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Mental Health Recovery Trauma Treatment

In Recovery, We Lean In to Let Go

Being in recovery from mental illness, substance abuse, alcoholism, eating disorders, behavioral issues, et cetera, require that we lean into some things that make us uncomfortable. Let me tell you, “leaning in” isn’t easy. Our brains like pleasure and revile pain. In fact, finding ourselves in rehab tells us that our habitual patterns of trying to put an elementary salve on a gushing wound weren’t working very well. It means that drinking, drugging, stealing or lying our way out of our feelings doesn’t work — at least not permanently. Frankly, none of these “solutions” ever work. Not in the long or short term.

By suggesting that we lean into our difficulties instead of leaning away, I am asking for you to embrace your courage. I am also asking you to trust in your exemplary clinical team, your support team, and in your own ability to do this difficult work while you are in treatment and beyond. Positive thinking or praying for it all to magically go away are both examples of temporary, feel-good actions that don’t provide a long-term solution. It’s wise to also recognize that the recovery process often requires legitimate, clinically supported psychological care.

Recovery is about change. It’s about shifting perspectives and learning how to redefine and revise old paradigms in order to create healthy ones. When we face our old thought patterns and old ideals, we offer ourselves the opportunity to let go. We often find ourselves able to walk through our issues not around them, recognizing that while they are present, ready and willing to make us miserable, we don’t have to take the bait. When we begin to look at our issues with some awareness and compassion, their negative influence has a chance to dissipate.

Our ability to recognize the negative for what it is allows us to invite the positive experiences and influences into our lives. In our recent blog, “How do You Stay Motivated,” I quoted Dr. Rick Hanson, Ph.D., who addresses this very thing: “The remedy is not to suppress negative experiences; when they happen, they happen. Rather, it is to foster positive experiences – and in particular, take them in so they become a permanent part of you.”

Negative experiences do not have to own us; in fact, they can be part of the landscape without being part of our foundations.  This is emblematic of recovery.

The process of recovery is not something you have to do alone. In fact, you can’t. There are support groups, clinicians, treatment facilities, therapists, et cetera, as available resources to you. Yes, there are things you may have to face and work through, but coming to an understanding that you don’t have to ride through that storm alone is a welcome relief.

Categories
Eating Disorders Mental Health Recovery

Eating Disorder Awareness Week: Insight From Michelle Gross, MA, LMFT

Continuing our week of honoring Eating Disorder Awareness Week, I spoke to Visions’ Michelle Gross, MA, LMFT who has specialized in the treatment of eating disorders for over 18 years. Her passion is in treating the eating disorder community both individuals, and their families. Eating Disorder Awareness is something we encourage and support via groups, individualized therapy, and nutritional support. I asked Michelle for some insight into what she tells families with a loved one who is suffering from an eating disorder or disordered eating behaviors. She says,

 

“When assisting a family who have just learned that their loved one is suffering from an eating disorder, I want them to know that eating disorders are a coping mechanism that tend to occur in individuals who suffer from anxiety and/or depression. Eating disorders numb pain (overeating), release feelings (purging), and create a feeling of control (counting calories). Eating disorders, although not always identical in form, tend to run in families. Family members need to know that the way in which they respond to their loved one is critical to the recovery process; however, they are not responsible for the development of the eating disorder itself. Eating disorders are an illness. Eating disorders are not about weight.”

 

Families who are confronted with this issue have to re-learn how to communicate with each other in a non-triggering way. I recently had to have a discussion with someone about their perpetual food talk and how triggering it was. Every meal was punctuated with negative commentary about weight gain, etc. So, eating with this person was becoming treacherous. Michelle Gross has wonderful insight and suggestions for situations just like this:

 

“It is important for family and friends to know how to be supportive. Unfortunately, the best of intentions to assist the eating disordered individual tend to backfire. Telling an anorexic that recently gained weight: ‘You look so much healthier,’ is easily misconstrued as being told one is ‘fat.’  Attempts to make sure an anorexic eats or a bulimic does not purge, create feelings of powerlessness that intensify the desire to feel in control by minimizing calories or purging.  Innocently mentioning one’s own need to lose weight or recently enjoying a vigorous workout, leave the eating disordered individual feeling inadequate and more dissatisfied with herself.  Loved one’s need to learn the ‘language’ spoken by the eating disordered individuals. Eating disorders are competitive.”

 

And what about triggers? Remember, what triggers one person may not trigger another, but some things are similar across the board. Michelle provides some salient advice here. If we begin to understand the psychological mechanisms of the eating disorder, our awareness and ability to support someone who is suffering increases. By opening our eyes, we can be supportive without judging the individual.

 

Michelle tells us that, “Family and friends also need to learn what triggers or intensifies eating disordered thoughts and behaviors.  Shopping for clothes, going to restaurants, exercising to reduce stress, can all intensify the eating disorder.  Eating disorders are reactive. The more one learns how their loved one’s eating triggers them, the more helpful one can be.”

 

Recovery is a family process, and that includes recovery from substance abuse, mental illness, eating disorders, or processing disorders. Treatment must include all facets of the family system. Learning how to do this is a process and a practice; and as Michelle illustrates, it is not one-sided affair:

 

“It is extremely valuable for family members to be part of the treatment.  Family sessions in addition to the individual therapy offers all members the opportunity to learn how to be supportive, to share concerns in a controlled environment, and gives the eating disordered individual an opportunity to express their feelings in an appropriate way vs. through the eating disordered behaviors.”

 

We need to unite as a recovery community, championing Eating Disorder Awareness Week and encouraging others to do the same. We can facilitate supportive environments and spaces for healing so those suffering from an eating disorder can begin to recover and find freedom from the devastating anguish caused by their eating disorders.

Categories
Body Image Eating Disorders Events Mental Health Recovery Teen Activism

Eating Disorder Awareness Week: Visions’ Stefanie Boone, MS, RD Shares Insight

It’s National Eating Disorder Association‘s Eating Disorder Awareness Week

often referred to as EDAW. I asked Stefanie Boone, MS, RD, to provide some insights and tips on what an eating disorder is, what is is not, and ways in which you can be supportive. This year’s EDAW theme is “I had no idea.” We are grateful to have Stefanie as part of the Visions family:

When I see parents, friends, or significant others trying to support their loved one with an eating disorder, my heart goes out to them. Besides feeling guilty (is this my fault?), worried (will he or she be OK?), and overwhelmed, they are often at loss around how to be helpful. Friends, family, and community need education around the following concepts:

–       That an eating disorder is really a symptom of deeper underlying issues;

–       That their loved one cannot just simply stop the behavior;

–       Certain things you may think would be supportive can actually make things worse;

–       That their own talk and behavior around food, diet, and being dissatisfied with their own bodies have and will continue to affect  their children or loved one;

–       That the sports team their child is a part of may actually be feeding into their ED.

My top five tips for those who want to be supportive are:

1. If you are trying to get your loved one to seek help, take a loving and non-judgmental stance with your loved one. An eating disorder is a mental illness, and requires professional help. Express your concern from a loving place.  Share how the ED is impacting you and your family.

2. If you are supporting an adult (spouse, parent, adult child) – do not be the food police. This is usually not helpful. With children and teens parents may need to be more involved – your child’s treatment team will guide you.

3. Be a positive role model – even if you do have your own opinions about food and even if you think you are “fat”, you need to stop sharing these thoughts and comments with your loved one.
And NEVER comment on how your loved looks – this is a very sensitive area and often a completely innocent comment such as “you look great” can be twisted into “is she saying I look fat?”

4. If your child is on a team sport, contact the coach – get more information as to what he/she is advising your children around food and exercise. Your child will most likely need to discontinue this sport at least temporarily while in recovery.

5. If you are a teen and have a friend you are worried about, talk to an adult about it immediately– teacher, school counselor, parents. I know this may be hard, but you may be saving your friend’s life.

 

Eating Disorder Awareness Week begins TODAY: 2/23-3/1. Please share your experience, strength and hope this week, using the hashtag #EDAW14. You never know who you’re helping or who might “hear” you for the first time.

Links to Check out:

How much DO you know? Take the NEDA QUIZ.

Proud2BMe Teen activist guide

Download NEDA’s Key Messages HERE and let others know why you’re participating.

 

Categories
Addiction Eating Disorders Recovery Smoking

Eating Disorders: Using Smoking As Weight Control

Smoking cigarettes in adolescence has always been considered a pathway to coolness, or a way to fit in. For a time, smoking began to be considered passé, but amongst teens in recovery, it still holds the mythical status of cool and is often key to fitting in. So much so, kids who want to quit or who don’t really want to smoke may even start smoking E-cigarettes in an attempt to reach the same level of cool. (It is just vapor, right?). I digress. For girls who smoke, there may be another reason behind the nasty habit: presumed thinness, or a path to thinness. Some assume that smoking is also the answer to hunger pains and subconsciously satisfy (albeit temporarily) the desire for food.

 

In their working paper titled “The Demand for Cigarettes as Derived from the Demand for Weight Control,” Stephanie Von Kinke Kessler Scholder and John Cawley found that “among teenagers who smoke frequently, 46% of girls and 30% of boys are smoking in part to control their weight.” We see this behavior all the time within our recovery community, particular among those suffering from and beginning to recover from eating disorders. For some, the idea is that it’s far easier to go smoke than to eat lunch. We are highly aware of this predilection amongst our eating disorder population and we take great measures to stop these behaviors in their tracks. Some of which include supervised meals and several focus groups dedicated to eating disorder recovery.

 

But what about someone struggling with an eating disorder who is not in the safe, healing environment of a treatment facility? What if they are on their own, doing the dance of recovery solely through meetings and fellowship? Will they notice their use of cigarettes to stifle hunger pains? More than likely, they will not. I remember being new and bragging that I was surviving on a diet of coffee and cigarettes, ever chasing the goal of “perfection.” At the same time, I also had a raging eating disorder, consuming my thinking and vision. I was clueless. It took me years to learn to recognize that smoking was a key to assisting me in my process of acquiring thinness.  In fact, one of the fears when I quit smoking was the presumed assurance of weight gain.

 

As always, one of the first steps to recovery is asking for help. This is not a feat that comes naturally to an addict or alcoholic. We are accustomed to “doing it all ourselves.” Still, going to meetings, getting a sponsor, finding a therapist, all of these things can help us begin the healing process. Beginning the process of digging deeply and getting to the root cause of whatever is causing you to harm yourself with addiction, starvation or binging, or binging and purging is crucial. We cannot recover alone, nor can we stop the insanity of our addictions without asking for help.

Categories
Body Image Eating Disorders Recovery

Body Image and You: Stand Up to Your Inner Voice

#EDAW13 #LoveMore

In honor of NEDA‘s annual Eating Disorder Awareness Week or EDAW, I had the opportunity to speak about body image and photography at Cal State Northridge. Conversation is a huge part of my photographic process and a key component in working with people.  It’s not uncommon for me to hear self-deprecating commentary from photography clients about their perceived weight issues, body expectations, body shape, size, imperfections, et cetera. We are never exactly where we think we should be, right? In those moments where we are particularly vulnerable (in front of a camera, for example), why wouldn’t we talk about how insecure we might feel? After all, we are inundated with manufactured “perfection” in advertising and media on a daily basis. I find it an honor and privilege to have the opportunity to use these moments to be of service as a body image advocate to honor whomever I’m photographing in order to create a creative partnership. In those moments, we can quiet that angry inner voice of delusion.

 

Recovery asks us to be of service. In my own recovery, I try and bring the energy of service work into everything I do: to love others, even when loving them is difficult. To love myself, regardless of my own perceived imperfections. Eating disorders and disordered eating both have this in common: body image issues. If anything, it is a side effect of being a human being in a visually saturated world, but it doesn’t have to become a necessary evil. There is a way to challenge the negative body image messages we encounter in our everyday lives. Changing your body image means changing the way you think about your body.

 

Start from within:

When you wake up, set an intention to say 3 nice things to yourself throughout the day. Write those things on post-its if you need to and stick them where you won’t miss them.

 

Change negative perceptions to those of acceptance and positivity

Silence your inner critic. Begin to recognize that A: you are not your thoughts,

and B: feelings aren’t facts.

When you hear that negative self-talk revving its engine, try and counteract it with a positive comment.

 

How do we learn to love ourselves when what we see is distorted?

We see reflections of ourselves wherever we go: shop windows, bathroom mirrors, dressing rooms, elevator doors, brass coverings, and random reflective surfaces. Our reflections are everywhere, but are they really a true reflection of us? Most often, they are not.  Many professionals are talking about “Mirror Fasting.” In this practice, you are asked to “fast” from looking at your reflection.

Try this: Make a decision to stop looking at your reflection for a day. See how you feel. Add another day. See how you feel. Women and men who do this tend to have an increase in self-esteem, and a more positive image of their bodies. What we see is not always reality when it comes to mirrors; when we suffer from body dysmorphia, what we see really becomes skewed. Kjerstin Gruys, a 29-year-old sociology graduate student documented her yearlong Mirror Fast in her blog, Mirror Mirror…Off the Wall. In that process, she learned to love her body. I’m not asking you to skip mirrors for a year, but perhaps trying it out for day or a week, noting the emotional effects would be beneficial.

 

Body image issues are something many of us face. Even in recovery, even knowing what we know about the negative factors behind a poor image of self, we struggle. But with what we know, we have to find the temerity to stand up to that inner bully and put a stop to the barrage of self-deprecating chatter. Today, I stood up to that voice and looked in the mirror and said, “You are magnificent.” It felt incredible.

Helpful reads:

How Yoga Changed My Mind (And My Relationship to my Body) by Melanie Klein

Starving for Connection by Chelsea Roff

Voice in Recovery

Categories
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
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.

National Institutes of Health. (2005). Retrieved November 7, 2005, from
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.

Smolak, L. (1996). National Eating Disorders Association/Next Door Neighbors Puppet Guide Book.

Sullivan, P. (1995). American Journal of Psychiatry, 152 (7), 1073-1074.