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.

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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.

News Anchor
Military Officer
College Athlete

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

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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


Understanding Hopelessness & Cultivating Hope: Discussing Suicide and the Death of Robin Williams

As the world feels and reacts to the news of Robin Williams’ death, the national conversation has turned quite rapidly to suicide and suicide prevention. Unfortunately, to those of us in the field of mental health, these headlines require daily observance. In general, individuals struggling with eating disorders are more likely than those without eating disorders to think about and attempt suicide. One study found that risk for suicide is approximately 23 times higher in those with eating disorders than in the general population of the same age (Harris and Barraclough, NSPL_Logo_home1997).

While we feel strongly that the details surrounding Williams’ death are a private matter, it has been publicly acknowledged that he was battling severe depression and had a long history of substance abuse.  Among a multitude of public reactions to the news, there is a pervasive feeling of shock that a person whose public life was built around laughter and joy could simultaneously be experiencing so much pain. People far and wide are wondering how this hilarious and much-loved person could actually be feeling so hopeless?

Hopelessness is a difficult topic, particularly for individuals who are not in the midst of feeling it and, perhaps as a result, have a difficult time conceptualizing how anyone else could ever get to a point that they feel completely unable to be helped. But understanding hopelessness is at the core of every discussion about suicide. Discussing it honestly and compassionately can make a difference for those who struggle. Carrie Arnold, a former guest speaker here at the Center, wrote openly about this on her blog after receiving the news about Williams. A poignant account of her own experience with depression and attempted suicide, Arnold captures the importance of striving to understand and develop compassion for individuals in a state of despair.

“We talk of people who complete suicide as being ‘selfish’ that they couldn’t sense their loved one’s pain. Yet when those feelings of utter despair washed over me, all I could think about was the pain I was causing others.”

Arnold goes on to talk about the venture back from despair and the rebuilding of hope, desire and gratitude, writing:

“Then you figure out that you have started living life again without even realizing it. There’s no miracle moment, here, just the slow stringing together of small moments into a narrative called your biography.”

Carrie Arnold’s story is extremely important to tell because it reflects the stories of so many others that don’t make headlines and rarely get told. This is the story of traveling to the brink of hopelessness and continuing right on through. This is the story of hope. The message to people struggling with eating disorders, depression or addiction is that you can prevail.  You can feel hopeless and still not be hopeless.

Almost every single guest speaker we’ve hosted to speak about recovery through the years has shared that he or she felt hopeless often and they fully believed recovery was impossible for them. They were sure of it. Yet there they are, years later, standing on a stage telling their incredible story of recovery.  Rest assured, many people living full,  meaningful lives without their eating little tree growingdisorders today were once sitting there in front of a computer screen thinking about how recovery was impossible for them too. Too many lives have been lost to suicide, there is no question about that. Yet so many others have been to the depths of hopelessness and traveled back. In fact, according to the Action Alliance for Suicide Prevention, “the vast majority of people who face adversity, mental illness, and other challenges—even those in high risk groups—do not die by suicide, but instead find support, treatment, or other ways to cope.” This is where we can begin to cultivate hope. Do not listen to any voice that says you can’t recover. YOU CAN.

The news of Robin Williams’ death is a reminder to each of us that hopelessness rarely puts itself on parade. Hopelessness hides; it isolates and it often masquerades as your neighbor, friend or coworker trudging quietly through the thickness of depression all while posting exciting status updates on Facebook or volunteering at their child’s school with a fresh smile. If we take something from the tragic passing of a beautiful person and talented actor, let it be this:

Depression does not discriminate.  A well-polished public life – house, career, car, body, wardrobe, etc – is not an accurate reflection of a person’s private life or emotional experience. Check-in with friends if you know they’ve struggled with depression in the past, and never assume that someone is okay based on outward appearance alone.

ASK FOR HELP.   It is not shameful to struggle out loud. Be honest with those around you about how you’re feeling and do not allow your hopelessness to hide.  Talk to friends, family or call the Suicide Prevention Lifeline at 1-800-273-TALK (8255) if you are in crisis.

Depression, eating disorders and substance abuse are treatable illnesses. If you’ve traveled through hopelessness and back again, share with others about that experience of healing so they know it’s possible and that hopelessness is not a one-way street. Encourage others to get treatment.

Know the signs and symptoms that someone is in immediate danger for suicidal behavior and become educated about underlying risk factors for suicide. For example, adolescent boys and girls engaging in multiple unhealthy weight control behaviors are at greater risk for experiencing suicidal thoughts (Kim, et al, 2009).

For more information about the risks of suicide associated with eating disorders, please visit Medical Complication of Eating Disorders.

If you are interested in getting treatment for an eating disorder and co-occurring issues such as depression, anxiety, trauma or substance abuse, please call us right away at (410) 938-5252.  You are not alone.


*Tree image courtesy of Just2shutter and FreeDigitalPhotos.net


This Week in #MediaLiteracy | 2 Campaigns You Should Know About

The world of social media presents an interesting dichotomy.  The challenges of existing in an online community are ever increasing.  Concerns about safety and security are high on the list of course (particularly for parents with tech savvy kids) but additional risks to overall well-being and self-esteem are lingering close behind.  Dangers include online bullying, exposure to harmful imagery or media, and the less sensationalized, yet still problematic, body bashing and body comparison often experienced within sites like Facebook and Pinterest.

Yet while these risks exist, these same online communities also provide a great opportunity for social change and grassroots organizing.  We’ve seen two such examples of powerful social media campaigns this week that we thought were worth sharing.  If you struggle with the body toxic environment online OR offline, perhaps these are opportunities for you to help create change for yourself and for others.   Take a look, find out more, get involved.  Just think, every minute you spend advocating for media literacy, body positivity and truth is one less minute you have to engage in the alternatives.


The Truth in Advertising Act of 2014 (HR4341) was introduced earlier this week with bipartisan support from Representatives in Florida and California and with collaboration from several great organizations including The Eating Disorders Coalition and The Brave Girls Alliance.

The groundbreaking bill calls on the Federal Trade Commission to develop a legislative framework for advertisements that alter the human body (i.e. shape, size, proportion, color, etc.) and asks for recommendations and remedies for photoshopped ads that are determined to be false/deceptive and which may contribute to a series of emotional, psychological and physical health issues, and economic consequences – particularly affecting, but not limited to, girls and women.” (via Brave Girls Alliance).  If this is something you support, its easy to get involved in any of the following ways:

  • Add your name to the Change.org petition by Seth Matlins
  • Read this great write-up about the Truth in Advertising Act by Matt Wetsel over at his blog, …Until Eating Disorders are No More.  He makes it easy to  find your representative in Congress and how to let them know you support the bill.
  • Take to Twitter, Facebook, Google+ and any other social media site with the hastag #TruthInAds to help spread the word. You can even stop by The Brave Girls Alliance for toolkits, images and talking points for the campaign.


The Illusionists is a 90 minute documentary about the body as the “finest consumer object” and the pursuit of ideal beauty around the world. Or: how corporations are getting richer by making us feel insecure about the way we look. 

The hard thing for most people about speaking out against society’s narrow ideals of beauty is that it can feel like you’re a fish swimming upstream in a strong current of Photoshopped bodies, fat talk, and dieting.  Taking a stand can mean you’re up against some pretty powerful forces like the beauty and fashion industries, the diet and weight loss industries and even the larger television and film media that rely on funding from these sources. This pressure compounds when you’re an independent filmmaker working to expose the stories and financial benefits behind the WORLD’S beauty ideals.  That’s what filmmaker, Elena Rossini is doing with her documentary The Illusionists and it’s why The Center for Eating Disorders has been a supporter of the film since it first launched via a Kickstarter campaign in 2011.

Now that the film is almost complete, Elena is swimming against that cultural current once more, and has taken to Twitter with the #AdoptTheIllusionists campaign to help the film, and its message, get the widest possible circulation. On her blog, Elena writes, “My passion for the project stems from its potential to incite activism: I strongly believe that The Illusionists can ignite important conversations about consumer culture, mass media, and the epidemic of body image dissatisfaction around the world. It only takes one person to believe in The Illusionists for the fate of the film to change. It could be a producer. An actress. A writer. An activist with the right connections. It could be you.”

The film has already caught the eye of accomplished artists and activists including Geena Davis and Stephen Fry.  If YOU want to see the first 4 minutes of the film and then show your support for the film, visit Elena’s post, It Only Takes One Person or go straight to the #AdoptTheIllusionists campaign page for supportive statements that are ready-to-tweet.

Let us know how you’ve supported the above campaigns and other ways you engage in media literacy activism.  Leave a comment below or join us on Facebook and Twitter.

What is ARFID?

In the last few months, you may have heard people talking about the “DSM-5” which was just published in May 2013 – this is the latest edition of the manual that mental health clinicians use for diagnosing psychiatric disorders. Formally, the DSM-V is The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.  The newest addition includes several changes to the way eating disorders are categorized and diagnosed.  This post will delve into one of those changes, specifically a new diagnosis called Avoidant / Restrictive Food Intake Disorder (also known as ARFID).

When a person is diagnosed with any type of mental health disorder by a treatment professional, it essentially means they meet a certain number of diagnostic criteria set forth by the DSM-V, in much the same way that someone would meet criteria and be diagnosed with a medical ailment such as heart disease or diabetes. The goal of diagnosing specific disorders is not to label or stigmatize a person but to capture their specific struggles and unique characteristics. This allows treatment providers to develop the best possible treatment plan and apply evidence-based interventions.

The DSM-V provides the following diagnostic criteria for ARFID:

A. An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

1.  Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
2.  Significant nutritional deficiency.
3.  Dependence on enteral feeding or oral nutritional supplements.
4.  Marked interference with psychosocial functioning.

B. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.

C. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.

D. The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.

So what does all this mean in plain English?

Individuals who meet the criteria for ARFID have developed some type of problem with eating (or for very young children, a problem with feeding). As a result of the eating problem, the person isn’t able to eat enough to get adequate calories or nutrition through their diet. There are many types of eating problems that might arise – difficulty digesting certain foods, avoiding certain colors or textures of food, eating only very small portions, having no appetite, or being afraid to eat after a frightening episode of choking or vomiting.

Because the person with ARFID isn’t able to get enough nutrition through their diet, they may end up losing weight. Or, younger kids with ARFID might not lose weight, but rather may not gain weight or grow as expected. Other people might need supplements (like Ensure or Pediasure or even tube feeding) to get adequate nutrition and calories. And most of all, individuals with ARFID may have problems at school or work because of their eating problems – such as avoiding work lunches, not getting schoolwork done because of the time it takes to eat, or even avoiding seeing friends or family at social events where food is present. A good example would be a young boy who almost choked on a hot dog one time, but now refuses to eat any type of solid food and can’t eat school lunches or even enjoy a taste of his own birthday cake. Another example might be a young girl who seems to have no interest in food, complains that “I’m just not hungry” and, as a result, eventually ends up losing weight.

What ARFID is not

It is important to be sure that the person’s problem with eating is not due to a lack of food or “food insecurity”. In other words, children living in poverty who don’t get enough to eat (and as a result are not growing as expected) would not be given the diagnosis of ARFID. An individual living in a famine (who loses weight because they are starving) would not be given the diagnosis of ARFID. It is also important to remember that the eating issues in ARFID are not related to a normal cultural or religious practice. For example, a person who is fasting during a religious holiday (such as Lent or Ramadan) would not be given the diagnosis of ARFID.

We know that individuals with anorexia or bulimia struggle with distortions in how they see their bodies and that they have significant concerns about their weight. But this type of thinking does not occur in ARFID – kids with ARFID typically don’t fear weight gain and don’t have a distorted body image. Also, in ARFID, the problems that people have with eating are not related to underlying medical problems. For example, a child going through cancer treatment might lose her appetite and avoid food because of chemotherapy – but this child would not be given a diagnosis of ARFID. Another example might be a teenager who is obsessed with a fear that he is going to ingest germs and get sick, and therefore refuses to eat any uncooked foods – this teenager would probably be given a diagnosis of obsessive-compulsive disorder rather than ARFID.

Filling in the gaps

Although ARFID is being presented as a new diagnosis, it might be more useful to simply consider it as a way of describing symptoms more specifically. A lot of patients with eating disorders don’t “fit” perfectly into a diagnosis of anorexia nervosa or bulimia nervosa – and so, prior to the release of the DSM-V, clinicians would often give those folks the diagnosis of Eating Disorder, Not Otherwise Specified (EDNOS). Unfortunately, if you say that someone has EDNOS, it doesn’t really give us much information about the person’s symptoms, other than that they have some kind of eating disorder.

In the past, before the DSM-V, kids with ARFID might have been diagnosed with EDNOS. They also could have been given another diagnosis called “Feeding Disorder of Infancy or Early Childhood” (although most clinicians didn’t use that diagnosis especially since one of its requirements was that the age of onset has to be before age six). But what about those kids or adults who have restrictive eating not related to fear of weight gain, who may or may not be a normal weight, and whose lives are severely impacted by their symptoms? This is where ARFID can fill in the gaps and help us to better understand those individuals.

As ARFID is officially still a new diagnostic category, there is little data available on its development, disease course, or prognosis. We do know that symptoms typically present in infancy or childhood, but they may also present or persist into adulthood. It is possible that some individuals with ARFID may go on to develop another eating disorder, such as anorexia nervosa or bulimia nervosa, but again, no research is available yet to give a clear picture of what happens down the road for these individuals. We also are still learning about effective treatments for individuals with ARFID. Although research is just beginning, we believe that behavioral interventions, such as forms of exposure therapy, may be useful. And of course, as in other eating disorders like anorexia or bulimia, treatment of underlying conditions such as anxiety or depression is crucial.

Many kids develop different or strange patterns of eating at some point in their life – refusing to eat vegetables for a few months, or wanting to eat only chicken nuggets for dinner – but for most individuals, those patterns eventually resolve on their own without intervention. For the small subset of individuals who have persistent or worsening problems with food intake, however, the introduction of ARFID means we are now able to better diagnose and describe their symptoms, which should ultimately result in better clinical outcomes.

The most important takeaway point in all of this? Eating disorders come in all shapes, sizes, and symptoms, and if you have questions or concerns, just ask.

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American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: American Psychiatric Association, 2013.

Kenney L, Walsh B. Avoidant/Restrictive Food Intake Disorder (ARFID) – Defining ARFID. Eating Disorders Review, Gurze Books, 2013; Vol 24, Issue 3.

 Written by Heather Goff, M.D., Child & Adolescent Psychiatrist


Connecting with EMME on Body Image, Beauty and Balance…


The Center for Eating Disorders at Sheppard Pratt is gearing up for a week of free community events in recognition of National Eating Disorder Awareness Week 2013.  To help us kick things off, supermodel and positive body image advocate, Emme will provide a special keynote presentation in Baltimore entitled “Connecting BODY+MIND+SPIRIT” on February 24th, 2013. In advance of this free event, we asked Emme to share her unique insights into the current cultural ideals regarding beauty and to comment on some of the key elements that have helped her establish a positive, balanced relationship with her body, mind and spirit throughout her career.

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 Q & A with Emme Aronson:

Q: Through your development of EmmeNation and your role as an Ambassador for the National Eating Disorder Association, you have become a powerful advocate for positive body image. What does the term body image mean to you and how did it come to be such a significant part of your overall message of self-acceptance?

Emme: Body image is the framework for the house where our soul resides. If the foundation is weak, the house crumbles and the soul cannot fully exhibit its magnificence. How we live day-to-day depends on whether or not we have a connective or disassociated connection with our soul and our body.

Often we live from the neck up in a constant, not fully self-accepting state so to speak. By not breaking this chain of self loathing, body bashing, and guilt, dis-ease within one’s self grows and negativity cycles infinitum. At the same time a select few get richer at the cost of millions being diseased or disconnected each day, even each hour if engaging in large doses of media/TV.

It has always been my opinion that only by taking responsibility for one’s health and well-being of the mind, body and spirit, all parts moving in unison together as a befriended system, will we ever be set free from the onslaught of purely capitalistic influences. Our vitality of health, not to mention our culture and the imminent sustainability of our environment,depends on this effort.

Q: What would you say are some of the biggest pressures facing women and girls today that impact the way they experience their bodies and their inner selves?

Emme: I feel it’s the “capitalism-at-all-costs” mentality which, sadly, gets carried on the backs of women starting at an early age. This constant reminder of inadequacy plants insecurity where there once was none, or the seeds may get passed down generationally from mothers to daughters. With the hypersexualized advertising culture in full swing today, these dormant seeds are watered and the negative impact on body image, self-esteem, goal setting, visualization, and accomplishments rolls on, eroding the cornerstone of our society – women and children.

Q: What has your modeling career taught you about your relationship with your body?

Emme: Coming from a news media background, I immediately saw the lack of body diversity in the reporting of beauty. The story was loud and clear that natural body diversity was not to be discussed in mainstream media, and if it was, you were not to highlight it or shoot beautiful, size diverse models side-by-side. This was due to pressures caused by astounding amounts of money being dumped into diet related advertising (based on products with a 98% failure rate). The diet industry today probably makes well over a hundred billion dollars a year. (Psychology Today stated 50 billion in 1997, up from 30 billion in 1987). Understandably, a conflict of interest precedes that kind of money, especially when in uninformed hands. So its my job, and the job of other NEDA ambassadors, to reach out to the media as best we can to share best practices in reporting on body and eating related issues via the protocol presented to networks, women’s magazines and online outlets. An informed media gives them the opportunity to do good and make a choice, which is the best case scenario.

Q: The fashion and beauty industries often receive a lot of criticism for the role they play in pressuring women (and men) to look better, thinner, different, “perfect”, etc. How have you managed to balance your interests in fashion and beauty with your message of self-acceptance and inner beauty.

Emme: Having regularly been involved in the beauty, fashion, TV and clothing industries during different parts of my 20+ year career, I work on maintaining a balance between all the influences. I’m sure I have ruffled a few feathers when I’ve refused to say a line for a commercial, submitted a suggested rewritten line for a show, or refused commercial opportunities worth a lot of money because they didn’t align with my brand. I know a few people thought I was too righteous or full of myself but at the end of the day, I realized I didn’t need to defend myself but instead, had to go by the feeling I had in my gut. Your gut is a wonderful guide, if it’s tight and constricted, wait on whatever is in front of you. If you feel ease and grace, move forward. You may not understand what’s holding you back but listen to that innate guide that’s been with us since the beginning of time. That sensation doesn’t lie. It sometimes takes a lifetime to be still and feel it but, more times than not, it’s right.

Q: At various points in your life you’ve been faced with significant challenges, including a cancer diagnosis, which have surely tested you emotionally and physically. How have you managed to maintain a gratitude-driven existence and a positive relationship with your body throughout these ups and downs?

Emme: If I didn’t have the hearty body that I have, my cancer and treatments during chemo would have wrecked me. I feel today that cancer was one of my best teachers on so many levels.

However, where I gained the most appreciation for my curvaceous body was when I was pregnant. I absolutely loved being able to carry a child and know I was holding this new life in me. Regardless of the fact that my body gained 70 pounds and I was very large, I felt, without a doubt, that this was what my body was meant to do and I embraced myself at every stage. I even did a photo shoot (with all my bits covered but pretty much nude) and it’s one of my favorite shots.

Q: What is your favorite or most useful piece of advice for individuals who still struggle to find peace with their bodies on a daily basis?

Emme: Develop your list of gratitude and concentrate on that list until the anxiety of not being perfect subsides. This stops me before negative self speak rears it’s angry head. (Granted this sometimes takes years to work, but never giving up breeds success). After repeating this often enough like a trained dog, you come to realize you are much more than the empty shell we call our body. Instead of value being based on shape or size, a person’s true value has a chance to rise and nourish the individual and those around them, shining light on personal character traits like: helpfulness, friendliness, playfulness, bravery, courageousness and so on. Once again, take away the soul and you’ve got nothing, just bones, tendons, muscle and fat.

Q: In addition to your work in the U.S., you’ve been active globally with efforts to help women develop positive relationships with their bodies. Can you tell us more about some of these international efforts?

Emme: I’ve been so blessed to have been given the chance to travel a great deal domestically as well as internationally for my work. As a model I got to represent curvy women on three continents, and today I speak out in national and international press on issues relating to self-acceptance, the tricky issues around body image and how important achieving a healthy balance is to sustainability. Recently I was nominated as a Green Apple Ambassador by the Center for Green Schools, a program of the United States Green Building Council (USGBC) (@mygreenschools).  I’m being asked to co-create a K-12 curriculum with the CGS showing the correlation between the following: positive body image + environment = sustainability. Not only in the confines of the ED community are these issues being worked on but in the corporate world, educational systems, and in architectural environments. What is now being discussed in many professional circles is this: If you don’t feel good about yourself, you will not reach for better, think better, act better, eat better, do better, and ultimately may not care about anything beyond your immediate grasp, thus disconnecting you from the world in which you live. Not a great scenario overall.

So there’s clearly a lot of work to be done in the here and now with children, parents, grandparents, schools and the professional community to take responsibility for what we say, think and do to ourselves, to others and to the environment. And guess what? It boils down to such a simple notion:everything rolls from the source!

Q: Do you think we, as a culture, are making progress moving towards “body peace” instead of body bashing as our norm? What have you noticed?

Emme: We’re certainly speaking more about our bodies in print and online, and women are more reflected ethnically, in more various shapes/sizes and in a wider age range, thankfully. All are very important for our culture to see what exists beyond sterile, digitalized images and corporate projections of beauty. However, the more we seem to make progress and move forward toward diverse representations, the corporate push for a more restrained image pops back in again. So education is key and awareness is paramount. An educated and positively engaged mind, body and spirit can help filter what we see, hear and absorb. Indeed, buyer-be-aware of what we “buy into”. Our dollars can be spent in much better ways and can send a bigger message if we really put our heads together for real change in corporate America. I’ve learned, slow change is lasting change.

Q: Who could benefit from attending your presentation in Baltimore on February 24th? What message or skill do you most hope people will take away with them after hearing your talk?

Emme: I hope to connect with those who want to feel less alone and those seeking answers. No need to suffer in silence or bump along life’s journey by yourself. There’s no right or wrong when seeking out one’s truth. So my only message is this: Come with an open heart, you never know what may inspire, inform or ignite you. There’s only one you, and you are perfect just as you are!


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Many thanks to Emme for taking the time to respond to our questions and for sharing her strength and insight with our readers.  If you’d like more information about Emme’s presentation on February 24th, you can visit www.eatingdisorder.org/events or download the event flyer.  The event is free to attend but pre-registration is required to reserve seats.

Interested in more on this topic with Emme?  Join us for a special Twitter Chat with her on Thursday, February 21, 2013 from 1:00-2:00 EST.  Follow @CEDatSheppPratt and @EmmeNation for details and reminders.   

All photos of Emme courtesy of EmmeNation.com

In response to Dr. Drew ~ Exercise bulimia is not a mild mental health issue

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Recently the well-known celebrity internist, Dr. Drew Pinsky, shot this video for CNN iReport. During the segment he answers viewers’ questions about mental and physical health,  including one about healthy exercise and another regarding diet pill addiction in which he references underlying eating disorders as a serious concern.  What seems to be warranting concern is not the answers he’s giving to the viewers so much but the opening statement of the video in which he lightheartedly discloses his own struggle with something he refers to as a “mild” mental health issue called exercise bulimia.  Dr. Drew’s remarks were as follows:  

I got a whiff of exercise bulimia. You sort of exercise too much, and if you miss it you freak out. You have to constantly exercise.  I don’t feel right if I don’t do it.  But, you know, a little whiff of mental health issue never hurt anybody. 

In actuality, “exercise bulimia” is not a formal diagnosis but is a popular term often used to describe a subset of individuals with anorexia or bulimia diagnoses who feel compelled to engage in excessive exercise as a form of compensation for calories.  Some of the signs and symptoms associated with excessive exercise include:  

  • Engaging in exercise even when sick or injured
  • Becoming seriously depressed if you can’t get a workout in
  • Exercising above and beyond what would be considered a normal amount of time 
  • Refusing to build in any days of rest or recovery days
  • Inflexibility as to time of day and mode of exercise
  • Prioritizing exercise over social dates, family functions, work, or school
  • Intense fear at states of rest
  • Intense anxiety at situations where preferred method of exercise is unavailable
  • Intense guilt when forced to stray from exercise routine
  • Refusal to eat if unable to exercise
  • Defining self-worth in terms of exercise performance

Upon seeing the video above, The Center for Eating Disorders’ Director, Harry Brandt, M.D., had serious concerns regarding Dr. Drew’s statement about exercise bulimia and specifically the public interpretations that would follow. 

“In the age of the internet and personal blogs there will always be misinformation out there, but it’s particularly concerning to see high profile medical professionals, in this case an internist, minimizing what is a very serious disorder for a lot of people”  said Dr. Brandt.  He went on to say that “eating disorders are difficult to identify and treat partly because they are a socially normative disease.  Common symptoms like weight loss, dieting, negative body image and excessive exercise are all reinforced in our society.   This can make it very difficult for people with serious eating disorders to recognize their behaviors as problematic and part of a more significant mental health problem.  Statements like Dr. Drew’s trivialize a dangerous behavior and unfortunately make it more difficult for individuals to justify getting help.”       

Dr. Drew’s opinion that, “a little whiff of mental health issue never hurt anyone” is actually far from true.  Something that may seem minor or mild could actually be indicative of a full-blown eating disorder or might represent the first signs that one is developing.   Eating disorders have the highest mortality rate of any mental illness.  Without treatment anywhere from 5-20% of individuals with eating disorders may eventually die from complications related to their illness.  Individuals with eating disorders who struggle with excessive exercise in particular are at risk for the following health problems: 

  • Increased injuries such as stress fractures, strains and sprains
  • Possible permanent damage to bones, muscles, joints, ligaments and tendons
  • Increased susceptibility to infections, fatigue and exhaustion
  • Muscle wasting (the body begins breaking down muscle mass as a source of energy)
  • Fatigue
  • Dehydration
  • Osteoporosis (bone loss)
  • Arthritis
  • Menstrual irregularities and reproductive problems, including infertility
  • Heart problems

Excessive or compulsive exercise does not always occur alongside an eating disorder but when it does, it can provide some of the first signs that someone is struggling with food and eating. We encourage influential health professionals like Dr. Drew to be mindful of the messages they share with the public and to take great care not to normalize or trivialize behaviors that could indicate someone is suffering from a serious mental health problem.

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If you are concerned that you are a loved may have an unhealthy relationship with exercise, please call us at (410) 938-5252 or visit our website at www.eatingdisorder.org .

LOVE YOUR TREE: A Special Community Exhibit of Student Artwork ~ August 2012






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“LOVE YOUR TREE”  ~ Community Art Exhibit 

August 9-12th, 2012 

Thurs, Fri, Sat: 10am-9pm / Sunday: 10am-5pm 

The Shops at Kenilworth in Towson, MD 

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Join us by the fountain at The Shops at Kenilworth for a unique look at six years of student artwork celebrating positive body image, the diversity of beauty, and self-acceptance.   This open exhibit is a kick-off for the Center for Eating Disorders’ 7th annual Love Your Tree campaign  which is currently accepting new artwork submissions from middle school, high school and college students.  Be sure to browse the exhibit, be a part of body positivity…and get a some shopping done while you’re at it!    

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To find out more about Love Your Tree, or to set-up a free art workshop for your school or youth organization, visit us during the exhibit at The Shops at Kenilworth or email the Love Your Tree program coordinator at kclemmer@sheppardpratt.org.

   You can also visit our website at www.eatingdisorder.org.  


What’s Really Going On with Facebook & Body Image?

The results of our recent survey regarding the intersection of Facebook use and body image have been highlighted by various news outlets over the past two weeks.  We discussed the implications of the survey results here (and as a guest post over at The Illusionists), drawing attention to the fact that 51% of the 600 survey respondents said they often compare themselves to others while on Facebook and that seeing photos on Facebook makes them more self-conscious about their own body and weight.  Additionally, 32% endorsed feelings of sadness when they compare their body to other people’s photos on Facebook which, for most people, is at least once a day if not more.

Facebook: Body Image Friend or Foe? at The Illusionists.org

We originally set out to do this survey because we were finding that patients with eating disorders were meeting with great difficulty in the recovery process when it came to logging into their Facebook accounts.  In fact, before we released the full survey results, one user on our Facebook page left the following comment:

Facebook definitely played a role in fueling my eating disorder symptoms and behaviors.  Most people only post pictures that glamorize their bodies and social life…There have been multiple times throughout my recovery that I have deactivated my account because the things I was seeing online were fogging my view of reality.  Realizing that the site was doing more harm than good for me has made me more aware of the things I post on my account.  I think it’s important to make sure we are trying to foster a safe and healthy community and we can only do that if we first change the way we act… .” -  Facebook User

While some media outlets have gone as far as to say that Facebook is a cause of negative body image and eating disorders, others have dismissed the significance of the results as par for the course in our  image and weight-obsessed culture.  Others, including this editorial assistant over at Allure Magazineonline, have spoken up in a personal, and humorous, way about the modern realities of  this pressure-to-be-perfect in Facebook photos. Despite the varied reactions, one thing became clear to us following the survey;   Individuals with eating disorders are not alone in their battle with body-obsession on Facebook.   

Since the survey, we’ve been asked multiple times about how body-pressure from online social media differs from the toxic messages we’ve been getting for decades from fashion magazines, commercials and weight-focused friends?   The answer: the content itself is nothing new to us as a society - conversations that are hyper-focused on weight loss, diets, bikini bodies, and who looks “hot or not” – but the delivery and dissemination of it is new.  We’ve noticed the following characteristics of online communities are unique in how they can potentially affect the relationship we have with our bodies: 

  • Accessibility - Online social networks never turn off.  Even when you’re by yourself you’re often not far from your laptop, iPad or Smartphone and the lure of logging in to Facebook.  In the past, waiting in line at the store might have included…waiting in line.  With a smartphone it could easily be spent browsing Facebook pics from your old college roomate’s beach vacation or reading about Aunt Sally’s 37th time going on a diet.  For better or worse, we have a lot more visual information at our fingertips than ever before. 
  • Immediacy – your status update or photo can literally be seen (and commented on) around the world in a matter of seconds.
  • Lack of control over what other people post and how people comment on it.
  • Two-way street- unlike with magazines or commercials, Facebook not only allows you to see photos of other people, but allows them to see photos of you.  Maybe even more importantly, YOU are seeing public photos of you which can sometimes create the most body anxiety, especially if your instinct is to zero in on all of your supposed “imperfections” in each picture.
  • Business or Pleasure? – there’s a unique mix between the personal and business realms on Facebook.  Users often use one account to stay connected with friends/family but also occasionally promote a product or business in their posts and photos.  This means we get advertisement-like messages about beauty, exercise and weight-loss products from people we like and/or trust.  Confusing? Definitely.     
  • The sheer number of people you are connected to on Facebook is more than you would ever casually socialize with on a Friday night. The thought of hundreds or even thousands of people zeroing in on what you imagine to be “imperfections” can be overwhelming when it comes to body insecurities.  (It’s important to remember that no one else is ever looking at you or your body in photos as closely as you are!) 
  • Body Comparisons while on Facebook take on new meaning because you’re seeing real people.  Unlike magazines and advertisements which feature [heavily photoshopped]models and celebrities, photos of Facebook friends may, unfortunately, feel like a more realistic or welcoming comparison.  

The truth is, when you get caught up in comparing yourself and your body to other people (online or off) you can’t win.  Blogger, Margarita Tartakovsky, shares her journey out of this comparison trap in How To Stop Comparing Yourself To Others, in which she reflects:  

When you’re rarely satisfied with yourself, your self-worth is shaky, and you see others’ lives as almost perfect – or definitely better than your own. You  constantly search outside yourself, and as a result, you knock yourself down. For many of us, comparing ourselves just changes stripes from time to time. One day, we want someone else’s abs, biceps or hips. Another day, we want their smarts or style. A few days later, we want their family life or financial situation.  Until we can truly believe in ourselves, the comparisons will swirl and sabotage…It’s interesting that now that I accept, appreciate and believe in my body, the physical comparisons have mostly quieted.

The trap of body negativity and comparisons on Facebook can certainly be difficult to avoid, especially if your online social atmosphere includes a lot of people who place a high value on appearance-only qualities or happen to be caught up in the diet mentality themselves.  The impact can feel much more powerful if your body image is already in a fragile state as is often the case for individuals with eating disorders and those recovering from eating disorders.  

The great news is that you can mold a more positive online experience for yourself.  If you’ve reflected on your Facebook use,  assessed its impact on your body image and realized that too much of your social networking time is spent feeling worried or sad about how you look, than it may be time to set some changes in motion.

You can start by vowing to maintain a body positive Facebook profile - this means not engaging in fat talk, self-criticism, diet discussion or body snarking while on Facebook. Once you’ve made the decision to do so, you can find tips and suggestions for incorporating body positivity in our post, Social Networks ~ Building a Body Positive Presence Online.

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Body Image Friend or Foe? How is Facebook affecting the way you feel about your Body?

ABC-2 News Interview - Does Facebook Make You Feel Fat?

Over the last year, major social networking and blog sites have taken steps to protect users from  dangerous Pro-ana and Pro-mia communities online.  These are sites that promote eating disorders as a way of life, instead of a genuine mental illness, and create an atmosphere that normalizes and encourages extremely dangerous weight-loss behaviors.  Most recently the popular photo sharing site, Pinterestupdated their policies regarding inappropriate content to include Pinners and boards that feature “thinspo” or “thinspiration” – images of dangerously thin bodies meant to motivate or inspire users to pursue greater weight loss.   While banning this content won’t cure eating disorders, it can certainly help to protect vulnerable individuals from tapping into these dangerous websites. 

Though somewhat hidden in “underground” niches across the web, the dangers of online pro-eating disorder sites have been well-documented, and we commend Pinterest, Facebook, and Tumblr for taking a stand to protect their users from these sites.  But perhaps more unsuspecting in their effects, are mainstream social network communities: general sites like Facebook that we all use everyday to keep in touch with friends and family across the world, to post pictures of our kids and pets, to share birthday wishes or follow favorite organizations.  

Have you ever thought about how Facebook use is affecting your relationship with your body? 

Recently, The Center for Eating Disorders commissioned a public survey of Facebook users age 16-40 and found that, for most Facebook users, the answer to this questions is actually quite concerning.  In response to the survey we found:

  • 51% of respondents said that seeing photos of themselves on Facebook makes them more conscious about their own body and their weight
  • 32% said they feel SAD when comparing Facebook photos of themselves to their friends’
  • 44% spend time wishing they had the same body or weight as a friend when looking at photos on Facebook
  • 37% said they feel that they need to change specific parts of their body when comparing their bodies to a friend’s body in Facebook photos

Now consider that 80% of the respondents in our survey reported that they log on to Facebook at least once a day and more than half of them log on several times each day.   Thus, we see the set-up  for a daily stream of negative body image thoughts which could potentially impact one’s self-esteem.

Recent articles on CNN.com and NYTimes.com have drawn attention to the heightened role that online social networks play in adolescents’ relationship with their bodies, specifically with regards to the sexualization of teens’ online photos.  Most recently, the self-esteem website Proud2BMe.org  featured a collection of sobering quotes  from real teens regarding their body image and Facebook use, a few of which are excerpted below:

“People get positive attention in the world by losing weight. And you can do it to an even greater extent on Facebook.”-Anika, 18

“It’s only the ‘standard beauty’ who gets the ‘likes’ I feel like to be the hot girl, you have to be like that, or wear your shirt too low and your skirt too high.” -Kirby, 18

“When looking at images of girls in a magazine almost all us know that they are altered electronically to appear perfect. When it comes to social media such as Facebook, most believe that they are looking at raw pictures, or ‘real girls.’ Whether this is true or not, they are ultimately used as a standard of comparison.    -Mary

What may be even more sobering is the reality that this mindset is not unique to adolescents. Survey results indicate that this is not just a phase we pass through or something teens will necessarily grow out of.   Respondents included adults in their 20s, 30s and 40s confirming that they experience similar patterns of body negativity and weight obsession when using Facebook.   

Body negativity on Facebook is not to be considered just a women’s issue either.  In this survey commissioned by CED, 40% of the male respondents agreed that they sometimes write negative comments about their own body in photos posted on Facebook (whereas 21% of females agree to doing so).

What do we gain from publicly, or privately, criticizing our bodies and constantly comparing our bodies to one another?  Does anyone really benefit from congratulating or praising people when they post about weight loss or diets in their Facebook updates?  Weight obsession and body shaming certainly isn’t new, but online social networks are creating a new frontier that seems to be publicizing our body insecurities while magnifying society’s love affair with diets and weight loss. CED’s associate director Dr. Steven Crawford had this to say in response to the survey results:

As people spend more time thinking about what’s wrong with their bodies, less time is spent on the positive realm and engaging in life in meaningful and fulfilling ways.  When people become more concerned with the image they project online and less concerned with holistic markers of health in real life, their body image may suffer and they may even turn, or return, to harmful fad diets or dangerous weight-control behaviors. We hope the results of this survey encourage people to really look at how their online behavior affects their outlook, and we caution them against being overly critical of their own bodies or other people’s bodies while on Facebook and other social networking sites.

Consider reflecting on your own Facebook use and how it could possibly be affecting your relationship with your body.   We suggest asking yourself the following questions to discern whether certain online behaviors or patterns are harming your self-esteem or body image:

  • How often do you publicly or privately criticize your own body while online?
  • How much time do you spend comparing your body to other people’s bodies online?
  • What percentage of your status updates focus on weight, diets or exercise? 
  • Do your comments on other people’s photos regularly focus on weight or appearance in a negative or positive way?  
  • How do you feel when you look through friends’ online albums? Do you ever get overwhelmed by this?  

It’s important to remember that Facebook, and social networking in general, is a wonderful way to stay in touch with and connect to other people and organizations.  Facebook certainly doesn’t cause negative body image in and of itself.  It does however, provide lots of fuel for the weight-obsession and body criticisms that already burn out of control in our larger culture.  This can be particularly worrisome for individuals who already struggle with severe negative body image or eating disorders.  During a recent interview with ABC-2 News regarding the survey results, CED Director, Dr. Harry Brandt added that,     

Facebook may be another step in our culture that promotes self-consciousness about appearance and feelings of low self-worth around [the] body, and those are significant factors in the proliferation of eating disorders.

If you find that you’re using Facebook as an outlet for feeling badly about your body, comparing yourself to others physically, or hyperfocusing on appearance and weight in your posts, it may be time to renovate your page.  Check out these follow-up posts:

Do you have suggestions? Want to share about you own experience?  Join the conversation, and start the movement towards online body positivity on our Facebook page.

You can findmore information about The Center for Eating Disorders at Sheppard Pratt on our website, www.EatingDisorder.org