"I Shouldn't, I've been so bad..."

"I have been SO bad today!" "I ate soo much yesterday, I cannot possibly eat today." "After that breakfast, I'm good until dinner!" How many times have you heard these kinds of comments, or made them yourself?? These are comments that we probably have all made at some point, and have also probably heard someone else make. So what's the problem with this kind of thinking about food?? Well, aside from being a form of 'fat-talk', this kind of thinking is very black-and-white, which is not usually an effective way to think about things. We see each decision or action as a total success or a total failure, which is rarely ever the case.

But even more than that, this kind of thinking about food fuels a diet mentality. I am not a nutritionist, and my training is not in nutrition, so I try to steer clear of getting into specifics about food! However, because I do work with clients who have eating disorders, I work with nutritionists (as we share clients) who educate me, in addition to any reading I might do! Anyways, Anna Lutz, a nutritionist that I have shared many clients with (who is currently on maternity leave- congrats Anna!) has had some helpful things to say on this very topic. First, our bodies do not take days into consideration. The patterns and behaviors that we establish with food over time are what matter to our bodies! In this vein, if we feel we have overeaten one day or are uncomfortable with a meal that we had last night or last week, our bodies do not react directly to that one event. One example of this is the way in which our bodies do not make drastic changes in 24 hours, even if we ate an extra serving or two of dessert the night before! Our bodies just don't work like this, even if we feel like they do! If we are consistently overeating or bingeing, then we are likely to notice a change in our bodies- and that is because we are establishing a pattern, and patterns are what our bodies respond to.

Our bodies will naturally gravitate towards our healthy weight (set point) when we are listening to them, by eating when we are hungry, and stopping when we are full. If we have a mentality towards food in which we have to 'make up for yesterday', it perpetuates an unhealthy cycle or pattern (binge/restrict) which does not move us in the direction of normal/healthy eating. This cycle also interferes with our bodies being able to find our set point! So next time you are tempted to cut out a meal one day or restrict calories because of what you ate the previous day, consider that your body reacts to patterns over time, and perhaps focus on trying to eat 'normally' by responding to hunger, stopping when you are full and choosing foods that you feel will satisfy you. For more information on eating 'normally', follow this link to read about The Rules of Normal Eating by Karen Koenig. This is a great book that I'd encourage you all to check out!

Brothers

I have been wanting to see the movie Brothers, so I finally went and saw it the other night! It's a powerful movie starring Jake Gyllenhaal, Natalie Portman and Tobey Maguire that examines the effects (mostly psychological) of war on one's family and its impact on familial relationships. Because this is not Rotten Tomatoes, the movie review website :), I will refrain from giving you a play by play on the movie - but if you are interested, follow this link to read some reviews. The reason I bring up this movie is not because I just want to talk about the movie... Rather, I had an interesting observation as I watched it that got me thinking more about the way that men and women are portrayed in the media, specifically as it relates to body image.

In this movie, Toby Maguire plays a Marine who is held as a prisoner of war. He is tortured and starved. For the role, he had to lose a considerable amount of weight. I noticed that he looked significantly underweight throughout the movie, and my friend who I was with noticed this too. Well, when I got home, I wanted to read some reviews about the movie because 1) i'm kind of a nerd, but 2) it had a pretty powerful message and I was curious how other people had interpreted its meaning. In the process, I came across some interviews done by Maguire where he discussed how he was required to lose a substantial amount of weight for the role. He mentioned that he only had a couple of weeks to drop the weight, and while he did consult a nutritionist one time before he began his weight loss, he admitted that he used very unhealthy means to reach his goal.

I guess what struck me about this is the fact that a majority of Hollywood actresses are significantly underweight all the time, and for the most part, the media views this as 'normal.' While magazines may write stories about which actress used which diet to lose weight fast, you typically hear stories about women being praised for losing drastic amounts of weight, even if it is unhealthy. I think what this illustration demonstrates is that when a woman is underweight, it is not really newsworthy because it is sort of an expectation as the ideal standard of beauty, whereas when a man loses too much weight, it is recognized as unhealthy-- it is assumed that he will return to his normal, healthy weight once the filming for his movie has reached completion. Why is it that we can recognize unhealthy weight and disordered behaviors in men and fail to do so with women? Being silent communicates acceptance, so when an actress is too thin, is cast in movies and people rave about her beauty, it sends a message that she is beautiful and okay. This message is a dangerous one.

I guess the culmination of my thoughts on Tobey Maguire amounted to more confirmation of my desire to increase awareness of the ways in which the media can be confusing and tricky with their double standards and messages. I think it is important to be aware of these mixed messages so as to avoid buying into the values and deceptions in them. I have mentioned the organization About-Face before in another post (click here to read it). It's main goal is to promote health by helping women to resist damaging messages from the media about their bodies and self-esteem. I recommend checking it out! To access their website, follow this link. In the mean time, be discerning as you interact with culture and media, and do not be afraid to be critical about what you see and observe...

Kids, Mental Health and Hope

I like to think that I am a 'glass half full' kind of person. Generally, I try to see the good in people and situations, and am hopeful about change- if I weren't, I'm not so sure that counseling would be the best field for me! All that to say... I noticed the other day that while I was reading an article about young people and mental health, I found myself taking a 'glass half empty' mentality. Why??

Well, according to a survey funded by the National Institute of Mental Health (NIMH) which will soon be published in the journal Pediatrics, 13 percent of all children and young teens have at least one 'mental health disorder.' And of that 13 percent, only half have been evaluated and treated by a mental health professional. These facts indicate that while one half of young people are being treated, one half are not. This is a staggering number when considering that half of all youth with mental illness are receiving no treatment or help at all.

This survey sampled 3, 042 children between the ages of 8 and 15, and the findings were based on assessments of these children for six common mental disorders--anxiety disorder, panic disorder, eating disorders (anorexia and bulimia), depression, ADHD (attention-deficit/hyperactivity disorder) and conduct disorder. For a bit of perspective, imagine if half of young people who deal with diabetes or asthma were living without medical treatment. To think about the number of children and teens who are suffering from untreated mental health issues is alarming. And sad! Research indicates that when mental health issues are not treated, they typically persist and become more severe with age. (I wrote a blog awhile back on teens and depression that addressed this issue- follow this link to read it and to learn some of the symptoms of childhood/teenage depression.) This is concerning because young children and teens who suffer from eating disorders, for example, and are not being treated are at serious risk for many physical and psychological problems. This is a serious issue!

The article suggested that part of this problem is due to the fact that there is a shortage of mental health workers that specialize in treating children, specifically psychiatrists. So what is a parent to do?? Perhaps we need to focus on educating more parents and teachers about the symptoms of anxiety, depression, eating disorders, ADHD, etc.. in children and teens so that they are able to notice the warning signs and advocate for their treatment. While mental health professionals have the tools and knowledge to diagnose and treat, parents and teachers are able to notice patterns of behavior in children over time that a professional is not necessarily capable of seeing when sitting with them for 30 minutes. To read this article in its entirety, follow this link, as well as this one for more info!

Turkey Day Anxiety: Part 2

Thanksgiving is tomorrow- and it seems like most people are either running around, making last minute preparations to host family and friends, or making sure that all the essential ingredients are present in their kitchens for cooking, or are packing/en route to be with family and friends. As I mentioned in my previous post (scroll down, or click here to read it), this time of the year is often accompanied by a significant amount of stress. Whether the holidays are stressful due to family tension, financial strain, or other difficult circumstances, one thing is certain- Thanksgiving has become a food holiday, meaning that food has become the main event.

What do we know about stress and eating? Well, for some people, stress during the holidays can lead to emotional eating, overeating, and/or binge eating, while for others who have struggled with restrictive eating, this tension may manifest in restrictive behavior with regards to the amount of food eaten or a preoccupation with what is being consumed. In addition, the heightened awareness that the media and our culture have placed upon food, weight, and our bodies has strongly impacted our beliefs about food. Therefore, a holiday that is centered around food can be triggering for anyone, but especially for those who are currently struggling with an eating disorder or eating issue, as it is not uncommon (unfortunately) for people to observe and make comments about who is eating how much, and how much weight so-and-so gained/lost since last year. If you are reading this, I would challenge you try to make it through this Thanksgiving without making any comments about what other people are eating, or how much they are eating, or any other comments along these lines. While this may seem like a minor adjustment to make, it would probably surprise you to find what an impact such a small change can make on others around you. If you are someone who struggles with an eating disorder, have struggled with one in the past, or struggle with body image issues, OR you will be spending this Thanksgiving with someone you love who you know or suspect struggles in any way with food, here are a few helpful tips, courtesy of NEDA, that may serve to alleviate the stress of such a time.

1. Worry more about the size of your heart than the size of your (fill-in-the-blank-body part). Think about how you can serve someone or do something nice for someone else- and do it. It helps to focus on others, and it helps to consider what you are thankful for.

2. Have conversations with your loved ones about things that matter to you all--dreams, goals, faith, relationships, concerns, fears, challenges, etc-- rather than focusing your energy and thoughts on food or body concerns.

3. Designate someone to be your 'support' person who you can call if you are struggling, or who you can talk with to encourage you to get through the tough moments.

4. Make goals for the day, and try to follow through with them. If you make goals with food, make sure you also make other non-food goals as well.

For more tips, follow this link for NEDA's complete list.

Here are some suggestions for families from Marcia Herrin and Nancy Matsumoto, authors of The Parent's Guide to Eating Disorders:

Try making your family’s holiday traditions more about relationships and activities than about food.

· Don’t skip meals or plan to undereat or diet the day following a family holiday.

· Talk to other family members in advance about not pushing food or commenting on diets, calories, or weight loss. Even too much emphasis on trying to make healthy choices at holiday meals can add to the stress.

· It is particularly important if your child is recovering from a serious eating disorder to have pre-warned family members about the kind of talk and attention that is appropriate. I suggest that parents develop a kind of code or signal that tells family members or other guests, “change the subject, and fast!”

· Because meal schedules may be altered and more snack foods and desserts are served during the holidays, it’s important that parents of an eating-disordered child be extra-solicitous and vigilant. If circumstances conspire to create a level of stress that interferes with your child’s recovery, you and your child should sit down and prioritize the extras in your lives. Remember that the first item on your list of important things to accomplish – even during the holidays -- should be your child’s recovery.

I think the most important thing to remember in all of this is the real meaning of Thanksgiving! No matter what we are going through, we always have things we can be thankful for. This doesn't minimize the tough things that some of us are going through or dealing with, but practicing gratitude does wonders for your outlook. Maybe you can make a list of all the things you are thankful for, or maybe you can make a point to discuss with your friends and family what you have been thankful for as you reflect on the past year. I hope everyone has a wonderful Thanksgiving!! I am so thankful for those of you who have been reading my blog, and for those of you who have encouraged and inspired me.

Turkey Day Anxiety: Part 1

Thanksgiving is rapidly approaching- it will be here in just a few days.. which is kind of hard to believe! It seems like time is flying by, doesn't it? Sometimes it is difficult to know how to prepare for the holiday season because it sneaks up on us so quickly and it is a time that elicits very mixed emotions- excitement, stress, happiness, sadness, irritation, hopefulness, etc.. There are so many different reasons for the range of emotions that are typical at this time of year, but I think the NY Times said it best today in an article entitled Food, Kin and Tension at Thanksgiving:

For Thanksgiving dinner, what side dish would you prefer to accompany your turkey — a serving of well-marinated conflict over how much or how little you eat, or some nice, fresh criticism of your cooking skills?

As awful as that sounds, you kind of have to laugh because there is a lot of truth in such a statement. Whenever families gather together around the holidays (as well as for other celebrations or events), tension and stress are not an uncommon part of the experience. What can add to that stress is the fact that Thanksgiving in our culture has become a food holiday- and if you have struggled with any kind of food issue- anorexia, bulimia, binge eating, disordered eating- even being a picky eater- then the stress can be overwhelming. Or, if you have a loved one who has dealt with any kind of food issue, then you also experience stress at the thought of how to behave and what to say or what not to say come meal time. It can be a tough time for all parties involved.

I am going to provide a few suggestions for how to approach Thanksgiving in light of some of these stressors, but I am going to do that in another post- soon to follow and before Thanksgiving! So check back. In the meantime, read the rest of this article from today's NY Times by following this link. PS- my favorite local hero, Cynthia Bulik, is quoted. She is popping up everywhere these days and that makes me so happy.

Drunkorexia

Drunkorexia is one of the latest trends in eating disorders. Like orthorexia, drunkorexia is not a medical or psychological diagnosis; you will not find this term in the Diagnostic and Statistical Manual of Mental Disorders. So what is drunkorexia? You might have a clue based on its name, but it is the combination of anorexic or bulimic eating disorder behaviors and alcoholic/binge drinking behaviors. The director of outpatient clinical services for the Renfrew Center, a nationally recognized eating disorder treatment facility, Dr. Douglas Bunnell explains: "Binge drinking is almost cool and hip, and losing weight and being thin is a cultural imperative for young women in America. Mixing both is not surprising, and it has reached a tipping point in terms of public awareness."

This kind of eating disorder is commonly seen in female college students, as participation in binge drinking continues to increase among this population. "Research shows that between 20 and 40 percent of women who suffer with bulimia also have a history of alcohol and/or drug problems. In one study, for example, 37.5 percent of bulimic individuals reported excessive alcohol use and 26.8 percent had a history of alcohol abuse or dependence" (Emax Health, Oct 2009). Another study was conducted in 2009 at the University of North Carolina at Chapel Hill and looked at the relationship between eating disorders and substance use in 13,000 women. What researchers found was that women who had an eating disorder were more likely to use substances than their counterparts without eating disorders. For more on this study, click here to access this article on Emax Health.com.

It is important to highlight drunkorexia-- according to the National Association of Anorexia Nervosa and Associated Disorders, 72 percent of women who are addicted to alcohol are also engaging in eating disorders. This is a very high number. Considering the health dangers of both alcoholism/binge drinking and eating disorders, the combination is very threatening. Health professionals need to be aware of this condition, as treatment is so essential to avoid the potentially fatal consequences of such behaviors. It is also helpful for people to be informed about drunkorexia, as we all might have family members, loved ones or others that we know who are possibly dealing with it. For more information, follow this LINK to read an article published in the NY Times last year on drunkorexia.

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...

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.

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.

Effects of Parent's Deployment on Children

A recent study published in the Journal of Developmental and Behavioral Pediatrics reports that a third of kids who have a parent who has been deployed is at greater risk for developing psychological problems. More research needs to be done, but what is clear is that kids who have a parent who has been/is deployed have been identified as 'at-risk.' Parents of these kids need to be aware of this, as it relates to the support that their kids may need. Not all kids are affected the same way and this study does not mean all kids with a deployed parent will have psychological problems. What it does mean is that parents need to be aware and can aim to prevent such issues by providing a supportive environment, and seeking professional help if needed.

Information retrieved from this article. For more information, follow the link to read the article.

Stress...

With a new academic year in full swing, I have heard parents, college students and teenagers alike mention the increased level of stress that accompanies this time of year. Changes in routines and schedules can be stressful- regardless of whether the change is positive or negative. We tend to think of negative events as being stressful, but positive events can also trigger stress. Whether you are returning to school as a student, or you are a parent who has children returning to school, or you are neither and are undergoing stressful situations at work/home, learning how to healthily manage stress is an important skill to possess. For this reason, I thought that I would post some tips for managing stress, brought to you by the American Psychological Association :)

Stress Tip Sheet

In today’s fast-paced and ever-connected world, stress has become a fact of life. Stress can cause people to feel overwhelmed or pushed to the limit. The American Psychological Association’s 2007 “Stress in America” poll found that one-third of people in the U.S. report experiencing extreme levels of stress. In addition, nearly one-in-five report that they are experiencing high levels of stress 15 or more days per month. While low to moderate levels of stress can be good for you when managed in healthy ways, extreme stress takes both an emotional and physical toll on the individual.

With the consequences of poorly managed stress ranging from fatigue to heart disease and obesity, it is important to know how to recognize high stress levels and take action to handle it in healthy ways. Being able to control stress is a learned behavior, and stress can be effectively managed by taking small steps toward changing unhealthy behaviors.

APA offers the following tips on how to manage your stress:

Understand how you experience stress, Everyone experiences stress differently. How do you know when you are stressed"How are your thoughts or behaviors different from times when you do not feel stressed"

Identify your sources of stress.What events or situations trigger stressful feelings" Are they related to your children, family, health, financial decisions, work, relationships or something else"

Learn your own stress signals.People experience stress in different ways. You may have a hard time concentrating or making decisions, feel angry, irritable or out of control, or experience headaches, muscle tension or a lack of energy. Gauge your stress signals.

Recognize how you deal with stress. Determine if you are using unhealthy behaviors (such as smoking, drinking alcohol and over/under eating) to cope. Is this a routine behavior, or is it specific to certain events or situations" Do you make unhealthy choices as a result of feeling rushed and overwhelmed"

Find healthy ways to manage stress. Consider healthy, stress-reducing activities such as meditation, exercising or talking things out with friends or family. Keep in mind that unhealthy behaviors develop over time and can be difficult to change. Don't take on too much at once. Focus on changing only one behavior at a time.

Take care of yourself. Eat right, get enough sleep, drink plenty of water and engage in regular physical activity. Ensure you have a healthy mind and body through activities like yoga, taking a short walk, going to the gym or playing sports that will enhance both your physical and mental health. Take regular vacations or other breaks from work. No matter how hectic life gets, make time for yourself — even if it's just simple things like reading a good book or listening to your favorite music.

Reach out for support. Accepting help from supportive friends and family can improve your ability to manage stress. If you continue to feel overwhelmed by stress, you may want to talk to a psychologist, who can help you better manage stress and change unhealthy behaviors.