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.

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

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

Mindful Eating on Campus ~ Part 2

This is the second post in a two-part blog about mindful eating at college.  If you missed part 1 you can find it here.

dining hallLearning to eat mindfully is a key step in repairing the relationship between your mind and body and trusting your body to guide your eating choices. However, it’s important to point out that not every college student is ready to fully embark upon a mindful eating approach.  Individuals who’ve struggled with an eating disorder may require a period of more structure, meal plans and guidance from a professional dietitian in order to help their bodies return to a place of health and re-establish trust in feelings of hunger and fullness.

When you, with input from your treatment team, feel ready to move towards mindful eating one helpful resource is Mindful Eating 101 by Dr. Susan Albers. In the first part of her book, Dr. Albers differentiates between mindful eating and mindless eating and outlines the seven main habits of mindful eaters which we reviewed in part 1 of this post. In this follow-up, we take a look at some of the specific strategies that Dr. Albers offers to help make mindful eating a reality on a college campus.

First, it is important to pay attention to the language that you use, as language can ultimately shape your behaviors. For example, imagine trying on a pair of pants in a department store fitting room and noticing that they feel too tight. You might think “I am so fat.”  If this carries a negative connotation for you it may lead you to deny yourself of proper nutrition in order to try to lose some weight and avoid the negative feelings. Alternatively, you might think “This brand really sizes their pants in a funky way,” which may instead lead you to try on a bigger size or even try to find pants from a different designer. It’s the same situation, with two very different results. Imagine how one’s self-esteem would be affected in both scenarios. In the first scenario, you can see how someone might start to feel badly about themselves and their body, perhaps even leaving the store without purchasing anything (or buying pants that don’t fit but vowing to fit into them by a specific date).  In the second scenario, the person has not been personally affected, will likely maintain positive self-esteem and will most likely go on to buy a great pair of pants that they feel good wearing. Starting today, be mindful of your speech to others and to yourself. Be aware of the language that might lead to unhealthy choices and try to use more affirming statements.

Similarly, avoid using the word “fat” to describe what is actually an emotion. Have you ever heard someone say that they are having a fat day? The person is most likely actually having a frustating day, an angry day or a sad day. Think about the difference in how someone might cope if they label their feelings as fat versus sad.  Someone who is sad might reach out to others for support, while someone who is labeling themselves as fat may come up with a new unhealthy diet plan. It is so important to identify the true emotion so that you can more accurately address it.  Think about it this way…if your best friend came up to you and said she was feeling sad you would probably not tell her to go try a new diet or hit the gym for an extra 2 hours.  Most likely you would comfort her, listen to her and maybe offer to take her somewhere to cheer her up.  After you identify your own emotions, try being compassionate towards yourself and comforting yourself as you would a best friend in a similar situation.

Once you have started paying attention to your language and emotions surrounding food and weight, you may be  ready to work on practicing mindful eating. Here are some tips from Dr. Albers’ book.

Get out of your rut: Sometimes we follow routines so mindlessly that we don’t stop to consider that there is an alternative to the same foods that we eat every day. Instead of automatically reaching for that oatmeal packet, consider what you might actually like to eat for breakfast and prepare that instead. You might want to try the dining hall instead of packing your lunch or vice versa to add some instant variety to your eating patterns.

Commit to mindfully eating one bite of your food during each meal. Try to savor the food using all of your 5 senses to really be present and in the moment.Its no secret, college can be pretty chaotic and stressful.  But one mindful bite per meal sounds like a pretty reasonable goal, right?

Rate your hunger level. Before you eat, try to gauge just how hungry you are. Let this guide you in making choices about what you put on your plate. Pay attention to how you are feeling physically while you are eating so that you can stop when you are satisfied and not when you are either too full or still hungry. This is especially helpful when confronting the dining hall buffet; ask yourself what you are actually craving so that you have a specific meal in mind instead of mindlessly grabbing food because it looks good.

Be Flexible: If you’ve ever struggled with an eating disorder or fallen victim to fad diets, you may have adopted some very persistent thoughts that tell you to avoid certain foods.  Unfortunately, when you follow rigid rules about eating, it becomes very hard to eat mindfully.  Notice your thoughts about food without judgment, and try not to let them influence the food choices that you make or how you feel about yourself for eating them.  Be flexible at each meal and eat what you are truly hungry for, stopping when you are full.

Don’t skip meals. Ever. It’s as simple as that. By skipping meals, you are setting yourself up to overeat or to make impulsive food choices.  Dieting and skipping meals also lowers your metabolism. Your body does not operate well without consistent energy, so it is very important to offer yourself balanced, consistent meals throughout every day.

Accept your emotions: It’s completely normal to experience a full range of feelings, from sadness to anger to joy. Emotions are temporary states that help to give you information about the situation that you are in. Some people try to act on their eating disorder symptoms as a way to avoid emotions, but this is not a healthy or successful strategy and often makes a situation much worse.

Create a safe environment. Do you notice that you tend to eat mindlessly in the same places or at the same times everyday?  Maybe you frequent the vending machine outside your Calculus class. If you are hungry, then eating that snack is a healthy response to your body’s signal.  But if you tend not to be hungry at that time, think about whether you are eating purely because you’re bored, frustrated or overwhelmed by the math class or simply out of habit?  Consider some alternatives.  Focus on allowing extra time for a very fulfilling and enjoyable breakfast just before your class so you’ll be better able to pay attention and less likely to turn to food for distraction or coping purposes.

Be wary of alcohol
. It’s no secret that drinking alcohol impairs your judgment. Sometimes people will eat more when they are drinking because they are not able to clearly follow their body’s signals. Others may be tempted to restrict to compensate for the calories from alcohol and find themselves even more impaired because there is no food to help their body process the alcohol. If you are of age and choose to drink, drink responsibly and in moderation.

Plan for the holidays and breaks. Special occasions such as Halloween, Thanksgiving, Hanukkah, Christmas and New Year’s seem to lead to an even more intense emphasis on eating and weight for those who are already struggling.  For some college students, the trips home will be extra stressful because of the family culture around food, meals and social gatherings.  Plan ahead – try to predict what might be triggering for you during the holidays and put support in place that will help you continue to eat in a mindful way. More tips for holiday eating and recovery can be found here.

Find a friend.  How many diets have recommended that you find a friend to go on the diet with so that you can have someone to keep you accountable? Instead of spiraling down the diet hole with a buddy, why not apply the same social technique but with a positive focus? Find a friend who is also interested in learning about mindful eating and encourage each other to practice these skills together.

Use your treatment team. If you are working on recovery from an eating disorder or from negative body image concerns, it is important to work with a trained professional who can help guide you through the process. The members of your treatment team are well-versed in mindful eating and can help you to set goals for achieving positive change, while also being able to point out obstacles that are posing a challenge to achieving your goals.

Whether you eat most frequently in your college dining hall, at a restaurant, or in your own dorm room or apartment, there is no secret formula for exactly what you are supposed to eat and how. The trick is simple: if you can work towards trusting your body and eating mindfully, your body will get just the right nutrition that it needs and your weight will naturally reach its healthy set point.  Your body is very smart and knows what it wants and needs at any given moment. Pay attention, follow its cues, and you may find that you suddenly have more physical and emotional energy than you have experienced in quite a long time.

If you are interested in learning more about mindful eating, visit Dr. Albers’ website, www.eatingmindfully.com for further tips and information.

If you are worried that you have an eating disorder and would like to find out about your treatment options, please call us at (410) 938-5252 or visit us on the web at www.eatingdisorder.org

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

 

Photo Credit: freedigitalphotos.net / lemonade

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.

Tried & True Strategies for a Recovery-Focused Holiday, Part III: AFTER Thanksgiving has Come and Gone

GratitudePost-holiday time can be filled with mixed emotions.  Some people experience RELIEF that it wasn’t as difficult as they had predicted, others struggle with post-holiday  FRUSTRATION or GUILT related to eating disorder behaviors or holiday meal challenges.  Still others head out of the holiday week EXCITED to return to the familiar structure and schedule of school or work. There may have been HAPPY times or SAD emotions woven throughout your Thanksgiving holiday as relationships and expectations for the holiday were tested. Maybe you tried some of the tips we suggested in Part I and Part II of our holiday blog series with a lot of success…or perhaps with a lot of struggle.  No matter how things went or how you’re feeling now its important to honor your emotions and continue on from this point in a recovery-focused way. Here are some tips that can help you make the most of your week-after-Thanksgiving (and beyond).

 

1. Change your filter.  So often, the eating disorder voice shines such a powerful spotlight on everything negative that it can be easy to get caught up in what went “wrong” on Thanksgiving day and ignore everything that was positive.  This is an example of a cognitive distortion called filtering.  In the days and weeks that follow, try not to allow your eating disorder to dictate how you will remember this holiday.  Instead, sit down with positive intention and make a point to reflect on what went well, what worked and who was integral to those successes.

2. Don’t skip therapy. (Sound familiar?)  If you had a hard time during the holiday and find yourself feeling frustrated or ashamed that you acted on symptoms, do not cancel appointments with providers.  Right after slip-ups is the ideal time to meet with a therapist or dietitian to process what happened, what the trigger was and how to prevent a holiday-induced downward spiral.  If your first appointment with a provider won’t be for another few days, take some time to jot down your observations and feelings about the holiday and what you want to remember to discuss with your therapist or dietitian.

3. Accept post-holiday compliments gracefully.  Individuals with eating disorders often have a hard time accepting positive feedback, especially when it clashes with their own negative beliefs about themselves or their abilities.  If someone is genuinely telling you that you did a good job with something, before you refute them, consider how your reaction will affect you and them. When Aunt Martha calls you this week and says  “Thanks for hosting us this weekend.  Your house looked beautiful all decorated for the holiday and the meal was just great,”  your instinct might be to say “Oh please, the turkey was dry and the house was a mess! I just didn’t have time to clean it the way I wanted to.”   When you completely reject a compliment it sends a message to the other person that you may be overly critical in general or that their opinion is not valued.  Additionally, if you deflect compliments from the same people repeatedly, they may be conditioned not to give them at all.  Most importantly, when you reject compliments you deny yourself the opportunity to absorb a positive belief which could go a long way in helping to boost your self-esteem and overall self worth.  Even if you’re struggling to believe that a compliment is true, allow yourself to receive it and entertain the idea that it just might have some validity.  Instead of deflecting, consider simple statements, such as “Thank you so much – that means a lot to me” or even, “Thanks” will work just fine.

4. Move On. If this holiday wasn’t what you had hoped for, let it go.  Don’t continue to blame yourself for things that may have been beyond your control.  Assess what can be changed in similar situations in the future and make note of them, then allow your mind to move on. Getting stuck in thoughts about how disastrous/boring/disappointing/etc. your Thanksgiving was is not going to help you make today the best it can be.  Remember that non-holidays are just as important in the long run of recovery.  Make today a good day; do the best thing for you and your recovery in this moment.

5. Keep the gratitude going.  Thanksgiving does a great job in helping to promote gratitude.  Even if you haven’t yet jumped on the #thanksvember bandwagon via Twitter or Facebook, it’s not too late to start. Take some time tonight to be grateful and send a genuine “thank you” to the support people that helped you enjoy the holiday…

  • If your mom changed the subject at dinner when a relative was harping on you for not taking seconds of her casserole, tell your mom later how much you appreciated her speaking up.  (If you live close by, give her a hug while you’re at it.)
  • If your friend answered frantic text messages you were sending on Thanksgiving day, let him know how much that meant to you that he was available for support in the thick of the holiday.
  • If your little nieces and nephews forced you into hysterical laughter with their impromptu Thanksgiving skit, send them little notes in the mail to let them know you can’t wait for their Christmas or Hanukkah performances too.
  • When it comes to gratitude, remember to use your voice.  It’s an  excellent opportunity to nourish the positives and create more of what you need for your recovery.

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Is there someone you relied on this Thanksgiving to help you through?   If you have feedback or comments about positive ways in which your support people helped out this holiday, we’d love to hear.  Share in the comments below or join the conversation on our Facebook page.

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Tried and True Strategies for a Recovery-Focused Holiday – Part I: BEFORE the Holiday

Tried and True Strategies for a Recovery-Focused Holiday – Part II: The Day OF Thanksgiving

Above photo courtesy of psychcentral.com (click on the photo to link to interesting research about the benefits of gratitude on health and wellness)

Tried and True Strategies for a Recovery-Focused Holiday – Part II

Each year we see many individuals with eating disorders, and even those in strong recovery, become increasingly anxious as the holidays approach.  Being on high alert for triggers or signs of relapse can be an effective way of staying recovery-focused and keeping yourself well. However, it’s also important to relax into the holiday and not allow the anxiety to overshadow what could be a very positive experience.

Yesterday in Part I, we shared strategies to help you plan ahead for a recovery-focused holiday.  Today in Part II, our staff share their top tips for making it through the actual day of a holiday with health and recovery intact.

Part II: The Day OF Thanksgiving…

Thanksgiving Mantel

  • RELAX – Focus on your breath, meditate, or listen to soothing music on your way to  he festivities so you start off the celebration in a positive place. If you show up in an anxious or negative mood right off the bat, it’s likely to affect those around you and be intensified.

Try to enjoy the holiday, not just survive it! Focus on what you would like to do and who you would like to do it with. Shift your attention from body image, food, and self-criticism and focus on what you want the meaning of the holiday to be for you.

~Kim Anderson, Ph.D., Therapist and Director of Psychology 

  • Check in with yourself about body comparisons. Believe it or not, we hear a lot about patients not liking family gatherings because they are comparing their bodies to other family members. For many people, these inter-family comparisons can be the most triggering or most intense body comparisons they face. If you find yourself going down that road, hit the pause button. Rewind, reconnect and consider engaging the person in conversation instead. See if you can find out something positive about them you never knew before. Remember that they are more than just their body and you are more than just yours.
  • Get grounded.  If you feel your thoughts drifting to food, body or weight, re-connect to something positive in the moment.  Sometimes wearing a special bracelet or keeping a special item in your pocket that you can reach for and touch/hold can help to ground you.  Connecting physically to an item can help you stay in the moment and tune out the eating disorder voice.
  • Cross generational boundaries.  Be mindful of the different support each generation of your family can offer.  Hanging out with siblings, cousins and others of a similar age to you can be a nice way to connect around common developments and gives you a chance to get support/empathy on specific life stage issues like being away at college, parenting stress, job hunting, retirement, etc. On the other hand, reaching out to older generations, like grandparents, is an opportunity to get outside of your own concerns, to see how priorities can shift throughout life and also to collect some family history. Consider sitting down with an older relative and asking them an open-ended question about their most memorable Thanksgiving.  Even the youngest generations have something to offer you in your recovery-focused holiday…

Spending time with the young children in your family during large family gatherings could be a good distraction from “grownup conversation”. Hang out with the kids, play games with them and ask them about themselves. You might even consider eating with the children and think about being a good role model for them.

~Lisa McCathran, LCPC,  CED Outpatient Therapist

  • Be the family photographer.  Grab your camera and put yourself in charge of documenting the day. Many extended families only have rare opportunities to spend time together.  Catching family memories on film will not only keep you focused on something other than the ED, it will give people around you a reason to smile and be mindful of the special moments throughout the day.
  • Hors d’oeuvres.  Food is often present at holiday gatherings long before the actual holiday meal is set on the table. Be prepared. When eating appetizers/munchies, instead of continually grazing and walking around with food, you may want to put all of your choices on a plate together at once so that you can see a total of what you are eating.  Then allow yourself to sit down and mindfully enjoy eating it.
  • Structure your time before and after the meal by preemptively volunteering to help out in ways you are most comfortable with. For example, ask if you could set the table instead of helping around the food in the kitchen. Instead of packing up the leftovers, consider offering to load the dishwasher or get the kids in their pajamas.
  • Be assertive in making sure you get seated next to your most supportive family member at the dinner table.
  • Use your support. If you took the effort to connect with a “safe person” in advance of the holiday, now you have to be sure to utilize them. It can be hard to ask for help in the moment but it will be worth it.

[Editors note: When we asked our dietitians to chime in on the “eating part” of the holiday and their best piece of advice, they all said the same thing…which means it’s probably pretty important.  That’s why we’ve included all of their input below without consolidating.  Even though it’s repetitive, it’s one of the most important things you can do to have a happy, safe and recovery-focused holiday while recovering from an eating disorder.]

  • Take the time to eat your three meals during the holiday.  Breakfast will be particularly important as it sets the stage for your hunger and fullness cues over the rest of the day.
  • Eat regularly!!! It’s the most important thing to do. This is not the best time to try a new eating schedule.
  • Do not skip meals! Do not plan to compensate for overeating later by skipping meals in advance.
  • Stick to the meal plan especially the day before the holiday and on Thanksgiving Day.

Have an adequate meal at each meal time prior to the Thanksgiving meal so that you’re able to enter the holiday meal hungry, but not ravenous.  When you skip meals or restrict during the day and then enter a meal ravenous, you’re much more likely to eat past fullness.  On the other hand, entering a meal with a natural level of hunger means you will be more likely to stop when you’re properly nourished and comfortably full.

~ Hannah Huguenin, MS, RD, LDN, CED Dietitian

  • Everyone needs a little alone time. Remember to take time by yourself to journal or relax during the day. If you’re staying with relatives and can’t find space inside the house to be alone, grab your coat, a cup of hot tea and step outside for fresh air, or consider volunteering to run an errand for your host
  • Play games. Don’t assume that your host will be prepared with distraction techniques for you – he or she will probably be pretty busy with holiday hosting tasks – so bring your own games to the party.  Grab a holiday-themed puzzle or some of your favorite board games that will encourage interaction. Need something quicker and easier?  Simply bring a deck of cards that you can use to play all sorts of different games with others or even by yourself.

Many people with eating disorders, especially those who’ve experienced trauma, may experience very intense emotions around the holidays. These strong feelings and stressors can be overwhelming but they don’t need to ruin or disrupt your holiday. Consider using a “containment strategy”. Write down the unpleasant thought or feeling on paper and put it “away” inside a designated containment box to be opened later when feeling safer such as in a therapist’s office or when the feeling has decreased in intensity.

~ Irene Rovira, Ph.D., Therapist & CED Psychology Coordinator

  • If you are not attending a family gathering it’s still important to plan a recovery-focused holiday.  In fact, it may be even more important to create structure and social opportunities that will keep you focused on the bigger picture and engaged in positive activities. This could include volunteering your time to other causes like a soup kitchen or a homeless shelter or it might mean finding another friend without plans and going out to a movie together.
  • You made a list, now check it twice. If you took the advice in Part I of this holiday blog series, then you should have a list of the top 3 most useful coping skills for you (this will be different for everyone).  If you’re going through the day and you’re struggling with eating disorder thoughts or urges to act on symptoms, refer back to your list and work through them again, making tweaks if necessary. For example, if you called or texted a friend who never replied, do it again but try someone else this time.  Just because the first person didn’t get back to you, doesn’t mean you have to give up.
  • RELAX and end your day with SELF-CARE.  Just as we suggest starting off the day with relaxation techniques, allow more time for yourself to decompress from the holiday as it comes to a close.  Breathe deeply, put on your favorite music playlist for the ride home, or take a few minutes to journal when you arrive home.  Regardless of how the day went, do something nice for yourself before you go to bed on Thanksgiving night. For some people, that might be taking a nice hot bath, reading a book, writing a supportive email to yourself, watching a favorite movie with your spouse or a best friend, or cuddling with your pet. Whatever it is, allow yourself to enjoy it.  Accept that you are deserving of self-care and able to bring your day to a close in a positive way.

We know this is a long list, and you can’t do every single thing on here ( and we don’t want you to overwhelm yourself by trying).  Just choose the ones that speak to you and that you think will be most helpful on your holiday.  Chat with support people and get their feedback regarding how these tips can fit into your specific family’s traditions and holiday schedules.

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Did you miss Part 1?  You can still go back and read the holiday planning and preparation tips here:  Tried and True Strategies for a Recovery-Focused Holiday, Part I: BEFORE the Holiday…

Find Part III here: Tried & True Strategies for a Recovery-Focused Holiday, Part III: AFTER Thanksgiving has Come and Gone

Have a good tip that we missed? Share your support and feedback on our Facebook page.

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Many thanks to the following CED providers who’ve contributed to this blog series:

  • Samantha Lewandowski, MS, RD, LDN
  • Hannah Huguenin, MS, RD, LDN
  • Jennifer Moran, Psy.D.
  • Kim Anderson, Ph.D.
  • Laura Sproch, Ph.D.
  • Irene Rovira, Ph.D.
  • Amy Scott, LCPC
  • Lisa McCathran, LCPC
  • Anne Holman, LCSW-C
  • Kate Clemmer, LCSW-C
  • Jennifer Lane, MS, OTR/L

 

 

 

New Collaborative Care Programs for parents, caregivers and loved ones

The Center for Eating Disorders at Sheppard Pratt has long urged the participation and inclusion of family members in the treatment process for both adolescent and adult patients with eating disorders.  In addition to all of our family treatment components, parents and family members have been able to access our community support group as well as a weekly family psychoeducation group.  We are excited to announce that, beginning in July 2012, family members and caregivers of our patients will be provided with an additional level of support and engagement in the recovery process.

The Collaborative Care Workshops are designed to help provide education and support for the friends and family members who are most central to the patient’s recovery process.

Building from the strengths of the family based model, Janet Treasure and her colleagues have developed a series of workshops for caregivers of loved ones who have been diagnosed with eating disorders as a way of meeting the needs of the carers.  The workshops are designed to educate carers on the key skills that clinicians have in treating eating disorders so that there is more continuity in care between the treatment setting and at home. The workshops are designed to address the most universal needs of the carers: connection with other carers; support; and skills training. Sessions reflect an adult learning modality in which skills are taught and then there is ample time for participants to practice these skills experientially. 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. (Treasure, Sepulveda, Whitaker, Todd and Lopez).

 ~ Outpatient Collaborative Care Workshops at CED ~

The 6-week Collaborative Care workshop series will be offered to parents, significant others and primary caregivers of individuals who are stepping down from our higher levels of care (inpatient or partial hospital programs). Typically, participation in the workshop series will begin the week following a loved one’s discharge from the eating disorder unit.  [UPDATE: As of July 2013, CC Workshops are open to all family members and support people during any stage of a loved one’s treatment and recovery.] Participation in the program will provide caregivers with the following resources, skills and opportunities:

  1. Provide basic eating disorder education, including current research findings about treatment recommendations, course of illness and treatment, prognosis, and basic understanding of how eating disorders are maintained.
  2. Define and recognize symptom substitution behaviors and strategies for managing these should they arise.
  3. Analyze carer needs and learning to implement self-care strategies, including mindfulness techniques.
  4. Learn effective communication skills to improve communication with their loved one who has an eating disorder.
  5. Recognize caregiver styles and learning to maximize strengths while working towards the most effective caregiver style.
  6. Define the different stages of change in the trans-theoretical model of change and understand how these stages can impact a loved one’s motivation throughout the treatment process.
  7. Learn how to help increase their loved one’s motivation towards recovery.
  8. Improve emotional intelligence by learning basic emotion regulation skills.
  9. Learn the basic theoretical model of cognitive behavioral therapy, as well as basic CBT techniques.
  10. Learn how to analyze how caregiver behaviors may inadvertently contribute to the maintenance of eating disorder behaviors in the family context.

Additionally, caregivers will learn about the interventions most commonly used by the Center for Eating Disorders.  Providing carers with education on the basic theoretical underpinnings of cognitive behavioral therapy and dialectical behavioral therapy will ensure that carers understand the skills that their loved ones have been taught in treatment. This will allow carers to be more fully able to support their loved one in attempts to challenge and/or block eating disorder cognitions and behaviors when they are at home. For more information about this program please email the Collaborative Care group facilitator, jmoran@sheppardpratt.org.

The Center for Eating Disorders has also added a 4-weekend Collaborative Care workshop series exclusively for family members  of current CED inpatients and partial hospital patients.  Please call us at (410) 938-5252 for more information.

Visit our website: www.eatingdisorder.org

Subscribe to our e-Newsletter

 

 References & Additional Resources:

Lock, J; Couturier, J; and Agras, W.S. (2006)Comparison of long-term outcomes in adolescents with anorexia nervosa treated with family therapy. Journal of American Academy of Child and Adolescent Psychiatry, 45(6), 66-72.

Lock, J.; Le Grange, D.; Agras, W.S. and Dare, C. (2001) Treatment Manual for Anorexia Nervosa: A Family Based Approach. New York: Guilford.

Silverman, J. Anorexia Nervosa: Historical Perspective on Treament (1997). In D.M. Garner & P.E. Garfinkel (Eds), Handbook of treatment for eating disorders, 2nd edition(pp 3-10) New York: Guilford Press.

Treasure, J., Schmidt, U. & Macdonald, P. (Eds). (2010) The Clinician’s Guide to Collaborative Caring in Eating Disorders: The New Maudsley Method. New York: Routledge.

Treasure, J., Sepulveda, A., Whitaker, W., Todd, G. & Lopez, C. (2010) Family and Carer workshops. In Treasure, J., Schmidt, U. & Macdonald, P. (Eds). (2010) The Clinician’s Guide to Collaborative Caring in Eating Disorders: The New Maudsley Method.(pp167-173) New York: Routledge.

Treasure, J.; Smith, G.; and Crane. A. (2007) Skills-based learning for caring for a loved one with an eating disorder: The new Maudsley method. New York: Routledge.

Nurturing a Positive Pregnancy…Lessons Learned from Eating Disorder Recovery

Several months ago, The Center for Eating Disorders had the pleasure of hosting former World Champion rower, Whitney Post, as a keynote speaker during National Eating Disorders Awareness Week.  In her talk, Invisible Victory, she spoke about her identity as an elite athlete and how she ultimately used it to her advantage in recovering from her eating disorder (ED).  During her visit to Baltimore, Whitney also shared that she was expecting a baby this June, and that  her work in ED recovery had provided a unique perspective and helpful skills for navigating the ups, downs and body image challenges of pregnancy.  In honor of Mother’s Day,  we asked Whitney if she would help us re-introduce our Nurture blog series for moms and mothers-to-be, and she graciously agreed.  The result is this insightful and delightfully down-to-earth Q&A  post about her ongoing journey through pregnancy and recovery. 

 Q & A with Whitney Post

Q: Have you noticed any similarities or parallels between the pregnancy experience and the recovery process?

WP: I remember early on in pregnancy lying in bed and trying to take stock of all the changes that were going on in my work, my body, my energy, and my identity.  It felt overwhelming to say the least, but what occurred to me was that I was so glad I had all the training of recovery to help me navigate this new journey.  I already knew how to surrender large areas of my life for the sake of something new and different.  I think both recovery and pregnancy are about building new life.  In each the process is long, full of uncertainty and discomfort, and full of hope.  There is a great demand for outside support and people who have been through the process before, and the ability to surrender to what the process is asking of you vs. having things exactly the way you want them.

Q: Can you describe how the process of recovering from an ED has helped you prepare for the experience of pregnancy, particularly as it relates to your body image?

WP: I wanted to be one of those women who remained toned and just grew a big round belly out front.  I am not.  I wanted to be one of those women who stayed true to her satisfying workout regimes.  I am not.  And I wanted to be one of those women who seemed to get more stylish as her belly grew, with cool accessories and funky outfits.  I am not. 

But what I am is one of those women who is putting the health of the child growing inside me first, and doing my best with all the rest.  I just do it while wearing clogs, and in between very moderate (“lame” would be another term) workouts.  As the weight started to come on, I could feel two sides of my brain at work.  One said, “this is a miracle and weight gain is part of the process.  This is healthy and natural.”  Meanwhile, another, old part of my brain shouted, “Hello!!!! You are gaining weight!!  Remember how unhappy you were last time this happened?  Do something about it now!!!”  Every time another round of clothes has to be retired because it becomes snug, a part of me feels an old tug to feel bad about myself.  But recovery taught me the skills of being able to recognize these two different voices and gave me the ability to make a choice, vs. listening to whichever voice is scarier.  I am pleased to say that, “this is normal and natural” now wins easily over “go on a diet!”

At my OB office when they check you in for each visit they hand you a cup to pee in and ask you to weigh yourself.  They leave the room and come back in about ten minutes.  For several months I would worry about having to weigh myself, as part of my recovery has involved not knowing how much I weigh.  I could have asked them to weigh me and just looked away, that would have been totally valid, but I just chose to do the drill and let them decide if I was gaining too much or too little.  As long as I’m not trying to control my weight, but rather trust that to the doctors, and manage healthy meals and appropriate workouts, I feel I am on track.

Q: How can pregnancy positively or negatively impact recovery? 

WP: I have found that I have had to work pretty hard at taking care of my recovery because my needs changed suddenly.  I had to find a new way to eat when everything made me nauseated.  I had to find a new way to work the tools of the program when I was too tired to go to 12-step meetings I normally went to.  I had to find women who were in recovery who had been pregnant to learn from them.  So suddenly, the little world of my recovery resources needed to be updated and shifted, and that has been a big investment on my part.  So I think if you let the things that sustain you in recovery slide because you have less energy or those resources don’t fit as well, you can be on a slippery slope, because you may also find yourself (as I often have) more emotionally vulnerable than normal.  But if you look at it as a time to invest in a new phase of recovery and build a community around you, it can strengthen you.

Q: Can you share some concrete steps women can take during pregnancy to help them nurture a positive relationship with their changing bodies?

  • Recognize you may have conflicting feelings and impulses but make sure your actions reflect your goals and values.  (for example – I want to diet because I don’t like gaining weight but my goal is to have a healthy baby and pregnancy, and so I will accept that gaining weight is part of the process and is temporary).
  • Talk to other women who have been through it and speak honestly about your experience.  You can be a wonderful mother and still not enjoy every aspect of pregnancy – they are not mutually exclusive.
  • Ensure from the outset that you have an OB who is supportive of prioritizing health vs. weight.  Then, trust your doctors when it comes to monitoring weight, exercise, etc., and get someone (nutritionist or physician) to work with you on the food and eating part, if you struggle with it, so you aren’t alone.
  • Focus on the positive parts – go to birthing classes, pay attention to the baby kicks, pick out baby clothes, prepare the house, etc.
  • Go with your body’s intuition about when it needs a rest, a snack or a cry.  You may not be able to keep up with your old self, or your old standards, and that’s okay.  It’s important to accept that your body now has a whole new task to prioritize; supporting the physical growth and development of your baby requires a lot of energy.

Q: As an eating disorder treatment professional, a recovery advocate and now a pregnant woman yourself, what are your thoughts on the mainstream media’s representation of pregnant and post-pregnancy bodies? 

WP: Mainstream media has never been helpful when it comes to figuring out how my body should look, and a pregnant body is no different.  The women chosen to be pregnancy models or on the covers of magazines are a very select group of pregnant women who all look much the same, and are all captured in about their fifth or sixth month of pregnancy when the belly is often cute and round.  If you go to a prenatal yoga class and look at all the bodies (as I often did – I was barely able to focus on the poses) you will see all the different shapes and sizes of bellies regardless of the phase of pregnancy.  Some of them seem pretty wacky looking as we are just not accustomed to seeing really pregnant women!  I find it much healthier to see these real live pregnant women than to look at the models.

As for “after the baby” the media is obsessed with how fast a woman can “get her body back.”  I’m happy Heidi Klum made it her goal to be a sexy Victoria secret model within weeks of giving birth, but I don’t think that is helpful for most women.  I am really looking forward to being able to run and do a sit up and move my body with greater ease and speed after the baby is born.  But the reality is I will be sleep deprived and in a very demanding phase of feeding, soothing, and getting to know a new baby, and at that time, I don’t need to be preoccupied with how quickly I can lose weight.  Focusing on eating well and getting in some sleep and exercise will be my goal for good self-care.

Q: Is there one piece of advice that has been particularly helpful for you in terms of staying focused on wellness and body positivity during pregnancy?

WP: Trust your body and stay connected ~ not that different from recovery, right? : )  Pregnancy can make you tired and moody, and both of those things can make socializing less appealing. I have found that I need to push myself to stay connected to old pals and to reach out to start to create a new community of moms-to-be. 

Q: Are there any lessons you’ve learned through ED recovery that you think may also be helpful for individuals as they venture into the day-to-day life of motherhood with a new baby?

WP:In recovery I spent a lot of time learning how to figure out what I needed, and how to stand up for that need while being kind and respectful of others.  But I still need to fight a part of me that is stuck in the habit of  “people pleasing.”  In pregnancy part of my job is to avoid putting myself in bad situations (being around people who have contagious colds or flus, overdoing myself with social/work demands), even though I might have been fine with these situations when not pregnant. This means I have to say “no” to things more often.  I learned early on that if I went against an instinct about my limits of comfort, I was really uncomfortable. I imagine some of the same will be true with an infant.  So my lesson that I am learning over again is that I need to respect my instincts and boundaries, and while I may inconvenience people in the process, we will all survive.

Whitney Post is the President and Co-Founder of Eating for Life Alliance and spends much of her time educating college students, professionals, athletes and coaches about eating disorder prevention and treatment. The Center for Eating Disorders is incredibly grateful to Whitney for sharing her insights, experiences,  and advice about pregnancy and recovery for this post We wish her well as she ventures into motherhood!  If you’d like to share your own ideas on this topic, please leave your thoughts in the comments section below or join the discussion on our Facebook Page

If you enjoyed this blog, you may want to read these previous entries from CED’s Nurture Blog Series:

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*Significant health risks (for mom and baby) are associated with eating disorders during pregnancy.  It is recommended that the eating disorder be significantly resolved before a pregnancy is attempted.  If pregnancy does occur prior to recovery, it is imperative that you receive appropriate medical and psychological support. If you are struggling with an eating disorder during pregnancy, or are working hard to maintain your recovery during pregnancy, we would like to remind you how important it is to be honest with your OB and other medical providers during this time.  It’s critical that your providers are aware of your medical history and any current and past ED symptoms so that they can provide the best possible health care for you and your baby.  

When Someone You Love Has an Eating Disorder

CED LeafThis is a special blog in advance National Eating Disorders Awareness Week (Feb 26th – March 3rd) and an upcoming free workshop, When Your Loved One has an Eating Disorder: Helping Them Heal on the Road to Recovery. You can find details about all of our upcoming NEDAWeek events at the end of the post.

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Guilt.  Shame.  Frustration.  Sadness.  Fear.  Anger.  These are just some of the emotions commonly experienced and expressed by support people when someone they love is struggling with an eating disorder (ED).  While each family experiences an ED, and the recovery process, in a unique way, there can be some commonalities that are important to talk about. Attending support groups, information sessions, and community workshops facilitated by treatment professionals are all great ways for support people to gain understanding and insight into the difficult journey their loved one is on.  It’s also a great way for family and friends to get feedback and support around their own feelings while they help their loved one navigate their way back to health.   A few of the most common struggles faced by family members are discussed below.    

Often times, parents and caregivers feel guilty and express concern that they may be to blame for their loved one’s eating disorder.

It can be terrifying for caregivers to find out that their loved one has an ED, especially as they begin to understand the level of suffering that comes with that.  A common reaction among parents is self-blame or intense guilt over the possibility that they may have contributed to their daughter’s or son’s illness.  This guilt can understandably create resistance or defensiveness and can be paralyzing for loved ones in the treatment process.  As long as the focus remains on “It’s all my fault.” it can be difficult to move towards “How can we as a family work together to support our loved one’s recovery?” 

While these illnesses have a complex combination of contributing factors, research has found them to be highly heritable, meaning 50-80% of one’s risk for developing an ED is dependent upon genetic factors. It’s important for families to receive reassurance that they are not to blame for their loved one’s illness while understanding that there are important ways they can help in the recovery process.  In fact, evidence-based treatment of EDs suggests educating family members and involving them in the treatment process greatly improves outcomes.  By identifying ways in which the ED has affected the family functioning and discussing dynamics that may be maintaining some of the person’s symptoms, families can work together towards improved communication, positive interactions and healing that extends far beyond the eating disorder.

Support people often feel anxious or frustrated about what to say vs. what not to say to a loved one with an eating disorder.  This can lead to fear that they are making their loved one worse because they don’t know how to respond in difficult situations involving food or body image.  Support people report that they often feel that they are “walking on eggshells” around their friend or family member with the eating disorder.

One of the most common examples of this dilemma occurs during the recovery process when support people may say something like “You look so much healthier,” but it is interpreted as “You look fat”.  Anyone who has been through an ED will tell you that they often feel irritable, and so much of their energy and time is spent thinking about weight and food that most comments people make about their appearance will automatically be construed in a negative way, even when they come from a place of care and concern.  Alternative comments that may be easier for your loved one to hear as they recover might be, “I’ve noticed you have a lot more energy lately” or “It is so nice to see you smiling today.”  One of the most helpful things support people can do is to communicate with their loved one by asking for a specific list of things that they can say or do that would be helpful to them when they are struggling.  Examples of things that are triggering or are not helpful to recovery could be useful as well.  Keep in mind that these lists may change at various points in the recovery process; communicate and revise often.

Also important to note: supporting someone through recovery from an ED is uniquely difficult compared to some other illnesses because of the cultural environment we live in.  Our society encourages and applauds hyper vigilance around weight, food and perfection yet recovery from an ED involves giving up some level of control over all three of those things.  Learning to filter unhelpful information and help your loved one resist damaging cultural messages about weight/food can feel like an uphill battle.  However, it does get easier with continued education about media literacy and guidance from therapists and registered dietitians who specialize in treating individuals with EDs.    

Support people are often so worried about the individual with the eating disorder that they focus 100% their energy on their loved one’s safety and recovery.   It becomes very easy to forget to seek their own support, neglect to keep up with their own self-care or let other personal priorities fall to the wayside. This can lead to mounting  feelings of exhaustion, depression or hopelessness.

Helping a loved one through the process of recovery from an ED can feel all-encompassing, especially when it’s your child or a spouse.   It often must become the family’s priority to get them back to a place of safety and stability, both physically and mentally.  However, support people can only offer stable, strong support when they are caring for themselves and staying stable, strong and rested themselves.  It’s important for caregivers to stay connected to their own friends, to seek out their own support and to set aside time to replenish themselves emotionally.  It could be as simple as sending a quick email to a friend every night before bed or scheduling a day trip to a favorite place. Whatever it is, remember the advice you get when you fly…you have to put on your own oxygen mask before you can effectively help those around you.

The truth is recovery can be a challenging process for all involved.  Even as progress is made, there are often set-backs or plateaus that can be confusing and frustrating .   Can you relate to the experiences discussed above?  Did you encounter other difficulties and roadblocks while learning to support a loved one in recovery?  Leave us a comment below or join in the discussion on our Facebook page.

At the Center for Eating Disorders, we recognize that there is a special need for education and support for the supporters themselves.  When Your Loved One Has an Eating Disorder: Helping Them Heal on the Road to Recovery is a FREE workshop designed to help family members and friends receive specialized education about EDs and their treatment, as well as insight into various care giving tools that can help facilitate the recovery process. Check out the details below, and don’t forget to RSVP by calling (410) 427-3886.

MARCH 1st, 2012  ~ When Your Loved One Has an Eating Disorder: Helping Them Heal on the Road to Recovery [download the event flyer]7:00 – 8:30 pm in  Baltimore, MD

 

 

Visit our Events Page for a full listing of upcoming events, including our NEDAWeek kick-off event, Invisible Victory: An Athlete’s Story of Hope & Triumph in Eating Disorder Recovery.

 

Invisible Victory

 

 

 www.eatingdisorder.org