The Center for Eating Disorders Blog

Adventures in Self-Care with Melissa Fabello, Part II

 

MF 003
In honor of National Eating Disorders Awareness Week 2016 (Feb. 21-27), we asked body acceptance activist and eating disorder recovery advocate, Melissa Fabello to share her thoughts on some essential eating disorder awareness topics.  If you missed it, you can find her thoughts on self-care, perfectionism and dieting in Part I.

Below, in part II she opens the door to important conversations about body neutrality and intersectionality, and she also shares the one thing she wants people struggling with eating disorders to know about recovery.

 


Q & A with MELISSA FABELLO: Part II

 

Q: You recently wrote an awesome list of 50 body acceptance resolutions for 2016. In that list you introduce body neutrality as an alternative goal when body positivity feels like too much pressure. What did you mean by that?

MF: There are so many aims of the body acceptance or body positivity movement that I love. I have found so much comfort, joy, and support within those communities, and I am forever grateful to them for that. I’ve also found some missteps that I think need correcting, one of which being the push for everyone to feel beautiful and to love their bodies. I think that’s a lovely goal, and I also think it’s too lofty for reality.

Because the truth is that no one loves their body every single day – no one. Part of how body image works is that it can shift and that we all have good days, and we all have bad days. Mostly, when we have healthy body image, we simply see our body for what it is without ascribing any meaning to it whatsoever, and we exist, full of acceptance, in that body. To me, that’s what body neutrality is about. It’s about acknowledging and accepting our body as is, rather than pushing ourselves to have extreme feelings about it either way.

And I like to think of it as an option – not an alternative to the mainstream body acceptance movement. I like to think of it as something that someone can choose to work toward, if that goal feels more realistic than one of unconditional love. Perhaps, even, I like to think of it as a stop on the train toward a more loving relationship with our bodies. I just think that pushing people to love their bodies can backfire if it creates another standard to live up to.

 

Q: In all of your writing and in advocating for individuals with eating disorders, you take great care to acknowledge the true diversity of those who are impacted. From gender to age to race and socioeconomic status, why is it so important to you to highlight these marginalized voices in your work?

MF: Intersectionality – the understanding that intersecting social identities exist, a term that was coined by Kimberlé Crenshaw – is an absolute must in any and all work, I believe, but especially in work that stems from feminism. The ways in which we’re impacted by society differ, based on our identities. As a queer woman, for example, I experience life differently than a straight woman or a queer man. As a white woman, I experience life differently than a woman of color or a white man. Our positionality within the complicated web of identity matters because it affects how we move through this world. This is true in regards to body image and eating disorders, too.

We talk a lot about the thin ideal in our work – and that’s a very real, valid concern. We talk less, though, about how our beauty ideals are also centered on whiteness, on a heteronormative idea of gender roles, on access to money, on youth, and many other intersections. The further that we get away from the ideal, the more suffering we may experience as a result, and the more pressure we may feel to approximate those ideals. And I think that when we center the most marginalized – the people furthest from that ideal – in our work, then we help more people. When our work focuses on white, middle class, cis women, for example, then those are the only people that we help.

The eating disorder field has long focused its efforts on a very specific population, and I think it’s far past time to admit that and to work actively to eradicate the ways that that focus perpetuates systems of oppression like white supremacy and classism, among others. Different voices need to be centered because different 670_06_NEDAW_TWITTER_01_2016_P12experiences exist and have been ignored.

 

Q: Who do you think could benefit from attending your presentation, Adventures in Self-Care: Everyday strategies for nurturing an imperfect recovery in the real world?

MF: I think that anyone could, honestly! It’s been my experience that conversations around self-care can be difficult to have because so few people practice it. I’m going to talk a lot about what self-care means and why it’s important, but I’m also going to give ideas on how to start cultivating more self-care practices in your life – in ways that are easy and practical. I think that anyone who feels like sometimes life is overwhelming and they need some “me” time could benefit from this conversation – and isn’t that everyone?

 

Q: Lastly, what is the one thing you would want to tell someone who is struggling with an eating disorder and may be feeling ambivalent, hopeless, overwhelmed by or resistant to the prospect of recovery?

MF: I want them to know that those are very real and valid feelings to have. I want them to know that we’ve all come up against that at some point or another. And I want them to know that one of the biggest obstacles to recovery is believing that it’s one huge accomplishment that looks a certain way. It’s not. Recovery is about a whole bunch of tiny successes that lead you to a healthier, happier place – defined by you. Recovery is in your reach because you get to decide what it looks like and how to get there. But first, you need to take the first step of believing (even skeptically!) that it’s a possibility. And it is. I promise you that it is.

 

Continue the conversation with us on Facebook and Twitter using the hashtag #bmoreselfcare. 


Many thanks to Melissa Fabello for taking the time to share her passionate and thoughtful responses. If you’d like to hear more from Melissa, join us in Baltimore on February 21 to help kick-off National Eating Disorders Awareness Week. Don’t forget to RSVP. Space is limited. 

Download an Event Flyer to share or post:
Adventures in Self-Care…Everyday strategies for nurturing an imperfect recovery in the real world (PDF)

You can find Part I of our Q&A with Melissa here.

 



 

Adventures in Self-Care with Melissa Fabello: Part 1

 

If you’ve ever seen one of her YouTube videos than you probably already know Melissa Fabello is a talented and passionate activist.  She also writes boldly and beautifully about eating disorder recovery, body image, diet culture and a host of other important issues. In advance of National Eating Disorders Awareness Week and her presentation in Baltimore on February 21, we asked Melissa to share her thoughts on why self-care is not self-ish, the intersection of eating disorders and perfectionism, and her experience with recovery in a society obsessed with dieting.  We are honored to share her responses with you below.

 

 


Q&A with MelissA Fabello – Part I

 

Q: A lot of people assume self-care to be synonymous with personal hygiene or the daily chores of living. This can sound like a pretty boring topic. Given that you will be in Baltimore on February 21 to discuss the Adventures in Self-Care as part of National Eating Disorders Awareness Week, can you explain more about what self-care really is and why it’s something we should be talking about?

MF: To start, I would actually argue that self-care should, indeed, be a daily chore of living. It should be an intentional practice that we partake in – every single day – in order to take care of ourselves. It really can be as simple as getting the right amount of sleep, drinking enough water, or eating a meal that fuels your body. It’s finding ways to insert self-care into those daily chores of living, which in turn, creates a life that may feel a bit more adventurous.

And when I say “adventurous,” I don’t necessarily mean thrill-seeking, but rather, simply, more livable. And what is more of an adventure than life itself? Self-care puts you in the position to live life more fully and to experience it more broadly because it cultivates your self-awareness and forces you to consider what makes you the happiest.


Self-care, really, is just any set of practices that are nourishing to you – physically, emotionally, and spiritually. Those practices can be preventative (like taking care of your physiological and mental health needs to the best of your ability every day), and they can also be intervention methods (think: calling out sick just to spend the day taking a bubble bath and reading novels). But the point is that they are necessary to all of our lives, but especially necessary when we’re in eating disorder recovery.

 

Q: We often hear from patients who fear that engaging in self-care is a selfish act. How would you respond to someone worried about being, or being perceived as, selfish?

MF: That’s a real concern, and it needs to be validated as such. We live in a culture that’s driven by capitalism, and the number one value held by capitalism is that of productivity. Have you ever slept in because your body needed rest, but then berated yourself for not getting up early enough to start in on your housework? Or have you ever taken a much needed day off to marathon your favorite TV show, but then felt bad that you didn’t work on your school work, even though you hadn’t taken a day off in two weeks? That guilt is the product of believing that our worth is tied up in how productive we are.

670_06_NEDAW_TWITTER_01_2016_P12 This is especially difficult for women. In our society, men are frequently defined by what they do out in the world. Women, though, are judged by how they take care of others. As such, women’s moral development, according to Carol Gilligan, is all about how we understand ourselves in relation to other people. Women, in particular, are taught that taking care of ourselves and putting ourselves first is not only a selfish act, but even an immoral one. And that’s just straight up sexist.


One small shift we can make is to redefine what “productivity” means to us. I have an ex-girlfriend who was a hustler, trying to make it in the music business. As such, every day when we talked, she’d ask me, “What did you do today?” or “What did you accomplish today?” And sometimes that really overwhelmed me – because what if I didn’t “do” or “accomplish” anything? But the truth is that even if what I did that day was laugh while playing with my cat, or if what I accomplished was taking a trip to the bookstore for fun, then I’ve been productive. I’ve produced something: self-care. I think we need to remind ourselves that taking care of ourselves is an accomplishment.

 

Q: Perfectionism is one of several genetic traits that have been identified by research to be associated with an increased risk for the development of eating disorders. From your experience and observation, how does the topic of self-care intersect with tendencies toward perfectionism?

MF: I like to think of myself as a recovering overachiever, although I still fall back into those old habits sometimes. Again, in a culture where we’re taught to value our productivity, it can be hard not to fall into perfectionism as a way to prove our worth. But the truth is that we need to learn to be okay with the fact that none of us is perfect, that we’re all going to make mistakes.

One of the most valuable pieces of self-care advice I’ve received lately is that of learning to be okay with “good enough.” I’m one of those people who, when I give 75%, will feel guilty and ashamed for not giving 100%. What happens that’s interesting, though, is that no one can ever tell that I didn’t give something my all. As far as they can tell, I gave 110% because what I did was absolutely, positively awesome. Learning to be okay with “good enough” means giving something a shot, but not letting it run our lives, and feeling comfortable with the amount of attention that we were able to give something.

Part of self-care is being able to say, “I can’t (or don’t want to) work on this anymore because it’s possible that continuing to do so will damage my mental health. So I’m done now.” And that means letting go of the idea that we – and everything associated with us – has to be perfect.

 

Q: Another risk factor for eating disorders stems from the emotional and physiological consequences of dieting. What other impacts do you see from a culture that markets diets as a valid form of self-care and a path towards self-acceptance?

MF: I’ll be honest: The day that I actively decided to go through weight restoration was the day I realized that I could never be both thinner and happy. I could only ever be one of the two. I could spend every second of every day counting, measuring, and restricting in an attempt to achieve self-acceptance through (what I thought was) self-improvement, or I could attempt to apologize to my body and recreate a healthy relationship with food and within that freedom, find happiness. That concrete realization – that I couldn’t work toward a “better” body and experience day to day happiness – was a huge shift for me.

A spoken word poem that I really love, “When the Fat Girl Gets Skinny” by Blythe Baird, has a line in it that says: “This was the year of eating when I was hungry without punishing myself / And I know it sounds ridiculous, but that sh– is hard.” And it is. It is hard. Because we live in a culture that is so focused on dieting as, like you said, “a valid form of self-care and a path towards self-acceptance” that deciding to go against that grain and to seek validation and happiness from elsewhere is a radical act. And make no mistake: Giving up diet culture is a radical act, both personally and politically. Our culture thrives on making us feel small, weak, and less-than. Rebelling against that pressure, declaring that you will not be contained, and saying “no” to everything that our culture and media want us to believe? That is an incredibly courageous act.

 

Be sure to check out Part II of our discussion with Melissa in which she delves into body image and the concept of intersectionality as it relates to eating disorders.

Join the conversation on Facebook and Twitter using the hashtag #bmoreselfcare. 


MF 006Melissa A. Fabello, M.Ed. is a body acceptance activist, sexuality scholar, and patriarchy smasher based in Philadelphia. She is currently a managing editor of Everyday Feminism, as well as a doctoral candidate at Widener University, working toward a PhD in Human Sexuality Studies. Melissa has worked closely with The National Eating Disorders Association, The Representation Project, and Adios Barbie on campaigns related to body image, eating disorders, and media literacy. Find out more about Melissa and her work at melissafabello.com.

 

 

 

Improving Body Image: 10 things you probably haven’t tried yet

When we make New Year’s resolutions we tend to think about the definition of the word RESOLUTION as “a firm decision to do or not to do something”. However, it might be helpful to remember that resolution can also mean “the act of finding an answer or solution to a conflict”. Perhaps this year, instead of making a firm to decision to change your appearance, you could resolve to decrease the conflict you experience with your body and see where that takes you instead. Below are ten small things you can do right now to help bring you closer to a resolution with your body. Where will you begin?

10 Steps to Improving Your Relationship with your Body#1 – STOP BLAMING YOUR BODY
Remember that negative body image is an ATTITUDE problem, not a BODY problem. Body image is a thought, perspective, idea, and interpretation that you have about your body. Your thoughts are not facts and they can be distorted. The good news is that the thoughts that aren’t working for us can be modified. Write down the phrase “My body image is a THINKING problem, not a BODY problem” and repeat this to yourself throughout the day.

#2 – BE A SCIENTIST
Monitor shape/weight checking behaviors for two days. Try to pick one work/school day and one home day. What are checking behaviors? They include looking in the mirror, looking down at yourself, weighing yourself, watching your reflection in store fronts/windows, measuring parts of your body with your hands, or feeling for certain anatomy to monitor the size of your body. Notice which of these you do, when, how often and in what context. Once you have this data, ask yourself, what am I trying to find out when I check my body? Is it really necessary to check this often? Is my checking biased or is it an objective way to look at my overall shape and weight? Most importantly, is it helping me? Checking behaviors usually are focused on parts of the body you are most uncomfortable with and tend to deepen insecurities. If you determine that it this is how checking is impacting you and that it is not helpful, start experimenting with decreasing these behaviors to see how it changes your thinking, attention and mood. Act like a scientist trying new formulas to see what the result is.

#3 – QUESTION & RE-LABEL “FEELINGS OF FATNESS”
Many people report that they experience “feeling fat.” Next time you experience this, monitor and observe these feelings. Based on your observations, ask yourself if these are in fact feelings or perhaps these are thoughts associated with certain negative mood states (feeling stressed, bored, guilty) or behavioral or physical sensations (i.e feeling full, bloated, hot). If this is the case, each time it happens, remind yourself to re-frame the experience of “feeling fat” and label it more accurately. For example, tell yourself, “I am feeling full right now” instead of “I am feeling fat right now.”

#4 – REDUCE SOCIAL MEDIA EXPOSURE.
It has been shown in research that exposure to many social media outlets can lead to comparison making- in the population at large and also for individuals struggling with eating disorders. Social media can be very difficult for people to stop cold turkey so if the idea of not being “linked in” sounds like too much, identify a goal that is more doable.

  • Reduce Facebook use to only once per day at a specified time.
  • Remove social media apps from your phone or get rid of all pop-up notifications.
  • If you use multiple social media accounts pick one, like Instagram or Twitter, from which to take a month-long vacation.I will not be defined by my body
  • Make every Thursday a social media free day and note differences in how you feel and how you spend your time as compared to the other days.

#5 – CREATE DAILY AFFIRMATIONS
Collect positive body image quotes or mantras that resonate with you. Place them in areas where you spend a lot of time each day – in your car, by your mirror, at your desk. Focus on one or two that are most meaningful to you. You can even send yourself a couple of alerts from your phone throughout the day as reminders of your positive affirmation. Change your affirmation when you feel the need to mix things up. (Remember, if the idea of loving your body feels too overwhelming as a goal, positive body image mantras don’t have to include messages of complete body adoration. They can, simply focus on body acceptance or even body neutrality.)

#6 – PARTICIPATE IN A JOYFUL MOVEMENT ACTIVITY
Engage in physical activities that interest you and in no way relate to changing your body weight or shape. These activities will be different for everyone based on your own thoughts and preferences. You might need to experiment to find an activity that you can participate in where negative body thoughts aren’t activated. Examples include nature walks, meditative stretching, getting a massage, playing dodge ball on a community team, dancing, or even swinging with your kids on the playground.

#7 – CHALLENGE ONE ASSUMPTION
Our assumptions about beauty and appearance are based on a variety of personal influences but can include society, family, peers, early learning experiences or culture. Examples of assumptions include physically attractive people have it all. If I could look as I wish, my life would be much happier. One’s outward appearance is a sign of the inner person. Pick just one of your assumptions and identify rational thoughts that dispute the assumption. Ask yourself what experiences you have had in your life or that you have noticed others having that do not align with these assumptions all of the time. In other words, work to disprove your own unhealthy theories.

#8 – BE AN ADVOCATE.
If you are trying to shift your own perspective from negative body image to positive body image you might want to start by telling others about body acceptance and working to promote change on a community level. Speak out against photoshopped adsCognitive dissonance refers to a situation in which someone holds attitudes, beliefs, or behaviors that contradict one another. Leon Festinger’s cognitive dissonance theory suggests that it’s uncomfortable for us to be in s by writing to an editor. Talk to your kids about the functionality of their bodies being more important than weight or size. Tell your friends about the negative consequences of dieting. When you do these things, you are creating cognitive dissonance. Research shows this is helpful in bringing your own thoughts and behaviors into alignment with your new positive message to others. (And yes, it’s totally okay if you aren’t sure that you completely believe everything you’re advocating for yet. You’ll get there.)

#9 – GET UNCOMFORTABLE.
When we make changes in life, usually our anxiety goes up before it starts to decrease. Challenging negative body image causes a great deal of discomfort for most people. Oftentimes this discomfort or anxiety can cause individuals to prefer to avoid working on the issue. That being said, the most effective strategy for working to decrease the effect of fear in our lives is to face our fears. (In therapy, this is called exposure therapy.) So remember that if you are feeling uncomfortable during these challenges, it probably means that the work is working.

#10 – ASK FOR HELP
Choose one or more of the above challenges. If you are able to do it and tolerate your discomfort, it would be worth it to try again, and again and again. If you aren’t able to bear the anxiety of it or your negative body image thoughts are getting in the way of living your life, give yourself the gift of help. Reach out to a trusted friend or family member, find a support group and/or call a therapist to set up an appointment. It really is possible to live without body hatred and all-consuming thoughts about weight but it often requires skills and input from other people. This in itself can be uncomfortable, but when you look back on this decision from a place of self-acceptance and body positivity you’ll be glad you didn’t avoid it any longer.


Do you have questions about treatment for negative body image or eating disorders? Call us at (410) 938-5252 or email Eatingdisorderinfo@sheppardpratt.org.
This post was written by Laura Sproch, PhD., Research Coordinator & Outpatient Therapist at The Center for Eating Disorders at Sheppard Pratt

 
 
 

Simple solutions for holiday (and everyday) conversations about food and weight


dining room
As we head into the holidays, it can be helpful to have a very simple plan for responding to family and friends drawn to the very topics that may be most troubling during recovery from an eating disorder.  Depending on how you spend your Thanksgiving this year, one or all of these suggestions may come in handy when the conversation takes a turn toward triggering language regarding bodies, food or weight.


Step 1:
Obstruct or change the conversation if you notice someone is heading into a discussion that makes you uncomfortable.

Remember people generally like to talk about themselves and their interests. If Aunt Marie is pressuring everyone to eat more pie or is gushing over a family member’s weight loss, use that as an opportunity to reflect the attention back to her. So who taught you how to bake? What are you up to at work Aunt Marie? How was that vacation you went on?

If you’re comfortable staying on the topic but exerting your power into the conversation you could try something like this: I’ve actually been learning a lot about how weight is not a good determinant of overall health. I’m focusing on my work-life balance and healthier ways to deal with stress. I’m thinking about meditation…have you ever tried it?


Step 2: Set boundaries
if someone continues to target you with questions or comments about your body or what you’re eating.

Here are some simple examples with varying levels of intensity.  You can choose which ones you think would work well for you, or create your own.

  • I try not to get involved in discussions about dieting and weight loss.
  • I’d prefer not to talk about my weight today.
  • I am so happy to be here with everyone, I don’t want to waste our time together talking about food/weight.
  • Please don’t comment on my body.
  • Let’s find something else to do or talk about.
  • I’d much rather tell you about school / work / hobby
  • It’s really stressful to me when people make comments about what I’m eating.
  • It’s actually not helpful for me to talk about calories or exercise.
  • I’m choosing to focus on other things this year.
  • It is not beneficial for me to feel badly about my body or guilty about what I ate.

The great thing about practicing these responses with other people is that you’ll be more likely to use them when struggling with negative self-talk or eating disorder thoughts in your own head too.


Step 3:
Step away & seek support.

If stressors persist or you find you just need a break from the crowd, locate your holiday ally or text a friend. Take some time to vent about what’s bothering you, take 3 very deep breaths, and then re-focus on the positive parts of the day.  Sounds simple but it can make a big difference.

You are deserving of a happy and healthy holiday. How you choose to create that is up to you.  Just remember that one insensitive comment from one person does not have to ruin your entire Thanksgiving. At anytime, you can choose to re-engage in both the celebration and your recovery.

*     *     *

Read more about healthy holiday coping…


 Concerned that you or a loved one may have an eating disorder?  Call us at (410) 938-5252 for a free and confidential phone assessment or visit www.eatingdisorder.org for more information about treatment options.

 

Photo credit: freedigitalphotos.net / digidreamgrafix

 

 

 

8 ways to take the focus off of food this Thanksgiving


Who’s bringing a dessert?  Can someone help with appetizers?  Here, have some more!  Are you really taking another helping?  I wish I could eat like you.  Ugh, my diet must start tomorrow!

guitarSound familiar? It’s not unusual for pre-Thanksgiving talk between family members to focus on food and food-related tasks. It’s also not uncommon for holiday conversation to revolve around what people are eating or not eating, who’s eating too much or too little and, in some cases, criticism or praise regarding weight and size. To be clear, making sure there’s enough food to feed everyone at a gathering is important, but it doesn’t need to be the center of everyone’s day.

When an individual is struggling with an eating disorder, or working hard to maintain recovery from one, these topics can activate disordered thoughts about food, trigger negative body image and impact a person’s ability to be emotionally or physically present at the gathering. Intentionally steering the day towards gratitude and connection instead of food and weight can take a bit of work in our diet-obsessed culture but it stands to benefit many, not just those with eating disorders.


Where to start?
These are just a few suggestions from our therapists and dietitians. Feel free to share your ideas and recommendations on our Facebook page.


1. Offer roles for family and friends who want to contribute something but may not want to bring food.
Not everyone enjoys cooking and some people, especially those with eating disorders, might feel incredibly anxious around food. There are definitely other ways to help and have a meaningful connection to the day that don’t involve preparing food. For example:

  • Planning activities or bringing a craft for the kids (or adults!) to work on.
  • Pet duty. Someone might really love to take the dogs out for a walk while everyone else is distracted in the kitchen or watching the football game.
  • Helping with clean-up and dish-washing (Yes, some people enjoy washing dishes!)
  • Ask the musicians of the family to bring their instruments.
  • See if anyone would be willing to put together a slideshow of past Thanksgiving photos for after-dinner viewing.

Quick Tip: Tap into everyone’s strengths. If your brother has taken up a recent interest in photography ask if he’d be willing to document the day and capture different positive interactions. How great would it be to have a beautiful photograph of a grandparent rocking a new baby or all the cousins playing football outside? These are, after all, the moments you’d choose to remember about a holiday, not how many calories you ate or an offhanded remark someone made about your weight gain/loss.


2. Give in to the gratitude trend.
Gratitude might seem like a big social media gimmick right now but the truth is it does have the power to shift your attitudes and perceptions. The moment dinner is served and everyone sits down to eat can be a moment of peak anxiety if you have an eating disorder. In anticipation of this, Google “gratitude quotes”, pick your favorites and write them on small cards to place at each table setting. Depending on how willing your family is, you could also give everyone a chance to go around and verbally share something for which they are grateful.


3. If you’re hosting, do a quick assessment of reading material around your house.
Put away (or better yet, recycle) any magazines that are overly focused on appearance, diet or beauty. Studies show even just 3 minutes of looking at fashion or “fitness” magazines can negatively impact self-esteem and trigger feelings of sadness and guilt. Do you really want your 7 year-old nephew to practice his reading skills with a fitness magazine full of photoshopped bodies? Do yourself and your guests a favor by instead stocking your coffee table with photo albums, short stories written by your kids, or some photography books by a favorite artist. (If you really want to make a body positive impact, you could leave a copy of Intuitive Eating or Health At Every Size laying around as well.)


4. Identify an ally (or two).
Many of us look forward to holidays with great anticipation because we get to spend time with family members we don’t often see. Some of us experience dread and stress for the very same reason. It’s no secret that family dynamics can be complicated. Instead of focusing on family members who are particularly difficult to handle, focus on the ones who can help. If you have a grandparent, cousin or significant other who knows you’re struggling with recovery, have a conversation with them in advance about the ways in which they can support you at the gathering, at the table, and in specific situations throughout the day.


5. Step away from the bathroom scale.
If you’re hosting and you have a scale in your house, move it out of sight temporarily, or permanently. If you are a guest in someone else’s house, consider asking them if they can stash it in a closet for the day. As a parent, spouse or support person of someone in recovery, this would be a great thing to take care of in advance as a way to advocate for your loved one.


6. Whatever you spend time focusing on will be what you spend time focusing on.
If you’re in recovery you likely going to need to think about meal plans and meeting nutritional needs and that’s okay, but make sure you also have holiday intentions that don’t involve food, eating or weight. Why? Because if all your goals that day revolve around what you’re eating you will be hyper-focused on food just like you were with the eating disorder. Prioritize your nutritional goals, talk them over with your dietitian and then consider adding some non-food goals like these:

  • I will record an interview with a grandparent. (Check out The Great Thanksgiving Listen)
  • I would love to cuddle with a relative’s new baby.
  • I’d like to sneak off to do a 3-minute mindful meditation before dinner
  • I’m going to talk with each family member about their favorite songs, then compile a playlist to share after the holiday.
  • I will give at least 3 non-appearance related compliments to other people on Thanksgiving day.

Quick Tip: Whatever you choose, make sure your goals are easy, achievable and positively worded. Think about adding good things into your experience, instead of avoiding a negative. For example, instead of saying “I won’t go on Facebook during our Thanksgiving get together” say “I look forward to taking a break from social media so I can catch up with my loved ones.” Remember, whatever you focus on will be what you’re focused on.


7. Remember that you cannot control everyone else.
We live in a food and weight-obsessed society, so it’s likely some of this conversation will make it’s way into your holiday despite your best efforts. If and when it does, be prepared with ways you can change the conversation, set boundaries and seek support.


8. Give Back –
Identify a local charity and ask all the Thanksgiving guests to bring a donation for the cause. Even if the day is hard for you and your recovery you will be left with a visual reminder of everyone’s generosity, (even if they couldn’t stop mentioning how many calories were in the appetizer all day).


Thanksgiving can be a truly beautiful holiday that reminds us all to give thanks and reflect upon the positives in life. Taking the focus off food might not only benefit those with an eating disorder but anyone struggling with negative thoughts, low self-esteem or loneliness this holiday season.

When we lift the food frenzy and body angst we are better able to focus on gratitude and authentic connection with others and ourselves.

Happy Thanksgiving.

*     *     *

You may also be interested in reading:

Simple solutions for holiday (and everyday) conversations about food and weight

 


 

Questions about treatment for an eating disorder? Call us at (410) 427-3886 or visit eatingdisorder.org

 Photo Credit: freedigitalphotos.net / bugtiger

Why Providers Must Stand Up and Join the March Against ED

This post was written by our Community Outreach Coordinator as a guest blog for the March against eating disorders.  It was originally posted on marchagainsted.com and has been cross posted here with their permission.


Teacher
Nurse
Barista
Artist
Accountant
Grandmother
Student
CEO
Musician
Author
Mom
News Anchor
Military Officer
College Athlete
Dad

They care for you, entertain you and bring you joy.  They protect you and teach you, create things for you.  They help you and mentor you. They are varied. They are diverse. They are important.

They are people you might see every day.

And they are people we might see every day in the course of providing care and treatment for individuals and families impacted by eating disorders.

MOM March 2014At The Center for Eating Disorders at Sheppard Pratt, we see numerous people each day struggling with anorexia, bulimia, binge eating disorder, ARFID and other feeding and eating disorders.  These individuals with eating disorders are varied.  They are diverse. They are important.

This is why we were proud to participate in the inaugural March Against Eating Disorders on Capitol Hill last fall and why we are eager to return this year on October 27th for an even larger and more impactful event. As physicians, therapists, dietitians and nurses specializing in the treatment of people with eating disorders, we see the daily struggle, the medical repercussions, the fear and the impact of eating disorders on relationships, careers and families.  But we also see the hope, the healing and comfort that comes with treatment and recovery.  That is why it’s so important for those of us in the field to stand up and share our voices too.

Why do we march?  

  • We march because eating disorders continue to be stigmatized, sensationalized, overlooked and underfunded despite having the highest mortality rate of any mental illness.
  • We march because no one chooses to have an eating disorder.  Eating disorders are highly heritable illnesses, meaning 50-80% of a person’s risk for developing an eating disorder is genetic. Additional causes are varied and complex.
  • We march because no family should hear “it’s just a phase, she’ll grow out of it.” from a medical professional before they make it through our doors. A lack of specialized eating disorder training for physicians delays detection and appropriate referrals. Delaying treatment delays recovery.
  • We march because 20-30% of our patients are men who thought they were the “only one” and suffered in silence for a long time. Eating disorders don’t discriminate and treatment shouldn’t either.
  • We march because parents do not cause eating disorders but eating disorders can cause heartache for parents and family members. Guilt, blame, stigma and outdated stereotypes can prevent families from getting the help they deserve. Current research supports an understanding that caregivers can play a positive and integral role in helping a loved one to heal from their eating disorder.
  • We march because eating disorders can be deadly but they can also be overcome.  Early intervention and evidence-based treatment makes a difference.
  • We march because no one should have to get sicker before they can get well. Insurance coverage for eating disorders must not be a barrier to quality care.
  • We march because we live together in a culture that equates weight loss with health, yet we work every day with individuals whose weight loss is associated with osteopenia, hair loss, fatigue, cardiac arrhythmia and infertility.  We support a movement that embraces health-focused goals for our schools and communities instead of weight-focused goals.

These are just some of the reasons why we are excited to stand with The Alliance for Eating Disorders Awareness, The Eating Disorder Coalition, and MAED – Mothers Against Eating Disorders at The #MarchAgainstED in our nation’s capitol.  Join us on October 27th to take a stand and help increase awareness about eating disorders.

Why will you march?  

Register now at www.MarchAgainstED.com

*     *     *

Clemmer.2015.final

 

Written by Kate Clemmer, LCSW-C, Community Outreach Coordinator at The Center for Eating Disorders at Sheppard Pratt for www.MarchAgainstED.com

The original posting of this blog is available at: http://www.marchagainsted.com/blog/why-providers-must-stand-up-and-join-the-march-against-ed

 

Surviving & Thriving through Mid-Terms & Finals

It seems like many colleges and universities have moved away from the standard exam schedule. In fact, it can seem like you are constantly studying for exams or writing papers, with no downtime or lull in the semester at all. Midterms and finals just mean a heightened level of existing anxiety or stress. Unfortunately, for many college students, that means there comes a point in the semester when it seems like there are way too many obligations and way too little time to manage them all.  If you are simultaneously working on recovery from an eating disorder this can be incredibly frustrating, particularly if everything seems to be equally important on your to-do list. While it can be easy to lose sight of how critical your recovery is in the midst of these academic priorities, its crucial to remember the potential consequences.  Turning to your eating disorder behaviors will only intensify the stress you’re body is under, making it mentally and physically harder to concentrate, harder to interact and connect with other people (i.e. study groups, roommates, support people) and much harder to accomplish that long list of study tasks.

Self-care, nourishing your body, following treatment recommendations and practicing your new healthy coping skills is what will eventually get you through the stress of mid-term or final exams.  While the hectic nature of college academics can’t be completely avoided, we can offer some tips to help make it feel more manageable and less likely to derail your progress in recovery.

Prioritize: Make a list of all of your upcoming responsibilities. Pull out the larger projects and see if you can break these down into smaller, more achievable tasks. For example, break down “10 page research paper” into: print articles; read articles; write an outline; write the rough draft; write the bibliography; and revise the paper. Write deadlines next to each item on your list and then organize your to-do list by due-date or high priority items. Don’t forget to breathe.

Eliminate unnecessary responsibilities: Do you really have to do everything on your list? You might have some things on there that are optional projects, or possibly some student organization meetings that are not imperative for you to attend. Perhaps you can ask for less hours at work during exam weeks. Remember that you can also always talk to your professor; if you have 3 exams scheduled on one day, one of your professors may actually be willing to allow you to take the exam for their class on a different day. If you just can’t adjust your schedule, know that this stress is temporary. Focus on the end point and plan a reward for yourself after big assignments are turned in.

Don’t give up on the basics: As tempting as it may be, you still need to prioritize sleeping, eating and self-care. In fact, it is even more important that you take care of yourself during this stressful time. Always strive to get as close to 8 hours of sleep each night as possible, remembering that lack of sleep can have a significant effect on hunger and eating patterns.  Make sure you are scheduling times to eat your meals and snacks and that you are thinking ahead. If you know you won’t have time to go back to your room for a meal, remember to pack your food with you or bring money to eat while you are out.

“The time to relax is when you don’t have time for it.”   

~Sydney Harris

Relaxation is vital. Take some time every day to take a deep breath and be still. Enjoy what the season has to offer.  Consider setting aside 30 minutes or an hour during your busy time to catch up with a friend or roommate – no multi-tasking or studying allowed during that time.

Keep your appointments: When things get hectic, it may be tempting to cancel your therapy or nutrition appointments so that you can spend more time studying.  This often makes sense in a moment of panic or stress but can easily lead towards losing sight of  recovery’s importance.   Cancelling appointments during high stress or high pressure times can be a risk  factor for relapse.  Consider a rock climber choosing to take off her safety harness right when she gets to the highest and steepest part of the cliff.  You’d probably question that decision right?  The same applies to your “safety harness” and your support system during difficult times.  If you are struggling to get to your appointments, speak to your therapist about this and decide together what is the best way to balance your responsibilities with your recovery in mind.

Reach Out:  Recovery can feel like a full-time job sometimes, and college is a full-time job for many students.  You may be realizing that you are struggling so much with both that you just can’t focus on your academics the way that you want to. You may have missed a number of classes, gotten behind in lectures or just feel too overwhelmed to truly focus. Don’t be afraid to talk with your professor and see if there is any way that you can catch up, delay some deadlines, or work with a tutor to help you in that class.  You don’t have to go through this on your own.  Ask for help and explore your options for support on campus. If you think you need to withdraw from a class and have missed the Drop/Add deadline, or if you are thinking about taking a medical leave of absence, schedule an appointment with the Dean of Students, an Academic Advisor, or someone at the Counseling Center – that is what they are there for!

While academics and exam stress can be overwhelming, just remember that you have options regarding how you handle that stress and how you let it affect you. You have already accomplished so much this semester.  Reflect on what has been working well so far and praise yourself for a job well done. If there are things that have been a struggle, now is a good time to evaluate what aspects of your self-care and stress tolerance could be improved.  Try  coming up with a reasonable plan to put into action for the rest of the semester and continue reflecting on it to see what is working and what isn’t. If you are stumped as to how to do this, reach out to others for support and additional ideas.

CED wishes you a memorable semester of academic success, balance and self-care.  For more insight on the intersection between college and eating disorder recovery, check out our whole blog series at: Battling Body Image Concerns & Disordered Eating on Campus .

If you are struggling with an eating disorder and need help or support, please call The Center for Eating Disorders at (410) 938-5252.  You can also reach us by email at EatingDisorderInfo@sheppardpratt.org.

 

Written by Jennifer Moran, PsyD, CED Therapist & College Liaison

Originally published on 11/11/2011

Reaching Out for Recovery Resources on Campus

As the newness of the school year starts to fade, you might be realizing that you or a loved one may need more support to maintain or re-focus on recovery while on campus.  It might feel discouraging to recognize that you are not doing as well as you had hoped, but you do not have to suffer alone.  Most colleges and universities provide a full Students on GC campusrange of services to their students, and it would be worthwhile to look into what is available on your campus. While every campus is unique, the following services are typically available at every school.

Student Health Center: The Health Center has physicians and nurses that are on site and specialize in working with college students. Many schools have at least one member of the staff that is familiar with working with people who have been diagnosed with eating disorders and will be able to help facilitate your care and make appropriate referrals on and off campus. Sometimes a dietitian is on staff to work with college students who need nutritional counseling.

Campus Counseling Center: The Counseling Center may be part of the Student Health Center, or it may be a completely separate department. At most schools, therapists are available to see students in individual therapy for a wide array of emotional and psychological concerns. The best part is that many of these services are free or very low-cost. The Counseling Center may also offer group therapy, which allows you to connect with others on campus who are facing some of the same concerns that you are. Some counseling centers may also work with a psychiatrist that can prescribe and monitor medications, if appropriate.

Peer Counselors: If the idea of speaking to a counselor is overwhelming, you may feel more comfortable initially meeting with a peer who has been trained to provide support. While a peer counselor is not qualified to do therapy, they can be a great support in supplementing your ongoing care or helping you to access the appropriate level of treatment for you.

Resident Advisors: Your RA is very knowledgeable about life on campus and can help direct you to the people in your community that can best assist you. They typically have gone through training to mediate conflict between roommates, to listen supportively to their residents and to help students access services on campus.

Dean of Students/Academic Advising: If your school work is starting to suffer because of your eating disorder or mood, you can speak to the Dean of Students or your Academic Advisor to explore your options. They will be prepared to help you with administrative concerns such as adding/dropping classes, communicating with your professors, adjusting your schedule to accommodate treatment, taking a medical leave of absence, and directing you to tutors and academic support programs.

Campus Ministries: If you are spiritually connected to your faith, you might feel more comfortable reaching out to the school’s chaplain. The chaplain is available to meet with students and can assist you in locating a place of worship consistent with your beliefs or can help direct you to more spiritually based counselors.

Off-Campus Treatment & Support: If you prefer to access services off campus or would like more specialized outpatient treatment, find out whether there are any treatment centers located close to your school.  The Center for Eating Disorders at Sheppard Pratt always welcomes students from surrounding colleges and universities during the school year. The Center is actually within walking distance to Towson University and is located within 5 miles of all of the following campuses:

Students who attend school a bit farther away from their treatment team, may be able to schedule classes in a way that frees up a particular day of the week for fitting in outpatient appointments with various providers.

The Center for Eating Disorders provides a wide array of treatment options including individual therapy, medication management, nutritional counseling, and a free support group every Wednesday night from 7:00-8:30 PM. If you need help finding outpatient treatment services close to your campus, you can visit The National Eating Disorder Association’s Treatment & Support Finder and search by state or zip code.

In the end, where you seek support is not as important as whether you seek support.  Remember that you are not alone and asking for help is a sign of strength.  If you are struggling, please reach out to a trusted friend, loved one, treatment provider or one of the campus supports listed above.

If you have any questions about the resources or services discussed above,please email Jennifer Moran, PsyD, CED’s College Liaison at jmoran@sheppardpratt.org or call (410) 938-5252.

***

Written by Jennifer Moran, Psy.D.

Originally published 9/13/11

The College Conundrum: Feeling Lonely & Isolated on a Campus Full of People

college students walking

Simple Steps to Strengthen Your Support System and Safe Guard Your Recovery

Have you ever looked through the wrong end of a pair of binoculars? Objects that are actually close appear clearly but look to be quite far away. If you are feeling socially isolated and alone, you may feel the same way about the people in your life: they are physically close but seem to be just distant enough that you can’t reach out to them. Maybe you are struggling to find the right group of friends at school and are feeling like everyone else has bonded with others to form tight-knit groups that are hard to penetrate. Or maybe you have been struggling and thus avoiding some of those people that are close to you. Either way, when you are feeling alone, it is hard to fight the eating disorder thoughts and urges that might creep in and try to keep you company.

Attending college is a unique experience in that there are so many people with similar interests, who are usually similarly aged, living and/or studying together in one spot. If you haven’t found the right group of people, keep looking, as they are likely somewhere on campus just waiting to welcome you into their lives. If you have been isolating, now is the time to commit to getting up and pushing yourself to reconnect with others, even if that feels really scary.

Be true to yourself. If the idea of going to a loud fraternity party sounds unappealing to you, chances are good that you aren’t going to meet your ideal friend at one. Take some time and think about what you would really like to do that might bring you pleasure. Would you rather spend a quiet evening with a small group of people or enjoy the outdoors with a hiking club? Would you enjoy a student service organization that hosts weekly charity events? Whatever your interest is, there are bound to be others on campus who share it. Contact your Student Affairs office to find a list of all of the student organizations on campus. If you see any that intrigue you, contact the president and find out meeting details and upcoming events. Peruse the school newspaper for lectures, concerts, theater events or student activities that seem interesting and challenge yourself to go to at least one.

If there is a person in your class that seems like someone you might like to get to know better, try approaching him/her.  Depending on how comfortable you are with speaking to new people, you might want to start with a simple greeting. A different time, you might want to ask them a question about the homework assignment to get a conversation started. Progress from there to asking them to study together, and if you seem to get along well, invite them to something fun that is not related to your class.  If it is hard or stressful for you to eat your meals with others for the time being, invite them to activities that are before or after meals so that you can enjoy your time together. On the other hand, if you do better eating around other people, try to schedule activities that include meals or snacks.

Important Tip: It might help to prepare yourself for some level
of rejection during the process of making new friends and
establishing social connections on campus. Not every person
you reach out to will respond positively or take you up
on the offer to hang out. That’s TOTALLY NORMAL and
does not mean you should stop reaching out.
Try not to
take it personally, and remember that they may be struggling
in their own way with social anxiety, health problems or school
and
family stressors.

If you cannot seem to find the right group of people on campus, try looking to the general community in your area. Pick up a local paper and look for events or activities that are open to the public. You might find that there are more people who have similar interests off-campus, and this is a great way to connect with them.

If you continue to struggle to connect with others, talk with your therapist about joining a therapy group. Groups can be a great way to talk about your experience with others who are experiencing similar types of situations. Here at the Center, we host an open Support Group every Wednesday night from 7:00-8:30 PM.  Therapy and Support groups are not meant to replace social relationships but can be a great place for sharing motivation and practicing interpersonal interaction.

When you are trying to heal from an eating disorder, the process can sometimes feel so draining and exhausting it can be tempting to give in to your urges.  Feeling alone on a campus full of people can make it even more difficult, so it’s important to accept that there is power in numbers.  It may take some courage and effort to reach out initially and try some of the tips listed above, but the payoff is worth it.  Once you welcome people into your daily life that you can turn to for support, even if it is just to distract you for awhile, you will have the extra strength to stay focused on recovery and you might even have a little fun in the process.

You can find more information about eating disorders and treatment and support options at www.eatingdisorder.org

Written by Jennifer Moran, PsyD. , CED Therapist & College Liaison
Originally published on 9/26/11

Balancing Act: Back-to-School Basics of Self-Care on Campus

It’s that time of year again! While it was just a few months ago that everyone was so excited for the start of summer break, there is also something very exciting about the start of a new school year: new school supplies, new classes, new back-to-school clothes and maybe even new friends. Notice a theme? The start of a school year offers the opportunity for new beginnings. For some, they will be making a major transition to living on a new campus where every aspect of the experience is, in fact, new. For others, returning to school or starting a new semester offers a chance to improve upon their earlier efforts at balancing school, their social life and self-care. For everyone, this new beginning is a time to pause and reflect on what your goals are for the semester and how you would like to achieve them.

Here at the Center for Eating Disorders , we often work with students who are struggling tocar breakdown balance all of their responsibilities during the very hectic semester. When mounting pressure and too many commitments forces something to be let go, too often people opt to give up sleep, meals, relaxation, or time for self-care. These basic needs are sometimes even viewed as a luxury. While the thought of failing to meet deadlines or getting poor grades can be very stressful, people tend to underestimate just how important the “luxury” of taking care of yourself is in the grand scheme of your overall ability to function. It would be similar to draining a car battery without ever recharging it; eventually, the battery is not going to work and the car won’t start!

Fortunately, this scenario can be prevented with a little foresight and some planning. The start of the semester is a great time to create a plan to help keep things balanced throughout the next couple of months. Here are some tips for creating a good plan.

  1. Write out your schedule for the semester. Once your classes, work schedules and social engagements are in the calendar, go back through and make sure that there are times for all three meals each day. Schedule them in so that they will not be forgotten!
  2. Plan accordingly. Do you have a work shift or a class that goes from 11-2? Plan to pack your lunch so that you can have something to eat during your break.  Look at your syllabi and put important deadlines and exam dates on your calendar. If you notice one week is going to be packed with things to do, plan ahead so you are not overwhelmed.
  3. Get connected to your safety net. Its the first week of school and everything might still be feeling new and  exciting and maybe even easy.   But even if you don’t feel like you need the extra support right now, take a moment while things are slow to identify the phone numbers and locations on campus for the student health center and the counseling center.  Save the info in your phone.  If a time comes later in the semester when you need to reach out for help, you will have made it a little easier for yourself to quickly connect with your campus support system.
  4. Choose a bedtime. School schedules can be erratic. You might start each day at different times based on your class schedule, and you might stay up very late on the weekends or during exam times.   But resist the urge to maintain this erratic sleep schedule throughout your entire college career.  Whenever possible, do your best to go to sleep and wake-up around the same time every day in an effort to get 7-8 hours of sleep each night, especially if you are working on recovery from an eating disorder.  Why? Balanced sleep can help you maintain balance in other areas of life as well, such as your mood and your eating.  This is partially because sleep helps your body regulate hormone levels, including those that stimulate feelings of hunger and fullness. When hormones are dysregulated it can set you up for overeating or  bingeing.   When you are tempted to pull those all-nighters during midterm week, remember that studies show a sleep deficit of 3-4 hours a night over the course of even just one week can interfere with the body’s ability to process nutrients from food, manage stress, and maintain a proper balance of hormones. (source: American Thoracic Society, International Conference, News release, San Diego, May 19-24, 2006.)
  5. Schedule “me” time. It is very important that you take time to check in with yourself. Try to find time to journal or do something you enjoy for even just a few minutes every day. If you know that you will struggle to fit this into your schedule, try signing up for a yoga class, a book club or another fun, relaxing activity to make sure that you stick with it.  This is also a great way to meet people with similar interests.
  6. Stay True to Yourself. It can be easy to feel pressured or rushed into making as many new friends as possible, sometimes by altering yourself and your priorities to fit in lest you risk being all alone. You may want to pause every so often and reflect on whether the company you are keeping is raising you up or is dragging you down. Are the new friendships you’re building helping you commit to self-care and positive self-worth or are they contributing to greater body/food anxieties? Listen carefully to your inner voice and let it guide you to make the best decisions for you.

We at the Center wish all of you a happy first semester at school!  Stay connected with this back-to-school blog series and other body image and eating disorder resources by liking CED’s Facebook Page or following @CEDatSheppPratt on Twitter.

Written by Jennifer Moran, PsyD, College Liaison, The Center for Eating Disorders at Sheppard Pratt

Originally published 9/6/11

Photo Credit: Freedigitalphotos / Naypong