Adventures in Self-Care with Melissa Fabello: Part 1

 

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

 

 


Q&A with MelissA Fabello – Part I

 

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

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

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


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

 

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

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

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


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

 

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

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

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

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

 

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

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

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

 

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

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


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

 

 

 

Mindful Eating on Campus ~ Part 1

college student at laptopFew things are more stressful for a student who is in recovery from their eating disorder than trying to negotiate eating on campus. College living is full of obstacles to eating consistently and mindfully: buffets in the dining halls; eating between classes and on the go; staying up until 4 AM; social events involving food; and limited access to the grocery store or a working kitchen. While many students in treatment are given guidelines as to how to eat in a healthy manner, it is often difficult to implement those strategies in a campus setting but it is possible.  A great resource for this task is the book, Mindful Eating 101: A Guide to Healthy Eating in College and Beyondby Dr. Susan Albers which we will reference throughout this post.

Mindfulness is an old concept that has, more recently become somewhat of a cultural catch phrase. Standing at a coffee shop bulletin board, you may notice advertisements for mindful meditation classes or yoga classes that promise skill development in the art of mindfulness or even magazine covers that stress the importance of mindful living. So, what is mindfulness?  Mindfulness refers to the ability to bring one’s awareness completely to the present moment.  In contrast, mindlessness, refers to behaving or doing things without much attention.

Consider that you are eating dinner in your dorm in front of the TV during your favorite night of Mindful Eating 101television. As you laugh along with the show and get intrigued by products during the commercials, you occasionally pick up your phone and make plans for the evening and attempt to skim a chapter in your text book for tomorrow’s quiz.  All the while, you also continue to go through the motions of eating your dinner…mindlessly. In this situation, your attention is likely focused on the characters and themes in the TV show and not on your food or your body’s response to the food.  When this happens, it is common for people to eat more than they normally would because they aren’t really enjoying their food, and they aren’t in touch with the mechanisms in the body that tell us when we want to stop eating. In contrast, when you choose a meal from the dining hall and sit at a table to enjoy it with a friend but without other distractions, you may find that you eat more slowly, you savor the tastes of the food, and you have an increased awareness of your hunger/satiety cues, which allow you to stop when you feel full. This style of eating would be considered mindful eating.

Individuals who’ve struggled with an eating disorder or have chronically dieted often lose touch with their body’s natural ability to regulate food and eating processes.  Sometimes they may need help establishing normal eating patterns again and re-connecting to their bodies.  In eating disorder treatment, mindfulness is a concept that is used frequently in helping people to develop awareness of their thoughts, emotions, patterns, triggers, and hunger/fullness cues.

Eating mindfully is an important skill because it allows you to eat exactly what your body wants in just the right amounts. Restricting your food intake or dieting is not mindful because it denies your body of the food that it needs for fuel and nourishment.  Bingeing is also not mindful eating because it exceeds the amount of food that your body wants or needs and may cause you to feel uncomfortably full or even pained.  Mindfulness involves trusting your body to maintain a balance.  Learning to eat mindfully can take time, so be gentle with yourself as you practice the steps that will allow you to eat intuitively in response to your own body’s needs.

Dr. Albers outlines the seven habits of mindful eaters in her book.  These habits are the key components of learning to eat mindfully.

  1. Awareness: Use your senses to gather information about the world. By using sight, sound, hearing, touch and taste, you can become attuned to what is going on around you at any moment. Turning this inward, you can better recognize your hunger, fullness and thirst cues to help guide your eating choices.
  2. Observation: Simply notice your thoughts and feelings as an impartial observer. The key is to do this without judgment. For example, if you have the thought “I am fat,” simply notice that it is there, label it as a negative thought, and move on.
  3. Shifting out of autopilot: Some of our routines become so mundane that it is difficult to pay close attention to the details. These routines sometimes enable mindless eating or skipping meals completely, and so you may want to change the routine or bring awareness to it in order to be more mindful. Try waking up a few minutes earlier to fit in breakfast or consider meeting a classmate someplace for lunch that you’ve never been before.
  4. Finding the gray area: Black and White thinking refers to thinking in extremes. Food is good or bad. Someone is fat or skinny. Clearly, life is not that simple. To be mindful, one must be flexible and avoid operating in extremes. An example of this is someone who is on a diet that forbids bread; even if a person wants bread they will deprive themselves of it because of the diet. Sometimes, this deprivation can lead to the person bingeing on bread. In contrast, a mindful eater would recognize the particular craving and allow herself to have an appropriate serving of bread at the time when she wants it.
  5. Be in the moment:  As a college student, you may find yourself frequently eating in class, while cramming for a test, or even while walking or driving across campus. Multi-tasking like this is not considered mindful because you cannot use your senses to enjoy the food or to stay aware of your hunger and fullness cues. Ideally, a mindful eater would sit with their meal on a plate at a table and devote their full attention to eating. However, this is not always a realistic goal for a college student.  Try making small changes that help you stay present during meals, such as always sitting down to eat and turning off your phone to remind yourself to stop texting and posting on Facebook until you finish your lunch.
  6. Non judgmental: Notice judgmental thoughts and proceed with compassion instead of criticism. Often at the campus dining halls, various stations offer different types and categories of food. If you notice yourself judging a particular food station ( “I can’t order from that section, everything is full of fat.”) notice the criticism attached to the food and label it (“there I go thinking of foods in good and bad categories again.”) Practice compassion and focus on truthful statements (“this food may have fat in it, but I need some fat to help me protect my organs”).  Try to incorporate different foods from each of the various food stations at the dining hall throughout the course of the week.
  7. Acceptance: Accept things for how they are as opposed to how you think they should be. Dr. Albers gives a great example in her book of accepting your shoe size, even if you wish it were different, because there really is nothing that you can do about it. As much as you may wish to have smaller or larger feet, eventually you must let go and accept that your feet are the size that they are.

If you’ve struggled with disordered eating, it may be easier to practice mindfulness at first with something that is not related to food. Try this simple exercise to practice the aforementioned skills. Close your eyes and simply count how many sounds you can hear in the room. When you think you have counted the sounds in the room, push yourself to try to hear beyond the room. Can you hear sounds from outside? In the hallway? What about the sounds closest to you…can you hear your own breathing? The sounds that you hear are happening in the here and now; congratulations…you have been successful at being mindful of the present moment! Now you might want to try doing a similar exercise with your food, using your senses to guide your eating.

For more information and tips on healthy eating during college, read Mindful Eating on Campus: Part 2 HERE…

 

Written by Jennifer Moran, PsyD, Therapist and College Liaison at The Center for Eating Disorders at Sheppard Pratt; Originally published on 10/11/11

 Photo Credit:
1. Vichaya Kiatying-Angsulee and freedigitalphotos.net
2. Susan Albers / mindfuleatingcafe.com

For more information about Dr. Albers and her Mindful Eating series, visit her website at www.mindfuleatingcafe.com.

FOOD LOGS: How they can help with eating disorder recovery (& why you might still be avoiding them)

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coffee-writing-stuart-milesFood logs are one of a variety of therapeutic tools used during treatment for an eating disorderFood logs – also referred to as food records or food journals – can take many forms.  Some people prefer to jot things down free form in a personal notebook while others do best filling out the prepared charts provided by their dietitian.  Many others have gone tech-friendly and use an app on their phone to track info and share it with providers. Regardless of the form it takes, a food log does much more than track your food.  A helpful format for food logs will include the time of day, a description of the meal or snack, actual food and beverage intake, location/setting of the meal and, most importantly, an individual’s thoughts and feelings before, during and after eating. Completing food logs and subsequently reviewing them with a registered dietitian can be a pretty powerful part of the recovery process. Not surprisingly, and perhaps because they can be so powerful, many individuals also experience some resistance to using them.  If you’ve ever been encouraged to complete food logs as part of your treatment for an eating disorder but had trouble starting or committing to the process, we thought it might help to know why a dietitian would recommend doing them and the specific ways in which they can aid in the recovery process.

Completing food logs throughout the week maximizes time spent in session with your providers. Weekly nutrition counseling sessions are often 30 minutes long.  It could potentially take up the most of that half hour to do a 24 or 48-hour verbal recall of your meals during the session. It’s easier to get down to business if the logs are already done. Plain and simple.

Food logs are like x-rays. If you hurt your arm and asked your doctor to put a cast on it, she would require you to get an x-ray first to see if, how and where it was broken. If you refused, she broken-armwould only be able to give you broad advice, like “take a Tylenol and get some rest.”  (If you’ve broken a bone before you probably know that wouldn’t help a whole lot). On the other hand, if your doctor could look at the x-ray of your arm she could fit you for the exact type of splint or cast needed, assign the proper amount of physical therapy, and provide individualized prescriptions for your pain.  In much the same way, food logs allow the dietitian to give you tailored advice and individualized strategies, rather than simply relying on a general, one-size-fits-all nutrition goal.

Food logs provide insight into your bigger picture. Sure, your food logs communicate specific details from each meal, but they also show trends and patterns over the course of the week related to meal times, location, hunger/satiety  cues, situational triggers and thoughts. Dietitians can often see connections on the food logs that patients don’t always see themselves. Seeing “the forest for the trees”  allows the dietitian to offer the most useful and beneficial feedback to the patient. Let’s say you arrived home from work late and ate an entire large pizza. Looking back on the food log we may see that you had an 8-hour gap without a meal that caused you to feel extremely hungry. Perhaps a goal would be set to have an afternoon snack available for those situations to help you get to dinner hungry, but not ravenous. On the other hand, maybe you had a stable breakfast, lunch, and afternoon snack, but your dietitian notices you hadn’t allowed yourself pizza in six months despite the fact that it’s one of your favorite foods. A more appropriate goal in that situation would be to practice food habituation with pizza (exposure to a food over time makes the food less compelling) and having a support person around when you’re eating it for a while. The bottom line: It’s harder to learn from the incident when we only see it from one angle. Food logs help us both have more perspective on why things happen, to know whether the set-up was physical or emotional and how to address the physical and emotional needs going forward.

Food logs provide a way to monitor progress. Nutrition therapy is about making changes that improve your relationship with food and your health. We tend to set small weekly goals that create momentum towards overarching goals and bigger changes over time. How will either of us know if the goals are met if we don’t keep track of them? Keeping a food log provides an objective look at progress from week to week and month to month.  It also takes the pressure off of you and your dietitian to recall from memory all of the details of your food and symptom use from the past month.  Rest assured, as you heal from your eating disorder you will have many more important things to use your brain for!

Returning to a normal and healthy relationship with food means appropriately responding to hunger and fullness signals. It’s impossible to do that if your signals are broken from chaotic or disordered eating. The best thing to get your digestive system and metabolism back on track is structured eating – meaning adequate amounts of food with adequate frequency.  Food logs aid in structured eating accountability, and structured eating over time sharpens your signals. Food logs and structured eating can provide the training wheels to help you get to a place of intuitive eating.

Food logs help connect your mind with your body.  Putting your pen to paper before, during or after a meal increases mindfulness with eating which can decrease mindless eating. Logging intake with your thoughts improves your ability to tell the difference between emotional hunger and physical hunger.  This practice also increases awareness to how certain foods make your body feel – energy, mood, mental clarity, digestive happiness, etc. Being aware of how foods make your body feel is important in working towards more sustainable and fulfilling eating practices.

Keeping up with food logs can help prevent relapse during transitions.  If you’ve ever received care for an eating disorder in an inpatient or partial hospital setting, you know the transition into outpatient or even intensive outpatient treatment can be difficult as you are once again responsible for completing more meals on your own. One way to help maintain the stability or progress you made in the higher level of care is to continue to self-monitor your intake and associated emotions during that transition and promptly discuss any specific challenges you encounter with your outpatient providers.  If you’re completing food logs, it’s easier to catch a slip-up before it becomes a full-blown relapse.

As mentioned earlier it’s not uncommon for individuals to question the benefit of food logs or to experience some resistance to the idea of completing them. A common reaction from patients is that, “writing down everything I eat makes things worse“ or “I don’t like doing food logs because it reminds hands with pen.africa and freedigitalphotosme of acting on my eating disorder.” As providers, we completely understand that rigidly tracking food and exercise can often be a symptom of the eating disorder.  That being said, there is a big difference between keeping a detailed, private food diary and collaborating with a dietitian to complete food logs during treatment. For one, the end goals are very different. If you tracked your food before it was probably to monitor strict adherence to dangerous eating disorder behaviors or dieting techniques. Those logs probably involved weighing, measuring, and counting calories and were done to benefit the distorted rules of the ED, not to honor or nourish your body. Conversely, the goal for food logs in treatment is to monitor weekly goals, help normalize eating behavior and to improve your relationship with food. When doing food logs with a dietitian, there is no good vs. bad, no shaming, no judgement. The role of the dietitian is not to be the food police waiting to condemn you. Rather, their role is that of a supportive detective. To examine the data, to see if there is something that is setting you up for problematic eating behaviors and then provide you with education and ideas to help make improvements going forward.

Still not sure? Here are a few additional tips for those of you who may have lingering fears about food logs…

For those that are embarrassed to show anyone… Does it make you nervous or uncomfortable to think about showing someone else a record of your daily eating behaviors? If you are worried that your dietitian will be shocked, grossed out, alarmed, or otherwise disturbed by your food log it can be helpful to think of the dietitian like any other specialist.  Take a dermatologist for example. You might feel nervous or uncomfortable during an annual skin check but to the dermatologist, that’s what they do everyday – they look at freckles and moles all day long.  Food logs and weights can be things that feel vulnerable to share, but remember, those are just pieces of data that the dietitian analyzes and they’ve seen and heard it all before. It’s their job to look at meal patterns and associated thoughts/behaviors. Vulnerability takes courage, but being courageous can lead to positive change. If you’re feeling shameful about sharing your food logs, remember this quote from AA – “secrets thrive in the dark and die in the light.” Being honest with your dietitian and allowing him or her to see your food logs is one of the first steps in moving away from the pain of the eating disorder.

For those who struggle with perfectionism… Food logs aid in improving nutrition behaviors just like practicing an instrument aids in learning the skill of playing an instrument. Writing down logs is intended to keep you in the mindset of practicing your nutrition goals for the week. The more often you practice a particular skill, the more it becomes a habit over time. That progression will not be perfect, and that’s a good thing. Even when you have a rough week and the goals aren’t met, food logs are still very helpful!  As providers, we actually learn more from the rough days than we do from the stable days. The logs allow us to see and discuss what some of the barriers might have been to meeting the goal, so we know what to try or be mindful of the following week. Portraying a “perfect” day of eating when it’s not what actually happened is not helpful.  Recording struggles or slip-ups in a food log allows us to work together to correct the focus and try again. Just like it takes practicing a song on the piano before you can play it without looking at the music – food logs keep you intentional in your practice of positive nutrition behaviors before you can naturally engage in the behaviors without the logs.

For those who don’t want to be stuck doing food logs for the rest of their lives (a.k.a. everyone)… Food logs are used to benefit an individual’s relationship with food and establish normal eating.  To that end, the goal is never for someone to be reliant on tracking their intake or completing food logs for the rest of time.  Rather, this is a temporary tool to help bridge the gap between eating disordered and eating intuitively. It might seem counter intuitive to spend your time tracking food in an effort to heal from a disorder that caused you to obsessively focus on food.  But if your goal is to one day be free from disordered eating, it can help to remember this: learning a new behavior often requires focusing on it more before you can focus on it less.

If a dietitian has recommended that you try doing food logs and you were never quite ready to give it a try but you continue to struggle with your ED, it might be worth taking some time for self-reflection. Would it be worth trying something new?  Consider what you would do if your car was stuck in the mud and the first two tow trucks to the scene couldn’t pull you out because they didn’t have the right tools. What would you say to a third one that came along with a different towing device?  Trying something new can sometimes help you to get unstuck. Even if you have tried food logs before and just couldn’t commit to the process, perhaps approaching an old tool with a new perspective or deeper understanding of how it works, could make all the difference.

CED-2014-19334-Mandala-FINALNot wanting to try food logs or other therapeutic tools suggested by your team, can be a form of avoidance. Consider whether you might be avoiding an awareness of particular behaviors or feelings.  Are you trying to avoid being accountable to make changes?  Are you avoiding acknowledgement of your body’s basic needs?  If any of these resonate with you, try being honest with your dietitian or therapist about why you may have been resistant to doing food logs in the past.  Ask for some strategies to make them more manageable or less anxiety-producing. Food logs do take time and you may not always like doing them, but there’s no denying that they can play an important role in facilitating positive change with the support of your treatment team. At the end of the day, doing food logs is temporary. A healthy relationship with food and your body lasts a lifetime.

Written by Hannah Huguenin, R.D. and Kate Clemmer, LCSW-C

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Are you struggling with an eating disorder but you’re not sure where to go for help? Contact The Center for Eating Disorders at Sheppard Pratt at (410) 938-5252 to do an initial phone assessment or visit eatingdisorder.org to learn more.  You may also want to check out our upcoming free events and workshops.

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Hannah Huguenin MS, RD, LDN

Registered Dietitian

Hannah Huguenin received her Bachelor of Science degree in Dietetics with a minor in Chemistry from Olivet Nazarene University in Illinois. She received her Masters degree from the University of Kansas Medical Center in Kansas City where she also completed her Dietetic Internship. During this internship, Hannah completed a rotation on an acute care eating disorder unit at the Research Medical Center in Kansas City. She has been with The Center for Eating Disorders since 2008, and provides individual nutritional counseling for the outpatient population. In her role at the Center, she provides ongoing support to help patients decrease eating disorder behaviors, meet their nutritional goals and improve their relationship with food through nutrition education.
 
 
Kate Clemmer, LCSW-C
Community Outreach Coordinator

Kate Clemmer earned her Master of Social Work degree from the University of Maryland, Baltimore in 2005 with a focus on Management & Community Organization and a specialization in Child, Adolescent & Family Health. Before joining the Center for Eating Disorders in 2008, Kate provided school-based therapy to adolescents and families in Baltimore City and coordinated a multi-school health education and prevention program. As the CED’s Outreach Coordinator, Kate currently facilitates trainings and workshops in the community, provides outreach to individuals interested in the Center’s services and coordinates the Center’s annual community events. These events include an annual Symposium for health professionals, the Love Your Tree Body Image Campaign, and National Eating Disorders Awareness Week. Kate also facilitates the Center’s community support group for individuals with eating disorders and their friends/family, held on Wednesday evenings.

 

Photo credit: freedigitalphoto.net and (in order) Stuart Miles, Boaz Yiftach, Africa

Matt Wetsel talks Eating Disorder “Recovery in Real Life” ~ #NEDAwareness Week Guest Blog

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WETSEL-headshot.mediumMATT WETSEL is an eating disorder and body image writer and advocate.  After suffering from anorexia as an undergraduate in college, Matt got involved with the Eating Disorders Coalition (EDC) doing volunteer lobby work and is now a member of the EDC Junior Board.  Matt launched the blog, Until Eating Disorders Are No More in 2011 and remains a consistently well-informed and responsible voice in the recovery community. We’re honored to feature some of Matt’s personal insights about recovery in the post below and at the upcoming event Recovery in Real Life You can read Matt Wetsel’s full bio here.

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Q & A featuring Matt Wetsel

Q: What is one fact about eating disorders that you think is most important for people to know and understand?

MW: We say it all the time but it’s always worth repeating, eating disorders are serious and must be taken seriously. Especially in America, we live in such a toxic culture that values thinness, promotes dieting, equates weight loss with health without exception, and encourages people to want to ‘improve’ their bodies as if they aren’t good enough already. All of these factors contribute to the trivializing of eating disorders, in popular culture but also within the medical establishment and especially the insurance industry.

It’s so expected of people to diet, to lose weight, etc. that it’s easy to slip into disordered eating behaviors that are actually quite unhealthy and, for some people, pave the way to an eating disorder. These behaviors are so normalized that the warning signs aren’t usually seen as such, but instead are rewarded by the culture and encouraged.

Q: What are some day-to-day differences between life with an eating disorder and living life in recovery/recovered from an eating disorder?

MW: I recall some studies that reported someone with an eating disorder spends maybe 90% of their waking hours thinking about food, weight, etc. When I was sick that was definitely true. It takes up so much of your time and energy that it starts to feel like it’s a part of you. When I would think about recovery, I was honestly terrified of what would be left of me if the eating disorder wasn’t a part of my life. I’d plan my social life, my free time, everything around food. I’d check the scale multiple times per day. I’d avoid friends and family just to avoid potentially having meals with them.

Now, meals are a central part of time I spend with people. I love to cook for friends, go to potlucks, things like that. I eat when I’m hungry, I stop when I’m full. I don’t remember the last time I felt anxious about eating, because it’s been years and years. Even when other hardships in my life have occurred (and there have been a few), I have healthy mechanisms for dealing with grief, depression, anxiety, etc. when life gets challenging. I don’t know what I weigh, and I don’t care.

Q:  What feedback would you give to the support people – friends and family – of individuals struggling with eating disorders? How can they best help to aid in the recovery process?

MW: This is a tough but important question. I’m always afraid to be too specific because good advice for one situation could be terrible advice for the next, depending on circumstances. That said, I think it’s very important to not let the person you’re trying to help or support be the sole source of information on eating disorders. Take time to educate yourself on the subject through other outlets. Make time for yourself and find ways to let go once in a while. If you have to, see a therapist of your own. If you don’t take care of yourself, you’ll be less capable of supporting someone else. It’s like on an airplane, you always put your own oxygen mask on first. That’s hard advice to take when you’re watching someone struggle, but it’s true.

Q: Everyone defines recovery differently. What does recovery mean to you?

MW: Much like the previous question about day-to-day differences, recovery, in a word, means freedom. When you spend so much of your time and energy worrying about food, it’s difficult to be productive in other aspects of your life. All of my relationships suffered while I was anorexic. My GPA tanked. I was in pretty constant physical discomfort.

In contrast, I’ve made lifelong friendships doing advocacy work. I ran a half marathon in 2011 that would have been impossible if I hadn’t recovered. I’m free to figure out who I am and what I want to do with my life without anorexia calling every shot, and that’s a really beautiful thing.

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On February 22, 2015, Matt Wetsel will co-facilitate a free workshop with Benjamin O’Keefe entitled, Eating Disorders: Creating a More Inclusive Recovery CultureThe workshop will examine how cultural experiences affect treatment, the experience of the body and the eating disorder recovery process.

 

It’s Diet Season: Are You Prepared?

girl with unbrella

Diet season is officially upon us.
Weight loss companies are well aware that millions of Americans are actively making New Year’s resolutions. Armed with teams of marketers and millions of dollars, they’ve spent the last twelve months crafting their year-end advertising.  And year after year they are wildly successful, at least in terms of revenue. According to this report, global weight loss markets were expected to be worth $586.3 billion in 2014. The U.S. is the largest contributor to that figure and was projected to reach $310 billion last year.

Yes, the weight loss industry has been preparing for an entire year. But, you can be prepared too. The first step is anticipating the messages that you will be bombarded with so you’re not caught off guard. Here are just a few of the diet industry’s strategies you are sure to encounter in the new year:

  • They will make a lot of promises for a “better” you, a “more successful” you, a “happier” you, but most emphatically, a “thinner” you. They will use those terms interchangeably to try to convince you that you cannot be better, happier or more successful without weight loss. You can.
  • They will pay celebrities enormous amounts of money to endorse what they are selling. Average salaries for celebrity weight-loss endorsers range from $500,000 to $3 million via ABC News.
  • They will tell you this time will be different.
  • They will make faulty connections between weight and health.
  • They will use scare tactics and personal stories to appeal to your emotions.
  • They will use before and after pictures that may or may not be the same person, are often retouched and photoshopped, or might just be stock images of someone who never used their product.
  • They will try to convince you that your body cannot be trusted to do one of it’s most basic jobs.  They will insist you need to pay them money to rely on external rules or charts for when and how much to eat.
  • They will ignore the natural and healthy diversity of bodies by telling you everyone can be thin if they work hard enough. This also happens to be one of the four toxic myths that promote most body image and weight concerns. This cycle works very well for diet companies because the more concerned people are with their bodies, the more likely they are to engage in weight control behaviors. In other words, it is in their best interest to keep you dissatisfied with your body so that you keep buying their product and it keeps being ineffective.
  • They will share short-term statistics from studies funded by their own investors to show how well their diet plan works for the first 3-6 months. They will not respond to requests for independent, long-term outcome studies.
  • They may tell you their product is “not a diet but a lifestyle”.
  • They will tell you your health is at risk. They will not tell you about studies like this which found the risk of mortality was higher among people in the underweight category than it was for those in the overweight category OR like this one which showed increased health behaviors led to improved health markers even in the absence of weight loss.
  • They may even include the phrase “results not typical” in fine print at the very bottom of their full page ad or in speedy verbal disclaimers at the end of a commercial.
  • It is only January yet still, they will tell you that summer is just around the corner and then attempt to make the case that your body is not “ready” for the beach. Spoiler Alert: If you have a body and you have the chance to go to a beach, then you are ready.
  • Are we missing anything? Can you think of other trends or predictable marketing slogans used by the diet industry to try to sell their products? You can add to the list on our Facebook page.

Why is it important to be prepared?
The National Eating Disorder Association reports that 35% of “normal dieters” progress to pathological dieting, and 20-25% of those individuals will develop eating disorders. This is not because eating disorders are simply “diets gone too far” but because diets trigger biological, emotional and mental shifts in the way you process food and information about that food. It is well established that diets can…

  • Dysregulate and weaken your body’s natural cues for hunger and fullness.
  • Trigger obsessive thoughts about food and weight
  • Cause intense cravings for off-limit foods
  • Create anxiety about certain types of food and in response to specific situations involving food such as eating with other people or in public places when the diet-safe food is unavailable.
  • Establish a pattern of failure, low self-esteem and distrust of one’s body
  • Assign moral judgment to foods
  • Develop a system in which exercise is used as a form of punishment instead of a fun or social activity

Clinging to the diet mentality or getting caught up in weight cycling is futile, not to mention potentially harmful to your health and your wallet. For individuals at risk for eating disorders, or for those in recovery, these dieting side effects can be even more dangerous and may create risk for relapse. This year, don’t let the diet season bring you down. Be prepared to stand up against diet pressures by knowing exactly what to expect.  If you find yourself getting overwhelmed or tempted by the ads this season, print out the list above and try checking off all of the marketing tactics you notice.  Then choose to move towards nourishment, self-care and non-judgment by inviting a body-positive friend to lunch, scheduling a massage, setting the table for a mindful eating experience or reaching out for extra support from a treatment provider.

Other Helpful Resources:

  1. Mindful Eating on Campus: Parts 1 & 2
  2. The Resolution Solution
  3. A Message for People Considering Their Next Diet (pdf) from Linda Bacon, PhD
  4. Ringing in the New Year in a New Way
  5. What is Intuitive Eating?
  6. www.eatingdisorder.org

Join CED on Facebook for body image inspiration and recovery support.

*Above image courtesy of freedigitalphotos.net and a454

Body Respect Q&A with Linda Bacon, Ph.D. ~ Part I


Linda Bacon, Ph.D. is an internationally recognized authority on weight and health.  She will stop by Baltimore this fall for two events aimed at dispelling long held myths about weight and health within the medical community and in our society at large. A nutrition professor and researcher, Dr. Bacon holds graduate degrees in physiology, psychology, and exercise metabolism, with a specialty in nutrition. She has conducted federally funded studies on diet and health, and  published in top scientific journals. Dr. Bacon’s advocacy for Health at Every Size (HAES) has generated a large following on social media platforms and the international lecture circuit. Her book, Health at Every Size: The Surprising Truth About Your Weight, called the “Bible” of the alternative health movement by Prevention Magazine, ranks consistently high in Amazon’s health titles. Her latest book, Body Respect: What Conventional Health Books Get Wrong, Leave Out, or Just Fail to Understand, co-authored by Lucy Aphramor, is a crash course in all you need to know about bodies and health.

We recently had the pleasure of corresponding with Dr. Bacon to get answers to some of your most popular questions about HAES, the work she does dispelling diet myths and her newest book, Body Respect.  You can find Part I of her responses below, and Part II is available here.

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Q & A with LINDA BACON, Ph.D.

Q: What led you to pursue writing about and researching health and weight science?

LB: My journey began from own personal pain: in my adolescence and early twenties, I believed that I was fat, that there was something wrong with being fat, and if only I lost weight, everything in my life would be better: my parents would be more proud of me, I’d be more popular… Those thoughts sent me on the painful journey of fighting my weight, and included an academic search for a solution. What I found along that academic journey surprised me: the research contradicted many of the commonly accepted beliefs I held about weight. I developed a critical lens through my work first as a psychotherapist, next as an exercise physiologist and later a nutritionist. And that critical lens has been so valuable in re-learning how to look at myself, and my own relationship with food and my body, and come to a sense of peace and contentment. The war that was originally waged against my self – the fat on my body – was more appropriately waged against oppressive attitudes about fat. I’m now on a mission to share what I’ve learned, both to support others in their personal journeys and to support social change. Our culture plays a huge role in fueling our disconnection with self and it’s critical we move towards a more just and compassionate world so that this struggle isn’t so normative. No one should experience the pain and body shame that I – and many others – routinely do.

Q: What are the most important tenets of Health at Every Size (HAES)?

LB: I see three aspects as being most important: 1) RESPECT, including respect for body diversity; 2) CRITICAL AWARENESS – challenging cultural and scientific assumptions; valuing people’s lived experience and body knowledge; and acknowledging social injustice as a hazard to health and well-being; and 3) COMPASSIONATE SELF-CARE – in eating, movement, and other areas. There’s a lot packed into those words, so here’s the simpler response: HAES is all about supporting people in moving towards greater acceptance and improved self-care, and advocating for the institutional and social change necessary to support that.

Free event in Baltimore on November 8th. Click image for details.

Q: Why do you think so many people continue to rely on dieting when the data isn’t there to back it up as an effective remedy for weight loss or improved health?

LB: I have a lot of compassion for dieters. The dieting belief system is so strongly a part of our culture and medical belief system, it makes sense that many people would buy into it and believe they are doing the right thing. And there is so much fantasy imbued in the results: the belief that one will be seen as attractive and successful, and that it will ameliorate disease. It makes sense many people grab onto it, and get a sense of hope when they try. And we’re taught to believe the “experts” rather than to trust our own experience. So when the diet fails to give them lasting results, the dieter blames him or herself, rather than the diet.

The diet is the problem and it’s the diet that fails, not the dieter. It takes courage to take our power back and recognize that the problem is out there, not in ourselves, that we have a system inside us well-designed to help us manage our weight, if only we trust it. The HAES journey is about helping people to understand that the source of their pain is not the weight itself – but the weight prejudice, and to reclaim their power to know what, when, how to eat, and a new attitude towards other self-care behaviors.

Not long ago, I had a very poignant experience of the damages of the diet mentality. I attended a wedding reception where there was a beautiful buffet of gourmet food. At one end of the buffet was the proud father of one of the brides. (I’m in California, where it’s legal for lesbians to marry.) He had helped plan this party; to him, sharing food was part of the ritual that brought his daughter’s friends and family together. At the other end, three women approached. One looked at the display and said, “Oh, I really shouldn’t.” Her friend commiserated, saying, “It really is tempting, isn’t it?” They all looked on sadly. This is the world we have created. These women are “good” dieters. For them, virtue lies in confronting the temptations of good food, exerting their willpower, and overcoming their desire.

This saddens me. I want a world where food is about nourishing us, body and soul, where we can celebrate with the shared ritual of eating. Where you eat what you want without guilt… and without bingeing. Where eating is uncomplicated by weight concerns.

Fortunately, that world is possible and the Health at Every Size movement helps to articulate it. I live in it myself, and I’ve tested it in a randomized controlled clinical trial. And my results have been reproduced by others. We have shown that people – yes, even “obese” people who are experienced dieters – can learn to dump the diet mentality and celebrate food, and that it results in improved nutritional choices and improved health outcomes. And that it does not result in that feared weight gain.

Q: In your new book, Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight, you and your co-author Lucy Aphramor write a lot about the influence of social justice on weight and health. What’s the most important thing you think people should understand about the impact of inequality and social differences on weight and health?

LB: I can sum it up in three words: “our stories matter.” Our experiences in the world get lodged in us on a cellular level. The experience of oppression, for example, triggers a chronic stress response, which in turn leads to weakened immunity and increased risk for many diseases. When we focus solely on an individual’s weight or health habits, we miss these structural and political inequities, and it stops us from addressing the policies and systems that have a far greater impact on our health. It also supports a culture of blaming individuals for their disease: e.g., “it’s your fault for getting diabetes; if only you ate better.”

How we get treated in the world has a huge impact on our health. Acknowledging the power of social status in determining health can help take the blame off of the individual and will have more significance for tackling health disparities than getting more people to stop smoking, or to be more active, or to eat more nutritiously. This doesn’t mean that we need to stop talking about behavior change: helping someone take better care of themselves is valuable. But it needs to be put in context. Once we understand this, it opens up new avenues for self-care and for how health care gets practiced.

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Interested?  Want to learn more about Dr. Bacon’s research and how the focus on weight can obstruct us from achieving health?  Read more in Body Respect Q&A with Linda Bacon: Part II.

Then join us in Baltimore on November 7th and 8th to see her speak. Visit our Events Page to reserve your seats.


 

Body Respect Q&A with Linda Bacon, Ph.D. ~ Part II

Welcome to Part II of our discussion with internationally acclaimed author and researcher, Linda Bacon, Ph.D.  If you missed Part I, you can find it here

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Q&A with Linda Bacon, Ph.D. ~ Part II

 

Q: What are some of the repercussions of evaluating a person’s health by their weight?

LB: One key repercussion is misdiagnosis. Some thin people get the diseases we blame on weight – and they often don’t get diagnosed until later when they’re more advanced and harder to treat – and many heavier people never get the diseases we blame on weight. And then of course, it introduces the nocebo effect: tell someone they’re going to get sick and they probably will. So it’s just bad medicine. (And expensive! Those excessive costs attributed to “obesity” can be better attributed to weight bias.) Fat or thin, the conflation of weight and health imbues people with a fear of fat and distracts us from what really matters. It brings stigma, a problem of social justice, into health care. It’s both ineffective AND damaging.

 

Q: How could a focus on weight, or on weight loss, get in the way of effective healthcare? Can you give a specific example?

LB: My knee has been bothering me a lot lately, and that provides for an easy example. My father suffered from similar knee problems. However, he was fat (I use that as a descriptive term, stripped of pejorative connotations) and I’m not, resulting in very different treatment from our orthopedists.

My doc told me to first try physical therapy, that stretching and strengthening the muscles around the joint can help. Surgery was also presented as an option.

But what did my father’s doctors recommend? They put him on diets – over and over again. He never developed a regular exercise habit and struggled with weight cycling and disordered eating his whole adult life.

Carrying more weight may have aggravated my dad’s joint problems; no doubt there are ways it’s hard to be in a fatter body. (I should add parenthetically, that there are also ways it confers health advantage, but that’s a much longer blog post.) But trying to lose that weight is no kind of solution. I can assure you, my father – almost all heavier people – they’ve tried already.

My dad went to his death with knee pain. That’s just not effective healthcare. Even if fat is a causative factor and weight loss may be helpful in reducing symptoms, that doesn’t mean that prescribing weight loss is an effective or helpful solution. (Note also that it’s well documented in the literature: prescribing weight loss is more likely to result in health-damaging weight cycling than sustained weight loss.)

My advice in training health care professionals in respectful care with larger people is to start by considering how they would treat someone in a thinner body. Appropriate exercise? Meds? Surgery? Then do what you can to support your patients in implementing your advice and handling the challenges posed by their particular body.

It’s important to remember that good health habits benefit everyone, across the weight spectrum. And that you can’t diagnose someone’s health habits by looking at them. My father – and people of all sizes – could also have benefited from eating disorders screening. Appropriate eating disorders treatment may – or may not – have a side effect of weight change.

 

Q: On November 7 and 8 you will be speaking at two events in Baltimore, one for the community and another specifically for health professionals. What are some of your main goals for each of those talks and who do you think could benefit from attending?

LB: More than anything else, I want to inspire people. For the general community, I want attendees to leave with a sense of hope, that they can lose the guilt and shame and instead take pleasure in eating, that they can look at their bodies kindly. And I want the health care professionals to leave with a greater sense of agency, feeling empowered that they know how to be helpful for people. I want all of us to walk away with a stronger sense of community, feeling that we’re part of a committed group of people helping to make this a more just and compassionate world.

 

Q: Are you hopeful that our medical community, or even our society in general, will be able to make a paradigm shift away from a focus on weight? What helps you stay focused on and inspired by this goal?

LB: I do feel quite hopeful. I’ve watched the transition that’s been happening over the years, how my message resonates with the medical community, once exposed. Most professionals are feeling disillusioned with the old system, and I’m frequently told that coming to hear me talk is a relief. It allows them to take their disquiet seriously and they feel empowered to be presented with solutions that make sense.

But I’m not naïve. As much as I’d like to have faith in the inevitability of justice being done, and the old paradigm being tossed by the wayside, I’m just not confident that’s going to happen large-scale in the mainstream anytime soon. But I find it very liberating to consider that maybe the point isn’t victory, as much as we would like to see that done. Maybe the real issue is that by speaking my truth, I sleep better at night and it gives me hope.

Desmond Tutu offered this advice as rationale for the work of a freedom fighter: You don’t do the things you do because others will necessarily join you in doing them, nor because they will ultimately prove successful. You do the things you do because the things you do are right.

Dr. Linda Bacon

So I try to let go of the preoccupation with outcome, and find fulfillment in my involvement in something worthwhile, and being a part of this greater community. I look forward to being at Sheppard Pratt soon, and connecting with more people committed to a more just and respectful world.

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Many thanks to Dr. Linda Bacon for sharing her time, expertise and compassion with our online communities.  Please join us November 7th in Baltimore when Dr. Bacon will offer an in-depth training for health professionals and then again on November 8th for an inspiring free community event. Find out more and register for both events here.

See Also: BODY RESPECT Q&A with Linda Bacon: Part I

Connecting with EMME on Body Image, Beauty and Balance…

 

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

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 Q & A with Emme Aronson:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

All photos of Emme courtesy of EmmeNation.com

Hope Through Science: CARRIE ARNOLD Talks About Decoding Eating Disorder Recovery

  

On November 4th, 2012 The Center for Eating Disorders at Sheppard Pratt will welcome Carrie Arnold to Baltimore for a special community event entitled, Hope Through Science: Decoding Eating Disorders.  Carrie Arnold is a trained scientist, science writer and also the creator of the popular eating disorder recovery blog, EdBites.  After her own decade-plus long battle with an eating disorder, Carrie recently released a new book designed to share the science of eating disorders in a user-friendly way that not only educates readers but empowers recovery.  In the book,  she discusses how delving into the biology behind anorexia helped her to overcome her own illness. 

In advance of her presentation, we asked Carrie to share a little bit about the new book,  the recovery journey, and why science is for everyone.  Read on to see Carrie’s responses, and don’t forget to click on the image at the bottom of the post for details on how to RSVP for her upcoming presentation. 

Q:  As a scientist, science writer and someone who has dealt with an eating disorder yourself, you have a unique perspective about some of the most critical aspects of the disorders and the science behind them.  What would you say is the one piece of scientific knowledge about eating disorders that everyone should know?

CA: I think the most important thing for someone to know about eating disorder science is that EDs are real, treatable illnesses. They are not choices–sufferers aren’t choosing to starve, binge eat, purge, and over-exercise. Rather, they are symptoms of a potentially deadly illness that requires rapid, intensive, and evidence-based treatment to bring about full recovery.

Q:  Can you list some of the potential benefits to learning about and understanding the biology of eating disorders? 

CA: For me, learning about science was a way to start moving forward rather than continually looking at my past to try and figure out what might have caused my disorder. Insight didn’t bring recovery. Learning my triggers was important, but trying to get to the “root cause” of my eating disorder wasn’t helpful because there really wasn’t a root cause. Rather, it was a perfect storm of events that tripped my predisposition to anorexia. Malnutrition and ED behaviors were perpetuating the disorder, and the first step in recovery was weight and nutritional rehabilitation.

Q:  What role did this knowledge play in your recovery process?

CA: Focusing on nutritional restoration as the first step of recovery was probably the most important. As much as I hated it (and believe me, I hated having to gain weight and stop ED behaviors!), I could think much clearer when I was at a healthy weight for me, and eating regularly. Studies have shown that reaching and maintaining a biologically appropriate weight is one of the best predictors of recovery, and having a treatment team and family that insisted upon this was probably the most important thing in my recovery.

Q:  Your new book focuses primarily on the science of anorexia but research gains have been made for all eating disorders in recent years.  Can individuals with bulimia, binge eating disorder and eating disorder NOS also benefit from uncovering the science behind their eating disorders? 

CA: Absolutely. I primarily discussed anorexia in my book because that was the disorder with which I had the most personal experience, and because the amount of research out there is so massive that I couldn’t tackle everything in just one book. Understanding what eating disorders are and what causes them (often, individuals have a biologically-based predisposition to EDs that are frequently triggered by an energy imbalance in the form of dieting, an attempt to “eat healthy,” growth spurts during puberty, increased training for sport, etc) can free the sufferer from blaming themselves and their families for past events and instead focus on moving forward.

Q:  Will your talk be applicable to individuals struggling with all types of eating disorders or just those with anorexia?

CA: This talk is definitely for people with any type of eating disorder. Even much of what we know about anorexia can be applied to other disorders–the importance of regular eating, addressing co-occurring conditions, understanding triggers, and relapse prevention. These things are universal.

Q:  While the focus of your book is on the biology and genetics of eating disorders, you make it a point to communicate that environment is still important and does influence behavior.  Why is this an critical reminder for readers?

CA: Many people hear the word “biology” or “genetics” and believe that if an eating disorder is related to either of those two things, then recovery is impossible. Their eating disorder was fate and there is nothing they can do. Which is the furthest thing from the truth! We can’t change our genes, but we can change our environment. Genes don’t act in a vacuum; environment is also important. Psychotherapy, for example, can physically change the brain and help you learn better coping strategies. I have to make sure to eat 3 meals and 2-3 snacks each day to maintain my recovery, as well as taking steps to prevent undue stress and sleep deprivation, all of which can trigger ED thoughts.

Q:  It can be helpful for individuals who are struggling with eating disorders to hear from other people in recovery, to know that it is possible, and that it’s worth it to keep moving forward.  What advice would you give to others who may still be struggling or are trying to find the motivation to pursue recovery?

CA: It was really hard for me to believe in recovery after years of illness, ineffective treatment, and failed attempts at recovery. Ultimately, I couldn’t sustain motivation on my own, especially in the face of overwhelming anxiety and depression. I needed other people in my life to believe in my own recovery until I was strong enough and well enough to believe it myself. It’s one of the most ironic features of my recovery- I didn’t have motivation to get better and sustain recovery behaviors until I was well on my way to wellness. It’s why support from friends, family, and treatment providers is so important.

Q:  What would you say has been the most meaningful or most worthwhile part of your own recovery?

CA: Not being so scared of everything. I can relax at times. I can laugh. I can be myself.

Q:  Who could benefit from coming to your talk, “Hope Through Science” in Baltimore on November 4th?  What would you say to people who might initially be turned off or intimidated by the word “science”?

CA: Eating disorders are so misunderstood that I think anyone touched by an eating disorder (sufferers, friends, family, and clinicians) could benefit from learning more about the subject. Our culture likes to portray science as something that’s just for geeks and eggheads. In reality, lots of people are interested in science, even if they don’t always know it. This won’t be like high school science class – I promise!

Q:  As someone who understands the suffering of an eating disorder and the hard work of recovery, what do you hope attendees will take away with them on November 4th after hearing your presentation?

CA: That recovery is hard work, takes a long time, and requires lots of support, but it’s possible with the right treatment.

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Many thanks to Carrie Arnold for taking the time to share her insight and knowledge for this blog.  Click on the image below for details about her upcoming presentation in Baltimore.  The event is FREE to attend but space is limited so be sure to RSVP.  If you have questions, please don’t hesitate to call us at (410) 938-5252.

Ringing in the New Year…in a new way

In our culture, holidays can get idealized through marketing, media messages and product promotions.  Thanksgiving has a reputation for being all about the food…it is, after all, a celebratory “feast”.  Christmas (and Hanukkah to a lesser extent) often comes with pressure to engage in frenzied shopping and elaborate gift exchanges. And to round out the season, New Year’s Eve arrives with a cultural assumption that  everyone will be happily ringing in the new year with hefty resolutions for weight loss and a perpetually full glass of alcohol.

All of these holidays come with their own joys and challenges. The annual combination of drinking and diet pressures during NYE can be especially troublesome for individuals working on recovery considering the high rate of overlap between substance abuse and eating disorders

Approximately 50% of individuals with an eating disorder (ED) abuse or are dependent on alcohol or illicit substances compared with approximately 9% of the general population …

…Conversely, females who report alcohol problems and/or binge drinking were more likely to report recent ED symptoms

  Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788663/

During the hard work of ED recovery, it can be very easy for individuals to fall into the trap of “symptom substitution”.  This occurs when someone is refraining from acting on their eating disorder symptoms but begins to engage in, or increases their reliance on, other unhealthy behaviors such as binge drinking, drug use or self-injury.  Individuals who struggle with an ED and alcoholism can encounter an especially slippery slope during holidays like NYE that promote and normalize heavy drinking.      

If you struggle with substance abuse and find yourself challenged by the idea of the alcohol-focused NYE celebration, or you’re worried about how it might affect your ED recovery, it’s a good idea to plan ahead and create a recovery-focused party plan.  Here are a few tips and ideas to get you started:

Explore your options.  If your friends are planning an evening of bar-hopping, drinking games or other events that are heavily dependent on alcohol, it might not be the best option for you this year.  Consider other outlets…do you have neighbors, co-workers, friends from your church or synagogue, siblings, cousins or other family members who will be getting together to celebrate?  Check in to see if they may have a more balanced celebration in mind and could be more supportive of your recovery efforts. You may need to look beyond your most immediate social network to find what you need.

You CAN have fun while in recovery from an eating disorder and substance abuse; don’t convince yourself otherwise. It can be tempting to assume that there are no options for an alcohol-free evening on New Year’s Eve, but resist the urge to isolate as an alternative.  Sitting at home by yourself watching the ball drop in Times Square might seem like the safe option now but could set you up for feelings of loneliness, depression and negative thoughts as you head into the new year.   Try, instead, to connect with at least one other person and plan something special like going to see a movie or a concert, or catch a comedy show. 

Identify a sober buddy. If you are looking forward to attending a NYE party and you know there will be alcohol there, find out if there is anyone else who will be abstaining from alcohol, and team up for support.  Don’t limit yourself to other people in recovery; consider your friend’s wife who is 6 months pregnant and not drinking, or your friend who is a nurse and has to leave the party to go straight to work at 2 am.  Create alliances to help safeguard your recovery.  At the very least, let your host or a good friend know in advance that you won’t be drinking so they can help alleviate any pressure to do so on the night of the event.

BYO.   Just because you are choosing to focus on recovery and may be abstaining from alcohol doesn’t mean you shouldn’t participate in the midnight toast. In fact, if you’ve been working hard on getting well and finding happiness outside of the eating disorder and/or alcoholism, you probably have a lot of reasons to celebrate the arrival of the New Year, and toast to the progress you’ve made thus far.  Pack your own bottle of sparkling cider and raise your glass in your own honor.

Fun alternatives. If recovery-focused plans fall through or just don’t seem to be coming together, consider some creative alternatives like offering to babysit your nieces and nephews or a bunch of the neighborhood kids.  Put your energy into creating a fun, kid-centric New Year’s Eve celebration for them that you can enjoy too.   Think silly string, noise makers, confetti and some glittery dress-up outfits from the thrift store.

Safety First.  Even if you don’t struggle with substance abuse, but you know you will be drinking on NYE, aim for moderation and be sure that you have a safe travel plan in place.  Either stay-the-night at your host’s house or arrange for a trustworthy designated driver. You can also look into public services in your city that offer free rides home on NYE.  If you’re in the Baltimore area you can call  877-963-Taxi to take advantage of the Tipsy? Taxi!

#DitchingDieting  Be prepared to be bombarded with new year’s resolutions and people’s new diet plans in the weeks that follow.  In an attempt to balance those triggering and unhealthy messages, set up a system in advance to expose yourself to more accurate information about dieting and engage in a body-positive community.  If you’re on Twitter, follow the hash tag #DitchingDieting, and learn more about the toxic diet culture in this post, Dare to Resolve to Ditch Dieting  from Adios Barbie. 

As the year comes to a close, remember that your recovery, your happiness  and your well-being is worth more than a few hours of partying on New Year’s Eve.  Try something new this year by allowing yourself the time and space to celebrate in a way that is safe and supportive of your emotional growth and your current stage of recovery.  Strive to be mindful and present as you welcome in a year of gratitude, positivity, strength and confidence.

Happy New Year from The Center for Eating Disorders at Sheppard Pratt!