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Eating Disorders

The Dangers of Dieting

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Dieting and Eating DisordersIt’s National Eating Disorders Awareness Week, and this year’s theme, “I Had No Idea,” focuses on raising awareness about the possible triggers and warning signs of eating disorders. Being able to recognize these signs, symptoms, and contributing factors makes early intervention possible and can prevent a full-blown eating disorder from developing. Early detection and intervention also increases the chances of full recovery.

According to the National Eating Disorders Association (NEDA) website, 20 million women and 10 million men in the United States will suffer from a clinical eating disorder such anorexia nervosa, bulimia nervosa, binge eating disorder, or an eating disorder not otherwise specified (EDNOS) at some point in their life. In addition, there are many who struggle with disordered eating – unhealthy eating behaviors that do not meet the full diagnostic criteria for an eating disorder, but still have detrimental physical and psychological consequences.

Many factors, both genetic and environmental, can contribute to the development of an eating disorder. Although we can’t do much about our genetics, there are risk factors we can control. I’d like to focus on one of the common catalysts for an eating disorder that is completely preventable – dieting.

Most people embark on a diet with good intentions, hoping to feel better in some way. No one goes on a diet thinking, “This diet won’t work,” or “This diet will damage my health.” But diets don’t work. Research shows us that diets rarely result in long-term weight loss and are actually associated with weight gain.

Diets are more than just ineffective – they can be harmful. As the graphic above shows, 35% of “normal dieters” progress to disordered eating, and of those, 20-25% will develop a partial or full-blown eating disorder. Although it is possible to change eating habits in a healthy, sustainable way, too often what starts as a seemingly reasonable diet plan, morphs into an unhealthy obsession. The hyper-focus on weight loss and/or eating perfectly begins to interfere with daily activities and negatively impact health and quality of life.

Here are some warning signs that your diet may have crossed the line from healthy to harmful:

  • Avoiding social situations that involve food
  • Feeling overwhelmed when unexpected changes occur with your food plan
  • Thinking about food all day (especially the foods that you don’t allow yourself to eat)
  • Ignoring your body’s signals of hunger
  • Feeling constantly deprived and unsatisfied
  • Feeling shaky, weak, fatigued, or irritable
  • Exercising in a punishing way to burn off what you ate or burn X number of calories
  • Frequent worry and anxiety about food
  • Feelings of guilt, disgust, or shame about eating
  • Hair loss, cold intolerance, irregular or absent menstrual cycles, lightheadedness, fainting, excessive weight loss, or digestive problems

If you are experiencing any of these signs and symptoms or are otherwise concerned about your eating habits or feelings about food, consult with a professional – the sooner the better. There is hope. Eating disorders are preventable and treatable. I have the honor of working with courageous men and women every day as they fight against their eating disorders to reclaim their lives. The process can be challenging at times, but the rewards are infinite.

For more information and resources, visit: nedawareness.org

All statistics quoted in this blog, can be found here.

Healthy Holiday Tips

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Healthy Holiday TipsWith Thanksgiving behind us, Hanukkah this week, and Christmas and New Year’s still to come, there’s no denying that the holidays are here. Are you enjoying the holiday season? Or are you feeling more stressed and overwhelmed than joyful? If you are feeling challenged by the food, festivities, or expectations of the season, here are some tips to help:

5 Tips to Survive and Thrive this Holiday Season 

1. Watch out for “all or nothing” thinking. Labeling your foods or eating habits as good or bad will set you up for frustration and disappointment, especially during the holiday season. Strive to embrace moderation. Then, eating one holiday cookie won’t lead to eating an entire tray because you feel like you already “blew it.”

2. Have a plan, but be flexible. Planning out your meals and snacks and anticipating and strategizing for challenges can be extremely helpful during the holiday season. But, try to build some flexibility into your plan so that unexpected changes don’t derail you.

3. Redefine healthy eating. It is not healthy to completely avoid holiday treats, to mindlessly overindulge in them, or to use them as a coping mechanism. It is healthy to give yourself permission to savor and enjoy your favorite foods, while remaining mindful of your hunger, fullness, and satisfaction cues.

4. Make self-care a priority. Make time to get groceries and cook meals so you can nourish yourself with healthy, enjoyable foods. Schedule time to exercise, plan some down-time, and try not to skimp on sleep. Use non-food strategies to deal with stress and emotions. Keep your regular appointments with your treatment team and ask for additional support if you need it.

5. Shift your focus away from food and weight. Instead, try to focus on family, friends, fun holiday activities, and the true meaning of the season.

Need more holiday tips? Check out my “Healthy Holiday Meal Tips” article in the ms nutrition Newsletter. Don’t want to miss out on future newsletters? Subscribe here! 

The list of tips in this blog post was adapted from a Holiday Workshop that I co-led with Allison Jupiter, LCSW.

Let’s Put an End to Weight Stigma

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Weight StigmaToday is day three of the 4th Annual Weight Stigma Awareness Week, hosted by the Binge Eating Disorder Association (BEDA). According to the Merriam-Webster dictionary, a stigma is “a set of negative and often unfair beliefs that a society or group of people have about something.” In the case of weight stigma, the unfair beliefs are based on a person’s weight, shape, and/or size.

Sadly, weight based stereotyping is pervasive in our society and seems to be a socially acceptable form of prejudice. From the media to the schoolyard to the workplace, children and adults are judged everyday based solely on their size. For example, a person of larger size than what our society considers acceptable may be perceived as lazy or lacking discipline. A thin person may be wrongly labeled as having an eating disorder.

Verbal abuse, bullying, and discrimination are common manifestations of weight stigma. Whether the consequences are subtle or overt, weight stigma can negatively impact all aspects of a targeted person’s life, including their self esteem, interpersonal relationships, education, employment, and healthcare.

One way to begin combating weight stigma is to challenge our own misconceptions.

Wonder if you might hold any weight biases? Ask yourself these questions:

1. A thin person is healthier than an overweight person. TRUE or FALSE? 

2. Weight loss is always a positive outcome. TRUE or FALSE?

3. If a person feels bad enough about their weight, they will be motivated to change it. TRUE or FALSE?

If you answered FALSE to all the questions, you are correct. If not, here is the truth:

1. Thin does not always mean healthy. Think about a thin individual who chain smokes, eats fast food daily, and doesn’t exercise. Would that person be healthier than someone with a BMI in the overweight range that doesn’t smoke, follows a healthy diet, and exercises five times a week?

2. Although weight loss as a consequence of adopting healthier behaviors may be positive, weight loss by any means is not healthy. In fact, many methods of weight control are anything but healthy.

3. Shaming people about their weight actually increases the risk of obesity and eating disorders.

To learn more about weight stigma, check out some of the Weight Stigma Awareness Week tools and resources on the BEDA website.

Musings on J.Crew and the New Size 000

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J.Crew Launches Size 000J.Crew has been heavily criticized since announcing the launch of their new women’s size 000, equivalent to an XXXS. A J.Crew spokesperson (as reported on today.com), defended the new size, saying it was launched to meet the demand for smaller sizes in Asia. The need for a triple zero is a direct result of J.Crew’s practice of vanity sizing, although the company is not exactly admitting it (only saying their sizes “run big”).

As the average weight of American adults has steadily increased over the last five decades, retailers have had to offer increasingly larger sizes to match this trend. But instead of just adding larger numbered sizes, J.Crew and other manufacturers have adjusted sizes downward. A size 12 may be labeled as an 8, an 8 becomes a size 4, and so on. With no real standards for clothing sizes, this practice, known as vanity sizing, has easily become the norm.

From petite to plus size, we all deserve to have stylish clothes that fit us well

Perhaps an unintended consequence of this practice is that women who were wearing a size 2 or 4 a decade ago have basically been vanity-sized out of adult clothing options. If the addition of size 000 is really about meeting the demand for smaller sizes, and their sizes already “run big,” why not adjust the sizes upward and add a size 22 or 24? J.Crew’s triple zero addition implies that there is something wrong with larger sizes – a fallacy worth taking a stand against.

Even the term “vanity sizing” is infuriating. It implies that the smaller the number on the tag, the better we feel about ourselves, making it more likely that we will buy. Do clothing manufacturers think we want to be lied to? Do they think we can’t be trusted to buy the clothes that fit us best just because we may not like the size on the tag?

Public Outcry

Since the launch of the new size, responses have ranged from blaming J. Crew for giving women eating disorders to contempt for those women who will fit in the new size. Blaming J.Crew for causing eating disorders oversimplifies these complex psychological disorders and is misguided. The harshness directed at women who may benefit from the addition of the new smaller size is downright wrong.

The recent criticism of J.Crew has also brought necessary attention and scrutiny to the practice of vanity sizing. I am not in favor of deceit, particularly for the purpose of monetary gain. Many women I know, including myself, would much prefer consistency in clothing sizes. I would love to walk into a store and know my size without having to try on 10 pairs of pants to figure out what to buy.

Vanity sizing needs to be addressed before negative number clothing sizes begin showing up in stores, but unfortunately the practice is probably not going anywhere any time soon. So what can we do?

Let’s start by not giving clothing companies the power to determine how we feel about ourselves

So many women today are unhappy with their bodies. Do I think that the unrealistic images that are portrayed in magazines and on runways contribute to our discontent? Yes. Do I think that we will all magically feel better about ourselves if that someday changes? No. Any validation that we feel when we see a certain number on the scale or fit into a certain clothing size is fleeting. Our sense of self-worth is much deeper than that. And it is up to us, not the clothing companies or fashion industry, to build and nurture our self esteem and confidence.

I have at least five different sizes of pants hanging in my closet that all currently fit me. Am I a better, more attractive person on the days that I wear my smaller-sized pants? I am not going to let a completely arbitrary number like my clothing size determine my self worth.

Whether we are inclined to direct judgment towards ourselves or others based on body shape and size, it helps to remember that the size you wear says nothing about who you are as a person. Just because a woman fits into a size 000 does not mean she has an eating disorder. And a woman wearing a plus size is not necessarily unhealthy or any other negative stereotype associated with larger sizes.

The triple zero controversy has people riled up, and some of the backlash aimed at J.Crew is warranted. But I prefer to focus my energy on reminding myself how powerful compassion and acceptance towards ourselves and others can be. I pledge to celebrate the things I love about myself and my body, regardless of the number printed on my clothing tags. Who’s with me?