating disorder treatment here in Canada, is the lack of being able to handle people's trauma. I agree that the reasons for eating disorders are diverse, but the people I was in treatment with who were the most wronged, were the people who had the most trauma. They were asked to give up their main coping mechanism while getting no support for the emotions that brought up. People were numbing to reduce symptoms of PTSD and the clinicians basically asked that they do their best to ignore the symptoms or pay for outside help. It's complicated because the healthcare was free, which we were all grateful for, but no one really got better because it didn't do enough

[@Juleshiker32]

I have to say that not all treatment centers are like these listed. Which I find shocking and appalling! When I was inpatient some of the therapist there were recovered from ED and they believe in full recovery. It really helped me knowing they previously had anorexia. I would ask so many questions and it gave me faith that I too could recover. I am still working on my recovery with help and watching these videos and getting better every day,. Matter of fact. I learned of Tabitha in treatment because the therapist were showing us her KZbin videos!

[@amyroseohanlon6320]

I spent over a year on inpatient wards between the ages of 16 and 22. It wasn’t until I came across ‘Rehabilitate, Rewire, Recover!’ aged 24 that I found a way forward. Two years later, I’m recovered, and I attribute that ENTIRELY to your writing. Hospital messed me up; you gave me my life back! Thank you for everything 🙏

[@amysafko8817]

Having been to many, many programs at all levels of care in the US - this is 100% true. Being 50, I have seen so many approaches from so called experts (approaches they claim are evidence based but when one digs deeper, the evidence is pretty slim). My only caveat I would add is making sure the coach is solid in their recovery and has been for a long enough while. I have seen some individuals on social media purporting to be coaches but they have only been in recovery a very, very short time before deeming themselves fully recovered.

[@katespalding2134]

Amy Safko it feels like one size fits all and it so doesn’t. I understand that resources are short but in the UK the patients needs are central to the model of treatment. I also understand that because brains are frequently malnourished, then they might not be that great at making best decisions and sometimes sufferers might need to have help in making those decisions. Surely a collaborative, flexible, imaginative approach might be preferable, central to which is using best practice, evidenced based, innovative treatment where individuals needs are catered for(not in a manipulative way EDway))

[@laurenadders9250]

Honestly I’m just so over how crappy “professional” ED services actually are! Treatment is still completely reliant on weight and we’re still being fed the message that full, complete recovery doesn’t really exist. According to these services the best we can aim for is sticking to a meal plan and staying at a target weight derived from an out of date bmi chart were our bodies don’t want to be. HONESTLY experts by experience in EDs are the only thing that’s given me hope that this isn’t it and that full recovery does exist. Your videos and blogs have done more for me then any ED service so thank you ❤️ the whole system does need over hauled but that would mean “professionals” acknowledging it needs to change.

[@jennesset1102]

To be fully recovered (from ED or addiction, etc) doesn’t it really come down to being sick of it all? A rock bottom? Coming to a reckoning with yourself that says, “whoa! I’m starving to death, hurting my family, and hurting my children (if you’re a parent), and I’m DOING SO INTENTIONALLY!” Maybe I’m abnormal, but the day I realized the sheer selfishness and intentionality behind my anorexic behavior to intentionally NOT eat while I fed everyone else, then I couldn’t be a victim in my own mind. I couldn’t play sad violins for myself because I wasn’t the oppressed. I was actually harming my body and my moody, delirious behavior was hurting those around me. I think having someone to talk to (just like you Tabitha) is really the only answer. Someone to say that it’s simple but not easy and the answer to almost every question is feed yourself. I’m not sure it’s just a systemic change that needs to happen. It’s each person realizing that every time they sit down to a plate of food and don’t eat, or purge, or binge, and exercise it off, that we are choosing eating disorder behavior over life. You are absolutely correct tho. Recovered individuals make the best helpers because you (I am recovered but I’m no coach lol) can easily crawl inside the minds of the sick and interrupt the script. But, on the other hand, if people want to be ill, then no person or system (broken or not) will change that. My family was very patient (kind of). They basically gave up on me at some point. But I look back now and the worse poison in the water was the individual that pitied me. I felt sorry enough for myself and pity validated my behavior. But still, I WAS CHOOSING ILLNESS. I could feel “triggered” or “sad”, but using ED to cope was ALL ON ME. But I guess it’s all personal. For me it was the horrific physical consequences, loss of all will to live, and really just getting to a place where it was EAT OR DIE and to heck with it!!! My journey involved a faith in Christ, but I won’t bore any of you with that, but if you’re not dead, then God’s not done and a recovered life is well worth living. ❤️

[@amyevans5273]

Wow, I like the way you write and what you have to say! Congrats on all the hard work and success. Do you mind me asking how long you lived with your disorder? You just seem like a lovely, funny and warm person free from the chains that binded you! I’m still pretty tightly locked up but I am searching hard for some hope. Thanks!

[@MariekeNoortje8104]

Exactly. For me there had to be a rock bottom and I'm there right now. Fighting to keep my husband who has stood by me through thick and thin (literally) and many other addictions besides my ED. He's amazing, but he's giving up on me and I don't blame him. I'm recovering for him now and yes, for me too. I'm so very sick of it all, I want the old me back.

[@alicewatts]

Preach it!!! Ironically, my dietitian and psychologist that both specialized in eating disorder recovery set me BACK in my recovery. It was the unlicensed, non-professionals that I found online that saved my life. Your channel is always the one that I refer people to for the best eating disorder recovery information. I found you late in my recovery in 2016 but have continued watching your content because it's gold.

[@chengreenman8840]

I 100% agree with this! Thank god someone finally said it! I've been a revolving door patient for so many years and have never received any help from my inpatient stays. The state I live in has only one treatment facility that takes my insurance so I'm unfortunately always forced to go there. They have a one size fits all mentality that all you have to do is feed the patient, make sure they gain weight(if that is part of their treatment plan) and then send them out into the real world to fend for themselves. I don't know if I know any patient there that hasn't been there at least twice because their treatment approach does not work!! They are just a money hungry cooperation profiting on people who can't afford to pay out of pocket to go to a nicer facility. Not to mention the entire facility is one dark hallway with locked doors at the end and at times there could be over 25 patients adolescents and adults admitted at a time. They have strict meal plans and meal timings so go forbid if your hungry in-between meals and snacks you can't have anything to eat. Oh and also the kitchen is completely locked so you don't go into the kitchen until its time to eat. I won't even mention the quality of the food and how its pretty much inedible, but it seems pretty counterintuitive to feed eating disorder patients disgusting food and expect them to eat it all I'm just saying. I have so much trauma from treatment that I refuse to go back. I probably should be seeking some help right now, but the fact is going back to a place like that will do more harm than good so I'm forced to manage on my own. It's sad that this is how we are treating people with eating disorders that have the highest mortality rate than any other mental illness.

[@lilbsbluvr07]

I agree tabitha. I will be honest though, because I had a bad experience. My first therapist was ‘recovering’ from an eating disorder. I was a newbie and had never seen a therapist or talked to anyone else that had experience with an eating disorder. I didn’t know that she was still sick. We celebrated in session the fact she finally cancelled her gym membership after thirty years, she showed me her ‘sick’ pictures. I truly believe she prolonged my issues with anorexia. She would say in session that she was just farther along on the recovery path than I was, but she didn’t believe in full recovery. I had to unlearn a loth and heal from seeing her for two years. Had I been able to work with you tabitha, eight years ago at the beginning of my ed, instead of her, I can guarantee I’d be better. Although I had a sucky experience, I can also say reading your books and taking in all of your resources, no one has ever helped me like you have. You have put into words the behaviors and thoughts I have in my head, and you have proven that being recovered and moving on with life is possible. You are proof!

[@katespalding2134]

I was hospitalised in the 1980s. I was on total bed rest, the down pipe on the sink was removed, I had to use the commode in front of the nurses, no visitors at all, mail was read before me,force fed, being held down and food forced down my throat and then laughed at when I struggled. No books, TV and the best of all, when I lost weight the shutters were locked so no light. No problem! Not trauma, not bitter, PTSD.

[@MariekeNoortje8104]

Wow Kate, that sounds medieval! Poor you! Unbelievable, how could they think such an approach would work? Are you better now, eating disorder wise or still struggling?

[@katespalding2134]

• Brook Potato • still really struggling. I’m now 58 and those memories are crystal clear.

[@MariekeNoortje8104]

@@katespalding2134 So sorry to hear that 😢 I was in IP treatment 2 years ago and it actually made me worse. They want me to go there again but there's just no way. Tabitha has helped me more than any of the many ED facilities I've been to (I'm 48, eating disordered since 26). Hang in there girl, we'll get there! ❤

[@jags-gb4dm]

My first admission was 1977, I too was on total bed rest for around a year, comode, bath once a week & I thought that was bad. Im so sorry to hear of the other torture you had to endure ❤️

[@katespalding2134]

Jilly beans treatment was so antiquated, I certainly didn’t receive any therapy. Have you recovered? Beautiful day in Bristol England, I hope it’s as equally beautiful where ever you are. Happy Sunday xxxxx

[@harmonyhope1709]

"I'm not polyfiller' Tabitha Farrar 2020 🙌🙏🤣💞

[@greernorton8419]

Also can’t wait for part two. I too have been in treatment a number of times with no help. You actually and a few others on Instagram/KZbin have helped me more than any treatment centre. You all that have helped me had the Ed. Thankyou so much for everything you have done for me 😊

[@nellijune]

When I got ill 14 years ago. I was confused. I didn't know what this illness called anorexia really was. Those days I really believed that inpatient treatment was only way to recover. I thought that recovery was something very complicated science and it is impossible to recover on my own. Wrong, terribly wrong! All these years I have been dependent on "professionals". Just now I realized that recovery is in my own hands.

[@eloisechapman4930]

I completely agree! I’m currently being treated by NHS eating disorder services in the U.K. and it’s unbelievably dysfunctional. I was treated by a different therapist to the one who first assessed me, and after six sessions where I felt like I was getting nowhere it turned out she hadn’t even read any of my notes before attempting to treat me. I was also receiving a different type of therapy to what was first recommended for me, because apparently you just get whatever type of therapist is available when you come to the top of the waiting list. She also decided that my anorexia was caused by clinical depression (I think this was because I said I was feeling low sometimes, but who doesn’t when they have anorexia?) and therefore decided that I needed to go on the highest dose of antidepressants possible. This lead to me losing control of my speech and often looking like I was drunk when I was walking, I was so unsteady on my feet. Luckily my mum called my GP for me (I wasn’t capable at this point) and he told me to reduce the dose immediately because I was being overdosed. It turns out that the ‘therapist’ was a social worker. As of now, I’m back on the waiting list. I’ve got more help from these videos and Tabitha’s books than anything else.

[@AZKflamenco]

I hear you Eloise and it’s good that you’re able to recognise that the NHS system is dysfunctional and not you! I used to work as a doctor in psychiatry in the NHS but left because I felt that I wasn’t able to give good quality care. The mental health services are completely broken and I have also had anorexia and been through the system as a patient after working for them.... twice. There are some good individuals obviously but you will learn most from people like Tabitha and experts by experience.... use both to gather as much knowledge as you can - because knowledge is power and I can tell you will use that in your recovery xxxx😘

[@govegan4348]

Last time in treatment me and my bed neighbour wrote fat on our board: We eat when ever, what ever and as much as we want. Fuck the system. Night nurse was convinced that you should not eat over your meal plan. And eating after 8 pm is bad in general cause you cant sleep with full tummys. Been in treatment many times and it did not help me at all. So lucky I found you. With basic science you teached me I could actually make a change in minds of doctors in treatment I was. They did not believe me at all at first but I convinced them by doing😊 fully nutritutionally rehabilitated I am now and still keeping on with Neural Rewiring

[@mrsvbentley3960]

Hi Tabitha I sent you an email last week in regards to that very topic that you're speaking of today about having somebody coach you if they have not suffered from an eating disorder. I thank you so much for everything that you give each person that listens to your podcast, KZbin video. Thank you, thank you love, you Tabitha

[@anjlewis5930]

Excellent explanation that sums up why so many people follow and hire recovery coaches like Tabitha!👍👌🙏

[@Snickerdoods.x]

I'm grateful to have a counselor who has gone through recovery herself. She just gets it. I don't have to try and explain things to her like I do to someone like my mom who has never had an eating disorder and can't even comprehend it.

[@katgray63]

I just had to pull my daughter from one of these programs after watching her have a nervous breakdown trying to live up to their unreasonable expectations and dismissing anything she said as just her eating disorder talking and trying to manipulate even though I could see she had valid concerns like the amount of food they kept cramming into her even though it was making her ill.It would make anyone ill.They also told us an alarming story of a client who made her daughter eat her vomit if she threw up and they said that's the lengths we have to go for in recovery sometimes.That was a disturbing moment where I said we are getting you the hell out of here and trying to do recovery your way

[@indix769]

I agree! I have three therapists and of course they kinda helped me a bit but you were actually the one who helped me the most. Therapists without their own experience often say problematic things.

[@kiki-oh7hi]

In the US, it is not only not required to have any personal experience with addiction, for instance, to work in the field; this distinction is important because some individuals in recovery will not be appropriate due to conflation with the patient. It violates HIPAA to ask someone at a job interview whether they are in recovery.It’s important to make the distinction between a sponsor and a therapist. I appreciate your points.

[@Evanescence4ever100]

i believe that too. there's no way to be able to help someone recover from anything if you don't have any personal experience. you can't know what it feels like by reading books or doing courses.

[@NiNa-op1uf]

"dysfunctional" "to attached" "don’t even know how to start to untangle the mess" - love it! feels like starting eating disorder recovery ;) but even if it seemed to be impossible - you showed us that real recovery is possible > and thanks to you (and other real recovered people who share their story and offer support) there will be a whole new generation of recovered people and these can then (when fully recovered) become doctors and therapists themselves and make a change and advance the research!

[@fitnessfischchen3263]

I love your advice tabitha..! Thank you!!! 👌👌❤

[@edi165]

totally agree! I am not saying that a coach is a replacement for medical doctor however when it comes to the ins & outs of recovery- a coach with lived experience is the only one who can truely help someone (this has been my experience after 6 years of treatment failing me anyway-) No degree or qualification is enough to fully understand what its like. On the flip side I have seen the most progress when listening to and confiding in others with lived experience

[@everybodyembody2316]

It's so frustrating to be failed over and over again by the very people who are supposed to be helping you. The people who are "qualified" and "professionals". I'm finally in full active recovery and making huge forward steps after 15 years with an ED because I found the recovery community on Instagram an " unqualified" coach online with loved experience

[@everybodyembody2316]

Lived experience!

[@mikadoavocado5164]

Love it❤️ Thank you so much for this Tabitha (and all of your content by the way, really helped me to make peace with food and actually recover.) I am currently doing a psychology degree and often doubted if I could become a therapist and work with people with EDs because I struggled with Anorexia myself. But I will no longer let old white men stop me

[@MinneHgl]

Be the change you want to see in the world - Cheesy, but you're already doing that :)

[@audreymatson3577]

I like your points about needing someone who has recovered to help people with eating disorders. My sister is Deaf and we all agree Deaf people should see Deaf mentors when they find out they're Deaf, not a hearing person who will get them cochlear implants.

[@giuliavalerio1704]

Hi Guys, Can somebody help me? I have started intuitive eating a week ago, i realised i dont have actually much hungry, but i want to eat unhealthy foods all the time, like for breakfast i had a bar of chocolate every day, its that normal? It's going to be like that forever? I Know eating like that its not good for my health, but i m listening to my body... Obs; if i wrote something wrong, sorry i ' m from Brazil

[@Ingridlosneslokken]

I could not agree more Tabs!!

[@madelonpaauwe2868]

Can't wait for part two :D

[@cazlovescakes]

Of course I don’t condone violence, but if anybody tries to tell you that you don’t exist, see if they still believe that after you’ve given them a clout round the head with your cast 😂 In all seriousness, though, I was recently in treatment and being told that full recovery wasn’t likely to be possible. Despite the fact that I was fully recovered for 4 years. I relapsed, but that’s because I had no knowledge whatsoever of the migration theory, so when I went on a diet, I didn’t realise it was more than likely to trigger this. This was 8 years ago. Knowing what I now do, if I do manage to recover again (and it’s entirely within my power to do so), I will NEVER go on a duet again.

[@sjm9876]

Hey I just wanted to say- I have suffered from substance use disorder as well- and I have had many counselors and therapists who were not recovered addicts. I found them to be much less effective than the ones with personal experience.

[@sjm9876]

But I just wanted to add that plenty of people have jobs in addiction recovery who aren’t addicts

[@eleonoreconstant]

Completely agree but feel like adding that changing the system is difficult even when no money is involved. French doctors really dont make much money for a living yet they are reluctant to change. Well my bad, you're right money is involved even when they dont make much because they'd still loose the little money they make from anorexics haha!! I hope your injury will get better soon!!!

[@astrid_sfrt4324]

Maybe the system will correct itself eventually by patients not going to traditional treatment anymore because experts by experience offer much more likely full recovery.

[@paitonfyfe1849]

YOU SAID IT

[@Atalithan]

PLEASE PLEASE answer this: I have really have a hard time breathing (for about 2 years), kind a like air hunger (dyspnea), i cant get enought air in and i yamn A LOT because of this. This makes me dont wanna eat cause when it happens when its hard to get enough air in it gets worse when u have to eat. This is not due to anxiety cause i get hard breathing even when im completley relaxed, ex while, wlking in woods, in the bath, in bed and so on. Have you experienced this? whats the cause? and how to fix it? cant afford to seek care and also never been taking seriosly. How to cope with gaining? I gain, and FREAK! I start hate myself, i have made a few suicideattempts when i weigh more. I hurt myself a lot when gain cause of anxiety like scratch, cut, and punsch myself. one time i hit myself so hard i the head the doctors thoght i got a bleed in the head. PLEASE HELP! I always wanna eat as late as i can, late breakfast, late lunch and really late dinner. Often i can eat dinner at around 21.00 and i get really really anxious to eat earlier. It feels like it gives me more freetime wich am scared of. I dont like do anything and thats why im scared to not been busy cause it makes me more anxious and sad. :'( I dont feel good eating so late and a large meal before bed but if i eat early it feels like i have a lot of time in the day (eventhoug i know its the same time i get free before the meal but its my f*cking brain thinks it pass more time if i eat late. One of my problem is that i dont like to do anything - nothing is fun. I dont have any friends and family. How did you make time pass when recover? Im so bored cause nothing is fun and that makes me so sad, and creates suicidal thoughts and make recovery much harder. HEEEELP - PLEASE answer. :'(

[@daisyeaton2452]

Maybe try a blood test for celiac disease? I felt like that before my diagnosis! Also could be something to do with low iron due to not eating enough x

[@daisyeaton2452]

I mean the breathing thing like I felt out of breath all the time and it made me not want to eat

[@Atalithan]

@@daisyeaton2452 I dont have celiac disease, I dont feel like out of breath. More that i cant get air in. I also yawn A LOT, especially when cant breathe, and make me not wanna eat either.

[@dalhousieDream]

Please see a pulmonary dr ASAP. It is possibly anxiety but check it with dr first for thorough tests.

[@angelaspielbusch1237]

Thank you 😊

[@lauradowdall5183]

shout it from the rafters Sista!!!!

[@em0t33th7]

Follow on from my last comment- how can I recover when I’m trans and can’t transition for years

[@anjlewis5930]

Have you ever listened to her podcasts? I believe she has one on this subject

[@em0t33th7]

anj lewis yeah and it didn’t give me any answers

[@daisydart9784]

Couldn’t have said it any better.

[@luciep8563]

absolutely spot on!

[@medeatigger9199]

Rock on, Tabitha.

[@MP-uz9xi]

you're the fucking best.

[@plainsong76]

Your videos are way too low in volume

[@cecilia7460]

this woman just said “i disagree with scientific-based studies and experiments because MY OWN experience was different” blamed it on old white male when she’s an old white woman, compared fixing RACISM to fixing eating disorder treatment... and yall agreeing w her?

[@eneapoggetti5341]

I don't think she said she disagrees with scientific-based studies and experiments. Sounds to me like she more accurately said that many commonly held beliefs about eating disorders actually have little to no scientific base at all. Which to be honest is true: most current treatment approaches are built out of thin air or on very old, very speculative early psychological studies that were generally based on a very small and non-representative subset of subjects. Furthermore, when you look at the wider picture ED treatment procotols are an absolute failure, as EDs are among the mental illnesses with the highest relapse rates (and also the most deadly). It's only fair to say that the whole system is in desperate need of radical improvements if we actually give a crap about people's health.

[@melinaburkhardt421]

You are way too rude! You call Tabitha old, that is ridiculous. If I were you, I would not expect an answer after that intro. Who are you defending., are you recovered with the help of old white men or what?

[@cecilia7460]

@@melinaburkhardt421 no, I'm recovered with the help of a general, non-specialized therapist, a public hospital dietitian and myself in a country where there is only one inpatient treatment center. americans love to complain on full stomachs.

[@melinaburkhardt421]

@@cecilia7460 Thank you for your response. You have survived, that is what matters. There seem to be more than one way to approach EDs. A good GP is wonderful and you probably had luck with the hospital dietitian. Good guidance and empathy. And experience. I believe that people can help you, even if they didn't have an ED. But they do not need to be of a certain professional class, do you agree with that?