Who are we missing? Eating Disorders & Minority Mental Health


Minority Mental Health Awareness Month was designated in 2008 to bring awareness to the unique struggles that underrepresented groups face in regard to mental illness in the United States.


Eating disorders can negatively affect almost every aspect of a person’s day-to-day life. They can also be associated with dangerous medical consequences. Recovery is possible though, and these negative effects can be minimized with early intervention and quality treatment. But treatment can’t happen if the people with eating disorders who need the help aren’t identified or supported in seeking that help.

Why do so many people with eating disorders go undetected?

There are many reasons why red flags and warning signs of an eating disorder (ED) might be overlooked.  A major factor being that our current culture normalizes dangerous weight-loss behaviors and promotes body dissatisfaction across the board. As a result, it can be hard to detect clinically significant behaviors in anyone when “everyone” seems to be caught up in a toxic diet culture. But there are other reasons that continue to have repercussions specifically for people in minority groups.

Researchers believe that only 1/3 of the people that meet criteria for an eating disorder ever actually receive treatment.1 

Most of what we know to be true about EDs (or any illness) is based on the existing  research on that topic. Much of the early research about eating disorders was done within populations of people who had already been diagnosed and had accessed treatment. Historically, the majority of people who sought and received eating disorder treatment were wealthy and white.2  Most were also relatively young and female. More and more research was done within this mostly homogeneous treatment-seeking population, and it reinforced misperceptions about who is impacted by eating disorders.

More recently, researchers are doing a better job of capturing representative samples, and advocates worldwide are doing tremendous amounts of work to educate communities   about diversity in eating disorders. Research on the prevalence of eating disorders in diverse communities has revealed a reality in stark contrast to the old stereotypes. For example:

  • Prevalence rates of bulimia nervosa, anorexia nervosa, and binge eating disorder are equal across ethnicities and socioeconomic levels 2,3
  • Prevalence of bulimia nervosa is significantly higher in Latinos and African Americans in comparison to non-Latino whites and Asians.2
  • Girls from a low-socioeconomic status (SES) household displayed a 32% increase in bulimic symptoms compared to girls in middle class households, and a 40% increase relative to girls in high income households.1

It’s clear that people from a variety of backgrounds and across racial and ethnic categories are impacted by serious eating disorders. And yet, we also know that equal and consistent access to treatment remains a problem for marginalized communities. Consider the following:

  • White, Non-Latino, high-SES girls are almost twice as likely to be diagnosed with an ED.1
  • Even though African American girls are more likely to exhibit bulimic behavior, only 0.7% of African American, low SES girls have been formerly diagnosed with an ED.1
  • College students of color are less likely to be diagnosed with an ED compared to white students.3
  • Lower SES students are less likely to receive treatment than students from more affluent backgrounds.3

These findings indicate that the popular perceptions of who is affected by EDs, specifically bulimia nervosa, are only accurate in terms of who is identified and diagnosed, not who is actually impacted. It also tells us that health and mental health providers are not immune from the stereotypes and may be less likely to recognize symptoms or warning signs in their minority patients. As a result, they may then be less likely to provide resources and make appropriate referrals.

Updated research, more thorough training for medical and mental health professionals and diverse outreach is needed across the board so that early intervention can be provided for all who are suffering from these life-threatening illnesses.

What can be done? 

You can help by getting involved in advocacy efforts to advance research and clinical practices for all people impacted by eating disorders. The National Eating Disorders Association (NEDA) and Eating Disorder Coalition (EDC) are two great places to start. If you work in education or health-focused organizations, you can take action to ensure that you and your colleagues receive regular training to enhance cultural competence within your field.

Individually, we should all evaluate whether we perpetuate myths about eating disorders by only sharing images or reading stories told through the lens of young, thin white women. Going forward, be sure to amplify the voices of people of color, men with eating disorders, LGBTQ communities and people in higher weight bodies who have historically not been included in eating disorder narratives. Even just boosting diverse posts and articles on social media can go a long way in helping to change the public perception of EDs and make it a little easier for those who need treatment to receive it, or at least recognize themselves in the coversation.

Tweeting about eating disorders, recovery, body acceptance or non-diet news? Check out: @MelissaDToler / @NalgonaPride / @FoodPsychPod ‏/ @dumplingskin ‏ / @thirdwheelED ‏ / @ASDAH ‏ / @DianneBondyYoga / @StigmaConf ‏ / @jameelajamil ‏ / @RadicalBodyLove / @NEDAstaff / @TFFED

If you think that you (or someone you know) may be struggling with an ED ask for help today. The sooner you connect to resources the sooner you can begin to feel better.  The Center for Eating Disorders is committed to being a safe, welcoming organization for people of all ages, races, ethnicities and genders. Call 410-938-5252 today.


Contributions by:
Avery Madison, Former CED Research Assistant
Avery graduated from Franklin & Marshall College where she earned her Bachelors of Arts in psychology with a minor in Spanish.  In addition to her RA role at The Center, she worked at a counseling center in Lancaster, PA providing one-on-one support for children and adolescents with emotional and behavioral difficulties.  Previously, she has worked as a medical advocate for the YWCA where she provided support to victims/survivors of sexual trauma.  Her past school research projects include examining the relationship between facial mimicry and empathy and between cell phone access and anxiety.


References:

  1. Ham, J., Iorio, D., & Sovinsky, M. (2012). Race, social class, and bulimia nervosa.Human Capital and Economic Opportunity Working Group Working Papers16.
  2. Marques, L., Alegria, M., Becker, A. E., Chen, C. N., Fang, A., Chosak, A., & Diniz, J. B. (2011). Comparative prevalence, correlates of impairment, and service utilization for eating disorders across US ethnic groups: Implications for reducing ethnic disparities in health care access for eating disorders. International Journal of Eating Disorders44(5), 412-420.
  3. Sonneville, K. R., & Lipson, S. K. (2018). Disparities in eating disorder diagnosis and treatment according to weight status, race/ethnicity, socioeconomic background, and sex among college students. International Journal of Eating Disorders.

When College Students Come Home for the Summer: Addressing Eating Concerns

 

You sent them off to college in the fall, full of pride, excitement… and probably some worry. Your worries might have been about academics, healthy relationships, finances and maybe even drugs and alcohol. The list of things we worry about as parents can feel endless.

While college can be an incredibly positive experience for many young adults, it is undoubtedly stressful and exhausting to undergo such a major life transition. The stressors of the college environment make it ripe for the development of many health and mental health problems, and eating disorders are no exception.

Now that the academic school year has come to a close, many college students have flown back to the nest for a summer reprieve. Whether your student was a freshman, a senior, or anywhere in between, this is an important time for parents to check-in about how their child has grown and matured, how they’ve been coping with the stress of school and to support any ongoing needs they may have before the next semester or stage of life begins.

Being back under the same roof again, eating meals together, means this also tends to be a time when many parents notice the signs of their college student’s struggle with an eating disorder. Some of the red flags that parents first report include:

  • Changes in eating and/or exercise habits: They may strictly adhere to new rules about what they can and cannot eat. They might also exercise excessively, even if it gets in the way of other important obligations or even when it’s dangerous to do so (ex: running despite a knee injury or driving to the gym in hazardous weather conditions).
  • Increased concerns about shape/weight: Frequent comments about their own body size (ex: “I’m too fat”) and that of others (ex: “She’s in such good shape!”) might suggest your child has a heightened focus on shape/weight. This may also be indicated by behaviors such as frequently weighing themselves or choosing to wear loose clothing to hide changes in their body shape.
  • Preoccupations with food and eating: Frequent dieting is one of the strongest predictors of the development of an eating disorder. Other key indicators include practices related to dieting such as tracking intake with an app, counting calories, cutting out entire food groups (e.g., veganism, the keto diet) and other restrictive practices that often result in increased anxiety or obsessionality about food; some people may frequently cook/bake food for other people that they themselves refuse to eat.
  • Secrecy and isolation: Eating disorders thrive in secrecy. You may notice your child choosing to eat dinner alone in their room instead of with the family or making other plans or excuses to avoid family mealtimes altogether. You may also find food, detox or diet product packaging hidden in the house. In line with this, they may withdraw from old friends and no longer engage in activities they used to enjoy.
  • Concentration difficulties: People affected by eating disorders are typically not receiving adequate levels of nutrition to function at their best. This nutritional deficit not only affects the body but also the brain, making it incredibly difficult to stay focused for even a short period of time (ex: frequently “zoning out” during conversation, slowed reaction time, poor recall).
  • Mood and energy changes: The way we eat and the amount of nutrients we consume impacts the brain’s ability to process and respond appropriately to emotionally triggering events—this means that even minor disturbances, like spilling coffee on a new shirt, can be incredibly distressing for someone who’s not getting consistent or adequate nutrition. Your child might seem “down” or lack energy, or they may seem “on edge” or especially anxious—either could be evidence of a co-occurring mental health concern or a result of an eating disorder.

For more on how the stress of the college environment can play a role in the development of eating disorders, click this image to read “Eating Disorders & The Transition to College.”

What to Say & How to Say It
When you’ve been looking forward to your’ child’s return from school all year, it can be jarring to notice any of these red flags. It’s tough to tackle eating and mental health issues with children at any age, but it’s further complicated with college-age children as they emerge into adulthood and a new type of independence. So, how do parents approach such personal topics with young adult children, while still respecting them as an autonomous individual? It’s always best to consult a professional regarding your family’s specific situation but here are a few general recommendations:

  • Respect your child’s privacy: Breaching the subject at a family gathering or public place is not the best idea. Your child is much more likely to be open and responsive if you voice your concern in a private, one-on-one setting, as this allows them a safe space to discuss such a personal issue.
  • Practice open, nonjudgmental communication: Eating disorders are highly stigmatized, and many who suffer may be reluctant to disclose their struggles with food and body image. Some may vehemently deny their problematic behaviors, while others may lack awareness that there even is a problem. The best way to combat stigma is through open discussion about eating disorders. Ask your child how they feel about their eating habits or body image, listen openly to their response, and withhold any judgmental or invalidating remarks. Make them feel heard by using their own words to reflect their statements and expressing validation of their pain (ex: “I am so sorry that you have been feeling […], it sounds like dealing with […] has been really tough.”).
  • Avoid blame: Steer clear of accusatory “you” statements (ex: “You need to eat more!”) that place unnecessary blame on your child and may trigger a defensive reaction from them. Instead, opt for “I” statements that allow your child to hear your concerns without feeling the need to defend themselves (ex: “I am concerned about the safety of this new diet product,” or, “I noticed you’ve had very little energy lately which is unusual for you.”)
  • Come prepared: When discussing triggering topics, it’s easy to let our emotions get the better of us and turn the conversation into a hostile argument. It may be helpful to think of what you want to say beforehand. Still, don’t be surprised if you’re met with some resistance or denial. Educate yourself about eating disorders– the risk factors, the physical and emotional consequences, and treatment options.

Next Steps?
Once you’ve communicated your concern, what can you do to ensure your child gets the proper care they need? Refer to our brief online assessment, which can be completed by your child themselves, or by you based on your observations of their behavior. This brief assessment provides valuable information about potentially problematic eating behaviors along with resources and suggestions for how to proceed.

We also offer FREE weekly support groups for individuals at any stage in eating disorder recovery, as well as their parents, friends, and loved ones. These groups are open to anyone – meaning your child does not need to be a patient at CED to attend, and parents are welcome to attend with or without their child.

If you are still concerned, the best option is to speak to a licensed professional who can provide a formal diagnosis and recommend treatment options depending on your child’s unique needs. Here at The Center for Eating Disorders, we have licensed mental health professionals available to consult with you over the phone and diverse programming throughout all levels of care. If you’re concerned about your child, please call us at (410)-938-5252 to to discuss next steps.

For more on how the stress of the college environment can play a role in the development of eating disorders, see Eating Disorders & The Transition to College.


Written by: 
PHOTO Jacquelyn PattonJacquelyn Patton, Research Assistant
Jacquelyn is a graduate student currently pursuing her Masters in Clinical Psychology at Towson University, with the intent to earn her degree in May 2020. She received her Bachelors of Science in Psychology from the University of Maryland, College Park in 2017. As an undergraduate, Jacquelyn served as a research assistant for the Center for Addiction, Personality, and Emotions Research where she conducted a study examining the impact of racism and racial/ethnic identity formation on health-risk behaviors, including disparate patterns of substance use. She joined the research team at CED as a volunteer research assistant in 2018 and worked on researching the utility and efficacy of telemedicine in the treatment of eating disorders.

Reference List

Anorexia and Bulimia Care. (n.d.). Parents. Retrieved from http://www.anorexiabulimiacare.org.uk/family-and-friends/parents

National Eating Disorder Association. (2018, February 22). Warning Signs and Symptoms. Retrieved from http://www.nationaleatingdisorders.org/warning-signs-and-symptoms

National Eating Disorder Association. (2015). NEDA TOOLKIT for Parents. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

When Pseudoscience Becomes Trendy: Q&A with Suman Ambwani, PhD. #NEDAwareness


PHOTO Dr. Suman Ambwani

Suman Ambwani received her PhD in psychology from Texas A&M University and completed her clinical psychology internship at the Medical University of South Carolina. She is an Associate Professor of Psychology at Dickinson College, where she teaches courses on psychopathology, research design and analysis, and eating disorders. She also serves as the Principal Investigator for the Clinical Assessment and Research (CARE) lab. Her scholarship examines factors associated with the development and maintenance of eating disorders, particularly cultural features (such as fat-shaming environments and pseudoscientific diet fads) and difficulties with interpersonal relationships. Dr. Ambwani is also currently involved with two clinical trials investigating technology-based guided self-help interventions for anorexia nervosa and strategies for caregivers to best support their loved ones with eating disorders.

In honor of National Eating Disorders Week (Feb 25-Mar 3) we sought to learn more about Dr. Ambwani and her work. Read on below to hear about her interest in eating disorders, her mentors, and what she hopes attendees will take away from her March 3 presentation in Baltimore.


Q: How did you become interested in the field of eating disorders research and the factors that contribute to them?

A: I must admit that I originally began investigating body image as a junior in college as a strategic decision – I wanted to work with a faculty member whom I greatly admired, and I knew that this topic fell under her area of expertise. That initial research led to a senior honors thesis examining relationships among gender, body image and experiences in romantic relationships. Delving into this area of study sparked more questions and helped me to understand the urgency of examining the complex, multifaceted factors associated with the development and maintenance of eating disorders.

 

Q: What is the CARE Lab at Dickinson and what kinds of current research are you doing? What makes your research innovative?

A: The CARE Lab focuses on understanding sociocultural and interpersonal factors that play a role in the development and maintenance of eating disorders. We hope that furthering our understanding of these factors will inform preventative efforts and facilitate more effective interventions for patients and their loved ones. Our research targets several theorized risk factors for disordered eating, including, “fat talk,” disrupted perceptions of social interactions, personality characteristics, negative mood, and difficulties in interpersonal relationships. We have used this work to inform guided self-help interventions for individuals with anorexia nervosa, and are presently collaborating on two clinical trials using these approaches in the UK. Recently, we have also begun investigating systemic factors, such as anti-fat bias and pseudoscientific dietary fads, to better understand how these could be targeted to prevent eating disorders on a broader scale and thus improve population health.

 

Q: You recently took some time away from teaching at Dickinson College to serve as a visiting scientist with the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) at Harvard’s School of Public Health. Can you tell us more about STRIPED and the work you did while you were there?

A: About two years ago, I read an article by the director of STRIPED, Dr. S. Bryn Austin, in which she advocated for policy translation work as a macro-environmental lever to prevent eating disorders. I was inspired by her call for action, in which she said “Bluntly stated, if we keep doing more of the same over the next 30 years of research, we will continue to earn only the same type of small-scale victories with little promise of substantial impact on population health.” I decided that I wanted to shift focus from individual-level factors to learn more about opportunities to target systemic factors to prevent eating disorders. STRIPED was my top choice for a research partnership given their leadership in this arena. During my time with STRIPED, I had the opportunity to be involved with several different research projects, such as projects on “clean eating,” social media, anti-weight discrimination legislation, and dietary weight loss supplements. I was also able to assist with training and dissemination efforts, such as a training program for primary care providers on screening and referral for eating disorders, and a workshop on developing online courses about eating disorders and other public health concerns. Finally, as STRIPED is currently assisting with three bills for the MA State Legislature (all targeting eating disorder risk factors), I was also able to learn about the procedures for policy translation work.

 

Q: You’re headed to Baltimore to present When Pseudoscience Becomes Trendy: An Exploration of Clean Eating, False Health Claims and Eating Disorder Risk. Why is this an especially relevant topic for our current culture?

A: Whether you peruse a magazine while checking-out of the grocery store, review your Instagram feed, or simply read the news, you are likely to be confronted with information about “clean” diet fads and their “miraculous” health benefits. But although “clean eating” is frequently touted in the popular press and in social media, there is very little scientific research on this dietary strategy. What does it even mean to “eat clean”? What kinds of claims are made about the benefits of “clean eating”? Could there be any risks associated with this dietary strategy? For instance, given the well-established link between dieting and increased risk for disordered eating, could following dietary fads like “clean eating” also confer increased risk for eating disorders?

 

Q: What makes something pseudoscience versus actual science? What are some of the biggest sources or promoters of pseudoscience?

A: Pseudoscience is when something masquerades as science but does not actually follow the stringent principles of the scientific method. For instance, Gwyneth Paltrow’s company, Goop, was recently charged with making unsubstantiated health claims about their rose quartz vaginal eggs and essential oils (claiming that they balanced hormones and prevented depression). As another example, someone might claim that a “clean diet” can cure cancer, but the only evidence that they can provide in support of this claim is unsystematic, or poorly measured, or non-replicable. Several websites make unsupported, non-evidence-based claims about “clean eating,” and close scrutiny often reveals a lack of nutritional expertise among the authors (many identify as “wellness gurus” or offer similarly ambiguous credentials).

 

Q: What are some examples of systemic factors that might contribute to the development or maintenance of eating disorders?

A: There are many systemic factors that could contribute to eating disorders. For instance, our cultural preoccupation with thinness and stigmatizing attitudes toward fatness create an environment where it is simply not ok to live in a larger body. As another example, our diet, weight-loss, and fashion industries shape unrealistic standards of beauty and fail to represent the real diversity of human bodies. Alternately, relatively low awareness and misinformation about eating disorders may contribute to failures in detection and thereby maintain eating disorder symptoms. Similarly, lack of access to appropriate care could be considered another systemic factor that serves to maintain illness symptoms.

 

Q: Who are some of your academic, clinical or advocacy role models? Any favorite books you think people could benefit from reading on the topics of eating disorder recovery, prevention or diet myth-busting?

A: I greatly admire Dr. S. Bryn Austin and her team at STRIPED for their dedication to preventing eating disorders. Dr. Austin is a wise and prolific scholar, a thoughtful mentor and leader, and a passionate advocate for policy change to improve public health. Those who wish to bridge the gap between science and policy to address eating disorder prevention and social justice should follow the work of STRIPED and consider contributing to support their efforts.

I also greatly admire the work of Professor Janet Treasure, an extraordinary clinician and researcher at King’s College London. Her scholarship has fundamentally shifted our understanding of brain processes, social relationships, and treatment approaches for eating disorders. Professor Treasure’s work is especially novel because it highlights patient and caregiver voices in developing treatments for eating disorders. In terms of recommended readings, I highly recommend the following:

 

Q: In addition to mental health providers and folks in the fitness and nutrition fields, who else do you think could benefit from attending your talk on March 3?

A: I think young people – older adolescents and young adults – could benefit from the talk. They could learn about the risks of these dietary fads and share the information with their peers.

 

Q: What do you hope attendees take away from your presentation?

A: I hope that they understand the research on dieting as a risk factor for eating disorders and the harmful impact of embracing pseudoscientific dietary fads (even those marketed as health-promoting strategies). I also hope that they start to think about how we can make a change in our culture, in our policies, and how doing so could serve to reduce eating disorder risk on a broader, population level.

 

Q: Where can our readers go to follow along with the great work you’re doing?

A: Please follow me on Twitter @sumanambwani or keep an eye on my lab website for updates!


Many thanks to Dr. Ambwani for her time and effort in answering our questions! Join us for her free presentation on March 3 in Baltimore. RSVP here

Eating disorders in film: Important reminders during awards season #popcultureED

 


Over 13 percent of teen girls suffer from an eating disorder by the age of 20. It’s not just girls either: disordered eating is almost as common in males as females and can extend long into adulthood. When we get right down to it, eating disorders are serious and people living with them have a higher risk of dying compared to same-aged peers. Still, disordered eating is often joked about and normalized in pop culture. This ‘awards season’, we’re nominating moments from popular movies of the past that show just how common distorted ideas about bodies, diet and food are in our culture. We still love some of these classic comedies, but let’s be careful to challenge unhealthy behaviors as we watch.

GIPHY Video Audience Giving a STanding Ovation

Unfortunately, some movie scenes can be quite triggering for folks with eating disorders and those in recovery. It’s not uncommon to see detailed ED thoughts and behaviors in films that that are never challenged or paired with appropriate education. So, we’ve taken a few movie examples below and added important reminders and fact-checking opportunities.

It’s possible to enjoy films while also thinking critically about their messaging. You might also want to actively decide whether to watch or not to watch before engaging with specific films that you know will normalize or showcase disordered eating.

First up on our #popcultureED tour is…


“THE DEVIL WEARS PRADA”

This movie, starring 2019 SAG awards winner Emily Blunt, reminds us that no goal is ever worth starving for. Emily Blunt’s character frequently makes comments about her restrictive eating and undeniable pursuit of a thinner body.

Nourishing your body consistently is a better way to keep yourself healthy enough to reach your career goals and be present to enjoy them. If you’re struggling to overcome thoughts that equate thinness with success, you’re not alone. Take a step and ask for help before things get worse. Whether you’re a fashion designer, a father, a teacher, or an artist, you deserve to be free of food and weight obsession.

 


“ROMY AND MICHELLE’S HIGH SCHOOL REUNION”

Romy and Mishelle share all sorts of diet obsessed banter in this movie, including this extremely dangerous quip. Reality Check: Candy is delicious, but it doesn’t provide nearly enough energy on its own for everything your amazing body does each day. All foods can fit in a healthy pattern of eating but one type of food on its own – whether candy or kale – can never meet all your nutritional needs. Incorporating a variety of fun and nourishing foods is best.

 


“MEAN GIRLS”

Did you know that some of the most common side effects of dieting are mood changes, depression and irritability. That could be one reason why Regina was always so negative and, quite frankly, pretty nasty to the people around her. Luckily, this movie does teach us that trying to be “perfect” can take its toll.

Did you know that perfectionism is a risk factor for the development of eating disorders?  Perfectionism can also cause you to miss out on opportunities to learn from mistakes and may ultimately get in the way of living a balanced, rewarding life.

 


“A CINDERELLA STORY”

Our bodies need different nutrients to fuel them. Cutting out entire food groups or sources of energy can cause major problems for your body (and really limit your options when eating out). One of the side effects often noted by people with eating disorders is that they begin to isolate from friends and family since they no longer feel comfortable eating around other people or they literally can’t find anything on the menu that fulfills the “rules”.

Social isolation can lead to all sorts of other diffculties and can worsen depression and anxiety. If you’ve noticed that you or a friend are retreating from meals or other previously enjoyed activities it might be time to seek support.

 


“ZOOLANDER”

Derek and Hansel are misinformed when it comes to losing weight. The fact is, purging is not an effective way to lose weight or prevent weight gain. In fact, over time, purging behaviors are associated with weight gain (and a whole host of serious medical consequences). On top pf being misinformed, the characters explode in laughter when Matilda opens up to them about her own history with bulimia.

This is obviously a comedy but it’s still important to remind ourselves while watching that purging is NEVER funny and purging is never a safe behavior. Don’t be like Derek and Hansel. If a friend shares with you that she or he is struggling, take it seriosly. If you need resources to help a friend, check out the Let’s Check In Discussion Guide.

 


“CLUELESS”

Cher and her friends engage in awful lot of weight shaming, diet talk and appearance bashing throughout this movie. (It’s actually hard to find a single scene without it).

Critical body talk and weight shaming – even when self-directed – has a lot of negative consequences. When you criticize your own body, it impacts you and the people around you negatively, making everyone more distracted by and less accepting of their own appearance.

Our thoughts affect our feelings and behaviors so it’s important to learn how to curb negative self-talk and practice saying kind things to yourself. Remember, your vibe attracts your tribe. Work on body acceptance and you’ll be more likely to attract friends who are body positive too.

 


“BRING IT ON” 

Sports have the power to promote self-esteem but not with a coach like Sparky Polastri who flat out disparages bodies and encourages restrictive eating disorders among his athletes.  Any coach who puts an emphasis on weight is bad news for the whole squad.

Not eating enough to fuel your workout can reduce strength, speed, and stamina and lead to increased risk of injury from things like stress fractures, fainting and muscle cramps – not what you want when you’re on top or bottom of the pyramid!

Sparky’s advice is way off; athletes burn a lot of energy through their training, so they actually need to eat more than non-athletes to properly fuel their bodies. Never be afraid to get a second opinion if a coach is steering you wrong.

 


“PITCH PERFECT”

Food shaming is ALL AROUND US in the movies and in real life so we get pretty used to hearing stuff like this. Something you think is a harmless joke about what someone is eating might actually have major repercussions for them.

We never know how the people around us feel about food or their bodies, so it’s best not to make offhand comments about what they should or shouldn’t be eating. Also, burgers are great and can be enjoyable and nourishing at any age!

 


“LITTLE MISS SUNSHINE”

Did anyone else’s heart break a little when Richard told Olive that ice cream would make her fat? In real life, instilling a fear of fatness does not keep kids (or adults for that matter) from gaining weight, but it can contribute to negative body image and disordered eating, including bingeing on foods that are deemed by adults to be forbidden or off-limits.

A better message for kids? All bodies are good bodies and it’s OK to enjoy a variety of different foods. You might also want to check out these other 8 tips for raising body positive kids (who are also competent eaters).

 


The Oscars

As you watch the Oscars and other awards shows this season, let’s cheer on the great acting and fun story lines while also keeping in mind how popular films – even comedies and parodies – can influence our own thoughts and expectations regarding food, weight and eating.

Join the conversation with us on social media using #popcultureED.

If you’ve had an eating disorder in the past or are in the early stages of recovery, sometimes it helps to have a specific support plan for watching potentially triggering or body shaming movies. Read more about that here: How to stay recovery-focused when interacting with triggering media

Don’t forget, eating disorders are serious and risky if untreated. The first step is awareness; If you suspect that you or someone you know has an eating disorder, visit  eatingdisorder.org or call 410-938-5252 for a free phone assessment.

4 social media changes you can make for the New Year…in 5 minutes or less


The pressures of resolutions and new beginnings after the holiday season can be overwhelming. So why not make a change that will help free up time and headspace while also improving body image?  Your social media life may be an area to evaluate…

Social media has undoubtedly become more and more prominent in our lives. On the one hand, these sites have showcased benefits, such as maintaining social connections and sharing meaningful content and life experiences with others1. On the other hand, problematic social networking site use (or SNS), such as commenting on others’ pictures and “lurking,” have been shown to have negative consequences on body image, self-esteem, and eating disorder symptoms. Even taking selfies, and excessively editing and manipulating these images, has been associated with greater body-related and eating concerns2.

As you reflect on the past year, think about how much time you spent scrolling through social media and comparing likes. What if you could start the new year off with a healthier and more productive approach to care for yourself and your self-esteem? These four simple tips can help you change social media behaviors in the new year.

 

1. Limit Overall Social Media Use


On average, we use social networking sites for over an hour a day3. While some of this social media time may be used in productive ways, maladaptive use of these sites for over an hour a day could lead to significant negative thoughts and feelings. Think about unplugging and limit time spent scrolling!

  • Set aside a specific time every day to use your favorite sites.
  • Delete the apps off your phone, limiting access to social media only from your computer.
  • Use digital reminders or post-it notes on your computer to remind you of other activities you might enjoy more than scrolling through a social media feed. Texting a friend? Planning a vacation? Registering for a class?

 

2. Think Critically About Social Media


For some, it might seem impossible to remove social media entirely in a world where use is growing rapidly. So, while we can limit use overall, it can be greatly beneficial to change the way we perceive what we are exposed to when we are using social media. While scrolling through Facebook and Instagram and viewing everyone’s carefully selected and manipulated “best-self”, be sure that you are thinking critically about what you are seeing and posting.

  • Remind yourself that images are often edited and re-edited!
  • Be mindful of comparing yourself with peers or celebrities’ photos on social media.
  • Notice if you are starting to feel poorly about yourself when scrolling and decide if it would be a good time to log off.

 

3. Remove or Block Negative Content


Exposure to content that promotes the “thin ideal”, or the promotion of a desire to be skinny or fit, is more common now than ever in a world of body-altering photo applications and “photoshopping” in the media. Many individuals with an eating disorder are prone to participate in negative social comparisons and are more likely to internalize the “thin ideal,” making them more susceptible to the negative effects of this type of imagery. Take some time to go through your social media and analyze what you are being exposed to and how it makes you feel.

  • Are anyone’s photos making you feel poorly about yourself?
  • Is a celebrity promoting disordered eating or dangerous products (like cleanses or detox teas) to maintain a “perfect figure?”
  • If images or accounts are not helping you work towards recovery, hide the posts or block photos.

 

4. Follow More Positive Accounts


While the negative effects of social media have been the focus here, there are many reasons why these platforms have skyrocketed in recent years. Sites such as Facebook and Instagram can be great to share accomplishments, keep in contact with distant friends, or even see what your favorite musician or politician is up to. We can help to control what kind of messages and content we are exposed to by changing who we follow on social media.

  • Fill your feed with positive role models, quotes, and positive peers to help create a body-positive environment that focuses on more than appearance to achieve self-worth.

Below are just a few examples of body positive or recovery-focused Instagram accounts you can choose to follow in the new year!

 


 

Written By:

Ava Sardoni, Research Assistant
The Center for Eating Disorders at Sheppard Pratt 

Ava is currently pursuing her Master’s in Clinical Psychology at Loyola University Maryland, with intent to graduate in May of 2019. She also earned her Bachelor of Arts in Psychology at Loyola University Maryland, graduating in May of 2018. Her past research projects include researching the relationship between specific personality traits and motivations for using online dating applications.


References:

  1. Cohen, R., Newton-John, T., & Slater, A. (2018). ‘Selfie’-objectification: The role of selfies in self-objectification and disordered eating in young women. Computers in Human Behavior, 79. 68-74. https://doi.org/10.1016/j.chb.2017.10.027
  2. McLean, S.A., Wertheim, E.H., Masters, J., Paxton, S.J. (2016). A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders. International Journal of Eating Disorders, 50. 847-851. doi: 10.1002/eat.22708
  3. Uhls, Y.T., Ellison, N.B., & Subrahmanyam, k. (2017). Benefits and Costs of Social Media in Adolescence. Pediatrics, 140(Supplement 2, S67-S70. Retrieved from http://pediatrics.aappublications.org/content/140/Supplement_2/S67.long

Telemental Health: Using Technology to Overcome Barriers to Eating Disorder Recovery


The highly specified nature of eating disorder care lends an important fact about treatment: Evidence-based eating disorder treatments are as complex as the disorders themselves and require well-trained and experienced clinicians to provide such specialized care. However, the complex and specialized nature of treatment yields one of the main challenges facing the field of eating disorder care today: There simply aren’t enough available providers to meet the needs of patients, and those qualified to offer evidence-based treatment tend to be concentrated in urban areas.1,2

Barriers to Quality Care

Eating disorders, on average, affect at least 30 million Americans of all ages and genders.3 Several effective treatments for eating disorders exist that have been shown to greatly improve physical health and mental wellbeing in a majority of patients. Evidence-based treatments such as cognitive-behavioral therapy, interpersonal therapy, and family-based therapy are designed to target specific concerns within particular eating disorder diagnoses and populations.4 But for patients with eating disorders living in rural areas, there are few treatment options. As a result, they are often forced to make difficult decisions, choose between less than optimal options, and deal with potentially negative consequences such as:

  • Traveling far distances to available specialty providers
  • Sacrificing excessive time away from school or work
  • Paying for travel in addition to treatment
  • Receiving lower level care from a provider with no experience or specialized training in the treatment of eating disorders
  • Opting to not get treatment at all and continuing to suffer with the serious consequences of an eating disorder.
One potential solution to the lack of readily accessible care for eating disorders is telemedicine, also known as telepsychology or telemental healthcare. 

Telemedicine allows clinicians to deliver specialized care to patients in a remote location via videoconferencing. In the field of general health care, telemedicine has existed for decades as a means to provide treatment to patients who could not travel to qualified providers. In this format, a patient can receive the same high-quality care they would from a specialist treatment center remotely in the comfort of their own home. Telemedicine is a relatively new method for eating disorder treatment, but research studies have shown its effectiveness to be practically equivalent to that of traditional face-to-face therapy.5

Though more research is needed to support this method of delivering therapy, the existing studies show that eating disorder treatment delivered through telemedicine can lead to positive outcomes such as:

  • The establishment of a healthy weight1,6
  • Decreased concerns about shape and weight1,2
  • Positive relationships with the providing clinician5

Disadvantages of telemedicine typically include technological difficulties,7 though rapid improvements in communication technology will likely combat issues found in past telemedicine research.8

Telemental Health offers a path to high-quality treatment for individuals affected by eating disorders who otherwise might not have access to it.

The Center for Eating Disorders at Sheppard Pratt now offers telemental health services for patients who live far distances from our offices. Dr. Jennifer Moran and Dr. Ekaterina Amarando are trained and licensed to provide psychotherapy for patients located in the state of Maryland, and Dr. Meghan Gaare is trained and licensed to provide psychiatric care for patients in the states of Maryland and Virginia.

For inquiries related to receiving telemedicine care, please call (410)-938-5252, or visit CED Telemental Health Program.

 


Written by: 
PHOTO Jacquelyn PattonJacquelyn Patton, Research Assistant
Jacquelyn is a graduate student currently pursuing her Masters in Clinical Psychology at Towson University, with the intent to earn her degree in May 2020. She received her Bachelors of Science in Psychology from the University of Maryland, College Park in 2017. As an undergraduate, Jacquelyn served as a research assistant for the Center for Addiction, Personality, and Emotions Research where she conducted a study examining the impact of racism and racial/ethnic identity formation on health-risk behaviors, including disparate patterns of substance use. She joined the research team at CED as a volunteer research assistant in 2018, working under the supervision of Dr. Sproch. In this role, Jacquelyn is currently researching the utility and efficacy of telemedicine in the treatment of eating disorders.

 


References

1. Anderson, K. E., Byrne, C. E., Crosby, R. D., & Le Grange, D. (2017). Utilizing telehealth to deliver family-based treatment for adolescent anorexia nervosa. International Journal of Eating Disorders, 50, 1235-1238. doi:10.1002/eat.22759

2. Simpson, S., Bell, L., Britton, P., Mitchell, D., Morrow, E., Johnston, A. L., & Brebner, J. (2006). Does video therapy work? A single case series of bulimic disorders. European Eating Disorders Review, 14, 226-241. doi:10.1002/erv.686

3. Eating Disorder Statistics. (2018). National Association of Anorexia Nervosa and Associated Disorders. Retrieved from http://www.anad.org/education-and-awareness/about-eating-.disorders/eating-disorders-statistics/

4. Yager, J., Devlin, M. J., Halmi, K. A., Herzog, D. B., Mitchell, J. E., Powers, P., & Zerbe, K. J. (2006). Practice guidelines for the treatment of patients with eating disorders. (3rd ed.) Retrieved from https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guideline s/eatingdisorders.pdf

5. Mitchell, J. E., Crosby, R. D., Wonderlich, S. A., Crow, S., Lancaster, K., Simonich, H., … & Myers, T. C. (2008). A randomized trial comparing the efficacy of cognitive–behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Behaviour research and therapy46, 581-592. doi:10.1016/j.brat.2008.02.004

6. Goldfield, G. S., & Boachie, A. (2003). Delivery of family therapy in the treatment of anorexia nervosa using telehealth. Telemedicine Journal and E-Health, 9, 111–114.  doi:10.1089/153056203763317729

7. Chakrabarti, S. (2015). Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World Journal of Psychiatry, 5, 286-304. doi:10.5498/wjp.v5.i3.286

8. Waugh, M., Voyles, D., & Thomas, M. R. (2015). Telepsychiatry: Benefits and costs in a changing health-care environment. International Review of Psychiatry27, 558–568. doi:10.3109/09540261.2015.1091291

 

 

Is your school or classroom a body-positive space for students?


It is widely accepted, from preschool to high school, that teachers and school staff play a big part in helping students to develop positive self-esteem. Many of those same teachers may not be aware that one of the most significant factors in an individual’s overall self-esteem is body image. So why does the way we see/think/feel about our bodies matter so much and what does that have to do with our classrooms? Consider the following:

  • 31% of adolescents do not engage in classroom debate for fear of drawing attention to how they look.1
  • 20% of teens say they stay away from class on days when they lack confidence about their appearance.1
  • On days when they feel bad about their looks, 20% of 15 to 17 year old girls will not give an opinion and 16% will avoid school altogether.2
  • A study of more than 11,000 teens found that students who saw themselves as overweight (regardless of actual weight) had lower academic performance than those who did not. This is important because it means the perception of being overweight – likely because of cultural bias and negative stereotypes that come with that – was a more significant determinant of academic performance than medically defined obesity.

If the way kids feel about their bodies impacts attendance, classroom engagement, academic performance and individual self-esteem, it makes a lot of sense for schools to be paying attention to body image.  Below are just a few ways you can work to establish a school environment that is body positive and doesn’t reinforce harmful weight stigma, appearance ideals or the diet mentality.


6 Guidelines for a Body Positive Classroom


Representation matters. 

Do a thorough scan of books, posters and other materials around your classroom. Do they include a wide representation of people with diverse bodies – both in weight and shape but also skin color, gender presentation and physical ability? Will all kids see themselves represented in the positive imagery around your classroom?

If your class involves physical fitness or health messaging, consider whether your resources show kids and adults of all shapes and sizes being active or just thin/muscular people? Are fatter bodies exclusively used in imagery meant to deter or shame people for specific behaviors? If you’re in need of new imagery, check out these inclusive stock fitness photos from The Body Positive Fitness Alliance.

Above all, remember that kids who feel good about their bodies, regardless of their weight, are more likely to engage in healthy behaviors and less likely to engage in risky or harmful behaviors like smoking and bingeing.4 To help bring body positivity into your class, add books and resources to your lesson plan or syllabus that promote body acceptance and provoke age appropriate conversations about the natural diversity of bodies. Messaging that focuses on 1) how health behaviors can make us feel, or 2) developing gratitude for the functionality of our bodies as opposed to what they weigh or look like, can promote self-care and confidence. A list of age-specific body positive resources is included at the end of this post – please scroll down to check it out!


Leave all personal diet-talk at the door and enforce that rule with fellow teachers and school staff.

We know that kids are listening to the adults around them even when we don’t think they are. Casual background discussions about cutting out carbs, trying a new “cleanse” or berating oneself for eating a cupcake are not as innocent as you might think. When little ears – or even mature high school ears – overhear their favorite teacher or respected mentor talking about food and bodies in critical or shameful ways they can internalize those messages. There are many reasons why we encourage adults not to introduce kids to dieting, including the fact that kids who diet are up to 18 times more likely to develop an eating disorder.5

Furthermore, there is no long-term evidence that any fad diets like keto, paleo, Whole30, Atkins or otherwise lead to reliable or sustainable weight loss. In fact, diets have been associated with longterm weight gain. Specifically, adolescent girls who diet are at 324% greater risk for obesity than those who do not.6


Normalize the variety of healthy body changes that take place before and during puberty. 

For example, it’s completely normal (and necessary) for a young girls’ body to store up extra fat before she gets her period for the first time. It’s also common for boys and girls to gain weight and fill out just prior to growth spurts in height. Remember this happens at very different times for different kids. If they experience these normal changes as abnormal or bad, it puts them at risk for body dissatisfaction and disordered eating. But If kids (and teachers and parents) can learn to anticipate these changes they may be more likely to trust their bodies as they grow and mature.


Incorporate MEDIA LITERACY into your curriculum.

It doesn’t matter if you teach preschool story time or AP Literature, there are countless opportunities to talk about how to handle cultural messages kids receive about beauty, appearance, health, and weight. The Center for Eating Disorders provides body image and media literacy workshops for educators and parents as well as arts-based campaigns like the Love Your Tree campaign. We also encourage school staff to pursue training in evidence-based prevention programs such as The Body Project and to work with local organizations to incorporate student activism projects that challenge the thin ideal and inspire brands to do better.

 

Weight-based bullying is more common than all other forms of teasing. Establish a policy against weight-based bullying and actively work to reduce body commentary in general.

What’s the difference between a teacher proclaiming “you look amazing! Have you lost weight?” and a student teasing her classmate for “packing on the pounds” over the summer? Not much actually. They both reinforce a negative bias towards larger bodies and establish an unnecessary focus on appearance/size. In our culture it is assumed that saying something one thinks is “nice” about someone’s body is a good thing but praising specific aspects of one’s appearance can be just as detrimental for the school community as a whole because it reinforces the dangerous appearance ideals. Consider the following scenarios:

Malik gets nicknamed “string bean” by the principal because he had a growth spurt and grew much taller and slimmer than his peers. Malik was already feeling self-conscious about his height and knows the principal was just kidding around but now he does everything he can to avoid seeing him in the hallways.

Dean came back to school a size smaller and friends are requesting her “weight loss secrets”. They don’t know she was in treatment for an eating disorder over the summer and has developed heart problems and other health complications as a result.

So what is a school or classroom policy that addresses all of the situations above? Something similar to “We just don’t comment on other peoples bodies” can be the most effective message to dissuade body-talk (praising or teasing) among students and staff.


Encourage colleagues – administrators, school nurses, coaches and physical education teachers – to review the evidence for any interventions they are implementing with regard to weight, health or nutrition. 

Every school should be asking whether there is quality, health-focused research to back up the intervention and does this program have the potential to do more harm than good? The truth is, many of these practices lack research and may have harmful consequences, yet many schools and childcare centers continue to implement them. Examples of such campaigns and curriculums currently include:

  • Publicly weighing kids in gym or health class
  • Giving kids assignments that require them to count calories and track their food
  • Hosting “Biggest Loser” weight-loss competitions among school staff
  • Sending home BMI report cards for students or calculating BMI in class.
  • Shaming kids’ lunch items or teaching very young kids to label food items as good/bad or healthy/junk.

When it comes to BMI report cards, even the Centers for Disease Control (CDC) notes in their report that “Little is known about the outcomes of BMI measurement programs, including effects on weight-related knowledge, attitudes, and behaviors of youth and their families. As a result, no consensus exists on the utility of BMI screening programs for young people.7

There is no indication that providing kids and parents with BMI information leads to any significant behavior change or improved health outcomes. Furthermore, unless safeguards are solidly in place, a risk of harm exists when children are simply told there is something wrong with their body size. Risks for body comparison and weight-based teasing also increase.8

What else are you doing to reduce weight-based teasing and make your classroom a safe place for students of all shapes and sizes? Tweet us @CEDSheppPratt today and share your experiences. 

 


Body Positive Resources:

For School Administrators:

Preschool/Elementary Kids & Parents:

Middle School:

High School/College:


Links to References:

  1. Ignoring it doesn’t make it stop.
  2. Beyond stereotypes: rebuilding the foundations of beauty beliefs.
  3. Perception of Overweight is Associated with Poor Academic Performance in US Adolescents
  4. Does Body Satisfaction Matter? Five-year Longitudinal Associations between Body Satisfaction and Health Behaviors in Adolescent Females and Males
  5. Onset of adolescent eating disorders: population based cohort study over 3 years
  6. Risk Factors for Body Dissatisfaction in Adolescent Girls: A Longitudinal Investigation
  7. A Report on the Facts and Concerns About BMI Screening in Schools

The Eating Instinct: Food Culture, Body Image and Guilt – Q&A with Virginia Sole-Smith

 


Virginia Sole-SmithVIRGINIA SOLE-SMITH‘s forthcoming book The Eating Instinct is described as “an exploration, both personal and deeply reported, of how we learn to eat in today’s toxic food culture”. 

Maybe you are struggling to get off the hamster wheel of dieting or you’re trying against all odds to raise kids with positive body image.

Perhaps you feel pressured to feed yourself perfectly or you’re working on recovery from an eating disorder. Maybe you can see the ravages of weight stigma and food shaming in your patients. We all intersect with this toxic food culture in different ways, but we can all benefit from Sole-Smith’s honest and eye-opening look at the issue.

In advance of her presentation in Baltimore next month, we asked Virginia Sole-Smith to tell us more about the book, her own experiences as a writer and a mom and about her mentors on the topics she writes about. Check out her responses below and register for her upcoming event here


{ Q&A with Virginia Sole-Smith }

 

What is The Eating Instinct all about and what inspired you to write it?

I’ve written about how women relate to food and our bodies for years — but when my newborn daughter Violet stopped eating as the result of intense medical trauma, I realized that I didn’t know anything about how eating begins or, really, why it falls apart. I began researching how we learn to eat and realized that we are all born with instincts for hunger and satiety, but somewhere along the way, we’re taught to ignore those instincts. I didn’t know how to teach my daughter to feel safe around food when that’s something so many people struggle with as adults — so I set out to collect stories of those struggles. In doing so, I discovered that our shame-based food culture is at the root of most people’s problems with food.

 

The subtitle of your book refers to the term “Food Culture” and you unpack this extensively in your writing, but how do you define food culture? And why is it a timely concept to explore?

I define food culture as all of the messages we get around food. We learn about food first from our family, but very quickly, from the wider world as well — teachers, doctors, media, advertisers, and so on. And all of those forces influence each other, so doctors, for example, may learn a little about weight and nutrition in medical school, but are also products of the family dinners they ate as kids and the diet memes they see circulating on Facebook. And right now, our food culture is at a sort of crossroads. For the past 20-30 years, it’s been dominated by two anxieties: the so-called obesity epidemic and the growing need for more sustainable food systems. Both of these issues are rooted in some very real concerns about our health and the environment. But we’ve really only tried to solve them by controlling how people eat in various ways — and it’s not working. Over the past decade or so in particular, these two issues have merged and created a new set of unrealistic standards around “clean eating” that perpetuate disordered eating without solving either problem.

The Eating Instinct [cover]

 

Your subtitle also references the word, guilt. What are some common examples of how guilt has come to be so intertwined with eating in our lives?

Unfortunately, guilt is a part of our eating life from the time we’re very small. We get pressure to clean our plates but not have any more cookies. Then as diet culture messages take hold, we begin to feel guilt over almost every food group in one way or another. As one mother I interviewed put it: “We’ve start to think that ‘low fat dairy’ should mean no dairy. Lean meat should mean no meat. Gluten is evil, so there go carbs. Fruit has too much sugar. Which means vegetables are the only foods parents feel good about feeding their kids — and kids don’t like vegetables!” It’s a mess.

 

As a writer, you’ve published pieces about body dissatisfaction and the diet mentality in several publications – like women’s magazines – that have traditionally been some of the biggest sources of fat shaming, weight loss advertising and thin-ideal promotion. Have you faced resistance or pushback from such sources when calling out these issues? If so, how do you handle it?

For many years, it was an uphill battle to get any stories criticizing diet culture into a mainstream women’s magazine. I’ve had some stories killed and others that were so heavily edited, I ended up feeling pretty unhappy with the messages they sent. But the tide does seem to be turning — British Cosmopolitan just featured Tess Holliday on their cover. Earlier this year, SELF ran a special “weight” issue with articles about weight stigma and health at every size.

There are still tons of damaging women’s media stories out there. Our work is not done. But I do think some of these brands are finally recognizing that the conversation needs to change.

 

Social media has become a huge part of our culture. Are there some intersections with social media and food culture, and do you address this in your book?

Absolutely. Instagram, in particular, has become a huge source of food culture and the diet mentality thanks to posts of what people are eating, before and after diet photos, and the rise of “wellness influencers” who make big bucks endorsing diet products and plans. It’s a huge problem because we’re on social media so constantly, which means the messages are becoming harder to shut out. But I also wonder how the performative nature of these sites is changing our relationship with food. After showering, going to the bathroom and sex, eating is probably our most intimate physical act. Yet we do it in public all the time — and now, we do it on the Internet all the time. That’s a very large stage.

 

Given the current culture you reference around food and weight, recovering from an eating disorder or just trying to eat more mindfully can often make us feel like we’re swimming upstream. Do you have any simple recommendations for individuals who want heal their relationship with food but have a hard time with conflicting messages from friends, doctors, diet industry, fitness gurus, etc.?

I think it’s very important to curate your media intake. Delete any health influencers, fitness gurus, etc — basically, anytime a post makes you feel bad about your own body, take that person out of your feed.

The other thing I suggest, which sounds simple, but often is not: Stop apologizing for your food choices and your body. Women are conditioned to feel like we can’t take up space and that we shouldn’t ever feel hungry. So many of us talk negatively about food or apologize for eating as a kind of unconscious reflex. If you can stop yourself from saying those words out loud — and it’s fine to just say nothing if saying something positive feels too hard! — it can be game changing.

 

As a mom, how do you prepare your own kids to be resilient and resistant to toxic messages about food and bodies that they will most certainly encounter? Do you ever worry about the messages they are getting about eating at school?

When my older daughter was 2 years old, she came home from daycare and told me “I have to finish my lunch before I can have my cookie!” It was such a record scratch moment. We worked so hard to help Violet feel safe around food again – and literally just a few months after she started eating on her own, here was a new message about food that was fundamentally saying “you’re doing it wrong.” I realized then that when it comes to feeding kids, one of our most important jobs is helping them learn to recognize and question these messages, and provide a space where diet culture rules don’t apply. Now Violet knows that at home, she can eat her meal in any order she wants — yes, even cookie first. But we’re continually navigating this as she hears new messages. The work is never done.

 

11/4/18 Event Flyer Who are some of your favorite resources and mentors on the topic of body acceptance that you turn to or have learned from the most in exploring these topics related to food and eating?

Naomi Wolf’s The Beauty Myth is almost 30 years old — but still completely relevant.

Linda Bacon’s Health At Every Size was a huge influence on my thinking on all of this.

And I love the groundbreaking work of Lexie and Lindsay Kite of Beauty Redefined.

 

What can people expect to take away from your event in Baltimore on November 4th? Who do you think could benefit most from attending?

I’ll be sharing my personal story of how we helped Violet learn to eat again — and how that made me realize that our current food culture has made eating feel unsafe for so many of us. We’ll look at how diet culture messages are showing up in places they absolutely should not be — like during pregnancy and in our kids’ lunch boxes — and talk about strategies for disconnecting from the onslaught. My message resonates particularly with parents — because we’re all struggling with the twin responsibilities of feeding our families and feeding ourselves. But anyone who has felt victimized by our modern food culture will find it helpful.


Virginia Sole-Smith is a journalist whose work has appeared in the New York Times Magazine, Harper’s and Elle and she’s a contributing editor with Parents Magazine as well as co-host of the highly recommended Comfort Food Podcast. She lives in New York’s Hudson Valley with her husband, two daughters, and three cats.

You can meet Virginia and hear her speak in Baltimore on November 4 during our free fall community event, Food Culture, Body Image, and Guilt in America.

Pre-registration is highly encouraged as space is limited. Online registration available at: eatingdisorder.org/events.

 

photo credit: Gabrielle Gerard Photography

NEDA Congressional Briefing on Eating Disorders

CED Co-Director, Dr. Steven Crawford, among panelists to speak on Capitol Hill

The National Eating Disorders Association (NEDA) in conjunction with the Congressional Mental Health Caucus hosted a Congressional Briefing on Capitol Hill on October 2, 2018. This briefing was held to educate representatives and legislative aides about eating disorders in overlooked populations. Panelists at the briefing included Chevese Turner (moderator), Mike Marjama, Claire Mysko, Janell Mensinger, PhD, and Steven Crawford, M.D.

Dr.Crawford, co-director at The Center fo Eating Disorders at Sheppard Pratt, began by discussing the different eating disorders and the risks and causes associated with them. He explained the differences in each disorder and the ways someone can help if they notice symptoms of an eating disorder in someone they care about. These include, seeking more information on the subject, locating resources, not focusing on weight, and encouraging the person to seek specialized treatment.

Dr. Janell Mensinger, an Associate Research Professor at Dornsife School of Public Health at Drexel University, presented on eating disorders and population weight. Her presentation focused on people in higher weight bodies and she explained how weight-related harassment is over four times more common than bullying. She stressed that we, as a society, need to shift focus from weight to health and provided research that shows eating disorders and extreme dieting are increasing among people in higher weight bodies.

The next panelist Claire Mysko, CEO of NEDA, spoke about a prevention program called the Body Project. The Body Project is a group-based intervention that helps decrease eating disorder symptoms and body dissatisfaction in high school girls. There are currently 388 trained facilitators for this program across the United States. Mysko also mentioned how NEDA is working on a similar program for young men.

The final panelist was former Seattle Mariners Catcher Mike Marjama who now serves as a NEDA Ambassador. Marjama presented his personal struggle with body dissatisfaction and an intense desire to change his body, which led to extreme behaviors around food and exercise, an eating disorder diagnosis and eventually hospitalization. His treatment and recovery however, led him to a baseball career and renewed appreciation for mindfulness and balance. After retiring he decided to speak openly about his disorder and his story has since been featured on Good Morning America. As an Ambassador for NEDA his goal is to help boys and men see through outdated stereotypes about eating disorders so they can get the help they need.

Eating disorders are one of the most dangerous mental health issues and should not be taken lightly. Unfortunately, they are too often overlooked in people with higher weight bodies, in athletes of all calibers and in traditionally marginalized populations. Our hope is that the information shared in the Oct 2nd hearing will assist legislators in creating policies that not only support prevention and treatment for eating disorders but improve overall public health.

Additional Advocacy Resources:

  • Get involved, learn about state-specific legislative actions and become a NEDA advocate.
  • Read summaries of current legislative actions, read about current initiatives and get involved with advocacy days on Capitol Hill with the Eating Disorder Coalition.
  • You can find out more about The Center for Eating Disorders’ recent advocacy work here.

Written by: Julie Seechuk, Social Work Intern 

NEDA Walk: There are many ways to make a difference


Despite their increasing prevalence, eating disorders receive significantly less funding than other major mental illnesses, and a lot of misinformation still exists about who is impacted and just how serious eating disorders can be. As treatment providers we know that for every person who walks through our doors and receives treatment, many others never get the help they need. We are participating in a NEDA Walk this year to try to help change that. As NEDA shares on their website, there are 30 million great reasons to participate in a walk. If you’re wondering why you should walk, consider the following.

To help raise awareness & restore hope…
Eating disorders are widely misunderstood illnesses, and old stereotypes and myths often prevent people from seeking help. Help fight stigma and shine a light on eating disorders as a serious public health issue.

To help save lives…
Eating disorders are associated with many different short-term and long-term health consequences, some of which are very serious and others that can be fatal. By participating in the NEDA Walk, you’ll be raising funds that support life-saving programs, advocacy efforts, and research initiatives.

To feel less alone…
Eating disorders can be extremely isolating illnesses. When you’re struggling or supporting a loved one with an eating disorder, it’s easy to feel like you’re the only one in the world who is going through it but we promise, you’re not. Participating in a NEDA Walk is a great way to come together as a recovery-focused group and engage as a community in positive change.

While there are countless reasons to participate in a Walk, it’s also extremely important to consider that there may be reasons not to walk too. Given that eating disorders often involve energy deficits and an unhealthy relationship with exercise, it’s important to remind potential walkers that your safety and recovery always need to come first.

Typical NEDA walks are 1- 2 miles in distance but for someone with an eating disorder, significant movement or walking – even a short distance – could be unsafe or contrary to treatment goals. Definitely check in with your treatment providers prior to participation if you’re having any of these symptoms:

  • recent fatigue, weakness or dizziness
  • episodes of fainting, falling or near falls (tripping) in past month
  • muscle cramps, numbness or paresthesia’s (limb falling asleep) in your extremities
  • recent dehydration and electrolyte abnormalities
  • inability to complete a meal without acting on symptoms the morning of the walk

Furthermore, even if you haven’t had the physical symptoms listed above, ask yourself the following questions:

  • Is your motivation to attend the walk driven primarily by a desire to engage in exercise?
  • Have your thoughts about the walk included calculations of distances, steps, calories, etc.?
  • Do your current treatment goals include taking a break from exercise or restrictions on movement?

If the answer to any of those questions is yes, be sure to set parameters with your treatment team around the best and safest way for you to participate. For example, it is important to remember that you can attend a NEDA Walk without doing the walk portion of the event! Bring a lawn chair, listen to the keynote speakers, and cheer on your team. You can also bring a buddy who can help you stay focused on the important aspects of the walk and who can help ensure you’re well-fueled before the event, symptom-free during the event and full of hope throughout the day.

Lastly, it’s 100% OKAY if you can’t attend a walk right now because you’re taking care of yourself. Sometimes self-care means saying no to some things so you can say yes to treatment or recovery. You can always participate by sharing about the cause online – or – use the event day as a catalyst for your own recovery. Locate a local support group, read a book about recovery, or make that call to a therapist you’ve been putting off.

However you choose to participate, remember that you are worth it and you are not alone.

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The Center for Eating Disorders at Sheppard Pratt will be joining NEDA and a host of other eating disorder and body image organizations for the Baltimore NEDA Walk on September 30 at Goucher College. Find out more here.