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Show i Vj : jQHNi Prestnted as a Community Service Ser-vice from Intei-mountaln Health Care. John Waterbury is Director Direc-tor of Community Services with Intermountain Health Care. Letters Let-ters and responses to the Dear John Column may be sent to him at: IHCH, 21st Hoor, 36 S. State, Salt Lake City, Utah, 84111. By John Waterbury Dear John: I have recently been involved in i chemical dependency treatment center where, naturally, the focus was on alcohol and drug abuse. I went through the program, attended all the meetings, meet-ings, and hopefully, have learned how to continue this period of sobriety. The problem is that I also have another problem. It is bulimia. I've had that problem even longer than chemical dependency, de-pendency, but no one even mentioned it when I was in treatment. treat-ment. The staff is a good professional group, but all we talked C about was alcohol and drugs. It seems someone, should have brought up the subject of eating disorders. I only feel treated half way. Dear 50-50: : 5(W0 You're right. Someone should have picked up on it. However, Howev-er, many chemical dependency treatment centers mistakenly focus only on chemical dependency, and when there are so many similarities between that and eating disorders, it becomes clear that both could be adequately addressed. The negative thoughts and feelings, and the loss of control are central to both problems. But since you missed out on this half of treatment, let me share some information that may be useful. First, let me point out some of the self-defeating types of thinking that often develop with eating disorders. These develop de-velop into patterns which generate additional self-defeating behaviors. be-haviors. Some of them include: It is essential to be loved by everyone. Since this goal is unattainable, efforts to live up to it will generate loss of confidence confi-dence and lowered self esteem. Self worth and low body weight are inextricably linked; to be fat is to be unacceptable. Keep in mind that these are two different subjects completely. It is possible to be happy and fat or sad and skinny. What we think about that and how we feel about that seems to be the controlling factor. , t- is "sLe"tial t0 develop complete self control and self discipline. While both self control and self discipline may enhance en-hance the quality of life, the qualifying word "complete" makes either attribute unattainable. These and other patterns of self-defeating thought processes tend to generate mood disorders which are further affected by the neuroendocrine disturbances that result from anorexia and bulimia. This sequence of cause and effect is not completely understood. But, the synergistic relationships between moods and appetite seem to be the result of both neurochemical disturbances dis-turbances and social pressures. The results of these disorders can be fatal. At the very least, anorexia causes a dulling of the emotions, depression, anxiety, mood swings, impaired self concept and lowered self worth On the other hand, bulimia causes cardiac problems, gastric irritation irrita-tion esophageal tears, enzyme imbalance and dental problems. With cither anorexia or bulimia, there arc a variety of treatment treat-ment approaches that have been successful and there arc others ; that arc extremely questionable. The key seems to be gaining the knowledge of the various options. Talk to people who have ' had similar problems Talk to professionals. Make an informed decision and follow through. Life is too short not to |