Could this be you, your friend or someone in your family? Food is your coping mechanism in trying to battle internal doubts and/or Dieting can be an attempt to feel a sense of control and improve self esteem and/or Bingeing is how to bring comfort or respond to the extremes of dieting. National Eating Disorders Association If you recognize yourself, or someone you care about, in this profile, then you’ve come to the right place! Our McGill Eating Disorder Program provides treatment to McGill students suffering from eating disorders. It is a multidisciplinary team including nurse, dietitian, counselors, psychotherapists, psychologists and psychiatrists trained in addressing eating disorders. In addition to individual therapy, we offer psycho educational groups, meal support groups, support for family and friends and other groups. We are here to help! 1 What are eating disorders (ED)? 3 major types of ED affect most people: Anorexia nervosa is a severe emotional disorder that impacts your mind and damages your body through starvation. It is having a « fat phobia », even though you’re underweight. Bulimia nervosa is concealing a secret life of bingeing (eating lots of food in one sitting often rapidly) and purging (get rid of the food by vomiting or overusing laxatives or diuretics, exercising excessively, or other methods) that constantly demoralizes you and drains you of energy and self esteem. EDNOS (Eating Disorder Not Otherwise Specified) includes all eating disorders that do not meet the criteria of Anorexia or Bulimia. Examples could include struggling with body image, weight and shape, bingeing, restricting, excessive dieting and exercising. Binge eating, which involves periods of bingeing while experiencing emotional suffering, is included in the EDNOS category. Binge eating does not involve purging. 2 Take our fast quizzes to self-assess you eating behaviors 1- Do you have an ED? Do you make yourself Sick because you feel uncomfortably full? Do you worry you have lost Control over how much you eat? Have you recently lost more than One stone (meaning 6kg or 20lbs) in a 3 month period? Do you believe yourself to be Fat when others say you are too thin? Would you say that Food dominates your life? *One point for every "yes"; a score of 2 indicates a likely case of an ED The SCOFF Eating Disorder Questionnaire, devised by researchers at St George's Hospital Medical School, is a valid and reliable screening tool for detecting the existence of an eating disorder. 2- Are you at risk of developing an ED? Genetics: you have siblings or parents with an eating disorder. Family influences: you feel less secure in your family. Your parents and siblings may be overly critical or tease you about your appearance. Psychological and emotional disorders: you suffer from depression, anxiety disorders or obsessivecompulsive disorder or low self-esteem, perfectionism, impulsive behavior, anger management difficulties, family conflicts or troubled relationships. Dieting: losing weight is often reinforced by positive comments from others and by you changing appearance. But dieting may be taken too far. Transitions: heading off to college, moving, landing a new job or a relationship breakup, change can bring emotional distress. Sports, work and artistic activities: you are an athlete, gymnast, a runner, a wrestler, a ballerina, an actor, a dancer or a model and coaches, parents or pressure of competition are encouraging you to lose weight. Media and society: You are highly exposed and influenced by the media, such as television and fashion magazines, which frequently focus on appearance, body shape and size and make you believe that thinness equates to success and popularity. Peer pressure may also fuel this desire to be thin. *One risk factor is sufficient to put you at risk for an ED and the more risk factors you have, the more you will be at risk of developing an eating disorder. 3 Signs and symptoms of ED Anorexia nervosa Thin appearance Abnormal blood counts Fatigue Dizziness or fainting Brittle nails Hair that thins, breaks or falls out Soft, downy hair covering the body (lanugo) Menstrual irregularities or loss of menstruation Constipation Dry skin Frequently being cold Irregular heart rhythms Low blood pressure Dehydration Bone loss Emotional and behavioral symptoms of anorexia may include: Refusal to eat Denial of hunger Excessive exercise Flat mood, lack of emotion, depression, irritability Difficulty concentrating Preoccupation with food MedlinePlus Medical Encyclopedia Red flags that family and friends may notice include Skipping meals Making excuses for not eating Eating only a few certain "safe" foods, usually those low in fat and calories Rigid meals or rituals, such as cutting food into tiny pieces or spitting food out after chewing Weighing food Cooking elaborate meals for others but refusing to eat them oneself Repeated weighing of oneself Frequent checking in the mirror for perceived flaws Wearing baggy or layered clothing Complaining about being fat 4 Bulimia nervosa Abnormal bowel functioning Damaged teeth and gums Swollen salivary glands (contributing to “Big Cheeks” effect) Sores in the throat and mouth Bloating Dehydration Fatigue Dry skin Irregular heartbeat Sores, scars or calluses on the knuckles or hands Menstrual irregularities or loss of menstruation (amenorrhea) Emotional and behavioral symptoms of bulimia may include: Constant dieting Feeling that you can't control your eating behavior Eating until the point of discomfort or pain Self-induced vomiting Laxative use Excessive exercise Unhealthy focus on body shape and weight Having a distorted, excessively negative body image Going to the bathroom after eating or during meals Hoarding food Depression or anxiety National Institute of Mental Health (NIMH) Binge-eating disorder Eating to the point of discomfort or pain Eating much more food during a binge episode than during a normal meal or snack Eating faster during binge episodes Feeling that your eating behavior is out of control Frequent dieting without weight loss Frequently eating alone Hoarding food Hiding empty food containers Feeling depressed, disgusted or upset over the amount eaten Depression or anxiety 5 Seeking Help Treatment for eating disorders is very important. Research indicates that eating disorders are less likely to be treated than other psychological problems. However, they do not go away on their own and leaving them untreated can have damaging effects ranging from hair loss, to fatigue, to osteoporosis, to heart failure and in some cases death. Death can result from heart failure, starvation, kidney failure and suicide. Those suffering from eating disorders often suffer from other disorders such as depression, anxiety, substance abuse, etc, in addition to their eating disorder. It is common for students suffering from eating disorders to also suffer from isolation (from family and friends), loneliness, loss of motivation, lack of concentration in school, etc. Having an eating disorder often involves being secretive due to feelings of shame, which leads to further isolation. If you feel you suffer from an eating disorder, we strongly encourage you to seek help. Treatment can help you recover; get back into school, begin to socialize with friends and peers again, rebuild relationships, gain some hobbies and ultimately regain control over your life. Treatment is best when you have a team approach. This type of program is now available at McGill. It is easily accessible by contacting the Eating Disorder Program at 514- 398 1050. The first step of asking for help is the hardest, but we are here to help! The sooner the treatment begins, the better and the easier it will be for you to fight those eating patterns that are affecting your life. Although recovery takes time, most people do recover. For more information please contact us at: Mental Health Services Brown Student Services Building 3600 McTavish Street, Suite 5500 Montreal, QC H3A 1Y2 Phone: 514-398 1050 E-mail: edpclerck.mentalhealth@mcgill.ca Website: www.mcgill.ca/mentalhealth/edp/ 6 What to Do and what Not to Do if you have an eating disorder, Do’s Do be hopeful and choose recovery, ask for help Do practice being imperfect; it’s okay to make mistakes! Do nurture your social network as part of your healing Do speak up! Do be truthful with your treatment team Do experiment with ways to enjoy being in your body Do appreciate that improvement often proceeds in baby steps Do keep track of your accomplishments Do talk with others about social pressures to be thin Do remember that people can and do recover from their eating disorder Don’ts Don’t diet Don’t try to fix your ED by yourself Don’t look for a quick fix Don’t do anything that feels extreme Don’t believe your weight determines your worth; throw the scale away Don’t avoid your negative feelings Don’t ignore signs of relapse Don’t nurture you fascination with « thin » Don’t put things off until you’re « thin enough », start enjoying your life now Don’t stop treatment too soon 7 Dieting Questionnaire on dieting Do you believe dieting makes you eat less? Do you believe weight loss makes you healthier? Do you believe dieting makes you lose weight? Do you believe dieting makes you happier? Do you believe thinness is the key to success? Do you believe dieting is never related to an eating disorder? If you have said yes to any of the above, you are mistaken. Please read on to understand the risks and dangers involved in dieting. Dieting is not always safe! Risks Repetitive cycles of gaining, losing & regaining weight (yo-yo dieting) affects your health in many negative ways, for example increased risk of heart disease and slowing down of your metabolism. Dieters often have deficiencies in nutrients, for example a lack of iron or calcium, which can lead to osteoporosis. Dieting can lead to a loss of muscle strength and endurance, decreased oxygen utilization, thinning hair, loss of coordination, dehydration and electrolyte imbalances, fainting, weakness, and slowed heart rate. Dieting affects your brain. Lacking energy can cause decreased brainpower (decreased concentration & memory, increased depression, low self esteem and stress). Most of all, dieting can dangerously lead to an eating disorder. Remember! Diets don’t work (95% of people who diet regain their weight within one year) Diets don’t necessarily improve your health Diets don’t make you beautiful Diets can rob you of energy and money Diets can make you afraid of food It is not your body that needs changes. It is your attitude! Increased self confidence is the key to gaining a healthy attitude! 8 Healthy Eating As a recovery from your eating disorder, it’s important to develop a way of eating that includes rather than excludes foods – an eating pattern that’s about health and enjoyment, not pounds and calories. A healthy and varied way of eating means you get the nutritional value from food that your body needs in order to function and thrive. It actually takes a wide variety of foods to supply all your nutritional needs: grains (including whole grains), proteins, vegetables, and fruits. Use Canada’s Food Guide to know how much food you need and what types of food are better for you: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/indexeng.php. Use the following ideas to start developing healthier eating habits and better relationship with food: Stop weighing yourself compulsively: weighing yourself too much sabotages your attempts of improving food intake because it reinforces restrictive eating and also gives a green light to your compulsive episodes. It is normal to go through weight fluctuations during nutritional readjustment because of probable dehydration, which can lead to water retention. It’s crucial to remember that water retention will go down as long as you are nourishing your body. Determine a schedule of food intakes: at the beginning of the normalization of food behaviors, the feelings of hunger and satiety are not reliable. This is why it is necessary to have precise hours for each food intake. Your food schedule must be your priority, and nothing must come between you and the times you prescribed yourself to eat. Even if you are not hungry, it is important to eat at the hours you set. Increase the frequency of your food intakes to 5 or 6 times per day: it is recommended to eat 3 meals a day with 3 snacks. The reason to have 6 food intakes a day is as follows: normally, hunger returns every 3-4 hours, the time needed to digest our last meal. If one gets used to eating every 3-4 hours, he or she is following the natural cycle of hunger, which will help normalize food intake. It is normal, after food restriction, that eating more often is difficult due to the sensation of fullness. This is why eating small quantities more often will help increase energy intake without causing any feelings of discomfort. At first, increase energy intake by choosing « safe » foods, and then gradually introduce « forbidden » foods: when you restrict certain foods, you are giving them power over you. This is why it is necessary to gradually introduce all foods during food normalization. It is also important to introduce them in a safe environment in order to dissipate the power given to them. Eat standardized portions: it is difficult to know what a standard portion is after having been a restrictive eater. Until you can gage an appropriate serving size for yourself by listening to your body, use Canada’s Food Guide to help you know the portions and the recommended servings. A Food Guide Serving may be close to what you eat, such as an apple. In other cases, such as rice or pasta, you may serve yourself more than one Food 9 Guide Serving. Most restaurants aim to please by offering great value through large portions. Just because you are given a large portion doesn’t mean you have to eat it all! Take some home for later. Listen to your body: eat when you’re hungry, stop when you’re full. Balance: balance means that most of the time you eat because you’re hungry and use food as fuel for your body. But it also means that sometimes you eat simply when the food appeals to you or when it is appropriate in a social setting, allowing yourself to eat for enjoyment. Such balance provides both physical satisfaction and decreases the likelihood of overeating certain foods due to a feeling of deprivation or denial. Eliminate all diet products: consuming these types of products confirms that you are giving them power. These diet products do not have a place when one wants to develop healthy attitudes toward food. Try to distract yourself after having eaten: normalizing eating behaviors can cause anxiety for someone suffering from an eating disorder. It is important to eat in a calm and favorable environment, preferably sitting at the table. After the meal, it is recommended to leave the room and to engage yourself in a relaxing activity according to your personal interests: art, gardening, music, etc. 10 Vegetarianism The vegetarian diet is defined by the exclusion of animal flesh as food. When this involves a strict exclusion of eggs and/or dairy products as well, this diet is referred to as veganism. When such products are included, it can be referred to as lacto-ovo-vegetarianism, or lactovegetarianism. There are many good reasons not to eat meat, ranging from concern for animals and the environment, to simply not liking the taste. Health reasons also attract many people to the vegetarian diet, which is high in fruits and vegetables, and low in saturated fat and cholesterol. But some people go “veggie” for a not-so-healthy reason: to mask food restriction and potentially harmful weight-control behaviors. A hallmark of eating disorders is separating foods into "good" and "bad" categories. Vegetarianism gives a person with an eating disorder, a handy reason to avoid eating an entire class of foods. Because meat and dairy products are often higher in calories and fats than fruits and vegetables, being a vegetarian fits right in with the goal of losing weight at any cost. It’s possible to be a healthy, happy person, at any size, vegetarian or not. And creating false categories for health based on body size is one way in which the health and weight loss industry overlap, and reap sizable profits. A person’s weight will tend to fall into a certain range that their body is happiest and healthiest at, called our “set point” or “natural” weight, and will tend to want to return to this weight range despite strict calorie restriction or excessive exercise. Many other factors affect a person’s weight, not only the type of food one eats, but the quantity of food one eats, the amount of activity one gets, and an individual’s genetics. A healthy vegetarian is someone who takes the time to ensure that he/she is getting all the nutrients his/her body needs. This person would be eating vegetarian sources of protein at all meals and making sure he/she finds alternate sources of protein, which is required to maintain a healthy metabolism, repair and build new tissue, and boost immunity. A healthy vegetarian also includes regular food sources providing calcium, iron, zinc, and Vitamin D & B12 as well as omega-3 fatty acids. This person is someone who is at peace with his/her decision to avoid animal products and who is committed to enjoying foods that nurture his/ her body and spirits. A healthy person is someone who has energy, listens to his or her body, and feeds it accordingly. For further information, please visit www.nedic.ca, Vegetarianism and Disordered Eating 11 Set Point Set point is a concept that refers to understanding and respecting a body’s natural weight range - a range which is “set” by different factors, such as: heredity, health, age and gender. Everyone has a set point and just as you have no control over how tall you will be, or what color your eyes and hair will be, you also have no control over what your set point will be. Your body is biologically and genetically determined to weigh within a certain weight range. The set point varies for each individual person. For instance, a woman at a height of 5'5" with a small frame may have a set point range between 120-130 lbs, but another woman with the same frame may have a set point range between 130-140 lbs. Their set points may be different, but that is the weight range their bodies will fight to maintain. A lot of us who have tried dieting know just how hard it is to lose weight and keep it off. In the first few weeks of dieting, weight is usually lost, but almost always gained back. Many people become frustrated because after a few weeks of dieting, they usually stop losing weight or start gaining it back, even though they are still restricting their food intake. This is a sign that the body is trying to fight to retain its natural weight. When you go below your body's natural set point, your metabolism will react by starting to slow down to try and conserve energy. Your body will start to sense it's in a state of semistarvation and will try to use the few calories it receives more effectively. You may start to sleep more and your body temperature will drop, which is why so many anorexics complain about being so cold. After too much weight loss many women experience the loss of their menstrual cycle. Their reproductive system shuts down because their bodies probably could not handle a pregnancy. Many people who diet also experience uncontrollable urges to binge because their body is telling them it needs more food than they are providing it to function properly. Just as your metabolism will slow down when you go under your body's set point, it will also increase if you go above it. The body will try to fight against the weight gain by increasing the metabolism and raising the body's temperature to try and burn off the unwanted calories. There is no test available to tell you what your body's natural set point is. The best way to determine what it is, is by eating normally and exercising moderately. If you have been dieting for years, it can take up to a year of normal eating for your body's metabolism to function properly and return you to the weight range that is healthy for you. Learning to accept the fact that your body needs to be at a certain weight is a good way to stop the vicious cycles of dieting. The more you try to go below your body's set point range, the harder your body will fight to retain it's natural weight. Engaging in a healthy eating and exercise routine, will allow your body to go to the weight it wants and needs to be at. Learning to love and accept who you are will help you to accept your body's natural set point. 12 It is unfortunate that we live in a society which is obsessed with thinness. Believing that thinness equals happiness and judging people by how they look contributes to unhealthy behaviors such as dieting, binging and purging. If we can accept each other for who we are, no matter what size we are, we are likely to be much happier, except, of course, for the diet industry. The diet industry, which unfortunately benefits from these unhealthy beliefs, would go out of business without a large following of people buying into these beliefs. 13 Healthy Exercise Take this quiz to know if you are exercising for the wrong reasons You are preoccupied with an exercise routine or intrusive thoughts about exercise that interfere with your ability to concentrate or focus You need to exercise, no matter what the cost (ie. cutting school, taking time off from work, etc) Exercise is your social life — you turn down social activities so as not to miss your scheduled workout You feel overly anxious, guilty or angry if unable to exercise and you can't tolerate changes or interruptions of your exercise routine You exercise alone to avoid having your routine disturbed Food choices are based solely on exercise (you exercise as punishment for eating "bad" foods, to purge calories or you overly restrict what you eat if you can't exercise) How you feel about yourself on a daily basis is based on how much exercise you perform or how hard you work out Exercise isn't fun or pleasurable or you're never satisfied with your physical achievements Amenorrhea (loss of three consecutive menses or failure to begin menstruating by age sixteen) and/or stress fractures You exercise even when you feel exhausted and/or are injured or sick; you ignore your body’s signals which tell you “you should take a break”. If you have said yes to any of the above, the way you exercise is not healthy. Please read on to understand the risks and dangers involved in exercising for the wrong reasons. 14 Exercising too much can cause all kinds of problems including: Injuries such as stress fractures, strains and sprains Low body fat - this may sound good but, for women, it can cause some serious problems. Menstrual period stopping, (a sign which may indicate your body is shutting down certain functions, which can be associated with bone loss) Fatigue Dehydration Osteoporosis Arthritis Reproductive problems Heart problems About 30 minutes of moderate exercise most days of the week is more than enough to help you maintain good health. Exercise shouldn’t be drudgery. And it certainly shouldn’t be your penance for eating too much. Dropping the focus on calorie burning while getting tuned in to your body opens up a whole new possibility: choosing exercise or physical activity because it feels good! The idea is to find an activity that appeals to your tastes and preferences, one that you really enjoy doing. 15 Healthy Body Image Body image and self-esteem are tied together since body image can affect how you feel about your whole self. When you put yourself down about how you look, it can lead to negative feelings about yourself in general. Poor self-esteem can also lead to eating disorders that can put your health in danger. Take this quiz and see how your Body Image I.Q. measures up. You avoided sports or working out because you didn’t want to be seen in gym clothes Eating even a small amount of food makes you feel fat You worry or obsess about your body not being small, thin or good enough You avoid wearing certain clothes because they make you feel fat You feel badly about yourself because you don’t like your body You want to change something about your body You compare yourself to others and "come up short" If you answered "Yes" to 3 or more questions, you may have a negative body image. See the following tips and ideas for help in changing your perception to a more positive one. 16 Some Helpful Hints on Coping Strategies It is not always easy to distract yourself when you have the urge to binge, purge or restrict. Sometimes it is helpful to make yourself a list of things you can to do to distract yourself when you want to try to delay your symptoms as long as possible. Here are some helpful hints. Write in a journal Listen to your favorite music Tell one person how you feel Paint a picture Take a long hot bath Hug someone Take a walk Rent your favorite movie Go to a movie Call an old friend/ sibling/parent Spend time with your pet Read a book Don’t buy fashion magazines Remember fashion photographs are technologically enhanced (most pictures are airbrushed!) Question standards before accepting them and ignore or challenge friends and family who act like the body police Wear clothes that fit Remind yourself “It’ll be OK” Take a deep breath and count to 10 Ask your therapist to make a tape with you that you can use during difficult times 17 Go to a favorite “safe” place (beach, park, woods, playground, etc) Think of the advice you would give to someone else…and take it. Say something good about yourself Meditate, use relaxation Call a Hotline Punch a pillow Spend time with your roommate, classmate, friends Stay in touch with others- don’t isolate yourself Do deep breathing Make a list of things to do Change your environment…walk out of the room, put on music or tv, eat something safe Visualize a stop sign And, most of all: Don’t be afraid to ask for help 18 Holiday tips Holidays are about being thankful for what you have and giving to others but mostly they are food-oriented festivities spent with family and friends. For someone with an eating disorder, such events are a big source of anxiety, especially if painful holiday memories are present. Here are some tips on how to handle this challenging time of the year. 1. Plan ahead. If you plan on visiting with friends and family, plan out the situation ahead of time in order to avoid extra stress and anxiety. You may also consider telling your family ahead of time not to make remarks about your eating disorder. 2. Eat regularly. Don’t skip meals and starve in attempt to make up for what you recently ate or about to eat. 3. Make a list. Write down each thing you need to get done for the holiday season. Getting things done ahead of time and having a list so you do not forget anything can save you a lot of unneeded stress. 4. Talk with your therapist. A therapist can work with you on coping methods and address specific worries or anxiety you may have. 5. Find a “HELPER”. This person will be there for you to talk with if thoughts regarding your eating disorder begin to enter your mind or you feel overwhelmed. 6. Determine your reactions ahead of time. If someone makes an awkward remark about your eating habits or weight, know what you plan to say ahead of time. This may help relieve anxiety during holiday events. 7. Offer to bring a dish. If you are unsure of what may be offered on the holiday menu, offer to bring something you know you will be willing to eat. 8. Be flexible. While this may be difficult, being flexible with plans and situations which may arise can relieve tension that may come with the holiday season. This may also prevent emotional eating. 9. Take part in fun activities. By taking part in fun activities, you can distract yourself from any food worries you may be having. 10. Confide in someone. Tell someone, who will be with you during meal times, your specific concerns and allow them to give you advice on what is appropriate. 11. Only attend what you can handle. Politely decline invitations if you feel the situation would make you uncomfortable or overwhelmed. Situations, which include non-food activities, might be most enjoyable at first. Eventually, however, it will be important to integrate those situations in your life. 12. Eat healthy foods. If you stick to a regular meal plan and eat healthy food then you reduce the risk of feeling “guilty” over eating. 13. Attend a support group. Attend events and make friends with others in the same situation, as this type of fellowship will provide you with support and encouragement. 14. Don’t focus on mistakes. If you feel too full or have experienced a binge, move on and do not allow it to stress you out. 15. Set goals. Instead of only focusing on food and weight during the holiday season, set other goals regarding what you might like to talk about and focus on. 19 Resources Aneb Quebec 114, Donegani avenue, Pointe-Claire, Quebec H9R 2W3 Phone: 514-630 0907 or 1-800-630-0907 Fax: 514-630 1225 Email: info@anebquebec.com Website: www.anebquebec.com Services offered: Help line and support groups for people struggling with eating disorders. Fees are required for certain activities. Argyle Institue 215 Redfern, Suite 305, Westmount, Quebec, H3Z 3L5 Phone: 514-931 5629 Fax: 514.931.8754 Website: http://www.argyleinstitute.org Service offered: Individual psychotherapy for people suffering from a variety of problems. Clients need to pay according to a sliding scale fee. BACA Eating Disorders Clinic Inc 3410, rue Peel, bureau 1206 Montreal (Quebec), Canada H3A 1H3 Phone: 514-544 2323 Fax: 514-759 3084 Email: info@CliniqueBACA.com Website: www.cliniquebaca.com Services offered: Multidisciplinary team offering outpatient services. Individual therapy, nutritional consultation, medical consultation, creative therapy and support group. Clients need to pay for therapy. Cognitive Behavioral Therapy Clinic Montreal General Hospital (Queen Elizabeth Health Complex) 2100 Marlowe Phone: 514- 485 7772 Fax: 514 485 5007 Services offered : Individual CBT. Clients must pay for therapy. Douglas Hospital Eating Disorder Unit 6875, LaSalle Blvd, Borough of Verdun, Montreal, Quebec H4H 1R3 Phone: 514-761 6131, ext. 2895 Website: www.douglas.qc.ca Services offered: Outpatient clinic, day program, partial day hospitalization, full hospitalization, individual, group and nutritional therapies. ÉquiLibre 7200 rue Hutchison, bureau 304, Montréal (Québec), H3N 1Z2 Phone: 514 270-3779, Toll Free: 1-877-270 3779, Fax: 514 270-1974 Email: info@equilibre.ca Website: www.equilibre.ca Services offered: Prevention workshops and promotion of healthy living. 20 The National Eating Disorder Information Centre (NEDIC) ES 7-421, 200 Elizabeth Street, Toronto, Ontario M5G 2C4 Phone: 416-340-4156, Fax: 416-340-4736, Toll-Free: 1-866-NEDIC-20 (1-866-633-4220) Email: nedic@uhn.on.ca Website: www.nedic.ca Services offered: Information and resources for eating disorders. Please check out their website for library, articles, pamphlets and information. 21 Helpful websites www.nationaleatingdisorders.org: offers information, resources, lists of books, action-oriented advocacy and media campaigns to educate the public and a community to people often feeling alone and overwhelmed in their struggle to access quality, affordable care. www.bulimia.com is a publishing company specialized in eating disorders publications. www.something-fishy.org offers general information about eating disorder. www.mirror-mirror.org is for individuals who are recovering from an eating disorder. www.edreferral.com gives referrals to eating disorders specialist in the United States. www.oa.org is an anonymous group support for people dealing with eating disorders. 22