Treatment Notes by Sari Fine Shepphird

A Quick Media Quiz...

2011-05-06T12:37:10-07:00

Do you watch any television? How about magazines, do you read them? Ever ridden the bus and noticed ad signs inside? When you drive in a car, do you notice billboards pass by? Sometimes I stroll through the mall, what about you? Do you notice ads in the display windows?

How many ads do you think the average person sees on an average day? From t-shirts that passers-by wear on their way, to ads on hats, shoes, and bumper stickers, plus all of the above sources...

The average person sees 3,000 ads every day, yep, on average that's true. And a full one-third of those ads directly speak to beauty and appearance (Source: National Eating Disorders Association).

But do these ads make an impact or stay in one's mind and memory?

Let's see...here's a quick quiz. See how many of these slogans come right back to you...

1. Slogan: You deserve a _____ today.

lunch
vacation
break
smooth shave

2. Slogan: There's always room for _____ .

Heinz
Volkswagon
Smuckers
Jell-O

3. Three frogs on lilli pads quip about which beer...

Coors Light
Michelob
Miller
Budweiser

4. Get the Sensation is the slogan for which candy bar?

York Peppermint Patty
Three Musketeers
Hershey's Kisses
Snickers

5. What did ("Please -- Don't Squeeze the Charmin!") Mr. Whipple wear?

long tie
bow tie
string tie
no tie

Other product slogans: Guess the Product...

Slogan: "Plop, plop, fizz, fizz, oh what a relief it is: _______________

Slogan: "It takes a licking but keeps on ticking" _____________

Slogan: "Gee, your hair smells _____________"

Slogan: "The incredible, edible ____________"

Next: What question does the glasses-wearing Verizon ad guy keep repeating over and over?

Next: Juan Valdez is the spokesman for which kind of coffee?

Next: Which name-brand laundry detergent box is orange? Which one is blue?

Get the point?

How about these ads?

Who is the spokes-person for Nutra-System? Who's is the spokesperson for Weight Watchers?

Which fitness chain uses the colors red and black in all of their ads and signage?

Name 3 former and recent spokespeople for Jenny Craig? Of these, which has notably gained back the weight that was lost?

Easy to recall, isn't it?

These ads, like all the rest, make an impact on our memories and minds.

Now let me ask you, name a spokesperson for health-at-every size, or someone who is noted for not giving into the pressure to diet or keep up with the thin ideal OR talk about their battle with weight?

Now name at least two others....

A little harder to do, isn't it?

Now, name an ad for a food-related product that is geared specifically for health, APART from weight loss and absent from the idea that the food is "decadent or indulgent"...

How about this. Name a famous person of at above average size who has NOT been scrutinized at all by the media for their weight....

Interesting, isn't it, what a quiz can show us about media influence. The impact, the reflex in our thinking, the automatic associations...

Share this with a friend, or share your own ads that you notice have had an impact on our collective culture...

Creative Ways of Expressing Feelings in Recovery

2011-04-29T15:25:37-07:00

In my last post, we talked about the importance of identifying feelings for recovery from eating disorders. So, you have identified what you are feeling...now what? Expressing one's feelings is just as important as identifying them. One new resource may just be able to help...

Finding Your Voice through Creativity: The Art and Journaling Workbook for Disordered Eating by Mindy Jacobson-Levy and Maureen Foy-Tornay provides some excellent exercises for identifying and expressing emotions throughout recovery. For example, the authors offer a "yucky feelings inventory" and suggestions for "disposing of your feelings" and also ways to identify "where your feelings may be stored in your body". Journal entries, drawings, and creative exercises help readers express their feelings in new and helpful ways.

Another resource that I have recommended in the past but is more than worth drawing attention to again is "The Food and Feelings Workbook" by psychotherapist Karen Koenig. I have recommended this resource time and time again to those who would benefit from making a greater connection between their feelings and their disordered eating symptoms, and I'll do so again today!

Identifying feelings for recovery

2011-04-21T11:45:51-07:00

Having trouble connecting to your feelings? Do you find it difficult to identify what you feel? Maybe you know that you are upset, but you can't say why - is it anger, fear, or anxiety?

If so, you are not alone. Studies and clinical data show that people with eating disorders often have difficulty identifying and expressing their feelings. Sometimes it's for fear of the feelings being too intense of unmanageable. Sometimes it's because a person is simply not practiced in being able to identify feelings. Some people have become so used to suppressing or ignoring or denying their own feelings that they have lost touch with how to label and express them. Still for others, the inability to express and identify emotions is some strong that it meets the criteria for a condition called Alexithymia, a symptom seen in up to 40-nearly 70% of all eating disorder patients. Alexithymia is not the same thing as denying emotions, simply an inability to find the right words to describe them.

If you have difficulty identifying or expressing your emotions, or if you frequently have the sense that you can't put your finger on what it is that you are experiencing or a sensation that you are having, try using a list of feeling words to help you.

Feeling words can help to prompt a person to be better able to label their emotions or describe their physical sensations that may in fact be the result of emotions they are experiencing but cannot identify.

For some sample lists, here is a useful website, as well as a download-able PDF...

Feeling words: http://www.psychpage.com/learning/library/assess/feelings.html

PDF of feeling words: http://childrenscenter.sa.ucsb.edu/CMSMedia/Documents/ParentSupport/FeelingWords.pdf

For more information about Alexithymia, see my book, 100 Questions and Answers about Anorexia Nervosa

More about Adult Eating Disorders

2011-03-31T15:11:00-07:00

Did you see the article in this week's New York Times? For some time now, we have been talking about the rise of eating disorders in adults, and now the New York Times has caught on...

As the article states, Judith Shaw is a 58-year-old yoga instructor in St. Louis, Ms. Shaw says she was nearing 40 when she decided to “get healthy” after having children. Soon, diet and exercise became an obsession.

“I was looking for something to validate myself,” she told me. “Somehow, the weight loss, and getting harder and firmer and trimmer and fitter, and then getting recognized for that, was fulfilling a need.”

She is one of the now countless thousands who continue to strive for bodily-perfection and develop an eating disorder long after the average age of these illnesses has come and gone.

The risks for older folks with eating disorders are not only just as serious, but as the article correctly sates, a concern "is that as women get older they are more adept at concealing the problem, and symptoms may be attributed to aging rather than to an eating disorder", and therefore be undetected.

For more about eating disorders in mature adults, you can find information and references in my book, "100 Questions and Answers about Anorexia Nervosa", and if you have a question, feel free to e-mail me at mail@drshepp.com or leave a comment here on Treatment Notes.

New Family Internet-based Early Bulimia Nervosa Study

2011-03-03T14:15:00-08:00

I wanted to pass along information about a new research study...check it out, and if you are interested and eligible, please consider participating!

Family Internet-based Early Bulimia Nervosa Study

"The University of Chicago is conducting a research study designed to examine the efficacy of an Internet-based program for parents with adolescent children who show early signs of bulimia nervosa. We are seeking families who have an adolescent (ages 12-17) who engages in binge eating (large amounts of food in a short period of time) and/or compensatory purging (e.g., vomiting). Participating families will use an Internet-based program to address their adolescent’s eating disorder symptoms."

To be eligible:
* Families with an adolescent child (ages 12-17)
* Adolescent demonstrates eating disorder symptoms

For information call:
Colleen Stiles-Shields at 773-834-5677 and mention your interest in the Family Internet-based Early Bulimia Nervosa Study

or e-mail Jocelyn Lebow:
epathprogram@gmail.com

or, to learn more, or to register online, visit:
http://epathprogram.org

Investigators for this study are:
Angela Celio Doyle, PhD
Daniel le Grange, PhD
Jocelyn Lebow

Eating Disorders Awareness Week Continues

2011-02-24T13:37:42-08:00

“It’s Time to Talk about It” is the theme of this year's National Eating Disorders Awareness Week (NEDAW), February 20-26, 2011.

Join the nation’s largest eating disorders outreach effort by committing to do just one thing to start the conversation in your community. NEDAW provides tons of free and discounted resources, fun activity ideas and much more! Click here to learn more about how you can make a difference.

Visit http://www.nationaleatingdisorders.org at anytime of the year for a wealth of free information about eating disorders and recovery!

Or, call the NEDA Information & Referral Helpline: 800 931-2237

De-moralizing Weight Gain

2011-02-17T15:53:32-08:00

I was reading a popular magazine this week, which contains an interview with a notable celebrity talking about the weight gain she experienced over the course of time, and which apparently left her 60 pounds heavier than she used to be. What struck me about her comments and her experience is that she called her weight gain "humiliating".

Humiliating. It seemed like a word steeped in shame and guilt. And to me, it sounds so undeservedly moralistic. It reminded me of all of the men and women that I have spoken with in my office over the years who feel like such "bad people" for having gained weight. In fact, I have heard countless folks describe their weight gain with moralistic words, not just with a sense of personal failure or self-regret, but of moral failure and humiliation.

Some definitions of humiliating:

Humiliation - the abasement of pride, which creates mortification or leads to a state of being humbled or reduced to lowliness or submission
broken: subdued or brought low in condition or status; "brought low"; "a broken man"; "his broken spirit"
state of disgrace
depriving one of self-esteem

Certainly there are bad decisions we make in life that justifiably cause humiliation as defined here...but gaining weight should not be one of them.

When are we, as a society and culture, going to stop moralizing weight gain? When are we going to stop seeing overweight others, and ourselves, as morally weak, or lacking strength of character, or "bad", or deserving of humiliation?

The celebrity's comments got me thinking...

What do you think?

Body Fat Basics

2011-02-10T16:49:00-08:00

How much body fat is the right amount of body fat?

Does everyone have the same amount of body fat?

What determines how much fat a person stores on their body?

These are some "body fat basics" that might be helpful in understanding why it is that we find such a variety of body types when we think of our friends and family.

First, it is important to know that body fat percentage varies from person to person and there is no ONE right percentage of body fat, although there is a healthy RANGE of body fat percentage.

The average body fat for women under the age of 30 is 20-25%, while for men, the average is 13-16%. Even for athletes, the range is fairly similar: 13-26% for elite female athletes and 8-15% for male athletes.

Did you know there are three different body types, and that your body type has a lot to do with how you store fat? It's true - may not be what we hear a lot of these days...we hear instead that there is one type in particular that we should all strive to be...but that is just not so.

The three genetic body types are:

Ectomporphs. These folks are generally lean and muscular and have a lower body fat percentage on average.
Mesomorphs. Naturally muscular folks that can increase there muscle mass fairly quickly.
Endomorphs. These folks tend to be more "stocky", with a wider set chest and hips and tend to gain and store fat a bit more easily.

Knowing one's own body type can be useful in understanding what the "right" range of body fat is for that individual. One size does, in fact, not fit all.

It's Award Season...Will Curves Be Under Fire Again?

2011-01-31T13:18:25-08:00

It's that time of year again...awards season. You know, the fashion, the dresses, the red carpet, the designers, and of course...the body watchers.

You may remember last year's fall-out after one fashion critic called actress Christina Hendricks a "big girl", with her hour glass figure and 1950"s pin-up looks.

Or, you may recall the Blog piece on another site that criticized the always slender actresses Courteney Cox, Jennifer Aniston, and Kate Hudson for seemingly having "put on a little weight" (http://tmagazine.blogs.nytimes.com/2010/01/18/now-scrutinizing-a-rounder-golden-globes/).

So, what will it be this year? Natalie's baby bump? Amy's "post baby weight?" Catherine's "full-figure?"

What has changed in Hollywood in the last decade is the acceptance of comments by the "body watchers" who offer critiques that influence audience opinions, not about performances, costumes, direction, or cinematography...but about weight and body shape. Unfortunately, such a trend continues the scrutiny of women (and increasingly, of men too), and increases the preoccupation in our culture with dieting, weight loss and the pursuit of the "thin ideal".

I have friends and family in the entertainment business, so I usually watch the awards shows, and this year, I'll be watching again. But I can tell you now that when I applaud accomplishments of the artists involved, it will be for their work, not their weight-loss or waistlines.

New Study Hilghlights Dangerous Diets and Eating Disorders in the Military

2010-12-07T14:10:59-08:00

In a new study reported in Army Times, soldiers are engaging in unhealthy diet behaviors and eating disordered symptoms, reportedly "dangerously starving themselves, gobbling diet pills and laxatives — even going under the knife in costly liposuction surgery — all to meet the Army’s weight standards and avoid losing their careers".

According to the study, nearly one in three Marines have gone to such measures to lose weight. And although the Army doesn’t keep data on the likely numbers of soldiers taking these risks, dozens of soldiers reportedly responded to a question from Army Times, sharing that they self-impose starvation, dehydration, diet pills and laxatives in order to make weight.

Male eating disorders are nothing new, with various vocations and sports such as modeling and wrestling, along with various populations such as NCAA male athletes falling victim to rigid weight standards and peer-influence that correlate with an increased risk for eating disorders.

Similar to NCAA and other athletic "weigh-ins", soldiers have weight limits that are publicly known and measured, with the Army Times reporting that many are "afraid of those limits, knowing that if they cross that line they won’t be promotable. Further, they cannot be assigned to leadership positions and they are not authorized to attend professional military schools. Their career is over if they don’t make satisfactory weight loss in two months..."

Reportedly, about 24,000 soldiers were discharged between 1992 and 2007 for failure to comply with weight standards outlined in Army Regulation 600-9, according to the 2009 Military Services Fitness Database report, which was published in the journal Military Medicine. "To save their careers, some soldiers turn to excessive, unnatural and unhealthy measures."

The study goes on to say that authorities do not "have a clear understanding how widespread this problem is” and “soldiers are hiding the fact they are doing this because they don’t want the problem exposed.” Yet the weight-loss culture and pressure is reportedly well known among fellow soldiers.

According to one soldier quoted in the Army Times, “I have been on a roller coaster of gains and losses for half my military career,” said the lieutenant colonel. “I have considered lipo, and I have certainly starved myself, dieted on only bread and water, or other similar extreme diets to make weight or tape. ... And it is no secret to any leader in the military what some soldiers will do to conform to standards that have been set.”

Female soldiers also report laxative use and self-starvation in the military, but as is typical, male eating disorders are less likely to be detected and/or even suspected.

Thankfully, there have been recent moves to improve military Physical Readiness Training with the goal of strengthening the overall health and well-being of soldiers, for example, training soldiers to eat and drink healthier items that not only prepare one for strenuous physical activity, but also fuel soldiers throughout their endeavors and aid in recovery afterward.