Anorexia nervosa is a serious disorder with devastating psychological and physical consequences. Almost 75 out of every 100,000 people are diagnosed with anorexia nervosa. More specifically, 0.6 percent of adolescent girls are diagnosed with this illness. We have a tremendous challenge before us to determine why it is that young people develop this illness. While we wrestle with this vexing dilemma, however, a more urgent challenge is what can be done to reverse anorexia and its array of devastating consequences.
Despite the crisis associated with self-starvation, few treatments have been tested, and anorexia nervosa remains a confusing trial for sufferers, their parents, doctors, and researchers. One intervention that has received considerable clinical attention is family-based treatment (FBT). In FBT, parents aren’t blamed for their child’s illness; instead, they’re viewed as a crucial resource in bringing about their child’s recovery. They are encouraged to be in charge of their son/daughter’s weight restoration while the therapist acknowledges the enormous difficulties of this task and supports the whole family. Once healthy weight has been restored, some of the developmental issues of adolescence are addressed in FBT.
Brave Girl Eating chronicles the Brown family’s ordeal battling Kitty’s anorexia nervosa—a remarkable journey that brings to life the almost unbearable struggle that both Kitty and her family endured. Anorexia nervosa brings about profound psychological as well as physiological changes in the sufferer. These changes are often so severe that it is common for parents not to recognize their offspring—to feel “This can’t be my child.” It is easy to see how perfectly competent, loving parents become bewildered and disorganized as they fail to understand this baffling illness. This confusion often makes them second-guess their natural instinct to reach out and help their child. As a consequence, they become immobilized in the face of the seemingly overwhelming power that anorexia has over their child and over them. The Browns’ story is an uplifting drama as the parents’ determination and perseverance, as well as Kitty’s brave efforts, succeed in wresting Kitty away from the eating disorder.
Understanding and treating anorexia nervosa are daunting tasks. But one thing is certain: food is medicine, and recovery cannot come about unless healthy weight is restored. Put more bluntly, one has to eat in order to get better. Many obstacles block the road to recovery, and in Brave Girl Eating the author describes some of these firsthand—for instance, the frustration experienced by both parents and teen when they get stuck in what we call “anorexic debates,” where even the most rational adult can be convinced by (or give in to) the teen’s insistence on the caloric “value” of a salad without a dressing. These debates demonstrate how malnutrition affects the mind and highlight the irrational power of the illness. As Brown points out, “The question isn’t why but what: What do we do now?”
Brown also shares many of the important lessons she and her family learned throughout their ordeal. Most affirming of parents, and valuable from my perspective, is that families (parents) are not helpless—they just have to (re)gain their confidence. This, of course, is no easy task; in fact, it is perhaps one of the most difficult goals to achieve in battling anorexia nervosa. But with the support of the therapist, parents have to “stand up” and face this illness, with love and caring. Kitty’s story demonstrates anorexia’s awful power over the teen sufferer and over the desperate parents trying to rescue their child.
Brave Girl Eating highlights some commonly held misinformation about anorexia nervosa. By showing us Kitty’s struggle, the author dispels the myth that anorexia nervosa is a choice. She equates it with other serious illnesses and disorders, and we are reminded that “anorexia chooses you!” Kitty’s struggle educates all of us about the turmoil and guilt felt by both patient and parents. Confusion and denial are commonplace as the eating disorder challenges every family member, not just the teen. This book also speaks to the frustration and anguish felt by all parents who try to understand and do something when they suspect their child has an eating disorder. These feelings are exacerbated when parents have to scramble to find a specialist eating-disorders team as they navigate the health-insurance quagmire.
It is all too clear that everyone involved in this battle with anorexia nervosa requires support and guidance. While Kitty’s family found ongoing support in their pediatrician and other professionals, they did not have access to a local FBT therapist and, instead, conducted the arduous task of weight restoration mostly by themselves. This absence of