Saturday, October 31, 2009

Q & A with Julie Holland : )

I got really excited when I came across this interview on PsychCentral.com with Julie Holland because I really like Julie-- aside from being a great person, she knows her eating disorder stuff. She is the Director of Certification for IAEDP (the International Association of Eating Disorders Professionals) and currently works for the Eating Recovery Center in Denver. Anyways, Julie spoke to PsychCentral.com about fat talk, self esteem, and other related topics, as October 19-23 was Fat Talk Free Week (to learn more about Fat Talk Free Week, check out my post here). She has some very good things to say, especially regarding helpful advice for parents on how to help their children have positive body image. The following interview is copied and pasted below but can be accessed on PsychCentral.com by clicking here.

Q&A with Julie Holland

By MARGARITA TARTAKOVSKY, M.S.
October 20, 2009

Julie Holland, MHS, CEDS, is recognized in the industry as both a clinician and public speaker. A certified eating disorders specialist, she has directed marketing and customer relationship management programs at several leading eating disorder treatment programs across the country. Ms. Holland has specialized in the treatment of self-esteem, eating and body image issues for adults and adolescents for more than 23 years. She is a Certified Eating Disorders Specialist and Director of Certification for the International Association of Eating Disorders Professionals, as well as an Approved IAEDP Supervisor.

  1. How does fat talk affect one’s self image?

    Fat talk brings a sense of negativity toward how individuals think about themselves and their body. It can also affect how individuals relate to others.

  2. What are several things parents can do to improve their child’s body image?
    • Be accepting of all body types rather than labeling one as the “best.” Encourage children to think about people they admire and love who are different body sizes and shapes.
    • Be positive about what our bodies do for us rather than placing so much emphasis on how they look.
    • One of the most important things a parent can do is be a positive role model - be positive about your own shape and size. Do not talk negatively about your own body or constantly complain about needing to change your body to fit a perceived ideal.
    • Think about statements you make and make sure what you are saying is a positive influence. For example, girls who are tall are often told “you are so big!!!” when what individuals really mean are “wow, you are really tall for your age.” Follow it up with a positive statement like “I bet you love being tall!” Otherwise, it can be perceived as negative.
  3. At what age should you start talking to your kids about body image?

    From birth on. I remember looking into my daughter’s eyes at a very young age - a few weeks, months - telling her how much I loved her and how much I wanted her in my life. All types of comments shape a child’s body image - not just messages about their bodies.

  4. Can you give an example of how to turn a negative thinking pattern into a positive one?
    • Encourage individuals to focus on the wonderful things their bodies do for them. Think of your body as a powerful tool and make a list of all the wonderful things you can do with it. Again, think about those individuals you love and admire who are different shapes and sizes.
    • Encourage children to be inquisitive, critical thinkers and not just accept things at face value. Rather than preventing children looking at magazines, encourage them to look at magazines and ask questions - “Why do they touch up the models’ photos?” “Why do they use young models to wear adult women’s clothing?” “Do I really like the way this model looks or is that what I’m being told I’m supposed to like?”
    • Learn to question messages portrayed in the media - magazines, television.
    • Each time you catch yourself or someone else saying something negative about yours or their body, replace it with three positive comments.
    • Don’t limit what you can do in life by your body size. Let others see you doing things - moving your body - regardless of body size.
    • Exercise and body movement are great ways to counteract negative body talk.
    • Stop using the scale to determine your worth. Don’t emphasize certain numbers on a scale. Your weight doesn’t define who you are as a person.
    • Stop comparing yourself to others. Being unique is what makes our world a wonderful place!
    • Compliment yourself frequently. Make a game of it: e.g. Every time I see a red car today I will say something positive about myself.
  5. The holidays are almost upon us, which means that talk of how to avoid gaining weight and New Year’s resolutions will be, too. How do you recommend we deal with all the advice?
    • Stay away from “good food, bad food” talk. Remember it’s all about moderation.
    • Encourage individuals to set resolutions that are non body-size-based. Instead, set goals that are “body movement” based. Make resolutions that are geared toward feeling good about your body now - not when you lose five pounds.
    • Surround yourself with people who have healthy relationships with their bodies, food and weight.
  6. Anything I haven’t asked that you’d like our readers to know about having a healthy body image or fat talk free week?

    Everything we do or say can impact another individual. Oftentimes, we think we are only our own worst enemy. However, at any given moment we are saying or doing something that can influence how another individual thinks about him- or herself. Pass good body talk and feelings along. Each of us makes a difference.


Friday, October 30, 2009

Time to Change the Clocks Again...


This Sunday, November 1, is a bittersweet day for many people. Sweet because we get one extra hour of sleep Saturday night, bitter because the days start getting shorter and darker earlier. Some people love this change- personally, it is not my favorite, but there are a lot worse things, that's for sure. Anyways, I often hear people saying how the shift around this time of the year has a pretty drastic impact on their mood. Seasonal Affective Disorder, or SAD, is a form of depression in which one's mood is affected by the changing of seasons and is often one possible explanation for this change in mood that people often express.

I recently read an article regarding new research findings for the treatment of SAD (click HERE to read it.). What researchers have found is that when treated for one year with Cognitive Behavioral Therapy, or CBT in conjunction with light therapy, patients show a reduction in the recurrence of the depression, as compared with those who only received light therapy. Interesting for those of you who deal with SAD- receiving CBT looks like it is a crucial piece of treatment!

Tuesday, October 27, 2009

Remuda Ranch (and Twins!!)

From time to time, we have reps from eating disorder treatment centers that stop by our office, or meet with us over lunch to tell us about their facilities, treatment modalities, etc... And because we specialize in treating eating disorders, we often end up referring a fair number of clients to treatment centers, so it is helpful to spend time with representatives so that we have good information and know the kind of service and treatment that we are recommending to our clients when we refer them somewhere. One of my favorite places (shameless plug because I did contract work there for awhile) is Carolina House- www.carolinaeatingdisorders.com. Check it out- it is fabulous!! I will share more about the Carolina House in another post, but for now, I want to share a little about Remuda Ranch. A rep from Remuda stopped by our office today and I wanted to share a few things that stood out to me.

First, I love that Remuda Ranch is a Christian based treatment center. While they accept clients of all faiths, their therapists are all Christians. About 3 years ago, Remuda was bought out- while they have loosened up on some of their Christian focused rules (they no longer require chapel attendance, for example), they still maintain a Christian focus, which I think is great. Second, they admit teenagers!! It is difficult to find residential treatment for eating disorders (especially locally) for teenagers and adolescents. Hospitals, like UNC, will admit teenagers, but for many parents, the thought of having their child in a residential type setting is easier to handle than having them in a hospital. Also, I was astounded to learn that Remuda will admit patients as young as 8 years old! It is SO sad that girls as young as 8 years old are struggling with eating disorders. The rep that came to our office, Michele, said that they got a call recently about a 7 year old needing treatment. How devastating.

Remuda, aside from individual/family/group therapy, offers equine therapy, as well as canine therapy. They also place a large focus on life after treatment and offer an equivalent of a sober living facility/halfway house program called LIFE for clients who have completed treatment. There are currently two locations in the US- Arizona and Virginia. To learn more about the different treatment and programs offered, visit Remuda's website at www.remudaranch.com.

Remuda Ranch was recently in the news (http://www.reuters.com/article/pressRelease/idUS118833+13-Oct-2009+PRN20091013) reporting that they have seen an increase in the number of twins that are suffering from eating disorders. I remember watching an episode of Intervention awhile back (great show on A&E that makes me cry every time I watch it) that featured a set of identical twins that were struggling with anorexia. If you aren't familiar with the show, the family of the featured people stage an intervention and persuade them to enter into treatment. The set of twins featured on the show went to Remuda in Virginia; when the show aired, they were doing well and were healthy. It was a very moving episode and very inspiring to see them recover.


Sunday, October 25, 2009

The Rules of "Normal Eating"


Karen R. Koenig's book The Rules of "Normal Eating" is a great book for anyone who has struggled with dieting, overeating, undereating, emotional eating and anything in between, as the cover of her book (pictured to the left) attests:). There are few books that address the variety of topics that she does in her book, of which include challenging irrational beliefs about food, eating, weight and our bodies. She identifies the differences between physical and emotional hunger, and outlines intuitive eating.

The four rules of eating that she says define a 'normal eater':
1- You eat when you are hungry.
2-You choose foods that you believe will satisfy you.
3-You stay connected to your body and eat with awareness and enjoyment.
4-You stop eating when you are full or satisfied.

While this list looks like a fairly simple set of rules to follow, it is much more difficult if you struggle with disordered eating or an eating disorder. Because eating issues and food struggles are not about food, the underlying issues must always be addressed in order for 'normal eating' to occur. For this reason, Koenig encourages the reader to reframe his or her fears and concerns about food and the rules of 'normal eating' -- she walks the reader through this process. If you do struggle with food issues, it is likely that therapy or some kind of support will be a necessary part of the healing and recovery process because reframing fears (along with other issues, such as control, etc) takes time and hard work. However, it is important to have books and resources that help you along on this journey. For more information on 'normal eating' according to Karen Koenig, visit her website at http://www.eatingnormal.com!

**The four rules were taken from page 20 of her book...

Thursday, October 22, 2009

Hungry Planet: What the World Eats


Peter Menzel, a photographer, and Faith D'Aluisio, a writer, joined together (they are actually a husband and wife duo!) to see how different families around the world eat. I heard about the book that they published, Hungry Planet: What the World Eats, which details their travels and experiences through words and pictures at a conference I was at last weekend. It provides an interesting perspective with regards to cultural beliefs about food. Time Magazine ran an article about this book and posted pictures, most of which can be accessed by clicking HERE and HERE. Hope you enjoy. For more information, check out their website (www.whattheworldeats.com).

Campaign For Real Beauty


Dove launched a global campaign back in 2004 that is now known as the DOVE Campaign for Real Beauty--I thought it was definitely worth mentioning for many reasons. The purpose of this campaign is to bring about change on a widespread scale by encouraging women to discuss and explore the definition of true beauty, as well as broaden the stereotypes that they hold about beauty. According to statistics compiled from a global study performed by Dove, only 2% of women believe they are beautiful. They also found that the majority of women define beauty as being thin, young and blonde. Based on these statistics and others (which can be accessed on Dove's website), Dove decided to take action by targeting young girls for the purpose of helping to address the issue of self-esteem.

There are many great resources on this site for young girls as well as teenagers, including quizzes, blogs, videos and more. These can be accessed by visiting Dove's website at www.campaignforrealbeauty.com.

One of my favorite things that Dove has done is to produce a few short videos that explore our perception of beauty, as well as how the media influences our perceptions of what is beautiful. I will post a few links so that you can view them if you would like. They are really great! The first one is called Evolution and documents a photo shoot from beginning to end, including the final image that we, as consumers/society, end up viewing. You can watch it by clicking HERE. The second one is my favorite- it gives me chills!! Click HERE to view it.

For more information on Dove's Campaign For Real Beauty, visit their website (link above).

Sunday, October 18, 2009

Guess What?? It's Fat Talk Free Week!!

Guess what this week is?? Fat Talk Free Week!! I just heard about this and I am so excited. What a great idea! So, what in the world is Fat Talk Free Week anyways? It is five whole days set aside, from October 19-23, to raise awareness of body image issues and to bring attention to how damaging the 'thin ideal' is for women in our society.

The following is a video which has been put together to inspire and impact, and I highly encourage you to watch it! The formatting is not working on the video below, so CLICK HERE to watch!



And another one! Because it is so good! CLICK HERE!!

Also, here are some facts that were put together by TriDelta, the sorority and Greek organization that is headlining this week's End Fat Talk campaign. You may find these facts surprising, interesting, disheartening. They may inspire you to join the fight! I lifted these facts to share from the End Fat Talk website (http://www.endfattalk.org), and they can be accessed by clicking on the 'stats' button.

81% of 10 year olds are afraid of being fat. 51% of 9 and 10 year old girls feel better about themselves if they are on a diet.(Mellin LM, Irwin CE & Scully S, 1992)

Barbie, the best selling fashion doll in the world, has unattainable and unhealthy body proportions. If she were alive, her waist would be smaller than patients with anorexia nervosa, and she would be unable to menstruate. Research has shown that very young girls (ages 5-7) who are exposed to Barbie have lower body esteem and want a thinner body than they have.(Dittmar, Halliwell, & Ive, 2006)

IN THE UNITED STATES...

More than 2/3 of women ages 18-25 would rather be mean or stupid than be fat and over 50% would rather be hit by a truck.(Martin, 2007)

1 in 4 women have avoided engaging in a physical activity or sport because they feel badly about the way they look.(Dove, Beyond Stereotypes: Rebuilding the Foundation of Beauty Beliefs)

According to a national survey, 60% of adolescent girls are currently trying to lose weight(1) and more than 50% have engaged in unhealthy weight control behaviors such as fasting, skipping meals, vomiting or smoking in the past year(2). Girls who use dangerous weight control behaviors like vomiting are more likely to attempt suicide(3).(1)http://www.cdc.gov/HealthyYouth/yrbs/pdf/yrbss07_mmwr.pdf; (2)Neumark-Sztainer, Story, Hannan, Perry, & Irving, 2002; (3)Crow, Eisenberg, Story, & Neumark-Sztainer, 2008)

Adolescent girls who are less satisfied with their bodies engage in less physical activity.(Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006)

Fashion models are thinner than 98% of women. (Smolak, 1996)

As many as 10 million females are suffering from anorexia or bulimia. That's more than are suffering from breast cancer. (National Eating Disorder Association)

AROUND THE WORLD...

Eating disorders are as prevalent in Italy as in the United States. (Favaro, Ferrara, & Santonastaso, 2003)

On a list of items including suicide, depression and drugs, Australian girls ranked body image as their most concerning issue. (National Survey of Young Australians, 2007)

63% of women in Brazil have considered having cosmetic surgery to enhance their appearance. (Dove, Beyond Stereotypes: Rebuilding the Foundation of Beauty Beliefs)

After three years of Western television, the rate of purging in Fijian girls went from 0% to 11% and 74% of Fijian girls now report feeling too big or too fat at least sometimes. (Becker, Burwell, Herzog, Hamburg, & Gilman, 2002)

Percentage of girls in one Israeli study who are...afraid of becoming fat: 63% and who are unhappy with their figure: 87%. (Latzer & Shatz, 2001)

Half of all women in Japan have avoided going to the doctor because they feel badly about their looks and more than half have avoided going on a job interview for the same reason. (Dove, Beyond Stereotypes: Rebuilding the Foundation of Beauty Beliefs)

When given a range of body types to choose from, 12% of Mexican girls selected the anorexic body size as their ideal body shape. (Austin & Smith, 2008)

Almost 1/3 of women in Saudi Arabia report crying because they feel badly about the way they look. (Dove, Beyond Stereotypes: Rebuilding the Foundation of Beauty Beliefs)



Click HERE for more detailed information on Fat Talk Free Week or visit www.endfattalk.org.

Saturday, October 17, 2009

Finding Balance

I recently came across a website that is a great resource for anyone struggling with disordered eating. The site is www.findingbalance.com and can be accessed by clicking HERE. Finding Balance is a faith-based nonprofit whose goal is to provide resources, support, information and encouragement for those struggling with food issues.

This site was started after a study was published in SELF magazine in 2008 by Cynthia Bulik, director of UNC's Eating Disorder Program, which reported that 75% of women have eating issues of some kind. This statistic is astounding. The creator of Finding Balance, Constance Rhodes, author of Life Inside the Thin Cage, was inspired to create the site as a way of reaching out to the many girls and women who struggle with food issues, as a tool to help and encourage. To read about Constance and her journey of recovery from disordered eating, click here. The site also aims to eliminate the stigma associated with eating and body image issues. For more information, visit the site at www.findingbalance.com.


Monday, October 12, 2009

Thoughts on the Freshman 15, Courtesy of Newsweek...


This fall, Newsweek Magazine wrote an article entitled "Rethinking The Freshman Fifteen." I was immediately drawn to this article for obvious reasons, as I work with eating disorders, but I also remember the hysteria surrounding the ominous freshman fifteen that I was bombarded with when going off to college. I remember hearing about these alleged 15 pounds that my fellow freshman and I needed to watch out for- relatives, people in my dorm, my RA, friends, professors, strangers who found out I was a freshman, etc... it all felt just a little bit much. What I liked about this article is that it highlights an at risk group- college freshman, and really, college students in general- but it also highlights a cultural notion- the freshman fifteen, which can trigger disordered eating in many college students who begin to fixate on not wanting to gain these 15 pounds.

While we know that each person responds differently to environmental stimuli, we also know that the trend in college dining halls to display caloric and nutritional information for all food being served has been difficult for some people. For this reason, Harvard University pulled the caloric and nutritional information from their dining halls last year, instead opting to feature it online for those who were interested. For some who may be recovering or trying to recover from an eating disorder, this information is triggering and may prove to be detrimental. For others who struggle with disordered eating, or for those who have no history of eating issues, the presence of such information can bring about an unhealthy awareness. The argument that a school like Yale makes (Yale University refuses to remove this information in their dining halls) is that obesity in our country is rising, and this is a helpful way to encourage healthy eating and weight management.

What stands out in my mind (click HERE to read this article) is not so much the debate over whether or not to display caloric and nutritional information about the food being served in dining halls, but how we help to engage college students in healthy ways of living. The number of EDNOS diagnoses (Eating Disorders Not Otherwise Specified- a diagnostic term which includes disordered eating behaviors that do not meet the exact criteria for anorexia and/or bulimia) has doubled, and according to a statistic in this article from the American College Health Association, 38 percent of college students are using eating disordered behaviors to manage weight. The need for education, therapy and healthy approaches to our bodies and food is something that we ALL need, but this article just reminds me that college students are at risk. Prevention efforts aimed at college students, as well as treatment, is essential.

Preventing Anxiety in Children: A Familial Approach


I recently came across an article detailing a study that looked at anxiety prevention which I enjoyed (I work with children and teens that deal with anxiety as well as their families) and thus, wanted to pass on this article of interest. A pilot study conducted at Johns Hopkins Children's Center recently looked at anxiety in children who have parents that are anxious. The researchers employed a family approach using cognitive behavioral therapy (CBT), and they found that as few as eight weekly sessions of family CBT therapy were helpful in reducing anxiety. This study used a very small sample size, but the results are significant as far as prevention efforts go. Golda Ginsburg, a child psychologist at Johns Hopkins and senior researcher on this team, reports that children who have parents with an anxiety disorder are seven times more likely to develop anxiety. As a result, in conjunction with what we know about children and anxiety (one in five children in the US develop anxiety disorders), this is helpful information for parents, as well as health care professionals. For more information on this study and to read this article, click HERE.

Sunday, October 11, 2009

Orthorexia



When most people hear about eating disorders, they typically think of anorexia, bulimia, and maybe even binge eating disorder. Binge eating disorder (BED) is receiving more attention lately than it has in the past--and as a side note, Cynthia Bulik, the Director of the UNC Eating Disorders Program, recently wrote a great book on binge eating called Crave that is worth checking out.

Anyways, what you may not know is that the way in which these eating disorders present themselves can differ from person to person. We are always learning more about eating disorders as research is being done, and recently, there have been an increasing number of discussions about a variation of anorexia called orthorexia. To be clear, orthorexia is not defined as its own type of eating disorder-- it is not included in the Diagnostic and Statistical Manual of Mental Disorders. Orthorexia is different from anorexia in its motivation, in that one who is orthorexic is not necessarily trying to lose weight or be thin; rather, one is trying to eat as healthfully as possible. As with all eating disorders, the underlying causes go much deeper than a desire to be thin or to be healthy.

Orthorexia, as defined by the National Association of Eating Disorders (NEDA), is a "fixation on righteous eating." Dr. Steven Bratman is responsible for coining this term, and he describes it as a "pathological fixation on eating proper food." Basically, the idea is that one becomes so obsessed with consuming healthy food, and refuses to eat anything but food that is of a high purity and quality. This may even apply to how a food is packaged. There is often an obsessive compulsive quality that accompanies this type of eating behavior. Most residential facilities that treat eating disorders treat orthorexia and are educated about this form of anorexia. For more information on orthorexia, follow THIS LINK.

Also, visit THIS LINK to read NEDA's information about orthorexia.

Saturday, October 3, 2009

Gurze Books- Eating Disorder Resources!


Gurze Books is a GREAT resource for information, resources, books, etc on eating disorders that has been around since 1980. It is a publishing company and its logo is located to the right. Gurze has a very user friendly website, located at http://www.bulimia.com and can be accessed by clicking here. There is something for everyone on this site, whether you are a parent of a child with an eating disorder, have an eating disorder yourself, or are a professional who wants more information on eating disorders. Check it out!

Beyond Eating Disorders Workshops

I wanted to highlight an opportunity for those of you who are interested in participating in an eating disorder recovery weekend workshop. There have been a few Beyond Eating Disorder workshops held recently, and the next one is being held October 16-18. It is likely that this workshop is near capacity, so if you are unable to attend in a few weeks, future workshops will be held in the coming months. I will make sure to advertise them on my blog, so that you will have more information. Thom Rutledge, a psychotherapist, author and speaker who I mentioned in a previous post, is holding these workshops outside of Nashville, TN in conjunction with Julie Merryman. If you are interested, or know someone who may be interested, follow this LINK for information! A link to Thom's website can be found here as well.