Be sure to start your holiday off right by giving your body what it needs at breakfast. People are often tempted to skip breakfast when they anticipate a large meal later in the day, but depriving yourself of breakfast will potentially set you up for a binge at the holiday meal.
There are often multiple food options available at holiday meals which can be very overwhelming when preparing your plate. Remind yourself that you are not obligated to try every dish or to take one of everything. Instead, plan to choose 1-2 items from each food group to create a balanced meal.
In preparing your plate, it can be helpful to remember appropriate portion sizes as suggested by the Food Guide Pyramid. One easy way to size up portions is to use your hand. A clenched fist is about a cup, and a cup is the amount recommended for a portion of pasta, rice, cereal, vegetables, and fruit. A meat portion should be about as big as your palm. For more information on portion sizes, visit: http://www.mypyramid.gov/.
Plan to allow yourself to eat “treats” and “extras”. This is socially and psychologically healthy!
Listen to your body! During the holiday season, meals are often frenzied and fast-paced, and it becomes very easy to neglect your hunger and fullness signals. Plan several ways to remind yourself to pause and be mindful of your body’s natural cues before, during and after the meal.
It can be helpful to call the host or hostess ahead of time to find out what will be on the holiday menu. Knowing the menu in advance can help you plan your meal and ensure that there will be options that you feel comfortable eating. If necessary, you can offer to bring a dish that will increase your comfort level with the meal.
Plan for how you will deal with possible discomfort around feelings of fullness; distract yourself by engaging in a positive coping activity such as playing a game, walking the dog, writing in a journal or enjoying the company of friends and family.
Talk to other family members in advance about not pushing food or commenting on diets, calories, or weight loss. Asking a parent or another supportive family member to spread this request can also be helpful.
Don’t forget about the day after your holiday meal! Plan to meet a friend for your meals the next day to help you resist the urge to skip meals or compensate for any slip-ups that occurred during the holiday.
Remember to relax, BREATHE, and enjoy the holiday as best you can! From all of us at The Center for Eating Disorders, have a very happy holiday season!
There are many things to consider when looking for treatment for an eating disorder. Is hospitalization necessary? How do I convince him/her to get treatment? How long does it take to overcome an eating disorder? Where do I go for help? And … What are the treatments anyway? One type of psychological treatment, known as Cognitive-behavioral therapy (CBT), will be described here.
Cognitive-behavioral therapy is a well-researched and proven method for the treatment of eating disorders. The cognitive-behavioral model for the treatment of eating disorders emphasizes the important role of both the cognitive (e.g., attitudes regarding weight and appearance) and behavioral (e.g., dietary restriction, binge-eating) factors that maintain the eating disorder and associated problems. It is a structured treatment that focuses on the present and the future. It is time-limited, although the amount of time may vary from 6 months to several years. The treatment is presented in stages with an initial emphasis on stabilization of symptoms and behavioral change. The patient and therapist work together to formulate a plan for stabilizing eating and eliminating symptoms, beginning with the very first session. Because emotions often intensify during this phase of treatment, tools (coping strategies) for managing these feelings are developed and become an important part of the work. CBT includes in-session activities as well as homework so that new behaviors can be practiced.
As treatment progresses, cognitive restructuring techniques (e.g., techniques aimed at recognizing and changing problem thinking patterns) are introduced. Thoughts and beliefs that perpetuate the problems (e.g., “I’m so fat and disgusting”; “I will only be happy if I can lose this weight”) are identified and work aimed at developing new perspectives and ideas (“my self-worth doesn’t depend on my size or shape”) begins. Additionally, during this stage of treatment, broader concerns such as relationship problems, body image, self-esteem problems, and emotion regulation are addressed. Even though CBT is focused on the elimination of symptoms, the overall goal of the treatment is to assist the patient in making their return to a happy life. So, very often, once symptoms are stabilized, treatment will expand to include other areas of concern and conflict. The final stage of CBT concentrates on relapse prevention and maintenance planning.
Although CBT is widely recognized as a first-line psychological treatment for eating disorders, not all therapists are trained in this treatment model. If you are looking for treatment for an eating disorder, it is always a good idea to make inquiries into the type of treatment provided and the training of the therapist.
The Center for Eating Disorders has well-trained and highly experienced clinicians who provide CBT at all levels of care. If you would like information regarding CBT available at the Center, please call (410) 938-5252 or email EatingDisorderInfo@sheppardpratt.org.
Submitted by Kim Anderson, Ph.D., Director of Psychology, CED
Art therapy is based on a belief that the creative process is healing and life affirming. For many people, emotional pain can be difficult to express verbally, and those who struggle with eating disorders often find it particularly difficult to use words to describe their experience. Art therapy provides a creative outlet for these pent up emotions and feelings that are too painful or overwhelming to put into words. Emotions can be intimidating, especially for those not used to feeling them. Working with an art therapist is a safe way to experience the emotion, while gaining confidence in one’s ability to cope. In time, you begin to develop a sense of trust in your own feelings and the ability to speak about them.
Art therapy for eating disorders can be done individually or in groups. Patients are sometimes given a theme or directive and asked to explore it metaphorically through the creative process. Others prefer to work in a more self-directed fashion, using the art to express thoughts and feelings as they arise. Body tracing is one example of how art therapy can be used to challenge the physical and emotional body image distortions that are common for people with eating disorders. Patients are often surprised by the insights and realizations they gain through art therapy.
In art therapy there is no such thing as good or bad art. No experience or talent is required. Art therapy is not about producing the next Michelangelo or Picasso, but instead about freely and spontaneously expressing oneself through the artistic process. It is an opportunity to non-verbally express thoughts and feelings that are held inside. Preferences for art materials vary: some prefer pencil and paper, others enjoy the fluidity of watercolors, layering of tissue paper, the intensity of oil pastels, or the grounding of clay. Patients in art therapy often find that the art media they are working with is related to the meaning of the piece they are creating.
There are many benefits to adding art therapy into one’s treatment for an eating disorder. In addition to helping improve emotional health, art therapy can build self-awareness, challenge body image distortions, reduce stress, and assist in healing the emotional effects of trauma. Perhaps most powerful is the potential for personal transformation and the empowerment which comes from the creative process.
Art therapy, which has been a valuable part of the Center for Eating Disorder’s Inpatient, Partial and IOP programs will be offered on an outpatient basis beginning January 5th, 2009. For information, please call (410) 938-5252.
To learn more about how Expressive Art Therapies are being used at the Center for Eating Disorders, visit:
Controversy quickly erupted last week over the expulsion of a young girl from a private school in New Hampshire. The expulsion was reportedly due to her diagnosis of Anorexia, and it has stimulated a lawsuit in which the etiology and legality of eating disorders as a disability will be scrutinized. While it would be irresponsible to comment on the specifics of a legal case in which the details are unclear, the Center for Eating Disorders would like to take the opportunity to remind readers about the genetic and biologic factors associated with an eating disorder diagnosis.
Research has shown that relatives of individuals who have had eating disorders are 7-12 times more likely to develop anorexia or bulimia than relatives of individuals who have never had an eating disorder.
Further research has compared identical twins who share 100% of their genetic material with fraternal twins who share approximately 50% of their genetic material. These studies have suggested that genetic factors have a potentially large influence on the development of anorexia.
A research study was completed involving nearly 200 people with anorexia and their relatives with eating disorders. It identified several regions of specific chromosomes that may contain genes associated with the risk for anorexia. The results also suggested that the risk of anorexia may be transmitted indirectly through genes that are closely associated with personality traits that, in turn, increase the risk for anorexia.
Recent legislation has helped to highlight this genetic understanding and has begun changing the legal perception of eating disorders from a “lifestyle” that is chosen, to a potentially fatal disease that has genetic origins. However, as we see in this most recent legal case, eating disorders remain a controversial and misunderstood diagnosis, and more research is needed to establish fair laws and opportunities for those who struggle with this illness.
The Director of the Center for Eating Disorders, Dr. Harry Brandt, commented on the issue at the site of the original article. Click on the link below to see the article and his comments.
Sarah Blake, Social Worker and Outreach Coordinator at the Center for Eating Disorders at Sheppard Pratt, offers insight on EDNOS, Eating Disorder Not Otherwise Specified.
So many of my patients have grappled with having the diagnosis of EDNOS. Eating Disorder Not Otherwise Specified is a classification for disordered eating that the DSM-IV lists as a category “for disorders of eating that do not meet the criteria for any specific Eating Disorder. Keep reading though, before making a judgment call about this diagnosis. In the rigid thinking of some of the patients I have worked with who have had eating disorders, having this diagnosis can initially mean to that individual that they have failed – to be a person who has a “real” eating disorder. This type of thinking can lead to a variety of other thoughts that can impede their recovery process.
The diagnosis of EDNOS can mean a wide range of things. It can mean you meet the criteria for Anorexia Nervosa, but you have maintained a menstrual cycle. It could mean that you struggle with severely restricting your food intake and have lost significant weight, but are currently at a fairly normal weight for your height. It could mean that you meet the criteria for Bulimia Nervosa but binges occur less then twice a week or that the cycles have occurred for less then a duration of 3 months. It could mean that you eat small amounts of food and then do something to compensate for having ingested the food. It could mean that you engage in a recurrent pattern of binge eating without any compensatory behaviors.
What is important to note here is that just because a person does not fit the exact criteria for Anorexia or Bulimia, does not mean they do not have a serious illness that requires attention. Countless individuals who are diagnosed with EDNOS are at risk for the same medical complications as those individuals who are diagnosed with Anorexia and Bulimia. These include (but are not limited to) dehydration, electrolyte imbalance, heart attack, and death. These are still eating disorders requiring necessary medical attention and psychological support.
EDNOS is a widespread problem. According to Eating Disorders: The Journal of Treatment and Prevention, EDNOS develops in 4-6% of the general population, and 50% of the individuals who come in for treatment for an eating disorder are given the diagnoses of EDNOS. There must be a reason that so many individuals are in this diagnostic category and it is most certainly not, that 50% of the people who come in to treatment are not “good enough” at their disordered eating, to get an “official diagnosis”!
No matter how extreme your eating issues are, they are taking away from the fullness of life you could be experiencing. The eating disorder may seem as if it provides comfort or security, but it does not allow you to feel a full range of emotions including: joy, surprise, love and even sadness and acceptance to name a few. Only by seeking help will you have the opportunity to truly begin to experience the fullness of life you desire.
*****Eating Disorder Not Otherwise Specified, Anorexia, Bulimia, and Binge Eating are all serious illnesses. If you or someone you know is struggling with an eating disorder – help is available! Contact us at 410-938-5252 or via the web http://www.eatingdisorder.org/get_help/ to talk to someone confidentially about your concerns.*****
RSS Feed