Dear Teachers, Coaches and Counselors,
As a mom, thank you for the endless hours spent caring, supporting, mentoring and teaching young people. Your job is truly one of selflessness. As a dietitian with an expertise in eating disorders, I would like to pass on a few suggestions to promote normal eating and healthy body image. Even if Health is not your subject, random dialogue about weight and food can be potentially harmful to those young people who are struggling with eating disorders.
True Confessions: I have been watching the 15th season of The Biggest Loser. I’m embarrassed to admit it because, as a Certified Eating Disorder Registered Dietitian, the Biggest Loser goes against all the principles that I know about permanent weight loss. I support moderation and balance in food and exercise. Participants of The Biggest Loser exercise 5 hours a day-about the amount of time most people work!
Last night was the finale and Rachel was awarded the grand prize. After seeing her gaunt face and bony body I’m wondering if her grand prize is Anorexia Nervosa. Yes, I know her BMI is within an acceptable range but the diagnosis of anorexia encompasses more than BMI. I wonder if she is able to consume an adequate amount of food so that she is not hungry or thinking about food all of the time. I wonder if she can eat a variety of foods, including grains and occasional sweets or desserts and restaurant foods. Does she have guilt or remorse after eating? Does she obsess about food, weight or exercise? How much does she need to exercise to maintain this new low body weight?
Anorexia Nervosa and Binge Eating Disorders are both disorders of extremes. Both are deadly and both interfere with quality of life. I hope that Rachel doesn’t end up spending her $250,000 prize on eating disorder treatment.
We live in toxic environment for eating disorder recovery. We are constantly bombarded with media messages that thinness equals perfection, success and beauty. Add that to our own relentless negative self talk that we are not good enough, not thin enough, not smart enough, and just not enough can take a toll on fragile tools of recovery. Here are the top 5 ways to prevent relapse.
1. Avoid the scale. Weighing, for most people, is a surefire way to slide the slippery slope to relapse. Most people struggling with eating disorders, distortions and low body esteem are likely to misinterpret their weight, regardless if their weight is higher or lower than expected. If their weight is higher than expected, feelings of being out of control, self loathing and body hatred are common. This can lead to more food restriction and excessive exercise. Sometimes weighing can trigger overeating. The person struggling with the eating disorder may feel so frustrated and defeated, they end up over or binge eating. This may go on for days or months until the next cycle of restricting.
If weight is lower than expected, the reward center of the brain does a happy dance. Fireworks explode and the Hallelujah chorus breaks out….until the person with the eating disorder looks down. “Hmmmm, one more pound and my stomach will be flat.” And thus begins the never ending quest for perfection.
2. Avoid “Recovery” Instagram, Tumblr, and similar sites. These so-called recovery accounts are another quick route to a rocky recovery. These sites typically advertise a person’s lowest weight, goal weight, current weight and pictures of stomachs, thighs and food. Is it really helpful to know all of this information? Those struggling with eating disorders tend to be a competitive group and these pictures are an invitation to relapse. Some of my clients also find talking about recovery or reading recovery books or blogs can be triggering. The authors often tell stories about the worst of times in the midst of their eating disorder which can lead my clients to minimize their own issues with food and body image. Perhaps even worse, my clients feel they are “failing recovery.”
3. Follow your meal plan. If you are in recovery from an eating disorder it is probably safe to assume that your hunger and fullness cues are faulty. Continued under eating causes hunger cues to disappear. Additionally depression and anxiety can lower hunger and appetite. Continued overeating creates an increased hunger. Most people in recovery need to use a meal plan as their guide for at least a year before embarking intuitive eating. Meal plans teach normal eating habits and skills that need to be relearned before doing it on your own. Meal plans normalize eating and even after hunger cues return, they provide a foundation for eating intuitively, the ultimate goal.
4. Not practicing daily gratitude. Need an attitude change? Try listing the things you are grateful for. Even negatives can turn into positives with perspective. For example, are you hating your body? Be thankful that you have a body and that you can walk, run and laugh. Gratitude can help shift values and broaden ideas.
Article submitted by R.S.
When my friend texted me upset after trying on clothes, my first reaction was to giggle. Obvious I felt sad she was going through a rough time, no that is NOT why I laughed! Basically, I had that urge to just laugh because who among us has not been brought to tears in a dressing room.
There’s some nice ones, granted, but most are pretty darn bad, and the ones that are bad, tend to be really really bad.
Why? Um, hello–crappy lighting, tilted mirrors that make you look wider and distorted, everything on display, you’re trying on a bunch of different sizes (in a world with vanity sizing, no less). You would think retailers would have figured this out by now and have nice dressing ones, but even the big names don’t always nail it. And if it sucks at some high-end boutique or department store, it only gets worse when you are in some cheap, trashy store like Forever 21 (don’t get me wrong–I love it, but face it, that dress will last you about half a wear)–everything ends up being cramped and hot and sweaty. GROSS.
A suggestion I’ve heard is simply avoid them at all costs. With online shopping and places that have and easy return policy, sure, this might be a great idea. But that isn’t always the most affordable, feasible, or sometimes even possible option. Soooo, when you absolutely most face the dreaded dressing room, here’s some tips:
“I’m thinking about getting a boob job for graduation,” announced 17 year old Lindsay* in our session last month.
Yes, you heard right. Lindsay is only 17 and graduating from high school next month. She is smart, outgoing and beautiful , both inside and out. She however, sees flaws when she looks in the mirror. She sees a crooked nose, a pudgy stomach, bulky thighs, and a flat chest. Lindsay is recovering from an eating disorder. She is weight restored and able to nourish her body adequately yet her negative view of herself and her body persists.
Unfortunately, body dissatisfaction is common and not just with people with eating disorders. Studies have found that 40% of 9 and 10 year old girls have tried to lose weight and 53% of 13 year olds are unhappy with their bodies. This increases to 78% by the time girls reach 17. This is not surprising considering our children are inundated with constant media messages about beauty and perfection.
How can you help your child love her body? Here are five points to remember.
1. Avoid criticizing your own body. If you talk negatively about your body, whether complaining about a flabby tummy or crows feet, you are sending a message that your body is not good enough. Model a healthy, positive body image even if it doesn’t come naturally. Say words like “my body feels strong today because I was able to work, garden and be mom today.” Focus on what your body can do rather than appearance and your child will also.
2. Avoid talking about others people’s bodies. Many times conversations about other people’s bodies and weights can cause everyone within listening distance to question their body. Imagine a 12 year old overhearing “Wow, have you seen Sarah? She’s gained so much weight!” Likewise, imagine a 12 year old overhearing “Ann has lost so much weight, she looks fabulous!” Both of these comments, even the compliment, send messages that gaining weight is negative, losing is positive, and bodies need to look a certain way. Become adept at steering conversation away from appearance and instead on attributes.
3. Remember that a girl’s body continues to change until they reach early 20’s. During this time girls will experience linear growth and a corresponding weight gain. Hormones cause necessary fat deposition in the pelvis, breasts, upper back and arms and lean body mass decreases from 80% of body weight in early puberty to 75% at maturity. It is not abnormal for a girl to gain 40 pounds over this time.
Because everyone experiences growth at varying rates, your 12 year old may be in class with girls who weigh 70 pounds and girls who weigh 115 pounds. Assure her that everyone eventually catches up and by the time her peers are high school seniors there will be less discrepancy in body weight.
4. Watch what you watch. Many parents screen media for sex and violence but neglect screening for “eating disorder porn.” Eating disorder porn are images that depict unrealistic thinness and body shapes. Obviously these images are ubiquitous! Limit buying magazines and watching TV shows to those who depict realistic bodies. Educate your child about the numerous techniques used to retouch photos. Encourage your child to think critically about the messages unrealistic body shapes and sizes send.
5. Love your child for who she is rather than what she looks like. Be sure to tell her what you personality characteristics you appreciate about her. For example say “I admire how you handled that sticky situation” or “You have been a good friend to Julie.” These comments help to develop her character and deemphasize appearance.
Pam Chin-Lai, MS, RD, LD, CEDRD specializes in the nutritional rehabilitation of eating disorders in children, adolescents and adults.