Simple solutions for holiday (and everyday) conversations about food and weight


dining room
As we head into the holidays, it can be helpful to have a very simple plan for responding to family and friends drawn to the very topics that may be most troubling during recovery from an eating disorder.  Depending on how you spend your holiday this year, one or all of these suggestions may come in handy when the conversation takes a turn toward triggering language regarding bodies, food or weight.


Step 1:
Obstruct or change the conversation if you notice someone is heading into a discussion that makes you uncomfortable.

Remember people generally like to talk about themselves and their interests. If Aunt Marie is pressuring everyone to eat more pie or is gushing over a family member’s weight loss, use that as an opportunity to reflect the attention back to her. So who taught you how to bake? What are you up to at work Aunt Marie? How was that vacation you went on?

If you’re comfortable staying on the topic but exerting your power into the conversation you could try something like this: I’ve actually been learning a lot about how weight is not a good determinant of overall health. I’m focusing on my work-life balance and healthier ways to deal with stress. I’m thinking about meditation…have you ever tried it?


Step 2: Set boundaries
if someone continues to target you with questions or comments about your body or what you’re eating.

Here are some simple examples with varying levels of intensity.  You can choose which ones you think would work well for you, or create your own.

  • I try not to get involved in discussions about dieting and weight loss.
  • I’d prefer not to talk about my weight today.
  • I am so happy to be here with everyone, I don’t want to waste our time together talking about food/weight.
  • Please don’t comment on my body.
  • Let’s find something else to do or talk about.
  • I’d much rather tell you about school / work / hobby
  • It’s really stressful to me when people make comments about what I’m eating.
  • It’s actually not helpful for me to talk about calories or exercise.
  • I’m choosing to focus on other things this year.
  • It is not beneficial for me to feel badly about my body or guilty about what I ate.

The great thing about practicing these responses with other people is that you’ll be more likely to use them when struggling with negative self-talk or eating disorder thoughts in your own head too.


Step 3:
Step away & seek support.

If stressors persist or you find you just need a break from the crowd, locate your holiday ally or text a friend. Take some time to vent about what’s bothering you, take 3 very deep breaths, and then re-focus on the positive parts of the day.  Sounds simple but it can make a big difference.

You are deserving of a happy and healthy holiday. How you choose to create that is up to you.  Just remember that one insensitive comment from one person does not have to ruin your entire holiday. At anytime, you can choose to re-engage in both the celebration and your recovery.

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Read more about healthy holiday coping…


 Concerned that you or a loved one may have an eating disorder?  Call us at (410) 938-5252 for a free and confidential phone assessment or visit www.eatingdisorder.org for more information about treatment options.

 

Photo credit: freedigitalphotos.net / digidreamgrafix

 

 

 

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8 ways to take the focus off of food this Thanksgiving


Who’s bringing a dessert?  Can someone help with appetizers?  Here, have some more!  Are you really taking another helping?  I wish I could eat like you.  Ugh, my diet must start tomorrow!

guitarSound familiar? It’s not unusual for pre-Thanksgiving talk between family members to focus on food and food-related tasks. It’s also not uncommon for holiday conversation to revolve around what people are eating or not eating, who’s eating too much or too little and, in some cases, criticism or praise regarding weight and size. To be clear, making sure there’s enough food to feed everyone at a gathering is important, but it doesn’t need to be the center of everyone’s day.

When an individual is struggling with an eating disorder, or working hard to maintain recovery from one, these topics can activate disordered thoughts about food, trigger negative body image and impact a person’s ability to be emotionally or physically present at the gathering. Intentionally steering the day towards gratitude and connection instead of food and weight can take a bit of work in our diet-obsessed culture but it stands to benefit many, not just those with eating disorders.


Where to start?
These are just a few suggestions from our therapists and dietitians. Feel free to share your ideas and recommendations on our Facebook page.


1. Offer roles for family and friends who want to contribute something but may not want to bring food.
Not everyone enjoys cooking and some people, especially those with eating disorders, might feel incredibly anxious around food. There are definitely other ways to help and have a meaningful connection to the day that don’t involve preparing food. For example:

  • Planning activities or bringing a craft for the kids (or adults!) to work on.
  • Pet duty. Someone might really love to take the dogs out for a walk while everyone else is distracted in the kitchen or watching the football game.
  • Helping with clean-up and dish-washing (Yes, some people enjoy washing dishes!)
  • Ask the musicians of the family to bring their instruments.
  • See if anyone would be willing to put together a slideshow of past Thanksgiving photos for after-dinner viewing.

Quick Tip: Tap into everyone’s strengths. If your brother has taken up a recent interest in photography ask if he’d be willing to document the day and capture different positive interactions. How great would it be to have a beautiful photograph of a grandparent rocking a new baby or all the cousins playing football outside? These are, after all, the moments you’d choose to remember about a holiday, not how many calories you ate or an offhanded remark someone made about your weight gain/loss.


2. Give in to the gratitude trend.
Gratitude might seem like a big social media gimmick right now but the truth is it does have the power to shift your attitudes and perceptions. The moment dinner is served and everyone sits down to eat can be a moment of peak anxiety if you have an eating disorder. In anticipation of this, Google “gratitude quotes”, pick your favorites and write them on small cards to place at each table setting. Depending on how willing your family is, you could also give everyone a chance to go around and verbally share something for which they are grateful.


3. If you’re hosting, do a quick assessment of reading material around your house.
Put away (or better yet, recycle) any magazines that are overly focused on appearance, diet or beauty. Studies show even just 3 minutes of looking at fashion or “fitness” magazines can negatively impact self-esteem and trigger feelings of sadness and guilt. Do you really want your 7 year-old nephew to practice his reading skills with a fitness magazine full of photoshopped bodies? Do yourself and your guests a favor by instead stocking your coffee table with photo albums, short stories written by your kids, or some photography books by a favorite artist. (If you really want to make a body positive impact, you could leave a copy of Intuitive Eating or Health At Every Size laying around as well.)


4. Identify an ally (or two).
Many of us look forward to holidays with great anticipation because we get to spend time with family members we don’t often see. Some of us experience dread and stress for the very same reason. It’s no secret that family dynamics can be complicated. Instead of focusing on family members who are particularly difficult to handle, focus on the ones who can help. If you have a grandparent, cousin or significant other who knows you’re struggling with recovery, have a conversation with them in advance about the ways in which they can support you at the gathering, at the table, and in specific situations throughout the day.


5. Step away from the bathroom scale.
If you’re hosting and you have a scale in your house, move it out of sight temporarily, or permanently. If you are a guest in someone else’s house, consider asking them if they can stash it in a closet for the day. As a parent, spouse or support person of someone in recovery, this would be a great thing to take care of in advance as a way to advocate for your loved one.


6. Whatever you spend time focusing on will be what you spend time focusing on.
If you’re in recovery you likely going to need to think about meal plans and meeting nutritional needs and that’s okay, but make sure you also have holiday intentions that don’t involve food, eating or weight. Why? Because if all your goals that day revolve around what you’re eating you will be hyper-focused on food just like you were with the eating disorder. Prioritize your nutritional goals, talk them over with your dietitian and then consider adding some non-food goals like these:

  • I will record an interview with a grandparent. (Check out The Great Thanksgiving Listen)
  • I would love to cuddle with a relative’s new baby.
  • I’d like to sneak off to do a 3-minute mindful meditation before dinner
  • I’m going to talk with each family member about their favorite songs, then compile a playlist to share after the holiday.
  • I will give at least 3 non-appearance related compliments to other people on Thanksgiving day.

Quick Tip: Whatever you choose, make sure your goals are easy, achievable and positively worded. Think about adding good things into your experience, instead of avoiding a negative. For example, instead of saying “I won’t go on Facebook during our Thanksgiving get together” say “I look forward to taking a break from social media so I can catch up with my loved ones.” Remember, whatever you focus on will be what you’re focused on.


7. Remember that you cannot control everyone else.
We live in a food and weight-obsessed society, so it’s likely some of this conversation will make it’s way into your holiday despite your best efforts. If and when it does, be prepared with ways you can change the conversation, set boundaries and seek support.


8. Give Back –
Identify a local charity and ask all the Thanksgiving guests to bring a donation for the cause. Even if the day is hard for you and your recovery you will be left with a visual reminder of everyone’s generosity, (even if they couldn’t stop mentioning how many calories were in the appetizer all day).


Thanksgiving can be a truly beautiful holiday that reminds us all to give thanks and reflect upon the positives in life. Taking the focus off food might not only benefit those with an eating disorder but anyone struggling with negative thoughts, low self-esteem or loneliness this holiday season.

When we lift the food frenzy and body angst we are better able to focus on gratitude and authentic connection with others and ourselves.

Happy Thanksgiving.

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You may also be interested in reading:

Simple solutions for holiday (and everyday) conversations about food and weight

 


 

Questions about treatment for an eating disorder? Call us at (410) 427-3886 or visit eatingdisorder.org

 Photo Credit: freedigitalphotos.net / bugtiger

Surviving & Thriving through Mid-Terms & Finals

It seems like many colleges and universities have moved away from the standard exam schedule. In fact, it can seem like you are constantly studying for exams or writing papers, with no downtime or lull in the semester at all. Midterms and finals just mean a heightened level of existing anxiety or stress. Unfortunately, for many college students, that means there comes a point in the semester when it seems like there are way too many obligations and way too little time to manage them all.  If you are simultaneously working on recovery from an eating disorder this can be incredibly frustrating, particularly if everything seems to be equally important on your to-do list. While it can be easy to lose sight of how critical your recovery is in the midst of these academic priorities, its crucial to remember the potential consequences.  Turning to your eating disorder behaviors will only intensify the stress you’re body is under, making it mentally and physically harder to concentrate, harder to interact and connect with other people (i.e. study groups, roommates, support people) and much harder to accomplish that long list of study tasks.

Self-care, nourishing your body, following treatment recommendations and practicing your new healthy coping skills is what will eventually get you through the stress of mid-term or final exams.  While the hectic nature of college academics can’t be completely avoided, we can offer some tips to help make it feel more manageable and less likely to derail your progress in recovery.

Prioritize: Make a list of all of your upcoming responsibilities. Pull out the larger projects and see if you can break these down into smaller, more achievable tasks. For example, break down “10 page research paper” into: print articles; read articles; write an outline; write the rough draft; write the bibliography; and revise the paper. Write deadlines next to each item on your list and then organize your to-do list by due-date or high priority items. Don’t forget to breathe.

Eliminate unnecessary responsibilities: Do you really have to do everything on your list? You might have some things on there that are optional projects, or possibly some student organization meetings that are not imperative for you to attend. Perhaps you can ask for less hours at work during exam weeks. Remember that you can also always talk to your professor; if you have 3 exams scheduled on one day, one of your professors may actually be willing to allow you to take the exam for their class on a different day. If you just can’t adjust your schedule, know that this stress is temporary. Focus on the end point and plan a reward for yourself after big assignments are turned in.

Don’t give up on the basics: As tempting as it may be, you still need to prioritize sleeping, eating and self-care. In fact, it is even more important that you take care of yourself during this stressful time. Always strive to get as close to 8 hours of sleep each night as possible, remembering that lack of sleep can have a significant effect on hunger and eating patterns.  Make sure you are scheduling times to eat your meals and snacks and that you are thinking ahead. If you know you won’t have time to go back to your room for a meal, remember to pack your food with you or bring money to eat while you are out.

“The time to relax is when you don’t have time for it.”   

~Sydney Harris

Relaxation is vital. Take some time every day to take a deep breath and be still. Enjoy what the season has to offer.  Consider setting aside 30 minutes or an hour during your busy time to catch up with a friend or roommate – no multi-tasking or studying allowed during that time.

Keep your appointments: When things get hectic, it may be tempting to cancel your therapy or nutrition appointments so that you can spend more time studying.  This often makes sense in a moment of panic or stress but can easily lead towards losing sight of  recovery’s importance.   Cancelling appointments during high stress or high pressure times can be a risk  factor for relapse.  Consider a rock climber choosing to take off her safety harness right when she gets to the highest and steepest part of the cliff.  You’d probably question that decision right?  The same applies to your “safety harness” and your support system during difficult times.  If you are struggling to get to your appointments, speak to your therapist about this and decide together what is the best way to balance your responsibilities with your recovery in mind.

Reach Out:  Recovery can feel like a full-time job sometimes, and college is a full-time job for many students.  You may be realizing that you are struggling so much with both that you just can’t focus on your academics the way that you want to. You may have missed a number of classes, gotten behind in lectures or just feel too overwhelmed to truly focus. Don’t be afraid to talk with your professor and see if there is any way that you can catch up, delay some deadlines, or work with a tutor to help you in that class.  You don’t have to go through this on your own.  Ask for help and explore your options for support on campus. If you think you need to withdraw from a class and have missed the Drop/Add deadline, or if you are thinking about taking a medical leave of absence, schedule an appointment with the Dean of Students, an Academic Advisor, or someone at the Counseling Center – that is what they are there for!

While academics and exam stress can be overwhelming, just remember that you have options regarding how you handle that stress and how you let it affect you. You have already accomplished so much this semester.  Reflect on what has been working well so far and praise yourself for a job well done. If there are things that have been a struggle, now is a good time to evaluate what aspects of your self-care and stress tolerance could be improved.  Try  coming up with a reasonable plan to put into action for the rest of the semester and continue reflecting on it to see what is working and what isn’t. If you are stumped as to how to do this, reach out to others for support and additional ideas.

CED wishes you a memorable semester of academic success, balance and self-care.  For more insight on the intersection between college and eating disorder recovery, check out our whole blog series at: Battling Body Image Concerns & Disordered Eating on Campus .

If you are struggling with an eating disorder and need help or support, please call The Center for Eating Disorders at (410) 938-5252.  You can also reach us by email at EatingDisorderInfo@sheppardpratt.org.

 

Written by Jennifer Moran, PsyD, CED Therapist & College Liaison

Originally published on 11/11/2011

Reaching Out for Recovery Resources on Campus

As the newness of the school year starts to fade, you might be realizing that you or a loved one may need more support to maintain or re-focus on recovery while on campus.  It might feel discouraging to recognize that you are not doing as well as you had hoped, but you do not have to suffer alone.  Most colleges and universities provide a full Students on GC campusrange of services to their students, and it would be worthwhile to look into what is available on your campus. While every campus is unique, the following services are typically available at every school.

Student Health Center: The Health Center has physicians and nurses that are on site and specialize in working with college students. Many schools have at least one member of the staff that is familiar with working with people who have been diagnosed with eating disorders and will be able to help facilitate your care and make appropriate referrals on and off campus. Sometimes a dietitian is on staff to work with college students who need nutritional counseling.

Campus Counseling Center: The Counseling Center may be part of the Student Health Center, or it may be a completely separate department. At most schools, therapists are available to see students in individual therapy for a wide array of emotional and psychological concerns. The best part is that many of these services are free or very low-cost. The Counseling Center may also offer group therapy, which allows you to connect with others on campus who are facing some of the same concerns that you are. Some counseling centers may also work with a psychiatrist that can prescribe and monitor medications, if appropriate.

Peer Counselors: If the idea of speaking to a counselor is overwhelming, you may feel more comfortable initially meeting with a peer who has been trained to provide support. While a peer counselor is not qualified to do therapy, they can be a great support in supplementing your ongoing care or helping you to access the appropriate level of treatment for you.

Resident Advisors: Your RA is very knowledgeable about life on campus and can help direct you to the people in your community that can best assist you. They typically have gone through training to mediate conflict between roommates, to listen supportively to their residents and to help students access services on campus.

Dean of Students/Academic Advising: If your school work is starting to suffer because of your eating disorder or mood, you can speak to the Dean of Students or your Academic Advisor to explore your options. They will be prepared to help you with administrative concerns such as adding/dropping classes, communicating with your professors, adjusting your schedule to accommodate treatment, taking a medical leave of absence, and directing you to tutors and academic support programs.

Campus Ministries: If you are spiritually connected to your faith, you might feel more comfortable reaching out to the school’s chaplain. The chaplain is available to meet with students and can assist you in locating a place of worship consistent with your beliefs or can help direct you to more spiritually based counselors.

Off-Campus Treatment & Support: If you prefer to access services off campus or would like more specialized outpatient treatment, find out whether there are any treatment centers located close to your school.  The Center for Eating Disorders at Sheppard Pratt always welcomes students from surrounding colleges and universities during the school year. The Center is actually within walking distance to Towson University and is located within 5 miles of all of the following campuses:

Students who attend school a bit farther away from their treatment team, may be able to schedule classes in a way that frees up a particular day of the week for fitting in outpatient appointments with various providers.

The Center for Eating Disorders provides a wide array of treatment options including individual therapy, medication management, nutritional counseling, and a free support group every Wednesday night from 7:00-8:30 PM. If you need help finding outpatient treatment services close to your campus, you can visit The National Eating Disorder Association’s Treatment & Support Finder and search by state or zip code.

In the end, where you seek support is not as important as whether you seek support.  Remember that you are not alone and asking for help is a sign of strength.  If you are struggling, please reach out to a trusted friend, loved one, treatment provider or one of the campus supports listed above.

If you have any questions about the resources or services discussed above,please email Jennifer Moran, PsyD, CED’s College Liaison at jmoran@sheppardpratt.org or call (410) 938-5252.

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Written by Jennifer Moran, Psy.D.

Originally published 9/13/11

Balancing Act: Back-to-School Basics of Self-Care on Campus

It’s that time of year again! While it was just a few months ago that everyone was so excited for the start of summer break, there is also something very exciting about the start of a new school year: new school supplies, new classes, new back-to-school clothes and maybe even new friends. Notice a theme? The start of a school year offers the opportunity for new beginnings. For some, they will be making a major transition to living on a new campus where every aspect of the experience is, in fact, new. For others, returning to school or starting a new semester offers a chance to improve upon their earlier efforts at balancing school, their social life and self-care. For everyone, this new beginning is a time to pause and reflect on what your goals are for the semester and how you would like to achieve them.

Here at the Center for Eating Disorders , we often work with students who are struggling tocar breakdown balance all of their responsibilities during the very hectic semester. When mounting pressure and too many commitments forces something to be let go, too often people opt to give up sleep, meals, relaxation, or time for self-care. These basic needs are sometimes even viewed as a luxury. While the thought of failing to meet deadlines or getting poor grades can be very stressful, people tend to underestimate just how important the “luxury” of taking care of yourself is in the grand scheme of your overall ability to function. It would be similar to draining a car battery without ever recharging it; eventually, the battery is not going to work and the car won’t start!

Fortunately, this scenario can be prevented with a little foresight and some planning. The start of the semester is a great time to create a plan to help keep things balanced throughout the next couple of months. Here are some tips for creating a good plan.

  1. Write out your schedule for the semester. Once your classes, work schedules and social engagements are in the calendar, go back through and make sure that there are times for all three meals each day. Schedule them in so that they will not be forgotten!
  2. Plan accordingly. Do you have a work shift or a class that goes from 11-2? Plan to pack your lunch so that you can have something to eat during your break.  Look at your syllabi and put important deadlines and exam dates on your calendar. If you notice one week is going to be packed with things to do, plan ahead so you are not overwhelmed.
  3. Get connected to your safety net. Its the first week of school and everything might still be feeling new and  exciting and maybe even easy.   But even if you don’t feel like you need the extra support right now, take a moment while things are slow to identify the phone numbers and locations on campus for the student health center and the counseling center.  Save the info in your phone.  If a time comes later in the semester when you need to reach out for help, you will have made it a little easier for yourself to quickly connect with your campus support system.
  4. Choose a bedtime. School schedules can be erratic. You might start each day at different times based on your class schedule, and you might stay up very late on the weekends or during exam times.   But resist the urge to maintain this erratic sleep schedule throughout your entire college career.  Whenever possible, do your best to go to sleep and wake-up around the same time every day in an effort to get 7-8 hours of sleep each night, especially if you are working on recovery from an eating disorder.  Why? Balanced sleep can help you maintain balance in other areas of life as well, such as your mood and your eating.  This is partially because sleep helps your body regulate hormone levels, including those that stimulate feelings of hunger and fullness. When hormones are dysregulated it can set you up for overeating or  bingeing.   When you are tempted to pull those all-nighters during midterm week, remember that studies show a sleep deficit of 3-4 hours a night over the course of even just one week can interfere with the body’s ability to process nutrients from food, manage stress, and maintain a proper balance of hormones. (source: American Thoracic Society, International Conference, News release, San Diego, May 19-24, 2006.)
  5. Schedule “me” time. It is very important that you take time to check in with yourself. Try to find time to journal or do something you enjoy for even just a few minutes every day. If you know that you will struggle to fit this into your schedule, try signing up for a yoga class, a book club or another fun, relaxing activity to make sure that you stick with it.  This is also a great way to meet people with similar interests.
  6. Stay True to Yourself. It can be easy to feel pressured or rushed into making as many new friends as possible, sometimes by altering yourself and your priorities to fit in lest you risk being all alone. You may want to pause every so often and reflect on whether the company you are keeping is raising you up or is dragging you down. Are the new friendships you’re building helping you commit to self-care and positive self-worth or are they contributing to greater body/food anxieties? Listen carefully to your inner voice and let it guide you to make the best decisions for you.

We at the Center wish all of you a happy first semester at school!  Stay connected with this back-to-school blog series and other body image and eating disorder resources by liking CED’s Facebook Page or following @CEDatSheppPratt on Twitter.

Written by Jennifer Moran, PsyD, College Liaison, The Center for Eating Disorders at Sheppard Pratt

Originally published 9/6/11

Photo Credit: Freedigitalphotos / Naypong

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.

Exciting Developments at The Center for Eating Disorders’ Intensive Outpatient Program

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An Intensive Outpatient Program (IOP) for eating disorders can be important for individuals who are transitioning out of an inpatient or partial hospital setting but would still benefit from more support and structure than is typically offered through weekly outpatient therapy.  The Center for Eating Disorders’  IOP provides 16 hours per week of intensive treatment in the evenings to allow individuals to fully engage in school, work and family during the day while continuing to focus on their recovery.

In the past six months, the IOP has seen some exciting changes and updates in programming. The program has returned to (a newly renovated!) space on the ground floor of the Sheppard Pratt B building, just downstairs from the inpatient and partial hospital units. Our multidisciplinary treatment team now includes members from psychiatry, psychology, art therapy, nutrition, occupational therapy, and social work.

Some of the recent exciting additions to IOP include:

  • Medical DirectorHeather Goff, MD has stepped into the role of Medical Director for the IOP, leading the multidisciplinary treatment team in providing care for patients. She also provides psychiatric treatment to all patients, including weekly assessments and medication management.
  • Clinical CoordinatorMorgan Krumeich, PsyD joined the IOP team in 2014 as our new clinical coordinator. She also leads group therapy and works with patients on an individual basis.
  • Collaborative Care Group – IOP now offers a weekly collaborative care group for parents, caregivers, and supports. Run by IOP social worker Annie Hanley, this group is similar to those offered at other levels of care, but is tailored specifically to the needs and issues that may arise during IOP treatment and associated transitions. All support persons are highly encouraged to attend this free weekly group, held on Tuesdays from 6:30PM-7:30PM.
  • Occupational Therapy – Occupational therapist Rachel Dehart has joined the IOP team and runs weekly OT groups for adults. Adolescents also have the opportunity to meet with an occupational therapist as needed. OT groups in IOP focus on the unique needs of individuals with eating disorders, including time management, grocery shopping, clothes shopping, involvement in the community, work or volunteering, and school.
  • Individualized Nutrition Consultations – With two dietitians now on the IOP team, Caitlin Royster and Kelly Daugherty, we continue to offer weekly nutrition groups for all patients. Additionally, dietitians are working to provide individual assessments and nutrition consultation for patients on a weekly basis.

The Intensive Outpatient Program is designed to work closely with individuals, their families, and outpatient providers in order to offer the most comprehensive care possible. And of course, we always work to incorporate patient feedback in order to ensure the IOP is continuously developing and meeting the needs of individuals, families and the community.

If you have questions about the Intensive Outpatient Program, please call (410) 938-5252 or email EatingDisorderInfo@sheppardpratt.org.

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Meet the IOP Staff

Heather Goff, M.D.
Child & Adolescent Psychiatrist
Medical Director, Intensive Outpatient Program
Dr. Goff joined the Center for Eating Disorders in 2011. A child and adolescent psychiatrist, she is board-certified in both Adult Psychiatry and Child & Adolescent Psychiatry, providing her a developmental perspective that enhances her work with patients of all ages. Her initial medical training was at New York Medical College, followed by a residency in Adult Psychiatry at Yale University, where she was a chief resident in 2005-2006. She then went on to complete a fellowship in Child and Adolescent Psychiatry at the Yale Child Study Center, where she was again chosen to be a chief resident in 2007-2008. Upon completion of her post-graduate training, Dr. Goff joined the Yale faculty, with joint appointments in the Department of Psychiatry and the Child Study Center. As a clinician-educator, she was the teaching attending for one of the adolescent inpatient units. She also served as Director of the Child Study Center at Madison, where she provided direct outpatient care to children, adolescents and their families. While at Yale, Dr. Goff was also a fellow at the Edward Zigler Center in Child Development and Public Policy, leading to her interest in the intersection of the media and social policy in the development and treatment of eating disorders. In her role at CED, Dr. Goff spent one year treating individuals in the inpatient and the partial hospital programs. In 2012, she transitioned to a new role as Medical Director of the Center’s Intensive Outpatient Program and is also completing assessments and evaluations for children and adolescents in our outpatient department.

Erin Birely, LGPC
Mental Health Counselor
Erin Birely graduated from Loyola University in Maryland in 2012 with a Master of Science degree in Counseling Psychology. She completed a year of internship at the Center for Eating Disorders from 2011-2012, and subsequently began working full time in 2012. She is currently working towards her LCPC certification. Erin provides individual check ins and goal setting with patients. Additionally she facilitates DBT groups focusing on symptom management and emotion regulation, and IPT groups focusing on processing interpersonal difficulties, as well as leading the Multi-Family and Supports Group on Wednesdays.

Kelly Daugherty, RD, LDN
Clinical Dietitian
Kelly Daugherty received her Bachelor of Science degree in Dietetics from Saint Catherine University in Minnesota. She completed her dietetic internship with an emphasis in clinical nutrition at Johns Hopkins Bayview Medical Center in Baltimore, MD. During this internship, Kelly completed rotations on an acute care eating disorder unit at Johns Hopkins Hospital in Baltimore and at the Center for Eating Disorders. Kelly joined the CED team in November 2014. She completes nutrition assessments, teaches nutrition groups and assists patients with menu planning in the inpatient, partial hospital, and intensive outpatient programs.

Caitlin Royster, RD, LDN
Clinical Dietitian
Caitlin Royster received her Bachelors of Science in Nutritional Sciences with a concentration in Dietetics from Cornell University. She completed her dietetic internship with a focus on clinical nutrition and nutrition research at the National Institutes of Health in Bethesda, MD. Caitlin joined the Center for Eating Disorders in July 2014. Here she conducts nutrition assessments, teaches nutrition groups, and assists patients with meal planning in the inpatient, partial hospitalization, and intensive outpatient programs. Prior to joining the Center for Eating Disorders, Caitlin worked in an acute care setting providing medical nutrition therapy and nutrition education to patients. Caitlin is passionate about neutralizing food for her patients and takes a non-diet approach to nutrition education.

Rachel Dehart MS, OTR/L
Occupational Therapist II
Rachel Dehart graduated with a Bachelor of Science Degree in Public & Community Health from the University of Maryland, College Park in 2007. She received her Master of Science Degree in Occupational Therapy from Towson University in 2010. Rachel is currently an occupational therapist on the Children’s Short-Term Inpatient Unit where she adapts and grades activities to meet various physical, emotional, and cognitive levels of children aged 3-12. Rachel facilitates Life Skills and Time Management occupational therapy groups in the CED Intensive Outpatient Program to assist patients with re-engagement in meaningful occupations at home and within the community.

Annie Hanley, LGSW
Family Therapist
Annie Hanley graduated from University of South Carolina with a Masters of Social Work in 2014. She is currently certified as a Licensed Graduate Social Worker and is working towards her LCSW-C licensure. Prior to joining the Center for Eating Disorders, Annie provided individual and family therapy at an eating disorder treatment center at both the inpatient and outpatient levels of care. She also has experience using the Trauma-Focused CBT model to work with children who have experienced trauma. In her current role, Annie works as a family therapist in the inpatient, partial hospitalization and intensive outpatient levels of care. She also facilitates groups in the intensive outpatient program (IOP), including the Tuesday IOP Collaborative Care group for family members and support people. Her past research includes examining the role of peer influence on eating disorder development.

Brianna Garrold, ATR
Clinical Art Therapist
Brianna Garrold received her BA in Fine Arts from Notre Dame of Maryland University in 2010 (formerly College of Notre Dame of Maryland) and her MA from The George Washington University in Art Therapy in 2012, with additional coursework in counseling and Trauma-Informed Care. Currently, Brianna works with inpatient, partial hospitalization, and Intensive Outpatient Program patients using the art process to help patients identify and express their emotions, manage anxiety, and treat body image distortions. Brianna received her ATR in September 2014, and is currently working towards completing the LCPC, and the LCPAT, Licensed Clinical Professional Art Therapist.

Morgan Krumeich, Psy.D.
Clinical Coordinator, Intensive Outpatient Program
Dr. Morgan Krumeich graduated from The George Washington University in 2014 with her Doctorate in Clinical Psychology. Prior to obtaining her doctoral degree, Dr. Krumeich obtained a Masters in Clinical Psychology from The George Washington University as well as a Masters in Education (specializing in Applied Child Studies) from Vanderbilt University. She previously spent two years at Sheppard Pratt as a psychology extern at The Lodge School, where she conducted individual therapy, in addition to co-leading group and family therapy. Dr. Krumeich completed a year of internship as a school psychologist in the Newark Public School System before returning to Sheppard Pratt in 2014 to become Clinical Coordinator at the Center for Eating Disorders Intensive Outpatient Program. Dr. Krumeich has specialized training in working with children and adolescents, but she has experience (and enjoys!) working with individuals of all ages.

 

Moving Past Resistance & Finding the Motivation to Change

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“Getting over a painful experience is much like crossing monkey bars.
You have to let go at some point in order to move forward.”
~C.S. Lewis

Change is hard. You’ve likely heard this statement before. It’s also likely you’ve experienced it firsthand because, well, we all have. It’s one of those universal truths. Perhaps you’ve gone through the end of a relationship, relocated to a different city, started a new job, or maybe even changed careers completely. It’s never easy, even when it is exciting. Inherent to every change, including those that are ultimately positive, are feelings omonkey barsf discomfort and fear. Why? It can be uncomfortable, even painful, to do things in a new way, particularly if you’ve been doing them the old way for a very long time. Given that we as humans are naturally programmed to avoid pain and discomfort, it can also mean we find ourselves unmotivated to change.

Deciding to pursue recovery from an eating disorder after several years or even decades of illness is extremely hard. Doing the work of recovery after years of using eating disordered behaviors can, for many individuals, invoke a lot of fear. Eating disorder behaviors and thoughts may have become so entrenched that ceasing these behaviors will require change to all other parts of life as well…rekindling old interests, developing new hobbies, re-building relationships around recovery instead of the disorder, possibly getting new clothes, implementing new routines and learning new coping skills. Knowing that change can be perceived as danger, even when it’s actually beneficial, can help individuals understand their resistance to it. More importantly, this knowledge can help individuals to move past it.

“Fear, Uncertainty and discomfort are
your compasses towards growth.”
~Celestine Chua

Eating Disorders, The Brain & Change

Understanding change is particularly relevant in the field of eating disorders because of the various factors that drive the disorders. Many people already understand that certain social and cultural pressures (like our diet-obsessed culture or excessively retouched advertising) can impact thoughts about food and weight and may serve to maintain eating disorder thoughts and behaviors. It can, however, be just as important to understand the biological pressures that maintain symptoms and decrease motivation to recover. For example, malnourishment and low body weight are biological markers that can impact the brain’s ability to react to new or changing situations. In other words, when someone is not nourished well, they are more likely to struggle with rigidity of thoughts, otherwise known as “cognitive inflexibility” or “poor set shifting”. Research has found that, even at healthy weights, individuals with eating disorders are more likely to be wired for cognitive inflexibility which can mean more resistant to change.

“This characteristic rigidity or inflexible way of thinking and behaving can act as a real hindrance to those who exhibit it. For example, an inflexible thinking style is likely to mean that an individual relies on strict habits and rules to order his/her life. This rule-bound way of living can impede the individual’s involvement in new opportunities and experiences, monopolize time that could be used more productively, and result in relationship difficulties if the rules become extremely rigid. (2010, Tchanturia & Hambrook)

When it comes to eating disorders, there are daily consequences of being set in your ways since those ways are ultimately harmful. When faced with a decision to pursue change or not, it can be helpful to take a closer look at the specific psychological, sociocultural, and biological barriers keeping you stuck or unmotivated. Only then can you make an informed decision.

Motivation to Change- A Model for Understanding How and Why Change Happens

Motivation to Change is a theoretical model that explores the process of behavior change – from wearing sunscreen to smoking cigarettes, drinking excessively to eating disorders. The model proposes that we all participate in the stages of change whenever we are about to make a change in our lives. Research has shown that when therapeutic intervention is matched to a patient’s stage of change and the therapy is conducted within that stage, a more positive and long-lasting result is more likely.

The Motivation to Change model is divided into the following 5 Stages of Change:

  1. Precontemplation – a lack of awareness of the problem; no intention to change
  2. Contemplation – awareness of the problem but uncertainty about making a change; someone is thinking about change, but is not committed
  3. Preparation – intending to take action; there is a desire to make a change and some planning prior to making the change
  4. Action – the actual time spent making the change and modifying behavior
  5. Maintenance – life once the change has been made, including relapse prevention

This is not a linear model. It is expected that individuals may move backward and forward through these stages and that there will be an ebb and flow of motivation. Even during the action phase, individuals will experience indecision and ambivalence. Understanding this process, and having the support of a therapist along the way, is important in reducing discouragement and increasing long-term success. After all, change is hard. But despite the fear and discomfort, change can also be a very beautiful thing.

“Your life does not get better by chance,
it gets better by change.”
~Jim Rohn

Motivation to Change at The Center for Eating Disorders

opposing arrowsThe Center for Eating Disorders incorporates the motivation to change model and concepts in individual therapy at all levels of care and in specialized treatment groups throughout our inpatient, partial hospital and intensive outpatient programs. This summer we are announcing the addition of an outpatient, once weekly, Motivation to Change Therapy Group for individuals with eating disorders. From the first to last session, group members will be asked to participate in discussion and homework activities designed to explore where they are in the model and how ready they feel to move to the next stage. The group will be offered on Saturdays from 4:00-5:00 PM beginning in June 2014.

Anyone interested in participating can contact Rachel Hendricks at (410) 427-3862 or rhendricks@sheppardpratt.org. The group is offered as a complete module, and participants will be encouraged to participate in each session as the sessions will be progressive.

While the Motivation to Change groups at The Center are exclusively for people with eating disorders, anyone can benefit from understanding motivation to change and using the principles to assess, prepare, and make change in their own lives.

Find details about the Motivation to Change group and a long list of other outpatient groups offered at The Center for Eating Disorders by clicking here.

“By changing nothing, nothing changes.”

~Tony Robbins

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References:

Tchanturia, K. & Hambrook, D. (2010). Cognitive Remediation Therapy for Anorexia Nervosa. In C.M. Grilo & J.E. Mitchell (Eds.), The Treatment of Eating Disorders: A clinical handbook ( pp. 130-149). New York, NY: Guilford.

Monkey Bars Image courtesy of photostock / FreeDigitalPhotos.net
Arrows image courtesy of Naypong / FreeDigitalPhotos.net

 

Seasonal Depression: Fall-ing into Winter

Fall on the SP Campus...
Does the idea of darkness during your 5pm commute home from work get you down? You’re not alone if you’ve noticed that it’s not just the flowers in your garden but also your mood that has “wilted” with the cooler temperatures. During the fall and winter months, people may experience a shift in their mood as we collectively adjust to less sunshine and more cold weather. But it might be more than just “the blues” if it is a persistent sadness that feels present most days and is interfering with your ability to function or engage in day-to-day life. If this is a pattern that’s occurred for at least two years in a row and impacts you at the same time each year, it might be Seasonal Affective Disorder.

Seasonal Affective Disorder (SAD)
Many people around the world suffer from SAD, now identified in the DSM-5 as Depressive Disorder with seasonal pattern. It is suspected that seasonal depression is, in part, caused by a reduced exposure to sunlight resulting in disruption to our natural circadian rhythm (the body’s “internal clock”), as well decreased levels of the hormones serotonin and melatonin which help to regulate mood, sleep and appetite. Not surprisingly, populations living farther from the equator experience higher rates of seasonal depression than places closest to it. Thus, this type of depression occurs more frequently in populations throughout the northern rather than southern parts of the United States. In fact, one study found prevalence rates to be 1.4% in Florida and a much higher 9.7% in New Hampshire. (1)  Much of the research also indicates younger people and women tend to be at higher risk for winter depressive episodes.

People who already struggle throughout the year with clinical depression or bipolar disorder may also experience worsening symptoms during specific seasons. For those with seasonal depression, the episodes of depression that occur in the fall/winter are significantly greater than those episodes that occur throughout the remainder of the calendar year. In any case, it’s important to pay attention to seasonal patterns in your mood so that you can prepare and seek appropriate treatment and support as needed.

Common symptoms of seasonal depression
Seasonal depressive episodes generally set in during late fall or early winter. Some of the most common signs and symptoms include:

  • decreased energy, lethargy
  • increased sleep, difficulty waking
  • social withdrawal and loss of interest in activities previously enjoyed
  • increased appetite, unintended weight gain
  • persistent sadness, hopelessness
  • difficulty concentrating or focusing on tasks

(Though less common, some people experience spring/summer depressive episodes and those symptoms can look a little different, more often encompassing sleeplessness, irritability, decreased appetite and weight loss, etc.)

How might seasonal depression affect people with eating disorders?
A depressive episode can impact eating patterns and thus, impact eating disorder recovery efforts.  Individuals suffering from seasonal depression often report increased appetite. Specific studies have indicated that individuals with SAD tend to experience more cravings for foods that are higher in carbohydrates and rich in starch and report increased consumption of carbohydrates when depressed, anxious or lonely. (2)  Combined with decreased energy and declining mood, these cravings can place one at higher risk for binge eating behaviors.

Other research has shown a seasonal component to depression especially for those individuals suffering from Bulimia Nervosa. (3)  The research revealed that patients with Bulimia Nervosa tended to experience seasonal patterns of mood and appetite similar to those described by many with SAD. (4)  Some research has further speculated with regard to a possible genetic link between eating disorders and susceptibility to changes in mood related to the season. (5)

Treatment Options for Individuals affected by seasonal depression
So what can you do when the light outside your window has turned to darkness and, perhaps, this has added fuel to the eating disorder fire as well? The good news is that there are many different treatment approaches that are helpful to those suffering from seasonal depression.

  • Light therapy or Phototherapy is a commonly prescribed treatment for individuals suffering from seasonal depression. In light therapy individuals sit in front of a “light box” for approximately thirty minutes daily or per their doctor’s recommendation. Research has shown that light therapy can relieve the symptoms of seasonal depression in as many as 70% of cases. (6)
  • Anti-depressant medications can also be helpful in treating winter depression and have been shown to improve mood, energy and sleep patterns. One of the ways in which these medications work is by increasing serotonin levels in the brain.
  • Evidence-based therapies for depression such as Cognitive Behavioral Therapy (CBT) can also be helpful for seasonal depression.
  • Behavioral interventions in your daily life can also be helpful in reducing symptoms of seasonal depression. Consider trying to incorporate some or all of these:
    1. Engage in activities with friends and family each day to ward off feelings of lonliness or isolation.
    2. Make a point to get outside in the sunlight for at least a portion of the day if possible. Schedule a walk with your colleague during break or sit outside instead of inside while you do your daily perusing of Facebook, however…
    3. Be mindful about whether online social networks make you feel worse instead of better OR if they take up large amounts of time that could be better spent connecting with people in person (see #1 above).
    4. Plan to get plenty of sleep on a consistent schedule; do your best to go to bed and wake up at the same times each day, and aim for 7-8 hours of sleep/day.
    5. Avoid the use of alcohol or other substances which can worsen depressive symptoms, complicate eating disorder symptoms and disrupt sleep.

Focus on the highlights of the changing season.
If you struggle with seasonal depression, a long autumn and the approaching winter can feel daunting. Holiday stress, can make things even more difficult for individuals who are triggered by tense family dynamics, elaborate meals and social gatherings. This year, Instead of focusing on the doldrums of the season or annual stressors, consider looking for positive seasonal activities in which to get involved. Now is the perfect time to go to a holiday parade, paint a room in your house a new color, volunteer for a new cause, plan a weekend getaway, attend a recovery event, build a snowman or read a winter-themed book. It could also be a great opportunity to finish your summer vacation scrapbook or try a new activity like snow tubing or ice skating. You can even practice guided imagery or meditation – just because there is snow outside it doesn’t mean you can’t imagine yourself relaxing on a warm beach.

Try not wish away the winter season.  Each season comes with its own set of challenges for individuals with eating disorders – just think of the onslaught of diet pressures throughout spring or the bathing suit saga of summer.  So the key is not to just “get through” each season (there will be a new set of stressors on the next calendar page after all) but to learn to live mindfully in each season and find ways you can enjoy what it has to offer.

Above all else remember to ask for help when you need it. Talk to your treatment providers about your seasonal mood changes and they can help to devise an individualized treatment plan that works for you. If you are seeing a Registered Dietitian now is the time to talk with them about the food cravings you might be experiencing and devise an approach to cope and integrate more variety into your meal plan. Remember to open up and involve your support system– let your friends or family be a part of the process by sharing with them what you are going through. With help and support, you’ll be celebrating the Vernal Equinox in no time and reflecting on a well-spent, memorable winter.

For questions about treatment for co-occurring depression and eating disorders, please visit our website at www.eatingdisorder.org

Written by Amy Scott, LCPC

 

References:

  1. Friedman, Richard A. (December 18, 2007) Brought on by Darkness, Disorder Needs Light. New York Times’’.
  2. Krauchi, K., Reich, S.,& Wirz-Justice, A. (1997). Eating style in seasonal affective disorder – who will gain weight in winter? Compr Psychiatry, Mar-April, 38 (2). 80-87.
  3. Lam, R.W, Goldner, E.M., & Grewal, A. Seasonality of symptoms in anorexia and bulimia. International Journal of Eating Disorders. 1996. Jan 19 (1): 34-44.
  4. Fornari, V.M, Braun, D. L., Sunday, S.R., Sandberg, D.E., Matthews, M, Chen, IL, Mandel, F.S., Halmi, KA & Katz, JL (1994) . Seasonal Patterns in Eating Disorder Subtypes.Compr Psychiatry. Nov /Dec; 35 (6): 450-456.
  5. Sher, L. (2001). Possible Genetic Link Between eating disorders and seasonal changes in mood and behavior. Med Hypothesis, Nov 57 (5): 606-608.
  6. Wein, Harrison ed. (2013). Beat the winter blues shedding light on seasonal sadness. NIH News in Health. Retrieved from http://newsinhealth.nih.gov/issue/Jan2013/Feature1.

 

Recovery Word Cloud

As part of our {Saturdays} {Sharing} {Support} series, we recently asked our Facebook followers to share the ONE word they would use to provide motivation and encouragement to other individuals or families in the recovery process.  This word cloud is a compilation of the wonderful responses we received both online and in groups here at CED. We’re thinking it might not be such a bad thing to have your head in the clouds after all.

  Thank you to everyone who participated on Facebook and shared your recovery motivation.  If you’re new to the CED blog, join us on Facebook and Twitter for ongoing recovery motivation and education about eating disorders and body image.