Eating Disorders & The Transition to College


In many ways, it is not a surprise that the transition to college can be so challenging. Moving from a home with your family into campus housing, often hundreds of miles away, with roommates you’ve never met can be quite a shock. It’s rarely easy for anyone. For many young adults however, the stress and unique social and environmental factors associated with this transition can contribute to the development, or exacerbation, of an eating disorder. Consider the following statistics:

  • In a survey of 185 female students on a college campus, 58% felt pressure to be a certain weight, and of the 83% that dieted for weight loss, 44% were already at a normal weight.1
  • 9% of 20-year-old males reported struggling with a clinical eating disorder.2
  • Of nearly 3,000 students on a university campus, 3.6% of the males experienced eating disorder symptoms.3
  • The rate of eating disorders among college students at one college increased from 7.9% to 25% for males and 23.4% to 32.6% for females over a 13 year period.4

College is supposed to be fun, educational and provide plenty of opportunities to be inspired by future career possibilities. So what makes this transitional time such a hotbed for eating disorders? The Multi-Service Eating Disorders Association (MEDA) offers several reasons why college students could be at increased risk for eating disorders. These include:

  • New peer groups or difficulty forming new friendships
  • Newfound self-reliance; no longer living under parental rules
  • Cafeterias and dining halls with an unlimited amount of food; making food choices independently may be difficult particularly when paired with conflicting messages about dites, nutrition and calories 
  • Fear of the “Freshmen 15”
  • Dorm-living
  • The desire to fit in; an intense pressure to be “perfect”
  • Academic and financial stress
  • Difficulty managing transitions

While many colleges offer support and resources for students who are struggling with the transition or mental health problems in general, students do need to seek them out. This isn’t as easy as it sounds considering a recent study on eating disorder prevalence in college students found that most were not aware that they had an eating disorder or, if they were, they were not willing to seek treatment.According to the research, the five most common reasons why college students may feel uncomfortable or refuse to seek treatment include:

  • Lack of perceived need and urgency
  • Perceived stigma surrounding diagnosis and treatment
  • Limited availability of services
  • Denial of illness
  • Lack of motivation for recovery inherent in ED

It’s important to know that you’re not alone and that help is available on and off-campus. It’s also important to know that eating disorders are serious illnesses that, if untreated, can progress rapidly and may become life-threatening.

Where can I go for help?

If you are a college student struggling with disordered eating, an unhealthy relationship with exercise, or negative body image, there are steps you can take to cultivate a more balanced and fulfilling time on campus.

  1. Identify treatment resources and support groups on or near you. Here is a great list of potential organizations, people and resources that might be able to help on most campuses.
  2. Incorporate basic self-care into your schedule.
  3. Get the facts about weight and diets; dispel the myth of the Freshmen 15
  4. Take some simple steps to strengthen your support system and break out of the loneliness or isolation you may be feeling.

Whether in college or any other stage of life, it’s crucial to ask for help and to learn that asking for help is a strength, not a weakness. Remember that you can’t tell how someone is handling the transition to college just by looking at them or their social media feeds. Many of the students around you may also be struggling in silence with similar feelings and symptoms.

For more information about eating disorders, body image and treatment options, visit eatingdisorder.org.

If you are a campus-based health provider and would like more information about eating disorders or trainings, please contact Jennifer Moran, Psy.D., College Liaison at The Center for Eating Disorders at Sheppard Pratt.


Seechuk_julie_2018.jpg

Written by: Julie Seechuk, BASW, Community Outreach Intern
Julie is currently pursuing her Masters in Social Work at Salisbury University online with an intent to graduate in May of 2020. Julie received her Bachelor’s Degree from Salisbury University in 2015 with a double major in Psychology and Social Work. In addition to pursuing her Masters and interning at The Center for Eating Disorders, Julie also works part-time as a Community Relations Coordinator for a Pediatric Oncology Nonprofit called The Cool Kids Campaign. As a community outreach intern, Julie assists with resource development, event coordination, social media and website maintenance, community outreach to schools, and The Center’s free weekly support group.


References

  1. Multi-service Eating Disorders Association. (2018). Eating Disorders College Students. Retrieved from: https://www.medainc.org/wp-content/uploads/2015/09/MEDA-College-Guide.pdf
  2. Allen, K., Byme, S., Oddy, W., & Crosby, R. (2013) “DSM-IV-TR and DSM5 eating disorders in adolescents: prevalence, stability, and psychosocial correlates in a population-based sample of male and female adolescents.” Journal of Abnormal Psychology.
  3. Eisenberg, D., Nicklett, E. J., Roeder, K., & Kirz, N. E. (2011). Eating disorder symptoms among college students: prevalence, persistence, correlates, and treatment-seeking. Journal of American college health: J of ACH, 59(8), 700-7.
  4. White, S, Reynolds–Malear, J., Cordero, E., “Disordered Eating and the Use of Unhealthy weight control methods in college students: 1995, 2002 and 2008” Eating Disorders–Journal of treatment and prevention.

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

 


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

GIPHY Video Audience Giving a STanding Ovation

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

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

First up on our #popcultureED tour is…


“THE DEVIL WEARS PRADA”

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

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

 


“ROMY AND MICHELLE’S HIGH SCHOOL REUNION”

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

 


“MEAN GIRLS”

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

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

 


“A CINDERELLA STORY”

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

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

 


“ZOOLANDER”

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

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

 


“CLUELESS”

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

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

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

 


“BRING IT ON” 

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

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

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

 


“PITCH PERFECT”

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

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

 


“LITTLE MISS SUNSHINE”

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

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

 


The Oscars

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

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

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

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

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


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

Barriers to Quality Care

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

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

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

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

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

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

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

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

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

 


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

 


References

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

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

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

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

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

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

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

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

 

 

Testimony on The Inclusion of Questions on Eating Disorders in National and State Youth Risk Assessment Tools


*     *     *

The following written testimony was provided by Steven Crawford, M.D. in advance of the Maryland State Medical Society House of Delegate’s vote on the matter of advocating for the inclusion of eating disorder questions in state and national health monitoring tools. 

Additional information on the position of Dr. Crawford and The Center for Eating Disorders at Sheppard Pratt can be found by reading the following articles: 

Data Collection Critical to Understanding Eating Disorders – Baltimore Sun

30 million people will experience eating disorders — the CDC needs to help – The Hill

More detailed information about resolution 10-18 is linked in the testimony below.

 *     *     *


Testimony of

Steven F. Crawford, M.D., Co-Director
The Center for Eating Disorders at Sheppard Pratt

Before the

MEDCHI, THE MARYLAND STATE MEDICAL SOCIETY HOUSE OF DELEGATES

April 29, 2018

Resolution 10-18 – The Inclusion of Questions on Eating Disorders in National and State Youth Risk Assessment Tools

My name is Dr. Steven Crawford, and I am pleased to appear today on behalf of The Center for Eating Disorders at Sheppard Pratt.  For nearly 30 years, on a daily basis, I have been involved in clinical care, teaching, and research of life-threatening eating disorders including anorexia nervosa and bulimia. I started my career in at Mercy Center for Eating Disorders, and subsequently I have held leadership positions in psychiatry at St. Joseph Medical Center, and currently, with Dr. Harry Brandt, I co-direct one of the largest hospital based eating disorders programs in the United States at Sheppard Pratt Health System.  I am a member of the Academy For Eating Disorders, a Distinguished Fellow the American Psychiatric Society, and a faculty member of the University of Maryland School of Medicine.

I come before you asking your support of Resolution 10-18 which asks for the “The Inclusion of Questions on Eating Disorders in National and State Youth Risk Assessment Tools.”

In the United States there are an estimated 20 to 25 million people who suffer from anorexia nervosa, bulimia nervosa and related eating disorders.  These illnesses destroy lives and devastate families throughout Maryland.  Anorexia nervosa has the highest death rate and the highest suicide rate of any psychiatric illness.   Further, the eating disorders are unique in that virtually every major organ system in the body can be affected by starvation, poor nutrition, and the dangerous behavioral patterns associated with eating disorders.  Sudden death is not uncommon.

After over two decades of mandatory surveillance of eating disorders signs and symptoms under the CDC’s Youth Risk Behavioral Surveillance System, the Centers for Disease Control (CDC) and state stakeholders voted to remove the mandatory eating disorders surveillance questions in 2015. The questions were removed under the pretense of changing public health priorities.  This, despite growing prevalence of eating disorders, an increasing awareness of their impact and the knowledge that every 62 minutes, someone dies as a direct result of an eating disorder.  Eating disorders should be among the top priorities of CDC because of their high death rate and the evidence that early identification and treatment are essential.

In this resolution, we request support of Med-Chi in advocating to the Maryland Department of Health for the immediate re-instatement of eating disorder questions in any current and future statewide Youth Risk Behavior Surveys (YRBS).  These efforts, if successful, would position Maryland as a national leader in tracking, assessing and mitigating the negative medical, social and financial burdens caused by eating disorders.

Additionally, we are working with the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED), the National Eating Disorders Association (NEDA), and The Eating Disorders Coalition (EDC) to ensure the eating disorder questions are reinstated on a national level through the CDC surveillance systems.  This resolution additionally asks the MedChi’s American Medical Association (AMA) Delegation ask our AMA to advocate that the CDC reinstate the eating disorder questions into the YRBSS.

It is our hope that the House of Delegates will support this critical initiative by passing resolution 10-18.


UPDATE: On April 29, 2018, the MedChi House of Delegates voted to adopt resolution 10-18.

 

Knitting Together Skills for Eating Disorder Recovery

April is National Occupational Therapy Month ~ #OTMonth 


If you’ve had an eating disorder yourself, or you know someone who has, you might know all-too-well that one of the side effects of these illnesses is decreased engagement in meaningful, fun or productive activities. Eating disorders have a way of overtaking a person’s energy and time, even altering the way the brain works.Knitted squares in blue, grey and white; the beginning stages of a blanket

As more time is spent obsessing about food and weight, and engaging in symptomatic behaviors, there tends to be less and less mental energy available for activities unrelated to meals, food or thoughts  of body dissatisfaction.  By no fault of their own, individuals who develop eating disorders often don’t realize how much the eating disorder shifts their focus and leads them away from people,  events, and activities they once enjoyed.  This is one of the reasons The Center for Eating Disorders (CED) at Sheppard Pratt has always incorporated Occupational Therapy into our treatment options for individuals with eating disorders.An individual’s “occupation” is any activity that occupies his or her time.  Thus, Occupational Therapists (OTs) focus on enabling people to participate in meaningful and purposeful activities of daily life. At CED, our OTs work to provide individuals with a setting where the behavioral changes made through Cognitive Behavior Therapy (CBT) and insights learned in other psychotherapies can be converted into new behaviors that become part of the long-term healing process. We’ve written before about some of the ways our OT Department does this through Horticulture Groups.  Similar work is done throughout the year in different ways – including through mindful knitting groups.

Knitting is a craft that requires both physical and cognitive skills and thus engages both mind and body simultaneously. Knitting has the advantage of engaging the senses with the sound of the needles, touch of the yarn and movement of the hands that, together, hold the attention of the mind in the present moment. Repetitive action can be calming, textures can provide grounding opportunities and hand movements offer engagement for mind and body. This can be a much-needed relief for persons with eating disorders whose thoughts are constantly being pulled to the last meal or to the next one, or to persistent negative beliefs about their body, weight or size.

Over the last two years since our knitting program began, the OTs in The Center for Eating Disorders’ Partial Hospital Program (PHP) facilitated two therapeutic knitting groups, running twice a week for 8 months a year as an addendum to our core CBT protocols and additional evidence-based therapies. Participants could join for one session or many and were reminded frequently that each contribution is part of the whole. In these groups, patients who were veteran knitters joined beginners, learning new skills and sharing experiences. The groups were an opportunity for individuals to practice mindfulness and socialize with peers while, as one participant put it, “focus on calming,repetitive activity that also produces a tangible result” completely separate from anything related to one’s eating disorder.  The tangible result? Mindful knitting participants worked to create a collage of knitted squares which, when knitted together, became finished baby blankets.

When asked about the impact of the groups, individuals indicated  they “became more centered, distracted from my negative thoughts”  and “my anxiety level changed”.  Others shared that “the knitting was calming; the repetitiveness of the knitting felt good.” The power of knitting as a therapeutic tool has been documented outside the individual experiences of our patients. According to Corkhill et al., (2014), knitting in groups can impact perceived happiness, improve social confidence and feelings of belonging.

The knitting group, like many of our other OT groups, offers a safe environment to explore a new hobby (or rekindle interest in an old one), challenge perfectionistic tendencies, relax in recovery-focused ways, and stay in the moment with the flow of the needles and yarn.  This opportunity to engage the mind and the body also allowed for reflection on the healing and recovery process. When our most recent group of participants were asked how to apply the skills learned in knitting group to their broader recovery goals, responses included all of the following:

  • “ I can look at each of my new coping skills as accomplishments and enjoy the state of calmness.”
  • “I didn’t give up. I can remember not to give up so quickly.”
  • “I was able to feel good about myself. I can definitely use that for self-esteem issues.”
  • “[I’m] very excited to go home and knit. It’s so helpful to practice being in the moment.

The knitting groups provided a healing experience, new mindfulness skills and a variety of powerful reflections for participants. They also provided participants with an outcome they could feel good about. Upon completion, the group’s resulting baby blankets were donated to newborns at Mt.Washington Pediatric Hospital where they can continue to promote healing in new and important ways.

Would you like to find out more about OT and other treatment options at The Center for Eating Disorders? Call us today at (410) 938-5252.


Christine Brown, MS, OTR/L

Blog Contributor: Christine Brown, MS, OTR/L is an Occupational Therapist at The Center for Eating Disorders. Christine received her Masters of Science degree from Virginia Commonwealth University in 1999. Prior to joining the team at The Center for Eating Disorders, Christine spent time providing community-based services as an intensive case manager and worked in a general psychiatric inpatient and partial hospital program.  In her current role at The Center, Christine provides occupational therapy for adults and adolescents in our inpatient and partial hospital programs. She assists patients in increasing engagement in valued roles and meaningful occupations through group and individual interventions. In addition to the knitting group and other OT groups, Christine facilitates the sensory awareness and horticulture specialty groups.

 


Reference:

Corkhill, Betsan & Hemmings, Jessica & Maddock, Angela & Riley, Jill. (2014). Knitting and Well-being. Textile: The Journal of Cloth and Culture. 12. 10.2752/175183514×13916051793433.

 

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

 

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.

Easing Anxiety About Grocery Shopping During Eating Disorder Recovery

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Easing Anxiety About grocery Shopping - Woman with Shopping Cart [IMAGE]Whether we like it or not, grocery shopping is a necessary task of adulthood. It can be annoying or simply unenjoyable for anyone who is living a busy life or just doesn’t enjoy shopping or cooking. Most adults however, make it in and out of the grocery store regularly without significant disruption, problems or stress. But for the millions of individuals living with an eating disorder, an everyday task like buying food for themselves or their families feels completely overwhelming. Just thinking about going food shopping can trigger intense anxiety and may result in avoidance or elevated eating disorder symptoms. Actually going to the store and getting out before the milk gets warm seems impossible at times.

Since having consistent, structured and fulfilling meals are such a fundamental part of eating disorder recovery, being able to source and purchase the food for those meals then becomes a primary part of treatment.  If someone is too anxious to step foot in the store, obsesses over the label on every item or finds they just wander aimlessly, it can really inhibit their ability to bring home the foods they need to meet their nutritional goals. As a result, difficulties with grocery shopping can become a significant barrier to recovery. That’s why our Outpatient Nutritional Coordinator put together these tips to help individuals with eating disorders (or anyone really) navigate the grocery experience and become more confident in your shopping ability.

Plan, Plan, Plan: This is one of the most impactful tips! Planning your meals ahead saves you time and money. It can also decrease anxiety at meal times since you know that you have something in place and what to expect. In order to maintain stable meals, you must have a menu planned and food available to meet that plan; remember to incorporate foods from all food groups. Set aside one hour, one day a week for meal planning. Planning ahead also cuts down on the amount of trips to the store you need to take during the week.  One to two trips to the grocery store per week is reasonable

Organize your list: Based on your planned menu, create a grocery list. Breaking it down into the sections of the grocery store can cut down on time spent in the store. People that “wing it” end up wandering too long or revisiting the same aisle two or three times. Keep a pad of paper in your kitchen or a list on your phone where you can write down food staples that you run out of during the week; add them to your main grocery list before you go.

Be realistic: Set realistic expectations when you plan your meals. What do you have going on this week?  Which nights will you have more time to cook?  Which nights do you need something easy to assemble?  At which meals would it make sense to use leftovers?   Pick up a variety of foods that require different levels of preparation.

Mission possible: Set a time limit and stick to it.  Make it your mission to be at the register in 30 minutes or less.

Add support: Go with a friend or support person for the first few times. Whether they know you have an eating disorder or not, this will help distract from any eating disorder thoughts in your head and will keep you more on task.  Letting your support person know your goal of being at the register in 30 minutes or less can also help hold you accountable to not wasting time wandering aisles or compulsively comparing items.

Stick with what you pick: If you find yourself spending too much time reading labels or comparing similar products, try to make the decision based on which one is on sale that week. Choosing the item based on price can also help expose you to different brands and allows you to discover which one your taste buds truly prefer.  Another way to decrease label reading is to view the grocery store ad online before going to the store when making your list.  This allows you to view items without being able to read their labels and to commit to having them on your grocery list based on what is on sale.  This is helpful for reducing time comparing products, getting exposure to trying different products out, and can save you money!

Shrink the store: Sometimes it’s fun to shop at a large grocery store and to have a lot of options, but for some people more options = more anxiety. If that’s the boat you’re in, try shopping at a smaller store such as Aldi, Eddie’s, or the grocery section at Target.   It’s a lot easier to decide which yogurt to buy when you have three options instead of thirty!  Having less options of yogurt, cereal, bread, crackers, etc, can reduce time spent in the aisles and will help you get out of the store faster.

Ditch the diet products:
Avoid being lured into fat free, sugar free, “diet products.”  They do not satisfy and will only leave you feeling hungry and stuck in the “diet mentality.”  Normalized eating incorporates regular products that are more satisfying and enjoyable.

Avoid the crowds: Try to shop at times when the grocery store is not as busy. Typically during the week, 3-6pm tends to be the busiest time at the grocery store.  Sundays are also very busy days.  Try to go in the morning, later in the evening, or on Saturday.   You can also look your grocery store up on google maps and look at their “popular times” bar graph to see less busy times to shop.

Check your status:
Be mindful of your vulnerability factors.  Are you tired? Stressed? Hungry? If the answer is yes, plan on engaging in some self-care first and going to the grocery store when you are feeling more rested, stable and satiated.

Ask an RD: If you need help planning meals, making grocery lists, expanding variety, and setting goals for improving your confidence with grocery shopping, ask your dietitian for support. If you do not have a dietitian, consider adding one to your treatment team if you are working through an eating disorder.

Remember that with learning any new skill, it takes practice and time.   If you have negative experiences with grocery shopping in your past, try some of these tips to begin developing more positive associations with going to the grocery store. Over time, this will help decrease your anxiety around grocery shopping. Plus, having food available for meals will help you stay on track on your journey to recovery.


The Center for Eating Disorders is excited to announce the launch of a brand new Grocery Shopping Support Program designed to aid individuals working on recovery from eating disorders including anorexia, bulimia and binge eating disorder. Parents/Caregivers of children and adolescents are also eligible for participation. Program components and goals include:

  • Snack/meal/menu planning
  • Grocery list development
  • Incorporation of challenging foods
  • Efficiently utilizing time spent in stores
  • Managing impulsive food purchases
  • Identifying triggers and coping skills
  • Decreasing anxiety around food and food purchases
  • Exposure to food-based environment
  • Individualized treatment goals

If you’re interested in scheduling a grocery support appointment, please call (410) 938-5252.  If you have questions about the program you can also email Hannah Huguenin.


Written By: Hannah Huguenin MS, RD, LDN
Outpatient Nutrition Coordinator

Hannah has been an integral part of The Center for Eating Disorders’ staff since 2008, and provides individual nutritional counseling for the outpatient population. In her role at The Center, she manages the outpatient nutrition team and leads program development. She was instrumental in building the Center’s new Grocery Shopping Support Program. Hannah also provides ongoing support to help patients decrease eating disorder behaviors, meet their nutritional goals and improve their relationship with food through nutrition education.

How to Stay Recovery-Focused When Interacting with Triggering Media

In our previous post we discussed a variety of reasons that individuals with eating disorders, especially those in the early stages of recovery, may choose not to watch the Netflix film To The Bone or other films they know could create roadblocks in their continued recovery.

With that said, triggering media has always been around and will always be a part of our society so it’s helpful to know how to navigate it.  Many individuals in long-term recovery or later stages of treatment might feel prepared to watch a film or read a book about eating disorders, despite triggering content. Many of our clinicians have helped to shape such exposure into therapeutic experiences for patients who are ready.  For example, during periods of strong recovery, seeing a film like To The Bone can be an opportunity to reflect on one’s own experience, see things from a new perspective, process lingering eating disorder thoughts or channel anger towards the eating disorder in productive ways.

If you’ve considered all of the options and decide you do want to watch a film about eating disorders, these are a few things to consider that can help you do so in safe and productive ways.

  1. Don’t watch alone. Watch with a support person you can trust and communicate openly with them about how it is impacting you in the moment. You might even consider pausing the show periodically to breathe, reflect and talk.
  2. Time it right. Only watch it when you know you’ll be attending a therapy session or support group within a few days so you can explore your reactions and get help challenging any distorted thoughts or concerns about what you see on screen. If you currently have a lot of other life stressors or you’re in a time of transition (moving, starting school, going through a divorce, etc.) you may want to consider waiting to watch until things settle down.
  3. Challenge the ED thoughts. Consider journaling about aspects of the movie that you find triggering and then refute and challenge the inaccurate, negative or distorted thoughts.
  4. Be an activist. Write a letter to the director of the film or to the editor of a local newspaper regarding what you liked or didn’t like, what was helpful vs. not helpful or what you’d like to see more of when it comes to films about eating disorders. For example, while To The Bone features one person of color and one male in supporting roles, the movie’s star and protagonist is a young, white, upper-middle class woman with anorexia. This doesn’t help to dismantle stereotypes about who is and isn’t impacted by eating disorders. Consider writing a letter that advocates for greater diversity in eating disorder representation or about another aspect of recovery that feels important to you.
  5. Create an escape clause. Allow yourself the option to stop watching at any point throughout the film. Eating disorders can be associated with all-or-nothing thinking so it may feel like once you start the movie you have to finish it, but remember it’s not so black and white. At any point, if you feel triggered or uneasy about what you’re watching, turn it off.
  6. Plan ahead. Decide in advance upon an alternative show to watch or a self-care activity you can do when the film is over (or if you stop watching early) that will help you sustain a more recovery-focused mindset.

Do you use these strategies or have other ideas for navigating triggering media safely?  Tweet them to us @CEDSheppPratt and we’ll add to the list. 


You may also be interested in reading: 
To Watch or Not to Watch: That is the Question, Navigating “To The Bone” and other potentially triggering movies about eating disorders

 

 

 

 

 

To Watch or Not to Watch: That is the Question

Navigating “To the Bone” and other Potentially Triggering or Inflammatory Movies about Eating Disorders

Like most things in life there are benefits and risks that come with exposure to media, especially media that depicts sensitive or potentially life-altering subject matter such as eating disorders, suicide or mental health. As you may have already noticed from the controversial conversations about it, the Netflix movie, To the Bone is no different. The film depicts a young woman, Ellen, in the throes of her eating disorder and follows her through the recovery process which the synopsis points out, includes
help from a “non-traditional doctor” played by Keanu Reeves. It may come as no surprise that the main character, Ellen, is a young, white, very thin, upper middle-class woman, and that the particular eating disorder she is dealing with is anorexia nervosa. Hollywood tends to over-rely on this stereotyped depiction of eating disorders, despite the fact that in reality, eating disorders and the people they impact are much more diverse.

As one of the nation’s longest-running providers of evidence-based treatment for children, adolescents and adults with eating disorders we’ve been asked by numerous patients and families in the previous weeks how to handle such a film.  And while To The Bone may be a new film, this is far from a new question.  Over the last several decades, similar questions have been raised in response to documentaries, blogs, fictional books and memoirs written by individuals recovering from eating disorders.

Decades of observing the impact of this type of media has reinforced our recommendation that individuals who are currently struggling with an eating disorder or those who are in the early stages of treatment and recovery don’t typically benefit from watching movies or reading books that display any of the following characteristics:

  • extremely graphic depictions of people engaged in eating disorder symptoms such as bingeing, purging, chewing/spitting, body checking, over-exercising, self-harming or abusing drugs and alcohol
  • detailed descriptions of ED thoughts and behaviors that are left unchallenged, unexplained or are not paired with sufficient education regarding the consequences
  • conversations that include specific numbers such as weights, clothing sizes, calorie counts or repetitions of exercise.

If you notice any of these characteristics in a movie, show or book, it should be a red flag that it might not be a beneficial resource or recovery-focused activity for someone who is currently struggling.

We always look to support popular media that finds a way to raise awareness and stimulate meaningful discussions about eating disorders in safe and non-triggering ways. With that in mind, we went into our own viewing of this newest movie with high hopes and an open mind. Unfortunately, what we found was that To The Bone ultimately ticks off all three of the red flags mentioned above. Furthermore, the film’s depiction of treatment methods and treatment protocols are far from helpful, safe, or accurate.  As a team of specialized professionals, many of whom have spent their entire careers learning about, researching and utilizing evidence-based treatments for eating disorders, this film was, quite frankly, disappointing and at times difficult for our staff to watch.

On the flip side, it did do a good job of illustrating the immense pain and struggle faced by those who are impacted by these illnesses. It also got people talking about an issue that is usually hushed in society despite the fact that eating disorders impact 20-30 million people.  Our hope would be that some viewers of the film gain insight or information that could help them check in with a friend or loved one who is showing warning signs and needs help.

Taking into account both perspectives and the possibility for all the positive and negative impacts, it’s crucial to think  critically about the media introduced to us as communities, families and individuals.

If you are a therapist, a parent, educator or friend of someone with an eating disorder

It’s really important to empower anyone considering watching a film about eating disorders to feel like they can disengage safely and with your support.  Let them know it’s okay to decide not to watch because it has the potential to be harmful for them and their recovery.  This can be a hard but powerful decision because it builds confidence and sets a precedent for recovery-focused decision-making.  How? Today, it might be saying no to a Netflix film that “everyone else is watching and talking about” but tomorrow it could be saying no to a dangerous cleanse that a favorite celebrity is promoting on social media or saying no to a friend that encourages you to step on her bathroom scale. Learning how to say no to such things, even when the societal pressure and internal urges are strong, is imperative for long-term recovery.

If you have an eating disorder or are in recovery from an eating disorder…

If you’re like a lot of our patients, seeing a trigger warning at the start of a film or hearing in advance that it might be detrimental isn’t always a deterrent and might even make the content more intriguing. We’ve heard from some of our patients that they choose to watch the film despite their own reservations and knowledge of the content.  Most of the reactions included versions of the following:

  • I found myself comparing my body to the actress in the film and thinking that maybe I wasn’t deserving of or didn’t really need treatment since I wasn’t as thin as her.
  • I found myself wishing I could go back to my eating disorder.
  • I was tempted to use “a little bit of my ED behaviors” and was reassuring myself I wouldn’t let it get that bad.
  • If she [the actress Lily Collins] can “lose weight safely” for this role after recovering from an eating disorder in real life than maybe I can too.  

Despite what may be positive intentions for this film, it’s important to be realistic about how it actually plays out for the millions of people with eating disorders who watch it. While not everyone will have reactions like these, we think it’s important for individuals and support people to know it’s a possibility that the person who is struggling with an eating disorder may overlook the negative aspects of the eating disorder on screen and only see the perceived positive or glamorized aspects.

If you are struggling with whether or not to watch this film, or engage with any other eating-disorder focused media, remember that it’s okay to say no. At the very least, we encourage you to discuss your decision with a treatment provider or trusted support person.  If you decide together that watching this type of film might actually be beneficial at certain stages of recovery, check out these guidelines for watching safely.

Some of the most important ways to enhance recovery and prevent relapse include: continuing regular contact with treatment providers, following evidence-based recommendations, engaging in regular self-care and creating a home environment that is conducive to your continued healing and recovery. In this case, that might also include creating a Netflix watchlist that doesn’t have anything to do with eating disorders.

Do you have thoughts on the film or the media surrounding it? Join the discussion on our Facebook page.


Written by Kate Clemmer, LCSW-C, Community Outreach Coordinator, The Center for Eating Disorders at Sheppard Pratt