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!

Update: Another Pro-Ana Slogan, Snack Factory?! Really?

If you didn't get a chance to check out my last post, scroll down and check it out... The Snack Factory, a company based out of San Francisco that makes different snack foods, recently began an ad campaign for their pretzel thin pretzel snacks by using a pro-anorexic advertisement. As you can see from the ad that is pictured in the post below (or you can click here to view it), this was a very offensive ad and the Snack Factory agreed to take it down. Well, believe it or not, this image to the left is what they replaced it with... "Tastes as good as skinny feels." Umm.... Hello!!! How is this any better than the previous one?? Are they just really that clueless or do they not care what the ad communicates?

I am going to give them the benefit of the doubt and assume that they are just really ignorant- but I think this again just highlights the need for a) more education and information to the general public about eating disorders and b) the need for continued advocacy and awareness being raised which may eventually help to change things like this that we see and encounter from day to day. It doesn't mean grand gestures. Maybe it means reading up on eating disorders (follow this link for great info on the NEDA site), encouraging your friends (and yourself!) to avoid fat talk, or maybe you point out myths about eating disorders when you have the opportunity! No matter what you do, there is nothing too small to help raise awareness. Every little bit counts.

I'm not sure if these ads are still up; I have not been able to find anything more on whether the Snack Factory pulled them or not. Hopefully they did. Please feel free to contact them and tell you how you feel about their ads if you are so inclined. Here is the link to their website and contact info!

Think Before You Advertise

Just a few weeks/months ago, there was controversy surrounding a t-shirt that Urban Outfitters was selling on their website and in stores. It said "Eat Less." [I wrote a post about it that you can check out here.] Since then, the shirt has been pulled from stores as well as from the UO website. It just boggles my mind when a company endorses an idea like this- it really makes me wonder who signed off on this, thinking it was a good idea!!

Well, the Snack Factory, a snack company based out of San Francisco, is marketing their new pretzel thin pretzel snacks and has stirred up quite a controversy over their choice of creative advertising. The picture above is the ad, and while I try to avoid using triggering images, I thought that this image was relatively safe- and important to show! So, here is the Snack Factory's idea of clever advertising. Too bad their advertising campaign comes at the expense of millions of young women and men who struggle with this very lie that 'you can never be too thin'. In response, people in New York City have been covering these ads with pictures of emaciated women, and the phrase, "Actually, you can [be too thin]." The Snack Factory responded to complaints via Twitter by saying that they are "using the word ‘thin’ in a creative way to describe our product," and that people "seem to be interpreting it in their own way... we're a thin pretzel cracker!"

I get that they thought they were being cute and creative, but that does not make it appropriate or okay. When you choose to promote a pro-eating disorder belief as your advertising campaign, you have to take responsibility for it. Thankfully, the VP of marketing for the Snack Factory has heard the public outrage and is responding by pulling the pictures and ads. This is another reminder that speaking out makes a difference, and that we can truly make an impact! This is also a good reminder that more education about eating disorders is needed, and that we need to continue to bust the myths about eating disorders so things like this will become less frequent.

Scouts Honor

I don't really have many regrets in my life- but one that I do have is that I was never a Girl Scout. Ok, that's kind of a joke- but I was a Campfire Girl :). Based on the name, you might have a good idea of what kind of group this was- an outdoorsy, camping group for young girls (similar to the Girl Scouts, just more focused on camping and outdoor activities). The funniest part about this is that I asked if I could be a Campfire Girl. For those of you who know me, this is pretty laughable. I love sunshine and being outside, but I'm not exactly the prototypical nature lover and I wasn't really what you would call an outdoorsy child. When the Campfire Girls used to have camping outings, I used to ask my parents to pick me up so I could go home and sleep in my own bed, and then drop me off back at the campsite in the morning so that I could sit around the bonfire in the morning with everyone else. How terrible is that?! Haha. Now that I look back, I'm thinking there was probably a better group for me. Perhaps the Girl Scouts? : )

The Girl Scouts have recently launched a new initiative to help boost girls' self-esteem. I have been so impressed with The Girl Scout organization- they have done SO much for young girls and have really invested a lot into nurturing the self-esteem and confidence of girls all across the US. Their mission: To build girls of courage, confidence, and character, who make the world a better place. Their new campaign, 'The Changing Face of Fashion' is based upon research that they conducted. They found that in spite of girls knowing that the fashion industry's ideals of beauty are unattainable and unrealistic, 89% of them still wanted to adhere to those standards!! As a result, the Girl Scouts hired four plus-size models and had them share their stories in a series of online videos about self-esteem and body image.

I really, really applaud the Girl Scout organization for using research and targeting a specific need of young women. I wonder though if there is a way for them to address this issue without the use of models? I wonder what it would be like for these young women to hear real women share their struggles with body image and self-esteem, and the impact that the fashion industry has had on them and how they have dealt with it and are dealing with it. I watched some of these videos (check them out here) and I wonder if these plus-size models (who are likely size 10's) do anything to help dispel these beliefs held by young women. I don't know that I have a better suggestion, but what I do know is that using the flawed modeling/fashion industry as a way to combat the irrational beliefs often perpetuated by the industry just seems a little confusing and backwards. I think at this point though, it is great just to get young girls to consider that beauty comes in all different sizes and shapes and colors. And it seems like that is what the Girl Scouts are doing! To check out more about the Girl Scouts and what they are doing, follow this link.

One Woman's Thoughts on Barbie...

I grew up playing with Barbies- cutting their hair, putting real make-up on them, and dressing them up in all kinds of crazy outfits. I actually used to force my brother to play Barbies with me sometimes when we were little and we would argue over who got to drive the Barbie corvette or the Barbie volvo- sorry Jonathan to out you like this. I was a bossy kid and I didn't like playing Barbies by myself! : ) Because of my history of playing with Barbies as a kid, I wouldn't say that I am a hater. But I would by no means say that I am a fan. The sort of global impact that Barbie has had on the self-esteems and body images of women everywhere is not to be overlooked. Let's just take a minute and look at the following facts about Barbie..

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

While statistics vary depending on which source you use, Barbie's dimensions (if she were alive) would be somewhere around the following- she would be 6 feet tall, 100 lbs., and wearing a size 4. Her measurements would be 39"/19"/33" and as a result would have to walk on all fours because her body's dimensions would not allow her to stand upright (Statistics taken from Eating Disorders Info and ANRED).

Does playing with Barbies cause eating disorders? No way. If that were the case, we'd all have developed eating disorders. But I believe that the way in which we view our bodies and beauty has probably been shaped by Barbie, a pop cultural icon, in some capacity. Interestingly enough, the story of how Barbie came to be might surprise you. It really surprised me. Dr. Susan Albers who has written some great books on mindful eating wrote a piece in the Huffington Post recently entitled "Why I Don't Hate Barbie Anymore." She shares about the life of Ruth Handler, the woman who created Barbie. Handler, the youngest of her 10 siblings, was raised by her eldest sister. She wanted to make something of herself and be successful in spite of the odds and circumstances stacked against her. Handler found worth, value and self-esteem in her work. She even went on to create prosthetics for breast cancer survivors who had lost their breasts to cancer- sadly, she was one of these women.

This article (as well as the book written about Handler's life) provides some very interesting context and thoughts on Barbie, her legacy and the woman behind the doll, as well as a GREAT message on self-esteem and where we each find our value. I would really encourage you to check it out (here!). Let me be clear- in the words of Dr. Albers- "Barbie's negative symbolism and impact on body image clearly overshadows the rest of this story." I can't do this piece justice in my description of it, so I would encourage you to read it for yourself (here). I know I am always encouraging you all to check out different articles, but if you read just one, read this one! What a great reminder that our value and worth as people come from more than our achievements and 'success.'

My Blog Is Getting a Makeover!!

Hi friends! My blog is undergoing a little bit of a makeover : ). I may be changing it around a little bit in the next few weeks before I decide on something, so bear with me as I continue to make some changes! Thanks so much for reading. I love all of your feedback- if any of you have any suggestions or topics that you would like to see on my blog, please let me know! You can email me at MeredithStokkeNCC@gmail.com. Thanks!

Project HEAL Q&A- Part Two

If you haven't had a chance to check out the first part of my interview with Project HEAL founders Liana Rosenman, Kristina Saffran, and Becky Allen, scroll down to my previous post or click here! These three teenagers are working hard to raise awareness about eating disorders, and they are also working hard to help people pay for their treatment by holding fundraisers and events. They have taken their own personal struggles with eating disorders and have used their experiences to give back and to help others. It sounds like this has been a helpful part of their own recovery! For the conclusion of my interview, continue reading below.

Me: What has this experience of giving back and helping others been like for you?

PH: It has been absolutely amazing! It is so rewarding to be able to speak with [our scholarship applicants] now and hear how our funding helped them regain their lives.

Our work with Project HEAL has also motivated us to stay strong and to remain fully recovered. We would never want to stand up in front of [people] presenting ourselves as people who we are not. We strive to be role models who are trying to recover and [role models] for everyone else dealing with body image issues. We would not want to be hypocritical.

4- If someone were interested in getting involved or donating to Project HEAL, what might you suggest they do? What opportunities exist to help?

If anyone would like to become involved with Project HEAL he or she should definitely contact us! We are interested in starting local chapters of Project HEAL at high schools and colleges. The main responsibility of the club would be to hold fundraising events including, but not limited to, bake sales, car washes, and the sale of Project HEAL merchandise. We would also encourage the club to hold regular meetings to discuss positive body image, self esteem, depression, etc. and to educate the younger grades on eating disorders. If someone would like to donate to Project HEAL or purchase Project HEAL merchandise, he or she is able to do so through our website. We also encourage everyone to look out for upcoming events on our website.

5- I work with a lot of young girls who have eating disorders, who struggle with the motivation to recover. I noticed a quote on your site: "We hope that people will be able to come to the same realization we have (without dealing with an eating disorder first!): We only live once so we must live it right. It is so much more fun to enjoy going out for ice cream with friends than to go running by yourself as punishment for eating an apple. Life really is worth living!" Having been there yourselves, what might you say to a peer, or a teenage girl, who is struggling?

In our opinion there are three key aspects to recovery:

1) Don't be afraid to admit you are struggling and need help -- Everyone deals with adversity. What truly separates us from one another is how we deal with that adversity; whether we let our adversity overcome us or whether we choose to overcome our adversity.

2) Remember that the physical weight gain almost always comes before one is actually comfortable with his or her body -- In the beginning food is like medicine. It is something our bodies need whether we want it or not. After (and during) weight restoration, we can work on our mentality- how we view ourselves. However, it is important to trust your treatment team. You may think you look overweight because mentally you are struggling. Trust your treatment team when they tell you that you are still too underweight. They are here to help, not harm, you.

3) Find a passion -- An eating disorder becomes one's identity. It consumes an individual and masks who he or she truly is. Thus, we encourage eating disorder sufferers to find something they love and to pursue that thing. Don't be afraid to try new activities no matter how old you are. Discover what you love, who you are. This will enable an individual to develop a new, healthy identity.

It is important to note that these young women are not trained therapists, but are women who have gone through their own personal struggles and are working to use their experiences to help others. If you are interested in finding out more about Project HEAL, follow this link to view their website. There are many ways to get involved- you can participate in a fundraising event, start a local chapter at your high school or college, you can donate money, or purchase merchandise from their site-- proceeds go towards scholarshipping individuals into treatment for an eating disorder. If you have any questions about Project HEAL, or would like to get more involved, you can contact them directly- their contact information is on their site, and is located here. A big thanks to the girls for all that they are doing to raise awareness and make a difference!!!

Project HEAL Q & A- Part One

A few posts ago, I wrote about the EDC- the Eating Disorder Coalition. The EDC is focused on "research, policy and action"-- working to promote systemic change and allocating funds in order that people suffering from eating disorders will have access to the care that they need! One of the many reasons that this is important is that currently, treatment for eating disorders is not very affordable for the average US resident. Residential treatment can cost more than $1000 per day; as most treatment centers admit patients for a minimum of 30-45 days, treatment can end up costing someone more than double the cost of a college education. Money can be a very limiting factor for people who need and want to be treated! For this reason, in addition to many others, I was very impressed by Project HEAL when I learned what this non-profit organization was doing.

Project HEAL made a very strong impression on me when I first heard about the work that they were doing to help people suffering from eating disorders. I saw a story on ABC News a few months ago about a young girl who was suffering from an eating disorder and could not afford treatment. Project HEAL came alongside her family and paid for her treatment. I was interested in finding out more about Project HEAL, so I used one of my favorite resources- google:).

Project HEAL (Help to Eat, Accept and Live) is made up of three young women- Liana Rosenman, Kristina Saffran, and Becky Allen- who are working to raise awareness about eating disorders, as well as raise funds to provide scholarships to individuals who need treatment. I wanted to find out a little bit more about the girls behind the group, what they are doing to raise awareness about eating disorders, and how we can support them in their efforts. As it turns out, they are three amazing young women who are striving to use their personal experiences with eating disorders to help others in their struggles. Here is the first part of my conversation with them.

Me: So, how did you all meet and what inspired you to come together and create Project HEAL?

PJ: It's actually a funny story. Liana was in Long Island Jewish Eating Disorder Treatment Center when Becky was there. When Becky was discharged she was there with Kristina. She kept in touch with both of them after her treatment there as they were a huge support system! About a year later she and Becky decided to have an "LIJ Halloween Reunion". We invited the people we were in treatment with, roughly about 20 girls, but it ended up just being the three of us. Since then our bond has only grown.

Becky originated the idea for Project HEAL. She was at a healthy weight and far along the road to recovery. Mentally, she was pretty strong, but once in a while would still look in the mirror and question whether she truly looked good. The idea was a very "spur of the moment" type thing. One night she was thinking, "Life shouldn't be like this. People shouldn't be so overly focused on their physical appearances." That, combined with witnessing people being turned away from treatment because their insurance would not cover them and their parents could not afford to pay out of pocket, led her to develop the idea for Project HEAL. After outlining its goals -- to raise money for eating disorder sufferers who otherwise would not be able to afford treatment and to educate the public on the dangers of eating disorders -- she called Liana and Kristina to see if they would be interested in jump starting this organization with her.

Me: I noticed on your website that you all have been able to give out four scholarships for treatment- that is really remarkable!!! What are some of your hopes and dreams for Project HEAL? What are some things that you all want to see happen as a result of your dedication and hard work? I saw Liana's interview on CBS and thought the benefit concert was a great idea!!

PH: Project HEAL's long term dream is to open a treatment center! We have so many ideas, from how [each] day [in treatment] is planned, what food will be served, and even the design of it! We are hoping to spread our message even further. We want to help as many people as we can! Project HEAL sends approximately two applicants to treatment a year. We hope we can raise this amount. We are looking to begin planning a benefit concert in the near future! We have been in touch with Jessica Simpson, and are hoping this will work out!

Our most immediate goal is to open chapters of Project HEAL at high schools and colleges. The idea would be for the students in these chapters to fundraise for Project HEAL and to educate their peers on the dangers of eating disorders.

To read the rest of the interview and hear about how you can get involved, check back soon!

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.

Update on EDC and Michelle Obama

Here is some encouraging and exciting news. If you didn't see my last post, scroll down real quick and skim it- it's pretty short. But I just wanted to follow up because Michelle Obama has listened to the concerns that people have had about her focus on childhood obesity and acknowledged that "The flip side to obesity can be eating disorders and we certainly don't want to enforce the reverse trend," she said. "The campaign 'Let's Move' is not about how our kids look. It's really about how our kids feel and our health." This is good news for all of us. Health and how we all feel is important, and I am glad that she is taking that into consideration as she moves forward with her Let's Move Campaign. She also encouraged parents not to focus on weight, or to talk about weight loss, but rather to focus on the overall picture of health. It is great to see that there has been a bit of a shift in her message. And, it also provides us with a reminder that speaking up can make a difference! To see how you can make a difference, follow this link.