SARATOGA — Do you know Paraag Marathe? You don’t know Paraag Marathe.
“Hey, it’s the same oven!” he exclaimed.
We had just entered the front door of Mountain Mike’s pizza parlor. Marathe grew up blocks away. But this was far more than Marathe’s old stomping ground. This was much more.
“I don’t know how long it’s been since I was here,” Marathe said, gazing around. “I helped my dad set up this place. I hired the first employees, I picked out this furniture. I picked this color scheme.”
Yes, it turns out there is a lot that all of us don’t know about Paraag Marathe. I used to think that was exactly how he and the 49ers wanted it. But as we sat down for a nearly two-hour lunch at the restaurant that this family once owned, a lot of insightful doors opened up into the team’s mystery man.
ONE OCTOBER DAY in the fall of my junior year of college, I found myself sitting in a chair across from a small blond woman with a look of deep concern on her face as she stared into mine. She had something to tell me, she said, and it was clear she knew that the something would upset me. Her eyes were wide, her hands on the arms of a chair that would have been more appropriate in a public library lounge. Her windowless office was warmly lit with a few small lamps, none of the bright fluorescence and antiseptic shine of a doctor’s office. Still, it was a doctor’s office, or at least it was an office in which something resembling medical care was taking place, and I had the feeling she was about to tell me that mine could no longer take place here.
Eating disorders (EDs) pose a serious threat to physical and mental wellbeing. Anorexia (AN) is characterized by extreme diet restriction and fear of weight gain, bulimia (BN) by vicious binge-purge cycles, and binge eating disorder (BED) by frequent binges, or consuming very large quantities of food while feeling a loss of control over one’s action. Individuals experiencing significant distress and impairment from maladaptive thoughts and behaviors related to eating, food, or body image but who do not meet criteria for AN, BN, or BED may also be diagnosed with Other Specified Eating and Feeding Disorder (OSFED). Moreover, EDs do not always occur in isolation. The complications associated with eating disorders can be exacerbated or prolonged when combined with alcohol misuse and binge drinking. In fact, eating disorders are highly comorbid with substance use disorders, particularly alcohol use disorder. This co-occurrence, however, varies across diagnostic subtypes. For example, research studies have found that individuals with BN may be up to three times more likely to report alcohol misuse problems than women without BN. Among individuals with AN, those with binge-purge subtype endorse higher rates of alcohol abuse (22%) compared to restricting subtype (12%). Research has also identified biological factors that may partly account for the relationship between the two disorders. Recent genetic analyses have observed strong genetic overlap between bulimic behaviors (e.g., binging and purging via vomiting, laxative use, excessive exercise, or diet pills) and problematic alcohol use and alcohol dependence., Brain imaging studies have shown similar patterns of activation in executive control and some reward regions of the brain in alcohol use disorder and BN/BED.
As those who work with people with eating disorders know, the landscape is changing in ways both positive and negative, exciting and troubling, and medically/therapeutically appropriate and terribly harmful, often at the same time. As the diagnostic criteria for eating disorders have changed to reflect the people we actually see in our offices, one positive shift has been the change in patient demographics. Though there is an unfortunate absence of research into this issue, one anecdotal change has been the increase in men seeking therapeutic assistance for eating disorders, body dissatisfaction, compulsive exercising, weight gain/loss, and many other issues commonly thought of as being the purview of women (Cox, 2017).
I recently jumped at the opportunity to form a men’s group at Balance Eating Disorder Treatment Center, in NYC. It was something I’ve wanted for awhile, but amassing a concentrated group of men to form a group has proved difficult. Balance advertised in as broad a manner as possible to attract as many members as possible. We invited men interested in examining their relationship with food, body, self, and society, focusing on body image concerns, emotional eating, relationship issues and sexuality, nutrition, healthy exercising, communication, and coping skills. We didn’t know who would respond.
As a thankful representative of the EDRC last month (June) I attended the 2017 Boston Children’s Hospital Female Athlete Conference (FAC) at Babson, College in Wellesley, MA. Since 1972’s passage of Title IX, the number of girls involved in competitive sports has dramatically increased thereby demanding more research be done on female athletes. With passion, foresight and awareness of the need for such research, funding and public awareness, Dr. Kate Ackerman, Sports Medicine physician at Boston Children’s Hospital and Director of the Female Athlete Program and Dawn Hynes, founder of Hynes Recovery Services together co-founded Boston Children’s Hospital FAC where proceeds from the conference go towards funding research on female athletes. The Boston Children’s Hospital FAC further explain the inspiration, goal and purpose on their website:
“In the last 40 years, the number of girls competing in high school sports increased from 295,000 to nearly 3.2 million with more women playing collegiate sports than ever before. As girls and young women become more empowered through sports, it is important to advance research on how sex and gender differences affect their performance and overall sports experience. With research advancement in mind, the Female Athlete Conference, the only conference of its kind in the U.S., centers on the specific health issues that make female athletes unique. Experts in sports medicine, sports psychology, sports science, nutrition and sports culture will present strategies to prevent and treat clinical issues and injuries that can limit a female athlete’s performance.”https://bostonchildrens.cloud-cme.com/Aph.aspx?P=1&EID=333
As a former college athlete, coach and current therapist, walking around meeting and speaking with conference presenters the evening before at a special dinner hosted by conference director and co-founder, Dr. Kate Ackerman, I said to myself, “I think I’ve found my tribe.” After seeing Dr. Jennifer L. Gaudiani deliver a powerful and informative opening presentation on the first day of the conference about medical complications concerning malnutrition and eating disorders generally speaking and athletes in particular, followed by attending a myriad of other important topics being presented about the research being done on issues specific to female athletes regarding race, gender politics, and performance, it’s safe to say I knew I found my tribe.
Filled with gratitude, excitement and a deeper appreciation for the new information and insight I gained over the last three days, my trip was made complete when I was able to meet the amazing Dawn Hynes where I shared my appreciation for the wonderful conference and thanked her for her hard work and steadfast commitment to treating and spreading awareness of eating disorders. Last but certainly not least, I could thank Dawn for her part in making this trip possible in the first place along with Janice and the EDRC who were proud sponsors of the event.
Sometime around 2010, about two-thirds of the way through his 13 years at the helm of the National Institute of Mental Health (NIMH)—the world’s largest mental-health research institution—Tom Insel started speaking with unusual frankness about how both psychiatry and his own institute were failing to help the mentally ill. Insel, runner-trim, quietly alert, and constitutionally diplomatic, did not rant about this. It’s not in him. You won’t hear him trash-talk colleagues or critics.
Yet within the bounds of his unbroken civility, Insel began voicing something between a regret and an indictment. In writings and public talks, he lamented the pharmaceutical industry’s failure to develop effective new drugs for depression, bipolar disorder, or schizophrenia; academic psychiatry’s overly cozy relationship with Big Pharma; and the paucity of treatments produced by the billions of dollars the NIMH had spent during his tenure. He blogged about the failure of psychiatry’s Diagnostic and Statistical Manual of Mental Disorders to provide a productive theoretical basis for research, then had the NIMH ditch the DSMaltogether—a decision that roiled the psychiatric establishment. Perhaps most startling, he began opening public talks by showing charts that revealed psychiatry as an underachieving laggard: While medical advances in the previous half century had reduced mortality rates from childhood leukemia, heart disease, and aids by 50 percent or more, they had failed to reduce suicide or disability from depression or schizophrenia.
From left to right: Toni Tullys, Director of County Behavioral Services, EDRC founder Janice Bremis, and volunteer Max Sala
On 4 May 2017, The Santa Clara County Behavioral Health Board (SCCBHB) honored Silicon Valley’s Eating Disorder Resource Center (EDRC) with the AGENCY HERO award, a part of the Community Heroes Award Ceremony. These honors are given to community agencies and members who have made an extraordinary difference in the lives of people with behavioral health illness.
Toni Tullys, Director of County Behavioral Services, and Gary Miles, Ph.D., Board President, presented the award to Founder Janice Bremis and volunteer Max Sala, recognizing the EDRC’s outstanding service and commitment to increasing research efforts, professional development, treatment access, and public awareness on eating disorders. The EDRC’s mission is inspired by Ms. Bremis’s dedication to end suffering for individuals by promoting access to quality care. We provide families and local communities resources for prevention and treatment and offer multiple support groups across the Bay Area.
Center for Change is committed to helping further research that it is essential for documenting and improving the effectiveness of eating disorder treatment programs and for increasing professionals’ understanding of these disorders. We are pleased to present the results of our 2-year pilot study that has been published in Eating Disorders: The Journal of Treatment and Prevention.
Six South Bay students have been named winners in the Eating Disorders Resource Center’s eighth annual Every Body’s Beautiful writing contest.
In the high school division, Sean-Yuei Tseng and Vivian Le, both seniors at Piedmont Hills High, placed first and second respectively and Ayushi Ray, a sophomore at Cupertino, placed third.
In the middle-school division, Carina Chiu, an eighth-grader at University Preparatory Academy charter school in San Jose placed first; and Elisia Macias, a seventh-grader at Brownell Middle School in Gilroy placed second. The third-place winner chose to remain anonymous.