Who are we missing? Eating Disorders & Minority Mental Health


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


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

Why do so many people with eating disorders go undetected?

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

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

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

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

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

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

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

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

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

What can be done? 

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

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

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

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


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


References:

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

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.

Adventures in Self-Care with Melissa Fabello: Part 1

 

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

 

 


Q&A with MelissA Fabello – Part I

 

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

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

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


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

 

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

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

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


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

 

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

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

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

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

 

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

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

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

 

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

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


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

 

 

 

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.

*     *     *

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

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.

***

Written by Jennifer Moran, Psy.D.

Originally published 9/13/11

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.

It’s Diet Season: Are You Prepared?

girl with unbrella

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

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

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

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

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

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

Other Helpful Resources:

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

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

*Above image courtesy of freedigitalphotos.net and a454

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

 

Outpatient Group Therapy at The Center for Eating Disorders {Summer 2014}

JUNE 2014 – The Center for Eating Disorders has launched several new outpatient therapy groups in addition to our other longstanding groups for individuals with eating disorders. Group therapy can be a great way to obtain additional support in the recovery process while also mastering beneficial new skill sets and practicing social interactions in a therapeutic setting with the guidance of a licensed therapist.  We invite you to review the current group therapy opportunities below and contact the group leader if interested.

THERAPY Groups…

Cognitive Behavioral Therapy (CBT) Group for BODY IMAGE
Tuesdays, 5:15 – 6:15 PM
Participants can expect to learn about how to promote positive body image using the cognitive-behavioral model.  The group lasts 10 sessions and will consist of a variety of body image topics (e.g. body checking, body avoidance, body comparison, emotional labeling, eating disorder mindset) and incorporates specific CBT skills with the goal of decreasing an individual’s preoccupation with weight and shape and their control. Please contact Laura Sproch, Ph.D. at 410-427-3851 for further information and to complete a brief phone screening. 

Cognitive Behavioral Therapy (CBT) for ADULTS
Tuesdays, 5:15-6:15 PM
Thursdays, 6:15-7:15 PM
Participants in this group will learn about the cognitive-behavioral model and its application for eating disorders and for the individual.  Group topics will rotate, based on the needs of the group, with a strong focus on the behavioral skills and making behavioral changes outside of the group.  Skills include, but are not limited to, self-monitoring, imagery, deep breathing, behavioral chain analysis, body image behavioral skills and problem solving. Contact Laura Sproch, PhD at (410) 427-3851 for more information.

Cognitive Behavioral Therapy (CBT) for ADOLESCENTS in Transition
Tuesdays, 5:30-7:00 PM
This is a Cogntitive Behavioral Therapy group for adolescents who are transitioning from a higher level of care (at any inpatient, residential or partial hospital eating disorder program) back into outpatient therapy.  The groups runs on a six-week session.  Contact Lisa McCathran, LCPC at (410) 427-3873 for more information.

Dialectical Behavior Therapy (DBT) Group 
Thursdays, 5:30-6:30 PM
DBT is an evidence-based treatment composed of four modules: Mindfulness, Distress Tolerance, Emotion Regulation and Interpersonal Effectiveness.  Extensive research has found DBT to be beneficial in the treatment of a variety of disorders, including mood disorders, anxiety disorders, substance abuse and eating disorders.  This particular DBT group is open to adults, ages 18 and over, with or without an eating disorder.  Interested individuals, or referring providers, should call Craig Boas, LCSW-C at (410) 427-3879 to complete the screening process. You can read more about DBT and each of the four modules here.

Interpersonal Therapy Group for Binge Eating Disorder / Compulsive Overeating
Tuesdays, 4:30-5:50 PM

Wednesdays, 7:15-8:35 PM
Thursdays, 4:40-6:00 PM 
Process-Oriented and skills-based therapy groups for adults (ages 22 and over) who struggle specifically with Binge Eating Disorder or compulsive overeating.  For more information about these specialized groups, please call David Roth, PhD at (410) 427-3871.

Interpersonal Therapy Group for Adults with Eating Disorders
Wednesdays, 5:30-7:00 PM
A process-oriented group for adults (ages 22 and over) with any type of eating disorder. This is a thematic, open-ended group in which members are encouraged to process current and past struggles in a way that improves insight into the role of the eating disorder in their life and provides an opportunity to develop strategies for moving toward recovery.  A variety of skillsets are introduced and practiced within the supportive framework of the group.  Contact David Roth, PhD at (410) 427-3871 for additional information.

Motivation to Change Therapy Group
Saturdays, 4:00-5:00 PM
Motivation to Change (MTC) is a group for individuals 18 and over with an eating disorder. Participants will be asked to complete a full module from beginning to end (12 groups per module). At the beginning of each module, participants will assess their stage of change and should be able to identify next steps and tools for implementing change by the end of each module. Please contact Rachel Hendricks, LCSW-C at 410-427-3862 for further information and to complete a brief screening over the phone.

SUPPORT Groups…

Collaborative Care Workshops for Caregivers & Family Members
(
Now being offered completely FREE OF CHARGE to all interested families)

Tuesdays, 5:30-7:00 PM 
These 6-week sessions based on the work of Dr. Janet Treasure, are designed to address the most universal needs of the carers: connection with other carers; support; and skills training.  Key skills taught include motivational interviewing, communication, the trans-theoretical model of change, self-care and behavior analysis. Research suggests that participation in these workshops, leads to benefits for both the carers and the patient. The workshops are OPEN to all support people at any stage of a loved one’s illness or recovery and are now being offered completely free of charge. You can read more about collaborative care on our blog.  Call (410) 427-3874 or email Dr. Jennifer Moran to register for the group.

Recovery-Focused Community Eating Disorder Support Group
Wednesdays, 7:00-8:30 PM
Read more about this and other opportunities on our support group page.

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The Center participates with an extensive list of insurance providers which means group therapy services can often be billed through insurance or participants may choose to self-pay. If you are interested in joining any of the groups listed above, please contact the specific group therapist directly or call the main number, (410) 938-5252.

If you are a physician or therapist interested in referring a patient for group therapy as an adjunt to existing individual or family therapy, please feel free to call the contacts listed above.  Our group therapists are committed to communication with providers in the community and to working collaboratively as a team to meet the needs of each patient.  With the proper release forms, group therapists welcome ongoing communication, can discuss skills and principles being covered in the groups, opportunities to apply the skills to individual therapy, and other relevant goals and progress.

Perfectly Imperfect: A Special Q&A with JENNI SCHAEFER

Jenni Schaefer
In recognition of National Eating Disorders Awareness Week (Feb. 23 – March 1), we caught up with Life Without Ed author and all-around inspiring person, JENNI SCHAEFER. 

It was about  five years ago that Jenni last visited The Center for Eating Disorders at Sheppard Pratt  and we are thrilled to welcome her back here to the CED blog and back to Baltimore on Saturday, March 1st for a new presentation entitled, Perfectly Imperfect: Eating & Body Image. 

It turns out that a lot can happen in five years.  Armed with a new relationship, a new book and lots of new experiences, Jenni continues to educate, inspire and lead by example both within the eating disorder community and beyond.  We are grateful to Jenni for taking the time to answer our questions and excited to share her responses below with our readers.

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Q & A with JENNI SCHAEFER  

Q: You’ve been a longtime advocate and activist for the National Eating Disorders Association (NEDA) and will be speaking in Baltimore in honor of National Eating Disorders Awareness Week 2014. What does this campaign mean to you and what progress have you seen around the awareness and education of eating disorders since you began this journey?

After struggling for years with an eating disorder, I finally picked up the phone in search of real help. I called 1-800-931-2237, which is NEDA’s Helpline.  NEDA sent me a list of treatment resources (via snail mail back then!), and my healing journey began. It is surreal to me how life has come full circle: I am honored to serve as the Chair of NEDA’s Ambassadors Council today. Working with NEDA and NEDAwareness Week means the world to me. My hope during the week is not only to encourage people to get help but also to prevent some from ever going down the treacherous road of an eating disorder in the first place. If I had participated in a NEDAwareness event years ago, I believe that my journey would have been a lot smoother. Maybe I never would have turned to Ed (aka “eating disorder”) in the first place, or maybe I would have realized that I had a problem and reached out for help sooner. Similar to the 2014 NEDAwareness theme, “I Had No Idea” that I was struggling with a life-threatening illness.

Since I began my recovery journey, I have seen eating disorders awareness and education improve greatly. Back when I was struggling in college, I rarely heard anyone talk about eating disorders. But, today, colleges all across the country ask me to speak at their NEDAwareness events. Again, it is amazing how life can come full circle like that!

Q: In addition to your hugely popular and inspirational books, Life Without Ed and Goodbye Ed, Hello Me, you have a new book out with co-author Jennifer Thomas, PhD called Almost Anorexic: Is My (Or My Loved One’s) Relationship with Food a Problem? What prompted you and Dr. Thomas to write this book, and can you elaborate on what you mean by the term “almost anorexic”?

While 1 in 200 adults will experience full-blown anorexia, at Cover: Almost Anorexicleast 1 in 20 (1 in 10 teen girls!) will struggle with restricting, bingeing and/or purging that doesn’t meet full diagnostic criteria for anorexia nervosa, bulimia nervosa or binge eating disorder. Almost Anorexic, which is the third book in Harvard Medical School’s The Almost Effect™ series, brings attention to the grey area between “normal eating” and an officially recognized eating disorder. Dr. Thomas and I want people to know that, regardless of their eating disorder diagnosis or lack thereof, both help and hope are available. A diagnostic label cannot adequately depict pain and suffering. All who struggle deserve help, and full recovery is possible.

[To learn more about
Almost Anorexic and to read book excerpts, click here. You can also watch a hopeful book trailer (video) or register to attend a professional workshop facilitated by the book’s co-authors.]

Q: There has been a lot of discussion within the eating disorder field recently around the conceptualization of eating disorders as brain-based illnesses as opposed to purely psychological or behavioral disorders. You touch on the implications of this in Almost Anorexic How can the words we use to define the disorder impact the recovery process?

When I first received help for my eating disorder, people told me that I would never fully recover. They said that an eating disorder was like diabetes and that it would be with me forever. Believing this, in the end, just served to keep me stuck. I had to change my language, and I had to connect with people who believed that I could get fully better. This made all of the difference.

In relation to brain disorder language, Almost Anorexic explains: “Some people and organizations have found brain-disorder language extremely helpful in explaining to others why individuals with eating disorders can’t just “snap out of it” and in absolving parents of guilt and blame for their child’s illness. Others, however, have worried that brain-disorder language may give sufferers and loved ones alike the hopeless (and false!) impression that eating disorders are lifelong illnesses that cannot be treated and may even provide a handy excuse for the continuation of dangerous symptoms (after all, your brain made you do it). To combat this, parent activist Laura Collins Lyster-Mensh has used the term “treatable brain disorder.” We suggest you use the terminology that works best for you. Words are powerful. Don’t let Ed hijack them.”

Q: Perfectionism is one of the genetically-based personality traits most highly associated with the development of eating disorders and will be the focus of your talk in Baltimore on March 1, 2014. Did perfectionism play a role in the development of your eating disorder? Did it also play a role in recovery?

I was not born with an eating disorder, but I was born with the perfectionism trait. Constantly striving to be perfect certainly made me more vulnerable to having an eating disorder. So did other genetic traits like high anxiety and obsessive-compulsiveness. However, when channeled in a positive direction, these traits played a crucial role in my recovery. I was able to refine perfectionism, for instance, and apply it to things like attending doctors’ appointments and finishing therapy assignments. When taken to the light, our genetic traits absolutely support recovery.

Q: Individuals who are perfectionists often struggle with the urge to compare themselves to people around them. Among individuals with eating disorders these comparisons are often appearance-based or weight-focused but can also be related to one’s career, house, family, wealth or talent. Constant comparison can be very triggering and detrimental to the recovery process. What strategies help you avoid this comparison trap?

My motto, as I originally wrote about in Life Without Ed, is “Compare and Despair.” Early in recovery, I actually displayed “Compare and Despair” on post-it notes throughout my home. These notes reminded me that comparing inevitably leads to despairing, so I did my best to stop setting myself up for this kind of self-loathing. Further, learning that I was not alone in my tendency to compare helped me to change as well.  The Center for Eating Disorders’ survey related to Facebook and comparisons, for instance, has helped people I know to better understand the growing prevalence of comparing (as well as the fall-out of it) and to feel a sense of camaraderie in making positive changes.

Q: In the age of social media, it seems the opportunity for comparing oneself to others has reached an all time high. Do you have any tips for individuals looking to use social media in a healthy way that is supportive of recovery?

In the tenth anniversary edition of Life Without Ed, which was just released, I talk about the fact that Ed surely has a Facebook account! Each time a person with an eating disorder logs in online, Ed does, too. This awareness is key. Further, individuals with eating disorders can change their online settings to block triggering people and ads. Within the anniversary edition of Life Without Ed, I give many tips for how to use technology to support your recovery, including using mobile apps like “Recovery Record” and “Rise Up + Recover.”

Q: You last visited The Center for Eating Disorders at Sheppard Pratt as a guest speaker in 2009 during which you spoke about the concept of being Recovered. from your eating disorder. What new insights about being Recovered. have you gained over the past 5 years, and has any of it surprised you?

I often say that I am recovered from my eating disorder, but not from life. Part of being “recovered.” actually means continual personal growth. Since my visit to Sheppard Pratt, I have blossomed in many areas, especially related to relationships. I have learned how to let more love into my life and have even gotten married. Luckily, my husband’s name is not Ed! Related to freedom from eating disorders, you can click here to download a table that Dr. Thomas and I created comparing “fully recovered” to “barely recovered.”

Q: What are some of the main points you hope to convey during your upcoming talk, Perfectly Imperfect on March 1st in Baltimore? Who do you think could benefit from attending the presentation?

One of the most common comments I receive from audience members is, “I don’t have an eating disorder, but I do have an Ed in my head.” People also relate to my efforts to overcome perfectionism as well as my journey to find happiness in life. We always have fun singing my song, “It’s Okay to be Happy.” That said, my talks are applicable to anyone who calls him or herself a human! On March 1st, I will discuss finding balance with food and weight in a world that is anything but balanced. We will talk about striving simultaneously for both excellence and “perfect imperfection.” And one big goal of my presentations is to laugh—a lot.

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Do you have your own questions for Jenni?  Join us on Twitter @CEDSheppPratt for a special Tweet Chat on Thursday, February 20, 2014 from 1:00-2:00pm EST with Jenni Schaefer (@jennischaefer) and Jennifer J. Thomas, PhD (@drjennythomas).  Use the hashtag #CEDchat to participate and follow along. Send your questions in advance to kclemmer@sheppardpratt.org and we might use them during the chat!

More About Jenni…
Jenni Schaefer’s breakthrough bestseller, Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too, established her as one of the leading lights in the recovery movement. With her second book, Goodbye Ed, Hello Me: Recover from Your Eating Disorder and Fall in Love with Life, she earned her place as one of the country’s foremost motivational writers and speakers. Jenni’s straightforward, realistic style has made her a role model, source of inspiration, and confidant to people worldwide looking to overcome adversity and live more fully. She speaks at conferences, at major universities, and in corporate settings; has appeared on many syndicated TV and radio shows; and has been quoted in publications including The New York Times. She is also chair of the Ambassadors Council of the National Eating Disorders Association. An accomplished singer/songwriter, she lives in Austin, Texas

Want to learn more about NEDAwareness Week Events at The Center for Eating Disorders at Sheppard Pratt?  Click HERE.