Beauty and The Mile High City !!!

Happy Saturday, everyone! It appears that I have taken an unintentional vacation from blogging :). I think it’s been almost two weeks since I’ve posted! A LOT has been going on! I am currently on a plane from Denver to Detroit (hey Eminem!) and will hopefully be back in Raleigh in a few short hours after a quick layover.

This past week, I had an opportunity to visit Eating Recovery Center in Denver on Thursday and Friday. It was an amazing trip and I’m looking forward to sharing more about my time there very soon! I will say… the staff there is beyond excellent. Four of the leading eating disorder doctors in the world work there (this is no joke), and together make up a pretty powerful team. I absolutely loved my time there, love their approach to treating adolescents and adults with eating disorders, and loved my time in Denver. I even got to see one of my oldest friends, Melissa, who lives in Denver- so, so fun.

I did have something I wanted to share real quick, in going along with my last post- ‘Body Beautiful.’ I watched Glee for the first time ever while I was on my way out to Denver Thursday. I’ve been told I’m a little out of the loop since I’ve never seen an episode so I thought I would take advantage of my time cooped up in a plane to catch up. Because I haven’t seen it before, I can’t really tell you much about where I was in the storyline, who the characters are etc.. But it just so happens that I watched an episode about beauty and weight. Funny, huh? :) The cheerleaders were being weighed like wrestlers, and had to ‘make weight’ in order to cheer at a pep rally or something. Well, this one girl started trying to starve herself so she could make weight. At the end, she realized that the whole thing was not worth her health and well-being, after being miserable and having another girl open up and share her own experiences with unhealthy, disordered eating. It was slightly cheesy and there were a few touchy, unfunny jokes about weight/eating disorders, but the overall message was really important and good. Below is a clip from the episode (wish I could find one that wasn't just the song, but -- I just thought it would be fun to post anyways). Check it out- and don't mind the first few seconds of the clip that are in Spanish and advertising a video game or something :).

I’m going to sign off and catch up on a few things, but I’m excited to share more about my trip to Denver soon! Also, don’t forget about the National Eating Disorders Association Walk happening THIS SUNDAY!!! At Meredith College in Raleigh. If you are interested in participating (or are not able to be there but would like to donate to the cause) follow this link. 

On 'Health'

In going along with my new theme of 'compassion' (see this post for more), I really really want to address the comments that Rush Limbaugh made on Monday about Michelle Obama. I just heard about this-- and am thankful for an opportunity to work on being compassionate:-). For those of you who haven't heard (I almost hate to tell you), but on his radio show on February 21st, Limbaugh made some pretty inflammatory comments about the First Lady. As you may know, she has worked very hard on initiating a campaign to fight childhood obesity. There have certainly been mixed feelings from the eating disorder community concerning her approach, but nonetheless, she ended up adding eating disorders under the campaign's umbrella and is (hopefully) working to address eating disorders as well.

Anyways, from what I understand, Michelle O. was vacationing at a ski resort recently with her family, and it was made known that she enjoyed a nice dinner while she was there, which included ribs. Limbaugh's comments: "The problem is, and dare I say this, it doesn't look like Michelle Obama follows her own nutritionary, dietary advice. We hear that she's out eating ribs at XXXX calories a serving with XXX grams of fat per serving. I'm trying to say that our First Lady does not project the image of women that you might see on the cover of the Sports Illustrated Swimsuit Issue or of a woman Alex Rodriguez might date every six months or what have you." He went on to say, "She's a hypocrite. Leaders are supposed to be leaders. If we're supposed to eat roots and berries and tree bark, show us how." Yikes!!!

While I am really sad that he made these comments, and would like to respond with some choice words, I think this is a great opportunity to address an important issue! Perhaps this whole exchange once again highlights the fact that we really struggle with extremes in our society. Black and white thinking, the 'diet mentality' .... call it what you want. But seriously-- who decided that you can't be healthy and eat ribs at dinner when you're on vacation (or not on vacation)? Being truly healthy requires moderation and balance. Simply eating "roots, berries and tree bark" would be just as much of a problem as if we all ate ribs for every meal.

Another thing I want to challenge is the assumption that looking like a swimsuit model is the picture of health. I could be wrong here, but it sounds like Limbaugh is saying that Mrs. Obama should look like a model. You cannot tell how healthy someone is simply by looking at them. Of course in extreme cases, yes- you can see with your eyes when someone might be ill (very underweight or very overweight). But people who may look fit, toned or 'in shape', thin, those who look average and healthy, ... they may have heart problems, blood pressure problems, bone density issues, etc due to unhealthy behaviors (diet pills, over exercise, steroids, purging, etc)... You never know how someone is treating their body and you never really know how healthy someone is just by looking at them. To infer that Michelle Obama needs to look like a swimsuit model in order to prove that she is following her own dietary advice is almost kind of funny because it is just so not true. The suggestion that swimsuit models or girls that A-Rod dates are the barometer of health is, in my opinion, one of the reasons why women in our culture struggle so much with knowing what it is to be truly healthy, not to mention why they have a tough time believing that beauty comes in all shapes and sizes. Most people (95% of the population in fact) could be healthy, balanced eaters and no matter what, will not ever have bodies that look like models. 5% of the population has a body type in nature that resembles that of a model.  And then there is airbrushing...  many of the models and images that we see are not even real. The point is- we aren't all made the same and we all have different body types, bone structures, etc. It is irresponsible to perpetuate the myth that 'health' looks one way, but it is also irresponsible for us to buy into it.

This post is getting lengthy- so I will conclude by encouraging you to think about what true health is and where you came up with your beliefs about what it is to be healthy. 'Health' is a loaded word. Limbaugh's assertions about health are clearly skewed, but remind all of us that we need to take a step back and consider what true health really looks like. Are extremes a measure of health?? How do you know if you are being truly balanced in your approach with food? These are important questions to consider.

Jenifer Ringer: A Body Image Role Model for the Holidays

One of my favorite Christmas traditions growing up?? Going to see the Nutcracker Ballet. I was pretty involved in ballet until the 7th grade, so it made the ballet even that much more meaningful and special to me. I have to say it's been a few years since I've gone- I think the last time I went I saw a very 'interesting' production at the Raleigh Memorial Theatre that featured a more modern interpretation and ballet style. Because I have such positive and warm memories surrounding the Nutcracker, it was even more sad to hear about what happened recently- that something so festive and beautiful could turn into an opportunity for criticism and ignorance. 

For those of you who are unfamiliar with the story, there was a pretty big controversy recently over some comments that dance critic Alistair Macaulay from the NY Times wrote about Jenifer Ringer, the ballerina playing the role of the Sugar Plum Fairy in the New York City Ballet's production of the Nutcracker. His critical comments were focused on her weight, which is bad enough- but she has been open about her struggles with anorexia and disordered eating in the past, which seemed to make this critique even more upsetting, disappointing, and irresponsible. Ringer was interviewed on the Today Show by Ann Curry, and I was extremely moved by how strong, gracious, articulate and healthy she was in communicating about the whole thing! This clip below is the segment that was featured- it provides the backstory as to what actually happened, and also includes the interview with Ringer. In total it is about 7 minutes, and I would really encourage you to watch it. (I have watched it a few times!!) She does a fabulous job of articulating that being a dancer did not cause her eating disorder (she busted an ED myth!) and around the 6:40 mark she has some very encouraging words for us about our bodies. Check it out below.

Drunkorexia Revisited

I have noticed that there have been a few articles circulating recently on 'drunkorexia'... Around this time last year, I wrote a post on drunkorexia that I thought I would re-post it in light of the attention it has been getting in the news! A recent article was written in the LA Times just a few weeks ago (follow this link to read it!)--it's a good one!

Drunkorexia is one of the latest trends in eating disorders. Likeorthorexia, 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 hereto access this article on Emax Health.com.

It is important to highlight the connection between eating disorders and alcohol-- 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.

Fat Talk Free Week is Here!

Fat Talk Free Week is happening this week. What does this mean?? Well, if you scroll down, the last few posts that I have written have been geared towards Fat Talk Free Week! This is a week set aside each year by Delta Delta Delta to raise awareness and promote healthy body image. The idea is that by making an intentional focus throughout the week not to 'fat talk' we might encourage ourselves and each other to think more positively, have a better self image, and not put a negative focus on our bodies.

So, what exactly is 'fat talk'???

"My butt looks huge!"

"My jeans are too tight!"

"You look really good, have you lost weight?"

"I look so gross today."

"I need to work out double today since I ate that piece of cake yesterday."

"I wish I could wear a size (---)"

"I need to lose 10 lbs."

These are just a few examples-- I am sure you can think of others that you say or have heard others say. I think we are pretty desensitized to 'fat talk' and for that reason, I think just becoming more aware of its presence and trying to eliminate it could bring about a huge and positive change- not just for us but for those around us too. Consider how your words have an impact on others-- when we say these disparaging remarks about ourselves in the presence of others, we are not just shaming ourselves- we are shaming others! It is difficult not to influence others when we speak negatively about our bodies or choices with food or the size of our jeans- so even if it is just out of respect for others, be kind to yourself! Try it this week and see how it feels! : )

Mean Girls, Fat Talk and A Video Contest!

Mean Girls was- and still is- a classic movie about high school, popularity, and being true to yourself. It makes me laugh every time I watch it (mostly out of disbelief) because of the way it depicts the social strata of high school. I will say that one thing Mean Girls does a great job of is humorously exposing some of the hideous ways that us girls treat each other, as well as the ways that we talk about ourselves and one another. I remember at my high school, we had our own version of 'the plastics' but they called themselves 'the six pack.' Gross! Anyways, one scene that really stands out to me takes place in Regina George's bedroom, where all four 'mean girls' are hanging out. They end up in front of the mirror, picking themselves apart and engaging in negative talk about their bodies. Cady, the new girl in the group, doesn't understand why they are talking so badly about themselves. The following is the dialogue that takes place in front of the mirror:

"My hips are huge."

"Oh please, I hate my calves."

"At least you can wear halters, I have man shoulders."

"My hairline is so weird."

"My pores are huge."

"My nail beds suck."

Now, let's face it. We all have moments where we may not feel our best, but ladies, this kind of talk, also known as 'fat talk' needs to stop! It is sad that we can be so harsh and critical of ourselves. So, what is fat talk and why do we need to cut it out?? According to the Reflections: Body Image Program, "Fat Talk describes all of the statements made in everyday conversation that reinforce the thin ideal and contribute to women’s dissatisfaction with their bodies. Examples of fat talk may include: “I’m so fat,” “Do I look fat in this?” “I need to lose 10 pounds” and “She’s too fat to be wearing that swimsuit.” Statements that are considered fat talk don’t necessarily have to be negative; they can seem positive yet also reinforce the need to be thin – “You look great! Have you lost weight?”." Fat talk reinforces unhealthy beliefs and attitudes about our bodies, and also has a negative impact on others as well!

So what can we do about this?! Well, there is a very unique way for you to get involved, share your voice, and help to impact change!! Fat Talk Free Week, put on annually by Tri-Delta and the Reflections: Body Image Program, will be starting soon-- on October 18-22! I will be posting more on this as the time draws closer, but wanted to alert you all of a great opportunity! This year, there is a video contest. Make a short video to show what you are doing to end 'fat talk' and upload it to the official End Fat Talk facebook fan page (here). Video submissions are due by Wednesday, October 20. Once uploaded, friends and family can vote for your video and one lucky winner will take home a $1000 gift card to Best Buy! This video campaign is a great way to promote positive body talk and to impact change!!

Below is a powerful video that was made to inspire change, as well as to promote Fat Talk Free Week. Consider participating in the video contest this year. And if you aren't feeling compelled to submit a video, that's okay!! But think about how else you might be able to get involved this year to help reduce and eliminate fat talk- whether it starts with you, in your own mind and conversations, or in conversations you have with others. One person can make a difference.

For those of you unfamiliar with TLC, it is the cable TV network that has brought us such gems as Jon and Kate Plus Eight, The Duggars: 19 Kids and Counting, I Didn't Know I was Pregnant and Toddlers and Tiaras. If my tone isn't giveaway enough, I won't elaborate any more on my opinion of these shows. [I will say, as a disclaimer, that my mind is just so blown by 'I Didn't Know I Was Pregnant'. How do these women NOT KNOW?!] Anyways, many people really like these shows- and that is just fine. What is not fine is that I just read an article in the LA Times about one of TLC's new shows, airing tonight, which follows people through their issues with food and disordered eating. The name of the show is called Freaky Eaters. Umm... FREAKY EATERS???!!

Now, my thought is that by calling yourself The Learning Channel, your intent is to educate people and help them learn! Part of educating people about eating disorders and helping them to understand disordered eating is to bust myths, emphasize the facts (genetics included), and hopefully in doing so, de-stigmatize mental illness. A show entitled FREAKY EATERS does not help do that- it does just the opposite by stigmatizing eating disorders and disordered eating by calling people 'freaky' who struggle in the ways that they relate to food!! It seems really insensitive and irresponsible.

I would encourage you to follow this link, which will take you to a web page that will allow you to email the network directly and share your feedback with them. You probably have other thoughts in addition to those that I have written- in fact, I am sure that you do! And I would encourage you to share them with the network as well! Part of raising awareness and education is to advocate- and this is a very simple way to do that!

Staying Skinny Beats What??

A headline in August 12's USA Today caught my attention- Women: Staying Skinny Beats Sex. The first line of the article, written by Nanci Hellmich, reads, "For many women, weight control is more important than sex." The stats that back that up? Out of 1001 adults, 52% of women say they would prefer to go without sex for the summer than gain 10 pounds. Even more, according to this same research, more people would rather lose 10-20 pounds than receive a promotion at work!! That is crazy and sad but is a realistic indicator of what the majority of people in our culture value. [As a disclaimer, after hunting around to find out where these statistics came from, I found the answer to be a little self-serving--Nutrisystem!! For those of you who don't know, Nutrisystem is a diet company that is a contender in the billion dollar dieting industry in our country!]

Does anyone else see this drive for thinness as a problem? Why does being thin supercede other values in life, like career and love?! And why aren't we doing more to work on changing the unhealthy notions and beliefs about our weight and bodies? Why are magazines and media outlets making irresponsible comments and perpetuating eating disorder myths (check out one response to W Magazine here)? More education and awareness needs to be happening, and fast!! You can start today by educating yourself about eating disorders- the facts and the myths- by going to NEDA's website for more information! It is important to note that the media does not cause eating disorders. The media can pose a risk to someone who is genetically determined to develop an eating disorder, but it is not one thing that typically causes them. I would encourage you to think about what else can you do today to educate yourself (and others) and then raise awareness.. I would love to hear your ideas- you can post a comment or send me an email if you have any ideas!

NEDA Coach and Trainer Toolkits are Out! Part 2 : )

As I mentioned in my previous post, the NEDA Coach and Trainer Toolkits are out and available for downloading here. I would encourage you to check it out, pass the link or toolkit on to anyone you know who interacts with athletes, coaches, and the health/fitness industry. I had a chance to interview Nancy Matsumoto, who coordinated and wrote the toolkits. She co-authored The Parent's Guide to Eating Disorders with nutritionist Marcia Herrin. Find out more about Nancy and Marcia, and their book, by following this link. Below is the conclusion of my interview with Nancy which I originally posted a few months ago. Enjoy!

If you missed part 1 of Athletes and Eating Disorders, you can scroll down a little to read it, or you can click here! I had the honor of interviewing Nancy Matsumoto (co-author of The Parent's Guide to Eating Disorders and a free-lance writer in NYC--follow this link for more on Nancy!), who is working on completing Toolkits for NEDA (National Eating Disorders Association) that are geared towards coaches and trainers. Both disordered eating and eating disorders impact many athletes, and one of the ways to promote health amongst athletes is to educate coaches and trainers, who are in unique positions of influence to point athletes towards the proper treatment and care of their bodies. Nancy, in my previous post, mentioned a phenomenon called the Female Athlete Triad, that I wanted to expand on (courtesy of NEDA).

Below is NEDA's description of this term/phenomenon:

The Female Athlete Triad includes 1) disordered eating, 2) loss of menstrual periods and 3) osteoporosis (loss of calcium resulting in weak bones). The lack of nutrition resulting from disordered eating can cause the loss of several or more consecutive periods. This in turn leads to calcium and bone loss, putting the athlete at greatly increased risk for stress fractures of the bones. Each of these conditions is a medical concern. Together they create serious health risks that may be life-threatening. While any female athlete can develop the triad, adolescent girls are most at risk because of the active biological changes and growth spurts, peer and social pressures, and rapidly changing life circumstances that go along with the teenage years. Males may develop similar syndromes.

The Female Athlete Triad puts female athletes at risk, and also inhibits their athletic performance. I am glad Nancy mentioned this because it is something that not many people know about (even in the field of eating disorders!). Below are the last few questions/answers of my interview with Nancy- I hope that you will find this informative (like I have)!

Me: What are some things that you have been struck by or learned about eating disorders and athletes through this process?

Nancy: One thing I’ve learned about athletics and eating disorders is that for the coach, the line between encouraging athletes to achieve peak performance levels and promoting unhealthy eating and training behaviors is blurred. For this reason, when coaches and trainers, are told they need to be more vigilant in spotting and addressing dangerous behaviors it can sound to them like their ability to do their jobs is being questioned and curtailed. They want to create winning athletes, and the traits that create champions—perfectionism, the desire to please coaches, and strong drive to succeed—are those often associated with eating disorders. They may fear that in order to encourage healthier behaviors among their athletes, they will have to discourage the very traits that make their athletes excel. What we hope the Toolkit will do is show that the better nourished and healthier the athlete is, the better her or his performance will be, and that although eating-disordered behaviors may seem to improve performance in the short run, in the long run they do not support athletic excellence.

Me: For many elite athletes who are competing at world class levels (whether collegiately, professionally, in the Olympics, etc), particularly in sports that may encourage (implicitly or explicitly) a high degree of scrutiny over body composition and weight for performance purposes (gymnastics, ice skating, running, wrestling, etc), eating disorders and disordered eating are increasing. Do you have any thoughts about how we might work towards helping athletes approach their performance and bodies from a more healthy standpoint?

Nancy: Yes, education and support for both athletes and coaches is very important. Some coaches are still not fully aware of the risks for and dangers of eating disorders among their athletes. We hope that once they do understand the facts, they will be open to discussing these risks with the team, stop making negative comments about weight or size, establish a zero tolerance policy for eating disordered behaviors, and foster a climate in which an athlete feels she or he can discuss these issues without fear of reprisal. For athletes, it’s great to have a sports nutritionist speak to the team about the importance of adequate fueling and hydration in their sport, to go over the warning signs for problem eating and exercise behaviors, and to encourage them to seek help at the earliest signs of a problem.

A lot of these strategies are about de-stigmatizing eating disorders, making athletes understand that disordered eating and eating disorders are a common problem among athletes, and that they can and should be discussed. Athletes should also know where there is help available, and that these problems can be solved with the right professional treatment. In many athletic settings, lack of knowledge about eating problems creates a climate of fear among eating-disordered athletes that makes it very difficult for them to admit to this problem. This causes a lot of suffering in silence. All the recovered athletes I spoke to talked about the tremendous stress of having to perform while also sustaining their disorder in secret.

When the Toolkits are completed and available, I will be sure to post a link so that any of you who may be interested in passing this information on to a coach you know, an athlete that you know, or if you are a coach/athlete yourself that desires this information, that you will be able to access it! By raising more awareness and promoting education for coaches and trainers, we can hopefully provide more care and restore health to those who are suffering from eating disorders and disordered eating. For more information on eating disorders, follow this link to access the National Eating Disorders Association site.

NEDA Coach and Trainer Toolkits are Out! Part 1 : )

Not too long ago, I wrote a few posts on eating disorders and athletes. I had a chance to speak with Nancy Matsumoto, who coordinated and wrote the coach and trainer toolkits for NEDA, which are designed to educate coaches and trainers about eating disorders. According to Nancy, "One of the goals of the toolkit is to balance an understanding of the goals and methods of coaches and trainers with the perspective of the eating disorder professionals who treat affected athletes."

I wanted to re-post the interview, as well as provide a link for you to check out these toolkits. If you are an athlete, a coach, a trainer, or know anyone who is, I encourage you to send around the link so that they can access and download this information! One of the best parts? It's free!! : ) Find it here! Below is the first post on my athletes and eating disorders series (or check it out here)- I will be posting the second one tomorrow! Enjoy! And for more info on the toolkits, follow this link to check out Nancy's blog post about it here.

Just a few days ago, I was saddened to read about a 16 year old high school sophomore named Krista Phelps, who recently lost her battle to anorexia. A talented, high school athlete from Des Moines, Iowa, Phelps collapsed and died while running. Just a few days prior, she had been 'healthy' (according to this article-- which clearly she was not) and competing in her second state track meet. The community is grieving this devastating loss, and in the midst of their grief, some interesting questions about athletes and eating disorders are being raised. This is not a new topic of discussion- many athletes have come forward to share their experiences with eating disorders and disordered eating (read about Tanith Belbin's story here). An anonymous coach is quoted in this article about Phelps as saying "anyone who's coached girls sports long enough knows of at least one [girl who has had an eating disorder]."

There seems to be a very fine line among athletes who train to be as fit as possible to achieve their best performance, while also remaining healthy and taking good care of themselves. It seems to me that coaches are in a unique position to pick up on warning signs and act as a liason for their athletes who may be struggling with an eating disorder by directing them towards the proper treatment. The challenge is that many coaches do not know what to look out for, and do not always know how to handle such fragile and potentially life-threatening situations! For that reason, the National Eating Disorders Association (NEDA) has initated a project to make toolkits for trainers and coaches. Nancy Matsumoto, who co-authored The Parent's Guide to Eating Disorders and has written for publications such as People Magazine, The LA Times, The NY Times and The Wall Street Journal (among others), has been appointed to create these toolkits. I had a chance to ask her a little more about how she got involved and what NEDA is doing to help come alongside coaches to support athletes who struggle with eating disorders. In light of Krista Phelps tragic death, I think this is something that would benefit us all to hear.

Me: I have been excited to hear that you are working with NEDA to make toolkits for trainers and coaches to help educate them about eating disorders. I know that this is still a work in progress and is not yet available, but can you share a little bit about your involvement with this project?

Nancy: Sure! Through my work as a former People magazine correspondent and as co-author with Marcia on The Parent’s Guide to Eating Disorders, I have reported various articles on eating disorders and body image. NEDA asked me to bid on the job of Toolkit Coordinator for their newest online Toolkit for coaches and trainers, and I was lucky enough to be contracted to do the job. NEDA’s existing online Toolkits are the Parent Toolkit and the EducatorToolkit. I started working on the Toolkit in January. At the moment, the Advisory Committee, made up of about a dozen experts in the field, is reviewing the Toolkit. We hope it will be online in late spring or summer, and will be publicized at the NEDA conference in New York City in the fall. We are now brainstorming on ways to publicize the Toolkit, so you can definitely help with that by telling your readers about it. If you have other ideas of ways to publicize the Toolkit, please let me know!

Me: What kind of information is being provided to trainers and coaches in these toolkits, and what are the goals of such a project?

Nancy: The first sections of the Coaches Toolkit will provide basic information on the different eating disorders: anorexia, bulimia and EDNOS, binge-eating disorder and disordered eating. It will answer frequently asked questions and debunk common myths about eating disorders; detail factors that put athletes at risk for eating disorders (for example participating in a weight-class sport, such as crew or wrestling, aesthetic sports, such as gymnastics or figure skating, or endurance sports, cross country, Nordic track skiing); discuss eating disorder symptoms common to athletes, and the Female Athlete Triad (a syndrome of three interlocking symptoms, disordered eating, irregular periods and low bone mass). There will be sections on encouraging healthy exercise among athletes, the role of the coach in eating disorders, and prevention among middle and high school athletes. Oh, and there will also be athletes’ own stories and conversations with professionals: nutritionists, psychologists and coaches themselves. The goal is to reach out to, educate and offer support to coaches and trainers who are on the front lines of eating disorders, but often do not know how to recognize or handle the problem.

I think that Nancy highlighted very well an issue that is all too common- coaches and trainers, who are on the front lines, need education and support to properly handle athletes with eating disorders. To see what else Nancy had to say, check back here soon for the rest of her interview! And to find out a little bit more about Nancy, follow this link to view her website!

On 'Stigmatizing Health' and Orthorexia Nervosa

The Huffington Post is great at stirring up controversy with its opinion pieces. That's partly why I love it. It's a good (and fairly benign) forum for people to engage with different thoughts and think critically. What I don't love, though, is when people write things that are not accurate or informed. Case in point- the other day, someone wrote an article on orthorexia nervosa that was very misinformed. It's okay if people have differing opinions (based on empirical evidence) regarding how to effectively treat an eating disorder, or if people disagree on how we can improve and increase accessibility of treatment. What is tough though is when someone in a public forum, who has no psychological training, refutes the validity of a mental illness.

The article is HERE if you are interested in checking it out. Or, I can save you the four minutes and give you a brief synopsis. In all honesty, you might want to read it just to get a sense of her perspective, but Christina Pirello argues that orthorexia nervosa has been made up by psychologists and health professionals in order that the status quo is maintained, which essentially fuels an industry (pharmaceutical) created to profit from our unhealthy eating. She believes that healthy eaters should not be marginalized for choosing to eat healthily and that healthy eating does not equate with being mentally unstable. While I agree with her on that last part, I think the problem with her argument is that she really doesn't get that eating disorders are not a lifestyle choice, like healthy eating is. Eating disorders are a mental illness. Someone who suffers from an orthorexia is no more choosing to eat healthy than someone who suffers from bipolar disorder chooses to have a mood disorder.

Orthorexia nervosa is not just the desire to eat healthy. Orthorexia interferes with one's ability to live a normal, high functioning life due to the pursuit of eating only pure and healthy foods. This may mean avoiding work, family and social commitments or events to avoid having to eat anything that is not pure, raw or healthy. Orthorexia is also pathological in nature. This means that the disorder goes beyond someone's desire to adhere to healthy eating; there are negative consequences that result from the behavior. If someone is just eating healthily, that is not pathological! It is pathological though when this pursuit of healthy eating interferes with one's ability to lead a normal life. The preoccupation with healthy eating can become an interference in everyday activities, relationships and life. It also becomes pathological when one's health is compromised. Often, one who is orthorexic may avoid eating anything but fruits and veggies- the way that this can affect one's body can be detrimental. Your brain needs carbs to function properly (maybe Pirello needs some carbs!) and your body needs other essential nutrients that cannot be utilized from a handful of foods. While I can appreciate a perspective that is different than my own, my fear is that Pirello's perspective serves to further perpetuate myths about eating disorders. For more information on orthorexia nervosa, follow this link.

A Diet is a Diet is a Diet

Lately I've been ragging on celebrities- Kim Kardashian, Jennifer Love Hewitt, and now... Jessica Simpson. I've written about Jessica Simpson in the past (here and here) because she has been involved in many efforts to encourage women to examine what real beauty is, both through her show, Price of Beauty, and through her work with Operation Smile. She was also on Oprah a few months ago, sharing her thoughts about beauty, body image, and her renewed sense of self. At one point, she got teary-eyed and when Oprah asked her what she was feeling, she responded that she was frustrated by the pressure put on women by the media to be thin.

Well, this week, Simpson posted on twitter that she has started a strict vegan diet. While she later added that this diet has nothing to do with weight loss, and only has to do with being healthy, I was a little disappointed and surprised that after her campaign to focus on health, beauty and accepting her body, that she would publicly discuss her 'strict vegan diet' that she says 'shocked her system.' Because she has made body image and beauty her platform, it seems irresponsible of her to mention her latest fad restrictive vegan diet. Diets, as I have preached and preached about, are ineffective and BAD (why? find out here). If Simpson chooses to follow a vegan diet, that is her choice, but to announce that she has started a new diet puts the focus in the wrong place, whether this diet has to do with weight loss or not. Some may disagree with me, and that is ok! But I think that it would be better if she kept that information to herself, especially due to her history of engaging in fad and yo-yo diets and the ongoing scrutiny over her weight- as anyone hearing about her latest diet would naturally assume it has to do with weight loss (as all of her other diets have been in the past).

Our society is obsessed with dieting, who is eating what, losing weight fast, bodies, etc. It's tough to go onto facebook or twitter anymore without reading a status update or tweet about some kind of disordered behaviors/thoughts regarding food and exercise. I'm not calling anyone out here or thinking of certain people as I write this (well, maybe Jessica haha), but the more we call attention to these things, the more we are playing into the unhealthy dynamic created by the media. As much as Jessica Simpson has experienced criticism and pressure from the media, I would think that she would not want to perpetuate the focus and value on such things herself. I am afraid that by making a public point to share her latest diet plan, she is compromising the stance she has been trying to model with health and beauty. It's not that all of her progress and encouragement to women has been completely wasted and forgotten, but she is sending some pretty mixed messages. From here on out, it might be more helpful for her to refrain from promoting or discussing her current meal plan. And so should everyone else. We don't need a play by play via facebook or twitter about how many pounds you lost last week or how fat you feel or how intense your exercise routine is or how you can fit into your skinny jeans again. Food nourishes our bodies, it gives us energy and fuel to think well and be active. Let's keep the focus there and spend the rest of our energy, time and thoughts on things that matter more, like family, friends, our careers, and making the world a better place.

EDNOS

I have posted in the past (here) about 'eating disorders not otherwise specified' -- commonly referred to as EDNOS. As a diagnosis, EDNOS is not very specific-- if one does not meet the criteria for anorexia or bulimia, then he or she is lumped into the EDNOS diagnosis. In this way, it can sometimes be seen as the 'kitchen sink' diagnosis. This can be problematic for many reasons-- mainly, a single diagnosis used for people that experience a range of different behavioral symptoms (binge eating- no purging, purging- no bingeing, night eating, etc) is not necessarily effective when it comes to treating the eating disorder. There was an article published in the NY Times awhile back that I have been meaning to post that you can access by following this link which addresses this very issue. I would encourage you all to check this article out! It helps to bust a few common eating disorder myths and provides a little more background on EDNOS. For more info on EDNOS, follow this link.

Race For The Cure and Body Image

The Susan G. Komen Race For The Cure took place in Raleigh, NC this past Saturday, and it was such an inspiring event. It held special meaning for me, as I have a grandmother and an aunt who have both battled breast cancer-- and survived!!! My aunt was actually in town from Oregon for follow up care at Duke, and so we formed a group and all participated together in this event. I have heard that participating in a Komen race is very different than other races, and as a first time participant, I think I saw why. First, there were SOOO many people that participated. If you look at the picture below-- it is a little tough to make out-- but as far as you can see, there are people that fill up the streets.

The other thing that seemed different to me was the heart and spirit in this event. I think that most people participating had been touched in some way by breast cancer. While my grandma and aunt are survivors, not everyone wins their battle with breast cancer. One of my friends that participated on our team lost her mother to breast cancer. Many, many people have lost loved ones to this illness and it is really heartbreaking.

The picture below is actually a shot of a few of the women that were on our team-- "Breast of Friends" : ) and you will notice the hot pink paper on these women's backs. These hot pink sheets of paper served as memorials to write names of people that you were walking in celebration of (survival), or in memory of, for those who have passed away. It was really sobering and emotional to see all of the names of people who have lost their lives to this illness. I think anytime, with any illness or disease, seeing names or faces make an impact because it personalizes the illness. In talking to my aunt over the course of her visit to Raleigh, she shared with me that battling and surviving breast cancer has changed her life and the way that she lives it in so many ways. One thing that she said that stood out to me was that she is thankful every single morning when she wakes up and realizes how blessed she is to be alive, and to have a body that works and is healthy.
This really impacted me and made me consider how her wise words can be applied to those of us who have not battled breast cancer! First, I think that her attitude of thankfulness is one to be emulated. There are a million ways that having an attitude of gratefulness and thankfulness can impact us-- as well as those around us. Whether it means that we worry a little less, we appreciate what we have more, or take our eyes off of what we lack and what we wish we had and focus on what we do have, it is always good to have perspective, and to live in a way that reflects that attitude.

Secondly, I think that this relates to body image and the ways that we think of and care for our bodies. I want to be clear, like I am often, that eating disorders are a mental illness. Part of having an eating disorder (diagnostically) is experiencing a severe disturbance and preoccupation with one's weight, shape, size, body-- so this is in no way meant to minimize the severity and nature of these thoughts. What I will say though, is that for those of us who struggle with body image and have a negative self-image, this may be a good reminder and an encouragement about all that our bodies can do for us, and how blessed we are to have bodies that are able to function how they are supposed to, that allow us to be active, and that allow us to experience life! Yes, it may be upsetting when our jeans fit more snug; yes, it may get you down when you flip through a magazine and see nothing but airbrushed 'beauties'; and yes, it may be frustrating when you don't feel good about yourself! These are all feelings that most women have experienced before, so you are not alone! But I will encourage you with the words of my brave aunt, who said that she wakes up every morning, thankful to be alive and to have a body that works. Rather than focus so much on the way that our bodies look, maybe if we start to appreciate all that our bodies do for us, and the fact that they allow us to experience life, we may begin to embrace our bodies a little more and appreciate them for what they are and what they do for us.

Some of you may have heard about the t- shirt that Urban Outfitters recently pulled from their online catalogue after much hate mail was received. The shirt said 'Eat Less' and was featured on a waif-y model. It is hard to believe that they actually went there! But they did, and while it may have been to generate some publicity (tacky, much?), enough people protested that they thankfully took it off of their website. I also heard that the shirt has been pulled from stores--so hopefully that is true!

A couple of my therapist friends who I got to know while doing some contract work at the Carolina House brought an awesome article to my attention that I just have to share. Below is this article that was published in Durham's Independent Weekly newspaper and written by Rebekah L. Cowell (follow this link to see the article) about some local women who are in recovery and working towards exposing myths about eating disorders that this t-shirt's message was perpetuating.

Amy Lambert used to tell herself what Urban Outfitters is telling millions of other young women: Eat Less.

It wasn't unusual for Lambert, who had an eating disorder for more than eight years, to consume little more than one container of yogurt in a day. Now recovering, Lambert led a protest last week outside of Urban Outfitters at Southpoint mall in Durham.

Last week, Urban Outfitters placed in their online catalogue a gray V-neck T-shirt worn by a rail-like young woman. On the front, in script, the words "Eat Less."

"Urban Outfitters targets a young demographic, and they are reinforcing the idea that eating disorders are a choice, not an illness," she said.

Four other women from a Durham Eating Disorder Support Group joined the peaceful protest, brandishing signs that read, "Messages Can Re-Enforce Deadly Beliefs" and distributing fliers titled "Messages in Media: 'Eat Less' is Humor That's Not Funny."

Mall security shut down the protest 30 minutes later.

"We want to make it a friendly family environment," said Public Safety Officer Sellers, who refused to disclose her first name. "We can't just have people here doing that [protesting and handing out literature]."

Urban Outfitters did not return the Indy's calls or e-mails regarding the ad campaign, but after national outcry the T-shirt was removed from the chain's website, though the shirts that have already been shipped will be in stores. When the Indy visited the store and asked for the T-shirt, it was not on the sales floor. An employee who didn't want to be named called the slogan "harsh."

At least 24 million Americans suffer from eating disorders, which have the highest mortality rate of any mental illness. Twenty percent of people with an eating disorder will die prematurely from complications related to their disease. Telling an individual with an eating disorder to "eat less" aggravates emotional, psychological and physical issues. And for those still stuck in dangerous patterns, it is a message of validation, says Chase Bannister, clinical director for Carolina House.

In fact, the T-shirt has been posted on "pro-anorexia" sites as a source of "thinspiration."

"The banner-statement 'Eat Less' can be a stinging trigger for women and men with anorexia, bulimia or binge-eating disorder," Bannister added, "ultimately providing reinforcement for the distorted belief our patients work so hard to stamp out: 'I will never be okay unless I'm thin.'

The women said by holding the protest, they sought to empower themselves and spread a message of acceptance for a healthy body. Sandy Yarnall had anorexia for more than half of her life. She finally received treatment in 2008. "I struggle every day with wanting to go back to a very unhealthy size, and where I was before recovery, and seeing that message did distress me."

Rebecca Clemins has had an eating disorder for 25 years. "Urban Outfitters put this tee on a waif-like model, which enforces the idea that being waif-like is preferred, and they are encouraging a lifestyle that is killing young women," she said.

"I can't imagine endorsing something that creates so much misery," said Carson Hadley, who developed her eating disorder in eighth grade. She had to drop out of high school during her senior year to get in-patient treatment at Carolina House. "That shirt reminded of what I can't be if I want to live."

I am so proud of the women who participated in this protest, shared their stories, fought to raise awareness and exposed myths about eating disorders. This can certainly be an inspiring act for those with eating disorders who are working towards health to see- that not only is recovery very possible, but that it can also be empowering to take a stand and work towards educating people about the truth about eating disorders.