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Eating Disorders Mental Health Parenting Recovery Treatment

Stress, an Eating Disorder, and Mental Health

…Eating Disorder… (Photo credit: ĐāżŦ {mostly absent})

A while back, I wrote about a child of 8 years old who was showing early signs of disordered eating behaviors. As noted at that time, the behavior was fueled by a father with his own poor relationship around food and a mother who is also victimized by his negative body and food talk. I’ve watching this child over the last year, hoping I was wrong, but knowing more and more that the signs I was seeing were none other than an eating disorder being nurtured and fed by self-hatred, stress, and a negative environment. Her organization of food has gotten more intense, as has her open disgust around whatever is on her plate. It’s not so much about being “fat” but more about her discernment around eating a growing number of “certain” foods.

There’s stress all around this kid: her father is impatient and fixated on his own weight and body image. Her mom is reacting to his actions by persistently apologizing when she eats, joining Weight Watchers, and choosing to ignore the cry for help at the dinner table. As a regular in their household, it’s been hard to watch and harder still not to say anything for fear of being shut out entirely. I’ve used my presence as an opportunity to change the dialogue when I can, but it’s hard speaking to a room full of deaf ears. I finally did say something when the negative talk was directed at me and as expected, my comment, despite coming from love, was met with a “Nah, I’m not worried about that.”

 

Stress is a huge culprit here. According to the Eating Recovery Center, “childhood stress is typically: personal, interpersonal, interfamilial, or global (a stress reaction to national or world news).”

  • Age is not a factor: Children of all ages experience stress, though they may express it differently.
  • Children are vulnerable.
  • Children respond differently to the stress in their environment.
  • Stress is cumulative. Adults aren’t the only one’s who can “only take so much.”
  • Change is stressful. Even positive change. I am reminded here of reorganizing a room in my house and my son getting utterly overwhelmed even though the change was positive. Our nervous systems are indifferent to our whims and desire to pile on more and more and the fact that we all may have a different response is something to be noted and respected.

Parents and adults alike would be wise to open a dialogue with their kids about stress and one’s perceptions of how things are. In the case of my young eating disorder study, dad is never around and only available on weekends; when he is there, he’s impatient and obsessively exercising or on his computer—detached from everyone. This provides a huge source of stress for her and for the rest of her family. Unfortunately, this has been weaved into her negative self talk and commentary about her family and hinders her relationships with others and with food. She’s angry, stressed out, and starving herself in response.

What can we do? We can start with the following:

  • Be an example of positive body talk.
  • Talk to our kids. Be open and honest, but be loving.
  • Eat mindfully. Turn off the TV. Make mealtime a place of solace and connection.
  • Don’t talk about stressful subjects at the dinner table. In other words: keep it light.
  • Don’t use food or eating as a means of punishment. (You’re going to bed without dinner).
  • Encourage self-care and self-love: At dinner, ask each person to express one thing they are grateful for.
  • Cook together. Show them that food isn’t the enemy.
  • Go on hikes or family walks.
  • Have family meetings. We do them council style in my house. It makes a world of difference.
  • Don’t be afraid to ask for professional help.
  • Be honest with your therapist. They can’t help you if you hold back.
  • Find a support group—being alone with your child or family is in crisis is too much for anyone.
  • Take care of yourself so you can take care of those around you.

If you’re worried that your son or daughter might be developing an eating disorder (note: boys are not immune to this!), look out for some of these signs.

(Please note, certain behaviors are warning signs, but in combination and over time, they can become quite serious):

Behaviors specific to anorexia:

  • Major weight loss (weighs 85% of normal weight for height or less)
  • Skips meals, always has an excuse for not eating (ill, just ate with a friend, stressed-out, not hungry).
  • Refuses to eat in front of others
  • Selects only low fat items with low nutrient levels, such as lettuce, tomatoes, and sprouts.
  • Reads food labels religiously; worried about calories and fat grams in foods.
  • Eats very small portions of foods
  • Becomes revolted by former favorite foods, such as desserts, red meats, potatoes
  • May help with meal shopping and preparation, but doesn’t eat with family
  • Eats in ritualistic ways, such as cutting food into small pieces or pushing food around plate
  • Lies about how much food was eaten
  • Has fears about weight gain and obesity, obsesses about clothing size. Complains about being fat, when in truth it is not so
  • Inspects image in mirror frequently, weighs self frequently
  • Exercises excessively and compulsively
  • May wear baggy clothing or many layers of clothing to hide weight loss and to stay warm
  • May become moody and irritable or have trouble concentrating. Denies that anything is wrong
  • May harm self with cutting or burning
  • Evidence of discarded packaging for diet pills, laxatives, or diuretics (water pills)
  • Stops menstruating
  • Has dry skin and hair, may have a growth of fine hair over body
  • May faint or feel dizzy frequently

Behaviors specific to bulimia

  • Preoccupation or anxiety about weight and shape
  • Disappearance of large quantities of food
  • Excuses self to go to the bathroom immediately after meals
  • Evidence of discarded packaging for laxatives, diuretics, enemas
  • May exercise compulsively
  • May skip meals at times
  • Teeth may develop cavities or enamel erosion
  • Broken blood vessels in the eyes from self-induced vomiting
  • Swollen salivary glands (swelling under the chin)
  • Calluses across the joints of the fingers from self-induced vomiting
  • May be evidence of alcohol or drug abuse, including steroid use
  • Possible self-harm behaviors, including cutting and burning

If you notice even one of these, it’s time to address it. Talk to your daughter or son, talk to your doctor. If necessary, elicit the help of a treatment facility. In other words: Get help. Showing our kids that we care and are willing to stop our own negative behaviors in order to help them is invaluable. It’s a family problem, not an individual one.

Categories
Addiction Adolescence Alcoholism Eating Disorders Mental Health Recovery Treatment

Resolutions: One Step at a Time

Resolution (Photo credit: vpickering)

So you made resolutions to stay sober in the New Year, now what?

Like most of us, you made a bunch of lofty resolutions, some of which may seem daunting and unattainable when looked at with the eyes of reality in the cold of January.  Maybe the hangover of the holidays made you realize you need to listen to that inner voice telling you this isn’t how life is supposed to be, and maybe, just maybe you need to get sober.  Perhaps you’re thinking, “How am I ever going to be able to live without drugs and alcohol? How can I learn to be comfortable in my own skin?”

 

Fortunately, the world did not end this past year, instead we have an incredible opportunity to create our own metaphorical “calendar” wherein we can make healthier, saner choices for the years to come.  This isn’t a calendar that includes doomsday prophesies and holidays sponsored by a beer company.  This is a calendar that celebrates caring for ourselves and healing our relationships.  From here on out, we have the chance to make every day a step closer to being the person we are capable of being, potentially making those resolutions become reality.

 

So, how do we go about doing this? I recently tweeted about an article from the Huffington Post that listed some suggestions for spiritual success as a foundation to our resolutions—the suggestions mirror much of what we talk about in our blog and were nice to see out there in the digital ether. I thought some of them were worth reiterating here because these practices and ideologies are key in supporting our recovery and enriching our sober lives. We have to start somewhere, right? This is how we do it!

 

  1. Make the decision to care for yourself and get sober.  You don’t have to live in misery anymore. Recovery isn’t easy, but it’s not has difficult as carrying the shame and guilt associated with our using behavior.
  2. Seal the deal and make it public.  Tell the people who care about you the most. That means people OTHER THAN your using friends.
  3. Find a sober community that supports you: 12-step groups, meditation groups, mental health support, or all of the above!
  4. Practice asking for help: this will save your bum more than you know. It’s amazing when you eventually realize how much easier things are when you don’t have to do them alone!

 

Remember: no more doomsday prophecies be they spiritual, metaphorical, or literal. We can do this recovery thing…one step at a time!

Categories
Body Image Eating Disorders Mental Health Recovery

Eating Disorders: Recovery and Service

Eating disorders can breed contempt or denial in those that don’t understand them while feeding the silent devastation and fear in those who have them. This is an inherently challenging situation. Types of eating disorders vary but we are most familiar with Anorexia and Bulimia or a variation of the two. Still, there are some who suffer from disordered eating. I’ve heard it said that disordered eating is not an “actual eating disorder,” but rather a “phase” of bad eating behaviors.  However, the DSM and professionals in the field of addiction and mental illness have proven that not to be the case. For example, disordered eating has now earned the diagnostic term Eating Disorder Not Otherwise Specified or EDNOS.

For real clarification, the DSM descriptions of the various criteria for Anorexia, Bulimia, and EDNOS can be found below:

Eating disorder not otherwise specified includes disorders of eating that do not meet the criteria for any specific eating disorder.

  1. For female patients, all of the criteria for anorexia nervosa are met except that the patient has regular menses.
  2. All of the criteria for anorexia nervosa are met except that, despite significant weight loss, the patient’s current weight is in the normal range.
  3. All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than twice a week or for less than 3 months.
  4. The patient has normal body weight and regularly uses inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies).
  5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.

The criteria for Anorexia Nervosa is:

  • Refusal to maintain body weight at or above a minimally normal weight for age and height: Weight loss leading to maintenance of body weight <85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.
  • Intense fear of gaining weight or becoming fat, even though under weight.
  • Disturbance in the way one’s body weight or shape are experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
  • Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women. Amenorrhea is defined as periods occurring only following hormone (e.g., estrogen) administration.

And the criteria for Bulimia Nervosa:

  • Recurrent episodes of binge eating characterized by both:
  1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
  2. A sense of lack of control over eating during the episode, defined by a feeling that one cannot stop eating or control what or how much one is eating
  3. Self-induced vomiting
  4. Misuse of laxatives, diuretics, enemas, or other medications
  5. Fasting
  6. Excessive exercise
  • Recurrent inappropriate compensatory behavior to prevent weight gain
  • The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • The disturbance does not occur exclusively during episodes of anorexia nervosa

Recovering from any of these eating disorders is hard work. We have to learn to navigate the food playing field with healthy awareness. One of the interesting things I’ve learned about recovering from my own eating disorder is that food is merely a symptomatic component of the greater problem: low self-esteem, an out of control environment, poor body image, fear, control. Not eating was always a way to control the chaos around me. What I was clueless about was the fact that I was created chaos within. The more out of control the outside environment is, the more control someone struggling with an eating disorder requires to simply survive. Yes, there’s deep irony in the use of “survive” here, because the end result of some severe eating disorders is ultimately death.

Chelsea Roff, a recovering anorexic, yoga teacher, speaker, and author, has come out publically with her story of recovery. Chelsea suffered from a stroke when she was 15 and ended up in a hospital for 18 months under constant care. Her essay, bravely discussing her story first appeared in the book 21st Century Yoga: Culture, Politics, & Practice. From there, she was swept into the fray of instant publicity and exposure, ranging from the Huffington Post to Dr. Sanjay Gupta on CNN. While being in recovery isn’t about celebrity, there’s something to be said for a young girl who is taking this exposure and using it for good. There’s something deeply inspiring about someone who came from near death and is now thriving and being of service. In the end, being of service is what it’s about.

Eating disorders have their way of creeping back in when we least expect it. When we are of service and helping others, our own transparency is paramount to that process. In other words, being of service helps keep us honest. We have to eat. We have to learn to develop healthy relationships with our bodies and with food. Here, instead of vigilantly controlling our intake of calories, we can direct our vigilance to being of service. I look to Voice in Recovery and Chelsea Roff as young women who give back what was so freely given to them. I look to Melanie Klein (also a contributor in 21st Century Yoga) and Claire Mysko to provide the education and passion for body image advocacy in order to help young people gain a better understanding of the deeply rooted, media-infused sources of poor body image and eating disorders.

Kindness starts from within. We can and will recover.

RESOURCES:

NEDA

NIMH

Proud2BMe

Voice in Recovery (ViR)

 

Categories
Addiction Eating Disorders Mental Health Recovery Service Therapy Treatment

Visions’ Los Angeles Outpatient

Los Angeles outpatient facilities are typically where one goes in order to transition from the intensive setting of being in an inpatient treatment facility to the wide-open world.  The outpatient setting is the perfect environment for clients to reintegrate themselves into their new mode of living a life in recovery. On occasion, outpatient can also be the first place one goes to get help when an inpatient facility seems like too much and trying to recover on his or her own has been futile..

At Visions’ Los Angeles outpatient facility, we focus on the entire family, ardently continuing the work that was begun at inpatient. We not only work with the clients but with their families in order to provide a continuum of support. We do this via schooling, team-building activities, therapeutic support, 12-step meetings, and various process groups. We address building and refining communication skills as well as nurturing the spiritual well being of our clients, all of which helps them understand how to be in recovery. We teach our families problem-solving skills, and help them develop new, healthy friendships. We host a variety of alumni and unity events, all of which foster a better relationship to being in recovery. The beauty of these events is, they naturally build community among the clients, showing them that they have sober support and a recovery community. Additionally, we encourage relationships with 12-step sponsors and participation in 12-step meetings, which inspires clients to be active participants in the continuum of their recovery.

In addition to our Intensive Outpatient program, we also have Launch, which is a wonderful Los Angeles outpatient program geared toward young adults transitioning out of adolescence and into adulthood. Launch is a life-skills program focusing on vocational, educational, and social skills.

Outpatient provides an amazing opportunity for our families: it’s the stepping stone between being in the controlled environment of a facility and interacting with the world at large but with the helping hand of a skilled support team. Entering recovery is frightening. It’s new, different, and at times overwhelming, but nothing is impossible when you have a support team guiding you along.

Categories
Body Image Eating Disorders Mental Health Recovery

Recovery: Living With ED

Being in recovery from an eating disorder isn’t a finite thing. There are days when the disordered thoughts may come rushing in, triggered by outside sources . There may be times where our body dysmorphia gets the upper hand and we can’t discern reality from our own delusion.  There also may be times when we find ourselves in a relationship with someone who’s at the tipping point of their own eating disorder. Typically, these types of circumstances are not emotionally safe, but in many ways,  they provide opportunities to engage in the practice of self-care: Ask for help, and whenever possible, walk away.

Eating disorders and disordered eating behaviors are tricky: the risk of sliding is always there, because, well, we HAVE to eat. Our bodies require the fuel, the love, and the dedicated care that feeding ourselves provides. But even in recovery with days, months, or even years of abstinence, there may be some rough days where we may get off track. The trick there is, do you have enough tools in your recovery tool box to ask for help and stop ED in its tracks?

Recovery from an eating disorder or disordered eating is a process. It’s an exercise in letting go of control and learning to trust those in your circle of support instead of the distorted voices of irrationality.  You may find that the practice of self-care will be the pièce de résistance in your recovery. Eventually, we discover that we are eating because we are being kind to ourselves. We are eating because we deserve to be healthy. When we feed ourselves,  we are taking care of this incredible body that we get to hang out in.

Here are some ways to practice healthy self care (adapted from this list from NEDA):

  • Remember that beauty comes in all shapes and sizes. There is not “right” way to look.
  • Celebrate all of the amazing things your body can do, like: breathe, run, jump, laugh, dream!
  • Keep a top 10 list of things you like about yourself that are NOT related to the way you look or how much you weigh.
  • Surround yourself with positive, supportive people. .
  • Use positive affirmations when the negative internal tapes start playing. You can even place post-its with positive affirmations on them in strategic places: like on your mirrors!
  • Wear clothes that are comfortable. In other words, work with your body, not against it.
  • Take care of yourself: get a manicure, go on a hike, take a bubble bath, read a good book.
  • Schedule some “do nothing” time so you can recharge.
  • Be mindful of your media intake and the messages you receive. Pay attention to messages that make you feel bad about yourself. Say something and maybe you can effect some change!
  • Be of service. Helping others gets us out of ourselves and into service. This is another way to make some positive changes.

As we continue down this path of recovery, our care for ourselves will allow us to care for those around us. We are so much more than our outsides.

“The ultimate lesson all of us have to learn is unconditional love, which includes not only others but ourselves as well.” – Elisabeth Kubler-Ross

Resources:

National Eating Disorders Association (NEDA)

National Association of Anorexia Nervosa and Associated Disorders

National Association for Males with Eating Disorders

International Association of Eating Disorders Professionals

Eating Disorders Coalition

Families Empowered and Supporting Treatment of Eating Disorders

Eating Disorders Resource Center

Voice in Recovery

 

Categories
Body Image Eating Disorders Mental Health

Eating Disorders: They Happen to Boys Too

He was 12 and his social circle was made up primarily of girls. It always had been. Sports weren’t of interest, and neither was the usual competitive atmosphere of boyhood. Frankly, William was a boy who’d rather draw, or ride his bike, or bake with his mom. When his girl-friends began the fat-talk, he thought it was ridiculous, but in truth, he began to silently take it all in. He started to look at himself and wonder if maybe he, too, was fat. William, being on the outskirts of male culture, found himself being seduced by the culture of thinness. While his male friends (yes, he had those too) began bulking up from sports and the like, he began to get thinner and thinner. All of a sudden, he found himself controlled by the demon we all know as ED.

Jonas was 14, a football hero in the making, but not nearly as “built” as some of his pals. Determined to get the much sought after V shape idealized by fitness magazines and late-night televisions ads, he started an exercise regimen which soon became obsessive and excessive. It wasn’t an issue of not being thin enough for Jonas. Instead, the issue was being fit enough. Before he knew it, his focus was entirely spent on attaining this idealized body type–one that didn’t quite fit into his genes: Jonas was a short, stocky kid with short, stocky parents. Still, ED wormed its way into Jonas’ life as well, albeit in a different form.

In Brave Girl Eating, Harriet Brown talks about the eating disorder as a demon. She describes the personality change that occurs when the Eating Disorder (ED) is speaking with its loud ferocity. The provocative noise is terrifying in the mind of the one suffering, but sadly, it’s often drowned out by the disease itself. In truth, ED nullifies ones real sense of self and replaces it with an unrealistic desire for perfection and control. One thing that shows up repeatedly with an eating disorder is this desire for perfection, which shows up in school as good grades, in sports as high-scorers, in Girl Scouts as top sellers. Eating disorders are often about gaining control when something in one’s life feels definitively out of control.

We are used to talking about girls when we talk about eating disorders, as though we assume boys are unaffected. But they are, and those numbers are increasing. Unfortunately, eating disorders can carry the stigma of being something women suffer from–This invites a higher probability of men and boys not asking for help. Recently, MSNBC highlighted three young men whose lives had been heavily impacted by eating disorders. One of the young men lost his life after an 8-year battle with anorexia. He just wanted a six-pack.

More than a million boys and men battle an eating disorder every day and “approximately 10% of eating disordered individuals coming to the attention of mental health professionals are male.” (National Eating Disorder Association).  The culture of “thin” is not only negatively impacting girls and women, but it’s begun to surreptitiously spin its nasty web in male culture. Advertizing aimed at women and girls suggests dieting and weight loss while ads geared toward men encourage fitness, weight-lifting, and muscle toning, so it makes sense that the female population is starving themselves or fat-talking their way out of life. But men and boys are suffering too, and they need a safe place to ask for help. Eating disorders are frightening, and not just for those watching the demise of someone they love. Being in it and listening to that voice of doom is terrifying. Getting help shouldn’t be another hurdle to climb.

For more information on Eating Disorders:

National Eating Disorders Association (NEDA)

National Association of Anorexia Nervosa and Associated Disorders

National Association for Males with Eating Disorders

International Association of Eating Disorders Professionals

Eating Disorders Coalition

Families Empowered and Supporting Treatment of Eating Disorders

Eating Disorders Resource Center

Fact Sheet (NEDA) What’s Going On With Me?

Study: The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication

 

Categories
Anxiety Body Image Eating Disorders Mental Health

Thanksgiving and Eating Disorders: A Mini Survival Guide

Image via Wikipedia

On the heels of my recent blog about fat talk and its negative ramifications, I am broaching the subject of food, anxiety, and eating disorders once again. It’s almost Thanksgiving, after all, a holiday which not only acts as a huge trigger for many suffering from or recovering from an eating disorder, but is often used as fodder for fat jokes and the subsequent fat talk. As if sitting down to dine with your already dysfunctional family isn’t enough.

As we set our gaze upon Thanksgiving and give thanks for all that we have, those suffering from an eating disorder may be having an entirely different experience. For one thing, the entire day is purportedly built upon the foundation of food; one is expected to eat…a lot.  With an eating disorder, those expectations can bring about a legitimate sense of fear, shame and anxiety. For example, an anorexic may be overly concerned with the appearance that he or she is not only eating, but enjoying a “normal” amount of food, while someone suffering from bulimia or binge-eating disorder may struggle with trying to manage their urges to binge and/or purge.  For both, there are triggers everywhere, from the wide array of food being offered to someone’s not-so-subtle commentary about your, or even their, current weight, shape, size, et cetera.

Eating disorders and disordered eating are complex conditions, emerging from a combination of behavioral, biological, psychological, emotional, interpersonal and social factors. For many, food becomes the one thing that is controllable, giving someone who feels inherent powerlessness some perceived power. My own experience is just that: I grew up in an out-of-control, dysfunctional environment, where food was used as a vehicle for mixed messages; controlling its intake became paramount to my own survival. Or at least I thought it did. What it really ended up doing was leaving an indelible mark of low self-esteem and body dysmorphia. I still occasionally encounter negative behaviors from some family members when I see them, but now I view it as an opportunity to stand up in the face of adversity, plant my feet in my recovery, and dine with dignity. See here for NEDA’s “Factors that may Contribute to Eating Disorders.”

Some things to think about for the holidays:

Get support: either via a therapist, a sponsor, or a good friend. Make sure that you have someone you can lean on during this holiday season. You don’t have to manage Thanksgiving alone.

Make a plan: I always make sure I have what I call an “escape” plan for these sorts of things. In other words, make yourself a schedule so you don’t have to wing it.

Don’t skip meals in “preparation” for the holiday: Maintain your regular eating schedule that’s become a part of your recovery. For example, don’t skip breakfast so you can “have room” for the Thanksgiving meal.

Ignore and don’t engage in the fat talk: It’s neither an act of self-care or helpful. If someone is engaging in this age-old, negative behavior: walk away or disengage. Other people’s issues surrounding food are not yours to manage.

Be kind to yourself: If you fall down and slip into old behavior, don’t use it as a springboard to self-destruction. Allow yourself to enjoy the things you like. I find that knowing my triggers allows me to navigate the stormy sea of family and impulse with better judgment. You can do this!

Breathe: Yes, that’s right. Breathe. If you’re feeling overwhelmed, take a step back and take 10 deep breaths and find your center. This really does help. (This is also the other reason bathrooms exist!)

Lastly, remember what Thanksgiving is really about: It’s not about the food. Not really. It’s about being grateful for those around you and for the blessings in your life. Bask in the glory of your recovery and sobriety, for without those, the least of your worries would be whether or not you can eat a piece of pumpkin pie!

Resources and articles used as reference:
Categories
Body Image Eating Disorders Mental Health

Adios, Chubby Chatter!

Image by Brent Weichsel via Flickr

“Do I these pants make me look fat?”

“OMG, I feel so fat today!”

“I can’t believe she’s wearing THAT!”

I honestly wish this commentary occurred less than it actually does, but the reality is, it doesn’t. It occurs on a daily basis in the lives of girls (and boys) from elementary school age to women in their older years. It’s the baseline for many conversations and it’s more often than not done without concern for those around them. Think about this: when someone who’s a size 2 says to a friend who’s a size 10 that she feels “fat,” there is an  implication of body-image judgment, regardless of intent or level of self-esteem of the person hearing the comment. As soon as we start adding to the ever-present dialogue that one body type is somehow better than another, we inadvertently fuel the fire of low self-esteem and negative body image. In fact, when asked about the consequences of fat talk, Elizabeth Easton, PsyD and clinical director of child and adolescent services at the Eating Recovery Center says, “Negative body image is an easy hook for individuals who struggle with self-esteem or identity to latch onto as a way to feel more confident and even accepted by others.” Fat talk is damaging, no matter how you look at it.

Parents play a huge part in this as both contributors and as allies in our efforts to combat this type of language. We need to be mindful of what we say about ourselves, letting go of the delusion that we are “just talking about ourselves,” because in the eyes of an impressionable young girl or boy, the negative impact is very real. We are our kids’ first teachers, and if we teach them to hate themselves because of our own perceived weight problem, we potentially create a lifetime of body-image issues that can translate into disordered eating and/or eating disorders. I’ll never forget the kindergartener at my son’s school who burst into tears during a dress rehearsal because her costume made her look fat  (she was playing Toto!); or the 8-year-old who won’t eat because she’s afraid she might get fat. Neither of these kids have a weight problem: rather, they have a perception problem brought on by the fear-inducing commentary from their parents, peers, and media. Fat talk is a real issue and one we need to ardently address. There are some very real consequences to this constant barrage of body bashing, and it shows in these eating-disorder statistics from NEDA:

  • In the US, as many as 10 million females and 1 million males are struggling with an eating disorder such as anorexia or bulimia;
  • 80% of American women are dissatisfied with their appearance;
  • The mortality rate for 15- 20-year-old  females who suffer from anorexia is 12 times the death rate of all other causes of death;
  • Anorexia has the highest premature fatality rate of any mental illness;
  • 40% of newly identified cases of anorexia are girls 15-19;
  • 54%  of women would rather be hit by a truck than be fat;
  • 81% of 10 year olds are afraid of being fat (Mellin et al., 1991).
  • 42% of 1st-3rd grade girls want to be thinner (Collins, 1991).
  • 67% of women 15-64 withdraw from life-engaging activities like giving an opinion, going to school, and going to the doctor because they feel badly about their looks;
  • Most fashion models are thinner than 98% of most American women (Smolak, 1996);
  • Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives (Neumark-Sztainer, 2005);
  • 46% of 9-11 year-olds are “sometimes” or “very often” on diets, and 82% of their families are “sometimes” or “very often” on diets (Gustafson-Larson & Terry, 1992);
  • 91% of women recently surveyed on a college campus had attempted to control their weight through dieting, 22% dieted “often” or “always” (Kurth et al., 1995);
  • 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full syndrome eating disorders (Shisslak & Crago, 1995);
  • 25% of American men and 45% of American women are on a diet on any given day (Smolak, 1996).

Next time you wonder if you look fat in your outfit, or feel compelled to use body bashing as a conversation starter, name 3 things that are positive about yourself. Challenge yourself to be kinder to YOU so you can affect positive change on those around you. You’re worth it.

For more information on eating disorders:

National Eating Disorders Association’s Information and Referral Helpline: 1-800-931-2237  | www.NationalEatingDisorders.org

References for aforementioned Statistics as documented at NEDA:

Collins, M.E. (1991). Body figure perceptions and preferences among pre-adolescent children. International Journal of Eating Disorders, 199-208.

Crowther, J.H., Wolf, E.M., & Sherwood, N. (1992). Epidemiology of bulimia nervosa. In M. Crowther, D.L. Tennenbaum. S.E. Hobfoll, & M.A.P. Stephens (Eds.). The Etiology of Bulimia Nervosa: The Individual and Familial Context (pp. 1-26) Washington, D.C.: Taylor & Francis.

Fairburn, C.G., Hay, P.J., & Welch, S.L. (1993). Binge eating and bulimia nervosa: Distribution and determinants.

In C.G. Fairburn & G.T. Wilson, (Eds.), Binge Eating: Nature, Assessment, and Treatment (pp. 123-143). New York: Guilford.

Gordon, R.A. (1990). Anorexia and Bulimia: Anatomy of a Social Epidemic. New York: Blackwell.

Grodstein, F., Levine, R., Spencer, T., Colditz, G.A., Stampfer, M. J. (1996). Three-year follow-up of participants in a commercial weight loss program: can you keep it off? Archives of Internal Medicine. 156 (12), 1302.

Gustafson-Larson, A.M., & Terry, R.D. (1992). Weight-related behaviors and concerns of fourth-grade children. Journal of American Dietetic Association, 818-822.

Hoek, H.W. (1995). The distribution of eating disorders. In K.D. Brownell & C.G. Fairburn (Eds.) Eating Disorders and Obesity: A Comprehensive Handbook (pp. 207-211). New York: Guilford.

Hoek, H.W., & van Hoeken, D. (2003). Review of the prevalence and incidence of eating  disorders. International Journal of Eating Disorders, 383-396.

Mellin, L., McNutt, S., Hu, Y., Schreiber, G.B., Crawford, P., & Obarzanek, E. (1991). A     longitudinal study of the dietary practices of black and white girls 9 and 10 years old at enrollment: The NHLBI growth and health study. Journal of Adolescent Health, 27-37.

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https://www.nih.gov/news/fundingresearchareas.htm

Neumark-Sztainer, D. (2005). I’m, Like, SO Fat!. New York: The Guilford Press. pp. 5.

Shisslak, C.M., Crago, M., & Estes, L.S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18 (3), 209-219.

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Categories
Body Image Eating Disorders Mental Health

Graduation: Europe or Lipo?

“Kid, you’ll move mountains!
So…be your name Buxbaum or Bixby or Bray or Mordecai Ale Van Allen O’Shea, 
You’re off to Great Places!
Today is your day!
Your mountain is waiting.
So…get on your way!” – Dr. Seuss
Image by MarinaCr via Flickr

Certainly, for some teens, plastic surgery can be positively life-changing. For example: a child who’s subject to excessive teasing because of an inordinately large nose may positively benefit from rhinoplasty; a burn victim can return to relative normalcy with appropriate plastic surgery; a breast reduction can allow a young girl to exercise without neck and back pain. On the other hand, what lies beyond what’s necessary for some is the skewed perceptions of beauty and perceived normalcy inadvertently thrust upon teens through social and mainstream media.  The innate dissatisfaction with how we look contributes to how we meet the world. To really illustrate this, we can look at the recent uproar that came about when a mother defended her decision to give her 8-year-old daughter Botox injections. Makes you wonder: What 8-year-old has wrinkles? Better yet, what 8-year-old is even aware of wrinkles?


 
“Statistics gathered over the last several years indicate a decrease in the overall number of cosmetic (aesthetic) surgeries of teenagers (those 18 and younger) having cosmetic surgery, with nonsurgical procedures including laser hair removal and chemical peels being the most popular in 2010.”

These statistics are both good and bad. I mean, the fact that less invasive surgeries are on the decline is certainly positive, but I am concerned about the remaining high numbers of girls seeking these procedures.  We know teens are up against extraordinary pressure to look and be a certain way–some of it is normal adolescence–but when parents start giving their kids gift certificates for a new nose or new breasts, the lesson becomes less about self-esteem and more about trying to attain the pop-culture paradigm of perfection.

So, what does this mean from a recovery standpoint?  Well, if we start by parenting our children with this idea that they aren’t enough, we end up sowing the seeds of self-hatred and dissatisfaction. Instead of laying a foundation of confidence and positive self-esteem, we end up paving a rocky road to addictive behaviors, which inevitably contributes to disordered eating and eating disorders alike. There’s no reason why this can’t be a springboard to have a heart-to-heart with your teen. It’s also an opportunity to look at what messages we are trying to give our kids. Being a teen is tough; let’s not contribute to the social tyranny by fanning the fires of social awkwardness. This too shall pass.

Bottom line? There are far more appropriate gifts for your teen than going under anesthesia and accumulating scars, no matter how small they are.  

Links that may be of interest:
Categories
Body Image Eating Disorders Mental Health Recovery Therapy

Starving at 8

image © sarit photography

I know an 8-year-old who’s been known to choose an outfit specifically because it makes her “look thin.” This same 8-year-old often doesn’t finish meals because she thinks she’s fat. She’s the same 8-year-old that has begun to develop food rituals, often leaving the table with a reorganized plate full of uneaten food. Simply put, she already has an irrational fear of getting fat.
It’s hard being a girl. It’s hard to find a way to look at your unique self without comparing it with images of Barbie or Bratz. It’s hard to accept that  the beauty standard set by Cinderella or Sleeping Beauty isn’t actually real. But children, whose minds are filled with wonderful imagination and fantasy, aren’t going to cognitively recognize images that are potentially harmful. Instead, many will attempt to achieve the pink, thin, fluffiness of a Disney princess, or the skinny sass of a Bratz doll. Often times, even when parents are encouraging a healthy body image, the education on the school yard has a dramatically different lesson plan than the one from home. I’ve overheard conversations on the school yard that have made me pause – -it’s clear that body-image issues are in abundance and the pressure to look thin and svelte is invasive and intense.

So what can parents do? Start with eliminating the shame game. This might mean letting your daughter dump that maple syrup on her pancakes or having a cupcake at a birthday party. It’s a treat, not a vehicle for punishment!  Encourage healthy eating, but can you do it with compassion rather than the mallet of criticism?  Eliminate “fat talk”: your kids don’t need to hear it and frankly, it’s not good for you either. Stop trying to control what those around you eat. It’s not your job!  I’ve seen dads controlling the food intake of their wives and daughters to the point of devastating eating disorders (my dad was one!); and I’ve seen moms spewing “fat talk” or signing up for any and every diet fad while their daughters learn to eat in secret or restrict because they’re terrified of the incendiary reaction of their parental food monitors. These behaviors certainly don’t encourage self-love. If anything, they sow the seeds of self-destruction.

If you’re worried that your son or daughter might be developing an eating disorder (note: boys are not immune to this!), look out for some of these signs.

(Please note, certain behaviors are warning signs, but in combination and over time, they can become quite serious):

Behaviors specific to anorexia:

  • Major weight loss (weighs 85% of normal weight for height or less)
  • Skips meals, always has an excuse for not eating (ill, just ate with a friend, stressed-out, not hungry).
  • Refuses to eat in front of others
  • Selects only low fat items with low nutrient levels, such as lettuce, tomatoes, and sprouts.
  • Reads food labels religiously; worried about calories and fat grams in foods.
  • Eats very small portions of foods
  • Becomes revolted by former favorite foods, such as desserts, red meats, potatoes
  • May help with meal shopping and preparation, but doesn’t eat with family
  • Eats in ritualistic ways, such as cutting food into small pieces or pushing food around plate
  • Lies about how much food was eaten
  • Has fears about weight gain and obesity, obsesses about clothing size. Complains about being fat, when in truth it is not so
  • Inspects image in mirror frequently, weighs self frequently
  • Exercises excessively and compulsively
  • May wear baggy clothing or many layers of clothing to hide weight loss and to stay warm
  • May become moody and irritable or have trouble concentrating. Denies that anything is wrong
  • May harm self with cutting or burning
  • Evidence of discarded packaging for diet pills, laxatives, or diuretics (water pills)
  • Stops menstruating
  • Has dry skin and hair, may have a growth of fine hair over body
  • May faint or feel dizzy frequently

Behaviors specific to bulimia

  • Preoccupation or anxiety about weight and shape
  • Disappearance of large quantities of food
  • Excuses self to go to the bathroom immediately after meals
  • Evidence of discarded packaging for laxatives, diuretics, enemas
  • May exercise compulsively
  • May skip meals at times
  • Teeth may develop cavities or enamel erosion
  • Broken blood vessels in the eyes from self-induced vomiting
  • Swollen salivary glands (swelling under the chin)
  • Calluses across the joints of the fingers from self-induced vomiting
  • May be evidence of alcohol or drug abuse, including steroid use
  • Possible self-harm behaviors, including cutting and burning

If you notice even one of these, it’s time to address it. Talk to your daughter or son, talk to your doctor. If necessary, elicit the help of a treatment facility. In other words: Get help. Showing our kids that we care and are willing to stop our own negative behaviors in order to help them is invaluable. It’s a family problem, not an individual one.

Some helpful links:

NEDA
WebMD
Voice in Recovery
Peggy Orenstein
maudsleyparents.org
Also, check out “Brave Girl Eating: A Family’s Struggle With Anorexia” By Harriet Brown