8 Tips for Raising Body Positive Kids (Who are also Competent Eaters)


If your goal is to raise kids with high levels of self-esteem, eating competence, body satisfaction and a healthy weight (which is different for everyone) then join the chorus of advocates saying #wakeupweightwatchers and ditch the diet mentality for yourself and your family.  We know weight-loss diets don’t work. We also know they can cause serious harm, especially when introduced to kids and teens.  Let’s prevent the weight loss industry from profiting off our children’s generation.

So if dieting doesn’t work to help kids maintain a healthy weight, what is a parent to do?  These 8 tips are a great place to start.

  1. Make a commitment to having family meals together as often as you can within your family’s schedule. Having regular sit-down meals as a family has been shown to be a protective factor against a range of health and mental health problems including disordered eating.1,2,3,4 
  2. Introduce and incorporate a variety of foods from different food groups at every meal. This doesn’t assume your kid will actually eat them but it’s important to expose them, even if it’s just on someone else’s plate.
  3. Teach and model body acceptance (as opposed to body criticism or body comparison). Kids are always listening and watching how the adults around them relate to their own bodies.
  4. Support your child’s natural ability to regulate hunger and satiety. Promote trust in their ability to self-regulate. We recommend learning more about Ellyn Satter’s Family Feeding Model and the Division of Responsibility in feeding.

Research has shown that size acceptance and learning to use hunger and fullness cues produces sustainable improvements in blood pressure, cholesterol levels, physical activity, self-esteem, and depression compared to dieting.” 5

 

  1. Engage in physical movement as a family with the goal of adventure, fun, coordination and social connection. Try not to frame exercise as punishment, as a way to gain permission to eat or as a means to an end (i.e. weight-loss).
  2. Incorporate all foods without fear or mixed messages. Food is energy and fuel but it’s also okay for it to be enjoyable too. Don’t forbid specific foods or categories of foods (unless there is an allergy of course). Refrain from using food as a reward at home and in the classroom as this can confuse kids, encourages them to eat in the absence of hunger or may lead to a pattern of rewarding oneself with food.6
  3. Refrain from labeling foods as “good foods” vs “bad foods”. Connecting foods with negative labels like bad, toxic or junk foods, can send kids a message that food is related to morality. Even young kids may internalize these labels. Ex) I ate a bad food, therefore I must be bad or I should feel badly. This can trigger strong feelings of guilt or shame related to eating as well as increased emotional eating.
  4. Support healthy sleep habits. Kids who don’t get enough sleep, or have chaotic sleep schedules, show changes in hormones that regulate hunger and appetite. Not getting enough sleep can also impact the way a child’s body metabolizes certain foods.7

While these tips are meant to be a very basic place to start, they might still feel overwhelming since we live in a culture of toxic messages about food and weight. It’s hard to let go of anxiety about our kids’ eating behavior and weight. These can also be difficult to implement if you have your own history of body image struggles, eating disorders or dieting.

If you’re worried that your own relationship with food or weight might be complicating the way you approach these issues with your kids or teens you’re not alone. It can be helpful to get support from a therapist with eating disorder expertise or other non-diet practitioners. At The Center for Eating Disorders at Sheppard Pratt we provide a number of services that can help, including:

If you’re interested in any of these services, please call (410) 938-5252 for more information. 

Previous Post: 10 reasons NOT to introduce dieting during childhood & adolescence


References:

  1. Losing weight won’t make you happy
  2. Are Family Meal Patterns Associated with Overall Diet Quality during the Transition from Early to Middle Adolescence?
  3. Family meals during adolescence are associated with higher diet quality and healthful meal patterns during young adulthood.
  4. BENEFITS OF FAMILY DINNERS
  5. 10 Reasons to Stop Dieting Now
  6. Secrets of Feeding a Healthy Family: how to eat, how to raise good eaters, how to cook
  7. The connection between sleep and growth

Additional Recommended Reading: Weight Science: Evaluating the Evidence for a Paradigm Shift

 

10 reasons NOT to introduce dieting during childhood & adolescence


Weight Watchers recently announced that it will offer free memberships to teens starting this summer. This announcement led to parents, physicians, dietitians and therapists around the world speaking out – and rightfully so – about the harmful effects of encouraging dieting in our kids. Why? Weight-loss diets have not been shown to provide any long-term health benefits.  Furthermore, dieting remains a major predictor for the development of eating disorders and worsens negative body image.

If you have kids or teens in your life that are feeling the pressure to diet or lose weight,  here are ten important facts and considerations to bear in mind.


1. Restrictive diets negatively impact children’s normal stages of growth and development. 

“Dieting is associated with potential negative physical health consequences. Nutritional deficiencies, particularly of iron and calcium, can also pose short- and long-term risks. In growing children and teenagers, even a marginal reduction in energy intake can be associated with growth deceleration1

2. Dieting is a major risk factor for the development of eating disorders. It can be hard to recognize eating disorders in teens or children, as many harmful attitudes about weight and food have become normalized in our culture. However, the problem is very real. And eating disorders don’t discriminate by gender, body type, ethnicity, or social status. According to Dianne Neumark-Sztainer, Ph.D., in the U.S. alone, more than 50% of adolescent girls and 33% of adolescent boys have used unhealthy weight control behaviors. Even when such behaviors don’t develop into clinical eating disorders, they can still have a significant negative impact on physical and mental health.

3. Dieting disrupts children’s innate ability to eat intuitively. Dieting teaches kids to override natural hunger and fullness cues which can have lifelong effects.

4. Diets often rely on externally mandated measures of food or fullness which  undermine our innate ability to feed ourselves well. Using external systems such as “points” or other charts and arbitrary ways of monitoring food intake teaches kids to shut down or ignore their own internal regulatory systems (including hunger and satiety cues) and to mistrust their own bodies.

5. Focusing on weight is problematic as it is not a reliable measure of health. Furthermore, weight-focused discussion in and of itself is a risk factor for obesity and eating disorders.

“Several studies have found that parental weight talk, whether it involves encouraging their children to diet or talking about their own dieting, is linked to overweight and EDs.” 2

6. Dieting teaches kids to associate eating with feelings of guilt and shame as opposed to viewing food as fuel and energy.

7. Dieting negatively impacts body image. Weight fluctuations, common with dieting behaviors, often end up fueling the cycle of body dissatisfaction and disordered eating.

8. Findings clearly indicate that dieting and unhealthy weight control behaviors predict significant weight gain over time.3 Weight loss diets are actually associated with higher lifetime BMI.

9. Weight loss diets are associated with decreased metabolism, food preoccupation, and binge eating.4

10. Weight loss diets are associated with increased rates of depression and decreased self-esteem.5,6

Once we all understand the facts about how diets actually impact children (and adults), we can help families focus on implementing actual evidence-based strategies that we know are more likely to result in positive outcomes and healthier kids.

The question becomes: How can family members and friends best support our nation’s youth towards a peaceful relationship with food and positive body image without introducing potentially harmful diet routines?

Check out our next post, 8 Tips for Raising Body Positive Kids (Who are also competent eaters) for some basic ideas and strategies.

References:

  1. Dieting in adolescence
  2. Preventing Obesity and Eating Disorders in Adolescents
  3. Dieting and Unhealthy Weight Control Behaviors During Adolescence: Associations With 10-Year Changes in Body Mass Index
  4. Intuitive Eating Category: Studies
  5. Risk and protective factors for depression that adolescents can modify: a systematic review and meta-analysis of longitudinal studies.
  6. Losing weight won’t make you happy 

Contributors:
Rebecca Hart, R.D.
Caitlin Royster, R.D.
Rebecca Thomas, R.D.
Kate Clemmer, LCSW-C
Hannah Huguenin, R.D.

Transition and Recovery with Ryan Sallans: A Reflection on TU’s Eating Disorder Awareness Week Event


What does it mean to live authentically? 

Honoring your truth.

In other words, understanding, accepting, and nurturing your various, intersecting identities, to live your best life. This was a major theme throughout a special event held in February at Towson University (TU) to help recognize National Eating Disorders Awareness Week.At the event, speaker Ryan Sallans shared his personal experience of gender identity development and eating disorder recovery with the TU community. Organized by TU’s Counseling Center, the event was well-attended and brought together various university and local organizations, including The Center for Eating Disorders at Sheppard Pratt, TU’s Center for Student Diversity and The TU Body Image Peer Educators (BIPE). Sallans is a well-known public speaker, author, and health educator, and has been featured on Larry King Live, NPR, The Advocate, and many other news and popular media outlets.

 

Documenting Self-Discovery through Transition and Recovery

Throughout his talk, Sallans highlighted the delicate balance between taking care of oneself and navigating important relationships that often change throughout transition. Of course, each individual’s experience is different and Sallans did well to emphasize his is only one story among many.

Despite transgender and gender non-binary identities being discussed more openly than ever, there remains a stark deficit in information regarding the intersection of body image, gender identity development, and eating disorders. Studies have suggested the prevalence of eating disorders is higher among transgender individuals when compared to the general population (Reisner et al., 2016; Watson, Veale, & Saewyc, 2016). This health disparity is likely influenced by the pervasive effects of transphobia in our society, which sets the stage for inequality and discrimination at home and beyond, creating unique risk factors for the trans community (Bockting, Miner, Swinburne-Romine, Hamilton, & Coleman, 2013; Watson et al., 2016).

Pair this with the fact that no one is immune to the influence of the multi-billion dollar beauty industry consistently sending a message that, in order to be happy, we must look a certain way. Each one of us, regardless of gender, is sold (to some extent) on the idea that by controlling our bodies, we can achieve happiness, wealth, and popularity. Those working in the eating disorder field have historically referred to this as the internalization of the “thin ideal” or the acceptance of unrealistic or narrow beauty standards (Thompson & Stice, 2001). Transgender individuals are not immune from this culturally normative body dissatisfaction.  But people with eating disorders who identify outside of the restrictive gender binary may also experience amplified body dissatisfaction because their gender identity and their sex assigned at birth do not match (Algars, Alanko, Santtila, & Sandnabba, 2012; Strandjord, Ng, & Rome, 2015).

Furthermore, adjusting to a changing body and gender expression (for those who opt for cosmetic, hormonal, and other gender-affirming interventions), as well as the public commentary this process often evokes, presents its own unique challenges that impact body image and self-esteem (Couturier, Pindiprolu, Findlay, & Johnson, 2014).

 

How does one survive, and thrive, when faced with such challenges?

Sallans encouraged everyone in the room that night to stay hopeful and connected, which for him means sharing life stories to better understand those that are different. His comments suggested tremendous patience and empathy for his loved ones’ process of arriving at a place of acceptance with his transition, while also emphasizing the need to disconnect at times to protect oneself. Sallans identified a number of strategies and resources he has found useful, starting with a non-judgmental awareness of his needs, his boundaries, and his triggers. He explored the role of psychotherapy, as well as self-guided research on lesbian, gay, bisexual, and transgender issues, in helping him to turn towards his inner truth and wisdom.

Consistent with national guidelines on psychotherapy with LGBTQ individuals, Sallans benefited tremendously from collaborating with an affirmative therapist; someone he was able to confide in during times of confusion and fear surrounding gender identity, at a time when very few were even considering gender outside of the binary. The trust and respect he built with his therapist created a safe space to discuss gender issues and eating disorders, which provided the platform for recovery and ultimately allowed for closer and more authentic connections with family and friends. Outside of therapy, Sallans said he found it incredibly useful to communicate about his emotions and take time out for himself. He acknowledged the need to unplug from negative relationships (and social media) and engage in routine self-care, which for him often includes going for walks and being in nature.

Self-care, use of coping skills for managing negative emotions, positive sense of identity and community, and feeling like you can count on those closest to you are universal factors associated with resiliency (Rutter, 2012). These factors are even more relevant for those who identify outside of the gender binary (Hill & Gunderson, 2015; Watson et al., 2016). If you or a loved one is struggling with an eating disorder and questioning gender identity, see the resource links below to gather information, find community, and get professional support.

 

For information regarding affirming and evidence-based treatment options and programs at The Center for Eating Disorders at Sheppard Pratt, please contact us at (410) 938-5252 or email us at eatingdisorderinfo@sheppardpratt.org.

 

Additional Resources:
https://www.ryansallans.com (Ryan Sallans’ Official Website)
www.genderspectrum.org
www.glaad.org
www.pflag.org
www.thetrevorproject.org
https://www.chasebrexton.org/our-services/lgbt-health-resource-center


Written By: Andrea Castelhano, PsyD, Outpatient Therapist – Dr. Castelhano is a licensed clinical psychologist in the outpatient department at The Center for Eating Disorders at Sheppard Pratt. She earned her doctorate in Clinical Psychology at the American School for Professional Psychology at Argosy University, DC where she received training in cognitive behavioral therapy and mindfulness-based approaches to psychotherapy. She also received specialized training in eating disorders, anxiety disorders, and co-occurring self-harm and suicidality. Additionally, she has provided affirmative therapy to individuals in the LGBTQ+ community throughout her training and professional career. Affirmative therapy is a therapeutic approach that respects individuals of all sexual orientations and genders, recognizes the impact of intersectionality on identity development and life experience, and addresses issues including discrimination and heterosexism as they relate to the individual’s broader treatment goals. Dr. Castelhano joined The Center for Eating Disorders in 2018 and brings her experience from a variety of clinical rotations, including a year-long practicum at Children’s National Medical Center Outpatient Eating Disorders Clinic,  APA-accredited clinical internship at Laureate Psychiatric Clinic and Hospital, and post-doctoral fellowship with the University of Tulsa Counseling and Psychological Services Center. She provides individual, family, and couples therapy, as well as psychological testing services. She is fluent in Spanish and Portuguese.


References

Algars, M., Alanko, K., Santtila, P., & Sandnabba, N.K. (2012). Disordered eating and gender identity disorder: A qualitative study. Eating Disorders: The Journal of Treatment & Prevention, 20, 300-311.

Bockting, W.O., Miner, M.H., Swinburne-Romine, R.E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103, 943-951.

Couturier, J., Pindiprolu, B., Findlay, S., & Johnson, N. (2014). Anorexia nervosa and gender dysphoria in two adolescents. International Journal of Eating Disorders, 48, 151-155.

Hill, C. A., & Gunderson, C. J. (2015). Resilience of lesbian, gay, and bisexual individuals in relation to social environment, personal characteristics, and emotion regulation strategies. Psychology of Sexual Orientation and Gender Diversity, 2, 232-252.

Reisner, S.L., Poteat, T., Keatley, J., Cabral, M., Mothopeng, T., Dunham, … Baral, S.D. (2016). Global health burden and needs of transgender populations: A review. The Lancet, 388, 412-436.

Rutter, M. (2012). Annual research review: Resilience – clinical implications. The Journal of Child Psychology and Psychiatry, 54, 474-487.

Strandjord, S.E., Ng, H., Rome, E.S. (2015). Effects of treating gender dysphoria and anorexia nervosa in a transgender adolescent: Lessons learned. International Journal of Eating Disorders, 48, 942-945.

Thompson, J.K. & Stice, E. (2001). Thin-ideal internalization: Mounting evidence for a new risk factor for body-image disturbance and eating pathology. Current Directions in Psychological Science, 10, 181-183.

Watson, R.J., Veale, J.F., & Saewyc, E.M. (2016). Disordered eating behaviors among transgender youth: Probability profiles from risk and protective factors. International Journal of Eating Disorders, 50, 515-522.

12 Tried and True Ways People Upheld a Recovery-Focused Holiday


Looking back on this holiday season, it’s safe to say that social gatherings and celebratory feasts posed some significant challenges for anyone trying to develop a more peaceful relationship with food – including those in recovery from an eating disorder. That’s why The Center for Eating Disorders at Sheppard Pratt launched a social media campaign called the “12 Days of Eating Disorder Recovery.” The initiative shared tips on how to maintain healthy relationships with food through the holiday season and beyond. These are summarized below – one for each day of the 12 days – so you can use them to navigate future holiday seasons and get a little help finding the joy and peace within the hustle and bustle.


#12DaysofEDRecovery

Day 1: Keep expectations realistic and set manageable goals that will help you stick to your plan.

Regardless of where you’re at in recovery, celebrations, holiday feasts and schedule changes can pose challenges. Planning ahead and setting realistic expectations can help you stay focused on what truly matters.


Day 2: Grab a notebook or journal and write down all the reasons why recovery is important to you.

While you’re at it, make another list of support people. Figure out in advance who you will call if things get overwhelming or if you simply need to get out of your own head. Things that help you cope daily are still needed during the holidays.

If you’re headed out of town, pack your suitcase with your notebook along with other recovery tools. This could be tangible things like a fidget cube, fun book, art supplies or a favorite essential oil.


Day 3: Connect in safe and meaningful ways with others in recovery.

Recovery from an eating disorder is a journey that requires support, encouragement and ongoing motivation. Individuals with eating disorders and their loved ones can find hope and help in others who understand what they’re going through. Support groups and therapy groups can be a great way to strengthen recovery skills and help remind you that you are not alone.


Day 4: Set a goal today that has nothing to do with food, weight or your eating disorder.

It’s common for social gatherings to revolve around food in our culture, especially during the holidays. These celebrations often lead to an intensified emphasis on meals and eating for those working on recovery from an eating disorder. Keep doing what you need to do to fuel your body in recovery, but try also setting a goal for yourself that has nothing to do with food or your eating disorder.


Day 5: Don’t let your eating disorder make decisions for you in the grocery store. Use price or brand to inform decisions instead of reading nutrition labels.

Whether we like it or not, grocery shopping is part of adulthood. But for the millions of individuals living with an eating disorder, this everyday task feels overwhelming and becomes a significant barrier to recovery. If you are worried about buying items for upcoming gatherings or celebrations, this tip can help make grocery shopping more manageable.


Day 6: Defuse grocery shopping stress by bringing a friend, avoiding crowds and shopping at smaller stores in off-peak hours.

If you’ve had negative experiences with grocery shopping, you can start developing more positive associations. A Registered Dietitian may provide some easy steps for managing your grocery list.

Ask your dietitian for support, or consider adding one to your treatment team if you haven’t done so. You can also go with a friend or support person the first few times to help distract from any eating disorder thoughts and avoid being triggered by diet products.


Day 7: Infuse your New Year with body positivity and gratitude.

Be prepared to see your newsfeed flooded with New Year’s resolutions, gym memberships and diet plans in the coming weeks. To balance triggering and unhealthy messages, remember to reality check all the bogus weight-loss ads and surround yourself online and IRL with body-positive people and organizations.

Pay attention to which images and messages contribute to your feeling badly about yourself or your body and do what you can to remove them from your daily life. When you notice them, remove them (unsubscribe, throw them away, etc.) or challenge them.

Focus on gratitude for the functionality of the breath in your body, the ability to move, see, hear, taste or touch. Try to elevate those in your mind as you go through your day.

Create your own New Year’s goals with body positive thoughts. Work to set aside unhealthy ideals and embrace your body.


Day 8: Tackle eating disorder stigma by dispelling myths among friends and family.

Major misconceptions about eating disorders are widespread, even among those closest to us. Family can be a key component to recovery success. Unfortunately, some family and friends may still subscribe to ED myths that lead to stigma and might make it harder to ask for help or to seek treatment. Help educate and increase awareness about eating disorders among your loved ones.


Day 9: Friends and family can be a great support network. Be open with the people closest to you about how they can best support you.

Holiday conversations often revolve around what people are eating or not eating, who’s eating too much or too little and even criticism or praise about body weight and size.  Did this happen for you during Chanukah or Christmas this year?

The start of a new year can be a great time to enlist family members as allies by being open about your needs and boundaries. Set the stage for healthier gatherings in the new year by having a post-holiday conversation with them about how their words impacted you and what they can do instead to support you at the table and in other stressful situations.


Day 10: Meditate or listen to soothing music to start your day in a positive place.

It’s not just about food and body image. Incorporating mindfulness in the new year can be a way to care for your overall mental health. If you’re heading back to work or school after winter break, find a way to change up your routine to build in mindfulness practices.  Even just three minutes of meditation can help you set a positive intention for the day.

You can be mindful in your social connections too. Cultivate awareness about the different support each generation of your family can offer. Hanging out with cousins can be a nice way to connect and get support on specific life stage issues like being away at college, parenting stress, job hunting, etc. On the other hand, reaching out to older generations, like grandparents, is an opportunity to see how priorities can shift throughout life. Even the youngest generations have something to offer you in your recovery-focused festivities.


Day 11: Aim for balance and flexibility rather than perfection.

Individuals who are perfectionists often struggle with the urge to compare themselves to people around them. Research has shown perfectionism to be a significant risk factor for the development of eating disorders.

Constantly striving to be perfect with food or appearance during the holidays can lead to tension and stress. Even those holiday photo cards hanging around your house can trigger negative social comparisons. Try making some small changes to help ease perfectionist tendencies this time of year.


Day 12: Support is essential to your wellbeing. Recovery is possible with treatment and support.

Whether you are an individual working on recovery, or a loved one who is close to someone in recovery during this time of year, it’s important to remember that support is essential to wellbeing.

Remember, you don’t have to go through this alone.

Ask for help.

 

If you are experiencing symptoms of an eating disorder and you’re not connected to a therapist or receiving treatment, don’t wait any longer.  There is no reason to go through this alone. Call (410) 938-5252 for a free phone assessment today.


This holiday season, and year-round, carry these tips with you. Recovery is possible and recovery is worth it.

A Focus on Body Image & Eating Disorders in Boys & Men for #menshealthmonth

“Get Lean in 2017”
“Shrink Your Gut,”
“Add Bulk To Your Arms”
“Get Rock Hard Abs,”

These are just a few of the typical headlines that can be seen on fitness and “health” magazines geared towards men. While there has been fairly widespread awareness cultivated around the media’s negative impact on women’s body image, not as much attention has been paid to how the media targets men and boys with similar body shaming tactics.

Our culture in general, and the media specifically, often pushes women to lose, lose, lose so they can be smaller, thinner and closer to an elusive definition of “perfect” but the opposite message is often being pushed towards men; most advertising and traditional media suggests the male quest for perfection requires they be bigger, stronger and more muscular.  Products previously peddled exclusively towards women – hair removal items, weight loss diets, tanning products, and plastic surgery – are expanding their markets by making men take a harder, longer and much more critical look at their own appearance.

A 2016 review of five national studies found that 20 to 40 percent of men were unhappy with some aspect of their looks, including physical appearance, weight, and muscle size and tone. An earlier study found that college aged men who viewed media images of muscular men showed a significantly greater discrepancy between their own perceived muscularity (what they think they look like) and their ideal body (what they feel they should look like). The researchers suggested their results could show that even brief exposure to such idealized images can increase body dissatisfaction in men.

Despite this ongoing push for men to get bigger and stronger, over the last decade we’ve also seen the juxtaposition of thinner versions of masculinity.  You can see it when looking at modern male mannequins with impossibly small waists and very slim – yet sculpted – abdomens and legs.  Conflicting body ideals abound. So what is the message after all…get bigger, but stay lean? Be muscular, but still fit in those trendy skinny jeans? It’s mind numbing to try and understand, and even more impossible to attain, yet these are the messages that boys are forced to decipher from a very young age and often continue to wrestle with into adulthood and middle age.

Given all of this, it isn’t that surprising a 2014 study of more than five thousand males aged 12 to 18 years found nearly 18 percent of boys are highly concerned about their weight and physique. Of the boys who were highly concerned with their weight, about half were worried only about gaining more muscle, and approximately a third were concerned with both thinness and muscularity simultaneously.

It’s important to note that, as is also the case with females, photoshopped advertisements and a general lack of diversity in the media’s representation of bodies does not in and of itself cause eating disorders. Eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder are complex illnesses with genetic and biologic underpinnings. However, environmental triggers such as narrow or unrealistic body ideals in the media can contribute to increased levels of body dissatisfaction which has been identified as a risk factor for eating disorders.

Dealing with unhealthy media messages is something that almost every man will have to deal with. As is also the case with girls and women, the dangers lie in the drastic steps some boys and men may take to try to manage increasing body image anxiety. Guys who are more dissatisfied with their bodies may be more likely to engage in risky weight loss, bulking or sculpting behaviors such as extremely restrictive diets, cleanses, steroids, supplements or excessive exercise. These are unhealthy and potentially dangerous behaviors for anyone.  However, in boys and men who are genetically at risk for eating disorders, these types of behaviors can set the stage for an eating disorder, triggering changes in the brain, disrupting metabolic functioning, dysregulating hunger/fullness cues and often worsening body image, mood and anxiety symptoms. Boys and men who have a history of trauma, are involved in sports or careers that promote weight loss and perfection, and those with close family members with a history of an eating disorder are also at higher risk for developing one themselves.

Eating disorders have long been miscategorized as purely a women’s issue, even by some healthcare professionals. As a result it’s quite common for major warning signs like excessive exercise or drastic changes to diet to be overlooked or even congratulated in men. Stigma and stereotypes in the eating disorders combine to make it difficult for men who are stuck in the cycle of disordered eating to break out of it and get help. It is suggested that 25-40% of people with eating disorders are men, yet they only make up about 10% of people seeking treatment.

Talking openly about eating disorders can help minimize shame and embarrassment for males struggling with these issues. At The Center for Eating Disorders at Sheppard Pratt, we’ve been treating men with eating disorders for more than twenty-five years and we’re encouraged by the changes we hear in the conversations more recently. More men have been speaking out locally and using national platforms to raise awareness. In just the last year, Zayn Malik of the band One Direction discussed his struggle with an eating disorder and anxiety, performer/songwriter Matthew Koma wrote a poignant blog about his recovery from anorexia, and Joey Julius, a football player at Penn State, made a series of public statements regarding his decision to seek treatment for binge eating disorder. Their messages all point to a resounding hopefulness stemming from the reality that treatment is available and men can heal from their eating disorders and body dissatisfaction.

So what can you do to help the men in your life?

Start by checking in with them. The Let’s Check In campaign is all about empowering individuals, families and communities to talk openly about eating disorders and to strengthen support for individuals of all genders who might feel alone. When it comes to eating disorders, early identification and prompt help-seeking can make a big difference. You can play a role in supporting prevention and recovery from eating disorders simply by educating and preparing yourself.

Know the risk factors and pay attention to any sudden shifts in diet, exercise routine or increased negative comments about themselves or their body. If you’re unsure, the confidential online assessment is a quick tool that can help you gauge whether someone you love might be at risk.  Second, if you are seeing increasing warning signs plan to check in with your friend or loved about your concerns and provide them with compassion and resources.  A fact sheet, conversation guide and additional resources are available at www.letscheckin.com/.


Regis Aguglia, LCSW-C

Written by:
Regis Aguglia, LCSW-C,
Family Therapist at The Center for Eating Disorders at Sheppard Pratt
Regis Aguglia earned his Masters in Social Work from the University of Maryland in 2010. Prior to joining The Center for Eating Disorders in 2014, Regis provided individual, family and group therapy in outpatient and school-based settings and gained experience treating individuals struggling with substance abuse. As a Family Therapist in The Center’s inpatient and partial hospital programs, Regis works with families to understand the impact of an eating disorder on the family system and helps to strengthen communication, coping skills, nutritional stability and recovery-focused support. Regis also facilitates a number of inpatient therapy groups including dual diagnosis groups for patients with co-occurring substance abuse and a specialty group for boys and men with eating disorders.

Spring Blog Round-Up


“Where flowers bloom, so does hope.”
~Lady Bird Johnson
*    *    *

Our CED Staff has been busy guest blogging for Eating Disorder Hope on a variety of topics from nutrition and meal plans to body image and relapse prevention. We hope you’ll take a look and share with friends, colleagues or clients who might benefit from the following information.

If you have questions about eating disorder treatment or a topic you’d like to see us write more about, please send your suggestions and requests to our Community Outreach Coordinator, Kate Clemmer at  kclemmer@sheppardpratt.org


The Importance of Incorporating Fear & Challenge Foods in Recovery

Written by Caitlyn Royster, R.D. & Rebecca Hart, R.D., Registered Dietitians

While you may technically be following your meal plan, without incorporating fear foods you are still giving the eating disorder a major foothold by preserving fear and anxiety. It might seem like choosing safe foods is better than acting on symptoms. However, over time this restriction can snowball and lead to relapse. READ MORE…


Mother’s Day Makeover: Boosting Body Image for Ourselves and Future Generations

Written by Irene Rovira, Ph.D.
Psychology Coordinator

Most of us appreciate all the mother figures and mom-types in our lives – including aunts, sisters, mentors and best friends – for the love they give or how they make us feel. We do not value them based on their weight or size. Yet we often hold a double standard when it comes to how we view ourselves…READ MORE to find 7 Tips to help boost body image for yourself and future generations



4 Changes You Can Make in Your Home to Support Eating Disorder Recovery & Reduce Relapse

Written by Kate Clemmer, LCSW-C
Community Outreach & Education Coordinator

It’s safe to say no one who has been through recovery from an eating disorder would downplay the difficulty or complexity of it. And while recovery is never simple or easy, there are some simple and straightforward changes you can make to reinforce recovery efforts and help prevent relapse. These specific modifications are not changes in thinking (cognition) or even changes in behavior but rather, changes to your physical living space – your home environment.  READ MORE…


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A Conversation with Bailey Webber, Co-Director of THE STUDENT BODY Film – Part 2

In addition to her debut as a filmmaker with The Student Body, Bailey Webber is an up-and-coming public speaker and has appeared as a guest on several television and radio shows. If you missed Part 1 of our conversation with Bailey, you can find it here and you can meet Bailey, along with her father and Co-Director of the film, Michael Webber, on February 26 at The Center for Eating Disorders at Sheppard Pratt


Q&A with Bailey Webber – Part 2

What have been the most common responses or reactions from people who’ve seen The Student Body? Have they all been positive?

BW: For about a year the film has played at film festivals and special premieres and screenings around the country and my dad and I have been fortunate enough to attend many of them and engage with the audiences. This gives us a great idea of how people are responding to the story and information and I’m so happy to say that the reaction has been incredible!

We have had adults stand up and explain that the story has completely changed their perspective on themselves, their kids, and others.  Students have felt empowered to speak up for the first time and share their own experiences, when before they were too ashamed to say anything.  Teachers, doctors and school nurses have thanked us for making the film, have shared their own emotional stories.  We receive emails and phone calls from people around the country, encouraging us to keep getting the message out.  We even have clinics that want to incorporate the film into their patient programs. 

Just this week we spoke with a clinician who has been battling this issue in her own school district for years, but with no success.  Months ago she arranged to bring the film to her city and worked to encourage the community to join her in seeing it.  The screening was last night and she called us immediately after.  She was so excited and explained that the school officials have finally agreed to stop sending out the letters and will be looking for help to approach the issue in a more productive way!  We were all so excited!  It’s such a game changer and it makes me feel so humbled and overwhelmed to see the film is being used as a tool to help bring about change with these issues. 

Do you have any personal advice or a message of hope for kids and teens who’ve been impacted negatively by bullying, BMI report cards or weight teasing?

BW: The biggest thing to know is that you are not alone and your voice does matter.  I also want them to know that things can change, but only if we are willing to speak up and engage.  Along those lines, there are a few things that I suggest to young people:

  1. Always be respectful. Taking a stand, speaking your mind and challenging authority doesn’t mean you have the right to disrespect another person in the process. Otherwise, you’ve just done something wrong yourself!
  2. Find an adult to learn from and help support you. My friend, Maddie, had a strong, smart, loving mother who was willing to stand behind her when she protested. For me, my dad had my back all along the way as I challenged authority at every corner. This can help give you the courage you need when taking on big challenges and getting outside of your comfort zone.
  3. Know your rights. My dad taught me that 90% of having rights is knowing my rights! Learn from an adult what is possible, what actions you can actually take, and what your rights are. Then bravely exercise those rights! Trust me, it feels great!
  4. Use your powerful voice! It’s surprising to learn that many people might feel the same way you do, but everyone is just waiting for someone else to speak up. Well, maybe you should be that “someone”! Start the conversation with your peers, your teachers, your parents and your school board. You’ll be amazed at the change that can happen when you finally choose to use your voice. I’ve experienced this twice in high school and you see it in the film. It’s amazing, it’s simple, and it can really change things for the better. You can do it, too!

What was it like to embark on a project this big with your dad as your partner? Did the two of you learn anything new about each other in the process?

BW: Working alongside my dad was amazing!   Growing up he always taught my sister and me to tackle big and difficult things, to face our fears, and to overcome any disadvantages that we might have rather than use them as excuses.  For me, making this film was an example of all of these things and having my dad mentor and encourage me through the process was everything.

Father/Daughter Filmmaking Duo, Michael Webber & Bailey Webber

In the beginning, he also explained that this was my project and he will be there to equal my effort, but no more.  In other words, if I don’t put in the time, if I don’t do the research, if I don’t do the work, neither will he.  But if I give it everything I have no matter how difficult the obstacles, then he will give his everything too.  We joke about it now because the film became an obsession for me and I would drag him all over the country and spend the next three years helping me make this film.  He even set aside other films he was working on just to help me see this through!

My dad would also assign books for me to read on filmmaking, journalism, writing – and I would read them all!  He would give me lists of films to watch and study and take notes on, and then he would discuss them with me.  He taught me how to edit, how to write for film, how story works and how to build these big story boards to work from as the production evolved.  It was the greatest filmmaking course ever! We had so much fun together and I hope that comes out in the film, especially with the humor that we brought to it.   So for me, the experience has changed me forever.

Who do you think could benefit from attending the screening of The Student Body here in Baltimore on February 26th? What overarching message do you hope they will take away from the event?

BW: Public screenings like this are great for parents, students, teachers, lawmakers, and anyone in the healthcare field.   All of these groups are represented in the film and will benefit from experiencing the other perspectives in the story.  My hope is that people will come away from the film with a greater understanding of the complexity behind obesity and eating disorders and with a new appreciation for the struggles that people have with their weight and body image.


Many thanks to Bailey Webber for taking the time to share about her experience filming The Student Body.  If you’d like to see the film and have a chance to ask Bailey and her dad, Michael Webber, more about their experience, join us in Baltimore on February 26 for a FREE SCREENING in recognition of National Eating Disorders Awareness Week. Attendance is free but space is limited – RSVP Today!

The Student Body

Read More: A Conversation with Bailey Webber, Co-Director of THE STUDENT BODY – Part 1

Turning a Body Positive Summer into a Body Positive Year

 

Turning a Body Positive Summer into a Body Positive Year(2)


We spent the summer talking about several steps you can take to turn body dissatisfaction into body acceptance. We also presented some of the very important reasons why someone might be motivated to embark on such a task. The bottom line: negative body image can negatively impact all other areas of life – career, academics, physical health, social interaction and intimate relationships. As many as 67% of women ages 15-64 withdraw from life-engaging activities because they feel badly about their bodies. And women are not alone in the struggle; Thirteen percent of college-aged men say their appearance is traumatic or difficult to handle as well.As we head into the fall, its important to remember that negative body image doesn’t just go away for most people simply because the beach vacations and relentless bikini body advertisements subside. As much as we wish that was the case, we know body image is much more than a seasonal hazard.

Body insecurity will follow young boys and girls into middle school classrooms where they may stop raising their hands or engaging in class discussion to avoid drawing attention to their appearance.

Body insecurity will follow young adults onto college campuses around the country where it, paired with genetic risk factors like perfectionism and anxiety, plus fear of the Freshman 15, may provide fuel for the development of an eating disorder.

Body insecurity will follow the new mom to the play date where she will silently compare and scrutinize her body. She’ll be sold a thousand different ways to get her pre-baby body back.


Body insecurity will follow the quiet colleague home from work each night.  He refuses to hang out with friends or start dating until he finally “bulks up” again.

These may be the realities of day-to-day life with body dissatisfaction but they don’t have to be the end of the story. In addition to the 3 Steps we laid out during the #bodypositivesummer campaign, here are a few guidelines to help boost body image in any season.

1. Don’t postpone important events or fun life goals for appearance or weight-related reasons. Putting off a special vacation, not applying for your dream job or not going on a date until you lose XX lbs. is a recipe for missed opportunities and delayed happiness. Saying you’ll get around to something in few months can quickly turn into a few years, or even decades. If you’ve been waiting to live life fully because you’re unhappy with your body, consider taking one small step today towards whatever it is you’ve been putting off. Research flights, update your resume or call an old friend.

2. Stop Fat Chat.  When among friends or in social settings commit to steering the conversation away from appearance-based judgments and into more positive territory.  The American Academy of Pediatrics recently released a report urging pediatricians and parents to stop focusing on weight, or even mentioning weight, during discussions with children and teens. The reason?  Focusing on weight backfires, often leading to unhealthy behaviors that are associated with both obesity and eating disorders. The same is true for adults. Stop focusing on your weight as the golden marker of health and you may actually find it’s easier and/or more fulfilling to engage in healthful behaviors.

3. Cleanse your social media feed. Disconnect from the negativity, surround yourself with positive, healthy, and uplifting social media accounts.  If you’re online quite a bit, there is no reason to allow Instagram followers who consistently engage in fat talk or body criticism to cloud your view of yourself. You have every right to unfollow Twitter users that promote weight loss or diet products, even if they are close friends or family members. Remember, you are the curator of your accounts; use that power to cultivate a body positive presence for yourself online.

4. Last but definitely not least…ASK FOR HELP.  Negative body image can be a risk factor in the development of eating disorders or may trigger relapse while in recovery from one. If you’re having a lot of negative body image thoughts throughout the day or they’re impacting your behaviors around food and weight it might be time to seek support. Specific evidence-based therapies like Cognitive Behavior Therapy can be effective in addressing body dissatisfaction. It can help to tell a trusted friend, spouse, or parent that you’re struggling and ask them to support you in getting connected to a counselor or therapist who is trained in these specific techniques.

Not sure where to turn?  You can complete a confidential online self-assessment here or call (410) 938-5252 for more information.

Visit eatingdisorder.org for additional resources.   

 

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Body Comparison: An Olympic Sport?


When cheering on the elite athletes at the Rio Olympics and in other high-profile sporting events, it can be easy to lose perspective and you may find yourself comparing your physical body to those at the peak of their sport careers. Lost in these comparisons, we too often become self-critical and forget the long journeys, support communities, financial resources, sacrifices and sheer hard work that comes with being an Olympic athlete.

Olympic bodiesEngaging in body comparison not only hurts you but serves to fuel the overall toxic culture of body shaming. After all, even Olympic athletes are subject to mean-spirited remarks about their appearance. In the most recent summer games, Ethiopian swimmer Nobel Kiros Habte faced some harsh comments for not matching the “look” of his peers, as did Mexican gymnast Alexa Moreno. Many others have faced similar backlash through the years.
Just as athletes are not immune from body shaming, it’s important to remember the “perfect” athletic body does not equate to perfect health. Making snap judgments about someone’s fitness or health based on their appearance is misleading – it’s rarely possible to tell, for example, if someone has an eating disorder just by looking at them. Athletes are not immune to eating disorders or struggles with body image. American cyclist and two-time national champion Mara Abbott has been open about her experience with anorexia. In a candid column for a cycling blog, she reflected on how it affected her performance: “Personally, having taking a hiatus from sport in 2012 due to an eating disorder, I can attest that my thinnest was definitely not my strongest. I really mean that. Please read that sentence more than once.”

As we gather around the television with our friends and families to celebrate athletic achievement, we can support the competitors, ourselves and each other by focusing less on physical appearance and more on the hard work and powerful accomplishments of these world-class athletes.  After all, Olympic bodies can be powerful, graceful, tough and resilient but they are also diverse.  From gymnastics to archery, swimming to shot put, let’s allow our athletes to be inspirations, not because of or in spite of their looks but for the attitude and spirit they project in aiming for their goals.  Let’s enjoy watching all sporting events – whether it’s a World Cup game or a pee wee soccer league – from a place of body appreciation and as part of a body positive summer.

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You might also be interested in reading:

Faking It: Sunless Tanning and the Risks You May Not Have Considered

Faking It_ SunlessTanning_SORENSENSkin cancer is among the most common forms of cancer in the United States. In fact, over the past three decades, there have been more cases of skin cancer than all other forms of cancers combined.1  Furthermore, a 2014 study published in the Journal of the American Medical Association-Dermatology estimated that more than 400,000 cases of skin cancer each year in the United States may be the result of indoor tanning, with approximately 6,000 of these cases being melanoma, the most deadly form of skin cancer.2

Most people are aware of these risks. Warnings of cancer and other related health problems are broadcast widely, and reminders to slather on sunscreen can be heard from all corners of our pools and beaches. At the same time though, the pressure to acquire the media’s ideal body is strong, and this culturally defined ideal frequently includes obtaining a “luxurious summer glow” or becoming a “bronzed beauty”. For some, the perceived benefits of tanning via sun exposure, or tanning bed, seemingly outweigh those severe health risks and they continue tanning despite the danger. In research on UV exposure, some excessive tanning behavior has even been described as an addiction. Many other people, including 1 in 10 adolescents, opt for what is promoted as the safer option – sunless tanning.

Body image avoidanceSunless tanning products (creams, foams, sprays, stains, etc.) are heavily promoted as a viable option for someone looking to achieve a summer glow without assuming the health risks of tanning beds or sun exposure. But is it completely without risk? If we know UV exposure is unhealthy, then why are we spending time and money trying to fake it? It’s a million dollar question with a million dollar answer, or more accurately, a $763 million answer; that’s how much the fast-growing sunless tanning industry was worth in 2014.

Like the bikini body, the elusive summer glow represents an unfair and unrealistic expectation that can contribute to an individuals’ experience of body dissatisfaction. Additionally, trying to change skin color with the use of sunless tanning products can be viewed as a form of body image avoidance. An inability to achieve the tan ideal, or the time and mental resources spent focused on one’s perceived inadequacies, simply magnify negative feelings towards the body.  Thus, sunless tanner may help dodge the bullet, so to speak, by avoiding UV rays, but it is not completely harmless. Body dissatisfaction, body image avoidance, and low self-esteem are some of the most well documented risk factors in the development and presentation of eating disorders.  Furthermore, studies have found links between general tanning behaviors and unhealthy weight control practices. Consider the following associations:

  • Steroid use and unhealthy weight loss strategies were 4x and 2.5x more likely, respectively, among high school males who used indoor tanning, compared to their non-tanning counterparts.3
  • Boys who tan were more likely to be trying to lose or gain weight than non-tanners.4
  • Female students who engaged in indoor tanning were also more likely to engage in unhealthy weight control practices.5
  • A belief that a tan improves appearance is one of the strongest predictors of UV exposure behaviors.6

We know that body dissatisfaction can drive both tanning and unhealthy weight control behaviors. These correlations underscore the point that, despite a lower skin cancer risk, promoting sunless tanning may still be problematic, especially in individuals who struggle or have struggled with body image. Promoting or validating the quest for a tan body has the potential to reinforce negative body image thoughts and perpetuate appearance related obsessions.

It is important to keep in mind that any beauty ideal is carefully crafted and enforced by #bodypositivesummer_TANNINGan industry that profits from the body dissatisfaction it’s “standards” create. Tanning is no different. In fact, it’s important to point out that the tan ideal is just one way that westernized beauty ideals promote insecurity or dissatisfaction across the spectrum of skin colors. The media’s pressure on Caucasian women to be tan occurs concurrently with tactics like whitewashing and digitally lightening the skin (and hair) of women of color in prominent advertisements. Writers at Beauty Redefined unpack the cultural implications of those practices in the post: Beauty Whitewashed: How white ideals exclude women of color.

By creating the narrowest possible margin for beauty, the media essentially convinces everyone their skin is either too light, too dark or some other shade of inadequate. As a result, people who internalize the cultural definitions of beauty feel ‘required’ to purchase some sort of product or service to achieve the ideal, or risk being invisible. As Director Elena Rossini reveals in her masterful documentary The Illusionists, the very same company that promotes tanning products in the U.S., profits off of skin-whitening creams in India.

Media influencing what we perceive as beauty is not exactly a new conversation, but sometimes these ideals become so much a cultural norm that we cease to question them. Just think how often the phrase “you look so tan!” is thrown around as a compliment or “I’m so pale” is delivered as a self-criticism.  Great diversity of skills, skin colors, body shapes and sizes is a natural and healthy part of life. Any group who tries to change that, especially for profit, should be met with critical speculation. Just as we attempt to challenge the thin ideal, we should seek to debunk tanning myths and push back against unrealistic or unhealthy expectations. One way to do that is by helping to build families and peer groups that prioritize body positivity and body acceptance.

As individuals, we can push back by refusing to buy-in to a heavily marketed tanning industry that includes outdoor tanning, indoor tanning or pre-packaged tanning. Perhaps the money, time, and mental resources devoted to the quest for a perfect summer glow could be better used elsewhere?

Find out just how much money you could save by expanding the infographic on the right.  Then head on over to Twitter or Instagram to tell us what you would do with your savings and how you intend to finish out your #bodypositivesummer free from the grip of body dissatisfaction.

 

About the Author:
t_sorenson_headshotTaylor Sorensen is a rising senior at Trinity College in Hartford, CT where she is majoring in Neuroscience.  At Trinity, Taylor is involved in research focusing on the neuronal underpinnings of Autism Spectrum Disorder.  She joined The Center for Eating Disorders as a summer intern in both the Research and Community Outreach Departments.


 

References:
  1. Stern, RS. Prevalence of a history of skin cancer in 2007: results of an incidence-based model. Arch Dermatol 2010; 146(3):279-282.
  2.  Wehner, MR. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol. 2014 Apr;150(4):390-400. doi: 10.1001/jamadermatol.2013.6896.
  3. Miyamoto J, Berkowitz Z, Jones SE, Saraiya M. Indoor tanning device use among male high school students in the United States. Journal of Adolescent Health. 2012;50:308–310. doi:10.1016/j.jadohealth.2011.08.007. [PubMed]
  4. Demko CA, Borawski EA, Debanne SM, Cooper KD, Stange KC. Use of indoor tanning facilities by white adolescents in the United States. Archives of Pediatriac and Adolescent Medicine. 2003;157:854–860. doi:10.1001/archpedi.157.9.854. [PubMed]
  5. Guy, GP. Et al. Indoor Tanning Among High School Students in the United states, 2009 and 2011. JAMA Dermatol. 2014 May; 150(5):501-511.
  6. Pagoto, SL, Hillhouse, J.Not All Tanners Are Created Equal: Implications of Tanning Subtypes for Skin Cancer Prevention. Arch Dermatol. 2008 Nov; 144(11): 1505–1508.

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