As parents, what do we wish we had known or had done for Andrea?

• We wish we had known that eating disorders are DEADLY and that more people die of bulimia than anorexia, often due to the electrolyte imbalances caused from purging.¹
  Death does not need to be the outcome of an eating disorder, though. We must hold uppermost in our minds the reality that complete healing IS possible. We must make certain our child's treatment team believes in full recovery, too.
• We wish we had known that complete healing is optimized with competent, intensive, aggressive, and early treatment.
• We wish we had known that treatment must initially focus on greatly reducing and as quickly as possible halting the ED behaviors. Positive effects of therapy are greatly reduced by the neurological changes caused from a continuation of starving, bingeing and/or purging. Healing is optimized by halting behaviors for 9 months or more. Disordered thoughts and feelings may hang on even after behaviors are stopped but to prioritize reduction of thoughts and feelings first, without addressing behaviors, is a recipe for disaster.
• We wish we had modeled, throughout Andrea's life, unconditional self-acceptance in our words, attitudes and actions.
• We wish we had understood that the black and white thinking {good/bad; fat/thin, safe/dangerous, etc.} Andrea exhibited was a part of the disease (and a characteristic way of speaking that we shared with our daughter).
• We wish we had been able to recognize and put aside our own misconceptions about eating disorders.
• We wish we had understood that Andrea was not fully aware of, or able to articulate, her emotional pain. Indeed, eating disorders alter brain chemistry and cause distortions in thinking that do not allow for rational thought--we must be our child's advocate.
• We wish we had known that as soon as clinical symptoms (starving, bingeing, purging) became apparent, Andrea had entered the realm of an emotional and psychological addiction.
• We wish we had known that having our daughter’s vital signs checked (especially pulse and heart rate) was as important, if not more important, than having blood work done (trouble often shows up in blood last…Andrea’s blood work always came back "normal").
• We wish we had known that a person can appear to look and feel fine and be close to death.
• We wish we had recognized that Andrea being cold all the time was a sign of hypothermia.
• We wish we had been told that the long, feathery eyelashes we noticed in the last weeks of her life were a warning sign. Lanugo, the baby-fine hair that often covers the bodies of those who are starving, can manifest itself in the eyelashes. Andrea did not look starved.
• We wish we had not accepted our culture's "normalization" of diets. We thought Andrea's preoccupation with weight and body size were normal 'rights of passage' that would recede with time, as ours had. Although as a culture we have normalized the act of dieting, there is nothing normal or natural about this behavior.
• We wish we had known that in the eating disordered world "dieting" is considered the "gateway drug" to an eating disorder as nearly every eating disorder begins with some form of weight loss "diet"
• We wish we had shared with Andrea that it is natural during adolescence (approximately ages 10-21) to gain from 20 to 50+ pounds as the female body readies itself for childbearing--the female body must increase body fat by 120% in order for menstruation to begin.2

and ...

• I, as her mother, wish with all my heart that I had been more of a parent (i.e. a "grown-up") and less of a friend in the final months of Andrea's life. As her friend, I lost my objectivity and relinquished some of my parental responsibilities. My empathy for her led, at times, to a subtle and inadvertent support of her illness. That is a reality I cannot change...along with all the other realities listed above. What I can do is to not blame myself for the things that were out of my control (especially the development of the ED) and to forgive myself for the behaviors and responses that were within my control, which I have. We all did the very best we could with what we knew at the time. Andrea, we, and her treatment providers shared, along with you, the same imperfect human condition.

and once again ...

• We wish for you to know and to trust that your child can heal. Our family's experience was a tragic conflagration of the "perfect" firestorm AND treatment and understanding of eating disorders has come a long way since 1999.

To contact Andrea's Voice Foundation, please click here.